03-6013761: maquininha de halloween
 Standard Charges                      ,,,,,,,,,,,,,,,,,,,,,,,,,,
,,,,,,,,,,,"N/A denotes rate was not supplied, not covered through fee schedule by payer, or is not billed to payer/charged to patient.",,,,,,,,,,,,,,,
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Last Updated: 11/03/2023,,,,,,,,,,,,,,,,,,,,,,,,,,
Prices Effective: 10/01/2023 (updated annually),,,,,,,,,,,,,,,,,,,,,,,,,,
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CDM Item Number,Revenue Code,Service ID,Service Mod1,Service Mod2,Service Mod3,Service Mod4,DRG Qualifier,DRG Code,Service Description,Gross Charge,Discounted Cash Price,Minimum Negotiated Charge,Maximum Negotiated Charge,AARP-MedicareComplete UnitedHealthCare Rate (Plan: Medicare Advantage),AETNA Rate,AETNA Medicare Advantage Rate (Plan: Medicare Advantage),Blue Cross Blue Shield of VT Rates,Vermont Blue Advantage Rate (Plan: Medicare Advantage),CIGNA Rate,CIGNA HealthSpring Rate (Plan: Medicare Advantage),Harvard Pilgrim HealthCare Rate,Harvard Pilgrim Stride Rate (Plan: Medicare Advantage),MVP HealthCare Rate,MVP HealthCare (Plan: Medicare Advantage),UHC MedicareComplete Rate (Plan: Medicare Advantage),United Healthcare Rate
1105004,0110,,,,,,N/A,N/A,$350.00,"$1,143.13",$849.75,$963.05,"$3,960.43","$3,960.43","$1,108.84","$3,960.43","$1,000.24","$3,960.43",$971.66,"$3,960.43","$1,063.11","$3,960.43","$1,085.97","$3,960.43","$3,960.43","$1,063.11"
1205005,0120,,,,,,N/A,N/A,RM & BD SWB SEMI-PRIVATE,$991.79,$737.25,$835.55,"$3,960.43","$3,960.43",$962.03,"$3,960.43",$867.81,"$3,960.43",$843.02,"$3,960.43",$922.36,"$3,960.43",$942.20,"$3,960.43","$3,960.43",$922.36
1205003,0121,,,,,,N/A,N/A,RM & BD SEMI-PRIVATE,"$3,358.76","$2,496.75","$2,829.65","$3,960.43","$3,960.43","$3,258.00","$3,960.43","$2,938.92","$3,960.43","$2,854.95","$3,960.43","$3,123.65","$3,960.43","$3,190.82","$3,960.43","$3,960.43","$3,123.65"
1205006,0121,,,,,,N/A,N/A,RM & BD SEMI-PRIVATE,"$2,891.62","$2,149.50","$2,436.10","$3,960.43","$3,960.43","$2,804.87","$3,960.43","$2,530.17","$3,960.43","$2,457.88","$3,960.43","$2,689.21","$3,960.43","$2,747.04","$3,960.43","$3,960.43","$2,689.21"
1200001,0122,,,,,,N/A,N/A,RM & BD OBS,"$3,655.39","$2,717.25","$3,079.55","$3,960.43","$3,960.43","$3,545.73","$3,960.43","$3,198.47","$3,960.43","$3,107.08","$3,960.43","$3,399.51","$3,960.43","$3,472.62","$3,960.43","$3,960.43","$3,399.51"
171000,0171,,,,,,N/A,N/A,Newborn - Level I,"$2,142.99","$1,593.00","$1,805.40","$3,960.43","$3,960.43","$2,078.70","$3,960.43","$1,875.11","$3,960.43","$1,821.54","$3,960.43","$1,992.98","$3,960.43","$2,035.84","$3,960.43","$3,960.43","$1,992.98"
171000,0171,,,,,,N/A,N/A,NEWBORN - LEVEL I,"$2,142.99","$1,593.00","$1,805.40","$3,960.43","$3,960.43","$2,078.70","$3,960.43","$1,875.11","$3,960.43","$1,821.54","$3,960.43","$1,992.98","$3,960.43","$2,035.84","$3,960.43","$3,960.43","$1,992.98"
1700008,0171,,,,,,N/A,N/A,INT CAR TRANSP ISOLE,$690.11,$513.00,$581.40,$663.48,N/A,$669.41,N/A,$603.85,N/A,$586.60,N/A,$641.81,N/A,$655.61,N/A,N/A,$641.81
172000,0172,,,,,,N/A,N/A,Newborn - Level Ii,"$2,788.71","$2,073.00","$2,349.40","$3,960.43","$3,960.43","$2,705.05","$3,960.43","$2,440.12","$3,960.43","$2,370.40","$3,960.43","$2,593.50","$3,960.43","$2,649.27","$3,960.43","$3,960.43","$2,593.50"
172000,0172,,,,,,N/A,N/A,NEWBORN - LEVEL II,"$2,788.71","$2,073.00","$2,349.40","$3,960.43","$3,960.43","$2,705.05","$3,960.43","$2,440.12","$3,960.43","$2,370.40","$3,960.43","$2,593.50","$3,960.43","$2,649.27","$3,960.43","$3,960.43","$2,593.50"
173000,0173,,,,,,N/A,N/A,Newborn - Level Iii,"$4,418.15","$3,284.25","$3,722.15","$4,247.63","$3,960.43","$4,285.60","$3,960.43","$3,865.88","$3,960.43","$3,755.43","$3,960.43","$4,108.88","$3,960.43","$4,197.24","$3,960.43","$3,960.43","$4,108.88"
173000,0173,,,,,,N/A,N/A,NEWBORN - LEVEL III,"$4,418.15","$3,284.25","$3,722.15","$4,247.63","$3,960.43","$4,285.60","$3,960.43","$3,865.88","$3,960.43","$3,755.43","$3,960.43","$4,108.88","$3,960.43","$4,197.24","$3,960.43","$3,960.43","$4,108.88"
174000,0174,,,,,,N/A,N/A,Newborn - Level Iv,"$5,857.91","$4,354.50","$3,960.43","$5,631.82","$3,960.43","$5,682.17","$3,960.43","$5,125.67","$3,960.43","$4,979.22","$3,960.43","$5,447.85","$3,960.43","$5,565.01","$3,960.43","$3,960.43","$5,447.85"
174000,0174,,,,,,N/A,N/A,NEWBORN - LEVEL IV,"$5,857.91","$4,354.50","$3,960.43","$5,631.82","$3,960.43","$5,682.17","$3,960.43","$5,125.67","$3,960.43","$4,979.22","$3,960.43","$5,447.85","$3,960.43","$5,565.01","$3,960.43","$3,960.43","$5,447.85"
2000001,0200,,,,,,N/A,N/A,RM & BD ICU,"$6,655.98","$4,947.75","$3,960.43","$6,399.09","$3,960.43","$6,456.30","$3,960.43","$5,823.98","$3,960.43","$5,657.58","$3,960.43","$6,190.06","$3,960.43","$6,323.18","$3,960.43","$3,960.43","$6,190.06"
2000002,0200,,,,,,N/A,N/A,RM & BD ICU,"$5,730.78","$4,260.00","$3,960.43","$5,509.60","$3,960.43","$5,558.86","$3,960.43","$5,014.43","$3,960.43","$4,871.16","$3,960.43","$5,329.62","$3,960.43","$5,444.24","$3,960.43","$3,960.43","$5,329.62"
90619S,0250,90619,,,,,N/A,N/A,MENINGOCOCCAL VACCINE,$0.01,$0.01,$0.01,$0.01,N/A,$0.01,N/A,N/A,N/A,N/A,N/A,$0.01,N/A,$0.01,N/A,N/A,$0.01
90620S,0250,90620,,,,,N/A,N/A,MENINGOCOCCAL B,$0.01,$0.01,$0.01,$0.01,N/A,$0.01,N/A,N/A,N/A,N/A,N/A,$0.01,N/A,$0.01,N/A,N/A,$0.01
90632S,0250,90632,,,,,N/A,N/A,HEPATITIS A INJ ADULT DOSAGE,$0.01,$0.01,$130.95,$135.00,N/A,$130.95,N/A,N/A,N/A,N/A,N/A,$130.95,N/A,$135.00,N/A,N/A,$130.95
90633S,0250,90633,,,,,N/A,N/A,HEP A,$0.01,$0.01,$0.01,$0.01,N/A,$0.01,N/A,N/A,N/A,N/A,N/A,$0.01,N/A,$0.01,N/A,N/A,$0.01
90636S,0250,90636,,,,,N/A,N/A,TWINRIX (HEP A & B),$0.01,$0.01,$129.01,$133.00,N/A,$129.01,N/A,N/A,N/A,N/A,N/A,$129.01,N/A,$133.00,N/A,N/A,$129.01
90648S,0250,90648,,,,,N/A,N/A,HIB VACCINE,$0.01,$0.01,$0.00,$0.01,N/A,$0.00,N/A,N/A,N/A,N/A,N/A,$0.00,N/A,$0.01,N/A,N/A,$0.00
90649S,0250,90649,,,,,N/A,N/A,HPV PROCEDURE,$0.01,$0.01,$0.01,$0.01,N/A,$0.01,N/A,N/A,N/A,N/A,N/A,$0.01,N/A,$0.01,N/A,N/A,$0.01
90651,0250,90651,,,,,N/A,N/A,HPV9,$398.53,$296.25,$796.37,$821.00,N/A,$796.37,N/A,N/A,N/A,N/A,N/A,$796.37,N/A,$821.00,N/A,N/A,$796.37
90651S,0250,90651,,,,,N/A,N/A,HPV9,$0.01,$0.01,$796.37,$821.00,N/A,$796.37,N/A,N/A,N/A,N/A,N/A,$796.37,N/A,$821.00,N/A,N/A,$796.37
90653,0250,90653,,,,,N/A,N/A,FLU VACCINE 0.5ML,$71.63,$53.25,$68.87,$71.00,N/A,$68.87,N/A,N/A,N/A,N/A,N/A,$68.87,N/A,$71.00,N/A,N/A,$68.87
90662,0250,90662,,,,,N/A,N/A,FLU VACCINE PRESER FREE 65YR,$68.61,$51.00,$65.96,$68.00,N/A,$65.96,N/A,N/A,N/A,N/A,N/A,$65.96,N/A,$68.00,N/A,N/A,$65.96
9066240,0250,90662,,,,,N/A,N/A,FLU VACCINE PRESER FREE 65YR,$68.61,$51.00,$65.96,$68.00,N/A,$65.96,N/A,N/A,N/A,N/A,N/A,$65.96,N/A,$68.00,N/A,N/A,$65.96
90662R,0250,90662,,,,,N/A,N/A,FLU VACCINE PRESERV FREE 65Y,$0.01,$0.01,$65.96,$68.00,N/A,$65.96,N/A,N/A,N/A,N/A,N/A,$65.96,N/A,$68.00,N/A,N/A,$65.96
90670S,0250,90670,,,,,N/A,N/A,PREVNAR 13,$0.01,$0.01,$242.50,$250.00,N/A,$242.50,N/A,N/A,N/A,N/A,N/A,$242.50,N/A,$250.00,N/A,N/A,$242.50
90673,0250,90673,,,,,N/A,N/A,FLU VACCINE,$71.63,$53.25,$68.87,$71.00,N/A,$68.87,N/A,N/A,N/A,N/A,N/A,$68.87,N/A,$71.00,N/A,N/A,$68.87
90674,0250,90674,,,,,N/A,N/A,FLU VACCINE,$71.63,$53.25,$68.87,$71.00,N/A,$68.87,N/A,N/A,N/A,N/A,N/A,$68.87,N/A,$71.00,N/A,N/A,$68.87
90680S,0250,90680,,,,,N/A,N/A,ROTAVIRUS,$0.01,$0.01,$0.01,$0.01,N/A,$0.01,N/A,N/A,N/A,N/A,N/A,$0.01,N/A,$0.01,N/A,N/A,$0.01
90681S,0250,90681,,,,,N/A,N/A,ROTARIX,$0.01,$0.01,$0.01,$0.01,N/A,$0.01,N/A,N/A,N/A,N/A,N/A,$0.01,N/A,$0.01,N/A,N/A,$0.01
90682,0250,90682,,,,,N/A,N/A,FLU VACCINE,$71.63,$53.25,$71.78,$74.00,N/A,$71.78,N/A,N/A,N/A,N/A,N/A,$71.78,N/A,$74.00,N/A,N/A,$71.78
90685,0250,90685,,,,,N/A,N/A,FLU VACCINE PRESER FREE,$46.41,$34.50,$44.62,$46.00,N/A,$44.62,N/A,N/A,N/A,N/A,N/A,$44.62,N/A,$46.00,N/A,N/A,$44.62
90685S,0250,90685,,,,,N/A,N/A,FLU VACCINE PRESER FREE,$0.01,$0.01,$44.62,$46.00,N/A,$44.62,N/A,N/A,N/A,N/A,N/A,$44.62,N/A,$46.00,N/A,N/A,$44.62
90686,0250,90686,,,,,N/A,N/A,FLU VACCINE 0.5ML,$34.30,$25.50,$33.95,$35.00,N/A,$33.95,N/A,N/A,N/A,N/A,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
5196091,0250,90686,,,,,N/A,N/A,FLU VACCINE 0.5ML,$34.30,$25.50,$33.95,$35.00,N/A,$33.95,N/A,N/A,N/A,N/A,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
90686R,0250,90686,,,,,N/A,N/A,FLU VACCINE 0.5ML,$0.01,$0.01,$33.95,$35.00,N/A,$33.95,N/A,N/A,N/A,N/A,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
90686S,0250,90686,,,,,N/A,N/A,FLU VACCINE-PRESERVATIVE FRE,$0.01,$0.01,$33.95,$35.00,N/A,$33.95,N/A,N/A,N/A,N/A,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
90688,0250,90688,,,,,N/A,N/A,FLU VACCINE,$34.30,$25.50,$41.71,$43.00,N/A,$41.71,N/A,N/A,N/A,N/A,N/A,$41.71,N/A,$43.00,N/A,N/A,$41.71
90688R,0250,90688,,,,,N/A,N/A,FLU VACCINE,$0.01,$0.01,$41.71,$43.00,N/A,$41.71,N/A,N/A,N/A,N/A,N/A,$41.71,N/A,$43.00,N/A,N/A,$41.71
90688S,0250,90688,,,,,N/A,N/A,FLU VACCINE-QUADRIVALENT,$0.01,$0.01,$41.71,$43.00,N/A,$41.71,N/A,N/A,N/A,N/A,N/A,$41.71,N/A,$43.00,N/A,N/A,$41.71
90694,0250,90694,,,,,N/A,N/A,FLU VACINE,$34.30,$25.50,$32.98,$34.00,N/A,$32.98,N/A,N/A,N/A,N/A,N/A,$32.98,N/A,$34.00,N/A,N/A,$32.98
90696S,0250,90696,,,,,N/A,N/A,KINRIX,$0.01,$0.01,$0.01,$0.01,N/A,$0.01,N/A,N/A,N/A,N/A,N/A,$0.01,N/A,$0.01,N/A,N/A,$0.01
90700S,0250,90700,,,,,N/A,N/A,DTaP,$0.01,$0.01,$0.01,$0.01,N/A,$0.01,N/A,N/A,N/A,N/A,N/A,$0.01,N/A,$0.01,N/A,N/A,$0.01
90710S,0250,90710,,,,,N/A,N/A,MMRV,$0.01,$0.01,$0.01,$0.01,N/A,$0.01,N/A,N/A,N/A,N/A,N/A,$0.01,N/A,$0.01,N/A,N/A,$0.01
90713S,0250,90713,,,,,N/A,N/A,POLIO VACINE,$0.01,$0.01,$101.85,$105.00,N/A,$101.85,N/A,N/A,N/A,N/A,N/A,$101.85,N/A,$105.00,N/A,N/A,$101.85
90714S,0250,90714,,,,,N/A,N/A,D T VACCINE IMMUNIZATION,$0.01,$0.01,$42.68,$44.00,N/A,$42.68,N/A,N/A,N/A,N/A,N/A,$42.68,N/A,$44.00,N/A,N/A,$42.68
90715S,0250,90715,,,,,N/A,N/A,TDaP,$0.01,$0.01,$41.71,$43.00,N/A,$41.71,N/A,N/A,N/A,N/A,N/A,$41.71,N/A,$43.00,N/A,N/A,$41.71
90716S,0250,90716,,,,,N/A,N/A,VARICELLA VACCINE,$0.01,$0.01,$173.63,$179.00,N/A,$173.63,N/A,N/A,N/A,$179.00,N/A,$173.63,N/A,$179.00,N/A,N/A,$173.63
90723S,0250,90723,,,,,N/A,N/A,PEDIARIX,$0.01,$0.01,$0.01,$0.01,N/A,$0.01,N/A,N/A,N/A,$0.01,N/A,$0.01,N/A,$0.01,N/A,N/A,$0.01
90734S,0250,90734,,,,,N/A,N/A,MENACTRA,$0.01,$0.01,$308.46,$318.00,N/A,$308.46,N/A,N/A,N/A,$318.00,N/A,$308.46,N/A,$318.00,N/A,N/A,$308.46
90736S,0250,90736,,,,,N/A,N/A,ZOSTER (SHINGLES) VACCINE S,$0.01,$0.01,$0.01,$0.01,N/A,$0.01,N/A,N/A,N/A,$0.01,N/A,$0.01,N/A,$0.01,N/A,N/A,$0.01
90744S,0250,90744,,,,,N/A,N/A,HEP B VACCINE < 11,$0.01,$0.01,$222.67,$229.56,N/A,$222.67,N/A,N/A,N/A,$229.56,N/A,$222.67,N/A,$229.56,N/A,N/A,$222.67
5190746,0250,90746,,,,,N/A,N/A,Hepatitis B vaccine - adult,$84.75,$63.00,$81.48,$84.00,N/A,$81.48,N/A,N/A,N/A,$84.00,N/A,$81.48,N/A,$84.00,N/A,N/A,$81.48
5190747,0250,90746,,,,,N/A,N/A,HEP A VACCINE,$84.75,$63.00,$81.48,$84.00,N/A,$81.48,N/A,N/A,N/A,$84.00,N/A,$81.48,N/A,$84.00,N/A,N/A,$81.48
90746S,0250,90746,,,,,N/A,N/A,HEP B VACCINE>20,$0.01,$0.01,$81.48,$84.00,N/A,$81.48,N/A,N/A,N/A,$84.00,N/A,$81.48,N/A,$84.00,N/A,N/A,$81.48
90750S,0250,90750,,,,,N/A,N/A,ZOSTER (SHINGLES) VACC RECOMB,$0.01,$0.01,$305.55,$315.00,N/A,$305.55,N/A,N/A,N/A,$315.00,N/A,$305.55,N/A,$315.00,N/A,N/A,$305.55
90756,0250,90756,,,,,N/A,N/A,FLU VACCINE,$34.30,$25.50,$33.95,$35.00,N/A,$33.95,N/A,N/A,N/A,$35.00,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
90756R,0250,90756,,,,,N/A,N/A,FLU VACCINE,$0.01,$0.01,$33.95,$35.00,N/A,$33.95,N/A,N/A,N/A,$35.00,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
90756S,0250,90756,,,,,N/A,N/A,FLU VACCINE,$0.01,$0.01,$33.95,$35.00,N/A,$33.95,N/A,N/A,N/A,$35.00,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
91307S,0250,91307,,,,,N/A,N/A,CORONAVIRUS VACCINE,$0.01,$0.01,$0.01,$0.01,N/A,$0.01,N/A,N/A,N/A,N/A,N/A,$0.01,N/A,$0.01,N/A,N/A,$0.01
90653R,0250,90653R,,,,,N/A,N/A,FLU VACCINE 0.5ML,$0.01,$0.01,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
90653S,0250,90653S,,,,,N/A,N/A,FLU VACCINE 0.5ML,$0.01,$0.01,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
90673R,0250,90673R,,,,,N/A,N/A,FLU VACCINE,$0.01,$0.01,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
90673S,0250,90673S,,,,,N/A,N/A,FLU VACCINE,$0.01,$0.01,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
90674R,0250,90674R,,,,,N/A,N/A,FLU VACCINE,$0.01,$0.01,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
90674S,0250,90674S,,,,,N/A,N/A,FLU VACCINE,$0.01,$0.01,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
90682R,0250,90682R,,,,,N/A,N/A,FLU VACCINE,$0.01,$0.01,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
90682S,0250,90682S,,,,,N/A,N/A,FLU VACCINE,$0.01,$0.01,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
90694R,0250,90694R,,,,,N/A,N/A,FLU VACCINE,$0.01,$0.01,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
90694S,0250,90694S,,,,,N/A,N/A,FLU VACCINE,$0.01,$0.01,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
Q2036,0250,Q2036,,,,,N/A,N/A,FLU VACCINE FLULAVAL 3YRS &,$34.30,$25.50,$32.98,$34.00,N/A,$32.98,N/A,N/A,N/A,$34.00,N/A,$32.98,N/A,$34.00,N/A,N/A,$32.98
S0119LSC,0250,S0119,,,,,N/A,N/A,ODANSETRON TABLET 4 MG,$8.07,$6.00,$7.76,$8.00,N/A,$7.76,N/A,N/A,N/A,$8.00,N/A,$7.76,N/A,$8.00,N/A,N/A,$7.76
3700013,0250,,,,,,N/A,N/A,DESFLURANE PER 15 MIN SEGMENTS,$153.36,$114.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3700014,0250,,,,,,N/A,N/A,SEVOFLURANE PER 15 MIN SEGMENT,$104.93,$78.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3700015,0250,,,,,,N/A,N/A,ISOFLURANE PER 15 MIN SEGMENTS,$17.15,$12.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
5190005,0250,,,,,,N/A,N/A,DIPHENYHDRAMINE,$6.05,$4.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
5190010,0250,,,,,,N/A,N/A,AMITRIPYLINE 25MG PO #25,$3.03,$2.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
5190011,0250,,,,,,N/A,N/A,CYCLOBENZAPRINE 10 MG #14,$9.08,$6.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
5190012,0250,,,,,,N/A,N/A,CYCLOBENZAPRINE 10 MG #28,$18.16,$13.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
5190014,0250,,,,,,N/A,N/A,ULTRAM,$9.08,$6.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
5190015,0250,,,,,,N/A,N/A,NAPROXEN #14,$13.12,$9.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
5190016,0250,,,,,,N/A,N/A,RELAFEN 750 MG # 14,$70.63,$52.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
5190017,0250,,,,,,N/A,N/A,RELAFEN 750 MG #28,$101.90,$75.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
5190020,0250,,,,,,N/A,N/A,LIDONCAINE 1%,$29.26,$21.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
5190021,0250,,,,,,N/A,N/A,IBURPROFEN 800MG #21,$12.11,$9.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
5190022,0250,,,,,,N/A,N/A,IBURPROFEN 800 MG #42,$18.16,$13.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
5190031,0250,,,,,,N/A,N/A,"BRACE, ANKLE L",$69.62,$51.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
5190034,0250,,,,,,N/A,N/A,MELOXICAM 7.5MG #14,$5.04,$3.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
5190035,0250,,,,,,N/A,N/A,DICLOFENAC 1.3% PATCH,$19.17,$14.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
5190036,0250,,,,,,N/A,N/A,LIDOCAINE 5% PATCH,$7.57,$5.63,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
5190037,0250,,,,,,N/A,N/A,CYCLOBENZAPRINE 5MG,$9.08,$6.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
5199454,0250,,,,,,N/A,N/A,CELEBREX #14,$91.81,$68.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
25231190,0250,,,,,,N/A,N/A,BISOPROLOL 5 MG TAB,$11.50,$8.55,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
5190014A,0250,,,,,,N/A,N/A,ULTRAM,$18.16,$13.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
5190015A,0250,,,,,,N/A,N/A,NAPROXEN #28,$26.23,$19.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
5190034A,0250,,,,,,N/A,N/A,MELOXICAM  7.5 MG  #28,$10.09,$7.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
5199454A,0250,,,,,,N/A,N/A,CELEBREX #28,$183.63,$136.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
72B9579,0255,A9579,,,,,N/A,N/A,20 ML GADILINIUM FOR MRI,$242.15,$180.00,"$4,656.00","$4,800.00",N/A,"$4,656.00",N/A,N/A,N/A,"$4,800.00",N/A,"$4,656.00",N/A,"$4,800.00",N/A,N/A,"$4,656.00"
4503301,0260,90760,,,,,N/A,N/A,Hydration Iv Up To One Hour,$336.99,$250.50,$367.63,$379.00,N/A,$367.63,N/A,N/A,N/A,$379.00,N/A,$367.63,N/A,$379.00,N/A,N/A,$367.63
7600303,0260,90760,,,,,N/A,N/A,Hydration Iv Up To One Hour,$382.39,$284.25,$367.63,$379.00,N/A,$367.63,N/A,N/A,N/A,$379.00,N/A,$367.63,N/A,$379.00,N/A,N/A,$367.63
7600305,0260,90760,,,,,N/A,N/A,Hydration Iv Up To One Hour,$370.28,$275.25,$367.63,$379.00,N/A,$367.63,N/A,N/A,N/A,$379.00,N/A,$367.63,N/A,$379.00,N/A,N/A,$367.63
7600307,0260,90760,,,,,N/A,N/A,Hydration Iv Up To One Hour,$373.31,$277.50,$367.63,$379.00,N/A,$367.63,N/A,N/A,N/A,$379.00,N/A,$367.63,N/A,$379.00,N/A,N/A,$367.63
7600309,0260,90760,,,,,N/A,N/A,Hydration Iv Up To One Hour,$335.98,$249.75,$367.63,$379.00,N/A,$367.63,N/A,N/A,N/A,$379.00,N/A,$367.63,N/A,$379.00,N/A,N/A,$367.63
4503302,0260,90761,,,,,N/A,N/A,Hydration Iv Ea Subsequent Hr,$208.85,$155.25,$99.91,$103.00,N/A,$99.91,N/A,N/A,N/A,$103.00,N/A,$99.91,N/A,$103.00,N/A,N/A,$99.91
7600304,0260,90761,,,,,N/A,N/A,Hydration Iv Ea Subsequent Hr,$103.92,$77.25,$99.91,$103.00,N/A,$99.91,N/A,N/A,N/A,$103.00,N/A,$99.91,N/A,$103.00,N/A,N/A,$99.91
7600306,0260,90761,,,,,N/A,N/A,Hydration Iv Ea Subsequent Hr,$98.88,$73.50,$99.91,$103.00,N/A,$99.91,N/A,N/A,N/A,$103.00,N/A,$99.91,N/A,$103.00,N/A,N/A,$99.91
7600308,0260,90761,,,,,N/A,N/A,Hydration Iv Ea Subsequent Hr,$101.90,$75.75,$99.91,$103.00,N/A,$99.91,N/A,N/A,N/A,$103.00,N/A,$99.91,N/A,$103.00,N/A,N/A,$99.91
7600310,0260,90761,,,,,N/A,N/A,Hydration Iv Ea Subsequent Hr,$90.80,$67.50,$99.91,$103.00,N/A,$99.91,N/A,N/A,N/A,$103.00,N/A,$99.91,N/A,$103.00,N/A,N/A,$99.91
5190776,0260,90776,,,,,N/A,N/A,Additional Iv Push -Same Drug,$95.85,$71.25,$100.88,$104.00,N/A,$100.88,N/A,N/A,N/A,$104.00,N/A,$100.88,N/A,$104.00,N/A,N/A,$100.88
7290776,0260,90776,,,,,N/A,N/A,Additional Iv Push -Same Drug,$94.84,$70.50,$100.88,$104.00,N/A,$100.88,N/A,N/A,N/A,$104.00,N/A,$100.88,N/A,$104.00,N/A,N/A,$100.88
7390776,0260,90776,,,,,N/A,N/A,Additional Iv Push -Same Drug,$101.90,$75.75,$100.88,$104.00,N/A,$100.88,N/A,N/A,N/A,$104.00,N/A,$100.88,N/A,$104.00,N/A,N/A,$100.88
9490776,0260,90776,,,,,N/A,N/A,Additional Iv Push -Same Drug,$104.93,$78.00,$100.88,$104.00,N/A,$100.88,N/A,N/A,N/A,$104.00,N/A,$100.88,N/A,$104.00,N/A,N/A,$100.88
5196360,0260,96360,,,,,N/A,N/A,HYDRATION IV UP TO ONE HOUR,$336.99,$250.50,$30.80,$334.00,$145.14,$323.98,$145.14,N/A,$145.14,$30.80,$145.14,$323.98,$145.14,$334.00,$145.14,$145.14,$323.98
7600314,0260,96360,,,,,N/A,N/A,HYDRATION IV UP TO ONE HOUR,$357.16,$265.50,$30.80,$334.00,$145.14,$323.98,$145.14,N/A,$145.14,$30.80,$145.14,$323.98,$145.14,$334.00,$145.14,$145.14,$323.98
27600314,0260,96360,,,,,N/A,N/A,HYDRATION IV UP TO ONE HOUR,$357.16,$265.50,$30.80,$334.00,$145.14,$323.98,$145.14,N/A,$145.14,$30.80,$145.14,$323.98,$145.14,$334.00,$145.14,$145.14,$323.98
4503301-59,0260,96360,,,,,N/A,N/A,HYDRATION IV UP TO 1 HOUR  -XU,$336.99,$250.50,$30.80,$334.00,$145.14,$323.98,$145.14,N/A,$145.14,$30.80,$145.14,$323.98,$145.14,$334.00,$145.14,$145.14,$323.98
5196360-59,0260,96360,,,,,N/A,N/A,HYDRATION IV UP TO 1 HOUR  -59,$250.22,$186.00,$30.80,$334.00,$145.14,$323.98,$145.14,N/A,$145.14,$30.80,$145.14,$323.98,$145.14,$334.00,$145.14,$145.14,$323.98
5196361,0260,96361,,,,,N/A,N/A,HYDRATION IV EA SUBSEQUENT HR,$208.85,$155.25,$41.13,$207.00,$84.87,$200.79,$84.87,N/A,$84.87,$41.13,$84.87,$200.79,$84.87,$207.00,$84.87,$84.87,$200.79
7600315,0260,96361,,,,,N/A,N/A,HYDRATION IV EA SUBSEQUENT HR,$96.86,$72.00,$41.13,$207.00,$84.87,$200.79,$84.87,N/A,$84.87,$41.13,$84.87,$200.79,$84.87,$207.00,$84.87,$84.87,$200.79
4503302-59,0260,96361,,,,,N/A,N/A,HYDRATION IV EA SUBSQNT HR,$208.85,$155.25,$41.13,$207.00,$84.87,$200.79,$84.87,N/A,$84.87,$41.13,$84.87,$200.79,$84.87,$207.00,$84.87,$84.87,$200.79
5196361-59,0260,96361,,,,,N/A,N/A,HYDRATION IV EA SUBSEQNT HR-59,$208.85,$155.25,$41.13,$207.00,$84.87,$200.79,$84.87,N/A,$84.87,$41.13,$84.87,$200.79,$84.87,$207.00,$84.87,$84.87,$200.79
3700009,0260,96365,,,,,N/A,N/A,INFUSION THERAPY UP TO ONE HR,"$1,321.71",$982.50,$15.78,"$1,235.00",$56.35,"$1,197.95",$56.35,N/A,$56.35,$15.78,$56.35,"$1,197.95",$56.35,"$1,235.00",$56.35,$56.35,"$1,197.95"
3996365,0260,96365,,,,,N/A,N/A,INFUSION THERAPY UP TO ONE HR,"$1,246.04",$926.25,$15.78,"$1,235.00",$56.35,"$1,197.95",$56.35,N/A,$56.35,$15.78,$56.35,"$1,197.95",$56.35,"$1,235.00",$56.35,$56.35,"$1,197.95"
5196365,0260,96365,,,,,N/A,N/A,INFUSION THERAPY UP TO ONE HR,"$1,173.40",$872.25,$15.78,"$1,235.00",$56.35,"$1,197.95",$56.35,N/A,$56.35,$15.78,$56.35,"$1,197.95",$56.35,"$1,235.00",$56.35,$56.35,"$1,197.95"
7600311,0260,96365,,,,,N/A,N/A,INFUSION THERAPY UP TO ONE HR,"$1,241.00",$922.50,$15.78,"$1,235.00",$56.35,"$1,197.95",$56.35,N/A,$56.35,$15.78,$56.35,"$1,197.95",$56.35,"$1,235.00",$56.35,$56.35,"$1,197.95"
4503300-59,0260,96365,,,,,N/A,N/A,INFUSION THERAPY UP TO 1 HR,"$1,173.40",$872.25,$15.78,"$1,235.00",$56.35,"$1,197.95",$56.35,N/A,$56.35,$15.78,$56.35,"$1,197.95",$56.35,"$1,235.00",$56.35,$56.35,"$1,197.95"
5196365-59,0260,96365,,,,,N/A,N/A,INFUSION THERAPY UP TO 1 HR-59,"$1,173.40",$872.25,$15.78,"$1,235.00",$56.35,"$1,197.95",$56.35,N/A,$56.35,$15.78,$56.35,"$1,197.95",$56.35,"$1,235.00",$56.35,$56.35,"$1,197.95"
3996366,0260,96366,,,,,N/A,N/A,IV INFUSION EA ADDITIONAL HR,$220.96,$164.25,$83.47,$205.00,$89.79,$198.85,$89.79,N/A,$89.79,$83.47,$89.79,$198.85,$89.79,$205.00,$89.79,$89.79,$198.85
5196366,0260,96366,,,,,N/A,N/A,IV INFUSION EA ADDITIONAL HR,$206.83,$153.75,$83.47,$205.00,$89.79,$198.85,$89.79,N/A,$89.79,$83.47,$89.79,$198.85,$89.79,$205.00,$89.79,$89.79,$198.85
7600312,0260,96366,,,,,N/A,N/A,IV INFUSION EA ADDITIONAL HR,$220.96,$164.25,$83.47,$205.00,$89.79,$198.85,$89.79,N/A,$89.79,$83.47,$89.79,$198.85,$89.79,$205.00,$89.79,$89.79,$198.85
4590781-59,0260,96366,,,,,N/A,N/A,IV INFUSION-EACH ADD HOUR  -XU,$206.83,$153.75,$83.47,$205.00,$89.79,$198.85,$89.79,N/A,$89.79,$83.47,$89.79,$198.85,$89.79,$205.00,$89.79,$89.79,$198.85
5196366-59,0260,96366,,,,,N/A,N/A,IV INFUSION-EA ADD HOUR    -59,$206.83,$153.75,$83.47,$205.00,$89.79,$198.85,$89.79,N/A,$89.79,$83.47,$89.79,$198.85,$89.79,$205.00,$89.79,$89.79,$198.85
3996367,0260,96367,,,,,N/A,N/A,SUBSEQUENT IV INFUSION,$144.28,$107.25,$25.35,$143.00,$58.63,$138.71,$58.63,N/A,$58.63,$25.35,$58.63,$138.71,$58.63,$143.00,$58.63,$58.63,$138.71
7690783,0260,96367,,,,,N/A,N/A,SUBSEQUENT IV INFUSION,$144.28,$107.25,$25.35,$143.00,$58.63,$138.71,$58.63,N/A,$58.63,$25.35,$58.63,$138.71,$58.63,$143.00,$58.63,$58.63,$138.71
7690784,0260,96367,,,,,N/A,N/A,SUBSEQUENT IV INFUSION,$141.25,$105.00,$25.35,$143.00,$58.63,$138.71,$58.63,N/A,$58.63,$25.35,$58.63,$138.71,$58.63,$143.00,$58.63,$58.63,$138.71
7690785,0260,96367,,,,,N/A,N/A,SUBSEQUENT IV INFUSION,$138.22,$102.75,$25.35,$143.00,$58.63,$138.71,$58.63,N/A,$58.63,$25.35,$58.63,$138.71,$58.63,$143.00,$58.63,$58.63,$138.71
4596368,0260,96368,,,,,N/A,N/A,IV INFUSION - CONCURRENT,$605.36,$450.00,$36.34,$638.00,$272.24,$618.86,$272.24,N/A,$272.24,$36.34,$272.24,$618.86,$272.24,$638.00,$272.24,$272.24,$618.86
7690780,0260,96368,,,,,N/A,N/A,IV INFUSION - CONCURRENT,$669.94,$498.00,$36.34,$638.00,$272.24,$618.86,$272.24,N/A,$272.24,$36.34,$272.24,$618.86,$272.24,$638.00,$272.24,$272.24,$618.86
7690781,0260,96368,,,,,N/A,N/A,IV INFUSION - CONCURRENT,$643.70,$478.50,$36.34,$638.00,$272.24,$618.86,$272.24,N/A,$272.24,$36.34,$272.24,$618.86,$272.24,$638.00,$272.24,$272.24,$618.86
7690782,0260,96368,,,,,N/A,N/A,IV INFUSION - CONCURRENT,$644.71,$479.25,$36.34,$638.00,$272.24,$618.86,$272.24,N/A,$272.24,$36.34,$272.24,$618.86,$272.24,$638.00,$272.24,$272.24,$618.86
3996376,0260,96376,,,,,N/A,N/A,ADDITIONAL IV PUSH -SAME DRUG,$100.89,$75.00,$19.37,$204.00,N/A,$197.88,N/A,N/A,N/A,$19.37,N/A,$197.88,N/A,$204.00,N/A,N/A,$197.88
5190776-59,0260,96376,,,,,N/A,N/A,ADDITIONAL IV PUSH         -59,$95.85,$71.25,$19.37,$204.00,N/A,$197.88,N/A,N/A,N/A,$19.37,N/A,$197.88,N/A,$204.00,N/A,N/A,$197.88
3996413,0260,96413,,,,,N/A,N/A,CHEMO INF UP TO ONE HOUR - IT,"$1,851.40","$1,376.25",$43.85,"$1,835.00",$752.35,"$1,779.95",$752.35,N/A,$752.35,$43.85,$752.35,"$1,779.95",$752.35,"$1,835.00",$752.35,$752.35,"$1,779.95"
3996415,0260,96415,,,,,N/A,N/A,CHEMO INFUSION -EACH ADD HR,$220.96,$164.25,$89.79,$219.00,$89.79,$212.43,$89.79,N/A,$89.79,$196.20,$89.79,$212.43,$89.79,$219.00,$89.79,$89.79,$212.43
3996416,0260,96416,,,,,N/A,N/A,CHEMO INF > 8 HRS PRT PUMP-IT,"$1,851.40","$1,376.25",$41.52,"$1,835.00",$752.35,"$1,779.95",$752.35,N/A,$752.35,$41.52,$752.35,"$1,779.95",$752.35,"$1,835.00",$752.35,$752.35,"$1,779.95"
4503300,0260,,,,,,N/A,N/A,Infusion Therapy Up To One Hr,"$1,173.40",$872.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4590781,0260,,,,,,N/A,N/A,Iv Infusion Ea Additional Hr,$206.83,$153.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7600201,0260,,,,,,N/A,N/A,Infusion Therapy Up To One Hr,"$1,321.71",$982.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7600202,0260,,,,,,N/A,N/A,Iv Infusion Ea Additional Hr,$235.08,$174.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7600204,0260,,,,,,N/A,N/A,Iv Infusion Ea Additional Hr,$235.08,$174.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7600205,0260,,,,,,N/A,N/A,Infusion Therapy Up To One Hr,"$1,283.37",$954.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7600206,0260,,,,,,N/A,N/A,Iv Infusion Ea Additional Hr,$228.02,$169.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7600301,0260,,,,,,N/A,N/A,Infusion Therapy Up To One Hr,"$1,285.39",$955.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7600302,0260,,,,,,N/A,N/A,Iv Infusion Ea Additional Hr,$230.04,$171.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2696521,0264,96521,,,,,N/A,N/A,REFILL & MAINT OF PORT. PUMP,"$1,406.46","$1,045.50",$194.81,"$1,351.00",$571.54,"$1,310.47",$571.54,N/A,$571.54,$194.81,$571.54,"$1,310.47",$571.54,"$1,351.00",$571.54,$571.54,"$1,310.47"
9696521,0264,96521,,,,,N/A,N/A,REFILL & MAINT OF PORT. PUMP,"$1,363.08","$1,013.25",$194.81,"$1,351.00",$571.54,"$1,310.47",$571.54,N/A,$571.54,$194.81,$571.54,"$1,310.47",$571.54,"$1,351.00",$571.54,$571.54,"$1,310.47"
2704029,0264,Q0081,,,,,N/A,N/A,SET STAT INFUSER D-70,$574.09,$426.75,$551.93,$569.00,N/A,$551.93,N/A,N/A,N/A,$569.00,N/A,$551.93,N/A,$569.00,N/A,N/A,$551.93
2713245AS,0275,27132,,,,,N/A,N/A,TOTAL HIP ARTHROPLASTY     ~AS,"$3,735.10","$2,776.50","$1,517.82","$3,702.00","$1,517.82","$3,590.94","$1,517.82","$3,165.21","$1,517.82","$2,956.85","$1,517.82","$3,590.94","$1,517.82","$3,702.00","$1,517.82","$1,517.82","$3,590.94"
360C1786,0275,C1786,,,,,N/A,N/A,Pacer Pulse Generator   -C1786,$0.00,$0.00,$0.00,$0.00,N/A,$0.00,N/A,N/A,N/A,$0.00,N/A,$0.00,N/A,$0.00,N/A,N/A,$0.00
360C2620,0275,C2620,,,,,N/A,N/A,Pacer Pulse Generator    C2620,$0.00,$0.00,$0.00,$0.00,N/A,$0.00,N/A,N/A,N/A,$0.00,N/A,$0.00,N/A,$0.00,N/A,N/A,$0.00
360C2621,0275,C2621,,,,,N/A,N/A,Pacer Pulse Generator    C2621,$0.00,$0.00,$0.00,$0.00,N/A,$0.00,N/A,N/A,N/A,$0.00,N/A,$0.00,N/A,$0.00,N/A,N/A,$0.00
2703124,0275,L3260,,,,,N/A,N/A,SHOE POST OP YOUTH,$133.18,$99.00,$128.04,$132.00,N/A,$128.04,N/A,N/A,N/A,$132.00,N/A,$128.04,N/A,$132.00,N/A,N/A,$128.04
2784552,0278,99070,,,,,N/A,N/A,RESTORE ORTHOBIOLOGIC IMPLANT,"$32,451.55","$24,123.00",$0.00,$0.00,N/A,$0.00,N/A,N/A,N/A,$0.00,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
2724370,0278,A4346,,,,,N/A,N/A,CATH SILICONE 3-WAY 18-30CC,$330.93,$246.00,$318.16,$328.00,N/A,$318.16,N/A,N/A,N/A,$328.00,N/A,$318.16,N/A,$328.00,N/A,N/A,$318.16
2725397,0278,B4087,,,,,N/A,N/A,TUBE FEEDING MIC JEJUNAL 6IN,"$2,873.46","$2,136.00","$2,762.56","$2,848.00",N/A,"$2,762.56",N/A,N/A,N/A,"$2,848.00",N/A,"$2,762.56",N/A,"$2,848.00",N/A,N/A,"$2,762.56"
2724758,0278,C1713,,,,,N/A,N/A,ANCHOR CORKSCREW SUTURE,"$1,181.47",$878.25,"$1,080.58","$1,114.00",N/A,"$1,080.58",N/A,N/A,N/A,"$1,114.00",N/A,"$1,080.58",N/A,"$1,114.00",N/A,N/A,"$1,080.58"
2725610,0278,C1713,,,,,N/A,N/A,HEALIX TRANSTEND IMPLANT,"$1,046.27",$777.75,"$1,080.58","$1,114.00",N/A,"$1,080.58",N/A,N/A,N/A,"$1,114.00",N/A,"$1,080.58",N/A,"$1,114.00",N/A,N/A,"$1,080.58"
2725617,0278,C1713,,,,,N/A,N/A,MINI QUICKE ANCHOR,$778.90,$579.00,"$1,080.58","$1,114.00",N/A,"$1,080.58",N/A,N/A,N/A,"$1,114.00",N/A,"$1,080.58",N/A,"$1,114.00",N/A,N/A,"$1,080.58"
2784592,0278,C1713,,,,,N/A,N/A,ANCHOR CORKSCREW 5.0,"$1,123.96",$835.50,"$1,080.58","$1,114.00",N/A,"$1,080.58",N/A,N/A,N/A,"$1,114.00",N/A,"$1,080.58",N/A,"$1,114.00",N/A,N/A,"$1,080.58"
2784593,0278,C1713,,,,,N/A,N/A,ANCHOR CORKSCREW 6.5,"$1,123.96",$835.50,"$1,080.58","$1,114.00",N/A,"$1,080.58",N/A,N/A,N/A,"$1,114.00",N/A,"$1,080.58",N/A,"$1,114.00",N/A,N/A,"$1,080.58"
2785109,0278,C1713,,,,,N/A,N/A,ANCHOR VERSALOK #210808,"$2,536.48","$1,885.50","$1,080.58","$1,114.00",N/A,"$1,080.58",N/A,N/A,N/A,"$1,114.00",N/A,"$1,080.58",N/A,"$1,114.00",N/A,N/A,"$1,080.58"
2724479,0278,C1751,,,,,N/A,N/A,TRAY SINGLE LUMEN PICC 4 FR,"$2,011.83","$1,495.50","$1,934.18","$1,994.00",N/A,"$1,934.18",N/A,N/A,N/A,"$1,994.00",N/A,"$1,934.18",N/A,"$1,994.00",N/A,N/A,"$1,934.18"
999C1760,0278,C1760,,,,,N/A,N/A,DMHC~IMPLANTS,"$1,025.08",$762.00,$985.52,"$1,016.00",N/A,$985.52,N/A,N/A,N/A,"$1,016.00",N/A,$985.52,N/A,"$1,016.00",N/A,N/A,$985.52
2785101,0278,C1763,,,,,N/A,N/A,GRAFT VAGINAL EROSION REPAIR,"$3,745.19","$2,784.00","$3,600.64","$3,712.00",N/A,"$3,600.64",N/A,N/A,N/A,"$3,712.00",N/A,"$3,600.64",N/A,"$3,712.00",N/A,N/A,"$3,600.64"
2724351,0278,C1765,,,,,N/A,N/A,Interceed 3 X 4,"$1,915.98","$1,424.25","$1,842.03","$1,899.00",N/A,"$1,842.03",N/A,N/A,N/A,"$1,899.00",N/A,"$1,842.03",N/A,"$1,899.00",N/A,N/A,"$1,842.03"
2785175,0278,C1767,,,,,N/A,N/A,UROL:NEUROSTIMULATOR #3058,"$63,796.29","$47,423.25","$61,334.07","$63,231.00",N/A,"$61,334.07",N/A,N/A,N/A,"$63,231.00",N/A,"$61,334.07",N/A,"$63,231.00",N/A,N/A,"$61,334.07"
2725055,0278,C1771,,,,,N/A,N/A,MONARC HAMMOCK (TOT),"$6,910.23","$5,136.75","$6,643.53","$6,849.00",N/A,"$6,643.53",N/A,N/A,N/A,"$6,849.00",N/A,"$6,643.53",N/A,"$6,849.00",N/A,N/A,"$6,643.53"
2725112,0278,C1771,,,,,N/A,N/A,SYSTEM S P A R C SLING,"$5,921.47","$4,401.75","$6,643.53","$6,849.00",N/A,"$6,643.53",N/A,N/A,N/A,"$6,849.00",N/A,"$6,643.53",N/A,"$6,849.00",N/A,N/A,"$6,643.53"
2785172,0278,C1778,,,,,N/A,N/A,UROL:LEAD KIT 3093-28,"$19,427.14","$14,441.25","$18,677.35","$19,255.00",N/A,"$18,677.35",N/A,N/A,N/A,"$19,255.00",N/A,"$18,677.35",N/A,"$19,255.00",N/A,N/A,"$18,677.35"
2720004,0278,C1781,,,,,N/A,N/A,General Surgery Special Order,$0.00,$0.00,"$6,158.46","$6,348.93",N/A,"$6,158.46",N/A,N/A,N/A,"$6,348.93",N/A,"$6,158.46",N/A,"$6,348.93",N/A,N/A,"$6,158.46"
2724654,0278,C1781,,,,,N/A,N/A,Mesh Bard Flat Sheet 3x 6,$813.21,$604.50,"$6,158.46","$6,348.93",N/A,"$6,158.46",N/A,N/A,N/A,"$6,348.93",N/A,"$6,158.46",N/A,"$6,348.93",N/A,N/A,"$6,158.46"
2724655,0278,C1781,,,,,N/A,N/A,Mesh Bard Flat Sheet 6x 6,$932.26,$693.00,"$6,158.46","$6,348.93",N/A,"$6,158.46",N/A,N/A,N/A,"$6,348.93",N/A,"$6,158.46",N/A,"$6,348.93",N/A,N/A,"$6,158.46"
2724976,0278,C1781,,,,,N/A,N/A,Mesh Prolite 2 X 4,$952.44,$708.00,"$6,158.46","$6,348.93",N/A,"$6,158.46",N/A,N/A,N/A,"$6,348.93",N/A,"$6,158.46",N/A,"$6,348.93",N/A,N/A,"$6,158.46"
2724995,0278,C1781,,,,,N/A,N/A,PLUG FISTULA BIO-A,"$4,711.75","$3,502.50","$6,158.46","$6,348.93",N/A,"$6,158.46",N/A,N/A,N/A,"$6,348.93",N/A,"$6,158.46",N/A,"$6,348.93",N/A,N/A,"$6,158.46"
2725415,0278,C1781,,,,,N/A,N/A,SYM15 MESH,"$3,059.11","$2,274.00","$6,158.46","$6,348.93",N/A,"$6,158.46",N/A,N/A,N/A,"$6,348.93",N/A,"$6,158.46",N/A,"$6,348.93",N/A,N/A,"$6,158.46"
2725454,0278,C1781,,,,,N/A,N/A,MESH SYMBOTEX SYM2012E,"$3,233.65","$2,403.75","$6,158.46","$6,348.93",N/A,"$6,158.46",N/A,N/A,N/A,"$6,348.93",N/A,"$6,158.46",N/A,"$6,348.93",N/A,N/A,"$6,158.46"
2725455,0278,C1781,,,,,N/A,N/A,MESH SYMBOTEX SYM2015,"$3,959.08","$2,943.00","$6,158.46","$6,348.93",N/A,"$6,158.46",N/A,N/A,N/A,"$6,348.93",N/A,"$6,158.46",N/A,"$6,348.93",N/A,N/A,"$6,158.46"
2725456,0278,C1781,,,,,N/A,N/A,MESH SYMBOTEX SYM2515E,"$6,019.34","$4,474.50","$6,158.46","$6,348.93",N/A,"$6,158.46",N/A,N/A,N/A,"$6,348.93",N/A,"$6,158.46",N/A,"$6,348.93",N/A,N/A,"$6,158.46"
2725457,0278,C1781,,,,,N/A,N/A,MESH PERMACOL P151520,"$27,186.90","$20,209.50","$6,158.46","$6,348.93",N/A,"$6,158.46",N/A,N/A,N/A,"$6,348.93",N/A,"$6,158.46",N/A,"$6,348.93",N/A,N/A,"$6,158.46"
2725458,0278,C1781,,,,,N/A,N/A,MESH PERMACOL P151828,"$50,236.13","$37,343.25","$6,158.46","$6,348.93",N/A,"$6,158.46",N/A,N/A,N/A,"$6,348.93",N/A,"$6,158.46",N/A,"$6,348.93",N/A,N/A,"$6,158.46"
2725459,0278,C1781,,,,,N/A,N/A,MESH SYMBOTEX SYM3020,"$8,226.90","$6,115.50","$6,158.46","$6,348.93",N/A,"$6,158.46",N/A,N/A,N/A,"$6,348.93",N/A,"$6,158.46",N/A,"$6,348.93",N/A,N/A,"$6,158.46"
2725480,0278,C1781,,,,,N/A,N/A,MESH SYMBOTEX SYM12,"$2,470.89","$1,836.75","$6,158.46","$6,348.93",N/A,"$6,158.46",N/A,N/A,N/A,"$6,348.93",N/A,"$6,158.46",N/A,"$6,348.93",N/A,N/A,"$6,158.46"
2780903,0278,C1781,,,,,N/A,N/A,PROLOOP MESH PLUG,"$1,046.27",$777.75,"$6,158.46","$6,348.93",N/A,"$6,158.46",N/A,N/A,N/A,"$6,348.93",N/A,"$6,158.46",N/A,"$6,348.93",N/A,N/A,"$6,158.46"
2784929,0278,C1781,,,,,N/A,N/A,MESH PARIETEX PC09,"$2,598.02","$1,931.25","$6,158.46","$6,348.93",N/A,"$6,158.46",N/A,N/A,N/A,"$6,348.93",N/A,"$6,158.46",N/A,"$6,348.93",N/A,N/A,"$6,158.46"
2784930,0278,C1781,,,,,N/A,N/A,MESH PARIETEX PC12,"$3,562.57","$2,648.25","$6,158.46","$6,348.93",N/A,"$6,158.46",N/A,N/A,N/A,"$6,348.93",N/A,"$6,158.46",N/A,"$6,348.93",N/A,N/A,"$6,158.46"
2784931,0278,C1781,,,,,N/A,N/A,MESH PARIETEX PC1510,"$3,562.57","$2,648.25","$6,158.46","$6,348.93",N/A,"$6,158.46",N/A,N/A,N/A,"$6,348.93",N/A,"$6,158.46",N/A,"$6,348.93",N/A,N/A,"$6,158.46"
2784932,0278,C1781,,,,,N/A,N/A,MESH PARIETEX #TEM1515G,"$2,192.43","$1,629.75","$6,158.46","$6,348.93",N/A,"$6,158.46",N/A,N/A,N/A,"$6,348.93",N/A,"$6,158.46",N/A,"$6,348.93",N/A,N/A,"$6,158.46"
2784934,0278,C1781,,,,,N/A,N/A,MESH PARIETEX #TEM1509G,"$2,127.85","$1,581.75","$6,158.46","$6,348.93",N/A,"$6,158.46",N/A,N/A,N/A,"$6,348.93",N/A,"$6,158.46",N/A,"$6,348.93",N/A,N/A,"$6,158.46"
2784935,0278,C1781,,,,,N/A,N/A,MESH PARIETEX PC2520,"$7,436.90","$5,528.25","$6,158.46","$6,348.93",N/A,"$6,158.46",N/A,N/A,N/A,"$6,348.93",N/A,"$6,158.46",N/A,"$6,348.93",N/A,N/A,"$6,158.46"
2784936,0278,C1781,,,,,N/A,N/A,MESH PARIETEX TET3030,"$2,489.05","$1,850.25","$6,158.46","$6,348.93",N/A,"$6,158.46",N/A,N/A,N/A,"$6,348.93",N/A,"$6,158.46",N/A,"$6,348.93",N/A,N/A,"$6,158.46"
2784970,0278,C1781,,,,,N/A,N/A,SURGIMESH WN,"$4,730.92","$3,516.75","$6,158.46","$6,348.93",N/A,"$6,158.46",N/A,N/A,N/A,"$6,348.93",N/A,"$6,158.46",N/A,"$6,348.93",N/A,N/A,"$6,158.46"
2785050,0278,C1781,,,,,N/A,N/A,Mesh Composit 10 X 14,"$11,747.09","$8,732.25","$6,158.46","$6,348.93",N/A,"$6,158.46",N/A,N/A,N/A,"$6,348.93",N/A,"$6,158.46",N/A,"$6,348.93",N/A,N/A,"$6,158.46"
2785056,0278,C1781,,,,,N/A,N/A,PATCH SMALL VENTRALEX ST,"$2,241.86","$1,666.50","$6,158.46","$6,348.93",N/A,"$6,158.46",N/A,N/A,N/A,"$6,348.93",N/A,"$6,158.46",N/A,"$6,348.93",N/A,N/A,"$6,158.46"
2785057,0278,C1781,,,,,N/A,N/A,PATCH MEDIUM VENTRALEX ST,"$2,799.81","$2,081.25","$6,158.46","$6,348.93",N/A,"$6,158.46",N/A,N/A,N/A,"$6,348.93",N/A,"$6,158.46",N/A,"$6,348.93",N/A,N/A,"$6,158.46"
2785058,0278,C1781,,,,,N/A,N/A,PATCH VENTRALEX ST LARGE,"$3,169.08","$2,355.75","$6,158.46","$6,348.93",N/A,"$6,158.46",N/A,N/A,N/A,"$6,348.93",N/A,"$6,158.46",N/A,"$6,348.93",N/A,N/A,"$6,158.46"
2785099,0278,C1781,,,,,N/A,N/A,MESH PARIETEX PCO3728,"$12,065.91","$8,969.25","$6,158.46","$6,348.93",N/A,"$6,158.46",N/A,N/A,N/A,"$6,348.93",N/A,"$6,158.46",N/A,"$6,348.93",N/A,N/A,"$6,158.46"
2785104,0278,C1781,,,,,N/A,N/A,PATCH ONLAY PROLENE PHSL,"$2,660.57","$1,977.75","$6,158.46","$6,348.93",N/A,"$6,158.46",N/A,N/A,N/A,"$6,348.93",N/A,"$6,158.46",N/A,"$6,348.93",N/A,N/A,"$6,158.46"
2785105,0278,C1781,,,,,N/A,N/A,PATCH ONLAY PROLENE PHSM,"$2,687.82","$1,998.00","$6,158.46","$6,348.93",N/A,"$6,158.46",N/A,N/A,N/A,"$6,348.93",N/A,"$6,158.46",N/A,"$6,348.93",N/A,N/A,"$6,158.46"
2785181,0278,C1781,,,,,N/A,N/A,GRAFT SURGICAL ALLOMAX 10X10,"$15,091.72","$11,218.50","$6,158.46","$6,348.93",N/A,"$6,158.46",N/A,N/A,N/A,"$6,348.93",N/A,"$6,158.46",N/A,"$6,348.93",N/A,N/A,"$6,158.46"
2785189,0278,C1781,,,,,N/A,N/A,MESH HERNIA VENTRIO SMALL OVAL,"$4,808.61","$3,574.50","$6,158.46","$6,348.93",N/A,"$6,158.46",N/A,N/A,N/A,"$6,348.93",N/A,"$6,158.46",N/A,"$6,348.93",N/A,N/A,"$6,158.46"
2785190,0278,C1781,,,,,N/A,N/A,MESH HERNIA MED.OVAL VENTRIO,"$7,186.68","$5,342.25","$6,158.46","$6,348.93",N/A,"$6,158.46",N/A,N/A,N/A,"$6,348.93",N/A,"$6,158.46",N/A,"$6,348.93",N/A,N/A,"$6,158.46"
2785191,0278,C1781,,,,,N/A,N/A,MESH HERNIA LG.CIRCLE VENTRIO,"$5,427.09","$4,034.25","$6,158.46","$6,348.93",N/A,"$6,158.46",N/A,N/A,N/A,"$6,348.93",N/A,"$6,158.46",N/A,"$6,348.93",N/A,N/A,"$6,158.46"
2785196,0278,C1781,,,,,N/A,N/A,Mesh Ventralight St 7 X 9,"$12,214.23","$9,079.50","$6,158.46","$6,348.93",N/A,"$6,158.46",N/A,N/A,N/A,"$6,348.93",N/A,"$6,158.46",N/A,"$6,348.93",N/A,N/A,"$6,158.46"
2785197,0278,C1781,,,,,N/A,N/A,Mesh Ventralight St 8 X10,"$9,170.26","$6,816.75","$6,158.46","$6,348.93",N/A,"$6,158.46",N/A,N/A,N/A,"$6,348.93",N/A,"$6,158.46",N/A,"$6,348.93",N/A,N/A,"$6,158.46"
2785236,0278,C1781,,,,,N/A,N/A,MESH PORGRIP TEM1208GL,"$1,807.01","$1,343.25","$6,158.46","$6,348.93",N/A,"$6,158.46",N/A,N/A,N/A,"$6,348.93",N/A,"$6,158.46",N/A,"$6,348.93",N/A,N/A,"$6,158.46"
2785237,0278,C1781,,,,,N/A,N/A,MESH PROGRIP TEM128GR,"$1,807.01","$1,343.25","$6,158.46","$6,348.93",N/A,"$6,158.46",N/A,N/A,N/A,"$6,348.93",N/A,"$6,158.46",N/A,"$6,348.93",N/A,N/A,"$6,158.46"
2785242,0278,C1781,,,,,N/A,N/A,PROGRIP LAP LPG1510,"$1,751.52","$1,302.00","$6,158.46","$6,348.93",N/A,"$6,158.46",N/A,N/A,N/A,"$6,348.93",N/A,"$6,158.46",N/A,"$6,348.93",N/A,N/A,"$6,158.46"
2785243,0278,C1781,,,,,N/A,N/A,MESH PROGRIP SINGLE 5.9X3.9,"$2,261.03","$1,680.75","$6,158.46","$6,348.93",N/A,"$6,158.46",N/A,N/A,N/A,"$6,348.93",N/A,"$6,158.46",N/A,"$6,348.93",N/A,N/A,"$6,158.46"
2785244,0278,C1781,,,,,N/A,N/A,MESH VENTRALIGHT ECHO 4.5,"$6,861.80","$5,100.75","$6,158.46","$6,348.93",N/A,"$6,158.46",N/A,N/A,N/A,"$6,348.93",N/A,"$6,158.46",N/A,"$6,348.93",N/A,N/A,"$6,158.46"
2785245,0278,C1781,,,,,N/A,N/A,MESH VENTRALIGHT ECHO 6.0,"$4,727.89","$3,514.50","$6,158.46","$6,348.93",N/A,"$6,158.46",N/A,N/A,N/A,"$6,348.93",N/A,"$6,158.46",N/A,"$6,348.93",N/A,N/A,"$6,158.46"
2725363,0278,C1783,,,,,N/A,N/A,STENT PHIPPS ISTENT,"$10,597.91","$7,878.00","$10,188.88","$10,504.00",N/A,"$10,188.88",N/A,N/A,N/A,"$10,504.00",N/A,"$10,188.88",N/A,"$10,504.00",N/A,N/A,"$10,188.88"
2785174,0278,C1787,,,,,N/A,N/A,UROL:PATIENT PROGRAMMER #3037,"$7,318.85","$5,440.50","$7,036.38","$7,254.00",N/A,"$7,036.38",N/A,N/A,N/A,"$7,254.00",N/A,"$7,036.38",N/A,"$7,254.00",N/A,N/A,"$7,036.38"
2785207,0278,C1788,,,,,N/A,N/A,KIT POWER PORT CHRONO FLEX 8FR,"$2,548.58","$1,894.50","$2,450.22","$2,526.00",N/A,"$2,450.22",N/A,N/A,N/A,"$2,526.00",N/A,"$2,450.22",N/A,"$2,526.00",N/A,N/A,"$2,450.22"
2724622,0278,C1877,,,,,N/A,N/A,URO: STENT URETERAL # 7788424,"$1,354.00","$1,006.50","$1,301.74","$1,342.00",N/A,"$1,301.74",N/A,N/A,N/A,"$1,342.00",N/A,"$1,301.74",N/A,"$1,342.00",N/A,N/A,"$1,301.74"
2785173,0278,C1894,,,,,N/A,N/A,UROL:LEAD INTRODUCER KIT355018,"$1,727.31","$1,284.00","$1,660.64","$1,712.00",N/A,"$1,660.64",N/A,N/A,N/A,"$1,712.00",N/A,"$1,660.64",N/A,"$1,712.00",N/A,N/A,"$1,660.64"
2785239,0278,C2631,,,,,N/A,N/A,Coaptite Implant,"$2,171.24","$1,614.00","$2,087.44","$2,152.00",N/A,"$2,087.44",N/A,N/A,N/A,"$2,152.00",N/A,"$2,087.44",N/A,"$2,152.00",N/A,N/A,"$2,087.44"
3600030,0278,L8699,,,,,N/A,N/A,Acl,$0.00,$0.00,$0.00,$0.00,N/A,$0.00,N/A,N/A,N/A,$0.00,N/A,$0.00,N/A,$0.00,N/A,N/A,$0.00
2785180,0278,Q4100,,,,,N/A,N/A,GRAFT SURGICAL ALLO MAX 13X15,"$38,082.44","$28,308.75","$36,612.65","$37,745.00",N/A,"$36,612.65",N/A,N/A,N/A,"$37,745.00",N/A,"$36,612.65",N/A,"$37,745.00",N/A,N/A,"$36,612.65"
2725446,0278,Q4101,,,,,N/A,N/A,APLIGRAF,"$7,834.42","$5,823.75","$7,532.05","$7,765.00",N/A,"$7,532.05",N/A,N/A,N/A,"$7,765.00",N/A,"$7,532.05",N/A,"$7,765.00",N/A,N/A,"$7,532.05"
2720005,0278,Q4186,,,,,N/A,N/A,Epifix,$0.00,$0.00,$155.20,$160.00,N/A,$155.20,N/A,N/A,N/A,$160.00,N/A,$155.20,N/A,$160.00,N/A,N/A,$155.20
2701121,0278,,,,,,N/A,N/A,TUBE T DRAIN T,$787.98,$585.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2701427,0278,,,,,,N/A,N/A,TUBE SMALL DRAIN,$421.74,$313.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2701595,0278,,,,,,N/A,N/A,STAPLER TA 30-3.5,"$1,347.94","$1,002.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2701977,0278,,,,,,N/A,N/A,HEMOCLIP TITANIUM,$281.49,$209.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2702009,0278,,,,,,N/A,N/A,STAPLER PPCEEA 25,"$4,522.07","$3,361.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2702060,0278,,,,,,N/A,N/A,LIGACLIP LT 200,$279.48,$207.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2702062,0278,,,,,,N/A,N/A,LIGACLIP  LT 300,$129.14,$96.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2703083,0278,,,,,,N/A,N/A,STAPLER ENDO GIA 30- 3.5,"$1,597.15","$1,187.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2703198,0278,,,,,,N/A,N/A,STAPLER TA 60-3.5,"$1,294.47",$962.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2703199,0278,,,,,,N/A,N/A,RELOAD STAPLER TA 60-3.5,$663.88,$493.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2703360,0278,,,,,,N/A,N/A,ROTICULATING DISSECT,$562.99,$418.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2704041,0278,,,,,,N/A,N/A,Endo Stitch Bralon 48,$992.80,$738.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2704157,0278,,,,,,N/A,N/A,STAPLER POWERED LDS15W,"$2,277.18","$1,692.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2704171,0278,,,,,,N/A,N/A,CATHETER IV PROTECTOR 14G,$54.48,$40.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2704219,0278,,,,,,N/A,N/A,Plug Marlex Medium,"$1,640.54","$1,219.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2704220,0278,,,,,,N/A,N/A,Plug Marlex Prefix Large,"$1,565.87","$1,164.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2704221,0278,,,,,,N/A,N/A,Plug Marlex Prefix Small,"$1,565.87","$1,164.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2704222,0278,,,,,,N/A,N/A,Plug Marlex Prefix Xlarge,"$1,935.15","$1,438.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2704268,0278,,,,,,N/A,N/A,MENESCUS MENDER II,"$1,656.68","$1,231.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2704269,0278,,,,,,N/A,N/A,TUBE-G PONSKY PULL PEG FR.20,"$2,796.78","$2,079.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2704326,0278,,,,,,N/A,N/A,ORTHOBLAST BONE PUTTY 5CC,"$8,094.73","$6,017.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2704327,0278,,,,,,N/A,N/A,ORTHOBLAST BONE PUTTY 10CC,"$6,697.34","$4,978.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2704342,0278,,,,,,N/A,N/A,Composix 6 X 8,"$11,756.17","$8,739.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2704405,0278,,,,,,N/A,N/A,GOODE T-GROMMET,$311.76,$231.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2720400,0278,,,,,,N/A,N/A,FIBER WIRE 400,$354.14,$263.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2720600,0278,,,,,,N/A,N/A,FIBER WIRE 600,$432.84,$321.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2724498,0278,,,,,,N/A,N/A,TUBE VENT COLLAR BUTTON,$261.32,$194.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2724506,0278,,,,,,N/A,N/A,UROLOGY: CATH FOLEY TIP PUNCH,$823.30,$612.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2724564,0278,,,,,,N/A,N/A,Mesh 3 D Max Right Large,"$3,583.75","$2,664.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2724565,0278,,,,,,N/A,N/A,Mesh 3 D Max Left Large,"$3,583.75","$2,664.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2724567,0278,,,,,,N/A,N/A,CATHETER IV AUTOGUARD 14 G,$68.61,$51.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2724568,0278,,,,,,N/A,N/A,CATHETER IV AUTOGUARD 16 G,$68.61,$51.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2725073,0278,,,,,,N/A,N/A,TUBE-U TYMPANOSTOMY REGULAR,$697.18,$518.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2725254,0278,,,,,,N/A,N/A,TUBE TITANIUM MORETZ,"$1,483.14","$1,102.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2725425,0278,,,,,,N/A,N/A,MESH SYM9,"$1,719.23","$1,278.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2725545,0278,,,,,,N/A,N/A,ANCHOR HEALIX 4.5 ADVANCE,"$2,462.82","$1,830.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2725546,0278,,,,,,N/A,N/A,LUPINE LOOP DUAL ANCHOR PLUS,"$2,396.23","$1,781.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2725551,0278,,,,,,N/A,N/A,ANCHOR HEALIX ADVANCE 4.5 BR,"$2,530.42","$1,881.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2725552,0278,,,,,,N/A,N/A,ANCHOR HEALIX 4.75 KNOTLESS,"$2,827.05","$2,101.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2725554,0278,,,,,,N/A,N/A,GYNECARE TVT SYSTEM,"$8,222.86","$6,112.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2782085,0278,,,,,,N/A,N/A,KIT CATH GROSHONG SINGLE 8-50,"$5,387.74","$4,005.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2784333,0278,,,,,,N/A,N/A,Kit Bardport Mri Single Port,"$4,629.02","$3,441.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2784375,0278,,,,,,N/A,N/A,Kit M.R.I. Dual Port,"$11,413.13","$8,484.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2784566,0278,,,,,,N/A,N/A,LIGATION SPRINGLOCK 5MM,"$2,430.54","$1,806.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2784666,0278,,,,,,N/A,N/A,STAPLER LINEAR CUTTER ATW45,"$4,239.57","$3,151.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2784667,0278,,,,,,N/A,N/A,RELOAD LINEAR CUTTER TR45W,"$1,439.76","$1,070.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2784668,0278,,,,,,N/A,N/A,RELOAD LINEAR CUTTER TR45B,"$1,286.40",$956.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2784669,0278,,,,,,N/A,N/A,RELOAD LINEAR CUTTER TR45G,"$1,286.40",$956.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2784782,0278,,,,,,N/A,N/A,RELOAD ROTICULATOR 60-2.5,"$1,764.64","$1,311.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2784783,0278,,,,,,N/A,N/A,RELOAD ROTICULATOR 60-3.5,"$1,764.64","$1,311.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2784784,0278,,,,,,N/A,N/A,RELOAD STRAIGHT GIA 45-2.5,"$1,220.82",$907.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2784785,0278,,,,,,N/A,N/A,RELOAD STRAIGHT GIA 45-3.5,"$1,220.82",$907.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2784786,0278,,,,,,N/A,N/A,RELOAD STRAIGHT GIA 30-2.5,"$1,220.82",$907.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2784787,0278,,,,,,N/A,N/A,STAPLER UNIVERSAL GIA,"$1,118.91",$831.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2784788,0278,,,,,,N/A,N/A,STAPLER ROTICULATOR 55-4.8,"$2,862.36","$2,127.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2784789,0278,,,,,,N/A,N/A,SURGICLIP PREMIUM MED,$757.71,$563.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2784790,0278,,,,,,N/A,N/A,RELOAD 60-3.8,$702.22,$522.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2784791,0278,,,,,,N/A,N/A,STAPLER GIA 60-3.8,"$1,289.43",$958.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2784792,0278,,,,,,N/A,N/A,ENDO CLIP APPLIER 5MM,"$2,233.79","$1,660.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2784794,0278,,,,,,N/A,N/A,RELOAD ROTICULATOR 30-2.5,"$1,886.72","$1,402.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2784795,0278,,,,,,N/A,N/A,RELOAD ROTICULATOR 45-3.5,"$1,255.12",$933.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2784796,0278,,,,,,N/A,N/A,RELOAD ROTICULATOR 45-2.5,"$1,255.12",$933.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2784842,0278,,,,,,N/A,N/A,SURGICLIP PREMIUM LARGE,$757.71,$563.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2785107,0278,,,,,,N/A,N/A,RELOAD ROTICULATOR 45-2.0,"$1,572.94","$1,169.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2785130,0278,,,,,,N/A,N/A,TACKER OBSORBABLE ABSTACK20,"$3,024.80","$2,248.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2785132,0278,,,,,,N/A,N/A,TACKER OBSORBABLE ABSTACK10,"$2,161.15","$1,606.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2785179,0278,,,,,,N/A,N/A,SUTURE CLIP LAPRA-TY XC200,"$1,220.82",$907.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2785183,0278,,,,,,N/A,N/A,LINA GOLD LOOP #EL0200-8,"$2,450.72","$1,821.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2785199,0278,,,,,,N/A,N/A,"MESH, COMPOSIT VENTRAL",$536.76,$399.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2785200,0278,,,,,,N/A,N/A,MESH COMPOSIT VENTRAL,$641.69,$477.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2785230,0278,,,,,,N/A,N/A,BETA-BSM BONE SUB.76-6025,"$5,482.58","$4,075.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2786412,0278,,,,,,N/A,N/A,SCREW ADVANCED MILAGRO 7X23MM,"$2,328.63","$1,731.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2786413,0278,,,,,,N/A,N/A,SCREW ADVANCED MILAGRO 8X23MM,"$2,328.63","$1,731.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2786414,0278,,,,,,N/A,N/A,SCREW ADVANCED MILAGRO 9X23MM,"$2,328.63","$1,731.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2786415,0278,,,,,,N/A,N/A,SCREW ADVANCED MILAGRO 10X23MM,"$2,328.63","$1,731.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3602631,0278,,,,,,N/A,N/A,DURASPHERE SYRINGE 1 ML,"$1,649.62","$1,226.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2703122,0290,A6530,,,,,N/A,N/A,STOCKING KNEE ELAS XLG(MCR NC),$134.19,$99.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2703118,0290,A6533,,,,,N/A,N/A,STOCKING THIGH M SH(MCR NC),$220.96,$164.25,$212.43,$219.00,N/A,$212.43,N/A,N/A,N/A,$219.00,N/A,$212.43,N/A,$219.00,N/A,N/A,$212.43
2703119,0290,A6533,,,,,N/A,N/A,STOCKING THIGH MED LONG(MCR NC,$240.13,$178.50,$212.43,$219.00,N/A,$212.43,N/A,N/A,N/A,$219.00,N/A,$212.43,N/A,$219.00,N/A,N/A,$212.43
2703120,0290,A6533,,,,,N/A,N/A,STOCKING THIGH LG SH(MCR NC),$220.96,$164.25,$212.43,$219.00,N/A,$212.43,N/A,N/A,N/A,$219.00,N/A,$212.43,N/A,$219.00,N/A,N/A,$212.43
2703121,0290,A6533,,,,,N/A,N/A,STOCKING THIGH LG LO,$220.96,$164.25,$212.43,$219.00,N/A,$212.43,N/A,N/A,N/A,$219.00,N/A,$212.43,N/A,$219.00,N/A,N/A,$212.43
L183045,0290,L1830,,,,,N/A,N/A,KNEE MOBILIZER,$151.34,$112.50,$145.50,$150.00,N/A,$145.50,N/A,N/A,N/A,$150.00,N/A,$145.50,N/A,$150.00,N/A,N/A,$145.50
L279545,0290,L2795,,,,,N/A,N/A,ADDITION LWR EXTREMITY,$126.12,$93.75,$121.25,$125.00,N/A,$121.25,N/A,N/A,N/A,$125.00,N/A,$121.25,N/A,$125.00,N/A,N/A,$121.25
L335045,0290,L3350,,,,,N/A,N/A,HEEL LIFT,$25.22,$18.75,$24.25,$25.00,N/A,$24.25,N/A,N/A,N/A,$25.00,N/A,$24.25,N/A,$25.00,N/A,N/A,$24.25
L370145,0290,L3702,,,,,N/A,N/A,TENNIS ELBOW BOND,$33.30,$24.75,$32.01,$33.00,N/A,$32.01,N/A,N/A,N/A,$33.00,N/A,$32.01,N/A,$33.00,N/A,N/A,$32.01
Q404645,0290,Q4046,,,,,N/A,N/A,"SHORT LG SPLNT,ADT, FIBERGLASS",$39.35,$29.25,$0.00,$39.00,N/A,$0.00,N/A,N/A,N/A,$39.00,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
2940004,0294,E0561,,,,,N/A,N/A,REMSTAR PASS-OVER HUMID(MCR NC,"$1,184.50",$880.50,"$1,138.78","$1,174.00",N/A,"$1,138.78",N/A,N/A,N/A,"$1,174.00",N/A,"$1,138.78",N/A,"$1,174.00",N/A,N/A,"$1,138.78"
3007001,0300,36410,,,,,N/A,N/A,BLOOD DRAW X2,$46.41,$34.50,$15.71,$46.00,N/A,$44.62,N/A,$39.33,N/A,$15.71,N/A,$44.62,N/A,$46.00,N/A,N/A,$44.62
36415,0300,36415,,,,,N/A,N/A,VENIPUNCTURE ROUTINE,$19.17,$14.25,$2.50,$50.00,$2.50,$48.50,$2.50,$42.75,$2.50,$6.27,$2.50,$48.50,$2.50,$50.00,$2.50,$2.50,$48.50
3000700,0300,36415,,,,,N/A,N/A,ROUTINE VENIPUNCTURE,$50.45,$37.50,$2.50,$50.00,$2.50,$48.50,$2.50,$42.75,$2.50,$6.27,$2.50,$48.50,$2.50,$50.00,$2.50,$2.50,$48.50
3000705,0300,36415,,,,,N/A,N/A,VENIPUNCTURE TEST KIT,$50.45,$37.50,$2.50,$50.00,$2.50,$48.50,$2.50,$42.75,$2.50,$6.27,$2.50,$48.50,$2.50,$50.00,$2.50,$2.50,$48.50
3036415,0300,36415,,,,,N/A,N/A,ROUTINE VENIPUNCTURE,$69.62,$51.75,$2.50,$50.00,$2.50,$48.50,$2.50,$42.75,$2.50,$6.27,$2.50,$48.50,$2.50,$50.00,$2.50,$2.50,$48.50
3641534,0300,36415,,,,,N/A,N/A,VENIPUNCTURE ROUTINE,$19.17,$14.25,$2.50,$50.00,$2.50,$48.50,$2.50,$42.75,$2.50,$6.27,$2.50,$48.50,$2.50,$50.00,$2.50,$2.50,$48.50
3641540,0300,36415,,,,,N/A,N/A,VENIPUNCTURE ROUTINE,$19.17,$14.25,$2.50,$50.00,$2.50,$48.50,$2.50,$42.75,$2.50,$6.27,$2.50,$48.50,$2.50,$50.00,$2.50,$2.50,$48.50
3641550,0300,36415,,,,,N/A,N/A,VENIPUNCTURE ROUTINE,$19.17,$14.25,$2.50,$50.00,$2.50,$48.50,$2.50,$42.75,$2.50,$6.27,$2.50,$48.50,$2.50,$50.00,$2.50,$2.50,$48.50
3936415,0300,36415,,,,,N/A,N/A,ROUTINE VENIPUNCTURE,$51.46,$38.25,$2.50,$50.00,$2.50,$48.50,$2.50,$42.75,$2.50,$6.27,$2.50,$48.50,$2.50,$50.00,$2.50,$2.50,$48.50
4500124,0300,36415,,,,,N/A,N/A,ROUTINE VENIPUNCTURE,$51.46,$38.25,$2.50,$50.00,$2.50,$48.50,$2.50,$42.75,$2.50,$6.27,$2.50,$48.50,$2.50,$50.00,$2.50,$2.50,$48.50
4836415,0300,36415,,,,,N/A,N/A,ROUTINE VENIPUNCTURE,$58.52,$43.50,$2.50,$50.00,$2.50,$48.50,$2.50,$42.75,$2.50,$6.27,$2.50,$48.50,$2.50,$50.00,$2.50,$2.50,$48.50
4936415,0300,36415,,,,,N/A,N/A,ROUTINE VENIPUNCTURE,$69.62,$51.75,$2.50,$50.00,$2.50,$48.50,$2.50,$42.75,$2.50,$6.27,$2.50,$48.50,$2.50,$50.00,$2.50,$2.50,$48.50
5136415,0300,36415,,,,,N/A,N/A,ROUTINE VENIPUNCTURE,$51.46,$38.25,$2.50,$50.00,$2.50,$48.50,$2.50,$42.75,$2.50,$6.27,$2.50,$48.50,$2.50,$50.00,$2.50,$2.50,$48.50
36416,0300,36416,,,,,N/A,N/A,CAPILLARY BLOOD COLLECTION,$21.19,$15.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3000701,0300,36416,,,,,N/A,N/A,CAPILLARY COLLECTION,$46.41,$34.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3641650,0300,36416,,,,,N/A,N/A,CAPILLARY BLOOD COLLECTION,$21.19,$15.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4136416,0300,36416,,,,,N/A,N/A,CAPILLARY DRAW,$29.26,$21.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4536416,0300,36416,,,,,N/A,N/A,COLLECTION OF CAPILLARY BLOOD,$26.23,$19.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7136416,0300,36416,,,,,N/A,N/A,CAPILLARY BLOOD COLLECTION,$24.21,$18.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3092142,0300,80061,,,,,N/A,N/A,MAYO LIPOPROTEIN METB PROFIL,$68.61,$51.00,$12.57,$208.00,N/A,$201.76,N/A,$19.42,N/A,$12.57,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3011040,0300,80100,,,,,N/A,N/A,Drug Screen Urine (Nvrh),$280.49,$208.50,$9.64,$297.00,N/A,$288.09,N/A,N/A,N/A,$9.64,N/A,$288.09,N/A,$297.00,N/A,N/A,$288.09
3091923,0300,80100,,,,,N/A,N/A,Mayo Buprenorphine,$577.11,$429.00,$9.64,$297.00,N/A,$288.09,N/A,N/A,N/A,$9.64,N/A,$288.09,N/A,$297.00,N/A,N/A,$288.09
3092135,0300,80100,,,,,N/A,N/A,MAYO NALAXONE,$591.24,$439.50,$9.64,$297.00,N/A,$288.09,N/A,N/A,N/A,$9.64,N/A,$288.09,N/A,$297.00,N/A,N/A,$288.09
3092246,0300,80100,,,,,N/A,N/A,"Mayo Drug Screen, Prescrip/Otc",$283.51,$210.75,$9.64,$297.00,N/A,$288.09,N/A,N/A,N/A,$9.64,N/A,$288.09,N/A,$297.00,N/A,N/A,$288.09
3010721,0300,80156,,,,,N/A,N/A,TEGRETOL (CARBAMAZEP,$280.49,$208.50,$269.66,$278.00,N/A,$269.66,N/A,$21.13,N/A,$278.00,N/A,$269.66,N/A,$278.00,N/A,N/A,$269.66
3099309,0300,80158,,,,,N/A,N/A,CYCLOSPORINE A,$345.06,$256.50,$17.60,$380.00,N/A,$368.60,N/A,$26.17,N/A,$17.60,N/A,$368.60,N/A,$380.00,N/A,N/A,$368.60
3091330,0300,80159,,,,,N/A,N/A,CLOZAPINE,$523.64,$389.25,$21.80,$519.00,N/A,$503.43,N/A,$29.22,N/A,$21.80,N/A,$503.43,N/A,$519.00,N/A,N/A,$503.43
3091121,0300,80160,,,,,N/A,N/A,Mayo Desipramine (Norpramin),$358.17,$266.25,$24.31,$355.00,N/A,$344.35,N/A,N/A,N/A,$24.31,N/A,$344.35,N/A,$355.00,N/A,N/A,$344.35
3010918,0300,80162,,,,,N/A,N/A,DIGOXIN,$254.25,$189.00,$244.44,$252.00,N/A,$244.44,N/A,$19.26,N/A,$252.00,N/A,$244.44,N/A,$252.00,N/A,N/A,$244.44
3010232,0300,80164,,,,,N/A,N/A,VALPROIC ACID (NVRH),$261.32,$194.25,$15.93,$259.00,N/A,$251.23,N/A,$19.63,N/A,$15.93,N/A,$251.23,N/A,$259.00,N/A,N/A,$251.23
3090923,0300,80168,,,,,N/A,N/A,ETHOSUXIMID ZARONTI,$312.77,$232.50,$300.70,$310.00,N/A,$300.70,N/A,$23.69,N/A,$310.00,N/A,$300.70,N/A,$310.00,N/A,N/A,$300.70
3091281,0300,80171,,,,,N/A,N/A,GABAPENTIN,$345.06,$256.50,$19.70,$342.00,N/A,$331.74,N/A,$23.84,N/A,$19.70,N/A,$331.74,N/A,$342.00,N/A,N/A,$331.74
3091143,0300,80176,,,,,N/A,N/A,SKBL LIDOCAINE SERUM,$178.58,$132.75,$15.93,$177.00,N/A,$171.69,N/A,$21.30,N/A,$15.93,N/A,$171.69,N/A,$177.00,N/A,N/A,$171.69
3010254,0300,80178,,,,,N/A,N/A,LITHIUM,$129.14,$96.00,$15.93,$150.00,N/A,$145.50,N/A,$9.58,N/A,$15.93,N/A,$145.50,N/A,$150.00,N/A,N/A,$145.50
3099284,0300,80178,,,,,N/A,N/A,LITHIUM,$115.02,$85.50,$15.93,$150.00,N/A,$145.50,N/A,$9.58,N/A,$15.93,N/A,$145.50,N/A,$150.00,N/A,N/A,$145.50
3099426,0300,80178,,,,,N/A,N/A,LITTLETON LITHIUM,$151.34,$112.50,$15.93,$150.00,N/A,$145.50,N/A,$9.58,N/A,$15.93,N/A,$145.50,N/A,$150.00,N/A,N/A,$145.50
3091231,0300,80182,,,,,N/A,N/A,Nortrytiline,$261.32,$194.25,$21.80,$259.00,N/A,$251.23,N/A,N/A,N/A,$21.80,N/A,$251.23,N/A,$259.00,N/A,N/A,$251.23
3010278,0300,80184,,,,,N/A,N/A,PHENOBARBITAL,$223.98,$166.50,$15.93,$222.00,N/A,$215.34,N/A,$22.19,N/A,$15.93,N/A,$215.34,N/A,$222.00,N/A,N/A,$215.34
3010277,0300,80185,,,,,N/A,N/A,DILANTIN,$254.25,$189.00,$18.44,$252.00,N/A,$244.44,N/A,$19.21,N/A,$18.44,N/A,$244.44,N/A,$252.00,N/A,N/A,$244.44
3090920,0300,80192,,,,,N/A,N/A,PROCAINAMIDE/NAPA        80192,$349.09,$259.50,$20.12,$346.00,N/A,$335.62,N/A,$24.29,N/A,$20.12,N/A,$335.62,N/A,$346.00,N/A,N/A,$335.62
3091018,0300,80194,,,,,N/A,N/A,QUINIDINE,$309.74,$230.25,$20.12,$307.00,N/A,$297.79,N/A,$21.17,N/A,$20.12,N/A,$297.79,N/A,$307.00,N/A,N/A,$297.79
3092214,0300,80195,,,,,N/A,N/A,FAHC SIROLIMUS,$101.90,$75.75,$17.60,$101.00,N/A,$97.97,N/A,$13.73,N/A,$17.60,N/A,$97.97,N/A,$101.00,N/A,N/A,$97.97
3010239,0300,80196,,,,,N/A,N/A,Salicylates,$138.22,$102.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3099528,0300,80197,,,,,N/A,N/A,TACROLIMUS (PROGRAF),$143.27,$106.50,$16.35,$380.00,N/A,$368.60,N/A,$14.63,N/A,$16.35,N/A,$368.60,N/A,$380.00,N/A,N/A,$368.60
3091111,0300,80200,,,,,N/A,N/A,DESIPRAMINE,$310.75,$231.00,$32.69,$308.00,N/A,$298.76,N/A,$23.39,N/A,$32.69,N/A,$298.76,N/A,$308.00,N/A,N/A,$298.76
3099147,0300,80201,,,,,N/A,N/A,TOPIRAMATE,$231.05,$171.75,$19.28,$229.00,N/A,$222.13,N/A,$17.28,N/A,$19.28,N/A,$222.13,N/A,$229.00,N/A,N/A,$222.13
3010295,0300,80202,,,,,N/A,N/A,VANCOMYCIN,$261.32,$194.25,$14.25,$259.00,N/A,$251.23,N/A,$19.63,N/A,$14.25,N/A,$251.23,N/A,$259.00,N/A,N/A,$251.23
3091106,0300,80202,,,,,N/A,N/A,VANCOMYCIN (LAB),$279.48,$207.75,$14.25,$259.00,N/A,$251.23,N/A,$19.63,N/A,$14.25,N/A,$251.23,N/A,$259.00,N/A,N/A,$251.23
3099843,0300,80203,,,,,N/A,N/A,MAYO ZONISAMIDE,$345.06,$256.50,$16.35,$342.00,N/A,$331.74,N/A,$19.21,N/A,$16.35,N/A,$331.74,N/A,$342.00,N/A,N/A,$331.74
3091928,0300,80299,,,,,N/A,N/A,MAYO DOXYCYCLINE,$177.57,$132.00,$32.69,$377.00,N/A,$365.69,N/A,$27.03,N/A,$32.69,N/A,$365.69,N/A,$377.00,N/A,N/A,$365.69
3091951,0300,80299,,,,,N/A,N/A,MAYO LSD CONFIRMATION URINE,$127.13,$94.50,$32.69,$377.00,N/A,$365.69,N/A,$27.03,N/A,$32.69,N/A,$365.69,N/A,$377.00,N/A,N/A,$365.69
3091953,0300,80299,,,,,N/A,N/A,MAYO TRAZODONE,$143.27,$106.50,$32.69,$377.00,N/A,$365.69,N/A,$27.03,N/A,$32.69,N/A,$365.69,N/A,$377.00,N/A,N/A,$365.69
3091909,0300,80301,,,,,N/A,N/A,"Mayo Amphetamines,Urine",$591.24,$439.50,$22.21,$586.00,N/A,$568.42,N/A,N/A,N/A,$22.21,N/A,$568.42,N/A,$586.00,N/A,N/A,$568.42
80305,0300,80305,,,,,N/A,N/A,URINE DRUG SCREEN,$111.99,$83.25,$107.67,$111.00,N/A,$107.67,N/A,$15.12,N/A,$111.00,N/A,$107.67,N/A,$111.00,N/A,N/A,$107.67
80305QW,0300,80305,,,,,N/A,N/A,URINE DRUG SCREEN,$111.99,$83.25,$107.67,$111.00,N/A,$107.67,N/A,$15.12,N/A,$111.00,N/A,$107.67,N/A,$111.00,N/A,N/A,$107.67
3091944,0300,80320,,,,,N/A,N/A,MAYO ETHANOL URINE CONFIRMATIO,$182.62,$135.75,$74.61,$219.00,N/A,$212.43,N/A,N/A,N/A,$74.61,N/A,$212.43,N/A,$219.00,N/A,N/A,$212.43
3091115,0300,80335,,,,,N/A,N/A,IMIPRAMINE,$657.83,$489.00,$0.00,$652.00,N/A,$632.44,N/A,N/A,N/A,$0.00,N/A,$632.44,N/A,$652.00,N/A,N/A,$632.44
3091932,0300,80345,,,,,N/A,N/A,MAYO BARBITURATE CONFIRMATION,$223.98,$166.50,$28.92,$222.00,N/A,$215.34,N/A,N/A,N/A,$28.92,N/A,$215.34,N/A,$222.00,N/A,N/A,$215.34
3092271,0300,80354,,,,,N/A,N/A,Mayo Fentanyl Urine,$370.28,$275.25,$28.92,$367.00,N/A,$355.99,N/A,N/A,N/A,$28.92,N/A,$355.99,N/A,$367.00,N/A,N/A,$355.99
3099341,0300,80360,,,,,N/A,N/A,RITALIN,$377.34,$280.50,$28.92,$374.00,N/A,$362.78,N/A,N/A,N/A,$28.92,N/A,$362.78,N/A,$374.00,N/A,N/A,$362.78
3092120,0300,80373,,,,,N/A,N/A,Mayo Tramadol,$345.06,$256.50,$28.92,$342.00,N/A,$331.74,N/A,N/A,N/A,$28.92,N/A,$331.74,N/A,$342.00,N/A,N/A,$331.74
81000,0300,81000,,,,,N/A,N/A,URINE ANALYSIS COMPLETE,$22.20,$16.50,$21.34,$38.98,N/A,$21.34,N/A,$5.83,N/A,$38.98,N/A,$21.34,N/A,$22.00,N/A,N/A,$21.34
3050303,0300,81000,,,,,N/A,N/A,Protein (Urine),$64.57,$48.00,$21.34,$38.98,N/A,$21.34,N/A,$5.83,N/A,$38.98,N/A,$21.34,N/A,$22.00,N/A,N/A,$21.34
8100040,0300,81000,,,,,N/A,N/A,URINE ANALIYSIS COMPLETE    ~G,$22.20,$16.50,$21.34,$38.98,N/A,$21.34,N/A,$5.83,N/A,$38.98,N/A,$21.34,N/A,$22.00,N/A,N/A,$21.34
81000LSC,0300,81000,,,,,N/A,N/A,URINE ANALYSIS COMPLETE,$42.38,$31.50,$21.34,$38.98,N/A,$21.34,N/A,$5.83,N/A,$38.98,N/A,$21.34,N/A,$22.00,N/A,N/A,$21.34
8100140,0300,81001,,,,,N/A,N/A,"URINALYSIS AUTOMATED,W/MICRO",$15.13,$11.25,$5.03,$42.00,N/A,$40.74,N/A,$4.60,N/A,$5.03,N/A,$40.74,N/A,$42.00,N/A,N/A,$40.74
81002,0300,81002,,,,,N/A,N/A,URINE MICRAL,$16.14,$12.00,$3.77,$101.00,N/A,$97.97,N/A,$3.94,N/A,$3.77,N/A,$97.97,N/A,$101.00,N/A,N/A,$97.97
3051297,0300,81002,,,,,N/A,N/A,ICOTEST,$41.37,$30.75,$3.77,$101.00,N/A,$97.97,N/A,$3.94,N/A,$3.77,N/A,$97.97,N/A,$101.00,N/A,N/A,$97.97
8100240,0300,81002,,,,,N/A,N/A,URINE MICRAL,$16.14,$12.00,$3.77,$101.00,N/A,$97.97,N/A,$3.94,N/A,$3.77,N/A,$97.97,N/A,$101.00,N/A,N/A,$97.97
81002LSC,0300,81002,,,,,N/A,N/A,URINE MICRAL,$31.28,$23.25,$3.77,$101.00,N/A,$97.97,N/A,$3.94,N/A,$3.77,N/A,$97.97,N/A,$101.00,N/A,N/A,$97.97
81003,0300,81003,,,,,N/A,N/A,"URINALYSIS-AUTOMATED,W/O MIC",$15.13,$11.25,$4.19,$41.00,N/A,$39.77,N/A,$3.26,N/A,$4.19,N/A,$39.77,N/A,$41.00,N/A,N/A,$39.77
3050404,0300,81003,,,,,N/A,N/A,URINE (DIP ONLY),$41.37,$30.75,$4.19,$41.00,N/A,$39.77,N/A,$3.26,N/A,$4.19,N/A,$39.77,N/A,$41.00,N/A,N/A,$39.77
3050806,0300,81003,,,,,N/A,N/A,URINALYSIS,$41.37,$30.75,$4.19,$41.00,N/A,$39.77,N/A,$3.26,N/A,$4.19,N/A,$39.77,N/A,$41.00,N/A,N/A,$39.77
8100340,0300,81003,,,,,N/A,N/A,"URINALYSIS AUTOMATED,W/MICRO",$15.13,$11.25,$4.19,$41.00,N/A,$39.77,N/A,$3.26,N/A,$4.19,N/A,$39.77,N/A,$41.00,N/A,N/A,$39.77
3050314,0300,81015,,,,,N/A,N/A,URINALYSIS-MICROSCOPIC ONLY,$60.54,$45.00,$2.51,$60.00,N/A,$58.20,N/A,$4.42,N/A,$2.51,N/A,$58.20,N/A,$60.00,N/A,N/A,$58.20
3050308,0300,81025,,,,,N/A,N/A,HCG QUAL URINE,$126.12,$93.75,$3.77,$61.00,N/A,$59.17,N/A,$12.48,N/A,$3.77,N/A,$59.17,N/A,$61.00,N/A,N/A,$59.17
4581025,0300,81025,,,,,N/A,N/A,URINE PREGNANCY TEST - ER,$64.57,$48.00,$3.77,$61.00,N/A,$59.17,N/A,$12.48,N/A,$3.77,N/A,$59.17,N/A,$61.00,N/A,N/A,$59.17
7081025,0300,81025,,,,,N/A,N/A,URINE HCG,$64.57,$48.00,$3.77,$61.00,N/A,$59.17,N/A,$12.48,N/A,$3.77,N/A,$59.17,N/A,$61.00,N/A,N/A,$59.17
8102575,0300,81025,,,,,N/A,N/A,URINE HCG,$61.55,$45.75,$3.77,$61.00,N/A,$59.17,N/A,$12.48,N/A,$3.77,N/A,$59.17,N/A,$61.00,N/A,N/A,$59.17
81025LSC,0300,81025,,,,,N/A,N/A,URINE PREG TEST,$37.33,$27.75,$3.77,$61.00,N/A,$59.17,N/A,$12.48,N/A,$3.77,N/A,$59.17,N/A,$61.00,N/A,N/A,$59.17
3011406,0300,81050,,,,,N/A,N/A,TOTAL VOLUME,$63.56,$47.25,$10.48,$63.00,N/A,$61.11,N/A,$5.28,N/A,$10.48,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3099121,0300,81050,,,,,N/A,N/A,TOTAL VOLUME 1,$63.56,$47.25,$10.48,$63.00,N/A,$61.11,N/A,$5.28,N/A,$10.48,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3099638,0300,82010,,,,,N/A,N/A,MAYO BETAHYDROXYBUTYRATE,$331.94,$246.75,$86.76,$329.00,N/A,$319.13,N/A,$9.53,N/A,$86.76,N/A,$319.13,N/A,$329.00,N/A,N/A,$319.13
3010263,0300,82043,,,,,N/A,N/A,MICROALBUMIN,$106.95,$79.50,$9.22,$106.00,N/A,$102.82,N/A,$8.38,N/A,$9.22,N/A,$102.82,N/A,$106.00,N/A,N/A,$102.82
3091344,0300,82105,,,,,N/A,N/A,AFP TUMOR MARKE,$407.61,$303.00,$17.18,$404.00,N/A,$391.88,N/A,$24.32,N/A,$17.18,N/A,$391.88,N/A,$404.00,N/A,N/A,$391.88
3091952,0300,82136,,,,,N/A,N/A,MAYO CYSTINURIA PROFILE URINE,$345.06,$256.50,$19.70,$342.00,N/A,$331.74,N/A,$22.12,N/A,$19.70,N/A,$331.74,N/A,$342.00,N/A,N/A,$331.74
3010265,0300,82140,,,,,N/A,N/A,AMMONIA,$280.49,$208.50,$20.12,$430.00,N/A,$417.10,N/A,$21.13,N/A,$20.12,N/A,$417.10,N/A,$430.00,N/A,N/A,$417.10
3099642,0300,82140,,,,,N/A,N/A,LRH AMMONIA,$433.84,$322.50,$20.12,$430.00,N/A,$417.10,N/A,$21.13,N/A,$20.12,N/A,$417.10,N/A,$430.00,N/A,N/A,$417.10
3010219,0300,82150,,,,,N/A,N/A,AMYLASE,$115.02,$85.50,$17.60,$114.00,N/A,$110.58,N/A,$9.40,N/A,$17.60,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3091424,0300,82157,,,,,N/A,N/A,ANDROSTENDIONE (#251),$553.91,$411.75,$7.96,$549.00,N/A,$532.53,N/A,$42.46,N/A,$7.96,N/A,$532.53,N/A,$549.00,N/A,N/A,$532.53
3092143,0300,82172,,,,,N/A,N/A,MAYO LIPOPROTEIN METB PROFIL,$68.61,$51.00,$17.60,$296.00,N/A,$287.12,N/A,$30.58,N/A,$17.60,N/A,$287.12,N/A,$296.00,N/A,N/A,$287.12
3099231,0300,82172,,,,,N/A,N/A,Lipoprotein (A),$298.65,$222.00,$17.60,$296.00,N/A,$287.12,N/A,$30.58,N/A,$17.60,N/A,$287.12,N/A,$296.00,N/A,N/A,$287.12
3091051,0300,82175,,,,,N/A,N/A,ARSENIC (URINE),$590.23,$438.75,$25.15,$358.00,N/A,$347.26,N/A,N/A,N/A,$25.15,N/A,$347.26,N/A,$358.00,N/A,N/A,$347.26
3091964,0300,82175,,,,,N/A,N/A,MAYO ARSENIC HAIR/NAILS,$117.04,$87.00,$25.15,$358.00,N/A,$347.26,N/A,N/A,N/A,$25.15,N/A,$347.26,N/A,$358.00,N/A,N/A,$347.26
3091269,0300,82232,,,,,N/A,N/A,BETA2-MICROGLOB,$310.75,$231.00,$19.28,$308.00,N/A,$298.76,N/A,$23.46,N/A,$19.28,N/A,$298.76,N/A,$308.00,N/A,N/A,$298.76
3091975,0300,82239,,,,,N/A,N/A,MAYO BILE ACIDS TOTAL,$133.18,$99.00,$19.28,$132.00,N/A,$128.04,N/A,$24.82,N/A,$19.28,N/A,$128.04,N/A,$132.00,N/A,N/A,$128.04
3010220,0300,82247,,,,,N/A,N/A,BILIRUBIN TOTAL,$114.01,$84.75,$20.54,$132.00,N/A,$128.04,N/A,$7.28,N/A,$20.54,N/A,$128.04,N/A,$132.00,N/A,N/A,$128.04
3010250,0300,82247,,,,,N/A,N/A,NBIL BILIRUBIN NEONATAL,$101.90,$75.75,$20.54,$132.00,N/A,$128.04,N/A,$7.28,N/A,$20.54,N/A,$128.04,N/A,$132.00,N/A,N/A,$128.04
3010222,0300,82248,,,,,N/A,N/A,BILIRUBIN DIRECT,$114.01,$84.75,$5.87,$124.00,N/A,$120.28,N/A,$5.85,N/A,$5.87,N/A,$120.28,N/A,$124.00,N/A,N/A,$120.28
82270,0300,82270,,,,,N/A,N/A,GUAIAC CARD 3,$20.18,$15.00,$5.87,$67.00,N/A,$64.99,N/A,$6.35,N/A,$5.87,N/A,$64.99,N/A,$67.00,N/A,N/A,$64.99
3050108,0300,82270,,,,,N/A,N/A,STOOL OCCULT BLOOD,$67.60,$50.25,$5.87,$67.00,N/A,$64.99,N/A,$6.35,N/A,$5.87,N/A,$64.99,N/A,$67.00,N/A,N/A,$64.99
82272,0300,82272,,,,,N/A,N/A,Guaiac Single Rectal,$30.27,$22.50,$5.45,$67.00,N/A,$64.99,N/A,$5.94,N/A,$5.45,N/A,$64.99,N/A,$67.00,N/A,N/A,$64.99
3010205,0300,82310,,,,,N/A,N/A,CALCIUM,$84.75,$63.00,$32.27,$84.00,N/A,$81.48,N/A,$7.48,N/A,$32.27,N/A,$81.48,N/A,$84.00,N/A,N/A,$81.48
3091101,0300,82330,,,,,N/A,N/A,CALCIUM IONIZED,$263.33,$195.75,$6.29,$261.00,N/A,$253.17,N/A,$19.84,N/A,$6.29,N/A,$253.17,N/A,$261.00,N/A,N/A,$253.17
3090319,0300,82340,,,,,N/A,N/A,CALCIUM 24HR URINE,$147.31,$109.50,$16.35,$176.00,N/A,$170.72,N/A,$8.74,N/A,$16.35,N/A,$170.72,N/A,$176.00,N/A,N/A,$170.72
3091427,0300,82340,,,,,N/A,N/A,CALCIUM UR RANDOM (SCBL2972),$115.02,$85.50,$16.35,$176.00,N/A,$170.72,N/A,$8.74,N/A,$16.35,N/A,$170.72,N/A,$176.00,N/A,N/A,$170.72
3097319,0300,82340,,,,,N/A,N/A,CALCIUM 24H URN STA,$115.02,$85.50,$16.35,$176.00,N/A,$170.72,N/A,$8.74,N/A,$16.35,N/A,$170.72,N/A,$176.00,N/A,N/A,$170.72
3090020,0300,82360,,,,,N/A,N/A,Kidney Stone Analysis,$248.20,$184.50,$7.13,$246.00,N/A,$238.62,N/A,$18.66,N/A,$7.13,N/A,$238.62,N/A,$246.00,N/A,N/A,$238.62
3010210,0300,82374,,,,,N/A,N/A,CO2,$96.86,$72.00,$21.80,$140.00,N/A,$135.80,N/A,$7.08,N/A,$21.80,N/A,$135.80,N/A,$140.00,N/A,N/A,$135.80
3091117,0300,82375,,,,,N/A,N/A,CARBON MONOXIDE,$329.92,$245.25,$5.87,$119.00,N/A,$115.43,N/A,$17.86,N/A,$5.87,N/A,$115.43,N/A,$119.00,N/A,N/A,$115.43
3091027,0300,82378,,,,,N/A,N/A,CEA,$473.19,$351.75,$14.67,$246.00,N/A,$238.62,N/A,$27.49,N/A,$14.67,N/A,$238.62,N/A,$246.00,N/A,N/A,$238.62
3091426,0300,82384,,,,,N/A,N/A,CATECHOLAMINE FRACT URINE,$477.23,$354.75,$20.12,$273.00,N/A,$264.81,N/A,$36.61,N/A,$20.12,N/A,$264.81,N/A,$273.00,N/A,N/A,$264.81
3010209,0300,82435,,,,,N/A,N/A,CHLORIDE,$91.81,$68.25,$16.77,$91.00,N/A,$88.27,N/A,$6.67,N/A,$16.77,N/A,$88.27,N/A,$91.00,N/A,N/A,$88.27
3010225,0300,82465,,,,,N/A,N/A,CHOLESTEROL,$89.80,$66.75,$5.87,$101.00,N/A,$97.97,N/A,$6.31,N/A,$5.87,N/A,$97.97,N/A,$101.00,N/A,N/A,$97.97
3092054,0300,82491,,,,,N/A,N/A,MAYO TRIMIPRAMINE(SURMONTIL),$345.06,$256.50,$331.74,$342.00,N/A,$331.74,N/A,N/A,N/A,$342.00,N/A,$331.74,N/A,$342.00,N/A,N/A,$331.74
3092137,0300,82491,,,,,N/A,N/A,MAYO PROTRIPTYLINE (VIVACTYL),$147.31,$109.50,$331.74,$342.00,N/A,$331.74,N/A,N/A,N/A,$342.00,N/A,$331.74,N/A,$342.00,N/A,N/A,$331.74
3092055,0300,82495,,,,,N/A,N/A,MAYO CHROMIUM,$387.43,$288.00,$372.48,$384.00,N/A,$372.48,N/A,$29.41,N/A,$384.00,N/A,$372.48,N/A,$384.00,N/A,N/A,$372.48
3099817,0300,82507,,,,,N/A,N/A,MAYO CITRATE EXCRETION 24HR UR,$352.12,$261.75,$24.31,$349.00,N/A,$338.53,N/A,$37.19,N/A,$24.31,N/A,$338.53,N/A,$349.00,N/A,N/A,$338.53
3099425,0300,82525,,,,,N/A,N/A,COPPER 24 HR URINE,$238.11,$177.00,$22.63,$236.00,N/A,$228.92,N/A,$17.99,N/A,$22.63,N/A,$228.92,N/A,$236.00,N/A,N/A,$228.92
3091891,0300,82530,,,,,N/A,N/A,MAYO CORTISOL RANDOM URINE,$300.66,$223.50,$15.09,$316.00,N/A,$306.52,N/A,$19.50,N/A,$15.09,N/A,$306.52,N/A,$316.00,N/A,N/A,$306.52
3092454,0300,82530,,,,,N/A,N/A,MAYO CRTSL/CRTSNE FREE 24 URNE,$217.93,$162.00,$15.09,$316.00,N/A,$306.52,N/A,$19.50,N/A,$15.09,N/A,$306.52,N/A,$316.00,N/A,N/A,$306.52
3099926,0300,82530,,,,,N/A,N/A,MAYO CORTISOL 24HR URINE,$318.83,$237.00,$15.09,$316.00,N/A,$306.52,N/A,$19.50,N/A,$15.09,N/A,$306.52,N/A,$316.00,N/A,N/A,$306.52
3091929,0300,82542,,,,,N/A,N/A,MAYO PROPOXYPHENE CONFIRMAT,$351.11,$261.00,$251.23,$259.00,N/A,$251.23,N/A,$26.50,N/A,$259.00,N/A,$251.23,N/A,$259.00,N/A,N/A,$251.23
3092136,0300,82544,,,,,N/A,N/A,MAYO GUANIDINOACETATE,$494.38,$367.50,$475.30,$490.00,N/A,$475.30,N/A,N/A,N/A,$490.00,N/A,$475.30,N/A,$490.00,N/A,N/A,$475.30
3010216,0300,82550,,,,,N/A,N/A,CK,$128.14,$95.25,$123.19,$127.00,N/A,$123.19,N/A,$8.04,N/A,$127.00,N/A,$123.19,N/A,$127.00,N/A,N/A,$123.19
3091043,0300,82552,,,,,N/A,N/A,CK ISO & TOT CK,$407.61,$303.00,$7.96,$404.00,N/A,$391.88,N/A,$19.42,N/A,$7.96,N/A,$391.88,N/A,$404.00,N/A,N/A,$391.88
3099398,0300,82553,,,,,N/A,N/A,CK-MB (FAHC),$239.12,$177.75,$15.93,$237.00,N/A,$229.89,N/A,$13.47,N/A,$15.93,N/A,$229.89,N/A,$237.00,N/A,N/A,$229.89
3010203,0300,82565,,,,,N/A,N/A,CREATININE,$103.92,$77.25,$13.83,$116.00,N/A,$112.52,N/A,$7.42,N/A,$13.83,N/A,$112.52,N/A,$116.00,N/A,N/A,$112.52
3010264,0300,82570,,,,,N/A,N/A,"CREATININE, URINE RANDOM",$103.92,$77.25,$6.29,$103.00,N/A,$99.91,N/A,$6.04,N/A,$6.29,N/A,$99.91,N/A,$103.00,N/A,N/A,$99.91
3010317,0300,82570,,,,,N/A,N/A,CREATININE 24HR URIN,$103.92,$77.25,$6.29,$103.00,N/A,$99.91,N/A,$6.04,N/A,$6.29,N/A,$99.91,N/A,$103.00,N/A,N/A,$99.91
3010275,0300,82575,,,,,N/A,N/A,CREATININE CLEARANCE,$99.89,$74.25,$6.29,$99.00,N/A,$96.03,N/A,$11.04,N/A,$6.29,N/A,$96.03,N/A,$99.00,N/A,N/A,$96.03
3091087,0300,82595,,,,,N/A,N/A,"CRYGLOBULINS, QT",$128.14,$95.25,$17.18,$127.00,N/A,$123.19,N/A,$9.38,N/A,$17.18,N/A,$123.19,N/A,$127.00,N/A,N/A,$123.19
3099069,0300,82595,,,,,N/A,N/A,CRYOGLOBULIN QT,$484.29,$360.00,$17.18,$127.00,N/A,$123.19,N/A,$9.38,N/A,$17.18,N/A,$123.19,N/A,$127.00,N/A,N/A,$123.19
3091108,0300,82600,,,,,N/A,N/A,MAYO CYANIDE,$163.45,$121.50,$7.96,$162.00,N/A,$157.14,N/A,$28.13,N/A,$7.96,N/A,$157.14,N/A,$162.00,N/A,N/A,$157.14
3010266,0300,82607,,,,,N/A,N/A,VITAMIN B12,$202.80,$150.75,$23.47,$193.00,N/A,$187.21,N/A,$21.56,N/A,$23.47,N/A,$187.21,N/A,$193.00,N/A,N/A,$187.21
3091005,0300,82607,,,,,N/A,N/A,B12,$194.73,$144.75,$23.47,$193.00,N/A,$187.21,N/A,$21.56,N/A,$23.47,N/A,$187.21,N/A,$193.00,N/A,N/A,$187.21
3091275,0300,82627,,,,,N/A,N/A,DHEA-S,$407.61,$303.00,$30.18,$404.00,N/A,$391.88,N/A,$32.23,N/A,$30.18,N/A,$391.88,N/A,$404.00,N/A,N/A,$391.88
3092144,0300,82664,,,,,N/A,N/A,MAYO LIPOPROTEIN METB PROFIL,$71.63,$53.25,$26.82,$130.00,N/A,$126.10,N/A,$69.01,N/A,$26.82,N/A,$126.10,N/A,$130.00,N/A,N/A,$126.10
3091276,0300,82668,,,,,N/A,N/A,ERYTHOPOIETIN,$349.09,$259.50,$73.77,$346.00,N/A,$335.62,N/A,$27.25,N/A,$73.77,N/A,$335.62,N/A,$346.00,N/A,N/A,$335.62
3091090,0300,82670,,,,,N/A,N/A,ESTRADIOL,$316.81,$235.50,$22.63,$317.00,N/A,$307.49,N/A,$40.51,N/A,$22.63,N/A,$307.49,N/A,$317.00,N/A,N/A,$307.49
3092088,0300,82677,,,,,N/A,N/A,MAYO ESTRIOL UNCONJUGATED,$106.95,$79.50,$33.53,$458.00,N/A,$444.26,N/A,$35.06,N/A,$33.53,N/A,$444.26,N/A,$458.00,N/A,N/A,$444.26
3091322,0300,82710,,,,,N/A,N/A,12 HR FECAL FAT,$545.84,$405.75,$30.18,$541.00,N/A,$524.77,N/A,$24.36,N/A,$30.18,N/A,$524.77,N/A,$541.00,N/A,N/A,$524.77
3011110,0300,82728,,,,,N/A,N/A,FERRITIN,$142.26,$105.75,$23.89,$141.00,N/A,$136.77,N/A,$19.76,N/A,$23.89,N/A,$136.77,N/A,$141.00,N/A,N/A,$136.77
3010267,0300,82746,,,,,N/A,N/A,FOLATE,$261.32,$194.25,$77.54,$259.00,N/A,$251.23,N/A,$21.32,N/A,$77.54,N/A,$251.23,N/A,$259.00,N/A,N/A,$251.23
3091044,0300,82746,,,,,N/A,N/A,FOLATE (Serum),$261.32,$194.25,$77.54,$259.00,N/A,$251.23,N/A,$21.32,N/A,$77.54,N/A,$251.23,N/A,$259.00,N/A,N/A,$251.23
3091204,0300,82784,,,,,N/A,N/A,IGM,$51.46,$38.25,$17.60,$146.00,N/A,$141.62,N/A,$13.49,N/A,$17.60,N/A,$141.62,N/A,$146.00,N/A,N/A,$141.62
3091205,0300,82784,,,,,N/A,N/A,IGG,$50.45,$37.50,$17.60,$146.00,N/A,$141.62,N/A,$13.49,N/A,$17.60,N/A,$141.62,N/A,$146.00,N/A,N/A,$141.62
3091209,0300,82784,,,,,N/A,N/A,IGA,$50.45,$37.50,$17.60,$146.00,N/A,$141.62,N/A,$13.49,N/A,$17.60,N/A,$141.62,N/A,$146.00,N/A,N/A,$141.62
3099429,0300,82784,,,,,N/A,N/A,IgG (CSF),$147.31,$109.50,$17.60,$146.00,N/A,$141.62,N/A,$13.49,N/A,$17.60,N/A,$141.62,N/A,$146.00,N/A,N/A,$141.62
3091013,0300,82785,,,,,N/A,N/A,IGE,$316.81,$235.50,$11.32,$247.00,N/A,$239.59,N/A,$23.87,N/A,$11.32,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3091229,0300,82785,,,,,N/A,N/A,IMGLOB E,$249.21,$185.25,$11.32,$247.00,N/A,$239.59,N/A,$23.87,N/A,$11.32,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3017996,0300,82800,,,,,N/A,N/A,PH VENOUS/ARTER STAT,$119.05,$88.50,$9.64,$132.00,N/A,$128.04,N/A,$12.38,N/A,$9.64,N/A,$128.04,N/A,$132.00,N/A,N/A,$128.04
4500138,0300,82800,,,,,N/A,N/A,BLOOD GASES pH ONLY,$133.18,$99.00,$9.64,$132.00,N/A,$128.04,N/A,$12.38,N/A,$9.64,N/A,$128.04,N/A,$132.00,N/A,N/A,$128.04
3010212,0300,82803,,,,,N/A,N/A,PCO2 (Single),$369.27,$274.50,$13.41,$366.00,N/A,$355.02,N/A,$37.80,N/A,$13.41,N/A,$355.02,N/A,$366.00,N/A,N/A,$355.02
3017212,0300,82803,,,,,N/A,N/A,PCO2 STAT,$143.27,$106.50,$13.41,$366.00,N/A,$355.02,N/A,$37.80,N/A,$13.41,N/A,$355.02,N/A,$366.00,N/A,N/A,$355.02
3017213,0300,82803,,,,,N/A,N/A,PO2 STAT (Single),$143.27,$106.50,$13.41,$366.00,N/A,$355.02,N/A,$37.80,N/A,$13.41,N/A,$355.02,N/A,$366.00,N/A,N/A,$355.02
3017229,0300,82803,,,,,N/A,N/A,BLOODGAS STAT,$369.27,$274.50,$13.41,$366.00,N/A,$355.02,N/A,$37.80,N/A,$13.41,N/A,$355.02,N/A,$366.00,N/A,N/A,$355.02
3091100,0300,82941,,,,,N/A,N/A,GASTRIN,$335.98,$249.75,$94.72,$333.00,N/A,$323.01,N/A,$25.56,N/A,$94.72,N/A,$323.01,N/A,$333.00,N/A,N/A,$323.01
3050311,0300,82945,,,,,N/A,N/A,Semen Smear Only,$137.22,$102.00,$17.18,$81.00,N/A,$78.57,N/A,$5.70,N/A,$17.18,N/A,$78.57,N/A,$81.00,N/A,N/A,$78.57
3057103,0300,82945,,,,,N/A,N/A,GLUCOSE CSF STAT,$81.72,$60.75,$17.18,$81.00,N/A,$78.57,N/A,$5.70,N/A,$17.18,N/A,$78.57,N/A,$81.00,N/A,N/A,$78.57
3010201,0300,82947,,,,,N/A,N/A,GLUCOSE SERUM,$81.72,$60.75,$4.61,$81.00,N/A,$78.57,N/A,$5.70,N/A,$4.61,N/A,$78.57,N/A,$81.00,N/A,N/A,$78.57
3010228,0300,82947,,,,,N/A,N/A,GLUCOSE 1-2 HR PP,$81.72,$60.75,$4.61,$81.00,N/A,$78.57,N/A,$5.70,N/A,$4.61,N/A,$78.57,N/A,$81.00,N/A,N/A,$78.57
82947LSC,0300,82947,,,,,N/A,N/A,BLOOD SUGAR QUANTITATIVE,$35.31,$26.25,$4.61,$81.00,N/A,$78.57,N/A,$5.70,N/A,$4.61,N/A,$78.57,N/A,$81.00,N/A,N/A,$78.57
82962,0300,82962,,,,,N/A,N/A,BLOOD GLUCOSE,$9.08,$6.75,$10.67,$11.74,N/A,$10.67,N/A,$4.76,N/A,$11.74,N/A,$10.67,N/A,$11.00,N/A,N/A,$10.67
4582962,0300,82962,,,,,N/A,N/A,BLOOD GLUCOSE MONITORING FS,$51.46,$38.25,$10.67,$11.74,N/A,$10.67,N/A,$4.76,N/A,$11.74,N/A,$10.67,N/A,$11.00,N/A,N/A,$10.67
7182962,0300,82962,,,,,N/A,N/A,BLOOD GLUCOSE,$11.10,$8.25,$10.67,$11.74,N/A,$10.67,N/A,$4.76,N/A,$11.74,N/A,$10.67,N/A,$11.00,N/A,N/A,$10.67
83036,0300,83036,,,,,N/A,N/A,GLYCOSYLATED HEMOGLOBIN TEST,$28.25,$21.00,$21.80,$103.00,N/A,$99.91,N/A,N/A,N/A,$21.80,N/A,$99.91,N/A,$103.00,N/A,N/A,$99.91
83036QW,0300,83036,,,,,N/A,N/A,GLYCOSYLATED HEMOGLOBIN TEST,$28.25,$21.00,$21.80,$103.00,N/A,$99.91,N/A,N/A,N/A,$21.80,N/A,$99.91,N/A,$103.00,N/A,N/A,$99.91
3091963,0300,83088,,,,,N/A,N/A,MAYO HISTAMINE 24 HR URINE,$544.83,$405.00,$20.12,$540.00,N/A,$523.80,N/A,N/A,N/A,$20.12,N/A,$523.80,N/A,$540.00,N/A,N/A,$523.80
3091912,0300,83150,,,,,N/A,N/A,MAYO HOMOVANILLIC ACID URINE,$173.54,$129.00,$21.38,$172.00,N/A,$166.84,N/A,N/A,N/A,$21.38,N/A,$166.84,N/A,$172.00,N/A,N/A,$166.84
3091372,0300,83497,,,,,N/A,N/A,5HIAA,$589.22,$438.00,$21.38,$584.00,N/A,$566.48,N/A,N/A,N/A,$21.38,N/A,$566.48,N/A,$584.00,N/A,N/A,$566.48
3091797,0300,83516,,,,,N/A,N/A,MAYO MYELOPEROXIDASE AB,$249.21,$185.25,$27.24,$222.00,N/A,$215.34,N/A,N/A,N/A,$27.24,N/A,$215.34,N/A,$222.00,N/A,N/A,$215.34
3092255,0300,83516,,,,,N/A,N/A,MAYO HISTONE AUTOANTIBODIES,$223.98,$166.50,$27.24,$222.00,N/A,$215.34,N/A,N/A,N/A,$27.24,N/A,$215.34,N/A,$222.00,N/A,N/A,$215.34
3092272,0300,83516,,,,,N/A,N/A,MAYO PROTEINASE 3 AB,$126.12,$93.75,$27.24,$222.00,N/A,$215.34,N/A,N/A,N/A,$27.24,N/A,$215.34,N/A,$222.00,N/A,N/A,$215.34
3091301,0300,83519,,,,,N/A,N/A,MAYO PARANEOPLAS AUTOANTIB,$691.12,$513.75,$13.83,$257.00,N/A,$249.29,N/A,N/A,N/A,$13.83,N/A,$249.29,N/A,$257.00,N/A,N/A,$249.29
3091895,0300,83519,,,,,N/A,N/A,MAYO PARANEOPLAS AUTOANTIB,$259.30,$192.75,$13.83,$257.00,N/A,$249.29,N/A,N/A,N/A,$13.83,N/A,$249.29,N/A,$257.00,N/A,N/A,$249.29
3091896,0300,83519,,,,,N/A,N/A,MAYO PARANEOPLAS AUTOANTIB,$259.30,$192.75,$13.83,$257.00,N/A,$249.29,N/A,N/A,N/A,$13.83,N/A,$249.29,N/A,$257.00,N/A,N/A,$249.29
3091936,0300,83519,,,,,N/A,N/A,MAYO THYROTROPIN RELEAS HORMON,$532.72,$396.00,$13.83,$257.00,N/A,$249.29,N/A,N/A,N/A,$13.83,N/A,$249.29,N/A,$257.00,N/A,N/A,$249.29
3092300,0300,83519,,,,,N/A,N/A,MAYO 21 HYDROXYLASE AB,$259.30,$192.75,$13.83,$257.00,N/A,$249.29,N/A,N/A,N/A,$13.83,N/A,$249.29,N/A,$257.00,N/A,N/A,$249.29
3091712,0300,83520,,,,,N/A,N/A,MAYO PARANEOPLAS AUTOANTIB,$249.21,$185.25,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3091958,0300,83520,,,,,N/A,N/A,Mayo Inflammatorybowel Panel,$249.21,$185.25,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3091959,0300,83520,,,,,N/A,N/A,Mayo Inflammatorybowel Panel,$249.21,$185.25,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3091973,0300,83520,,,,,N/A,N/A,MAYO IGF BINDING PROTEIN 3,$249.21,$185.25,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3092366,0300,83520,,,,,N/A,N/A,MAYO HU ANTIBODY,$249.21,$185.25,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3092367,0300,83520,,,,,N/A,N/A,MAYO HU ANTIBODY,$249.21,$185.25,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3099783,0300,83520,,,,,N/A,N/A,MAYO C1 ESTERASE INHIBITOR,$249.21,$185.25,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3092152,0300,83615,,,,,N/A,N/A,MAYO LD BODY FLUID,$106.95,$79.50,$13.83,$118.00,N/A,$114.46,N/A,N/A,N/A,$13.83,N/A,$114.46,N/A,$118.00,N/A,N/A,$114.46
3010296,0300,83690,,,,,N/A,N/A,LIPASE,$94.84,$70.50,$14.67,$94.00,N/A,$91.18,N/A,N/A,N/A,$14.67,N/A,$91.18,N/A,$94.00,N/A,N/A,$91.18
3091961,0300,83716,,,,,N/A,N/A,MAYO LDL SUBFRACTIONATION,$156.39,$116.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3010258,0300,83718,,,,,N/A,N/A,LIPID 2 HDL,$129.14,$96.00,$41.08,$128.00,N/A,$124.16,N/A,N/A,N/A,$41.08,N/A,$124.16,N/A,$128.00,N/A,N/A,$124.16
3092455,0300,83789,,,,,N/A,N/A,MAYO CRTSL/CRTSNE FREE 24 URNE,$217.93,$162.00,$31.85,$385.00,N/A,$373.45,N/A,N/A,N/A,$31.85,N/A,$373.45,N/A,$385.00,N/A,N/A,$373.45
3099927,0300,83789,,,,,N/A,N/A,MAYO CORTISOL 24HR URINE,$345.06,$256.50,$31.85,$385.00,N/A,$373.45,N/A,N/A,N/A,$31.85,N/A,$373.45,N/A,$385.00,N/A,N/A,$373.45
3092062,0300,83835,,,,,N/A,N/A,MAYO METANEP FRAC RAND URINE,$86.77,$64.50,$19.70,$320.00,N/A,$310.40,N/A,N/A,N/A,$19.70,N/A,$310.40,N/A,$320.00,N/A,N/A,$310.40
3099102,0300,83872,,,,,N/A,N/A,FAHC MUCIN CLOT,$117.04,$87.00,$34.37,$116.00,N/A,$112.52,N/A,N/A,N/A,$34.37,N/A,$112.52,N/A,$116.00,N/A,N/A,$112.52
3092183,0300,83890,,,,,N/A,N/A,MAYO MEN2 MUTATION SCREEN,$36.32,$27.00,$29.34,$179.00,N/A,$173.63,N/A,N/A,N/A,$29.34,N/A,$173.63,N/A,$179.00,N/A,N/A,$173.63
3099402,0300,83890,,,,,N/A,N/A,HEMOCHROMATOSIS GENE TEST 3,$84.75,$63.00,$29.34,$179.00,N/A,$173.63,N/A,N/A,N/A,$29.34,N/A,$173.63,N/A,$179.00,N/A,N/A,$173.63
3092185,0300,83892,,,,,N/A,N/A,MAYO MEN2 MUTATION SCREEN,$36.32,$27.00,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3092186,0300,83892,,,,,N/A,N/A,MAYO MEN2 MUTATION SCREEN,$36.32,$27.00,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3099174,0300,83892,,,,,N/A,N/A,HEP CRNA TEST 1,$200.78,$149.25,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3099400,0300,83892,,,,,N/A,N/A,HEMOCHROMATOSIS GENE TEST 1,$76.68,$57.00,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3095014,0300,83894,,,,,N/A,N/A,SEPARATION,$156.39,$116.25,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3095015,0300,83894,,,,,N/A,N/A,SEPARATION (2),$156.39,$116.25,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3099050,0300,83894,,,,,N/A,N/A,SEPARATION,$209.86,$156.00,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3099175,0300,83894,,,,,N/A,N/A,HEP CRNA TEST 2,$200.78,$149.25,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3099404,0300,83894,,,,,N/A,N/A,HEMOCHROMATOSIS GENE TEST 5,$76.68,$57.00,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3092095,0300,83896,,,,,N/A,N/A,FACTOR 5 MUTATION #22722,$88.79,$66.00,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3092096,0300,83896,,,,,N/A,N/A,FACTOR 5 MUTATION #22722,$88.79,$66.00,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3092111,0300,83896,,,,,N/A,N/A,MAYO TAY SACHS,$88.79,$66.00,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3095010,0300,83896,,,,,N/A,N/A,NUCLEI C ACID PROBE,$156.39,$116.25,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3095011,0300,83896,,,,,N/A,N/A,NUCLEI C ACID PROBE (2),$156.39,$116.25,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3099051,0300,83896,,,,,N/A,N/A,NUCLEI ACID PROBE,$209.86,$156.00,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3099176,0300,83896,,,,,N/A,N/A,HEP CRNA TEST 3,$200.78,$149.25,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3095012,0300,83898,,,,,N/A,N/A,MOLECULAR DIAG. AMP.,$249.21,$185.25,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3095013,0300,83898,,,,,N/A,N/A,MOLECULAR DIAG. AMP (2),$249.21,$185.25,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3099052,0300,83898,,,,,N/A,N/A,MOLECULAR DIAGNOSTIC,$209.86,$156.00,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3099177,0300,83898,,,,,N/A,N/A,HEP CRNA TEST 4,$200.78,$149.25,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092184,0300,83900,,,,,N/A,N/A,MAYO MEN2 MUTATION SCREEN,$36.32,$27.00,$73.72,$76.00,N/A,$73.72,N/A,N/A,N/A,$76.00,N/A,$73.72,N/A,$76.00,N/A,N/A,$73.72
3099401,0300,83900,,,,,N/A,N/A,HEMOCHROMATOSIS GENE TEST 2,$76.68,$57.00,$73.72,$76.00,N/A,$73.72,N/A,N/A,N/A,$76.00,N/A,$73.72,N/A,$76.00,N/A,N/A,$73.72
3099047,0300,83902,,,,,N/A,N/A,HEP TEST 1,$209.86,$156.00,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3099178,0300,83902,,,,,N/A,N/A,HEP CRNA TEST 5,$200.78,$149.25,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3092097,0300,83903,,,,,N/A,N/A,FACTOR 5 MUTATION #22722,$89.80,$66.75,$86.33,$89.00,N/A,$86.33,N/A,N/A,N/A,$89.00,N/A,$86.33,N/A,$89.00,N/A,N/A,$86.33
3092158,0300,83904,,,,,N/A,N/A,MAYO MEN2 MUTATION SCREEN,$35.31,$26.25,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092159,0300,83904,,,,,N/A,N/A,MAYO MEN2 MUTATION SCREEN,$35.31,$26.25,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092160,0300,83904,,,,,N/A,N/A,MAYO MEN2 MUTATION SCREEN,$35.31,$26.25,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092161,0300,83904,,,,,N/A,N/A,MAYO MEN2 MUTATION SCREEN,$35.31,$26.25,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092162,0300,83904,,,,,N/A,N/A,MAYO MEN2 MUTATION SCREEN,$35.31,$26.25,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092163,0300,83904,,,,,N/A,N/A,MAYO MEN2 MUTATION SCREEN,$35.31,$26.25,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092164,0300,83904,,,,,N/A,N/A,MAYO MEN2 MUTATION SCREEN,$35.31,$26.25,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092165,0300,83904,,,,,N/A,N/A,MAYO MEN2 MUTATION SCREEN,$35.31,$26.25,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092166,0300,83904,,,,,N/A,N/A,MAYO MEN2 MUTATION SCREEN,$35.31,$26.25,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092167,0300,83904,,,,,N/A,N/A,MAYO MEN2 MUTATION SCREEN,$35.31,$26.25,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092168,0300,83904,,,,,N/A,N/A,MAYO MEN2 MUTATION SCREEN,$35.31,$26.25,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092169,0300,83904,,,,,N/A,N/A,MAYO MEN2 MUTATION SCREEN,$35.31,$26.25,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092098,0300,83908,,,,,N/A,N/A,FACTOR 5 MUTATION #22722,$88.79,$66.00,$85.36,$88.00,N/A,$85.36,N/A,N/A,N/A,$88.00,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3092099,0300,83908,,,,,N/A,N/A,FACTOR 5 MUTATION #22722,$88.79,$66.00,$85.36,$88.00,N/A,$85.36,N/A,N/A,N/A,$88.00,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3092170,0300,83909,,,,,N/A,N/A,MAYO MEN2 MUTATION SCREEN,$35.31,$26.25,$33.95,$35.00,N/A,$33.95,N/A,N/A,N/A,$35.00,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
3092171,0300,83909,,,,,N/A,N/A,MAYO MEN2 MUTATION SCREEN,$35.31,$26.25,$33.95,$35.00,N/A,$33.95,N/A,N/A,N/A,$35.00,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
3092172,0300,83909,,,,,N/A,N/A,MAYO MEN2 MUTATION SCREEN,$35.31,$26.25,$33.95,$35.00,N/A,$33.95,N/A,N/A,N/A,$35.00,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
3092173,0300,83909,,,,,N/A,N/A,MAYO MEN2 MUTATION SCREEN,$35.31,$26.25,$33.95,$35.00,N/A,$33.95,N/A,N/A,N/A,$35.00,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
3092174,0300,83909,,,,,N/A,N/A,MAYO MEN2 MUTATION SCREEN,$35.31,$26.25,$33.95,$35.00,N/A,$33.95,N/A,N/A,N/A,$35.00,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
3092175,0300,83909,,,,,N/A,N/A,MAYO MEN2 MUTATION SCREEN,$35.31,$26.25,$33.95,$35.00,N/A,$33.95,N/A,N/A,N/A,$35.00,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
3092176,0300,83909,,,,,N/A,N/A,MAYO MEN2 MUTATION SCREEN,$35.31,$26.25,$33.95,$35.00,N/A,$33.95,N/A,N/A,N/A,$35.00,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
3092177,0300,83909,,,,,N/A,N/A,MAYO MEN2 MUTATION SCREEN,$35.31,$26.25,$33.95,$35.00,N/A,$33.95,N/A,N/A,N/A,$35.00,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
3092178,0300,83909,,,,,N/A,N/A,MAYO MEN2 MUTATION SCREEN,$35.31,$26.25,$33.95,$35.00,N/A,$33.95,N/A,N/A,N/A,$35.00,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
3092179,0300,83909,,,,,N/A,N/A,MAYO MEN2 MUTATION SCREEN,$35.31,$26.25,$33.95,$35.00,N/A,$33.95,N/A,N/A,N/A,$35.00,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
3092180,0300,83909,,,,,N/A,N/A,MAYO MEN2 MUTATION SCREEN,$35.31,$26.25,$33.95,$35.00,N/A,$33.95,N/A,N/A,N/A,$35.00,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
3092181,0300,83909,,,,,N/A,N/A,MAYO MEN2 MUTATION SCREEN,$35.31,$26.25,$33.95,$35.00,N/A,$33.95,N/A,N/A,N/A,$35.00,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
3092182,0300,83912,,,,,N/A,N/A,MAYO MEN2 MUTATION SCREEN,$36.32,$27.00,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3095006,0300,83912,,,,,N/A,N/A,INTERPRETATION,$180.60,$134.25,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3099031,0300,83912,,,,,N/A,N/A,INTERPRETATION,$234.07,$174.00,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3099048,0300,83912,,,,,N/A,N/A,INTERPRETATION,$209.86,$156.00,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3099179,0300,83912,,,,,N/A,N/A,HEP CRNA TEST 6,$200.78,$149.25,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3099405,0300,83912,,,,,N/A,N/A,HEMOCHROMATOSIS GENE TEST 6,$76.68,$57.00,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3091394,0300,83915,,,,,N/A,N/A,NUCLEOTIDASE 5,$265.35,$197.25,$255.11,$263.00,N/A,$255.11,N/A,N/A,N/A,$263.00,N/A,$255.11,N/A,$263.00,N/A,N/A,$255.11
3092218,0300,83916,,,,,N/A,N/A,MAYO OLIGOCLONAL BANDS,$384.41,$285.75,$13.41,$381.00,N/A,$369.57,N/A,N/A,N/A,$13.41,N/A,$369.57,N/A,$381.00,N/A,N/A,$369.57
3092219,0300,83916,,,,,N/A,N/A,MAYO OLIGOCLONAL BANDS,$384.41,$285.75,$13.41,$381.00,N/A,$369.57,N/A,N/A,N/A,$13.41,N/A,$369.57,N/A,$381.00,N/A,N/A,$369.57
3091047,0300,83930,,,,,N/A,N/A,OSMOLALITY,$129.14,$96.00,$124.16,$128.00,N/A,$124.16,N/A,N/A,N/A,$128.00,N/A,$124.16,N/A,$128.00,N/A,N/A,$124.16
3091419,0300,83935,,,,,N/A,N/A,OSMOLALITY URINE (#678),$134.19,$99.75,$7.96,$279.00,N/A,$270.63,N/A,N/A,N/A,$7.96,N/A,$270.63,N/A,$279.00,N/A,N/A,$270.63
3092059,0300,83935,,,,,N/A,N/A,MAYO VASOPRESSION URINE,$281.49,$209.25,$7.96,$279.00,N/A,$270.63,N/A,N/A,N/A,$7.96,N/A,$270.63,N/A,$279.00,N/A,N/A,$270.63
3091203,0300,83945,,,,,N/A,N/A,OXALATE 24 HR URINE,$248.20,$184.50,$36.05,$246.00,N/A,$238.62,N/A,N/A,N/A,$36.05,N/A,$238.62,N/A,$246.00,N/A,N/A,$238.62
3099347,0300,83970,,,,,N/A,N/A,FAHC PTH INTACT,$753.68,$560.25,$17.18,$747.00,N/A,$724.59,N/A,N/A,N/A,$17.18,N/A,$724.59,N/A,$747.00,N/A,N/A,$724.59
83986,0300,83986,,,,,N/A,N/A,NITRA TEST PAPER,$10.09,$7.50,$49.46,$61.00,N/A,$59.17,N/A,N/A,N/A,$49.46,N/A,$59.17,N/A,$61.00,N/A,N/A,$59.17
3057947,0300,83986,,,,,N/A,N/A,PH BODY FLUID,$61.55,$45.75,$49.46,$61.00,N/A,$59.17,N/A,N/A,N/A,$49.46,N/A,$59.17,N/A,$61.00,N/A,N/A,$59.17
3090112,0300,83986,,,,,N/A,N/A,PH STOOL,$45.40,$33.75,$49.46,$61.00,N/A,$59.17,N/A,N/A,N/A,$49.46,N/A,$59.17,N/A,$61.00,N/A,N/A,$59.17
3090530,0300,84030,,,,,N/A,N/A,PKU & NEWBORN SCREEN,$283.51,$210.75,$23.47,$281.00,N/A,$272.57,N/A,N/A,N/A,$23.47,N/A,$272.57,N/A,$281.00,N/A,N/A,$272.57
3091211,0300,84066,,,,,N/A,N/A,ACID PHOS FRACT,$186.65,$138.75,$6.71,$185.00,N/A,$179.45,N/A,N/A,N/A,$6.71,N/A,$179.45,N/A,$185.00,N/A,N/A,$179.45
3010217,0300,84075,,,,,N/A,N/A,ALK PHOSPHATASE,$103.92,$77.25,$11.74,$103.00,N/A,$99.91,N/A,N/A,N/A,$11.74,N/A,$99.91,N/A,$103.00,N/A,N/A,$99.91
3091035,0300,84080,,,,,N/A,N/A,ALKAL PHOS ISOE,$627.56,$466.50,$6.29,$281.00,N/A,$272.57,N/A,N/A,N/A,$6.29,N/A,$272.57,N/A,$281.00,N/A,N/A,$272.57
3010206,0300,84100,,,,,N/A,N/A,PHOSPHORUS,$95.85,$71.25,$17.60,$95.00,N/A,$92.15,N/A,N/A,N/A,$17.60,N/A,$92.15,N/A,$95.00,N/A,N/A,$92.15
3091979,0300,84126,,,,,N/A,N/A,MAYO PORPHYRINS FECES,$360.19,$267.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3010208,0300,84132,,,,,N/A,N/A,POTASSIUM,$91.81,$68.25,$17.60,$137.00,N/A,$132.89,N/A,N/A,N/A,$17.60,N/A,$132.89,N/A,$137.00,N/A,N/A,$132.89
3010726,0300,84133,,,,,N/A,N/A,"POTASSIUM, URINE",$88.79,$66.00,$5.87,$88.00,N/A,$85.36,N/A,N/A,N/A,$5.87,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3091449,0300,84134,,,,,N/A,N/A,PREALBUMIN,$280.49,$208.50,$5.87,$278.00,N/A,$269.66,N/A,N/A,N/A,$5.87,N/A,$269.66,N/A,$278.00,N/A,N/A,$269.66
3091049,0300,84144,,,,,N/A,N/A,PROGESTERONE,$384.41,$285.75,$27.24,$381.00,N/A,$369.57,N/A,N/A,N/A,$27.24,N/A,$369.57,N/A,$381.00,N/A,N/A,$369.57
3091048,0300,84146,,,,,N/A,N/A,PROLACTIN,$404.58,$300.75,$32.69,$401.00,N/A,$388.97,N/A,N/A,N/A,$32.69,N/A,$388.97,N/A,$401.00,N/A,N/A,$388.97
3010240,0300,84153,,,,,N/A,N/A,"PSA, SCREENING NVRH",$352.12,$261.75,$50.30,$337.00,N/A,$326.89,N/A,N/A,N/A,$50.30,N/A,$326.89,N/A,$337.00,N/A,N/A,$326.89
3091325,0300,84153,,,,,N/A,N/A,Psa Total & Free,$340.01,$252.75,$50.30,$337.00,N/A,$326.89,N/A,N/A,N/A,$50.30,N/A,$326.89,N/A,$337.00,N/A,N/A,$326.89
3010221,0300,84155,,,,,N/A,N/A,TOTAL PROTEIN,$72.64,$54.00,$22.21,$72.00,N/A,$69.84,N/A,N/A,N/A,$22.21,N/A,$69.84,N/A,$72.00,N/A,N/A,$69.84
3010316,0300,84155,,,,,N/A,N/A,PROTEIN 24HR URINE,$72.64,$54.00,$22.21,$72.00,N/A,$69.84,N/A,N/A,N/A,$22.21,N/A,$69.84,N/A,$72.00,N/A,N/A,$69.84
3057102,0300,84155,,,,,N/A,N/A,Total Protein (Csf),$72.64,$54.00,$22.21,$72.00,N/A,$69.84,N/A,N/A,N/A,$22.21,N/A,$69.84,N/A,$72.00,N/A,N/A,$69.84
3099128,0300,84155,,,,,N/A,N/A,PROTEIN 1,$72.64,$54.00,$22.21,$72.00,N/A,$69.84,N/A,N/A,N/A,$22.21,N/A,$69.84,N/A,$72.00,N/A,N/A,$69.84
3091014,0300,84165,,,,,N/A,N/A,PROTEIN ELEC,$206.83,$153.75,$4.61,$205.00,$84.50,$198.85,$84.50,N/A,$84.50,$4.61,$84.50,$198.85,$84.50,$205.00,$84.50,$84.50,$198.85
3099010,0300,84165,,,,,N/A,N/A,IMMUNOFIXATION 24% UR 2,$206.83,$153.75,$4.61,$205.00,$84.50,$198.85,$84.50,N/A,$84.50,$4.61,$84.50,$198.85,$84.50,$205.00,$84.50,$84.50,$198.85
3099129,0300,84165,,,,,N/A,N/A,PROTEIN ELEC 2,$206.83,$153.75,$4.61,$205.00,$84.50,$198.85,$84.50,N/A,$84.50,$4.61,$84.50,$198.85,$84.50,$205.00,$84.50,$84.50,$198.85
3092365,0300,84182,,,,,N/A,N/A,MAYO HU ANTIBODY,$249.21,$185.25,$43.21,$258.71,$258.71,$239.59,$258.71,N/A,$258.71,$43.21,$258.71,$239.59,$258.71,$247.00,$258.71,$258.71,$239.59
3091226,0300,84202,,,,,N/A,N/A,FEP,$281.49,$209.25,$57.04,$236.00,N/A,$228.92,N/A,N/A,N/A,$57.04,N/A,$228.92,N/A,$236.00,N/A,N/A,$228.92
3099337,0300,84207,,,,,N/A,N/A,VITAMIN B6,$532.72,$396.00,$31.85,$528.00,N/A,$512.16,N/A,N/A,N/A,$31.85,N/A,$512.16,N/A,$528.00,N/A,N/A,$512.16
3091945,0300,84238,,,,,N/A,N/A,MAYO SOLUBLE TRANSFERRIN RECEP,$187.66,$139.50,$85.50,$186.00,N/A,$180.42,N/A,N/A,N/A,$85.50,N/A,$180.42,N/A,$186.00,N/A,N/A,$180.42
3091319,0300,84244,,,,,N/A,N/A,RENIN,$418.71,$311.25,$44.01,$415.00,N/A,$402.55,N/A,N/A,N/A,$44.01,N/A,$402.55,N/A,$415.00,N/A,N/A,$402.55
3092056,0300,84255,,,,,N/A,N/A,MAYO SELENIUM,$99.89,$74.25,$24.31,$136.00,N/A,$131.92,N/A,N/A,N/A,$24.31,N/A,$131.92,N/A,$136.00,N/A,N/A,$131.92
3091974,0300,84260,,,,,N/A,N/A,MAYO SEROTONIN,$589.22,$438.00,$30.60,$584.00,N/A,$566.48,N/A,N/A,N/A,$30.60,N/A,$566.48,N/A,$584.00,N/A,N/A,$566.48
3010207,0300,84295,,,,,N/A,N/A,SODIUM,$89.80,$66.75,$25.99,$89.00,N/A,$86.33,N/A,N/A,N/A,$25.99,N/A,$86.33,N/A,$89.00,N/A,N/A,$86.33
3010724,0300,84300,,,,,N/A,N/A,"SODIUM, URINE",$96.86,$72.00,$5.87,$264.00,N/A,$256.08,N/A,N/A,N/A,$5.87,N/A,$256.08,N/A,$264.00,N/A,N/A,$256.08
3091016,0300,84305,,,,,N/A,N/A,SKBL SOMATOMEDIN C L,$494.38,$367.50,$5.87,$490.00,N/A,$475.30,N/A,N/A,N/A,$5.87,N/A,$475.30,N/A,$490.00,N/A,N/A,$475.30
3099362,0300,84305,,,,,N/A,N/A,SOMATOMEDIN-C (ENDOCRINE SCIE),$321.85,$239.25,$5.87,$490.00,N/A,$475.30,N/A,N/A,N/A,$5.87,N/A,$475.30,N/A,$490.00,N/A,N/A,$475.30
3092032,0300,84425,,,,,N/A,N/A,MAYO VITAMIN B1,$405.59,$301.50,$31.02,$402.00,N/A,$389.94,N/A,N/A,N/A,$31.02,N/A,$389.94,N/A,$402.00,N/A,N/A,$389.94
3010719,0300,84436,,,,,N/A,N/A,T4,$135.20,$100.50,$19.28,$134.00,N/A,$129.98,N/A,N/A,N/A,$19.28,N/A,$129.98,N/A,$134.00,N/A,N/A,$129.98
3010237,0300,84439,,,,,N/A,N/A,FREE T4 (NVRH),$170.51,$126.75,$8.38,$169.00,N/A,$163.93,N/A,N/A,N/A,$8.38,N/A,$163.93,N/A,$169.00,N/A,N/A,$163.93
3092053,0300,84442,,,,,N/A,N/A,MAYO THYROXINE BIND GLOBULIN,$117.04,$87.00,$10.90,$116.00,N/A,$112.52,N/A,N/A,N/A,$10.90,N/A,$112.52,N/A,$116.00,N/A,N/A,$112.52
3011007,0300,84443,,,,,N/A,N/A,TSH,$309.74,$230.25,$17.60,$342.00,N/A,$331.74,N/A,N/A,N/A,$17.60,N/A,$331.74,N/A,$342.00,N/A,N/A,$331.74
3099330,0300,84443,,,,,N/A,N/A,MAYO TSH SENSITIVE,$345.06,$256.50,$17.60,$342.00,N/A,$331.74,N/A,N/A,N/A,$17.60,N/A,$331.74,N/A,$342.00,N/A,N/A,$331.74
3099280,0300,84445,,,,,N/A,N/A,THYROID STIM IMMUNOGLOBLN,$960.51,$714.00,$20.12,$952.00,N/A,$923.44,N/A,N/A,N/A,$20.12,N/A,$923.44,N/A,$952.00,N/A,N/A,$923.44
3091317,0300,84446,,,,,N/A,N/A,VITAMIN E,$274.43,$204.00,$61.19,$272.00,N/A,$263.84,N/A,N/A,N/A,$61.19,N/A,$263.84,N/A,$272.00,N/A,N/A,$263.84
3010214,0300,84450,,,,,N/A,N/A,SGOT (AST),$103.92,$77.25,$17.18,$103.00,N/A,$99.91,N/A,N/A,N/A,$17.18,N/A,$99.91,N/A,$103.00,N/A,N/A,$99.91
3010241,0300,84460,,,,,N/A,N/A,ALT,$94.84,$70.50,$6.29,$94.00,N/A,$91.18,N/A,N/A,N/A,$6.29,N/A,$91.18,N/A,$94.00,N/A,N/A,$91.18
3091196,0300,84466,,,,,N/A,N/A,TRANSFERRIN,$245.17,$182.25,$6.29,$243.00,N/A,$235.71,N/A,N/A,N/A,$6.29,N/A,$235.71,N/A,$243.00,N/A,N/A,$235.71
3010224,0300,84478,,,,,N/A,N/A,TRIGLYCERIDES,$115.02,$85.50,$15.51,$210.00,N/A,$203.70,N/A,N/A,N/A,$15.51,N/A,$203.70,N/A,$210.00,N/A,N/A,$203.70
3090718,0300,84480,,,,,N/A,N/A,TOTAL T3,$264.34,$196.50,$7.96,$262.00,N/A,$254.14,N/A,N/A,N/A,$7.96,N/A,$254.14,N/A,$262.00,N/A,N/A,$254.14
3091232,0300,84481,,,,,N/A,N/A,T3 FREE,$311.76,$231.75,$17.18,$309.00,N/A,$299.73,N/A,N/A,N/A,$17.18,N/A,$299.73,N/A,$309.00,N/A,N/A,$299.73
3017950,0300,84484,,,,,N/A,N/A,"TROPONIN-I, QT",$191.70,$142.50,$18.86,$190.00,N/A,$184.30,N/A,N/A,N/A,$18.86,N/A,$184.30,N/A,$190.00,N/A,N/A,$184.30
3010202,0300,84520,,,,,N/A,N/A,UREA NITROGEN,$70.63,$52.50,$67.90,$70.00,N/A,$67.90,N/A,N/A,N/A,$70.00,N/A,$67.90,N/A,$70.00,N/A,N/A,$67.90
3092119,0300,84540,,,,,N/A,N/A,FAHC BUN 24HR URINE,$24.21,$18.00,$4.61,$24.00,N/A,$23.28,N/A,N/A,N/A,$4.61,N/A,$23.28,N/A,$24.00,N/A,N/A,$23.28
3010204,0300,84550,,,,,N/A,N/A,URIC ACID,$90.80,$67.50,$6.71,$90.00,N/A,$87.30,N/A,N/A,N/A,$6.71,N/A,$87.30,N/A,$90.00,N/A,N/A,$87.30
3090318,0300,84560,,,,,N/A,N/A,URIC ACID 24HR URIN,$147.31,$109.50,$5.45,$186.00,N/A,$180.42,N/A,N/A,N/A,$5.45,N/A,$180.42,N/A,$186.00,N/A,N/A,$180.42
3091447,0300,84560,,,,,N/A,N/A,URIC ACID RU (SCBL1744),$187.66,$139.50,$5.45,$186.00,N/A,$180.42,N/A,N/A,N/A,$5.45,N/A,$180.42,N/A,$186.00,N/A,N/A,$180.42
3099123,0300,84560,,,,,N/A,N/A,URIC ACID,$89.80,$66.75,$5.45,$186.00,N/A,$180.42,N/A,N/A,N/A,$5.45,N/A,$180.42,N/A,$186.00,N/A,N/A,$180.42
3091002,0300,84585,,,,,N/A,N/A,VMA,$298.65,$222.00,$6.29,$296.00,N/A,$287.12,N/A,N/A,N/A,$6.29,N/A,$287.12,N/A,$296.00,N/A,N/A,$287.12
3091095,0300,84586,,,,,N/A,N/A,VIP,$365.24,$271.50,$18.44,$362.00,N/A,$351.14,N/A,N/A,N/A,$18.44,N/A,$351.14,N/A,$362.00,N/A,N/A,$351.14
3092060,0300,84588,,,,,N/A,N/A,MAYO VASOPRESSION URINE,$283.51,$210.75,$42.33,$281.00,N/A,$272.57,N/A,N/A,N/A,$42.33,N/A,$272.57,N/A,$281.00,N/A,N/A,$272.57
3091036,0300,84590,,,,,N/A,N/A,VITAMIN A LEVEL,$224.99,$167.25,$40.66,$223.00,N/A,$216.31,N/A,N/A,N/A,$40.66,N/A,$216.31,N/A,$223.00,N/A,N/A,$216.31
3091965,0300,84600,,,,,N/A,N/A,FAHC ALCOHOL SCREEN,$309.74,$230.25,$16.35,$307.00,N/A,$297.79,N/A,N/A,N/A,$16.35,N/A,$297.79,N/A,$307.00,N/A,N/A,$297.79
3091980,0300,84999,,,,,N/A,N/A,MAYO VITAMIN B12 BINDING CAPAC,$126.12,$93.75,$9.22,$438.00,N/A,$424.86,N/A,N/A,N/A,$9.22,N/A,$424.86,N/A,$438.00,N/A,N/A,$424.86
3050425,0300,85007,,,,,N/A,N/A,DIFFERENTIAL (Manual),$60.54,$45.00,$0.00,$60.00,N/A,$58.20,N/A,N/A,N/A,$0.00,N/A,$58.20,N/A,$60.00,N/A,N/A,$58.20
3051404,0300,85009,,,,,N/A,N/A,"DIFFERENTIAL, BUFFY COAT",$105.94,$78.75,$4.19,$105.00,N/A,$101.85,N/A,N/A,N/A,$4.19,N/A,$101.85,N/A,$105.00,N/A,N/A,$101.85
3050405,0300,85014,,,,,N/A,N/A,HEMATOCRIT,$50.45,$37.50,$8.38,$57.00,N/A,$55.29,N/A,N/A,N/A,$8.38,N/A,$55.29,N/A,$57.00,N/A,N/A,$55.29
85014LSC,0300,85014,,,,,N/A,N/A,HEMATOCRIT,$31.28,$23.25,$8.38,$57.00,N/A,$55.29,N/A,N/A,N/A,$8.38,N/A,$55.29,N/A,$57.00,N/A,N/A,$55.29
8501850,0300,85018,,,,,N/A,N/A,HEMOGLOBIN,$16.14,$12.00,$2.93,$16.00,N/A,$15.52,N/A,N/A,N/A,$2.93,N/A,$15.52,N/A,$16.00,N/A,N/A,$15.52
3050402,0300,85025,,,,,N/A,N/A,CBC/DIFF,$155.38,$115.50,$2.93,$154.00,N/A,$149.38,N/A,N/A,N/A,$2.93,N/A,$149.38,N/A,$154.00,N/A,N/A,$149.38
3054402,0300,85025,,,,,N/A,N/A,V-CBC W/DIFFERENTIAL,$72.64,$54.00,$2.93,$154.00,N/A,$149.38,N/A,N/A,N/A,$2.93,N/A,$149.38,N/A,$154.00,N/A,N/A,$149.38
3050734,0300,85027,,,,,N/A,N/A,CBC,$128.14,$95.25,$9.22,$127.00,N/A,$123.19,N/A,N/A,N/A,$9.22,N/A,$123.19,N/A,$127.00,N/A,N/A,$123.19
3091968,0300,85032,,,,,N/A,N/A,FAHC CMV ANTIGENEMIA ASSAY,$226.00,$168.00,$7.96,$224.00,N/A,$217.28,N/A,N/A,N/A,$7.96,N/A,$217.28,N/A,$224.00,N/A,N/A,$217.28
3050101,0300,85041,,,,,N/A,N/A,CELL COUNT/DIFF - CSF,$333.96,$248.25,$5.03,$331.00,N/A,$321.07,N/A,N/A,N/A,$5.03,N/A,$321.07,N/A,$331.00,N/A,N/A,$321.07
3050406,0300,85041,,,,,N/A,N/A,RED BLOOD COUNT,$54.48,$40.50,$5.03,$331.00,N/A,$321.07,N/A,N/A,N/A,$5.03,N/A,$321.07,N/A,$331.00,N/A,N/A,$321.07
3095003,0300,85048,,,,,N/A,N/A,WBC,$279.48,$207.75,$4.61,$126.00,N/A,$122.22,N/A,N/A,N/A,$4.61,N/A,$122.22,N/A,$126.00,N/A,N/A,$122.22
3050412,0300,85049,,,,,N/A,N/A,PLATELET COUNT,$101.90,$75.75,$2.93,$101.00,N/A,$97.97,N/A,N/A,N/A,$2.93,N/A,$97.97,N/A,$101.00,N/A,N/A,$97.97
3050421,0300,85170,,,,,N/A,N/A,CLOT RETRACTION,$71.63,$53.25,$58.15,$71.00,N/A,$68.87,N/A,N/A,N/A,$58.15,N/A,$68.87,N/A,$71.00,N/A,N/A,$68.87
3092267,0300,85210,,,,,N/A,N/A,FAHC FACTOR 2 ASSAY,$151.34,$112.50,$19.70,$150.00,N/A,$145.50,N/A,N/A,N/A,$19.70,N/A,$145.50,N/A,$150.00,N/A,N/A,$145.50
3092268,0300,85230,,,,,N/A,N/A,FAHC FACTOR 7 ASSAY,$151.34,$112.50,$15.51,$150.00,N/A,$145.50,N/A,N/A,N/A,$15.51,N/A,$145.50,N/A,$150.00,N/A,N/A,$145.50
3092269,0300,85260,,,,,N/A,N/A,FAHC FACTOR 10 ASSAY,$342.03,$254.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3092067,0300,85270,,,,,N/A,N/A,FAHC FACTOR 11 ASSAY,$155.38,$115.50,$23.05,$154.00,N/A,$149.38,N/A,N/A,N/A,$23.05,N/A,$149.38,N/A,$154.00,N/A,N/A,$149.38
3091418,0300,85300,,,,,N/A,N/A,ANTITHROMBIN III (#216),$712.31,$529.50,$19.70,$308.00,N/A,$298.76,N/A,N/A,N/A,$19.70,N/A,$298.76,N/A,$308.00,N/A,N/A,$298.76
3099027,0300,85300,,,,,N/A,N/A,ANTI THROMBIN TEST 1,$736.53,$547.50,$19.70,$308.00,N/A,$298.76,N/A,N/A,N/A,$19.70,N/A,$298.76,N/A,$308.00,N/A,N/A,$298.76
3099028,0300,85301,,,,,N/A,N/A,ANTI THROMBIN TEST 2,$736.53,$547.50,$14.25,$730.00,N/A,$708.10,N/A,N/A,N/A,$14.25,N/A,$708.10,N/A,$730.00,N/A,N/A,$708.10
3099476,0300,85303,,,,,N/A,N/A,"FAHC PROTEIN C, FUNCTIONAL",$245.17,$182.25,$14.25,$308.00,N/A,$298.76,N/A,N/A,N/A,$14.25,N/A,$298.76,N/A,$308.00,N/A,N/A,$298.76
3099477,0300,85306,,,,,N/A,N/A,"FAHC PROTEIN S, FUNCTIONAL",$430.82,$320.25,$13.83,$427.00,N/A,$414.19,N/A,N/A,N/A,$13.83,N/A,$414.19,N/A,$427.00,N/A,N/A,$414.19
3050401,0300,85378,,,,,N/A,N/A,D-Dimer,$141.25,$105.00,$96.82,$140.00,N/A,$135.80,N/A,N/A,N/A,$96.82,N/A,$135.80,N/A,$140.00,N/A,N/A,$135.80
3099527,0300,85460,,,,,N/A,N/A,KLEIHOWER-BETKE,$153.36,$114.00,$36.88,$152.00,N/A,$147.44,N/A,N/A,N/A,$36.88,N/A,$147.44,N/A,$152.00,N/A,N/A,$147.44
3091272,0300,85540,,,,,N/A,N/A,LEUKOCYTE ALK PHOS,$289.57,$215.25,$15.93,$287.00,N/A,$278.39,N/A,N/A,N/A,$15.93,N/A,$278.39,N/A,$287.00,N/A,N/A,$278.39
3092057,0300,85576,,,,,N/A,N/A,FAHC PLATELET FUNCTION ANALYS,$409.63,$304.50,$15.93,$406.00,$166.46,$393.82,$166.46,N/A,$166.46,$15.93,$166.46,$393.82,$166.46,$406.00,$166.46,$166.46,$393.82
3099234,0300,85597,,,,,N/A,N/A,LUPUS TEST 1,$238.11,$177.00,$51.60,$236.00,N/A,$228.92,N/A,N/A,N/A,$51.60,N/A,$228.92,N/A,$236.00,N/A,N/A,$228.92
3050413,0300,85610,,,,,N/A,N/A,PROTHROMBIN TIME,$81.72,$60.75,$15.52,$81.00,N/A,$15.52,N/A,N/A,N/A,$21.80,N/A,$15.52,N/A,$81.00,N/A,N/A,$15.52
85610QW,0300,85610,,,,,N/A,N/A,Prothrominbin Time,$12.11,$9.00,$15.52,$81.00,N/A,$15.52,N/A,N/A,N/A,$21.80,N/A,$15.52,N/A,$81.00,N/A,N/A,$15.52
3092270,0300,85611,,,,,N/A,N/A,FAHC 50/50 MIX PROTIME,$86.77,$64.50,$83.42,$86.00,N/A,$83.42,N/A,N/A,N/A,$86.00,N/A,$83.42,N/A,$86.00,N/A,N/A,$83.42
3095022,0300,85613,,,,,N/A,N/A,RUSSEL VIPOR DILUTED,$280.49,$208.50,$4.61,$182.00,N/A,$176.54,N/A,N/A,N/A,$4.61,N/A,$176.54,N/A,$182.00,N/A,N/A,$176.54
3099235,0300,85613,,,,,N/A,N/A,LUPUS TEST 2,$194.73,$144.75,$4.61,$182.00,N/A,$176.54,N/A,N/A,N/A,$4.61,N/A,$176.54,N/A,$182.00,N/A,N/A,$176.54
3050410,0300,85652,,,,,N/A,N/A,SEDRATE ESR,$57.51,$42.75,$11.32,$57.00,N/A,$55.29,N/A,N/A,N/A,$11.32,N/A,$55.29,N/A,$57.00,N/A,N/A,$55.29
3050414,0300,85730,,,,,N/A,N/A,PARTIAL THROMBO (PTT,$118.05,$87.75,$7.13,$278.00,N/A,$269.66,N/A,N/A,N/A,$7.13,N/A,$269.66,N/A,$278.00,N/A,N/A,$269.66
3095016,0300,85730,,,,,N/A,N/A,PTT,$234.07,$174.00,$7.13,$278.00,N/A,$269.66,N/A,N/A,N/A,$7.13,N/A,$269.66,N/A,$278.00,N/A,N/A,$269.66
3095021,0300,85730,,,,,N/A,N/A,PROTEIN C,$280.49,$208.50,$7.13,$278.00,N/A,$269.66,N/A,N/A,N/A,$7.13,N/A,$269.66,N/A,$278.00,N/A,N/A,$269.66
3099236,0300,85730,,,,,N/A,N/A,LUPUS TEST 3,$194.73,$144.75,$7.13,$278.00,N/A,$269.66,N/A,N/A,N/A,$7.13,N/A,$269.66,N/A,$278.00,N/A,N/A,$269.66
3095017,0300,85732,,,,,N/A,N/A,PTT SUBSTITUTION,$234.07,$174.00,$7.13,$232.00,N/A,$225.04,N/A,N/A,N/A,$7.13,N/A,$225.04,N/A,$232.00,N/A,N/A,$225.04
3099204,0300,85810,,,,,N/A,N/A,FAHC VISCOSITY,$105.94,$78.75,$7.96,$105.00,N/A,$101.85,N/A,N/A,N/A,$7.96,N/A,$101.85,N/A,$105.00,N/A,N/A,$101.85
3091925,0300,86003,,,,,N/A,N/A,MAYO WHEAT IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092041,0300,86003,,,,,N/A,N/A,MAYO COCKROACH IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092043,0300,86003,,,,,N/A,N/A,MAYO NON-SEAS ALLERGEN PROF,$22.20,$16.50,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092044,0300,86003,,,,,N/A,N/A,MAYO NON-SEAS ALLERGEN PROF,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092045,0300,86003,,,,,N/A,N/A,MAYO NON-SEAS ALLERGEN PROF,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092046,0300,86003,,,,,N/A,N/A,MAYO NON-SEAS ALLERGEN PROF,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092047,0300,86003,,,,,N/A,N/A,MAYO NON-SEAS ALLERGEN PROF,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092048,0300,86003,,,,,N/A,N/A,MAYO NON-SEAS ALLERGEN PROF,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092049,0300,86003,,,,,N/A,N/A,MAYO NON-SEAS ALLERGEN PROF,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092050,0300,86003,,,,,N/A,N/A,MAYO NON-SEAS ALLERGEN PROF,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092051,0300,86003,,,,,N/A,N/A,MAYO NON-SEAS ALLERGEN PROF,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092052,0300,86003,,,,,N/A,N/A,MAYO NON-SEAS ALLERGEN PROF,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092068,0300,86003,,,,,N/A,N/A,MAYO BERMUDA GRASS,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092069,0300,86003,,,,,N/A,N/A,MAYO JOHNSON GRASS,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092070,0300,86003,,,,,N/A,N/A,MAYO MEADOW FESCUE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092071,0300,86003,,,,,N/A,N/A,MAYO RED SORREL,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092072,0300,86003,,,,,N/A,N/A,MAYO ROUGH PIGWEED,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092073,0300,86003,,,,,N/A,N/A,MAYO ENGLISH PLANTAIN,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092074,0300,86003,,,,,N/A,N/A,MAYO SILVER BIRCH,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092075,0300,86003,,,,,N/A,N/A,MAYO CEDAR,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092076,0300,86003,,,,,N/A,N/A,MAYO MAPLE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092077,0300,86003,,,,,N/A,N/A,MAYO PENICILLIUM,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092078,0300,86003,,,,,N/A,N/A,MAYO CANDIDA ALBICANS,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092079,0300,86003,,,,,N/A,N/A,MAYO HORSE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092080,0300,86003,,,,,N/A,N/A,MAYO HOUSE DUST DP,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092081,0300,86003,,,,,N/A,N/A,MAYO HOUSE DUST H-S,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092082,0300,86003,,,,,N/A,N/A,MAYO HOUSE DUST GREER,$79.71,$59.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092122,0300,86003,,,,,N/A,N/A,MAYO CRANBERRY IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092123,0300,86003,,,,,N/A,N/A,MAYO STRAWBERRY IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092154,0300,86003,,,,,N/A,N/A,MAYO CHEESE CHEDDAR,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092155,0300,86003,,,,,N/A,N/A,MAYO EGG WHITE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092156,0300,86003,,,,,N/A,N/A,MAYO EGG YOLK,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092211,0300,86003,,,,,N/A,N/A,MAYO WEED PANEL #4,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092212,0300,86003,,,,,N/A,N/A,MAYO FALSE RAGWEED,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092213,0300,86003,,,,,N/A,N/A,MAYO BEECH,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092215,0300,86003,,,,,N/A,N/A,MAYO MOLD PANEL,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092216,0300,86003,,,,,N/A,N/A,MAYO FEATHER PANEL #1,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092230,0300,86003,,,,,N/A,N/A,MAYOALLERGENPROF DAIRY/GRAIN,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092231,0300,86003,,,,,N/A,N/A,MAYOALLERGENPROF DAIRY/GRAIN,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092232,0300,86003,,,,,N/A,N/A,MAYOALLERGENPROF DAIRY/GRAIN,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092233,0300,86003,,,,,N/A,N/A,MAYOALLERGENPROF DAIRY/GRAIN,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092234,0300,86003,,,,,N/A,N/A,MAYOALLERGENPROF DAIRY/GRAIN,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092245,0300,86003,,,,,N/A,N/A,MAYO SWEET VERNAL GRASS,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092256,0300,86003,,,,,N/A,N/A,MAYO AMOXICILLIN IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092257,0300,86003,,,,,N/A,N/A,MAYO PENICILLIN G IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092258,0300,86003,,,,,N/A,N/A,MAYO PENICILLIN V IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092302,0300,86003,,,,,N/A,N/A,MAYO MUCOR,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092303,0300,86003,,,,,N/A,N/A,MAYO WHITE HICKORY,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092304,0300,86003,,,,,N/A,N/A,MAYO WHITE PINE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092305,0300,86003,,,,,N/A,N/A,MAYO WILLOW,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092306,0300,86003,,,,,N/A,N/A,MAYO LAMBS QUARTER,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092307,0300,86003,,,,,N/A,N/A,MAY MUGWORT,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092350,0300,86003,,,,,N/A,N/A,"MAYO BEEF, IgE",$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092351,0300,86003,,,,,N/A,N/A,"MAYO SESAME SEED, IgE",$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092352,0300,86003,,,,,N/A,N/A,"MAYO LETTICE, IgE",$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092353,0300,86003,,,,,N/A,N/A,"MAYO ONION,IgE",$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092354,0300,86003,,,,,N/A,N/A,"MAYO TOMATO,IgE",$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093461,0300,86003,,,,,N/A,N/A,"MAYO ANNATTO SEED, IGE",$85.76,$63.75,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3099736,0300,86003,,,,,N/A,N/A,MAYO MILK PROCESSED,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092065,0300,86022,,,,,N/A,N/A,ARC HLA PLATELET ALLOIMMUN SCR,$862.64,$641.25,$18.02,$297.00,N/A,$288.09,N/A,N/A,N/A,$18.02,N/A,$288.09,N/A,$297.00,N/A,N/A,$288.09
3099019,0300,86022,,,,,N/A,N/A,PLATELET ANTIBODY,$88.79,$66.00,$18.02,$297.00,N/A,$288.09,N/A,N/A,N/A,$18.02,N/A,$288.09,N/A,$297.00,N/A,N/A,$288.09
3099308,0300,86023,,,,,N/A,N/A,PLATELET ANTIBODIES,"$1,320.70",$981.75,$22.21,"$1,309.00",N/A,"$1,269.73",N/A,N/A,N/A,$22.21,N/A,"$1,269.73",N/A,"$1,309.00",N/A,N/A,"$1,269.73"
3091004,0300,86038,,,,,N/A,N/A,ANA,$234.07,$174.00,$15.09,$236.00,N/A,$228.92,N/A,N/A,N/A,$15.09,N/A,$228.92,N/A,$236.00,N/A,N/A,$228.92
3091921,0300,86038,,,,,N/A,N/A,MAYO ANA-HEP 2 PROFILE,$238.11,$177.00,$15.09,$236.00,N/A,$228.92,N/A,N/A,N/A,$15.09,N/A,$228.92,N/A,$236.00,N/A,N/A,$228.92
3091922,0300,86039,,,,,N/A,N/A,MAYO ANA-HEP 2 PROFILE,$239.12,$177.75,$14.67,$237.00,N/A,$229.89,N/A,N/A,N/A,$14.67,N/A,$229.89,N/A,$237.00,N/A,N/A,$229.89
3010243,0300,86140,,,,,N/A,N/A,CRP QUANTITATIVE,$70.63,$52.50,$67.90,$70.00,N/A,$67.90,N/A,N/A,N/A,$70.00,N/A,$67.90,N/A,$70.00,N/A,N/A,$67.90
3099064,0300,86148,,,,,N/A,N/A,PHOSPHOLIPID #717,$286.54,$213.00,$30.60,$263.00,N/A,$255.11,N/A,N/A,N/A,$30.60,N/A,$255.11,N/A,$263.00,N/A,N/A,$255.11
3091098,0300,86160,,,,,N/A,N/A,COMPLEMENT C3,$233.07,$173.25,$9.64,$187.00,N/A,$181.39,N/A,N/A,N/A,$9.64,N/A,$181.39,N/A,$187.00,N/A,N/A,$181.39
3091368,0300,86160,,,,,N/A,N/A,COMPLEMENT C4,$233.07,$173.25,$9.64,$187.00,N/A,$181.39,N/A,N/A,N/A,$9.64,N/A,$181.39,N/A,$187.00,N/A,N/A,$181.39
3099452,0300,86160,,,,,N/A,N/A,C2 COMPLEMENT,$444.94,$330.75,$9.64,$187.00,N/A,$181.39,N/A,N/A,N/A,$9.64,N/A,$181.39,N/A,$187.00,N/A,N/A,$181.39
3092301,0300,86161,,,,,N/A,N/A,MAYO C1 ESTERASE INHIB FUNCT,$126.12,$93.75,$14.25,$231.00,N/A,$224.07,N/A,N/A,N/A,$14.25,N/A,$224.07,N/A,$231.00,N/A,N/A,$224.07
3099451,0300,86161,,,,,N/A,N/A,C1 FUNCTIONAL ACTIVITY,$333.96,$248.25,$14.25,$231.00,N/A,$224.07,N/A,N/A,N/A,$14.25,N/A,$224.07,N/A,$231.00,N/A,N/A,$224.07
3091258,0300,86162,,,,,N/A,N/A,TOTAL CH50,$332.95,$247.50,$14.25,$330.00,N/A,$320.10,N/A,N/A,N/A,$14.25,N/A,$320.10,N/A,$330.00,N/A,N/A,$320.10
3091273,0300,86225,,,,,N/A,N/A,UVM ANIT-DNA(DOUBLE STRANDED),$265.35,$197.25,$15.93,$263.00,N/A,$255.11,N/A,N/A,N/A,$15.93,N/A,$255.11,N/A,$263.00,N/A,N/A,$255.11
3091380,0300,86255,,,,,N/A,N/A,"UVM ANCA, IFA",$456.04,$339.00,$21.38,$297.25,$297.25,$222.13,$297.25,N/A,$297.25,$21.38,$297.25,$222.13,$297.25,$229.00,$297.25,$297.25,$222.13
3091960,0300,86255,,,,,N/A,N/A,MAYO INFLAMMATORYBOWEL PANEL,$231.05,$171.75,$21.38,$297.25,$297.25,$222.13,$297.25,N/A,$297.25,$21.38,$297.25,$222.13,$297.25,$229.00,$297.25,$297.25,$222.13
3099044,0300,86255,,,,,N/A,N/A,ANTI-MITOCHONDRIAL AB 2,$272.41,$202.50,$21.38,$297.25,$297.25,$222.13,$297.25,N/A,$297.25,$21.38,$297.25,$222.13,$297.25,$229.00,$297.25,$297.25,$222.13
3099054,0300,86255,,,,,N/A,N/A,ANCA TEST 1,$231.05,$171.75,$21.38,$297.25,$297.25,$222.13,$297.25,N/A,$297.25,$21.38,$297.25,$222.13,$297.25,$229.00,$297.25,$297.25,$222.13
3099055,0300,86255,,,,,N/A,N/A,ANCA TEST 2,$231.05,$171.75,$21.38,$297.25,$297.25,$222.13,$297.25,N/A,$297.25,$21.38,$297.25,$222.13,$297.25,$229.00,$297.25,$297.25,$222.13
3099092,0300,86255,,,,,N/A,N/A,ENDOMYSIAL AB,$231.05,$171.75,$21.38,$297.25,$297.25,$222.13,$297.25,N/A,$297.25,$21.38,$297.25,$222.13,$297.25,$229.00,$297.25,$297.25,$222.13
3099238,0300,86255,,,,,N/A,N/A,SMOOTH MUSCLE ANTIBODIES,$231.05,$171.75,$21.38,$297.25,$297.25,$222.13,$297.25,N/A,$297.25,$21.38,$297.25,$222.13,$297.25,$229.00,$297.25,$297.25,$222.13
3099310,0300,86255,,,,,N/A,N/A,RETICULIN ANTIBODIES,$462.09,$343.50,$21.38,$297.25,$297.25,$222.13,$297.25,N/A,$297.25,$21.38,$297.25,$222.13,$297.25,$229.00,$297.25,$297.25,$222.13
3091897,0300,86256,,,,,N/A,N/A,MAYO PARANEOPLAS AUTOANTIB,$233.07,$173.25,$36.51,$231.00,$94.71,$224.07,$94.71,N/A,$94.71,$36.51,$94.71,$224.07,$94.71,$231.00,$94.71,$94.71,$224.07
3091898,0300,86256,,,,,N/A,N/A,MAYO PARANEOPLAS AUTOANTIB,$233.07,$173.25,$36.51,$231.00,$94.71,$224.07,$94.71,N/A,$94.71,$36.51,$94.71,$224.07,$94.71,$231.00,$94.71,$94.71,$224.07
3091899,0300,86256,,,,,N/A,N/A,MAYO PARANEOPLAS AUTOANTIB,$233.07,$173.25,$36.51,$231.00,$94.71,$224.07,$94.71,N/A,$94.71,$36.51,$94.71,$224.07,$94.71,$231.00,$94.71,$94.71,$224.07
3091900,0300,86256,,,,,N/A,N/A,MAYO PARANEOPLAS AUTOANTIB,$233.07,$173.25,$36.51,$231.00,$94.71,$224.07,$94.71,N/A,$94.71,$36.51,$94.71,$224.07,$94.71,$231.00,$94.71,$94.71,$224.07
3091901,0300,86256,,,,,N/A,N/A,MAYO PARANEOPLAS AUTOANTIB,$233.07,$173.25,$36.51,$231.00,$94.71,$224.07,$94.71,N/A,$94.71,$36.51,$94.71,$224.07,$94.71,$231.00,$94.71,$94.71,$224.07
3091902,0300,86256,,,,,N/A,N/A,MAYO PARANEOPLAS AUTOANTIB,$233.07,$173.25,$36.51,$231.00,$94.71,$224.07,$94.71,N/A,$94.71,$36.51,$94.71,$224.07,$94.71,$231.00,$94.71,$94.71,$224.07
3091903,0300,86256,,,,,N/A,N/A,MAYO PARANEOPLAS AUTOANTIB,$233.07,$173.25,$36.51,$231.00,$94.71,$224.07,$94.71,N/A,$94.71,$36.51,$94.71,$224.07,$94.71,$231.00,$94.71,$94.71,$224.07
3091904,0300,86256,,,,,N/A,N/A,MAYO PARANEOPLAS AUTOANTIB,$233.07,$173.25,$36.51,$231.00,$94.71,$224.07,$94.71,N/A,$94.71,$36.51,$94.71,$224.07,$94.71,$231.00,$94.71,$94.71,$224.07
3091308,0300,86300,,,,,N/A,N/A,Ca-15-3,$396.51,$294.75,$36.51,$393.00,N/A,$381.21,N/A,N/A,N/A,$36.51,N/A,$381.21,N/A,$393.00,N/A,N/A,$381.21
3099507,0300,86300,,,,,N/A,N/A,CA 27.29,$396.51,$294.75,$36.51,$393.00,N/A,$381.21,N/A,N/A,N/A,$36.51,N/A,$381.21,N/A,$393.00,N/A,N/A,$381.21
3091328,0300,86301,,,,,N/A,N/A,CA19-9,$396.51,$294.75,$25.15,$393.00,N/A,$381.21,N/A,N/A,N/A,$25.15,N/A,$381.21,N/A,$393.00,N/A,N/A,$381.21
3091217,0300,86304,,,,,N/A,N/A,CA125,$396.51,$294.75,$25.15,$393.00,N/A,$381.21,N/A,N/A,N/A,$25.15,N/A,$381.21,N/A,$393.00,N/A,N/A,$381.21
3020509,0300,86308,,,,,N/A,N/A,INFO MONO SCREENING,$73.65,$54.75,$25.15,$73.00,N/A,$70.81,N/A,N/A,N/A,$25.15,N/A,$70.81,N/A,$73.00,N/A,N/A,$70.81
86308LSC,0300,86308,,,,,N/A,N/A,MONO TESTING,$52.46,$39.00,$25.15,$73.00,N/A,$70.81,N/A,N/A,N/A,$25.15,N/A,$70.81,N/A,$73.00,N/A,N/A,$70.81
3099967,0300,86317,,,,,N/A,N/A,Mayo West Nile Virus,$101.90,$75.75,$19.40,$25.15,N/A,$19.40,N/A,N/A,N/A,$25.15,N/A,$19.40,N/A,$20.00,N/A,N/A,$19.40
3099968,0300,86317,,,,,N/A,N/A,Mayo West Nile Virus,$101.90,$75.75,$19.40,$25.15,N/A,$19.40,N/A,N/A,N/A,$25.15,N/A,$19.40,N/A,$20.00,N/A,N/A,$19.40
3091443,0300,86340,,,,,N/A,N/A,MAYO INTRINSIC FACTOR AB,$287.55,$213.75,$25.57,$285.00,N/A,$276.45,N/A,N/A,N/A,$25.57,N/A,$276.45,N/A,$285.00,N/A,N/A,$276.45
3091918,0300,86341,,,,,N/A,N/A,MAYO GAD65 Ab ASSAY,$378.35,$281.25,$18.02,$164.00,N/A,$159.08,N/A,N/A,N/A,$18.02,N/A,$159.08,N/A,$164.00,N/A,N/A,$159.08
3099448,0300,86359,,,,,N/A,N/A,CD4/CD8 (FAHC) TEST 1,$223.98,$166.50,$45.27,$220.00,N/A,$213.40,N/A,N/A,N/A,$45.27,N/A,$213.40,N/A,$220.00,N/A,N/A,$213.40
3099449,0300,86360,,,,,N/A,N/A,CD4/CD8 (FAHC) TEST 2,$265.35,$197.25,$45.27,$124.00,N/A,$120.28,N/A,N/A,N/A,$45.27,N/A,$120.28,N/A,$124.00,N/A,N/A,$120.28
3091067,0300,86376,,,,,N/A,N/A,THYRD AB GROUP,$280.49,$208.50,$32.27,$278.00,N/A,$269.66,N/A,N/A,N/A,$32.27,N/A,$269.66,N/A,$278.00,N/A,N/A,$269.66
3091309,0300,86431,,,,,N/A,N/A,UVM RHEUMATOID FACTOR,$114.01,$84.75,$13.83,$142.00,N/A,$137.74,N/A,N/A,N/A,$13.83,N/A,$137.74,N/A,$142.00,N/A,N/A,$137.74
86580,0300,86580,,,,,N/A,N/A,TB INTRADERMAL TEST,$25.22,$18.75,$11.89,$74.61,$11.89,$24.25,$11.89,N/A,$11.89,$74.61,$11.89,$24.25,$11.89,$25.00,$11.89,$11.89,$24.25
4586580,0300,86580,,,,,N/A,N/A,PPD TEST,$31.28,$23.25,$11.89,$74.61,$11.89,$24.25,$11.89,N/A,$11.89,$74.61,$11.89,$24.25,$11.89,$25.00,$11.89,$11.89,$24.25
86580LSC,0300,86580,,,,,N/A,N/A,TB INTRADERMAL TEST,$29.26,$21.75,$11.89,$74.61,$11.89,$24.25,$11.89,N/A,$11.89,$74.61,$11.89,$24.25,$11.89,$25.00,$11.89,$11.89,$24.25
3090105,0300,86592,,,,,N/A,N/A,CSF VDRL,$80.72,$60.00,$77.60,$80.00,N/A,$77.60,N/A,N/A,N/A,N/A,N/A,$77.60,N/A,$80.00,N/A,N/A,$77.60
3099252,0300,86592,,,,,N/A,N/A,RPR,$80.72,$60.00,$77.60,$80.00,N/A,$77.60,N/A,N/A,N/A,N/A,N/A,$77.60,N/A,$80.00,N/A,N/A,$77.60
3092118,0300,86618,,,,,N/A,N/A,MAYO TICK BORNE AB PANEL,$275.44,$204.75,$18.44,$273.00,N/A,$264.81,N/A,N/A,N/A,$18.44,N/A,$264.81,N/A,$273.00,N/A,N/A,$264.81
3092217,0300,86618,,,,,N/A,N/A,MAYO LYME DISEASE CSF,$271.40,$201.75,$18.44,$273.00,N/A,$264.81,N/A,N/A,N/A,$18.44,N/A,$264.81,N/A,$273.00,N/A,N/A,$264.81
3091888,0300,86635,,,,,N/A,N/A,MAYO COCCIDIOIDES AB,$88.79,$66.00,$15.09,$88.00,N/A,$85.36,N/A,N/A,N/A,$15.09,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3091889,0300,86635,,,,,N/A,N/A,MAYO COCCIDIOIDES AB,$88.79,$66.00,$15.09,$88.00,N/A,$85.36,N/A,N/A,N/A,$15.09,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3091890,0300,86635,,,,,N/A,N/A,MAYO COCCIDIOIDES AB,$91.81,$68.25,$15.09,$88.00,N/A,$85.36,N/A,N/A,N/A,$15.09,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3002510,0300,86644,,,,,N/A,N/A,CMV NEGATIVE CHARGE,$277.46,$206.25,$14.67,$275.00,N/A,$266.75,N/A,N/A,N/A,$14.67,N/A,$266.75,N/A,$275.00,N/A,N/A,$266.75
3091432,0300,86644,,,,,N/A,N/A,CMV IGG (SCBL6731),$86.77,$64.50,$14.67,$275.00,N/A,$266.75,N/A,N/A,N/A,$14.67,N/A,$266.75,N/A,$275.00,N/A,N/A,$266.75
3099059,0300,86644,,,,,N/A,N/A,MAYO CMV IgG Ab,$277.46,$206.25,$14.67,$275.00,N/A,$266.75,N/A,N/A,N/A,$14.67,N/A,$266.75,N/A,$275.00,N/A,N/A,$266.75
3092130,0300,86645,,,,,N/A,N/A,MAYO TORCH PROFILE IgM,$275.44,$204.75,$17.18,$273.00,N/A,$264.81,N/A,N/A,N/A,$17.18,N/A,$264.81,N/A,$273.00,N/A,N/A,$264.81
3099060,0300,86645,,,,,N/A,N/A,MAYO CMV IgM Ab,$275.44,$204.75,$17.18,$273.00,N/A,$264.81,N/A,N/A,N/A,$17.18,N/A,$264.81,N/A,$273.00,N/A,N/A,$264.81
3092265,0300,86652,,,,,N/A,N/A,MAYO E EQU ENCEP IgG/IgM CSF,$81.72,$60.75,$18.44,$71.00,N/A,$68.87,N/A,N/A,N/A,$18.44,N/A,$68.87,N/A,$71.00,N/A,N/A,$68.87
3092266,0300,86652,,,,,N/A,N/A,MAYO E EQU ENCEP IgG/IgM CSF,$80.72,$60.00,$18.44,$71.00,N/A,$68.87,N/A,N/A,N/A,$18.44,N/A,$68.87,N/A,$71.00,N/A,N/A,$68.87
3091938,0300,86658,,,,,N/A,N/A,MAYO COXSACKIE A AB PANEL,$91.81,$68.25,$15.93,$88.00,N/A,$85.36,N/A,N/A,N/A,$15.93,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3091939,0300,86658,,,,,N/A,N/A,MAYO COXSACKIE A AB PANEL,$91.81,$68.25,$15.93,$88.00,N/A,$85.36,N/A,N/A,N/A,$15.93,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3091940,0300,86658,,,,,N/A,N/A,MAYO COXSACKIE A AB PANEL,$88.79,$66.00,$15.93,$88.00,N/A,$85.36,N/A,N/A,N/A,$15.93,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3091941,0300,86658,,,,,N/A,N/A,MAYO COXSACKIE A AB PANEL,$88.79,$66.00,$15.93,$88.00,N/A,$85.36,N/A,N/A,N/A,$15.93,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3091942,0300,86658,,,,,N/A,N/A,MAYO COXSACKIE A AB PANEL,$88.79,$66.00,$15.93,$88.00,N/A,$85.36,N/A,N/A,N/A,$15.93,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3091943,0300,86658,,,,,N/A,N/A,MAYO COXSACKIE A AB PANEL,$88.79,$66.00,$15.93,$88.00,N/A,$85.36,N/A,N/A,N/A,$15.93,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3099491,0300,86658,,,,,N/A,N/A,POLIO ANTIBODIES TEST 1,$202.80,$150.75,$15.93,$88.00,N/A,$85.36,N/A,N/A,N/A,$15.93,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3099492,0300,86658,,,,,N/A,N/A,POLIO ANTIBODIES TEST 2,$202.80,$150.75,$15.93,$88.00,N/A,$85.36,N/A,N/A,N/A,$15.93,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3099493,0300,86658,,,,,N/A,N/A,POLIO ANTIBODIES TEST 3,$202.80,$150.75,$15.93,$88.00,N/A,$85.36,N/A,N/A,N/A,$15.93,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3095020,0300,86664,,,,,N/A,N/A,NUCLEAR AG(EB),$275.44,$204.75,$15.93,$273.00,N/A,$264.81,N/A,N/A,N/A,$15.93,N/A,$264.81,N/A,$273.00,N/A,N/A,$264.81
3095018,0300,86665,,,,,N/A,N/A,VCA(EB),$275.44,$204.75,$18.44,$273.00,N/A,$264.81,N/A,N/A,N/A,$18.44,N/A,$264.81,N/A,$273.00,N/A,N/A,$264.81
3095019,0300,86665,,,,,N/A,N/A,VCA(EB) [2],$275.44,$204.75,$18.44,$273.00,N/A,$264.81,N/A,N/A,N/A,$18.44,N/A,$264.81,N/A,$273.00,N/A,N/A,$264.81
3091970,0300,86666,,,,,N/A,N/A,MAYO EHRLICHIA AB PANEL,$155.38,$115.50,$21.80,$186.00,N/A,$180.42,N/A,N/A,N/A,$21.80,N/A,$180.42,N/A,$186.00,N/A,N/A,$180.42
3091971,0300,86666,,,,,N/A,N/A,MAYO EHRLICHIA AB PANEL,$153.36,$114.00,$21.80,$186.00,N/A,$180.42,N/A,N/A,N/A,$21.80,N/A,$180.42,N/A,$186.00,N/A,N/A,$180.42
3092115,0300,86666,,,,,N/A,N/A,MAYO TICK BORNE AB PANEL,$187.66,$139.50,$21.80,$186.00,N/A,$180.42,N/A,N/A,N/A,$21.80,N/A,$180.42,N/A,$186.00,N/A,N/A,$180.42
3092116,0300,86666,,,,,N/A,N/A,MAYO TICK BORNE AB PANEL,$187.66,$139.50,$21.80,$186.00,N/A,$180.42,N/A,N/A,N/A,$21.80,N/A,$180.42,N/A,$186.00,N/A,N/A,$180.42
3092134,0300,86668,,,,,N/A,N/A,FAHC TULAREMIA Ab,$54.48,$40.50,$12.15,$85.00,N/A,$82.45,N/A,N/A,N/A,$12.15,N/A,$82.45,N/A,$85.00,N/A,N/A,$82.45
3091972,0300,86671,,,,,N/A,N/A,MAYO MICROPOLYSPORA FAENI IgG,$129.14,$96.00,$17.18,$88.00,N/A,$85.36,N/A,N/A,N/A,$17.18,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3091264,0300,86677,,,,,N/A,N/A,H-PYLORIC QL,$467.14,$347.25,$17.60,$58.00,N/A,$56.26,N/A,N/A,N/A,$17.60,N/A,$56.26,N/A,$58.00,N/A,N/A,$56.26
3092153,0300,86682,,,,,N/A,N/A,MAYO STRONGYLOIDES IgG AB,$206.83,$153.75,$20.12,$181.00,N/A,$175.57,N/A,N/A,N/A,$20.12,N/A,$175.57,N/A,$181.00,N/A,N/A,$175.57
3091220,0300,86689,,,,,N/A,N/A,HIV WESTERN BLOT,$467.14,$347.25,$10.90,$463.00,N/A,$449.11,N/A,N/A,N/A,$10.90,N/A,$449.11,N/A,$463.00,N/A,N/A,$449.11
3092131,0300,86694,,,,,N/A,N/A,MAYO TORCH PROFILE IgM,$277.46,$206.25,$20.54,$142.00,N/A,$137.74,N/A,N/A,N/A,$20.54,N/A,$137.74,N/A,$142.00,N/A,N/A,$137.74
3099065,0300,86695,,,,,N/A,N/A,HERPES I/IGM,$394.50,$293.25,$17.18,$391.00,N/A,$379.27,N/A,N/A,N/A,$17.18,N/A,$379.27,N/A,$391.00,N/A,N/A,$379.27
3099066,0300,86696,,,,,N/A,N/A,HERPES II/IGM,$394.50,$293.25,$15.93,$366.00,N/A,$355.02,N/A,N/A,N/A,$15.93,N/A,$355.02,N/A,$366.00,N/A,N/A,$355.02
3091699,0300,86701,,,,,N/A,N/A,UVM HIV-1/2 Ag&Ab SCREEN,$174.55,$129.75,$16.77,$173.00,N/A,$167.81,N/A,N/A,N/A,$16.77,N/A,$167.81,N/A,$173.00,N/A,N/A,$167.81
3091438,0300,86705,,,,,N/A,N/A,HEP B CORE AB IGM (SCBL4848),$228.02,$169.50,$14.67,$226.00,N/A,$219.22,N/A,N/A,N/A,$14.67,N/A,$219.22,N/A,$226.00,N/A,N/A,$219.22
3091137,0300,86707,,,,,N/A,N/A,HBE AB,$224.99,$167.25,$12.99,$223.00,N/A,$216.31,N/A,N/A,N/A,$12.99,N/A,$216.31,N/A,$223.00,N/A,N/A,$216.31
3091277,0300,86708,,,,,N/A,N/A,"HEP A AB, TOTAL (508)",$238.11,$177.00,$13.83,$236.00,N/A,$228.92,N/A,N/A,N/A,$13.83,N/A,$228.92,N/A,$236.00,N/A,N/A,$228.92
3092259,0300,86720,,,,,N/A,N/A,"MAYO LEPTOSPIRA AB,CSF",$127.13,$94.50,$14.67,$170.00,N/A,$164.90,N/A,N/A,N/A,$14.67,N/A,$164.90,N/A,$170.00,N/A,N/A,$164.90
3099397,0300,86720,,,,,N/A,N/A,MAYO LEPTOSPIRA AB,$171.52,$127.50,$14.67,$170.00,N/A,$164.90,N/A,N/A,N/A,$14.67,N/A,$164.90,N/A,$170.00,N/A,N/A,$164.90
3091080,0300,86735,,,,,N/A,N/A,MUMPS ANTIBODY,$54.48,$40.50,$19.28,$80.00,N/A,$77.60,N/A,N/A,N/A,$19.28,N/A,$77.60,N/A,$80.00,N/A,N/A,$77.60
3091063,0300,86738,,,,,N/A,N/A,MYCOPLASMA,$393.49,$292.50,$15.51,$201.00,N/A,$194.97,N/A,N/A,N/A,$15.51,N/A,$194.97,N/A,$201.00,N/A,N/A,$194.97
3092117,0300,86753,,,,,N/A,N/A,MAYO TICK BORNE AB PANEL,$180.60,$134.25,$18.02,$113.00,N/A,$109.61,N/A,N/A,N/A,$18.02,N/A,$109.61,N/A,$113.00,N/A,N/A,$109.61
3091977,0300,86757,,,,,N/A,N/A,MAYO SPOTTED FEVER ABIgG&IgM,$369.27,$274.50,$15.09,$366.00,N/A,$355.02,N/A,N/A,N/A,$15.09,N/A,$355.02,N/A,$366.00,N/A,N/A,$355.02
3091978,0300,86757,,,,,N/A,N/A,MAYO SPOTTED FEVER ABIgG&IgM,$369.27,$274.50,$15.09,$366.00,N/A,$355.02,N/A,N/A,N/A,$15.09,N/A,$355.02,N/A,$366.00,N/A,N/A,$355.02
3090517,0300,86762,,,,,N/A,N/A,RUBELLA,$54.48,$40.50,$23.05,$275.00,N/A,$266.75,N/A,N/A,N/A,$23.05,N/A,$266.75,N/A,$275.00,N/A,N/A,$266.75
3092132,0300,86762,,,,,N/A,N/A,MAYO TORCH PROFILE IgM,$277.46,$206.25,$23.05,$275.00,N/A,$266.75,N/A,N/A,N/A,$23.05,N/A,$266.75,N/A,$275.00,N/A,N/A,$266.75
3098517,0300,86762,,,,,N/A,N/A,PRNTL PKG RUBELLA,$156.39,$116.25,$23.05,$275.00,N/A,$266.75,N/A,N/A,N/A,$23.05,N/A,$266.75,N/A,$275.00,N/A,N/A,$266.75
3091450,0300,86765,,,,,N/A,N/A,UVM MEASLES IgG Ab,$54.48,$40.50,$17.18,$54.00,N/A,$52.38,N/A,N/A,N/A,$17.18,N/A,$52.38,N/A,$54.00,N/A,N/A,$52.38
3099489,0300,86765,,,,,N/A,N/A,RUBEOLA IGM ANTIBODY,$380.37,$282.75,$17.18,$54.00,N/A,$52.38,N/A,N/A,N/A,$17.18,N/A,$52.38,N/A,$54.00,N/A,N/A,$52.38
3092446,0300,86768,,,,,N/A,N/A,MAYO SALMONELLA TOT ANTIBODY,$40.36,$30.00,$15.51,$36.00,N/A,$34.92,N/A,N/A,N/A,$15.51,N/A,$34.92,N/A,$36.00,N/A,N/A,$34.92
3092447,0300,86768,,,,,N/A,N/A,MAYO SALMONELLA TOT ANTIBODY,$40.36,$30.00,$15.51,$36.00,N/A,$34.92,N/A,N/A,N/A,$15.51,N/A,$34.92,N/A,$36.00,N/A,N/A,$34.92
3092448,0300,86768,,,,,N/A,N/A,MAYO SALMONELLA TOT ANTIBODY,$36.32,$27.00,$15.51,$36.00,N/A,$34.92,N/A,N/A,N/A,$15.51,N/A,$34.92,N/A,$36.00,N/A,N/A,$34.92
3092449,0300,86768,,,,,N/A,N/A,MAYO SALMONELLA TOT ANTIBODY,$36.32,$27.00,$15.51,$36.00,N/A,$34.92,N/A,N/A,N/A,$15.51,N/A,$34.92,N/A,$36.00,N/A,N/A,$34.92
3092450,0300,86768,,,,,N/A,N/A,MAYO SALMONELLA TOT ANTIBODY,$36.32,$27.00,$15.51,$36.00,N/A,$34.92,N/A,N/A,N/A,$15.51,N/A,$34.92,N/A,$36.00,N/A,N/A,$34.92
3091454,0300,86774,,,,,N/A,N/A,TETANUS ANTIBODY,$329.92,$245.25,$273.00,$327.00,N/A,$317.19,N/A,N/A,N/A,$273.00,N/A,$317.19,N/A,$327.00,N/A,N/A,$317.19
3091060,0300,86777,,,,,N/A,N/A,Toxopl Ab Igg,$277.46,$206.25,$17.60,$275.00,N/A,$266.75,N/A,N/A,N/A,$17.60,N/A,$266.75,N/A,$275.00,N/A,N/A,$266.75
3091934,0300,86777,,,,,N/A,N/A,MAYO TOXOPLASMA IgM & IgG,$277.46,$206.25,$17.60,$275.00,N/A,$266.75,N/A,N/A,N/A,$17.60,N/A,$266.75,N/A,$275.00,N/A,N/A,$266.75
3091233,0300,86778,,,,,N/A,N/A,MAYO TOXOPLASMA IgM & IgG,$277.46,$206.25,$17.18,$275.00,N/A,$266.75,N/A,N/A,N/A,$17.18,N/A,$266.75,N/A,$275.00,N/A,N/A,$266.75
3092133,0300,86778,,,,,N/A,N/A,MAYO TORCH PROFILE IgM,$277.46,$206.25,$17.18,$275.00,N/A,$266.75,N/A,N/A,N/A,$17.18,N/A,$266.75,N/A,$275.00,N/A,N/A,$266.75
3091015,0300,86781,,,,,N/A,N/A,FTA,$194.73,$144.75,$15.93,$193.00,N/A,$187.21,N/A,N/A,N/A,$15.93,N/A,$187.21,N/A,$193.00,N/A,N/A,$187.21
3099757,0300,86787,,,,,N/A,N/A,MAYO VZV IgG Ab,$249.21,$185.25,$15.09,$247.00,N/A,$239.59,N/A,N/A,N/A,$15.09,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3099758,0300,86787,,,,,N/A,N/A,MAYO VZV IgM Ab,$249.21,$185.25,$15.09,$247.00,N/A,$239.59,N/A,N/A,N/A,$15.09,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3091042,0300,86800,,,,,N/A,N/A,THYROGLB AB,$234.07,$174.00,$15.51,$232.00,N/A,$225.04,N/A,N/A,N/A,$15.51,N/A,$225.04,N/A,$232.00,N/A,N/A,$225.04
3099254,0300,86804,,,,,N/A,N/A,MAYO HEPATITIS C RIBA,$298.65,$222.00,$17.18,$296.00,N/A,$287.12,N/A,N/A,N/A,$17.18,N/A,$287.12,N/A,$296.00,N/A,N/A,$287.12
3092064,0300,86813,,,,,N/A,N/A,FAHC HLA FOR PLATELETS,$281.49,$209.25,$31.02,$279.00,N/A,$270.63,N/A,N/A,N/A,$31.02,N/A,$270.63,N/A,$279.00,N/A,N/A,$270.63
3091916,0300,86817,,,,,N/A,N/A,FAHC DR TYPE,$768.81,$571.50,$36.05,$762.00,N/A,$739.14,N/A,N/A,N/A,$36.05,N/A,$739.14,N/A,$762.00,N/A,N/A,$739.14
30999260,0300,86849,,,,,N/A,N/A,LAMBERT-EATON SYNDROME TEST 2,$354.14,$263.25,$127.42,$351.00,N/A,$340.47,N/A,N/A,N/A,$127.42,N/A,$340.47,N/A,$351.00,N/A,N/A,$340.47
3030706,0300,86850,,,,,N/A,N/A,ANTIBODY SCREENING,$177.57,$132.00,$0.00,$134.00,N/A,$129.98,N/A,N/A,N/A,$0.00,N/A,$129.98,N/A,$134.00,N/A,N/A,$129.98
3099244,0300,86850,,,,,N/A,N/A,ARC ANTIBODY SCREEN,$135.20,$100.50,$0.00,$134.00,N/A,$129.98,N/A,N/A,N/A,$0.00,N/A,$129.98,N/A,$134.00,N/A,N/A,$129.98
3099632,0300,86850,,,,,N/A,N/A,ARC ANTIBODY SCREEN,$88.79,$66.00,$0.00,$134.00,N/A,$129.98,N/A,N/A,N/A,$0.00,N/A,$129.98,N/A,$134.00,N/A,N/A,$129.98
3099137,0300,86860,,,,,N/A,N/A,ARC ELUTION TEST,$349.09,$259.50,$11.74,$346.00,N/A,$335.62,N/A,N/A,N/A,$11.74,N/A,$335.62,N/A,$346.00,N/A,N/A,$335.62
3099211,0300,86860,,,,,N/A,N/A,ARC ELUTION,$99.89,$74.25,$11.74,$346.00,N/A,$335.62,N/A,N/A,N/A,$11.74,N/A,$335.62,N/A,$346.00,N/A,N/A,$335.62
3030708,0300,86870,,,,,N/A,N/A,ANTIBODY ID,$383.40,$285.00,$39.40,$319.00,N/A,$309.43,N/A,N/A,N/A,$39.40,N/A,$309.43,N/A,$319.00,N/A,N/A,$309.43
3099245,0300,86870,,,,,N/A,N/A,ARC ANTIBODY SCREEN,$321.85,$239.25,$39.40,$319.00,N/A,$309.43,N/A,N/A,N/A,$39.40,N/A,$309.43,N/A,$319.00,N/A,N/A,$309.43
3030705,0300,86880,,,,,N/A,N/A,DIRECT COOMBS,$106.95,$79.50,$53.65,$106.00,N/A,$102.82,N/A,N/A,N/A,$53.65,N/A,$102.82,N/A,$106.00,N/A,N/A,$102.82
3099246,0300,86880,,,,,N/A,N/A,ARC DIRECT COOMBS,$135.20,$100.50,$53.65,$106.00,N/A,$102.82,N/A,N/A,N/A,$53.65,N/A,$102.82,N/A,$106.00,N/A,N/A,$102.82
3091816,0300,86886,,,,,N/A,N/A,ARC ANTIBODY TITER,$103.92,$77.25,$6.71,$136.00,N/A,$131.92,N/A,N/A,N/A,$6.71,N/A,$131.92,N/A,$136.00,N/A,N/A,$131.92
3030710,0300,86900,,,,,N/A,N/A,GROUP ONLY,$159.41,$118.50,$153.26,$174.36,N/A,$153.26,N/A,N/A,N/A,$174.36,N/A,$153.26,N/A,$158.00,N/A,N/A,$153.26
3091753,0300,86900,,,,,N/A,N/A,ARC ABO,$159.41,$118.50,$153.26,$174.36,N/A,$153.26,N/A,N/A,N/A,$174.36,N/A,$153.26,N/A,$158.00,N/A,N/A,$153.26
3099247,0300,86900,,,,,N/A,N/A,ARC ABO,$159.41,$118.50,$153.26,$174.36,N/A,$153.26,N/A,N/A,N/A,$174.36,N/A,$153.26,N/A,$158.00,N/A,N/A,$153.26
3030703,0300,86901,,,,,N/A,N/A,RHD,$63.56,$47.25,$3.77,$63.00,N/A,$61.11,N/A,N/A,N/A,$3.77,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3099248,0300,86901,,,,,N/A,N/A,ARC RH,$135.20,$100.50,$3.77,$63.00,N/A,$61.11,N/A,N/A,N/A,$3.77,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3030714,0300,86902,,,,,N/A,N/A,ANTIGEN TYPING (DONOR UNITS),$321.85,$239.25,$3.77,$319.00,N/A,$309.43,N/A,N/A,N/A,$3.77,N/A,$309.43,N/A,$319.00,N/A,N/A,$309.43
3099264,0300,86902,,,,,N/A,N/A,ARC ANTIGEN,$321.85,$239.25,$3.77,$319.00,N/A,$309.43,N/A,N/A,N/A,$3.77,N/A,$309.43,N/A,$319.00,N/A,N/A,$309.43
3092221,0300,86906,,,,,N/A,N/A,ARC RH PHENOTYPE,$99.89,$74.25,$4.61,$99.00,N/A,$96.03,N/A,N/A,N/A,$4.61,N/A,$96.03,N/A,$99.00,N/A,N/A,$96.03
3030701,0300,86920,,,,,N/A,N/A,CROSS MATCH,$161.43,$120.00,$9.22,$160.00,N/A,$155.20,N/A,N/A,N/A,$9.22,N/A,$155.20,N/A,$160.00,N/A,N/A,$155.20
3900718,0300,86945,,,,,N/A,N/A,IRRADIATION FEE,$105.94,$78.75,$24.73,$105.00,N/A,$101.85,N/A,N/A,N/A,$24.73,N/A,$101.85,N/A,$105.00,N/A,N/A,$101.85
3091817,0300,86976,,,,,N/A,N/A,ARC DILUTION OF SERUM,$48.43,$36.00,$36.46,$48.00,N/A,$46.56,N/A,N/A,N/A,$36.46,N/A,$46.56,N/A,$48.00,N/A,N/A,$46.56
8708840,0300,87088,,,,,N/A,N/A,URINE CULTURE,$27.24,$20.25,$9.64,$27.00,N/A,$26.19,N/A,N/A,N/A,$9.64,N/A,$26.19,N/A,$27.00,N/A,N/A,$26.19
3099663,0300,87101,,,,,N/A,N/A,"FAHC FUNGUS CULT SKN,HR,NLS",$150.33,$111.75,$9.64,$149.00,N/A,$144.53,N/A,N/A,N/A,$9.64,N/A,$144.53,N/A,$149.00,N/A,N/A,$144.53
3092033,0300,87102,,,,,N/A,N/A,MAYO FUNGUS CULTURE ROUTINE,$165.47,$123.00,$9.22,$164.00,N/A,$159.08,N/A,N/A,N/A,$9.22,N/A,$159.08,N/A,$164.00,N/A,N/A,$159.08
3091886,0300,87172,,,,,N/A,N/A,MAYO PERIANAL SWAB FR PINWORMS,$88.79,$66.00,$5.03,$88.00,N/A,$85.36,N/A,N/A,N/A,$5.03,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
99987205,0300,87205,,,,,N/A,N/A,LABORATORY,$118.05,$87.75,$10.48,$88.00,N/A,$85.36,N/A,N/A,N/A,$10.48,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3091926,0300,87206,,,,,N/A,N/A,FAHC CYCLOSPORA DETECTION,$107.96,$80.25,$5.03,$16.00,N/A,$15.52,N/A,N/A,N/A,$5.03,N/A,$15.52,N/A,$16.00,N/A,N/A,$15.52
3099605,0300,87206,,,,,N/A,N/A,"FAHC FUNGUS CULT SKN,HR,NLS",$122.08,$90.75,$5.03,$16.00,N/A,$15.52,N/A,N/A,N/A,$5.03,N/A,$15.52,N/A,$16.00,N/A,N/A,$15.52
87210,0300,87210,,,,,N/A,N/A,WET MOUNT,$21.19,$15.75,$21.80,$88.00,N/A,$85.36,N/A,N/A,N/A,$21.80,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
87220LSC,0300,87220,,,,,N/A,N/A,WET MOUNT,$42.38,$31.50,$7.13,$88.00,N/A,$85.36,N/A,N/A,N/A,$7.13,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3091967,0300,87271,,,,,N/A,N/A,FAHC CMV ANTIGENEMIA ASSAY,$226.00,$168.00,$24.31,$224.00,N/A,$217.28,N/A,N/A,N/A,$24.31,N/A,$217.28,N/A,$224.00,N/A,N/A,$217.28
3092087,0300,87272,,,,,N/A,N/A,FAHC MICROSPORIDIUM EXAM,$68.61,$51.00,$15.93,$91.00,N/A,$88.27,N/A,N/A,N/A,$15.93,N/A,$88.27,N/A,$91.00,N/A,N/A,$88.27
3092063,0300,87380,,,,,N/A,N/A,MAYO HEPATITIS D VIRUS Ag,$299.66,$222.75,$13.83,$297.00,N/A,$288.09,N/A,N/A,N/A,$13.83,N/A,$288.09,N/A,$297.00,N/A,N/A,$288.09
3091962,0300,87385,,,,,N/A,N/A,MAYO HISTOPLASMA Ag,$309.74,$230.25,$22.21,$307.00,N/A,$297.79,N/A,N/A,N/A,$22.21,N/A,$297.79,N/A,$307.00,N/A,N/A,$297.79
87426QW,0300,87426,,,,,N/A,N/A,Sars-Cov-2,$0.00,$0.00,$0.00,$0.00,N/A,$0.00,N/A,N/A,N/A,N/A,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
87428QW,0300,87428,,,,,N/A,N/A,Sar-Cov-2 & Flu A+b,$0.00,$0.00,$0.00,$0.00,N/A,$0.00,N/A,N/A,N/A,N/A,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
3060329,0300,87480,,,,,N/A,N/A,VAGINAL PATHOGEN SCREEN,$96.86,$72.00,$42.33,$96.00,N/A,$93.12,N/A,N/A,N/A,$42.33,N/A,$93.12,N/A,$96.00,N/A,N/A,$93.12
3020523,0300,87493,,,,,N/A,N/A,XPERT C. DIFFICILE,$105.94,$78.75,$42.33,$105.00,N/A,$101.85,N/A,N/A,N/A,$42.33,N/A,$101.85,N/A,$105.00,N/A,N/A,$101.85
3092235,0300,87497,,,,,N/A,N/A,MAYO CMV DNA QN PCR,$810.18,$602.25,$42.33,$803.00,N/A,$778.91,N/A,N/A,N/A,$42.33,N/A,$778.91,N/A,$803.00,N/A,N/A,$778.91
3060330,0300,87510,,,,,N/A,N/A,VAGINAL PATHOGEN SCREEN,$96.86,$72.00,$93.12,$154.24,N/A,$93.12,N/A,N/A,N/A,$154.24,N/A,$93.12,N/A,$96.00,N/A,N/A,$93.12
3092061,0300,87516,,,,,N/A,N/A,"HEPATITIS B VIRUS DNA QL,PCR",$517.59,$384.75,$23.89,$513.00,N/A,$497.61,N/A,N/A,N/A,$23.89,N/A,$497.61,N/A,$513.00,N/A,N/A,$497.61
3020511,0300,87635,,,,,N/A,N/A,COVID-19 PCR (NVRH),$142.26,$105.75,$136.77,$500.45,N/A,$136.77,N/A,N/A,N/A,$500.45,N/A,$136.77,N/A,$141.00,N/A,N/A,$136.77
3020512,0300,87637,,,,,N/A,N/A,COVID/FLU/RSV PCR (NVRH),$322.86,$240.00,$310.40,$320.00,N/A,$310.40,N/A,N/A,N/A,$320.00,N/A,$310.40,N/A,$320.00,N/A,N/A,$310.40
3020524,0300,87641,,,,,N/A,N/A,XPERT MRSA,$99.89,$74.25,$96.03,$99.00,N/A,$96.03,N/A,N/A,N/A,$99.00,N/A,$96.03,N/A,$99.00,N/A,N/A,$96.03
3060331,0300,87660,,,,,N/A,N/A,VAGINAL PATHOGEN SCREEN,$96.86,$72.00,$42.33,$96.00,N/A,$93.12,N/A,N/A,N/A,$42.33,N/A,$93.12,N/A,$96.00,N/A,N/A,$93.12
4587802,0300,87802,,,,,N/A,N/A,Rapid Strep Test - Er,$99.89,$74.25,$84.25,$99.00,N/A,$96.03,N/A,N/A,N/A,$84.25,N/A,$96.03,N/A,$99.00,N/A,N/A,$96.03
87804,0300,87804,,,,,N/A,N/A,INFLUENZA A & B,$32.29,$24.00,$15.09,$35.00,N/A,$33.95,N/A,N/A,N/A,$15.09,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
8780459LSC,0300,87804,,,,,N/A,N/A,INFLUENZA A & B,$35.31,$26.25,$15.09,$35.00,N/A,$33.95,N/A,N/A,N/A,$15.09,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
87804LSC,0300,87804,,,,,N/A,N/A,INFLUENZA A & B,$35.31,$26.25,$15.09,$35.00,N/A,$33.95,N/A,N/A,N/A,$15.09,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
5187880,0300,87880,,,,,N/A,N/A,STREPTOCOCCUS GROUP,$75.67,$56.25,$19.70,$75.00,N/A,$72.75,N/A,N/A,N/A,$19.70,N/A,$72.75,N/A,$75.00,N/A,N/A,$72.75
87880LSC,0300,87880,,,,,N/A,N/A,STREP GROUP A,$42.38,$31.50,$19.70,$75.00,N/A,$72.75,N/A,N/A,N/A,$19.70,N/A,$72.75,N/A,$75.00,N/A,N/A,$72.75
88155LSC,0300,88155,,,,,N/A,N/A,PAP SMEAR COLLECTION,$49.44,$36.75,$18.02,$49.00,N/A,$47.53,N/A,N/A,N/A,$18.02,N/A,$47.53,N/A,$49.00,N/A,N/A,$47.53
3092681,0300,88189,,,,,N/A,N/A,LEUKEMIA PANELFLOW CYTO FAHC,$999.86,$743.25,$46.31,$991.00,$46.31,$961.27,$46.31,N/A,$46.31,$74.49,$46.31,$961.27,$46.31,$991.00,$46.31,$46.31,$961.27
3091947,0300,88271,,,,,N/A,N/A,MAYO 17q 11.2 DELETION NF1,$254.25,$189.00,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3091948,0300,88271,,,,,N/A,N/A,MAYO 17q 11.2 DELETION NF1,$254.25,$189.00,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3091982,0300,88271,,,,,N/A,N/A,MAYO 15q PRADER WILLI/ANGEL,$143.27,$106.50,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3091983,0300,88271,,,,,N/A,N/A,MAYO 15q PRADER WILLI/ANGEL,$143.27,$106.50,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3091984,0300,88271,,,,,N/A,N/A,MAYO 15q PRADER WILLI/ANGEL,$143.27,$106.50,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3091988,0300,88271,,,,,N/A,N/A,MAYO SUBTELOMERIC REG ANOMAL,$45.40,$33.75,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3091989,0300,88271,,,,,N/A,N/A,MAYO SUBTELOMERIC REG ANOMAL,$45.40,$33.75,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3091990,0300,88271,,,,,N/A,N/A,MAYO SUBTELOMERIC REG ANOMAL,$45.40,$33.75,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3091991,0300,88271,,,,,N/A,N/A,MAYO SUBTELOMERIC REG ANOMAL,$45.40,$33.75,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3091992,0300,88271,,,,,N/A,N/A,MAYO SUBTELOMERIC REG ANOMAL,$45.40,$33.75,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3091993,0300,88271,,,,,N/A,N/A,MAYO SUBTELOMERIC REG ANOMAL,$45.40,$33.75,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3091995,0300,88271,,,,,N/A,N/A,MAYO SUBTELOMERIC REG ANOMAL,$45.40,$33.75,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3091996,0300,88271,,,,,N/A,N/A,MAYO SUBTELOMERIC REG ANOMAL,$45.40,$33.75,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3091997,0300,88271,,,,,N/A,N/A,MAYO SUBTELOMERIC REG ANOMAL,$45.40,$33.75,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3091998,0300,88271,,,,,N/A,N/A,MAYO SUBTELOMERIC REG ANOMAL,$45.40,$33.75,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3091999,0300,88271,,,,,N/A,N/A,MAYO SUBTELOMERIC REG ANOMAL,$45.40,$33.75,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3092000,0300,88271,,,,,N/A,N/A,MAYO SUBTELOMERIC REG ANOMAL,$46.41,$34.50,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3092001,0300,88271,,,,,N/A,N/A,MAYO SUBTELOMERIC REG ANOMAL,$45.40,$33.75,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3092002,0300,88271,,,,,N/A,N/A,MAYO SUBTELOMERIC REG ANOMAL,$45.40,$33.75,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3092003,0300,88271,,,,,N/A,N/A,MAYO SUBTELOMERIC REG ANOMAL,$45.40,$33.75,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3092004,0300,88271,,,,,N/A,N/A,MAYO SUBTELOMERIC REG ANOMAL,$45.40,$33.75,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3092005,0300,88271,,,,,N/A,N/A,MAYO SUBTELOMERIC REG ANOMAL,$45.40,$33.75,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3092006,0300,88271,,,,,N/A,N/A,MAYO SUBTELOMERIC REG ANOMAL,$45.40,$33.75,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3092007,0300,88271,,,,,N/A,N/A,MAYO SUBTELOMERIC REG ANOMAL,$46.41,$34.50,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3092008,0300,88271,,,,,N/A,N/A,MAYO SUBTELOMERIC REG ANOMAL,$23.21,$17.25,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3092009,0300,88271,,,,,N/A,N/A,MAYO SUBTELOMERIC REG ANOMAL,$46.41,$34.50,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3092010,0300,88271,,,,,N/A,N/A,MAYO SUBTELOMERIC REG ANOMAL,$46.41,$34.50,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3092011,0300,88271,,,,,N/A,N/A,MAYO SUBTELOMERIC REG ANOMAL,$46.41,$34.50,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3092012,0300,88271,,,,,N/A,N/A,MAYO SUBTELOMERIC REG ANOMAL,$46.41,$34.50,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3092013,0300,88271,,,,,N/A,N/A,MAYO SUBTELOMERIC REG ANOMAL,$46.41,$34.50,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3092014,0300,88271,,,,,N/A,N/A,MAYO SUBTELOMERIC REG ANOMAL,$46.41,$34.50,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3092015,0300,88271,,,,,N/A,N/A,MAYO SUBTELOMERIC REG ANOMAL,$46.41,$34.50,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3092016,0300,88271,,,,,N/A,N/A,MAYO SUBTELOMERIC REG ANOMAL,$46.41,$34.50,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3092017,0300,88271,,,,,N/A,N/A,MAYO SUBTELOMERIC REG ANOMAL,$46.41,$34.50,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3092018,0300,88271,,,,,N/A,N/A,MAYO SUBTELOMERIC REG ANOMAL,$46.41,$34.50,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3092019,0300,88271,,,,,N/A,N/A,MAYO SUBTELOMERIC REG ANOMAL,$46.41,$34.50,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3092020,0300,88271,,,,,N/A,N/A,MAYO SUBTELOMERIC REG ANOMAL,$46.41,$34.50,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3092021,0300,88271,,,,,N/A,N/A,MAYO SUBTELOMERIC REG ANOMAL,$46.41,$34.50,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3092022,0300,88271,,,,,N/A,N/A,MAYO SUBTELOMERIC REG ANOMAL,$46.41,$34.50,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3092023,0300,88271,,,,,N/A,N/A,MAYO SUBTELOMERIC REG ANOMAL,$46.41,$34.50,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3092024,0300,88271,,,,,N/A,N/A,MAYO SUBTELOMERIC REG ANOMAL,$46.41,$34.50,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3092025,0300,88271,,,,,N/A,N/A,MAYO SUBTELOMERIC REG ANOMAL,$46.41,$34.50,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3092027,0300,88271,,,,,N/A,N/A,MAYO SUBTELOMERIC REG ANOMAL,$46.41,$34.50,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3092028,0300,88271,,,,,N/A,N/A,MAYO SUBTELOMERIC REG ANOMAL,$46.41,$34.50,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3092125,0300,88271,,,,,N/A,N/A,MAYO 22q11.2 DELETION/DUPL,$174.55,$129.75,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3092126,0300,88271,,,,,N/A,N/A,MAYO 22q11.2 DELETION/DUPL,$174.55,$129.75,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3091985,0300,88273,,,,,N/A,N/A,MAYO 15q PRADER WILLI/ANGEL,$143.27,$106.50,$25.57,$45.00,N/A,$43.65,N/A,N/A,N/A,$25.57,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3092029,0300,88273,,,,,N/A,N/A,MAYO SUBTELOMERIC REG ANOMAL,$45.40,$33.75,$25.57,$45.00,N/A,$43.65,N/A,N/A,N/A,$25.57,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3092030,0300,88273,,,,,N/A,N/A,MAYO SUBTELOMERIC REG ANOMAL,$45.40,$33.75,$25.57,$45.00,N/A,$43.65,N/A,N/A,N/A,$25.57,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3092127,0300,88273,,,,,N/A,N/A,MAYO 22q11.2 DELETION/DUPL,$177.57,$132.00,$25.57,$45.00,N/A,$43.65,N/A,N/A,N/A,$25.57,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3091949,0300,88275,,,,,N/A,N/A,MAYO 17q 11.2 DELETION NF1,$254.25,$189.00,$50.72,$751.00,N/A,$728.47,N/A,N/A,N/A,$50.72,N/A,$728.47,N/A,$751.00,N/A,N/A,$728.47
3091950,0300,88291,,,,,N/A,N/A,MAYO 17q 11.2 DELETION NF1,$254.25,$189.00,$61.61,$176.00,$168.10,$170.72,$168.10,N/A,$168.10,$61.61,$168.10,$170.72,$168.10,$176.00,$168.10,$168.10,$170.72
3091986,0300,88291,,,,,N/A,N/A,MAYO 15q PRADER WILLI/ANGEL,$138.22,$102.75,$61.61,$176.00,$168.10,$170.72,$168.10,N/A,$168.10,$61.61,$168.10,$170.72,$168.10,$176.00,$168.10,$168.10,$170.72
3092031,0300,88291,,,,,N/A,N/A,MAYO SUBTELOMERIC REG ANOMAL,$45.40,$33.75,$61.61,$176.00,$168.10,$170.72,$168.10,N/A,$168.10,$61.61,$168.10,$170.72,$168.10,$176.00,$168.10,$168.10,$170.72
3092128,0300,88291,,,,,N/A,N/A,MAYO 22q11.2 DELETION/DUPL,$177.57,$132.00,$61.61,$176.00,$168.10,$170.72,$168.10,N/A,$168.10,$61.61,$168.10,$170.72,$168.10,$176.00,$168.10,$168.10,$170.72
3050511,0300,89051,,,,,N/A,N/A,CELL COUNT & DIF BFL,$107.96,$80.25,$5.87,$125.00,N/A,$121.25,N/A,N/A,N/A,$5.87,N/A,$121.25,N/A,$125.00,N/A,N/A,$121.25
3050114,0300,89060,,,,,N/A,N/A,CRYSTAL ID,$141.25,$105.00,$6.71,$158.00,$64.78,$153.26,$64.78,N/A,$64.78,$6.71,$64.78,$153.26,$64.78,$158.00,$64.78,$64.78,$153.26
3057114,0300,89060,,,,,N/A,N/A,CRYSTAL ID STAT,$126.12,$93.75,$6.71,$158.00,$64.78,$153.26,$64.78,N/A,$64.78,$6.71,$64.78,$153.26,$64.78,$158.00,$64.78,$64.78,$153.26
3099478,0300,89060,,,,,N/A,N/A,FAHC CRYSTAL ANALYSIS (BF),$159.41,$118.50,$6.71,$158.00,$64.78,$153.26,$64.78,N/A,$64.78,$6.71,$64.78,$153.26,$64.78,$158.00,$64.78,$64.78,$153.26
3091389,0300,89160,,,,,N/A,N/A,FECAL MUSCLE FIBER,$365.24,$271.50,$30.64,$362.00,N/A,$351.14,N/A,N/A,N/A,$30.64,N/A,$351.14,N/A,$362.00,N/A,N/A,$351.14
3092121,0300,89325,,,,,N/A,N/A,MAYO SPERM AB,$318.83,$237.00,$10.48,$316.00,N/A,$306.52,N/A,N/A,N/A,$10.48,N/A,$306.52,N/A,$316.00,N/A,N/A,$306.52
99000LSC,0300,99000,,,,,N/A,N/A,SPECIMEN COLLECTION,$31.28,$23.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3000996,0300,,,,,,N/A,N/A,HANDLING FEE,$54.48,$40.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3000997,0300,,,,,,N/A,N/A,STAT SHIPPING & HANDLING,$444.94,$330.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3064601,0300,,,,,,N/A,N/A,V-CULTURE ROUTINE,$105.94,$78.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3064607,0300,,,,,,N/A,N/A,V-SENSITIVITIES,$91.81,$68.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3091500,0300,,,,,,N/A,N/A,DRUG SCREEN COLLECTION,$54.48,$40.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3091818,0300,,,,,,N/A,N/A,ARC CALL IN FEE,$354.14,$263.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3092228,0300,,,,,,N/A,N/A,NCHC IMMUNIZATION PANEL CLIENT,$183.63,$136.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3500001,0300,,,,,,N/A,N/A,INDEPENDENT BLOOD ALCOHOL~ LAB,$88.79,$66.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3909218,0300,,,,,,N/A,N/A,PRE EMPLOYMENT WORK PROFILE,$106.95,$79.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3909219,0300,,,,,,N/A,N/A,EMPLOYMENT EXPOSURE PROFILE,$135.20,$100.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3909220,0300,,,,,,N/A,N/A,PATIENT EXPOSURE PROFILE,$163.45,$121.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3909221,0300,,,,,,N/A,N/A,EMPLOYEE EXPOSURE FOLLOW-UP,$80.72,$60.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3010211,0301,80048,,,,,N/A,N/A,BASIC METABOLIC PANEL,$165.47,$123.00,$143.56,$430.83,N/A,$143.56,N/A,$9.87,N/A,$430.83,N/A,$143.56,N/A,$148.00,N/A,N/A,$143.56
3010226,0301,80051,,,,,N/A,N/A,LYTES (ELECTROLYTES),$137.22,$102.00,$10.06,$136.00,N/A,$131.92,N/A,$10.16,N/A,$10.06,N/A,$131.92,N/A,$136.00,N/A,N/A,$131.92
3010218,0301,80053,,,,,N/A,N/A,COMPREHENSIVE METABOLIC PANEL,$203.81,$151.50,$8.38,$202.00,N/A,$195.94,N/A,$15.31,N/A,$8.38,N/A,$195.94,N/A,$202.00,N/A,N/A,$195.94
3040001,0301,80055,,,,,N/A,N/A,PRENATAL PROFILE I,$607.38,$451.50,N/A,N/A,N/A,N/A,N/A,$68.86,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3010233,0301,80061,,,,,N/A,N/A,LIPID2A,$209.86,$156.00,$12.57,$208.00,N/A,$201.76,N/A,$19.42,N/A,$12.57,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3010249,0301,80069,,,,,N/A,N/A,RENAL FUNCTION PANEL,$171.52,$127.50,$15.93,$170.00,N/A,$164.90,N/A,$12.59,N/A,$15.93,N/A,$164.90,N/A,$170.00,N/A,N/A,$164.90
3099726,0301,80074,,,,,N/A,N/A,MAYO HEPABC PANEL,$879.80,$654.00,$10.48,$872.00,N/A,$845.84,N/A,$69.06,N/A,$10.48,N/A,$845.84,N/A,$872.00,N/A,N/A,$845.84
3010234,0301,80076,,,,,N/A,N/A,LIVER PANEL,$178.58,$132.75,$57.42,$177.00,N/A,$171.69,N/A,$11.85,N/A,$57.42,N/A,$171.69,N/A,$177.00,N/A,N/A,$171.69
3091267,0301,80151,,,,,N/A,N/A,MAYO AMIODARONE,$70.63,$52.50,N/A,N/A,N/A,N/A,N/A,$18.64,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3091324,0301,80173,,,,,N/A,N/A,HALDOL,$308.74,$229.50,$25.99,$306.00,N/A,$296.82,N/A,$22.88,N/A,$25.99,N/A,$296.82,N/A,$306.00,N/A,N/A,$296.82
3091251,0301,80175,,,,,N/A,N/A,LAMOTRG/LAMICTL,$263.33,$195.75,$18.86,$261.00,N/A,$253.17,N/A,$19.21,N/A,$18.86,N/A,$253.17,N/A,$261.00,N/A,N/A,$253.17
3090220,0301,80188,,,,,N/A,N/A,PRIMIDONE (MAYO),$317.82,$236.25,$16.35,$315.00,N/A,$305.55,N/A,$24.06,N/A,$16.35,N/A,$305.55,N/A,$315.00,N/A,N/A,$305.55
3091072,0301,80299,,,,,N/A,N/A,NORPACE,$286.54,$213.00,$32.69,$377.00,N/A,$365.69,N/A,$27.03,N/A,$32.69,N/A,$365.69,N/A,$377.00,N/A,N/A,$365.69
3091257,0301,80299,,,,,N/A,N/A,FLECAINIDE,$277.46,$206.25,$32.69,$377.00,N/A,$365.69,N/A,$27.03,N/A,$32.69,N/A,$365.69,N/A,$377.00,N/A,N/A,$365.69
3091261,0301,80299,,,,,N/A,N/A,Clomipramine,$263.33,$195.75,$32.69,$377.00,N/A,$365.69,N/A,$27.03,N/A,$32.69,N/A,$365.69,N/A,$377.00,N/A,N/A,$365.69
3091302,0301,80299,,,,,N/A,N/A,MAYO FELBAMATE,$345.06,$256.50,$32.69,$377.00,N/A,$365.69,N/A,$27.03,N/A,$32.69,N/A,$365.69,N/A,$377.00,N/A,N/A,$365.69
3010245,0301,80320,,,,,N/A,N/A,Ethanol (Bac),$182.62,$135.75,$74.61,$219.00,N/A,$212.43,N/A,N/A,N/A,$74.61,N/A,$212.43,N/A,$219.00,N/A,N/A,$212.43
3010286,0301,80329,,,,,N/A,N/A,Acetaminophen,$387.43,$288.00,$28.92,$384.00,N/A,$372.48,N/A,N/A,N/A,$28.92,N/A,$372.48,N/A,$384.00,N/A,N/A,$372.48
3099829,0301,80400,,,,,N/A,N/A,CORTISOL STIMULATION,$468.15,$348.00,$28.92,$464.00,N/A,$450.08,N/A,$47.30,N/A,$28.92,N/A,$450.08,N/A,$464.00,N/A,N/A,$450.08
3099586,0301,82017,,,,,N/A,N/A,ACYLCARNITINE,$834.39,$620.25,$9.64,$827.00,N/A,$802.19,N/A,$21.48,N/A,$9.64,N/A,$802.19,N/A,$827.00,N/A,N/A,$802.19
3091054,0301,82024,,,,,N/A,N/A,ACTH,$730.47,$543.00,$20.12,$724.00,N/A,$702.28,N/A,$56.00,N/A,$20.12,N/A,$702.28,N/A,$724.00,N/A,N/A,$702.28
3099718,0301,82030,,,,,N/A,N/A,MAYO CYCLIC AMP,$558.95,$415.50,$46.52,$554.00,N/A,$537.38,N/A,$37.41,N/A,$46.52,N/A,$537.38,N/A,$554.00,N/A,N/A,$537.38
3010246,0301,82040,,,,,N/A,N/A,ALBUMIN,$85.76,$63.75,$31.02,$85.00,N/A,$82.45,N/A,$7.18,N/A,$31.02,N/A,$82.45,N/A,$85.00,N/A,N/A,$82.45
3099226,0301,82040,,,,,N/A,N/A,FAHC IgG INDEX CSF,$71.63,$53.25,$31.02,$85.00,N/A,$82.45,N/A,$7.18,N/A,$31.02,N/A,$82.45,N/A,$85.00,N/A,N/A,$82.45
3099741,0301,82043,,,,,N/A,N/A,MICRO ALBUMIN,$106.95,$79.50,$9.22,$106.00,N/A,$102.82,N/A,$8.38,N/A,$9.22,N/A,$102.82,N/A,$106.00,N/A,N/A,$102.82
3091032,0301,82085,,,,,N/A,N/A,ALDOLASE,$187.66,$139.50,$180.42,$186.00,N/A,$180.42,N/A,$14.08,N/A,$186.00,N/A,$180.42,N/A,$186.00,N/A,N/A,$180.42
3091318,0301,82088,,,,,N/A,N/A,ALDOSTERONE,$769.82,$572.25,$11.74,$763.00,N/A,$740.11,N/A,$59.09,N/A,$11.74,N/A,$740.11,N/A,$763.00,N/A,N/A,$740.11
3099428,0301,82088,,,,,N/A,N/A,ALDOSTERONE 24 HR URINE,$223.98,$166.50,$11.74,$763.00,N/A,$740.11,N/A,$59.09,N/A,$11.74,N/A,$740.11,N/A,$763.00,N/A,N/A,$740.11
3091059,0301,82103,,,,,N/A,N/A,ALPH1 ANTITRY,$170.51,$126.75,$49.04,$193.00,N/A,$187.21,N/A,$19.49,N/A,$49.04,N/A,$187.21,N/A,$193.00,N/A,N/A,$187.21
3093143,0301,82103,,,,,N/A,N/A,"MAYO ALPHA 1 ANTITRYPSIN,FECES",$79.71,$59.25,$49.04,$193.00,N/A,$187.21,N/A,$19.49,N/A,$49.04,N/A,$187.21,N/A,$193.00,N/A,N/A,$187.21
3091266,0301,82164,,,,,N/A,N/A,A C E,$691.12,$513.75,$35.21,$685.00,N/A,$664.45,N/A,$21.17,N/A,$35.21,N/A,$664.45,N/A,$685.00,N/A,N/A,$664.45
3010302,0301,82247,,,,,N/A,N/A,N BILI TOTAL,$125.11,$93.00,$20.54,$132.00,N/A,$128.04,N/A,$7.28,N/A,$20.54,N/A,$128.04,N/A,$132.00,N/A,N/A,$128.04
3010303,0301,82248,,,,,N/A,N/A,N BILI DIRECT,$125.11,$93.00,$5.87,$124.00,N/A,$120.28,N/A,$5.85,N/A,$5.87,N/A,$120.28,N/A,$124.00,N/A,N/A,$120.28
3050422,0301,82270,,,,,N/A,N/A,STOOL OCCULT BLOOD X3,$53.47,$39.75,$5.87,$67.00,N/A,$64.99,N/A,$6.35,N/A,$5.87,N/A,$64.99,N/A,$67.00,N/A,N/A,$64.99
3010300,0301,82306,,,,,N/A,N/A,VITAMIN D 25 TOTAL,$401.56,$298.50,$28.50,$398.00,N/A,$386.06,N/A,$42.92,N/A,$28.50,N/A,$386.06,N/A,$398.00,N/A,N/A,$386.06
3091037,0301,82306,,,,,N/A,N/A,VITAMIN D(25-HYDROXY),$380.37,$282.75,$28.50,$398.00,N/A,$386.06,N/A,$42.92,N/A,$28.50,N/A,$386.06,N/A,$398.00,N/A,N/A,$386.06
3017955,0301,82375,,,,,N/A,N/A,CARBOXYHEMOGLOBIN (NVRH),$120.06,$89.25,$5.87,$119.00,N/A,$115.43,N/A,$17.86,N/A,$5.87,N/A,$115.43,N/A,$119.00,N/A,N/A,$115.43
3091392,0301,82379,,,,,N/A,N/A,CARNITINE,$249.21,$185.25,$22.63,$247.00,N/A,$239.59,N/A,$21.48,N/A,$22.63,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3010256,0301,82465,,,,,N/A,N/A,LIPID 2 CHOLESTEROL,$101.90,$75.75,$5.87,$101.00,N/A,$97.97,N/A,$6.31,N/A,$5.87,N/A,$97.97,N/A,$101.00,N/A,N/A,$97.97
3091300,0301,82486,,,,,N/A,N/A,Organic Acids (Urine),$345.06,$256.50,$9.64,$122.00,N/A,$118.34,N/A,N/A,N/A,$9.64,N/A,$118.34,N/A,$122.00,N/A,N/A,$118.34
3099579,0301,82491,,,,,N/A,N/A,Mayo Methanephrines (Serum),$345.06,$256.50,$331.74,$342.00,N/A,$331.74,N/A,N/A,N/A,$342.00,N/A,$331.74,N/A,$342.00,N/A,N/A,$331.74
3099742,0301,82570,,,,,N/A,N/A,CREAT RATIO,$101.90,$75.75,$6.29,$103.00,N/A,$99.91,N/A,$6.04,N/A,$6.29,N/A,$99.91,N/A,$103.00,N/A,N/A,$99.91
3010297,0301,82731,,,,,N/A,N/A,FETAL FIBRONECTIN,"$1,212.75",$901.50,$16.35,"$1,202.00",N/A,"$1,165.94",N/A,$93.39,N/A,$16.35,N/A,"$1,165.94",N/A,"$1,202.00",N/A,N/A,"$1,165.94"
3017957,0301,82803,,,,,N/A,N/A,ISTAT ARTERIAL BLOOD GAS,$234.07,$174.00,$13.41,$366.00,N/A,$355.02,N/A,$37.80,N/A,$13.41,N/A,$355.02,N/A,$366.00,N/A,N/A,$355.02
3017956,0301,82805,,,,,N/A,N/A,ABL 90 ARTERIAL BLOOD GAS,$234.07,$174.00,$31.44,$232.00,N/A,$225.04,N/A,$86.65,N/A,$31.44,N/A,$225.04,N/A,$232.00,N/A,N/A,$225.04
3010248,0301,82947,,,,,N/A,N/A,FASTING GLUCOSE,$81.72,$60.75,$4.61,$81.00,N/A,$78.57,N/A,$5.70,N/A,$4.61,N/A,$78.57,N/A,$81.00,N/A,N/A,$78.57
3010230,0301,82950,,,,,N/A,N/A,GLUCOSE 1-2 H W/GLUC,$95.85,$71.25,$4.61,$95.00,N/A,$92.15,N/A,$6.89,N/A,$4.61,N/A,$92.15,N/A,$95.00,N/A,N/A,$92.15
3010235,0301,82951,,,,,N/A,N/A,GLUCOSE TOLERAN 3 HR,$248.20,$184.50,$5.87,$246.00,N/A,$238.62,N/A,$18.66,N/A,$5.87,N/A,$238.62,N/A,$246.00,N/A,N/A,$238.62
3010948,0301,82951,,,,,N/A,N/A,GLUCOSE - 2 HR GTT,$172.53,$128.25,$5.87,$246.00,N/A,$238.62,N/A,$18.66,N/A,$5.87,N/A,$238.62,N/A,$246.00,N/A,N/A,$238.62
3010947,0301,82952,,,,,N/A,N/A,Additional Glucose,$212.89,$158.25,$15.51,$211.00,N/A,$204.67,N/A,$5.68,N/A,$15.51,N/A,$204.67,N/A,$211.00,N/A,N/A,$204.67
3010268,0301,82977,,,,,N/A,N/A,GGT,$142.26,$105.75,$3.77,$141.00,N/A,$136.77,N/A,$10.44,N/A,$3.77,N/A,$136.77,N/A,$141.00,N/A,N/A,$136.77
3091034,0301,83001,,,,,N/A,N/A,FSH,$358.17,$266.25,$20.12,$355.00,N/A,$344.35,N/A,$26.94,N/A,$20.12,N/A,$344.35,N/A,$355.00,N/A,N/A,$344.35
3091033,0301,83002,,,,,N/A,N/A,LH,$421.74,$313.50,$22.21,$418.00,N/A,$405.46,N/A,$26.85,N/A,$22.21,N/A,$405.46,N/A,$418.00,N/A,N/A,$405.46
3091088,0301,83003,,,,,N/A,N/A,GROWTH HORM (HG,$372.30,$276.75,$22.21,$369.00,N/A,$357.93,N/A,$24.17,N/A,$22.21,N/A,$357.93,N/A,$369.00,N/A,N/A,$357.93
3091066,0301,83010,,,,,N/A,N/A,HAPTOGLOBIN,$240.13,$178.50,$20.12,$51.00,N/A,$49.47,N/A,$18.24,N/A,$20.12,N/A,$49.47,N/A,$51.00,N/A,N/A,$49.47
3091293,0301,83020,,,,,N/A,N/A,HGB ELECTROPHORESIS,$248.20,$184.50,$1.86,$246.00,$1.86,$238.62,$1.86,$26.39,$1.86,$26.41,$1.86,$238.62,$1.86,$246.00,$1.86,$1.86,$238.62
3010945,0301,83036,,,,,N/A,N/A,HGB A1C,$103.92,$77.25,$21.80,$103.00,N/A,$99.91,N/A,N/A,N/A,$21.80,N/A,$99.91,N/A,$103.00,N/A,N/A,$99.91
3091141,0301,83036,,,,,N/A,N/A,HEMOGLOBIN AIC,$200.78,$149.25,$21.80,$103.00,N/A,$99.91,N/A,N/A,N/A,$21.80,N/A,$99.91,N/A,$103.00,N/A,N/A,$99.91
3099619,0301,83090,,,,,N/A,N/A,FAHC HOMOCYSTEINE,$345.06,$256.50,$35.63,$342.00,N/A,$331.74,N/A,N/A,N/A,$35.63,N/A,$331.74,N/A,$342.00,N/A,N/A,$331.74
3091371,0301,83150,,,,,N/A,N/A,HVA#530,$516.58,$384.00,$21.38,$172.00,N/A,$166.84,N/A,N/A,N/A,$21.38,N/A,$166.84,N/A,$172.00,N/A,N/A,$166.84
3091157,0301,83491,,,,,N/A,N/A,17-HYDROXYCORT,$525.66,$390.75,$26.82,$521.00,N/A,$505.37,N/A,N/A,N/A,$26.82,N/A,$505.37,N/A,$521.00,N/A,N/A,$505.37
3091388,0301,83498,,,,,N/A,N/A,MAYO 17-HYDROXYPROGESTERONE,$516.58,$384.00,$15.51,$512.00,N/A,$496.64,N/A,N/A,N/A,$15.51,N/A,$496.64,N/A,$512.00,N/A,N/A,$496.64
3091039,0301,83500,,,,,N/A,N/A,HYDROXYPROLINE FREE,$879.80,$654.00,$32.69,$872.00,N/A,$845.84,N/A,N/A,N/A,$32.69,N/A,$845.84,N/A,$872.00,N/A,N/A,$845.84
3099576,0301,83516,,,,,N/A,N/A,MAYO GLIADIN IgG,$249.21,$185.25,$27.24,$222.00,N/A,$215.34,N/A,N/A,N/A,$27.24,N/A,$215.34,N/A,$222.00,N/A,N/A,$215.34
3099577,0301,83516,,,,,N/A,N/A,MAYO GLIADIN IgA,$249.21,$185.25,$27.24,$222.00,N/A,$215.34,N/A,N/A,N/A,$27.24,N/A,$215.34,N/A,$222.00,N/A,N/A,$215.34
3099386,0301,83519,,,,,N/A,N/A,Tryptase,$259.30,$192.75,$13.83,$257.00,N/A,$249.29,N/A,N/A,N/A,$13.83,N/A,$249.29,N/A,$257.00,N/A,N/A,$249.29
3091358,0301,83520,,,,,N/A,N/A,GMIT,$249.21,$185.25,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3099046,0301,83520,,,,,N/A,N/A,SULFATIDE 2,$272.41,$202.50,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3099053,0301,83520,,,,,N/A,N/A,GLOMERULAR BASEMENT MEMBRANE,$695.16,$516.75,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3099414,0301,83520,,,,,N/A,N/A,Fahc Fetal Lung Maturity,$418.71,$311.25,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3091287,0301,83525,,,,,N/A,N/A,INSULIN,$223.98,$166.50,$20.54,$222.00,N/A,$215.34,N/A,N/A,N/A,$20.54,N/A,$215.34,N/A,$222.00,N/A,N/A,$215.34
3010273,0301,83540,,,,,N/A,N/A,IRON SERUM,$128.14,$95.25,$15.51,$127.00,N/A,$123.19,N/A,N/A,N/A,$15.51,N/A,$123.19,N/A,$127.00,N/A,N/A,$123.19
3010274,0301,83550,,,,,N/A,N/A,IRON BINDG CAP TOTAL,$171.52,$127.50,$7.96,$170.00,N/A,$164.90,N/A,N/A,N/A,$7.96,N/A,$164.90,N/A,$170.00,N/A,N/A,$164.90
3091158,0301,83582,,,,,N/A,N/A,17-Ketosterid U,"$1,088.65",$809.25,$10.48,"$1,079.00",N/A,"$1,046.63",N/A,N/A,N/A,$10.48,N/A,"$1,046.63",N/A,"$1,079.00",N/A,N/A,"$1,046.63"
3010298,0301,83605,,,,,N/A,N/A,LACTATE,$205.82,$153.00,$15.51,$204.00,N/A,$197.88,N/A,N/A,N/A,$15.51,N/A,$197.88,N/A,$204.00,N/A,N/A,$197.88
3099099,0301,83605,,,,,N/A,N/A,LACTIC ACID,$205.82,$153.00,$15.51,$204.00,N/A,$197.88,N/A,N/A,N/A,$15.51,N/A,$197.88,N/A,$204.00,N/A,N/A,$197.88
3010215,0301,83615,,,,,N/A,N/A,LDH,$119.05,$88.50,$13.83,$118.00,N/A,$114.46,N/A,N/A,N/A,$13.83,N/A,$114.46,N/A,$118.00,N/A,N/A,$114.46
3091070,0301,83625,,,,,N/A,N/A,LDH ISOENZYM TO,$495.39,$368.25,$7.13,$491.00,N/A,$476.27,N/A,N/A,N/A,$7.13,N/A,$476.27,N/A,$491.00,N/A,N/A,$476.27
3091061,0301,83655,,,,,N/A,N/A,"LEAD, BLOOD",$234.07,$174.00,$23.47,$346.00,N/A,$335.62,N/A,N/A,N/A,$23.47,N/A,$335.62,N/A,$346.00,N/A,N/A,$335.62
3099455,0301,83655,,,,,N/A,N/A,LEAD 24 HR URINE,$349.09,$259.50,$23.47,$346.00,N/A,$335.62,N/A,N/A,N/A,$23.47,N/A,$335.62,N/A,$346.00,N/A,N/A,$335.62
3091006,0301,83715,,,,,N/A,N/A,LIPOPROTEIN PHE,$444.94,$330.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3010429,0301,83718,,,,,N/A,N/A,HDL,$115.02,$85.50,$41.08,$128.00,N/A,$124.16,N/A,N/A,N/A,$41.08,N/A,$124.16,N/A,$128.00,N/A,N/A,$124.16
3091434,0301,83721,,,,,N/A,N/A,DIRECT LDL SBCL#8293,$180.60,$134.25,$9.64,$179.00,N/A,$173.63,N/A,N/A,N/A,$9.64,N/A,$173.63,N/A,$179.00,N/A,N/A,$173.63
3010253,0301,83735,,,,,N/A,N/A,MAGNESIUM,$133.18,$99.00,$20.54,$132.00,N/A,$128.04,N/A,N/A,N/A,$20.54,N/A,$128.04,N/A,$132.00,N/A,N/A,$128.04
3091445,0301,83735,,,,,N/A,N/A,MAGNESIUM 24HR URINE,$80.72,$60.00,$20.54,$132.00,N/A,$128.04,N/A,N/A,N/A,$20.54,N/A,$128.04,N/A,$132.00,N/A,N/A,$128.04
3099205,0301,83735,,,,,N/A,N/A,MAGNESIUM RBC&PLASMA,$209.86,$156.00,$20.54,$132.00,N/A,$128.04,N/A,N/A,N/A,$20.54,N/A,$128.04,N/A,$132.00,N/A,N/A,$128.04
3091114,0301,83825,,,,,N/A,N/A,MERCURY,$511.53,$380.25,$491.79,$507.00,N/A,$491.79,N/A,N/A,N/A,$507.00,N/A,$491.79,N/A,$507.00,N/A,N/A,$491.79
3099456,0301,83825,,,,,N/A,N/A,MERCURY 24 HR URINE,$468.15,$348.00,$491.79,$507.00,N/A,$491.79,N/A,N/A,N/A,$507.00,N/A,$491.79,N/A,$507.00,N/A,N/A,$491.79
3091260,0301,83858,,,,,N/A,N/A,METHSUXIMEDE,$365.24,$271.50,$20.54,$507.00,N/A,$491.79,N/A,N/A,N/A,$20.54,N/A,$491.79,N/A,$507.00,N/A,N/A,$491.79
3099488,0301,83858,,,,,N/A,N/A,METHSUXIMIDE,$511.53,$380.25,$20.54,$507.00,N/A,$491.79,N/A,N/A,N/A,$20.54,N/A,$491.79,N/A,$507.00,N/A,N/A,$491.79
3099222,0301,83873,,,,,N/A,N/A,MYELIN BASIC PROTEIN CSF,$516.58,$384.00,$7.13,$512.00,N/A,$496.64,N/A,N/A,N/A,$7.13,N/A,$496.64,N/A,$512.00,N/A,N/A,$496.64
3091124,0301,83874,,,,,N/A,N/A,"MYOGLOBIN,URINE",$249.21,$185.25,$20.54,$247.00,N/A,$239.59,N/A,N/A,N/A,$20.54,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3095005,0301,83890,,,,,N/A,N/A,MOLECULAR DIAGNOSTICS,$180.60,$134.25,$29.34,$179.00,N/A,$173.63,N/A,N/A,N/A,$29.34,N/A,$173.63,N/A,$179.00,N/A,N/A,$173.63
3095023,0301,83892,,,,,N/A,N/A,ENZYMATIC DIGESTION,"$1,491.21","$1,108.50",$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3099049,0301,83892,,,,,N/A,N/A,ENZYMATIC DIGESTION,$209.86,$156.00,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3099667,0301,84443,,,,,N/A,N/A,UVM THYROID CASCADE,$319.83,$237.75,$17.60,$342.00,N/A,$331.74,N/A,N/A,N/A,$17.60,N/A,$331.74,N/A,$342.00,N/A,N/A,$331.74
3091280,0301,84620,,,,,N/A,N/A,XYLOSE ABS (BLOOD),$389.45,$289.50,$20.54,$386.00,N/A,$374.42,N/A,N/A,N/A,$20.54,N/A,$374.42,N/A,$386.00,N/A,N/A,$374.42
3091028,0301,84630,,,,,N/A,N/A,ZINC PLASMA,$310.75,$231.00,$15.51,$158.00,N/A,$153.26,N/A,N/A,N/A,$15.51,N/A,$153.26,N/A,$158.00,N/A,N/A,$153.26
3091342,0301,84681,,,,,N/A,N/A,C PEPTIDE URIN,$541.80,$402.75,$13.83,$537.00,N/A,$520.89,N/A,N/A,N/A,$13.83,N/A,$520.89,N/A,$537.00,N/A,N/A,$520.89
3091428,0301,84681,,,,,N/A,N/A,C PEPTIDE SERUM,$396.51,$294.75,$13.83,$537.00,N/A,$520.89,N/A,N/A,N/A,$13.83,N/A,$520.89,N/A,$537.00,N/A,N/A,$520.89
3010946,0301,84702,,,,,N/A,N/A,HCG QUANT SERUM,$279.48,$207.75,$268.69,$277.00,N/A,$268.69,N/A,N/A,N/A,$277.00,N/A,$268.69,N/A,$277.00,N/A,N/A,$268.69
3050946,0301,84702,,,,,N/A,N/A,HCG QUANTAT SER,$234.07,$174.00,$268.69,$277.00,N/A,$268.69,N/A,N/A,N/A,$277.00,N/A,$268.69,N/A,$277.00,N/A,N/A,$268.69
3099447,0301,84702,,,,,N/A,N/A,HCG TUMOR MARKER,$279.48,$207.75,$268.69,$277.00,N/A,$268.69,N/A,N/A,N/A,$277.00,N/A,$268.69,N/A,$277.00,N/A,N/A,$268.69
3050272,0301,84703,,,,,N/A,N/A,HCG BETA SER QUAL,$150.33,$111.75,$18.02,$149.00,N/A,$144.53,N/A,N/A,N/A,$18.02,N/A,$144.53,N/A,$149.00,N/A,N/A,$144.53
3099747,0301,87522,,,,,N/A,N/A,HEPC BRANCHED DNA,"$1,118.91",$831.75,$42.33,"$1,109.00",N/A,"$1,075.73",N/A,N/A,N/A,$42.33,N/A,"$1,075.73",N/A,"$1,109.00",N/A,N/A,"$1,075.73"
3010115,0301,,,,,,N/A,N/A,PCO2 (Combined),$101.90,$75.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3010116,0301,,,,,,N/A,N/A,PO2 (Combined),$101.90,$75.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3060316,0302,82657,,,,,N/A,N/A,Rapid Influenza A & B,$55.49,$41.25,$13.83,$342.00,N/A,$331.74,N/A,$32.15,N/A,$13.83,N/A,$331.74,N/A,$342.00,N/A,N/A,$331.74
3099595,0302,86003,,,,,N/A,N/A,MAYO LATEX,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3099727,0302,86003,,,,,N/A,N/A,MAYO SHRIMP ALLERGEN,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3099735,0302,86003,,,,,N/A,N/A,MAYO MILK ALLERGEN,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3099737,0302,86003,,,,,N/A,N/A,MAYO CHOCOLATE ALLERGEN,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3099590,0302,86235,,,,,N/A,N/A,EXTRACTABLE NUCLEAR ANTIGEN.,$430.82,$320.25,$16.35,$340.00,N/A,$329.80,N/A,N/A,N/A,$16.35,N/A,$329.80,N/A,$340.00,N/A,N/A,$329.80
3099591,0302,86235,,,,,N/A,N/A,"EXTRACTABLE NUCLEAR ANTIGEN,",$430.82,$320.25,$16.35,$340.00,N/A,$329.80,N/A,N/A,N/A,$16.35,N/A,$329.80,N/A,$340.00,N/A,N/A,$329.80
3099043,0302,86255,,,,,N/A,N/A,ANTI-MITOCHONDRIAL AB 1,$272.41,$202.50,$21.38,$297.25,$297.25,$222.13,$297.25,N/A,$297.25,$21.38,$297.25,$222.13,$297.25,$229.00,$297.25,$297.25,$222.13
3091286,0302,86317,,,,,N/A,N/A,RABIES AB TITER,$421.74,$313.50,$19.40,$25.15,N/A,$19.40,N/A,N/A,N/A,$25.15,N/A,$19.40,N/A,$20.00,N/A,N/A,$19.40
3099504,0302,86403,,,,,N/A,N/A,CRYPTOCOCCUS ANTIGEN,$336.99,$250.50,$20.12,$170.00,N/A,$164.90,N/A,N/A,N/A,$20.12,N/A,$164.90,N/A,$170.00,N/A,N/A,$164.90
3091351,0302,86609,,,,,N/A,N/A,C DIFF ANTIBODY (s),$572.07,$425.25,$18.02,$35.00,N/A,$33.95,N/A,N/A,N/A,$18.02,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
3091367,0302,86609,,,,,N/A,N/A,Bartonella,$187.66,$139.50,$72.08,$140.00,N/A,$135.80,N/A,N/A,N/A,$72.08,N/A,$135.80,N/A,$140.00,N/A,N/A,$135.80
3091457,0302,86609,,,,,N/A,N/A,PNEU Ab VAC RESP TEST1,$101.90,$75.75,$18.02,$35.00,N/A,$33.95,N/A,N/A,N/A,$18.02,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
3091458,0302,86609,,,,,N/A,N/A,PNEU Ab VAC RESP TEST2,$101.90,$75.75,$18.02,$35.00,N/A,$33.95,N/A,N/A,N/A,$18.02,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
3091459,0302,86609,,,,,N/A,N/A,PNEU Ab VAC RESP TEST3,$101.90,$75.75,$18.02,$35.00,N/A,$33.95,N/A,N/A,N/A,$18.02,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
3091460,0302,86609,,,,,N/A,N/A,PNEU Ab VAC RESP TEST4,$101.90,$75.75,$18.02,$35.00,N/A,$33.95,N/A,N/A,N/A,$18.02,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
3091461,0302,86609,,,,,N/A,N/A,PNEU Ab VAC RESP TEST5,$101.90,$75.75,$18.02,$35.00,N/A,$33.95,N/A,N/A,N/A,$18.02,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
3091462,0302,86609,,,,,N/A,N/A,PNEU Ab VAC RESP TEST6,$101.90,$75.75,$18.02,$35.00,N/A,$33.95,N/A,N/A,N/A,$18.02,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
3091214,0302,86618,,,,,N/A,N/A,UVM LYME AB W/REFLEX LYME WB,$265.35,$197.25,$18.44,$273.00,N/A,$264.81,N/A,N/A,N/A,$18.44,N/A,$264.81,N/A,$273.00,N/A,N/A,$264.81
3099296,0302,86631,,,,,N/A,N/A,CHLAMYDIA SEROLOGY 1,$230.04,$171.00,$14.25,$228.00,N/A,$221.16,N/A,N/A,N/A,$14.25,N/A,$221.16,N/A,$228.00,N/A,N/A,$221.16
3099297,0302,86631,,,,,N/A,N/A,CHLAMYDIA SEROLOGY 2,$230.04,$171.00,$14.25,$228.00,N/A,$221.16,N/A,N/A,N/A,$14.25,N/A,$221.16,N/A,$228.00,N/A,N/A,$221.16
3099298,0302,86631,,,,,N/A,N/A,CHLAMYDIA SEROLOGY 3,$230.04,$171.00,$14.25,$228.00,N/A,$221.16,N/A,N/A,N/A,$14.25,N/A,$221.16,N/A,$228.00,N/A,N/A,$221.16
3099302,0302,86632,,,,,N/A,N/A,CHLAMYDIA SEROLOGY 4,$243.15,$180.75,$14.25,$241.00,N/A,$233.77,N/A,N/A,N/A,$14.25,N/A,$233.77,N/A,$241.00,N/A,N/A,$233.77
3099303,0302,86632,,,,,N/A,N/A,CHLAMYDIA SEROLOGY 5,$243.15,$180.75,$14.25,$241.00,N/A,$233.77,N/A,N/A,N/A,$14.25,N/A,$233.77,N/A,$241.00,N/A,N/A,$233.77
3099304,0302,86632,,,,,N/A,N/A,CHLAMYDIA SEROLOGY 6,$243.15,$180.75,$14.25,$241.00,N/A,$233.77,N/A,N/A,N/A,$14.25,N/A,$233.77,N/A,$241.00,N/A,N/A,$233.77
3090106,0302,86674,,,,,N/A,N/A,Giardia Antigen,$275.44,$204.75,$14.67,$273.00,N/A,$264.81,N/A,N/A,N/A,$14.67,N/A,$264.81,N/A,$273.00,N/A,N/A,$264.81
30992293,0302,86735,,,,,N/A,N/A,MAYO MUMPS QB IGB&IGM CSF,$80.72,$60.00,$19.28,$80.00,N/A,$77.60,N/A,N/A,N/A,$19.28,N/A,$77.60,N/A,$80.00,N/A,N/A,$77.60
3099711,0302,86747,,,,,N/A,N/A,PARVOVIRUS IGA/IGM MAYO,$180.60,$134.25,$15.93,$179.00,N/A,$173.63,N/A,N/A,N/A,$15.93,N/A,$173.63,N/A,$179.00,N/A,N/A,$173.63
3099712,0302,86747,,,,,N/A,N/A,PARVOVIRUS IGA/IGM,$180.60,$134.25,$15.93,$179.00,N/A,$173.63,N/A,N/A,N/A,$15.93,N/A,$173.63,N/A,$179.00,N/A,N/A,$173.63
3030716,0302,86977,,,,,N/A,N/A,ARC INCUBATION W/INHIBITORS,$95.85,$71.25,$43.59,$107.00,N/A,$103.79,N/A,N/A,N/A,$43.59,N/A,$103.79,N/A,$107.00,N/A,N/A,$103.79
3030715,0302,86978,,,,,N/A,N/A,ARC MISCELLANEOUS ADSORPTIONS,$135.20,$100.50,$43.59,$134.00,N/A,$129.98,N/A,N/A,N/A,$43.59,N/A,$129.98,N/A,$134.00,N/A,N/A,$129.98
3098134,0302,87340,,,,,N/A,N/A,PRNTL PKG HEP BS AG,$94.84,$70.50,$19.28,$94.00,N/A,$91.18,N/A,N/A,N/A,$19.28,N/A,$91.18,N/A,$94.00,N/A,N/A,$91.18
3091138,0302,87350,,,,,N/A,N/A,HBE AG,$224.99,$167.25,$12.57,$223.00,N/A,$216.31,N/A,N/A,N/A,$12.57,N/A,$216.31,N/A,$223.00,N/A,N/A,$216.31
3060312,0302,87420,,,,,N/A,N/A,Respiratory Syncytial Virus,$223.98,$166.50,$28.92,$222.00,N/A,$215.34,N/A,N/A,N/A,$28.92,N/A,$215.34,N/A,$222.00,N/A,N/A,$215.34
3099229,0302,87425,,,,,N/A,N/A,SBCL ROTAVIRUS ANTIGEN DETECT,$456.04,$339.00,$16.77,$452.00,N/A,$438.44,N/A,N/A,N/A,$16.77,N/A,$438.44,N/A,$452.00,N/A,N/A,$438.44
3050429,0305,82272,,,,,N/A,N/A,STOOL OCCULT BLOOD DIAGNOSTIC,$67.60,$50.25,$5.45,$67.00,N/A,$64.99,N/A,$5.94,N/A,$5.45,N/A,$64.99,N/A,$67.00,N/A,N/A,$64.99
3050430,0305,82272,,,,,N/A,N/A,STOOL OCCULT BLOODx2 DIAGNOSTI,$53.47,$39.75,$5.45,$67.00,N/A,$64.99,N/A,$5.94,N/A,$5.45,N/A,$64.99,N/A,$67.00,N/A,N/A,$64.99
3050426,0305,85008,,,,,N/A,N/A,VETERINARY EOSINOPHOL COUNT,$53.47,$39.75,$4.61,$53.00,N/A,$51.41,N/A,N/A,N/A,$4.61,N/A,$51.41,N/A,$53.00,N/A,N/A,$51.41
3010405,0305,85014,,,,,N/A,N/A,Body Fluid Hemoglobin (Bfhgb),$57.51,$42.75,$8.38,$57.00,N/A,$55.29,N/A,N/A,N/A,$8.38,N/A,$55.29,N/A,$57.00,N/A,N/A,$55.29
3050423,0305,85018,,,,,N/A,N/A,HEMOGLOBIN,$50.45,$37.50,$2.93,$16.00,N/A,$15.52,N/A,N/A,N/A,$2.93,N/A,$15.52,N/A,$16.00,N/A,N/A,$15.52
3050432,0305,85045,,,,,N/A,N/A,RETICULOCYTE,$84.75,$63.00,$3.77,$84.00,N/A,$81.48,N/A,N/A,N/A,$3.77,N/A,$81.48,N/A,$84.00,N/A,N/A,$81.48
3050400,0305,85048,,,,,N/A,N/A,ABSOLUTE EOSINOPHIL COUNT,$127.13,$94.50,$4.61,$126.00,N/A,$122.22,N/A,N/A,N/A,$4.61,N/A,$122.22,N/A,$126.00,N/A,N/A,$122.22
3100018,0305,85095,,,,,N/A,N/A,Bone Marrow Asp Only,$0.00,$0.00,$0.00,$5.45,N/A,$0.00,N/A,N/A,N/A,$5.45,N/A,$0.00,N/A,$0.00,N/A,N/A,$0.00
3100015,0305,85097,,,,,N/A,N/A,FN NEED ASP BIOP DP,$425.77,$316.50,$173.20,$422.00,$173.20,$409.34,$173.20,N/A,$173.20,N/A,$173.20,$409.34,$173.20,$422.00,$173.20,$173.20,$409.34
3099621,0305,85300,,,,,N/A,N/A,FAHC ANTITHROMBIN 3 FUNCTIONAL,$310.75,$231.00,$19.70,$308.00,N/A,$298.76,N/A,N/A,N/A,$19.70,N/A,$298.76,N/A,$308.00,N/A,N/A,$298.76
3099626,0305,85303,,,,,N/A,N/A,FAHC PROTEIN C FUNCTIONAL,$310.75,$231.00,$14.25,$308.00,N/A,$298.76,N/A,N/A,N/A,$14.25,N/A,$298.76,N/A,$308.00,N/A,N/A,$298.76
3099088,0305,85305,,,,,N/A,N/A,PROTEIN S ACTIVITY,$627.56,$466.50,$16.77,$622.00,N/A,$603.34,N/A,N/A,N/A,$16.77,N/A,$603.34,N/A,$622.00,N/A,N/A,$603.34
3099627,0305,85306,,,,,N/A,N/A,FAHC PROTEIN S FUNCTIONAL,$310.75,$231.00,$13.83,$427.00,N/A,$414.19,N/A,N/A,N/A,$13.83,N/A,$414.19,N/A,$427.00,N/A,N/A,$414.19
3030713,0305,85460,,,,,N/A,N/A,Fetal Screen,$153.36,$114.00,$36.88,$152.00,N/A,$147.44,N/A,N/A,N/A,$36.88,N/A,$147.44,N/A,$152.00,N/A,N/A,$147.44
3099622,0305,85610,,,,,N/A,N/A,FAHC PROTIME,$310.75,$231.00,$15.52,$81.00,N/A,$15.52,N/A,N/A,N/A,$21.80,N/A,$15.52,N/A,$81.00,N/A,N/A,$15.52
3099620,0305,85613,,,,,N/A,N/A,FAHC DILUTE RUSSELL VIPER VENO,$309.74,$230.25,$4.61,$182.00,N/A,$176.54,N/A,N/A,N/A,$4.61,N/A,$176.54,N/A,$182.00,N/A,N/A,$176.54
3099625,0305,85670,,,,,N/A,N/A,FAHC THROMBIN TIME,$94.84,$70.50,$6.71,$94.00,N/A,$91.18,N/A,N/A,N/A,$6.71,N/A,$91.18,N/A,$94.00,N/A,N/A,$91.18
3099623,0305,85730,,,,,N/A,N/A,FAHC PTT,$310.75,$231.00,$7.13,$278.00,N/A,$269.66,N/A,N/A,N/A,$7.13,N/A,$269.66,N/A,$278.00,N/A,N/A,$269.66
3099624,0305,85732,,,,,N/A,N/A,FAHC PTT 50/50 MIX,$310.75,$231.00,$7.13,$232.00,N/A,$225.04,N/A,N/A,N/A,$7.13,N/A,$225.04,N/A,$232.00,N/A,N/A,$225.04
3050417,0305,89051,,,,,N/A,N/A,BODY FLUID DIFFERENTIAL,$126.12,$93.75,$5.87,$125.00,N/A,$121.25,N/A,N/A,N/A,$5.87,N/A,$121.25,N/A,$125.00,N/A,N/A,$121.25
3050419,0305,89051,,,,,N/A,N/A,CSF CELL COUNT &DIFFERENTIAL,$63.56,$47.25,$5.87,$125.00,N/A,$121.25,N/A,N/A,N/A,$5.87,N/A,$121.25,N/A,$125.00,N/A,N/A,$121.25
3060333,0306,83630,,,,,N/A,N/A,LACTOFERRIN DETECTION,$374.32,$278.25,$15.51,$371.00,N/A,$359.87,N/A,N/A,N/A,$15.51,N/A,$359.87,N/A,$371.00,N/A,N/A,$359.87
3091341,0306,83898,,,,,N/A,N/A,Hep C (Pcr) Quant,"$1,208.71",$898.50,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3060613,0306,86588,,,,,N/A,N/A,Strep A Antigen,$107.96,$80.25,$11.97,$107.00,N/A,$103.79,N/A,N/A,N/A,$11.97,N/A,$103.79,N/A,$107.00,N/A,N/A,$103.79
3091402,0306,86849,,,,,N/A,N/A,Fahc Legionella Ag(Urine),$101.90,$75.75,$127.42,$351.00,N/A,$340.47,N/A,N/A,N/A,$127.42,N/A,$340.47,N/A,$351.00,N/A,N/A,$340.47
3090003,0306,87015,,,,,N/A,N/A,CONCENTRATION FOR PARASITES,$161.43,$120.00,$43.59,$63.00,N/A,$61.11,N/A,N/A,N/A,$43.59,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3060612,0306,87040,,,,,N/A,N/A,BLOOD CULTURE,$150.33,$111.75,$7.96,$149.00,N/A,$144.53,N/A,N/A,N/A,$7.96,N/A,$144.53,N/A,$149.00,N/A,N/A,$144.53
3099427,0306,87046,,,,,N/A,N/A,STOOL AEROBIC ADDITIONAL PATHO,$159.41,$118.50,$11.32,$40.00,N/A,$38.80,N/A,N/A,N/A,$11.32,N/A,$38.80,N/A,$40.00,N/A,N/A,$38.80
3060601,0306,87070,,,,,N/A,N/A,CULTURE ROUTINE,$170.51,$126.75,$11.32,$169.00,N/A,$163.93,N/A,N/A,N/A,$11.32,N/A,$163.93,N/A,$169.00,N/A,N/A,$163.93
3099655,0306,87070,,,,,N/A,N/A,FAHC BACTERIAL TISSUE/SMEAR,$170.51,$126.75,$11.32,$169.00,N/A,$163.93,N/A,N/A,N/A,$11.32,N/A,$163.93,N/A,$169.00,N/A,N/A,$163.93
3060313,0306,87072,,,,,N/A,N/A,Bacterial Id (Aerobic),$81.72,$60.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3060740,0306,87072,,,,,N/A,N/A,Chlamydia Antigen,$254.25,$189.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3090995,0306,87072,,,,,N/A,N/A,State Lab Pertussis,$114.01,$84.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3060611,0306,87075,,,,,N/A,N/A,ANAEROBIC CULTURE,$182.62,$135.75,$10.48,$170.00,N/A,$164.90,N/A,N/A,N/A,$10.48,N/A,$164.90,N/A,$170.00,N/A,N/A,$164.90
3060315,0306,87076,,,,,N/A,N/A,ANAEROBIC BACTERIAL ID,$81.72,$60.75,$11.32,$81.00,N/A,$78.57,N/A,N/A,N/A,$11.32,N/A,$78.57,N/A,$81.00,N/A,N/A,$78.57
3060314,0306,87077,,,,,N/A,N/A,Urine Bacterial Identification,$80.72,$60.00,$9.64,$95.00,N/A,$92.15,N/A,N/A,N/A,$9.64,N/A,$92.15,N/A,$95.00,N/A,N/A,$92.15
3060328,0306,87077,,,,,N/A,N/A,FA BACTERIAL IDENTIFICATION,$95.85,$71.25,$9.64,$95.00,N/A,$92.15,N/A,N/A,N/A,$9.64,N/A,$92.15,N/A,$95.00,N/A,N/A,$92.15
3060322,0306,87081,,,,,N/A,N/A,MRSA SCREEN-PATIENT,$85.76,$63.75,$9.64,$85.00,N/A,$82.45,N/A,N/A,N/A,$9.64,N/A,$82.45,N/A,$85.00,N/A,N/A,$82.45
3060324,0306,87081,,,,,N/A,N/A,GC CULTURE,$85.76,$63.75,$9.64,$85.00,N/A,$82.45,N/A,N/A,N/A,$9.64,N/A,$82.45,N/A,$85.00,N/A,N/A,$82.45
3060603,0306,87081,,,,,N/A,N/A,BETA STREPT SCREEN,$85.76,$63.75,$9.64,$85.00,N/A,$82.45,N/A,N/A,N/A,$9.64,N/A,$82.45,N/A,$85.00,N/A,N/A,$82.45
3060606,0306,87086,,,,,N/A,N/A,URINE CULTURE,$115.02,$85.50,$7.96,$114.00,N/A,$110.58,N/A,N/A,N/A,$7.96,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3090605,0306,87101,,,,,N/A,N/A,FUNGUS CULTURE (Skin),$147.31,$109.50,$9.64,$149.00,N/A,$144.53,N/A,N/A,N/A,$9.64,N/A,$144.53,N/A,$149.00,N/A,N/A,$144.53
3060320,0306,87102,,,,,N/A,N/A,YEAST CULTURE (VAGINAL SCREEN),$91.81,$68.25,$9.22,$164.00,N/A,$159.08,N/A,N/A,N/A,$9.22,N/A,$159.08,N/A,$164.00,N/A,N/A,$159.08
3095002,0306,87102,,,,,N/A,N/A,CULTURE FUNGI,$159.41,$118.50,$9.22,$164.00,N/A,$159.08,N/A,N/A,N/A,$9.22,N/A,$159.08,N/A,$164.00,N/A,N/A,$159.08
3099514,0306,87102,,,,,N/A,N/A,FAHC FUNGUS CULTURE TISSUE,$122.08,$90.75,$9.22,$164.00,N/A,$159.08,N/A,N/A,N/A,$9.22,N/A,$159.08,N/A,$164.00,N/A,N/A,$159.08
3099604,0306,87102,,,,,N/A,N/A,"CULTURE,FUNGI,ISOLATION,",$165.47,$123.00,$9.22,$164.00,N/A,$159.08,N/A,N/A,N/A,$9.22,N/A,$159.08,N/A,$164.00,N/A,N/A,$159.08
3099978,0306,87110,,,,,N/A,N/A,FAHC CHLAMYDIA CULTURE,$374.32,$278.25,$18.44,$371.00,N/A,$359.87,N/A,N/A,N/A,$18.44,N/A,$359.87,N/A,$371.00,N/A,N/A,$359.87
3091347,0306,87116,,,,,N/A,N/A,TB BLOOD CULTURE (M),$394.50,$293.25,$23.47,$160.00,N/A,$155.20,N/A,N/A,N/A,$23.47,N/A,$155.20,N/A,$160.00,N/A,N/A,$155.20
3095001,0306,87116,,,,,N/A,N/A,AFB CONCENTRATION,$161.43,$120.00,$23.47,$160.00,N/A,$155.20,N/A,N/A,N/A,$23.47,N/A,$155.20,N/A,$160.00,N/A,N/A,$155.20
3099068,0306,87116,,,,,N/A,N/A,ACID FAST 2,$151.34,$112.50,$23.47,$160.00,N/A,$155.20,N/A,N/A,N/A,$23.47,N/A,$155.20,N/A,$160.00,N/A,N/A,$155.20
3099513,0306,87116,,,,,N/A,N/A,FAHC AFB CULTURE MISCELLANEOUS,$207.84,$154.50,$23.47,$160.00,N/A,$155.20,N/A,N/A,N/A,$23.47,N/A,$155.20,N/A,$160.00,N/A,N/A,$155.20
3090604,0306,87118,,,,,N/A,N/A,AFB CULTURE-VTST LAB,$105.94,$78.75,$12.99,$110.00,N/A,$106.70,N/A,N/A,N/A,$12.99,N/A,$106.70,N/A,$110.00,N/A,N/A,$106.70
3095034,0306,87140,,,,,N/A,N/A,FLORESCENT CULTURE TYPE (1),$226.00,$168.00,$17.60,$240.00,N/A,$232.80,N/A,N/A,N/A,$17.60,N/A,$232.80,N/A,$240.00,N/A,N/A,$232.80
3095035,0306,87140,,,,,N/A,N/A,FLORESCENT (2),$143.27,$106.50,$17.60,$240.00,N/A,$232.80,N/A,N/A,N/A,$17.60,N/A,$232.80,N/A,$240.00,N/A,N/A,$232.80
3099509,0306,87140,,,,,N/A,N/A,VARICELLA-ZOSTER TEST 1,$252.24,$187.50,$17.60,$240.00,N/A,$232.80,N/A,N/A,N/A,$17.60,N/A,$232.80,N/A,$240.00,N/A,N/A,$232.80
3099979,0306,87140,,,,,N/A,N/A,FAHC CHLAMYDIA CULTURE,$110.98,$82.50,$17.60,$240.00,N/A,$232.80,N/A,N/A,N/A,$17.60,N/A,$232.80,N/A,$240.00,N/A,N/A,$232.80
3099665,0306,87168,,,,,N/A,N/A,FAHC ARTHROPOD IDENTIFICATION',$88.79,$66.00,$85.36,$138.73,N/A,$85.36,N/A,N/A,N/A,$138.73,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3061417,0306,87172,,,,,N/A,N/A,PINWORM,$58.52,$43.50,$5.03,$88.00,N/A,$85.36,N/A,N/A,N/A,$5.03,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3090110,0306,87177,,,,,N/A,N/A,OVA PARASITES,$174.55,$129.75,$5.03,$173.00,N/A,$167.81,N/A,N/A,N/A,$5.03,N/A,$167.81,N/A,$173.00,N/A,N/A,$167.81
3060335,0306,87181,,,,,N/A,N/A,DHMC ANTIBIOTIC SUSCEPTIBILITY,$367.25,$273.00,$10.90,$364.00,N/A,$353.08,N/A,N/A,N/A,$10.90,N/A,$353.08,N/A,$364.00,N/A,N/A,$353.08
3060334,0306,87186,,,,,N/A,N/A,UVM SENSITIVITY,$31.28,$23.25,$5.87,$81.00,N/A,$78.57,N/A,N/A,N/A,$5.87,N/A,$78.57,N/A,$81.00,N/A,N/A,$78.57
3060607,0306,87186,,,,,N/A,N/A,SENSITIVITIES: MIC,$170.51,$126.75,$5.87,$81.00,N/A,$78.57,N/A,N/A,N/A,$5.87,N/A,$78.57,N/A,$81.00,N/A,N/A,$78.57
3060319,0306,87205,,,,,N/A,N/A,GRAM STAIN (VAGINAL SCREEN),$91.81,$68.25,$10.48,$88.00,N/A,$85.36,N/A,N/A,N/A,$10.48,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3060325,0306,87205,,,,,N/A,N/A,VETERINARIAN GRAMSTAIN,$53.47,$39.75,$10.48,$88.00,N/A,$85.36,N/A,N/A,N/A,$10.48,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3060602,0306,87205,,,,,N/A,N/A,GRAMSTAIN,$88.79,$66.00,$10.48,$88.00,N/A,$85.36,N/A,N/A,N/A,$10.48,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3090400,0306,87205,,,,,N/A,N/A,STOOL WBC,$228.02,$169.50,$10.48,$88.00,N/A,$85.36,N/A,N/A,N/A,$10.48,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3099654,0306,87205,,,,,N/A,N/A,FAHC BACTERIAL TISSUE/SMEAR,$88.79,$66.00,$10.48,$88.00,N/A,$85.36,N/A,N/A,N/A,$10.48,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3060608,0306,87206,,,,,N/A,N/A,ACID FAST SMEAR - VTST LAB,$91.81,$68.25,$5.03,$16.00,N/A,$15.52,N/A,N/A,N/A,$5.03,N/A,$15.52,N/A,$16.00,N/A,N/A,$15.52
3095000,0306,87206,,,,,N/A,N/A,FLORESCENT STAIN,$161.43,$120.00,$5.03,$16.00,N/A,$15.52,N/A,N/A,N/A,$5.03,N/A,$15.52,N/A,$16.00,N/A,N/A,$15.52
3099067,0306,87206,,,,,N/A,N/A,ACID FAST 1,$163.45,$121.50,$5.03,$16.00,N/A,$15.52,N/A,N/A,N/A,$5.03,N/A,$15.52,N/A,$16.00,N/A,N/A,$15.52
3099662,0306,87206,,,,,N/A,N/A,SMEAR FLORESCENT AND/OR ACID,$114.01,$84.75,$5.03,$16.00,N/A,$15.52,N/A,N/A,N/A,$5.03,N/A,$15.52,N/A,$16.00,N/A,N/A,$15.52
3060311,0306,87207,,,,,N/A,N/A,TZANK SMEAR,$91.81,$68.25,$6.29,$160.00,$84.46,$155.20,$84.46,N/A,$84.46,$6.29,$84.46,$155.20,$84.46,$160.00,$84.46,$84.46,$155.20
3090004,0306,87207,,,,,N/A,N/A,"SMEAR, SPECIAL STAIN",$161.43,$120.00,$6.29,$160.00,$84.46,$155.20,$84.46,N/A,$84.46,$6.29,$84.46,$155.20,$84.46,$160.00,$84.46,$84.46,$155.20
3099269,0306,87207,,,,,N/A,N/A,PARASITE EXAM BLOOD,$207.84,$154.50,$6.29,$160.00,$84.46,$155.20,$84.46,N/A,$84.46,$6.29,$84.46,$155.20,$84.46,$160.00,$84.46,$84.46,$155.20
3060318,0306,87210,,,,,N/A,N/A,WET PREP (VAGINAL SCREEN),$88.79,$66.00,$21.80,$88.00,N/A,$85.36,N/A,N/A,N/A,$21.80,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3060519,0306,87210,,,,,N/A,N/A,WET PREP,$88.79,$66.00,$21.80,$88.00,N/A,$85.36,N/A,N/A,N/A,$21.80,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3060610,0306,87210,,,,,N/A,N/A,INDIA INK PREP,$81.72,$60.75,$21.80,$88.00,N/A,$85.36,N/A,N/A,N/A,$21.80,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3091253,0306,87210,,,,,N/A,N/A,CRYPTOSPORDIUM SMR,$259.30,$192.75,$21.80,$88.00,N/A,$85.36,N/A,N/A,N/A,$21.80,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3060609,0306,87220,,,,,N/A,N/A,KOH PREP,$88.79,$66.00,$7.13,$88.00,N/A,$85.36,N/A,N/A,N/A,$7.13,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3095032,0306,87252,,,,,N/A,N/A,TISSUE CULTURE (1),$266.36,$198.00,$23.89,$199.00,N/A,$193.03,N/A,N/A,N/A,$23.89,N/A,$193.03,N/A,$199.00,N/A,N/A,$193.03
3095033,0306,87252,,,,,N/A,N/A,TISSUE CULTURE (2),$200.78,$149.25,$23.89,$199.00,N/A,$193.03,N/A,N/A,N/A,$23.89,N/A,$193.03,N/A,$199.00,N/A,N/A,$193.03
3099135,0306,87252,,,,,N/A,N/A,INFLUENZA VIRAL CULT (VT.ST.),$200.78,$149.25,$23.89,$199.00,N/A,$193.03,N/A,N/A,N/A,$23.89,N/A,$193.03,N/A,$199.00,N/A,N/A,$193.03
3099510,0306,87252,,,,,N/A,N/A,VARICELLA-ZOSTER TEST 2,$266.36,$198.00,$23.89,$199.00,N/A,$193.03,N/A,N/A,N/A,$23.89,N/A,$193.03,N/A,$199.00,N/A,N/A,$193.03
3099599,0306,87252,,,,,N/A,N/A,FAHC HERPES SIMPLEX CULTURE,$223.98,$166.50,$23.89,$199.00,N/A,$193.03,N/A,N/A,N/A,$23.89,N/A,$193.03,N/A,$199.00,N/A,N/A,$193.03
3060332,0306,87324,,,,,N/A,N/A,C DIFFICLE TOXIN,$207.84,$154.50,$14.25,$206.00,N/A,$199.82,N/A,N/A,N/A,$14.25,N/A,$199.82,N/A,$206.00,N/A,N/A,$199.82
3099167,0306,87490,,,,,N/A,N/A,Uvm Chlamydia Probe,$495.39,$368.25,$42.33,$491.00,N/A,$476.27,N/A,N/A,N/A,$42.33,N/A,$476.27,N/A,$491.00,N/A,N/A,$476.27
3099168,0306,87490,,,,,N/A,N/A,Uvm Gc Probe,$495.39,$368.25,$42.33,$491.00,N/A,$476.27,N/A,N/A,N/A,$42.33,N/A,$476.27,N/A,$491.00,N/A,N/A,$476.27
3099581,0306,87529,,,,,N/A,N/A,"HERPES SIMPLEX VIRUS,AMPLIFIED",$495.39,$368.25,$51.55,$90.00,N/A,$87.30,N/A,N/A,N/A,$51.55,N/A,$87.30,N/A,$90.00,N/A,N/A,$87.30
3099582,0306,87529,,,,,N/A,N/A,"HERPES SIMPLEX VIRUS,AMPLIFIED",$495.39,$368.25,$51.55,$90.00,N/A,$87.30,N/A,N/A,N/A,$51.55,N/A,$87.30,N/A,$90.00,N/A,N/A,$87.30
3099600,0306,87536,,,,,N/A,N/A,FAHC HIV ULTRASENSITIVE,$526.67,$391.50,$42.33,$522.00,N/A,$506.34,N/A,N/A,N/A,$42.33,N/A,$506.34,N/A,$522.00,N/A,N/A,$506.34
3100046,0306,87621,,,,,N/A,N/A,Hpv Dna Amp Probe,$541.80,$402.75,$42.33,$491.00,N/A,$476.27,N/A,N/A,N/A,$42.33,N/A,$476.27,N/A,$491.00,N/A,N/A,$476.27
3099166,0306,87797,,,,,N/A,N/A,Chlamydia/Gc Probe (Copley),$756.71,$562.50,$42.33,$75.00,N/A,$72.75,N/A,N/A,N/A,$42.33,N/A,$72.75,N/A,$75.00,N/A,N/A,$72.75
3099583,0306,87798,,,,,N/A,N/A,INFECT. AGT DET   (DNA or RNA),$495.39,$368.25,$36.05,$231.00,N/A,$224.07,N/A,N/A,N/A,$36.05,N/A,$224.07,N/A,$231.00,N/A,N/A,$224.07
3093452,0309,30365,,,,,N/A,N/A,"MAYO OPIATES, S/P",$313.78,$233.25,$127.51,$127.51,$127.51,N/A,$127.51,N/A,$127.51,N/A,$127.51,N/A,$127.51,N/A,$127.51,$127.51,N/A
3092777,0309,80100,,,,,N/A,N/A,Mayo Drug Screen Prescription,$283.51,$210.75,$9.64,$297.00,N/A,$288.09,N/A,N/A,N/A,$9.64,N/A,$288.09,N/A,$297.00,N/A,N/A,$288.09
3099702,0309,80100,,,,,N/A,N/A,MAYO DRUG SCREEN  PLASMA,$299.66,$222.75,$9.64,$297.00,N/A,$288.09,N/A,N/A,N/A,$9.64,N/A,$288.09,N/A,$297.00,N/A,N/A,$288.09
3092422,0309,80101,,,,,N/A,N/A,MAYO SERUM DRUGS ABUSE PANEL,$43.38,$32.25,$276.45,$285.00,N/A,$276.45,N/A,N/A,N/A,$285.00,N/A,$276.45,N/A,$285.00,N/A,N/A,$276.45
3092423,0309,80101,,,,,N/A,N/A,MAYO SERUM DRUGS ABUSE PANEL,$43.38,$32.25,$276.45,$285.00,N/A,$276.45,N/A,N/A,N/A,$285.00,N/A,$276.45,N/A,$285.00,N/A,N/A,$276.45
3092424,0309,80101,,,,,N/A,N/A,MAYO SERUM DRUGS ABUSE PANEL,$43.38,$32.25,$276.45,$285.00,N/A,$276.45,N/A,N/A,N/A,$285.00,N/A,$276.45,N/A,$285.00,N/A,N/A,$276.45
3092425,0309,80101,,,,,N/A,N/A,MAYO SERUM DRUGS ABUSE PANEL,$43.38,$32.25,$276.45,$285.00,N/A,$276.45,N/A,N/A,N/A,$285.00,N/A,$276.45,N/A,$285.00,N/A,N/A,$276.45
3092426,0309,80101,,,,,N/A,N/A,MAYO SERUM DRUGS ABUSE PANEL,$43.38,$32.25,$276.45,$285.00,N/A,$276.45,N/A,N/A,N/A,$285.00,N/A,$276.45,N/A,$285.00,N/A,N/A,$276.45
3092427,0309,80101,,,,,N/A,N/A,MAYO SERUM DRUGS ABUSE PANEL,$43.38,$32.25,$276.45,$285.00,N/A,$276.45,N/A,N/A,N/A,$285.00,N/A,$276.45,N/A,$285.00,N/A,N/A,$276.45
3092428,0309,80101,,,,,N/A,N/A,MAYO SERUM DRUGS ABUSE PANEL,$43.38,$32.25,$276.45,$285.00,N/A,$276.45,N/A,N/A,N/A,$285.00,N/A,$276.45,N/A,$285.00,N/A,N/A,$276.45
3092429,0309,80101,,,,,N/A,N/A,MAYO SERUM DRUGS ABUSE PANEL,$43.38,$32.25,$276.45,$285.00,N/A,$276.45,N/A,N/A,N/A,$285.00,N/A,$276.45,N/A,$285.00,N/A,N/A,$276.45
3092430,0309,80101,,,,,N/A,N/A,MAYO SERUM DRUGS ABUSE PANEL,$43.38,$32.25,$276.45,$285.00,N/A,$276.45,N/A,N/A,N/A,$285.00,N/A,$276.45,N/A,$285.00,N/A,N/A,$276.45
3092431,0309,80101,,,,,N/A,N/A,MAYO SERUM DRUGS ABUSE PANEL,$43.38,$32.25,$276.45,$285.00,N/A,$276.45,N/A,N/A,N/A,$285.00,N/A,$276.45,N/A,$285.00,N/A,N/A,$276.45
3092548,0309,80101,,,,,N/A,N/A,Mayo Flunitrazepam (Rohypnol),$209.86,$156.00,$276.45,$285.00,N/A,$276.45,N/A,N/A,N/A,$285.00,N/A,$276.45,N/A,$285.00,N/A,N/A,$276.45
3092820,0309,80101,,,,,N/A,N/A,MAYO ALCOHOL BIOMARKERS,$85.76,$63.75,$276.45,$285.00,N/A,$276.45,N/A,N/A,N/A,$285.00,N/A,$276.45,N/A,$285.00,N/A,N/A,$276.45
3092854,0309,80101,,,,,N/A,N/A,Mayo Alcohol Biomarkers Urine,$86.77,$64.50,$276.45,$285.00,N/A,$276.45,N/A,N/A,N/A,$285.00,N/A,$276.45,N/A,$285.00,N/A,N/A,$276.45
3092974,0309,80101,,,,,N/A,N/A,MAYO SEDATIVE HYPNOT PAN UR,$205.82,$153.00,$829.35,$855.00,N/A,$829.35,N/A,N/A,N/A,$855.00,N/A,$829.35,N/A,$855.00,N/A,N/A,$829.35
3092997,0309,80101,,,,,N/A,N/A,Mayo Drug Screen 9 Panel Sp,$205.82,$153.00,"$2,488.05","$2,565.00",N/A,"$2,488.05",N/A,N/A,N/A,"$2,565.00",N/A,"$2,488.05",N/A,"$2,565.00",N/A,N/A,"$2,488.05"
3093018,0309,80101,,,,,N/A,N/A,MAYO GHB SCREEN,$151.34,$112.50,$276.45,$285.00,N/A,$276.45,N/A,N/A,N/A,$285.00,N/A,$276.45,N/A,$285.00,N/A,N/A,$276.45
3099858,0309,80101,,,,,N/A,N/A,MAYO CONFIRMD DRG SCRN 1,$287.55,$213.75,$276.45,$285.00,N/A,$276.45,N/A,N/A,N/A,$285.00,N/A,$276.45,N/A,$285.00,N/A,N/A,$276.45
3099859,0309,80101,,,,,N/A,N/A,MAYO CONFIRMD DRG SCRN 2,$53.47,$39.75,$276.45,$285.00,N/A,$276.45,N/A,N/A,N/A,$285.00,N/A,$276.45,N/A,$285.00,N/A,N/A,$276.45
3099860,0309,80101,,,,,N/A,N/A,MAYO CONFIRMD DRG SCRN 3,$53.47,$39.75,$276.45,$285.00,N/A,$276.45,N/A,N/A,N/A,$285.00,N/A,$276.45,N/A,$285.00,N/A,N/A,$276.45
3099861,0309,80101,,,,,N/A,N/A,MAYO CONFIRMD DRG SCRN 4,$49.44,$36.75,$276.45,$285.00,N/A,$276.45,N/A,N/A,N/A,$285.00,N/A,$276.45,N/A,$285.00,N/A,N/A,$276.45
3099862,0309,80101,,,,,N/A,N/A,MAYO CONFIRMD DRG SCRN 5,$49.44,$36.75,$276.45,$285.00,N/A,$276.45,N/A,N/A,N/A,$285.00,N/A,$276.45,N/A,$285.00,N/A,N/A,$276.45
3099863,0309,80101,,,,,N/A,N/A,MAYO CONFIRMD DRG SCRN 6,$49.44,$36.75,$276.45,$285.00,N/A,$276.45,N/A,N/A,N/A,$285.00,N/A,$276.45,N/A,$285.00,N/A,N/A,$276.45
3099864,0309,80101,,,,,N/A,N/A,MAYO CONFIRMD DRG SCRN 7,$49.44,$36.75,$276.45,$285.00,N/A,$276.45,N/A,N/A,N/A,$285.00,N/A,$276.45,N/A,$285.00,N/A,N/A,$276.45
3099865,0309,80101,,,,,N/A,N/A,MAYO CONFIRMED DRUG SCREEN 8,$49.44,$36.75,$276.45,$285.00,N/A,$276.45,N/A,N/A,N/A,$285.00,N/A,$276.45,N/A,$285.00,N/A,N/A,$276.45
3099866,0309,80101,,,,,N/A,N/A,MAYO CONFIRMED DRUG SCREEN 9,$49.44,$36.75,$276.45,$285.00,N/A,$276.45,N/A,N/A,N/A,$285.00,N/A,$276.45,N/A,$285.00,N/A,N/A,$276.45
3099867,0309,80101,,,,,N/A,N/A,MAYO CONFIRMED DRUG SCREEN10,$49.44,$36.75,$276.45,$285.00,N/A,$276.45,N/A,N/A,N/A,$285.00,N/A,$276.45,N/A,$285.00,N/A,N/A,$276.45
3099868,0309,80101,,,,,N/A,N/A,MAYO CONFIRMED DRUG SCREEN11,$49.44,$36.75,$276.45,$285.00,N/A,$276.45,N/A,N/A,N/A,$285.00,N/A,$276.45,N/A,$285.00,N/A,N/A,$276.45
3099869,0309,80101,,,,,N/A,N/A,Mayo Confirmed Drug Screen12,$49.44,$36.75,$276.45,$285.00,N/A,$276.45,N/A,N/A,N/A,$285.00,N/A,$276.45,N/A,$285.00,N/A,N/A,$276.45
3099501,0309,80102,,,,,N/A,N/A,Mayo Benzodiazepine (Confirm),$253.24,$188.25,$243.47,$251.00,N/A,$243.47,N/A,N/A,N/A,$251.00,N/A,$243.47,N/A,$251.00,N/A,N/A,$243.47
3092526,0309,80150,,,,,N/A,N/A,FAHC AMIKACIN TROUGH,$86.77,$64.50,$83.42,$86.00,N/A,$83.42,N/A,$21.87,N/A,$86.00,N/A,$83.42,N/A,$86.00,N/A,N/A,$83.42
3092527,0309,80150,,,,,N/A,N/A,FAHC AMI KACIN PEAK,$86.77,$64.50,$83.42,$86.00,N/A,$83.42,N/A,$21.87,N/A,$86.00,N/A,$83.42,N/A,$86.00,N/A,N/A,$83.42
3093453,0309,80150,,,,,N/A,N/A,MAYO AINIKACIN,$57.51,$42.75,$83.42,$86.00,N/A,$83.42,N/A,$21.87,N/A,$86.00,N/A,$83.42,N/A,$86.00,N/A,N/A,$83.42
3099911,0309,80154,,,,,N/A,N/A,MAYO DIAZEPAM,$191.70,$142.50,$18.02,$190.00,N/A,$184.30,N/A,N/A,N/A,$18.02,N/A,$184.30,N/A,$190.00,N/A,N/A,$184.30
3093455,0309,80158,,,,,N/A,N/A,DHMC CYCLOSPORINE,$383.40,$285.00,$17.60,$380.00,N/A,$368.60,N/A,$26.17,N/A,$17.60,N/A,$368.60,N/A,$380.00,N/A,N/A,$368.60
3095404,0309,80162,,,,,N/A,N/A,UVM DIFFERENTIAL LAVAGE FLUID,$21.19,$15.75,$244.44,$252.00,N/A,$244.44,N/A,$19.26,N/A,$252.00,N/A,$244.44,N/A,$252.00,N/A,N/A,$244.44
3091210,0309,80166,,,,,N/A,N/A,Mayo Doxepin,$358.17,$266.25,$16.35,$355.00,N/A,$344.35,N/A,N/A,N/A,$16.35,N/A,$344.35,N/A,$355.00,N/A,N/A,$344.35
3093714,0309,80170,,,,,N/A,N/A,UVM OR LRH GENTAMICIN,$22.20,$16.50,$19.70,$22.00,N/A,$21.34,N/A,$23.75,N/A,$19.70,N/A,$21.34,N/A,$22.00,N/A,N/A,$21.34
3099965,0309,80177,,,,,N/A,N/A,MAYO LEVETIRACETAM,$345.06,$256.50,$17.60,$342.00,N/A,$331.74,N/A,$19.21,N/A,$17.60,N/A,$331.74,N/A,$342.00,N/A,N/A,$331.74
3092987,0309,80180,,,,,N/A,N/A,MAYO MYCOPHENOLIC ACID,$88.79,$66.00,$7.96,$88.00,N/A,$85.36,N/A,$26.17,N/A,$7.96,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3099915,0309,80183,,,,,N/A,N/A,MAYO TRILEPTAL,$345.06,$256.50,$331.74,$342.00,N/A,$331.74,N/A,$19.21,N/A,$342.00,N/A,$331.74,N/A,$342.00,N/A,N/A,$331.74
3093378,0309,80185,,,,,N/A,N/A,UVM PHENYTOIN,$30.27,$22.50,$18.44,$252.00,N/A,$244.44,N/A,$19.21,N/A,$18.44,N/A,$244.44,N/A,$252.00,N/A,N/A,$244.44
3099960,0309,80185,,,,,N/A,N/A,MAYO PHENYTOIN TOTAL&FREE,$254.25,$189.00,$18.44,$252.00,N/A,$244.44,N/A,$19.21,N/A,$18.44,N/A,$244.44,N/A,$252.00,N/A,N/A,$244.44
3091254,0309,80186,,,,,N/A,N/A,MAYO PHENYTOIN TOTAL&FREE,$313.78,$233.25,$15.93,$311.00,N/A,$301.67,N/A,$19.95,N/A,$15.93,N/A,$301.67,N/A,$311.00,N/A,N/A,$301.67
3093465,0309,80195,,,,,N/A,N/A,DHMC SIROLIMUS (RAPUMUNE0,$383.40,$285.00,$17.60,$101.00,N/A,$97.97,N/A,$13.73,N/A,$17.60,N/A,$97.97,N/A,$101.00,N/A,N/A,$97.97
3093454,0309,80197,,,,,N/A,N/A,DHMC TACROLIMUS (FK-506),$383.40,$285.00,$16.35,$380.00,N/A,$368.60,N/A,$14.63,N/A,$16.35,N/A,$368.60,N/A,$380.00,N/A,N/A,$368.60
3099748,0309,80198,,,,,N/A,N/A,FAHC THEOPHYLLINE,$272.41,$202.50,$16.35,$270.00,N/A,$261.90,N/A,$20.50,N/A,$16.35,N/A,$261.90,N/A,$270.00,N/A,N/A,$261.90
3091734,0309,80199,,,,,N/A,N/A,MAYO TIAGABINE,$263.33,$195.75,$17.18,$261.00,N/A,$253.17,N/A,$29.71,N/A,$17.18,N/A,$253.17,N/A,$261.00,N/A,N/A,$253.17
3093010,0309,80235,,,,,N/A,N/A,MAYO LACOSAMIDE,$157.39,$117.00,$15.93,$156.00,N/A,$151.32,N/A,$29.82,N/A,$15.93,N/A,$151.32,N/A,$156.00,N/A,N/A,$151.32
3091834,0309,80299,,,,,N/A,N/A,Mayo Sertraline,$153.36,$114.00,$32.69,$377.00,N/A,$365.69,N/A,$27.03,N/A,$32.69,N/A,$365.69,N/A,$377.00,N/A,N/A,$365.69
3092667,0309,80299,,,,,N/A,N/A,MAYO ITRACONAZOLE,$263.33,$195.75,$32.69,$377.00,N/A,$365.69,N/A,$27.03,N/A,$32.69,N/A,$365.69,N/A,$377.00,N/A,N/A,$365.69
3092683,0309,80299,,,,,N/A,N/A,MAYO CARBOXY-THC MECONIUM,$263.33,$195.75,$32.69,$377.00,N/A,$365.69,N/A,$27.03,N/A,$32.69,N/A,$365.69,N/A,$377.00,N/A,N/A,$365.69
3092696,0309,80299,,,,,N/A,N/A,MAYO DULOXETINE,$263.33,$195.75,$32.69,$377.00,N/A,$365.69,N/A,$27.03,N/A,$32.69,N/A,$365.69,N/A,$377.00,N/A,N/A,$365.69
3092749,0309,80299,,,,,N/A,N/A,MAYO VORICONAZOLE,$263.33,$195.75,$32.69,$377.00,N/A,$365.69,N/A,$27.03,N/A,$32.69,N/A,$365.69,N/A,$377.00,N/A,N/A,$365.69
3092846,0309,80299,,,,,N/A,N/A,MAYO EVEROLIMUS BLOOD,$313.78,$233.25,$32.69,$377.00,N/A,$365.69,N/A,$27.03,N/A,$32.69,N/A,$365.69,N/A,$377.00,N/A,N/A,$365.69
3092912,0309,80299,,,,,N/A,N/A,MAYO KETAMINE CONFIRMATION URI,$236.09,$175.50,$32.69,$377.00,N/A,$365.69,N/A,$27.03,N/A,$32.69,N/A,$365.69,N/A,$377.00,N/A,N/A,$365.69
3093289,0309,80299,,,,,N/A,N/A,"Mayo Infliximab,Quant W/Reflex",$250.22,$186.00,$32.69,$377.00,N/A,$365.69,N/A,$27.03,N/A,$32.69,N/A,$365.69,N/A,$377.00,N/A,N/A,$365.69
3093412,0309,80299,,,,,N/A,N/A,MAYO ESLICARBAZEPINE,$192.71,$143.25,$32.69,$377.00,N/A,$365.69,N/A,$27.03,N/A,$32.69,N/A,$365.69,N/A,$377.00,N/A,N/A,$365.69
3093415,0309,80299,,,,,N/A,N/A,Mayo Adalimumab Qn Reflex,$380.37,$282.75,$32.69,$377.00,N/A,$365.69,N/A,$27.03,N/A,$32.69,N/A,$365.69,N/A,$377.00,N/A,N/A,$365.69
3093423,0309,80299,,,,,N/A,N/A,MAYO RUFINAMIDE,$94.84,$70.50,$32.69,$377.00,N/A,$365.69,N/A,$27.03,N/A,$32.69,N/A,$365.69,N/A,$377.00,N/A,N/A,$365.69
3093692,0309,80299,,,,,N/A,N/A,MAYO USTEKINUMAB QN WITH ANTIB,$191.70,$142.50,$32.69,$377.00,N/A,$365.69,N/A,$27.03,N/A,$32.69,N/A,$365.69,N/A,$377.00,N/A,N/A,$365.69
3095414,0309,80299,,,,,N/A,N/A,MAYO MITOTANE (LYSODREN),$106.95,$79.50,$32.69,$377.00,N/A,$365.69,N/A,$27.03,N/A,$32.69,N/A,$365.69,N/A,$377.00,N/A,N/A,$365.69
3095479,0309,80299,,,,,N/A,N/A,MAYO THIOPURINE METABOLITES,$347.08,$258.00,$32.69,$377.00,N/A,$365.69,N/A,$27.03,N/A,$32.69,N/A,$365.69,N/A,$377.00,N/A,N/A,$365.69
3095505,0309,80299,,,,,N/A,N/A,Mayo Dexamethasone,$128.14,$95.25,$32.69,$377.00,N/A,$365.69,N/A,$27.03,N/A,$32.69,N/A,$365.69,N/A,$377.00,N/A,N/A,$365.69
3095520,0309,80299,,,,,N/A,N/A,"Mayo Rivaroxaban, Anti-Xa, P",$244.16,$181.50,$32.69,$377.00,N/A,$365.69,N/A,$27.03,N/A,$32.69,N/A,$365.69,N/A,$377.00,N/A,N/A,$365.69
3099656,0309,80299,,,,,N/A,N/A,Mayo Bupropion,$263.33,$195.75,$32.69,$377.00,N/A,$365.69,N/A,$27.03,N/A,$32.69,N/A,$365.69,N/A,$377.00,N/A,N/A,$365.69
3099939,0309,80299,,,,,N/A,N/A,MAYO IBUPROFEN,$174.55,$129.75,$32.69,$377.00,N/A,$365.69,N/A,$27.03,N/A,$32.69,N/A,$365.69,N/A,$377.00,N/A,N/A,$365.69
3093106,0309,80301,,,,,N/A,N/A,Arup Umbilical Cord Drug Det,$114.01,$84.75,$22.21,$586.00,N/A,$568.42,N/A,N/A,N/A,$22.21,N/A,$568.42,N/A,$586.00,N/A,N/A,$568.42
3093313,0309,80302,,,,,N/A,N/A,"Mayo Ethyl Glucuronide Scr,U",$283.51,$210.75,$272.57,$281.00,N/A,$272.57,N/A,N/A,N/A,$281.00,N/A,$272.57,N/A,$281.00,N/A,N/A,$272.57
3091730,0309,80304,,,,,N/A,N/A,Mayo Hypoglycemic Agent Screen,$283.51,$210.75,$109.61,$113.00,N/A,$109.61,N/A,N/A,N/A,$113.00,N/A,$109.61,N/A,$113.00,N/A,N/A,$109.61
3093105,0309,80304,,,,,N/A,N/A,Aurp Umbilical Cord Drug Det,$114.01,$84.75,$219.22,$226.00,N/A,$219.22,N/A,N/A,N/A,$226.00,N/A,$219.22,N/A,$226.00,N/A,N/A,$219.22
3093336,0309,80307,,,,,N/A,N/A,MAYO BENZODIAZEPINES SERUM,$141.25,$105.00,$15.09,$734.00,N/A,$711.98,N/A,$74.57,N/A,$15.09,N/A,$711.98,N/A,$734.00,N/A,N/A,$711.98
3093419,0309,80307,,,,,N/A,N/A,MAYO DRUG SCREEN (HAIR),$740.56,$550.50,$15.09,$734.00,N/A,$711.98,N/A,$74.57,N/A,$15.09,N/A,$711.98,N/A,$734.00,N/A,N/A,$711.98
3093426,0309,80307,,,,,N/A,N/A,"MAYO ACETAMINOPHEN,URINE",$116.03,$86.25,$15.09,$734.00,N/A,$711.98,N/A,$74.57,N/A,$15.09,N/A,$711.98,N/A,$734.00,N/A,N/A,$711.98
3093459,0309,80307,,,,,N/A,N/A,"MAYO GABAPENTIN,URINE",$212.89,$158.25,$15.09,$734.00,N/A,$711.98,N/A,$74.57,N/A,$15.09,N/A,$711.98,N/A,$734.00,N/A,N/A,$711.98
3093616,0309,80307,,,,,N/A,N/A,MAYO NALOXONE SCR TOTAL URINE,$309.74,$230.25,$15.09,$734.00,N/A,$711.98,N/A,$74.57,N/A,$15.09,N/A,$711.98,N/A,$734.00,N/A,N/A,$711.98
3095394,0309,80307,,,,,N/A,N/A,MAYO CONTROLLED SUBSTANCE URIN,$72.64,$54.00,$15.09,$734.00,N/A,$711.98,N/A,$74.57,N/A,$15.09,N/A,$711.98,N/A,$734.00,N/A,N/A,$711.98
3095405,0309,80307,,,,,N/A,N/A,MAYO OXYCODONE SCREEN URINE,$53.47,$39.75,$15.09,$734.00,N/A,$711.98,N/A,$74.57,N/A,$15.09,N/A,$711.98,N/A,$734.00,N/A,N/A,$711.98
3099319,0309,80307,,,,,N/A,N/A,MAYO MECONIUM DRUG SCREEN,$283.51,$210.75,$15.09,$734.00,N/A,$711.98,N/A,$74.57,N/A,$15.09,N/A,$711.98,N/A,$734.00,N/A,N/A,$711.98
3099848,0309,80307,,,,,N/A,N/A,MAYO DRUG ABUSE SCREEN #9446,$394.50,$293.25,$15.09,$734.00,N/A,$711.98,N/A,$74.57,N/A,$15.09,N/A,$711.98,N/A,$734.00,N/A,N/A,$711.98
3093350,0309,80320,,,,,N/A,N/A,"MAYO ETHANOL,URINE",$220.96,$164.25,$74.61,$219.00,N/A,$212.43,N/A,N/A,N/A,$74.61,N/A,$212.43,N/A,$219.00,N/A,N/A,$212.43
3093473,0309,80320,,,,,N/A,N/A,"Mayo Volatile, Scrn,U",$70.63,$52.50,$74.61,$219.00,N/A,$212.43,N/A,N/A,N/A,$74.61,N/A,$212.43,N/A,$219.00,N/A,N/A,$212.43
3092417,0309,80323,,,,,N/A,N/A,MAYO NICOTINE&METABOLITES,$449.99,$334.50,$28.92,$446.00,N/A,$432.62,N/A,N/A,N/A,$28.92,N/A,$432.62,N/A,$446.00,N/A,N/A,$432.62
3092894,0309,80323,,,,,N/A,N/A,MAYO NICOTINE & METABOLITES UR,$87.78,$65.25,$28.92,$446.00,N/A,$432.62,N/A,N/A,N/A,$28.92,N/A,$432.62,N/A,$446.00,N/A,N/A,$432.62
3095456,0309,80324,,,,,N/A,N/A,MAYO LISDEXAMFETAMINE AS MET,$202.80,$150.75,$28.92,$201.00,N/A,$194.97,N/A,N/A,N/A,$28.92,N/A,$194.97,N/A,$201.00,N/A,N/A,$194.97
3093318,0309,80333,,,,,N/A,N/A,MAYO ANTIDEPRESSANTSCREEN UR,$68.61,$51.00,$28.92,$72.00,N/A,$69.84,N/A,N/A,N/A,$28.92,N/A,$69.84,N/A,$72.00,N/A,N/A,$69.84
3093319,0309,80333,,,,,N/A,N/A,MAYO ANTIDEPRESSANTSCREEN UR,$68.61,$51.00,$28.92,$72.00,N/A,$69.84,N/A,N/A,N/A,$28.92,N/A,$69.84,N/A,$72.00,N/A,N/A,$69.84
3093320,0309,80333,,,,,N/A,N/A,MAYO ANTIDEPRESSANTSCREEN UR,$72.64,$54.00,$28.92,$72.00,N/A,$69.84,N/A,N/A,N/A,$28.92,N/A,$69.84,N/A,$72.00,N/A,N/A,$69.84
3095408,0309,80333,,,,,N/A,N/A,MAYO ANTIDEPRESSANT URINE/SERU,$62.55,$46.50,$28.92,$72.00,N/A,$69.84,N/A,N/A,N/A,$28.92,N/A,$69.84,N/A,$72.00,N/A,N/A,$69.84
3093575,0309,80335,,,,,N/A,N/A,MAYO AMITRIPTYLINE & NORTRIPTY,$36.32,$27.00,$0.00,$652.00,N/A,$632.44,N/A,N/A,N/A,$0.00,N/A,$632.44,N/A,$652.00,N/A,N/A,$632.44
3092743,0309,80336,,,,,N/A,N/A,MAYO TRICYCLIC ANTIDEPR SCR,"$1,545.70","$1,149.00",$28.92,"$1,532.00",N/A,"$1,486.04",N/A,N/A,N/A,$28.92,N/A,"$1,486.04",N/A,"$1,532.00",N/A,N/A,"$1,486.04"
3095409,0309,80337,,,,,N/A,N/A,MAYO ANTIDEPRESSANT URINE/SERU,$48.43,$36.00,$0.00,$48.00,N/A,$46.56,N/A,N/A,N/A,$0.00,N/A,$46.56,N/A,$48.00,N/A,N/A,$46.56
3093557,0309,80339,,,,,N/A,N/A,"MAYO PERAMPANEL, S",$280.49,$208.50,$0.00,$278.00,N/A,$269.66,N/A,N/A,N/A,$0.00,N/A,$269.66,N/A,$278.00,N/A,N/A,$269.66
3093260,0309,80342,,,,,N/A,N/A,MAYO LURASIDONE,$248.20,$184.50,$28.92,$342.00,N/A,$331.74,N/A,N/A,N/A,$28.92,N/A,$331.74,N/A,$342.00,N/A,N/A,$331.74
3099660,0309,80342,,,,,N/A,N/A,SEROQUEL,$345.06,$256.50,$28.92,$342.00,N/A,$331.74,N/A,N/A,N/A,$28.92,N/A,$331.74,N/A,$342.00,N/A,N/A,$331.74
3093149,0309,80346,,,,,N/A,N/A,MAYO CLONAZEPAM,$48.43,$36.00,$28.92,$311.00,N/A,$301.67,N/A,N/A,N/A,$28.92,N/A,$301.67,N/A,$311.00,N/A,N/A,$301.67
3093447,0309,80346,,,,,N/A,N/A,"MAYO BENZODIAZEPINES,S/P",$313.78,$233.25,$28.92,$311.00,N/A,$301.67,N/A,N/A,N/A,$28.92,N/A,$301.67,N/A,$311.00,N/A,N/A,$301.67
3093525,0309,80346,,,,,N/A,N/A,"MAYO CLOBAZAM & METABOLITE,S",$116.03,$86.25,$28.92,$311.00,N/A,$301.67,N/A,N/A,N/A,$28.92,N/A,$301.67,N/A,$311.00,N/A,N/A,$301.67
3093649,0309,80346,,,,,N/A,N/A,MAYO ALPRAZOLAM (XANAX),$95.85,$71.25,$28.92,$311.00,N/A,$301.67,N/A,N/A,N/A,$28.92,N/A,$301.67,N/A,$311.00,N/A,N/A,$301.67
3095395,0309,80347,,,,,N/A,N/A,MAYO CONTROLLED SUBSTANCE URIN,$26.23,$19.50,$25.22,$28.92,N/A,$25.22,N/A,N/A,N/A,$28.92,N/A,$25.22,N/A,$26.00,N/A,N/A,$25.22
3093496,0309,80348,,,,,N/A,N/A,MAYO BUPRENORPHINE METABOLITE,$254.25,$189.00,$0.00,$252.00,N/A,$244.44,N/A,N/A,N/A,$0.00,N/A,$244.44,N/A,$252.00,N/A,N/A,$244.44
3093052,0309,80349,,,,,N/A,N/A,"Mayo Cannabinoids,Confirmation",$105.94,$78.75,$0.00,$105.00,N/A,$101.85,N/A,N/A,N/A,$0.00,N/A,$101.85,N/A,$105.00,N/A,N/A,$101.85
3093118,0309,80349,,,,,N/A,N/A,Mayo Thc Metabolite S/P,$105.94,$78.75,$0.00,$105.00,N/A,$101.85,N/A,N/A,N/A,$0.00,N/A,$101.85,N/A,$105.00,N/A,N/A,$101.85
3093259,0309,80349,,,,,N/A,N/A,Mayo Thc Confirmation S,$236.09,$175.50,$0.00,$105.00,N/A,$101.85,N/A,N/A,N/A,$0.00,N/A,$101.85,N/A,$105.00,N/A,N/A,$101.85
3093495,0309,80349,,,,,N/A,N/A,"MAYO THC METABOLITE, S/P",$159.41,$118.50,$0.00,$105.00,N/A,$101.85,N/A,N/A,N/A,$0.00,N/A,$101.85,N/A,$105.00,N/A,N/A,$101.85
3095512,0309,80349,,,,,N/A,N/A,Mayo Cannabidiol,$285.53,$212.25,$0.00,$105.00,N/A,$101.85,N/A,N/A,N/A,$0.00,N/A,$101.85,N/A,$105.00,N/A,N/A,$101.85
3093150,0309,80352,,,,,N/A,N/A,"MAYO SYNTHETIC CANNABINOIDS,UR",$153.36,$114.00,$28.92,$152.00,N/A,$147.44,N/A,N/A,N/A,$28.92,N/A,$147.44,N/A,$152.00,N/A,N/A,$147.44
3093448,0309,80353,,,,,N/A,N/A,"Mayo Cocaine, S/P",$313.78,$233.25,$0.00,$287.00,N/A,$278.39,N/A,$30.44,N/A,$0.00,N/A,$278.39,N/A,$287.00,N/A,N/A,$278.39
3099498,0309,80353,,,,,N/A,N/A,"Mayo Cocaine Confirmation,Urin",$289.57,$215.25,$0.00,$287.00,N/A,$278.39,N/A,$30.44,N/A,$0.00,N/A,$278.39,N/A,$287.00,N/A,N/A,$278.39
3093017,0309,80356,,,,,N/A,N/A,MAYO 6-MAM URINE,$194.73,$144.75,$28.92,$193.00,N/A,$187.21,N/A,N/A,N/A,$28.92,N/A,$187.21,N/A,$193.00,N/A,N/A,$187.21
3091719,0309,80358,,,,,N/A,N/A,MAYO METHADONE,$304.70,$226.50,$28.92,$311.00,N/A,$301.67,N/A,$31.95,N/A,$28.92,N/A,$301.67,N/A,$311.00,N/A,N/A,$301.67
3091861,0309,80358,,,,,N/A,N/A,MAYO METHADONE CONFIRMATION,$304.70,$226.50,$28.92,$311.00,N/A,$301.67,N/A,$31.95,N/A,$28.92,N/A,$301.67,N/A,$311.00,N/A,N/A,$301.67
3093053,0309,80358,,,,,N/A,N/A,"MAYO METHADONE&METABOL, CONFRM",$114.01,$84.75,$28.92,$311.00,N/A,$301.67,N/A,$31.95,N/A,$28.92,N/A,$301.67,N/A,$311.00,N/A,N/A,$301.67
3093449,0309,80358,,,,,N/A,N/A,"MAYO METHADONE,S/P",$313.78,$233.25,$28.92,$311.00,N/A,$301.67,N/A,$31.95,N/A,$28.92,N/A,$301.67,N/A,$311.00,N/A,N/A,$301.67
3093713,0309,80360,,,,,N/A,N/A,"MAYO METHYL & METABOLITE, URIN",$117.04,$87.00,$28.92,$374.00,N/A,$362.78,N/A,N/A,N/A,$28.92,N/A,$362.78,N/A,$374.00,N/A,N/A,$362.78
3093342,0309,80361,,,,,N/A,N/A,"Mayo Opiate Confirmation ,Ur",$128.14,$95.25,$28.92,$311.00,N/A,$301.67,N/A,N/A,N/A,$28.92,N/A,$301.67,N/A,$311.00,N/A,N/A,$301.67
3093343,0309,80361,,,,,N/A,N/A,"Mayo Opiate Confirmation ,Ur",$128.14,$95.25,$28.92,$311.00,N/A,$301.67,N/A,N/A,N/A,$28.92,N/A,$301.67,N/A,$311.00,N/A,N/A,$301.67
3093349,0309,80361,,,,,N/A,N/A,Mayo Opiates Serum/Plasma,$115.02,$85.50,$28.92,$311.00,N/A,$301.67,N/A,N/A,N/A,$28.92,N/A,$301.67,N/A,$311.00,N/A,N/A,$301.67
3093451,0309,80361,,,,,N/A,N/A,"Mayo Opiates, S/P",$313.78,$233.25,$28.92,$311.00,N/A,$301.67,N/A,N/A,N/A,$28.92,N/A,$301.67,N/A,$311.00,N/A,N/A,$301.67
3095502,0309,80361,,,,,N/A,N/A,Mayo Hydrocodone W/Metab Confi,$41.37,$30.75,$28.92,$311.00,N/A,$301.67,N/A,N/A,N/A,$28.92,N/A,$301.67,N/A,$311.00,N/A,N/A,$301.67
3095504,0309,80362,,,,,N/A,N/A,Uvm Naloxone & Naltrex Conf Ur,$72.64,$54.00,$28.92,$72.00,N/A,$69.84,N/A,N/A,N/A,$28.92,N/A,$69.84,N/A,$72.00,N/A,N/A,$69.84
3095393,0309,80364,,,,,N/A,N/A,MAYO CONTROLLED SUBSTANCE URIN,$18.16,$13.50,$28.92,$44.00,N/A,$42.68,N/A,N/A,N/A,$28.92,N/A,$42.68,N/A,$44.00,N/A,N/A,$42.68
3095402,0309,80364,,,,,N/A,N/A,"MAYO TARGET OPIOID SCREEN,URIN",$44.39,$33.00,$28.92,$44.00,N/A,$42.68,N/A,N/A,N/A,$28.92,N/A,$42.68,N/A,$44.00,N/A,N/A,$42.68
3092509,0309,80365,,,,,N/A,N/A,Mayo Oxcodone Urine Qt,$735.52,$546.75,$0.00,$729.00,N/A,$707.13,N/A,N/A,N/A,$0.00,N/A,$707.13,N/A,$729.00,N/A,N/A,$707.13
3093348,0309,80365,,,,,N/A,N/A,Mayo Opiates Serum/Plasma,$115.02,$85.50,$0.00,$729.00,N/A,$707.13,N/A,N/A,N/A,$0.00,N/A,$707.13,N/A,$729.00,N/A,N/A,$707.13
3093698,0309,80365,,,,,N/A,N/A,"MAYO OPIATE CONFIRMATION, URIN",$91.81,$68.25,$0.00,$729.00,N/A,$707.13,N/A,N/A,N/A,$0.00,N/A,$707.13,N/A,$729.00,N/A,N/A,$707.13
3093258,0309,80369,,,,,N/A,N/A,MAYO CYCLOBENZAPINE (FLEXERIL),$94.84,$70.50,$28.92,$115.00,N/A,$111.55,N/A,N/A,N/A,$28.92,N/A,$111.55,N/A,$115.00,N/A,N/A,$111.55
3093372,0309,80369,,,,,N/A,N/A,MAYO MEPROBAMATE,$116.03,$86.25,$28.92,$115.00,N/A,$111.55,N/A,N/A,N/A,$28.92,N/A,$111.55,N/A,$115.00,N/A,N/A,$111.55
3095410,0309,80369,,,,,N/A,N/A,MAYO ANTIDEPRESSANT URINE/SERU,$58.52,$43.50,$28.92,$115.00,N/A,$111.55,N/A,N/A,N/A,$28.92,N/A,$111.55,N/A,$115.00,N/A,N/A,$111.55
3093274,0309,80372,,,,,N/A,N/A,MAYO TAPENTADOL & METABOLITE U,$63.56,$47.25,$28.92,$63.00,N/A,$61.11,N/A,N/A,N/A,$28.92,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093214,0309,80373,,,,,N/A,N/A,Mayo Tramadol Serum/Plasma,$194.73,$144.75,$28.92,$342.00,N/A,$331.74,N/A,N/A,N/A,$28.92,N/A,$331.74,N/A,$342.00,N/A,N/A,$331.74
3091736,0309,80375,,,,,N/A,N/A,MAYO MERCAPTOPURINE,$308.74,$229.50,$28.92,$297.00,N/A,$288.09,N/A,$32.74,N/A,$28.92,N/A,$288.09,N/A,$297.00,N/A,N/A,$288.09
3093299,0309,80375,,,,,N/A,N/A,"MAYO METHAQUALONE CONFIRM,UR",$134.19,$99.75,$28.92,$297.00,N/A,$288.09,N/A,$32.74,N/A,$28.92,N/A,$288.09,N/A,$297.00,N/A,N/A,$288.09
3093555,0309,80375,,,,,N/A,N/A,"MAYO APIXABAN (ELIQUIS),P",$299.66,$222.75,$28.92,$297.00,N/A,$288.09,N/A,$32.74,N/A,$28.92,N/A,$288.09,N/A,$297.00,N/A,N/A,$288.09
3093374,0309,80400,,,,,N/A,N/A,UVM BASELINE & 30MIN CORTISOL,$18.16,$13.50,$28.92,$464.00,N/A,$450.08,N/A,$47.30,N/A,$28.92,N/A,$450.08,N/A,$464.00,N/A,N/A,$450.08
3091823,0309,81002,,,,,N/A,N/A,MAYO HEMOGLOBIN URINE,$101.90,$75.75,$3.77,$101.00,N/A,$97.97,N/A,$3.94,N/A,$3.77,N/A,$97.97,N/A,$101.00,N/A,N/A,$97.97
3093753,0309,81170,,,,,N/A,N/A,MAYO BCR/ABL1 MUTATION SEQUEN,$435.86,$324.00,$4.19,$432.00,N/A,$419.04,N/A,$342.69,N/A,$4.19,N/A,$419.04,N/A,$432.00,N/A,N/A,$419.04
3093648,0309,81173,,,,,N/A,N/A,MAYO ANDROGEN INSENSITIVITY,$871.72,$648.00,$360.46,$864.00,N/A,$838.08,N/A,$319.43,N/A,$360.46,N/A,$838.08,N/A,$864.00,N/A,N/A,$838.08
3093597,0309,81180,,,,,N/A,N/A,MAYO SCA-3MJD (ATXN3) DNA,$871.72,$648.00,$362.13,$864.00,N/A,$838.08,N/A,$145.22,N/A,$362.13,N/A,$838.08,N/A,$864.00,N/A,N/A,$838.08
3093466,0309,81206,,,,,N/A,N/A,DHMC BCR/ABL1 PCR,$729.46,$542.25,$164.72,$723.00,N/A,$701.31,N/A,$237.74,N/A,$164.72,N/A,$701.31,N/A,$723.00,N/A,N/A,$701.31
3093470,0309,81206,,,,,N/A,N/A,"Mayo  BCR/ABL1,p210,Quant",$513.55,$381.75,$164.72,$723.00,N/A,$701.31,N/A,$237.74,N/A,$164.72,N/A,$701.31,N/A,$723.00,N/A,N/A,$701.31
3095478,0309,81207,,,,,N/A,N/A,"MAYO BCR/ABL 1, p190 PCR",$435.86,$324.00,$196.99,$432.00,N/A,$419.04,N/A,$210.02,N/A,$196.99,N/A,$419.04,N/A,$432.00,N/A,N/A,$419.04
3093306,0309,81211,,,,,N/A,N/A,MAYO BRCA 1&BRCA2 GENE ANALY,"$2,573.81","$1,913.25",$210.83,"$2,551.00",N/A,"$2,474.47",N/A,N/A,N/A,$210.83,N/A,"$2,474.47",N/A,"$2,551.00",N/A,N/A,"$2,474.47"
3093226,0309,81213,,,,,N/A,N/A,MAYO BRCA1 &BRCA2 DEL/DAP,$722.40,$537.00,$694.52,$716.00,N/A,$694.52,N/A,N/A,N/A,$716.00,N/A,$694.52,N/A,$716.00,N/A,N/A,$694.52
3095483,0309,81220,,,,,N/A,N/A,MAYO CYSTIC MUTATION PANEL,$209.86,$156.00,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3095482,0309,81222,,,,,N/A,N/A,MAYO CYSTIC MUTATION PANEL,$164.46,$122.25,$158.11,$668.52,N/A,$158.11,N/A,N/A,N/A,$668.52,N/A,$158.11,N/A,$163.00,N/A,N/A,$158.11
3093210,0309,81229,,,,,N/A,N/A,MAYO CHROMOSOMAL MICRO BLOOD,"$2,696.90","$2,004.75",$522.66,"$2,673.00",N/A,"$2,592.81",N/A,"$1,160.00",N/A,$522.66,N/A,"$2,592.81",N/A,"$2,673.00",N/A,N/A,"$2,592.81"
3093559,0309,81232,,,,,N/A,N/A,MAYO DPYD GENOTYPE,$836.41,$621.75,$804.13,"$1,393.21",N/A,$804.13,N/A,N/A,N/A,"$1,393.21",N/A,$804.13,N/A,$829.00,N/A,N/A,$804.13
3095469,0309,81240,,,,,N/A,N/A,MAYO PROTHROMBIN G20210A MUTAT,$108.97,$81.00,$104.76,$209.99,N/A,$104.76,N/A,$77.87,N/A,$209.99,N/A,$104.76,N/A,$108.00,N/A,N/A,$104.76
3093583,0309,81241,,,,,N/A,N/A,MAYO FACTOR V LEIDEN R506Q MUT,$321.85,$239.25,$78.80,$319.00,N/A,$309.43,N/A,$96.71,N/A,$78.80,N/A,$309.43,N/A,$319.00,N/A,N/A,$309.43
3095386,0309,81241,,,,,N/A,N/A,MAYO FACTOR V LEIDEN R506Q MUT,$321.85,$239.25,$78.80,$319.00,N/A,$309.43,N/A,$96.71,N/A,$78.80,N/A,$309.43,N/A,$319.00,N/A,N/A,$309.43
3095476,0309,81256,,,,,N/A,N/A,MAYO HEREDITARY HEMOCHROMATOSI,$187.66,$139.50,$88.02,$186.00,N/A,$180.42,N/A,$94.77,N/A,$88.02,N/A,$180.42,N/A,$186.00,N/A,N/A,$180.42
3093366,0309,81260,,,,,N/A,N/A,MAYO HEREDITARY SENSORY NEUR,$987.75,$734.25,$78.38,$979.00,N/A,$949.63,N/A,N/A,N/A,$78.38,N/A,$949.63,N/A,$979.00,N/A,N/A,$949.63
3092368,0309,81270,,,,,N/A,N/A,FAHC JAK2 V617F MUTATION,$754.69,$561.00,$47.36,$748.00,N/A,$725.56,N/A,$132.91,N/A,$47.36,N/A,$725.56,N/A,$748.00,N/A,N/A,$725.56
3093682,0309,81270,,,,,N/A,N/A,DHMC JAK2 V617F,$129.14,$96.00,$47.36,$748.00,N/A,$725.56,N/A,$132.91,N/A,$47.36,N/A,$725.56,N/A,$748.00,N/A,N/A,$725.56
3093535,0309,81271,,,,,N/A,N/A,MAYO HUNTINGTON DISEASE ANALY,$349.09,$259.50,$110.23,$346.00,N/A,$335.62,N/A,$150.70,N/A,$110.23,N/A,$335.62,N/A,$346.00,N/A,N/A,$335.62
3095517,0309,81273,,,,,N/A,N/A,Mayo Kit Asp816val Mutation,$584.18,$434.25,$164.72,$579.00,N/A,$561.63,N/A,$132.36,N/A,$164.72,N/A,$561.63,N/A,$579.00,N/A,N/A,$561.63
3093032,0309,81291,,,,,N/A,N/A,MAYO MTHFR 2 MUTATION ANALYSIS,$366.25,$272.25,$230.94,$363.00,N/A,$352.11,N/A,$73.28,N/A,$230.94,N/A,$352.11,N/A,$363.00,N/A,N/A,$352.11
3093608,0309,81291,,,,,N/A,N/A,MAYO MTHFR A1298C MUTATION ANA,$183.63,$136.50,$230.94,$363.00,N/A,$352.11,N/A,$73.28,N/A,$230.94,N/A,$352.11,N/A,$363.00,N/A,N/A,$352.11
3093609,0309,81291,,,,,N/A,N/A,MAYO MTHFR C977T MUTATION ANA,$182.62,$135.75,$230.94,$363.00,N/A,$352.11,N/A,$73.28,N/A,$230.94,N/A,$352.11,N/A,$363.00,N/A,N/A,$352.11
3093536,0309,81315,,,,,N/A,N/A,"MAYO PML/RARA QUANT,PCR",$593.26,$441.00,$418.72,$588.00,N/A,$570.36,N/A,$300.60,N/A,$418.72,N/A,$570.36,N/A,$588.00,N/A,N/A,$570.36
3092779,0309,81324,,,,,N/A,N/A,MAYO COMPLETE HNPP EVAL,$44.39,$33.00,$42.68,$248.97,N/A,$42.68,N/A,N/A,N/A,$248.97,N/A,$42.68,N/A,$44.00,N/A,N/A,$42.68
3092780,0309,81325,,,,,N/A,N/A,MAYO COMPLETE HNPP EVAL,$155.38,$115.50,$597.52,"$3,643.12",N/A,$597.52,N/A,N/A,N/A,"$3,643.12",N/A,$597.52,N/A,$616.00,N/A,N/A,$597.52
3093483,0309,81329,,,,,N/A,N/A,MAYO SMA CARRIER SCREENING,$418.71,$311.25,$402.55,$924.61,N/A,$402.55,N/A,$145.22,N/A,$924.61,N/A,$402.55,N/A,$415.00,N/A,N/A,$402.55
3092833,0309,81350,,,,,N/A,N/A,MAYO UGT A1 TA REPEAT GENOTYPE,"$1,397.38","$1,038.75",$61.19,"$1,385.00",N/A,"$1,343.45",N/A,N/A,N/A,$61.19,N/A,"$1,343.45",N/A,"$1,385.00",N/A,N/A,"$1,343.45"
3093351,0309,81372,,,,,N/A,N/A,MAYO HLA CLASS I MOLECULAR TYP,$369.27,$274.50,$281.24,$366.00,N/A,$355.02,N/A,$443.95,N/A,$281.24,N/A,$355.02,N/A,$366.00,N/A,N/A,$355.02
3092866,0309,81373,,,,,N/A,N/A,"FAHC HLA B TYPE, DNA",$208.85,$155.25,$200.79,$484.94,N/A,$200.79,N/A,$176.24,N/A,$484.94,N/A,$200.79,N/A,$207.00,N/A,N/A,$200.79
3093596,0309,81374,,,,,N/A,N/A,MAYO HLA-A29 DETECTION,$290.57,$216.00,$152.98,$288.00,N/A,$279.36,N/A,$107.78,N/A,$152.98,N/A,$279.36,N/A,$288.00,N/A,N/A,$279.36
3092886,0309,81376,,,,,N/A,N/A,MAYO NARCOLEPSY ASSOC Ag,$138.22,$102.75,$89.28,$137.00,N/A,$132.89,N/A,$177.22,N/A,$89.28,N/A,$132.89,N/A,$137.00,N/A,N/A,$132.89
3095462,0309,81381,,,,,N/A,N/A,"MAYO HLA-B*57:01 GENOTYPE, VAR",$231.05,$171.75,$146.70,$229.00,N/A,$222.13,N/A,$186.89,N/A,$146.70,N/A,$222.13,N/A,$229.00,N/A,N/A,$222.13
3092542,0309,81382,,,,,N/A,N/A,MAYO HLA-DQB1,$889.89,$661.50,$204.12,$882.00,N/A,$855.54,N/A,$179.34,N/A,$204.12,N/A,$855.54,N/A,$882.00,N/A,N/A,$855.54
3092963,0309,81400,,,,,N/A,N/A,MAYO PAI-1 LOCUS 4G/5G,$589.22,$438.00,$148.37,$584.00,N/A,$566.48,N/A,$70.36,N/A,$148.37,N/A,$566.48,N/A,$584.00,N/A,N/A,$566.48
3092621,0309,81401,,,,,N/A,N/A,MAYO SMA EVALUATION,"$1,182.48",$879.00,$76.70,"$1,614.00",N/A,"$1,565.58",N/A,$150.70,N/A,$76.70,N/A,"$1,565.58",N/A,"$1,614.00",N/A,N/A,"$1,565.58"
3092707,0309,81401,,,,,N/A,N/A,MAYO LHON MTDNA EVALUATION,"$1,628.43","$1,210.50",$76.70,"$1,614.00",N/A,"$1,565.58",N/A,$150.70,N/A,$76.70,N/A,"$1,565.58",N/A,"$1,614.00",N/A,N/A,"$1,565.58"
3092953,0309,81401,,,,,N/A,N/A,MAYO SCA 1 DNA,$873.74,$649.50,$76.70,"$1,614.00",N/A,"$1,565.58",N/A,$150.70,N/A,$76.70,N/A,"$1,565.58",N/A,"$1,614.00",N/A,N/A,"$1,565.58"
3093565,0309,81401,,,,,N/A,N/A,MAYO COMPREHENSIVE SCA PANEL,"$1,231.92",$915.75,$76.70,"$1,614.00",N/A,"$1,565.58",N/A,$150.70,N/A,$76.70,N/A,"$1,565.58",N/A,"$1,614.00",N/A,N/A,"$1,565.58"
3099870,0309,81401,,,,,N/A,N/A,MAYO APOLIPOPROTEIN & GENO,"$1,102.77",$819.75,$76.70,"$1,614.00",N/A,"$1,565.58",N/A,$150.70,N/A,$76.70,N/A,"$1,565.58",N/A,"$1,614.00",N/A,N/A,"$1,565.58"
3099871,0309,81401,,,,,N/A,N/A,MAYO APOLIPOPROTEIN/GENO 1,$223.98,$166.50,$76.70,"$1,614.00",N/A,"$1,565.58",N/A,$150.70,N/A,$76.70,N/A,"$1,565.58",N/A,"$1,614.00",N/A,N/A,"$1,565.58"
3093245,0309,81403,,,,,N/A,N/A,MAYO FAMILIAL MUTATION,$592.25,$440.25,$164.72,$587.00,N/A,$569.39,N/A,$203.72,N/A,$164.72,N/A,$569.39,N/A,$587.00,N/A,N/A,$569.39
3093547,0309,81403,,,,,N/A,N/A,MAYO Y CHROMOSOME MICRDELETION,$401.56,$298.50,$164.72,$587.00,N/A,$569.39,N/A,$203.72,N/A,$164.72,N/A,$569.39,N/A,$587.00,N/A,N/A,$569.39
3093369,0309,81404,,,,,N/A,N/A,"MAYO TTR GENE,FULL GENE ANALYS",$805.13,$598.50,$222.56,$798.00,N/A,$774.06,N/A,$302.31,N/A,$222.56,N/A,$774.06,N/A,$798.00,N/A,N/A,$774.06
3093129,0309,81405,,,,,N/A,N/A,MAYO X-LINKED ADRENOLEUKODYSTR,"$1,309.60",$973.50,$330.28,"$1,373.00",N/A,"$1,331.81",N/A,$331.49,N/A,$330.28,N/A,"$1,331.81",N/A,"$1,373.00",N/A,N/A,"$1,331.81"
3093370,0309,81405,,,,,N/A,N/A,MAYO FABRY DISEASE GENE ANALYS,"$1,385.27","$1,029.75",$330.28,"$1,373.00",N/A,"$1,331.81",N/A,$331.49,N/A,$330.28,N/A,"$1,331.81",N/A,"$1,373.00",N/A,N/A,"$1,331.81"
3093571,0309,81405,,,,,N/A,N/A,MAYO TP53 GENE SOMATIC MUTATIO,$717.36,$533.25,$330.28,"$1,373.00",N/A,"$1,331.81",N/A,$331.49,N/A,$330.28,N/A,"$1,331.81",N/A,"$1,373.00",N/A,N/A,"$1,331.81"
3093367,0309,81406,,,,,N/A,N/A,MAYO HEREDITARY SENSORY NEUR,$987.75,$734.25,$362.13,$979.00,N/A,$949.63,N/A,N/A,N/A,$362.13,N/A,$949.63,N/A,$979.00,N/A,N/A,$949.63
3093577,0309,81440,,,,,N/A,N/A,MAYO MITOCHONDRIAL NUC GENE,"$4,308.17","$3,202.50",$339.92,"$4,270.00",N/A,"$4,141.90",N/A,N/A,N/A,$339.92,N/A,"$4,141.90",N/A,"$4,270.00",N/A,N/A,"$4,141.90"
3093673,0309,81450,,,,,N/A,N/A,DHMC MYELOID PANEL,"$1,333.82",$991.50,"$1,282.34","$3,992.69",N/A,"$1,282.34",N/A,N/A,N/A,"$3,992.69",N/A,"$1,282.34",N/A,"$1,322.00",N/A,N/A,"$1,282.34"
3092883,0309,81479,,,,,N/A,N/A,MAYO OPMD DNA TEST,$903.00,$671.25,$912.46,$979.00,N/A,$949.63,N/A,N/A,N/A,$912.46,N/A,$949.63,N/A,$979.00,N/A,N/A,$949.63
3093368,0309,81479,,,,,N/A,N/A,MAYO HEREDITARY SENSORY NEUR,$987.75,$734.25,$912.46,$979.00,N/A,$949.63,N/A,N/A,N/A,$912.46,N/A,$949.63,N/A,$979.00,N/A,N/A,$949.63
3091814,0309,81511,,,,,N/A,N/A,"MAYO QUAD SCREEN,MATERNAL",$147.31,$109.50,$0.00,$146.00,N/A,$141.62,N/A,N/A,N/A,$0.00,N/A,$141.62,N/A,$146.00,N/A,N/A,$141.62
3095526,0309,81513,,,,,N/A,N/A,Mayo Bacterial Vaginosis,$27.24,$20.25,$26.19,$184.42,N/A,$26.19,N/A,$142.63,N/A,$184.42,N/A,$26.19,N/A,$27.00,N/A,N/A,$26.19
3093122,0309,81596,,,,,N/A,N/A,MAYO HCV FIBROSIS,$364.23,$270.75,$171.43,$361.00,N/A,$350.17,N/A,$76.52,N/A,$171.43,N/A,$350.17,N/A,$361.00,N/A,N/A,$350.17
3092878,0309,82040,,,,,N/A,N/A,MAYO MULTIPLE SCLEROSIS PROF,$16.14,$12.00,$31.02,$85.00,N/A,$82.45,N/A,$7.18,N/A,$31.02,N/A,$82.45,N/A,$85.00,N/A,N/A,$82.45
3092879,0309,82042,,,,,N/A,N/A,MAYO MULTIPLE SCLEROSIS PROF,$16.14,$12.00,$5.87,$71.00,N/A,$68.87,N/A,$10.39,N/A,$5.87,N/A,$68.87,N/A,$71.00,N/A,N/A,$68.87
3093537,0309,82042,,,,,N/A,N/A,UVM ALBUMIN BODY FLUID,$11.10,$8.25,$5.87,$71.00,N/A,$68.87,N/A,$10.39,N/A,$5.87,N/A,$68.87,N/A,$71.00,N/A,N/A,$68.87
3099223,0309,82042,,,,,N/A,N/A,FAHC IgG INDEX CSF,$72.64,$54.00,$5.87,$71.00,N/A,$68.87,N/A,$10.39,N/A,$5.87,N/A,$68.87,N/A,$71.00,N/A,N/A,$68.87
3092882,0309,82043,,,,,N/A,N/A,MAYO MICROALBUMINURIA 24 HR UR,$26.23,$19.50,$9.22,$106.00,N/A,$102.82,N/A,$8.38,N/A,$9.22,N/A,$102.82,N/A,$106.00,N/A,N/A,$102.82
3092975,0309,82055,,,,,N/A,N/A,MAYO SEDATIVE HYPNOT PAN UR,$53.47,$39.75,$7.13,$53.00,N/A,$51.41,N/A,N/A,N/A,$7.13,N/A,$51.41,N/A,$53.00,N/A,N/A,$51.41
3093711,0309,82088,,,,,N/A,N/A,"MAYO ALDOSTERONE, P",$34.30,$25.50,$11.74,$763.00,N/A,$740.11,N/A,$59.09,N/A,$11.74,N/A,$740.11,N/A,$763.00,N/A,N/A,$740.11
3095444,0309,82088,,,,,N/A,N/A,"MAYO ALDOSTERONE, 24HR URINE",$76.68,$57.00,$11.74,$763.00,N/A,$740.11,N/A,$59.09,N/A,$11.74,N/A,$740.11,N/A,$763.00,N/A,N/A,$740.11
3099834,0309,82088,,,,,N/A,N/A,MAYO ALDOSTERONE SODIUM 24HR,$266.36,$198.00,$11.74,$763.00,N/A,$740.11,N/A,$59.09,N/A,$11.74,N/A,$740.11,N/A,$763.00,N/A,N/A,$740.11
3092436,0309,82103,,,,,N/A,N/A,MAYO ALPHA1 ANTI DEF PROFILE,$23.21,$17.25,$49.04,$193.00,N/A,$187.21,N/A,$19.49,N/A,$49.04,N/A,$187.21,N/A,$193.00,N/A,N/A,$187.21
3092914,0309,82103,,,,,N/A,N/A,MAYO A1A CLEARANCE,$71.63,$53.25,$49.04,$193.00,N/A,$187.21,N/A,$19.49,N/A,$49.04,N/A,$187.21,N/A,$193.00,N/A,N/A,$187.21
3093243,0309,82103,,,,,N/A,N/A,ALPHA-1-ANTITRYPSIN,$45.40,$33.75,$49.04,$193.00,N/A,$187.21,N/A,$19.49,N/A,$49.04,N/A,$187.21,N/A,$193.00,N/A,N/A,$187.21
3095458,0309,82103,,,,,N/A,N/A,"MAYO ALPHA-1-ANTITRYPSIN, S",$170.51,$126.75,$49.04,$193.00,N/A,$187.21,N/A,$19.49,N/A,$49.04,N/A,$187.21,N/A,$193.00,N/A,N/A,$187.21
3099845,0309,82103,,,,,N/A,N/A,MAYO ALPHA 1 ANTI GENOTYPE,$194.73,$144.75,$49.04,$193.00,N/A,$187.21,N/A,$19.49,N/A,$49.04,N/A,$187.21,N/A,$193.00,N/A,N/A,$187.21
3099846,0309,82104,,,,,N/A,N/A,MAYO ALPHA 1 ANTI GENOTYPE,$194.73,$144.75,$16.35,$193.00,N/A,$187.21,N/A,$20.97,N/A,$16.35,N/A,$187.21,N/A,$193.00,N/A,N/A,$187.21
3090547,0309,82105,,,,,N/A,N/A,FAHC AFP,$279.48,$207.75,$17.18,$404.00,N/A,$391.88,N/A,$24.32,N/A,$17.18,N/A,$391.88,N/A,$404.00,N/A,N/A,$391.88
3093016,0309,82105,,,,,N/A,N/A,MAYO  AFP SINGLE MARKER MATERN,$38.34,$28.50,$17.18,$404.00,N/A,$391.88,N/A,$24.32,N/A,$17.18,N/A,$391.88,N/A,$404.00,N/A,N/A,$391.88
3091830,0309,82108,,,,,N/A,N/A,MAYO ALUMINUM,$208.85,$155.25,$20.12,$207.00,N/A,$200.79,N/A,N/A,N/A,$20.12,N/A,$200.79,N/A,$207.00,N/A,N/A,$200.79
3099267,0309,82135,,,,,N/A,N/A,"MAYO AMINOLEVULINIC ACID, UR",$202.80,$150.75,$30.60,$201.00,N/A,$194.97,N/A,$23.85,N/A,$30.60,N/A,$194.97,N/A,$201.00,N/A,N/A,$194.97
3092508,0309,82139,,,,,N/A,N/A,"MAYO AMINO ACID QN ION EX, P",$206.83,$153.75,$23.47,$205.00,N/A,$198.85,N/A,$22.12,N/A,$23.47,N/A,$198.85,N/A,$205.00,N/A,N/A,$198.85
3095434,0309,82140,,,,,N/A,N/A,MAYO SUPERSATURATION 24HR URIN,$30.27,$22.50,$20.12,$430.00,N/A,$417.10,N/A,$21.13,N/A,$20.12,N/A,$417.10,N/A,$430.00,N/A,N/A,$417.10
3092687,0309,82145,,,,,N/A,N/A,"MAYO AMPHETAMINE,MECONIUM",$298.65,$222.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3092688,0309,82145,,,,,N/A,N/A,"MAYO AMPHETAMINE,MECONIUM",$298.65,$222.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3092887,0309,82150,,,,,N/A,N/A,MAYO AMYLASE BODY FLUID,$86.77,$64.50,$17.60,$114.00,N/A,$110.58,N/A,$9.40,N/A,$17.60,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3093131,0309,82150,,,,,N/A,N/A,MAYO AMYLASE PANCREATIC FLUID,$64.57,$48.00,$17.60,$114.00,N/A,$110.58,N/A,$9.40,N/A,$17.60,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092584,0309,82164,,,,,N/A,N/A,"MAYO ACE, CSF",$191.70,$142.50,$35.21,$685.00,N/A,$664.45,N/A,$21.17,N/A,$35.21,N/A,$664.45,N/A,$685.00,N/A,N/A,$664.45
3093218,0309,82172,,,,,N/A,N/A,MAYO APOLIPOPROTEIN A1&B,$68.61,$51.00,$35.20,$592.00,N/A,$574.24,N/A,$61.16,N/A,$35.20,N/A,$574.24,N/A,$592.00,N/A,N/A,$574.24
3093632,0309,82172,,,,,N/A,N/A,MAYO APOLIPOPROTEIN B,$26.23,$19.50,$17.60,$296.00,N/A,$287.12,N/A,$30.58,N/A,$17.60,N/A,$287.12,N/A,$296.00,N/A,N/A,$287.12
3093699,0309,82172,,,,,N/A,N/A,MAYO APOLIPROPROTEIN A1,$59.53,$44.25,$17.60,$296.00,N/A,$287.12,N/A,$30.58,N/A,$17.60,N/A,$287.12,N/A,$296.00,N/A,N/A,$287.12
3099879,0309,82172,,,,,N/A,N/A,MAYO APOLIPOPROTEIN AI,$272.41,$202.50,$17.60,$296.00,N/A,$287.12,N/A,$30.58,N/A,$17.60,N/A,$287.12,N/A,$296.00,N/A,N/A,$287.12
3092758,0309,82175,,,,,N/A,N/A,MAYO HEAVY METALS SCR OCC,$114.01,$84.75,$25.15,$358.00,N/A,$347.26,N/A,N/A,N/A,$25.15,N/A,$347.26,N/A,$358.00,N/A,N/A,$347.26
3093065,0309,82175,,,,,N/A,N/A,"MAYO ARSENIC FRACTION, R UR",$122.08,$90.75,$25.15,$358.00,N/A,$347.26,N/A,N/A,N/A,$25.15,N/A,$347.26,N/A,$358.00,N/A,N/A,$347.26
3093599,0309,82175,,,,,N/A,N/A,ARSENIC,$18.16,$13.50,$25.15,$358.00,N/A,$347.26,N/A,N/A,N/A,$25.15,N/A,$347.26,N/A,$358.00,N/A,N/A,$347.26
3093719,0309,82175,,,,,N/A,N/A,MAYO ARSENIC SPECIAT 24 URINE,$109.97,$81.75,$25.15,$358.00,N/A,$347.26,N/A,N/A,N/A,$25.15,N/A,$347.26,N/A,$358.00,N/A,N/A,$347.26
3095419,0309,82175,,,,,N/A,N/A,"MAYO ARSENIC SPECIA,RANDOM URI",$120.06,$89.25,$25.15,$358.00,N/A,$347.26,N/A,N/A,N/A,$25.15,N/A,$347.26,N/A,$358.00,N/A,N/A,$347.26
3099634,0309,82175,,,,,N/A,N/A,MAYO ARSENIC (BLOOD),$361.20,$268.50,$25.15,$358.00,N/A,$347.26,N/A,N/A,N/A,$25.15,N/A,$347.26,N/A,$358.00,N/A,N/A,$347.26
3099825,0309,82175,,,,,N/A,N/A,MAYO HEAVY METALS SCREEN BLOOD,$226.00,$168.00,$25.15,$358.00,N/A,$347.26,N/A,N/A,N/A,$25.15,N/A,$347.26,N/A,$358.00,N/A,N/A,$347.26
3099948,0309,82180,,,,,N/A,N/A,MAYO ASCORBIC ACID,$516.58,$384.00,$22.63,$512.00,N/A,$496.64,N/A,$14.34,N/A,$22.63,N/A,$496.64,N/A,$512.00,N/A,N/A,$496.64
3099713,0309,82190,,,,,N/A,N/A,MAYO IODINE,$341.02,$253.50,$11.74,$338.00,N/A,$327.86,N/A,$18.08,N/A,$11.74,N/A,$327.86,N/A,$338.00,N/A,N/A,$327.86
3099602,0309,82239,,,,,N/A,N/A,"Mayo Bile Acids,Fractionated",$627.56,$466.50,$19.28,$132.00,N/A,$128.04,N/A,$24.82,N/A,$19.28,N/A,$128.04,N/A,$132.00,N/A,N/A,$128.04
3092962,0309,82247,,,,,N/A,N/A,MAYO BILIRUBIN BODY FLUID,$133.18,$99.00,$20.54,$132.00,N/A,$128.04,N/A,$7.28,N/A,$20.54,N/A,$128.04,N/A,$132.00,N/A,N/A,$128.04
3093704,0309,82247,,,,,N/A,N/A,MAYO TOTAL BILIRUBIN,$58.52,$43.50,$20.54,$132.00,N/A,$128.04,N/A,$7.28,N/A,$20.54,N/A,$128.04,N/A,$132.00,N/A,N/A,$128.04
3092901,0309,82274,,,,,N/A,N/A,MAYO OCCULT BLD QL,$142.26,$105.75,$5.03,$141.00,N/A,$136.77,N/A,$20.01,N/A,$5.03,N/A,$136.77,N/A,$141.00,N/A,N/A,$136.77
3092388,0309,82300,,,,,N/A,N/A,"MAYO CADMIUM, BLOOD",$84.75,$63.00,$19.28,$224.00,N/A,$217.28,N/A,N/A,N/A,$19.28,N/A,$217.28,N/A,$224.00,N/A,N/A,$217.28
3092389,0309,82300,,,,,N/A,N/A,"MAYO CADMIUM, URINE",$84.75,$63.00,$19.28,$224.00,N/A,$217.28,N/A,N/A,N/A,$19.28,N/A,$217.28,N/A,$224.00,N/A,N/A,$217.28
3092759,0309,82300,,,,,N/A,N/A,MAYO HEAVY METALS SCR OCC,$138.22,$102.75,$19.28,$224.00,N/A,$217.28,N/A,N/A,N/A,$19.28,N/A,$217.28,N/A,$224.00,N/A,N/A,$217.28
3093600,0309,82300,,,,,N/A,N/A,CADMIUM,$22.20,$16.50,$19.28,$224.00,N/A,$217.28,N/A,N/A,N/A,$19.28,N/A,$217.28,N/A,$224.00,N/A,N/A,$217.28
3099826,0309,82300,,,,,N/A,N/A,MAYO HEAVY METALS SCREEN BLOOD,$226.00,$168.00,$19.28,$224.00,N/A,$217.28,N/A,N/A,N/A,$19.28,N/A,$217.28,N/A,$224.00,N/A,N/A,$217.28
3091123,0309,82308,,,,,N/A,N/A,MAYO CALCITONIN,$508.51,$378.00,$35.63,$504.00,N/A,$488.88,N/A,$38.85,N/A,$35.63,N/A,$488.88,N/A,$504.00,N/A,N/A,$488.88
3093646,0309,82310,,,,,N/A,N/A,"MAYO CALCIUM, RANDON UR",$34.30,$25.50,$32.27,$84.00,N/A,$81.48,N/A,$7.48,N/A,$32.27,N/A,$81.48,N/A,$84.00,N/A,N/A,$81.48
3095432,0309,82340,,,,,N/A,N/A,MAYO SUPERSATURATION 24HR URIN,$13.12,$9.75,$16.35,$176.00,N/A,$170.72,N/A,$8.74,N/A,$16.35,N/A,$170.72,N/A,$176.00,N/A,N/A,$170.72
3099816,0309,82340,,,,,N/A,N/A,MAYO CALCIUM 24 HR URINE,$177.57,$132.00,$16.35,$176.00,N/A,$170.72,N/A,$8.74,N/A,$16.35,N/A,$170.72,N/A,$176.00,N/A,N/A,$170.72
3093066,0309,82373,,,,,N/A,N/A,MAYO CARB DEF TRANSFERRIN,$69.62,$51.75,$15.51,$69.00,N/A,$66.93,N/A,$26.19,N/A,$15.51,N/A,$66.93,N/A,$69.00,N/A,N/A,$66.93
3093696,0309,82373,,,,,N/A,N/A,"MAYO CDG, S",$62.55,$46.50,$15.51,$69.00,N/A,$66.93,N/A,$26.19,N/A,$15.51,N/A,$66.93,N/A,$69.00,N/A,N/A,$66.93
3092769,0309,82374,,,,,N/A,N/A,"MAYO BICARBONATE,URINE",$141.25,$105.00,$21.80,$140.00,N/A,$135.80,N/A,$7.08,N/A,$21.80,N/A,$135.80,N/A,$140.00,N/A,N/A,$135.80
3090944,0309,82375,,,,,N/A,N/A,LRH CARBOXYHEMOGLOBIN,$120.06,$89.25,$5.87,$119.00,N/A,$115.43,N/A,$17.86,N/A,$5.87,N/A,$115.43,N/A,$119.00,N/A,N/A,$115.43
3093130,0309,82378,,,,,N/A,N/A,MAYO CEA PANCREATIC CYST FLUID,$207.84,$154.50,$14.67,$246.00,N/A,$238.62,N/A,$27.49,N/A,$14.67,N/A,$238.62,N/A,$246.00,N/A,N/A,$238.62
3093151,0309,82378,,,,,N/A,N/A,MAYO CEA PERITONEAL FLUID,$248.20,$184.50,$14.67,$246.00,N/A,$238.62,N/A,$27.49,N/A,$14.67,N/A,$238.62,N/A,$246.00,N/A,N/A,$238.62
3093595,0309,82378,,,,,N/A,N/A,"MAYO CEA, PLEURAL FLUID",$248.20,$184.50,$14.67,$246.00,N/A,$238.62,N/A,$27.49,N/A,$14.67,N/A,$238.62,N/A,$246.00,N/A,N/A,$238.62
3091038,0309,82380,,,,,N/A,N/A,MAYO BETA-CAROTENE,$329.92,$245.25,N/A,N/A,N/A,N/A,N/A,$13.37,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3092529,0309,82384,,,,,N/A,N/A,MAYO CATECHOLAMINE FRACT FR P,$79.71,$59.25,$20.12,$273.00,N/A,$264.81,N/A,$36.61,N/A,$20.12,N/A,$264.81,N/A,$273.00,N/A,N/A,$264.81
3093276,0309,82390,,,,,N/A,N/A,MAYO CERULOPLASMIN,$105.94,$78.75,$30.18,$105.00,N/A,$101.85,N/A,$15.57,N/A,$30.18,N/A,$101.85,N/A,$105.00,N/A,N/A,$101.85
3091881,0309,82397,,,,,N/A,N/A,MAYO PTH-RELATED PEPTIDE,$153.36,$114.00,$12.99,$282.00,N/A,$273.54,N/A,$17.43,N/A,$12.99,N/A,$273.54,N/A,$282.00,N/A,N/A,$273.54
3093388,0309,82397,,,,,N/A,N/A,MAYO REFELX INFLIXIMAB Ab,$236.09,$175.50,$12.99,$282.00,N/A,$273.54,N/A,$17.43,N/A,$12.99,N/A,$273.54,N/A,$282.00,N/A,N/A,$273.54
3093638,0309,82397,,,,,N/A,N/A,MAYO HMG-COA REDUCTASE AB,$284.52,$211.50,$12.99,$282.00,N/A,$273.54,N/A,$17.43,N/A,$12.99,N/A,$273.54,N/A,$282.00,N/A,N/A,$273.54
3095384,0309,82397,,,,,N/A,N/A,MAYO VEDOLIZUMAB QT WITH AB,$202.80,$150.75,$12.99,$282.00,N/A,$273.54,N/A,$17.43,N/A,$12.99,N/A,$273.54,N/A,$282.00,N/A,N/A,$273.54
3095385,0309,82397,,,,,N/A,N/A,MAYO VEDOLIZUMAB QT WITH AB,$202.80,$150.75,$12.99,$282.00,N/A,$273.54,N/A,$17.43,N/A,$12.99,N/A,$273.54,N/A,$282.00,N/A,N/A,$273.54
3099715,0309,82397,,,,,N/A,N/A,Mayo Chromogranin A,$206.83,$153.75,$12.99,$282.00,N/A,$273.54,N/A,$17.43,N/A,$12.99,N/A,$273.54,N/A,$282.00,N/A,N/A,$273.54
3095423,0309,82436,,,,,N/A,N/A,MAYO SUPERSATURATION 24HR URIN,$12.11,$9.00,$5.45,$205.00,N/A,$198.85,N/A,$8.34,N/A,$5.45,N/A,$198.85,N/A,$205.00,N/A,N/A,$198.85
3099709,0309,82436,,,,,N/A,N/A,FAHC CHLORIDE 24 HR URINE,$206.83,$153.75,$5.45,$205.00,N/A,$198.85,N/A,$8.34,N/A,$5.45,N/A,$198.85,N/A,$205.00,N/A,N/A,$198.85
3099805,0309,82436,,,,,N/A,N/A,FAHC RANDOM URINE CHLORIDE,$46.41,$34.50,$5.45,$205.00,N/A,$198.85,N/A,$8.34,N/A,$5.45,N/A,$198.85,N/A,$205.00,N/A,N/A,$198.85
3091869,0309,82438,,,,,N/A,N/A,MAYO ELECTROLYTES STOOL,$96.86,$72.00,$6.71,$96.00,N/A,$93.12,N/A,$7.25,N/A,$6.71,N/A,$93.12,N/A,$96.00,N/A,N/A,$93.12
3093238,0309,82465,,,,,N/A,N/A,CHOLESTEROL TOTAL CDC S,$21.19,$15.75,$5.87,$101.00,N/A,$97.97,N/A,$6.31,N/A,$5.87,N/A,$97.97,N/A,$101.00,N/A,N/A,$97.97
3093706,0309,82465,,,,,N/A,N/A,MAYO CHOLESTEROL,$36.32,$27.00,$5.87,$101.00,N/A,$97.97,N/A,$6.31,N/A,$5.87,N/A,$97.97,N/A,$101.00,N/A,N/A,$97.97
3091296,0309,82480,,,,,N/A,N/A,MAYO PSEUDOCHOLINESTERASE,$91.81,$68.25,$5.03,$91.00,N/A,$88.27,N/A,$11.41,N/A,$5.03,N/A,$88.27,N/A,$91.00,N/A,N/A,$88.27
3092537,0309,82486,,,,,N/A,N/A,MAYO BENZODIAZEPINES SERUM,$123.09,$91.50,$9.64,$122.00,N/A,$118.34,N/A,N/A,N/A,$9.64,N/A,$118.34,N/A,$122.00,N/A,N/A,$118.34
3092538,0309,82486,,,,,N/A,N/A,MAYO BENZODIAZEPINES SERUM,$122.08,$90.75,$9.64,$122.00,N/A,$118.34,N/A,N/A,N/A,$9.64,N/A,$118.34,N/A,$122.00,N/A,N/A,$118.34
3092462,0309,82489,,,,,N/A,N/A,"CHROMATOGRAPHY,QUAL;THIN LAYER",$173.54,$129.00,$166.84,$172.00,N/A,$166.84,N/A,N/A,N/A,$172.00,N/A,$166.84,N/A,$172.00,N/A,N/A,$166.84
3092504,0309,82491,,,,,N/A,N/A,MAYO BENZTROPINE( COGENTIN),$126.12,$93.75,$331.74,$342.00,N/A,$331.74,N/A,N/A,N/A,$342.00,N/A,$331.74,N/A,$342.00,N/A,N/A,$331.74
3092976,0309,82491,,,,,N/A,N/A,MAYO SEDATIVE HYPNOT PAN UR,$88.79,$66.00,$331.74,$342.00,N/A,$331.74,N/A,N/A,N/A,$342.00,N/A,$331.74,N/A,$342.00,N/A,N/A,$331.74
3099991,0309,82491,,,,,N/A,N/A,MAYO 6-TG,$411.65,$306.00,$331.74,$342.00,N/A,$331.74,N/A,N/A,N/A,$342.00,N/A,$331.74,N/A,$342.00,N/A,N/A,$331.74
3099992,0309,82491,,,,,N/A,N/A,MAYO 6-TG,$411.65,$306.00,$331.74,$342.00,N/A,$331.74,N/A,N/A,N/A,$342.00,N/A,$331.74,N/A,$342.00,N/A,N/A,$331.74
3093028,0309,82492,,,,,N/A,N/A,"Mayo Coenzyme,Q10,Reduc&Total",$199.77,$148.50,$192.06,$198.00,N/A,$192.06,N/A,N/A,N/A,$198.00,N/A,$192.06,N/A,$198.00,N/A,N/A,$192.06
3095426,0309,82507,,,,,N/A,N/A,MAYO SUPERSATURATION 24HR URIN,$57.51,$42.75,$24.31,$349.00,N/A,$338.53,N/A,$37.19,N/A,$24.31,N/A,$338.53,N/A,$349.00,N/A,N/A,$338.53
3092684,0309,82520,,,,,N/A,N/A,MAYO COCAINE MECONIUM,$289.57,$215.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3093288,0309,82523,,,,,N/A,N/A,"MAYO N-TELOPEPTIDE,X-LINKED",$207.84,$154.50,$33.53,$243.00,N/A,$235.71,N/A,$26.38,N/A,$33.53,N/A,$235.71,N/A,$243.00,N/A,N/A,$235.71
3093326,0309,82523,,,,,N/A,N/A,MAYO BETA-CROSSLAPS,$60.54,$45.00,$33.53,$243.00,N/A,$235.71,N/A,$26.38,N/A,$33.53,N/A,$235.71,N/A,$243.00,N/A,N/A,$235.71
3099154,0309,82523,,,,,N/A,N/A,N-TELOPEPTIDE,$245.17,$182.25,$33.53,$243.00,N/A,$235.71,N/A,$26.38,N/A,$33.53,N/A,$235.71,N/A,$243.00,N/A,N/A,$235.71
3092881,0309,82525,,,,,N/A,N/A,MAYO COPPER RANDOM URINE,$54.48,$40.50,$22.63,$236.00,N/A,$228.92,N/A,$17.99,N/A,$22.63,N/A,$228.92,N/A,$236.00,N/A,N/A,$228.92
3095412,0309,82525,,,,,N/A,N/A,MAYO COPPER RBCs,$91.81,$68.25,$22.63,$236.00,N/A,$228.92,N/A,$17.99,N/A,$22.63,N/A,$228.92,N/A,$236.00,N/A,N/A,$228.92
3095467,0309,82525,,,,,N/A,N/A,"MAYO COPPER, S",$33.30,$24.75,$22.63,$236.00,N/A,$228.92,N/A,$17.99,N/A,$22.63,N/A,$228.92,N/A,$236.00,N/A,N/A,$228.92
3092523,0309,82530,,,,,N/A,N/A,MAYO CORTISOL SALIVA,$318.83,$237.00,$15.09,$316.00,N/A,$306.52,N/A,$19.50,N/A,$15.09,N/A,$306.52,N/A,$316.00,N/A,N/A,$306.52
3092750,0309,82530,,,,,N/A,N/A,MAYO CORTISOL FREE LC/MS/MS,$318.83,$237.00,$15.09,$316.00,N/A,$306.52,N/A,$19.50,N/A,$15.09,N/A,$306.52,N/A,$316.00,N/A,N/A,$306.52
3093286,0309,82530,,,,,N/A,N/A,MAYO CORTISOL FREE&TOTAL,$140.24,$104.25,$15.09,$316.00,N/A,$306.52,N/A,$19.50,N/A,$15.09,N/A,$306.52,N/A,$316.00,N/A,N/A,$306.52
3091773,0309,82533,,,,,N/A,N/A,FAHC DEXAMETHASONE SUPPRESSION,$312.77,$232.50,$20.12,$310.00,N/A,$300.70,N/A,$23.64,N/A,$20.12,N/A,$300.70,N/A,$310.00,N/A,N/A,$300.70
3093287,0309,82533,,,,,N/A,N/A,MAYO CORTISOL FREE&TOTAL,$137.22,$102.00,$20.12,$310.00,N/A,$300.70,N/A,$23.64,N/A,$20.12,N/A,$300.70,N/A,$310.00,N/A,N/A,$300.70
3093373,0309,82533,,,,,N/A,N/A,UVM CORTISOL OR CORTISOL 60MIN,$38.34,$28.50,$20.12,$310.00,N/A,$300.70,N/A,$23.64,N/A,$20.12,N/A,$300.70,N/A,$310.00,N/A,N/A,$300.70
3092856,0309,82540,,,,,N/A,N/A,MAYO CREATINE DISORDERSPANEL,$40.36,$30.00,$19.70,$40.00,N/A,$38.80,N/A,$6.73,N/A,$19.70,N/A,$38.80,N/A,$40.00,N/A,N/A,$38.80
3092977,0309,82541,,,,,N/A,N/A,MAYO SEDATIVE HYPNOT PAN UR,$88.79,$66.00,$5.45,$88.00,N/A,$85.36,N/A,N/A,N/A,$5.45,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3092363,0309,82542,,,,,N/A,N/A,MAYO RISPERIDONE & METABOLITE,$211.88,$157.50,$251.23,$259.00,N/A,$251.23,N/A,$26.50,N/A,$259.00,N/A,$251.23,N/A,$259.00,N/A,N/A,$251.23
3092472,0309,82542,,,,,N/A,N/A,Mayo Fatty Acid Profile Esstl,$202.80,$150.75,$251.23,$259.00,N/A,$251.23,N/A,$26.50,N/A,$259.00,N/A,$251.23,N/A,$259.00,N/A,N/A,$251.23
3092534,0309,82542,,,,,N/A,N/A,MAYO OPIATES SERUM,$175.56,$130.50,$251.23,$259.00,N/A,$251.23,N/A,$26.50,N/A,$259.00,N/A,$251.23,N/A,$259.00,N/A,N/A,$251.23
3092535,0309,82542,,,,,N/A,N/A,MAYO OPIATES SERUM,$175.56,$130.50,$251.23,$259.00,N/A,$251.23,N/A,$26.50,N/A,$259.00,N/A,$251.23,N/A,$259.00,N/A,N/A,$251.23
3092598,0309,82542,,,,,N/A,N/A,MAYO ZIPRASIDONE,$156.39,$116.25,$251.23,$259.00,N/A,$251.23,N/A,$26.50,N/A,$259.00,N/A,$251.23,N/A,$259.00,N/A,N/A,$251.23
3092813,0309,82542,,,,,N/A,N/A,MAYO PREGABALIN (LYRICA),$128.14,$95.25,$251.23,$259.00,N/A,$251.23,N/A,$26.50,N/A,$259.00,N/A,$251.23,N/A,$259.00,N/A,N/A,$251.23
3092992,0309,82542,,,,,N/A,N/A,MAYO OLANZAPINE (ZYREXA),$133.18,$99.00,$251.23,$259.00,N/A,$251.23,N/A,$26.50,N/A,$259.00,N/A,$251.23,N/A,$259.00,N/A,N/A,$251.23
3093031,0309,82542,,,,,N/A,N/A,MAYO PREGABALIN(LYRICA),$107.96,$80.25,$251.23,$259.00,N/A,$251.23,N/A,$26.50,N/A,$259.00,N/A,$251.23,N/A,$259.00,N/A,N/A,$251.23
3093244,0309,82542,,,,,N/A,N/A,A1AT PROTEOTYPE S/Z LC-MS/MS,$58.52,$43.50,$251.23,$259.00,N/A,$251.23,N/A,$26.50,N/A,$259.00,N/A,$251.23,N/A,$259.00,N/A,N/A,$251.23
3093548,0309,82542,,,,,N/A,N/A,"MAYO GALACTITOL, QN, URINE",$261.32,$194.25,$251.23,$259.00,N/A,$251.23,N/A,$26.50,N/A,$259.00,N/A,$251.23,N/A,$259.00,N/A,N/A,$251.23
3093667,0309,82542,,,,,N/A,N/A,MAYO N-METHYLHISTAM 24HR URINE,$71.63,$53.25,$251.23,$259.00,N/A,$251.23,N/A,$26.50,N/A,$259.00,N/A,$251.23,N/A,$259.00,N/A,N/A,$251.23
3095465,0309,82542,,,,,N/A,N/A,"MAYO LEUKOTRIENE E4, 24HR URIN",$236.09,$175.50,$251.23,$259.00,N/A,$251.23,N/A,$26.50,N/A,$259.00,N/A,$251.23,N/A,$259.00,N/A,N/A,$251.23
3095498,0309,82542,,,,,N/A,N/A,Mayo Protoporphyrins Fractiona,$156.39,$116.25,$251.23,$259.00,N/A,$251.23,N/A,$26.50,N/A,$259.00,N/A,$251.23,N/A,$259.00,N/A,N/A,$251.23
3095510,0309,82542,,,,,N/A,N/A,"Mayo N-Methylhistamine, Random",$50.45,$37.50,$251.23,$259.00,N/A,$251.23,N/A,$26.50,N/A,$259.00,N/A,$251.23,N/A,$259.00,N/A,N/A,$251.23
3099989,0309,82542,,,,,N/A,N/A,MAYO SMITH-LEMLI-OPITZ SCREEN,$416.69,$309.75,$251.23,$259.00,N/A,$251.23,N/A,$26.50,N/A,$259.00,N/A,$251.23,N/A,$259.00,N/A,N/A,$251.23
3092772,0309,82543,,,,,N/A,N/A,MEVALONIC ACID QT BY GC/MS,$271.40,$201.75,$260.93,$269.00,N/A,$260.93,N/A,N/A,N/A,$269.00,N/A,$260.93,N/A,$269.00,N/A,N/A,$260.93
3099900,0309,82544,,,,,N/A,N/A,"MAYO ACYLGLYCINES,QT URINE",$345.06,$256.50,$475.30,$490.00,N/A,$475.30,N/A,N/A,N/A,$490.00,N/A,$475.30,N/A,$490.00,N/A,N/A,$475.30
3091750,0309,82550,,,,,N/A,N/A,MAYO CK ISOENZYME ELECTRO,$128.14,$95.25,$123.19,$127.00,N/A,$123.19,N/A,$8.04,N/A,$127.00,N/A,$123.19,N/A,$127.00,N/A,N/A,$123.19
3091751,0309,82552,,,,,N/A,N/A,MAYO CK ISOENZYME ELECTRO,$226.00,$168.00,$7.96,$404.00,N/A,$391.88,N/A,$19.42,N/A,$7.96,N/A,$391.88,N/A,$404.00,N/A,N/A,$391.88
3091853,0309,82553,,,,,N/A,N/A,MAYO CK-MB ISOENZYME,$84.75,$63.00,$15.93,$237.00,N/A,$229.89,N/A,$13.47,N/A,$15.93,N/A,$229.89,N/A,$237.00,N/A,N/A,$229.89
3092473,0309,82565,,,,,N/A,N/A,FAHC CREATININE RANDOM URINE,$117.04,$87.00,$13.83,$116.00,N/A,$112.52,N/A,$7.42,N/A,$13.83,N/A,$112.52,N/A,$116.00,N/A,N/A,$112.52
3092857,0309,82570,,,,,N/A,N/A,MAYO CREATINE DISORDERSPANEL,$43.38,$32.25,$6.29,$103.00,N/A,$99.91,N/A,$6.04,N/A,$6.29,N/A,$99.91,N/A,$103.00,N/A,N/A,$99.91
3092961,0309,82570,,,,,N/A,N/A,MAYO CREATININE BODY FLUID,$57.51,$42.75,$6.29,$103.00,N/A,$99.91,N/A,$6.04,N/A,$6.29,N/A,$99.91,N/A,$103.00,N/A,N/A,$99.91
3095430,0309,82570,,,,,N/A,N/A,MAYO SUPERSATURATION 24HR URIN,$11.10,$8.25,$6.29,$103.00,N/A,$99.91,N/A,$6.04,N/A,$6.29,N/A,$99.91,N/A,$103.00,N/A,N/A,$99.91
3095466,0309,82570,,,,,N/A,N/A,"MAYO CREATININE, 24HR URINE",$51.46,$38.25,$6.29,$103.00,N/A,$99.91,N/A,$6.04,N/A,$6.29,N/A,$99.91,N/A,$103.00,N/A,N/A,$99.91
3095511,0309,82570,,,,,N/A,N/A,"Mayo N-Methylhistamine, Random",$11.10,$8.25,$6.29,$103.00,N/A,$99.91,N/A,$6.04,N/A,$6.29,N/A,$99.91,N/A,$103.00,N/A,N/A,$99.91
3091820,0309,82585,,,,,N/A,N/A,MAYO CRYOGLOBULIN,$170.51,$126.75,$11.32,$169.00,N/A,$163.93,N/A,$17.23,N/A,$11.32,N/A,$163.93,N/A,$169.00,N/A,N/A,$163.93
3091821,0309,82595,,,,,N/A,N/A,MAYO CRYOGLOBULIN,$128.14,$95.25,$17.18,$127.00,N/A,$123.19,N/A,$9.38,N/A,$17.18,N/A,$123.19,N/A,$127.00,N/A,N/A,$123.19
3093477,0309,82610,,,,,N/A,N/A,"MAYO CYSTATIN C EGFR,S",$59.53,$44.25,$18.02,$59.00,N/A,$57.23,N/A,$20.62,N/A,$18.02,N/A,$57.23,N/A,$59.00,N/A,N/A,$57.23
3099716,0309,82626,,,,,N/A,N/A,MAYO DHEA,$462.09,$343.50,$22.21,$458.00,N/A,$444.26,N/A,$36.64,N/A,$22.21,N/A,$444.26,N/A,$458.00,N/A,N/A,$444.26
3099951,0309,82642,,,,,N/A,N/A,MAYO DIHYDROTESTOSTERONE,$234.07,$174.00,$26.82,$232.00,N/A,$225.04,N/A,$34.16,N/A,$26.82,N/A,$225.04,N/A,$232.00,N/A,N/A,$225.04
3091375,0309,82652,,,,,N/A,N/A,"VITAMIN D(1,25 DIHYDROXY)",$729.46,$542.25,$35.21,$723.00,N/A,$701.31,N/A,$55.83,N/A,$35.21,N/A,$701.31,N/A,$723.00,N/A,N/A,$701.31
3093468,0309,82656,,,,,N/A,N/A,Mayo Pancreatic Elastase-1,$134.19,$99.75,$46.10,$133.00,N/A,$129.01,N/A,$16.72,N/A,$46.10,N/A,$129.01,N/A,$133.00,N/A,N/A,$129.01
3092512,0309,82657,,,,,N/A,N/A,MAYO BETA-GLUCOS LEUKOCYTES,$209.86,$156.00,$13.83,$342.00,N/A,$331.74,N/A,$32.15,N/A,$13.83,N/A,$331.74,N/A,$342.00,N/A,N/A,$331.74
3092718,0309,82657,,,,,N/A,N/A,MAYO METHEMOGLOBIN EVALUATIO,$345.06,$256.50,$13.83,$342.00,N/A,$331.74,N/A,$32.15,N/A,$13.83,N/A,$331.74,N/A,$342.00,N/A,N/A,$331.74
3092885,0309,82657,,,,,N/A,N/A,MAYO ADENOSINE DEAMINASE BLD,$113.00,$84.00,$13.83,$342.00,N/A,$331.74,N/A,$32.15,N/A,$13.83,N/A,$331.74,N/A,$342.00,N/A,N/A,$331.74
3093346,0309,82657,,,,,N/A,N/A,MAYO TPMT ACTIVITY PROFILE,$441.92,$328.50,$13.83,$342.00,N/A,$331.74,N/A,$32.15,N/A,$13.83,N/A,$331.74,N/A,$342.00,N/A,N/A,$331.74
3093385,0309,82657,,,,,N/A,N/A,MAYO ALADEHYDRATASE,$186.65,$138.75,$13.83,$342.00,N/A,$331.74,N/A,$32.15,N/A,$13.83,N/A,$331.74,N/A,$342.00,N/A,N/A,$331.74
3099633,0309,82657,,,,,N/A,N/A,Mayo Beta - Glucuronidase Csf,$394.50,$293.25,$13.83,$342.00,N/A,$331.74,N/A,$32.15,N/A,$13.83,N/A,$331.74,N/A,$342.00,N/A,N/A,$331.74
3093569,0309,82664,,,,,N/A,N/A,MAYO ELECTROPHORETIC,$131.16,$97.50,$26.82,$130.00,N/A,$126.10,N/A,$69.01,N/A,$26.82,N/A,$126.10,N/A,$130.00,N/A,N/A,$126.10
3092768,0309,82670,,,,,N/A,N/A,MAYO ESTROGENS E1&E2 FRACTI,$50.45,$37.50,$22.63,$317.00,N/A,$307.49,N/A,$40.51,N/A,$22.63,N/A,$307.49,N/A,$317.00,N/A,N/A,$307.49
3093269,0309,82670,,,,,N/A,N/A,MAYO ESTRADIOL RAPID,$319.83,$237.75,$22.63,$317.00,N/A,$307.49,N/A,$40.51,N/A,$22.63,N/A,$307.49,N/A,$317.00,N/A,N/A,$307.49
3090549,0309,82677,,,,,N/A,N/A,FAHC UNCONJUGATED ESTRIOL,$462.09,$343.50,$33.53,$458.00,N/A,$444.26,N/A,$35.06,N/A,$33.53,N/A,$444.26,N/A,$458.00,N/A,N/A,$444.26
3092767,0309,82679,,,,,N/A,N/A,MAYO ESTROGENS E1&E2 FRACTI,$55.49,$41.25,$28.92,$250.00,N/A,$242.50,N/A,$36.18,N/A,$28.92,N/A,$242.50,N/A,$250.00,N/A,N/A,$242.50
3099950,0309,82679,,,,,N/A,N/A,MAYO ESTRONE,$252.24,$187.50,$28.92,$250.00,N/A,$242.50,N/A,$36.18,N/A,$28.92,N/A,$242.50,N/A,$250.00,N/A,N/A,$242.50
3099508,0309,82710,,,,,N/A,N/A,"FAT, FECES QT",$319.83,$237.75,$30.18,$541.00,N/A,$524.77,N/A,$24.36,N/A,$30.18,N/A,$524.77,N/A,$541.00,N/A,N/A,$524.77
3099801,0309,82726,,,,,N/A,N/A,MAYO FATTY ACID PEROXISOMAL,$345.06,$256.50,$20.12,$342.00,N/A,$331.74,N/A,$28.64,N/A,$20.12,N/A,$331.74,N/A,$342.00,N/A,N/A,$331.74
3099806,0309,82728,,,,,N/A,N/A,FAHC FERRITIN,$142.26,$105.75,$23.89,$141.00,N/A,$136.77,N/A,$19.76,N/A,$23.89,N/A,$136.77,N/A,$141.00,N/A,N/A,$136.77
3099949,0309,82731,,,,,N/A,N/A,FAHC FETAL FIBRONECTIN,$753.68,$560.25,$16.35,"$1,202.00",N/A,"$1,165.94",N/A,$93.39,N/A,$16.35,N/A,"$1,165.94",N/A,"$1,202.00",N/A,N/A,"$1,165.94"
3091774,0309,82784,,,,,N/A,N/A,MAYO IgG SUBCLASSES,$147.31,$109.50,$17.60,$146.00,N/A,$141.62,N/A,$13.49,N/A,$17.60,N/A,$141.62,N/A,$146.00,N/A,N/A,$141.62
3092876,0309,82784,,,,,N/A,N/A,MAYO MULTIPLE SCLEROSIS PROF,$44.39,$33.00,$35.20,$292.00,N/A,$283.24,N/A,$26.98,N/A,$35.20,N/A,$283.24,N/A,$292.00,N/A,N/A,$283.24
3093330,0309,82784,,,,,N/A,N/A,MAYO IgA SUBCLASSES,$57.51,$42.75,$17.60,$146.00,N/A,$141.62,N/A,$13.49,N/A,$17.60,N/A,$141.62,N/A,$146.00,N/A,N/A,$141.62
3093340,0309,82784,,,,,N/A,N/A,MAYO CELIAC DISEASE CASCADE,$23.21,$17.25,$17.60,$146.00,N/A,$141.62,N/A,$13.49,N/A,$17.60,N/A,$141.62,N/A,$146.00,N/A,N/A,$141.62
3093390,0309,82784,,,,,N/A,N/A,UVM CELIAC DISEASE PANEL,$23.21,$17.25,$17.60,$146.00,N/A,$141.62,N/A,$13.49,N/A,$17.60,N/A,$141.62,N/A,$146.00,N/A,N/A,$141.62
3093504,0309,82784,,,,,N/A,N/A,MAYO IMMUNOGLOBULIN D,$58.52,$43.50,$17.60,$146.00,N/A,$141.62,N/A,$13.49,N/A,$17.60,N/A,$141.62,N/A,$146.00,N/A,N/A,$141.62
3099224,0309,82784,,,,,N/A,N/A,FAHC IgG INDEX CSF,$71.63,$53.25,$17.60,$146.00,N/A,$141.62,N/A,$13.49,N/A,$17.60,N/A,$141.62,N/A,$146.00,N/A,N/A,$141.62
3099225,0309,82784,,,,,N/A,N/A,FAHC IgG INDEX CSF,$71.63,$53.25,$17.60,$146.00,N/A,$141.62,N/A,$13.49,N/A,$17.60,N/A,$141.62,N/A,$146.00,N/A,N/A,$141.62
3093614,0309,82785,,,,,N/A,N/A,MAYO RESP PROFILE REG 1N ATLAN,$218.94,$162.75,$11.32,$247.00,N/A,$239.59,N/A,$23.87,N/A,$11.32,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3091775,0309,82787,,,,,N/A,N/A,MAYO IgG SUBCLASSES,$72.64,$54.00,$19.70,$72.00,N/A,$69.84,N/A,$9.36,N/A,$19.70,N/A,$69.84,N/A,$72.00,N/A,N/A,$69.84
3091776,0309,82787,,,,,N/A,N/A,MAYO IgG SUBCLASSES,$72.64,$54.00,$19.70,$72.00,N/A,$69.84,N/A,$9.36,N/A,$19.70,N/A,$69.84,N/A,$72.00,N/A,N/A,$69.84
3091777,0309,82787,,,,,N/A,N/A,MAYO IgG SUBCLASSES,$72.64,$54.00,$19.70,$72.00,N/A,$69.84,N/A,$9.36,N/A,$19.70,N/A,$69.84,N/A,$72.00,N/A,N/A,$69.84
3091778,0309,82787,,,,,N/A,N/A,MAYO IgG SUBCLASSES,$72.64,$54.00,$19.70,$72.00,N/A,$69.84,N/A,$9.36,N/A,$19.70,N/A,$69.84,N/A,$72.00,N/A,N/A,$69.84
3093331,0309,82787,,,,,N/A,N/A,MAYO IgA SUBCLASSES,$95.85,$71.25,$19.70,$72.00,N/A,$69.84,N/A,$9.36,N/A,$19.70,N/A,$69.84,N/A,$72.00,N/A,N/A,$69.84
3093684,0309,82787,,,,,N/A,N/A,MAYO IMMUNOGLOBULIN SUBCLASS I,$136.21,$101.25,$19.70,$72.00,N/A,$69.84,N/A,$9.36,N/A,$19.70,N/A,$69.84,N/A,$72.00,N/A,N/A,$69.84
3093425,0309,82943,,,,,N/A,N/A,MAYO GLUCAGON PLASMA,$71.63,$53.25,$21.38,$71.00,N/A,$68.87,N/A,$20.72,N/A,$21.38,N/A,$68.87,N/A,$71.00,N/A,N/A,$68.87
3093686,0309,82945,,,,,N/A,N/A,"MAYO GLUCOSE, BF",$27.24,$20.25,$17.18,$81.00,N/A,$78.57,N/A,$5.70,N/A,$17.18,N/A,$78.57,N/A,$81.00,N/A,N/A,$78.57
3095501,0309,82945,,,,,N/A,N/A,Uvm Glucose Urine,$5.04,$3.75,$17.18,$81.00,N/A,$78.57,N/A,$5.70,N/A,$17.18,N/A,$78.57,N/A,$81.00,N/A,N/A,$78.57
3093708,0309,82947,,,,,N/A,N/A,MAYO GLUCOSE,$52.46,$39.00,$4.61,$81.00,N/A,$78.57,N/A,$5.70,N/A,$4.61,N/A,$78.57,N/A,$81.00,N/A,N/A,$78.57
3093694,0309,82955,,,,,N/A,N/A,"MAYO G6PD ENZYME ACTIVITY, B",$41.37,$30.75,$4.61,$41.00,N/A,$39.77,N/A,$14.07,N/A,$4.61,N/A,$39.77,N/A,$41.00,N/A,N/A,$39.77
3093703,0309,82977,,,,,N/A,N/A,MAYO GGT,$45.40,$33.75,$3.77,$141.00,N/A,$136.77,N/A,$10.44,N/A,$3.77,N/A,$136.77,N/A,$141.00,N/A,N/A,$136.77
3099912,0309,82985,,,,,N/A,N/A,MAYO FRUCTOSAMINE,$159.41,$118.50,$8.80,$158.00,N/A,$153.26,N/A,$24.30,N/A,$8.80,N/A,$153.26,N/A,$158.00,N/A,N/A,$153.26
3093701,0309,83010,,,,,N/A,N/A,MAYO HAPTOGLOBIN,$51.46,$38.25,$20.12,$51.00,N/A,$49.47,N/A,$18.24,N/A,$20.12,N/A,$49.47,N/A,$51.00,N/A,N/A,$49.47
3092827,0309,83013,,,,,N/A,N/A,MAYO H PYLORI C UREA BREATH,$258.29,$192.00,$15.09,$256.00,N/A,$248.32,N/A,$97.67,N/A,$15.09,N/A,$248.32,N/A,$256.00,N/A,N/A,$248.32
3092850,0309,83018,,,,,N/A,N/A,"MAYO IODINE,RANDOM URINE",$89.80,$66.75,$80.89,$224.00,N/A,$217.28,N/A,N/A,N/A,$80.89,N/A,$217.28,N/A,$224.00,N/A,N/A,$217.28
3092965,0309,83018,,,,,N/A,N/A,"MAYO IODINE,24HR URINE",$84.75,$63.00,$80.89,$224.00,N/A,$217.28,N/A,N/A,N/A,$80.89,N/A,$217.28,N/A,$224.00,N/A,N/A,$217.28
3093294,0309,83018,,,,,N/A,N/A,"MAYO URANIUM,URINE",$226.00,$168.00,$80.89,$224.00,N/A,$217.28,N/A,N/A,N/A,$80.89,N/A,$217.28,N/A,$224.00,N/A,N/A,$217.28
3093315,0309,83018,,,,,N/A,N/A,MAYO COBALT RANDOM URINE,$101.90,$75.75,$80.89,$224.00,N/A,$217.28,N/A,N/A,N/A,$80.89,N/A,$217.28,N/A,$224.00,N/A,N/A,$217.28
3093533,0309,83018,,,,,N/A,N/A,"MAYO GADOLINIUM, 24HR URINE",$345.06,$256.50,$80.89,$224.00,N/A,$217.28,N/A,N/A,N/A,$80.89,N/A,$217.28,N/A,$224.00,N/A,N/A,$217.28
3092719,0309,83020,,,,,N/A,N/A,MAYO METHEMOGLOBIN EVALUATIO,$248.20,$184.50,$1.86,$246.00,$1.86,$238.62,$1.86,$26.39,$1.86,$26.41,$1.86,$238.62,$1.86,$246.00,$1.86,$1.86,$238.62
3099940,0309,83021,,,,,N/A,N/A,MAYO HEMOGLOBIN F,$187.66,$139.50,$37.34,$186.00,N/A,$180.42,N/A,N/A,N/A,$37.34,N/A,$180.42,N/A,$186.00,N/A,N/A,$180.42
3092721,0309,83050,,,,,N/A,N/A,MAYO METHEMOGLOBIN EVALUATIO,$143.27,$106.50,$11.74,$142.00,N/A,$137.74,N/A,N/A,N/A,$11.74,N/A,$137.74,N/A,$142.00,N/A,N/A,$137.74
3093102,0309,83050,,,,,N/A,N/A,MAYO METHEMOGLOBIN&SULFHEMO,$26.23,$19.50,$11.74,$142.00,N/A,$137.74,N/A,N/A,N/A,$11.74,N/A,$137.74,N/A,$142.00,N/A,N/A,$137.74
3092722,0309,83060,,,,,N/A,N/A,MAYO METHEMOGLOBIN EVALUATIO,$161.43,$120.00,$10.06,$160.00,N/A,$155.20,N/A,N/A,N/A,$10.06,N/A,$155.20,N/A,$160.00,N/A,N/A,$155.20
3093103,0309,83060,,,,,N/A,N/A,MAYO METHEMOGLOBIN&SULFHEMO,$30.27,$22.50,$10.06,$160.00,N/A,$155.20,N/A,N/A,N/A,$10.06,N/A,$155.20,N/A,$160.00,N/A,N/A,$155.20
3091829,0309,83070,,,,,N/A,N/A,MAYO HEMOSIDERIN URINE,$80.72,$60.00,$10.48,$80.00,N/A,$77.60,N/A,N/A,N/A,$10.48,N/A,$77.60,N/A,$80.00,N/A,N/A,$77.60
3092589,0309,83080,,,,,N/A,N/A,MAYO HEXOSAMINIDOSE A&TOTAL S,$96.86,$72.00,$5.87,$149.00,N/A,$144.53,N/A,N/A,N/A,$5.87,N/A,$144.53,N/A,$149.00,N/A,N/A,$144.53
3093626,0309,83080,,,,,N/A,N/A,"MAYO HEXOSAMINIDASE A&T TOT,WB",$150.33,$111.75,$5.87,$149.00,N/A,$144.53,N/A,N/A,N/A,$5.87,N/A,$144.53,N/A,$149.00,N/A,N/A,$144.53
3091403,0309,83088,,,,,N/A,N/A,MAYO HISTAMINE,$234.07,$174.00,$20.12,$540.00,N/A,$523.80,N/A,N/A,N/A,$20.12,N/A,$523.80,N/A,$540.00,N/A,N/A,$523.80
3092629,0309,83088,,,,,N/A,N/A,MAYO HISTAMINE WHOLE BLOOD,$544.83,$405.00,$20.12,$540.00,N/A,$523.80,N/A,N/A,N/A,$20.12,N/A,$523.80,N/A,$540.00,N/A,N/A,$523.80
3092792,0309,83150,,,,,N/A,N/A,MAYO VMA&HVA PEDIATRIC URINE,$80.72,$60.00,$21.38,$172.00,N/A,$166.84,N/A,N/A,N/A,$21.38,N/A,$166.84,N/A,$172.00,N/A,N/A,$166.84
3091876,0309,83516,,,,,N/A,N/A,Mayo Cyclic Citrullinated Pep,$223.98,$166.50,$27.24,$222.00,N/A,$215.34,N/A,N/A,N/A,$27.24,N/A,$215.34,N/A,$222.00,N/A,N/A,$215.34
3092223,0309,83516,,,,,N/A,N/A,MAYO TISSUE TRANSGLUTAMINASE,$223.98,$166.50,$27.24,$222.00,N/A,$215.34,N/A,N/A,N/A,$27.24,N/A,$215.34,N/A,$222.00,N/A,N/A,$215.34
3092578,0309,83516,,,,,N/A,N/A,MAYO AUTOIMMUNE LIVER DISEAS,$223.98,$166.50,$27.24,$222.00,N/A,$215.34,N/A,N/A,N/A,$27.24,N/A,$215.34,N/A,$222.00,N/A,N/A,$215.34
3092594,0309,83516,,,,,N/A,N/A,Mayo Antimullerian Hormone,$223.98,$166.50,$27.24,$222.00,N/A,$215.34,N/A,N/A,N/A,$27.24,N/A,$215.34,N/A,$222.00,N/A,N/A,$215.34
3092678,0309,83516,,,,,N/A,N/A,MAYO MYOSITIS AB PANEL COMP,$223.98,$166.50,$217.92,"$1,776.00",N/A,"$1,722.72",N/A,N/A,N/A,$217.92,N/A,"$1,722.72",N/A,"$1,776.00",N/A,N/A,"$1,722.72"
3092756,0309,83516,,,,,N/A,N/A,MAYO TYSABRI ANTIBODIES,$575.10,$427.50,$27.24,$222.00,N/A,$215.34,N/A,N/A,N/A,$27.24,N/A,$215.34,N/A,$222.00,N/A,N/A,$215.34
3092896,0309,83516,,,,,N/A,N/A,MAYO NS6S ANTIBODY,$866.68,$644.25,$27.24,$222.00,N/A,$215.34,N/A,N/A,N/A,$27.24,N/A,$215.34,N/A,$222.00,N/A,N/A,$215.34
3092924,0309,83516,,,,,N/A,N/A,MAYO CROHN'S DISEASE PROFILE,$250.22,$186.00,$81.72,$666.00,N/A,$646.02,N/A,N/A,N/A,$81.72,N/A,$646.02,N/A,$666.00,N/A,N/A,$646.02
3092957,0309,83516,,,,,N/A,N/A,MAYO AMPHIPHYSIN AB IgG,$422.75,$314.25,$27.24,$222.00,N/A,$215.34,N/A,N/A,N/A,$27.24,N/A,$215.34,N/A,$222.00,N/A,N/A,$215.34
3093391,0309,83516,,,,,N/A,N/A,UVM CELIAC DISEASE PANEL,$26.23,$19.50,$27.24,$222.00,N/A,$215.34,N/A,N/A,N/A,$27.24,N/A,$215.34,N/A,$222.00,N/A,N/A,$215.34
3093440,0309,83516,,,,,N/A,N/A,"MAYO MITOCHONDRIAL Ab,M2",$45.40,$33.75,$27.24,$222.00,N/A,$215.34,N/A,N/A,N/A,$27.24,N/A,$215.34,N/A,$222.00,N/A,N/A,$215.34
3093489,0309,83516,,,,,N/A,N/A,"MAYO PARIETAL CELL AB, IGG",$40.36,$30.00,$27.24,$222.00,N/A,$215.34,N/A,N/A,N/A,$27.24,N/A,$215.34,N/A,$222.00,N/A,N/A,$215.34
3093529,0309,83516,,,,,N/A,N/A,MAYO AUTOIMMUNE LIVER DISEASE,$17.15,$12.75,$27.24,$222.00,N/A,$215.34,N/A,N/A,N/A,$27.24,N/A,$215.34,N/A,$222.00,N/A,N/A,$215.34
3093652,0309,83516,,,,,N/A,N/A,MAYO BP 180 IgG,$85.76,$63.75,$27.24,$222.00,N/A,$215.34,N/A,N/A,N/A,$27.24,N/A,$215.34,N/A,$222.00,N/A,N/A,$215.34
3093653,0309,83516,,,,,N/A,N/A,MAYO BP 230 IgG,$85.76,$63.75,$27.24,$222.00,N/A,$215.34,N/A,N/A,N/A,$27.24,N/A,$215.34,N/A,$222.00,N/A,N/A,$215.34
3093717,0309,83516,,,,,N/A,N/A,MAYO IMMUNOASSAY NONANTIBODY,$23.21,$17.25,$27.24,$222.00,N/A,$215.34,N/A,N/A,N/A,$27.24,N/A,$215.34,N/A,$222.00,N/A,N/A,$215.34
3095450,0309,83516,,,,,N/A,N/A,MAYO IMMUNOASSAY NONANTIBODY,$21.19,$15.75,$27.24,$222.00,N/A,$215.34,N/A,N/A,N/A,$27.24,N/A,$215.34,N/A,$222.00,N/A,N/A,$215.34
3099928,0309,83516,,,,,N/A,N/A,MAYO TISSUE TRANSGLUTAMINASE,$223.98,$166.50,$27.24,$222.00,N/A,$215.34,N/A,N/A,N/A,$27.24,N/A,$215.34,N/A,$222.00,N/A,N/A,$215.34
3099964,0309,83516,,,,,N/A,N/A,MAYO 14-3-3 PROTEIN CSF,$413.67,$307.50,$27.24,$222.00,N/A,$215.34,N/A,N/A,N/A,$27.24,N/A,$215.34,N/A,$222.00,N/A,N/A,$215.34
3092236,0309,83519,,,,,N/A,N/A,MAYO SUBSTANCE P,$526.67,$391.50,$13.83,$257.00,N/A,$249.29,N/A,N/A,N/A,$13.83,N/A,$249.29,N/A,$257.00,N/A,N/A,$249.29
3092597,0309,83519,,,,,N/A,N/A,MAYO MUSK ANTIBODY,$259.30,$192.75,$13.83,$257.00,N/A,$249.29,N/A,N/A,N/A,$13.83,N/A,$249.29,N/A,$257.00,N/A,N/A,$249.29
3092788,0309,83519,,,,,N/A,N/A,Mayo Leptin,$186.65,$138.75,$13.83,$257.00,N/A,$249.29,N/A,N/A,N/A,$13.83,N/A,$249.29,N/A,$257.00,N/A,N/A,$249.29
3092832,0309,83519,,,,,N/A,N/A,MAYO PANCREATIC POLYPEPTIDE,$120.06,$89.25,$13.83,$257.00,N/A,$249.29,N/A,N/A,N/A,$13.83,N/A,$249.29,N/A,$257.00,N/A,N/A,$249.29
3092911,0309,83519,,,,,N/A,N/A,MAYO ACH RECEPTOR MODULATINGAb,$119.05,$88.50,$13.83,$257.00,N/A,$249.29,N/A,N/A,N/A,$13.83,N/A,$249.29,N/A,$257.00,N/A,N/A,$249.29
3092951,0309,83519,,,,,N/A,N/A,MAYO MG/LES EVALUATION,$356.16,$264.75,$55.32,"$1,028.00",N/A,$997.16,N/A,N/A,N/A,$55.32,N/A,$997.16,N/A,"$1,028.00",N/A,N/A,$997.16
3093257,0309,83519,,,,,N/A,N/A,MAYO IGFBP-1,$135.20,$100.50,$13.83,$257.00,N/A,$249.29,N/A,N/A,N/A,$13.83,N/A,$249.29,N/A,$257.00,N/A,N/A,$249.29
3093414,0309,83519,,,,,N/A,N/A,MAYO FREE PROGESTERONE,$318.83,$237.00,$13.83,$257.00,N/A,$249.29,N/A,N/A,N/A,$13.83,N/A,$249.29,N/A,$257.00,N/A,N/A,$249.29
3093463,0309,83519,,,,,N/A,N/A,MAYO MG/LES EVALUATION,$500.43,$372.00,$13.83,$257.00,N/A,$249.29,N/A,N/A,N/A,$13.83,N/A,$249.29,N/A,$257.00,N/A,N/A,$249.29
3093561,0309,83519,,,,,N/A,N/A,MAYO EPILEPSY AUTOIMMUNE EVAL,$125.11,$93.00,$13.83,$257.00,N/A,$249.29,N/A,N/A,N/A,$13.83,N/A,$249.29,N/A,$257.00,N/A,N/A,$249.29
3093587,0309,83519,,,,,N/A,N/A,MAYO ENCEPHALOPATHY EVAL#3,$114.01,$84.75,$41.49,$771.00,N/A,$747.87,N/A,N/A,N/A,$41.49,N/A,$747.87,N/A,$771.00,N/A,N/A,$747.87
3093642,0309,83519,,,,,N/A,N/A,MAYO PROCOLLAGEN I INTACT N-TE,$270.40,$201.00,$13.83,$257.00,N/A,$249.29,N/A,N/A,N/A,$13.83,N/A,$249.29,N/A,$257.00,N/A,N/A,$249.29
3093671,0309,83519,,,,,N/A,N/A,MAYO ACHR GANGLIONIC NEUR AB,$109.97,$81.75,$13.83,$257.00,N/A,$249.29,N/A,N/A,N/A,$13.83,N/A,$249.29,N/A,$257.00,N/A,N/A,$249.29
3093672,0309,83519,,,,,N/A,N/A,MAYO NEURONAL (V-G) K+ CHAN AB,$55.49,$41.25,$13.83,$257.00,N/A,$249.29,N/A,N/A,N/A,$13.83,N/A,$249.29,N/A,$257.00,N/A,N/A,$249.29
3093695,0309,83519,,,,,N/A,N/A,MAYO PTH ANTIBODY,$261.32,$194.25,$13.83,$257.00,N/A,$249.29,N/A,N/A,N/A,$13.83,N/A,$249.29,N/A,$257.00,N/A,N/A,$249.29
3093750,0309,83519,,,,,N/A,N/A,MAYO MG EVALUATION MUSK REFLEX,$66.59,$49.50,$13.83,$257.00,N/A,$249.29,N/A,N/A,N/A,$13.83,N/A,$249.29,N/A,$257.00,N/A,N/A,$249.29
3093752,0309,83519,,,,,N/A,N/A,MAYO MG REFLEX MUSK AUTOAB,$647.74,$481.50,$13.83,$257.00,N/A,$249.29,N/A,N/A,N/A,$13.83,N/A,$249.29,N/A,$257.00,N/A,N/A,$249.29
3092323,0309,83520,,,,,N/A,N/A,MAYO SOLUBLE LIVER ANTIGEN,$226.00,$168.00,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3092433,0309,83520,,,,,N/A,N/A,"MAYO CENTROMERE AB,IgG",$249.21,$185.25,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3092506,0309,83520,,,,,N/A,N/A,MAYO INFLIXIMAB/HACA,$250.22,$186.00,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3092507,0309,83520,,,,,N/A,N/A,MAYO INFLIXIMAB/HACA,$250.22,$186.00,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3092530,0309,83520,,,,,N/A,N/A,MAYO ANTI-IgA,$224.99,$167.25,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3092596,0309,83520,,,,,N/A,N/A,FAHC METHOTREXATE,$80.72,$60.00,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3092679,0309,83520,,,,,N/A,N/A,MAYO MYOSITIS AB PANEL COMP,$249.21,$185.25,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3092765,0309,83520,,,,,N/A,N/A,Mayo Nmo/Aqp4 Igg,$484.29,$360.00,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3092775,0309,83520,,,,,N/A,N/A,MAYO MOTOR&SENSORY NEUR EVAL,$555.93,$413.25,$222.10,"$2,470.00",N/A,"$2,395.90",N/A,N/A,N/A,$222.10,N/A,"$2,395.90",N/A,"$2,470.00",N/A,N/A,"$2,395.90"
3092859,0309,83520,,,,,N/A,N/A,MAYO CYTOKINE PANEL 12 BY MAFD,$604.36,$449.25,$266.52,"$2,964.00",N/A,"$2,875.08",N/A,N/A,N/A,$266.52,N/A,"$2,875.08",N/A,"$2,964.00",N/A,N/A,"$2,875.08"
3092895,0309,83520,,,,,N/A,N/A,MAYO GALOP Ab,$797.06,$592.50,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3092916,0309,83520,,,,,N/A,N/A,MAYO TRANSFORM GROWTH FAC BETA,$309.74,$230.25,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3092952,0309,83520,,,,,N/A,N/A,MAYO MG/LES EVALUATION,$88.79,$66.00,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3092954,0309,83520,,,,,N/A,N/A,MAYO RNA POLYMERASE III IgE,$84.75,$63.00,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3092985,0309,83520,,,,,N/A,N/A,MAYO FIBROSPECT II,$347.08,$258.00,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3093051,0309,83520,,,,,N/A,N/A,"MAYO NEURON-SPEC ENOLASE,CSF",$48.43,$36.00,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3093055,0309,83520,,,,,N/A,N/A,"MAYO RIBOSOME P AB, IgG",$64.57,$48.00,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3093111,0309,83520,,,,,N/A,N/A,MAYO INTERLEUKIN 13,$577.11,$429.00,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3093138,0309,83520,,,,,N/A,N/A,MAYO INHIBIN A&B TUMORMARKER,$68.61,$51.00,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3093267,0309,83520,,,,,N/A,N/A,MAYO FIBROBLAST FACTOR 23,$137.22,$102.00,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3093290,0309,83520,,,,,N/A,N/A,MAYO VASCULAR ENDOTHELIAL GROW,$313.78,$233.25,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3093371,0309,83520,,,,,N/A,N/A,MAYO TNF-ALPHA,$577.11,$429.00,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3093416,0309,83520,,,,,N/A,N/A,MAYO REFLEX ADALIMUMAB,$247.19,$183.75,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3093441,0309,83520,,,,,N/A,N/A,MAYO THROMBIN-ANTITH COMPLEX,$286.54,$213.00,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3093464,0309,83520,,,,,N/A,N/A,MAYO MG/LES EVALUATION,$127.13,$94.50,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3093474,0309,83520,,,,,N/A,N/A,Mayo GDF 15,$280.49,$208.50,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3093518,0309,83520,,,,,N/A,N/A,"MAYO INTERLEUKIN 6, PLASMA",$145.29,$108.00,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3093541,0309,83520,,,,,N/A,N/A,MAYO MALE TRANS GRO FACT,$273.42,$203.25,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3093641,0309,83520,,,,,N/A,N/A,MAYO INTERFERON GAMMA,$175.56,$130.50,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3093668,0309,83520,,,,,N/A,N/A,MAYO INTERLEUKIN 2,$169.50,$126.00,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3093669,0309,83520,,,,,N/A,N/A,MAYO INTERLEUKIN 10,$198.76,$147.75,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3093693,0309,83520,,,,,N/A,N/A,MAYO ISTEKINUMAB QN WITH ANTIB,$178.58,$132.75,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3093712,0309,83520,,,,,N/A,N/A,MAYO MMP-9(MATRIX METALL-9),$150.33,$111.75,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3095448,0309,83520,,,,,N/A,N/A,MAYO IMMUNOASSAY QUANT NOS NON,$31.28,$23.25,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3095484,0309,83520,,,,,N/A,N/A,"MAYO MAG IgM, S",$177.57,$132.00,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3095485,0309,83520,,,,,N/A,N/A,MAYO PRIMARY MEMBRANOUS NEPHRO,$313.78,$233.25,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3095521,0309,83520,,,,,N/A,N/A,Mayo Autoantibody To C1q,$197.75,$147.00,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3099941,0309,83520,,,,,N/A,N/A,MAYO SULFATIDE AUTO ANTIBODY,$403.58,$300.00,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3099942,0309,83520,,,,,N/A,N/A,MAYO SULFATIDE AUTO ANTIBODY,$403.58,$300.00,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3099953,0309,83520,,,,,N/A,N/A,MAYO B-TYPE NATRIURETIC PEPTID,$431.83,$321.00,$22.21,$247.00,N/A,$239.59,N/A,N/A,N/A,$22.21,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3093262,0309,83525,,,,,N/A,N/A,MAYO INSULIN FREE & TOTAL,$35.31,$26.25,$20.54,$222.00,N/A,$215.34,N/A,N/A,N/A,$20.54,N/A,$215.34,N/A,$222.00,N/A,N/A,$215.34
3093263,0309,83527,,,,,N/A,N/A,MAYO INSULIN FREE & TOTAL,$40.36,$30.00,$13.83,$40.00,N/A,$38.80,N/A,N/A,N/A,$13.83,N/A,$38.80,N/A,$40.00,N/A,N/A,$38.80
3099739,0309,83582,,,,,N/A,N/A,MAYO 17 KETOGEN/17 KETOSTEROID,$159.41,$118.50,$10.48,"$1,079.00",N/A,"$1,046.63",N/A,N/A,N/A,$10.48,N/A,"$1,046.63",N/A,"$1,079.00",N/A,N/A,"$1,046.63"
3099740,0309,83586,,,,,N/A,N/A,MAYO 17KETOGEN/17 KETOSTEROIDS,$143.27,$106.50,$18.44,$142.00,N/A,$137.74,N/A,N/A,N/A,$18.44,N/A,$137.74,N/A,$142.00,N/A,N/A,$137.74
3099899,0309,83605,,,,,N/A,N/A,MAYO D- LACTATE,$266.36,$198.00,$15.51,$204.00,N/A,$197.88,N/A,N/A,N/A,$15.51,N/A,$197.88,N/A,$204.00,N/A,N/A,$197.88
3095390,0309,83631,,,,,N/A,N/A,"MAYO LACTOFERRIN, QUANT, STOOL",$250.22,$186.00,$23.47,$248.00,N/A,$240.56,N/A,N/A,N/A,$23.47,N/A,$240.56,N/A,$248.00,N/A,N/A,$240.56
3092760,0309,83655,,,,,N/A,N/A,MAYO HEAVY METALS SCR OCC,$72.64,$54.00,$23.47,$346.00,N/A,$335.62,N/A,N/A,N/A,$23.47,N/A,$335.62,N/A,$346.00,N/A,N/A,$335.62
3093309,0309,83655,,,,,N/A,N/A,MAYO LEAD 24 HR URINE,$50.45,$37.50,$23.47,$346.00,N/A,$335.62,N/A,N/A,N/A,$23.47,N/A,$335.62,N/A,$346.00,N/A,N/A,$335.62
3093601,0309,83655,,,,,N/A,N/A,LEAD,$13.12,$9.75,$23.47,$346.00,N/A,$335.62,N/A,N/A,N/A,$23.47,N/A,$335.62,N/A,$346.00,N/A,N/A,$335.62
3099827,0309,83655,,,,,N/A,N/A,MAYO HEAVY METALS SCREEN BLOOD,$224.99,$167.25,$23.47,$346.00,N/A,$335.62,N/A,N/A,N/A,$23.47,N/A,$335.62,N/A,$346.00,N/A,N/A,$335.62
3093117,0309,83690,,,,,N/A,N/A,MAYO LIPASE BODY FLUID,$45.40,$33.75,$14.67,$94.00,N/A,$91.18,N/A,N/A,N/A,$14.67,N/A,$91.18,N/A,$94.00,N/A,N/A,$91.18
3093236,0309,83695,,,,,N/A,N/A,LIPOPROTEIN (A) S,$89.80,$66.75,$8.38,$89.00,N/A,$86.33,N/A,N/A,N/A,$8.38,N/A,$86.33,N/A,$89.00,N/A,N/A,$86.33
3093241,0309,83698,,,,,N/A,N/A,MAYO LP-PLA2 ACTIVITY,$231.05,$171.75,$17.18,$229.00,N/A,$222.13,N/A,N/A,N/A,$17.18,N/A,$222.13,N/A,$229.00,N/A,N/A,$222.13
3092874,0309,83704,,,,,N/A,N/A,MAYO NMR LIPOPROFILE,$72.64,$54.00,$55.75,$72.00,N/A,$69.84,N/A,N/A,N/A,$55.75,N/A,$69.84,N/A,$72.00,N/A,N/A,$69.84
3093239,0309,83718,,,,,N/A,N/A,HDL CHOLESTEROL CDC S,$58.52,$43.50,$41.08,$128.00,N/A,$124.16,N/A,N/A,N/A,$41.08,N/A,$124.16,N/A,$128.00,N/A,N/A,$124.16
3010439,0309,83721,,,,,N/A,N/A,DIRECT LDL CHOLESTEROL,$178.58,$132.75,$9.64,$179.00,N/A,$173.63,N/A,N/A,N/A,$9.64,N/A,$173.63,N/A,$179.00,N/A,N/A,$173.63
3093088,0309,83727,,,,,N/A,N/A,MAYO GONADOTROPIN RELEAS HORM,$382.39,$284.25,$12.57,$379.00,N/A,$367.63,N/A,N/A,N/A,$12.57,N/A,$367.63,N/A,$379.00,N/A,N/A,$367.63
3091870,0309,83735,,,,,N/A,N/A,MAYO ELECTROLYTES STOOL,$133.18,$99.00,$20.54,$132.00,N/A,$128.04,N/A,N/A,N/A,$20.54,N/A,$128.04,N/A,$132.00,N/A,N/A,$128.04
3092207,0309,83735,,,,,N/A,N/A,MAYO MAGNESIUM RBC'S,$133.18,$99.00,$20.54,$132.00,N/A,$128.04,N/A,N/A,N/A,$20.54,N/A,$128.04,N/A,$132.00,N/A,N/A,$128.04
3092295,0309,83735,,,,,N/A,N/A,MAYO MUMPS QB IGB&IGM SERUM,$60.54,$45.00,$20.54,$132.00,N/A,$128.04,N/A,N/A,N/A,$20.54,N/A,$128.04,N/A,$132.00,N/A,N/A,$128.04
3092461,0309,83735,,,,,N/A,N/A,MAGNESIUM,$173.54,$129.00,$20.54,$132.00,N/A,$128.04,N/A,N/A,N/A,$20.54,N/A,$128.04,N/A,$132.00,N/A,N/A,$128.04
3095433,0309,83735,,,,,N/A,N/A,MAYO SUPERSATURATION 24HR URIN,$14.13,$10.50,$20.54,$132.00,N/A,$128.04,N/A,N/A,N/A,$20.54,N/A,$128.04,N/A,$132.00,N/A,N/A,$128.04
3092864,0309,83785,,,,,N/A,N/A,"MAYO MANGANESE, RBC",$217.93,$162.00,$7.96,$216.00,N/A,$209.52,N/A,N/A,N/A,$7.96,N/A,$209.52,N/A,$216.00,N/A,N/A,$209.52
3099364,0309,83785,,,,,N/A,N/A,MAYO MANGANESE,$206.83,$153.75,$7.96,$216.00,N/A,$209.52,N/A,N/A,N/A,$7.96,N/A,$209.52,N/A,$216.00,N/A,N/A,$209.52
3092224,0309,83789,,,,,N/A,N/A,"MAYO THIOPURINE METHYLTR, RBC",$308.74,$229.50,$31.85,$385.00,N/A,$373.45,N/A,N/A,N/A,$31.85,N/A,$373.45,N/A,$385.00,N/A,N/A,$373.45
3092590,0309,83789,,,,,N/A,N/A,MAYO COBALT S,$345.06,$256.50,$31.85,$385.00,N/A,$373.45,N/A,N/A,N/A,$31.85,N/A,$373.45,N/A,$385.00,N/A,N/A,$373.45
3092821,0309,83789,,,,,N/A,N/A,MAYO BATH SALTS PANEL,$388.44,$288.75,$31.85,$385.00,N/A,$373.45,N/A,N/A,N/A,$31.85,N/A,$373.45,N/A,$385.00,N/A,N/A,$373.45
3092858,0309,83789,,,,,N/A,N/A,MAYO CREATINE DISORDERSPANEL,$126.12,$93.75,$31.85,$385.00,N/A,$373.45,N/A,N/A,N/A,$31.85,N/A,$373.45,N/A,$385.00,N/A,N/A,$373.45
3093019,0309,83789,,,,,N/A,N/A,"MAYO BILE ACIDS,FRACT&TOTAL",$172.53,$128.25,$31.85,$385.00,N/A,$373.45,N/A,N/A,N/A,$31.85,N/A,$373.45,N/A,$385.00,N/A,N/A,$373.45
3099984,0309,83805,,,,,N/A,N/A,MAYO MEPROBAMATE,$180.60,$134.25,$28.92,$179.00,N/A,$173.63,N/A,N/A,N/A,$28.92,N/A,$173.63,N/A,$179.00,N/A,N/A,$173.63
3092761,0309,83825,,,,,N/A,N/A,MAYO HEAVY METALS SCR OCC,$97.87,$72.75,$491.79,$507.00,N/A,$491.79,N/A,N/A,N/A,$507.00,N/A,$491.79,N/A,$507.00,N/A,N/A,$491.79
3093602,0309,83825,,,,,N/A,N/A,MERCURY,$16.14,$12.00,$491.79,$507.00,N/A,$491.79,N/A,N/A,N/A,$507.00,N/A,$491.79,N/A,$507.00,N/A,N/A,$491.79
3095380,0309,83825,,,,,N/A,N/A,"MAYO MERCURY, B",$21.19,$15.75,$491.79,$507.00,N/A,$491.79,N/A,N/A,N/A,$507.00,N/A,$491.79,N/A,$507.00,N/A,N/A,$491.79
3099828,0309,83825,,,,,N/A,N/A,MAYO HEAVY METALS SCREEN BLOOD,$224.99,$167.25,$491.79,$507.00,N/A,$491.79,N/A,N/A,N/A,$507.00,N/A,$491.79,N/A,$507.00,N/A,N/A,$491.79
3099823,0309,83835,,,,,N/A,N/A,MAYO METHANEPHRINES 24 HR,$322.86,$240.00,$19.70,$320.00,N/A,$310.40,N/A,N/A,N/A,$19.70,N/A,$310.40,N/A,$320.00,N/A,N/A,$310.40
3092698,0309,83864,,,,,N/A,N/A,"MAYO MUCOPOLYSACCHARIDES,QN,UR",$322.86,$240.00,$310.40,$320.00,N/A,$310.40,N/A,N/A,N/A,$320.00,N/A,$310.40,N/A,$320.00,N/A,N/A,$310.40
3092668,0309,83874,,,,,N/A,N/A,MAYO MYOGLOBLULIN S,$249.21,$185.25,$20.54,$247.00,N/A,$239.59,N/A,N/A,N/A,$20.54,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3010261,0309,83880,,,,,N/A,N/A,B-TYPE NATRIURETIC PEPTIDE,$620.50,$461.25,$15.51,$638.00,N/A,$618.86,N/A,N/A,N/A,$15.51,N/A,$618.86,N/A,$638.00,N/A,N/A,$618.86
3092666,0309,83880,,,,,N/A,N/A,MAYO NT-PRO BNP,$643.70,$478.50,$15.51,$638.00,N/A,$618.86,N/A,N/A,N/A,$15.51,N/A,$618.86,N/A,$638.00,N/A,N/A,$618.86
3091720,0309,83883,,,,,N/A,N/A,MAYO RETINOL BINDING PROTEIN,$238.11,$177.00,$47.36,$220.00,N/A,$213.40,N/A,N/A,N/A,$47.36,N/A,$213.40,N/A,$220.00,N/A,N/A,$213.40
3092251,0309,83883,,,,,N/A,N/A,MAYO IMMUON TOTAL CHAINS URI,$54.48,$40.50,$47.36,$220.00,N/A,$213.40,N/A,N/A,N/A,$47.36,N/A,$213.40,N/A,$220.00,N/A,N/A,$213.40
3092550,0309,83883,,,,,N/A,N/A,MAYO IMMUNO TOTAL CHAINS URI,$54.48,$40.50,$47.36,$220.00,N/A,$213.40,N/A,N/A,N/A,$47.36,N/A,$213.40,N/A,$220.00,N/A,N/A,$213.40
3092551,0309,83883,,,,,N/A,N/A,MAYO IMMUNO TOTAL CHAINS URI,$54.48,$40.50,$47.36,$220.00,N/A,$213.40,N/A,N/A,N/A,$47.36,N/A,$213.40,N/A,$220.00,N/A,N/A,$213.40
3092575,0309,83883,,,,,N/A,N/A,MAYO IMMUNO FREE LIGHT CHAIN,$221.97,$165.00,$47.36,$220.00,N/A,$213.40,N/A,N/A,N/A,$47.36,N/A,$213.40,N/A,$220.00,N/A,N/A,$213.40
3092576,0309,83883,,,,,N/A,N/A,MAYO IMMUNO FREE LIGHT CHAIN,$221.97,$165.00,$47.36,$220.00,N/A,$213.40,N/A,N/A,N/A,$47.36,N/A,$213.40,N/A,$220.00,N/A,N/A,$213.40
3092986,0309,83883,,,,,N/A,N/A,MAYO FIBROSPECT II,$183.63,$136.50,$47.36,$220.00,N/A,$213.40,N/A,N/A,N/A,$47.36,N/A,$213.40,N/A,$220.00,N/A,N/A,$213.40
3093700,0309,83883,,,,,N/A,N/A,MAYO ALPHA-2-MACROGLOBULIN,$61.55,$45.75,$47.36,$220.00,N/A,$213.40,N/A,N/A,N/A,$47.36,N/A,$213.40,N/A,$220.00,N/A,N/A,$213.40
3093022,0309,83885,,,,,N/A,N/A,MAYO NICKLE,$105.94,$78.75,$16.35,$105.00,N/A,$101.85,N/A,N/A,N/A,$16.35,N/A,$101.85,N/A,$105.00,N/A,N/A,$101.85
3092437,0309,83890,,,,,N/A,N/A,MAYO ALPHA1 ANTI DEF PROFILE,$23.21,$17.25,$29.34,$179.00,N/A,$173.63,N/A,N/A,N/A,$29.34,N/A,$173.63,N/A,$179.00,N/A,N/A,$173.63
3092795,0309,83890,,,,,N/A,N/A,MAYO LI FRAUMENI P53 GEN DEL,$79.71,$59.25,$29.34,$179.00,N/A,$173.63,N/A,N/A,N/A,$29.34,N/A,$173.63,N/A,$179.00,N/A,N/A,$173.63
3099785,0309,83890,,,,,N/A,N/A,MAYO CANAVAN DISEASE,$118.05,$87.75,$29.34,$179.00,N/A,$173.63,N/A,N/A,N/A,$29.34,N/A,$173.63,N/A,$179.00,N/A,N/A,$173.63
3100102,0309,83890,,,,,N/A,N/A,MAYO KRAS GENE 7 MUT PAN TUM,$72.64,$54.00,$29.34,$179.00,N/A,$173.63,N/A,N/A,N/A,$29.34,N/A,$173.63,N/A,$179.00,N/A,N/A,$173.63
3092475,0309,83891,,,,,N/A,N/A,MD; ISOLATION OR EXTRACTION,$271.40,$201.75,$260.93,$269.00,N/A,$260.93,N/A,N/A,N/A,$269.00,N/A,$260.93,N/A,$269.00,N/A,N/A,$260.93
3092540,0309,83891,,,,,N/A,N/A,MAYO LIMB GIRDLE MUSC DYSTR,$99.89,$74.25,$260.93,$269.00,N/A,$260.93,N/A,N/A,N/A,$269.00,N/A,$260.93,N/A,$269.00,N/A,N/A,$260.93
3092555,0309,83891,,,,,N/A,N/A,MAYO DPD GENE MUTATION,$38.34,$28.50,$260.93,$269.00,N/A,$260.93,N/A,N/A,N/A,$269.00,N/A,$260.93,N/A,$269.00,N/A,N/A,$260.93
3092644,0309,83891,,,,,N/A,N/A,MAYO AUTOSOMAL DOM ATA EVAL,$143.27,$106.50,$260.93,$269.00,N/A,$260.93,N/A,N/A,N/A,$269.00,N/A,$260.93,N/A,$269.00,N/A,N/A,$260.93
3092815,0309,83891,,,,,N/A,N/A,MAYO INTERLENKIN 28B GENOTYP,$76.68,$57.00,$260.93,$269.00,N/A,$260.93,N/A,N/A,N/A,$269.00,N/A,$260.93,N/A,$269.00,N/A,N/A,$260.93
3099930,0309,83891,,,,,N/A,N/A,MAYO FRAGILE X SYNDROME,$163.45,$121.50,$260.93,$269.00,N/A,$260.93,N/A,N/A,N/A,$269.00,N/A,$260.93,N/A,$269.00,N/A,N/A,$260.93
3092556,0309,83892,,,,,N/A,N/A,Mayo Dpd Gene Mutation,$67.60,$50.25,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3099770,0309,83892,,,,,N/A,N/A,MAYO HEREDITARY HEMOCHROMATOSI,$155.38,$115.50,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3099771,0309,83892,,,,,N/A,N/A,MAYO HEREDITARY HEMOCHROMATOSI,$155.38,$115.50,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3099786,0309,83892,,,,,N/A,N/A,Mayo Canavan Disease,$118.05,$87.75,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3099787,0309,83892,,,,,N/A,N/A,Mayo Canavan Disease,$118.05,$87.75,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3099931,0309,83892,,,,,N/A,N/A,MAYO FRAGILE X SYNDROME,$163.45,$121.50,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3092645,0309,83894,,,,,N/A,N/A,MAYO AUTOSOMAL DOM ATA EVAL,"$1,235.95",$918.75,"$1,815.84","$1,872.00",N/A,"$1,815.84",N/A,N/A,N/A,"$1,872.00",N/A,"$1,815.84",N/A,"$1,872.00",N/A,N/A,"$1,815.84"
3092807,0309,83894,,,,,N/A,N/A,MAYO LI FRAUMENI P53 GEN DEL,$79.71,$59.25,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3099768,0309,83894,,,,,N/A,N/A,MAYO HEREDITARY HEMOCHROMATOSI,$155.38,$115.50,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3099769,0309,83894,,,,,N/A,N/A,MAYO HEREDITARY HEMOCHROMATOSI,$155.38,$115.50,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3099788,0309,83894,,,,,N/A,N/A,Mayo Canavan Disease,$118.05,$87.75,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3099789,0309,83894,,,,,N/A,N/A,Mayo Canavan Disease,$118.05,$87.75,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3099932,0309,83894,,,,,N/A,N/A,MAYO FRAGILE X SYNDROME,$163.45,$121.50,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3099933,0309,83894,,,,,N/A,N/A,MAYO FRAGILE X SYNDROME,$163.45,$121.50,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3092108,0309,83896,,,,,N/A,N/A,MAYO TAY SACHS,$88.79,$66.00,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3092109,0309,83896,,,,,N/A,N/A,MAYO TAY SACHS,$88.79,$66.00,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3092110,0309,83896,,,,,N/A,N/A,MAYO TAY SACHS,$88.79,$66.00,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3092439,0309,83896,,,,,N/A,N/A,MAYO ALPHA1 ANTI DEF PROFILE,$22.20,$16.50,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3092440,0309,83896,,,,,N/A,N/A,MAYO ALPHA1 ANTI DEF PROFILE,$22.20,$16.50,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3092816,0309,83896,,,,,N/A,N/A,MAYO INTERLENKIN 28B GENOTYP,$147.31,$109.50,$403.52,$416.00,N/A,$403.52,N/A,N/A,N/A,$416.00,N/A,$403.52,N/A,$416.00,N/A,N/A,$403.52
3099790,0309,83896,,,,,N/A,N/A,MAYO CANAVAN DISEASE,$118.05,$87.75,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3099934,0309,83896,,,,,N/A,N/A,MAYO FRAGILE X SYNDROME,$163.45,$121.50,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3100103,0309,83896,,,,,N/A,N/A,MAYO KRAS GENE 7 MUT PAN TUM,$473.19,$351.75,"$1,412.32","$1,456.00",N/A,"$1,412.32",N/A,N/A,N/A,"$1,456.00",N/A,"$1,412.32",N/A,"$1,456.00",N/A,N/A,"$1,412.32"
3099935,0309,83897,,,,,N/A,N/A,MAYO FRAGILE X SYNDROME,$163.45,$121.50,$157.14,$162.00,N/A,$157.14,N/A,N/A,N/A,$162.00,N/A,$157.14,N/A,$162.00,N/A,N/A,$157.14
3092441,0309,83898,,,,,N/A,N/A,MAYO ALPHA1 ANTI DEF PROFILE,$22.20,$16.50,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092442,0309,83898,,,,,N/A,N/A,MAYO ALPHA1 ANTI DEF PROFILE,$22.20,$16.50,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092476,0309,83898,,,,,N/A,N/A,"MD; AMPLIFICATION, TARGET",$115.02,$85.50,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092477,0309,83898,,,,,N/A,N/A,"MD; AMPLIFICATION, TARGET",$115.02,$85.50,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092478,0309,83898,,,,,N/A,N/A,"MD; AMPLIFICATION, TARGET",$115.02,$85.50,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092479,0309,83898,,,,,N/A,N/A,"MD; AMPLIFICATION, TARGET",$115.02,$85.50,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092480,0309,83898,,,,,N/A,N/A,"MD; AMPLIFICATION, TARGET",$115.02,$85.50,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092481,0309,83898,,,,,N/A,N/A,"MD; AMPLIFICATION, TARGET",$115.02,$85.50,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092482,0309,83898,,,,,N/A,N/A,"MD; AMPLIFICATION, TARGET",$115.02,$85.50,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092483,0309,83898,,,,,N/A,N/A,"MD; AMPLIFICATION, TARGET",$115.02,$85.50,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092484,0309,83898,,,,,N/A,N/A,"MD; AMPLIFICATION, TARGET",$115.02,$85.50,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092541,0309,83898,,,,,N/A,N/A,MAYO LIMB GIRDLE MUSC DYSTR,"$7,216.95","$5,364.75","$13,711.92","$14,136.00",N/A,"$13,711.92",N/A,N/A,N/A,"$14,136.00",N/A,"$13,711.92",N/A,"$14,136.00",N/A,N/A,"$13,711.92"
3092557,0309,83898,,,,,N/A,N/A,MAYO DPD GENE MUTATION,$134.19,$99.75,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092646,0309,83898,,,,,N/A,N/A,MAYO AUTOSOMAL DOM ATA EVAL,"$4,234.52","$3,147.75","$3,427.98","$3,534.00",N/A,"$3,427.98",N/A,N/A,N/A,"$3,534.00",N/A,"$3,427.98",N/A,"$3,534.00",N/A,N/A,"$3,427.98"
3092796,0309,83898,,,,,N/A,N/A,MAYO LI FRAUMENI P53 GEN DEL,$79.71,$59.25,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092797,0309,83898,,,,,N/A,N/A,MAYO LI FRAUMENI P53 GEN DEL,$72.64,$54.00,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092798,0309,83898,,,,,N/A,N/A,MAYO LI FRAUMENI P53 GEN DEL,$72.64,$54.00,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092799,0309,83898,,,,,N/A,N/A,MAYO LI FRAUMENI P53 GEN DEL,$72.64,$54.00,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092800,0309,83898,,,,,N/A,N/A,MAYO LI FRAUMENI P53 GEN DEL,$72.64,$54.00,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092801,0309,83898,,,,,N/A,N/A,MAYO LI FRAUMENI P53 GEN DEL,$72.64,$54.00,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092802,0309,83898,,,,,N/A,N/A,MAYO LI FRAUMENI P53 GEN DEL,$72.64,$54.00,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092803,0309,83898,,,,,N/A,N/A,MAYO LI FRAUMENI P53 GEN DEL,$72.64,$54.00,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092804,0309,83898,,,,,N/A,N/A,MAYO LI FRAUMENI P53 GEN DEL,$72.64,$54.00,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092805,0309,83898,,,,,N/A,N/A,MAYO LI FRAUMENI P53 GEN DEL,$72.64,$54.00,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092806,0309,83898,,,,,N/A,N/A,MAYO LI FRAUMENI P53 GEN DEL,$72.64,$54.00,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092817,0309,83898,,,,,N/A,N/A,MAYO INTERLENKIN 28B GENOTYP,$299.66,$222.75,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3099791,0309,83898,,,,,N/A,N/A,Mayo Canavan Disease,$118.05,$87.75,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3099936,0309,83898,,,,,N/A,N/A,MAYO FRAGILE X SYNDROME,$161.43,$120.00,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3100104,0309,83898,,,,,N/A,N/A,MAYO KRAS GENE 7 MUT PAN TUM,$473.19,$351.75,$774.06,$798.00,N/A,$774.06,N/A,N/A,N/A,$798.00,N/A,$774.06,N/A,$798.00,N/A,N/A,$774.06
3092112,0309,83900,,,,,N/A,N/A,MAYO TAY SACHS,$88.79,$66.00,$73.72,$76.00,N/A,$73.72,N/A,N/A,N/A,$76.00,N/A,$73.72,N/A,$76.00,N/A,N/A,$73.72
3092781,0309,83900,,,,,N/A,N/A,MAYO COMPLETE HNPP EVAL,$44.39,$33.00,$73.72,$76.00,N/A,$73.72,N/A,N/A,N/A,$76.00,N/A,$73.72,N/A,$76.00,N/A,N/A,$73.72
3092782,0309,83901,,,,,N/A,N/A,MAYO COMPLETE HNPP EVAL,$629.58,$468.00,$605.37,$624.07,N/A,$605.37,N/A,N/A,N/A,$624.07,N/A,$605.37,N/A,$624.07,N/A,N/A,$605.37
3092486,0309,83904,,,,,N/A,N/A,MD; MUTATION IDENTIFICATION,$115.02,$85.50,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092487,0309,83904,,,,,N/A,N/A,MD; MUTATION IDENTIFICATION,$115.02,$85.50,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092488,0309,83904,,,,,N/A,N/A,MD; MUTATION IDENTIFICATION,$115.02,$85.50,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092489,0309,83904,,,,,N/A,N/A,MD; MUTATION IDENTIFICATION,$115.02,$85.50,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092490,0309,83904,,,,,N/A,N/A,MD; MUTATION IDENTIFICATION,$115.02,$85.50,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092491,0309,83904,,,,,N/A,N/A,MD; MUTATION IDENTIFICATION,$115.02,$85.50,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092492,0309,83904,,,,,N/A,N/A,MD; MUTATION IDENTIFICATION,$115.02,$85.50,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092493,0309,83904,,,,,N/A,N/A,MD; MUTATION IDENTIFICATION,$115.02,$85.50,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092494,0309,83904,,,,,N/A,N/A,MD; MUTATION IDENTIFICATION,$115.02,$85.50,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092495,0309,83904,,,,,N/A,N/A,MD; MUTATION IDENTIFICATION,$115.02,$85.50,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092496,0309,83904,,,,,N/A,N/A,MD; MUTATION IDENTIFICATION,$115.02,$85.50,$110.58,$114.00,N/A,$110.58,N/A,N/A,N/A,$114.00,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092647,0309,83904,,,,,N/A,N/A,MAYO AUTOSOMAL DOM ATA EVAL,"$3,147.89","$2,340.00","$2,543.34","$2,622.00",N/A,"$2,543.34",N/A,N/A,N/A,"$2,622.00",N/A,"$2,543.34",N/A,"$2,622.00",N/A,N/A,"$2,543.34"
3092665,0309,83904,,,,,N/A,N/A,MAYO LIMB GIRDLE MUSC DYSTR,"$7,216.95","$5,364.75","$13,711.92","$14,136.00",N/A,"$13,711.92",N/A,N/A,N/A,"$14,136.00",N/A,"$13,711.92",N/A,"$14,136.00",N/A,N/A,"$13,711.92"
3092783,0309,83904,,,,,N/A,N/A,MAYO COMPLETE HNPP EVAL,$155.38,$115.50,$442.32,$456.00,N/A,$442.32,N/A,N/A,N/A,$456.00,N/A,$442.32,N/A,$456.00,N/A,N/A,$442.32
3092106,0309,83908,,,,,N/A,N/A,MAYO PROTHROMBIN G2021A MUTATN,$85.76,$63.75,$85.36,$88.00,N/A,$85.36,N/A,N/A,N/A,$88.00,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3092107,0309,83908,,,,,N/A,N/A,MAYO PROTHROMBIN G2021A MUTATN,$85.76,$63.75,$85.36,$88.00,N/A,$85.36,N/A,N/A,N/A,$88.00,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3092558,0309,83909,,,,,N/A,N/A,MAYO DPD GENE MUTATION,$134.19,$99.75,$33.95,$35.00,N/A,$33.95,N/A,N/A,N/A,$35.00,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
3092648,0309,83909,,,,,N/A,N/A,MAYO AUTOSOMAL DOM ATA EVAL,$143.27,$106.50,$33.95,$35.00,N/A,$33.95,N/A,N/A,N/A,$35.00,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
3092784,0309,83909,,,,,N/A,N/A,MAYO COMPLETE HNPP EVAL,$188.67,$140.25,$169.75,$175.00,N/A,$169.75,N/A,N/A,N/A,$175.00,N/A,$169.75,N/A,$175.00,N/A,N/A,$169.75
3092789,0309,83909,,,,,N/A,N/A,MAYO LIMB GIRDLE MUSC DYSTR,$99.89,$74.25,$33.95,$35.00,N/A,$33.95,N/A,N/A,N/A,$35.00,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
3092438,0309,83912,,,,,N/A,N/A,MAYO ALPHA1 ANTI DEF PROFILE,$23.21,$17.25,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3092559,0309,83912,,,,,N/A,N/A,MAYO DPD GENE MUTATION,$38.34,$28.50,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3092649,0309,83912,,,,,N/A,N/A,MAYO AUTOSOMAL DOM ATA EVAL,$143.27,$106.50,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3092785,0309,83912,,,,,N/A,N/A,MAYO COMPLETE HNPP EVAL,$48.43,$36.00,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3092790,0309,83912,,,,,N/A,N/A,MAYO LIMB GIRDLE MUSC DYSTR,$99.89,$74.25,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3092808,0309,83912,,,,,N/A,N/A,MAYO LI FRAUMENI P53 GEN DEL,$79.71,$59.25,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3092818,0309,83912,,,,,N/A,N/A,MAYO INTERLENKIN 28B GENOTYP,$76.68,$57.00,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3099792,0309,83912,,,,,N/A,N/A,MAYO CANAVAN DISEASE,$107.96,$80.25,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3099937,0309,83912,,,,,N/A,N/A,MAYO FRAGILE X SYNDROME,$161.43,$120.00,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3100105,0309,83912,,,,,N/A,N/A,MAYO KRAS GENE 7 MUT PAN TUM,$72.64,$54.00,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3092089,0309,83914,,,,,N/A,N/A,MAYO CANAVAN DISEASE,$118.05,$87.75,$129.01,$133.00,N/A,$129.01,N/A,N/A,N/A,$133.00,N/A,$129.01,N/A,$133.00,N/A,N/A,$129.01
3092113,0309,83914,,,,,N/A,N/A,MAYO TAY SACHS,$88.79,$66.00,$129.01,$133.00,N/A,$129.01,N/A,N/A,N/A,$133.00,N/A,$129.01,N/A,$133.00,N/A,N/A,$129.01
3092560,0309,83914,,,,,N/A,N/A,MAYO DPD GENE MUTATION,$134.19,$99.75,$129.01,$133.00,N/A,$129.01,N/A,N/A,N/A,$133.00,N/A,$129.01,N/A,$133.00,N/A,N/A,$129.01
3092786,0309,83914,,,,,N/A,N/A,MAYO COMPLETE HNPP EVAL,$704.24,$523.50,"$2,451.19","$2,527.00",N/A,"$2,451.19",N/A,N/A,N/A,"$2,527.00",N/A,"$2,451.19",N/A,"$2,527.00",N/A,N/A,"$2,451.19"
3092877,0309,83916,,,,,N/A,N/A,MAYO MULTIPLE SCLEROSIS PROF,$86.77,$64.50,$26.82,$762.00,N/A,$739.14,N/A,N/A,N/A,$26.82,N/A,$739.14,N/A,$762.00,N/A,N/A,$739.14
3092562,0309,83921,,,,,N/A,N/A,"MAYO METHYLMALONIC ACID QT,UR",$126.12,$93.75,$32.69,$130.00,N/A,$126.10,N/A,N/A,N/A,$32.69,N/A,$126.10,N/A,$130.00,N/A,N/A,$126.10
3093386,0309,83921,,,,,N/A,N/A,"MAYO TRICHLORACETIC ACID,URINE",$131.16,$97.50,$32.69,$130.00,N/A,$126.10,N/A,N/A,N/A,$32.69,N/A,$126.10,N/A,$130.00,N/A,N/A,$126.10
3092685,0309,83925,,,,,N/A,N/A,MAYO OPIATE MECONIUM,$370.28,$275.25,$25.57,$367.00,N/A,$355.99,N/A,N/A,N/A,$25.57,N/A,$355.99,N/A,$367.00,N/A,N/A,$355.99
3099946,0309,83925,,,,,N/A,N/A,MAYO OXYCODONE,$370.28,$275.25,$25.57,$367.00,N/A,$355.99,N/A,N/A,N/A,$25.57,N/A,$355.99,N/A,$367.00,N/A,N/A,$355.99
3095431,0309,83935,,,,,N/A,N/A,MAYO SUPERSATURATION 24HR URIN,$14.13,$10.50,$7.96,$279.00,N/A,$270.63,N/A,N/A,N/A,$7.96,N/A,$270.63,N/A,$279.00,N/A,N/A,$270.63
3092690,0309,83937,,,,,N/A,N/A,MAYO OSTEOCALCIN,$238.11,$177.00,$8.38,$236.00,N/A,$228.92,N/A,N/A,N/A,$8.38,N/A,$228.92,N/A,$236.00,N/A,N/A,$228.92
3095427,0309,83945,,,,,N/A,N/A,MAYO SUPERSATURATION 24HR URIN,$30.27,$22.50,$36.05,$246.00,N/A,$238.62,N/A,N/A,N/A,$36.05,N/A,$238.62,N/A,$246.00,N/A,N/A,$238.62
3095428,0309,83986,,,,,N/A,N/A,MAYO SUPERSATURATION 24HR URIN,$7.06,$5.25,$49.46,$61.00,N/A,$59.17,N/A,N/A,N/A,$49.46,N/A,$59.17,N/A,$61.00,N/A,N/A,$59.17
3095503,0309,83986,,,,,N/A,N/A,"Mayo Ph, 24hr Urine",$16.14,$12.00,$49.46,$61.00,N/A,$59.17,N/A,N/A,N/A,$49.46,N/A,$59.17,N/A,$61.00,N/A,N/A,$59.17
3092485,0309,83989,,,,,N/A,N/A,"MD; AMPLIFICATION, TARGET",$115.02,$85.50,$4.19,$114.00,N/A,$110.58,N/A,N/A,N/A,$4.19,N/A,$110.58,N/A,$114.00,N/A,N/A,$110.58
3092237,0309,83992,,,,,N/A,N/A,MAYO PHENCYCLIDINE CONFIRM,$106.95,$79.50,$270.63,$279.00,N/A,$270.63,N/A,N/A,N/A,$279.00,N/A,$270.63,N/A,$279.00,N/A,N/A,$270.63
3092670,0309,83992,,,,,N/A,N/A,MAYO PCP CONFIRMATION MECONUIM,$281.49,$209.25,$270.63,$279.00,N/A,$270.63,N/A,N/A,N/A,$279.00,N/A,$270.63,N/A,$279.00,N/A,N/A,$270.63
3092695,0309,83993,,,,,N/A,N/A,MAYO CALPROTECTIN,$374.32,$278.25,$49.88,$371.00,N/A,$359.87,N/A,N/A,N/A,$49.88,N/A,$359.87,N/A,$371.00,N/A,N/A,$359.87
3099641,0309,84075,,,,,N/A,N/A,"PHOSPHATASE,ALKALINE;",$103.92,$77.25,$11.74,$103.00,N/A,$99.91,N/A,N/A,N/A,$11.74,N/A,$99.91,N/A,$103.00,N/A,N/A,$99.91
3092764,0309,84080,,,,,N/A,N/A,MAYO BONE ALKALINE PHOSPHATASE,$107.96,$80.25,$6.29,$281.00,N/A,$272.57,N/A,N/A,N/A,$6.29,N/A,$272.57,N/A,$281.00,N/A,N/A,$272.57
3099640,0309,84080,,,,,N/A,N/A,"PHOSHATASE,ALKALINE ISOENZYMES",$283.51,$210.75,$6.29,$281.00,N/A,$272.57,N/A,N/A,N/A,$6.29,N/A,$272.57,N/A,$281.00,N/A,N/A,$272.57
3093411,0309,84100,,,,,N/A,N/A,MAYO ELECTROLYTES STOOL,$73.65,$54.75,$17.60,$95.00,N/A,$92.15,N/A,N/A,N/A,$17.60,N/A,$92.15,N/A,$95.00,N/A,N/A,$92.15
3095424,0309,84105,,,,,N/A,N/A,MAYO SUPERSATURATION 24HR URIN,$12.11,$9.00,$5.87,$103.00,N/A,$99.91,N/A,N/A,N/A,$5.87,N/A,$99.91,N/A,$103.00,N/A,N/A,$99.91
3099807,0309,84105,,,,,N/A,N/A,FAHC RANDOM URINE PHOSPHORUS,$68.61,$51.00,$5.87,$103.00,N/A,$99.91,N/A,N/A,N/A,$5.87,N/A,$99.91,N/A,$103.00,N/A,N/A,$99.91
3099818,0309,84105,,,,,N/A,N/A,MAYO PHOSPHORUS 24HR URINE,$103.92,$77.25,$5.87,$103.00,N/A,$99.91,N/A,N/A,N/A,$5.87,N/A,$99.91,N/A,$103.00,N/A,N/A,$99.91
3099760,0309,84109,,,,,N/A,N/A,Mayo Mycoplasma Hominis Cult,$331.94,$246.75,$7.13,$329.00,N/A,$319.13,N/A,N/A,N/A,$7.13,N/A,$319.13,N/A,$329.00,N/A,N/A,$319.13
3092669,0309,84110,,,,,N/A,N/A,"MAYO PORPHOB ,QN,RANDOM URINE",$119.05,$88.50,$114.46,$118.00,N/A,$114.46,N/A,N/A,N/A,$118.00,N/A,$114.46,N/A,$118.00,N/A,N/A,$114.46
3099976,0309,84110,,,,,N/A,N/A,"MAYO PORPHYRINS,QT,U",$119.05,$88.50,$114.46,$118.00,N/A,$114.46,N/A,N/A,N/A,$118.00,N/A,$114.46,N/A,$118.00,N/A,N/A,$114.46
3020506,0309,84112,,,,,N/A,N/A,ROM PLUS (RUP FETAL MEMBRANES),$236.09,$175.50,$10.06,$234.00,N/A,$226.98,N/A,N/A,N/A,$10.06,N/A,$226.98,N/A,$234.00,N/A,N/A,$226.98
3099776,0309,84120,,,,,N/A,N/A,Mayo Porphyrins Profile,$137.22,$102.00,$117.78,$279.00,N/A,$270.63,N/A,N/A,N/A,$117.78,N/A,$270.63,N/A,$279.00,N/A,N/A,$270.63
3099975,0309,84120,,,,,N/A,N/A,"MAYO PORPHYRINS,QT,U",$281.49,$209.25,$117.78,$279.00,N/A,$270.63,N/A,N/A,N/A,$117.78,N/A,$270.63,N/A,$279.00,N/A,N/A,$270.63
3092863,0309,84132,,,,,N/A,N/A,"MAYO POTASSIUM, RBC'S",$138.22,$102.75,$17.60,$137.00,N/A,$132.89,N/A,N/A,N/A,$17.60,N/A,$132.89,N/A,$137.00,N/A,N/A,$132.89
3095422,0309,84133,,,,,N/A,N/A,MAYO SUPERSATURATION 24HR URIN,$9.08,$6.75,$5.87,$88.00,N/A,$85.36,N/A,N/A,N/A,$5.87,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3095516,0309,84133,,,,,N/A,N/A,"Uv, Potassium, Randon Urine",$5.04,$3.75,$5.87,$88.00,N/A,$85.36,N/A,N/A,N/A,$5.87,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3092733,0309,84140,,,,,N/A,N/A,MAYO PREGNENOLONE+17-OH,$394.50,$293.25,$17.60,$391.00,N/A,$379.27,N/A,N/A,N/A,$17.60,N/A,$379.27,N/A,$391.00,N/A,N/A,$379.27
3092964,0309,84140,,,,,N/A,N/A,MAYO PREGNENOLONE,$150.33,$111.75,$17.60,$391.00,N/A,$379.27,N/A,N/A,N/A,$17.60,N/A,$379.27,N/A,$391.00,N/A,N/A,$379.27
3092732,0309,84143,,,,,N/A,N/A,MAYO PREGNENOLONE+17-OH,$413.67,$307.50,$24.73,$410.00,N/A,$397.70,N/A,N/A,N/A,$24.73,N/A,$397.70,N/A,$410.00,N/A,N/A,$397.70
3050433,0309,84145,,,,,N/A,N/A,PROCALCITONIN,$135.20,$100.50,$25.15,$189.00,N/A,$183.33,N/A,N/A,N/A,$25.15,N/A,$183.33,N/A,$189.00,N/A,N/A,$183.33
3093487,0309,84145,,,,,N/A,N/A,MAYO PROCALCITONIN,$190.69,$141.75,$25.15,$189.00,N/A,$183.33,N/A,N/A,N/A,$25.15,N/A,$183.33,N/A,$189.00,N/A,N/A,$183.33
3092787,0309,84150,,,,,N/A,N/A,"MAYO PROSTAGLANDIN D2, URINE",$621.51,$462.00,$23.47,$341.00,N/A,$330.77,N/A,N/A,N/A,$23.47,N/A,$330.77,N/A,$341.00,N/A,N/A,$330.77
3093013,0309,84150,,,,,N/A,N/A,MAYOIIBETA-PROSTAGLANDIN F2 UR,$110.98,$82.50,$23.47,$341.00,N/A,$330.77,N/A,N/A,N/A,$23.47,N/A,$330.77,N/A,$341.00,N/A,N/A,$330.77
3093209,0309,84150,,,,,N/A,N/A,"MAYO 2,3 DINOR II BETA PROSTAG",$73.65,$54.75,$23.47,$341.00,N/A,$330.77,N/A,N/A,N/A,$23.47,N/A,$330.77,N/A,$341.00,N/A,N/A,$330.77
3095514,0309,84150,,,,,N/A,N/A,"Mayo Prostaglandin D2, Serum",$344.05,$255.75,$23.47,$341.00,N/A,$330.77,N/A,N/A,N/A,$23.47,N/A,$330.77,N/A,$341.00,N/A,N/A,$330.77
3093132,0309,84153,,,,,N/A,N/A,"MAYO PSA,ULTRASENSITIVE",$114.01,$84.75,$50.30,$337.00,N/A,$326.89,N/A,N/A,N/A,$50.30,N/A,$326.89,N/A,$337.00,N/A,N/A,$326.89
3099657,0309,84153,,,,,N/A,N/A,UVM PSA DIAGNOSTIC,$340.01,$252.75,$50.30,$337.00,N/A,$326.89,N/A,N/A,N/A,$50.30,N/A,$326.89,N/A,$337.00,N/A,N/A,$326.89
3099658,0309,84153,,,,,N/A,N/A,UVM PSA SCREENING,$367.25,$273.00,$50.30,$337.00,N/A,$326.89,N/A,N/A,N/A,$50.30,N/A,$326.89,N/A,$337.00,N/A,N/A,$326.89
3099798,0309,84155,,,,,N/A,N/A,FAHC IMMUNOFIXATION/SPEP,$72.64,$54.00,$22.21,$72.00,N/A,$69.84,N/A,N/A,N/A,$22.21,N/A,$69.84,N/A,$72.00,N/A,N/A,$69.84
3092586,0309,84156,,,,,N/A,N/A,MAYO MONOPCLONAL PROT URINE,$43.38,$32.25,$4.61,$43.00,N/A,$41.71,N/A,N/A,N/A,$4.61,N/A,$41.71,N/A,$43.00,N/A,N/A,$41.71
3093515,0309,84156,,,,,N/A,N/A,UVM MONOCLONAL URINE STUDY,$8.07,$6.00,$4.61,$43.00,N/A,$41.71,N/A,N/A,N/A,$4.61,N/A,$41.71,N/A,$43.00,N/A,N/A,$41.71
3092884,0309,84157,,,,,N/A,N/A,MAYO TOTAL PROTEIN BODY FLUID,$57.51,$42.75,$4.61,$57.00,N/A,$55.29,N/A,N/A,N/A,$4.61,N/A,$55.29,N/A,$57.00,N/A,N/A,$55.29
3099797,0309,84165,,,,,N/A,N/A,FAHC IMMUNOFIXATION/SPEP,$206.83,$153.75,$4.61,$205.00,$84.50,$198.85,$84.50,N/A,$84.50,$4.61,$84.50,$198.85,$84.50,$205.00,$84.50,$84.50,$198.85
3099804,0309,84165,,,,,N/A,N/A,FAHC 24HR URINE ELECTROPHORES,$206.83,$153.75,$4.61,$205.00,$84.50,$198.85,$84.50,N/A,$84.50,$4.61,$84.50,$198.85,$84.50,$205.00,$84.50,$84.50,$198.85
3092587,0309,84166,,,,,N/A,N/A,MAYO MONOPCLONAL PROT URINE,$43.38,$32.25,$32.39,$79.00,$32.39,$76.63,$32.39,N/A,$32.39,$34.83,$32.39,$76.63,$32.39,$79.00,$32.39,$32.39,$76.63
3093312,0309,84166,,,,,N/A,N/A,MAYO P&L BODY FLUID,$79.71,$59.25,$32.39,$79.00,$32.39,$76.63,$32.39,N/A,$32.39,$34.83,$32.39,$76.63,$32.39,$79.00,$32.39,$32.39,$76.63
3093516,0309,84166,,,,,N/A,N/A,UVM MONOCLONAL URINE STUDY,$38.34,$28.50,$32.39,$79.00,$32.39,$76.63,$32.39,N/A,$32.39,$34.83,$32.39,$76.63,$32.39,$79.00,$32.39,$32.39,$76.63
3092910,0309,84182,,,,,N/A,N/A,MAYO CRMP-5IgG WB,$170.51,$126.75,$43.21,$258.71,$258.71,$239.59,$258.71,N/A,$258.71,$43.21,$258.71,$239.59,$258.71,$247.00,$258.71,$258.71,$239.59
3092966,0309,84182,,,,,N/A,N/A,MAYO RECOMBX CV2 ANTIBODY,$636.64,$473.25,$43.21,$258.71,$258.71,$239.59,$258.71,N/A,$258.71,$43.21,$258.71,$239.59,$258.71,$247.00,$258.71,$258.71,$239.59
3092138,0309,84202,,,,,N/A,N/A,MAYO ZINC PROTOPORPHYRIN,$59.53,$44.25,$57.04,$236.00,N/A,$228.92,N/A,N/A,N/A,$57.04,N/A,$228.92,N/A,$236.00,N/A,N/A,$228.92
3099876,0309,84202,,,,,N/A,N/A,"MAYO PROTO,FRACT RBC 1",$238.11,$177.00,$57.04,$236.00,N/A,$228.92,N/A,N/A,N/A,$57.04,N/A,$228.92,N/A,$236.00,N/A,N/A,$228.92
3099877,0309,84202,,,,,N/A,N/A,"MAYO PROTO,FRACT RBC 2",$239.12,$177.75,$57.04,$236.00,N/A,$228.92,N/A,N/A,N/A,$57.04,N/A,$228.92,N/A,$236.00,N/A,N/A,$228.92
3099977,0309,84206,,,,,N/A,N/A,MAYO PROINSULIN,$183.63,$136.50,$17.18,$182.00,N/A,$176.54,N/A,N/A,N/A,$17.18,N/A,$176.54,N/A,$182.00,N/A,N/A,$176.54
3092500,0309,84210,,,,,N/A,N/A,"MAYO PYRUVIC ACID,B",$135.20,$100.50,$33.95,$134.00,N/A,$129.98,N/A,N/A,N/A,$33.95,N/A,$129.98,N/A,$134.00,N/A,N/A,$129.98
3092362,0309,84220,,,,,N/A,N/A,MAYO PYURATE KINASE RBC,$110.98,$82.50,$17.18,$110.00,N/A,$106.70,N/A,N/A,N/A,$17.18,N/A,$106.70,N/A,$110.00,N/A,N/A,$106.70
3099914,0309,84235,,,,,N/A,N/A,MAYO THYROTROPIN RECEPTOR AB,$988.76,$735.00,$11.32,$980.00,N/A,$950.60,N/A,N/A,N/A,$11.32,N/A,$950.60,N/A,$980.00,N/A,N/A,$950.60
3092543,0309,84252,,,,,N/A,N/A,MAYO RIBOFLAVIN (VITAMIN B2),$101.90,$75.75,$26.41,$101.00,N/A,$97.97,N/A,N/A,N/A,$26.41,N/A,$97.97,N/A,$101.00,N/A,N/A,$97.97
3092862,0309,84255,,,,,N/A,N/A,"MAYO SELENIUM, RBC'S",$137.22,$102.00,$24.31,$136.00,N/A,$131.92,N/A,N/A,N/A,$24.31,N/A,$131.92,N/A,$136.00,N/A,N/A,$131.92
3095418,0309,84260,,,,,N/A,N/A,"MAYO SEROTONIN, 24 HR URINE",$61.55,$45.75,$30.60,$584.00,N/A,$566.48,N/A,N/A,N/A,$30.60,N/A,$566.48,N/A,$584.00,N/A,N/A,$566.48
3099888,0309,84270,,,,,N/A,N/A,MAYO SEX HORMONE BIND GLOBULIN,$414.67,$308.25,$37.30,$411.00,N/A,$398.67,N/A,N/A,N/A,$37.30,N/A,$398.67,N/A,$411.00,N/A,N/A,$398.67
3095421,0309,84300,,,,,N/A,N/A,MAYO SUPERSATURATION 24HR URIN,$11.10,$8.25,$5.87,$264.00,N/A,$256.08,N/A,N/A,N/A,$5.87,N/A,$256.08,N/A,$264.00,N/A,N/A,$256.08
3095515,0309,84300,,,,,N/A,N/A,"Uvm Sodium, Randon Urine",$5.04,$3.75,$5.87,$264.00,N/A,$256.08,N/A,N/A,N/A,$5.87,N/A,$256.08,N/A,$264.00,N/A,N/A,$256.08
3099835,0309,84300,,,,,N/A,N/A,MAYO ALDOSTERONE SODIUM 24HR,$266.36,$198.00,$5.87,$264.00,N/A,$256.08,N/A,N/A,N/A,$5.87,N/A,$256.08,N/A,$264.00,N/A,N/A,$256.08
3091871,0309,84302,,,,,N/A,N/A,MAYO ELECTROLYTES STOOL,$96.86,$72.00,$6.29,$113.00,N/A,$109.61,N/A,N/A,N/A,$6.29,N/A,$109.61,N/A,$113.00,N/A,N/A,$109.61
3091872,0309,84302,,,,,N/A,N/A,MAYO ELECTROLYTES STOOL,$88.79,$66.00,$6.29,$113.00,N/A,$109.61,N/A,N/A,N/A,$6.29,N/A,$109.61,N/A,$113.00,N/A,N/A,$109.61
3091873,0309,84302,,,,,N/A,N/A,MAYO ELECTROLYTES STOOL,$88.79,$66.00,$6.29,$113.00,N/A,$109.61,N/A,N/A,N/A,$6.29,N/A,$109.61,N/A,$113.00,N/A,N/A,$109.61
3092225,0309,84302,,,,,N/A,N/A,"MAYO SODIUM,QN,FECES",$114.01,$84.75,$6.29,$113.00,N/A,$109.61,N/A,N/A,N/A,$6.29,N/A,$109.61,N/A,$113.00,N/A,N/A,$109.61
3092831,0309,84307,,,,,N/A,N/A,MAYO SOMATOSTATIN (PLASMA),$367.25,$273.00,$25.57,$364.00,N/A,$353.08,N/A,N/A,N/A,$25.57,N/A,$353.08,N/A,$364.00,N/A,N/A,$353.08
3092151,0309,84311,,,,,N/A,N/A,MAYO PORPHYRINS TOTAL RBC,$110.98,$82.50,$21.80,$196.00,N/A,$190.12,N/A,N/A,N/A,$21.80,N/A,$190.12,N/A,$196.00,N/A,N/A,$190.12
3092631,0309,84311,,,,,N/A,N/A,MAYO ADENOSINE DEAMINASE FLUID,$221.97,$165.00,$21.80,$196.00,N/A,$190.12,N/A,N/A,N/A,$21.80,N/A,$190.12,N/A,$196.00,N/A,N/A,$190.12
3093345,0309,84311,,,,,N/A,N/A,"MAYO CHYMOTRYPSIN,STOOL",$197.75,$147.00,$21.80,$196.00,N/A,$190.12,N/A,N/A,N/A,$21.80,N/A,$190.12,N/A,$196.00,N/A,N/A,$190.12
3093567,0309,84311,,,,,N/A,N/A,MAYO SPECTROPHOTOMETRY,$18.16,$13.50,$21.80,$196.00,N/A,$190.12,N/A,N/A,N/A,$21.80,N/A,$190.12,N/A,$196.00,N/A,N/A,$190.12
3093660,0309,84311,,,,,N/A,N/A,MAYO ADENOSINE DEMINASE PLEURA,$155.38,$115.50,$21.80,$196.00,N/A,$190.12,N/A,N/A,N/A,$21.80,N/A,$190.12,N/A,$196.00,N/A,N/A,$190.12
3092845,0309,84376,,,,,N/A,N/A,MAYO OLIGOSACCHARIDE SCREEN UR,$89.80,$66.75,$9.64,$89.00,N/A,$86.33,N/A,N/A,N/A,$9.64,N/A,$86.33,N/A,$89.00,N/A,N/A,$86.33
3093633,0309,84376,,,,,N/A,N/A,"MAYO REDUCING SUBSTANCE,F",$70.63,$52.50,$9.64,$89.00,N/A,$86.33,N/A,N/A,N/A,$9.64,N/A,$86.33,N/A,$89.00,N/A,N/A,$86.33
3095425,0309,84392,,,,,N/A,N/A,MAYO SUPERSATURATION 24HR URIN,$12.11,$9.00,$6.71,$297.00,N/A,$288.09,N/A,N/A,N/A,$6.71,N/A,$288.09,N/A,$297.00,N/A,N/A,$288.09
3099962,0309,84392,,,,,N/A,N/A,MAYO SULFATE 24HR URINE,$299.66,$222.75,$6.71,$297.00,N/A,$288.09,N/A,N/A,N/A,$6.71,N/A,$288.09,N/A,$297.00,N/A,N/A,$288.09
3092497,0309,84402,,,,,N/A,N/A,MAYO TESTOSTERONE FREE,$482.27,$358.50,$6.71,$97.00,N/A,$94.09,N/A,N/A,N/A,$6.71,N/A,$94.09,N/A,$97.00,N/A,N/A,$94.09
3092571,0309,84402,,,,,N/A,N/A,"MAYO TESTOSTERONE T,BIO,FREE",$97.87,$72.75,$13.42,$194.00,N/A,$188.18,N/A,N/A,N/A,$13.42,N/A,$188.18,N/A,$194.00,N/A,N/A,$188.18
3093324,0309,84402,,,,,N/A,N/A,"MAYO TESTOSTERONE T,BIO FREE",$51.46,$38.25,$6.71,$97.00,N/A,$94.09,N/A,N/A,N/A,$6.71,N/A,$94.09,N/A,$97.00,N/A,N/A,$94.09
3093406,0309,84402,,,,,N/A,N/A,"MAYO TESTOSTERONE,FREE",$59.53,$44.25,$6.71,$97.00,N/A,$94.09,N/A,N/A,N/A,$6.71,N/A,$94.09,N/A,$97.00,N/A,N/A,$94.09
3092570,0309,84403,,,,,N/A,N/A,"MAYO TESTOSTERONE T,BIO,FREE",$50.45,$37.50,$30.60,$60.00,N/A,$58.20,N/A,N/A,N/A,$30.60,N/A,$58.20,N/A,$60.00,N/A,N/A,$58.20
3093021,0309,84403,,,,,N/A,N/A,"MAYO TESTOSTERONE,TOTAL",$505.48,$375.75,$30.60,$60.00,N/A,$58.20,N/A,N/A,N/A,$30.60,N/A,$58.20,N/A,$60.00,N/A,N/A,$58.20
3093293,0309,84403,,,,,N/A,N/A,MAYO TESTOSTERONE TOT/BIO,$50.45,$37.50,$30.60,$60.00,N/A,$58.20,N/A,N/A,N/A,$30.60,N/A,$58.20,N/A,$60.00,N/A,N/A,$58.20
3093322,0309,84403,,,,,N/A,N/A,"MAYO TESTOSTERONE T,BIO FREE",$52.46,$39.00,$30.60,$60.00,N/A,$58.20,N/A,N/A,N/A,$30.60,N/A,$58.20,N/A,$60.00,N/A,N/A,$58.20
3093405,0309,84403,,,,,N/A,N/A,"MAYO TESTOSTERONE,TOTAL",$60.54,$45.00,$30.60,$60.00,N/A,$58.20,N/A,N/A,N/A,$30.60,N/A,$58.20,N/A,$60.00,N/A,N/A,$58.20
3093323,0309,84410,,,,,N/A,N/A,"MAYO TESTOSTERONE T,BIO FREE",$103.92,$77.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3093407,0309,84410,,,,,N/A,N/A,"MAYO TESTOSTERONE,BIOAVAILABLE",$114.01,$84.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3091832,0309,84432,,,,,N/A,N/A,MAYO THYROGLOBULIN,$309.74,$230.25,$25.57,$307.00,N/A,$297.79,N/A,N/A,N/A,$25.57,N/A,$297.79,N/A,$307.00,N/A,N/A,$297.79
3093705,0309,84450,,,,,N/A,N/A,MAYO AST,$71.63,$53.25,$17.18,$103.00,N/A,$99.91,N/A,N/A,N/A,$17.18,N/A,$99.91,N/A,$103.00,N/A,N/A,$99.91
3093702,0309,84460,,,,,N/A,N/A,MAYO ALT,$44.39,$33.00,$6.29,$94.00,N/A,$91.18,N/A,N/A,N/A,$6.29,N/A,$91.18,N/A,$94.00,N/A,N/A,$91.18
3092991,0309,84478,,,,,N/A,N/A,"MAYO TRIGLYCERIDES,BF",$211.88,$157.50,$15.51,$210.00,N/A,$203.70,N/A,N/A,N/A,$15.51,N/A,$203.70,N/A,$210.00,N/A,N/A,$203.70
3093240,0309,84478,,,,,N/A,N/A,TRIGLYCERIDES TOTAL CDC S,$21.19,$15.75,$15.51,$210.00,N/A,$203.70,N/A,N/A,N/A,$15.51,N/A,$203.70,N/A,$210.00,N/A,N/A,$203.70
3093568,0309,84478,,,,,N/A,N/A,MAYO ASSAY OF TRIGLYCERIDES,$16.14,$12.00,$15.51,$210.00,N/A,$203.70,N/A,N/A,N/A,$15.51,N/A,$203.70,N/A,$210.00,N/A,N/A,$203.70
3093707,0309,84478,,,,,N/A,N/A,MAYO TRIGLYCERIDE,$78.70,$58.50,$15.51,$210.00,N/A,$203.70,N/A,N/A,N/A,$15.51,N/A,$203.70,N/A,$210.00,N/A,N/A,$203.70
3095522,0309,84479,,,,,N/A,N/A,Mayo T3 Uptake,$47.42,$35.25,$6.71,$127.00,N/A,$123.19,N/A,N/A,N/A,$6.71,N/A,$123.19,N/A,$127.00,N/A,N/A,$123.19
3099408,0309,84479,,,,,N/A,N/A,MAYO FREE THYROXINE INDEX,$128.14,$95.25,$6.71,$127.00,N/A,$123.19,N/A,N/A,N/A,$6.71,N/A,$123.19,N/A,$127.00,N/A,N/A,$123.19
3099287,0309,84482,,,,,N/A,N/A,MAYO T3 REVERSE,$493.37,$366.75,$20.54,$489.00,N/A,$474.33,N/A,N/A,N/A,$20.54,N/A,$474.33,N/A,$489.00,N/A,N/A,$474.33
3093650,0309,84484,,,,,N/A,N/A,"MAYO TROPONIN, 5TH GEN",$64.57,$48.00,$18.86,$190.00,N/A,$184.30,N/A,N/A,N/A,$18.86,N/A,$184.30,N/A,$190.00,N/A,N/A,$184.30
3099925,0309,84517,,,,,N/A,N/A,Mayo Hepatitis B Viral Dna Qt,$430.82,$320.25,$15.09,$427.00,N/A,$414.19,N/A,N/A,N/A,$15.09,N/A,$414.19,N/A,$427.00,N/A,N/A,$414.19
3095435,0309,84540,,,,,N/A,N/A,MAYO SUPERSATURATION 24HR URIN,$12.11,$9.00,$4.61,$24.00,N/A,$23.28,N/A,N/A,N/A,$4.61,N/A,$23.28,N/A,$24.00,N/A,N/A,$23.28
3095429,0309,84560,,,,,N/A,N/A,MAYO SUPERSATURATION 24HR URIN,$11.10,$8.25,$5.45,$186.00,N/A,$180.42,N/A,N/A,N/A,$5.45,N/A,$180.42,N/A,$186.00,N/A,N/A,$180.42
3099815,0309,84560,,,,,N/A,N/A,MAYO URIC ACID 24 HR URINE,$89.80,$66.75,$5.45,$186.00,N/A,$180.42,N/A,N/A,N/A,$5.45,N/A,$180.42,N/A,$186.00,N/A,N/A,$180.42
3092793,0309,84585,,,,,N/A,N/A,MAYO VMA&HVA PEDIATRIC URINE,$80.72,$60.00,$6.29,$296.00,N/A,$287.12,N/A,N/A,N/A,$6.29,N/A,$287.12,N/A,$296.00,N/A,N/A,$287.12
3091349,0309,84588,,,,,N/A,N/A,MAYO ARGININE VASOPRESSIN,$283.51,$210.75,$42.33,$281.00,N/A,$272.57,N/A,N/A,N/A,$42.33,N/A,$272.57,N/A,$281.00,N/A,N/A,$272.57
3093063,0309,84591,,,,,N/A,N/A,MAYO BIOTIN (VIT B7),$155.38,$115.50,$13.83,$186.00,N/A,$180.42,N/A,N/A,N/A,$13.83,N/A,$180.42,N/A,$186.00,N/A,N/A,$180.42
3093064,0309,84591,,,,,N/A,N/A,MAYO PANTOTHENIC ACID (VIT B5),$118.05,$87.75,$13.83,$186.00,N/A,$180.42,N/A,N/A,N/A,$13.83,N/A,$180.42,N/A,$186.00,N/A,N/A,$180.42
3095445,0309,84591,,,,,N/A,N/A,"MAYO VITAMIN B3 & METABOLITES,",$187.66,$139.50,$13.83,$186.00,N/A,$180.42,N/A,N/A,N/A,$13.83,N/A,$180.42,N/A,$186.00,N/A,N/A,$180.42
3091706,0309,84597,,,,,N/A,N/A,MAYO VITAMIN K1,$266.36,$198.00,$20.54,$264.00,N/A,$256.08,N/A,N/A,N/A,$20.54,N/A,$256.08,N/A,$264.00,N/A,N/A,$256.08
3092573,0309,84620,,,,,N/A,N/A,MAYO XYLOSE ABSORPTION TEST,$106.95,$79.50,$20.54,$386.00,N/A,$374.42,N/A,N/A,N/A,$20.54,N/A,$374.42,N/A,$386.00,N/A,N/A,$374.42
3092324,0309,84630,,,,,N/A,N/A,MAYO ZINC RBC'S,$159.41,$118.50,$15.51,$158.00,N/A,$153.26,N/A,N/A,N/A,$15.51,N/A,$153.26,N/A,$158.00,N/A,N/A,$153.26
3095468,0309,84630,,,,,N/A,N/A,"MAYO ZINC, S",$30.27,$22.50,$15.51,$158.00,N/A,$153.26,N/A,N/A,N/A,$15.51,N/A,$153.26,N/A,$158.00,N/A,N/A,$153.26
3095519,0309,84630,,,,,N/A,N/A,"Mayo Zinc, Plasma",$89.80,$66.75,$15.51,$158.00,N/A,$153.26,N/A,N/A,N/A,$15.51,N/A,$153.26,N/A,$158.00,N/A,N/A,$153.26
3090548,0309,84702,,,,,N/A,N/A,FAHC HCG,$279.48,$207.75,$268.69,$277.00,N/A,$268.69,N/A,N/A,N/A,$277.00,N/A,$268.69,N/A,$277.00,N/A,N/A,$268.69
3092209,0309,84999,,,,,N/A,N/A,MAYO OSMOLALITY FECES,$64.57,$48.00,$9.22,$438.00,N/A,$424.86,N/A,N/A,N/A,$9.22,N/A,$424.86,N/A,$438.00,N/A,N/A,$424.86
3092226,0309,84999,,,,,N/A,N/A,"MAYO POTASSIUM QN,FECES",$114.01,$84.75,$9.22,$438.00,N/A,$424.86,N/A,N/A,N/A,$9.22,N/A,$424.86,N/A,$438.00,N/A,N/A,$424.86
3092299,0309,84999,,,,,N/A,N/A,MAY YO AB,$655.81,$487.50,$9.22,$438.00,N/A,$424.86,N/A,N/A,N/A,$9.22,N/A,$424.86,N/A,$438.00,N/A,N/A,$424.86
3092515,0309,84999,,,,,N/A,N/A,Mayo Sycamore Ige,$23.21,$17.25,$9.22,$438.00,N/A,$424.86,N/A,N/A,N/A,$9.22,N/A,$424.86,N/A,$438.00,N/A,N/A,$424.86
3092595,0309,84999,,,,,N/A,N/A,MAYO HPV TRITECT BY PCR,$658.84,$489.75,$9.22,$438.00,N/A,$424.86,N/A,N/A,N/A,$9.22,N/A,$424.86,N/A,$438.00,N/A,N/A,$424.86
3093292,0309,84999,,,,,N/A,N/A,MAYO TESTOSTERONE TOT/BIO,$7.06,$5.25,$9.22,$438.00,N/A,$424.86,N/A,N/A,N/A,$9.22,N/A,$424.86,N/A,$438.00,N/A,N/A,$424.86
3093333,0309,84999,,,,,N/A,N/A,"Mayo Aspirin,Ige",$70.63,$52.50,$9.22,$438.00,N/A,$424.86,N/A,N/A,N/A,$9.22,N/A,$424.86,N/A,$438.00,N/A,N/A,$424.86
3093471,0309,84999,,,,,N/A,N/A,"Mayo C. albicans,IgG",$71.63,$53.25,$9.22,$438.00,N/A,$424.86,N/A,N/A,N/A,$9.22,N/A,$424.86,N/A,$438.00,N/A,N/A,$424.86
3093680,0309,84999,,,,,N/A,N/A,MAYO FLUCONAZOLE(DIFLUCAN),$129.14,$96.00,$9.22,$438.00,N/A,$424.86,N/A,N/A,N/A,$9.22,N/A,$424.86,N/A,$438.00,N/A,N/A,$424.86
3093697,0309,84999,,,,,N/A,N/A,MAYO RESIN T3 UPTAKE,$55.49,$41.25,$9.22,$438.00,N/A,$424.86,N/A,N/A,N/A,$9.22,N/A,$424.86,N/A,$438.00,N/A,N/A,$424.86
3099972,0309,84999,,,,,N/A,N/A,MAYO HER-2/NEU,$441.92,$328.50,$9.22,$438.00,N/A,$424.86,N/A,N/A,N/A,$9.22,N/A,$424.86,N/A,$438.00,N/A,N/A,$424.86
3093526,0309,85013,,,,,N/A,N/A,"UVM HEMATOCRIT,BODY FLUID",$13.12,$9.75,$6.29,$13.00,N/A,$12.61,N/A,N/A,N/A,$6.29,N/A,$12.61,N/A,$13.00,N/A,N/A,$12.61
3095457,0309,85045,,,,,N/A,N/A,UVM RETICULOCYTE COUNT,$84.75,$63.00,$3.77,$84.00,N/A,$81.48,N/A,N/A,N/A,$3.77,N/A,$81.48,N/A,$84.00,N/A,N/A,$81.48
3050403,0309,85048,,,,,N/A,N/A,WBC ONLY,$54.48,$40.50,$4.61,$126.00,N/A,$122.22,N/A,N/A,N/A,$4.61,N/A,$122.22,N/A,$126.00,N/A,N/A,$122.22
3095460,0309,85230,,,,,N/A,N/A,MAYO COAG FACTOR VII ASSAY,$126.12,$93.75,$15.51,$150.00,N/A,$145.50,N/A,N/A,N/A,$15.51,N/A,$145.50,N/A,$150.00,N/A,N/A,$145.50
3091772,0309,85240,,,,,N/A,N/A,FAHC FACTOR 8 ASSAY,$310.75,$231.00,$21.38,$308.00,N/A,$298.76,N/A,N/A,N/A,$21.38,N/A,$298.76,N/A,$308.00,N/A,N/A,$298.76
3093622,0309,85240,,,,,N/A,N/A,MAYO COAG FACTOR VIII ASSAY,$70.63,$52.50,$21.38,$308.00,N/A,$298.76,N/A,N/A,N/A,$21.38,N/A,$298.76,N/A,$308.00,N/A,N/A,$298.76
3092545,0309,85245,,,,,N/A,N/A,FAHC VON WILLEBRAND FACT ACTIV,$142.26,$105.75,$21.38,$141.00,N/A,$136.77,N/A,N/A,N/A,$21.38,N/A,$136.77,N/A,$141.00,N/A,N/A,$136.77
3093265,0309,85245,,,,,N/A,N/A,MAYO RISTOCETIN CO-FACTOR,$67.60,$50.25,$21.38,$141.00,N/A,$136.77,N/A,N/A,N/A,$21.38,N/A,$136.77,N/A,$141.00,N/A,N/A,$136.77
3092546,0309,85246,,,,,N/A,N/A,FAHC VON WILLEBRAND FACT ANTIG,$226.00,$168.00,$27.66,$224.00,N/A,$217.28,N/A,N/A,N/A,$27.66,N/A,$217.28,N/A,$224.00,N/A,N/A,$217.28
3093623,0309,85246,,,,,N/A,N/A,MAYO VON WILLEBRAND FACTOR Ag,$88.79,$66.00,$27.66,$224.00,N/A,$217.28,N/A,N/A,N/A,$27.66,N/A,$217.28,N/A,$224.00,N/A,N/A,$217.28
3092544,0309,85247,,,,,N/A,N/A,MAYO VON WILLEBRAND FACTOR MUL,$126.12,$93.75,$27.66,$125.00,N/A,$121.25,N/A,N/A,N/A,$27.66,N/A,$121.25,N/A,$125.00,N/A,N/A,$121.25
3092139,0309,85250,,,,,N/A,N/A,FAHC FACTOR 9 ASSAY,$159.41,$118.50,$27.66,$158.00,N/A,$153.26,N/A,N/A,N/A,$27.66,N/A,$153.26,N/A,$158.00,N/A,N/A,$153.26
3092838,0309,85260,,,,,N/A,N/A,MAYO FACTOR X CHROMOGENIC,$330.93,$246.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3092210,0309,85280,,,,,N/A,N/A,MAYO COAG FACTOR 12,$155.38,$115.50,$21.38,$154.00,N/A,$149.38,N/A,N/A,N/A,$21.38,N/A,$149.38,N/A,$154.00,N/A,N/A,$149.38
3093588,0309,85290,,,,,N/A,N/A,UVM FACTOR 13 ANTIGEN,$120.06,$89.25,$23.05,$119.00,N/A,$115.43,N/A,N/A,N/A,$23.05,N/A,$115.43,N/A,$119.00,N/A,N/A,$115.43
3093534,0309,85300,,,,,N/A,N/A,"MAYO ANTITHROMBIN ACTIVITY,P",$49.44,$36.75,$19.70,$308.00,N/A,$298.76,N/A,N/A,N/A,$19.70,N/A,$298.76,N/A,$308.00,N/A,N/A,$298.76
3095442,0309,85302,,,,,N/A,N/A,"MAYO PROTEIN C, TOTAL ANTIGEN",$96.86,$72.00,$12.99,$591.00,N/A,$573.27,N/A,N/A,N/A,$12.99,N/A,$573.27,N/A,$591.00,N/A,N/A,$573.27
3099286,0309,85302,,,,,N/A,N/A,MAYO PROTEIN C Ag,$596.28,$443.25,$12.99,$591.00,N/A,$573.27,N/A,N/A,N/A,$12.99,N/A,$573.27,N/A,$591.00,N/A,N/A,$573.27
3099610,0309,85307,,,,,N/A,N/A,MAYO APC RESISTANCE,$403.58,$300.00,$18.44,$400.00,N/A,$388.00,N/A,N/A,N/A,$18.44,N/A,$388.00,N/A,$400.00,N/A,N/A,$388.00
3092741,0309,85366,,,,,N/A,N/A,MAYO PROLONGED CLOT TIME PRO,$170.51,$126.75,$18.44,$199.00,N/A,$193.03,N/A,N/A,N/A,$18.44,N/A,$193.03,N/A,$199.00,N/A,N/A,$193.03
3093439,0309,85366,,,,,N/A,N/A,MAYO SOLUBLE FIBER MONOMER,$200.78,$149.25,$18.44,$199.00,N/A,$193.03,N/A,N/A,N/A,$18.44,N/A,$193.03,N/A,$199.00,N/A,N/A,$193.03
3092740,0309,85379,,,,,N/A,N/A,MAYO PROLONGED CLOT TIME PRO,$199.77,$148.50,$11.74,$307.00,N/A,$297.79,N/A,N/A,N/A,$11.74,N/A,$297.79,N/A,$307.00,N/A,N/A,$297.79
3099802,0309,85379,,,,,N/A,N/A,FAHC THROMBOSIS PANEL/ NO COUM,$309.74,$230.25,$11.74,$307.00,N/A,$297.79,N/A,N/A,N/A,$11.74,N/A,$297.79,N/A,$307.00,N/A,N/A,$297.79
3092458,0309,85384,,,,,N/A,N/A,LRH FIBRINOGEN,$143.27,$106.50,$12.15,$165.00,N/A,$160.05,N/A,N/A,N/A,$12.15,N/A,$160.05,N/A,$165.00,N/A,N/A,$160.05
3092739,0309,85384,,,,,N/A,N/A,MAYO PROLONGED CLOT TIME PRO,$166.48,$123.75,$12.15,$165.00,N/A,$160.05,N/A,N/A,N/A,$12.15,N/A,$160.05,N/A,$165.00,N/A,N/A,$160.05
3093438,0309,85385,,,,,N/A,N/A,MAYO FIBRINOGEN ANTIGEN P,$140.24,$104.25,$11.74,$139.00,N/A,$134.83,N/A,N/A,N/A,$11.74,N/A,$134.83,N/A,$139.00,N/A,N/A,$134.83
3092742,0309,85390,,,,,N/A,N/A,MAYO PROLONGED CLOT TIME PRO,$103.92,$77.25,$17.18,$108.00,N/A,$104.76,N/A,N/A,N/A,$17.18,N/A,$104.76,N/A,$108.00,N/A,N/A,$104.76
3093625,0309,85390,,,,,N/A,N/A,MAYO VON WILLEBRAND DIS INTERP,$60.54,$45.00,$17.18,$108.00,N/A,$104.76,N/A,N/A,N/A,$17.18,N/A,$104.76,N/A,$108.00,N/A,N/A,$104.76
3095461,0309,85390,,,,,N/A,N/A,MAYO FVII INHIB TECH INTERPRET,$108.97,$81.00,$17.18,$108.00,N/A,$104.76,N/A,N/A,N/A,$17.18,N/A,$104.76,N/A,$108.00,N/A,N/A,$104.76
3093233,0309,85397,,,,,N/A,N/A,MAYO ADAMTS13 ACTIVITY INHIB,$203.81,$151.50,$62.95,$202.00,N/A,$195.94,N/A,N/A,N/A,$62.95,N/A,$195.94,N/A,$202.00,N/A,N/A,$195.94
3093624,0309,85397,,,,,N/A,N/A,MAYO VON WILLEBRAND FACOTR ACT,$119.05,$88.50,$62.95,$202.00,N/A,$195.94,N/A,N/A,N/A,$62.95,N/A,$195.94,N/A,$202.00,N/A,N/A,$195.94
3092704,0309,85461,,,,,N/A,N/A,FAHC FETAL SCREEN,$129.14,$96.00,$9.22,$128.00,N/A,$124.16,N/A,N/A,N/A,$9.22,N/A,$124.16,N/A,$128.00,N/A,N/A,$124.16
3092443,0309,85520,,,,,N/A,N/A,MAYO HEPARIN ANTI-XA ASSAY,$117.04,$87.00,$11.32,$116.00,N/A,$112.52,N/A,N/A,N/A,$11.32,N/A,$112.52,N/A,$116.00,N/A,N/A,$112.52
3092999,0309,85520,,,,,N/A,N/A,FAHC HEPARIN LEVEL LMWH,$90.80,$67.50,$11.32,$116.00,N/A,$112.52,N/A,N/A,N/A,$11.32,N/A,$112.52,N/A,$116.00,N/A,N/A,$112.52
3093310,0309,85520,,,,,N/A,N/A,UVM QUALITATIVE ANTI Xa,$88.79,$66.00,$11.32,$116.00,N/A,$112.52,N/A,N/A,N/A,$11.32,N/A,$112.52,N/A,$116.00,N/A,N/A,$112.52
3092227,0309,85549,,,,,N/A,N/A,MAYO LYSOZYME,$317.82,$236.25,$10.48,$315.00,N/A,$305.55,N/A,N/A,N/A,$10.48,N/A,$305.55,N/A,$315.00,N/A,N/A,$305.55
3092522,0309,85557,,,,,N/A,N/A,MAYO OSMOTIC FRAGILITY RBC,$128.14,$95.25,$22.63,$127.00,N/A,$123.19,N/A,N/A,N/A,$22.63,N/A,$123.19,N/A,$127.00,N/A,N/A,$123.19
3093676,0309,85598,,,,,N/A,N/A,MAYO HEXAGONAL PHOSPHOLIPID NE,$188.67,$140.25,$21.80,$187.00,N/A,$181.39,N/A,N/A,N/A,$21.80,N/A,$181.39,N/A,$187.00,N/A,N/A,$181.39
3092735,0309,85610,,,,,N/A,N/A,MAYO PROLONGED CLOT TIME PRO,$81.72,$60.75,$15.52,$81.00,N/A,$15.52,N/A,N/A,N/A,$21.80,N/A,$15.52,N/A,$81.00,N/A,N/A,$15.52
3092737,0309,85613,,,,,N/A,N/A,MAYO PROLONGED CLOT TIME PRO,$183.63,$136.50,$4.61,$182.00,N/A,$176.54,N/A,N/A,N/A,$4.61,N/A,$176.54,N/A,$182.00,N/A,N/A,$176.54
3092869,0309,85613,,,,,N/A,N/A,FAHC CA CONFIRM TEST,$41.37,$30.75,$4.61,$182.00,N/A,$176.54,N/A,N/A,N/A,$4.61,N/A,$176.54,N/A,$182.00,N/A,N/A,$176.54
3093273,0309,85613,,,,,N/A,N/A,MAYO DRVVT SCREEN & REFLEX,$35.31,$26.25,$4.61,$182.00,N/A,$176.54,N/A,N/A,N/A,$4.61,N/A,$176.54,N/A,$182.00,N/A,N/A,$176.54
3093311,0309,85613,,,,,N/A,N/A,UVM 50/50 MIX DVV,$24.21,$18.00,$4.61,$182.00,N/A,$176.54,N/A,N/A,N/A,$4.61,N/A,$176.54,N/A,$182.00,N/A,N/A,$176.54
3099311,0309,85660,,,,,N/A,N/A,FAHC SICKLE CELL TEST,$107.96,$80.25,$3.35,$107.00,N/A,$103.79,N/A,N/A,N/A,$3.35,N/A,$103.79,N/A,$107.00,N/A,N/A,$103.79
3092738,0309,85670,,,,,N/A,N/A,MAYO PROLONGED CLOT TIME PRO,$94.84,$70.50,$6.71,$94.00,N/A,$91.18,N/A,N/A,N/A,$6.71,N/A,$91.18,N/A,$94.00,N/A,N/A,$91.18
3092736,0309,85730,,,,,N/A,N/A,MAYO PROLONGED CLOT TIME PRO,$118.05,$87.75,$7.13,$278.00,N/A,$269.66,N/A,N/A,N/A,$7.13,N/A,$269.66,N/A,$278.00,N/A,N/A,$269.66
3093379,0309,85732,,,,,N/A,N/A,UVM SILICA CONFIRMATORY TEST,$51.46,$38.25,$7.13,$232.00,N/A,$225.04,N/A,N/A,N/A,$7.13,N/A,$225.04,N/A,$232.00,N/A,N/A,$225.04
3093664,0309,85999,,,,,N/A,N/A,"MAYO EOSINOPHILS, URINE",$99.89,$74.25,$13.83,$99.00,N/A,$96.03,N/A,N/A,N/A,$13.83,N/A,$96.03,N/A,$99.00,N/A,N/A,$96.03
3093041,0309,86001,,,,,N/A,N/A,MAYO PORK IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093042,0309,86001,,,,,N/A,N/A,MAYO TURKEY IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093043,0309,86001,,,,,N/A,N/A,MAYO GARLIC IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093044,0309,86001,,,,,N/A,N/A,MAYO MUSHROOM IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093045,0309,86001,,,,,N/A,N/A,MAYO ONION IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093046,0309,86001,,,,,N/A,N/A,MAYO BROCCOLI IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093047,0309,86001,,,,,N/A,N/A,MAYO CHEESE CHEDDAR IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093048,0309,86001,,,,,N/A,N/A,MAYO CHICKEN IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093049,0309,86001,,,,,N/A,N/A,MAYO APPLE IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093050,0309,86001,,,,,N/A,N/A,MAYO BEEF IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093072,0309,86001,,,,,N/A,N/A,MAYO WHEAT IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093073,0309,86001,,,,,N/A,N/A,MAYO OAT IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093074,0309,86001,,,,,N/A,N/A,MAYO GLUTEN IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093075,0309,86001,,,,,N/A,N/A,MAYO CASEIN IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093076,0309,86001,,,,,N/A,N/A,MAYO WHEY IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093077,0309,86001,,,,,N/A,N/A,MAYO EGG YOLK IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093078,0309,86001,,,,,N/A,N/A,MAYO EGG WHITE IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093079,0309,86001,,,,,N/A,N/A,MAYO CORN IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093080,0309,86001,,,,,N/A,N/A,MAYO CHOCOLATE/CACAO IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093081,0309,86001,,,,,N/A,N/A,MAYO PEANUT IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093090,0309,86001,,,,,N/A,N/A,MAYO SOYBEAN IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093142,0309,86001,,,,,N/A,N/A,"MAYO LETTUCE,IgG",$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093152,0309,86001,,,,,N/A,N/A,MAYO ALMOND-FOOD IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093153,0309,86001,,,,,N/A,N/A,MAYO CABBAGE IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093154,0309,86001,,,,,N/A,N/A,MAYO TOMATO IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093155,0309,86001,,,,,N/A,N/A,MAYO CASHEW IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093156,0309,86001,,,,,N/A,N/A,MAYO RICE IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093157,0309,86001,,,,,N/A,N/A,MAYO SPINACH IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093169,0309,86001,,,,,N/A,N/A,MAYO CHEESE MOLD IgG,$77.69,$57.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093170,0309,86001,,,,,N/A,N/A,MAYO LIMA BEAN IgG,$77.69,$57.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093171,0309,86001,,,,,N/A,N/A,MAYO CHICK PEA IgG,$77.69,$57.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093172,0309,86001,,,,,N/A,N/A,MAYO BLACK BERRY IgG,$77.69,$57.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093173,0309,86001,,,,,N/A,N/A,MAYO BRUSSEL SPROUTS IgG,$77.69,$57.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093174,0309,86001,,,,,N/A,N/A,MAYO MALT IgG,$77.69,$57.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093175,0309,86001,,,,,N/A,N/A,MAYO HOPS IgG,$77.69,$57.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093176,0309,86001,,,,,N/A,N/A,MAYO BUCKWHEAT IgG,$77.69,$57.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093177,0309,86001,,,,,N/A,N/A,MAYO BRAZIL NUT IgG,$77.69,$57.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093178,0309,86001,,,,,N/A,N/A,MAYO CRANBERRY IgG,$77.69,$57.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093179,0309,86001,,,,,N/A,N/A,MAYO WHITE POTATO IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093180,0309,86001,,,,,N/A,N/A,MAYO SWEET POTATO IgG,$77.69,$57.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093181,0309,86001,,,,,N/A,N/A,MAYO ASPARAGUS IgG,$77.69,$57.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093183,0309,86001,,,,,N/A,N/A,MAYO CUCUMBER IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093184,0309,86001,,,,,N/A,N/A,MAYO GREEN PEA IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093185,0309,86001,,,,,N/A,N/A,MAYO LENTIL IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093186,0309,86001,,,,,N/A,N/A,MAYO COCONUT IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093187,0309,86001,,,,,N/A,N/A,MAYO CARROT IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093188,0309,86001,,,,,N/A,N/A,MAYO GREEN/STRING BEAN IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093189,0309,86001,,,,,N/A,N/A,MAYO ORANGE IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093190,0309,86001,,,,,N/A,N/A,MAYO BANANA IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093191,0309,86001,,,,,N/A,N/A,MAYO WALNUT FOOD IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093192,0309,86001,,,,,N/A,N/A,MAYO WATERMELON IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093193,0309,86001,,,,,N/A,N/A,MAYO CELERY IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093194,0309,86001,,,,,N/A,N/A,MAYO EGG WHOLE IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093195,0309,86001,,,,,N/A,N/A,MAYO BEAN NAVY/WHITE IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093196,0309,86001,,,,,N/A,N/A,MAYO BARLEY IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093197,0309,86001,,,,,N/A,N/A,MAYO BLUEBERRY IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093198,0309,86001,,,,,N/A,N/A,MAYO PECAN IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093199,0309,86001,,,,,N/A,N/A,MAYO RYE FOOD IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093200,0309,86001,,,,,N/A,N/A,MAYO PINEAPPLE IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093208,0309,86001,,,,,N/A,N/A,MAYO CAULIFLOWER IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093221,0309,86001,,,,,N/A,N/A,MAYO BLACK PEPPER IgG,$63.56,$47.25,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093222,0309,86001,,,,,N/A,N/A,MAYO RYE GRASS IgG,$77.69,$57.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093223,0309,86001,,,,,N/A,N/A,MAYO HADDOCK IgG,$77.69,$57.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093224,0309,86001,,,,,N/A,N/A,MAYO TUNA IgG,$77.69,$57.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093225,0309,86001,,,,,N/A,N/A,MAYO COFFEE IgG,$77.69,$57.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093234,0309,86001,,,,,N/A,N/A,MAYO PISTACHIO IgG,$77.69,$57.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093687,0309,86001,,,,,N/A,N/A,MAYO CANDIDA ALBICANS IgG,$64.57,$48.00,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093715,0309,86001,,,,,N/A,N/A,MAYO HYPERSEN PNEUMONITIS PANE,$174.55,$129.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093721,0309,86001,,,,,N/A,N/A,MAYO ALTERNIA TENUIS IgG,$25.22,$18.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093723,0309,86001,,,,,N/A,N/A,MAYO AUREOBASIDIUM PULLULANS,$25.22,$18.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093724,0309,86001,,,,,N/A,N/A,MAYO MICROPOLYSPORA FAENI IgG,$25.22,$18.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093725,0309,86001,,,,,N/A,N/A,MAYO PENICILLIUM CHRYSOGENUM,$25.22,$18.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093726,0309,86001,,,,,N/A,N/A,MAYO PHOMA BETAE IgG,$25.22,$18.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093728,0309,86001,,,,,N/A,N/A,MAYO TRICHODERMA VIRIDE IgG,$25.22,$18.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093730,0309,86001,,,,,N/A,N/A,MAYO BARLEY IgG,$21.19,$15.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093731,0309,86001,,,,,N/A,N/A,MAYO BEEF IgG,$21.19,$15.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093732,0309,86001,,,,,N/A,N/A,MAYO CASEIN IgG,$21.19,$15.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093733,0309,86001,,,,,N/A,N/A,MAYO CHICKEN IgG,$21.19,$15.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093734,0309,86001,,,,,N/A,N/A,MAYO CHOCOLATE/CACAO IgG,$21.19,$15.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093735,0309,86001,,,,,N/A,N/A,MAYO CODFISH/SCROD IgG,$21.19,$15.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093736,0309,86001,,,,,N/A,N/A,MAYO CORN IgG,$21.19,$15.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093737,0309,86001,,,,,N/A,N/A,MAYO EGG WHTIE IgG,$21.19,$15.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093738,0309,86001,,,,,N/A,N/A,MAYO MALT IgG,$21.19,$15.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093739,0309,86001,,,,,N/A,N/A,MAYO OAT IgG,$21.19,$15.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093740,0309,86001,,,,,N/A,N/A,MAYO ORANGE IgG,$21.19,$15.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093741,0309,86001,,,,,N/A,N/A,MAYO PEANUT IgG,$21.19,$15.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093742,0309,86001,,,,,N/A,N/A,MAYO PORK IgG,$21.19,$15.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093743,0309,86001,,,,,N/A,N/A,MAYO POTATO WHITE IgG,$21.19,$15.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093744,0309,86001,,,,,N/A,N/A,MAYO RYE FOOD IgG,$21.19,$15.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093745,0309,86001,,,,,N/A,N/A,MAYO SOYBEAN IgG,$21.19,$15.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093746,0309,86001,,,,,N/A,N/A,MAYO TOMATO IgG,$21.19,$15.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093747,0309,86001,,,,,N/A,N/A,MAYO WHEAT IgG,$21.19,$15.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093748,0309,86001,,,,,N/A,N/A,MAYO YEAST S. CEREVISAE IgG,$21.19,$15.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3095471,0309,86001,,,,,N/A,N/A,MAYO HYPERSENS PNEUMON PANEL,$25.22,$18.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
30937220,0309,86001,,,,,N/A,N/A,MAYO ASPERGILLUS FUMIGATUS IgG,$25.22,$18.75,$0.00,$63.00,N/A,$61.11,N/A,N/A,N/A,$0.00,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3091700,0309,86003,,,,,N/A,N/A,MAYO HORSEFLY/STABLEFLY,$54.48,$40.50,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3091701,0309,86003,,,,,N/A,N/A,MAYO FIRE ANT,$54.48,$40.50,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3091724,0309,86003,,,,,N/A,N/A,MAYO CANARY FEATHERS,$54.48,$40.50,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3091725,0309,86003,,,,,N/A,N/A,MAYO RABBIT EPITHELIUM,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3091728,0309,86003,,,,,N/A,N/A,MAYO ASPERGILLUS FUMIGATUS,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3091757,0309,86003,,,,,N/A,N/A,MAYO PEANUT IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092145,0309,86003,,,,,N/A,N/A,MAYO CHICKEN IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092208,0309,86003,,,,,N/A,N/A,MAYO CARMINE(RED) DYE IgE,$115.02,$85.50,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092238,0309,86003,,,,,N/A,N/A,MAYO ELM,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092239,0309,86003,,,,,N/A,N/A,MAYO WHITE ASH,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092240,0309,86003,,,,,N/A,N/A,MAYO HELMINTHOSPORUIM HALODES,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092241,0309,86003,,,,,N/A,N/A,MAYO FUSARIUM MONILIFORME,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092242,0309,86003,,,,,N/A,N/A,MAYO RED TOP,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092243,0309,86003,,,,,N/A,N/A,MAYO ORCHARD GRASS,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092244,0309,86003,,,,,N/A,N/A,MAYO RYE GRASS,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092377,0309,86003,,,,,N/A,N/A,"MAYO HONEYBEE VENOM, IGE",$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092378,0309,86003,,,,,N/A,N/A,"MAYO WHT FCD HRNT VENOM, IgE",$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092379,0309,86003,,,,,N/A,N/A,"MAYO YLW FACED HRNT VENOM, IgE",$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092380,0309,86003,,,,,N/A,N/A,"MAYO WASP VENOM, IgE",$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092381,0309,86003,,,,,N/A,N/A,"MAYO YLW JACKET VENNOM, IgE",$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092382,0309,86003,,,,,N/A,N/A,"MAYO BLUE MUSSELL, Ige",$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092383,0309,86003,,,,,N/A,N/A,"MAYO CLAM, Ige",$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092384,0309,86003,,,,,N/A,N/A,"MAYO OYSTER, Ige",$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092385,0309,86003,,,,,N/A,N/A,"MAYO SCALLOP, Ige",$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092412,0309,86003,,,,,N/A,N/A,"MAYO BANANA,IgE",$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092413,0309,86003,,,,,N/A,N/A,MAYO GREEN PEPPER IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092414,0309,86003,,,,,N/A,N/A,MAYO AVOCADO IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092415,0309,86003,,,,,N/A,N/A,MAYO KIWI FRUIT IgE,$31.28,$23.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092416,0309,86003,,,,,N/A,N/A,"MAYO CHESTNUT,SWEET IgE",$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092432,0309,86003,,,,,N/A,N/A,"MAYO SUNFLOWER SEED, IgE",$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092435,0309,86003,,,,,N/A,N/A,MAYO JUNE GRASS IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092501,0309,86003,,,,,N/A,N/A,"MAYO GOLDENROD, IgE",$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092513,0309,86003,,,,,N/A,N/A,MAYO GIANT RAGWEED IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092514,0309,86003,,,,,N/A,N/A,MAYO COTTONWOOD IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092516,0309,86003,,,,,N/A,N/A,MAYO EPICOCCUM PURPURAS IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092517,0309,86003,,,,,N/A,N/A,MAYO CURVULARIA LUNATA IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092519,0309,86003,,,,,N/A,N/A,MAYO CORN IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092520,0309,86003,,,,,N/A,N/A,MAYO WALNUT-FOOD IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092521,0309,86003,,,,,N/A,N/A,MAYO FOOD PANEL,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092524,0309,86003,,,,,N/A,N/A,MAYO SOYBEAN IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092525,0309,86003,,,,,N/A,N/A,MAYO CASEIN IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092528,0309,86003,,,,,N/A,N/A,MAYO PINEAPPLE IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092553,0309,86003,,,,,N/A,N/A,MAYO EPITHELIA PANEL #1,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092561,0309,86003,,,,,N/A,N/A,MAYO GLUTEN IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092563,0309,86003,,,,,N/A,N/A,Mayo Seasonal Allergen Panel,$147.31,$109.50,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092572,0309,86003,,,,,N/A,N/A,MAYO SPINACH IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092599,0309,86003,,,,,N/A,N/A,MAYO PINE NUT EgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092602,0309,86003,,,,,N/A,N/A,MAYO CRAB IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092603,0309,86003,,,,,N/A,N/A,MAYO LOBSTER IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092628,0309,86003,,,,,N/A,N/A,"MAYO HAMSTER,IgE",$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092633,0309,86003,,,,,N/A,N/A,MAYO MACADAMIA NUT IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092634,0309,86003,,,,,N/A,N/A,MAYO HADDOCK IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092635,0309,86003,,,,,N/A,N/A,MAYO MEGRIM IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092636,0309,86003,,,,,N/A,N/A,MAYO ALMOND IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092637,0309,86003,,,,,N/A,N/A,MAYO BRAZIL NUT IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092638,0309,86003,,,,,N/A,N/A,NAYO HALIBUT IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092639,0309,86003,,,,,N/A,N/A,MAYO HAZELNUT FOOD IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092640,0309,86003,,,,,N/A,N/A,MAYO TUNA IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092641,0309,86003,,,,,N/A,N/A,"MAYO SALMON,IgE",$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092642,0309,86003,,,,,N/A,N/A,"MAYO CODFISH, IgE",$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092650,0309,86003,,,,,N/A,N/A,"MAYO CHILI PEPPER, IgE",$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092651,0309,86003,,,,,N/A,N/A,"MAYO PAPRIKA,IgE",$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092652,0309,86003,,,,,N/A,N/A,"MAYO WHITE POTATO, IgE",$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092657,0309,86003,,,,,N/A,N/A,"MAYO ASPERGILLUS NIGER, IgE",$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092691,0309,86003,,,,,N/A,N/A,"MAYO FOD PANEL 2, IgE",$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092694,0309,86003,,,,,N/A,N/A,MAYO PEDIATRIC ALL SCR 3-8YR,$23.21,$17.25,$55.32,$138.00,N/A,$133.86,N/A,N/A,N/A,$55.32,N/A,$133.86,N/A,$138.00,N/A,N/A,$133.86
3092723,0309,86003,,,,,N/A,N/A,MAYO COCONUT IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092724,0309,86003,,,,,N/A,N/A,MAYO CASHEW IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092812,0309,86003,,,,,N/A,N/A,MAYO TREE PANEL #1,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092823,0309,86003,,,,,N/A,N/A,MAYO PECAN-FOOD IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092824,0309,86003,,,,,N/A,N/A,MAYO HONEY IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092825,0309,86003,,,,,N/A,N/A,MAYO PISTACHIO IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092826,0309,86003,,,,,N/A,N/A,MAYO MOSQUITO IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092828,0309,86003,,,,,N/A,N/A,MAYO HOUSE DUST PANEL,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092836,0309,86003,,,,,N/A,N/A,MAYO TREE PANEL #1,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092837,0309,86003,,,,,N/A,N/A,MAYO WEED #1 PANEL,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092861,0309,86003,,,,,N/A,N/A,"MAYO SPRUCE,IgE",$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092867,0309,86003,,,,,N/A,N/A,MAYO WHEY IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092868,0309,86003,,,,,N/A,N/A,"MAYO CHEESE AMERICAN, IgE",$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092888,0309,86003,,,,,N/A,N/A,"MAYO RICE,IgE",$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092889,0309,86003,,,,,N/A,N/A,MAYO BROCCOLI IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092890,0309,86003,,,,,N/A,N/A,"MAYO OAT,IgE",$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092891,0309,86003,,,,,N/A,N/A,MAYO PORK IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092892,0309,86003,,,,,N/A,N/A,MAYO BAKER'S YEAST IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092897,0309,86003,,,,,N/A,N/A,MAYO COTTAGE CHEESE IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092898,0309,86003,,,,,N/A,N/A,MAYO AUREOBASIDIUM PULLUL IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092899,0309,86003,,,,,N/A,N/A,MAYO BOTRYTIS CINEREA IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092900,0309,86003,,,,,N/A,N/A,MAYO STEMPHYLIUM IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092955,0309,86003,,,,,N/A,N/A,MAYO DOUGLAS FIR IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092956,0309,86003,,,,,N/A,N/A,MAYO BALD CYPRESS IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092978,0309,86003,,,,,N/A,N/A,MAYO ORANGE  IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092979,0309,86003,,,,,N/A,N/A,MAYO GRAPE IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092980,0309,86003,,,,,N/A,N/A,MAYO LEMON IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092981,0309,86003,,,,,N/A,N/A,MAYO GRAPEFRUIT IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092982,0309,86003,,,,,N/A,N/A,MAYO LIME IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092983,0309,86003,,,,,N/A,N/A,MAYO FOOD-FRUIT PANEL,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3092990,0309,86003,,,,,N/A,N/A,MAYO SQUASH IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093000,0309,86003,,,,,N/A,N/A,MAYO MACKEREL IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093001,0309,86003,,,,,N/A,N/A,MAYO TROUT IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093002,0309,86003,,,,,N/A,N/A,MAYO SOLE IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093003,0309,86003,,,,,N/A,N/A,MAYO SQUID IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093004,0309,86003,,,,,N/A,N/A,MAYO SWORDFISH IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093009,0309,86003,,,,,N/A,N/A,MAYO MANDARIN IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093011,0309,86003,,,,,N/A,N/A,"MAYO CHEESE,MOLD,IgE",$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093012,0309,86003,,,,,N/A,N/A,"MAYO COFFEE, IgE",$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093033,0309,86003,,,,,N/A,N/A,MAYO CUTVULARIA SPICIFERA IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093035,0309,86003,,,,,N/A,N/A,"MAYO RHODOTORULA,IgE",$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093056,0309,86003,,,,,N/A,N/A,"MAYO NUTMEG, IgE",$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093057,0309,86003,,,,,N/A,N/A,"MAYO CINNAMON, IgE",$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093067,0309,86003,,,,,N/A,N/A,MAYO VENOM BUMBLE BEE IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093082,0309,86003,,,,,N/A,N/A,"MAYO BARLEY,IgE",$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093083,0309,86003,,,,,N/A,N/A,"MAYO BLUEBERRY,IgE",$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093084,0309,86003,,,,,N/A,N/A,MAYO WATERMELON IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093085,0309,86003,,,,,N/A,N/A,"MAYO MELONS,IgE",$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093086,0309,86003,,,,,N/A,N/A,"MAYO APPLE ,IgE",$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093114,0309,86003,,,,,N/A,N/A,MAYO CHICKEN FEATHER IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093115,0309,86003,,,,,N/A,N/A,MAYO COW EPITHELIUM IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093116,0309,86003,,,,,N/A,N/A,MAYO GOAT IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093140,0309,86003,,,,,N/A,N/A,MAYO ASCARIS IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093141,0309,86003,,,,,N/A,N/A,"MAYO POPPY SEED, IgE",$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093158,0309,86003,,,,,N/A,N/A,MAYO ASPARAGUS IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093159,0309,86003,,,,,N/A,N/A,MAYO BRUSSEL SPROUTS IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093160,0309,86003,,,,,N/A,N/A,MAYO BUCKWHEAT IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093161,0309,86003,,,,,N/A,N/A,MAYO  CABBAGE IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093162,0309,86003,,,,,N/A,N/A,MAYO CARROT IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093163,0309,86003,,,,,N/A,N/A,MAYO CAULIFLOWER IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093164,0309,86003,,,,,N/A,N/A,MAYO CELERY IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093165,0309,86003,,,,,N/A,N/A,MAYO CHICK PEA IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093166,0309,86003,,,,,N/A,N/A,MAYO GREEN PEA IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093167,0309,86003,,,,,N/A,N/A,MAYO GREEN STRING BEAN IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093168,0309,86003,,,,,N/A,N/A,MAYO KIDNEY BEAN IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093182,0309,86003,,,,,N/A,N/A,MAYO SWEET POTATO IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093201,0309,86003,,,,,N/A,N/A,MAYO LIMA BEAN IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093202,0309,86003,,,,,N/A,N/A,MAYO MALT IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093203,0309,86003,,,,,N/A,N/A,MAYO RYE IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093204,0309,86003,,,,,N/A,N/A,MAYO CUCUMBER IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093205,0309,86003,,,,,N/A,N/A,MAYO HOP FRUIT IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093206,0309,86003,,,,,N/A,N/A,MAYO BLACKBERRY IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093207,0309,86003,,,,,N/A,N/A,MAYO GARLIC IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093215,0309,86003,,,,,N/A,N/A,MAYO CEDAR RED IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093216,0309,86003,,,,,N/A,N/A,MAYO EGG WHOLE IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093220,0309,86003,,,,,N/A,N/A,MAYO BLACK/WHITE PEPPER IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093253,0309,86003,,,,,N/A,N/A,MAYO CURRY IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093255,0309,86003,,,,,N/A,N/A,MAYO TETANUS TOXOID IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093256,0309,86003,,,,,N/A,N/A,MAYO AMPICILLIN IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093264,0309,86003,,,,,N/A,N/A,MAYO PEPPER CAYENNE IgE,$54.48,$40.50,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093266,0309,86003,,,,,N/A,N/A,MAYO PAPAYA IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093270,0309,86003,,,,,N/A,N/A,MAYO ROUGH MARSH ELDER IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093271,0309,86003,,,,,N/A,N/A,MAYO COCKLEBUR IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093272,0309,86003,,,,,N/A,N/A,MAYO WORMWOOD IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093277,0309,86003,,,,,N/A,N/A,MAYO MOUSE PROTEIN IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093278,0309,86003,,,,,N/A,N/A,MAYO CHERRY IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093279,0309,86003,,,,,N/A,N/A,MAYO APRICOT IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093280,0309,86003,,,,,N/A,N/A,MAYO PEAR IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093281,0309,86003,,,,,N/A,N/A,MAYO NECTARINE IgE,$72.64,$54.00,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093282,0309,86003,,,,,N/A,N/A,MAYO PERCH IgE,$54.48,$40.50,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093283,0309,86003,,,,,N/A,N/A,MAYO PLUM IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093284,0309,86003,,,,,N/A,N/A,MAYO WALNUT TREE IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093325,0309,86003,,,,,N/A,N/A,MAYO LENTIL IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093337,0309,86003,,,,,N/A,N/A,MAYO EPICOCCIM NIRUM IgE,$72.64,$54.00,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093344,0309,86003,,,,,N/A,N/A,"MAYO EGGPLANT,IgE",$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093392,0309,86003,,,,,N/A,N/A,MAYO GUM CARAGEENAN IgE,$72.64,$54.00,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093413,0309,86003,,,,,N/A,N/A,MAYO MUSTARD IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093460,0309,86003,,,,,N/A,N/A,"MAYO CAROB,IgE",$21.19,$15.75,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093467,0309,86003,,,,,N/A,N/A,Mayo Peach Ige,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093478,0309,86003,,,,,N/A,N/A,MAYO DEER IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093482,0309,86003,,,,,N/A,N/A,MAYO WHITE BEAN IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093519,0309,86003,,,,,N/A,N/A,MAYO DOCK YELLOW IgE,$63.56,$47.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093549,0309,86003,,,,,N/A,N/A,MAYO PEANUT COMPONENT REFLEX,$11.10,$8.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093615,0309,86003,,,,,N/A,N/A,MAYO RESP PROFILE REG 1N ATLAN,$9.08,$6.75,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093674,0309,86003,,,,,N/A,N/A,"MAYO GALACTOSE-ALPHA-1,3-GALAC",$87.78,$65.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093685,0309,86003,,,,,N/A,N/A,MAYO INSULIN (HUMAN) IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093688,0309,86003,,,,,N/A,N/A,MAYO GUINEA PIG EPITHELIUM IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3095382,0309,86003,,,,,N/A,N/A,MAYO GRASS PANEL #2,$57.51,$42.75,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3095406,0309,86003,,,,,N/A,N/A,"MAYO MUSHROOM, IgE",$40.36,$30.00,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3095413,0309,86003,,,,,N/A,N/A,MAYO GINGER IgE,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3095451,0309,86003,,,,,N/A,N/A,"MAYO ANISE, IgE",$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3095500,0309,86003,,,,,N/A,N/A,Mayo Bean Black Ige,$62.55,$46.50,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3095518,0309,86003,,,,,N/A,N/A,Mayo Jalapeno/Chipotle Ige,$62.55,$46.50,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3099690,0309,86003,,,,,N/A,N/A,MAYO OAK,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3099691,0309,86003,,,,,N/A,N/A,MAYO TIMOTHY GRASS,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3099692,0309,86003,,,,,N/A,N/A,NORTHEASTERN ALLERGY SCREEN,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3099693,0309,86003,,,,,N/A,N/A,MAYO SHORT RAGWEED,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3099694,0309,86003,,,,,N/A,N/A,NORTHEASTERN ALLERGY SCREEN,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3099695,0309,86003,,,,,N/A,N/A,MAYO CAT,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3099696,0309,86003,,,,,N/A,N/A,MAYO DOG,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3099697,0309,86003,,,,,N/A,N/A,MAYO CLADOSPORIUM,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3099698,0309,86003,,,,,N/A,N/A,MAYO ALTERNARIA TENUIS,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3099699,0309,86003,,,,,N/A,N/A,MAYO HOUSE DUST DF,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3099983,0309,86003,,,,,N/A,N/A,MAYO FINCH FEATHERS,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3099993,0309,86003,,,,,N/A,N/A,MAYO FOOD-NUT PANEL #2,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3099994,0309,86003,,,,,N/A,N/A,MAYO FOOD-FRUIT PANEL,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3099996,0309,86003,,,,,N/A,N/A,MAYO FOOD-GRAIN PANEL,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3099997,0309,86003,,,,,N/A,N/A,MAYO FOOD-MEAT PANEL,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3099998,0309,86003,,,,,N/A,N/A,MAYO FOOD-SEAFOOD PANEL,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3099999,0309,86003,,,,,N/A,N/A,MAYO FOOD NUT PANEL #1,$23.21,$17.25,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
6093461,0309,86003,,,,,N/A,N/A,"MAYO ANNATTO SEED, IgE",$78.70,$58.50,$9.22,$23.00,N/A,$22.31,N/A,N/A,N/A,$9.22,N/A,$22.31,N/A,$23.00,N/A,N/A,$22.31
3093550,0309,86008,,,,,N/A,N/A,MAYO PEANUT COMPONENTS,$380.37,$282.75,$31.45,$565.00,N/A,$548.05,N/A,N/A,N/A,$31.45,N/A,$548.05,N/A,$565.00,N/A,N/A,$548.05
3095415,0309,86008,,,,,N/A,N/A,MAYO OVOMUCOID IgE,$23.21,$17.25,$6.29,$113.00,N/A,$109.61,N/A,N/A,N/A,$6.29,N/A,$109.61,N/A,$113.00,N/A,N/A,$109.61
3095416,0309,86008,,,,,N/A,N/A,MAYO OVALBUMIN IgE,$23.21,$17.25,$6.29,$113.00,N/A,$109.61,N/A,N/A,N/A,$6.29,N/A,$109.61,N/A,$113.00,N/A,N/A,$109.61
3095452,0309,86008,,,,,N/A,N/A,MAYO WALNUT COMPONENT rJUG r1,$114.01,$84.75,$6.29,$113.00,N/A,$109.61,N/A,N/A,N/A,$6.29,N/A,$109.61,N/A,$113.00,N/A,N/A,$109.61
3095453,0309,86008,,,,,N/A,N/A,MAYO WALNUT COMPONENT rJUG r 3,$114.01,$84.75,$6.29,$113.00,N/A,$109.61,N/A,N/A,N/A,$6.29,N/A,$109.61,N/A,$113.00,N/A,N/A,$109.61
3095454,0309,86008,,,,,N/A,N/A,MAYO CASHEW COMPONENT rANA 0 3,$114.01,$84.75,$6.29,$113.00,N/A,$109.61,N/A,N/A,N/A,$6.29,N/A,$109.61,N/A,$113.00,N/A,N/A,$109.61
3095455,0309,86008,,,,,N/A,N/A,MAYO HAZELNUT COMPONENT PANEL,$322.86,$240.00,$6.29,$113.00,N/A,$109.61,N/A,N/A,N/A,$6.29,N/A,$109.61,N/A,$113.00,N/A,N/A,$109.61
3093134,0309,86021,,,,,N/A,N/A,MAYO GRANULOCYTE Ab,$88.79,$66.00,$21.38,$88.00,N/A,$85.36,N/A,N/A,N/A,$21.38,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3092298,0309,86022,,,,,N/A,N/A,MAYO HERARIN - PF4 AB,$299.66,$222.75,$18.02,$297.00,N/A,$288.09,N/A,N/A,N/A,$18.02,N/A,$288.09,N/A,$297.00,N/A,N/A,$288.09
3093640,0309,86022,,,,,N/A,N/A,MAYO PLATELET ANTIBODY SCREEN,$95.85,$71.25,$18.02,$297.00,N/A,$288.09,N/A,N/A,N/A,$18.02,N/A,$288.09,N/A,$297.00,N/A,N/A,$288.09
3099813,0309,86022,,,,,N/A,N/A,MAYO DLL BOUND PLATELET AUTOAB,$768.81,$571.50,$18.02,$297.00,N/A,$288.09,N/A,N/A,N/A,$18.02,N/A,$288.09,N/A,$297.00,N/A,N/A,$288.09
3093296,0309,86038,,,,,N/A,N/A,MAYO CONNECTIVE TISS DISEASE,$26.23,$19.50,$15.09,$236.00,N/A,$228.92,N/A,N/A,N/A,$15.09,N/A,$228.92,N/A,$236.00,N/A,N/A,$228.92
3093531,0309,86038,,,,,N/A,N/A,MAYO AUTOIMMUNE LIVER DISEASE,$16.14,$12.00,$15.09,$236.00,N/A,$228.92,N/A,N/A,N/A,$15.09,N/A,$228.92,N/A,$236.00,N/A,N/A,$228.92
3093039,0309,86039,,,,,N/A,N/A,UVMMC ANA TITER,$23.21,$17.25,$14.67,$237.00,N/A,$229.89,N/A,N/A,N/A,$14.67,N/A,$229.89,N/A,$237.00,N/A,N/A,$229.89
3091795,0309,86060,,,,,N/A,N/A,MAYO STREPTOCOCCAL AB,$91.81,$68.25,$13.41,$128.00,N/A,$124.16,N/A,N/A,N/A,$13.41,N/A,$124.16,N/A,$128.00,N/A,N/A,$124.16
3092917,0309,86060,,,,,N/A,N/A,FAHC ASO TITER,$129.14,$96.00,$13.41,$128.00,N/A,$124.16,N/A,N/A,N/A,$13.41,N/A,$124.16,N/A,$128.00,N/A,N/A,$124.16
3092810,0309,86088,,,,,N/A,N/A,MAYO CONNECTIVE TISS DIS CAS,$48.43,$36.00,$8.80,$48.00,N/A,$46.56,N/A,N/A,N/A,$8.80,N/A,$46.56,N/A,$48.00,N/A,N/A,$46.56
3099545,0309,86140,,,,,N/A,N/A,Crp High Sensitivity,$70.63,$52.50,$67.90,$70.00,N/A,$67.90,N/A,N/A,N/A,$70.00,N/A,$67.90,N/A,$70.00,N/A,N/A,$67.90
3093237,0309,86141,,,,,N/A,N/A,C-REACTIVE PROT HIGH SEN,$89.80,$66.75,$6.29,$89.00,N/A,$86.33,N/A,N/A,N/A,$6.29,N/A,$86.33,N/A,$89.00,N/A,N/A,$86.33
3093394,0309,86141,,,,,N/A,N/A,UVM CRP HIGH SENSITIVITY,$31.28,$23.25,$6.29,$89.00,N/A,$86.33,N/A,N/A,N/A,$6.29,N/A,$86.33,N/A,$89.00,N/A,N/A,$86.33
3092988,0309,86146,,,,,N/A,N/A,"MAYO BETA 2 GP1,IgG/IgM",$701.21,$521.25,$31.02,$92.00,N/A,$89.24,N/A,N/A,N/A,$31.02,N/A,$89.24,N/A,$92.00,N/A,N/A,$89.24
3093058,0309,86146,,,,,N/A,N/A,UVM BETA 2 GLYCOPROTEIN IgG,$46.41,$34.50,$15.51,$46.00,N/A,$44.62,N/A,N/A,N/A,$15.51,N/A,$44.62,N/A,$46.00,N/A,N/A,$44.62
3093059,0309,86146,,,,,N/A,N/A,UVM BETA 2 GLYCOPROTEIN IgM,$46.41,$34.50,$15.51,$46.00,N/A,$44.62,N/A,N/A,N/A,$15.51,N/A,$44.62,N/A,$46.00,N/A,N/A,$44.62
3093060,0309,86146,,,,,N/A,N/A,UVM BETA 2 GLYCOPROTEIN IgA,$46.41,$34.50,$15.51,$46.00,N/A,$44.62,N/A,N/A,N/A,$15.51,N/A,$44.62,N/A,$46.00,N/A,N/A,$44.62
3092699,0309,86147,,,,,N/A,N/A,MAYO PHOSPOLIPID AB IgA,$265.35,$197.25,$30.60,$64.00,N/A,$62.08,N/A,N/A,N/A,$30.60,N/A,$62.08,N/A,$64.00,N/A,N/A,$62.08
3093644,0309,86147,,,,,N/A,N/A,MAYO PHOSPHOLIPID ANTIBODIES,$64.57,$48.00,$30.60,$64.00,N/A,$62.08,N/A,N/A,N/A,$30.60,N/A,$62.08,N/A,$64.00,N/A,N/A,$62.08
3093645,0309,86147,,,,,N/A,N/A,MAYO PHOSPHOLIPID ANTIBODIES,$64.57,$48.00,$30.60,$64.00,N/A,$62.08,N/A,N/A,N/A,$30.60,N/A,$62.08,N/A,$64.00,N/A,N/A,$62.08
3092701,0309,86148,,,,,N/A,N/A,MAYO PHOSPHATIDYLSERINE,$265.35,$197.25,$30.60,$263.00,N/A,$255.11,N/A,N/A,N/A,$30.60,N/A,$255.11,N/A,$263.00,N/A,N/A,$255.11
3092702,0309,86148,,,,,N/A,N/A,MAYO PHOSPHATIDYLSERINE,$265.35,$197.25,$30.60,$263.00,N/A,$255.11,N/A,N/A,N/A,$30.60,N/A,$255.11,N/A,$263.00,N/A,N/A,$255.11
3092703,0309,86148,,,,,N/A,N/A,MAYO PHOSPHATIDYLSERINE,$265.35,$197.25,$30.60,$263.00,N/A,$255.11,N/A,N/A,N/A,$30.60,N/A,$255.11,N/A,$263.00,N/A,N/A,$255.11
3093540,0309,86157,,,,,N/A,N/A,MAYO COLD AGGLUTININ TITER,$61.55,$45.75,$19.28,$61.00,N/A,$59.17,N/A,N/A,N/A,$19.28,N/A,$59.17,N/A,$61.00,N/A,N/A,$59.17
3092945,0309,86160,,,,,N/A,N/A,MAYO C4a LEVEL,$188.67,$140.25,$9.64,$187.00,N/A,$181.39,N/A,N/A,N/A,$9.64,N/A,$181.39,N/A,$187.00,N/A,N/A,$181.39
3092946,0309,86160,,,,,N/A,N/A,MAYO C3a LEVEL,$188.67,$140.25,$9.64,$187.00,N/A,$181.39,N/A,N/A,N/A,$9.64,N/A,$181.39,N/A,$187.00,N/A,N/A,$181.39
3099799,0309,86160,,,,,N/A,N/A,MAYO C1Q COMPLEMENT,$233.07,$173.25,$9.64,$187.00,N/A,$181.39,N/A,N/A,N/A,$9.64,N/A,$181.39,N/A,$187.00,N/A,N/A,$181.39
3091711,0309,86161,,,,,N/A,N/A,MAYO C2 COMPLEMENT COMPONENT,$233.07,$173.25,$14.25,$231.00,N/A,$224.07,N/A,N/A,N/A,$14.25,N/A,$224.07,N/A,$231.00,N/A,N/A,$224.07
3093040,0309,86161,,,,,N/A,N/A,"MAYO C4 COMPLEMENT, FUNCTIONAL",$77.69,$57.75,$14.25,$231.00,N/A,$224.07,N/A,N/A,N/A,$14.25,N/A,$224.07,N/A,$231.00,N/A,N/A,$224.07
3092811,0309,86200,,,,,N/A,N/A,MAYO CONNECTIVE TISS DIS CAS,$48.43,$36.00,$24.31,$48.00,N/A,$46.56,N/A,N/A,N/A,$24.31,N/A,$46.56,N/A,$48.00,N/A,N/A,$46.56
3093297,0309,86200,,,,,N/A,N/A,MAYO CONNECTIVE TISS DISEASE,$27.24,$20.25,$24.31,$48.00,N/A,$46.56,N/A,N/A,N/A,$24.31,N/A,$46.56,N/A,$48.00,N/A,N/A,$46.56
3093395,0309,86200,,,,,N/A,N/A,UVM CYCLIC CITRULLINATED PEPTI,$40.36,$30.00,$24.31,$48.00,N/A,$46.56,N/A,N/A,N/A,$24.31,N/A,$46.56,N/A,$48.00,N/A,N/A,$46.56
3091796,0309,86215,,,,,N/A,N/A,MAYO STREPTOCOCCAL AB,$91.81,$68.25,$15.51,$133.00,N/A,$129.01,N/A,N/A,N/A,$15.51,N/A,$129.01,N/A,$133.00,N/A,N/A,$129.01
3093108,0309,86215,,,,,N/A,N/A,MAYO ANTI-DNASE B TITER,$134.19,$99.75,$15.51,$133.00,N/A,$129.01,N/A,N/A,N/A,$15.51,N/A,$129.01,N/A,$133.00,N/A,N/A,$129.01
3091878,0309,86235,,,,,N/A,N/A,MAYO AUTOANTIBODIES TO SS-A,$343.04,$255.00,$16.35,$340.00,N/A,$329.80,N/A,N/A,N/A,$16.35,N/A,$329.80,N/A,$340.00,N/A,N/A,$329.80
3091879,0309,86235,,,,,N/A,N/A,MAYO AUTOANTIBODIES TO SS-B,$343.04,$255.00,$16.35,$340.00,N/A,$329.80,N/A,N/A,N/A,$16.35,N/A,$329.80,N/A,$340.00,N/A,N/A,$329.80
3091880,0309,86235,,,,,N/A,N/A,MAYO AUTOANTIBODIES TO SCL 70,$143.27,$106.50,$16.35,$340.00,N/A,$329.80,N/A,N/A,N/A,$16.35,N/A,$329.80,N/A,$340.00,N/A,N/A,$329.80
3091884,0309,86235,,,,,N/A,N/A,MAYO AUTOANTIBODIES TO SM,$343.04,$255.00,$16.35,$340.00,N/A,$329.80,N/A,N/A,N/A,$16.35,N/A,$329.80,N/A,$340.00,N/A,N/A,$329.80
3091885,0309,86235,,,,,N/A,N/A,MAYO AUTOANTIBODIES TO U1RNP,$343.04,$255.00,$16.35,$340.00,N/A,$329.80,N/A,N/A,N/A,$16.35,N/A,$329.80,N/A,$340.00,N/A,N/A,$329.80
3092677,0309,86235,,,,,N/A,N/A,MAYO MYOSITIS AB PANEL COMP,$343.04,$255.00,$16.35,$340.00,N/A,$329.80,N/A,N/A,N/A,$16.35,N/A,$329.80,N/A,$340.00,N/A,N/A,$329.80
3093298,0309,86235,,,,,N/A,N/A,MAYO CHROMATIN Ab,$128.14,$95.25,$16.35,$340.00,N/A,$329.80,N/A,N/A,N/A,$16.35,N/A,$329.80,N/A,$340.00,N/A,N/A,$329.80
3093718,0309,86235,,,,,N/A,N/A,MAYO NUCLEAR ANTIGEN ANTIBODY,$35.31,$26.25,$16.35,$340.00,N/A,$329.80,N/A,N/A,N/A,$16.35,N/A,$329.80,N/A,$340.00,N/A,N/A,$329.80
3095449,0309,86235,,,,,N/A,N/A,MAYO NUCLEAR ANTIGEN ANTIBODY,$31.28,$23.25,$16.35,$340.00,N/A,$329.80,N/A,N/A,N/A,$16.35,N/A,$329.80,N/A,$340.00,N/A,N/A,$329.80
3099840,0309,86235,,,,,N/A,N/A,MAYO AB TO EXTRACTABLE NUC AG,$343.04,$255.00,$16.35,$340.00,N/A,$329.80,N/A,N/A,N/A,$16.35,N/A,$329.80,N/A,$340.00,N/A,N/A,$329.80
3099884,0309,86235,,,,,N/A,N/A,MAYO AUTOANTIBODIES TO JO 1,$343.04,$255.00,$16.35,$340.00,N/A,$329.80,N/A,N/A,N/A,$16.35,N/A,$329.80,N/A,$340.00,N/A,N/A,$329.80
3092579,0309,86255,,,,,N/A,N/A,MAYO AUTOIMMUNE LIVER DISEAS,$231.05,$171.75,$21.38,$297.25,$297.25,$222.13,$297.25,N/A,$297.25,$21.38,$297.25,$222.13,$297.25,$229.00,$297.25,$297.25,$222.13
3092593,0309,86255,,,,,N/A,N/A,MAYO ANTI-OVARY ANTIBODY,$231.05,$171.75,$21.38,$297.25,$297.25,$222.13,$297.25,N/A,$297.25,$21.38,$297.25,$222.13,$297.25,$229.00,$297.25,$297.25,$222.13
3092697,0309,86255,,,,,N/A,N/A,MAYO NEUROMYELITIS OPTICA AB,$231.05,$171.75,$21.38,$297.25,$297.25,$222.13,$297.25,N/A,$297.25,$21.38,$297.25,$222.13,$297.25,$229.00,$297.25,$297.25,$222.13
3092774,0309,86255,,,,,N/A,N/A,MAYO MOTOR&SENSORY NEUR EVAL,$69.62,$51.75,$21.38,$297.25,$297.25,$222.13,$297.25,N/A,$297.25,$21.38,$297.25,$222.13,$297.25,$229.00,$297.25,$297.25,$222.13
3093485,0309,86255,,,,,N/A,N/A,"MAYO PARANEOPLASTIC EVAL, CSF",$612.43,$455.25,$192.42,"$2,675.25","$2,675.25","$1,999.17","$2,675.25",N/A,"$2,675.25",$192.42,"$2,675.25","$1,999.17","$2,675.25","$2,061.00","$2,675.25","$2,675.25","$1,999.17"
3093530,0309,86255,,,,,N/A,N/A,MAYO AUTOIMMUNE LIVER DISEASE,$30.27,$22.50,$21.38,$297.25,$297.25,$222.13,$297.25,N/A,$297.25,$21.38,$297.25,$222.13,$297.25,$229.00,$297.25,$297.25,$222.13
3093556,0309,86255,,,,,N/A,N/A,"MAYO MOG FACS, S",$731.48,$543.75,$21.38,$297.25,$297.25,$222.13,$297.25,N/A,$297.25,$21.38,$297.25,$222.13,$297.25,$229.00,$297.25,$297.25,$222.13
3093562,0309,86255,,,,,N/A,N/A,MAYO EPILEPSY AUTOIMMUNE EVAL,$89.80,$66.75,$21.38,$297.25,$297.25,$222.13,$297.25,N/A,$297.25,$21.38,$297.25,$222.13,$297.25,$229.00,$297.25,$297.25,$222.13
3093585,0309,86255,,,,,N/A,N/A,MAYO ENCEPHALOPATHY EVAL#1,$82.73,$61.50,$363.46,"$5,053.25","$5,053.25","$3,776.21","$5,053.25",N/A,"$5,053.25",$363.46,"$5,053.25","$3,776.21","$5,053.25","$3,893.00","$5,053.25","$5,053.25","$3,776.21"
3093629,0309,86255,,,,,N/A,N/A,MAYO NMO/AQP4 FACS,$505.48,$375.75,$21.38,$297.25,$297.25,$222.13,$297.25,N/A,$297.25,$21.38,$297.25,$222.13,$297.25,$229.00,$297.25,$297.25,$222.13
3093630,0309,86255,,,,,N/A,N/A,MAYO MOG FACS,$505.48,$375.75,$21.38,$297.25,$297.25,$222.13,$297.25,N/A,$297.25,$21.38,$297.25,$222.13,$297.25,$229.00,$297.25,$297.25,$222.13
3093665,0309,86255,,,,,N/A,N/A,MAYO CASPR2-IgG CBA,$42.38,$31.50,$21.38,$297.25,$297.25,$222.13,$297.25,N/A,$297.25,$21.38,$297.25,$222.13,$297.25,$229.00,$297.25,$297.25,$222.13
3093666,0309,86255,,,,,N/A,N/A,MAYO LGI-IgG CBA,$42.38,$31.50,$21.38,$297.25,$297.25,$222.13,$297.25,N/A,$297.25,$21.38,$297.25,$222.13,$297.25,$229.00,$297.25,$297.25,$222.13
3093751,0309,86255,,,,,N/A,N/A,MAYO MG REFLEX ACHR MODULAT FC,$99.89,$74.25,$21.38,$297.25,$297.25,$222.13,$297.25,N/A,$297.25,$21.38,$297.25,$222.13,$297.25,$229.00,$297.25,$297.25,$222.13
3095486,0309,86255,,,,,N/A,N/A,"MAYO PLA2R, IFA",$313.78,$233.25,$21.38,$297.25,$297.25,$222.13,$297.25,N/A,$297.25,$21.38,$297.25,$222.13,$297.25,$229.00,$297.25,$297.25,$222.13
3095487,0309,86255,,,,,N/A,N/A,MAYO THSD7A,$433.84,$322.50,$21.38,$297.25,$297.25,$222.13,$297.25,N/A,$297.25,$21.38,$297.25,$222.13,$297.25,$229.00,$297.25,$297.25,$222.13
3099714,0309,86255,,,,,N/A,N/A,MAYO LIVER-KIDNEY MICRO AB,$266.36,$198.00,$21.38,$297.25,$297.25,$222.13,$297.25,N/A,$297.25,$21.38,$297.25,$222.13,$297.25,$229.00,$297.25,$297.25,$222.13
3099898,0309,86255,,,,,N/A,N/A,MAYO ANCA PANEL,$231.05,$171.75,$21.38,$297.25,$297.25,$222.13,$297.25,N/A,$297.25,$21.38,$297.25,$222.13,$297.25,$229.00,$297.25,$297.25,$222.13
3093036,0309,86256,,,,,N/A,N/A,UVMMC (FAHC) ANCA TITER,$186.65,$138.75,$36.51,$231.00,$94.71,$224.07,$94.71,N/A,$94.71,$36.51,$94.71,$224.07,$94.71,$231.00,$94.71,$94.71,$224.07
3093068,0309,86256,,,,,N/A,N/A,UVM SMOOTH MUSCLE Ab TITER,$20.18,$15.00,$36.51,$231.00,$94.71,$224.07,$94.71,N/A,$94.71,$36.51,$94.71,$224.07,$94.71,$231.00,$94.71,$94.71,$224.07
3093380,0309,86256,,,,,N/A,N/A,MAYO EMA TITER IgA,$183.63,$136.50,$36.51,$231.00,$94.71,$224.07,$94.71,N/A,$94.71,$36.51,$94.71,$224.07,$94.71,$231.00,$94.71,$94.71,$224.07
3095411,0309,86305,,,,,N/A,N/A,MAYO HE4,$52.46,$39.00,$25.15,$52.00,N/A,$50.44,N/A,N/A,N/A,$25.15,N/A,$50.44,N/A,$52.00,N/A,N/A,$50.44
3095403,0309,86308,,,,,N/A,N/A,UVM MONOSPOT,$73.65,$54.75,$25.15,$73.00,N/A,$70.81,N/A,N/A,N/A,$25.15,N/A,$70.81,N/A,$73.00,N/A,N/A,$70.81
3093591,0309,86316,,,,,N/A,N/A,"MAYO AFP, PERITONEAL FLUID",$110.98,$82.50,$6.29,$110.00,N/A,$106.70,N/A,N/A,N/A,$6.29,N/A,$106.70,N/A,$110.00,N/A,N/A,$106.70
3091781,0309,86317,,,,,N/A,N/A,MAYO S PNEUMONIAE IgG AB-23,$20.18,$15.00,$19.40,$25.15,N/A,$19.40,N/A,N/A,N/A,$25.15,N/A,$19.40,N/A,$20.00,N/A,N/A,$19.40
3091782,0309,86317,,,,,N/A,N/A,MAYO S PNEUMONIAE IgG AB-23,$20.18,$15.00,$19.40,$25.15,N/A,$19.40,N/A,N/A,N/A,$25.15,N/A,$19.40,N/A,$20.00,N/A,N/A,$19.40
3091783,0309,86317,,,,,N/A,N/A,MAYO S PNEUMONIAE IgG AB-23,$20.18,$15.00,$19.40,$25.15,N/A,$19.40,N/A,N/A,N/A,$25.15,N/A,$19.40,N/A,$20.00,N/A,N/A,$19.40
3091784,0309,86317,,,,,N/A,N/A,MAYO S PNEUMONIAE IgG AB-23,$20.18,$15.00,$19.40,$25.15,N/A,$19.40,N/A,N/A,N/A,$25.15,N/A,$19.40,N/A,$20.00,N/A,N/A,$19.40
3091785,0309,86317,,,,,N/A,N/A,MAYO S PNEUMONIAE IgG AB-23,$20.18,$15.00,$19.40,$25.15,N/A,$19.40,N/A,N/A,N/A,$25.15,N/A,$19.40,N/A,$20.00,N/A,N/A,$19.40
3091786,0309,86317,,,,,N/A,N/A,MAYO S PNEUMONIAE IgG AB-23,$20.18,$15.00,$19.40,$25.15,N/A,$19.40,N/A,N/A,N/A,$25.15,N/A,$19.40,N/A,$20.00,N/A,N/A,$19.40
3091787,0309,86317,,,,,N/A,N/A,MAYO S PNEUMONIAE IgG AB-23,$20.18,$15.00,$19.40,$25.15,N/A,$19.40,N/A,N/A,N/A,$25.15,N/A,$19.40,N/A,$20.00,N/A,N/A,$19.40
3091788,0309,86317,,,,,N/A,N/A,MAYO S PNEUMONIAE IgG AB-23,$20.18,$15.00,$19.40,$25.15,N/A,$19.40,N/A,N/A,N/A,$25.15,N/A,$19.40,N/A,$20.00,N/A,N/A,$19.40
3091789,0309,86317,,,,,N/A,N/A,MAYO S PNEUMONIAE IgG AB-23,$20.18,$15.00,$19.40,$25.15,N/A,$19.40,N/A,N/A,N/A,$25.15,N/A,$19.40,N/A,$20.00,N/A,N/A,$19.40
3091790,0309,86317,,,,,N/A,N/A,MAYO S PNEUMONIAE IgG AB-23,$20.18,$15.00,$19.40,$25.15,N/A,$19.40,N/A,N/A,N/A,$25.15,N/A,$19.40,N/A,$20.00,N/A,N/A,$19.40
3091791,0309,86317,,,,,N/A,N/A,MAYO S PNEUMONIAE IgG AB-23,$20.18,$15.00,$19.40,$25.15,N/A,$19.40,N/A,N/A,N/A,$25.15,N/A,$19.40,N/A,$20.00,N/A,N/A,$19.40
3091792,0309,86317,,,,,N/A,N/A,MAYO S PNEUMONIAE IgG AB-23,$20.18,$15.00,$19.40,$25.15,N/A,$19.40,N/A,N/A,N/A,$25.15,N/A,$19.40,N/A,$20.00,N/A,N/A,$19.40
3091798,0309,86317,,,,,N/A,N/A,Mayo Hepatitis B Ab Qt,$178.58,$132.75,$19.40,$25.15,N/A,$19.40,N/A,N/A,N/A,$25.15,N/A,$19.40,N/A,$20.00,N/A,N/A,$19.40
3092187,0309,86317,,,,,N/A,N/A,MAYO S PNEUMONIAE IgG AB-23,$20.18,$15.00,$19.40,$25.15,N/A,$19.40,N/A,N/A,N/A,$25.15,N/A,$19.40,N/A,$20.00,N/A,N/A,$19.40
3092188,0309,86317,,,,,N/A,N/A,MAYO S PNEUMONIAE IgG AB-23,$20.18,$15.00,$19.40,$25.15,N/A,$19.40,N/A,N/A,N/A,$25.15,N/A,$19.40,N/A,$20.00,N/A,N/A,$19.40
3092189,0309,86317,,,,,N/A,N/A,MAYO S PNEUMONIAE IgG AB-23,$20.18,$15.00,$19.40,$25.15,N/A,$19.40,N/A,N/A,N/A,$25.15,N/A,$19.40,N/A,$20.00,N/A,N/A,$19.40
3092190,0309,86317,,,,,N/A,N/A,MAYO S PNEUMONIAE IgG AB-23,$20.18,$15.00,$19.40,$25.15,N/A,$19.40,N/A,N/A,N/A,$25.15,N/A,$19.40,N/A,$20.00,N/A,N/A,$19.40
3092191,0309,86317,,,,,N/A,N/A,MAYO S PNEUMONIAE IgG AB-23,$20.18,$15.00,$19.40,$25.15,N/A,$19.40,N/A,N/A,N/A,$25.15,N/A,$19.40,N/A,$20.00,N/A,N/A,$19.40
3092192,0309,86317,,,,,N/A,N/A,MAYO S PNEUMONIAE IgG AB-23,$20.18,$15.00,$19.40,$25.15,N/A,$19.40,N/A,N/A,N/A,$25.15,N/A,$19.40,N/A,$20.00,N/A,N/A,$19.40
3092193,0309,86317,,,,,N/A,N/A,MAYO S PNEUMONIAE IgG AB-23,$20.18,$15.00,$19.40,$25.15,N/A,$19.40,N/A,N/A,N/A,$25.15,N/A,$19.40,N/A,$20.00,N/A,N/A,$19.40
3092194,0309,86317,,,,,N/A,N/A,MAYO S PNEUMONIAE IgG AB-23,$20.18,$15.00,$19.40,$25.15,N/A,$19.40,N/A,N/A,N/A,$25.15,N/A,$19.40,N/A,$20.00,N/A,N/A,$19.40
3092195,0309,86317,,,,,N/A,N/A,MAYO S PNEUMONIAE IgG AB-23,$20.18,$15.00,$19.40,$25.15,N/A,$19.40,N/A,N/A,N/A,$25.15,N/A,$19.40,N/A,$20.00,N/A,N/A,$19.40
3092196,0309,86317,,,,,N/A,N/A,MAYO S PNEUMONIAE IgG AB-23,$20.18,$15.00,$19.40,$25.15,N/A,$19.40,N/A,N/A,N/A,$25.15,N/A,$19.40,N/A,$20.00,N/A,N/A,$19.40
3092197,0309,86317,,,,,N/A,N/A,MAYO S PNEUMONIAE IgG AB-23,$20.18,$15.00,$19.40,$25.15,N/A,$19.40,N/A,N/A,N/A,$25.15,N/A,$19.40,N/A,$20.00,N/A,N/A,$19.40
3092552,0309,86317,,,,,N/A,N/A,Mayo N.Mening Igg Vac Response,$234.07,$174.00,$19.40,$25.15,N/A,$19.40,N/A,N/A,N/A,$25.15,N/A,$19.40,N/A,$20.00,N/A,N/A,$19.40
3093087,0309,86317,,,,,N/A,N/A,MAYO PNEUMOCOCCAL Ab PANEL,$191.70,$142.50,$232.80,$301.80,N/A,$232.80,N/A,N/A,N/A,$301.80,N/A,$232.80,N/A,$240.00,N/A,N/A,$232.80
3099796,0309,86320,,,,,N/A,N/A,FAHC IMMUNOFIXATION/SPEP,$280.49,$208.50,$18.02,$278.00,$113.98,$269.66,$113.98,N/A,$113.98,$18.02,$113.98,$269.66,$113.98,$278.00,$113.98,$113.98,$269.66
3099847,0309,86325,,,,,N/A,N/A,Fahc Immunofixation (Urine),$425.77,$316.50,$57.88,$422.00,$173.20,$409.34,$173.20,N/A,$173.20,$57.88,$173.20,$409.34,$173.20,$422.00,$173.20,$173.20,$409.34
3093300,0309,86331,,,,,N/A,N/A,MAYO ASPERGILLUS IgG PRECIPITI,$147.31,$109.50,$346.50,$728.00,N/A,$706.16,N/A,N/A,N/A,$346.50,N/A,$706.16,N/A,$728.00,N/A,N/A,$706.16
3095397,0309,86331,,,,,N/A,N/A,MAYO PIGEON DE,$104.93,$78.00,$49.50,$104.00,N/A,$100.88,N/A,N/A,N/A,$49.50,N/A,$100.88,N/A,$104.00,N/A,N/A,$100.88
3095398,0309,86331,,,,,N/A,N/A,MAYO PARAKEET,$104.93,$78.00,$49.50,$104.00,N/A,$100.88,N/A,N/A,N/A,$49.50,N/A,$100.88,N/A,$104.00,N/A,N/A,$100.88
3095399,0309,86331,,,,,N/A,N/A,MAYO COCKATIEL,$104.93,$78.00,$49.50,$104.00,N/A,$100.88,N/A,N/A,N/A,$49.50,N/A,$100.88,N/A,$104.00,N/A,N/A,$100.88
3095400,0309,86331,,,,,N/A,N/A,MAYO PARROT,$104.93,$78.00,$49.50,$104.00,N/A,$100.88,N/A,N/A,N/A,$49.50,N/A,$100.88,N/A,$104.00,N/A,N/A,$100.88
3095401,0309,86331,,,,,N/A,N/A,MAYO PIGEON SERA,$104.93,$78.00,$49.50,$104.00,N/A,$100.88,N/A,N/A,N/A,$49.50,N/A,$100.88,N/A,$104.00,N/A,N/A,$100.88
3093675,0309,86332,,,,,N/A,N/A,MAYO CIQ BINDING ASSAY,$113.00,$84.00,$14.25,$112.00,N/A,$108.64,N/A,N/A,N/A,$14.25,N/A,$108.64,N/A,$112.00,N/A,N/A,$108.64
3099800,0309,86332,,,,,N/A,N/A,MAYO IMMUNE COMPLEX RAJI,$333.96,$248.25,$14.25,$112.00,N/A,$108.64,N/A,N/A,N/A,$14.25,N/A,$108.64,N/A,$112.00,N/A,N/A,$108.64
3092588,0309,86335,,,,,N/A,N/A,MAYO MONOPCLONAL PROT URINE,$44.39,$33.00,$29.34,$135.71,$135.71,$128.04,$135.71,N/A,$135.71,$29.34,$135.71,$128.04,$135.71,$132.00,$135.71,$135.71,$128.04
3093427,0309,86335,,,,,N/A,N/A,"MAYO BETA 2 TRANSFERRIN,BF",$133.18,$99.00,$29.34,$135.71,$135.71,$128.04,$135.71,N/A,$135.71,$29.34,$135.71,$128.04,$135.71,$132.00,$135.71,$135.71,$128.04
3093517,0309,86335,,,,,N/A,N/A,UVM MONOCLONAL URINE STUDY,$45.40,$33.75,$29.34,$135.71,$135.71,$128.04,$135.71,N/A,$135.71,$29.34,$135.71,$128.04,$135.71,$132.00,$135.71,$135.71,$128.04
3093137,0309,86336,,,,,N/A,N/A,MAYO INHIBIN A&B TUMORMARKER,$80.72,$60.00,$57.04,$80.00,N/A,$77.60,N/A,N/A,N/A,$57.04,N/A,$77.60,N/A,$80.00,N/A,N/A,$77.60
3092829,0309,86337,,,,,N/A,N/A,MAYO INSULIN AB,$76.68,$57.00,$18.86,$76.00,N/A,$73.72,N/A,N/A,N/A,$18.86,N/A,$73.72,N/A,$76.00,N/A,N/A,$73.72
3093302,0309,86337,,,,,N/A,N/A,MAYO DIABETES MELL TYPE 1 EV,$54.48,$40.50,$18.86,$76.00,N/A,$73.72,N/A,N/A,N/A,$18.86,N/A,$73.72,N/A,$76.00,N/A,N/A,$73.72
3093227,0309,86341,,,,,N/A,N/A,MAYO ISLET ANTIGEN 2 Ab,$45.40,$33.75,$18.02,$164.00,N/A,$159.08,N/A,N/A,N/A,$18.02,N/A,$159.08,N/A,$164.00,N/A,N/A,$159.08
3093303,0309,86341,,,,,N/A,N/A,MAYO DIABETES MELL TYPE 1 EV,$99.89,$74.25,$54.06,$492.00,N/A,$477.24,N/A,N/A,N/A,$54.06,N/A,$477.24,N/A,$492.00,N/A,N/A,$477.24
3093563,0309,86341,,,,,N/A,N/A,MAYO EPILEPSY AUTOIMMUNE EVAL,$165.47,$123.00,$18.02,$164.00,N/A,$159.08,N/A,N/A,N/A,$18.02,N/A,$159.08,N/A,$164.00,N/A,N/A,$159.08
3093586,0309,86341,,,,,N/A,N/A,MAYO ENCEPHALOPATHY EVAL#2,$145.29,$108.00,$18.02,$164.00,N/A,$159.08,N/A,N/A,N/A,$18.02,N/A,$159.08,N/A,$164.00,N/A,N/A,$159.08
3095508,0309,86343,,,,,N/A,N/A,Mayo Cu Index,$177.57,$132.00,$28.50,$176.00,N/A,$170.72,N/A,N/A,N/A,$28.50,N/A,$170.72,N/A,$176.00,N/A,N/A,$170.72
3092915,0309,86353,,,,,N/A,N/A,MAYO LYMPH PROLIFERATION PANEL,"$1,987.61","$1,477.50",$30.18,"$1,970.00",N/A,"$1,910.90",N/A,N/A,N/A,$30.18,N/A,"$1,910.90",N/A,"$1,970.00",N/A,N/A,"$1,910.90"
3092654,0309,86355,,,,,N/A,N/A,CD20 B-CELLS,$223.98,$166.50,$59.10,$220.00,N/A,$213.40,N/A,N/A,N/A,$59.10,N/A,$213.40,N/A,$220.00,N/A,N/A,$213.40
3092968,0309,86355,,,,,N/A,N/A,MAYO NK CYTOTOXICITY PROFILE,$221.97,$165.00,$59.10,$220.00,N/A,$213.40,N/A,N/A,N/A,$59.10,N/A,$213.40,N/A,$220.00,N/A,N/A,$213.40
3093024,0309,86355,,,,,N/A,N/A,FAHC IMM DEFIC PANEL B&NK,$31.28,$23.25,$59.10,$220.00,N/A,$213.40,N/A,N/A,N/A,$59.10,N/A,$213.40,N/A,$220.00,N/A,N/A,$213.40
3093359,0309,86355,,,,,N/A,N/A,MAYO BCELL PHENOTYPE PROFILE,$125.11,$93.00,$59.10,$220.00,N/A,$213.40,N/A,N/A,N/A,$59.10,N/A,$213.40,N/A,$220.00,N/A,N/A,$213.40
3092655,0309,86356,,,,,N/A,N/A,CD20 B-CELLS,$209.86,$156.00,$45.27,$208.00,N/A,$201.76,N/A,N/A,N/A,$45.27,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3092656,0309,86356,,,,,N/A,N/A,CD20 B-CELLS,$209.86,$156.00,$45.27,$208.00,N/A,$201.76,N/A,N/A,N/A,$45.27,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3092969,0309,86357,,,,,N/A,N/A,MAYO NK CYTOTOXICITY PROFILE,$219.95,$163.50,$32.27,$218.00,N/A,$211.46,N/A,N/A,N/A,$32.27,N/A,$211.46,N/A,$218.00,N/A,N/A,$211.46
3093025,0309,86357,,,,,N/A,N/A,FAHC IMM DEFIC PANEL B&NK,$31.28,$23.25,$32.27,$218.00,N/A,$211.46,N/A,N/A,N/A,$32.27,N/A,$211.46,N/A,$218.00,N/A,N/A,$211.46
3093358,0309,86357,,,,,N/A,N/A,MAYO BCELL PHENOTYPE PROFILE,$125.11,$93.00,$32.27,$218.00,N/A,$211.46,N/A,N/A,N/A,$32.27,N/A,$211.46,N/A,$218.00,N/A,N/A,$211.46
3092566,0309,86359,,,,,N/A,N/A,MAYO T-CELL PHENOTYPING ADV,$248.20,$184.50,$45.27,$220.00,N/A,$213.40,N/A,N/A,N/A,$45.27,N/A,$213.40,N/A,$220.00,N/A,N/A,$213.40
3092970,0309,86359,,,,,N/A,N/A,MAYO NK CYTOTOXICITY PROFILE,$221.97,$165.00,$45.27,$220.00,N/A,$213.40,N/A,N/A,N/A,$45.27,N/A,$213.40,N/A,$220.00,N/A,N/A,$213.40
3093026,0309,86359,,,,,N/A,N/A,FAHC IMM DEFIC PANEL B&NK,$31.28,$23.25,$45.27,$220.00,N/A,$213.40,N/A,N/A,N/A,$45.27,N/A,$213.40,N/A,$220.00,N/A,N/A,$213.40
3093357,0309,86359,,,,,N/A,N/A,MAYO BCELL PHENOTYPE PROFILE,$125.11,$93.00,$45.27,$220.00,N/A,$213.40,N/A,N/A,N/A,$45.27,N/A,$213.40,N/A,$220.00,N/A,N/A,$213.40
3092971,0309,86360,,,,,N/A,N/A,MAYO NK CYTOTOXICITY PROFILE,$235.08,$174.75,$45.27,$124.00,N/A,$120.28,N/A,N/A,N/A,$45.27,N/A,$120.28,N/A,$124.00,N/A,N/A,$120.28
3093027,0309,86360,,,,,N/A,N/A,FAHC IMM DEFIC PANEL B&NK,$58.52,$43.50,$45.27,$124.00,N/A,$120.28,N/A,N/A,N/A,$45.27,N/A,$120.28,N/A,$124.00,N/A,N/A,$120.28
3093356,0309,86360,,,,,N/A,N/A,MAYO BCELL PHENOTYPE PROFILE,$125.11,$93.00,$45.27,$124.00,N/A,$120.28,N/A,N/A,N/A,$45.27,N/A,$120.28,N/A,$124.00,N/A,N/A,$120.28
3092567,0309,86361,,,,,N/A,N/A,MAYO T-CELL PHENOTYPING ADV,$245.17,$182.25,$56.58,$243.00,N/A,$235.71,N/A,N/A,N/A,$56.58,N/A,$235.71,N/A,$243.00,N/A,N/A,$235.71
3092591,0309,86376,,,,,N/A,N/A,MAYO AUTOIMMUNE LIVER DISEAS,$280.49,$208.50,$32.27,$278.00,N/A,$269.66,N/A,N/A,N/A,$32.27,N/A,$269.66,N/A,$278.00,N/A,N/A,$269.66
3093592,0309,86376,,,,,N/A,N/A,MAYO LIVER CYTOSOL (LC-1) AUTO,$403.58,$300.00,$32.27,$278.00,N/A,$269.66,N/A,N/A,N/A,$32.27,N/A,$269.66,N/A,$278.00,N/A,N/A,$269.66
3099880,0309,86376,,,,,N/A,N/A,MAYO THYROPEROXIDASE AB,$270.40,$201.00,$32.27,$278.00,N/A,$269.66,N/A,N/A,N/A,$32.27,N/A,$269.66,N/A,$278.00,N/A,N/A,$269.66
3092672,0309,86382,,,,,N/A,N/A,MAYO INTERFERON NUTRALIZ AB,$321.85,$239.25,$17.60,$319.00,N/A,$309.43,N/A,N/A,N/A,$17.60,N/A,$309.43,N/A,$319.00,N/A,N/A,$309.43
3091779,0309,86403,,,,,N/A,N/A,MAYO H INFLUENZAE (LATEX),$135.20,$100.50,$20.12,$170.00,N/A,$164.90,N/A,N/A,N/A,$20.12,N/A,$164.90,N/A,$170.00,N/A,N/A,$164.90
3092364,0309,86403,,,,,N/A,N/A,MAYO CANDIDA ALBICANS Ag DETEC,$171.52,$127.50,$20.12,$170.00,N/A,$164.90,N/A,N/A,N/A,$20.12,N/A,$164.90,N/A,$170.00,N/A,N/A,$164.90
3099963,0309,86403,,,,,N/A,N/A,FAHC CRYPTOCOCCAL ANTIGEN(CSF),$199.77,$148.50,$20.12,$170.00,N/A,$164.90,N/A,N/A,N/A,$20.12,N/A,$164.90,N/A,$170.00,N/A,N/A,$164.90
3099897,0309,86431,,,,,N/A,N/A,MAYO RHEUMATOID FACTOR(B FLUID,$143.27,$106.50,$13.83,$142.00,N/A,$137.74,N/A,N/A,N/A,$13.83,N/A,$137.74,N/A,$142.00,N/A,N/A,$137.74
3093476,0309,86480,,,,,N/A,N/A,UVM TB Quantiferon Gold plus,$216.92,$161.25,$6.71,$215.00,N/A,$208.55,N/A,N/A,N/A,$6.71,N/A,$208.55,N/A,$215.00,N/A,N/A,$208.55
3093338,0309,86593,,,,,N/A,N/A,MAYO RPR TITER,$25.22,$18.75,$5.03,$25.00,N/A,$24.25,N/A,N/A,N/A,$5.03,N/A,$24.25,N/A,$25.00,N/A,N/A,$24.25
3091729,0309,86606,,,,,N/A,N/A,"MAYO ASPERGILLUS FUMIGATUS,IgG",$283.51,$210.75,$5.45,$58.00,N/A,$56.26,N/A,N/A,N/A,$5.45,N/A,$56.26,N/A,$58.00,N/A,N/A,$56.26
3092466,0309,86606,,,,,N/A,N/A,"MAYO ASPERGILLUS AB,ID",$58.52,$43.50,$5.45,$58.00,N/A,$56.26,N/A,N/A,N/A,$5.45,N/A,$56.26,N/A,$58.00,N/A,N/A,$56.26
3092467,0309,86606,,,,,N/A,N/A,"MAYO ASPERGILLUS AB,ID",$58.52,$43.50,$5.45,$58.00,N/A,$56.26,N/A,N/A,N/A,$5.45,N/A,$56.26,N/A,$58.00,N/A,N/A,$56.26
3092468,0309,86606,,,,,N/A,N/A,"MAYO ASPERGILLUS AB,ID",$58.52,$43.50,$5.45,$58.00,N/A,$56.26,N/A,N/A,N/A,$5.45,N/A,$56.26,N/A,$58.00,N/A,N/A,$56.26
3092391,0309,86609,,,,,N/A,N/A,MAYO PNEUMOCOCCAL AB PANEL,$36.32,$27.00,$18.02,$35.00,N/A,$33.95,N/A,N/A,N/A,$18.02,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
3092392,0309,86609,,,,,N/A,N/A,MAYO PNEUMOCOCCAL AB PANEL,$36.32,$27.00,$18.02,$35.00,N/A,$33.95,N/A,N/A,N/A,$18.02,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
3092393,0309,86609,,,,,N/A,N/A,MAYO PNEUMOCOCCAL AB PANEL,$36.32,$27.00,$18.02,$35.00,N/A,$33.95,N/A,N/A,N/A,$18.02,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
3092394,0309,86609,,,,,N/A,N/A,MAYO PNEUMOCOCCAL AB PANEL,$36.32,$27.00,$18.02,$35.00,N/A,$33.95,N/A,N/A,N/A,$18.02,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
3092395,0309,86609,,,,,N/A,N/A,MAYO PNEUMOCOCCAL AB PANEL,$35.31,$26.25,$18.02,$35.00,N/A,$33.95,N/A,N/A,N/A,$18.02,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
3092396,0309,86609,,,,,N/A,N/A,MAYO PNEUMOCOCCAL AB PANEL,$35.31,$26.25,$18.02,$35.00,N/A,$33.95,N/A,N/A,N/A,$18.02,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
3092397,0309,86609,,,,,N/A,N/A,MAYO PNEUMOCOCCAL AB PANEL,$35.31,$26.25,$18.02,$35.00,N/A,$33.95,N/A,N/A,N/A,$18.02,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
3092398,0309,86609,,,,,N/A,N/A,MAYO PNEUMOCOCCAL AB PANEL,$35.31,$26.25,$18.02,$35.00,N/A,$33.95,N/A,N/A,N/A,$18.02,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
3092399,0309,86609,,,,,N/A,N/A,MAYO PNEUMOCOCCAL AB PANEL,$35.31,$26.25,$18.02,$35.00,N/A,$33.95,N/A,N/A,N/A,$18.02,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
3092400,0309,86609,,,,,N/A,N/A,MAYO PNEUMOCOCCAL AB PANEL,$35.31,$26.25,$18.02,$35.00,N/A,$33.95,N/A,N/A,N/A,$18.02,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
3092401,0309,86609,,,,,N/A,N/A,MAYO PNEUMOCOCCAL AB PANEL,$35.31,$26.25,$18.02,$35.00,N/A,$33.95,N/A,N/A,N/A,$18.02,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
3092402,0309,86609,,,,,N/A,N/A,MAYO PNEUMOCOCCAL AB PANEL,$35.31,$26.25,$18.02,$35.00,N/A,$33.95,N/A,N/A,N/A,$18.02,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
3092547,0309,86609,,,,,N/A,N/A,MAYO NEISSERIA GONORRHOEAE AbS,$138.22,$102.75,$18.02,$35.00,N/A,$33.95,N/A,N/A,N/A,$18.02,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
3092763,0309,86609,,,,,N/A,N/A,MAYO LISTERIA ANTBODIES CF,$182.62,$135.75,$18.02,$35.00,N/A,$33.95,N/A,N/A,N/A,$18.02,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
3093486,0309,86612,,,,,N/A,N/A,MAYO BLASTOMYCES ANTIBODY,$69.62,$51.75,$15.51,$69.00,N/A,$66.93,N/A,N/A,N/A,$15.51,N/A,$66.93,N/A,$69.00,N/A,N/A,$66.93
3092470,0309,86615,,,,,N/A,N/A,"MAYO BORDETELLA,PERT IgG AB",$114.01,$84.75,$15.51,$113.00,N/A,$109.61,N/A,N/A,N/A,$15.51,N/A,$109.61,N/A,$113.00,N/A,N/A,$109.61
3092471,0309,86615,,,,,N/A,N/A,"MAYO BORDETELLA,PERT IgG AB",$114.01,$84.75,$15.51,$113.00,N/A,$109.61,N/A,N/A,N/A,$15.51,N/A,$109.61,N/A,$113.00,N/A,N/A,$109.61
3093268,0309,86615,,,,,N/A,N/A,MAYO B.PERTUSSIS IgG,$157.39,$117.00,$15.51,$113.00,N/A,$109.61,N/A,N/A,N/A,$15.51,N/A,$109.61,N/A,$113.00,N/A,N/A,$109.61
3093503,0309,86617,,,,,N/A,N/A,UVM LYME AB IMMUNOBLOT(REFLEX),$87.78,$65.25,$31.86,$174.00,N/A,$168.78,N/A,N/A,N/A,$31.86,N/A,$168.78,N/A,$174.00,N/A,N/A,$168.78
3095443,0309,86618,,,,,N/A,N/A,MAYO LYME DISEASE SEROLOGY,$20.18,$15.00,$18.44,$273.00,N/A,$264.81,N/A,N/A,N/A,$18.44,N/A,$264.81,N/A,$273.00,N/A,N/A,$264.81
3092921,0309,86619,,,,,N/A,N/A,MAYO BORRELIA HERMSII Ab PANEL,$331.94,$246.75,$41.08,$658.00,N/A,$638.26,N/A,N/A,N/A,$41.08,N/A,$638.26,N/A,$658.00,N/A,N/A,$638.26
3091812,0309,86622,,,,,N/A,N/A,MAYO BRUCELLA ABIgG&IgM,$171.52,$127.50,$15.93,$170.00,N/A,$164.90,N/A,N/A,N/A,$15.93,N/A,$164.90,N/A,$170.00,N/A,N/A,$164.90
3091813,0309,86622,,,,,N/A,N/A,MAYO BRUCELLA ABIgG&IgM,$171.52,$127.50,$15.93,$170.00,N/A,$164.90,N/A,N/A,N/A,$15.93,N/A,$164.90,N/A,$170.00,N/A,N/A,$164.90
3092199,0309,86628,,,,,N/A,N/A,"MAYO CANDIDA IgG,IgA,IgM AB",$233.07,$173.25,$10.90,$231.00,N/A,$224.07,N/A,N/A,N/A,$10.90,N/A,$224.07,N/A,$231.00,N/A,N/A,$224.07
3092200,0309,86628,,,,,N/A,N/A,"MAYO CANDIDA IgG,IgA,IgM AB",$233.07,$173.25,$10.90,$231.00,N/A,$224.07,N/A,N/A,N/A,$10.90,N/A,$224.07,N/A,$231.00,N/A,N/A,$224.07
3092201,0309,86628,,,,,N/A,N/A,"MAYO CANDIDA IgG,IgA,IgM AB",$233.07,$173.25,$10.90,$231.00,N/A,$224.07,N/A,N/A,N/A,$10.90,N/A,$224.07,N/A,$231.00,N/A,N/A,$224.07
3093147,0309,86631,,,,,N/A,N/A,MAYO CHLAMYDIA SPECIES PANEL,$110.98,$82.50,$14.25,$228.00,N/A,$221.16,N/A,N/A,N/A,$14.25,N/A,$221.16,N/A,$228.00,N/A,N/A,$221.16
3093148,0309,86632,,,,,N/A,N/A,MAYO CHLAMYDIA SPECIES PANEL,$60.54,$45.00,$14.25,$241.00,N/A,$233.77,N/A,N/A,N/A,$14.25,N/A,$233.77,N/A,$241.00,N/A,N/A,$233.77
3092919,0309,86638,,,,,N/A,N/A,MAYO Q FEVER AB IgG/IgM,$99.89,$74.25,$27.66,$198.00,N/A,$192.06,N/A,N/A,N/A,$27.66,N/A,$192.06,N/A,$198.00,N/A,N/A,$192.06
3099643,0309,86648,,,,,N/A,N/A,MAYO DIPTHERIA AB,$394.50,$293.25,$20.12,$391.00,N/A,$379.27,N/A,N/A,N/A,$20.12,N/A,$379.27,N/A,$391.00,N/A,N/A,$379.27
3093581,0309,86652,,,,,N/A,N/A,MAYO E EQUINE ENCEP IgG,$71.63,$53.25,$18.44,$71.00,N/A,$68.87,N/A,N/A,N/A,$18.44,N/A,$68.87,N/A,$71.00,N/A,N/A,$68.87
3093582,0309,86652,,,,,N/A,N/A,MAYO E EQUINE ENCEP IgM,$71.63,$53.25,$18.44,$71.00,N/A,$68.87,N/A,N/A,N/A,$18.44,N/A,$68.87,N/A,$71.00,N/A,N/A,$68.87
3092841,0309,86653,,,,,N/A,N/A,MAYO STLOUIS ENCEP.IgG/IgMAb,$49.44,$36.75,$15.93,$49.00,N/A,$47.53,N/A,N/A,N/A,$15.93,N/A,$47.53,N/A,$49.00,N/A,N/A,$47.53
3092842,0309,86653,,,,,N/A,N/A,MAYO STLOUIS ENCEP.IgG/IgMAb,$49.44,$36.75,$15.93,$49.00,N/A,$47.53,N/A,N/A,N/A,$15.93,N/A,$47.53,N/A,$49.00,N/A,N/A,$47.53
3093328,0309,86658,,,,,N/A,N/A,MAYO  COXSACKIE B(1-6) Ab,$151.34,$112.50,$95.58,$528.00,N/A,$512.16,N/A,N/A,N/A,$95.58,N/A,$512.16,N/A,$528.00,N/A,N/A,$512.16
3092948,0309,86659,,,,,N/A,N/A,MAYO HSV1/2 TYPE SPECIF IgE,$151.34,$112.50,$15.51,$150.00,N/A,$145.50,N/A,N/A,N/A,$15.51,N/A,$145.50,N/A,$150.00,N/A,N/A,$145.50
3092464,0309,86663,,,,,N/A,N/A,"MAYO EPSTN-BAR VRS IGB,ERLY AG",$91.81,$68.25,$88.27,$91.00,N/A,$88.27,N/A,N/A,N/A,$91.00,N/A,$88.27,N/A,$91.00,N/A,N/A,$88.27
3099683,0309,86665,,,,,N/A,N/A,MAYO EPSTEIN-BARR VIRUS IGM,$275.44,$204.75,$18.44,$273.00,N/A,$264.81,N/A,N/A,N/A,$18.44,N/A,$264.81,N/A,$273.00,N/A,N/A,$264.81
3092404,0309,86666,,,,,N/A,N/A,MAYO&CHAFFEENSIS AB IgG&IgM,$174.55,$129.75,$21.80,$186.00,N/A,$180.42,N/A,N/A,N/A,$21.80,N/A,$180.42,N/A,$186.00,N/A,N/A,$180.42
3092405,0309,86666,,,,,N/A,N/A,MAYO&CHAFFEENSIS AB IgG&IgM,$174.55,$129.75,$21.80,$186.00,N/A,$180.42,N/A,N/A,N/A,$21.80,N/A,$180.42,N/A,$186.00,N/A,N/A,$180.42
3092725,0309,86666,,,,,N/A,N/A,"MAYO ANAPLASMA,PHGCYTP[HIM,IgG",$96.86,$72.00,$21.80,$186.00,N/A,$180.42,N/A,N/A,N/A,$21.80,N/A,$180.42,N/A,$186.00,N/A,N/A,$180.42
3092918,0309,86666,,,,,N/A,N/A,MAYO ANAPLAS PHAGOCYTO IgG/IgM,$286.54,$213.00,$43.60,$372.00,N/A,$360.84,N/A,N/A,N/A,$43.60,N/A,$360.84,N/A,$372.00,N/A,N/A,$360.84
3093139,0309,86666,,,,,N/A,N/A,MAYO E CHAFFEENSIS IgG,$89.80,$66.75,$21.80,$186.00,N/A,$180.42,N/A,N/A,N/A,$21.80,N/A,$180.42,N/A,$186.00,N/A,N/A,$180.42
3093618,0309,86668,,,,,N/A,N/A,"MAYO F. TULARENSIS Ab,IgM &IgG",$85.76,$63.75,$12.15,$85.00,N/A,$82.45,N/A,N/A,N/A,$12.15,N/A,$82.45,N/A,$85.00,N/A,N/A,$82.45
3093619,0309,86668,,,,,N/A,N/A,"MAYO F. TULARENSIS Ab,IgM &IgG",$85.76,$63.75,$12.15,$85.00,N/A,$82.45,N/A,N/A,N/A,$12.15,N/A,$82.45,N/A,$85.00,N/A,N/A,$82.45
3092925,0309,86671,,,,,N/A,N/A,MAYO CROHN'S DISEASE PROFILE,$88.79,$66.00,$17.18,$88.00,N/A,$85.36,N/A,N/A,N/A,$17.18,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3099821,0309,86671,,,,,N/A,N/A,MAYO SACCHAROMYCES,$234.07,$174.00,$17.18,$88.00,N/A,$85.36,N/A,N/A,N/A,$17.18,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3099822,0309,86671,,,,,N/A,N/A,MAYO SACCHAROMYCES,$228.02,$169.50,$17.18,$88.00,N/A,$85.36,N/A,N/A,N/A,$17.18,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3092865,0309,86677,,,,,N/A,N/A,MAYO HELICOBACTER PYLORI IgA,$58.52,$43.50,$17.60,$58.00,N/A,$56.26,N/A,N/A,N/A,$17.60,N/A,$56.26,N/A,$58.00,N/A,N/A,$56.26
3093008,0309,86677,,,,,N/A,N/A,"MAYO H.PYLORI Ab,IgG,IgM,IgA",$81.72,$60.75,$52.80,$174.00,N/A,$168.78,N/A,N/A,N/A,$52.80,N/A,$168.78,N/A,$174.00,N/A,N/A,$168.78
3092834,0309,86682,,,,,N/A,N/A,MAYO CYSTICERCUS IgG AB,$194.73,$144.75,$20.12,$181.00,N/A,$175.57,N/A,N/A,N/A,$20.12,N/A,$175.57,N/A,$181.00,N/A,N/A,$175.57
3092835,0309,86682,,,,,N/A,N/A,MAYO ECHINOCCUS Ab IgG,$97.87,$72.75,$20.12,$181.00,N/A,$175.57,N/A,N/A,N/A,$20.12,N/A,$175.57,N/A,$181.00,N/A,N/A,$175.57
3093512,0309,86682,,,,,N/A,N/A,"MAYO TOXOCARA Ab IgG,S",$182.62,$135.75,$20.12,$181.00,N/A,$175.57,N/A,N/A,N/A,$20.12,N/A,$175.57,N/A,$181.00,N/A,N/A,$175.57
3093627,0309,86682,,,,,N/A,N/A,"MAYO SCHISTOSOMA Ab, IgG",$105.94,$78.75,$20.12,$181.00,N/A,$175.57,N/A,N/A,N/A,$20.12,N/A,$175.57,N/A,$181.00,N/A,N/A,$175.57
3092770,0309,86684,,,,,N/A,N/A,"MAYO H INFLUENZA B AB,IgG",$69.62,$51.75,$15.51,$69.00,N/A,$66.93,N/A,N/A,N/A,$15.51,N/A,$66.93,N/A,$69.00,N/A,N/A,$66.93
3099746,0309,86687,,,,,N/A,N/A,MAYO HILV I/II AB,$165.47,$123.00,$18.86,$164.00,N/A,$159.08,N/A,N/A,N/A,$18.86,N/A,$159.08,N/A,$164.00,N/A,N/A,$159.08
3093418,0309,86689,,,,,N/A,N/A,MAYO HTLV-1/2Ab CONFIMATION,$208.85,$155.25,$10.90,$463.00,N/A,$449.11,N/A,N/A,N/A,$10.90,N/A,$449.11,N/A,$463.00,N/A,N/A,$449.11
3093658,0309,86692,,,,,N/A,N/A,MAYO HEPATITIS D TOTAL ABS,$101.90,$75.75,$23.05,$101.00,N/A,$97.97,N/A,N/A,N/A,$23.05,N/A,$97.97,N/A,$101.00,N/A,N/A,$97.97
3099755,0309,86694,,,,,N/A,N/A,FAHC HERPES SIMPLEX AB IgG,$143.27,$106.50,$20.54,$142.00,N/A,$137.74,N/A,N/A,N/A,$20.54,N/A,$137.74,N/A,$142.00,N/A,N/A,$137.74
3099765,0309,86694,,,,,N/A,N/A,"MAYO HSV AB,IgM",$277.46,$206.25,$20.54,$142.00,N/A,$137.74,N/A,N/A,N/A,$20.54,N/A,$137.74,N/A,$142.00,N/A,N/A,$137.74
3090007,0309,86695,,,,,N/A,N/A,"HERPES SIMPLEX,TYPE 1",$183.63,$136.50,$17.18,$391.00,N/A,$379.27,N/A,N/A,N/A,$17.18,N/A,$379.27,N/A,$391.00,N/A,N/A,$379.27
3091882,0309,86695,,,,,N/A,N/A,"MAYO HSV 1&2 IgG,AB",$253.24,$188.25,$17.18,$391.00,N/A,$379.27,N/A,N/A,N/A,$17.18,N/A,$379.27,N/A,$391.00,N/A,N/A,$379.27
3099970,0309,86695,,,,,N/A,N/A,MAYO HERPES SIMP VIRUS1/2IGM,$253.24,$188.25,$17.18,$391.00,N/A,$379.27,N/A,N/A,N/A,$17.18,N/A,$379.27,N/A,$391.00,N/A,N/A,$379.27
3091883,0309,86696,,,,,N/A,N/A,"MAYO HSV 1&2 IgG,AB",$369.27,$274.50,$15.93,$366.00,N/A,$355.02,N/A,N/A,N/A,$15.93,N/A,$355.02,N/A,$366.00,N/A,N/A,$355.02
3092949,0309,86696,,,,,N/A,N/A,MAYO HSV1/2 TYPE SPECIF IgE,$151.34,$112.50,$15.93,$366.00,N/A,$355.02,N/A,N/A,N/A,$15.93,N/A,$355.02,N/A,$366.00,N/A,N/A,$355.02
3099971,0309,86696,,,,,N/A,N/A,MAYO HERPES SIMP VIRUS1/2IGM,$369.27,$274.50,$15.93,$366.00,N/A,$355.02,N/A,N/A,N/A,$15.93,N/A,$355.02,N/A,$366.00,N/A,N/A,$355.02
3091702,0309,86698,,,,,N/A,N/A,MAYO HISTOPLASMA AB,$329.92,$245.25,$23.05,$327.00,N/A,$317.19,N/A,N/A,N/A,$23.05,N/A,$317.19,N/A,$327.00,N/A,N/A,$317.19
3093501,0309,86701,,,,,N/A,N/A,"UVM HIV 1,2 AB DIFFERENTIATION",$68.61,$51.00,$16.77,$173.00,N/A,$167.81,N/A,N/A,N/A,$16.77,N/A,$167.81,N/A,$173.00,N/A,N/A,$167.81
3092675,0309,86702,,,,,N/A,N/A,MAYO HIV 2 AB EVAL,$203.81,$151.50,$10.48,$68.00,N/A,$65.96,N/A,N/A,N/A,$10.48,N/A,$65.96,N/A,$68.00,N/A,N/A,$65.96
3093502,0309,86702,,,,,N/A,N/A,"UVM HIV 1,2 AB DIFFERENTIATION",$68.61,$51.00,$10.48,$68.00,N/A,$65.96,N/A,N/A,N/A,$10.48,N/A,$65.96,N/A,$68.00,N/A,N/A,$65.96
3092674,0309,86703,,,,,N/A,N/A,MAYO HIV-1/2 AB EVAL,$203.81,$151.50,$16.35,$202.00,N/A,$195.94,N/A,N/A,N/A,$16.35,N/A,$195.94,N/A,$202.00,N/A,N/A,$195.94
3099889,0309,86703,,,,,N/A,N/A,MAYO HIV-1/2 AB EVALUATION,$203.81,$151.50,$16.35,$202.00,N/A,$195.94,N/A,N/A,N/A,$16.35,N/A,$195.94,N/A,$202.00,N/A,N/A,$195.94
3091735,0309,86704,,,,,N/A,N/A,MAYO HEPATITIS B CORE IgG&IgM,$233.07,$173.25,$16.35,$231.00,N/A,$224.07,N/A,N/A,N/A,$16.35,N/A,$224.07,N/A,$231.00,N/A,N/A,$224.07
3092582,0309,86704,,,,,N/A,N/A,MAYO CHRONIC HEPATITIS PROF,$36.32,$27.00,$16.35,$231.00,N/A,$224.07,N/A,N/A,N/A,$16.35,N/A,$224.07,N/A,$231.00,N/A,N/A,$224.07
3093402,0309,86704,,,,,N/A,N/A,Uvm Hepatitis B Core Antibody,$27.24,$20.25,$16.35,$231.00,N/A,$224.07,N/A,N/A,N/A,$16.35,N/A,$224.07,N/A,$231.00,N/A,N/A,$224.07
3091140,0309,86706,,,,,N/A,N/A,EMPLOYEE HEPATITIS B,$35.31,$26.25,$14.25,$36.00,N/A,$34.92,N/A,N/A,N/A,$14.25,N/A,$34.92,N/A,$36.00,N/A,N/A,$34.92
3092592,0309,86706,,,,,N/A,N/A,MAYO CHRONIC HEPATITIS PROF,$36.32,$27.00,$14.25,$36.00,N/A,$34.92,N/A,N/A,N/A,$14.25,N/A,$34.92,N/A,$36.00,N/A,N/A,$34.92
3093401,0309,86706,,,,,N/A,N/A,UVM HEP B SURFACE ANTIBODY,$25.22,$18.75,$14.25,$36.00,N/A,$34.92,N/A,N/A,N/A,$14.25,N/A,$34.92,N/A,$36.00,N/A,N/A,$34.92
3099841,0309,86708,,,,,N/A,N/A,MAYO HEPATITIS A IGG/IGM,$238.11,$177.00,$13.83,$236.00,N/A,$228.92,N/A,N/A,N/A,$13.83,N/A,$228.92,N/A,$236.00,N/A,N/A,$228.92
3093038,0309,86709,,,,,N/A,N/A,UVMMC HEPATITIS A-IgM,$23.21,$17.25,$15.09,$216.00,N/A,$209.52,N/A,N/A,N/A,$15.09,N/A,$209.52,N/A,$216.00,N/A,N/A,$209.52
3093404,0309,86709,,,,,N/A,N/A,UVM HEPATITIS A IgM Ab,$31.28,$23.25,$15.09,$216.00,N/A,$209.52,N/A,N/A,N/A,$15.09,N/A,$209.52,N/A,$216.00,N/A,N/A,$209.52
3099882,0309,86709,,,,,N/A,N/A,"MAYO HEPATITIS A AB, IGM",$217.93,$162.00,$15.09,$216.00,N/A,$209.52,N/A,N/A,N/A,$15.09,N/A,$209.52,N/A,$216.00,N/A,N/A,$209.52
3093655,0309,86710,,,,,N/A,N/A,MAYO INFLUENZA B IgG,$20.18,$15.00,$13.41,$113.00,N/A,$109.61,N/A,N/A,N/A,$13.41,N/A,$109.61,N/A,$113.00,N/A,N/A,$109.61
3093656,0309,86710,,,,,N/A,N/A,MAYO INFLUENZA B IgM,$20.18,$15.00,$13.41,$113.00,N/A,$109.61,N/A,N/A,N/A,$13.41,N/A,$109.61,N/A,$113.00,N/A,N/A,$109.61
3099902,0309,86710,,,,,N/A,N/A,MAYO INFLUENZA A VIRUS,$114.01,$84.75,$13.41,$113.00,N/A,$109.61,N/A,N/A,N/A,$13.41,N/A,$109.61,N/A,$113.00,N/A,N/A,$109.61
3099903,0309,86710,,,,,N/A,N/A,MAYO INFLUENZA A VIRUS,$114.01,$84.75,$13.41,$113.00,N/A,$109.61,N/A,N/A,N/A,$13.41,N/A,$109.61,N/A,$113.00,N/A,N/A,$109.61
3090009,0309,86713,,,,,N/A,N/A,"ANTIBODY, LEGIONELLA",$293.60,$218.25,$16.35,$291.00,N/A,$282.27,N/A,N/A,N/A,$16.35,N/A,$282.27,N/A,$291.00,N/A,N/A,$282.27
3090010,0309,86713,,,,,N/A,N/A,"ANTIBODY, LEGIONELLA",$293.60,$218.25,$16.35,$291.00,N/A,$282.27,N/A,N/A,N/A,$16.35,N/A,$282.27,N/A,$291.00,N/A,N/A,$282.27
3092848,0309,86717,,,,,N/A,N/A,MAYO LEISHMANIASIS Ab,$72.64,$54.00,$18.44,$72.00,N/A,$69.84,N/A,N/A,N/A,$18.44,N/A,$69.84,N/A,$72.00,N/A,N/A,$69.84
3092292,0309,86735,,,,,N/A,N/A,MAYO MUMPS AB IGB&IGM CSF,$79.71,$59.25,$19.28,$80.00,N/A,$77.60,N/A,N/A,N/A,$19.28,N/A,$77.60,N/A,$80.00,N/A,N/A,$77.60
3092293,0309,86735,,,,,N/A,N/A,MAYO MUMPS AB IGB&IGM CSF,$80.72,$60.00,$19.28,$80.00,N/A,$77.60,N/A,N/A,N/A,$19.28,N/A,$77.60,N/A,$80.00,N/A,N/A,$77.60
3092296,0309,86735,,,,,N/A,N/A,MAYO MUMPS QB IGB&IGM SERUM,$60.54,$45.00,$19.28,$80.00,N/A,$77.60,N/A,N/A,N/A,$19.28,N/A,$77.60,N/A,$80.00,N/A,N/A,$77.60
3093113,0309,86738,,,,,N/A,N/A,MAYO M PNEUMONIAE IgM by IFA,$180.60,$134.25,$15.51,$201.00,N/A,$194.97,N/A,N/A,N/A,$15.51,N/A,$194.97,N/A,$201.00,N/A,N/A,$194.97
3099753,0309,86738,,,,,N/A,N/A,MAYO MYCOPLASMA PNEUM IG G/IGM,$202.80,$150.75,$15.51,$201.00,N/A,$194.97,N/A,N/A,N/A,$15.51,N/A,$194.97,N/A,$201.00,N/A,N/A,$194.97
3099754,0309,86738,,,,,N/A,N/A,MAYO MYCOPLASMA PNEUM IG G/IGM,$202.80,$150.75,$15.51,$201.00,N/A,$194.97,N/A,N/A,N/A,$15.51,N/A,$194.97,N/A,$201.00,N/A,N/A,$194.97
3092204,0309,86753,,,,,N/A,N/A,"MAYO BABESIA MIC IgG,IgM AB",$99.89,$74.25,$18.02,$113.00,N/A,$109.61,N/A,N/A,N/A,$18.02,N/A,$109.61,N/A,$113.00,N/A,N/A,$109.61
3092205,0309,86753,,,,,N/A,N/A,"MAYO BABESIA MIC IgG,IgM AB",$99.89,$74.25,$18.02,$113.00,N/A,$109.61,N/A,N/A,N/A,$18.02,N/A,$109.61,N/A,$113.00,N/A,N/A,$109.61
3092920,0309,86753,,,,,N/A,N/A,MAYO WA1 IgG Ab,$188.67,$140.25,$18.02,$113.00,N/A,$109.61,N/A,N/A,N/A,$18.02,N/A,$109.61,N/A,$113.00,N/A,N/A,$109.61
3093305,0309,86753,,,,,N/A,N/A,MAYO TRYPANOSOMA CRUZI IgM Ab,$114.01,$84.75,$18.02,$113.00,N/A,$109.61,N/A,N/A,N/A,$18.02,N/A,$109.61,N/A,$113.00,N/A,N/A,$109.61
3093539,0309,86753,,,,,N/A,N/A,MAYO BABESIA MICROTI IgG Ab,$63.56,$47.25,$18.02,$113.00,N/A,$109.61,N/A,N/A,N/A,$18.02,N/A,$109.61,N/A,$113.00,N/A,N/A,$109.61
3095477,0309,86753,,,,,N/A,N/A,"MAYO T.CRUZI TOTAL AB, EIA",$59.53,$44.25,$18.02,$113.00,N/A,$109.61,N/A,N/A,N/A,$18.02,N/A,$109.61,N/A,$113.00,N/A,N/A,$109.61
3099938,0309,86753,,,,,N/A,N/A,MAYO E. HISTOLTICA AB,$135.20,$100.50,$18.02,$113.00,N/A,$109.61,N/A,N/A,N/A,$18.02,N/A,$109.61,N/A,$113.00,N/A,N/A,$109.61
3092147,0309,86757,,,,,N/A,N/A,MAYO RICKETTSIA AB PANEL,$369.27,$274.50,$15.09,$366.00,N/A,$355.02,N/A,N/A,N/A,$15.09,N/A,$355.02,N/A,$366.00,N/A,N/A,$355.02
3092148,0309,86757,,,,,N/A,N/A,MAYO RICKETTSIA AB PANEL,$369.27,$274.50,$15.09,$366.00,N/A,$355.02,N/A,N/A,N/A,$15.09,N/A,$355.02,N/A,$366.00,N/A,N/A,$355.02
3092149,0309,86757,,,,,N/A,N/A,MAYO RICKETTSIA AB PANEL,$369.27,$274.50,$15.09,$366.00,N/A,$355.02,N/A,N/A,N/A,$15.09,N/A,$355.02,N/A,$366.00,N/A,N/A,$355.02
3092150,0309,86757,,,,,N/A,N/A,MAYO RICKETTSIA AB PANEL,$369.27,$274.50,$15.09,$366.00,N/A,$355.02,N/A,N/A,N/A,$15.09,N/A,$355.02,N/A,$366.00,N/A,N/A,$355.02
3099725,0309,86762,,,,,N/A,N/A,MAYO RUBELLA IGM,$433.84,$322.50,$23.05,$275.00,N/A,$266.75,N/A,N/A,N/A,$23.05,N/A,$266.75,N/A,$275.00,N/A,N/A,$266.75
3093576,0309,86765,,,,,N/A,N/A,"MAYO MEASLES (RUBEOLA), IGM",$35.31,$26.25,$17.18,$54.00,N/A,$52.38,N/A,N/A,N/A,$17.18,N/A,$52.38,N/A,$54.00,N/A,N/A,$52.38
3093612,0309,86769,,,,,N/A,N/A,MAYO SARS CORONAVIRUS 2 IgG Ab,$58.52,$43.50,$15.93,$55.00,N/A,$53.35,N/A,N/A,N/A,$15.93,N/A,$53.35,N/A,$55.00,N/A,N/A,$53.35
3093709,0309,86769,,,,,N/A,N/A,MAYO SARS-COV-2 NUCLEOCAPSID A,$55.49,$41.25,$15.93,$55.00,N/A,$53.35,N/A,N/A,N/A,$15.93,N/A,$53.35,N/A,$55.00,N/A,N/A,$53.35
3093710,0309,86769,,,,,N/A,N/A,MAYO SARS-COV-2 SPIKE AB,$55.49,$41.25,$15.93,$55.00,N/A,$53.35,N/A,N/A,N/A,$15.93,N/A,$53.35,N/A,$55.00,N/A,N/A,$53.35
3093327,0309,86780,,,,,N/A,N/A,MAYO SYPHILIS Ab BY TP-PA,$59.53,$44.25,$17.18,$84.00,N/A,$81.48,N/A,N/A,N/A,$17.18,N/A,$81.48,N/A,$84.00,N/A,N/A,$81.48
3099981,0309,86780,,,,,N/A,N/A,MAYO SYPHILIS TOTAL Ab W/REFLE,$84.75,$63.00,$17.18,$84.00,N/A,$81.48,N/A,N/A,N/A,$17.18,N/A,$81.48,N/A,$84.00,N/A,N/A,$81.48
3099913,0309,86784,,,,,N/A,N/A,MAYO TRICHINELLA AB,$174.55,$129.75,$167.81,$173.00,N/A,$167.81,N/A,N/A,N/A,$173.00,N/A,$167.81,N/A,$173.00,N/A,N/A,$167.81
3092996,0309,86788,,,,,N/A,N/A,MAYO WEST NILE VIR IgG/IgMAb,$51.46,$38.25,$15.51,$51.00,N/A,$49.47,N/A,N/A,N/A,$15.51,N/A,$49.47,N/A,$51.00,N/A,N/A,$49.47
3092995,0309,86789,,,,,N/A,N/A,MAYO WEST NILE VIR IgG/IgMAb,$46.41,$34.50,$20.12,$46.00,N/A,$44.62,N/A,N/A,N/A,$20.12,N/A,$44.62,N/A,$46.00,N/A,N/A,$44.62
3092297,0309,86790,,,,,N/A,N/A,MAYO HANTAVIRUS AB IGG,$303.69,$225.75,$17.18,$236.00,N/A,$228.92,N/A,N/A,N/A,$17.18,N/A,$228.92,N/A,$236.00,N/A,N/A,$228.92
3092755,0309,86790,,,,,N/A,N/A,MAYO HEPATITIS & Ab IgM/or IgG,$180.60,$134.25,$17.18,$236.00,N/A,$228.92,N/A,N/A,N/A,$17.18,N/A,$228.92,N/A,$236.00,N/A,N/A,$228.92
3093121,0309,86790,,,,,N/A,N/A,MAYO CHIKUNGUNYA Abs,$321.85,$239.25,$34.36,$472.00,N/A,$457.84,N/A,N/A,N/A,$34.36,N/A,$457.84,N/A,$472.00,N/A,N/A,$457.84
3093135,0309,86790,,,,,N/A,N/A,MAYO HERPESVIRUS 7 IgG&IgM,$330.93,$246.00,$34.36,$472.00,N/A,$457.84,N/A,N/A,N/A,$34.36,N/A,$457.84,N/A,$472.00,N/A,N/A,$457.84
3093417,0309,86790,,,,,N/A,N/A,MAYO HTLV-1/2 Ab SCREEN,$36.32,$27.00,$17.18,$236.00,N/A,$228.92,N/A,N/A,N/A,$17.18,N/A,$228.92,N/A,$236.00,N/A,N/A,$228.92
3099831,0309,86790,,,,,N/A,N/A,MAYO DENGUE FEVER AB PANEL 1,$238.11,$177.00,$17.18,$236.00,N/A,$228.92,N/A,N/A,N/A,$17.18,N/A,$228.92,N/A,$236.00,N/A,N/A,$228.92
3099832,0309,86790,,,,,N/A,N/A,MAYO DENGUE FEVER AB PANEL 2,$238.11,$177.00,$17.18,$236.00,N/A,$228.92,N/A,N/A,N/A,$17.18,N/A,$228.92,N/A,$236.00,N/A,N/A,$228.92
3091833,0309,86800,,,,,N/A,N/A,MAYO THYROGLOBULIN,$234.07,$174.00,$15.51,$232.00,N/A,$225.04,N/A,N/A,N/A,$15.51,N/A,$225.04,N/A,$232.00,N/A,N/A,$225.04
3092583,0309,86803,,,,,N/A,N/A,MAYO CHRONIC HEPATITIS PROF,$36.32,$27.00,$19.28,$204.00,N/A,$197.88,N/A,N/A,N/A,$19.28,N/A,$197.88,N/A,$204.00,N/A,N/A,$197.88
3093403,0309,86803,,,,,N/A,N/A,UVM HEPATITIS C Ab W/REFLEX,$40.36,$30.00,$19.28,$204.00,N/A,$197.88,N/A,N/A,N/A,$19.28,N/A,$197.88,N/A,$204.00,N/A,N/A,$197.88
3099750,0309,86803,,,,,N/A,N/A,MAYO HEP C AB,$205.82,$153.00,$19.28,$204.00,N/A,$197.88,N/A,N/A,N/A,$19.28,N/A,$197.88,N/A,$204.00,N/A,N/A,$197.88
3099842,0309,86803,,,,,N/A,N/A,MAYO HEPATITIS CAB/REFLEX PCR,$254.25,$189.00,$19.28,$204.00,N/A,$197.88,N/A,N/A,N/A,$19.28,N/A,$197.88,N/A,$204.00,N/A,N/A,$197.88
3092972,0309,86805,,,,,N/A,N/A,MAYO NK CYTOTOXICITY PROFILE,$303.69,$225.75,$18.44,$301.00,N/A,$291.97,N/A,N/A,N/A,$18.44,N/A,$291.97,N/A,$301.00,N/A,N/A,$291.97
3093316,0309,86812,,,,,N/A,N/A,MAYO HCA-B27,$61.55,$45.75,$59.17,$227.59,N/A,$59.17,N/A,N/A,N/A,$227.59,N/A,$59.17,N/A,$61.00,N/A,N/A,$59.17
3092360,0309,86813,,,,,N/A,N/A,FAHC HLA TYPING,$263.33,$195.75,$31.02,$279.00,N/A,$270.63,N/A,N/A,N/A,$31.02,N/A,$270.63,N/A,$279.00,N/A,N/A,$270.63
3092658,0309,86816,,,,,N/A,N/A,MAYO CELIAC ASSO HLA-DQ TYPING,$312.77,$232.50,$69.58,$310.00,N/A,$300.70,N/A,N/A,N/A,$69.58,N/A,$300.70,N/A,$310.00,N/A,N/A,$300.70
3099453,0309,86860,,,,,N/A,N/A,ARC ABO RESOLUTION,$365.24,$271.50,$11.74,$346.00,N/A,$335.62,N/A,N/A,N/A,$11.74,N/A,$335.62,N/A,$346.00,N/A,N/A,$335.62
3091756,0309,86870,,,,,N/A,N/A,ARC ANTIBODY ID,$321.85,$239.25,$39.40,$319.00,N/A,$309.43,N/A,N/A,N/A,$39.40,N/A,$309.43,N/A,$319.00,N/A,N/A,$309.43
3091755,0309,86880,,,,,N/A,N/A,ARC DIRECT COOMBS,$106.95,$79.50,$53.65,$106.00,N/A,$102.82,N/A,N/A,N/A,$53.65,N/A,$102.82,N/A,$106.00,N/A,N/A,$102.82
3092531,0309,86885,,,,,N/A,N/A,ARC AB ID/EC SELECT REG CELL,$114.01,$84.75,$6.29,$113.00,N/A,$109.61,N/A,N/A,N/A,$6.29,N/A,$109.61,N/A,$113.00,N/A,N/A,$109.61
3092502,0309,86886,,,,,N/A,N/A,"MAYO ISOAGGLUTININ, ANTI-A",$137.22,$102.00,$6.71,$136.00,N/A,$131.92,N/A,N/A,N/A,$6.71,N/A,$131.92,N/A,$136.00,N/A,N/A,$131.92
3092503,0309,86886,,,,,N/A,N/A,"MAYO ISOAGGLUTININ, ANTI-B",$137.22,$102.00,$6.71,$136.00,N/A,$131.92,N/A,N/A,N/A,$6.71,N/A,$131.92,N/A,$136.00,N/A,N/A,$131.92
3093362,0309,86886,,,,,N/A,N/A,UVM ISOHEMAGGLUTININS QT,$205.82,$153.00,$6.71,$136.00,N/A,$131.92,N/A,N/A,N/A,$6.71,N/A,$131.92,N/A,$136.00,N/A,N/A,$131.92
3093363,0309,86900,,,,,N/A,N/A,UVM ISOHEMAGGLUTININS QT,$159.41,$118.50,$153.26,$174.36,N/A,$153.26,N/A,N/A,N/A,$174.36,N/A,$153.26,N/A,$158.00,N/A,N/A,$153.26
3091754,0309,86901,,,,,N/A,N/A,ARC RH,$63.56,$47.25,$3.77,$63.00,N/A,$61.11,N/A,N/A,N/A,$3.77,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093364,0309,86901,,,,,N/A,N/A,UVM ISOHEMAGGLUTININS QT,$31.28,$23.25,$3.77,$63.00,N/A,$61.11,N/A,N/A,N/A,$3.77,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3091935,0309,86905,,,,,N/A,N/A,ARC PHENOTYPE,$49.44,$36.75,$7.54,$49.00,N/A,$47.53,N/A,N/A,N/A,$7.54,N/A,$47.53,N/A,$49.00,N/A,N/A,$47.53
3093015,0309,86905,,,,,N/A,N/A,"ARC RBC Ag,OTHER THAN ABOorD",$48.43,$36.00,$7.54,$49.00,N/A,$47.53,N/A,N/A,N/A,$7.54,N/A,$47.53,N/A,$49.00,N/A,N/A,$47.53
3091863,0309,86978,,,,,N/A,N/A,ARC DIFFERENTIAL ADSORPTION,$88.79,$66.00,$43.59,$134.00,N/A,$129.98,N/A,N/A,N/A,$43.59,N/A,$129.98,N/A,$134.00,N/A,N/A,$129.98
3093354,0309,87015,,,,,N/A,N/A,"UVM AFB CULTURE,URINE",$24.21,$18.00,$43.59,$63.00,N/A,$61.11,N/A,N/A,N/A,$43.59,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093492,0309,87015,,,,,N/A,N/A,"MAYO FILARIA, B",$63.56,$47.25,$43.59,$63.00,N/A,$61.11,N/A,N/A,N/A,$43.59,N/A,$61.11,N/A,$63.00,N/A,N/A,$61.11
3093681,0309,87045,,,,,N/A,N/A,VDHL ENTERIC SCREEN CHARGE,$21.19,$15.75,$12.57,$22.00,N/A,$21.34,N/A,N/A,N/A,$12.57,N/A,$21.34,N/A,$22.00,N/A,N/A,$21.34
3095389,0309,87045,,,,,N/A,N/A,"MAYO CULTURE, ENTERIC PATHOGEN",$22.20,$16.50,$12.57,$22.00,N/A,$21.34,N/A,N/A,N/A,$12.57,N/A,$21.34,N/A,$22.00,N/A,N/A,$21.34
3093232,0309,87046,,,,,N/A,N/A,UVM FECES CUL UNUSUAL PATHOGEN,$40.36,$30.00,$11.32,$40.00,N/A,$38.80,N/A,N/A,N/A,$11.32,N/A,$38.80,N/A,$40.00,N/A,N/A,$38.80
3095388,0309,87046,,,,,N/A,N/A,"MAYO CULTURE, ENTERIC PATHOGEN",$22.20,$16.50,$11.32,$40.00,N/A,$38.80,N/A,N/A,N/A,$11.32,N/A,$38.80,N/A,$40.00,N/A,N/A,$38.80
3091738,0309,87070,,,,,N/A,N/A,FAHC ANAEROBIC CULTURE,$84.75,$63.00,$11.32,$169.00,N/A,$163.93,N/A,N/A,N/A,$11.32,N/A,$163.93,N/A,$169.00,N/A,N/A,$163.93
3093007,0309,87070,,,,,N/A,N/A,"MAYO CYSTIC FIBROSIS,CULTURE",$211.88,$157.50,$11.32,$169.00,N/A,$163.93,N/A,N/A,N/A,$11.32,N/A,$163.93,N/A,$169.00,N/A,N/A,$163.93
3093099,0309,87070,,,,,N/A,N/A,UVM RESPIRTORY CULTURE&SMEAR,$49.44,$36.75,$11.32,$169.00,N/A,$163.93,N/A,N/A,N/A,$11.32,N/A,$163.93,N/A,$169.00,N/A,N/A,$163.93
3093376,0309,87070,,,,,N/A,N/A,UVM GROUP B SUSCEPTIBILITY,$35.31,$26.25,$11.32,$169.00,N/A,$163.93,N/A,N/A,N/A,$11.32,N/A,$163.93,N/A,$169.00,N/A,N/A,$163.93
3099779,0309,87070,,,,,N/A,N/A,FAHC BACTERIAL CULTURE OTHER,$170.51,$126.75,$11.32,$169.00,N/A,$163.93,N/A,N/A,N/A,$11.32,N/A,$163.93,N/A,$169.00,N/A,N/A,$163.93
3099781,0309,87070,,,,,N/A,N/A,FAHC BACTERIAL CULTURE/SMEAR,$138.22,$102.75,$11.32,$169.00,N/A,$163.93,N/A,N/A,N/A,$11.32,N/A,$163.93,N/A,$169.00,N/A,N/A,$163.93
3092373,0309,87075,,,,,N/A,N/A,FAHC ANAEROBE CULTURE/SMEAR OT,$171.52,$127.50,$10.48,$170.00,N/A,$164.90,N/A,N/A,N/A,$10.48,N/A,$164.90,N/A,$170.00,N/A,N/A,$164.90
3000027,0309,87076,,,,,N/A,N/A,MAYO ID MASS SPEC ANAEROBE,$59.53,$44.25,$11.32,$81.00,N/A,$78.57,N/A,N/A,N/A,$11.32,N/A,$78.57,N/A,$81.00,N/A,N/A,$78.57
3092905,0309,87076,,,,,N/A,N/A,MAYO ORGANISM ID AN,$235.08,$174.75,$22.64,$162.00,N/A,$157.14,N/A,N/A,N/A,$22.64,N/A,$157.14,N/A,$162.00,N/A,N/A,$157.14
3000030,0309,87077,,,,,N/A,N/A,MAYO ID by MALDI-TOF MASS SPEC,$59.53,$44.25,$9.64,$95.00,N/A,$92.15,N/A,N/A,N/A,$9.64,N/A,$92.15,N/A,$95.00,N/A,N/A,$92.15
3093054,0309,87077,,,,,N/A,N/A,"MAYO ORGANISM REFER ID,AEROBIC",$183.63,$136.50,$9.64,$95.00,N/A,$92.15,N/A,N/A,N/A,$9.64,N/A,$92.15,N/A,$95.00,N/A,N/A,$92.15
3095490,0309,87077,,,,,N/A,N/A,UVM BACTERIAL ID,$18.16,$13.50,$9.64,$95.00,N/A,$92.15,N/A,N/A,N/A,$9.64,N/A,$92.15,N/A,$95.00,N/A,N/A,$92.15
3092751,0309,87081,,,,,N/A,N/A,MAYO C DIPHTHERIAE CULTURE,$85.76,$63.75,$9.64,$85.00,N/A,$82.45,N/A,N/A,N/A,$9.64,N/A,$82.45,N/A,$85.00,N/A,N/A,$82.45
3093217,0309,87081,,,,,N/A,N/A,UVM VRE SCREEN,$36.32,$27.00,$9.64,$85.00,N/A,$82.45,N/A,N/A,N/A,$9.64,N/A,$82.45,N/A,$85.00,N/A,N/A,$82.45
3093497,0309,87101,,,,,N/A,N/A,"MAYO FUNGAL CULTURE, DERMAL",$59.53,$44.25,$9.64,$149.00,N/A,$144.53,N/A,N/A,N/A,$9.64,N/A,$144.53,N/A,$149.00,N/A,N/A,$144.53
3093523,0309,87101,,,,,N/A,N/A,UVMSKIN/HAIR/NAIL FUNGAL CU/SM,$34.30,$25.50,$9.64,$149.00,N/A,$144.53,N/A,N/A,N/A,$9.64,N/A,$144.53,N/A,$149.00,N/A,N/A,$144.53
3093109,0309,87102,,,,,N/A,N/A,MAYO FUNGAL CULTURE,$44.39,$33.00,$9.22,$164.00,N/A,$159.08,N/A,N/A,N/A,$9.22,N/A,$159.08,N/A,$164.00,N/A,N/A,$159.08
3093377,0309,87102,,,,,N/A,N/A,UVM FUNGAL CULTURE,$30.27,$22.50,$9.22,$164.00,N/A,$159.08,N/A,N/A,N/A,$9.22,N/A,$159.08,N/A,$164.00,N/A,N/A,$159.08
3093520,0309,87102,,,,,N/A,N/A,UVM FUNGAL CULTURE & SMEAR,$30.27,$22.50,$9.22,$164.00,N/A,$159.08,N/A,N/A,N/A,$9.22,N/A,$159.08,N/A,$164.00,N/A,N/A,$159.08
3091346,0309,87103,,,,,N/A,N/A,FAHC FUNGUS BLOOD CULTURE,$101.90,$75.75,$10.06,$101.00,N/A,$97.97,N/A,N/A,N/A,$10.06,N/A,$97.97,N/A,$101.00,N/A,N/A,$97.97
3092843,0309,87106,,,,,N/A,N/A,"FAHC YEAST ID, PLATE SUBMITTED",$38.34,$28.50,$24.73,$38.00,N/A,$36.86,N/A,N/A,N/A,$24.73,N/A,$36.86,N/A,$38.00,N/A,N/A,$36.86
3092880,0309,87107,,,,,N/A,N/A,FAHC MOLD IDENTIFICATION,$34.30,$25.50,$12.57,$68.00,N/A,$65.96,N/A,N/A,N/A,$12.57,N/A,$65.96,N/A,$68.00,N/A,N/A,$65.96
3093498,0309,87107,,,,,N/A,N/A,MAYO FUNGAL ID,$48.43,$36.00,$12.57,$68.00,N/A,$65.96,N/A,N/A,N/A,$12.57,N/A,$65.96,N/A,$68.00,N/A,N/A,$65.96
3093677,0309,87107,,,,,N/A,N/A,"MAYO CULTURE,REF FOR FUNGUS ID",$68.61,$51.00,$12.57,$68.00,N/A,$65.96,N/A,N/A,N/A,$12.57,N/A,$65.96,N/A,$68.00,N/A,N/A,$65.96
3093678,0309,87107,,,,,N/A,N/A,MAYO FUNGAL IDENT PANEL B,$73.65,$54.75,$12.57,$68.00,N/A,$65.96,N/A,N/A,N/A,$12.57,N/A,$65.96,N/A,$68.00,N/A,N/A,$65.96
3095489,0309,87107,,,,,N/A,N/A,UVM FUNGAL ID,$24.21,$18.00,$12.57,$68.00,N/A,$65.96,N/A,N/A,N/A,$12.57,N/A,$65.96,N/A,$68.00,N/A,N/A,$65.96
3099759,0309,87109,,,,,N/A,N/A,Mayo Ureaplasma Pcr,$177.57,$132.00,$12.57,$176.00,N/A,$170.72,N/A,N/A,N/A,$12.57,N/A,$170.72,N/A,$176.00,N/A,N/A,$170.72
3092463,0309,87116,,,,,N/A,N/A,MAYO MYCOBACTERIA CULTURE,$104.93,$78.00,$23.47,$160.00,N/A,$155.20,N/A,N/A,N/A,$23.47,N/A,$155.20,N/A,$160.00,N/A,N/A,$155.20
3093353,0309,87116,,,,,N/A,N/A,"UVM AFB CULTURE,URINE",$24.21,$18.00,$23.47,$160.00,N/A,$155.20,N/A,N/A,N/A,$23.47,N/A,$155.20,N/A,$160.00,N/A,N/A,$155.20
3093634,0309,87116,,,,,N/A,N/A,UVM AFB BLOOD CLUTURE,$35.31,$26.25,$23.47,$160.00,N/A,$155.20,N/A,N/A,N/A,$23.47,N/A,$155.20,N/A,$160.00,N/A,N/A,$155.20
3095528,0309,87118,,,,,N/A,N/A,Mayo Mycobacteria Id& Suscept,$110.98,$82.50,$12.99,$110.00,N/A,$106.70,N/A,N/A,N/A,$12.99,N/A,$106.70,N/A,$110.00,N/A,N/A,$106.70
3093679,0309,87153,,,,,N/A,N/A,MAYO D2 SEQUENCING IDENTIFICAT,$146.30,$108.75,$6.71,$145.00,N/A,$140.65,N/A,N/A,N/A,$6.71,N/A,$140.65,N/A,$145.00,N/A,N/A,$140.65
3093420,0309,87169,,,,,N/A,N/A,MAYO PARASITE IDENTIFICATION,$81.72,$60.75,$5.03,$193.00,N/A,$187.21,N/A,N/A,N/A,$5.03,N/A,$187.21,N/A,$193.00,N/A,N/A,$187.21
3099743,0309,87169,,,,,N/A,N/A,FAHC WORM IDENTIFICATION,$194.73,$144.75,$5.03,$193.00,N/A,$187.21,N/A,N/A,N/A,$5.03,N/A,$187.21,N/A,$193.00,N/A,N/A,$187.21
3091733,0309,87172,,,,,N/A,N/A,FAHC PINWORM EXAM,$88.79,$66.00,$5.03,$88.00,N/A,$85.36,N/A,N/A,N/A,$5.03,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3093383,0309,87177,,,,,N/A,N/A,MAYO PARASITIC EXAM (O&P),$23.21,$17.25,$5.03,$173.00,N/A,$167.81,N/A,N/A,N/A,$5.03,N/A,$167.81,N/A,$173.00,N/A,N/A,$167.81
3000029,0309,87181,,,,,N/A,N/A,MAYO ANAEROBE SUSCEP/AGENT,$43.38,$32.25,$10.90,$364.00,N/A,$353.08,N/A,N/A,N/A,$10.90,N/A,$353.08,N/A,$364.00,N/A,N/A,$353.08
3092906,0309,87181,,,,,N/A,N/A,MAYO ORGANISM ID AN,$53.47,$39.75,$32.70,"$1,092.00",N/A,"$1,059.24",N/A,N/A,N/A,$32.70,N/A,"$1,059.24",N/A,"$1,092.00",N/A,N/A,"$1,059.24"
3093254,0309,87181,,,,,N/A,N/A,MAYO ANAEROBIC SUSCEPTIBILITY,$105.94,$78.75,$32.70,"$1,092.00",N/A,"$1,059.24",N/A,N/A,N/A,$32.70,N/A,"$1,059.24",N/A,"$1,092.00",N/A,N/A,"$1,059.24"
3000028,0309,87185,,,,,N/A,N/A,MAYO BETA LACTAMASE,$43.38,$32.25,$5.87,$43.00,N/A,$41.71,N/A,N/A,N/A,$5.87,N/A,$41.71,N/A,$43.00,N/A,N/A,$41.71
3093307,0309,87186,,,,,N/A,N/A,"MAYO SUSCEPTIBILITY PANEL,YEAS",$263.33,$195.75,$5.87,$81.00,N/A,$78.57,N/A,N/A,N/A,$5.87,N/A,$78.57,N/A,$81.00,N/A,N/A,$78.57
3093334,0309,87186,,,,,N/A,N/A,"MAYO  AEROBIC SUSCEPTIBIL,MIC",$101.90,$75.75,$5.87,$81.00,N/A,$78.57,N/A,N/A,N/A,$5.87,N/A,$78.57,N/A,$81.00,N/A,N/A,$78.57
3093510,0309,87186,,,,,N/A,N/A,UVM SUSCEPTIBILITY,$16.14,$12.00,$5.87,$81.00,N/A,$78.57,N/A,N/A,N/A,$5.87,N/A,$78.57,N/A,$81.00,N/A,N/A,$78.57
3093511,0309,87186,,,,,N/A,N/A,MAYO SUSCEPTIBILITY SLOW GROW,$267.37,$198.75,$5.87,$81.00,N/A,$78.57,N/A,N/A,N/A,$5.87,N/A,$78.57,N/A,$81.00,N/A,N/A,$78.57
3095491,0309,87186,,,,,N/A,N/A,"UVM SUSCEPTIBILITY, BACTERIAL",$36.32,$27.00,$5.87,$81.00,N/A,$78.57,N/A,N/A,N/A,$5.87,N/A,$78.57,N/A,$81.00,N/A,N/A,$78.57
3095492,0309,87186,,,,,N/A,N/A,UVM UTHSA MICAFUNGIN,$81.72,$60.75,$5.87,$81.00,N/A,$78.57,N/A,N/A,N/A,$5.87,N/A,$78.57,N/A,$81.00,N/A,N/A,$78.57
3095493,0309,87186,,,,,N/A,N/A,UVM UTHSA FLUCONAZOLE,$81.72,$60.75,$5.87,$81.00,N/A,$78.57,N/A,N/A,N/A,$5.87,N/A,$78.57,N/A,$81.00,N/A,N/A,$78.57
3095494,0309,87186,,,,,N/A,N/A,UVM UTHSA POSACONAZOLE,$81.72,$60.75,$5.87,$81.00,N/A,$78.57,N/A,N/A,N/A,$5.87,N/A,$78.57,N/A,$81.00,N/A,N/A,$78.57
3095495,0309,87186,,,,,N/A,N/A,UVM UTHSA VORICONZOLE,$81.72,$60.75,$5.87,$81.00,N/A,$78.57,N/A,N/A,N/A,$5.87,N/A,$78.57,N/A,$81.00,N/A,N/A,$78.57
3095496,0309,87186,,,,,N/A,N/A,UVM UTHSA ISAVUCONAZOLE,$81.72,$60.75,$5.87,$81.00,N/A,$78.57,N/A,N/A,N/A,$5.87,N/A,$78.57,N/A,$81.00,N/A,N/A,$78.57
3095527,0309,87186,,,,,N/A,N/A,"Mayo Yeast, Mic",$61.55,$45.75,$5.87,$81.00,N/A,$78.57,N/A,N/A,N/A,$5.87,N/A,$78.57,N/A,$81.00,N/A,N/A,$78.57
3091740,0309,87205,,,,,N/A,N/A,FAHC ANAEROBIC CULTURE,$86.77,$64.50,$10.48,$88.00,N/A,$85.36,N/A,N/A,N/A,$10.48,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3092375,0309,87205,,,,,N/A,N/A,FAHC ANAEROBE CULTURE/SMEAR,$58.52,$43.50,$10.48,$88.00,N/A,$85.36,N/A,N/A,N/A,$10.48,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3092376,0309,87205,,,,,N/A,N/A,FAHC WRGT STN FOR EOPSINOPHILS,$80.72,$60.00,$10.48,$88.00,N/A,$85.36,N/A,N/A,N/A,$10.48,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3093098,0309,87205,,,,,N/A,N/A,UVM RESPIRTORY CULTURE&SMEAR,$48.43,$36.00,$10.48,$88.00,N/A,$85.36,N/A,N/A,N/A,$10.48,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3093578,0309,87205,,,,,N/A,N/A,MAYO GRAM STAIN BACT VAGINOSIS,$178.58,$132.75,$10.48,$88.00,N/A,$85.36,N/A,N/A,N/A,$10.48,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3099782,0309,87205,,,,,N/A,N/A,FAHC BACTERIAL CULTURE/SMEAR,$94.84,$70.50,$10.48,$88.00,N/A,$85.36,N/A,N/A,N/A,$10.48,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3093375,0309,87206,,,,,N/A,N/A,UVM  AFB SMEAR,$25.22,$18.75,$5.03,$16.00,N/A,$15.52,N/A,N/A,N/A,$5.03,N/A,$15.52,N/A,$16.00,N/A,N/A,$15.52
3093521,0309,87206,,,,,N/A,N/A,UVM FUNGAL CULTURE & SMEAR,$7.06,$5.25,$5.03,$16.00,N/A,$15.52,N/A,N/A,N/A,$5.03,N/A,$15.52,N/A,$16.00,N/A,N/A,$15.52
3093524,0309,87206,,,,,N/A,N/A,UVMSKIN/HAIR/NAIL FUNGAL CU/SM,$7.06,$5.25,$5.03,$16.00,N/A,$15.52,N/A,N/A,N/A,$5.03,N/A,$15.52,N/A,$16.00,N/A,N/A,$15.52
3093252,0309,87207,,,,,N/A,N/A,MAYO MALARIA %PARASITEMIA,$106.95,$79.50,$6.29,$160.00,$84.46,$155.20,$84.46,N/A,$84.46,$6.29,$84.46,$155.20,$84.46,$160.00,$84.46,$84.46,$155.20
3093384,0309,87209,,,,,N/A,N/A,MAYO PARASITIC EXAM (O&P),$40.36,$30.00,$28.96,$40.00,N/A,$38.80,N/A,N/A,N/A,$28.96,N/A,$38.80,N/A,$40.00,N/A,N/A,$38.80
3093493,0309,87210,,,,,N/A,N/A,"MAYO FILARIA, B",$51.46,$38.25,$21.80,$88.00,N/A,$85.36,N/A,N/A,N/A,$21.80,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
3099803,0309,87230,,,,,N/A,N/A,MAYO C.DIFFICLE CYTOTOXIN AB,$372.30,$276.75,$5.03,$369.00,N/A,$357.93,N/A,N/A,N/A,$5.03,N/A,$357.93,N/A,$369.00,N/A,N/A,$357.93
3092457,0309,87252,,,,,N/A,N/A,FAHC NON RESPIRATORY VIRAL CUL,$84.75,$63.00,$23.89,$199.00,N/A,$193.03,N/A,N/A,N/A,$23.89,N/A,$193.03,N/A,$199.00,N/A,N/A,$193.03
3093479,0309,87252,,,,,N/A,N/A,"MAYO VIRAL CULTURE, NON-RESPI",$63.56,$47.25,$23.89,$199.00,N/A,$193.03,N/A,N/A,N/A,$23.89,N/A,$193.03,N/A,$199.00,N/A,N/A,$193.03
3093527,0309,87252,,,,,N/A,N/A,"MAYO VIRAL CULTURE,RESPIRATORY",$53.47,$39.75,$23.89,$199.00,N/A,$193.03,N/A,N/A,N/A,$23.89,N/A,$193.03,N/A,$199.00,N/A,N/A,$193.03
3092673,0309,87253,,,,,N/A,N/A,MAYO INTERFERON NUTRALIZ AB,$385.42,$286.50,$31.44,$382.00,N/A,$370.54,N/A,N/A,N/A,$31.44,N/A,$370.54,N/A,$382.00,N/A,N/A,$370.54
3093579,0309,87305,,,,,N/A,N/A,MAYO ASPERGILLUS ANTIGEN,$89.80,$66.75,$14.25,$89.00,N/A,$86.33,N/A,N/A,N/A,$14.25,N/A,$86.33,N/A,$89.00,N/A,N/A,$86.33
3093428,0309,87328,,,,,N/A,N/A,MAYO CRYPTOSPORIDUIM F,$76.68,$57.00,$14.25,$76.00,N/A,$73.72,N/A,N/A,N/A,$14.25,N/A,$73.72,N/A,$76.00,N/A,N/A,$73.72
3093381,0309,87329,,,,,N/A,N/A,MAYO GIARDIA Ag,$46.41,$34.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3093396,0309,87338,,,,,N/A,N/A,UVM H.PYLORI Ag STOOL,$70.63,$52.50,$16.77,$222.00,N/A,$215.34,N/A,N/A,N/A,$16.77,N/A,$215.34,N/A,$222.00,N/A,N/A,$215.34
3099688,0309,87338,,,,,N/A,N/A,MAYO HELICOBACTER PYLORI AG,$223.98,$166.50,$16.77,$222.00,N/A,$215.34,N/A,N/A,N/A,$16.77,N/A,$215.34,N/A,$222.00,N/A,N/A,$215.34
3093110,0309,87339,,,,,N/A,N/A,MAYO E.HISTOLYTICA Ag,$148.31,$110.25,$17.18,$147.00,N/A,$142.59,N/A,N/A,N/A,$17.18,N/A,$142.59,N/A,$147.00,N/A,N/A,$142.59
3092581,0309,87340,,,,,N/A,N/A,MAYO CHRONIC HEPATITIS PROF,$38.34,$28.50,$19.28,$94.00,N/A,$91.18,N/A,N/A,N/A,$19.28,N/A,$91.18,N/A,$94.00,N/A,N/A,$91.18
3093400,0309,87340,,,,,N/A,N/A,UVM HEP B SURFACE ANTIGEN,$38.34,$28.50,$19.28,$94.00,N/A,$91.18,N/A,N/A,N/A,$19.28,N/A,$91.18,N/A,$94.00,N/A,N/A,$91.18
3091864,0309,87341,,,,,N/A,N/A,FAHC HEPATITIS B SUR Ag CONF,$94.84,$70.50,$12.57,$94.00,N/A,$91.18,N/A,N/A,N/A,$12.57,N/A,$91.18,N/A,$94.00,N/A,N/A,$91.18
3095506,0309,87380,,,,,N/A,N/A,Mayo Hepatitis D Antigen,$144.28,$107.25,$13.83,$297.00,N/A,$288.09,N/A,N/A,N/A,$13.83,N/A,$288.09,N/A,$297.00,N/A,N/A,$288.09
3092847,0309,87385,,,,,N/A,N/A,"MAYO HISTOPLASMA Ag,URINE",$199.77,$148.50,$22.21,$307.00,N/A,$297.79,N/A,N/A,N/A,$22.21,N/A,$297.79,N/A,$307.00,N/A,N/A,$297.79
3093089,0309,87389,,,,,N/A,N/A,MAYO HIV-1/2 Ag&Ab SCREEN,$43.38,$32.25,$15.93,$43.00,N/A,$41.71,N/A,N/A,N/A,$15.93,N/A,$41.71,N/A,$43.00,N/A,N/A,$41.71
3092902,0309,87449,,,,,N/A,N/A,MAYO BLASTOMYCES Ag,$182.62,$135.75,$175.57,$181.00,N/A,$175.57,N/A,N/A,N/A,$181.00,N/A,$175.57,N/A,$181.00,N/A,N/A,$175.57
3093532,0309,87449,,,,,N/A,N/A,"MAYO FUNGITELL, S",$182.62,$135.75,$175.57,$181.00,N/A,$175.57,N/A,N/A,N/A,$181.00,N/A,$175.57,N/A,$181.00,N/A,N/A,$175.57
3093690,0309,87449,,,,,N/A,N/A,"MAYO BLASTOMYCES AG, QUANT,URI",$154.37,$114.75,$175.57,$181.00,N/A,$175.57,N/A,N/A,N/A,$181.00,N/A,$175.57,N/A,$181.00,N/A,N/A,$175.57
3092387,0309,87450,,,,,N/A,N/A,"Mayo Strptcccs Pnemna,Ag Urine",$114.01,$84.75,$14.25,$113.00,N/A,$109.61,N/A,N/A,N/A,$14.25,N/A,$109.61,N/A,$113.00,N/A,N/A,$109.61
3093506,0309,87476,,,,,N/A,N/A,"MAYO LYME DISEASE PCR, B",$45.40,$33.75,$43.65,$45.00,N/A,$43.65,N/A,N/A,N/A,$45.00,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3099904,0309,87476,,,,,N/A,N/A,MAYO BORRELIA BURGDORFERI PCR,$495.39,$368.25,$43.65,$45.00,N/A,$43.65,N/A,N/A,N/A,$45.00,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3095524,0309,87481,,,,,N/A,N/A,Mayo Candida Species,$27.24,$20.25,$23.89,$27.00,N/A,$26.19,N/A,N/A,N/A,$23.89,N/A,$26.19,N/A,$27.00,N/A,N/A,$26.19
3093144,0309,87491,,,,,N/A,N/A,"MAYO C.TRACH,MISC RNA",$69.62,$51.75,$27.24,$69.00,N/A,$66.93,N/A,N/A,N/A,$27.24,N/A,$66.93,N/A,$69.00,N/A,N/A,$66.93
3092206,0309,87496,,,,,N/A,N/A,MAYO CYTOMEGALOVIRUS BY PCR,$495.39,$368.25,$44.85,$132.00,N/A,$128.04,N/A,N/A,N/A,$44.85,N/A,$128.04,N/A,$132.00,N/A,N/A,$128.04
3092936,0309,87496,,,,,N/A,N/A,FAHC RESPIRATORY VIRUS DET,$22.20,$16.50,$44.85,$132.00,N/A,$128.04,N/A,N/A,N/A,$44.85,N/A,$128.04,N/A,$132.00,N/A,N/A,$128.04
3092939,0309,87496,,,,,N/A,N/A,FAHC CMV URINE VIRUS DETECTION,$133.18,$99.00,$44.85,$132.00,N/A,$128.04,N/A,N/A,N/A,$44.85,N/A,$128.04,N/A,$132.00,N/A,N/A,$128.04
3092930,0309,87498,,,,,N/A,N/A,FAHC CSF VIRUS DETECTION,$36.32,$27.00,$51.55,$124.00,N/A,$120.28,N/A,N/A,N/A,$51.55,N/A,$120.28,N/A,$124.00,N/A,N/A,$120.28
3093475,0309,87498,,,,,N/A,N/A,"Mayo Enterovirus PCR,P",$125.11,$93.00,$51.55,$124.00,N/A,$120.28,N/A,N/A,N/A,$51.55,N/A,$120.28,N/A,$124.00,N/A,N/A,$120.28
3093509,0309,87498,,,,,N/A,N/A,"UVM ENTEROVIRUS PCR, CSF",$108.97,$81.00,$51.55,$124.00,N/A,$120.28,N/A,N/A,N/A,$51.55,N/A,$120.28,N/A,$124.00,N/A,N/A,$120.28
3092937,0309,87502,,,,,N/A,N/A,FAHC RESPIRATORY VIRUS DET,$22.20,$16.50,$21.34,$42.33,N/A,$21.34,N/A,N/A,N/A,$42.33,N/A,$21.34,N/A,$22.00,N/A,N/A,$21.34
3092938,0309,87503,,,,,N/A,N/A,FAHC RESPIRATORY VIRUS DET,$22.20,$16.50,$21.34,$115.26,N/A,$21.34,N/A,N/A,N/A,$115.26,N/A,$21.34,N/A,$22.00,N/A,N/A,$21.34
3093231,0309,87505,,,,,N/A,N/A,UVM FECAL BACTERIAL PATHOGENS,$279.48,$207.75,$35.21,$277.00,N/A,$268.69,N/A,N/A,N/A,$35.21,N/A,$268.69,N/A,$277.00,N/A,N/A,$268.69
3092361,0309,87517,,,,,N/A,N/A,MAYO HEP B VIRUS DNA PCR QT,$333.96,$248.25,$42.33,$331.00,N/A,$321.07,N/A,N/A,N/A,$42.33,N/A,$321.07,N/A,$331.00,N/A,N/A,$321.07
3099314,0309,87521,,,,,N/A,N/A,HEPATITIS C GENOTYPE,$495.39,$368.25,$51.55,$491.00,N/A,$476.27,N/A,N/A,N/A,$51.55,N/A,$476.27,N/A,$491.00,N/A,N/A,$476.27
3093611,0309,87522,,,,,N/A,N/A,UVM HCV RNA DETECTION QUANTITA,$122.08,$90.75,$42.33,"$1,109.00",N/A,"$1,075.73",N/A,N/A,N/A,$42.33,N/A,"$1,075.73",N/A,"$1,109.00",N/A,N/A,"$1,075.73"
3092851,0309,87529,,,,,N/A,N/A,"MAYO HSV TYPE 1&2 DNA,PCR",$366.25,$272.25,$103.10,$180.00,N/A,$174.60,N/A,N/A,N/A,$103.10,N/A,$174.60,N/A,$180.00,N/A,N/A,$174.60
3092929,0309,87529,,,,,N/A,N/A,FAHC CSF VIRUS DETECTION,$69.62,$51.75,$103.10,$180.00,N/A,$174.60,N/A,N/A,N/A,$103.10,N/A,$174.60,N/A,$180.00,N/A,N/A,$174.60
3092940,0309,87529,,,,,N/A,N/A,FAHC OCULAR VIRUS DETECTION,$90.80,$67.50,$103.10,$180.00,N/A,$174.60,N/A,N/A,N/A,$103.10,N/A,$174.60,N/A,$180.00,N/A,N/A,$174.60
3092942,0309,87529,,,,,N/A,N/A,FAHC MUCOCUTANEOUS VIRUS DET,$90.80,$67.50,$103.10,$180.00,N/A,$174.60,N/A,N/A,N/A,$103.10,N/A,$174.60,N/A,$180.00,N/A,N/A,$174.60
3093229,0309,87529,,,,,N/A,N/A,"MAYO HSV AND VZV,PCR",$96.86,$72.00,$51.55,$90.00,N/A,$87.30,N/A,N/A,N/A,$51.55,N/A,$87.30,N/A,$90.00,N/A,N/A,$87.30
3093480,0309,87529,,,,,N/A,N/A,UVM HERPES SIMPLEX VIRUS PCR,$55.49,$41.25,$103.10,$180.00,N/A,$174.60,N/A,N/A,N/A,$103.10,N/A,$174.60,N/A,$180.00,N/A,N/A,$174.60
3095437,0309,87529,,,,,N/A,N/A,MAYO HERPES SIMP VIRUS PCR BLO,$38.34,$28.50,$51.55,$90.00,N/A,$87.30,N/A,N/A,N/A,$51.55,N/A,$87.30,N/A,$90.00,N/A,N/A,$87.30
3095438,0309,87529,,,,,N/A,N/A,MAYO HERPES SIMP VIRUS PCR BLO,$38.34,$28.50,$51.55,$90.00,N/A,$87.30,N/A,N/A,N/A,$51.55,N/A,$87.30,N/A,$90.00,N/A,N/A,$87.30
3095440,0309,87529,,,,,N/A,N/A,MAYO HERPES SIMP VIRUS PCR VAR,$38.34,$28.50,$51.55,$90.00,N/A,$87.30,N/A,N/A,N/A,$51.55,N/A,$87.30,N/A,$90.00,N/A,N/A,$87.30
3095441,0309,87529,,,,,N/A,N/A,MAYO HERPES SIMP VIRUS PCR VAR,$38.34,$28.50,$51.55,$90.00,N/A,$87.30,N/A,N/A,N/A,$51.55,N/A,$87.30,N/A,$90.00,N/A,N/A,$87.30
3093513,0309,87532,,,,,N/A,N/A,"MAYO HHV-6 PCR,P",$173.54,$129.00,$42.33,$172.00,N/A,$166.84,N/A,N/A,N/A,$42.33,N/A,$166.84,N/A,$172.00,N/A,N/A,$166.84
93472,0309,87535,,,,,N/A,N/A,"Mayo Hiv-1 Rna Qual,P",$423.75,$315.00,$42.33,$458.00,N/A,$444.26,N/A,N/A,N/A,$42.33,N/A,$444.26,N/A,$458.00,N/A,N/A,$444.26
93472,0309,87535,,,,,N/A,N/A,"Mayo HIV-1 RNA Qual,P",$423.75,$315.00,$42.33,$458.00,N/A,$444.26,N/A,N/A,N/A,$42.33,N/A,$444.26,N/A,$458.00,N/A,N/A,$444.26
3093472,0309,87535,,,,,N/A,N/A,"MAYO HIV-1 RNA QUAL, P",$462.09,$343.50,$42.33,$458.00,N/A,$444.26,N/A,N/A,N/A,$42.33,N/A,$444.26,N/A,$458.00,N/A,N/A,$444.26
3093610,0309,87536,,,,,N/A,N/A,UVM HIV 1 RNA QUANTITATION,$122.08,$90.75,$42.33,$522.00,N/A,$506.34,N/A,N/A,N/A,$42.33,N/A,$506.34,N/A,$522.00,N/A,N/A,$506.34
3092632,0309,87556,,,,,N/A,N/A,"MAYO MTB COMPLES,RAPID PCR",$487.32,$362.25,$102.27,$483.00,N/A,$468.51,N/A,N/A,N/A,$102.27,N/A,$468.51,N/A,$483.00,N/A,N/A,$468.51
3095472,0309,87563,,,,,N/A,N/A,MAYO MYCOPLASMA GENITALIUM TMA,$144.28,$107.25,$49.88,$143.00,N/A,$138.71,N/A,N/A,N/A,$49.88,N/A,$138.71,N/A,$143.00,N/A,N/A,$138.71
3092386,0309,87581,,,,,N/A,N/A,MAYO MYCOPLASMA PNEUMONIAE DNA,$467.14,$347.25,$42.33,$463.00,N/A,$449.11,N/A,N/A,N/A,$42.33,N/A,$449.11,N/A,$463.00,N/A,N/A,$449.11
3093145,0309,87591,,,,,N/A,N/A,"MAYO N.GONORR,MISC,RNA",$69.62,$51.75,$42.33,$69.00,N/A,$66.93,N/A,N/A,N/A,$42.33,N/A,$66.93,N/A,$69.00,N/A,N/A,$66.93
3099762,0309,87621,,,,,N/A,N/A,MAYO HUMAN PAPILLOMAVIRUS DET,$495.39,$368.25,$42.33,$491.00,N/A,$476.27,N/A,N/A,N/A,$42.33,N/A,$476.27,N/A,$491.00,N/A,N/A,$476.27
3099763,0309,87621,,,,,N/A,N/A,MAYO HUMAN PAPILLOMAVIRUS DET,$495.39,$368.25,$42.33,$491.00,N/A,$476.27,N/A,N/A,N/A,$42.33,N/A,$476.27,N/A,$491.00,N/A,N/A,$476.27
3093091,0309,87624,,,,,N/A,N/A,MAYO HPV PCR (VAG),$107.96,$80.25,$103.79,$107.00,N/A,$103.79,N/A,N/A,N/A,$107.00,N/A,$103.79,N/A,$107.00,N/A,N/A,$103.79
3093570,0309,87625,,,,,N/A,N/A,"UVM HPV GENOTYPING16,18,&45,TP",$31.28,$23.25,$30.07,$42.33,N/A,$30.07,N/A,N/A,N/A,$42.33,N/A,$30.07,N/A,$31.00,N/A,N/A,$30.07
3092935,0309,87631,,,,,N/A,N/A,FAHC RESPIRATORY VIRUS DET,$236.09,$175.50,$97.24,$468.00,N/A,$453.96,N/A,N/A,N/A,$97.24,N/A,$453.96,N/A,$468.00,N/A,N/A,$453.96
3093484,0309,87631,,,,,N/A,N/A,"UVM INFLUENZA, RSV PCR",$236.09,$175.50,$48.62,$234.00,N/A,$226.98,N/A,N/A,N/A,$48.62,N/A,$226.98,N/A,$234.00,N/A,N/A,$226.98
3093508,0309,87632,,,,,N/A,N/A,UVM EXPAND RESPIRAT PANEL PCR,$600.32,$446.25,$171.43,$595.00,N/A,$577.15,N/A,N/A,N/A,$171.43,N/A,$577.15,N/A,$595.00,N/A,N/A,$577.15
3093308,0309,87633,,,,,N/A,N/A,MAYO RESPIRATORY VIRUS PANEL,$776.88,$577.50,$261.96,$770.00,N/A,$746.90,N/A,N/A,N/A,$261.96,N/A,$746.90,N/A,$770.00,N/A,N/A,$746.90
3093647,0309,87653,,,,,N/A,N/A,UVM GROUP B STREP PCR,$42.38,$31.50,$40.74,$42.33,N/A,$40.74,N/A,N/A,N/A,$42.33,N/A,$40.74,N/A,$42.00,N/A,N/A,$40.74
3093421,0309,87661,,,,,N/A,N/A,MAYO TRICH VAGINALIS RNA,$129.14,$96.00,$23.89,$128.00,N/A,$124.16,N/A,N/A,N/A,$23.89,N/A,$124.16,N/A,$128.00,N/A,N/A,$124.16
3095525,0309,87661,,,,,N/A,N/A,Mayo Trichomonas Vaginalis,$27.24,$20.25,$23.89,$128.00,N/A,$124.16,N/A,N/A,N/A,$23.89,N/A,$124.16,N/A,$128.00,N/A,N/A,$124.16
3092202,0309,87798,,,,,N/A,N/A,MAYO BABESIA MICROTI BY PCR,$319.83,$237.75,$36.05,$231.00,N/A,$224.07,N/A,N/A,N/A,$36.05,N/A,$224.07,N/A,$231.00,N/A,N/A,$224.07
3092532,0309,87798,,,,,N/A,N/A,FAHC C DIFFICILE MOLECULAR DET,$495.39,$368.25,$36.05,$231.00,N/A,$224.07,N/A,N/A,N/A,$36.05,N/A,$224.07,N/A,$231.00,N/A,N/A,$224.07
3092600,0309,87798,,,,,N/A,N/A,"MAYO TOXOPLASMA GONDII PCR,CSF",$233.07,$173.25,$36.05,$231.00,N/A,$224.07,N/A,N/A,N/A,$36.05,N/A,$224.07,N/A,$231.00,N/A,N/A,$224.07
3092601,0309,87798,,,,,N/A,N/A,"MAYO EPSTEIN BARRVIRUS PCR,CSF",$233.07,$173.25,$36.05,$231.00,N/A,$224.07,N/A,N/A,N/A,$36.05,N/A,$224.07,N/A,$231.00,N/A,N/A,$224.07
3092776,0309,87798,,,,,N/A,N/A,MAYO SHIGA TOXIN PCR,$443.93,$330.00,$36.05,$231.00,N/A,$224.07,N/A,N/A,N/A,$36.05,N/A,$224.07,N/A,$231.00,N/A,N/A,$224.07
3092819,0309,87798,,,,,N/A,N/A,MAYO BARTONELLA PCR,$202.80,$150.75,$36.05,$231.00,N/A,$224.07,N/A,N/A,N/A,$36.05,N/A,$224.07,N/A,$231.00,N/A,N/A,$224.07
3092839,0309,87798,,,,,N/A,N/A,"MAYO EHRLICHIA PCR,BLOOD",$160.42,$119.25,$36.05,$231.00,N/A,$224.07,N/A,N/A,N/A,$36.05,N/A,$224.07,N/A,$231.00,N/A,N/A,$224.07
3092849,0309,87798,,,,,N/A,N/A,MAYO WEST NILE VIRUS PCR (CSF),$120.06,$89.25,$36.05,$231.00,N/A,$224.07,N/A,N/A,N/A,$36.05,N/A,$224.07,N/A,$231.00,N/A,N/A,$224.07
3092926,0309,87798,,,,,N/A,N/A,MAYO PARVOVIRUS B19 PCR 9,$187.66,$139.50,$36.05,$231.00,N/A,$224.07,N/A,N/A,N/A,$36.05,N/A,$224.07,N/A,$231.00,N/A,N/A,$224.07
3092931,0309,87798,,,,,N/A,N/A,FAHC CSF VIRUS DETECTION,$36.32,$27.00,$36.05,$231.00,N/A,$224.07,N/A,N/A,N/A,$36.05,N/A,$224.07,N/A,$231.00,N/A,N/A,$224.07
3092941,0309,87798,,,,,N/A,N/A,FAHC OCULAR VIRUS DETECTION,$46.41,$34.50,$36.05,$231.00,N/A,$224.07,N/A,N/A,N/A,$36.05,N/A,$224.07,N/A,$231.00,N/A,N/A,$224.07
3092943,0309,87798,,,,,N/A,N/A,FAHC MUCOCUTANEOUS VIRUS DET,$46.41,$34.50,$36.05,$231.00,N/A,$224.07,N/A,N/A,N/A,$36.05,N/A,$224.07,N/A,$231.00,N/A,N/A,$224.07
3092944,0309,87798,,,,,N/A,N/A,FAHC RESPIRATORY VIRUS DET,$43.38,$32.25,$72.10,$462.00,N/A,$448.14,N/A,N/A,N/A,$72.10,N/A,$448.14,N/A,$462.00,N/A,N/A,$448.14
3093006,0309,87798,,,,,N/A,N/A,"MAYO BABESIA SPECIES,PCR,B",$186.65,$138.75,$36.05,$231.00,N/A,$224.07,N/A,N/A,N/A,$36.05,N/A,$224.07,N/A,$231.00,N/A,N/A,$224.07
3093020,0309,87798,,,,,N/A,N/A,"MAYO JC VIRUS PCR,CSF",$182.62,$135.75,$36.05,$231.00,N/A,$224.07,N/A,N/A,N/A,$36.05,N/A,$224.07,N/A,$231.00,N/A,N/A,$224.07
3093100,0309,87798,,,,,N/A,N/A,MAYO COCCIDIOIDES PCR,$261.32,$194.25,$36.05,$231.00,N/A,$224.07,N/A,N/A,N/A,$36.05,N/A,$224.07,N/A,$231.00,N/A,N/A,$224.07
3093107,0309,87798,,,,,N/A,N/A,MAYO ADENOVIRUS PCR,$115.02,$85.50,$36.05,$231.00,N/A,$224.07,N/A,N/A,N/A,$36.05,N/A,$224.07,N/A,$231.00,N/A,N/A,$224.07
3093119,0309,87798,,,,,N/A,N/A,"MAYO CHIKUNGUNYA,QUAL PCR",$509.51,$378.75,$36.05,$231.00,N/A,$224.07,N/A,N/A,N/A,$36.05,N/A,$224.07,N/A,$231.00,N/A,N/A,$224.07
3093230,0309,87798,,,,,N/A,N/A,"MAYO HSV AND VZV,PCR",$96.86,$72.00,$36.05,$231.00,N/A,$224.07,N/A,N/A,N/A,$36.05,N/A,$224.07,N/A,$231.00,N/A,N/A,$224.07
3093251,0309,87798,,,,,N/A,N/A,MAYO MALARIA PCR,$200.78,$149.25,$36.05,$231.00,N/A,$224.07,N/A,N/A,N/A,$36.05,N/A,$224.07,N/A,$231.00,N/A,N/A,$224.07
3093422,0309,87798,,,,,N/A,N/A,MAYO HEPATITIS & QT PCR,$722.40,$537.00,$36.05,$231.00,N/A,$224.07,N/A,N/A,N/A,$36.05,N/A,$224.07,N/A,$231.00,N/A,N/A,$224.07
3093424,0309,87798,,,,,N/A,N/A,MAYO NOROVIRUS PCR,$379.36,$282.00,$72.10,$462.00,N/A,$448.14,N/A,N/A,N/A,$72.10,N/A,$448.14,N/A,$462.00,N/A,N/A,$448.14
3093481,0309,87798,,,,,N/A,N/A,UVM VARICELLA ZOSTER PCR,$67.60,$50.25,$36.05,$231.00,N/A,$224.07,N/A,N/A,N/A,$36.05,N/A,$224.07,N/A,$231.00,N/A,N/A,$224.07
3093507,0309,87798,,,,,N/A,N/A,"MAYO LYME DISEASE PCR, B",$85.76,$63.75,$72.10,$462.00,N/A,$448.14,N/A,N/A,N/A,$72.10,N/A,$448.14,N/A,$462.00,N/A,N/A,$448.14
3093551,0309,87798,,,,,N/A,N/A,MAYO EHRLICHIA/ANAPLASMA PCR,$24.21,$18.00,$144.20,$924.00,N/A,$896.28,N/A,N/A,N/A,$144.20,N/A,$896.28,N/A,$924.00,N/A,N/A,$896.28
3093552,0309,87798,,,,,N/A,N/A,MAYO BABESIA SPECIES PCR,$24.21,$18.00,$108.15,$693.00,N/A,$672.21,N/A,N/A,N/A,$108.15,N/A,$672.21,N/A,$693.00,N/A,N/A,$672.21
3093553,0309,87798,,,,,N/A,N/A,MAYO BORRELIA MIYAMOTOI PCR,$24.21,$18.00,$36.05,$231.00,N/A,$224.07,N/A,N/A,N/A,$36.05,N/A,$224.07,N/A,$231.00,N/A,N/A,$224.07
3093564,0309,87798,,,,,N/A,N/A,"MAYO WEST NILE VIRUS PCR,P",$116.03,$86.25,$36.05,$231.00,N/A,$224.07,N/A,N/A,N/A,$36.05,N/A,$224.07,N/A,$231.00,N/A,N/A,$224.07
3093620,0309,87798,,,,,N/A,N/A,"MAYO MICROSPORIDIA SPECIES,PCR",$443.93,$330.00,$36.05,$231.00,N/A,$224.07,N/A,N/A,N/A,$36.05,N/A,$224.07,N/A,$231.00,N/A,N/A,$224.07
3093683,0309,87798,,,,,N/A,N/A,"MAYO BORRELIA MIYAMOTOI PCR,B",$96.86,$72.00,$36.05,$231.00,N/A,$224.07,N/A,N/A,N/A,$36.05,N/A,$224.07,N/A,$231.00,N/A,N/A,$224.07
3095507,0309,87798,,,,,N/A,N/A,"Mayo Pneumocystis Pcr, Varies",$124.10,$92.25,$36.05,$231.00,N/A,$224.07,N/A,N/A,N/A,$36.05,N/A,$224.07,N/A,$231.00,N/A,N/A,$224.07
3095513,0309,87798,,,,,N/A,N/A,"Mayo Toxoplasma Gondii Pcr, B",$116.03,$86.25,$36.05,$231.00,N/A,$224.07,N/A,N/A,N/A,$36.05,N/A,$224.07,N/A,$231.00,N/A,N/A,$224.07
3099778,0309,87798,,,,,N/A,N/A,MAYO VARICELLA-ZOSTER PCR CSF,$148.31,$110.25,$36.05,$231.00,N/A,$224.07,N/A,N/A,N/A,$36.05,N/A,$224.07,N/A,$231.00,N/A,N/A,$224.07
3092498,0309,87799,,,,,N/A,N/A,"MAYO BK VIRUS DNA QN,PLASMA",$165.47,$123.00,$42.33,$248.00,N/A,$240.56,N/A,N/A,N/A,$42.33,N/A,$240.56,N/A,$248.00,N/A,N/A,$240.56
3092499,0309,87799,,,,,N/A,N/A,"MAYO BK VIRUS DNA QN,URINE",$165.47,$123.00,$42.33,$248.00,N/A,$240.56,N/A,N/A,N/A,$42.33,N/A,$240.56,N/A,$248.00,N/A,N/A,$240.56
3093442,0309,87799,,,,,N/A,N/A,"MAYO EBV DNA DETECT/Qt,P",$159.41,$118.50,$42.33,$248.00,N/A,$240.56,N/A,N/A,N/A,$42.33,N/A,$240.56,N/A,$248.00,N/A,N/A,$240.56
3093639,0309,87799,,,,,N/A,N/A,"MAYO BK VIRUS PCR, QUANT, U",$172.53,$128.25,$42.33,$248.00,N/A,$240.56,N/A,N/A,N/A,$42.33,N/A,$240.56,N/A,$248.00,N/A,N/A,$240.56
3095470,0309,87799,,,,,N/A,N/A,MAYO HERPES VIRUS 7 DNA QUANT,$318.83,$237.00,$42.33,$248.00,N/A,$240.56,N/A,N/A,N/A,$42.33,N/A,$240.56,N/A,$248.00,N/A,N/A,$240.56
3095488,0309,87799,,,,,N/A,N/A,"MAYO JC VIRUS DNA, QN PCR",$433.84,$322.50,$42.33,$248.00,N/A,$240.56,N/A,N/A,N/A,$42.33,N/A,$240.56,N/A,$248.00,N/A,N/A,$240.56
3095499,0309,87799,,,,,N/A,N/A,"Arup Adenovirus Qt, Blood",$250.22,$186.00,$42.33,$248.00,N/A,$240.56,N/A,N/A,N/A,$42.33,N/A,$240.56,N/A,$248.00,N/A,N/A,$240.56
3092922,0309,87801,,,,,N/A,N/A,BARTONELLA PCR B,$188.67,$140.25,$51.55,$187.00,N/A,$181.39,N/A,N/A,N/A,$51.55,N/A,$181.39,N/A,$187.00,N/A,N/A,$181.39
3093558,0309,87801,,,,,N/A,N/A,MAYO LEGIONELLA PCR,$136.21,$101.25,$51.55,$187.00,N/A,$181.39,N/A,N/A,N/A,$51.55,N/A,$181.39,N/A,$187.00,N/A,N/A,$181.39
3099961,0309,87801,,,,,N/A,N/A,MAYO BORDETELLA (PCR),$882.82,$656.25,$51.55,$187.00,N/A,$181.39,N/A,N/A,N/A,$51.55,N/A,$181.39,N/A,$187.00,N/A,N/A,$181.39
3095475,0309,87900,,,,,N/A,N/A,MAYO PHENOTYPE INFECT AGENT DR,$439.90,$327.00,$19.70,$436.00,N/A,$422.92,N/A,N/A,N/A,$19.70,N/A,$422.92,N/A,$436.00,N/A,N/A,$422.92
3092913,0309,87901,,,,,N/A,N/A,MAYO HIV-1 GENOTYPIC DRUG RESI,$681.03,$506.25,$156.76,"$2,163.00",N/A,"$2,098.11",N/A,N/A,N/A,$156.76,N/A,"$2,098.11",N/A,"$2,163.00",N/A,N/A,"$2,098.11"
3099432,0309,87901,,,,,N/A,N/A,MAYO HIV GENOTYPING DRUG RES,"$2,182.34","$1,622.25",$156.76,"$2,163.00",N/A,"$2,098.11",N/A,N/A,N/A,$156.76,N/A,"$2,098.11",N/A,"$2,163.00",N/A,N/A,"$2,098.11"
3093341,0309,87902,,,,,N/A,N/A,MAYO HCV GENOTYPE RESOLUTION,$122.08,$90.75,$309.32,$861.00,N/A,$835.17,N/A,N/A,N/A,$309.32,N/A,$835.17,N/A,$861.00,N/A,N/A,$835.17
3095474,0309,87902,,,,,N/A,N/A,MAYO GENOTYPE DNA HEPATITIS C,$868.70,$645.75,$309.32,$861.00,N/A,$835.17,N/A,N/A,N/A,$309.32,N/A,$835.17,N/A,$861.00,N/A,N/A,$835.17
3093657,0309,87906,,,,,N/A,N/A,MAYO HIV-1 INTEGRASE GENOTYPE,$511.53,$380.25,$309.32,$507.00,N/A,$491.79,N/A,N/A,N/A,$309.32,N/A,$491.79,N/A,$507.00,N/A,N/A,$491.79
3092844,0309,87999,,,,,N/A,N/A,MAYO TROFILE PHENOTYPIC CORE,"$3,495.98","$2,598.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3099101,0309,88108,,,,,N/A,N/A,CMV URINE CULTURE,$265.35,$197.25,$17.83,$263.00,$17.83,$255.11,$17.83,N/A,$17.83,$80.51,$17.83,$255.11,$17.83,$263.00,$17.83,$17.83,$255.11
3092568,0309,88184,,,,,N/A,N/A,MAYO T-CELL PHENOTYPING ADV,$245.17,$182.25,$97.97,$167.98,$114.80,$97.97,$114.80,N/A,$114.80,$167.98,$114.80,$97.97,$114.80,$101.00,$114.80,$114.80,$97.97
3092729,0309,88184,,,,,N/A,N/A,MAYO LEUKEMIA LYMPHOMA TRIAG,$45.40,$33.75,$97.97,$167.98,$114.80,$97.97,$114.80,N/A,$114.80,$167.98,$114.80,$97.97,$114.80,$101.00,$114.80,$114.80,$97.97
3093457,0309,88184,,,,,N/A,N/A,UVM CD19 CD20 STUDY,$101.90,$75.75,$97.97,$167.98,$114.80,$97.97,$114.80,N/A,$114.80,$167.98,$114.80,$97.97,$114.80,$101.00,$114.80,$114.80,$97.97
3093544,0309,88184,,,,,N/A,N/A,MAYO FLOWCYTOMETRY/TC 1,$50.45,$37.50,$195.94,$335.96,$229.60,$195.94,$229.60,N/A,$229.60,$335.96,$229.60,$195.94,$229.60,$202.00,$229.60,$229.60,$195.94
3093573,0309,88184,,,,,N/A,N/A,MAYO CKP53 PROTOCAL(RELFEX ONL,$282.50,$210.00,$97.97,$167.98,$114.80,$97.97,$114.80,N/A,$114.80,$167.98,$114.80,$97.97,$114.80,$101.00,$114.80,$114.80,$97.97
3093636,0309,88184,,,,,N/A,N/A,MAYO FLOWCYTOMETRY/TC1 MARKER,$148.31,$110.25,$97.97,$167.98,$114.80,$97.97,$114.80,N/A,$114.80,$167.98,$114.80,$97.97,$114.80,$101.00,$114.80,$114.80,$97.97
3092730,0309,88185,,,,,N/A,N/A,MAYO LEUKEMIA LYMPHOMA TRIAG,$141.25,$105.00,$344.40,$636.00,$344.40,$616.92,$344.40,N/A,$344.40,$500.82,$344.40,$616.92,$344.40,$636.00,$344.40,$344.40,$616.92
3093458,0309,88185,,,,,N/A,N/A,UVM CD19 CD20 STUDY,$101.90,$75.75,$57.40,$106.00,$57.40,$102.82,$57.40,N/A,$57.40,$83.47,$57.40,$102.82,$57.40,$106.00,$57.40,$57.40,$102.82
3093543,0309,88185,,,,,N/A,N/A,MAYO  FLOWCYTOMETRY/TC,$20.18,$15.00,$401.80,$742.00,$401.80,$719.74,$401.80,N/A,$401.80,$584.29,$401.80,$719.74,$401.80,$742.00,$401.80,$401.80,$719.74
3093574,0309,88185,,,,,N/A,N/A,MAYO CKP53 PROTOCAL(RELFEX ONL,$106.95,$79.50,$57.40,$106.00,$57.40,$102.82,$57.40,N/A,$57.40,$83.47,$57.40,$102.82,$57.40,$106.00,$57.40,$57.40,$102.82
3093637,0309,88185,,,,,N/A,N/A,MAYO FLOWCYTOMETRY/TC ADD-ON,$50.45,$37.50,$57.40,$106.00,$57.40,$102.82,$57.40,N/A,$57.40,$83.47,$57.40,$102.82,$57.40,$106.00,$57.40,$57.40,$102.82
3092727,0309,88187,,,,,N/A,N/A,MAYO FLOW CYTOMETRY INTER2-8,$119.05,$88.50,$27.66,$118.00,$48.38,$114.46,$48.38,N/A,$48.38,$27.66,$48.38,$114.46,$48.38,$118.00,$48.38,$48.38,$114.46
3093545,0309,88188,,,,,N/A,N/A,MAYO FLOWCYTOMETRY INTER 9-15M,$170.51,$126.75,$43.25,$169.00,$69.29,$163.93,$69.29,N/A,$69.29,$43.25,$69.29,$163.93,$69.29,$169.00,$69.29,$69.29,$163.93
3093247,0309,88237,,,,,N/A,N/A,UVM FISH FOR CLL,$35.31,$26.25,$33.95,$168.91,N/A,$33.95,N/A,N/A,N/A,$168.91,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
3099955,0309,88262,,,,,N/A,N/A,"MAYO CHROMOSOMES,CONG BLOOD",$414.67,$308.25,$172.68,$537.00,N/A,$520.89,N/A,N/A,N/A,$172.68,N/A,$520.89,N/A,$537.00,N/A,N/A,$520.89
3092407,0309,88271,,,,,N/A,N/A,"MAYO BCR/ABL, FISH",$409.63,$304.50,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3092408,0309,88271,,,,,N/A,N/A,"MAYO BCR/ABL, FISH",$409.63,$304.50,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3092958,0309,88271,,,,,N/A,N/A,"MAYO CLL,LOCUS ANOMALIES,FIS",$286.54,$213.00,$87.30,$301.78,N/A,$87.30,N/A,N/A,N/A,$301.78,N/A,$87.30,N/A,$90.00,N/A,N/A,$87.30
3093248,0309,88271,,,,,N/A,N/A,UVM FISH FOR CLL,$212.89,$158.25,$305.55,"$1,056.23",N/A,$305.55,N/A,N/A,N/A,"$1,056.23",N/A,$305.55,N/A,$315.00,N/A,N/A,$305.55
3100130,0309,88271,,,,,N/A,N/A,Mayo POC Aneuploidy Det Fish,$298.65,$222.00,$87.30,$301.78,N/A,$87.30,N/A,N/A,N/A,$301.78,N/A,$87.30,N/A,$90.00,N/A,N/A,$87.30
3092409,0309,88275,,,,,N/A,N/A,"MAYO BCR/ABL, FISH",$757.71,$563.25,$50.72,$751.00,N/A,$728.47,N/A,N/A,N/A,$50.72,N/A,$728.47,N/A,$751.00,N/A,N/A,$728.47
3092410,0309,88275,,,,,N/A,N/A,"MAYO BCR/ABL, FISH",$757.71,$563.25,$50.72,$751.00,N/A,$728.47,N/A,N/A,N/A,$50.72,N/A,$728.47,N/A,$751.00,N/A,N/A,$728.47
3092959,0309,88275,,,,,N/A,N/A,"MAYO CLL,LOCUS ANOMALIES,FIS",$173.54,$129.00,$50.72,$751.00,N/A,$728.47,N/A,N/A,N/A,$50.72,N/A,$728.47,N/A,$751.00,N/A,N/A,$728.47
3093250,0309,88275,,,,,N/A,N/A,UVM FISH FOR CLL,$94.84,$70.50,$152.16,"$2,253.00",N/A,"$2,185.41",N/A,N/A,N/A,$152.16,N/A,"$2,185.41",N/A,"$2,253.00",N/A,N/A,"$2,185.41"
3092290,0309,88291,,,,,N/A,N/A,"MAYO CLL,LOCUS ANOMALIES,FISH",$43.38,$32.25,$61.61,$176.00,$168.10,$170.72,$168.10,N/A,$168.10,$61.61,$168.10,$170.72,$168.10,$176.00,$168.10,$168.10,$170.72
3092411,0309,88291,,,,,N/A,N/A,"MAYO BCR/ABL, FISH",$117.04,$87.00,$61.61,$176.00,$168.10,$170.72,$168.10,N/A,$168.10,$61.61,$168.10,$170.72,$168.10,$176.00,$168.10,$168.10,$170.72
3092960,0309,88291,,,,,N/A,N/A,"MAYO CLL,LOCUS ANOMALIES,FIS",$160.42,$119.25,$61.61,$176.00,$168.10,$170.72,$168.10,N/A,$168.10,$61.61,$168.10,$170.72,$168.10,$176.00,$168.10,$168.10,$170.72
3093249,0309,88291,,,,,N/A,N/A,UVM FISH FOR CLL,$270.40,$201.00,$61.61,$176.00,$168.10,$170.72,$168.10,N/A,$168.10,$61.61,$168.10,$170.72,$168.10,$176.00,$168.10,$168.10,$170.72
3100131,0309,88291,,,,,N/A,N/A,Mayo POC Aneuploidy Det Fish,$189.68,$141.00,$61.61,$176.00,$168.10,$170.72,$168.10,N/A,$168.10,$61.61,$168.10,$170.72,$168.10,$176.00,$168.10,$168.10,$170.72
3100133,0309,88364,,,,,N/A,N/A,MAYO HPV HIGH/LOW RISK DNA,$335.98,$249.75,$136.53,$333.00,$136.53,$323.01,$136.53,N/A,$136.53,$162.12,$136.53,$323.01,$136.53,$333.00,$136.53,$136.53,$323.01
3100134,0309,88365,,,,,N/A,N/A,MAYO HPV HIGH/LOW RISK DNA,$335.98,$249.75,$136.53,$333.00,$136.53,$323.01,$136.53,N/A,$136.53,$187.56,$136.53,$323.01,$136.53,$333.00,$136.53,$136.53,$323.01
3092605,0309,88368,,,,,N/A,N/A,MAYO UROVYSION BLADDER CANCER,$126.12,$93.75,$66.10,$241.19,$66.10,$156.17,$66.10,N/A,$66.10,$241.19,$66.10,$156.17,$66.10,$161.00,$66.10,$66.10,$156.17
3092606,0309,88368,,,,,N/A,N/A,MAYO UROVYSION BLADDER CANCER,$127.13,$94.50,$66.10,$241.19,$66.10,$156.17,$66.10,N/A,$66.10,$241.19,$66.10,$156.17,$66.10,$161.00,$66.10,$66.10,$156.17
3092607,0309,88368,,,,,N/A,N/A,MAYO UROVYSION BLADDER CANCER,$127.13,$94.50,$66.10,$241.19,$66.10,$156.17,$66.10,N/A,$66.10,$241.19,$66.10,$156.17,$66.10,$161.00,$66.10,$66.10,$156.17
3092608,0309,88368,,,,,N/A,N/A,MAYO UROVYSION BLADDER CANCER,$127.13,$94.50,$66.10,$241.19,$66.10,$156.17,$66.10,N/A,$66.10,$241.19,$66.10,$156.17,$66.10,$161.00,$66.10,$66.10,$156.17
3050416,0309,89050,,,,,N/A,N/A,BODY FLUID CELL COUNT,$70.63,$52.50,$67.90,$265.53,N/A,$67.90,N/A,N/A,N/A,$265.53,N/A,$67.90,N/A,$70.00,N/A,N/A,$67.90
3050418,0309,89050,,,,,N/A,N/A,CSF CELL COUNT &DIFFERENTIAL,$58.52,$43.50,$67.90,$265.53,N/A,$67.90,N/A,N/A,N/A,$265.53,N/A,$67.90,N/A,$70.00,N/A,N/A,$67.90
3091875,0309,89240,,,,,N/A,N/A,"MAYO FERTILITY TEST,SEMEN",$135.20,$100.50,$5.87,$134.00,N/A,$129.98,N/A,N/A,N/A,$5.87,N/A,$129.98,N/A,$134.00,N/A,N/A,$129.98
3091874,0309,89310,,,,,N/A,N/A,"MAYO FERTILITY TEST,SEMEN",$170.51,$126.75,$0.00,$169.00,N/A,$163.93,N/A,N/A,N/A,$0.00,N/A,$163.93,N/A,$169.00,N/A,N/A,$163.93
3093589,0309,0027U,,,,,N/A,N/A,MAYO JAK2 EXON 12 MUTATION,$393.49,$292.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3093554,0309,0064U,,,,,N/A,N/A,MAYO SYPHILIS TOT BILL ONLY#2,$84.75,$63.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3093606,0309,0097U,,,,,N/A,N/A,"MAYO GI PATHOGEN PANEL PCR, F",$404.58,$300.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
G0328,0309,G0328,,,,,N/A,N/A,COLORECTAL CANCER SCREENING,$45.40,$33.75,$43.65,$45.00,N/A,$43.65,N/A,N/A,N/A,$45.00,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3900011,0309,P9022,,,,,N/A,N/A,ARC WASHED RBC FEE,$289.57,$215.25,"$1,148.48","$1,184.00",N/A,"$1,148.48",N/A,N/A,N/A,"$1,184.00",N/A,"$1,148.48",N/A,"$1,184.00",N/A,N/A,"$1,148.48"
3093594,0309,U0003,,,,,N/A,N/A,UVM COVID-19 CORONAVIRUS,$136.21,$101.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3093607,0309,U0003,,,,,N/A,N/A,MAYO SARA-COV-2 RNA DECTECTION,$136.21,$101.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3093659,0309,U0003,,,,,N/A,N/A,DHMC SARS-COV-2 RNA,$136.21,$101.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3095446,0309,U0003,,,,,N/A,N/A,"MAYO SARS-COV-2 PCR, VARIES",$94.84,$70.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3000695,0309,U0005,,,,,N/A,N/A,COVID-19 TESTING,$107.96,$80.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3900034,0309,,,,,,N/A,N/A,Arc Thawing Rare Reagent Red,$52.46,$39.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
33091862,0309,,,,,,N/A,N/A,ARC INHIBITION OF SERUM,$99.89,$74.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3099502,0310,80102,,,,,N/A,N/A,Mayo Thc Conf. Urine,$253.24,$188.25,$243.47,$251.00,N/A,$243.47,N/A,N/A,N/A,$251.00,N/A,$243.47,N/A,$251.00,N/A,N/A,$243.47
3100107,0310,81210,,,,,N/A,N/A,BRAF MUTATION ANALYSIS(PTH),$628.57,$467.25,$173.94,$623.00,N/A,$604.31,N/A,$207.93,N/A,$173.94,N/A,$604.31,N/A,$623.00,N/A,N/A,$604.31
3100109,0310,81288,,,,,N/A,N/A,Mlh1 Hypermethylation (Pth),$503.46,$374.25,$150.05,$499.00,N/A,$484.03,N/A,N/A,N/A,$150.05,N/A,$484.03,N/A,$499.00,N/A,N/A,$484.03
3100115,0310,81301,,,,,N/A,N/A,MICROSATELLITE INSTABILITY(PTH,$479.25,$356.25,$78.38,$475.00,N/A,$460.75,N/A,$458.25,N/A,$78.38,N/A,$460.75,N/A,$475.00,N/A,N/A,$460.75
3092034,0310,81331,,,,,N/A,N/A,MAYO PRADER WILL ANGEL ANALY,"$1,001.88",$744.75,$164.72,$993.00,N/A,$963.21,N/A,N/A,N/A,$164.72,N/A,$963.21,N/A,$993.00,N/A,N/A,$963.21
3092036,0310,83892,,,,,N/A,N/A,MAYO PRADER WILL ANGEL ANALY,$36.32,$27.00,$201.76,$208.00,N/A,$201.76,N/A,N/A,N/A,$208.00,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
3092460,0310,84100,,,,,N/A,N/A,PHOSPHORUS INORGANIC PHOSPHATE,$49.44,$36.75,$17.60,$95.00,N/A,$92.15,N/A,N/A,N/A,$17.60,N/A,$92.15,N/A,$95.00,N/A,N/A,$92.15
3091256,0310,86787,,,,,N/A,N/A,UVM VARICELLA IgG,$54.48,$40.50,$15.09,$247.00,N/A,$239.59,N/A,N/A,N/A,$15.09,N/A,$239.59,N/A,$247.00,N/A,N/A,$239.59
3090008,0310,86790,,,,,N/A,N/A,"ANTIBODY, VIRUS NOS",$161.43,$120.00,$17.18,$236.00,N/A,$228.92,N/A,N/A,N/A,$17.18,N/A,$228.92,N/A,$236.00,N/A,N/A,$228.92
3091862,0310,86977,,,,,N/A,N/A,ARC INHIBITION OF SERUM,$107.96,$80.25,$43.59,$107.00,N/A,$103.79,N/A,N/A,N/A,$43.59,N/A,$103.79,N/A,$107.00,N/A,N/A,$103.79
3099450,0310,87272,,,,,N/A,N/A,CRYPTOSPORIDIUM (STOOL),$91.81,$68.25,$15.93,$91.00,N/A,$88.27,N/A,N/A,N/A,$15.93,N/A,$88.27,N/A,$91.00,N/A,N/A,$88.27
3100090,0310,88142,,,,,N/A,N/A,LRH THIN PREP PAP DIAGN,$313.78,$233.25,$26.21,$321.00,N/A,$311.37,N/A,N/A,N/A,$26.21,N/A,$311.37,N/A,$321.00,N/A,N/A,$311.37
3100118,0310,88172,,,,,N/A,N/A,CYTOLOGY BF PATH ASSISTED FNA,$84.75,$63.00,$18.02,$84.00,$34.44,$81.48,$34.44,N/A,$34.44,$18.02,$34.44,$81.48,$34.44,$84.00,$34.44,$34.44,$81.48
3100119,0310,88177,,,,,N/A,N/A,CYTOLOGY BF PATH ASSIT FNA ADD,$84.75,$63.00,$34.44,$84.00,$34.44,$81.48,$34.44,N/A,$34.44,$66.67,$34.44,$81.48,$34.44,$84.00,$34.44,$34.44,$81.48
3099163,0310,88230,,,,,N/A,N/A,CHROMOSOME TEST 1,$657.83,$489.00,$39.77,$100.57,N/A,$39.77,N/A,N/A,N/A,$100.57,N/A,$39.77,N/A,$41.00,N/A,N/A,$39.77
3099957,0310,88230,,,,,N/A,N/A,"MAYO CHROMOSOMES,CONG BLOOD",$413.67,$307.50,$39.77,$100.57,N/A,$39.77,N/A,N/A,N/A,$100.57,N/A,$39.77,N/A,$41.00,N/A,N/A,$39.77
3100038,0310,88233,,,,,N/A,N/A,TISS CHROMO ANALYSIS (CULTURE),"$1,653.65","$1,229.25",$139.99,"$1,639.00",N/A,"$1,589.83",N/A,N/A,N/A,$139.99,N/A,"$1,589.83",N/A,"$1,639.00",N/A,N/A,"$1,589.83"
3099164,0310,88262,,,,,N/A,N/A,CHROMOSOME TEST 2,"$2,339.73","$1,739.25",$172.68,$537.00,N/A,$520.89,N/A,N/A,N/A,$172.68,N/A,$520.89,N/A,$537.00,N/A,N/A,$520.89
3100039,0310,88262,,,,,N/A,N/A,TISS CHROM ANALYSIS 15-20 CELL,$679.02,$504.75,$172.68,$537.00,N/A,$520.89,N/A,N/A,N/A,$172.68,N/A,$520.89,N/A,$537.00,N/A,N/A,$520.89
3100120,0310,88271,,,,,N/A,N/A,UVM FISH DNA PROBE,$89.80,$66.75,$43.65,$150.89,N/A,$43.65,N/A,N/A,N/A,$150.89,N/A,$43.65,N/A,$45.00,N/A,N/A,$43.65
3100142,0310,88271,,,,,N/A,N/A,"Mayo Mdm2f Fish, Tissue",$475.21,$353.25,$87.30,$301.78,N/A,$87.30,N/A,N/A,N/A,$301.78,N/A,$87.30,N/A,$90.00,N/A,N/A,$87.30
3100143,0310,88274,,,,,N/A,N/A,"Mayo Interphases, 25-99",$237.10,$176.25,$41.91,$235.00,N/A,$227.95,N/A,N/A,N/A,$41.91,N/A,$227.95,N/A,$235.00,N/A,N/A,$227.95
3100121,0310,88275,,,,,N/A,N/A,UVM IN SITU HYBRIDIZATION,$122.08,$90.75,$50.72,$751.00,N/A,$728.47,N/A,N/A,N/A,$50.72,N/A,$728.47,N/A,$751.00,N/A,N/A,$728.47
3099956,0310,88291,,,,,N/A,N/A,"MAYO CHROMOSOMES,CONG BLOOD",$413.67,$307.50,$61.61,$176.00,$168.10,$170.72,$168.10,N/A,$168.10,$61.61,$168.10,$170.72,$168.10,$176.00,$168.10,$168.10,$170.72
3100004,0310,88300,,,,,N/A,N/A,LEVEL 1 GROSS ONLY,$133.18,$99.00,$39.91,$132.00,$54.12,$128.04,$54.12,N/A,$54.12,$39.91,$54.12,$128.04,$54.12,$132.00,$54.12,$54.12,$128.04
3100005,0310,88302,,,,,N/A,N/A,LEVEL 2 GROSS&MICRO,$162.44,$120.75,$20.04,$161.00,$66.10,$156.17,$66.10,N/A,$66.10,$20.04,$66.10,$156.17,$66.10,$161.00,$66.10,$66.10,$156.17
3100006,0310,88304,,,,,N/A,N/A,LEVEL3 GROSS&MICRO,$206.83,$153.75,$41.38,$185.00,$75.85,$179.45,$75.85,N/A,$75.85,$41.38,$75.85,$179.45,$75.85,$185.00,$75.85,$75.85,$179.45
3100034,0310,88304,,,,,N/A,N/A,SKIN BIOPSY - SIMPLE (SK3),$186.65,$138.75,$41.38,$185.00,$75.85,$179.45,$75.85,N/A,$75.85,$41.38,$75.85,$179.45,$75.85,$185.00,$75.85,$75.85,$179.45
3100007,0310,88305,,,,,N/A,N/A,LEVEL 4 GROSS&MICRO,$279.48,$207.75,$54.54,$392.00,$157.44,$380.24,$157.44,N/A,$157.44,$54.54,$157.44,$380.24,$157.44,$392.00,$157.44,$157.44,$380.24
3100012,0310,88305,,,,,N/A,N/A,BONE MARROW NEED BIO,$395.50,$294.00,$54.54,$392.00,$157.44,$380.24,$157.44,N/A,$157.44,$54.54,$157.44,$380.24,$157.44,$392.00,$157.44,$157.44,$380.24
3100032,0310,88305,,,,,N/A,N/A,SKIN BIOPSY,$518.60,$385.50,$54.54,$392.00,$157.44,$380.24,$157.44,N/A,$157.44,$54.54,$157.44,$380.24,$157.44,$392.00,$157.44,$157.44,$380.24
3100033,0310,88305,,,,,N/A,N/A,SUBSEQ SPECIMEN,$383.40,$285.00,$54.54,$392.00,$157.44,$380.24,$157.44,N/A,$157.44,$54.54,$157.44,$380.24,$157.44,$392.00,$157.44,$157.44,$380.24
3100035,0310,88305,,,,,N/A,N/A,SKIN BIOPSY - COMPLEX (SK4),$387.43,$288.00,$54.54,$392.00,$157.44,$380.24,$157.44,N/A,$157.44,$54.54,$157.44,$380.24,$157.44,$392.00,$157.44,$157.44,$380.24
3100008,0310,88307,,,,,N/A,N/A,LEVEL 5 GROSS & MICRO,$637.65,$474.00,$92.66,$775.00,$317.75,$751.75,$317.75,N/A,$317.75,$92.66,$317.75,$751.75,$317.75,$775.00,$317.75,$317.75,$751.75
3100010,0310,88307,,,,,N/A,N/A,Decalcification,$781.93,$581.25,$92.66,$775.00,$317.75,$751.75,$317.75,N/A,$317.75,$92.66,$317.75,$751.75,$317.75,$775.00,$317.75,$317.75,$751.75
3100009,0310,88309,,,,,N/A,N/A,LEVEL 6 GROSS&MICRO,$843.47,$627.00,$342.76,$836.00,$342.76,$810.92,$342.76,N/A,$342.76,$376.14,$342.76,$810.92,$342.76,$836.00,$342.76,$342.76,$810.92
3100024,0310,88311,,,,,N/A,N/A,TISSUE DECAL,$107.96,$80.25,$43.87,$572.95,$43.87,$103.79,$43.87,N/A,$43.87,$572.95,$43.87,$103.79,$43.87,$107.00,$43.87,$43.87,$103.79
3100023,0310,88312,,,,,N/A,N/A,SPECIAL STAINS GRP 1,$296.63,$220.50,$12.54,$294.00,$12.54,$285.18,$12.54,N/A,$12.54,$27.30,$12.54,$285.18,$12.54,$294.00,$12.54,$12.54,$285.18
3100019,0310,88313,,,,,N/A,N/A,IRON STAIN,$157.39,$117.00,$89.38,$218.00,$89.38,$211.46,$89.38,N/A,$89.38,$146.70,$89.38,$211.46,$89.38,$218.00,$89.38,$89.38,$211.46
3100025,0310,88313,,,,,N/A,N/A,SPECIAL STAINS GRP 2,$219.95,$163.50,$89.38,$218.00,$89.38,$211.46,$89.38,N/A,$89.38,$146.70,$89.38,$211.46,$89.38,$218.00,$89.38,$89.38,$211.46
3100026,0310,88313,,,,,N/A,N/A,Special Stains Grp 3,$175.56,$130.50,$89.38,$218.00,$89.38,$211.46,$89.38,N/A,$89.38,$146.70,$89.38,$211.46,$89.38,$218.00,$89.38,$89.38,$211.46
3100028,0310,88313,,,,,N/A,N/A,IRON STAIN,$151.34,$112.50,$89.38,$218.00,$89.38,$211.46,$89.38,N/A,$89.38,$146.70,$89.38,$211.46,$89.38,$218.00,$89.38,$89.38,$211.46
3100011,0310,88331,,,,,N/A,N/A,FROZEN SECTION 8943,$325.89,$242.25,$105.85,$323.00,N/A,$313.31,N/A,N/A,N/A,$105.85,N/A,$313.31,N/A,$323.00,N/A,N/A,$313.31
3100022,0310,88332,,,,,N/A,N/A,FROZEN SECTION EXTRA,$325.89,$242.25,$132.43,$323.00,$132.43,$313.31,$132.43,N/A,$132.43,$135.58,$132.43,$313.31,$132.43,$323.00,$132.43,$132.43,$313.31
3100138,0310,88341,,,,,N/A,N/A,Mayo Blc-2 Ihc Stain,$86.77,$64.50,$35.26,$86.00,$35.26,$83.42,$35.26,N/A,$35.26,$71.32,$35.26,$83.42,$35.26,$86.00,$35.26,$35.26,$83.42
3100139,0310,88341,,,,,N/A,N/A,Mayo Blc-6 Ihc Stain,$86.77,$64.50,$35.26,$86.00,$35.26,$83.42,$35.26,N/A,$35.26,$71.32,$35.26,$83.42,$35.26,$86.00,$35.26,$35.26,$83.42
3100140,0310,88341,,,,,N/A,N/A,Mayp Myc Ihc Stain,$86.77,$64.50,$35.26,$86.00,$35.26,$83.42,$35.26,N/A,$35.26,$71.32,$35.26,$83.42,$35.26,$86.00,$35.26,$35.26,$83.42
3100036,0310,88342,,,,,N/A,N/A,Immunoperoxidase Stain,$178.58,$132.75,$86.33,$122.18,$122.18,$86.33,$122.18,N/A,$122.18,$121.92,$122.18,$86.33,$122.18,$89.00,$122.18,$122.18,$86.33
3100037,0310,88342,,,,,N/A,N/A,FAHC P16 ANTIBODY STAIN,$300.66,$223.50,$86.33,$122.18,$122.18,$86.33,$122.18,N/A,$122.18,$121.92,$122.18,$86.33,$122.18,$89.00,$122.18,$122.18,$86.33
3100111,0310,88342,,,,,N/A,N/A,IHC STAINING HNPCC (PTH),$89.80,$66.75,$86.33,$122.18,$122.18,$86.33,$122.18,N/A,$122.18,$121.92,$122.18,$86.33,$122.18,$89.00,$122.18,$122.18,$86.33
3100112,0310,88342,,,,,N/A,N/A,IHC STAINING HNPCC (PTH),$89.80,$66.75,$86.33,$122.18,$122.18,$86.33,$122.18,N/A,$122.18,$121.92,$122.18,$86.33,$122.18,$89.00,$122.18,$122.18,$86.33
3100113,0310,88342,,,,,N/A,N/A,IHC STAINING HNPCC (PTH),$89.80,$66.75,$86.33,$122.18,$122.18,$86.33,$122.18,N/A,$122.18,$121.92,$122.18,$86.33,$122.18,$89.00,$122.18,$122.18,$86.33
3100114,0310,88342,,,,,N/A,N/A,IHC STAINING HNPCC (PTH),$89.80,$66.75,$86.33,$122.18,$122.18,$86.33,$122.18,N/A,$122.18,$121.92,$122.18,$86.33,$122.18,$89.00,$122.18,$122.18,$86.33
3100122,0310,88346,,,,,N/A,N/A,C3 IMMUNOFLUORESCENT AB,$22.20,$16.50,$9.20,$137.61,$9.20,$21.34,$9.20,N/A,$9.20,$137.61,$9.20,$21.34,$9.20,$22.00,$9.20,$9.20,$21.34
3100123,0310,88346,,,,,N/A,N/A,IgA IMMUNOFLUORESCENT AB,$22.20,$16.50,$9.20,$137.61,$9.20,$21.34,$9.20,N/A,$9.20,$137.61,$9.20,$21.34,$9.20,$22.00,$9.20,$9.20,$21.34
3100124,0310,88346,,,,,N/A,N/A,IgM IMMUNOFLUORESCENT AB,$22.20,$16.50,$9.20,$137.61,$9.20,$21.34,$9.20,N/A,$9.20,$137.61,$9.20,$21.34,$9.20,$22.00,$9.20,$9.20,$21.34
3100125,0310,88346,,,,,N/A,N/A,POLYVALENT IF,$22.20,$16.50,$9.20,$137.61,$9.20,$21.34,$9.20,N/A,$9.20,$137.61,$9.20,$21.34,$9.20,$22.00,$9.20,$9.20,$21.34
3100126,0310,88346,,,,,N/A,N/A,IgG IMMUNOFLUORESCENT AB,$22.20,$16.50,$9.20,$137.61,$9.20,$21.34,$9.20,N/A,$9.20,$137.61,$9.20,$21.34,$9.20,$22.00,$9.20,$9.20,$21.34
3099005,0310,88358,,,,,N/A,N/A,Era Tumor,$151.34,$112.50,$61.50,$189.37,$61.50,$145.50,$61.50,N/A,$61.50,$189.37,$61.50,$145.50,$61.50,$150.00,$61.50,$61.50,$145.50
3099006,0310,88358,,,,,N/A,N/A,Pra Tumor,$151.34,$112.50,$61.50,$189.37,$61.50,$145.50,$61.50,N/A,$61.50,$189.37,$61.50,$145.50,$61.50,$150.00,$61.50,$61.50,$145.50
3100128,0310,88360,,,,,N/A,N/A,UVM MIB-1 IHC SEMI QT%,$52.46,$39.00,$74.21,$182.81,$74.21,$175.57,$74.21,N/A,$74.21,$182.81,$74.21,$175.57,$74.21,$181.00,$74.21,$74.21,$175.57
3100135,0310,88360,,,,,N/A,N/A,Uvm Her2neu Ipex (Pth),$100.89,$75.00,$74.21,$182.81,$74.21,$175.57,$74.21,N/A,$74.21,$182.81,$74.21,$175.57,$74.21,$181.00,$74.21,$74.21,$175.57
3100097,0310,88368,,,,,N/A,N/A,UROVYSION(TM) FISH,$162.44,$120.75,$66.10,$241.19,$66.10,$156.17,$66.10,N/A,$66.10,$241.19,$66.10,$156.17,$66.10,$161.00,$66.10,$66.10,$156.17
3100098,0310,88368,,,,,N/A,N/A,UROVYSION(TM) FISH,$162.44,$120.75,$66.10,$241.19,$66.10,$156.17,$66.10,N/A,$66.10,$241.19,$66.10,$156.17,$66.10,$161.00,$66.10,$66.10,$156.17
3100099,0310,88368,,,,,N/A,N/A,UROVYSION(TM) FISH,$162.44,$120.75,$66.10,$241.19,$66.10,$156.17,$66.10,N/A,$66.10,$241.19,$66.10,$156.17,$66.10,$161.00,$66.10,$66.10,$156.17
3100100,0310,88368,,,,,N/A,N/A,UROVYSION(TM) FISH,$162.44,$120.75,$66.10,$241.19,$66.10,$156.17,$66.10,N/A,$66.10,$241.19,$66.10,$156.17,$66.10,$161.00,$66.10,$66.10,$156.17
3100106,0310,88368,,,,,N/A,N/A,Her-2 Dial Ish (Fahc),$404.58,$300.75,$66.10,$241.19,$66.10,$156.17,$66.10,N/A,$66.10,$241.19,$66.10,$156.17,$66.10,$161.00,$66.10,$66.10,$156.17
3100127,0310,88368,,,,,N/A,N/A,SINGLE PROB/SITU HYBRIDIZATION,$113.00,$84.00,$66.10,$241.19,$66.10,$156.17,$66.10,N/A,$66.10,$241.19,$66.10,$156.17,$66.10,$161.00,$66.10,$66.10,$156.17
3100136,0310,88377,,,,,N/A,N/A,"Mayo B-Cell Lymphoma Fish, Tis",$516.58,$384.00,$29.92,$512.00,$29.92,$496.64,$29.92,N/A,$29.92,$177.82,$29.92,$496.64,$29.92,$512.00,$29.92,$29.92,$496.64
3100137,0310,88377,,,,,N/A,N/A,Mayo B-Cell Lymphoma Add Probe,$221.97,$165.00,$29.92,$512.00,$29.92,$496.64,$29.92,N/A,$29.92,$177.82,$29.92,$496.64,$29.92,$512.00,$29.92,$29.92,$496.64
3100141,0310,88381,,,,,N/A,N/A,Mayo Slide Review,$99.89,$74.25,$4.59,$551.75,$4.59,$96.03,$4.59,N/A,$4.59,$551.75,$4.59,$96.03,$4.59,$99.00,$4.59,$4.59,$96.03
3100027,0310,89399,,,,,N/A,N/A,Path /Unknown,$0.00,$0.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3100013,0311,88104,,,,,N/A,N/A,"CYTO FLUID,WASH/BRUS",$518.60,$385.50,$154.66,$185.00,N/A,$179.45,N/A,N/A,N/A,$154.66,N/A,$179.45,N/A,$185.00,N/A,N/A,$179.45
3100031,0311,88104,,,,,N/A,N/A,NON GYN CYTOLOGY MCH,$186.65,$138.75,$154.66,$185.00,N/A,$179.45,N/A,N/A,N/A,$154.66,N/A,$179.45,N/A,$185.00,N/A,N/A,$179.45
3100030,0311,88141,,,,,N/A,N/A,Lrh Screening Pap,$191.70,$142.50,$76.32,$190.00,$131.61,$184.30,$131.61,N/A,$131.61,$76.32,$131.61,$184.30,$131.61,$190.00,$131.61,$131.61,$184.30
3100040,0311,88141,,,,,N/A,N/A,Fahc Screening Pap,$191.70,$142.50,$76.32,$190.00,$131.61,$184.30,$131.61,N/A,$131.61,$76.32,$131.61,$184.30,$131.61,$190.00,$131.61,$131.61,$184.30
3100065,0311,88142,,,,,N/A,N/A,Fahc Thin Prep Diagnostic Pap,$323.87,$240.75,$26.21,$321.00,N/A,$311.37,N/A,N/A,N/A,$26.21,N/A,$311.37,N/A,$321.00,N/A,N/A,$311.37
3100070,0311,88142,,,,,N/A,N/A,FAHC THIN PREP PAP SCREENING,$313.78,$233.25,$26.21,$321.00,N/A,$311.37,N/A,N/A,N/A,$26.21,N/A,$311.37,N/A,$321.00,N/A,N/A,$311.37
3100080,0311,88142,,,,,N/A,N/A,LRH THIN PREP PAP SCREENING,$313.78,$233.25,$26.21,$321.00,N/A,$311.37,N/A,N/A,N/A,$26.21,N/A,$311.37,N/A,$321.00,N/A,N/A,$311.37
3100050,0311,88150,,,,,N/A,N/A,LRH DIAGNOSTIC PAP,$191.70,$142.50,$24.31,$190.00,N/A,$184.30,N/A,N/A,N/A,$24.31,N/A,$184.30,N/A,$190.00,N/A,N/A,$184.30
3100014,0311,88162,,,,,N/A,N/A,CYTO EX>5 SL/MULT ST,$518.60,$385.50,$17.60,$514.00,$21.74,$498.58,$21.74,N/A,$21.74,$17.60,$21.74,$498.58,$21.74,$514.00,$21.74,$21.74,$498.58
3100060,0311,88164,,,,,N/A,N/A,FAHC DIAGNOSTIC PAP,$191.70,$142.50,$124.75,$190.00,N/A,$184.30,N/A,N/A,N/A,$124.75,N/A,$184.30,N/A,$190.00,N/A,N/A,$184.30
3091218,0311,88180,,,,,N/A,N/A,T Helper Induce (Cd4),$526.67,$391.50,$35.01,$126.00,N/A,$122.22,N/A,N/A,N/A,$35.01,N/A,$122.22,N/A,$126.00,N/A,N/A,$122.22
3095004,0311,88180,,,,,N/A,N/A,FLOW CYTOMETRY,$279.48,$207.75,$35.01,$126.00,N/A,$122.22,N/A,N/A,N/A,$35.01,N/A,$122.22,N/A,$126.00,N/A,N/A,$122.22
3099367,0311,88180,,,,,N/A,N/A,"Leukemia Panel, Flow Cyto 1",$25.22,$18.75,$35.01,$126.00,N/A,$122.22,N/A,N/A,N/A,$35.01,N/A,$122.22,N/A,$126.00,N/A,N/A,$122.22
3099368,0311,88180,,,,,N/A,N/A,"Leukemia Panel, Flow Cyto 2",$565.01,$420.00,$875.25,"$3,150.00",N/A,"$3,055.50",N/A,N/A,N/A,$875.25,N/A,"$3,055.50",N/A,"$3,150.00",N/A,N/A,"$3,055.50"
3100042,0311,88180,,,,,N/A,N/A,Flow Cyto Leuk Pnl (Fahc),$127.13,$94.50,$35.01,$126.00,N/A,$122.22,N/A,N/A,N/A,$35.01,N/A,$122.22,N/A,$126.00,N/A,N/A,$122.22
3100043,0311,88180,,,,,N/A,N/A,Flow Cyto Leuk Pnl (Fahc),$127.13,$94.50,$35.01,$126.00,N/A,$122.22,N/A,N/A,N/A,$35.01,N/A,$122.22,N/A,$126.00,N/A,N/A,$122.22
3100044,0311,88180,,,,,N/A,N/A,Flow Cyto Leuk Pnl (Fahc),$127.13,$94.50,$35.01,$126.00,N/A,$122.22,N/A,N/A,N/A,$35.01,N/A,$122.22,N/A,$126.00,N/A,N/A,$122.22
3100047,0311,88180,,,,,N/A,N/A,Flow Cyto Leuk Pnl (Fahc),$127.13,$94.50,$35.01,$126.00,N/A,$122.22,N/A,N/A,N/A,$35.01,N/A,$122.22,N/A,$126.00,N/A,N/A,$122.22
3100048,0311,88180,,,,,N/A,N/A,Flow Cyto Leuk Pnl (Fahc),$127.13,$94.50,$35.01,$126.00,N/A,$122.22,N/A,N/A,N/A,$35.01,N/A,$122.22,N/A,$126.00,N/A,N/A,$122.22
3100049,0311,88180,,,,,N/A,N/A,Flow Cyto Leuk Pnl (Fahc),$127.13,$94.50,$35.01,$126.00,N/A,$122.22,N/A,N/A,N/A,$35.01,N/A,$122.22,N/A,$126.00,N/A,N/A,$122.22
3100051,0311,88180,,,,,N/A,N/A,Flow Cyto Leuk Pnl (Fahc),$127.13,$94.50,$35.01,$126.00,N/A,$122.22,N/A,N/A,N/A,$35.01,N/A,$122.22,N/A,$126.00,N/A,N/A,$122.22
3100052,0311,88180,,,,,N/A,N/A,Flow Cyto Leuk Pnl (Fahc),$127.13,$94.50,$35.01,$126.00,N/A,$122.22,N/A,N/A,N/A,$35.01,N/A,$122.22,N/A,$126.00,N/A,N/A,$122.22
3100053,0311,88180,,,,,N/A,N/A,Flow Cyto Leuk Pnl (Fahc),$127.13,$94.50,$35.01,$126.00,N/A,$122.22,N/A,N/A,N/A,$35.01,N/A,$122.22,N/A,$126.00,N/A,N/A,$122.22
3100054,0311,88180,,,,,N/A,N/A,Flow Cyto Leuk Pnl (Fahc),$127.13,$94.50,$35.01,$126.00,N/A,$122.22,N/A,N/A,N/A,$35.01,N/A,$122.22,N/A,$126.00,N/A,N/A,$122.22
3100055,0311,88180,,,,,N/A,N/A,Flow Cyto Leuk Pnl (Fahc),$127.13,$94.50,$35.01,$126.00,N/A,$122.22,N/A,N/A,N/A,$35.01,N/A,$122.22,N/A,$126.00,N/A,N/A,$122.22
3100056,0311,88180,,,,,N/A,N/A,Flow Cyto Leuk Pnl (Fahc),$127.13,$94.50,$35.01,$126.00,N/A,$122.22,N/A,N/A,N/A,$35.01,N/A,$122.22,N/A,$126.00,N/A,N/A,$122.22
3100057,0311,88180,,,,,N/A,N/A,Flow Cyto Leuk Pnl (Fahc),$127.13,$94.50,$35.01,$126.00,N/A,$122.22,N/A,N/A,N/A,$35.01,N/A,$122.22,N/A,$126.00,N/A,N/A,$122.22
3100058,0311,88180,,,,,N/A,N/A,Flow Cyto Leuk Pnl (Fahc),$127.13,$94.50,$35.01,$126.00,N/A,$122.22,N/A,N/A,N/A,$35.01,N/A,$122.22,N/A,$126.00,N/A,N/A,$122.22
3100059,0311,88180,,,,,N/A,N/A,Flow Cyto Leuk Pnl (Fahc),$127.13,$94.50,$35.01,$126.00,N/A,$122.22,N/A,N/A,N/A,$35.01,N/A,$122.22,N/A,$126.00,N/A,N/A,$122.22
3100062,0311,88180,,,,,N/A,N/A,Cyto Lymp Pnl(Fahc) Tst 1,$138.22,$102.75,$35.01,$126.00,N/A,$122.22,N/A,N/A,N/A,$35.01,N/A,$122.22,N/A,$126.00,N/A,N/A,$122.22
3100063,0311,88180,,,,,N/A,N/A,Cyto Lymp Pnl(Fahc) Tst 2,$138.22,$102.75,$35.01,$126.00,N/A,$122.22,N/A,N/A,N/A,$35.01,N/A,$122.22,N/A,$126.00,N/A,N/A,$122.22
3100064,0311,88180,,,,,N/A,N/A,Cyto Lymp Pnl(Fahc) Tst 3,$138.22,$102.75,$35.01,$126.00,N/A,$122.22,N/A,N/A,N/A,$35.01,N/A,$122.22,N/A,$126.00,N/A,N/A,$122.22
3100066,0311,88180,,,,,N/A,N/A,Cyto Lymp Pnl(Fahc) Tst 5,$138.22,$102.75,$35.01,$126.00,N/A,$122.22,N/A,N/A,N/A,$35.01,N/A,$122.22,N/A,$126.00,N/A,N/A,$122.22
3100067,0311,88180,,,,,N/A,N/A,Cyto Lymp Pnl(Fahc) Tst 6,$138.22,$102.75,$35.01,$126.00,N/A,$122.22,N/A,N/A,N/A,$35.01,N/A,$122.22,N/A,$126.00,N/A,N/A,$122.22
3100068,0311,88180,,,,,N/A,N/A,Cyto Lymp Pnl(Fahc) Tst 7,$138.22,$102.75,$35.01,$126.00,N/A,$122.22,N/A,N/A,N/A,$35.01,N/A,$122.22,N/A,$126.00,N/A,N/A,$122.22
3100069,0311,88180,,,,,N/A,N/A,Cyto Lymp Pnl(Fahc) Tst 8,$138.22,$102.75,$35.01,$126.00,N/A,$122.22,N/A,N/A,N/A,$35.01,N/A,$122.22,N/A,$126.00,N/A,N/A,$122.22
3100073,0311,88180,,,,,N/A,N/A,Cyto Lymp Pnl(Fahc) Tst12,$138.22,$102.75,$35.01,$126.00,N/A,$122.22,N/A,N/A,N/A,$35.01,N/A,$122.22,N/A,$126.00,N/A,N/A,$122.22
3100074,0311,88180,,,,,N/A,N/A,Cyto Lymp Pnl(Fahc) Tst13,$138.22,$102.75,$35.01,$126.00,N/A,$122.22,N/A,N/A,N/A,$35.01,N/A,$122.22,N/A,$126.00,N/A,N/A,$122.22
3100075,0311,88180,,,,,N/A,N/A,Cyto Lymp Pnl(Fahc) Tst14,$138.22,$102.75,$35.01,$126.00,N/A,$122.22,N/A,N/A,N/A,$35.01,N/A,$122.22,N/A,$126.00,N/A,N/A,$122.22
3100076,0311,88180,,,,,N/A,N/A,Cyto Lymp Pnl(Fahc) Tst15,$138.22,$102.75,$35.01,$126.00,N/A,$122.22,N/A,N/A,N/A,$35.01,N/A,$122.22,N/A,$126.00,N/A,N/A,$122.22
3100077,0311,88180,,,,,N/A,N/A,Cyto Lymp Pnl(Fahc) Tst16,$138.22,$102.75,$35.01,$126.00,N/A,$122.22,N/A,N/A,N/A,$35.01,N/A,$122.22,N/A,$126.00,N/A,N/A,$122.22
3100078,0311,88180,,,,,N/A,N/A,Dna Analysis By Fc,$187.66,$139.50,$35.01,$126.00,N/A,$122.22,N/A,N/A,N/A,$35.01,N/A,$122.22,N/A,$126.00,N/A,N/A,$122.22
3100079,0311,88180,,,,,N/A,N/A,Flow Cyto Leuk Pnl (Fahc),$127.13,$94.50,$35.01,$126.00,N/A,$122.22,N/A,N/A,N/A,$35.01,N/A,$122.22,N/A,$126.00,N/A,N/A,$122.22
3100081,0311,88180,,,,,N/A,N/A,Flow Cyto Leuk Pnl (Fahc),$127.13,$94.50,$35.01,$126.00,N/A,$122.22,N/A,N/A,N/A,$35.01,N/A,$122.22,N/A,$126.00,N/A,N/A,$122.22
3100082,0311,88180,,,,,N/A,N/A,Flow Cyto Leuk Pnl (Fahc),$127.13,$94.50,$35.01,$126.00,N/A,$122.22,N/A,N/A,N/A,$35.01,N/A,$122.22,N/A,$126.00,N/A,N/A,$122.22
3100083,0311,88180,,,,,N/A,N/A,Cyto Lymp Pnl(Fahc) Tst 4,$138.22,$102.75,$35.01,$126.00,N/A,$122.22,N/A,N/A,N/A,$35.01,N/A,$122.22,N/A,$126.00,N/A,N/A,$122.22
3100084,0311,88180,,,,,N/A,N/A,Cyto Lymp Pnl(Fahc) Tst 9,$138.22,$102.75,$35.01,$126.00,N/A,$122.22,N/A,N/A,N/A,$35.01,N/A,$122.22,N/A,$126.00,N/A,N/A,$122.22
3100085,0311,88180,,,,,N/A,N/A,Cyto Lymp Pnl(Fahc) Tst10,$138.22,$102.75,$35.01,$126.00,N/A,$122.22,N/A,N/A,N/A,$35.01,N/A,$122.22,N/A,$126.00,N/A,N/A,$122.22
3100086,0311,88180,,,,,N/A,N/A,Cyto Lymp Pnl(Fahc) Tst11,$138.22,$102.75,$35.01,$126.00,N/A,$122.22,N/A,N/A,N/A,$35.01,N/A,$122.22,N/A,$126.00,N/A,N/A,$122.22
3100087,0311,88180,,,,,N/A,N/A,Flow Cyto Leuk Pnl (Fahc),$127.13,$94.50,$35.01,$126.00,N/A,$122.22,N/A,N/A,N/A,$35.01,N/A,$122.22,N/A,$126.00,N/A,N/A,$122.22
3100088,0311,88180,,,,,N/A,N/A,Flow Cyto Leuk Pnl (Fahc),$127.13,$94.50,$35.01,$126.00,N/A,$122.22,N/A,N/A,N/A,$35.01,N/A,$122.22,N/A,$126.00,N/A,N/A,$122.22
3100089,0311,88180,,,,,N/A,N/A,Flow Cyto Leuk Pnl (Fahc),$127.13,$94.50,$35.01,$126.00,N/A,$122.22,N/A,N/A,N/A,$35.01,N/A,$122.22,N/A,$126.00,N/A,N/A,$122.22
3100016,0311,88182,,,,,N/A,N/A,"FLOW CYTOMETRY,CELL CYCLE/DNA",$499.43,$371.25,$22.95,$495.00,$22.95,$480.15,$22.95,N/A,$22.95,N/A,$22.95,$480.15,$22.95,$495.00,$22.95,$22.95,$480.15
3100095,0311,88305,,,,,N/A,N/A,CYTOLOGY CELL BLOCK FAHC,$94.84,$70.50,$54.54,$392.00,$157.44,$380.24,$157.44,N/A,$157.44,$54.54,$157.44,$380.24,$157.44,$392.00,$157.44,$157.44,$380.24
3100091,0311,88342,,,,,N/A,N/A,Herceptest,$283.51,$210.75,$86.33,$122.18,$122.18,$86.33,$122.18,N/A,$122.18,$121.92,$122.18,$86.33,$122.18,$89.00,$122.18,$122.18,$86.33
3100093,0311,88360,,,,,N/A,N/A,ESTROGEN/PROGEST IPEX STN,$182.62,$135.75,$74.21,$182.81,$74.21,$175.57,$74.21,N/A,$74.21,$182.81,$74.21,$175.57,$74.21,$181.00,$74.21,$74.21,$175.57
3100094,0311,88360,,,,,N/A,N/A,ESTROGEN/PROGEST IPEX STN,$182.62,$135.75,$74.21,$182.81,$74.21,$175.57,$74.21,N/A,$74.21,$182.81,$74.21,$175.57,$74.21,$181.00,$74.21,$74.21,$175.57
3207467,0320,19291,,,,,N/A,N/A,RAD. NEEDLE LOCALIZAT W PLACMN,"$3,243.74","$2,411.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3202050,0320,20501,,,,,N/A,N/A,RAD. FISTULA-SINUS INTRO,$380.37,$282.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3220501,0320,20501,,,,,N/A,N/A,INJECTION OF SINUS TRACT,$343.04,$255.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3207099,0320,36598,,,,,N/A,N/A,DYE STUDYCATH PLACEMENT&PA,$592.25,$440.25,$60.95,"$3,193.00",$139.13,"$3,097.21",$139.13,"$2,730.02",$139.13,$60.95,$139.13,"$3,097.21",$139.13,"$3,193.00",$139.13,$139.13,"$3,097.21"
4277002,0320,36598,,,,,N/A,N/A,DYE STUDY CATH/LINE PLACEMENT,"$3,221.55","$2,394.75",$60.95,"$3,193.00",$139.13,"$3,097.21",$139.13,"$2,730.02",$139.13,$60.95,$139.13,"$3,097.21",$139.13,"$3,193.00",$139.13,$139.13,"$3,097.21"
3247531,0320,47531,,,,,N/A,N/A,"CHOLANGIOGRAM,INJECTION",$293.60,$218.25,$119.31,"$1,433.93",$119.31,$282.27,$119.31,$248.81,$119.31,"$1,433.93",$119.31,$282.27,$119.31,$291.00,$119.31,$119.31,$282.27
3207444,0320,49465,,,,,N/A,N/A,GASTROINTESTINAL TUBE INJ&FLUO,$113.00,$84.00,$45.92,$150.05,$45.92,$108.64,$45.92,$95.76,$45.92,$150.05,$45.92,$108.64,$45.92,$112.00,$45.92,$45.92,$108.64
3207003,0320,70030,,,,,N/A,N/A,RAD. EYE FB,$870.72,$647.25,$353.83,$353.83,$353.83,N/A,$353.83,N/A,$353.83,N/A,$353.83,N/A,$353.83,N/A,$353.83,$353.83,N/A
3207010,0320,70100,,,,,N/A,N/A,RAD. MAND-PARTIAL,$839.44,$624.00,$341.12,$341.12,$341.12,N/A,$341.12,N/A,$341.12,N/A,$341.12,N/A,$341.12,N/A,$341.12,$341.12,N/A
3207011-50,0320,70110,,,,,N/A,N/A,MANDIBLE COMPLETE BILATERAL,"$1,245.03",$925.50,$55.94,$55.94,$55.94,N/A,$55.94,N/A,$55.94,N/A,$55.94,N/A,$55.94,N/A,$55.94,$55.94,N/A
3207013-50,0320,70130,,,,,N/A,N/A,MASTOIDS BILATERAL,$997.84,$741.75,$45.49,$45.49,$45.49,N/A,$45.49,N/A,$45.49,N/A,$45.49,N/A,$45.49,N/A,$45.49,$45.49,N/A
3207027-50,0320,70134,,,,,N/A,N/A,INTERAUDITORY BILATERAL,$980.69,$729.00,$398.52,$398.52,$398.52,N/A,$398.52,N/A,$398.52,N/A,$398.52,N/A,$398.52,N/A,$398.52,$398.52,N/A
3207014,0320,70140,,,,,N/A,N/A,RAD. FACIAL-LIMITED,$482.27,$358.50,$195.98,$195.98,$195.98,N/A,$195.98,N/A,$195.98,N/A,$195.98,N/A,$195.98,N/A,$195.98,$195.98,N/A
3207015,0320,70150,,,,,N/A,N/A,RAD. FACIAL-COMPLETE,"$1,201.65",$893.25,$488.31,$488.31,$488.31,N/A,$488.31,N/A,$488.31,N/A,$488.31,N/A,$488.31,N/A,$488.31,$488.31,N/A
3207016,0320,70160,,,,,N/A,N/A,RAD. NASAL,$717.36,$533.25,$291.51,$291.51,$291.51,N/A,$291.51,N/A,$291.51,N/A,$291.51,N/A,$291.51,N/A,$291.51,$291.51,N/A
3207019-50,0320,70190,,,,,N/A,N/A,OPTIC FORMINA BILATERAL,"$1,138.08",$846.00,$462.48,$462.48,$462.48,N/A,$462.48,N/A,$462.48,N/A,$462.48,N/A,$462.48,N/A,$462.48,$462.48,N/A
3207020-50,0320,70200,,,,,N/A,N/A,ORBITS BILATERAL,"$1,217.79",$905.25,$494.87,$494.87,$494.87,N/A,$494.87,N/A,$494.87,N/A,$494.87,N/A,$494.87,N/A,$494.87,$494.87,N/A
3207021,0320,70210,,,,,N/A,N/A,RAD. LIMITED SINUS SERIES,$541.80,$402.75,$22.17,$22.17,$22.17,N/A,$22.17,N/A,$22.17,N/A,$22.17,N/A,$22.17,N/A,$22.17,$22.17,N/A
3207022,0320,70220,,,,,N/A,N/A,RAD. PARANASAL,$973.63,$723.75,$395.65,$395.65,$395.65,N/A,$395.65,N/A,$395.65,N/A,$395.65,N/A,$395.65,N/A,$395.65,$395.65,N/A
3207024,0320,70240,,,,,N/A,N/A,RAD. SELLA TURICA,$523.64,$389.25,$212.79,$212.79,$212.79,N/A,$212.79,N/A,$212.79,N/A,$212.79,N/A,$212.79,N/A,$212.79,$212.79,N/A
3207025,0320,70250,,,,,N/A,N/A,RAD. SKULL LIMITED,$540.79,$402.00,$219.76,$219.76,$219.76,N/A,$219.76,N/A,$219.76,N/A,$219.76,N/A,$219.76,N/A,$219.76,$219.76,N/A
3207026,0320,70260,,,,,N/A,N/A,RAD. SKULL-COMPLETE,"$1,115.89",$829.50,$453.46,$453.46,$453.46,N/A,$453.46,N/A,$453.46,N/A,$453.46,N/A,$453.46,N/A,$453.46,$453.46,N/A
3207033-LT,0320,70328,,,,,N/A,N/A,RAD. LT TEMPO UNILAT,$388.44,$288.75,$157.85,$157.85,$157.85,N/A,$157.85,N/A,$157.85,N/A,$157.85,N/A,$157.85,N/A,$157.85,$157.85,N/A
3207033-RT,0320,70328,,,,,N/A,N/A,RAD. RT TEMPO UNILAT,$388.44,$288.75,$157.85,$157.85,$157.85,N/A,$157.85,N/A,$157.85,N/A,$157.85,N/A,$157.85,N/A,$157.85,$157.85,N/A
3207034,0320,70330,,,,,N/A,N/A,RAD. TEMPO. BILAT.,$388.44,$288.75,$157.85,$157.85,$157.85,N/A,$157.85,N/A,$157.85,N/A,$157.85,N/A,$157.85,N/A,$157.85,$157.85,N/A
3207036,0320,70360,,,,,N/A,N/A,RAD. NECK,$469.16,$348.75,$19.65,$19.65,$19.65,N/A,$19.65,N/A,$19.65,N/A,$19.65,N/A,$19.65,N/A,$19.65,$19.65,N/A
3207038LT,0320,70380,,,,,N/A,N/A,RAD. LT SALIVARY GLAND,$590.23,$438.75,$239.85,$239.85,$239.85,N/A,$239.85,N/A,$239.85,N/A,$239.85,N/A,$239.85,N/A,$239.85,$239.85,N/A
3207038RT,0320,70380,,,,,N/A,N/A,RAD. RT SALIVARY GLAND,$590.23,$438.75,$239.85,$239.85,$239.85,N/A,$239.85,N/A,$239.85,N/A,$239.85,N/A,$239.85,N/A,$239.85,$239.85,N/A
3207039LT,0320,70390,,,,,N/A,N/A,RAD. LT SIALOGRAPHY,"$1,105.80",$822.00,$449.36,$449.36,$449.36,N/A,$449.36,N/A,$449.36,N/A,$449.36,N/A,$449.36,N/A,$449.36,$449.36,N/A
3207039RT,0320,70390,,,,,N/A,N/A,RAD. RT SIALOGRAPHY,"$1,105.80",$822.00,$449.36,$449.36,$449.36,N/A,$449.36,N/A,$449.36,N/A,$449.36,N/A,$449.36,N/A,$449.36,$449.36,N/A
3207100,0320,71010,,,,,N/A,N/A,Rad. Chest 1 View,$443.93,$330.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3207101,0320,71020,,,,,N/A,N/A,Rad. Chest 2 View,$839.44,$624.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3207103,0320,71023,,,,,N/A,N/A,Chest Fluoroscopy,"$1,515.43","$1,126.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3207102,0320,71030,,,,,N/A,N/A,Rad. Chest-Complete,"$1,291.44",$960.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
32071047,0320,71047,,,,,N/A,N/A,RAD CHEST 3 VIEWS,$888.88,$660.75,$361.21,$361.21,$361.21,N/A,$361.21,N/A,$361.21,N/A,$361.21,N/A,$361.21,N/A,$361.21,$361.21,N/A
3207109,0320,71090,,,,,N/A,N/A,RAD. PACEMAKER INSERT W C-ARM,"$2,211.60","$1,644.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3271100,0320,71100,,,,,N/A,N/A,LT/RT RIBS TWO VIEWS,"$1,241.00",$922.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3207110-LT,0320,71100,,,,,N/A,N/A,RAD. LT RIBS,"$1,245.03",$925.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3207110-RT,0320,71100,,,,,N/A,N/A,RAD. RT RIBS,"$1,245.03",$925.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3271121,0320,71101,,,,,N/A,N/A,LT/RT RIBS with PA CXR,"$1,666.77","$1,239.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
32171101,0320,71101,,,,,N/A,N/A,RT RIBS AND PA CXR,"$1,666.77","$1,239.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3207111,0320,71110,,,,,N/A,N/A,RAD. RIBS BILATERAL,"$1,390.32","$1,033.50",$564.98,$564.98,$564.98,N/A,$564.98,N/A,$564.98,N/A,$564.98,N/A,$564.98,N/A,$564.98,$564.98,N/A
3207112,0320,71120,,,,,N/A,N/A,RAD. STERNUM,$656.82,$488.25,$266.91,$266.91,$266.91,N/A,$266.91,N/A,$266.91,N/A,$266.91,N/A,$266.91,N/A,$266.91,$266.91,N/A
3207113,0320,71130,,,,,N/A,N/A,RAD. STERNOCLAVICUL.,$540.79,$402.00,$219.76,$219.76,$219.76,N/A,$219.76,N/A,$219.76,N/A,$219.76,N/A,$219.76,N/A,$219.76,$219.76,N/A
36576378,0320,71215,,,,,N/A,N/A,CHEST FOR PE,"$1,112.86",$827.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3207201,0320,72010,,,,,N/A,N/A,Rad. Spine Entire,"$1,582.02","$1,176.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3207202,0320,72020,,,,,N/A,N/A,THORACIC SPINE 1 VIEW ONLY,$373.31,$277.50,$151.70,$151.70,$151.70,N/A,$151.70,N/A,$151.70,N/A,$151.70,N/A,$151.70,N/A,$151.70,$151.70,N/A
3272020,0320,72020,,,,,N/A,N/A,SPINE 1 VIEW,$189.68,$141.00,$151.70,$151.70,$151.70,N/A,$151.70,N/A,$151.70,N/A,$151.70,N/A,$151.70,N/A,$151.70,$151.70,N/A
325569,0320,72040,,,,,N/A,N/A,Pain Clinic Cerv S 2 View,$0.00,$0.00,$3.12,$3.12,$3.12,N/A,$3.12,N/A,$3.12,N/A,$3.12,N/A,$3.12,N/A,$3.12,$3.12,N/A
3207204,0320,72040,,,,,N/A,N/A,RAD. SPINE CERVICAL,$738.54,$549.00,$3.12,$3.12,$3.12,N/A,$3.12,N/A,$3.12,N/A,$3.12,N/A,$3.12,N/A,$3.12,$3.12,N/A
3207205,0320,72050,,,,,N/A,N/A,RAD. CERVICAL 4 VIEW,"$1,063.42",$790.50,$432.14,$432.14,$432.14,N/A,$432.14,N/A,$432.14,N/A,$432.14,N/A,$432.14,N/A,$432.14,$432.14,N/A
3207206,0320,72052,,,,,N/A,N/A,RAD. CERVICAL COMPL.,"$1,222.84",$909.00,$496.92,$496.92,$496.92,N/A,$496.92,N/A,$496.92,N/A,$496.92,N/A,$496.92,N/A,$496.92,$496.92,N/A
3207115,0320,72069,,,,,N/A,N/A,Scoliosis,$590.23,$438.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3272069,0320,72069,,,,,N/A,N/A,SCOLIOSIS TL SPINE STANDING,$300.66,$223.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
325570,0320,72070,,,,,N/A,N/A,Pain Clinic Thoracic Sp 2 View,$0.00,$0.00,$321.44,$321.44,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,$321.44,N/A
3207207,0320,72070,,,,,N/A,N/A,Rad. Spine Thoracic,$791.01,$588.00,$321.44,$321.44,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,$321.44,N/A
3207208,0320,72080,,,,,N/A,N/A,RAD. SPINE THOR. LUM,$738.54,$549.00,$3.12,$3.12,$3.12,N/A,$3.12,N/A,$3.12,N/A,$3.12,N/A,$3.12,N/A,$3.12,$3.12,N/A
325571,0320,72100,,,,,N/A,N/A,Pain Clinic Lumbar Sp 2 View,$0.00,$0.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3207210,0320,72100,,,,,N/A,N/A,RAD. SPINE LUMBO-SAC,$738.54,$549.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3207211,0320,72110,,,,,N/A,N/A,RAD. SPINE COMPLETE,"$1,211.74",$900.75,$492.41,$492.41,$492.41,N/A,$492.41,N/A,$492.41,N/A,$492.41,N/A,$492.41,N/A,$492.41,$492.41,N/A
32072114,0320,72114,,,,,N/A,N/A,RAD SPINE LUMB COM W/FLEX&EXT,$148.31,$110.25,$6.27,$6.27,$6.27,N/A,$6.27,N/A,$6.27,N/A,$6.27,N/A,$6.27,N/A,$6.27,$6.27,N/A
32072120,0320,72120,,,,,N/A,N/A,RAD LUMBARSPINE FLEX/EXT ONLY,$96.86,$72.00,$39.36,$39.36,$39.36,N/A,$39.36,N/A,$39.36,N/A,$39.36,N/A,$39.36,N/A,$39.36,$39.36,N/A
3207217,0320,72170,,,,,N/A,N/A,"RAD. PELVIS, A-P",$495.39,$368.25,$21.31,$21.31,$21.31,N/A,$21.31,N/A,$21.31,N/A,$21.31,N/A,$21.31,N/A,$21.31,$21.31,N/A
32072190,0320,72190,,,,,N/A,N/A,PELVIS WITH OBLIQUES 3 VIEWS,$590.23,$438.75,$239.85,$239.85,$239.85,N/A,$239.85,N/A,$239.85,N/A,$239.85,N/A,$239.85,N/A,$239.85,$239.85,N/A
325573,0320,72200,,,,,N/A,N/A,Pain Clinic Si Jt 2 View,$0.00,$0.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3207219,0320,72202,,,,,N/A,N/A,RAD. SI JOINTS,"$1,070.49",$795.75,$435.10,$435.10,$435.10,N/A,$435.10,N/A,$435.10,N/A,$435.10,N/A,$435.10,N/A,$435.10,$435.10,N/A
325572,0320,72220,,,,,N/A,N/A,Pain Clinic Sacrum 2 View,$0.00,$0.00,$229.60,$229.60,$229.60,N/A,$229.60,N/A,$229.60,N/A,$229.60,N/A,$229.60,N/A,$229.60,$229.60,N/A
3207222,0320,72220,,,,,N/A,N/A,RAD. SACRUM-COCCYX,$655.81,$487.50,$229.60,$229.60,$229.60,N/A,$229.60,N/A,$229.60,N/A,$229.60,N/A,$229.60,N/A,$229.60,$229.60,N/A
3207245-LT,0320,73000,,,,,N/A,N/A,RAD. LT CLAVICLE,$625.54,$465.00,$254.20,$254.20,$254.20,N/A,$254.20,N/A,$254.20,N/A,$254.20,N/A,$254.20,N/A,$254.20,$254.20,N/A
3207245-RT,0320,73000,,,,,N/A,N/A,RAD. RT CLAVICLE,$625.54,$465.00,$254.20,$254.20,$254.20,N/A,$254.20,N/A,$254.20,N/A,$254.20,N/A,$254.20,N/A,$254.20,$254.20,N/A
3207246-LT,0320,73010,,,,,N/A,N/A,RAD. LT SCAPULA,$553.91,$411.75,$225.90,$225.90,$225.90,N/A,$225.90,N/A,$225.90,N/A,$225.90,N/A,$225.90,N/A,$225.90,$225.90,N/A
3207246-RT,0320,73010,,,,,N/A,N/A,RAD.RT SCAPULA,$553.91,$411.75,$225.90,$225.90,$225.90,N/A,$225.90,N/A,$225.90,N/A,$225.90,N/A,$225.90,N/A,$225.90,$225.90,N/A
3207247-LT,0320,73020,,,,,N/A,N/A,RAD. LT SHOULDER 1 PROJ,$457.05,$339.75,$185.73,$185.73,$185.73,N/A,$185.73,N/A,$185.73,N/A,$185.73,N/A,$185.73,N/A,$185.73,$185.73,N/A
3207247-RT,0320,73020,,,,,N/A,N/A,RAD. RT SHOULDER 1 PROJ,$457.05,$339.75,$185.73,$185.73,$185.73,N/A,$185.73,N/A,$185.73,N/A,$185.73,N/A,$185.73,N/A,$185.73,$185.73,N/A
3207263-LT,0320,73020,,,,,N/A,N/A,LFT SHOULDER 1 VW POST REDUCT,$457.05,$339.75,$185.73,$185.73,$185.73,N/A,$185.73,N/A,$185.73,N/A,$185.73,N/A,$185.73,N/A,$185.73,$185.73,N/A
3207263-RT,0320,73020,,,,,N/A,N/A,RT SHOULDER 1 VW POST REDUCT,$457.05,$339.75,$185.73,$185.73,$185.73,N/A,$185.73,N/A,$185.73,N/A,$185.73,N/A,$185.73,N/A,$185.73,$185.73,N/A
3207248,0320,73030,,,,,N/A,N/A,RAD. SHOULDER COMPL.,$491.35,$365.25,$321.44,$321.44,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,$321.44,N/A
3207244LT,0320,73030,,,,,N/A,N/A,Pain Clinic Lt Shoulder-2 View,$0.00,$0.00,$321.44,$321.44,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,$321.44,N/A
3207244RT,0320,73030,,,,,N/A,N/A,Pain Clinic Rt Shoulder-2 View,$0.00,$0.00,$321.44,$321.44,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,$321.44,N/A
3207248-LT,0320,73030,,,,,N/A,N/A,RAD.LT SHOULDER COMPLETE,$791.01,$588.00,$321.44,$321.44,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,$321.44,N/A
3207248-RT,0320,73030,,,,,N/A,N/A,RAD. RT SHOULDER COMPLETE,$791.01,$588.00,$321.44,$321.44,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,$321.44,N/A
3207264-LT,0320,73030,,,,,N/A,N/A,LEFT SHOULDER CMPT POST REDUCT,$791.01,$588.00,$321.44,$321.44,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,$321.44,N/A
3207264-RT,0320,73030,,,,,N/A,N/A,RGT SHOULDER CMPLT POST REDUCT,$791.01,$588.00,$321.44,$321.44,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,$321.44,N/A
3207249,0320,73050,,,,,N/A,N/A,RAD. ACROMIO-CLAVIC.,$888.88,$660.75,$361.21,$361.21,$361.21,N/A,$361.21,N/A,$361.21,N/A,$361.21,N/A,$361.21,N/A,$361.21,$361.21,N/A
3207250-LT,0320,73060,,,,,N/A,N/A,RAD. LT HUMERUS,$752.67,$559.50,$35.86,$35.86,$35.86,N/A,$35.86,N/A,$35.86,N/A,$35.86,N/A,$35.86,N/A,$35.86,$35.86,N/A
3207250-RT,0320,73060,,,,,N/A,N/A,RAD. RT HUMERUS,$752.67,$559.50,$35.86,$35.86,$35.86,N/A,$35.86,N/A,$35.86,N/A,$35.86,N/A,$35.86,N/A,$35.86,$35.86,N/A
3207251,0320,73070,,,,,N/A,N/A,ELBOW LTD POST REDUCTION,$533.73,$396.75,$212.79,$212.79,$212.79,N/A,$212.79,N/A,$212.79,N/A,$212.79,N/A,$212.79,N/A,$212.79,$212.79,N/A
3207251-LT,0320,73070,,,,,N/A,N/A,LEFT ELBOW LTD POST REDUCTION,$440.91,$327.75,$212.79,$212.79,$212.79,N/A,$212.79,N/A,$212.79,N/A,$212.79,N/A,$212.79,N/A,$212.79,$212.79,N/A
3207251-RT,0320,73070,,,,,N/A,N/A,RIGHT ELBOW LTD  POST REDUCT,$533.73,$396.75,$212.79,$212.79,$212.79,N/A,$212.79,N/A,$212.79,N/A,$212.79,N/A,$212.79,N/A,$212.79,$212.79,N/A
3207252-LT,0320,73070,,,,,N/A,N/A,RAD. LT ELBOW LIMITED,$533.73,$396.75,$212.79,$212.79,$212.79,N/A,$212.79,N/A,$212.79,N/A,$212.79,N/A,$212.79,N/A,$212.79,$212.79,N/A
3207252-RT,0320,73070,,,,,N/A,N/A,RAD. RT ELBOW LIMITED,$533.73,$396.75,$212.79,$212.79,$212.79,N/A,$212.79,N/A,$212.79,N/A,$212.79,N/A,$212.79,N/A,$212.79,$212.79,N/A
3207254,0320,73080,,,,,N/A,N/A,ELBOW CMPLTE POST REDUCT,$656.82,$488.25,$266.91,$266.91,$266.91,N/A,$266.91,N/A,$266.91,N/A,$266.91,N/A,$266.91,N/A,$266.91,$266.91,N/A
3207253-LT,0320,73080,,,,,N/A,N/A,RAD. LT ELBOW COMPLETE,$656.82,$488.25,$266.91,$266.91,$266.91,N/A,$266.91,N/A,$266.91,N/A,$266.91,N/A,$266.91,N/A,$266.91,$266.91,N/A
3207253-RT,0320,73080,,,,,N/A,N/A,RAD. RT ELBOW COMPLETE,$656.82,$488.25,$266.91,$266.91,$266.91,N/A,$266.91,N/A,$266.91,N/A,$266.91,N/A,$266.91,N/A,$266.91,$266.91,N/A
3207254-LT,0320,73080,,,,,N/A,N/A,LEFT ELBOW  POST REDUCT,$656.82,$488.25,$266.91,$266.91,$266.91,N/A,$266.91,N/A,$266.91,N/A,$266.91,N/A,$266.91,N/A,$266.91,$266.91,N/A
3207254-RT,0320,73080,,,,,N/A,N/A,RGT ELBOW COMPLETE-POST REDUCT,$656.82,$488.25,$266.91,$266.91,$266.91,N/A,$266.91,N/A,$266.91,N/A,$266.91,N/A,$266.91,N/A,$266.91,$266.91,N/A
3207255-LT,0320,73090,,,,,N/A,N/A,RAD. LT FOREARM,$533.73,$396.75,$216.89,$216.89,$216.89,N/A,$216.89,N/A,$216.89,N/A,$216.89,N/A,$216.89,N/A,$216.89,$216.89,N/A
3207255-RT,0320,73090,,,,,N/A,N/A,RAD. RT FOREARM,$533.73,$396.75,$216.89,$216.89,$216.89,N/A,$216.89,N/A,$216.89,N/A,$216.89,N/A,$216.89,N/A,$216.89,$216.89,N/A
3207257,0320,73100,,,,,N/A,N/A,RAD. WRIST LIMITED,$330.93,$246.00,$216.89,$216.89,$216.89,N/A,$216.89,N/A,$216.89,N/A,$216.89,N/A,$216.89,N/A,$216.89,$216.89,N/A
3207257-LT,0320,73100,,,,,N/A,N/A,RAD. LT WRIST LIMITED,$533.73,$396.75,$216.89,$216.89,$216.89,N/A,$216.89,N/A,$216.89,N/A,$216.89,N/A,$216.89,N/A,$216.89,$216.89,N/A
3207257-RT,0320,73100,,,,,N/A,N/A,RT WRIST LIMITED,$533.73,$396.75,$216.89,$216.89,$216.89,N/A,$216.89,N/A,$216.89,N/A,$216.89,N/A,$216.89,N/A,$216.89,$216.89,N/A
3207258-LT,0320,73110,,,,,N/A,N/A,RAD. LT WRIST COMPLETE,$635.63,$472.50,$258.30,$258.30,$258.30,N/A,$258.30,N/A,$258.30,N/A,$258.30,N/A,$258.30,N/A,$258.30,$258.30,N/A
3207258-RT,0320,73110,,,,,N/A,N/A,RAD.RT WRIST COMPLETE,$635.63,$472.50,$258.30,$258.30,$258.30,N/A,$258.30,N/A,$258.30,N/A,$258.30,N/A,$258.30,N/A,$258.30,$258.30,N/A
3207260,0320,73120,,,,,N/A,N/A,BIL HAND & WRIST ARTHRITIS STU,$533.73,$396.75,$216.89,$216.89,$216.89,N/A,$216.89,N/A,$216.89,N/A,$216.89,N/A,$216.89,N/A,$216.89,$216.89,N/A
3207260-LT,0320,73120,,,,,N/A,N/A,RAD. LT HAND LIMITED,$533.73,$396.75,$216.89,$216.89,$216.89,N/A,$216.89,N/A,$216.89,N/A,$216.89,N/A,$216.89,N/A,$216.89,$216.89,N/A
3207260-RT,0320,73120,,,,,N/A,N/A,RAD. RT HAND LIMITED,$533.73,$396.75,$216.89,$216.89,$216.89,N/A,$216.89,N/A,$216.89,N/A,$216.89,N/A,$216.89,N/A,$216.89,$216.89,N/A
3207259-LT,0320,73130,,,,,N/A,N/A,RAD. LT HAND 3 VIEWS,$656.82,$488.25,$266.91,$266.91,$266.91,N/A,$266.91,N/A,$266.91,N/A,$266.91,N/A,$266.91,N/A,$266.91,$266.91,N/A
3207259-RT,0320,73130,,,,,N/A,N/A,RAD. RT HAND 3 VIEWS,$656.82,$488.25,$266.91,$266.91,$266.91,N/A,$266.91,N/A,$266.91,N/A,$266.91,N/A,$266.91,N/A,$266.91,$266.91,N/A
3207261,0320,73140,,,,,N/A,N/A,RAD. FINGERS,$200.78,$149.25,$27.87,$27.87,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,$27.87,N/A
3207261-F1,0320,73140,,,,,N/A,N/A,LEFT INDEX FINGER,$511.53,$380.25,$27.87,$27.87,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,$27.87,N/A
3207261-F2,0320,73140,,,,,N/A,N/A,LEFT MIDDLE FINGER,$511.53,$380.25,$27.87,$27.87,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,$27.87,N/A
3207261-F3,0320,73140,,,,,N/A,N/A,LEFT RING FINGER,$511.53,$380.25,$27.87,$27.87,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,$27.87,N/A
3207261-F4,0320,73140,,,,,N/A,N/A,LEFT LITTLE FINGER,$511.53,$380.25,$27.87,$27.87,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,$27.87,N/A
3207261-F5,0320,73140,,,,,N/A,N/A,RIGHT THUMB,$511.53,$380.25,$27.87,$27.87,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,$27.87,N/A
3207261-F6,0320,73140,,,,,N/A,N/A,RIGHT INDEX FINGER,$511.53,$380.25,$27.87,$27.87,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,$27.87,N/A
3207261-F7,0320,73140,,,,,N/A,N/A,RIGHT MIDDLE FINGER,$511.53,$380.25,$27.87,$27.87,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,$27.87,N/A
3207261-F8,0320,73140,,,,,N/A,N/A,RIGHT RING FINGER,$511.53,$380.25,$27.87,$27.87,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,$27.87,N/A
3207261-F9,0320,73140,,,,,N/A,N/A,RIGHT LITTLE FINGER,$511.53,$380.25,$27.87,$27.87,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,$27.87,N/A
3207261-FA,0320,73140,,,,,N/A,N/A,LEFT THUMB,$511.53,$380.25,$27.87,$27.87,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,$27.87,N/A
3207262-F1,0320,73140,,,,,N/A,N/A,POST REDUCTION LT INDEX FINGER,$511.53,$380.25,$27.87,$27.87,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,$27.87,N/A
3207262-F2,0320,73140,,,,,N/A,N/A,LEFT MIDDLE FINGER POST REDUCT,$511.53,$380.25,$27.87,$27.87,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,$27.87,N/A
3207262-F3,0320,73140,,,,,N/A,N/A,LEFT RING FINGER-POST REDUCT,$511.53,$380.25,$27.87,$27.87,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,$27.87,N/A
3207262-F4,0320,73140,,,,,N/A,N/A,LEFT LITTLE FINGER-POST REDUCT,$511.53,$380.25,$27.87,$27.87,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,$27.87,N/A
3207262-F5,0320,73140,,,,,N/A,N/A,RIGHT THUMB POST REDUCTION,$511.53,$380.25,$27.87,$27.87,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,$27.87,N/A
3207262-F6,0320,73140,,,,,N/A,N/A,RGHT INDEX FINGER POST REDUCT,$511.53,$380.25,$27.87,$27.87,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,$27.87,N/A
3207262-F7,0320,73140,,,,,N/A,N/A,RGT MIDDLE FINGER-POST REDUCT,$511.53,$380.25,$27.87,$27.87,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,$27.87,N/A
3207262-F8,0320,73140,,,,,N/A,N/A,RIGHT RING FINGER-POST REDUCT,$511.53,$380.25,$27.87,$27.87,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,$27.87,N/A
3207262-F9,0320,73140,,,,,N/A,N/A,RGT LITTLE FINGER POST REDUCT,$511.53,$380.25,$27.87,$27.87,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,$27.87,N/A
3207262-FA,0320,73140,,,,,N/A,N/A,LEFT THUMB  POST REDUCTION,$511.53,$380.25,$27.87,$27.87,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,N/A,$27.87,$27.87,N/A
3207299,0320,73500,,,,,N/A,N/A,RAD. HIP 1 VIEW,$656.82,$488.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3207299-LT,0320,73500,,,,,N/A,N/A,Rad. Lt Hip 1 View,$546.85,$406.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3207266LT,0320,73501,,,,,N/A,N/A,PAIN CLINIC L HIP 2 VIEW,$40.36,$30.00,$16.40,$16.40,$16.40,N/A,$16.40,N/A,$16.40,N/A,$16.40,N/A,$16.40,N/A,$16.40,$16.40,N/A
3207266RT,0320,73501,,,,,N/A,N/A,PAIN CLINIC R HIP 2 VIEW,$40.36,$30.00,$16.40,$16.40,$16.40,N/A,$16.40,N/A,$16.40,N/A,$16.40,N/A,$16.40,N/A,$16.40,$16.40,N/A
3207300,0320,73510,,,,,N/A,N/A,RAD. HIP COMPLETE,$655.81,$487.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3273510,0320,73520,,,,,N/A,N/A,Bilateral Hips Adult,"$1,301.53",$967.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3207353LT,0320,73530,,,,,N/A,N/A,RAD. INTRA OP LT HIP W C-ARM,"$2,232.78","$1,659.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3207353RT,0320,73530,,,,,N/A,N/A,RAD. INTRA OP RT HIP W C- ARM,"$2,232.78","$1,659.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3207303-50,0320,73550,,,,,N/A,N/A,RAD-FEMUR,$778.90,$579.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3207304,0320,73560,,,,,N/A,N/A,RAD. KNEE LIMITED,$372.30,$276.75,$483.39,$483.39,$483.39,N/A,$483.39,N/A,$483.39,N/A,$483.39,N/A,$483.39,N/A,$483.39,$483.39,N/A
3207313,0320,73560,,,,,N/A,N/A,Knees Bilat Merchant View,$600.32,$446.25,$483.39,$483.39,$483.39,N/A,$483.39,N/A,$483.39,N/A,$483.39,N/A,$483.39,N/A,$483.39,$483.39,N/A
3207315,0320,73560,,,,,N/A,N/A,BILAT KNEES LATERAL VIEWS,$600.32,$446.25,$483.39,$483.39,$483.39,N/A,$483.39,N/A,$483.39,N/A,$483.39,N/A,$483.39,N/A,$483.39,$483.39,N/A
327356050,0320,73560,,,,,N/A,N/A,Knees Bilat Merchant View,"$1,189.54",$884.25,$483.39,$483.39,$483.39,N/A,$483.39,N/A,$483.39,N/A,$483.39,N/A,$483.39,N/A,$483.39,$483.39,N/A
3207304-LT,0320,73560,,,,,N/A,N/A,RAD. LT KNEE LIMITED,$600.32,$446.25,$483.39,$483.39,$483.39,N/A,$483.39,N/A,$483.39,N/A,$483.39,N/A,$483.39,N/A,$483.39,$483.39,N/A
3207304-RT,0320,73560,,,,,N/A,N/A,RAD. RT KNEE LIMITED,$600.32,$446.25,$483.39,$483.39,$483.39,N/A,$483.39,N/A,$483.39,N/A,$483.39,N/A,$483.39,N/A,$483.39,$483.39,N/A
3207317,0320,73562,,,,,N/A,N/A,AP BILATERAL KNEES & LATERALS,$647.74,$481.50,$263.63,$263.63,$263.63,N/A,$263.63,N/A,$263.63,N/A,$263.63,N/A,$263.63,N/A,$263.63,$263.63,N/A
3207311-50,0320,73562,,,,,N/A,N/A,KNEE 3 VIEWS,$648.75,$482.25,$263.63,$263.63,$263.63,N/A,$263.63,N/A,$263.63,N/A,$263.63,N/A,$263.63,N/A,$263.63,$263.63,N/A
3207311-LT,0320,73562,,,,,N/A,N/A,LEFT KNEE 3 VIEWS,$648.75,$482.25,$263.63,$263.63,$263.63,N/A,$263.63,N/A,$263.63,N/A,$263.63,N/A,$263.63,N/A,$263.63,$263.63,N/A
3207311-RT,0320,73562,,,,,N/A,N/A,RT KNEE 3 VIEWS,$648.75,$482.25,$263.63,$263.63,$263.63,N/A,$263.63,N/A,$263.63,N/A,$263.63,N/A,$263.63,N/A,$263.63,$263.63,N/A
3207305,0320,73564,,,,,N/A,N/A,RAD. KNEE COMPLETE,$491.35,$365.25,$321.44,$321.44,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,$321.44,N/A
3207305-LT,0320,73564,,,,,N/A,N/A,RAD. LT KNEE COMPLETE,$791.01,$588.00,$321.44,$321.44,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,$321.44,N/A
3207305-RT,0320,73564,,,,,N/A,N/A,RAD. RT KNEE COMPLETE,$791.01,$588.00,$321.44,$321.44,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,$321.44,N/A
3207314,0320,73565,,,,,N/A,N/A,KNEES BILAT AP STANDING,$600.32,$446.25,$243.95,$243.95,$243.95,N/A,$243.95,N/A,$243.95,N/A,$243.95,N/A,$243.95,N/A,$243.95,$243.95,N/A
3207306-LT,0320,73590,,,,,N/A,N/A,RAD. LT TIBIA-FIBULA,$698.19,$519.00,$283.72,$283.72,$283.72,N/A,$283.72,N/A,$283.72,N/A,$283.72,N/A,$283.72,N/A,$283.72,$283.72,N/A
3207306-RT,0320,73590,,,,,N/A,N/A,RAD. RT TIBIA-FIBULA,$698.19,$519.00,$283.72,$283.72,$283.72,N/A,$283.72,N/A,$283.72,N/A,$283.72,N/A,$283.72,N/A,$283.72,$283.72,N/A
3207307,0320,73600,,,,,N/A,N/A,RAD. ANKLE LIMITED,$372.30,$276.75,$243.95,$243.95,$243.95,N/A,$243.95,N/A,$243.95,N/A,$243.95,N/A,$243.95,N/A,$243.95,$243.95,N/A
3207307-LT,0320,73600,,,,,N/A,N/A,RAD. LT ANKLE LIMITED,$600.32,$446.25,$243.95,$243.95,$243.95,N/A,$243.95,N/A,$243.95,N/A,$243.95,N/A,$243.95,N/A,$243.95,$243.95,N/A
3207307-RT,0320,73600,,,,,N/A,N/A,RAD. RT ANKLE LIMITED,$600.32,$446.25,$243.95,$243.95,$243.95,N/A,$243.95,N/A,$243.95,N/A,$243.95,N/A,$243.95,N/A,$243.95,$243.95,N/A
3207308-LT,0320,73610,,,,,N/A,N/A,RAD. LT ANKLE COMPLETE,$671.95,$499.50,$273.60,$273.60,$273.60,N/A,$273.60,N/A,$273.60,N/A,$273.60,N/A,$273.60,N/A,$273.60,$273.60,N/A
3207308-RT,0320,73610,,,,,N/A,N/A,RAD. RT ANKLE COMPLETE,$671.95,$499.50,$273.60,$273.60,$273.60,N/A,$273.60,N/A,$273.60,N/A,$273.60,N/A,$273.60,N/A,$273.60,$273.60,N/A
3207309-LT,0320,73620,,,,,N/A,N/A,RAD. LT FOOT LIMITED,$600.32,$446.25,$243.95,$243.95,$243.95,N/A,$243.95,N/A,$243.95,N/A,$243.95,N/A,$243.95,N/A,$243.95,$243.95,N/A
3207309-RT,0320,73620,,,,,N/A,N/A,RAD. RT FOOT LIMITED,$600.32,$446.25,$243.95,$243.95,$243.95,N/A,$243.95,N/A,$243.95,N/A,$243.95,N/A,$243.95,N/A,$243.95,$243.95,N/A
3207310-LT,0320,73630,,,,,N/A,N/A,RAD. LT FOOT COMPLETE,$635.63,$472.50,$258.30,$258.30,$258.30,N/A,$258.30,N/A,$258.30,N/A,$258.30,N/A,$258.30,N/A,$258.30,$258.30,N/A
3207310-RT,0320,73630,,,,,N/A,N/A,RAD. RT RAD FOOT COMPLETE,$635.63,$472.50,$258.30,$258.30,$258.30,N/A,$258.30,N/A,$258.30,N/A,$258.30,N/A,$258.30,N/A,$258.30,$258.30,N/A
3207312-LT,0320,73650,,,,,N/A,N/A,RAD. LT OC CALCIS HEEL,$600.32,$446.25,$243.95,$243.95,$243.95,N/A,$243.95,N/A,$243.95,N/A,$243.95,N/A,$243.95,N/A,$243.95,$243.95,N/A
3207312-RT,0320,73650,,,,,N/A,N/A,RAD. RT OC CALCIS HEEL,$600.32,$446.25,$243.95,$243.95,$243.95,N/A,$243.95,N/A,$243.95,N/A,$243.95,N/A,$243.95,N/A,$243.95,$243.95,N/A
3207320-RT,0320,73660,,,,,N/A,N/A,RAD. RT TOES,$546.85,$406.50,$222.22,$222.22,$222.22,N/A,$222.22,N/A,$222.22,N/A,$222.22,N/A,$222.22,N/A,$222.22,$222.22,N/A
3207320-T1,0320,73660,,,,,N/A,N/A,LEFT SECOND TOE,$546.85,$406.50,$222.22,$222.22,$222.22,N/A,$222.22,N/A,$222.22,N/A,$222.22,N/A,$222.22,N/A,$222.22,$222.22,N/A
3207320-T2,0320,73660,,,,,N/A,N/A,LEFT THIRD TOE,$546.85,$406.50,$222.22,$222.22,$222.22,N/A,$222.22,N/A,$222.22,N/A,$222.22,N/A,$222.22,N/A,$222.22,$222.22,N/A
3207320-T3,0320,73660,,,,,N/A,N/A,LEFT FOURTH TOE,$546.85,$406.50,$222.22,$222.22,$222.22,N/A,$222.22,N/A,$222.22,N/A,$222.22,N/A,$222.22,N/A,$222.22,$222.22,N/A
3207320-T4,0320,73660,,,,,N/A,N/A,LEFT FIFTH TOE,$546.85,$406.50,$222.22,$222.22,$222.22,N/A,$222.22,N/A,$222.22,N/A,$222.22,N/A,$222.22,N/A,$222.22,$222.22,N/A
3207320-T5,0320,73660,,,,,N/A,N/A,RIGHT GREAT TOE,$546.85,$406.50,$222.22,$222.22,$222.22,N/A,$222.22,N/A,$222.22,N/A,$222.22,N/A,$222.22,N/A,$222.22,$222.22,N/A
3207320-T6,0320,73660,,,,,N/A,N/A,RIGHT SECOND TOE,$546.85,$406.50,$222.22,$222.22,$222.22,N/A,$222.22,N/A,$222.22,N/A,$222.22,N/A,$222.22,N/A,$222.22,$222.22,N/A
3207320-T7,0320,73660,,,,,N/A,N/A,RIGHT THIRD TOE,$546.85,$406.50,$222.22,$222.22,$222.22,N/A,$222.22,N/A,$222.22,N/A,$222.22,N/A,$222.22,N/A,$222.22,$222.22,N/A
3207320-T8,0320,73660,,,,,N/A,N/A,RT FOURTH TOE,$546.85,$406.50,$222.22,$222.22,$222.22,N/A,$222.22,N/A,$222.22,N/A,$222.22,N/A,$222.22,N/A,$222.22,$222.22,N/A
3207320-T9,0320,73660,,,,,N/A,N/A,RT FIFTH TOE,$546.85,$406.50,$222.22,$222.22,$222.22,N/A,$222.22,N/A,$222.22,N/A,$222.22,N/A,$222.22,N/A,$222.22,$222.22,N/A
3207320-TA,0320,73660,,,,,N/A,N/A,LEFT GREAT TOE,$546.85,$406.50,$222.22,$222.22,$222.22,N/A,$222.22,N/A,$222.22,N/A,$222.22,N/A,$222.22,N/A,$222.22,$222.22,N/A
3207350,0320,74000,,,,,N/A,N/A,Rad. Abdomen A-P,$681.03,$506.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3207351,0320,74019,,,,,N/A,N/A,RAD. ABDOMEN 2 VIEW,$903.00,$671.25,$366.95,$366.95,$366.95,N/A,$366.95,N/A,$366.95,N/A,$366.95,N/A,$366.95,N/A,$366.95,$366.95,N/A
3207352,0320,74022,,,,,N/A,N/A,RAD. ABDOMEN 3 VIEW,"$1,351.98","$1,005.00",$549.40,$549.40,$549.40,N/A,$549.40,N/A,$549.40,N/A,$549.40,N/A,$549.40,N/A,$549.40,$549.40,N/A
3207355,0320,74220,,,,,N/A,N/A,Rad. Esophagus Double,$868.70,$645.75,$549.40,$549.40,$549.40,N/A,$549.40,N/A,$549.40,N/A,$549.40,N/A,$549.40,N/A,$549.40,$549.40,N/A
32074220,0320,74220,,,,,N/A,N/A,RF BARIUM SWALLOW SINGLE,$838.43,$623.25,$549.40,$549.40,$549.40,N/A,$549.40,N/A,$549.40,N/A,$549.40,N/A,$549.40,N/A,$549.40,$549.40,N/A
99974220,0320,74220,,,,,N/A,N/A,SO BARIUM SWALLOW,"$1,351.98","$1,005.00",$549.40,$549.40,$549.40,N/A,$549.40,N/A,$549.40,N/A,$549.40,N/A,$549.40,N/A,$549.40,$549.40,N/A
32074240,0320,74240,,,,,N/A,N/A,RAD UPPER GI SINGLE,"$1,483.14","$1,102.50",$62.70,$62.70,$62.70,N/A,$62.70,N/A,$62.70,N/A,$62.70,N/A,$62.70,N/A,$62.70,$62.70,N/A
3207356,0320,74246,,,,,N/A,N/A,RAD. UPPER GI DOUBLE,"$1,536.62","$1,142.25",$624.43,$624.43,$624.43,N/A,$624.43,N/A,$624.43,N/A,$624.43,N/A,$624.43,N/A,$624.43,$624.43,N/A
32074248,0320,74248,,,,,N/A,N/A,RAD SBFT,$963.54,$716.25,$391.55,$391.55,$391.55,N/A,$391.55,N/A,$391.55,N/A,$391.55,N/A,$391.55,N/A,$391.55,$391.55,N/A
3207357,0320,74250,,,,,N/A,N/A,RAD. SMALL BOWEL,$963.54,$716.25,$391.55,$391.55,$391.55,N/A,$391.55,N/A,$391.55,N/A,$391.55,N/A,$391.55,N/A,$391.55,$391.55,N/A
3207359,0320,74270,,,,,N/A,N/A,RAD. BAR EN W/GLUCAG,"$1,557.80","$1,158.00",$633.40,$633.40,$633.40,N/A,$633.40,N/A,$633.40,N/A,$633.40,N/A,$633.40,N/A,$633.40,$633.40,N/A
3207360,0320,74270,,,,,N/A,N/A,RAD. ROUTINE BARI EN,"$1,557.80","$1,158.00",$633.40,$633.40,$633.40,N/A,$633.40,N/A,$633.40,N/A,$633.40,N/A,$633.40,N/A,$633.40,$633.40,N/A
3207362,0320,74270,,,,,N/A,N/A,RAD. COLON GASTROGRA,"$1,557.80","$1,158.00",$633.40,$633.40,$633.40,N/A,$633.40,N/A,$633.40,N/A,$633.40,N/A,$633.40,N/A,$633.40,$633.40,N/A
3207361,0320,74280,,,,,N/A,N/A,RAD. AIR CONT BAR EN,"$2,295.34","$1,706.25",$932.75,$932.75,$932.75,N/A,$932.75,N/A,$932.75,N/A,$932.75,N/A,$932.75,N/A,$932.75,$932.75,N/A
3274280,0320,74280,,,,,N/A,N/A,BARIUM ENEMA W CONT W GLUGAGON,"$2,295.34","$1,706.25",$932.75,$932.75,$932.75,N/A,$932.75,N/A,$932.75,N/A,$932.75,N/A,$932.75,N/A,$932.75,$932.75,N/A
3207363,0320,74290,,,,,N/A,N/A,RAD. CHOLECYSTOGRAPH,$584.18,$434.25,$237.39,$237.39,$237.39,N/A,$237.39,N/A,$237.39,N/A,$237.39,N/A,$237.39,N/A,$237.39,$237.39,N/A
3207364,0320,74291,,,,,N/A,N/A,RAD. CHOLECYS 2 DOSE,$894.93,$665.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3207365,0320,74300,,,,,N/A,N/A,RAD. CHOLANGIO OP,"$1,389.31","$1,032.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3207366,0320,74300,,,,,N/A,N/A,RAD. CHOLANG POST OP,$834.39,$620.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3207367,0320,74301,,,,,N/A,N/A,ADDITIONAL INTRAOP FILM SET,$868.70,$645.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3207372,0320,74400,,,,,N/A,N/A,RAD. URO INTRA,"$1,389.31","$1,032.75",$564.57,$564.57,$564.57,N/A,$564.57,N/A,$564.57,N/A,$564.57,N/A,$564.57,N/A,$564.57,$564.57,N/A
3207373,0320,74415,,,,,N/A,N/A,RAD. URO INT,"$2,295.34","$1,706.25",$932.75,$932.75,$932.75,N/A,$932.75,N/A,$932.75,N/A,$932.75,N/A,$932.75,N/A,$932.75,$932.75,N/A
3207374,0320,74420,,,,,N/A,N/A,RAD. URO RETRO KUB,"$1,257.14",$934.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3274451,0320,74420,,,,,N/A,N/A,RETROGRADE PYELOGRAM,"$1,651.63","$1,227.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3207442,0320,74425,,,,,N/A,N/A,NEPHROSTOGRAM,"$1,063.42",$790.50,$432.14,$432.14,$432.14,N/A,$432.14,N/A,$432.14,N/A,$432.14,N/A,$432.14,N/A,$432.14,$432.14,N/A
3207445,0320,74425,,,,,N/A,N/A,LOOPOGRAM,"$1,063.42",$790.50,$432.14,$432.14,$432.14,N/A,$432.14,N/A,$432.14,N/A,$432.14,N/A,$432.14,N/A,$432.14,$432.14,N/A
3207375,0320,74430,,,,,N/A,N/A,RAD. CYSTOGRAPHY,$621.51,$462.00,$252.56,$252.56,$252.56,N/A,$252.56,N/A,$252.56,N/A,$252.56,N/A,$252.56,N/A,$252.56,$252.56,N/A
3207377,0320,74450,,,,,N/A,N/A,RAD. URETHRO RETROGR,$820.27,$609.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3274450,0320,74450,,,,,N/A,N/A,RETROGRADE URETHROCYSTOGRAPHY,$546.85,$406.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3207378,0320,74455,,,,,N/A,N/A,RAD. URETHRO VOIDING,"$1,144.14",$850.50,$464.94,$464.94,$464.94,N/A,$464.94,N/A,$464.94,N/A,$464.94,N/A,$464.94,N/A,$464.94,$464.94,N/A
3207447,0320,74475,,,,,N/A,N/A,NEPHROSTOMY INSERTION IN OR,"$3,669.51","$2,727.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3207448,0320,74485,,,,,N/A,N/A,NEPHROSTOMY DILATATION,"$2,462.82","$1,830.75",$1.81,$1.81,$1.81,N/A,$1.81,N/A,$1.81,N/A,$1.81,N/A,$1.81,N/A,$1.81,$1.81,N/A
3207390,0320,74710,,,,,N/A,N/A,RAD. PELVIMETRY,$820.27,$609.75,$333.33,$333.33,$333.33,N/A,$333.33,N/A,$333.33,N/A,$333.33,N/A,$333.33,N/A,$333.33,$333.33,N/A
3207393,0320,74740,,,,,N/A,N/A,RAD. HYSTEROSALPINOGRAPHY,"$1,125.98",$837.00,$457.56,$457.56,$457.56,N/A,$457.56,N/A,$457.56,N/A,$457.56,N/A,$457.56,N/A,$457.56,$457.56,N/A
3275820,0320,75820,,,,,N/A,N/A,VENOGRAM EXTREMITY UNILATERAL,"$2,434.57","$1,809.75",$989.33,$989.33,$989.33,N/A,$989.33,N/A,$989.33,N/A,$989.33,N/A,$989.33,N/A,$989.33,$989.33,N/A
429987,0320,76000,,,,,N/A,N/A,Fluoro Pain Clinic,$0.00,$0.00,$566.21,$566.21,$566.21,N/A,$566.21,N/A,$566.21,N/A,$566.21,N/A,$566.21,N/A,$566.21,$566.21,N/A
3201934,0320,76000,,,,,N/A,N/A,FLUOROSCOPE EXAM IN OR<HR -59,"$1,393.35","$1,035.75",$566.21,$566.21,$566.21,N/A,$566.21,N/A,$566.21,N/A,$566.21,N/A,$566.21,N/A,$566.21,$566.21,N/A
3227600,0320,76000,,,,,N/A,N/A,FLUORO - ONLY,"$1,393.35","$1,035.75",$566.21,$566.21,$566.21,N/A,$566.21,N/A,$566.21,N/A,$566.21,N/A,$566.21,N/A,$566.21,$566.21,N/A
3276000,0320,76000,,,,,N/A,N/A,FLUOROSCOPE EXAM,"$1,393.35","$1,035.75",$566.21,$566.21,$566.21,N/A,$566.21,N/A,$566.21,N/A,$566.21,N/A,$566.21,N/A,$566.21,$566.21,N/A
7201394,0320,76000,,,,,N/A,N/A,FLUOROSCOPE EXAM,"$1,393.35","$1,035.75",$566.21,$566.21,$566.21,N/A,$566.21,N/A,$566.21,N/A,$566.21,N/A,$566.21,N/A,$566.21,$566.21,N/A
7600075,0320,76000,,,,,N/A,N/A,FLUOROSCOPY,"$1,219.81",$906.75,$566.21,$566.21,$566.21,N/A,$566.21,N/A,$566.21,N/A,$566.21,N/A,$566.21,N/A,$566.21,$566.21,N/A
3201933,0320,76001,,,,,N/A,N/A,"FLUOROSCOPE EXAM, EXTENSIVE-59","$2,606.09","$1,937.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3276006,0320,76006,,,,,N/A,N/A,Stress Views Uni Or Bilat,$662.87,$492.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3276010,0320,76010,,,,,N/A,N/A,SINGLE VIEW FOREIGN BODY CHILD,$300.66,$223.50,$122.18,$122.18,$122.18,N/A,$122.18,N/A,$122.18,N/A,$122.18,N/A,$122.18,N/A,$122.18,$122.18,N/A
3207454,0320,76020,,,,,N/A,N/A,Rad. Bone Age,$544.83,$405.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3207455,0320,76040,,,,,N/A,N/A,Rad. Bone Length,"$1,524.51","$1,133.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3207458,0320,76062,,,,,N/A,N/A,Rad. Bone Survey,"$2,294.33","$1,705.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3207457,0320,76065,,,,,N/A,N/A,Rad. Bone Survey Infant<1 Yr,"$1,250.08",$929.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3276077,0320,76077,,,,,N/A,N/A,Vertebral Frx Assessment,$432.84,$321.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3207464,0320,76080,,,,,N/A,N/A,RAD. FISTULA SINOGRAM,$518.60,$385.50,$21.74,$21.74,$21.74,N/A,$21.74,N/A,$21.74,N/A,$21.74,N/A,$21.74,N/A,$21.74,$21.74,N/A
3207468,0320,76096,,,,,N/A,N/A,Rad. Needle Localization,"$1,105.80",$822.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3276499,0320,76499,,,,,N/A,N/A,PICC LINE PLACEMENT- NO FLUORO,$193.72,$144.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3207552,0320,77001,,,,,N/A,N/A,LINE PLACEMENT NO IMAGES,$411.65,$306.00,$453.50,$453.50,$453.50,N/A,$453.50,N/A,$453.50,N/A,$453.50,N/A,$453.50,N/A,$453.50,$453.50,N/A
3277003,0320,77001,,,,,N/A,N/A,OR CARM LINE PLACEMENT,"$1,114.88",$828.75,$453.50,$453.50,$453.50,N/A,$453.50,N/A,$453.50,N/A,$453.50,N/A,$453.50,N/A,$453.50,$453.50,N/A
3277002,0320,77002,,,,,N/A,N/A,FLUORO GUIDED JOINT INJECTION,$694.15,$516.00,$282.80,$282.80,$282.80,N/A,$282.80,N/A,$282.80,N/A,$282.80,N/A,$282.80,N/A,$282.80,$282.80,N/A
7700275,0320,77002,,,,,N/A,N/A,FLUOROSCOPIC GUIDANCE,$161.43,$120.00,$282.80,$282.80,$282.80,N/A,$282.80,N/A,$282.80,N/A,$282.80,N/A,$282.80,N/A,$282.80,$282.80,N/A
7700375,0320,77003,,,,,N/A,N/A,FLUOROSCOPIC GUIDANCE PROCD,$198.76,$147.75,$8.77,$8.77,$8.77,N/A,$8.77,N/A,$8.77,N/A,$8.77,N/A,$8.77,N/A,$8.77,$8.77,N/A
3298221,0320,77071,,,,,N/A,N/A,STRESS VIEWS,$147.31,$109.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3207499,0320,77074,,,,,N/A,N/A,PEDIATRIC BONE SURVEY LTD,$894.93,$665.25,$363.67,$363.67,$363.67,N/A,$363.67,N/A,$363.67,N/A,$363.67,N/A,$363.67,N/A,$363.67,$363.67,N/A
3207114,0320,77077,,,,,N/A,N/A,LONG LENGTH JOINT SURVEY -1VW,$600.32,$446.25,$243.95,$243.95,$243.95,N/A,$243.95,N/A,$243.95,N/A,$243.95,N/A,$243.95,N/A,$243.95,$243.95,N/A
3207583,0320,77080,,,,,N/A,N/A,DEXA BONE DENSITY,"$1,152.21",$856.50,$468.22,$468.22,$468.22,N/A,$468.22,N/A,$468.22,N/A,$468.22,N/A,$468.22,N/A,$468.22,$468.22,N/A
3276078,0320,77081,,,,,N/A,N/A,DEXA PERIPHERAL SKELETON,$343.04,$255.00,$139.40,$139.40,$139.40,N/A,$139.40,N/A,$139.40,N/A,$139.40,N/A,$139.40,N/A,$139.40,$139.40,N/A
3207299-RT,0320,,,,,,N/A,N/A,Rad. Rt Hip 1 View,$546.85,$406.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3207300-LT,0320,,,,,,N/A,N/A,Rad. Lt Hip Complete,$888.88,$660.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3207300-RT,0320,,,,,,N/A,N/A,Rad. Rt Hip Complete,$888.88,$660.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3207303-LT,0320,,,,,,N/A,N/A,Rad. Lt Femur,$778.90,$579.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3207303-RT,0320,,,,,,N/A,N/A,Rad. Rt Femur,$778.90,$579.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3207571-LT,0320,,,,,,N/A,N/A,Intr-Oper Arteriogram L Extrem,"$1,576.97","$1,172.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3207571-RT,0320,,,,,,N/A,N/A,Intra-Oper Arteriogram R Extre,"$1,576.97","$1,172.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3207582-LT,0320,,,,,,N/A,N/A,Intra-Operative L Leg Venogram,$777.89,$578.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3207582-RT,0320,,,,,,N/A,N/A,Intraoperative R Leg Venogram,$790.00,$587.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3207584-LT,0320,,,,,,N/A,N/A,LEFT RIBS & PA CXR,"$1,295.48",$963.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3207584-RT,0320,,,,,,N/A,N/A,RIGHT RIBS & PA CXR,"$1,295.48",$963.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3240001,0324,71010,,,,,N/A,N/A,"Portable Ap Chest, Postline",$0.00,$0.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3407819,0340,38792,,,,,N/A,N/A,Lymphoscintigraphy,$988.76,$735.00,$41.80,$294.00,$41.80,$285.18,$41.80,$251.37,$41.80,$55.97,$41.80,$285.18,$41.80,$294.00,$41.80,$41.80,$285.18
340871350,0340,38792,,,,,N/A,N/A,"LYMPHOSCINTOGRAPHY,ISTP-INJ-50",$296.63,$220.50,$41.80,$294.00,$41.80,$285.18,$41.80,$251.37,$41.80,$55.97,$41.80,$285.18,$41.80,$294.00,$41.80,$41.80,$285.18
3057599-RT,0340,73702,,,,,N/A,N/A,CT RT LOWER EXTREMITY WO & W,$793.03,$589.50,$322.26,$322.26,$322.26,N/A,$322.26,N/A,$322.26,N/A,$322.26,N/A,$322.26,N/A,$322.26,$322.26,N/A
3507599-LT,0340,73702,,,,,N/A,N/A,CT LEFT LOWER EXTREMITY WO & W,$793.03,$589.50,$322.26,$322.26,$322.26,N/A,$322.26,N/A,$322.26,N/A,$322.26,N/A,$322.26,N/A,$322.26,$322.26,N/A
3507599-RT,0340,73702,,,,,N/A,N/A,CT RT LOWER EXTREMITY WO & W,$793.03,$589.50,$322.26,$322.26,$322.26,N/A,$322.26,N/A,$322.26,N/A,$322.26,N/A,$322.26,N/A,$322.26,$322.26,N/A
3476380,0340,76380,,,,,N/A,N/A,"CT, LMTD OR LOCALZD FOLLOW-UP",$466.13,$346.50,$189.42,$189.42,$189.42,N/A,$189.42,N/A,$189.42,N/A,$189.42,N/A,$189.42,N/A,$189.42,$189.42,N/A
4076813LT,0340,76642,,,,,N/A,N/A,LT AXILLA US,$468.15,$348.00,$19.24,$19.24,$19.24,N/A,$19.24,N/A,$19.24,N/A,$19.24,N/A,$19.24,N/A,$19.24,$19.24,N/A
4076813RT,0340,76642,,,,,N/A,N/A,RT AXILLA US,$468.15,$348.00,$19.24,$19.24,$19.24,N/A,$19.24,N/A,$19.24,N/A,$19.24,N/A,$19.24,N/A,$19.24,$19.24,N/A
3404310,0340,78000,,,,,N/A,N/A,I 131 Thyroid Uptake,$932.26,$693.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3404700,0340,78010,,,,,N/A,N/A,Thyroid Scan,"$1,696.03","$1,260.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3478013,0340,78014,,,,,N/A,N/A,I 123 THYROID UPTAKE & SCAN,"$1,358.03","$1,009.50",$551.86,$551.86,$551.86,N/A,$551.86,N/A,$551.86,N/A,$551.86,N/A,$551.86,N/A,$551.86,$551.86,N/A
3478070,0340,78070,,,,,N/A,N/A,NM PARATHYROID SCAN,"$1,222.84",$909.00,$496.92,$496.92,$496.92,N/A,$496.92,N/A,$496.92,N/A,$496.92,N/A,$496.92,N/A,$496.92,$496.92,N/A
3404240,0340,78261,,,,,N/A,N/A,GI SCAN MECKELS,"$2,008.80","$1,493.25",$816.31,$816.31,$816.31,N/A,$816.31,N/A,$816.31,N/A,$816.31,N/A,$816.31,N/A,$816.31,$816.31,N/A
3478264,0340,78264,,,,,N/A,N/A,Nm Gastric Emptying,$0.00,$0.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3404180,0340,78278,,,,,N/A,N/A,GI BLEED TAGGED RBC,"$2,436.59","$1,811.25",$99.15,$99.15,$99.15,N/A,$99.15,N/A,$99.15,N/A,$99.15,N/A,$99.15,N/A,$99.15,$99.15,N/A
3404190,0340,78290,,,,,N/A,N/A,GI BLEED SULFUR-COLLOID,"$2,387.15","$1,774.50",$97.60,$97.60,$97.60,N/A,$97.60,N/A,$97.60,N/A,$97.60,N/A,$97.60,N/A,$97.60,$97.60,N/A
3404130,0340,78306,,,,,N/A,N/A,BONE SCAN WHOLE BODY GRP,"$3,686.67","$2,740.50","$1,498.14","$1,498.14","$1,498.14",N/A,"$1,498.14",N/A,"$1,498.14",N/A,"$1,498.14",N/A,"$1,498.14",N/A,"$1,498.14","$1,498.14",N/A
3478579,0340,78579,,,,,N/A,N/A,LUNG VENT AER W/A9567,"$2,006.78","$1,491.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3404220,0340,78580,,,,,N/A,N/A,"LUNG SCAN, PERFUSION W/A9540","$2,426.50","$1,803.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3478582,0340,78582,,,,,N/A,N/A,VENT & PERF SCAN W/A9558&A9540,"$3,222.55","$2,395.50","$1,367.76","$1,367.76","$1,367.76",N/A,"$1,367.76",N/A,"$1,367.76",N/A,"$1,367.76",N/A,"$1,367.76",N/A,"$1,367.76","$1,367.76",N/A
3478588,0340,78582,,,,,N/A,N/A,LUNG VENT PERF AEW/A9567&A9540,"$3,365.82","$2,502.00","$1,367.76","$1,367.76","$1,367.76",N/A,"$1,367.76",N/A,"$1,367.76",N/A,"$1,367.76",N/A,"$1,367.76",N/A,"$1,367.76","$1,367.76",N/A
3404290,0340,78708,,,,,N/A,N/A,RENOGRAM W/LASIX/CAPTOPRIL,"$4,387.88","$3,261.75","$1,783.90","$1,783.90","$1,783.90",N/A,"$1,783.90",N/A,"$1,783.90",N/A,"$1,783.90",N/A,"$1,783.90",N/A,"$1,783.90","$1,783.90",N/A
3408764,0340,78803,,,,,N/A,N/A,Tumor Localization Spect W/Ct,"$3,866.26","$2,874.00","$1,571.12","$1,571.12","$1,571.12",N/A,"$1,571.12",N/A,"$1,571.12",N/A,"$1,571.12",N/A,"$1,571.12",N/A,"$1,571.12","$1,571.12",N/A
3507880,0340,78803,,,,,N/A,N/A,Tomographic (Spect) W/Ct,"$3,333.54","$2,478.00","$1,571.12","$1,571.12","$1,571.12",N/A,"$1,571.12",N/A,"$1,571.12",N/A,"$1,571.12",N/A,"$1,571.12",N/A,"$1,571.12","$1,571.12",N/A
3404900,0340,78804,,,,,N/A,N/A,WHOLE BODY GALLIUM SCAN,"$6,441.07","$4,788.00","$2,617.44","$2,617.44","$2,617.44",N/A,"$2,617.44",N/A,"$2,617.44",N/A,"$2,617.44",N/A,"$2,617.44",N/A,"$2,617.44","$2,617.44",N/A
3408715,0340,A4641,,,,,N/A,N/A,Lymphoscint~ Injection Proc,$569.04,$423.00,$547.08,$564.00,N/A,$547.08,N/A,N/A,N/A,$564.00,N/A,$547.08,N/A,$564.00,N/A,N/A,$547.08
3478015,0340,A9512,,,,,N/A,N/A,Tech 99,$0.00,$0.00,$0.00,$0.00,N/A,$0.00,N/A,N/A,N/A,$0.00,N/A,$0.00,N/A,$0.00,N/A,N/A,$0.00
3404313,0340,A9516,,,,,N/A,N/A,I 123 Thyroid Uptake&Scan Grp,$0.00,$0.00,$0.00,$0.00,N/A,$0.00,N/A,N/A,N/A,$0.00,N/A,$0.00,N/A,$0.00,N/A,N/A,$0.00
3478014,0340,A9528,,,,,N/A,N/A,I 131 Thyroid Uptake,$0.00,$0.00,$0.00,$0.00,N/A,$0.00,N/A,N/A,N/A,$0.00,N/A,$0.00,N/A,$0.00,N/A,N/A,$0.00
3404160,0340,,,,,,N/A,N/A,Hepatobiliary(Cck),"$2,996.55","$2,227.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3404140,0341,78305,,,,,N/A,N/A,BONE SCAN MULTI AREAS,"$3,641.26","$2,706.75","$1,479.69","$1,479.69","$1,479.69",N/A,"$1,479.69",N/A,"$1,479.69",N/A,"$1,479.69",N/A,"$1,479.69",N/A,"$1,479.69","$1,479.69",N/A
3404120,0341,78315,,,,,N/A,N/A,3 PHASE BONE SCAN,"$4,798.52","$3,567.00","$1,949.96","$1,949.96","$1,949.96",N/A,"$1,949.96",N/A,"$1,949.96",N/A,"$1,949.96",N/A,"$1,949.96",N/A,"$1,949.96","$1,949.96",N/A
3404150,0341,78320,,,,,N/A,N/A,BONE SCAN SPECT,"$4,289.00","$3,188.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3478451,0341,78451,,,,,N/A,N/A,MPI SPECT SINGLE STUDY,"$5,047.73","$3,752.25",$251.23,$251.23,$251.23,N/A,$251.23,N/A,$251.23,N/A,$251.23,N/A,$251.23,N/A,$251.23,$251.23,N/A
34178452,0341,78452,,,,,N/A,N/A,MPI REST & STRESS NUC,"$10,088.39","$7,499.25",$464.94,$464.94,$464.94,N/A,$464.94,N/A,$464.94,N/A,$464.94,N/A,$464.94,N/A,$464.94,$464.94,N/A
3404270,0341,78473,,,,,N/A,N/A,MUGA EJECTION FRACTION,"$5,431.12","$4,037.25",$227.30,$227.30,$227.30,N/A,$227.30,N/A,$227.30,N/A,$227.30,N/A,$227.30,N/A,$227.30,$227.30,N/A
3407663,0341,78579,,,,,N/A,N/A,VENTILATION  LUNG SCAN &A9558,"$1,866.54","$1,387.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3407684,0341,78707,,,,,N/A,N/A,RENOGRAM IMAGE WO PH,"$2,785.68","$2,070.75","$1,132.10","$1,132.10","$1,132.10",N/A,"$1,132.10",N/A,"$1,132.10",N/A,"$1,132.10",N/A,"$1,132.10",N/A,"$1,132.10","$1,132.10",N/A
3404110,0341,78802,,,,,N/A,N/A,ABSCESS IMAGING WHOLE BODY,"$8,751.55","$6,505.50","$3,556.34","$3,556.34","$3,556.34",N/A,"$3,556.34",N/A,"$3,556.34",N/A,"$3,556.34",N/A,"$3,556.34",N/A,"$3,556.34","$3,556.34",N/A
3408728,0341,78805,,,,,N/A,N/A,ABSCESS IMAGING LIMITED,"$1,978.53","$1,470.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3408713,0343,38792,,,,,N/A,N/A,"Sulfur Colloid Per Dose,20 Mci",$0.00,$0.00,$41.80,$294.00,$41.80,$285.18,$41.80,$251.37,$41.80,$55.97,$41.80,$285.18,$41.80,$294.00,$41.80,$41.80,$285.18
3404008,0343,A4641,,,,,N/A,N/A,Techenetium Tc 99 M Sestamibi,$0.00,$0.00,$547.08,$564.00,N/A,$547.08,N/A,N/A,N/A,$564.00,N/A,$547.08,N/A,$564.00,N/A,N/A,$547.08
3404014,0343,A4641,,,,,N/A,N/A,Technetium Tc 99m Sestamibi,$0.00,$0.00,$547.08,$564.00,N/A,$547.08,N/A,N/A,N/A,$564.00,N/A,$547.08,N/A,$564.00,N/A,N/A,$547.08
3407698,0343,A4641,,,,,N/A,N/A,I 123 Capsule,$0.00,$0.00,$547.08,$564.00,N/A,$547.08,N/A,N/A,N/A,$564.00,N/A,$547.08,N/A,$564.00,N/A,N/A,$547.08
3408711,0343,A4641,,,,,N/A,N/A,Technetium Tc 99m Medronate,$0.00,$0.00,$547.08,$564.00,N/A,$547.08,N/A,N/A,N/A,$564.00,N/A,$547.08,N/A,$564.00,N/A,N/A,$547.08
3408714,0343,A4641,,,,,N/A,N/A,# Pulmolite,$0.00,$0.00,$547.08,$564.00,N/A,$547.08,N/A,N/A,N/A,$564.00,N/A,$547.08,N/A,$564.00,N/A,N/A,$547.08
3408716,0343,A4641,,,,,N/A,N/A,Gallium Ga-67 Citrate,$0.00,$0.00,$547.08,$564.00,N/A,$547.08,N/A,N/A,N/A,$564.00,N/A,$547.08,N/A,$564.00,N/A,N/A,$547.08
3408717,0343,A4641,,,,,N/A,N/A,Thallous Chloride Tl 201/Mci,$0.00,$0.00,$547.08,$564.00,N/A,$547.08,N/A,N/A,N/A,$564.00,N/A,$547.08,N/A,$564.00,N/A,N/A,$547.08
3408719,0343,A4641,,,,,N/A,N/A,"# Dtpa, Dx, Up To 25 Mci",$84.75,$63.00,$547.08,$564.00,N/A,$547.08,N/A,N/A,N/A,$564.00,N/A,$547.08,N/A,$564.00,N/A,N/A,$547.08
3408720,0343,A4641,,,,,N/A,N/A,"Dicopac Co57/58 Dx,Pr Sty,1uci",$413.67,$307.50,$547.08,$564.00,N/A,$547.08,N/A,N/A,N/A,$564.00,N/A,$547.08,N/A,$564.00,N/A,N/A,$547.08
3408721,0343,A4641,,,,,N/A,N/A,"# I-131,Dx, Per Erci",$109.97,$81.75,$547.08,$564.00,N/A,$547.08,N/A,N/A,N/A,$564.00,N/A,$547.08,N/A,$564.00,N/A,N/A,$547.08
3408723,0343,A4641,,,,,N/A,N/A,"# Mag 3,Pr Stdy Ds,Up To 30mci",$260.31,$193.50,$547.08,$564.00,N/A,$547.08,N/A,N/A,N/A,$564.00,N/A,$547.08,N/A,$564.00,N/A,N/A,$547.08
3408724,0343,A4641,,,,,N/A,N/A,# Cck Per 5 Ugm,$0.00,$0.00,$547.08,$564.00,N/A,$547.08,N/A,N/A,N/A,$564.00,N/A,$547.08,N/A,$564.00,N/A,N/A,$547.08
3408726,0343,A4641,,,,,N/A,N/A,Technetium Tc 99 M Sestamibi,$0.00,$0.00,$547.08,$564.00,N/A,$547.08,N/A,N/A,N/A,$564.00,N/A,$547.08,N/A,$564.00,N/A,N/A,$547.08
3404642,0343,A4642,,,,,N/A,N/A,SATUMOMAB PENDETIDE PER DOSE,"$2,657.55","$1,975.50","$2,554.98","$2,634.00",N/A,"$2,554.98",N/A,N/A,N/A,"$2,634.00",N/A,"$2,554.98",N/A,"$2,634.00",N/A,N/A,"$2,554.98"
3404009,0343,A9500,,,,,N/A,N/A,Technectium Tc 99 M Tetrafos,$152.35,$113.25,$146.47,$151.00,N/A,$146.47,N/A,N/A,N/A,$151.00,N/A,$146.47,N/A,$151.00,N/A,N/A,$146.47
3404012,0343,A9500,,,,,N/A,N/A,Cardiolite X 2,$0.00,$0.00,$146.47,$151.00,N/A,$146.47,N/A,N/A,N/A,$151.00,N/A,$146.47,N/A,$151.00,N/A,N/A,$146.47
3409500,0343,A9500,,,,,N/A,N/A,"Sestamibi,Dx,Stdy Ds,To 40 Mci",$0.00,$0.00,$146.47,$151.00,N/A,$146.47,N/A,N/A,N/A,$151.00,N/A,$146.47,N/A,$151.00,N/A,N/A,$146.47
3409502,0343,A9502,,,,,N/A,N/A,"Tetrofsmn,Dx,Stdy Ds,To 40 Mci",$0.00,$0.00,$0.00,$0.00,N/A,$0.00,N/A,N/A,N/A,$0.00,N/A,$0.00,N/A,$0.00,N/A,N/A,$0.00
3409503,0343,A9503,,,,,N/A,N/A,Tc99-Medronate Mdp,$0.00,$0.00,$0.00,$0.00,N/A,$0.00,N/A,N/A,N/A,$0.00,N/A,$0.00,N/A,$0.00,N/A,N/A,$0.00
3409504,0343,A9504,,,,,N/A,N/A,"TC 99M APCITIDE, PER VIAL",$147.31,$109.50,$141.62,$146.00,N/A,$141.62,N/A,N/A,N/A,$146.00,N/A,$141.62,N/A,$146.00,N/A,N/A,$141.62
3409505,0343,A9505,,,,,N/A,N/A,Thallous Chloride Tl 201/Mci,$0.00,$0.00,$0.00,$0.00,N/A,$0.00,N/A,N/A,N/A,$0.00,N/A,$0.00,N/A,$0.00,N/A,N/A,$0.00
3409507,0343,A9507,,,,,N/A,N/A,Indium/111 Carpromab Pendetide,"$1,134.05",$843.00,"$1,090.28","$1,124.00",N/A,"$1,090.28",N/A,N/A,N/A,"$1,124.00",N/A,"$1,090.28",N/A,"$1,124.00",N/A,N/A,"$1,090.28"
3409512,0343,A9512,,,,,N/A,N/A,"Pertechnetate,Dx,Per Mci",$0.00,$0.00,$0.00,$0.00,N/A,$0.00,N/A,N/A,N/A,$0.00,N/A,$0.00,N/A,$0.00,N/A,N/A,$0.00
3401098,0343,A9515,,,,,N/A,N/A,"TC99M PENTETATE, PER VIAL",$74.66,$55.50,$71.78,$74.00,N/A,$71.78,N/A,N/A,N/A,$74.00,N/A,$71.78,N/A,$74.00,N/A,N/A,$71.78
3401087,0343,A9516,,,,,N/A,N/A,"I-23 Per 100 Uci, Dx Use",$0.00,$0.00,$0.00,$0.00,N/A,$0.00,N/A,N/A,N/A,$0.00,N/A,$0.00,N/A,$0.00,N/A,N/A,$0.00
3409516,0343,A9516,,,,,N/A,N/A,"I-123,Cap,Dx,Per 100 Uci",$0.00,$0.00,$0.00,$0.00,N/A,$0.00,N/A,N/A,N/A,$0.00,N/A,$0.00,N/A,$0.00,N/A,N/A,$0.00
3401188,0343,A9517,,,,,N/A,N/A,"I-131 PER UCI,DX USE",$6.05,$4.50,$5.82,$6.00,N/A,$5.82,N/A,N/A,N/A,$6.00,N/A,$5.82,N/A,$6.00,N/A,N/A,$5.82
3401096,0343,A9521,,,,,N/A,N/A,"TC99M EXAMETAZIME,PER DOSE","$1,354.00","$1,006.50","$1,301.74","$1,342.00",N/A,"$1,301.74",N/A,N/A,N/A,"$1,342.00",N/A,"$1,301.74",N/A,"$1,342.00",N/A,N/A,"$1,301.74"
3409538,0343,A9538,,,,,N/A,N/A,"Pyrophosphate,Dx,Stdy Ds,25mci",$0.00,$0.00,$0.00,$0.00,N/A,$0.00,N/A,N/A,N/A,$0.00,N/A,$0.00,N/A,$0.00,N/A,N/A,$0.00
3409547,0343,A9547,,,,,N/A,N/A,"Oxyquinoline,Dx,Per 0.5 Mci",$0.00,$0.00,$0.00,$0.00,N/A,$0.00,N/A,N/A,N/A,$0.00,N/A,$0.00,N/A,$0.00,N/A,N/A,$0.00
3403004,0343,A9558,,,,,N/A,N/A,"Xe 133, Per 10 Mci",$0.00,$0.00,$0.00,$0.00,N/A,$0.00,N/A,N/A,N/A,$0.00,N/A,$0.00,N/A,$0.00,N/A,N/A,$0.00
3409559,0343,A9559,,,,,N/A,N/A,"Cyanocobalamin.Or,Pr Stdy",$0.00,$0.00,$0.00,$0.00,N/A,$0.00,N/A,N/A,N/A,$0.00,N/A,$0.00,N/A,$0.00,N/A,N/A,$0.00
3409560,0343,A9560,,,,,N/A,N/A,"Red Bld Cells,Dx,Stdyds,30 Mci",$0.00,$0.00,$0.00,$0.00,N/A,$0.00,N/A,N/A,N/A,$0.00,N/A,$0.00,N/A,$0.00,N/A,N/A,$0.00
3401079,0343,C1079,,,,,N/A,N/A,CO 57/58 0.5 mCi,$927.22,$689.25,$891.43,$919.00,N/A,$891.43,N/A,N/A,N/A,$919.00,N/A,$891.43,N/A,$919.00,N/A,N/A,$891.43
3788052,0343,C1093,,,,,N/A,N/A,RADIOPHARMACEUTICAL IMG. AGT.,"$1,921.02","$1,428.00","$1,846.88","$1,904.00",N/A,"$1,846.88",N/A,N/A,N/A,"$1,904.00",N/A,"$1,846.88",N/A,"$1,904.00",N/A,N/A,"$1,846.88"
3401122,0343,C1122,,,,,N/A,N/A,"TC99M ARCITUMOMAB, PER VIAL","$3,945.96","$2,933.25","$3,793.67","$3,911.00",N/A,"$3,793.67",N/A,N/A,N/A,"$3,911.00",N/A,"$3,793.67",N/A,"$3,911.00",N/A,N/A,"$3,793.67"
3401200,0343,C1200,,,,,N/A,N/A,"TC99M SODIUM,GLUCOHENTONAT",$344.05,$255.75,$330.77,$341.00,N/A,$330.77,N/A,N/A,N/A,$341.00,N/A,$330.77,N/A,$341.00,N/A,N/A,$330.77
3401201,0343,C1201,,,,,N/A,N/A,"TC99M SUCCIMER, PER VIAL",$436.87,$324.75,$420.01,$433.00,N/A,$420.01,N/A,N/A,N/A,$433.00,N/A,$420.01,N/A,$433.00,N/A,N/A,$420.01
3401207,0343,C1207,,,,,N/A,N/A,"Octreotide Acetate, Depot 1 Mg",$451.00,$335.25,"$17,343.60","$17,880.00",N/A,"$17,343.60",N/A,N/A,N/A,"$17,880.00",N/A,"$17,343.60",N/A,"$17,880.00",N/A,N/A,"$17,343.60"
3409013,0343,C9013,,,,,N/A,N/A,"CO 57 COBALTOUS CL, 1 ML",$36.32,$27.00,$34.92,$36.00,N/A,$34.92,N/A,N/A,N/A,$36.00,N/A,$34.92,N/A,$36.00,N/A,N/A,$34.92
3403003,0343,Q3003,,,,,N/A,N/A,TECHNETIUM TC99M BICISATE,"$1,292.45",$960.75,"$1,242.57","$1,281.00",N/A,"$1,242.57",N/A,N/A,N/A,"$1,281.00",N/A,"$1,242.57",N/A,"$1,281.00",N/A,N/A,"$1,242.57"
3403006,0343,Q3006,,,,,N/A,N/A,TECHNETIUM TC99M GLUCEPATATE,$75.67,$56.25,$72.75,$75.00,N/A,$72.75,N/A,N/A,N/A,$75.00,N/A,$72.75,N/A,$75.00,N/A,N/A,$72.75
3403009,0343,Q3009,,,,,N/A,N/A,TECHNETIUM TC99M OXIDRONATE,$119.05,$88.50,$114.46,$118.00,N/A,$114.46,N/A,N/A,N/A,$118.00,N/A,$114.46,N/A,$118.00,N/A,N/A,$114.46
3403012,0343,Q3012,,,,,N/A,N/A,CYANOCOBALAMIN COBALT CO57,$315.80,$234.75,$303.61,$313.00,N/A,$303.61,N/A,N/A,N/A,$313.00,N/A,$303.61,N/A,$313.00,N/A,N/A,$303.61
3401095,0343,,,,,,N/A,N/A,"TC 99M DEPREOTIDE, PER VIAL","$2,428.52","$1,805.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3401097,0343,,,,,,N/A,N/A,"TC99M MEBROFENIN, PER VIAL",$166.48,$123.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3401099,0343,,,,,,N/A,N/A,"TC99M PYROPHOSPHATE, PER VIAL",$140.24,$104.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3401202,0343,,,,,,N/A,N/A,"TC99M SULFUR COLLIOD, DOSE",$118.05,$87.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3507604,0350,70486,,,,,N/A,N/A,CT MAX FACIAL W/O CONTRAST,$533.00,$399.75,$218.53,$218.53,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,$218.53,N/A
3507663,0350,70486,,,,,N/A,N/A,CT SINUS LIMITED,$533.00,$399.75,$218.53,$218.53,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,$218.53,N/A
3507605,0350,70487,,,,,N/A,N/A,CT MAX FACIAL W/ CONTRAST,$561.00,$420.75,$23.10,$23.10,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,$23.10,N/A
3574175,0350,71275,,,,,N/A,N/A,THORACIC AORTA W,$745.00,$558.75,$35.45,$35.45,$35.45,N/A,$35.45,N/A,$35.45,N/A,$35.45,N/A,$35.45,N/A,$35.45,$35.45,N/A
99971476,0350,71476,,,,,N/A,N/A,CT SCAN,"$2,753.00","$2,064.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3507215,0350,72125,,,,,N/A,N/A,CT CERVICAL SPINE W/O CONTRAST,$533.00,$399.75,$218.53,$218.53,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,$218.53,N/A
3507216,0350,72126,,,,,N/A,N/A,CT CERVICAL SPINE W CONTRAST,$534.00,$400.50,$218.94,$218.94,$218.94,N/A,$218.94,N/A,$218.94,N/A,$218.94,N/A,$218.94,N/A,$218.94,$218.94,N/A
3507217,0350,72127,,,,,N/A,N/A,CT CERVICAL SPINE W/WO CONTRAS,$864.00,$648.00,$354.24,$354.24,$354.24,N/A,$354.24,N/A,$354.24,N/A,$354.24,N/A,$354.24,N/A,$354.24,$354.24,N/A
3507218,0350,72128,,,,,N/A,N/A,CT THORACIC SPINE W/O CONTRAST,$533.00,$399.75,$218.53,$218.53,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,$218.53,N/A
3507212,0350,72129,,,,,N/A,N/A,CT THORACIC SPINE W CONTRAST,$561.00,$420.75,$217.71,$217.71,$217.71,N/A,$217.71,N/A,$217.71,N/A,$217.71,N/A,$217.71,N/A,$217.71,$217.71,N/A
3507210,0350,72130,,,,,N/A,N/A,CT THORACIC SPINE W/WO CONTRAS,$786.00,$589.50,$322.26,$322.26,$322.26,N/A,$322.26,N/A,$322.26,N/A,$322.26,N/A,$322.26,N/A,$322.26,$322.26,N/A
3572132,0350,72132,,,,,N/A,N/A,CT LUMBAR SPINE W/CONTRAST,$561.00,$420.75,$23.10,$23.10,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,$23.10,N/A
3573206,0350,73206,,,,,N/A,N/A,CTA UPPER EXTREMITY,$845.00,$633.75,$346.45,$346.45,$346.45,N/A,$346.45,N/A,$346.45,N/A,$346.45,N/A,$346.45,N/A,$346.45,$346.45,N/A
3573706,0350,73706,,,,,N/A,N/A,CTA LOWER EXTREMITY,$845.00,$633.75,$346.45,$346.45,$346.45,N/A,$346.45,N/A,$346.45,N/A,$346.45,N/A,$346.45,N/A,$346.45,$346.45,N/A
3507592,0350,74150,,,,,N/A,N/A,CT ABD UPPER W/O CONTRAST',$533.00,$399.75,$218.53,$218.53,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,$218.53,N/A
3507608,0350,74176,,,,,N/A,N/A,CT RENAL COLIC W/O CONTRAST,"$1,056.00",$792.00,$432.96,$432.96,$432.96,N/A,$432.96,N/A,$432.96,N/A,$432.96,N/A,$432.96,N/A,$432.96,$432.96,N/A
3507293,0350,74177,,,,,N/A,N/A,CT ABD & PELVIS WITH CONTRAST,"$1,100.00",$825.00,$451.00,$451.00,$451.00,N/A,$451.00,N/A,$451.00,N/A,$451.00,N/A,$451.00,N/A,$451.00,$451.00,N/A
3576089,0350,74178,,,,,N/A,N/A,CT ABD/PELVIS WO & W CONTRAST,"$1,650.00","$1,237.50",$676.50,$676.50,$676.50,N/A,$676.50,N/A,$676.50,N/A,$676.50,N/A,$676.50,N/A,$676.50,$676.50,N/A
3507662,0350,76070,,,,,N/A,N/A,Ct Peripheral Bone Density,$84.00,$63.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3507670,0350,76070,,,,,N/A,N/A,Ct Central Bone Density,$334.00,$250.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3576376,0350,76376,,,,,N/A,N/A,Ct-3d Reconstruction,$0.00,$0.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3576377,0350,76377,,,,,N/A,N/A,Ct-3d Reconstruction On Workst,$0.00,$0.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3507585,0351,70450,,,,,N/A,N/A,CT HEAD W/O CONTRAST,$533.00,$399.75,$218.53,$218.53,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,$218.53,N/A
3507583,0351,70460,,,,,N/A,N/A,CT HEAD W/CONTRAST,$561.00,$420.75,$23.10,$23.10,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,$23.10,N/A
3507588,0351,70470,,,,,N/A,N/A,CT HEAD W & W/O CONTRAST,$864.00,$648.00,$354.24,$354.24,$354.24,N/A,$354.24,N/A,$354.24,N/A,$354.24,N/A,$354.24,N/A,$354.24,$354.24,N/A
3507048,0351,70480,,,,,N/A,N/A,CT ORBITS W/O CONTRAST,$533.00,$399.75,$218.53,$218.53,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,$218.53,N/A
3507080,0351,70480,,,,,N/A,N/A,CT SELLA TURCICA  WO CONTRAST,$533.00,$399.75,$218.53,$218.53,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,$218.53,N/A
3507480,0351,70480,,,,,N/A,N/A,CT TEMPORAL BONE  WO CONTRAST,$533.00,$399.75,$218.53,$218.53,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,$218.53,N/A
3507049,0351,70481,,,,,N/A,N/A,CT ORBIT W/ CONTR,$561.00,$420.75,$23.10,$23.10,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,$23.10,N/A
3507081,0351,70481,,,,,N/A,N/A,CT SELLA TURCICA  W CONTRAST,$561.00,$420.75,$23.10,$23.10,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,$23.10,N/A
3507481,0351,70481,,,,,N/A,N/A,CT TEMPORAL BONE  W CONTRAST,$561.00,$420.75,$23.10,$23.10,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,$23.10,N/A
3507082,0351,70482,,,,,N/A,N/A,CT SELLA TURCICA W/WO CONTRAST,$864.00,$648.00,$354.24,$354.24,$354.24,N/A,$354.24,N/A,$354.24,N/A,$354.24,N/A,$354.24,N/A,$354.24,$354.24,N/A
3507482,0351,70482,,,,,N/A,N/A,CT TEMPORAL BONE W/WO CONTRAST,$864.00,$648.00,$354.24,$354.24,$354.24,N/A,$354.24,N/A,$354.24,N/A,$354.24,N/A,$354.24,N/A,$354.24,$354.24,N/A
3507577,0351,70482,,,,,N/A,N/A,CT ORBIT W/ WO CONTRAST,$864.00,$648.00,$354.24,$354.24,$354.24,N/A,$354.24,N/A,$354.24,N/A,$354.24,N/A,$354.24,N/A,$354.24,$354.24,N/A
3507086,0351,70486,,,,,N/A,N/A,CT SINUS WO CONTRAST,$533.00,$399.75,$218.53,$218.53,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,$218.53,N/A
3507087,0351,70487,,,,,N/A,N/A,CT SINUS W CONTRAST,$561.00,$420.75,$23.10,$23.10,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,$23.10,N/A
3507088,0351,70488,,,,,N/A,N/A,CT SINUS W/WO CONTRAST,$864.00,$648.00,$354.24,$354.24,$354.24,N/A,$354.24,N/A,$354.24,N/A,$354.24,N/A,$354.24,N/A,$354.24,$354.24,N/A
3507578,0351,70488,,,,,N/A,N/A,CT MAX FACIAL W/ WO CONTRAST,$864.00,$648.00,$354.24,$354.24,$354.24,N/A,$354.24,N/A,$354.24,N/A,$354.24,N/A,$354.24,N/A,$354.24,$354.24,N/A
3507606,0351,70490,,,,,N/A,N/A,CT NECK W/O CONTRAST,$533.00,$399.75,$218.53,$218.53,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,$218.53,N/A
3507607,0351,70491,,,,,N/A,N/A,CT NECK W/CONTRAST,$561.00,$420.75,$23.10,$23.10,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,$23.10,N/A
3507213,0351,72133,,,,,N/A,N/A,CT SPINE LS W/WO CONTRAST,$786.00,$589.50,$322.26,$322.26,$322.26,N/A,$322.26,N/A,$322.26,N/A,$322.26,N/A,$322.26,N/A,$322.26,$322.26,N/A
3507594,0351,72192,,,,,N/A,N/A,CT PELVIS WO CONTRAST,$533.00,$399.75,$218.53,$218.53,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,$218.53,N/A
3507320,0351,73200,,,,,N/A,N/A,CT UPPER EXT W/O CONTR,$533.00,$399.75,$218.53,$218.53,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,$218.53,N/A
3507321,0351,73201,,,,,N/A,N/A,CT UPPER EXT W/ CONTR,$561.00,$420.75,$23.10,$23.10,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,$23.10,N/A
3507321-RT,0351,73201,,,,,N/A,N/A,CT RT UPPER EXT W/ CONTRAST,$561.00,$420.75,$23.10,$23.10,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,$23.10,N/A
3507598,0351,73202,,,,,N/A,N/A,CT UPPER EXT  W/ WO CONTR,$786.00,$589.50,$322.26,$322.26,$322.26,N/A,$322.26,N/A,$322.26,N/A,$322.26,N/A,$322.26,N/A,$322.26,$322.26,N/A
3507581-RT,0351,73700,,,,,N/A,N/A,CT RT LOWER EXT W/O CONTRAST,$533.00,$399.75,$218.53,$218.53,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,$218.53,N/A
3507599,0351,73702,,,,,N/A,N/A,CT LOWER EXT W/WO CONTR,$786.00,$589.50,$322.26,$322.26,$322.26,N/A,$322.26,N/A,$322.26,N/A,$322.26,N/A,$322.26,N/A,$322.26,$322.26,N/A
3507320-LT,0351,,,,,,N/A,N/A,CT LT UPPER EXT W/O CONTRAST,$533.00,$399.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3507320-RT,0351,,,,,,N/A,N/A,CT RT UPPER EXT W/O CONTRAST,$533.00,$399.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3507321-LT,0351,,,,,,N/A,N/A,CT LT UPPER EXT W/CONTRAST,$561.00,$420.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3507581-LT,0351,,,,,,N/A,N/A,CT LT EXT LOWER W/O CONTRAST,$533.00,$399.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3507598-LT,0351,,,,,,N/A,N/A,CT LT UPPER EXT W WO CONTRAST,$786.00,$589.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3507598-RT,0351,,,,,,N/A,N/A,CT RT UPPWR EXT W WO CONTRAST,$786.00,$589.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99970486,0352,70486,,,,,N/A,N/A,CT SCAN/HEAD,"$2,781.00","$2,085.75",$218.53,$218.53,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,$218.53,N/A
3570496,0352,70496,,,,,N/A,N/A,CT ANGIOGRAPHY BRAIN,$561.00,$420.75,$23.10,$23.10,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,$23.10,N/A
3577670,0352,70498,,,,,N/A,N/A,CTA NECK/CAROTID,$561.00,$420.75,$23.10,$23.10,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,$23.10,N/A
3507589,0352,71250,,,,,N/A,N/A,CT CHEST W/O,$533.00,$399.75,$218.53,$218.53,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,$218.53,N/A
3507590,0352,71250,,,,,N/A,N/A,Ct Chest Lung Cancer Screening,$533.00,$399.75,$218.53,$218.53,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,$218.53,N/A
3507591,0352,71260,,,,,N/A,N/A,CT CHEST W/CONTRAST,$561.00,$420.75,$23.10,$23.10,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,$23.10,N/A
3507127,0352,71270,,,,,N/A,N/A,CT CHEST W & W/O CONTRAST,$846.00,$634.50,$346.86,$346.86,$346.86,N/A,$346.86,N/A,$346.86,N/A,$346.86,N/A,$346.86,N/A,$346.86,$346.86,N/A
3576378,0352,71275,,,,,N/A,N/A,CHEST FOR PE,$745.00,$558.75,$35.45,$35.45,$35.45,N/A,$35.45,N/A,$35.45,N/A,$35.45,N/A,$35.45,N/A,$35.45,$35.45,N/A
3507299,0352,72128,,,,,N/A,N/A,T-Spine Recons,$0.00,$0.00,$218.53,$218.53,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,$218.53,N/A
3507596,0352,72131,,,,,N/A,N/A,CT SPINE W/O CONTR.,$533.00,$399.75,$218.53,$218.53,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,$218.53,N/A
3507888,0352,72131,,,,,N/A,N/A,L Spine Recons,$0.00,$0.00,$218.53,$218.53,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,$218.53,N/A
3752132,0352,72132,,,,,N/A,N/A,CT LUMBAR SPINE W/ CONTRAST,$561.00,$420.75,$23.10,$23.10,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,$23.10,N/A
3507595,0352,72193,,,,,N/A,N/A,CT LOWER ABDOMEN W/CONTRAST,$561.00,$420.75,$23.10,$23.10,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,$23.10,N/A
3507587,0352,72194,,,,,N/A,N/A,CT PELVIS W & W/O CONTRAST,$864.00,$648.00,$354.24,$354.24,$354.24,N/A,$354.24,N/A,$354.24,N/A,$354.24,N/A,$354.24,N/A,$354.24,$354.24,N/A
3507593,0352,74160,,,,,N/A,N/A,CT ABD UPPER W/CONTR,$561.00,$420.75,$23.10,$23.10,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,$23.10,N/A
3507586,0352,74170,,,,,N/A,N/A,CT ABD UPPER W& W/O CONTRAST,$864.00,$648.00,$354.24,$354.24,$354.24,N/A,$354.24,N/A,$354.24,N/A,$354.24,N/A,$354.24,N/A,$354.24,$354.24,N/A
359878,0352,74174,,,,,N/A,N/A,CTA ABD & PELVIS,"$1,200.00",$900.00,$492.00,$492.00,$492.00,N/A,$492.00,N/A,$492.00,N/A,$492.00,N/A,$492.00,N/A,$492.00,$492.00,N/A
3574174,0352,74175,,,,,N/A,N/A,ABDOMINAL AORTA CT,$745.00,$558.75,$35.45,$35.45,$35.45,N/A,$35.45,N/A,$35.45,N/A,$35.45,N/A,$35.45,N/A,$35.45,$35.45,N/A
3574177,0352,74177,,,,,N/A,N/A,CT ABD & PELVIS W ORIN COMB,"$1,100.00",$825.00,$451.00,$451.00,$451.00,N/A,$451.00,N/A,$451.00,N/A,$451.00,N/A,$451.00,N/A,$451.00,$451.00,N/A
3574178,0352,74178,,,,,N/A,N/A,CT ABD & PELVIS WO&W ORIN COMB,"$1,650.00","$1,237.50",$676.50,$676.50,$676.50,N/A,$676.50,N/A,$676.50,N/A,$676.50,N/A,$676.50,N/A,$676.50,$676.50,N/A
9207799-L5,0352,93971,,,,,N/A,N/A,LEFT EXT VASCULAR UNILAT,$416.00,$312.00,$184.90,$416.00,$184.90,$403.52,$184.90,N/A,$184.90,$227.72,$184.90,$403.52,$184.90,$416.00,$184.90,$184.90,$403.52
9207799-R5,0352,93971,,,,,N/A,N/A,RIGHT EXT VASCULAR UNILAT,$416.00,$312.00,$184.90,$416.00,$184.90,$403.52,$184.90,N/A,$184.90,$227.72,$184.90,$403.52,$184.90,$416.00,$184.90,$184.90,$403.52
3507600,0359,70492,,,,,N/A,N/A,CT NECK W & W/O CONTRAST,$864.00,$648.00,$354.24,$354.24,$354.24,N/A,$354.24,N/A,$354.24,N/A,$354.24,N/A,$354.24,N/A,$354.24,$354.24,N/A
3507597,0359,72132,,,,,N/A,N/A,CT SPINE LS W/CONTRAST,$561.00,$420.75,$23.10,$23.10,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,$23.10,N/A
3507581,0359,73700,,,,,N/A,N/A,CT EXT. LOWER W/O CONTRAST,$533.00,$399.75,$218.53,$218.53,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,N/A,$218.53,$218.53,N/A
3507582,0359,73701,,,,,N/A,N/A,CT EXT. LOWER W/CONTRAST,$561.00,$420.75,$23.10,$23.10,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,N/A,$23.10,$23.10,N/A
35975635,0359,75635,,,,,N/A,N/A,CTA ABD AORTA W/RUNOFF,$534.00,$400.50,$218.94,$218.94,$218.94,N/A,$218.94,N/A,$218.94,N/A,$218.94,N/A,$218.94,N/A,$218.94,$218.94,N/A
3507582-LT,0359,,,,,,N/A,N/A,CT LT EXT LOWER W/CONTRAST,$561.00,$420.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3507582-RT,0359,,,,,,N/A,N/A,CT RT EXT LOWER W/CONTRAST,$561.00,$420.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
1190075,0360,11900,,,,,N/A,N/A,INJ INTRALESIONAL UP TO 7 LES,$205.82,$153.00,$31.16,$174.00,$71.34,$168.78,$71.34,$148.77,$71.34,$31.16,$71.34,$168.78,$71.34,$174.00,$71.34,$71.34,$168.78
3201929,0360,19281,,,,,N/A,N/A,NEEDLE LOCALIZATION PLACEMENT,"$3,243.74","$2,411.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2055075,0360,20550,,,,,N/A,N/A,INJ TENDON SHEATH OR LIGAMENT,$595.27,$442.50,$41.41,$101.00,$41.41,$97.97,$41.41,$86.36,$41.41,$69.22,$41.41,$97.97,$41.41,$101.00,$41.41,$41.41,$97.97
2055275,0360,20552,,,,,N/A,N/A,TPI SINGLE/ MULIT 1 OR 2 MUSCL,$595.27,$442.50,$34.30,$590.00,$34.30,$572.30,$34.30,$504.45,$34.30,$67.34,$34.30,$572.30,$34.30,$590.00,$34.30,$34.30,$572.30
2055375,0360,20553,,,,,N/A,N/A,TPI SINGLE/ MULIT > 3 MUSCLES,$595.27,$442.50,$76.14,$590.00,N/A,$572.30,N/A,$504.45,N/A,$76.14,N/A,$572.30,N/A,$590.00,N/A,N/A,$572.30
2060075,0360,20600,,,,,N/A,N/A,INJ BURSA/TENDON SMALL,$549.87,$408.75,$39.36,$96.00,$39.36,$93.12,$39.36,$82.08,$39.36,$63.57,$39.36,$93.12,$39.36,$96.00,$39.36,$39.36,$93.12
2060575,0360,20605,,,,,N/A,N/A,INJ BURSA/TENDON INTERMED,$595.27,$442.50,$39.77,$99.00,$39.77,$96.03,$39.77,$84.65,$39.77,$66.08,$39.77,$96.03,$39.77,$99.00,$39.77,$39.77,$96.03
2060675,0360,20606,,,,,N/A,N/A,DRAIN/INJ JOINT/BURSA W/US,$116.03,$86.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2061075,0360,20610,,,,,N/A,N/A,INJ BURSA/TENDON MAJOR,$595.27,$442.50,$51.25,$125.00,$51.25,$121.25,$51.25,$106.88,$51.25,$80.71,$51.25,$121.25,$51.25,$125.00,$51.25,$51.25,$121.25
2061175,0360,20611,,,,,N/A,N/A,"DRAIN/INJECT, JOINT/BURSA W/ U",$148.31,$110.25,$75.30,$75.30,$75.30,N/A,$75.30,N/A,$75.30,N/A,$75.30,N/A,$75.30,N/A,$75.30,$75.30,N/A
2709675,0360,27096,,,,,N/A,N/A,SI JOINT INJ,"$1,680.89","$1,249.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3629893,0360,29893,,,,,N/A,N/A,"SCOPE, PLANTAR, FASCIOTOMY","$7,477.25","$5,558.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3636489,0360,36489,,,,,N/A,N/A,Insertion Of Picc Line,"$4,049.89","$3,010.50","$3,486.18","$3,594.00",N/A,"$3,486.18",N/A,"$3,072.87",N/A,"$3,594.00",N/A,"$3,486.18",N/A,"$3,594.00",N/A,N/A,"$3,486.18"
4900023,0360,36489,,,,,N/A,N/A,Insertion Of Picc Line,"$3,626.13","$2,695.50","$3,486.18","$3,594.00",N/A,"$3,486.18",N/A,"$3,072.87",N/A,"$3,594.00",N/A,"$3,486.18",N/A,"$3,594.00",N/A,N/A,"$3,486.18"
3636568,0360,36568,,,,,N/A,N/A,"INSERTION OF PICC, UNDER 5 YRS","$4,049.89","$3,010.50",$154.41,"$4,014.00",$911.84,"$3,893.58",$911.84,"$3,431.97",$911.84,$154.41,$911.84,"$3,893.58",$911.84,"$4,014.00",$911.84,$911.84,"$3,893.58"
363656874,0360,36568,,,,,N/A,N/A,Insertion of PICC < 5     -74,"$2,243.88","$1,668.00",$154.41,"$4,014.00",$911.84,"$3,893.58",$911.84,"$3,431.97",$911.84,$154.41,$911.84,"$3,893.58",$911.84,"$4,014.00",$911.84,$911.84,"$3,893.58"
363656974,0360,36569,,,,,N/A,N/A,INSERTION OF PICC LINE -A-ABT,"$2,243.88","$1,668.00",$97.58,$230.00,$97.58,$223.10,$97.58,$196.65,$97.58,$158.03,$97.58,$223.10,$97.58,$230.00,$97.58,$97.58,$223.10
3636491,0360,36572,,,,,N/A,N/A,INSERT OF PICC LINEW/IMAG<5AGE,"$4,049.89","$3,010.50",$154.26,"$4,014.00","$1,645.74","$3,893.58","$1,645.74","$3,431.97","$1,645.74",$154.26,"$1,645.74","$3,893.58","$1,645.74","$4,014.00","$1,645.74","$1,645.74","$3,893.58"
3636490,0360,36573,,,,,N/A,N/A,INSERTION OF PICC LINE W/IMAG,"$4,049.89","$3,010.50",$142.32,"$1,645.74","$1,645.74",$794.43,"$1,645.74",$700.25,"$1,645.74",$142.32,"$1,645.74",$794.43,"$1,645.74",$819.00,"$1,645.74","$1,645.74",$794.43
3036584,0360,36584,,,,,N/A,N/A,REPLACEMENT OF PICC LINE,"$4,049.89","$3,010.50",$101.21,"$4,014.00","$1,645.74","$3,893.58","$1,645.74","$3,431.97","$1,645.74",$101.21,"$1,645.74","$3,893.58","$1,645.74","$4,014.00","$1,645.74","$1,645.74","$3,893.58"
3636584,0360,36584,,,,,N/A,N/A,REPLACEMENT OF PICC LINE,"$3,626.13","$2,695.50",$101.21,"$4,014.00","$1,645.74","$3,893.58","$1,645.74","$3,431.97","$1,645.74",$101.21,"$1,645.74","$3,893.58","$1,645.74","$4,014.00","$1,645.74","$1,645.74","$3,893.58"
3938220,0360,38220,,,,,N/A,N/A,BONE MARROW ASPIRATION,"$1,033.15",$768.00,$117.61,"$1,060.00",$434.60,"$1,028.20",$434.60,$906.30,$434.60,$117.61,$434.60,"$1,028.20",$434.60,"$1,060.00",$434.60,$434.60,"$1,028.20"
3641010,0360,41010,,,,,N/A,N/A,INCISION OF LINGUAL FRENUM,"$1,530.56","$1,137.75",$621.97,$621.97,$621.97,N/A,$621.97,N/A,$621.97,N/A,$621.97,N/A,$621.97,N/A,$621.97,$621.97,N/A
3600008,0360,54150,,,,,N/A,N/A,CIRCUMCISION,"$1,461.95","$1,086.75",$0.00,$594.90,$594.90,$0.00,$594.90,$0.00,$594.90,$199.11,$594.90,$0.00,$594.90,N/A,$594.90,$594.90,$0.00
57260,0360,57260,,,,,N/A,N/A,REPAIR OF VAGINA,"$1,631.46","$1,212.75",$662.97,"$1,617.00",$662.97,"$1,568.49",$662.97,"$1,382.54",$662.97,"$1,016.97",$662.97,"$1,568.49",$662.97,"$1,617.00",$662.97,$662.97,"$1,568.49"
6227075,0360,62270,,,,,N/A,N/A,LUMBAR PUNCTURE DIAGNOSTIC,$861.63,$640.50,$83.35,$207.00,$88.97,$200.79,$88.97,$176.99,$88.97,$83.35,$88.97,$200.79,$88.97,$207.00,$88.97,$88.97,$200.79
7162270,0360,62270,,,,,N/A,N/A,SPINAL PUNCTURE LUMBAR,$688.10,$511.50,$83.35,$207.00,$88.97,$200.79,$88.97,$176.99,$88.97,$83.35,$88.97,$200.79,$88.97,$207.00,$88.97,$88.97,$200.79
6227275,0360,62272,,,,,N/A,N/A,LUMBAR PUNCTURE THERAPEUTIC,$861.63,$640.50,$78.63,$291.00,$119.31,$282.27,$119.31,$248.81,$119.31,$78.63,$119.31,$282.27,$119.31,$291.00,$119.31,$119.31,$282.27
6227375,0360,62273,,,,,N/A,N/A,BLOOD PATCH,"$1,680.89","$1,249.50",$110.72,$683.60,$683.60,N/A,$683.60,$0.00,$683.60,$110.72,$683.60,N/A,$683.60,N/A,$683.60,$683.60,N/A
6232075,0360,62320,,,,,N/A,N/A,CERVICAL/THORACIC W/O IMAGING,"$1,554.78","$1,155.75",$189.61,"$1,541.00",$631.81,"$1,494.77",$631.81,"$1,317.56",$631.81,$189.61,$631.81,"$1,494.77",$631.81,"$1,541.00",$631.81,$631.81,"$1,494.77"
6232175,0360,62321,,,,,N/A,N/A,CERVICAL/THORACIC WITH IMAGING,"$1,872.59","$1,392.00",$76.96,"$1,856.00",$76.96,"$1,800.32",$76.96,"$1,586.88",$76.96,$127.71,$76.96,"$1,800.32",$76.96,"$1,856.00",$76.96,$76.96,"$1,800.32"
6232275,0360,62322,,,,,N/A,N/A,LUMBAR/SACRAL W/O IMAGING,"$1,680.89","$1,249.50",$139.73,"$1,666.00",$683.60,"$1,616.02",$683.60,"$1,424.43",$683.60,$139.73,$683.60,"$1,616.02",$683.60,"$1,666.00",$683.60,$683.60,"$1,616.02"
6232375,0360,62323,,,,,N/A,N/A,LUMBAR/SACRAL WITH IMAGING,"$1,872.59","$1,392.00",$76.96,"$1,856.00",$76.96,"$1,800.32",$76.96,"$1,586.88",$76.96,$104.93,$76.96,"$1,800.32",$76.96,"$1,856.00",$76.96,$76.96,"$1,800.32"
6232475,0360,62324,,,,,N/A,N/A,CERVICAL/THORACIC W/O IMAGING,"$1,680.89","$1,249.50",$128.70,"$1,666.00",$683.60,"$1,616.02",$683.60,"$1,424.43",$683.60,$128.70,$683.60,"$1,616.02",$683.60,"$1,666.00",$683.60,$683.60,"$1,616.02"
6232575,0360,62325,,,,,N/A,N/A,CERVICAL/THORACIC WITH IMAGING,"$1,872.59","$1,392.00",$76.96,"$1,856.00",$76.96,"$1,800.32",$76.96,"$1,586.88",$76.96,$115.83,$76.96,"$1,800.32",$76.96,"$1,856.00",$76.96,$76.96,"$1,800.32"
6232675,0360,62326,,,,,N/A,N/A,LUMBAR/SACRAL W/O IMAGING,"$1,680.89","$1,249.50",$143.43,"$1,666.00",$683.60,"$1,616.02",$683.60,"$1,424.43",$683.60,$143.43,$683.60,"$1,616.02",$683.60,"$1,666.00",$683.60,$683.60,"$1,616.02"
6232775,0360,62327,,,,,N/A,N/A,LUMBAR/SACRAL WITH IMAGING,"$1,872.59","$1,392.00",$76.96,"$1,856.00",$76.96,"$1,800.32",$76.96,"$1,586.88",$76.96,$111.72,$76.96,"$1,800.32",$76.96,"$1,856.00",$76.96,$76.96,"$1,800.32"
6236775,0360,62367,,,,,N/A,N/A,ELEC ANALY W/O REPROG OR REFIL,$540.79,$402.00,$219.76,$536.00,$219.76,$519.92,$219.76,$458.28,$219.76,$381.07,$219.76,$519.92,$219.76,$536.00,$219.76,$219.76,$519.92
6236875,0360,62368,,,,,N/A,N/A,ELEC ANALY W/REPROG W/O REFILL,$540.79,$402.00,$31.91,$536.00,$219.76,$519.92,$219.76,$458.28,$219.76,$31.91,$219.76,$519.92,$219.76,$536.00,$219.76,$219.76,$519.92
6237075,0360,62370,,,,,N/A,N/A,ELEC ANALY W/REPROG&REFILL MD,$485.30,$360.75,$45.29,$481.00,$197.21,$466.57,$197.21,$411.26,$197.21,$45.29,$197.21,$466.57,$197.21,$481.00,$197.21,$197.21,$466.57
6440575,0360,64405,,,,,N/A,N/A,GREATER OCCIPITAL NERVE,$861.63,$640.50,$63.43,$233.00,$68.47,$226.01,$68.47,$134.99,$68.47,$63.43,$68.47,$226.01,$68.47,$233.00,$68.47,$68.47,$226.01
6441775,0360,64417,,,,,N/A,N/A,AXILLARY NERVE BLOCK,$861.63,$640.50,$35.14,$83.32,$35.14,N/A,$35.14,$222.24,$35.14,$83.32,$35.14,N/A,$35.14,N/A,$35.14,$35.14,N/A
6441875,0360,64418,,,,,N/A,N/A,SUPRASCAPULAR NERVE,$861.63,$640.50,$35.14,$78.70,$35.14,N/A,$35.14,$183.39,$35.14,$78.70,$35.14,N/A,$35.14,N/A,$35.14,$35.14,N/A
6442075,0360,64420,,,,,N/A,N/A,"INTERCOSTAL NERVE,SINGLE",$861.63,$640.50,$35.14,$74.00,$35.14,N/A,$35.14,$203.63,$35.14,$74.00,$35.14,N/A,$35.14,N/A,$35.14,$35.14,N/A
6442175,0360,64421,,,,,N/A,N/A,"INTERCOSTAL NERVE,MULIT,REGION","$1,680.89","$1,249.50",$76.88,$683.60,$683.60,N/A,$683.60,$74.66,$683.60,$76.88,$683.60,N/A,$683.60,N/A,$683.60,$683.60,N/A
6442575,0360,64425,,,,,N/A,N/A,"ILIOHYPOGASTRIC,ILIOINGUINAL",$861.63,$640.50,$12.30,$217.00,$12.30,$210.49,$12.30,$187.36,$12.30,$32.37,$12.30,$210.49,$12.30,$217.00,$12.30,$12.30,$210.49
6444575,0360,64445,,,,,N/A,N/A,SCIATIC NERVE BLOCK,"$1,680.89","$1,249.50",$55.92,"$1,666.00",$683.60,"$1,616.02",$683.60,$206.45,$683.60,$55.92,$683.60,"$1,616.02",$683.60,"$1,666.00",$683.60,$683.60,"$1,616.02"
6444775,0360,64447,,,,,N/A,N/A,FEMORAL NERVE BLOCK,$861.63,$640.50,$35.14,$854.00,$35.14,$828.38,$35.14,$123.12,$35.14,$69.76,$35.14,$828.38,$35.14,$854.00,$35.14,$35.14,$828.38
6445075,0360,64450,,,,,N/A,N/A,OTHER PERIPHERAL NERVE,$861.63,$640.50,$68.47,$167.00,$68.47,$161.99,$68.47,$127.02,$68.47,$78.69,$68.47,$161.99,$68.47,$167.00,$68.47,$68.47,$161.99
6445157,0360,64451,,,,,N/A,N/A,NERVE BLOCK,$526.67,$391.50,$54.88,$522.00,$214.20,$506.34,$214.20,$257.60,$214.20,$54.88,$214.20,$506.34,$214.20,$522.00,$214.20,$214.20,$506.34
6445475,0360,64454,,,,,N/A,N/A,NERVE BLOCK,$530.70,$394.50,$102.13,$526.00,$215.66,$510.22,$215.66,$260.22,$215.66,$102.13,$215.66,$510.22,$215.66,$526.00,$215.66,$215.66,$510.22
6447975,0360,64479,,,,,N/A,N/A,TRANSFORAMINAL CERVICAL/THORAC,"$1,680.89","$1,249.50",$99.83,"$1,666.00",$683.60,"$1,616.02",$683.60,$389.44,$683.60,$99.83,$683.60,"$1,616.02",$683.60,"$1,666.00",$683.60,$683.60,"$1,616.02"
6448075,0360,64480,,,,,N/A,N/A,TRANSFOR CERVICAL/THORA EA ADD,$861.63,$640.50,$35.14,$854.00,$35.14,$828.38,$35.14,$256.62,$35.14,$170.41,$35.14,$828.38,$35.14,$854.00,$35.14,$35.14,$828.38
6448375,0360,64483,,,,,N/A,N/A,TRANSFORAMINAL LUMBAR/SACRAL,"$1,680.89","$1,249.50",$80.59,"$1,666.00",$683.60,"$1,616.02",$683.60,$407.45,$683.60,$80.59,$683.60,"$1,616.02",$683.60,"$1,666.00",$683.60,$683.60,"$1,616.02"
6448475,0360,64484,,,,,N/A,N/A,TRANSFOR LUMBAR/SACRAL EA ADD,$861.63,$640.50,$35.14,$854.00,$35.14,$828.38,$35.14,$246.02,$35.14,$145.15,$35.14,$828.38,$35.14,$854.00,$35.14,$35.14,$828.38
6449075,0360,64490,,,,,N/A,N/A,"CERVICAL/THORACIC, SINGLE LVL","$1,680.89","$1,249.50",$89.72,"$1,666.00",$683.60,"$1,616.02",$683.60,$328.06,$683.60,$89.72,$683.60,"$1,616.02",$683.60,"$1,666.00",$683.60,$683.60,"$1,616.02"
6449175,0360,64491,,,,,N/A,N/A,CERVICAL/THORACIC 2ND LVL,$595.27,$442.50,$137.44,$590.00,$241.90,$572.30,$241.90,$213.89,$241.90,$137.44,$241.90,$572.30,$241.90,$590.00,$241.90,$241.90,$572.30
6449275,0360,64492,,,,,N/A,N/A,CERVICAL/THOR 3RD & ADD'L LVL,$595.27,$442.50,$77.85,$590.00,$241.90,$572.30,$241.90,$213.89,$241.90,$77.85,$241.90,$572.30,$241.90,$590.00,$241.90,$241.90,$572.30
6449375,0360,64493,,,,,N/A,N/A,LUMBAR/SACRAL SINGLE LVL,"$1,680.89","$1,249.50",$79.22,"$1,666.00",$683.60,"$1,616.02",$683.60,$299.12,$683.60,$79.22,$683.60,"$1,616.02",$683.60,"$1,666.00",$683.60,$683.60,"$1,616.02"
6449475,0360,64494,,,,,N/A,N/A,LUMBAR/SACRAL 2ND LVL,$595.27,$442.50,$117.67,$590.00,$241.90,$572.30,$241.90,$199.05,$241.90,$117.67,$241.90,$572.30,$241.90,$590.00,$241.90,$241.90,$572.30
6449575,0360,64495,,,,,N/A,N/A,LUMBAR/SACRAL 3RD & ADD'L LVLS,$595.27,$442.50,$67.02,$590.00,$241.90,$572.30,$241.90,$199.05,$241.90,$67.02,$241.90,$572.30,$241.90,$590.00,$241.90,$241.90,$572.30
6450575,0360,64505,,,,,N/A,N/A,SPHENOPALATINE GANGLION,$595.27,$442.50,$67.93,$590.00,$241.90,$572.30,$241.90,$172.74,$241.90,$67.93,$241.90,$572.30,$241.90,$590.00,$241.90,$241.90,$572.30
6451075,0360,64510,,,,,N/A,N/A,STELLATE GANGLION,"$1,680.89","$1,249.50",$128.89,"$1,666.00",$683.60,"$1,616.02",$683.60,$187.79,$683.60,$128.89,$683.60,"$1,616.02",$683.60,"$1,666.00",$683.60,$683.60,"$1,616.02"
6451775,0360,64517,,,,,N/A,N/A,HYPOGASTRIC PLEXUS ANESTHETIC,"$1,680.89","$1,249.50",$100.25,"$1,666.00",$683.60,"$1,616.02",$683.60,$287.41,$683.60,$100.25,$683.60,"$1,616.02",$683.60,"$1,666.00",$683.60,$683.60,"$1,616.02"
6452075,0360,64520,,,,,N/A,N/A,"THORACIC,LUMBAR SYMPATHETIC","$1,680.89","$1,249.50",$164.40,"$1,666.00",$683.60,"$1,616.02",$683.60,$260.28,$683.60,$164.40,$683.60,"$1,616.02",$683.60,"$1,666.00",$683.60,$683.60,"$1,616.02"
6453075,0360,64530,,,,,N/A,N/A,CELIAC PLEXUS,"$1,680.89","$1,249.50",$109.65,"$1,666.00",$683.60,"$1,616.02",$683.60,$349.69,$683.60,$109.65,$683.60,"$1,616.02",$683.60,"$1,666.00",$683.60,$683.60,"$1,616.02"
6461275,0360,64612,,,,,N/A,N/A,BOTOX INJ FACIAL NERVE,$595.27,$442.50,$138.70,$572.00,$234.52,$554.84,$234.52,$207.89,$234.52,$138.70,$234.52,$554.84,$234.52,$572.00,$234.52,$234.52,$554.84
6461475,0360,64614,,,,,N/A,N/A,BOTOX INJ EXTR/TRUNK,$861.63,$640.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
6462475,0360,64624,,,,,N/A,N/A,NERVE BLOCK,"$1,017.01",$756.00,$98.56,"$2,216.00",$98.56,"$2,149.52",$98.56,$498.80,$98.56,$153.78,$98.56,"$2,149.52",$98.56,"$2,216.00",$98.56,$98.56,"$2,149.52"
64624C75,0360,64624,,,,,N/A,N/A,NERVE BLOCK COOL,"$2,235.81","$1,662.00",$98.56,"$2,216.00",$98.56,"$2,149.52",$98.56,$498.80,$98.56,$153.78,$98.56,"$2,149.52",$98.56,"$2,216.00",$98.56,$98.56,"$2,149.52"
6462575,0360,64625,,,,,N/A,N/A,NERVE BLOCK,"$1,239.99",$921.75,$191.09,"$1,229.00",N/A,"$1,192.13",N/A,$608.87,N/A,$191.09,N/A,"$1,192.13",N/A,"$1,229.00",N/A,N/A,"$1,192.13"
6463375,0360,64633,,,,,N/A,N/A,SINGLE FACET JOINT CERV/THORAC,"$1,423.61","$1,058.25",$149.58,"$3,438.00",$149.58,"$3,334.86",$149.58,$562.29,$149.58,$251.85,$149.58,"$3,334.86",$149.58,"$3,438.00",$149.58,$149.58,"$3,334.86"
64633C75,0360,64633,,,,,N/A,N/A,SINGLE FACET JOINT C/T COOL,"$3,468.74","$2,578.50",$149.58,"$3,438.00",$149.58,"$3,334.86",$149.58,$562.29,$149.58,$251.85,$149.58,"$3,334.86",$149.58,"$3,438.00",$149.58,$149.58,"$3,334.86"
6463475,0360,64634,,,,,N/A,N/A,FACET JOINT CERV EACH ADD'L,$236.09,$175.50,$292.45,"$3,438.00",$926.60,"$3,334.86",$926.60,$258.61,$926.60,$292.45,$926.60,"$3,334.86",$926.60,"$3,438.00",$926.60,$926.60,"$3,334.86"
64634C75,0360,64634,,,,,N/A,N/A,ADD FACET JOINT C/T COOL,"$2,280.20","$1,695.00",$292.45,"$3,438.00",$926.60,"$3,334.86",$926.60,$258.61,$926.60,$292.45,$926.60,"$3,334.86",$926.60,"$3,438.00",$926.60,$926.60,"$3,334.86"
6463575,0360,64635,,,,,N/A,N/A,"SINGLE FACET JOINT, LUMBAR/SAC","$2,152.07","$1,599.75",$87.90,"$4,160.00",$175.60,"$4,035.20",$175.60,$552.64,$175.60,$87.90,$175.60,"$4,035.20",$175.60,"$4,160.00",$175.60,$175.60,"$4,035.20"
64635C75,0360,64635,,,,,N/A,N/A,SINGLE FACET JOINT L/S COOL,"$4,197.19","$3,120.00",$87.90,"$4,160.00",$175.60,"$4,035.20",$175.60,$552.64,$175.60,$87.90,$175.60,"$4,035.20",$175.60,"$4,160.00",$175.60,$175.60,"$4,035.20"
6463675,0360,64636,,,,,N/A,N/A,FACET JOINT EACH ADD'L,$713.32,$530.25,$288.54,"$2,735.00","$1,121.35","$2,652.95","$1,121.35",$232.89,"$1,121.35",$288.54,"$1,121.35","$2,652.95","$1,121.35","$2,735.00","$1,121.35","$1,121.35","$2,652.95"
64636C75,0360,64636,,,,,N/A,N/A,ADD FACET JOINT L/S COOL,"$2,759.45","$2,051.25",$288.54,"$2,735.00","$1,121.35","$2,652.95","$1,121.35",$232.89,"$1,121.35",$288.54,"$1,121.35","$2,652.95","$1,121.35","$2,735.00","$1,121.35","$1,121.35","$2,652.95"
6464075,0360,64640,,,,,N/A,N/A,OTHER PERIPHERAL NERVE OR BRAN,"$1,680.89","$1,249.50",$77.33,"$1,666.00","$1,514.13","$1,616.02","$1,514.13",$267.64,"$1,514.13",$77.33,"$1,514.13","$1,616.02","$1,514.13","$1,666.00","$1,514.13","$1,514.13","$1,616.02"
646405975,0360,64640,,,,,N/A,N/A,ADD PERIPH NERVE BLK,"$1,680.89","$1,249.50",$77.33,"$1,666.00","$1,514.13","$1,616.02","$1,514.13",$267.64,"$1,514.13",$77.33,"$1,514.13","$1,616.02","$1,514.13","$1,666.00","$1,514.13","$1,514.13","$1,616.02"
6464059C75,0360,64640,,,,,N/A,N/A,ADD PERIPH NERVE BLK COOL,"$3,726.02","$2,769.75",$77.33,"$1,666.00","$1,514.13","$1,616.02","$1,514.13",$267.64,"$1,514.13",$77.33,"$1,514.13","$1,616.02","$1,514.13","$1,666.00","$1,514.13","$1,514.13","$1,616.02"
64640C75,0360,64640,,,,,N/A,N/A,OTH PERIPH NERVE BLK COOL,"$3,726.02","$2,769.75",$77.33,"$1,666.00","$1,514.13","$1,616.02","$1,514.13",$267.64,"$1,514.13",$77.33,"$1,514.13","$1,616.02","$1,514.13","$1,666.00","$1,514.13","$1,514.13","$1,616.02"
G025975,0360,G0259,,,,,N/A,N/A,SI JOINT INJ,"$1,680.89","$1,249.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
G026075,0360,G0260,,,,,N/A,N/A,SI JOINT INJ,"$1,680.89","$1,249.50",$164.00,$164.00,N/A,N/A,N/A,N/A,N/A,$164.00,N/A,N/A,N/A,$164.00,N/A,N/A,N/A
3300006,0360,,,,,,N/A,N/A,Bladder Instillation,"$1,394.36","$1,036.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3600001,0360,,,,,,N/A,N/A,OPERATING ROOM MAJOR 30 MIN,"$4,932.71","$3,666.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3600007,0360,,,,,,N/A,N/A,GEN SURG SUTURE,$151.34,$112.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3600012,0360,,,,,,N/A,N/A,MICROSURGICAL SUTURE,$253.24,$188.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3600032,0360,,,,,,N/A,N/A,PROCEDURE WITH SEDATION 30 MIN,"$2,021.92","$1,503.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3600033,0360,,,,,,N/A,N/A,PROCEDURE W/O SEDATION 30 MIN,"$1,052.32",$782.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3600035,0360,,,,,,N/A,N/A,MINOR PROCEDURE 30 MIN,$36.32,$27.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4900006,0360,,,,,,N/A,N/A,MINOR PROC ASM & PRP,$467.14,$347.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4950080,0360,,,,,,N/A,N/A,PERCUTANEOUS LITHOTRIPSY,"$6,752.84","$5,019.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4950590,0360,,,,,,N/A,N/A,ESWL-LITHOTRIPSY,"$8,996.72","$6,687.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4952353,0360,,,,,,N/A,N/A,TRANSRTHL URTRSCPC LITHOTRIPSY,"$6,752.84","$5,019.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7100013,0360,,,,,,N/A,N/A,EXTENDED RECOVERY TIME,$182.62,$135.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9996000,0360,,,,,,N/A,N/A,NEW ENGLAND ORGAN BANK PT,"$1,507.36","$1,120.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3201930,0361,19291,,,,,N/A,N/A,Needle Local Placemnt Add'L,$0.00,$0.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3204255,0361,42550,,,,,N/A,N/A,RAD. SIALOGRAPHY INTRO,$541.80,$402.75,$22.17,$537.00,$22.17,$520.89,$22.17,$459.14,$22.17,$92.69,$22.17,$520.89,$22.17,$537.00,$22.17,$22.17,$520.89
9915340A,0370,99153,,,,,N/A,N/A,Moderate Sedation Ea Add 15 ~t,$0.00,$0.00,$41.00,$100.00,$41.00,$97.00,$41.00,N/A,$41.00,N/A,$41.00,$97.00,$41.00,$100.00,$41.00,$41.00,$97.00
9915340B,0370,99153,,,,,N/A,N/A,MODERATE SEDATION EA ADD 15 ~P,$100.89,$75.00,$41.00,$100.00,$41.00,$97.00,$41.00,N/A,$41.00,N/A,$41.00,$97.00,$41.00,$100.00,$41.00,$41.00,$97.00
9915345A,0370,99153,,,,,N/A,N/A,Moderate Sedation Ea Add 15 ~t,$0.00,$0.00,$41.00,$100.00,$41.00,$97.00,$41.00,N/A,$41.00,N/A,$41.00,$97.00,$41.00,$100.00,$41.00,$41.00,$97.00
9915345B,0370,99153,,,,,N/A,N/A,MODERATE SEDATION EA ADD 15 ~P,$100.89,$75.00,$41.00,$100.00,$41.00,$97.00,$41.00,N/A,$41.00,N/A,$41.00,$97.00,$41.00,$100.00,$41.00,$41.00,$97.00
G050040,0370,G0500,,,,,N/A,N/A,MODERATE SEDATION INT 15 MIN~G,$100.89,$75.00,$56.12,$100.00,$56.12,$97.00,$56.12,N/A,$56.12,$100.00,$56.12,$97.00,$56.12,$100.00,$56.12,$56.12,$97.00
G050045,0370,G0500,,,,,N/A,N/A,MODERATE SEDATION INT 15 MIN,$100.89,$75.00,$56.12,$100.00,$56.12,$97.00,$56.12,N/A,$56.12,$100.00,$56.12,$97.00,$56.12,$100.00,$56.12,$56.12,$97.00
GMMM145A,0370,GMMM1,,,,,N/A,N/A,Moderate Sedation Int 15 Min~t,$0.00,$0.00,$97.00,$100.00,N/A,$97.00,N/A,N/A,N/A,$100.00,N/A,$97.00,N/A,$100.00,N/A,N/A,$97.00
GMMM145B,0370,GMMM1,,,,,N/A,N/A,MODERATE SEDATION INT 15 MIN~P,$100.89,$75.00,$97.00,$100.00,N/A,$97.00,N/A,N/A,N/A,$100.00,N/A,$97.00,N/A,$100.00,N/A,N/A,$97.00
3700001,0370,,,,,,N/A,N/A,GEN ANES W/O INVASIVE AIRWAY,"$1,784.81","$1,326.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3700002,0370,,,,,,N/A,N/A,GEN ANES SUPPLIES WITH LMA,"$2,198.48","$1,634.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3700005,0370,,,,,,N/A,N/A,MAC ANESTH SUPPLIES,"$1,277.32",$949.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3700006,0370,,,,,,N/A,N/A,SPINAL/EPIDURAL ANES SUPPLIES,"$1,533.59","$1,140.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3700007,0370,,,,,,N/A,N/A,REGIONAL ANESTH SUPPLIES,"$1,332.81",$990.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3700008,0370,,,,,,N/A,N/A,GEN ANESTH SUP WITH ENDO TUBE,"$1,850.40","$1,375.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3900015,0390,36520,,,,,N/A,N/A,Plt Pheresis Hla Matcher Lr,"$4,607.83","$3,425.25","$4,429.99","$4,567.00",N/A,"$4,429.99",N/A,"$3,904.79",N/A,"$4,567.00",N/A,"$4,429.99",N/A,"$4,567.00",N/A,N/A,"$4,429.99"
3900026,0390,36520,,,,,N/A,N/A,Plt Pheresis Leuko-Reduced,"$3,480.84","$2,587.50","$4,429.99","$4,567.00",N/A,"$4,429.99",N/A,"$3,904.79",N/A,"$4,567.00",N/A,"$4,429.99",N/A,"$4,567.00",N/A,N/A,"$4,429.99"
3099250,0390,86880,,,,,N/A,N/A,Arc Pretreatment,$91.81,$68.25,$53.65,$106.00,N/A,$102.82,N/A,N/A,N/A,$53.65,N/A,$102.82,N/A,$106.00,N/A,N/A,$102.82
3900012,0390,86927,,,,,N/A,N/A,"FRESH FROZEN PLASMA, EACH UNIT",$76.68,$57.00,$43.59,$76.00,N/A,$73.72,N/A,N/A,N/A,$43.59,N/A,$73.72,N/A,$76.00,N/A,N/A,$73.72
3030718,0390,86970,,,,,N/A,N/A,ARC PRE-RX RBC'S W/CHEMICALS,$80.72,$60.00,$36.46,$80.00,N/A,$77.60,N/A,N/A,N/A,$36.46,N/A,$77.60,N/A,$80.00,N/A,N/A,$77.60
3900031,0390,C1011,,,,,N/A,N/A,Pltph Lr Cmv,"$3,923.77","$2,916.75","$3,772.33","$3,889.00",N/A,"$3,772.33",N/A,N/A,N/A,"$3,889.00",N/A,"$3,772.33",N/A,"$3,889.00",N/A,N/A,"$3,772.33"
3900027,0390,C1018,,,,,N/A,N/A,Lp Rbc Irr,"$1,259.16",$936.00,"$1,305.62","$1,346.00",N/A,"$1,305.62",N/A,N/A,N/A,"$1,346.00",N/A,"$1,305.62",N/A,"$1,346.00",N/A,N/A,"$1,305.62"
3900028,0390,C1018,,,,,N/A,N/A,Lp Rbc Irr Cmv,"$1,358.03","$1,009.50","$1,305.62","$1,346.00",N/A,"$1,305.62",N/A,N/A,N/A,"$1,346.00",N/A,"$1,305.62",N/A,"$1,346.00",N/A,N/A,"$1,305.62"
3900006,0390,P9012,,,,,N/A,N/A,CRYO PROC FEE,$340.01,$252.75,$326.89,$337.00,N/A,$326.89,N/A,N/A,N/A,$337.00,N/A,$326.89,N/A,$337.00,N/A,N/A,$326.89
3900003,0390,P9016,,,,,N/A,N/A,RBC PEDI PROC FEE,$807.15,$600.00,"$1,128.11","$1,163.00",N/A,"$1,128.11",N/A,N/A,N/A,"$1,163.00",N/A,"$1,128.11",N/A,"$1,163.00",N/A,N/A,"$1,128.11"
3900009,0390,P9016,,,,,N/A,N/A,L P PCKD CELLS PROCESSING FEE,"$1,173.40",$872.25,"$1,128.11","$1,163.00",N/A,"$1,128.11",N/A,N/A,N/A,"$1,163.00",N/A,"$1,128.11",N/A,"$1,163.00",N/A,N/A,"$1,128.11"
3900004,0390,P9017,,,,,N/A,N/A,Fp Proc Fee,$549.87,$408.75,$528.65,$545.00,N/A,$528.65,N/A,N/A,N/A,$545.00,N/A,$528.65,N/A,$545.00,N/A,N/A,$528.65
3900005,0390,P9019,,,,,N/A,N/A,PLT PROC FEE,$462.09,$343.50,$444.26,$458.00,N/A,$444.26,N/A,N/A,N/A,$458.00,N/A,$444.26,N/A,$458.00,N/A,N/A,$444.26
3900002,0390,P9021,,,,,N/A,N/A,RBC PROC FEE,$805.13,$598.50,$774.06,$798.00,N/A,$774.06,N/A,N/A,N/A,$798.00,N/A,$774.06,N/A,$798.00,N/A,N/A,$774.06
3900008,0390,P9021,,,,,N/A,N/A,AUT PROC FEE,"$1,194.58",$888.00,$774.06,$798.00,N/A,$774.06,N/A,N/A,N/A,$798.00,N/A,$774.06,N/A,$798.00,N/A,N/A,$774.06
3900029,0390,,,,,,N/A,N/A,Pltph Lr Irr,"$3,692.72","$2,745.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3900030,0390,,,,,,N/A,N/A,Pltph Lr Irr Cmv,"$3,831.95","$2,848.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3643000,0391,36430,,,,,N/A,N/A,BLOOD TRANSFUSION,"$3,629.16","$2,697.75",$64.44,"$3,597.00","$1,474.77","$3,489.09","$1,474.77","$3,075.44","$1,474.77",$64.44,"$1,474.77","$3,489.09","$1,474.77","$3,597.00","$1,474.77","$1,474.77","$3,489.09"
3936430,0391,36430,,,,,N/A,N/A,"TRANSFUSION,BLOOD COMPONENTS","$3,418.29","$2,541.00",$64.44,"$3,597.00","$1,474.77","$3,489.09","$1,474.77","$3,075.44","$1,474.77",$64.44,"$1,474.77","$3,489.09","$1,474.77","$3,597.00","$1,474.77","$1,474.77","$3,489.09"
4536430,0391,36430,,,,,N/A,N/A,"TRANSFUSION, BLOOD COMPONENTS","$3,282.08","$2,439.75",$64.44,"$3,597.00","$1,474.77","$3,489.09","$1,474.77","$3,075.44","$1,474.77",$64.44,"$1,474.77","$3,489.09","$1,474.77","$3,597.00","$1,474.77","$1,474.77","$3,489.09"
7600027,0391,36430,,,,,N/A,N/A,"TRANSFUSION, BLOOD COMPONENTS","$3,629.16","$2,697.75",$64.44,"$3,597.00","$1,474.77","$3,489.09","$1,474.77","$3,075.44","$1,474.77",$64.44,"$1,474.77","$3,489.09","$1,474.77","$3,597.00","$1,474.77","$1,474.77","$3,489.09"
7600029,0391,36430,,,,,N/A,N/A,"TRANSFUSION, BLOOD COMPONENTS","$3,629.16","$2,697.75",$64.44,"$3,597.00","$1,474.77","$3,489.09","$1,474.77","$3,075.44","$1,474.77",$64.44,"$1,474.77","$3,489.09","$1,474.77","$3,597.00","$1,474.77","$1,474.77","$3,489.09"
7600031,0391,36430,,,,,N/A,N/A,"TRANSFUSION, BLOOD COMPONENTS","$3,629.16","$2,697.75",$64.44,"$3,597.00","$1,474.77","$3,489.09","$1,474.77","$3,075.44","$1,474.77",$64.44,"$1,474.77","$3,489.09","$1,474.77","$3,597.00","$1,474.77","$1,474.77","$3,489.09"
7600042,0391,36430,,,,,N/A,N/A,"TRANSFUSION, BLOOD COMPONENTS","$3,425.35","$2,546.25",$64.44,"$3,597.00","$1,474.77","$3,489.09","$1,474.77","$3,075.44","$1,474.77",$64.44,"$1,474.77","$3,489.09","$1,474.77","$3,597.00","$1,474.77","$1,474.77","$3,489.09"
7600043,0391,36430,,,,,N/A,N/A,"TRANSFUSION, BLOOD COMPONENTS","$3,485.89","$2,591.25",$64.44,"$3,597.00","$1,474.77","$3,489.09","$1,474.77","$3,075.44","$1,474.77",$64.44,"$1,474.77","$3,489.09","$1,474.77","$3,597.00","$1,474.77","$1,474.77","$3,489.09"
3900032,0391,P9073,,,,,N/A,N/A,LVDS CHARGE,$107.96,$80.25,$278.39,$287.00,N/A,$278.39,N/A,N/A,N/A,$287.00,N/A,$278.39,N/A,$287.00,N/A,N/A,$278.39
3900033,0391,P9073,,,,,N/A,N/A,PR CHARGE,$193.72,$144.00,$278.39,$287.00,N/A,$278.39,N/A,N/A,N/A,$287.00,N/A,$278.39,N/A,$287.00,N/A,N/A,$278.39
4007888,0400,76499,,,,,N/A,N/A,Nc Exam Ultrasound,$0.00,$0.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4000389,0400,76706,,,,,N/A,N/A,AAA SCREENING ABD US,$234.07,$174.00,$95.12,$95.12,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,$95.12,N/A
4007677,0400,76770,,,,,N/A,N/A,US RENAL,$234.07,$174.00,$95.12,$95.12,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,$95.12,N/A
4076775,0400,76775,,,,,N/A,N/A,AAA DIAGNOSTIC ABD US,$234.07,$174.00,$177.12,$177.12,$177.12,N/A,$177.12,N/A,$177.12,N/A,$177.12,N/A,$177.12,N/A,$177.12,$177.12,N/A
4076998,0400,76998,,,,,N/A,N/A,Us Guidance Intraop,$0.00,$0.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
407608759,0400,77061,,,,,N/A,N/A,TOMO SCREEN SAME DAY UNI DAI,$128.14,$95.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
407608659,0400,77063,,,,,N/A,N/A,TOMO SCREENING W59 MOD,$280.49,$208.50,$113.98,$113.98,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,$113.98,N/A
4007111,0400,C8929,,,,,N/A,N/A,ECHOCARDIOGRAM WITH CONTRAST,"$1,113.87",$828.00,"$1,070.88","$1,104.00",N/A,"$1,070.88",N/A,N/A,N/A,"$1,104.00",N/A,"$1,070.88",N/A,"$1,104.00",N/A,N/A,"$1,070.88"
4007112,0400,Q9957,,,,,N/A,N/A,DEFINITY,$223.98,$166.50,$215.34,$222.00,N/A,$215.34,N/A,N/A,N/A,$222.00,N/A,$215.34,N/A,$222.00,N/A,N/A,$215.34
4007465,0401,76090,,,,,N/A,N/A,Diagnostic Uni Mammo,"$1,028.11",$764.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4007464,0401,76091,,,,,N/A,N/A,Diagnostic Bil Mammo,"$1,309.60",$973.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4076087,0401,77061,,,,,N/A,N/A,DIAG UNI TOMOSYNTHESIS,$257.28,$191.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4076088,0401,77062,,,,,N/A,N/A,DIAG BIL TOMOSYNTHESIS,$280.49,$208.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4007494GG,0401,G0204,,,,,N/A,N/A,"DIAGNOSTIC BIL,MAMMO SAME DAY","$1,183.49",$879.75,"$1,137.81","$1,173.00",N/A,"$1,137.81",N/A,N/A,N/A,"$1,173.00",N/A,"$1,137.81",N/A,"$1,173.00",N/A,N/A,"$1,137.81"
4007495GG,0401,G0206,,,,,N/A,N/A,UNILAT DIAGNOSTIC SAME DAY,$903.00,$671.25,$868.15,$895.00,N/A,$868.15,N/A,N/A,N/A,$895.00,N/A,$868.15,N/A,$895.00,N/A,N/A,$868.15
4007685,0402,76506,,,,,N/A,N/A,US CRANIAL,$231.05,$171.75,$93.89,$93.89,$93.89,N/A,$93.89,N/A,$93.89,N/A,$93.89,N/A,$93.89,N/A,$93.89,$93.89,N/A
4576512A,0402,76512,,,,,N/A,N/A,"OPHTH US, B W/NON-QUANT A   ~T",$40.36,$30.00,$119.72,$119.72,$119.72,N/A,$119.72,N/A,$119.72,N/A,$119.72,N/A,$119.72,N/A,$119.72,$119.72,N/A
7651280A,0402,76512,,,,,N/A,N/A,"OPHTH US, B W/NON-QUANT A   ~T",$40.36,$30.00,$119.72,$119.72,$119.72,N/A,$119.72,N/A,$119.72,N/A,$119.72,N/A,$119.72,N/A,$119.72,$119.72,N/A
3676536,0402,76536,,,,,N/A,N/A,THYROID US/OR,$295.62,$219.75,$113.98,$113.98,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,$113.98,N/A
4007781,0402,76536,,,,,N/A,N/A,SOFT TISSUE HEAD OR NECK,$234.07,$174.00,$113.98,$113.98,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,$113.98,N/A
4007791,0402,76536,,,,,N/A,N/A,US THYROID LTD.,$234.07,$174.00,$113.98,$113.98,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,$113.98,N/A
4007792,0402,76536,,,,,N/A,N/A,US THYROID COMPLETE,$234.07,$174.00,$113.98,$113.98,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,$113.98,N/A
4576536A,0402,76536,,,,,N/A,N/A,US EXAM OF HEAD AND NECK    ~T,$206.83,$153.75,$113.98,$113.98,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,$113.98,N/A
7653640A,0402,76536,,,,,N/A,N/A,"ULTRASOUND NECK,THORAX,ABD  ~T",$63.56,$47.25,$113.98,$113.98,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,$113.98,N/A
7653680A,0402,76536,,,,,N/A,N/A,US EXAM OF HEAD AND NECK    ~T,$206.83,$153.75,$113.98,$113.98,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,$113.98,N/A
4007779,0402,76604,,,,,N/A,N/A,US CHEST,$234.07,$174.00,$87.33,$87.33,$87.33,N/A,$87.33,N/A,$87.33,N/A,$87.33,N/A,$87.33,N/A,$87.33,$87.33,N/A
4576604A,0402,76604,,,,,N/A,N/A,"US EXAM, CHEST, B-SCAN      ~T",$90.80,$67.50,$87.33,$87.33,$87.33,N/A,$87.33,N/A,$87.33,N/A,$87.33,N/A,$87.33,N/A,$87.33,$87.33,N/A
7660440A,0402,76604,,,,,N/A,N/A,"ULTRASOUND, CHEST           ~T",$141.25,$105.00,$87.33,$87.33,$87.33,N/A,$87.33,N/A,$87.33,N/A,$87.33,N/A,$87.33,N/A,$87.33,$87.33,N/A
766045280A,0402,76604,,,,,N/A,N/A,"US EXAM, CHEST, B-SCAN      ~T",$90.80,$67.50,$87.33,$87.33,$87.33,N/A,$87.33,N/A,$87.33,N/A,$87.33,N/A,$87.33,N/A,$87.33,$87.33,N/A
7660480A,0402,76604,,,,,N/A,N/A,"US EXAM, CHEST, B-SCAN      ~T",$90.80,$67.50,$87.33,$87.33,$87.33,N/A,$87.33,N/A,$87.33,N/A,$87.33,N/A,$87.33,N/A,$87.33,$87.33,N/A
4076812LT,0402,76641,,,,,N/A,N/A,LT BREAST US COMPLETE,$234.07,$174.00,$79.54,$79.54,$79.54,N/A,$79.54,N/A,$79.54,N/A,$79.54,N/A,$79.54,N/A,$79.54,$79.54,N/A
4076812RT,0402,76641,,,,,N/A,N/A,RT BREAST US COMPLETE,$234.07,$174.00,$79.54,$79.54,$79.54,N/A,$79.54,N/A,$79.54,N/A,$79.54,N/A,$79.54,N/A,$79.54,$79.54,N/A
4576642A,0402,76642,,,,,N/A,N/A,UNILATERAL LIMITED BREAST UL~T,$55.49,$41.25,$19.24,$19.24,$19.24,N/A,$19.24,N/A,$19.24,N/A,$19.24,N/A,$19.24,N/A,$19.24,$19.24,N/A
7664240A,0402,76642,,,,,N/A,N/A,ULTRASOUND LIMITED          ~T,$141.25,$105.00,$19.24,$19.24,$19.24,N/A,$19.24,N/A,$19.24,N/A,$19.24,N/A,$19.24,N/A,$19.24,$19.24,N/A
7664280A,0402,76642,,,,,N/A,N/A,UNILATERAL LIMITED BREAST UL~T,$55.49,$41.25,$19.24,$19.24,$19.24,N/A,$19.24,N/A,$19.24,N/A,$19.24,N/A,$19.24,N/A,$19.24,$19.24,N/A
4007794,0402,76645,,,,,N/A,N/A,UNILATERAL BREAST ULTRASOUND,$234.07,$174.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4007795,0402,76645,,,,,N/A,N/A,BILATERAL BREAST ULTRASOUND,$234.07,$174.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4007770,0402,76700,,,,,N/A,N/A,US ABD. COMPLETE,$234.07,$174.00,$95.12,$95.12,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,$95.12,N/A
4207768,0402,76700,,,,,N/A,N/A,US ABD TWO ORGANS,$234.07,$174.00,$95.12,$95.12,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,$95.12,N/A
3676705,0402,76705,,,,,N/A,N/A,ABD ULTRASOUND-1 ORGAN/OR,$352.12,$261.75,$25.82,$25.82,$25.82,N/A,$25.82,N/A,$25.82,N/A,$25.82,N/A,$25.82,N/A,$25.82,$25.82,N/A
4007771,0402,76705,,,,,N/A,N/A,US ABDOMEN LIMITED/FOLLOW UP,$234.07,$174.00,$25.82,$25.82,$25.82,N/A,$25.82,N/A,$25.82,N/A,$25.82,N/A,$25.82,N/A,$25.82,$25.82,N/A
4576705A,0402,76705,,,,,N/A,N/A,ABD ULTRASOUND-1 ORGAN      ~T,$145.29,$108.00,$25.82,$25.82,$25.82,N/A,$25.82,N/A,$25.82,N/A,$25.82,N/A,$25.82,N/A,$25.82,$25.82,N/A
7670540A,0402,76705,,,,,N/A,N/A,US ABD LIMITED              ~T,$143.27,$106.50,$25.82,$25.82,$25.82,N/A,$25.82,N/A,$25.82,N/A,$25.82,N/A,$25.82,N/A,$25.82,$25.82,N/A
7670580A,0402,76705,,,,,N/A,N/A,ECHO EXAM OF ABDOMEN        ~T,$145.29,$108.00,$25.82,$25.82,$25.82,N/A,$25.82,N/A,$25.82,N/A,$25.82,N/A,$25.82,N/A,$25.82,$25.82,N/A
4007780,0402,76770,,,,,N/A,N/A,US RENAL,$234.07,$174.00,$95.12,$95.12,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,$95.12,N/A
4576775A,0402,76775,,,,,N/A,N/A,US RETRO PERI LIMITED       ~T,$78.70,$58.50,$177.12,$177.12,$177.12,N/A,$177.12,N/A,$177.12,N/A,$177.12,N/A,$177.12,N/A,$177.12,$177.12,N/A
7677540A,0402,76775,,,,,N/A,N/A,US RETRO PERI LIMITED       ~T,$67.60,$50.25,$177.12,$177.12,$177.12,N/A,$177.12,N/A,$177.12,N/A,$177.12,N/A,$177.12,N/A,$177.12,$177.12,N/A
7677580A,0402,76775,,,,,N/A,N/A,US RETRO PERI LIMITED       ~T,$78.70,$58.50,$177.12,$177.12,$177.12,N/A,$177.12,N/A,$177.12,N/A,$177.12,N/A,$177.12,N/A,$177.12,$177.12,N/A
4007801,0402,76801,,,,,N/A,N/A,OB US 1ST TRIMESTER TRANSABD,$234.07,$174.00,$95.12,$95.12,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,$95.12,N/A
4007809,0402,76801,,,,,N/A,N/A,FETAL SURVEY SCREENING 1ST TRI,$234.07,$174.00,$95.12,$95.12,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,$95.12,N/A
4007999,0402,76801,,,,,N/A,N/A,OB 1ST TRIMESTER W/MODIFIER,$234.07,$174.00,$95.12,$95.12,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,$95.12,N/A
4007802,0402,76802,,,,,N/A,N/A,OB US 1ST TRI ADDIT GESTATION,$234.07,$174.00,$95.12,$95.12,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,$95.12,N/A
4009991,0402,76802,,,,,N/A,N/A,OB US 1ST TRI ADDIT GESTATION,$234.07,$174.00,$95.12,$95.12,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,$95.12,N/A
40276802,0402,76802,,,,,N/A,N/A,OB US <14 WEEK ADDIT GEST,$234.07,$174.00,$95.12,$95.12,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,$95.12,N/A
4007778,0402,76805,,,,,N/A,N/A,US OB,$234.07,$174.00,$95.12,$95.12,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,$95.12,N/A
4007803,0402,76805,,,,,N/A,N/A,FETAL SURVEY SCREENING,$234.07,$174.00,$95.12,$95.12,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,$95.12,N/A
4007810,0402,76805,,,,,N/A,N/A,OB 2-3 TRIMESTER W/MODIFIER,$234.07,$174.00,$95.12,$95.12,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,$95.12,N/A
4007800,0402,76810,,,,,N/A,N/A,OB US 2-3 TRI ADDIT GESTATION,$234.07,$174.00,$95.12,$95.12,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,$95.12,N/A
4009992,0402,76810,,,,,N/A,N/A,OB US 2-3 TRI ADDIT GESTATION,$234.07,$174.00,$95.12,$95.12,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,$95.12,N/A
4007804,0402,76812,,,,,N/A,N/A,FETAL SURVEY ADDIT GESTATION,$244.16,$181.50,$99.22,$99.22,$99.22,N/A,$99.22,N/A,$99.22,N/A,$99.22,N/A,$99.22,N/A,$99.22,$99.22,N/A
4007891,0402,76815,,,,,N/A,N/A,LIMITED OB,$256.27,$190.50,$99.22,$99.22,$99.22,N/A,$99.22,N/A,$99.22,N/A,$99.22,N/A,$99.22,N/A,$99.22,$99.22,N/A
4576815A,0402,76815,,,,,N/A,N/A,"OB US, LIMITED, FETUS(S)    ~T",$68.61,$51.00,$99.22,$99.22,$99.22,N/A,$99.22,N/A,$99.22,N/A,$99.22,N/A,$99.22,N/A,$99.22,$99.22,N/A
4007998,0402,76816,,,,,N/A,N/A,OB ASSESSMENT/WEIGHT/AFI,$256.27,$190.50,$14.14,$14.14,$14.14,N/A,$14.14,N/A,$14.14,N/A,$14.14,N/A,$14.14,N/A,$14.14,$14.14,N/A
4027681659,0402,76816,,,,,N/A,N/A,US OB AFI & WEIGHT TWINS,$256.27,$190.50,$14.14,$14.14,$14.14,N/A,$14.14,N/A,$14.14,N/A,$14.14,N/A,$14.14,N/A,$14.14,$14.14,N/A
4007823,0402,76817,,,,,N/A,N/A,FETAL SURVEY TRANS VAG,$256.27,$190.50,$14.14,$14.14,$14.14,N/A,$14.14,N/A,$14.14,N/A,$14.14,N/A,$14.14,N/A,$14.14,$14.14,N/A
4007892,0402,76817,,,,,N/A,N/A,TRANS VAG OB US,$256.27,$190.50,$14.14,$14.14,$14.14,N/A,$14.14,N/A,$14.14,N/A,$14.14,N/A,$14.14,N/A,$14.14,$14.14,N/A
4576817A,0402,76817,,,,,N/A,N/A,"TRANSVAGINAL US, OBSTETRIC  ~T",$73.65,$54.75,$14.14,$14.14,$14.14,N/A,$14.14,N/A,$14.14,N/A,$14.14,N/A,$14.14,N/A,$14.14,$14.14,N/A
4007689,0402,76819,,,,,N/A,N/A,US BIOPHYSICAL PROF,$203.81,$151.50,$82.82,$82.82,$82.82,N/A,$82.82,N/A,$82.82,N/A,$82.82,N/A,$82.82,N/A,$82.82,$82.82,N/A
40276820,0402,76820,,,,,N/A,N/A,US DOPPLER UMB ART,$254.25,$189.00,$13.32,$13.32,$13.32,N/A,$13.32,N/A,$13.32,N/A,$13.32,N/A,$13.32,N/A,$13.32,$13.32,N/A
3676830,0402,76830,,,,,N/A,N/A,TRANS VAGINAL US/OR,$295.62,$219.75,$119.72,$119.72,$119.72,N/A,$119.72,N/A,$119.72,N/A,$119.72,N/A,$119.72,N/A,$119.72,$119.72,N/A
4007799,0402,76830,,,,,N/A,N/A,US TRANS VAG,$234.07,$174.00,$119.72,$119.72,$119.72,N/A,$119.72,N/A,$119.72,N/A,$119.72,N/A,$119.72,N/A,$119.72,$119.72,N/A
4576830A,0402,76830,,,,,N/A,N/A,"TRANSVAGINAL US, NON-OB     ~T",$57.51,$42.75,$119.72,$119.72,$119.72,N/A,$119.72,N/A,$119.72,N/A,$119.72,N/A,$119.72,N/A,$119.72,$119.72,N/A
768305280A,0402,76830,,,,,N/A,N/A,"TRANSVAGINAL US, NON-OB     ~T",$57.51,$42.75,$119.72,$119.72,$119.72,N/A,$119.72,N/A,$119.72,N/A,$119.72,N/A,$119.72,N/A,$119.72,$119.72,N/A
7683080A,0402,76830,,,,,N/A,N/A,"TRANSVAGINAL US, NON-OB     ~T",$57.51,$42.75,$119.72,$119.72,$119.72,N/A,$119.72,N/A,$119.72,N/A,$119.72,N/A,$119.72,N/A,$119.72,$119.72,N/A
4076831,0402,76831,,,,,N/A,N/A,SONOTLYSTOGRAM,$234.07,$174.00,$95.12,$95.12,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,$95.12,N/A
3676856,0402,76856,,,,,N/A,N/A,PELVIS US/OR,$295.62,$219.75,$95.12,$95.12,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,$95.12,N/A
4007777,0402,76856,,,,,N/A,N/A,US PELVIS,$234.07,$174.00,$95.12,$95.12,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,$95.12,N/A
4576856,0402,76856,,,,,N/A,N/A,PELVIC US/ER,$295.62,$219.75,$95.12,$95.12,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,$95.12,N/A
4076857,0402,76857,,,,,N/A,N/A,US EXAM PELVIS LIMITED,$178.58,$132.75,$91.20,$91.20,$91.20,N/A,$91.20,N/A,$91.20,N/A,$91.20,N/A,$91.20,N/A,$91.20,$91.20,N/A
4576857A,0402,76857,,,,,N/A,N/A,US EXAM PELVIC LIMITED      ~T,$59.53,$44.25,$91.20,$91.20,$91.20,N/A,$91.20,N/A,$91.20,N/A,$91.20,N/A,$91.20,N/A,$91.20,$91.20,N/A
7685740A,0402,76857,,,,,N/A,N/A,US EXAN PELVIC LIMITED      ~T,$183.63,$136.50,$91.20,$91.20,$91.20,N/A,$91.20,N/A,$91.20,N/A,$91.20,N/A,$91.20,N/A,$91.20,$91.20,N/A
7685780A,0402,76857,,,,,N/A,N/A,US EXAM PELVIC LIMITED      ~T,$59.53,$44.25,$91.20,$91.20,$91.20,N/A,$91.20,N/A,$91.20,N/A,$91.20,N/A,$91.20,N/A,$91.20,$91.20,N/A
4007797,0402,76870,,,,,N/A,N/A,US SCROTUM,$234.07,$174.00,$17.10,$17.10,$17.10,N/A,$17.10,N/A,$17.10,N/A,$17.10,N/A,$17.10,N/A,$17.10,$17.10,N/A
4576870A,0402,76870,,,,,N/A,N/A,US SCROTUM                  ~T,$172.53,$128.25,$17.10,$17.10,$17.10,N/A,$17.10,N/A,$17.10,N/A,$17.10,N/A,$17.10,N/A,$17.10,$17.10,N/A
7687080A,0402,76870,,,,,N/A,N/A,US SCROTUM                  ~T,$172.53,$128.25,$17.10,$17.10,$17.10,N/A,$17.10,N/A,$17.10,N/A,$17.10,N/A,$17.10,N/A,$17.10,$17.10,N/A
4007687,0402,76872,,,,,N/A,N/A,PROSTATE US,$234.07,$174.00,$68.60,$68.60,$68.60,N/A,$68.60,N/A,$68.60,N/A,$68.60,N/A,$68.60,N/A,$68.60,$68.60,N/A
3676880,0402,76880,,,,,N/A,N/A,EXTREMITY US/OR (NON-VASCULAR),$352.12,$261.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4007782,0402,76880,,,,,N/A,N/A,Soft Tissue Ext Us Complete,$234.07,$174.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4576880,0402,76880,,,,,N/A,N/A,Extremity Us/Er (Non-Vascular),$248.20,$184.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4007783,0402,76882,,,,,N/A,N/A,SOFT TISSUE EXAM UNLISTED DX,$419.72,$312.00,$1.25,$1.25,$1.25,N/A,$1.25,N/A,$1.25,N/A,$1.25,N/A,$1.25,N/A,$1.25,$1.25,N/A
4076882,0402,76882,,,,,N/A,N/A,SOFT TISSUE EXT US LIMITED,$419.72,$312.00,$1.25,$1.25,$1.25,N/A,$1.25,N/A,$1.25,N/A,$1.25,N/A,$1.25,N/A,$1.25,$1.25,N/A
4576882A,0402,76882,,,,,N/A,N/A,US EXTREMITY NON-VASC REAL-T~T,$77.69,$57.75,$1.25,$1.25,$1.25,N/A,$1.25,N/A,$1.25,N/A,$1.25,N/A,$1.25,N/A,$1.25,$1.25,N/A
7688240A,0402,76882,,,,,N/A,N/A,ULTRASOUND LIMITED          ~T,$25.22,$18.75,$1.25,$1.25,$1.25,N/A,$1.25,N/A,$1.25,N/A,$1.25,N/A,$1.25,N/A,$1.25,$1.25,N/A
7688280A,0402,76882,,,,,N/A,N/A,US EXTREMITY NON-VASC REAL-T~T,$77.69,$57.75,$1.25,$1.25,$1.25,N/A,$1.25,N/A,$1.25,N/A,$1.25,N/A,$1.25,N/A,$1.25,$1.25,N/A
3676937,0402,76937,,,,,N/A,N/A,US GUIDANCE VASCULAR ACCESS~OR,$354.14,$263.25,$143.91,$143.91,$143.91,N/A,$143.91,N/A,$143.91,N/A,$143.91,N/A,$143.91,N/A,$143.91,$143.91,N/A
4576937A,0402,76937,,,,,N/A,N/A,"US GUIDE, VASCULAR ACCESS   ~T",$14.13,$10.50,$143.91,$143.91,$143.91,N/A,$143.91,N/A,$143.91,N/A,$143.91,N/A,$143.91,N/A,$143.91,$143.91,N/A
3408761,0402,76942,,,,,N/A,N/A,US GUIDANCE NEEDLE PLACMT  -CT,$234.07,$174.00,$89.79,$89.79,$89.79,N/A,$89.79,N/A,$89.79,N/A,$89.79,N/A,$89.79,N/A,$89.79,$89.79,N/A
3408762,0402,76942,,,,,N/A,N/A,PROSTATE ULTRASOUND W BIOPSY,$234.07,$174.00,$89.79,$89.79,$89.79,N/A,$89.79,N/A,$89.79,N/A,$89.79,N/A,$89.79,N/A,$89.79,$89.79,N/A
3676942,0402,76942,,,,,N/A,N/A,US GUIDANCE NEEDLE PLCMNT  -OR,$354.14,$263.25,$89.79,$89.79,$89.79,N/A,$89.79,N/A,$89.79,N/A,$89.79,N/A,$89.79,N/A,$89.79,$89.79,N/A
7694275,0402,76942,,,,,N/A,N/A,US GUIDE FOR NEEDLE PLACEMENT,$68.61,$51.00,$89.79,$89.79,$89.79,N/A,$89.79,N/A,$89.79,N/A,$89.79,N/A,$89.79,N/A,$89.79,$89.79,N/A
4576942A,0402,76942,,,,,N/A,N/A,US GUIDANCE NEEDLE PLCMNT   ~T,$63.56,$47.25,$89.79,$89.79,$89.79,N/A,$89.79,N/A,$89.79,N/A,$89.79,N/A,$89.79,N/A,$89.79,$89.79,N/A
7694240A,0402,76942,,,,,N/A,N/A,Echo Guide For Biopsy       ~t,$0.00,$0.00,$89.79,$89.79,$89.79,N/A,$89.79,N/A,$89.79,N/A,$89.79,N/A,$89.79,N/A,$89.79,$89.79,N/A
4007796,0402,76999,,,,,N/A,N/A,US BREAST SPECIMEN,$233.07,$173.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
34078457,0402,78456,,,,,N/A,N/A,ACUTE VENOUS THROMBUS IMAGE,$680.03,$505.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4007000,0402,93303,,,,,N/A,N/A,ECHOCARDIOGRAM PEDIATRIC,$476.22,$354.00,$193.52,$503.70,$193.52,$458.81,$193.52,N/A,$193.52,$503.70,$193.52,$458.81,$193.52,$481.00,$193.52,$193.52,$458.81
4007003,0402,93306,,,,,N/A,N/A,US HEART,"$1,012.98",$753.00,$197.21,$481.00,$197.21,$466.57,$197.21,N/A,$197.21,$439.60,$197.21,$466.57,$197.21,$481.00,$197.21,$197.21,$466.57
4007004,0402,93307,,,,,N/A,N/A,US HEART WO DOPPLER OR COLOR,$476.22,$354.00,$148.82,$473.00,$193.52,$458.81,$193.52,N/A,$193.52,$148.82,$193.52,$458.81,$193.52,$473.00,$193.52,$193.52,$458.81
4593971A,0402,93971,,,,,N/A,N/A,EXTREMITY STUDY             ~T,$33.30,$24.75,$184.90,$416.00,$184.90,$403.52,$184.90,N/A,$184.90,$227.72,$184.90,$403.52,$184.90,$416.00,$184.90,$184.90,$403.52
9397140A,0402,93971,,,,,N/A,N/A,UNILATERAL OR LIMITED STUDY ~T,$208.85,$155.25,$184.90,$416.00,$184.90,$403.52,$184.90,N/A,$184.90,$227.72,$184.90,$403.52,$184.90,$416.00,$184.90,$184.90,$403.52
9397180A,0402,93971,,,,,N/A,N/A,EXTREMITY STUDY             ~T,$33.30,$24.75,$184.90,$416.00,$184.90,$403.52,$184.90,N/A,$184.90,$227.72,$184.90,$403.52,$184.90,$416.00,$184.90,$184.90,$403.52
4093990,0402,93990,,,,,N/A,N/A,FISTULA EVALUATION -US,$542.81,$403.50,$22.58,$538.00,$22.58,$521.86,$22.58,N/A,$22.58,$141.17,$22.58,$521.86,$22.58,$538.00,$22.58,$22.58,$521.86
4007114,0402,C8924,,,,,N/A,N/A,US ECHO LIMITED W/DEFINITY,$679.02,$504.75,$652.81,$673.00,N/A,$652.81,N/A,N/A,N/A,$673.00,N/A,$652.81,N/A,$673.00,N/A,N/A,$652.81
4007793,0402,,,,,,N/A,N/A,Us Needle Localization,$234.07,$174.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4007794-LT,0402,,,,,,N/A,N/A,Lt Breast Ultrasound,$468.15,$348.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4007794-RT,0402,,,,,,N/A,N/A,Rt Breast Ultrasound,$468.15,$348.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4007466,0403,76092,,,,,N/A,N/A,Screening Mammo,"$1,157.25",$860.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
400749259,0403,77057,,,,,N/A,N/A,Screening Mammo W/59 Mod,"$1,043.24",$775.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4076086,0403,77063,,,,,N/A,N/A,SCREEN TOMOSYNTHESIS,$280.49,$208.50,$113.98,$113.98,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,$113.98,N/A
5194010,0410,94010,,,,,N/A,N/A,SPIROMETRY,$93.83,$69.75,$84.70,$376.00,$154.16,$364.72,$154.16,N/A,$154.16,$84.70,$154.16,$364.72,$154.16,$376.00,$154.16,$154.16,$364.72
5100001B,0410,94010,,,,,N/A,N/A,PFT,$162.44,$120.75,$84.70,$376.00,$154.16,$364.72,$154.16,N/A,$154.16,$84.70,$154.16,$364.72,$154.16,$376.00,$154.16,$154.16,$364.72
4100059,0410,94060,,,,,N/A,N/A,BRONCHODILATION RESPONSIVENESS,$732.49,$544.50,$38.95,$726.00,$297.66,$704.22,$297.66,N/A,$297.66,$38.95,$297.66,$704.22,$297.66,$726.00,$297.66,$297.66,$704.22
4194200,0410,94200,,,,,N/A,N/A,MAX VOLUNTARY VENTILATION,$202.80,$150.75,$33.00,$207.00,N/A,$200.79,N/A,N/A,N/A,$33.00,N/A,$200.79,N/A,$207.00,N/A,N/A,$200.79
4194452,0410,94452,,,,,N/A,N/A,HAST                   94452TC,$186.65,$138.75,$51.29,$185.00,$75.85,$179.45,$75.85,N/A,$75.85,$51.29,$75.85,$179.45,$75.85,$185.00,$75.85,$75.85,$179.45
4194453,0410,94453,,,,,N/A,N/A,HAST WITH O2 TITRATION 94453TC,$254.25,$189.00,$13.32,$252.00,$13.32,$244.44,$13.32,N/A,$13.32,$67.77,$13.32,$244.44,$13.32,$252.00,$13.32,$13.32,$244.44
4100076,0410,94644,,,,,N/A,N/A,CONTINUOUS NEBULIZER 1ST HOUR,$123.09,$91.50,$18.56,$122.00,$89.38,$118.34,$89.38,N/A,$89.38,$18.56,$89.38,$118.34,$89.38,$122.00,$89.38,$89.38,$118.34
4100077,0410,94645,,,,,N/A,N/A,CONTINUOUS NEBULIZER ADD'L HR,$44.39,$33.00,$18.40,$80.33,$18.40,$42.68,$18.40,N/A,$18.40,$80.33,$18.40,$42.68,$18.40,$44.00,$18.40,$18.40,$42.68
4194667,0410,94667,,,,,N/A,N/A,SECRETION CLEARANCE,$406.60,$302.25,$22.22,$403.00,$165.23,$390.91,$165.23,N/A,$165.23,$22.22,$165.23,$390.91,$165.23,$403.00,$165.23,$165.23,$390.91
4100036,0410,94668,,,,,N/A,N/A,CPT - SUBSEQUENT,$207.84,$154.50,$28.17,$206.00,$84.46,$199.82,$84.46,N/A,$84.46,$28.17,$84.46,$199.82,$84.46,$206.00,$84.46,$84.46,$199.82
4194668,0410,94668,,,,,N/A,N/A,SECRETION CLEARANCE SUBSEQUENT,$207.84,$154.50,$28.17,$206.00,$84.46,$199.82,$84.46,N/A,$84.46,$28.17,$84.46,$199.82,$84.46,$206.00,$84.46,$84.46,$199.82
4194726,0410,94726,,,,,N/A,N/A,PLETHYSMOGRAPHY,$369.27,$274.50,$0.00,$366.00,N/A,$355.02,N/A,N/A,N/A,$0.00,N/A,$355.02,N/A,$366.00,N/A,N/A,$355.02
4100057,0410,95070,,,,,N/A,N/A,INHALATION BRONCHIAL CHALLENGE,"$1,029.12",$765.00,$0.95,"$1,020.00",N/A,$989.40,N/A,N/A,N/A,$0.95,N/A,$989.40,N/A,"$1,020.00",N/A,N/A,$989.40
4100073,0412,94002,,,,,N/A,N/A,VENT ASST & MANAGE  1ST DAY,"$1,060.40",$788.25,$43.91,"$1,051.00",$43.91,"$1,019.47",$43.91,N/A,$43.91,$177.98,$43.91,"$1,019.47",$43.91,"$1,051.00",$43.91,$43.91,"$1,019.47"
4100074,0412,94003,,,,,N/A,N/A,VENT ASST & MANAGE SUBSQ DAYS,$600.32,$446.25,$118.66,$595.00,$243.95,$577.15,$243.95,N/A,$243.95,$118.66,$243.95,$577.15,$243.95,$595.00,$243.95,$243.95,$577.15
4100034,0412,94640,,,,,N/A,N/A,UPDRAFT,$207.84,$154.50,$207.98,$218.00,N/A,$211.46,N/A,N/A,N/A,$207.98,N/A,$211.46,N/A,$218.00,N/A,N/A,$211.46
4100037,0412,94640,,,,,N/A,N/A,MDI,$191.70,$142.50,$207.98,$218.00,N/A,$211.46,N/A,N/A,N/A,$207.98,N/A,$211.46,N/A,$218.00,N/A,N/A,$211.46
4100038,0412,94640,,,,,N/A,N/A,MDI SUB,$191.70,$142.50,$207.98,$218.00,N/A,$211.46,N/A,N/A,N/A,$207.98,N/A,$211.46,N/A,$218.00,N/A,N/A,$211.46
4100712,0412,94640,,,,,N/A,N/A,UPDRAFT,$219.95,$163.50,$207.98,$218.00,N/A,$211.46,N/A,N/A,N/A,$207.98,N/A,$211.46,N/A,$218.00,N/A,N/A,$211.46
7610043,0412,94640,,,,,N/A,N/A,AIRWAY INHALATION TREATMENT,$41.37,$30.75,$207.98,$218.00,N/A,$211.46,N/A,N/A,N/A,$207.98,N/A,$211.46,N/A,$218.00,N/A,N/A,$211.46
4100170,0412,94660,,,,,N/A,N/A,CPAP,"$1,387.29","$1,031.25",$21.77,"$1,375.00",$563.75,"$1,333.75",$563.75,N/A,$563.75,$21.77,$563.75,"$1,333.75",$563.75,"$1,375.00",$563.75,$563.75,"$1,333.75"
4100035,0412,94667,,,,,N/A,N/A,CPT,$207.84,$154.50,$22.22,$403.00,$165.23,$390.91,$165.23,N/A,$165.23,$22.22,$165.23,$390.91,$165.23,$403.00,$165.23,$165.23,$390.91
4100029,0412,,,,,,N/A,N/A,Rt Aerosal Therapy,$370.28,$275.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4100066,0412,,,,,,N/A,N/A,Inhaler Instruction,$207.84,$154.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4229540,0420,29540,,,,,N/A,N/A,"STRAP,ANKLE AND/OR FOOT  29540",$209.86,$156.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4229580,0420,29580,,,,,N/A,N/A,"STRAPPING,UNNA BOOT      29540",$249.21,$185.25,$36.49,$89.00,$36.49,$86.33,$36.49,$76.10,$36.49,$46.77,$36.49,$86.33,$36.49,$89.00,$36.49,$36.49,$86.33
4200908,0420,90912,,,,,N/A,N/A,BFB TRAINING FIRS 15 MIN 90912,$101.90,$75.75,$41.41,$101.00,$41.41,$97.97,$41.41,N/A,$41.41,N/A,$41.41,$97.97,$41.41,$101.00,$41.41,$41.41,$97.97
4200909,0420,90913,,,,,N/A,N/A,BFB TRAINING ADD'L15 MIN 90913,$57.51,$42.75,$23.37,$57.00,$23.37,$55.29,$23.37,N/A,$23.37,$49.36,$23.37,$55.29,$23.37,$57.00,$23.37,$23.37,$55.29
4200199,0420,95992,,,,,N/A,N/A,CANALITH REPOSITION PROC 95992,$88.79,$66.00,$36.80,$75.00,$36.80,$72.75,$36.80,N/A,$36.80,$52.58,$36.80,$72.75,$36.80,$75.00,$36.80,$36.80,$72.75
4200208,0420,97010,,,,,N/A,N/A,HOT OR COLD PACKS    97010~LYN,$86.77,$64.50,$24.28,$86.00,N/A,$83.42,N/A,N/A,N/A,$24.28,N/A,$83.42,N/A,$86.00,N/A,N/A,$83.42
4297010,0420,97010,,,,,N/A,N/A,"HOT OR COLD PACKS,AT 97010~STJ",$86.77,$64.50,$24.28,$86.00,N/A,$83.42,N/A,N/A,N/A,$24.28,N/A,$83.42,N/A,$86.00,N/A,N/A,$83.42
4297011,0420,97010,,,,,N/A,N/A,HOT OR COLD PACKS-AT 97010~LYN,$86.77,$64.50,$24.28,$86.00,N/A,$83.42,N/A,N/A,N/A,$24.28,N/A,$83.42,N/A,$86.00,N/A,N/A,$83.42
4201383,0420,97014,,,,,N/A,N/A,"ELECT STIM,AT        97014~STJ",$42.38,$31.50,$7.07,$42.00,N/A,$40.74,N/A,N/A,N/A,$7.07,N/A,$40.74,N/A,$42.00,N/A,N/A,$40.74
4300205,0420,97014,,,,,N/A,N/A,ELECT STIMULA AT     97014~LYN,$42.38,$31.50,$7.07,$42.00,N/A,$40.74,N/A,N/A,N/A,$7.07,N/A,$40.74,N/A,$42.00,N/A,N/A,$40.74
4097016,0420,97016,,,,,N/A,N/A,VASOPNEUMATIC DEVICE 97016~LYN,$48.43,$36.00,$15.51,$48.00,$19.68,$46.56,$19.68,N/A,$19.68,$15.51,$19.68,$46.56,$19.68,$48.00,$19.68,$19.68,$46.56
4297016,0420,97016,,,,,N/A,N/A,VASOPNEUMATIC DEVICE 97016~STJ,$48.43,$36.00,$15.51,$48.00,$19.68,$46.56,$19.68,N/A,$19.68,$15.51,$19.68,$46.56,$19.68,$48.00,$19.68,$19.68,$46.56
1700009,0420,97028,,,,,N/A,N/A,PHOTOTHERAPY,"$1,431.69","$1,064.25",$20.74,"$1,419.00",$581.79,"$1,376.43",$581.79,N/A,$581.79,$20.74,$581.79,"$1,376.43",$581.79,"$1,419.00",$581.79,$581.79,"$1,376.43"
4200206,0420,97032,,,,,N/A,N/A,ELECTR STIM 1/4HR PT 97032~LYN,$42.38,$31.50,$9.48,$42.00,$17.22,$40.74,$17.22,N/A,$17.22,$9.48,$17.22,$40.74,$17.22,$42.00,$17.22,$17.22,$40.74
4200111,0420,97033,,,,,N/A,N/A,IONTOPH 1/4 HR PT    97033~STJ,$41.37,$30.75,$16.81,$41.00,$16.81,$39.77,$16.81,N/A,$16.81,$17.12,$16.81,$39.77,$16.81,$41.00,$16.81,$16.81,$39.77
4200126,0420,97110,,,,,N/A,N/A,THERA PROC 1/4 HR PT 97110~STJ,$64.57,$48.00,$16.72,$64.00,$26.24,$62.08,$26.24,N/A,$26.24,$16.72,$26.24,$62.08,$26.24,$64.00,$26.24,$26.24,$62.08
4297110,0420,97110,,,,,N/A,N/A,"THERAPEUTIC PROC,AT  97110~STJ",$64.57,$48.00,$16.72,$64.00,$26.24,$62.08,$26.24,N/A,$26.24,$16.72,$26.24,$62.08,$26.24,$64.00,$26.24,$26.24,$62.08
4297111,0420,97110,,,,,N/A,N/A,"THERAP PROC ,AT      97110~LYN",$64.57,$48.00,$16.72,$64.00,$26.24,$62.08,$26.24,N/A,$26.24,$16.72,$26.24,$62.08,$26.24,$64.00,$26.24,$26.24,$62.08
4200118,0420,97112,,,,,N/A,N/A,NEUROMUSCULAR RE-ED  97112~STJ,$64.57,$48.00,$26.24,$64.00,$26.24,$62.08,$26.24,N/A,$26.24,$34.64,$26.24,$62.08,$26.24,$64.00,$26.24,$26.24,$62.08
4200218,0420,97112,,,,,N/A,N/A,NEUROMUSCULAR RE-ED  97112~LYN,$64.57,$48.00,$26.24,$64.00,$26.24,$62.08,$26.24,N/A,$26.24,$34.64,$26.24,$62.08,$26.24,$64.00,$26.24,$26.24,$62.08
4297112,0420,97112,,,,,N/A,N/A,NEUROMUSC RE-ED AT   97112~STJ,$230.04,$171.00,$26.24,$64.00,$26.24,$62.08,$26.24,N/A,$26.24,$34.64,$26.24,$62.08,$26.24,$64.00,$26.24,$26.24,$62.08
4297212,0420,97112,,,,,N/A,N/A,NEUROMUS RE-ED AT    97112~LYN,$230.04,$171.00,$26.24,$64.00,$26.24,$62.08,$26.24,N/A,$26.24,$34.64,$26.24,$62.08,$26.24,$64.00,$26.24,$26.24,$62.08
4297116,0420,97116,,,,,N/A,N/A,GAIT TRAINING -AT    97116~STJ,$197.75,$147.00,$8.36,$196.00,$8.36,$190.12,$8.36,N/A,$8.36,$43.89,$8.36,$190.12,$8.36,$196.00,$8.36,$8.36,$190.12
4297117,0420,97116,,,,,N/A,N/A,"GAIT TRAINING,AT     97116~LYN",$197.75,$147.00,$8.36,$196.00,$8.36,$190.12,$8.36,N/A,$8.36,$43.89,$8.36,$190.12,$8.36,$196.00,$8.36,$8.36,$190.12
4297116-59,0420,97116,,,,,N/A,N/A,"GAIT TRAINING,PT-59  97116~STJ",$197.75,$147.00,$8.36,$196.00,$8.36,$190.12,$8.36,N/A,$8.36,$43.89,$8.36,$190.12,$8.36,$196.00,$8.36,$8.36,$190.12
4200215,0420,97124,,,,,N/A,N/A,MASSAGE LYN              97142,$52.46,$39.00,$21.32,$52.00,$21.32,$50.44,$21.32,N/A,$21.32,$34.64,$21.32,$50.44,$21.32,$52.00,$21.32,$21.32,$50.44
4200112,0420,97140,,,,,N/A,N/A,MANUAL THERAPY-PT    97140~STJ,$64.57,$48.00,$25.39,$64.00,$26.24,$62.08,$26.24,N/A,$26.24,$25.39,$26.24,$62.08,$26.24,$64.00,$26.24,$26.24,$62.08
4201512,0420,97140,,,,,N/A,N/A,PT MANUAL THERAPY    97140 -59,$231.05,$171.75,$25.39,$64.00,$26.24,$62.08,$26.24,N/A,$26.24,$25.39,$26.24,$62.08,$26.24,$64.00,$26.24,$26.24,$62.08
4297151,0420,97150,,,,,N/A,N/A,"GROUP THERAPY, AT    97150~LYN",$169.50,$126.00,$31.83,$168.00,$68.88,$162.96,$68.88,N/A,$68.88,$31.83,$68.88,$162.96,$68.88,$168.00,$68.88,$68.88,$162.96
97163,0420,97163,,,,,N/A,N/A,EVALUATION PT HIGH COMPLEX,$169.50,$126.00,$68.88,$168.00,$68.88,$162.96,$68.88,N/A,$68.88,$116.56,$68.88,$162.96,$68.88,$168.00,$68.88,$68.88,$162.96
4200220,0420,97504,,,,,N/A,N/A,"Ortho Fit 1/4hr,Pt   97760~lyn",$91.81,$68.25,$76.12,$220.00,N/A,$213.40,N/A,N/A,N/A,$76.12,N/A,$213.40,N/A,$220.00,N/A,N/A,$213.40
4200225,0420,97530,,,,,N/A,N/A,THERAP ACTIVIT 1/4HR   97530~L,$64.57,$48.00,$26.24,$64.00,$26.24,$62.08,$26.24,N/A,$26.24,$64.00,$26.24,$62.08,$26.24,$64.00,$26.24,$26.24,$62.08
4200243,0420,97545,,,,,N/A,N/A,WORK CONDIT 1ST 2 HR 97545~LYN,$446.96,$332.25,$181.63,$443.00,$181.63,$429.71,$181.63,N/A,$181.63,$315.00,$181.63,$429.71,$181.63,$443.00,$181.63,$181.63,$429.71
4200143,0420,97546,,,,,N/A,N/A,WRK CONDIT 3RD HR    97546~STJ,$134.19,$99.75,$54.53,$192.77,$54.53,$129.01,$54.53,N/A,$54.53,$192.77,$54.53,$129.01,$54.53,$133.00,$54.53,$54.53,$129.01
4200145,0420,97546,,,,,N/A,N/A,WRK CONDIT 4 HRS     97546~STJ,$134.19,$99.75,$54.53,$192.77,$54.53,$129.01,$54.53,N/A,$54.53,$192.77,$54.53,$129.01,$54.53,$133.00,$54.53,$54.53,$129.01
4200147,0420,97546,,,,,N/A,N/A,WRK CONDIT 5 HR      97546~LYN,$134.19,$99.75,$54.53,$192.77,$54.53,$129.01,$54.53,N/A,$54.53,$192.77,$54.53,$129.01,$54.53,$133.00,$54.53,$54.53,$129.01
4200149,0420,97546,,,,,N/A,N/A,WRK CONDIT 6TH HR    97546~STJ,$134.19,$99.75,$54.53,$192.77,$54.53,$129.01,$54.53,N/A,$54.53,$192.77,$54.53,$129.01,$54.53,$133.00,$54.53,$54.53,$129.01
4200244,0420,97546,,,,,N/A,N/A,WORK CONDIT ADD HR   97546~LYN,$227.01,$168.75,$54.53,$192.77,$54.53,$129.01,$54.53,N/A,$54.53,$192.77,$54.53,$129.01,$54.53,$133.00,$54.53,$54.53,$129.01
4097597,0420,97597,,,,,N/A,N/A,"WOUND DEBRIDEMENT,PT 97597~LYN",$257.28,$191.25,$14.55,$170.00,$14.55,$164.90,$14.55,N/A,$14.55,N/A,$14.55,$164.90,$14.55,$170.00,$14.55,$14.55,$164.90
4297597,0420,97597,,,,,N/A,N/A,"WOUND DEBRIDEMENT,OT 97597~STJ",$257.28,$191.25,$14.55,$170.00,$14.55,$164.90,$14.55,N/A,$14.55,N/A,$14.55,$164.90,$14.55,$170.00,$14.55,$14.55,$164.90
4297601,0420,97597,,,,,N/A,N/A,"WOUND DEBRIDEMENT,PT 97597~STJ",$257.28,$191.25,$14.55,$170.00,$14.55,$164.90,$14.55,N/A,$14.55,N/A,$14.55,$164.90,$14.55,$170.00,$14.55,$14.55,$164.90
4097598,0420,97598,,,,,N/A,N/A,"RMVL DEV TIS 20CM,PT 97598~LYN",$394.50,$293.25,$16.31,$391.00,$16.31,$379.27,$16.31,N/A,$16.31,$40.95,$16.31,$379.27,$16.31,$391.00,$16.31,$16.31,$379.27
4297598,0420,97598,,,,,N/A,N/A,"RMVL DEV TISS 20CM,PT97598~STJ",$394.50,$293.25,$16.31,$391.00,$16.31,$379.27,$16.31,N/A,$16.31,$40.95,$16.31,$379.27,$16.31,$391.00,$16.31,$16.31,$379.27
4207602,0420,97602,,,,,N/A,N/A,"WOUND CAR NON-SEL,PT 97602~LYN",$216.92,$161.25,$28.48,$170.00,N/A,$164.90,N/A,N/A,N/A,$28.48,N/A,$164.90,N/A,$170.00,N/A,N/A,$164.90
4297602,0420,97602,,,,,N/A,N/A,"WOUND CAR NON-SEL,PT 97602~STJ",$216.92,$161.25,$28.48,$170.00,N/A,$164.90,N/A,N/A,N/A,$28.48,N/A,$164.90,N/A,$170.00,N/A,N/A,$164.90
4200089,0420,97750,,,,,N/A,N/A,FUNCT CAPACITY TEST LYN  97750,"$2,750.37","$2,044.50",$27.95,$76.26,$76.26,$62.08,$76.26,N/A,$76.26,$27.95,$76.26,$62.08,$76.26,$64.00,$76.26,$76.26,$62.08
4200138,0420,97763,,,,,N/A,N/A,ORTHOTIC FABRICATION     97763,$91.81,$68.25,$37.31,$91.00,$37.31,$88.27,$37.31,N/A,$37.31,$39.47,$37.31,$88.27,$37.31,$91.00,$37.31,$37.31,$88.27
4200238,0420,97763,,,,,N/A,N/A,ORTHOTIC FABRICATION     97763,$91.81,$68.25,$37.31,$91.00,$37.31,$88.27,$37.31,N/A,$37.31,$39.47,$37.31,$88.27,$37.31,$91.00,$37.31,$37.31,$88.27
4200281,0420,G0281,,,,,N/A,N/A,ELEC STIM-III/IV ULCERS G0281,$86.77,$64.50,$12.03,$86.00,$12.03,$83.42,$12.03,N/A,$12.03,$86.00,$12.03,$83.42,$12.03,$86.00,$12.03,$12.03,$83.42
G0283,0420,G0283,,,,,N/A,N/A,"ELECTRICAL STIMULATION,PT",$42.38,$31.50,$12.03,$42.00,$12.03,$40.74,$12.03,N/A,$12.03,$42.00,$12.03,$40.74,$12.03,$42.00,$12.03,$12.03,$40.74
4200043,0420,,,,,,N/A,N/A,W0RK CONDIT 1ST 2 HR 97545~STJ,$446.96,$332.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4200044,0420,,,,,,N/A,N/A,WORK CONDIT ADD HR   97546~STJ,$227.01,$168.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4200088,0420,,,,,,N/A,N/A,FUNCT CAPACITY TEST  97750~STJ,"$2,750.37","$2,044.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4200101,0420,,,,,,N/A,N/A,AQUATICS THERAPY     97113~STJ,$85.76,$63.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4200103,0420,,,,,,N/A,N/A,CONTRT BATHS 1/4HRPT 97034~STJ,$140.24,$104.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4200105,0420,,,,,,N/A,N/A,"ELECT STIMULA,PT     97014~STJ",$42.38,$31.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4200106,0420,,,,,,N/A,N/A,ELECT STIM 1/4 HR PT 97032~STJ,$42.38,$31.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4200107,0420,,,,,,N/A,N/A,"GAIT TRAINING,PT     97116~STJ",$197.75,$147.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4200108,0420,,,,,,N/A,N/A,HOT OR COLD PACKS    97010~STJ,$86.77,$64.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4200120,0420,,,,,,N/A,N/A,Ortho Fit/Trn 1/4hrpt97760~stj,$220.96,$164.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4200121,0420,,,,,,N/A,N/A,"PARAFFIN BATH,PT     97018~STJ",$113.00,$84.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4200122,0420,,,,,,N/A,N/A,PHYS PERF TEST15 MIN 97750~STJ,$69.62,$51.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4200123,0420,,,,,,N/A,N/A,Prosth Training 1/4hr97761~stj,$220.96,$164.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4200124,0420,,,,,,N/A,N/A,"SELF CARE TRAIN,PT   97535~STJ",$221.97,$165.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4200125,0420,,,,,,N/A,N/A,THERAP ACTIVIT 1/4HR S   97530,$64.57,$48.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4200127,0420,,,,,,N/A,N/A,"TRACTION,MECHANICAL  97012~STJ",$162.44,$120.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4200129,0420,,,,,,N/A,N/A,ULTRASOUND 1/4 HR PT 97035~STJ,$34.30,$25.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4200132,0420,,,,,,N/A,N/A,WHEELCHAIR MANAGE    97542~STJ,$161.43,$120.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4200133,0420,,,,,,N/A,N/A,"WHIRLPOOL,PT         97022~STJ",$143.27,$106.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4200136,0420,,,,,,N/A,N/A,"GROUP THERAPY,AT     97150~STJ",$169.50,$126.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4200201,0420,,,,,,N/A,N/A,AQUATICS THERAPY     97113~LYN,$85.76,$63.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4200203,0420,,,,,,N/A,N/A,CONTR BATHS 1/4 HRPT 97034~LYN,$140.24,$104.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4200205,0420,,,,,,N/A,N/A,"ELECT STIMULA,PT     97014~LYN",$42.38,$31.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4200207,0420,,,,,,N/A,N/A,"GAIT TRAINING,PT     97116~LYN",$197.75,$147.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4200211,0420,,,,,,N/A,N/A,IONTOP 1/4 HR PT     97033~LYN,$41.37,$30.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4200212,0420,,,,,,N/A,N/A,MANUAL THERAPY-PT    97140~LYN,$64.57,$48.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4200221,0420,,,,,,N/A,N/A,"PARAFFIN BATH,PT     97018~LYN",$113.00,$84.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4200222,0420,,,,,,N/A,N/A,PHYS PERF TEST 15MIN 97750~LYN,$69.62,$51.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4200223,0420,,,,,,N/A,N/A,Prosth Train 1/4hr   97761~lyn,$220.96,$164.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4200224,0420,,,,,,N/A,N/A,"SELF CARE TRAIN, PT  97535~LYN",$221.97,$165.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4200226,0420,,,,,,N/A,N/A,THERAP PROC 1/4 HRPT 97110~LYN,$64.57,$48.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4200227,0420,,,,,,N/A,N/A,"TRACTION,MECHANICAL  97012~LYN",$162.44,$120.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4200229,0420,,,,,,N/A,N/A,ULTRASOUND 1/4 HR PT 97035~LYN,$34.30,$25.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4200232,0420,,,,,,N/A,N/A,WHEELCHAIR MANAGE    97542~LYN,$161.43,$120.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4200233,0420,,,,,,N/A,N/A,"WHIRLPOOL,PT         97022~LYN",$143.27,$106.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4200236,0420,,,,,,N/A,N/A,GROUP THERAPY        97150~LYN,$169.50,$126.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4200900,0424,97161,,,,,N/A,N/A,EVAL PT LOW COMPLEX  97161~STJ,$169.50,$126.00,$20.74,$168.00,$68.88,$162.96,$68.88,N/A,$68.88,$20.74,$68.88,$162.96,$68.88,$168.00,$68.88,$68.88,$162.96
4200903,0424,97161,,,,,N/A,N/A,EVAL PT LOW COMPLEX  97161~LYN,$169.50,$126.00,$20.74,$168.00,$68.88,$162.96,$68.88,N/A,$68.88,$20.74,$68.88,$162.96,$68.88,$168.00,$68.88,$68.88,$162.96
4200901,0424,97162,,,,,N/A,N/A,EVAL PT MOD COMPLEX  97162~STJ,$169.50,$126.00,$68.88,$168.00,$68.88,$162.96,$68.88,N/A,$68.88,$116.56,$68.88,$162.96,$68.88,$168.00,$68.88,$68.88,$162.96
4200904,0424,97162,,,,,N/A,N/A,EVAL PT MOD COMPLEX  97162~LYN,$169.50,$126.00,$68.88,$168.00,$68.88,$162.96,$68.88,N/A,$68.88,$116.56,$68.88,$162.96,$68.88,$168.00,$68.88,$68.88,$162.96
4200902,0424,97163,,,,,N/A,N/A,EVAL PT HIGH COMPLEX 97163~STJ,$169.50,$126.00,$68.88,$168.00,$68.88,$162.96,$68.88,N/A,$68.88,$116.56,$68.88,$162.96,$68.88,$168.00,$68.88,$68.88,$162.96
4200905,0424,97163,,,,,N/A,N/A,EVAL PT HIGH COMPLEX 97163~LYN,$169.50,$126.00,$68.88,$168.00,$68.88,$162.96,$68.88,N/A,$68.88,$116.56,$68.88,$162.96,$68.88,$168.00,$68.88,$68.88,$162.96
4200906,0424,97164,,,,,N/A,N/A,"RE-EVALUATION,PT     97164~STJ",$257.28,$191.25,$14.55,$168.00,$14.55,$162.96,$14.55,N/A,$14.55,$116.56,$14.55,$162.96,$14.55,$168.00,$14.55,$14.55,$162.96
4200907,0424,97164,,,,,N/A,N/A,"RE-EVALUATION,PT     97164~LYN",$257.28,$191.25,$14.55,$168.00,$14.55,$162.96,$14.55,N/A,$14.55,$116.56,$14.55,$162.96,$14.55,$168.00,$14.55,$14.55,$162.96
4200040,0429,,,,,,N/A,N/A,INDUSTRL EVAL 1 HR STJ,$493.37,$366.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4200041,0429,,,,,,N/A,N/A,INDUST EVAL 1 1/2 HR STJ,$735.52,$546.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4200042,0429,,,,,,N/A,N/A,INDUST EVAL 2 HR STJ,$875.76,$651.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4200049,0429,,,,,,N/A,N/A,JOB SITE EVAL PER 1/2 HOUR,$199.77,$148.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4200050,0429,,,,,,N/A,N/A,PRE EMPLOY SCREEN,$116.03,$86.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4200240,0429,,,,,,N/A,N/A,INDUSTRL EVAL 1 HR. LYN,$493.37,$366.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4200241,0429,,,,,,N/A,N/A,INDUST EVAL 1/2 HRE LYN,$735.52,$546.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4200242,0429,,,,,,N/A,N/A,INDUST EVAL 2 HR. LYN,$875.76,$651.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4397014,0430,97014,,,,,N/A,N/A,"ELECT STIMULA,OT     97014~LYN",$42.38,$31.50,$7.07,$42.00,N/A,$40.74,N/A,N/A,N/A,$7.07,N/A,$40.74,N/A,$42.00,N/A,N/A,$40.74
4397032,0430,97014,,,,,N/A,N/A,"Elect Stimulat,Ot    97032~lyn",$42.38,$31.50,$7.07,$42.00,N/A,$40.74,N/A,N/A,N/A,$7.07,N/A,$40.74,N/A,$42.00,N/A,N/A,$40.74
4397018,0430,97018,,,,,N/A,N/A,"PARAFFIN BATH,OT     97018~LYN",$113.00,$84.00,$13.90,$112.00,$45.92,$108.64,$45.92,N/A,$45.92,$13.90,$45.92,$108.64,$45.92,$112.00,$45.92,$45.92,$108.64
4397022,0430,97022,,,,,N/A,N/A,WHIRLPOOL.OT         97022~LYN,$143.27,$106.50,$6.66,$142.00,$58.22,$137.74,$58.22,N/A,$58.22,$6.66,$58.22,$137.74,$58.22,$142.00,$58.22,$58.22,$137.74
4300111,0430,97033,,,,,N/A,N/A,IONTOPH 1/4 HR OT    97033~STJ,$41.37,$30.75,$16.81,$41.00,$16.81,$39.77,$16.81,N/A,$16.81,$17.12,$16.81,$39.77,$16.81,$41.00,$16.81,$16.81,$39.77
4397033,0430,97033,,,,,N/A,N/A,IONTOPH 1/4 HR OT    97033~LYN,$41.37,$30.75,$16.81,$41.00,$16.81,$39.77,$16.81,N/A,$16.81,$17.12,$16.81,$39.77,$16.81,$41.00,$16.81,$16.81,$39.77
4397034,0430,97034,,,,,N/A,N/A,CONTR BATHS 1/4 HROT 97034~LYN,$140.24,$104.25,$23.56,$139.00,$56.99,$134.83,$56.99,N/A,$56.99,$23.56,$56.99,$134.83,$56.99,$139.00,$56.99,$56.99,$134.83
4397035,0430,97035,,,,,N/A,N/A,ULTRASOUND 1/4 HR OT 97035~LYN,$34.30,$25.50,$13.94,$34.00,$13.94,$32.98,$13.94,N/A,$13.94,$17.12,$13.94,$32.98,$13.94,$34.00,$13.94,$13.94,$32.98
4397110,0430,97110,,,,,N/A,N/A,THERAP PROC 1/4 HROT 97110~LYN,$211.88,$157.50,$16.72,$64.00,$26.24,$62.08,$26.24,N/A,$26.24,$16.72,$26.24,$62.08,$26.24,$64.00,$26.24,$26.24,$62.08
4307112,0430,97112,,,,,N/A,N/A,NEUROMUS RE-ED OT    97112~LYN,$230.04,$171.00,$26.24,$64.00,$26.24,$62.08,$26.24,N/A,$26.24,$34.64,$26.24,$62.08,$26.24,$64.00,$26.24,$26.24,$62.08
4397112,0430,97112,,,,,N/A,N/A,NEUROMUS RE-ED-OT    97112~STJ,$64.57,$48.00,$26.24,$64.00,$26.24,$62.08,$26.24,N/A,$26.24,$34.64,$26.24,$62.08,$26.24,$64.00,$26.24,$26.24,$62.08
4307116,0430,97116,,,,,N/A,N/A,GAIT TRAINING-OT     97116~LYN,$197.75,$147.00,$8.36,$196.00,$8.36,$190.12,$8.36,N/A,$8.36,$43.89,$8.36,$190.12,$8.36,$196.00,$8.36,$8.36,$190.12
4397116,0430,97116,,,,,N/A,N/A,"GAIT TRAINING,OT     97116~STJ",$197.75,$147.00,$8.36,$196.00,$8.36,$190.12,$8.36,N/A,$8.36,$43.89,$8.36,$190.12,$8.36,$196.00,$8.36,$8.36,$190.12
4307116-59,0430,97116,,,,,N/A,N/A,"GAIT TRAINING,OT-59  97116~LYN",$197.75,$147.00,$8.36,$196.00,$8.36,$190.12,$8.36,N/A,$8.36,$43.89,$8.36,$190.12,$8.36,$196.00,$8.36,$8.36,$190.12
4397116-59,0430,97116,,,,,N/A,N/A,"GAIT TRAINING,OT-59  97116~STJ",$197.75,$147.00,$8.36,$196.00,$8.36,$190.12,$8.36,N/A,$8.36,$43.89,$8.36,$190.12,$8.36,$196.00,$8.36,$8.36,$190.12
4297129,0430,97129,,,,,N/A,N/A,THER INTERV COGNIT FUNCT 97129,$77.69,$57.75,$31.57,$77.00,$31.57,$74.69,$31.57,N/A,$31.57,$34.01,$31.57,$74.69,$31.57,$77.00,$31.57,$31.57,$74.69
4297130,0430,97130,,,,,N/A,N/A,THER INTERV COGNIT FUNCT 97130,$77.69,$57.75,$26.59,$77.00,$31.57,$74.69,$31.57,N/A,$31.57,$26.59,$31.57,$74.69,$31.57,$77.00,$31.57,$31.57,$74.69
4297140,0430,97140,,,,,N/A,N/A,MANUAL THERAPY OT    97140~STJ,$64.57,$48.00,$25.39,$64.00,$26.24,$62.08,$26.24,N/A,$26.24,$25.39,$26.24,$62.08,$26.24,$64.00,$26.24,$26.24,$62.08
4397140,0430,97140,,,,,N/A,N/A,MANUAL THERAPY-OT    97140~LYN,$234.07,$174.00,$25.39,$64.00,$26.24,$62.08,$26.24,N/A,$26.24,$25.39,$26.24,$62.08,$26.24,$64.00,$26.24,$26.24,$62.08
4297150,0430,97150,,,,,N/A,N/A,GROUP THERAPY        97150~STJ,$169.50,$126.00,$31.83,$168.00,$68.88,$162.96,$68.88,N/A,$68.88,$31.83,$68.88,$162.96,$68.88,$168.00,$68.88,$68.88,$162.96
4297504,0430,97504,,,,,N/A,N/A,Orthotic Training        97760,$221.97,$165.00,$76.12,$220.00,N/A,$213.40,N/A,N/A,N/A,$76.12,N/A,$213.40,N/A,$220.00,N/A,N/A,$213.40
4397504,0430,97504,,,,,N/A,N/A,"Ortho Fit 1/4hr,Ot   97760~lyn",$91.81,$68.25,$76.12,$220.00,N/A,$213.40,N/A,N/A,N/A,$76.12,N/A,$213.40,N/A,$220.00,N/A,N/A,$213.40
5997504,0430,97504,,,,,N/A,N/A,Ortho Trng-Separ Site    97760,$221.97,$165.00,$76.12,$220.00,N/A,$213.40,N/A,N/A,N/A,$76.12,N/A,$213.40,N/A,$220.00,N/A,N/A,$213.40
4297504-59,0430,97504,,,,,N/A,N/A,ORTHOT TRNG - SEPAR SITE 97760,$221.97,$165.00,$76.12,$220.00,N/A,$213.40,N/A,N/A,N/A,$76.12,N/A,$213.40,N/A,$220.00,N/A,N/A,$213.40
4297520,0430,97520,,,,,N/A,N/A,Prosthetic Training      97761,$221.97,$165.00,$213.40,$315.00,N/A,$213.40,N/A,N/A,N/A,$315.00,N/A,$213.40,N/A,$220.00,N/A,N/A,$213.40
4297530,0430,97530,,,,,N/A,N/A,THERAPEUTIC ACTIVITIES   97530,$64.57,$48.00,$26.24,$64.00,$26.24,$62.08,$26.24,N/A,$26.24,$64.00,$26.24,$62.08,$26.24,$64.00,$26.24,$26.24,$62.08
4300125,0430,97530,,,,,N/A,N/A,THERAP ACTIVIT 1/4HR S   97530,$64.57,$48.00,$26.24,$64.00,$26.24,$62.08,$26.24,N/A,$26.24,$64.00,$26.24,$62.08,$26.24,$64.00,$26.24,$26.24,$62.08
4397535,0430,97535,,,,,N/A,N/A,"SELF CARE TRAIN, OT  97535~LYN",$221.97,$165.00,$9.20,$220.00,$9.20,$213.40,$9.20,N/A,$9.20,$45.10,$9.20,$213.40,$9.20,$220.00,$9.20,$9.20,$213.40
4297542,0430,97542,,,,,N/A,N/A,"WHEELCHR MGMT TRN,OT 97542~STJ",$161.43,$120.00,$38.66,$160.00,$65.60,$155.20,$65.60,N/A,$65.60,$38.66,$65.60,$155.20,$65.60,$160.00,$65.60,$65.60,$155.20
4297543,0430,97543,,,,,N/A,N/A,"WHEELCH MGMT TRAIN,OT97543~LYN",$161.43,$120.00,$37.46,$160.00,N/A,$155.20,N/A,N/A,N/A,$37.46,N/A,$155.20,N/A,$160.00,N/A,N/A,$155.20
4307601,0430,97597,,,,,N/A,N/A,"WOUND DEBRIDEMENT,OT 97597~LYN",$257.28,$191.25,$14.55,$170.00,$14.55,$164.90,$14.55,N/A,$14.55,N/A,$14.55,$164.90,$14.55,$170.00,$14.55,$14.55,$164.90
4397601,0430,97597,,,,,N/A,N/A,"WOUND DEBRIDEMENT,OT 97597~STJ",$257.28,$191.25,$14.55,$170.00,$14.55,$164.90,$14.55,N/A,$14.55,N/A,$14.55,$164.90,$14.55,$170.00,$14.55,$14.55,$164.90
4097568,0430,97598,,,,,N/A,N/A,"RMVL DEV TIS20CM,OT  97598~LYN",$394.50,$293.25,$16.31,$391.00,$16.31,$379.27,$16.31,N/A,$16.31,$40.95,$16.31,$379.27,$16.31,$391.00,$16.31,$16.31,$379.27
4397598,0430,97598,,,,,N/A,N/A,"RMVL DEV TISS 20CM,OT97598~STJ",$394.50,$293.25,$16.31,$391.00,$16.31,$379.27,$16.31,N/A,$16.31,$40.95,$16.31,$379.27,$16.31,$391.00,$16.31,$16.31,$379.27
4307602,0430,97602,,,,,N/A,N/A,"WOUND CAR NON-SEL,OT 97602~LYN",$216.92,$161.25,$28.48,$170.00,N/A,$164.90,N/A,N/A,N/A,$28.48,N/A,$164.90,N/A,$170.00,N/A,N/A,$164.90
4397602,0430,97602,,,,,N/A,N/A,"WOUND CAR NON-SEL,OT 97602~STJ",$216.92,$161.25,$28.48,$170.00,N/A,$164.90,N/A,N/A,N/A,$28.48,N/A,$164.90,N/A,$170.00,N/A,N/A,$164.90
431G8995,0430,G8995,,,,,N/A,N/A,OTHER PT&OT SUBS DIS STAT L,$4.04,$3.00,$3.88,$4.00,N/A,$3.88,N/A,N/A,N/A,$4.00,N/A,$3.88,N/A,$4.00,N/A,N/A,$3.88
4300103,0430,,,,,,N/A,N/A,CONTRT BATHS 1/4HROT 97034~STJ,$140.24,$104.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4300105,0430,,,,,,N/A,N/A,"ELECT STIMUL,OT      97014~STJ",$42.38,$31.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4300106,0430,,,,,,N/A,N/A,ELECT STIM 1/4 HR OT 97032~STJ,$42.38,$31.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4300112,0430,,,,,,N/A,N/A,MANUAL THERAPY-OT    97140~STJ,$64.57,$48.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4300120,0430,,,,,,N/A,N/A,"Orthot Fit 1/4hr,Ot  97760~stj",$91.81,$68.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4300121,0430,,,,,,N/A,N/A,"PARAFFIN BATH,OT     97018~STJ",$113.00,$84.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4300124,0430,,,,,,N/A,N/A,"SELF CARE TRAIN, OT  97535~STJ",$221.97,$165.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4300126,0430,,,,,,N/A,N/A,THERA PROC 1/4 HR OT 97110~STJ,$64.57,$48.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4300129,0430,,,,,,N/A,N/A,ULTRASOUND 1/4 HR OT 97035~STJ,$34.30,$25.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4300133,0430,,,,,,N/A,N/A,"WHIRLPOOL,OT         97022~STJ",$143.27,$106.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4297013,0434,97165,,,,,N/A,N/A,"EVALUATION, OT       97165~STJ",$169.50,$126.00,$68.88,$168.00,$68.88,$162.96,$68.88,N/A,$68.88,$79.74,$68.88,$162.96,$68.88,$168.00,$68.88,$68.88,$162.96
4297014,0434,97166,,,,,N/A,N/A,"EVALUATION, OT       97166~STJ",$169.50,$126.00,$68.88,$168.00,$68.88,$162.96,$68.88,N/A,$68.88,$112.94,$68.88,$162.96,$68.88,$168.00,$68.88,$68.88,$162.96
4297015,0434,97167,,,,,N/A,N/A,"EVALUATION, OT       97167~STJ",$169.50,$126.00,$56.58,$168.00,$56.58,$162.96,$56.58,N/A,$56.58,$112.94,$56.58,$162.96,$56.58,$168.00,$56.58,$56.58,$162.96
4297017,0434,97168,,,,,N/A,N/A,"RE-EVALUATION, OT    97168~STJ",$257.28,$191.25,$14.55,$255.00,$14.55,$247.35,$14.55,N/A,$14.55,$112.94,$14.55,$247.35,$14.55,$255.00,$14.55,$14.55,$247.35
4400002,0440,92507,,,,,N/A,N/A,SPEECH THER. 1 UNIT   92507,$207.84,$154.50,$84.46,$206.00,$84.46,$199.82,$84.46,N/A,$84.46,$206.00,$84.46,$199.82,$84.46,$206.00,$84.46,$84.46,$199.82
4492526,0440,92526,,,,,N/A,N/A,SWALLOW TREATMENT      92526,$150.33,$111.75,$61.90,$149.00,$61.90,$144.53,$61.90,N/A,$61.90,$123.54,$61.90,$144.53,$61.90,$149.00,$61.90,$61.90,$144.53
4492610,0440,92610,,,,,N/A,N/A,SWALLOWING EVALUATION   92610,$270.40,$201.00,$19.88,$268.00,$19.88,N/A,$19.88,N/A,$19.88,$80.19,$19.88,N/A,$19.88,$268.00,$19.88,$19.88,N/A
4492611,0440,92611,,,,,N/A,N/A,SWALLOWING EVAL WITH VIDEO,$140.24,$104.25,$56.99,$139.00,$56.99,N/A,$56.99,N/A,$56.99,$78.24,$56.99,N/A,$56.99,$139.00,$56.99,$56.99,N/A
4400003,0444,92521,,,,,N/A,N/A,SP THER EVAL FLUENCY   92521,$744.60,$553.50,$32.58,$738.00,$32.58,$715.86,$32.58,N/A,$32.58,$41.40,$32.58,$715.86,$32.58,$738.00,$32.58,$32.58,$715.86
4400004,0444,92522,,,,,N/A,N/A,SP THER EVAL PROD   92522,$744.60,$553.50,$32.58,$738.00,$32.58,$715.86,$32.58,N/A,$32.58,$151.20,$32.58,$715.86,$32.58,$738.00,$32.58,$32.58,$715.86
4400005,0444,92523,,,,,N/A,N/A,SP THER EVAL S&L COMP   92523,$744.60,$553.50,$32.58,$738.00,$32.58,$715.86,$32.58,N/A,$32.58,$126.10,$32.58,$715.86,$32.58,$738.00,$32.58,$32.58,$715.86
4400006,0444,92524,,,,,N/A,N/A,SP THER EVAL QUAL ANALY  92524,$744.60,$553.50,$32.58,$738.00,$32.58,$715.86,$32.58,N/A,$32.58,$260.05,$32.58,$715.86,$32.58,$738.00,$32.58,$32.58,$715.86
4496105,0444,96105,,,,,N/A,N/A,ASSESSMENT OF APHASIA 96105,$270.40,$201.00,$19.88,$268.00,$19.88,$259.96,$19.88,N/A,$19.88,$42.33,$19.88,$259.96,$19.88,$268.00,$19.88,$19.88,$259.96
4400007,0444,96125,,,,,N/A,N/A,SP STAND COGNITIVE PERF  96125,$303.69,$225.75,$11.40,$301.00,$123.41,$291.97,$123.41,N/A,$123.41,$11.40,$123.41,$291.97,$123.41,$301.00,$123.41,$123.41,$291.97
4510021,0450,10021,,,,,N/A,N/A,FINE NEEDLE ASP       10021~TC,$361.20,$268.50,$93.14,$430.00,N/A,$417.10,N/A,$367.65,N/A,$93.14,N/A,$417.10,N/A,$430.00,N/A,N/A,$417.10
4501402,0450,10060,,,,,N/A,N/A,INC I&D ABSCESS SML   10060~TC,$505.48,$375.75,$8.77,$197.00,$8.77,N/A,$8.77,$168.44,$8.77,$177.59,$8.77,N/A,$8.77,$197.00,$8.77,$8.77,N/A
4500402A,0450,10060,,,,,N/A,N/A,INC I&D ABSCESS SML    10060~T,$505.48,$375.75,$8.77,$197.00,$8.77,N/A,$8.77,$168.44,$8.77,$177.59,$8.77,N/A,$8.77,$197.00,$8.77,$8.77,N/A
4501404,0450,10061,,,,,N/A,N/A,INC I&D ABSCESS LRG   10061~TC,$698.19,$519.00,$15.60,$366.00,$15.60,$355.02,$15.60,$312.93,$15.60,$312.38,$15.60,$355.02,$15.60,$366.00,$15.60,$15.60,$355.02
4500404A,0450,10061,,,,,N/A,N/A,INC I&D ABSCESS LRG    10061~T,$698.19,$519.00,$15.60,$366.00,$15.60,$355.02,$15.60,$312.93,$15.60,$312.38,$15.60,$355.02,$15.60,$366.00,$15.60,$15.60,$355.02
4501405,0450,10080,,,,,N/A,N/A,DRAIN PILONIDAL CYST  10080~TC,$515.57,$383.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500405A,0450,10080,,,,,N/A,N/A,INC PILONIDAL CYST     10080~T,$515.57,$383.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4502008,0450,10081,,,,,N/A,N/A,I&D PILONIDAL AB COMP 10081~TC,"$1,489.20","$1,107.00",$152.52,$372.00,$152.52,$360.84,$152.52,$318.06,$152.52,$293.55,$152.52,$360.84,$152.52,$372.00,$152.52,$152.52,$360.84
4501008A,0450,10081,,,,,N/A,N/A,I&D PILONIDAL AB CMP   10081~T,"$1,489.20","$1,107.00",$152.52,$372.00,$152.52,$360.84,$152.52,$318.06,$152.52,$293.55,$152.52,$360.84,$152.52,$372.00,$152.52,$152.52,$360.84
4501213,0450,10120,,,,,N/A,N/A,RMV FB SIMPLE         10120~TC,$526.67,$391.50,$83.64,$204.00,$83.64,$197.88,$83.64,$174.42,$83.64,$179.14,$83.64,$197.88,$83.64,$204.00,$83.64,$83.64,$197.88
4500213A,0450,10120,,,,,N/A,N/A,RMV FB SIMPLE          10120~T,$484.29,$360.00,$83.64,$204.00,$83.64,$197.88,$83.64,$174.42,$83.64,$179.14,$83.64,$197.88,$83.64,$204.00,$83.64,$83.64,$197.88
4500267A,0450,10121,,,,,N/A,N/A,RMV FB COMPLEX         10121~T,"$1,330.79",$989.25,$172.61,$421.00,$172.61,$408.37,$172.61,$359.96,$172.61,$314.50,$172.61,$408.37,$172.61,$421.00,$172.61,$172.61,$408.37
4501406,0450,10140,,,,,N/A,N/A,DRAIN HEMATOMA FLUID  10140~TC,$533.73,$396.75,$117.26,$266.00,$117.26,$258.02,$117.26,$227.43,$117.26,$202.56,$117.26,$258.02,$117.26,$266.00,$117.26,$117.26,$258.02
4500406A,0450,10140,,,,,N/A,N/A,INC I&D HEMATOMA SIM   10140~T,$533.73,$396.75,$117.26,$266.00,$117.26,$258.02,$117.26,$227.43,$117.26,$202.56,$117.26,$258.02,$117.26,$266.00,$117.26,$117.26,$258.02
4501424,0450,10160,,,,,N/A,N/A,PUNC. DRAINAGE LESN   10160~TC,$755.70,$561.75,$16.72,$392.00,$16.72,$380.24,$16.72,$335.16,$16.72,$162.64,$16.72,$380.24,$16.72,$392.00,$16.72,$16.72,$380.24
4500424A,0450,10160,,,,,N/A,N/A,I&D ASPIR ABSCESS      10160~T,$525.66,$390.75,$16.72,$392.00,$16.72,$380.24,$16.72,$335.16,$16.72,$162.64,$16.72,$380.24,$16.72,$392.00,$16.72,$16.72,$380.24
4510180A,0450,10180,,,,,N/A,N/A,I&D COMP POSTOP WOUND INFECT~T,"$4,990.22","$3,709.50",$163.59,$399.00,$163.59,$387.03,$163.59,$341.15,$163.59,$301.36,$163.59,$387.03,$163.59,$399.00,$163.59,$163.59,$387.03
4510180TC,0450,10180,,,,,N/A,N/A,I&D COMP POSTOP WOUND INFECT~T,"$4,990.22","$3,709.50",$163.59,$399.00,$163.59,$387.03,$163.59,$341.15,$163.59,$301.36,$163.59,$387.03,$163.59,$399.00,$163.59,$163.59,$387.03
4501418,0450,11000,,,,,N/A,N/A,DEBRIDE INFECTED SKIN 11000~TC,$673.97,$501.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500418A,0450,11000,,,,,N/A,N/A,DEBRIDMENT INFCT SKIN  11000~T,$374.32,$278.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501421,0450,11010,,,,,N/A,N/A,DEBRIDE INFECTED SKIN 11010~TC,"$2,066.31","$1,536.00",$239.30,$583.00,$239.30,$565.51,$239.30,$498.47,$239.30,$283.64,$239.30,$565.51,$239.30,$583.00,$239.30,$239.30,$565.51
4500421A,0450,11010,,,,,N/A,N/A,DEBRIDE INFECTED SKIN  11010~T,"$2,066.31","$1,536.00",$239.30,$583.00,$239.30,$565.51,$239.30,$498.47,$239.30,$283.64,$239.30,$565.51,$239.30,$583.00,$239.30,$239.30,$565.51
4511012A,0450,11012,,,,,N/A,N/A,"DBRDE ON FX-SKN,SUB,MS 11012~T","$1,408.48","$1,047.00",$419.43,"$1,023.00",$419.43,$992.31,$419.43,$874.67,$419.43,$427.36,$419.43,$992.31,$419.43,"$1,023.00",$419.43,$419.43,$992.31
4511042A,0450,11042,,,,,N/A,N/A,"DEBRIDE, SKIN + SUBQ   11042~T",$846.50,$629.25,$61.50,$150.00,$61.50,$145.50,$61.50,$128.25,$61.50,$62.57,$61.50,$145.50,$61.50,$150.00,$61.50,$61.50,$145.50
4511043A,0450,11043,,,,,N/A,N/A,"DEBRIDE,SKN, SUB & MUS 11043~T",$846.50,$629.25,$159.32,$390.00,$159.90,$378.30,$159.90,$333.45,$159.90,$159.32,$159.90,$378.30,$159.90,$390.00,$159.90,$159.90,$378.30
4511044A,0450,11044,,,,,N/A,N/A,"DBR,SKN,SUB,MSCL,BONE  11044~T","$2,223.70","$1,653.00",$231.11,$634.00,$259.94,$614.98,$259.94,$542.07,$259.94,$231.11,$259.94,$614.98,$259.94,$634.00,$259.94,$259.94,$614.98
4511055A,0450,11055,,,,,N/A,N/A,PARNG/CUTNG CORN/CALLS 11055~T,$281.49,$209.25,$16.62,$65.00,$26.65,$63.05,$26.65,$55.58,$26.65,$16.62,$26.65,$63.05,$26.65,$65.00,$26.65,$26.65,$63.05
4511200A,0450,11200,,,,,N/A,N/A,RMVL SKIN TAGS;15 OR<  11200~T,$248.20,$184.50,$58.63,$143.00,$58.63,$138.71,$58.63,$122.27,$58.63,$78.65,$58.63,$138.71,$58.63,$143.00,$58.63,$58.63,$138.71
4511300A,0450,11300,,,,,N/A,N/A,SKIN LESION REMOVAL         ~T,$257.28,$191.25,$35.19,$107.00,$43.87,$103.79,$43.87,$91.49,$43.87,$35.19,$43.87,$103.79,$43.87,$107.00,$43.87,$43.87,$103.79
4501428,0450,11400,,,,,N/A,N/A,REMOVAL SKIN LESION   11400~TC,"$1,491.21","$1,108.50",$66.10,$161.00,$66.10,$156.17,$66.10,$137.66,$66.10,$87.14,$66.10,$156.17,$66.10,$161.00,$66.10,$66.10,$156.17
4500428A,0450,11400,,,,,N/A,N/A,EXC BNGN LES 0-0.5 CM  11140~T,$777.89,$578.25,$66.10,$161.00,$66.10,$156.17,$66.10,$137.66,$66.10,$87.14,$66.10,$156.17,$66.10,$161.00,$66.10,$66.10,$156.17
4500429A,0450,11401,,,,,N/A,N/A,EXC BGN LES .6-1.0 CM  11401~T,$837.42,$622.50,$86.51,$211.00,$86.51,$204.67,$86.51,$180.11,$86.51,$109.64,$86.51,$204.67,$86.51,$211.00,$86.51,$86.51,$204.67
4511441A,0450,11441,,,,,N/A,N/A,EXCISED DIAMETER 0.6-1.0CM~T,$391.47,$291.00,$113.16,$276.00,$113.16,$267.72,$113.16,$235.98,$113.16,$137.29,$113.16,$267.72,$113.16,$276.00,$113.16,$113.16,$267.72
45011719A,0450,11719,,,,,N/A,N/A,TRIM OF NONDYSTROPHIC NAILS ~T,$114.01,$84.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
45011720A,0450,11720,,,,,N/A,N/A,DEBRIDE NAILS ANY METHD 1-5 ~P,$228.02,$169.50,$14.76,$36.00,$14.76,$34.92,$14.76,$30.78,$14.76,$15.15,$14.76,$34.92,$14.76,$36.00,$14.76,$14.76,$34.92
45011721A,0450,11721,,,,,N/A,N/A,DEBRIDE NAILS ANY METHD >6  ~T,$228.02,$169.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501432,0450,11730,,,,,N/A,N/A,REMOVAL OF NAIL PLATE 11730~TC,$329.92,$245.25,$0.00,$56.22,N/A,$0.00,N/A,$0.00,N/A,$56.22,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
4500432A,0450,11730,,,,,N/A,N/A,AVULSION OF NAIL       11730~T,$330.93,$246.00,$0.00,$56.22,N/A,$0.00,N/A,$0.00,N/A,$56.22,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
4501407,0450,11740,,,,,N/A,N/A,INC SUB UNG HEMATOMA  11740~TC,$293.60,$218.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500407A,0450,11740,,,,,N/A,N/A,INC SUB UNG HEMATOMA   11740~T,$188.67,$140.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501434,0450,11750,,,,,N/A,N/A,REMOVAL OF NAILBED    11750-TC,"$1,491.21","$1,108.50",$138.17,$337.00,$138.17,$326.89,$138.17,$288.14,$138.17,$174.56,$138.17,$326.89,$138.17,$337.00,$138.17,$138.17,$326.89
4500434A,0450,11750,,,,,N/A,N/A,EXCISION OF NAIL & MATRIX   ~T,$922.17,$685.50,$138.17,$337.00,$138.17,$326.89,$138.17,$288.14,$138.17,$174.56,$138.17,$326.89,$138.17,$337.00,$138.17,$138.17,$326.89
4501419,0450,11760,,,,,N/A,N/A,RECON NAIL BED SIMPLE 11760~TC,$915.11,$680.25,$79.54,$194.14,$79.54,$188.18,$79.54,$165.87,$79.54,$194.14,$79.54,$188.18,$79.54,$194.00,$79.54,$79.54,$188.18
4500419A,0450,11760,,,,,N/A,N/A,RECON NAIL BED SIMPLE  11760~T,$675.99,$502.50,$79.54,$194.14,$79.54,$188.18,$79.54,$165.87,$79.54,$194.14,$79.54,$188.18,$79.54,$194.00,$79.54,$79.54,$188.18
4511765A,0450,11765,,,,,N/A,N/A,WEDGE EXC SKIN OF NAIL      ~T,$799.08,$594.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4511770A,0450,11770,,,,,N/A,N/A,EXC OF PILONIDAL CYST SIMP  ~T,"$5,646.03","$4,197.00",$159.80,$388.00,$159.80,$376.36,$159.80,$331.74,$159.80,$314.73,$159.80,$376.36,$159.80,$388.00,$159.80,$159.80,$376.36
4501601,0450,12001,,,,,N/A,N/A,LAC REPAIR 2.5 CM OR< 12001~TC,$915.11,$680.25,$45.36,$199.00,$81.59,$193.03,$81.59,$170.15,$81.59,$45.36,$81.59,$193.03,$81.59,$199.00,$81.59,$81.59,$193.03
4500601A,0450,12001,,,,,N/A,N/A,LAC REPAIR 2.5CM OR <  12001~G,$636.64,$473.25,$45.36,$199.00,$81.59,$193.03,$81.59,$170.15,$81.59,$45.36,$81.59,$193.03,$81.59,$199.00,$81.59,$81.59,$193.03
4501603,0450,12002,,,,,N/A,N/A,REP LAC 2.6-7.5 CM    12002~TC,$914.10,$679.50,$17.10,$261.00,$17.10,$253.17,$17.10,$223.16,$17.10,$59.83,$17.10,$253.17,$17.10,$261.00,$17.10,$17.10,$253.17
4500603A,0450,12002,,,,,N/A,N/A,REP LAC 2.6-7.5 CM     12002~T,$691.12,$513.75,$17.10,$261.00,$17.10,$253.17,$17.10,$223.16,$17.10,$59.83,$17.10,$253.17,$17.10,$261.00,$17.10,$17.10,$253.17
4501606,0450,12004,,,,,N/A,N/A,REP LAC 7.6-12.5 CM   12004~TC,$915.11,$680.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500606A,0450,12004,,,,,N/A,N/A,REP LAC 7.6-12.5 CM    12004~T,$758.72,$564.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501607,0450,12005,,,,,N/A,N/A,REP LAC 12.6-20.0 CM  12005~TC,$915.11,$680.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500607A,0450,12005,,,,,N/A,N/A,REP LAC 12.6-20.0 CM   12005~T,$866.68,$644.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501608,0450,12006,,,,,N/A,N/A,REP LAC 20.1-30.O CM  12006~TC,$914.10,$679.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500608A,0450,12006,,,,,N/A,N/A,REP LAC 20.1-30.0 CM   12006~T,"$1,029.12",$765.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501609,0450,12007,,,,,N/A,N/A,REPAIR LAC >30CM      12007~TC,$830.36,$617.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500609A,0450,12007,,,,,N/A,N/A,REPAIR LAC >30CM       12007~T,"$1,112.86",$827.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501633,0450,12011,,,,,N/A,N/A,REPAIR  LAC 2.5 OR <  12011~TC,$914.10,$679.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500633A,0450,12011,,,,,N/A,N/A,REPAIR  LAC 2.5 OR <   12011~T,$674.98,$501.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501634,0450,12013,,,,,N/A,N/A,RPR OF LAC 2.6-5.0 CM 12013~TC,$914.10,$679.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500634A,0450,12013,,,,,N/A,N/A,RPR OF LAC 2.6-5.0 CM  12013~T,$714.33,$531.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501636,0450,12014,,,,,N/A,N/A,REP LAC 5.1-7.5 CM    12014-TC,$915.11,$680.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500636A,0450,12014,,,,,N/A,N/A,REPAIR LAC 5.1-7.5 CM  12014~T,"$1,971.47","$1,465.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501637,0450,12015,,,,,N/A,N/A,REP LAC 7.6-12.5 CM   12015~TC,$915.11,$680.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500637A,0450,12015,,,,,N/A,N/A,REP LAC 7.6-12.5 CM    12015~T,$908.05,$675.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501638,0450,12016,,,,,N/A,N/A,REP LAC 12.6-20.0 CM  12016TC,$915.11,$680.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500638A,0450,12016,,,,,N/A,N/A,RPR LAC 12.6-20.0 CM   12016~T,"$1,037.19",$771.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501639,0450,12017,,,,,N/A,N/A,REP LAC 20.1-30       12017~TC,$915.11,$680.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500639A,0450,12017,,,,,N/A,N/A,REP LAC 20.1-30        12017~T,"$1,242.01",$923.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501640,0450,12018,,,,,N/A,N/A,REP LAC > 30 CM       12018~TC,$915.11,$680.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500640A,0450,12018,,,,,N/A,N/A,REP LAC >30 CM         12018~T,"$1,423.61","$1,058.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4512020A,0450,12020,,,,,N/A,N/A,"SMP CLSRE,WOUND DEHISC 12020~T","$1,047.28",$778.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4512021A,0450,12021,,,,,N/A,N/A,CLOSURE OF SPLIT WOUND 12021~T,$487.32,$362.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501610,0450,12031,,,,,N/A,N/A,2LYR CLOS 2.5 CM >    12031~TC,$915.11,$680.25,$119.72,$292.00,$119.72,$283.24,$119.72,$249.66,$119.72,$258.03,$119.72,$283.24,$119.72,$292.00,$119.72,$119.72,$283.24
4500610A,0450,12031,,,,,N/A,N/A,2LYR CLOS 2.5CM        12031~T,$738.54,$549.00,$119.72,$292.00,$119.72,$283.24,$119.72,$249.66,$119.72,$258.03,$119.72,$283.24,$119.72,$292.00,$119.72,$119.72,$283.24
4501611,0450,12032,,,,,N/A,N/A,2 LYR CLOS 2.6-7.5 CM 12032~TC,$915.11,$680.25,$161.13,$393.00,$161.13,$381.21,$161.13,$336.02,$161.13,$323.30,$161.13,$381.21,$161.13,$393.00,$161.13,$161.13,$381.21
4500611A,0450,12032,,,,,N/A,N/A,2LYR CLOS 2.6-7.5 CM  12032 ~T,$790.00,$587.25,$161.13,$393.00,$161.13,$381.21,$161.13,$336.02,$161.13,$323.30,$161.13,$381.21,$161.13,$393.00,$161.13,$161.13,$381.21
4501613,0450,12034,,,,,N/A,N/A,2 LYR CLS 7.6-12.5 CM 12034~TC,$914.10,$679.50,$168.10,$410.00,$168.10,$397.70,$168.10,$350.55,$168.10,$348.85,$168.10,$397.70,$168.10,$410.00,$168.10,$168.10,$397.70
4500613A,0450,12034,,,,,N/A,N/A,2 LYR CLOS 7.6-12.5CM  12034~T,$887.87,$660.00,$168.10,$410.00,$168.10,$397.70,$168.10,$350.55,$168.10,$348.85,$168.10,$397.70,$168.10,$410.00,$168.10,$168.10,$397.70
4501614,0450,12035,,,,,N/A,N/A,2 LYR CLOS 12.6-20    12035~TC,$922.17,$685.50,$197.21,$481.00,$197.21,$466.57,$197.21,$411.26,$197.21,$407.81,$197.21,$466.57,$197.21,$481.00,$197.21,$197.21,$466.57
4500614A,0450,12035,,,,,N/A,N/A,2 LYR CLOS 12.6-20     12035~T,$987.75,$734.25,$197.21,$481.00,$197.21,$466.57,$197.21,$411.26,$197.21,$407.81,$197.21,$466.57,$197.21,$481.00,$197.21,$197.21,$466.57
4501615,0450,12036,,,,,N/A,N/A,2 LYR CL 20.1-30.0 CM 12036~TC,$915.11,$680.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500615A,0450,12036,,,,,N/A,N/A,2 LYR CLOS 20.1-30CM   12036~T,"$1,147.16",$852.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501616,0450,12037,,,,,N/A,N/A,2 LAYER CLOS < 30 CM  12037~TC,"$4,469.60","$3,322.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500616A,0450,12037,,,,,N/A,N/A,2 LYR CLOS > 30CM      12037~T,"$2,696.90","$2,004.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501625,0450,12041,,,,,N/A,N/A,2 LYR CLO 2.5CM OR L  12041~TC,$914.10,$679.50,$134.48,$328.00,$134.48,$318.16,$134.48,$280.44,$134.48,$246.94,$134.48,$318.16,$134.48,$328.00,$134.48,$134.48,$318.16
4500625A,0450,12041,,,,,N/A,N/A,2 LYR CLOS 2.5CM OR <  12041~T,$774.87,$576.00,$134.48,$328.00,$134.48,$318.16,$134.48,$280.44,$134.48,$246.94,$134.48,$318.16,$134.48,$328.00,$134.48,$134.48,$318.16
4501627,0450,12042,,,,,N/A,N/A,2 LYR CLOS 2.6-7.5 CM 12042~TC,$915.11,$680.25,$159.90,$390.00,$159.90,$378.30,$159.90,$333.45,$159.90,$333.41,$159.90,$378.30,$159.90,$390.00,$159.90,$159.90,$378.30
4500627A,0450,12042,,,,,N/A,N/A,2 LYR CLOS 2.6-7.5C    12042~T,$831.37,$618.00,$159.90,$390.00,$159.90,$378.30,$159.90,$333.45,$159.90,$333.41,$159.90,$378.30,$159.90,$390.00,$159.90,$159.90,$378.30
4501629,0450,12044,,,,,N/A,N/A,2 LYR CLO 7.6-12.5 CM 12044~TC,$915.11,$680.25,$182.40,$444.00,$182.40,$430.68,$182.40,$379.62,$182.40,$361.63,$182.40,$430.68,$182.40,$444.00,$182.40,$182.40,$430.68
4500629A,0450,12044,,,,,N/A,N/A,2 LYR CLOS 7.6-12.5    12044~T,$933.27,$693.75,$182.40,$444.00,$182.40,$430.68,$182.40,$379.62,$182.40,$361.63,$182.40,$430.68,$182.40,$444.00,$182.40,$182.40,$430.68
4501630,0450,12045,,,,,N/A,N/A,2 LYR CLOS 12.6-20 CM 12045~TC,$915.11,$680.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500630A,0450,12045,,,,,N/A,N/A,2 LYR CLOS 12.6-20     12045~T,"$1,031.14",$766.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4507631,0450,12046,,,,,N/A,N/A,2 LYR CLOS 20.1-30 CM 12046~TC,$914.10,$679.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500631A,0450,12046,,,,,N/A,N/A,2 LYR CLOS 20.1-30 CM  12046~T,"$1,189.54",$884.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501632,0450,12047,,,,,N/A,N/A,2 LYR CLOS > 30 CM    12047~TC,"$4,471.62","$3,324.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500632A,0450,12047,,,,,N/A,N/A,2 LYR CLOS >30CM       12047~T,"$2,722.12","$2,023.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501641,0450,12051,,,,,N/A,N/A,2 LYR CLOS 2.5CM      12051~TC,$915.11,$680.25,$149.65,$365.00,$149.65,$354.05,$149.65,$312.08,$149.65,$287.31,$149.65,$354.05,$149.65,$365.00,$149.65,$149.65,$354.05
4500641A,0450,12051,,,,,N/A,N/A,2 LYR CLOS 2.5 CM <    12051~T,$801.10,$595.50,$149.65,$365.00,$149.65,$354.05,$149.65,$312.08,$149.65,$287.31,$149.65,$354.05,$149.65,$365.00,$149.65,$149.65,$354.05
4501642,0450,12052,,,,,N/A,N/A,2 LYR CLO 2.6-5.0 CM  12052~TC,$915.11,$680.25,$159.90,$390.00,$159.90,$378.30,$159.90,$333.45,$159.90,$339.25,$159.90,$378.30,$159.90,$390.00,$159.90,$159.90,$378.30
4500642A,0450,12052,,,,,N/A,N/A,2 LYR CLOS 2.5 CM <    12051~T,$837.42,$622.50,$159.90,$390.00,$159.90,$378.30,$159.90,$333.45,$159.90,$339.25,$159.90,$378.30,$159.90,$390.00,$159.90,$159.90,$378.30
4501644,0450,12053,,,,,N/A,N/A,2 LYR CLOS 5.1-7.5 CM 12053~TC,$915.11,$680.25,$179.58,$438.00,$179.58,$424.86,$179.58,$374.49,$179.58,$365.16,$179.58,$424.86,$179.58,$438.00,$179.58,$179.58,$424.86
4500644A,0450,12053,,,,,N/A,N/A,2 LYR CLOS 5.1-7.5 CM  12053~T,$920.15,$684.00,$179.58,$438.00,$179.58,$424.86,$179.58,$374.49,$179.58,$365.16,$179.58,$424.86,$179.58,$438.00,$179.58,$179.58,$424.86
4501645,0450,12054,,,,,N/A,N/A,2 LYR CLOS 7.6-12.5 C 12054~TC,$914.10,$679.50,$195.16,$476.00,$195.16,$461.72,$195.16,$406.98,$195.16,$368.30,$195.16,$461.72,$195.16,$476.00,$195.16,$195.16,$461.72
4500645A,0450,12054,,,,,N/A,N/A,2 LYR CLOS 7.6-12.5    12054~T,"$1,001.88",$744.75,$195.16,$476.00,$195.16,$461.72,$195.16,$406.98,$195.16,$368.30,$195.16,$461.72,$195.16,$476.00,$195.16,$195.16,$461.72
4501646,0450,12055,,,,,N/A,N/A,2 LYR CLOS 12.6-20.0C 12055~TC,$915.11,$680.25,$252.56,$616.00,$252.56,N/A,$252.56,$526.68,$252.56,$503.70,$252.56,N/A,$252.56,$616.00,$252.56,$252.56,N/A
4500646A,0450,12055,,,,,N/A,N/A,2 LYR CLOS 12.6-20 CM  12055~T,"$1,181.47",$878.25,$252.56,$616.00,$252.56,N/A,$252.56,$526.68,$252.56,$503.70,$252.56,N/A,$252.56,$616.00,$252.56,$252.56,N/A
4501647,0450,12056,,,,,N/A,N/A,2 LYR CLOSN 20.1-30 C 12056~TC,$915.11,$680.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500647A,0450,12056,,,,,N/A,N/A,2 LYR CLOS 20.1-30CM   12056~T,"$1,716.21","$1,275.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501648,0450,12057,,,,,N/A,N/A,2 LYR CLOS >30 CM     12057~TC,"$4,471.62","$3,324.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500648A,0450,12057,,,,,N/A,N/A,2 LYR CLOS >30 CM      12057~T,"$3,236.68","$2,406.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4513100,0450,13100,,,,,N/A,N/A,STN COMP RPR 1.1-2.5  13100~TC,"$1,157.25",$860.25,$26.64,$504.00,$26.64,$488.88,$26.64,$430.92,$26.64,$342.33,$26.64,$488.88,$26.64,$504.00,$26.64,$26.64,$488.88
4513101,0450,13101,,,,,N/A,N/A,STN COMP RPR 2.6-7CM  13101~TC,"$1,157.25",$860.25,$25.51,$611.00,$25.51,$592.67,$25.51,$522.41,$25.51,$426.93,$25.51,$592.67,$25.51,$611.00,$25.51,$25.51,$592.67
4500653A,0450,13101,,,,,N/A,N/A,COMP REPAIR 2.5-7.5 CM 13101~T,$600.32,$446.25,$25.51,$611.00,$25.51,$592.67,$25.51,$522.41,$25.51,$426.93,$25.51,$592.67,$25.51,$611.00,$25.51,$25.51,$592.67
4513102,0450,13102,,,,,N/A,N/A,SUTURING WOUND EC ADD 5CM,$220.96,$164.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4513120,0450,13120,,,,,N/A,N/A,RPR CMP 1.1-2.5CM     13120~TC,$442.92,$329.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500658A,0450,13120,,,,,N/A,N/A,COMP REP SCLP/ARM/LEG  13120~T,$850.54,$632.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500659A,0450,13121,,,,,N/A,N/A,COMP REPSCLP/ARM/LEG   13121~T,"$1,200.64",$892.50,$269.37,$657.00,$269.37,$637.29,$269.37,$561.74,$269.37,$440.29,$269.37,$637.29,$269.37,$657.00,$269.37,$269.37,$637.29
4513131,0450,13131,,,,,N/A,N/A,HNDS/FTCOMP1.1-2.5 CM 13121~TC,$442.92,$329.25,$245.18,$598.00,$245.18,$580.06,$245.18,$511.29,$245.18,$413.25,$245.18,$580.06,$245.18,$598.00,$245.18,$245.18,$580.06
4513132,0450,13132,,,,,N/A,N/A,HNDS/FT CMP2.6-7.5 CM 13132~TC,$442.92,$329.25,$26.35,$635.00,$26.35,$615.95,$26.35,$542.93,$26.35,$515.68,$26.35,$615.95,$26.35,$635.00,$26.35,$26.35,$615.95
4500655A,0450,13132,,,,,N/A,N/A,COMP REP 2.6-7.5 CM    13132~T,$876.77,$651.75,$26.35,$635.00,$26.35,$615.95,$26.35,$542.93,$26.35,$515.68,$26.35,$615.95,$26.35,$635.00,$26.35,$26.35,$615.95
4513151,0450,13151,,,,,N/A,N/A,FCE/E/E/N COMP1.1-2.5 13151~TC,$442.92,$329.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4513152,0450,13152,,,,,N/A,N/A,F/E/E/N COMP 2.6-7 CM 13152~TC,"$1,157.25",$860.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4513153A,0450,13153,,,,,N/A,N/A,"COMPLEX REPAIR, E,N,E,L",$478.24,$355.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501503,0450,16000,,,,,N/A,N/A,IST DEGREE BURN INT.  16000~TC,$671.95,$499.50,$45.51,$111.00,$45.51,$107.67,$45.51,$94.91,$45.51,$46.41,$45.51,$107.67,$45.51,$111.00,$45.51,$45.51,$107.67
4500503A,0450,16000,,,,,N/A,N/A,1ST DEGREE BURN INT    16000~T,$406.60,$302.25,$45.51,$111.00,$45.51,$107.67,$45.51,$94.91,$45.51,$46.41,$45.51,$107.67,$45.51,$111.00,$45.51,$45.51,$107.67
4501504,0450,16020,,,,,N/A,N/A,DEBRIDE SML BURN      16020-TC,$671.95,$499.50,$53.71,$131.00,$53.71,$127.07,$53.71,$112.01,$53.71,$93.42,$53.71,$127.07,$53.71,$131.00,$53.71,$53.71,$127.07
4500504A,0450,16020,,,,,N/A,N/A,DEBRIDE SML BURN       16020~T,$401.56,$298.50,$53.71,$131.00,$53.71,$127.07,$53.71,$112.01,$53.71,$93.42,$53.71,$127.07,$53.71,$131.00,$53.71,$53.71,$127.07
4501505,0450,16025,,,,,N/A,N/A,DEBRIDE MED BURN      16025-TC,$553.91,$411.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500505A,0450,16025,,,,,N/A,N/A,DEBRMT OF MEDIUM BURNS 16025~T,$525.66,$390.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501506,0450,16030,,,,,N/A,N/A,DEBRIDE LRG BURNS     16030~TC,$673.97,$501.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500506A,0450,16030,,,,,N/A,N/A,DEBRIDMNT OF LGE BURNS 1603O~T,$621.51,$462.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501507,0450,16035,,,,,N/A,N/A,ESCHAROTOMY           16035~TC,"$2,415.40","$1,795.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500507A,0450,16035,,,,,N/A,N/A,ESCHAROTOMY            16035~T,"$1,614.30","$1,200.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4517250A,0450,17250,,,,,N/A,N/A,CAUTERIZATION CHEMICAL 17250~T,$318.83,$237.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4502012A,0450,20102,,,,,N/A,N/A,WOUND EXPLORATN ABMN   201O2~T,"$5,967.88","$4,436.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501013,0450,20103,,,,,N/A,N/A,WOUND EXPLORE EXTRMY  20103~TC,$752.67,$559.50,$336.20,$820.00,$336.20,$795.40,$336.20,$701.10,$336.20,$612.09,$336.20,$795.40,$336.20,$820.00,$336.20,$336.20,$795.40
4502013A,0450,20103,,,,,N/A,N/A,WOUND EXPLORATN  EXTRY 201O3~T,"$1,008.94",$750.00,$336.20,$820.00,$336.20,$795.40,$336.20,$701.10,$336.20,$612.09,$336.20,$795.40,$336.20,$820.00,$336.20,$336.20,$795.40
4501211,0450,20520,,,,,N/A,N/A,RMV FB MUSCLE TEN/SH  20520~TC,"$1,491.21","$1,108.50",$144.32,$362.00,$144.32,$351.14,$144.32,$309.51,$144.32,$264.30,$144.32,$351.14,$144.32,$362.00,$144.32,$144.32,$351.14
4500211A,0450,20520,,,,,N/A,N/A,RMV FB MUSCLE TEN/SH   20520~T,"$1,121.94",$834.00,$144.32,$362.00,$144.32,$351.14,$144.32,$309.51,$144.32,$264.30,$144.32,$351.14,$144.32,$362.00,$144.32,$144.32,$351.14
4501227,0450,20525,,,,,N/A,N/A,F/B REMOVAL MUSCLE CP 20525~TC,"$4,612.87","$3,429.00",$236.16,$578.00,$236.16,$560.66,$236.16,$494.19,$236.16,$439.37,$236.16,$560.66,$236.16,$578.00,$236.16,$236.16,$560.66
4500227A,0450,20525,,,,,N/A,N/A,FB REMVL MUSCLE CMPLX  20525~T,"$2,696.90","$2,004.75",$236.16,$578.00,$236.16,$560.66,$236.16,$494.19,$236.16,$439.37,$236.16,$560.66,$236.16,$578.00,$236.16,$236.16,$560.66
4501229,0450,20550,,,,,N/A,N/A,INJ TENDON SHEATH     20550~TC,$793.03,$589.50,$41.41,$101.00,$41.41,$97.97,$41.41,$86.36,$41.41,$69.22,$41.41,$97.97,$41.41,$101.00,$41.41,$41.41,$97.97
4500229A,0450,20550,,,,,N/A,N/A,INJECTION TENDON SHTH  20550~T,$453.01,$336.75,$41.41,$101.00,$41.41,$97.97,$41.41,$86.36,$41.41,$69.22,$41.41,$97.97,$41.41,$101.00,$41.41,$41.41,$97.97
4520551A,0450,20551,,,,,N/A,N/A,INJ: SNGLTNDN ORGN     20551~T,$757.71,$563.25,$69.85,$337.00,$125.87,$326.89,$125.87,$288.14,$125.87,$69.85,$125.87,$326.89,$125.87,$337.00,$125.87,$125.87,$326.89
4520552A,0450,20552,,,,,N/A,N/A,INJ: TRIGER POINTS     20552~T,$757.71,$563.25,$34.30,$590.00,$34.30,$572.30,$34.30,$504.45,$34.30,$67.34,$34.30,$572.30,$34.30,$590.00,$34.30,$34.30,$572.30
4520553A,0450,20553,,,,,N/A,N/A,INJ: TRIGER POINTS     20553~T,$757.71,$563.25,$76.14,$590.00,N/A,$572.30,N/A,$504.45,N/A,$76.14,N/A,$572.30,N/A,$590.00,N/A,N/A,$572.30
4501202,0450,20600,,,,,N/A,N/A,ARTHRO SM JOINT       20600~TC,$799.08,$594.00,$39.36,$96.00,$39.36,$93.12,$39.36,$82.08,$39.36,$63.57,$39.36,$93.12,$39.36,$96.00,$39.36,$39.36,$93.12
4500202A,0450,20600,,,,,N/A,N/A,ARTHRO SM JOINT        20600~T,$439.90,$327.00,$39.36,$96.00,$39.36,$93.12,$39.36,$82.08,$39.36,$63.57,$39.36,$93.12,$39.36,$96.00,$39.36,$39.36,$93.12
4501206,0450,20605,,,,,N/A,N/A,ARTHRO INTER JOINT    20605~TC,$797.06,$592.50,$39.77,$99.00,$39.77,$96.03,$39.77,$84.65,$39.77,$66.08,$39.77,$96.03,$39.77,$99.00,$39.77,$39.77,$96.03
4500205A,0450,20605,,,,,N/A,N/A,ARTHRO INTER JOINT     20605~T,"$1,047.28",$778.50,$39.77,$99.00,$39.77,$96.03,$39.77,$84.65,$39.77,$66.08,$39.77,$96.03,$39.77,$99.00,$39.77,$39.77,$96.03
4500209,0450,20610,,,,,N/A,N/A,ARTHRO MAJOR JOINT    20610~TC,$456.04,$339.00,$51.25,$125.00,$51.25,$121.25,$51.25,$106.88,$51.25,$80.71,$51.25,$121.25,$51.25,$125.00,$51.25,$51.25,$121.25
4500208A,0450,20610,,,,,N/A,N/A,ARTHRO MAJOR JOINT     20610~T,$477.23,$354.75,$51.25,$125.00,$51.25,$121.25,$51.25,$106.88,$51.25,$80.71,$51.25,$121.25,$51.25,$125.00,$51.25,$51.25,$121.25
4501334,0450,21300,,,,,N/A,N/A,FRACTURED SKULL CLSD  21300~TC,"$4,442.36","$3,302.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4521315A,0450,21315,,,,,N/A,N/A,CLSED TREAT OF NASAL BONE FX~T,$205.82,$153.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4521320A,0450,21320,,,,,N/A,N/A,FRACTURE/DISLOC PROC ON HEAD~T,$205.82,$153.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500315,0450,21480,,,,,N/A,N/A,DISC TEMP JOINT,$528.68,$393.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4521480A,0450,21480,,,,,N/A,N/A,RESET DISLOCATED JAW   21480~T,$636.64,$473.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501337,0450,21820,,,,,N/A,N/A,TRTMNT STERNUM FRACT  21820-TC,$616.46,$458.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500337A,0450,21820,,,,,N/A,N/A,FX STERNUM CLOSED    21820  ~T,$566.02,$420.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501339,0450,22310,,,,,N/A,N/A,TRTMNT SPINE FRACTURE 22310-TC,$616.46,$458.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500339A,0450,22310,,,,,N/A,N/A,FX VERTEBRAL BODY    2231054~T,$884.84,$657.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501279,0450,23330,,,,,N/A,N/A,RMV FB SHLDR SUBCUT   23330-TC,"$1,491.21","$1,108.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500279A,0450,23330,,,,,N/A,N/A,RMV FB SHLDR SUBCUT    23330~T,"$1,233.93",$917.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501340,0450,23500,,,,,N/A,N/A,TRTMNT CLAVICLE FRACT 23500-TC,"$1,762.62","$1,310.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500340A,0450,23500,,,,,N/A,N/A,FX CLAVICLE CLOSED     23500~T,"$1,214.76",$903.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500341A,0450,23505,,,,,N/A,N/A,FX CLAVICLE W MANPLTN  23505~T,$433.84,$322.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501342,0450,23520,,,,,N/A,N/A,TRTMNT CLAVICLE DIS   23520-TC,$616.46,$458.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500342A,0450,23520,,,,,N/A,N/A,DSLST CLAVICULAR     2352054~T,$765.79,$569.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4523525A,0450,23525,,,,,N/A,N/A,CLSD TX STERNO CLAV    23525~T,"$1,132.03",$841.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501316,0450,23540,,,,,N/A,N/A,DISLOCATED CLSD AC JT 23540-TC,$616.46,$458.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500316A,0450,23540,,,,,N/A,N/A,DISC CLSD AC JOIN    2354054~T,$776.88,$577.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4523545A,0450,23545,,,,,N/A,N/A,TREAT CLAVICLE DISLOCATION  ~T,$842.46,$626.25,$251.74,$251.74,$251.74,N/A,$251.74,N/A,$251.74,N/A,$251.74,N/A,$251.74,N/A,$251.74,$251.74,N/A
4501343,0450,23570,,,,,N/A,N/A,TMT SHLDR BLDE FX     23570~TC,$616.46,$458.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500343A,0450,23570,,,,,N/A,N/A,FX SCAPULA CLOS      2357054~T,$797.06,$592.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501344,0450,23600,,,,,N/A,N/A,TRMT OF HUMERUS FRAC  2360O-TC,$778.90,$579.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500344A,0450,23600,,,,,N/A,N/A,FX HUMERAL NC CLOSE  2360054~T,"$1,082.59",$804.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501345,0450,23620,,,,,N/A,N/A,TRMT OF HUMERUS FRAC  23620-TC,$778.90,$579.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500345A,0450,23620,,,,,N/A,N/A,FX GRT ERTUBEROSITY  2362054~T,$946.39,$703.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501317,0450,23650,,,,,N/A,N/A,CLOSED SHLDR W/O ANES 23650-TC,$616.46,$458.25,$171.38,"$1,367.70",$171.38,"$1,367.70",$171.38,$357.39,$171.38,$528.05,$171.38,"$1,367.70",$171.38,$418.00,$171.38,$171.38,"$1,367.70"
4500317A,0450,23650,,,,,N/A,N/A,CLSD SHLDER W/O ANS  2365054~T,$616.46,$458.25,$171.38,"$1,367.70",$171.38,"$1,367.70",$171.38,$357.39,$171.38,$528.05,$171.38,"$1,367.70",$171.38,$418.00,$171.38,$171.38,"$1,367.70"
4500346A,0450,23655,,,,,N/A,N/A,DISLOC SHLDR W ANES  2365554~T,"$2,270.12","$1,687.50",$336.20,$820.00,$336.20,$405.46,$336.20,$701.10,$336.20,$735.61,$336.20,$405.46,$336.20,$820.00,$336.20,$336.20,$405.46
4523665,0450,23665,,,,,N/A,N/A,TREAT DISLOCATION/FRACTURE,"$1,175.42",$873.75,$352.60,$860.00,$352.60,$795.40,$352.60,$735.30,$352.60,$718.27,$352.60,$795.40,$352.60,$860.00,$352.60,$352.60,$795.40
4523931A,0450,23931,,,,,N/A,N/A,I&D UPPER ARMS; BURSA  23931~T,"$5,936.60","$4,413.00",$128.33,$479.18,$128.33,$479.18,$128.33,$267.62,$128.33,$286.94,$128.33,$479.18,$128.33,$313.00,$128.33,$128.33,$479.18
4501298,0450,24200,,,,,N/A,N/A,REM FB UPER ARM/ELBOW 24200-TC,"$1,357.02","$1,008.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500298A,0450,24200,,,,,N/A,N/A,REM FB UPPER ARM/ELBW  24200~T,"$1,087.64",$808.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501347,0450,24500,,,,,N/A,N/A,TRMT OF HUMERUS FRAC  24500-TC,$778.90,$579.00,$264.86,$646.00,$264.86,$626.62,$264.86,$552.33,$264.86,$602.39,$264.86,$626.62,$264.86,$646.00,$264.86,$264.86,$626.62
4500347A,0450,24500,,,,,N/A,N/A,FX HUMERALSHAFT CLSD 2450054~T,"$1,117.91",$831.00,$264.86,$646.00,$264.86,$626.62,$264.86,$552.33,$264.86,$602.39,$264.86,$626.62,$264.86,$646.00,$264.86,$264.86,$626.62
4512453,0450,24530,,,,,N/A,N/A,FX HUMERAL TRANSCONDY 24530~TC,$823.30,$612.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4502453A,0450,24530,,,,,N/A,N/A,FX HUMRL TRNSCNDY LA 2453054~T,"$1,091.67",$811.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4512456,0450,24560,,,,,N/A,N/A,FX HUMERAL EPICNDYLAR 24560~TC,$813.21,$604.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4502456A,0450,24560,,,,,N/A,N/A,FX HUMERALEPCONDYLAR 2456054~T,$998.85,$742.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501318,0450,24600,,,,,N/A,N/A,DISL CLOSED ELBOW     24600~TC,$813.21,$604.50,$295.20,$720.00,$295.20,$698.40,$295.20,$615.60,$295.20,$606.06,$295.20,$698.40,$295.20,$720.00,$295.20,$295.20,$698.40
4500318A,0450,24600,,,,,N/A,N/A,DISC CLSD ELBOW      2460054~T,"$1,330.79",$989.25,$295.20,$720.00,$295.20,$698.40,$295.20,$615.60,$295.20,$606.06,$295.20,$698.40,$295.20,$720.00,$295.20,$295.20,$698.40
4500348A,0450,24605,,,,,N/A,N/A,DISLOC ELBOW W ANES  246O554~T,"$2,242.87","$1,667.25",$415.33,"$1,013.00",$415.33,$982.61,$415.33,$866.12,$415.33,$861.15,$415.33,$982.61,$415.33,"$1,013.00",$415.33,$415.33,$982.61
4501319,0450,24640,,,,,N/A,N/A,DISC RAD HEAD SUB CH  24640~TC,$813.21,$604.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500319A,0450,24640,,,,,N/A,N/A,DISC RAD HEAD SU CH  2464054~T,$661.86,$492.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501349,0450,24650,,,,,N/A,N/A,FX RAD HEAD W/O MANIP 24650~TC,$813.21,$604.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500349A,0450,24650,,,,,N/A,N/A,FX RADL HEAD W/OMANI 2465054~T,$874.75,$650.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4512467,0450,24670,,,,,N/A,N/A,FX PROXIMAL ULNA      24670~TC,$813.21,$604.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4502467A,0450,24670,,,,,N/A,N/A,FX PROXIMAL ULNA     2467054~T,$988.76,$735.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4524675,0450,24675,,,,,N/A,N/A,"CLSD TX PROX ULNA FX,W/MAN -TC","$2,465.85","$1,833.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501350,0450,25500,,,,,N/A,N/A,FX RADIAL SHAFT       25500~TC,$813.21,$604.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500350A,0450,25500,,,,,N/A,N/A,FX RADIAL SHAFT      2550054~T,$908.05,$675.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501351,0450,25530,,,,,N/A,N/A,FX ULNAR SHAFT        25530~TC,$778.90,$579.00,$189.42,$462.00,$189.42,$448.14,$189.42,$395.01,$189.42,$441.10,$189.42,$448.14,$189.42,$462.00,$189.42,$189.42,$448.14
4500351A,0450,25530,,,,,N/A,N/A,FX ULNAR SHAFT       2553054~T,$866.68,$644.25,$189.42,$462.00,$189.42,$448.14,$189.42,$395.01,$189.42,$441.10,$189.42,$448.14,$189.42,$462.00,$189.42,$189.42,$448.14
4501352,0450,25560,,,,,N/A,N/A,FRACTURE RADIUS/ULNA  25560~TC,$813.21,$604.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500352A,0450,25560,,,,,N/A,N/A,FX ULNAR & RADIA SFT 25560  ~T,$487.32,$362.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4525565,0450,25565,,,,,N/A,N/A,CLOSED TREATMENT OF RADIAL FX,"$2,638.38","$1,961.25",$425.99,"$1,039.00",$425.99,"$1,007.83",$425.99,$888.35,$425.99,$835.25,$425.99,"$1,007.83",$425.99,"$1,039.00",$425.99,$425.99,"$1,007.83"
4501353,0450,25600,,,,,N/A,N/A,TRTMT- FX RADIUS/ULNA 25600~TC,$813.21,$604.50,$215.25,$585.83,$215.25,$509.25,$215.25,$448.88,$215.25,$585.83,$215.25,$509.25,$215.25,$525.00,$215.25,$215.25,$509.25
4500353A,0450,25600,,,,,N/A,N/A,FX DISTAL SHAFT      25600  ~T,$951.43,$707.25,$215.25,$585.83,$215.25,$509.25,$215.25,$448.88,$215.25,$585.83,$215.25,$509.25,$215.25,$525.00,$215.25,$215.25,$509.25
4525605,0450,25605,,,,,N/A,N/A,TREATMENT OF FX W/MANIPULATION,"$1,604.21","$1,192.50",$599.42,"$1,462.00",$599.42,"$1,418.14",$599.42,"$1,250.01",$599.42,$920.22,$599.42,"$1,418.14",$599.42,"$1,462.00",$599.42,$599.42,"$1,418.14"
4501354,0450,25622,,,,,N/A,N/A,FX CARPAL SCAPHOID    25622~TC,$813.21,$604.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500354A,0450,25622,,,,,N/A,N/A,FX CARPAL SCAPHOID   2562254~T,$942.35,$700.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4525630A,0450,25630,,,,,N/A,N/A,CLSED FX CARPAL BONE W/O MAN~T,$389.45,$289.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501355,0450,25650,,,,,N/A,N/A,FX-ULNAR/STYLOID      25650~TC,$830.36,$617.25,$239.30,$583.00,$239.30,$565.51,$239.30,$498.47,$239.30,$553.52,$239.30,$565.51,$239.30,$583.00,$239.30,$239.30,$565.51
4500355A,0450,25650,,,,,N/A,N/A,FX ULNAR STYLOID     2565054~G,"$1,008.94",$750.00,$239.30,$583.00,$239.30,$565.51,$239.30,$498.47,$239.30,$553.52,$239.30,$565.51,$239.30,$583.00,$239.30,$239.30,$565.51
4501356,0450,25690,,,,,N/A,N/A,TRTMT OF WRIST DIS    25690~TC,$823.30,$612.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500356A,0450,25690,,,,,N/A,N/A,DISLOCATION LUNATE     25690~T,"$1,747.48","$1,299.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501408,0450,26010,,,,,N/A,N/A,DRAIN FINGER ABSCESS  26010~TC,$506.49,$376.50,$126.69,$126.69,$126.69,N/A,$126.69,N/A,$126.69,N/A,$126.69,N/A,$126.69,N/A,$126.69,$126.69,N/A
4500408A,0450,26010,,,,,N/A,N/A,I&D FINGER ABS SIMPL   26010~T,$533.73,$396.75,$126.69,$126.69,$126.69,N/A,$126.69,N/A,$126.69,N/A,$126.69,N/A,$126.69,N/A,$126.69,$126.69,N/A
4501657,0450,26410,,,,,N/A,N/A,EXT TEND REP DORS HD  26410~TC,"$4,186.09","$3,111.75",$623.20,$623.20,$623.20,N/A,$623.20,N/A,$623.20,N/A,$623.20,N/A,$623.20,N/A,$623.20,$623.20,N/A
4500657A,0450,26410,,,,,N/A,N/A,EXT TEND REP DORS HD 2641054~T,"$3,586.78","$2,666.25",$623.20,$623.20,$623.20,N/A,$623.20,N/A,$623.20,N/A,$623.20,N/A,$623.20,N/A,$623.20,$623.20,N/A
4501656,0450,26418,,,,,N/A,N/A,EXT OF TEN REP DOR FG 26418~TC,"$4,186.09","$3,111.75",$464.53,$464.53,$464.53,N/A,$464.53,N/A,$464.53,N/A,$464.53,N/A,$464.53,N/A,$464.53,$464.53,N/A
4500656A,0450,26418,,,,,N/A,N/A,EXT TEND REP DORS FG 2641854~T,"$3,518.17","$2,615.25",$464.53,$464.53,$464.53,N/A,$464.53,N/A,$464.53,N/A,$464.53,N/A,$464.53,N/A,$464.53,$464.53,N/A
4501331,0450,26600,,,,,N/A,N/A,CL/FX METACARPAL      26600~TC,$823.30,$612.00,$216.89,$216.89,$216.89,N/A,$216.89,N/A,$216.89,N/A,$216.89,N/A,$216.89,N/A,$216.89,$216.89,N/A
4500331A,0450,26600,,,,,N/A,N/A,CL/FX METACARPAL SG  2660054~T,$830.36,$617.25,$216.89,$216.89,$216.89,N/A,$216.89,N/A,$216.89,N/A,$216.89,N/A,$216.89,N/A,$216.89,$216.89,N/A
4526605A,0450,26605,,,,,N/A,N/A,TREAT METACARPAL FRACTURE   ~T,$104.93,$78.00,$249.69,$249.69,$249.69,N/A,$249.69,N/A,$249.69,N/A,$249.69,N/A,$249.69,N/A,$249.69,$249.69,N/A
4501320,0450,26641,,,,,N/A,N/A,DISC CARPOMET THUMB   26641~TC,$823.30,$612.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500320A,0450,26641,,,,,N/A,N/A,DISC CARPOMET THUMB  2664154~T,"$1,250.08",$929.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501357,0450,26645,,,,,N/A,N/A,TRMT OF THUMB FRAC    26645~TC,$823.30,$612.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500357A,0450,26645,,,,,N/A,N/A,FX CARPOMETACARPAL   2664554~T,"$1,377.20","$1,023.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501441,0450,26670,,,,,N/A,N/A,DISLOCATED FINGER     22670~TC,$616.46,$458.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500441A,0450,26670,,,,,N/A,N/A,DSLC CARPOMETACARPAL 2667054~T,"$1,085.62",$807.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501321,0450,26700,,,,,N/A,N/A,DISLOCATED MCP JOINT  26700~TC,$616.46,$458.25,$249.69,$249.69,$249.69,N/A,$249.69,N/A,$249.69,N/A,$249.69,N/A,$249.69,N/A,$249.69,$249.69,N/A
4500321A,0450,26700,,,,,N/A,N/A,DIS CARPOMETACARPAL  26700  ~T,"$1,027.10",$763.50,$249.69,$249.69,$249.69,N/A,$249.69,N/A,$249.69,N/A,$249.69,N/A,$249.69,N/A,$249.69,$249.69,N/A
4501442,0450,26705,,,,,N/A,N/A,KNUCKLE DISLOCATION   26705~TC,"$4,068.05","$3,024.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500442A,0450,26705,,,,,N/A,N/A,DSLC MP FGR W ANEST  2670554~T,"$1,344.92",$999.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501332,0450,26720,,,,,N/A,N/A,TRTMNT OF FINGER FX   26720~TC,$690.11,$513.00,$145.14,$145.14,$145.14,N/A,$145.14,N/A,$145.14,N/A,$145.14,N/A,$145.14,N/A,$145.14,$145.14,N/A
4500332A,0450,26720,,,,,N/A,N/A,CL/FX PHALANGEAL EA  2672054~T,$636.64,$473.25,$145.14,$145.14,$145.14,N/A,$145.14,N/A,$145.14,N/A,$145.14,N/A,$145.14,N/A,$145.14,$145.14,N/A
4501358,0450,26725,,,,,N/A,N/A,TRTMT OF FINGER FRAC  26724~TC,$616.46,$458.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500358A,0450,26725,,,,,N/A,N/A,FX PHLNGEAL SHFT/MA  2672554~T,"$1,065.44",$792.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501359,0450,26727,,,,,N/A,N/A,TRTMT OF FINGER FRACTURE   -TC,"$5,991.09","$4,453.50",$439.11,$439.11,$439.11,N/A,$439.11,N/A,$439.11,N/A,$439.11,N/A,$439.11,N/A,$439.11,$439.11,N/A
4500359A,0450,26727,,,,,N/A,N/A,FX PHALANGEALSHFT/PRCT 26727~T,"$3,817.83","$2,838.00",$439.11,$439.11,$439.11,N/A,$439.11,N/A,$439.11,N/A,$439.11,N/A,$439.11,N/A,$439.11,$439.11,N/A
4526742,0450,26742,,,,,N/A,N/A,TREATMENT OF ARTICULAR FX,"$1,704.10","$1,266.75",$273.47,$273.47,$273.47,N/A,$273.47,N/A,$273.47,N/A,$273.47,N/A,$273.47,N/A,$273.47,$273.47,N/A
4500333A,0450,26750,,,,,N/A,N/A,CL/FX DISTAL PHAL E  26750  ~T,$674.98,$501.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501333A,0450,26750,,,,,N/A,N/A,TREATMENT FINGER FX    26750~T,$626.55,$465.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501360,0450,26755,,,,,N/A,N/A,TRTMT OF FINGER FRAC  26755~TC,$609.40,$453.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500360A,0450,26755,,,,,N/A,N/A,FX DSTL PHLNX MANI   2675554~T,"$1,124.97",$836.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501361,0450,26765,,,,,N/A,N/A,TRTMT OF FINGER FRAC  26770~TC,"$8,223.87","$6,113.25",$47.13,$47.13,$47.13,N/A,$47.13,N/A,$47.13,N/A,$47.13,N/A,$47.13,N/A,$47.13,$47.13,N/A
4526765,0450,26765,,,,,N/A,N/A,"TREAT FINGER FRACTURE, EACH","$1,138.08",$846.00,$47.13,$47.13,$47.13,N/A,$47.13,N/A,$47.13,N/A,$47.13,N/A,$47.13,N/A,$47.13,$47.13,N/A
4500361A,0450,26765,,,,,N/A,N/A,FX PHLNX DISTAL OPN         ~T,"$4,497.85","$3,343.50",$47.13,$47.13,$47.13,N/A,$47.13,N/A,$47.13,N/A,$47.13,N/A,$47.13,N/A,$47.13,$47.13,N/A
4501325,0450,26770,,,,,N/A,N/A,DSLCTD IP JNTS FNGRS  26775~TC,$466.13,$346.50,$27.50,$27.50,$27.50,N/A,$27.50,N/A,$27.50,N/A,$27.50,N/A,$27.50,N/A,$27.50,$27.50,N/A
4500325A,0450,26770,,,,,N/A,N/A,DISC IPJOINTS FINGER  26770 ~T,$466.13,$346.50,$27.50,$27.50,$27.50,N/A,$27.50,N/A,$27.50,N/A,$27.50,N/A,$27.50,N/A,$27.50,$27.50,N/A
4501362,0450,26775,,,,,N/A,N/A,FINGER DISLOCATION    26775~TC,"$4,068.05","$3,024.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500362A,0450,26775,,,,,N/A,N/A,DSLC IP FINGER WANEST  26775~T,"$2,614.16","$1,943.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
45026951,0450,26951,,,,,N/A,N/A,AMPUTATION PHALANX HAND,"$1,898.83","$1,411.50",$555.96,$555.96,$555.96,N/A,$555.96,N/A,$555.96,N/A,$555.96,N/A,$555.96,N/A,$555.96,$555.96,N/A
4501219,0450,27086,,,,,N/A,N/A,RMV FB PELVIS/HIP     27086-TC,"$1,491.21","$1,108.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500219A,0450,27086,,,,,N/A,N/A,RMV FB PELVIS/HIP      27086~T,"$1,090.66",$810.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501363,0450,27200,,,,,N/A,N/A,TAIL BONE FRACTURE    27200~TC,$616.46,$458.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500363A,0450,27200,,,,,N/A,N/A,FX COCCYX CLOSED     2720054~T,$772.85,$574.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4527250,0450,27250,,,,,N/A,N/A,"CLSD TX OF HIP DISLOC,W/O ANES",$488.33,$363.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4527265A,0450,27265,,,,,N/A,N/A,CLSD HIP RDS/P RPLMT   27265~T,$591.24,$439.50,$375.56,$375.56,$375.56,N/A,$375.56,N/A,$375.56,N/A,$375.56,N/A,$375.56,N/A,$375.56,$375.56,N/A
4527508A,0450,27508,,,,,N/A,N/A,TREATMENT OF THIGH FRACTURE ~T,$105.94,$78.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501369,0450,27520,,,,,N/A,N/A,TRTMT OF KNEE CAP FX  27520~TC,$823.30,$612.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500369A,0450,27520,,,,,N/A,N/A,FX PATELLA           2752054~T,"$1,050.31",$780.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4527530A,0450,27530,,,,,N/A,N/A,CLSD TMT TBL FRX PRCML 27530~T,"$2,267.09","$1,685.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500322A,0450,27550,,,,,N/A,N/A,CLSD TRMT TIBIAL SHAFT 27750~T,$518.60,$385.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501370,0450,27560,,,,,N/A,N/A,TRMT KNEE CAP DSLCTN  27560~TC,$823.30,$612.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500323A,0450,27560,,,,,N/A,N/A,DISCLOCATION PTLLR   2756054~T,$876.77,$651.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500370A,0450,27560,,,,,N/A,N/A,DISLOCATION PATELLA  2756054~T,"$1,175.42",$873.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501436,0450,27603,,,,,N/A,N/A,DRAIN LWR LEG LESION  27603~TC,"$2,284.24","$1,698.00",$414.51,"$1,011.00",$414.51,$980.67,$414.51,$864.41,$414.51,$699.71,$414.51,$980.67,$414.51,"$1,011.00",$414.51,$414.51,$980.67
4500436A,0450,27603,,,,,N/A,N/A,I&D ABSCSS ANKLE/LEG 2760354~T,"$2,456.77","$1,826.25",$414.51,"$1,011.00",$414.51,$980.67,$414.51,$864.41,$414.51,$699.71,$414.51,$980.67,$414.51,"$1,011.00",$414.51,$414.51,$980.67
4501371,0450,27750,,,,,N/A,N/A,TRTMT OF TIBIA FX     27750~TC,$813.21,$604.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500371A,0450,27750,,,,,N/A,N/A,FX TIBIAL SHAFT      2775054~T,"$1,165.33",$866.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4527752,0450,27752,,,,,N/A,N/A,CLOSED TREATMENT TIB SHAF FX,"$3,311.34","$2,461.50",$444.44,"$1,084.00",$444.44,"$1,051.48",$444.44,$926.82,$444.44,$882.83,$444.44,"$1,051.48",$444.44,"$1,084.00",$444.44,$444.44,"$1,051.48"
4501372,0450,27760,,,,,N/A,N/A,TRTMT OF ANKLE FX     27760~TC,$813.21,$604.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500372A,0450,27760,,,,,N/A,N/A,FX DISTAL MEDIAL MA  27760  ~T,"$1,064.43",$791.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4527767A,0450,27767,,,,,N/A,N/A,CLOSED TREAT POST MAL FX    ~T,$775.87,$576.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4527768A,0450,27768,,,,,N/A,N/A,TX POST MALL FX        27768~T,$401.56,$298.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501373,0450,27780,,,,,N/A,N/A,TRTMT FX FIBULA       27780~TC,$823.30,$612.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500373A,0450,27780,,,,,N/A,N/A,FX FIBULA            2778054~T,$990.78,$736.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4527786A,0450,27786,,,,,N/A,N/A,CLSD TX DISTAL FIBULA FX    ~T,$712.31,$529.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4527788A,0450,27788,,,,,N/A,N/A,TREATMENT OF ANKLE FRACTURE ~T,$968.58,$720.00,$694.74,$855.00,N/A,$829.35,N/A,$731.03,N/A,$694.74,N/A,$829.35,N/A,$855.00,N/A,N/A,$829.35
4527808,0450,27808,,,,,N/A,N/A,TREATMENT OF  ANKLE FRACTURE,$725.43,$539.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4527810A,0450,27810,,,,,N/A,N/A,TREATMENT OF ANKLE FRACTURE ~T,$210.87,$156.75,$256.66,$764.31,$256.66,$607.22,$256.66,$535.23,$256.66,$764.31,$256.66,$607.22,$256.66,$626.00,$256.66,$256.66,$607.22
4527818A,0450,27818,,,,,N/A,N/A,TRMNT ANKLE FRACTURE 2781854-T,$572.07,$425.25,$41.41,"$1,001.00",$41.41,$970.97,$41.41,$855.86,$41.41,$783.77,$41.41,$970.97,$41.41,"$1,001.00",$41.41,$41.41,$970.97
4527825A,0450,27825,,,,,N/A,N/A,TREAT LOWER LEG FRACTURE    ~T,$983.72,$731.25,$447.31,"$1,091.00",$447.31,"$1,058.27",$447.31,$932.81,$447.31,$880.73,$447.31,"$1,058.27",$447.31,"$1,091.00",$447.31,$447.31,"$1,058.27"
4501324,0450,27840,,,,,N/A,N/A,DISLOCATED ANKLE      27840~TC,$813.21,$604.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500324A,0450,27840,,,,,N/A,N/A,DISC ANKLE           2784054~T,"$1,414.53","$1,051.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501223,0450,28190,,,,,N/A,N/A,RMVL FB FOOT SUBCUT   28190~TC,"$1,491.21","$1,108.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500223A,0450,28190,,,,,N/A,N/A,RMV FB FOOT SUBCUT   2819054~T,"$1,107.82",$823.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501228,0450,28192,,,,,N/A,N/A,RMV FB FOOT DEEP      28192~TC,"$3,881.39","$2,885.25",$318.16,$776.00,$318.16,$752.72,$318.16,$663.48,$318.16,$559.29,$318.16,$752.72,$318.16,$776.00,$318.16,$318.16,$752.72
4500228A,0450,28192,,,,,N/A,N/A,RMV FB FOOT DEEP       28192~T,"$2,614.16","$1,943.25",$318.16,$776.00,$318.16,$752.72,$318.16,$663.48,$318.16,$559.29,$318.16,$752.72,$318.16,$776.00,$318.16,$318.16,$752.72
45028400A,0450,28400,,,,,N/A,N/A,"CLSD TX CALCANL FX,W/OMANIP ~T",$389.45,$289.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4528430A,0450,28430,,,,,N/A,N/A,TREATMENT OF FX/DISL FOOT/TOE,$515.57,$383.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4528435,0450,28435,,,,,N/A,N/A,TREATMENT OF ANKLE FRACTURE ~T,$791.01,$588.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501375,0450,28450,,,,,N/A,N/A,TRTMT OF MID FOOT FX  28450~TC,$813.21,$604.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500375A,0450,28450,,,,,N/A,N/A,FX TARSAL            2845054~T,$918.14,$682.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500328A,0450,28470,,,,,N/A,N/A,CL/FX METATARSAL E   28470  ~T,$883.83,$657.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501328A,0450,28470,,,,,N/A,N/A,CL/FX METATARSAL EA    28470~T,$308.74,$229.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4528475A,0450,28475,,,,,N/A,N/A,TREATMENT OF METATARSAL FX  ~T,$340.01,$252.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501329,0450,28490,,,,,N/A,N/A,CL/FX GREAT TOE       28490~TC,$624.53,$464.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500329A,0450,28490,,,,,N/A,N/A,CL/FX GREAT TOE      28490  ~T,$572.07,$425.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501330,0450,28510,,,,,N/A,N/A,CL/FX OTHER TOES      28510~TC,$616.46,$458.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500330A,0450,28510,,,,,N/A,N/A,CL/FX OTHER TOES     2851054~T,$572.07,$425.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501376,0450,28515,,,,,N/A,N/A,TRTMT OF TOE FRACTURE 28515~TC,$616.46,$458.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500376A,0450,28515,,,,,N/A,N/A,FX OTHER TOE W MANIP 2851554~T,$621.51,$462.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501377,0450,28530,,,,,N/A,N/A,FX SESAMOID           28530~TC,$813.21,$604.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500377A,0450,28530,,,,,N/A,N/A,FX SESAMOID          2853054~T,$675.99,$502.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501327,0450,28630,,,,,N/A,N/A,DSLCTED MTP JOINT     28630~TC,$616.46,$458.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500327A,0450,28630,,,,,N/A,N/A,DISC MTP JOINT         28630~T,$646.73,$480.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501326,0450,28660,,,,,N/A,N/A,DISLCTD IP JNTS  TOES 28660~TC,$616.46,$458.25,$77.90,$190.00,$77.90,$184.30,$77.90,$162.45,$77.90,$164.42,$77.90,$184.30,$77.90,$190.00,$77.90,$77.90,$184.30
4500326A,0450,28660,,,,,N/A,N/A,DISC IPJOINTS TOES   2866054~T,$610.41,$453.75,$77.90,$190.00,$77.90,$184.30,$77.90,$162.45,$77.90,$164.42,$77.90,$184.30,$77.90,$190.00,$77.90,$77.90,$184.30
4501382,0450,28665,,,,,N/A,N/A,DISC TOE W ANESTH     28665~TC,"$8,223.87","$6,113.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500382A,0450,28665,,,,,N/A,N/A,DISLOCATION TOE W ANES 28665~T,"$3,756.28","$2,792.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4528675,0450,28675,,,,,N/A,N/A,TREATMENT OF FX/DISLOCATION,"$4,105.38","$3,051.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4529065A,0450,29065,,,,,N/A,N/A,LONG ARM CAST APPLICATION   ~T,$470.17,$349.50,$98.40,$240.00,$98.40,$232.80,$98.40,$205.20,$98.40,$120.15,$98.40,$232.80,$98.40,$240.00,$98.40,$98.40,$232.80
4529075A,0450,29075,,,,,N/A,N/A,SHORT ARM CAST APPLICATION  ~T,$470.17,$349.50,$56.58,$138.00,$56.58,$133.86,$56.58,$117.99,$56.58,$110.37,$56.58,$133.86,$56.58,$138.00,$56.58,$56.58,$133.86
4501383,0450,29105,,,,,N/A,N/A,LONG ARM SPLINT       29105~TC,$358.17,$266.25,$54.12,$132.00,$54.12,$128.04,$54.12,$112.86,$54.12,$73.88,$54.12,$128.04,$54.12,$132.00,$54.12,$54.12,$128.04
4500383A,0450,29105,,,,,N/A,N/A,LONG ARM SPLINT APP    29105~T,$300.66,$223.50,$54.12,$132.00,$54.12,$128.04,$54.12,$112.86,$54.12,$73.88,$54.12,$128.04,$54.12,$132.00,$54.12,$54.12,$128.04
4501384,0450,29125,,,,,N/A,N/A,SHORT ARM SPLINT APP  29125~TC,$358.17,$266.25,$36.49,$93.00,$36.49,$90.21,$36.49,$79.52,$36.49,$70.50,$36.49,$90.21,$36.49,$93.00,$36.49,$36.49,$90.21
4500384A,0450,29125,,,,,N/A,N/A,SHORT ARM SPLINT APP   29125~T,$252.24,$187.50,$36.49,$93.00,$36.49,$90.21,$36.49,$79.52,$36.49,$70.50,$36.49,$90.21,$36.49,$93.00,$36.49,$36.49,$90.21
4501385,0450,29130,,,,,N/A,N/A,FGRS/HAND SPLINT APP  29130~TC,$658.84,$489.75,$26.65,$65.00,$26.65,$63.05,$26.65,$55.58,$26.65,$50.99,$26.65,$63.05,$26.65,$65.00,$26.65,$26.65,$63.05
4500385A,0450,29130,,,,,N/A,N/A,FINGERS/HAND SPLT APP  29130~T,$233.07,$173.25,$26.65,$65.00,$26.65,$63.05,$26.65,$55.58,$26.65,$50.99,$26.65,$63.05,$26.65,$65.00,$26.65,$26.65,$63.05
4501388,0450,29240,,,,,N/A,N/A,SHOULDER SPLINT APP   29240~TC,$658.84,$489.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500388A,0450,29240,,,,,N/A,N/A,SHOULDER SPLINT APP    29240~T,$389.45,$289.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501387,0450,29260,,,,,N/A,N/A,ELBOW/WRIST SPLT APP  29260~TC,$658.84,$489.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500387A,0450,29260,,,,,N/A,N/A,ELBOW/WRIST SPLT APP   29260~T,$361.20,$268.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501389,0450,29280,,,,,N/A,N/A,STRAPPING FINGER/HAND 29280~TC,$658.84,$489.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500389A,0450,29280,,,,,N/A,N/A,STRAPPING FNGR/HAND    29280~T,$453.01,$336.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4529345A,0450,29345,,,,,N/A,N/A,LONG LEG CAST APPLICATION   ~T,$470.17,$349.50,$96.35,$235.00,$96.35,$227.95,$96.35,$200.93,$96.35,$175.91,$96.35,$227.95,$96.35,$235.00,$96.35,$96.35,$227.95
4529405A,0450,29405,,,,,N/A,N/A,SHORT LEG CAST APPLICATION  ~T,$470.17,$349.50,$12.90,$150.00,$12.90,$145.50,$12.90,$128.25,$12.90,$103.99,$12.90,$145.50,$12.90,$150.00,$12.90,$12.90,$145.50
4501390,0450,29505,,,,,N/A,N/A,LONG LEG SPLINT APP   29505~TC,$416.69,$309.75,$41.00,$100.00,$41.00,$97.00,$41.00,$85.50,$41.00,$91.41,$41.00,$97.00,$41.00,$100.00,$41.00,$41.00,$97.00
4500390A,0450,29505,,,,,N/A,N/A,LONG LEG SPLINT APP    29505~T,$308.74,$229.50,$41.00,$100.00,$41.00,$97.00,$41.00,$85.50,$41.00,$91.41,$41.00,$97.00,$41.00,$100.00,$41.00,$41.00,$97.00
4501391,0450,29515,,,,,N/A,N/A,SHORT LEG SPLINT APP 29515~TC,$420.73,$312.75,$46.74,$114.00,$46.74,$110.58,$46.74,$97.47,$46.74,$86.92,$46.74,$110.58,$46.74,$114.00,$46.74,$46.74,$110.58
4500391A,0450,29515,,,,,N/A,N/A,SHORT LEG SPLINT APP   29515~T,$304.70,$226.50,$46.74,$114.00,$46.74,$110.58,$46.74,$97.47,$46.74,$86.92,$46.74,$110.58,$46.74,$114.00,$46.74,$46.74,$110.58
4500392A,0450,29530,,,,,N/A,N/A,STRAPPING KNEE         29530~T,$311.76,$231.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500393A,0450,29540,,,,,N/A,N/A,STRAPPING ANKLE/FOOT   29540~T,$266.36,$198.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500394A,0450,29550,,,,,N/A,N/A,STRAPPING TOES         29550~T,$254.25,$189.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
45029581A,0450,29581,,,,,N/A,N/A,MULTI DRESSING LEG BELW KNEE~T,$281.49,$209.25,$39.36,$96.00,$39.36,$93.12,$39.36,$82.08,$39.36,$49.74,$39.36,$93.12,$39.36,$96.00,$39.36,$39.36,$93.12
4529584A,0450,29584,,,,,N/A,N/A,"JONES DRESS,UPR ARM TO HAND ~T",$281.49,$209.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500396A,0450,29700,,,,,N/A,N/A,REMOVAL BIVALVE CAST   29700~T,$274.43,$204.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4529700A,0450,29700,,,,,N/A,N/A,"CAST REMOVAL,BOOT OR BODY   ~T",$470.17,$349.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500397A,0450,29705,,,,,N/A,N/A,REM FULL ARM/LEG CAST  29705~T,$305.71,$227.25,$51.25,$125.00,$51.25,$121.25,$51.25,$106.88,$51.25,$80.72,$51.25,$121.25,$51.25,$125.00,$51.25,$51.25,$121.25
4501266,0450,30300,,,,,N/A,N/A,RMV FB INTRANASAL     30300~TC,$637.65,$474.00,$184.93,"$1,010.00",N/A,$979.70,N/A,$863.55,N/A,$184.93,N/A,$979.70,N/A,"$1,010.00",N/A,N/A,$979.70
4500266A,0450,30300,,,,,N/A,N/A,RMV FB INTRANASAL      30300~T,$545.84,$405.75,$184.93,"$1,010.00",N/A,$979.70,N/A,$863.55,N/A,$184.93,N/A,$979.70,N/A,"$1,010.00",N/A,N/A,$979.70
4530300A,0450,30300,,,,,N/A,N/A,"FB REMOVAL,INTRANASAL  30300~T",$206.83,$153.75,$184.93,"$1,010.00",N/A,$979.70,N/A,$863.55,N/A,$184.93,N/A,$979.70,N/A,"$1,010.00",N/A,N/A,$979.70
4501012,0450,30901,,,,,N/A,N/A,EPISTAXIS CTRLNASAL   30901~TC,$836.41,$621.75,$83.33,$741.00,N/A,$718.77,N/A,$633.56,N/A,$83.33,N/A,$718.77,N/A,$741.00,N/A,N/A,$718.77
4500012A,0450,30901,,,,,N/A,N/A,EPISTAXIS CTRL NASAL   30901~T,$527.68,$392.25,$83.33,$741.00,N/A,$718.77,N/A,$633.56,N/A,$83.33,N/A,$718.77,N/A,$741.00,N/A,N/A,$718.77
4501113,0450,30903,,,,,N/A,N/A,EPISTAXIS CAUTRY/PCKG 30903~TC,$831.37,$618.00,$114.78,"$1,572.00",N/A,"$1,524.84",N/A,"$1,344.06",N/A,$114.78,N/A,"$1,524.84",N/A,"$1,572.00",N/A,N/A,"$1,524.84"
4501114,0450,30905,,,,,N/A,N/A,EPISTAXIS PSTRR PCKNG 30905~TC,$831.37,$618.00,$156.57,"$1,082.00",N/A,"$1,049.54",N/A,$925.11,N/A,$156.57,N/A,"$1,049.54",N/A,"$1,082.00",N/A,N/A,"$1,049.54"
4500114A,0450,30905,,,,,N/A,N/A,EPISTAXIS PSTERR PCKG  30905~T,$708.28,$526.50,$156.57,"$1,082.00",N/A,"$1,049.54",N/A,$925.11,N/A,$156.57,N/A,"$1,049.54",N/A,"$1,082.00",N/A,N/A,"$1,049.54"
4531231,0450,31231,,,,,N/A,N/A,NASAL ENDOSCOPY-TC          ~T,$469.16,$348.75,$95.50,$465.00,N/A,$451.05,N/A,$397.58,N/A,$95.50,N/A,$451.05,N/A,$465.00,N/A,N/A,$451.05
4501016,0450,31500,,,,,N/A,N/A,ENDOTRACHEAL INTUB    31500~TC,"$1,681.90","$1,250.25",$62.32,"$1,667.00",$62.32,"$1,616.99",$62.32,"$1,425.29",$62.32,$210.87,$62.32,"$1,616.99",$62.32,"$1,667.00",$62.32,$62.32,"$1,616.99"
4500016A,0450,31500,,,,,N/A,N/A,ENDOTRACHEAL INTUB     31500~T,$810.18,$602.25,$62.32,"$1,667.00",$62.32,"$1,616.99",$62.32,"$1,425.29",$62.32,$210.87,$62.32,"$1,616.99",$62.32,"$1,667.00",$62.32,$62.32,"$1,616.99"
4531505,0450,31505,,,,,N/A,N/A,INDIRECT LARYNGOSCOPY 31505~TC,$481.26,$357.75,$72.95,$477.00,N/A,$462.69,N/A,$407.84,N/A,$72.95,N/A,$462.69,N/A,$477.00,N/A,N/A,$462.69
4503150A,0450,31505,,,,,N/A,N/A,INDIRECT LARYNGOSCOPY  31505~T,$193.72,$144.00,$72.95,$477.00,N/A,$462.69,N/A,$407.84,N/A,$72.95,N/A,$462.69,N/A,$477.00,N/A,N/A,$462.69
4501115,0450,31511,,,,,N/A,N/A,LARYNGOSCOPY FB REMOV 31511~TC,$481.26,$357.75,$196.94,$911.00,N/A,$883.67,N/A,$778.91,N/A,$196.94,N/A,$883.67,N/A,$911.00,N/A,N/A,$883.67
4500115A,0450,31511,,,,,N/A,N/A,LARYNGOSCOPY FB REMOV  31511~T,$502.45,$373.50,$196.94,$911.00,N/A,$883.67,N/A,$778.91,N/A,$196.94,N/A,$883.67,N/A,$911.00,N/A,N/A,$883.67
4501116,0450,31515,,,,,N/A,N/A,DIRECT LARYNGNOSCOPY  31515~TC,"$4,564.44","$3,393.00",$165.03,"$4,524.00",N/A,"$4,388.28",N/A,"$3,868.02",N/A,$165.03,N/A,"$4,388.28",N/A,"$4,524.00",N/A,N/A,"$4,388.28"
4500116A,0450,31515,,,,,N/A,N/A,DIRECT LARYNGOSCOPY    31515~T,"$2,335.70","$1,736.25",$165.03,"$4,524.00",N/A,"$4,388.28",N/A,"$3,868.02",N/A,$165.03,N/A,"$4,388.28",N/A,"$4,524.00",N/A,N/A,"$4,388.28"
4501117,0450,31525,,,,,N/A,N/A,DIRECT LARYNGOSCOPY   31525~TC,"$5,022.50","$3,733.50",$236.75,"$4,978.00",N/A,"$4,828.66",N/A,"$4,256.19",N/A,$236.75,N/A,"$4,828.66",N/A,"$4,978.00",N/A,N/A,"$4,828.66"
4500117A,0450,31525,,,,,N/A,N/A,LARYNGOSCOPY DIAGNOSTC 31525~T,"$2,493.09","$1,853.25",$236.75,"$4,978.00",N/A,"$4,828.66",N/A,"$4,256.19",N/A,$236.75,N/A,"$4,828.66",N/A,"$4,978.00",N/A,N/A,"$4,828.66"
4501118,0450,31575,,,,,N/A,N/A,FLEX LARYNGOSCOPY     31575~TC,$223.98,$166.50,$100.23,$677.00,N/A,$656.69,N/A,$578.84,N/A,$100.23,N/A,$656.69,N/A,$677.00,N/A,N/A,$656.69
4500118A,0450,31575,,,,,N/A,N/A,DRT FLEX LARYNGOSCOPY  31575~T,$386.42,$287.25,$100.23,$677.00,N/A,$656.69,N/A,$578.84,N/A,$100.23,N/A,$656.69,N/A,$677.00,N/A,N/A,$656.69
4501019,0450,31603,,,,,N/A,N/A,TRACHEOSTOMY - TRANSTR     ~TC,"$4,597.74","$3,417.75",$474.79,"$4,557.00",N/A,"$4,420.29",N/A,"$3,896.24",N/A,$474.79,N/A,"$4,420.29",N/A,"$4,557.00",N/A,N/A,"$4,420.29"
4500019A,0450,31603,,,,,N/A,N/A,TRACHEOSTOMY-TRANSTR   31603~T,"$2,616.18","$1,944.75",$474.79,"$4,557.00",N/A,"$4,420.29",N/A,"$3,896.24",N/A,$474.79,N/A,"$4,420.29",N/A,"$4,557.00",N/A,N/A,"$4,420.29"
4501063,0450,31605,,,,,N/A,N/A,TRACHEOSTOMY CRIC/MB       ~TC,"$4,599.76","$3,419.25",$185.73,$488.64,$185.73,$439.41,$185.73,$387.32,$185.73,$488.64,$185.73,$439.41,$185.73,$453.00,$185.73,$185.73,$439.41
4500063A,0450,31605,,,,,N/A,N/A,TRACHEOSTOMY-CRIC/MB   31605~T,"$2,509.23","$1,865.25",$185.73,$488.64,$185.73,$439.41,$185.73,$387.32,$185.73,$488.64,$185.73,$439.41,$185.73,$453.00,$185.73,$185.73,$439.41
4501119,0450,31622,,,,,N/A,N/A,BRONCHOSCOPY               ~TC,"$3,028.84","$2,251.50",$197.53,$359.00,N/A,$348.23,N/A,$306.95,N/A,$197.53,N/A,$348.23,N/A,$359.00,N/A,N/A,$348.23
4500119A,0450,31622,,,,,N/A,N/A,BRONCHOSCOPY           31622~T,"$1,734.37","$1,289.25",$197.53,$359.00,N/A,$348.23,N/A,$306.95,N/A,$197.53,N/A,$348.23,N/A,$359.00,N/A,N/A,$348.23
4531635A,0450,31635,,,,,N/A,N/A,BRONCHOSCOPY W/FB REMOVAL   ~T,$392.48,$291.75,$263.48,$263.48,N/A,N/A,N/A,$0.00,N/A,$263.48,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501057,0450,32000,,,,,N/A,N/A,Thoracentesis/Aspir   32554~tc,"$1,645.58","$1,223.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4513200,0450,32002,,,,,N/A,N/A,Thorcentesis          32554~tc,"$1,360.05","$1,011.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4503200A,0450,32002,,,,,N/A,N/A,Thoracentesis          32554~t,"$1,463.97","$1,088.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501010,0450,32020,,,,,N/A,N/A,Tube Thoracostomy          ~tc,"$1,360.05","$1,011.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500057A,0450,32421,,,,,N/A,N/A,Thoracentesis/Aspir    32554~t,"$1,645.58","$1,223.25",$71.12,$71.12,$71.12,N/A,$71.12,N/A,$71.12,N/A,$71.12,N/A,$71.12,N/A,$71.12,$71.12,N/A
4532551A,0450,32551,,,,,N/A,N/A,TUBE THORACOSTOMY      32551~T,"$1,360.05","$1,011.00",$174.25,$425.00,$174.25,$412.25,$174.25,$363.38,$174.25,$267.10,$174.25,$412.25,$174.25,$425.00,$174.25,$174.25,$412.25
45032554A,0450,32554,,,,,N/A,N/A,PERICARDIOCENTESIS          ~T,"$1,545.70","$1,149.00",$155.38,"$1,018.00",$417.38,$987.46,$417.38,$870.39,$417.38,$155.38,$417.38,$987.46,$417.38,"$1,018.00",$417.38,$417.38,$987.46
4532555A,0450,32555,,,,,N/A,N/A,THORACENTESIS W/IMAG GUIDAN~T,"$1,645.58","$1,223.25",$192.61,$718.00,$294.38,$696.46,$294.38,$613.89,$294.38,$192.61,$294.38,$696.46,$294.38,$718.00,$294.38,$294.38,$696.46
4501120,0450,33210,,,,,N/A,N/A,TRNSVNUS TEMP PACMKR  33210~TC,$895.94,$666.00,$143.91,$351.00,$143.91,$340.47,$143.91,$300.11,$143.91,$275.25,$143.91,$340.47,$143.91,$351.00,$143.91,$143.91,$340.47
4500120A,0450,33210,,,,,N/A,N/A,TRANSVENO TMP PCMKR  3321054~T,$967.57,$719.25,$143.91,$351.00,$143.91,$340.47,$143.91,$300.11,$143.91,$275.25,$143.91,$340.47,$143.91,$351.00,$143.91,$143.91,$340.47
4535206,0450,35206,,,,,N/A,N/A,REPR BLOOD VESEL UPPER EXTR-TC,"$7,445.98","$5,535.00",$769.98,"$1,878.00",$769.98,"$1,821.66",$769.98,"$1,605.69",$769.98,"$1,321.26",$769.98,"$1,821.66",$769.98,"$1,878.00",$769.98,$769.98,"$1,821.66"
4535207A,0450,35207,,,,,N/A,N/A,"SURG REPAIR HAND,FINGER     ~T","$5,053.78","$3,756.75",$675.27,"$1,647.00",$675.27,"$1,597.59",$675.27,"$1,408.19",$675.27,"$1,310.50",$675.27,"$1,597.59",$675.27,"$1,647.00",$675.27,$675.27,"$1,597.59"
4501108,0450,36425,,,,,N/A,N/A,VENOUS CUTDOWN > AGE1 36425~TC,"$2,006.78","$1,491.75",$68.33,"$1,989.00",N/A,"$1,929.33",N/A,"$1,700.60",N/A,$68.33,N/A,"$1,929.33",N/A,"$1,989.00",N/A,N/A,"$1,929.33"
4501062,0450,36488,,,,,N/A,N/A,INSERTION OF CATH <2  36488~TC,"$2,006.78","$1,491.75","$1,929.33","$1,989.00",N/A,"$1,929.33",N/A,"$1,700.60",N/A,"$1,989.00",N/A,"$1,929.33",N/A,"$1,989.00",N/A,N/A,"$1,929.33"
4501076,0450,36489,,,,,N/A,N/A,PERCUTANEOUS>2        36489~TC,"$2,027.97","$1,507.50","$3,486.18","$3,594.00",N/A,"$3,486.18",N/A,"$3,072.87",N/A,"$3,594.00",N/A,"$3,486.18",N/A,"$3,594.00",N/A,N/A,"$3,486.18"
4501091,0450,36491,,,,,N/A,N/A,CUTDOWN > AGE 2       36491~TC,"$2,006.78","$1,491.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4536540,0450,36540,,,,,N/A,N/A,Blood Draw Comp Implanted Port,$340.01,$252.75,$360.84,$372.00,N/A,$360.84,N/A,$318.06,N/A,$372.00,N/A,$360.84,N/A,$372.00,N/A,N/A,$360.84
4536555A,0450,36555,,,,,N/A,N/A,CENTRAL LINE INSERTION 36555~T,"$2,996.55","$2,227.50",$143.35,"$3,359.00",N/A,"$3,258.23",N/A,"$2,871.95",N/A,$143.35,N/A,"$3,258.23",N/A,"$3,359.00",N/A,N/A,"$3,258.23"
4536556A,0450,36556,,,,,N/A,N/A,CENTRAL LINE INSERTION 36556~T,"$2,996.55","$2,227.50",$142.40,$419.00,$171.79,$406.43,$171.79,$358.25,$171.79,$142.40,$171.79,$406.43,$171.79,$419.00,$171.79,$171.79,$406.43
4536573A,0450,36573,,,,,N/A,N/A,PICC 5YRS>                  ~T,$617.47,$459.00,$142.32,"$1,645.74","$1,645.74",$794.43,"$1,645.74",$700.25,"$1,645.74",$142.32,"$1,645.74",$794.43,"$1,645.74",$819.00,"$1,645.74","$1,645.74",$794.43
4536590,0450,36590,,,,,N/A,N/A,REMVL OF TUNNEL CENT VENOUS,$270.40,$201.00,$196.80,$480.00,$196.80,$465.60,$196.80,$410.40,$196.80,$319.87,$196.80,$465.60,$196.80,$480.00,$196.80,$196.80,$465.60
4536592,0450,36592,,,,,N/A,N/A,BLOOD DRAW FROM PICC LINE,$197.75,$147.00,$52.07,$200.00,$86.51,$194.00,$86.51,$171.00,$86.51,$52.07,$86.51,$194.00,$86.51,$200.00,$86.51,$86.51,$194.00
4536593,0450,36593,,,,,N/A,N/A,DCLT VASC ACCSS DVCE/CAT-36593,"$1,039.21",$772.50,$25.10,"$1,130.00",$25.10,"$1,096.10",$25.10,$966.15,$25.10,$57.22,$25.10,"$1,096.10",$25.10,"$1,130.00",$25.10,$25.10,"$1,096.10"
4536620A,0450,36620,,,,,N/A,N/A,ARTERIAL CATH               ~T,$148.31,$110.25,$53.71,$131.00,$53.71,$127.07,$53.71,$112.01,$53.71,$75.19,$53.71,$127.07,$53.71,$131.00,$53.71,$53.71,$127.07
4500106,0450,36680,,,,,N/A,N/A,INTRAOSSEOUS NEEDLE    36680~P,$566.02,$420.75,$98.27,$630.00,N/A,$611.10,N/A,$538.65,N/A,$98.27,N/A,$611.10,N/A,$630.00,N/A,N/A,$611.10
4501106,0450,36680,,,,,N/A,N/A,INTRAOSSEOUS NEEDLE   36680~TC,$635.63,$472.50,$98.27,$630.00,N/A,$611.10,N/A,$538.65,N/A,$98.27,N/A,$611.10,N/A,$630.00,N/A,N/A,$611.10
4501127,0450,37785,,,,,N/A,N/A,LITIGATION VARICOSE VEINS  ~TC,"$5,462.40","$4,060.50",$429.04,"$3,907.00",N/A,"$3,789.79",N/A,"$3,340.49",N/A,$429.04,N/A,"$3,789.79",N/A,"$3,907.00",N/A,N/A,"$3,789.79"
4500127A,0450,37785,,,,,N/A,N/A,LIG VARICOSE VEINS     37785~T,"$2,944.09","$2,188.50",$429.04,"$3,907.00",N/A,"$3,789.79",N/A,"$3,340.49",N/A,$429.04,N/A,"$3,789.79",N/A,"$3,907.00",N/A,N/A,"$3,789.79"
4500410,0450,40800,,,,,N/A,N/A,I&D MOUTH ABS SIMPL,$326.90,$243.00,$185.92,$324.00,N/A,$314.28,N/A,$277.02,N/A,$185.92,N/A,$314.28,N/A,$324.00,N/A,N/A,$314.28
4501268,0450,40804,,,,,N/A,N/A,FB RMVL MOUTH EMBD    40804~TC,$638.66,$474.75,$174.27,"$1,094.00",N/A,"$1,061.18",N/A,$935.37,N/A,$174.27,N/A,"$1,061.18",N/A,"$1,094.00",N/A,N/A,"$1,061.18"
4500268A,0450,40804,,,,,N/A,N/A,FB REM MOUTH EMBDED  4080454~T,$605.36,$450.00,$174.27,"$1,094.00",N/A,"$1,061.18",N/A,$935.37,N/A,$174.27,N/A,"$1,061.18",N/A,"$1,094.00",N/A,N/A,"$1,061.18"
4501661,0450,41250,,,,,N/A,N/A,REP FLR MOUTH 0-2.5CM 41250~TC,$638.66,$474.75,$232.76,$633.00,N/A,$614.01,N/A,$541.22,N/A,$232.76,N/A,$614.01,N/A,$633.00,N/A,N/A,$614.01
4500661A,0450,41250,,,,,N/A,N/A,REP FLR MTH 0-2.5CM    41250~G,$662.87,$492.75,$232.76,$633.00,N/A,$614.01,N/A,$541.22,N/A,$232.76,N/A,$614.01,N/A,$633.00,N/A,N/A,$614.01
4500456,0450,41800,,,,,N/A,N/A,I&D PERIDONTAL ABSCESS,"$1,739.41","$1,293.00",$241.26,$241.26,N/A,N/A,N/A,$0.00,N/A,$241.26,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4542000A,0450,42000,,,,,N/A,N/A,DRAINAGE MOUTH ROOF LESION  ~T,$247.19,$183.75,$155.39,$624.00,$155.39,$605.28,$155.39,$533.52,$155.39,$159.98,$155.39,$605.28,$155.39,$624.00,$155.39,$155.39,$605.28
4501457,0450,42700,,,,,N/A,N/A,I&D PERITONSILLAR ABS 42700~TC,$638.66,$474.75,$203.90,$633.00,N/A,$614.01,N/A,$541.22,N/A,$203.90,N/A,$614.01,N/A,$633.00,N/A,N/A,$614.01
4500457A,0450,42700,,,,,N/A,N/A,I&D PERITONSILLARABS 4270054~T,$560.97,$417.00,$203.90,$633.00,N/A,$614.01,N/A,$541.22,N/A,$203.90,N/A,$614.01,N/A,$633.00,N/A,N/A,$614.01
4501226,0450,42809,,,,,N/A,N/A,RMV FB PHARYNX             ~TC,$638.66,$474.75,$188.52,$633.00,N/A,$614.01,N/A,$541.22,N/A,$188.52,N/A,$614.01,N/A,$633.00,N/A,N/A,$614.01
4500226A,0450,42809,,,,,N/A,N/A,RMVL FB PHARYNX        42809~T,$641.69,$477.00,$188.52,$633.00,N/A,$614.01,N/A,$541.22,N/A,$188.52,N/A,$614.01,N/A,$633.00,N/A,N/A,$614.01
4542960A,0450,42960,,,,,N/A,N/A,CONTRL THROAT BLEEDING 42960~T,$466.13,$346.50,$245.37,"$1,102.00",N/A,"$1,068.94",N/A,$942.21,N/A,$245.37,N/A,"$1,068.94",N/A,"$1,102.00",N/A,N/A,"$1,068.94"
4501458,0450,43750,,,,,N/A,N/A,CHGE GASTROSTOMY TUBE 43750~TC,$887.87,$660.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
45043753A,0450,43753,,,,,N/A,N/A,"GASTRIC INTUB/ASP,INC LAVAGE~T",$171.52,$127.50,$17.22,$42.00,$17.22,$40.74,$17.22,$35.91,$17.22,$36.73,$17.22,$40.74,$17.22,$42.00,$17.22,$17.22,$40.74
4543762A,0450,43762,,,,,N/A,N/A,REPLACE GASTROSTOMY TUBE,$580.14,$431.25,$19.65,$465.00,$19.65,$451.05,$19.65,$397.58,$19.65,$63.34,$19.65,$451.05,$19.65,$465.00,$19.65,$19.65,$451.05
4500461A,0450,46040,,,,,N/A,N/A,I&D ISCHIORCTL ABSCSS  46040~T,"$1,158.26",$861.00,$311.60,"$1,440.00",$311.60,"$1,396.80",$311.60,"$1,231.20",$311.60,$408.89,$311.60,"$1,396.80",$311.60,"$1,440.00",$311.60,$311.60,"$1,396.80"
4501413,0450,46050,,,,,N/A,N/A,I&D PERIANAL ABS      46050~TC,$878.79,$653.25,$87.74,$725.44,$87.74,$217.28,$87.74,$191.52,$87.74,$725.44,$87.74,$217.28,$87.74,$224.00,$87.74,$87.74,$217.28
4500413A,0450,46050,,,,,N/A,N/A,I&D PERIANAL ABS       46050~T,$621.51,$462.00,$87.74,$725.44,$87.74,$217.28,$87.74,$191.52,$87.74,$725.44,$87.74,$217.28,$87.74,$224.00,$87.74,$87.74,$217.28
4501415,0450,46083,,,,,N/A,N/A,INCISE EXTERNAL HEM   46083~TC,$878.79,$653.25,$13.32,$267.07,$13.32,$244.44,$13.32,$215.46,$13.32,$267.07,$13.32,$244.44,$13.32,$252.00,$13.32,$13.32,$244.44
4500415A,0450,46083,,,,,N/A,N/A,I&D THROM HEM EXT      46083~T,$661.86,$492.00,$13.32,$267.07,$13.32,$244.44,$13.32,$215.46,$13.32,$267.07,$13.32,$244.44,$13.32,$252.00,$13.32,$13.32,$244.44
4500058A,0450,49080,,,,,N/A,N/A,Abdml Paracentesis          ~t,$787.98,$585.75,"$1,002.98","$2,672.18",N/A,"$1,002.98",N/A,$884.07,N/A,"$2,672.18",N/A,"$1,002.98",N/A,"$1,034.00",N/A,N/A,"$1,002.98"
4501058,0450,49082,,,,,N/A,N/A,ABDML PARACENTESIS    49082~TC,"$1,360.05","$1,011.00",$85.69,$209.00,$85.69,$202.73,$85.69,$178.70,$85.69,N/A,$85.69,$202.73,$85.69,$209.00,$85.69,$85.69,$202.73
4501465,0450,51000,,,,,N/A,N/A,DRAINAGE OF BLADDER   51000~TC,"$1,446.82","$1,075.50",$934.56,"$1,434.00",N/A,"$1,390.98",N/A,"$1,226.07",N/A,$934.56,N/A,"$1,390.98",N/A,"$1,434.00",N/A,N/A,"$1,390.98"
4501467,0450,51700,,,,,N/A,N/A,BLADDER IRRIGATION    51700~TC,$823.30,$612.00,$92.25,$225.00,$92.25,$218.25,$92.25,$192.38,$92.25,$104.39,$92.25,$218.25,$92.25,$225.00,$92.25,$92.25,$218.25
4500467A,0450,51700,,,,,N/A,N/A,BLADDER IRRIGATION     51700~T,$468.15,$348.00,$92.25,$225.00,$92.25,$218.25,$92.25,$192.38,$92.25,$104.39,$92.25,$218.25,$92.25,$225.00,$92.25,$92.25,$218.25
4500470A,0450,51702,,,,,N/A,N/A,BLDDR CATH BALLOON 51702-54 ~T,$560.97,$417.00,$41.35,$124.00,$59.86,$120.28,$59.86,$106.02,$59.86,$41.35,$59.86,$120.28,$59.86,$124.00,$59.86,$59.86,$120.28
4551702A,0450,51702,,,,,N/A,N/A,"FOLEY,SIMPLE INSERTION 51702~T",$226.00,$168.00,$41.35,$124.00,$59.86,$120.28,$59.86,$106.02,$59.86,$41.35,$59.86,$120.28,$59.86,$124.00,$59.86,$59.86,$120.28
4501470,0450,51703,,,,,N/A,N/A,BLADDER CATH BALLON   51703~TC,$813.21,$604.50,$41.02,$239.00,$97.99,$231.83,$97.99,$204.35,$97.99,$41.02,$97.99,$231.83,$97.99,$239.00,$97.99,$97.99,$231.83
4551703A,0450,51703,,,,,N/A,N/A,"FOLEY, COMPLEX INSERT  51703~T",$425.77,$316.50,$41.02,$239.00,$97.99,$231.83,$97.99,$204.35,$97.99,$41.02,$97.99,$231.83,$97.99,$239.00,$97.99,$97.99,$231.83
4501468,0450,51705,,,,,N/A,N/A,CYSTOSTOMY TUBE CHNG  51705~TC,$887.87,$660.00,$76.67,$187.00,$76.67,$181.39,$76.67,$159.89,$76.67,$124.30,$76.67,$181.39,$76.67,$187.00,$76.67,$76.67,$181.39
4500468A,0450,51705,,,,,N/A,N/A,CHANGE OF CYSTOSTOMY   51705~G,$498.42,$370.50,$76.67,$187.00,$76.67,$181.39,$76.67,$159.89,$76.67,$124.30,$76.67,$181.39,$76.67,$187.00,$76.67,$76.67,$181.39
4551798,0450,51798,,,,,N/A,N/A,BLADDER SCAN/OS,$192.71,$143.25,$24.60,$318.31,$24.60,$58.20,$24.60,$51.30,$24.60,$318.31,$24.60,$58.20,$24.60,$60.00,$24.60,$24.60,$58.20
4552000,0450,52000,,,,,N/A,N/A,CYSTOURETHROSCOPY           ~T,"$1,645.58","$1,223.25",$123.82,"$1,217.63",$123.82,$292.94,$123.82,$258.21,$123.82,"$1,217.63",$123.82,$292.94,$123.82,$302.00,$123.82,$123.82,$292.94
4552281,0450,52281,,,,,N/A,N/A,CYSTOSCOPY AND TREATMENT,"$4,243.60","$3,154.50",$289.50,$705.00,$289.50,$683.85,$289.50,$602.78,$289.50,$428.82,$289.50,$683.85,$289.50,$705.00,$289.50,$289.50,$683.85
4554001A,0450,54001,,,,,N/A,N/A,DORSAL SLIT PREPUSE        ~TC,"$4,487.77","$3,336.00",$0.00,$401.00,N/A,$388.97,N/A,$342.86,N/A,$0.00,N/A,$388.97,N/A,$401.00,N/A,N/A,$388.97
4500026A,0450,54095,,,,,N/A,N/A,Er Vaginal Deliver   5940954~t,"$4,090.24","$3,040.50",$280.44,"$4,054.00",N/A,"$3,932.38",N/A,"$3,466.17",N/A,$280.44,N/A,"$3,932.38",N/A,"$4,054.00",N/A,N/A,"$3,932.38"
4554220A,0450,54220,,,,,N/A,N/A,IRRIGAT OF CORPORA CAVERNOSA~T,$587.20,$436.50,$140.97,$356.00,$145.96,$345.32,$145.96,$304.38,$145.96,$140.97,$145.96,$345.32,$145.96,$356.00,$145.96,$145.96,$345.32
4554700A,0450,54700,,,,,N/A,N/A,"I&D DEPID,TESTES/SCROTAL ABS~T","$5,724.73","$4,255.50",$482.09,$708.97,N/A,$482.09,N/A,$424.94,N/A,$708.97,N/A,$482.09,N/A,$497.00,N/A,N/A,$482.09
4554700TC,0450,54700,,,,,N/A,N/A,"I&D DEPID,TESTS/SCROTAL ABS~TC","$5,724.73","$4,255.50",$482.09,$708.97,N/A,$482.09,N/A,$424.94,N/A,$708.97,N/A,$482.09,N/A,$497.00,N/A,N/A,$482.09
4555100A,0450,55100,,,,,N/A,N/A,I&D SCROTAL WALL ABSCESS    ~T,"$3,187.24","$2,369.25",$228.78,$840.86,$228.78,$541.26,$228.78,$477.09,$228.78,$840.86,$228.78,$541.26,$228.78,$558.00,$228.78,$228.78,$541.26
4555100TC,0450,55100,,,,,N/A,N/A,I&D SCROTAL WALL ABSCESS   ~TC,"$3,187.24","$2,369.25",$228.78,$840.86,$228.78,$541.26,$228.78,$477.09,$228.78,$840.86,$228.78,$541.26,$228.78,$558.00,$228.78,$228.78,$541.26
4556405A,0450,56405,,,,,N/A,N/A,I & D OF VULVA/PERINEUM     ~T,$48.43,$36.00,$264.81,$273.00,N/A,$264.81,N/A,$233.42,N/A,N/A,N/A,$264.81,N/A,$273.00,N/A,N/A,$264.81
4501417,0450,56420,,,,,N/A,N/A,DRAIN GLAND ABSCESS   56420~TC,$895.94,$666.00,$207.94,$888.00,N/A,$861.36,N/A,$759.24,N/A,$207.94,N/A,$861.36,N/A,$888.00,N/A,N/A,$861.36
4500417A,0450,56420,,,,,N/A,N/A,I&D BARTHOL CYST AB  5642054~T,$645.72,$480.00,$207.94,$888.00,N/A,$861.36,N/A,$759.24,N/A,$207.94,N/A,$861.36,N/A,$888.00,N/A,N/A,$861.36
4501021,0450,57020,,,,,N/A,N/A,COLPOCENTESIS (SEPPR)      ~TC,"$3,306.30","$2,457.75",$185.70,"$1,872.00",N/A,"$1,815.84",N/A,"$1,600.56",N/A,$185.70,N/A,"$1,815.84",N/A,"$1,872.00",N/A,N/A,"$1,815.84"
4500021A,0450,57020,,,,,N/A,N/A,COLPOCENTESIS (SEPPR)  57020~T,"$1,583.03","$1,176.75",$185.70,"$1,872.00",N/A,"$1,815.84",N/A,"$1,600.56",N/A,$185.70,N/A,"$1,815.84",N/A,"$1,872.00",N/A,N/A,"$1,815.84"
4558301,0450,58301,,,,,N/A,N/A,REMOVAL OF IUD,$639.67,$475.50,$84.69,$634.00,N/A,$614.98,N/A,$542.07,N/A,$84.69,N/A,$614.98,N/A,$634.00,N/A,N/A,$614.98
4501026,0450,59409,,,,,N/A,N/A,ER VAGINAL DELIVERY   59409~TC,"$4,139.68","$3,077.25",$0.00,"$2,370.70",N/A,$0.00,N/A,$0.00,N/A,"$2,370.70",N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
4501056,0450,62270,,,,,N/A,N/A,SPINAL PUNCTURE LUMB  62270~TC,"$1,134.05",$843.00,$83.35,$207.00,$88.97,$200.79,$88.97,$176.99,$88.97,$83.35,$88.97,$200.79,$88.97,$207.00,$88.97,$88.97,$200.79
4500056A,0450,62270,,,,,N/A,N/A,SPINAL PUNCTURE LMB    62270~T,$658.84,$489.75,$83.35,$207.00,$88.97,$200.79,$88.97,$176.99,$88.97,$83.35,$88.97,$200.79,$88.97,$207.00,$88.97,$88.97,$200.79
4562273,0450,62273,,,,,N/A,N/A,INJECT EPI BLOOD PATCH,"$1,377.20","$1,023.75",$110.72,$683.60,$683.60,N/A,$683.60,$0.00,$683.60,$110.72,$683.60,N/A,$683.60,N/A,$683.60,$683.60,N/A
4562328A,0450,62328,,,,,N/A,N/A,SPINAL PUNCTURE             ~T,$282.50,$210.00,$133.78,$730.00,N/A,$708.10,N/A,$624.15,N/A,$133.78,N/A,$708.10,N/A,$730.00,N/A,N/A,$708.10
4562329A,0450,62329,,,,,N/A,N/A,SPINAL PUNCTURE             ~T,$188.67,$140.25,$113.34,$653.00,$267.73,$633.41,$267.73,$558.32,$267.73,$113.34,$267.73,$633.41,$267.73,$653.00,$267.73,$267.73,$633.41
4500131,0450,64400,,,,,N/A,N/A,TRIGEMINAL NERVE BLOCK,$822.29,$611.25,$466.95,$815.00,N/A,$790.55,N/A,$149.74,N/A,$466.95,N/A,$790.55,N/A,$815.00,N/A,N/A,$790.55
4564447,0450,64447,,,,,N/A,N/A,"NERVE BLOCK INJ, SINGLE",$162.44,$120.75,$35.14,$854.00,$35.14,$828.38,$35.14,$123.12,$35.14,$69.76,$35.14,$828.38,$35.14,$854.00,$35.14,$35.14,$828.38
4500133A,0450,64450,,,,,N/A,N/A,PERIPHERAL NERVE BLOCK 64450~T,$630.59,$468.75,$68.47,$167.00,$68.47,$161.99,$68.47,$127.02,$68.47,$78.69,$68.47,$161.99,$68.47,$167.00,$68.47,$68.47,$161.99
4564505A,0450,64505,,,,,N/A,N/A,SPHENOPALATINE GANGLION     ~T,$595.27,$442.50,$67.93,$590.00,$241.90,$572.30,$241.90,$172.74,$241.90,$67.93,$241.90,$572.30,$241.90,$590.00,$241.90,$241.90,$572.30
4501273,0450,65205,,,,,N/A,N/A,CONJUNCT SUPERFIC          ~TC,$992.80,$738.00,$148.18,$669.00,N/A,$648.93,N/A,$96.00,N/A,$148.18,N/A,$648.93,N/A,$669.00,N/A,N/A,$648.93
4500273A,0450,65205,,,,,N/A,N/A,CONJUNCT SUPERFIC    6520554~T,$505.48,$375.75,$148.18,$669.00,N/A,$648.93,N/A,$96.00,N/A,$148.18,N/A,$648.93,N/A,$669.00,N/A,N/A,$648.93
4501277,0450,65210,,,,,N/A,N/A,CONJUNCT EMBEDDED     65210~TC,$992.80,$738.00,$51.07,$729.00,N/A,$707.13,N/A,$129.44,N/A,$51.07,N/A,$707.13,N/A,$729.00,N/A,N/A,$707.13
4500277A,0450,65210,,,,,N/A,N/A,CONJUNCT EMBEDDED      65210~T,$533.73,$396.75,$51.07,$729.00,N/A,$707.13,N/A,$129.44,N/A,$51.07,N/A,$707.13,N/A,$729.00,N/A,N/A,$707.13
4501134,0450,65220,,,,,N/A,N/A,FB REMOVAL CORNEA          ~TC,$992.80,$738.00,$63.95,$558.00,N/A,$541.26,N/A,$138.77,N/A,$63.95,N/A,$541.26,N/A,$558.00,N/A,N/A,$541.26
4500134A,0450,65220,,,,,N/A,N/A,FB REMOVAL CORNEA      65220~T,$461.09,$342.75,$63.95,$558.00,N/A,$541.26,N/A,$138.77,N/A,$63.95,N/A,$541.26,N/A,$558.00,N/A,N/A,$541.26
4501283,0450,65222,,,,,N/A,N/A,REMV FOREIGN BODY FROM EYE ~TC,$992.80,$738.00,$71.83,$758.00,N/A,$735.26,N/A,$156.75,N/A,$71.83,N/A,$735.26,N/A,$758.00,N/A,N/A,$735.26
4500283A,0450,65222,,,,,N/A,N/A,CORNEAL W/SLIT LAMP    65222~T,$543.82,$404.25,$71.83,$758.00,N/A,$735.26,N/A,$156.75,N/A,$71.83,N/A,$735.26,N/A,$758.00,N/A,N/A,$735.26
4565800A,0450,65800,,,,,N/A,N/A,ANTERIOR SEGMENT PROCEDURE,$335.98,$249.75,$323.01,$333.00,N/A,$323.01,N/A,$216.69,N/A,N/A,N/A,$323.01,N/A,$333.00,N/A,N/A,$323.01
4567935,0450,67935,,,,,N/A,N/A,SUTURE WOUND EYELID        ~TC,"$1,873.60","$1,392.75","$1,183.64","$1,857.00",N/A,"$1,801.29",N/A,$904.98,N/A,"$1,183.64",N/A,"$1,801.29",N/A,"$1,857.00",N/A,N/A,"$1,801.29"
4501135,0450,67938,,,,,N/A,N/A,FB REMOVAL IN EYELID       ~TC,"$1,053.33",$783.00,$765.30,"$1,051.00",N/A,"$1,019.47",N/A,$398.27,N/A,$765.30,N/A,"$1,019.47",N/A,"$1,051.00",N/A,N/A,"$1,019.47"
4500135A,0450,67938,,,,,N/A,N/A,FB REMOVAL EMBD EYELD  67938~T,$638.66,$474.75,$765.30,"$1,051.00",N/A,"$1,019.47",N/A,$398.27,N/A,$765.30,N/A,"$1,019.47",N/A,"$1,051.00",N/A,N/A,"$1,019.47"
4568530,0450,68530,,,,,N/A,N/A,REMOVE FOREIGN BODY LACRIMAL,$608.39,$452.25,$165.77,$603.00,N/A,$584.91,N/A,$865.98,N/A,$165.77,N/A,$584.91,N/A,$603.00,N/A,N/A,$584.91
4501420,0450,69000,,,,,N/A,N/A,DRAIN EXT. EAR LESION 69000~TC,$755.70,$561.75,$440.61,$974.00,N/A,$944.78,N/A,$220.11,N/A,$440.61,N/A,$944.78,N/A,$974.00,N/A,N/A,$944.78
4500420A,0450,69000,,,,,N/A,N/A,I&D EXT EAR ABS        69000~T,$533.73,$396.75,$440.61,$974.00,N/A,$944.78,N/A,$220.11,N/A,$440.61,N/A,$944.78,N/A,$974.00,N/A,N/A,$944.78
4501224,0450,69200,,,,,N/A,N/A,RMV FB AUDIT CANAL         ~TC,$405.59,$301.50,$389.82,$548.00,N/A,$531.56,N/A,$156.88,N/A,$389.82,N/A,$531.56,N/A,$548.00,N/A,N/A,$531.56
4500224A,0450,69200,,,,,N/A,N/A,RMV FB EX AUDIT CANA   69200~T,$330.93,$246.00,$389.82,$548.00,N/A,$531.56,N/A,$156.88,N/A,$389.82,N/A,$531.56,N/A,$548.00,N/A,N/A,$531.56
4569209A,0450,69209,,,,,N/A,N/A,REMOVAL IMP CERUMEN FLUSHING~T,$169.50,$126.00,$145.00,$210.00,N/A,$203.70,N/A,$16.02,N/A,$145.00,N/A,$203.70,N/A,$210.00,N/A,N/A,$203.70
4501217,0450,69210,,,,,N/A,N/A,RMV IMPACT EAR WAX         ~TC,$405.59,$301.50,$23.19,$359.00,N/A,$348.23,N/A,$71.60,N/A,$23.19,N/A,$348.23,N/A,$359.00,N/A,N/A,$348.23
4500217A,0450,69210,,,,,N/A,N/A,RMV IMPACT CERUMEN     69210~T,$266.36,$198.00,$23.19,$359.00,N/A,$348.23,N/A,$71.60,N/A,$23.19,N/A,$348.23,N/A,$359.00,N/A,N/A,$348.23
4500143,0450,90471,,,,,N/A,N/A,"Rabies Vaccine, Im",$151.34,$112.50,$23.78,$181.00,$23.78,$175.57,$23.78,N/A,$23.78,N/A,$23.78,$175.57,$23.78,$181.00,$23.78,$23.78,$175.57
4590471,0450,90471,,,,,N/A,N/A,IMMUNIZATION ADMINISTRATION ~G,$182.62,$135.75,$23.78,$181.00,$23.78,$175.57,$23.78,N/A,$23.78,N/A,$23.78,$175.57,$23.78,$181.00,$23.78,$23.78,$175.57
9890472A,0450,90472,,,,,N/A,N/A,ADD'L VACCINE ADMINISTRATION~T,$182.62,$135.75,$16.96,$181.00,$22.14,$175.57,$22.14,N/A,$22.14,$16.96,$22.14,$175.57,$22.14,$181.00,$22.14,$22.14,$175.57
4590703,0450,90703,,,,,N/A,N/A,"TETANUS VACCINE, IM",$148.31,$110.25,$142.59,$147.00,N/A,$142.59,N/A,N/A,N/A,N/A,N/A,$142.59,N/A,$147.00,N/A,N/A,$142.59
4500147,0450,90746,,,,,N/A,N/A,IMMUN HEP B ABOVE 19YRS,$148.31,$110.25,$81.48,$84.00,N/A,$81.48,N/A,N/A,N/A,$84.00,N/A,$81.48,N/A,$84.00,N/A,N/A,$81.48
4590767,0450,90767,,,,,N/A,N/A,Subsequent Iv Infusion,$133.18,$99.00,$128.04,$132.00,N/A,$128.04,N/A,N/A,N/A,$132.00,N/A,$128.04,N/A,$132.00,N/A,N/A,$128.04
4590784,0450,90774,,,,,N/A,N/A,"Therapeutic Injection,Iv Push",$295.62,$219.75,$284.21,$293.00,N/A,$284.21,N/A,N/A,N/A,$293.00,N/A,$284.21,N/A,$293.00,N/A,N/A,$284.21
4590774-59,0450,90774,,,,,N/A,N/A,"THERAPEUTIC INJECT,IV PUSH -59",$199.77,$148.50,$284.21,$293.00,N/A,$284.21,N/A,N/A,N/A,$293.00,N/A,$284.21,N/A,$293.00,N/A,N/A,$284.21
4590776,0450,90776,,,,,N/A,N/A,Additional Iv Push -Same Drug,$95.85,$71.25,$100.88,$104.00,N/A,$100.88,N/A,N/A,N/A,$104.00,N/A,$100.88,N/A,$104.00,N/A,N/A,$100.88
4501071,0450,91105,,,,,N/A,N/A,GASTRIC LAVAGE        91105~TC,"$1,274.29",$947.25,$27.61,"$1,263.00",N/A,"$1,225.11",N/A,N/A,N/A,$27.61,N/A,"$1,225.11",N/A,"$1,263.00",N/A,N/A,"$1,225.11"
4501151,0450,91105,,,,,N/A,N/A,GASTRIC INTUB/LAVAGE  91105~TC,$527.68,$392.25,$27.61,"$1,263.00",N/A,"$1,225.11",N/A,N/A,N/A,$27.61,N/A,"$1,225.11",N/A,"$1,263.00",N/A,N/A,"$1,225.11"
4501155,0450,92950,,,,,N/A,N/A,CARDIOPULMONARY RESUS.     ~TC,"$1,681.90","$1,250.25",$69.28,"$1,932.00",N/A,"$1,874.04",N/A,N/A,N/A,$69.28,N/A,"$1,874.04",N/A,"$1,932.00",N/A,N/A,"$1,874.04"
4500155A,0450,92950,,,,,N/A,N/A,CARDIOPULMONARY RESUS  92950~T,"$1,292.45",$960.75,$69.28,"$1,932.00",N/A,"$1,874.04",N/A,N/A,N/A,$69.28,N/A,"$1,874.04",N/A,"$1,932.00",N/A,N/A,"$1,874.04"
4501156,0450,92953,,,,,N/A,N/A,TRANSCUTABEOUS TEMP PACMAKR~TC,"$1,680.89","$1,249.50",$385.42,"$1,717.00",N/A,"$1,665.49",N/A,N/A,N/A,$385.42,N/A,"$1,665.49",N/A,"$1,717.00",N/A,N/A,"$1,665.49"
4500156A,0450,92953,,,,,N/A,N/A,TRANSCUTANEU TMP PCMKR 92953~T,$922.17,$685.50,$385.42,"$1,717.00",N/A,"$1,665.49",N/A,N/A,N/A,$385.42,N/A,"$1,665.49",N/A,"$1,717.00",N/A,N/A,"$1,665.49"
4502156A,0450,92953,,,,,N/A,N/A,TEMPORARY PACEMAKER - 92953 T,"$1,050.31",$780.75,$385.42,"$1,717.00",N/A,"$1,665.49",N/A,N/A,N/A,$385.42,N/A,"$1,665.49",N/A,"$1,717.00",N/A,N/A,"$1,665.49"
4501157,0450,92960,,,,,N/A,N/A,CARDIOVERSION              ~TC,"$1,680.89","$1,249.50",$1.90,$372.00,$81.55,$360.84,$81.55,N/A,$81.55,$1.90,$81.55,$360.84,$81.55,$372.00,$81.55,$81.55,$360.84
4500157A,0450,92960,,,,,N/A,N/A,CARDIOVERSION          92960~T,"$1,079.57",$802.50,$1.90,$372.00,$81.55,$360.84,$81.55,N/A,$81.55,$1.90,$81.55,$360.84,$81.55,$372.00,$81.55,$81.55,$360.84
4593288A,0450,93288,,,,,N/A,N/A,PACE MAKER DEVICE EVAL      ~T,$44.39,$33.00,$31.16,$113.20,$31.16,$83.42,$31.16,N/A,$31.16,$113.20,$31.16,$83.42,$31.16,$86.00,$31.16,$31.16,$83.42
4501161,0450,94060,,,,,N/A,N/A,PEAK EXPIRATORY FLOW RATE  ~TC,$624.53,$464.25,$38.95,$726.00,$297.66,$704.22,$297.66,N/A,$297.66,$38.95,$297.66,$704.22,$297.66,$726.00,$297.66,$297.66,$704.22
4500162,0450,94640,,,,,N/A,N/A,AEROSOL INHALATION,$182.62,$135.75,$207.98,$218.00,N/A,$211.46,N/A,N/A,N/A,$207.98,N/A,$211.46,N/A,$218.00,N/A,N/A,$211.46
4500262,0450,94640,,,,,N/A,N/A,AEROSOL INHALATION         -76,$182.62,$135.75,$207.98,$218.00,N/A,$211.46,N/A,N/A,N/A,$207.98,N/A,$211.46,N/A,$218.00,N/A,N/A,$211.46
4501162,0450,94640,,,,,N/A,N/A,AEROSOL INHALATION    94640~TC,$178.58,$132.75,$207.98,$218.00,N/A,$211.46,N/A,N/A,N/A,$207.98,N/A,$211.46,N/A,$218.00,N/A,N/A,$211.46
4595992A,0450,95992,,,,,N/A,N/A,CANALITH REPOSITIONING PROC ~T,$36.32,$27.00,$36.80,$75.00,$36.80,$72.75,$36.80,N/A,$36.80,$52.58,$36.80,$72.75,$36.80,$75.00,$36.80,$36.80,$72.75
4597597A,0450,97597,,,,,N/A,N/A,"DEBRIDEMENT OPEN WOUND,20CM<~T",$299.66,$222.75,$14.55,$170.00,$14.55,$164.90,$14.55,N/A,$14.55,N/A,$14.55,$164.90,$14.55,$170.00,$14.55,$14.55,$164.90
4597598A,0450,97598,,,,,N/A,N/A,DEBRIDEMENT OPEN WOUND      ~T,$299.66,$222.75,$16.31,$391.00,$16.31,$379.27,$16.31,N/A,$16.31,$40.95,$16.31,$379.27,$16.31,$391.00,$16.31,$16.31,$379.27
4597607A,0450,97607,,,,,N/A,N/A,NEG. PRESSURE WOUND THERAPY ~T,$27.24,$20.25,$31.82,$148.00,$64.78,$143.56,$64.78,N/A,$64.78,$31.82,$64.78,$143.56,$64.78,$148.00,$64.78,$64.78,$143.56
4500168,0450,99175,,,,,N/A,N/A,IPECAC/CHARCOAL & OBSERVATIO,$94.84,$70.50,$3.42,$94.00,N/A,$91.18,N/A,N/A,N/A,$3.42,N/A,$91.18,N/A,$94.00,N/A,N/A,$91.18
4500169,0450,99195,,,,,N/A,N/A,THERAPEUTIC PHLEB     99195~TC,$180.60,$134.25,$4.82,$310.00,$78.31,$300.70,$78.31,N/A,$78.31,$4.82,$78.31,$300.70,$78.31,$310.00,$78.31,$78.31,$300.70
4500269,0450,99195,,,,,N/A,N/A,"PHLEBOTOMY,THERAPEUTIC   99915",$312.77,$232.50,$4.82,$310.00,$78.31,$300.70,$78.31,N/A,$78.31,$4.82,$78.31,$300.70,$78.31,$310.00,$78.31,$78.31,$300.70
4500715,0450,99218,,,,,N/A,N/A,ER OBSERVATION,$156.39,$116.25,N/A,N/A,N/A,N/A,N/A,$135.61,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500701,0450,99281,,,,,N/A,N/A,LEVEL I               99281~TC,$453.01,$336.75,$28.29,$449.00,$28.29,$435.53,$28.29,N/A,$28.29,$196.81,$28.29,$435.53,$28.29,$449.00,$28.29,$28.29,$435.53
4500701-27,0450,99281,,,,,N/A,N/A,LEVEL I             99281~TC27,$453.01,$336.75,$28.29,$449.00,$28.29,$435.53,$28.29,N/A,$28.29,$196.81,$28.29,$435.53,$28.29,$449.00,$28.29,$28.29,$435.53
4500701CS,0450,99281,,,,,N/A,N/A,LEVEL I             99281CS~TC,$453.01,$336.75,$28.29,$449.00,$28.29,$435.53,$28.29,N/A,$28.29,$196.81,$28.29,$435.53,$28.29,$449.00,$28.29,$28.29,$435.53
4501701CS,0450,99281,,,,,N/A,N/A,LEVEL I             99281~25CS,$453.01,$336.75,$28.29,$449.00,$28.29,$435.53,$28.29,N/A,$28.29,$196.81,$28.29,$435.53,$28.29,$449.00,$28.29,$28.29,$435.53
4500702,0450,99282,,,,,N/A,N/A,LEVEL II              99282~TC,$453.01,$336.75,$5.43,$449.00,$5.43,$435.53,$5.43,N/A,$5.43,$21.65,$5.43,$435.53,$5.43,$449.00,$5.43,$5.43,$435.53
4500702-27,0450,99282,,,,,N/A,N/A,LEVEL II            99282~TC27,$453.01,$336.75,$5.43,$449.00,$5.43,$435.53,$5.43,N/A,$5.43,$21.65,$5.43,$435.53,$5.43,$449.00,$5.43,$5.43,$435.53
4500702CS,0450,99282,,,,,N/A,N/A,LEVEL II            99282CS~TC,$453.01,$336.75,$5.43,$449.00,$5.43,$435.53,$5.43,N/A,$5.43,$21.65,$5.43,$435.53,$5.43,$449.00,$5.43,$5.43,$435.53
4501702CS,0450,99282,,,,,N/A,N/A,LEVEL II            99282~25CS,$453.01,$336.75,$5.43,$449.00,$5.43,$435.53,$5.43,N/A,$5.43,$21.65,$5.43,$435.53,$5.43,$449.00,$5.43,$5.43,$435.53
4500703,0450,99283,,,,,N/A,N/A,LEVEL III             99283~TC,$811.19,$603.00,$41.90,$804.00,$48.79,$779.88,$48.79,N/A,$48.79,$41.90,$48.79,$779.88,$48.79,$804.00,$48.79,$48.79,$779.88
4599283,0450,99283,,,,,N/A,N/A,SAV PROFESSIONAL EXAM,$252.24,$187.50,$41.90,$804.00,$48.79,$779.88,$48.79,N/A,$48.79,$41.90,$48.79,$779.88,$48.79,$804.00,$48.79,$48.79,$779.88
4500703-27,0450,99283,,,,,N/A,N/A,LEVEL III           99283~TC27,$811.19,$603.00,$41.90,$804.00,$48.79,$779.88,$48.79,N/A,$48.79,$41.90,$48.79,$779.88,$48.79,$804.00,$48.79,$48.79,$779.88
4500703CS,0450,99283,,,,,N/A,N/A,LEVEL III           99283CS~TC,$811.19,$603.00,$41.90,$804.00,$48.79,$779.88,$48.79,N/A,$48.79,$41.90,$48.79,$779.88,$48.79,$804.00,$48.79,$48.79,$779.88
4501703CS,0450,99283,,,,,N/A,N/A,LEVEL III -25       99283~25CS,$811.19,$603.00,$41.90,$804.00,$48.79,$779.88,$48.79,N/A,$48.79,$41.90,$48.79,$779.88,$48.79,$804.00,$48.79,$48.79,$779.88
4500704,0450,99284,,,,,N/A,N/A,LEVEL IV              99284~TC,"$1,218.80",$906.00,$70.74,"$1,208.00",$95.53,"$1,171.76",$95.53,N/A,$95.53,$70.74,$95.53,"$1,171.76",$95.53,"$1,208.00",$95.53,$95.53,"$1,171.76"
4501704,0450,99284,,,,,N/A,N/A,LEVEL IV              99284~25,"$1,218.80",$906.00,$70.74,"$1,208.00",$95.53,"$1,171.76",$95.53,N/A,$95.53,$70.74,$95.53,"$1,171.76",$95.53,"$1,208.00",$95.53,$95.53,"$1,171.76"
4500704-27,0450,99284,,,,,N/A,N/A,LEVEL IV            99284~TC27,"$1,218.80",$906.00,$70.74,"$1,208.00",$95.53,"$1,171.76",$95.53,N/A,$95.53,$70.74,$95.53,"$1,171.76",$95.53,"$1,208.00",$95.53,$95.53,"$1,171.76"
4500704CS,0450,99284,,,,,N/A,N/A,LEVEL IV            99284CS~TC,"$1,218.80",$906.00,$70.74,"$1,208.00",$95.53,"$1,171.76",$95.53,N/A,$95.53,$70.74,$95.53,"$1,171.76",$95.53,"$1,208.00",$95.53,$95.53,"$1,171.76"
4501704CS,0450,99284,,,,,N/A,N/A,LEVEL IV            99284~25CS,"$1,218.80",$906.00,$70.74,"$1,208.00",$95.53,"$1,171.76",$95.53,N/A,$95.53,$70.74,$95.53,"$1,171.76",$95.53,"$1,208.00",$95.53,$95.53,"$1,171.76"
4500705,0450,99285,,,,,N/A,N/A,LEVEL  V              99285~TC,"$1,218.80",$906.00,$120.19,"$1,208.00",$145.96,"$1,171.76",$145.96,N/A,$145.96,$120.19,$145.96,"$1,171.76",$145.96,"$1,208.00",$145.96,$145.96,"$1,171.76"
4500705-27,0450,99285,,,,,N/A,N/A,LEVEL V             9928527~TC,"$1,218.80",$906.00,$120.19,"$1,208.00",$145.96,"$1,171.76",$145.96,N/A,$145.96,$120.19,$145.96,"$1,171.76",$145.96,"$1,208.00",$145.96,$145.96,"$1,171.76"
4500705CS,0450,99285,,,,,N/A,N/A,LEVEL  V            99285CS~TC,"$1,218.80",$906.00,$120.19,"$1,208.00",$145.96,"$1,171.76",$145.96,N/A,$145.96,$120.19,$145.96,"$1,171.76",$145.96,"$1,208.00",$145.96,$145.96,"$1,171.76"
4501705CS,0450,99285,,,,,N/A,N/A,LEVEL V   -25CS       99285~TC,"$1,218.80",$906.00,$120.19,"$1,208.00",$145.96,"$1,171.76",$145.96,N/A,$145.96,$120.19,$145.96,"$1,171.76",$145.96,"$1,208.00",$145.96,$145.96,"$1,171.76"
4500004A,0450,99291,,,,,N/A,N/A,CRITICAL CARE        9929125~T,"$1,901.85","$1,413.75",$174.83,"$1,885.00",$225.91,"$1,828.45",$225.91,N/A,$225.91,$174.83,$225.91,"$1,828.45",$225.91,"$1,885.00",$225.91,$225.91,"$1,828.45"
4500004ACS,0450,99291,,,,,N/A,N/A,CRITICAL CARE      9929125CS~T,"$1,901.85","$1,413.75",$174.83,"$1,885.00",$225.91,"$1,828.45",$225.91,N/A,$225.91,$174.83,$225.91,"$1,828.45",$225.91,"$1,885.00",$225.91,$225.91,"$1,828.45"
4500005A,0450,99291,,,,,N/A,N/A,CRITICAL CARE        9929125~T,"$1,901.85","$1,413.75",$174.83,"$1,885.00",$225.91,"$1,828.45",$225.91,N/A,$225.91,$174.83,$225.91,"$1,828.45",$225.91,"$1,885.00",$225.91,$225.91,"$1,828.45"
4500008A,0450,99292,,,,,N/A,N/A,CRITICAL CARE 30 MIN   99292~T,$421.74,$313.50,$215.40,$556.00,$227.96,$539.32,$227.96,N/A,$227.96,$215.40,$227.96,$539.32,$227.96,$556.00,$227.96,$227.96,$539.32
4500008ACS,0450,99292,,,,,N/A,N/A,CRITICAL CARE 30 MIN 99292CS~T,$421.74,$313.50,$215.40,$556.00,$227.96,$539.32,$227.96,N/A,$227.96,$215.40,$227.96,$539.32,$227.96,$556.00,$227.96,$227.96,$539.32
4513121,0450,1311T,,,,,N/A,N/A,Rpr Cmp  2.6-7.5 Cm   13121~tc,$442.92,$329.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
45Q3014,0450,Q3014,,,,,N/A,N/A,TELEHEATH ORIGINATING SITE FEE,$31.28,$23.25,$25.22,$26.00,N/A,$25.22,N/A,N/A,N/A,$26.00,N/A,$25.22,N/A,$26.00,N/A,N/A,$25.22
4500002,0450,,,,,,N/A,N/A,INDEPENDENT BLD ALCOHOL  ~EMER,$61.55,$45.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500150,0450,,,,,,N/A,N/A,"Therapeutic Injection,Iv Push",$295.62,$219.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501701,0450,,,,,,N/A,N/A,LEVEL I               99281~25,$453.01,$336.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501702,0450,,,,,,N/A,N/A,LEVEL II 9928225      99282~25,$453.01,$336.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501703,0450,,,,,,N/A,N/A,LEVEL III -25         99283~25,$811.19,$603.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501705,0450,,,,,,N/A,N/A,LEVEL V   -25         99285~TC,"$1,218.80",$906.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4599901,0450,,,,,,N/A,N/A,SAV EXAM,$622.52,$462.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4527752-TC,0450,,,,,,N/A,N/A,CLOSED TRMT TIB.SHAF FX;W MAN,"$3,311.34","$2,461.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4600038,0460,94010,,,,,N/A,N/A,PFT SCREEN,$379.36,$282.00,$84.70,$376.00,$154.16,$364.72,$154.16,N/A,$154.16,$84.70,$154.16,$364.72,$154.16,$376.00,$154.16,$154.16,$364.72
4600039,0460,94060,,,,,N/A,N/A,PFT SCREEN W/BD,$732.49,$544.50,$38.95,$726.00,$297.66,$704.22,$297.66,N/A,$297.66,$38.95,$297.66,$704.22,$297.66,$726.00,$297.66,$297.66,$704.22
4694060,0460,94060,,,,,N/A,N/A,PEAK EXPIRATORY FLOW RATE  -TC,$610.41,$453.75,$38.95,$726.00,$297.66,$704.22,$297.66,N/A,$297.66,$38.95,$297.66,$704.22,$297.66,$726.00,$297.66,$297.66,$704.22
4100055,0460,94150,,,,,N/A,N/A,VITAL CAPACITY TEST,$223.98,$166.50,$30.07,$93.89,$93.89,$30.07,$93.89,N/A,$93.89,$82.20,$93.89,$30.07,$93.89,$31.00,$93.89,$93.89,$30.07
4594150,0460,94150,,,,,N/A,N/A,VITAL CAPACITY TEST,$231.05,$171.75,$30.07,$93.89,$93.89,$30.07,$93.89,N/A,$93.89,$82.20,$93.89,$30.07,$93.89,$31.00,$93.89,$93.89,$30.07
5194150,0460,94150,,,,,N/A,N/A,VITAL CAPACITY TEST,$216.92,$161.25,$30.07,$93.89,$93.89,$30.07,$93.89,N/A,$93.89,$82.20,$93.89,$30.07,$93.89,$31.00,$93.89,$93.89,$30.07
4194260,0460,94260,,,,,N/A,N/A,Thoracic Gas Volume,$369.27,$274.50,$15.60,$366.00,$15.60,$355.02,$15.60,N/A,$15.60,$23.40,$15.60,$355.02,$15.60,$366.00,$15.60,$15.60,$355.02
4194360,0460,94360,,,,,N/A,N/A,Measure Airflow Resistance,$230.04,$171.00,$221.16,$228.00,N/A,$221.16,N/A,N/A,N/A,$228.00,N/A,$221.16,N/A,$228.00,N/A,N/A,$221.16
4600002,0460,94617,,,,,N/A,N/A,EXERCISE CHALLENGE,$976.65,$726.00,$71.38,$968.00,$396.88,$938.96,$396.88,N/A,$396.88,$71.38,$396.88,$938.96,$396.88,$968.00,$396.88,$396.88,$938.96
4100058,0460,94618,,,,,N/A,N/A,OXIMETRY WITH EXERCISE,$369.27,$274.50,$15.60,$968.00,$15.60,$938.96,$15.60,N/A,$15.60,$124.15,$15.60,$938.96,$15.60,$968.00,$15.60,$15.60,$938.96
4194720,0460,94720,,,,,N/A,N/A,Diffusion Capacity,$349.09,$259.50,$43.53,$346.00,N/A,$335.62,N/A,N/A,N/A,$43.53,N/A,$335.62,N/A,$346.00,N/A,N/A,$335.62
4600051,0460,94760,,,,,N/A,N/A,RT PULSE OXIM PER RD,$145.29,$108.00,$59.40,$144.00,$59.40,$139.68,$59.40,N/A,$59.40,$78.75,$59.40,$139.68,$59.40,$144.00,$59.40,$59.40,$139.68
4600452,0460,94761,,,,,N/A,N/A,NURSERY NURSE PULSE OXIM SHIFT,$674.98,$501.75,$3.01,$669.00,$274.29,$648.93,$274.29,N/A,$274.29,$3.01,$274.29,$648.93,$274.29,$669.00,$274.29,$274.29,$648.93
4100072,0460,94762,,,,,N/A,N/A,NOCT. O2 DESAT. STDY,$897.96,$667.50,$4.84,$890.00,$364.90,$863.30,$364.90,N/A,$364.90,$4.84,$364.90,$863.30,$364.90,$890.00,$364.90,$364.90,$863.30
4600451,0460,.,,,,,N/A,N/A,NURSERY NURSE PULSE OXIM READ,$175.56,$130.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4690237,0469,94618,,,,,N/A,N/A,SIX MINUTE WALK - RT/RN,$171.52,$127.50,$15.60,$968.00,$15.60,$938.96,$15.60,N/A,$15.60,$124.15,$15.60,$938.96,$15.60,$968.00,$15.60,$15.60,$938.96
4697110,0469,97110,,,,,N/A,N/A,THERAPEUTIC PROC 1/4 HR PT~PR,$228.02,$169.50,$16.72,$64.00,$26.24,$62.08,$26.24,N/A,$26.24,$16.72,$26.24,$62.08,$26.24,$64.00,$26.24,$26.24,$62.08
4697150,0469,97150,,,,,N/A,N/A,GROUP THERAPY              ~PR,$180.60,$134.25,$31.83,$168.00,$68.88,$162.96,$68.88,N/A,$68.88,$31.83,$68.88,$162.96,$68.88,$168.00,$68.88,$68.88,$162.96
4697535,0469,97535,,,,,N/A,N/A,Education PT/OT,$203.81,$151.50,$9.20,$220.00,$9.20,$213.40,$9.20,N/A,$9.20,$45.10,$9.20,$213.40,$9.20,$220.00,$9.20,$9.20,$213.40
4697750,0469,97750,,,,,N/A,N/A,Six Minute Walk - PT/OT,$187.66,$139.50,$27.95,$76.26,$76.26,$62.08,$76.26,N/A,$76.26,$27.95,$76.26,$62.08,$76.26,$64.00,$76.26,$76.26,$62.08
4699211,0469,99211,,,,,N/A,N/A,Education - RN/RT,$286.54,$213.00,$24.19,$182.62,$24.19,$57.23,$24.19,$95.56,$24.19,$182.62,$24.19,$57.23,$24.19,$59.00,$24.19,$24.19,$57.23
4690001,0469,G0237,,,,,N/A,N/A,THERAPEUTIC EXERCISE-RT/RN,$171.52,$127.50,$10.66,$170.00,$10.66,$164.90,$10.66,N/A,$10.66,$170.00,$10.66,$164.90,$10.66,$170.00,$10.66,$10.66,$164.90
4690002,0469,G0238,,,,,N/A,N/A,Therapeutic Proc. Indiv. RT/RN,$171.52,$127.50,$10.32,$170.00,$10.32,$164.90,$10.32,N/A,$10.32,$170.00,$10.32,$164.90,$10.32,$170.00,$10.32,$10.32,$164.90
4690003,0469,G0239,,,,,N/A,N/A,Therapeutic Proc. Group  RT/RN,$90.80,$67.50,$12.69,$116.00,$12.69,$112.52,$12.69,N/A,$12.69,$116.00,$12.69,$112.52,$12.69,$116.00,$12.69,$12.69,$112.52
47092586,0470,,,,,,N/A,N/A,Newborn Hearing Screening,$674.98,$501.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7600041,0480,92960,,,,,N/A,N/A,CARDIOVERSION,"$1,894.79","$1,408.50",$1.90,$372.00,$81.55,$360.84,$81.55,N/A,$81.55,$1.90,$81.55,$360.84,$81.55,$372.00,$81.55,$81.55,$360.84
7600313,0480,92960,,,,,N/A,N/A,CARDIOVERSION,"$1,972.48","$1,466.25",$1.90,$372.00,$81.55,$360.84,$81.55,N/A,$81.55,$1.90,$81.55,$360.84,$81.55,$372.00,$81.55,$81.55,$360.84
7692960,0480,92960,,,,,N/A,N/A,CARDIOVERSION (ABORTED)    -73,"$1,894.79","$1,408.50",$1.90,$372.00,$81.55,$360.84,$81.55,N/A,$81.55,$1.90,$81.55,$360.84,$81.55,$372.00,$81.55,$81.55,$360.84
4500158A,0480,92977,,,,,N/A,N/A,THROMBOLYSIS           92977~T,"$1,339.87",$996.00,$69.30,"$1,683.00",$69.30,"$1,632.51",$69.30,N/A,$69.30,$229.37,$69.30,"$1,632.51",$69.30,"$1,683.00",$69.30,$69.30,"$1,632.51"
4007002,0480,93307,,,,,N/A,N/A,ECHOCARDIOGRAPH 2D TRANSTHOR,$476.22,$354.00,$148.82,$473.00,$193.52,$458.81,$193.52,N/A,$193.52,$148.82,$193.52,$458.81,$193.52,$473.00,$193.52,$193.52,$458.81
4007032,0480,93312,,,,,N/A,N/A,HEART TRANSESOPHAGEAL,$973.63,$723.75,$217.75,$711.00,$476.10,$689.67,$476.10,N/A,$476.10,$217.75,$476.10,$689.67,$476.10,$711.00,$476.10,$476.10,$689.67
4807800,0480,93312,,,,,N/A,N/A,ECHOCARDIOGRAPH 2D TRANSESOPH,$973.63,$723.75,$217.75,$711.00,$476.10,$689.67,$476.10,N/A,$476.10,$217.75,$476.10,$689.67,$476.10,$711.00,$476.10,$476.10,$689.67
4007010,0480,93320,,,,,N/A,N/A,DOPPLER COMPLETE,$249.21,$185.25,$11.27,$532.43,$11.27,$239.59,$11.27,N/A,$11.27,$532.43,$11.27,$239.59,$11.27,$247.00,$11.27,$11.27,$239.59
4803320,0480,93320,,,,,N/A,N/A,DOPPLER COMPLETE,$249.21,$185.25,$11.27,$532.43,$11.27,$239.59,$11.27,N/A,$11.27,$532.43,$11.27,$239.59,$11.27,$247.00,$11.27,$11.27,$239.59
4007020,0480,93325,,,,,N/A,N/A,DOPPLER COLOR FLOW,$195.73,$145.50,$79.54,$194.00,$79.54,$188.18,$79.54,N/A,$79.54,$115.01,$79.54,$188.18,$79.54,$194.00,$79.54,$79.54,$188.18
4803325,0480,93325,,,,,N/A,N/A,DOPPLER COLOR FLOW,$195.73,$145.50,$79.54,$194.00,$79.54,$188.18,$79.54,N/A,$79.54,$115.01,$79.54,$188.18,$79.54,$194.00,$79.54,$79.54,$188.18
4807801,0480,93350,,,,,N/A,N/A,STRESS ECHOCARDIOGRAM,$518.60,$385.50,$21.74,$467.00,$21.74,$452.99,$21.74,N/A,$21.74,$54.13,$21.74,$452.99,$21.74,$467.00,$21.74,$21.74,$452.99
4800012,0482,59412,,,,,N/A,N/A,VERSION,$728.45,$541.50,$296.20,"$1,044.35",$296.20,$700.34,$296.20,$617.31,$296.20,"$1,044.35",$296.20,$700.34,$296.20,$722.00,$296.20,$296.20,$700.34
4800003,0482,93017,,,,,N/A,N/A,C LAB STRESS TESTING,"$1,752.53","$1,302.75",$46.04,"$1,299.00",$712.17,"$1,260.03",$712.17,N/A,$712.17,$46.04,$712.17,"$1,260.03",$712.17,"$1,299.00",$712.17,$712.17,"$1,260.03"
4800009,0482,,,,,,N/A,N/A,STRESS & NON STRESS,"$1,415.54","$1,052.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
40093308,0483,93308,,,,,N/A,N/A,US ECHO FOLLOW UP OR LIMITED,$506.49,$376.50,$25.82,$310.19,$25.82,$251.23,$25.82,N/A,$25.82,$310.19,$25.82,$251.23,$25.82,$259.00,$25.82,$25.82,$251.23
4593308A,0483,93308,,,,,N/A,N/A,ECHO EXAM OF HEART          ~T,$175.56,$130.50,$25.82,$310.19,$25.82,$251.23,$25.82,N/A,$25.82,$310.19,$25.82,$251.23,$25.82,$259.00,$25.82,$25.82,$251.23
9330880A,0483,93308,,,,,N/A,N/A,ECHO EXAM OF HEART          ~T,$175.56,$130.50,$25.82,$310.19,$25.82,$251.23,$25.82,N/A,$25.82,$310.19,$25.82,$251.23,$25.82,$259.00,$25.82,$25.82,$251.23
7600316,0483,93312,,,,,N/A,N/A,ECHO TRANSESOPHAGEAL,$973.63,$723.75,$217.75,$711.00,$476.10,$689.67,$476.10,N/A,$476.10,$217.75,$476.10,$689.67,$476.10,$711.00,$476.10,$476.10,$689.67
9331274,0483,93312,,,,,N/A,N/A,ECHO TRANSESOPHAGEAL,"$1,171.38",$870.75,$217.75,$711.00,$476.10,$689.67,$476.10,N/A,$476.10,$217.75,$476.10,$689.67,$476.10,$711.00,$476.10,$476.10,$689.67
4932421,0490,32421,,,,,N/A,N/A,Thoracentesis        32554-Tc,"$1,797.93","$1,336.50",$71.12,$71.12,$71.12,N/A,$71.12,N/A,$71.12,N/A,$71.12,N/A,$71.12,N/A,$71.12,$71.12,N/A
7632421,0490,32421,,,,,N/A,N/A,Thoracentesis               Tc,"$1,747.48","$1,299.00",$71.12,$71.12,$71.12,N/A,$71.12,N/A,$71.12,N/A,$71.12,N/A,$71.12,N/A,$71.12,$71.12,N/A
4936540,0490,36540,,,,,N/A,N/A,Collect Blood Venous Device,$340.01,$252.75,$360.84,$372.00,N/A,$360.84,N/A,$318.06,N/A,$372.00,N/A,$360.84,N/A,$372.00,N/A,N/A,$360.84
7336540,0490,36540,,,,,N/A,N/A,Blood Draw Comp Implanted Port,$373.31,$277.50,$360.84,$372.00,N/A,$360.84,N/A,$318.06,N/A,$372.00,N/A,$360.84,N/A,$372.00,N/A,N/A,$360.84
7636540,0490,36540,,,,,N/A,N/A,Blood Draw Comp Implanted Port,$375.33,$279.00,$360.84,$372.00,N/A,$360.84,N/A,$318.06,N/A,$372.00,N/A,$360.84,N/A,$372.00,N/A,N/A,$360.84
3936575,0490,36575,,,,,N/A,N/A,REPAIR OF PICC LINE,"$1,502.31","$1,116.75",$57.77,"$1,667.00",$683.47,"$1,616.99",$683.47,"$1,425.29",$683.47,$57.77,$683.47,"$1,616.99",$683.47,"$1,667.00",$683.47,$683.47,"$1,616.99"
4936575,0490,36575,,,,,N/A,N/A,REPAIR OF PICC LINE,"$1,681.90","$1,250.25",$57.77,"$1,667.00",$683.47,"$1,616.99",$683.47,"$1,425.29",$683.47,$57.77,$683.47,"$1,616.99",$683.47,"$1,667.00",$683.47,$683.47,"$1,616.99"
3936592,0490,36592,,,,,N/A,N/A,PICC -CENTRAL LINE BLOOD DRAW,$206.83,$153.75,$52.07,$200.00,$86.51,$194.00,$86.51,$171.00,$86.51,$52.07,$86.51,$194.00,$86.51,$200.00,$86.51,$86.51,$194.00
4936592,0490,36592,,,,,N/A,N/A,PICC -CENTRAL LINE BLOOD DRAW,$212.89,$158.25,$52.07,$200.00,$86.51,$194.00,$86.51,$171.00,$86.51,$52.07,$86.51,$194.00,$86.51,$200.00,$86.51,$86.51,$194.00
7636592,0490,36592,,,,,N/A,N/A,PICC-CENTRAL LINE BLOOD DRAW,$221.97,$165.00,$52.07,$200.00,$86.51,$194.00,$86.51,$171.00,$86.51,$52.07,$86.51,$194.00,$86.51,$200.00,$86.51,$86.51,$194.00
3936593,0490,36593,,,,,N/A,N/A,DECLOT VASC ACCESS DEVICE/CATH,"$1,102.77",$819.75,$25.10,"$1,130.00",$25.10,"$1,096.10",$25.10,$966.15,$25.10,$57.22,$25.10,"$1,096.10",$25.10,"$1,130.00",$25.10,$25.10,"$1,096.10"
4936593,0490,36593,,,,,N/A,N/A,PORT FLUSH,$77.69,$57.75,$25.10,"$1,130.00",$25.10,"$1,096.10",$25.10,$966.15,$25.10,$57.22,$25.10,"$1,096.10",$25.10,"$1,130.00",$25.10,$25.10,"$1,096.10"
6336593,0490,36593,,,,,N/A,N/A,DECLOT VASC ACCESS DEVISE/CATH,"$1,140.10",$847.50,$25.10,"$1,130.00",$25.10,"$1,096.10",$25.10,$966.15,$25.10,$57.22,$25.10,"$1,096.10",$25.10,"$1,130.00",$25.10,$25.10,"$1,096.10"
6338220,0490,38220,,,,,N/A,N/A,BONE MARROW ASPIRATION,"$1,069.48",$795.00,$117.61,"$1,060.00",$434.60,"$1,028.20",$434.60,$906.30,$434.60,$117.61,$434.60,"$1,028.20",$434.60,"$1,060.00",$434.60,$434.60,"$1,028.20"
5159000,0490,59000,,,,,N/A,N/A,AMNIOCENTESIS,$500.43,$372.00,$23.36,$913.22,$23.36,N/A,$23.36,$424.08,$23.36,$913.22,$23.36,N/A,$23.36,$496.00,$23.36,$23.36,N/A
3662270,0490,62270,,,,,N/A,N/A,SPINAL PUNCTURE LUMBAR,$822.29,$611.25,$83.35,$207.00,$88.97,$200.79,$88.97,$176.99,$88.97,$83.35,$88.97,$200.79,$88.97,$207.00,$88.97,$88.97,$200.79
4962270,0490,62270,,,,,N/A,N/A,SPINAL PUNCTURE LUMBAR,$587.20,$436.50,$83.35,$207.00,$88.97,$200.79,$88.97,$176.99,$88.97,$83.35,$88.97,$200.79,$88.97,$207.00,$88.97,$88.97,$200.79
3662272,0490,62272,,,,,N/A,N/A,SPINAL LUMBAR PUNCTURE DIAG,"$1,189.54",$884.25,$78.63,$291.00,$119.31,$282.27,$119.31,$248.81,$119.31,$78.63,$119.31,$282.27,$119.31,$291.00,$119.31,$119.31,$282.27
6393017,0490,93017,,,,,N/A,N/A,CARDIOVASCULAR STRESS TEST,"$1,310.61",$974.25,$46.04,"$1,299.00",$712.17,"$1,260.03",$712.17,N/A,$712.17,$46.04,$712.17,"$1,260.03",$712.17,"$1,299.00",$712.17,$712.17,"$1,260.03"
9597075,0490,95970,,,,,N/A,N/A,NEURO W/O REPROG,$265.35,$197.25,$17.83,$263.00,$17.83,$255.11,$17.83,N/A,$17.83,N/A,$17.83,$255.11,$17.83,$263.00,$17.83,$17.83,$255.11
9597175,0490,95971,,,,,N/A,N/A,NEURO W/ REPROGRAMMING,$361.20,$268.50,$24.55,$358.00,$146.78,$347.26,$146.78,N/A,$146.78,$24.55,$146.78,$347.26,$146.78,$358.00,$146.78,$146.78,$347.26
9599175,0490,95991,,,,,N/A,N/A,PUMP REFILL & MAIN,$268.38,$199.50,$19.60,$266.00,$19.60,$258.02,$19.60,N/A,$19.60,$52.25,$19.60,$258.02,$19.60,$266.00,$19.60,$19.60,$258.02
4996523,0490,96523,,,,,N/A,N/A,PORT FLUSH -INTRAVENOUS ACCESS,$212.89,$158.25,$86.51,$205.00,$86.51,$198.85,$86.51,N/A,$86.51,$202.26,$86.51,$198.85,$86.51,$205.00,$86.51,$86.51,$198.85
1002140A,0510,10021,,,,,N/A,N/A,"SKIN,SUB INCISION & DRAIN   ~T",$170.51,$126.75,$93.14,$430.00,N/A,$417.10,N/A,$367.65,N/A,$93.14,N/A,$417.10,N/A,$430.00,N/A,N/A,$417.10
1006040A,0510,10060,,,,,N/A,N/A,DRAINAGE OF SKIN ABSCESS    ~T,$22.20,$16.50,$8.77,$197.00,$8.77,N/A,$8.77,$168.44,$8.77,$177.59,$8.77,N/A,$8.77,$197.00,$8.77,$8.77,N/A
1006140A,0510,10061,,,,,N/A,N/A,DRAINAGE OF SKIN ABSCESS    ~T,$61.55,$45.75,$15.60,$366.00,$15.60,$355.02,$15.60,$312.93,$15.60,$312.38,$15.60,$355.02,$15.60,$366.00,$15.60,$15.60,$355.02
1006145A,0510,10061,,,,,N/A,N/A,DRAINAGE OF SKIN ABSCESS    ~T,$30.27,$22.50,$15.60,$366.00,$15.60,$355.02,$15.60,$312.93,$15.60,$312.38,$15.60,$355.02,$15.60,$366.00,$15.60,$15.60,$355.02
5110061A,0510,10061,,,,,N/A,N/A,"I & D, COMPLICATED          ~T",$397.52,$295.50,$15.60,$366.00,$15.60,$355.02,$15.60,$312.93,$15.60,$312.38,$15.60,$355.02,$15.60,$366.00,$15.60,$15.60,$355.02
1008140A,0510,10081,,,,,N/A,N/A,Drainage Of Pilonidal Cyst  ~t,$0.00,$0.00,$152.52,$372.00,$152.52,$360.84,$152.52,$318.06,$152.52,$293.55,$152.52,$360.84,$152.52,$372.00,$152.52,$152.52,$360.84
1012040A,0510,10120,,,,,N/A,N/A,Remove Foreign Body         ~t,$0.00,$0.00,$83.64,$204.00,$83.64,$197.88,$83.64,$174.42,$83.64,$179.14,$83.64,$197.88,$83.64,$204.00,$83.64,$83.64,$197.88
1012045A,0510,10120,,,,,N/A,N/A,"Inscn & Reml Forgn Bdy,Subq ~t",$0.00,$0.00,$83.64,$204.00,$83.64,$197.88,$83.64,$174.42,$83.64,$179.14,$83.64,$197.88,$83.64,$204.00,$83.64,$83.64,$197.88
1012140A,0510,10121,,,,,N/A,N/A,Remove Foreign Body         ~t,$0.00,$0.00,$172.61,$421.00,$172.61,$408.37,$172.61,$359.96,$172.61,$314.50,$172.61,$408.37,$172.61,$421.00,$172.61,$172.61,$408.37
1012145A,0510,10121,,,,,N/A,N/A,"Inscn & Reml Forgn Bdy,Comp ~t",$0.00,$0.00,$172.61,$421.00,$172.61,$408.37,$172.61,$359.96,$172.61,$314.50,$172.61,$408.37,$172.61,$421.00,$172.61,$172.61,$408.37
1014040A,0510,10140,,,,,N/A,N/A,DRAINAGE OF HEMATOMA/FLUID  ~T,$45.40,$33.75,$117.26,$266.00,$117.26,$258.02,$117.26,$227.43,$117.26,$202.56,$117.26,$258.02,$117.26,$266.00,$117.26,$117.26,$258.02
1014045A,0510,10140,,,,,N/A,N/A,DRAINAGE OF HEMATOMA/FLUID  ~T,$45.40,$33.75,$117.26,$266.00,$117.26,$258.02,$117.26,$227.43,$117.26,$202.56,$117.26,$258.02,$117.26,$266.00,$117.26,$117.26,$258.02
1016040A,0510,10160,,,,,N/A,N/A,PUNCTURE ASPIRA OF ABSCESS  ~T,$206.83,$153.75,$16.72,$392.00,$16.72,$380.24,$16.72,$335.16,$16.72,$162.64,$16.72,$380.24,$16.72,$392.00,$16.72,$16.72,$380.24
1016045A,0510,10160,,,,,N/A,N/A,PUNCTURE ASPIRA OF ABSCESS  ~T,$206.83,$153.75,$16.72,$392.00,$16.72,$380.24,$16.72,$335.16,$16.72,$162.64,$16.72,$380.24,$16.72,$392.00,$16.72,$16.72,$380.24
1018040A,0510,10180,,,,,N/A,N/A,"COMPLEX DRAINAGE, WOUND     ~T",$72.64,$54.00,$163.59,$399.00,$163.59,$387.03,$163.59,$341.15,$163.59,$301.36,$163.59,$387.03,$163.59,$399.00,$163.59,$163.59,$387.03
1100140A,0510,11001,,,,,N/A,N/A,DEBRIDEMENT                 ~T,$20.18,$15.00,$14.79,$42.00,$16.81,$40.74,$16.81,$35.91,$16.81,$14.79,$16.81,$40.74,$16.81,$42.00,$16.81,$16.81,$40.74
1100440A,0510,11004,,,,,N/A,N/A,Debride Genitalia & Perineum~t,$0.00,$0.00,$541.61,"$1,321.00",$541.61,"$1,281.37",$541.61,"$1,129.46",$541.61,$582.94,$541.61,"$1,281.37",$541.61,"$1,321.00",$541.61,$541.61,"$1,281.37"
1100540A,0510,11005,,,,,N/A,N/A,Debride Abdom Wall          ~t,$0.00,$0.00,$735.95,"$1,795.00",$735.95,"$1,741.15",$735.95,"$1,534.73",$735.95,$787.18,$735.95,"$1,741.15",$735.95,"$1,795.00",$735.95,$735.95,"$1,741.15"
1100840A,0510,11008,,,,,N/A,N/A,Remove Mesh From Abd Wall   ~t,$0.00,$0.00,$273.60,$666.00,$273.60,$646.02,$273.60,$569.43,$273.60,$276.48,$273.60,$646.02,$273.60,$666.00,$273.60,$273.60,$646.02
1101045A,0510,11010,,,,,N/A,N/A,Debridement                 ~t,$0.00,$0.00,$239.30,$583.00,$239.30,$565.51,$239.30,$498.47,$239.30,$283.64,$239.30,$565.51,$239.30,$583.00,$239.30,$239.30,$565.51
1101145A,0510,11011,,,,,N/A,N/A,"DEBRIDE SKIN/MUSCLE, FX     ~T",$23.21,$17.25,$284.54,$284.54,$284.54,N/A,$284.54,N/A,$284.54,N/A,$284.54,N/A,$284.54,N/A,$284.54,$284.54,N/A
1101245A,0510,11012,,,,,N/A,N/A,"Debride Skin/Muscle/Bone, Fx~t",$0.00,$0.00,$419.43,"$1,023.00",$419.43,$992.31,$419.43,$874.67,$419.43,$427.36,$419.43,$992.31,$419.43,"$1,023.00",$419.43,$419.43,$992.31
1104240A,0510,11042,,,,,N/A,N/A,DEBRIDE SKIN/TISSUE         ~T,$66.59,$49.50,$61.50,$150.00,$61.50,$145.50,$61.50,$128.25,$61.50,$62.57,$61.50,$145.50,$61.50,$150.00,$61.50,$61.50,$145.50
1104245A,0510,11042,,,,,N/A,N/A,DEBRIDEMENT                 ~T,$66.59,$49.50,$61.50,$150.00,$61.50,$145.50,$61.50,$128.25,$61.50,$62.57,$61.50,$145.50,$61.50,$150.00,$61.50,$61.50,$145.50
1104340A,0510,11043,,,,,N/A,N/A,"Debrid,Muscle First 20sq Cm ~t",$0.00,$0.00,$159.32,$390.00,$159.90,$378.30,$159.90,$333.45,$159.90,$159.32,$159.90,$378.30,$159.90,$390.00,$159.90,$159.90,$378.30
1104345A,0510,11043,,,,,N/A,N/A,Debrdmnt Mus/Fas Fir 20sqcm<~t,$0.00,$0.00,$159.32,$390.00,$159.90,$378.30,$159.90,$333.45,$159.90,$159.32,$159.90,$378.30,$159.90,$390.00,$159.90,$159.90,$378.30
1104440A,0510,11044,,,,,N/A,N/A,Debride Tissue/Muscle/Bone  ~t,$0.00,$0.00,$231.11,$634.00,$259.94,$614.98,$259.94,$542.07,$259.94,$231.11,$259.94,$614.98,$259.94,$634.00,$259.94,$259.94,$614.98
1104445A,0510,11044,,,,,N/A,N/A,"Debridement,Bone            ~t",$0.00,$0.00,$231.11,$634.00,$259.94,$614.98,$259.94,$542.07,$259.94,$231.11,$259.94,$614.98,$259.94,$634.00,$259.94,$259.94,$614.98
1104540A,0510,11045,,,,,N/A,N/A,DBRDMT SUBC TISSUE ADD 20SQ ~T,$11.10,$8.25,$22.55,$55.00,$22.55,$53.35,$22.55,$47.03,$22.55,$26.85,$22.55,$53.35,$22.55,$55.00,$22.55,$22.55,$53.35
1104640A,0510,11046,,,,,N/A,N/A,Each Additional 20sq Cm     ~t,$0.00,$0.00,$3.34,$74.00,$3.34,$71.78,$3.34,$63.27,$3.34,$56.68,$3.34,$71.78,$3.34,$74.00,$3.34,$3.34,$71.78
1104740A,0510,11047,,,,,N/A,N/A,DEB BONE ADD-ON             ~T,$26.23,$19.50,$53.13,$186.00,$53.13,$180.42,$53.13,$159.03,$53.13,$99.26,$53.13,$180.42,$53.13,$186.00,$53.13,$53.13,$180.42
1105545A,0510,11055,,,,,N/A,N/A,Trim Skin Lesion            ~t,$0.00,$0.00,$16.62,$65.00,$26.65,$63.05,$26.65,$55.58,$26.65,$16.62,$26.65,$63.05,$26.65,$65.00,$26.65,$26.65,$63.05
1105645,0510,11056,,,,,N/A,N/A,"TRIM SKIN LESION, 2 TO 4    ~G",$59.53,$44.25,$23.23,$124.00,$31.16,$120.28,$31.16,$106.02,$31.16,$23.23,$31.16,$120.28,$31.16,$124.00,$31.16,$31.16,$120.28
1105645A,0510,11056,,,,,N/A,N/A,"Trim Skin Lesion, 2 To 4    ~t",$0.00,$0.00,$23.23,$124.00,$31.16,$120.28,$31.16,$106.02,$31.16,$23.23,$31.16,$120.28,$31.16,$124.00,$31.16,$31.16,$120.28
1105745A,0510,11057,,,,,N/A,N/A,"Trim Skin Lesion, Over 4    ~t",$0.00,$0.00,$30.05,$84.00,$34.44,$81.48,$34.44,$71.82,$34.44,$30.05,$34.44,$81.48,$34.44,$84.00,$34.44,$34.44,$81.48
1110240A,0510,11102,,,,,N/A,N/A,SKIN BIOPSY                 ~T,$40.36,$30.00,$82.41,$82.41,$82.41,N/A,$82.41,N/A,$82.41,N/A,$82.41,N/A,$82.41,N/A,$82.41,$82.41,N/A
1110340A,0510,11103,,,,,N/A,N/A,SKIN BIOPSY EA SEPARATE     ~T,$10.09,$7.50,$44.69,$44.69,$44.69,N/A,$44.69,N/A,$44.69,N/A,$44.69,N/A,$44.69,N/A,$44.69,$44.69,N/A
1110440A,0510,11104,,,,,N/A,N/A,PUNCH BIOPSY                ~T,$53.47,$39.75,$13.73,$13.73,$13.73,N/A,$13.73,N/A,$13.73,N/A,$13.73,N/A,$13.73,N/A,$13.73,$13.73,N/A
1110540A,0510,11105,,,,,N/A,N/A,PUNCH BIOPSY EA SEPARATE    ~T,$24.21,$18.00,$5.84,$5.84,$5.84,N/A,$5.84,N/A,$5.84,N/A,$5.84,N/A,$5.84,N/A,$5.84,$5.84,N/A
1110640A,0510,11106,,,,,N/A,N/A,INCISIONAL BIOPSY           ~T,$50.45,$37.50,$125.46,$125.46,$125.46,N/A,$125.46,N/A,$125.46,N/A,$125.46,N/A,$125.46,N/A,$125.46,$125.46,N/A
1110740A,0510,11107,,,,,N/A,N/A,INCISIONAL BIOPSY EA SEPART ~T,$47.42,$35.25,$6.27,$6.27,$6.27,N/A,$6.27,N/A,$6.27,N/A,$6.27,N/A,$6.27,N/A,$6.27,$6.27,N/A
1120040A,0510,11200,,,,,N/A,N/A,REMOVAL OF SKIN TAGS        ~T,$12.11,$9.00,$58.63,$143.00,$58.63,$138.71,$58.63,$122.27,$58.63,$78.65,$58.63,$138.71,$58.63,$143.00,$58.63,$58.63,$138.71
1120140A,0510,11201,,,,,N/A,N/A,REMOVAL SKIN TAG EA ADD 10  ~T,$18.16,$13.50,$16.99,$45.00,$18.45,$43.65,$18.45,$38.48,$18.45,$16.99,$18.45,$43.65,$18.45,$45.00,$18.45,$18.45,$43.65
1130040A,0510,11300,,,,,N/A,N/A,SHAVE SKIN LESION           ~T,$4.04,$3.00,$35.19,$107.00,$43.87,$103.79,$43.87,$91.49,$43.87,$35.19,$43.87,$103.79,$43.87,$107.00,$43.87,$43.87,$103.79
1130140A,0510,11301,,,,,N/A,N/A,SHAVE SKIM LESION           ~T,$17.15,$12.75,$49.61,$121.00,$49.61,$117.37,$49.61,$103.46,$49.61,$53.29,$49.61,$117.37,$49.61,$121.00,$49.61,$49.61,$117.37
1130240A,0510,11302,,,,,N/A,N/A,SHAVE SKIN LESION           ~T,$10.09,$7.50,$62.52,$154.00,$63.14,$149.38,$63.14,$131.67,$63.14,$62.52,$63.14,$149.38,$63.14,$154.00,$63.14,$63.14,$149.38
1130540A,0510,11305,,,,,N/A,N/A,SHAV EPDRML LESN 0.5CM LESS ~T,$126.12,$93.75,$39.44,$233.00,$95.53,$226.01,$95.53,$199.22,$95.53,$39.44,$95.53,$226.01,$95.53,$233.00,$95.53,$95.53,$226.01
1130640A,0510,11306,,,,,N/A,N/A,SHAV EPDRML LESN 0.6-1.0CM  ~T,$126.12,$93.75,$51.45,$233.00,$93.89,$226.01,$93.89,$199.22,$93.89,$51.45,$93.89,$226.01,$93.89,$233.00,$93.89,$93.89,$226.01
1130740A,0510,11307,,,,,N/A,N/A,SHAVE SKIN LESION           ~T,$25.22,$18.75,$62.73,$153.00,$62.73,$148.41,$62.73,$130.82,$62.73,$66.19,$62.73,$148.41,$62.73,$153.00,$62.73,$62.73,$148.41
1130840A,0510,11308,,,,,N/A,N/A,SHAVE SKIN LESION           ~T,$29.26,$21.75,$75.05,$189.00,$77.49,$183.33,$77.49,$161.50,$77.49,$75.05,$77.49,$183.33,$77.49,$189.00,$77.49,$77.49,$183.33
1131040A,0510,11310,,,,,N/A,N/A,SHAVIN LESION DIAM 0.5 OR < ~T,$98.88,$73.50,$47.41,$182.00,$74.62,$176.54,$74.62,$155.61,$74.62,$47.41,$74.62,$176.54,$74.62,$182.00,$74.62,$74.62,$176.54
1131140A,0510,11311,,,,,N/A,N/A,SHAVE SKIN LESION           ~T,$24.21,$18.00,$59.40,$144.00,$59.40,$139.68,$59.40,$123.12,$59.40,$65.51,$59.40,$139.68,$59.40,$144.00,$59.40,$59.40,$139.68
1131240A,0510,11312,,,,,N/A,N/A,SHAVE SKIN LESION           ~T,$92.82,$69.00,$77.47,$232.00,$95.12,$225.04,$95.12,$198.36,$95.12,$77.47,$95.12,$225.04,$95.12,$232.00,$95.12,$95.12,$225.04
1140040A,0510,11400,,,,,N/A,N/A,EXC TR-EXT B9+MARG 0.5 < CM ~T,$18.16,$13.50,$66.10,$161.00,$66.10,$156.17,$66.10,$137.66,$66.10,$87.14,$66.10,$156.17,$66.10,$161.00,$66.10,$66.10,$156.17
1140140A,0510,11401,,,,,N/A,N/A,EXC TR-EXT B9+MARG 0.6-1 CM ~T,$22.20,$16.50,$86.51,$211.00,$86.51,$204.67,$86.51,$180.11,$86.51,$109.64,$86.51,$204.67,$86.51,$211.00,$86.51,$86.51,$204.67
1140240A,0510,11402,,,,,N/A,N/A,EXC TR-EXT B9+MARG 1.1-2 CM ~T,$34.30,$25.50,$99.22,$242.00,$99.22,$234.74,$99.22,$206.91,$99.22,$120.39,$99.22,$234.74,$99.22,$242.00,$99.22,$99.22,$234.74
1140245A,0510,11402,,,,,N/A,N/A,EXC TR-EXT B9+MARG 1.1-2 CM ~T,$34.30,$25.50,$99.22,$242.00,$99.22,$234.74,$99.22,$206.91,$99.22,$120.39,$99.22,$234.74,$99.22,$242.00,$99.22,$99.22,$234.74
1140340A,0510,11403,,,,,N/A,N/A,EXC TR-EXT B9+MARG 2.1-3 CM ~T,$25.22,$18.75,$118.49,$289.00,$118.49,$280.33,$118.49,$247.10,$118.49,$154.18,$118.49,$280.33,$118.49,$289.00,$118.49,$118.49,$280.33
1140345A,0510,11403,,,,,N/A,N/A,EXC TR-EXT B9+MARG 2.1-3 CM ~T,$291.58,$216.75,$118.49,$289.00,$118.49,$280.33,$118.49,$247.10,$118.49,$154.18,$118.49,$280.33,$118.49,$289.00,$118.49,$118.49,$280.33
1140440A,0510,11404,,,,,N/A,N/A,EXC TR-EXT B9+MARG 3.1-4CM  ~T,$32.29,$24.00,$133.25,$215.00,$133.25,$208.55,$133.25,$183.83,$133.25,$169.43,$133.25,$208.55,$133.25,$215.00,$133.25,$133.25,$208.55
1140445A,0510,11404,,,,,N/A,N/A,EXC TR-EXT B9+MARG 3.1-4CM  ~T,$32.29,$24.00,$133.25,$215.00,$133.25,$208.55,$133.25,$183.83,$133.25,$169.43,$133.25,$208.55,$133.25,$215.00,$133.25,$133.25,$208.55
1140640A,0510,11406,,,,,N/A,N/A,EXC TR-EXT B9+MARG > 4.0 CM ~T,$38.34,$28.50,$129.56,$418.00,$129.56,$405.46,$129.56,$357.39,$129.56,$255.59,$129.56,$405.46,$129.56,$418.00,$129.56,$129.56,$405.46
1140645A,0510,11406,,,,,N/A,N/A,EXC TR-EXT B9+MARG > 4.0 CM ~T,$38.34,$28.50,$129.56,$418.00,$129.56,$405.46,$129.56,$357.39,$129.56,$255.59,$129.56,$405.46,$129.56,$418.00,$129.56,$129.56,$405.46
1142040A,0510,11420,,,,,N/A,N/A,EXCISION .5CM OR LESS       ~T,$28.25,$21.00,$86.04,$179.00,$114.39,$173.63,$114.39,$153.05,$114.39,$86.04,$114.39,$173.63,$114.39,$179.00,$114.39,$114.39,$173.63
1142045A,0510,11420,,,,,N/A,N/A,EXCISION .5CM OR LESS       ~T,$28.25,$21.00,$86.04,$179.00,$114.39,$173.63,$114.39,$153.05,$114.39,$86.04,$114.39,$173.63,$114.39,$179.00,$114.39,$114.39,$173.63
1142140A,0510,11421,,,,,N/A,N/A,EXC H-F-NK-SP B9+MARG 0.3-1 ~T,$31.28,$23.25,$96.76,$236.00,$96.76,$228.92,$96.76,$201.78,$96.76,$113.89,$96.76,$228.92,$96.76,$236.00,$96.76,$96.76,$228.92
1142145A,0510,11421,,,,,N/A,N/A,EXC H-F-NK-SP B9+MARG 0.6-1 ~T,$31.28,$23.25,$96.76,$236.00,$96.76,$228.92,$96.76,$201.78,$96.76,$113.89,$96.76,$228.92,$96.76,$236.00,$96.76,$96.76,$228.92
1142240A,0510,11422,,,,,N/A,N/A,EXC H-F-NK-SP B9+MARG 1.1-2 ~T,$29.26,$21.75,$113.16,$276.00,$113.16,$267.72,$113.16,$235.98,$113.16,$141.01,$113.16,$267.72,$113.16,$276.00,$113.16,$113.16,$267.72
1142245A,0510,11422,,,,,N/A,N/A,EXC H-F-NK-SP B9+MARG 1.1-2 ~T,$29.26,$21.75,$113.16,$276.00,$113.16,$267.72,$113.16,$235.98,$113.16,$141.01,$113.16,$267.72,$113.16,$276.00,$113.16,$113.16,$267.72
1142340A,0510,11423,,,,,N/A,N/A,EXC H-F-NK-SP B9+MARG 2.1-3 ~T,$37.33,$27.75,$133.25,$325.00,$133.25,$315.25,$133.25,$277.88,$133.25,$161.73,$133.25,$315.25,$133.25,$325.00,$133.25,$133.25,$315.25
1142440A,0510,11424,,,,,N/A,N/A,EXC H-F-NK-SP B9+MARG 3.1-4 ~T,$77.69,$57.75,$154.57,$377.00,$154.57,$365.69,$154.57,$322.34,$154.57,$183.80,$154.57,$365.69,$154.57,$377.00,$154.57,$154.57,$365.69
1142445A,0510,11424,,,,,N/A,N/A,EXC H-F-NK-SP B9+MARG 3.1-4 ~T,$77.69,$57.75,$154.57,$377.00,$154.57,$365.69,$154.57,$322.34,$154.57,$183.80,$154.57,$365.69,$154.57,$377.00,$154.57,$154.57,$365.69
1142640A,0510,11426,,,,,N/A,N/A,EXC H-F-NK-SP B9+MARG > 4 CM~T,$50.45,$37.50,$227.14,$227.14,$227.14,N/A,$227.14,N/A,$227.14,N/A,$227.14,N/A,$227.14,N/A,$227.14,$227.14,N/A
1142645A,0510,11426,,,,,N/A,N/A,EXC H-F-NK-SP B9+MARG > 4CM ~T,$50.45,$37.50,$227.14,$227.14,$227.14,N/A,$227.14,N/A,$227.14,N/A,$227.14,N/A,$227.14,N/A,$227.14,$227.14,N/A
1144040A,0510,11440,,,,,N/A,N/A,"Excision,Other Benign Lesion~t",$0.00,$0.00,$56.17,$167.00,$56.17,$161.99,$56.17,$142.79,$56.17,$109.55,$56.17,$161.99,$56.17,$167.00,$56.17,$56.17,$161.99
1144045A,0510,11440,,,,,N/A,N/A,Exc Face-Mm B9+marg 0.5 < Cm~t,$0.00,$0.00,$56.17,$167.00,$56.17,$161.99,$56.17,$142.79,$56.17,$109.55,$56.17,$161.99,$56.17,$167.00,$56.17,$56.17,$161.99
1144140A,0510,11441,,,,,N/A,N/A,EXC FACE-MM B9+MARG 0.6-1  ~T,$36.32,$27.00,$113.16,$276.00,$113.16,$267.72,$113.16,$235.98,$113.16,$137.29,$113.16,$267.72,$113.16,$276.00,$113.16,$113.16,$267.72
1144240A,0510,11442,,,,,N/A,N/A,Exc Face-Mm 1.1 To 2.0 Cm   ~t,$0.00,$0.00,$113.57,$277.00,$113.57,$268.69,$113.57,$236.84,$113.57,$151.35,$113.57,$268.69,$113.57,$277.00,$113.57,$113.57,$268.69
1144340A,0510,11443,,,,,N/A,N/A,EXCISED DIAMETER 2.1-3.0 CM ~T,$585.19,$435.00,$185.17,$760.00,$311.60,$737.20,$311.60,$649.80,$311.60,$185.17,$311.60,$737.20,$311.60,$760.00,$311.60,$311.60,$737.20
1144440A,0510,11444,,,,,N/A,N/A,Exc Of Benign Les 3.1>4.0cm ~t,$0.00,$0.00,$176.71,$431.00,$176.71,$418.07,$176.71,$368.51,$176.71,$234.52,$176.71,$418.07,$176.71,$431.00,$176.71,$176.71,$418.07
1145140A,0510,11451,,,,,N/A,N/A,"REMOVAL, SWEAT GLAND LESION ~T",$30.27,$22.50,$252.15,$615.00,$252.15,$596.55,$252.15,$525.83,$252.15,$556.60,$252.15,$596.55,$252.15,$615.00,$252.15,$252.15,$596.55
1146240A,0510,11462,,,,,N/A,N/A,Treat Of Hidradenitis       ~t,$0.00,$0.00,$193.52,$472.00,$193.52,$457.84,$193.52,$403.56,$193.52,$416.86,$193.52,$457.84,$193.52,$472.00,$193.52,$193.52,$457.84
1160040A,0510,11600,,,,,N/A,N/A,Excision Mal Lesion         ~t,$0.00,$0.00,$98.81,$241.00,$98.81,$233.77,$98.81,$206.06,$98.81,$127.42,$98.81,$233.77,$98.81,$241.00,$98.81,$98.81,$233.77
1160140A,0510,11601,,,,,N/A,N/A,EXC TR-EXT MLG+MARG 0.6-1   ~T,$3.03,$2.25,$114.80,$280.00,$114.80,N/A,$114.80,$239.40,$114.80,$154.33,$114.80,N/A,$114.80,$280.00,$114.80,$114.80,N/A
1160240A,0510,11602,,,,,N/A,N/A,EXC TR-EXT MLG+MARG 1.1-2   ~T,$19.17,$14.25,$122.18,$299.00,$122.18,$290.03,$122.18,$255.65,$122.18,$167.92,$122.18,$290.03,$122.18,$299.00,$122.18,$122.18,$290.03
1160340A,0510,11603,,,,,N/A,N/A,EXC TR-EXT MLG+MARG 2.1-3   ~T,$18.16,$13.50,$134.48,$328.00,$134.48,$318.16,$134.48,$280.44,$134.48,$200.22,$134.48,$318.16,$134.48,$328.00,$134.48,$134.48,$318.16
1160440A,0510,11604,,,,,N/A,N/A,Exc Malig Lesion 3.1-4.0cm  ~t,$0.00,$0.00,$167.28,$408.00,$167.28,$395.76,$167.28,$348.84,$167.28,$220.67,$167.28,$395.76,$167.28,$408.00,$167.28,$167.28,$395.76
1160640A,0510,11606,,,,,N/A,N/A,Excised Diameter Over 4.0cm ~t,$0.00,$0.00,$298.89,$729.00,$298.89,$707.13,$298.89,$623.30,$298.89,$326.60,$298.89,$707.13,$298.89,$729.00,$298.89,$298.89,$707.13
1162040A,0510,11620,,,,,N/A,N/A,Skin Lesion Removal         ~t,$0.00,$0.00,$98.81,$241.00,$98.81,$233.77,$98.81,$206.06,$98.81,$128.15,$98.81,$233.77,$98.81,$241.00,$98.81,$98.81,$233.77
1162045A,0510,11620,,,,,N/A,N/A,Skin Lesion Removal         ~t,$0.00,$0.00,$98.81,$241.00,$98.81,$233.77,$98.81,$206.06,$98.81,$128.15,$98.81,$233.77,$98.81,$241.00,$98.81,$98.81,$233.77
1162140A,0510,11621,,,,,N/A,N/A,EXC H-F-NK-SP MLG+MAR 0.6-1 ~T,$23.21,$17.25,$114.39,$279.00,$114.39,$270.63,$114.39,$238.55,$114.39,$154.69,$114.39,$270.63,$114.39,$279.00,$114.39,$114.39,$270.63
1162240A,0510,11622,,,,,N/A,N/A,EXC H-F-NK-SP MLG+MAR 1.1-2 ~T,$2.02,$1.50,$132.20,$324.00,$132.20,$314.28,$132.20,$277.02,$132.20,$175.47,$132.20,$314.28,$132.20,$324.00,$132.20,$132.20,$314.28
1162340A,0510,11623,,,,,N/A,N/A,EXCISION OF MAL LESIONS     ~T,$2.02,$1.50,$166.50,$407.00,$166.50,$394.79,$166.50,$347.99,$166.50,$217.26,$166.50,$394.79,$166.50,$407.00,$166.50,$166.50,$394.79
1162440A,0510,11624,,,,,N/A,N/A,Exc H-F-Nk-Sp Mlg+mar3.1-4.0~t,$0.00,$0.00,$188.19,$459.00,$188.19,$445.23,$188.19,$392.45,$188.19,$245.79,$188.19,$445.23,$188.19,$459.00,$188.19,$188.19,$445.23
1162640A,0510,11626,,,,,N/A,N/A,Exc Mal Lesion Dia >4 Cm    ~t,$0.00,$0.00,$231.24,$231.24,$231.24,N/A,$231.24,N/A,$231.24,N/A,$231.24,N/A,$231.24,N/A,$231.24,$231.24,N/A
1164040A,0510,11640,,,,,N/A,N/A,Exc Face-Mm Malig+marg 0.5< ~t,$0.00,$0.00,$116.85,$285.00,$116.85,$276.45,$116.85,$243.68,$116.85,$131.46,$116.85,$276.45,$116.85,$285.00,$116.85,$116.85,$276.45
1164140A,0510,11641,,,,,N/A,N/A,EXC FACE-MM MALG+MARG 0.6-1 ~T,$46.41,$34.50,$14.22,$342.00,$14.22,$331.74,$14.22,$292.41,$14.22,$161.15,$14.22,$331.74,$14.22,$342.00,$14.22,$14.22,$331.74
1164240,0510,11642,,,,,N/A,N/A,EXC FACEMM MALG+MARG1.1-2.0 ~G,$350.10,$260.25,$142.27,$347.00,$142.27,$336.59,$142.27,$296.69,$142.27,$188.63,$142.27,$336.59,$142.27,$347.00,$142.27,$142.27,$336.59
1164240A,0510,11642,,,,,N/A,N/A,Exc Facemm Malg+marg1.1-2.0 ~t,$0.00,$0.00,$142.27,$347.00,$142.27,$336.59,$142.27,$296.69,$142.27,$188.63,$142.27,$336.59,$142.27,$347.00,$142.27,$142.27,$336.59
1164340A,0510,11643,,,,,N/A,N/A,Ex Malig Lesion 2.1 - 3.0cm ~t,$0.00,$0.00,$182.45,$445.00,$182.45,$431.65,$182.45,$380.48,$182.45,$235.78,$182.45,$431.65,$182.45,$445.00,$182.45,$182.45,$431.65
1164440A,0510,11644,,,,,N/A,N/A,Exc Face-Mm Malig+marg 3.1-4~t,$0.00,$0.00,$274.70,$670.00,$274.70,N/A,$274.70,$572.85,$274.70,$292.21,$274.70,N/A,$274.70,$670.00,$274.70,$274.70,N/A
1164640A,0510,11646,,,,,N/A,N/A,Skin Lesion Removal >4.0cm  ~t,$0.00,$0.00,$322.26,$786.00,$322.26,$762.42,$322.26,$672.03,$322.26,$403.91,$322.26,$762.42,$322.26,$786.00,$322.26,$322.26,$762.42
1172040A,0510,11720,,,,,N/A,N/A,Debridement Of Nail         ~t,$0.00,$0.00,$14.76,$36.00,$14.76,$34.92,$14.76,$30.78,$14.76,$15.15,$14.76,$34.92,$14.76,$36.00,$14.76,$14.76,$34.92
1175045A,0510,11750,,,,,N/A,N/A,REMOVAL OF NAIL BED         ~T,$6.05,$4.50,$138.17,$337.00,$138.17,$326.89,$138.17,$288.14,$138.17,$174.56,$138.17,$326.89,$138.17,$337.00,$138.17,$138.17,$326.89
1176045A,0510,11760,,,,,N/A,N/A,Repair Of Nail Bed          ~t,$0.00,$0.00,$79.54,$194.14,$79.54,$188.18,$79.54,$165.87,$79.54,$194.14,$79.54,$188.18,$79.54,$194.00,$79.54,$79.54,$188.18
1177040A,0510,11770,,,,,N/A,N/A,REMOVAL OF PILONIDAL LESION ~T,$55.49,$41.25,$159.80,$388.00,$159.80,$376.36,$159.80,$331.74,$159.80,$314.73,$159.80,$376.36,$159.80,$388.00,$159.80,$159.80,$376.36
1177140A,0510,11771,,,,,N/A,N/A,Treatment Pilonidal Cyst Ext~t,$0.00,$0.00,$348.90,$849.00,$348.90,$823.53,$348.90,$725.90,$348.90,$753.19,$348.90,$823.53,$348.90,$849.00,$348.90,$348.90,$823.53
1177240A,0510,11772,,,,,N/A,N/A,REMOVAL OF PILONIDAL LESION ~T,$114.01,$84.75,$463.30,"$1,130.00",$463.30,"$1,096.10",$463.30,$966.15,$463.30,$997.43,$463.30,"$1,096.10",$463.30,"$1,130.00",$463.30,$463.30,"$1,096.10"
1190040A,0510,11900,,,,,N/A,N/A,INJ INTRALESIONAL UP 7 LES  ~T,$14.13,$10.50,$31.16,$174.00,$71.34,$168.78,$71.34,$148.77,$71.34,$31.16,$71.34,$168.78,$71.34,$174.00,$71.34,$71.34,$168.78
1200140A,0510,12001,,,,,N/A,N/A,Suturing Superficial Wounds ~t,$0.00,$0.00,$45.36,$199.00,$81.59,$193.03,$81.59,$170.15,$81.59,$45.36,$81.59,$193.03,$81.59,$199.00,$81.59,$81.59,$193.03
5112001A,0510,12001,,,,,N/A,N/A,LAC REPAIR 2.5CM OR <  12001,$141.25,$105.00,$45.36,$199.00,$81.59,$193.03,$81.59,$170.15,$81.59,$45.36,$81.59,$193.03,$81.59,$199.00,$81.59,$81.59,$193.03
5112002,0510,12002,,,,,N/A,N/A,REP LAC 2.6-7.5 CM     12002~P,$340.01,$252.75,$17.10,$261.00,$17.10,$253.17,$17.10,$223.16,$17.10,$59.83,$17.10,$253.17,$17.10,$261.00,$17.10,$17.10,$253.17
1200240A,0510,12002,,,,,N/A,N/A,REPAIR SUPERFICIAL WOUND (S)~T,$43.38,$32.25,$17.10,$261.00,$17.10,$253.17,$17.10,$223.16,$17.10,$59.83,$17.10,$253.17,$17.10,$261.00,$17.10,$17.10,$253.17
1200245A,0510,12002,,,,,N/A,N/A,REPAIR SUPERFICIAL WOUND (S)~T,$43.38,$32.25,$17.10,$261.00,$17.10,$253.17,$17.10,$223.16,$17.10,$59.83,$17.10,$253.17,$17.10,$261.00,$17.10,$17.10,$253.17
1203140A,0510,12031,,,,,N/A,N/A,LAYER CLOSURE OF WOUND(S)   ~T,$18.16,$13.50,$119.72,$292.00,$119.72,$283.24,$119.72,$249.66,$119.72,$258.03,$119.72,$283.24,$119.72,$292.00,$119.72,$119.72,$283.24
1203240A,0510,12032,,,,,N/A,N/A,LAYER CLOSURE OF WOUND(S)   ~T,$27.24,$20.25,$161.13,$393.00,$161.13,$381.21,$161.13,$336.02,$161.13,$323.30,$161.13,$381.21,$161.13,$393.00,$161.13,$161.13,$381.21
1203245A,0510,12032,,,,,N/A,N/A,LAYER CLOSURE OF WOUND(S)   ~T,$27.24,$20.25,$161.13,$393.00,$161.13,$381.21,$161.13,$336.02,$161.13,$323.30,$161.13,$381.21,$161.13,$393.00,$161.13,$161.13,$381.21
1203440A,0510,12034,,,,,N/A,N/A,LAYER CLOSURE OF WOUNDS(S)  ~T,$156.39,$116.25,$168.10,$410.00,$168.10,$397.70,$168.10,$350.55,$168.10,$348.85,$168.10,$397.70,$168.10,$410.00,$168.10,$168.10,$397.70
1203445A,0510,12034,,,,,N/A,N/A,LAYER CLOSURE OF WOUNDS(S)  ~T,$156.39,$116.25,$168.10,$410.00,$168.10,$397.70,$168.10,$350.55,$168.10,$348.85,$168.10,$397.70,$168.10,$410.00,$168.10,$168.10,$397.70
5112034A,0510,12034,,,,,N/A,N/A,RPR INMT S/A/T/E/706-12.5-T-TC,$155.38,$115.50,$168.10,$410.00,$168.10,$397.70,$168.10,$350.55,$168.10,$348.85,$168.10,$397.70,$168.10,$410.00,$168.10,$168.10,$397.70
1203540A,0510,12035,,,,,N/A,N/A,Repair Wound 12.6 To 20.0cm ~t,$0.00,$0.00,$197.21,$481.00,$197.21,$466.57,$197.21,$411.26,$197.21,$407.81,$197.21,$466.57,$197.21,$481.00,$197.21,$197.21,$466.57
1203545A,0510,12035,,,,,N/A,N/A,Repair Wound 12.6 To 20.0cm ~t,$0.00,$0.00,$197.21,$481.00,$197.21,$466.57,$197.21,$411.26,$197.21,$407.81,$197.21,$466.57,$197.21,$481.00,$197.21,$197.21,$466.57
1204140A,0510,12041,,,,,N/A,N/A,LAYER CLOSURE OF WOUNDS(S)  ~T,$8.07,$6.00,$134.48,$328.00,$134.48,$318.16,$134.48,$280.44,$134.48,$246.94,$134.48,$318.16,$134.48,$328.00,$134.48,$134.48,$318.16
1204145A,0510,12041,,,,,N/A,N/A,LAYER CLOSURE OF WOUNDS(S)  ~T,$8.07,$6.00,$134.48,$328.00,$134.48,$318.16,$134.48,$280.44,$134.48,$246.94,$134.48,$318.16,$134.48,$328.00,$134.48,$134.48,$318.16
1204240A,0510,12042,,,,,N/A,N/A,LAYER CLOSURE OF WOUNDS(S)  ~T,$16.14,$12.00,$159.90,$390.00,$159.90,$378.30,$159.90,$333.45,$159.90,$333.41,$159.90,$378.30,$159.90,$390.00,$159.90,$159.90,$378.30
1204245A,0510,12042,,,,,N/A,N/A,LAYER CLOSURE OF WOUNDS     ~T,$16.14,$12.00,$159.90,$390.00,$159.90,$378.30,$159.90,$333.45,$159.90,$333.41,$159.90,$378.30,$159.90,$390.00,$159.90,$159.90,$378.30
1204440A,0510,12044,,,,,N/A,N/A,LAYER CLOSURE OF WOUND(S)   ~T,$40.36,$30.00,$182.40,$444.00,$182.40,$430.68,$182.40,$379.62,$182.40,$361.63,$182.40,$430.68,$182.40,$444.00,$182.40,$182.40,$430.68
1205140A,0510,12051,,,,,N/A,N/A,LAYER CLOSURE OF WOUNDS(S)  ~T,$156.39,$116.25,$149.65,$365.00,$149.65,$354.05,$149.65,$312.08,$149.65,$287.31,$149.65,$354.05,$149.65,$365.00,$149.65,$149.65,$354.05
1205240A,0510,12052,,,,,N/A,N/A,LAYER CLOSURE OF WOUNDS(S)  ~T,$43.38,$32.25,$159.90,$390.00,$159.90,$378.30,$159.90,$333.45,$159.90,$339.25,$159.90,$378.30,$159.90,$390.00,$159.90,$159.90,$378.30
1205340A,0510,12053,,,,,N/A,N/A,Repair Scalp Wound 5.1cm-7.5~t,$0.00,$0.00,$179.58,$438.00,$179.58,$424.86,$179.58,$374.49,$179.58,$365.16,$179.58,$424.86,$179.58,$438.00,$179.58,$179.58,$424.86
1205440A,0510,12054,,,,,N/A,N/A,LAYER CLOSURE OF WOUND(S)  ~T,$50.45,$37.50,$195.16,$476.00,$195.16,$461.72,$195.16,$406.98,$195.16,$368.30,$195.16,$461.72,$195.16,$476.00,$195.16,$195.16,$461.72
1205440B,0510,12054,,,,,N/A,N/A,LAYER CLOSURE OF WOUND(S)  ~P,$429.81,$319.50,$195.16,$476.00,$195.16,$461.72,$195.16,$406.98,$195.16,$368.30,$195.16,$461.72,$195.16,$476.00,$195.16,$195.16,$461.72
1205540A,0510,12055,,,,,N/A,N/A,LAYER CLOSURE OF WOUND(S)   ~T,$16.14,$12.00,$252.56,$616.00,$252.56,N/A,$252.56,$526.68,$252.56,$503.70,$252.56,N/A,$252.56,$616.00,$252.56,$252.56,N/A
1310040A,0510,13100,,,,,N/A,N/A,REPAIR OF WOUND OR LESION   ~T,$63.56,$47.25,$26.64,$504.00,$26.64,$488.88,$26.64,$430.92,$26.64,$342.33,$26.64,$488.88,$26.64,$504.00,$26.64,$26.64,$488.88
1310140A,0510,13101,,,,,N/A,N/A,REPAIR OF WOUND OR LESION   ~T,$73.65,$54.75,$25.51,$611.00,$25.51,$592.67,$25.51,$522.41,$25.51,$426.93,$25.51,$592.67,$25.51,$611.00,$25.51,$25.51,$592.67
1312140A,0510,13121,,,,,N/A,N/A,REPAIR OF WOUND OR LESION   ~T,$41.37,$30.75,$269.37,$657.00,$269.37,$637.29,$269.37,$561.74,$269.37,$440.29,$269.37,$637.29,$269.37,$657.00,$269.37,$269.37,$637.29
1312240A,0510,13122,,,,,N/A,N/A,Repair Ea Addt 5cm Or Less  ~t,$0.00,$0.00,$8.77,$197.00,$8.77,$191.09,$8.77,$168.44,$8.77,$140.28,$8.77,$191.09,$8.77,$197.00,$8.77,$8.77,$191.09
1313145A,0510,13131,,,,,N/A,N/A,Repair Of Wound Or Lesion   ~t,$0.00,$0.00,$245.18,$598.00,$245.18,$580.06,$245.18,$511.29,$245.18,$413.25,$245.18,$580.06,$245.18,$598.00,$245.18,$245.18,$580.06
1313240A,0510,13132,,,,,N/A,N/A,Suturing Of Wounds 2.6cm-7.5~t,$0.00,$0.00,$26.35,$635.00,$26.35,$615.95,$26.35,$542.93,$26.35,$515.68,$26.35,$615.95,$26.35,$635.00,$26.35,$26.35,$615.95
1313245A,0510,13132,,,,,N/A,N/A,Suturing Of Wounds 2.6cm-7.5~t,$0.00,$0.00,$26.35,$635.00,$26.35,$615.95,$26.35,$542.93,$26.35,$515.68,$26.35,$615.95,$26.35,$635.00,$26.35,$26.35,$615.95
1313340A,0510,13133,,,,,N/A,N/A,Ea Additional 5cm Or Less   ~t,$0.00,$0.00,$18.24,$264.00,$18.24,$256.08,$18.24,$225.72,$18.24,$213.86,$18.24,$256.08,$18.24,$264.00,$18.24,$18.24,$256.08
1313345A,0510,13133,,,,,N/A,N/A,Ea Additional 5cm Or Less   ~t,$0.00,$0.00,$18.24,$264.00,$18.24,$256.08,$18.24,$225.72,$18.24,$213.86,$18.24,$256.08,$18.24,$264.00,$18.24,$18.24,$256.08
1316040A,0510,13160,,,,,N/A,N/A,Late Closure Of Wound       ~t,$0.00,$0.00,$681.83,"$1,663.00",$681.83,N/A,$681.83,"$1,421.87",$681.83,"$1,352.96",$681.83,N/A,$681.83,"$1,663.00",$681.83,$681.83,N/A
1316045A,0510,13160,,,,,N/A,N/A,Second Closure Of Surg Wound~t,$0.00,$0.00,$681.83,"$1,663.00",$681.83,N/A,$681.83,"$1,421.87",$681.83,"$1,352.96",$681.83,N/A,$681.83,"$1,663.00",$681.83,$681.83,N/A
1400040A,0510,14000,,,,,N/A,N/A,SKIN TISSUE REARRANGEMENT   ~T,$53.47,$39.75,$431.73,"$1,053.00",$431.73,"$1,021.41",$431.73,$900.32,$431.73,$518.43,$431.73,"$1,021.41",$431.73,"$1,053.00",$431.73,$431.73,"$1,021.41"
1402040A,0510,14020,,,,,N/A,N/A,Skin Tissue Rearrangement   ~t,$0.00,$0.00,$497.74,"$1,214.00",$497.74,"$1,177.58",$497.74,"$1,037.97",$497.74,$585.12,$497.74,"$1,177.58",$497.74,"$1,214.00",$497.74,$497.74,"$1,177.58"
1430140A,0510,14301,,,,,N/A,N/A,Adjac Tissue Trans 30-60cm  ~t,$0.00,$0.00,$725.70,"$1,770.00",$725.70,"$1,716.90",$725.70,"$1,513.35",$725.70,$898.67,$725.70,"$1,716.90",$725.70,"$1,770.00",$725.70,$725.70,"$1,716.90"
1430240A,0510,14302,,,,,N/A,N/A,ADJT TIS/TRNSFR EA ADD'L30CM~T,$25.22,$18.75,$178.35,$435.00,$178.35,$421.95,$178.35,$371.93,$178.35,$222.31,$178.35,$421.95,$178.35,$435.00,$178.35,$178.35,$421.95
1500240A,0510,15002,,,,,N/A,N/A,PREP SITE                   ~T,$45.40,$33.75,$179.58,$438.00,$179.58,$424.86,$179.58,$374.49,$179.58,$227.08,$179.58,$424.86,$179.58,$438.00,$179.58,$179.58,$424.86
1500245A,0510,15002,,,,,N/A,N/A,PREP SITE                   ~T,$45.40,$33.75,$179.58,$438.00,$179.58,$424.86,$179.58,$374.49,$179.58,$227.08,$179.58,$424.86,$179.58,$438.00,$179.58,$179.58,$424.86
1500340A,0510,15003,,,,,N/A,N/A,Prep Site Ea Add 100sq Cm   ~t,$0.00,$0.00,$46.30,$167.00,$68.47,$161.99,$68.47,$142.79,$68.47,$46.30,$68.47,$161.99,$68.47,$167.00,$68.47,$68.47,$161.99
1510040A,0510,15100,,,,,N/A,N/A,SKIN SPLIT GRAFT            ~T,$248.20,$184.50,$648.21,"$1,581.00",$648.21,N/A,$648.21,"$1,351.76",$648.21,$739.25,$648.21,N/A,$648.21,"$1,581.00",$648.21,$648.21,N/A
1513040A,0510,15130,,,,,N/A,N/A,"DERM AUTOGRAFT, TRNK/ARM/LEG~T",$65.58,$48.75,$477.65,$477.65,$477.65,N/A,$477.65,N/A,$477.65,N/A,$477.65,N/A,$477.65,N/A,$477.65,$477.65,N/A
1520040A,0510,15200,,,,,N/A,N/A,Full Thickness Graft        ~t,$0.00,$0.00,$551.40,"$1,344.00",$551.40,"$1,303.68",$551.40,"$1,149.12",$551.40,$695.38,$551.40,"$1,303.68",$551.40,"$1,344.00",$551.40,$551.40,"$1,303.68"
1522040A,0510,15220,,,,,N/A,N/A,Skin Grafts                 ~t,$0.00,$0.00,$55.53,"$1,233.00",$55.53,"$1,196.01",$55.53,"$1,054.22",$55.53,$633.37,$55.53,"$1,196.01",$55.53,"$1,233.00",$55.53,$55.53,"$1,196.01"
1524040A,0510,15240,,,,,N/A,N/A,Skin Graft Full Thickness   ~t,$0.00,$0.00,$654.77,"$1,597.00",$654.77,"$1,549.09",$654.77,"$1,365.44",$654.77,$825.53,$654.77,"$1,549.09",$654.77,"$1,597.00",$654.77,$654.77,"$1,549.09"
1527140A,0510,15271,,,,,N/A,N/A,Skin Sub Graft Trnk/Arm/Leg ~t,$0.00,$0.00,$69.29,$169.00,$69.29,$163.93,$69.29,$144.50,$69.29,$86.48,$69.29,$163.93,$69.29,$169.00,$69.29,$69.29,$163.93
1576940A,0510,15769,,,,,N/A,N/A,GRAFTING OF SOFT TISSUE     ~T,$25.22,$18.75,$395.65,$395.65,$395.65,N/A,$395.65,N/A,$395.65,N/A,$395.65,N/A,$395.65,N/A,$395.65,$395.65,N/A
1593140A,0510,15931,,,,,N/A,N/A,"Exc,Pressure Ulcer W/Prim Cl~t",$0.00,$0.00,$533.00,"$1,300.00",$533.00,"$1,261.00",$533.00,"$1,111.50",$533.00,$726.49,$533.00,"$1,261.00",$533.00,"$1,300.00",$533.00,$533.00,"$1,261.00"
1593340A,0510,15933,,,,,N/A,N/A,"Exc, Press Ulcer W/Ostectomy~t",$0.00,$0.00,$663.38,"$1,618.00",$663.38,"$1,569.46",$663.38,"$1,383.39",$663.38,$896.79,$663.38,"$1,569.46",$663.38,"$1,618.00",$663.38,$663.38,"$1,569.46"
1600040A,0510,16000,,,,,N/A,N/A,Burns Initial Treatment     ~t,$0.00,$0.00,$45.51,$111.00,$45.51,$107.67,$45.51,$94.91,$45.51,$46.41,$45.51,$107.67,$45.51,$111.00,$45.51,$45.51,$107.67
1602040A,0510,16020,,,,,N/A,N/A,TREATMENT OF BURN(S)        ~T,$11.10,$8.25,$53.71,$131.00,$53.71,$127.07,$53.71,$112.01,$53.71,$93.42,$53.71,$127.07,$53.71,$131.00,$53.71,$53.71,$127.07
1700040A,0510,17000,,,,,N/A,N/A,DESTROY BEN/PREMLG LESION   ~T,$4.04,$3.00,$44.28,$108.00,$44.28,$104.76,$44.28,$92.34,$44.28,$56.51,$44.28,$104.76,$44.28,$108.00,$44.28,$44.28,$104.76
1700340A,0510,17003,,,,,N/A,N/A,"DESTROY LESIONS, 2-14       ~T",$18.16,$13.50,$2.20,$22.00,$9.43,$21.34,$9.43,$18.81,$9.43,$2.20,$9.43,$21.34,$9.43,$22.00,$9.43,$9.43,$21.34
1711040A,0510,17110,,,,,N/A,N/A,"DESTRUCT LESION, 1-14       ~T",$18.16,$13.50,$56.58,$138.00,$56.58,$133.86,$56.58,$117.99,$56.58,$69.20,$56.58,$133.86,$56.58,$138.00,$56.58,$56.58,$133.86
1726140A,0510,17261,,,,,N/A,N/A,DESTRUT MAL LESION 0.6>1.0CM~T,$207.84,$154.50,$158.26,$158.26,$158.26,N/A,$158.26,N/A,$158.26,N/A,$158.26,N/A,$158.26,N/A,$158.26,$158.26,N/A
1728040A,0510,17280,,,,,N/A,N/A,"Destruction,Malig Lesion    ~t",$0.00,$0.00,$72.98,$178.00,$72.98,$172.66,$72.98,$152.19,$72.98,$90.12,$72.98,$172.66,$72.98,$178.00,$72.98,$72.98,$172.66
1728140A,0510,17281,,,,,N/A,N/A,DESTRUCT MAL LES 0.6-1.0 CM ~T,$296.63,$220.50,$22.99,$539.00,$22.99,$522.83,$22.99,$460.85,$22.99,$122.70,$22.99,$522.83,$22.99,$539.00,$22.99,$22.99,$522.83
1573440A,0510,17534,,,,,N/A,N/A,Muscle Myocutaneous Trunk   ~t,$0.00,$0.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
1902040A,0510,19020,,,,,N/A,N/A,INCISION OF BREAST LESION   ~T,$25.22,$18.75,$239.85,$585.00,$239.85,$567.45,$239.85,$500.18,$239.85,$530.19,$239.85,$567.45,$239.85,$585.00,$239.85,$239.85,$567.45
1908340A,0510,19083,,,,,N/A,N/A,"Biopsy Breast 1st Lesion,Inc~t",$0.00,$0.00,$264.57,"$1,076.00",$441.16,"$1,043.72",$441.16,$919.98,$441.16,$264.57,$441.16,"$1,043.72",$441.16,"$1,076.00",$441.16,$441.16,"$1,043.72"
1908440A,0510,19084,,,,,N/A,N/A,BIOPSY BREAST EA ADD LESION ~T,$32.29,$24.00,$131.94,$675.00,$276.75,$654.75,$276.75,$577.13,$276.75,$131.94,$276.75,$654.75,$276.75,$675.00,$276.75,$276.75,$654.75
1910040A,0510,19100,,,,,N/A,N/A,BX BREAST PERCUT W/O IMAGE  ~T,$33.30,$24.75,$72.16,$176.00,$72.16,$170.72,$72.16,$150.48,$72.16,$115.44,$72.16,$170.72,$72.16,$176.00,$72.16,$72.16,$170.72
1911040A,0510,19110,,,,,N/A,N/A,NIPPLE EXPLORATION          ~T,$67.60,$50.25,$276.34,$674.00,$276.34,$653.78,$276.34,$576.27,$276.34,$596.36,$276.34,$653.78,$276.34,$674.00,$276.34,$276.34,$653.78
1912040A,0510,19120,,,,,N/A,N/A,Exc Of Cyst. Fibro          ~t,$0.00,$0.00,$334.97,$817.00,$334.97,$792.49,$334.97,$698.54,$334.97,$702.84,$334.97,$792.49,$334.97,$817.00,$334.97,$334.97,$792.49
1912540A,0510,19125,,,,,N/A,N/A,"EXCISION, BREAST LESION     ~T",$59.53,$44.25,$365.72,$882.00,$365.72,$855.54,$365.72,$754.11,$365.72,$776.74,$365.72,$855.54,$365.72,$882.00,$365.72,$365.72,$855.54
1930140A,0510,19301,,,,,N/A,N/A,"Mastectomy, Partial         ~t",$0.00,$0.00,$487.80,"$1,188.00",$487.80,"$1,152.36",$487.80,"$1,015.74",$487.80,"$1,108.82",$487.80,"$1,152.36",$487.80,"$1,188.00",$487.80,$487.80,"$1,152.36"
1930340A,0510,19303,,,,,N/A,N/A,"Mastectomy,Simple, Complete ~t",$0.00,$0.00,$821.64,"$2,004.00",$821.64,"$1,943.88",$821.64,"$1,713.42",$821.64,"$1,609.59",$821.64,"$1,943.88",$821.64,"$2,004.00",$821.64,$821.64,"$1,943.88"
1930540A,0510,19305,,,,,N/A,N/A,Mast Rad W/Pectoral Musc Ax ~t,$0.00,$0.00,$872.48,"$2,128.00",$872.48,"$2,064.16",$872.48,"$1,819.44",$872.48,"$1,925.79",$872.48,"$2,064.16",$872.48,"$2,128.00",$872.48,$872.48,"$2,064.16"
2010040A,0510,20100,,,,,N/A,N/A,"Explore Wound, Neck         ~t",$0.00,$0.00,$563.34,"$1,374.00",$563.34,"$1,332.78",$563.34,"$1,174.77",$563.34,"$1,058.65",$563.34,"$1,332.78",$563.34,"$1,374.00",$563.34,$563.34,"$1,332.78"
2010340A,0510,20103,,,,,N/A,N/A,"EXPLORE WOUND, EXTREMITY    ~T",$20.18,$15.00,$336.20,$820.00,$336.20,$795.40,$336.20,$701.10,$336.20,$612.09,$336.20,$795.40,$336.20,$820.00,$336.20,$336.20,$795.40
2010345A,0510,20103,,,,,N/A,N/A,"EXPLORE WOUND, EXTREMITY    ~T",$20.18,$15.00,$336.20,$820.00,$336.20,$795.40,$336.20,$701.10,$336.20,$612.09,$336.20,$795.40,$336.20,$820.00,$336.20,$336.20,$795.40
2020540A,0510,20205,,,,,N/A,N/A,Deep Muscle Biopsy          ~t,$0.00,$0.00,$138.17,$337.00,$138.17,$326.89,$138.17,$288.14,$138.17,$268.61,$138.17,$326.89,$138.17,$337.00,$138.17,$138.17,$326.89
2020640A,0510,20206,,,,,N/A,N/A,"NEEDLE BIOPSY, MUSCLE       ~T",$40.36,$30.00,$101.92,$300.00,$123.00,$291.00,$123.00,$256.50,$123.00,$101.92,$123.00,$291.00,$123.00,$300.00,$123.00,$123.00,$291.00
2022545A,0510,20225,,,,,N/A,N/A,Percutaneous Bone Biopsy    ~t,$0.00,$0.00,$43.91,"$1,051.00",$43.91,"$1,019.47",$43.91,$898.61,$43.91,$231.66,$43.91,"$1,019.47",$43.91,"$1,051.00",$43.91,$43.91,"$1,019.47"
2024045A,0510,20240,,,,,N/A,N/A,"BONE BIOPSY, EXCISIONAL     ~T",$43.38,$32.25,$222.63,$543.00,$222.63,$526.71,$222.63,$464.27,$222.63,$253.74,$222.63,$526.71,$222.63,$543.00,$222.63,$222.63,$526.71
2024545A,0510,20245,,,,,N/A,N/A,"BONE BIOPSY, EXCISIONAL     ~T",$53.47,$39.75,$554.73,"$1,353.00",$554.73,"$1,312.41",$554.73,"$1,156.82",$554.73,$612.94,$554.73,"$1,312.41",$554.73,"$1,353.00",$554.73,$554.73,"$1,312.41"
2052045A,0510,20520,,,,,N/A,N/A,REMOVAL FOREIGN BODY        ~T,$69.62,$51.75,$144.32,$362.00,$144.32,$351.14,$144.32,$309.51,$144.32,$264.30,$144.32,$351.14,$144.32,$362.00,$144.32,$144.32,$351.14
2052545A,0510,20525,,,,,N/A,N/A,REMOVAL FOREIGN BODY        ~T,$115.02,$85.50,$236.16,$578.00,$236.16,$560.66,$236.16,$494.19,$236.16,$439.37,$236.16,$560.66,$236.16,$578.00,$236.16,$236.16,$560.66
2052645A,0510,20526,,,,,N/A,N/A,"THER INJECTION, CARP TUNNEL ~T",$39.35,$29.25,$56.99,$56.99,$56.99,N/A,$56.99,N/A,$56.99,N/A,$56.99,N/A,$56.99,N/A,$56.99,$56.99,N/A
2055045A,0510,20550,,,,,N/A,N/A,Inj Tendon Sheath/Ligament  ~t,$0.00,$0.00,$41.41,$101.00,$41.41,$97.97,$41.41,$86.36,$41.41,$69.22,$41.41,$97.97,$41.41,$101.00,$41.41,$41.41,$97.97
5120551,0510,20551,,,,,N/A,N/A,Tendon Origin Insertion/Inject,$340.01,$252.75,$69.85,$337.00,$125.87,$326.89,$125.87,$288.14,$125.87,$69.85,$125.87,$326.89,$125.87,$337.00,$125.87,$125.87,$326.89
2055145A,0510,20551,,,,,N/A,N/A,INJ TENDON ORIGIN/INSERTION ~T,$259.30,$192.75,$69.85,$337.00,$125.87,$326.89,$125.87,$288.14,$125.87,$69.85,$125.87,$326.89,$125.87,$337.00,$125.87,$125.87,$326.89
2055240A,0510,20552,,,,,N/A,N/A,Inj Trigger Point           ~t,$0.00,$0.00,$34.30,$590.00,$34.30,$572.30,$34.30,$504.45,$34.30,$67.34,$34.30,$572.30,$34.30,$590.00,$34.30,$34.30,$572.30
2055245A,0510,20552,,,,,N/A,N/A,Inj Trigger Point           ~t,$0.00,$0.00,$34.30,$590.00,$34.30,$572.30,$34.30,$504.45,$34.30,$67.34,$34.30,$572.30,$34.30,$590.00,$34.30,$34.30,$572.30
5120600,0510,20600,,,,,N/A,N/A,"DRAIN/INJECT,JOINT/BURSA",$196.74,$146.25,$39.36,$96.00,$39.36,$93.12,$39.36,$82.08,$39.36,$63.57,$39.36,$93.12,$39.36,$96.00,$39.36,$39.36,$93.12
2060045A,0510,20600,,,,,N/A,N/A,"DRAIN/INJECT, JOINT BURSA   ~T",$20.18,$15.00,$39.36,$96.00,$39.36,$93.12,$39.36,$82.08,$39.36,$63.57,$39.36,$93.12,$39.36,$96.00,$39.36,$39.36,$93.12
5020605,0510,20605,,,,,N/A,N/A,ARTHRO INTER JOINT,$196.74,$146.25,$39.77,$99.00,$39.77,$96.03,$39.77,$84.65,$39.77,$66.08,$39.77,$96.03,$39.77,$99.00,$39.77,$39.77,$96.03
5120605,0510,20605,,,,,N/A,N/A,ARTHRO INTER JOINT,$196.74,$146.25,$39.77,$99.00,$39.77,$96.03,$39.77,$84.65,$39.77,$66.08,$39.77,$96.03,$39.77,$99.00,$39.77,$39.77,$96.03
2060545A,0510,20605,,,,,N/A,N/A,"DRAIN/INJECT, JOINT BURSA   ~T",$21.19,$15.75,$39.77,$99.00,$39.77,$96.03,$39.77,$84.65,$39.77,$66.08,$39.77,$96.03,$39.77,$99.00,$39.77,$39.77,$96.03
5220605A,0510,20605,,,,,N/A,N/A,"ASP/INJ,INTERMED JOINT     -TC",$660.86,$491.25,$39.77,$99.00,$39.77,$96.03,$39.77,$84.65,$39.77,$66.08,$39.77,$96.03,$39.77,$99.00,$39.77,$39.77,$96.03
5020610,0510,20610,,,,,N/A,N/A,ARTHRO MAJOR JOINT,$201.79,$150.00,$51.25,$125.00,$51.25,$121.25,$51.25,$106.88,$51.25,$80.71,$51.25,$121.25,$51.25,$125.00,$51.25,$51.25,$121.25
5220610,0510,20610,,,,,N/A,N/A,INJECT JOINT LARGE,$201.79,$150.00,$51.25,$125.00,$51.25,$121.25,$51.25,$106.88,$51.25,$80.71,$51.25,$121.25,$51.25,$125.00,$51.25,$51.25,$121.25
2061045A,0510,20610,,,,,N/A,N/A,"DRAIN/INJECT, JOINT/BURS    ~T",$31.28,$23.25,$51.25,$125.00,$51.25,$121.25,$51.25,$106.88,$51.25,$80.71,$51.25,$121.25,$51.25,$125.00,$51.25,$51.25,$121.25
4520610A,0510,20610,,,,,N/A,N/A,"Drain/Inject, Joint/Bursa  ~tc",$0.00,$0.00,$51.25,$125.00,$51.25,$121.25,$51.25,$106.88,$51.25,$80.71,$51.25,$121.25,$51.25,$125.00,$51.25,$51.25,$121.25
2061145A,0510,20611,,,,,N/A,N/A,"Drain/Inject, Joint/Bursa W/~t",$13.12,$9.75,$75.30,$75.30,$75.30,N/A,$75.30,N/A,$75.30,N/A,$75.30,N/A,$75.30,N/A,$75.30,$75.30,N/A
2067045A,0510,20670,,,,,N/A,N/A,REMOVAL OF SUPPORT IMPLANT  ~T,$84.75,$63.00,$259.91,$668.00,$273.88,$647.96,$273.88,$571.14,$273.88,$259.91,$273.88,$647.96,$273.88,$668.00,$273.88,$273.88,$647.96
2068045A,0510,20680,,,,,N/A,N/A,REMOVAL OF SUPPORT IMPLANT  ~T,$35.31,$26.25,$272.24,$748.19,$272.24,$644.08,$272.24,$567.72,$272.24,$748.19,$272.24,$644.08,$272.24,$664.00,$272.24,$272.24,$644.08
2069045A,0510,20690,,,,,N/A,N/A,APPLY BONE FIXATION DEVICE  ~T,$16.14,$12.00,$457.56,"$1,116.00",$457.56,"$1,082.52",$457.56,$954.18,$457.56,"$1,059.90",$457.56,"$1,082.52",$457.56,"$1,116.00",$457.56,$457.56,"$1,082.52"
2069445A,0510,20694,,,,,N/A,N/A,Prod Relate To Bony Fixation~t,$0.00,$0.00,$277.57,$677.00,$277.57,$656.69,$277.57,$578.84,$277.57,$607.17,$277.57,$656.69,$277.57,$677.00,$277.57,$277.57,$656.69
2070045A,0510,20700,,,,,N/A,N/A,MANUAL DRUG DELIVERY DEVICE ~T,$22.20,$16.50,$78.72,$78.72,$78.72,N/A,$78.72,N/A,$78.72,N/A,$78.72,N/A,$78.72,N/A,$78.72,$78.72,N/A
2070245A,0510,20702,,,,,N/A,N/A,Drug Delivery Device        ~t,$0.00,$0.00,$113.98,$113.98,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,$113.98,N/A
2070445A,0510,20704,,,,,N/A,N/A,INSERTION DRUG DEL DEVICE   ~T,$40.36,$30.00,$118.90,$118.90,$118.90,N/A,$118.90,N/A,$118.90,N/A,$118.90,N/A,$118.90,N/A,$118.90,$118.90,N/A
2070545A,0510,20705,,,,,N/A,N/A,REMOVAL DRUG DEL DEVICE     ~T,$25.22,$18.75,$98.40,$98.40,$98.40,N/A,$98.40,N/A,$98.40,N/A,$98.40,N/A,$98.40,N/A,$98.40,$98.40,N/A
2090045A,0510,20900,,,,,N/A,N/A,Bone & Tissue Autografts    ~t,$0.00,$0.00,$323.14,"$1,058.00",$433.78,"$1,026.26",$433.78,$904.59,$433.78,$323.14,$433.78,"$1,026.26",$433.78,"$1,058.00",$433.78,$433.78,"$1,026.26"
2090245A,0510,20902,,,,,N/A,N/A,REMOVAL OF BONE FOR GRAFT   ~T,$62.55,$46.50,$491.83,"$1,300.00",$558.42,"$1,261.00",$558.42,"$1,111.50",$558.42,$491.83,$558.42,"$1,261.00",$558.42,"$1,300.00",$558.42,$558.42,"$1,261.00"
2098545A,0510,20985,,,,,N/A,N/A,CPTR SURGICAL NAVIGATION    ~T,$42.38,$31.50,$115.62,$282.00,$115.62,$273.54,$115.62,$241.11,$115.62,$254.79,$115.62,$273.54,$115.62,$282.00,$115.62,$115.62,$273.54
2101140A,0510,21011,,,,,N/A,N/A,Excision Tumor Soft Tis Face~t,$0.00,$0.00,$211.15,$515.00,$211.15,$499.55,$211.15,$440.33,$211.15,$460.90,$211.15,$499.55,$211.15,$515.00,$211.15,$211.15,$499.55
2101240A,0510,21012,,,,,N/A,N/A,Excision 2cm>               ~t,$0.00,$0.00,$274.70,$670.00,$274.70,$649.90,$274.70,$572.85,$274.70,$601.38,$274.70,$649.90,$274.70,$670.00,$274.70,$274.70,$649.90
2101440A,0510,21014,,,,,N/A,N/A,Excision 2cm Or Greater     ~t,$0.00,$0.00,$34.22,$928.77,$34.22,$719.74,$34.22,$634.41,$34.22,$928.77,$34.22,$719.74,$34.22,$742.00,$34.22,$34.22,$719.74
2150140A,0510,21501,,,,,N/A,N/A,DRAIN NECK/CHEST LESION    ~T,$20.18,$15.00,$291.10,$710.00,$291.10,$688.70,$291.10,$607.05,$291.10,$587.41,$291.10,$688.70,$291.10,$710.00,$291.10,$291.10,$688.70
2155240A,0510,21552,,,,,N/A,N/A,Excision Tumor 3cm Or >     ~t,$0.00,$0.00,$257.89,$789.32,$257.89,$610.13,$257.89,$537.80,$257.89,$789.32,$257.89,$610.13,$257.89,$629.00,$257.89,$257.89,$610.13
2155540A,0510,21555,,,,,N/A,N/A,Excision Tumor Neck         ~t,$0.00,$0.00,$274.70,$670.00,$274.70,$649.90,$274.70,$572.85,$274.70,$544.37,$274.70,$649.90,$274.70,$670.00,$274.70,$274.70,$649.90
2160140A,0510,21601,,,,,N/A,N/A,EXCISION CHEST WALL TUMOR   ~T,$37.33,$27.75,$958.17,$958.17,$958.17,N/A,$958.17,N/A,$958.17,N/A,$958.17,N/A,$958.17,N/A,$958.17,$958.17,N/A
2160240A,0510,21602,,,,,N/A,N/A,EXCISION CHEST WALL TUMOR   ~T,$52.46,$39.00,"$1,292.32","$1,292.32","$1,292.32",N/A,"$1,292.32",N/A,"$1,292.32",N/A,"$1,292.32",N/A,"$1,292.32",N/A,"$1,292.32","$1,292.32",N/A
2160340A,0510,21603,,,,,N/A,N/A,EXCISION CHEST WALL TUMOR   ~T,$80.72,$60.00,"$1,426.80","$1,426.80","$1,426.80",N/A,"$1,426.80",N/A,"$1,426.80",N/A,"$1,426.80",N/A,"$1,426.80",N/A,"$1,426.80","$1,426.80",N/A
2181140A,0510,21811,,,,,N/A,N/A,Open Treat Of Rib Fx 1-3    ~t,$0.00,$0.00,$467.81,$467.81,$467.81,N/A,$467.81,N/A,$467.81,N/A,$467.81,N/A,$467.81,N/A,$467.81,$467.81,N/A
2192040A,0510,21920,,,,,N/A,N/A,Biop Soft Tissue Back/Flank ~t,$0.00,$0.00,$137.76,$336.00,$137.76,$325.92,$137.76,$287.28,$137.76,$279.11,$137.76,$325.92,$137.76,$336.00,$137.76,$137.76,$325.92
2193140A,0510,21931,,,,,N/A,N/A,Exc Back Les Sc 3 Cm/>      ~t,$0.00,$0.00,$371.46,$906.00,$371.46,N/A,$371.46,$774.63,$371.46,$830.07,$371.46,N/A,$371.46,$906.00,$371.46,$371.46,N/A
2193240A,0510,21932,,,,,N/A,N/A,Exc Back Tum Deep < 5 Cm    ~t,$0.00,$0.00,$52.70,"$1,270.00",$52.70,"$1,231.90",$52.70,"$1,085.85",$52.70,"$1,170.27",$52.70,"$1,231.90",$52.70,"$1,270.00",$52.70,$52.70,"$1,231.90"
2193340A,0510,21933,,,,,N/A,N/A,Exc Back Tum Deep 5 Cm/>    ~t,$0.00,$0.00,$582.61,"$1,421.00",$582.61,"$1,378.37",$582.61,"$1,214.96",$582.61,"$1,302.58",$582.61,"$1,378.37",$582.61,"$1,421.00",$582.61,$582.61,"$1,378.37"
2290040A,0510,22900,,,,,N/A,N/A,Exc Tumor Deep < 5cm        ~t,$0.00,$0.00,$393.60,$998.06,$393.60,$931.20,$393.60,$820.80,$393.60,$998.06,$393.60,$931.20,$393.60,$960.00,$393.60,$393.60,$931.20
2290140A,0510,22901,,,,,N/A,N/A,EXC ABDL TUM DEEP 5 CM/>    ~T,$59.53,$44.25,$524.39,"$1,279.00",$524.39,"$1,240.63",$524.39,"$1,093.55",$524.39,"$1,175.89",$524.39,"$1,240.63",$524.39,"$1,279.00",$524.39,$524.39,"$1,240.63"
2290240A,0510,22902,,,,,N/A,N/A,Exc Abd Les Sc < 3 Cm       ~t,$0.00,$0.00,$26.35,$635.00,$26.35,$615.95,$26.35,$542.93,$26.35,$591.02,$26.35,$615.95,$26.35,$635.00,$26.35,$26.35,$615.95
2290340A,0510,22903,,,,,N/A,N/A,Excision 3cm >              ~t,$0.00,$0.00,$251.74,$777.73,$251.74,$595.58,$251.74,$524.97,$251.74,$777.73,$251.74,$595.58,$251.74,$614.00,$251.74,$251.74,$595.58
2302045A,0510,23020,,,,,N/A,N/A,Release Shoulder Joint      ~t,$0.00,$0.00,$639.60,"$1,560.00",$639.60,"$1,513.20",$639.60,"$1,333.80",$639.60,"$1,232.01",$639.60,"$1,513.20",$639.60,"$1,560.00",$639.60,$639.60,"$1,513.20"
2303040A,0510,23030,,,,,N/A,N/A,DRAIN SHOULDER LESION       ~T,$37.33,$27.75,$273.60,$666.00,$273.60,$646.02,$273.60,$569.43,$273.60,$452.84,$273.60,$646.02,$273.60,$666.00,$273.60,$273.60,$646.02
2304445A,0510,23044,,,,,N/A,N/A,EXPLORATORY SHOULDER SURGERY~T,$79.71,$59.25,$524.39,"$1,279.00",$524.39,"$1,240.63",$524.39,"$1,093.55",$524.39,"$1,007.25",$524.39,"$1,240.63",$524.39,"$1,279.00",$524.39,$524.39,"$1,240.63"
2306645A,0510,23066,,,,,N/A,N/A,BIOPSY SHOULDER TISUES      ~T,$133.18,$99.00,$313.24,$764.00,$313.24,$741.08,$313.24,$653.22,$313.24,$657.02,$313.24,$741.08,$313.24,$764.00,$313.24,$313.24,$741.08
2307145A,0510,23071,,,,,N/A,N/A,EXCISION TUMOR SOFT TISSUE S~T,$25.22,$18.75,$33.87,$807.00,$33.87,$782.79,$33.87,$689.99,$33.87,$744.53,$33.87,$782.79,$33.87,$807.00,$33.87,$33.87,$782.79
2307645A,0510,23076,,,,,N/A,N/A,Excision Soft Tissue Tumor  ~t,$0.00,$0.00,$442.39,"$1,079.00",$442.39,"$1,046.63",$442.39,$922.55,$442.39,$963.40,$442.39,"$1,046.63",$442.39,"$1,079.00",$442.39,$442.39,"$1,046.63"
2312045A,0510,23120,,,,,N/A,N/A,"Partial Removal,Collar Bone ~t",$0.00,$0.00,$525.21,"$1,281.00",$525.21,"$1,242.57",$525.21,"$1,095.26",$525.21,"$1,052.56",$525.21,"$1,242.57",$525.21,"$1,281.00",$525.21,$525.21,"$1,242.57"
2313045A,0510,23130,,,,,N/A,N/A,"Remove Shoulder Bone,Part   ~t",$0.00,$0.00,$567.85,"$1,385.00",$567.85,"$1,343.45",$567.85,"$1,184.18",$567.85,"$1,106.71",$567.85,"$1,343.45",$567.85,"$1,385.00",$567.85,$567.85,"$1,343.45"
2314045A,0510,23140,,,,,N/A,N/A,REMOVAL OF BONE LESION      ~T,$44.39,$33.00,$469.40,"$1,144.00",$469.40,"$1,109.68",$469.40,$978.12,$469.40,$995.25,$469.40,"$1,109.68",$469.40,"$1,144.00",$469.40,$469.40,"$1,109.68"
2340545A,0510,23405,,,,,N/A,N/A,"Repair,Rev/Recon Tenotomy   ~p",$0.00,$0.00,$487.80,"$1,188.00",$487.80,"$1,152.36",$487.80,"$1,015.74",$487.80,"$1,109.72",$487.80,"$1,152.36",$487.80,"$1,188.00",$487.80,$487.80,"$1,152.36"
2341045A,0510,23410,,,,,N/A,N/A,"Repair Rotator Cuff,Acute   ~t",$0.00,$0.00,$848.70,"$2,070.00",$848.70,"$2,007.90",$848.70,"$1,769.85",$848.70,"$1,462.58",$848.70,"$2,007.90",$848.70,"$2,070.00",$848.70,$848.70,"$2,007.90"
2341245A,0510,23412,,,,,N/A,N/A,"Repair Rotator Cuff,Chronic ~t",$0.00,$0.00,$91.59,"$2,199.00",$91.59,"$2,133.03",$91.59,"$1,880.15",$91.59,"$1,518.96",$91.59,"$2,133.03",$91.59,"$2,199.00",$91.59,$91.59,"$2,133.03"
2341545A,0510,23415,,,,,N/A,N/A,Release Shoulder Ligament   ~t,$0.00,$0.00,$697.00,"$1,700.00",$697.00,"$1,649.00",$697.00,"$1,453.50",$697.00,"$1,247.75",$697.00,"$1,649.00",$697.00,"$1,700.00",$697.00,$697.00,"$1,649.00"
2342045A,0510,23420,,,,,N/A,N/A,"Shoulder, Repair Of         ~t",$0.00,$0.00,$936.44,"$2,284.00",$936.44,"$2,215.48",$936.44,"$1,952.82",$936.44,"$1,734.29",$936.44,"$2,215.48",$936.44,"$2,284.00",$936.44,$936.44,"$2,215.48"
2343045A,0510,23430,,,,,N/A,N/A,Repair Biceps Tendon        ~t,$0.00,$0.00,$71.92,"$1,712.00",$71.92,"$1,660.64",$71.92,"$1,463.76",$71.92,"$1,330.25",$71.92,"$1,660.64",$71.92,"$1,712.00",$71.92,$71.92,"$1,660.64"
2344045A,0510,23440,,,,,N/A,N/A,Remove/Transplant Tendon    ~t,$0.00,$0.00,$727.75,"$1,775.00",$727.75,"$1,721.75",$727.75,"$1,517.63",$727.75,"$1,348.25",$727.75,"$1,721.75",$727.75,"$1,775.00",$727.75,$727.75,"$1,721.75"
2345545A,0510,23455,,,,,N/A,N/A,Repair Shoulder Capsule     ~t,$0.00,$0.00,$965.14,"$2,354.00",$965.14,"$2,283.38",$965.14,"$2,012.67",$965.14,"$1,767.45",$965.14,"$2,283.38",$965.14,"$2,354.00",$965.14,$965.14,"$2,283.38"
2347045A,0510,23470,,,,,N/A,N/A,Reconstruct Shoulder Joint  ~t,$0.00,$0.00,"$1,144.31","$2,791.00","$1,144.31","$2,707.27","$1,144.31","$2,386.31","$1,144.31","$2,131.98","$1,144.31","$2,707.27","$1,144.31","$2,791.00","$1,144.31","$1,144.31","$2,707.27"
2347245A,0510,23472,,,,,N/A,N/A,Reconstruct Shoulder Joint  ~t,$0.00,$0.00,"$1,383.75","$3,375.00","$1,383.75","$3,273.75","$1,383.75","$2,885.63","$1,383.75","$2,567.40","$1,383.75","$3,273.75","$1,383.75","$3,375.00","$1,383.75","$1,383.75","$3,273.75"
2348545A,0510,23485,,,,,N/A,N/A,Revision Of Collar Bone     ~t,$0.00,$0.00,$96.92,"$2,212.00",$96.92,"$2,145.64",$96.92,"$1,891.26",$96.92,"$1,688.16",$96.92,"$2,145.64",$96.92,"$2,212.00",$96.92,$96.92,"$2,145.64"
2351545A,0510,23515,,,,,N/A,N/A,Treat Clavicle Fracture     ~t,$0.00,$0.00,$541.20,"$1,334.00",$541.20,"$1,293.98",$541.20,"$1,140.57",$541.20,"$1,286.98",$541.20,"$1,293.98",$541.20,"$1,334.00",$541.20,$541.20,"$1,293.98"
2354545A,0510,23545,,,,,N/A,N/A,TREAT CLAVICLE DISLOCATION  ~T,$14.13,$10.50,$251.74,$251.74,$251.74,N/A,$251.74,N/A,$251.74,N/A,$251.74,N/A,$251.74,N/A,$251.74,$251.74,N/A
2355045A,0510,23550,,,,,N/A,N/A,TREAT CLAVICLE DISLOCATION  ~T,$84.75,$63.00,$526.44,"$1,284.00",$526.44,"$1,245.48",$526.44,"$1,097.82",$526.44,"$1,025.77",$526.44,"$1,245.48",$526.44,"$1,284.00",$526.44,$526.44,"$1,245.48"
2355245A,0510,23552,,,,,N/A,N/A,TREAT CLAVICLE DISLOCATION  ~T,$90.80,$67.50,$61.90,"$1,400.00",$61.90,"$1,358.00",$61.90,"$1,197.00",$61.90,"$1,171.41",$61.90,"$1,358.00",$61.90,"$1,400.00",$61.90,$61.90,"$1,358.00"
2360545A,0510,23605,,,,,N/A,N/A,Closed Tmt Humeral Fracture ~t,$0.00,$0.00,$336.61,$821.00,$336.61,N/A,$336.61,$701.96,$336.61,$771.52,$336.61,N/A,$336.61,$821.00,$336.61,$336.61,N/A
2361545A,0510,23615,,,,,N/A,N/A,"Treatment,Humerus Frx       ~t",$0.00,$0.00,$72.74,"$1,714.00",$72.74,$796.37,$72.74,"$1,465.47",$72.74,"$1,575.63",$72.74,$796.37,$72.74,"$1,714.00",$72.74,$72.74,$796.37
2363045A,0510,23630,,,,,N/A,N/A,Treat Humerus Fracture      ~t,$0.00,$0.00,$578.10,"$1,662.58",$578.10,"$1,662.58",$578.10,"$1,205.55",$578.10,"$1,393.29",$578.10,"$1,662.58",$578.10,"$1,410.00",$578.10,$578.10,"$1,662.58"
2365045A,0510,23650,,,,,N/A,N/A,Closed Treatment Of Shoulder~t,$0.00,$0.00,$171.38,"$1,367.70",$171.38,"$1,367.70",$171.38,$357.39,$171.38,$528.05,$171.38,"$1,367.70",$171.38,$418.00,$171.38,$171.38,"$1,367.70"
2365545A,0510,23655,,,,,N/A,N/A,Treat Shoulder Dislocation  ~t,$0.00,$0.00,$336.20,$820.00,$336.20,$405.46,$336.20,$701.10,$336.20,$735.61,$336.20,$405.46,$336.20,$820.00,$336.20,$336.20,$405.46
2366545A,0510,23665,,,,,N/A,N/A,TREAT DISLOCATION/FRACTURE  ~T,$60.54,$45.00,$352.60,$860.00,$352.60,$795.40,$352.60,$735.30,$352.60,$718.27,$352.60,$795.40,$352.60,$860.00,$352.60,$352.60,$795.40
2370045A,0510,23700,,,,,N/A,N/A,Fixation Of Shoulder        ~t,$0.00,$0.00,$182.40,$834.20,$182.40,$834.20,$182.40,$379.62,$182.40,$349.14,$182.40,$834.20,$182.40,$444.00,$182.40,$182.40,$834.20
2393040A,0510,23930,,,,,N/A,N/A,Drainage Of Arm Lesion      ~t,$0.00,$0.00,$22.54,$494.00,$22.54,$430.68,$22.54,$422.37,$22.54,$384.32,$22.54,$430.68,$22.54,$494.00,$22.54,$22.54,$430.68
2393145A,0510,23931,,,,,N/A,N/A,Incision Bursa              ~t,$0.00,$0.00,$128.33,$479.18,$128.33,$479.18,$128.33,$267.62,$128.33,$286.94,$128.33,$479.18,$128.33,$313.00,$128.33,$128.33,$479.18
2407140A,0510,24071,,,,,N/A,N/A,Exc Arm/Elbow Les Sc 3 Cm/> ~t,$0.00,$0.00,$303.61,$786.00,$322.26,$303.61,$322.26,$672.03,$322.26,$719.94,$322.26,$303.61,$322.26,$786.00,$322.26,$322.26,$303.61
2407545A,0510,24075,,,,,N/A,N/A,Excision Soft Tissue Tumor  ~t,$0.00,$0.00,$27.60,$762.42,$27.60,$762.42,$27.60,$564.30,$27.60,$587.20,$27.60,$762.42,$27.60,$660.00,$27.60,$27.60,$762.42
2407645A,0510,24076,,,,,N/A,N/A,Remove Arm/Elbow Lesion     ~t,$0.00,$0.00,$43.91,"$1,051.00",$43.91,$640.20,$43.91,$898.61,$43.91,$968.80,$43.91,$640.20,$43.91,"$1,051.00",$43.91,$43.91,$640.20
2410145A,0510,24101,,,,,N/A,N/A,EXPLORE/TREAT ELBOW JOINT   ~T,$138.22,$102.75,$466.17,"$1,137.00",$466.17,N/A,$466.17,$972.14,$466.17,$905.22,$466.17,N/A,$466.17,"$1,137.00",$466.17,$466.17,N/A
2410545A,0510,24105,,,,,N/A,N/A,Removal Elbow Bursa         ~t,$0.00,$0.00,$37.90,$749.00,$37.90,$726.53,$37.90,$640.40,$37.90,$647.73,$37.90,$726.53,$37.90,$749.00,$37.90,$37.90,$726.53
2411045A,0510,24110,,,,,N/A,N/A,REMOVE HUMERUS LESION       ~T,$27.24,$20.25,$544.70,"$1,327.00",$544.70,"$1,287.19",$544.70,"$1,134.59",$544.70,"$1,041.86",$544.70,"$1,287.19",$544.70,"$1,327.00",$544.70,$544.70,"$1,287.19"
2412045A,0510,24120,,,,,N/A,N/A,Remove Elbow Lesion         ~t,$0.00,$0.00,$485.85,"$1,185.00",$485.85,"$1,149.45",$485.85,"$1,013.18",$485.85,$956.02,$485.85,"$1,149.45",$485.85,"$1,185.00",$485.85,$485.85,"$1,149.45"
2413045A,0510,24130,,,,,N/A,N/A,Removal Of Head Of Radius   ~t,$0.00,$0.00,$473.55,"$1,155.00",$473.55,"$1,120.35",$473.55,$987.53,$473.55,$917.79,$473.55,"$1,120.35",$473.55,"$1,155.00",$473.55,$473.55,"$1,120.35"
2414045A,0510,24140,,,,,N/A,N/A,PARTIAL REMOVAL OF ARM BONE ~T,$45.40,$33.75,$73.97,"$1,717.00",$73.97,"$1,665.49",$73.97,"$1,468.04",$73.97,"$1,257.88",$73.97,"$1,665.49",$73.97,"$1,717.00",$73.97,$73.97,"$1,665.49"
2414745A,0510,24147,,,,,N/A,N/A,Partial Excision            ~t,$0.00,$0.00,$59.63,"$1,243.00",$59.63,"$1,205.71",$59.63,"$1,062.77",$59.63,"$1,129.18",$59.63,"$1,205.71",$59.63,"$1,243.00",$59.63,$59.63,"$1,205.71"
2414945A,0510,24149,,,,,N/A,N/A,Radical Resection Elbow     ~t,$0.00,$0.00,$999.17,"$2,437.00",$999.17,"$2,363.89",$999.17,"$2,083.64",$999.17,"$2,099.54",$999.17,"$2,363.89",$999.17,"$2,437.00",$999.17,$999.17,"$2,363.89"
2431045A,0510,24310,,,,,N/A,N/A,REVISION OF ARM TENDON      ~T,$47.42,$35.25,$445.67,"$1,087.00",$445.67,"$1,054.39",$445.67,$929.39,$445.67,$851.67,$445.67,"$1,054.39",$445.67,"$1,087.00",$445.67,$445.67,"$1,054.39"
2434145A,0510,24341,,,,,N/A,N/A,REPAIR ARM TENDON/MUSCLE    ~T,$50.45,$37.50,$61.80,"$1,488.00",$61.80,"$1,443.36",$61.80,"$1,272.24",$61.80,"$1,335.71",$61.80,"$1,443.36",$61.80,"$1,488.00",$61.80,$61.80,"$1,443.36"
2434245A,0510,24342,,,,,N/A,N/A,Repair Of Ruptured Tendon   ~t,$0.00,$0.00,$65.57,"$1,477.00",$65.57,"$1,432.69",$65.57,"$1,262.84",$65.57,"$1,385.54",$65.57,"$1,432.69",$65.57,"$1,477.00",$65.57,$65.57,"$1,432.69"
2434345A,0510,24343,,,,,N/A,N/A,Repr Elbow Lat Ligmnt W/Tiss~t,$0.00,$0.00,$648.21,"$1,581.00",$648.21,"$1,533.57",$648.21,"$1,351.76",$648.21,"$1,278.50",$648.21,"$1,533.57",$648.21,"$1,581.00",$648.21,$648.21,"$1,533.57"
2435745A,0510,24357,,,,,N/A,N/A,"Tenotomy, Elbow, Tennis     ~t",$0.00,$0.00,$379.66,$926.00,$379.66,$898.22,$379.66,$791.73,$379.66,$757.18,$379.66,$898.22,$379.66,$926.00,$379.66,$379.66,$898.22
2435845A,0510,24358,,,,,N/A,N/A,TNOT ELBOW LATSL\MEDIAL DEBR~T,$25.22,$18.75,$451.00,"$1,007.00",$451.00,$976.79,$451.00,$860.99,$451.00,$948.23,$451.00,$976.79,$451.00,"$1,007.00",$451.00,$451.00,$976.79
2435945A,0510,24359,,,,,N/A,N/A,Repair Elbow Deb/Attch Open ~t,$0.00,$0.00,$459.61,"$1,185.24",$459.61,"$1,087.37",$459.61,$958.46,$459.61,"$1,185.24",$459.61,"$1,087.37",$459.61,"$1,121.00",$459.61,$459.61,"$1,087.37"
2443045A,0510,24430,,,,,N/A,N/A,Repair Non/Mal Union Humerus~t,$0.00,$0.00,$858.13,"$2,093.00",$858.13,"$2,030.21",$858.13,"$1,789.52",$858.13,"$1,877.28",$858.13,"$2,030.21",$858.13,"$2,093.00",$858.13,$858.13,"$2,030.21"
2443545A,0510,24435,,,,,N/A,N/A,Repair/Recon Elbow/Upper Arm~t,$0.00,$0.00,$883.14,"$2,154.00",$883.14,"$2,089.38",$883.14,"$1,841.67",$883.14,"$1,924.66",$883.14,"$2,089.38",$883.14,"$2,154.00",$883.14,$883.14,"$2,089.38"
2450045A,0510,24500,,,,,N/A,N/A,TREAT HUMERUS FRACTURE      ~T,$26.23,$19.50,$264.86,$646.00,$264.86,$626.62,$264.86,$552.33,$264.86,$602.39,$264.86,$626.62,$264.86,$646.00,$264.86,$264.86,$626.62
2450545A,0510,24505,,,,,N/A,N/A,TREAT HUMERUS FRACTURE      ~T,$30.27,$22.50,$394.10,$991.00,$394.10,$961.27,$394.10,$847.31,$394.10,$814.80,$394.10,$961.27,$394.10,$991.00,$394.10,$394.10,$961.27
2451545A,0510,24515,,,,,N/A,N/A,Treat Humerus Fracture      ~t,$0.00,$0.00,$815.49,"$1,989.00",$815.49,"$1,929.33",$815.49,"$1,700.60",$815.49,"$1,570.71",$815.49,"$1,929.33",$815.49,"$1,989.00",$815.49,$815.49,"$1,929.33"
2451645A,0510,24516,,,,,N/A,N/A,Treat Of Humeral Shaft Fx   ~t,$0.00,$0.00,$538.74,"$1,531.87",$538.74,"$1,274.58",$538.74,"$1,123.47",$538.74,"$1,531.87",$538.74,"$1,274.58",$538.74,"$1,314.00",$538.74,$538.74,"$1,274.58"
2453845A,0510,24538,,,,,N/A,N/A,Treat Humerus Fracture      ~t,$0.00,$0.00,$7.69,"$1,709.00",$7.69,"$1,657.73",$7.69,"$1,461.20",$7.69,"$1,400.73",$7.69,"$1,657.73",$7.69,"$1,709.00",$7.69,$7.69,"$1,657.73"
2460045A,0510,24600,,,,,N/A,N/A,TREAT ELBOW DISLOCATION     ~T,$123.09,$91.50,$295.20,$720.00,$295.20,$698.40,$295.20,$615.60,$295.20,$606.06,$295.20,$698.40,$295.20,$720.00,$295.20,$295.20,$698.40
2460545A,0510,24605,,,,,N/A,N/A,Treat Elbow Dislocation     ~t,$0.00,$0.00,$415.33,"$1,013.00",$415.33,$982.61,$415.33,$866.12,$415.33,$861.15,$415.33,$982.61,$415.33,"$1,013.00",$415.33,$415.33,$982.61
2463545A,0510,24635,,,,,N/A,N/A,Open Treatment Fx Elbow     ~t,$0.00,$0.00,$544.89,"$1,329.00",$544.89,"$1,289.13",$544.89,"$1,136.30",$544.89,"$1,209.60",$544.89,"$1,289.13",$544.89,"$1,329.00",$544.89,$544.89,"$1,289.13"
2465545A,0510,24655,,,,,N/A,N/A,Treat Radius Fracture       ~t,$0.00,$0.00,$352.60,$860.00,$352.60,$834.20,$352.60,$735.30,$352.60,$723.58,$352.60,$834.20,$352.60,$860.00,$352.60,$352.60,$834.20
2466545A,0510,24665,,,,,N/A,N/A,Open Trt Radial Head/Neck Fx~t,$0.00,$0.00,$348.50,"$1,181.08",$348.50,$824.50,$348.50,$726.75,$348.50,"$1,181.08",$348.50,$824.50,$348.50,$850.00,$348.50,$348.50,$824.50
2468545A,0510,24685,,,,,N/A,N/A,Open Treatment Of Ulnar Fx  ~t,$0.00,$0.00,$55.12,"$1,232.00",$55.12,"$1,195.04",$55.12,"$1,053.36",$55.12,"$1,173.61",$55.12,"$1,195.04",$55.12,"$1,232.00",$55.12,$55.12,"$1,195.04"
2500045A,0510,25000,,,,,N/A,N/A,Incision Tendon Sheath      ~t,$0.00,$0.00,$387.45,$945.00,$387.45,$916.65,$387.45,$807.98,$387.45,$621.52,$387.45,$916.65,$387.45,$945.00,$387.45,$387.45,$916.65
2500145A,0510,25001,,,,,N/A,N/A,Incise Flexor Carpi Radials ~t,$0.00,$0.00,$291.92,$712.00,$291.92,$690.64,$291.92,$608.76,$291.92,$623.48,$291.92,$690.64,$291.92,$712.00,$291.92,$291.92,$690.64
2504045A,0510,25040,,,,,N/A,N/A,Explore/Treat Wrist Joint   ~t,$0.00,$0.00,$556.78,"$1,358.00",$556.78,"$1,317.26",$556.78,"$1,161.09",$556.78,"$1,004.32",$556.78,"$1,317.26",$556.78,"$1,358.00",$556.78,$556.78,"$1,317.26"
2507345A,0510,25073,,,,,N/A,N/A,Exc Forearm Tum Deep 3 Cm/> ~t,$0.00,$0.00,$424.35,"$1,035.00",$424.35,"$1,003.95",$424.35,$884.93,$424.35,$955.26,$424.35,"$1,003.95",$424.35,"$1,035.00",$424.35,$424.35,"$1,003.95"
2507545A,0510,25075,,,,,N/A,N/A,REMOVAL FOREARM LESION SUB  ~T,$281.49,$209.25,$364.90,$890.00,$364.90,$863.30,$364.90,$760.95,$364.90,$564.50,$364.90,$863.30,$364.90,$890.00,$364.90,$364.90,$863.30
2507645A,0510,25076,,,,,N/A,N/A,REMOVAL FOREARM LESION DEEP ~T,$33.30,$24.75,$546.53,"$1,333.00",$546.53,"$1,293.01",$546.53,"$1,139.72",$546.53,$925.58,$546.53,"$1,293.01",$546.53,"$1,333.00",$546.53,$546.53,"$1,293.01"
2510145A,0510,25101,,,,,N/A,N/A,Proc Of Bones Arm/Wrist     ~t,$0.00,$0.00,$33.87,$807.00,$33.87,$782.79,$33.87,$689.99,$33.87,$728.87,$33.87,$782.79,$33.87,$807.00,$33.87,$33.87,$782.79
2510545A,0510,25105,,,,,N/A,N/A,REMOVE WRIST JOINT LINING   ~T,$48.43,$36.00,$53.48,$53.48,$53.48,N/A,$53.48,N/A,$53.48,N/A,$53.48,N/A,$53.48,N/A,$53.48,$53.48,N/A
2511045A,0510,25110,,,,,N/A,N/A,"Exc,Lesion Tendon Sheath    ~t",$0.00,$0.00,$277.98,$678.00,$277.98,$657.66,$277.98,$579.69,$277.98,$620.66,$277.98,$657.66,$277.98,$678.00,$277.98,$277.98,$657.66
2511140A,0510,25111,,,,,N/A,N/A,Remove Wrist Tendon Lesion  ~t,$0.00,$0.00,$38.32,$752.00,$38.32,$729.44,$38.32,$642.96,$38.32,$584.76,$38.32,$729.44,$38.32,$752.00,$38.32,$38.32,$729.44
2511145A,0510,25111,,,,,N/A,N/A,Remove Wrist Tendon Lesion  ~t,$0.00,$0.00,$38.32,$752.00,$38.32,$729.44,$38.32,$642.96,$38.32,$584.76,$38.32,$729.44,$38.32,$752.00,$38.32,$38.32,$729.44
2511245A,0510,25112,,,,,N/A,N/A,"Excision, Recurrent         ~t",$0.00,$0.00,$299.30,$730.00,$299.30,$708.10,$299.30,$624.15,$299.30,$700.40,$299.30,$708.10,$299.30,$730.00,$299.30,$299.30,$708.10
2511545A,0510,25115,,,,,N/A,N/A,Remove Wrist/Forearm Lesion ~t,$0.00,$0.00,$866.74,"$2,114.00",$866.74,"$2,050.58",$866.74,"$1,807.47",$866.74,"$1,354.55",$866.74,"$2,050.58",$866.74,"$2,114.00",$866.74,$866.74,"$2,050.58"
2511645A,0510,25116,,,,,N/A,N/A,Remove Wrist/Forearm Lesion ~t,$0.00,$0.00,"$1,083.30","$1,871.00",N/A,"$1,814.87",N/A,"$1,599.71",N/A,"$1,083.30",N/A,"$1,814.87",N/A,"$1,871.00",N/A,N/A,"$1,814.87"
2511845A,0510,25118,,,,,N/A,N/A,Syn Ext Tendon Sheath Wrist ~t,$0.00,$0.00,$34.63,$743.00,$34.63,$720.71,$34.63,$635.27,$34.63,$689.10,$34.63,$720.71,$34.63,$743.00,$34.63,$34.63,$720.71
2513045A,0510,25130,,,,,N/A,N/A,Removal Of Wrist Lesion     ~t,$0.00,$0.00,$446.90,"$1,090.00",$446.90,"$1,057.30",$446.90,$931.95,$446.90,$812.75,$446.90,"$1,057.30",$446.90,"$1,090.00",$446.90,$446.90,"$1,057.30"
2515045A,0510,25150,,,,,N/A,N/A,PARTIAL REMOVAL OF ULNA     ~G,$134.19,$99.75,$587.53,"$1,433.00",$587.53,"$1,390.01",$587.53,"$1,225.22",$587.53,"$1,019.15",$587.53,"$1,390.01",$587.53,"$1,433.00",$587.53,$587.53,"$1,390.01"
2521045A,0510,25210,,,,,N/A,N/A,REMOVAL OF WRIST BONE       ~T,$49.44,$36.75,$53.89,"$1,229.00",$53.89,"$1,192.13",$53.89,"$1,050.80",$53.89,$886.28,$53.89,"$1,192.13",$53.89,"$1,229.00",$53.89,$53.89,"$1,192.13"
2524845A,0510,25248,,,,,N/A,N/A,Remove Forearm Foreign Body ~t,$0.00,$0.00,$517.10,"$1,261.00",$517.10,"$1,223.17",$517.10,"$1,078.16",$517.10,$750.73,$517.10,"$1,223.17",$517.10,"$1,261.00",$517.10,$517.10,"$1,223.17"
2525945A,0510,25259,,,,,N/A,N/A,Manipulation Of Wrist       ~t,$0.00,$0.00,$338.25,$825.00,$338.25,$800.25,$338.25,$705.38,$338.25,$774.34,$338.25,$800.25,$338.25,$825.00,$338.25,$338.25,$800.25
2527045A,0510,25270,,,,,N/A,N/A,Repair Forearm Tendon/Muscle~t,$0.00,$0.00,$681.83,"$1,663.00",$681.83,"$1,613.11",$681.83,"$1,421.87",$681.83,$888.61,$681.83,"$1,613.11",$681.83,"$1,663.00",$681.83,$681.83,"$1,613.11"
2527545A,0510,25275,,,,,N/A,N/A,REPAIR FOREARM TENDON SHEATH~T,$25.22,$18.75,$619.92,"$1,512.00",$619.92,"$1,466.64",$619.92,N/A,$619.92,"$1,203.50",$619.92,"$1,466.64",$619.92,"$1,512.00",$619.92,$619.92,"$1,466.64"
2529545A,0510,25295,,,,,N/A,N/A,RELEASE WRIST/FOREARM TENDON~T,$27.24,$20.25,$78.70,"$1,727.00",$78.70,"$1,675.19",$78.70,"$1,476.59",$78.70,$947.42,$78.70,"$1,675.19",$78.70,"$1,727.00",$78.70,$78.70,"$1,675.19"
2531045A,0510,25310,,,,,N/A,N/A,Tendon Transplt/Transfer    ~t,$0.00,$0.00,$498.15,"$1,215.00",$498.15,"$1,178.55",$498.15,"$1,038.83",$498.15,"$1,114.17",$498.15,"$1,178.55",$498.15,"$1,215.00",$498.15,$498.15,"$1,178.55"
2533245A,0510,25332,,,,,N/A,N/A,Repair/Reconst Forearm/Wrist~t,$0.00,$0.00,$687.57,"$1,677.00",$687.57,"$1,626.69",$687.57,"$1,433.84",$687.57,"$1,507.77",$687.57,"$1,626.69",$687.57,"$1,677.00",$687.57,$687.57,"$1,626.69"
2539045A,0510,25390,,,,,N/A,N/A,SHORTEN RADIUS OR ULNA      ~T,$50.45,$37.50,"$1,362.43","$2,323.00","$1,362.43","$2,253.31","$1,362.43","$1,986.17","$1,362.43","$1,376.41","$1,362.43","$2,253.31","$1,362.43","$2,323.00","$1,362.43","$1,362.43","$2,253.31"
2540045A,0510,25400,,,,,N/A,N/A,REPAIR RADIUS OR ULNA       ~T,$33.30,$24.75,$997.53,"$2,433.00",$997.53,"$2,360.01",$997.53,"$2,080.22",$997.53,"$1,434.39",$997.53,"$2,360.01",$997.53,"$2,433.00",$997.53,$997.53,"$2,360.01"
2540545A,0510,25405,,,,,N/A,N/A,REPAIR/GRAFT RADIUS OR ULNA ~T,$55.49,$41.25,"$1,211.55","$2,955.00","$1,211.55","$2,866.35","$1,211.55",N/A,"$1,211.55","$1,848.04","$1,211.55","$2,866.35","$1,211.55","$2,955.00","$1,211.55","$1,211.55","$2,866.35"
2542545A,0510,25425,,,,,N/A,N/A,REPAIR/GRAFT RADIUS OR ULNA ~T,$93.83,$69.75,$139.13,"$3,193.00",$139.13,"$3,097.21",$139.13,"$2,730.02",$139.13,"$1,716.92",$139.13,"$3,097.21",$139.13,"$3,193.00",$139.13,$139.13,"$3,097.21"
2544545A,0510,25445,,,,,N/A,N/A,Treat Fracture Of Ulna      ~t,$0.00,$0.00,$583.20,"$1,422.00",$583.20,"$1,379.34",$583.20,"$1,215.81",$583.20,"$1,288.95",$583.20,"$1,379.34",$583.20,"$1,422.00",$583.20,$583.20,"$1,379.34"
2544745A,0510,25447,,,,,N/A,N/A,Repair Wrist Joint (S)      ~t,$0.00,$0.00,$734.31,"$1,791.00",$734.31,"$1,737.27",$734.31,"$1,531.31",$734.31,"$1,486.10",$734.31,"$1,737.27",$734.31,"$1,791.00",$734.31,$734.31,"$1,737.27"
2551545A,0510,25515,,,,,N/A,N/A,TREAT FRACTURE OF RADIUS    ~T,$74.66,$55.50,$645.34,"$1,574.00",$645.34,"$1,526.78",$645.34,"$1,345.77",$645.34,"$1,198.46",$645.34,"$1,526.78",$645.34,"$1,574.00",$645.34,$645.34,"$1,526.78"
2553045A,0510,25530,,,,,N/A,N/A,Treat Fracture Of Ulna      ~t,$0.00,$0.00,$189.42,$462.00,$189.42,$448.14,$189.42,$395.01,$189.42,$441.10,$189.42,$448.14,$189.42,$462.00,$189.42,$189.42,$448.14
2554545A,0510,25545,,,,,N/A,N/A,Treat Fracture Of Ulna      ~t,$0.00,$0.00,$641.24,"$1,564.00",$641.24,"$1,517.08",$641.24,"$1,337.22",$641.24,"$1,119.11",$641.24,"$1,517.08",$641.24,"$1,564.00",$641.24,$641.24,"$1,517.08"
2556545A,0510,25565,,,,,N/A,N/A,TREAT FRACTURE RADIUS & ULNA~T,$39.35,$29.25,$425.99,"$1,039.00",$425.99,"$1,007.83",$425.99,$888.35,$425.99,$835.25,$425.99,"$1,007.83",$425.99,"$1,039.00",$425.99,$425.99,"$1,007.83"
2560045A,0510,25600,,,,,N/A,N/A,"TREATMENT,RADIUS/ULNA FRX   ~T",$59.53,$44.25,$215.25,$585.83,$215.25,$509.25,$215.25,$448.88,$215.25,$585.83,$215.25,$509.25,$215.25,$525.00,$215.25,$215.25,$509.25
2560545A,0510,25605,,,,,N/A,N/A,"TREATMENT,RADIUS/ULNA FRX   ~T",$69.62,$51.75,$599.42,"$1,462.00",$599.42,"$1,418.14",$599.42,"$1,250.01",$599.42,$920.22,$599.42,"$1,418.14",$599.42,"$1,462.00",$599.42,$599.42,"$1,418.14"
2560645A,0510,25606,,,,,N/A,N/A,Clsd Rdtn Int.Fix Raius/Ulma~t,$0.00,$0.00,$65.57,"$1,477.00",$65.57,"$1,432.69",$65.57,"$1,262.84",$65.57,"$1,194.73",$65.57,"$1,432.69",$65.57,"$1,477.00",$65.57,$65.57,"$1,432.69"
2560745A,0510,25607,,,,,N/A,N/A,Optx Dstl Radl Ex Artic Fx  ~t,$0.00,$0.00,$564.57,"$1,377.00",$564.57,"$1,335.69",$564.57,"$1,177.34",$564.57,"$1,321.95",$564.57,"$1,335.69",$564.57,"$1,377.00",$564.57,$564.57,"$1,335.69"
2560845A,0510,25608,,,,,N/A,N/A,Optx Dstl Radl I Artic Fx   ~t,$0.00,$0.00,$599.42,"$1,477.18",$599.42,"$1,418.14",$599.42,"$1,250.01",$599.42,"$1,477.18",$599.42,"$1,418.14",$599.42,"$1,462.00",$599.42,$599.42,"$1,418.14"
2560945A,0510,25609,,,,,N/A,N/A,Optmt Dstl Radl I-Artic Frx ~t,$0.00,$0.00,$763.42,"$1,875.15",$763.42,"$1,806.14",$763.42,"$1,592.01",$763.42,"$1,875.15",$763.42,"$1,806.14",$763.42,"$1,862.00",$763.42,$763.42,"$1,806.14"
2562845A,0510,25628,,,,,N/A,N/A,TREAT WRIST BONE FRACTURE   ~T,$30.27,$22.50,$627.30,"$1,530.00",$627.30,"$1,484.10",$627.30,"$1,308.15",$627.30,"$1,290.87",$627.30,"$1,484.10",$627.30,"$1,530.00",$627.30,$627.30,"$1,484.10"
2564545A,0510,25645,,,,,N/A,N/A,TREAT WRIST BONE FRACTURE   ~T,$48.43,$36.00,$536.28,"$1,308.00",$536.28,"$1,268.76",$536.28,"$1,118.34",$536.28,"$1,024.61",$536.28,"$1,268.76",$536.28,"$1,308.00",$536.28,$536.28,"$1,268.76"
2565045A,0510,25650,,,,,N/A,N/A,TREAT WRIST BONE FRACTURE   ~T,$50.45,$37.50,$239.30,$583.00,$239.30,$565.51,$239.30,$498.47,$239.30,$553.52,$239.30,$565.51,$239.30,$583.00,$239.30,$239.30,$565.51
2565145A,0510,25651,,,,,N/A,N/A,PIN ULNAR STYLOID FRACTURE  ~T,$25.22,$18.75,$416.97,"$1,017.00",$416.97,$986.49,$416.97,$869.54,$416.97,$881.90,$416.97,$986.49,$416.97,"$1,017.00",$416.97,$416.97,$986.49
2565245A,0510,25652,,,,,N/A,N/A,TREAT FRACTURE ULNAR STYLOID~T,$73.65,$54.75,$562.93,"$1,373.00",$562.93,"$1,331.81",$562.93,"$1,173.92",$562.93,"$1,116.59",$562.93,"$1,331.81",$562.93,"$1,373.00",$562.93,$562.93,"$1,331.81"
2580045A,0510,25800,,,,,N/A,N/A,Fusion Wrist Joint          ~t,$0.00,$0.00,$726.93,"$1,773.00",$726.93,"$1,719.81",$726.93,"$1,515.92",$726.93,"$1,310.69",$726.93,"$1,719.81",$726.93,"$1,773.00",$726.93,$726.93,"$1,719.81"
2582045A,0510,25820,,,,,N/A,N/A,Wrist Fusion Limited        ~t,$0.00,$0.00,$498.56,"$1,216.00",$498.56,"$1,179.52",$498.56,"$1,039.68",$498.56,"$1,164.62",$498.56,"$1,179.52",$498.56,"$1,216.00",$498.56,$498.56,"$1,179.52"
2601045A,0510,26010,,,,,N/A,N/A,Incision Dr Of Finger       ~t,$0.00,$0.00,$126.69,$126.69,$126.69,N/A,$126.69,N/A,$126.69,N/A,$126.69,N/A,$126.69,N/A,$126.69,$126.69,N/A
2601145A,0510,26011,,,,,N/A,N/A,DRAINAGE OF FINGER ABSCESS  ~T,$24.21,$18.00,$235.75,$235.75,$235.75,N/A,$235.75,N/A,$235.75,N/A,$235.75,N/A,$235.75,N/A,$235.75,$235.75,N/A
2602045A,0510,26020,,,,,N/A,N/A,Incision Dr Tend Digit/Palm ~t,$0.00,$0.00,$355.47,$355.47,$355.47,N/A,$355.47,N/A,$355.47,N/A,$355.47,N/A,$355.47,N/A,$355.47,$355.47,N/A
2603745A,0510,26037,,,,,N/A,N/A,Decompress Fingers/Hand     ~t,$0.00,$0.00,$523.57,$523.57,$523.57,N/A,$523.57,N/A,$523.57,N/A,$523.57,N/A,$523.57,N/A,$523.57,$523.57,N/A
2604045A,0510,26040,,,,,N/A,N/A,RELEASE PALM CONTRACTURE    ~T,$21.19,$15.75,$283.31,$283.31,$283.31,N/A,$283.31,N/A,$283.31,N/A,$283.31,N/A,$283.31,N/A,$283.31,$283.31,N/A
2605545A,0510,26055,,,,,N/A,N/A,INCISE FINGER TENDON SHEATH ~T,$457.05,$339.75,$41.00,$41.00,$41.00,N/A,$41.00,N/A,$41.00,N/A,$41.00,N/A,$41.00,N/A,$41.00,$41.00,N/A
2607545A,0510,26075,,,,,N/A,N/A,Incision Tendon             ~t,$0.00,$0.00,$273.47,$273.47,$273.47,N/A,$273.47,N/A,$273.47,N/A,$273.47,N/A,$273.47,N/A,$273.47,$273.47,N/A
2611145A,0510,26111,,,,,N/A,N/A,Excise Tumor Hand/Finger    ~t,$0.00,$0.00,$311.19,$311.19,$311.19,N/A,$311.19,N/A,$311.19,N/A,$311.19,N/A,$311.19,N/A,$311.19,$311.19,N/A
2611545A,0510,26115,,,,,N/A,N/A,REMOVAL HAND LESION SUBCUT  ~T,$166.48,$123.75,$33.50,$33.50,$33.50,N/A,$33.50,N/A,$33.50,N/A,$33.50,N/A,$33.50,N/A,$33.50,$33.50,N/A
2611645A,0510,26116,,,,,N/A,N/A,Removal Hand Lesion Deep    ~t,$0.00,$0.00,$442.39,$442.39,$442.39,N/A,$442.39,N/A,$442.39,N/A,$442.39,N/A,$442.39,N/A,$442.39,$442.39,N/A
2612145A,0510,26121,,,,,N/A,N/A,Release Palm Contracture    ~t,$0.00,$0.00,$558.42,$558.42,$558.42,N/A,$558.42,N/A,$558.42,N/A,$558.42,N/A,$558.42,N/A,$558.42,$558.42,N/A
2612345A,0510,26123,,,,,N/A,N/A,Exc Fasc W/Release Sing Dig ~t,$0.00,$0.00,$644.93,$644.93,$644.93,N/A,$644.93,N/A,$644.93,N/A,$644.93,N/A,$644.93,N/A,$644.93,$644.93,N/A
2612545A,0510,26125,,,,,N/A,N/A,Fasciectomy Ea Add Digit    ~t,$0.00,$0.00,$217.30,$217.30,$217.30,N/A,$217.30,N/A,$217.30,N/A,$217.30,N/A,$217.30,N/A,$217.30,$217.30,N/A
2614045A,0510,26140,,,,,N/A,N/A,"Revise Finger Joint, Each   ~t",$0.00,$0.00,$469.45,$469.45,$469.45,N/A,$469.45,N/A,$469.45,N/A,$469.45,N/A,$469.45,N/A,$469.45,$469.45,N/A
2614545A,0510,26145,,,,,N/A,N/A,"Syn,Tend Sheath Palm/Finger ~t",$0.00,$0.00,$439.11,$439.11,$439.11,N/A,$439.11,N/A,$439.11,N/A,$439.11,N/A,$439.11,N/A,$439.11,$439.11,N/A
2616040A,0510,26160,,,,,N/A,N/A,REMOVE TENDON SHEATH LESION ~T,$85.76,$63.75,$447.72,$447.72,$447.72,N/A,$447.72,N/A,$447.72,N/A,$447.72,N/A,$447.72,N/A,$447.72,$447.72,N/A
2616045A,0510,26160,,,,,N/A,N/A,REMOVE TENDON SHEATH LESION ~T,$85.76,$63.75,$447.72,$447.72,$447.72,N/A,$447.72,N/A,$447.72,N/A,$447.72,N/A,$447.72,N/A,$447.72,$447.72,N/A
2621045A,0510,26210,,,,,N/A,N/A,REMOVAL OF FINGER LESION    ~T,$49.44,$36.75,$45.49,$45.49,$45.49,N/A,$45.49,N/A,$45.49,N/A,$45.49,N/A,$45.49,N/A,$45.49,$45.49,N/A
2623045A,0510,26230,,,,,N/A,N/A,Partial Removal Hand Bone   ~t,$0.00,$0.00,$471.50,$471.50,$471.50,N/A,$471.50,N/A,$471.50,N/A,$471.50,N/A,$471.50,N/A,$471.50,$471.50,N/A
2623545A,0510,26235,,,,,N/A,N/A,"Partial Removal, Finger Bone~t",$0.00,$0.00,$462.70,$462.70,$462.70,N/A,$462.70,N/A,$462.70,N/A,$462.70,N/A,$462.70,N/A,$462.70,$462.70,N/A
2623645A,0510,26236,,,,,N/A,N/A,"PARTIAL REMOVAL, FINGER BONE~T",$45.40,$33.75,$47.95,$47.95,$47.95,N/A,$47.95,N/A,$47.95,N/A,$47.95,N/A,$47.95,N/A,$47.95,$47.95,N/A
2634045A,0510,26340,,,,,N/A,N/A,Repair Finger/Hand          ~t,$0.00,$0.00,$271.42,$271.42,$271.42,N/A,$271.42,N/A,$271.42,N/A,$271.42,N/A,$271.42,N/A,$271.42,$271.42,N/A
2635045A,0510,26350,,,,,N/A,N/A,REPAIR FINGER/HAND TENDON   ~T,$90.80,$67.50,$774.90,$774.90,$774.90,N/A,$774.90,N/A,$774.90,N/A,$774.90,N/A,$774.90,N/A,$774.90,$774.90,N/A
2635645A,0510,26356,,,,,N/A,N/A,Reapair Finger/Hand Tendon  ~t,$0.00,$0.00,$996.30,$996.30,$996.30,N/A,$996.30,N/A,$996.30,N/A,$996.30,N/A,$996.30,N/A,$996.30,$996.30,N/A
2637045A,0510,26370,,,,,N/A,N/A,Repair Finger/Hand Tendon   ~t,$0.00,$0.00,$838.86,$838.86,$838.86,N/A,$838.86,N/A,$838.86,N/A,$838.86,N/A,$838.86,N/A,$838.86,$838.86,N/A
2637345A,0510,26373,,,,,N/A,N/A,REPAIR FINGER/HAND TENDON   ~T,$30.27,$22.50,$92.00,$92.00,$92.00,N/A,$92.00,N/A,$92.00,N/A,$92.00,N/A,$92.00,N/A,$92.00,$92.00,N/A
2641045A,0510,26410,,,,,N/A,N/A,REPAIR HAND TENDON          ~T,$20.18,$15.00,$623.20,$623.20,$623.20,N/A,$623.20,N/A,$623.20,N/A,$623.20,N/A,$623.20,N/A,$623.20,$623.20,N/A
2641245A,0510,26412,,,,,N/A,N/A,Repairw/Free Graft Ea Tendon~t,$0.00,$0.00,$545.71,$545.71,$545.71,N/A,$545.71,N/A,$545.71,N/A,$545.71,N/A,$545.71,N/A,$545.71,$545.71,N/A
2641545A,0510,26415,,,,,N/A,N/A,"EXCISION, HAND/FINGER TENDON~T",$56.50,$42.00,$76.96,$76.96,$76.96,N/A,$76.96,N/A,$76.96,N/A,$76.96,N/A,$76.96,N/A,$76.96,$76.96,N/A
2641845A,0510,26418,,,,,N/A,N/A,Repair Finger/Hand          ~t,$0.00,$0.00,$464.53,$464.53,$464.53,N/A,$464.53,N/A,$464.53,N/A,$464.53,N/A,$464.53,N/A,$464.53,$464.53,N/A
2643745A,0510,26437,,,,,N/A,N/A,Realignment Of Tendons      ~t,$0.00,$0.00,$657.64,$657.64,$657.64,N/A,$657.64,N/A,$657.64,N/A,$657.64,N/A,$657.64,N/A,$657.64,$657.64,N/A
2644045A,0510,26440,,,,,N/A,N/A,Release Palm/Finger Tendon  ~t,$0.00,$0.00,$692.90,$692.90,$692.90,N/A,$692.90,N/A,$692.90,N/A,$692.90,N/A,$692.90,N/A,$692.90,$692.90,N/A
2644545A,0510,26445,,,,,N/A,N/A,Release Hand/Finger Tendon  ~t,$0.00,$0.00,$653.54,$653.54,$653.54,N/A,$653.54,N/A,$653.54,N/A,$653.54,N/A,$653.54,N/A,$653.54,$653.54,N/A
2645045A,0510,26450,,,,,N/A,N/A,"Tenotomy,Flex,Palm Ea Tendon~t",$0.00,$0.00,$321.85,$321.85,$321.85,N/A,$321.85,N/A,$321.85,N/A,$321.85,N/A,$321.85,N/A,$321.85,$321.85,N/A
2645545A,0510,26455,,,,,N/A,N/A,"Tenotomy,Flex,Fnger Ea Tend ~t",$0.00,$0.00,$321.44,$321.44,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,$321.44,N/A
2646045A,0510,26460,,,,,N/A,N/A,"Tentmy,Ext,Hand,Fin,Ea Tend ~t",$0.00,$0.00,$313.24,$313.24,$313.24,N/A,$313.24,N/A,$313.24,N/A,$313.24,N/A,$313.24,N/A,$313.24,$313.24,N/A
2648045A,0510,26480,,,,,N/A,N/A,Repair Wrist Joint (S)      ~t,$0.00,$0.00,$587.12,$587.12,$587.12,N/A,$587.12,N/A,$587.12,N/A,$587.12,N/A,$587.12,N/A,$587.12,$587.12,N/A
2648345A,0510,26483,,,,,N/A,N/A,Transfer Of Tendon W/Graft  ~t,$0.00,$0.00,$674.86,$674.86,$674.86,N/A,$674.86,N/A,$674.86,N/A,$674.86,N/A,$674.86,N/A,$674.86,$674.86,N/A
2652545A,0510,26525,,,,,N/A,N/A,Release Finger Contracture  ~t,$0.00,$0.00,$725.29,$725.29,$725.29,N/A,$725.29,N/A,$725.29,N/A,$725.29,N/A,$725.29,N/A,$725.29,$725.29,N/A
2654045A,0510,26540,,,,,N/A,N/A,Repair Hand Joint           ~t,$0.00,$0.00,$612.13,$612.13,$612.13,N/A,$612.13,N/A,$612.13,N/A,$612.13,N/A,$612.13,N/A,$612.13,$612.13,N/A
2654145A,0510,26541,,,,,N/A,N/A,Repair Hand Joint W/Graft   ~t,$0.00,$0.00,$835.99,$835.99,$835.99,N/A,$835.99,N/A,$835.99,N/A,$835.99,N/A,$835.99,N/A,$835.99,$835.99,N/A
2660045A,0510,26600,,,,,N/A,N/A,TREAT METACARPAL FRACTURE   ~T,$21.19,$15.75,$216.89,$216.89,$216.89,N/A,$216.89,N/A,$216.89,N/A,$216.89,N/A,$216.89,N/A,$216.89,$216.89,N/A
2660545A,0510,26605,,,,,N/A,N/A,TREATMENT OF METACARPAL FX  ~T,$92.82,$69.00,$249.69,$249.69,$249.69,N/A,$249.69,N/A,$249.69,N/A,$249.69,N/A,$249.69,N/A,$249.69,$249.69,N/A
2660845A,0510,26608,,,,,N/A,N/A,Treat Metacarpal Fracture   ~t,$0.00,$0.00,$445.67,$445.67,$445.67,N/A,$445.67,N/A,$445.67,N/A,$445.67,N/A,$445.67,N/A,$445.67,$445.67,N/A
2661545A,0510,26615,,,,,N/A,N/A,Treat Metacarpal Fracture   ~t,$0.00,$0.00,$41.00,$41.00,$41.00,N/A,$41.00,N/A,$41.00,N/A,$41.00,N/A,$41.00,N/A,$41.00,$41.00,N/A
2665045A,0510,26650,,,,,N/A,N/A,TREAT THUMB FRACTURE        ~T,$62.55,$46.50,$476.42,$476.42,$476.42,N/A,$476.42,N/A,$476.42,N/A,$476.42,N/A,$476.42,N/A,$476.42,$476.42,N/A
2667645A,0510,26676,,,,,N/A,N/A,Pin Hand Dislocation        ~t,$0.00,$0.00,$467.81,$467.81,$467.81,N/A,$467.81,N/A,$467.81,N/A,$467.81,N/A,$467.81,N/A,$467.81,$467.81,N/A
2670045A,0510,26700,,,,,N/A,N/A,Treat Knuckle Dislocation   ~t,$0.00,$0.00,$249.69,$249.69,$249.69,N/A,$249.69,N/A,$249.69,N/A,$249.69,N/A,$249.69,N/A,$249.69,$249.69,N/A
2672045A,0510,26720,,,,,N/A,N/A,"TREAT FINGER FRACTURE, EACH ~T",$14.13,$10.50,$145.14,$145.14,$145.14,N/A,$145.14,N/A,$145.14,N/A,$145.14,N/A,$145.14,N/A,$145.14,$145.14,N/A
2672745A,0510,26727,,,,,N/A,N/A,Treat Finger Fracture Each  ~t,$0.00,$0.00,$439.11,$439.11,$439.11,N/A,$439.11,N/A,$439.11,N/A,$439.11,N/A,$439.11,N/A,$439.11,$439.11,N/A
2673545A,0510,26735,,,,,N/A,N/A,Open Treatment Phalangeal Fx~t,$0.00,$0.00,$489.13,$489.13,$489.13,N/A,$489.13,N/A,$489.13,N/A,$489.13,N/A,$489.13,N/A,$489.13,$489.13,N/A
2674045A,0510,26740,,,,,N/A,N/A,"TREAT FINGER FRACTURE, EACH ~T",$13.12,$9.75,$177.53,$177.53,$177.53,N/A,$177.53,N/A,$177.53,N/A,$177.53,N/A,$177.53,N/A,$177.53,$177.53,N/A
2674245A,0510,26742,,,,,N/A,N/A,Treatment Of Fx/Disloc Hand ~t,$0.00,$0.00,$273.47,$273.47,$273.47,N/A,$273.47,N/A,$273.47,N/A,$273.47,N/A,$273.47,N/A,$273.47,$273.47,N/A
2674645A,0510,26746,,,,,N/A,N/A,Fracture/Dislocation        ~t,$0.00,$0.00,$564.57,$564.57,$564.57,N/A,$564.57,N/A,$564.57,N/A,$564.57,N/A,$564.57,N/A,$564.57,$564.57,N/A
2675645A,0510,26756,,,,,N/A,N/A,Pin Finger Fracture Each    ~t,$0.00,$0.00,$386.63,$386.63,$386.63,N/A,$386.63,N/A,$386.63,N/A,$386.63,N/A,$386.63,N/A,$386.63,$386.63,N/A
2676545A,0510,26765,,,,,N/A,N/A,Treatment Of Fx Finger/Hand ~p,$0.00,$0.00,$47.13,$47.13,$47.13,N/A,$47.13,N/A,$47.13,N/A,$47.13,N/A,$47.13,N/A,$47.13,$47.13,N/A
2677045A,0510,26770,,,,,N/A,N/A,TREAT FINGER DISLOCATION    ~T,$15.13,$11.25,$27.50,$27.50,$27.50,N/A,$27.50,N/A,$27.50,N/A,$27.50,N/A,$27.50,N/A,$27.50,$27.50,N/A
2678545A,0510,26785,,,,,N/A,N/A,Treat Finger Dislocation    ~t,$0.00,$0.00,$335.79,$335.79,$335.79,N/A,$335.79,N/A,$335.79,N/A,$335.79,N/A,$335.79,N/A,$335.79,$335.79,N/A
2684145A,0510,26841,,,,,N/A,N/A,Fusion Of Thumb             ~t,$0.00,$0.00,$772.44,$772.44,$772.44,N/A,$772.44,N/A,$772.44,N/A,$772.44,N/A,$772.44,N/A,$772.44,$772.44,N/A
2686045A,0510,26860,,,,,N/A,N/A,Arth Interphalangeal Joint  ~t,$0.00,$0.00,$45.18,$45.18,$45.18,N/A,$45.18,N/A,$45.18,N/A,$45.18,N/A,$45.18,N/A,$45.18,$45.18,N/A
2695145A,0510,26951,,,,,N/A,N/A,Amputation Finger/Thumb     ~t,$0.00,$0.00,$555.96,$555.96,$555.96,N/A,$555.96,N/A,$555.96,N/A,$555.96,N/A,$555.96,N/A,$555.96,$555.96,N/A
2695245A,0510,26952,,,,,N/A,N/A,Amp Fin/Thum W/Loc Adv Flap ~t,$0.00,$0.00,$514.96,$514.96,$514.96,N/A,$514.96,N/A,$514.96,N/A,$514.96,N/A,$514.96,N/A,$514.96,$514.96,N/A
2699045A,0510,26990,,,,,N/A,N/A,Drainage Of Pelvis Lesion   ~t,$0.00,$0.00,$565.80,$565.80,$565.80,N/A,$565.80,N/A,$565.80,N/A,$565.80,N/A,$565.80,N/A,$565.80,$565.80,N/A
2700145A,0510,27001,,,,,N/A,N/A,Incision Of Hip Tendon      ~t,$0.00,$0.00,$970.09,"$1,233.00",N/A,"$1,196.01",N/A,"$1,054.22",N/A,$970.09,N/A,"$1,196.01",N/A,"$1,233.00",N/A,N/A,"$1,196.01"
2700645A,0510,27006,,,,,N/A,N/A,Incision Of Hip Tendon      ~t,$0.00,$0.00,"$1,290.32","$3,346.00","$1,371.86","$3,245.62","$1,371.86","$2,860.83","$1,371.86","$1,290.32","$1,371.86","$3,245.62","$1,371.86","$3,346.00","$1,371.86","$1,371.86","$3,245.62"
2702545A,0510,27025,,,,,N/A,N/A,Incision Of Hip/Thigh Fascia~t,$0.00,$0.00,$763.42,"$1,862.00",$763.42,"$1,806.14",$763.42,"$1,592.01",$763.42,"$1,638.46",$763.42,"$1,806.14",$763.42,"$1,862.00",$763.42,$763.42,"$1,806.14"
2703045A,0510,27030,,,,,N/A,N/A,Drainage Of Hip Joint       ~t,$0.00,$0.00,$88.68,"$2,148.00",$88.68,"$2,083.56",$88.68,"$1,836.54",$88.68,"$1,666.79",$88.68,"$2,083.56",$88.68,"$2,148.00",$88.68,$88.68,"$2,083.56"
2703345A,0510,27033,,,,,N/A,N/A,Surg Incision Of Hip        ~t,$0.00,$0.00,$788.84,"$1,924.00",$788.84,"$1,866.28",$788.84,"$1,645.02",$788.84,"$1,730.10",$788.84,"$1,866.28",$788.84,"$1,924.00",$788.84,$788.84,"$1,866.28"
2704545A,0510,27045,,,,,N/A,N/A,"Remove Turmor, Hip/Pelv 5cm>~t",$0.00,$0.00,$558.10,"$1,361.00",$558.10,"$1,320.17",$558.10,"$1,163.66",$558.10,"$1,301.99",$558.10,"$1,320.17",$558.10,"$1,361.00",$558.10,$558.10,"$1,320.17"
2704745A,0510,27047,,,,,N/A,N/A,REMOVE HIP/PELVIS LESION    ~T,$425.77,$316.50,$471.91,"$1,151.00",$471.91,"$1,116.47",$471.91,$984.11,$471.91,$638.52,$471.91,"$1,116.47",$471.91,"$1,151.00",$471.91,$471.91,"$1,116.47"
2704845A,0510,27048,,,,,N/A,N/A,"Excision,Tumor,Soft Tiss <cm~t",$0.00,$0.00,$351.78,"$1,084.29",$351.78,$832.26,$351.78,$733.59,$351.78,"$1,084.29",$351.78,$832.26,$351.78,$858.00,$351.78,$351.78,$832.26
2706245A,0510,27062,,,,,N/A,N/A,Remove Femur Lesion/Bursa   ~t,$0.00,$0.00,$47.54,$994.00,$47.54,$964.18,$47.54,$849.87,$47.54,$816.93,$47.54,$964.18,$47.54,$994.00,$47.54,$47.54,$964.18
2709145A,0510,27091,,,,,N/A,N/A,REMOVAL OF HIP PROSTHESIS   ~T,$41.37,$30.75,$141.81,"$3,441.00",$141.81,"$3,337.77",$141.81,"$2,942.06",$141.81,"$2,818.59",$141.81,"$3,337.77",$141.81,"$3,441.00",$141.81,$141.81,"$3,337.77"
2709345A,0510,27093,,,,,N/A,N/A,Injection Prodcedure For Hip~t,$0.00,$0.00,$122.56,$534.00,$218.94,$517.98,$218.94,$456.57,$218.94,$122.56,$218.94,$517.98,$218.94,$534.00,$218.94,$218.94,$517.98
2709545A,0510,27095,,,,,N/A,N/A,Injection For Hip W/Anes    ~t,$0.00,$0.00,$29.10,$510.00,$29.10,$494.70,$29.10,$436.05,$29.10,$146.79,$29.10,$494.70,$29.10,$510.00,$29.10,$29.10,$494.70
2710045A,0510,27100,,,,,N/A,N/A,Transfer Of Adb Muscle      ~t,$0.00,$0.00,$51.86,"$1,480.37",$51.86,"$1,208.62",$51.86,"$1,065.33",$51.86,"$1,480.37",$51.86,"$1,208.62",$51.86,"$1,246.00",$51.86,$51.86,"$1,208.62"
2712545A,0510,27125,,,,,N/A,N/A,"Repair,Revision,Partial Hip ~p",$0.00,$0.00,$881.90,"$2,149.00",$881.90,"$2,084.53",$881.90,"$1,837.40",$881.90,"$2,008.52",$881.90,"$2,084.53",$881.90,"$2,149.00",$881.90,$881.90,"$2,084.53"
2713045A,0510,27130,,,,,N/A,N/A,Total Hip Arthroplasty      ~t,$0.00,$0.00,$132.98,"$6,356.00",$132.98,"$6,165.32",$132.98,"$5,434.38",$132.98,"$2,277.00",$132.98,"$6,165.32",$132.98,"$6,356.00",$132.98,$132.98,"$6,165.32"
2713245A,0510,27132,,,,,N/A,N/A,Total Hip Arthroplasty      ~t,$0.00,$0.00,"$1,517.82","$3,702.00","$1,517.82","$3,590.94","$1,517.82","$3,165.21","$1,517.82","$2,956.85","$1,517.82","$3,590.94","$1,517.82","$3,702.00","$1,517.82","$1,517.82","$3,590.94"
2713445A,0510,27134,,,,,N/A,N/A,Revision Total Hip Both Comp~t,$0.00,$0.00,"$1,513.31","$6,391.00","$1,513.31","$6,199.27","$1,513.31","$5,464.31","$1,513.31","$3,367.07","$1,513.31","$6,199.27","$1,513.31","$6,391.00","$1,513.31","$1,513.31","$6,199.27"
2713745A,0510,27137,,,,,N/A,N/A,REVISE HIP JOINT REPLACEMENT~T,$40.36,$30.00,"$1,369.40","$3,340.00","$1,369.40","$3,239.80","$1,369.40","$2,855.70","$1,369.40","$2,594.63","$1,369.40","$3,239.80","$1,369.40","$3,340.00","$1,369.40","$1,369.40","$3,239.80"
2713845A,0510,27138,,,,,N/A,N/A,Repair Femoral Comp Only    ~p,$0.00,$0.00,"$1,426.39","$3,479.00","$1,426.39","$3,374.63","$1,426.39","$2,974.55","$1,426.39","$2,695.36","$1,426.39","$3,374.63","$1,426.39","$3,479.00","$1,426.39","$1,426.39","$3,374.63"
2718745A,0510,27187,,,,,N/A,N/A,Reinforce Hip Bones         ~t,$0.00,$0.00,$943.00,"$2,300.00",$943.00,"$2,231.00",$943.00,"$1,966.50",$943.00,"$1,770.71",$943.00,"$2,231.00",$943.00,"$2,300.00",$943.00,$943.00,"$2,231.00"
2721545A,0510,27215,,,,,N/A,N/A,TREAT PELVIC FRACTURE(S)    ~T,$38.34,$28.50,$671.58,"$1,638.00",$671.58,"$1,588.86",$671.58,"$1,400.49",$671.58,"$1,087.36",$671.58,"$1,588.86",$671.58,"$1,638.00",$671.58,$671.58,"$1,588.86"
2723545A,0510,27235,,,,,N/A,N/A,Treat Thigh Fracture        ~t,$0.00,$0.00,$863.50,"$2,105.00",$863.50,"$2,041.85",$863.50,"$1,799.78",$863.50,"$1,613.93",$863.50,"$2,041.85",$863.50,"$2,105.00",$863.50,$863.50,"$2,041.85"
2723645A,0510,27236,,,,,N/A,N/A,Total Hip Arthroplasty      ~t,$0.00,$0.00,$138.12,"$2,532.00",$138.12,"$2,456.04",$138.12,"$2,164.86",$138.12,"$2,117.70",$138.12,"$2,456.04",$138.12,"$2,532.00",$138.12,$138.12,"$2,456.04"
2724045A,0510,27240,,,,,N/A,N/A,Treat Thigh Fracture        ~t,$0.00,$0.00,$852.39,"$2,079.00",$852.39,"$2,016.63",$852.39,"$1,777.55",$852.39,"$1,706.85",$852.39,"$2,016.63",$852.39,"$2,079.00",$852.39,$852.39,"$2,016.63"
2724445A,0510,27244,,,,,N/A,N/A,"Treatment, Thigh Frx        ~t",$0.00,$0.00,$16.26,"$2,586.00",$16.26,"$2,508.42",$16.26,"$2,211.03",$16.26,"$2,178.93",$16.26,"$2,508.42",$16.26,"$2,586.00",$16.26,$16.26,"$2,508.42"
2724545A,0510,27245,,,,,N/A,N/A,"Treatment, Thigh Frx        ~t",$0.00,$0.00,"$1,327.58","$3,238.00","$1,327.58","$3,140.86","$1,327.58","$2,768.49","$1,327.58","$2,176.95","$1,327.58","$3,140.86","$1,327.58","$3,238.00","$1,327.58","$1,327.58","$3,140.86"
2724845A,0510,27248,,,,,N/A,N/A,Treat Thigh Fracture        ~t,$0.00,$0.00,$724.47,"$1,767.00",$724.47,"$1,713.99",$724.47,"$1,510.79",$724.47,"$1,326.94",$724.47,"$1,713.99",$724.47,"$1,767.00",$724.47,$724.47,"$1,713.99"
2725245A,0510,27252,,,,,N/A,N/A,Treat Hip Dislocation       ~t,$0.00,$0.00,$69.44,"$1,684.00",$69.44,"$1,633.48",$69.44,"$1,439.82",$69.44,"$1,345.24",$69.44,"$1,633.48",$69.44,"$1,684.00",$69.44,$69.44,"$1,633.48"
2726545A,0510,27265,,,,,N/A,N/A,TREAT HIP DISLOCATION       ~T,$25.22,$18.75,$375.56,$375.56,$375.56,N/A,$375.56,N/A,$375.56,N/A,$375.56,N/A,$375.56,N/A,$375.56,$375.56,N/A
2726645A,0510,27266,,,,,N/A,N/A,Treatment Of Fx/Disloc Hip ~p,$0.00,$0.00,$476.42,$476.42,$476.42,N/A,$476.42,N/A,$476.42,N/A,$476.42,N/A,$476.42,N/A,$476.42,$476.42,N/A
2727545A,0510,27275,,,,,N/A,N/A,Manipulation Hip Joint      ~t,$0.00,$0.00,$149.24,$364.00,$149.24,$353.08,$149.24,$311.22,$149.24,$330.11,$149.24,$353.08,$149.24,$364.00,$149.24,$149.24,$353.08
2730140A,0510,27301,,,,,N/A,N/A,Incision/Drainage           ~t,$0.00,$0.00,$4.16,$976.00,$4.16,$946.72,$4.16,$834.48,$4.16,$902.72,$4.16,$946.72,$4.16,$976.00,$4.16,$4.16,$946.72
2730145A,0510,27301,,,,,N/A,N/A,Incision/Drainage           ~t,$0.00,$0.00,$4.16,$976.00,$4.16,$946.72,$4.16,$834.48,$4.16,$902.72,$4.16,$946.72,$4.16,$976.00,$4.16,$4.16,$946.72
2730545A,0510,27305,,,,,N/A,N/A,Incise Thigh Tend & Fascia  ~t,$0.00,$0.00,$366.54,$894.00,$366.54,$867.18,$366.54,$764.37,$366.54,$864.42,$366.54,$867.18,$366.54,$894.00,$366.54,$366.54,$867.18
2731045A,0510,27310,,,,,N/A,N/A,Exploration Of Knee Joint   ~t,$0.00,$0.00,$653.95,"$1,595.00",$653.95,"$1,547.15",$653.95,"$1,363.73",$653.95,"$1,306.80",$653.95,"$1,547.15",$653.95,"$1,595.00",$653.95,$653.95,"$1,547.15"
2732340A,0510,27323,,,,,N/A,N/A,Biopsy Thigh Or Knee        ~t,$0.00,$0.00,$159.80,$388.00,$159.80,$376.36,$159.80,$331.74,$159.80,$312.70,$159.80,$376.36,$159.80,$388.00,$159.80,$159.80,$376.36
2732445A,0510,27324,,,,,N/A,N/A,"Biopsy, Thigh Soft Tissues  ~t",$0.00,$0.00,$289.50,$726.74,$289.50,$683.85,$289.50,$602.78,$289.50,$726.74,$289.50,$683.85,$289.50,$705.00,$289.50,$289.50,$683.85
2732740A,0510,27327,,,,,N/A,N/A,"Repair,Rev/Recon Tenotomy   ~t",$0.00,$0.00,$246.41,$601.00,$246.41,$582.97,$246.41,$513.86,$246.41,$557.48,$246.41,$582.97,$246.41,$601.00,$246.41,$246.41,$582.97
2732745A,0510,27327,,,,,N/A,N/A,"Repair,Rev/Recon Tenotomy   ~t",$0.00,$0.00,$246.41,$601.00,$246.41,$582.97,$246.41,$513.86,$246.41,$557.48,$246.41,$582.97,$246.41,$601.00,$246.41,$246.41,$582.97
2732845A,0510,27328,,,,,N/A,N/A,Exc Thigh/Knee Tum Deep<5cm ~t,$0.00,$0.00,$432.96,"$1,105.23",$432.96,"$1,024.32",$432.96,$902.88,$432.96,"$1,105.23",$432.96,"$1,024.32",$432.96,"$1,056.00",$432.96,$432.96,"$1,024.32"
2733145A,0510,27331,,,,,N/A,N/A,EXPLORE/TREAT KNEE JOINT   ~T,$75.67,$56.25,$41.00,"$1,075.00",$41.00,"$1,042.75",$41.00,$919.13,$41.00,$854.91,$41.00,"$1,042.75",$41.00,"$1,075.00",$41.00,$41.00,"$1,042.75"
2733245A,0510,27332,,,,,N/A,N/A,Resection Proc Thigh/Knee   ~t,$0.00,$0.00,$527.26,"$1,286.00",$527.26,"$1,247.42",$527.26,"$1,099.53",$527.26,"$1,155.08",$527.26,"$1,247.42",$527.26,"$1,286.00",$527.26,$527.26,"$1,247.42"
2733445A,0510,27334,,,,,N/A,N/A,REMOVE KNEE JOINT LINING    ~T,$40.36,$30.00,$624.43,"$1,523.00",$624.43,"$1,477.31",$624.43,"$1,302.17",$624.43,"$1,226.00",$624.43,"$1,477.31",$624.43,"$1,523.00",$624.43,$624.43,"$1,477.31"
2733545A,0510,27335,,,,,N/A,N/A,Resection Proc Thigh/Knee   ~t,$0.00,$0.00,$619.51,"$1,511.00",$619.51,"$1,465.67",$619.51,"$1,291.91",$619.51,"$1,367.13",$619.51,"$1,465.67",$619.51,"$1,511.00",$619.51,$619.51,"$1,465.67"
2733740A,0510,27337,,,,,N/A,N/A,Excision 3cm Or Greater     ~t,$0.00,$0.00,$328.41,$742.65,$328.41,$574.24,$328.41,$506.16,$328.41,$742.65,$328.41,$574.24,$328.41,$592.00,$328.41,$328.41,$574.24
2733745A,0510,27337,,,,,N/A,N/A,Exc Thigh/Knee Les>3cm      ~t,$0.00,$0.00,$328.41,$742.65,$328.41,$574.24,$328.41,$506.16,$328.41,$742.65,$328.41,$574.24,$328.41,$592.00,$328.41,$328.41,$574.24
2734045A,0510,27340,,,,,N/A,N/A,"Excision, Prepatellr Bursa  ~t",$0.00,$0.00,$285.36,$696.00,$285.36,$675.12,$285.36,$595.08,$285.36,$673.01,$285.36,$675.12,$285.36,$696.00,$285.36,$285.36,$675.12
2734545A,0510,27345,,,,,N/A,N/A,Removal Of Knee Cyst        ~t,$0.00,$0.00,$45.18,"$1,098.00",$45.18,"$1,065.06",$45.18,$938.79,$45.18,$869.73,$45.18,"$1,065.06",$45.18,"$1,098.00",$45.18,$45.18,"$1,065.06"
2734745A,0510,27347,,,,,N/A,N/A,Exc Of Lesion               ~t,$0.00,$0.00,$38.73,$945.78,$38.73,$730.41,$38.73,$643.82,$38.73,$945.78,$38.73,$730.41,$38.73,$753.00,$38.73,$38.73,$730.41
2735045A,0510,27350,,,,,N/A,N/A,Patellectomy Or Hemi        ~t,$0.00,$0.00,$533.82,"$1,302.00",$533.82,"$1,262.94",$533.82,"$1,113.21",$533.82,"$1,169.35",$533.82,"$1,262.94",$533.82,"$1,302.00",$533.82,$533.82,"$1,262.94"
2735545A,0510,27355,,,,,N/A,N/A,REMOVE FEMUR LESION         ~T,$62.55,$46.50,$558.42,"$1,362.00",$558.42,"$1,321.14",$558.42,"$1,164.51",$558.42,"$1,085.40",$558.42,"$1,321.14",$558.42,"$1,362.00",$558.42,$558.42,"$1,321.14"
2736045A,0510,27360,,,,,N/A,N/A,"Part Excis Bone, Femr,Tib   ~p",$0.00,$0.00,$66.51,"$1,611.00",$66.51,"$1,562.67",$66.51,"$1,377.41",$66.51,"$1,607.43",$66.51,"$1,562.67",$66.51,"$1,611.00",$66.51,$66.51,"$1,562.67"
2737245A,0510,27372,,,,,N/A,N/A,REMOVAL OF FOREIGN BODY     ~T,$175.56,$130.50,$376.79,$919.00,$376.79,$891.43,$376.79,$785.75,$376.79,$716.24,$376.79,$891.43,$376.79,$919.00,$376.79,$376.79,$891.43
2738045A,0510,27380,,,,,N/A,N/A,Tendon Repair               ~t,$0.00,$0.00,$557.60,"$1,360.00",$557.60,"$1,319.20",$557.60,"$1,162.80",$557.60,"$1,116.10",$557.60,"$1,319.20",$557.60,"$1,360.00",$557.60,$557.60,"$1,319.20"
2738545A,0510,27385,,,,,N/A,N/A,Repair Thigh Muscle         ~t,$0.00,$0.00,$595.32,"$1,452.00",$595.32,"$1,408.44",$595.32,"$1,241.46",$595.32,"$1,087.66",$595.32,"$1,408.44",$595.32,"$1,452.00",$595.32,$595.32,"$1,408.44"
2738645A,0510,27386,,,,,N/A,N/A,Repair/Graft Of Thigh Muscle~t,$0.00,$0.00,$776.95,"$1,895.00",$776.95,"$1,838.15",$776.95,"$1,620.23",$776.95,"$1,536.11",$776.95,"$1,838.15",$776.95,"$1,895.00",$776.95,$776.95,"$1,838.15"
2740545A,0510,27405,,,,,N/A,N/A,Repair Of Knee Ligament     ~t,$0.00,$0.00,$524.80,"$1,280.00",$524.80,"$1,241.60",$524.80,"$1,094.40",$524.80,"$1,209.76",$524.80,"$1,241.60",$524.80,"$1,280.00",$524.80,$524.80,"$1,241.60"
2740745A,0510,27407,,,,,N/A,N/A,REPAIR OF KNEE LIGAMENT     ~T,$58.52,$43.50,$72.78,"$1,758.00",$72.78,"$1,705.26",$72.78,"$1,503.09",$72.78,"$1,422.10",$72.78,"$1,705.26",$72.78,"$1,758.00",$72.78,$72.78,"$1,705.26"
2740945A,0510,27409,,,,,N/A,N/A,Repair/Reconst Of Femur/Knee~t,$0.00,$0.00,$79.89,"$1,929.00",$79.89,"$1,871.13",$79.89,"$1,649.30",$79.89,"$1,722.59",$79.89,"$1,871.13",$79.89,"$1,929.00",$79.89,$79.89,"$1,871.13"
2741845A,0510,27418,,,,,N/A,N/A,REPAIR DEGENERATED KNEECAP  ~T,$70.63,$52.50,$766.70,"$1,940.00",$766.70,"$1,881.80",$766.70,"$1,658.70",$766.70,"$1,483.96",$766.70,"$1,881.80",$766.70,"$1,940.00",$766.70,$766.70,"$1,881.80"
2742045A,0510,27420,,,,,N/A,N/A,Revision Of Unstable Kneecap~t,$0.00,$0.00,$695.77,"$1,697.30",$695.77,"$1,646.38",$695.77,"$1,451.19",$695.77,"$1,327.63",$695.77,"$1,646.38",$695.77,"$1,697.30",$695.77,$695.77,"$1,646.38"
2742545A,0510,27425,,,,,N/A,N/A,Lat Retinacular Release Open~t,$0.00,$0.00,$814.80,"$1,010.00",N/A,$979.70,N/A,$863.55,N/A,$814.80,N/A,$979.70,N/A,"$1,010.00",N/A,N/A,$979.70
2742745A,0510,27427,,,,,N/A,N/A,Reconstruction Knee         ~t,$0.00,$0.00,$665.84,"$1,624.00",$665.84,"$1,575.28",$665.84,"$1,388.52",$665.84,"$1,273.76",$665.84,"$1,575.28",$665.84,"$1,624.00",$665.84,$665.84,"$1,575.28"
2742945A,0510,27429,,,,,N/A,N/A,"RECONSTRUCTION, KNEE        ~T",$45.40,$33.75,$184.45,"$2,645.00",$184.45,"$2,565.65",$184.45,"$2,261.48",$184.45,"$2,235.51",$184.45,"$2,565.65",$184.45,"$2,645.00",$184.45,$184.45,"$2,565.65"
2743045A,0510,27430,,,,,N/A,N/A,"Repair, Quadricepsplaty     ~t",$0.00,$0.00,$574.00,"$1,400.00",$574.00,"$1,358.00",$574.00,"$1,197.00",$574.00,"$1,325.84",$574.00,"$1,358.00",$574.00,"$1,400.00",$574.00,$574.00,"$1,358.00"
2743745A,0510,27437,,,,,N/A,N/A,"Arthroplasty,Patella        ~t",$0.00,$0.00,$47.13,"$1,182.09",$47.13,$963.21,$47.13,$849.02,$47.13,"$1,182.09",$47.13,$963.21,$47.13,$993.00,$47.13,$47.13,$963.21
2743845A,0510,27438,,,,,N/A,N/A,Repair/Reconst Femur/Knee   ~t,$0.00,$0.00,$689.21,"$1,681.00",$689.21,"$1,630.57",$689.21,"$1,437.26",$689.21,"$1,497.85",$689.21,"$1,630.57",$689.21,"$1,681.00",$689.21,$689.21,"$1,630.57"
2744145A,0510,27441,,,,,N/A,N/A,REVISION OF KNEE JOINT      ~T,$70.63,$52.50,$684.70,"$1,670.00",$684.70,N/A,$684.70,"$1,427.85",$684.70,"$1,468.22",$684.70,N/A,$684.70,"$1,670.00",$684.70,$684.70,N/A
2744245A,0510,27442,,,,,N/A,N/A,REVISION OF KNEE JOINT      ~T,$74.66,$55.50,$89.34,"$1,974.00",$89.34,"$1,914.78",$89.34,"$1,687.77",$89.34,"$1,550.91",$89.34,"$1,914.78",$89.34,"$1,974.00",$89.34,$89.34,"$1,914.78"
2744345A,0510,27443,,,,,N/A,N/A,REVISION OF KNEE JOINT      ~T,$61.55,$45.75,$763.10,"$1,861.00",$763.10,"$1,805.17",$763.10,"$1,687.77",$763.10,"$1,455.56",$763.10,"$1,805.17",$763.10,"$1,861.00",$763.10,$763.10,"$1,805.17"
2744645A,0510,27446,,,,,N/A,N/A,Revision Of Knee Joint      ~t,$77.69,$57.75,$156.57,"$5,277.00",$156.57,"$5,118.69",$156.57,"$4,511.84",$156.57,"$2,046.18",$156.57,"$5,118.69",$156.57,"$5,277.00",$156.57,$156.57,"$5,118.69"
2744745A,0510,27447,,,,,N/A,N/A,Total Knee Arthroplasty     ~t,$0.00,$0.00,$164.00,"$4,000.00",$164.00,"$3,880.00",$164.00,"$3,420.00",$164.00,"$2,274.40",$164.00,"$3,880.00",$164.00,"$4,000.00",$164.00,$164.00,"$3,880.00"
2745045A,0510,27450,,,,,N/A,N/A,INCISION OF THIGH           ~T,$50.45,$37.50,$954.48,"$2,328.00",$954.48,"$2,258.16",$954.48,"$1,990.44",$954.48,"$1,807.24",$954.48,"$2,258.16",$954.48,"$2,328.00",$954.48,$954.48,"$2,258.16"
2745545A,0510,27455,,,,,N/A,N/A,Realignment Of Knee         ~t,$0.00,$0.00,$882.32,"$2,152.00",$882.32,"$2,087.44",$882.32,"$1,839.96",$882.32,"$1,708.43",$882.32,"$2,087.44",$882.32,"$2,152.00",$882.32,$882.32,"$2,087.44"
2747045A,0510,27470,,,,,N/A,N/A,REPAIR OF THIGH             ~T,$43.38,$32.25,$183.63,"$2,643.00",$183.63,"$2,563.71",$183.63,"$2,259.77",$183.63,"$2,093.29",$183.63,"$2,563.71",$183.63,"$2,643.00",$183.63,$183.63,"$2,563.71"
2747245A,0510,27472,,,,,N/A,N/A,REPAIR/GRAFT OF THIGH       ~T,$84.75,$63.00,"$1,182.44","$2,884.00","$1,182.44","$2,797.48","$1,182.44","$2,465.82","$1,182.44","$2,242.67","$1,182.44","$2,797.48","$1,182.44","$2,884.00","$1,182.44","$1,182.44","$2,797.48"
2747745A,0510,27477,,,,,N/A,N/A,Repair/Reconst Femur/Knee   ~t,$0.00,$0.00,$599.42,"$1,462.00",$599.42,"$1,418.14",$599.42,"$1,250.01",$599.42,"$1,308.85",$599.42,"$1,418.14",$599.42,"$1,462.00",$599.42,$599.42,"$1,418.14"
2748645A,0510,27486,,,,,N/A,N/A,Revise/Replace Knee Joint   ~t,$0.00,$0.00,"$1,276.33","$3,113.00","$1,276.33","$3,019.61","$1,276.33","$2,661.62","$1,276.33","$2,489.29","$1,276.33","$3,019.61","$1,276.33","$3,113.00","$1,276.33","$1,276.33","$3,019.61"
2748745A,0510,27487,,,,,N/A,N/A,Revise/Replace Knee Joint   ~t,$0.00,$0.00,"$1,631.39","$3,979.00","$1,631.39","$3,859.63","$1,631.39","$3,402.05","$1,631.39","$3,102.29","$1,631.39","$3,859.63","$1,631.39","$3,979.00","$1,631.39","$1,631.39","$3,859.63"
2748845A,0510,27488,,,,,N/A,N/A,Removal Of Knee Prosthesis  ~t,$0.00,$0.00,$167.64,"$2,604.00",$167.64,"$2,525.88",$167.64,"$2,226.42",$167.64,"$2,129.82",$167.64,"$2,525.88",$167.64,"$2,604.00",$167.64,$167.64,"$2,525.88"
2749545A,0510,27495,,,,,N/A,N/A,Reinforce Thigh             ~t,$0.00,$0.00,$149.19,"$2,559.00",$149.19,"$2,482.23",$149.19,"$2,187.95",$149.19,"$2,006.28",$149.19,"$2,482.23",$149.19,"$2,559.00",$149.19,$149.19,"$2,482.23"
2750645A,0510,27506,,,,,N/A,N/A,"Treatment, Thigh Frx        ~t",$0.00,$0.00,"$1,175.47","$2,867.00","$1,175.47","$2,780.99","$1,175.47","$2,451.29","$1,175.47","$2,372.89","$1,175.47","$2,780.99","$1,175.47","$2,867.00","$1,175.47","$1,175.47","$2,780.99"
2750745A,0510,27507,,,,,N/A,N/A,Open Treatment Of Femoral Fx~t,$0.00,$0.00,$761.78,"$1,858.00",$761.78,"$1,802.26",$761.78,"$1,588.59",$761.78,"$1,719.64",$761.78,"$1,802.26",$761.78,"$1,858.00",$761.78,$761.78,"$1,802.26"
2750945A,0510,27509,,,,,N/A,N/A,TREATMENT OF THIGH FRACTURE ~T,$75.67,$56.25,$64.75,"$1,475.00",$64.75,"$1,430.75",$64.75,"$1,261.13",$64.75,"$1,210.03",$64.75,"$1,430.75",$64.75,"$1,475.00",$64.75,$64.75,"$1,430.75"
2751045A,0510,27510,,,,,N/A,N/A,Treatment Of Thigh Fracture ~t,$0.00,$0.00,$637.96,"$1,556.00",$637.96,"$1,509.32",$637.96,"$1,330.38",$637.96,"$1,213.54",$637.96,"$1,509.32",$637.96,"$1,556.00",$637.96,$637.96,"$1,509.32"
2751145A,0510,27511,,,,,N/A,N/A,Treatment Of Femoral        ~t,$0.00,$0.00,$572.36,"$1,768.82",$572.36,"$1,354.12",$572.36,"$1,193.58",$572.36,"$1,768.82",$572.36,"$1,354.12",$572.36,"$1,396.00",$572.36,$572.36,"$1,354.12"
2751345A,0510,27513,,,,,N/A,N/A,"Treatment, Thigh Frx        ~t",$0.00,$0.00,"$1,234.92","$3,012.00","$1,234.92","$2,921.64","$1,234.92","$2,575.26","$1,234.92","$2,191.13","$1,234.92","$2,921.64","$1,234.92","$3,012.00","$1,234.92","$1,234.92","$2,921.64"
2751445A,0510,27514,,,,,N/A,N/A,Open Treat Of Femoral Fx    ~t,$0.00,$0.00,$792.12,"$1,932.00",$792.12,"$1,874.04",$792.12,"$1,651.86",$792.12,"$1,716.21",$792.12,"$1,874.04",$792.12,"$1,932.00",$792.12,$792.12,"$1,874.04"
2752445A,0510,27524,,,,,N/A,N/A,"Treatment, Kneecap Frx      ~t",$0.00,$0.00,$77.66,"$1,726.00",$77.66,"$1,674.22",$77.66,"$1,475.73",$77.66,"$1,344.24",$77.66,"$1,674.22",$77.66,"$1,726.00",$77.66,$77.66,"$1,674.22"
2753245A,0510,27532,,,,,N/A,N/A,Treat Knee Fracture         ~t,$0.00,$0.00,$532.18,"$1,298.00",$532.18,"$1,259.06",$532.18,"$1,109.79",$532.18,"$1,033.50",$532.18,"$1,259.06",$532.18,"$1,298.00",$532.18,$532.18,"$1,259.06"
2753545A,0510,27535,,,,,N/A,N/A,Treatment Open Fx Tibial    ~t,$0.00,$0.00,$738.82,"$1,802.00",$738.82,"$1,747.94",$738.82,"$1,540.71",$738.82,"$1,595.11",$738.82,"$1,747.94",$738.82,"$1,802.00",$738.82,$738.82,"$1,747.94"
2753645A,0510,27536,,,,,N/A,N/A,Treatment Of Fx             ~t,$0.00,$0.00,$98.72,"$2,392.00",$98.72,"$2,320.24",$98.72,"$2,045.16",$98.72,"$2,103.70",$98.72,"$2,320.24",$98.72,"$2,392.00",$98.72,$98.72,"$2,320.24"
2754045A,0510,27540,,,,,N/A,N/A,Treat Knee Fracture         ~t,$0.00,$0.00,$879.45,"$2,145.00",$879.45,"$2,080.65",$879.45,"$1,833.98",$879.45,"$1,451.89",$879.45,"$2,080.65",$879.45,"$2,145.00",$879.45,$879.45,"$2,080.65"
2755245A,0510,27552,,,,,N/A,N/A,Fx Or Disloc Requir Anes    ~t,$0.00,$0.00,$483.80,"$1,180.00",$483.80,"$1,144.60",$483.80,"$1,008.90",$483.80,"$1,134.98",$483.80,"$1,144.60",$483.80,"$1,180.00",$483.80,$483.80,"$1,144.60"
2756245A,0510,27562,,,,,N/A,N/A,TREAT KNEECAP DISLOCATION   ~T,$55.49,$41.25,$47.95,$995.00,$47.95,$965.15,$47.95,$850.73,$47.95,$878.82,$47.95,$965.15,$47.95,$995.00,$47.95,$47.95,$965.15
2757045A,0510,27570,,,,,N/A,N/A,Fixation Of Knee Joint      ~t,$0.00,$0.00,$136.53,$333.00,$136.53,$323.01,$136.53,$284.72,$136.53,$271.21,$136.53,$323.01,$136.53,$333.00,$136.53,$136.53,$323.01
2759045A,0510,27590,,,,,N/A,N/A,Amputation At Femur Or Knee ~t,$0.00,$0.00,$658.87,"$1,607.00",$658.87,"$1,558.79",$658.87,"$1,373.99",$658.87,"$1,371.97",$658.87,"$1,558.79",$658.87,"$1,607.00",$658.87,$658.87,"$1,558.79"
2760045A,0510,27600,,,,,N/A,N/A,Decompression Of Lower Leg  ~t,$0.00,$0.00,$393.19,$959.00,$393.19,$930.23,$393.19,$819.95,$393.19,$714.89,$393.19,$930.23,$393.19,$959.00,$393.19,$393.19,$930.23
2760245A,0510,27602,,,,,N/A,N/A,DECOMPRESSION OF LOWER LEG  ~T,$18.16,$13.50,$482.98,"$1,178.00",$482.98,"$1,142.66",$482.98,"$1,007.19",$482.98,$842.64,$482.98,"$1,142.66",$482.98,"$1,178.00",$482.98,$482.98,"$1,142.66"
2760345A,0510,27603,,,,,N/A,N/A,Incisional Prod Low Leg/Ank ~t,$0.00,$0.00,$414.51,"$1,011.00",$414.51,$980.67,$414.51,$864.41,$414.51,$699.71,$414.51,$980.67,$414.51,"$1,011.00",$414.51,$414.51,$980.67
2760645A,0510,27606,,,,,N/A,N/A,INCISION OF ACHILLES TENDON ~T,$40.36,$30.00,$291.10,$710.00,$291.10,$688.70,$291.10,$607.05,$291.10,$490.01,$291.10,$688.70,$291.10,$710.00,$291.10,$291.10,$688.70
2761045A,0510,27610,,,,,N/A,N/A,Explore/Treat Ankle Joint   ~t,$0.00,$0.00,$594.50,"$1,450.00",$594.50,"$1,406.50",$594.50,"$1,239.75",$594.50,"$1,161.53",$594.50,"$1,406.50",$594.50,"$1,450.00",$594.50,$594.50,"$1,406.50"
2761845A,0510,27618,,,,,N/A,N/A,REMOVE LOWER LEG LESION     ~T,$52.46,$39.00,$349.32,$852.00,$349.32,$826.44,$349.32,$728.46,$349.32,$543.92,$349.32,$826.44,$349.32,$852.00,$349.32,$349.32,$826.44
2761945A,0510,27619,,,,,N/A,N/A,Exc Leg/Ank Tumor <5 Cm     ~t,$0.00,$0.00,$421.70,"$1,027.00",$421.70,$996.19,$421.70,$878.09,$421.70,$822.07,$421.70,$996.19,$421.70,"$1,027.00",$421.70,$421.70,$996.19
2762045A,0510,27620,,,,,N/A,N/A,Explore/Treat Ankle Loint   ~t,$0.00,$0.00,$441.16,"$1,027.00",$441.16,$996.19,$441.16,$878.09,$441.16,$809.48,$441.16,$996.19,$441.16,"$1,027.00",$441.16,$441.16,$996.19
2763045A,0510,27630,,,,,N/A,N/A,Bone/Joint Prod Ankle/Leg   ~t,$0.00,$0.00,$464.94,"$1,134.00",$464.94,"$1,099.98",$464.94,$969.57,$464.94,$647.21,$464.94,"$1,099.98",$464.94,"$1,134.00",$464.94,$464.94,"$1,099.98"
2763245A,0510,27632,,,,,N/A,N/A,Exc Leg/Ankle Les Sc 3 Cm/> ~t,$0.00,$0.00,$332.10,$810.00,$332.10,$785.70,$332.10,$692.55,$332.10,$731.88,$332.10,$785.70,$332.10,$810.00,$332.10,$332.10,$785.70
2763445A,0510,27634,,,,,N/A,N/A,EXC LEG/ANKLE TUM DEP 5 CM/>~T,$36.32,$27.00,$547.76,"$1,336.00",$547.76,"$1,295.92",$547.76,"$1,142.28",$547.76,"$1,203.82",$547.76,"$1,295.92",$547.76,"$1,336.00",$547.76,$547.76,"$1,295.92"
2763545A,0510,27635,,,,,N/A,N/A,Excision/Curettage Of Bone  ~t,$0.00,$0.00,$562.11,"$1,371.00",$562.11,"$1,329.87",$562.11,"$1,172.21",$562.11,"$1,043.19",$562.11,"$1,329.87",$562.11,"$1,371.00",$562.11,$562.11,"$1,329.87"
2763745A,0510,27637,,,,,N/A,N/A,REMOVE/GRAFT LEG BONE LESION~T,$14.13,$10.50,$72.74,"$1,714.00",$72.74,"$1,662.58",$72.74,"$1,465.47",$72.74,"$1,325.48",$72.74,"$1,662.58",$72.74,"$1,714.00",$72.74,$72.74,"$1,662.58"
2764045A,0510,27640,,,,,N/A,N/A,PARTIAL REMOVAL OF TIBIA    ~T,$40.36,$30.00,$836.40,"$2,040.00",$836.40,"$1,978.80",$836.40,"$1,744.20",$836.40,"$1,483.30",$836.40,"$1,978.80",$836.40,"$2,040.00",$836.40,$836.40,"$1,978.80"
2764145A,0510,27641,,,,,N/A,N/A,PARTIAL REMOVAL OF FIBULA   ~T,$54.48,$40.50,$678.14,"$1,654.00",$678.14,"$1,604.38",$678.14,"$1,414.17",$678.14,"$1,172.81",$678.14,"$1,604.38",$678.14,"$1,654.00",$678.14,$678.14,"$1,604.38"
2765045A,0510,27650,,,,,N/A,N/A,Repair Achilles Tendon      ~t,$0.00,$0.00,$667.70,"$1,627.00",$667.70,"$1,578.19",$667.70,"$1,391.09",$667.70,"$1,182.58",$667.70,"$1,578.19",$667.70,"$1,627.00",$667.70,$667.70,"$1,578.19"
2765245A,0510,27652,,,,,N/A,N/A,REPAIR/GRAFT ACHILLES TENDON~T,$37.33,$27.75,$712.17,"$1,737.00",$712.17,"$1,684.89",$712.17,"$1,485.14",$712.17,"$1,190.05",$712.17,"$1,684.89",$712.17,"$1,737.00",$712.17,$712.17,"$1,684.89"
2765445A,0510,27654,,,,,N/A,N/A,Repair/Recon Lower Leg      ~t,$0.00,$0.00,$587.12,"$1,432.00",$587.12,"$1,389.04",$587.12,"$1,224.36",$587.12,"$1,274.95",$587.12,"$1,389.04",$587.12,"$1,432.00",$587.12,$587.12,"$1,389.04"
2765845A,0510,27658,,,,,N/A,N/A,"Repair, Flexortendon, Leg   ~t",$0.00,$0.00,$35.55,$855.00,$35.55,$829.35,$35.55,$731.03,$35.55,$664.00,$35.55,$829.35,$35.55,$855.00,$35.55,$35.55,$829.35
2766445A,0510,27664,,,,,N/A,N/A,Repair Extensor Tendon      ~t,$0.00,$0.00,$346.40,$844.00,$346.40,$818.68,$346.40,$721.62,$346.40,$650.81,$346.40,$818.68,$346.40,$844.00,$346.40,$346.40,$818.68
2767645A,0510,27676,,,,,N/A,N/A,"Repr,Dslc Prsnl Tendw/Fib Os~t",$0.00,$0.00,$488.72,"$1,192.00",$488.72,"$1,156.24",$488.72,"$1,019.16",$488.72,"$1,071.91",$488.72,"$1,156.24",$488.72,"$1,192.00",$488.72,$488.72,"$1,156.24"
2768045A,0510,27680,,,,,N/A,N/A,Release Of Lower Leg Tendon ~t,$0.00,$0.00,$419.43,"$1,023.00",$419.43,$992.31,$419.43,$874.67,$419.43,$753.16,$419.43,$992.31,$419.43,"$1,023.00",$419.43,$419.43,$992.31
2768545A,0510,27685,,,,,N/A,N/A,"Repair, Flexortendon, Leg   ~t",$0.00,$0.00,$353.10,$861.00,$353.10,$835.17,$353.10,$736.16,$353.10,$833.17,$353.10,$835.17,$353.10,$861.00,$353.10,$353.10,$835.17
2769145A,0510,27691,,,,,N/A,N/A,Repair/Reconst Leg/Ankle    ~t,$0.00,$0.00,$617.50,"$1,505.00",$617.50,"$1,459.85",$617.50,"$1,286.78",$617.50,"$1,332.52",$617.50,"$1,459.85",$617.50,"$1,505.00",$617.50,$617.50,"$1,459.85"
2769545A,0510,27695,,,,,N/A,N/A,Repair Of Ankle Ligament    ~t,$0.00,$0.00,$478.60,"$1,166.00",$478.60,"$1,131.02",$478.60,$996.93,$478.60,$853.56,$478.60,"$1,131.02",$478.60,"$1,166.00",$478.60,$478.60,"$1,131.02"
2772045A,0510,27720,,,,,N/A,N/A,Repair Of Tibia             ~t,$0.00,$0.00,$822.46,"$2,006.00",$822.46,"$1,945.82",$822.46,"$1,715.13",$822.46,"$1,560.00",$822.46,"$1,945.82",$822.46,"$2,006.00",$822.46,$822.46,"$1,945.82"
2772645A,0510,27726,,,,,N/A,N/A,REPAIR FIBULA NONUNION      ~T,$49.44,$36.75,$758.90,$758.90,$758.90,N/A,$758.90,N/A,$758.90,N/A,$758.90,N/A,$758.90,N/A,$758.90,$758.90,N/A
2775245A,0510,27752,,,,,N/A,N/A,TREATMENT TIBIA FRACTURE    ~T,$177.57,$132.00,$444.44,"$1,084.00",$444.44,"$1,051.48",$444.44,$926.82,$444.44,$882.83,$444.44,"$1,051.48",$444.44,"$1,084.00",$444.44,$444.44,"$1,051.48"
2775645A,0510,27756,,,,,N/A,N/A,Prctneous Skltal Fix Of Tib ~t,$0.00,$0.00,$455.51,"$1,111.00",$455.51,"$1,077.67",$455.51,$949.91,$455.51,"$1,033.60",$455.51,"$1,077.67",$455.51,"$1,111.00",$455.51,$455.51,"$1,077.67"
2775845A,0510,27758,,,,,N/A,N/A,Open Trtment Tibial Shaft Fx~t,$0.00,$0.00,$72.74,"$1,714.00",$72.74,"$1,662.58",$72.74,"$1,465.47",$72.74,"$1,596.00",$72.74,"$1,662.58",$72.74,"$1,714.00",$72.74,$72.74,"$1,662.58"
2775945A,0510,27759,,,,,N/A,N/A,"Treatment,Of Tibial Shaft Fx~t",$0.00,$0.00,$935.62,"$2,282.00",$935.62,"$2,213.54",$935.62,"$1,951.11",$935.62,"$1,774.28",$935.62,"$2,213.54",$935.62,"$2,282.00",$935.62,$935.62,"$2,213.54"
2776645A,0510,27766,,,,,N/A,N/A,TREATMENT OF ANKLE FRACTURE ~T,$50.45,$37.50,$63.93,"$1,473.00",$63.93,"$1,428.81",$63.93,"$1,259.42",$63.93,"$1,085.87",$63.93,"$1,428.81",$63.93,"$1,473.00",$63.93,$63.93,"$1,428.81"
2776945A,0510,27769,,,,,N/A,N/A,OPTX POST ANKLE FX          ~T,$97.87,$72.75,$572.77,"$1,397.00",$572.77,"$1,355.09",$572.77,"$1,194.44",$572.77,"$1,305.54",$572.77,"$1,355.09",$572.77,"$1,397.00",$572.77,$572.77,"$1,355.09"
2778145A,0510,27781,,,,,N/A,N/A,TREATMENT OF FIBULA FRACTURE~T,$29.26,$21.75,$348.90,$829.00,$348.90,$804.13,$348.90,$708.80,$348.90,$721.52,$348.90,$804.13,$348.90,$829.00,$348.90,$348.90,$804.13
2778845A,0510,27788,,,,,N/A,N/A,Treatment Of Ankle Fracture ~t,$0.00,$0.00,$694.74,$855.00,N/A,$829.35,N/A,$731.03,N/A,$694.74,N/A,$829.35,N/A,$855.00,N/A,N/A,$829.35
2779245A,0510,27792,,,,,N/A,N/A,Treatment Of Ankle Fracture ~t,$0.00,$0.00,$565.80,"$1,380.00",$565.80,"$1,338.60",$565.80,"$1,179.90",$565.80,"$1,156.52",$565.80,"$1,338.60",$565.80,"$1,380.00",$565.80,$565.80,"$1,338.60"
2781045A,0510,27810,,,,,N/A,N/A,Fx/Disloc W/Manipulation    ~t,$0.00,$0.00,$256.66,$764.31,$256.66,$607.22,$256.66,$535.23,$256.66,$764.31,$256.66,$607.22,$256.66,$626.00,$256.66,$256.66,$607.22
2781445A,0510,27814,,,,,N/A,N/A,Treatment Of Ankle Fracture ~t,$0.00,$0.00,$747.20,"$1,822.00",$747.20,"$1,767.34",$747.20,"$1,557.81",$747.20,"$1,367.87",$747.20,"$1,767.34",$747.20,"$1,822.00",$747.20,$747.20,"$1,767.34"
2781845A,0510,27818,,,,,N/A,N/A,Closed Fx Trimall Anklew/Mal~t,$0.00,$0.00,$41.41,"$1,001.00",$41.41,$970.97,$41.41,$855.86,$41.41,$783.77,$41.41,$970.97,$41.41,"$1,001.00",$41.41,$41.41,$970.97
2782245A,0510,27822,,,,,N/A,N/A,Treatment Of Ankle Fracture ~t,$0.00,$0.00,$835.99,"$2,039.00",$835.99,"$1,977.83",$835.99,"$1,743.35",$835.99,"$1,570.90",$835.99,"$1,977.83",$835.99,"$2,039.00",$835.99,$835.99,"$1,977.83"
2782345A,0510,27823,,,,,N/A,N/A,Treatment Of Fracture       ~t,$0.00,$0.00,$785.15,"$1,915.00",$785.15,"$1,857.55",$785.15,"$1,637.33",$785.15,"$1,765.45",$785.15,"$1,857.55",$785.15,"$1,915.00",$785.15,$785.15,"$1,857.55"
2782545A,0510,27825,,,,,N/A,N/A,Treat Lower Leg Fracture    ~t,$0.00,$0.00,$447.31,"$1,091.00",$447.31,"$1,058.27",$447.31,$932.81,$447.31,$880.73,$447.31,"$1,058.27",$447.31,"$1,091.00",$447.31,$447.31,"$1,058.27"
2782745A,0510,27827,,,,,N/A,N/A,Treat Lower Leg Fracture    ~t,$0.00,$0.00,$887.24,"$2,164.00",$887.24,"$2,099.08",$887.24,"$1,850.22",$887.24,"$2,003.42",$887.24,"$2,099.08",$887.24,"$2,164.00",$887.24,$887.24,"$2,099.08"
2782845A,0510,27828,,,,,N/A,N/A,Treatment Of Fx/Disloc Foot ~t,$0.00,$0.00,$162.72,"$2,592.00",$162.72,"$2,514.24",$162.72,"$2,216.16",$162.72,"$2,370.79",$162.72,"$2,514.24",$162.72,"$2,592.00",$162.72,$162.72,"$2,514.24"
2782945A,0510,27829,,,,,N/A,N/A,Treat Lower Leg Joint       ~t,$0.00,$0.00,$471.90,"$1,275.22",$471.90,"$1,114.53",$471.90,$982.40,$471.90,"$1,275.22",$471.90,"$1,114.53",$471.90,"$1,149.00",$471.90,$471.90,"$1,114.53"
2784845A,0510,27848,,,,,N/A,N/A,TREAT ANKLE DISLOCATION     ~T,$74.66,$55.50,$89.34,$89.34,$89.34,N/A,$89.34,N/A,$89.34,N/A,$89.34,N/A,$89.34,N/A,$89.34,$89.34,N/A
2786045A,0510,27860,,,,,N/A,N/A,FIXATION OF ANKLE JOINT     ~T,$10.09,$7.50,$300.83,$410.00,N/A,$397.70,N/A,$350.55,N/A,$300.83,N/A,$397.70,N/A,$410.00,N/A,N/A,$397.70
2787045A,0510,27870,,,,,N/A,N/A,"Fusion Of Ankle Joint, Open ~p",$0.00,$0.00,$949.15,$949.15,$949.15,N/A,$949.15,N/A,$949.15,N/A,$949.15,N/A,$949.15,N/A,$949.15,$949.15,N/A
2788040A,0510,27880,,,,,N/A,N/A,AMPUTATION OF LOWER LEG   ~T,$96.86,$72.00,$736.36,"$2,315.00",$736.36,"$2,245.55",$736.36,"$1,979.33",$736.36,"$1,573.34",$736.36,"$2,245.55",$736.36,"$2,315.00",$736.36,$736.36,"$2,245.55"
2788440A,0510,27884,,,,,N/A,N/A,Amputation Follow-Up Surgery~t,$0.00,$0.00,$54.38,"$1,318.00",$54.38,"$1,278.46",$54.38,"$1,126.89",$54.38,"$1,008.71",$54.38,"$1,278.46",$54.38,"$1,318.00",$54.38,$54.38,"$1,278.46"
2800845A,0510,28008,,,,,N/A,N/A,Incision Of Foot Fascia     ~t,$0.00,$0.00,$294.79,$719.00,$294.79,$697.43,$294.79,$614.75,$294.79,$530.91,$294.79,$697.43,$294.79,$719.00,$294.79,$294.79,$697.43
2801045A,0510,28010,,,,,N/A,N/A,INCISION OF TOE TENDON      ~T,$85.76,$63.75,$2.90,$490.00,$2.90,$475.30,$2.90,$418.95,$2.90,$372.35,$2.90,$475.30,$2.90,$490.00,$2.90,$2.90,$475.30
2802045A,0510,28020,,,,,N/A,N/A,EXPLORATION OF FOOT JOINT   ~T,$39.35,$29.25,$352.19,$859.00,$352.19,$833.23,$352.19,$734.45,$352.19,$656.90,$352.19,$833.23,$352.19,$859.00,$352.19,$352.19,$833.23
2803545A,0510,28035,,,,,N/A,N/A,DECOMPRESSION TIBIA NERVE   ~T,$175.56,$130.50,$394.42,$862.00,$394.42,$836.14,$394.42,$737.01,$394.42,$639.30,$394.42,$836.14,$394.42,$862.00,$394.42,$394.42,$836.14
2803945A,0510,28039,,,,,N/A,N/A,Excision 1.5cm Or >         ~t,$0.00,$0.00,$271.83,$663.00,$271.83,$643.11,$271.83,$566.87,$271.83,$618.69,$271.83,$643.11,$271.83,$663.00,$271.83,$271.83,$643.11
2804345A,0510,28043,,,,,N/A,N/A,EXCISION OF FOOT LESION     ~T,$110.98,$82.50,$257.70,$627.00,$257.70,$608.19,$257.70,$536.09,$257.70,$466.89,$257.70,$608.19,$257.70,$627.00,$257.70,$257.70,$608.19
2806045A,0510,28060,,,,,N/A,N/A,"Partial Removal, Foot Fascia~t",$0.00,$0.00,$35.96,$856.00,$35.96,$830.32,$35.96,$731.88,$35.96,$647.57,$35.96,$830.32,$35.96,$856.00,$35.96,$35.96,$830.32
2808045A,0510,28080,,,,,N/A,N/A,REMOVAL OF FOOT LESION      ~T,$54.48,$40.50,$277.57,$277.57,$277.57,N/A,$277.57,N/A,$277.57,N/A,$277.57,N/A,$277.57,N/A,$277.57,$277.57,N/A
2808845A,0510,28088,,,,,N/A,N/A,EXCISE FOOT TENDON SHEATH   ~T,$28.25,$21.00,$298.48,$728.00,$298.48,$706.16,$298.48,$622.44,$298.48,$506.14,$298.48,$706.16,$298.48,$728.00,$298.48,$298.48,$706.16
2810345A,0510,28103,,,,,N/A,N/A,Resection Proc  Foot/Toes   ~t,$0.00,$0.00,$325.54,$764.00,$325.54,$741.08,$325.54,$653.22,$325.54,$697.19,$325.54,$741.08,$325.54,$764.00,$325.54,$325.54,$741.08
2810845A,0510,28108,,,,,N/A,N/A,REMOVAL OF FOOT LESION      ~T,$139.23,$103.50,$284.95,$695.00,$284.95,$674.15,$284.95,$594.23,$284.95,$515.66,$284.95,$674.15,$284.95,$695.00,$284.95,$284.95,$674.15
2811045A,0510,28110,,,,,N/A,N/A,PART REMOVAL OF METATARSAL  ~T,$129.14,$96.00,$28.85,$695.00,$28.85,$674.15,$28.85,$594.23,$28.85,$520.24,$28.85,$674.15,$28.85,$695.00,$28.85,$28.85,$674.15
2811845A,0510,28118,,,,,N/A,N/A,REMOVAL OF HEEL BONE        ~T,$181.61,$135.00,$397.70,$970.00,$397.70,$940.90,$397.70,$829.35,$397.70,$750.92,$397.70,$940.90,$397.70,$970.00,$397.70,$397.70,$940.90
2811945A,0510,28119,,,,,N/A,N/A,"Excision, For Spur          ~t",$0.00,$0.00,$287.41,$701.00,$287.41,$679.97,$287.41,$599.36,$287.41,$648.64,$287.41,$679.97,$287.41,$701.00,$287.41,$287.41,$679.97
2812245A,0510,28122,,,,,N/A,N/A,Tarsal Or Metatarsal Bone   ~t,$0.00,$0.00,$36.27,$783.60,$36.27,$724.59,$36.27,$638.69,$36.27,$783.60,$36.27,$724.59,$36.27,$747.00,$36.27,$36.27,$724.59
2819245A,0510,28192,,,,,N/A,N/A,REMOVAL OF FOOT FOREIGN BODY~T,$26.23,$19.50,$318.16,$776.00,$318.16,$752.72,$318.16,$663.48,$318.16,$559.29,$318.16,$752.72,$318.16,$776.00,$318.16,$318.16,$752.72
2822645A,0510,28226,,,,,N/A,N/A,RELEASE OF FOOT TENDONS     ~T,$54.48,$40.50,$317.34,$317.34,$317.34,N/A,$317.34,N/A,$317.34,N/A,$317.34,N/A,$317.34,N/A,$317.34,$317.34,N/A
2823845A,0510,28238,,,,,N/A,N/A,REVISION OF FOOT TENDON     ~T,$95.85,$71.25,$489.95,"$1,195.00",$489.95,"$1,159.15",$489.95,"$1,021.73",$489.95,$865.91,$489.95,"$1,159.15",$489.95,"$1,195.00",$489.95,$489.95,"$1,159.15"
2828045A,0510,28280,,,,,N/A,N/A,FUSION OF TOES              ~T,$215.91,$160.50,$371.87,$907.00,$371.87,$879.79,$371.87,$775.49,$371.87,$620.35,$371.87,$879.79,$371.87,$907.00,$371.87,$371.87,$879.79
2828545A,0510,28285,,,,,N/A,N/A,REPAIR IF HAMMERTOE         ~T,$134.19,$99.75,$684.58,$752.00,N/A,$729.44,N/A,$642.96,N/A,$684.58,N/A,$729.44,N/A,$752.00,N/A,N/A,$729.44
2828945A,0510,28289,,,,,N/A,N/A,Repair Of Hallux Rigidus    ~t,$0.00,$0.00,$492.82,"$1,202.00",$492.82,"$1,165.94",$492.82,"$1,027.71",$492.82,$820.25,$492.82,"$1,165.94",$492.82,"$1,202.00",$492.82,$492.82,"$1,165.94"
2829145A,0510,28291,,,,,N/A,N/A,Repair/Reconst Foot/Toe     ~t,$0.00,$0.00,$587.53,$587.53,$587.53,N/A,$587.53,N/A,$587.53,N/A,$587.53,N/A,$587.53,N/A,$587.53,$587.53,N/A
2829545A,0510,28295,,,,,N/A,N/A,Repair/Reconst Foot/Toe     ~t,$0.00,$0.00,$513.32,$513.32,$513.32,N/A,$513.32,N/A,$513.32,N/A,$513.32,N/A,$513.32,N/A,$513.32,$513.32,N/A
2829645A,0510,28296,,,,,N/A,N/A,Correction Bunion           ~t,$0.00,$0.00,$563.75,"$1,375.00",$563.75,"$1,333.75",$563.75,"$1,175.63",$563.75,$918.57,$563.75,"$1,333.75",$563.75,"$1,375.00",$563.75,$563.75,"$1,333.75"
2829745A,0510,28297,,,,,N/A,N/A,CORRECTION OF BUNION        ~T,$56.50,$42.00,$596.96,"$1,502.00",$596.96,"$1,456.94",$596.96,"$1,284.21",$596.96,"$1,078.57",$596.96,"$1,456.94",$596.96,"$1,502.00",$596.96,$596.96,"$1,456.94"
2830045A,0510,28300,,,,,N/A,N/A,Incision Of Heel Bone       ~t,$0.00,$0.00,$643.29,"$1,569.00",$643.29,"$1,521.93",$643.29,"$1,341.50",$643.29,"$1,161.14",$643.29,"$1,521.93",$643.29,"$1,569.00",$643.29,$643.29,"$1,521.93"
2844545A,0510,28445,,,,,N/A,N/A,TREAT ANKLE FRACTURE        ~T,$50.45,$37.50,$136.70,"$2,527.00",$136.70,"$2,451.19",$136.70,"$2,160.59",$136.70,"$1,830.34",$136.70,"$2,451.19",$136.70,"$2,527.00",$136.70,$136.70,"$2,451.19"
2847645A,0510,28476,,,,,N/A,N/A,TREAT METATARSAL FRACTURE   ~T,$18.16,$13.50,$318.98,$778.00,$318.98,$754.66,$318.98,$665.19,$318.98,$697.37,$318.98,$754.66,$318.98,$778.00,$318.98,$318.98,$754.66
2850545A,0510,28505,,,,,N/A,N/A,TREAT BIG TOE FRACTURE      ~T,$50.45,$37.50,$398.11,$971.00,$398.11,$941.87,$398.11,$830.21,$398.11,$890.10,$398.11,$941.87,$398.11,$971.00,$398.11,$398.11,$941.87
2866045A,0510,28660,,,,,N/A,N/A,TREAT TOE DISLOCATION       ~T,$10.09,$7.50,$77.90,$190.00,$77.90,$184.30,$77.90,$162.45,$77.90,$164.42,$77.90,$184.30,$77.90,$190.00,$77.90,$77.90,$184.30
2870545A,0510,28705,,,,,N/A,N/A,Arthrodesis Pantalar        ~t,$0.00,$0.00,$812.21,"$2,167.93",$812.21,"$1,921.57",$812.21,"$1,693.76",$812.21,"$2,167.93",$812.21,"$1,921.57",$812.21,"$1,981.00",$812.21,$812.21,"$1,921.57"
2871545A,0510,28715,,,,,N/A,N/A,FUSION OF FOOT BONES        ~T,$63.56,$47.25,$886.83,"$2,163.00",$886.83,"$2,098.11",$886.83,"$1,849.37",$886.83,"$1,680.91",$886.83,"$2,098.11",$886.83,"$2,163.00",$886.83,$886.83,"$2,098.11"
2872545A,0510,28725,,,,,N/A,N/A,Arthrodesis Foot/Toe Subtal ~t,$0.00,$0.00,$633.45,"$1,546.00",$633.45,"$1,499.62",$633.45,"$1,321.83",$633.45,"$1,388.80",$633.45,"$1,499.62",$633.45,"$1,546.00",$633.45,$633.45,"$1,499.62"
2873045A,0510,28730,,,,,N/A,N/A,Arthrodesis Of Foot         ~t,$0.00,$0.00,$743.74,"$1,814.00",$743.74,"$1,759.58",$743.74,"$1,550.97",$743.74,"$1,312.57",$743.74,"$1,759.58",$743.74,"$1,814.00",$743.74,$743.74,"$1,759.58"
2875045A,0510,28750,,,,,N/A,N/A,Fusion Of Big Toe Joint     ~t,$0.00,$0.00,$581.38,"$1,418.00",$581.38,"$1,375.46",$581.38,"$1,212.39",$581.38,"$1,040.51",$581.38,"$1,375.46",$581.38,"$1,418.00",$581.38,$581.38,"$1,375.46"
2882040A,0510,28820,,,,,N/A,N/A,Amputation Of Toe           ~t,$0.00,$0.00,$314.88,$768.00,$314.88,$744.96,$314.88,$656.64,$314.88,$320.60,$314.88,$744.96,$314.88,$768.00,$314.88,$314.88,$744.96
2882045A,0510,28820,,,,,N/A,N/A,Amputation Of Toe           ~t,$0.00,$0.00,$314.88,$768.00,$314.88,$744.96,$314.88,$656.64,$314.88,$320.60,$314.88,$744.96,$314.88,$768.00,$314.88,$314.88,$744.96
2882540A,0510,28825,,,,,N/A,N/A,Repair Reconstr Of Foot/Toe ~t,$0.00,$0.00,$38.32,$752.00,$38.32,$729.44,$38.32,$642.96,$38.32,$311.09,$38.32,$729.44,$38.32,$752.00,$38.32,$38.32,$729.44
2882545A,0510,28825,,,,,N/A,N/A,Repair Reconstr Of Foot/Toe ~t,$0.00,$0.00,$38.32,$752.00,$38.32,$729.44,$38.32,$642.96,$38.32,$311.09,$38.32,$729.44,$38.32,$752.00,$38.32,$38.32,$729.44
2906545A,0510,29065,,,,,N/A,N/A,APPL CAST SHOULDER TO HAND  ~T,$161.43,$120.00,$98.40,$240.00,$98.40,$232.80,$98.40,$205.20,$98.40,$120.15,$98.40,$232.80,$98.40,$240.00,$98.40,$98.40,$232.80
2907545A,0510,29075,,,,,N/A,N/A,"APPLICATION CAST, FOREARM   ~T",$25.22,$18.75,$56.58,$138.00,$56.58,$133.86,$56.58,$117.99,$56.58,$110.37,$56.58,$133.86,$56.58,$138.00,$56.58,$56.58,$133.86
2908545A,0510,29085,,,,,N/A,N/A,"APPLICATION CAST,HAND/WRIST ~T",$161.43,$120.00,$57.40,$240.00,$57.40,$232.80,$57.40,$205.20,$57.40,$118.54,$57.40,$232.80,$57.40,$240.00,$57.40,$57.40,$232.80
2910545A,0510,29105,,,,,N/A,N/A,"APPLICATION SPLINT,LONG ARM ~T",$22.20,$16.50,$54.12,$132.00,$54.12,$128.04,$54.12,$112.86,$54.12,$73.88,$54.12,$128.04,$54.12,$132.00,$54.12,$54.12,$128.04
2912545A,0510,29125,,,,,N/A,N/A,"APPLICATION SPLINT,FOREARM  ~T",$14.13,$10.50,$36.49,$93.00,$36.49,$90.21,$36.49,$79.52,$36.49,$70.50,$36.49,$90.21,$36.49,$93.00,$36.49,$36.49,$90.21
2913045A,0510,29130,,,,,N/A,N/A,APPLICATION OF FINGER SPLINT~T,$10.09,$7.50,$26.65,$65.00,$26.65,$63.05,$26.65,$55.58,$26.65,$50.99,$26.65,$63.05,$26.65,$65.00,$26.65,$26.65,$63.05
2934545A,0510,29345,,,,,N/A,N/A,"APPLICATION CAST, LONG LEG  ~T",$47.42,$35.25,$96.35,$235.00,$96.35,$227.95,$96.35,$200.93,$96.35,$175.91,$96.35,$227.95,$96.35,$235.00,$96.35,$96.35,$227.95
2936545A,0510,29365,,,,,N/A,N/A,APPLICATION LONG LEG CAST   ~T,$41.37,$30.75,$153.10,$204.00,N/A,$197.88,N/A,$174.42,N/A,$153.10,N/A,$197.88,N/A,$204.00,N/A,N/A,$197.88
2940545A,0510,29405,,,,,N/A,N/A,"APPLICATION CAST,SHORT LEG  ~T",$31.28,$23.25,$12.90,$150.00,$12.90,$145.50,$12.90,$128.25,$12.90,$103.99,$12.90,$145.50,$12.90,$150.00,$12.90,$12.90,$145.50
2950545A,0510,29505,,,,,N/A,N/A,Application Of Splint       ~t,$0.00,$0.00,$41.00,$100.00,$41.00,$97.00,$41.00,$85.50,$41.00,$91.41,$41.00,$97.00,$41.00,$100.00,$41.00,$41.00,$97.00
4229515,0510,29515,,,,,N/A,N/A,APPLICATION  SHORT LEG SPLINT,$95.85,$71.25,$46.74,$114.00,$46.74,$110.58,$46.74,$97.47,$46.74,$86.92,$46.74,$110.58,$46.74,$114.00,$46.74,$46.74,$110.58
2951545A,0510,29515,,,,,N/A,N/A,"APPLICATION SPLINT,LOWER LEG~T",$21.19,$15.75,$46.74,$114.00,$46.74,$110.58,$46.74,$97.47,$46.74,$86.92,$46.74,$110.58,$46.74,$114.00,$46.74,$46.74,$110.58
2958040A,0510,29580,,,,,N/A,N/A,Unna Boot                   ~t,$0.00,$0.00,$36.49,$89.00,$36.49,$86.33,$36.49,$76.10,$36.49,$46.77,$36.49,$86.33,$36.49,$89.00,$36.49,$36.49,$86.33
2958140A,0510,29581,,,,,N/A,N/A,Apply Multlay Comprs Lwr Leg~t,$0.00,$0.00,$39.36,$96.00,$39.36,$93.12,$39.36,$82.08,$39.36,$49.74,$39.36,$93.12,$39.36,$96.00,$39.36,$39.36,$93.12
2958145A,0510,29581,,,,,N/A,N/A,Apply Multlay Comprs Lwr Leg~t,$0.00,$0.00,$39.36,$96.00,$39.36,$93.12,$39.36,$82.08,$39.36,$49.74,$39.36,$93.12,$39.36,$96.00,$39.36,$39.36,$93.12
2970545A,0510,29705,,,,,N/A,N/A,REM FULL ARM/LEG CAST       ~T,$15.13,$11.25,$51.25,$125.00,$51.25,$121.25,$51.25,$106.88,$51.25,$80.72,$51.25,$121.25,$51.25,$125.00,$51.25,$51.25,$121.25
2973045A,0510,29730,,,,,N/A,N/A,Removal Of Small Intestine  ~t,$0.00,$0.00,$77.57,$108.00,N/A,$104.76,N/A,$92.34,N/A,$77.57,N/A,$104.76,N/A,$108.00,N/A,N/A,$104.76
2980545A,0510,29805,,,,,N/A,N/A,Shoulder Arthroscopy Dx     ~t,$0.00,$0.00,$446.90,"$1,090.00",$446.90,"$1,057.30",$446.90,$931.95,$446.90,$844.40,$446.90,"$1,057.30",$446.90,"$1,090.00",$446.90,$446.90,"$1,057.30"
2980645A,0510,29806,,,,,N/A,N/A,SHOULDER ARTHROSCOPY/SURGERY~T,$40.36,$30.00,$991.79,"$2,419.00",$991.79,"$2,346.43",$991.79,"$2,068.25",$991.79,"$1,882.69",$991.79,"$2,346.43",$991.79,"$2,419.00",$991.79,$991.79,"$2,346.43"
2980745A,0510,29807,,,,,N/A,N/A,SHOULDER ARTHROSCOPY/SURGERY~T,$57.51,$42.75,$966.37,"$2,357.00",$966.37,"$2,286.29",$966.37,"$2,015.24",$966.37,"$1,840.50",$966.37,"$2,286.29",$966.37,"$2,357.00",$966.37,$966.37,"$2,286.29"
2981945A,0510,29819,,,,,N/A,N/A,SHOULDER ARTHROSCOPY/SURG   ~T,$61.55,$45.75,$558.10,"$1,361.00",$558.10,"$1,320.17",$558.10,"$1,163.66",$558.10,"$1,053.07",$558.10,"$1,320.17",$558.10,"$1,361.00",$558.10,$558.10,"$1,320.17"
2982045A,0510,29820,,,,,N/A,N/A,SHOULDER ARTHROSCOPY/SURGERY~T,$55.49,$41.25,$514.55,"$1,255.00",$514.55,"$1,217.35",$514.55,"$1,073.03",$514.55,$963.35,$514.55,"$1,217.35",$514.55,"$1,255.00",$514.55,$514.55,"$1,217.35"
2982245A,0510,29822,,,,,N/A,N/A,"Debridement,Limited         ~t",$0.00,$0.00,$467.40,"$1,140.00",$467.40,"$1,105.80",$467.40,$974.70,$467.40,$970.19,$467.40,"$1,105.80",$467.40,"$1,140.00",$467.40,$467.40,"$1,105.80"
2982345A,0510,29823,,,,,N/A,N/A,"Debridement, Extensive      ~t",$0.00,$0.00,$51.86,"$1,246.00",$51.86,"$1,208.62",$51.86,"$1,065.33",$51.86,"$1,060.96",$51.86,"$1,208.62",$51.86,"$1,246.00",$51.86,$51.86,"$1,208.62"
2982445A,0510,29824,,,,,N/A,N/A,SHOULDER ARTHROSCOPY/SURGERY~T,$59.53,$44.25,$61.49,"$1,489.00",$61.49,"$1,444.33",$61.49,"$1,273.10",$61.49,"$1,210.58",$61.49,"$1,444.33",$61.49,"$1,489.00",$61.49,$61.49,"$1,444.33"
2982545A,0510,29825,,,,,N/A,N/A,SHOULDER ARTHROSCOPY/SURGERY~T,$58.52,$43.50,$556.78,"$1,358.00",$556.78,"$1,317.26",$556.78,"$1,161.09",$556.78,"$1,052.71",$556.78,"$1,317.26",$556.78,"$1,358.00",$556.78,$556.78,"$1,317.26"
2982645A,0510,29826,,,,,N/A,N/A,Shoulder Arthroscopy Surgery~t,$0.00,$0.00,$64.83,$64.83,$64.83,N/A,$64.83,N/A,$64.83,N/A,$64.83,N/A,$64.83,N/A,$64.83,$64.83,N/A
2982745A,0510,29827,,,,,N/A,N/A,Artho Proc W/Rot Cuff Repair~t,$0.00,$0.00,$867.56,"$2,116.00",$867.56,"$2,052.52",$867.56,"$1,809.18",$867.56,"$1,902.15",$867.56,"$2,052.52",$867.56,"$2,116.00",$867.56,$867.56,"$2,052.52"
2982845A,0510,29828,,,,,N/A,N/A,ARTHROSCOPY SHOULDER BICEPS ~T,$75.67,$56.25,$727.75,"$1,775.00",$727.75,"$1,721.75",$727.75,"$1,517.63",$727.75,"$1,633.34",$727.75,"$1,721.75",$727.75,"$1,775.00",$727.75,$727.75,"$1,721.75"
2983745A,0510,29837,,,,,N/A,N/A,ELBOW ARTHROSCOPY/SURGERY   ~T,$35.31,$26.25,$53.89,"$1,229.00",$53.89,"$1,192.13",$53.89,"$1,050.80",$53.89,$946.39,$53.89,"$1,192.13",$53.89,"$1,229.00",$53.89,$53.89,"$1,192.13"
2984845A,0510,29848,,,,,N/A,N/A,Wrist Endoscopy Surgery     ~t,$0.00,$0.00,$425.17,"$1,037.00",$425.17,"$1,005.89",$425.17,$886.64,$425.17,$916.72,$425.17,"$1,005.89",$425.17,"$1,037.00",$425.17,$425.17,"$1,005.89"
2986245A,0510,29862,,,,,N/A,N/A,Hip Arthroscopy/Surgery     ~t,$0.00,$0.00,$714.22,"$1,742.00",$714.22,"$1,689.74",$714.22,"$1,489.41",$714.22,"$1,452.19",$714.22,"$1,689.74",$714.22,"$1,742.00",$714.22,$714.22,"$1,689.74"
2986345A,0510,29863,,,,,N/A,N/A,Hip Arthroscopy/Surgery     ~t,$0.00,$0.00,$78.48,"$1,728.00",$78.48,"$1,676.16",$78.48,"$1,477.44",$78.48,"$1,449.40",$78.48,"$1,676.16",$78.48,"$1,728.00",$78.48,$78.48,"$1,676.16"
2986845A,0510,29868,,,,,N/A,N/A,"Meniscal Trnspl, Knee W/Scpe~t",$0.00,$0.00,"$1,578.50","$3,850.00","$1,578.50","$3,734.50","$1,578.50","$3,291.75","$1,578.50","$2,956.01","$1,578.50","$3,734.50","$1,578.50","$3,850.00","$1,578.50","$1,578.50","$3,734.50"
2987045A,0510,29870,,,,,N/A,N/A,KNEE ARTHROSCOPY DX         ~T,$184.64,$137.25,$384.58,$928.00,$384.58,$900.16,$384.58,$793.44,$384.58,$728.83,$384.58,$900.16,$384.58,$928.00,$384.58,$384.58,$900.16
2987145A,0510,29871,,,,,N/A,N/A,Knee Arthroscopy/Drainage   ~t,$0.00,$0.00,$481.34,"$1,174.00",$481.34,"$1,138.78",$481.34,"$1,003.77",$481.34,$920.81,$481.34,"$1,138.78",$481.34,"$1,174.00",$481.34,$481.34,"$1,138.78"
2987345A,0510,29873,,,,,N/A,N/A,Knee Arthroscopy/Surgery    ~t,$0.00,$0.00,$484.21,"$1,181.00",$484.21,"$1,145.57",$484.21,"$1,009.75",$484.21,$962.09,$484.21,"$1,145.57",$484.21,"$1,181.00",$484.21,$484.21,"$1,145.57"
2987445A,0510,29874,,,,,N/A,N/A,Knee Arthroscopy/Surgery    ~t,$0.00,$0.00,$55.94,"$1,234.00",$55.94,"$1,196.98",$55.94,"$1,055.07",$55.94,$961.46,$55.94,"$1,196.98",$55.94,"$1,234.00",$55.94,$55.94,"$1,196.98"
2987545A,0510,29875,,,,,N/A,N/A,Knee Arthroscopy/Surgery    ~t,$0.00,$0.00,$492.00,"$1,200.00",$492.00,"$1,164.00",$492.00,"$1,026.00",$492.00,$889.47,$492.00,"$1,164.00",$492.00,"$1,200.00",$492.00,$492.00,"$1,164.00"
2987645A,0510,29876,,,,,N/A,N/A,Knee Arthroscopy/Surgery    ~t,$0.00,$0.00,$578.51,"$1,411.00",$578.51,"$1,368.67",$578.51,"$1,206.40",$578.51,"$1,167.18",$578.51,"$1,368.67",$578.51,"$1,411.00",$578.51,$578.51,"$1,368.67"
2987745A,0510,29877,,,,,N/A,N/A,Knee Arthroscopy/Surgery    ~t,$0.00,$0.00,$545.71,"$1,331.00",$545.71,"$1,291.07",$545.71,"$1,138.01",$545.71,"$1,111.07",$545.71,"$1,291.07",$545.71,"$1,331.00",$545.71,$545.71,"$1,291.07"
2987945A,0510,29879,,,,,N/A,N/A,Knee Arthroscopy/Surgery    ~t,$0.00,$0.00,$587.94,"$1,434.00",$587.94,"$1,390.98",$587.94,"$1,226.07",$587.94,"$1,181.45",$587.94,"$1,390.98",$587.94,"$1,434.00",$587.94,$587.94,"$1,390.98"
2988045A,0510,29880,,,,,N/A,N/A,Knee Arthroscopy/Surgery    ~t,$0.00,$0.00,$615.00,"$1,500.00",$615.00,"$1,455.00",$615.00,"$1,282.50",$615.00,"$1,006.29",$615.00,"$1,455.00",$615.00,"$1,500.00",$615.00,$615.00,"$1,455.00"
2988145A,0510,29881,,,,,N/A,N/A,Knee Arthroscopy/Surgery    ~t,$0.00,$0.00,$738.00,"$1,800.00",$738.00,"$1,746.00",$738.00,"$1,539.00",$738.00,$970.82,$738.00,"$1,746.00",$738.00,"$1,800.00",$738.00,$738.00,"$1,746.00"
2988345A,0510,29883,,,,,N/A,N/A,KNEE ARTHROSCOPY/SURGERY    ~T,$50.45,$37.50,$78.23,"$1,903.00",$78.23,"$1,845.91",$78.23,"$1,627.07",$78.23,"$1,494.00",$78.23,"$1,845.91",$78.23,"$1,903.00",$78.23,$78.23,"$1,845.91"
2988445A,0510,29884,,,,,N/A,N/A,Knee Arthroscopy/Surgery    ~t,$0.00,$0.00,$543.25,"$1,325.00",$543.25,"$1,285.25",$543.25,"$1,132.88",$543.25,"$1,106.94",$543.25,"$1,285.25",$543.25,"$1,325.00",$543.25,$543.25,"$1,285.25"
2988745A,0510,29887,,,,,N/A,N/A,Knee Arthroscopy/Surgery    ~t,$0.00,$0.00,$657.64,"$1,604.00",$657.64,"$1,555.88",$657.64,"$1,371.42",$657.64,"$1,343.27",$657.64,"$1,555.88",$657.64,"$1,604.00",$657.64,$657.64,"$1,555.88"
2988845A,0510,29888,,,,,N/A,N/A,Knee Arthroscopy/Surgery    ~t,$0.00,$0.00,$938.80,"$2,288.00",$938.80,"$2,219.36",$938.80,"$1,956.24",$938.80,"$1,739.99",$938.80,"$2,219.36",$938.80,"$2,288.00",$938.80,$938.80,"$2,219.36"
2988945A,0510,29889,,,,,N/A,N/A,Knee Arthroscopy/Surgery    ~t,$0.00,$0.00,$114.13,"$2,693.00",$114.13,"$2,612.21",$114.13,"$2,302.52",$114.13,"$2,174.96",$114.13,"$2,612.21",$114.13,"$2,693.00",$114.13,$114.13,"$2,612.21"
2989145A,0510,29891,,,,,N/A,N/A,Ankle Arthroscopy/Surgery   ~t,$0.00,$0.00,$615.41,"$1,501.00",$615.41,"$1,455.97",$615.41,"$1,283.36",$615.41,"$1,200.24",$615.41,"$1,455.97",$615.41,"$1,501.00",$615.41,$615.41,"$1,455.97"
2989545A,0510,29895,,,,,N/A,N/A,Ankle Arthroscopy/Surgery   ~t,$0.00,$0.00,$482.57,"$1,177.00",$482.57,"$1,141.69",$482.57,"$1,006.34",$482.57,$838.17,$482.57,"$1,141.69",$482.57,"$1,177.00",$482.57,$482.57,"$1,141.69"
2989745A,0510,29897,,,,,N/A,N/A,Ankle Arthroscopy/Surgery   ~t,$0.00,$0.00,$55.53,"$1,233.00",$55.53,"$1,196.01",$55.53,"$1,054.22",$55.53,$888.00,$55.53,"$1,196.01",$55.53,"$1,233.00",$55.53,$55.53,"$1,196.01"
2989845A,0510,29898,,,,,N/A,N/A,Ankle Arthroscopy/Surgery   ~t,$0.00,$0.00,"$1,003.11","$1,371.00",N/A,"$1,329.87",N/A,"$1,172.21",N/A,"$1,003.11",N/A,"$1,329.87",N/A,"$1,371.00",N/A,N/A,"$1,329.87"
2991445A,0510,29914,,,,,N/A,N/A,Arthroscopy Hip W/Femoro    ~t,$0.00,$0.00,$86.60,"$1,966.00",$86.60,"$1,907.02",$86.60,"$1,680.93",$86.60,"$1,774.20",$86.60,"$1,907.02",$86.60,"$1,966.00",$86.60,$86.60,"$1,907.02"
2991545A,0510,29915,,,,,N/A,N/A,Arthroscopy Hip W/Acetabulop~t,$0.00,$0.00,$821.23,"$2,003.00",$821.23,"$1,942.91",$821.23,"$1,712.57",$821.23,"$1,816.29",$821.23,"$1,942.91",$821.23,"$2,003.00",$821.23,$821.23,"$1,942.91"
2991645A,0510,29916,,,,,N/A,N/A,Arthroscopy Hip W/Labral Rep~t,$0.00,$0.00,$821.23,"$2,003.00",$821.23,"$1,942.91",$821.23,"$1,712.57",$821.23,"$1,817.11",$821.23,"$1,942.91",$821.23,"$2,003.00",$821.23,$821.23,"$1,942.91"
3150040A,0510,31500,,,,,N/A,N/A,Introd Intubation           ~t,$0.00,$0.00,$62.32,"$1,667.00",$62.32,"$1,616.99",$62.32,"$1,425.29",$62.32,$210.87,$62.32,"$1,616.99",$62.32,"$1,667.00",$62.32,$62.32,"$1,616.99"
3157640A,0510,31576,,,,,N/A,N/A,Laryngoscopy With Biopsy    ~t,$0.00,$0.00,$124.23,$303.00,$124.23,$293.91,$124.23,$259.07,$124.23,$176.20,$124.23,$293.91,$124.23,$303.00,$124.23,$124.23,$293.91
3160540A,0510,31605,,,,,N/A,N/A,INCISION OF WINDPIPE        ~T,$25.22,$18.75,$185.73,$488.64,$185.73,$439.41,$185.73,$387.32,$185.73,$488.64,$185.73,$439.41,$185.73,$453.00,$185.73,$185.73,$439.41
3162240A,0510,31622,,,,,N/A,N/A,Endoscopy Lung              ~t,$0.00,$0.00,$197.53,$359.00,N/A,$348.23,N/A,$306.95,N/A,$197.53,N/A,$348.23,N/A,$359.00,N/A,N/A,$348.23
3162340A,0510,31623,,,,,N/A,N/A,Endoscopy Of Lung           ~t,$0.00,$0.00,$153.75,$375.00,$153.75,$363.75,$153.75,$320.63,$153.75,$199.97,$153.75,$363.75,$153.75,$375.00,$153.75,$153.75,$363.75
3180040A,0510,31800,,,,,N/A,N/A,Repair Of Windpipe Injury   ~t,$0.00,$0.00,$63.58,"$1,538.00",$63.58,"$1,491.86",$63.58,"$1,314.99",$63.58,"$1,103.15",$63.58,"$1,491.86",$63.58,"$1,538.00",$63.58,$63.58,"$1,491.86"
3255040A,0510,32550,,,,,N/A,N/A,INSERTION OF PLEURAL CATH   ~T,$42.38,$31.50,$354.12,$987.00,$363.67,$957.39,$363.67,$843.89,$363.67,$354.12,$363.67,$957.39,$363.67,$987.00,$363.67,$363.67,$957.39
3255140A,0510,32551,,,,,N/A,N/A,Insertion Of Chest Tube     ~t,$0.00,$0.00,$174.25,$425.00,$174.25,$412.25,$174.25,$363.38,$174.25,$267.10,$174.25,$412.25,$174.25,$425.00,$174.25,$174.25,$412.25
3255240A,0510,32552,,,,,N/A,N/A,Removal Chest Tube/Catheter ~t,$0.00,$0.00,$131.20,$320.00,$131.20,$310.40,$131.20,$273.60,$131.20,$275.07,$131.20,$310.40,$131.20,$320.00,$131.20,$131.20,$310.40
3255440A,0510,32554,,,,,N/A,N/A,Intro & Removal Thoraqcent  ~t,$0.00,$0.00,$155.38,"$1,018.00",$417.38,$987.46,$417.38,$870.39,$417.38,$155.38,$417.38,$987.46,$417.38,"$1,018.00",$417.38,$417.38,$987.46
3255540A,0510,32555,,,,,N/A,N/A,Thoraqcentesis W/Imag Guidan~t,$0.00,$0.00,$192.61,$718.00,$294.38,$696.46,$294.38,$613.89,$294.38,$192.61,$294.38,$696.46,$294.38,$718.00,$294.38,$294.38,$696.46
3255640A,0510,32556,,,,,N/A,N/A,Pleural Asp/Drainage        ~t,$0.00,$0.00,$39.96,$756.00,$39.96,$733.32,$39.96,$646.38,$39.96,$213.31,$39.96,$733.32,$39.96,$756.00,$39.96,$39.96,$733.32
3260840A,0510,32608,,,,,N/A,N/A,Thoracoscopy W/Bx Nodule    ~t,$0.00,$0.00,$299.30,$299.30,$299.30,N/A,$299.30,N/A,$299.30,N/A,$299.30,N/A,$299.30,N/A,$299.30,$299.30,N/A
3260940A,0510,32609,,,,,N/A,N/A,Thoraco W/Biopsyies Pleura  ~t,$0.00,$0.00,$27.50,$27.50,$27.50,N/A,$27.50,N/A,$27.50,N/A,$27.50,N/A,$27.50,N/A,$27.50,$27.50,N/A
3301640A,0510,33016,,,,,N/A,N/A,PERICARDIUM                 ~T,$65.58,$48.75,$19.65,$19.65,$19.65,N/A,$19.65,N/A,$19.65,N/A,$19.65,N/A,$19.65,N/A,$19.65,$19.65,N/A
3320740A,0510,33207,,,,,N/A,N/A,Insertion Of Heart Pacemaker~t,$0.00,$0.00,$482.57,"$1,177.00",$482.57,"$1,141.69",$482.57,"$1,006.34",$482.57,$820.60,$482.57,"$1,141.69",$482.57,"$1,177.00",$482.57,$482.57,"$1,141.69"
3320840A,0510,33208,,,,,N/A,N/A,Insertion Of Heart Pacemaker~t,$0.00,$0.00,$489.95,"$1,195.00",$489.95,"$1,159.15",$489.95,"$1,021.73",$489.95,$890.47,$489.95,"$1,159.15",$489.95,"$1,195.00",$489.95,$489.95,"$1,159.15"
3321040A,0510,33210,,,,,N/A,N/A,Insert/Replace Temp Electr  ~t,$0.00,$0.00,$143.91,$351.00,$143.91,$340.47,$143.91,$300.11,$143.91,$275.25,$143.91,$340.47,$143.91,$351.00,$143.91,$143.91,$340.47
3321240A,0510,33212,,,,,N/A,N/A,INSERTION OF PULSE GENERATOR~T,$25.22,$18.75,$554.29,$825.00,N/A,$800.25,N/A,$705.38,N/A,$554.29,N/A,$800.25,N/A,$825.00,N/A,N/A,$800.25
3321640A,0510,33216,,,,,N/A,N/A,Insertion Of Pacemaker      ~t,$0.00,$0.00,$36.68,$748.00,$36.68,$725.56,$36.68,$639.54,$36.68,$640.60,$36.68,$725.56,$36.68,$748.00,$36.68,$36.68,$725.56
3322740A,0510,33227,,,,,N/A,N/A,Remove&Replace Pm Gen Singl~t,$0.00,$0.00,$265.68,$648.00,$265.68,$628.56,$265.68,$554.04,$265.68,$582.47,$265.68,$628.56,$265.68,$648.00,$265.68,$265.68,$628.56
3322840A,0510,33228,,,,,N/A,N/A,Removal Of Pacemaker Dual   ~t,$0.00,$0.00,$299.30,$730.00,$299.30,$708.10,$299.30,$624.15,$299.30,$609.24,$299.30,$708.10,$299.30,$730.00,$299.30,$299.30,$708.10
3323440A,0510,33234,,,,,N/A,N/A,Removal Of Pacemaker        ~t,$0.00,$0.00,$397.70,$970.00,$397.70,$940.90,$397.70,$829.35,$397.70,$834.67,$397.70,$940.90,$397.70,$970.00,$397.70,$397.70,$940.90
3324140A,0510,33241,,,,,N/A,N/A,REMOVE PULSE GENERATOR      ~T,$25.22,$18.75,$234.11,$571.00,$234.11,$553.87,$234.11,$488.21,$234.11,$371.46,$234.11,$553.87,$234.11,$571.00,$234.11,$234.11,$553.87
3520640A,0510,35206,,,,,N/A,N/A,Repr Blood Vessel Upper Ext ~t,$0.00,$0.00,$769.98,"$1,878.00",$769.98,"$1,821.66",$769.98,"$1,605.69",$769.98,"$1,321.26",$769.98,"$1,821.66",$769.98,"$1,878.00",$769.98,$769.98,"$1,821.66"
3520740A,0510,35207,,,,,N/A,N/A,REPAIR BLOOD VESSEL LESION  ~T,$47.42,$35.25,$675.27,"$1,647.00",$675.27,"$1,597.59",$675.27,"$1,408.19",$675.27,"$1,310.50",$675.27,"$1,597.59",$675.27,"$1,647.00",$675.27,$675.27,"$1,597.59"
3520745A,0510,35207,,,,,N/A,N/A,REPAIR BLOOD VESSEL LESION  ~T,$47.42,$35.25,$675.27,"$1,647.00",$675.27,"$1,597.59",$675.27,"$1,408.19",$675.27,"$1,310.50",$675.27,"$1,597.59",$675.27,"$1,647.00",$675.27,$675.27,"$1,597.59"
3522645A,0510,35226,,,,,N/A,N/A,Repair Blood Vessel Lesion  ~t,$0.00,$0.00,$851.57,$851.57,$851.57,N/A,$851.57,N/A,$851.57,N/A,$851.57,N/A,$851.57,N/A,$851.57,$851.57,N/A
3584040A,0510,35840,,,,,N/A,N/A,Ex Explor Repair Rev Abdomen~t,$0.00,$0.00,$519.88,"$2,045.11",$519.88,"$1,229.96",$519.88,"$1,084.14",$519.88,"$2,045.11",$519.88,"$1,229.96",$519.88,"$1,268.00",$519.88,$519.88,"$1,229.96"
3614040A,0510,36140,,,,,N/A,N/A,Insert Needle Extrem Artery~t,$0.00,$0.00,$150.87,$592.00,$242.72,$574.24,$242.72,$506.16,$242.72,$150.87,$242.72,$574.24,$242.72,$592.00,$242.72,$242.72,$574.24
3641640,0510,36416,,,,,N/A,N/A,CAPILLARY BLOOD COLLECTION,$21.19,$15.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3647140A,0510,36471,,,,,N/A,N/A,INJECTION THERAPY OF VEINS  ~T,$19.17,$14.25,$97.99,$239.00,$97.99,$231.83,$97.99,$204.35,$97.99,$125.22,$97.99,$231.83,$97.99,$239.00,$97.99,$97.99,$231.83
3647540A,0510,36475,,,,,N/A,N/A,Destruction Of Veins        ~t,$0.00,$0.00,$137.63,"$3,343.00",$137.63,"$3,242.71",$137.63,"$2,858.27",$137.63,$460.12,$137.63,"$3,242.71",$137.63,"$3,343.00",$137.63,$137.63,"$3,242.71"
3655640A,0510,36556,,,,,N/A,N/A,INSERT NON-TUNNEL CV CATH   ~T,$36.32,$27.00,$142.40,$419.00,$171.79,$406.43,$171.79,$358.25,$171.79,$142.40,$171.79,$406.43,$171.79,$419.00,$171.79,$171.79,$406.43
3655840A,0510,36558,,,,,N/A,N/A,Insert Tunneled Catheter    ~t,$0.00,$0.00,$439.20,"$1,041.00",N/A,"$1,009.77",N/A,$890.06,N/A,$439.20,N/A,"$1,009.77",N/A,"$1,041.00",N/A,N/A,"$1,009.77"
3656140A,0510,36561,,,,,N/A,N/A,INSERT TUNNELED CV CATH     ~T,$146.30,$108.75,$563.14,"$1,755.00",$719.55,"$1,702.35",$719.55,"$1,500.53",$719.55,$563.14,$719.55,"$1,702.35",$719.55,"$1,755.00",$719.55,$719.55,"$1,702.35"
3656940A,0510,36569,,,,,N/A,N/A,Insert Picc Cath            ~t,$19.17,$14.25,$97.58,$230.00,$97.58,$223.10,$97.58,$196.65,$97.58,$158.03,$97.58,$223.10,$97.58,$230.00,$97.58,$97.58,$223.10
3657640A,0510,36576,,,,,N/A,N/A,REPAIR TUNNELED CV CATH     ~T,$66.59,$49.50,$241.90,$590.00,$241.90,$572.30,$241.90,$504.45,$241.90,$309.99,$241.90,$572.30,$241.90,$590.00,$241.90,$241.90,$572.30
3658040A,0510,36580,,,,,N/A,N/A,Replace Cent Venous Cath    ~t,$0.00,$0.00,$110.91,$480.00,$196.80,$465.60,$196.80,$410.40,$196.80,$110.91,$196.80,$465.60,$196.80,$480.00,$196.80,$196.80,$465.60
3658240A,0510,36582,,,,,N/A,N/A,Replacement Port A Cath    ~ T,$0.00,$0.00,$485.10,"$1,797.00",$736.77,"$1,743.09",$736.77,"$1,536.44",$736.77,$485.10,$736.77,"$1,743.09",$736.77,"$1,797.00",$736.77,$736.77,"$1,743.09"
3936589,0510,36589,,,,,N/A,N/A,REMOVAL OF PICC,$373.31,$277.50,$25.51,$241.00,$25.51,$233.77,$25.51,$206.06,$25.51,$233.69,$25.51,$233.77,$25.51,$241.00,$25.51,$25.51,$233.77
3658940A,0510,36589,,,,,N/A,N/A,Removal Of Tunneled Cv Cath ~t,$0.00,$0.00,$25.51,$241.00,$25.51,$233.77,$25.51,$206.06,$25.51,$233.69,$25.51,$233.77,$25.51,$241.00,$25.51,$25.51,$233.77
3659040A,0510,36590,,,,,N/A,N/A,Remvl Of Tunnel Cent Venous ~t,$0.00,$0.00,$196.80,$480.00,$196.80,$465.60,$196.80,$410.40,$196.80,$319.87,$196.80,$465.60,$196.80,$480.00,$196.80,$196.80,$465.60
3659140,0510,36591,,,,,N/A,N/A,BLOOD DRAW COMP IMPLANTED PORT,$204.81,$152.25,$46.05,$361.00,$231.24,$350.17,$231.24,$308.66,$231.24,$46.05,$231.24,$350.17,$231.24,$361.00,$231.24,$231.24,$350.17
3659340A,0510,36593,,,,,N/A,N/A,DECLOT VASCULAR DEVICE      ~T,$10.09,$7.50,$25.10,"$1,130.00",$25.10,"$1,096.10",$25.10,$966.15,$25.10,$57.22,$25.10,"$1,096.10",$25.10,"$1,130.00",$25.10,$25.10,"$1,096.10"
3662040A,0510,36620,,,,,N/A,N/A,"Insertion Catheter, Artery  ~t",$0.00,$0.00,$53.71,$131.00,$53.71,$127.07,$53.71,$112.01,$53.71,$75.19,$53.71,$127.07,$53.71,$131.00,$53.71,$53.71,$127.07
3760940A,0510,37609,,,,,N/A,N/A,Ligation Or Bx Temp Artery  ~t,$0.00,$0.00,$191.88,$468.00,$191.88,$453.96,$191.88,$400.14,$191.88,$344.94,$191.88,$453.96,$191.88,$468.00,$191.88,$191.88,$453.96
3771840A,0510,37718,,,,,N/A,N/A,LIGATE/STRIP SHORT LEG VEIN ~T,$20.18,$15.00,$377.20,$920.00,$377.20,$892.40,$377.20,$786.60,$377.20,$701.60,$377.20,$892.40,$377.20,$920.00,$377.20,$377.20,$892.40
3772240A,0510,37722,,,,,N/A,N/A,Ligate/Strip Long Leg Vein  ~t,$0.00,$0.00,$399.75,$975.00,$399.75,$945.75,$399.75,$833.63,$399.75,$776.42,$399.75,$945.75,$399.75,$975.00,$399.75,$399.75,$945.75
3776540A,0510,37765,,,,,N/A,N/A,Phleb Veins -Extrem- To 20  ~t,$0.00,$0.00,$332.10,$810.00,$332.10,$785.70,$332.10,$692.55,$332.10,$448.73,$332.10,$785.70,$332.10,$810.00,$332.10,$332.10,$785.70
3822140A,0510,38221,,,,,N/A,N/A,Bone Marrow Proc Biopsy     ~t,$0.00,$0.00,$97.58,$238.00,$97.58,$230.86,$97.58,$203.49,$97.58,$119.68,$97.58,$230.86,$97.58,$238.00,$97.58,$97.58,$230.86
3850040A,0510,38500,,,,,N/A,N/A,Biopsy Or Exc Of Lymph Node ~t,$0.00,$0.00,$193.93,$473.00,$193.93,$458.81,$193.93,$404.42,$193.93,$430.35,$193.93,$458.81,$193.93,$473.00,$193.93,$193.93,$458.81
3850540A,0510,38505,,,,,N/A,N/A,Exc Of Lymph By Needle      ~t,$0.00,$0.00,$76.67,$187.00,$76.67,$181.39,$76.67,$159.89,$76.67,$118.57,$76.67,$181.39,$76.67,$187.00,$76.67,$76.67,$181.39
3851040A,0510,38510,,,,,N/A,N/A,"BIOPSY/REMOVAL, LYMPH NODES ~T",$141.25,$105.00,$382.12,$932.00,$382.12,$904.04,$382.12,$796.86,$382.12,$705.14,$382.12,$904.04,$382.12,$932.00,$382.12,$382.12,$904.04
3852540A,0510,38525,,,,,N/A,N/A,"Biopsy/Removal, Lymph Nodes ~t",$0.00,$0.00,$329.64,$805.00,$329.64,$780.85,$329.64,$688.28,$329.64,$741.20,$329.64,$780.85,$329.64,$805.00,$329.64,$329.64,$780.85
3853140A,0510,38531,,,,,N/A,N/A,BIOPSY/EXCISION             ~T,$76.68,$57.00,$359.16,$876.00,$359.16,$849.72,$359.16,$748.98,$359.16,$750.21,$359.16,$849.72,$359.16,$876.00,$359.16,$359.16,$849.72
3879240A,0510,38792,,,,,N/A,N/A,Excision Opn Deep Axil Node ~t,$0.00,$0.00,$41.80,$294.00,$41.80,$285.18,$41.80,$251.37,$41.80,$55.97,$41.80,$285.18,$41.80,$294.00,$41.80,$41.80,$285.18
3890040A,0510,38900,,,,,N/A,N/A,Cannulation/Inject/Proc     ~t,$0.00,$0.00,$228.13,$268.00,N/A,$259.96,N/A,$229.14,N/A,$228.13,N/A,$259.96,N/A,$268.00,N/A,N/A,$259.96
4083045A,0510,40830,,,,,N/A,N/A,REPAIR MOUTH LACERATION     ~T,$28.25,$21.00,$146.78,$358.00,$146.78,$347.26,$146.78,$306.09,$146.78,$251.48,$146.78,$347.26,$146.78,$358.00,$146.78,$146.78,$347.26
4321540A,0510,43215,,,,,N/A,N/A,Esophagus Endoscopy         ~t,$0.00,$0.00,$238.23,$582.00,$238.62,$564.54,$238.62,$497.61,$238.62,$238.23,$238.62,$564.54,$238.62,$582.00,$238.62,$238.62,$564.54
4322040A,0510,43220,,,,,N/A,N/A,Endo W/Trans Balloon Dil    ~t,$0.00,$0.00,$200.03,"$1,626.00",$666.66,"$1,577.22",$666.66,"$1,390.23",$666.66,$200.03,$666.66,"$1,577.22",$666.66,"$1,626.00",$666.66,$666.66,"$1,577.22"
4323340A,0510,43233,,,,,N/A,N/A,Endoscopic Proc W/Dilation  ~t,$0.00,$0.00,$191.88,$468.00,$191.88,$453.96,$191.88,$400.14,$191.88,$386.82,$191.88,$453.96,$191.88,$468.00,$191.88,$191.88,$453.96
4323540A,0510,43235,,,,,N/A,N/A,"UPPER GI ENDOSCOPY, DIAG    ~T",$36.32,$27.00,$182.86,$482.00,$182.86,$467.54,$182.86,$412.11,$182.86,$208.11,$182.86,$467.54,$182.86,$482.00,$182.86,$182.86,$467.54
4323640A,0510,43236,,,,,N/A,N/A,UPPR GI SCOPE W/SUBMUC INJ  ~T,$27.24,$20.25,$158.67,$387.00,$158.67,$375.39,$158.67,$330.89,$158.67,$234.89,$158.67,$375.39,$158.67,$387.00,$158.67,$158.67,$375.39
4323940A,0510,43239,,,,,N/A,N/A,"UPPER GI ENDOSCOPY, BIOPSY  ~T",$43.38,$32.25,$233.70,$570.00,$233.70,$552.90,$233.70,$487.35,$233.70,$234.89,$233.70,$552.90,$233.70,$570.00,$233.70,$233.70,$552.90
4324540A,0510,43245,,,,,N/A,N/A,Uppr Gi Scope Dilate Strictr~t,$0.00,$0.00,$36.80,$880.00,$36.80,$853.60,$36.80,$752.40,$36.80,$298.06,$36.80,$853.60,$36.80,$880.00,$36.80,$36.80,$853.60
4324640A,0510,43246,,,,,N/A,N/A,Up Endos W/Plcmnt Gast Tube ~t,$0.00,$0.00,$21.72,$492.00,$21.72,$477.24,$21.72,$420.66,$21.72,$337.72,$21.72,$477.24,$21.72,$492.00,$21.72,$21.72,$477.24
4324740A,0510,43247,,,,,N/A,N/A,Operative Upper Gi Enoscopy ~t,$0.00,$0.00,$237.80,$580.00,$237.80,$562.60,$237.80,$495.90,$237.80,$299.96,$237.80,$562.60,$237.80,$580.00,$237.80,$237.80,$562.60
4324940A,0510,43249,,,,,N/A,N/A,"Esoph Endoscopy, Dilation   ~t",$0.00,$0.00,$260.65,"$1,551.00",$635.91,"$1,504.47",$635.91,"$1,326.11",$635.91,$260.65,$635.91,"$1,504.47",$635.91,"$1,551.00",$635.91,$635.91,"$1,504.47"
4325040A,0510,43250,,,,,N/A,N/A,Endo Proc W/ Removal Tumor  ~t,$0.00,$0.00,$266.91,$651.00,$266.91,$631.47,$266.91,$556.61,$266.91,$288.19,$266.91,$631.47,$266.91,$651.00,$266.91,$266.91,$631.47
4325140A,0510,43251,,,,,N/A,N/A,Endoscopic Proc Remove Tumor~t,$0.00,$0.00,$293.15,$715.00,$293.15,$693.55,$293.15,$611.33,$293.15,$332.50,$293.15,$693.55,$293.15,$715.00,$293.15,$293.15,$693.55
4325540A,0510,43255,,,,,N/A,N/A,Operative Upper Gi Endoscopy~t,$0.00,$0.00,$275.93,$673.00,$275.93,$652.81,$275.93,$575.42,$275.93,$340.31,$275.93,$652.81,$275.93,$673.00,$275.93,$275.93,$652.81
4333240A,0510,43332,,,,,N/A,N/A,Transab Esoph Hiat Hern Rpr ~t,$0.00,$0.00,$911.20,"$2,222.00",$911.20,"$2,155.34",$911.20,"$1,899.81",$911.20,"$1,923.18",$911.20,"$2,155.34",$911.20,"$2,222.00",$911.20,$911.20,"$2,155.34"
4350040A,0510,43500,,,,,N/A,N/A,Surgical Opening Of Stomach ~t,$0.00,$0.00,$621.97,"$1,517.00",$621.97,"$1,471.49",$621.97,"$1,297.04",$621.97,"$1,318.05",$621.97,"$1,471.49",$621.97,"$1,517.00",$621.97,$621.97,"$1,471.49"
4363240A,0510,43632,,,,,N/A,N/A,"Removal Of Stomach, Partial ~t",$0.00,$0.00,"$1,558.41","$3,801.00","$1,558.41","$3,686.97","$1,558.41","$3,249.86","$1,558.41","$3,388.28","$1,558.41","$3,686.97","$1,558.41","$3,801.00","$1,558.41","$1,558.41","$3,686.97"
4375340A,0510,43753,,,,,N/A,N/A,Non Surgical Gastric Tube   ~t,$0.00,$0.00,$17.22,$42.00,$17.22,$40.74,$17.22,$35.91,$17.22,$36.73,$17.22,$40.74,$17.22,$42.00,$17.22,$17.22,$40.74
4376240A,0510,43762,,,,,N/A,N/A,REPLACE OF GASTROSTOMY TUBE ~T,$25.22,$18.75,$19.65,$465.00,$19.65,$451.05,$19.65,$397.58,$19.65,$63.34,$19.65,$451.05,$19.65,$465.00,$19.65,$19.65,$451.05
4376340A,0510,43763,,,,,N/A,N/A,Req Revision Gastrostomy Tra~t,$0.00,$0.00,$73.80,$180.00,$73.80,$174.60,$73.80,$153.90,$73.80,$141.99,$73.80,$174.60,$73.80,$180.00,$73.80,$73.80,$174.60
4383040A,0510,43830,,,,,N/A,N/A,Place Gastrostomy Tube      ~t,$0.00,$0.00,$556.37,"$1,357.00",$556.37,"$1,316.29",$556.37,"$1,160.24",$556.37,"$1,186.26",$556.37,"$1,316.29",$556.37,"$1,357.00",$556.37,$556.37,"$1,316.29"
4384040A,0510,43840,,,,,N/A,N/A,Repair Of Stomach Lesion    ~t,$0.00,$0.00,$866.74,"$2,275.04",$866.74,"$2,050.58",$866.74,"$1,807.47",$866.74,"$2,275.04",$866.74,"$2,050.58",$866.74,"$2,114.00",$866.74,$866.74,"$2,050.58"
4400540A,0510,44005,,,,,N/A,N/A,Freeing Of Bowel Adhesion   ~t,$0.00,$0.00,$891.75,"$2,175.00",$891.75,"$2,109.75",$891.75,"$1,859.63",$891.75,"$1,827.76",$891.75,"$2,109.75",$891.75,"$2,175.00",$891.75,$891.75,"$2,109.75"
4402040A,0510,44020,,,,,N/A,N/A,Inc Enterotomy Sm Intest    ~t,$0.00,$0.00,$553.90,"$1,633.36",$553.90,"$1,308.53",$553.90,"$1,153.40",$553.90,"$1,633.36",$553.90,"$1,308.53",$553.90,"$1,349.00",$553.90,$553.90,"$1,308.53"
4405040A,0510,44050,,,,,N/A,N/A,Reduce Bowel Obstruction    ~t,$0.00,$0.00,$776.54,"$1,894.00",$776.54,"$1,837.18",$776.54,"$1,619.37",$776.54,"$1,567.88",$776.54,"$1,837.18",$776.54,"$1,894.00",$776.54,$776.54,"$1,837.18"
4405540A,0510,44055,,,,,N/A,N/A,Correct Malrotation Of Bowel~t,$0.00,$0.00,"$1,193.92","$2,912.00","$1,193.92","$2,824.64","$1,193.92","$2,489.76","$1,193.92","$2,487.25","$1,193.92","$2,824.64","$1,193.92","$2,912.00","$1,193.92","$1,193.92","$2,824.64"
4412040A,0510,44120,,,,,N/A,N/A,Removal Of Small Intestine  ~t,$0.00,$0.00,$934.80,"$2,280.00",$934.80,"$2,211.60",$934.80,"$1,949.40",$934.80,"$2,042.68",$934.80,"$2,211.60",$934.80,"$2,280.00",$934.80,$934.80,"$2,211.60"
4412140A,0510,44121,,,,,N/A,N/A,Removal Of Small Intestine  ~t,$0.00,$0.00,$232.88,$568.00,$232.88,$550.96,$232.88,$485.64,$232.88,$400.81,$232.88,$550.96,$232.88,$568.00,$232.88,$232.88,$550.96
4412540A,0510,44125,,,,,N/A,N/A,Excision W/Enterostomy      ~t,$0.00,$0.00,$67.76,"$1,972.68",$67.76,"$1,586.92",$67.76,"$1,398.78",$67.76,"$1,972.68",$67.76,"$1,586.92",$67.76,"$1,636.00",$67.76,$67.76,"$1,586.92"
4413040A,0510,44130,,,,,N/A,N/A,Bowel To Bowel Fusion       ~t,$0.00,$0.00,$83.19,"$2,202.29",$83.19,"$1,900.23",$83.19,"$1,674.95",$83.19,"$2,202.29",$83.19,"$1,900.23",$83.19,"$1,959.00",$83.19,$83.19,"$1,900.23"
4413940A,0510,44139,,,,,N/A,N/A,Mobiliaztion Of Splenic     ~t,$0.00,$0.00,$93.70,$227.00,$93.70,$220.19,$93.70,$194.09,$93.70,$200.32,$93.70,$220.19,$93.70,$227.00,$93.70,$93.70,$220.19
4414040A,0510,44140,,,,,N/A,N/A,Partial Removal Of Colon    ~t,$0.00,$0.00,$115.87,"$2,807.00",$115.87,"$2,722.79",$115.87,"$2,399.99",$115.87,"$2,246.58",$115.87,"$2,722.79",$115.87,"$2,807.00",$115.87,$115.87,"$2,722.79"
4414140A,0510,44141,,,,,N/A,N/A,Colon Resect W/Skin Colos   ~t,$0.00,$0.00,"$1,467.80","$3,580.00","$1,467.80","$3,472.60","$1,467.80","$3,060.90","$1,467.80","$3,054.98","$1,467.80","$3,472.60","$1,467.80","$3,580.00","$1,467.80","$1,467.80","$3,472.60"
4414340A,0510,44143,,,,,N/A,N/A,Colon Resection W/End Colost~t,$0.00,$0.00,"$1,336.60","$3,260.00","$1,336.60",N/A,"$1,336.60","$2,787.30","$1,336.60","$2,783.08","$1,336.60",N/A,"$1,336.60","$3,260.00","$1,336.60","$1,336.60",N/A
4414440A,0510,44144,,,,,N/A,N/A,Colon Resection Procedure   ~t,$0.00,$0.00,"$1,421.88","$3,468.00","$1,421.88","$3,363.96","$1,421.88","$2,965.14","$1,421.88","$2,956.79","$1,421.88","$3,363.96","$1,421.88","$3,468.00","$1,421.88","$1,421.88","$3,363.96"
4414540A,0510,44145,,,,,N/A,N/A,Partial Removal Of Colon    ~t,$0.00,$0.00,"$1,279.20","$3,120.00","$1,279.20","$3,026.40","$1,279.20","$2,667.60","$1,279.20","$2,763.00","$1,279.20","$3,026.40","$1,279.20","$3,120.00","$1,279.20","$1,279.20","$3,026.40"
4415040A,0510,44150,,,,,N/A,N/A,Removal Of Colon            ~t,$0.00,$0.00,"$1,453.86","$3,546.00","$1,453.86","$3,439.62","$1,453.86","$3,031.83","$1,453.86","$3,128.14","$1,453.86","$3,439.62","$1,453.86","$3,546.00","$1,453.86","$1,453.86","$3,439.62"
4416040A,0510,44160,,,,,N/A,N/A,Removal Of Colon            ~t,$0.00,$0.00,$122.95,"$2,495.00",$122.95,"$2,420.15",$122.95,"$2,133.23",$122.95,"$2,077.94",$122.95,"$2,420.15",$122.95,"$2,495.00",$122.95,$122.95,"$2,420.15"
4418040A,0510,44180,,,,,N/A,N/A,"Laparo, Surg, Enterolysis   ~t",$0.00,$0.00,$71.92,"$1,712.00",$71.92,"$1,660.64",$71.92,"$1,463.76",$71.92,"$1,541.10",$71.92,"$1,660.64",$71.92,"$1,712.00",$71.92,$71.92,"$1,660.64"
4418840A,0510,44188,,,,,N/A,N/A,Lap Colostomy               ~t,$0.00,$0.00,$992.20,"$2,420.00",$992.20,"$2,347.40",$992.20,"$2,069.10",$992.20,"$2,055.70",$992.20,"$2,347.40",$992.20,"$2,420.00",$992.20,$992.20,"$2,347.40"
4420240A,0510,44202,,,,,N/A,N/A,Lap Enterostomy Procedure   ~t,$0.00,$0.00,"$1,112.74","$2,714.00","$1,112.74","$2,632.58","$1,112.74","$2,320.47","$1,112.74","$2,318.59","$1,112.74","$2,632.58","$1,112.74","$2,714.00","$1,112.74","$1,112.74","$2,632.58"
4420440A,0510,44204,,,,,N/A,N/A,Laparo Partial Colectomy    ~t,$0.00,$0.00,"$2,072.89","$2,571.24",N/A,"$2,072.89",N/A,"$1,827.14",N/A,"$2,571.24",N/A,"$2,072.89",N/A,"$2,137.00",N/A,N/A,"$2,072.89"
4420540A,0510,44205,,,,,N/A,N/A,Colectomy                   ~t,$0.00,$0.00,$18.76,"$2,636.00",$18.76,"$2,556.92",$18.76,"$2,253.78",$18.76,"$2,236.50",$18.76,"$2,556.92",$18.76,"$2,636.00",$18.76,$18.76,"$2,556.92"
4420640A,0510,44206,,,,,N/A,N/A,Lap Part Colectomy W/Stoma  ~t,$0.00,$0.00,"$1,484.20","$3,620.00","$1,484.20","$3,511.40","$1,484.20","$3,095.10","$1,484.20","$2,925.76","$1,484.20","$3,511.40","$1,484.20","$3,620.00","$1,484.20","$1,484.20","$3,511.40"
4420740A,0510,44207,,,,,N/A,N/A,Coloectomy Part W/Anastom   ~t,$0.00,$0.00,"$1,476.82","$3,602.00","$1,476.82","$3,493.94","$1,476.82","$3,079.71","$1,476.82","$3,034.95","$1,476.82","$3,493.94","$1,476.82","$3,602.00","$1,476.82","$1,476.82","$3,493.94"
4421340A,0510,44213,,,,,N/A,N/A,Lap Enterostomy Procedure   ~t,$0.00,$0.00,$154.16,$376.00,$154.16,$364.72,$154.16,$321.48,$154.16,$311.48,$154.16,$364.72,$154.16,$376.00,$154.16,$154.16,$364.72
4422740A,0510,44227,,,,,N/A,N/A,Lap Enterostomy Proc        ~t,$0.00,$0.00,"$2,780.56","$3,273.00",N/A,"$3,174.81",N/A,"$2,798.42",N/A,"$2,780.56",N/A,"$3,174.81",N/A,"$3,273.00",N/A,N/A,"$3,174.81"
4431040A,0510,44310,,,,,N/A,N/A,ILEOSTOMY/JEJUNOSTOMY       ~T,$42.38,$31.50,$878.22,"$2,142.00",$878.22,"$2,077.74",$878.22,"$1,831.41",$878.22,"$1,743.30",$878.22,"$2,077.74",$878.22,"$2,142.00",$878.22,$878.22,"$2,077.74"
4431240A,0510,44312,,,,,N/A,N/A,REVISION OF ILEOSTOMY       ~T,$32.29,$24.00,$464.12,"$1,132.00",$464.12,"$1,098.04",$464.12,$967.86,$464.12,"$1,006.54",$464.12,"$1,098.04",$464.12,"$1,132.00",$464.12,$464.12,"$1,098.04"
4432040A,0510,44320,,,,,N/A,N/A,Colostomy                   ~t,$0.00,$0.00,$162.31,"$2,591.00",$162.31,"$2,513.27",$162.31,"$2,215.31",$162.31,"$2,013.77",$162.31,"$2,513.27",$162.31,"$2,591.00",$162.31,$162.31,"$2,513.27"
4434640A,0510,44346,,,,,N/A,N/A,Open Enterostomy Procedure  ~t,$0.00,$0.00,$965.96,"$2,356.00",$965.96,"$2,285.32",$965.96,"$2,014.38",$965.96,"$1,985.81",$965.96,"$2,285.32",$965.96,"$2,356.00",$965.96,$965.96,"$2,285.32"
4438640A,0510,44386,,,,,N/A,N/A,"ENDOSCOPY, BOWEL POUCH/BIOP ~T",$22.20,$16.50,$150.67,$282.00,N/A,$273.54,N/A,$241.11,N/A,$150.67,N/A,$273.54,N/A,$282.00,N/A,N/A,$273.54
4438840A,0510,44388,,,,,N/A,N/A,Colonscopy Through Stoma    ~t,$0.00,$0.00,$185.32,$452.00,$185.32,$438.44,$185.32,$386.46,$185.32,$263.98,$185.32,$438.44,$185.32,$452.00,$185.32,$185.32,$438.44
4438940A,0510,44389,,,,,N/A,N/A,Endoscopy With Biopsy       ~t,$0.00,$0.00,$227.96,$556.00,$227.96,$539.32,$227.96,$475.38,$227.96,$291.29,$227.96,$539.32,$227.96,$556.00,$227.96,$227.96,$539.32
4439440A,0510,44394,,,,,N/A,N/A,Removal Of Tumor By Snare   ~t,$0.00,$0.00,$286.59,$699.00,$286.59,$678.03,$286.59,$597.65,$286.59,$381.00,$286.59,$678.03,$286.59,$699.00,$286.59,$286.59,$678.03
4440440A,0510,44404,,,,,N/A,N/A,Colonoscopy W/Injection     ~t,$0.00,$0.00,$290.94,$886.00,$363.26,$859.42,$363.26,$757.53,$363.26,$290.94,$363.26,$859.42,$363.26,$886.00,$363.26,$363.26,$859.42
4450040A,0510,44500,,,,,N/A,N/A,"INTRO, GASTROINTESTINAL TUBE~T",$10.09,$7.50,$4.10,$62.00,$4.10,$60.14,$4.10,$53.01,$4.10,$33.22,$4.10,$60.14,$4.10,$62.00,$4.10,$4.10,$60.14
4460240A,0510,44602,,,,,N/A,N/A,Suture Of Sm Intestine      ~t,$0.00,$0.00,$166.00,"$2,600.00",$166.00,"$2,522.00",$166.00,"$2,223.00",$166.00,"$2,349.64",$166.00,"$2,522.00",$166.00,"$2,600.00",$166.00,$166.00,"$2,522.00"
4460340A,0510,44603,,,,,N/A,N/A,"Suture, Small Intestine     ~t",$0.00,$0.00,"$1,322.25","$3,225.00","$1,322.25","$3,128.25","$1,322.25","$2,757.38","$1,322.25","$2,704.19","$1,322.25","$3,128.25","$1,322.25","$3,225.00","$1,322.25","$1,322.25","$3,128.25"
4460440A,0510,44604,,,,,N/A,N/A,Suture Of Large Intestine   ~t,$0.00,$0.00,$598.19,"$1,768.11",$598.19,"$1,415.23",$598.19,"$1,247.45",$598.19,"$1,768.11",$598.19,"$1,415.23",$598.19,"$1,459.00",$598.19,$598.19,"$1,415.23"
4462040A,0510,44620,,,,,N/A,N/A,Repair Bowel Opening        ~t,$0.00,$0.00,$599.83,"$1,463.00",$599.83,"$1,419.11",$599.83,"$1,250.87",$599.83,"$1,452.50",$599.83,"$1,419.11",$599.83,"$1,463.00",$599.83,$599.83,"$1,419.11"
4462540A,0510,44625,,,,,N/A,N/A,Repair W/Resec & Anastom    ~t,$0.00,$0.00,$779.00,"$1,900.00",$779.00,"$1,843.00",$779.00,"$162,450.00",$779.00,"$1,697.74",$779.00,"$1,843.00",$779.00,"$1,900.00",$779.00,$779.00,"$1,843.00"
4464040A,0510,44640,,,,,N/A,N/A,Clos Of Intstnl Cutns Fstl  ~t,$0.00,$0.00,$171.74,"$2,614.00",$171.74,"$2,535.58",$171.74,"$2,234.97",$171.74,"$2,335.57",$171.74,"$2,535.58",$171.74,"$2,614.00",$171.74,$171.74,"$2,535.58"
4466040A,0510,44660,,,,,N/A,N/A,Repair Bowel-Bladder Fistu  ~t,$0.00,$0.00,"$1,143.49","$2,789.00","$1,143.49","$2,705.33","$1,143.49","$2,384.60","$1,143.49","$2,246.06","$1,143.49","$2,705.33","$1,143.49","$2,789.00","$1,143.49","$1,143.49","$2,705.33"
4470140A,0510,44701,,,,,N/A,N/A,Intestinal Procedure        ~t,$0.00,$0.00,$134.48,$328.00,$134.48,$318.16,$134.48,$280.44,$134.48,$280.73,$134.48,$318.16,$134.48,$328.00,$134.48,$134.48,$318.16
4479940A,0510,44799,,,,,N/A,N/A,Unlisted Procedure Intestine~t,$0.00,$0.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4485040A,0510,44850,,,,,N/A,N/A,REPAIR OF MESENTERY         ~T,$48.43,$36.00,$61.80,"$1,488.00",$61.80,"$1,443.36",$61.80,"$1,272.24",$61.80,"$1,255.57",$61.80,"$1,443.36",$61.80,"$1,488.00",$61.80,$61.80,"$1,443.36"
4495040A,0510,44950,,,,,N/A,N/A,Appendectomy                ~t,$0.00,$0.00,$364.49,"$1,078.45",$364.49,$862.33,$364.49,$760.10,$364.49,"$1,078.45",$364.49,$862.33,$364.49,$889.00,$364.49,$364.49,$862.33
4495540A,0510,44955,,,,,N/A,N/A,Appendectomy Add-On         ~t,$0.00,$0.00,$88.97,$217.00,$88.97,$210.49,$88.97,$185.54,$88.97,$138.96,$88.97,$210.49,$88.97,$217.00,$88.97,$88.97,$210.49
4496040A,0510,44960,,,,,N/A,N/A,Appendectomy                ~t,$0.00,$0.00,$686.75,"$1,675.00",$686.75,"$1,624.75",$686.75,"$1,432.13",$686.75,"$1,470.11",$686.75,"$1,624.75",$686.75,"$1,675.00",$686.75,$686.75,"$1,624.75"
4497040A,0510,44970,,,,,N/A,N/A,"Laparoscopy, Appendectomy   ~t",$0.00,$0.00,$496.51,"$1,211.00",$496.51,"$1,174.67",$496.51,"$1,035.41",$496.51,"$1,013.09",$496.51,"$1,174.67",$496.51,"$1,211.00",$496.51,$496.51,"$1,174.67"
4500040A,0510,45000,,,,,N/A,N/A,DRAINAGE OF PELVIC ABSCESS  ~T,$20.18,$15.00,$332.10,$810.00,$332.10,$785.70,$332.10,$692.55,$332.10,$724.70,$332.10,$785.70,$332.10,$810.00,$332.10,$332.10,$785.70
4510040A,0510,45100,,,,,N/A,N/A,Biopsy Of Rectum            ~t,$0.00,$0.00,$235.34,$574.00,$235.34,$556.78,$235.34,$490.77,$235.34,$513.44,$235.34,$556.78,$235.34,$574.00,$235.34,$235.34,$556.78
4511140A,0510,45111,,,,,N/A,N/A,Open/Transrectal Procedure  ~t,$0.00,$0.00,$889.29,"$2,169.00",$889.29,"$2,103.93",$889.29,"$1,854.50",$889.29,"$1,827.92",$889.29,"$2,103.93",$889.29,"$2,169.00",$889.29,$889.29,"$2,103.93"
4513040A,0510,45130,,,,,N/A,N/A,Excision .5cm Or Less       ~t,$0.00,$0.00,$63.99,"$1,826.36",$63.99,"$1,492.83",$63.99,"$1,315.85",$63.99,"$1,826.36",$63.99,"$1,492.83",$63.99,"$1,539.00",$63.99,$63.99,"$1,492.83"
4517140A,0510,45171,,,,,N/A,N/A,Excision Of Rectal Tumor    ~t,$0.00,$0.00,$481.34,"$1,174.00",$481.34,"$1,138.78",$481.34,"$1,003.77",$481.34,"$1,063.91",$481.34,"$1,138.78",$481.34,"$1,174.00",$481.34,$481.34,"$1,138.78"
4519040A,0510,45190,,,,,N/A,N/A,"DESTRUCTION, RECTAL TUMOR   ~T",$52.46,$39.00,$554.32,"$1,352.00",$554.32,"$1,311.44",$554.32,"$1,155.96",$554.32,"$1,210.16",$554.32,"$1,311.44",$554.32,"$1,352.00",$554.32,$554.32,"$1,311.44"
4530540A,0510,45305,,,,,N/A,N/A,PROCTOSIGMOIDOSCOPY W/BX    ~T,$25.22,$18.75,$122.85,$211.00,N/A,$204.67,N/A,$180.41,N/A,$122.85,N/A,$204.67,N/A,$211.00,N/A,N/A,$204.67
4531740A,0510,45317,,,,,N/A,N/A,Rigid Proctosig W/Cont Bleed~t,$0.00,$0.00,$1.86,$246.00,$1.86,$238.62,$1.86,$210.33,$1.86,$186.21,$1.86,$238.62,$1.86,$246.00,$1.86,$1.86,$238.62
4533040A,0510,45330,,,,,N/A,N/A,"Sigmoid, Flexible, Diag     ~t",$0.00,$0.00,$79.54,$194.00,$79.54,$188.18,$79.54,$165.87,$79.54,$94.53,$79.54,$188.18,$79.54,$194.00,$79.54,$79.54,$188.18
4533140A,0510,45331,,,,,N/A,N/A,Sigmoidoscopy And Biopsy    ~t,$0.00,$0.00,$116.30,$283.00,$116.30,$274.51,$116.30,$241.97,$116.30,$122.00,$116.30,$274.51,$116.30,$283.00,$116.30,$116.30,$274.51
4533440A,0510,45334,,,,,N/A,N/A,Flexible Sigmoidoscopy      ~t,$0.00,$0.00,$199.27,$543.00,N/A,$526.71,N/A,$464.27,N/A,$199.27,N/A,$526.71,N/A,$543.00,N/A,N/A,$526.71
4533540A,0510,45335,,,,,N/A,N/A,Sigmoid W/Dir Submucosal    ~t,$0.00,$0.00,$112.99,$389.00,$159.49,$377.33,$159.49,$332.60,$159.49,$112.99,$159.49,$377.33,$159.49,$389.00,$159.49,$159.49,$377.33
4533840A,0510,45338,,,,,N/A,N/A,Flexible Sigmoido Proc      ~t,$0.00,$0.00,$184.50,$450.00,$184.50,$436.50,$184.50,$384.75,$184.50,$203.90,$184.50,$436.50,$184.50,$450.00,$184.50,$184.50,$436.50
4535040A,0510,45350,,,,,N/A,N/A,Sigmoidoscopy W/ Band Ligation,$0.00,$0.00,$3.94,$734.00,$3.94,$711.98,$3.94,$627.57,$3.94,$170.68,$3.94,$711.98,$3.94,$734.00,$3.94,$3.94,$711.98
4537840A,0510,45378,,,,,N/A,N/A,DIAGNOSTIC COLONOSCOPY      ~T,$59.53,$44.25,$248.50,$546.00,$248.50,$529.62,$248.50,$466.83,$248.50,$313.95,$248.50,$529.62,$248.50,$546.00,$248.50,$248.50,$529.62
4538040A,0510,45380,,,,,N/A,N/A,COLONOSCOPY AND BIOPSY      ~T,$68.61,$51.00,$0.00,$650.00,$266.50,$0.00,$266.50,$555.75,$266.50,$485.35,$266.50,$0.00,$266.50,$650.00,$266.50,$266.50,$0.00
4538140A,0510,45381,,,,,N/A,N/A,"COLONOSCOPY, SUBMUCOUS INJ  ~T",$62.55,$46.50,$27.60,$654.00,$27.60,$630.50,$27.60,$559.17,$27.60,$340.74,$27.60,$630.50,$27.60,$654.00,$27.60,$27.60,$630.50
4538240A,0510,45382,,,,,N/A,N/A,Endoscopy W/Contr Bleeding  ~t,$0.00,$0.00,$346.45,$845.00,$346.45,$634.38,$346.45,$722.48,$346.45,$439.38,$346.45,$634.38,$346.45,$845.00,$346.45,$346.45,$634.38
4538440A,0510,45384,,,,,N/A,N/A,LESION REMOVAL COLONOSCOPY  ~T,$80.72,$60.00,$299.71,$819.65,$299.71,$819.65,$299.71,$625.01,$299.71,$384.59,$299.71,$819.65,$299.71,$731.00,$299.71,$299.71,$819.65
4538540A,0510,45385,,,,,N/A,N/A,LESION REMOVAL COLONOSCOPY  ~T,$81.72,$60.75,$3.94,$734.00,$3.94,$709.07,$3.94,$627.57,$3.94,$638.99,$3.94,$709.07,$3.94,$734.00,$3.94,$3.94,$709.07
4538640A,0510,45386,,,,,N/A,N/A,COLONOSCOPY DILATE STRICTURE~T,$50.45,$37.50,$358.59,$940.00,$385.40,$711.98,$385.40,$803.70,$385.40,$358.59,$385.40,$711.98,$385.40,$940.00,$385.40,$385.40,$711.98
4538840A,0510,45388,,,,,N/A,N/A,COLONOSCOPY w/ABLATION TUMOR~T,$28.25,$21.00,$458.34,"$2,811.00","$1,152.51",$911.80,"$1,152.51","$2,403.41","$1,152.51",$458.34,"$1,152.51",$911.80,"$1,152.51","$2,811.00","$1,152.51","$1,152.51",$911.80
4539340A,0510,45393,,,,,N/A,N/A,COLONOSCOPY W/DECOMPRESSION ~T,$30.27,$22.50,$217.30,"$2,726.67",$217.30,"$2,726.67",$217.30,$453.15,$217.30,$427.68,$217.30,"$2,726.67",$217.30,$530.00,$217.30,$217.30,"$2,726.67"
4539840A,0510,45398,,,,,N/A,N/A,Colonoscopy W/Band          ~t,$0.00,$0.00,$3.94,$734.00,$3.94,$514.10,$3.94,$627.57,$3.94,$396.43,$3.94,$514.10,$3.94,$734.00,$3.94,$3.94,$514.10
4555040A,0510,45550,,,,,N/A,N/A,REPAIR RECTUM/REMOVE SIGMOID~T,$38.34,$28.50,"$1,245.58","$3,038.00","$1,245.58","$2,946.86","$1,245.58","$2,597.49","$1,245.58","$2,467.05","$1,245.58","$2,946.86","$1,245.58","$3,038.00","$1,245.58","$1,245.58","$2,946.86"
4599040A,0510,45990,,,,,N/A,N/A,"SURG DX EXAM, ANORECTAL     ~T",$19.17,$14.25,$93.89,$396.07,$93.89,$222.13,$93.89,$195.80,$93.89,$396.07,$93.89,$222.13,$93.89,$229.00,$93.89,$93.89,$222.13
4602040A,0510,46020,,,,,N/A,N/A,Placement Of Seton          ~t,$0.00,$0.00,$177.35,$449.00,$184.90,$435.53,$184.90,$383.90,$184.90,$177.35,$184.90,$435.53,$184.90,$449.00,$184.90,$184.90,$435.53
4604040A,0510,46040,,,,,N/A,N/A,Incision & Drain Abcess     ~t,$0.00,$0.00,$311.60,"$1,440.00",$311.60,"$1,396.80",$311.60,"$1,231.20",$311.60,$408.89,$311.60,"$1,396.80",$311.60,"$1,440.00",$311.60,$311.60,"$1,396.80"
4605040A,0510,46050,,,,,N/A,N/A,INCISION OF ANAL ABSCESS    ~T,$30.27,$22.50,$87.74,$725.44,$87.74,$217.28,$87.74,$191.52,$87.74,$725.44,$87.74,$217.28,$87.74,$224.00,$87.74,$87.74,$217.28
4608040A,0510,46080,,,,,N/A,N/A,Surg Incision Sphincter     ~t,$0.00,$0.00,$129.15,$315.00,$129.15,$305.55,$129.15,$269.33,$129.15,$170.87,$129.15,$305.55,$129.15,$315.00,$129.15,$129.15,$305.55
4608340A,0510,46083,,,,,N/A,N/A,Surg Incision Of Thrombosed ~t,$0.00,$0.00,$13.32,$267.07,$13.32,$244.44,$13.32,$215.46,$13.32,$267.07,$13.32,$244.44,$13.32,$252.00,$13.32,$13.32,$244.44
4620040A,0510,46200,,,,,N/A,N/A,REMOVAL OF ANAL FISSURE     ~T,$23.21,$17.25,$186.83,$623.00,$255.43,$604.31,$255.43,N/A,$255.43,$186.83,$255.43,$604.31,$255.43,$623.00,$255.43,$255.43,$604.31
4622140A,0510,46221,,,,,N/A,N/A,LIGATION OF HEMORRHOID(S)   ~T,$54.48,$40.50,$144.73,$353.00,$144.73,$342.41,$144.73,$301.82,$144.73,$205.55,$144.73,$342.41,$144.73,$353.00,$144.73,$144.73,$342.41
4625040A,0510,46250,,,,,N/A,N/A,Hemorrhoidectomy            ~t,$0.00,$0.00,$25.51,$611.00,$25.51,$592.67,$25.51,$522.41,$25.51,$293.96,$25.51,$592.67,$25.51,$611.00,$25.51,$25.51,$592.67
4625540A,0510,46255,,,,,N/A,N/A,HEMORRHOIDECTOMY            ~T,$60.54,$45.00,$286.18,$698.00,$286.18,$677.06,$286.18,$596.79,$286.18,$548.66,$286.18,$677.06,$286.18,$698.00,$286.18,$286.18,$677.06
4625740A,0510,46257,,,,,N/A,N/A,Hemorrhoidectomy          ~t,$0.00,$0.00,$235.75,$611.82,$235.75,$557.75,$235.75,$491.63,$235.75,$611.82,$235.75,$557.75,$235.75,$575.00,$235.75,$235.75,$557.75
4626040A,0510,46260,,,,,N/A,N/A,Hemorrhoidectomy            ~t,$0.00,$0.00,$369.00,$369.00,$369.00,N/A,$369.00,N/A,$369.00,N/A,$369.00,N/A,$369.00,N/A,$369.00,$369.00,N/A
4626140A,0510,46261,,,,,N/A,N/A,Hemorrhoidectomy            ~t,$0.00,$0.00,$293.56,$293.56,$293.56,N/A,$293.56,N/A,$293.56,N/A,$293.56,N/A,$293.56,N/A,$293.56,$293.56,N/A
4627040A,0510,46270,,,,,N/A,N/A,Resection Of Anal Fistula   ~t,$0.00,$0.00,$317.75,$775.00,$317.75,$751.75,$317.75,$662.63,$317.75,$734.37,$317.75,$751.75,$317.75,$775.00,$317.75,$317.75,$751.75
4627540A,0510,46275,,,,,N/A,N/A,Removal Of Anal Fistula     ~t,$0.00,$0.00,$323.49,$789.00,$323.49,$765.33,$323.49,$674.60,$323.49,$685.63,$323.49,$765.33,$323.49,$789.00,$323.49,$323.49,$765.33
4628040A,0510,46280,,,,,N/A,N/A,REMOVAL OF ANAL FISTULA     ~T,$55.49,$41.25,$366.95,$895.00,$366.95,$868.15,$366.95,$765.23,$366.95,$722.55,$366.95,$868.15,$366.95,$895.00,$366.95,$366.95,$868.15
4632040A,0510,46320,,,,,N/A,N/A,REMOVAL OF HEMORRHOID CLOT  ~T,$33.30,$24.75,$95.53,$821.79,$95.53,$226.01,$95.53,$199.22,$95.53,$821.79,$95.53,$226.01,$95.53,$233.00,$95.53,$95.53,$226.01
4660040A,0510,46600,,,,,N/A,N/A,DIAGNOSTIC ANOSCOPY         ~T,$7.06,$5.25,$48.79,$192.32,$48.79,$115.43,$48.79,$101.75,$48.79,$192.32,$48.79,$115.43,$48.79,$119.00,$48.79,$48.79,$115.43
4660640A,0510,46606,,,,,N/A,N/A,Anoscopy And Biopsy         ~t,$0.00,$0.00,$17.83,$263.00,$17.83,$255.11,$17.83,$224.87,$17.83,$68.60,$17.83,$255.11,$17.83,$263.00,$17.83,$17.83,$255.11
4661040A,0510,46610,,,,,N/A,N/A,"ANOSCOPY, REMOVE LESION     ~T",$23.21,$17.25,$127.40,$305.00,$129.15,$295.85,$129.15,$260.78,$129.15,$127.40,$129.15,$295.85,$129.15,$305.00,$129.15,$129.15,$295.85
4661140A,0510,46611,,,,,N/A,N/A,Anoscopic Procedure         ~t,$0.00,$0.00,$124.64,$304.00,$124.64,$294.88,$124.64,$259.92,$124.64,$134.69,$124.64,$294.88,$124.64,$304.00,$124.64,$124.64,$294.88
4661440A,0510,46614,,,,,N/A,N/A,Anoscopic Procedure         ~t,$0.00,$0.00,$11.29,$269.00,$11.29,$260.93,$11.29,$230.00,$11.29,$135.73,$11.29,$260.93,$11.29,$269.00,$11.29,$11.29,$260.93
4692240A,0510,46922,,,,,N/A,N/A,EXCISION OF ANAL LESION(S)  ~T,$31.28,$23.25,$107.92,$300.00,$123.00,$291.00,$123.00,$256.50,$123.00,$107.92,$123.00,$291.00,$123.00,$300.00,$123.00,$123.00,$291.00
46924040,0510,46924,,,,,N/A,N/A,"DESTRUCTION OF LESION,ANUS","$2,646.45","$1,967.25",$232.25,"$1,066.00",$437.60,"$1,034.02",$437.60,$911.43,$437.60,$232.25,$437.60,"$1,034.02",$437.60,"$1,066.00",$437.60,$437.60,"$1,034.02"
4692440A,0510,46924,,,,,N/A,N/A,"Destruction Of Lesion,Anus  ~t",$0.00,$0.00,$232.25,"$1,066.00",$437.60,"$1,034.02",$437.60,$911.43,$437.60,$232.25,$437.60,"$1,034.02",$437.60,"$1,066.00",$437.60,$437.60,"$1,034.02"
4693040A,0510,46930,,,,,N/A,N/A,Destroy Internal Hemorrhoids~t,$0.00,$0.00,$12.54,$306.24,$12.54,$285.18,$12.54,$251.37,$12.54,$306.24,$12.54,$285.18,$12.54,$294.00,$12.54,$12.54,$285.18
4694640A,0510,46946,,,,,N/A,N/A,LIGATION OF HEMORRHOIDS     ~T,$62.55,$46.50,$189.42,$462.00,$189.42,$448.14,$189.42,$395.01,$189.42,$265.71,$189.42,$448.14,$189.42,$462.00,$189.42,$189.42,$448.14
4694840A,0510,46948,,,,,N/A,N/A,HEMORRHOIDECTOMY            ~T,$54.48,$40.50,$362.44,$884.00,$362.44,$857.48,$362.44,$755.82,$362.44,$662.75,$362.44,$857.48,$362.44,$884.00,$362.44,$362.44,$857.48
4700040A,0510,47000,,,,,N/A,N/A,Needle Biopsy Of Liver      ~t,$0.00,$0.00,$161.95,$768.05,$161.95,$383.15,$161.95,$337.73,$161.95,$768.05,$161.95,$383.15,$161.95,$395.00,$161.95,$161.95,$383.15
4700140A,0510,47001,,,,,N/A,N/A,Needle Biopsy Of Liver      ~t,$0.00,$0.00,$82.41,$201.00,$82.41,$194.97,$82.41,$171.86,$82.41,$149.98,$82.41,$194.97,$82.41,$201.00,$82.41,$82.41,$194.97
4710040A,0510,47100,,,,,N/A,N/A,Wedge Biopsy Of Liver       ~t,$0.00,$0.00,$171.65,"$1,672.00",N/A,"$1,621.84",N/A,"$1,429.56",N/A,$171.65,N/A,"$1,621.84",N/A,"$1,672.00",N/A,N/A,"$1,621.84"
4756240A,0510,47562,,,,,N/A,N/A,Laparoscopic Cholecystectomy~t,$0.00,$0.00,$119.85,"$1,522.00",$624.20,"$1,476.34",$624.20,"$1,301.31",$624.20,$119.85,$624.20,"$1,476.34",$624.20,"$1,522.00",$624.20,$624.20,"$1,476.34"
4756340A,0510,47563,,,,,N/A,N/A,Laparo Cholecystectomy/Graph~t,$0.00,$0.00,$669.53,"$1,633.00",$669.53,"$1,584.01",$669.53,"$1,396.22",$669.53,"$1,108.95",$669.53,"$1,584.01",$669.53,"$1,633.00",$669.53,$669.53,"$1,584.01"
4756440A,0510,47564,,,,,N/A,N/A,Chol W/Explor Of Com Duct   ~t,$0.00,$0.00,$89.93,"$2,173.00",$89.93,"$2,107.81",$89.93,"$1,857.92",$89.93,"$1,206.63",$89.93,"$2,107.81",$89.93,"$2,173.00",$89.93,$89.93,"$2,107.81"
4760040A,0510,47600,,,,,N/A,N/A,Removal Of Gallbladder      ~t,$0.00,$0.00,$765.47,"$1,875.98",$765.47,"$1,810.99",$765.47,"$1,596.29",$765.47,"$1,875.98",$765.47,"$1,810.99",$765.47,"$1,867.00",$765.47,$765.47,"$1,810.99"
4760540A,0510,47605,,,,,N/A,N/A,Cholecysectomy W/Cholngigrpy~t,$0.00,$0.00,$759.32,"$1,852.00",$759.32,"$1,796.44",$759.32,"$1,583.46",$759.32,"$1,794.51",$759.32,"$1,796.44",$759.32,"$1,852.00",$759.32,$759.32,"$1,796.44"
4761040A,0510,47610,,,,,N/A,N/A,Chole W/Explo Common Duct   ~t,$0.00,$0.00,$12.40,"$2,444.00",$12.40,"$2,370.68",$12.40,"$2,089.62",$12.40,"$1,890.03",$12.40,"$2,370.68",$12.40,"$2,444.00",$12.40,$12.40,"$2,370.68"
4778040A,0510,47780,,,,,N/A,N/A,Anastomosis Royx-En-Y       ~t,$0.00,$0.00,"$1,893.79","$4,619.00","$1,893.79","$4,480.43","$1,893.79","$3,949.25","$1,893.79","$2,100.11","$1,893.79","$4,480.43","$1,893.79","$4,619.00","$1,893.79","$1,893.79","$4,480.43"
4799940,0510,47999,,,,,N/A,N/A,Unlisted Proc Biliary Tract,$0.00,$0.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4900040A,0510,49000,,,,,N/A,N/A,Exploration Of Abdomen      ~t,$0.00,$0.00,$66.92,"$1,881.85",$66.92,"$1,563.64",$66.92,"$1,378.26",$66.92,"$1,881.85",$66.92,"$1,563.64",$66.92,"$1,612.00",$66.92,$66.92,"$1,563.64"
4900240A,0510,49002,,,,,N/A,N/A,Reopening Of Abdomen        ~t,$0.00,$0.00,$86.60,"$1,966.00",$86.60,"$1,907.02",$86.60,"$1,680.93",$86.60,"$1,290.76",$86.60,"$1,907.02",$86.60,"$1,966.00",$86.60,$86.60,"$1,907.02"
4901040A,0510,49010,,,,,N/A,N/A,Exploration Behind Abdomen  ~t,$0.00,$0.00,$72.74,"$1,748.29",$72.74,"$1,662.58",$72.74,"$1,465.47",$72.74,"$1,748.29",$72.74,"$1,662.58",$72.74,"$1,714.00",$72.74,$72.74,"$1,662.58"
4908240A,0510,49082,,,,,N/A,N/A,Abd Paracentesis            ~t,$0.00,$0.00,$85.69,$209.00,$85.69,$202.73,$85.69,$178.70,$85.69,N/A,$85.69,$202.73,$85.69,$209.00,$85.69,$85.69,$202.73
4908340A,0510,49083,,,,,N/A,N/A,Expl. & Drain Proc W/Imag   ~t,$0.00,$0.00,$123.62,$386.00,$158.26,$374.42,$158.26,$330.03,$158.26,$123.62,$158.26,$374.42,$158.26,$386.00,$158.26,$158.26,$374.42
4908440A,0510,49084,,,,,N/A,N/A,Exploratory/Drainage Proc   ~t,$0.00,$0.00,$83.23,$203.00,$83.23,$196.91,$83.23,$173.57,$83.23,$180.72,$83.23,$196.91,$83.23,$203.00,$83.23,$83.23,$196.91
4918040A,0510,49180,,,,,N/A,N/A,"BIOPSY, ABDOMINAL MASS      ~T",$25.22,$18.75,$166.46,$406.00,$166.46,$393.82,$166.46,$347.13,$166.46,$179.64,$166.46,$393.82,$166.46,$406.00,$166.46,$166.46,$393.82
4920340A,0510,49203,,,,,N/A,N/A,Exc Abd Tum 5 Cm Or Less    ~t,$0.00,$0.00,$142.16,"$2,065.00",$846.65,"$2,003.05",$846.65,"$1,765.58",$846.65,$142.16,$846.65,"$2,003.05",$846.65,"$2,065.00",$846.65,$846.65,"$2,003.05"
4920440A,0510,49204,,,,,N/A,N/A,Open Restruction/Excision   ~t,$0.00,$0.00,"$1,228.77","$2,997.00","$1,228.77","$2,907.09","$1,228.77","$2,562.44","$1,228.77","$2,003.98","$1,228.77","$2,907.09","$1,228.77","$2,997.00","$1,228.77","$1,228.77","$2,907.09"
4925540A,0510,49255,,,,,N/A,N/A,Removal Of Omentum          ~t,$0.00,$0.00,$6.65,"$1,465.00",$6.65,"$1,421.05",$6.65,"$1,252.58",$6.65,$994.00,$6.65,"$1,421.05",$6.65,"$1,465.00",$6.65,$6.65,"$1,421.05"
4932040A,0510,49320,,,,,N/A,N/A,Laparoscopy Sep Procedure   ~t,$0.00,$0.00,$251.33,"$1,332.82",$251.33,$594.61,$251.33,$524.12,$251.33,"$1,332.82",$251.33,$594.61,$251.33,$613.00,$251.33,$251.33,$594.61
4932240A,0510,49322,,,,,N/A,N/A,"Laparoscopy, Aspiration     ~t",$0.00,$0.00,$336.20,$820.00,$336.20,$795.40,$336.20,$701.10,$336.20,$581.93,$336.20,$795.40,$336.20,$820.00,$336.20,$336.20,$795.40
4932940,0510,49329,,,,,N/A,N/A,Unlisted Lap Prod Abd,$0.00,$0.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4940240A,0510,49402,,,,,N/A,N/A,"REMOVE FOREIGN BODY, ADBOMEN~T",$14.13,$10.50,$631.27,"$1,614.00",$661.74,"$1,565.58",$661.74,"$1,379.97",$661.74,$631.27,$661.74,"$1,565.58",$661.74,"$1,614.00",$661.74,$661.74,"$1,565.58"
4940540A,0510,49405,,,,,N/A,N/A,Image Guided Fluid Coll     ~t,$0.00,$0.00,$421.48,"$1,434.34",$421.48,$997.16,$421.48,$878.94,$421.48,"$1,434.34",$421.48,$997.16,$421.48,"$1,028.00",$421.48,$421.48,$997.16
4942240A,0510,49422,,,,,N/A,N/A,Remove Perm Cannula/Catheter~t,$0.00,$0.00,$331.36,$865.00,$354.65,$839.05,$354.65,$739.58,$354.65,$331.36,$354.65,$839.05,$354.65,$865.00,$354.65,$354.65,$839.05
4944140A,0510,49441,,,,,N/A,N/A,Place Duod/Jej Tube Perc    ~t,$0.00,$0.00,$25.82,$502.00,$25.82,$486.94,$25.82,$429.21,$25.82,$368.89,$25.82,$486.94,$25.82,$502.00,$25.82,$25.82,$486.94
4945040A,0510,49450,,,,,N/A,N/A,REPLACE G/C TUBE PERC       ~T,$22.20,$16.50,$344.40,$344.40,$344.40,N/A,$344.40,N/A,$344.40,N/A,$344.40,N/A,$344.40,N/A,$344.40,$344.40,N/A
4945140A,0510,49451,,,,,N/A,N/A,REPLACE DUOD/JEJ TUBE PERC  ~T,$25.22,$18.75,$364.49,$889.00,$364.49,$862.33,$364.49,$760.10,$364.49,$403.12,$364.49,$862.33,$364.49,$889.00,$364.49,$364.49,$862.33
4950540A,0510,49505,,,,,N/A,N/A,Prp I/Hern Init Reduc >5 Yr ~t,$0.00,$0.00,$44.34,"$1,074.00",$44.34,"$1,041.78",$44.34,$918.27,$44.34,$52.19,$44.34,"$1,041.78",$44.34,"$1,074.00",$44.34,$44.34,"$1,041.78"
4950740A,0510,49507,,,,,N/A,N/A,Prp I/Hern Init Reduc >5 Yr ~t,$0.00,$0.00,$544.89,"$1,329.00",$544.89,"$1,289.13",$544.89,"$1,136.30",$544.89,$880.74,$544.89,"$1,289.13",$544.89,"$1,329.00",$544.89,$544.89,"$1,289.13"
4952040A,0510,49520,,,,,N/A,N/A,"Rerepair Ing Hernia, Reduce ~t",$0.00,$0.00,$546.53,"$1,333.00",$546.53,"$1,293.01",$546.53,"$1,139.72",$546.53,$988.12,$546.53,"$1,293.01",$546.53,"$1,333.00",$546.53,$546.53,"$1,293.01"
4952140A,0510,49521,,,,,N/A,N/A,Rerepairing Hernia Blocked  ~t,$0.00,$0.00,$716.27,"$1,747.00",$716.27,"$1,694.59",$716.27,"$1,493.00",$716.27,"$1,064.24",$716.27,"$1,694.59",$716.27,"$1,747.00",$716.27,$716.27,"$1,694.59"
4952540A,0510,49525,,,,,N/A,N/A,"Repair Ing Hernia, Sliding  ~t",$0.00,$0.00,$49.36,"$1,204.49",$49.36,"$1,160.12",$49.36,"$1,022.58",$49.36,"$1,204.49",$49.36,"$1,160.12",$49.36,"$1,196.00",$49.36,$49.36,"$1,160.12"
4955040A,0510,49550,,,,,N/A,N/A,"Rpr Rem Hernia, Init, Reduce~t",$0.00,$0.00,$494.87,"$1,207.00",$494.87,"$1,170.79",$494.87,"$1,031.99",$494.87,$966.31,$494.87,"$1,170.79",$494.87,"$1,207.00",$494.87,$494.87,"$1,170.79"
4955340A,0510,49553,,,,,N/A,N/A,Removal Of Small Intestine  ~t,$0.00,$0.00,$478.47,"$1,167.00",$478.47,"$1,131.99",$478.47,$997.79,$478.47,$971.55,$478.47,"$1,131.99",$478.47,"$1,167.00",$478.47,$478.47,"$1,131.99"
4965040A,0510,49650,,,,,N/A,N/A,Lap Ing Hernia Repair Init  ~p,$0.00,$0.00,$343.58,$838.00,$343.58,$812.86,$343.58,$716.49,$343.58,$838.00,$343.58,$812.86,$343.58,$838.00,$343.58,$343.58,$812.86
4965140A,0510,49651,,,,,N/A,N/A,Repair Recur Inguin Hernia  ~t,$0.00,$0.00,$421.70,"$1,027.00",$421.70,$996.19,$421.70,$878.09,$421.70,$729.43,$421.70,$996.19,$421.70,"$1,027.00",$421.70,$421.70,$996.19
4965340A,0510,49653,,,,,N/A,N/A,LAP VENT/ABD HERN PROC COMP ~T,$41.37,$30.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4990040A,0510,49900,,,,,N/A,N/A,Surgical Repair Abd Wall    ~t,$0.00,$0.00,$665.20,"$1,622.00",$665.20,"$1,573.34",$665.20,"$1,386.81",$665.20,$949.27,$665.20,"$1,573.34",$665.20,"$1,622.00",$665.20,$665.20,"$1,573.34"
4990540A,0510,49905,,,,,N/A,N/A,OMENTAL FLAP INTRA-ABDOM    ~T,$38.34,$28.50,$343.58,"$1,378.50",$343.58,$812.86,$343.58,$716.49,$343.58,"$1,378.50",$343.58,$812.86,$343.58,$838.00,$343.58,$343.58,$812.86
5008040A,0510,50080,,,,,N/A,N/A,Percut Nephrostolithomtomy  ~t,$0.00,$0.00,$586.20,"$1,949.00",$799.90,"$1,890.53",$799.90,"$1,666.40",$799.90,$586.20,$799.90,"$1,890.53",$799.90,"$1,949.00",$799.90,$799.90,"$1,890.53"
5038540A,0510,50385,,,,,N/A,N/A,CHANGE STENT VIA TRANSURETH ~T,$30.27,$22.50,$188.60,"$1,420.18",$188.60,$446.20,$188.60,$393.30,$188.60,"$1,420.18",$188.60,$446.20,$188.60,$460.00,$188.60,$188.60,$446.20
5043140A,0510,50431,,,,,N/A,N/A,Percutaneous & Injection Pro~t,$0.00,$0.00,$38.32,$752.00,$38.32,$729.44,$38.32,$642.96,$38.32,$355.30,$38.32,$729.44,$38.32,$752.00,$38.32,$38.32,$729.44
5054540A,0510,50545,,,,,N/A,N/A,Laparo Radical Nephrectomy  ~t,$0.00,$0.00,$245.73,"$3,086.00","$1,265.26","$2,993.42","$1,265.26","$2,638.53","$1,265.26",$245.73,"$1,265.26","$2,993.42","$1,265.26","$3,086.00","$1,265.26","$1,265.26","$2,993.42"
5059040A,0510,50590,,,,,N/A,N/A,FRAGMENTING OF KIDNEY STONE ~T,$27.24,$20.25,$527.26,"$1,962.52",$527.26,"$1,247.42",$527.26,"$1,099.53",$527.26,"$1,962.52",$527.26,"$1,247.42",$527.26,"$1,286.00",$527.26,$527.26,"$1,247.42"
5104040A,0510,51040,,,,,N/A,N/A,Cystostomy With Drainage    ~t,$0.00,$0.00,$293.15,$715.00,$293.15,$693.55,$293.15,$611.33,$293.15,$715.00,$293.15,$693.55,$293.15,$715.00,$293.15,$293.15,$693.55
5104540A,0510,51045,,,,,N/A,N/A,Cystostomy                  ~t,$0.00,$0.00,$46.72,$992.00,$46.72,$962.24,$46.72,$848.16,$46.72,$478.69,$46.72,$962.24,$46.72,$992.00,$46.72,$46.72,$962.24
5105040A,0510,51050,,,,,N/A,N/A,Removal Of Bladder Stone    ~t,$0.00,$0.00,$39.32,$952.00,$39.32,$923.44,$39.32,$813.96,$39.32,$820.73,$39.32,$923.44,$39.32,$952.00,$39.32,$39.32,$923.44
5110240A,0510,51102,,,,,N/A,N/A,CYSTOSCOPY                  ~T,$53.47,$39.75,$147.19,$775.35,$147.19,$348.23,$147.19,$306.95,$147.19,$775.35,$147.19,$348.23,$147.19,$359.00,$147.19,$147.19,$348.23
5150040A,0510,51500,,,,,N/A,N/A,Removal Of Bladder Cyst     ~t,$0.00,$0.00,$236.79,"$1,418.00",N/A,"$1,375.46",N/A,"$1,212.39",N/A,$236.79,N/A,"$1,375.46",N/A,"$1,418.00",N/A,N/A,"$1,375.46"
5161040A,0510,51610,,,,,N/A,N/A,"Introduction, Inj Procedure ~t",$0.00,$0.00,$122.59,"$1,045.14",$122.59,$290.03,$122.59,$255.65,$122.59,"$1,045.14",$122.59,$290.03,$122.59,$299.00,$122.59,$122.59,$290.03
5170040A,0510,51700,,,,,N/A,N/A,BLADDER IRRIGATION          ~T,$156.39,$116.25,$92.25,$225.00,$92.25,$218.25,$92.25,$192.38,$92.25,$104.39,$92.25,$218.25,$92.25,$225.00,$92.25,$92.25,$218.25
5170140A,0510,51701,,,,,N/A,N/A,INSERT BLADDER CATHETER     ~T,$11.10,$8.25,$48.79,$119.00,$48.79,$115.43,$48.79,$101.75,$48.79,$49.87,$48.79,$115.43,$48.79,$119.00,$48.79,$48.79,$115.43
5170240A,0510,51702,,,,,N/A,N/A,INSERT TEMP BLADDER CATH    ~T,$8.07,$6.00,$41.35,$124.00,$59.86,$120.28,$59.86,$106.02,$59.86,$41.35,$59.86,$120.28,$59.86,$124.00,$59.86,$59.86,$120.28
5170340A,0510,51703,,,,,N/A,N/A,"Intro Compl Alt Ana, Fx Cath~t",$0.00,$0.00,$41.02,$239.00,$97.99,$231.83,$97.99,$204.35,$97.99,$41.02,$97.99,$231.83,$97.99,$239.00,$97.99,$97.99,$231.83
5170345A,0510,51703,,,,,N/A,N/A,"Intro Compl Alt Ana, Fx Cath~t",$0.00,$0.00,$41.02,$239.00,$97.99,$231.83,$97.99,$204.35,$97.99,$41.02,$97.99,$231.83,$97.99,$239.00,$97.99,$97.99,$231.83
5170540A,0510,51705,,,,,N/A,N/A,CHANGE OF BLADDER TUBE      ~T,$13.12,$9.75,$76.67,$187.00,$76.67,$181.39,$76.67,$159.89,$76.67,$124.30,$76.67,$181.39,$76.67,$187.00,$76.67,$76.67,$181.39
5171040A,0510,51710,,,,,N/A,N/A,CHANGE OF BLADDER TUBE      ~T,$17.15,$12.75,$12.50,$250.00,$12.50,$242.50,$12.50,$213.75,$12.50,$84.12,$12.50,$242.50,$12.50,$250.00,$12.50,$12.50,$242.50
5171540A,0510,51715,,,,,N/A,N/A,Endoscopic Inject Of Implant~t,$0.00,$0.00,$129.45,$476.00,$195.16,$461.72,$195.16,$406.98,$195.16,$129.45,$195.16,$461.72,$195.16,$476.00,$195.16,$195.16,$461.72
5172040A,0510,51720,,,,,N/A,N/A,TREATMENT OF BLADDER LESION ~T,$80.72,$60.00,$93.89,$325.02,$93.89,$241.53,$93.89,$212.90,$93.89,$325.02,$93.89,$241.53,$93.89,$249.00,$93.89,$93.89,$241.53
5172640A,0510,51726,,,,,N/A,N/A,COMPLEX CYSTOMETROGRAM      ~T,$457.05,$339.75,$71.04,$630.00,$258.30,$611.10,$258.30,$538.65,$258.30,$71.04,$258.30,$611.10,$258.30,$630.00,$258.30,$258.30,$611.10
5172840A,0510,51728,,,,,N/A,N/A,CYSTOMETROGRAM W/VP         ~G,$373.31,$277.50,$239.44,$584.00,$239.44,$566.48,$239.44,$499.32,$239.44,$518.32,$239.44,$566.48,$239.44,$584.00,$239.44,$239.44,$566.48
5172940A,0510,51729,,,,,N/A,N/A,CYSTOMETROGRAM W/ VP&UP     ~T,$267.37,$198.75,$223.45,$629.63,$223.45,$528.65,$223.45,$465.98,$223.45,$629.63,$223.45,$528.65,$223.45,$545.00,$223.45,$223.45,$528.65
5174140A,0510,51741,,,,,N/A,N/A,"ELECTRO-UROFLOWMETRY, FIRST ~T",$51.46,$38.25,$164.90,$666.43,N/A,$164.90,N/A,$145.35,N/A,$666.43,N/A,$164.90,N/A,$170.00,N/A,N/A,$164.90
5178440A,0510,51784,,,,,N/A,N/A,ANAL/URINARY MUSCLE STUDY   ~T,$246.18,$183.00,$23.00,$402.00,$164.82,$389.94,$164.82,$343.71,$164.82,$23.00,$164.82,$389.94,$164.82,$402.00,$164.82,$164.82,$389.94
5179740A,0510,51797,,,,,N/A,N/A,INTRAABDONINAL PRESSURE TEST~T,$194.73,$144.75,$110.04,$670.00,$274.70,$649.90,$274.70,$572.85,$274.70,$110.04,$274.70,$649.90,$274.70,$670.00,$274.70,$274.70,$649.90
5179840A,0510,51798,,,,,N/A,N/A,US URINE CAPACITY MEASURE   ~T,$60.54,$45.00,$24.60,$318.31,$24.60,$58.20,$24.60,$51.30,$24.60,$318.31,$24.60,$58.20,$24.60,$60.00,$24.60,$24.60,$58.20
5186040A,0510,51860,,,,,N/A,N/A,REPAIR OF BLADDER WOUND     ~T,$63.56,$47.25,$17.13,"$1,663.00",$681.83,"$1,613.11",$681.83,"$1,421.87",$681.83,$17.13,$681.83,"$1,613.11",$681.83,"$1,663.00",$681.83,$681.83,"$1,613.11"
5200040A,0510,52000,,,,,N/A,N/A,CYSTOSCOPY                  ~T,$21.19,$15.75,$123.82,"$1,217.63",$123.82,$292.94,$123.82,$258.21,$123.82,"$1,217.63",$123.82,$292.94,$123.82,$302.00,$123.82,$123.82,$292.94
5200140A,0510,52001,,,,,N/A,N/A,Cystourethroscopy W/Irrig   ~t,$0.00,$0.00,$35.45,$745.00,$35.45,$722.65,$35.45,$636.98,$35.45,$130.67,$35.45,$722.65,$35.45,$745.00,$35.45,$35.45,$722.65
5200540A,0510,52005,,,,,N/A,N/A,CYSTCSCOPY & URETER CATHETER~T,$28.25,$21.00,$246.82,$605.00,$246.82,$586.85,$246.82,$517.28,$246.82,$465.79,$246.82,$586.85,$246.82,$605.00,$246.82,$246.82,$586.85
5220440A,0510,52204,,,,,N/A,N/A,CYSTOSCOPY                  ~T,$12.11,$9.00,$215.62,$946.00,N/A,$917.62,N/A,$808.83,N/A,$215.62,N/A,$917.62,N/A,$946.00,N/A,N/A,$917.62
5221440A,0510,52214,,,,,N/A,N/A,"Cystourethroscopy, W/Fulgur ~t",$0.00,$0.00,$229.35,"$1,759.00",$721.19,"$1,706.23",$721.19,"$1,503.95",$721.19,$229.35,$721.19,"$1,706.23",$721.19,"$1,759.00",$721.19,$721.19,"$1,706.23"
5222440A,0510,52224,,,,,N/A,N/A,Cysto W/Treatment           ~t,$0.00,$0.00,$285.98,"$1,867.00",$765.47,"$1,810.99",$765.47,"$1,596.29",$765.47,$285.98,$765.47,"$1,810.99",$765.47,"$1,867.00",$765.47,$765.47,"$1,810.99"
5223440A,0510,52234,,,,,N/A,N/A,Cystoscopy And Treatment    ~t,$0.00,$0.00,$24.67,$587.00,$24.67,$569.39,$24.67,$501.89,$24.67,$330.14,$24.67,$569.39,$24.67,$587.00,$24.67,$24.67,$569.39
5223540A,0510,52235,,,,,N/A,N/A,Cystoscopy And Treatment    ~t,$0.00,$0.00,$281.67,$687.00,$281.67,$666.39,$281.67,$587.39,$281.67,$398.47,$281.67,$666.39,$281.67,$687.00,$281.67,$281.67,$666.39
5224040A,0510,52240,,,,,N/A,N/A,LARGE BLADDER TUMORS        ~T,$50.45,$37.50,$467.53,"$1,214.00",$497.74,"$1,177.58",$497.74,"$1,037.97",$497.74,$467.53,$497.74,"$1,177.58",$497.74,"$1,214.00",$497.74,$497.74,"$1,177.58"
5227640A,0510,52276,,,,,N/A,N/A,Cystoscopy And Treatment    ~t,$0.00,$0.00,$259.53,$633.00,$259.53,$614.01,$259.53,$541.22,$259.53,$402.27,$259.53,$614.01,$259.53,$633.00,$259.53,$259.53,$614.01
5228140A,0510,52281,,,,,N/A,N/A,CYSTOSCOPY AND TREATMENT    ~T,$40.36,$30.00,$289.50,$705.00,$289.50,$683.85,$289.50,$602.78,$289.50,$428.82,$289.50,$683.85,$289.50,$705.00,$289.50,$289.50,$683.85
5228740A,0510,52287,,,,,N/A,N/A,Cystourethroscopy Inj Chemo ~t,$0.00,$0.00,$157.30,$383.00,$157.30,$371.51,$157.30,$327.47,$157.30,$246.80,$157.30,$371.51,$157.30,$383.00,$157.30,$157.30,$371.51
5231040A,0510,52310,,,,,N/A,N/A,CYSTOSCOPY AND TREATMENT    ~T,$43.38,$32.25,$25.41,$501.00,$25.41,$485.97,$25.41,$428.36,$25.41,$274.57,$25.41,$485.97,$25.41,$501.00,$25.41,$25.41,$485.97
5231540A,0510,52315,,,,,N/A,N/A,CYSTOSCOPY AND TREATMENT    ~T,$56.50,$42.00,$245.39,$990.00,$446.90,$960.30,$446.90,$846.45,$446.90,$245.39,$446.90,$960.30,$446.90,$990.00,$446.90,$446.90,$960.30
5231740A,0510,52317,,,,,N/A,N/A,REMOVE BLADDER STONE        ~T,$110.98,$82.50,$82.82,"$2,002.00",$82.82,"$1,941.94",$82.82,"$1,711.71",$82.82,$445.44,$82.82,"$1,941.94",$82.82,"$2,002.00",$82.82,$82.82,"$1,941.94"
5231840A,0510,52318,,,,,N/A,N/A,Remove Bladder Stone        ~t,$0.00,$0.00,$469.45,"$1,145.00",$469.45,"$1,110.65",$469.45,$978.98,$469.45,$562.38,$469.45,"$1,110.65",$469.45,"$1,145.00",$469.45,$469.45,"$1,110.65"
5232040A,0510,52320,,,,,N/A,N/A,CYSTOSCOPY AND TREATMENT    ~T,$90.80,$67.50,$241.90,$767.72,$241.90,$572.30,$241.90,$504.45,$241.90,$767.72,$241.90,$572.30,$241.90,$590.00,$241.90,$241.90,$572.30
5233040A,0510,52330,,,,,N/A,N/A,Cystrthrscpy Mani W/O Re Cal~t,$0.00,$0.00,$519.04,"$1,583.00",$649.30,"$1,535.51",$649.30,"$1,353.47",$649.30,$519.04,$649.30,"$1,535.51",$649.30,"$1,583.00",$649.30,$649.30,"$1,535.51"
5233240A,0510,52332,,,,,N/A,N/A,CYSTOSCOPY AND TREATMENT    ~T,$37.33,$27.75,$387.40,$944.00,$387.40,$915.68,$387.40,$807.12,$387.40,$427.08,$387.40,$915.68,$387.40,$944.00,$387.40,$387.40,$915.68
5234140A,0510,52341,,,,,N/A,N/A,Cysto W/Ureter Stricture Tx ~t,$0.00,$0.00,$252.34,$765.00,$313.65,$742.05,$313.65,$654.08,$313.65,$252.34,$313.65,$742.05,$313.65,$765.00,$313.65,$313.65,$742.05
5234440A,0510,52344,,,,,N/A,N/A,Cyst W/Ureter Treatment     ~t,$0.00,$0.00,$315.29,$769.00,$315.29,$745.93,$315.29,$657.50,$315.29,$460.25,$315.29,$745.93,$315.29,$769.00,$315.29,$315.29,$745.93
5234540A,0510,52345,,,,,N/A,N/A,Cysto/Uretero W/Up Stricture~t,$0.00,$0.00,$425.99,"$1,039.00",$425.99,"$1,007.83",$425.99,$888.35,$425.99,$597.86,$425.99,"$1,007.83",$425.99,"$1,039.00",$425.99,$425.99,"$1,007.83"
5235140A,0510,52351,,,,,N/A,N/A,Cystouretero & Or Pyeloscope~t,$0.00,$0.00,$35.86,$746.00,$35.86,$723.62,$35.86,$637.83,$35.86,$723.40,$35.86,$723.62,$35.86,$746.00,$35.86,$35.86,$723.62
5235240A,0510,52352,,,,,N/A,N/A,Cystouretero W/Stone Remove ~t,$0.00,$0.00,$358.34,$874.00,$358.34,$847.78,$358.34,$747.27,$358.34,$490.19,$358.34,$847.78,$358.34,$874.00,$358.34,$358.34,$847.78
5235340A,0510,52353,,,,,N/A,N/A,Cystouretero W/Lithotripsy  ~t,$0.00,$0.00,$413.28,"$1,008.00",$413.28,$977.76,$413.28,$861.84,$413.28,$573.72,$413.28,$977.76,$413.28,"$1,008.00",$413.28,$413.28,$977.76
5235440A,0510,52354,,,,,N/A,N/A,Ureter Bx Or Fulguration    ~t,$0.00,$0.00,$34.71,$831.00,$34.71,$806.07,$34.71,$710.51,$34.71,$635.16,$34.71,$806.07,$34.71,$831.00,$34.71,$34.71,$806.07
5235640A,0510,52356,,,,,N/A,N/A,Ureteroscopy W/Litho&Indwell~t,$0.00,$0.00,$339.89,$829.00,$339.89,$804.13,$339.89,$708.80,$339.89,$676.26,$339.89,$804.13,$339.89,$829.00,$339.89,$339.89,$804.13
5245040A,0510,52450,,,,,N/A,N/A,INCISION OF PROSTATE        ~T,$49.44,$36.75,$43.90,"$1,049.00",$43.90,"$1,017.53",$43.90,$896.90,$43.90,$673.94,$43.90,"$1,017.53",$43.90,"$1,049.00",$43.90,$43.90,"$1,017.53"
5250040A,0510,52500,,,,,N/A,N/A,REVISION OF BLADDER NECK    ~T,$50.45,$37.50,$471.50,"$1,150.00",$471.50,"$1,115.50",$471.50,$983.25,$471.50,$776.44,$471.50,"$1,115.50",$471.50,"$1,150.00",$471.50,$471.50,"$1,115.50"
5260140A,0510,52601,,,,,N/A,N/A,Prostatectomy (Turp)        ~t,$0.00,$0.00,$599.83,"$1,463.00",$599.83,"$1,419.11",$599.83,"$1,250.87",$599.83,$805.80,$599.83,"$1,419.11",$599.83,"$1,463.00",$599.83,$599.83,"$1,419.11"
5263040A,0510,52630,,,,,N/A,N/A,Remove Prostate Regrowth    ~t,$0.00,$0.00,$446.80,"$1,191.66",$446.80,"$1,055.36",$446.80,$930.24,$446.80,"$1,191.66",$446.80,"$1,055.36",$446.80,"$1,088.00",$446.80,$446.80,"$1,055.36"
5264040A,0510,52640,,,,,N/A,N/A,Post-Op Bladder Neck Contr  ~t,$0.00,$0.00,$364.90,$890.00,$364.90,$863.30,$364.90,$760.95,$364.90,$663.13,$364.90,$863.30,$364.90,$890.00,$364.90,$364.90,$863.30
5264840A,0510,52648,,,,,N/A,N/A,LASER SURGERY OF PROSTATE   ~T,$86.77,$64.50,$525.69,"$2,157.00",$884.37,"$2,092.29",$884.37,"$1,844.24",$884.37,$525.69,$884.37,"$2,092.29",$884.37,"$2,157.00",$884.37,$884.37,"$2,092.29"
5320040A,0510,53200,,,,,N/A,N/A,BIOPSY OF URETHRA           ~T,$44.39,$33.00,$154.57,"$1,132.55",$154.57,$365.69,$154.57,$322.34,$154.57,"$1,132.55",$154.57,$365.69,$154.57,$377.00,$154.57,$154.57,$365.69
5321540A,0510,53215,,,,,N/A,N/A,Excision Male               ~t,$0.00,$0.00,$230.58,"$2,062.00",$845.42,"$2,000.14",$845.42,"$1,763.01",$845.42,$230.58,$845.42,"$2,000.14",$845.42,"$2,062.00",$845.42,$845.42,"$2,000.14"
5322040A,0510,53220,,,,,N/A,N/A,Exc Or Fulg Of Ca Of Urethra~t,$0.00,$0.00,$369.82,"$1,515.04",$369.82,$874.94,$369.82,$771.21,$369.82,"$1,515.04",$369.82,$874.94,$369.82,$902.00,$369.82,$369.82,$874.94
5326540A,0510,53265,,,,,N/A,N/A,TREATMENT OF URETHRA LESION ~T,$25.22,$18.75,$174.25,$741.52,$174.25,$412.25,$174.25,$363.38,$174.25,$741.52,$174.25,$412.25,$174.25,$425.00,$174.25,$174.25,$412.25
5360040A,0510,53600,,,,,N/A,N/A,DILATE URETHRA STRICTURE    ~T,$21.19,$15.75,$63.55,$308.34,$63.55,$150.35,$63.55,$132.53,$63.55,$308.34,$63.55,$150.35,$63.55,$155.00,$63.55,$63.55,$150.35
5360140A,0510,53601,,,,,N/A,N/A,Dilation Urethial Subseq    ~t,$0.00,$0.00,$59.40,$144.00,$59.40,$139.68,$59.40,$123.12,$59.40,$103.63,$59.40,$139.68,$59.40,$144.00,$59.40,$59.40,$139.68
5360540A,0510,53605,,,,,N/A,N/A,Dilation Of Urethral Strct  ~t,$0.00,$0.00,$53.30,$130.00,$53.30,$126.10,$53.30,$111.15,$53.30,$87.09,$53.30,$126.10,$53.30,$130.00,$53.30,$53.30,$126.10
5366040A,0510,53660,,,,,N/A,N/A,Dilation Female Urethra     ~t,$0.00,$0.00,$52.89,$129.00,$52.89,$125.13,$52.89,$110.30,$52.89,$104.53,$52.89,$125.13,$52.89,$129.00,$52.89,$52.89,$125.13
5389940A,0510,53899,,,,,N/A,N/A,Bladder Botox Injection     ~t,$0.00,$0.00,$67.82,$652.00,N/A,$632.44,N/A,$557.46,N/A,$67.82,N/A,$632.44,N/A,$652.00,N/A,N/A,$632.44
5400140A,0510,54001,,,,,N/A,N/A,Slitting Of Prepuce         ~t,$0.00,$0.00,$0.00,$401.00,N/A,$388.97,N/A,$342.86,N/A,$0.00,N/A,$388.97,N/A,$401.00,N/A,N/A,$388.97
5406040A,0510,54060,,,,,N/A,N/A,EXCISION OF PENIS LESION(S) ~T,$29.26,$21.75,$119.72,$292.00,$119.72,$283.24,$119.72,$249.66,$119.72,$229.79,$119.72,$283.24,$119.72,$292.00,$119.72,$119.72,$283.24
5406540A,0510,54065,,,,,N/A,N/A,"DESTRUCTION, PENIS LESION(S)~T",$39.35,$29.25,$138.99,$339.00,$138.99,$328.83,$138.99,$289.85,$138.99,$214.33,$138.99,$328.83,$138.99,$339.00,$138.99,$138.99,$328.83
5410040A,0510,54100,,,,,N/A,N/A,Excision Biopsy Of Penis    ~t,$0.00,$0.00,$19.47,$267.00,$19.47,$258.99,$19.47,$228.29,$19.47,N/A,$19.47,$258.99,$19.47,$267.00,$19.47,$19.47,$258.99
5416140A,0510,54161,,,,,N/A,N/A,Circumcision                ~t,$0.00,$0.00,$158.20,$451.00,$184.91,$437.47,$184.91,$385.61,$184.91,$158.20,$184.91,$437.47,$184.91,$451.00,$184.91,$184.91,$437.47
5416240A,0510,54162,,,,,N/A,N/A,LYSIS PENIL CIRCUMIC LESION ~T,$15.13,$11.25,$178.76,$436.00,$178.76,$422.92,$178.76,$372.78,$178.76,$323.24,$178.76,$422.92,$178.76,$436.00,$178.76,$178.76,$422.92
5420040A,0510,54200,,,,,N/A,N/A,INJ PROCEDURE FOR PEYRONIE  ~T,$18.16,$13.50,$77.80,$327.88,$77.80,$182.36,$77.80,$160.74,$77.80,$327.88,$77.80,$182.36,$77.80,$188.00,$77.80,$77.80,$182.36
5422040A,0510,54220,,,,,N/A,N/A,Treatment Of Penis Lesion   ~t,$0.00,$0.00,$140.97,$356.00,$145.96,$345.32,$145.96,$304.38,$145.96,$140.97,$145.96,$345.32,$145.96,$356.00,$145.96,$145.96,$345.32
5423540A,0510,54235,,,,,N/A,N/A,Penile Injection            ~t,$0.00,$0.00,$6.68,$216.27,$6.68,$143.56,$6.68,$126.54,$6.68,$216.27,$6.68,$143.56,$6.68,$148.00,$6.68,$6.68,$143.56
5440540A,0510,54405,,,,,N/A,N/A,Insert Of Mult-Comp Inf Pros~t,$0.00,$0.00,$119.27,"$1,593.00",N/A,"$1,545.21",N/A,"$1,362.02",N/A,$119.27,N/A,"$1,545.21",N/A,"$1,593.00",N/A,N/A,"$1,545.21"
5450540A,0510,54505,,,,,N/A,N/A,Biopsy Of Testis            ~t,$0.00,$0.00,$482.09,"$1,470.40",N/A,$482.09,N/A,$424.94,N/A,"$1,470.40",N/A,$482.09,N/A,$497.00,N/A,N/A,$482.09
5470040A,0510,54700,,,,,N/A,N/A,I&D Epididymis              ~t,$0.00,$0.00,$482.09,$708.97,N/A,$482.09,N/A,$424.94,N/A,$708.97,N/A,$482.09,N/A,$497.00,N/A,N/A,$482.09
5480040A,0510,54800,,,,,N/A,N/A,BIOPSY OF EPIDIDYMIS        ~T,$15.13,$11.25,$295.85,$350.13,N/A,$295.85,N/A,$260.78,N/A,$350.13,N/A,$295.85,N/A,$305.00,N/A,N/A,$295.85
5484040A,0510,54840,,,,,N/A,N/A,REMOVE EPIDIDYMIS LESION    ~T,$39.35,$29.25,$134.83,$203.71,N/A,$134.83,N/A,$118.85,N/A,$203.71,N/A,$134.83,N/A,$139.00,N/A,N/A,$134.83
5486040A,0510,54860,,,,,N/A,N/A,Removal Of Epididymis       ~t,$0.00,$0.00,$530.62,$891.00,N/A,$864.27,N/A,$761.81,N/A,$530.62,N/A,$864.27,N/A,$891.00,N/A,N/A,$864.27
5500040A,0510,55000,,,,,N/A,N/A,DRAINAGE OF HYDROCELE       ~T,$22.20,$16.50,$193.03,$689.10,N/A,$193.03,N/A,$170.15,N/A,$689.10,N/A,$193.03,N/A,$199.00,N/A,N/A,$193.03
5504040A,0510,55040,,,,,N/A,N/A,Removal Of Hydrocele        ~t,$0.00,$0.00,$137.63,$767.00,$314.47,$743.99,$314.47,$655.79,$314.47,$137.63,$314.47,$743.99,$314.47,$767.00,$314.47,$314.47,$743.99
5504140A,0510,55041,,,,,N/A,N/A,REMOVAL OF HYDROCELES       ~T,$48.43,$36.00,$446.80,"$1,040.00",$446.80,"$1,008.80",$446.80,$889.20,$446.80,$556.84,$446.80,"$1,008.80",$446.80,"$1,040.00",$446.80,$446.80,"$1,008.80"
5510040A,0510,55100,,,,,N/A,N/A,I&D Scrotal Abscess         ~t,$0.00,$0.00,$228.78,$840.86,$228.78,$541.26,$228.78,$477.09,$228.78,$840.86,$228.78,$541.26,$228.78,$558.00,$228.78,$228.78,$541.26
5515040A,0510,55150,,,,,N/A,N/A,REMOVAL OF SCROTUM          ~T,$27.24,$20.25,$274.13,"$1,027.00",$421.70,$996.19,$421.70,$878.09,$421.70,$274.13,$421.70,$996.19,$421.70,"$1,027.00",$421.70,$421.70,$996.19
5517540A,0510,55175,,,,,N/A,N/A,REVISION OF SCROTUM         ~T,$65.58,$48.75,$313.65,$808.94,$313.65,$742.05,$313.65,$654.08,$313.65,$808.94,$313.65,$742.05,$313.65,$765.00,$313.65,$313.65,$742.05
5525040A,0510,55250,,,,,N/A,N/A,REMOVAL OF SPERM DUCT(S)    ~T,$45.40,$33.75,$334.15,$835.00,$334.15,$809.95,$334.15,$713.93,$334.15,$599.85,$334.15,$809.95,$334.15,$835.00,$334.15,$334.15,$809.95
5552040A,0510,55520,,,,,N/A,N/A,REMOVAL OF SPERM CORD LESION~T,$24.21,$18.00,$358.34,$874.00,$358.34,$847.78,$358.34,$747.27,$358.34,$644.75,$358.34,$847.78,$358.34,$874.00,$358.34,$358.34,$847.78
5553040A,0510,55530,,,,,N/A,N/A,REVISE SPERMATIC CORD VEINS ~T,$25.22,$18.75,$33.50,$805.00,$33.50,$780.85,$33.50,$688.28,$33.50,$744.28,$33.50,$780.85,$33.50,$805.00,$33.50,$33.50,$780.85
5553540A,0510,55535,,,,,N/A,N/A,REVISE SPERMATIC CORD VEINS ~T,$25.22,$18.75,$379.25,$925.00,$379.25,$897.25,$379.25,$790.88,$379.25,$579.50,$379.25,$897.25,$379.25,$925.00,$379.25,$379.25,$897.25
5570040A,0510,55700,,,,,N/A,N/A,BIOPSY OF PROSTATE          ~T,$11.10,$8.25,$133.66,$707.45,$133.66,$316.22,$133.66,$278.73,$133.66,$707.45,$133.66,$316.22,$133.66,$326.00,$133.66,$133.66,$316.22
5583140A,0510,55831,,,,,N/A,N/A,Removal Of Prostate         ~t,$0.00,$0.00,$847.47,"$2,067.00",$847.47,"$2,004.99",$847.47,"$1,767.29",$847.47,"$1,429.45",$847.47,"$2,004.99",$847.47,"$2,067.00",$847.47,$847.47,"$2,004.99"
5584540A,0510,55845,,,,,N/A,N/A,Extensive Prostate Surgery  ~t,$0.00,$0.00,"$1,388.67","$3,387.00","$1,388.67","$3,285.39","$1,388.67","$2,895.89","$1,388.67","$1,545.89","$1,388.67","$3,285.39","$1,388.67","$3,387.00","$1,388.67","$1,388.67","$3,285.39"
55845AS40A,0510,55845,,,,,N/A,N/A,Extensive Prostate Surgry As~t,$0.00,$0.00,"$1,388.67","$3,387.00","$1,388.67","$3,285.39","$1,388.67","$2,895.89","$1,388.67","$1,545.89","$1,388.67","$3,285.39","$1,388.67","$3,387.00","$1,388.67","$1,388.67","$3,285.39"
5614240A,0510,56142,,,,,N/A,N/A,LYSIS PENIL CIRCUMIC LESION ~T,$15.13,$11.25,$14.55,"$2,221.57",N/A,$14.55,N/A,$12.83,N/A,"$2,221.57",N/A,$14.55,N/A,$15.00,N/A,N/A,$14.55
5713540A,0510,57135,,,,,N/A,N/A,Remove Vagina Lesion        ~t,$0.00,$0.00,$167.28,$284.95,$167.28,N/A,$167.28,$0.00,$167.28,$284.95,$167.28,N/A,$167.28,N/A,$167.28,$167.28,N/A
5724040A,0510,57240,,,,,N/A,N/A,Repair Bladder & Vagina     ~t,$0.00,$0.00,$378.84,$924.00,$378.84,$896.28,$378.84,$790.02,$378.84,$546.82,$378.84,$896.28,$378.84,$924.00,$378.84,$378.84,$896.28
5728740A,0510,57287,,,,,N/A,N/A,REVISE/REMOVE SLING REPAIR  ~T,$50.45,$37.50,$617.46,"$1,506.00",$617.46,"$1,460.82",$617.46,"$1,287.63",$617.46,"$1,147.66",$617.46,"$1,460.82",$617.46,"$1,506.00",$617.46,$617.46,"$1,460.82"
5728840A,0510,57288,,,,,N/A,N/A,Repair Bladder Defect       ~t,$0.00,$0.00,$723.65,"$1,765.00",$723.65,"$1,712.05",$723.65,"$1,509.08",$723.65,"$1,223.80",$723.65,"$1,712.05",$723.65,"$1,765.00",$723.65,$723.65,"$1,712.05"
5818040A,0510,58180,,,,,N/A,N/A,Partial Hysterectomy        ~t,$0.00,$0.00,$875.35,"$2,135.00",$875.35,"$2,070.95",$875.35,"$1,825.43",$875.35,"$1,668.24",$875.35,"$2,070.95",$875.35,"$2,135.00",$875.35,$875.35,"$2,070.95"
5866040A,0510,58660,,,,,N/A,N/A,"Laparoscopy, Lysis          ~t",$0.00,$0.00,$64.42,"$1,562.00",$64.42,"$1,515.14",$64.42,"$1,335.51",$64.42,$124.93,$64.42,"$1,515.14",$64.42,"$1,562.00",$64.42,$64.42,"$1,515.14"
5866140A,0510,58661,,,,,N/A,N/A,Laparoscopy Remove Adnexa   ~t,$0.00,$0.00,$625.66,"$1,526.00",$625.66,"$1,480.22",$625.66,"$1,304.73",$625.66,"$1,119.07",$625.66,"$1,480.22",$625.66,"$1,526.00",$625.66,$625.66,"$1,480.22"
5872040A,0510,58720,,,,,N/A,N/A,Salp/Oophorectomy Comp/Part ~t,$0.00,$0.00,$575.64,"$1,312.18",$575.64,N/A,$575.64,$0.00,$575.64,"$1,312.18",$575.64,N/A,$575.64,N/A,$575.64,$575.64,N/A
5951440A,0510,59514,,,,,N/A,N/A,Cesarean Delivery Only      ~t,$0.00,$0.00,"$2,126.26","$2,604.92","$2,126.26",N/A,"$2,126.26",$0.00,"$2,126.26","$2,604.92","$2,126.26",N/A,"$2,126.26",N/A,"$2,126.26","$2,126.26",N/A
6227050A,0510,62270,,,,,N/A,N/A,"SPINAL FLUID TAP, DIAGNOSTIC~T",$6.05,$4.50,$83.35,$207.00,$88.97,$200.79,$88.97,$176.99,$88.97,$83.35,$88.97,$200.79,$88.97,$207.00,$88.97,$88.97,$200.79
6227250A,0510,62272,,,,,N/A,N/A,DRAIN CEREBRO SPINAL FLUID  ~T,$38.34,$28.50,$78.63,$291.00,$119.31,$282.27,$119.31,$248.81,$119.31,$78.63,$119.31,$282.27,$119.31,$291.00,$119.31,$119.31,$282.27
6232950A,0510,62329,,,,,N/A,N/A,SPINAL PUNCTURE             ~T,$53.47,$39.75,$113.34,$653.00,$267.73,$633.41,$267.73,$558.32,$267.73,$113.34,$267.73,$633.41,$267.73,$653.00,$267.73,$267.73,$633.41
6236540A,0510,62365,,,,,N/A,N/A,REMOVE SPINE INFUSION DEVICE~T,$50.45,$37.50,$35.14,$854.00,$35.14,$828.38,$35.14,$730.17,$35.14,$495.12,$35.14,$828.38,$35.14,$854.00,$35.14,$35.14,$828.38
6440550,0510,64405,,,,,N/A,N/A,"N BLOCK INJ, OCCIPITAL      ~G",$168.49,$125.25,$63.43,$233.00,$68.47,$226.01,$68.47,$134.99,$68.47,$63.43,$68.47,$226.01,$68.47,$233.00,$68.47,$68.47,$226.01
4564405A,0510,64405,,,,,N/A,N/A,OCCIPITAL NERVE BLOCK       ~T,$41.37,$30.75,$63.43,$233.00,$68.47,$226.01,$68.47,$134.99,$68.47,$63.43,$68.47,$226.01,$68.47,$233.00,$68.47,$68.47,$226.01
6440550A,0510,64405,,,,,N/A,N/A,"N BLOCK INJ, OCCIPITAL      ~T",$21.19,$15.75,$63.43,$233.00,$68.47,$226.01,$68.47,$134.99,$68.47,$63.43,$68.47,$226.01,$68.47,$233.00,$68.47,$68.47,$226.01
6442540A,0510,64425,,,,,N/A,N/A,"N BLOCK INJ,ILIO-ING/HYPOGI ~T",$30.27,$22.50,$12.30,$217.00,$12.30,$210.49,$12.30,$187.36,$12.30,$32.37,$12.30,$210.49,$12.30,$217.00,$12.30,$12.30,$210.49
6442540B,0510,64425,,,,,N/A,N/A,"N BLOCK INJ,ILIO-ING/HYPOGI ~P",$188.67,$140.25,$12.30,$217.00,$12.30,$210.49,$12.30,$187.36,$12.30,$32.37,$12.30,$210.49,$12.30,$217.00,$12.30,$12.30,$210.49
6445040A,0510,64450,,,,,N/A,N/A,"N BLOCK, OTHER PERIPHERAL   ~T",$32.29,$24.00,$68.47,$167.00,$68.47,$161.99,$68.47,$127.02,$68.47,$78.69,$68.47,$161.99,$68.47,$167.00,$68.47,$68.47,$161.99
6445050A,0510,64450,,,,,N/A,N/A,"N BLOCK, OTHER PERIPHERAL   ~T",$32.29,$24.00,$68.47,$167.00,$68.47,$161.99,$68.47,$127.02,$68.47,$78.69,$68.47,$161.99,$68.47,$167.00,$68.47,$68.47,$161.99
6445545A,0510,64455,,,,,N/A,N/A,INJ ANES/STEROID PLANTAR    ~T,$17.15,$12.75,$38.13,$105.79,$38.13,$90.21,$38.13,$58.84,$38.13,$105.79,$38.13,$90.21,$38.13,$93.00,$38.13,$38.13,$90.21
6456640A,0510,64566,,,,,N/A,N/A,"Post Tib Neurostim,Prg Need~t",$0.00,$0.00,$82.41,$201.00,$82.41,$194.97,$82.41,$136.58,$82.41,$122.70,$82.41,$194.97,$82.41,$201.00,$82.41,$82.41,$194.97
6458540A,0510,64585,,,,,N/A,N/A,REVISE/REMOVE NEUROELECTRODE~T,$25.22,$18.75,$39.35,$735.00,$55.35,$712.95,$55.35,$376.31,$55.35,$39.35,$55.35,$712.95,$55.35,$735.00,$55.35,$55.35,$712.95
6459540A,0510,64595,,,,,N/A,N/A,REVISE/REMOVE NEURORECEIVER ~T,$20.18,$15.00,$186.60,$701.00,$287.41,$679.97,$287.41,$533.93,$287.41,$186.60,$287.41,$679.97,$287.41,$701.00,$287.41,$287.41,$679.97
6461250A,0510,64612,,,,,N/A,N/A,CHEMODENERVATION OF MUSCLE  ~T,$283.51,$210.75,$138.70,$572.00,$234.52,$554.84,$234.52,$207.89,$234.52,$138.70,$234.52,$554.84,$234.52,$572.00,$234.52,$234.52,$554.84
6470845A,0510,64708,,,,,N/A,N/A,Revise Arm/Leg Nerve        ~t,$0.00,$0.00,$423.48,"$1,037.00",$425.17,"$1,005.89",$425.17,$548.01,$425.17,$423.48,$425.17,"$1,005.89",$425.17,"$1,037.00",$425.17,$425.17,"$1,005.89"
6471845A,0510,64718,,,,,N/A,N/A,Revise Ulnar Nerve Elbow    ~t,$0.00,$0.00,$462.89,"$1,129.00",$462.89,"$1,095.13",$462.89,$734.47,$462.89,$662.10,$462.89,"$1,095.13",$462.89,"$1,129.00",$462.89,$462.89,"$1,095.13"
6472145A,0510,64721,,,,,N/A,N/A,Carpal Tunnel Surgery       ~t,$0.00,$0.00,$489.13,"$1,193.00",$489.13,"$1,157.21",$489.13,$956.76,$489.13,$529.35,$489.13,"$1,157.21",$489.13,"$1,193.00",$489.13,$489.13,"$1,157.21"
6483145A,0510,64831,,,,,N/A,N/A,Repair Of Digit Nerve       ~t,$0.00,$0.00,$567.43,"$1,556.00",$637.96,"$1,509.32",$637.96,$823.94,$637.96,$567.43,$637.96,"$1,509.32",$637.96,"$1,556.00",$637.96,$637.96,"$1,509.32"
6485745A,0510,64857,,,,,N/A,N/A,Repair Arm/Leg Nerve        ~t,$0.00,$0.00,$898.49,"$2,282.00",$935.62,"$2,213.54",$935.62,"$1,463.29",$935.62,$898.49,$935.62,"$2,213.54",$935.62,"$2,282.00",$935.62,$935.62,"$2,213.54"
7664140A,0510,76641,,,,,N/A,N/A,"Ultrasound, Breast          ~t",$0.00,$0.00,$79.54,$79.54,$79.54,N/A,$79.54,N/A,$79.54,N/A,$79.54,N/A,$79.54,N/A,$79.54,$79.54,N/A
7664540A,0510,76645,,,,,N/A,N/A,Us Exam                     ~t,$0.00,$0.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7687240A,0510,76872,,,,,N/A,N/A,Us. Transrectal             ~t,$0.00,$0.00,$68.60,$68.60,$68.60,N/A,$68.60,N/A,$68.60,N/A,$68.60,N/A,$68.60,N/A,$68.60,$68.60,N/A
7700140A,0510,77001,,,,,N/A,N/A,Fluor Gid Ctr Vad Plmt Rplt ~t,$0.00,$0.00,$453.50,$453.50,$453.50,N/A,$453.50,N/A,$453.50,N/A,$453.50,N/A,$453.50,N/A,$453.50,$453.50,N/A
7700245A,0510,77002,,,,,N/A,N/A,Fluro Guide Needle Placement~t,$0.00,$0.00,$282.80,$282.80,$282.80,N/A,$282.80,N/A,$282.80,N/A,$282.80,N/A,$282.80,N/A,$282.80,$282.80,N/A
7707145A,0510,77071,,,,,N/A,N/A,X-Ray Stress View           ~t,$0.00,$0.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7845234A,0510,78452,,,,,N/A,N/A,Mpi Multiple Studies        ~t,$0.00,$0.00,$464.94,$464.94,$464.94,N/A,$464.94,N/A,$464.94,N/A,$464.94,N/A,$464.94,N/A,$464.94,$464.94,N/A
8501840,0510,85018,,,,,N/A,N/A,HEMOBLOBIN,$16.14,$12.00,$2.93,$16.00,N/A,$15.52,N/A,N/A,N/A,$2.93,N/A,$15.52,N/A,$16.00,N/A,N/A,$15.52
5186580,0510,86580,,,,,N/A,N/A,PPD,$25.22,$18.75,$11.89,$74.61,$11.89,$24.25,$11.89,N/A,$11.89,$74.61,$11.89,$24.25,$11.89,$25.00,$11.89,$11.89,$24.25
5190472,0510,90472,,,,,N/A,N/A,"IMMUNIZATION,EA ADD VACCINE",$26.23,$19.50,$16.96,$181.00,$22.14,$175.57,$22.14,N/A,$22.14,$16.96,$22.14,$175.57,$22.14,$181.00,$22.14,$22.14,$175.57
5190703,0510,90703,,,,,N/A,N/A,"TETANUS TOXOID, ADSORBED IM",$57.51,$42.75,$142.59,$147.00,N/A,$142.59,N/A,N/A,N/A,N/A,N/A,$142.59,N/A,$147.00,N/A,N/A,$142.59
5190707,0510,90707,,,,,N/A,N/A,MMR,$105.94,$78.75,$101.85,$105.00,N/A,$101.85,N/A,N/A,N/A,N/A,N/A,$101.85,N/A,$105.00,N/A,N/A,$101.85
5190715,0510,90715,,,,,N/A,N/A,TDAP VACCINE,$43.38,$32.25,$41.71,$43.00,N/A,$41.71,N/A,N/A,N/A,N/A,N/A,$41.71,N/A,$43.00,N/A,N/A,$41.71
9080150A,0510,90801,,,,,N/A,N/A,PSYCHIATRIC DIAGNSTC INV/EM ~T,$111.99,$83.25,$199.08,$344.00,N/A,$333.68,N/A,N/A,N/A,$199.08,N/A,$333.68,N/A,$344.00,N/A,N/A,$333.68
9080250A,0510,90802,,,,,N/A,N/A,INTRACTVE PSYCHIATRIC INT/EX~T,$110.98,$82.50,$376.36,$388.00,N/A,$376.36,N/A,N/A,N/A,$388.00,N/A,$376.36,N/A,$388.00,N/A,N/A,$376.36
9086250A,0510,90862,,,,,N/A,N/A,PHARMOCOLOGIC MANAGEMENT    ~T,$74.66,$55.50,$114.82,$166.00,N/A,$161.02,N/A,N/A,N/A,$114.82,N/A,$161.02,N/A,$166.00,N/A,N/A,$161.02
9296034A,0510,92960,,,,,N/A,N/A,Cardioversion               ~t,$0.00,$0.00,$1.90,$372.00,$81.55,$360.84,$81.55,N/A,$81.55,$1.90,$81.55,$360.84,$81.55,$372.00,$81.55,$81.55,$360.84
9301634A,0510,93016,,,,,N/A,N/A,Stress Supervision          ~t,$0.00,$0.00,$0.00,$151.10,$27.88,$0.00,$27.88,N/A,$27.88,$151.10,$27.88,$0.00,$27.88,N/A,$27.88,$27.88,$0.00
9301834A,0510,93018,,,,,N/A,N/A,Stress Inter/Report         ~t,$0.00,$0.00,$44.62,$74.25,N/A,$44.62,N/A,N/A,N/A,$74.25,N/A,$44.62,N/A,$46.00,N/A,N/A,$44.62
9304034A,0510,93040,,,,,N/A,N/A,"Ekg Rhythm,1,3leads,W/I&R   ~t",$0.00,$0.00,$17.22,$42.00,$17.22,$40.74,$17.22,N/A,$17.22,$30.80,$17.22,$40.74,$17.22,$42.00,$17.22,$17.22,$40.74
9322734A,0510,93227,,,,,N/A,N/A,Holter Inter                ~t,$0.00,$0.00,$31.16,$76.00,$31.16,$73.72,$31.16,N/A,$31.16,$42.69,$31.16,$73.72,$31.16,$76.00,$31.16,$31.16,$73.72
9322834A,0510,93228,,,,,N/A,N/A,Cer Inter                   ~t,$0.00,$0.00,$24.19,$59.00,$24.19,$57.23,$24.19,N/A,$24.19,$39.69,$24.19,$57.23,$24.19,$59.00,$24.19,$24.19,$57.23
9324834A,0510,93248,,,,,N/A,N/A,14 Day Cardiac Monitoring   ~t,$0.00,$0.00,$25.42,$62.00,$25.42,$60.14,$25.42,N/A,$25.42,$54.30,$25.42,$60.14,$25.42,$62.00,$25.42,$25.42,$60.14
9326034A,0510,93260,,,,,N/A,N/A,SUBCUTANEOUS LEAD DEFIB     ~T,$47.42,$35.25,$56.58,$138.00,$56.58,$133.86,$56.58,N/A,$56.58,$57.16,$56.58,$133.86,$56.58,$138.00,$56.58,$56.58,$133.86
9327234A,0510,93272,,,,,N/A,N/A,"Ecg/Review, Inter Only      ~t",$0.00,$0.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9327934A,0510,93279,,,,,N/A,N/A,PM DEVICE PROGR EVAL        ~T,$18.16,$13.50,$18.96,$87.00,N/A,$84.39,N/A,N/A,N/A,$18.96,N/A,$84.39,N/A,$87.00,N/A,N/A,$84.39
9328034A,0510,93280,,,,,N/A,N/A,PM DEVICE PROGR EVAL        ~T,$23.21,$17.25,$54.94,$142.11,$54.94,$114.46,$54.94,N/A,$54.94,$142.11,$54.94,$114.46,$54.94,$118.00,$54.94,$54.94,$114.46
9328040A,0510,93280,,,,,N/A,N/A,Pacemaker Dev Prog Eval Dual~t,$0.00,$0.00,$54.94,$142.11,$54.94,$114.46,$54.94,N/A,$54.94,$142.11,$54.94,$114.46,$54.94,$118.00,$54.94,$54.94,$114.46
9328134A,0510,93281,,,,,N/A,N/A,PM DEVIC PROG EVAL MULT LEAD~T,$29.26,$21.75,$151.32,$168.15,N/A,$151.32,N/A,N/A,N/A,$168.15,N/A,$151.32,N/A,$156.00,N/A,N/A,$151.32
9328234A,0510,93282,,,,,N/A,N/A,"ICD DEVICE PROG EVAL,1SNGL  ~T",$29.26,$21.75,$11.89,$179.27,$11.89,$139.68,$11.89,N/A,$11.89,$179.27,$11.89,$139.68,$11.89,$144.00,$11.89,$11.89,$139.68
9328334A,0510,93283,,,,,N/A,N/A,"ICD DEVICE PROG EVAL,DUAL   ~T",$36.32,$27.00,$75.85,$185.00,$75.85,$179.45,$75.85,N/A,$75.85,$170.37,$75.85,$179.45,$75.85,$185.00,$75.85,$75.85,$179.45
9328434A,0510,93284,,,,,N/A,N/A,"ICD DEVICE PROG EVAL,MULT   ~T",$46.41,$34.50,$84.50,$208.91,$84.50,$198.85,$84.50,N/A,$84.50,$208.91,$84.50,$198.85,$84.50,$205.00,$84.50,$84.50,$198.85
9328534A,0510,93285,,,,,N/A,N/A,ILR DEVICE EVAL PROG        ~T,$18.16,$13.50,$34.92,$225.95,$84.50,$34.92,$84.50,N/A,$84.50,$225.95,$84.50,$34.92,$84.50,$36.00,$84.50,$84.50,$34.92
9328634A,0510,93286,,,,,N/A,N/A,PERI-PROCEDURAL DEVICE EVAL ~T,$14.13,$10.50,$18.86,$127.28,$18.86,$44.62,$18.86,N/A,$18.86,$127.28,$18.86,$44.62,$18.86,$46.00,$18.86,$18.86,$44.62
9328734A,0510,93287,,,,,N/A,N/A,PERI-PRCDRL DF EVAL         ~T,$54.48,$40.50,$42.23,$103.00,$42.23,$99.91,$42.23,N/A,$42.23,$97.22,$42.23,$99.91,$42.23,$103.00,$42.23,$42.23,$99.91
9328834A,0510,93288,,,,,N/A,N/A,PM DEVICE EVAL IN PERSON    ~T,$18.16,$13.50,$31.16,$113.20,$31.16,$83.42,$31.16,N/A,$31.16,$113.20,$31.16,$83.42,$31.16,$86.00,$31.16,$31.16,$83.42
9328840A,0510,93288,,,,,N/A,N/A,Pacemaker Device Eval/Person~t,$0.00,$0.00,$31.16,$113.20,$31.16,$83.42,$31.16,N/A,$31.16,$113.20,$31.16,$83.42,$31.16,$86.00,$31.16,$31.16,$83.42
9328934A,0510,93289,,,,,N/A,N/A,ICD DEVICE INTERRAGATE      ~T,$36.32,$27.00,$61.91,$151.00,$61.91,$146.47,$61.91,N/A,$61.91,$117.97,$61.91,$146.47,$61.91,$151.00,$61.91,$61.91,$146.47
9329134A,0510,93291,,,,,N/A,N/A,ILR DEVICE INTERRAGATE      ~T,$18.16,$13.50,$34.85,$153.32,$34.85,$82.45,$34.85,N/A,$34.85,$153.32,$34.85,$82.45,$34.85,$85.00,$34.85,$34.85,$82.45
9329434A,0510,93294,,,,,N/A,N/A,PM DEVICE INTERRAGATE REMOTE~T,$18.16,$13.50,$3.75,$103.89,$3.75,$72.75,$3.75,N/A,$3.75,$103.89,$3.75,$72.75,$3.75,$75.00,$3.75,$3.75,$72.75
9329440A,0510,93294,,,,,N/A,N/A,Interro Eval Remote </90    ~t,$0.00,$0.00,$3.75,$103.89,$3.75,$72.75,$3.75,N/A,$3.75,$103.89,$3.75,$72.75,$3.75,$75.00,$3.75,$3.75,$72.75
9329534A,0510,93295,,,,,N/A,N/A,ICD DEVICE INTERROGAT REMOTE~T,$13.12,$9.75,$35.26,$86.00,$35.26,$83.42,$35.26,N/A,$35.26,$63.93,$35.26,$83.42,$35.26,$86.00,$35.26,$35.26,$83.42
9329634A,0510,93296,,,,,N/A,N/A,Pm/Icd Remote Tech Serv     ~t,$0.00,$0.00,$24.60,$79.17,$24.60,$58.20,$24.60,N/A,$24.60,$79.17,$24.60,$58.20,$24.60,$60.00,$24.60,$24.60,$58.20
9329640A,0510,93296,,,,,N/A,N/A,Pm/Icd Remote Tech Serv     ~t,$0.00,$0.00,$24.60,$79.17,$24.60,$58.20,$24.60,N/A,$24.60,$79.17,$24.60,$58.20,$24.60,$60.00,$24.60,$24.60,$58.20
9329834A,0510,93298,,,,,N/A,N/A,Ilr Device Interrogat Remote~t,$0.00,$0.00,$22.96,$56.00,$22.96,$54.32,$22.96,N/A,$22.96,$54.55,$22.96,$54.32,$22.96,$56.00,$22.96,$22.96,$54.32
9330634A,0510,93306,,,,,N/A,N/A,Echo Reading                ~t,$0.00,$0.00,$197.21,$481.00,$197.21,$466.57,$197.21,N/A,$197.21,$439.60,$197.21,$466.57,$197.21,$481.00,$197.21,$197.21,$466.57
9330734A,0510,93307,,,,,N/A,N/A,ECHO EXAM OF HEART          ~T,$25.22,$18.75,$148.82,$473.00,$193.52,$458.81,$193.52,N/A,$193.52,$148.82,$193.52,$458.81,$193.52,$473.00,$193.52,$193.52,$458.81
9330834A,0510,93308,,,,,N/A,N/A,ECHO EXAM OF HEART          ~T,$19.17,$14.25,$25.82,$310.19,$25.82,$251.23,$25.82,N/A,$25.82,$310.19,$25.82,$251.23,$25.82,$259.00,$25.82,$25.82,$251.23
9331234A,0510,93312,,,,,N/A,N/A,ECHO TRANSESOPHAGEAL        ~T,$85.76,$63.75,$217.75,$711.00,$476.10,$689.67,$476.10,N/A,$476.10,$217.75,$476.10,$689.67,$476.10,$711.00,$476.10,$476.10,$689.67
9335034A,0510,93350,,,,,N/A,N/A,Stress Echo                 ~t,$0.00,$0.00,$21.74,$467.00,$21.74,$452.99,$21.74,N/A,$21.74,$54.13,$21.74,$452.99,$21.74,$467.00,$21.74,$21.74,$452.99
9372734A,0510,93727,,,,,N/A,N/A,"Ecg/Review, Inter Only      ~t",$0.00,$0.00,$65.96,$415.87,N/A,$65.96,N/A,N/A,N/A,$415.87,N/A,$65.96,N/A,$68.00,N/A,N/A,$65.96
9388040A,0510,93880,,,,,N/A,N/A,Noninvasive Tests Arteries  ~t,$0.00,$0.00,$19.37,$323.00,$132.43,$313.31,$132.43,N/A,$132.43,$19.37,$132.43,$313.31,$132.43,$323.00,$132.43,$132.43,$313.31
9388240A,0510,93882,,,,,N/A,N/A,Noninvasive Tests Arteries  ~t,$0.00,$0.00,$1.45,$245.00,$1.45,$237.65,$1.45,N/A,$1.45,$231.93,$1.45,$237.65,$1.45,$245.00,$1.45,$1.45,$237.65
9392240A,0510,93922,,,,,N/A,N/A,NONINVASIVE VASCULAR STUDIES~T,$24.21,$18.00,$73.39,$179.00,$73.39,$173.63,$73.39,N/A,$73.39,$150.58,$73.39,$173.63,$73.39,$179.00,$73.39,$73.39,$173.63
5194799,0510,94799,,,,,N/A,N/A,RESPIRATOR CLEARANCE,$85.76,$63.75,$10.78,$85.00,N/A,$82.45,N/A,N/A,N/A,$10.78,N/A,$82.45,N/A,$85.00,N/A,N/A,$82.45
9571750A,0510,95717,,,,,N/A,N/A,Eeg 2-12 Hours W/O Video    ~t,$0.00,$0.00,$201.76,$387.71,N/A,$201.76,N/A,N/A,N/A,$387.71,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
9571850A,0510,95718,,,,,N/A,N/A,Eeg 2-12 Hours W/Video      ~t,$0.00,$0.00,$132.21,$273.00,N/A,$264.81,N/A,N/A,N/A,$132.21,N/A,$264.81,N/A,$273.00,N/A,N/A,$264.81
9571950A,0510,95719,,,,,N/A,N/A,Eeg 12-26 Hours W/O Video   ~t,$0.00,$0.00,$174.79,$321.00,N/A,$311.37,N/A,N/A,N/A,$174.79,N/A,$311.37,N/A,$321.00,N/A,N/A,$311.37
9572050A,0510,95720,,,,,N/A,N/A,Eeg 12-26 Hours W/Video,$0.00,$0.00,$204.54,$423.00,N/A,$410.31,N/A,N/A,N/A,$204.54,N/A,$410.31,N/A,$423.00,N/A,N/A,$410.31
9572150A,0510,95721,,,,,N/A,N/A,EEG UP TO 60HRS W/O VIDEO   ~T,$9.08,$6.75,$269.04,$400.00,N/A,$388.00,N/A,N/A,N/A,$269.04,N/A,$388.00,N/A,$400.00,N/A,N/A,$388.00
9572250A,0510,95722,,,,,N/A,N/A,Eeg >36hr Up To 60hrs       ~t,$0.00,$0.00,$269.50,$450.00,N/A,$436.50,N/A,N/A,N/A,$269.50,N/A,$436.50,N/A,$450.00,N/A,N/A,$436.50
9572350A,0510,95723,,,,,N/A,N/A,Eeg > 60hrs                 ~t,$0.00,$0.00,$50.44,$328.26,N/A,$50.44,N/A,N/A,N/A,$328.26,N/A,$50.44,N/A,$52.00,N/A,N/A,$50.44
9572450A,0510,95724,,,,,N/A,N/A,EEG 60-74 HOURS             ~T,$35.31,$26.25,$333.60,$635.00,N/A,$615.95,N/A,N/A,N/A,$333.60,N/A,$615.95,N/A,$635.00,N/A,N/A,$615.95
9581350A,0510,95813,,,,,N/A,N/A,"EEG, OVER 1 HOUR            ~T",$28.25,$21.00,$465.20,$509.00,N/A,$493.73,N/A,N/A,N/A,$465.20,N/A,$493.73,N/A,$509.00,N/A,N/A,$493.73
9581650A,0510,95816,,,,,N/A,N/A,"Eeg, Awake And Drowsy       ~t",$0.00,$0.00,$362.78,$571.81,N/A,$362.78,N/A,N/A,N/A,$571.81,N/A,$362.78,N/A,$374.00,N/A,N/A,$362.78
9581950A,0510,95819,,,,,N/A,N/A,"EEG, AWAKE AND ASLEEP       ~T",$44.39,$33.00,$430.68,$509.00,N/A,$430.68,N/A,N/A,N/A,$509.00,N/A,$430.68,N/A,$444.00,N/A,N/A,$430.68
9582250A,0510,95822,,,,,N/A,N/A,"EEG, COMA OR SLEEP ONLY     ~T",$25.22,$18.75,$610.89,$701.00,N/A,$679.97,N/A,N/A,N/A,$610.89,N/A,$679.97,N/A,$701.00,N/A,N/A,$679.97
9583050A,0510,95830,,,,,N/A,N/A,INSERT ELECTRODES FOR EEG   ~T,$56.50,$42.00,$269.66,$556.95,N/A,$269.66,N/A,N/A,N/A,$556.95,N/A,$269.66,N/A,$278.00,N/A,N/A,$269.66
9586050A,0510,95860,,,,,N/A,N/A,"MUSCLE TEST, ONE LIMB       ~T",$70.63,$52.50,$169.75,$175.00,N/A,$169.75,N/A,N/A,N/A,$175.00,N/A,$169.75,N/A,$175.00,N/A,N/A,$169.75
9586150A,0510,95861,,,,,N/A,N/A,"MUSCLE TEST, 2 LIMBS        ~T",$116.03,$86.25,$159.87,$260.00,N/A,$252.20,N/A,N/A,N/A,$159.87,N/A,$252.20,N/A,$260.00,N/A,N/A,$252.20
9586950A,0510,95869,,,,,N/A,N/A,"MUSCLE TEST, THOR PARASPINAL~T",$70.63,$52.50,$135.80,$230.91,N/A,$135.80,N/A,N/A,N/A,$230.91,N/A,$135.80,N/A,$140.00,N/A,N/A,$135.80
9587050A,0510,95870,,,,,N/A,N/A,"MUSCLE TEST, NONPARASPINAL  ~T",$45.40,$33.75,$116.40,$137.70,N/A,$116.40,N/A,N/A,N/A,$137.70,N/A,$116.40,N/A,$120.00,N/A,N/A,$116.40
9587450A,0510,95874,,,,,N/A,N/A,Needle Electrom For Guidance~t,$0.00,$0.00,$115.43,$122.95,N/A,$115.43,N/A,N/A,N/A,$122.95,N/A,$115.43,N/A,$119.00,N/A,N/A,$115.43
9588550A,0510,95885,,,,,N/A,N/A,"NEEDLE EMG,EA EXTREMITY     ~T",$77.69,$57.75,$108.64,$112.00,N/A,$108.64,N/A,N/A,N/A,$111.82,N/A,$108.64,N/A,$112.00,N/A,N/A,$108.64
9588650A,0510,95886,,,,,N/A,N/A,"NEEDLE EMG, COMPLETE        ~T",$81.72,$60.75,$89.69,$175.00,N/A,$169.75,N/A,N/A,N/A,$89.69,N/A,$169.75,N/A,$175.00,N/A,N/A,$169.75
9588750A,0510,95887,,,,,N/A,N/A,"NEEDLE EMG,NON-EXT DONEW/NCD~T",$82.73,$61.50,$137.02,$156.00,N/A,$151.32,N/A,N/A,N/A,$137.02,N/A,$151.32,N/A,$156.00,N/A,N/A,$151.32
9590750A,0510,95907,,,,,N/A,N/A,NERVE CONDUCTION STUDY 1-2  ~T,$63.56,$47.25,$118.58,$236.00,N/A,$228.92,N/A,N/A,N/A,$118.58,N/A,$228.92,N/A,$236.00,N/A,N/A,$228.92
9590850A,0510,95908,,,,,N/A,N/A,NERVE CONDUCTION STUDY 3-4  ~T,$76.68,$57.00,$127.13,$291.00,N/A,$282.27,N/A,N/A,N/A,$127.13,N/A,$282.27,N/A,$291.00,N/A,N/A,$282.27
9590950A,0510,95909,,,,,N/A,N/A,NERVE CONDUCTION STUDY 5-6  ~T,$91.81,$68.25,$160.58,$348.00,N/A,$337.56,N/A,N/A,N/A,$160.58,N/A,$337.56,N/A,$348.00,N/A,N/A,$337.56
9591050A,0510,95910,,,,,N/A,N/A,NERVE CONDUCTION STUDY 7-8  ~T,$119.05,$88.50,$191.92,$458.00,N/A,$444.26,N/A,N/A,N/A,$191.92,N/A,$444.26,N/A,$458.00,N/A,N/A,$444.26
9591150A,0510,95911,,,,,N/A,N/A,NERVE CONDUCTION STUDY 9-10 ~T,$137.22,$102.00,$251.96,$555.00,N/A,$538.35,N/A,N/A,N/A,$251.96,N/A,$538.35,N/A,$555.00,N/A,N/A,$538.35
9591250A,0510,95912,,,,,N/A,N/A,NERVE CONDUCTION STUDY 11-12~T,$155.38,$115.50,$302.45,$649.00,N/A,$629.53,N/A,N/A,N/A,$302.45,N/A,$629.53,N/A,$649.00,N/A,N/A,$629.53
9591350A,0510,95913,,,,,N/A,N/A,NERVE CONDUCT STUDY 13 OR > ~T,$173.54,$129.00,$349.58,$752.00,N/A,$729.44,N/A,N/A,N/A,$349.58,N/A,$729.44,N/A,$752.00,N/A,N/A,$729.44
9592350A,0510,95923,,,,,N/A,N/A,SSR NERVE TEST              ~T,$70.63,$52.50,$223.10,$405.87,N/A,$223.10,N/A,N/A,N/A,$405.87,N/A,$223.10,N/A,$230.00,N/A,N/A,$223.10
9597150A,0510,95971,,,,,N/A,N/A,NEURO W/ REPROGRAMMING      ~T,$17.15,$12.75,$24.55,$358.00,$146.78,$347.26,$146.78,N/A,$146.78,$24.55,$146.78,$347.26,$146.78,$358.00,$146.78,$146.78,$347.26
9612750,0510,96127,,,,,N/A,N/A,Emotional/Behavioral Assessm,$0.00,$0.00,$0.00,$120.84,N/A,$0.00,N/A,N/A,N/A,$120.84,N/A,$0.00,N/A,$0.00,N/A,N/A,$0.00
5199420,0510,96160,,,,,N/A,N/A,Resp: Questionnaire Interp,$25.22,$18.75,$1.25,$25.00,$1.25,$24.25,$1.25,N/A,$1.25,$23.17,$1.25,$24.25,$1.25,$25.00,$1.25,$1.25,$24.25
5096372,0510,96372,,,,,N/A,N/A,THERAPEUTIC INJECTION,$40.36,$30.00,$24.15,$283.72,$283.72,N/A,$283.72,N/A,$283.72,$24.15,$283.72,N/A,$283.72,$185.00,$283.72,$283.72,N/A
9637240,0510,96372,,,,,N/A,N/A,INJECTION-MEDICATION,$42.38,$31.50,$24.15,$283.72,$283.72,N/A,$283.72,N/A,$283.72,$24.15,$283.72,N/A,$283.72,$185.00,$283.72,$283.72,N/A
9637250,0510,96372,,,,,N/A,N/A,INJECTION MEDICATION,$42.38,$31.50,$24.15,$283.72,$283.72,N/A,$283.72,N/A,$283.72,$24.15,$283.72,N/A,$283.72,$185.00,$283.72,$283.72,N/A
9640140A,0510,96401,,,,,N/A,N/A,CHEMO ADMINISTRATION        ~T,$330.93,$246.00,$11.79,$328.00,$134.48,$318.16,$134.48,N/A,$134.48,$11.79,$134.48,$318.16,$134.48,$328.00,$134.48,$134.48,$318.16
9640240,0510,96402,,,,,N/A,N/A,CHEMO HORMON ANTINEOPL SQ/IM,$70.63,$52.50,$28.70,$108.95,$28.70,$67.90,$28.70,N/A,$28.70,$108.95,$28.70,$67.90,$28.70,$70.00,$28.70,$28.70,$67.90
9759740A,0510,97597,,,,,N/A,N/A,DEBRIDEMENT WOUND 20 SQ CM< ~T,$105.94,$78.75,$14.55,$170.00,$14.55,$164.90,$14.55,N/A,$14.55,N/A,$14.55,$164.90,$14.55,$170.00,$14.55,$14.55,$164.90
9759745A,0510,97597,,,,,N/A,N/A,ACTIVE WOUND CARE DEBRID    ~T,$105.94,$78.75,$14.55,$170.00,$14.55,$164.90,$14.55,N/A,$14.55,N/A,$14.55,$164.90,$14.55,$170.00,$14.55,$14.55,$164.90
9759840A,0510,97598,,,,,N/A,N/A,Active Wound Care           ~t,$0.00,$0.00,$16.31,$391.00,$16.31,$379.27,$16.31,N/A,$16.31,$40.95,$16.31,$379.27,$16.31,$391.00,$16.31,$16.31,$379.27
97602,0510,97602,,,,,N/A,N/A,WOUND CARE WET TO DRY,$171.52,$127.50,$28.48,$170.00,N/A,$164.90,N/A,N/A,N/A,$28.48,N/A,$164.90,N/A,$170.00,N/A,N/A,$164.90
9760240,0510,97602,,,,,N/A,N/A,WOUND CARE WET TO DRY,$171.52,$127.50,$28.48,$170.00,N/A,$164.90,N/A,N/A,N/A,$28.48,N/A,$164.90,N/A,$170.00,N/A,N/A,$164.90
9760540A,0510,97605,,,,,N/A,N/A,Active Wound Care Neg Press ~t,$0.00,$0.00,$27.88,$96.58,$27.88,$65.96,$27.88,N/A,$27.88,$96.58,$27.88,$65.96,$27.88,$68.00,$27.88,$27.88,$65.96
9760545A,0510,97605,,,,,N/A,N/A,Active Wound Care Neg Press ~t,$0.00,$0.00,$27.88,$96.58,$27.88,$65.96,$27.88,N/A,$27.88,$96.58,$27.88,$65.96,$27.88,$68.00,$27.88,$27.88,$65.96
9760640A,0510,97606,,,,,N/A,N/A,"NEG PRESS WOUND TX, > 50 CM ~T",$10.09,$7.50,$24.60,$60.00,$24.60,$58.20,$24.60,N/A,$24.60,$29.00,$24.60,$58.20,$24.60,$60.00,$24.60,$24.60,$58.20
9760740A,0510,97607,,,,,N/A,N/A,NEG. PRESSURE WOUND THERAPY ~T,$84.75,$63.00,$31.82,$148.00,$64.78,$143.56,$64.78,N/A,$64.78,$31.82,$64.78,$143.56,$64.78,$148.00,$64.78,$64.78,$143.56
9760745A,0510,97607,,,,,N/A,N/A,NEG. PRESSURE WOUND THERAPY ~T,$84.75,$63.00,$31.82,$148.00,$64.78,$143.56,$64.78,N/A,$64.78,$31.82,$64.78,$143.56,$64.78,$148.00,$64.78,$64.78,$143.56
5199000,0510,99000,,,,,N/A,N/A,DRUG SCREEN,$50.45,$37.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
5199199,0510,99199,,,,,N/A,N/A,DRUG SCREEN WITH MRO,$100.89,$75.00,$97.00,$123.02,N/A,$97.00,N/A,N/A,N/A,$123.02,N/A,$97.00,N/A,$100.00,N/A,N/A,$97.00
9600066A,0510,99202,,,,,N/A,N/A,NP-EXPANDED PROBLEM-PA   WIC,$73.65,$54.75,$0.00,$113.00,$52.89,$109.61,$52.89,$192.79,$52.89,$0.00,$52.89,$109.61,$52.89,$113.00,$52.89,$52.89,$109.61
960920225A,0510,99202,,,,,N/A,N/A,NP TC EXPANDED FOCUS MD 25,$192.71,$143.25,$0.00,$113.00,$52.89,$109.61,$52.89,$244.38,$52.89,$0.00,$52.89,$109.61,$52.89,$113.00,$52.89,$52.89,$109.61
9920234A,0510,99202,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT,NEW ~T",$19.17,$14.25,$0.00,$113.00,$52.89,$109.61,$52.89,$90.78,$52.89,$0.00,$52.89,$109.61,$52.89,$113.00,$52.89,$52.89,$109.61
9920240A,0510,99202,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT, NEW~T",$16.14,$12.00,$0.00,$113.00,$52.89,$109.61,$52.89,$192.79,$52.89,$0.00,$52.89,$109.61,$52.89,$113.00,$52.89,$52.89,$109.61
9920245A,0510,99202,,,,,N/A,N/A,OFFICE/OUTPATIENT VISIT NEW ~T,$16.14,$12.00,$0.00,$113.00,$52.89,$109.61,$52.89,$90.78,$52.89,$0.00,$52.89,$109.61,$52.89,$113.00,$52.89,$52.89,$109.61
9920250A,0510,99202,,,,,N/A,N/A,OFFICE/OUTPATIENT VISIT NEW ~T,$16.14,$12.00,$0.00,$113.00,$52.89,$109.61,$52.89,$192.79,$52.89,$0.00,$52.89,$109.61,$52.89,$113.00,$52.89,$52.89,$109.61
9920334A,0510,99203,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT,NEW ~T",$80.72,$60.00,$48.70,$170.00,$69.70,$164.90,$69.70,$244.38,$69.70,$48.70,$69.70,$164.90,$69.70,$170.00,$69.70,$69.70,$164.90
9920340A,0510,99203,,,,,N/A,N/A,OFFICE/OUTPATIENT VISIT NEW ~T,$70.63,$52.50,$48.70,$170.00,$69.70,$164.90,$69.70,$134.79,$69.70,$48.70,$69.70,$164.90,$69.70,$170.00,$69.70,$69.70,$164.90
9920345A,0510,99203,,,,,N/A,N/A,OFFICE/OUTPATIENT VISIT NEW ~T,$70.63,$52.50,$48.70,$170.00,$69.70,$164.90,$69.70,$244.38,$69.70,$48.70,$69.70,$164.90,$69.70,$170.00,$69.70,$69.70,$164.90
9920350A,0510,99203,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT, NEW~T",$70.63,$52.50,$48.70,$170.00,$69.70,$164.90,$69.70,$134.79,$69.70,$48.70,$69.70,$164.90,$69.70,$170.00,$69.70,$69.70,$164.90
9920434A,0510,99204,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT,NEW ~T",$80.72,$60.00,$82.46,$240.00,$98.40,$232.80,$98.40,$192.79,$98.40,$82.46,$98.40,$232.80,$98.40,$240.00,$98.40,$98.40,$232.80
9920440A,0510,99204,,,,,N/A,N/A,OFFICE/OUTPATIENT VISIT NEW ~T,$70.63,$52.50,$82.46,$240.00,$98.40,$232.80,$98.40,$90.78,$98.40,$82.46,$98.40,$232.80,$98.40,$240.00,$98.40,$98.40,$232.80
9920445A,0510,99204,,,,,N/A,N/A,OFFICE/OUTPATIENT VISIT NEW ~T,$70.63,$52.50,$82.46,$240.00,$98.40,$232.80,$98.40,$192.79,$98.40,$82.46,$98.40,$232.80,$98.40,$240.00,$98.40,$98.40,$232.80
9920450A,0510,99204,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT, NEW~T",$70.63,$52.50,$82.46,$240.00,$98.40,$232.80,$98.40,$90.78,$98.40,$82.46,$98.40,$232.80,$98.40,$240.00,$98.40,$98.40,$232.80
9920534A,0510,99205,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT,NEW ~T",$137.22,$102.00,$127.10,$326.00,$127.10,$316.22,$127.10,N/A,$127.10,$134.46,$127.10,$316.22,$127.10,$326.00,$127.10,$127.10,$316.22
9920540A,0510,99205,,,,,N/A,N/A,OFFICE/OUTPATIENT VISIT NEW ~T,$121.07,$90.00,$127.10,$326.00,$127.10,$316.22,$127.10,N/A,$127.10,$134.46,$127.10,$316.22,$127.10,$326.00,$127.10,$127.10,$316.22
9920545A,0510,99205,,,,,N/A,N/A,OFFICE/OUTPATIENT VISIT NEW ~T,$121.07,$90.00,$127.10,$326.00,$127.10,$316.22,$127.10,N/A,$127.10,$134.46,$127.10,$316.22,$127.10,$326.00,$127.10,$127.10,$316.22
9920550A,0510,99205,,,,,N/A,N/A,OFFICE/OUTPATIENT VISIT  NEW~T,$121.07,$90.00,$127.10,$326.00,$127.10,$316.22,$127.10,N/A,$127.10,$134.46,$127.10,$316.22,$127.10,$326.00,$127.10,$127.10,$316.22
3999211,0510,99211,,,,,N/A,N/A,CLINIC VISIT ESTABLISHED,$138.22,$102.75,$24.19,$182.62,$24.19,$57.23,$24.19,$58.97,$24.19,$182.62,$24.19,$57.23,$24.19,$59.00,$24.19,$24.19,$57.23
4900012,0510,99211,,,,,N/A,N/A,CLINIC VISIT ESTABLISHED,$339.00,$252.00,$24.19,$182.62,$24.19,$57.23,$24.19,$135.61,$24.19,$182.62,$24.19,$57.23,$24.19,$59.00,$24.19,$24.19,$57.23
7699211,0510,99211,,,,,N/A,N/A,CLINIC VISIT ESTABLISHED,$147.31,$109.50,$24.19,$182.62,$24.19,$57.23,$24.19,$100.44,$24.19,$182.62,$24.19,$57.23,$24.19,$59.00,$24.19,$24.19,$57.23
9921134A,0510,99211,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT, EST~T",$12.11,$9.00,$24.19,$182.62,$24.19,$57.23,$24.19,$164.07,$24.19,$182.62,$24.19,$57.23,$24.19,$59.00,$24.19,$24.19,$57.23
9921140A,0510,99211,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT, EST~T",$9.08,$6.75,$24.19,$182.62,$24.19,$57.23,$24.19,$44.22,$24.19,$182.62,$24.19,$57.23,$24.19,$59.00,$24.19,$24.19,$57.23
9921145A,0510,99211,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT, EST~T",$9.08,$6.75,$24.19,$182.62,$24.19,$57.23,$24.19,$117.88,$24.19,$182.62,$24.19,$57.23,$24.19,$59.00,$24.19,$24.19,$57.23
9921150A,0510,99211,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT, EST~T",$9.08,$6.75,$24.19,$182.62,$24.19,$57.23,$24.19,N/A,$24.19,$182.62,$24.19,$57.23,$24.19,$59.00,$24.19,$24.19,$57.23
9921234A,0510,99212,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT, EST~T",$13.12,$9.75,$8.95,$59.00,$24.19,$57.23,$24.19,$158.99,$24.19,$8.95,$24.19,$57.23,$24.19,$59.00,$24.19,$24.19,$57.23
9921240A,0510,99212,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT, EST~T",$10.09,$7.50,$8.95,$59.00,$24.19,$57.23,$24.19,$223.43,$24.19,$8.95,$24.19,$57.23,$24.19,$59.00,$24.19,$24.19,$57.23
9921245A,0510,99212,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT, EST~T",$10.09,$7.50,$8.95,$59.00,$24.19,$57.23,$24.19,$164.07,$24.19,$8.95,$24.19,$57.23,$24.19,$59.00,$24.19,$24.19,$57.23
9921250A,0510,99212,,,,,N/A,N/A,OFFICE/OUTPATIENT VISIT EST ~T,$10.09,$7.50,$8.95,$59.00,$24.19,$57.23,$24.19,$44.22,$24.19,$8.95,$24.19,$57.23,$24.19,$59.00,$24.19,$24.19,$57.23
9921334A,0510,99213,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT, EST~T",$29.26,$21.75,$35.65,$98.00,$45.92,$95.06,$45.92,$111.06,$45.92,$35.65,$45.92,$95.06,$45.92,$98.00,$45.92,$45.92,$95.06
9921340A,0510,99213,,,,,N/A,N/A,OFFICE/OUTPATIENT VISIT EST ~T,$25.22,$18.75,$35.65,$98.00,$45.92,$95.06,$45.92,$223.43,$45.92,$35.65,$45.92,$95.06,$45.92,$98.00,$45.92,$45.92,$95.06
9921345A,0510,99213,,,,,N/A,N/A,OFFICE/OUTPATIENT VISIT EST ~T,$25.22,$18.75,$35.65,$98.00,$45.92,$95.06,$45.92,$164.07,$45.92,$35.65,$45.92,$95.06,$45.92,$98.00,$45.92,$45.92,$95.06
9921350A,0510,99213,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT,EST ~T",$25.22,$18.75,$35.65,$98.00,$45.92,$95.06,$45.92,$44.22,$45.92,$35.65,$45.92,$95.06,$45.92,$98.00,$45.92,$45.92,$95.06
9921434A,0510,99214,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT, EST~T",$69.62,$51.75,$66.76,$170.00,$69.70,$164.90,$69.70,$158.99,$69.70,$66.76,$69.70,$164.90,$69.70,$170.00,$69.70,$69.70,$164.90
9921440A,0510,99214,,,,,N/A,N/A,OFFICE/OUTPATIENT VISIT EST ~T,$60.54,$45.00,$66.76,$170.00,$69.70,$164.90,$69.70,$117.63,$69.70,$66.76,$69.70,$164.90,$69.70,$170.00,$69.70,$69.70,$164.90
9921445A,0510,99214,,,,,N/A,N/A,OFFICE/OUTPATIENT VISIT EST ~T,$60.54,$45.00,$66.76,$170.00,$69.70,$164.90,$69.70,$231.34,$69.70,$66.76,$69.70,$164.90,$69.70,$170.00,$69.70,$69.70,$164.90
9921450A,0510,99214,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT, EST~T",$60.54,$45.00,$66.76,$170.00,$69.70,$164.90,$69.70,$82.17,$69.70,$66.76,$69.70,$164.90,$69.70,$170.00,$69.70,$69.70,$164.90
9921534A,0510,99215,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT, EST~T",$73.65,$54.75,$95.53,$230.00,$95.53,$223.10,$95.53,$100.44,$95.53,$98.71,$95.53,$223.10,$95.53,$230.00,$95.53,$95.53,$223.10
9921540A,0510,99215,,,,,N/A,N/A,"OFFICE/OUTPT VISIT, EST     ~T",$70.63,$52.50,$95.53,$230.00,$95.53,$223.10,$95.53,$158.99,$95.53,$98.71,$95.53,$223.10,$95.53,$230.00,$95.53,$95.53,$223.10
9921545A,0510,99215,,,,,N/A,N/A,OFFICE/OUTPATIENT VISIT EST ~T,$70.63,$52.50,$95.53,$230.00,$95.53,$223.10,$95.53,$117.63,$95.53,$98.71,$95.53,$223.10,$95.53,$230.00,$95.53,$95.53,$223.10
9921550A,0510,99215,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT, EST~T",$70.63,$52.50,$95.53,$230.00,$95.53,$223.10,$95.53,$231.34,$95.53,$98.71,$95.53,$223.10,$95.53,$230.00,$95.53,$95.53,$223.10
9922134A,0510,99221,,,,,N/A,N/A,Initial Inpt/Observ Hosp    ~t,$0.00,$0.00,$66.83,$163.00,$66.83,$158.11,$66.83,$189.12,$66.83,$145.27,$66.83,$158.11,$66.83,$163.00,$66.83,$66.83,$158.11
9922140A,0510,99221,,,,,N/A,N/A,Initial Inpt/Observ Hosp    ~t,$0.00,$0.00,$66.83,$163.00,$66.83,$158.11,$66.83,$111.06,$66.83,$145.27,$66.83,$158.11,$66.83,$163.00,$66.83,$66.83,$158.11
9922145A,0510,99221,,,,,N/A,N/A,Initial Inpt/Observ Hosp    ~t,$0.00,$0.00,$66.83,$163.00,$66.83,$158.11,$66.83,$223.43,$66.83,$145.27,$66.83,$158.11,$66.83,$163.00,$66.83,$66.83,$158.11
9922150A,0510,99221,,,,,N/A,N/A,Initial Inpt/Observ Hosp    ~t,$0.00,$0.00,$66.83,$163.00,$66.83,$158.11,$66.83,$164.07,$66.83,$145.27,$66.83,$158.11,$66.83,$163.00,$66.83,$66.83,$158.11
9922234A,0510,99222,,,,,N/A,N/A,Initial Inpt/Observ Hosp    ~t,$0.00,$0.00,$94.30,$259.00,$94.30,$251.23,$94.30,$135.61,$94.30,$98.50,$94.30,$251.23,$94.30,$259.00,$94.30,$94.30,$251.23
9922240A,0510,99222,,,,,N/A,N/A,Initial Inpt/Observ Hosp    ~t,$0.00,$0.00,$94.30,$259.00,$94.30,$251.23,$94.30,$100.44,$94.30,$98.50,$94.30,$251.23,$94.30,$259.00,$94.30,$94.30,$251.23
9922245A,0510,99222,,,,,N/A,N/A,Initial Inpt/Observ Hosp    ~t,$116.03,$86.25,$94.30,$259.00,$94.30,$251.23,$94.30,$158.99,$94.30,$98.50,$94.30,$251.23,$94.30,$259.00,$94.30,$94.30,$251.23
9922250A,0510,99222,,,,,N/A,N/A,Initial Inpt/Observ Hosp    ~t,$116.03,$86.25,$94.30,$259.00,$94.30,$251.23,$94.30,$117.63,$94.30,$98.50,$94.30,$251.23,$94.30,$259.00,$94.30,$94.30,$251.23
9922334A,0510,99223,,,,,N/A,N/A,Initial Hospital Care       ~t,$0.00,$0.00,$133.36,$165.00,$135.30,$160.05,$135.30,$135.61,$135.30,$133.36,$135.30,$160.05,$135.30,$165.00,$135.30,$135.30,$160.05
9922340A,0510,99223,,,,,N/A,N/A,INITIAL HOSPITAL CARE       ~T,$166.48,$123.75,$133.36,$165.00,$135.30,$160.05,$135.30,$100.44,$135.30,$133.36,$135.30,$160.05,$135.30,$165.00,$135.30,$135.30,$160.05
9922345A,0510,99223,,,,,N/A,N/A,INITIAL HOSPITAL CARE       ~T,$166.48,$123.75,$133.36,$165.00,$135.30,$160.05,$135.30,$158.99,$135.30,$133.36,$135.30,$160.05,$135.30,$165.00,$135.30,$135.30,$160.05
9922350A,0510,99223,,,,,N/A,N/A,INITIAL HOSPITAL CARE       ~T,$166.48,$123.75,$133.36,$165.00,$135.30,$160.05,$135.30,$117.63,$135.30,$133.36,$135.30,$160.05,$135.30,$165.00,$135.30,$135.30,$160.05
9923134A,0510,99231,,,,,N/A,N/A,Subsequent Hospital Care    ~t,$0.00,$0.00,$34.30,$196.72,$34.30,$80.51,$34.30,$111.06,$34.30,$196.72,$34.30,$80.51,$34.30,$83.00,$34.30,$34.30,$80.51
9923140A,0510,99231,,,,,N/A,N/A,SUBSEQUENT HOSPITAL CARE    ~T,$13.12,$9.75,$34.30,$196.72,$34.30,$80.51,$34.30,$223.43,$34.30,$196.72,$34.30,$80.51,$34.30,$83.00,$34.30,$34.30,$80.51
9923145A,0510,99231,,,,,N/A,N/A,SUBSEQUENT HOSPITAL CARE    ~T,$13.12,$9.75,$34.30,$196.72,$34.30,$80.51,$34.30,$164.07,$34.30,$196.72,$34.30,$80.51,$34.30,$83.00,$34.30,$34.30,$80.51
9923150A,0510,99231,,,,,N/A,N/A,SUBSEQUENT HOSPITAL CARE    ~T,$13.12,$9.75,$34.30,$196.72,$34.30,$80.51,$34.30,$44.22,$34.30,$196.72,$34.30,$80.51,$34.30,$83.00,$34.30,$34.30,$80.51
9923234A,0510,99232,,,,,N/A,N/A,Subsequent Hospital Care    ~t,$0.00,$0.00,$37.75,$152.00,$62.32,$147.44,$62.32,N/A,$62.32,$37.75,$62.32,$147.44,$62.32,$152.00,$62.32,$62.32,$147.44
9923240A,0510,99232,,,,,N/A,N/A,SUBSEQUENT HOSPITAL CARE    ~T,$60.54,$45.00,$37.75,$152.00,$62.32,$147.44,$62.32,N/A,$62.32,$37.75,$62.32,$147.44,$62.32,$152.00,$62.32,$62.32,$147.44
9923245A,0510,99232,,,,,N/A,N/A,SUBSEQUENT HOSPITAL CARE    ~T,$60.54,$45.00,$37.75,$152.00,$62.32,$147.44,$62.32,N/A,$62.32,$37.75,$62.32,$147.44,$62.32,$152.00,$62.32,$62.32,$147.44
9923250A,0510,99232,,,,,N/A,N/A,SUBSEQUENT HOSPITAL CARE    ~T,$60.54,$45.00,$37.75,$152.00,$62.32,$147.44,$62.32,N/A,$62.32,$37.75,$62.32,$147.44,$62.32,$152.00,$62.32,$62.32,$147.44
9923334A,0510,99233,,,,,N/A,N/A,SUBSEQUENT HOSPITAL CARE    ~T,$85.76,$63.75,$70.61,$219.00,$89.79,$212.43,$89.79,N/A,$89.79,$70.61,$89.79,$212.43,$89.79,$219.00,$89.79,$89.79,$212.43
9923340A,0510,99233,,,,,N/A,N/A,SUBSEQUENT HOSPITAL CARE    ~T,$85.76,$63.75,$70.61,$219.00,$89.79,$212.43,$89.79,N/A,$89.79,$70.61,$89.79,$212.43,$89.79,$219.00,$89.79,$89.79,$212.43
9923345A,0510,99233,,,,,N/A,N/A,SUBSEQUENT HOSPITAL CARE    ~T,$85.76,$63.75,$70.61,$219.00,$89.79,$212.43,$89.79,N/A,$89.79,$70.61,$89.79,$212.43,$89.79,$219.00,$89.79,$89.79,$212.43
9923350A,0510,99233,,,,,N/A,N/A,SUBSEQUENT HOSPITAL CARE    ~T,$85.76,$63.75,$70.61,$219.00,$89.79,$212.43,$89.79,N/A,$89.79,$70.61,$89.79,$212.43,$89.79,$219.00,$89.79,$89.79,$212.43
9923434A,0510,99234,,,,,N/A,N/A,Observ/Hosp Same Date       ~t,$0.00,$0.00,$101.51,$360.00,$147.60,$349.20,$147.60,N/A,$147.60,$101.51,$147.60,$349.20,$147.60,$360.00,$147.60,$147.60,$349.20
9923534A,0510,99235,,,,,N/A,N/A,Observ/Hosp Same Date       ~t,$0.00,$0.00,$128.81,$476.00,$195.16,$461.72,$195.16,N/A,$195.16,$128.81,$195.16,$461.72,$195.16,$476.00,$195.16,$195.16,$461.72
9923540A,0510,99235,,,,,N/A,N/A,Observ/Hosp Same Date       ~t,$0.00,$0.00,$128.81,$476.00,$195.16,$461.72,$195.16,N/A,$195.16,$128.81,$195.16,$461.72,$195.16,$476.00,$195.16,$195.16,$461.72
9923634A,0510,99236,,,,,N/A,N/A,Observ/Hosp Same Date       ~t,$0.00,$0.00,$164.22,$528.00,$243.13,$512.16,$243.13,N/A,$243.13,$164.22,$243.13,$512.16,$243.13,$528.00,$243.13,$243.13,$512.16
9923640A,0510,99236,,,,,N/A,N/A,Observ/Hosp Same Date       ~t,$0.00,$0.00,$164.22,$528.00,$243.13,$512.16,$243.13,N/A,$243.13,$164.22,$243.13,$512.16,$243.13,$528.00,$243.13,$243.13,$512.16
9923834A,0510,99238,,,,,N/A,N/A,Hospital Discharge Day      ~t,$0.00,$0.00,$114.39,$210.77,$114.39,$116.40,$114.39,N/A,$114.39,$210.77,$114.39,$116.40,$114.39,$120.00,$114.39,$114.39,$116.40
9923840A,0510,99238,,,,,N/A,N/A,Hospital Discharge Day      ~t,$0.00,$0.00,$114.39,$210.77,$114.39,$116.40,$114.39,N/A,$114.39,$210.77,$114.39,$116.40,$114.39,$120.00,$114.39,$114.39,$116.40
9923845A,0510,99238,,,,,N/A,N/A,HOSPITAL DISCHARGE DAY      ~T,$60.54,$45.00,$114.39,$210.77,$114.39,$116.40,$114.39,N/A,$114.39,$210.77,$114.39,$116.40,$114.39,$120.00,$114.39,$114.39,$116.40
9923934A,0510,99239,,,,,N/A,N/A,Hospital Discharge Day      ~t,$0.00,$0.00,$11.68,$279.00,$11.68,$270.63,$11.68,N/A,$11.68,$71.11,$11.68,$270.63,$11.68,$279.00,$11.68,$11.68,$270.63
9923940A,0510,99239,,,,,N/A,N/A,Initial Hospital Care       ~t,$0.00,$0.00,$11.68,$279.00,$11.68,$270.63,$11.68,N/A,$11.68,$71.11,$11.68,$270.63,$11.68,$279.00,$11.68,$11.68,$270.63
9924240A,0510,99242,,,,,N/A,N/A,Office Consultation         ~t,$0.00,$0.00,$104.82,$130.00,N/A,$126.10,N/A,N/A,N/A,$104.82,N/A,$126.10,N/A,$130.00,N/A,N/A,$126.10
9924245A,0510,99242,,,,,N/A,N/A,Office Consultation         ~t,$0.00,$0.00,$104.82,$130.00,N/A,$126.10,N/A,N/A,N/A,$104.82,N/A,$126.10,N/A,$130.00,N/A,N/A,$126.10
99242S40A,0510,99242,,,,,N/A,N/A,Office Consultation         ~t,$0.00,$0.00,$104.82,$130.00,N/A,$126.10,N/A,N/A,N/A,$104.82,N/A,$126.10,N/A,$130.00,N/A,N/A,$126.10
9924340A,0510,99243,,,,,N/A,N/A,Office Consultation         ~t,$0.00,$0.00,$66.95,$130.00,N/A,$126.10,N/A,N/A,N/A,$66.95,N/A,$126.10,N/A,$130.00,N/A,N/A,$126.10
9924345A,0510,99243,,,,,N/A,N/A,"Consult, Office             ~t",$0.00,$0.00,$66.95,$130.00,N/A,$126.10,N/A,N/A,N/A,$66.95,N/A,$126.10,N/A,$130.00,N/A,N/A,$126.10
9924350A,0510,99243,,,,,N/A,N/A,Office Consultation         ~t,$0.00,$0.00,$66.95,$130.00,N/A,$126.10,N/A,N/A,N/A,$66.95,N/A,$126.10,N/A,$130.00,N/A,N/A,$126.10
9924434A,0510,99244,,,,,N/A,N/A,Office Consultation         ~t,$0.00,$0.00,$93.66,$248.00,N/A,$240.56,N/A,N/A,N/A,$93.66,N/A,$240.56,N/A,$248.00,N/A,N/A,$240.56
9924440A,0510,99244,,,,,N/A,N/A,Office Consultation         ~t,$0.00,$0.00,$93.66,$248.00,N/A,$240.56,N/A,N/A,N/A,$93.66,N/A,$240.56,N/A,$248.00,N/A,N/A,$240.56
9924445A,0510,99244,,,,,N/A,N/A,Office Consultation         ~t,$0.00,$0.00,$93.66,$248.00,N/A,$240.56,N/A,N/A,N/A,$93.66,N/A,$240.56,N/A,$248.00,N/A,N/A,$240.56
9924450A,0510,99244,,,,,N/A,N/A,Office Consultation         ~t,$0.00,$0.00,$93.66,$248.00,N/A,$240.56,N/A,N/A,N/A,$93.66,N/A,$240.56,N/A,$248.00,N/A,N/A,$240.56
99244S40A,0510,99244,,,,,N/A,N/A,Office Consultation         ~t,$0.00,$0.00,$93.66,$248.00,N/A,$240.56,N/A,N/A,N/A,$93.66,N/A,$240.56,N/A,$248.00,N/A,N/A,$240.56
9924534A,0510,99245,,,,,N/A,N/A,Office Consultation         ~t,$0.00,$0.00,$150.61,$316.00,N/A,$306.52,N/A,N/A,N/A,$150.61,N/A,$306.52,N/A,$316.00,N/A,N/A,$306.52
9924540A,0510,99245,,,,,N/A,N/A,Office Consultation         ~t,$0.00,$0.00,$150.61,$316.00,N/A,$306.52,N/A,N/A,N/A,$150.61,N/A,$306.52,N/A,$316.00,N/A,N/A,$306.52
9924550A,0510,99245,,,,,N/A,N/A,Office Consultation         ~t,$0.00,$0.00,$150.61,$316.00,N/A,$306.52,N/A,N/A,N/A,$150.61,N/A,$306.52,N/A,$316.00,N/A,N/A,$306.52
99245S40A,0510,99245,,,,,N/A,N/A,Office Consultation         ~t,$0.00,$0.00,$150.61,$316.00,N/A,$306.52,N/A,N/A,N/A,$150.61,N/A,$306.52,N/A,$316.00,N/A,N/A,$306.52
9925234A,0510,99252,,,,,N/A,N/A,Initial Inpatient Consult   ~t,$0.00,$0.00,$172.66,$186.26,N/A,$172.66,N/A,N/A,N/A,$186.26,N/A,$172.66,N/A,$178.00,N/A,N/A,$172.66
9925240A,0510,99252,,,,,N/A,N/A,INITIAL INPATIENT CONSULT   ~T,$18.16,$13.50,$172.66,$186.26,N/A,$172.66,N/A,N/A,N/A,$186.26,N/A,$172.66,N/A,$178.00,N/A,N/A,$172.66
9925334A,0510,99253,,,,,N/A,N/A,Initial Inpatient Consult   ~t,$0.00,$0.00,$73.30,$234.00,N/A,$226.98,N/A,N/A,N/A,$73.30,N/A,$226.98,N/A,$234.00,N/A,N/A,$226.98
9925340A,0510,99253,,,,,N/A,N/A,INITIAL INPATIENT CONSULT   ~T,$20.18,$15.00,$73.30,$234.00,N/A,$226.98,N/A,N/A,N/A,$73.30,N/A,$226.98,N/A,$234.00,N/A,N/A,$226.98
9925440A,0510,99254,,,,,N/A,N/A,INITIAL INPATIENT CONSULT   ~T,$26.23,$19.50,$112.66,$336.00,N/A,$325.92,N/A,N/A,N/A,$112.66,N/A,$325.92,N/A,$336.00,N/A,N/A,$325.92
9925450A,0510,99254,,,,,N/A,N/A,Initial Inpatient Consult   ~t,$0.00,$0.00,$112.66,$336.00,N/A,$325.92,N/A,N/A,N/A,$112.66,N/A,$325.92,N/A,$336.00,N/A,N/A,$325.92
9925534A,0510,99255,,,,,N/A,N/A,Initial Inpatient Consult   ~t,$0.00,$0.00,$163.41,$462.00,N/A,$448.14,N/A,N/A,N/A,$163.41,N/A,$448.14,N/A,$462.00,N/A,N/A,$448.14
9925550A,0510,99255,,,,,N/A,N/A,Initial Inpatient Consult   ~g,$0.00,$0.00,$163.41,$462.00,N/A,$448.14,N/A,N/A,N/A,$163.41,N/A,$448.14,N/A,$462.00,N/A,N/A,$448.14
9928134A,0510,99281,,,,,N/A,N/A,Er Depart Visit E&M         ~t,$0.00,$0.00,$28.29,$449.00,$28.29,$435.53,$28.29,N/A,$28.29,$196.81,$28.29,$435.53,$28.29,$449.00,$28.29,$28.29,$435.53
9928145A,0510,99281,,,,,N/A,N/A,Er Depart Visit E&M         ~t,$0.00,$0.00,$28.29,$449.00,$28.29,$435.53,$28.29,N/A,$28.29,$196.81,$28.29,$435.53,$28.29,$449.00,$28.29,$28.29,$435.53
9928234A,0510,99282,,,,,N/A,N/A,Er Depart Visit E&M         ~t,$0.00,$0.00,$5.43,$449.00,$5.43,$435.53,$5.43,N/A,$5.43,$21.65,$5.43,$435.53,$5.43,$449.00,$5.43,$5.43,$435.53
9928240A,0510,99282,,,,,N/A,N/A,New Or Est Patient E&M      ~t,$0.00,$0.00,$5.43,$449.00,$5.43,$435.53,$5.43,N/A,$5.43,$21.65,$5.43,$435.53,$5.43,$449.00,$5.43,$5.43,$435.53
9928334A,0510,99283,,,,,N/A,N/A,Er Depart Visit E&M         ~t,$0.00,$0.00,$41.90,$804.00,$48.79,$779.88,$48.79,N/A,$48.79,$41.90,$48.79,$779.88,$48.79,$804.00,$48.79,$48.79,$779.88
9928340A,0510,99283,,,,,N/A,N/A,Emergency Department E&M    ~t,$0.00,$0.00,$41.90,$804.00,$48.79,$779.88,$48.79,N/A,$48.79,$41.90,$48.79,$779.88,$48.79,$804.00,$48.79,$48.79,$779.88
9928345A,0510,99283,,,,,N/A,N/A,Emergency Department E&M    ~t,$0.00,$0.00,$41.90,$804.00,$48.79,$779.88,$48.79,N/A,$48.79,$41.90,$48.79,$779.88,$48.79,$804.00,$48.79,$48.79,$779.88
9928350A,0510,99283,,,,,N/A,N/A,Emergency Depart Visit E&M  ~t,$0.00,$0.00,$41.90,$804.00,$48.79,$779.88,$48.79,N/A,$48.79,$41.90,$48.79,$779.88,$48.79,$804.00,$48.79,$48.79,$779.88
9928440A,0510,99284,,,,,N/A,N/A,Emergency Dept Visit        ~t,$0.00,$0.00,$70.74,"$1,208.00",$95.53,"$1,171.76",$95.53,N/A,$95.53,$70.74,$95.53,"$1,171.76",$95.53,"$1,208.00",$95.53,$95.53,"$1,171.76"
9928445A,0510,99284,,,,,N/A,N/A,Emergency Department Visit  ~t,$0.00,$0.00,$70.74,"$1,208.00",$95.53,"$1,171.76",$95.53,N/A,$95.53,$70.74,$95.53,"$1,171.76",$95.53,"$1,208.00",$95.53,$95.53,"$1,171.76"
9928540A,0510,99285,,,,,N/A,N/A,Emergency Dept Visit        ~t,$0.00,$0.00,$120.19,"$1,208.00",$145.96,"$1,171.76",$145.96,N/A,$145.96,$120.19,$145.96,"$1,171.76",$145.96,"$1,208.00",$145.96,$145.96,"$1,171.76"
9928545A,0510,99285,,,,,N/A,N/A,Emergency Dept Visit        ~t,$0.00,$0.00,$120.19,"$1,208.00",$145.96,"$1,171.76",$145.96,N/A,$145.96,$120.19,$145.96,"$1,171.76",$145.96,"$1,208.00",$145.96,$145.96,"$1,171.76"
9929134A,0510,99291,,,,,N/A,N/A,"CRITICAL CARE, FIRST HOUR   ~T",$64.57,$48.00,$174.83,"$1,885.00",$225.91,"$1,828.45",$225.91,N/A,$225.91,$174.83,$225.91,"$1,828.45",$225.91,"$1,885.00",$225.91,$225.91,"$1,828.45"
9929140A,0510,99291,,,,,N/A,N/A,"CRITICAL CARE, FIRST HOUR   ~T",$55.49,$41.25,$174.83,"$1,885.00",$225.91,"$1,828.45",$225.91,N/A,$225.91,$174.83,$225.91,"$1,828.45",$225.91,"$1,885.00",$225.91,$225.91,"$1,828.45"
9929234A,0510,99292,,,,,N/A,N/A,CRITICAL CARE ADDL 30 MIN   ~T,$224.99,$167.25,$215.40,$556.00,$227.96,$539.32,$227.96,N/A,$227.96,$215.40,$227.96,$539.32,$227.96,$556.00,$227.96,$227.96,$539.32
9929240A,0510,99292,,,,,N/A,N/A,CRITICAL CARE ADDL 30 MIN   ~T,$199.77,$148.50,$215.40,$556.00,$227.96,$539.32,$227.96,N/A,$227.96,$215.40,$227.96,$539.32,$227.96,$556.00,$227.96,$227.96,$539.32
9930440A,0510,99304,,,,,N/A,N/A,Nursing Facility Care       ~t,$0.00,$0.00,$5.33,$130.00,$5.33,$126.10,$5.33,N/A,$5.33,$108.15,$5.33,$126.10,$5.33,$130.00,$5.33,$5.33,$126.10
9930445A,0510,99304,,,,,N/A,N/A,Nursing Facility Care       ~t,$0.00,$0.00,$5.33,$130.00,$5.33,$126.10,$5.33,N/A,$5.33,$108.15,$5.33,$126.10,$5.33,$130.00,$5.33,$5.33,$126.10
9930450A,0510,99304,,,,,N/A,N/A,Nursing Facility Care       ~t,$0.00,$0.00,$5.33,$130.00,$5.33,$126.10,$5.33,N/A,$5.33,$108.15,$5.33,$126.10,$5.33,$130.00,$5.33,$5.33,$126.10
9930640A,0510,99306,,,,,N/A,N/A,"NURSING FACILITY CARE, INIT ~T",$11.10,$8.25,$56.99,$239.00,$56.99,$231.83,$56.99,N/A,$56.99,$127.62,$56.99,$231.83,$56.99,$239.00,$56.99,$56.99,$231.83
9930645A,0510,99306,,,,,N/A,N/A,"NURSING FACILITY CARE, INIT ~T",$11.10,$8.25,$56.99,$239.00,$56.99,$231.83,$56.99,N/A,$56.99,$127.62,$56.99,$231.83,$56.99,$239.00,$56.99,$56.99,$231.83
9930650A,0510,99306,,,,,N/A,N/A,"Nursing Facility Care, Init ~t",$0.00,$0.00,$56.99,$239.00,$56.99,$231.83,$56.99,N/A,$56.99,$127.62,$56.99,$231.83,$56.99,$239.00,$56.99,$56.99,$231.83
9930840A,0510,99308,,,,,N/A,N/A,"NURSING FAC CARE, SUBSEQ    ~T",$32.29,$24.00,$43.36,$126.00,$51.66,$122.22,$51.66,N/A,$51.66,$43.36,$51.66,$122.22,$51.66,$126.00,$51.66,$51.66,$122.22
9930845A,0510,99308,,,,,N/A,N/A,"NURSING FAC CARE, SUBSEQ    ~T",$32.29,$24.00,$43.36,$126.00,$51.66,$122.22,$51.66,N/A,$51.66,$43.36,$51.66,$122.22,$51.66,$126.00,$51.66,$51.66,$122.22
9930850A,0510,99308,,,,,N/A,N/A,"Nursing Fac Care, Subseq    ~t",$0.00,$0.00,$43.36,$126.00,$51.66,$122.22,$51.66,N/A,$51.66,$43.36,$51.66,$122.22,$51.66,$126.00,$51.66,$51.66,$122.22
9931040A,0510,99310,,,,,N/A,N/A,"Nursing Fac Care, Subseq    ~t",$0.00,$0.00,$11.70,$270.00,$11.70,$261.90,$11.70,N/A,$11.70,$89.87,$11.70,$261.90,$11.70,$270.00,$11.70,$11.70,$261.90
9934740A,0510,99347,,,,,N/A,N/A,"Home Visit, Est Patient     ~t",$0.00,$0.00,$45.10,$216.58,$45.10,$106.70,$45.10,N/A,$45.10,$216.58,$45.10,$106.70,$45.10,$110.00,$45.10,$45.10,$106.70
9934840A,0510,99348,,,,,N/A,N/A,"HOME VISIT, EST PATIENT     ~T",$21.19,$15.75,$7.11,$171.00,$7.11,$165.87,$7.11,N/A,$7.11,$54.21,$7.11,$165.87,$7.11,$171.00,$7.11,$7.11,$165.87
9935440A,0510,99354,,,,,N/A,N/A,"PROLONGED SERVICE, OFFICE   ~T",$48.43,$36.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9935450A,0510,99354,,,,,N/A,N/A,"PROLONGED SERVICE, OFFICE   ~T",$48.43,$36.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9935540A,0510,99355,,,,,N/A,N/A,"PROLONGED SERVICE, OFFICE   ~T",$46.41,$34.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9941750A,0510,99417,,,,,N/A,N/A,Prolonged Services          ~t,$14.13,$10.50,$5.25,$64.00,N/A,N/A,N/A,N/A,N/A,$5.25,N/A,N/A,N/A,$64.00,N/A,N/A,N/A
9944745A,0510,99447,,,,,N/A,N/A,ONLINE/TELEPHONE CONSULT    ~T,$10.09,$7.50,$29.93,$98.91,$29.93,$70.81,$29.93,N/A,$29.93,$98.91,$29.93,$70.81,$29.93,$73.00,$29.93,$29.93,$70.81
9945540,0510,99455,,,,,N/A,N/A,ENT~FAA PHYSICAL,$131.16,$97.50,$33.05,$110.00,$53.30,N/A,$53.30,N/A,$53.30,$33.05,$53.30,N/A,$53.30,$110.00,$53.30,$53.30,N/A
0298T34A,0510,0298T,,,,,N/A,N/A,14 Day Cardiac Monitoring   ~t,$0.00,$0.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
G010440A,0510,G0104,,,,,N/A,N/A,COLORECTAL CA SCREENING;FLEX~T,$28.25,$21.00,$133.86,$187.25,$187.25,$133.86,$187.25,N/A,$187.25,$138.00,$187.25,$133.86,$187.25,$138.00,$187.25,$187.25,$133.86
G010540A,0510,G0105,,,,,N/A,N/A,COLRECT/CA SCREEN COLON HIGH~T,$59.53,$44.25,$338.14,$432.00,$338.14,$419.04,$338.14,N/A,$338.14,$432.00,$338.14,$419.04,$338.14,$432.00,$338.14,$338.14,$419.04
G012140A,0510,G0121,,,,,N/A,N/A,COLRECT/CA SCREEN COLON HIGH~T,$59.53,$44.25,$338.33,$491.00,$338.33,$476.27,$338.33,N/A,$338.33,$491.00,$338.33,$476.27,$338.33,$491.00,$338.33,$338.33,$476.27
G036440A,0510,G0364,,,,,N/A,N/A,Bone Marrow Aspiration      ~t,$0.00,$0.00,$18.00,$18.00,N/A,N/A,N/A,N/A,N/A,$18.00,N/A,N/A,N/A,$18.00,N/A,N/A,N/A
G221234A,0510,G2212,,,,,N/A,N/A,PROLONGED SERVICES          ~T,$14.13,$10.50,$31.54,$64.00,$31.54,$62.08,$31.54,N/A,$31.54,$64.00,$31.54,$62.08,$31.54,$64.00,$31.54,$31.54,$62.08
G221240A,0510,G2212,,,,,N/A,N/A,Prolonged Services          ~t,$0.00,$0.00,$31.54,$64.00,$31.54,$62.08,$31.54,N/A,$31.54,$64.00,$31.54,$62.08,$31.54,$64.00,$31.54,$31.54,$62.08
G221245A,0510,G2212,,,,,N/A,N/A,PROLONGED SERVICES          ~T,$14.13,$10.50,$31.54,$64.00,$31.54,$62.08,$31.54,N/A,$31.54,$64.00,$31.54,$62.08,$31.54,$64.00,$31.54,$31.54,$62.08
G221250A,0510,G2212,,,,,N/A,N/A,PROLONGED SERVICES          ~T,$14.13,$10.50,$31.54,$64.00,$31.54,$62.08,$31.54,N/A,$31.54,$64.00,$31.54,$62.08,$31.54,$64.00,$31.54,$31.54,$62.08
51J1885,0510,J1885,,,,,N/A,N/A,TORADOL PER 15MG,$10.09,$7.50,$55.51,$57.23,N/A,$55.51,N/A,N/A,N/A,$57.23,N/A,$55.51,N/A,$57.23,N/A,N/A,$55.51
V500840,0510,V5008,,,,,N/A,N/A,HEARING SCREENING,$10.09,$7.50,$10.00,$10.00,N/A,N/A,N/A,N/A,N/A,$10.00,N/A,N/A,N/A,$10.00,N/A,N/A,N/A
5100002,0510,,,,,,N/A,N/A,MRO                       ~KJT,$20.18,$15.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
5100003,0510,,,,,,N/A,N/A,SPECIMEN COLLECTION       ~KJT,$19.17,$14.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7600207,0510,,,,,,N/A,N/A,NURSING PROCEDURE,$299.66,$222.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9586050,0510,,,,,,N/A,N/A,"MUSCLE TEST, ONE LIMB       ~G",$176.56,$131.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99214T,0510,,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT, EST",$70.63,$52.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
5120550,0519,20550,,,,,N/A,N/A,TENDON SHEATH INJECTION,$201.79,$150.00,$41.41,$101.00,$41.41,$97.97,$41.41,$86.36,$41.41,$69.22,$41.41,$97.97,$41.41,$101.00,$41.41,$41.41,$97.97
5199245,0519,99088,,,,,N/A,N/A,Office Consult - V,$504.47,$375.00,$0.00,$0.00,N/A,$0.00,N/A,N/A,N/A,$0.00,N/A,$0.00,N/A,$0.00,N/A,N/A,$0.00
5199202,0519,99202,,,,,N/A,N/A,New Patient-Level II,$168.49,$125.25,$0.00,$113.00,$52.89,$109.61,$52.89,$134.79,$52.89,$0.00,$52.89,$109.61,$52.89,$113.00,$52.89,$52.89,$109.61
5199202-25,0519,99202,,,,,N/A,N/A,New Patient-Level II       -25,$142.26,$105.75,$0.00,$113.00,$52.89,$109.61,$52.89,$134.79,$52.89,$0.00,$52.89,$109.61,$52.89,$113.00,$52.89,$52.89,$109.61
5199203,0519,99203,,,,,N/A,N/A,New Patient-Level III,$232.06,$172.50,$48.70,$170.00,$69.70,$164.90,$69.70,$192.79,$69.70,$48.70,$69.70,$164.90,$69.70,$170.00,$69.70,$69.70,$164.90
5199203-25,0519,99203,,,,,N/A,N/A,New Patient-Level III      -25,$252.24,$187.50,$48.70,$170.00,$69.70,$164.90,$69.70,$192.79,$69.70,$48.70,$69.70,$164.90,$69.70,$170.00,$69.70,$69.70,$164.90
5199204,0519,99204,,,,,N/A,N/A,New Patient-Level IV,$355.15,$264.00,$82.46,$240.00,$98.40,$232.80,$98.40,$134.79,$98.40,$82.46,$98.40,$232.80,$98.40,$240.00,$98.40,$98.40,$232.80
5199204-25,0519,99204,,,,,N/A,N/A,New Patient-Level IV       -25,$316.81,$235.50,$82.46,$240.00,$98.40,$232.80,$98.40,$134.79,$98.40,$82.46,$98.40,$232.80,$98.40,$240.00,$98.40,$98.40,$232.80
5199205,0519,99205,,,,,N/A,N/A,New Patient-Level V,$441.92,$328.50,$127.10,$326.00,$127.10,$316.22,$127.10,$134.79,$127.10,$134.46,$127.10,$316.22,$127.10,$326.00,$127.10,$127.10,$316.22
5199205-25,0519,99205,,,,,N/A,N/A,New Patient-Level V        -25,$379.36,$282.00,$127.10,$326.00,$127.10,$316.22,$127.10,N/A,$127.10,$134.46,$127.10,$316.22,$127.10,$326.00,$127.10,$127.10,$316.22
5199211,0519,99211,,,,,N/A,N/A,Established Pt-Level I,$66.59,$49.50,$24.19,$182.62,$24.19,$57.23,$24.19,$189.12,$24.19,$182.62,$24.19,$57.23,$24.19,$59.00,$24.19,$24.19,$57.23
51899211,0519,99211,,,,,N/A,N/A,Physical Exam Follow-up,$45.40,$33.75,$24.19,$182.62,$24.19,$57.23,$24.19,$223.43,$24.19,$182.62,$24.19,$57.23,$24.19,$59.00,$24.19,$24.19,$57.23
5199211-25,0519,99211,,,,,N/A,N/A,Established Pt-Level I     -25,$66.59,$49.50,$24.19,$182.62,$24.19,$57.23,$24.19,$117.63,$24.19,$182.62,$24.19,$57.23,$24.19,$59.00,$24.19,$24.19,$57.23
5199212,0519,99212,,,,,N/A,N/A,Established Pt-Level II,$105.94,$78.75,$8.95,$59.00,$24.19,$57.23,$24.19,$95.56,$24.19,$8.95,$24.19,$57.23,$24.19,$59.00,$24.19,$24.19,$57.23
5199212-25,0519,99212,,,,,N/A,N/A,Established Pt-Level II    -25,$109.97,$81.75,$8.95,$59.00,$24.19,$57.23,$24.19,$111.06,$24.19,$8.95,$24.19,$57.23,$24.19,$59.00,$24.19,$24.19,$57.23
5199213,0519,99213,,,,,N/A,N/A,Established Pt-Level III,$151.34,$112.50,$35.65,$98.00,$45.92,$95.06,$45.92,$58.97,$45.92,$35.65,$45.92,$95.06,$45.92,$98.00,$45.92,$45.92,$95.06
5199213-25,0519,99213,,,,,N/A,N/A,Established Pt-Level III   -25,$127.13,$94.50,$35.65,$98.00,$45.92,$95.06,$45.92,$100.44,$45.92,$35.65,$45.92,$95.06,$45.92,$98.00,$45.92,$45.92,$95.06
5199214,0519,99214,,,,,N/A,N/A,Established Pt-Level IV,$207.84,$154.50,$66.76,$170.00,$69.70,$164.90,$69.70,$58.97,$69.70,$66.76,$69.70,$164.90,$69.70,$170.00,$69.70,$69.70,$164.90
5199214-25,0519,99214,,,,,N/A,N/A,Established Pt-Level IV     25,$207.84,$154.50,$66.76,$170.00,$69.70,$164.90,$69.70,$100.44,$69.70,$66.76,$69.70,$164.90,$69.70,$170.00,$69.70,$69.70,$164.90
5199215-25,0519,99214,,,,,N/A,N/A,Established Pt-Level V     -25,$328.91,$244.50,$66.76,$170.00,$69.70,$164.90,$69.70,$111.06,$69.70,$66.76,$69.70,$164.90,$69.70,$170.00,$69.70,$69.70,$164.90
5199215,0519,99215,,,,,N/A,N/A,Established Pt-Level V,$349.09,$259.50,$95.53,$230.00,$95.53,$223.10,$95.53,$58.97,$95.53,$98.71,$95.53,$223.10,$95.53,$230.00,$95.53,$95.53,$223.10
5199241,0519,99241,,,,,N/A,N/A,Office Consult I,$190.69,$141.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
5199242,0519,99242,,,,,N/A,N/A,Office Consult II,$281.49,$209.25,$104.82,$130.00,N/A,$126.10,N/A,N/A,N/A,$104.82,N/A,$126.10,N/A,$130.00,N/A,N/A,$126.10
5199243,0519,99243,,,,,N/A,N/A,Office Consult-III,$365.24,$271.50,$66.95,$130.00,N/A,$126.10,N/A,N/A,N/A,$66.95,N/A,$126.10,N/A,$130.00,N/A,N/A,$126.10
5199244,0519,99243,,,,,N/A,N/A,Office Consult-IV,$403.58,$300.00,$66.95,$130.00,N/A,$126.10,N/A,N/A,N/A,$66.95,N/A,$126.10,N/A,$130.00,N/A,N/A,$126.10
5199354,0519,99354,,,,,N/A,N/A,PROLONGED VISIT,$281.49,$209.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
5199355,0519,99355,,,,,N/A,N/A,PROLONGED ADD 30 MINUTES,$133.18,$99.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
5199358,0519,99358,,,,,N/A,N/A,PROLONGED VISIT         ~99358,$242.15,$180.00,$129.01,$175.93,N/A,$129.01,N/A,N/A,N/A,$175.93,N/A,$129.01,N/A,$133.00,N/A,N/A,$129.01
5199359,0519,99359,,,,,N/A,N/A,"PROLONGED, ADD 30 MIN  ~ 99359",$123.09,$91.50,$109.76,$122.00,N/A,$118.34,N/A,N/A,N/A,$109.76,N/A,$118.34,N/A,$122.00,N/A,N/A,$118.34
5199441,0519,99441,,,,,N/A,N/A,TELEPHONE EVALUATION 5-10 MINS,$50.45,$37.50,$21.32,$52.00,$21.32,$50.44,$21.32,N/A,$21.32,$27.75,$21.32,$50.44,$21.32,$52.00,$21.32,$21.32,$50.44
5199442,0519,99442,,,,,N/A,N/A,TELEPHONE EVALUATION 11-20 MIN,$76.68,$57.00,$31.16,$76.00,$31.16,$73.72,$31.16,N/A,$31.16,$35.65,$31.16,$73.72,$31.16,$76.00,$31.16,$31.16,$73.72
5199443,0519,99443,,,,,N/A,N/A,TELEPHONE EVALUATION 21-30 MIN,$110.98,$82.50,$47.15,$110.00,$47.15,$106.70,$47.15,N/A,$47.15,$66.96,$47.15,$106.70,$47.15,$110.00,$47.15,$47.15,$106.70
5199455,0519,99455,,,,,N/A,N/A,Physical (Pre-Emp or FIT),$110.98,$82.50,$33.05,$110.00,$53.30,N/A,$53.30,N/A,$53.30,$33.05,$53.30,N/A,$53.30,$110.00,$53.30,$53.30,N/A
5199456,0519,99456,,,,,N/A,N/A,DOT Physical,$90.80,$67.50,$0.00,$90.00,$36.90,$87.30,$36.90,N/A,$36.90,$0.00,$36.90,$87.30,$36.90,$90.00,$36.90,$36.90,$87.30
5190025,0519,A4570,,,,,N/A,N/A,SPLINT WRIST RIGHT UNIVERSAL,$91.81,$68.25,$88.27,$91.00,N/A,$88.27,N/A,N/A,N/A,$91.00,N/A,$88.27,N/A,$91.00,N/A,N/A,$88.27
5109991,0519,,,,,,N/A,N/A,MEDICAL EXAM,$595.27,$442.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
5199996,0519,,,,,,N/A,N/A,FIT TEST ONE TIME FEE,$100.89,$75.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
5199997,0519,,,,,,N/A,N/A,FIT TEST,$25.22,$18.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
51920001,0519,,,,,,N/A,N/A,FIT TEST SET UP FEE,$100.89,$75.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
64486,0521,64486,,,,,N/A,N/A,TAP BLOCK UNILATERAL BY INJE,$247.19,$183.75,$1.45,$245.00,$1.45,$237.65,$1.45,$143.84,$1.45,$67.48,$1.45,$237.65,$1.45,$245.00,$1.45,$1.45,$237.65
93040,0521,93040,,,,,N/A,N/A,RHYTHM ECG WITH REPORT,$36.32,$27.00,$17.22,$42.00,$17.22,$40.74,$17.22,N/A,$17.22,$30.80,$17.22,$40.74,$17.22,$42.00,$17.22,$17.22,$40.74
95992,0521,95992,,,,,N/A,N/A,CANALITH REPOSITIONING PROCE,$75.67,$56.25,$36.80,$75.00,$36.80,$72.75,$36.80,N/A,$36.80,$52.58,$36.80,$72.75,$36.80,$75.00,$36.80,$36.80,$72.75
96127,0521,96127,,,,,N/A,N/A,Emotional/Behavioral Assessm,$0.00,$0.00,$0.00,$120.84,N/A,$0.00,N/A,N/A,N/A,$120.84,N/A,$0.00,N/A,$0.00,N/A,N/A,$0.00
G0101,0521,G0101,,,,,N/A,N/A,PELVIC EXAM,$67.60,$50.25,$38.50,$67.00,$38.50,$64.99,$38.50,N/A,$38.50,$67.00,$38.50,$64.99,$38.50,$67.00,$38.50,$38.50,$64.99
G0403,0521,G0403,,,,,N/A,N/A,EKG FOR INITIAL PREVENTIVE E,$41.37,$30.75,$14.24,$41.00,$14.24,$39.77,$14.24,N/A,$14.24,$41.00,$14.24,$39.77,$14.24,$41.00,$14.24,$14.24,$39.77
G0405,0521,G0405,,,,,N/A,N/A,MEDICARE-ECG INTERPRET/REPOR,$24.21,$18.00,$7.97,$24.00,$7.97,$23.28,$7.97,N/A,$7.97,$24.00,$7.97,$23.28,$7.97,$24.00,$7.97,$7.97,$23.28
G0438,0521,G0438,,,,,N/A,N/A,MEDICARE INITIAL ANNUAL WELL,$173.54,$129.00,$163.38,$172.00,$163.38,$166.84,$163.38,N/A,$163.38,$172.00,$163.38,$166.84,$163.38,$172.00,$163.38,$163.38,$166.84
G0439,0521,G0439,,,,,N/A,N/A,MEDICARE SUBSEQUENT ANNU WEL,$111.99,$83.25,$107.67,$128.09,$128.09,$107.67,$128.09,N/A,$128.09,$111.00,$128.09,$107.67,$128.09,$111.00,$128.09,$128.09,$107.67
Q0091,0521,Q0091,,,,,N/A,N/A,OBTAINING SCREEN PAP SMEAR,$46.41,$34.50,$43.31,$46.00,$43.31,$44.62,$43.31,N/A,$43.31,$46.00,$43.31,$44.62,$43.31,$46.00,$43.31,$43.31,$44.62
23073,0521,,,,,,N/A,N/A,EXC SHOULDER TUM DEEP 5 CM/>,"$1,346.93","$1,001.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
36591,0521,,,,,,N/A,N/A,COLLECT BLOOD FROM IMPLANT V,$47.42,$35.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2706645A,0540,27066,,,,,N/A,N/A,Removal Of Hip Bone Lesion  ~t,$0.00,$0.00,$727.75,"$1,775.00",$727.75,"$1,721.75",$727.75,"$1,517.63",$727.75,"$1,457.56",$727.75,"$1,721.75",$727.75,"$1,775.00",$727.75,$727.75,"$1,721.75"
6107033,0610,70336,,,,,N/A,N/A,MRI TMJ W/O CONTRAST,"$3,482.86","$2,589.00","$1,415.32","$1,415.32","$1,415.32",N/A,"$1,415.32",N/A,"$1,415.32",N/A,"$1,415.32",N/A,"$1,415.32",N/A,"$1,415.32","$1,415.32",N/A
6107040,0610,70540,,,,,N/A,N/A,MRI ORBIT/FACE/NECK  W/O CONT,"$3,348.67","$2,489.25","$1,786.78","$1,786.78","$1,786.78",N/A,"$1,786.78",N/A,"$1,786.78",N/A,"$1,786.78",N/A,"$1,786.78",N/A,"$1,786.78","$1,786.78",N/A
6107052,0610,70540,,,,,N/A,N/A,Mra Head W/O & W Contrast,"$4,396.96","$3,268.50","$1,786.78","$1,786.78","$1,786.78",N/A,"$1,786.78",N/A,"$1,786.78",N/A,"$1,786.78",N/A,"$1,786.78",N/A,"$1,786.78","$1,786.78",N/A
6107049,0610,70541,,,,,N/A,N/A,Mra Neck/Orbit/Face W/O Cont,"$3,348.67","$2,489.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
6107045,0610,70542,,,,,N/A,N/A,MRI ORBIT/FACE/NECK W CONTRAST,"$3,871.30","$2,877.75","$1,573.17","$1,573.17","$1,573.17",N/A,"$1,573.17",N/A,"$1,573.17",N/A,"$1,573.17",N/A,"$1,573.17",N/A,"$1,573.17","$1,573.17",N/A
6107054,0610,70543,,,,,N/A,N/A,MRI ORBIT/FACE/NECK W&W/O CONT,"$3,976.23","$2,955.75","$1,615.81","$1,615.81","$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81","$1,615.81",N/A
6170544,0610,70544,,,,,N/A,N/A,MRI ANGIOGRAPHY HEAD W/O DYE,"$3,976.23","$2,955.75","$1,615.81","$1,615.81","$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81","$1,615.81",N/A
6170545,0610,70545,,,,,N/A,N/A,MRA BRAIN W,"$3,871.30","$2,877.75","$1,573.17","$1,573.17","$1,573.17",N/A,"$1,573.17",N/A,"$1,573.17",N/A,"$1,573.17",N/A,"$1,573.17",N/A,"$1,573.17","$1,573.17",N/A
6170546,0610,70546,,,,,N/A,N/A,MRA BRAIN WO & W,"$4,396.96","$3,268.50","$1,786.78","$1,786.78","$1,786.78",N/A,"$1,786.78",N/A,"$1,786.78",N/A,"$1,786.78",N/A,"$1,786.78",N/A,"$1,786.78","$1,786.78",N/A
6170988,0610,70546,,,,,N/A,N/A,"MRA/MRV BRAIN WO, W","$3,976.23","$2,955.75","$1,786.78","$1,786.78","$1,786.78",N/A,"$1,786.78",N/A,"$1,786.78",N/A,"$1,786.78",N/A,"$1,786.78",N/A,"$1,786.78","$1,786.78",N/A
6100548,0610,70548,,,,,N/A,N/A,"MRA WITH CONTRAST, NECK","$3,348.67","$2,489.25",$136.79,$136.79,$136.79,N/A,$136.79,N/A,$136.79,N/A,$136.79,N/A,$136.79,N/A,$136.79,$136.79,N/A
6100549,0610,70549,,,,,N/A,N/A,MRA NECK W/WO CONTRAST,"$3,348.67","$2,489.25",$136.79,$136.79,$136.79,N/A,$136.79,N/A,$136.79,N/A,$136.79,N/A,$136.79,N/A,$136.79,$136.79,N/A
6107015,0610,70551,,,,,N/A,N/A,MRI BRAIN/PITUIT/IAC W/O CONT,"$3,348.67","$2,489.25",$136.79,$136.79,$136.79,N/A,$136.79,N/A,$136.79,N/A,$136.79,N/A,$136.79,N/A,$136.79,$136.79,N/A
6107020,0610,70552,,,,,N/A,N/A,MRI BRAIN/PITTU/ICA W/CONT,"$3,348.67","$2,489.25","$1,615.81","$1,615.81","$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81","$1,615.81",N/A
6107025,0610,70552,,,,,N/A,N/A,Mri Iac And/Or Brain,"$3,976.23","$2,955.75","$1,615.81","$1,615.81","$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81","$1,615.81",N/A
6107155,0610,71550,,,,,N/A,N/A,MRI CHEST W/O CONTRAST,"$3,482.86","$2,589.00","$1,415.32","$1,415.32","$1,415.32",N/A,"$1,415.32",N/A,"$1,415.32",N/A,"$1,415.32",N/A,"$1,415.32",N/A,"$1,415.32","$1,415.32",N/A
6107154,0610,71552,,,,,N/A,N/A,MRI CHEST W/WO CONTRAST,"$4,135.65","$3,074.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
6107211,0610,72141,,,,,N/A,N/A,MRI CERVICAL SPINE W/O CONTRAS,"$3,348.67","$2,489.25",$136.79,$136.79,$136.79,N/A,$136.79,N/A,$136.79,N/A,$136.79,N/A,$136.79,N/A,$136.79,$136.79,N/A
6107211-52,0610,72141,,,,,N/A,N/A,MRI CERVICAL W/O,"$2,810.91","$2,089.50",$136.79,$136.79,$136.79,N/A,$136.79,N/A,$136.79,N/A,$136.79,N/A,$136.79,N/A,$136.79,$136.79,N/A
6107212,0610,72142,,,,,N/A,N/A,Mri Cervical Spine W/Wo Contr,"$3,976.23","$2,955.75","$1,615.81","$1,615.81","$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81","$1,615.81",N/A
6107216,0610,72146,,,,,N/A,N/A,MRI THORACIC SPINE W/O CONTRAS,"$3,348.67","$2,489.25",$136.79,$136.79,$136.79,N/A,$136.79,N/A,$136.79,N/A,$136.79,N/A,$136.79,N/A,$136.79,$136.79,N/A
6107216-52,0610,72146,,,,,N/A,N/A,MRI THORACIC W/O,"$2,810.91","$2,089.50",$136.79,$136.79,$136.79,N/A,$136.79,N/A,$136.79,N/A,$136.79,N/A,$136.79,N/A,$136.79,$136.79,N/A
6107214,0610,72147,,,,,N/A,N/A,Mri Lumbar Spine W Contrast,"$3,871.30","$2,877.75","$1,615.81","$1,615.81","$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81","$1,615.81",N/A
6107217,0610,72147,,,,,N/A,N/A,Mri Thoracic Spine W/Wo Cont,"$3,976.23","$2,955.75","$1,615.81","$1,615.81","$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81","$1,615.81",N/A
6107218,0610,72148,,,,,N/A,N/A,MRI LUMBAR SPINE W/O CONTRAST,"$3,348.67","$2,489.25","$1,615.81","$1,615.81","$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81","$1,615.81",N/A
6107218-52,0610,72148,,,,,N/A,N/A,MRI L SPINE W/O,"$2,810.91","$2,089.50","$1,615.81","$1,615.81","$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81","$1,615.81",N/A
6107215,0610,72158,,,,,N/A,N/A,MRI LUMBAR SPINE W W/O CONTRAS,"$3,976.23","$2,955.75","$1,615.81","$1,615.81","$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81","$1,615.81",N/A
6107291,0610,72195,,,,,N/A,N/A,MRI PELVIS W/O CONTRAST,"$3,482.86","$2,589.00","$1,415.32","$1,415.32","$1,415.32",N/A,"$1,415.32",N/A,"$1,415.32",N/A,"$1,415.32",N/A,"$1,415.32",N/A,"$1,415.32","$1,415.32",N/A
6107219,0610,72196,,,,,N/A,N/A,MRI PELVIS W CONTRAST,"$4,173.98","$3,102.75","$1,696.17","$1,696.17","$1,696.17",N/A,"$1,696.17",N/A,"$1,696.17",N/A,"$1,696.17",N/A,"$1,696.17",N/A,"$1,696.17","$1,696.17",N/A
6172197,0610,72197,,,,,N/A,N/A,MRI PELVIS WO & W,"$4,135.65","$3,074.25",$168.59,$168.59,$168.59,N/A,$168.59,N/A,$168.59,N/A,$168.59,N/A,$168.59,N/A,$168.59,$168.59,N/A
6107325RT,0610,73129,,,,,N/A,N/A,Mri Rt Upper Extrem W Cont,"$3,871.30","$2,877.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
6107322LT,0610,73218,,,,,N/A,N/A,MRI LT UPPER EXTREM W/O CONTR,"$3,421.32","$2,543.25",$139.31,$139.31,$139.31,N/A,$139.31,N/A,$139.31,N/A,$139.31,N/A,$139.31,N/A,$139.31,$139.31,N/A
6107322RT,0610,73218,,,,,N/A,N/A,MRI RT UPPER EXTREM W/O CONTR,"$3,421.32","$2,543.25",$139.31,$139.31,$139.31,N/A,$139.31,N/A,$139.31,N/A,$139.31,N/A,$139.31,N/A,$139.31,$139.31,N/A
6107325LT,0610,73219,,,,,N/A,N/A,MRI LT UPPER EXTREM W CONTR,"$3,871.30","$2,877.75","$1,573.17","$1,573.17","$1,573.17",N/A,"$1,573.17",N/A,"$1,573.17",N/A,"$1,573.17",N/A,"$1,573.17",N/A,"$1,573.17","$1,573.17",N/A
6108916LT,0610,73220,,,,,N/A,N/A,MRI LT UPPER EXTREMITY WO/W,"$3,976.23","$2,955.75","$1,615.81","$1,615.81","$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81","$1,615.81",N/A
6108916RT,0610,73220,,,,,N/A,N/A,MRI RT UPPER EXTREMITY WO/W,"$3,976.23","$2,955.75","$1,615.81","$1,615.81","$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81","$1,615.81",N/A
6107321LT,0610,73221,,,,,N/A,N/A,MRI LT UPPER JOINT W/O CONTRAS,"$3,348.67","$2,489.25",$136.79,$136.79,$136.79,N/A,$136.79,N/A,$136.79,N/A,$136.79,N/A,$136.79,N/A,$136.79,$136.79,N/A
6107321RT,0610,73221,,,,,N/A,N/A,MRI RT UPPER JOINT W/O CONTRAS,"$3,348.67","$2,489.25",$136.79,$136.79,$136.79,N/A,$136.79,N/A,$136.79,N/A,$136.79,N/A,$136.79,N/A,$136.79,$136.79,N/A
6107352LT,0610,73222,,,,,N/A,N/A,MRI UPPER JOINT W CONTRAST,"$4,012.55","$2,982.75",$163.57,$163.57,$163.57,N/A,$163.57,N/A,$163.57,N/A,$163.57,N/A,$163.57,N/A,$163.57,$163.57,N/A
6107352RT,0610,73222,,,,,N/A,N/A,MRI UPPER JOINT W CONTRAST,"$3,871.30","$2,877.75",$163.57,$163.57,$163.57,N/A,$163.57,N/A,$163.57,N/A,$163.57,N/A,$163.57,N/A,$163.57,$163.57,N/A
6108921LT,0610,73223,,,,,N/A,N/A,MRI-L UPPER JOINT WO/W CONTR,"$3,871.30","$2,877.75","$1,573.17","$1,573.17","$1,573.17",N/A,"$1,573.17",N/A,"$1,573.17",N/A,"$1,573.17",N/A,"$1,573.17",N/A,"$1,573.17","$1,573.17",N/A
6108921RT,0610,73223,,,,,N/A,N/A,MRI RT UPPER JOINT WO/W,"$3,871.30","$2,877.75","$1,573.17","$1,573.17","$1,573.17",N/A,"$1,573.17",N/A,"$1,573.17",N/A,"$1,573.17",N/A,"$1,573.17",N/A,"$1,573.17","$1,573.17",N/A
6107370LT,0610,73718,,,,,N/A,N/A,MRI LT LWR EXTREM W/O CONTR,"$3,348.67","$2,489.25",$136.79,$136.79,$136.79,N/A,$136.79,N/A,$136.79,N/A,$136.79,N/A,$136.79,N/A,$136.79,$136.79,N/A
6107370RT,0610,73718,,,,,N/A,N/A,MRI RT LOWR  EXTREM W/O CON,"$3,348.67","$2,489.25",$136.79,$136.79,$136.79,N/A,$136.79,N/A,$136.79,N/A,$136.79,N/A,$136.79,N/A,$136.79,$136.79,N/A
6107372LT,0610,73719,,,,,N/A,N/A,MRI LT LWR EXTREM W CONTRAST,"$3,871.30","$2,877.75","$1,573.17","$1,573.17","$1,573.17",N/A,"$1,573.17",N/A,"$1,573.17",N/A,"$1,573.17",N/A,"$1,573.17",N/A,"$1,573.17","$1,573.17",N/A
6107372RT,0610,73719,,,,,N/A,N/A,MRI RT LOWR EXTREM W CONTRAST,"$3,871.30","$2,877.75","$1,573.17","$1,573.17","$1,573.17",N/A,"$1,573.17",N/A,"$1,573.17",N/A,"$1,573.17",N/A,"$1,573.17",N/A,"$1,573.17","$1,573.17",N/A
6108912LT,0610,73720,,,,,N/A,N/A,MRI LT LOWER EXTREMITY WO/W,"$3,976.23","$2,955.75","$1,615.81","$1,615.81","$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81","$1,615.81",N/A
6108912RT,0610,73720,,,,,N/A,N/A,MRI RT LOWER EXTREMITY WO/W,"$3,976.23","$2,955.75","$1,615.81","$1,615.81","$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81","$1,615.81",N/A
6107371LT,0610,73721,,,,,N/A,N/A,LT LOWER JOINT W/O CONTRAST,"$3,348.67","$2,489.25",$136.79,$136.79,$136.79,N/A,$136.79,N/A,$136.79,N/A,$136.79,N/A,$136.79,N/A,$136.79,$136.79,N/A
6107371RT,0610,73721,,,,,N/A,N/A,RT LOWER JOINT W/O CONTRAST,"$3,348.67","$2,489.25",$136.79,$136.79,$136.79,N/A,$136.79,N/A,$136.79,N/A,$136.79,N/A,$136.79,N/A,$136.79,$136.79,N/A
3102722-RT,0610,73722,,,,,N/A,N/A,MRI RT LOWER JOINT W,"$3,065.16","$2,278.50","$1,517.41","$1,517.41","$1,517.41",N/A,"$1,517.41",N/A,"$1,517.41",N/A,"$1,517.41",N/A,"$1,517.41",N/A,"$1,517.41","$1,517.41",N/A
6102722-RT,0610,73722,,,,,N/A,N/A,MRI RT LOWER JOINT W,"$3,734.09","$2,775.75","$1,517.41","$1,517.41","$1,517.41",N/A,"$1,517.41",N/A,"$1,517.41",N/A,"$1,517.41",N/A,"$1,517.41",N/A,"$1,517.41","$1,517.41",N/A
6103722LT,0610,73722,,,,,N/A,N/A,MRI LT LOWER JOINT W,"$3,348.67","$2,489.25","$1,517.41","$1,517.41","$1,517.41",N/A,"$1,517.41",N/A,"$1,517.41",N/A,"$1,517.41",N/A,"$1,517.41",N/A,"$1,517.41","$1,517.41",N/A
6103722RT,0610,73722,,,,,N/A,N/A,MRI RT LOWER JOINT W,"$3,348.67","$2,489.25","$1,517.41","$1,517.41","$1,517.41",N/A,"$1,517.41",N/A,"$1,517.41",N/A,"$1,517.41",N/A,"$1,517.41",N/A,"$1,517.41","$1,517.41",N/A
6107373LT,0610,73723,,,,,N/A,N/A,MRI LT LOWER JOINT WO/W,"$3,976.23","$2,955.75","$1,615.81","$1,615.81","$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81","$1,615.81",N/A
6107373RT,0610,73723,,,,,N/A,N/A,MRI RT LOWER JOINT WO/W,"$3,976.23","$2,955.75","$1,615.81","$1,615.81","$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81","$1,615.81",N/A
6107411,0610,74181,,,,,N/A,N/A,MRI ABDOMEN W/O CONTRAST,"$3,482.86","$2,589.00","$1,415.32","$1,415.32","$1,415.32",N/A,"$1,415.32",N/A,"$1,415.32",N/A,"$1,415.32",N/A,"$1,415.32",N/A,"$1,415.32","$1,415.32",N/A
6107418,0610,74183,,,,,N/A,N/A,MRI ABDOMEN W/WO CONTRAST,"$4,135.65","$3,074.25",$168.59,$168.59,$168.59,N/A,$168.59,N/A,$168.59,N/A,$168.59,N/A,$168.59,N/A,$168.59,$168.59,N/A
6108922,0610,76498,,,,,N/A,N/A,MRI CTL SPINAL SURVEY W/O CONT,"$3,482.86","$2,589.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
6176499,0610,76498,,,,,N/A,N/A,MRI LIMITED EXAM,"$2,996.55","$2,227.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
6108900,0610,C8900,,,,,N/A,N/A,"MRA W/CONT, ABD (0284) C8900","$4,173.98","$3,102.75","$4,012.89","$4,137.00",N/A,"$4,012.89",N/A,N/A,N/A,"$4,137.00",N/A,"$4,012.89",N/A,"$4,137.00",N/A,N/A,"$4,012.89"
6108901,0610,C8901,,,,,N/A,N/A,"MRA W/O CONT, ABD (0336)","$3,897.54","$2,897.25","$3,747.11","$3,863.00",N/A,"$3,747.11",N/A,N/A,N/A,"$3,863.00",N/A,"$3,747.11",N/A,"$3,863.00",N/A,N/A,"$3,747.11"
6108909,0610,C8909,,,,,N/A,N/A,"MRA W/CONT, CHEST  (0284)","$4,173.98","$3,102.75","$4,012.89","$4,137.00",N/A,"$4,012.89",N/A,N/A,N/A,"$4,137.00",N/A,"$4,012.89",N/A,"$4,137.00",N/A,N/A,"$4,012.89"
6108910,0610,C8910,,,,,N/A,N/A,"MRA W/O CONT, CHEST (0336)","$3,897.54","$2,897.25","$3,747.11","$3,863.00",N/A,"$3,747.11",N/A,N/A,N/A,"$3,863.00",N/A,"$3,747.11",N/A,"$3,863.00",N/A,N/A,"$3,747.11"
6108911,0610,C8911,,,,,N/A,N/A,"MRA W/O FOL W/CONT, CHEST","$4,573.53","$3,399.75","$4,397.01","$4,533.00",N/A,"$4,397.01",N/A,N/A,N/A,"$4,533.00",N/A,"$4,397.01",N/A,"$4,533.00",N/A,N/A,"$4,397.01"
6172142,0612,72142,,,,,N/A,N/A,MRI CERVICAL SPINE W/CONTRAST,"$3,871.30","$2,877.75","$1,615.81","$1,615.81","$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81","$1,615.81",N/A
6107220,0612,72147,,,,,N/A,N/A,MRI THORACIC SPINE WITH CONT,"$3,871.30","$2,877.75","$1,615.81","$1,615.81","$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81","$1,615.81",N/A
6172147,0612,72147,,,,,N/A,N/A,MRI THORACIC SPINE W/CONTRAST,"$4,012.55","$2,982.75","$1,615.81","$1,615.81","$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81",N/A,"$1,615.81","$1,615.81",N/A
4990375,0636,90375,,,,,N/A,N/A,RABIES IG,$151.34,$112.50,$12.99,$150.00,$61.50,$145.50,$61.50,N/A,$61.50,$12.99,$61.50,$145.50,$61.50,$150.00,$61.50,$61.50,$145.50
3900717,0636,90384,,,,,N/A,N/A,MICROGAM DOSE,$300.66,$223.50,$122.18,$122.18,$122.18,N/A,$122.18,N/A,$122.18,N/A,$122.18,N/A,$122.18,N/A,$122.18,$122.18,N/A
9058640A,0636,90586,,,,,N/A,N/A,BCG PER VIAL                ~T,$274.43,$204.00,$12.77,$272.00,N/A,$263.84,N/A,N/A,N/A,$12.77,N/A,$263.84,N/A,$272.00,N/A,N/A,$263.84
9609079,0636,90632,,,,,N/A,N/A,HEP A,$136.21,$101.25,$130.95,$135.00,N/A,$130.95,N/A,N/A,N/A,N/A,N/A,$130.95,N/A,$135.00,N/A,N/A,$130.95
4500144,0636,90634,,,,,N/A,N/A,HEPATITIS A VACCINE,$141.25,$105.00,$0.01,$0.01,N/A,$0.01,N/A,N/A,N/A,N/A,N/A,$0.01,N/A,$0.01,N/A,N/A,$0.01
9609083,0636,90636,,,,,N/A,N/A,HEP A&B TWINRIX,$134.19,$99.75,$129.01,$133.00,N/A,$129.01,N/A,N/A,N/A,N/A,N/A,$129.01,N/A,$133.00,N/A,N/A,$129.01
9600103,0636,90658,,,,,N/A,N/A,Flu Vaccine > 3 Years Im   -Tc,$8.07,$6.00,$21.34,$22.00,N/A,$21.34,N/A,N/A,N/A,N/A,N/A,$21.34,N/A,$22.00,N/A,N/A,$21.34
9600104,0636,90658,,,,,N/A,N/A,Flu Vaccine > 3 Years Im   -Tc,$12.11,$9.00,$21.34,$22.00,N/A,$21.34,N/A,N/A,N/A,N/A,N/A,$21.34,N/A,$22.00,N/A,N/A,$21.34
9600724,0636,90658,,,,,N/A,N/A,FLU VACCINE > 3 YEARS IM    ~T,$21.19,$15.75,$21.34,$22.00,N/A,$21.34,N/A,N/A,N/A,N/A,N/A,$21.34,N/A,$22.00,N/A,N/A,$21.34
9609005A,0636,90658,,,,,N/A,N/A,Flu Vaccine > 3 Years Im    ~t,$22.20,$16.50,$21.34,$22.00,N/A,$21.34,N/A,N/A,N/A,N/A,N/A,$21.34,N/A,$22.00,N/A,N/A,$21.34
9609006A,0636,90658,,,,,N/A,N/A,Flu Vaccine > 3 Years Im   -Tc,$22.20,$16.50,$21.34,$22.00,N/A,$21.34,N/A,N/A,N/A,N/A,N/A,$21.34,N/A,$22.00,N/A,N/A,$21.34
9609009A,0636,90658,,,,,N/A,N/A,Flu Vaccine > 3 Years      -Tc,$22.20,$16.50,$21.34,$22.00,N/A,$21.34,N/A,N/A,N/A,N/A,N/A,$21.34,N/A,$22.00,N/A,N/A,$21.34
9600901A,0636,90663,,,,,N/A,N/A,"INFLUENZA VIRUS VACCINE, PAN",$16.14,$12.00,$14.55,$15.00,N/A,$14.55,N/A,N/A,N/A,N/A,N/A,$14.55,N/A,$15.00,N/A,N/A,$14.55
9600902A,0636,90663,,,,,N/A,N/A,INFLUENZA VIRUS VACCINE PAN,$15.13,$11.25,$14.55,$15.00,N/A,$14.55,N/A,N/A,N/A,N/A,N/A,$14.55,N/A,$15.00,N/A,N/A,$14.55
9600903A,0636,90663,,,,,N/A,N/A,INFLUENZA VIRUS VACCINE PAN,$3.03,$2.25,$14.55,$15.00,N/A,$14.55,N/A,N/A,N/A,N/A,N/A,$14.55,N/A,$15.00,N/A,N/A,$14.55
9600905A,0636,90663,,,,,N/A,N/A,INFLUENZA VIRUS VACCINE PAN,$14.13,$10.50,$14.55,$15.00,N/A,$14.55,N/A,N/A,N/A,N/A,N/A,$14.55,N/A,$15.00,N/A,N/A,$14.55
9600906A,0636,90663,,,,,N/A,N/A,INFLUENZA VIRUS VACCINE PAN,$15.13,$11.25,$14.55,$15.00,N/A,$14.55,N/A,N/A,N/A,N/A,N/A,$14.55,N/A,$15.00,N/A,N/A,$14.55
9600907A,0636,90663,,,,,N/A,N/A,INFLUENZA VIRUS VACCINE PAN,$0.01,$0.01,$14.55,$15.00,N/A,$14.55,N/A,N/A,N/A,N/A,N/A,$14.55,N/A,$15.00,N/A,N/A,$14.55
9600908A,0636,90663,,,,,N/A,N/A,INFLUENZA VIRUS VACCINE PAN,$15.13,$11.25,$14.55,$15.00,N/A,$14.55,N/A,N/A,N/A,N/A,N/A,$14.55,N/A,$15.00,N/A,N/A,$14.55
9609084,0636,90670,,,,,N/A,N/A,PREVNAR 13,$252.24,$187.50,$242.50,$250.00,N/A,$242.50,N/A,N/A,N/A,N/A,N/A,$242.50,N/A,$250.00,N/A,N/A,$242.50
90672,0636,90672,,,,,N/A,N/A,FLUMIST,$0.01,$0.01,$0.01,$0.01,N/A,$0.01,N/A,N/A,N/A,N/A,N/A,$0.01,N/A,$0.01,N/A,N/A,$0.01
9609077,0636,90686,,,,,N/A,N/A,FLU VACCINE,$43.38,$32.25,$33.95,$35.00,N/A,$33.95,N/A,N/A,N/A,N/A,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
90707LSC,0636,90707,,,,,N/A,N/A,MMR VACCINE,$66.59,$49.50,$101.85,$105.00,N/A,$101.85,N/A,N/A,N/A,N/A,N/A,$101.85,N/A,$105.00,N/A,N/A,$101.85
5190716,0636,90716,,,,,N/A,N/A,VARICELLA VIRUS VACCINE,$180.60,$134.25,$173.63,$179.00,N/A,$173.63,N/A,N/A,N/A,$179.00,N/A,$173.63,N/A,$179.00,N/A,N/A,$173.63
90718LSC,0636,90718,,,,,N/A,N/A,D T VACCINE IMMUNIZATION,$37.33,$27.75,$35.89,$37.00,N/A,$35.89,N/A,N/A,N/A,$37.00,N/A,$35.89,N/A,$37.00,N/A,N/A,$35.89
9609073,0636,90732,,,,,N/A,N/A,PNEUMOCCAL CCC,$136.21,$101.25,$130.95,$135.00,N/A,$130.95,N/A,N/A,N/A,$135.00,N/A,$130.95,N/A,$135.00,N/A,N/A,$130.95
9609074,0636,90745,,,,,N/A,N/A,Hep B Vac Ccc,$134.19,$99.75,$129.01,$133.00,N/A,$129.01,N/A,N/A,N/A,$133.00,N/A,$129.01,N/A,$133.00,N/A,N/A,$129.01
90746LSC,0636,90746,,,,,N/A,N/A,HEP B VACCINE AGE>20,$73.65,$54.75,$81.48,$84.00,N/A,$81.48,N/A,N/A,N/A,$84.00,N/A,$81.48,N/A,$84.00,N/A,N/A,$81.48
5190750,0636,90750,,,,,N/A,N/A,SHINGLES VACCINE,$261.32,$194.25,$305.55,$315.00,N/A,$305.55,N/A,N/A,N/A,$315.00,N/A,$305.55,N/A,$315.00,N/A,N/A,$305.55
90672S,0636,90672S,,,,,N/A,N/A,FLUMIST,$0.01,$0.01,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
J0171,0636,J0171,,,,,N/A,N/A,INJ EPINEPHRINE 0.1 MG,$26.23,$19.50,$25.22,$26.00,N/A,$25.22,N/A,N/A,N/A,$26.00,N/A,$25.22,N/A,$26.00,N/A,N/A,$25.22
J0171LSC,0636,J0171,,,,,N/A,N/A,EPINEPHRINE,$26.23,$19.50,$25.22,$26.00,N/A,$25.22,N/A,N/A,N/A,$26.00,N/A,$25.22,N/A,$26.00,N/A,N/A,$25.22
J0270,0636,J0270,,,,,N/A,N/A,INJ ALPROSTADIL 1.25 MCG,$420.73,$312.75,$404.49,$417.00,N/A,$404.49,N/A,N/A,N/A,$417.00,N/A,$404.49,N/A,$417.00,N/A,N/A,$404.49
J027040,0636,J0270,,,,,N/A,N/A,INJ ALPROSTADIL 1.25 MCG,$420.73,$312.75,$404.49,$417.00,N/A,$404.49,N/A,N/A,N/A,$417.00,N/A,$404.49,N/A,$417.00,N/A,N/A,$404.49
J0561,0636,J0561,,,,,N/A,N/A,"INJ PEN G BENZ 100,000 UNITS",$12.11,$9.00,$658.97,$679.35,N/A,$658.97,N/A,N/A,N/A,$679.35,N/A,$658.97,N/A,$679.35,N/A,N/A,$658.97
J0585,0636,J0585,,,,,N/A,N/A,INJ ONABOTULINUMTOXINA 1 UNITS,$16.14,$12.00,"$1,846.45","$1,903.56",N/A,"$1,846.45",N/A,N/A,N/A,"$1,903.56",N/A,"$1,846.45",N/A,"$1,903.56",N/A,N/A,"$1,846.45"
5190000,0636,J0696,,,,,N/A,N/A,INJ CEFTRIAXONE PER 250 MG,$46.41,$34.50,$150.62,$155.28,N/A,$150.62,N/A,N/A,N/A,$155.28,N/A,$150.62,N/A,$155.28,N/A,N/A,$150.62
J0696,0636,J0696,,,,,N/A,N/A,INJ CEFTRIAXONE PER 250 MG,$12.11,$9.00,$150.62,$155.28,N/A,$150.62,N/A,N/A,N/A,$155.28,N/A,$150.62,N/A,$155.28,N/A,N/A,$150.62
J069640,0636,J0696,,,,,N/A,N/A,INJ CEFTRIAXONE PER 250 MG,$12.11,$9.00,$150.62,$155.28,N/A,$150.62,N/A,N/A,N/A,$155.28,N/A,$150.62,N/A,$155.28,N/A,N/A,$150.62
J0696LSC,0636,J0696,,,,,N/A,N/A,CERTRIAXONE,$20.18,$15.00,$150.62,$155.28,N/A,$150.62,N/A,N/A,N/A,$155.28,N/A,$150.62,N/A,$155.28,N/A,N/A,$150.62
J0702,0636,J0702,,,,,N/A,N/A,"Injection, Betamethasone 3mg",$25.22,$18.75,$24.25,$25.00,N/A,$24.25,N/A,N/A,N/A,$25.00,N/A,$24.25,N/A,$25.00,N/A,N/A,$24.25
J0897,0636,J0897,,,,,N/A,N/A,INJ DENOSUMAB 1 MG,"$1,890.75","$1,405.50","$3,371.91","$3,476.20",N/A,"$3,371.91",N/A,N/A,N/A,"$3,476.20",N/A,"$3,371.91",N/A,"$3,476.20",N/A,N/A,"$3,371.91"
J089740,0636,J0897,,,,,N/A,N/A,Inj Denosumab 1 Mg,"$1,890.75","$1,405.50","$3,371.91","$3,476.20",N/A,"$3,371.91",N/A,N/A,N/A,"$3,476.20",N/A,"$3,371.91",N/A,"$3,476.20",N/A,N/A,"$3,371.91"
J1020,0636,J1020,,,,,N/A,N/A,INJ METHYPREDNISOLONE ACE 20MG,$35.31,$26.25,$33.95,$35.00,N/A,$33.95,N/A,N/A,N/A,$35.00,N/A,$33.95,N/A,$35.00,N/A,N/A,$33.95
J1030,0636,J1030,,,,,N/A,N/A,INJ METHYPREDNISOLONE ACE 40MG,$43.38,$32.25,$114.85,$118.40,N/A,$114.85,N/A,N/A,N/A,$118.40,N/A,$114.85,N/A,$118.40,N/A,N/A,$114.85
J103040,0636,J1030,,,,,N/A,N/A,INJ METHYPREDNISOLONE ACE 40MG,$43.38,$32.25,$114.85,$118.40,N/A,$114.85,N/A,N/A,N/A,$118.40,N/A,$114.85,N/A,$118.40,N/A,N/A,$114.85
J103045,0636,J1030,,,,,N/A,N/A,INJ METHYPREDNISOLONE ACE 40MG,$43.38,$32.25,$114.85,$118.40,N/A,$114.85,N/A,N/A,N/A,$118.40,N/A,$114.85,N/A,$118.40,N/A,N/A,$114.85
J1040,0636,J1040,,,,,N/A,N/A,INJ METHYPREDNISOLONE ACE 80MG,$69.62,$51.75,$66.93,$69.00,N/A,$66.93,N/A,N/A,N/A,$69.00,N/A,$66.93,N/A,$69.00,N/A,N/A,$66.93
J104040,0636,J1040,,,,,N/A,N/A,Inj Methyprednisolone Ace 80mg,$69.62,$51.75,$66.93,$69.00,N/A,$66.93,N/A,N/A,N/A,$69.00,N/A,$66.93,N/A,$69.00,N/A,N/A,$66.93
J104045,0636,J1040,,,,,N/A,N/A,INJ METHYPREDNISOLONE ACE 80MG,$69.62,$51.75,$66.93,$69.00,N/A,$66.93,N/A,N/A,N/A,$69.00,N/A,$66.93,N/A,$69.00,N/A,N/A,$66.93
J1050,0636,J1050,,,,,N/A,N/A,INJ MEDROXYPROGESTERIN ACE 1MG,$39.35,$29.25,$280.65,$289.33,N/A,$280.65,N/A,N/A,N/A,$289.33,N/A,$280.65,N/A,$289.33,N/A,N/A,$280.65
J1071,0636,J1071,,,,,N/A,N/A,INJ TESTOSTERONE CYPIONATE 1MG,$0.88,$0.65,$0.84,$0.87,N/A,$0.84,N/A,N/A,N/A,$0.87,N/A,$0.84,N/A,$0.87,N/A,N/A,$0.84
J107140,0636,J1071,,,,,N/A,N/A,INJ TESTOSTERONE CYPIONATE 1MG,$0.88,$0.65,$0.84,$0.87,N/A,$0.84,N/A,N/A,N/A,$0.87,N/A,$0.84,N/A,$0.87,N/A,N/A,$0.84
J1100,0636,J1100,,,,,N/A,N/A,INJ DEXAMETHASONE NA PHOS 1MG,$0.85,$0.63,$55.22,$56.93,N/A,$55.22,N/A,N/A,N/A,$56.93,N/A,$55.22,N/A,$56.93,N/A,N/A,$55.22
999J1170,0636,J1170,,,,,N/A,N/A,"INJECTION, HYDROMORPHONE",$4.36,$3.24,$13.80,$14.23,N/A,$13.80,N/A,N/A,N/A,$14.23,N/A,$13.80,N/A,$14.23,N/A,N/A,$13.80
J1200,0636,J1200,,,,,N/A,N/A,INJ DIPHENHYDRAMINE UP TO 50MG,$6.05,$4.50,$86.16,$88.82,N/A,$86.16,N/A,N/A,N/A,$88.82,N/A,$86.16,N/A,$88.82,N/A,N/A,$86.16
J1580,0636,J1580,,,,,N/A,N/A,INJ GENTAMICIN UP TO 80MG,$7.06,$5.25,$73.40,$75.67,N/A,$73.40,N/A,N/A,N/A,$75.67,N/A,$73.40,N/A,$75.67,N/A,N/A,$73.40
J158040,0636,J1580,,,,,N/A,N/A,INJ GENTAMICIN UP TO 80MG,$14.13,$10.50,$73.40,$75.67,N/A,$73.40,N/A,N/A,N/A,$75.67,N/A,$73.40,N/A,$75.67,N/A,N/A,$73.40
999J1610,0636,J1610,,,,,N/A,N/A,"INJ,GLUCAGON HYDROCHLORIDE 1MG",$198.52,$147.57,$49.44,$50.97,N/A,$49.44,N/A,N/A,N/A,$50.97,N/A,$49.44,N/A,$50.97,N/A,N/A,$49.44
J1630,0636,J1630,,,,,N/A,N/A,INJ HALOPERIDOL UP TO 5MG,$30.27,$22.50,$29.10,$30.00,N/A,$29.10,N/A,N/A,N/A,$30.00,N/A,$29.10,N/A,$30.00,N/A,N/A,$29.10
J1644,0636,J1644,,,,,N/A,N/A,INJ HEPARIN NA PER 1000 UNITS,$328.91,$244.50,$316.22,$326.00,N/A,$316.22,N/A,N/A,N/A,$326.00,N/A,$316.22,N/A,$326.00,N/A,N/A,$316.22
J164440,0636,J1644,,,,,N/A,N/A,HEPARIN,$328.91,$244.50,$316.22,$326.00,N/A,$316.22,N/A,N/A,N/A,$326.00,N/A,$316.22,N/A,$326.00,N/A,N/A,$316.22
J1720,0636,J1720,,,,,N/A,N/A,INJ HYDROCORTISONE SUCC UP 100,$28.25,$21.00,$27.16,$28.00,N/A,$27.16,N/A,N/A,N/A,$28.00,N/A,$27.16,N/A,$28.00,N/A,N/A,$27.16
J172040,0636,J1720,,,,,N/A,N/A,INJ HYDROCORTISONE SUCC UP 100,$28.25,$21.00,$27.16,$28.00,N/A,$27.16,N/A,N/A,N/A,$28.00,N/A,$27.16,N/A,$28.00,N/A,N/A,$27.16
J1885,0636,J1885,,,,,N/A,N/A,INJ KETOROLAC PER 15MG,$10.09,$7.50,$55.51,$57.23,N/A,$55.51,N/A,N/A,N/A,$57.23,N/A,$55.51,N/A,$57.23,N/A,N/A,$55.51
J188540,0636,J1885,,,,,N/A,N/A,INJ KETOROLAC PER 15MG,$10.09,$7.50,$55.51,$57.23,N/A,$55.51,N/A,N/A,N/A,$57.23,N/A,$55.51,N/A,$57.23,N/A,N/A,$55.51
J188550,0636,J1885,,,,,N/A,N/A,INJ KETOROLAC PER 15MG,$10.09,$7.50,$55.51,$57.23,N/A,$55.51,N/A,N/A,N/A,$57.23,N/A,$55.51,N/A,$57.23,N/A,N/A,$55.51
J1885LSC,0636,J1885,,,,,N/A,N/A,TORADOL 15 MG,$10.09,$7.50,$55.51,$57.23,N/A,$55.51,N/A,N/A,N/A,$57.23,N/A,$55.51,N/A,$57.23,N/A,N/A,$55.51
J1950,0636,J1950,,,,,N/A,N/A,INJ LEUPROLIDE ACE(DEPOT)3.75M,$672.96,$500.25,$787.67,$812.03,N/A,$787.67,N/A,N/A,N/A,$812.03,N/A,$787.67,N/A,$812.03,N/A,N/A,$787.67
J195040,0636,J1950,,,,,N/A,N/A,Inj Leuprolide Ace(Depot)3.75m,$698.19,$519.00,$787.67,$812.03,N/A,$787.67,N/A,N/A,N/A,$812.03,N/A,$787.67,N/A,$812.03,N/A,N/A,$787.67
J2060,0636,J2060,,,,,N/A,N/A,LORazepam 2 MG/ML VIAL,$5.04,$3.75,$48.25,$49.74,N/A,$48.25,N/A,N/A,N/A,$49.74,N/A,$48.25,N/A,$49.74,N/A,N/A,$48.25
J2175,0636,J2175,,,,,N/A,N/A,INJ MEPERIDINE PER 100MG,$10.09,$7.50,$116.02,$119.61,N/A,$116.02,N/A,N/A,N/A,$119.61,N/A,$116.02,N/A,$119.61,N/A,N/A,$116.02
J2212,0636,J2212,,,,,N/A,N/A,INJ METHYLNALTREXONE 0.1MG,$426.78,$317.25,$410.34,$423.00,N/A,$410.34,N/A,N/A,N/A,$423.00,N/A,$410.34,N/A,$423.00,N/A,N/A,$410.34
J221240,0636,J2212,,,,,N/A,N/A,INJ METHYLNALTREXONE 0.1MG,$426.78,$317.25,$410.34,$423.00,N/A,$410.34,N/A,N/A,N/A,$423.00,N/A,$410.34,N/A,$423.00,N/A,N/A,$410.34
J2270,0636,J2270,,,,,N/A,N/A,MORPHINE INJECTION UP TO 10MG,$8.07,$6.00,$66.46,$68.52,N/A,$66.46,N/A,N/A,N/A,$68.52,N/A,$66.46,N/A,$68.52,N/A,N/A,$66.46
J2405,0636,J2405,,,,,N/A,N/A,INJ ONDANSETRON PER 1MG,$2.02,$1.50,$11.86,$12.23,N/A,$11.86,N/A,N/A,N/A,$12.23,N/A,$11.86,N/A,$12.23,N/A,N/A,$11.86
J2550,0636,J2550,,,,,N/A,N/A,INJ PROMETHAZINE UP TO 50MG,$18.16,$13.50,$17.46,$18.00,N/A,$17.46,N/A,N/A,N/A,$18.00,N/A,$17.46,N/A,$18.00,N/A,N/A,$17.46
J255050,0636,J2550,,,,,N/A,N/A,INJ PROMETHAZINE UP TO 50MG,$18.16,$13.50,$17.46,$18.00,N/A,$17.46,N/A,N/A,N/A,$18.00,N/A,$17.46,N/A,$18.00,N/A,N/A,$17.46
J2550LSC,0636,J2550,,,,,N/A,N/A,PROMETHAZINE 25 MG,$18.16,$13.50,$17.46,$18.00,N/A,$17.46,N/A,N/A,N/A,$18.00,N/A,$17.46,N/A,$18.00,N/A,N/A,$17.46
J2765,0636,J2765,,,,,N/A,N/A,INJ Metoclopramide UP TO 10MG,$20.18,$15.00,$58.78,$60.60,N/A,$58.78,N/A,N/A,N/A,$60.60,N/A,$58.78,N/A,$60.60,N/A,N/A,$58.78
J2790,0636,J2790,,,,,N/A,N/A,RHO GAM 1 DOSE,$173.54,$129.00,$485.59,$500.61,N/A,$485.59,N/A,N/A,N/A,$500.61,N/A,$485.59,N/A,$500.61,N/A,N/A,$485.59
J2920,0636,J2920,,,,,N/A,N/A,INJ METHYLPRED NA SUCC UP 40MG,$21.19,$15.75,$20.37,$21.00,N/A,$20.37,N/A,N/A,N/A,$21.00,N/A,$20.37,N/A,$21.00,N/A,N/A,$20.37
J2930,0636,J2930,,,,,N/A,N/A,INJ METHYLPRED NA SUCC UP125MG,$30.27,$22.50,$183.17,$188.84,N/A,$183.17,N/A,N/A,N/A,$188.84,N/A,$183.17,N/A,$188.84,N/A,N/A,$183.17
J293040,0636,J2930,,,,,N/A,N/A,INJ METHYLPRED NA SUCC UP125MG,$60.54,$45.00,$183.17,$188.84,N/A,$183.17,N/A,N/A,N/A,$188.84,N/A,$183.17,N/A,$188.84,N/A,N/A,$183.17
50J3301,0636,J3301,,,,,N/A,N/A,Inj Triamcinolone Acet 10mg,$50.45,$37.50,$48.50,$50.00,N/A,$48.50,N/A,N/A,N/A,$50.00,N/A,$48.50,N/A,$50.00,N/A,N/A,$48.50
J3301,0636,J3301,,,,,N/A,N/A,INJ TRIAMCINOLONE ACET 10MG,$50.45,$37.50,$48.50,$50.00,N/A,$48.50,N/A,N/A,N/A,$50.00,N/A,$48.50,N/A,$50.00,N/A,N/A,$48.50
J3304,0636,J3304,,,,,N/A,N/A,INJ TRIAMCINOLONE ACE ER MC1MG,"$1,610.27","$1,197.00","$1,548.12","$1,596.00",N/A,"$1,548.12",N/A,N/A,N/A,"$1,596.00",N/A,"$1,548.12",N/A,"$1,596.00",N/A,N/A,"$1,548.12"
J330445,0636,J3304,,,,,N/A,N/A,INJ TRIAMCINOLONE ACE ER MC1MG,"$1,610.27","$1,197.00","$1,548.12","$1,596.00",N/A,"$1,548.12",N/A,N/A,N/A,"$1,596.00",N/A,"$1,548.12",N/A,"$1,596.00",N/A,N/A,"$1,548.12"
J3420,0636,J3420,,,,,N/A,N/A,INJ CYANOCOBALAMIN UP 1000 MG,$8.07,$6.00,$59.09,$60.92,N/A,$59.09,N/A,N/A,N/A,$60.92,N/A,$59.09,N/A,$60.92,N/A,N/A,$59.09
J3490V,0636,J3490,,,,,N/A,N/A,VERAPAMIL 10MG,$253.24,$188.25,$0.97,$1.00,N/A,$0.97,N/A,N/A,N/A,$1.00,N/A,$0.97,N/A,$1.00,N/A,N/A,$0.97
J3490V40,0636,J3490,,,,,N/A,N/A,VERAPAMIL 10 MG,$253.24,$188.25,$0.97,$1.00,N/A,$0.97,N/A,N/A,N/A,$1.00,N/A,$0.97,N/A,$1.00,N/A,N/A,$0.97
J3590,0636,J3590,,,,,N/A,N/A,AIMOVIG,"$1,321.71",$982.50,"$12,158.95","$12,535.00",N/A,"$12,158.95",N/A,N/A,N/A,"$12,535.00",N/A,"$12,158.95",N/A,"$12,535.00",N/A,N/A,"$12,158.95"
J7296,0636,J7296,,,,,N/A,N/A,Iud Contracept Kyleena 19.5mg,"$1,059.39",$787.50,"$2,473.16","$2,549.65",N/A,"$2,473.16",N/A,N/A,N/A,"$2,549.65",N/A,"$2,473.16",N/A,"$2,549.65",N/A,N/A,"$2,473.16"
J7297,0636,J7297,,,,,N/A,N/A,IUD CONTRACEPT LILETTA,"$1,008.94",$750.00,"$2,205.12","$2,273.32",N/A,"$2,205.12",N/A,N/A,N/A,"$2,273.32",N/A,"$2,205.12",N/A,"$2,273.32",N/A,N/A,"$2,205.12"
J7298,0636,J7298,,,,,N/A,N/A,IUD CONTRACEPT MIRENA 52 MG,"$1,059.39",$787.50,"$1,018.50","$1,050.00",N/A,"$1,018.50",N/A,N/A,N/A,"$1,050.00",N/A,"$1,018.50",N/A,"$1,050.00",N/A,N/A,"$1,018.50"
J7300,0636,J7300,,,,,N/A,N/A,IUD CONTRACEPTIVE COPPER,$892.91,$663.75,"$1,304.63","$1,344.98",N/A,"$1,304.63",N/A,N/A,N/A,"$1,344.98",N/A,"$1,304.63",N/A,"$1,344.98",N/A,N/A,"$1,304.63"
J7301,0636,J7301,,,,,N/A,N/A,IUD CONTRACEPTIVE SKYLA 13.5MG,$908.05,$675.00,"$2,279.66","$2,350.17",N/A,"$2,279.66",N/A,N/A,N/A,"$2,350.17",N/A,"$2,279.66",N/A,"$2,350.17",N/A,N/A,"$2,279.66"
J7307,0636,J7307,,,,,N/A,N/A,ETOMOGESTREL INPLANT SYSTEM,"$1,260.17",$936.75,"$1,211.53","$1,249.00",N/A,"$1,211.53",N/A,N/A,N/A,"$1,249.00",N/A,"$1,211.53",N/A,"$1,249.00",N/A,N/A,"$1,211.53"
J7318,0636,J7318,,,,,N/A,N/A,INJ HYALURONON DUROLANE 1MG,"$2,401.28","$1,785.00","$2,308.60","$2,380.00",N/A,"$2,308.60",N/A,N/A,N/A,"$2,380.00",N/A,"$2,308.60",N/A,"$2,380.00",N/A,N/A,"$2,308.60"
J731845,0636,J7318,,,,,N/A,N/A,INJ HYALURONON DUROLANE 1MG,"$2,401.28","$1,785.00","$2,308.60","$2,380.00",N/A,"$2,308.60",N/A,N/A,N/A,"$2,380.00",N/A,"$2,308.60",N/A,"$2,380.00",N/A,N/A,"$2,308.60"
J7325,0636,J7325,,,,,N/A,N/A,INJ HYALURONON SYNVISC-ONE 1MG,$18.29,$13.60,$17.59,$18.13,N/A,$17.59,N/A,N/A,N/A,$18.13,N/A,$17.59,N/A,$18.13,N/A,N/A,$17.59
J732545,0636,J7325,,,,,N/A,N/A,INJ HYALURONON SYNVISC-ONE 1MG,$18.16,$13.50,$17.59,$18.13,N/A,$17.59,N/A,N/A,N/A,$18.13,N/A,$17.59,N/A,$18.13,N/A,N/A,$17.59
J7327,0636,J7327,,,,,N/A,N/A,INJ HYALURONON MONOVISC PERDOS,$988.76,$735.00,$950.60,$980.00,N/A,$950.60,N/A,N/A,N/A,$980.00,N/A,$950.60,N/A,$980.00,N/A,N/A,$950.60
J732745,0636,J7327,,,,,N/A,N/A,INJ HYALURONON MONOVISC PERDOS,$988.76,$735.00,$950.60,$980.00,N/A,$950.60,N/A,N/A,N/A,$980.00,N/A,$950.60,N/A,$980.00,N/A,N/A,$950.60
5190007,0636,J7620,,,,,N/A,N/A,ALBUTEROL 2.5MG/IPRATROPIUM .5,$15.13,$11.25,$14.55,$15.00,N/A,$14.55,N/A,N/A,N/A,$15.00,N/A,$14.55,N/A,$15.00,N/A,N/A,$14.55
J7620,0636,J7620,,,,,N/A,N/A,ALBUTEROL 2.5MG/IPRATROPIUM .5,$15.13,$11.25,$14.55,$15.00,N/A,$14.55,N/A,N/A,N/A,$15.00,N/A,$14.55,N/A,$15.00,N/A,N/A,$14.55
J7645,0636,J7645,,,,,N/A,N/A,IPRATROPIUM PER MG,$5.04,$3.75,$4.85,$5.00,N/A,$4.85,N/A,N/A,N/A,$5.00,N/A,$4.85,N/A,$5.00,N/A,N/A,$4.85
6360001,0636,J7674,,,,,N/A,N/A,"Methacholine Chloride,per 1 mg",$506.49,$376.50,$486.94,$502.00,N/A,$486.94,N/A,N/A,N/A,$502.00,N/A,$486.94,N/A,$502.00,N/A,N/A,$486.94
J9030,0636,J9030,,,,,N/A,N/A,BCG (INTRAVESICAL) PER INST,$297.64,$221.25,$286.15,$295.00,N/A,$286.15,N/A,N/A,N/A,$295.00,N/A,$286.15,N/A,$295.00,N/A,N/A,$286.15
J903040,0636,J9030,,,,,N/A,N/A,BCG (INTRAVESICAL) PER INST,$297.64,$221.25,$286.15,$295.00,N/A,$286.15,N/A,N/A,N/A,$295.00,N/A,$286.15,N/A,$295.00,N/A,N/A,$286.15
J9201,0636,J9201,,,,,N/A,N/A,INJ GEMCITABINE 200 MG,$353.13,$262.50,$339.50,$350.00,N/A,$339.50,N/A,N/A,N/A,$350.00,N/A,$339.50,N/A,$350.00,N/A,N/A,$339.50
J920140,0636,J9201,,,,,N/A,N/A,INJ GEMCITABINE 200 MG,$353.13,$262.50,$339.50,$350.00,N/A,$339.50,N/A,N/A,N/A,$350.00,N/A,$339.50,N/A,$350.00,N/A,N/A,$339.50
J9214,0636,J9214,,,,,N/A,N/A,INJ INTERFERON ALFA2B 1MILLON,$50.45,$37.50,$48.50,$50.00,N/A,$48.50,N/A,N/A,N/A,$50.00,N/A,$48.50,N/A,$50.00,N/A,N/A,$48.50
J921440,0636,J9214,,,,,N/A,N/A,INJ INTERFERON ALFA2B 1MILLON,$50.45,$37.50,$48.50,$50.00,N/A,$48.50,N/A,N/A,N/A,$50.00,N/A,$48.50,N/A,$50.00,N/A,N/A,$48.50
J9217,0636,J9217,,,,,N/A,N/A,INJ LEUPROLIDE ACE(DEPOT)7.5MG,$461.09,$342.75,$443.29,$457.00,N/A,$443.29,N/A,N/A,N/A,$457.00,N/A,$443.29,N/A,$457.00,N/A,N/A,$443.29
J921740,0636,J9217,,,,,N/A,N/A,INJ LEUPROLIDE ACE(DEPOT)7.5MG,$461.09,$342.75,$443.29,$457.00,N/A,$443.29,N/A,N/A,N/A,$457.00,N/A,$443.29,N/A,$457.00,N/A,N/A,$443.29
J9217E,0636,J9217,,,,,N/A,N/A,INJ LEUPROLIDE ACE(DEPOT)45MG,"$1,976.51","$1,469.25",$443.29,$457.00,N/A,$443.29,N/A,N/A,N/A,$457.00,N/A,$443.29,N/A,$457.00,N/A,N/A,$443.29
J9217E40A,0636,J9217,,,,,N/A,N/A,INJ LEUPROLIDE ACE(DEPOT)45MG,"$1,976.51","$1,469.25",$443.29,$457.00,N/A,$443.29,N/A,N/A,N/A,$457.00,N/A,$443.29,N/A,$457.00,N/A,N/A,$443.29
J9260,0636,J9260,,,,,N/A,N/A,INJ METHOTREXATE 50MG,$10.09,$7.50,$9.70,$10.00,N/A,$9.70,N/A,N/A,N/A,$10.00,N/A,$9.70,N/A,$10.00,N/A,N/A,$9.70
J9280,0636,J9280,,,,,N/A,N/A,INJ MITOMYCIN 5 MG,$579.13,$430.50,$626.68,$646.06,N/A,$626.68,N/A,N/A,N/A,$646.06,N/A,$626.68,N/A,$646.06,N/A,N/A,$626.68
J928040,0636,J9280,,,,,N/A,N/A,INJ MITOMYCIN 5 MG,$579.13,$430.50,$626.68,$646.06,N/A,$626.68,N/A,N/A,N/A,$646.06,N/A,$626.68,N/A,$646.06,N/A,N/A,$626.68
Q2038,0636,Q2038,,,,,N/A,N/A,INFLUENZA VACCINATION,$68.61,$51.00,$65.96,$68.00,N/A,$65.96,N/A,N/A,N/A,$68.00,N/A,$65.96,N/A,$68.00,N/A,N/A,$65.96
Q4186,0636,Q4186,,,,,N/A,N/A,EPIFIX,$161.43,$120.00,$155.20,$160.00,N/A,$155.20,N/A,N/A,N/A,$160.00,N/A,$155.20,N/A,$160.00,N/A,N/A,$155.20
90649,0636,,,,,,N/A,N/A,HPV VACCINE 3 DOSE SCH. INTR,$250.22,$186.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3900711,0636,,,,,,N/A,N/A,Rho Gam Dose,$488.33,$363.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
J330140,0636,,,,,,N/A,N/A,INJ TRIAMCINOLONE ACET 10MG,$50.45,$37.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4900002,0710,,,,,,N/A,N/A,DSU RECOVERY,$831.37,$618.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4900003,0710,,,,,,N/A,N/A,ADD'L DSU RECOVERY PER MIN,$18.16,$13.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7100001,0710,,,,,,N/A,N/A,RECOVERY ROOM FIRST HOUR,"$1,389.31","$1,032.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7100002,0710,,,,,,N/A,N/A,ADDTL RECOVERY ROOM PER MIN,$29.26,$21.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7100003,0710,,,,,,N/A,N/A,EYEBLOCK/MONITORING ONE HOUR,"$1,389.31","$1,032.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7100004,0710,,,,,,N/A,N/A,MS PHASE II RECOVERY,$943.36,$701.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7100006,0710,,,,,,N/A,N/A,SECONDARY RECOVERY 1ST HR,$787.98,$585.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7100007,0710,,,,,,N/A,N/A,MS PHASE II RECOVERY ADD'L MIN,$17.15,$12.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7100009,0710,,,,,,N/A,N/A,SECONDARY RECOVERY ADD HR,$543.82,$404.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7100014,0710,,,,,,N/A,N/A,RECOVERY - 1ST 6 HOURS,$305.71,$227.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7100017,0710,,,,,,N/A,N/A,SECONDARY RECOVERY 1ST HR SCU,$787.98,$585.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7100018,0710,,,,,,N/A,N/A,SECONDARY RECOVERY ADD HR SCU,$543.82,$404.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7100019,0710,,,,,,N/A,N/A,EXTENDED RECOVERY SERVICES,$170.51,$126.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7100021,0710,,,,,,N/A,N/A,NURSERY RECOVERY,$147.31,$109.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7106300,0710,,,,,,N/A,N/A,SCU PHASE I RECOVERY,"$1,463.97","$1,088.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7116300,0710,,,,,,N/A,N/A,SCU PHASE II RECOVERY,$917.13,$681.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7136300,0710,,,,,,N/A,N/A,SCU PHASE I RECOVERY ADD'L 30M,$748.63,$556.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7146300,0710,,,,,,N/A,N/A,SCU PHASE II RECOVERY ADD'L HR,$621.51,$462.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9900710,0710,,,,,,N/A,N/A,DMHC~ANGIO RECOVERY 1 HOUR,$962.53,$715.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4800007,0720,59020,,,,,N/A,N/A,STRESS TEST~P,$935.29,$695.25,$23.36,$23.36,$23.36,N/A,$23.36,N/A,$23.36,N/A,$23.36,N/A,$23.36,N/A,$23.36,$23.36,N/A
7209999,0720,99088,,,,,N/A,N/A,Labor Room Misc,$0.00,$0.00,$0.00,$0.00,N/A,$0.00,N/A,N/A,N/A,$0.00,N/A,$0.00,N/A,$0.00,N/A,N/A,$0.00
7205920,0721,59200,,,,,N/A,N/A,LABOR INDUCTION,"$1,782.80","$1,325.25",$185.37,"$1,767.00",$724.47,"$1,713.99",$724.47,$0.00,$724.47,$185.37,$724.47,"$1,713.99",$724.47,"$1,767.00",$724.47,$724.47,"$1,713.99"
7609997,0721,99088,,,,,N/A,N/A,Observation Misc Obs,$0.00,$0.00,$0.00,$0.00,N/A,$0.00,N/A,N/A,N/A,$0.00,N/A,$0.00,N/A,$0.00,N/A,N/A,$0.00
7200011,0721,G0378,,,,,N/A,N/A,LABOR INDUCTION,"$1,782.80","$1,325.25",$146.47,$151.00,N/A,$146.47,N/A,N/A,N/A,$151.00,N/A,$146.47,N/A,$151.00,N/A,N/A,$146.47
7600003,0721,G0378,,,,,N/A,N/A,OBSERVATION OBSTETRICS,$153.36,$114.00,$146.47,$151.00,N/A,$146.47,N/A,N/A,N/A,$151.00,N/A,$146.47,N/A,$151.00,N/A,N/A,$146.47
7200001,0722,,,,,,N/A,N/A,LABOR ROOM & DELIVERY,"$4,597.74","$3,417.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7200010,0722,,,,,,N/A,N/A,OBS NURS TIME AMB RN,$479.25,$356.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7200015,0722,,,,,,N/A,N/A,DELIVERY RM 1/2 HR,"$2,452.73","$1,823.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7200016,0722,,,,,,N/A,N/A,RECOVERY CHGS 1ST HR,$969.59,$720.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7200017,0722,,,,,,N/A,N/A,REC CHGS ADD1/2 HR,$523.64,$389.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7200008,0724,,,,,,N/A,N/A,BIRTHING RM 24 HOURS,"$7,042.40","$5,235.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7200020,0724,,,,,,N/A,N/A,BIRTHING RM 36 HRS,"$8,250.10","$6,132.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
3092374,0730,87075,,,,,N/A,N/A,Fahc Anaerobe Culture/Smear,$0.00,$0.00,$10.48,$170.00,N/A,$164.90,N/A,N/A,N/A,$10.48,N/A,$164.90,N/A,$170.00,N/A,N/A,$164.90
93005,0730,93005,,,,,N/A,N/A,"ELECTROCARDIOGRAM, TRACING",$43.38,$32.25,$113.00,$346.00,$141.86,$335.62,$141.86,N/A,$141.86,$113.00,$141.86,$335.62,$141.86,$346.00,$141.86,$141.86,$335.62
4193005,0730,93005,,,,,N/A,N/A,Pre/Post Cardioversion Ekg,$0.00,$0.00,$113.00,$346.00,$141.86,$335.62,$141.86,N/A,$141.86,$113.00,$141.86,$335.62,$141.86,$346.00,$141.86,$141.86,$335.62
9393005,0730,93005,,,,,N/A,N/A,Pre/Post Cardioversion Ekg,$0.00,$0.00,$113.00,$346.00,$141.86,$335.62,$141.86,N/A,$141.86,$113.00,$141.86,$335.62,$141.86,$346.00,$141.86,$141.86,$335.62
419300559,0730,93005,,,,,N/A,N/A,CARDIOVERSION EXTRA EKG    -59,$432.84,$321.75,$113.00,$346.00,$141.86,$335.62,$141.86,N/A,$141.86,$113.00,$141.86,$335.62,$141.86,$346.00,$141.86,$141.86,$335.62
939300559,0730,93005,,,,,N/A,N/A,CARDIOVERSION EXTRA EKG    -59,$461.09,$342.75,$113.00,$346.00,$141.86,$335.62,$141.86,N/A,$141.86,$113.00,$141.86,$335.62,$141.86,$346.00,$141.86,$141.86,$335.62
7300004A,0730,93005,,,,,N/A,N/A,EKG SCU,$370.28,$275.25,$113.00,$346.00,$141.86,$335.62,$141.86,N/A,$141.86,$113.00,$141.86,$335.62,$141.86,$346.00,$141.86,$141.86,$335.62
7300005A,0730,93005,,,,,N/A,N/A,EKG (RT),$349.09,$259.50,$113.00,$346.00,$141.86,$335.62,$141.86,N/A,$141.86,$113.00,$141.86,$335.62,$141.86,$346.00,$141.86,$141.86,$335.62
7300007A,0730,93005,,,,,N/A,N/A,EKG (CARD OP),$349.09,$259.50,$113.00,$346.00,$141.86,$335.62,$141.86,N/A,$141.86,$113.00,$141.86,$335.62,$141.86,$346.00,$141.86,$141.86,$335.62
7300711A,0730,93005,,,,,N/A,N/A,EKG                    93005~T,$349.09,$259.50,$113.00,$346.00,$141.86,$335.62,$141.86,N/A,$141.86,$113.00,$141.86,$335.62,$141.86,$346.00,$141.86,$141.86,$335.62
9300534A,0730,93005,,,,,N/A,N/A,"ELECTROCARDIOGRAM, TRACING",$45.40,$33.75,$113.00,$346.00,$141.86,$335.62,$141.86,N/A,$141.86,$113.00,$141.86,$335.62,$141.86,$346.00,$141.86,$141.86,$335.62
3493010B,0730,93010,,,,,N/A,N/A,EKG,$25.22,$18.75,$13.77,$74.00,$36.80,$71.78,$36.80,N/A,$36.80,$13.77,$36.80,$71.78,$36.80,$74.00,$36.80,$36.80,$71.78
7300004B,0730,93010,,,,,N/A,N/A,EKG SCU,$82.73,$61.50,$13.77,$74.00,$36.80,$71.78,$36.80,N/A,$36.80,$13.77,$36.80,$71.78,$36.80,$74.00,$36.80,$36.80,$71.78
7300005B,0730,93010,,,,,N/A,N/A,EKG (RT)~P~,$74.66,$55.50,$13.77,$74.00,$36.80,$71.78,$36.80,N/A,$36.80,$13.77,$36.80,$71.78,$36.80,$74.00,$36.80,$36.80,$71.78
7300007B,0730,93010,,,,,N/A,N/A,EKG (CARD OP),$74.66,$55.50,$13.77,$74.00,$36.80,$71.78,$36.80,N/A,$36.80,$13.77,$36.80,$71.78,$36.80,$74.00,$36.80,$36.80,$71.78
7300711B,0730,93010,,,,,N/A,N/A,EKG                    93010~P,$88.79,$66.00,$13.77,$74.00,$36.80,$71.78,$36.80,N/A,$36.80,$13.77,$36.80,$71.78,$36.80,$74.00,$36.80,$36.80,$71.78
7300002,0730,93017,,,,,N/A,N/A,Long Lead Ii,$182.62,$135.75,$46.04,"$1,299.00",$712.17,"$1,260.03",$712.17,N/A,$712.17,$46.04,$712.17,"$1,260.03",$712.17,"$1,299.00",$712.17,$712.17,"$1,260.03"
7300025,0730,93272,,,,,N/A,N/A,CARDIAC EVENT RECORDER READING,$318.83,$237.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
93005NC,0730,NC,,,,,N/A,N/A,"Electrocardiogram, Tracing",$0.00,$0.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7300003,0731,93225,,,,,N/A,N/A,C LAB HOLTER MONITOR,"$1,210.73",$900.00,$12.29,"$1,200.00",$492.00,"$1,164.00",$492.00,N/A,$492.00,$12.29,$492.00,"$1,164.00",$492.00,"$1,200.00",$492.00,$492.00,"$1,164.00"
7393226,0731,93226,,,,,N/A,N/A,HOLTER SCANNING ANALYSIS,"$1,124.97",$836.25,$457.15,$457.15,$457.15,N/A,$457.15,N/A,$457.15,N/A,$457.15,N/A,$457.15,N/A,$457.15,$457.15,N/A
7393227,0731,0296T,,,,,N/A,N/A,14 Day Cardiac Monitoring,"$1,210.73",$900.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7300020,0732,93270,,,,,N/A,N/A,CER HOOK-UP,$861.63,$640.50,$162.21,$854.00,N/A,$828.38,N/A,N/A,N/A,$162.21,N/A,$828.38,N/A,$854.00,N/A,N/A,$828.38
7495705,0740,95705,,,,,N/A,N/A,"EEG, WITHOUT VIDEO 2-12  HOURS",$283.51,$210.75,$179.21,$281.00,N/A,$272.57,N/A,N/A,N/A,$179.21,N/A,$272.57,N/A,$281.00,N/A,N/A,$272.57
7495708,0740,95708,,,,,N/A,N/A,"EEG, WITHOUT VIDEO 12-26 HOURS",$481.26,$357.75,$247.21,$470.00,N/A,$455.90,N/A,N/A,N/A,$247.21,N/A,$455.90,N/A,$470.00,N/A,N/A,$455.90
4195711,0740,95711,,,,,N/A,N/A,EEG 2-12 HOURS,"$1,684.93","$1,252.50",$363.68,"$1,670.00",N/A,"$1,619.90",N/A,N/A,N/A,$363.68,N/A,"$1,619.90",N/A,"$1,670.00",N/A,N/A,"$1,619.90"
4195714,0740,95714,,,,,N/A,N/A,EEG 12-26 HOURS,"$3,369.86","$2,505.00",$263.15,"$3,340.00",N/A,"$3,239.80",N/A,N/A,N/A,$263.15,N/A,"$3,239.80",N/A,"$3,340.00",N/A,N/A,"$3,239.80"
4195955,0740,95812,,,,,N/A,N/A,"EEG, 41-60 MINUTES",$694.15,$516.00,$419.08,$688.00,N/A,$667.36,N/A,N/A,N/A,$419.08,N/A,$667.36,N/A,$688.00,N/A,N/A,$667.36
4195956,0740,95813,,,,,N/A,N/A,EEG GREATER THAN 1 HOUR,$836.41,$621.75,$465.20,$509.00,N/A,$493.73,N/A,N/A,N/A,$465.20,N/A,$493.73,N/A,$509.00,N/A,N/A,$493.73
7400004,0740,95816,,,,,N/A,N/A,Eeg Awake And Drowsy,"$1,181.47",$878.25,$362.78,$571.81,N/A,$362.78,N/A,N/A,N/A,$571.81,N/A,$362.78,N/A,$374.00,N/A,N/A,$362.78
7400005,0740,95819,,,,,N/A,N/A,Eeg Awake And Asleep,"$1,181.47",$878.25,$430.68,$509.00,N/A,$430.68,N/A,N/A,N/A,$509.00,N/A,$430.68,N/A,$444.00,N/A,N/A,$430.68
7400006,0740,95822,,,,,N/A,N/A,"EEG, COMA OR SLEEP ONLY",$924.19,$687.00,$610.89,$701.00,N/A,$679.97,N/A,N/A,N/A,$610.89,N/A,$679.97,N/A,$701.00,N/A,N/A,$679.97
7600020,0760,G0378,,,,,N/A,N/A,OBSERVATION NURSERY,$150.33,$111.75,$146.47,$151.00,N/A,$146.47,N/A,N/A,N/A,$151.00,N/A,$146.47,N/A,$151.00,N/A,N/A,$146.47
3636410,0761,36410,,,,,N/A,N/A,MIDLINE CATHETER PLACEMENT,$44.39,$33.00,$15.71,$46.00,N/A,$44.62,N/A,$39.33,N/A,$15.71,N/A,$44.62,N/A,$46.00,N/A,N/A,$44.62
3936591,0761,36591,,,,,N/A,N/A,COLLECT BLOOD VENOUS DEVICE,$364.23,$270.75,$46.05,$361.00,$231.24,$350.17,$231.24,$308.66,$231.24,$46.05,$231.24,$350.17,$231.24,$361.00,$231.24,$231.24,$350.17
4600037,0761,36600,,,,,N/A,N/A,RT ABG DRAW FEE,$209.86,$156.00,$26.61,$208.00,$85.28,$201.76,$85.28,$177.84,$85.28,$26.61,$85.28,$201.76,$85.28,$208.00,$85.28,$85.28,$201.76
7686890,0761,86890,,,,,N/A,N/A,"AUTOLOGOUS BD COL, PRCSG, STRG",$726.44,$540.00,$6.29,$720.00,N/A,$698.40,N/A,N/A,N/A,$6.29,N/A,$698.40,N/A,$720.00,N/A,N/A,$698.40
7686891,0761,86891,,,,,N/A,N/A,AUTOLOGOUS -POSTOP SALVAGE,$199.77,$148.50,$123.65,$198.00,N/A,$192.06,N/A,N/A,N/A,$123.65,N/A,$192.06,N/A,$198.00,N/A,N/A,$192.06
9697607,0761,97607,,,,,N/A,N/A,NEG PRESSURE WOUND THERAPY,$70.63,$52.50,$31.82,$148.00,$64.78,$143.56,$64.78,N/A,$64.78,$31.82,$64.78,$143.56,$64.78,$148.00,$64.78,$64.78,$143.56
4500716,0762,G0378,,,,,N/A,N/A,OBSERVATION,$152.35,$113.25,$146.47,$151.00,N/A,$146.47,N/A,N/A,N/A,$151.00,N/A,$146.47,N/A,$151.00,N/A,N/A,$146.47
4500717,0762,G0378,,,,,N/A,N/A,OBSERVATION - ER,$152.35,$113.25,$146.47,$151.00,N/A,$146.47,N/A,N/A,N/A,$151.00,N/A,$146.47,N/A,$151.00,N/A,N/A,$146.47
7600022,0762,G0378,,,,,N/A,N/A,OBSERVATION HOURS,$152.35,$113.25,$146.47,$151.00,N/A,$146.47,N/A,N/A,N/A,$151.00,N/A,$146.47,N/A,$151.00,N/A,N/A,$146.47
7600024,0762,G0378,,,,,N/A,N/A,OBSERVATION HOURS,$152.35,$113.25,$146.47,$151.00,N/A,$146.47,N/A,N/A,N/A,$151.00,N/A,$146.47,N/A,$151.00,N/A,N/A,$146.47
7600050,0762,G0378,,,,,N/A,N/A,OBSERVATION,$125.11,$93.00,$146.47,$151.00,N/A,$146.47,N/A,N/A,N/A,$151.00,N/A,$146.47,N/A,$151.00,N/A,N/A,$146.47
7600051,0762,G0378,,,,,N/A,N/A,OBSERVATION,$126.12,$93.75,$146.47,$151.00,N/A,$146.47,N/A,N/A,N/A,$151.00,N/A,$146.47,N/A,$151.00,N/A,N/A,$146.47
7600103,0762,G0378,,,,,N/A,N/A,OBSERVATION,$153.36,$114.00,$146.47,$151.00,N/A,$146.47,N/A,N/A,N/A,$151.00,N/A,$146.47,N/A,$151.00,N/A,N/A,$146.47
4500719,0762,,,,,,N/A,N/A,OBSERVATION - ER,$147.31,$109.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7600001,0762,,,,,,N/A,N/A,Observation - Observation Unit,$152.35,$113.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7600006,0762,,,,,,N/A,N/A,Observation  - Scu,$147.31,$109.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7600008,0762,,,,,,N/A,N/A,Observation - Medical,$152.35,$113.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7600010,0762,,,,,,N/A,N/A,Observation,$147.31,$109.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7600026,0762,,,,,,N/A,N/A,Observation,$147.31,$109.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7600038,0762,,,,,,N/A,N/A,Observation,$147.31,$109.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9600901B,0771,90470,,,,,N/A,N/A,H1N1 VACCINE ADMINISTRATION,$58.52,$43.50,$12.77,$57.00,$23.78,$55.29,$23.78,N/A,$23.78,$12.77,$23.78,$55.29,$23.78,$57.00,$23.78,$23.78,$55.29
9600902B,0771,90470,,,,,N/A,N/A,H1n1 Vaccine Administration,$50.45,$37.50,$12.77,$57.00,$23.78,$55.29,$23.78,N/A,$23.78,$12.77,$23.78,$55.29,$23.78,$57.00,$23.78,$23.78,$55.29
9600903B,0771,90470,,,,,N/A,N/A,H1N1 VACCINE ADMINISTRATION,$25.22,$18.75,$12.77,$57.00,$23.78,$55.29,$23.78,N/A,$23.78,$12.77,$23.78,$55.29,$23.78,$57.00,$23.78,$23.78,$55.29
9600905B,0771,90470,,,,,N/A,N/A,H1N1 VACCINE ADMINISTRATION,$52.46,$39.00,$12.77,$57.00,$23.78,$55.29,$23.78,N/A,$23.78,$12.77,$23.78,$55.29,$23.78,$57.00,$23.78,$23.78,$55.29
9600906B,0771,90470,,,,,N/A,N/A,H1N1 VACCINE ADMINISTRATION,$57.51,$42.75,$12.77,$57.00,$23.78,$55.29,$23.78,N/A,$23.78,$12.77,$23.78,$55.29,$23.78,$57.00,$23.78,$23.78,$55.29
9600907B,0771,90470,,,,,N/A,N/A,H1N1 VACCINE ADMINISTRATION,$20.18,$15.00,$12.77,$57.00,$23.78,$55.29,$23.78,N/A,$23.78,$12.77,$23.78,$55.29,$23.78,$57.00,$23.78,$23.78,$55.29
9600908B,0771,90470,,,,,N/A,N/A,H1N1 VACCINE ADMINISTRATION,$57.51,$42.75,$12.77,$57.00,$23.78,$55.29,$23.78,N/A,$23.78,$12.77,$23.78,$55.29,$23.78,$57.00,$23.78,$23.78,$55.29
5090471,0771,90471,,,,,N/A,N/A,IMMUNIZATION ADMINISTRATION ~P,$50.45,$37.50,$23.78,$181.00,$23.78,$175.57,$23.78,N/A,$23.78,N/A,$23.78,$175.57,$23.78,$181.00,$23.78,$23.78,$175.57
5190471,0771,90471,,,,,N/A,N/A,IMMUNIZATION ADMINISTRATION~P,$26.23,$19.50,$23.78,$181.00,$23.78,$175.57,$23.78,N/A,$23.78,N/A,$23.78,$175.57,$23.78,$181.00,$23.78,$23.78,$175.57
7600132,0771,90471,,,,,N/A,N/A,IMMUNIZATION ADMINISTRATIOn,$24.21,$18.00,$23.78,$181.00,$23.78,$175.57,$23.78,N/A,$23.78,N/A,$23.78,$175.57,$23.78,$181.00,$23.78,$23.78,$175.57
9609085,0771,90471,,,,,N/A,N/A,IMMUNIZATION ADMINISTRATION,$54.48,$40.50,$23.78,$181.00,$23.78,$175.57,$23.78,N/A,$23.78,N/A,$23.78,$175.57,$23.78,$181.00,$23.78,$23.78,$175.57
9609724,0771,90471,,,,,N/A,N/A,IMMUNIZATION ADMINISTRATION~P,$25.22,$18.75,$23.78,$181.00,$23.78,$175.57,$23.78,N/A,$23.78,N/A,$23.78,$175.57,$23.78,$181.00,$23.78,$23.78,$175.57
4590471A,0771,90471,,,,,N/A,N/A,IMMUNIZATION ADMINISTRATION ~T,$182.62,$135.75,$23.78,$181.00,$23.78,$175.57,$23.78,N/A,$23.78,N/A,$23.78,$175.57,$23.78,$181.00,$23.78,$23.78,$175.57
5190471CV,0771,90471,,,,,N/A,N/A,Immunization Admin,$0.00,$0.00,$23.78,$181.00,$23.78,$175.57,$23.78,N/A,$23.78,N/A,$23.78,$175.57,$23.78,$181.00,$23.78,$23.78,$175.57
9609003B,0771,90471,,,,,N/A,N/A,IMMUNIZATION ADMINISTRATION-PC,$41.37,$30.75,$23.78,$181.00,$23.78,$175.57,$23.78,N/A,$23.78,N/A,$23.78,$175.57,$23.78,$181.00,$23.78,$23.78,$175.57
9609005B,0771,90471,,,,,N/A,N/A,IMMUNIZATION ADMINISTRATION ~P,$50.45,$37.50,$23.78,$181.00,$23.78,$175.57,$23.78,N/A,$23.78,N/A,$23.78,$175.57,$23.78,$181.00,$23.78,$23.78,$175.57
9609006B,0771,90471,,,,,N/A,N/A,IMMUNIZATION ADMINISTRATION~P,$57.51,$42.75,$23.78,$181.00,$23.78,$175.57,$23.78,N/A,$23.78,N/A,$23.78,$175.57,$23.78,$181.00,$23.78,$23.78,$175.57
9609007B,0771,90471,,,,,N/A,N/A,IMMUNIZATION ADMINISTRATION-PC,$58.52,$43.50,$23.78,$181.00,$23.78,$175.57,$23.78,N/A,$23.78,N/A,$23.78,$175.57,$23.78,$181.00,$23.78,$23.78,$175.57
9609009B,0771,90471,,,,,N/A,N/A,IMMUNIZATION ADMINISTRATION-PC,$57.51,$42.75,$23.78,$181.00,$23.78,$175.57,$23.78,N/A,$23.78,N/A,$23.78,$175.57,$23.78,$181.00,$23.78,$23.78,$175.57
96090896,0771,90472,,,,,N/A,N/A,EACH ADDITIONAL IMMUN ADMIN,$54.48,$40.50,$16.96,$181.00,$22.14,$175.57,$22.14,N/A,$22.14,$16.96,$22.14,$175.57,$22.14,$181.00,$22.14,$22.14,$175.57
90697S,0771,90697,,,,,N/A,N/A,VAXELIS VACCINE,$0.01,$0.01,$0.01,$0.01,N/A,$0.01,N/A,N/A,N/A,N/A,N/A,$0.01,N/A,$0.01,N/A,N/A,$0.01
90714,0771,90714,,,,,N/A,N/A,D T VACCINE IMMUNIZATION,$44.39,$33.00,$42.68,$44.00,N/A,$42.68,N/A,N/A,N/A,N/A,N/A,$42.68,N/A,$44.00,N/A,N/A,$42.68
9073400,0771,90734,,,,,N/A,N/A,MENACTRA VACCINE,$320.84,$238.50,$308.46,$318.00,N/A,$308.46,N/A,N/A,N/A,$318.00,N/A,$308.46,N/A,$318.00,N/A,N/A,$308.46
9075000,0771,90750,,,,,N/A,N/A,ZOSTER (SHINGLES) VACCINE,$317.82,$236.25,$305.55,$315.00,N/A,$305.55,N/A,N/A,N/A,$315.00,N/A,$305.55,N/A,$315.00,N/A,N/A,$305.55
91300,0771,91300,,,,,N/A,N/A,PFIZER COVID-19 VACCINE,$0.01,$0.01,$0.01,$0.01,N/A,$0.01,N/A,N/A,N/A,N/A,N/A,$0.01,N/A,$0.01,N/A,N/A,$0.01
91301,0771,91301,,,,,N/A,N/A,MODERNA COVID-19 VACCINE,$0.01,$0.01,$0.01,$0.01,N/A,$0.01,N/A,N/A,N/A,N/A,N/A,$0.01,N/A,$0.01,N/A,N/A,$0.01
91302,0771,91302,,,,,N/A,N/A,ASTRAZENEA COVID-19 VACCINE,$0.01,$0.01,$0.01,$0.01,N/A,$0.01,N/A,N/A,N/A,N/A,N/A,$0.01,N/A,$0.01,N/A,N/A,$0.01
91303,0771,91303,,,,,N/A,N/A,JANSSEN COVID-19 VACCINE,$0.01,$0.01,$0.01,$0.01,N/A,$0.01,N/A,N/A,N/A,N/A,N/A,$0.01,N/A,$0.01,N/A,N/A,$0.01
91304,0771,91304,,,,,N/A,N/A,NOVAVAX VACCINE,$0.01,$0.01,$0.01,$0.01,N/A,$0.01,N/A,N/A,N/A,N/A,N/A,$0.01,N/A,$0.01,N/A,N/A,$0.01
91305,0771,91305,,,,,N/A,N/A,PFIZER LOW DOSE COVID VACCINE,$0.01,$0.01,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
91306,0771,91306,,,,,N/A,N/A,MODERNA LOW DOSE COVID VACCINE,$0.01,$0.01,$0.01,$0.01,N/A,$0.01,N/A,N/A,N/A,N/A,N/A,$0.01,N/A,$0.01,N/A,N/A,$0.01
91306R,0771,91306,,,,,N/A,N/A,MODERNA LOW DOSE COVID VACCINE,$0.01,$0.01,$0.01,$0.01,N/A,$0.01,N/A,N/A,N/A,N/A,N/A,$0.01,N/A,$0.01,N/A,N/A,$0.01
91308,0771,91308,,,,,N/A,N/A,PFIZER VACCINE 6 MONTH TO 5YR,$0.01,$0.01,$0.01,$0.01,N/A,$0.01,N/A,N/A,N/A,N/A,N/A,$0.01,N/A,$0.01,N/A,N/A,$0.01
91309,0771,91309,,,,,N/A,N/A,MODERNA COVID-19 VACCINE,$0.01,$0.01,$0.01,$0.01,N/A,$0.01,N/A,N/A,N/A,N/A,N/A,$0.01,N/A,$0.01,N/A,N/A,$0.01
91311,0771,91311,,,,,N/A,N/A,MODERNA VACCINE 6 MONTH TO 5YR,$0.01,$0.01,$0.01,$0.01,N/A,$0.01,N/A,N/A,N/A,N/A,N/A,$0.01,N/A,$0.01,N/A,N/A,$0.01
91312,0771,91312,,,,,N/A,N/A,PFIZER COVID-19 VACCINE,$0.01,$0.01,$0.01,$0.01,N/A,$0.01,N/A,N/A,N/A,N/A,N/A,$0.01,N/A,$0.01,N/A,N/A,$0.01
91312S,0771,91312,,,,,N/A,N/A,PFIZER COVID-19 VACCINE,$0.01,$0.01,$0.01,$0.01,N/A,$0.01,N/A,N/A,N/A,N/A,N/A,$0.01,N/A,$0.01,N/A,N/A,$0.01
91313,0771,91313,,,,,N/A,N/A,MODERNA COVID-19 VACCINE,$0.01,$0.01,$0.01,$0.01,N/A,$0.01,N/A,N/A,N/A,N/A,N/A,$0.01,N/A,$0.01,N/A,N/A,$0.01
91316,0771,91316,,,,,N/A,N/A,Moderna Vaccine,$0.01,$0.01,$0.01,$0.01,N/A,$0.01,N/A,N/A,N/A,N/A,N/A,$0.01,N/A,$0.01,N/A,N/A,$0.01
91317,0771,91317,,,,,N/A,N/A,Pfizer Vaccine,$0.01,$0.01,$0.01,$0.01,N/A,$0.01,N/A,N/A,N/A,N/A,N/A,$0.01,N/A,$0.01,N/A,N/A,$0.01
4596365BE,0771,96365,,,,,N/A,N/A,Infusion Therapy Up To One Hr,"$1,246.04",$926.25,$15.78,"$1,235.00",$56.35,"$1,197.95",$56.35,N/A,$56.35,$15.78,$56.35,"$1,197.95",$56.35,"$1,235.00",$56.35,$56.35,"$1,197.95"
4596365CV,0771,96365,,,,,N/A,N/A,Infusion Therapy Up To One Hr,"$1,246.04",$926.25,$15.78,"$1,235.00",$56.35,"$1,197.95",$56.35,N/A,$56.35,$15.78,$56.35,"$1,197.95",$56.35,"$1,235.00",$56.35,$56.35,"$1,197.95"
4596365SO,0771,96365,,,,,N/A,N/A,INFUSION THERAPY UP TO ONE HR,"$1,246.04",$926.25,$15.78,"$1,235.00",$56.35,"$1,197.95",$56.35,N/A,$56.35,$15.78,$56.35,"$1,197.95",$56.35,"$1,235.00",$56.35,$56.35,"$1,197.95"
7196365CV,0771,96365,,,,,N/A,N/A,Infusion Therapy Up To One Hr,"$1,245.03",$925.50,$15.78,"$1,235.00",$56.35,"$1,197.95",$56.35,N/A,$56.35,$15.78,$56.35,"$1,197.95",$56.35,"$1,235.00",$56.35,$56.35,"$1,197.95"
3996372CV,0771,96372,,,,,N/A,N/A,THERAPEUTIC INJECTION SC/IM,$186.65,$138.75,$24.15,$283.72,$283.72,N/A,$283.72,N/A,$283.72,$24.15,$283.72,N/A,$283.72,$185.00,$283.72,$283.72,N/A
7096374,0771,96374,,,,,N/A,N/A,"THERAEUPTIC INJECTION,IV PUSH",$295.62,$219.75,$16.18,$293.00,$127.51,$284.21,$127.51,N/A,$127.51,$16.18,$127.51,$284.21,$127.51,$293.00,$127.51,$127.51,$284.21
3996374CV,0771,96374,,,,,N/A,N/A,"THERAEUPTIC INJECTION,IV PUSH",$295.62,$219.75,$16.18,$293.00,$127.51,$284.21,$127.51,N/A,$127.51,$16.18,$127.51,$284.21,$127.51,$293.00,$127.51,$127.51,$284.21
0001A,0771,0001A,,,,,N/A,N/A,PFIZER FIRST ADMINISTRATION,$21.41,$15.92,$0.00,$21.22,N/A,#REF!,N/A,N/A,N/A,$16.96,N/A,N/A,N/A,$21.22,N/A,N/A,$13.01
0002A,0771,0002A,,,,,N/A,N/A,PFIZER SECOND ADMINISTRATION,$21.41,$15.92,$0.00,$21.22,N/A,#REF!,N/A,N/A,N/A,$16.96,N/A,N/A,N/A,$21.22,N/A,N/A,$13.01
0003A,0771,0003A,,,,,N/A,N/A,PFIZER BOOSTER ADMINISTRATION,$21.41,$15.92,$0.00,$21.22,N/A,#REF!,N/A,N/A,N/A,$16.96,N/A,N/A,N/A,$21.22,N/A,N/A,$13.01
0004A,0771,0004A,,,,,N/A,N/A,PFIZER BOOSTER ADMINISTRATION,$21.41,$15.92,$0.00,$21.22,N/A,#REF!,N/A,N/A,N/A,$16.96,N/A,N/A,N/A,$21.22,N/A,N/A,$13.01
0011A,0771,0011A,,,,,N/A,N/A,MODERNA FIRST ADMINISTRATION,$21.41,$15.92,$0.00,$21.22,N/A,#REF!,N/A,N/A,N/A,$16.96,N/A,N/A,N/A,$21.22,N/A,N/A,$13.01
0012A,0771,0012A,,,,,N/A,N/A,MODERNA SECOND ADMINISTRATION,$21.41,$15.92,$0.00,$21.22,N/A,#REF!,N/A,N/A,N/A,$16.96,N/A,N/A,N/A,$21.22,N/A,N/A,$13.01
0013A,0771,0013A,,,,,N/A,N/A,MODERNA BOOSTER ADMINISTRATION,$21.41,$15.92,$0.00,$21.22,N/A,#REF!,N/A,N/A,N/A,$16.96,N/A,N/A,N/A,$21.22,N/A,N/A,$13.01
0021A,0771,0021A,,,,,N/A,N/A,ASTRAZENECA FIRST ADMINISTRAT,$21.41,$15.92,$0.00,$21.22,N/A,#REF!,N/A,N/A,N/A,$16.96,N/A,N/A,N/A,$21.22,N/A,N/A,$13.01
0022A,0771,0022A,,,,,N/A,N/A,ASTRAZENECA SECOND ADMINISTRAT,$21.41,$15.92,$0.00,$21.22,N/A,#REF!,N/A,N/A,N/A,$16.96,N/A,N/A,N/A,$21.22,N/A,N/A,$13.01
0031A,0771,0031A,,,,,N/A,N/A,JANSEEN FIRST ADMINISTRATION,$21.41,$15.92,$0.00,$21.22,N/A,#REF!,N/A,N/A,N/A,$16.96,N/A,N/A,N/A,$21.22,N/A,N/A,$13.01
0034A,0771,0034A,,,,,N/A,N/A,JANSEEN BOOSTER ADMINISTRATION,$21.41,$15.92,$0.00,$21.22,N/A,#REF!,N/A,N/A,N/A,$16.96,N/A,N/A,N/A,$21.22,N/A,N/A,$13.01
0041A,0771,0041A,,,,,N/A,N/A,IMMUNIZIOTN ADMINIS FIRST DOSE,$21.41,$15.92,$0.00,$21.22,N/A,#REF!,N/A,N/A,N/A,$16.96,N/A,N/A,N/A,$21.22,N/A,N/A,$13.01
0042A,0771,0042A,,,,,N/A,N/A,IMMUNIZIOTN ADMINIS SEC   DOSE,$21.41,$15.92,$0.00,$21.22,N/A,#REF!,N/A,N/A,N/A,$16.96,N/A,N/A,N/A,$21.22,N/A,N/A,$13.01
0051A,0771,0051A,,,,,N/A,N/A,PFIZER FIRST ADMIN LOW DOSE,$21.41,$15.92,$0.00,$21.22,N/A,#REF!,N/A,N/A,N/A,$16.96,N/A,N/A,N/A,$21.22,N/A,N/A,$13.01
0052A,0771,0052A,,,,,N/A,N/A,PFIZER SECOND ADMIN LOW DOSE,$21.41,$15.92,$0.00,$21.22,N/A,#REF!,N/A,N/A,N/A,$16.96,N/A,N/A,N/A,$21.22,N/A,N/A,$13.01
0053A,0771,0053A,,,,,N/A,N/A,PFIZER BOOSTER ADMIN LOW DOSE,$21.41,$15.92,$0.00,$21.22,N/A,#REF!,N/A,N/A,N/A,$16.96,N/A,N/A,N/A,$21.22,N/A,N/A,$13.01
0054A,0771,0054A,,,,,N/A,N/A,PFIZER BOOSTER ADMIN LOW DOSE,$21.41,$15.92,$0.00,$21.22,N/A,#REF!,N/A,N/A,N/A,$16.96,N/A,N/A,N/A,$21.22,N/A,N/A,$13.01
0064A,0771,0064A,,,,,N/A,N/A,MODERNA BOOSTER ADMIN LOW DOSE,$21.41,$15.92,$0.00,$21.22,N/A,#REF!,N/A,N/A,N/A,$16.96,N/A,N/A,N/A,$21.22,N/A,N/A,$13.01
0071A,0771,0071A,,,,,N/A,N/A,IMMUNIZATION ADMINSTRATION,$21.41,$15.92,$0.00,$21.22,N/A,#REF!,N/A,N/A,N/A,$16.96,N/A,N/A,N/A,$21.22,N/A,N/A,$13.01
0072A,0771,0072A,,,,,N/A,N/A,IMMUNIZATION ADMINSTRATION,$21.41,$15.92,$0.00,$21.22,N/A,#REF!,N/A,N/A,N/A,$16.96,N/A,N/A,N/A,$21.22,N/A,N/A,$13.01
0073A,0771,0073A,,,,,N/A,N/A,IMMUNIZATION ADMINSTRATION,$21.41,$15.92,$0.00,$21.22,N/A,#REF!,N/A,N/A,N/A,$16.96,N/A,N/A,N/A,$21.22,N/A,N/A,$13.01
0074A,0771,0074A,,,,,N/A,N/A,IMMUNIZATION ADMINSTRATION,$21.41,$15.92,$0.00,$21.22,N/A,#REF!,N/A,N/A,N/A,$16.96,N/A,N/A,N/A,$21.22,N/A,N/A,$13.01
0081A,0771,0081A,,,,,N/A,N/A,IMMUNIZATION ADMINSTRATION,$21.41,$15.92,$0.00,$21.22,N/A,#REF!,N/A,N/A,N/A,$16.96,N/A,N/A,N/A,$21.22,N/A,N/A,$13.01
0082A,0771,0082A,,,,,N/A,N/A,IMMUNIZATION ADMINSTRATION,$21.41,$15.92,$0.00,$21.22,N/A,#REF!,N/A,N/A,N/A,$16.96,N/A,N/A,N/A,$21.22,N/A,N/A,$13.01
0083A,0771,0083A,,,,,N/A,N/A,IMMUNIZATION ADMINSTRATION,$21.41,$15.92,$0.00,$21.22,N/A,#REF!,N/A,N/A,N/A,$16.96,N/A,N/A,N/A,$21.22,N/A,N/A,$13.01
0094A,0771,0094A,,,,,N/A,N/A,MODERNA BOOSTER ADMINISTRATION,$21.41,$15.92,$0.00,$21.22,N/A,#REF!,N/A,N/A,N/A,$16.96,N/A,N/A,N/A,$21.22,N/A,N/A,$13.01
0111A,0771,0111A,,,,,N/A,N/A,IMMUNIZATION ADMINISTRATION,$21.41,$15.92,$0.00,$21.22,N/A,#REF!,N/A,N/A,N/A,$16.96,N/A,N/A,N/A,$21.22,N/A,N/A,$13.01
0112A,0771,0112A,,,,,N/A,N/A,IMMUNIZATION ADMINISTRATION,$21.41,$15.92,$0.00,$21.22,N/A,#REF!,N/A,N/A,N/A,$16.96,N/A,N/A,N/A,$21.22,N/A,N/A,$13.01
0113A,0771,0113A,,,,,N/A,N/A,IMMUNIZATION ADMINISTRATION,$21.41,$15.92,$0.00,$21.22,N/A,#REF!,N/A,N/A,N/A,$16.96,N/A,N/A,N/A,$21.22,N/A,N/A,$13.01
0124A,0771,0124A,,,,,N/A,N/A,PFIZER BOOSTER ADMINISTRATION,$21.41,$15.92,$0.00,$21.22,N/A,#REF!,N/A,N/A,N/A,$16.96,N/A,N/A,N/A,$21.22,N/A,N/A,$13.01
0134A,0771,0134A,,,,,N/A,N/A,MODERNA BOOSTER ADMINISTRATION,$21.41,$15.92,$0.00,$21.22,N/A,#REF!,N/A,N/A,N/A,$16.96,N/A,N/A,N/A,$21.22,N/A,N/A,$13.01
0164A,0771,0164A,,,,,N/A,N/A,Immunization Administration,$21.41,$15.92,$0.00,$21.22,N/A,#REF!,N/A,N/A,N/A,$16.96,N/A,N/A,N/A,$21.22,N/A,N/A,$13.01
0173A,0771,0173A,,,,,N/A,N/A,Immunization Administration,$21.41,$15.92,$0.00,$21.22,N/A,$19.73,N/A,N/A,N/A,$16.96,N/A,N/A,N/A,$21.22,N/A,N/A,$13.01
M0201,0771,M0201,,,,,N/A,N/A,HOME COVID ADMINISTRATION,$21.41,$15.92,$20.58,$21.22,N/A,$20.58,N/A,N/A,N/A,$21.22,N/A,$20.58,N/A,$21.22,N/A,N/A,$20.58
7696365,0771,M0220,,,,,N/A,N/A,INFUSION THERAPY UP TO ONE HR,"$1,201.65",$893.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9600091,0771,,,,,,N/A,N/A,FLU VACCINE & ADM INCLUSIVE -E,$30.27,$22.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
96Q3014,0780,Q3014,,,,,N/A,N/A,TELEHEATH ORIGINATING SITE FEE,$26.23,$19.50,$25.22,$26.00,N/A,$25.22,N/A,N/A,N/A,$26.00,N/A,$25.22,N/A,$26.00,N/A,N/A,$25.22
90801,0900,90801,,,,,N/A,N/A,PSY DX INTERVIEW,$347.08,$258.00,$199.08,$344.00,N/A,$333.68,N/A,N/A,N/A,$199.08,N/A,$333.68,N/A,$344.00,N/A,N/A,$333.68
90832,0900,90832,,,,,N/A,N/A,PSYC 30 MIN,$70.63,$52.50,$28.70,$70.00,$28.70,$67.90,$28.70,N/A,$28.70,N/A,$28.70,$67.90,$28.70,$70.00,$28.70,$28.70,$67.90
90833,0900,90833,,,,,N/A,N/A,PSYC 30 MIN + E&M,$59.53,$44.25,$24.19,$77.65,$24.19,$57.23,$24.19,N/A,$24.19,$77.65,$24.19,$57.23,$24.19,$59.00,$24.19,$24.19,$57.23
90834,0900,90834,,,,,N/A,N/A,PSYC 45 MIN,$104.93,$78.00,$42.64,$104.00,$42.64,$100.88,$42.64,N/A,$42.64,$71.68,$42.64,$100.88,$42.64,$104.00,$42.64,$42.64,$100.88
90836,0900,90836,,,,,N/A,N/A,PSYC 45 MIN + E&M,$96.86,$72.00,$39.36,$102.47,$39.36,$93.12,$39.36,N/A,$39.36,$102.47,$39.36,$93.12,$39.36,$96.00,$39.36,$39.36,$93.12
90837,0900,90837,,,,,N/A,N/A,PSYC 60 MIN,$158.40,$117.75,$64.37,$157.00,$64.37,$152.29,$64.37,N/A,$64.37,$90.63,$64.37,$152.29,$64.37,$157.00,$64.37,$64.37,$152.29
90838,0900,90838,,,,,N/A,N/A,PSYC 60 MIN + E&M,$155.38,$115.50,$63.14,$154.00,$63.14,$149.38,$63.14,N/A,$63.14,$151.60,$63.14,$149.38,$63.14,$154.00,$63.14,$63.14,$149.38
90839,0900,90839,,,,,N/A,N/A,CRISIS PSYCHOTHERAPY 60 MIN,$277.46,$206.25,$112.75,$275.00,$112.75,$266.75,$112.75,N/A,$112.75,$120.24,$112.75,$266.75,$112.75,$275.00,$112.75,$112.75,$266.75
90840,0900,90840,,,,,N/A,N/A,CRISIS PSYCHOTHERAPY 30 MIN,$132.17,$98.25,$53.71,$144.03,$53.71,$127.07,$53.71,N/A,$53.71,$144.03,$53.71,$127.07,$53.71,$131.00,$53.71,$53.71,$127.07
90846,0900,90846,,,,,N/A,N/A,FAMILY PSYTX W/O PATIENT,$232.06,$172.50,$68.48,$230.00,$94.30,$223.10,$94.30,N/A,$94.30,$68.48,$94.30,$223.10,$94.30,$230.00,$94.30,$94.30,$223.10
90847,0900,90847,,,,,N/A,N/A,FAMILY PSYTX W/PATIENT,$275.44,$204.75,$110.84,$273.00,$111.93,$264.81,$111.93,N/A,$111.93,$110.84,$111.93,$264.81,$111.93,$273.00,$111.93,$111.93,$264.81
45H0046,0900,H0046,,,,,N/A,N/A,MENTAL HEALTH SERVICES,$227.01,$168.75,$218.25,$225.00,N/A,$218.25,N/A,N/A,N/A,$225.00,N/A,$218.25,N/A,$225.00,N/A,N/A,$218.25
7200005,0920,59025,,,,,N/A,N/A,NON STRESS TEST,$728.45,$541.50,$174.00,$722.00,$296.20,$700.34,$296.20,$617.31,$296.20,$174.00,$296.20,$700.34,$296.20,$722.00,$296.20,$296.20,$700.34
5902552TC,0920,59025,,,,,N/A,N/A,FETAL NONSTRESS TEST,$175.56,$130.50,$174.00,$722.00,$296.20,$700.34,$296.20,$617.31,$296.20,$174.00,$296.20,$700.34,$296.20,$722.00,$296.20,$296.20,$700.34
6494780,0920,94780,,,,,N/A,N/A,CAR SEAT CHALLENGE,$103.92,$77.25,$22.55,$103.00,$22.55,$99.91,$22.55,N/A,$22.55,$35.95,$22.55,$99.91,$22.55,$103.00,$22.55,$22.55,$99.91
6494781,0920,94781,,,,,N/A,N/A,CAR SEAT CHALLENGE ADDITIONAL,$55.49,$41.25,$30.76,$55.00,N/A,$53.35,N/A,N/A,N/A,$30.76,N/A,$53.35,N/A,$55.00,N/A,N/A,$53.35
4003870,0921,93880,,,,,N/A,N/A,"US CAROTID, COMPLETE",$534.74,$397.50,$19.37,$323.00,$132.43,$313.31,$132.43,N/A,$132.43,$19.37,$132.43,$313.31,$132.43,$323.00,$132.43,$132.43,$313.31
9207798,0921,93970,,,,,N/A,N/A,BILATERAL PERIVASCULAR STUDY,$428.80,$318.75,$0.00,$174.25,$174.25,$0.00,$174.25,N/A,$174.25,$149.55,$174.25,$0.00,$174.25,N/A,$174.25,$174.25,$0.00
9207799,0921,93971,,,,,N/A,N/A,UNILATERAL PERIVASCULAR STUDY,$419.72,$312.00,$184.90,$416.00,$184.90,$403.52,$184.90,N/A,$184.90,$227.72,$184.90,$403.52,$184.90,$416.00,$184.90,$184.90,$403.52
9207799-LT,0921,93971,,,,,N/A,N/A,LT PERIVASCULAR STUDY,$419.72,$312.00,$184.90,$416.00,$184.90,$403.52,$184.90,N/A,$184.90,$227.72,$184.90,$403.52,$184.90,$416.00,$184.90,$184.90,$403.52
9207799-RT,0921,93971,,,,,N/A,N/A,RT PERIVASCULAR STUDY,$419.72,$312.00,$184.90,$416.00,$184.90,$403.52,$184.90,N/A,$184.90,$227.72,$184.90,$403.52,$184.90,$416.00,$184.90,$184.90,$403.52
4593979A,0921,93979,,,,,N/A,N/A,VASCULAR STUDY              ~T,$174.55,$129.75,$7.93,$218.48,$7.93,$194.00,$7.93,N/A,$7.93,$218.48,$7.93,$194.00,$7.93,$200.00,$7.93,$7.93,$194.00
9397980A,0921,93979,,,,,N/A,N/A,VASCULAR STUDY              ~T,$174.55,$129.75,$7.93,$218.48,$7.93,$194.00,$7.93,N/A,$7.93,$218.48,$7.93,$194.00,$7.93,$200.00,$7.93,$7.93,$194.00
9207800,0921,93990,,,,,N/A,N/A,HEMODIALYSIS MAPPING,$542.81,$403.50,$22.58,$538.00,$22.58,$521.86,$22.58,N/A,$22.58,$141.17,$22.58,$521.86,$22.58,$538.00,$22.58,$22.58,$521.86
4100056,0924,94070,,,,,N/A,N/A,RT BRONCHIAL PROV PF,"$1,029.12",$765.00,$61.37,"$1,020.00",$418.20,$989.40,$418.20,N/A,$418.20,$61.37,$418.20,$989.40,$418.20,"$1,020.00",$418.20,$418.20,$989.40
4500148,0940,90772,,,,,N/A,N/A,Therapeutic Injection Sc/Im-Tc,$174.55,$129.75,$183.33,$189.00,N/A,$183.33,N/A,N/A,N/A,$189.00,N/A,$183.33,N/A,$189.00,N/A,N/A,$183.33
7200782,0940,90772,,,,,N/A,N/A,Therapeutic Injection Sc/Im,$177.57,$132.00,$183.33,$189.00,N/A,$183.33,N/A,N/A,N/A,$189.00,N/A,$183.33,N/A,$189.00,N/A,N/A,$183.33
7390782,0940,90772,,,,,N/A,N/A,Therapeutic Injection Sc/Im,$190.69,$141.75,$183.33,$189.00,N/A,$183.33,N/A,N/A,N/A,$189.00,N/A,$183.33,N/A,$189.00,N/A,N/A,$183.33
9400057,0940,90772,,,,,N/A,N/A,Therapeutic Injection Sc/Im,$194.73,$144.75,$183.33,$189.00,N/A,$183.33,N/A,N/A,N/A,$189.00,N/A,$183.33,N/A,$189.00,N/A,N/A,$183.33
7690774,0940,90774,,,,,N/A,N/A,"Therapeutic Injection,Iv Push",$300.66,$223.50,$284.21,$293.00,N/A,$284.21,N/A,N/A,N/A,$293.00,N/A,$284.21,N/A,$293.00,N/A,N/A,$284.21
4590775,0940,90775,,,,,N/A,N/A,Additional Iv Push,$180.60,$134.25,$189.15,$195.00,N/A,$189.15,N/A,N/A,N/A,$195.00,N/A,$189.15,N/A,$195.00,N/A,N/A,$189.15
7690775,0940,90775,,,,,N/A,N/A,Additional Iv Push,$196.74,$146.25,$189.15,$195.00,N/A,$189.15,N/A,N/A,N/A,$195.00,N/A,$189.15,N/A,$195.00,N/A,N/A,$189.15
3996372,0940,96372,,,,,N/A,N/A,THERAPEUTIC INJECTION SC/IM,$186.65,$138.75,$24.15,$283.72,$283.72,N/A,$283.72,N/A,$283.72,$24.15,$283.72,N/A,$283.72,$185.00,$283.72,$283.72,N/A
7390783,0940,96372,,,,,N/A,N/A,THERAPEUTIC INJECTION SC/IM,$191.70,$142.50,$24.15,$283.72,$283.72,N/A,$283.72,N/A,$283.72,$24.15,$283.72,N/A,$283.72,$185.00,$283.72,$283.72,N/A
459637259,0940,96372,,,,,N/A,N/A,IM INJECTION OF DRUG,$174.55,$129.75,$24.15,$283.72,$283.72,N/A,$283.72,N/A,$283.72,$24.15,$283.72,N/A,$283.72,$185.00,$283.72,$283.72,N/A
4596372CV,0940,96372,,,,,N/A,N/A,THERAPEUTIC INJECTION SC/IM-TC,$698.19,$519.00,$24.15,$283.72,$283.72,N/A,$283.72,N/A,$283.72,$24.15,$283.72,N/A,$283.72,$185.00,$283.72,$283.72,N/A
4996374,0940,96374,,,,,N/A,N/A,"THERAEUPTIC INJECTION,IV PUSH",$300.66,$223.50,$16.18,$293.00,$127.51,$284.21,$127.51,N/A,$127.51,$16.18,$127.51,$284.21,$127.51,$293.00,$127.51,$127.51,$284.21
7690778,0940,96374,,,,,N/A,N/A,"THERAPEUTIC INJECTION, IV PUSH",$313.78,$233.25,$16.18,$293.00,$127.51,$284.21,$127.51,N/A,$127.51,$16.18,$127.51,$284.21,$127.51,$293.00,$127.51,$127.51,$284.21
7690779,0940,96374,,,,,N/A,N/A,"THERAPEUTIC INJECTION, IV PUSH",$313.78,$233.25,$16.18,$293.00,$127.51,$284.21,$127.51,N/A,$127.51,$16.18,$127.51,$284.21,$127.51,$293.00,$127.51,$127.51,$284.21
7996374,0940,96374,,,,,N/A,N/A,"THERAEUPTIC INJECTION,IV PUSH",$295.62,$219.75,$16.18,$293.00,$127.51,$284.21,$127.51,N/A,$127.51,$16.18,$127.51,$284.21,$127.51,$293.00,$127.51,$127.51,$284.21
4500150-59,0940,96374,,,,,N/A,N/A,"THERAPEUTIC INJECT,IV PUSH -XU",$295.62,$219.75,$16.18,$293.00,$127.51,$284.21,$127.51,N/A,$127.51,$16.18,$127.51,$284.21,$127.51,$293.00,$127.51,$127.51,$284.21
4590784-59,0940,96374,,,,,N/A,N/A,"THERAPEUTIC INJECT,IV PUSH -59",$295.62,$219.75,$16.18,$293.00,$127.51,$284.21,$127.51,N/A,$127.51,$16.18,$127.51,$284.21,$127.51,$293.00,$127.51,$127.51,$284.21
5196374-59,0940,96374,,,,,N/A,N/A,"THERAEUPTIC INJECT,IV PUSH -59",$201.79,$150.00,$16.18,$293.00,$127.51,$284.21,$127.51,N/A,$127.51,$16.18,$127.51,$284.21,$127.51,$293.00,$127.51,$127.51,$284.21
96374LSC,0940,96374,,,,,N/A,N/A,"THERAPEUTIC INJECTION, PUSH",$249.21,$185.25,$16.18,$293.00,$127.51,$284.21,$127.51,N/A,$127.51,$16.18,$127.51,$284.21,$127.51,$293.00,$127.51,$127.51,$284.21
4996375,0940,96375,,,,,N/A,N/A,ADDITIONAL IV PUSH,$196.74,$146.25,$47.51,$179.00,$83.64,$173.63,$83.64,N/A,$83.64,$47.51,$83.64,$173.63,$83.64,$179.00,$83.64,$83.64,$173.63
5196375,0940,96375,,,,,N/A,N/A,ADDITIONAL IV PUSH,$180.60,$134.25,$47.51,$179.00,$83.64,$173.63,$83.64,N/A,$83.64,$47.51,$83.64,$173.63,$83.64,$179.00,$83.64,$83.64,$173.63
7096375,0940,96375,,,,,N/A,N/A,ADDITIONAL IV PUSH,$192.71,$143.25,$47.51,$179.00,$83.64,$173.63,$83.64,N/A,$83.64,$47.51,$83.64,$173.63,$83.64,$179.00,$83.64,$83.64,$173.63
7690776,0940,96375,,,,,N/A,N/A,ADDITIONAL IV PUSH,$205.82,$153.00,$47.51,$179.00,$83.64,$173.63,$83.64,N/A,$83.64,$47.51,$83.64,$173.63,$83.64,$179.00,$83.64,$83.64,$173.63
7696375,0940,96375,,,,,N/A,N/A,ADDITIONAL IV PUSH,$199.77,$148.50,$47.51,$179.00,$83.64,$173.63,$83.64,N/A,$83.64,$47.51,$83.64,$173.63,$83.64,$179.00,$83.64,$83.64,$173.63
4590775-59,0940,96375,,,,,N/A,N/A,ADDITIONAL IV PUSH,$180.60,$134.25,$47.51,$179.00,$83.64,$173.63,$83.64,N/A,$83.64,$47.51,$83.64,$173.63,$83.64,$179.00,$83.64,$83.64,$173.63
5196375-59,0940,96375,,,,,N/A,N/A,ADDITIONAL IV PUSH         -59,$180.60,$134.25,$47.51,$179.00,$83.64,$173.63,$83.64,N/A,$83.64,$47.51,$83.64,$173.63,$83.64,$179.00,$83.64,$83.64,$173.63
4590776-59,0940,96376,,,,,N/A,N/A,ADD. IV PUSH-SAME DRUG     -XU,$95.85,$71.25,$19.37,$204.00,N/A,$197.88,N/A,N/A,N/A,$19.37,N/A,$197.88,N/A,$204.00,N/A,N/A,$197.88
3696523,0940,96523,,,,,N/A,N/A,PORT FLUSH,$206.83,$153.75,$86.51,$205.00,$86.51,$198.85,$86.51,N/A,$86.51,$202.26,$86.51,$198.85,$86.51,$205.00,$86.51,$86.51,$198.85
7600007,0940,96900,,,,,N/A,N/A,UV LIGHT THERAPY,$105.94,$78.75,$38.27,$126.69,$126.69,$101.85,$126.69,N/A,$126.69,$38.27,$126.69,$101.85,$126.69,$105.00,$126.69,$126.69,$101.85
7670007,0940,96900,,,,,N/A,N/A,UV LIGHT INITIAL VISIT,$311.76,$231.75,$38.27,$126.69,$126.69,$101.85,$126.69,N/A,$126.69,$38.27,$126.69,$101.85,$126.69,$105.00,$126.69,$126.69,$101.85
3999199,0940,99195,,,,,N/A,N/A,"PHLEBOTOMY,THERAPEUTIC",$192.71,$143.25,$4.82,$310.00,$78.31,$300.70,$78.31,N/A,$78.31,$4.82,$78.31,$300.70,$78.31,$310.00,$78.31,$78.31,$300.70
4500270,0940,99195,,,,,N/A,N/A,"PHELBTMY,THERAPEUTIC  99195-TC",$180.60,$134.25,$4.82,$310.00,$78.31,$300.70,$78.31,N/A,$78.31,$4.82,$78.31,$300.70,$78.31,$310.00,$78.31,$78.31,$300.70
9800011,0942,95250,,,,,N/A,N/A,GLUCOSE MONITORING,$548.86,$408.00,$0.00,$544.00,N/A,$527.68,N/A,N/A,N/A,$0.00,N/A,$527.68,N/A,$544.00,N/A,N/A,$527.68
9800001,0942,97802,,,,,N/A,N/A,NUTRN ASSMT-INITIAL EA-15 MIN,$84.75,$63.00,$0.00,$84.00,$34.44,$81.48,$34.44,N/A,$34.44,$0.00,$34.44,$81.48,$34.44,$84.00,$34.44,$34.44,$81.48
9800005,0942,97803,,,,,N/A,N/A,NUTR REASSMT-INDIV EA-15 MIN,$84.75,$63.00,$34.44,$84.00,$34.44,$81.48,$34.44,N/A,$34.44,$37.53,$34.44,$81.48,$34.44,$84.00,$34.44,$34.44,$81.48
9800006,0942,97804,,,,,N/A,N/A,NUTR THER. GROUP EACH 30 MIN.,$45.40,$33.75,$18.45,$45.00,$18.45,$43.65,$18.45,N/A,$18.45,$31.95,$18.45,$43.65,$18.45,$45.00,$18.45,$18.45,$43.65
9800014,0942,98966,,,,,N/A,N/A,TELEPHONE ONLY ASSESS 5-10 MIN,$61.55,$45.75,$17.77,$61.00,$25.10,$59.17,$25.10,N/A,$25.10,$17.77,$25.10,$59.17,$25.10,$61.00,$25.10,$25.10,$59.17
9800015,0942,98967,,,,,N/A,N/A,TELEPHONE ONLY ASSESS 11-20MIN,$61.55,$45.75,$14.40,$61.00,$25.10,$59.17,$25.10,N/A,$25.10,$14.40,$25.10,$59.17,$25.10,$61.00,$25.10,$25.10,$59.17
9800016,0942,98968,,,,,N/A,N/A,TELEPHONE ONLY ASSESS 21-30MIN,$61.55,$45.75,$25.10,$61.00,$25.10,$59.17,$25.10,N/A,$25.10,$28.41,$25.10,$59.17,$25.10,$61.00,$25.10,$25.10,$59.17
4100075,0942,99406,,,,,N/A,N/A,SMOKING CESSATION 3-10 MINUTES,$40.36,$30.00,$39.77,$100.16,N/A,$39.77,N/A,N/A,N/A,$100.16,N/A,$39.77,N/A,$41.00,N/A,N/A,$39.77
9800007,0942,G0108,,,,,N/A,N/A,DIABETES SLF-MGMT INDIV 30 MIN,$186.65,$138.75,$54.21,$185.00,$54.21,$179.45,$54.21,N/A,$54.21,$185.00,$54.21,$179.45,$54.21,$185.00,$54.21,$54.21,$179.45
9800008,0942,G0109,,,,,N/A,N/A,DIABETES SLF-MGNT GRP   30 MIN,$100.89,$75.00,$15.41,$100.00,$15.41,$97.00,$15.41,N/A,$15.41,$100.00,$15.41,$97.00,$15.41,$100.00,$15.41,$15.41,$97.00
9800009,0942,G0270,,,,,N/A,N/A,MNT REASSESSMENT 2ND REF -IND,$84.75,$63.00,$31.99,$84.00,$31.99,$81.48,$31.99,N/A,$31.99,$84.00,$31.99,$81.48,$31.99,$84.00,$31.99,$31.99,$81.48
9800010,0942,G0271,,,,,N/A,N/A,MNT REASSESSMENT -2ND REF- GRP,$45.40,$33.75,$16.76,$45.00,$16.76,$43.65,$16.76,N/A,$16.76,$45.00,$16.76,$43.65,$16.76,$45.00,$16.76,$16.76,$43.65
9400001,0943,93797,,,,,N/A,N/A,Cardiac Rehab Phase Ii,$163.45,$121.50,$66.42,$162.00,$66.42,$157.14,$66.42,N/A,$66.42,N/A,$66.42,$157.14,$66.42,$162.00,$66.42,$66.42,$157.14
9400007,0943,,,,,,N/A,N/A,CARDIAC REHAB PHASE III-2,$40.36,$30.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4694626,0948,94626,,,,,N/A,N/A,PULMONARY REHAB ONE HOUR,$199.77,$148.50,$81.18,$81.18,$81.18,N/A,$81.18,N/A,$81.18,N/A,$81.18,N/A,$81.18,N/A,$81.18,$81.18,N/A
G023760,0948,G0237,,,,,N/A,N/A,NON COPD STRNGTH&ENDURANCE 15M,$116.03,$86.25,$10.66,$170.00,$10.66,$164.90,$10.66,N/A,$10.66,$170.00,$10.66,$164.90,$10.66,$170.00,$10.66,$10.66,$164.90
G023860,0948,G0238,,,,,N/A,N/A,NON COPD RESPIRATORY FUNC 15M,$117.04,$87.00,$10.32,$170.00,$10.32,$164.90,$10.32,N/A,$10.32,$170.00,$10.32,$164.90,$10.32,$170.00,$10.32,$10.32,$164.90
G023960,0948,G0239,,,,,N/A,N/A,NON COPD FUNCTION&STRENGTH GRP,$117.04,$87.00,$12.69,$116.00,$12.69,$112.52,$12.69,N/A,$12.69,$116.00,$12.69,$112.52,$12.69,$116.00,$12.69,$12.69,$112.52
10005,0960,10005,,,,,N/A,N/A,NEEDLE ASPIRATION BIOPSY,$263.33,$195.75,$17.10,$17.10,$17.10,N/A,$17.10,N/A,$17.10,N/A,$17.10,N/A,$17.10,N/A,$17.10,$17.10,N/A
10021,0960,10021,,,,,N/A,N/A,FNA W/O IMAGE,$305.71,$227.25,$93.14,$430.00,N/A,$417.10,N/A,$367.65,N/A,$93.14,N/A,$417.10,N/A,$430.00,N/A,N/A,$417.10
10030,0960,10030,,,,,N/A,N/A,IMAGE-GUIDED FLUID COLL DRAI,$926.21,$688.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
10035,0960,10035,,,,,N/A,N/A,PLACEMENT OF SOFT TISSUE LOC,"$1,107.82",$823.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
10040,0960,10040,,,,,N/A,N/A,ACNE SURGERY,$183.63,$136.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
10060,0960,10060,,,,,N/A,N/A,DRAINAGE OF SKIN ABSCESS,$198.76,$147.75,$8.77,$197.00,$8.77,N/A,$8.77,$168.44,$8.77,$177.59,$8.77,N/A,$8.77,$197.00,$8.77,$8.77,N/A
9610060,0960,10060,,,,,N/A,N/A,"I&D, ABSCESS; SIMPLE   10060~P",$100.89,$75.00,$8.77,$197.00,$8.77,N/A,$8.77,$168.44,$8.77,$177.59,$8.77,N/A,$8.77,$197.00,$8.77,$8.77,N/A
10061,0960,10061,,,,,N/A,N/A,DRAINAGE OF SKIN ABSCESS,$369.27,$274.50,$15.60,$366.00,$15.60,$355.02,$15.60,$312.93,$15.60,$312.38,$15.60,$355.02,$15.60,$366.00,$15.60,$15.60,$355.02
9610061,0960,10061,,,,,N/A,N/A,"I&D, ABSCESS;COMPLICATED-10061",$229.03,$170.25,$15.60,$366.00,$15.60,$355.02,$15.60,$312.93,$15.60,$312.38,$15.60,$355.02,$15.60,$366.00,$15.60,$15.60,$355.02
10080,0960,10080,,,,,N/A,N/A,DRAINAGE OF PILONIDAL CYST,$224.99,$167.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9610080,0960,10080,,,,,N/A,N/A,INC PILONIDAL CYSTS     -10080,$224.99,$167.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
10081,0960,10081,,,,,N/A,N/A,DRAINAGE OF PILONIDAL CYST,$375.33,$279.00,$152.52,$372.00,$152.52,$360.84,$152.52,$318.06,$152.52,$293.55,$152.52,$360.84,$152.52,$372.00,$152.52,$152.52,$360.84
9610081,0960,10081,,,,,N/A,N/A,I&D PILONIDAL ABCS COMP -10081,$344.05,$255.75,$152.52,$372.00,$152.52,$360.84,$152.52,$318.06,$152.52,$293.55,$152.52,$360.84,$152.52,$372.00,$152.52,$152.52,$360.84
10120,0960,10120,,,,,N/A,N/A,REMOVE FOREIGN BODY,$206.83,$153.75,$83.64,$204.00,$83.64,$197.88,$83.64,$174.42,$83.64,$179.14,$83.64,$197.88,$83.64,$204.00,$83.64,$83.64,$197.88
9610120,0960,10120,,,,,N/A,N/A,REMOVAL FB-SIMPLE       -10120,$181.61,$135.00,$83.64,$204.00,$83.64,$197.88,$83.64,$174.42,$83.64,$179.14,$83.64,$197.88,$83.64,$204.00,$83.64,$83.64,$197.88
10121,0960,10121,,,,,N/A,N/A,REMOVE FOREIGN BODY,$424.76,$315.75,$172.61,$421.00,$172.61,$408.37,$172.61,$359.96,$172.61,$314.50,$172.61,$408.37,$172.61,$421.00,$172.61,$172.61,$408.37
9610121,0960,10121,,,,,N/A,N/A,REMOVAL FB COMPLEX      -10121,$330.93,$246.00,$172.61,$421.00,$172.61,$408.37,$172.61,$359.96,$172.61,$314.50,$172.61,$408.37,$172.61,$421.00,$172.61,$172.61,$408.37
10140,0960,10140,,,,,N/A,N/A,DRAINAGE OF HEMATOMA/FLUID,$268.38,$199.50,$117.26,$266.00,$117.26,$258.02,$117.26,$227.43,$117.26,$202.56,$117.26,$258.02,$117.26,$266.00,$117.26,$117.26,$258.02
9610140,0960,10140,,,,,N/A,N/A,I&D HEMATOMA SIMPLE     -10140,$334.97,$249.00,$117.26,$266.00,$117.26,$258.02,$117.26,$227.43,$117.26,$202.56,$117.26,$258.02,$117.26,$266.00,$117.26,$117.26,$258.02
10160,0960,10160,,,,,N/A,N/A,PUNCTURE DRAINAGE OF LESION,$216.92,$161.25,$16.72,$392.00,$16.72,$380.24,$16.72,$335.16,$16.72,$162.64,$16.72,$380.24,$16.72,$392.00,$16.72,$16.72,$380.24
9610160,0960,10160,,,,,N/A,N/A,I&D ASPIRATION ABSCESS  -10160,$339.00,$252.00,$16.72,$392.00,$16.72,$380.24,$16.72,$335.16,$16.72,$162.64,$16.72,$380.24,$16.72,$392.00,$16.72,$16.72,$380.24
10180,0960,10180,,,,,N/A,N/A,"COMPLEX DRAINAGE, WOUND",$402.57,$299.25,$163.59,$399.00,$163.59,$387.03,$163.59,$341.15,$163.59,$301.36,$163.59,$387.03,$163.59,$399.00,$163.59,$163.59,$387.03
9611000,0960,11000,,,,,N/A,N/A,DEBRIDEMENT INFCT SKIN  -11000,$233.07,$173.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
11001,0960,11001,,,,,N/A,N/A,DEBRIDE INFECTED SKIN ADD-ON,$41.37,$30.75,$14.79,$42.00,$16.81,$40.74,$16.81,$35.91,$16.81,$14.79,$16.81,$40.74,$16.81,$42.00,$16.81,$16.81,$40.74
9611001,0960,11001,,,,,N/A,N/A,DEBRIDEMENT SKN ADD 10%-961101,$29.26,$21.75,$14.79,$42.00,$16.81,$40.74,$16.81,$35.91,$16.81,$14.79,$16.81,$40.74,$16.81,$42.00,$16.81,$16.81,$40.74
11004,0960,11004,,,,,N/A,N/A,DEBRIDGE GENITALIA & PERINEUM,"$1,332.81",$990.75,$541.61,"$1,321.00",$541.61,"$1,281.37",$541.61,"$1,129.46",$541.61,$582.94,$541.61,"$1,281.37",$541.61,"$1,321.00",$541.61,$541.61,"$1,281.37"
11005,0960,11005,,,,,N/A,N/A,DEBRIDGE ABDOMINAL WALL,"$1,811.05","$1,346.25",$735.95,"$1,795.00",$735.95,"$1,741.15",$735.95,"$1,534.73",$735.95,$787.18,$735.95,"$1,741.15",$735.95,"$1,795.00",$735.95,$735.95,"$1,741.15"
11008,0960,11008,,,,,N/A,N/A,REMOVE MESH FROM ABDML WALL,$671.95,$499.50,$273.60,$666.00,$273.60,$646.02,$273.60,$569.43,$273.60,$276.48,$273.60,$646.02,$273.60,$666.00,$273.60,$273.60,$646.02
11010,0960,11010,,,,,N/A,N/A,DEBRIDEMENT,$588.21,$437.25,$239.30,$583.00,$239.30,$565.51,$239.30,$498.47,$239.30,$283.64,$239.30,$565.51,$239.30,$583.00,$239.30,$239.30,$565.51
11011,0960,11011,,,,,N/A,N/A,DEBRIDE SKIN\MUSCLE FX,$700.20,$520.50,$284.54,$284.54,$284.54,N/A,$284.54,N/A,$284.54,N/A,$284.54,N/A,$284.54,N/A,$284.54,$284.54,N/A
11012,0960,11012,,,,,N/A,N/A,"DEBRIDE SKIN/MUSCLE/BONE, FX","$1,032.15",$767.25,$419.43,"$1,023.00",$419.43,$992.31,$419.43,$874.67,$419.43,$427.36,$419.43,$992.31,$419.43,"$1,023.00",$419.43,$419.43,$992.31
11042,0960,11042,,,,,N/A,N/A,DEBRIDE SKIN/TISSUE,$151.34,$112.50,$61.50,$150.00,$61.50,$145.50,$61.50,$128.25,$61.50,$62.57,$61.50,$145.50,$61.50,$150.00,$61.50,$61.50,$145.50
11043,0960,11043,,,,,N/A,N/A,DEBRIDE TISSUE/MUSCLE,$393.49,$292.50,$159.32,$390.00,$159.90,$378.30,$159.90,$333.45,$159.90,$159.32,$159.90,$378.30,$159.90,$390.00,$159.90,$159.90,$378.30
11044,0960,11044,,,,,N/A,N/A,DEBRIDE TISSUE/MUSCLE/BONE,$639.67,$475.50,$231.11,$634.00,$259.94,$614.98,$259.94,$542.07,$259.94,$231.11,$259.94,$614.98,$259.94,$634.00,$259.94,$259.94,$614.98
11045,0960,11045,,,,,N/A,N/A,DBRDMT SUBCUTANEOUS TISSUE E,$51.46,$38.25,$22.55,$55.00,$22.55,$53.35,$22.55,$47.03,$22.55,$26.85,$22.55,$53.35,$22.55,$55.00,$22.55,$22.55,$53.35
11046,0960,11046,,,,,N/A,N/A,DEB MUSC/FASCIA ADD-ON,$74.66,$55.50,$3.34,$74.00,$3.34,$71.78,$3.34,$63.27,$3.34,$56.68,$3.34,$71.78,$3.34,$74.00,$3.34,$3.34,$71.78
11047,0960,11047,,,,,N/A,N/A,DEB BONE ADD-ON,$187.66,$139.50,$53.13,$186.00,$53.13,$180.42,$53.13,$159.03,$53.13,$99.26,$53.13,$180.42,$53.13,$186.00,$53.13,$53.13,$180.42
11055,0960,11055,,,,,N/A,N/A,TRIM SKIN LESION,$65.58,$48.75,$16.62,$65.00,$26.65,$63.05,$26.65,$55.58,$26.65,$16.62,$26.65,$63.05,$26.65,$65.00,$26.65,$26.65,$63.05
11056,0960,11056,,,,,N/A,N/A,TRIM SKIN LESION 2 TO 4,$76.68,$57.00,$23.23,$124.00,$31.16,$120.28,$31.16,$106.02,$31.16,$23.23,$31.16,$120.28,$31.16,$124.00,$31.16,$31.16,$120.28
11057,0960,11057,,,,,N/A,N/A,TRIM SKIN LESION OVER 4,$84.75,$63.00,$30.05,$84.00,$34.44,$81.48,$34.44,$71.82,$34.44,$30.05,$34.44,$81.48,$34.44,$84.00,$34.44,$34.44,$81.48
11062,0960,11062,,,,,N/A,N/A,EXC TR-EXT MLG+MARG 1.1-2,$253.24,$188.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
11100,0960,11100,,,,,N/A,N/A,"BIOPSY, SKIN LESION",$111.99,$83.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
11101,0960,11101,,,,,N/A,N/A,"BIOPSY, SKIN ADD-ON",$58.52,$43.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
11102,0960,11102,,,,,N/A,N/A,SKIN BIOPSY,$202.80,$150.75,$82.41,$82.41,$82.41,N/A,$82.41,N/A,$82.41,N/A,$82.41,N/A,$82.41,N/A,$82.41,$82.41,N/A
11103,0960,11103,,,,,N/A,N/A,SKIN BIOPSY EA SEPARATE,$109.97,$81.75,$44.69,$44.69,$44.69,N/A,$44.69,N/A,$44.69,N/A,$44.69,N/A,$44.69,N/A,$44.69,$44.69,N/A
11104,0960,11104,,,,,N/A,N/A,PUNCH BIOPSY,$255.26,$189.75,$13.73,$13.73,$13.73,N/A,$13.73,N/A,$13.73,N/A,$13.73,N/A,$13.73,N/A,$13.73,$13.73,N/A
11105,0960,11105,,,,,N/A,N/A,PUNCH BIOPSY EA SEPARATE,$125.11,$93.00,$5.84,$5.84,$5.84,N/A,$5.84,N/A,$5.84,N/A,$5.84,N/A,$5.84,N/A,$5.84,$5.84,N/A
11106,0960,11106,,,,,N/A,N/A,INCISIONAL BIOPSY,$308.74,$229.50,$125.46,$125.46,$125.46,N/A,$125.46,N/A,$125.46,N/A,$125.46,N/A,$125.46,N/A,$125.46,$125.46,N/A
11107,0960,11107,,,,,N/A,N/A,INCISIONAL BIOPSY EA SEPARATE,$148.31,$110.25,$6.27,$6.27,$6.27,N/A,$6.27,N/A,$6.27,N/A,$6.27,N/A,$6.27,N/A,$6.27,$6.27,N/A
11200,0960,11200,,,,,N/A,N/A,REMOVAL OF SKIN TAGS,$144.28,$107.25,$58.63,$143.00,$58.63,$138.71,$58.63,$122.27,$58.63,$78.65,$58.63,$138.71,$58.63,$143.00,$58.63,$58.63,$138.71
11201,0960,11201,,,,,N/A,N/A,REMOVE SKIN TAGS ADD-ON,$45.40,$33.75,$16.99,$45.00,$18.45,$43.65,$18.45,$38.48,$18.45,$16.99,$18.45,$43.65,$18.45,$45.00,$18.45,$18.45,$43.65
11300,0960,11300,,,,,N/A,N/A,SHAVE SKIN LESION,$103.92,$77.25,$35.19,$107.00,$43.87,$103.79,$43.87,$91.49,$43.87,$35.19,$43.87,$103.79,$43.87,$107.00,$43.87,$43.87,$103.79
11301,0960,11301,,,,,N/A,N/A,SHAVE SKIN LESION,$125.11,$93.00,$49.61,$121.00,$49.61,$117.37,$49.61,$103.46,$49.61,$53.29,$49.61,$117.37,$49.61,$121.00,$49.61,$49.61,$117.37
11302,0960,11302,,,,,N/A,N/A,SHAVE SKIN LESION,$145.29,$108.00,$62.52,$154.00,$63.14,$149.38,$63.14,$131.67,$63.14,$62.52,$63.14,$149.38,$63.14,$154.00,$63.14,$63.14,$149.38
11303,0960,11303,,,,,N/A,N/A,SHAVE SKIN LESION,$166.48,$123.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
11305,0960,11305,,,,,N/A,N/A,SHAVE SKIN LESION,$108.97,$81.00,$39.44,$233.00,$95.53,$226.01,$95.53,$199.22,$95.53,$39.44,$95.53,$226.01,$95.53,$233.00,$95.53,$95.53,$226.01
11306,0960,11306,,,,,N/A,N/A,SHAVE SKIN LESION,$135.20,$100.50,$51.45,$233.00,$93.89,$226.01,$93.89,$199.22,$93.89,$51.45,$93.89,$226.01,$93.89,$233.00,$93.89,$93.89,$226.01
11307,0960,11307,,,,,N/A,N/A,SHAVE SKIN LESION,$154.37,$114.75,$62.73,$153.00,$62.73,$148.41,$62.73,$130.82,$62.73,$66.19,$62.73,$148.41,$62.73,$153.00,$62.73,$62.73,$148.41
11308,0960,11308,,,,,N/A,N/A,SHAVE SKIN LESION,$190.69,$141.75,$75.05,$189.00,$77.49,$183.33,$77.49,$161.50,$77.49,$75.05,$77.49,$183.33,$77.49,$189.00,$77.49,$77.49,$183.33
11310,0960,11310,,,,,N/A,N/A,SHAVE SKIN LESION,$170.51,$126.75,$47.41,$182.00,$74.62,$176.54,$74.62,$155.61,$74.62,$47.41,$74.62,$176.54,$74.62,$182.00,$74.62,$74.62,$176.54
11311,0960,11311,,,,,N/A,N/A,SHAVE SKIN LESION,$145.29,$108.00,$59.40,$144.00,$59.40,$139.68,$59.40,$123.12,$59.40,$65.51,$59.40,$139.68,$59.40,$144.00,$59.40,$59.40,$139.68
11312,0960,11312,,,,,N/A,N/A,SHAVE SKIN LESION,$165.47,$123.00,$77.47,$232.00,$95.12,$225.04,$95.12,$198.36,$95.12,$77.47,$95.12,$225.04,$95.12,$232.00,$95.12,$95.12,$225.04
11313,0960,11313,,,,,N/A,N/A,SHAVE SKIN LESION,$220.96,$164.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
11400,0960,11400,,,,,N/A,N/A,EXC TR-EXT B9+MARG 0.5 < CM,$162.44,$120.75,$66.10,$161.00,$66.10,$156.17,$66.10,$137.66,$66.10,$87.14,$66.10,$156.17,$66.10,$161.00,$66.10,$66.10,$156.17
11401,0960,11401,,,,,N/A,N/A,EXC TR-EXT B9+MARG 0.6-1 CM,$212.89,$158.25,$86.51,$211.00,$86.51,$204.67,$86.51,$180.11,$86.51,$109.64,$86.51,$204.67,$86.51,$211.00,$86.51,$86.51,$204.67
11402,0960,11402,,,,,N/A,N/A,EXC TR-EXT B9+MARG 1.1-2 CM,$244.16,$181.50,$99.22,$242.00,$99.22,$234.74,$99.22,$206.91,$99.22,$120.39,$99.22,$234.74,$99.22,$242.00,$99.22,$99.22,$234.74
11403,0960,11403,,,,,N/A,N/A,EXC TR-EXT B9+MARG 2.1-3 CM,$291.58,$216.75,$118.49,$289.00,$118.49,$280.33,$118.49,$247.10,$118.49,$154.18,$118.49,$280.33,$118.49,$289.00,$118.49,$118.49,$280.33
11404,0960,11404,,,,,N/A,N/A,EXC TR-EXT B9+MARG 3.1-4 CM,$327.91,$243.75,$133.25,$215.00,$133.25,$208.55,$133.25,$183.83,$133.25,$169.43,$133.25,$208.55,$133.25,$215.00,$133.25,$133.25,$208.55
11406,0960,11406,,,,,N/A,N/A,EXC TR-EXT B9+MARG > 4.0 CM,$419.72,$312.00,$129.56,$418.00,$129.56,$405.46,$129.56,$357.39,$129.56,$255.59,$129.56,$405.46,$129.56,$418.00,$129.56,$129.56,$405.46
11420,0960,11420,,,,,N/A,N/A,EXC H-F-NK-SP B9+MARG 0.5 <,$180.60,$134.25,$86.04,$179.00,$114.39,$173.63,$114.39,$153.05,$114.39,$86.04,$114.39,$173.63,$114.39,$179.00,$114.39,$114.39,$173.63
11421,0960,11421,,,,,N/A,N/A,EXC H-F-NK-SP B9+MARG 0.6-1,$238.11,$177.00,$96.76,$236.00,$96.76,$228.92,$96.76,$201.78,$96.76,$113.89,$96.76,$228.92,$96.76,$236.00,$96.76,$96.76,$228.92
11422,0960,11422,,,,,N/A,N/A,EXC H-F-NK-SP B9+MARG 1.1-2,$278.47,$207.00,$113.16,$276.00,$113.16,$267.72,$113.16,$235.98,$113.16,$141.01,$113.16,$267.72,$113.16,$276.00,$113.16,$113.16,$267.72
11423,0960,11423,,,,,N/A,N/A,EXC H-F-NK-SP B9+MARG 2.1-3,$327.91,$243.75,$133.25,$325.00,$133.25,$315.25,$133.25,$277.88,$133.25,$161.73,$133.25,$315.25,$133.25,$325.00,$133.25,$133.25,$315.25
11424,0960,11424,,,,,N/A,N/A,EXC H-F-NK-SP B9+MARG 3.1-4,$380.37,$282.75,$154.57,$377.00,$154.57,$365.69,$154.57,$322.34,$154.57,$183.80,$154.57,$365.69,$154.57,$377.00,$154.57,$154.57,$365.69
11426,0960,11426,,,,,N/A,N/A,EXC H-F-NK-SP B9+MARG > 4CM,$558.95,$415.50,$227.14,$227.14,$227.14,N/A,$227.14,N/A,$227.14,N/A,$227.14,N/A,$227.14,N/A,$227.14,$227.14,N/A
11440,0960,11440,,,,,N/A,N/A,EXC FACE-MM B9+MARG 0.5 < CM,$168.49,$125.25,$56.17,$167.00,$56.17,$161.99,$56.17,$142.79,$56.17,$109.55,$56.17,$161.99,$56.17,$167.00,$56.17,$56.17,$161.99
11441,0960,11441,,,,,N/A,N/A,EXC FACE-MM B9+MARG 0.6-1 CM,$278.47,$207.00,$113.16,$276.00,$113.16,$267.72,$113.16,$235.98,$113.16,$137.29,$113.16,$267.72,$113.16,$276.00,$113.16,$113.16,$267.72
11442,0960,11442,,,,,N/A,N/A,EXC FACE-MM B9+MARG 1.1-2 CM,$279.48,$207.75,$113.57,$277.00,$113.57,$268.69,$113.57,$236.84,$113.57,$151.35,$113.57,$268.69,$113.57,$277.00,$113.57,$113.57,$268.69
11443,0960,11443,,,,,N/A,N/A,EXC FACE-MM B9+MARG 2.1-3 CM,$766.79,$570.00,$185.17,$760.00,$311.60,$737.20,$311.60,$649.80,$311.60,$185.17,$311.60,$737.20,$311.60,$760.00,$311.60,$311.60,$737.20
11444,0960,11444,,,,,N/A,N/A,EXC FACE-MM B9+MARG 3.1-4 CM,$434.85,$323.25,$176.71,$431.00,$176.71,$418.07,$176.71,$368.51,$176.71,$234.52,$176.71,$418.07,$176.71,$431.00,$176.71,$176.71,$418.07
11446,0960,11446,,,,,N/A,N/A,EXC FACE-MM B9+MARG > 4 CM,$683.05,$507.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
11450,0960,11450,,,,,N/A,N/A,"REMOVAL, SWEAT GLAND LESION",$482.27,$358.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
11451,0960,11451,,,,,N/A,N/A,"REMOVAL, SWEAT GLAND LESION",$620.50,$461.25,$252.15,$615.00,$252.15,$596.55,$252.15,$525.83,$252.15,$556.60,$252.15,$596.55,$252.15,$615.00,$252.15,$252.15,$596.55
11462,0960,11462,,,,,N/A,N/A,"REMOVAL, SWEAT GLAND LESION",$467.14,$347.25,$193.52,$472.00,$193.52,$457.84,$193.52,$403.56,$193.52,$416.86,$193.52,$457.84,$193.52,$472.00,$193.52,$193.52,$457.84
11470,0960,11470,,,,,N/A,N/A,"REMOVAL, SWEAT GLAND LESION",$540.79,$402.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
11600,0960,11600,,,,,N/A,N/A,EXC TR-EXT MLG+MARG 0.5 < CM,$243.15,$180.75,$98.81,$241.00,$98.81,$233.77,$98.81,$206.06,$98.81,$127.42,$98.81,$233.77,$98.81,$241.00,$98.81,$98.81,$233.77
11602,0960,11602,,,,,N/A,N/A,EXC TR-EXT MLG+MARG 1.1-2 CM,$300.66,$223.50,$122.18,$299.00,$122.18,$290.03,$122.18,$255.65,$122.18,$167.92,$122.18,$290.03,$122.18,$299.00,$122.18,$122.18,$290.03
11603,0960,11603,,,,,N/A,N/A,EXC TR-EXT MLG+MARG 2.1-3 CM,$330.93,$246.00,$134.48,$328.00,$134.48,$318.16,$134.48,$280.44,$134.48,$200.22,$134.48,$318.16,$134.48,$328.00,$134.48,$134.48,$318.16
11604,0960,11604,,,,,N/A,N/A,EXC TR-EXT MLG+MARG 3.1-4 CM,$411.65,$306.00,$167.28,$408.00,$167.28,$395.76,$167.28,$348.84,$167.28,$220.67,$167.28,$395.76,$167.28,$408.00,$167.28,$167.28,$395.76
11606,0960,11606,,,,,N/A,N/A,EXC TR-EXT MLG+MARG > 4 CM,$735.52,$546.75,$298.89,$729.00,$298.89,$707.13,$298.89,$623.30,$298.89,$326.60,$298.89,$707.13,$298.89,$729.00,$298.89,$298.89,$707.13
11620,0960,11620,,,,,N/A,N/A,EXC H-F-NK-SP MLG+MARG 0.5 <,$243.15,$180.75,$98.81,$241.00,$98.81,$233.77,$98.81,$206.06,$98.81,$128.15,$98.81,$233.77,$98.81,$241.00,$98.81,$98.81,$233.77
11621,0960,11621,,,,,N/A,N/A,EXC H-F-NK-SP MLG+MARG 0.6-1,$281.49,$209.25,$114.39,$279.00,$114.39,$270.63,$114.39,$238.55,$114.39,$154.69,$114.39,$270.63,$114.39,$279.00,$114.39,$114.39,$270.63
11622,0960,11622,,,,,N/A,N/A,EXC H-F-NK-SP MLG+MARG 1.1-2,$326.90,$243.00,$132.20,$324.00,$132.20,$314.28,$132.20,$277.02,$132.20,$175.47,$132.20,$314.28,$132.20,$324.00,$132.20,$132.20,$314.28
11623,0960,11623,,,,,N/A,N/A,EXC H-F-NK-SP MLG+MARG 2.1-3,$410.64,$305.25,$166.50,$407.00,$166.50,$394.79,$166.50,$347.99,$166.50,$217.26,$166.50,$394.79,$166.50,$407.00,$166.50,$166.50,$394.79
11624,0960,11624,,,,,N/A,N/A,EXC H-F-NK-SP MLG+MARG 3.1-4,$463.10,$344.25,$188.19,$459.00,$188.19,$445.23,$188.19,$392.45,$188.19,$245.79,$188.19,$445.23,$188.19,$459.00,$188.19,$188.19,$445.23
11626,0960,11626,,,,,N/A,N/A,EXC H-F-NK-SP MLG+MARG < 4 CM,$569.04,$423.00,$231.24,$231.24,$231.24,N/A,$231.24,N/A,$231.24,N/A,$231.24,N/A,$231.24,N/A,$231.24,$231.24,N/A
11640,0960,11640,,,,,N/A,N/A,EXC FACE-MM MALIG+MARG 0.5 <,$287.55,$213.75,$116.85,$285.00,$116.85,$276.45,$116.85,$243.68,$116.85,$131.46,$116.85,$276.45,$116.85,$285.00,$116.85,$116.85,$276.45
11641,0960,11641,,,,,N/A,N/A,EXC FACE-MM MALIG+MARG 0.6-1,$345.06,$256.50,$14.22,$342.00,$14.22,$331.74,$14.22,$292.41,$14.22,$161.15,$14.22,$331.74,$14.22,$342.00,$14.22,$14.22,$331.74
11642,0960,11642,,,,,N/A,N/A,EXC FACE-MM MALIG+MARG 1.1-2,$350.10,$260.25,$142.27,$347.00,$142.27,$336.59,$142.27,$296.69,$142.27,$188.63,$142.27,$336.59,$142.27,$347.00,$142.27,$142.27,$336.59
11643,0960,11643,,,,,N/A,N/A,EXC FACE-MM MALIG+MARG 2.1-3,$448.98,$333.75,$182.45,$445.00,$182.45,$431.65,$182.45,$380.48,$182.45,$235.78,$182.45,$431.65,$182.45,$445.00,$182.45,$182.45,$431.65
11646,0960,11646,,,,,N/A,N/A,EXC FACE-MM MALIG+MARG > 4 CM,$793.03,$589.50,$322.26,$786.00,$322.26,$762.42,$322.26,$672.03,$322.26,$403.91,$322.26,$762.42,$322.26,$786.00,$322.26,$322.26,$762.42
11719,0960,11719,,,,,N/A,N/A,TRIM NAIL(S),$25.22,$18.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
11720,0960,11720,,,,,N/A,N/A,"DEBRIDGE NAIL, 1-5",$36.32,$27.00,$14.76,$36.00,$14.76,$34.92,$14.76,$30.78,$14.76,$15.15,$14.76,$34.92,$14.76,$36.00,$14.76,$14.76,$34.92
11721,0960,11721,,,,,N/A,N/A,"DEBRIDE NAIL, 6 OR MORE",$73.65,$54.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
11730,0960,11730,,,,,N/A,N/A,REMOVAL OF NAIL PLATE,$151.34,$112.50,$0.00,$56.22,N/A,$0.00,N/A,$0.00,N/A,$56.22,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
11732,0960,11732,,,,,N/A,N/A,"REMOVE NAIL PLATE, ADD-ON",$76.68,$57.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
11740,0960,11740,,,,,N/A,N/A,DRAIN BLOOD FROM UNDER NAIL,$69.62,$51.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
11750,0960,11750,,,,,N/A,N/A,REMOVAL OF NAIL BED,$340.01,$252.75,$138.17,$337.00,$138.17,$326.89,$138.17,$288.14,$138.17,$174.56,$138.17,$326.89,$138.17,$337.00,$138.17,$138.17,$326.89
9711750,0960,11750,,,,,N/A,N/A,REMOVE PORTION OF TOENAIL,$226.00,$168.00,$138.17,$337.00,$138.17,$326.89,$138.17,$288.14,$138.17,$174.56,$138.17,$326.89,$138.17,$337.00,$138.17,$138.17,$326.89
11760,0960,11760,,,,,N/A,N/A,REPAIR OF NAIL BED,$316.81,$235.50,$79.54,$194.14,$79.54,$188.18,$79.54,$165.87,$79.54,$194.14,$79.54,$188.18,$79.54,$194.00,$79.54,$79.54,$188.18
11765,0960,11765,,,,,N/A,N/A,"EXCISION OF NAIL FOLD, TOE",$180.60,$134.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9711765,0960,11765,,,,,N/A,N/A,WEDGE EX OF SKIN OF NAIL FOLD,$191.70,$142.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
11770,0960,11770,,,,,N/A,N/A,REMOVAL OF PILONIDAL LESION,$391.47,$291.00,$159.80,$388.00,$159.80,$376.36,$159.80,$331.74,$159.80,$314.73,$159.80,$376.36,$159.80,$388.00,$159.80,$159.80,$376.36
11771,0960,11771,,,,,N/A,N/A,REMOVAL OF PILONIDAL LESION,$861.63,$640.50,$348.90,$849.00,$348.90,$823.53,$348.90,$725.90,$348.90,$753.19,$348.90,$823.53,$348.90,$849.00,$348.90,$348.90,$823.53
11772,0960,11772,,,,,N/A,N/A,REMOVAL OF PILONIDAL LESION,"$1,140.10",$847.50,$463.30,"$1,130.00",$463.30,"$1,096.10",$463.30,$966.15,$463.30,$997.43,$463.30,"$1,096.10",$463.30,"$1,130.00",$463.30,$463.30,"$1,096.10"
11900,0960,11900,,,,,N/A,N/A,INJ INTRALESIONAL UP TO 7 LES,$175.56,$130.50,$31.16,$174.00,$71.34,$168.78,$71.34,$148.77,$71.34,$31.16,$71.34,$168.78,$71.34,$174.00,$71.34,$71.34,$168.78
11981,0960,11981,,,,,N/A,N/A,INSERT DRUG IMPLANT DEVICE,$203.81,$151.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
11982,0960,11982,,,,,N/A,N/A,REMOVE DRUG IMPLANT DEVICE,$249.21,$185.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
11983,0960,11983,,,,,N/A,N/A,REMOVE/INSERT DRUG IMPLANT,$447.97,$333.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
12001,0960,12001,,,,,N/A,N/A,REPAIR SUPERFICIAL WOUND(S),$235.08,$174.75,$45.36,$199.00,$81.59,$193.03,$81.59,$170.15,$81.59,$45.36,$81.59,$193.03,$81.59,$199.00,$81.59,$81.59,$193.03
9612001,0960,12001,,,,,N/A,N/A,REPAIR SUPERFICIAL WOUND(S),$235.08,$174.75,$45.36,$199.00,$81.59,$193.03,$81.59,$170.15,$81.59,$45.36,$81.59,$193.03,$81.59,$199.00,$81.59,$81.59,$193.03
5012001B,0960,12001,,,,,N/A,N/A,LAC REPAIR 2.5CM OR <  12001,$273.42,$203.25,$45.36,$199.00,$81.59,$193.03,$81.59,$170.15,$81.59,$45.36,$81.59,$193.03,$81.59,$199.00,$81.59,$81.59,$193.03
12002,0960,12002,,,,,N/A,N/A,REPAIR SUPERFICIAL WOUND(S),$263.33,$195.75,$17.10,$261.00,$17.10,$253.17,$17.10,$223.16,$17.10,$59.83,$17.10,$253.17,$17.10,$261.00,$17.10,$17.10,$253.17
12004,0960,12004,,,,,N/A,N/A,REPAIR SUPERFICIAL WOUND(S),$308.74,$229.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
12005,0960,12005,,,,,N/A,N/A,REPAIR SUPERFICIAL WOUND(S),$386.42,$287.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
12011,0960,12011,,,,,N/A,N/A,REPAIR SUPERFICIAL WOUND(S),$242.15,$180.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
12020,0960,12020,,,,,N/A,N/A,CLOSURE OF SPLIT WOUND,$429.81,$319.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
12031,0960,12031,,,,,N/A,N/A,LAYER CLOSURE OF WOUND(S),$294.61,$219.00,$119.72,$292.00,$119.72,$283.24,$119.72,$249.66,$119.72,$258.03,$119.72,$283.24,$119.72,$292.00,$119.72,$119.72,$283.24
12032,0960,12032,,,,,N/A,N/A,LAYER CLOSURE OF WOUND(S),$396.51,$294.75,$161.13,$393.00,$161.13,$381.21,$161.13,$336.02,$161.13,$323.30,$161.13,$381.21,$161.13,$393.00,$161.13,$161.13,$381.21
12034,0960,12034,,,,,N/A,N/A,LAYER CLOSURE OF WOUND(S),$413.67,$307.50,$168.10,$410.00,$168.10,$397.70,$168.10,$350.55,$168.10,$348.85,$168.10,$397.70,$168.10,$410.00,$168.10,$168.10,$397.70
12035,0960,12035,,,,,N/A,N/A,LAYER CLOSURE OF WOUND(S),$527.68,$392.25,$197.21,$481.00,$197.21,$466.57,$197.21,$411.26,$197.21,$407.81,$197.21,$466.57,$197.21,$481.00,$197.21,$197.21,$466.57
12041,0960,12041,,,,,N/A,N/A,LAYER CLOSURE OF WOUND(S),$330.93,$246.00,$134.48,$328.00,$134.48,$318.16,$134.48,$280.44,$134.48,$246.94,$134.48,$318.16,$134.48,$328.00,$134.48,$134.48,$318.16
12042,0960,12042,,,,,N/A,N/A,LAYER CLOSURE OF WOUND(S),$393.49,$292.50,$159.90,$390.00,$159.90,$378.30,$159.90,$333.45,$159.90,$333.41,$159.90,$378.30,$159.90,$390.00,$159.90,$159.90,$378.30
12044,0960,12044,,,,,N/A,N/A,LAYER CLOSURE OF WOUND(S),$447.97,$333.00,$182.40,$444.00,$182.40,$430.68,$182.40,$379.62,$182.40,$361.63,$182.40,$430.68,$182.40,$444.00,$182.40,$182.40,$430.68
12051,0960,12051,,,,,N/A,N/A,LAYER CLOSURE OF WOUND(S),$368.26,$273.75,$149.65,$365.00,$149.65,$354.05,$149.65,$312.08,$149.65,$287.31,$149.65,$354.05,$149.65,$365.00,$149.65,$149.65,$354.05
12052,0960,12052,,,,,N/A,N/A,LAYER CLOSURE OF WOUND(S),$393.49,$292.50,$159.90,$390.00,$159.90,$378.30,$159.90,$333.45,$159.90,$339.25,$159.90,$378.30,$159.90,$390.00,$159.90,$159.90,$378.30
12053,0960,12053,,,,,N/A,N/A,LAYER CLOSURE OF WOUND(S),$441.92,$328.50,$179.58,$438.00,$179.58,$424.86,$179.58,$374.49,$179.58,$365.16,$179.58,$424.86,$179.58,$438.00,$179.58,$179.58,$424.86
12054,0960,12054,,,,,N/A,N/A,LAYER CLOSURE OF WOUND(S),$480.26,$357.00,$195.16,$476.00,$195.16,$461.72,$195.16,$406.98,$195.16,$368.30,$195.16,$461.72,$195.16,$476.00,$195.16,$195.16,$461.72
12055,0960,12055,,,,,N/A,N/A,LAYER CLOSURE OF WOUND(S),$621.51,$462.00,$252.56,$616.00,$252.56,N/A,$252.56,$526.68,$252.56,$503.70,$252.56,N/A,$252.56,$616.00,$252.56,$252.56,N/A
13100,0960,13100,,,,,N/A,N/A,REPAIR OF WOUND OR LESION,$508.51,$378.00,$26.64,$504.00,$26.64,$488.88,$26.64,$430.92,$26.64,$342.33,$26.64,$488.88,$26.64,$504.00,$26.64,$26.64,$488.88
13101,0960,13101,,,,,N/A,N/A,REPAIR OF WOUND OR LESION,$616.46,$458.25,$25.51,$611.00,$25.51,$592.67,$25.51,$522.41,$25.51,$426.93,$25.51,$592.67,$25.51,$611.00,$25.51,$25.51,$592.67
13121,0960,13121,,,,,N/A,N/A,REPAIR OF WOUND OR LESION,$662.87,$492.75,$269.37,$657.00,$269.37,$637.29,$269.37,$561.74,$269.37,$440.29,$269.37,$637.29,$269.37,$657.00,$269.37,$269.37,$637.29
13122,0960,13122,,,,,N/A,N/A,REPAIR WOUND/LESION ADD-ON,$198.76,$147.75,$8.77,$197.00,$8.77,$191.09,$8.77,$168.44,$8.77,$140.28,$8.77,$191.09,$8.77,$197.00,$8.77,$8.77,$191.09
13131,0960,13131,,,,,N/A,N/A,REPAIR OF WOUND OR LESION,$603.35,$448.50,$245.18,$598.00,$245.18,$580.06,$245.18,$511.29,$245.18,$413.25,$245.18,$580.06,$245.18,$598.00,$245.18,$245.18,$580.06
13132,0960,13132,,,,,N/A,N/A,SUTURING OF WOUNDS 2.6CM-7.5,$640.68,$476.25,$26.35,$635.00,$26.35,$615.95,$26.35,$542.93,$26.35,$515.68,$26.35,$615.95,$26.35,$635.00,$26.35,$26.35,$615.95
13133,0960,13133,,,,,N/A,N/A,EA ADDITIONAL 5CM OR LESS,$266.36,$198.00,$18.24,$264.00,$18.24,$256.08,$18.24,$225.72,$18.24,$213.86,$18.24,$256.08,$18.24,$264.00,$18.24,$18.24,$256.08
13152,0960,13152,,,,,N/A,N/A,REPAIR OF WOUND OR LESION,$966.56,$718.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
14000,0960,14000,,,,,N/A,N/A,SKIN TISSUE REARRANGEMENT,"$1,062.41",$789.75,$431.73,"$1,053.00",$431.73,"$1,021.41",$431.73,$900.32,$431.73,$518.43,$431.73,"$1,021.41",$431.73,"$1,053.00",$431.73,$431.73,"$1,021.41"
14020,0960,14020,,,,,N/A,N/A,SKIN TISSUE REARRANGEMENT,"$1,224.85",$910.50,$497.74,"$1,214.00",$497.74,"$1,177.58",$497.74,"$1,037.97",$497.74,$585.12,$497.74,"$1,177.58",$497.74,"$1,214.00",$497.74,$497.74,"$1,177.58"
14040,0960,14040,,,,,N/A,N/A,SKIN TISSUE REARRANGEMENT,"$1,401.42","$1,041.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
14041,0960,14041,,,,,N/A,N/A,SKIN TISSUE REARRANGEMENT,"$1,871.58","$1,391.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
14060,0960,14060,,,,,N/A,N/A,SKIN TISSUE REARRANGEMENT,"$1,482.13","$1,101.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
14061,0960,14061,,,,,N/A,N/A,SKIN TISSUE REARRANGEMENT,"$2,020.91","$1,502.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
14301,0960,14301,,,,,N/A,N/A,SKIN TISSUE REARRANGEMENT,"$1,770.69","$1,316.25",$725.70,"$1,770.00",$725.70,"$1,716.90",$725.70,"$1,513.35",$725.70,$898.67,$725.70,"$1,716.90",$725.70,"$1,770.00",$725.70,$725.70,"$1,716.90"
14302,0960,14302,,,,,N/A,N/A,ADJT TIS/TRNSFR EA ADDL 30CM,$438.89,$326.25,$178.35,$435.00,$178.35,$421.95,$178.35,$371.93,$178.35,$222.31,$178.35,$421.95,$178.35,$435.00,$178.35,$178.35,$421.95
15002,0960,15002,,,,,N/A,N/A,PREP SITE,$441.92,$328.50,$179.58,$438.00,$179.58,$424.86,$179.58,$374.49,$179.58,$227.08,$179.58,$424.86,$179.58,$438.00,$179.58,$179.58,$424.86
15003,0960,15003,,,,,N/A,N/A,PREP SITE EA ADDL 100SQ CM,$168.49,$125.25,$46.30,$167.00,$68.47,$161.99,$68.47,$142.79,$68.47,$46.30,$68.47,$161.99,$68.47,$167.00,$68.47,$68.47,$161.99
15100,0960,15100,,,,,N/A,N/A,SKIN SPLIT GRAFT,"$1,595.13","$1,185.75",$648.21,"$1,581.00",$648.21,N/A,$648.21,"$1,351.76",$648.21,$739.25,$648.21,N/A,$648.21,"$1,581.00",$648.21,$648.21,N/A
15130,0960,15130,,,,,N/A,N/A,"DERM AUTOGRAFT, TRNK/ARM/LEG","$1,175.42",$873.75,$477.65,$477.65,$477.65,N/A,$477.65,N/A,$477.65,N/A,$477.65,N/A,$477.65,N/A,$477.65,$477.65,N/A
15200,0960,15200,,,,,N/A,N/A,SKIN FULL GRAFT,"$1,342.90",$998.25,$551.40,"$1,344.00",$551.40,"$1,303.68",$551.40,"$1,149.12",$551.40,$695.38,$551.40,"$1,303.68",$551.40,"$1,344.00",$551.40,$551.40,"$1,303.68"
15220,0960,15220,,,,,N/A,N/A,SKIN FULL GRAFT,"$1,365.10","$1,014.75",$55.53,"$1,233.00",$55.53,"$1,196.01",$55.53,"$1,054.22",$55.53,$633.37,$55.53,"$1,196.01",$55.53,"$1,233.00",$55.53,$55.53,"$1,196.01"
15240,0960,15240,,,,,N/A,N/A,SKIN FULL GRAFT,"$1,594.13","$1,185.00",$654.77,"$1,597.00",$654.77,"$1,549.09",$654.77,"$1,365.44",$654.77,$825.53,$654.77,"$1,549.09",$654.77,"$1,597.00",$654.77,$654.77,"$1,549.09"
15260,0960,15260,,,,,N/A,N/A,SKIN FULL GRAFT,"$1,729.32","$1,285.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
15271,0960,15271,,,,,N/A,N/A,SKIN SUB GRAFT TRNK/ARM/LEG,$170.51,$126.75,$69.29,$169.00,$69.29,$163.93,$69.29,$144.50,$69.29,$86.48,$69.29,$163.93,$69.29,$169.00,$69.29,$69.29,$163.93
15273,0960,15273,,,,,N/A,N/A,SKIN SUB GRFT T/ARM/LG CHILD,$404.58,$300.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
15274,0960,15274,,,,,N/A,N/A,SKN SUB GRFT T/A/L CHILD ADD,$86.77,$64.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
15275,0960,15275,,,,,N/A,N/A,SKIN SUB GRAFT FACE/NK/HF/G,$196.74,$146.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
15734,0960,15734,,,,,N/A,N/A,"MUSCLE-SKIN GRAFT, TRUNK","$2,867.41","$2,131.50","$1,165.22","$2,842.00","$1,165.22","$2,756.74","$1,165.22","$2,429.91","$1,165.22","$1,547.67","$1,165.22","$2,756.74","$1,165.22","$2,842.00","$1,165.22","$1,165.22","$2,756.74"
15769,0960,15769,,,,,N/A,N/A,GRAFTING OF SOFT TISSUE,$973.63,$723.75,$395.65,$395.65,$395.65,N/A,$395.65,N/A,$395.65,N/A,$395.65,N/A,$395.65,N/A,$395.65,$395.65,N/A
15852,0960,15852,,,,,N/A,N/A,DRESSING CHANGE NOT FOR BURN,$117.04,$87.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
15931,0960,15931,,,,,N/A,N/A,REMOVE SACRUM PRESSURE SORE,"$1,418.57","$1,054.50",$533.00,"$1,300.00",$533.00,"$1,261.00",$533.00,"$1,111.50",$533.00,$726.49,$533.00,"$1,261.00",$533.00,"$1,300.00",$533.00,$533.00,"$1,261.00"
15933,0960,15933,,,,,N/A,N/A,REMOVE SACRUM PRESSURE SORE,"$1,773.72","$1,318.50",$663.38,"$1,618.00",$663.38,"$1,569.46",$663.38,"$1,383.39",$663.38,$896.79,$663.38,"$1,569.46",$663.38,"$1,618.00",$663.38,$663.38,"$1,569.46"
16000,0960,16000,,,,,N/A,N/A,INITIAL TREATMENT OF BURN(S),$111.99,$83.25,$45.51,$111.00,$45.51,$107.67,$45.51,$94.91,$45.51,$46.41,$45.51,$107.67,$45.51,$111.00,$45.51,$45.51,$107.67
16020,0960,16020,,,,,N/A,N/A,TREATMENT OF BURN(S),$132.17,$98.25,$53.71,$131.00,$53.71,$127.07,$53.71,$112.01,$53.71,$93.42,$53.71,$127.07,$53.71,$131.00,$53.71,$53.71,$127.07
17000,0960,17000,,,,,N/A,N/A,DESTROY BENIGN/PREMLG LESION,$108.97,$81.00,$44.28,$108.00,$44.28,$104.76,$44.28,$92.34,$44.28,$56.51,$44.28,$104.76,$44.28,$108.00,$44.28,$44.28,$104.76
17003,0960,17003,,,,,N/A,N/A,"DESTROY LESIONS, 2-14",$23.21,$17.25,$2.20,$22.00,$9.43,$21.34,$9.43,$18.81,$9.43,$2.20,$9.43,$21.34,$9.43,$22.00,$9.43,$9.43,$21.34
17106,0960,17106,,,,,N/A,N/A,DESTRUCTION OF SKIN LESIONS,$738.54,$549.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
17110,0960,17110,,,,,N/A,N/A,"DESTRUCT LESION, 1-14",$139.23,$103.50,$56.58,$138.00,$56.58,$133.86,$56.58,$117.99,$56.58,$69.20,$56.58,$133.86,$56.58,$138.00,$56.58,$56.58,$133.86
17111,0960,17111,,,,,N/A,N/A,"DESTRUCT LESION, 15 OR MORE",$170.51,$126.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
17250,0960,17250,,,,,N/A,N/A,"CHEMICAL CAUTERY, TISSUE",$92.82,$69.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
17261,0960,17261,,,,,N/A,N/A,DESTRUCT MAL LESION 0.6>1.0CM,$185.64,$138.00,$158.26,$158.26,$158.26,N/A,$158.26,N/A,$158.26,N/A,$158.26,N/A,$158.26,N/A,$158.26,$158.26,N/A
17280,0960,17280,,,,,N/A,N/A,"DESTRUCTION,MALIG LESION",$184.64,$137.25,$72.98,$178.00,$72.98,$172.66,$72.98,$152.19,$72.98,$90.12,$72.98,$172.66,$72.98,$178.00,$72.98,$72.98,$172.66
17281,0960,17281,,,,,N/A,N/A,DESTRUCT MAL LES 0.6-1.0 CM,$261.32,$194.25,$22.99,$539.00,$22.99,$522.83,$22.99,$460.85,$22.99,$122.70,$22.99,$522.83,$22.99,$539.00,$22.99,$22.99,$522.83
19000,0960,19000,,,,,N/A,N/A,DRAINAGE OF BREAST LESION,$148.31,$110.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
19001,0960,19001,,,,,N/A,N/A,DRAIN BREAST LESION ADD-ON,$56.50,$42.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
19020,0960,19020,,,,,N/A,N/A,INCISION OF BREAST LESION,$590.23,$438.75,$239.85,$585.00,$239.85,$567.45,$239.85,$500.18,$239.85,$530.19,$239.85,$567.45,$239.85,$585.00,$239.85,$239.85,$567.45
19083,0960,19083,,,,,N/A,N/A,"BIOPSY BREAST 1ST LESION,INC","$1,085.62",$807.00,$264.57,"$1,076.00",$441.16,"$1,043.72",$441.16,$919.98,$441.16,$264.57,$441.16,"$1,043.72",$441.16,"$1,076.00",$441.16,$441.16,"$1,043.72"
19084,0960,19084,,,,,N/A,N/A,BIOPSY BREAST EA ADD LESION,$681.03,$506.25,$131.94,$675.00,$276.75,$654.75,$276.75,$577.13,$276.75,$131.94,$276.75,$654.75,$276.75,$675.00,$276.75,$276.75,$654.75
19100,0960,19100,,,,,N/A,N/A,BX BREAST PERCUT W/O IMAGE,$177.57,$132.00,$72.16,$176.00,$72.16,$170.72,$72.16,$150.48,$72.16,$115.44,$72.16,$170.72,$72.16,$176.00,$72.16,$72.16,$170.72
19101,0960,19101,,,,,N/A,N/A,"BIOPSY OF BREAST, OPEN",$483.28,$359.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
19110,0960,19110,,,,,N/A,N/A,NIPPLE EXPLORATION,$680.03,$505.50,$276.34,$674.00,$276.34,$653.78,$276.34,$576.27,$276.34,$596.36,$276.34,$653.78,$276.34,$674.00,$276.34,$276.34,$653.78
19112,0960,19112,,,,,N/A,N/A,EXCISE BREAST DUCT FISTULA,$606.37,$450.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
19120,0960,19120,,,,,N/A,N/A,REMOVAL OF BREAST LESION,$824.30,$612.75,$334.97,$817.00,$334.97,$792.49,$334.97,$698.54,$334.97,$702.84,$334.97,$792.49,$334.97,$817.00,$334.97,$334.97,$792.49
19125,0960,19125,,,,,N/A,N/A,"EXCISION, BREAST LESION",$889.89,$661.50,$365.72,$882.00,$365.72,$855.54,$365.72,$754.11,$365.72,$776.74,$365.72,$855.54,$365.72,$882.00,$365.72,$365.72,$855.54
19300,0960,19300,,,,,N/A,N/A,MAST GYNECOMASTIA,$783.95,$582.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
19301,0960,19301,,,,,N/A,N/A,MAST PRTL,"$1,229.90",$914.25,$487.80,"$1,188.00",$487.80,"$1,152.36",$487.80,"$1,015.74",$487.80,"$1,108.82",$487.80,"$1,152.36",$487.80,"$1,188.00",$487.80,$487.80,"$1,152.36"
19303,0960,19303,,,,,N/A,N/A,MAST SMPL COMPL,"$1,903.87","$1,415.25",$821.64,"$2,004.00",$821.64,"$1,943.88",$821.64,"$1,713.42",$821.64,"$1,609.59",$821.64,"$1,943.88",$821.64,"$2,004.00",$821.64,$821.64,"$1,943.88"
19305,0960,19305,,,,,N/A,N/A,MAST RAD W/PECTORAL MUSC AX,"$2,147.02","$1,596.00",$872.48,"$2,128.00",$872.48,"$2,064.16",$872.48,"$1,819.44",$872.48,"$1,925.79",$872.48,"$2,064.16",$872.48,"$2,128.00",$872.48,$872.48,"$2,064.16"
19307,0960,19307,,,,,N/A,N/A,"MAST, MOD RAD","$2,267.09","$1,685.25",$826.56,"$2,016.00",$826.56,"$1,955.52",$826.56,"$1,723.68",$826.56,"$1,992.24",$826.56,"$1,955.52",$826.56,"$2,016.00",$826.56,$826.56,"$1,955.52"
20100,0960,20100,,,,,N/A,N/A,"EXPLORE WOUND, NECK","$1,386.28","$1,030.50",$563.34,"$1,374.00",$563.34,"$1,332.78",$563.34,"$1,174.77",$563.34,"$1,058.65",$563.34,"$1,332.78",$563.34,"$1,374.00",$563.34,$563.34,"$1,332.78"
20103,0960,20103,,,,,N/A,N/A,"EXPLORE WOUND, EXTREMITY",$827.33,$615.00,$336.20,$820.00,$336.20,$795.40,$336.20,$701.10,$336.20,$612.09,$336.20,$795.40,$336.20,$820.00,$336.20,$336.20,$795.40
20205,0960,20205,,,,,N/A,N/A,DEEP MUSCLE BIOPSY,$340.01,$252.75,$138.17,$337.00,$138.17,$326.89,$138.17,$288.14,$138.17,$268.61,$138.17,$326.89,$138.17,$337.00,$138.17,$138.17,$326.89
20206,0960,20206,,,,,N/A,N/A,"NEEDLE BIOPSY, MUSCLE",$302.68,$225.00,$101.92,$300.00,$123.00,$291.00,$123.00,$256.50,$123.00,$101.92,$123.00,$291.00,$123.00,$300.00,$123.00,$123.00,$291.00
20225,0960,20225,,,,,N/A,N/A,PERCUTANEOUS BONE BIOPSY,"$1,060.40",$788.25,$43.91,"$1,051.00",$43.91,"$1,019.47",$43.91,$898.61,$43.91,$231.66,$43.91,"$1,019.47",$43.91,"$1,051.00",$43.91,$43.91,"$1,019.47"
20240,0960,20240,,,,,N/A,N/A,"BONE BIOPSY, EXCISIONAL",$547.85,$407.25,$222.63,$543.00,$222.63,$526.71,$222.63,$464.27,$222.63,$253.74,$222.63,$526.71,$222.63,$543.00,$222.63,$222.63,$526.71
20245,0960,20245,,,,,N/A,N/A,"BONE BIOPSY, EXCISIONAL","$1,365.10","$1,014.75",$554.73,"$1,353.00",$554.73,"$1,312.41",$554.73,"$1,156.82",$554.73,$612.94,$554.73,"$1,312.41",$554.73,"$1,353.00",$554.73,$554.73,"$1,312.41"
20520,0960,20520,,,,,N/A,N/A,REMOVAL FOREIGN BODY,$355.15,$264.00,$144.32,$362.00,$144.32,$351.14,$144.32,$309.51,$144.32,$264.30,$144.32,$351.14,$144.32,$362.00,$144.32,$144.32,$351.14
20525,0960,20525,,,,,N/A,N/A,REMOVAL OF FOREIGN BODY,$581.15,$432.00,$236.16,$578.00,$236.16,$560.66,$236.16,$494.19,$236.16,$439.37,$236.16,$560.66,$236.16,$578.00,$236.16,$236.16,$560.66
20526,0960,20526,,,,,N/A,N/A,"THER INJECTION, CARP TUNNEL",$140.24,$104.25,$56.99,$56.99,$56.99,N/A,$56.99,N/A,$56.99,N/A,$56.99,N/A,$56.99,N/A,$56.99,$56.99,N/A
20550,0960,20550,,,,,N/A,N/A,INJ TENDON SHEATH/LIGAMENT,$101.90,$75.75,$41.41,$101.00,$41.41,$97.97,$41.41,$86.36,$41.41,$69.22,$41.41,$97.97,$41.41,$101.00,$41.41,$41.41,$97.97
20551,0960,20551,,,,,N/A,N/A,ING TENDON ORIGIN/INSERTION,$103.92,$77.25,$69.85,$337.00,$125.87,$326.89,$125.87,$288.14,$125.87,$69.85,$125.87,$326.89,$125.87,$337.00,$125.87,$125.87,$326.89
20552,0960,20552,,,,,N/A,N/A,"INJ TRIGGER POINT, 1/2 MUSCL",$83.74,$62.25,$34.30,$590.00,$34.30,$572.30,$34.30,$504.45,$34.30,$67.34,$34.30,$572.30,$34.30,$590.00,$34.30,$34.30,$572.30
20553,0960,20553,,,,,N/A,N/A,"INJECT TRIGGER POINTS, =/> 3",$92.82,$69.00,$76.14,$590.00,N/A,$572.30,N/A,$504.45,N/A,$76.14,N/A,$572.30,N/A,$590.00,N/A,N/A,$572.30
20600,0960,20600,,,,,N/A,N/A,"DRAIN/INJECT, JOINT/BURSA",$96.86,$72.00,$39.36,$96.00,$39.36,$93.12,$39.36,$82.08,$39.36,$63.57,$39.36,$93.12,$39.36,$96.00,$39.36,$39.36,$93.12
20605,0960,20605,,,,,N/A,N/A,"DRAIN/INJECT, JOINT/BURSA",$99.89,$74.25,$39.77,$99.00,$39.77,$96.03,$39.77,$84.65,$39.77,$66.08,$39.77,$96.03,$39.77,$99.00,$39.77,$39.77,$96.03
20606,0960,20606,,,,,N/A,N/A,DRAIN/INJ JOINT/BURSA W/US,$181.61,$135.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
20610,0960,20610,,,,,N/A,N/A,"DRAIN/INJECT, JOINT/BURSA",$126.12,$93.75,$51.25,$125.00,$51.25,$121.25,$51.25,$106.88,$51.25,$80.71,$51.25,$121.25,$51.25,$125.00,$51.25,$51.25,$121.25
9620610,0960,20610,,,,,N/A,N/A,DRAIN/INJECT JNT BURSA  ~20610,$115.02,$85.50,$51.25,$125.00,$51.25,$121.25,$51.25,$106.88,$51.25,$80.71,$51.25,$121.25,$51.25,$125.00,$51.25,$51.25,$121.25
20611,0960,20611,,,,,N/A,N/A,"DRAIN/INJECT, JOINT/BURSA W/ U",$184.64,$137.25,$75.30,$75.30,$75.30,N/A,$75.30,N/A,$75.30,N/A,$75.30,N/A,$75.30,N/A,$75.30,$75.30,N/A
20612,0960,20612,,,,,N/A,N/A,ASPIRATE/INJ GANGLION CYST,$101.90,$75.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
20670,0960,20670,,,,,N/A,N/A,REMOVAL OF SUPPORT IMPLANT,$673.97,$501.00,$259.91,$668.00,$273.88,$647.96,$273.88,$571.14,$273.88,$259.91,$273.88,$647.96,$273.88,$668.00,$273.88,$273.88,$647.96
20680,0960,20680,,,,,N/A,N/A,REMOVAL OF SUPPORT IMPLANT,$829.35,$616.50,$272.24,$748.19,$272.24,$644.08,$272.24,$567.72,$272.24,$748.19,$272.24,$644.08,$272.24,$664.00,$272.24,$272.24,$644.08
20690,0960,20690,,,,,N/A,N/A,APPLY BONE FIXATION DEVICE,"$1,125.98",$837.00,$457.56,"$1,116.00",$457.56,"$1,082.52",$457.56,$954.18,$457.56,"$1,059.90",$457.56,"$1,082.52",$457.56,"$1,116.00",$457.56,$457.56,"$1,082.52"
20692,0960,20692,,,,,N/A,N/A,APPLY BONE FIXATION DEVICE,"$2,138.95","$1,590.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
20694,0960,20694,,,,,N/A,N/A,PROD RELATE TO BONY FIXATION,$683.05,$507.75,$277.57,$677.00,$277.57,$656.69,$277.57,$578.84,$277.57,$607.17,$277.57,$656.69,$277.57,$677.00,$277.57,$277.57,$656.69
20700,0960,20700,,,,,N/A,N/A,MANUAL DRUG DELIVERY DEVICE,$193.72,$144.00,$78.72,$78.72,$78.72,N/A,$78.72,N/A,$78.72,N/A,$78.72,N/A,$78.72,N/A,$78.72,$78.72,N/A
20702,0960,20702,,,,,N/A,N/A,DRUG DELIVERY DEVICE,$280.49,$208.50,$113.98,$113.98,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,$113.98,N/A
20703,0960,20703,,,,,N/A,N/A,INSERTION DRUG DELIVERY DEVICE,$292.59,$217.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
20704,0960,20704,,,,,N/A,N/A,INSERTION DRUG DELIVERY DEVICE,$292.59,$217.50,$118.90,$118.90,$118.90,N/A,$118.90,N/A,$118.90,N/A,$118.90,N/A,$118.90,N/A,$118.90,$118.90,N/A
20705,0960,20705,,,,,N/A,N/A,REMOVAL DRUG DEL DEVICE,$242.15,$180.00,$98.40,$98.40,$98.40,N/A,$98.40,N/A,$98.40,N/A,$98.40,N/A,$98.40,N/A,$98.40,$98.40,N/A
20900,0960,20900,,,,,N/A,N/A,BONE & TISSUE AUTOGRAFTS,"$1,067.46",$793.50,$323.14,"$1,058.00",$433.78,"$1,026.26",$433.78,$904.59,$433.78,$323.14,$433.78,"$1,026.26",$433.78,"$1,058.00",$433.78,$433.78,"$1,026.26"
20902,0960,20902,,,,,N/A,N/A,REMOVAL OF BONE FOR GRAFT,"$1,374.18","$1,021.50",$491.83,"$1,300.00",$558.42,"$1,261.00",$558.42,"$1,111.50",$558.42,$491.83,$558.42,"$1,261.00",$558.42,"$1,300.00",$558.42,$558.42,"$1,261.00"
20910,0960,20910,,,,,N/A,N/A,REMOVE CARTILAGE FOR GRAFT,$986.74,$733.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
20912,0960,20912,,,,,N/A,N/A,REMOVE CARTILAGE FOR GRAFT,"$1,139.09",$846.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
20985,0960,20985,,,,,N/A,N/A,CPTR-ASST SURGICAL NAVIGATIO,$284.52,$211.50,$115.62,$282.00,$115.62,$273.54,$115.62,$241.11,$115.62,$254.79,$115.62,$273.54,$115.62,$282.00,$115.62,$115.62,$273.54
21011,0960,21011,,,,,N/A,N/A,EXCISION TUMOR SOFT TISS FACE,$519.60,$386.25,$211.15,$515.00,$211.15,$499.55,$211.15,$440.33,$211.15,$460.90,$211.15,$499.55,$211.15,$515.00,$211.15,$211.15,$499.55
21012,0960,21012,,,,,N/A,N/A,EXCISION 2CM >,$668.93,$497.25,$274.70,$670.00,$274.70,$649.90,$274.70,$572.85,$274.70,$601.38,$274.70,$649.90,$274.70,$670.00,$274.70,$274.70,$649.90
21014,0960,21014,,,,,N/A,N/A,EXCISION 2CM OR GREATER,"$1,034.16",$768.75,$34.22,$928.77,$34.22,$719.74,$34.22,$634.41,$34.22,$928.77,$34.22,$719.74,$34.22,$742.00,$34.22,$34.22,$719.74
21031,0960,21031,,,,,N/A,N/A,"REMOVE EXOSTOSIS, MANDIBLE",$647.74,$481.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
21315,0960,21315,,,,,N/A,N/A,TREATMENT OF NOSE FRACTURE,$316.81,$235.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
21501,0960,21501,,,,,N/A,N/A,DRAIN NECK/CHEST LESION,$716.35,$532.50,$291.10,$710.00,$291.10,$688.70,$291.10,$607.05,$291.10,$587.41,$291.10,$688.70,$291.10,$710.00,$291.10,$291.10,$688.70
21554,0960,21554,,,,,N/A,N/A,EXC NECK TUM DEEP 5 CM/>,"$1,423.61","$1,058.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
21555,0960,21555,,,,,N/A,N/A,"REMOVE LESION, NECK/CHEST",$712.31,$529.50,$274.70,$670.00,$274.70,$649.90,$274.70,$572.85,$274.70,$544.37,$274.70,$649.90,$274.70,$670.00,$274.70,$274.70,$649.90
21601,0960,21601,,,,,N/A,N/A,EXCISION CHEST WALL TUMOR,"$2,357.89","$1,752.75",$958.17,$958.17,$958.17,N/A,$958.17,N/A,$958.17,N/A,$958.17,N/A,$958.17,N/A,$958.17,$958.17,N/A
21602,0960,21602,,,,,N/A,N/A,EXCISION CHEST WALL TUMOR,"$3,180.18","$2,364.00","$1,292.32","$1,292.32","$1,292.32",N/A,"$1,292.32",N/A,"$1,292.32",N/A,"$1,292.32",N/A,"$1,292.32",N/A,"$1,292.32","$1,292.32",N/A
21603,0960,21603,,,,,N/A,N/A,EXCISION CHEST WALL TUMOR,"$3,511.11","$2,610.00","$1,426.80","$1,426.80","$1,426.80",N/A,"$1,426.80",N/A,"$1,426.80",N/A,"$1,426.80",N/A,"$1,426.80",N/A,"$1,426.80","$1,426.80",N/A
21811,0960,21811,,,,,N/A,N/A,OPEN TREAT OF RIB FX 1-3,"$1,151.20",$855.75,$467.81,$467.81,$467.81,N/A,$467.81,N/A,$467.81,N/A,$467.81,N/A,$467.81,N/A,$467.81,$467.81,N/A
21920,0960,21920,,,,,N/A,N/A,BIOPSY SOFT TISSUE BACK/FLANK,$339.00,$252.00,$137.76,$336.00,$137.76,$325.92,$137.76,$287.28,$137.76,$279.11,$137.76,$325.92,$137.76,$336.00,$137.76,$137.76,$325.92
21932,0960,21932,,,,,N/A,N/A,EXC BACK TUM DEEP < 5 CM,"$1,281.35",$952.50,$52.70,"$1,270.00",$52.70,"$1,231.90",$52.70,"$1,085.85",$52.70,"$1,170.27",$52.70,"$1,231.90",$52.70,"$1,270.00",$52.70,$52.70,"$1,231.90"
21933,0960,21933,,,,,N/A,N/A,EXC BACK TUM DEEP 5 CM/>,"$1,433.70","$1,065.75",$582.61,"$1,421.00",$582.61,"$1,378.37",$582.61,"$1,214.96",$582.61,"$1,302.58",$582.61,"$1,378.37",$582.61,"$1,421.00",$582.61,$582.61,"$1,378.37"
22900,0960,22900,,,,,N/A,N/A,REMOVE ABDOMINAL WALL LESION,"$1,057.37",$786.00,$393.60,$998.06,$393.60,$931.20,$393.60,$820.80,$393.60,$998.06,$393.60,$931.20,$393.60,$960.00,$393.60,$393.60,$931.20
22901,0960,22901,,,,,N/A,N/A,EXC ABDL TUM DEEP 5 CM/>,"$1,290.43",$959.25,$524.39,"$1,279.00",$524.39,"$1,240.63",$524.39,"$1,093.55",$524.39,"$1,175.89",$524.39,"$1,240.63",$524.39,"$1,279.00",$524.39,$524.39,"$1,240.63"
22902,0960,22902,,,,,N/A,N/A,EXC ABD LES SC < 3 CM,$640.68,$476.25,$26.35,$635.00,$26.35,$615.95,$26.35,$542.93,$26.35,$591.02,$26.35,$615.95,$26.35,$635.00,$26.35,$26.35,$615.95
22903,0960,22903,,,,,N/A,N/A,EXC ABD LES SC 3 CM/>,$848.52,$630.75,$251.74,$777.73,$251.74,$595.58,$251.74,$524.97,$251.74,$777.73,$251.74,$595.58,$251.74,$614.00,$251.74,$251.74,$595.58
23000,0960,23000,,,,,N/A,N/A,REMOVAL OF CALCIUM DEPOSITS,$830.36,$617.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
23020,0960,23020,,,,,N/A,N/A,RELEASE SHOULDER JOINT,"$1,573.95","$1,170.00",$639.60,"$1,560.00",$639.60,"$1,513.20",$639.60,"$1,333.80",$639.60,"$1,232.01",$639.60,"$1,513.20",$639.60,"$1,560.00",$639.60,$639.60,"$1,513.20"
23030,0960,23030,,,,,N/A,N/A,DRAIN SHOULDER LESION,$671.95,$499.50,$273.60,$666.00,$273.60,$646.02,$273.60,$569.43,$273.60,$452.84,$273.60,$646.02,$273.60,$666.00,$273.60,$273.60,$646.02
23044,0960,23044,,,,,N/A,N/A,EXPLORATORY SHOULDER SURGERY,"$1,290.43",$959.25,$524.39,"$1,279.00",$524.39,"$1,240.63",$524.39,"$1,093.55",$524.39,"$1,007.25",$524.39,"$1,240.63",$524.39,"$1,279.00",$524.39,$524.39,"$1,240.63"
23605,0960,23065,,,,,N/A,N/A,CLOSED TMT HUMERAL FRACTURE,$828.34,$615.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
23066,0960,23066,,,,,N/A,N/A,BIOPSY SHOULDER TISSUES,"$1,065.44",$792.00,$313.24,$764.00,$313.24,$741.08,$313.24,$653.22,$313.24,$657.02,$313.24,$741.08,$313.24,$764.00,$313.24,$313.24,$741.08
23071,0960,23071,,,,,N/A,N/A,EXCISION TUMOR SOFT TISSUE S,$814.21,$605.25,$33.87,$807.00,$33.87,$782.79,$33.87,$689.99,$33.87,$744.53,$33.87,$782.79,$33.87,$807.00,$33.87,$33.87,$782.79
23076,0960,23076,,,,,N/A,N/A,EXCISION SOFT TISSUE TUMOR,"$1,088.65",$809.25,$442.39,"$1,079.00",$442.39,"$1,046.63",$442.39,$922.55,$442.39,$963.40,$442.39,"$1,046.63",$442.39,"$1,079.00",$442.39,$442.39,"$1,046.63"
23120,0960,23120,,,,,N/A,N/A,"PARTIAL REMOVAL, COLLAR BONE","$1,292.45",$960.75,$525.21,"$1,281.00",$525.21,"$1,242.57",$525.21,"$1,095.26",$525.21,"$1,052.56",$525.21,"$1,242.57",$525.21,"$1,281.00",$525.21,$525.21,"$1,242.57"
23130,0960,23130,,,,,N/A,N/A,"REMOVE SHOULDER BONE, PART","$1,397.38","$1,038.75",$567.85,"$1,385.00",$567.85,"$1,343.45",$567.85,"$1,184.18",$567.85,"$1,106.71",$567.85,"$1,343.45",$567.85,"$1,385.00",$567.85,$567.85,"$1,343.45"
23140,0960,23140,,,,,N/A,N/A,REMOVAL OF BONE LESION,"$1,154.23",$858.00,$469.40,"$1,144.00",$469.40,"$1,109.68",$469.40,$978.12,$469.40,$995.25,$469.40,"$1,109.68",$469.40,"$1,144.00",$469.40,$469.40,"$1,109.68"
23350,0960,23350,,,,,N/A,N/A,INJECTION FOR SHOULDER X-RAY,$357.16,$265.50,$89.34,$354.00,$145.14,$343.38,$145.14,$302.67,$145.14,$89.34,$145.14,$343.38,$145.14,$354.00,$145.14,$145.14,$343.38
23405,0960,23405,,,,,N/A,N/A,INCISION OF TENDON & MUSCLE,"$1,460.95","$1,086.00",$487.80,"$1,188.00",$487.80,"$1,152.36",$487.80,"$1,015.74",$487.80,"$1,109.72",$487.80,"$1,152.36",$487.80,"$1,188.00",$487.80,$487.80,"$1,152.36"
23410,0960,23410,,,,,N/A,N/A,"REPAIR ROTATOR CUFF, ACUTE","$2,088.51","$1,552.50",$848.70,"$2,070.00",$848.70,"$2,007.90",$848.70,"$1,769.85",$848.70,"$1,462.58",$848.70,"$2,007.90",$848.70,"$2,070.00",$848.70,$848.70,"$2,007.90"
23412,0960,23412,,,,,N/A,N/A,"REPAIR ROTATOR CUFF, CHRONIC","$2,218.66","$1,649.25",$91.59,"$2,199.00",$91.59,"$2,133.03",$91.59,"$1,880.15",$91.59,"$1,518.96",$91.59,"$2,133.03",$91.59,"$2,199.00",$91.59,$91.59,"$2,133.03"
23415,0960,23415,,,,,N/A,N/A,RELEASE OF SHOULDER LIGAMENT,"$1,715.20","$1,275.00",$697.00,"$1,700.00",$697.00,"$1,649.00",$697.00,"$1,453.50",$697.00,"$1,247.75",$697.00,"$1,649.00",$697.00,"$1,700.00",$697.00,$697.00,"$1,649.00"
23420,0960,23420,,,,,N/A,N/A,REPAIR OF SHOULDER,"$2,304.42","$1,713.00",$936.44,"$2,284.00",$936.44,"$2,215.48",$936.44,"$1,952.82",$936.44,"$1,734.29",$936.44,"$2,215.48",$936.44,"$2,284.00",$936.44,$936.44,"$2,215.48"
23430,0960,23430,,,,,N/A,N/A,REPAIR BICEPS TENDON,"$1,727.31","$1,284.00",$71.92,"$1,712.00",$71.92,"$1,660.64",$71.92,"$1,463.76",$71.92,"$1,330.25",$71.92,"$1,660.64",$71.92,"$1,712.00",$71.92,$71.92,"$1,660.64"
23440,0960,23440,,,,,N/A,N/A,REMOVE/TRANSPLANT TENDON,"$1,790.87","$1,331.25",$727.75,"$1,775.00",$727.75,"$1,721.75",$727.75,"$1,517.63",$727.75,"$1,348.25",$727.75,"$1,721.75",$727.75,"$1,775.00",$727.75,$727.75,"$1,721.75"
23455,0960,23455,,,,,N/A,N/A,REPAIR SHOULDER CAPSULE,"$2,375.04","$1,765.50",$965.14,"$2,354.00",$965.14,"$2,283.38",$965.14,"$2,012.67",$965.14,"$1,767.45",$965.14,"$2,283.38",$965.14,"$2,354.00",$965.14,$965.14,"$2,283.38"
23470,0960,23470,,,,,N/A,N/A,RECONSTRUCT SHOULDER JOINT,"$2,815.95","$2,093.25","$1,144.31","$2,791.00","$1,144.31","$2,707.27","$1,144.31","$2,386.31","$1,144.31","$2,131.98","$1,144.31","$2,707.27","$1,144.31","$2,791.00","$1,144.31","$1,144.31","$2,707.27"
23472,0960,23472,,,,,N/A,N/A,RECONSTRUCT SHOULDER JOINT,"$3,405.17","$2,531.25","$1,383.75","$3,375.00","$1,383.75","$3,273.75","$1,383.75","$2,885.63","$1,383.75","$2,567.40","$1,383.75","$3,273.75","$1,383.75","$3,375.00","$1,383.75","$1,383.75","$3,273.75"
23485,0960,23485,,,,,N/A,N/A,REVISION OF COLLAR BONE,"$2,231.78","$1,659.00",$96.92,"$2,212.00",$96.92,"$2,145.64",$96.92,"$1,891.26",$96.92,"$1,688.16",$96.92,"$2,145.64",$96.92,"$2,212.00",$96.92,$96.92,"$2,145.64"
23515,0960,23515,,,,,N/A,N/A,TREAT CLAVICLE FRACTURE,"$1,397.38","$1,038.75",$541.20,"$1,334.00",$541.20,"$1,293.98",$541.20,"$1,140.57",$541.20,"$1,286.98",$541.20,"$1,293.98",$541.20,"$1,334.00",$541.20,$541.20,"$1,293.98"
23545,0960,23545,,,,,N/A,N/A,TREAT CLAVICLE DISLOCATION,$619.49,$460.50,$251.74,$251.74,$251.74,N/A,$251.74,N/A,$251.74,N/A,$251.74,N/A,$251.74,N/A,$251.74,$251.74,N/A
23550,0960,23550,,,,,N/A,N/A,TREAT CLAVICLE DISLOCATION,"$1,295.48",$963.00,$526.44,"$1,284.00",$526.44,"$1,245.48",$526.44,"$1,097.82",$526.44,"$1,025.77",$526.44,"$1,245.48",$526.44,"$1,284.00",$526.44,$526.44,"$1,245.48"
23552,0960,23552,,,,,N/A,N/A,TREAT CLAVICLE DISLOCATION,"$1,503.32","$1,117.50",$61.90,"$1,400.00",$61.90,"$1,358.00",$61.90,"$1,197.00",$61.90,"$1,171.41",$61.90,"$1,358.00",$61.90,"$1,400.00",$61.90,$61.90,"$1,358.00"
23615,0960,23615,,,,,N/A,N/A,TREATMENT HUMERUS FRX,"$1,729.32","$1,285.50",$72.74,"$1,714.00",$72.74,$796.37,$72.74,"$1,465.47",$72.74,"$1,575.63",$72.74,$796.37,$72.74,"$1,714.00",$72.74,$72.74,$796.37
23630,0960,23630,,,,,N/A,N/A,TREAT HUMERUS FRACTURE,"$1,422.61","$1,057.50",$578.10,"$1,662.58",$578.10,"$1,662.58",$578.10,"$1,205.55",$578.10,"$1,393.29",$578.10,"$1,662.58",$578.10,"$1,410.00",$578.10,$578.10,"$1,662.58"
23650,0960,23650,,,,,N/A,N/A,CLOSED TREATMENT OF SHOULDER,$421.74,$313.50,$171.38,"$1,367.70",$171.38,"$1,367.70",$171.38,$357.39,$171.38,$528.05,$171.38,"$1,367.70",$171.38,$418.00,$171.38,$171.38,"$1,367.70"
23655,0960,23655,,,,,N/A,N/A,TREAT SHOULDER DISLOCATION,$827.33,$615.00,$336.20,$820.00,$336.20,$405.46,$336.20,$701.10,$336.20,$735.61,$336.20,$405.46,$336.20,$820.00,$336.20,$336.20,$405.46
23665,0960,23665,,,,,N/A,N/A,TREAT DISLOCATION/FRACTURE,$867.69,$645.00,$352.60,$860.00,$352.60,$795.40,$352.60,$735.30,$352.60,$718.27,$352.60,$795.40,$352.60,$860.00,$352.60,$352.60,$795.40
23700,0960,23700,,,,,N/A,N/A,FIXATION OF SHOULDER,$447.97,$333.00,$182.40,$834.20,$182.40,$834.20,$182.40,$379.62,$182.40,$349.14,$182.40,$834.20,$182.40,$444.00,$182.40,$182.40,$834.20
23930,0960,23930,,,,,N/A,N/A,DRAINAGE OF ARM LESION,$498.42,$370.50,$22.54,$494.00,$22.54,$430.68,$22.54,$422.37,$22.54,$384.32,$22.54,$430.68,$22.54,$494.00,$22.54,$22.54,$430.68
23931,0960,23931,,,,,N/A,N/A,INCISION BURSA,$315.80,$234.75,$128.33,$479.18,$128.33,$479.18,$128.33,$267.62,$128.33,$286.94,$128.33,$479.18,$128.33,$313.00,$128.33,$128.33,$479.18
24071,0960,24071,,,,,N/A,N/A,EXC ARM/ELBOW LES SC 3 CM/>,$793.03,$589.50,$303.61,$786.00,$322.26,$303.61,$322.26,$672.03,$322.26,$719.94,$322.26,$303.61,$322.26,$786.00,$322.26,$322.26,$303.61
24075,0960,24075,,,,,N/A,N/A,EXCISION OF SOFT TISSUE TUMOR,$665.90,$495.00,$27.60,$762.42,$27.60,$762.42,$27.60,$564.30,$27.60,$587.20,$27.60,$762.42,$27.60,$660.00,$27.60,$27.60,$762.42
24076,0960,24076,,,,,N/A,N/A,REMOVE ARM/ELBOW LESION,"$1,060.40",$788.25,$43.91,"$1,051.00",$43.91,$640.20,$43.91,$898.61,$43.91,$968.80,$43.91,$640.20,$43.91,"$1,051.00",$43.91,$43.91,$640.20
24101,0960,24101,,,,,N/A,N/A,EXPLORE/TREAT ELBOW JOINT,"$1,147.16",$852.75,$466.17,"$1,137.00",$466.17,N/A,$466.17,$972.14,$466.17,$905.22,$466.17,N/A,$466.17,"$1,137.00",$466.17,$466.17,N/A
24105,0960,24105,,,,,N/A,N/A,REMOVAL OF ELBOW BURSA,$755.70,$561.75,$37.90,$749.00,$37.90,$726.53,$37.90,$640.40,$37.90,$647.73,$37.90,$726.53,$37.90,$749.00,$37.90,$37.90,$726.53
24110,0960,24110,,,,,N/A,N/A,REMOVE HUMERUS LESION,"$1,338.86",$995.25,$544.70,"$1,327.00",$544.70,"$1,287.19",$544.70,"$1,134.59",$544.70,"$1,041.86",$544.70,"$1,287.19",$544.70,"$1,327.00",$544.70,$544.70,"$1,287.19"
24120,0960,24120,,,,,N/A,N/A,REMOVE ELBOW LESION,"$1,195.59",$888.75,$485.85,"$1,185.00",$485.85,"$1,149.45",$485.85,"$1,013.18",$485.85,$956.02,$485.85,"$1,149.45",$485.85,"$1,185.00",$485.85,$485.85,"$1,149.45"
24130,0960,24130,,,,,N/A,N/A,REMOVAL OF HEAD OF RADIUS,"$1,165.33",$866.25,$473.55,"$1,155.00",$473.55,"$1,120.35",$473.55,$987.53,$473.55,$917.79,$473.55,"$1,120.35",$473.55,"$1,155.00",$473.55,$473.55,"$1,120.35"
24140,0960,24140,,,,,N/A,N/A,PARTIAL REMOVAL OF ARM BONE,"$1,732.35","$1,287.75",$73.97,"$1,717.00",$73.97,"$1,665.49",$73.97,"$1,468.04",$73.97,"$1,257.88",$73.97,"$1,665.49",$73.97,"$1,717.00",$73.97,$73.97,"$1,665.49"
24147,0960,24147,,,,,N/A,N/A,PARTIAL EXCISION,"$1,254.11",$932.25,$59.63,"$1,243.00",$59.63,"$1,205.71",$59.63,"$1,062.77",$59.63,"$1,129.18",$59.63,"$1,205.71",$59.63,"$1,243.00",$59.63,$59.63,"$1,205.71"
24149,0960,24149,,,,,N/A,N/A,RADICAL RESECTION ELBOW,"$2,458.79","$1,827.75",$999.17,"$2,437.00",$999.17,"$2,363.89",$999.17,"$2,083.64",$999.17,"$2,099.54",$999.17,"$2,363.89",$999.17,"$2,437.00",$999.17,$999.17,"$2,363.89"
24164,0960,24164,,,,,N/A,N/A,REMOVE RADIUS HEAD IMPLANT,"$1,140.10",$847.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
24200,0960,24200,,,,,N/A,N/A,REMOVAL OF ARM FOREIGN BODY,$320.84,$238.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
24201,0960,24201,,,,,N/A,N/A,REMOVAL OF ARM FOREIGN BODY,$890.89,$662.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
24300,0960,24300,,,,,N/A,N/A,MANIPULATE ELBOW W/ANESTH,$887.87,$660.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
24310,0960,24310,,,,,N/A,N/A,REVISION OF ARM TENDON,"$1,096.72",$815.25,$445.67,"$1,087.00",$445.67,"$1,054.39",$445.67,$929.39,$445.67,$851.67,$445.67,"$1,054.39",$445.67,"$1,087.00",$445.67,$445.67,"$1,054.39"
24341,0960,24341,,,,,N/A,N/A,REPAIR ARM TENDON/MUSCLE,"$1,501.30","$1,116.00",$61.80,"$1,488.00",$61.80,"$1,443.36",$61.80,"$1,272.24",$61.80,"$1,335.71",$61.80,"$1,443.36",$61.80,"$1,488.00",$61.80,$61.80,"$1,443.36"
24342,0960,24342,,,,,N/A,N/A,REPAIR OF RUPTURED TENDON,"$1,826.18","$1,357.50",$65.57,"$1,477.00",$65.57,"$1,432.69",$65.57,"$1,262.84",$65.57,"$1,385.54",$65.57,"$1,432.69",$65.57,"$1,477.00",$65.57,$65.57,"$1,432.69"
24343,0960,24343,,,,,N/A,N/A,REPR ELBOW LAT LIGMNT W/TISS,"$1,595.13","$1,185.75",$648.21,"$1,581.00",$648.21,"$1,533.57",$648.21,"$1,351.76",$648.21,"$1,278.50",$648.21,"$1,533.57",$648.21,"$1,581.00",$648.21,$648.21,"$1,533.57"
24357,0960,24357,,,,,N/A,N/A,REPAIR ELBOW PERC,$864.66,$642.75,$379.66,$926.00,$379.66,$898.22,$379.66,$791.73,$379.66,$757.18,$379.66,$898.22,$379.66,$926.00,$379.66,$379.66,$898.22
24358,0960,24358,,,,,N/A,N/A,TNOT ELBOW LATERAL/MEDIAL DEBR,"$1,019.03",$757.50,$451.00,"$1,007.00",$451.00,$976.79,$451.00,$860.99,$451.00,$948.23,$451.00,$976.79,$451.00,"$1,007.00",$451.00,$451.00,$976.79
24359,0960,24359,,,,,N/A,N/A,REPAIR ELBOW DEB/ATTCH OPEN,"$1,279.34",$951.00,$459.61,"$1,185.24",$459.61,"$1,087.37",$459.61,$958.46,$459.61,"$1,185.24",$459.61,"$1,087.37",$459.61,"$1,121.00",$459.61,$459.61,"$1,087.37"
24366,0960,24366,,,,,N/A,N/A,RECONSTRUCT HEAD OF RADIUS,"$1,588.07","$1,180.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
24430,0960,24430,,,,,N/A,N/A,REPAIR NON/MAL UNION HUMERUS,"$2,156.10","$1,602.75",$858.13,"$2,093.00",$858.13,"$2,030.21",$858.13,"$1,789.52",$858.13,"$1,877.28",$858.13,"$2,030.21",$858.13,"$2,093.00",$858.13,$858.13,"$2,030.21"
24435,0960,24435,,,,,N/A,N/A,REPAIR/RECON ELBOW\UPPERARM,"$2,173.26","$1,615.50",$883.14,"$2,154.00",$883.14,"$2,089.38",$883.14,"$1,841.67",$883.14,"$1,924.66",$883.14,"$2,089.38",$883.14,"$2,154.00",$883.14,$883.14,"$2,089.38"
24500,0960,24500,,,,,N/A,N/A,TREAT HUMERUS FRACTURE,$651.78,$484.50,$264.86,$646.00,$264.86,$626.62,$264.86,$552.33,$264.86,$602.39,$264.86,$626.62,$264.86,$646.00,$264.86,$264.86,$626.62
24505,0960,24505,,,,,N/A,N/A,TREAT HUMERUS FRACTURE,$999.86,$743.25,$394.10,$991.00,$394.10,$961.27,$394.10,$847.31,$394.10,$814.80,$394.10,$961.27,$394.10,$991.00,$394.10,$394.10,$961.27
24515,0960,24515,,,,,N/A,N/A,TREAT HUMERUS FRACTURE,"$2,006.78","$1,491.75",$815.49,"$1,989.00",$815.49,"$1,929.33",$815.49,"$1,700.60",$815.49,"$1,570.71",$815.49,"$1,929.33",$815.49,"$1,989.00",$815.49,$815.49,"$1,929.33"
24516,0960,24516,,,,,N/A,N/A,TREAT OF HUMERAL SHAFT FX,"$1,325.75",$985.50,$538.74,"$1,531.87",$538.74,"$1,274.58",$538.74,"$1,123.47",$538.74,"$1,531.87",$538.74,"$1,274.58",$538.74,"$1,314.00",$538.74,$538.74,"$1,274.58"
24538,0960,24538,,,,,N/A,N/A,TREAT HUMERUS FRACTURE,"$1,724.28","$1,281.75",$7.69,"$1,709.00",$7.69,"$1,657.73",$7.69,"$1,461.20",$7.69,"$1,400.73",$7.69,"$1,657.73",$7.69,"$1,709.00",$7.69,$7.69,"$1,657.73"
24586,0960,24586,,,,,N/A,N/A,TREAT ELBOW FRACTURE,"$2,529.41","$1,880.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
24600,0960,24600,,,,,N/A,N/A,TREAT ELBOW DISLOCATION,$726.44,$540.00,$295.20,$720.00,$295.20,$698.40,$295.20,$615.60,$295.20,$606.06,$295.20,$698.40,$295.20,$720.00,$295.20,$295.20,$698.40
24605,0960,24605,,,,,N/A,N/A,TREAT ELBOW DISLOCATION,"$1,022.06",$759.75,$415.33,"$1,013.00",$415.33,$982.61,$415.33,$866.12,$415.33,$861.15,$415.33,$982.61,$415.33,"$1,013.00",$415.33,$415.33,$982.61
24635,0960,24635,,,,,N/A,N/A,OPEN TREATMENT FX ELBOW,"$1,340.88",$996.75,$544.89,"$1,329.00",$544.89,"$1,289.13",$544.89,"$1,136.30",$544.89,"$1,209.60",$544.89,"$1,289.13",$544.89,"$1,329.00",$544.89,$544.89,"$1,289.13"
24640,0960,24640,,,,,N/A,N/A,TREAT ELBOW DISLOCATION,$189.68,$141.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
24655,0960,24655,,,,,N/A,N/A,TREAT RADIUS FRACTURE,$867.69,$645.00,$352.60,$860.00,$352.60,$834.20,$352.60,$735.30,$352.60,$723.58,$352.60,$834.20,$352.60,$860.00,$352.60,$352.60,$834.20
24665,0960,24665,,,,,N/A,N/A,OPEN TRT RAD HEAND/NECK FX,$857.60,$637.50,$348.50,"$1,181.08",$348.50,$824.50,$348.50,$726.75,$348.50,"$1,181.08",$348.50,$824.50,$348.50,$850.00,$348.50,$348.50,$824.50
24685,0960,24685,,,,,N/A,N/A,OPEN TREATMENT OF ULNAR FX,"$1,243.01",$924.00,$55.12,"$1,232.00",$55.12,"$1,195.04",$55.12,"$1,053.36",$55.12,"$1,173.61",$55.12,"$1,195.04",$55.12,"$1,232.00",$55.12,$55.12,"$1,195.04"
25000,0960,25000,,,,,N/A,N/A,INCISION OF TENDON SHEATH,$953.45,$708.75,$387.45,$945.00,$387.45,$916.65,$387.45,$807.98,$387.45,$621.52,$387.45,$916.65,$387.45,$945.00,$387.45,$387.45,$916.65
25001,0960,25001,,,,,N/A,N/A,INCISE FLEXOR CARPI RADIALS,$718.37,$534.00,$291.92,$712.00,$291.92,$690.64,$291.92,$608.76,$291.92,$623.48,$291.92,$690.64,$291.92,$712.00,$291.92,$291.92,$690.64
25040,0960,25040,,,,,N/A,N/A,EXPLORE/TREAT WRIST JOINT,"$1,370.14","$1,018.50",$556.78,"$1,358.00",$556.78,"$1,317.26",$556.78,"$1,161.09",$556.78,"$1,004.32",$556.78,"$1,317.26",$556.78,"$1,358.00",$556.78,$556.78,"$1,317.26"
25071,0960,25071,,,,,N/A,N/A,EXC FOREARM LES SC 3 CM/>,$833.38,$619.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
25073,0960,25073,,,,,N/A,N/A,EXC FOREARM TUM DEEP 3 CM/>,"$1,044.25",$776.25,$424.35,"$1,035.00",$424.35,"$1,003.95",$424.35,$884.93,$424.35,$955.26,$424.35,"$1,003.95",$424.35,"$1,035.00",$424.35,$424.35,"$1,003.95"
25075,0960,25075,,,,,N/A,N/A,REMOVAL FOREARM LESION SUB,$897.96,$667.50,$364.90,$890.00,$364.90,$863.30,$364.90,$760.95,$364.90,$564.50,$364.90,$863.30,$364.90,$890.00,$364.90,$364.90,$863.30
25076,0960,25076,,,,,N/A,N/A,REMOVAL FOREARM LESION DEEP,"$1,344.92",$999.75,$546.53,"$1,333.00",$546.53,"$1,293.01",$546.53,"$1,139.72",$546.53,$925.58,$546.53,"$1,293.01",$546.53,"$1,333.00",$546.53,$546.53,"$1,293.01"
25101,0960,25101,,,,,N/A,N/A,PROC OF BONES ARM/WRIST,$996.83,$741.00,$33.87,$807.00,$33.87,$782.79,$33.87,$689.99,$33.87,$728.87,$33.87,$782.79,$33.87,$807.00,$33.87,$33.87,$782.79
25105,0960,25105,,,,,N/A,N/A,REMOVE WRIST JOINT LINING,"$1,238.98",$921.00,$53.48,$53.48,$53.48,N/A,$53.48,N/A,$53.48,N/A,$53.48,N/A,$53.48,N/A,$53.48,$53.48,N/A
25110,0960,25110,,,,,N/A,N/A,"EXC, LESION TENDON SHEATH",$684.06,$508.50,$277.98,$678.00,$277.98,$657.66,$277.98,$579.69,$277.98,$620.66,$277.98,$657.66,$277.98,$678.00,$277.98,$277.98,$657.66
25111,0960,25111,,,,,N/A,N/A,REMOVE WRIST TENDON LESION,$758.72,$564.00,$38.32,$752.00,$38.32,$729.44,$38.32,$642.96,$38.32,$584.76,$38.32,$729.44,$38.32,$752.00,$38.32,$38.32,$729.44
25112,0960,25112,,,,,N/A,N/A,REREMOVE WRIST TENDON LESION,$923.18,$686.25,$299.30,$730.00,$299.30,$708.10,$299.30,$624.15,$299.30,$700.40,$299.30,$708.10,$299.30,$730.00,$299.30,$299.30,$708.10
25115,0960,25115,,,,,N/A,N/A,REMOVE WRIST/FOREARM LESION,"$2,132.90","$1,585.50",$866.74,"$2,114.00",$866.74,"$2,050.58",$866.74,"$1,807.47",$866.74,"$1,354.55",$866.74,"$2,050.58",$866.74,"$2,114.00",$866.74,$866.74,"$2,050.58"
25116,0960,25116,,,,,N/A,N/A,REMOVE WRIST/FOREARM LESION,"$1,887.73","$1,403.25","$1,083.30","$1,871.00",N/A,"$1,814.87",N/A,"$1,599.71",N/A,"$1,083.30",N/A,"$1,814.87",N/A,"$1,871.00",N/A,N/A,"$1,814.87"
25118,0960,25118,,,,,N/A,N/A,SYN EXT TENDON SHEATH WRIST,$749.64,$557.25,$34.63,$743.00,$34.63,$720.71,$34.63,$635.27,$34.63,$689.10,$34.63,$720.71,$34.63,$743.00,$34.63,$34.63,$720.71
25130,0960,25130,,,,,N/A,N/A,REMOVAL OF WRIST LESION,"$1,099.74",$817.50,$446.90,"$1,090.00",$446.90,"$1,057.30",$446.90,$931.95,$446.90,$812.75,$446.90,"$1,057.30",$446.90,"$1,090.00",$446.90,$446.90,"$1,057.30"
25150,0960,25150,,,,,N/A,N/A,PARTIAL REMOVAL OF ULNA,"$1,445.81","$1,074.75",$587.53,"$1,433.00",$587.53,"$1,390.01",$587.53,"$1,225.22",$587.53,"$1,019.15",$587.53,"$1,390.01",$587.53,"$1,433.00",$587.53,$587.53,"$1,390.01"
25210,0960,25210,,,,,N/A,N/A,REMOVAL OF WRIST BONE,"$1,199.63",$891.75,$53.89,"$1,229.00",$53.89,"$1,192.13",$53.89,"$1,050.80",$53.89,$886.28,$53.89,"$1,192.13",$53.89,"$1,229.00",$53.89,$53.89,"$1,192.13"
25248,0960,25248,,,,,N/A,N/A,REMOVE FOREARM FOREIGN BODY,"$1,272.27",$945.75,$517.10,"$1,261.00",$517.10,"$1,223.17",$517.10,"$1,078.16",$517.10,$750.73,$517.10,"$1,223.17",$517.10,"$1,261.00",$517.10,$517.10,"$1,223.17"
25259,0960,25259,,,,,N/A,N/A,MANIPULATION OF WRIST,$832.38,$618.75,$338.25,$825.00,$338.25,$800.25,$338.25,$705.38,$338.25,$774.34,$338.25,$800.25,$338.25,$825.00,$338.25,$338.25,$800.25
25270,0960,25270,,,,,N/A,N/A,REPAIR FOREARM TENDON/MUSCLE,"$1,677.87","$1,247.25",$681.83,"$1,663.00",$681.83,"$1,613.11",$681.83,"$1,421.87",$681.83,$888.61,$681.83,"$1,613.11",$681.83,"$1,663.00",$681.83,$681.83,"$1,613.11"
25275,0960,25275,,,,,N/A,N/A,REPAIR FOREARM TENDON SHEATH,"$1,525.52","$1,134.00",$619.92,"$1,512.00",$619.92,"$1,466.64",$619.92,N/A,$619.92,"$1,203.50",$619.92,"$1,466.64",$619.92,"$1,512.00",$619.92,$619.92,"$1,466.64"
25295,0960,25295,,,,,N/A,N/A,RELEASE WRIST/FOREARM TENDON,"$1,742.44","$1,295.25",$78.70,"$1,727.00",$78.70,"$1,675.19",$78.70,"$1,476.59",$78.70,$947.42,$78.70,"$1,675.19",$78.70,"$1,727.00",$78.70,$78.70,"$1,675.19"
25310,0960,25310,,,,,N/A,N/A,TENDON TRANSPLANT/TRANSFER,"$1,976.51","$1,469.25",$498.15,"$1,215.00",$498.15,"$1,178.55",$498.15,"$1,038.83",$498.15,"$1,114.17",$498.15,"$1,178.55",$498.15,"$1,215.00",$498.15,$498.15,"$1,178.55"
25320,0960,25320,,,,,N/A,N/A,REPAIR/REVISE WRIST JOINT,"$2,088.51","$1,552.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
25332,0960,25332,,,,,N/A,N/A,REPAIR\RECON FOREARM\WRIST,"$1,691.99","$1,257.75",$687.57,"$1,677.00",$687.57,"$1,626.69",$687.57,"$1,433.84",$687.57,"$1,507.77",$687.57,"$1,626.69",$687.57,"$1,677.00",$687.57,$687.57,"$1,626.69"
25390,0960,25390,,,,,N/A,N/A,SHORTEN RADIUS OR ULNA,"$2,343.77","$1,742.25","$1,362.43","$2,323.00","$1,362.43","$2,253.31","$1,362.43","$1,986.17","$1,362.43","$1,376.41","$1,362.43","$2,253.31","$1,362.43","$2,323.00","$1,362.43","$1,362.43","$2,253.31"
25400,0960,25400,,,,,N/A,N/A,REPAIR RADIUS OR ULNA,"$2,454.75","$1,824.75",$997.53,"$2,433.00",$997.53,"$2,360.01",$997.53,"$2,080.22",$997.53,"$1,434.39",$997.53,"$2,360.01",$997.53,"$2,433.00",$997.53,$997.53,"$2,360.01"
25405,0960,25405,,,,,N/A,N/A,REPAIR/GRAFT RADIUS OR ULNA,"$2,981.42","$2,216.25","$1,211.55","$2,955.00","$1,211.55","$2,866.35","$1,211.55",N/A,"$1,211.55","$1,848.04","$1,211.55","$2,866.35","$1,211.55","$2,955.00","$1,211.55","$1,211.55","$2,866.35"
25425,0960,25425,,,,,N/A,N/A,REPAIR/GRAFT RADIUS OF ULNA,"$3,221.55","$2,394.75",$139.13,"$3,193.00",$139.13,"$3,097.21",$139.13,"$2,730.02",$139.13,"$1,716.92",$139.13,"$3,097.21",$139.13,"$3,193.00",$139.13,$139.13,"$3,097.21"
25445,0960,25445,,,,,N/A,N/A,REPAIR\RECONSTRUCTION,"$1,434.71","$1,066.50",$583.20,"$1,422.00",$583.20,"$1,379.34",$583.20,"$1,215.81",$583.20,"$1,288.95",$583.20,"$1,379.34",$583.20,"$1,422.00",$583.20,$583.20,"$1,379.34"
25447,0960,25447,,,,,N/A,N/A,REPAIR WRIST JOINT(S),"$1,807.01","$1,343.25",$734.31,"$1,791.00",$734.31,"$1,737.27",$734.31,"$1,531.31",$734.31,"$1,486.10",$734.31,"$1,737.27",$734.31,"$1,791.00",$734.31,$734.31,"$1,737.27"
25515,0960,25515,,,,,N/A,N/A,TREAT FRACTURE OF RADIUS,"$1,588.07","$1,180.50",$645.34,"$1,574.00",$645.34,"$1,526.78",$645.34,"$1,345.77",$645.34,"$1,198.46",$645.34,"$1,526.78",$645.34,"$1,574.00",$645.34,$645.34,"$1,526.78"
25530,0960,25530,,,,,N/A,N/A,TREAT FRACTURE OF ULNA,$466.13,$346.50,$189.42,$462.00,$189.42,$448.14,$189.42,$395.01,$189.42,$441.10,$189.42,$448.14,$189.42,$462.00,$189.42,$189.42,$448.14
25545,0960,25545,,,,,N/A,N/A,TREAT FRACTURE OF ULNA,"$1,577.98","$1,173.00",$641.24,"$1,564.00",$641.24,"$1,517.08",$641.24,"$1,337.22",$641.24,"$1,119.11",$641.24,"$1,517.08",$641.24,"$1,564.00",$641.24,$641.24,"$1,517.08"
25565,0960,25565,,,,,N/A,N/A,TREAT FRACTURE RADIUS & ULNA,"$1,048.29",$779.25,$425.99,"$1,039.00",$425.99,"$1,007.83",$425.99,$888.35,$425.99,$835.25,$425.99,"$1,007.83",$425.99,"$1,039.00",$425.99,$425.99,"$1,007.83"
25575,0960,25575,,,,,N/A,N/A,TREAT FRACTURE OF RADIUS/ULNA,"$1,898.83","$1,411.50",$771.62,"$1,882.00",$771.62,"$1,825.54",$771.62,"$1,609.11",$771.62,"$1,613.56",$771.62,"$1,825.54",$771.62,"$1,882.00",$771.62,$771.62,"$1,825.54"
25600,0960,25600,,,,,N/A,N/A,TREAT FRACTURE RADIUS/ULNA,$585.19,$435.00,$215.25,$585.83,$215.25,$509.25,$215.25,$448.88,$215.25,$585.83,$215.25,$509.25,$215.25,$525.00,$215.25,$215.25,$509.25
25605,0960,25605,,,,,N/A,N/A,TREAT FRACTURE RADIUS/ULNA,"$1,139.09",$846.75,$599.42,"$1,462.00",$599.42,"$1,418.14",$599.42,"$1,250.01",$599.42,$920.22,$599.42,"$1,418.14",$599.42,"$1,462.00",$599.42,$599.42,"$1,418.14"
25606,0960,25606,,,,,N/A,N/A,CLOSED RED-INT. FIX RAD/ULNA,"$1,490.20","$1,107.75",$65.57,"$1,477.00",$65.57,"$1,432.69",$65.57,"$1,262.84",$65.57,"$1,194.73",$65.57,"$1,432.69",$65.57,"$1,477.00",$65.57,$65.57,"$1,432.69"
25607,0960,25607,,,,,N/A,N/A,OPTX DSTL RADL EX ARTIC FX,"$1,423.61","$1,058.25",$564.57,"$1,377.00",$564.57,"$1,335.69",$564.57,"$1,177.34",$564.57,"$1,321.95",$564.57,"$1,335.69",$564.57,"$1,377.00",$564.57,$564.57,"$1,335.69"
25608,0960,25608,,,,,N/A,N/A,OPTX DSTL RADL I-ARTIC FX/EP,"$1,595.13","$1,185.75",$599.42,"$1,477.18",$599.42,"$1,418.14",$599.42,"$1,250.01",$599.42,"$1,477.18",$599.42,"$1,418.14",$599.42,"$1,462.00",$599.42,$599.42,"$1,418.14"
25609,0960,25609,,,,,N/A,N/A,OPTX DSTL RADL I-ARTIC FX/EP,"$2,028.98","$1,508.25",$763.42,"$1,875.15",$763.42,"$1,806.14",$763.42,"$1,592.01",$763.42,"$1,875.15",$763.42,"$1,806.14",$763.42,"$1,862.00",$763.42,$763.42,"$1,806.14"
25628,0960,25628,,,,,N/A,N/A,TREAT WRIST BONE FRACTURE,"$1,543.68","$1,147.50",$627.30,"$1,530.00",$627.30,"$1,484.10",$627.30,"$1,308.15",$627.30,"$1,290.87",$627.30,"$1,484.10",$627.30,"$1,530.00",$627.30,$627.30,"$1,484.10"
25645,0960,25645,,,,,N/A,N/A,TREAT WRIST BONE FRACTURE,"$1,319.69",$981.00,$536.28,"$1,308.00",$536.28,"$1,268.76",$536.28,"$1,118.34",$536.28,"$1,024.61",$536.28,"$1,268.76",$536.28,"$1,308.00",$536.28,$536.28,"$1,268.76"
25650,0960,25650,,,,,N/A,N/A,TREAT WRIST BONE FRACTURE,$588.21,$437.25,$239.30,$583.00,$239.30,$565.51,$239.30,$498.47,$239.30,$553.52,$239.30,$565.51,$239.30,$583.00,$239.30,$239.30,$565.51
25651,0960,25651,,,,,N/A,N/A,PIN ULNAR STYLOID FRACTURE,"$1,026.09",$762.75,$416.97,"$1,017.00",$416.97,$986.49,$416.97,$869.54,$416.97,$881.90,$416.97,$986.49,$416.97,"$1,017.00",$416.97,$416.97,$986.49
25652,0960,25652,,,,,N/A,N/A,TREAT FRACTURE ULNAR STYLOID,"$1,385.27","$1,029.75",$562.93,"$1,373.00",$562.93,"$1,331.81",$562.93,"$1,173.92",$562.93,"$1,116.59",$562.93,"$1,331.81",$562.93,"$1,373.00",$562.93,$562.93,"$1,331.81"
25690,0960,25690,,,,,N/A,N/A,TREATMENT WRIST DISLOCATION,"$1,042.24",$774.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
25800,0960,25800,,,,,N/A,N/A,FUSION WRIST JOINT,"$1,788.85","$1,329.75",$726.93,"$1,773.00",$726.93,"$1,719.81",$726.93,"$1,515.92",$726.93,"$1,310.69",$726.93,"$1,719.81",$726.93,"$1,773.00",$726.93,$726.93,"$1,719.81"
25820,0960,25820,,,,,N/A,N/A,WRIST FUSION LIMITED,"$1,226.87",$912.00,$498.56,"$1,216.00",$498.56,"$1,179.52",$498.56,"$1,039.68",$498.56,"$1,164.62",$498.56,"$1,179.52",$498.56,"$1,216.00",$498.56,$498.56,"$1,179.52"
26010,0960,26010,,,,,N/A,N/A,DRAINAGE OF FINGER ABSCESS,$311.76,$231.75,$126.69,$126.69,$126.69,N/A,$126.69,N/A,$126.69,N/A,$126.69,N/A,$126.69,N/A,$126.69,$126.69,N/A
26011,0960,26011,,,,,N/A,N/A,DRAINAGE OF FINGER ABSCESS,$580.14,$431.25,$235.75,$235.75,$235.75,N/A,$235.75,N/A,$235.75,N/A,$235.75,N/A,$235.75,N/A,$235.75,$235.75,N/A
26020,0960,26020,,,,,N/A,N/A,INCISION DR TEND DIGIT\PALM,$874.75,$650.25,$355.47,$355.47,$355.47,N/A,$355.47,N/A,$355.47,N/A,$355.47,N/A,$355.47,N/A,$355.47,$355.47,N/A
26037,0960,26037,,,,,N/A,N/A,DECOMPRESS FINGERS/HAND,"$1,288.42",$957.75,$523.57,$523.57,$523.57,N/A,$523.57,N/A,$523.57,N/A,$523.57,N/A,$523.57,N/A,$523.57,$523.57,N/A
26040,0960,26040,,,,,N/A,N/A,RELEASE PALM CONTRACTURE,$697.18,$518.25,$283.31,$283.31,$283.31,N/A,$283.31,N/A,$283.31,N/A,$283.31,N/A,$283.31,N/A,$283.31,$283.31,N/A
26055,0960,26055,,,,,N/A,N/A,INCISE FINGER TENDON SHEATH,"$1,008.94",$750.00,$41.00,$41.00,$41.00,N/A,$41.00,N/A,$41.00,N/A,$41.00,N/A,$41.00,N/A,$41.00,$41.00,N/A
26075,0960,26075,,,,,N/A,N/A,INCISION TENDON,$712.31,$529.50,$273.47,$273.47,$273.47,N/A,$273.47,N/A,$273.47,N/A,$273.47,N/A,$273.47,N/A,$273.47,$273.47,N/A
26080,0960,26080,,,,,N/A,N/A,EXPLORE/TREAT FINGER JOINT,$857.60,$637.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
26111,0960,26111,,,,,N/A,N/A,EXCISE TUMOR HAND/FINGER,$825.31,$613.50,$311.19,$311.19,$311.19,N/A,$311.19,N/A,$311.19,N/A,$311.19,N/A,$311.19,N/A,$311.19,$311.19,N/A
26115,0960,26115,,,,,N/A,N/A,REMOVAL HAND LESION SUBCUT,$812.20,$603.75,$33.50,$33.50,$33.50,N/A,$33.50,N/A,$33.50,N/A,$33.50,N/A,$33.50,N/A,$33.50,$33.50,N/A
26116,0960,26116,,,,,N/A,N/A,REMOVAL HAND LESION DEEP,"$1,088.65",$809.25,$442.39,$442.39,$442.39,N/A,$442.39,N/A,$442.39,N/A,$442.39,N/A,$442.39,N/A,$442.39,$442.39,N/A
26121,0960,26121,,,,,N/A,N/A,RELEASE PALM CONTRACTURE,"$1,374.18","$1,021.50",$558.42,$558.42,$558.42,N/A,$558.42,N/A,$558.42,N/A,$558.42,N/A,$558.42,N/A,$558.42,$558.42,N/A
26123,0960,26123,,,,,N/A,N/A,RELEASE PALM CONTRACTURE,"$1,716.21","$1,275.75",$644.93,$644.93,$644.93,N/A,$644.93,N/A,$644.93,N/A,$644.93,N/A,$644.93,N/A,$644.93,$644.93,N/A
26125,0960,26125,,,,,N/A,N/A,FASCIECTOMY EA ADD DIGIT,$534.74,$397.50,$217.30,$217.30,$217.30,N/A,$217.30,N/A,$217.30,N/A,$217.30,N/A,$217.30,N/A,$217.30,$217.30,N/A
26135,0960,26135,,,,,N/A,N/A,"REVISE FINGER JOINT, EACH","$1,271.26",$945.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
26140,0960,26140,,,,,N/A,N/A,"REVISE FINGER JOINT, EACH","$1,155.24",$858.75,$469.45,$469.45,$469.45,N/A,$469.45,N/A,$469.45,N/A,$469.45,N/A,$469.45,N/A,$469.45,$469.45,N/A
26145,0960,26145,,,,,N/A,N/A,SYN TEND SHEATH PALM\FINGER,"$1,080.57",$803.25,$439.11,$439.11,$439.11,N/A,$439.11,N/A,$439.11,N/A,$439.11,N/A,$439.11,N/A,$439.11,$439.11,N/A
26160,0960,26160,,,,,N/A,N/A,REMOVE TENDON SHEATH LESION,"$1,101.76",$819.00,$447.72,$447.72,$447.72,N/A,$447.72,N/A,$447.72,N/A,$447.72,N/A,$447.72,N/A,$447.72,$447.72,N/A
26200,0960,26200,,,,,N/A,N/A,REMOVE HAND BONE LESION,"$1,029.12",$765.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
26210,0960,26210,,,,,N/A,N/A,REMOVAL OF FINGER LESION,$997.84,$741.75,$45.49,$45.49,$45.49,N/A,$45.49,N/A,$45.49,N/A,$45.49,N/A,$45.49,N/A,$45.49,$45.49,N/A
26230,0960,26230,,,,,N/A,N/A,PARTIAL REMOVAL HAND BONE,"$1,160.28",$862.50,$471.50,$471.50,$471.50,N/A,$471.50,N/A,$471.50,N/A,$471.50,N/A,$471.50,N/A,$471.50,$471.50,N/A
26235,0960,26235,,,,,N/A,N/A,"PARTIAL REMOVAL, FINGER BONE","$1,137.08",$845.25,$462.70,$462.70,$462.70,N/A,$462.70,N/A,$462.70,N/A,$462.70,N/A,$462.70,N/A,$462.70,$462.70,N/A
26236,0960,26236,,,,,N/A,N/A,"PARTIAL REMOVAL, FINGER BONE","$1,003.90",$746.25,$47.95,$47.95,$47.95,N/A,$47.95,N/A,$47.95,N/A,$47.95,N/A,$47.95,N/A,$47.95,$47.95,N/A
26340,0960,26340,,,,,N/A,N/A,REPAIR FINGER\HAND,$667.92,$496.50,$271.42,$271.42,$271.42,N/A,$271.42,N/A,$271.42,N/A,$271.42,N/A,$271.42,N/A,$271.42,$271.42,N/A
26350,0960,26350,,,,,N/A,N/A,REPAIR FINGER/HAND TENDON,"$1,906.90","$1,417.50",$774.90,$774.90,$774.90,N/A,$774.90,N/A,$774.90,N/A,$774.90,N/A,$774.90,N/A,$774.90,$774.90,N/A
26356,0960,26356,,,,,N/A,N/A,REPAIR FINGER/HAND TENDON,"$2,451.72","$1,822.50",$996.30,$996.30,$996.30,N/A,$996.30,N/A,$996.30,N/A,$996.30,N/A,$996.30,N/A,$996.30,$996.30,N/A
26370,0960,26370,,,,,N/A,N/A,REPAIR FINGER/HAND TENDON,"$2,064.29","$1,534.50",$838.86,$838.86,$838.86,N/A,$838.86,N/A,$838.86,N/A,$838.86,N/A,$838.86,N/A,$838.86,$838.86,N/A
26373,0960,26373,,,,,N/A,N/A,REPAIR FINGER/HAND TENDON,"$2,249.94","$1,672.50",$92.00,$92.00,$92.00,N/A,$92.00,N/A,$92.00,N/A,$92.00,N/A,$92.00,N/A,$92.00,$92.00,N/A
26410,0960,26410,,,,,N/A,N/A,REPAIR HAND TENDON,"$1,533.59","$1,140.00",$623.20,$623.20,$623.20,N/A,$623.20,N/A,$623.20,N/A,$623.20,N/A,$623.20,N/A,$623.20,$623.20,N/A
26412,0960,26412,,,,,N/A,N/A,REPAIRW\FREE GRAFT EA TENDON,"$1,342.90",$998.25,$545.71,$545.71,$545.71,N/A,$545.71,N/A,$545.71,N/A,$545.71,N/A,$545.71,N/A,$545.71,$545.71,N/A
26415,0960,26415,,,,,N/A,N/A,"EXCISION, HAND/FINGER TENDON","$1,872.59","$1,392.00",$76.96,$76.96,$76.96,N/A,$76.96,N/A,$76.96,N/A,$76.96,N/A,$76.96,N/A,$76.96,$76.96,N/A
26418,0960,26418,,,,,N/A,N/A,REPAIR FINGER TENDON,"$1,530.56","$1,137.75",$464.53,$464.53,$464.53,N/A,$464.53,N/A,$464.53,N/A,$464.53,N/A,$464.53,N/A,$464.53,$464.53,N/A
26433,0960,26433,,,,,N/A,N/A,REPAIR FINGER TENDON,"$1,189.54",$884.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
26437,0960,26437,,,,,N/A,N/A,REALIGNMENT OF TENDONS,"$1,618.34","$1,203.00",$657.64,$657.64,$657.64,N/A,$657.64,N/A,$657.64,N/A,$657.64,N/A,$657.64,N/A,$657.64,$657.64,N/A
26440,0960,26440,,,,,N/A,N/A,RELEASE PALM/FINGER TENDON,"$1,705.11","$1,267.50",$692.90,$692.90,$692.90,N/A,$692.90,N/A,$692.90,N/A,$692.90,N/A,$692.90,N/A,$692.90,$692.90,N/A
26445,0960,26445,,,,,N/A,N/A,RELEASE HAND/FINGER TENDON,"$1,608.25","$1,195.50",$653.54,$653.54,$653.54,N/A,$653.54,N/A,$653.54,N/A,$653.54,N/A,$653.54,N/A,$653.54,$653.54,N/A
26450,0960,26450,,,,,N/A,N/A,"TENOTOMY,FLEX,PALM EA TENDON",$792.02,$588.75,$321.85,$321.85,$321.85,N/A,$321.85,N/A,$321.85,N/A,$321.85,N/A,$321.85,N/A,$321.85,$321.85,N/A
26455,0960,26455,,,,,N/A,N/A,"TENOTOMY,FLEX,FNGER EA TEND","$1,016.00",$755.25,$321.44,$321.44,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,$321.44,N/A
26460,0960,26460,,,,,N/A,N/A,TENTMY EXT HAND FIN EA TEND,$770.83,$573.00,$313.24,$313.24,$313.24,N/A,$313.24,N/A,$313.24,N/A,$313.24,N/A,$313.24,N/A,$313.24,$313.24,N/A
26480,0960,26480,,,,,N/A,N/A,TRANSPLANT HAND TENDON,"$2,015.86","$1,498.50",$587.12,$587.12,$587.12,N/A,$587.12,N/A,$587.12,N/A,$587.12,N/A,$587.12,N/A,$587.12,$587.12,N/A
26483,0960,26483,,,,,N/A,N/A,TRANSFER OF TENDON W\GRAFT,"$1,660.72","$1,234.50",$674.86,$674.86,$674.86,N/A,$674.86,N/A,$674.86,N/A,$674.86,N/A,$674.86,N/A,$674.86,$674.86,N/A
26516,0960,26516,,,,,N/A,N/A,FUSION OF KNUCKLE JOINT,"$1,809.03","$1,344.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
26525,0960,26525,,,,,N/A,N/A,RELEASE FINGER CONTRACTURE,"$1,784.81","$1,326.75",$725.29,$725.29,$725.29,N/A,$725.29,N/A,$725.29,N/A,$725.29,N/A,$725.29,N/A,$725.29,$725.29,N/A
26530,0960,26530,,,,,N/A,N/A,REVISE KNUCKLE JOINT,"$1,216.78",$904.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
26540,0960,26540,,,,,N/A,N/A,REPAIR HAND JOINT,"$1,706.12","$1,268.25",$612.13,$612.13,$612.13,N/A,$612.13,N/A,$612.13,N/A,$612.13,N/A,$612.13,N/A,$612.13,$612.13,N/A
26541,0960,26541,,,,,N/A,N/A,REPAIR HAND JOINT W/GRAFT,"$2,057.23","$1,529.25",$835.99,$835.99,$835.99,N/A,$835.99,N/A,$835.99,N/A,$835.99,N/A,$835.99,N/A,$835.99,$835.99,N/A
26600,0960,26600,,,,,N/A,N/A,TREAT METACARPAL FRACTURE,$533.73,$396.75,$216.89,$216.89,$216.89,N/A,$216.89,N/A,$216.89,N/A,$216.89,N/A,$216.89,N/A,$216.89,$216.89,N/A
26605,0960,26605,,,,,N/A,N/A,TREAT METACARPAL FRACTURE,$614.44,$456.75,$249.69,$249.69,$249.69,N/A,$249.69,N/A,$249.69,N/A,$249.69,N/A,$249.69,N/A,$249.69,$249.69,N/A
26608,0960,26608,,,,,N/A,N/A,TREAT METACARPAL FRACTURE,"$1,096.72",$815.25,$445.67,$445.67,$445.67,N/A,$445.67,N/A,$445.67,N/A,$445.67,N/A,$445.67,N/A,$445.67,$445.67,N/A
26615,0960,26615,,,,,N/A,N/A,TREAT METACARPAL FRACTURE,"$1,114.88",$828.75,$41.00,$41.00,$41.00,N/A,$41.00,N/A,$41.00,N/A,$41.00,N/A,$41.00,N/A,$41.00,$41.00,N/A
26650,0960,26650,,,,,N/A,N/A,TREAT THUMB FRACTURE,"$1,172.39",$871.50,$476.42,$476.42,$476.42,N/A,$476.42,N/A,$476.42,N/A,$476.42,N/A,$476.42,N/A,$476.42,$476.42,N/A
26676,0960,26676,,,,,N/A,N/A,PIN HAND DISLOCATION,"$1,151.20",$855.75,$467.81,$467.81,$467.81,N/A,$467.81,N/A,$467.81,N/A,$467.81,N/A,$467.81,N/A,$467.81,$467.81,N/A
26700,0960,26700,,,,,N/A,N/A,TREAT KNUCKLE DISLOCATION,$614.44,$456.75,$249.69,$249.69,$249.69,N/A,$249.69,N/A,$249.69,N/A,$249.69,N/A,$249.69,N/A,$249.69,$249.69,N/A
26720,0960,26720,,,,,N/A,N/A,"TREAT FINGER FRACTURE, EACH",$357.16,$265.50,$145.14,$145.14,$145.14,N/A,$145.14,N/A,$145.14,N/A,$145.14,N/A,$145.14,N/A,$145.14,$145.14,N/A
26725,0960,26725,,,,,N/A,N/A,"TREAT FINGER FRACTURE, EACH",$646.73,$480.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
26727,0960,26727,,,,,N/A,N/A,TREAT FINGER FRACTURE EACH,"$1,080.57",$803.25,$439.11,$439.11,$439.11,N/A,$439.11,N/A,$439.11,N/A,$439.11,N/A,$439.11,N/A,$439.11,$439.11,N/A
26735,0960,26735,,,,,N/A,N/A,"TREAT FINGER FRACTURE, EACH","$1,157.25",$860.25,$489.13,$489.13,$489.13,N/A,$489.13,N/A,$489.13,N/A,$489.13,N/A,$489.13,N/A,$489.13,$489.13,N/A
26740,0960,26740,,,,,N/A,N/A,"TREAT FINGER FRACTURE, EACH",$436.87,$324.75,$177.53,$177.53,$177.53,N/A,$177.53,N/A,$177.53,N/A,$177.53,N/A,$177.53,N/A,$177.53,$177.53,N/A
26742,0960,26742,,,,,N/A,N/A,"TREAT FINGER FRACTURE, EACH",$729.46,$542.25,$273.47,$273.47,$273.47,N/A,$273.47,N/A,$273.47,N/A,$273.47,N/A,$273.47,N/A,$273.47,$273.47,N/A
26746,0960,26746,,,,,N/A,N/A,FRACTURE\DISLOCATION,"$1,389.31","$1,032.75",$564.57,$564.57,$564.57,N/A,$564.57,N/A,$564.57,N/A,$564.57,N/A,$564.57,N/A,$564.57,$564.57,N/A
26755,0960,26755,,,,,N/A,N/A,"TREAT FINGER FRACTURE,EACH",$576.10,$428.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
26756,0960,26756,,,,,N/A,N/A,PIN FINGER FRACTURE EACH,$951.43,$707.25,$386.63,$386.63,$386.63,N/A,$386.63,N/A,$386.63,N/A,$386.63,N/A,$386.63,N/A,$386.63,$386.63,N/A
26765,0960,26765,,,,,N/A,N/A,"TREAT FINGER FRACTURE, EACH",$969.59,$720.75,$47.13,$47.13,$47.13,N/A,$47.13,N/A,$47.13,N/A,$47.13,N/A,$47.13,N/A,$47.13,$47.13,N/A
26770,0960,26770,,,,,N/A,N/A,TREAT FINGER DISLOCATION,$509.51,$378.75,$27.50,$27.50,$27.50,N/A,$27.50,N/A,$27.50,N/A,$27.50,N/A,$27.50,N/A,$27.50,$27.50,N/A
26775,0960,26775,,,,,N/A,N/A,TREAT FINGER DISLOCATION,$708.28,$526.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
26785,0960,26785,,,,,N/A,N/A,TREAT FINGER DISLOCATION,$826.32,$614.25,$335.79,$335.79,$335.79,N/A,$335.79,N/A,$335.79,N/A,$335.79,N/A,$335.79,N/A,$335.79,$335.79,N/A
26841,0960,26841,,,,,N/A,N/A,FUSION OF THUMB,"$1,900.84","$1,413.00",$772.44,$772.44,$772.44,N/A,$772.44,N/A,$772.44,N/A,$772.44,N/A,$772.44,N/A,$772.44,$772.44,N/A
26860,0960,26860,,,,,N/A,N/A,ARTH INTERPHALANGEAL JOINT,"$1,107.82",$823.50,$45.18,$45.18,$45.18,N/A,$45.18,N/A,$45.18,N/A,$45.18,N/A,$45.18,N/A,$45.18,$45.18,N/A
26951,0960,26951,,,,,N/A,N/A,AMPUTATION OF FINGER/THUMB,"$1,368.12","$1,017.00",$555.96,$555.96,$555.96,N/A,$555.96,N/A,$555.96,N/A,$555.96,N/A,$555.96,N/A,$555.96,$555.96,N/A
26952,0960,26952,,,,,N/A,N/A,AMP FIN\THUM W\LOC ADV FLAP,"$1,267.23",$942.00,$514.96,$514.96,$514.96,N/A,$514.96,N/A,$514.96,N/A,$514.96,N/A,$514.96,N/A,$514.96,$514.96,N/A
26990,0960,26990,,,,,N/A,N/A,DRAINAGE OF PELVIS LESION,"$1,392.34","$1,035.00",$565.80,$565.80,$565.80,N/A,$565.80,N/A,$565.80,N/A,$565.80,N/A,$565.80,N/A,$565.80,$565.80,N/A
26992,0960,26992,,,,,N/A,N/A,DRAINAGE OF BONE LESION,"$2,230.77","$1,658.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
27001,0960,27001,,,,,N/A,N/A,INCISION OF HIP TENDON,"$1,244.02",$924.75,$970.09,"$1,233.00",N/A,"$1,196.01",N/A,"$1,054.22",N/A,$970.09,N/A,"$1,196.01",N/A,"$1,233.00",N/A,N/A,"$1,196.01"
27006,0960,27006,,,,,N/A,N/A,INCISION OF HIP TENDON,"$3,375.91","$2,509.50","$1,290.32","$3,346.00","$1,371.86","$3,245.62","$1,371.86","$2,860.83","$1,371.86","$1,290.32","$1,371.86","$3,245.62","$1,371.86","$3,346.00","$1,371.86","$1,371.86","$3,245.62"
27025,0960,27025,,,,,N/A,N/A,INCISION OF HIP/THIGH FASCIA,"$1,878.65","$1,396.50",$763.42,"$1,862.00",$763.42,"$1,806.14",$763.42,"$1,592.01",$763.42,"$1,638.46",$763.42,"$1,806.14",$763.42,"$1,862.00",$763.42,$763.42,"$1,806.14"
27030,0960,27030,,,,,N/A,N/A,SURG INCISION OF HIP,"$1,826.18","$1,357.50",$88.68,"$2,148.00",$88.68,"$2,083.56",$88.68,"$1,836.54",$88.68,"$1,666.79",$88.68,"$2,083.56",$88.68,"$2,148.00",$88.68,$88.68,"$2,083.56"
27033,0960,27033,,,,,N/A,N/A,SURG INCISION OF HIP,"$1,941.20","$1,443.00",$788.84,"$1,924.00",$788.84,"$1,866.28",$788.84,"$1,645.02",$788.84,"$1,730.10",$788.84,"$1,866.28",$788.84,"$1,924.00",$788.84,$788.84,"$1,866.28"
27045,0960,27045,,,,,N/A,N/A,REMOVE TUMOR HIP/PELV 5CM>,"$1,456.91","$1,083.00",$558.10,"$1,361.00",$558.10,"$1,320.17",$558.10,"$1,163.66",$558.10,"$1,301.99",$558.10,"$1,320.17",$558.10,"$1,361.00",$558.10,$558.10,"$1,320.17"
27047,0960,27047,,,,,N/A,N/A,REMOVE HIP/PELVIS LESION,"$1,161.29",$863.25,$471.91,"$1,151.00",$471.91,"$1,116.47",$471.91,$984.11,$471.91,$638.52,$471.91,"$1,116.47",$471.91,"$1,151.00",$471.91,$471.91,"$1,116.47"
27048,0960,27048,,,,,N/A,N/A,"EXCISION TUMOR, SOFT TISS, <CM","$1,164.32",$865.50,$351.78,"$1,084.29",$351.78,$832.26,$351.78,$733.59,$351.78,"$1,084.29",$351.78,$832.26,$351.78,$858.00,$351.78,$351.78,$832.26
27054,0960,27054,,,,,N/A,N/A,REMOVAL OF HIP JOINT LINING,"$1,515.43","$1,126.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
27062,0960,27062,,,,,N/A,N/A,REMOVE FEMUR LESION/BURSA,"$1,002.89",$745.50,$47.54,$994.00,$47.54,$964.18,$47.54,$849.87,$47.54,$816.93,$47.54,$964.18,$47.54,$994.00,$47.54,$47.54,$964.18
27066,0960,27066,,,,,N/A,N/A,REMOVAL OF HIP BONE LESION,"$1,790.87","$1,331.25",$727.75,"$1,775.00",$727.75,"$1,721.75",$727.75,"$1,517.63",$727.75,"$1,457.56",$727.75,"$1,721.75",$727.75,"$1,775.00",$727.75,$727.75,"$1,721.75"
27091,0960,27091,,,,,N/A,N/A,REMOVAL OF HIP PROSTHESIS,"$3,471.76","$2,580.75",$141.81,"$3,441.00",$141.81,"$3,337.77",$141.81,"$2,942.06",$141.81,"$2,818.59",$141.81,"$3,337.77",$141.81,"$3,441.00",$141.81,$141.81,"$3,337.77"
27095,0960,27095,,,,,N/A,N/A,INJECTION FOR HIP W\ANES,$514.56,$382.50,$29.10,$510.00,$29.10,$494.70,$29.10,$436.05,$29.10,$146.79,$29.10,$494.70,$29.10,$510.00,$29.10,$29.10,$494.70
27096,0960,27096,,,,,N/A,N/A,INJECT SACROILIAC JOINT,$473.19,$351.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
27100,0960,27100,,,,,N/A,N/A,TRANSFER OF ADB MUSCLE,"$1,257.14",$934.50,$51.86,"$1,480.37",$51.86,"$1,208.62",$51.86,"$1,065.33",$51.86,"$1,480.37",$51.86,"$1,208.62",$51.86,"$1,246.00",$51.86,$51.86,"$1,208.62"
27125,0960,27125,,,,,N/A,N/A,REPAIR REVISION PARTIAL HIP,"$2,168.21","$1,611.75",$881.90,"$2,149.00",$881.90,"$2,084.53",$881.90,"$1,837.40",$881.90,"$2,008.52",$881.90,"$2,084.53",$881.90,"$2,149.00",$881.90,$881.90,"$2,084.53"
27130,0960,27130,,,,,N/A,N/A,TOTAL HIP ARTHROPLASTY,"$3,206.41","$2,383.50",$132.98,"$6,356.00",$132.98,"$6,165.32",$132.98,"$5,434.38",$132.98,"$2,277.00",$132.98,"$6,165.32",$132.98,"$6,356.00",$132.98,$132.98,"$6,165.32"
27132,0960,27132,,,,,N/A,N/A,TOTAL HIP ARTHROPLASTY,"$3,735.10","$2,776.50","$1,517.82","$3,702.00","$1,517.82","$3,590.94","$1,517.82","$3,165.21","$1,517.82","$2,956.85","$1,517.82","$3,590.94","$1,517.82","$3,702.00","$1,517.82","$1,517.82","$3,590.94"
27134,0960,27134,,,,,N/A,N/A,REVISE HIP JOINT REPLACEMENT,"$4,449.43","$3,307.50","$1,513.31","$6,391.00","$1,513.31","$6,199.27","$1,513.31","$5,464.31","$1,513.31","$3,367.07","$1,513.31","$6,199.27","$1,513.31","$6,391.00","$1,513.31","$1,513.31","$6,199.27"
27137,0960,27137,,,,,N/A,N/A,REVISE HIP JOINT REPLACEMENT,"$3,369.86","$2,505.00","$1,369.40","$3,340.00","$1,369.40","$3,239.80","$1,369.40","$2,855.70","$1,369.40","$2,594.63","$1,369.40","$3,239.80","$1,369.40","$3,340.00","$1,369.40","$1,369.40","$3,239.80"
27138,0960,27138,,,,,N/A,N/A,REPAIR FEMORAL COMP ONLY,"$3,510.10","$2,609.25","$1,426.39","$3,479.00","$1,426.39","$3,374.63","$1,426.39","$2,974.55","$1,426.39","$2,695.36","$1,426.39","$3,374.63","$1,426.39","$3,479.00","$1,426.39","$1,426.39","$3,374.63"
27187,0960,27187,,,,,N/A,N/A,REINFORCE HIP BONES,"$2,320.56","$1,725.00",$943.00,"$2,300.00",$943.00,"$2,231.00",$943.00,"$1,966.50",$943.00,"$1,770.71",$943.00,"$2,231.00",$943.00,"$2,300.00",$943.00,$943.00,"$2,231.00"
27215,0960,27215,,,,,N/A,N/A,TREAT PELVIC FRACTURE(S),"$1,652.64","$1,228.50",$671.58,"$1,638.00",$671.58,"$1,588.86",$671.58,"$1,400.49",$671.58,"$1,087.36",$671.58,"$1,588.86",$671.58,"$1,638.00",$671.58,$671.58,"$1,588.86"
27235,0960,27235,,,,,N/A,N/A,TREAT THIGH FRACTURE,"$2,066.31","$1,536.00",$863.50,"$2,105.00",$863.50,"$2,041.85",$863.50,"$1,799.78",$863.50,"$1,613.93",$863.50,"$2,041.85",$863.50,"$2,105.00",$863.50,$863.50,"$2,041.85"
27236,0960,27236,,,,,N/A,N/A,TREAT THIGH FRACTURE,"$2,554.64","$1,899.00",$138.12,"$2,532.00",$138.12,"$2,456.04",$138.12,"$2,164.86",$138.12,"$2,117.70",$138.12,"$2,456.04",$138.12,"$2,532.00",$138.12,$138.12,"$2,456.04"
27244,0960,27244,,,,,N/A,N/A,TREATMENT THIGH FRX,"$2,609.12","$1,939.50",$16.26,"$2,586.00",$16.26,"$2,508.42",$16.26,"$2,211.03",$16.26,"$2,178.93",$16.26,"$2,508.42",$16.26,"$2,586.00",$16.26,$16.26,"$2,508.42"
27245,0960,27245,,,,,N/A,N/A,TREAT THIGH FRACTURE,"$3,266.95","$2,428.50","$1,327.58","$3,238.00","$1,327.58","$3,140.86","$1,327.58","$2,768.49","$1,327.58","$2,176.95","$1,327.58","$3,140.86","$1,327.58","$3,238.00","$1,327.58","$1,327.58","$3,140.86"
27248,0960,27248,,,,,N/A,N/A,TREAT THIGH FRACTURE,"$1,782.80","$1,325.25",$724.47,"$1,767.00",$724.47,"$1,713.99",$724.47,"$1,510.79",$724.47,"$1,326.94",$724.47,"$1,713.99",$724.47,"$1,767.00",$724.47,$724.47,"$1,713.99"
27252,0960,27252,,,,,N/A,N/A,TREAT HIP DISLOCATION,"$1,699.05","$1,263.00",$69.44,"$1,684.00",$69.44,"$1,633.48",$69.44,"$1,439.82",$69.44,"$1,345.24",$69.44,"$1,633.48",$69.44,"$1,684.00",$69.44,$69.44,"$1,633.48"
27265,0960,27265,,,,,N/A,N/A,TREAT HIP DISLOCATION,$924.19,$687.00,$375.56,$375.56,$375.56,N/A,$375.56,N/A,$375.56,N/A,$375.56,N/A,$375.56,N/A,$375.56,$375.56,N/A
27266,0960,27266,,,,,N/A,N/A,TREAT HIP DISLOCATION,"$1,319.69",$981.00,$476.42,$476.42,$476.42,N/A,$476.42,N/A,$476.42,N/A,$476.42,N/A,$476.42,N/A,$476.42,$476.42,N/A
27267,0960,27267,,,,,N/A,N/A,CLOSED TX FEMORAL FRACTURE P,$840.45,$624.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
27275,0960,27275,,,,,N/A,N/A,MANIPULATION HIP JOINT,$367.25,$273.00,$149.24,$364.00,$149.24,$353.08,$149.24,$311.22,$149.24,$330.11,$149.24,$353.08,$149.24,$364.00,$149.24,$149.24,$353.08
27301,0960,27301,,,,,N/A,N/A,DRAIN THIGH/KNEE LESION,"$1,106.81",$822.75,$4.16,$976.00,$4.16,$946.72,$4.16,$834.48,$4.16,$902.72,$4.16,$946.72,$4.16,$976.00,$4.16,$4.16,$946.72
27305,0960,27305,,,,,N/A,N/A,INCISE THIGH TENDON & FASCIA,"$1,057.37",$786.00,$366.54,$894.00,$366.54,$867.18,$366.54,$764.37,$366.54,$864.42,$366.54,$867.18,$366.54,$894.00,$366.54,$366.54,$867.18
27310,0960,27310,,,,,N/A,N/A,EXPLORATION OF KNEE JOINT,"$1,609.26","$1,196.25",$653.95,"$1,595.00",$653.95,"$1,547.15",$653.95,"$1,363.73",$653.95,"$1,306.80",$653.95,"$1,547.15",$653.95,"$1,595.00",$653.95,$653.95,"$1,547.15"
27323,0960,27323,,,,,N/A,N/A,BIOPSY THIGH OR KNEE,$391.47,$291.00,$159.80,$388.00,$159.80,$376.36,$159.80,$331.74,$159.80,$312.70,$159.80,$376.36,$159.80,$388.00,$159.80,$159.80,$376.36
27324,0960,27324,,,,,N/A,N/A,"BIOPSY, THIGH SOFT TISSUES",$862.64,$641.25,$289.50,$726.74,$289.50,$683.85,$289.50,$602.78,$289.50,$726.74,$289.50,$683.85,$289.50,$705.00,$289.50,$289.50,$683.85
27327,0960,27327,,,,,N/A,N/A,REPAIR REV\RECON TENOTOMY,$606.37,$450.75,$246.41,$601.00,$246.41,$582.97,$246.41,$513.86,$246.41,$557.48,$246.41,$582.97,$246.41,$601.00,$246.41,$246.41,$582.97
27328,0960,27328,,,,,N/A,N/A,EXC THIGH/KNEE TUMOR DEEP <5CM,"$1,175.42",$873.75,$432.96,"$1,105.23",$432.96,"$1,024.32",$432.96,$902.88,$432.96,"$1,105.23",$432.96,"$1,024.32",$432.96,"$1,056.00",$432.96,$432.96,"$1,024.32"
27331,0960,27331,,,,,N/A,N/A,EXPLORE/TREAT KNEE JOINT,"$1,084.61",$806.25,$41.00,"$1,075.00",$41.00,"$1,042.75",$41.00,$919.13,$41.00,$854.91,$41.00,"$1,042.75",$41.00,"$1,075.00",$41.00,$41.00,"$1,042.75"
27332,0960,27332,,,,,N/A,N/A,RESECTION PROC THIGH\KNEE,"$1,297.50",$964.50,$527.26,"$1,286.00",$527.26,"$1,247.42",$527.26,"$1,099.53",$527.26,"$1,155.08",$527.26,"$1,247.42",$527.26,"$1,286.00",$527.26,$527.26,"$1,247.42"
27334,0960,27334,,,,,N/A,N/A,REMOVE KNEE JOINT LINING,"$1,536.62","$1,142.25",$624.43,"$1,523.00",$624.43,"$1,477.31",$624.43,"$1,302.17",$624.43,"$1,226.00",$624.43,"$1,477.31",$624.43,"$1,523.00",$624.43,$624.43,"$1,477.31"
27335,0960,27335,,,,,N/A,N/A,RESCETION PROC THIGH\KNEE,"$1,524.51","$1,133.25",$619.51,"$1,511.00",$619.51,"$1,465.67",$619.51,"$1,291.91",$619.51,"$1,367.13",$619.51,"$1,465.67",$619.51,"$1,511.00",$619.51,$619.51,"$1,465.67"
27337,0960,27337,,,,,N/A,N/A,EXC THIGH/KNEE LES 3 CM >,$819.26,$609.00,$328.41,$742.65,$328.41,$574.24,$328.41,$506.16,$328.41,$742.65,$328.41,$574.24,$328.41,$592.00,$328.41,$328.41,$574.24
27340,0960,27340,,,,,N/A,N/A,EXCISION PREPATELLR BURSA,$702.22,$522.00,$285.36,$696.00,$285.36,$675.12,$285.36,$595.08,$285.36,$673.01,$285.36,$675.12,$285.36,$696.00,$285.36,$285.36,$675.12
27345,0960,27345,,,,,N/A,N/A,REMOVAL OF KNEE CYST,"$1,097.73",$816.00,$45.18,"$1,098.00",$45.18,"$1,065.06",$45.18,$938.79,$45.18,$869.73,$45.18,"$1,065.06",$45.18,"$1,098.00",$45.18,$45.18,"$1,065.06"
27347,0960,27347,,,,,N/A,N/A,EXC OF LESION,$759.73,$564.75,$38.73,$945.78,$38.73,$730.41,$38.73,$643.82,$38.73,$945.78,$38.73,$730.41,$38.73,$753.00,$38.73,$38.73,$730.41
27350,0960,27350,,,,,N/A,N/A,PATELLECTOMY OR HEMI,"$1,313.64",$976.50,$533.82,"$1,302.00",$533.82,"$1,262.94",$533.82,"$1,113.21",$533.82,"$1,169.35",$533.82,"$1,262.94",$533.82,"$1,302.00",$533.82,$533.82,"$1,262.94"
27355,0960,27355,,,,,N/A,N/A,REMOVE FEMUR LESION,"$1,374.18","$1,021.50",$558.42,"$1,362.00",$558.42,"$1,321.14",$558.42,"$1,164.51",$558.42,"$1,085.40",$558.42,"$1,321.14",$558.42,"$1,362.00",$558.42,$558.42,"$1,321.14"
27360,0960,27360,,,,,N/A,N/A,PART EXCIS BONE FEMR TIB,"$1,625.40","$1,208.25",$66.51,"$1,611.00",$66.51,"$1,562.67",$66.51,"$1,377.41",$66.51,"$1,607.43",$66.51,"$1,562.67",$66.51,"$1,611.00",$66.51,$66.51,"$1,562.67"
27372,0960,27372,,,,,N/A,N/A,REMOVAL OF FOREIGN BODY,$927.22,$689.25,$376.79,$919.00,$376.79,$891.43,$376.79,$785.75,$376.79,$716.24,$376.79,$891.43,$376.79,$919.00,$376.79,$376.79,$891.43
27380,0960,27380,,,,,N/A,N/A,TENDON REPAIR,"$1,372.16","$1,020.00",$557.60,"$1,360.00",$557.60,"$1,319.20",$557.60,"$1,162.80",$557.60,"$1,116.10",$557.60,"$1,319.20",$557.60,"$1,360.00",$557.60,$557.60,"$1,319.20"
27385,0960,27385,,,,,N/A,N/A,REPAIR OF THIGH MUSCLE,"$1,464.98","$1,089.00",$595.32,"$1,452.00",$595.32,"$1,408.44",$595.32,"$1,241.46",$595.32,"$1,087.66",$595.32,"$1,408.44",$595.32,"$1,452.00",$595.32,$595.32,"$1,408.44"
27386,0960,27386,,,,,N/A,N/A,REPAIR/GRAFT OF THIGH MUSCLE,"$1,911.94","$1,421.25",$776.95,"$1,895.00",$776.95,"$1,838.15",$776.95,"$1,620.23",$776.95,"$1,536.11",$776.95,"$1,838.15",$776.95,"$1,895.00",$776.95,$776.95,"$1,838.15"
27405,0960,27405,,,,,N/A,N/A,REPAIR OF KNEE LIGAMENT,"$1,291.44",$960.00,$524.80,"$1,280.00",$524.80,"$1,241.60",$524.80,"$1,094.40",$524.80,"$1,209.76",$524.80,"$1,241.60",$524.80,"$1,280.00",$524.80,$524.80,"$1,241.60"
27407,0960,27407,,,,,N/A,N/A,REPAIR OF KNEE LIGAMENT,"$1,773.72","$1,318.50",$72.78,"$1,758.00",$72.78,"$1,705.26",$72.78,"$1,503.09",$72.78,"$1,422.10",$72.78,"$1,705.26",$72.78,"$1,758.00",$72.78,$72.78,"$1,705.26"
27409,0960,27409,,,,,N/A,N/A,REPAIR\RECONST OF FEMUR/KNEE,"$1,946.25","$1,446.75",$79.89,"$1,929.00",$79.89,"$1,871.13",$79.89,"$1,649.30",$79.89,"$1,722.59",$79.89,"$1,871.13",$79.89,"$1,929.00",$79.89,$79.89,"$1,871.13"
27418,0960,27418,,,,,N/A,N/A,REPAIR DEGENERATED KNEECAP,"$1,886.72","$1,402.50",$766.70,"$1,940.00",$766.70,"$1,881.80",$766.70,"$1,658.70",$766.70,"$1,483.96",$766.70,"$1,881.80",$766.70,"$1,940.00",$766.70,$766.70,"$1,881.80"
27420,0960,27420,,,,,N/A,N/A,REVISION OF UNSTABLE KNEECAP,"$1,712.17","$1,272.75",$695.77,"$1,697.30",$695.77,"$1,646.38",$695.77,"$1,451.19",$695.77,"$1,327.63",$695.77,"$1,646.38",$695.77,"$1,697.30",$695.77,$695.77,"$1,646.38"
27422,0960,27422,,,,,N/A,N/A,REVISION OF UNSTABLE KNEECAP,"$1,709.14","$1,270.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
27425,0960,27425,,,,,N/A,N/A,LAT RETINACULAR RELEASE OPEN,"$1,019.03",$757.50,$814.80,"$1,010.00",N/A,$979.70,N/A,$863.55,N/A,$814.80,N/A,$979.70,N/A,"$1,010.00",N/A,N/A,$979.70
27427,0960,27427,,,,,N/A,N/A,"RECONSTRUCTION, KNEE","$1,638.52","$1,218.00",$665.84,"$1,624.00",$665.84,"$1,575.28",$665.84,"$1,388.52",$665.84,"$1,273.76",$665.84,"$1,575.28",$665.84,"$1,624.00",$665.84,$665.84,"$1,575.28"
27429,0960,27429,,,,,N/A,N/A,"RECONSTRUCTION, KNEE","$2,668.65","$1,983.75",$184.45,"$2,645.00",$184.45,"$2,565.65",$184.45,"$2,261.48",$184.45,"$2,235.51",$184.45,"$2,565.65",$184.45,"$2,645.00",$184.45,$184.45,"$2,565.65"
27430,0960,27430,,,,,N/A,N/A,REVISION OF THIGH MUSCLES,"$1,687.96","$1,254.75",$574.00,"$1,400.00",$574.00,"$1,358.00",$574.00,"$1,197.00",$574.00,"$1,325.84",$574.00,"$1,358.00",$574.00,"$1,400.00",$574.00,$574.00,"$1,358.00"
27437,0960,27437,,,,,N/A,N/A,ARTHROPLASTY PATELLA,"$1,001.88",$744.75,$47.13,"$1,182.09",$47.13,$963.21,$47.13,$849.02,$47.13,"$1,182.09",$47.13,$963.21,$47.13,$993.00,$47.13,$47.13,$963.21
27438,0960,27438,,,,,N/A,N/A,REPAIR\RECONST FEMUR\KNEE,"$1,696.03","$1,260.75",$689.21,"$1,681.00",$689.21,"$1,630.57",$689.21,"$1,437.26",$689.21,"$1,497.85",$689.21,"$1,630.57",$689.21,"$1,681.00",$689.21,$689.21,"$1,630.57"
27442,0960,27442,,,,,N/A,N/A,REVISION OF KNEE JOINT,"$1,991.65","$1,480.50",$89.34,"$1,974.00",$89.34,"$1,914.78",$89.34,"$1,687.77",$89.34,"$1,550.91",$89.34,"$1,914.78",$89.34,"$1,974.00",$89.34,$89.34,"$1,914.78"
27443,0960,27443,,,,,N/A,N/A,REVISION OF KNEE JOINT,"$1,877.64","$1,395.75",$763.10,"$1,861.00",$763.10,"$1,805.17",$763.10,"$1,687.77",$763.10,"$1,455.56",$763.10,"$1,805.17",$763.10,"$1,861.00",$763.10,$763.10,"$1,805.17"
27446,0960,27446,,,,,N/A,N/A,REVISION OF KNEE JOINT,"$2,600.04","$1,932.75",$156.57,"$5,277.00",$156.57,"$5,118.69",$156.57,"$4,511.84",$156.57,"$2,046.18",$156.57,"$5,118.69",$156.57,"$5,277.00",$156.57,$156.57,"$5,118.69"
27447,0960,27447,,,,,N/A,N/A,TOTAL KNEE ARTHROPLASTY,"$3,462.68","$2,574.00",$164.00,"$4,000.00",$164.00,"$3,880.00",$164.00,"$3,420.00",$164.00,"$2,274.40",$164.00,"$3,880.00",$164.00,"$4,000.00",$164.00,$164.00,"$3,880.00"
27450,0960,27450,,,,,N/A,N/A,INCISION OF THIGH,"$2,348.81","$1,746.00",$954.48,"$2,328.00",$954.48,"$2,258.16",$954.48,"$1,990.44",$954.48,"$1,807.24",$954.48,"$2,258.16",$954.48,"$2,328.00",$954.48,$954.48,"$2,258.16"
27455,0960,27455,,,,,N/A,N/A,REALIGNMENT OF KNEE,"$2,171.24","$1,614.00",$882.32,"$2,152.00",$882.32,"$2,087.44",$882.32,"$1,839.96",$882.32,"$1,708.43",$882.32,"$2,087.44",$882.32,"$2,152.00",$882.32,$882.32,"$2,087.44"
27470,0960,27470,,,,,N/A,N/A,REPAIR OF THIGH,"$2,666.63","$1,982.25",$183.63,"$2,643.00",$183.63,"$2,563.71",$183.63,"$2,259.77",$183.63,"$2,093.29",$183.63,"$2,563.71",$183.63,"$2,643.00",$183.63,$183.63,"$2,563.71"
27472,0960,27472,,,,,N/A,N/A,REPAIR/GRAFT OF THIGH,"$2,909.78","$2,163.00","$1,182.44","$2,884.00","$1,182.44","$2,797.48","$1,182.44","$2,465.82","$1,182.44","$2,242.67","$1,182.44","$2,797.48","$1,182.44","$2,884.00","$1,182.44","$1,182.44","$2,797.48"
27477,0960,27477,,,,,N/A,N/A,TIBIA & FIBULA PROXIMAL,"$1,475.07","$1,096.50",$599.42,"$1,462.00",$599.42,"$1,418.14",$599.42,"$1,250.01",$599.42,"$1,308.85",$599.42,"$1,418.14",$599.42,"$1,462.00",$599.42,$599.42,"$1,418.14"
27486,0960,27486,,,,,N/A,N/A,REVISE/REPLACE KNEE JOINT,"$3,140.83","$2,334.75","$1,276.33","$3,113.00","$1,276.33","$3,019.61","$1,276.33","$2,661.62","$1,276.33","$2,489.29","$1,276.33","$3,019.61","$1,276.33","$3,113.00","$1,276.33","$1,276.33","$3,019.61"
27487,0960,27487,,,,,N/A,N/A,REVISE/REPLACE KNEE JOINT,"$4,014.57","$2,984.25","$1,631.39","$3,979.00","$1,631.39","$3,859.63","$1,631.39","$3,402.05","$1,631.39","$3,102.29","$1,631.39","$3,859.63","$1,631.39","$3,979.00","$1,631.39","$1,631.39","$3,859.63"
27488,0960,27488,,,,,N/A,N/A,REMOVAL OF KNEE PROSTHESIS,"$2,627.28","$1,953.00",$167.64,"$2,604.00",$167.64,"$2,525.88",$167.64,"$2,226.42",$167.64,"$2,129.82",$167.64,"$2,525.88",$167.64,"$2,604.00",$167.64,$167.64,"$2,525.88"
27495,0960,27495,,,,,N/A,N/A,REINFORCE THIGH,"$2,581.88","$1,919.25",$149.19,"$2,559.00",$149.19,"$2,482.23",$149.19,"$2,187.95",$149.19,"$2,006.28",$149.19,"$2,482.23",$149.19,"$2,559.00",$149.19,$149.19,"$2,482.23"
27506,0960,27506,,,,,N/A,N/A,"TREATMENT, THIGH FRACTURE","$2,892.63","$2,150.25","$1,175.47","$2,867.00","$1,175.47","$2,780.99","$1,175.47","$2,451.29","$1,175.47","$2,372.89","$1,175.47","$2,780.99","$1,175.47","$2,867.00","$1,175.47","$1,175.47","$2,780.99"
27507,0960,27507,,,,,N/A,N/A,OPEN TREATMENT FEMORAL FX,"$1,874.61","$1,393.50",$761.78,"$1,858.00",$761.78,"$1,802.26",$761.78,"$1,588.59",$761.78,"$1,719.64",$761.78,"$1,802.26",$761.78,"$1,858.00",$761.78,$761.78,"$1,802.26"
27509,0960,27509,,,,,N/A,N/A,TREATMENT OF THIGH FRACTURE,"$1,488.19","$1,106.25",$64.75,"$1,475.00",$64.75,"$1,430.75",$64.75,"$1,261.13",$64.75,"$1,210.03",$64.75,"$1,430.75",$64.75,"$1,475.00",$64.75,$64.75,"$1,430.75"
27510,0960,27510,,,,,N/A,N/A,TREATMENT OF THIGH FRACTURE,"$1,569.91","$1,167.00",$637.96,"$1,556.00",$637.96,"$1,509.32",$637.96,"$1,330.38",$637.96,"$1,213.54",$637.96,"$1,509.32",$637.96,"$1,556.00",$637.96,$637.96,"$1,509.32"
27511,0960,27511,,,,,N/A,N/A,TREATMENT OF FEMORAL,"$1,408.48","$1,047.00",$572.36,"$1,768.82",$572.36,"$1,354.12",$572.36,"$1,193.58",$572.36,"$1,768.82",$572.36,"$1,354.12",$572.36,"$1,396.00",$572.36,$572.36,"$1,354.12"
27513,0960,27513,,,,,N/A,N/A,TREATMENT OF THIGH FRACTURE,"$3,038.93","$2,259.00","$1,234.92","$3,012.00","$1,234.92","$2,921.64","$1,234.92","$2,575.26","$1,234.92","$2,191.13","$1,234.92","$2,921.64","$1,234.92","$3,012.00","$1,234.92","$1,234.92","$2,921.64"
27514,0960,27514,,,,,N/A,N/A,OPEN TREAT OF FEMORAL FX,"$1,949.27","$1,449.00",$792.12,"$1,932.00",$792.12,"$1,874.04",$792.12,"$1,651.86",$792.12,"$1,716.21",$792.12,"$1,874.04",$792.12,"$1,932.00",$792.12,$792.12,"$1,874.04"
27524,0960,27524,,,,,N/A,N/A,TREAT KNEECAP FRACTURE,"$1,741.43","$1,294.50",$77.66,"$1,726.00",$77.66,"$1,674.22",$77.66,"$1,475.73",$77.66,"$1,344.24",$77.66,"$1,674.22",$77.66,"$1,726.00",$77.66,$77.66,"$1,674.22"
27532,0960,27532,,,,,N/A,N/A,TREAT KNEE FRACTURE,"$1,309.60",$973.50,$532.18,"$1,298.00",$532.18,"$1,259.06",$532.18,"$1,109.79",$532.18,"$1,033.50",$532.18,"$1,259.06",$532.18,"$1,298.00",$532.18,$532.18,"$1,259.06"
27535,0960,27535,,,,,N/A,N/A,TREAT KNEE FRACTURE,"$2,060.26","$1,531.50",$738.82,"$1,802.00",$738.82,"$1,747.94",$738.82,"$1,540.71",$738.82,"$1,595.11",$738.82,"$1,747.94",$738.82,"$1,802.00",$738.82,$738.82,"$1,747.94"
27536,0960,27536,,,,,N/A,N/A,TREATMENT OF FX,"$2,413.38","$1,794.00",$98.72,"$2,392.00",$98.72,"$2,320.24",$98.72,"$2,045.16",$98.72,"$2,103.70",$98.72,"$2,320.24",$98.72,"$2,392.00",$98.72,$98.72,"$2,320.24"
27540,0960,27540,,,,,N/A,N/A,TREAT KNEE FRACTURE,"$2,164.18","$1,608.75",$879.45,"$2,145.00",$879.45,"$2,080.65",$879.45,"$1,833.98",$879.45,"$1,451.89",$879.45,"$2,080.65",$879.45,"$2,145.00",$879.45,$879.45,"$2,080.65"
27552,0960,27552,,,,,N/A,N/A,FX OR DISLOC REQUIR ANES,"$1,190.55",$885.00,$483.80,"$1,180.00",$483.80,"$1,144.60",$483.80,"$1,008.90",$483.80,"$1,134.98",$483.80,"$1,144.60",$483.80,"$1,180.00",$483.80,$483.80,"$1,144.60"
27562,0960,27562,,,,,N/A,N/A,TREAT KNEECAP DISLOCATION,"$1,003.90",$746.25,$47.95,$995.00,$47.95,$965.15,$47.95,$850.73,$47.95,$878.82,$47.95,$965.15,$47.95,$995.00,$47.95,$47.95,$965.15
27570,0960,27570,,,,,N/A,N/A,FIXATION OF KNEE JOINT,$335.98,$249.75,$136.53,$333.00,$136.53,$323.01,$136.53,$284.72,$136.53,$271.21,$136.53,$323.01,$136.53,$333.00,$136.53,$136.53,$323.01
27590,0960,27590,,,,,N/A,N/A,AMPUTATE LEG AT FEMUR OR KNEE,"$1,786.83","$1,328.25",$658.87,"$1,607.00",$658.87,"$1,558.79",$658.87,"$1,373.99",$658.87,"$1,371.97",$658.87,"$1,558.79",$658.87,"$1,607.00",$658.87,$658.87,"$1,558.79"
27600,0960,27600,,,,,N/A,N/A,DECOMPRESSION OF LOWER LEG,$967.57,$719.25,$393.19,$959.00,$393.19,$930.23,$393.19,$819.95,$393.19,$714.89,$393.19,$930.23,$393.19,$959.00,$393.19,$393.19,$930.23
27602,0960,27602,,,,,N/A,N/A,DECOMPRESSION OF LOWER LEG,"$1,188.53",$883.50,$482.98,"$1,178.00",$482.98,"$1,142.66",$482.98,"$1,007.19",$482.98,$842.64,$482.98,"$1,142.66",$482.98,"$1,178.00",$482.98,$482.98,"$1,142.66"
27603,0960,27603,,,,,N/A,N/A,DRAIN LOWER LEG LESION,"$1,020.04",$758.25,$414.51,"$1,011.00",$414.51,$980.67,$414.51,$864.41,$414.51,$699.71,$414.51,$980.67,$414.51,"$1,011.00",$414.51,$414.51,$980.67
27606,0960,27606,,,,,N/A,N/A,INCISION OF ACHILLES TENDON,$716.35,$532.50,$291.10,$710.00,$291.10,$688.70,$291.10,$607.05,$291.10,$490.01,$291.10,$688.70,$291.10,$710.00,$291.10,$291.10,$688.70
27610,0960,27610,,,,,N/A,N/A,EXPLORE/TREAT ANKLE JOINT,"$1,462.96","$1,087.50",$594.50,"$1,450.00",$594.50,"$1,406.50",$594.50,"$1,239.75",$594.50,"$1,161.53",$594.50,"$1,406.50",$594.50,"$1,450.00",$594.50,$594.50,"$1,406.50"
27618,0960,27618,,,,,N/A,N/A,REMOVE LOWER LEG LESION,$859.62,$639.00,$349.32,$852.00,$349.32,$826.44,$349.32,$728.46,$349.32,$543.92,$349.32,$826.44,$349.32,$852.00,$349.32,$349.32,$826.44
27619,0960,27619,,,,,N/A,N/A,EXC LEG\ANK TUMOR,"$1,036.18",$770.25,$421.70,"$1,027.00",$421.70,$996.19,$421.70,$878.09,$421.70,$822.07,$421.70,$996.19,$421.70,"$1,027.00",$421.70,$421.70,$996.19
27620,0960,27620,,,,,N/A,N/A,EXPLORE/TREAT ANKLE JOINT,"$1,085.62",$807.00,$441.16,"$1,027.00",$441.16,$996.19,$441.16,$878.09,$441.16,$809.48,$441.16,$996.19,$441.16,"$1,027.00",$441.16,$441.16,$996.19
27630,0960,27630,,,,,N/A,N/A,REMOVAL OF TENDON LESION,"$1,144.14",$850.50,$464.94,"$1,134.00",$464.94,"$1,099.98",$464.94,$969.57,$464.94,$647.21,$464.94,"$1,099.98",$464.94,"$1,134.00",$464.94,$464.94,"$1,099.98"
27632,0960,27632,,,,,N/A,N/A,EXC LEG/ANKLE LES SC 3 CM/>,$817.24,$607.50,$332.10,$810.00,$332.10,$785.70,$332.10,$692.55,$332.10,$731.88,$332.10,$785.70,$332.10,$810.00,$332.10,$332.10,$785.70
27634,0960,27634,,,,,N/A,N/A,EXC LEG/ANKLE TUM DEP 5 CM/>,"$1,347.94","$1,002.00",$547.76,"$1,336.00",$547.76,"$1,295.92",$547.76,"$1,142.28",$547.76,"$1,203.82",$547.76,"$1,295.92",$547.76,"$1,336.00",$547.76,$547.76,"$1,295.92"
27635,0960,27635,,,,,N/A,N/A,REMOVE LOWER LEG BONE LESION,"$1,383.26","$1,028.25",$562.11,"$1,371.00",$562.11,"$1,329.87",$562.11,"$1,172.21",$562.11,"$1,043.19",$562.11,"$1,329.87",$562.11,"$1,371.00",$562.11,$562.11,"$1,329.87"
27637,0960,27637,,,,,N/A,N/A,REMOVE/GRAFT LEG BONE LESION,"$1,729.32","$1,285.50",$72.74,"$1,714.00",$72.74,"$1,662.58",$72.74,"$1,465.47",$72.74,"$1,325.48",$72.74,"$1,662.58",$72.74,"$1,714.00",$72.74,$72.74,"$1,662.58"
27638,0960,27638,,,,,N/A,N/A,REMOVE/GRAFT LEG BONE LESION,"$1,800.96","$1,338.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
27640,0960,27640,,,,,N/A,N/A,PARTIAL REMOVAL OF TIBIA,"$2,058.24","$1,530.00",$836.40,"$2,040.00",$836.40,"$1,978.80",$836.40,"$1,744.20",$836.40,"$1,483.30",$836.40,"$1,978.80",$836.40,"$2,040.00",$836.40,$836.40,"$1,978.80"
27641,0960,27641,,,,,N/A,N/A,PARTIAL REMOVAL OF FIBULA,"$1,668.79","$1,240.50",$678.14,"$1,654.00",$678.14,"$1,604.38",$678.14,"$1,414.17",$678.14,"$1,172.81",$678.14,"$1,604.38",$678.14,"$1,654.00",$678.14,$678.14,"$1,604.38"
27650,0960,27650,,,,,N/A,N/A,REPAIR ACHILLES TENDON,"$1,641.55","$1,220.25",$667.70,"$1,627.00",$667.70,"$1,578.19",$667.70,"$1,391.09",$667.70,"$1,182.58",$667.70,"$1,578.19",$667.70,"$1,627.00",$667.70,$667.70,"$1,578.19"
27652,0960,27652,,,,,N/A,N/A,REPAIR/GRAFT ACHILLES TENDON,"$1,752.53","$1,302.75",$712.17,"$1,737.00",$712.17,"$1,684.89",$712.17,"$1,485.14",$712.17,"$1,190.05",$712.17,"$1,684.89",$712.17,"$1,737.00",$712.17,$712.17,"$1,684.89"
27654,0960,27654,,,,,N/A,N/A,REPAIR/RECON LOWER LEG,"$1,444.80","$1,074.00",$587.12,"$1,432.00",$587.12,"$1,389.04",$587.12,"$1,224.36",$587.12,"$1,274.95",$587.12,"$1,389.04",$587.12,"$1,432.00",$587.12,$587.12,"$1,389.04"
27658,0960,27658,,,,,N/A,N/A,REPAIR FLEXORTENDON LEG,$862.64,$641.25,$35.55,$855.00,$35.55,$829.35,$35.55,$731.03,$35.55,$664.00,$35.55,$829.35,$35.55,$855.00,$35.55,$35.55,$829.35
27664,0960,27664,,,,,N/A,N/A,REPAIR EXTENSOR TENDON,$851.55,$633.00,$346.40,$844.00,$346.40,$818.68,$346.40,$721.62,$346.40,$650.81,$346.40,$818.68,$346.40,$844.00,$346.40,$346.40,$818.68
27676,0960,27676,,,,,N/A,N/A,REPR DSLCPRSNL TENDW\FIB OS,"$1,202.66",$894.00,$488.72,"$1,192.00",$488.72,"$1,156.24",$488.72,"$1,019.16",$488.72,"$1,071.91",$488.72,"$1,156.24",$488.72,"$1,192.00",$488.72,$488.72,"$1,156.24"
27680,0960,27680,,,,,N/A,N/A,RELEASE OF LOWER LEG TENDON,"$1,032.15",$767.25,$419.43,"$1,023.00",$419.43,$992.31,$419.43,$874.67,$419.43,$753.16,$419.43,$992.31,$419.43,"$1,023.00",$419.43,$419.43,$992.31
27685,0960,27685,,,,,N/A,N/A,REPAIR FLEXORTENDON LEG,$868.70,$645.75,$353.10,$861.00,$353.10,$835.17,$353.10,$736.16,$353.10,$833.17,$353.10,$835.17,$353.10,$861.00,$353.10,$353.10,$835.17
27687,0960,27687,,,,,N/A,N/A,REVISION OF CALF TENDON,"$1,098.74",$816.75,$446.49,"$1,089.00",$446.49,"$1,056.33",$446.49,$931.10,$446.49,$814.76,$446.49,"$1,056.33",$446.49,"$1,089.00",$446.49,$446.49,"$1,056.33"
27691,0960,27691,,,,,N/A,N/A,REVISE LOWER LEG TENDON,"$1,690.98","$1,257.00",$617.50,"$1,505.00",$617.50,"$1,459.85",$617.50,"$1,286.78",$617.50,"$1,332.52",$617.50,"$1,459.85",$617.50,"$1,505.00",$617.50,$617.50,"$1,459.85"
27695,0960,27695,,,,,N/A,N/A,REAPAIR OF ANKLE LIGAMENT,"$1,176.42",$874.50,$478.60,"$1,166.00",$478.60,"$1,131.02",$478.60,$996.93,$478.60,$853.56,$478.60,"$1,131.02",$478.60,"$1,166.00",$478.60,$478.60,"$1,131.02"
27698,0960,27698,,,,,N/A,N/A,REPAIR OF ANKLE LIGAMENT,"$1,554.78","$1,155.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
27720,0960,27720,,,,,N/A,N/A,REPAIR OF TIBIA,"$2,023.93","$1,504.50",$822.46,"$2,006.00",$822.46,"$1,945.82",$822.46,"$1,715.13",$822.46,"$1,560.00",$822.46,"$1,945.82",$822.46,"$2,006.00",$822.46,$822.46,"$1,945.82"
27726,0960,27726,,,,,N/A,N/A,REPAIR FIBULA NONUNION,"$1,865.53","$1,386.75",$758.90,$758.90,$758.90,N/A,$758.90,N/A,$758.90,N/A,$758.90,N/A,$758.90,N/A,$758.90,$758.90,N/A
27752,0960,27752,,,,,N/A,N/A,TREATMENT OF TIBIA FRACTURE,"$1,093.69",$813.00,$444.44,"$1,084.00",$444.44,"$1,051.48",$444.44,$926.82,$444.44,$882.83,$444.44,"$1,051.48",$444.44,"$1,084.00",$444.44,$444.44,"$1,051.48"
27756,0960,27756,,,,,N/A,N/A,PRTNEOUS SKLTAL FX OF TIB,"$1,120.93",$833.25,$455.51,"$1,111.00",$455.51,"$1,077.67",$455.51,$949.91,$455.51,"$1,033.60",$455.51,"$1,077.67",$455.51,"$1,111.00",$455.51,$455.51,"$1,077.67"
27758,0960,27758,,,,,N/A,N/A,OPEN TRTMENT TIBIAL SHFT FX,"$1,729.32","$1,285.50",$72.74,"$1,714.00",$72.74,"$1,662.58",$72.74,"$1,465.47",$72.74,"$1,596.00",$72.74,"$1,662.58",$72.74,"$1,714.00",$72.74,$72.74,"$1,662.58"
27759,0960,27759,,,,,N/A,N/A,TREATMENT OF TIBIA FRACTURE,"$2,302.40","$1,711.50",$935.62,"$2,282.00",$935.62,"$2,213.54",$935.62,"$1,951.11",$935.62,"$1,774.28",$935.62,"$2,213.54",$935.62,"$2,282.00",$935.62,$935.62,"$2,213.54"
27766,0960,27766,,,,,N/A,N/A,TREATMENT OF ANKLE FRACTURE,"$1,486.17","$1,104.75",$63.93,"$1,473.00",$63.93,"$1,428.81",$63.93,"$1,259.42",$63.93,"$1,085.87",$63.93,"$1,428.81",$63.93,"$1,473.00",$63.93,$63.93,"$1,428.81"
27769,0960,27769,,,,,N/A,N/A,OPTX POST ANKLE FX,"$1,409.49","$1,047.75",$572.77,"$1,397.00",$572.77,"$1,355.09",$572.77,"$1,194.44",$572.77,"$1,305.54",$572.77,"$1,355.09",$572.77,"$1,397.00",$572.77,$572.77,"$1,355.09"
27781,0960,27781,,,,,N/A,N/A,TREATMENT OF FIBULA FRACTURE,$856.59,$636.75,$348.90,$829.00,$348.90,$804.13,$348.90,$708.80,$348.90,$721.52,$348.90,$804.13,$348.90,$829.00,$348.90,$348.90,$804.13
27788,0960,27788,,,,,N/A,N/A,TREATMENT OF ANKLE FRACTURE,$862.64,$641.25,$694.74,$855.00,N/A,$829.35,N/A,$731.03,N/A,$694.74,N/A,$829.35,N/A,$855.00,N/A,N/A,$829.35
27792,0960,27792,,,,,N/A,N/A,TREATMENT OF ANKLE FRACTURE,"$1,392.34","$1,035.00",$565.80,"$1,380.00",$565.80,"$1,338.60",$565.80,"$1,179.90",$565.80,"$1,156.52",$565.80,"$1,338.60",$565.80,"$1,380.00",$565.80,$565.80,"$1,338.60"
27810,0960,27810,,,,,N/A,N/A,FX\DISLOC W\MANIPULATION,$631.60,$469.50,$256.66,$764.31,$256.66,$607.22,$256.66,$535.23,$256.66,$764.31,$256.66,$607.22,$256.66,$626.00,$256.66,$256.66,$607.22
27814,0960,27814,,,,,N/A,N/A,TREATMENT OF ANKLE FRACTURE,"$1,838.29","$1,366.50",$747.20,"$1,822.00",$747.20,"$1,767.34",$747.20,"$1,557.81",$747.20,"$1,367.87",$747.20,"$1,767.34",$747.20,"$1,822.00",$747.20,$747.20,"$1,767.34"
27818,0960,27818,,,,,N/A,N/A,CLOSED FX TRIMALL ANKLE W/MAL,"$1,009.95",$750.75,$41.41,"$1,001.00",$41.41,$970.97,$41.41,$855.86,$41.41,$783.77,$41.41,$970.97,$41.41,"$1,001.00",$41.41,$41.41,$970.97
27822,0960,27822,,,,,N/A,N/A,TREATMENT OF ANKLE FRACTURE,"$2,057.23","$1,529.25",$835.99,"$2,039.00",$835.99,"$1,977.83",$835.99,"$1,743.35",$835.99,"$1,570.90",$835.99,"$1,977.83",$835.99,"$2,039.00",$835.99,$835.99,"$1,977.83"
27823,0960,27823,,,,,N/A,N/A,TREAT OF FX W/FIXATION,"$1,932.12","$1,436.25",$785.15,"$1,915.00",$785.15,"$1,857.55",$785.15,"$1,637.33",$785.15,"$1,765.45",$785.15,"$1,857.55",$785.15,"$1,915.00",$785.15,$785.15,"$1,857.55"
27825,0960,27825,,,,,N/A,N/A,TREAT LOWER LEG FRACTURE,"$1,100.75",$818.25,$447.31,"$1,091.00",$447.31,"$1,058.27",$447.31,$932.81,$447.31,$880.73,$447.31,"$1,058.27",$447.31,"$1,091.00",$447.31,$447.31,"$1,058.27"
27827,0960,27827,,,,,N/A,N/A,TREAT LOWER LEG FRACTURE,"$2,553.63","$1,898.25",$887.24,"$2,164.00",$887.24,"$2,099.08",$887.24,"$1,850.22",$887.24,"$2,003.42",$887.24,"$2,099.08",$887.24,"$2,164.00",$887.24,$887.24,"$2,099.08"
27828,0960,27828,,,,,N/A,N/A,TREATMENT OF FX\DISLOC FOOT,"$2,615.17","$1,944.00",$162.72,"$2,592.00",$162.72,"$2,514.24",$162.72,"$2,216.16",$162.72,"$2,370.79",$162.72,"$2,514.24",$162.72,"$2,592.00",$162.72,$162.72,"$2,514.24"
27829,0960,27829,,,,,N/A,N/A,TREAT LOWER LEG JOINT,"$1,333.82",$991.50,$471.90,"$1,275.22",$471.90,"$1,114.53",$471.90,$982.40,$471.90,"$1,275.22",$471.90,"$1,114.53",$471.90,"$1,149.00",$471.90,$471.90,"$1,114.53"
27848,0960,27848,,,,,N/A,N/A,TREAT ANKLE DISLOCATION,"$1,991.65","$1,480.50",$89.34,$89.34,$89.34,N/A,$89.34,N/A,$89.34,N/A,$89.34,N/A,$89.34,N/A,$89.34,$89.34,N/A
27860,0960,27860,,,,,N/A,N/A,FIXATION OF ANKLE JOINT,$413.67,$307.50,$300.83,$410.00,N/A,$397.70,N/A,$350.55,N/A,$300.83,N/A,$397.70,N/A,$410.00,N/A,N/A,$397.70
27870,0960,27870,,,,,N/A,N/A,"FUSION OF ANKLE JOINT, OPEN","$2,335.70","$1,736.25",$949.15,$949.15,$949.15,N/A,$949.15,N/A,$949.15,N/A,$949.15,N/A,$949.15,N/A,$949.15,$949.15,N/A
27880,0960,27880,,,,,N/A,N/A,AMPUTATION OF LOWER LEG,"$1,812.06","$1,347.00",$736.36,"$2,315.00",$736.36,"$2,245.55",$736.36,"$1,979.33",$736.36,"$1,573.34",$736.36,"$2,245.55",$736.36,"$2,315.00",$736.36,$736.36,"$2,245.55"
27884,0960,27884,,,,,N/A,N/A,AMPUTATION FOLLOW-UP SURGERY,"$1,329.78",$988.50,$54.38,"$1,318.00",$54.38,"$1,278.46",$54.38,"$1,126.89",$54.38,"$1,008.71",$54.38,"$1,278.46",$54.38,"$1,318.00",$54.38,$54.38,"$1,278.46"
27894,0960,27894,,,,,N/A,N/A,DECOMPRESSION OF LEG,"$1,740.42","$1,293.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
27093,0960,27903,,,,,N/A,N/A,INJECTION PRODCEDURE OF HIP,$538.77,$400.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
28008,0960,28008,,,,,N/A,N/A,INCISION OF FOOT FASCIA,$725.43,$539.25,$294.79,$719.00,$294.79,$697.43,$294.79,$614.75,$294.79,$530.91,$294.79,$697.43,$294.79,$719.00,$294.79,$294.79,$697.43
28010,0960,28010,,,,,N/A,N/A,INCISION OF TOE TENDON,$494.38,$367.50,$2.90,$490.00,$2.90,$475.30,$2.90,$418.95,$2.90,$372.35,$2.90,$475.30,$2.90,$490.00,$2.90,$2.90,$475.30
28020,0960,28020,,,,,N/A,N/A,EXPLORATION OF FOOT JOINT,$866.68,$644.25,$352.19,$859.00,$352.19,$833.23,$352.19,$734.45,$352.19,$656.90,$352.19,$833.23,$352.19,$859.00,$352.19,$352.19,$833.23
28035,0960,28035,,,,,N/A,N/A,DECOMPRESSION TIBIA NERVE,$869.71,$646.50,$394.42,$862.00,$394.42,$836.14,$394.42,$737.01,$394.42,$639.30,$394.42,$836.14,$394.42,$862.00,$394.42,$394.42,$836.14
28039,0960,28039,,,,,N/A,N/A,EXC FOOT/TOE TUM SC 1.5 CM/>,$712.31,$529.50,$271.83,$663.00,$271.83,$643.11,$271.83,$566.87,$271.83,$618.69,$271.83,$643.11,$271.83,$663.00,$271.83,$271.83,$643.11
28043,0960,28043,,,,,N/A,N/A,EXCISION OF FOOT LESION,$632.61,$470.25,$257.70,$627.00,$257.70,$608.19,$257.70,$536.09,$257.70,$466.89,$257.70,$608.19,$257.70,$627.00,$257.70,$257.70,$608.19
28060,0960,28060,,,,,N/A,N/A,"PARTIAL REMOVAL, FOOT FASCIA",$863.65,$642.00,$35.96,$856.00,$35.96,$830.32,$35.96,$731.88,$35.96,$647.57,$35.96,$830.32,$35.96,$856.00,$35.96,$35.96,$830.32
28080,0960,28080,,,,,N/A,N/A,REMOVAL OF FOOT LESION,$720.38,$535.50,$277.57,$277.57,$277.57,N/A,$277.57,N/A,$277.57,N/A,$277.57,N/A,$277.57,N/A,$277.57,$277.57,N/A
28086,0960,28086,,,,,N/A,N/A,EXCISE FOOT TENDON SHEATH,$895.94,$666.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
28088,0960,28088,,,,,N/A,N/A,EXCISE FOOT TENDON SHEATH,$734.51,$546.00,$298.48,$728.00,$298.48,$706.16,$298.48,$622.44,$298.48,$506.14,$298.48,$706.16,$298.48,$728.00,$298.48,$298.48,$706.16
28090,0960,28090,,,,,N/A,N/A,REMOVAL OF FOOT LESION,$744.60,$553.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
28092,0960,28092,,,,,N/A,N/A,REMOVAL OF TOE LESIONS,$674.98,$501.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
28100,0960,28100,,,,,N/A,N/A,EXC/CURT CYST/TUMOR TAL/CAL,$980.69,$729.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
28103,0960,28103,,,,,N/A,N/A,RESECTION PROC FOOT/TOES,"$1,056.36",$785.25,$325.54,$764.00,$325.54,$741.08,$325.54,$653.22,$325.54,$697.19,$325.54,$741.08,$325.54,$764.00,$325.54,$325.54,$741.08
28104,0960,28104,,,,,N/A,N/A,REMOVAL OF FOOT LESION,$857.60,$637.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
28108,0960,28108,,,,,N/A,N/A,REMOVAL OF FOOT LESIONS,$701.21,$521.25,$284.95,$695.00,$284.95,$674.15,$284.95,$594.23,$284.95,$515.66,$284.95,$674.15,$284.95,$695.00,$284.95,$284.95,$674.15
28110,0960,28110,,,,,N/A,N/A,PARTIAL REMOVAL OF METATARSAL,$691.12,$513.75,$28.85,$695.00,$28.85,$674.15,$28.85,$594.23,$28.85,$520.24,$28.85,$674.15,$28.85,$695.00,$28.85,$28.85,$674.15
28114,0960,28114,,,,,N/A,N/A,PARTIAL REMOVAL OF METATARSAL,"$1,721.25","$1,279.50","$1,492.23","$1,706.00",N/A,"$1,654.82",N/A,"$1,458.63",N/A,"$1,492.23",N/A,"$1,654.82",N/A,"$1,706.00",N/A,N/A,"$1,654.82"
28118,0960,28118,,,,,N/A,N/A,REMOVAL OF HEEL BONE,$978.67,$727.50,$397.70,$970.00,$397.70,$940.90,$397.70,$829.35,$397.70,$750.92,$397.70,$940.90,$397.70,$970.00,$397.70,$397.70,$940.90
28119,0960,28119,,,,,N/A,N/A,REMOVAL OF HEEL SPUR,$864.66,$642.75,$287.41,$701.00,$287.41,$679.97,$287.41,$599.36,$287.41,$648.64,$287.41,$679.97,$287.41,$701.00,$287.41,$287.41,$679.97
28120,0960,28120,,,,,N/A,N/A,RELEASE OF FOOT TENDON,$984.73,$732.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
28122,0960,28122,,,,,N/A,N/A,TARSAL OR METATARSAL BONE,$753.68,$560.25,$36.27,$783.60,$36.27,$724.59,$36.27,$638.69,$36.27,$783.60,$36.27,$724.59,$36.27,$747.00,$36.27,$36.27,$724.59
28124,0960,28124,,,,,N/A,N/A,PARTIAL REMOVAL OF TOE,$799.08,$594.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
28190,0960,28190,,,,,N/A,N/A,REMOVAL OF FOOT FOREIGN BODY,$350.10,$260.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
28192,0960,28192,,,,,N/A,N/A,REMOVAL OF FOOT FOREIGN BODY,$782.94,$582.00,$318.16,$776.00,$318.16,$752.72,$318.16,$663.48,$318.16,$559.29,$318.16,$752.72,$318.16,$776.00,$318.16,$318.16,$752.72
28200,0960,28200,,,,,N/A,N/A,REPAIR OF FOOT TENDON,$772.85,$574.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
28208,0960,28208,,,,,N/A,N/A,REPAIR\RECONST FOOT\TOE,$637.65,$474.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
28222,0960,28222,,,,,N/A,N/A,RELEASE OF FOOT TENDONS,$922.17,$685.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
28226,0960,28226,,,,,N/A,N/A,RELEASE OF FOOT TENDONS,$780.92,$580.50,$317.34,$317.34,$317.34,N/A,$317.34,N/A,$317.34,N/A,$317.34,N/A,$317.34,N/A,$317.34,$317.34,N/A
28232,0960,28232,,,,,N/A,N/A,INCISION OF TOE TENDON,$631.60,$469.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
28238,0960,28238,,,,,N/A,N/A,REVISION OF FOOT TENDON,"$1,205.68",$896.25,$489.95,"$1,195.00",$489.95,"$1,159.15",$489.95,"$1,021.73",$489.95,$865.91,$489.95,"$1,159.15",$489.95,"$1,195.00",$489.95,$489.95,"$1,159.15"
28270,0960,28270,,,,,N/A,N/A,CAP METATARS JOINT,$680.03,$505.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
28280,0960,28280,,,,,N/A,N/A,FUSION OF TOES,$915.11,$680.25,$371.87,$907.00,$371.87,$879.79,$371.87,$775.49,$371.87,$620.35,$371.87,$879.79,$371.87,$907.00,$371.87,$371.87,$879.79
28285,0960,28285,,,,,N/A,N/A,CORRECTION HAMMER TOE,$733.50,$545.25,$684.58,$752.00,N/A,$729.44,N/A,$642.96,N/A,$684.58,N/A,$729.44,N/A,$752.00,N/A,N/A,$729.44
28288,0960,28288,,,,,N/A,N/A,PARTIAL REMOVAL OF FOOT BONE,$906.03,$673.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
28289,0960,28289,,,,,N/A,N/A,REPAIR OF HALLUX RIGIDUS,"$1,212.75",$901.50,$492.82,"$1,202.00",$492.82,"$1,165.94",$492.82,"$1,027.71",$492.82,$820.25,$492.82,"$1,165.94",$492.82,"$1,202.00",$492.82,$492.82,"$1,165.94"
28291,0960,28291,,,,,N/A,N/A,REPAIR/RECONSTRUCT FOOT/TOE,"$1,445.81","$1,074.75",$587.53,$587.53,$587.53,N/A,$587.53,N/A,$587.53,N/A,$587.53,N/A,$587.53,N/A,$587.53,$587.53,N/A
28292,0960,28292,,,,,N/A,N/A,CORRECTION OF BUNION,"$1,190.55",$885.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
28295,0960,28295,,,,,N/A,N/A,REPAIR/RECONSTRUCT FOOT/TOE,"$1,263.19",$939.00,$513.32,$513.32,$513.32,N/A,$513.32,N/A,$513.32,N/A,$513.32,N/A,$513.32,N/A,$513.32,$513.32,N/A
28296,0960,28296,,,,,N/A,N/A,CORRECTION OF BUNION,"$1,387.29","$1,031.25",$563.75,"$1,375.00",$563.75,"$1,333.75",$563.75,"$1,175.63",$563.75,$918.57,$563.75,"$1,333.75",$563.75,"$1,375.00",$563.75,$563.75,"$1,333.75"
28297,0960,28297,,,,,N/A,N/A,CORRECTION OF BUNION,"$1,469.02","$1,092.00",$596.96,"$1,502.00",$596.96,"$1,456.94",$596.96,"$1,284.21",$596.96,"$1,078.57",$596.96,"$1,456.94",$596.96,"$1,502.00",$596.96,$596.96,"$1,456.94"
28298,0960,28298,,,,,N/A,N/A,CORRECTION OF BUNION,"$1,229.90",$914.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
28300,0960,28300,,,,,N/A,N/A,INCISION OF HEEL BONE,"$1,583.03","$1,176.75",$643.29,"$1,569.00",$643.29,"$1,521.93",$643.29,"$1,341.50",$643.29,"$1,161.14",$643.29,"$1,521.93",$643.29,"$1,569.00",$643.29,$643.29,"$1,521.93"
28308,0960,28308,,,,,N/A,N/A,INCISION OF METATARSAL,$851.55,$633.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
28313,0960,28313,,,,,N/A,N/A,REPAIR DEFORMITY OF TOE,$931.25,$692.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
28322,0960,28322,,,,,N/A,N/A,REPAIR\RECONST OF FOOT,"$1,181.47",$878.25,$48.11,"$1,171.00",$48.11,"$1,135.87",$48.11,"$1,001.21",$48.11,"$1,030.52",$48.11,"$1,135.87",$48.11,"$1,171.00",$48.11,$48.11,"$1,135.87"
28435,0960,28435,,,,,N/A,N/A,TREATMENT OF ANKLE FRACTURE,$674.98,$501.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
28445,0960,28445,,,,,N/A,N/A,TREAT ANKLE FRACTURE,"$2,549.59","$1,895.25",$136.70,"$2,527.00",$136.70,"$2,451.19",$136.70,"$2,160.59",$136.70,"$1,830.34",$136.70,"$2,451.19",$136.70,"$2,527.00",$136.70,$136.70,"$2,451.19"
28475,0960,28475,,,,,N/A,N/A,TREAT METATARSAL FRACTURE,$583.17,$433.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
28476,0960,28476,,,,,N/A,N/A,TREAT METATARSAL FRACTURE,$784.96,$583.50,$318.98,$778.00,$318.98,$754.66,$318.98,$665.19,$318.98,$697.37,$318.98,$754.66,$318.98,$778.00,$318.98,$318.98,$754.66
28505,0960,28505,,,,,N/A,N/A,TREAT BIG TOE FRACTURE,$979.68,$728.25,$398.11,$971.00,$398.11,$941.87,$398.11,$830.21,$398.11,$890.10,$398.11,$941.87,$398.11,$971.00,$398.11,$398.11,$941.87
28525,0960,28525,,,,,N/A,N/A,TREAT TOE FRACTURE,$790.00,$587.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
28660,0960,28660,,,,,N/A,N/A,TREAT TOE DISLOCATION,$191.70,$142.50,$77.90,$190.00,$77.90,$184.30,$77.90,$162.45,$77.90,$164.42,$77.90,$184.30,$77.90,$190.00,$77.90,$77.90,$184.30
28705,0960,28705,,,,,N/A,N/A,ARTHRODESIS PATALAR,"$1,998.71","$1,485.75",$812.21,"$2,167.93",$812.21,"$1,921.57",$812.21,"$1,693.76",$812.21,"$2,167.93",$812.21,"$1,921.57",$812.21,"$1,981.00",$812.21,$812.21,"$1,921.57"
28715,0960,28715,,,,,N/A,N/A,FUSION OF FOOT BONES,"$2,182.34","$1,622.25",$886.83,"$2,163.00",$886.83,"$2,098.11",$886.83,"$1,849.37",$886.83,"$1,680.91",$886.83,"$2,098.11",$886.83,"$2,163.00",$886.83,$886.83,"$2,098.11"
28725,0960,28725,,,,,N/A,N/A,FUSION OF FOOT BONES,"$1,895.80","$1,409.25",$633.45,"$1,546.00",$633.45,"$1,499.62",$633.45,"$1,321.83",$633.45,"$1,388.80",$633.45,"$1,499.62",$633.45,"$1,546.00",$633.45,$633.45,"$1,499.62"
28750,0960,28750,,,,,N/A,N/A,FUSION OF BIG TOE,"$1,430.68","$1,063.50",$581.38,"$1,418.00",$581.38,"$1,375.46",$581.38,"$1,212.39",$581.38,"$1,040.51",$581.38,"$1,375.46",$581.38,"$1,418.00",$581.38,$581.38,"$1,375.46"
28755,0960,28755,,,,,N/A,N/A,ARTHRODESIS INTER JOINT,$666.91,$495.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
28810,0960,28810,,,,,N/A,N/A,AMPUTATION TOE SINGLE,$857.60,$637.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
28820,0960,28820,,,,,N/A,N/A,AMPUTATION OF TOE,$781.93,$581.25,$314.88,$768.00,$314.88,$744.96,$314.88,$656.64,$314.88,$320.60,$314.88,$744.96,$314.88,$768.00,$314.88,$314.88,$744.96
28825,0960,28825,,,,,N/A,N/A,REPAIR RECONSTR OF FOOT\TOE,$758.72,$564.00,$38.32,$752.00,$38.32,$729.44,$38.32,$642.96,$38.32,$311.09,$38.32,$729.44,$38.32,$752.00,$38.32,$38.32,$729.44
29065,0960,29065,,,,,N/A,N/A,APPLICATION OF LONG ARM CAST,$242.15,$180.00,$98.40,$240.00,$98.40,$232.80,$98.40,$205.20,$98.40,$120.15,$98.40,$232.80,$98.40,$240.00,$98.40,$98.40,$232.80
29075,0960,29075,,,,,N/A,N/A,APPLICATION OF FOREARM CAST,$139.23,$103.50,$56.58,$138.00,$56.58,$133.86,$56.58,$117.99,$56.58,$110.37,$56.58,$133.86,$56.58,$138.00,$56.58,$56.58,$133.86
29085,0960,29085,,,,,N/A,N/A,"APPLICATION CAST, HAND/WRIST",$242.15,$180.00,$57.40,$240.00,$57.40,$232.80,$57.40,$205.20,$57.40,$118.54,$57.40,$232.80,$57.40,$240.00,$57.40,$57.40,$232.80
29105,0960,29105,,,,,N/A,N/A,APPLY LONG ARM SPLINT,$133.18,$99.00,$54.12,$132.00,$54.12,$128.04,$54.12,$112.86,$54.12,$73.88,$54.12,$128.04,$54.12,$132.00,$54.12,$54.12,$128.04
29125,0960,29125,,,,,N/A,N/A,APPLY FOREARM SPLINT,$93.83,$69.75,$36.49,$93.00,$36.49,$90.21,$36.49,$79.52,$36.49,$70.50,$36.49,$90.21,$36.49,$93.00,$36.49,$36.49,$90.21
29130,0960,29130,,,,,N/A,N/A,APPLICATION OF FINGER SPLINT,$65.58,$48.75,$26.65,$65.00,$26.65,$63.05,$26.65,$55.58,$26.65,$50.99,$26.65,$63.05,$26.65,$65.00,$26.65,$26.65,$63.05
29131,0960,29131,,,,,N/A,N/A,APPLICATION OF FINGER SPLINT,$75.67,$56.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
29280,0960,29280,,,,,N/A,N/A,STRAPPING OF HAND OR FINGER,$78.70,$58.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
29345,0960,29345,,,,,N/A,N/A,APPLICATION OF LONG LEG CAST,$237.10,$176.25,$96.35,$235.00,$96.35,$227.95,$96.35,$200.93,$96.35,$175.91,$96.35,$227.95,$96.35,$235.00,$96.35,$96.35,$227.95
29365,0960,29365,,,,,N/A,N/A,APPLICATION OF LONG LEG CAST,$205.82,$153.00,$153.10,$204.00,N/A,$197.88,N/A,$174.42,N/A,$153.10,N/A,$197.88,N/A,$204.00,N/A,N/A,$197.88
29425,0960,29425,,,,,N/A,N/A,APPLY SHORT LEG CAST,$168.49,$125.25,$53.30,$130.00,$53.30,$126.10,$53.30,$111.15,$53.30,$97.25,$53.30,$126.10,$53.30,$130.00,$53.30,$53.30,$126.10
29505,0960,29505,,,,,N/A,N/A,APPLICATION OF SPLINT,$109.97,$81.75,$41.00,$100.00,$41.00,$97.00,$41.00,$85.50,$41.00,$91.41,$41.00,$97.00,$41.00,$100.00,$41.00,$41.00,$97.00
29515,0960,29515,,,,,N/A,N/A,APPLICATION LOWER LEG SPLINT,$115.02,$85.50,$46.74,$114.00,$46.74,$110.58,$46.74,$97.47,$46.74,$86.92,$46.74,$110.58,$46.74,$114.00,$46.74,$46.74,$110.58
29540,0960,29540,,,,,N/A,N/A,STRAPPING OF ANKLE AND/OR FT,$78.70,$58.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
29550,0960,29550,,,,,N/A,N/A,STRAPPING OF TOES,$73.65,$54.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
29580,0960,29580,,,,,N/A,N/A,APPLICATION OF PASTE BOOT,$89.80,$66.75,$36.49,$89.00,$36.49,$86.33,$36.49,$76.10,$36.49,$46.77,$36.49,$86.33,$36.49,$89.00,$36.49,$36.49,$86.33
29581,0960,29581,,,,,N/A,N/A,APPLY MULTLAY COMPRS LWR LEG,$96.86,$72.00,$39.36,$96.00,$39.36,$93.12,$39.36,$82.08,$39.36,$49.74,$39.36,$93.12,$39.36,$96.00,$39.36,$39.36,$93.12
29705,0960,29705,,,,,N/A,N/A,REM FULL ARM/LEG CAST,$126.12,$93.75,$51.25,$125.00,$51.25,$121.25,$51.25,$106.88,$51.25,$80.72,$51.25,$121.25,$51.25,$125.00,$51.25,$51.25,$121.25
29710,0960,29710,,,,,N/A,N/A,REMOVAL/REVISION OF CAST,$197.75,$147.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
29730,0960,29730,,,,,N/A,N/A,WINDOWING OF CAST,$108.97,$81.00,$77.57,$108.00,N/A,$104.76,N/A,$92.34,N/A,$77.57,N/A,$104.76,N/A,$108.00,N/A,N/A,$104.76
29805,0960,29805,,,,,N/A,N/A,SHOULDER ARTHOSCOPY DX,"$1,099.74",$817.50,$446.90,"$1,090.00",$446.90,"$1,057.30",$446.90,$931.95,$446.90,$844.40,$446.90,"$1,057.30",$446.90,"$1,090.00",$446.90,$446.90,"$1,057.30"
29806,0960,29806,,,,,N/A,N/A,SHOULDER ARTHROSCOPY/SURGERY,"$2,440.63","$1,814.25",$991.79,"$2,419.00",$991.79,"$2,346.43",$991.79,"$2,068.25",$991.79,"$1,882.69",$991.79,"$2,346.43",$991.79,"$2,419.00",$991.79,$991.79,"$2,346.43"
29807,0960,29807,,,,,N/A,N/A,SHOULDER ARTHROSCOPY/SURGERY,"$2,378.07","$1,767.75",$966.37,"$2,357.00",$966.37,"$2,286.29",$966.37,"$2,015.24",$966.37,"$1,840.50",$966.37,"$2,286.29",$966.37,"$2,357.00",$966.37,$966.37,"$2,286.29"
29819,0960,29819,,,,,N/A,N/A,SHOULDER ARTHROSCOPY\SURG,"$1,373.17","$1,020.75",$558.10,"$1,361.00",$558.10,"$1,320.17",$558.10,"$1,163.66",$558.10,"$1,053.07",$558.10,"$1,320.17",$558.10,"$1,361.00",$558.10,$558.10,"$1,320.17"
29820,0960,29820,,,,,N/A,N/A,SHOULDER ARTHROSCOPY/SURGERY,"$1,266.22",$941.25,$514.55,"$1,255.00",$514.55,"$1,217.35",$514.55,"$1,073.03",$514.55,$963.35,$514.55,"$1,217.35",$514.55,"$1,255.00",$514.55,$514.55,"$1,217.35"
29822,0960,29822,,,,,N/A,N/A,SHOULDER ARTHROSCOPY/SURGERY,"$1,344.92",$999.75,$467.40,"$1,140.00",$467.40,"$1,105.80",$467.40,$974.70,$467.40,$970.19,$467.40,"$1,105.80",$467.40,"$1,140.00",$467.40,$467.40,"$1,105.80"
29823,0960,29823,,,,,N/A,N/A,SHOULDER ARTHROSCOPY/SURGERY,"$1,467.00","$1,090.50",$51.86,"$1,246.00",$51.86,"$1,208.62",$51.86,"$1,065.33",$51.86,"$1,060.96",$51.86,"$1,208.62",$51.86,"$1,246.00",$51.86,$51.86,"$1,208.62"
29824,0960,29824,,,,,N/A,N/A,SHOULDER ARTHROSCOPY/SURGERY,"$1,502.31","$1,116.75",$61.49,"$1,489.00",$61.49,"$1,444.33",$61.49,"$1,273.10",$61.49,"$1,210.58",$61.49,"$1,444.33",$61.49,"$1,489.00",$61.49,$61.49,"$1,444.33"
29825,0960,29825,,,,,N/A,N/A,SHOULDER ARTHROSCOPY\SURGERY,"$1,370.14","$1,018.50",$556.78,"$1,358.00",$556.78,"$1,317.26",$556.78,"$1,161.09",$556.78,"$1,052.71",$556.78,"$1,317.26",$556.78,"$1,358.00",$556.78,$556.78,"$1,317.26"
29826,0960,29826,,,,,N/A,N/A,SHOULDER ARTHROSCOPY/SURGERY,"$1,576.97","$1,172.25",$64.83,$64.83,$64.83,N/A,$64.83,N/A,$64.83,N/A,$64.83,N/A,$64.83,N/A,$64.83,$64.83,N/A
29827,0960,29827,,,,,N/A,N/A,ARTHROSCOP ROTATOR CUFF REPR,"$2,573.81","$1,913.25",$867.56,"$2,116.00",$867.56,"$2,052.52",$867.56,"$1,809.18",$867.56,"$1,902.15",$867.56,"$2,052.52",$867.56,"$2,116.00",$867.56,$867.56,"$2,052.52"
29828,0960,29828,,,,,N/A,N/A,ARTHROSCOPY SHOULDER BICEPS,"$1,790.87","$1,331.25",$727.75,"$1,775.00",$727.75,"$1,721.75",$727.75,"$1,517.63",$727.75,"$1,633.34",$727.75,"$1,721.75",$727.75,"$1,775.00",$727.75,$727.75,"$1,721.75"
29837,0960,29837,,,,,N/A,N/A,ELBOW ARTHROSCOPY/SURGERY,"$1,239.99",$921.75,$53.89,"$1,229.00",$53.89,"$1,192.13",$53.89,"$1,050.80",$53.89,$946.39,$53.89,"$1,192.13",$53.89,"$1,229.00",$53.89,$53.89,"$1,192.13"
29848,0960,29848,,,,,N/A,N/A,WRIST ENDOSCOPY/SURGERY,"$1,046.27",$777.75,$425.17,"$1,037.00",$425.17,"$1,005.89",$425.17,$886.64,$425.17,$916.72,$425.17,"$1,005.89",$425.17,"$1,037.00",$425.17,$425.17,"$1,005.89"
29862,0960,29862,,,,,N/A,N/A,HIP ARTHROSCOPY/SURGERY,"$1,757.57","$1,306.50",$714.22,"$1,742.00",$714.22,"$1,689.74",$714.22,"$1,489.41",$714.22,"$1,452.19",$714.22,"$1,689.74",$714.22,"$1,742.00",$714.22,$714.22,"$1,689.74"
29863,0960,29863,,,,,N/A,N/A,HIP ARTHROSCOPY/SURGERY,"$1,743.45","$1,296.00",$78.48,"$1,728.00",$78.48,"$1,676.16",$78.48,"$1,477.44",$78.48,"$1,449.40",$78.48,"$1,676.16",$78.48,"$1,728.00",$78.48,$78.48,"$1,676.16"
29868,0960,29868,,,,,N/A,N/A,"MENISCAL TRNSPL, KNEE W/SCPE","$3,884.42","$2,887.50","$1,578.50","$3,850.00","$1,578.50","$3,734.50","$1,578.50","$3,291.75","$1,578.50","$2,956.01","$1,578.50","$3,734.50","$1,578.50","$3,850.00","$1,578.50","$1,578.50","$3,734.50"
29870,0960,29870,,,,,N/A,N/A,KNEE ARTHROSCOPY DX,$946.39,$703.50,$384.58,$928.00,$384.58,$900.16,$384.58,$793.44,$384.58,$728.83,$384.58,$900.16,$384.58,$928.00,$384.58,$384.58,$900.16
29871,0960,29871,,,,,N/A,N/A,KNEE ARTHROSCOPY/DRAINAGE,"$1,184.50",$880.50,$481.34,"$1,174.00",$481.34,"$1,138.78",$481.34,"$1,003.77",$481.34,$920.81,$481.34,"$1,138.78",$481.34,"$1,174.00",$481.34,$481.34,"$1,138.78"
29873,0960,29873,,,,,N/A,N/A,KNEE ARTHROSCOPY/SURGERY,"$1,191.56",$885.75,$484.21,"$1,181.00",$484.21,"$1,145.57",$484.21,"$1,009.75",$484.21,$962.09,$484.21,"$1,145.57",$484.21,"$1,181.00",$484.21,$484.21,"$1,145.57"
29874,0960,29874,,,,,N/A,N/A,KNEE ARTHROSCOPY/SURGERY,"$1,245.03",$925.50,$55.94,"$1,234.00",$55.94,"$1,196.98",$55.94,"$1,055.07",$55.94,$961.46,$55.94,"$1,196.98",$55.94,"$1,234.00",$55.94,$55.94,"$1,196.98"
29875,0960,29875,,,,,N/A,N/A,KNEE ARTHROSCOPY/SURGERY,"$1,210.73",$900.00,$492.00,"$1,200.00",$492.00,"$1,164.00",$492.00,"$1,026.00",$492.00,$889.47,$492.00,"$1,164.00",$492.00,"$1,200.00",$492.00,$492.00,"$1,164.00"
29876,0960,29876,,,,,N/A,N/A,KNEE ARTHROSCOPY/SURGERY,"$1,423.61","$1,058.25",$578.51,"$1,411.00",$578.51,"$1,368.67",$578.51,"$1,206.40",$578.51,"$1,167.18",$578.51,"$1,368.67",$578.51,"$1,411.00",$578.51,$578.51,"$1,368.67"
29877,0960,29877,,,,,N/A,N/A,KNEE ARTHROSCOPY/SURGERY,"$1,342.90",$998.25,$545.71,"$1,331.00",$545.71,"$1,291.07",$545.71,"$1,138.01",$545.71,"$1,111.07",$545.71,"$1,291.07",$545.71,"$1,331.00",$545.71,$545.71,"$1,291.07"
29879,0960,29879,,,,,N/A,N/A,KNEE ARTHROSCOPY/SURGERY,"$1,446.82","$1,075.50",$587.94,"$1,434.00",$587.94,"$1,390.98",$587.94,"$1,226.07",$587.94,"$1,181.45",$587.94,"$1,390.98",$587.94,"$1,434.00",$587.94,$587.94,"$1,390.98"
29880,0960,29880,,,,,N/A,N/A,KNEE ARTHROSCOPY/SURGERY,"$1,513.41","$1,125.00",$615.00,"$1,500.00",$615.00,"$1,455.00",$615.00,"$1,282.50",$615.00,"$1,006.29",$615.00,"$1,455.00",$615.00,"$1,500.00",$615.00,$615.00,"$1,455.00"
29881,0960,29881,,,,,N/A,N/A,KNEE ARTHROSCOPY/SURGERY,"$1,402.43","$1,042.50",$738.00,"$1,800.00",$738.00,"$1,746.00",$738.00,"$1,539.00",$738.00,$970.82,$738.00,"$1,746.00",$738.00,"$1,800.00",$738.00,$738.00,"$1,746.00"
29882,0960,29882,,,,,N/A,N/A,KNEE ARTHROSCOPY/SURGERY,"$1,517.45","$1,128.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
29883,0960,29883,,,,,N/A,N/A,KNEE ARTHROSCOPY/SURGERY,"$1,920.01","$1,427.25",$78.23,"$1,903.00",$78.23,"$1,845.91",$78.23,"$1,627.07",$78.23,"$1,494.00",$78.23,"$1,845.91",$78.23,"$1,903.00",$78.23,$78.23,"$1,845.91"
29884,0960,29884,,,,,N/A,N/A,KNEE ARTHROSCOPY/SURGERY,"$1,336.85",$993.75,$543.25,"$1,325.00",$543.25,"$1,285.25",$543.25,"$1,132.88",$543.25,"$1,106.94",$543.25,"$1,285.25",$543.25,"$1,325.00",$543.25,$543.25,"$1,285.25"
29887,0960,29887,,,,,N/A,N/A,KNEE ARTHROSCOPY/SURGERY,"$1,618.34","$1,203.00",$657.64,"$1,604.00",$657.64,"$1,555.88",$657.64,"$1,371.42",$657.64,"$1,343.27",$657.64,"$1,555.88",$657.64,"$1,604.00",$657.64,$657.64,"$1,555.88"
29888,0960,29888,,,,,N/A,N/A,KNEE ARTHROSCOPY/SURGERY,"$2,308.45","$1,716.00",$938.80,"$2,288.00",$938.80,"$2,219.36",$938.80,"$1,956.24",$938.80,"$1,739.99",$938.80,"$2,219.36",$938.80,"$2,288.00",$938.80,$938.80,"$2,219.36"
29889,0960,29889,,,,,N/A,N/A,KNEE ARTHROSCOPY/SURGERY,"$2,717.08","$2,019.75",$114.13,"$2,693.00",$114.13,"$2,612.21",$114.13,"$2,302.52",$114.13,"$2,174.96",$114.13,"$2,612.21",$114.13,"$2,693.00",$114.13,$114.13,"$2,612.21"
29891,0960,29891,,,,,N/A,N/A,ANKLE ARTHROSCOPY/SURGERY,"$1,514.42","$1,125.75",$615.41,"$1,501.00",$615.41,"$1,455.97",$615.41,"$1,283.36",$615.41,"$1,200.24",$615.41,"$1,455.97",$615.41,"$1,501.00",$615.41,$615.41,"$1,455.97"
29895,0960,29895,,,,,N/A,N/A,ANKLE ARTHROSCOPY/SURGERY,"$1,187.52",$882.75,$482.57,"$1,177.00",$482.57,"$1,141.69",$482.57,"$1,006.34",$482.57,$838.17,$482.57,"$1,141.69",$482.57,"$1,177.00",$482.57,$482.57,"$1,141.69"
29897,0960,29897,,,,,N/A,N/A,ANKLE ARTHROSCOPY/SURGERY,"$1,244.02",$924.75,$55.53,"$1,233.00",$55.53,"$1,196.01",$55.53,"$1,054.22",$55.53,$888.00,$55.53,"$1,196.01",$55.53,"$1,233.00",$55.53,$55.53,"$1,196.01"
29898,0960,29898,,,,,N/A,N/A,ANKLE ARTHROSCOPY/SURGERY,"$1,383.26","$1,028.25","$1,003.11","$1,371.00",N/A,"$1,329.87",N/A,"$1,172.21",N/A,"$1,003.11",N/A,"$1,329.87",N/A,"$1,371.00",N/A,N/A,"$1,329.87"
29914,0960,29914,,,,,N/A,N/A,ARTHROSCOPY HIP W/FEMOROPLASTY,"$1,983.58","$1,474.50",$86.60,"$1,966.00",$86.60,"$1,907.02",$86.60,"$1,680.93",$86.60,"$1,774.20",$86.60,"$1,907.02",$86.60,"$1,966.00",$86.60,$86.60,"$1,907.02"
29915,0960,29915,,,,,N/A,N/A,ARTHROSCOPY HIP W/ACETABULOPLA,"$2,020.91","$1,502.25",$821.23,"$2,003.00",$821.23,"$1,942.91",$821.23,"$1,712.57",$821.23,"$1,816.29",$821.23,"$1,942.91",$821.23,"$2,003.00",$821.23,$821.23,"$1,942.91"
29916,0960,29916,,,,,N/A,N/A,ARTHROSCOPY HIP W/LABRAL REPAI,"$2,020.91","$1,502.25",$821.23,"$2,003.00",$821.23,"$1,942.91",$821.23,"$1,712.57",$821.23,"$1,817.11",$821.23,"$1,942.91",$821.23,"$2,003.00",$821.23,$821.23,"$1,942.91"
30100,0960,30100,,,,,N/A,N/A,INTRANASAL BIOPSY,$166.48,$123.75,$100.76,$100.76,N/A,N/A,N/A,$0.00,N/A,$100.76,N/A,N/A,N/A,N/A,N/A,N/A,N/A
30115,0960,30115,,,,,N/A,N/A,REMOVAL OF NOSE POLYP(S),$937.31,$696.75,$716.37,$716.37,N/A,N/A,N/A,$0.00,N/A,$716.37,N/A,N/A,N/A,N/A,N/A,N/A,N/A
30117,0960,30117,,,,,N/A,N/A,REMOVAL OF INTRANASAL LESION,$964.55,$717.00,$511.15,$511.15,N/A,N/A,N/A,$0.00,N/A,$511.15,N/A,N/A,N/A,N/A,N/A,N/A,N/A
30130,0960,30130,,,,,N/A,N/A,REMOVAL OF TURBINATE BONES,$830.36,$617.25,$642.92,$642.92,N/A,N/A,N/A,$0.00,N/A,$642.92,N/A,N/A,N/A,N/A,N/A,N/A,N/A
30140,0960,30140,,,,,N/A,N/A,REMOVAL OF TURBINATE BONES,$896.95,$666.75,$265.70,$265.70,N/A,N/A,N/A,$0.00,N/A,$265.70,N/A,N/A,N/A,N/A,N/A,N/A,N/A
30220,0960,30220,,,,,N/A,N/A,INSERT NASAL SEPTAL BUTTON,$339.00,$252.00,$189.68,$189.68,N/A,N/A,N/A,$0.00,N/A,$189.68,N/A,N/A,N/A,N/A,N/A,N/A,N/A
30300,0960,30300,,,,,N/A,N/A,REMOVE NASAL FOREIGN BODY,$272.41,$202.50,$184.93,"$1,010.00",N/A,$979.70,N/A,$863.55,N/A,$184.93,N/A,$979.70,N/A,"$1,010.00",N/A,N/A,$979.70
30465,0960,30465,,,,,N/A,N/A,REPAIR NASAL STENOSIS,"$2,195.45","$1,632.00","$1,569.28","$1,569.28",N/A,N/A,N/A,$0.00,N/A,"$1,569.28",N/A,N/A,N/A,N/A,N/A,N/A,N/A
30520,0960,30520,,,,,N/A,N/A,REPAIR OF NASAL SEPTUM,"$1,253.10",$931.50,"$1,030.24","$1,030.24",N/A,N/A,N/A,$0.00,N/A,"$1,030.24",N/A,N/A,N/A,N/A,N/A,N/A,N/A
30801,0960,30801,,,,,N/A,N/A,"CAUTERIZATION, INNER NOSE",$278.47,$207.00,$234.97,$234.97,N/A,N/A,N/A,$0.00,N/A,$234.97,N/A,N/A,N/A,N/A,N/A,N/A,N/A
30802,0960,30802,,,,,N/A,N/A,"CAUTERIZATION, INNER NOSE",$409.63,$304.50,$311.24,$311.24,N/A,N/A,N/A,$0.00,N/A,$311.24,N/A,N/A,N/A,N/A,N/A,N/A,N/A
30901,0960,30901,,,,,N/A,N/A,CONTROL OF NOSEBLEED,$148.31,$110.25,$83.33,$741.00,N/A,$718.77,N/A,$633.56,N/A,$83.33,N/A,$718.77,N/A,$741.00,N/A,N/A,$718.77
9630901,0960,30901,,,,,N/A,N/A,CONTROL OF NOSEBLEED,$148.31,$110.25,$83.33,$741.00,N/A,$718.77,N/A,$633.56,N/A,$83.33,N/A,$718.77,N/A,$741.00,N/A,N/A,$718.77
30903,0960,30903,,,,,N/A,N/A,CONTROL OF NOSEBLEED,$234.07,$174.00,$114.78,"$1,572.00",N/A,"$1,524.84",N/A,"$1,344.06",N/A,$114.78,N/A,"$1,524.84",N/A,"$1,572.00",N/A,N/A,"$1,524.84"
30905,0960,30905,,,,,N/A,N/A,CONTROL OF NOSEBLEED,$348.08,$258.75,$156.57,"$1,082.00",N/A,"$1,049.54",N/A,$925.11,N/A,$156.57,N/A,"$1,049.54",N/A,"$1,082.00",N/A,N/A,"$1,049.54"
30906,0960,30906,,,,,N/A,N/A,REPEAT CONTROL OF NOSEBLEED,$344.05,$255.75,$201.86,$201.86,N/A,N/A,N/A,$0.00,N/A,$201.86,N/A,N/A,N/A,N/A,N/A,N/A,N/A
30930,0960,30930,,,,,N/A,N/A,"THERAPY, FRACTURE OF NOSE",$269.39,$200.25,$178.60,$178.60,N/A,N/A,N/A,$0.00,N/A,$178.60,N/A,N/A,N/A,N/A,N/A,N/A,N/A
31231,0960,31231,,,,,N/A,N/A,"NASAL ENDOSCOPY, DX",$213.90,$159.00,$95.50,$465.00,N/A,$451.05,N/A,$397.58,N/A,$95.50,N/A,$451.05,N/A,$465.00,N/A,N/A,$451.05
31237,0960,31237,,,,,N/A,N/A,"NASAL/SINUS ENDOSCOPY, SURG",$459.07,$341.25,$236.98,$236.98,N/A,N/A,N/A,$0.00,N/A,$236.98,N/A,N/A,N/A,N/A,N/A,N/A,N/A
31238,0960,31238,,,,,N/A,N/A,"NASAL/SINUS ENDOSCOPY, SURG",$500.43,$372.00,$248.23,$248.23,N/A,N/A,N/A,$0.00,N/A,$248.23,N/A,N/A,N/A,N/A,N/A,N/A,N/A
31254,0960,31254,,,,,N/A,N/A,REVISION OF ETHMOID SINUS,$705.25,$524.25,$361.49,$361.49,N/A,N/A,N/A,$0.00,N/A,$361.49,N/A,N/A,N/A,N/A,N/A,N/A,N/A
31267,0960,31267,,,,,N/A,N/A,"ENDOSCOPY, MAXILLARY SINUS",$825.31,$613.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
31500,0960,31500,,,,,N/A,N/A,INSERT EMERGENCY AIRWAY,$274.43,$204.00,$62.32,"$1,667.00",$62.32,"$1,616.99",$62.32,"$1,425.29",$62.32,$210.87,$62.32,"$1,616.99",$62.32,"$1,667.00",$62.32,$62.32,"$1,616.99"
9631500,0960,31500,,,,,N/A,N/A,INTUBATION,$221.97,$165.00,$62.32,"$1,667.00",$62.32,"$1,616.99",$62.32,"$1,425.29",$62.32,$210.87,$62.32,"$1,616.99",$62.32,"$1,667.00",$62.32,$62.32,"$1,616.99"
31502,0960,31502,,,,,N/A,N/A,CHANGE OF WINDPIPE AIRWAY,$94.84,$70.50,$52.19,$52.19,N/A,N/A,N/A,$0.00,N/A,$52.19,N/A,N/A,N/A,N/A,N/A,N/A,N/A
31526,0960,31526,,,,,N/A,N/A,DIAGNOSTIC LARYNGOSCOPY,$402.57,$299.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
31530,0960,31530,,,,,N/A,N/A,OPERATIVE LARYNGOSCOPY,$500.43,$372.00,$293.80,$293.80,N/A,N/A,N/A,$0.00,N/A,$293.80,N/A,N/A,N/A,N/A,N/A,N/A,N/A
31536,0960,31536,,,,,N/A,N/A,OPERATIVE LARYNGOSCOPY,$544.83,$405.00,$310.83,$310.83,N/A,N/A,N/A,$0.00,N/A,$310.83,N/A,N/A,N/A,N/A,N/A,N/A,N/A
31541,0960,31541,,,,,N/A,N/A,OPERATIVE LARYNGOSCOPY,$685.07,$509.25,$389.30,$389.30,N/A,N/A,N/A,$0.00,N/A,$389.30,N/A,N/A,N/A,N/A,N/A,N/A,N/A
31575,0960,31575,,,,,N/A,N/A,DIAGNOSTIC LARYNGOSCOPY,$187.66,$139.50,$100.23,$677.00,N/A,$656.69,N/A,$578.84,N/A,$100.23,N/A,$656.69,N/A,$677.00,N/A,N/A,$656.69
31576,0960,31576,,,,,N/A,N/A,LARYNGOSCOPY WITH BIOPSY,$305.71,$227.25,$124.23,$303.00,$124.23,$293.91,$124.23,$259.07,$124.23,$176.20,$124.23,$293.91,$124.23,$303.00,$124.23,$124.23,$293.91
31605,0960,31605,,,,,N/A,N/A,INCISION OF WINDPIPE,$457.05,$339.75,$185.73,$488.64,$185.73,$439.41,$185.73,$387.32,$185.73,$488.64,$185.73,$439.41,$185.73,$453.00,$185.73,$185.73,$439.41
31613,0960,31613,,,,,N/A,N/A,REPAIR WINDPIPE OPENING,$982.71,$730.50,$0.00,$669.95,N/A,$0.00,N/A,$0.00,N/A,$669.95,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
31622,0960,31622,,,,,N/A,N/A,ENDOSCOPY LUNG,$362.21,$269.25,$197.53,$359.00,N/A,$348.23,N/A,$306.95,N/A,$197.53,N/A,$348.23,N/A,$359.00,N/A,N/A,$348.23
31623,0960,31623,,,,,N/A,N/A,ENDOSCOPY OF LUNG,$378.35,$281.25,$153.75,$375.00,$153.75,$363.75,$153.75,$320.63,$153.75,$199.97,$153.75,$363.75,$153.75,$375.00,$153.75,$153.75,$363.75
31624,0960,31624,,,,,N/A,N/A,ENDOSCOPY OF LUNG W/BRONCHIAL,$527.68,$392.25,$201.87,$201.87,N/A,N/A,N/A,$0.00,N/A,$201.87,N/A,N/A,N/A,N/A,N/A,N/A,N/A
31625,0960,31625,,,,,N/A,N/A,ENDOSCOPY OF LUNG W/BRON BIOSP,$734.51,$546.00,$235.53,$235.53,N/A,N/A,N/A,$0.00,N/A,$235.53,N/A,N/A,N/A,N/A,N/A,N/A,N/A
31628,0960,31628,,,,,N/A,N/A,ENDOSCOPY LUNG W/TRANS BIOPSY,$440.91,$327.75,$265.85,$265.85,N/A,N/A,N/A,$0.00,N/A,$265.85,N/A,N/A,N/A,N/A,N/A,N/A,N/A
31629,0960,31629,,,,,N/A,N/A,ENODSCOPY LUNG W/TRAN NEED ASP,$965.56,$717.75,$281.19,$281.19,N/A,N/A,N/A,$0.00,N/A,$281.19,N/A,N/A,N/A,N/A,N/A,N/A,N/A
31632,0960,31632,,,,,N/A,N/A,ENDOSCOPY LUNG W/TRANS BIOPSY,$130.15,$96.75,$74.53,$74.53,N/A,N/A,N/A,$0.00,N/A,$74.53,N/A,N/A,N/A,N/A,N/A,N/A,N/A
31633,0960,31633,,,,,N/A,N/A,ENODS LUNGW/TRAN NEED ASP EA,$162.44,$120.75,$95.88,$95.88,N/A,N/A,N/A,$0.00,N/A,$95.88,N/A,N/A,N/A,N/A,N/A,N/A,N/A
31635,0960,31635,,,,,N/A,N/A,BRONCHOSCOPY W/FB REMOVAL,$480.26,$357.00,$263.48,$263.48,N/A,N/A,N/A,$0.00,N/A,$263.48,N/A,N/A,N/A,N/A,N/A,N/A,N/A
31645,0960,31645,,,,,N/A,N/A,"BRONCHOSCOPY, CLEAR AIRWAYS",$489.34,$363.75,$221.17,$221.17,N/A,N/A,N/A,$0.00,N/A,$221.17,N/A,N/A,N/A,N/A,N/A,N/A,N/A
31800,0960,31800,,,,,N/A,N/A,REPAIR OF WINDPIPE INJURY,"$1,551.75","$1,153.50",$63.58,"$1,538.00",$63.58,"$1,491.86",$63.58,"$1,314.99",$63.58,"$1,103.15",$63.58,"$1,491.86",$63.58,"$1,538.00",$63.58,$63.58,"$1,491.86"
32550,0960,32550,,,,,N/A,N/A,INSERTION OF PLEURAL CATH,$894.93,$665.25,$354.12,$987.00,$363.67,$957.39,$363.67,$843.89,$363.67,$354.12,$363.67,$957.39,$363.67,$987.00,$363.67,$363.67,$957.39
32551,0960,32551,,,,,N/A,N/A,TUBE THORACOSTOMY INCLUDES W,$332.95,$247.50,$174.25,$425.00,$174.25,$412.25,$174.25,$363.38,$174.25,$267.10,$174.25,$412.25,$174.25,$425.00,$174.25,$174.25,$412.25
32552,0960,32552,,,,,N/A,N/A,REMOVE LUNG CATHETER,$322.86,$240.00,$131.20,$320.00,$131.20,$310.40,$131.20,$273.60,$131.20,$275.07,$131.20,$310.40,$131.20,$320.00,$131.20,$131.20,$310.40
32554,0960,32554,,,,,N/A,N/A,"THORAQCENTESIS, NEEDLE OR CA","$1,027.10",$763.50,$155.38,"$1,018.00",$417.38,$987.46,$417.38,$870.39,$417.38,$155.38,$417.38,$987.46,$417.38,"$1,018.00",$417.38,$417.38,$987.46
9632000,0960,32554,,,,,N/A,N/A,THORACENTESIS W/O TB   32554~P,"$1,027.10",$763.50,$155.38,"$1,018.00",$417.38,$987.46,$417.38,$870.39,$417.38,$155.38,$417.38,$987.46,$417.38,"$1,018.00",$417.38,$417.38,$987.46
32555,0960,32555,,,,,N/A,N/A,THORAQCENTESIS W/IMAGIN GUID,$724.42,$538.50,$192.61,$718.00,$294.38,$696.46,$294.38,$613.89,$294.38,$192.61,$294.38,$696.46,$294.38,$718.00,$294.38,$294.38,$696.46
32556,0960,32556,,,,,N/A,N/A,PLEURAL DRAINAGE,$762.76,$567.00,$39.96,$756.00,$39.96,$733.32,$39.96,$646.38,$39.96,$213.31,$39.96,$733.32,$39.96,$756.00,$39.96,$39.96,$733.32
32560,0960,32560,,,,,N/A,N/A,INSTILLATION DRUG CHEST TUBE,$151.34,$112.50,$132.19,$132.19,N/A,N/A,N/A,$0.00,N/A,$132.19,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9632560,0960,32560,,,,,N/A,N/A,INSTILLATION DRUG CHEST TUBE,$151.34,$112.50,$132.19,$132.19,N/A,N/A,N/A,$0.00,N/A,$132.19,N/A,N/A,N/A,N/A,N/A,N/A,N/A
32561,0960,32561,,,,,N/A,N/A,LYSE CHEST FIBRIN INIT DAY,$137.22,$102.00,$117.72,$117.72,N/A,N/A,N/A,$0.00,N/A,$117.72,N/A,N/A,N/A,N/A,N/A,N/A,N/A
32562,0960,32562,,,,,N/A,N/A,INSTLJ CH TUBE/CATH AGENT FBRN,$123.09,$91.50,$105.08,$105.08,N/A,N/A,N/A,$0.00,N/A,$105.08,N/A,N/A,N/A,N/A,N/A,N/A,N/A
32608,0960,32608,,,,,N/A,N/A,THORACOSCOPY W/BX NODULE,$736.53,$547.50,$299.30,$299.30,$299.30,N/A,$299.30,N/A,$299.30,N/A,$299.30,N/A,$299.30,N/A,$299.30,$299.30,N/A
32609,0960,32609,,,,,N/A,N/A,THORACOSCOPY WITH BIOPSYIES OF,$509.51,$378.75,$27.50,$27.50,$27.50,N/A,$27.50,N/A,$27.50,N/A,$27.50,N/A,$27.50,N/A,$27.50,$27.50,N/A
33016,0960,33016,,,,,N/A,N/A,PERICARDIUM,$469.16,$348.75,$19.65,$19.65,$19.65,N/A,$19.65,N/A,$19.65,N/A,$19.65,N/A,$19.65,N/A,$19.65,$19.65,N/A
33207,0960,33207,,,,,N/A,N/A,INSERTION OF HEART PACEMAKER,"$1,187.52",$882.75,$482.57,"$1,177.00",$482.57,"$1,141.69",$482.57,"$1,006.34",$482.57,$820.60,$482.57,"$1,141.69",$482.57,"$1,177.00",$482.57,$482.57,"$1,141.69"
33208,0960,33208,,,,,N/A,N/A,INSERTION OF HEART PACEMAKER,"$1,205.68",$896.25,$489.95,"$1,195.00",$489.95,"$1,159.15",$489.95,"$1,021.73",$489.95,$890.47,$489.95,"$1,159.15",$489.95,"$1,195.00",$489.95,$489.95,"$1,159.15"
33210,0960,33210,,,,,N/A,N/A,INSERTION OF HEART ELECTRODE,$427.79,$318.00,$143.91,$351.00,$143.91,$340.47,$143.91,$300.11,$143.91,$275.25,$143.91,$340.47,$143.91,$351.00,$143.91,$143.91,$340.47
33212,0960,33212,,,,,N/A,N/A,INSERTION OF PULSE GENERATOR,$832.38,$618.75,$554.29,$825.00,N/A,$800.25,N/A,$705.38,N/A,$554.29,N/A,$800.25,N/A,$825.00,N/A,N/A,$800.25
33216,0960,33216,,,,,N/A,N/A,"INSER LEAD PACE-DEFIB, ONE",$930.24,$691.50,$36.68,$748.00,$36.68,$725.56,$36.68,$639.54,$36.68,$640.60,$36.68,$725.56,$36.68,$748.00,$36.68,$36.68,$725.56
33227,0960,33227,,,,,N/A,N/A,REMOVE & REPLACE PM GEN SINGLE,$653.79,$486.00,$265.68,$648.00,$265.68,$628.56,$265.68,$554.04,$265.68,$582.47,$265.68,$628.56,$265.68,$648.00,$265.68,$265.68,$628.56
33228,0960,33228,,,,,N/A,N/A,REMV&REPLC PM GEN DUAL LEAD,$682.04,$507.00,$299.30,$730.00,$299.30,$708.10,$299.30,$624.15,$299.30,$609.24,$299.30,$708.10,$299.30,$730.00,$299.30,$299.30,$708.10
33234,0960,33234,,,,,N/A,N/A,REMOVAL OF PACEMAKER SYSTEM,"$1,188.53",$883.50,$397.70,$970.00,$397.70,$940.90,$397.70,$829.35,$397.70,$834.67,$397.70,$940.90,$397.70,$970.00,$397.70,$397.70,$940.90
33241,0960,33241,,,,,N/A,N/A,REMOVE PULSE GENERATOR,$576.10,$428.25,$234.11,$571.00,$234.11,$553.87,$234.11,$488.21,$234.11,$371.46,$234.11,$553.87,$234.11,$571.00,$234.11,$234.11,$553.87
35206,0960,35206,,,,,N/A,N/A,REPAIR BLOOD VESSEL LESION,"$1,894.79","$1,408.50",$769.98,"$1,878.00",$769.98,"$1,821.66",$769.98,"$1,605.69",$769.98,"$1,321.26",$769.98,"$1,821.66",$769.98,"$1,878.00",$769.98,$769.98,"$1,821.66"
35207,0960,35207,,,,,N/A,N/A,REPAIR BLOOD VESSEL LESION,"$1,661.72","$1,235.25",$675.27,"$1,647.00",$675.27,"$1,597.59",$675.27,"$1,408.19",$675.27,"$1,310.50",$675.27,"$1,597.59",$675.27,"$1,647.00",$675.27,$675.27,"$1,597.59"
35226,0960,35226,,,,,N/A,N/A,REPAIR BLOOD VESSEL LESION,"$2,095.57","$1,557.75",$851.57,$851.57,$851.57,N/A,$851.57,N/A,$851.57,N/A,$851.57,N/A,$851.57,N/A,$851.57,$851.57,N/A
35761,0960,35761,,,,,N/A,N/A,EXPLORATION OF ARTERY/VEIN,$889.89,$661.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
35840,0960,35840,,,,,N/A,N/A,EXPLORE ABDOMINAL VESSELS,"$2,241.86","$1,666.50",$519.88,"$2,045.11",$519.88,"$1,229.96",$519.88,"$1,084.14",$519.88,"$2,045.11",$519.88,"$1,229.96",$519.88,"$1,268.00",$519.88,$519.88,"$1,229.96"
36140,0960,36140,,,,,N/A,N/A,ESTABLISH ACCESS TO ARTERY,$597.29,$444.00,$150.87,$592.00,$242.72,$574.24,$242.72,$506.16,$242.72,$150.87,$242.72,$574.24,$242.72,$592.00,$242.72,$242.72,$574.24
36400,0960,36400,,,,,N/A,N/A,BL DRAW < 3 YRS FEM/JUGULAR,$52.46,$39.00,$32.62,$32.62,N/A,N/A,N/A,$0.00,N/A,$32.62,N/A,N/A,N/A,N/A,N/A,N/A,N/A
36406,0960,36406,,,,,N/A,N/A,BL DRAW < 3 YRS OTHER VEIN,$49.44,$36.75,$14.77,$14.77,N/A,N/A,N/A,$0.00,N/A,$14.77,N/A,N/A,N/A,N/A,N/A,N/A,N/A
36410,0960,36410,,,,,N/A,N/A,NON-ROUTINE BL DRAW > 3 YRS,$35.31,$26.25,$15.71,$46.00,N/A,$44.62,N/A,$39.33,N/A,$15.71,N/A,$44.62,N/A,$46.00,N/A,N/A,$44.62
9636415,0960,36415,,,,,N/A,N/A,BLOOD DRAW,$54.48,$40.50,$2.50,$50.00,$2.50,$48.50,$2.50,$42.75,$2.50,$6.27,$2.50,$48.50,$2.50,$50.00,$2.50,$2.50,$48.50
36471,0960,36471,,,,,N/A,N/A,INJECTION THERAPY OF VEINS,$241.14,$179.25,$97.99,$239.00,$97.99,$231.83,$97.99,$204.35,$97.99,$125.22,$97.99,$231.83,$97.99,$239.00,$97.99,$97.99,$231.83
36475,0960,36475,,,,,N/A,N/A,"ENDOVENOUS RF, 1ST VEIN","$3,372.89","$2,507.25",$137.63,"$3,343.00",$137.63,"$3,242.71",$137.63,"$2,858.27",$137.63,$460.12,$137.63,"$3,242.71",$137.63,"$3,343.00",$137.63,$137.63,"$3,242.71"
36476,0960,36476,,,,,N/A,N/A,"ENDOVENOUS RF, VEIN ADD-ON",$659.85,$490.50,$220.99,$220.99,N/A,N/A,N/A,$0.00,N/A,$220.99,N/A,N/A,N/A,N/A,N/A,N/A,N/A
36510,0960,36510,,,,,N/A,N/A,"INSERTION OF CATHETER, VEIN",$202.80,$150.75,$91.00,$91.00,N/A,N/A,N/A,$0.00,N/A,$91.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A
36556,0960,36556,,,,,N/A,N/A,INSERT NON-TUNNEL CV CATH,$422.75,$314.25,$142.40,$419.00,$171.79,$406.43,$171.79,$358.25,$171.79,$142.40,$171.79,$406.43,$171.79,$419.00,$171.79,$171.79,$406.43
9636556,0960,36556,,,,,N/A,N/A,PLACEMENT OF VENOUS ACCESS,$422.75,$314.25,$142.40,$419.00,$171.79,$406.43,$171.79,$358.25,$171.79,$142.40,$171.79,$406.43,$171.79,$419.00,$171.79,$171.79,$406.43
36558,0960,36558,,,,,N/A,N/A,INSERT TUNNELED CV CATHETER,"$1,050.31",$780.75,$439.20,"$1,041.00",N/A,"$1,009.77",N/A,$890.06,N/A,$439.20,N/A,"$1,009.77",N/A,"$1,041.00",N/A,N/A,"$1,009.77"
36561,0960,36561,,,,,N/A,N/A,INSERT TUNNELED CV CATH,"$1,770.69","$1,316.25",$563.14,"$1,755.00",$719.55,"$1,702.35",$719.55,"$1,500.53",$719.55,$563.14,$719.55,"$1,702.35",$719.55,"$1,755.00",$719.55,$719.55,"$1,702.35"
36569,0960,36569,,,,,N/A,N/A,INSERT PICC CATH,$231.05,$171.75,$97.58,$230.00,$97.58,$223.10,$97.58,$196.65,$97.58,$158.03,$97.58,$223.10,$97.58,$230.00,$97.58,$97.58,$223.10
36572,0960,36572,,,,,N/A,N/A,INSERT OF PICC LINEW/IMAG<5AGE,$523.64,$389.25,$154.26,"$4,014.00","$1,645.74","$3,893.58","$1,645.74","$3,431.97","$1,645.74",$154.26,"$1,645.74","$3,893.58","$1,645.74","$4,014.00","$1,645.74","$1,645.74","$3,893.58"
36573,0960,36573,,,,,N/A,N/A,INSERTION OF PICC LINEW/IMAG,$492.36,$366.00,$142.32,"$1,645.74","$1,645.74",$794.43,"$1,645.74",$700.25,"$1,645.74",$142.32,"$1,645.74",$794.43,"$1,645.74",$819.00,"$1,645.74","$1,645.74",$794.43
36576,0960,36576,,,,,N/A,N/A,REPAIR TUNNELED CV CATH,$595.27,$442.50,$241.90,$590.00,$241.90,$572.30,$241.90,$504.45,$241.90,$309.99,$241.90,$572.30,$241.90,$590.00,$241.90,$241.90,$572.30
36580,0960,36580,,,,,N/A,N/A,REPLACE CENTRAL CVAD CATHETER,$484.29,$360.00,$110.91,$480.00,$196.80,$465.60,$196.80,$410.40,$196.80,$110.91,$196.80,$465.60,$196.80,$480.00,$196.80,$196.80,$465.60
36582,0960,36582,,,,,N/A,N/A,REPLACEMENT PORT A CATHETER,"$1,813.07","$1,347.75",$485.10,"$1,797.00",$736.77,"$1,743.09",$736.77,"$1,536.44",$736.77,$485.10,$736.77,"$1,743.09",$736.77,"$1,797.00",$736.77,$736.77,"$1,743.09"
36589,0960,36589,,,,,N/A,N/A,REMOVAL OF TUNNELED CV CATH,$347.08,$258.00,$25.51,$241.00,$25.51,$233.77,$25.51,$206.06,$25.51,$233.69,$25.51,$233.77,$25.51,$241.00,$25.51,$25.51,$233.77
36590,0960,36590,,,,,N/A,N/A,REMOVAL TUNNELED CV CATH,$484.29,$360.00,$196.80,$480.00,$196.80,$465.60,$196.80,$410.40,$196.80,$319.87,$196.80,$465.60,$196.80,$480.00,$196.80,$196.80,$465.60
36593,0960,36593,,,,,N/A,N/A,DECLOT VASCULAR DEVICE,$61.55,$45.75,$25.10,"$1,130.00",$25.10,"$1,096.10",$25.10,$966.15,$25.10,$57.22,$25.10,"$1,096.10",$25.10,"$1,130.00",$25.10,$25.10,"$1,096.10"
36600,0960,36600,,,,,N/A,N/A,WITHDRAWAL OF ARTERIAL BLOOD,$41.37,$30.75,$26.61,$208.00,$85.28,$201.76,$85.28,$177.84,$85.28,$26.61,$85.28,$201.76,$85.28,$208.00,$85.28,$85.28,$201.76
36620,0960,36620,,,,,N/A,N/A,"INSERTION CATHETER, ARTERY",$132.17,$98.25,$53.71,$131.00,$53.71,$127.07,$53.71,$112.01,$53.71,$75.19,$53.71,$127.07,$53.71,$131.00,$53.71,$53.71,$127.07
9636620,0960,36620,,,,,N/A,N/A,INSERT NEEDLE ARTERIAL,$103.92,$77.25,$53.71,$131.00,$53.71,$127.07,$53.71,$112.01,$53.71,$75.19,$53.71,$127.07,$53.71,$131.00,$53.71,$53.71,$127.07
36660,0960,36660,,,,,N/A,N/A,"INSERTION CATHETER, ARTERY",$176.56,$131.25,$0.00,$117.27,N/A,$0.00,N/A,$0.00,N/A,$117.27,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
36680,0960,36680,,,,,N/A,N/A,INTRAOSSEOUS NEEDLE,$545.84,$405.75,$98.27,$630.00,N/A,$611.10,N/A,$538.65,N/A,$98.27,N/A,$611.10,N/A,$630.00,N/A,N/A,$611.10
37609,0960,37609,,,,,N/A,N/A,TEMPORAL ARTERY PROCEDURE,$472.18,$351.00,$191.88,$468.00,$191.88,$453.96,$191.88,$400.14,$191.88,$344.94,$191.88,$453.96,$191.88,$468.00,$191.88,$191.88,$453.96
37718,0960,37718,,,,,N/A,N/A,LIGATE/STRIP SHORT LEG VEIN,$928.22,$690.00,$377.20,$920.00,$377.20,$892.40,$377.20,$786.60,$377.20,$701.60,$377.20,$892.40,$377.20,$920.00,$377.20,$377.20,$892.40
37722,0960,37722,,,,,N/A,N/A,LIGATE/STRIP LONG LEG VEIN,"$1,077.55",$801.00,$399.75,$975.00,$399.75,$945.75,$399.75,$833.63,$399.75,$776.42,$399.75,$945.75,$399.75,$975.00,$399.75,$399.75,$945.75
37765,0960,37765,,,,,N/A,N/A,PHLEB VEINS - EXTREM - to 20,"$1,114.88",$828.75,$332.10,$810.00,$332.10,$785.70,$332.10,$692.55,$332.10,$448.73,$332.10,$785.70,$332.10,$810.00,$332.10,$332.10,$785.70
38100,0960,38100,,,,,N/A,N/A,"REMOVAL OF SPLEEN, TOTAL","$2,186.37","$1,625.25",$83.19,"$1,959.00",$83.19,"$1,900.23",$83.19,"$1,674.95",$83.19,"$1,925.94",$83.19,"$1,900.23",$83.19,"$1,959.00",$83.19,$83.19,"$1,900.23"
38221,0960,38221,,,,,N/A,N/A,BONE MARROW BIOPSY,$240.13,$178.50,$97.58,$238.00,$97.58,$230.86,$97.58,$203.49,$97.58,$119.68,$97.58,$230.86,$97.58,$238.00,$97.58,$97.58,$230.86
9638221,0960,38221,,,,,N/A,N/A,BONE MARROW;BIOPSY      -38221,$240.13,$178.50,$97.58,$238.00,$97.58,$230.86,$97.58,$203.49,$97.58,$119.68,$97.58,$230.86,$97.58,$238.00,$97.58,$97.58,$230.86
38500,0960,38500,,,,,N/A,N/A,"BIOPSY/REMOVAL, LYMPH NODES",$554.92,$412.50,$193.93,$473.00,$193.93,$458.81,$193.93,$404.42,$193.93,$430.35,$193.93,$458.81,$193.93,$473.00,$193.93,$193.93,$458.81
38505,0960,38505,,,,,N/A,N/A,"NEEDLE BIOPSY, LYMPH NODES",$188.67,$140.25,$76.67,$187.00,$76.67,$181.39,$76.67,$159.89,$76.67,$118.57,$76.67,$181.39,$76.67,$187.00,$76.67,$76.67,$181.39
38510,0960,38510,,,,,N/A,N/A,"BIOPSY/REMOVAL, LYMPH NODES",$940.33,$699.00,$382.12,$932.00,$382.12,$904.04,$382.12,$796.86,$382.12,$705.14,$382.12,$904.04,$382.12,$932.00,$382.12,$382.12,$904.04
38525,0960,38525,,,,,N/A,N/A,"BIOPSY/REMOVAL, LYMPH NODES",$892.91,$663.75,$329.64,$805.00,$329.64,$780.85,$329.64,$688.28,$329.64,$741.20,$329.64,$780.85,$329.64,$805.00,$329.64,$329.64,$780.85
38531,0960,38531,,,,,N/A,N/A,BIOPSY/EXCISION,$883.83,$657.00,$359.16,$876.00,$359.16,$849.72,$359.16,$748.98,$359.16,$750.21,$359.16,$849.72,$359.16,$876.00,$359.16,$359.16,$849.72
38792,0960,38792,,,,,N/A,N/A,IDENTIFY SENTINEL NODE,$91.81,$68.25,$41.80,$294.00,$41.80,$285.18,$41.80,$251.37,$41.80,$55.97,$41.80,$285.18,$41.80,$294.00,$41.80,$41.80,$285.18
38900,0960,38900,,,,,N/A,N/A,IO MAP OF SENTINEL LYMPH NODE,$257.28,$191.25,$228.13,$268.00,N/A,$259.96,N/A,$229.14,N/A,$228.13,N/A,$259.96,N/A,$268.00,N/A,N/A,$259.96
39501,0960,39501,,,,,N/A,N/A,REPAIR DIAPHRAGM LACERATION,"$1,874.61","$1,393.50",$761.78,"$1,858.00",$761.78,"$1,802.26",$761.78,"$1,588.59",$761.78,"$1,464.65",$761.78,"$1,802.26",$761.78,"$1,858.00",$761.78,$761.78,"$1,802.26"
40490,0960,40490,,,,,N/A,N/A,BIOPSY OF LIP,$171.52,$127.50,$105.01,$105.01,N/A,N/A,N/A,$0.00,N/A,$105.01,N/A,N/A,N/A,N/A,N/A,N/A,N/A
40510,0960,40510,,,,,N/A,N/A,PARTIAL EXCISION OF LIP,$815.22,$606.00,$527.99,$527.99,N/A,N/A,N/A,$0.00,N/A,$527.99,N/A,N/A,N/A,N/A,N/A,N/A,N/A
40808,0960,40808,,,,,N/A,N/A,BIOPSY OF MOUTH LESION,$228.02,$169.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
40810,0960,40810,,,,,N/A,N/A,EXCISION OF MOUTH LESION,$277.46,$206.25,$186.51,$186.51,N/A,N/A,N/A,$0.00,N/A,$186.51,N/A,N/A,N/A,N/A,N/A,N/A,N/A
40812,0960,40812,,,,,N/A,N/A,EXCISE/REPAIR MOUTH LESION,$443.93,$330.00,$285.30,$285.30,N/A,N/A,N/A,$0.00,N/A,$285.30,N/A,N/A,N/A,N/A,N/A,N/A,N/A
40830,0960,40830,,,,,N/A,N/A,REPAIR MOUTH LACERATION,$361.20,$268.50,$146.78,$358.00,$146.78,$347.26,$146.78,$306.09,$146.78,$251.48,$146.78,$347.26,$146.78,$358.00,$146.78,$146.78,$347.26
41000,0960,41000,,,,,N/A,N/A,DRAINAGE OF MOUTH LESION,$254.25,$189.00,$164.99,$164.99,N/A,N/A,N/A,$0.00,N/A,$164.99,N/A,N/A,N/A,N/A,N/A,N/A,N/A
41010,0960,41010,,,,,N/A,N/A,INCISION OF TONGUE FOLD,$259.30,$192.75,$621.97,$621.97,$621.97,N/A,$621.97,N/A,$621.97,N/A,$621.97,N/A,$621.97,N/A,$621.97,$621.97,N/A
41017,0960,41017,,,,,N/A,N/A,DRAINAGE OF MOUTH LESION,$786.97,$585.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
41100,0960,41100,,,,,N/A,N/A,BIOPSY OF TONGUE,$286.54,$213.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
41105,0960,41105,,,,,N/A,N/A,BIOPSY OF TONGUE,$256.27,$190.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
41108,0960,41108,,,,,N/A,N/A,BIOPSY OF FLOOR OF MOUTH,$203.81,$151.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
41110,0960,41110,,,,,N/A,N/A,EXCISION OF TONGUE LESION,$294.61,$219.00,$197.37,$197.37,N/A,N/A,N/A,$0.00,N/A,$197.37,N/A,N/A,N/A,N/A,N/A,N/A,N/A
41115,0960,41115,,,,,N/A,N/A,EXCISION OF TONGUE FOLD,$336.99,$250.50,$221.45,$221.45,N/A,N/A,N/A,$0.00,N/A,$221.45,N/A,N/A,N/A,N/A,N/A,N/A,N/A
41116,0960,41116,,,,,N/A,N/A,EXCISION OF MOUTH LESION,$489.34,$363.75,$327.56,$327.56,N/A,N/A,N/A,$0.00,N/A,$327.56,N/A,N/A,N/A,N/A,N/A,N/A,N/A
41252,0960,41252,,,,,N/A,N/A,REPAIR TONGUE LACERATION,$491.35,$365.25,$314.58,$314.58,N/A,N/A,N/A,$0.00,N/A,$314.58,N/A,N/A,N/A,N/A,N/A,N/A,N/A
41520,0960,41520,,,,,N/A,N/A,"RECONSTRUCTION, TONGUE FOLD",$592.25,$440.25,$379.47,$379.47,N/A,N/A,N/A,$0.00,N/A,$379.47,N/A,N/A,N/A,N/A,N/A,N/A,N/A
41800,0960,41800,,,,,N/A,N/A,DRAINAGE OF GUM LESION,$290.57,$216.00,$241.26,$241.26,N/A,N/A,N/A,$0.00,N/A,$241.26,N/A,N/A,N/A,N/A,N/A,N/A,N/A
41825,0960,41825,,,,,N/A,N/A,EXCISION OF GUM LESION,$330.93,$246.00,$182.25,$182.25,N/A,N/A,N/A,$0.00,N/A,$182.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A
42100,0960,42100,,,,,N/A,N/A,BIOPSY ROOF OF MOUTH,$251.23,$186.75,$163.93,$163.93,N/A,N/A,N/A,$0.00,N/A,$163.93,N/A,N/A,N/A,N/A,N/A,N/A,N/A
42104,0960,42104,,,,,N/A,N/A,"EXCISION LESION, MOUTH ROOF",$299.66,$222.75,$204.28,$204.28,N/A,N/A,N/A,$0.00,N/A,$204.28,N/A,N/A,N/A,N/A,N/A,N/A,N/A
42140,0960,42140,,,,,N/A,N/A,EXCISION OF UVULA,$345.06,$256.50,$240.02,$240.02,N/A,N/A,N/A,$0.00,N/A,$240.02,N/A,N/A,N/A,N/A,N/A,N/A,N/A
42310,0960,42310,,,,,N/A,N/A,DRAINAGE OF SALIVARY GLAND,$288.56,$214.50,$204.60,$204.60,N/A,N/A,N/A,$0.00,N/A,$204.60,N/A,N/A,N/A,N/A,N/A,N/A,N/A
42330,0960,42330,,,,,N/A,N/A,REMOVAL OF SALIVARY STONE,$379.36,$282.00,$247.96,$247.96,N/A,N/A,N/A,$0.00,N/A,$247.96,N/A,N/A,N/A,N/A,N/A,N/A,N/A
42405,0960,42405,,,,,N/A,N/A,BIOPSY OF SALIVARY GLAND,$538.77,$400.50,$340.27,$340.27,N/A,N/A,N/A,$0.00,N/A,$340.27,N/A,N/A,N/A,N/A,N/A,N/A,N/A
42420,0960,42420,,,,,N/A,N/A,EXCISE PAROTID GLAND/LESION,"$2,991.51","$2,223.75",$14.50,"$2,450.00",$14.50,"$2,376.50",$14.50,"$2,094.75",$14.50,"$1,771.70",$14.50,"$2,376.50",$14.50,"$2,450.00",$14.50,$14.50,"$2,376.50"
42440,0960,42440,,,,,N/A,N/A,EXCISE SUBMAXILLARY GLAND,"$1,100.75",$818.25,$621.87,$621.87,N/A,N/A,N/A,$0.00,N/A,$621.87,N/A,N/A,N/A,N/A,N/A,N/A,N/A
42700,0960,42700,,,,,N/A,N/A,DRAINAGE OF TONSIL ABSCESS,$310.75,$231.00,$203.90,$633.00,N/A,$614.01,N/A,$541.22,N/A,$203.90,N/A,$614.01,N/A,$633.00,N/A,N/A,$614.01
42800,0960,42800,,,,,N/A,N/A,BIOPSY OF THROAT,$259.30,$192.75,$172.59,$172.59,N/A,N/A,N/A,$0.00,N/A,$172.59,N/A,N/A,N/A,N/A,N/A,N/A,N/A
42804,0960,42804,,,,,N/A,N/A,BIOPSY OF UPPER NOSE/THROAT,$275.44,$204.75,$179.14,$179.14,N/A,N/A,N/A,$0.00,N/A,$179.14,N/A,N/A,N/A,N/A,N/A,N/A,N/A
42808,0960,42808,,,,,N/A,N/A,EXCISE PHARYNX LESION,$395.50,$294.00,$246.43,$246.43,N/A,N/A,N/A,$0.00,N/A,$246.43,N/A,N/A,N/A,N/A,N/A,N/A,N/A
42820,0960,42820,,,,,N/A,N/A,REMOVE TONSILS AND ADENOIDS,$670.95,$498.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
42821,0960,42821,,,,,N/A,N/A,REMOVE TONSILS AND ADENOIDS,$726.44,$540.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
42825,0960,42825,,,,,N/A,N/A,REMOVAL OF TONSILS,$613.44,$456.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
42826,0960,42826,,,,,N/A,N/A,REMOVAL OF TONSILS,$597.29,$444.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
42830,0960,42830,,,,,N/A,N/A,REMOVAL OF ADENOIDS,$477.23,$354.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
42831,0960,42831,,,,,N/A,N/A,REMOVAL OF ADENOIDS,$516.58,$384.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
42860,0960,42860,,,,,N/A,N/A,EXCISION OF TONSIL TAGS,$430.82,$320.25,$288.49,$288.49,N/A,N/A,N/A,$0.00,N/A,$288.49,N/A,N/A,N/A,N/A,N/A,N/A,N/A
42960,0960,42960,,,,,N/A,N/A,CONTROL THROAT BLEEDING,$402.57,$299.25,$245.37,"$1,102.00",N/A,"$1,068.94",N/A,$942.21,N/A,$245.37,N/A,"$1,068.94",N/A,"$1,102.00",N/A,N/A,"$1,068.94"
42962,0960,42962,,,,,N/A,N/A,CONTROL THROAT BLEEDING,"$1,216.78",$904.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
43215,0960,43215,,,,,N/A,N/A,ESOPHAGUS ENDOSCOPY,$587.20,$436.50,$238.23,$582.00,$238.62,$564.54,$238.62,$497.61,$238.62,$238.23,$238.62,$564.54,$238.62,$582.00,$238.62,$238.62,$564.54
43220,0960,43220,,,,,N/A,N/A,"ESOPHAGUS ENDOSCOPY, DILATION","$1,640.54","$1,219.50",$200.03,"$1,626.00",$666.66,"$1,577.22",$666.66,"$1,390.23",$666.66,$200.03,$666.66,"$1,577.22",$666.66,"$1,626.00",$666.66,$666.66,"$1,577.22"
43233,0960,43233,,,,,N/A,N/A,ENDOSCOPIC PROC W/DILATION,$472.18,$351.00,$191.88,$468.00,$191.88,$453.96,$191.88,$400.14,$191.88,$386.82,$191.88,$453.96,$191.88,$468.00,$191.88,$191.88,$453.96
43235,0960,43235,,,,,N/A,N/A,"UPPR GI ENDOSCOPY, DIAGNOSIS",$449.99,$334.50,$182.86,$482.00,$182.86,$467.54,$182.86,$412.11,$182.86,$208.11,$182.86,$467.54,$182.86,$482.00,$182.86,$182.86,$467.54
43236,0960,43236,,,,,N/A,N/A,UPPR GI SCOPE W/SUBMUC INJ,$390.46,$290.25,$158.67,$387.00,$158.67,$375.39,$158.67,$330.89,$158.67,$234.89,$158.67,$375.39,$158.67,$387.00,$158.67,$158.67,$375.39
43239,0960,43239,,,,,N/A,N/A,"UPPER GI ENDOSCOPY, BIOPSY",$575.10,$427.50,$233.70,$570.00,$233.70,$552.90,$233.70,$487.35,$233.70,$234.89,$233.70,$552.90,$233.70,$570.00,$233.70,$233.70,$552.90
43245,0960,43245,,,,,N/A,N/A,UPPR GI SCOPE DILATE STRICTR,$887.87,$660.00,$36.80,$880.00,$36.80,$853.60,$36.80,$752.40,$36.80,$298.06,$36.80,$853.60,$36.80,$880.00,$36.80,$36.80,$853.60
43246,0960,43246,,,,,N/A,N/A,PLACE GASTROSTOMY TUBE,$567.02,$421.50,$21.72,$492.00,$21.72,$477.24,$21.72,$420.66,$21.72,$337.72,$21.72,$477.24,$21.72,$492.00,$21.72,$21.72,$477.24
43247,0960,43247,,,,,N/A,N/A,OPERATIVE UPPER GI ENDOSCOPY,$585.19,$435.00,$237.80,$580.00,$237.80,$562.60,$237.80,$495.90,$237.80,$299.96,$237.80,$562.60,$237.80,$580.00,$237.80,$237.80,$562.60
43249,0960,43249,,,,,N/A,N/A,"ESOPH ENDOSCOPY, DILATION","$1,564.87","$1,163.25",$260.65,"$1,551.00",$635.91,"$1,504.47",$635.91,"$1,326.11",$635.91,$260.65,$635.91,"$1,504.47",$635.91,"$1,551.00",$635.91,$635.91,"$1,504.47"
43250,0960,43250,,,,,N/A,N/A,UPPER GI ENDOSCOPY/TUMOR,$656.82,$488.25,$266.91,$651.00,$266.91,$631.47,$266.91,$556.61,$266.91,$288.19,$266.91,$631.47,$266.91,$651.00,$266.91,$266.91,$631.47
43251,0960,43251,,,,,N/A,N/A,OPERATIVE UPPER GI ENDOSCOPY,$721.39,$536.25,$293.15,$715.00,$293.15,$693.55,$293.15,$611.33,$293.15,$332.50,$293.15,$693.55,$293.15,$715.00,$293.15,$293.15,$693.55
43255,0960,43255,,,,,N/A,N/A,OPERATIVE UPPER GI ENDOSCOPY,$679.02,$504.75,$275.93,$673.00,$275.93,$652.81,$275.93,$575.42,$275.93,$340.31,$275.93,$652.81,$275.93,$673.00,$275.93,$275.93,$652.81
43332,0960,43332,,,,,N/A,N/A,TRANSAB ESOPH HIAT HERN RPR,"$2,241.86","$1,666.50",$911.20,"$2,222.00",$911.20,"$2,155.34",$911.20,"$1,899.81",$911.20,"$1,923.18",$911.20,"$2,155.34",$911.20,"$2,222.00",$911.20,$911.20,"$2,155.34"
43460,0960,43460,,,,,N/A,N/A,PRESSURE TREATMENT ESOPHAGUS,$498.42,$370.50,$0.00,$360.57,N/A,$0.00,N/A,$0.00,N/A,$360.57,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
43500,0960,43500,,,,,N/A,N/A,SURGICAL OPENING OF STOMACH,"$1,530.56","$1,137.75",$621.97,"$1,517.00",$621.97,"$1,471.49",$621.97,"$1,297.04",$621.97,"$1,318.05",$621.97,"$1,471.49",$621.97,"$1,517.00",$621.97,$621.97,"$1,471.49"
43501,0960,43501,,,,,N/A,N/A,SURGICAL REPAIR OF STOMACH,"$2,712.03","$2,016.00",$112.80,"$2,688.00",$112.80,"$2,607.36",$112.80,"$2,298.24",$112.80,"$2,257.29",$112.80,"$2,607.36",$112.80,"$2,688.00",$112.80,$112.80,"$2,607.36"
43605,0960,43605,,,,,N/A,N/A,BIOPSY OF STOMACH,"$1,651.63","$1,227.75",$671.17,"$1,637.00",$671.17,"$1,587.89",$671.17,"$1,399.64",$671.17,"$1,406.53",$671.17,"$1,587.89",$671.17,"$1,637.00",$671.17,$671.17,"$1,587.89"
43611,0960,43611,,,,,N/A,N/A,EXCISION OF STOMACH LESION,"$2,427.51","$1,804.50",$977.85,"$2,385.00",$977.85,"$2,313.45",$977.85,"$2,039.18",$977.85,"$2,048.98",$977.85,"$2,313.45",$977.85,"$2,385.00",$977.85,$977.85,"$2,313.45"
43632,0960,43632,,,,,N/A,N/A,"REMOVAL OF STOMACH, PARTIAL","$3,834.98","$2,850.75","$1,558.41","$3,801.00","$1,558.41","$3,686.97","$1,558.41","$3,249.86","$1,558.41","$3,388.28","$1,558.41","$3,686.97","$1,558.41","$3,801.00","$1,558.41","$1,558.41","$3,686.97"
9643752,0960,43752,,,,,N/A,N/A,NASO OR ORO-GASTRIC TUBE,$64.57,$48.00,$68.59,$68.59,N/A,N/A,N/A,$0.00,N/A,$68.59,N/A,N/A,N/A,N/A,N/A,N/A,N/A
43753,0960,43753,,,,,N/A,N/A,NON SURGICAL GASTRIC TUBE,$40.36,$30.00,$17.22,$42.00,$17.22,$40.74,$17.22,$35.91,$17.22,$36.73,$17.22,$40.74,$17.22,$42.00,$17.22,$17.22,$40.74
43762,0960,43762,,,,,N/A,N/A,REPLACE OF GASTROSTOMY TUBE,$469.16,$348.75,$19.65,$465.00,$19.65,$451.05,$19.65,$397.58,$19.65,$63.34,$19.65,$451.05,$19.65,$465.00,$19.65,$19.65,$451.05
43763,0960,43763,,,,,N/A,N/A,REQ REVISION GASTROSTOMY TRACT,$181.61,$135.00,$73.80,$180.00,$73.80,$174.60,$73.80,$153.90,$73.80,$141.99,$73.80,$174.60,$73.80,$180.00,$73.80,$73.80,$174.60
43830,0960,43830,,,,,N/A,N/A,PLACE GASTROSTOMY TUB,"$1,369.13","$1,017.75",$556.37,"$1,357.00",$556.37,"$1,316.29",$556.37,"$1,160.24",$556.37,"$1,186.26",$556.37,"$1,316.29",$556.37,"$1,357.00",$556.37,$556.37,"$1,316.29"
43840,0960,43840,,,,,N/A,N/A,REPAIR OF STOMACH LESION,"$2,573.81","$1,913.25",$866.74,"$2,275.04",$866.74,"$2,050.58",$866.74,"$1,807.47",$866.74,"$2,275.04",$866.74,"$2,050.58",$866.74,"$2,114.00",$866.74,$866.74,"$2,050.58"
44005,0960,44005,,,,,N/A,N/A,FREEING OF BOWEL ADHESION,"$2,194.44","$1,631.25",$891.75,"$2,175.00",$891.75,"$2,109.75",$891.75,"$1,859.63",$891.75,"$1,827.76",$891.75,"$2,109.75",$891.75,"$2,175.00",$891.75,$891.75,"$2,109.75"
44020,0960,44020,,,,,N/A,N/A,EXPLORE SMALL INTESTINE,"$1,903.87","$1,415.25",$553.90,"$1,633.36",$553.90,"$1,308.53",$553.90,"$1,153.40",$553.90,"$1,633.36",$553.90,"$1,308.53",$553.90,"$1,349.00",$553.90,$553.90,"$1,308.53"
44050,0960,44050,,,,,N/A,N/A,REDUCE BOWEL OBSTRUCTION,"$1,910.93","$1,420.50",$776.54,"$1,894.00",$776.54,"$1,837.18",$776.54,"$1,619.37",$776.54,"$1,567.88",$776.54,"$1,837.18",$776.54,"$1,894.00",$776.54,$776.54,"$1,837.18"
44120,0960,44120,,,,,N/A,N/A,REMOVAL OF SMALL INTESTINE,"$2,323.59","$1,727.25",$934.80,"$2,280.00",$934.80,"$2,211.60",$934.80,"$1,949.40",$934.80,"$2,042.68",$934.80,"$2,211.60",$934.80,"$2,280.00",$934.80,$934.80,"$2,211.60"
44121,0960,44121,,,,,N/A,N/A,REMOVAL OF SMALL INTESTINE,$573.08,$426.00,$232.88,$568.00,$232.88,$550.96,$232.88,$485.64,$232.88,$400.81,$232.88,$550.96,$232.88,$568.00,$232.88,$232.88,$550.96
44125,0960,44125,,,,,N/A,N/A,EXCISION W/ ENTEROSTOMY,"$2,370.00","$1,761.75",$67.76,"$1,972.68",$67.76,"$1,586.92",$67.76,"$1,398.78",$67.76,"$1,972.68",$67.76,"$1,586.92",$67.76,"$1,636.00",$67.76,$67.76,"$1,586.92"
44130,0960,44130,,,,,N/A,N/A,BOWEL TO BOWEL FUSION,"$2,488.05","$1,849.50",$83.19,"$2,202.29",$83.19,"$1,900.23",$83.19,"$1,674.95",$83.19,"$2,202.29",$83.19,"$1,900.23",$83.19,"$1,959.00",$83.19,$83.19,"$1,900.23"
44139,0960,44139,,,,,N/A,N/A,MOBILIZATION OF COLON,$287.55,$213.75,$93.70,$227.00,$93.70,$220.19,$93.70,$194.09,$93.70,$200.32,$93.70,$220.19,$93.70,$227.00,$93.70,$93.70,$220.19
44140,0960,44140,,,,,N/A,N/A,PARTIAL REMOVAL OF COLON,"$2,832.09","$2,105.25",$115.87,"$2,807.00",$115.87,"$2,722.79",$115.87,"$2,399.99",$115.87,"$2,246.58",$115.87,"$2,722.79",$115.87,"$2,807.00",$115.87,$115.87,"$2,722.79"
44143,0960,44143,,,,,N/A,N/A,COLON RESECTION W/END COLOST,"$3,213.47","$2,388.75","$1,336.60","$3,260.00","$1,336.60",N/A,"$1,336.60","$2,787.30","$1,336.60","$2,783.08","$1,336.60",N/A,"$1,336.60","$3,260.00","$1,336.60","$1,336.60",N/A
44145,0960,44145,,,,,N/A,N/A,PARTIAL REMOVAL OF COLON,"$3,550.46","$2,639.25","$1,279.20","$3,120.00","$1,279.20","$3,026.40","$1,279.20","$2,667.60","$1,279.20","$2,763.00","$1,279.20","$3,026.40","$1,279.20","$3,120.00","$1,279.20","$1,279.20","$3,026.40"
44150,0960,44150,,,,,N/A,N/A,REMOVAL OF COLON,"$3,577.70","$2,659.50","$1,453.86","$3,546.00","$1,453.86","$3,439.62","$1,453.86","$3,031.83","$1,453.86","$3,128.14","$1,453.86","$3,439.62","$1,453.86","$3,546.00","$1,453.86","$1,453.86","$3,439.62"
44160,0960,44160,,,,,N/A,N/A,REMOVAL OF COLON,"$2,517.31","$1,871.25",$122.95,"$2,495.00",$122.95,"$2,420.15",$122.95,"$2,133.23",$122.95,"$2,077.94",$122.95,"$2,420.15",$122.95,"$2,495.00",$122.95,$122.95,"$2,420.15"
44180,0960,44180,,,,,N/A,N/A,"LAP, ENTEROLYSIS","$1,843.33","$1,370.25",$71.92,"$1,712.00",$71.92,"$1,660.64",$71.92,"$1,463.76",$71.92,"$1,541.10",$71.92,"$1,660.64",$71.92,"$1,712.00",$71.92,$71.92,"$1,660.64"
44188,0960,44188,,,,,N/A,N/A,LAP COLOSTOMY,"$2,352.85","$1,749.00",$992.20,"$2,420.00",$992.20,"$2,347.40",$992.20,"$2,069.10",$992.20,"$2,055.70",$992.20,"$2,347.40",$992.20,"$2,420.00",$992.20,$992.20,"$2,347.40"
44202,0960,44202,,,,,N/A,N/A,LAP RESECT S/INTESTINE SINGL,"$2,960.23","$2,200.50","$1,112.74","$2,714.00","$1,112.74","$2,632.58","$1,112.74","$2,320.47","$1,112.74","$2,318.59","$1,112.74","$2,632.58","$1,112.74","$2,714.00","$1,112.74","$1,112.74","$2,632.58"
44204,0960,44204,,,,,N/A,N/A,LAPARO PARTIAL COLECTOMY,"$3,343.63","$2,485.50","$2,072.89","$2,571.24",N/A,"$2,072.89",N/A,"$1,827.14",N/A,"$2,571.24",N/A,"$2,072.89",N/A,"$2,137.00",N/A,N/A,"$2,072.89"
44206,0960,44206,,,,,N/A,N/A,LAP PART COLECTOMY W/STOMA,"$3,652.36","$2,715.00","$1,484.20","$3,620.00","$1,484.20","$3,511.40","$1,484.20","$3,095.10","$1,484.20","$2,925.76","$1,484.20","$3,511.40","$1,484.20","$3,620.00","$1,484.20","$1,484.20","$3,511.40"
44207,0960,44207,,,,,N/A,N/A,COLOCTOMY PART W/ANASTOM,"$3,960.09","$2,943.75","$1,476.82","$3,602.00","$1,476.82","$3,493.94","$1,476.82","$3,079.71","$1,476.82","$3,034.95","$1,476.82","$3,493.94","$1,476.82","$3,602.00","$1,476.82","$1,476.82","$3,493.94"
44210,0960,44210,,,,,N/A,N/A,LAPARO TOTAL PROCTOCOLECTOMY,"$3,800.68","$2,825.25",$0.00,"$2,976.96",N/A,$0.00,N/A,$0.00,N/A,"$2,976.96",N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
44213,0960,44213,,,,,N/A,N/A,LAP ENTEROSTOMY W/PROCEDURE,$423.75,$315.00,$154.16,$376.00,$154.16,$364.72,$154.16,$321.48,$154.16,$311.48,$154.16,$364.72,$154.16,$376.00,$154.16,$154.16,$364.72
44227,0960,44227,,,,,N/A,N/A,"LAP, CLOSE ENTEROSTOMY","$3,315.38","$2,464.50","$2,780.56","$3,273.00",N/A,"$3,174.81",N/A,"$2,798.42",N/A,"$2,780.56",N/A,"$3,174.81",N/A,"$3,273.00",N/A,N/A,"$3,174.81"
44310,0960,44310,,,,,N/A,N/A,ILEOSTOMY/JEJUNOSTOMY,"$2,161.15","$1,606.50",$878.22,"$2,142.00",$878.22,"$2,077.74",$878.22,"$1,831.41",$878.22,"$1,743.30",$878.22,"$2,077.74",$878.22,"$2,142.00",$878.22,$878.22,"$2,077.74"
44312,0960,44312,,,,,N/A,N/A,REVISION OF ILEOSTOMY,"$1,142.12",$849.00,$464.12,"$1,132.00",$464.12,"$1,098.04",$464.12,$967.86,$464.12,"$1,006.54",$464.12,"$1,098.04",$464.12,"$1,132.00",$464.12,$464.12,"$1,098.04"
44320,0960,44320,,,,,N/A,N/A,COLOSTOMY,"$2,414.39","$1,794.75",$162.31,"$2,591.00",$162.31,"$2,513.27",$162.31,"$2,215.31",$162.31,"$2,013.77",$162.31,"$2,513.27",$162.31,"$2,591.00",$162.31,$162.31,"$2,513.27"
44346,0960,44346,,,,,N/A,N/A,OPEN ENTEROSTOMY PROCEDURE,"$2,322.58","$1,726.50",$965.96,"$2,356.00",$965.96,"$2,285.32",$965.96,"$2,014.38",$965.96,"$1,985.81",$965.96,"$2,285.32",$965.96,"$2,356.00",$965.96,$965.96,"$2,285.32"
44386,0960,44386,,,,,N/A,N/A,"ENDOSCOPY, BOWEL POUCH/BIOP",$284.52,$211.50,$150.67,$282.00,N/A,$273.54,N/A,$241.11,N/A,$150.67,N/A,$273.54,N/A,$282.00,N/A,N/A,$273.54
44388,0960,44388,,,,,N/A,N/A,COLONOSCOPY,$456.04,$339.00,$185.32,$452.00,$185.32,$438.44,$185.32,$386.46,$185.32,$263.98,$185.32,$438.44,$185.32,$452.00,$185.32,$185.32,$438.44
44389,0960,44389,,,,,N/A,N/A,ENDOSCOPY WITH BIOPSY,$560.97,$417.00,$227.96,$556.00,$227.96,$539.32,$227.96,$475.38,$227.96,$291.29,$227.96,$539.32,$227.96,$556.00,$227.96,$227.96,$539.32
44392,0960,44392,,,,,N/A,N/A,COLONOSCOPY & POLYPECTOMY,$599.31,$445.50,$0.00,$334.71,N/A,$0.00,N/A,$0.00,N/A,$334.71,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
44394,0960,44394,,,,,N/A,N/A,REMOVAL OF TUMOR BY SNARE,$705.25,$524.25,$286.59,$699.00,$286.59,$678.03,$286.59,$597.65,$286.59,$381.00,$286.59,$678.03,$286.59,$699.00,$286.59,$286.59,$678.03
44404,0960,44404,,,,,N/A,N/A,COLONOSCOPY W/INJECTION,$893.92,$664.50,$290.94,$886.00,$363.26,$859.42,$363.26,$757.53,$363.26,$290.94,$363.26,$859.42,$363.26,$886.00,$363.26,$363.26,$859.42
44500,0960,44500,,,,,N/A,N/A,"INTRO, GASTROINTESTINAL TUBE",$62.55,$46.50,$4.10,$62.00,$4.10,$60.14,$4.10,$53.01,$4.10,$33.22,$4.10,$60.14,$4.10,$62.00,$4.10,$4.10,$60.14
4450040B,0960,44500,,,,,N/A,N/A,"INTRO, GASTROINTESTINAL TUBE~P",$52.46,$39.00,$4.10,$62.00,$4.10,$60.14,$4.10,$53.01,$4.10,$33.22,$4.10,$60.14,$4.10,$62.00,$4.10,$4.10,$60.14
44602,0960,44602,,,,,N/A,N/A,"SUTURE, SMALL INTESTINE","$2,667.64","$1,983.00",$166.00,"$2,600.00",$166.00,"$2,522.00",$166.00,"$2,223.00",$166.00,"$2,349.64",$166.00,"$2,522.00",$166.00,"$2,600.00",$166.00,$166.00,"$2,522.00"
44604,0960,44604,,,,,N/A,N/A,"SUTURE, LARGE INTESTINE","$2,151.06","$1,599.00",$598.19,"$1,768.11",$598.19,"$1,415.23",$598.19,"$1,247.45",$598.19,"$1,768.11",$598.19,"$1,415.23",$598.19,"$1,459.00",$598.19,$598.19,"$1,415.23"
44620,0960,44620,,,,,N/A,N/A,REPAIR BOWEL OPENING,"$1,672.82","$1,243.50",$599.83,"$1,463.00",$599.83,"$1,419.11",$599.83,"$1,250.87",$599.83,"$1,452.50",$599.83,"$1,419.11",$599.83,"$1,463.00",$599.83,$599.83,"$1,419.11"
44625,0960,44625,,,,,N/A,N/A,REPAIR BOWEL OPENING,"$2,036.04","$1,513.50",$779.00,"$1,900.00",$779.00,"$1,843.00",$779.00,"$162,450.00",$779.00,"$1,697.74",$779.00,"$1,843.00",$779.00,"$1,900.00",$779.00,$779.00,"$1,843.00"
44640,0960,44640,,,,,N/A,N/A,REPAIR BOWEL-SKIN FISTULA,"$2,888.60","$2,147.25",$171.74,"$2,614.00",$171.74,"$2,535.58",$171.74,"$2,234.97",$171.74,"$2,335.57",$171.74,"$2,535.58",$171.74,"$2,614.00",$171.74,$171.74,"$2,535.58"
44660,0960,44660,,,,,N/A,N/A,REPAIR BLADDER-BOWEL FISTULA,"$2,813.93","$2,091.75","$1,143.49","$2,789.00","$1,143.49","$2,705.33","$1,143.49","$2,384.60","$1,143.49","$2,246.06","$1,143.49","$2,705.33","$1,143.49","$2,789.00","$1,143.49","$1,143.49","$2,705.33"
44661,0960,44661,,,,,N/A,N/A,REPAIR BOWEL-BLADDER FISTULA,"$3,269.97","$2,430.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
44700,0960,44700,,,,,N/A,N/A,SUSPEND BOWEL W/PROSTHESIS,"$2,165.19","$1,609.50","$1,683.98","$1,683.98",N/A,N/A,N/A,$0.00,N/A,"$1,683.98",N/A,N/A,N/A,N/A,N/A,N/A,N/A
44701,0960,44701,,,,,N/A,N/A,INTRAOP COLON LAVAGE ADD-ON,$399.54,$297.00,$134.48,$328.00,$134.48,$318.16,$134.48,$280.44,$134.48,$280.73,$134.48,$318.16,$134.48,$328.00,$134.48,$134.48,$318.16
44850,0960,44850,,,,,N/A,N/A,REPAIR OF MESENTERY,"$1,501.30","$1,116.00",$61.80,"$1,488.00",$61.80,"$1,443.36",$61.80,"$1,272.24",$61.80,"$1,255.57",$61.80,"$1,443.36",$61.80,"$1,488.00",$61.80,$61.80,"$1,443.36"
44950,0960,44950,,,,,N/A,N/A,APPENDECTOMY,"$1,369.13","$1,017.75",$364.49,"$1,078.45",$364.49,$862.33,$364.49,$760.10,$364.49,"$1,078.45",$364.49,$862.33,$364.49,$889.00,$364.49,$364.49,$862.33
44955,0960,44955,,,,,N/A,N/A,APPENDECTOMY ADD-ON,$218.94,$162.75,$88.97,$217.00,$88.97,$210.49,$88.97,$185.54,$88.97,$138.96,$88.97,$210.49,$88.97,$217.00,$88.97,$88.97,$210.49
44960,0960,44960,,,,,N/A,N/A,APPENDECTOMY,"$1,689.97","$1,256.25",$686.75,"$1,675.00",$686.75,"$1,624.75",$686.75,"$1,432.13",$686.75,"$1,470.11",$686.75,"$1,624.75",$686.75,"$1,675.00",$686.75,$686.75,"$1,624.75"
44970,0960,44970,,,,,N/A,N/A,"LAPAROSCOPY, APPENDECTOMY","$1,221.83",$908.25,$496.51,"$1,211.00",$496.51,"$1,174.67",$496.51,"$1,035.41",$496.51,"$1,013.09",$496.51,"$1,174.67",$496.51,"$1,211.00",$496.51,$496.51,"$1,174.67"
45000,0960,45000,,,,,N/A,N/A,DRAINAGE OF PELVIC ABSCESS,$817.24,$607.50,$332.10,$810.00,$332.10,$785.70,$332.10,$692.55,$332.10,$724.70,$332.10,$785.70,$332.10,$810.00,$332.10,$332.10,$785.70
45100,0960,45100,,,,,N/A,N/A,BIOPSY OF RECTUM,$579.13,$430.50,$235.34,$574.00,$235.34,$556.78,$235.34,$490.77,$235.34,$513.44,$235.34,$556.78,$235.34,$574.00,$235.34,$235.34,$556.78
45111,0960,45111,,,,,N/A,N/A,OPEN/TRANSRECTAL PROCEDURE,"$2,255.99","$1,677.00",$889.29,"$2,169.00",$889.29,"$2,103.93",$889.29,"$1,854.50",$889.29,"$1,827.92",$889.29,"$2,103.93",$889.29,"$2,169.00",$889.29,$889.29,"$2,103.93"
45130,0960,45130,,,,,N/A,N/A,EXCISION OF REC .5CM OR LESS,"$2,202.52","$1,637.25",$63.99,"$1,826.36",$63.99,"$1,492.83",$63.99,"$1,315.85",$63.99,"$1,826.36",$63.99,"$1,492.83",$63.99,"$1,539.00",$63.99,$63.99,"$1,492.83"
45171,0960,45171,,,,,N/A,N/A,EXC RCT TUM NOT INCL MUSCULARI,"$1,184.50",$880.50,$481.34,"$1,174.00",$481.34,"$1,138.78",$481.34,"$1,003.77",$481.34,"$1,063.91",$481.34,"$1,138.78",$481.34,"$1,174.00",$481.34,$481.34,"$1,138.78"
45190,0960,45190,,,,,N/A,N/A,"DESTRUCTION, RECTAL TUMOR","$1,364.09","$1,014.00",$554.32,"$1,352.00",$554.32,"$1,311.44",$554.32,"$1,155.96",$554.32,"$1,210.16",$554.32,"$1,311.44",$554.32,"$1,352.00",$554.32,$554.32,"$1,311.44"
45305,0960,45305,,,,,N/A,N/A,PROCTOSIGMOIDOSCOPY W/BX,$212.89,$158.25,$122.85,$211.00,N/A,$204.67,N/A,$180.41,N/A,$122.85,N/A,$204.67,N/A,$211.00,N/A,N/A,$204.67
45317,0960,45317,,,,,N/A,N/A,RIGID PROCTOSIG W/CONT BLEED,$248.20,$184.50,$1.86,$246.00,$1.86,$238.62,$1.86,$210.33,$1.86,$186.21,$1.86,$238.62,$1.86,$246.00,$1.86,$1.86,$238.62
45330,0960,45330,,,,,N/A,N/A,DIAGNOSTIC SIGMOIDOSCOPY,$195.73,$145.50,$79.54,$194.00,$79.54,$188.18,$79.54,$165.87,$79.54,$94.53,$79.54,$188.18,$79.54,$194.00,$79.54,$79.54,$188.18
45331,0960,45331,,,,,N/A,N/A,SIGMOIDOSCOPY AND BIOPSY,$285.53,$212.25,$116.30,$283.00,$116.30,$274.51,$116.30,$241.97,$116.30,$122.00,$116.30,$274.51,$116.30,$283.00,$116.30,$116.30,$274.51
45333,0960,45333,,,,,N/A,N/A,SIGMOIDOSCOPY & POLYPECTOMY,$387.43,$288.00,$0.00,$158.65,N/A,$0.00,N/A,$0.00,N/A,$158.65,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
45334,0960,45334,,,,,N/A,N/A,FLEXIBLE SIGMOIDOSCOPY,$547.85,$407.25,$199.27,$543.00,N/A,$526.71,N/A,$464.27,N/A,$199.27,N/A,$526.71,N/A,$543.00,N/A,N/A,$526.71
45335,0960,45335,,,,,N/A,N/A,SIGMOID W/DIR SUBMUCOSAL INJ,$392.48,$291.75,$112.99,$389.00,$159.49,$377.33,$159.49,$332.60,$159.49,$112.99,$159.49,$377.33,$159.49,$389.00,$159.49,$159.49,$377.33
45338,0960,45338,,,,,N/A,N/A,FLEXIBLE SIGMOID PROCEDURE,$454.02,$337.50,$184.50,$450.00,$184.50,$436.50,$184.50,$384.75,$184.50,$203.90,$184.50,$436.50,$184.50,$450.00,$184.50,$184.50,$436.50
45350,0960,45350,,,,,N/A,N/A,SIGMOIDOSCOPY W/ BAND LIGATION,$740.56,$550.50,$3.94,$734.00,$3.94,$711.98,$3.94,$627.57,$3.94,$170.68,$3.94,$711.98,$3.94,$734.00,$3.94,$3.94,$711.98
45378,0960,45378,,,,,N/A,N/A,DIAGNOSTIC COLONOSCOPY,$550.88,$409.50,$248.50,$546.00,$248.50,$529.62,$248.50,$466.83,$248.50,$313.95,$248.50,$529.62,$248.50,$546.00,$248.50,$248.50,$529.62
45380,0960,45380,,,,,N/A,N/A,COLONOSCOPY AND BIOPSY,$655.81,$487.50,$0.00,$650.00,$266.50,$0.00,$266.50,$555.75,$266.50,$485.35,$266.50,$0.00,$266.50,$650.00,$266.50,$266.50,$0.00
45381,0960,45381,,,,,N/A,N/A,"COLONOSCOPY, SUBMUCOUS INJ",$659.85,$490.50,$27.60,$654.00,$27.60,$630.50,$27.60,$559.17,$27.60,$340.74,$27.60,$630.50,$27.60,$654.00,$27.60,$27.60,$630.50
45382,0960,45382,,,,,N/A,N/A,COLONOSCOPY/CONTROL BLEEDING,$852.55,$633.75,$346.45,$845.00,$346.45,$634.38,$346.45,$722.48,$346.45,$439.38,$346.45,$634.38,$346.45,$845.00,$346.45,$346.45,$634.38
45384,0960,45384,,,,,N/A,N/A,LESION REMOVAL COLONOSCOPY,$656.82,$488.25,$299.71,$819.65,$299.71,$819.65,$299.71,$625.01,$299.71,$384.59,$299.71,$819.65,$299.71,$731.00,$299.71,$299.71,$819.65
45385,0960,45385,,,,,N/A,N/A,LESION REMOVAL COLONOSCOPY,$740.56,$550.50,$3.94,$734.00,$3.94,$709.07,$3.94,$627.57,$3.94,$638.99,$3.94,$709.07,$3.94,$734.00,$3.94,$3.94,$709.07
45386,0960,45386,,,,,N/A,N/A,COLONOSCOPY DILATE STRICTURE,$948.40,$705.00,$358.59,$940.00,$385.40,$711.98,$385.40,$803.70,$385.40,$358.59,$385.40,$711.98,$385.40,$940.00,$385.40,$385.40,$711.98
45388,0960,45388,,,,,N/A,N/A,COLONOSCOPY w/ABLATION TUMOR,"$2,836.13","$2,108.25",$458.34,"$2,811.00","$1,152.51",$911.80,"$1,152.51","$2,403.41","$1,152.51",$458.34,"$1,152.51",$911.80,"$1,152.51","$2,811.00","$1,152.51","$1,152.51",$911.80
45393,0960,45393,,,,,N/A,N/A,COLONOSCOPY W/DECOMPRESSION,$534.74,$397.50,$217.30,"$2,726.67",$217.30,"$2,726.67",$217.30,$453.15,$217.30,$427.68,$217.30,"$2,726.67",$217.30,$530.00,$217.30,$217.30,"$2,726.67"
45398,0960,45398,,,,,N/A,N/A,COLONOSCOPY W/BAND LIGATION,$740.56,$550.50,$3.94,$734.00,$3.94,$514.10,$3.94,$627.57,$3.94,$396.43,$3.94,$514.10,$3.94,$734.00,$3.94,$3.94,$514.10
45505,0960,45505,,,,,N/A,N/A,REPAIR OF RECTUM,"$1,137.08",$845.25,$711.98,"$1,028.59",N/A,$711.98,N/A,$0.00,N/A,"$1,028.59",N/A,$711.98,N/A,N/A,N/A,N/A,$711.98
45540,0960,45540,,,,,N/A,N/A,CORRECT RECTAL PROLAPSE,"$2,192.43","$1,629.75","$1,780.84","$1,780.84",N/A,N/A,N/A,$0.00,N/A,"$1,780.84",N/A,N/A,N/A,N/A,N/A,N/A,N/A
45550,0960,45550,,,,,N/A,N/A,REPAIR RECTUM/REMOVE SIGMOID,"$3,065.16","$2,278.50","$1,245.58","$3,038.00","$1,245.58","$2,946.86","$1,245.58","$2,597.49","$1,245.58","$2,467.05","$1,245.58","$2,946.86","$1,245.58","$3,038.00","$1,245.58","$1,245.58","$2,946.86"
45915,0960,45915,,,,,N/A,N/A,REMOVE RECTAL OBSTRUCTION,$492.36,$366.00,$0.00,$327.11,N/A,$0.00,N/A,$0.00,N/A,$327.11,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
45990,0960,45990,,,,,N/A,N/A,"SURG DX EXAM, ANORECTAL",$231.05,$171.75,$93.89,$396.07,$93.89,$222.13,$93.89,$195.80,$93.89,$396.07,$93.89,$222.13,$93.89,$229.00,$93.89,$93.89,$222.13
46020,0960,46020,,,,,N/A,N/A,PLACEMENT OF SETON,$453.01,$336.75,$177.35,$449.00,$184.90,$435.53,$184.90,$383.90,$184.90,$177.35,$184.90,$435.53,$184.90,$449.00,$184.90,$184.90,$435.53
46040,0960,46040,,,,,N/A,N/A,INCISION OF RECTAL ABSCESS,$807.15,$600.00,$311.60,"$1,440.00",$311.60,"$1,396.80",$311.60,"$1,231.20",$311.60,$408.89,$311.60,"$1,396.80",$311.60,"$1,440.00",$311.60,$311.60,"$1,396.80"
46050,0960,46050,,,,,N/A,N/A,INCISION OF ANAL ABSCESS,$226.00,$168.00,$87.74,$725.44,$87.74,$217.28,$87.74,$191.52,$87.74,$725.44,$87.74,$217.28,$87.74,$224.00,$87.74,$87.74,$217.28
46080,0960,46080,,,,,N/A,N/A,INCISION OF ANAL SPHINCTER,$347.08,$258.00,$129.15,$315.00,$129.15,$305.55,$129.15,$269.33,$129.15,$170.87,$129.15,$305.55,$129.15,$315.00,$129.15,$129.15,$305.55
46083,0960,46083,,,,,N/A,N/A,INCISE EXTERNAL HEMORRHOID,$254.25,$189.00,$13.32,$267.07,$13.32,$244.44,$13.32,$215.46,$13.32,$267.07,$13.32,$244.44,$13.32,$252.00,$13.32,$13.32,$244.44
46200,0960,46200,,,,,N/A,N/A,REMOVAL OF ANAL FISSURE,$628.57,$467.25,$186.83,$623.00,$255.43,$604.31,$255.43,N/A,$255.43,$186.83,$255.43,$604.31,$255.43,$623.00,$255.43,$255.43,$604.31
46220,0960,46220,,,,,N/A,N/A,REMOVAL OF ANAL TAG,$238.11,$177.00,$0.00,$580.94,N/A,$0.00,N/A,$0.00,N/A,$580.94,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
46221,0960,46221,,,,,N/A,N/A,LIGATION OF HEMORRHOID(S),$372.30,$276.75,$144.73,$353.00,$144.73,$342.41,$144.73,$301.82,$144.73,$205.55,$144.73,$342.41,$144.73,$353.00,$144.73,$144.73,$342.41
46230,0960,46230,,,,,N/A,N/A,REMOVAL OF ANAL TAGS,$368.26,$273.75,$0.00,$335.33,N/A,$0.00,N/A,$0.00,N/A,$335.33,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
46250,0960,46250,,,,,N/A,N/A,HEMORRHOIDECTOMY,$616.46,$458.25,$25.51,$611.00,$25.51,$592.67,$25.51,$522.41,$25.51,$293.96,$25.51,$592.67,$25.51,$611.00,$25.51,$25.51,$592.67
46255,0960,46255,,,,,N/A,N/A,HEMORRHOIDECTOMY,$704.24,$523.50,$286.18,$698.00,$286.18,$677.06,$286.18,$596.79,$286.18,$548.66,$286.18,$677.06,$286.18,$698.00,$286.18,$286.18,$677.06
46260,0960,46260,,,,,N/A,N/A,HEMORRHOIDECTOMY,$910.06,$676.50,$369.00,$369.00,$369.00,N/A,$369.00,N/A,$369.00,N/A,$369.00,N/A,$369.00,N/A,$369.00,$369.00,N/A
46270,0960,46270,,,,,N/A,N/A,RESECTION OF ANAL FISTULA,$750.65,$558.00,$317.75,$775.00,$317.75,$751.75,$317.75,$662.63,$317.75,$734.37,$317.75,$751.75,$317.75,$775.00,$317.75,$317.75,$751.75
46275,0960,46275,,,,,N/A,N/A,REMOVAL OF ANAL FISTULA,$796.05,$591.75,$323.49,$789.00,$323.49,$765.33,$323.49,$674.60,$323.49,$685.63,$323.49,$765.33,$323.49,$789.00,$323.49,$323.49,$765.33
46280,0960,46280,,,,,N/A,N/A,REMOVAL OF ANAL FISTULA,$903.00,$671.25,$366.95,$895.00,$366.95,$868.15,$366.95,$765.23,$366.95,$722.55,$366.95,$868.15,$366.95,$895.00,$366.95,$366.95,$868.15
46320,0960,46320,,,,,N/A,N/A,REMOVAL OF HEMORRHOID CLOT,$235.08,$174.75,$95.53,$821.79,$95.53,$226.01,$95.53,$199.22,$95.53,$821.79,$95.53,$226.01,$95.53,$233.00,$95.53,$95.53,$226.01
46600,0960,46600,,,,,N/A,N/A,DIAGNOSTIC ANOSCOPY,$120.06,$89.25,$48.79,$192.32,$48.79,$115.43,$48.79,$101.75,$48.79,$192.32,$48.79,$115.43,$48.79,$119.00,$48.79,$48.79,$115.43
46606,0960,46606,,,,,N/A,N/A,ANOSCOPY AND BIOPSY,$265.35,$197.25,$17.83,$263.00,$17.83,$255.11,$17.83,$224.87,$17.83,$68.60,$17.83,$255.11,$17.83,$263.00,$17.83,$17.83,$255.11
46610,0960,46610,,,,,N/A,N/A,"ANOSCOPY, REMOVE LESION",$307.73,$228.75,$127.40,$305.00,$129.15,$295.85,$129.15,$260.78,$129.15,$127.40,$129.15,$295.85,$129.15,$305.00,$129.15,$129.15,$295.85
46611,0960,46611,,,,,N/A,N/A,ANOSCOPIC PROCEDURE,$306.72,$228.00,$124.64,$304.00,$124.64,$294.88,$124.64,$259.92,$124.64,$134.69,$124.64,$294.88,$124.64,$304.00,$124.64,$124.64,$294.88
46922,0960,46922,,,,,N/A,N/A,EXCISION OF ANAL LESION(S),$302.68,$225.00,$107.92,$300.00,$123.00,$291.00,$123.00,$256.50,$123.00,$107.92,$123.00,$291.00,$123.00,$300.00,$123.00,$123.00,$291.00
46924,0960,46924,,,,,N/A,N/A,DESTRUCTION OF LESION/ANUS,"$1,075.53",$799.50,$232.25,"$1,066.00",$437.60,"$1,034.02",$437.60,$911.43,$437.60,$232.25,$437.60,"$1,034.02",$437.60,"$1,066.00",$437.60,$437.60,"$1,034.02"
46930,0960,46930,,,,,N/A,N/A,DESTROY INTERNAL HEMORRHOIDS,$296.63,$220.50,$12.54,$306.24,$12.54,$285.18,$12.54,$251.37,$12.54,$306.24,$12.54,$285.18,$12.54,$294.00,$12.54,$12.54,$285.18
46946,0960,46946,,,,,N/A,N/A,LIGATION OF HEMORRHOIDS,$466.13,$346.50,$189.42,$462.00,$189.42,$448.14,$189.42,$395.01,$189.42,$265.71,$189.42,$448.14,$189.42,$462.00,$189.42,$189.42,$448.14
46948,0960,46948,,,,,N/A,N/A,HEMORRHOIDECTOMY,$891.90,$663.00,$362.44,$884.00,$362.44,$857.48,$362.44,$755.82,$362.44,$662.75,$362.44,$857.48,$362.44,$884.00,$362.44,$362.44,$857.48
47000,0960,47000,,,,,N/A,N/A,NEEDLE BIOPSY OF LIVER,$398.53,$296.25,$161.95,$768.05,$161.95,$383.15,$161.95,$337.73,$161.95,$768.05,$161.95,$383.15,$161.95,$395.00,$161.95,$161.95,$383.15
47001,0960,47001,,,,,N/A,N/A,"NEEDLE BIOPSY, LIVER ADD-ON",$248.20,$184.50,$82.41,$201.00,$82.41,$194.97,$82.41,$171.86,$82.41,$149.98,$82.41,$194.97,$82.41,$201.00,$82.41,$82.41,$194.97
47100,0960,47100,,,,,N/A,N/A,WEDGE BIOPSY OF LIVER,"$1,686.95","$1,254.00",$171.65,"$1,672.00",N/A,"$1,621.84",N/A,"$1,429.56",N/A,$171.65,N/A,"$1,621.84",N/A,"$1,672.00",N/A,N/A,"$1,621.84"
47562,0960,47562,,,,,N/A,N/A,LAPAROSCOPIC CHOLECYSTECTOMY,"$1,535.61","$1,141.50",$119.85,"$1,522.00",$624.20,"$1,476.34",$624.20,"$1,301.31",$624.20,$119.85,$624.20,"$1,476.34",$624.20,"$1,522.00",$624.20,$624.20,"$1,476.34"
47563,0960,47563,,,,,N/A,N/A,LAPARO CHOLECYSTECTOMY/GRAPH,"$1,647.60","$1,224.75",$669.53,"$1,633.00",$669.53,"$1,584.01",$669.53,"$1,396.22",$669.53,"$1,108.95",$669.53,"$1,584.01",$669.53,"$1,633.00",$669.53,$669.53,"$1,584.01"
47564,0960,47564,,,,,N/A,N/A,LAPARO CHOLECYSTECTOMY/EXPLR,"$2,079.43","$1,545.75",$89.93,"$2,173.00",$89.93,"$2,107.81",$89.93,"$1,857.92",$89.93,"$1,206.63",$89.93,"$2,107.81",$89.93,"$2,173.00",$89.93,$89.93,"$2,107.81"
47600,0960,47600,,,,,N/A,N/A,REMOVAL OF GALLBLADDER,"$2,059.25","$1,530.75",$765.47,"$1,875.98",$765.47,"$1,810.99",$765.47,"$1,596.29",$765.47,"$1,875.98",$765.47,"$1,810.99",$765.47,"$1,867.00",$765.47,$765.47,"$1,810.99"
47605,0960,47605,,,,,N/A,N/A,CHOLECYSECTOMY W/CHOLNGIGRPY,"$2,023.93","$1,504.50",$759.32,"$1,852.00",$759.32,"$1,796.44",$759.32,"$1,583.46",$759.32,"$1,794.51",$759.32,"$1,796.44",$759.32,"$1,852.00",$759.32,$759.32,"$1,796.44"
47610,0960,47610,,,,,N/A,N/A,CHOLE W/EXPLO COMMON DUCT,"$2,557.66","$1,901.25",$12.40,"$2,444.00",$12.40,"$2,370.68",$12.40,"$2,089.62",$12.40,"$1,890.03",$12.40,"$2,370.68",$12.40,"$2,444.00",$12.40,$12.40,"$2,370.68"
47780,0960,47780,,,,,N/A,N/A,ANASTOMOSIS ROYX-EN-Y,"$4,660.29","$3,464.25","$1,893.79","$4,619.00","$1,893.79","$4,480.43","$1,893.79","$3,949.25","$1,893.79","$2,100.11","$1,893.79","$4,480.43","$1,893.79","$4,619.00","$1,893.79","$1,893.79","$4,480.43"
49000,0960,49000,,,,,N/A,N/A,EXPLORATION OF ABDOMEN,"$1,626.41","$1,209.00",$66.92,"$1,881.85",$66.92,"$1,563.64",$66.92,"$1,378.26",$66.92,"$1,881.85",$66.92,"$1,563.64",$66.92,"$1,612.00",$66.92,$66.92,"$1,563.64"
49002,0960,49002,,,,,N/A,N/A,REOPENING OF ABDOMEN,"$1,983.58","$1,474.50",$86.60,"$1,966.00",$86.60,"$1,907.02",$86.60,"$1,680.93",$86.60,"$1,290.76",$86.60,"$1,907.02",$86.60,"$1,966.00",$86.60,$86.60,"$1,907.02"
49010,0960,49010,,,,,N/A,N/A,EXPLORATION BEHIND ABDOMEN,"$1,801.97","$1,339.50",$72.74,"$1,748.29",$72.74,"$1,662.58",$72.74,"$1,465.47",$72.74,"$1,748.29",$72.74,"$1,662.58",$72.74,"$1,714.00",$72.74,$72.74,"$1,662.58"
49020,0960,49020,,,,,N/A,N/A,DRAIN ABDOMINAL ABSCESS,"$3,144.87","$2,337.75","$1,542.52","$1,542.52",N/A,N/A,N/A,$0.00,N/A,"$1,542.52",N/A,N/A,N/A,N/A,N/A,N/A,N/A
49082,0960,49082,,,,,N/A,N/A,ABD PARACENTESIS,$210.87,$156.75,$85.69,$209.00,$85.69,$202.73,$85.69,$178.70,$85.69,N/A,$85.69,$202.73,$85.69,$209.00,$85.69,$85.69,$202.73
9649080,0960,49082,,,,,N/A,N/A,PERITONEOCENTSIS D/T-INT-49082,$210.87,$156.75,$85.69,$209.00,$85.69,$202.73,$85.69,$178.70,$85.69,N/A,$85.69,$202.73,$85.69,$209.00,$85.69,$85.69,$202.73
49083,0960,49083,,,,,N/A,N/A,ABD PARACENTESIS W/IMAGING,$389.45,$289.50,$123.62,$386.00,$158.26,$374.42,$158.26,$330.03,$158.26,$123.62,$158.26,$374.42,$158.26,$386.00,$158.26,$158.26,$374.42
49084,0960,49084,,,,,N/A,N/A,EXPLORATION/DRAINAGE PROCEDURE,$193.72,$144.00,$83.23,$203.00,$83.23,$196.91,$83.23,$173.57,$83.23,$180.72,$83.23,$196.91,$83.23,$203.00,$83.23,$83.23,$196.91
9649081,0960,49084,,,,,N/A,N/A,PERITONEOCENTSIS D/T-SBQ-49084,$319.83,$237.75,$83.23,$203.00,$83.23,$196.91,$83.23,$173.57,$83.23,$180.72,$83.23,$196.91,$83.23,$203.00,$83.23,$83.23,$196.91
49180,0960,49180,,,,,N/A,N/A,"BIOPSY, ABDOMINAL MASS",$409.63,$304.50,$166.46,$406.00,$166.46,$393.82,$166.46,$347.13,$166.46,$179.64,$166.46,$393.82,$166.46,$406.00,$166.46,$166.46,$393.82
49203,0960,49203,,,,,N/A,N/A,EXC ABD TUM 5 CM OR LESS,"$2,283.23","$1,697.25",$142.16,"$2,065.00",$846.65,"$2,003.05",$846.65,"$1,765.58",$846.65,$142.16,$846.65,"$2,003.05",$846.65,"$2,065.00",$846.65,$846.65,"$2,003.05"
49204,0960,49204,,,,,N/A,N/A,OPEN RESTRUCTION/EXCISION,"$2,904.74","$2,159.25","$1,228.77","$2,997.00","$1,228.77","$2,907.09","$1,228.77","$2,562.44","$1,228.77","$2,003.98","$1,228.77","$2,907.09","$1,228.77","$2,997.00","$1,228.77","$1,228.77","$2,907.09"
49250,0960,49250,,,,,N/A,N/A,EXCISION OF UMBILICUS,"$1,202.66",$894.00,$0.00,"$2,550.41",N/A,$0.00,N/A,$0.00,N/A,"$2,550.41",N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
49255,0960,49255,,,,,N/A,N/A,REMOVAL OF OMENTUM,"$1,594.13","$1,185.00",$6.65,"$1,465.00",$6.65,"$1,421.05",$6.65,"$1,252.58",$6.65,$994.00,$6.65,"$1,421.05",$6.65,"$1,465.00",$6.65,$6.65,"$1,421.05"
49320,0960,49320,,,,,N/A,N/A,DIAG LAPARO SEPARATE PROC,$736.53,$547.50,$251.33,"$1,332.82",$251.33,$594.61,$251.33,$524.12,$251.33,"$1,332.82",$251.33,$594.61,$251.33,$613.00,$251.33,$251.33,$594.61
49321,0960,49321,,,,,N/A,N/A,"LAPAROSCOPY, BIOPSY",$767.80,$570.75,$0.00,$553.86,N/A,$0.00,N/A,$0.00,N/A,$553.86,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
49322,0960,49322,,,,,N/A,N/A,"LAPAROSCOPY, ASPIRATION",$827.33,$615.00,$336.20,$820.00,$336.20,$795.40,$336.20,$701.10,$336.20,$581.93,$336.20,$795.40,$336.20,$820.00,$336.20,$336.20,$795.40
49402,0960,49402,,,,,N/A,N/A,"REMOVE FOREIGN BODY, ADBOMEN","$1,628.43","$1,210.50",$631.27,"$1,614.00",$661.74,"$1,565.58",$661.74,"$1,379.97",$661.74,$631.27,$661.74,"$1,565.58",$661.74,"$1,614.00",$661.74,$661.74,"$1,565.58"
49422,0960,49422,,,,,N/A,N/A,REMOVE PERM CANNULA/CATHETER,$872.73,$648.75,$331.36,$865.00,$354.65,$839.05,$354.65,$739.58,$354.65,$331.36,$354.65,$839.05,$354.65,$865.00,$354.65,$354.65,$839.05
49441,0960,49441,,,,,N/A,N/A,PLACE DUOD/JEJ TUBE PERC,$506.49,$376.50,$25.82,$502.00,$25.82,$486.94,$25.82,$429.21,$25.82,$368.89,$25.82,$486.94,$25.82,$502.00,$25.82,$25.82,$486.94
49450,0960,49450,,,,,N/A,N/A,REPLACE G/C TUBE PERC,$847.51,$630.00,$344.40,$344.40,$344.40,N/A,$344.40,N/A,$344.40,N/A,$344.40,N/A,$344.40,N/A,$344.40,$344.40,N/A
49451,0960,49451,,,,,N/A,N/A,REPLACE DUOD/JEJ TUBE PERC,$896.95,$666.75,$364.49,$889.00,$364.49,$862.33,$364.49,$760.10,$364.49,$403.12,$364.49,$862.33,$364.49,$889.00,$364.49,$364.49,$862.33
49505,0960,49505,,,,,N/A,N/A,PRP I/HERN INIT REDUC >5 YR,"$1,083.60",$805.50,$44.34,"$1,074.00",$44.34,"$1,041.78",$44.34,$918.27,$44.34,$52.19,$44.34,"$1,041.78",$44.34,"$1,074.00",$44.34,$44.34,"$1,041.78"
49507,0960,49507,,,,,N/A,N/A,PRP I/HERN INIT BLOCK >5 YR,"$1,340.88",$996.75,$544.89,"$1,329.00",$544.89,"$1,289.13",$544.89,"$1,136.30",$544.89,$880.74,$544.89,"$1,289.13",$544.89,"$1,329.00",$544.89,$544.89,"$1,289.13"
49520,0960,49520,,,,,N/A,N/A,"REREPAIR ING HERNIA, REDUCE","$1,344.92",$999.75,$546.53,"$1,333.00",$546.53,"$1,293.01",$546.53,"$1,139.72",$546.53,$988.12,$546.53,"$1,293.01",$546.53,"$1,333.00",$546.53,$546.53,"$1,293.01"
49521,0960,49521,,,,,N/A,N/A,"REREPAIR ING HERNIA, BLOCKED","$1,645.58","$1,223.25",$716.27,"$1,747.00",$716.27,"$1,694.59",$716.27,"$1,493.00",$716.27,"$1,064.24",$716.27,"$1,694.59",$716.27,"$1,747.00",$716.27,$716.27,"$1,694.59"
49525,0960,49525,,,,,N/A,N/A,"REPAIR ING HERNIA, SLIDING","$1,206.69",$897.00,$49.36,"$1,204.49",$49.36,"$1,160.12",$49.36,"$1,022.58",$49.36,"$1,204.49",$49.36,"$1,160.12",$49.36,"$1,196.00",$49.36,$49.36,"$1,160.12"
49550,0960,49550,,,,,N/A,N/A,"RPR REM HERNIA, INIT, REDUCE","$1,217.79",$905.25,$494.87,"$1,207.00",$494.87,"$1,170.79",$494.87,"$1,031.99",$494.87,$966.31,$494.87,"$1,170.79",$494.87,"$1,207.00",$494.87,$494.87,"$1,170.79"
49553,0960,49553,,,,,N/A,N/A,"RPR FEM HERNIA, INIT BLOCKED","$1,322.72",$983.25,$478.47,"$1,167.00",$478.47,"$1,131.99",$478.47,$997.79,$478.47,$971.55,$478.47,"$1,131.99",$478.47,"$1,167.00",$478.47,$478.47,"$1,131.99"
49560,0960,49560,,,,,N/A,N/A,"RPR VENTRAL HERN INIT, REDUC","$1,598.16","$1,188.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
49561,0960,49561,,,,,N/A,N/A,"RPR VENTRAL HERN INIT, BLOCK","$1,942.21","$1,443.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
49565,0960,49565,,,,,N/A,N/A,"REREPAIR VENTRAL HERN, REDUCE","$1,603.21","$1,191.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
49566,0960,49566,,,,,N/A,N/A,"REREPAIR VENTRAL HERN, BLOCK","$1,964.41","$1,460.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
49568,0960,49568,,,,,N/A,N/A,HERNIA REPAIR W/MESH,$630.59,$468.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
49570,0960,49570,,,,,N/A,N/A,"RPR EPIGASTRIC HERN, REDUCE",$842.46,$626.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
49572,0960,49572,,,,,N/A,N/A,"RPR EPIGASTRIC HERN, BLOCKED",$982.71,$730.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
49585,0960,49585,,,,,N/A,N/A,"RPR UMBIL HERN, REDUC > 5 YR",$908.05,$675.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
49587,0960,49587,,,,,N/A,N/A,"RPR UMBIL HERN, BLOCK > 5 YR","$1,078.56",$801.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
49590,0960,49590,,,,,N/A,N/A,REPAIR SPIGELIAN HERNIA,"$1,205.68",$896.25,"$1,064.08","$1,064.08",N/A,N/A,N/A,$0.00,N/A,"$1,064.08",N/A,N/A,N/A,N/A,N/A,N/A,N/A
49650,0960,49650,,,,,N/A,N/A,LAPARO HERNIA REPAIR INITIAL,$908.05,$675.00,$343.58,$838.00,$343.58,$812.86,$343.58,$716.49,$343.58,$838.00,$343.58,$812.86,$343.58,$838.00,$343.58,$343.58,$812.86
49651,0960,49651,,,,,N/A,N/A,LAPARO HERNIA REPAIR RECUR,"$1,175.42",$873.75,$421.70,"$1,027.00",$421.70,$996.19,$421.70,$878.09,$421.70,$729.43,$421.70,$996.19,$421.70,"$1,027.00",$421.70,$421.70,$996.19
49652,0960,49652,,,,,N/A,N/A,LAP VENT/ABD HERNIA REPAIR,"$1,359.04","$1,010.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
49653,0960,49653,,,,,N/A,N/A,LAP VENT/ABD HERN PROC COMP,"$1,696.03","$1,260.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
49654,0960,49654,,,,,N/A,N/A,LAP INC HERNIA REPAIR,"$1,542.67","$1,146.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
49655,0960,49655,,,,,N/A,N/A,LAP INC HERN REPAIR COMP,"$1,882.68","$1,399.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
49656,0960,49656,,,,,N/A,N/A,LAP INC HERNIA REPAIR RECUR,"$1,666.77","$1,239.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
49905,0960,49905,,,,,N/A,N/A,"OMENTAL FLAP, INTRA-ABDOM",$845.49,$628.50,$343.58,"$1,378.50",$343.58,$812.86,$343.58,$716.49,$343.58,"$1,378.50",$343.58,$812.86,$343.58,$838.00,$343.58,$343.58,$812.86
50080,0960,50080,,,,,N/A,N/A,PERCUT NEPHROSTOLITHOMTOMY,"$1,966.42","$1,461.75",$586.20,"$1,949.00",$799.90,"$1,890.53",$799.90,"$1,666.40",$799.90,$586.20,$799.90,"$1,890.53",$799.90,"$1,949.00",$799.90,$799.90,"$1,890.53"
50385,0960,50385,,,,,N/A,N/A,CHANGE STENT VIA TRANSURETH,$464.11,$345.00,$188.60,"$1,420.18",$188.60,$446.20,$188.60,$393.30,$188.60,"$1,420.18",$188.60,$446.20,$188.60,$460.00,$188.60,$188.60,$446.20
50431,0960,50431,,,,,N/A,N/A,PERCUTANEOUS & INJECTION PROC,$758.72,$564.00,$38.32,$752.00,$38.32,$729.44,$38.32,$642.96,$38.32,$355.30,$38.32,$729.44,$38.32,$752.00,$38.32,$38.32,$729.44
50435,0960,50435,,,,,N/A,N/A,REMOVE TUBE W/FLUORO,$196.74,$146.25,$79.95,$195.00,$79.95,$189.15,$79.95,$166.73,$79.95,$106.95,$79.95,$189.15,$79.95,$195.00,$79.95,$79.95,$189.15
50436,0960,50436,,,,,N/A,N/A,REMOVE TUBE W/FLUORO,$296.63,$220.50,$12.54,$294.00,$12.54,$285.18,$12.54,$251.37,$12.54,$161.87,$12.54,$285.18,$12.54,$294.00,$12.54,$12.54,$285.18
50545,0960,50545,,,,,N/A,N/A,LAPARO RADICAL NEPHRECTOMY,"$3,113.59","$2,314.50",$245.73,"$3,086.00","$1,265.26","$2,993.42","$1,265.26","$2,638.53","$1,265.26",$245.73,"$1,265.26","$2,993.42","$1,265.26","$3,086.00","$1,265.26","$1,265.26","$2,993.42"
50546,0960,50546,,,,,N/A,N/A,LAPAROSCOPIC NEPHRECTOMY,"$2,709.00","$2,013.75",$11.85,"$2,409.00",$11.85,"$2,336.73",$11.85,"$2,059.70",$11.85,"$2,177.95",$11.85,"$2,336.73",$11.85,"$2,409.00",$11.85,$11.85,"$2,336.73"
51040,0960,51040,,,,,N/A,N/A,INCISE & DRAIN BLADDER,$721.39,$536.25,$293.15,$715.00,$293.15,$693.55,$293.15,$611.33,$293.15,$715.00,$293.15,$693.55,$293.15,$715.00,$293.15,$293.15,$693.55
51045,0960,51045,,,,,N/A,N/A,CYSTOSTOMY,"$1,000.87",$744.00,$46.72,$992.00,$46.72,$962.24,$46.72,$848.16,$46.72,$478.69,$46.72,$962.24,$46.72,$992.00,$46.72,$46.72,$962.24
51050,0960,51050,,,,,N/A,N/A,REMOVAL OF BLADDER STONE,$986.74,$733.50,$39.32,$952.00,$39.32,$923.44,$39.32,$813.96,$39.32,$820.73,$39.32,$923.44,$39.32,$952.00,$39.32,$39.32,$923.44
51102,0960,51102,,,,,N/A,N/A,DRAIN BL W/CATH INSERTION,$362.21,$269.25,$147.19,$775.35,$147.19,$348.23,$147.19,$306.95,$147.19,$775.35,$147.19,$348.23,$147.19,$359.00,$147.19,$147.19,$348.23
51500,0960,51500,,,,,N/A,N/A,REMOVAL OF BLADDER CYST,"$1,430.68","$1,063.50",$236.79,"$1,418.00",N/A,"$1,375.46",N/A,"$1,212.39",N/A,$236.79,N/A,"$1,375.46",N/A,"$1,418.00",N/A,N/A,"$1,375.46"
51610,0960,51610,,,,,N/A,N/A,"INTRODUCTION, INJ PROCEDURE",$301.67,$224.25,$122.59,"$1,045.14",$122.59,$290.03,$122.59,$255.65,$122.59,"$1,045.14",$122.59,$290.03,$122.59,$299.00,$122.59,$122.59,$290.03
51701,0960,51701,,,,,N/A,N/A,INSERT BLADDER CATHETER,$120.06,$89.25,$48.79,$119.00,$48.79,$115.43,$48.79,$101.75,$48.79,$49.87,$48.79,$115.43,$48.79,$119.00,$48.79,$48.79,$115.43
51702,0960,51702,,,,,N/A,N/A,INSERT TEMP BLADDER CATH,$147.31,$109.50,$41.35,$124.00,$59.86,$120.28,$59.86,$106.02,$59.86,$41.35,$59.86,$120.28,$59.86,$124.00,$59.86,$59.86,$120.28
51703,0960,51703,,,,,N/A,N/A,"INSERT BLADDER CATH, COMPLEX",$241.14,$179.25,$41.02,$239.00,$97.99,$231.83,$97.99,$204.35,$97.99,$41.02,$97.99,$231.83,$97.99,$239.00,$97.99,$97.99,$231.83
9651703,0960,51703,,,,,N/A,N/A,"INSERT BLADDER CATH, COMPLEX",$241.14,$179.25,$41.02,$239.00,$97.99,$231.83,$97.99,$204.35,$97.99,$41.02,$97.99,$231.83,$97.99,$239.00,$97.99,$97.99,$231.83
51705,0960,51705,,,,,N/A,N/A,CHANGE OF BLADDER TUBE,$188.67,$140.25,$76.67,$187.00,$76.67,$181.39,$76.67,$159.89,$76.67,$124.30,$76.67,$181.39,$76.67,$187.00,$76.67,$76.67,$181.39
9651705,0960,51705,,,,,N/A,N/A,CHANGE OF BLADDER TUBE,$188.67,$140.25,$76.67,$187.00,$76.67,$181.39,$76.67,$159.89,$76.67,$124.30,$76.67,$181.39,$76.67,$187.00,$76.67,$76.67,$181.39
51715,0960,51715,,,,,N/A,N/A,ENDOSCOPIC INJECTION/IMPLANT,$480.26,$357.00,$129.45,$476.00,$195.16,$461.72,$195.16,$406.98,$195.16,$129.45,$195.16,$461.72,$195.16,$476.00,$195.16,$195.16,$461.72
51720,0960,51720,,,,,N/A,N/A,TREATMENT OF BLADDER LESION,$251.23,$186.75,$93.89,$325.02,$93.89,$241.53,$93.89,$212.90,$93.89,$325.02,$93.89,$241.53,$93.89,$249.00,$93.89,$93.89,$241.53
51726,0960,51726,,,,,N/A,N/A,COMPLEX CYSTOMETROGRAM,$782.94,$582.00,$71.04,$630.00,$258.30,$611.10,$258.30,$538.65,$258.30,$71.04,$258.30,$611.10,$258.30,$630.00,$258.30,$258.30,$611.10
51728,0960,51728,,,,,N/A,N/A,CYSTOMETROGRAM W/VP,$633.61,$471.00,$239.44,$584.00,$239.44,$566.48,$239.44,$499.32,$239.44,$518.32,$239.44,$566.48,$239.44,$584.00,$239.44,$239.44,$566.48
51729,0960,51729,,,,,N/A,N/A,CYSTOMETROGRAM W/ VP&UP,$549.87,$408.75,$223.45,$629.63,$223.45,$528.65,$223.45,$465.98,$223.45,$629.63,$223.45,$528.65,$223.45,$545.00,$223.45,$223.45,$528.65
51741,0960,51741,,,,,N/A,N/A,"ELECTRO-UROFLOWMETRY, FIRST",$171.52,$127.50,$164.90,$666.43,N/A,$164.90,N/A,$145.35,N/A,$666.43,N/A,$164.90,N/A,$170.00,N/A,N/A,$164.90
51784,0960,51784,,,,,N/A,N/A,ANAL/URINARY MUSCLE STUDY,$405.59,$301.50,$23.00,$402.00,$164.82,$389.94,$164.82,$343.71,$164.82,$23.00,$164.82,$389.94,$164.82,$402.00,$164.82,$164.82,$389.94
51797,0960,51797,,,,,N/A,N/A,INTRAABDOMINAL PRESSURE TEST,$675.99,$502.50,$110.04,$670.00,$274.70,$649.90,$274.70,$572.85,$274.70,$110.04,$274.70,$649.90,$274.70,$670.00,$274.70,$274.70,$649.90
51798,0960,51798,,,,,N/A,N/A,US URINE CAPACITY MEASURE,$36.32,$27.00,$24.60,$318.31,$24.60,$58.20,$24.60,$51.30,$24.60,$318.31,$24.60,$58.20,$24.60,$60.00,$24.60,$24.60,$58.20
51860,0960,51860,,,,,N/A,N/A,REPAIR OF BLADDER WOUND,"$1,677.87","$1,247.25",$17.13,"$1,663.00",$681.83,"$1,613.11",$681.83,"$1,421.87",$681.83,$17.13,$681.83,"$1,613.11",$681.83,"$1,663.00",$681.83,$681.83,"$1,613.11"
52000,0960,52000,,,,,N/A,N/A,CYSTOSCOPY,$304.70,$226.50,$123.82,"$1,217.63",$123.82,$292.94,$123.82,$258.21,$123.82,"$1,217.63",$123.82,$292.94,$123.82,$302.00,$123.82,$123.82,$292.94
52001,0960,52001,,,,,N/A,N/A,CYSTOURETHROSCOPY W/IRRIG,$751.66,$558.75,$35.45,$745.00,$35.45,$722.65,$35.45,$636.98,$35.45,$130.67,$35.45,$722.65,$35.45,$745.00,$35.45,$35.45,$722.65
52005,0960,52005,,,,,N/A,N/A,CYSTOSCOPY & URETER CATHETER,$610.41,$453.75,$246.82,$605.00,$246.82,$586.85,$246.82,$517.28,$246.82,$465.79,$246.82,$586.85,$246.82,$605.00,$246.82,$246.82,$586.85
52204,0960,52204,,,,,N/A,N/A,CYSTOSCOPY,$954.46,$709.50,$215.62,$946.00,N/A,$917.62,N/A,$808.83,N/A,$215.62,N/A,$917.62,N/A,$946.00,N/A,N/A,$917.62
52214,0960,52214,,,,,N/A,N/A,"CYSTOURETHROSCOPY, W/FULGUR","$1,774.73","$1,319.25",$229.35,"$1,759.00",$721.19,"$1,706.23",$721.19,"$1,503.95",$721.19,$229.35,$721.19,"$1,706.23",$721.19,"$1,759.00",$721.19,$721.19,"$1,706.23"
52224,0960,52224,,,,,N/A,N/A,CYSTO W/TREATMENT,"$1,883.69","$1,400.25",$285.98,"$1,867.00",$765.47,"$1,810.99",$765.47,"$1,596.29",$765.47,$285.98,$765.47,"$1,810.99",$765.47,"$1,867.00",$765.47,$765.47,"$1,810.99"
52234,0960,52234,,,,,N/A,N/A,CYSTOSCOPY AND TREATMENT,$592.25,$440.25,$24.67,$587.00,$24.67,$569.39,$24.67,$501.89,$24.67,$330.14,$24.67,$569.39,$24.67,$587.00,$24.67,$24.67,$569.39
52235,0960,52235,,,,,N/A,N/A,CYSTOSCOPY AND TREATMENT,$693.14,$515.25,$281.67,$687.00,$281.67,$666.39,$281.67,$587.39,$281.67,$398.47,$281.67,$666.39,$281.67,$687.00,$281.67,$281.67,$666.39
52240,0960,52240,,,,,N/A,N/A,LARGE BLADDER TUMORS,"$1,224.85",$910.50,$467.53,"$1,214.00",$497.74,"$1,177.58",$497.74,"$1,037.97",$497.74,$467.53,$497.74,"$1,177.58",$497.74,"$1,214.00",$497.74,$497.74,"$1,177.58"
52250,0960,52250,,,,,N/A,N/A,CYSTOSCOPY AND RADIOTRACER,$578.12,$429.75,$555.81,$635.16,N/A,$555.81,N/A,$489.92,N/A,$635.16,N/A,$555.81,N/A,$573.00,N/A,N/A,$555.81
52260,0960,52260,,,,,N/A,N/A,CYSTOSCOPY AND TREATMENT,$500.43,$372.00,$387.72,$496.00,N/A,$481.12,N/A,$424.08,N/A,$387.72,N/A,$481.12,N/A,$496.00,N/A,N/A,$481.12
52275,0960,52275,,,,,N/A,N/A,CYSTOSCOPY & REVISE URETHRA,$597.29,$444.00,$0.00,$341.49,N/A,$0.00,N/A,$0.00,N/A,$341.49,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
52276,0960,52276,,,,,N/A,N/A,CYSTOSCOPY AND TREATMENT,$638.66,$474.75,$259.53,$633.00,$259.53,$614.01,$259.53,$541.22,$259.53,$402.27,$259.53,$614.01,$259.53,$633.00,$259.53,$259.53,$614.01
52281,0960,52281,,,,,N/A,N/A,CYSTOSCOPY AND TREATMENT,$670.95,$498.75,$289.50,$705.00,$289.50,$683.85,$289.50,$602.78,$289.50,$428.82,$289.50,$683.85,$289.50,$705.00,$289.50,$289.50,$683.85
52287,0960,52287,,,,,N/A,N/A,CYSTOURETHROSCOPY INJECT CHE,$386.42,$287.25,$157.30,$383.00,$157.30,$371.51,$157.30,$327.47,$157.30,$246.80,$157.30,$371.51,$157.30,$383.00,$157.30,$157.30,$371.51
52310,0960,52310,,,,,N/A,N/A,CYSTOSCOPY AND TREATMENT,$505.48,$375.75,$25.41,$501.00,$25.41,$485.97,$25.41,$428.36,$25.41,$274.57,$25.41,$485.97,$25.41,$501.00,$25.41,$25.41,$485.97
52315,0960,52315,,,,,N/A,N/A,CYSTOSCOPY AND TREATMENT,$998.85,$742.50,$245.39,$990.00,$446.90,$960.30,$446.90,$846.45,$446.90,$245.39,$446.90,$960.30,$446.90,$990.00,$446.90,$446.90,$960.30
52317,0960,52317,,,,,N/A,N/A,REMOVE BLADDER STONE,"$2,019.90","$1,501.50",$82.82,"$2,002.00",$82.82,"$1,941.94",$82.82,"$1,711.71",$82.82,$445.44,$82.82,"$1,941.94",$82.82,"$2,002.00",$82.82,$82.82,"$1,941.94"
52318,0960,52318,,,,,N/A,N/A,REMOVE BLADDER STONE,"$1,155.24",$858.75,$469.45,"$1,145.00",$469.45,"$1,110.65",$469.45,$978.98,$469.45,$562.38,$469.45,"$1,110.65",$469.45,"$1,145.00",$469.45,$469.45,"$1,110.65"
52320,0960,52320,,,,,N/A,N/A,CYSTOSCOPY AND TREATMENT,$595.27,$442.50,$241.90,$767.72,$241.90,$572.30,$241.90,$504.45,$241.90,$767.72,$241.90,$572.30,$241.90,$590.00,$241.90,$241.90,$572.30
52325,0960,52325,,,,,N/A,N/A,"CYSTOSCOPY, STONE REMOVAL",$777.89,$578.25,$0.00,$399.38,N/A,$0.00,N/A,$0.00,N/A,$399.38,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
52330,0960,52330,,,,,N/A,N/A,CYSTRTHRSCPY MANI W/O RE CAL,"$1,597.15","$1,187.25",$519.04,"$1,583.00",$649.30,"$1,535.51",$649.30,"$1,353.47",$649.30,$519.04,$649.30,"$1,535.51",$649.30,"$1,583.00",$649.30,$649.30,"$1,535.51"
52332,0960,52332,,,,,N/A,N/A,CYSTOSCOPY AND TREATMENT,$952.44,$708.00,$387.40,$944.00,$387.40,$915.68,$387.40,$807.12,$387.40,$427.08,$387.40,$915.68,$387.40,$944.00,$387.40,$387.40,$915.68
52341,0960,52341,,,,,N/A,N/A,CYSTO W/URETER STRICTURE TX,$771.84,$573.75,$252.34,$765.00,$313.65,$742.05,$313.65,$654.08,$313.65,$252.34,$313.65,$742.05,$313.65,$765.00,$313.65,$313.65,$742.05
52344,0960,52344,,,,,N/A,N/A,"CYSTO/URETERO, STRICTURE TX",$985.73,$732.75,$315.29,$769.00,$315.29,$745.93,$315.29,$657.50,$315.29,$460.25,$315.29,$745.93,$315.29,$769.00,$315.29,$315.29,$745.93
52345,0960,52345,,,,,N/A,N/A,CYSTO/URETERO W/UP STRICTURE,"$1,048.29",$779.25,$425.99,"$1,039.00",$425.99,"$1,007.83",$425.99,$888.35,$425.99,$597.86,$425.99,"$1,007.83",$425.99,"$1,039.00",$425.99,$425.99,"$1,007.83"
52346,0960,52346,,,,,N/A,N/A,CYSTOURETERO W/RENAL STRICT,"$1,176.42",$874.50,$639.22,$639.22,N/A,N/A,N/A,$0.00,N/A,$639.22,N/A,N/A,N/A,N/A,N/A,N/A,N/A
52351,0960,52351,,,,,N/A,N/A,CYSTOURETERO & OR PYELOSCOPE,$752.67,$559.50,$35.86,$746.00,$35.86,$723.62,$35.86,$637.83,$35.86,$723.40,$35.86,$723.62,$35.86,$746.00,$35.86,$35.86,$723.62
52352,0960,52352,,,,,N/A,N/A,CYSTOURETERO W/STONE REMOVE,$881.81,$655.50,$358.34,$874.00,$358.34,$847.78,$358.34,$747.27,$358.34,$490.19,$358.34,$847.78,$358.34,$874.00,$358.34,$358.34,$847.78
52353,0960,52353,,,,,N/A,N/A,CYSTOURETERO W/LITHOTRIPSY,"$1,017.01",$756.00,$413.28,"$1,008.00",$413.28,$977.76,$413.28,$861.84,$413.28,$573.72,$413.28,$977.76,$413.28,"$1,008.00",$413.28,$413.28,$977.76
52354,0960,52354,,,,,N/A,N/A,CYSTOURETERO W/BIOPSY,$942.35,$700.50,$34.71,$831.00,$34.71,$806.07,$34.71,$710.51,$34.71,$635.16,$34.71,$806.07,$34.71,$831.00,$34.71,$34.71,$806.07
52356,0960,52356,,,,,N/A,N/A,URETHEROSCOPY W/LITHO & INDW,$836.41,$621.75,$339.89,$829.00,$339.89,$804.13,$339.89,$708.80,$339.89,$676.26,$339.89,$804.13,$339.89,$829.00,$339.89,$339.89,$804.13
52450,0960,52450,,,,,N/A,N/A,INCISION OF PROSTATE,"$1,058.38",$786.75,$43.90,"$1,049.00",$43.90,"$1,017.53",$43.90,$896.90,$43.90,$673.94,$43.90,"$1,017.53",$43.90,"$1,049.00",$43.90,$43.90,"$1,017.53"
52500,0960,52500,,,,,N/A,N/A,REVISION OF BLADDER NECK,"$1,160.28",$862.50,$471.50,"$1,150.00",$471.50,"$1,115.50",$471.50,$983.25,$471.50,$776.44,$471.50,"$1,115.50",$471.50,"$1,150.00",$471.50,$471.50,"$1,115.50"
52601,0960,52601,,,,,N/A,N/A,PROSTATECTOMY (TURP),"$1,668.79","$1,240.50",$599.83,"$1,463.00",$599.83,"$1,419.11",$599.83,"$1,250.87",$599.83,$805.80,$599.83,"$1,419.11",$599.83,"$1,463.00",$599.83,$599.83,"$1,419.11"
52630,0960,52630,,,,,N/A,N/A,REMOVE PROSTATE REGROWTH,"$1,097.73",$816.00,$446.80,"$1,191.66",$446.80,"$1,055.36",$446.80,$930.24,$446.80,"$1,191.66",$446.80,"$1,055.36",$446.80,"$1,088.00",$446.80,$446.80,"$1,055.36"
52640,0960,52640,,,,,N/A,N/A,POST-OP BLADDER NECK CONTR,$897.96,$667.50,$364.90,$890.00,$364.90,$863.30,$364.90,$760.95,$364.90,$663.13,$364.90,$863.30,$364.90,$890.00,$364.90,$364.90,$863.30
52648,0960,52648,,,,,N/A,N/A,LASER SURGERY OF PROSTATE,"$2,176.28","$1,617.75",$525.69,"$2,157.00",$884.37,"$2,092.29",$884.37,"$1,844.24",$884.37,$525.69,$884.37,"$2,092.29",$884.37,"$2,157.00",$884.37,$884.37,"$2,092.29"
53200,0960,53200,,,,,N/A,N/A,BIOPSY OF URETHRA,$380.37,$282.75,$154.57,"$1,132.55",$154.57,$365.69,$154.57,$322.34,$154.57,"$1,132.55",$154.57,$365.69,$154.57,$377.00,$154.57,$154.57,$365.69
53215,0960,53215,,,,,N/A,N/A,EXCISION MALE,"$2,080.43","$1,546.50",$230.58,"$2,062.00",$845.42,"$2,000.14",$845.42,"$1,763.01",$845.42,$230.58,$845.42,"$2,000.14",$845.42,"$2,062.00",$845.42,$845.42,"$2,000.14"
53220,0960,53220,,,,,N/A,N/A,EXC OR FULG OF CA OF URETHRA,"$1,001.88",$744.75,$369.82,"$1,515.04",$369.82,$874.94,$369.82,$771.21,$369.82,"$1,515.04",$369.82,$874.94,$369.82,$902.00,$369.82,$369.82,$874.94
53265,0960,53265,,,,,N/A,N/A,TREATMENT OF URETHRA LESION,$428.80,$318.75,$174.25,$741.52,$174.25,$412.25,$174.25,$363.38,$174.25,$741.52,$174.25,$412.25,$174.25,$425.00,$174.25,$174.25,$412.25
53600,0960,53600,,,,,N/A,N/A,DILATE URETHRA STRICTURE,$156.39,$116.25,$63.55,$308.34,$63.55,$150.35,$63.55,$132.53,$63.55,$308.34,$63.55,$150.35,$63.55,$155.00,$63.55,$63.55,$150.35
53601,0960,53601,,,,,N/A,N/A,DILATION URETHIAL SUBSEQ,$145.29,$108.00,$59.40,$144.00,$59.40,$139.68,$59.40,$123.12,$59.40,$103.63,$59.40,$139.68,$59.40,$144.00,$59.40,$59.40,$139.68
53605,0960,53605,,,,,N/A,N/A,DILATION OF URETHRAL STRCT,$161.43,$120.00,$53.30,$130.00,$53.30,$126.10,$53.30,$111.15,$53.30,$87.09,$53.30,$126.10,$53.30,$130.00,$53.30,$53.30,$126.10
53660,0960,53660,,,,,N/A,N/A,DILATION FEMALE URETHRA,$130.15,$96.75,$52.89,$129.00,$52.89,$125.13,$52.89,$110.30,$52.89,$104.53,$52.89,$125.13,$52.89,$129.00,$52.89,$52.89,$125.13
53899,0960,53899,,,,,N/A,N/A,BLADDER BOTOX INJECTION,$657.83,$489.00,$67.82,$652.00,N/A,$632.44,N/A,$557.46,N/A,$67.82,N/A,$632.44,N/A,$652.00,N/A,N/A,$632.44
54001,0960,54001,,,,,N/A,N/A,SLITTING OF PREPUCE,$404.58,$300.75,$0.00,$401.00,N/A,$388.97,N/A,$342.86,N/A,$0.00,N/A,$388.97,N/A,$401.00,N/A,N/A,$388.97
54060,0960,54060,,,,,N/A,N/A,EXCISION OF PENIS LESION(S),$294.61,$219.00,$119.72,$292.00,$119.72,$283.24,$119.72,$249.66,$119.72,$229.79,$119.72,$283.24,$119.72,$292.00,$119.72,$119.72,$283.24
54065,0960,54065,,,,,N/A,N/A,"DESTRUCTION, PENIS LESION(S)",$342.03,$254.25,$138.99,$339.00,$138.99,$328.83,$138.99,$289.85,$138.99,$214.33,$138.99,$328.83,$138.99,$339.00,$138.99,$138.99,$328.83
54100,0960,54100,,,,,N/A,N/A,EXCISION BIOPSY OF PENIS,$269.39,$200.25,$19.47,$267.00,$19.47,$258.99,$19.47,$228.29,$19.47,N/A,$19.47,$258.99,$19.47,$267.00,$19.47,$19.47,$258.99
54150,0960,54150,,,,,N/A,N/A,CIRCUMCISION,$238.11,$177.00,$0.00,$594.90,$594.90,$0.00,$594.90,$0.00,$594.90,$199.11,$594.90,$0.00,$594.90,N/A,$594.90,$594.90,$0.00
54161,0960,54161,,,,,N/A,N/A,CIRCUMCISION,$455.03,$338.25,$158.20,$451.00,$184.91,$437.47,$184.91,$385.61,$184.91,$158.20,$184.91,$437.47,$184.91,$451.00,$184.91,$184.91,$437.47
54162,0960,54162,,,,,N/A,N/A,LYSIS PENIL CIRCUMIC LESION,$439.90,$327.00,$178.76,$436.00,$178.76,$422.92,$178.76,$372.78,$178.76,$323.24,$178.76,$422.92,$178.76,$436.00,$178.76,$178.76,$422.92
54200,0960,54200,,,,,N/A,N/A,INJ PROCEDURE FOR PEYRONIE,$189.68,$141.00,$77.80,$327.88,$77.80,$182.36,$77.80,$160.74,$77.80,$327.88,$77.80,$182.36,$77.80,$188.00,$77.80,$77.80,$182.36
54220,0960,54220,,,,,N/A,N/A,TREATMENT OF PENIS LESION,$359.18,$267.00,$140.97,$356.00,$145.96,$345.32,$145.96,$304.38,$145.96,$140.97,$145.96,$345.32,$145.96,$356.00,$145.96,$145.96,$345.32
54235,0960,54235,,,,,N/A,N/A,PENILE INJECTION,$168.49,$125.25,$6.68,$216.27,$6.68,$143.56,$6.68,$126.54,$6.68,$216.27,$6.68,$143.56,$6.68,$148.00,$6.68,$6.68,$143.56
54405,0960,54405,,,,,N/A,N/A,INSERT MULTI-COMP PENIS PROS,"$1,811.05","$1,346.25",$119.27,"$1,593.00",N/A,"$1,545.21",N/A,"$1,362.02",N/A,$119.27,N/A,"$1,545.21",N/A,"$1,593.00",N/A,N/A,"$1,545.21"
54417,0960,54417,,,,,N/A,N/A,"REMV/REPLC PENIS PROC, COMPL","$1,904.88","$1,416.00",$0.00,"$1,324.00",N/A,$0.00,N/A,$0.00,N/A,"$1,324.00",N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
54450,0960,54450,,,,,N/A,N/A,PREPUTIAL STRETCHING,$149.32,$111.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
54505,0960,54505,,,,,N/A,N/A,BIOPSY OF TESTIS,$501.44,$372.75,$482.09,"$1,470.40",N/A,$482.09,N/A,$424.94,N/A,"$1,470.40",N/A,$482.09,N/A,$497.00,N/A,N/A,$482.09
54520,0960,54520,,,,,N/A,N/A,"ORCHIECTOMY,W OR W/O TEST",$755.70,$561.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
54530,0960,54530,,,,,N/A,N/A,"ORCHIECTOMY, RADIAL 50","$1,202.66",$894.00,$345.08,"$1,192.00",N/A,"$1,156.24",N/A,"$1,019.16",N/A,$345.08,N/A,"$1,156.24",N/A,"$1,192.00",N/A,N/A,"$1,156.24"
54640,0960,54640,,,,,N/A,N/A,SUSPENSION OF TESTIS,$999.86,$743.25,$0.00,$834.49,N/A,$0.00,N/A,$0.00,N/A,$834.49,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
54700,0960,54700,,,,,N/A,N/A,DRAINAGE OF SCROTUM,$501.44,$372.75,$482.09,$708.97,N/A,$482.09,N/A,$424.94,N/A,$708.97,N/A,$482.09,N/A,$497.00,N/A,N/A,$482.09
54800,0960,54800,,,,,N/A,N/A,BIOPSY OF EPIDIDYMIS,$307.73,$228.75,$295.85,$350.13,N/A,$295.85,N/A,$260.78,N/A,$350.13,N/A,$295.85,N/A,$305.00,N/A,N/A,$295.85
54840,0960,54840,,,,,N/A,N/A,REMOVE EPIDIDYMIS LESION,$745.61,$554.25,$134.83,$203.71,N/A,$134.83,N/A,$118.85,N/A,$203.71,N/A,$134.83,N/A,$139.00,N/A,N/A,$134.83
54860,0960,54860,,,,,N/A,N/A,REMOVAL OF EPIDIDYMIS,$868.70,$645.75,$530.62,$891.00,N/A,$864.27,N/A,$761.81,N/A,$530.62,N/A,$864.27,N/A,$891.00,N/A,N/A,$864.27
55000,0960,55000,,,,,N/A,N/A,DRAINAGE OF HYDROCELE,$200.78,$149.25,$193.03,$689.10,N/A,$193.03,N/A,$170.15,N/A,$689.10,N/A,$193.03,N/A,$199.00,N/A,N/A,$193.03
55040,0960,55040,,,,,N/A,N/A,REMOVAL OF HYDROCELE,$773.86,$575.25,$137.63,$767.00,$314.47,$743.99,$314.47,$655.79,$314.47,$137.63,$314.47,$743.99,$314.47,$767.00,$314.47,$314.47,$743.99
55041,0960,55041,,,,,N/A,N/A,REMOVAL OF HYDROCELES,"$1,097.73",$816.00,$446.80,"$1,040.00",$446.80,"$1,008.80",$446.80,$889.20,$446.80,$556.84,$446.80,"$1,008.80",$446.80,"$1,040.00",$446.80,$446.80,"$1,008.80"
55100,0960,55100,,,,,N/A,N/A,I&D SCROTAL ABSCESS,$562.99,$418.50,$228.78,$840.86,$228.78,$541.26,$228.78,$477.09,$228.78,$840.86,$228.78,$541.26,$228.78,$558.00,$228.78,$228.78,$541.26
55150,0960,55150,,,,,N/A,N/A,REMOVAL OF SCROTUM,"$1,036.18",$770.25,$274.13,"$1,027.00",$421.70,$996.19,$421.70,$878.09,$421.70,$274.13,$421.70,$996.19,$421.70,"$1,027.00",$421.70,$421.70,$996.19
55175,0960,55175,,,,,N/A,N/A,REVISION OF SCROTUM,$771.84,$573.75,$313.65,$808.94,$313.65,$742.05,$313.65,$654.08,$313.65,$808.94,$313.65,$742.05,$313.65,$765.00,$313.65,$313.65,$742.05
55250,0960,55250,,,,,N/A,N/A,REMOVAL OF SPERM DUCT(S),$842.46,$626.25,$334.15,$835.00,$334.15,$809.95,$334.15,$713.93,$334.15,$599.85,$334.15,$809.95,$334.15,$835.00,$334.15,$334.15,$809.95
55500,0960,55500,,,,,N/A,N/A,REMOVAL OF HYDROCELE,$819.26,$609.00,$0.00,$778.39,N/A,$0.00,N/A,$0.00,N/A,$778.39,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
55520,0960,55520,,,,,N/A,N/A,REMOVAL OF SPERM CORD LESION,$881.81,$655.50,$358.34,$874.00,$358.34,$847.78,$358.34,$747.27,$358.34,$644.75,$358.34,$847.78,$358.34,$874.00,$358.34,$358.34,$847.78
55530,0960,55530,,,,,N/A,N/A,REMOVE SPERMATIC CORD VEINS,$812.20,$603.75,$33.50,$805.00,$33.50,$780.85,$33.50,$688.28,$33.50,$744.28,$33.50,$780.85,$33.50,$805.00,$33.50,$33.50,$780.85
55535,0960,55535,,,,,N/A,N/A,REVISE SPERMATIC CORD VEINS,$933.27,$693.75,$379.25,$925.00,$379.25,$897.25,$379.25,$790.88,$379.25,$579.50,$379.25,$897.25,$379.25,$925.00,$379.25,$379.25,$897.25
55700,0960,55700,,,,,N/A,N/A,BIOPSY OF PROSTATE,$328.91,$244.50,$133.66,$707.45,$133.66,$316.22,$133.66,$278.73,$133.66,$707.45,$133.66,$316.22,$133.66,$326.00,$133.66,$133.66,$316.22
55831,0960,55831,,,,,N/A,N/A,REMOVAL OF PROSTATE,"$2,085.48","$1,550.25",$847.47,"$2,067.00",$847.47,"$2,004.99",$847.47,"$1,767.29",$847.47,"$1,429.45",$847.47,"$2,004.99",$847.47,"$2,067.00",$847.47,$847.47,"$2,004.99"
55845,0960,55845,,,,,N/A,N/A,EXTENSIVE PROSTATE SURGERY,"$3,700.79","$2,751.00","$1,388.67","$3,387.00","$1,388.67","$3,285.39","$1,388.67","$2,895.89","$1,388.67","$1,545.89","$1,388.67","$3,285.39","$1,388.67","$3,387.00","$1,388.67","$1,388.67","$3,285.39"
56405,0960,56405,,,,,N/A,N/A,I & D OF VULVA/PERINEUM,$244.16,$181.50,$264.81,$273.00,N/A,$264.81,N/A,$233.42,N/A,N/A,N/A,$264.81,N/A,$273.00,N/A,N/A,$264.81
56420,0960,56420,,,,,N/A,N/A,DRAINAGE OF GLAND ABSCESS,$232.06,$172.50,$207.94,$888.00,N/A,$861.36,N/A,$759.24,N/A,$207.94,N/A,$861.36,N/A,$888.00,N/A,N/A,$861.36
56440,0960,56440,,,,,N/A,N/A,SURGERY FOR VULVA LESION,$432.84,$321.75,$181.08,$181.08,N/A,N/A,N/A,$0.00,N/A,$181.08,N/A,N/A,N/A,N/A,N/A,N/A,N/A
56441,0960,56441,,,,,N/A,N/A,LYSIS OF LABIAL LESION(S),$320.84,$238.50,$299.76,$299.76,N/A,N/A,N/A,$0.00,N/A,$299.76,N/A,N/A,N/A,N/A,N/A,N/A,N/A
56442,0960,56442,,,,,N/A,N/A,HYMENOTOMY SIMPLE INCISION,$96.86,$72.00,$253.95,$253.95,N/A,N/A,N/A,$0.00,N/A,$253.95,N/A,N/A,N/A,N/A,N/A,N/A,N/A
56501,0960,56501,,,,,N/A,N/A,"DESTROY, VULVA LESIONS, SIM",$261.32,$194.25,$77.20,$77.20,N/A,N/A,N/A,$0.00,N/A,$77.20,N/A,N/A,N/A,N/A,N/A,N/A,N/A
56515,0960,56515,,,,,N/A,N/A,DESTROY VULVA LESION/S COMPL,$433.84,$322.50,$217.20,$217.20,N/A,N/A,N/A,$0.00,N/A,$217.20,N/A,N/A,N/A,N/A,N/A,N/A,N/A
56605,0960,56605,,,,,N/A,N/A,BIOPSY OF VULVA/PERINEUM,$151.34,$112.50,$350.05,$350.05,N/A,N/A,N/A,$0.00,N/A,$350.05,N/A,N/A,N/A,N/A,N/A,N/A,N/A
56606,0960,56606,,,,,N/A,N/A,BIOPSY OF VULVA/PERINEUM,$87.78,$65.25,$97.52,$97.52,N/A,N/A,N/A,$0.00,N/A,$97.52,N/A,N/A,N/A,N/A,N/A,N/A,N/A
56620,0960,56620,,,,,N/A,N/A,PARTIAL REMOVAL OF VULVA,"$1,160.28",$862.50,$47.92,$47.92,N/A,N/A,N/A,$0.00,N/A,$47.92,N/A,N/A,N/A,N/A,N/A,N/A,N/A
56700,0960,56700,,,,,N/A,N/A,PARTIAL REMOVAL OF HYMEN,$412.66,$306.75,$958.02,$958.02,N/A,N/A,N/A,$0.00,N/A,$958.02,N/A,N/A,N/A,N/A,N/A,N/A,N/A
56740,0960,56740,,,,,N/A,N/A,REMOVE VAGINA GLAND LESION,$675.99,$502.50,$335.39,$335.39,N/A,N/A,N/A,$0.00,N/A,$335.39,N/A,N/A,N/A,N/A,N/A,N/A,N/A
56820,0960,56820,,,,,N/A,N/A,EXAM OF VULVA W/SCOPE,$206.83,$153.75,$519.67,$519.67,N/A,N/A,N/A,$0.00,N/A,$519.67,N/A,N/A,N/A,N/A,N/A,N/A,N/A
56821,0960,56821,,,,,N/A,N/A,EXAM/BIOPSY OF VULVA W/SCOPE,$283.51,$210.75,$138.36,$138.36,N/A,N/A,N/A,$0.00,N/A,$138.36,N/A,N/A,N/A,N/A,N/A,N/A,N/A
57061,0960,57061,,,,,N/A,N/A,DEST VAG LESION BLY,$105.94,$78.75,$131.43,$131.43,N/A,N/A,N/A,$0.00,N/A,$131.43,N/A,N/A,N/A,N/A,N/A,N/A,N/A
57100,0960,57100,,,,,N/A,N/A,BIOPSY OF VAGINA,$162.44,$120.75,$187.93,$187.93,N/A,N/A,N/A,$0.00,N/A,$187.93,N/A,N/A,N/A,N/A,N/A,N/A,N/A
57120,0960,57120,,,,,N/A,N/A,CLOSURE OF VAGINA,"$1,137.08",$845.25,$107.85,$107.85,N/A,N/A,N/A,$0.00,N/A,$107.85,N/A,N/A,N/A,N/A,N/A,N/A,N/A
57130,0960,57130,,,,,N/A,N/A,REMOVE VAGINA LESION,$378.35,$281.25,$878.46,$878.46,N/A,N/A,N/A,$0.00,N/A,$878.46,N/A,N/A,N/A,N/A,N/A,N/A,N/A
57135,0960,57135,,,,,N/A,N/A,REMOVE VAGINA LESION,$411.65,$306.00,$167.28,$284.95,$167.28,N/A,$167.28,$0.00,$167.28,$284.95,$167.28,N/A,$167.28,N/A,$167.28,$167.28,N/A
57160,0960,57160,,,,,N/A,N/A,INSERT PESSARY/OTHER DEVICE,$120.06,$89.25,$309.03,$309.03,N/A,N/A,N/A,$0.00,N/A,$309.03,N/A,N/A,N/A,N/A,N/A,N/A,N/A
57170,0960,57170,,,,,N/A,N/A,FITTING OF DIAPHRAGM/CAP,$139.23,$103.50,$76.43,$76.43,N/A,N/A,N/A,$0.00,N/A,$76.43,N/A,N/A,N/A,N/A,N/A,N/A,N/A
57180,0960,57180,,,,,N/A,N/A,TREAT VAGINAL BLEEDING,$269.39,$200.25,$78.51,$78.51,N/A,N/A,N/A,$0.00,N/A,$78.51,N/A,N/A,N/A,N/A,N/A,N/A,N/A
57200,0960,57200,,,,,N/A,N/A,REPAIR OF VAGINA,$644.71,$479.25,$199.75,$199.75,N/A,N/A,N/A,$0.00,N/A,$199.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A
57240,0960,57240,,,,,N/A,N/A,REPAIR BLADDER & VAGINA,"$1,314.65",$977.25,$378.84,$924.00,$378.84,$896.28,$378.84,$790.02,$378.84,$546.82,$378.84,$896.28,$378.84,$924.00,$378.84,$378.84,$896.28
57250,0960,57250,,,,,N/A,N/A,REPAIR RECTUM & VAGINA,"$1,324.74",$984.75,"$1,012.64","$1,012.64",N/A,N/A,N/A,$0.00,N/A,"$1,012.64",N/A,N/A,N/A,N/A,N/A,N/A,N/A
57265,0960,57265,,,,,N/A,N/A,EXTENSIVE REPAIR OF VAGINA,"$1,790.87","$1,331.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
57268,0960,57268,,,,,N/A,N/A,REPAIR OF BOWEL BULGE,"$1,036.18",$770.25,$996.19,"$1,287.34",N/A,$996.19,N/A,$878.09,N/A,"$1,287.34",N/A,$996.19,N/A,"$1,027.00",N/A,N/A,$996.19
57283,0960,57283,,,,,N/A,N/A,"COLPOPEXY, INTRAPERITONEAL","$1,577.98","$1,173.00",$839.31,$839.31,N/A,N/A,N/A,$0.00,N/A,$839.31,N/A,N/A,N/A,N/A,N/A,N/A,N/A
57285,0960,57285,,,,,N/A,N/A,REPAIR PARAVAG DEFECT VAG,"$1,327.77",$987.00,"$1,154.90","$1,154.90",N/A,N/A,N/A,$0.00,N/A,"$1,154.90",N/A,N/A,N/A,N/A,N/A,N/A,N/A
57287,0960,57287,,,,,N/A,N/A,REVISE/REMOVE SLING REPAIR,"$1,519.46","$1,129.50",$617.46,"$1,506.00",$617.46,"$1,460.82",$617.46,"$1,287.63",$617.46,"$1,147.66",$617.46,"$1,460.82",$617.46,"$1,506.00",$617.46,$617.46,"$1,460.82"
57288,0960,57288,,,,,N/A,N/A,REPAIR BLADDER DEFECT,"$1,780.78","$1,323.75",$723.65,"$1,765.00",$723.65,"$1,712.05",$723.65,"$1,509.08",$723.65,"$1,223.80",$723.65,"$1,712.05",$723.65,"$1,765.00",$723.65,$723.65,"$1,712.05"
57410,0960,57410,,,,,N/A,N/A,PELVIC EXAMINATION,$251.23,$186.75,"$1,228.22","$1,228.22",N/A,N/A,N/A,$0.00,N/A,"$1,228.22",N/A,N/A,N/A,N/A,N/A,N/A,N/A
57420,0960,57420,,,,,N/A,N/A,EXAM OF VAGINA W/SCOPE,$218.94,$162.75,$173.80,$173.80,N/A,N/A,N/A,$0.00,N/A,$173.80,N/A,N/A,N/A,N/A,N/A,N/A,N/A
57421,0960,57421,,,,,N/A,N/A,EXAM/BIOPSY OF VAG W/SCOPE,$302.68,$225.00,$147.20,$147.20,N/A,N/A,N/A,$0.00,N/A,$147.20,N/A,N/A,N/A,N/A,N/A,N/A,N/A
57452,0960,57452,,,,,N/A,N/A,EXAM OF CERVIX W/SCOPE,$217.93,$162.00,$199.21,$199.21,N/A,N/A,N/A,$0.00,N/A,$199.21,N/A,N/A,N/A,N/A,N/A,N/A,N/A
57454,0960,57454,,,,,N/A,N/A,BX/CURETT OF CERVIX W/SCOPE,$333.96,$248.25,$149.46,$149.46,N/A,N/A,N/A,$0.00,N/A,$149.46,N/A,N/A,N/A,N/A,N/A,N/A,N/A
57455,0960,57455,,,,,N/A,N/A,BIOPSY OF CERVIX W/SCOPE,$274.43,$204.00,$220.05,$220.05,N/A,N/A,N/A,$0.00,N/A,$220.05,N/A,N/A,N/A,N/A,N/A,N/A,N/A
57456,0960,57456,,,,,N/A,N/A,ENDOCERV CURETTAGE W/SCOPE,$256.27,$190.50,$178.95,$178.95,N/A,N/A,N/A,$0.00,N/A,$178.95,N/A,N/A,N/A,N/A,N/A,N/A,N/A
57460,0960,57460,,,,,N/A,N/A,"BX OF CERVIX W/SCOPE, LEEP",$499.43,$371.25,$166.28,$166.28,N/A,N/A,N/A,$0.00,N/A,$166.28,N/A,N/A,N/A,N/A,N/A,N/A,N/A
57461,0960,57461,,,,,N/A,N/A,"CONZ OF CERVIX W/SCOPE, LEEP",$550.88,$409.50,$262.97,$262.97,N/A,N/A,N/A,$0.00,N/A,$262.97,N/A,N/A,N/A,N/A,N/A,N/A,N/A
57500,0960,57500,,,,,N/A,N/A,BIOPSY OF CERVIX,$201.79,$150.00,$302.72,$302.72,N/A,N/A,N/A,$0.00,N/A,$302.72,N/A,N/A,N/A,N/A,N/A,N/A,N/A
57505,0960,57505,,,,,N/A,N/A,ENDOCERVICAL CURETTAGE,$212.89,$158.25,$123.37,$123.37,N/A,N/A,N/A,$0.00,N/A,$123.37,N/A,N/A,N/A,N/A,N/A,N/A,N/A
57511,0960,57511,,,,,N/A,N/A,CRYOCAUTERY OF CERVIX,$310.75,$231.00,$177.93,$177.93,N/A,N/A,N/A,$0.00,N/A,$177.93,N/A,N/A,N/A,N/A,N/A,N/A,N/A
57520,0960,57520,,,,,N/A,N/A,CONIZATION OF CERVIX,$653.79,$486.00,$241.44,$241.44,N/A,N/A,N/A,$0.00,N/A,$241.44,N/A,N/A,N/A,N/A,N/A,N/A,N/A
57522,0960,57522,,,,,N/A,N/A,CONIZATION OF CERVIX,$548.86,$408.00,$487.62,$487.62,N/A,N/A,N/A,$0.00,N/A,$487.62,N/A,N/A,N/A,N/A,N/A,N/A,N/A
57720,0960,57720,,,,,N/A,N/A,REVISION OF CERVIX,$683.05,$507.75,$421.74,$421.74,N/A,N/A,N/A,$0.00,N/A,$421.74,N/A,N/A,N/A,N/A,N/A,N/A,N/A
57800,0960,57800,,,,,N/A,N/A,DILATION OF CERVICAL CANAL,$120.06,$89.25,$553.40,$553.40,N/A,N/A,N/A,$0.00,N/A,$553.40,N/A,N/A,N/A,N/A,N/A,N/A,N/A
58100,0960,58100,,,,,N/A,N/A,BIOPSY OF UTERUS LINING,$216.92,$161.25,$79.02,$79.02,N/A,N/A,N/A,$0.00,N/A,$79.02,N/A,N/A,N/A,N/A,N/A,N/A,N/A
58110,0960,58110,,,,,N/A,N/A,BX DONE W/COLPOSCOPY ADD-ON,$96.86,$72.00,$104.68,$104.68,N/A,N/A,N/A,$0.00,N/A,$104.68,N/A,N/A,N/A,N/A,N/A,N/A,N/A
58120,0960,58120,,,,,N/A,N/A,DILATION AND CURETTAGE,$490.34,$364.50,$66.76,$66.76,N/A,N/A,N/A,$0.00,N/A,$66.76,N/A,N/A,N/A,N/A,N/A,N/A,N/A
58145,0960,58145,,,,,N/A,N/A,MYOMECTOMY VAG METHOD,"$1,216.78",$904.50,$383.46,$383.46,N/A,N/A,N/A,$0.00,N/A,$383.46,N/A,N/A,N/A,N/A,N/A,N/A,N/A
58150,0960,58150,,,,,N/A,N/A,TOTAL HYSTERECTOMY,"$2,160.14","$1,605.75",$942.80,$942.80,N/A,N/A,N/A,$0.00,N/A,$942.80,N/A,N/A,N/A,N/A,N/A,N/A,N/A
58180,0960,58180,,,,,N/A,N/A,PARTIAL HYSTERECTOMY,"$2,154.09","$1,601.25",$875.35,"$2,135.00",$875.35,"$2,070.95",$875.35,"$1,825.43",$875.35,"$1,668.24",$875.35,"$2,070.95",$875.35,"$2,135.00",$875.35,$875.35,"$2,070.95"
58260,0960,58260,,,,,N/A,N/A,VAGINAL HYSTERECTOMY,"$1,868.56","$1,389.00","$1,583.37","$1,852.00",N/A,"$1,796.44",N/A,"$1,583.46",N/A,"$1,583.37",N/A,"$1,796.44",N/A,"$1,852.00",N/A,N/A,"$1,796.44"
58262,0960,58262,,,,,N/A,N/A,VAG HYST INCLUDING T/O,"$2,104.65","$1,564.50","$1,388.03","$2,086.00",N/A,"$2,023.42",N/A,"$1,783.53",N/A,"$1,388.03",N/A,"$2,023.42",N/A,"$2,086.00",N/A,N/A,"$2,023.42"
58263,0960,58263,,,,,N/A,N/A,VAG HYST W/T/O & VAG REPAIR,"$2,276.17","$1,692.00","$1,533.21","$2,256.00",N/A,"$2,188.32",N/A,"$1,928.88",N/A,"$1,533.21",N/A,"$2,188.32",N/A,"$2,256.00",N/A,N/A,"$2,188.32"
58270,0960,58270,,,,,N/A,N/A,VAG HYST W/ENTEROCELE REPAIR,"$2,024.94","$1,505.25","$1,644.64","$1,644.64",N/A,N/A,N/A,$0.00,N/A,"$1,644.64",N/A,N/A,N/A,N/A,N/A,N/A,N/A
58291,0960,58291,,,,,N/A,N/A,"VAG HYST INCL T/O, COMPLEX","$2,914.83","$2,166.75","$1,478.70","$1,478.70",N/A,N/A,N/A,$0.00,N/A,"$1,478.70",N/A,N/A,N/A,N/A,N/A,N/A,N/A
58300,0960,58300,,,,,N/A,N/A,INSERT IUD,$177.57,$132.00,"$2,059.35","$2,059.35",N/A,N/A,N/A,$0.00,N/A,"$2,059.35",N/A,N/A,N/A,N/A,N/A,N/A,N/A
58301,0960,58301,,,,,N/A,N/A,REMOVE INTRAUTERINE DEVICE,$169.50,$126.00,$84.69,$634.00,N/A,$614.98,N/A,$542.07,N/A,$84.69,N/A,$614.98,N/A,$634.00,N/A,N/A,$614.98
58340,0960,58340,,,,,N/A,N/A,CATHETER FOR HYSTEROGRAPHY,$335.98,$249.75,$109.35,$109.35,N/A,N/A,N/A,$0.00,N/A,$109.35,N/A,N/A,N/A,N/A,N/A,N/A,N/A
58350,0960,58350,,,,,N/A,N/A,REOPEN FALLOPIAN TUBE,$182.62,$135.75,$94.20,$94.20,N/A,N/A,N/A,$0.00,N/A,$94.20,N/A,N/A,N/A,N/A,N/A,N/A,N/A
58353,0960,58353,,,,,N/A,N/A,"ENDOMETR ABLATE, THERMAL","$2,213.61","$1,645.50",$155.34,$155.34,N/A,N/A,N/A,$0.00,N/A,$155.34,N/A,N/A,N/A,N/A,N/A,N/A,N/A
58541,0960,58541,,,,,N/A,N/A,LAPS SUPRACRV HYST 250 G/<,"$1,698.05","$1,262.25",$381.71,$381.71,N/A,N/A,N/A,$0.00,N/A,$381.71,N/A,N/A,N/A,N/A,N/A,N/A,N/A
58542,0960,58542,,,,,N/A,N/A,LSH W/T/O UT 250 G OR LESS,"$1,894.79","$1,408.50","$1,209.67","$1,209.67",N/A,N/A,N/A,$0.00,N/A,"$1,209.67",N/A,N/A,N/A,N/A,N/A,N/A,N/A
58550,0960,58550,,,,,N/A,N/A,LAPARO-ASST VAG HYSTERECTOMY,"$2,040.08","$1,516.50","$1,375.10","$1,375.10",N/A,N/A,N/A,$0.00,N/A,"$1,375.10",N/A,N/A,N/A,N/A,N/A,N/A,N/A
58552,0960,58552,,,,,N/A,N/A,LAPARO-VAG HYST INCL T/O,"$2,272.13","$1,689.00","$1,458.36","$1,458.36",N/A,N/A,N/A,$0.00,N/A,"$1,458.36",N/A,N/A,N/A,N/A,N/A,N/A,N/A
58553,0960,58553,,,,,N/A,N/A,"LAPARO-VAG HYST, COMPLEX","$2,656.54","$1,974.75","$1,621.47","$1,621.47",N/A,N/A,N/A,$0.00,N/A,"$1,621.47",N/A,N/A,N/A,N/A,N/A,N/A,N/A
58554,0960,58554,,,,,N/A,N/A,"LAPARO-VAG HYST W/T/O, COMPL","$3,062.13","$2,276.25","$1,852.88","$1,852.88",N/A,N/A,N/A,$0.00,N/A,"$1,852.88",N/A,N/A,N/A,N/A,N/A,N/A,N/A
58555,0960,58555,,,,,N/A,N/A,"HYSTEROSCOPY, DX, SEP PROC",$466.13,$346.50,"$2,157.46","$2,157.46",N/A,N/A,N/A,$0.00,N/A,"$2,157.46",N/A,N/A,N/A,N/A,N/A,N/A,N/A
58558,0960,58558,,,,,N/A,N/A,"HYSTEROSCOPY, BIOPSY",$658.84,$489.75,$249.47,$249.47,N/A,N/A,N/A,$0.00,N/A,$249.47,N/A,N/A,N/A,N/A,N/A,N/A,N/A
58559,0960,58559,,,,,N/A,N/A,"HYSTEROSCOPY, LYSIS",$848.52,$630.75,$379.32,$379.32,N/A,N/A,N/A,$0.00,N/A,$379.32,N/A,N/A,N/A,N/A,N/A,N/A,N/A
58561,0960,58561,,,,,N/A,N/A,"HYSTEROSCOPY, REMOVE MYOMA","$1,362.07","$1,012.50",$467.50,$467.50,N/A,N/A,N/A,$0.00,N/A,$467.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A
58562,0960,58562,,,,,N/A,N/A,"HYSTEROSCOPY, REMOVE FB",$721.39,$536.25,$588.02,$588.02,N/A,N/A,N/A,$0.00,N/A,$588.02,N/A,N/A,N/A,N/A,N/A,N/A,N/A
58563,0960,58563,,,,,N/A,N/A,"HYSTEROSCOPY, ABLATION","$3,523.22","$2,619.00",$364.40,$364.40,N/A,N/A,N/A,$0.00,N/A,$364.40,N/A,N/A,N/A,N/A,N/A,N/A,N/A
58571,0960,58571,,,,,N/A,N/A,TLH W/T/O 250 G OR LESS,"$2,026.96","$1,506.75",$404.66,$404.66,N/A,N/A,N/A,$0.00,N/A,$404.66,N/A,N/A,N/A,N/A,N/A,N/A,N/A
58573,0960,58573,,,,,N/A,N/A,TLH W/T/O UTERUS OVER 250 G,"$2,593.98","$1,928.25","$1,493.07","$1,493.07",N/A,N/A,N/A,$0.00,N/A,"$1,493.07",N/A,N/A,N/A,N/A,N/A,N/A,N/A
58605,0960,58605,,,,,N/A,N/A,DIVISION OF FALLOPIAN TUBE,$768.81,$571.50,"$2,004.49","$2,004.49",N/A,N/A,N/A,$0.00,N/A,"$2,004.49",N/A,N/A,N/A,N/A,N/A,N/A,N/A
58611,0960,58611,,,,,N/A,N/A,LIGATE OVIDUCT(S) ADD-ON,$194.73,$144.75,$557.77,$557.77,N/A,N/A,N/A,$0.00,N/A,$557.77,N/A,N/A,N/A,N/A,N/A,N/A,N/A
58660,0960,58660,,,,,N/A,N/A,"LAPAROSCOPY, LYSIS","$1,575.96","$1,171.50",$64.42,"$1,562.00",$64.42,"$1,515.14",$64.42,"$1,335.51",$64.42,$124.93,$64.42,"$1,515.14",$64.42,"$1,562.00",$64.42,$64.42,"$1,515.14"
58661,0960,58661,,,,,N/A,N/A,"LAPAROSCOPY, REMOVE ADNEXA","$1,539.64","$1,144.50",$625.66,"$1,526.00",$625.66,"$1,480.22",$625.66,"$1,304.73",$625.66,"$1,119.07",$625.66,"$1,480.22",$625.66,"$1,526.00",$625.66,$625.66,"$1,480.22"
58662,0960,58662,,,,,N/A,N/A,"LAPAROSCOPY, EXCISE LESIONS","$1,671.81","$1,242.75","$1,075.32","$1,075.32",N/A,N/A,N/A,$0.00,N/A,"$1,075.32",N/A,N/A,N/A,N/A,N/A,N/A,N/A
58670,0960,58670,,,,,N/A,N/A,"LAPAROSCOPY, TUBAL CAUTERY",$841.46,$625.50,"$1,175.12","$1,175.12",N/A,N/A,N/A,$0.00,N/A,"$1,175.12",N/A,N/A,N/A,N/A,N/A,N/A,N/A
58671,0960,58671,,,,,N/A,N/A,"LAPAROSCOPY, TUBAL BLOCK",$841.46,$625.50,$616.02,$616.02,N/A,N/A,N/A,$0.00,N/A,$616.02,N/A,N/A,N/A,N/A,N/A,N/A,N/A
58700,0960,58700,,,,,N/A,N/A,REMOVAL OF FALLOPIAN TUBE,"$1,715.20","$1,275.00",$616.02,$616.02,N/A,N/A,N/A,$0.00,N/A,$616.02,N/A,N/A,N/A,N/A,N/A,N/A,N/A
58720,0960,58720,,,,,N/A,N/A,SALP/OOPHORECTOMY COMP/PART,"$1,627.42","$1,209.75",$575.64,"$1,312.18",$575.64,N/A,$575.64,$0.00,$575.64,"$1,312.18",$575.64,N/A,$575.64,N/A,$575.64,$575.64,N/A
58740,0960,58740,,,,,N/A,N/A,REVISE FALLOPIAN TUBE(S),"$2,006.78","$1,491.75","$1,244.77","$1,244.77",N/A,N/A,N/A,$0.00,N/A,"$1,244.77",N/A,N/A,N/A,N/A,N/A,N/A,N/A
58920,0960,58920,,,,,N/A,N/A,PARTIAL REMOVAL OF OVARY(S),"$1,611.28","$1,197.75","$1,483.86","$1,483.86",N/A,N/A,N/A,$0.00,N/A,"$1,483.86",N/A,N/A,N/A,N/A,N/A,N/A,N/A
58925,0960,58925,,,,,N/A,N/A,REMOVAL OF OVARIAN CYST(S),"$1,620.36","$1,204.50","$1,183.65","$1,183.65",N/A,N/A,N/A,$0.00,N/A,"$1,183.65",N/A,N/A,N/A,N/A,N/A,N/A,N/A
58940,0960,58940,,,,,N/A,N/A,REMOVAL OF OVARY(S),"$1,081.58",$804.00,"$1,261.67","$1,261.67",N/A,N/A,N/A,$0.00,N/A,"$1,261.67",N/A,N/A,N/A,N/A,N/A,N/A,N/A
59025,0960,59025,,,,,N/A,N/A,FETAL NON-STRESS TEST,$95.85,$71.25,$174.00,$722.00,$296.20,$700.34,$296.20,$617.31,$296.20,$174.00,$296.20,$700.34,$296.20,$722.00,$296.20,$296.20,$700.34
5902526,0960,59025,,,,,N/A,N/A,FETAL NON-STRESS TEST,$95.85,$71.25,$174.00,$722.00,$296.20,$700.34,$296.20,$617.31,$296.20,$174.00,$296.20,$700.34,$296.20,$722.00,$296.20,$296.20,$700.34
59050,0960,59050,,,,,N/A,N/A,FETAL MONITOR W/REPORT,$126.12,$93.75,$29.12,$29.12,N/A,N/A,N/A,$0.00,N/A,$29.12,N/A,N/A,N/A,N/A,N/A,N/A,N/A
59120,0960,59120,,,,,N/A,N/A,TREAT ECTOPIC PREGNANCY,"$1,743.45","$1,296.00",$49.09,$49.09,N/A,N/A,N/A,$0.00,N/A,$49.09,N/A,N/A,N/A,N/A,N/A,N/A,N/A
59151,0960,59151,,,,,N/A,N/A,TREAT ECTOPIC PREGNANCY,"$1,728.31","$1,284.75",$805.11,"$1,713.00",N/A,"$1,661.61",N/A,"$1,510.79",N/A,$805.11,N/A,"$1,661.61",N/A,"$1,713.00",N/A,N/A,"$1,661.61"
59160,0960,59160,,,,,N/A,N/A,D & C AFTER DELIVERY,$473.19,$351.75,$0.00,$762.19,N/A,$0.00,N/A,N/A,N/A,$762.19,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
59200,0960,59200,,,,,N/A,N/A,INSERT CERVICAL DILATOR,$111.99,$83.25,$185.37,"$1,767.00",$724.47,"$1,713.99",$724.47,$0.00,$724.47,$185.37,$724.47,"$1,713.99",$724.47,"$1,767.00",$724.47,$724.47,"$1,713.99"
59300,0960,59300,,,,,N/A,N/A,EPISIOTOMY OR VAGINAL REPAIR,$336.99,$250.50,$0.00,$43.63,N/A,$0.00,N/A,$0.00,N/A,$43.63,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
59320,0960,59320,,,,,N/A,N/A,REVISION OF CERVIX,$368.26,$273.75,$0.00,$144.02,N/A,$0.00,N/A,$0.00,N/A,$144.02,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
59400,0960,59400,,,,,N/A,N/A,OBSTETRICAL CARE,"$4,016.59","$2,985.75",$148.00,"$3,981.00",N/A,"$3,861.57",N/A,"$3,403.76",N/A,$148.00,N/A,"$3,861.57",N/A,"$3,981.00",N/A,N/A,"$3,861.57"
59409,0960,59409,,,,,N/A,N/A,OBSTETRICAL CARE,"$1,868.56","$1,389.00",$0.00,"$2,370.70",N/A,$0.00,N/A,$0.00,N/A,"$2,370.70",N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
59410,0960,59410,,,,,N/A,N/A,OBSTETRICAL CARE,"$2,089.51","$1,553.25",$0.00,$790.20,N/A,$0.00,N/A,$0.00,N/A,$790.20,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
59412,0960,59412,,,,,N/A,N/A,ANTEPARTUM MANIPULATION,$251.23,$186.75,$296.20,"$1,044.35",$296.20,$700.34,$296.20,$617.31,$296.20,"$1,044.35",$296.20,$700.34,$296.20,$722.00,$296.20,$296.20,$700.34
59414,0960,59414,,,,,N/A,N/A,DELIVER PLACENTA,$224.99,$167.25,$0.00,$100.44,N/A,$0.00,N/A,$0.00,N/A,$100.44,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
59425,0960,59425,,,,,N/A,N/A,ANTEPARTUM CARE ONLY,$684.06,$508.50,$0.00,$88.94,N/A,$0.00,N/A,$0.00,N/A,$88.94,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
59426,0960,59426,,,,,N/A,N/A,ANTEPARTUM CARE ONLY,"$1,208.71",$898.50,$428.05,"$1,198.00",N/A,"$1,162.06",N/A,"$1,024.29",N/A,$428.05,N/A,"$1,162.06",N/A,"$1,198.00",N/A,N/A,"$1,162.06"
59430,0960,59430,,,,,N/A,N/A,CARE AFTER DELIVERY,$305.71,$227.25,$0.00,$784.89,N/A,$0.00,N/A,$0.00,N/A,$784.89,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
59510,0960,59510,,,,,N/A,N/A,CESAREAN DELIVERY,"$4,447.41","$3,306.00",$176.76,"$4,408.00",N/A,"$4,275.76",N/A,"$3,768.84",N/A,$176.76,N/A,"$4,275.76",N/A,"$4,408.00",N/A,N/A,"$4,275.76"
59514,0960,59514,,,,,N/A,N/A,CESAREAN DELIVERY ONLY,"$2,205.54","$1,639.50","$2,126.26","$2,604.92","$2,126.26",N/A,"$2,126.26",$0.00,"$2,126.26","$2,604.92","$2,126.26",N/A,"$2,126.26",N/A,"$2,126.26","$2,126.26",N/A
59515,0960,59515,,,,,N/A,N/A,CESAREAN DELIVERY,"$2,493.09","$1,853.25","$1,357.05","$1,357.05",N/A,N/A,N/A,$0.00,N/A,"$1,357.05",N/A,N/A,N/A,N/A,N/A,N/A,N/A
59525,0960,59525,,,,,N/A,N/A,REMOVE UTERUS AFTER CESAREAN,"$1,174.41",$873.00,"$1,280.24","$1,280.24",N/A,N/A,N/A,$0.00,N/A,"$1,280.24",N/A,N/A,N/A,N/A,N/A,N/A,N/A
59610,0960,59610,,,,,N/A,N/A,VBAC DELIVERY,"$4,210.31","$3,129.75",$469.82,$469.82,N/A,N/A,N/A,$0.00,N/A,$469.82,N/A,N/A,N/A,N/A,N/A,N/A,N/A
59614,0960,59614,,,,,N/A,N/A,VBAC CARE AFTER DELIVERY,"$2,308.45","$1,716.00","$2,463.99","$2,463.99",N/A,N/A,N/A,$0.00,N/A,"$2,463.99",N/A,N/A,N/A,N/A,N/A,N/A,N/A
59618,0960,59618,,,,,N/A,N/A,ATTEMPTED VBAC DELIVERY,"$4,516.02","$3,357.00","$1,121.36","$1,121.36",N/A,N/A,N/A,$0.00,N/A,"$1,121.36",N/A,N/A,N/A,N/A,N/A,N/A,N/A
59620,0960,59620,,,,,N/A,N/A,ATTEMPTED VBAC DELIVERY ONLY,"$2,414.39","$1,794.75","$2,631.47","$2,631.47",N/A,N/A,N/A,$0.00,N/A,"$2,631.47",N/A,N/A,N/A,N/A,N/A,N/A,N/A
59622,0960,59622,,,,,N/A,N/A,ATTEMPTED VBAC AFTER CARE,"$2,726.16","$2,026.50",$917.16,$917.16,N/A,N/A,N/A,$0.00,N/A,$917.16,N/A,N/A,N/A,N/A,N/A,N/A,N/A
59812,0960,59812,,,,,N/A,N/A,TREATMENT OF MISCARRIAGE,$642.69,$477.75,"$1,325.87","$1,325.87",N/A,N/A,N/A,$0.00,N/A,"$1,325.87",N/A,N/A,N/A,N/A,N/A,N/A,N/A
59820,0960,59820,,,,,N/A,N/A,CARE OF MISCARRIAGE,$734.51,$546.00,$304.89,$304.89,N/A,N/A,N/A,$0.00,N/A,$304.89,N/A,N/A,N/A,N/A,N/A,N/A,N/A
59830,0960,59830,,,,,N/A,N/A,TREAT UTERUS INFECTION,$987.75,$734.25,$381.73,$381.73,N/A,N/A,N/A,$0.00,N/A,$381.73,N/A,N/A,N/A,N/A,N/A,N/A,N/A
60300,0960,60300,,,,,N/A,N/A,ASPIRATION AND/OR INJECTION,$122.08,$90.75,$458.59,$458.59,N/A,N/A,N/A,$0.00,N/A,$458.59,N/A,N/A,N/A,N/A,N/A,N/A,N/A
62270,0960,62270,,,,,N/A,N/A,"SPINAL FLUID TAP, DIAGNOSTIC",$208.85,$155.25,$83.35,$207.00,$88.97,$200.79,$88.97,$176.99,$88.97,$83.35,$88.97,$200.79,$88.97,$207.00,$88.97,$88.97,$200.79
9662270,0960,62270,,,,,N/A,N/A,"SPINAL PUNCTURE, LUMBAR -62270",$208.85,$155.25,$83.35,$207.00,$88.97,$200.79,$88.97,$176.99,$88.97,$83.35,$88.97,$200.79,$88.97,$207.00,$88.97,$88.97,$200.79
62272,0960,62272,,,,,N/A,N/A,DRAIN CEREBRO SPINAL FLUID,$293.60,$218.25,$78.63,$291.00,$119.31,$282.27,$119.31,$248.81,$119.31,$78.63,$119.31,$282.27,$119.31,$291.00,$119.31,$119.31,$282.27
62273,0960,62273,,,,,N/A,N/A,INJECT EPIDURAL PATCH,$270.40,$201.00,$110.72,$683.60,$683.60,N/A,$683.60,$0.00,$683.60,$110.72,$683.60,N/A,$683.60,N/A,$683.60,$683.60,N/A
62282,0960,62282,,,,,N/A,N/A,TREAT SPINAL CANAL LESION,$644.71,$479.25,$146.38,$639.00,N/A,$619.83,N/A,$546.35,N/A,$146.38,N/A,$619.83,N/A,$639.00,N/A,N/A,$619.83
62321,0960,62321,,,,,N/A,N/A,INJ SPINE C/T W/ IMAGIN,$390.46,$290.25,$76.96,"$1,856.00",$76.96,"$1,800.32",$76.96,"$1,586.88",$76.96,$127.71,$76.96,"$1,800.32",$76.96,"$1,856.00",$76.96,$76.96,"$1,800.32"
62322,0960,62322,,,,,N/A,N/A,INJ SPINE L/S W/O IMAGING,$200.78,$149.25,$139.73,"$1,666.00",$683.60,"$1,616.02",$683.60,"$1,424.43",$683.60,$139.73,$683.60,"$1,616.02",$683.60,"$1,666.00",$683.60,$683.60,"$1,616.02"
62323,0960,62323,,,,,N/A,N/A,INJ SPINE L/S W/IMAGING,$349.09,$259.50,$76.96,"$1,856.00",$76.96,"$1,800.32",$76.96,"$1,586.88",$76.96,$104.93,$76.96,"$1,800.32",$76.96,"$1,856.00",$76.96,$76.96,"$1,800.32"
62326,0960,62326,,,,,N/A,N/A,INJ SPINE W/CATH L/S W/O IMA,$235.08,$174.75,$143.43,"$1,666.00",$683.60,"$1,616.02",$683.60,"$1,424.43",$683.60,$143.43,$683.60,"$1,616.02",$683.60,"$1,666.00",$683.60,$683.60,"$1,616.02"
62327,0960,62327,,,,,N/A,N/A,EPIDURAL USING US GUIDANCE,$205.82,$153.00,$76.96,"$1,856.00",$76.96,"$1,800.32",$76.96,"$1,586.88",$76.96,$111.72,$76.96,"$1,800.32",$76.96,"$1,856.00",$76.96,$76.96,"$1,800.32"
62328,0960,62328,,,,,N/A,N/A,SPINAL PUNCTURE,$736.53,$547.50,$133.78,$730.00,N/A,$708.10,N/A,$624.15,N/A,$133.78,N/A,$708.10,N/A,$730.00,N/A,N/A,$708.10
62329,0960,62329,,,,,N/A,N/A,SPINAL PUNCTURE,$658.84,$489.75,$113.34,$653.00,$267.73,$633.41,$267.73,$558.32,$267.73,$113.34,$267.73,$633.41,$267.73,$653.00,$267.73,$267.73,$633.41
62362,0960,62362,,,,,N/A,N/A,IMPLANT SPINE INFUSION PUMP,"$1,095.71",$814.50,$351.52,$351.52,N/A,N/A,N/A,$0.00,N/A,$351.52,N/A,N/A,N/A,N/A,N/A,N/A,N/A
62365,0960,62365,,,,,N/A,N/A,REMOVE SPINE INFUSION DEVICE,$861.63,$640.50,$35.14,$854.00,$35.14,$828.38,$35.14,$730.17,$35.14,$495.12,$35.14,$828.38,$35.14,$854.00,$35.14,$35.14,$828.38
62368,0960,62368,,,,,N/A,N/A,ANALYZE SPINE INFUSION PUMP,$90.80,$67.50,$31.91,$536.00,$219.76,$519.92,$219.76,$458.28,$219.76,$31.91,$219.76,$519.92,$219.76,$536.00,$219.76,$219.76,$519.92
62370,0960,62370,,,,,N/A,N/A,ANL SP INF PMP W/MDREPRG&FIL,$164.46,$122.25,$45.29,$481.00,$197.21,$466.57,$197.21,$411.26,$197.21,$45.29,$197.21,$466.57,$197.21,$481.00,$197.21,$197.21,$466.57
63650,0960,63650,,,,,N/A,N/A,IMPLANT NEUROELECTRODES,$932.26,$693.00,$60.17,$60.17,N/A,N/A,N/A,"$2,309.96",N/A,$60.17,N/A,N/A,N/A,N/A,N/A,N/A,N/A
63685,0960,63685,,,,,N/A,N/A,INSRT/REDO SPINE N GENERATOR,"$1,068.47",$794.25,$540.18,$540.18,N/A,N/A,N/A,$678.38,N/A,$540.18,N/A,N/A,N/A,N/A,N/A,N/A,N/A
64405,0960,64405,,,,,N/A,N/A,"N BLOCK INJ, OCCIPITAL",$168.49,$125.25,$63.43,$233.00,$68.47,$226.01,$68.47,$134.99,$68.47,$63.43,$68.47,$226.01,$68.47,$233.00,$68.47,$68.47,$226.01
64413,0960,64413,,,,,N/A,N/A,"N BLOCK INJ, CERVICAL PLEXUS",$180.60,$134.25,$67.59,$179.00,N/A,$173.63,N/A,N/A,N/A,$67.59,N/A,$173.63,N/A,$179.00,N/A,N/A,$173.63
64415,0960,64415,,,,,N/A,N/A,"N BLOCK INJ, BRACHIAL PLEXUS",$188.67,$140.25,N/A,N/A,N/A,N/A,N/A,$186.38,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
64416,0960,64416,,,,,N/A,N/A,NERVE BLOCK,$232.06,$172.50,$81.89,$81.89,N/A,N/A,N/A,$141.17,N/A,$81.89,N/A,N/A,N/A,N/A,N/A,N/A,N/A
64417,0960,64417,,,,,N/A,N/A,AXILLARY NERVE BLOCK,$264.34,$196.50,$35.14,$83.32,$35.14,N/A,$35.14,$222.24,$35.14,$83.32,$35.14,N/A,$35.14,N/A,$35.14,$35.14,N/A
64418,0960,64418,,,,,N/A,N/A,SUPRASCAPULAR NERVE BLOCK,$240.13,$178.50,$35.14,$78.70,$35.14,N/A,$35.14,$183.39,$35.14,$78.70,$35.14,N/A,$35.14,N/A,$35.14,$35.14,N/A
64420,0960,64420,,,,,N/A,N/A,INTERCOSTAL NERVE SINGLE,$687.09,$510.75,$35.14,$74.00,$35.14,N/A,$35.14,$203.63,$35.14,$74.00,$35.14,N/A,$35.14,N/A,$35.14,$35.14,N/A
64421,0960,64421,,,,,N/A,N/A,"N BLOCK INJ, INTERCOST, MLT",$454.02,$337.50,$76.88,$683.60,$683.60,N/A,$683.60,$74.66,$683.60,$76.88,$683.60,N/A,$683.60,N/A,$683.60,$683.60,N/A
64425,0960,64425,,,,,N/A,N/A,"N BLOCK INJ, ILIO-ING/HYPOGI",$218.94,$162.75,$12.30,$217.00,$12.30,$210.49,$12.30,$187.36,$12.30,$32.37,$12.30,$210.49,$12.30,$217.00,$12.30,$12.30,$210.49
64435,0960,64435,,,,,N/A,N/A,N BLOCK INJ PARACERVICAL,$205.82,$153.00,$0.00,$71.85,N/A,$0.00,N/A,$183.20,N/A,$71.85,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
64445,0960,64445,,,,,N/A,N/A,"N BLOCK INJ, SCIATIC, SNG",$208.85,$155.25,$55.92,"$1,666.00",$683.60,"$1,616.02",$683.60,$206.45,$683.60,$55.92,$683.60,"$1,616.02",$683.60,"$1,666.00",$683.60,$683.60,"$1,616.02"
64447,0960,64447,,,,,N/A,N/A,"N BLOCK INJ FEM, SINGLE",$182.62,$135.75,$35.14,$854.00,$35.14,$828.38,$35.14,$123.12,$35.14,$69.76,$35.14,$828.38,$35.14,$854.00,$35.14,$35.14,$828.38
64448,0960,64448,,,,,N/A,N/A,NERVE BLOCK,$126.12,$93.75,$0.00,$68.58,N/A,$0.00,N/A,$166.24,N/A,$68.58,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
64450,0960,64450,,,,,N/A,N/A,"N BLOCK, OTHER PERIPHERAL",$168.49,$125.25,$68.47,$167.00,$68.47,$161.99,$68.47,$127.02,$68.47,$78.69,$68.47,$161.99,$68.47,$167.00,$68.47,$68.47,$161.99
64451,0960,64451,,,,,N/A,N/A,NERVE BLOCK,$433.84,$322.50,$54.88,$522.00,$214.20,$506.34,$214.20,$257.60,$214.20,$54.88,$214.20,$506.34,$214.20,$522.00,$214.20,$214.20,$506.34
64454,0960,64454,,,,,N/A,N/A,NERVE BLOCK,$437.88,$325.50,$102.13,$526.00,$215.66,$510.22,$215.66,$260.22,$215.66,$102.13,$215.66,$510.22,$215.66,$526.00,$215.66,$215.66,$510.22
64455,0960,64455,,,,,N/A,N/A,INJ ANES/STEROID PLANTAR,$70.63,$52.50,$38.13,$105.79,$38.13,$90.21,$38.13,$58.84,$38.13,$105.79,$38.13,$90.21,$38.13,$93.00,$38.13,$38.13,$90.21
64461,0960,64461,,,,,N/A,N/A,PARAVERTEBRAL BLOCK,$278.47,$207.00,$43.79,$276.00,N/A,$267.72,N/A,$180.94,N/A,$43.79,N/A,$267.72,N/A,$276.00,N/A,N/A,$267.72
64479,0960,64479,,,,,N/A,N/A,INJ FORAMEN EPIDURAL C/T,$393.49,$292.50,$99.83,"$1,666.00",$683.60,"$1,616.02",$683.60,$389.44,$683.60,$99.83,$683.60,"$1,616.02",$683.60,"$1,666.00",$683.60,$683.60,"$1,616.02"
64480,0960,64480,,,,,N/A,N/A,INJ FORAMEN EPIDURAL ADD-ON,$259.30,$192.75,$35.14,$854.00,$35.14,$828.38,$35.14,$256.62,$35.14,$170.41,$35.14,$828.38,$35.14,$854.00,$35.14,$35.14,$828.38
64483,0960,64483,,,,,N/A,N/A,INJ FORAMEN EPIDURAL L/S,$411.65,$306.00,$80.59,"$1,666.00",$683.60,"$1,616.02",$683.60,$407.45,$683.60,$80.59,$683.60,"$1,616.02",$683.60,"$1,666.00",$683.60,$683.60,"$1,616.02"
64484,0960,64484,,,,,N/A,N/A,INJ FORAMEN EPIDURAL ADD-ON,$249.21,$185.25,$35.14,$854.00,$35.14,$828.38,$35.14,$246.02,$35.14,$145.15,$35.14,$828.38,$35.14,$854.00,$35.14,$35.14,$828.38
64488,0960,64488,,,,,N/A,N/A,TAP BLOCK,$494.38,$367.50,$72.30,$490.00,N/A,$475.30,N/A,$177.13,N/A,$72.30,N/A,$475.30,N/A,$490.00,N/A,N/A,$475.30
64490,0960,64490,,,,,N/A,N/A,NJX DX/THER AGT PVRT FACET J,$331.94,$246.75,$89.72,"$1,666.00",$683.60,"$1,616.02",$683.60,$328.06,$683.60,$89.72,$683.60,"$1,616.02",$683.60,"$1,666.00",$683.60,$683.60,"$1,616.02"
64491,0960,64491,,,,,N/A,N/A,INJ PARAVERT F JNT C/T 2 LEV,$215.91,$160.50,$137.44,$590.00,$241.90,$572.30,$241.90,$213.89,$241.90,$137.44,$241.90,$572.30,$241.90,$590.00,$241.90,$241.90,$572.30
64492,0960,64492,,,,,N/A,N/A,INJ PARAVERT F JNT C/T 3 LEV,$215.91,$160.50,$77.85,$590.00,$241.90,$572.30,$241.90,$213.89,$241.90,$77.85,$241.90,$572.30,$241.90,$590.00,$241.90,$241.90,$572.30
64493,0960,64493,,,,,N/A,N/A,NJX DX/THER AGT PVRT FACET J,$302.68,$225.00,$79.22,"$1,666.00",$683.60,"$1,616.02",$683.60,$299.12,$683.60,$79.22,$683.60,"$1,616.02",$683.60,"$1,666.00",$683.60,$683.60,"$1,616.02"
64494,0960,64494,,,,,N/A,N/A,INJ PARAVERT F JNT L/S 2 LEV,$201.79,$150.00,$117.67,$590.00,$241.90,$572.30,$241.90,$199.05,$241.90,$117.67,$241.90,$572.30,$241.90,$590.00,$241.90,$241.90,$572.30
64495,0960,64495,,,,,N/A,N/A,INJ PARAVERT F JNT L/S 3 LEV,$201.79,$150.00,$67.02,$590.00,$241.90,$572.30,$241.90,$199.05,$241.90,$67.02,$241.90,$572.30,$241.90,$590.00,$241.90,$241.90,$572.30
64510,0960,64510,,,,,N/A,N/A,"N BLOCK, STELLATE GANGLION",$189.68,$141.00,$128.89,"$1,666.00",$683.60,"$1,616.02",$683.60,$187.79,$683.60,$128.89,$683.60,"$1,616.02",$683.60,"$1,666.00",$683.60,$683.60,"$1,616.02"
64520,0960,64520,,,,,N/A,N/A,"N BLOCK, LUMBAR/THORACIC",$263.33,$195.75,$164.40,"$1,666.00",$683.60,"$1,616.02",$683.60,$260.28,$683.60,$164.40,$683.60,"$1,616.02",$683.60,"$1,666.00",$683.60,$683.60,"$1,616.02"
64566,0960,64566,,,,,N/A,N/A,NEUROELTRD STIM POST TIBIAL,$202.80,$150.75,$82.41,$201.00,$82.41,$194.97,$82.41,$136.58,$82.41,$122.70,$82.41,$194.97,$82.41,$201.00,$82.41,$82.41,$194.97
64585,0960,64585,,,,,N/A,N/A,REVISE/REMOVE NEUROELECTRODE,$741.57,$551.25,$39.35,$735.00,$55.35,$712.95,$55.35,$376.31,$55.35,$39.35,$55.35,$712.95,$55.35,$735.00,$55.35,$55.35,$712.95
64595,0960,64595,,,,,N/A,N/A,REVISE/REMOVE NEURORECEIVER,$707.27,$525.75,$186.60,$701.00,$287.41,$679.97,$287.41,$533.93,$287.41,$186.60,$287.41,$679.97,$287.41,$701.00,$287.41,$287.41,$679.97
64611,0960,64611,,,,,N/A,N/A,CHEMODENERV SALIV GLANDS,$176.56,$131.25,$0.00,$165.07,N/A,$0.00,N/A,$127.43,N/A,$165.07,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
64612,0960,64612,,,,,N/A,N/A,"DESTROY NERVE, FACE MUSCLE",$305.71,$227.25,$138.70,$572.00,$234.52,$554.84,$234.52,$207.89,$234.52,$138.70,$234.52,$554.84,$234.52,$572.00,$234.52,$234.52,$554.84
64615,0960,64615,,,,,N/A,N/A,CHEMICAL DENERVATION PROC HE,$290.57,$216.00,$0.00,$151.89,N/A,$0.00,N/A,$170.73,N/A,$151.89,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
64624,0960,64624,,,,,N/A,N/A,NERVE BLOCK,$839.44,$624.00,$98.56,"$2,216.00",$98.56,"$2,149.52",$98.56,$498.80,$98.56,$153.78,$98.56,"$2,149.52",$98.56,"$2,216.00",$98.56,$98.56,"$2,149.52"
64625,0960,64625,,,,,N/A,N/A,NERVE BLOCK,"$1,024.07",$761.25,$191.09,"$1,229.00",N/A,"$1,192.13",N/A,$608.87,N/A,$191.09,N/A,"$1,192.13",N/A,"$1,229.00",N/A,N/A,"$1,192.13"
64633,0960,64633,,,,,N/A,N/A,DESTROY CERV/THOR FACET JNT,$908.05,$675.00,$149.58,"$3,438.00",$149.58,"$3,334.86",$149.58,$562.29,$149.58,$251.85,$149.58,"$3,334.86",$149.58,"$3,438.00",$149.58,$149.58,"$3,334.86"
64634,0960,64634,,,,,N/A,N/A,DESTROY C/TH FACET JNT ADDL,$261.32,$194.25,$292.45,"$3,438.00",$926.60,"$3,334.86",$926.60,$258.61,$926.60,$292.45,$926.60,"$3,334.86",$926.60,"$3,438.00",$926.60,$926.60,"$3,334.86"
64635,0960,64635,,,,,N/A,N/A,DESTROY LUMB/SAC FACET JNT,$557.94,$414.75,$87.90,"$4,160.00",$175.60,"$4,035.20",$175.60,$552.64,$175.60,$87.90,$175.60,"$4,035.20",$175.60,"$4,160.00",$175.60,$175.60,"$4,035.20"
64636,0960,64636,,,,,N/A,N/A,DESTROY L/S FACET JNT ADDL,$235.08,$174.75,$288.54,"$2,735.00","$1,121.35","$2,652.95","$1,121.35",$232.89,"$1,121.35",$288.54,"$1,121.35","$2,652.95","$1,121.35","$2,735.00","$1,121.35","$1,121.35","$2,652.95"
64640,0960,64640,,,,,N/A,N/A,INJECTION TREATMENT OF NERVE,$433.84,$322.50,$77.33,"$1,666.00","$1,514.13","$1,616.02","$1,514.13",$267.64,"$1,514.13",$77.33,"$1,514.13","$1,616.02","$1,514.13","$1,666.00","$1,514.13","$1,514.13","$1,616.02"
64642,0960,64642,,,,,N/A,N/A,CHEMODENERVATION OF ONE EXTR,$775.87,$576.75,$154.35,$154.35,N/A,N/A,N/A,$166.11,N/A,$154.35,N/A,N/A,N/A,N/A,N/A,N/A,N/A
64650,0960,64650,,,,,N/A,N/A,CHEMODENERV ECCRINE GLANDS,$89.80,$66.75,$136.38,$136.38,N/A,N/A,N/A,$89.48,N/A,$136.38,N/A,N/A,N/A,N/A,N/A,N/A,N/A
64704,0960,64704,,,,,N/A,N/A,REVISE HAND/FOOT NERVE,$749.64,$557.25,$52.21,$52.21,N/A,N/A,N/A,$474.17,N/A,$52.21,N/A,N/A,N/A,N/A,N/A,N/A,N/A
64708,0960,64708,,,,,N/A,N/A,REVISE ARM/LEG NERVE,"$1,046.27",$777.75,$423.48,"$1,037.00",$425.17,"$1,005.89",$425.17,$548.01,$425.17,$423.48,$425.17,"$1,005.89",$425.17,"$1,037.00",$425.17,$425.17,"$1,005.89"
64718,0960,64718,,,,,N/A,N/A,REVISE ULNAR NERVE AT ELBOW,"$1,152.21",$856.50,$462.89,"$1,129.00",$462.89,"$1,095.13",$462.89,$734.47,$462.89,$662.10,$462.89,"$1,095.13",$462.89,"$1,129.00",$462.89,$462.89,"$1,095.13"
64719,0960,64719,,,,,N/A,N/A,REVISE ULNAR NERVE AT WRIST,$889.89,$661.50,$0.00,$780.71,N/A,$0.00,N/A,$539.23,N/A,$780.71,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
64721,0960,64721,,,,,N/A,N/A,CARPAL TUNNEL SURGERY,"$1,203.67",$894.75,$489.13,"$1,193.00",$489.13,"$1,157.21",$489.13,$956.76,$489.13,$529.35,$489.13,"$1,157.21",$489.13,"$1,193.00",$489.13,$489.13,"$1,157.21"
64831,0960,64831,,,,,N/A,N/A,REPAIR OF DIGIT NERVE,"$1,569.91","$1,167.00",$567.43,"$1,556.00",$637.96,"$1,509.32",$637.96,$823.94,$637.96,$567.43,$637.96,"$1,509.32",$637.96,"$1,556.00",$637.96,$637.96,"$1,509.32"
64857,0960,64857,,,,,N/A,N/A,REPAIR ARM/LEG NERVE,"$2,302.40","$1,711.50",$898.49,"$2,282.00",$935.62,"$2,213.54",$935.62,"$1,463.29",$935.62,$898.49,$935.62,"$2,213.54",$935.62,"$2,282.00",$935.62,$935.62,"$2,213.54"
64872,0960,64872,,,,,N/A,N/A,SUBSEQUENT REPAIR OF NERVE,$295.62,$219.75,"$1,360.76","$1,360.76",N/A,N/A,N/A,$186.81,N/A,"$1,360.76",N/A,N/A,N/A,N/A,N/A,N/A,N/A
65222,0960,65222,,,,,N/A,N/A,REMOVE FOREIGN BODY FROM EYE,$176.56,$131.25,$71.83,$758.00,N/A,$735.26,N/A,$156.75,N/A,$71.83,N/A,$735.26,N/A,$758.00,N/A,N/A,$735.26
66989,0960,66989,,,,,N/A,N/A,EXTRACAPSULAR CATARACT REMOVAL,$863.65,$642.00,$156.63,$856.00,N/A,$830.32,N/A,"$1,011.65",N/A,$156.63,N/A,$830.32,N/A,$856.00,N/A,N/A,$830.32
66991,0960,66991,,,,,N/A,N/A,EXTRACAPSULAR CATARACT REMOVAL,$689.11,$512.25,$662.51,"$1,481.22",N/A,$662.51,N/A,$808.40,N/A,"$1,481.22",N/A,$662.51,N/A,$683.00,N/A,N/A,$662.51
68100,0960,68100,,,,,N/A,N/A,BIOPSY OF EYELID LINING,$381.38,$283.50,$204.96,$204.96,N/A,N/A,N/A,$377.20,N/A,$204.96,N/A,N/A,N/A,N/A,N/A,N/A,N/A
69005,0960,69005,,,,,N/A,N/A,DRAIN EXTERNAL EAR LESION,$368.26,$273.75,$184.90,$184.90,N/A,N/A,N/A,$296.25,N/A,$184.90,N/A,N/A,N/A,N/A,N/A,N/A,N/A
69020,0960,69020,,,,,N/A,N/A,DRAIN OUTER EAR CANAL LESION,$328.91,$244.50,$238.69,$238.69,N/A,N/A,N/A,$271.27,N/A,$238.69,N/A,N/A,N/A,N/A,N/A,N/A,N/A
69105,0960,69105,,,,,N/A,N/A,BIOPSY OF EXTERNAL EAR CANAL,$160.42,$119.25,$217.60,$217.60,N/A,N/A,N/A,$161.34,N/A,$217.60,N/A,N/A,N/A,N/A,N/A,N/A,N/A
69145,0960,69145,,,,,N/A,N/A,REMOVE EAR CANAL LESION(S),$549.87,$408.75,$93.85,$93.85,N/A,N/A,N/A,$429.62,N/A,$93.85,N/A,N/A,N/A,N/A,N/A,N/A,N/A
69200,0960,69200,,,,,N/A,N/A,CLEAR OUTER EAR CANAL,$251.23,$186.75,$389.82,$548.00,N/A,$531.56,N/A,$156.88,N/A,$389.82,N/A,$531.56,N/A,$548.00,N/A,N/A,$531.56
69205,0960,69205,,,,,N/A,N/A,CLEAR OUTER EAR CANAL,$239.12,$177.75,$70.36,$70.36,N/A,N/A,N/A,$150.90,N/A,$70.36,N/A,N/A,N/A,N/A,N/A,N/A,N/A
69209,0960,69209,,,,,N/A,N/A,CERUMEN REMOVAL IRRIGATION/L,$26.23,$19.50,$145.00,$210.00,N/A,$203.70,N/A,$16.02,N/A,$145.00,N/A,$203.70,N/A,$210.00,N/A,N/A,$203.70
69210,0960,69210,,,,,N/A,N/A,REMOVE IMPACTED EAR WAX,$79.71,$59.25,$23.19,$359.00,N/A,$348.23,N/A,$71.60,N/A,$23.19,N/A,$348.23,N/A,$359.00,N/A,N/A,$348.23
9769210,0960,69210,,,,,N/A,N/A,REMOVAL IMPACTED CERUMEN,$72.64,$54.00,$23.19,$359.00,N/A,$348.23,N/A,$71.60,N/A,$23.19,N/A,$348.23,N/A,$359.00,N/A,N/A,$348.23
69220,0960,69220,,,,,N/A,N/A,CLEAN OUT MASTOID CAVITY,$160.42,$119.25,$49.53,$49.53,N/A,N/A,N/A,$158.16,N/A,$49.53,N/A,N/A,N/A,N/A,N/A,N/A,N/A
69421,0960,69421,,,,,N/A,N/A,INCISION OF EARDRUM,$362.21,$269.25,$76.28,$76.28,N/A,N/A,N/A,$201.55,N/A,$76.28,N/A,N/A,N/A,N/A,N/A,N/A,N/A
69424,0960,69424,,,,,N/A,N/A,REMOVE VENTILATING TUBE,$152.35,$113.25,$227.31,$227.31,N/A,N/A,N/A,$150.38,N/A,$227.31,N/A,N/A,N/A,N/A,N/A,N/A,N/A
69433,0960,69433,,,,,N/A,N/A,MYRINGOTOMY,$403.58,$300.00,$91.11,$91.11,N/A,N/A,N/A,$232.70,N/A,$91.11,N/A,N/A,N/A,N/A,N/A,N/A,N/A
69436,0960,69436,,,,,N/A,N/A,CREATE EARDRUM OPENING,$396.51,$294.75,$197.90,$197.90,N/A,N/A,N/A,$226.48,N/A,$197.90,N/A,N/A,N/A,N/A,N/A,N/A,N/A
69610,0960,69610,,,,,N/A,N/A,REPAIR OF EARDRUM,$720.38,$535.50,"$1,645.27","$1,645.27",N/A,N/A,N/A,$500.01,N/A,"$1,645.27",N/A,N/A,N/A,N/A,N/A,N/A,N/A
74420,0960,74420,,,,,N/A,N/A,"UROGRAPHY,RETRO W OR W/O",$287.55,$213.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
74740,0960,74740,,,,,N/A,N/A,"X-RAY, FEMALE GENITAL TRACT",$170.51,$126.75,$457.56,$457.56,$457.56,N/A,$457.56,N/A,$457.56,N/A,$457.56,N/A,$457.56,N/A,$457.56,$457.56,N/A
76000,0960,76000,,,,,N/A,N/A,FLUOROSCOPE EXAMINATION,$144.28,$107.25,$566.21,$566.21,$566.21,N/A,$566.21,N/A,$566.21,N/A,$566.21,N/A,$566.21,N/A,$566.21,$566.21,N/A
76512,0960,76512,,,,,N/A,N/A,"OPHTH US, B W/NON-QUANT A",$294.61,$219.00,$119.72,$119.72,$119.72,N/A,$119.72,N/A,$119.72,N/A,$119.72,N/A,$119.72,N/A,$119.72,$119.72,N/A
7651280B,0960,76512,,,,,N/A,N/A,"OPHTH US, B W/NON-QUANT A   ~P",$291.58,$216.75,$119.72,$119.72,$119.72,N/A,$119.72,N/A,$119.72,N/A,$119.72,N/A,$119.72,N/A,$119.72,$119.72,N/A
76536,0960,76536,,,,,N/A,N/A,US EXAM OF HEAD AND NECK,$249.21,$185.25,$113.98,$113.98,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,$113.98,N/A
7653680B,0960,76536,,,,,N/A,N/A,US EXAM OF HEAD AND NECK    ~P,$73.65,$54.75,$113.98,$113.98,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,$113.98,N/A
76604,0960,76604,,,,,N/A,N/A,"US EXAM, CHEST, B-SCAN",$190.69,$141.75,$87.33,$87.33,$87.33,N/A,$87.33,N/A,$87.33,N/A,$87.33,N/A,$87.33,N/A,$87.33,$87.33,N/A
766045280B,0960,76604,,,,,N/A,N/A,"US EXAM, CHEST, B-SCAN      ~P",$124.10,$92.25,$87.33,$87.33,$87.33,N/A,$87.33,N/A,$87.33,N/A,$87.33,N/A,$87.33,N/A,$87.33,$87.33,N/A
7660480B,0960,76604,,,,,N/A,N/A,"US EXAM, CHEST, B-SCAN      ~P",$124.10,$92.25,$87.33,$87.33,$87.33,N/A,$87.33,N/A,$87.33,N/A,$87.33,N/A,$87.33,N/A,$87.33,$87.33,N/A
76641,0960,76641,,,,,N/A,N/A,ULTRASOUND BREAST UNILATERAL,$180.60,$134.25,$79.54,$79.54,$79.54,N/A,$79.54,N/A,$79.54,N/A,$79.54,N/A,$79.54,N/A,$79.54,$79.54,N/A
76642,0960,76642,,,,,N/A,N/A,UNILATERAL LIMITED BREAST UL,$180.60,$134.25,$19.24,$19.24,$19.24,N/A,$19.24,N/A,$19.24,N/A,$19.24,N/A,$19.24,N/A,$19.24,$19.24,N/A
7664280B,0960,76642,,,,,N/A,N/A,UNILATERAL LIMITED BREAST UL~P,$131.16,$97.50,$19.24,$19.24,$19.24,N/A,$19.24,N/A,$19.24,N/A,$19.24,N/A,$19.24,N/A,$19.24,$19.24,N/A
76705,0960,76705,,,,,N/A,N/A,ECHO EXAM OF ABDOMEN,$191.70,$142.50,$25.82,$25.82,$25.82,N/A,$25.82,N/A,$25.82,N/A,$25.82,N/A,$25.82,N/A,$25.82,$25.82,N/A
7670580B,0960,76705,,,,,N/A,N/A,ECHO EXAM OF ABDOMEN        ~P,$70.63,$52.50,$25.82,$25.82,$25.82,N/A,$25.82,N/A,$25.82,N/A,$25.82,N/A,$25.82,N/A,$25.82,$25.82,N/A
76775,0960,76775,,,,,N/A,N/A,US RETRO PERI LIMITED,$227.01,$168.75,$177.12,$177.12,$177.12,N/A,$177.12,N/A,$177.12,N/A,$177.12,N/A,$177.12,N/A,$177.12,$177.12,N/A
7677580B,0960,76775,,,,,N/A,N/A,US RETRO PERI LIMITED       ~P,$177.57,$132.00,$177.12,$177.12,$177.12,N/A,$177.12,N/A,$177.12,N/A,$177.12,N/A,$177.12,N/A,$177.12,$177.12,N/A
76801,0960,76801,,,,,N/A,N/A,"OB US < 14 WKS, SINGLE FETUS",$320.84,$238.50,$95.12,$95.12,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,$95.12,N/A
76802,0960,76802,,,,,N/A,N/A,OB US<14WKS  ADD'L FETUS,$205.82,$153.00,$95.12,$95.12,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,$95.12,N/A
76805,0960,76805,,,,,N/A,N/A,"OB US >/= 14 WKS, SNGL FETUS",$320.84,$238.50,$95.12,$95.12,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,$95.12,N/A
76810,0960,76810,,,,,N/A,N/A,OB US 2-3 TRI ADDIT GESTATION,$182.62,$135.75,$95.12,$95.12,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,$95.12,N/A
76815,0960,76815,,,,,N/A,N/A,"OB US, LIMITED, FETUS(S)",$216.92,$161.25,$99.22,$99.22,$99.22,N/A,$99.22,N/A,$99.22,N/A,$99.22,N/A,$99.22,N/A,$99.22,$99.22,N/A
76816,0960,76816,,,,,N/A,N/A,"OB US, FOLLOW-UP, PER FETUS",$214.90,$159.75,$14.14,$14.14,$14.14,N/A,$14.14,N/A,$14.14,N/A,$14.14,N/A,$14.14,N/A,$14.14,$14.14,N/A
76817,0960,76817,,,,,N/A,N/A,"TRANSVAGINAL US, OBSTETRIC",$235.08,$174.75,$14.14,$14.14,$14.14,N/A,$14.14,N/A,$14.14,N/A,$14.14,N/A,$14.14,N/A,$14.14,$14.14,N/A
76818,0960,76818,,,,,N/A,N/A,FETAL BIOPHYS PROFILE W/NST,$285.53,$212.25,$116.30,$116.30,$116.30,N/A,$116.30,N/A,$116.30,N/A,$116.30,N/A,$116.30,N/A,$116.30,$116.30,N/A
76819,0960,76819,,,,,N/A,N/A,FETAL BIOPHYS PROFIL W/O NST,$249.21,$185.25,$82.82,$82.82,$82.82,N/A,$82.82,N/A,$82.82,N/A,$82.82,N/A,$82.82,N/A,$82.82,$82.82,N/A
76830,0960,76830,,,,,N/A,N/A,"TRANSVAGINAL US, NON-OB",$261.32,$194.25,$119.72,$119.72,$119.72,N/A,$119.72,N/A,$119.72,N/A,$119.72,N/A,$119.72,N/A,$119.72,$119.72,N/A
768305280B,0960,76830,,,,,N/A,N/A,"TRANSVAGINAL US, NON-OB     ~P",$237.10,$176.25,$119.72,$119.72,$119.72,N/A,$119.72,N/A,$119.72,N/A,$119.72,N/A,$119.72,N/A,$119.72,$119.72,N/A
7683080B,0960,76830,,,,,N/A,N/A,"TRANSVAGINAL US, NON-OB     ~P",$210.87,$156.75,$119.72,$119.72,$119.72,N/A,$119.72,N/A,$119.72,N/A,$119.72,N/A,$119.72,N/A,$119.72,$119.72,N/A
76831,0960,76831,,,,,N/A,N/A,"ECHO EXAM, UTERUS",$264.34,$196.50,$95.12,$95.12,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,N/A,$95.12,$95.12,N/A
76857,0960,76857,,,,,N/A,N/A,US EXAM PELVIC LIMITED,$203.81,$151.50,$91.20,$91.20,$91.20,N/A,$91.20,N/A,$91.20,N/A,$91.20,N/A,$91.20,N/A,$91.20,$91.20,N/A
7685780B,0960,76857,,,,,N/A,N/A,US EXAM PELVIC LIMITED      ~P,$170.51,$126.75,$91.20,$91.20,$91.20,N/A,$91.20,N/A,$91.20,N/A,$91.20,N/A,$91.20,N/A,$91.20,$91.20,N/A
76870,0960,76870,,,,,N/A,N/A,US SCROTUM,$234.07,$174.00,$17.10,$17.10,$17.10,N/A,$17.10,N/A,$17.10,N/A,$17.10,N/A,$17.10,N/A,$17.10,$17.10,N/A
7687080B,0960,76870,,,,,N/A,N/A,US SCROTUM                  ~P,$90.80,$67.50,$17.10,$17.10,$17.10,N/A,$17.10,N/A,$17.10,N/A,$17.10,N/A,$17.10,N/A,$17.10,$17.10,N/A
76872,0960,76872,,,,,N/A,N/A,"US, TRANSRECTAL",$167.48,$124.50,$68.60,$68.60,$68.60,N/A,$68.60,N/A,$68.60,N/A,$68.60,N/A,$68.60,N/A,$68.60,$68.60,N/A
76882,0960,76882,,,,,N/A,N/A,US EXTREMITY NON-VASC REAL-T,$71.63,$53.25,$1.25,$1.25,$1.25,N/A,$1.25,N/A,$1.25,N/A,$1.25,N/A,$1.25,N/A,$1.25,$1.25,N/A
7688280B,0960,76882,,,,,N/A,N/A,US EXTREMITY NON-VASC REAL-T~P,$53.47,$39.75,$1.25,$1.25,$1.25,N/A,$1.25,N/A,$1.25,N/A,$1.25,N/A,$1.25,N/A,$1.25,$1.25,N/A
76937,0960,76937,,,,,N/A,N/A,"US GUIDE, VASCULAR ACCESS",$73.65,$54.75,$143.91,$143.91,$143.91,N/A,$143.91,N/A,$143.91,N/A,$143.91,N/A,$143.91,N/A,$143.91,$143.91,N/A
9676937,0960,76937,,,,,N/A,N/A,IMAGING GUIDANCE,$45.40,$33.75,$143.91,$143.91,$143.91,N/A,$143.91,N/A,$143.91,N/A,$143.91,N/A,$143.91,N/A,$143.91,$143.91,N/A
76942,0960,76942,,,,,N/A,N/A,ECHO GUIDE FOR BIOPSY,$220.96,$164.25,$89.79,$89.79,$89.79,N/A,$89.79,N/A,$89.79,N/A,$89.79,N/A,$89.79,N/A,$89.79,$89.79,N/A
76998,0960,76998,,,,,N/A,N/A,ULTRASONIC GUIDANCE INTRAOPERA,$344.05,$255.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
77001,0960,77001,,,,,N/A,N/A,FLUOR GID CTR VAD PLMT RPLCM,$242.15,$180.00,$453.50,$453.50,$453.50,N/A,$453.50,N/A,$453.50,N/A,$453.50,N/A,$453.50,N/A,$453.50,$453.50,N/A
77002,0960,77002,,,,,N/A,N/A,FLUOROSCOPIC GUIDANCE NEEDLE,$158.40,$117.75,$282.80,$282.80,$282.80,N/A,$282.80,N/A,$282.80,N/A,$282.80,N/A,$282.80,N/A,$282.80,$282.80,N/A
77003,0960,77003,,,,,N/A,N/A,FLUOROGUIDE FOR SPINE INJECT,$148.31,$110.25,$8.77,$8.77,$8.77,N/A,$8.77,N/A,$8.77,N/A,$8.77,N/A,$8.77,N/A,$8.77,$8.77,N/A
77071,0960,77071,,,,,N/A,N/A,X-RAY STRESS VIEW,$121.07,$90.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
78452,0960,78452,,,,,N/A,N/A,MYOCARDIAL SPECT MULTIPLE STUD,"$1,144.14",$850.50,$464.94,$464.94,$464.94,N/A,$464.94,N/A,$464.94,N/A,$464.94,N/A,$464.94,N/A,$464.94,$464.94,N/A
80061,0960,80061,,,,,N/A,N/A,LIPID PANEL,$43.38,$32.25,$12.57,$208.00,N/A,$201.76,N/A,$19.42,N/A,$12.57,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
80307,0960,80307,,,,,N/A,N/A,URINE DRUG SCREEN,$111.99,$83.25,$15.09,$734.00,N/A,$711.98,N/A,$74.57,N/A,$15.09,N/A,$711.98,N/A,$734.00,N/A,N/A,$711.98
81001,0960,81001,,,,,N/A,N/A,"URINALYSIS AUTOMATED, W/MICR",$15.13,$11.25,$5.03,$42.00,N/A,$40.74,N/A,$4.60,N/A,$5.03,N/A,$40.74,N/A,$42.00,N/A,N/A,$40.74
81025,0960,81025,,,,,N/A,N/A,URINE PREG TEST COLOR COMPAR,$27.24,$20.25,$3.77,$61.00,N/A,$59.17,N/A,$12.48,N/A,$3.77,N/A,$59.17,N/A,$61.00,N/A,N/A,$59.17
9682607,0960,82607,,,,,N/A,N/A,Vitamin B12  CCC,$165.47,$123.00,$23.47,$193.00,N/A,$187.21,N/A,$21.56,N/A,$23.47,N/A,$187.21,N/A,$193.00,N/A,N/A,$187.21
82962LSC,0960,82962,,,,,N/A,N/A,BLOOD GLUCOSE,$9.08,$6.75,$10.67,$11.74,N/A,$10.67,N/A,$4.76,N/A,$11.74,N/A,$10.67,N/A,$11.00,N/A,N/A,$10.67
83655,0960,83655,,,,,N/A,N/A,LEAD TEST,$33.30,$24.75,$23.47,$346.00,N/A,$335.62,N/A,N/A,N/A,$23.47,N/A,$335.62,N/A,$346.00,N/A,N/A,$335.62
86485,0960,84685,,,,,N/A,N/A,SKIN TEST CANDIDA,$39.35,$29.25,$25.15,$39.00,N/A,$37.83,N/A,N/A,N/A,$25.15,N/A,$37.83,N/A,$39.00,N/A,N/A,$37.83
85018,0960,85018,,,,,N/A,N/A,HEMOGLOBIN,$16.14,$12.00,$2.93,$16.00,N/A,$15.52,N/A,N/A,N/A,$2.93,N/A,$15.52,N/A,$16.00,N/A,N/A,$15.52
85018QW,0960,85018,,,,,N/A,N/A,HEMOGLOBIN,$16.14,$12.00,$2.93,$16.00,N/A,$15.52,N/A,N/A,N/A,$2.93,N/A,$15.52,N/A,$16.00,N/A,N/A,$15.52
86308,0960,86308,,,,,N/A,N/A,MONO TESTING,$49.44,$36.75,$25.15,$73.00,N/A,$70.81,N/A,N/A,N/A,$25.15,N/A,$70.81,N/A,$73.00,N/A,N/A,$70.81
9608658,0960,86580,,,,,N/A,N/A,PPD CCC,$18.16,$13.50,$11.89,$74.61,$11.89,$24.25,$11.89,N/A,$11.89,$74.61,$11.89,$24.25,$11.89,$25.00,$11.89,$11.89,$24.25
87081,0960,87081,,,,,N/A,N/A,THROAT CULTURE,$18.16,$13.50,$9.64,$85.00,N/A,$82.45,N/A,N/A,N/A,$9.64,N/A,$82.45,N/A,$85.00,N/A,N/A,$82.45
87088,0960,87088,,,,,N/A,N/A,URINE CULTURE,$27.24,$20.25,$9.64,$27.00,N/A,$26.19,N/A,N/A,N/A,$9.64,N/A,$26.19,N/A,$27.00,N/A,N/A,$26.19
87210LSC,0960,87210,,,,,N/A,N/A,WET MOUNT W/KOH,$21.19,$15.75,$21.80,$88.00,N/A,$85.36,N/A,N/A,N/A,$21.80,N/A,$85.36,N/A,$88.00,N/A,N/A,$85.36
87880,0960,87880,,,,,N/A,N/A,STREP GROUP A,$26.23,$19.50,$19.70,$75.00,N/A,$72.75,N/A,N/A,N/A,$19.70,N/A,$72.75,N/A,$75.00,N/A,N/A,$72.75
90385,0960,90385,,,,,N/A,N/A,MICRHOGAM - SINGLE DOSE,$47.42,$35.25,$45.59,$47.00,N/A,$45.59,N/A,N/A,N/A,$47.00,N/A,$45.59,N/A,$47.00,N/A,N/A,$45.59
90460,0960,90460,,,,,N/A,N/A,IMMUNIZATION ADMIN,$21.41,$15.92,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
90461,0960,90461,,,,,N/A,N/A,IMMUNIZATION ADMIN,$21.41,$15.92,$16.96,$16.96,N/A,N/A,N/A,N/A,N/A,$16.96,N/A,N/A,N/A,N/A,N/A,N/A,N/A
90471,0960,90471,,,,,N/A,N/A,IMMUNIZATION ADMIN,$21.41,$15.92,$23.78,$181.00,$23.78,$175.57,$23.78,N/A,$23.78,N/A,$23.78,$175.57,$23.78,$181.00,$23.78,$23.78,$175.57
90471NPS,0960,90471,,,,,N/A,N/A,IMMUNIZATION ADMIN-NO PHYSIC,$0.01,$0.01,$23.78,$181.00,$23.78,$175.57,$23.78,N/A,$23.78,N/A,$23.78,$175.57,$23.78,$181.00,$23.78,$23.78,$175.57
90471S,0960,90471,,,,,N/A,N/A,IMMUNIZATION ADMIN,$21.41,$15.92,$23.78,$181.00,$23.78,$175.57,$23.78,N/A,$23.78,N/A,$23.78,$175.57,$23.78,$181.00,$23.78,$23.78,$175.57
90472,0960,90472,,,,,N/A,N/A,"IMMUNIZATION ADMIN, EACH ADD",$21.41,$15.92,$16.96,$181.00,$22.14,$175.57,$22.14,N/A,$22.14,$16.96,$22.14,$175.57,$22.14,$181.00,$22.14,$22.14,$175.57
9600747,0960,90472,,,,,N/A,N/A,IMMUNIZATION ADM MULTI CCC,$6.05,$4.50,$16.96,$181.00,$22.14,$175.57,$22.14,N/A,$22.14,$16.96,$22.14,$175.57,$22.14,$181.00,$22.14,$22.14,$175.57
90472NPS,0960,90472,,,,,N/A,N/A,"IMMUNIZATION ADMIN,ADD-NO PH",$0.01,$0.01,$16.96,$181.00,$22.14,$175.57,$22.14,N/A,$22.14,$16.96,$22.14,$175.57,$22.14,$181.00,$22.14,$22.14,$175.57
90472R,0960,90472,,,,,N/A,N/A,"IMMUNIZATION ADMIN, EACH ADD",$21.41,$15.92,$16.96,$181.00,$22.14,$175.57,$22.14,N/A,$22.14,$16.96,$22.14,$175.57,$22.14,$181.00,$22.14,$22.14,$175.57
90472S,0960,90472,,,,,N/A,N/A,"IMMUNIZATION ADMIN, EACH ADD",$21.41,$15.92,$16.96,$181.00,$22.14,$175.57,$22.14,N/A,$22.14,$16.96,$22.14,$175.57,$22.14,$181.00,$22.14,$22.14,$175.57
90474,0960,90474,,,,,N/A,N/A,IMADM INTRANSL/ORAL EA VACC,$21.41,$15.92,$0.00,$12.77,N/A,$0.00,N/A,N/A,N/A,$12.77,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
90474S,0960,90474,,,,,N/A,N/A,IMADM INTRANSL/ORAL EA VACC,$21.41,$15.92,$0.00,$12.77,N/A,$0.00,N/A,N/A,N/A,$12.77,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
90586,0960,90586,,,,,N/A,N/A,BCG PER VIAL,$274.43,$204.00,$12.77,$272.00,N/A,$263.84,N/A,N/A,N/A,$12.77,N/A,$263.84,N/A,$272.00,N/A,N/A,$263.84
9062000,0960,90620,,,,,N/A,N/A,MENINGOCOCCAL VACCINE,$61.55,$45.75,$0.01,$0.01,N/A,$0.01,N/A,N/A,N/A,N/A,N/A,$0.01,N/A,$0.01,N/A,N/A,$0.01
90632,0960,90632,,,,,N/A,N/A,HEPATIS A INJ ADULT DOSAGE,$76.68,$57.00,$130.95,$135.00,N/A,$130.95,N/A,N/A,N/A,N/A,N/A,$130.95,N/A,$135.00,N/A,N/A,$130.95
90670,0960,90670,,,,,N/A,N/A,PREVNAR 13 PNEUMOCOCCAL VACC,$191.70,$142.50,$242.50,$250.00,N/A,$242.50,N/A,N/A,N/A,N/A,N/A,$242.50,N/A,$250.00,N/A,N/A,$242.50
90670R,0960,90670,,,,,N/A,N/A,PREVNAR 13,$0.01,$0.01,$242.50,$250.00,N/A,$242.50,N/A,N/A,N/A,N/A,N/A,$242.50,N/A,$250.00,N/A,N/A,$242.50
90671,0960,90671,,,,,N/A,N/A,PNEUMOCOCCAL VACCINES PCV 15,$191.70,$142.50,$0.01,$0.01,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,$0.01,N/A,N/A,N/A
90671R,0960,90671,,,,,N/A,N/A,PNEUMOCOCCAL VACCINES PCV 15,$0.01,$0.01,$0.01,$0.01,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,$0.01,N/A,N/A,N/A
90671S,0960,90671,,,,,N/A,N/A,PNEUMOCOCCAL VACCINES PCV 15,$0.01,$0.01,$0.01,$0.01,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,$0.01,N/A,N/A,N/A
90677,0960,90677,,,,,N/A,N/A,PNEUMOCOCCAL VACCINES PCV 20,$191.70,$142.50,$0.01,$0.01,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,$0.01,N/A,N/A,N/A
90677R,0960,90677,,,,,N/A,N/A,PNEUMOCOCCAL VACCINES PCV 20,$0.01,$0.01,$0.01,$0.01,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,$0.01,N/A,N/A,N/A
90677S,0960,90677,,,,,N/A,N/A,PNEUMOCOCCAL VACCINES PCV 20,$0.01,$0.01,$0.01,$0.01,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,$0.01,N/A,N/A,N/A
90707S,0960,90707,,,,,N/A,N/A,MMR VACCINE,$0.01,$0.01,$101.85,$105.00,N/A,$101.85,N/A,N/A,N/A,N/A,N/A,$101.85,N/A,$105.00,N/A,N/A,$101.85
90715,0960,90715,,,,,N/A,N/A,Tdap,$51.46,$38.25,$41.71,$43.00,N/A,$41.71,N/A,N/A,N/A,N/A,N/A,$41.71,N/A,$43.00,N/A,N/A,$41.71
9609078,0960,90715,,,,,N/A,N/A,TETANUS/DIPTH CCC,$53.47,$39.75,$41.71,$43.00,N/A,$41.71,N/A,N/A,N/A,N/A,N/A,$41.71,N/A,$43.00,N/A,N/A,$41.71
90716,0960,90716,,,,,N/A,N/A,VARICELLA VACCINE IMMUNIZATI,$136.21,$101.25,$173.63,$179.00,N/A,$173.63,N/A,N/A,N/A,$179.00,N/A,$173.63,N/A,$179.00,N/A,N/A,$173.63
90732R,0960,90732,,,,,N/A,N/A,PNEUMOCOCCAL VACCINE,$0.01,$0.01,$130.95,$135.00,N/A,$130.95,N/A,N/A,N/A,$135.00,N/A,$130.95,N/A,$135.00,N/A,N/A,$130.95
90732S,0960,90732,,,,,N/A,N/A,PNEUMOCOCCAL VACCINE,$0.01,$0.01,$130.95,$135.00,N/A,$130.95,N/A,N/A,N/A,$135.00,N/A,$130.95,N/A,$135.00,N/A,N/A,$130.95
90734,0960,90734,,,,,N/A,N/A,MENACTRA,$255.26,$189.75,$308.46,$318.00,N/A,$308.46,N/A,N/A,N/A,$318.00,N/A,$308.46,N/A,$318.00,N/A,N/A,$308.46
9690734,0960,90734,,,,,N/A,N/A,MENACTRA,$320.84,$238.50,$308.46,$318.00,N/A,$308.46,N/A,N/A,N/A,$318.00,N/A,$308.46,N/A,$318.00,N/A,N/A,$308.46
90736,0960,90736,,,,,N/A,N/A,ZOSTER(SHINGLES) VACCINE,$252.24,$187.50,$0.01,$0.01,N/A,$0.01,N/A,N/A,N/A,$0.01,N/A,$0.01,N/A,$0.01,N/A,N/A,$0.01
90739,0960,90739,,,,,N/A,N/A,HEPLISAV-B STATE SUPPLIED,$0.01,$0.01,$0.01,$0.01,N/A,$0.01,N/A,N/A,N/A,$0.01,N/A,$0.01,N/A,$0.01,N/A,N/A,$0.01
90744,0960,90744,,,,,N/A,N/A,HEP B VACCINE AGE<11,$69.62,$51.75,$222.67,$229.56,N/A,$222.67,N/A,N/A,N/A,$229.56,N/A,$222.67,N/A,$229.56,N/A,N/A,$222.67
90746,0960,90746,,,,,N/A,N/A,HEP B VACCINE AGE>20,$79.71,$59.25,$81.48,$84.00,N/A,$81.48,N/A,N/A,N/A,$84.00,N/A,$81.48,N/A,$84.00,N/A,N/A,$81.48
90791,0960,90791,,,,,N/A,N/A,PSYC EVAL,$168.49,$125.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
90792,0960,90792,,,,,N/A,N/A,PSYC EVAL W MEDICAL SERVICE,$173.54,$129.00,$176.13,$176.13,N/A,N/A,N/A,N/A,N/A,$176.13,N/A,N/A,N/A,N/A,N/A,N/A,N/A
92511,0960,92511,,,,,N/A,N/A,NASOPHARYNGOSCOPY,$151.34,$112.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
92551,0960,92551,,,,,N/A,N/A,SCREENING PURE TONE TEST,$18.16,$13.50,$95.78,$95.78,N/A,N/A,N/A,N/A,N/A,$95.78,N/A,N/A,N/A,N/A,N/A,N/A,N/A
92552,0960,92552,,,,,N/A,N/A,"PURE TONE AUDIOMETRY, AIR",$72.64,$54.00,$13.08,$13.08,N/A,N/A,N/A,N/A,N/A,$13.08,N/A,N/A,N/A,N/A,N/A,N/A,N/A
92553,0960,92553,,,,,N/A,N/A,"AUDIOMETRY, AIR & BONE",$106.95,$79.50,$36.47,$36.47,N/A,N/A,N/A,N/A,N/A,$36.47,N/A,N/A,N/A,N/A,N/A,N/A,N/A
92555,0960,92555,,,,,N/A,N/A,SPEECH THRESHOLD AUDIOMETRY,$61.55,$45.75,$44.66,$44.66,N/A,N/A,N/A,N/A,N/A,$44.66,N/A,N/A,N/A,N/A,N/A,N/A,N/A
92556,0960,92556,,,,,N/A,N/A,"SPEECH AUDIOMETRY, COMPLETE",$75.67,$56.25,$27.90,$27.90,N/A,N/A,N/A,N/A,N/A,$27.90,N/A,N/A,N/A,N/A,N/A,N/A,N/A
92557,0960,92557,,,,,N/A,N/A,COMPREHENSIVE HEARING TEST,$188.67,$140.25,$44.27,$44.27,N/A,N/A,N/A,N/A,N/A,$44.27,N/A,N/A,N/A,N/A,N/A,N/A,N/A
92558,0960,92558,,,,,N/A,N/A,EVOKED OTOACOUSTIC EMISSIONS,$16.14,$12.00,$15.52,$36.33,N/A,$15.52,N/A,N/A,N/A,$36.33,N/A,$15.52,N/A,$16.00,N/A,N/A,$15.52
92561,0960,92561,,,,,N/A,N/A,"BEKESY AUDIOMETRY, DIAGNOSIS",$73.65,$54.75,$9.57,$9.57,N/A,N/A,N/A,N/A,N/A,$9.57,N/A,N/A,N/A,N/A,N/A,N/A,N/A
92565,0960,92565,,,,,N/A,N/A,"STENGER TEST, PURE TONE",$50.45,$37.50,$0.00,$0.00,N/A,N/A,N/A,N/A,N/A,$0.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A
92567,0960,92567,,,,,N/A,N/A,TYMPANOMETRY,$76.68,$57.00,$19.71,$19.71,N/A,N/A,N/A,N/A,N/A,$19.71,N/A,N/A,N/A,N/A,N/A,N/A,N/A
92579,0960,92579,,,,,N/A,N/A,VISUAL AUDIOMETRY (VRA),$167.48,$124.50,$11.91,$11.91,N/A,N/A,N/A,N/A,N/A,$11.91,N/A,N/A,N/A,N/A,N/A,N/A,N/A
92582,0960,92582,,,,,N/A,N/A,CONDITIONING PLAY AUDIOMETRY,$141.25,$105.00,$42.57,$42.57,N/A,N/A,N/A,N/A,N/A,$42.57,N/A,N/A,N/A,N/A,N/A,N/A,N/A
92583,0960,92583,,,,,N/A,N/A,SELECT PICTURE AUDIOMETRY,$122.08,$90.75,$85.03,$85.03,N/A,N/A,N/A,N/A,N/A,$85.03,N/A,N/A,N/A,N/A,N/A,N/A,N/A
92587,0960,92587,,,,,N/A,N/A,EVOKED AUDITORY TEST,$169.50,$126.00,$57.13,$57.13,N/A,N/A,N/A,N/A,N/A,$57.13,N/A,N/A,N/A,N/A,N/A,N/A,N/A
92588,0960,92588,,,,,N/A,N/A,EVOKED AUDITORY TEST,$252.24,$187.50,$20.48,$20.48,N/A,N/A,N/A,N/A,N/A,$20.48,N/A,N/A,N/A,N/A,N/A,N/A,N/A
92590,0960,92590,,,,,N/A,N/A,HEARING AID EXAM & SELECT MONA,$121.07,$90.00,$38.23,$120.00,N/A,$116.40,N/A,N/A,N/A,$38.23,N/A,$116.40,N/A,$120.00,N/A,N/A,$116.40
92591,0960,92591,,,,,N/A,N/A,HEARING AID CHECK,$121.07,$90.00,$62.51,$120.00,N/A,$116.40,N/A,N/A,N/A,$62.51,N/A,$116.40,N/A,$120.00,N/A,N/A,$116.40
92592,0960,92592,,,,,N/A,N/A,HEARING AID CHECK,$20.18,$15.00,$19.40,$80.10,N/A,$19.40,N/A,N/A,N/A,$80.10,N/A,$19.40,N/A,$20.00,N/A,N/A,$19.40
92593,0960,92593,,,,,N/A,N/A,HA CHECK BINAURAL,$60.54,$45.00,$24.60,$60.00,N/A,$58.20,N/A,N/A,N/A,$24.60,N/A,$58.20,N/A,$60.00,N/A,N/A,$58.20
92594,0960,92594,,,,,N/A,N/A,HEARING AID EVAL MONAURAL,$20.18,$15.00,$19.40,$41.02,N/A,$19.40,N/A,N/A,N/A,$41.02,N/A,$19.40,N/A,$20.00,N/A,N/A,$19.40
92595,0960,92595,,,,,N/A,N/A,HEARING AID EVAL BINAURAL,$121.07,$90.00,$23.43,$120.00,N/A,$116.40,N/A,N/A,N/A,$23.43,N/A,$116.40,N/A,$120.00,N/A,N/A,$116.40
92596,0960,92596,,,,,N/A,N/A,EAR PROTECTOR EVALUATION,$87.78,$65.25,$51.38,$51.38,N/A,N/A,N/A,N/A,N/A,$51.38,N/A,N/A,N/A,N/A,N/A,N/A,N/A
92625,0960,92625,,,,,N/A,N/A,TINNITUS ASSESSMENT,$121.07,$90.00,$103.29,$120.00,N/A,$116.40,N/A,N/A,N/A,$103.29,N/A,$116.40,N/A,$120.00,N/A,N/A,$116.40
92960,0960,92960,,,,,N/A,N/A,"CARDIOVERSION ELECTRIC, EXT",$375.33,$279.00,$1.90,$372.00,$81.55,$360.84,$81.55,N/A,$81.55,$1.90,$81.55,$360.84,$81.55,$372.00,$81.55,$81.55,$360.84
9692960,0960,92960,,,,,N/A,N/A,CARDIOVERSION,$360.19,$267.75,$1.90,$372.00,$81.55,$360.84,$81.55,N/A,$81.55,$1.90,$81.55,$360.84,$81.55,$372.00,$81.55,$81.55,$360.84
93005B,0960,93005,,,,,N/A,N/A,EKG,$43.38,$32.25,$113.00,$346.00,$141.86,$335.62,$141.86,N/A,$141.86,$113.00,$141.86,$335.62,$141.86,$346.00,$141.86,$141.86,$335.62
93010,0960,93010,,,,,N/A,N/A,"ECG,INTERPRETATION & REPORT",$24.21,$18.00,$13.77,$74.00,$36.80,$71.78,$36.80,N/A,$36.80,$13.77,$36.80,$71.78,$36.80,$74.00,$36.80,$36.80,$71.78
963015,0960,93015,,,,,N/A,N/A,EXERCISE STRESS TEST,$193.72,$144.00,$0.00,$17.46,N/A,$0.00,N/A,N/A,N/A,$17.46,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
93016,0960,93016,,,,,N/A,N/A,CARDIOVASCULAR STRESS TEST,$62.55,$46.50,$0.00,$151.10,$27.88,$0.00,$27.88,N/A,$27.88,$151.10,$27.88,$0.00,$27.88,N/A,$27.88,$27.88,$0.00
93018,0960,93018,,,,,N/A,N/A,CARDIOVASCULAR STRESS TEST,$46.41,$34.50,$44.62,$74.25,N/A,$44.62,N/A,N/A,N/A,$74.25,N/A,$44.62,N/A,$46.00,N/A,N/A,$44.62
9693015,0960,93018,,,,,N/A,N/A,EXERCISE TOLERANCE TEST,$216.92,$161.25,$44.62,$74.25,N/A,$44.62,N/A,N/A,N/A,$74.25,N/A,$44.62,N/A,$46.00,N/A,N/A,$44.62
93041,0960,93041,,,,,N/A,N/A,"RHYTHM ECG, TRACING",$162.44,$120.75,$26.79,$26.79,N/A,N/A,N/A,N/A,N/A,$26.79,N/A,N/A,N/A,N/A,N/A,N/A,N/A
93227,0960,93227,,,,,N/A,N/A,"ECG MONITOR/REVIEW, UP TO 48HR",$76.68,$57.00,$31.16,$76.00,$31.16,$73.72,$31.16,N/A,$31.16,$42.69,$31.16,$73.72,$31.16,$76.00,$31.16,$31.16,$73.72
93228,0960,93228,,,,,N/A,N/A,REMOTE 30 DAY ECG REV/REPORT,$59.53,$44.25,$24.19,$59.00,$24.19,$57.23,$24.19,N/A,$24.19,$39.69,$24.19,$57.23,$24.19,$59.00,$24.19,$24.19,$57.23
93248,0960,93248,,,,,N/A,N/A,14 DAY CARDIAC MONITORING,$62.55,$46.50,$25.42,$62.00,$25.42,$60.14,$25.42,N/A,$25.42,$54.30,$25.42,$60.14,$25.42,$62.00,$25.42,$25.42,$60.14
93260,0960,93260,,,,,N/A,N/A,SUBCUTANEOUS LEAD DEFIB,$87.78,$65.25,$56.58,$138.00,$56.58,$133.86,$56.58,N/A,$56.58,$57.16,$56.58,$133.86,$56.58,$138.00,$56.58,$56.58,$133.86
93261,0960,93261,,,,,N/A,N/A,IMPLANTABLE SUBCUTANEOUS LEAD,$73.65,$54.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
93272,0960,93272,,,,,N/A,N/A,"ECG/REVIEW, INTERPRET ONLY",$76.68,$57.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
93279,0960,93279,,,,,N/A,N/A,PM DEVICE PROGR EVAL SNGL,$75.67,$56.25,$18.96,$87.00,N/A,$84.39,N/A,N/A,N/A,$18.96,N/A,$84.39,N/A,$87.00,N/A,N/A,$84.39
93280,0960,93280,,,,,N/A,N/A,PM DEVICE PROGR EVAL DUAL,$119.05,$88.50,$54.94,$142.11,$54.94,$114.46,$54.94,N/A,$54.94,$142.11,$54.94,$114.46,$54.94,$118.00,$54.94,$54.94,$114.46
93281,0960,93281,,,,,N/A,N/A,PM DEVICE PROGR EVAL MULTI,$156.39,$116.25,$151.32,$168.15,N/A,$151.32,N/A,N/A,N/A,$168.15,N/A,$151.32,N/A,$156.00,N/A,N/A,$151.32
93282,0960,93282,,,,,N/A,N/A,ICD DEVICE PROG EVAL 1 SNGL,$144.28,$107.25,$11.89,$179.27,$11.89,$139.68,$11.89,N/A,$11.89,$179.27,$11.89,$139.68,$11.89,$144.00,$11.89,$11.89,$139.68
93283,0960,93283,,,,,N/A,N/A,ICD DEVICE PROGR EVAL DUAL,$183.63,$136.50,$75.85,$185.00,$75.85,$179.45,$75.85,N/A,$75.85,$170.37,$75.85,$179.45,$75.85,$185.00,$75.85,$75.85,$179.45
93284,0960,93284,,,,,N/A,N/A,ICD DEVICE PROGR EVAL MULT,$204.81,$152.25,$84.50,$208.91,$84.50,$198.85,$84.50,N/A,$84.50,$208.91,$84.50,$198.85,$84.50,$205.00,$84.50,$84.50,$198.85
93285,0960,93285,,,,,N/A,N/A,PROGRAM EVAL IMPLANTABLE DEV I,$97.87,$72.75,$34.92,$225.95,$84.50,$34.92,$84.50,N/A,$84.50,$225.95,$84.50,$34.92,$84.50,$36.00,$84.50,$84.50,$34.92
93286,0960,93286,,,,,N/A,N/A,PERI-PROCEDURAL DEVICE EVAL,$43.38,$32.25,$18.86,$127.28,$18.86,$44.62,$18.86,N/A,$18.86,$127.28,$18.86,$44.62,$18.86,$46.00,$18.86,$18.86,$44.62
93287,0960,93287,,,,,N/A,N/A,PERI-PRCDRL DF EVAL,$98.88,$73.50,$42.23,$103.00,$42.23,$99.91,$42.23,N/A,$42.23,$97.22,$42.23,$99.91,$42.23,$103.00,$42.23,$42.23,$99.91
93288,0960,93288,,,,,N/A,N/A,PM DEVICE EVAL IN PERSON,$76.68,$57.00,$31.16,$113.20,$31.16,$83.42,$31.16,N/A,$31.16,$113.20,$31.16,$83.42,$31.16,$86.00,$31.16,$31.16,$83.42
9693288,0960,93288,,,,,N/A,N/A,INTERRAGATION DEVICE EVAL,$68.61,$51.00,$31.16,$113.20,$31.16,$83.42,$31.16,N/A,$31.16,$113.20,$31.16,$83.42,$31.16,$86.00,$31.16,$31.16,$83.42
93289,0960,93289,,,,,N/A,N/A,ICD DEVICE INTERROGATE,$149.32,$111.00,$61.91,$151.00,$61.91,$146.47,$61.91,N/A,$61.91,$117.97,$61.91,$146.47,$61.91,$151.00,$61.91,$61.91,$146.47
93291,0960,93291,,,,,N/A,N/A,ILR DEVICE INTERROGATE,$83.74,$62.25,$34.85,$153.32,$34.85,$82.45,$34.85,N/A,$34.85,$153.32,$34.85,$82.45,$34.85,$85.00,$34.85,$34.85,$82.45
93294,0960,93294,,,,,N/A,N/A,INTERRO EVAL REMOTE </90,$65.58,$48.75,$3.75,$103.89,$3.75,$72.75,$3.75,N/A,$3.75,$103.89,$3.75,$72.75,$3.75,$75.00,$3.75,$3.75,$72.75
93295,0960,93295,,,,,N/A,N/A,ICD DEVICE INTERROGAT REMOTE,$86.77,$64.50,$35.26,$86.00,$35.26,$83.42,$35.26,N/A,$35.26,$63.93,$35.26,$83.42,$35.26,$86.00,$35.26,$35.26,$83.42
93296,0960,93296,,,,,N/A,N/A,PM/ICD REMOTE TECH SERV,$55.49,$41.25,$24.60,$79.17,$24.60,$58.20,$24.60,N/A,$24.60,$79.17,$24.60,$58.20,$24.60,$60.00,$24.60,$24.60,$58.20
93298,0960,93298,,,,,N/A,N/A,ILR DEVICE INTERROGAT REMOTE,$53.47,$39.75,$22.96,$56.00,$22.96,$54.32,$22.96,N/A,$22.96,$54.55,$22.96,$54.32,$22.96,$56.00,$22.96,$22.96,$54.32
93306,0960,93306,,,,,N/A,N/A,TTE W/DOPPLER COMPLETE,$485.30,$360.75,$197.21,$481.00,$197.21,$466.57,$197.21,N/A,$197.21,$439.60,$197.21,$466.57,$197.21,$481.00,$197.21,$197.21,$466.57
93307,0960,93307,,,,,N/A,N/A,ECHO EXAM OF HEART,$477.23,$354.75,$148.82,$473.00,$193.52,$458.81,$193.52,N/A,$193.52,$148.82,$193.52,$458.81,$193.52,$473.00,$193.52,$193.52,$458.81
93308,0960,93308,,,,,N/A,N/A,ECHO EXAM OF HEART,$250.22,$186.00,$25.82,$310.19,$25.82,$251.23,$25.82,N/A,$25.82,$310.19,$25.82,$251.23,$25.82,$259.00,$25.82,$25.82,$251.23
9330880B,0960,93308,,,,,N/A,N/A,ECHO EXAM OF HEART          ~P,$105.94,$78.75,$25.82,$310.19,$25.82,$251.23,$25.82,N/A,$25.82,$310.19,$25.82,$251.23,$25.82,$259.00,$25.82,$25.82,$251.23
93312,0960,93312,,,,,N/A,N/A,ECHO TRANSESOPHAGEAL,$716.35,$532.50,$217.75,$711.00,$476.10,$689.67,$476.10,N/A,$476.10,$217.75,$476.10,$689.67,$476.10,$711.00,$476.10,$476.10,$689.67
93350,0960,93350,,,,,N/A,N/A,ECHO TRANSTHORACIC,$471.17,$350.25,$21.74,$467.00,$21.74,$452.99,$21.74,N/A,$21.74,$54.13,$21.74,$452.99,$21.74,$467.00,$21.74,$21.74,$452.99
93727,0960,93727,,,,,N/A,N/A,ANALYZE ILR SYSTEM,$68.61,$51.00,$65.96,$415.87,N/A,$65.96,N/A,N/A,N/A,$415.87,N/A,$65.96,N/A,$68.00,N/A,N/A,$65.96
93880,0960,93880,,,,,N/A,N/A,EXTRACRANIAL STUDY,$325.89,$242.25,$19.37,$323.00,$132.43,$313.31,$132.43,N/A,$132.43,$19.37,$132.43,$313.31,$132.43,$323.00,$132.43,$132.43,$313.31
93882,0960,93882,,,,,N/A,N/A,NONINVASIVE TESTS ARTERIES,$247.19,$183.75,$1.45,$245.00,$1.45,$237.65,$1.45,N/A,$1.45,$231.93,$1.45,$237.65,$1.45,$245.00,$1.45,$1.45,$237.65
93922,0960,93922,,,,,N/A,N/A,EXTREMITY STUDY,$180.60,$134.25,$73.39,$179.00,$73.39,$173.63,$73.39,N/A,$73.39,$150.58,$73.39,$173.63,$73.39,$179.00,$73.39,$73.39,$173.63
93923,0960,93923,,,,,N/A,N/A,EXTREMITY STUDY,$266.36,$198.00,$0.00,$98.85,N/A,$0.00,N/A,N/A,N/A,$98.85,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
93925,0960,93925,,,,,N/A,N/A,LOWER EXTREMITY STUDY,$327.91,$243.75,$0.00,$153.14,N/A,$0.00,N/A,N/A,N/A,$153.14,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
93926,0960,93926,,,,,N/A,N/A,LOWER EXTREMITY STUDY,$232.06,$172.50,$223.10,$295.58,N/A,$223.10,N/A,N/A,N/A,$295.58,N/A,$223.10,N/A,$230.00,N/A,N/A,$223.10
93931,0960,93931,,,,,N/A,N/A,UPPER EXTREMITY STUDY,$211.88,$157.50,$0.00,$173.88,N/A,$0.00,N/A,N/A,N/A,$173.88,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
93970,0960,93970,,,,,N/A,N/A,EXTREMITY STUDY,$302.68,$225.00,$0.00,$174.25,$174.25,$0.00,$174.25,N/A,$174.25,$149.55,$174.25,$0.00,$174.25,N/A,$174.25,$174.25,$0.00
93971,0960,93971,,,,,N/A,N/A,EXTREMITY STUDY,$231.05,$171.75,$184.90,$416.00,$184.90,$403.52,$184.90,N/A,$184.90,$227.72,$184.90,$403.52,$184.90,$416.00,$184.90,$184.90,$403.52
9397180B,0960,93971,,,,,N/A,N/A,EXTREMITY STUDY             ~P,$227.01,$168.75,$184.90,$416.00,$184.90,$403.52,$184.90,N/A,$184.90,$227.72,$184.90,$403.52,$184.90,$416.00,$184.90,$184.90,$403.52
93975,0960,93975,,,,,N/A,N/A,VASCULAR STUDY,$391.47,$291.00,$0.00,$143.12,N/A,$0.00,N/A,N/A,N/A,$143.12,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
93978,0960,93978,,,,,N/A,N/A,VASCULAR STUDY,$297.64,$221.25,$0.00,$322.40,N/A,$0.00,N/A,N/A,N/A,$322.40,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
93979,0960,93979,,,,,N/A,N/A,VASCULAR STUDY,$201.79,$150.00,$7.93,$218.48,$7.93,$194.00,$7.93,N/A,$7.93,$218.48,$7.93,$194.00,$7.93,$200.00,$7.93,$7.93,$194.00
9397980B,0960,93979,,,,,N/A,N/A,VASCULAR STUDY              ~P,$46.41,$34.50,$7.93,$218.48,$7.93,$194.00,$7.93,N/A,$7.93,$218.48,$7.93,$194.00,$7.93,$200.00,$7.93,$7.93,$194.00
94010,0960,94010,,,,,N/A,N/A,BREATHING CAPACITY TEST,$78.70,$58.50,$84.70,$376.00,$154.16,$364.72,$154.16,N/A,$154.16,$84.70,$154.16,$364.72,$154.16,$376.00,$154.16,$154.16,$364.72
94060,0960,94060,,,,,N/A,N/A,BRONCHODILATION RESPONSIVENESS,$21.19,$15.75,$38.95,$726.00,$297.66,$704.22,$297.66,N/A,$297.66,$38.95,$297.66,$704.22,$297.66,$726.00,$297.66,$297.66,$704.22
7394060,0960,94060,,,,,N/A,N/A,BRONCHODILATION RESPONSIVENESS,$25.22,$18.75,$38.95,$726.00,$297.66,$704.22,$297.66,N/A,$297.66,$38.95,$297.66,$704.22,$297.66,$726.00,$297.66,$297.66,$704.22
94070,0960,94070,,,,,N/A,N/A,RESPIRATORY BRONCHOSPASM EVAL,$126.12,$93.75,$61.37,"$1,020.00",$418.20,$989.40,$418.20,N/A,$418.20,$61.37,$418.20,$989.40,$418.20,"$1,020.00",$418.20,$418.20,$989.40
94200,0960,94200,,,,,N/A,N/A,Lung function test,$6.05,$4.50,$33.00,$207.00,N/A,$200.79,N/A,N/A,N/A,$33.00,N/A,$200.79,N/A,$207.00,N/A,N/A,$200.79
94375,0960,94375,,,,,N/A,N/A,RESPIRATORY FLOW VOLUME LOOP,$78.70,$58.50,$0.00,$0.00,N/A,$0.00,N/A,N/A,N/A,$0.00,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
94610,0960,94610,,,,,N/A,N/A,INTRAPULMONARY SURFACTANT AD,$123.09,$91.50,$0.00,$93.19,N/A,$0.00,N/A,N/A,N/A,$93.19,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
94618,0960,94618,,,,,N/A,N/A,PULMONARY STRESS TEST 6MIN WAL,$67.60,$50.25,$15.60,$968.00,$15.60,$938.96,$15.60,N/A,$15.60,$124.15,$15.60,$938.96,$15.60,$968.00,$15.60,$15.60,$938.96
94621,0960,94621,,,,,N/A,N/A,CARDIOPULMONARY EXERCISE TEST,$320.84,$238.50,$0.00,$43.77,N/A,$0.00,N/A,N/A,N/A,$43.77,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
94664,0960,94664,,,,,N/A,N/A,DEMO EVAL OF AEROSOL GENERATOR,$34.30,$25.50,$48.85,$48.85,N/A,N/A,N/A,N/A,N/A,$48.85,N/A,N/A,N/A,N/A,N/A,N/A,N/A
94726,0960,94726,,,,,N/A,N/A,PLETHYSMOGRAPHY,$24.21,$18.00,$0.00,$366.00,N/A,$355.02,N/A,N/A,N/A,$0.00,N/A,$355.02,N/A,$366.00,N/A,N/A,$355.02
7394726,0960,94726,,,,,N/A,N/A,PLETHYSMOGRAPHY,$29.26,$21.75,$0.00,$366.00,N/A,$355.02,N/A,N/A,N/A,$0.00,N/A,$355.02,N/A,$366.00,N/A,N/A,$355.02
94729,0960,94729,,,,,N/A,N/A,DIFFUSION CAPACITY,$18.16,$13.50,$0.00,$72.15,N/A,$0.00,N/A,N/A,N/A,$72.15,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
7394729,0960,94729,,,,,N/A,N/A,DIFFUSION CAPACITY,$22.20,$16.50,$0.00,$72.15,N/A,$0.00,N/A,N/A,N/A,$72.15,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
94761,0960,94761,,,,,N/A,N/A,MULTI DETERMINAT DURING EXCERI,$14.13,$10.50,$3.01,$669.00,$274.29,$648.93,$274.29,N/A,$274.29,$3.01,$274.29,$648.93,$274.29,$669.00,$274.29,$274.29,$648.93
94780,0960,94780,,,,,N/A,N/A,CAR SEAT/BED TEST 60 MIN,$63.56,$47.25,$22.55,$103.00,$22.55,$99.91,$22.55,N/A,$22.55,$35.95,$22.55,$99.91,$22.55,$103.00,$22.55,$22.55,$99.91
95004,0960,95004,,,,,N/A,N/A,PERCUT ALLERGY SKIN TESTS,$13.12,$9.75,$0.00,$0.00,N/A,N/A,N/A,N/A,N/A,$0.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A
95012,0960,95012,,,,,N/A,N/A,NITRIC OXIDE EXPIRED GAS DETER,$21.19,$15.75,$4.29,$266.90,$266.90,N/A,$266.90,N/A,$266.90,$4.29,$266.90,N/A,$266.90,N/A,$266.90,$266.90,N/A
95024,0960,95024,,,,,N/A,N/A,"ID ALLERGY TEST, DRUG/BUG",$16.14,$12.00,$21.35,$21.35,N/A,N/A,N/A,N/A,N/A,$21.35,N/A,N/A,N/A,N/A,N/A,N/A,N/A
95070,0960,95070,,,,,N/A,N/A,RT BRONCHIAL PROV,$71.63,$53.25,$0.95,"$1,020.00",N/A,$989.40,N/A,N/A,N/A,$0.95,N/A,$989.40,N/A,"$1,020.00",N/A,N/A,$989.40
95115,0960,95115,,,,,N/A,N/A,"IMMUNOTHERAPY, ONE INJECTION",$39.35,$29.25,$37.52,$37.52,N/A,N/A,N/A,N/A,N/A,$37.52,N/A,N/A,N/A,N/A,N/A,N/A,N/A
95117,0960,95117,,,,,N/A,N/A,IMMUNOTHERAPY INJECTIONS,$47.42,$35.25,$9.86,$9.86,N/A,N/A,N/A,N/A,N/A,$9.86,N/A,N/A,N/A,N/A,N/A,N/A,N/A
95165,0960,95165,,,,,N/A,N/A,ANTIGEN THERAPY SERVICES,$22.20,$16.50,$12.08,$12.08,N/A,N/A,N/A,N/A,N/A,$12.08,N/A,N/A,N/A,N/A,N/A,N/A,N/A
95199,0960,95199,,,,,N/A,N/A,UNLISTED ALLERGY SERVICE,$176.56,$131.25,$3.18,$175.00,N/A,$169.75,N/A,N/A,N/A,$3.18,N/A,$169.75,N/A,$175.00,N/A,N/A,$169.75
95717,0960,95717,,,,,N/A,N/A,EEG 2-12 HOURS W/O VIDEO,$209.86,$156.00,$201.76,$387.71,N/A,$201.76,N/A,N/A,N/A,$387.71,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
95718,0960,95718,,,,,N/A,N/A,EEG 2-12 HOURS W/VIDEO,$275.44,$204.75,$132.21,$273.00,N/A,$264.81,N/A,N/A,N/A,$132.21,N/A,$264.81,N/A,$273.00,N/A,N/A,$264.81
95719,0960,95719,,,,,N/A,N/A,EEG 12-26 HOURS W/O VIDEO,$323.87,$240.75,$174.79,$321.00,N/A,$311.37,N/A,N/A,N/A,$174.79,N/A,$311.37,N/A,$321.00,N/A,N/A,$311.37
95720,0960,95720,,,,,N/A,N/A,EEG 12-26 HOURS W/VIDEO,$426.78,$317.25,$204.54,$423.00,N/A,$410.31,N/A,N/A,N/A,$204.54,N/A,$410.31,N/A,$423.00,N/A,N/A,$410.31
95721,0960,95721,,,,,N/A,N/A,EEG UP TO 60HRS WITHOUT VIDEO,$412.66,$306.75,$269.04,$400.00,N/A,$388.00,N/A,N/A,N/A,$269.04,N/A,$388.00,N/A,$400.00,N/A,N/A,$388.00
95722,0960,95722,,,,,N/A,N/A,EEG >36HR UP TO 60HRS,$454.02,$337.50,$269.50,$450.00,N/A,$436.50,N/A,N/A,N/A,$269.50,N/A,$436.50,N/A,$450.00,N/A,N/A,$436.50
95723,0960,95723,,,,,N/A,N/A,EEG > 60HRS,$524.65,$390.00,$50.44,$328.26,N/A,$50.44,N/A,N/A,N/A,$328.26,N/A,$50.44,N/A,$52.00,N/A,N/A,$50.44
95724,0960,95724,,,,,N/A,N/A,EEG 60-74 HOURS,$640.68,$476.25,$333.60,$635.00,N/A,$615.95,N/A,N/A,N/A,$333.60,N/A,$615.95,N/A,$635.00,N/A,N/A,$615.95
95813,0960,95813,,,,,N/A,N/A,"EEG, OVER 1 HOUR",$513.55,$381.75,$465.20,$509.00,N/A,$493.73,N/A,N/A,N/A,$465.20,N/A,$493.73,N/A,$509.00,N/A,N/A,$493.73
95816,0960,95816,,,,,N/A,N/A,"EEG, AWAKE AND DROWSY",$377.34,$280.50,$362.78,$571.81,N/A,$362.78,N/A,N/A,N/A,$571.81,N/A,$362.78,N/A,$374.00,N/A,N/A,$362.78
95819,0960,95819,,,,,N/A,N/A,"EEG, AWAKE AND ASLEEP",$447.97,$333.00,$430.68,$509.00,N/A,$430.68,N/A,N/A,N/A,$509.00,N/A,$430.68,N/A,$444.00,N/A,N/A,$430.68
95822,0960,95822,,,,,N/A,N/A,"EEG, COMA OR SLEEP ONLY",$707.27,$525.75,$610.89,$701.00,N/A,$679.97,N/A,N/A,N/A,$610.89,N/A,$679.97,N/A,$701.00,N/A,N/A,$679.97
95830,0960,95830,,,,,N/A,N/A,INSERT ELECTRODES FOR EEG,$270.40,$201.00,$269.66,$556.95,N/A,$269.66,N/A,N/A,N/A,$556.95,N/A,$269.66,N/A,$278.00,N/A,N/A,$269.66
95834,0960,95834,,,,,N/A,N/A,"BODY MUSCLE TESTING, MANUAL",$97.87,$72.75,$94.09,$121.16,N/A,$94.09,N/A,N/A,N/A,$121.16,N/A,$94.09,N/A,$97.00,N/A,N/A,$94.09
95860,0960,95860,,,,,N/A,N/A,"MUSCLE TEST, ONE LIMB",$221.97,$165.00,$169.75,$175.00,N/A,$169.75,N/A,N/A,N/A,$175.00,N/A,$169.75,N/A,$175.00,N/A,N/A,$169.75
95861,0960,95861,,,,,N/A,N/A,"MUSCLE TEST, 2 LIMBS",$262.32,$195.00,$159.87,$260.00,N/A,$252.20,N/A,N/A,N/A,$159.87,N/A,$252.20,N/A,$260.00,N/A,N/A,$252.20
95869,0960,95869,,,,,N/A,N/A,"MUSCLE TEST, THOR PARASPINAL",$141.25,$105.00,$135.80,$230.91,N/A,$135.80,N/A,N/A,N/A,$230.91,N/A,$135.80,N/A,$140.00,N/A,N/A,$135.80
95870,0960,95870,,,,,N/A,N/A,"MUSCLE TEST, NONPARASPINAL",$121.07,$90.00,$116.40,$137.70,N/A,$116.40,N/A,N/A,N/A,$137.70,N/A,$116.40,N/A,$120.00,N/A,N/A,$116.40
95874,0960,95874,,,,,N/A,N/A,"GUIDE NERV DESTR, NEEDLE EMG",$128.14,$95.25,$115.43,$122.95,N/A,$115.43,N/A,N/A,N/A,$122.95,N/A,$115.43,N/A,$119.00,N/A,N/A,$115.43
95885,0960,95885,,,,,N/A,N/A,EMG LIMITED,$113.00,$84.00,$108.64,$112.00,N/A,$108.64,N/A,N/A,N/A,$111.82,N/A,$108.64,N/A,$112.00,N/A,N/A,$108.64
95886,0960,95886,,,,,N/A,N/A,"EMG 1 LIMB, 5+MUSCLES",$176.56,$131.25,$89.69,$175.00,N/A,$169.75,N/A,N/A,N/A,$89.69,N/A,$169.75,N/A,$175.00,N/A,N/A,$169.75
95887,0960,95887,,,,,N/A,N/A,EMG CN OR AXIAL,$157.39,$117.00,$137.02,$156.00,N/A,$151.32,N/A,N/A,N/A,$137.02,N/A,$151.32,N/A,$156.00,N/A,N/A,$151.32
95907,0960,95907,,,,,N/A,N/A,NERVE CONDUCTION STUDIES 1-2,$238.11,$177.00,$118.58,$236.00,N/A,$228.92,N/A,N/A,N/A,$118.58,N/A,$228.92,N/A,$236.00,N/A,N/A,$228.92
95908,0960,95908,,,,,N/A,N/A,NERVE CONDUCTION STUDIES 3-4,$293.60,$218.25,$127.13,$291.00,N/A,$282.27,N/A,N/A,N/A,$127.13,N/A,$282.27,N/A,$291.00,N/A,N/A,$282.27
95909,0960,95909,,,,,N/A,N/A,NERVE CONDUCTION STUDIES 5-6,$351.11,$261.00,$160.58,$348.00,N/A,$337.56,N/A,N/A,N/A,$160.58,N/A,$337.56,N/A,$348.00,N/A,N/A,$337.56
95910,0960,95910,,,,,N/A,N/A,NERVE CONDUCTION STUDIES 7-8,$462.09,$343.50,$191.92,$458.00,N/A,$444.26,N/A,N/A,N/A,$191.92,N/A,$444.26,N/A,$458.00,N/A,N/A,$444.26
95911,0960,95911,,,,,N/A,N/A,NERVE CONDUCTION STUDIES 9-1,$559.96,$416.25,$251.96,$555.00,N/A,$538.35,N/A,N/A,N/A,$251.96,N/A,$538.35,N/A,$555.00,N/A,N/A,$538.35
95912,0960,95912,,,,,N/A,N/A,NERVE CONDUCTION STUDY 11-12,$654.80,$486.75,$302.45,$649.00,N/A,$629.53,N/A,N/A,N/A,$302.45,N/A,$629.53,N/A,$649.00,N/A,N/A,$629.53
95913,0960,95913,,,,,N/A,N/A,NERVE CONDUCTION STUDIES (13,$758.72,$564.00,$349.58,$752.00,N/A,$729.44,N/A,N/A,N/A,$349.58,N/A,$729.44,N/A,$752.00,N/A,N/A,$729.44
95923,0960,95923,,,,,N/A,N/A,AUTONOMIC NERV FUNCTION TEST,$232.06,$172.50,$223.10,$405.87,N/A,$223.10,N/A,N/A,N/A,$405.87,N/A,$223.10,N/A,$230.00,N/A,N/A,$223.10
95951,0960,95951,,,,,N/A,N/A,EEG MONITORING/VIDEORECORD,"$4,169.95","$3,099.75",$175.55,$175.55,N/A,N/A,N/A,N/A,N/A,$175.55,N/A,N/A,N/A,N/A,N/A,N/A,N/A
95953,0960,95953,,,,,N/A,N/A,EEG MONITORING/COMPUTER,$828.34,$615.75,$821.00,$821.00,N/A,N/A,N/A,N/A,N/A,$821.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A
95971,0960,95971,,,,,N/A,N/A,NEURO W/ REPROGRAMMING,$309.74,$230.25,$24.55,$358.00,$146.78,$347.26,$146.78,N/A,$146.78,$24.55,$146.78,$347.26,$146.78,$358.00,$146.78,$146.78,$347.26
96110,0960,96110,,,,,N/A,N/A,"DEVELOPMENTAL TEST, LIM",$26.23,$19.50,$114.28,$114.28,N/A,N/A,N/A,N/A,N/A,$114.28,N/A,N/A,N/A,N/A,N/A,N/A,N/A
96156,0960,96156,,,,,N/A,N/A,HEALTH BEHAVIOR ASSESSMENT,$194.73,$144.75,$5.41,$5.41,N/A,N/A,N/A,N/A,N/A,$5.41,N/A,N/A,N/A,N/A,N/A,N/A,N/A
96158,0960,96158,,,,,N/A,N/A,HEALTH BEHAVIOR INTERVENTION,$133.18,$99.00,$96.89,$96.89,N/A,N/A,N/A,N/A,N/A,$96.89,N/A,N/A,N/A,N/A,N/A,N/A,N/A
96159,0960,96159,,,,,N/A,N/A,HEALTH BEHAVIOR INT EA ADD 15M,$45.40,$33.75,$66.49,$66.49,N/A,N/A,N/A,N/A,N/A,$66.49,N/A,N/A,N/A,N/A,N/A,N/A,N/A
96164,0960,96164,,,,,N/A,N/A,HEALTH BHEAVIOR INTERVENT GROU,$20.18,$15.00,$3.19,$3.19,N/A,N/A,N/A,N/A,N/A,$3.19,N/A,N/A,N/A,N/A,N/A,N/A,N/A
96165,0960,96165,,,,,N/A,N/A,HEALTH BEHAV INTER GR EA 15,$10.09,$7.50,$9.79,$9.79,N/A,N/A,N/A,N/A,N/A,$9.79,N/A,N/A,N/A,N/A,N/A,N/A,N/A
96167,0960,96167,,,,,N/A,N/A,HEALTH BEHAVIOR INTERVENT FAM,$142.26,$105.75,$4.38,$4.38,N/A,N/A,N/A,N/A,N/A,$4.38,N/A,N/A,N/A,N/A,N/A,N/A,N/A
96168,0960,96168,,,,,N/A,N/A,HEALTH BEHA INTE FAM EA ADD 15,$50.45,$37.50,$70.88,$70.88,N/A,N/A,N/A,N/A,N/A,$70.88,N/A,N/A,N/A,N/A,N/A,N/A,N/A
96170,0960,96170,,,,,N/A,N/A,HEALTH BEHAVIOR INTERVENT FAM,$131.16,$97.50,$25.16,$25.16,N/A,N/A,N/A,N/A,N/A,$25.16,N/A,N/A,N/A,N/A,N/A,N/A,N/A
96171,0960,96171,,,,,N/A,N/A,HEALTH BEHA INT FAM EA ADD 15,$47.42,$35.25,$85.85,$85.85,N/A,N/A,N/A,N/A,N/A,$85.85,N/A,N/A,N/A,N/A,N/A,N/A,N/A
96360,0960,96360,,,,,N/A,N/A,HYDRATION IV INFUSION INIT,$116.03,$86.25,$30.80,$334.00,$145.14,$323.98,$145.14,N/A,$145.14,$30.80,$145.14,$323.98,$145.14,$334.00,$145.14,$145.14,$323.98
96372,0960,96372,,,,,N/A,N/A,THER/PROPH/DIAG INJ SC/IM,$42.38,$31.50,$24.15,$283.72,$283.72,N/A,$283.72,N/A,$283.72,$24.15,$283.72,N/A,$283.72,$185.00,$283.72,$283.72,N/A
9609087,0960,96372,,,,,N/A,N/A,IM ADMIN OF DRUG,$169.50,$126.00,$24.15,$283.72,$283.72,N/A,$283.72,N/A,$283.72,$24.15,$283.72,N/A,$283.72,$185.00,$283.72,$283.72,N/A
96401,0960,96401,,,,,N/A,N/A,CHEMO ADMINISTRATION,$148.31,$110.25,$11.79,$328.00,$134.48,$318.16,$134.48,N/A,$134.48,$11.79,$134.48,$318.16,$134.48,$328.00,$134.48,$134.48,$318.16
96402,0960,96402,,,,,N/A,N/A,CHEMO HORMON ANTINEOPL SQ/IM,$70.63,$52.50,$28.70,$108.95,$28.70,$67.90,$28.70,N/A,$28.70,$108.95,$28.70,$67.90,$28.70,$70.00,$28.70,$28.70,$67.90
97014,0960,97014,,,,,N/A,N/A,"Electrical Stimulation,Pt",$42.38,$31.50,$7.07,$42.00,N/A,$40.74,N/A,N/A,N/A,$7.07,N/A,$40.74,N/A,$42.00,N/A,N/A,$40.74
97032,0960,97032,,,,,N/A,N/A,ELECTRICAL STIM 1/4 HR PT,$42.38,$31.50,$9.48,$42.00,$17.22,$40.74,$17.22,N/A,$17.22,$9.48,$17.22,$40.74,$17.22,$42.00,$17.22,$17.22,$40.74
97033,0960,97033,,,,,N/A,N/A,IONTOPHORESIS 1/4 HR,$41.37,$30.75,$16.81,$41.00,$16.81,$39.77,$16.81,N/A,$16.81,$17.12,$16.81,$39.77,$16.81,$41.00,$16.81,$16.81,$39.77
97035,0960,97035,,,,,N/A,N/A,ULTRASOUND 1/4 HR PT,$34.30,$25.50,$13.94,$34.00,$13.94,$32.98,$13.94,N/A,$13.94,$17.12,$13.94,$32.98,$13.94,$34.00,$13.94,$13.94,$32.98
97110,0960,97110,,,,,N/A,N/A,THERAPEUTIC PROC 1/4 HR PT,$64.57,$48.00,$16.72,$64.00,$26.24,$62.08,$26.24,N/A,$26.24,$16.72,$26.24,$62.08,$26.24,$64.00,$26.24,$26.24,$62.08
97112,0960,97112,,,,,N/A,N/A,NEUROMUSCULAR RE-ED,$64.57,$48.00,$26.24,$64.00,$26.24,$62.08,$26.24,N/A,$26.24,$34.64,$26.24,$62.08,$26.24,$64.00,$26.24,$26.24,$62.08
97113,0960,97113,,,,,N/A,N/A,AQUATICS THERAPY,$85.76,$63.75,$34.85,$85.00,$34.85,$82.45,$34.85,N/A,$34.85,$40.27,$34.85,$82.45,$34.85,$85.00,$34.85,$34.85,$82.45
97124,0960,97124,,,,,N/A,N/A,MASSAGE THERAPY,$52.46,$39.00,$21.32,$52.00,$21.32,$50.44,$21.32,N/A,$21.32,$34.64,$21.32,$50.44,$21.32,$52.00,$21.32,$21.32,$50.44
97140,0960,97140,,,,,N/A,N/A,MANUAL THERAPY,$64.57,$48.00,$25.39,$64.00,$26.24,$62.08,$26.24,N/A,$26.24,$25.39,$26.24,$62.08,$26.24,$64.00,$26.24,$26.24,$62.08
97161,0960,97161,,,,,N/A,N/A,EVALUATION PT LOW COMPLEX,$169.50,$126.00,$20.74,$168.00,$68.88,$162.96,$68.88,N/A,$68.88,$20.74,$68.88,$162.96,$68.88,$168.00,$68.88,$68.88,$162.96
97162,0960,97162,,,,,N/A,N/A,EVALUATION PT MOD COMPLEX,$169.50,$126.00,$68.88,$168.00,$68.88,$162.96,$68.88,N/A,$68.88,$116.56,$68.88,$162.96,$68.88,$168.00,$68.88,$68.88,$162.96
97164,0960,97164,,,,,N/A,N/A,"RE-EVALUATION,PT",$257.28,$191.25,$14.55,$168.00,$14.55,$162.96,$14.55,N/A,$14.55,$116.56,$14.55,$162.96,$14.55,$168.00,$14.55,$14.55,$162.96
97530,0960,97530,,,,,N/A,N/A,THERAPEUTIC ACTIVITIES 1/4HR,$64.57,$48.00,$26.24,$64.00,$26.24,$62.08,$26.24,N/A,$26.24,$64.00,$26.24,$62.08,$26.24,$64.00,$26.24,$26.24,$62.08
97545,0960,97545,,,,,N/A,N/A,WORK HARDENING,$317.82,$236.25,$181.63,$443.00,$181.63,$429.71,$181.63,N/A,$181.63,$315.00,$181.63,$429.71,$181.63,$443.00,$181.63,$181.63,$429.71
97546,0960,97546,,,,,N/A,N/A,WORK HARDENING ADD ON,$34.30,$25.50,$54.53,$192.77,$54.53,$129.01,$54.53,N/A,$54.53,$192.77,$54.53,$129.01,$54.53,$133.00,$54.53,$54.53,$129.01
97598,0960,97568,,,,,N/A,N/A,ACTIVE WOUND CARE,$149.32,$111.00,$76.82,$76.82,N/A,N/A,N/A,N/A,N/A,$76.82,N/A,N/A,N/A,N/A,N/A,N/A,N/A
97597,0960,97597,,,,,N/A,N/A,ACTIVE WOUND CARE/20 CM OR <,$171.52,$127.50,$14.55,$170.00,$14.55,$164.90,$14.55,N/A,$14.55,N/A,$14.55,$164.90,$14.55,$170.00,$14.55,$14.55,$164.90
9797597,0960,97597,,,,,N/A,N/A,ACTIVE WOUND CARE DEBRID,$99.89,$74.25,$14.55,$170.00,$14.55,$164.90,$14.55,N/A,$14.55,N/A,$14.55,$164.90,$14.55,$170.00,$14.55,$14.55,$164.90
97605,0960,97605,,,,,N/A,N/A,"NEG PRESS WOUND TX, < 50 CM",$68.61,$51.00,$27.88,$96.58,$27.88,$65.96,$27.88,N/A,$27.88,$96.58,$27.88,$65.96,$27.88,$68.00,$27.88,$27.88,$65.96
97606,0960,97606,,,,,N/A,N/A,"NEG PRESS WOUND TX, > 50 CM",$60.54,$45.00,$24.60,$60.00,$24.60,$58.20,$24.60,N/A,$24.60,$29.00,$24.60,$58.20,$24.60,$60.00,$24.60,$24.60,$58.20
97607,0960,97607,,,,,N/A,N/A,NEG. PRESSURE WOUND THERAPY,$84.75,$63.00,$31.82,$148.00,$64.78,$143.56,$64.78,N/A,$64.78,$31.82,$64.78,$143.56,$64.78,$148.00,$64.78,$64.78,$143.56
97608,0960,97608,,,,,N/A,N/A,NEG.PRESSURE WOUND THERAPY >,$88.79,$66.00,$0.00,$25.16,N/A,$0.00,N/A,N/A,N/A,$25.16,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
97750,0960,97750,,,,,N/A,N/A,PHYS PERF TEST-15 MINUTES,$64.57,$48.00,$27.95,$76.26,$76.26,$62.08,$76.26,N/A,$76.26,$27.95,$76.26,$62.08,$76.26,$64.00,$76.26,$76.26,$62.08
97763,0960,97763,,,,,N/A,N/A,ORTHOTIC TRAINING,$69.62,$51.75,$37.31,$91.00,$37.31,$88.27,$37.31,N/A,$37.31,$39.47,$37.31,$88.27,$37.31,$91.00,$37.31,$37.31,$88.27
97799,0960,97799,,,,,N/A,N/A,DRY NEEDLING,$18.16,$13.50,$0.00,$63.21,N/A,$0.00,N/A,N/A,N/A,$63.21,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
99152,0960,99152,,,,,N/A,N/A,MODERATE SEDATION PT>5YRS IN,$100.89,$75.00,N/A,N/A,N/A,N/A,N/A,$62.64,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99153,0960,99153,,,,,N/A,N/A,MODERATE SEDATION PT>5YRS EA,$100.89,$75.00,$41.00,$100.00,$41.00,$97.00,$41.00,$13.32,$41.00,N/A,$41.00,$97.00,$41.00,$100.00,$41.00,$41.00,$97.00
99173,0960,99173,,,,,N/A,N/A,VISION SCREEN,$38.34,$28.50,$0.00,$12.19,N/A,$0.00,N/A,$9.89,N/A,$12.19,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
99177,0960,99177,,,,,N/A,N/A,SCREENING FOR AMBLYOGENIC,$8.07,$6.00,$0.00,$34.13,N/A,$0.00,N/A,N/A,N/A,$34.13,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
99195,0960,99195,,,,,N/A,N/A,PHLEBOTOMY,$188.67,$140.25,$4.82,$310.00,$78.31,$300.70,$78.31,N/A,$78.31,$4.82,$78.31,$300.70,$78.31,$310.00,$78.31,$78.31,$300.70
99202,0960,99202,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT, NEW",$114.01,$84.75,$0.00,$113.00,$52.89,$109.61,$52.89,$90.78,$52.89,$0.00,$52.89,$109.61,$52.89,$113.00,$52.89,$52.89,$109.61
9609202,0960,99202,,,,,N/A,N/A,NEW PT LEVEL 2 CCC,$113.00,$84.00,$0.00,$113.00,$52.89,$109.61,$52.89,$192.79,$52.89,$0.00,$52.89,$109.61,$52.89,$113.00,$52.89,$52.89,$109.61
9699202,0960,99202,,,,,N/A,N/A,OP VISIT~HOSPITALIST    ~99202,$91.81,$68.25,$0.00,$113.00,$52.89,$109.61,$52.89,$244.38,$52.89,$0.00,$52.89,$109.61,$52.89,$113.00,$52.89,$52.89,$109.61
9920200,0960,99202,,,,,N/A,N/A,NEW PATIENT,$151.34,$112.50,$0.00,$113.00,$52.89,$109.61,$52.89,$90.78,$52.89,$0.00,$52.89,$109.61,$52.89,$113.00,$52.89,$52.89,$109.61
99203,0960,99203,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT, NEW",$171.52,$127.50,$48.70,$170.00,$69.70,$164.90,$69.70,$134.79,$69.70,$48.70,$69.70,$164.90,$69.70,$170.00,$69.70,$69.70,$164.90
9609203,0960,99203,,,,,N/A,N/A,NEW PT LEVEL 3 CCC,$166.48,$123.75,$48.70,$170.00,$69.70,$164.90,$69.70,$244.38,$69.70,$48.70,$69.70,$164.90,$69.70,$170.00,$69.70,$69.70,$164.90
9699203,0960,99203,,,,,N/A,N/A,OP VISIT ~HOSPITALIST   ~99203,$136.21,$101.25,$48.70,$170.00,$69.70,$164.90,$69.70,$90.78,$69.70,$48.70,$69.70,$164.90,$69.70,$170.00,$69.70,$69.70,$164.90
9920300,0960,99203,,,,,N/A,N/A,NEW PATIENT,$226.00,$168.00,$48.70,$170.00,$69.70,$164.90,$69.70,$134.79,$69.70,$48.70,$69.70,$164.90,$69.70,$170.00,$69.70,$69.70,$164.90
99204,0960,99204,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT, NEW",$242.15,$180.00,$82.46,$240.00,$98.40,$232.80,$98.40,$90.78,$98.40,$82.46,$98.40,$232.80,$98.40,$240.00,$98.40,$98.40,$232.80
9609204,0960,99204,,,,,N/A,N/A,NEW PT LEVEL 4 CCC,$237.10,$176.25,$82.46,$240.00,$98.40,$232.80,$98.40,$192.79,$98.40,$82.46,$98.40,$232.80,$98.40,$240.00,$98.40,$98.40,$232.80
9699204,0960,99204,,,,,N/A,N/A,OP VISIT~HOSPITALIST    ~99204,$194.73,$144.75,$82.46,$240.00,$98.40,$232.80,$98.40,$244.38,$98.40,$82.46,$98.40,$232.80,$98.40,$240.00,$98.40,$98.40,$232.80
9920400,0960,99204,,,,,N/A,N/A,NEW PATIENT,$317.82,$236.25,$82.46,$240.00,$98.40,$232.80,$98.40,$90.78,$98.40,$82.46,$98.40,$232.80,$98.40,$240.00,$98.40,$98.40,$232.80
99205,0960,99205,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT, NEW",$312.77,$232.50,$127.10,$326.00,$127.10,$316.22,$127.10,$244.38,$127.10,$134.46,$127.10,$316.22,$127.10,$326.00,$127.10,$127.10,$316.22
9699205,0960,99205,,,,,N/A,N/A,OP VISIT~HOSPITALIST    ~99205,$312.77,$232.50,$127.10,$326.00,$127.10,$316.22,$127.10,$192.79,$127.10,$134.46,$127.10,$316.22,$127.10,$326.00,$127.10,$127.10,$316.22
9920500,0960,99205,,,,,N/A,N/A,NEW PATIENT,$351.11,$261.00,$127.10,$326.00,$127.10,$316.22,$127.10,$244.38,$127.10,$134.46,$127.10,$316.22,$127.10,$326.00,$127.10,$127.10,$316.22
99205ET,0960,99205,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT, NEW",$247.19,$183.75,$127.10,$326.00,$127.10,$316.22,$127.10,N/A,$127.10,$134.46,$127.10,$316.22,$127.10,$326.00,$127.10,$127.10,$316.22
99211,0960,99211,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT, EST",$59.53,$44.25,$24.19,$182.62,$24.19,$57.23,$24.19,$29.67,$24.19,$182.62,$24.19,$57.23,$24.19,$59.00,$24.19,$24.19,$57.23
9609211,0960,99211,,,,,N/A,N/A,EST PT LEVEL 1 CCC,$177.57,$132.00,$24.19,$182.62,$24.19,$57.23,$24.19,$111.06,$24.19,$182.62,$24.19,$57.23,$24.19,$59.00,$24.19,$24.19,$57.23
9921100,0960,99211,,,,,N/A,N/A,ESTABLISHED PATIENT,$80.72,$60.00,$24.19,$182.62,$24.19,$57.23,$24.19,$158.99,$24.19,$182.62,$24.19,$57.23,$24.19,$59.00,$24.19,$24.19,$57.23
99212,0960,99212,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT, EST",$59.53,$44.25,$8.95,$59.00,$24.19,$57.23,$24.19,$58.97,$24.19,$8.95,$24.19,$57.23,$24.19,$59.00,$24.19,$24.19,$57.23
9609213,0960,99212,,,,,N/A,N/A,EST PT LEVEL 2 CCC,$106.95,$79.50,$8.95,$59.00,$24.19,$57.23,$24.19,$135.61,$24.19,$8.95,$24.19,$57.23,$24.19,$59.00,$24.19,$24.19,$57.23
9699212,0960,99212,,,,,N/A,N/A,OP VISIT-HOSPITALIST    -99212,$54.48,$40.50,$8.95,$59.00,$24.19,$57.23,$24.19,$189.12,$24.19,$8.95,$24.19,$57.23,$24.19,$59.00,$24.19,$24.19,$57.23
9921200,0960,99212,,,,,N/A,N/A,ESTABLISHED PATIENT,$80.72,$60.00,$8.95,$59.00,$24.19,$57.23,$24.19,$100.44,$24.19,$8.95,$24.19,$57.23,$24.19,$59.00,$24.19,$24.19,$57.23
99213,0960,99213,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT, EST",$98.88,$73.50,$35.65,$98.00,$45.92,$95.06,$45.92,$95.56,$45.92,$35.65,$45.92,$95.06,$45.92,$98.00,$45.92,$45.92,$95.06
9609215,0960,99213,,,,,N/A,N/A,EST PT LEVEL 3 CCC,$106.95,$79.50,$35.65,$98.00,$45.92,$95.06,$45.92,$95.56,$45.92,$35.65,$45.92,$95.06,$45.92,$98.00,$45.92,$45.92,$95.06
9699213,0960,99213,,,,,N/A,N/A,OFFICE/OUTPATIENT VISIT EST,$80.72,$60.00,$35.65,$98.00,$45.92,$95.06,$45.92,$135.61,$45.92,$35.65,$45.92,$95.06,$45.92,$98.00,$45.92,$45.92,$95.06
9921300,0960,99213,,,,,N/A,N/A,ESTABLISHED PATIENT,$131.16,$97.50,$35.65,$98.00,$45.92,$95.06,$45.92,$189.12,$45.92,$35.65,$45.92,$95.06,$45.92,$98.00,$45.92,$45.92,$95.06
99214,0960,99214,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT, EST",$171.52,$127.50,$66.76,$170.00,$69.70,$164.90,$69.70,$135.61,$69.70,$66.76,$69.70,$164.90,$69.70,$170.00,$69.70,$69.70,$164.90
9609216,0960,99214,,,,,N/A,N/A,EST PT LEVEL 4 CCC,$192.71,$143.25,$66.76,$170.00,$69.70,$164.90,$69.70,$95.56,$69.70,$66.76,$69.70,$164.90,$69.70,$170.00,$69.70,$69.70,$164.90
9699214,0960,99214,,,,,N/A,N/A,OP VISIT-HOSPITALIST    -99214,$171.52,$127.50,$66.76,$170.00,$69.70,$164.90,$69.70,$135.61,$69.70,$66.76,$69.70,$164.90,$69.70,$170.00,$69.70,$69.70,$164.90
9921400,0960,99214,,,,,N/A,N/A,ESTABLISHED PATIENT,$192.71,$143.25,$66.76,$170.00,$69.70,$164.90,$69.70,$189.12,$69.70,$66.76,$69.70,$164.90,$69.70,$170.00,$69.70,$69.70,$164.90
99215,0960,99215,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT, EST",$232.06,$172.50,$95.53,$230.00,$95.53,$223.10,$95.53,$189.12,$95.53,$98.71,$95.53,$223.10,$95.53,$230.00,$95.53,$95.53,$223.10
9609217,0960,99215,,,,,N/A,N/A,EST PT LEVEL 5 CCC,$261.32,$194.25,$95.53,$230.00,$95.53,$223.10,$95.53,$95.56,$95.53,$98.71,$95.53,$223.10,$95.53,$230.00,$95.53,$95.53,$223.10
9699215,0960,99215,,,,,N/A,N/A,OP VISIT-HOSPITALIST    -99215,$232.06,$172.50,$95.53,$230.00,$95.53,$223.10,$95.53,$135.61,$95.53,$98.71,$95.53,$223.10,$95.53,$230.00,$95.53,$95.53,$223.10
9921500,0960,99215,,,,,N/A,N/A,ESTABLISHED PATIENT,$261.32,$194.25,$95.53,$230.00,$95.53,$223.10,$95.53,$189.12,$95.53,$98.71,$95.53,$223.10,$95.53,$230.00,$95.53,$95.53,$223.10
99217,0960,99217,,,,,N/A,N/A,OBSERVATION CARE DISCHARGE,$170.51,$126.75,N/A,N/A,N/A,N/A,N/A,$100.44,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9699217,0960,99217,,,,,N/A,N/A,OBSERVATION CARE DISC   -99217,$188.67,$140.25,N/A,N/A,N/A,N/A,N/A,$95.56,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99218,0960,99218,,,,,N/A,N/A,OBSERVATION CARE,$187.66,$139.50,N/A,N/A,N/A,N/A,N/A,$111.06,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9699218,0960,99218,,,,,N/A,N/A,INITIAL OBSERVATION CARE-99218,$170.51,$126.75,N/A,N/A,N/A,N/A,N/A,$189.12,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99219,0960,99219,,,,,N/A,N/A,OBSERVATION CARE,$268.38,$199.50,N/A,N/A,N/A,N/A,N/A,$158.99,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9699219,0960,99219,,,,,N/A,N/A,INITIAL OBSERVATION CARE-99219,$268.38,$199.50,N/A,N/A,N/A,N/A,N/A,$135.61,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9699218A1,0960,99219,,,,,N/A,N/A,INITIAL OBV CARE      -99218AI,$170.51,$126.75,N/A,N/A,N/A,N/A,N/A,$189.12,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9699219A1,0960,99219,,,,,N/A,N/A,INITIAL OBV CARE      -99219AI,$296.63,$220.50,N/A,N/A,N/A,N/A,N/A,$100.44,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99220,0960,99220,,,,,N/A,N/A,OBSERVATION CARE,$376.33,$279.75,N/A,N/A,N/A,N/A,N/A,$223.43,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9699220,0960,99220,,,,,N/A,N/A,INITIAL OBSERVATION CARE-99220,$415.68,$309.00,N/A,N/A,N/A,N/A,N/A,$135.61,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9699220A1,0960,99220,,,,,N/A,N/A,INITIAL OBV CARE      -99220AI,$415.68,$309.00,N/A,N/A,N/A,N/A,N/A,$189.12,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99221,0960,99221,,,,,N/A,N/A,INITIAL HOSPITAL CARE,$193.72,$144.00,$66.83,$163.00,$66.83,$158.11,$66.83,$117.63,$66.83,$145.27,$66.83,$158.11,$66.83,$163.00,$66.83,$66.83,$158.11
9699221,0960,99221,,,,,N/A,N/A,INITIAL HOSPITAL CARE   -99221,$191.70,$142.50,$66.83,$163.00,$66.83,$158.11,$66.83,$58.97,$66.83,$145.27,$66.83,$158.11,$66.83,$163.00,$66.83,$66.83,$158.11
9922125,0960,99221,,,,,N/A,N/A,LOW COMPLEXITY MDM 30 MIN  -25,$181.61,$135.00,$66.83,$163.00,$66.83,$158.11,$66.83,$95.56,$66.83,$145.27,$66.83,$158.11,$66.83,$163.00,$66.83,$66.83,$158.11
9699221A1,0960,99221,,,,,N/A,N/A,INITIAL HOSPITAL CARE -99221AI,$181.61,$135.00,$66.83,$163.00,$66.83,$158.11,$66.83,$135.61,$66.83,$145.27,$66.83,$158.11,$66.83,$163.00,$66.83,$66.83,$158.11
9699222,0960,99222,,,,,N/A,N/A,INITIAL HOSPITAL CARE   -99222,$232.06,$172.50,$94.30,$259.00,$94.30,$251.23,$94.30,$58.97,$94.30,$98.50,$94.30,$251.23,$94.30,$259.00,$94.30,$94.30,$251.23
9699222A1,0960,99222,,,,,N/A,N/A,INITIAL HOSPITAL CARE9699222AI,$232.06,$172.50,$94.30,$259.00,$94.30,$251.23,$94.30,$95.56,$94.30,$98.50,$94.30,$251.23,$94.30,$259.00,$94.30,$94.30,$251.23
9699223,0960,99223,,,,,N/A,N/A,INITIAL HOSPITAL CARE   -99223,$332.95,$247.50,$133.36,$165.00,$135.30,$160.05,$135.30,$58.97,$135.30,$133.36,$135.30,$160.05,$135.30,$165.00,$135.30,$135.30,$160.05
9699223A1,0960,99223,,,,,N/A,N/A,INITIAL HOSPITAL CARE9699223AI,$332.95,$247.50,$133.36,$165.00,$135.30,$160.05,$135.30,$95.56,$135.30,$133.36,$135.30,$160.05,$135.30,$165.00,$135.30,$135.30,$160.05
99224,0960,99224,,,,,N/A,N/A,SBSQ OBSERVATION CARE/DAY LO,$76.68,$57.00,N/A,N/A,N/A,N/A,N/A,$44.22,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9699224,0960,99224,,,,,N/A,N/A,SUB OBV-LOW COMPLEXITY  -99224,$379.36,$282.00,N/A,N/A,N/A,N/A,N/A,$58.97,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99225,0960,99225,,,,,N/A,N/A,SUBSEQUENT OBSERVATION CARE,$140.24,$104.25,N/A,N/A,N/A,N/A,N/A,$82.17,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9699225,0960,99225,,,,,N/A,N/A,SUB OBV-MOD COMPLEXITY  -99225,$472.18,$351.00,N/A,N/A,N/A,N/A,N/A,$58.97,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99226,0960,99226,,,,,N/A,N/A,SBSQ OBSERVATION CARE/DAY HI,$200.78,$149.25,N/A,N/A,N/A,N/A,N/A,$29.67,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9699226,0960,99226,,,,,N/A,N/A,SUB OBV-HIGH COMPLEXITY -99226,$588.21,$437.25,N/A,N/A,N/A,N/A,N/A,$58.97,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9699231,0960,99231,,,,,N/A,N/A,SUBSEQUENT HOSPITAL CARE-99231,$83.74,$62.25,$34.30,$196.72,$34.30,$80.51,$34.30,$100.44,$34.30,$196.72,$34.30,$80.51,$34.30,$83.00,$34.30,$34.30,$80.51
9699232,0960,99232,,,,,N/A,N/A,SUBSEQUENT HOSPITAL CARE-99232,$153.36,$114.00,$37.75,$152.00,$62.32,$147.44,$62.32,N/A,$62.32,$37.75,$62.32,$147.44,$62.32,$152.00,$62.32,$62.32,$147.44
9699233,0960,99233,,,,,N/A,N/A,SUBSEQUENT HOSPITAL CARE-99233,$220.96,$164.25,$70.61,$219.00,$89.79,$212.43,$89.79,N/A,$89.79,$70.61,$89.79,$212.43,$89.79,$219.00,$89.79,$89.79,$212.43
99234,0960,99234,,,,,N/A,N/A,ADMIT & DISCHARGE SAME DATE,$323.87,$240.75,$101.51,$360.00,$147.60,$349.20,$147.60,$192.02,$147.60,$101.51,$147.60,$349.20,$147.60,$360.00,$147.60,$147.60,$349.20
9699234,0960,99234,,,,,N/A,N/A,SD  OBV/ADM LOW SEVERITY-99234,$323.87,$240.75,$101.51,$360.00,$147.60,$349.20,$147.60,N/A,$147.60,$101.51,$147.60,$349.20,$147.60,$360.00,$147.60,$147.60,$349.20
9699234A1,0960,99234,,,,,N/A,N/A,OBV/ADM LOW SEVERITY  -99234AI,$357.16,$265.50,$101.51,$360.00,$147.60,$349.20,$147.60,N/A,$147.60,$101.51,$147.60,$349.20,$147.60,$360.00,$147.60,$147.60,$349.20
99235,0960,99235,,,,,N/A,N/A,ADMIT & DISCHARGE SAME DATE,$427.79,$318.00,$128.81,$476.00,$195.16,$461.72,$195.16,$253.51,$195.16,$128.81,$195.16,$461.72,$195.16,$476.00,$195.16,$195.16,$461.72
9699235,0960,99235,,,,,N/A,N/A,SD  OBV/ADM MOD SEVERITY-99235,$427.79,$318.00,$128.81,$476.00,$195.16,$461.72,$195.16,N/A,$195.16,$128.81,$195.16,$461.72,$195.16,$476.00,$195.16,$195.16,$461.72
9699235A1,0960,99235,,,,,N/A,N/A,OBV/ADM MOD SEVERITY  -99235AI,$472.18,$351.00,$128.81,$476.00,$195.16,$461.72,$195.16,N/A,$195.16,$128.81,$195.16,$461.72,$195.16,$476.00,$195.16,$195.16,$461.72
99236,0960,99236,,,,,N/A,N/A,ADMIT & DISCHARGE SAME DATE,$532.72,$396.00,$164.22,$528.00,$243.13,$512.16,$243.13,$316.60,$243.13,$164.22,$243.13,$512.16,$243.13,$528.00,$243.13,$243.13,$512.16
9699236,0960,99236,,,,,N/A,N/A,SD  OBV/ADM HGH SEVERITY-99236,$532.72,$396.00,$164.22,$528.00,$243.13,$512.16,$243.13,N/A,$243.13,$164.22,$243.13,$512.16,$243.13,$528.00,$243.13,$243.13,$512.16
9699236A1,0960,99236,,,,,N/A,N/A,OBV/ADM HGH SEVERITY -992363AI,$588.21,$437.25,$164.22,$528.00,$243.13,$512.16,$243.13,N/A,$243.13,$164.22,$243.13,$512.16,$243.13,$528.00,$243.13,$243.13,$512.16
99238,0960,99238,,,,,N/A,N/A,HOSPITAL DISCHARGE DAY,$121.07,$90.00,$114.39,$210.77,$114.39,$116.40,$114.39,$100.69,$114.39,$210.77,$114.39,$116.40,$114.39,$120.00,$114.39,$114.39,$116.40
9699238,0960,99238,,,,,N/A,N/A,DISCHARGE MGMT < 30 MINS-99238,$121.07,$90.00,$114.39,$210.77,$114.39,$116.40,$114.39,N/A,$114.39,$210.77,$114.39,$116.40,$114.39,$120.00,$114.39,$114.39,$116.40
99239,0960,99239,,,,,N/A,N/A,HOSPITAL DISCHARGE DAY,$232.06,$172.50,$11.68,$279.00,$11.68,$270.63,$11.68,$137.26,$11.68,$71.11,$11.68,$270.63,$11.68,$279.00,$11.68,$11.68,$270.63
9699239,0960,99239,,,,,N/A,N/A,DISCHARGE MGMT > 30 MINS-99239,$232.06,$172.50,$11.68,$279.00,$11.68,$270.63,$11.68,N/A,$11.68,$71.11,$11.68,$270.63,$11.68,$279.00,$11.68,$11.68,$270.63
99241,0960,99241,,,,,N/A,N/A,OFFICE CONSULTATION,$71.63,$53.25,N/A,N/A,N/A,N/A,N/A,$70.90,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9699241,0960,99241,,,,,N/A,N/A,OUTPATIENT CONSULTATION,$71.63,$53.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99242,0960,99242,,,,,N/A,N/A,OFFICE CONSULTATION,$90.80,$67.50,$104.82,$130.00,N/A,$126.10,N/A,$129.49,N/A,$104.82,N/A,$126.10,N/A,$130.00,N/A,N/A,$126.10
9699242,0960,99242,,,,,N/A,N/A,OFFICE CONSULTATION,$131.16,$97.50,$104.82,$130.00,N/A,$126.10,N/A,N/A,N/A,$104.82,N/A,$126.10,N/A,$130.00,N/A,N/A,$126.10
99243,0960,99243,,,,,N/A,N/A,OFFICE CONSULTATION,$174.55,$129.75,$66.95,$130.00,N/A,$126.10,N/A,$172.72,N/A,$66.95,N/A,$126.10,N/A,$130.00,N/A,N/A,$126.10
9699243,0960,99243,,,,,N/A,N/A,OUTPATIENT CONSULTATION,$174.55,$129.75,$66.95,$130.00,N/A,$126.10,N/A,N/A,N/A,$66.95,N/A,$126.10,N/A,$130.00,N/A,N/A,$126.10
99244,0960,99244,,,,,N/A,N/A,OFFICE CONSULTATION,$250.22,$186.00,$93.66,$248.00,N/A,$240.56,N/A,$247.54,N/A,$93.66,N/A,$240.56,N/A,$248.00,N/A,N/A,$240.56
9699244,0960,99244,,,,,N/A,N/A,OFFICE CONSULTATION,$250.22,$186.00,$93.66,$248.00,N/A,$240.56,N/A,N/A,N/A,$93.66,N/A,$240.56,N/A,$248.00,N/A,N/A,$240.56
99245,0960,99245,,,,,N/A,N/A,OFFICE CONSULTATION,$318.83,$237.00,$150.61,$316.00,N/A,$306.52,N/A,$315.56,N/A,$150.61,N/A,$306.52,N/A,$316.00,N/A,N/A,$306.52
9699245,0960,99245,,,,,N/A,N/A,OFFICE CONSULTATION,$318.83,$237.00,$150.61,$316.00,N/A,$306.52,N/A,N/A,N/A,$150.61,N/A,$306.52,N/A,$316.00,N/A,N/A,$306.52
99251,0960,99251,,,,,N/A,N/A,INITIAL INPATIENT CONSULT,$86.77,$64.50,N/A,N/A,N/A,N/A,N/A,$57.93,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9699251,0960,99251,,,,,N/A,N/A,INPATIENT CONSULTATION  -99251,$86.77,$64.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99252,0960,99252,,,,,N/A,N/A,INITIAL INPATIENT CONSULT,$172.53,$128.25,$172.66,$186.26,N/A,$172.66,N/A,$101.88,N/A,$186.26,N/A,$172.66,N/A,$178.00,N/A,N/A,$172.66
9699252,0960,99252,,,,,N/A,N/A,INPATIENT CONSULTATION  -99252,$172.53,$128.25,$172.66,$186.26,N/A,$172.66,N/A,N/A,N/A,$186.26,N/A,$172.66,N/A,$178.00,N/A,N/A,$172.66
99253,0960,99253,,,,,N/A,N/A,INITIAL INPATIENT CONSULT,$236.09,$175.50,$73.30,$234.00,N/A,$226.98,N/A,$143.03,N/A,$73.30,N/A,$226.98,N/A,$234.00,N/A,N/A,$226.98
9699253,0960,99253,,,,,N/A,N/A,INPATIENT CONSULTATION  -99253,$236.09,$175.50,$73.30,$234.00,N/A,$226.98,N/A,N/A,N/A,$73.30,N/A,$226.98,N/A,$234.00,N/A,N/A,$226.98
99254,0960,99254,,,,,N/A,N/A,INITIAL INPATIENT CONSULT,$339.00,$252.00,$112.66,$336.00,N/A,$325.92,N/A,$206.28,N/A,$112.66,N/A,$325.92,N/A,$336.00,N/A,N/A,$325.92
9699254,0960,99254,,,,,N/A,N/A,INPATIENT CONSULTATION  -99254,$339.00,$252.00,$112.66,$336.00,N/A,$325.92,N/A,N/A,N/A,$112.66,N/A,$325.92,N/A,$336.00,N/A,N/A,$325.92
99255,0960,99255,,,,,N/A,N/A,INITIAL INPATIENT CONSULT,$466.13,$346.50,$163.41,$462.00,N/A,$448.14,N/A,$277.43,N/A,$163.41,N/A,$448.14,N/A,$462.00,N/A,N/A,$448.14
9699255,0960,99255,,,,,N/A,N/A,INPATIENT CONSULTATION  -99255,$466.13,$346.50,$163.41,$462.00,N/A,$448.14,N/A,N/A,N/A,$163.41,N/A,$448.14,N/A,$462.00,N/A,N/A,$448.14
99281,0960,99281,,,,,N/A,N/A,EMERGENCY DEPT VISIT,$41.37,$30.75,$28.29,$449.00,$28.29,$435.53,$28.29,$25.09,$28.29,$196.81,$28.29,$435.53,$28.29,$449.00,$28.29,$28.29,$435.53
99282,0960,99282,,,,,N/A,N/A,EMERGENCY DEPT VISIT,$81.72,$60.75,$5.43,$449.00,$5.43,$435.53,$5.43,49.0.7,$5.43,$21.65,$5.43,$435.53,$5.43,$449.00,$5.43,$5.43,$435.53
99283,0960,99283,,,,,N/A,N/A,EMERGENCY DEPT VISIT,$148.31,$110.25,$41.90,$804.00,$48.79,$779.88,$48.79,$87.26,$48.79,$41.90,$48.79,$779.88,$48.79,$804.00,$48.79,$48.79,$779.88
9699283,0960,99283,,,,,N/A,N/A,EMERGENCY DEPARTMENT E&M,$457.05,$339.75,$41.90,$804.00,$48.79,$779.88,$48.79,N/A,$48.79,$41.90,$48.79,$779.88,$48.79,$804.00,$48.79,$48.79,$779.88
99284,0960,99284,,,,,N/A,N/A,EMERGENCY DEPT VISIT,$234.07,$174.00,$70.74,"$1,208.00",$95.53,"$1,171.76",$95.53,$140.71,$95.53,$70.74,$95.53,"$1,171.76",$95.53,"$1,208.00",$95.53,$95.53,"$1,171.76"
99285,0960,99285,,,,,N/A,N/A,EMERGENCY DEPT VISIT,$359.18,$267.00,$120.19,"$1,208.00",$145.96,"$1,171.76",$145.96,$218.52,$145.96,$120.19,$145.96,"$1,171.76",$145.96,"$1,208.00",$145.96,$145.96,"$1,171.76"
99291,0960,99291,,,,,N/A,N/A,"CRITICAL CARE, FIRST HOUR",$493.37,$366.75,$174.83,"$1,885.00",$225.91,"$1,828.45",$225.91,$362.98,$225.91,$174.83,$225.91,"$1,828.45",$225.91,"$1,885.00",$225.91,$225.91,"$1,828.45"
9699291,0960,99291,,,,,N/A,N/A,CRTCAL CARE- 1ST 30-74 - 99291,$493.37,$366.75,$174.83,"$1,885.00",$225.91,"$1,828.45",$225.91,N/A,$225.91,$174.83,$225.91,"$1,828.45",$225.91,"$1,885.00",$225.91,$225.91,"$1,828.45"
99292,0960,99292,,,,,N/A,N/A,"CRITICAL CARE, ADD'L 30 MIN",$249.21,$185.25,$215.40,$556.00,$227.96,$539.32,$227.96,$160.96,$227.96,$215.40,$227.96,$539.32,$227.96,$556.00,$227.96,$227.96,$539.32
9699292,0960,99292,,,,,N/A,N/A,CRTCAL CARE-ADDTNL 30M  -99292,$249.21,$185.25,$215.40,$556.00,$227.96,$539.32,$227.96,N/A,$227.96,$215.40,$227.96,$539.32,$227.96,$556.00,$227.96,$227.96,$539.32
99304,0960,99304,,,,,N/A,N/A,"NURSING FACILITY CARE, INIT",$177.57,$132.00,$5.33,$130.00,$5.33,$126.10,$5.33,$105.50,$5.33,$108.15,$5.33,$126.10,$5.33,$130.00,$5.33,$5.33,$126.10
9699304,0960,99304,,,,,N/A,N/A,INITIAL: STRFWD/LOW COMP:25,$171.52,$127.50,$5.33,$130.00,$5.33,$126.10,$5.33,N/A,$5.33,$108.15,$5.33,$126.10,$5.33,$130.00,$5.33,$5.33,$126.10
9799304,0960,99304,,,,,N/A,N/A,INITIAL: STRFWD/LOW COMP:25,$171.52,$127.50,$5.33,$130.00,$5.33,$126.10,$5.33,N/A,$5.33,$108.15,$5.33,$126.10,$5.33,$130.00,$5.33,$5.33,$126.10
9699304A1,0960,99304,,,,,N/A,N/A,STRFWD/LOW COMP:25    -99304AI,$159.41,$118.50,$5.33,$130.00,$5.33,$126.10,$5.33,N/A,$5.33,$108.15,$5.33,$126.10,$5.33,$130.00,$5.33,$5.33,$126.10
99305,0960,99305,,,,,N/A,N/A,"NURSING FACILITY CARE, INIT",$251.23,$186.75,$88.31,$239.00,$97.99,$231.83,$97.99,$148.22,$97.99,$88.31,$97.99,$231.83,$97.99,$239.00,$97.99,$97.99,$231.83
9699305,0960,99305,,,,,N/A,N/A,INITIAL: MODERATE COMPEXITY:35,$241.14,$179.25,$88.31,$239.00,$97.99,$231.83,$97.99,N/A,$97.99,$88.31,$97.99,$231.83,$97.99,$239.00,$97.99,$97.99,$231.83
9799305,0960,99305,,,,,N/A,N/A,INITIAL:MODERATE COMPLEXITY:35,$241.14,$179.25,$88.31,$239.00,$97.99,$231.83,$97.99,N/A,$97.99,$88.31,$97.99,$231.83,$97.99,$239.00,$97.99,$97.99,$231.83
9699305A1,0960,99305,,,,,N/A,N/A,INIT MOD COMPLXY:35   -99305AI,$222.98,$165.75,$88.31,$239.00,$97.99,$231.83,$97.99,N/A,$97.99,$88.31,$97.99,$231.83,$97.99,$239.00,$97.99,$97.99,$231.83
99306,0960,99306,,,,,N/A,N/A,"NURSING FACILITY CARE, INIT",$318.83,$237.00,$56.99,$239.00,$56.99,$231.83,$56.99,$189.81,$56.99,$127.62,$56.99,$231.83,$56.99,$239.00,$56.99,$56.99,$231.83
9699306,0960,99306,,,,,N/A,N/A,INITIAL: HIGH COMPLEXITY:45,$308.74,$229.50,$56.99,$239.00,$56.99,$231.83,$56.99,N/A,$56.99,$127.62,$56.99,$231.83,$56.99,$239.00,$56.99,$56.99,$231.83
9799306,0960,99306,,,,,N/A,N/A,INITIAL: HIGH COMPLEXITY:45,$308.74,$229.50,$56.99,$239.00,$56.99,$231.83,$56.99,N/A,$56.99,$127.62,$56.99,$231.83,$56.99,$239.00,$56.99,$56.99,$231.83
9699306A1,0960,99306,,,,,N/A,N/A,INIT:HIGH COMPLEX:45  -99306AI,$285.53,$212.25,$56.99,$239.00,$56.99,$231.83,$56.99,N/A,$56.99,$127.62,$56.99,$231.83,$56.99,$239.00,$56.99,$56.99,$231.83
99307,0960,99307,,,,,N/A,N/A,"NURSING FAC CARE, SUBSEQ",$85.76,$63.75,$33.62,$163.98,$33.62,$79.54,$33.62,$52.64,$33.62,$163.98,$33.62,$79.54,$33.62,$82.00,$33.62,$33.62,$79.54
9699307,0960,99307,,,,,N/A,N/A,STRFWD/LOW COMPLEXITY MDM:15,$82.73,$61.50,$33.62,$163.98,$33.62,$79.54,$33.62,N/A,$33.62,$163.98,$33.62,$79.54,$33.62,$82.00,$33.62,$33.62,$79.54
9799307,0960,99307,,,,,N/A,N/A,STRFWD/LOW COMPLEXITY MDM:15,$82.73,$61.50,$33.62,$163.98,$33.62,$79.54,$33.62,N/A,$33.62,$163.98,$33.62,$79.54,$33.62,$82.00,$33.62,$33.62,$79.54
99308,0960,99308,,,,,N/A,N/A,"NURSING FAC CARE, SUBSEQ",$132.17,$98.25,$43.36,$126.00,$51.66,$122.22,$51.66,$82.90,$51.66,$43.36,$51.66,$122.22,$51.66,$126.00,$51.66,$51.66,$122.22
9699308,0960,99308,,,,,N/A,N/A,LOW COMPLEXITY MDM: 15,$128.14,$95.25,$43.36,$126.00,$51.66,$122.22,$51.66,N/A,$51.66,$43.36,$51.66,$122.22,$51.66,$126.00,$51.66,$51.66,$122.22
9799308,0960,99308,,,,,N/A,N/A,LOW COMPLEXITY MDM: 15,$128.14,$95.25,$43.36,$126.00,$51.66,$122.22,$51.66,N/A,$51.66,$43.36,$51.66,$122.22,$51.66,$126.00,$51.66,$51.66,$122.22
99309,0960,99309,,,,,N/A,N/A,"NURSING FAC CARE, SUBSEQ",$177.57,$132.00,$67.96,$176.00,$72.16,$170.72,$72.16,$109.63,$72.16,$67.96,$72.16,$170.72,$72.16,$176.00,$72.16,$72.16,$170.72
9699309,0960,99309,,,,,N/A,N/A,MOD COMPLEXITY MDM:25,$177.57,$132.00,$67.96,$176.00,$72.16,$170.72,$72.16,N/A,$72.16,$67.96,$72.16,$170.72,$72.16,$176.00,$72.16,$72.16,$170.72
9799309,0960,99309,,,,,N/A,N/A,MOD COMPLEXITY MDM:25,$177.57,$132.00,$67.96,$176.00,$72.16,$170.72,$72.16,N/A,$72.16,$67.96,$72.16,$170.72,$72.16,$176.00,$72.16,$72.16,$170.72
9930950,0960,99309,,,,,N/A,N/A,SUBSEQENT NURS FAC CARE,$169.50,$126.00,$67.96,$176.00,$72.16,$170.72,$72.16,N/A,$72.16,$67.96,$72.16,$170.72,$72.16,$176.00,$72.16,$72.16,$170.72
99310,0960,99310,,,,,N/A,N/A,"NURSING FAC CARE, SUBSEQ",$257.28,$191.25,$11.70,$270.00,$11.70,$261.90,$11.70,$161.32,$11.70,$89.87,$11.70,$261.90,$11.70,$270.00,$11.70,$11.70,$261.90
9699310,0960,99310,,,,,N/A,N/A,HIGH COMPLEXITY MDM:35,$249.21,$185.25,$11.70,$270.00,$11.70,$261.90,$11.70,N/A,$11.70,$89.87,$11.70,$261.90,$11.70,$270.00,$11.70,$11.70,$261.90
9799310,0960,99310,,,,,N/A,N/A,HIGH COMPLEXITY MDM:35,$249.21,$185.25,$11.70,$270.00,$11.70,$261.90,$11.70,N/A,$11.70,$89.87,$11.70,$261.90,$11.70,$270.00,$11.70,$11.70,$261.90
99315,0960,99315,,,,,N/A,N/A,DISCHARGE DAY MANAGEMENT,$149.32,$111.00,$6.68,$148.00,$6.68,$143.56,$6.68,$92.51,$6.68,$133.23,$6.68,$143.56,$6.68,$148.00,$6.68,$6.68,$143.56
9699315,0960,99315,,,,,N/A,N/A,DISCHARGE DAY MANAGEMENT,$149.32,$111.00,$6.68,$148.00,$6.68,$143.56,$6.68,N/A,$6.68,$133.23,$6.68,$143.56,$6.68,$148.00,$6.68,$6.68,$143.56
9799315,0960,99315,,,,,N/A,N/A,DISCHARGE DAY MANAGEMENT,$149.32,$111.00,$6.68,$148.00,$6.68,$143.56,$6.68,N/A,$6.68,$133.23,$6.68,$143.56,$6.68,$148.00,$6.68,$6.68,$143.56
99316,0960,99316,,,,,N/A,N/A,NURSING FAC DISCHARGE DAY,$199.77,$148.50,$71.81,$198.00,$81.18,$192.06,$81.18,$122.50,$81.18,$71.81,$81.18,$192.06,$81.18,$198.00,$81.18,$81.18,$192.06
9699316,0960,99316,,,,,N/A,N/A,DISCHARGE DAY MANAGEMENT > 30m,$196.74,$146.25,$71.81,$198.00,$81.18,$192.06,$81.18,N/A,$81.18,$71.81,$81.18,$192.06,$81.18,$198.00,$81.18,$81.18,$192.06
9799316,0960,99316,,,,,N/A,N/A,DISCHARGE DAY MANAGEMENT > 30m,$196.74,$146.25,$71.81,$198.00,$81.18,$192.06,$81.18,N/A,$81.18,$71.81,$81.18,$192.06,$81.18,$198.00,$81.18,$81.18,$192.06
99318,0960,99318,,,,,N/A,N/A,ANNUAL NURSING FAC ASSESSMENT,$183.63,$136.50,N/A,N/A,N/A,N/A,N/A,$108.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9799318,0960,99318,,,,,N/A,N/A,ANNUAL NURS FACILITY ASSESSMNT,$182.62,$135.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99324,0960,99324,,,,,N/A,N/A,DOMICIL/R-HOME VISIT NEW PAT,$132.17,$98.25,N/A,N/A,N/A,N/A,N/A,$78.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99325,0960,99325,,,,,N/A,N/A,DOMICIL/R-HOME VISIT NEW PAT,$191.70,$142.50,N/A,N/A,N/A,N/A,N/A,$115.45,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99326,0960,99326,,,,,N/A,N/A,DOMICIL/R-HOME VISIT NEW PAT,$278.47,$207.00,N/A,N/A,N/A,N/A,N/A,$171.69,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99327,0960,99327,,,,,N/A,N/A,DOMICIL/R-HOME VISIT NEW PAT,$365.24,$271.50,N/A,N/A,N/A,N/A,N/A,$226.06,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99334,0960,99334,,,,,N/A,N/A,DOMICIL/R-HOME VISIT EST PAT,$117.04,$87.00,N/A,N/A,N/A,N/A,N/A,$277.19,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9699334,0960,99334,,,,,N/A,N/A,HOME VISIT FOR EVAL,$364.23,$270.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99336,0960,99336,,,,,N/A,N/A,DOMICIL/R-HOME VISIT EST PAT,$257.28,$191.25,N/A,N/A,N/A,N/A,N/A,$69.62,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99337,0960,99337,,,,,N/A,N/A,DOMICIL/R-HOME VISIT EST PAT,$368.26,$273.75,N/A,N/A,N/A,N/A,N/A,$225.04,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99339,0960,99339,,,,,N/A,N/A,CARE PLAN OVERSIGHT,$121.07,$90.00,N/A,N/A,N/A,N/A,N/A,$97.79,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99340,0960,99340,,,,,N/A,N/A,PRLGD SRV W/O CNTCT EA AD 30,$138.22,$102.75,N/A,N/A,N/A,N/A,N/A,$136.55,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99341,0960,99341,,,,,N/A,N/A,"HOME VISIT, NEW PATIENT",$140.24,$104.25,$103.42,$103.42,N/A,N/A,N/A,$82.64,N/A,$103.42,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99342,0960,99342,,,,,N/A,N/A,"HOME VISIT, NEW PATIENT",$205.82,$153.00,$204.00,$204.00,N/A,N/A,N/A,$121.94,N/A,$204.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99343,0960,99343,,,,,N/A,N/A,"HOME VISIT, NEW PATIENT",$300.66,$223.50,N/A,N/A,N/A,N/A,N/A,$177.94,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99344,0960,99344,,,,,N/A,N/A,"HOME VISIT, NEW PATIENT",$392.48,$291.75,$389.00,$389.00,N/A,N/A,N/A,$236.90,N/A,$389.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9699344,0960,99344,,,,,N/A,N/A,HOME VISIT FOR EVAL,$364.23,$270.75,$389.00,$389.00,N/A,N/A,N/A,N/A,N/A,$389.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99345,0960,99345,,,,,N/A,N/A,"HOME VISIT, NEW PATIENT",$485.30,$360.75,$178.53,$178.53,N/A,N/A,N/A,$288.86,N/A,$178.53,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9699345,0960,99345,,,,,N/A,N/A,HOME VISIT FOR E&M,$438.89,$326.25,$178.53,$178.53,N/A,N/A,N/A,N/A,N/A,$178.53,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99347,0960,99347,,,,,N/A,N/A,"HOME VISIT, EST PATIENT",$110.98,$82.50,$45.10,$216.58,$45.10,$106.70,$45.10,$65.58,$45.10,$216.58,$45.10,$106.70,$45.10,$110.00,$45.10,$45.10,$106.70
9699347,0960,99347,,,,,N/A,N/A,"HOME VISIT, EST PATIENT",$129.14,$96.00,$45.10,$216.58,$45.10,$106.70,$45.10,N/A,$45.10,$216.58,$45.10,$106.70,$45.10,$110.00,$45.10,$45.10,$106.70
99348,0960,99348,,,,,N/A,N/A,"HOME VISIT, EST PATIENT",$172.53,$128.25,$7.11,$171.00,$7.11,$165.87,$7.11,$105.53,$7.11,$54.21,$7.11,$165.87,$7.11,$171.00,$7.11,$7.11,$165.87
9099348,0960,99348,,,,,N/A,N/A,"HOME VISIT, EST PATIENT",$201.79,$150.00,$7.11,$171.00,$7.11,$165.87,$7.11,N/A,$7.11,$54.21,$7.11,$165.87,$7.11,$171.00,$7.11,$7.11,$165.87
9699348,0960,99348,,,,,N/A,N/A,SUBSEQUENT HOME VISIT,$168.49,$125.25,$7.11,$171.00,$7.11,$165.87,$7.11,N/A,$7.11,$54.21,$7.11,$165.87,$7.11,$171.00,$7.11,$7.11,$165.87
99349,0960,99349,,,,,N/A,N/A,"HOME VISIT, EST PATIENT",$267.37,$198.75,$0.00,$82.66,$13.73,$0.00,$13.73,$161.90,$13.73,$82.66,$13.73,$0.00,$13.73,N/A,$13.73,$13.73,$0.00
9699349,0960,99349,,,,,N/A,N/A,SUBSEQUENT HOME VIST,$255.26,$189.75,$0.00,$82.66,$13.73,$0.00,$13.73,N/A,$13.73,$82.66,$13.73,$0.00,$13.73,N/A,$13.73,$13.73,$0.00
99350,0960,99350,,,,,N/A,N/A,"HOME VISIT, EST PATIENT",$392.48,$291.75,$0.00,$127.27,N/A,$0.00,N/A,$235.54,N/A,$127.27,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
9099350,0960,99350,,,,,N/A,N/A,"HOME EST, PATIENT",$457.05,$339.75,$0.00,$127.27,N/A,$0.00,N/A,N/A,N/A,$127.27,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
99354,0960,99354,,,,,N/A,N/A,"PROLONGED SERVICE, OFFICE",$228.02,$169.50,N/A,N/A,N/A,N/A,N/A,$156.35,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9699354,0960,99354,,,,,N/A,N/A,OP PROLONGED PHY SER 1HR-99354,$251.23,$186.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99355,0960,99355,,,,,N/A,N/A,"PROLONGED SERVICE, OFFICE",$223.98,$166.50,N/A,N/A,N/A,N/A,N/A,$145.72,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9699355,0960,99355,,,,,N/A,N/A,OP PROLONGED PHY SER A30-99356,$220.96,$164.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99356,0960,99356,,,,,N/A,N/A,"PROLONGED SERVICE, INPATIENT",$218.94,$162.75,N/A,N/A,N/A,N/A,N/A,$129.97,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9699356,0960,99356,,,,,N/A,N/A,IP PROLONGED PHY 1/2 HR  99356,$241.14,$179.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9999356,0960,99356,,,,,N/A,N/A,IP PROLONGED PHY SERV  - 99356,$215.91,$160.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99357,0960,99357,,,,,N/A,N/A,"PROLONGED SERVICE, INPATIENT",$219.95,$163.50,N/A,N/A,N/A,N/A,N/A,$129.97,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9699357,0960,99357,,,,,N/A,N/A,IP PROLONGED PHY SER A30-99356,$216.92,$161.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99358,0960,99358,,,,,N/A,N/A,PROLONG SERV W/O CONTACT @ H,$134.19,$99.75,$129.01,$175.93,N/A,$129.01,N/A,$132.38,N/A,$175.93,N/A,$129.01,N/A,$133.00,N/A,N/A,$129.01
9699358,0960,99358,,,,,N/A,N/A,PROLONG SERV W/O CONTACT,$241.14,$179.25,$129.01,$175.93,N/A,$129.01,N/A,N/A,N/A,$175.93,N/A,$129.01,N/A,$133.00,N/A,N/A,$129.01
99359,0960,99359,,,,,N/A,N/A,PROLONGD SERV W/O CONTACT EA,$108.97,$81.00,$109.76,$122.00,N/A,$118.34,N/A,$63.70,N/A,$109.76,N/A,$118.34,N/A,$122.00,N/A,N/A,$118.34
9699359,0960,99359,,,,,N/A,N/A,PROLONG SERV W/O CONTACT,$216.92,$161.25,$109.76,$122.00,N/A,$118.34,N/A,N/A,N/A,$109.76,N/A,$118.34,N/A,$122.00,N/A,N/A,$118.34
99360,0960,99360,,,,,N/A,N/A,HOSPITAL STAND BY (@ 1/2 HR),$117.04,$87.00,$52.66,$52.66,N/A,N/A,N/A,$77.35,N/A,$52.66,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9699367,0960,99367,,,,,N/A,N/A,MEDICAL TEAM CONF PT/FAM 30MIN,$100.89,$75.00,$60.10,$60.10,N/A,N/A,N/A,N/A,N/A,$60.10,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99381,0960,99381,,,,,N/A,N/A,PREVENTIVE VISIT NEW INFANT,$155.38,$115.50,$55.35,$55.35,N/A,N/A,N/A,$153.14,N/A,$55.35,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99382,0960,99382,,,,,N/A,N/A,PREVENTIVE VISIT NEW AGE 1-4,$166.48,$123.75,$75.40,$75.40,N/A,N/A,N/A,$164.88,N/A,$75.40,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99383,0960,99383,,,,,N/A,N/A,PREVENTIVE VISIT AGE 5-11,$163.45,$121.50,$80.31,$80.31,N/A,N/A,N/A,$161.53,N/A,$80.31,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99384,0960,99384,,,,,N/A,N/A,PREVENTIVE VISIT AGE 12-17,$180.60,$134.25,$85.41,$85.41,N/A,N/A,N/A,$175.50,N/A,$85.41,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99385,0960,99385,,,,,N/A,N/A,PREVENTIVE VIST 18-39,$180.60,$134.25,$100.16,$100.16,N/A,N/A,N/A,$175.50,N/A,$100.16,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99386,0960,99386,,,,,N/A,N/A,PREVENTIVE VISIT AGE 40-64,$210.87,$156.75,$96.11,$96.11,N/A,N/A,N/A,$206.24,N/A,$96.11,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99387,0960,99387,,,,,N/A,N/A,PREVENTATIVE NEW PT AGE 65+,$230.04,$171.00,$116.86,$116.86,N/A,N/A,N/A,$223.56,N/A,$116.86,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99391,0960,99391,,,,,N/A,N/A,PREVENTIVE VISIT ESTABL INFA,$118.05,$87.75,$125.66,$125.66,N/A,N/A,N/A,$116.26,N/A,$125.66,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99392,0960,99392,,,,,N/A,N/A,PREVENTATIVE EST PT AGE 1-4,$132.17,$98.25,$68.70,$68.70,N/A,N/A,N/A,$130.23,N/A,$68.70,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99393,0960,99393,,,,,N/A,N/A,PREVENTIVE VISIT ESTABL 5-11,$130.15,$96.75,$75.40,$75.40,N/A,N/A,N/A,$128.55,N/A,$75.40,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99394,0960,99394,,,,,N/A,N/A,PREVENTIVE VISIT ESTAB 12-17,$146.30,$108.75,$75.40,$75.40,N/A,N/A,N/A,$141.96,N/A,$75.40,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99395,0960,99395,,,,,N/A,N/A,PREVENTATIVE EXAM AGE 18-39,$148.31,$110.25,$85.41,$85.41,N/A,N/A,N/A,$143.65,N/A,$85.41,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99396,0960,99396,,,,,N/A,N/A,PREVENTATIVE EXAM AGE 40-64,$164.46,$122.25,$87.86,$87.86,N/A,N/A,N/A,$158.73,N/A,$87.86,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99397,0960,99397,,,,,N/A,N/A,PREVENTATIVE EXAM AGE 65+,$178.58,$132.75,$95.41,$95.41,N/A,N/A,N/A,$174.94,N/A,$95.41,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99406,0960,99406,,,,,N/A,N/A,BEHAV CHNG SMOKING 3-10 MIN,$23.21,$17.25,$39.77,$100.16,N/A,$39.77,N/A,$16.99,N/A,$100.16,N/A,$39.77,N/A,$41.00,N/A,N/A,$39.77
9699406,0960,99406,,,,,N/A,N/A,SMOKING CESSATION COUN 3-10MIN,$32.29,$24.00,$39.77,$100.16,N/A,$39.77,N/A,N/A,N/A,$100.16,N/A,$39.77,N/A,$41.00,N/A,N/A,$39.77
99407,0960,99407,,,,,N/A,N/A,BEHAV CHNG SMOKING > 10 MIN,$49.44,$36.75,$12.30,$12.30,N/A,N/A,N/A,$32.59,N/A,$12.30,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9699407,0960,99407,,,,,N/A,N/A,SMOKING CESSATION COUN >10MIN,$64.57,$48.00,$12.30,$12.30,N/A,N/A,N/A,N/A,N/A,$12.30,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99415,0960,99415,,,,,N/A,N/A,PROLONGED CLINICAL STAFF SERV,$20.18,$15.00,$25.30,$25.30,N/A,N/A,N/A,$11.64,N/A,$25.30,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99416,0960,99416,,,,,N/A,N/A,PROLONGED CLINICAL STAFF SERV,$10.09,$7.50,$10.01,$10.01,N/A,N/A,N/A,$6.32,N/A,$10.01,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99417,0960,99417,,,,,N/A,N/A,PROLONGED SERVICES,$64.57,$48.00,$5.25,$64.00,N/A,N/A,N/A,$72.86,N/A,$5.25,N/A,N/A,N/A,$64.00,N/A,N/A,N/A
9941700,0960,99417,,,,,N/A,N/A,PROLONGED SERVICES,$72.64,$54.00,$5.25,$64.00,N/A,N/A,N/A,N/A,N/A,$5.25,N/A,N/A,N/A,$64.00,N/A,N/A,N/A
99421,0960,99421,,,,,N/A,N/A,DIGITAL E&M 5-10 MIN,$50.45,$37.50,$21.32,$52.00,$21.32,$50.44,$21.32,$18.22,$21.32,N/A,$21.32,$50.44,$21.32,$52.00,$21.32,$21.32,$50.44
99422,0960,99422,,,,,N/A,N/A,DIGITAL E&M 11-20 MIN,$50.45,$37.50,$12.65,$52.00,$21.32,$50.44,$21.32,$36.25,$21.32,$12.65,$21.32,$50.44,$21.32,$52.00,$21.32,$21.32,$50.44
99423,0960,99423,,,,,N/A,N/A,DIGITAL E&M 21 MIN,$59.53,$44.25,$25.42,$62.00,$25.42,$60.14,$25.42,$58.62,$25.42,$25.65,$25.42,$60.14,$25.42,$62.00,$25.42,$25.42,$60.14
99439,0960,99439,,,,,N/A,N/A,CHRONIC CARE MANAGE ADD 20 MIN,$80.72,$60.00,$0.00,$40.55,N/A,$0.00,N/A,$41.77,N/A,$40.55,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
99441,0960,99441,,,,,N/A,N/A,TELEPHONE EVALUATION 5-10 MINS,$50.45,$37.50,$21.32,$52.00,$21.32,$50.44,$21.32,$22.25,$21.32,$27.75,$21.32,$50.44,$21.32,$52.00,$21.32,$21.32,$50.44
99442,0960,99442,,,,,N/A,N/A,TELEPHONE EVALUATION 11-20 MIN,$76.68,$57.00,$31.16,$76.00,$31.16,$73.72,$31.16,$44.23,$31.16,$35.65,$31.16,$73.72,$31.16,$76.00,$31.16,$31.16,$73.72
99443,0960,99443,,,,,N/A,N/A,TELEPHONE EVALUATION 21-30 MIN,$110.98,$82.50,$47.15,$110.00,$47.15,$106.70,$47.15,$71.67,$47.15,$66.96,$47.15,$106.70,$47.15,$110.00,$47.15,$47.15,$106.70
99447,0960,99447,,,,,N/A,N/A,ONLINE/TELEPHONE CONSULTATIVE,$73.65,$54.75,$29.93,$98.91,$29.93,$70.81,$29.93,$43.15,$29.93,$98.91,$29.93,$70.81,$29.93,$73.00,$29.93,$29.93,$70.81
99455,0960,99455,,,,,N/A,N/A,ENT-FAA PHYSICAL,$117.04,$87.00,$33.05,$110.00,$53.30,N/A,$53.30,N/A,$53.30,$33.05,$53.30,N/A,$53.30,$110.00,$53.30,$53.30,N/A
99460,0960,99460,,,,,N/A,N/A,INIT NB EM PER DAY HOSP,$186.65,$138.75,$0.00,$0.00,N/A,N/A,N/A,$107.40,N/A,$0.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9699460,0960,99460,,,,,N/A,N/A,INITIAL HOSP/BIRTH CARE,$189.68,$141.00,$0.00,$0.00,N/A,N/A,N/A,N/A,N/A,$0.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99462,0960,99462,,,,,N/A,N/A,SBSQ NB EM PER DAY HOSP,$83.74,$62.25,$93.96,$93.96,N/A,N/A,N/A,$50.22,N/A,$93.96,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99463,0960,99463,,,,,N/A,N/A,SAME DAY NB DISCHARGE,$219.95,$163.50,$40.90,$40.90,N/A,N/A,N/A,$126.76,N/A,$40.90,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99464,0960,99464,,,,,N/A,N/A,ATTENDANCE AT DELIVERY,$143.27,$106.50,$108.51,$108.51,N/A,N/A,N/A,$96.58,N/A,$108.51,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99465,0960,99465,,,,,N/A,N/A,DELIVERY/BIRTHING ROOM RESUS,$286.54,$213.00,$73.41,$73.41,N/A,N/A,N/A,$198.03,N/A,$73.41,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99468,0960,99468,,,,,N/A,N/A,NEONATE CRIT CARE INITIAL,"$1,772.71","$1,317.75",N/A,N/A,N/A,N/A,N/A,"$1,179.01",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99473,0960,99473,,,,,N/A,N/A,DEVICE CALIBRATION,$22.20,$16.50,$143.31,$143.31,N/A,N/A,N/A,$13.34,N/A,$143.31,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99487,0960,99487,,,,,N/A,N/A,COMPLEX CHRONIC CARE MANAGE 60,$80.72,$60.00,$12.99,$12.99,N/A,N/A,N/A,$109.91,N/A,$12.99,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99489,0960,99489,,,,,N/A,N/A,COMPLEX CHRONIC CARE MAN ADD,$80.72,$60.00,$50.71,$50.71,N/A,N/A,N/A,$55.06,N/A,$50.71,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99490,0960,99490,,,,,N/A,N/A,CHRONIC CARE MANAGE 20,$80.72,$60.00,$25.30,$25.30,N/A,N/A,N/A,$53.25,N/A,$25.30,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99497,0960,99497,,,,,N/A,N/A,ADVANCED DIRECTIVE GUIDANCE,$165.47,$123.00,N/A,N/A,N/A,N/A,N/A,$102.56,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99498,0960,99498,,,,,N/A,N/A,ADVANCED DIRECTIVE GUIDANCE,$144.28,$107.25,N/A,N/A,N/A,N/A,N/A,$90.07,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99991,0960,99991,,,,,N/A,N/A,BOTOX FIRST SEG.,$353.13,$262.50,$194.68,$194.68,N/A,N/A,N/A,N/A,N/A,$194.68,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99992,0960,99992,,,,,N/A,N/A,BOTOX SECOND SEG.,$302.68,$225.00,$300.00,$300.00,N/A,N/A,N/A,N/A,N/A,$300.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99993,0960,99993,,,,,N/A,N/A,BOTOX THIRD SEG.,$252.24,$187.50,$250.00,$250.00,N/A,N/A,N/A,N/A,N/A,$250.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99994,0960,99994,,,,,N/A,N/A,MISC. SELF PAY PROCEDURE,$10.09,$7.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99995,0960,99995,,,,,N/A,N/A,MISC. SELF PAY PROCEDURE,$50.45,$37.50,$50.00,$50.00,N/A,N/A,N/A,N/A,N/A,$50.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99996,0960,99996,,,,,N/A,N/A,FACIAL FILLERS,$655.81,$487.50,$650.00,$650.00,N/A,N/A,N/A,N/A,N/A,$650.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99997,0960,99997,,,,,N/A,N/A,PONARIS OIL,$22.20,$16.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
0298T,0960,0298T,,,,,N/A,N/A,14 DAY CARDIAC MONITORING,$62.55,$46.50,$0.00,$62.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
C8929,0960,C8929,,,,,N/A,N/A,TTE W/DOPPLER COMPLETE W/CONT,$431.83,$321.00,"$1,070.88","$1,104.00",N/A,"$1,070.88",N/A,N/A,N/A,"$1,104.00",N/A,"$1,070.88",N/A,"$1,104.00",N/A,N/A,"$1,070.88"
9600727,0960,G0009,,,,,N/A,N/A,ADMIN-PNEUMON VACCINE CCC,$41.37,$30.75,$0.00,$41.00,N/A,$0.00,N/A,N/A,N/A,$41.00,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
G0010,0960,G0010,,,,,N/A,N/A,HEPLISAV-B STATE SUPPLIED,$21.41,$15.92,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
G0071,0960,G0071,,,,,N/A,N/A,TECHNOLOGY-BASED SERVICES,$50.45,$37.50,$50.00,$50.00,N/A,N/A,N/A,N/A,N/A,$50.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A
G0102,0960,G0102,,,,,N/A,N/A,DIGITAL RECTAL EX PROSTATE CA,$47.42,$35.25,$0.00,$23.18,$23.18,$0.00,$23.18,N/A,$23.18,N/A,$23.18,$0.00,$23.18,N/A,$23.18,$23.18,$0.00
G0104,0960,G0104,,,,,N/A,N/A,COLORECTAL CA SCREENING;FLEXIB,$139.23,$103.50,$133.86,$187.25,$187.25,$133.86,$187.25,N/A,$187.25,$138.00,$187.25,$133.86,$187.25,$138.00,$187.25,$187.25,$133.86
G0105,0960,G0105,,,,,N/A,N/A,COLORECTAL CA SCREENING COLO,$495.39,$368.25,$338.14,$432.00,$338.14,$419.04,$338.14,N/A,$338.14,$432.00,$338.14,$419.04,$338.14,$432.00,$338.14,$338.14,$419.04
G0121,0960,G0121,,,,,N/A,N/A,COLORECTAL CA SCREENING COLO,$495.39,$368.25,$338.33,$491.00,$338.33,$476.27,$338.33,N/A,$338.33,$491.00,$338.33,$476.27,$338.33,$491.00,$338.33,$338.33,$476.27
G0127,0960,G0127,,,,,N/A,N/A,TRIM NAIL(S),$25.22,$18.75,$23.51,$25.00,$23.51,$24.25,$23.51,N/A,$23.51,$25.00,$23.51,$24.25,$23.51,$25.00,$23.51,$23.51,$24.25
G0259,0960,G0259,,,,,N/A,N/A,SI JOINT INJ,$201.79,$150.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
G0260,0960,G0260,,,,,N/A,N/A,INJECT SACROILIAC JOINT,$165.47,$123.00,$164.00,$164.00,N/A,N/A,N/A,N/A,N/A,$164.00,N/A,N/A,N/A,$164.00,N/A,N/A,N/A
G0268,0960,G0268,,,,,N/A,N/A,REMOVAL OF IMPACTED WAX MD,$74.66,$55.50,$51.91,$51.91,$51.91,N/A,$51.91,N/A,$51.91,N/A,$51.91,N/A,$51.91,N/A,$51.91,$51.91,N/A
G0289,0960,G0289,,,,,N/A,N/A,"ARTHRO, LOOSE BODY + CHONDRO",$206.83,$153.75,$81.17,$81.17,$81.17,N/A,$81.17,N/A,$81.17,N/A,$81.17,N/A,$81.17,N/A,$81.17,$81.17,N/A
G0364,0960,G0364,,,,,N/A,N/A,BONE MARROW ASPIRATION,$23.21,$17.25,$18.00,$18.00,N/A,N/A,N/A,N/A,N/A,$18.00,N/A,N/A,N/A,$18.00,N/A,N/A,N/A
G0402,0960,G0402,,,,,N/A,N/A,INITIAL MEDICARE PHYSICAL,$182.62,$135.75,$163.72,$163.72,$163.72,N/A,$163.72,N/A,$163.72,N/A,$163.72,N/A,$163.72,N/A,$163.72,$163.72,N/A
G0442,0960,G0442,,,,,N/A,N/A,ANNUAL ALCOHOL MISUSE SCR 15,$38.34,$28.50,$18.45,$18.45,$18.45,N/A,$18.45,N/A,$18.45,N/A,$18.45,N/A,$18.45,N/A,$18.45,$18.45,N/A
G0443,0960,G0443,,,,,N/A,N/A,FACE/FACE COUNSEL ALCOH 15M 4X,$52.46,$39.00,$25.11,$25.11,$25.11,N/A,$25.11,N/A,$25.11,N/A,$25.11,N/A,$25.11,N/A,$25.11,$25.11,N/A
G0444,0960,G0444,,,,,N/A,N/A,ANNUAL DEPRESSION SCREEN 15MIN,$37.33,$27.75,$18.45,$18.45,$18.45,N/A,$18.45,N/A,$18.45,N/A,$18.45,N/A,$18.45,N/A,$18.45,$18.45,N/A
G0445,0960,G0445,,,,,N/A,N/A,HI INT BH COUN TO PRVEN STI 30,$54.48,$40.50,$26.12,$26.12,$26.12,N/A,$26.12,N/A,$26.12,N/A,$26.12,N/A,$26.12,N/A,$26.12,$26.12,N/A
G0446,0960,G0446,,,,,N/A,N/A,INTENSIVE BH THER CARDIO DISEA,$52.46,$39.00,$25.45,$25.45,$25.45,N/A,$25.45,N/A,$25.45,N/A,$25.45,N/A,$25.45,N/A,$25.45,$25.45,N/A
G0447,0960,G0447,,,,,N/A,N/A,F/F BEHAVIOR COUNS FOR OBESITY,$52.46,$39.00,$25.11,$25.11,$25.11,N/A,$25.11,N/A,$25.11,N/A,$25.11,N/A,$25.11,N/A,$25.11,$25.11,N/A
G0473,0960,G0473,,,,,N/A,N/A,F/F BEHAV COUNS FOR OBESITY GR,$25.22,$18.75,$12.37,$12.37,$12.37,N/A,$12.37,N/A,$12.37,N/A,$12.37,N/A,$12.37,N/A,$12.37,$12.37,N/A
G0500,0960,G0500,,,,,N/A,N/A,MODERATE SEDATION INITIAL 15,$100.89,$75.00,$56.12,$100.00,$56.12,$97.00,$56.12,N/A,$56.12,$100.00,$56.12,$97.00,$56.12,$100.00,$56.12,$56.12,$97.00
G0513,0960,G0513,,,,,N/A,N/A,PROLON PREVEN SV DIR PT CONTAC,$130.15,$96.75,$62.41,$62.41,$62.41,N/A,$62.41,N/A,$62.41,N/A,$62.41,N/A,$62.41,N/A,$62.41,$62.41,N/A
G0514,0960,G0514,,,,,N/A,N/A,PROLON PREV SV ADDITION 30 MIN,$130.15,$96.75,$62.41,$62.41,$62.41,N/A,$62.41,N/A,$62.41,N/A,$62.41,N/A,$62.41,N/A,$62.41,$62.41,N/A
G2010,0960,G2010,,,,,N/A,N/A,REMOTE EVALUATION,$50.45,$37.50,$12.03,$52.00,$12.03,$50.44,$12.03,N/A,$12.03,$52.00,$12.03,$50.44,$12.03,$52.00,$12.03,$12.03,$50.44
G2012,0960,G2012,,,,,N/A,N/A,TECHNOLOGY-BASED SERVICES,$50.45,$37.50,$13.91,$50.00,$13.91,$48.50,$13.91,N/A,$13.91,$50.00,$13.91,$48.50,$13.91,$50.00,$13.91,$13.91,$48.50
G2025,0960,G2025,,,,,N/A,N/A,TELEHEALTH VISIT,$109.97,$81.75,$0.00,$0.00,N/A,$0.00,N/A,N/A,N/A,N/A,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
G2212,0960,G2212,,,,,N/A,N/A,PROLONGED SERVICES,$64.57,$48.00,$31.54,$64.00,$31.54,$62.08,$31.54,N/A,$31.54,$64.00,$31.54,$62.08,$31.54,$64.00,$31.54,$31.54,$62.08
G9001,0960,G9001,,,,,N/A,N/A,COORDINATED CARE,$41.37,$30.75,$17.00,$17.00,N/A,N/A,N/A,N/A,N/A,$17.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A
L3334,0960,L3334,,,,,N/A,N/A,HEEL LIFT,$15.13,$11.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
Q3014,0960,Q3014,,,,,N/A,N/A,TELEHEATH ORIGINATING SITE FEE,$27.24,$20.25,$25.22,$26.00,N/A,$25.22,N/A,N/A,N/A,$26.00,N/A,$25.22,N/A,$26.00,N/A,N/A,$25.22
Q4013,0960,Q4013,,,,,N/A,N/A,"GAUNTLET CAST, ADULT, PLASTER",$30.27,$22.50,$0.00,$30.00,N/A,$0.00,N/A,N/A,N/A,$30.00,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
Q4046,0960,Q4046,,,,,N/A,N/A,"SHORT LG SPLNT, ADT, FIBERGLAS",$39.35,$29.25,$0.00,$39.00,N/A,$0.00,N/A,N/A,N/A,$39.00,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
Q4101,0960,Q4101,,,,,N/A,N/A,APLIGRAF,"$6,738.71","$5,009.25","$7,532.05","$7,765.00",N/A,"$7,532.05",N/A,N/A,N/A,"$7,765.00",N/A,"$7,532.05",N/A,"$7,765.00",N/A,N/A,"$7,532.05"
Q4159,0960,Q4159,,,,,N/A,N/A,AFFINITY,"$3,178.16","$2,362.50","$3,055.50","$3,150.00",N/A,"$3,055.50",N/A,N/A,N/A,"$3,150.00",N/A,"$3,055.50",N/A,"$3,150.00",N/A,N/A,"$3,055.50"
Q4160,0960,Q4160,,,,,N/A,N/A,NUSHIELD,"$6,738.71","$5,009.25","$6,478.63","$6,679.00",N/A,"$6,478.63",N/A,N/A,N/A,"$6,679.00",N/A,"$6,478.63",N/A,"$6,679.00",N/A,N/A,"$6,478.63"
Q4195,0960,Q4195,,,,,N/A,N/A,PURAPLY,"$6,738.71","$5,009.25","$6,478.63","$6,679.00",N/A,"$6,478.63",N/A,N/A,N/A,"$6,679.00",N/A,"$6,478.63",N/A,"$6,679.00",N/A,N/A,"$6,478.63"
T1013,0960,T1013,,,,,N/A,N/A,Interpreter Services 15 Minu,$43.38,$32.25,$43.00,$43.00,N/A,N/A,N/A,N/A,N/A,$43.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A
T1023TM,0960,T1023,,,,,N/A,N/A,T1023TM,$37.33,$27.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
V5008,0960,V5008,,,,,N/A,N/A,WET-HEARING SCREENING,$10.09,$7.50,$10.00,$10.00,N/A,N/A,N/A,N/A,N/A,$10.00,N/A,N/A,N/A,$10.00,N/A,N/A,N/A
11000,0960,,,,,,N/A,N/A,DEBRIDGE INFECTED SKIN,$79.71,$59.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
11601,0960,,,,,,N/A,N/A,EXC TR-EXT MLG+MARG 0.6-1 CM,$282.50,$210.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
11644,0960,,,,,,N/A,N/A,EXC FACE-MM MALIG+MARG 3.1-4,$675.99,$502.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
12036,0960,,,,,,N/A,N/A,LAYER CLOSURE OF WOUND(S),$627.56,$466.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
13160,0960,,,,,,N/A,N/A,LATE CLOSURE OF WOUND,"$1,677.87","$1,247.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
19285,0960,,,,,,N/A,N/A,"BREAST 1ST LESION,INCL ULTRA",$552.90,$411.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
20950,0960,,,,,,N/A,N/A,"FLUID PRESSURE, MUSCLE",$329.92,$245.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
21552,0960,,,,,,N/A,N/A,EXCISION TUMOR 3CM OR >,$869.71,$646.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
21931,0960,,,,,,N/A,N/A,EXC BACK LESION SC 3CM >,$914.10,$679.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
25360,0960,,,,,,N/A,N/A,REVISION OF ULNA,"$2,088.51","$1,552.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
28160,0960,,,,,,N/A,N/A,PARTIAL REMOVAL OF TOE,$667.92,$496.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
28485,0960,,,,,,N/A,N/A,TREAT METATARSAL FRACTURE,"$1,053.33",$783.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
28730,0960,,,,,,N/A,N/A,FUSION OF FOOT BONES,"$1,830.22","$1,360.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
30020,0960,,,,,,N/A,N/A,DRAINAGE OF NOSE LESION,$271.40,$201.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
37766,0960,,,,,,N/A,N/A,PHLEB VEINS - EXTREM 20,"$1,358.03","$1,009.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
42835,0960,,,,,,N/A,N/A,REMOVAL OF ADENOIDS,$444.94,$330.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
44055,0960,,,,,,N/A,N/A,CORRECT MALROTATION OF BOWEL,"$2,938.03","$2,184.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
44141,0960,,,,,,N/A,N/A,COLON RESECT W/SKIN COLOS,"$3,472.77","$2,581.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
44144,0960,,,,,,N/A,N/A,COLON RESECTION PROCEDURE,"$3,366.83","$2,502.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
44205,0960,,,,,,N/A,N/A,COLECTOMY,"$2,967.29","$2,205.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
44603,0960,,,,,,N/A,N/A,"SUTURE, SMALL INTESTINE","$3,067.18","$2,280.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
46257,0960,,,,,,N/A,N/A,HEMORRHOIDECTOMY,$810.18,$602.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
46261,0960,,,,,,N/A,N/A,HEMORRHOIDECTOMY,"$1,012.98",$753.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
46614,0960,,,,,,N/A,N/A,ANOSCOPIC PROCEDURE,$271.40,$201.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
49900,0960,,,,,,N/A,N/A,REPAIR OF ABDOMINAL WALL,"$1,761.61","$1,309.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
50590,0960,,,,,,N/A,N/A,FRAGMENTING OF KIDNEY STONE,"$1,297.50",$964.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
51700,0960,,,,,,N/A,N/A,IRRIGATION OF BLADDER,$227.01,$168.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
51710,0960,,,,,,N/A,N/A,CHANGE OF BLADDER TUBE,$252.24,$187.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
57295,0960,,,,,,N/A,N/A,CHANGE VAGINAL GRAFT,"$1,051.32",$781.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
58140,0960,,,,,,N/A,N/A,MYOMECTOMY ABDOM METHOD,"$2,064.29","$1,534.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
74400,0960,,,,,,N/A,N/A,PYELOGRAPHY-INTERP,$232.06,$172.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
76856,0960,,,,,,N/A,N/A,"US EXAM, PELVIC, COMPLETE",$258.29,$192.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
92270,0960,,,,,,N/A,N/A,ELECTRO-OCULOGRAPHY,$217.93,$162.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
96365,0960,,,,,,N/A,N/A,THER/PROPH/DIAG IV INF INIT,$147.31,$109.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
96371,0960,,,,,,N/A,N/A,SC THER INFUSION RESET PUMP,$175.56,$130.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
432550,0960,,,,,,N/A,N/A,OPERATIVE UPPER GI ENDOSCOPY,$595.27,$442.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
469240,0960,,,,,,N/A,N/A,"DESTRUCTION OF LESION, ANUS","$1,075.53",$799.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
BRACE,0960,,,,,,N/A,N/A,BRACE,$64.57,$48.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
FIVE CORE,0960,,,,,,N/A,N/A,FIVE CORE CLASSES,$128.14,$95.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
PILA,0960,,,,,,N/A,N/A,PILATES,$15.13,$11.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
POET,0960,,,,,,N/A,N/A,POET TESTING,$116.03,$86.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
POOL,0960,,,,,,N/A,N/A,POOL,$153.36,$114.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9080150B,0961,90801,,,,,N/A,N/A,PSYCHIATRIC DIAGNSTC INV/EM ~P,$259.30,$192.75,$199.08,$344.00,N/A,$333.68,N/A,N/A,N/A,$199.08,N/A,$333.68,N/A,$344.00,N/A,N/A,$333.68
9080250B,0961,90802,,,,,N/A,N/A,INTRACTVE PSYCHIATRIC INT/EX~P,$280.49,$208.50,$376.36,$388.00,N/A,$376.36,N/A,N/A,N/A,$388.00,N/A,$376.36,N/A,$388.00,N/A,N/A,$376.36
9086250B,0961,90862,,,,,N/A,N/A,PHARMOCOLOGIC MANAGEMENT    ~P,$92.82,$69.00,$114.82,$166.00,N/A,$161.02,N/A,N/A,N/A,$114.82,N/A,$161.02,N/A,$166.00,N/A,N/A,$161.02
90732,0963,90732,,,,,N/A,N/A,PNEUMOCOCCAL VACCINE,$121.07,$90.00,$130.95,$135.00,N/A,$130.95,N/A,N/A,N/A,$135.00,N/A,$130.95,N/A,$135.00,N/A,N/A,$130.95
94640,0963,94640,,,,,N/A,N/A,AIRWAY INHALATION TREATMENT,$36.32,$27.00,$207.98,$218.00,N/A,$211.46,N/A,N/A,N/A,$207.98,N/A,$211.46,N/A,$218.00,N/A,N/A,$211.46
99232,0963,99232,,,,,N/A,N/A,SUBSEQUENT HOSPITAL CARE,$153.36,$114.00,$37.75,$152.00,$62.32,$147.44,$62.32,$83.77,$62.32,$37.75,$62.32,$147.44,$62.32,$152.00,$62.32,$62.32,$147.44
99233,0963,99233,,,,,N/A,N/A,SUBSEQUENT HOSPITAL CARE,$220.96,$164.25,$70.61,$219.00,$89.79,$212.43,$89.79,$120.26,$89.79,$70.61,$89.79,$212.43,$89.79,$219.00,$89.79,$89.79,$212.43
G0008,0963,G0008,,,,,N/A,N/A,INFLUENZA IMMUN. ADM MCR ONL,$26.23,$19.50,$0.00,$57.00,N/A,$0.00,N/A,N/A,N/A,$57.00,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
G000840,0963,G0008,,,,,N/A,N/A,INFLUENZA IMMUN. ADM MCR ONL,$26.23,$19.50,$0.00,$57.00,N/A,$0.00,N/A,N/A,N/A,$57.00,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
G0009,0963,G0009,,,,,N/A,N/A,PNEUMOCOCAL VAC ADM MCR,$26.23,$19.50,$0.00,$41.00,N/A,$0.00,N/A,N/A,N/A,$41.00,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
36468,0963,,,,,,N/A,N/A,SINGLE OR MULTI INJECT OF SC,$181.61,$135.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
97T1013,0969,T1013,,,,,N/A,N/A,INTERPRETER SERVICES ea 15 MIN,$76.68,$57.00,$43.00,$43.00,N/A,N/A,N/A,N/A,N/A,$43.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A
98T1013,0969,T1013,,,,,N/A,N/A,INTERPRETER SERVICES ea 15 MIN,$69.62,$51.75,$43.00,$43.00,N/A,N/A,N/A,N/A,N/A,$43.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A
15734AS40,0975,15734,,,,,N/A,N/A,MUSCLE MYOCUTANEOUS TRUNK  ~AS,"$2,867.41","$2,131.50","$1,165.22","$2,842.00","$1,165.22","$2,756.74","$1,165.22","$2,429.91","$1,165.22","$1,547.67","$1,165.22","$2,756.74","$1,165.22","$2,842.00","$1,165.22","$1,165.22","$2,756.74"
19301AS40,0975,19301,,,,,N/A,N/A,"MASTECTOMY, PARTIAL        ~AS","$1,198.62",$891.00,$487.80,"$1,188.00",$487.80,"$1,152.36",$487.80,"$1,015.74",$487.80,"$1,108.82",$487.80,"$1,152.36",$487.80,"$1,188.00",$487.80,$487.80,"$1,152.36"
19303AS40,0975,19303,,,,,N/A,N/A,"MASTECTOMY,SIMPLE, COMPLETE~AS","$2,021.92","$1,503.00",$821.64,"$2,004.00",$821.64,"$1,943.88",$821.64,"$1,713.42",$821.64,"$1,609.59",$821.64,"$1,943.88",$821.64,"$2,004.00",$821.64,$821.64,"$1,943.88"
1930740AS,0975,19307,,,,,N/A,N/A,MAST. MOD RAD              ~AS,"$2,034.02","$1,512.00",$826.56,"$2,016.00",$826.56,"$1,955.52",$826.56,"$1,723.68",$826.56,"$1,992.24",$826.56,"$1,955.52",$826.56,"$2,016.00",$826.56,$826.56,"$1,955.52"
20680AS45B,0975,20680,,,,,N/A,N/A,Removal Of Support Implant  ~p,$0.00,$0.00,$272.24,$748.19,$272.24,$644.08,$272.24,$567.72,$272.24,$748.19,$272.24,$644.08,$272.24,$664.00,$272.24,$272.24,$644.08
20902AS45,0975,20902,,,,,N/A,N/A,REMOVAL OF BONE FOR GRAFT  ~AS,"$1,311.62",$975.00,$491.83,"$1,300.00",$558.42,"$1,261.00",$558.42,"$1,111.50",$558.42,$491.83,$558.42,"$1,261.00",$558.42,"$1,300.00",$558.42,$558.42,"$1,261.00"
2101140AS,0975,21011,,,,,N/A,N/A,EXCISION TUMOR SOF TIS FACE~AS,$519.60,$386.25,$211.15,$515.00,$211.15,$499.55,$211.15,$440.33,$211.15,$460.90,$211.15,$499.55,$211.15,$515.00,$211.15,$211.15,$499.55
2155240AS,0975,21552,,,,,N/A,N/A,Excision Tumor 3cm Or >    ~as,$634.62,$471.75,$257.89,$789.32,$257.89,$610.13,$257.89,$537.80,$257.89,$789.32,$257.89,$610.13,$257.89,$629.00,$257.89,$257.89,$610.13
21811AS40,0975,21811,,,,,N/A,N/A,OPEN TREAT OF RIB FX 1-3   ~AS,"$1,151.20",$855.75,$467.81,$467.81,$467.81,N/A,$467.81,N/A,$467.81,N/A,$467.81,N/A,$467.81,N/A,$467.81,$467.81,N/A
21931AS40,0975,21931,,,,,N/A,N/A,EXC BACK LES SC 3 CM/>      ~P,$914.10,$679.50,$371.46,$906.00,$371.46,N/A,$371.46,$774.63,$371.46,$830.07,$371.46,N/A,$371.46,$906.00,$371.46,$371.46,N/A
21933AS40,0975,21933,,,,,N/A,N/A,EXC BACK TUM DEEP 5 CM/>   ~AS,"$1,433.70","$1,065.75",$582.61,"$1,421.00",$582.61,"$1,378.37",$582.61,"$1,214.96",$582.61,"$1,302.58",$582.61,"$1,378.37",$582.61,"$1,421.00",$582.61,$582.61,"$1,378.37"
22900AS40,0975,22900,,,,,N/A,N/A,EXC TUMOR DEEP < 5CM       ~AS,$968.58,$720.00,$393.60,$998.06,$393.60,$931.20,$393.60,$820.80,$393.60,$998.06,$393.60,$931.20,$393.60,$960.00,$393.60,$393.60,$931.20
22901AS40,0975,22901,,,,,N/A,N/A,EXC ABDL TUM DEEP 5 CM/>   ~AS,"$1,290.43",$959.25,$524.39,"$1,279.00",$524.39,"$1,240.63",$524.39,"$1,093.55",$524.39,"$1,175.89",$524.39,"$1,240.63",$524.39,"$1,279.00",$524.39,$524.39,"$1,240.63"
22902AS40,0975,22902,,,,,N/A,N/A,EXC ABD LES SC < 3 CM      ~AS,$640.68,$476.25,$26.35,$635.00,$26.35,$615.95,$26.35,$542.93,$26.35,$591.02,$26.35,$615.95,$26.35,$635.00,$26.35,$26.35,$615.95
22903AS40,0975,22903,,,,,N/A,N/A,EXCISION 3CM >             ~AS,$619.49,$460.50,$251.74,$777.73,$251.74,$595.58,$251.74,$524.97,$251.74,$777.73,$251.74,$595.58,$251.74,$614.00,$251.74,$251.74,$595.58
2302045AS,0975,23020,,,,,N/A,N/A,RELEASE SHOULDER JOINT     ~AS,"$1,573.95","$1,170.00",$639.60,"$1,560.00",$639.60,"$1,513.20",$639.60,"$1,333.80",$639.60,"$1,232.01",$639.60,"$1,513.20",$639.60,"$1,560.00",$639.60,$639.60,"$1,513.20"
23071AS45,0975,23071,,,,,N/A,N/A,Excision Tumor Soft Tissue ~as,$788.99,$586.50,$33.87,$807.00,$33.87,$782.79,$33.87,$689.99,$33.87,$744.53,$33.87,$782.79,$33.87,$807.00,$33.87,$33.87,$782.79
2312045AS,0975,23120,,,,,N/A,N/A,"PARTIAL REMOVAL,COLLAR BONE~AS","$1,292.45",$960.75,$525.21,"$1,281.00",$525.21,"$1,242.57",$525.21,"$1,095.26",$525.21,"$1,052.56",$525.21,"$1,242.57",$525.21,"$1,281.00",$525.21,$525.21,"$1,242.57"
23120AS45,0975,23120,,,,,N/A,N/A,"PARTIAL REMOVAL,COLLAR BONE ~A","$1,292.45",$960.75,$525.21,"$1,281.00",$525.21,"$1,242.57",$525.21,"$1,095.26",$525.21,"$1,052.56",$525.21,"$1,242.57",$525.21,"$1,281.00",$525.21,$525.21,"$1,242.57"
23130AS45,0975,23130,,,,,N/A,N/A,"Remove Shoulder Bone,Part  ~as",$0.00,$0.00,$567.85,"$1,385.00",$567.85,"$1,343.45",$567.85,"$1,184.18",$567.85,"$1,106.71",$567.85,"$1,343.45",$567.85,"$1,385.00",$567.85,$567.85,"$1,343.45"
23405AS45,0975,23405,,,,,N/A,N/A,"REPAIR,REV/RECON TENOTOMY  ~AS","$1,198.62",$891.00,$487.80,"$1,188.00",$487.80,"$1,152.36",$487.80,"$1,015.74",$487.80,"$1,109.72",$487.80,"$1,152.36",$487.80,"$1,188.00",$487.80,$487.80,"$1,152.36"
2341045AS,0975,23410,,,,,N/A,N/A,"REPAIR ROTATOR CUFF,ACUTE  ~AS","$2,088.51","$1,552.50",$848.70,"$2,070.00",$848.70,"$2,007.90",$848.70,"$1,769.85",$848.70,"$1,462.58",$848.70,"$2,007.90",$848.70,"$2,070.00",$848.70,$848.70,"$2,007.90"
23410AS45,0975,23410,,,,,N/A,N/A,"REPAIR ROTATOR CUFF,ACUTE  ~AS","$2,088.51","$1,552.50",$848.70,"$2,070.00",$848.70,"$2,007.90",$848.70,"$1,769.85",$848.70,"$1,462.58",$848.70,"$2,007.90",$848.70,"$2,070.00",$848.70,$848.70,"$2,007.90"
2341245AS,0975,23412,,,,,N/A,N/A,REPAIR ROTATOR CUFF CHRONIC~AS,"$2,218.66","$1,649.25",$91.59,"$2,199.00",$91.59,"$2,133.03",$91.59,"$1,880.15",$91.59,"$1,518.96",$91.59,"$2,133.03",$91.59,"$2,199.00",$91.59,$91.59,"$2,133.03"
23415AS45,0975,23415,,,,,N/A,N/A,RELEASE SHOULDER LIGAMENT  ~AS,"$1,715.20","$1,275.00",$697.00,"$1,700.00",$697.00,"$1,649.00",$697.00,"$1,453.50",$697.00,"$1,247.75",$697.00,"$1,649.00",$697.00,"$1,700.00",$697.00,$697.00,"$1,649.00"
2342045AS,0975,23420,,,,,N/A,N/A,"SHOULDER, REPAIR OF        ~AS","$2,304.42","$1,713.00",$936.44,"$2,284.00",$936.44,"$2,215.48",$936.44,"$1,952.82",$936.44,"$1,734.29",$936.44,"$2,215.48",$936.44,"$2,284.00",$936.44,$936.44,"$2,215.48"
23420AS45,0975,23420,,,,,N/A,N/A,"SHOULDER, REPAIR OF        ~AS","$2,304.42","$1,713.00",$936.44,"$2,284.00",$936.44,"$2,215.48",$936.44,"$1,952.82",$936.44,"$1,734.29",$936.44,"$2,215.48",$936.44,"$2,284.00",$936.44,$936.44,"$2,215.48"
2343045AS,0975,23430,,,,,N/A,N/A,REPAIR BICEPS TENDON       ~AS,"$1,727.31","$1,284.00",$71.92,"$1,712.00",$71.92,"$1,660.64",$71.92,"$1,463.76",$71.92,"$1,330.25",$71.92,"$1,660.64",$71.92,"$1,712.00",$71.92,$71.92,"$1,660.64"
23430AS45,0975,23430,,,,,N/A,N/A,REPAIR BICEPS TENDON       ~AS,"$1,727.31","$1,284.00",$71.92,"$1,712.00",$71.92,"$1,660.64",$71.92,"$1,463.76",$71.92,"$1,330.25",$71.92,"$1,660.64",$71.92,"$1,712.00",$71.92,$71.92,"$1,660.64"
2344045AS,0975,23440,,,,,N/A,N/A,REMOVE/TRANSPLANT TENDON   ~AS,"$1,790.87","$1,331.25",$727.75,"$1,775.00",$727.75,"$1,721.75",$727.75,"$1,517.63",$727.75,"$1,348.25",$727.75,"$1,721.75",$727.75,"$1,775.00",$727.75,$727.75,"$1,721.75"
2345545AS,0975,23455,,,,,N/A,N/A,REPAIR SHOULDER CAPSULE    ~AS,"$2,375.04","$1,765.50",$965.14,"$2,354.00",$965.14,"$2,283.38",$965.14,"$2,012.67",$965.14,"$1,767.45",$965.14,"$2,283.38",$965.14,"$2,354.00",$965.14,$965.14,"$2,283.38"
23455AS45,0975,23455,,,,,N/A,N/A,REPAIR SHOULDER CAPSULE    ~AS,"$2,375.04","$1,765.50",$965.14,"$2,354.00",$965.14,"$2,283.38",$965.14,"$2,012.67",$965.14,"$1,767.45",$965.14,"$2,283.38",$965.14,"$2,354.00",$965.14,$965.14,"$2,283.38"
2347045AS,0975,23470,,,,,N/A,N/A,RECONSTRUCT SHOULDER JOINT ~AS,"$2,815.95","$2,093.25","$1,144.31","$2,791.00","$1,144.31","$2,707.27","$1,144.31","$2,386.31","$1,144.31","$2,131.98","$1,144.31","$2,707.27","$1,144.31","$2,791.00","$1,144.31","$1,144.31","$2,707.27"
23470AS45,0975,23470,,,,,N/A,N/A,RECONSTRUCT SHOULDER JOINT ~AS,"$2,815.95","$2,093.25","$1,144.31","$2,791.00","$1,144.31","$2,707.27","$1,144.31","$2,386.31","$1,144.31","$2,131.98","$1,144.31","$2,707.27","$1,144.31","$2,791.00","$1,144.31","$1,144.31","$2,707.27"
2347245AS,0975,23472,,,,,N/A,N/A,RECONSTRUCT SHOULDER JOINT ~AS,"$3,405.17","$2,531.25","$1,383.75","$3,375.00","$1,383.75","$3,273.75","$1,383.75","$2,885.63","$1,383.75","$2,567.40","$1,383.75","$3,273.75","$1,383.75","$3,375.00","$1,383.75","$1,383.75","$3,273.75"
23485AS45,0975,23485,,,,,N/A,N/A,REVISION OF COLLAR BONE    ~AS,"$2,231.78","$1,659.00",$96.92,"$2,212.00",$96.92,"$2,145.64",$96.92,"$1,891.26",$96.92,"$1,688.16",$96.92,"$2,145.64",$96.92,"$2,212.00",$96.92,$96.92,"$2,145.64"
2351545AS,0975,23515,,,,,N/A,N/A,TREAT CLAVICLE FRACTURE    ~AS,"$1,331.80",$990.00,$541.20,"$1,334.00",$541.20,"$1,293.98",$541.20,"$1,140.57",$541.20,"$1,286.98",$541.20,"$1,293.98",$541.20,"$1,334.00",$541.20,$541.20,"$1,293.98"
23550AS45,0975,23550,,,,,N/A,N/A,TREAT CLAVICLE DISLOCATION ~AS,"$1,295.48",$963.00,$526.44,"$1,284.00",$526.44,"$1,245.48",$526.44,"$1,097.82",$526.44,"$1,025.77",$526.44,"$1,245.48",$526.44,"$1,284.00",$526.44,$526.44,"$1,245.48"
2361545AS,0975,23615,,,,,N/A,N/A,"TREATMENT,HUMERUS FRX      ~AS","$1,729.32","$1,285.50",$72.74,"$1,714.00",$72.74,$796.37,$72.74,"$1,465.47",$72.74,"$1,575.63",$72.74,$796.37,$72.74,"$1,714.00",$72.74,$72.74,$796.37
23615AS45,0975,23615,,,,,N/A,N/A,"TREATMENT,HUMERUS FRX      ~AS","$1,729.32","$1,285.50",$72.74,"$1,714.00",$72.74,$796.37,$72.74,"$1,465.47",$72.74,"$1,575.63",$72.74,$796.37,$72.74,"$1,714.00",$72.74,$72.74,$796.37
23630AS45,0975,23630,,,,,N/A,N/A,TREAT HUMERUS FRACTURE     ~AS,"$1,422.61","$1,057.50",$578.10,"$1,662.58",$578.10,"$1,662.58",$578.10,"$1,205.55",$578.10,"$1,393.29",$578.10,"$1,662.58",$578.10,"$1,410.00",$578.10,$578.10,"$1,662.58"
23931AS45,0975,23931,,,,,N/A,N/A,INCISION BURSA             ~AS,$315.80,$234.75,$128.33,$479.18,$128.33,$479.18,$128.33,$267.62,$128.33,$286.94,$128.33,$479.18,$128.33,$313.00,$128.33,$128.33,$479.18
2407140AS,0975,24071,,,,,N/A,N/A,EXC ARM/ELBOW LES SC 3 CM/>~AS,$793.03,$589.50,$303.61,$786.00,$322.26,$303.61,$322.26,$672.03,$322.26,$719.94,$322.26,$303.61,$322.26,$786.00,$322.26,$322.26,$303.61
2410145AS,0975,24101,,,,,N/A,N/A,EXPLORE/TREAT ELBOW JOINT  ~AS,"$1,147.16",$852.75,$466.17,"$1,137.00",$466.17,N/A,$466.17,$972.14,$466.17,$905.22,$466.17,N/A,$466.17,"$1,137.00",$466.17,$466.17,N/A
24140AS45,0975,24140,,,,,N/A,N/A,PARTIAL REMOVAL OF ARM BONE~AS,"$1,732.35","$1,287.75",$73.97,"$1,717.00",$73.97,"$1,665.49",$73.97,"$1,468.04",$73.97,"$1,257.88",$73.97,"$1,665.49",$73.97,"$1,717.00",$73.97,$73.97,"$1,665.49"
2414945AS,0975,24149,,,,,N/A,N/A,RADICAL RESECTION ELBOW    ~AS,"$2,458.79","$1,827.75",$999.17,"$2,437.00",$999.17,"$2,363.89",$999.17,"$2,083.64",$999.17,"$2,099.54",$999.17,"$2,363.89",$999.17,"$2,437.00",$999.17,$999.17,"$2,363.89"
2434145AS,0975,24341,,,,,N/A,N/A,REPAIR ARM TENDON/MUSCLE   ~AS,"$1,501.30","$1,116.00",$61.80,"$1,488.00",$61.80,"$1,443.36",$61.80,"$1,272.24",$61.80,"$1,335.71",$61.80,"$1,443.36",$61.80,"$1,488.00",$61.80,$61.80,"$1,443.36"
24342AS45,0975,24342,,,,,N/A,N/A,REPAIR OF RUPTURED TENDON  ~AS,"$1,490.20","$1,107.75",$65.57,"$1,477.00",$65.57,"$1,432.69",$65.57,"$1,262.84",$65.57,"$1,385.54",$65.57,"$1,432.69",$65.57,"$1,477.00",$65.57,$65.57,"$1,432.69"
24343AS45,0975,24343,,,,,N/A,N/A,REPR ELBOW LAT LIGMNT W/TIS~AS,"$1,595.13","$1,185.75",$648.21,"$1,581.00",$648.21,"$1,533.57",$648.21,"$1,351.76",$648.21,"$1,278.50",$648.21,"$1,533.57",$648.21,"$1,581.00",$648.21,$648.21,"$1,533.57"
24359AS45,0975,24359,,,,,N/A,N/A,Repair Elbow Deb/Attch Open~as,$0.00,$0.00,$459.61,"$1,185.24",$459.61,"$1,087.37",$459.61,$958.46,$459.61,"$1,185.24",$459.61,"$1,087.37",$459.61,"$1,121.00",$459.61,$459.61,"$1,087.37"
2443045AS,0975,24430,,,,,N/A,N/A,REPAIRNON/MAL UNION HUMERUS~AS,"$2,111.71","$1,569.75",$858.13,"$2,093.00",$858.13,"$2,030.21",$858.13,"$1,789.52",$858.13,"$1,877.28",$858.13,"$2,030.21",$858.13,"$2,093.00",$858.13,$858.13,"$2,030.21"
24435AS45,0975,24435,,,,,N/A,N/A,REPAIR/RECON ELBOW/UPPERARM~AS,"$2,173.26","$1,615.50",$883.14,"$2,154.00",$883.14,"$2,089.38",$883.14,"$1,841.67",$883.14,"$1,924.66",$883.14,"$2,089.38",$883.14,"$2,154.00",$883.14,$883.14,"$2,089.38"
2451545AS,0975,24515,,,,,N/A,N/A,TREAT HUMERUS FRACTURE     ~AS,"$2,006.78","$1,491.75",$815.49,"$1,989.00",$815.49,"$1,929.33",$815.49,"$1,700.60",$815.49,"$1,570.71",$815.49,"$1,929.33",$815.49,"$1,989.00",$815.49,$815.49,"$1,929.33"
24516AS45,0975,24516,,,,,N/A,N/A,TREAT OF HUMERAL SHAFT FX  ~AS,"$1,325.75",$985.50,$538.74,"$1,531.87",$538.74,"$1,274.58",$538.74,"$1,123.47",$538.74,"$1,531.87",$538.74,"$1,274.58",$538.74,"$1,314.00",$538.74,$538.74,"$1,274.58"
24635AS45,0975,24635,,,,,N/A,N/A,OPEN TREATMENT FX ELBOW    ~AS,"$1,340.88",$996.75,$544.89,"$1,329.00",$544.89,"$1,289.13",$544.89,"$1,136.30",$544.89,"$1,209.60",$544.89,"$1,289.13",$544.89,"$1,329.00",$544.89,$544.89,"$1,289.13"
24665AS45,0975,24665,,,,,N/A,N/A,OPEN TRT RAD HEAD/NECK FX  ~AS,$857.60,$637.50,$348.50,"$1,181.08",$348.50,$824.50,$348.50,$726.75,$348.50,"$1,181.08",$348.50,$824.50,$348.50,$850.00,$348.50,$348.50,$824.50
24685AS45,0975,24685,,,,,N/A,N/A,OPEN TREATMENT OF ULNAR FX ~AS,"$1,243.01",$924.00,$55.12,"$1,232.00",$55.12,"$1,195.04",$55.12,"$1,053.36",$55.12,"$1,173.61",$55.12,"$1,195.04",$55.12,"$1,232.00",$55.12,$55.12,"$1,195.04"
25332AS45,0975,25332,,,,,N/A,N/A,REPAIR/RECON FOREARM/WRIST ~AS,"$1,691.99","$1,257.75",$687.57,"$1,677.00",$687.57,"$1,626.69",$687.57,"$1,433.84",$687.57,"$1,507.77",$687.57,"$1,626.69",$687.57,"$1,677.00",$687.57,$687.57,"$1,626.69"
2540045AS,0975,25400,,,,,N/A,N/A,REPAIR RADIUS OR ULNA      ~AS,"$2,454.75","$1,824.75",$997.53,"$2,433.00",$997.53,"$2,360.01",$997.53,"$2,080.22",$997.53,"$1,434.39",$997.53,"$2,360.01",$997.53,"$2,433.00",$997.53,$997.53,"$2,360.01"
25405AS45,0975,25405,,,,,N/A,N/A,REPAIR/GRAFT RADIUS OR ULNA~AS,"$2,981.42","$2,216.25","$1,211.55","$2,955.00","$1,211.55","$2,866.35","$1,211.55",N/A,"$1,211.55","$1,848.04","$1,211.55","$2,866.35","$1,211.55","$2,955.00","$1,211.55","$1,211.55","$2,866.35"
2542545AS,0975,25425,,,,,N/A,N/A,REPAIR/GRAFT RADIUS OR ULNA~AS,"$3,221.55","$2,394.75",$139.13,"$3,193.00",$139.13,"$3,097.21",$139.13,"$2,730.02",$139.13,"$1,716.92",$139.13,"$3,097.21",$139.13,"$3,193.00",$139.13,$139.13,"$3,097.21"
2544745AS,0975,25447,,,,,N/A,N/A,REPAIR WRIST JOINT (S)     ~AS,"$1,807.01","$1,343.25",$734.31,"$1,791.00",$734.31,"$1,737.27",$734.31,"$1,531.31",$734.31,"$1,486.10",$734.31,"$1,737.27",$734.31,"$1,791.00",$734.31,$734.31,"$1,737.27"
25447AS45,0975,25447,,,,,N/A,N/A,REPAIR WRIST JOINT (S)     ~AS,"$1,807.01","$1,343.25",$734.31,"$1,791.00",$734.31,"$1,737.27",$734.31,"$1,531.31",$734.31,"$1,486.10",$734.31,"$1,737.27",$734.31,"$1,791.00",$734.31,$734.31,"$1,737.27"
25515AS45,0975,25515,,,,,N/A,N/A,TREAT FRACTURE OF RADIUS   ~AS,"$1,588.07","$1,180.50",$645.34,"$1,574.00",$645.34,"$1,526.78",$645.34,"$1,345.77",$645.34,"$1,198.46",$645.34,"$1,526.78",$645.34,"$1,574.00",$645.34,$645.34,"$1,526.78"
2554545AS,0975,25545,,,,,N/A,N/A,TREAT FRACTURE OF ULNA     ~AS,"$1,577.98","$1,173.00",$641.24,"$1,564.00",$641.24,"$1,517.08",$641.24,"$1,337.22",$641.24,"$1,119.11",$641.24,"$1,517.08",$641.24,"$1,564.00",$641.24,$641.24,"$1,517.08"
2557545AS,0975,25575,,,,,N/A,N/A,TREAT FRACTURE RADIUS/ULNA ~AS,"$1,898.83","$1,411.50",$771.62,"$1,882.00",$771.62,"$1,825.54",$771.62,"$1,609.11",$771.62,"$1,613.56",$771.62,"$1,825.54",$771.62,"$1,882.00",$771.62,$771.62,"$1,825.54"
2560545AS,0975,25605,,,,,N/A,N/A,OPTX DSTL RADL I ARTIC FX  ~AS,"$1,475.07","$1,096.50",$599.42,"$1,462.00",$599.42,"$1,418.14",$599.42,"$1,250.01",$599.42,$920.22,$599.42,"$1,418.14",$599.42,"$1,462.00",$599.42,$599.42,"$1,418.14"
25607AS45,0975,25607,,,,,N/A,N/A,OPTX DSTL RADL EX ARTIC FX ~AS,"$1,389.31","$1,032.75",$564.57,"$1,377.00",$564.57,"$1,335.69",$564.57,"$1,177.34",$564.57,"$1,321.95",$564.57,"$1,335.69",$564.57,"$1,377.00",$564.57,$564.57,"$1,335.69"
25608AS45,0975,25608,,,,,N/A,N/A,OPTX DSTL RADL I ARTIC FX  ~AS,"$1,475.07","$1,096.50",$599.42,"$1,477.18",$599.42,"$1,418.14",$599.42,"$1,250.01",$599.42,"$1,477.18",$599.42,"$1,418.14",$599.42,"$1,462.00",$599.42,$599.42,"$1,418.14"
2560945AS,0975,25609,,,,,N/A,N/A,OPTMT DSTL RADL I-ARTIC FRX~AS,"$1,475.07","$1,096.50",$763.42,"$1,875.15",$763.42,"$1,806.14",$763.42,"$1,592.01",$763.42,"$1,875.15",$763.42,"$1,806.14",$763.42,"$1,862.00",$763.42,$763.42,"$1,806.14"
25609AS45,0975,25609,,,,,N/A,N/A,OPTMT DSTL RADL I-ARTIC FRX~AS,"$1,878.65","$1,396.50",$763.42,"$1,875.15",$763.42,"$1,806.14",$763.42,"$1,592.01",$763.42,"$1,875.15",$763.42,"$1,806.14",$763.42,"$1,862.00",$763.42,$763.42,"$1,806.14"
25645AS45,0975,25645,,,,,N/A,N/A,TREAT WRIST BONE FRACTURE  ~AS,"$1,319.69",$981.00,$536.28,"$1,308.00",$536.28,"$1,268.76",$536.28,"$1,118.34",$536.28,"$1,024.61",$536.28,"$1,268.76",$536.28,"$1,308.00",$536.28,$536.28,"$1,268.76"
25652AS45,0975,25652,,,,,N/A,N/A,TREAT FRACT ULNAR STYLOID  ~AS,"$1,385.27","$1,029.75",$562.93,"$1,373.00",$562.93,"$1,331.81",$562.93,"$1,173.92",$562.93,"$1,116.59",$562.93,"$1,331.81",$562.93,"$1,373.00",$562.93,$562.93,"$1,331.81"
2580045AS,0975,25800,,,,,N/A,N/A,FUSION WRIST JOINT         ~AS,"$1,788.85","$1,329.75",$726.93,"$1,773.00",$726.93,"$1,719.81",$726.93,"$1,515.92",$726.93,"$1,310.69",$726.93,"$1,719.81",$726.93,"$1,773.00",$726.93,$726.93,"$1,719.81"
25820AS45,0975,25820,,,,,N/A,N/A,WRIST FUSION LIMITED       ~AS,"$1,226.87",$912.00,$498.56,"$1,216.00",$498.56,"$1,179.52",$498.56,"$1,039.68",$498.56,"$1,164.62",$498.56,"$1,179.52",$498.56,"$1,216.00",$498.56,$498.56,"$1,179.52"
2611145AS,0975,26111,,,,,N/A,N/A,EXCISE TUMOR HAND/FINGER   ~AS,$765.79,$569.25,$311.19,$311.19,$311.19,N/A,$311.19,N/A,$311.19,N/A,$311.19,N/A,$311.19,N/A,$311.19,$311.19,N/A
26356AS45,0975,26356,,,,,N/A,N/A,Repair Finger/Hand Tendon  ~as,$0.00,$0.00,$996.30,$996.30,$996.30,N/A,$996.30,N/A,$996.30,N/A,$996.30,N/A,$996.30,N/A,$996.30,$996.30,N/A
26480AS45,0975,26480,,,,,N/A,N/A,Trans Or Transpl Of Tendon ~as,$0.00,$0.00,$587.12,$587.12,$587.12,N/A,$587.12,N/A,$587.12,N/A,$587.12,N/A,$587.12,N/A,$587.12,$587.12,N/A
26483AS45,0975,26483,,,,,N/A,N/A,TRANSFER OF TENDON W/GRAFT ~AS,"$1,660.72","$1,234.50",$674.86,$674.86,$674.86,N/A,$674.86,N/A,$674.86,N/A,$674.86,N/A,$674.86,N/A,$674.86,$674.86,N/A
26540AS45,0975,26540,,,,,N/A,N/A,Repair Hand Joint          ~as,$0.00,$0.00,$612.13,$612.13,$612.13,N/A,$612.13,N/A,$612.13,N/A,$612.13,N/A,$612.13,N/A,$612.13,$612.13,N/A
2654145AS,0975,26541,,,,,N/A,N/A,REPAIR HAND JOINT W/GRAFT  ~AS,"$2,057.23","$1,529.25",$835.99,$835.99,$835.99,N/A,$835.99,N/A,$835.99,N/A,$835.99,N/A,$835.99,N/A,$835.99,$835.99,N/A
26615AS45,0975,26615,,,,,N/A,N/A,Treat Metacarpal Fracture  ~as,$0.00,$0.00,$41.00,$41.00,$41.00,N/A,$41.00,N/A,$41.00,N/A,$41.00,N/A,$41.00,N/A,$41.00,$41.00,N/A
2700145AS,0975,27001,,,,,N/A,N/A,INCISION OF HIP TENDON     ~AS,"$1,244.02",$924.75,$970.09,"$1,233.00",N/A,"$1,196.01",N/A,"$1,054.22",N/A,$970.09,N/A,"$1,196.01",N/A,"$1,233.00",N/A,N/A,"$1,196.01"
2700645AS,0975,27006,,,,,N/A,N/A,INCISION OF HIP TENDON     ~AS,"$3,375.91","$2,509.50","$1,290.32","$3,346.00","$1,371.86","$3,245.62","$1,371.86","$2,860.83","$1,371.86","$1,290.32","$1,371.86","$3,245.62","$1,371.86","$3,346.00","$1,371.86","$1,371.86","$3,245.62"
27006AS45,0975,27006,,,,,N/A,N/A,INCISION OF HIP TENDON     ~AS,"$3,375.91","$2,509.50","$1,290.32","$3,346.00","$1,371.86","$3,245.62","$1,371.86","$2,860.83","$1,371.86","$1,290.32","$1,371.86","$3,245.62","$1,371.86","$3,346.00","$1,371.86","$1,371.86","$3,245.62"
2703045AS,0975,27030,,,,,N/A,N/A,DRAINAGE OF HIP JOINT      ~AS,"$2,167.20","$1,611.00",$88.68,"$2,148.00",$88.68,"$2,083.56",$88.68,"$1,836.54",$88.68,"$1,666.79",$88.68,"$2,083.56",$88.68,"$2,148.00",$88.68,$88.68,"$2,083.56"
27030AS45,0975,27030,,,,,N/A,N/A,SURG INCISION OF HIP       ~AS,"$1,826.18","$1,357.50",$88.68,"$2,148.00",$88.68,"$2,083.56",$88.68,"$1,836.54",$88.68,"$1,666.79",$88.68,"$2,083.56",$88.68,"$2,148.00",$88.68,$88.68,"$2,083.56"
2704540AS,0975,27045,,,,,N/A,N/A,"REMOVE TURMOR,HIP/EPLV 5CM>~AS","$1,373.17","$1,020.75",$558.10,"$1,361.00",$558.10,"$1,320.17",$558.10,"$1,163.66",$558.10,"$1,301.99",$558.10,"$1,320.17",$558.10,"$1,361.00",$558.10,$558.10,"$1,320.17"
27045AS45,0975,27045,,,,,N/A,N/A,"REMOVE TURMOR, HIP/PELV 5CM>","$1,373.17","$1,020.75",$558.10,"$1,361.00",$558.10,"$1,320.17",$558.10,"$1,163.66",$558.10,"$1,301.99",$558.10,"$1,320.17",$558.10,"$1,361.00",$558.10,$558.10,"$1,320.17"
2704745AS,0975,27047,,,,,N/A,N/A,REMOVE HIP/PELVIS LESION   ~AS,"$1,161.29",$863.25,$471.91,"$1,151.00",$471.91,"$1,116.47",$471.91,$984.11,$471.91,$638.52,$471.91,"$1,116.47",$471.91,"$1,151.00",$471.91,$471.91,"$1,116.47"
2704845AS,0975,27048,,,,,N/A,N/A,"EXCISION,TUMOR,SOFT TISS <CM~P",$865.67,$643.50,$351.78,"$1,084.29",$351.78,$832.26,$351.78,$733.59,$351.78,"$1,084.29",$351.78,$832.26,$351.78,$858.00,$351.78,$351.78,$832.26
27062AS45,0975,27062,,,,,N/A,N/A,Remove Femur Lesion/Bursa  ~as,$0.00,$0.00,$47.54,$994.00,$47.54,$964.18,$47.54,$849.87,$47.54,$816.93,$47.54,$964.18,$47.54,$994.00,$47.54,$47.54,$964.18
27066AS45,0975,27066,,,,,N/A,N/A,REMOVAL OF HIP BONE LESION ~AS,"$1,790.87","$1,331.25",$727.75,"$1,775.00",$727.75,"$1,721.75",$727.75,"$1,517.63",$727.75,"$1,457.56",$727.75,"$1,721.75",$727.75,"$1,775.00",$727.75,$727.75,"$1,721.75"
2709145AS,0975,27091,,,,,N/A,N/A,REMOVAL OF HIP PROSTHESIS  ~AS,"$3,471.76","$2,580.75",$141.81,"$3,441.00",$141.81,"$3,337.77",$141.81,"$2,942.06",$141.81,"$2,818.59",$141.81,"$3,337.77",$141.81,"$3,441.00",$141.81,$141.81,"$3,337.77"
27100AS45,0975,27100,,,,,N/A,N/A,TRANSFER OF ADB MUSCLE     ~AS,"$1,257.14",$934.50,$51.86,"$1,480.37",$51.86,"$1,208.62",$51.86,"$1,065.33",$51.86,"$1,480.37",$51.86,"$1,208.62",$51.86,"$1,246.00",$51.86,$51.86,"$1,208.62"
27125AS45,0975,27125,,,,,N/A,N/A,"REPAIR,REVISION,PARTIAL HIP~AS","$2,168.21","$1,611.75",$881.90,"$2,149.00",$881.90,"$2,084.53",$881.90,"$1,837.40",$881.90,"$2,008.52",$881.90,"$2,084.53",$881.90,"$2,149.00",$881.90,$881.90,"$2,084.53"
2713050AS,0975,27130,,,,,N/A,N/A,TOTAL HIP ARTHROPLASTY     ~AS,"$6,412.82","$4,767.00",$132.98,"$6,356.00",$132.98,"$6,165.32",$132.98,"$5,434.38",$132.98,"$2,277.00",$132.98,"$6,165.32",$132.98,"$6,356.00",$132.98,$132.98,"$6,165.32"
27130AS45,0975,27130,,,,,N/A,N/A,TOTAL HIP ARTHROPLASTY     ~AS,"$3,206.41","$2,383.50",$132.98,"$6,356.00",$132.98,"$6,165.32",$132.98,"$5,434.38",$132.98,"$2,277.00",$132.98,"$6,165.32",$132.98,"$6,356.00",$132.98,$132.98,"$6,165.32"
27134AS45,0975,27134,,,,,N/A,N/A,REVSN TOTAL HIP BOTH COMP  ~AS,"$3,724.00","$2,768.25","$1,513.31","$6,391.00","$1,513.31","$6,199.27","$1,513.31","$5,464.31","$1,513.31","$3,367.07","$1,513.31","$6,199.27","$1,513.31","$6,391.00","$1,513.31","$1,513.31","$6,199.27"
2713745AS,0975,27137,,,,,N/A,N/A,REVISE HIP JNT REPLACEMENT ~AS,"$3,369.86","$2,505.00","$1,369.40","$3,340.00","$1,369.40","$3,239.80","$1,369.40","$2,855.70","$1,369.40","$2,594.63","$1,369.40","$3,239.80","$1,369.40","$3,340.00","$1,369.40","$1,369.40","$3,239.80"
27138AS45,0975,27138,,,,,N/A,N/A,REPAIR FEMORAL COMP ONLY   ~AS,"$3,510.10","$2,609.25","$1,426.39","$3,479.00","$1,426.39","$3,374.63","$1,426.39","$2,974.55","$1,426.39","$2,695.36","$1,426.39","$3,374.63","$1,426.39","$3,479.00","$1,426.39","$1,426.39","$3,374.63"
27187AS45,0975,27187,,,,,N/A,N/A,REINFORCE HIP BONES        ~AS,"$2,320.56","$1,725.00",$943.00,"$2,300.00",$943.00,"$2,231.00",$943.00,"$1,966.50",$943.00,"$1,770.71",$943.00,"$2,231.00",$943.00,"$2,300.00",$943.00,$943.00,"$2,231.00"
27215AS45,0975,27215,,,,,N/A,N/A,TREAT PELVIC FRACTURE(S)   ~AS,"$1,652.64","$1,228.50",$671.58,"$1,638.00",$671.58,"$1,588.86",$671.58,"$1,400.49",$671.58,"$1,087.36",$671.58,"$1,588.86",$671.58,"$1,638.00",$671.58,$671.58,"$1,588.86"
27235AS45,0975,27235,,,,,N/A,N/A,Treat Thigh Fracture       ~as,$0.00,$0.00,$863.50,"$2,105.00",$863.50,"$2,041.85",$863.50,"$1,799.78",$863.50,"$1,613.93",$863.50,"$2,041.85",$863.50,"$2,105.00",$863.50,$863.50,"$2,041.85"
2723645AS,0975,27236,,,,,N/A,N/A,"TREATMENT, THIGH FRX       ~AS","$2,554.64","$1,899.00",$138.12,"$2,532.00",$138.12,"$2,456.04",$138.12,"$2,164.86",$138.12,"$2,117.70",$138.12,"$2,456.04",$138.12,"$2,532.00",$138.12,$138.12,"$2,456.04"
27236AS45,0975,27236,,,,,N/A,N/A,"TREATMENT, THIGH FRX       ~AS","$2,554.64","$1,899.00",$138.12,"$2,532.00",$138.12,"$2,456.04",$138.12,"$2,164.86",$138.12,"$2,117.70",$138.12,"$2,456.04",$138.12,"$2,532.00",$138.12,$138.12,"$2,456.04"
27244AS45A,0975,27244,,,,,N/A,N/A,"Treatment, Thigh Frx        ~t",$0.00,$0.00,$16.26,"$2,586.00",$16.26,"$2,508.42",$16.26,"$2,211.03",$16.26,"$2,178.93",$16.26,"$2,508.42",$16.26,"$2,586.00",$16.26,$16.26,"$2,508.42"
27244AS45B,0975,27244,,,,,N/A,N/A,"TREATMENT, THIGH FRX        ~P","$2,609.12","$1,939.50",$16.26,"$2,586.00",$16.26,"$2,508.42",$16.26,"$2,211.03",$16.26,"$2,178.93",$16.26,"$2,508.42",$16.26,"$2,586.00",$16.26,$16.26,"$2,508.42"
2724545AS,0975,27245,,,,,N/A,N/A,"TREATMENT, THIGH FRX       ~AS","$3,266.95","$2,428.50","$1,327.58","$3,238.00","$1,327.58","$3,140.86","$1,327.58","$2,768.49","$1,327.58","$2,176.95","$1,327.58","$3,140.86","$1,327.58","$3,238.00","$1,327.58","$1,327.58","$3,140.86"
27245AS45,0975,27245,,,,,N/A,N/A,"TREATMENT, THIGH FRX       ~AS","$3,266.95","$2,428.50","$1,327.58","$3,238.00","$1,327.58","$3,140.86","$1,327.58","$2,768.49","$1,327.58","$2,176.95","$1,327.58","$3,140.86","$1,327.58","$3,238.00","$1,327.58","$1,327.58","$3,140.86"
27305AS45,0975,27305,,,,,N/A,N/A,INCISE THIGH TEND & FASCIA ~AS,$901.99,$670.50,$366.54,$894.00,$366.54,$867.18,$366.54,$764.37,$366.54,$864.42,$366.54,$867.18,$366.54,$894.00,$366.54,$366.54,$867.18
2731045AS,0975,27310,,,,,N/A,N/A,EXPLORATION OF KNEE JOINT  ~AS,"$1,609.26","$1,196.25",$653.95,"$1,595.00",$653.95,"$1,547.15",$653.95,"$1,363.73",$653.95,"$1,306.80",$653.95,"$1,547.15",$653.95,"$1,595.00",$653.95,$653.95,"$1,547.15"
2733245AS,0975,27332,,,,,N/A,N/A,RESECTION PROC THIGH/KNEE ~AS,"$1,297.50",$964.50,$527.26,"$1,286.00",$527.26,"$1,247.42",$527.26,"$1,099.53",$527.26,"$1,155.08",$527.26,"$1,247.42",$527.26,"$1,286.00",$527.26,$527.26,"$1,247.42"
2733445AS,0975,27334,,,,,N/A,N/A,REMOVE KNEE JOINT LINING   ~AS,"$1,536.62","$1,142.25",$624.43,"$1,523.00",$624.43,"$1,477.31",$624.43,"$1,302.17",$624.43,"$1,226.00",$624.43,"$1,477.31",$624.43,"$1,523.00",$624.43,$624.43,"$1,477.31"
2733545AS,0975,27335,,,,,N/A,N/A,RESECTION PROC THIGH/KNEE  ~AS,"$1,524.51","$1,133.25",$619.51,"$1,511.00",$619.51,"$1,465.67",$619.51,"$1,291.91",$619.51,"$1,367.13",$619.51,"$1,465.67",$619.51,"$1,511.00",$619.51,$619.51,"$1,465.67"
27337AS45,0975,27337,,,,,N/A,N/A,EXC THIGH/KNEE LES>3CM     ~AS,$808.16,$600.75,$328.41,$742.65,$328.41,$574.24,$328.41,$506.16,$328.41,$742.65,$328.41,$574.24,$328.41,$592.00,$328.41,$328.41,$574.24
27345AS45,0975,27345,,,,,N/A,N/A,REMOVAL OF KNEE CYST        ~G,"$1,107.82",$823.50,$45.18,"$1,098.00",$45.18,"$1,065.06",$45.18,$938.79,$45.18,$869.73,$45.18,"$1,065.06",$45.18,"$1,098.00",$45.18,$45.18,"$1,065.06"
27350AS45,0975,27350,,,,,N/A,N/A,PATELLECTOMY OR HEMI       ~AS,"$1,313.64",$976.50,$533.82,"$1,302.00",$533.82,"$1,262.94",$533.82,"$1,113.21",$533.82,"$1,169.35",$533.82,"$1,262.94",$533.82,"$1,302.00",$533.82,$533.82,"$1,262.94"
27355AS45,0975,27355,,,,,N/A,N/A,REMOVE FEMUR LESION        ~AS,"$1,374.18","$1,021.50",$558.42,"$1,362.00",$558.42,"$1,321.14",$558.42,"$1,164.51",$558.42,"$1,085.40",$558.42,"$1,321.14",$558.42,"$1,362.00",$558.42,$558.42,"$1,321.14"
27360AS45,0975,27360,,,,,N/A,N/A,"PART EXCIS BONE, FEMR,TIB  ~AS","$1,625.40","$1,208.25",$66.51,"$1,611.00",$66.51,"$1,562.67",$66.51,"$1,377.41",$66.51,"$1,607.43",$66.51,"$1,562.67",$66.51,"$1,611.00",$66.51,$66.51,"$1,562.67"
2738045AS,0975,27380,,,,,N/A,N/A,TENDON REPAIR   ~AS,"$1,372.16","$1,020.00",$557.60,"$1,360.00",$557.60,"$1,319.20",$557.60,"$1,162.80",$557.60,"$1,116.10",$557.60,"$1,319.20",$557.60,"$1,360.00",$557.60,$557.60,"$1,319.20"
2738545AS,0975,27385,,,,,N/A,N/A,REPAIR THIGH MUSCLE        ~AS,"$1,464.98","$1,089.00",$595.32,"$1,452.00",$595.32,"$1,408.44",$595.32,"$1,241.46",$595.32,"$1,087.66",$595.32,"$1,408.44",$595.32,"$1,452.00",$595.32,$595.32,"$1,408.44"
27385AS45,0975,27385,,,,,N/A,N/A,REPAIR THIGH MUSCLE        ~AS,"$1,464.98","$1,089.00",$595.32,"$1,452.00",$595.32,"$1,408.44",$595.32,"$1,241.46",$595.32,"$1,087.66",$595.32,"$1,408.44",$595.32,"$1,452.00",$595.32,$595.32,"$1,408.44"
27386AS45,0975,27386,,,,,N/A,N/A,REPAIR/GRAFT OF THIGH MUSCL~AS,"$1,911.94","$1,421.25",$776.95,"$1,895.00",$776.95,"$1,838.15",$776.95,"$1,620.23",$776.95,"$1,536.11",$776.95,"$1,838.15",$776.95,"$1,895.00",$776.95,$776.95,"$1,838.15"
27405AS45,0975,27405,,,,,N/A,N/A,REPAIR OF KNEE LIGAMENT    ~AS,"$1,291.44",$960.00,$524.80,"$1,280.00",$524.80,"$1,241.60",$524.80,"$1,094.40",$524.80,"$1,209.76",$524.80,"$1,241.60",$524.80,"$1,280.00",$524.80,$524.80,"$1,241.60"
2740945AS,0975,27409,,,,,N/A,N/A,REPAIR/RECON OF FEMUR/KNEE~AS,"$1,946.25","$1,446.75",$79.89,"$1,929.00",$79.89,"$1,871.13",$79.89,"$1,649.30",$79.89,"$1,722.59",$79.89,"$1,871.13",$79.89,"$1,929.00",$79.89,$79.89,"$1,871.13"
2741845AS,0975,27418,,,,,N/A,N/A,REPAIR DEGENERATED KNEECAP ~AS,"$1,886.72","$1,402.50",$766.70,"$1,940.00",$766.70,"$1,881.80",$766.70,"$1,658.70",$766.70,"$1,483.96",$766.70,"$1,881.80",$766.70,"$1,940.00",$766.70,$766.70,"$1,881.80"
27427AS45,0975,27427,,,,,N/A,N/A,RECONSTRUCTION KNEE        ~AS,"$1,638.52","$1,218.00",$665.84,"$1,624.00",$665.84,"$1,575.28",$665.84,"$1,388.52",$665.84,"$1,273.76",$665.84,"$1,575.28",$665.84,"$1,624.00",$665.84,$665.84,"$1,575.28"
27249AS45,0975,27429,,,,,N/A,N/A,"RECONSTRUCTION, KNEE       ~AS","$2,668.65","$1,983.75",$184.45,"$2,645.00",$184.45,"$2,565.65",$184.45,"$2,261.48",$184.45,"$2,235.51",$184.45,"$2,565.65",$184.45,"$2,645.00",$184.45,$184.45,"$2,565.65"
27429AS45,0975,27429,,,,,N/A,N/A,"RECOMSTRUCTION,KNEE        ~AS","$2,668.65","$1,983.75",$184.45,"$2,645.00",$184.45,"$2,565.65",$184.45,"$2,261.48",$184.45,"$2,235.51",$184.45,"$2,565.65",$184.45,"$2,645.00",$184.45,$184.45,"$2,565.65"
27430AS45,0975,27430,,,,,N/A,N/A,"REPAIR, QUADRICEPSPLATY    ~AS","$1,412.52","$1,050.00",$574.00,"$1,400.00",$574.00,"$1,358.00",$574.00,"$1,197.00",$574.00,"$1,325.84",$574.00,"$1,358.00",$574.00,"$1,400.00",$574.00,$574.00,"$1,358.00"
27437AS45,0975,27437,,,,,N/A,N/A,"ARTHROPLASTY,PATELLA       ~AS","$1,001.88",$744.75,$47.13,"$1,182.09",$47.13,$963.21,$47.13,$849.02,$47.13,"$1,182.09",$47.13,$963.21,$47.13,$993.00,$47.13,$47.13,$963.21
27438AS45,0975,27438,,,,,N/A,N/A,REPAIR/RECONST FEMUR/KNEE  ~AS,"$1,696.03","$1,260.75",$689.21,"$1,681.00",$689.21,"$1,630.57",$689.21,"$1,437.26",$689.21,"$1,497.85",$689.21,"$1,630.57",$689.21,"$1,681.00",$689.21,$689.21,"$1,630.57"
27441AS45,0975,27441,,,,,N/A,N/A,REVISION OF KNEE JOINT     ~AS,"$1,684.93","$1,252.50",$684.70,"$1,670.00",$684.70,N/A,$684.70,"$1,427.85",$684.70,"$1,468.22",$684.70,N/A,$684.70,"$1,670.00",$684.70,$684.70,N/A
27442AS45,0975,27442,,,,,N/A,N/A,REVISION OF KNEE JOINT     ~AS,"$1,991.65","$1,480.50",$89.34,"$1,974.00",$89.34,"$1,914.78",$89.34,"$1,687.77",$89.34,"$1,550.91",$89.34,"$1,914.78",$89.34,"$1,974.00",$89.34,$89.34,"$1,914.78"
27443AS45,0975,27443,,,,,N/A,N/A,REVISION OF KNEE JOINT     ~AS,"$1,877.64","$1,395.75",$763.10,"$1,861.00",$763.10,"$1,805.17",$763.10,"$1,687.77",$763.10,"$1,455.56",$763.10,"$1,805.17",$763.10,"$1,861.00",$763.10,$763.10,"$1,805.17"
27446AS45,0975,27446,,,,,N/A,N/A,REVISION OF KNEE JOINT     ~AS,"$2,600.04","$1,932.75",$156.57,"$5,277.00",$156.57,"$5,118.69",$156.57,"$4,511.84",$156.57,"$2,046.18",$156.57,"$5,118.69",$156.57,"$5,277.00",$156.57,$156.57,"$5,118.69"
2744745AS,0975,27447,,,,,N/A,N/A,TOTAL KNEE ARTHROPLASTY    ~AS,"$4,035.76","$3,000.00",$164.00,"$4,000.00",$164.00,"$3,880.00",$164.00,"$3,420.00",$164.00,"$2,274.40",$164.00,"$3,880.00",$164.00,"$4,000.00",$164.00,$164.00,"$3,880.00"
27447AS45,0975,27447,,,,,N/A,N/A,TOTAL KNEE ARTHROPLASTY    ~AS,"$4,035.76","$3,000.00",$164.00,"$4,000.00",$164.00,"$3,880.00",$164.00,"$3,420.00",$164.00,"$2,274.40",$164.00,"$3,880.00",$164.00,"$4,000.00",$164.00,$164.00,"$3,880.00"
27450AS45,0975,27450,,,,,N/A,N/A,INCISION OF THIGH          ~AS,"$2,348.81","$1,746.00",$954.48,"$2,328.00",$954.48,"$2,258.16",$954.48,"$1,990.44",$954.48,"$1,807.24",$954.48,"$2,258.16",$954.48,"$2,328.00",$954.48,$954.48,"$2,258.16"
2745545AS,0975,27455,,,,,N/A,N/A,REALIGNMENT OF KNEE        ~AS,"$2,171.24","$1,614.00",$882.32,"$2,152.00",$882.32,"$2,087.44",$882.32,"$1,839.96",$882.32,"$1,708.43",$882.32,"$2,087.44",$882.32,"$2,152.00",$882.32,$882.32,"$2,087.44"
2747045AS,0975,27470,,,,,N/A,N/A,REPAIR OF THIGH            ~AS,"$2,666.63","$1,982.25",$183.63,"$2,643.00",$183.63,"$2,563.71",$183.63,"$2,259.77",$183.63,"$2,093.29",$183.63,"$2,563.71",$183.63,"$2,643.00",$183.63,$183.63,"$2,563.71"
27472AS45,0975,27472,,,,,N/A,N/A,REPAIR/GRAFT OF THIGH      ~AS,"$2,909.78","$2,163.00","$1,182.44","$2,884.00","$1,182.44","$2,797.48","$1,182.44","$2,465.82","$1,182.44","$2,242.67","$1,182.44","$2,797.48","$1,182.44","$2,884.00","$1,182.44","$1,182.44","$2,797.48"
27477AS45,0975,27477,,,,,N/A,N/A,TIBIA & FIBULA PROXIMAL    ~AS,"$1,475.07","$1,096.50",$599.42,"$1,462.00",$599.42,"$1,418.14",$599.42,"$1,250.01",$599.42,"$1,308.85",$599.42,"$1,418.14",$599.42,"$1,462.00",$599.42,$599.42,"$1,418.14"
2748645AS,0975,27486,,,,,N/A,N/A,REVISE/REPLACE KNEE JOINT  ~AS,"$3,140.83","$2,334.75","$1,276.33","$3,113.00","$1,276.33","$3,019.61","$1,276.33","$2,661.62","$1,276.33","$2,489.29","$1,276.33","$3,019.61","$1,276.33","$3,113.00","$1,276.33","$1,276.33","$3,019.61"
2748745AS,0975,27487,,,,,N/A,N/A,REVISE/REPLACE KNEE JOINT  ~AS,"$4,014.57","$2,984.25","$1,631.39","$3,979.00","$1,631.39","$3,859.63","$1,631.39","$3,402.05","$1,631.39","$3,102.29","$1,631.39","$3,859.63","$1,631.39","$3,979.00","$1,631.39","$1,631.39","$3,859.63"
27487AS45,0975,27487,,,,,N/A,N/A,REVISE/REPLACE KNEE JOINT  ~AS,"$4,014.57","$2,984.25","$1,631.39","$3,979.00","$1,631.39","$3,859.63","$1,631.39","$3,402.05","$1,631.39","$3,102.29","$1,631.39","$3,859.63","$1,631.39","$3,979.00","$1,631.39","$1,631.39","$3,859.63"
2748845AS,0975,27488,,,,,N/A,N/A,REMOVAL OF KNEE PROSTHESIS ~AS,"$2,627.28","$1,953.00",$167.64,"$2,604.00",$167.64,"$2,525.88",$167.64,"$2,226.42",$167.64,"$2,129.82",$167.64,"$2,525.88",$167.64,"$2,604.00",$167.64,$167.64,"$2,525.88"
27495AS45,0975,27495,,,,,N/A,N/A,REINFORCE THIGH            ~AS,"$2,581.88","$1,919.25",$149.19,"$2,559.00",$149.19,"$2,482.23",$149.19,"$2,187.95",$149.19,"$2,006.28",$149.19,"$2,482.23",$149.19,"$2,559.00",$149.19,$149.19,"$2,482.23"
2750645AS,0975,27506,,,,,N/A,N/A,"TREATMENT, THIGH FRX       ~AS","$2,892.63","$2,150.25","$1,175.47","$2,867.00","$1,175.47","$2,780.99","$1,175.47","$2,451.29","$1,175.47","$2,372.89","$1,175.47","$2,780.99","$1,175.47","$2,867.00","$1,175.47","$1,175.47","$2,780.99"
27507AS45,0975,27507,,,,,N/A,N/A,OPEN TREATMENT FEMORAL FX  ~AS,"$1,874.61","$1,393.50",$761.78,"$1,858.00",$761.78,"$1,802.26",$761.78,"$1,588.59",$761.78,"$1,719.64",$761.78,"$1,802.26",$761.78,"$1,858.00",$761.78,$761.78,"$1,802.26"
27511AS45,0975,27511,,,,,N/A,N/A,TREATMENT OF FEMORAL       ~AS,"$1,408.48","$1,047.00",$572.36,"$1,768.82",$572.36,"$1,354.12",$572.36,"$1,193.58",$572.36,"$1,768.82",$572.36,"$1,354.12",$572.36,"$1,396.00",$572.36,$572.36,"$1,354.12"
2751345AS,0975,27513,,,,,N/A,N/A,"TREATMENT, THIGH FRX       ~AS","$3,038.93","$2,259.00","$1,234.92","$3,012.00","$1,234.92","$2,921.64","$1,234.92","$2,575.26","$1,234.92","$2,191.13","$1,234.92","$2,921.64","$1,234.92","$3,012.00","$1,234.92","$1,234.92","$2,921.64"
27514AS45,0975,27514,,,,,N/A,N/A,OPEN TREAT OF FEMORAL FX   ~AS,"$1,949.27","$1,449.00",$792.12,"$1,932.00",$792.12,"$1,874.04",$792.12,"$1,651.86",$792.12,"$1,716.21",$792.12,"$1,874.04",$792.12,"$1,932.00",$792.12,$792.12,"$1,874.04"
2752445AS,0975,27524,,,,,N/A,N/A,"TREATMENT, KNEECAP FRX     ~AS","$1,741.43","$1,294.50",$77.66,"$1,726.00",$77.66,"$1,674.22",$77.66,"$1,475.73",$77.66,"$1,344.24",$77.66,"$1,674.22",$77.66,"$1,726.00",$77.66,$77.66,"$1,674.22"
27524AS45,0975,27524,,,,,N/A,N/A,"TREATMENT, KNEECAP FRX     ~AS","$1,741.43","$1,294.50",$77.66,"$1,726.00",$77.66,"$1,674.22",$77.66,"$1,475.73",$77.66,"$1,344.24",$77.66,"$1,674.22",$77.66,"$1,726.00",$77.66,$77.66,"$1,674.22"
27535AS45,0975,27535,,,,,N/A,N/A,TREATMENT OPEN FX TIBIAL   ~AS,"$1,818.11","$1,351.50",$738.82,"$1,802.00",$738.82,"$1,747.94",$738.82,"$1,540.71",$738.82,"$1,595.11",$738.82,"$1,747.94",$738.82,"$1,802.00",$738.82,$738.82,"$1,747.94"
27536AS45,0975,27536,,,,,N/A,N/A,TREATMENT OF FX            ~AS,"$2,413.38","$1,794.00",$98.72,"$2,392.00",$98.72,"$2,320.24",$98.72,"$2,045.16",$98.72,"$2,103.70",$98.72,"$2,320.24",$98.72,"$2,392.00",$98.72,$98.72,"$2,320.24"
2754045AS,0975,27540,,,,,N/A,N/A,TREAT KNEE FRACTURE        ~AS,"$2,164.18","$1,608.75",$879.45,"$2,145.00",$879.45,"$2,080.65",$879.45,"$1,833.98",$879.45,"$1,451.89",$879.45,"$2,080.65",$879.45,"$2,145.00",$879.45,$879.45,"$2,080.65"
2759045AS,0975,27590,,,,,N/A,N/A,AMPUTATION AT FEMUR OR KNEE~AS,"$1,621.37","$1,205.25",$658.87,"$1,607.00",$658.87,"$1,558.79",$658.87,"$1,373.99",$658.87,"$1,371.97",$658.87,"$1,558.79",$658.87,"$1,607.00",$658.87,$658.87,"$1,558.79"
27606AS45,0975,27606,,,,,N/A,N/A,INCISION OF ACHILLES TENDON~AS,$716.35,$532.50,$291.10,$710.00,$291.10,$688.70,$291.10,$607.05,$291.10,$490.01,$291.10,$688.70,$291.10,$710.00,$291.10,$291.10,$688.70
2762045AS,0975,27620,,,,,N/A,N/A,EXPLOR/TREAT ANKLE LOINT   ~AS,"$1,036.18",$770.25,$441.16,"$1,027.00",$441.16,$996.19,$441.16,$878.09,$441.16,$809.48,$441.16,$996.19,$441.16,"$1,027.00",$441.16,$441.16,$996.19
27632AS45,0975,27632,,,,,N/A,N/A,EXC LEG/ANKLE LES SC 3 CM/>~AS,$817.24,$607.50,$332.10,$810.00,$332.10,$785.70,$332.10,$692.55,$332.10,$731.88,$332.10,$785.70,$332.10,$810.00,$332.10,$332.10,$785.70
27634AS45,0975,27634,,,,,N/A,N/A,EXC LEG/ANKLE TUM DEP 5 CM/~AS,"$1,347.94","$1,002.00",$547.76,"$1,336.00",$547.76,"$1,295.92",$547.76,"$1,142.28",$547.76,"$1,203.82",$547.76,"$1,295.92",$547.76,"$1,336.00",$547.76,$547.76,"$1,295.92"
27637AS45,0975,27637,,,,,N/A,N/A,REMOVE/GRAFT LEG BONE LESIO~AS,"$1,729.32","$1,285.50",$72.74,"$1,714.00",$72.74,"$1,662.58",$72.74,"$1,465.47",$72.74,"$1,325.48",$72.74,"$1,662.58",$72.74,"$1,714.00",$72.74,$72.74,"$1,662.58"
27640AS45,0975,27640,,,,,N/A,N/A,PARTIAL REMOVAL OF TIBIA   ~AS,"$2,058.24","$1,530.00",$836.40,"$2,040.00",$836.40,"$1,978.80",$836.40,"$1,744.20",$836.40,"$1,483.30",$836.40,"$1,978.80",$836.40,"$2,040.00",$836.40,$836.40,"$1,978.80"
2765045AS,0975,27650,,,,,N/A,N/A,REPAIR ACHILLES TENDON     ~AS,"$1,641.55","$1,220.25",$667.70,"$1,627.00",$667.70,"$1,578.19",$667.70,"$1,391.09",$667.70,"$1,182.58",$667.70,"$1,578.19",$667.70,"$1,627.00",$667.70,$667.70,"$1,578.19"
2765445AS,0975,27654,,,,,N/A,N/A,REPAIR/RECON LOWER LEG     ~AS,"$1,444.80","$1,074.00",$587.12,"$1,432.00",$587.12,"$1,389.04",$587.12,"$1,224.36",$587.12,"$1,274.95",$587.12,"$1,389.04",$587.12,"$1,432.00",$587.12,$587.12,"$1,389.04"
27658AS45,0975,27658,,,,,N/A,N/A,"REPAIR, FLEXORTENDON, LEG  ~AS",$862.64,$641.25,$35.55,$855.00,$35.55,$829.35,$35.55,$731.03,$35.55,$664.00,$35.55,$829.35,$35.55,$855.00,$35.55,$35.55,$829.35
27676AS45,0975,27676,,,,,N/A,N/A,"REPR,DSLCPRSNL TENDW/FIB OS~AS","$1,202.66",$894.00,$488.72,"$1,192.00",$488.72,"$1,156.24",$488.72,"$1,019.16",$488.72,"$1,071.91",$488.72,"$1,156.24",$488.72,"$1,192.00",$488.72,$488.72,"$1,156.24"
2768745AS,0975,27687,,,,,N/A,N/A,REVISION OF CALF TENDON    ~AS,"$1,098.74",$816.75,$446.49,"$1,089.00",$446.49,"$1,056.33",$446.49,$931.10,$446.49,$814.76,$446.49,"$1,056.33",$446.49,"$1,089.00",$446.49,$446.49,"$1,056.33"
27691AS45,0975,27691,,,,,N/A,N/A,REPAIR/RECONST LEG/ANKLE   ~AS,"$1,518.45","$1,128.75",$617.50,"$1,505.00",$617.50,"$1,459.85",$617.50,"$1,286.78",$617.50,"$1,332.52",$617.50,"$1,459.85",$617.50,"$1,505.00",$617.50,$617.50,"$1,459.85"
27720AS45,0975,27720,,,,,N/A,N/A,REPAIR OF TIBIA            ~AS,"$2,023.93","$1,504.50",$822.46,"$2,006.00",$822.46,"$1,945.82",$822.46,"$1,715.13",$822.46,"$1,560.00",$822.46,"$1,945.82",$822.46,"$2,006.00",$822.46,$822.46,"$1,945.82"
27756AS45,0975,27756,,,,,N/A,N/A,PRCTNEOUS SKLTAL FIX OF TIB~AS,"$1,120.93",$833.25,$455.51,"$1,111.00",$455.51,"$1,077.67",$455.51,$949.91,$455.51,"$1,033.60",$455.51,"$1,077.67",$455.51,"$1,111.00",$455.51,$455.51,"$1,077.67"
27758AS45,0975,27758,,,,,N/A,N/A,OPEN TRTMENT TIBIAL SHFT FX~AS,"$1,729.32","$1,285.50",$72.74,"$1,714.00",$72.74,"$1,662.58",$72.74,"$1,465.47",$72.74,"$1,596.00",$72.74,"$1,662.58",$72.74,"$1,714.00",$72.74,$72.74,"$1,662.58"
2775945AS,0975,27759,,,,,N/A,N/A,"TREATMENT,OF TIBIAL SHAFT FX~A","$2,302.40","$1,711.50",$935.62,"$2,282.00",$935.62,"$2,213.54",$935.62,"$1,951.11",$935.62,"$1,774.28",$935.62,"$2,213.54",$935.62,"$2,282.00",$935.62,$935.62,"$2,213.54"
27759AS45,0975,27759,,,,,N/A,N/A,TREATMENT OF TIBIAL SHAFT FX~P,"$1,390.32","$1,033.50",$935.62,"$2,282.00",$935.62,"$2,213.54",$935.62,"$1,951.11",$935.62,"$1,774.28",$935.62,"$2,213.54",$935.62,"$2,282.00",$935.62,$935.62,"$2,213.54"
2779245AS,0975,27792,,,,,N/A,N/A,TREATMENT OF ANKLE FRACTURE~AS,"$1,392.34","$1,035.00",$565.80,"$1,380.00",$565.80,"$1,338.60",$565.80,"$1,179.90",$565.80,"$1,156.52",$565.80,"$1,338.60",$565.80,"$1,380.00",$565.80,$565.80,"$1,338.60"
2781445AS,0975,27814,,,,,N/A,N/A,TREATMENT OF ANKLE FRACTURE~AS,"$1,838.29","$1,366.50",$747.20,"$1,822.00",$747.20,"$1,767.34",$747.20,"$1,557.81",$747.20,"$1,367.87",$747.20,"$1,767.34",$747.20,"$1,822.00",$747.20,$747.20,"$1,767.34"
27814AS45,0975,27814,,,,,N/A,N/A,TREATMENT OF ANKLE FRACTURE~AS,"$1,838.29","$1,366.50",$747.20,"$1,822.00",$747.20,"$1,767.34",$747.20,"$1,557.81",$747.20,"$1,367.87",$747.20,"$1,767.34",$747.20,"$1,822.00",$747.20,$747.20,"$1,767.34"
2782245AS,0975,27822,,,,,N/A,N/A,TREATMENT OF ANKLE FRACTURE~AS,"$2,057.23","$1,529.25",$835.99,"$2,039.00",$835.99,"$1,977.83",$835.99,"$1,743.35",$835.99,"$1,570.90",$835.99,"$1,977.83",$835.99,"$2,039.00",$835.99,$835.99,"$1,977.83"
27822AS45,0975,27822,,,,,N/A,N/A,TREATMENT OF ANKLE FRACTURE~AS,"$2,057.23","$1,529.25",$835.99,"$2,039.00",$835.99,"$1,977.83",$835.99,"$1,743.35",$835.99,"$1,570.90",$835.99,"$1,977.83",$835.99,"$2,039.00",$835.99,$835.99,"$1,977.83"
2782345AS,0975,27823,,,,,N/A,N/A,TREATMENT OF FRACTURE      ~AS,"$1,932.12","$1,436.25",$785.15,"$1,915.00",$785.15,"$1,857.55",$785.15,"$1,637.33",$785.15,"$1,765.45",$785.15,"$1,857.55",$785.15,"$1,915.00",$785.15,$785.15,"$1,857.55"
27823AS45,0975,27823,,,,,N/A,N/A,TREAT OF FX W/FIXATION     ~AS,"$1,912.95","$1,422.00",$785.15,"$1,915.00",$785.15,"$1,857.55",$785.15,"$1,637.33",$785.15,"$1,765.45",$785.15,"$1,857.55",$785.15,"$1,915.00",$785.15,$785.15,"$1,857.55"
27827AS45,0975,27827,,,,,N/A,N/A,TREATMENT OF FX OF TIBIA  ~AS,"$2,183.35","$1,623.00",$887.24,"$2,164.00",$887.24,"$2,099.08",$887.24,"$1,850.22",$887.24,"$2,003.42",$887.24,"$2,099.08",$887.24,"$2,164.00",$887.24,$887.24,"$2,099.08"
27828AS45,0975,27828,,,,,N/A,N/A,TREATMENT OF FX/DISLOC FOOT~AS,"$2,615.17","$1,944.00",$162.72,"$2,592.00",$162.72,"$2,514.24",$162.72,"$2,216.16",$162.72,"$2,370.79",$162.72,"$2,514.24",$162.72,"$2,592.00",$162.72,$162.72,"$2,514.24"
2782945AS,0975,27829,,,,,N/A,N/A,TREAT LOWER LEG JOINT      ~AS,"$1,159.27",$861.75,$471.90,"$1,275.22",$471.90,"$1,114.53",$471.90,$982.40,$471.90,"$1,275.22",$471.90,"$1,114.53",$471.90,"$1,149.00",$471.90,$471.90,"$1,114.53"
27848AS45,0975,27848,,,,,N/A,N/A,TREAT ANKLE DISLOCATION    ~AS,"$1,991.65","$1,480.50",$89.34,$89.34,$89.34,N/A,$89.34,N/A,$89.34,N/A,$89.34,N/A,$89.34,N/A,$89.34,$89.34,N/A
27870AS45,0975,27870,,,,,N/A,N/A,"FUSION OF ANKLE JOINT, OPEN~AS","$2,335.70","$1,736.25",$949.15,$949.15,$949.15,N/A,$949.15,N/A,$949.15,N/A,$949.15,N/A,$949.15,N/A,$949.15,$949.15,N/A
27880AS40,0975,27880,,,,,N/A,N/A,AMPUTATION OF LOWER LEG    ~AS,"$1,812.06","$1,347.00",$736.36,"$2,315.00",$736.36,"$2,245.55",$736.36,"$1,979.33",$736.36,"$1,573.34",$736.36,"$2,245.55",$736.36,"$2,315.00",$736.36,$736.36,"$2,245.55"
28039AS45,0975,28039,,,,,N/A,N/A,EXCISION 1.5CM OR >        ~AS,$668.93,$497.25,$271.83,$663.00,$271.83,$643.11,$271.83,$566.87,$271.83,$618.69,$271.83,$643.11,$271.83,$663.00,$271.83,$271.83,$643.11
2810345AS,0975,28103,,,,,N/A,N/A,RESECTION PROC  FOOT/TOES  ~AS,$801.10,$595.50,$325.54,$764.00,$325.54,$741.08,$325.54,$653.22,$325.54,$697.19,$325.54,$741.08,$325.54,$764.00,$325.54,$325.54,$741.08
2811445AS,0975,28114,,,,,N/A,N/A,PART REMOVAL OF METATARSAL ~AS,"$1,721.25","$1,279.50","$1,492.23","$1,706.00",N/A,"$1,654.82",N/A,"$1,458.63",N/A,"$1,492.23",N/A,"$1,654.82",N/A,"$1,706.00",N/A,N/A,"$1,654.82"
2811845AS,0975,28118,,,,,N/A,N/A,REMOVAL OF HEEL BONE       ~AS,$797.06,$592.50,$397.70,$970.00,$397.70,$940.90,$397.70,$829.35,$397.70,$750.92,$397.70,$940.90,$397.70,$970.00,$397.70,$397.70,$940.90
28119AS45,0975,28119,,,,,N/A,N/A,"EXCISION, FOR SPUR         ~AS",$707.27,$525.75,$287.41,$701.00,$287.41,$679.97,$287.41,$599.36,$287.41,$648.64,$287.41,$679.97,$287.41,$701.00,$287.41,$287.41,$679.97
2828945AS,0975,28289,,,,,N/A,N/A,REPAIR OF HALLUX RIGIDUS   ~AS,"$1,212.75",$901.50,$492.82,"$1,202.00",$492.82,"$1,165.94",$492.82,"$1,027.71",$492.82,$820.25,$492.82,"$1,165.94",$492.82,"$1,202.00",$492.82,$492.82,"$1,165.94"
28289AS45,0975,28289,,,,,N/A,N/A,REPAIR OF HALLUX RIGIDUS   ~AS,"$1,212.75",$901.50,$492.82,"$1,202.00",$492.82,"$1,165.94",$492.82,"$1,027.71",$492.82,$820.25,$492.82,"$1,165.94",$492.82,"$1,202.00",$492.82,$492.82,"$1,165.94"
2829645AS,0975,28296,,,,,N/A,N/A,CORRECTION BUNION          ~AS,"$1,387.29","$1,031.25",$563.75,"$1,375.00",$563.75,"$1,333.75",$563.75,"$1,175.63",$563.75,$918.57,$563.75,"$1,333.75",$563.75,"$1,375.00",$563.75,$563.75,"$1,333.75"
2829745AS,0975,28297,,,,,N/A,N/A,CORRECTION OF BUNION       ~AS,"$1,469.02","$1,092.00",$596.96,"$1,502.00",$596.96,"$1,456.94",$596.96,"$1,284.21",$596.96,"$1,078.57",$596.96,"$1,456.94",$596.96,"$1,502.00",$596.96,$596.96,"$1,456.94"
28300AS45,0975,28300,,,,,N/A,N/A,INCISION OF HEEL BONE      ~AS,"$1,583.03","$1,176.75",$643.29,"$1,569.00",$643.29,"$1,521.93",$643.29,"$1,341.50",$643.29,"$1,161.14",$643.29,"$1,521.93",$643.29,"$1,569.00",$643.29,$643.29,"$1,521.93"
28322AS45,0975,28322,,,,,N/A,N/A,REPAIR/RECONST OF FOOT    ~AS,"$1,181.47",$878.25,$48.11,"$1,171.00",$48.11,"$1,135.87",$48.11,"$1,001.21",$48.11,"$1,030.52",$48.11,"$1,135.87",$48.11,"$1,171.00",$48.11,$48.11,"$1,135.87"
28445AS45,0975,28445,,,,,N/A,N/A,TREAT ANKLE FRACTURE       ~AS,"$2,549.59","$1,895.25",$136.70,"$2,527.00",$136.70,"$2,451.19",$136.70,"$2,160.59",$136.70,"$1,830.34",$136.70,"$2,451.19",$136.70,"$2,527.00",$136.70,$136.70,"$2,451.19"
28705AS45,0975,28705,,,,,N/A,N/A,ARTHRODESIS PANTALAR       ~AS,"$1,998.71","$1,485.75",$812.21,"$2,167.93",$812.21,"$1,921.57",$812.21,"$1,693.76",$812.21,"$2,167.93",$812.21,"$1,921.57",$812.21,"$1,981.00",$812.21,$812.21,"$1,921.57"
28715AS45,0975,28715,,,,,N/A,N/A,FUSION OF FOOT BONES       ~AS,"$2,182.34","$1,622.25",$886.83,"$2,163.00",$886.83,"$2,098.11",$886.83,"$1,849.37",$886.83,"$1,680.91",$886.83,"$2,098.11",$886.83,"$2,163.00",$886.83,$886.83,"$2,098.11"
28725AS45,0975,28725,,,,,N/A,N/A,ARTHRODESIS FOOT/TOE SUBTAL~AS,"$1,558.81","$1,158.75",$633.45,"$1,546.00",$633.45,"$1,499.62",$633.45,"$1,321.83",$633.45,"$1,388.80",$633.45,"$1,499.62",$633.45,"$1,546.00",$633.45,$633.45,"$1,499.62"
28730AS45,0975,28730,,,,,N/A,N/A,FUSION OF FOOT BONES       ~AS,"$1,830.22","$1,360.50",$743.74,"$1,814.00",$743.74,"$1,759.58",$743.74,"$1,550.97",$743.74,"$1,312.57",$743.74,"$1,759.58",$743.74,"$1,814.00",$743.74,$743.74,"$1,759.58"
2875045AS,0975,28750,,,,,N/A,N/A,FUSION OF BIG TOE JOINT    ~AS,"$1,430.68","$1,063.50",$581.38,"$1,418.00",$581.38,"$1,375.46",$581.38,"$1,212.39",$581.38,"$1,040.51",$581.38,"$1,375.46",$581.38,"$1,418.00",$581.38,$581.38,"$1,375.46"
29822AS45,0975,29822,,,,,N/A,N/A,"DEBRIDEMENT,LIMITED        ~AS","$1,150.19",$855.00,$467.40,"$1,140.00",$467.40,"$1,105.80",$467.40,$974.70,$467.40,$970.19,$467.40,"$1,105.80",$467.40,"$1,140.00",$467.40,$467.40,"$1,105.80"
29823AS45,0975,29823,,,,,N/A,N/A,"DEBRIDEMENT, EXTENSIVE     ~AS","$1,257.14",$934.50,$51.86,"$1,246.00",$51.86,"$1,208.62",$51.86,"$1,065.33",$51.86,"$1,060.96",$51.86,"$1,208.62",$51.86,"$1,246.00",$51.86,$51.86,"$1,208.62"
29824AS45,0975,29824,,,,,N/A,N/A,SHOULDER ARTHROSCOPY/SURG  ~AS,"$1,502.31","$1,116.75",$61.49,"$1,489.00",$61.49,"$1,444.33",$61.49,"$1,273.10",$61.49,"$1,210.58",$61.49,"$1,444.33",$61.49,"$1,489.00",$61.49,$61.49,"$1,444.33"
2982645AS,0975,29826,,,,,N/A,N/A,SHOULDER ARTHROSCOPY SURGRY~AS,"$1,576.97","$1,172.25",$64.83,$64.83,$64.83,N/A,$64.83,N/A,$64.83,N/A,$64.83,N/A,$64.83,N/A,$64.83,$64.83,N/A
29827AS45,0975,29827,,,,,N/A,N/A,ARTHO PROCW/ROT CUFF REPAIR~AS,"$2,134.92","$1,587.00",$867.56,"$2,116.00",$867.56,"$2,052.52",$867.56,"$1,809.18",$867.56,"$1,902.15",$867.56,"$2,052.52",$867.56,"$2,116.00",$867.56,$867.56,"$2,052.52"
2982845AS,0975,29828,,,,,N/A,N/A,ARTHROSCOPY SHOULDER BICEPS~AS,"$1,790.87","$1,331.25",$727.75,"$1,775.00",$727.75,"$1,721.75",$727.75,"$1,517.63",$727.75,"$1,633.34",$727.75,"$1,721.75",$727.75,"$1,775.00",$727.75,$727.75,"$1,721.75"
29837AS45,0975,29837,,,,,N/A,N/A,ELBOW ARTHROSCOPY/SURGERY  ~AS,"$1,239.99",$921.75,$53.89,"$1,229.00",$53.89,"$1,192.13",$53.89,"$1,050.80",$53.89,$946.39,$53.89,"$1,192.13",$53.89,"$1,229.00",$53.89,$53.89,"$1,192.13"
2984845AS,0975,29848,,,,,N/A,N/A,WRIST ENDOSCOPY SURGERY    ~AS,"$1,046.27",$777.75,$425.17,"$1,037.00",$425.17,"$1,005.89",$425.17,$886.64,$425.17,$916.72,$425.17,"$1,005.89",$425.17,"$1,037.00",$425.17,$425.17,"$1,005.89"
2986245AS,0975,29862,,,,,N/A,N/A,HIP ARTHROSCOPY/SURGERY    ~AS,"$1,757.57","$1,306.50",$714.22,"$1,742.00",$714.22,"$1,689.74",$714.22,"$1,489.41",$714.22,"$1,452.19",$714.22,"$1,689.74",$714.22,"$1,742.00",$714.22,$714.22,"$1,689.74"
29863AS45,0975,29863,,,,,N/A,N/A,HIP ARTHROSCOPY/SURGERY    ~AS,"$1,743.45","$1,296.00",$78.48,"$1,728.00",$78.48,"$1,676.16",$78.48,"$1,477.44",$78.48,"$1,449.40",$78.48,"$1,676.16",$78.48,"$1,728.00",$78.48,$78.48,"$1,676.16"
29881AS45,0975,29881,,,,,N/A,N/A,Knee Arthroscopy/Surgery   ~as,$0.00,$0.00,$738.00,"$1,800.00",$738.00,"$1,746.00",$738.00,"$1,539.00",$738.00,$970.82,$738.00,"$1,746.00",$738.00,"$1,800.00",$738.00,$738.00,"$1,746.00"
2988445AS,0975,29884,,,,,N/A,N/A,KNEE ARTHROSCOPY/SURGERY   ~AS,"$1,336.85",$993.75,$543.25,"$1,325.00",$543.25,"$1,285.25",$543.25,"$1,132.88",$543.25,"$1,106.94",$543.25,"$1,285.25",$543.25,"$1,325.00",$543.25,$543.25,"$1,285.25"
2988845AS,0975,29888,,,,,N/A,N/A,KNEE ARTHROSCOPY/SURGERY   ~AS,"$2,308.45","$1,716.00",$938.80,"$2,288.00",$938.80,"$2,219.36",$938.80,"$1,956.24",$938.80,"$1,739.99",$938.80,"$2,219.36",$938.80,"$2,288.00",$938.80,$938.80,"$2,219.36"
29889AS45,0975,29889,,,,,N/A,N/A,KNEE ARTHROSCOPY/SURGERY   ~AS,"$2,717.08","$2,019.75",$114.13,"$2,693.00",$114.13,"$2,612.21",$114.13,"$2,302.52",$114.13,"$2,174.96",$114.13,"$2,612.21",$114.13,"$2,693.00",$114.13,$114.13,"$2,612.21"
29891AS45,0975,29891,,,,,N/A,N/A,ANKLE ARTHROSCOPY/SURGERY  ~AS,"$1,514.42","$1,125.75",$615.41,"$1,501.00",$615.41,"$1,455.97",$615.41,"$1,283.36",$615.41,"$1,200.24",$615.41,"$1,455.97",$615.41,"$1,501.00",$615.41,$615.41,"$1,455.97"
29897AS45,0975,29897,,,,,N/A,N/A,ANKLE ARTHROSCOPY/SURGERY  ~AS,"$1,244.02",$924.75,$55.53,"$1,233.00",$55.53,"$1,196.01",$55.53,"$1,054.22",$55.53,$888.00,$55.53,"$1,196.01",$55.53,"$1,233.00",$55.53,$55.53,"$1,196.01"
2991445AS,0975,29914,,,,,N/A,N/A,ARTHROSCOPY HIP W/FEMORO   ~AS,"$1,983.58","$1,474.50",$86.60,"$1,966.00",$86.60,"$1,907.02",$86.60,"$1,680.93",$86.60,"$1,774.20",$86.60,"$1,907.02",$86.60,"$1,966.00",$86.60,$86.60,"$1,907.02"
29915AS45,0975,29915,,,,,N/A,N/A,ARTHROSCOPY HIP W/ACETABULO~AS,"$2,020.91","$1,502.25",$821.23,"$2,003.00",$821.23,"$1,942.91",$821.23,"$1,712.57",$821.23,"$1,816.29",$821.23,"$1,942.91",$821.23,"$2,003.00",$821.23,$821.23,"$1,942.91"
29916AS45,0975,29916,,,,,N/A,N/A,ARTHROSCOPY HIP W/LABRAL RE~AS,"$2,020.91","$1,502.25",$821.23,"$2,003.00",$821.23,"$1,942.91",$821.23,"$1,712.57",$821.23,"$1,817.11",$821.23,"$1,942.91",$821.23,"$2,003.00",$821.23,$821.23,"$1,942.91"
3522645AS,0975,35226,,,,,N/A,N/A,REPAIR BLOOD VESSEL LESION ~AS,"$2,095.57","$1,557.75",$851.57,$851.57,$851.57,N/A,$851.57,N/A,$851.57,N/A,$851.57,N/A,$851.57,N/A,$851.57,$851.57,N/A
35840AS40,0975,35840,,,,,N/A,N/A,EX EXPLOR REPAIR REV ABD   ~AS,"$1,279.34",$951.00,$519.88,"$2,045.11",$519.88,"$1,229.96",$519.88,"$1,084.14",$519.88,"$2,045.11",$519.88,"$1,229.96",$519.88,"$1,268.00",$519.88,$519.88,"$1,229.96"
3810040AS,0975,38100,,,,,N/A,N/A,"REMOVAL OF SPLEEN, TOTAL   ~AS","$1,976.51","$1,469.25",$83.19,"$1,959.00",$83.19,"$1,900.23",$83.19,"$1,674.95",$83.19,"$1,925.94",$83.19,"$1,900.23",$83.19,"$1,959.00",$83.19,$83.19,"$1,900.23"
38525AS40,0975,38525,,,,,N/A,N/A,EXCISION OPN DEEP AXIL NODE~AS,$811.19,$603.00,$329.64,$805.00,$329.64,$780.85,$329.64,$688.28,$329.64,$741.20,$329.64,$780.85,$329.64,$805.00,$329.64,$329.64,$780.85
3950140AS,0975,39501,,,,,N/A,N/A,REPAIR DIAPHRAGM LACERATION~AS,"$1,874.61","$1,393.50",$761.78,"$1,858.00",$761.78,"$1,802.26",$761.78,"$1,588.59",$761.78,"$1,464.65",$761.78,"$1,802.26",$761.78,"$1,858.00",$761.78,$761.78,"$1,802.26"
4242040AS,0975,42420,,,,,N/A,N/A,EXCISE PAROTID GLAND/LESION~AS,"$2,471.90","$1,837.50",$14.50,"$2,450.00",$14.50,"$2,376.50",$14.50,"$2,094.75",$14.50,"$1,771.70",$14.50,"$2,376.50",$14.50,"$2,450.00",$14.50,$14.50,"$2,376.50"
4323540AS,0975,43235,,,,,N/A,N/A,"UPPER GI ENDOSCOPY, DIAG   ~AS",$449.99,$334.50,$182.86,$482.00,$182.86,$467.54,$182.86,$412.11,$182.86,$208.11,$182.86,$467.54,$182.86,$482.00,$182.86,$182.86,$467.54
4350140AS,0975,43501,,,,,N/A,N/A,SURGICAL REPAIR OF STOMACH ~AS,"$2,712.03","$2,016.00",$112.80,"$2,688.00",$112.80,"$2,607.36",$112.80,"$2,298.24",$112.80,"$2,257.29",$112.80,"$2,607.36",$112.80,"$2,688.00",$112.80,$112.80,"$2,607.36"
4360540AS,0975,43605,,,,,N/A,N/A,BIOPSY OF STOMACH          ~AS,"$1,651.63","$1,227.75",$671.17,"$1,637.00",$671.17,"$1,587.89",$671.17,"$1,399.64",$671.17,"$1,406.53",$671.17,"$1,587.89",$671.17,"$1,637.00",$671.17,$671.17,"$1,587.89"
4361140AS,0975,43611,,,,,N/A,N/A,GASTRIC INCISIONAL/RESECT  ~AS,"$2,406.32","$1,788.75",$977.85,"$2,385.00",$977.85,"$2,313.45",$977.85,"$2,039.18",$977.85,"$2,048.98",$977.85,"$2,313.45",$977.85,"$2,385.00",$977.85,$977.85,"$2,313.45"
43632AS40,0975,43632,,,,,N/A,N/A,"REMOVAL OF STOMACH, PARTIAL~AS","$3,834.98","$2,850.75","$1,558.41","$3,801.00","$1,558.41","$3,686.97","$1,558.41","$3,249.86","$1,558.41","$3,388.28","$1,558.41","$3,686.97","$1,558.41","$3,801.00","$1,558.41","$1,558.41","$3,686.97"
4383040AS,0975,43830,,,,,N/A,N/A,PLACE GASTROSTOMY TUBE     ~AS,"$1,369.13","$1,017.75",$556.37,"$1,357.00",$556.37,"$1,316.29",$556.37,"$1,160.24",$556.37,"$1,186.26",$556.37,"$1,316.29",$556.37,"$1,357.00",$556.37,$556.37,"$1,316.29"
4384040AS,0975,43840,,,,,N/A,N/A,REPAIR OF STOMACH LESION   ~AS,"$2,132.90","$1,585.50",$866.74,"$2,275.04",$866.74,"$2,050.58",$866.74,"$1,807.47",$866.74,"$2,275.04",$866.74,"$2,050.58",$866.74,"$2,114.00",$866.74,$866.74,"$2,050.58"
43840AS40,0975,43840,,,,,N/A,N/A,REPAIR OF STOMACH LESION   ~AS,"$2,132.90","$1,585.50",$866.74,"$2,275.04",$866.74,"$2,050.58",$866.74,"$1,807.47",$866.74,"$2,275.04",$866.74,"$2,050.58",$866.74,"$2,114.00",$866.74,$866.74,"$2,050.58"
4400540AS,0975,44005,,,,,N/A,N/A,FREEING OF BOWEL ADHESION  ~AS,"$2,194.44","$1,631.25",$891.75,"$2,175.00",$891.75,"$2,109.75",$891.75,"$1,859.63",$891.75,"$1,827.76",$891.75,"$2,109.75",$891.75,"$2,175.00",$891.75,$891.75,"$2,109.75"
44005AS40,0975,44005,,,,,N/A,N/A,FREEING OF BOWEL ADHESION  ~AS,"$2,194.44","$1,631.25",$891.75,"$2,175.00",$891.75,"$2,109.75",$891.75,"$1,859.63",$891.75,"$1,827.76",$891.75,"$2,109.75",$891.75,"$2,175.00",$891.75,$891.75,"$2,109.75"
44020AS40,0975,44020,,,,,N/A,N/A,INC ENTEROTOMY SM INTEST   ~AS,"$1,361.06","$1,011.75",$553.90,"$1,633.36",$553.90,"$1,308.53",$553.90,"$1,153.40",$553.90,"$1,633.36",$553.90,"$1,308.53",$553.90,"$1,349.00",$553.90,$553.90,"$1,308.53"
4405540AS,0975,44055,,,,,N/A,N/A,CORRECT MALROATION OF BOWEL~AS,"$2,938.03","$2,184.00","$1,193.92","$2,912.00","$1,193.92","$2,824.64","$1,193.92","$2,489.76","$1,193.92","$2,487.25","$1,193.92","$2,824.64","$1,193.92","$2,912.00","$1,193.92","$1,193.92","$2,824.64"
4412040AS,0975,44120,,,,,N/A,N/A,REMOVAL OF SMALL INTESTINE ~AS,"$2,300.38","$1,710.00",$934.80,"$2,280.00",$934.80,"$2,211.60",$934.80,"$1,949.40",$934.80,"$2,042.68",$934.80,"$2,211.60",$934.80,"$2,280.00",$934.80,$934.80,"$2,211.60"
44120AS40,0975,44120,,,,,N/A,N/A,REMOVAL OF SMALL INTESTINE ~AS,"$2,300.38","$1,710.00",$934.80,"$2,280.00",$934.80,"$2,211.60",$934.80,"$1,949.40",$934.80,"$2,042.68",$934.80,"$2,211.60",$934.80,"$2,280.00",$934.80,$934.80,"$2,211.60"
44121AS40,0975,44121,,,,,N/A,N/A,REMOVAL OF SMALL INTESTINE ~AS,$573.08,$426.00,$232.88,$568.00,$232.88,$550.96,$232.88,$485.64,$232.88,$400.81,$232.88,$550.96,$232.88,$568.00,$232.88,$232.88,$550.96
44125AS40,0975,44125,,,,,N/A,N/A,EXCISION W/ENTEROSTOMY     ~AS,"$1,650.63","$1,227.00",$67.76,"$1,972.68",$67.76,"$1,586.92",$67.76,"$1,398.78",$67.76,"$1,972.68",$67.76,"$1,586.92",$67.76,"$1,636.00",$67.76,$67.76,"$1,586.92"
4413040AS,0975,44130,,,,,N/A,N/A,BOWEL TO BOWEL FUSION      ~AS,"$1,976.51","$1,469.25",$83.19,"$2,202.29",$83.19,"$1,900.23",$83.19,"$1,674.95",$83.19,"$2,202.29",$83.19,"$1,900.23",$83.19,"$1,959.00",$83.19,$83.19,"$1,900.23"
4413940AS,0975,44139,,,,,N/A,N/A,MOBILIAZTION OF SPLENIC    ~AS,$229.03,$170.25,$93.70,$227.00,$93.70,$220.19,$93.70,$194.09,$93.70,$200.32,$93.70,$220.19,$93.70,$227.00,$93.70,$93.70,$220.19
4414040AS,0975,44140,,,,,N/A,N/A,PARTIAL REMOVAL OF COLON   ~AS,"$2,832.09","$2,105.25",$115.87,"$2,807.00",$115.87,"$2,722.79",$115.87,"$2,399.99",$115.87,"$2,246.58",$115.87,"$2,722.79",$115.87,"$2,807.00",$115.87,$115.87,"$2,722.79"
44140AS40,0975,44140,,,,,N/A,N/A,PARTIAL REMOVAL OF COLON   ~AS,"$2,832.09","$2,105.25",$115.87,"$2,807.00",$115.87,"$2,722.79",$115.87,"$2,399.99",$115.87,"$2,246.58",$115.87,"$2,722.79",$115.87,"$2,807.00",$115.87,$115.87,"$2,722.79"
44141AS40,0975,44141,,,,,N/A,N/A,COLON RESECT W/SKIN COLOS  ~AS,"$3,612.01","$2,685.00","$1,467.80","$3,580.00","$1,467.80","$3,472.60","$1,467.80","$3,060.90","$1,467.80","$3,054.98","$1,467.80","$3,472.60","$1,467.80","$3,580.00","$1,467.80","$1,467.80","$3,472.60"
44143AS40,0975,44143,,,,,N/A,N/A,COLON RESECTIONw/END COLOST~AS,"$3,289.14","$2,445.00","$1,336.60","$3,260.00","$1,336.60",N/A,"$1,336.60","$2,787.30","$1,336.60","$2,783.08","$1,336.60",N/A,"$1,336.60","$3,260.00","$1,336.60","$1,336.60",N/A
4414440AS,0975,44144,,,,,N/A,N/A,COLON RESECTION PROCEDURE  ~AS,"$3,499.00","$2,601.00","$1,421.88","$3,468.00","$1,421.88","$3,363.96","$1,421.88","$2,965.14","$1,421.88","$2,956.79","$1,421.88","$3,363.96","$1,421.88","$3,468.00","$1,421.88","$1,421.88","$3,363.96"
4414540AS,0975,44145,,,,,N/A,N/A,PARTIAL REMOVAL OF COLON   ~AS,"$3,147.89","$2,340.00","$1,279.20","$3,120.00","$1,279.20","$3,026.40","$1,279.20","$2,667.60","$1,279.20","$2,763.00","$1,279.20","$3,026.40","$1,279.20","$3,120.00","$1,279.20","$1,279.20","$3,026.40"
4415040AS,0975,44150,,,,,N/A,N/A,REMOVAL OF COLON           ~AS,"$3,577.70","$2,659.50","$1,453.86","$3,546.00","$1,453.86","$3,439.62","$1,453.86","$3,031.83","$1,453.86","$3,128.14","$1,453.86","$3,439.62","$1,453.86","$3,546.00","$1,453.86","$1,453.86","$3,439.62"
4416040AS,0975,44160,,,,,N/A,N/A,REMOVAL OF COLON           ~AS,"$2,517.31","$1,871.25",$122.95,"$2,495.00",$122.95,"$2,420.15",$122.95,"$2,133.23",$122.95,"$2,077.94",$122.95,"$2,420.15",$122.95,"$2,495.00",$122.95,$122.95,"$2,420.15"
44180AS40,0975,44180,,,,,N/A,N/A,"LAPARO, SURG, ENTEROLYSIS  ~AS","$1,727.31","$1,284.00",$71.92,"$1,712.00",$71.92,"$1,660.64",$71.92,"$1,463.76",$71.92,"$1,541.10",$71.92,"$1,660.64",$71.92,"$1,712.00",$71.92,$71.92,"$1,660.64"
4418840AS,0975,44188,,,,,N/A,N/A,LAP COLOSTOMY              ~AS,"$2,441.63","$1,815.00",$992.20,"$2,420.00",$992.20,"$2,347.40",$992.20,"$2,069.10",$992.20,"$2,055.70",$992.20,"$2,347.40",$992.20,"$2,420.00",$992.20,$992.20,"$2,347.40"
4420240AS,0975,44202,,,,,N/A,N/A,LAP ENTEROSTOMY PROCEDURE ~AS,"$2,738.26","$2,035.50","$1,112.74","$2,714.00","$1,112.74","$2,632.58","$1,112.74","$2,320.47","$1,112.74","$2,318.59","$1,112.74","$2,632.58","$1,112.74","$2,714.00","$1,112.74","$1,112.74","$2,632.58"
4420440AS,0975,44204,,,,,N/A,N/A,LAPARO PARTIAL COLECTOMY   ~AS,"$2,156.10","$1,602.75","$2,072.89","$2,571.24",N/A,"$2,072.89",N/A,"$1,827.14",N/A,"$2,571.24",N/A,"$2,072.89",N/A,"$2,137.00",N/A,N/A,"$2,072.89"
4420540AS,0975,44205,,,,,N/A,N/A,COLECTOMY                  ~AS,"$2,659.57","$1,977.00",$18.76,"$2,636.00",$18.76,"$2,556.92",$18.76,"$2,253.78",$18.76,"$2,236.50",$18.76,"$2,556.92",$18.76,"$2,636.00",$18.76,$18.76,"$2,556.92"
44206AS40,0975,44206,,,,,N/A,N/A,LAP PART COLECTOMY W/STOMA,"$3,652.36","$2,715.00","$1,484.20","$3,620.00","$1,484.20","$3,511.40","$1,484.20","$3,095.10","$1,484.20","$2,925.76","$1,484.20","$3,511.40","$1,484.20","$3,620.00","$1,484.20","$1,484.20","$3,511.40"
44207AS40,0975,44207,,,,,N/A,N/A,COLOECTOMY PART W/ANASTOM  ~AS,"$3,634.20","$2,701.50","$1,476.82","$3,602.00","$1,476.82","$3,493.94","$1,476.82","$3,079.71","$1,476.82","$3,034.95","$1,476.82","$3,493.94","$1,476.82","$3,602.00","$1,476.82","$1,476.82","$3,493.94"
4421340AS,0975,44213,,,,,N/A,N/A,LAP ENTEROSTOMY PROCEDURE  ~AS,$379.36,$282.00,$154.16,$376.00,$154.16,$364.72,$154.16,$321.48,$154.16,$311.48,$154.16,$364.72,$154.16,$376.00,$154.16,$154.16,$364.72
4422740AS,0975,44227,,,,,N/A,N/A,LAP ENTEROSTOMY PROC       ~AS,"$3,302.26","$2,454.75","$2,780.56","$3,273.00",N/A,"$3,174.81",N/A,"$2,798.42",N/A,"$2,780.56",N/A,"$3,174.81",N/A,"$3,273.00",N/A,N/A,"$3,174.81"
4431040AS,0975,44310,,,,,N/A,N/A,ILEOSTOMY/JEJUNOSTOMY      ~AS,"$2,161.15","$1,606.50",$878.22,"$2,142.00",$878.22,"$2,077.74",$878.22,"$1,831.41",$878.22,"$1,743.30",$878.22,"$2,077.74",$878.22,"$2,142.00",$878.22,$878.22,"$2,077.74"
44320AS40,0975,44320,,,,,N/A,N/A,COLOSTOMY                  ~AS,"$2,614.16","$1,943.25",$162.31,"$2,591.00",$162.31,"$2,513.27",$162.31,"$2,215.31",$162.31,"$2,013.77",$162.31,"$2,513.27",$162.31,"$2,591.00",$162.31,$162.31,"$2,513.27"
44602AS40,0975,44602,,,,,N/A,N/A,SUTURE OF SM INTESTINE     ~AS,"$2,623.24","$1,950.00",$166.00,"$2,600.00",$166.00,"$2,522.00",$166.00,"$2,223.00",$166.00,"$2,349.64",$166.00,"$2,522.00",$166.00,"$2,600.00",$166.00,$166.00,"$2,522.00"
44604AS40,0975,44604,,,,,N/A,N/A,SUTURE OF LARGE INTESTINE  ~AS,"$1,472.04","$1,094.25",$598.19,"$1,768.11",$598.19,"$1,415.23",$598.19,"$1,247.45",$598.19,"$1,768.11",$598.19,"$1,415.23",$598.19,"$1,459.00",$598.19,$598.19,"$1,415.23"
4462040AS,0975,44620,,,,,N/A,N/A,REPAIR BOWEL OPENING       ~AS,"$1,476.08","$1,097.25",$599.83,"$1,463.00",$599.83,"$1,419.11",$599.83,"$1,250.87",$599.83,"$1,452.50",$599.83,"$1,419.11",$599.83,"$1,463.00",$599.83,$599.83,"$1,419.11"
44625AS40,0975,44625,,,,,N/A,N/A,REPAIR W/RESEC & ANASTOM   ~AS,"$1,916.99","$1,425.00",$779.00,"$1,900.00",$779.00,"$1,843.00",$779.00,"$162,450.00",$779.00,"$1,697.74",$779.00,"$1,843.00",$779.00,"$1,900.00",$779.00,$779.00,"$1,843.00"
44640AS40,0975,44640,,,,,N/A,N/A,CLOS OF INTSTNL CUTNS FSTL ~AS,"$2,637.37","$1,960.50",$171.74,"$2,614.00",$171.74,"$2,535.58",$171.74,"$2,234.97",$171.74,"$2,335.57",$171.74,"$2,535.58",$171.74,"$2,614.00",$171.74,$171.74,"$2,535.58"
4466040AS,0975,44660,,,,,N/A,N/A,REPAIR BOWEL-BLADDER FISTU ~AS,"$2,813.93","$2,091.75","$1,143.49","$2,789.00","$1,143.49","$2,705.33","$1,143.49","$2,384.60","$1,143.49","$2,246.06","$1,143.49","$2,705.33","$1,143.49","$2,789.00","$1,143.49","$1,143.49","$2,705.33"
4470140AS,0975,44701,,,,,N/A,N/A,INTESTINAL PROCEDURE       ~AS,$330.93,$246.00,$134.48,$328.00,$134.48,$318.16,$134.48,$280.44,$134.48,$280.73,$134.48,$318.16,$134.48,$328.00,$134.48,$134.48,$318.16
44850AS40,0975,44850,,,,,N/A,N/A,REPAIR OF MESENTERY        ~AS,"$1,501.30","$1,116.00",$61.80,"$1,488.00",$61.80,"$1,443.36",$61.80,"$1,272.24",$61.80,"$1,255.57",$61.80,"$1,443.36",$61.80,"$1,488.00",$61.80,$61.80,"$1,443.36"
4495040AS,0975,44950,,,,,N/A,N/A,APPENDECTOMY               ~AS,$896.95,$666.75,$364.49,"$1,078.45",$364.49,$862.33,$364.49,$760.10,$364.49,"$1,078.45",$364.49,$862.33,$364.49,$889.00,$364.49,$364.49,$862.33
44955AS40,0975,44955,,,,,N/A,N/A,APPENDECTOMY ADD-ON        ~AS,$218.94,$162.75,$88.97,$217.00,$88.97,$210.49,$88.97,$185.54,$88.97,$138.96,$88.97,$210.49,$88.97,$217.00,$88.97,$88.97,$210.49
4496040AS,0975,44960,,,,,N/A,N/A,APPENDECTOMY               ~AS,"$1,689.97","$1,256.25",$686.75,"$1,675.00",$686.75,"$1,624.75",$686.75,"$1,432.13",$686.75,"$1,470.11",$686.75,"$1,624.75",$686.75,"$1,675.00",$686.75,$686.75,"$1,624.75"
4497040AS,0975,44970,,,,,N/A,N/A,"LAPAROSCOPY, APPENDECTOMY  ~AS","$1,221.83",$908.25,$496.51,"$1,211.00",$496.51,"$1,174.67",$496.51,"$1,035.41",$496.51,"$1,013.09",$496.51,"$1,174.67",$496.51,"$1,211.00",$496.51,$496.51,"$1,174.67"
4511140AS,0975,45111,,,,,N/A,N/A,OPEN/TRANSRECTAL PROCEDURE ~AS,"$2,188.39","$1,626.75",$889.29,"$2,169.00",$889.29,"$2,103.93",$889.29,"$1,854.50",$889.29,"$1,827.92",$889.29,"$2,103.93",$889.29,"$2,169.00",$889.29,$889.29,"$2,103.93"
4513040AS,0975,45130,,,,,N/A,N/A,EXCISION OF RECTAL         ~AS,"$1,552.76","$1,154.25",$63.99,"$1,826.36",$63.99,"$1,492.83",$63.99,"$1,315.85",$63.99,"$1,826.36",$63.99,"$1,492.83",$63.99,"$1,539.00",$63.99,$63.99,"$1,492.83"
45171AS40,0975,45171,,,,,N/A,N/A,EXCISION OF RECTAL TUMOR   ~AS,"$1,184.50",$880.50,$481.34,"$1,174.00",$481.34,"$1,138.78",$481.34,"$1,003.77",$481.34,"$1,063.91",$481.34,"$1,138.78",$481.34,"$1,174.00",$481.34,$481.34,"$1,138.78"
45550AS40,0975,45550,,,,,N/A,N/A,REPAIR RECTUMREMOVE SIGMOID~AS,"$3,065.16","$2,278.50","$1,245.58","$3,038.00","$1,245.58","$2,946.86","$1,245.58","$2,597.49","$1,245.58","$2,467.05","$1,245.58","$2,946.86","$1,245.58","$3,038.00","$1,245.58","$1,245.58","$2,946.86"
4710040AS,0975,47100,,,,,N/A,N/A,WEDGE BIOPSY OF LIVER      ~AS,"$1,686.95","$1,254.00",$171.65,"$1,672.00",N/A,"$1,621.84",N/A,"$1,429.56",N/A,$171.65,N/A,"$1,621.84",N/A,"$1,672.00",N/A,N/A,"$1,621.84"
4756240AS,0975,47562,,,,,N/A,N/A,LAPAROSC CHOLECYSTEMCTOMY  ~AS,"$1,535.61","$1,141.50",$119.85,"$1,522.00",$624.20,"$1,476.34",$624.20,"$1,301.31",$624.20,$119.85,$624.20,"$1,476.34",$624.20,"$1,522.00",$624.20,$624.20,"$1,476.34"
47562AS40,0975,47562,,,,,N/A,N/A,LAPAROSCOPIC CHOLECTOMY    ~AS,"$1,535.61","$1,141.50",$119.85,"$1,522.00",$624.20,"$1,476.34",$624.20,"$1,301.31",$624.20,$119.85,$624.20,"$1,476.34",$624.20,"$1,522.00",$624.20,$624.20,"$1,476.34"
4756340AS,0975,47563,,,,,N/A,N/A,LAPARO CHOLECYSTECTOMY/GRAP~AS,"$1,647.60","$1,224.75",$669.53,"$1,633.00",$669.53,"$1,584.01",$669.53,"$1,396.22",$669.53,"$1,108.95",$669.53,"$1,584.01",$669.53,"$1,633.00",$669.53,$669.53,"$1,584.01"
47564AS40,0975,47564,,,,,N/A,N/A,CHOL W/EXPLOR OF COM DUCT  ~AS,"$2,192.43","$1,629.75",$89.93,"$2,173.00",$89.93,"$2,107.81",$89.93,"$1,857.92",$89.93,"$1,206.63",$89.93,"$2,107.81",$89.93,"$2,173.00",$89.93,$89.93,"$2,107.81"
4760040AS,0975,47600,,,,,N/A,N/A,REMOVAL OF GALLBLADDER     ~AS,"$1,883.69","$1,400.25",$765.47,"$1,875.98",$765.47,"$1,810.99",$765.47,"$1,596.29",$765.47,"$1,875.98",$765.47,"$1,810.99",$765.47,"$1,867.00",$765.47,$765.47,"$1,810.99"
47600AS40,0975,47600,,,,,N/A,N/A,REMOVAL OF GALLBLADDER     ~AS,"$1,883.69","$1,400.25",$765.47,"$1,875.98",$765.47,"$1,810.99",$765.47,"$1,596.29",$765.47,"$1,875.98",$765.47,"$1,810.99",$765.47,"$1,867.00",$765.47,$765.47,"$1,810.99"
4760540AS,0975,47605,,,,,N/A,N/A,CHOLE W/CHOLNGIGRPY        ~AS,"$1,868.56","$1,389.00",$759.32,"$1,852.00",$759.32,"$1,796.44",$759.32,"$1,583.46",$759.32,"$1,794.51",$759.32,"$1,796.44",$759.32,"$1,852.00",$759.32,$759.32,"$1,796.44"
4761040AS,0975,47610,,,,,N/A,N/A,CHOLE W/EXPLO COMMON DUCT  ~AS,"$2,465.85","$1,833.00",$12.40,"$2,444.00",$12.40,"$2,370.68",$12.40,"$2,089.62",$12.40,"$1,890.03",$12.40,"$2,370.68",$12.40,"$2,444.00",$12.40,$12.40,"$2,370.68"
4900040AS,0975,49000,,,,,N/A,N/A,EXPLORATION OF ABDOMEN     ~AS,"$1,626.41","$1,209.00",$66.92,"$1,881.85",$66.92,"$1,563.64",$66.92,"$1,378.26",$66.92,"$1,881.85",$66.92,"$1,563.64",$66.92,"$1,612.00",$66.92,$66.92,"$1,563.64"
4901040AS,0975,49010,,,,,N/A,N/A,EXPLORATION BEHIND ABDOMEN ~AS,"$1,729.32","$1,285.50",$72.74,"$1,748.29",$72.74,"$1,662.58",$72.74,"$1,465.47",$72.74,"$1,748.29",$72.74,"$1,662.58",$72.74,"$1,714.00",$72.74,$72.74,"$1,662.58"
4920340AS,0975,49203,,,,,N/A,N/A,EXC ABD TUM 5 CM OR LESS   ~AS,"$2,083.46","$1,548.75",$142.16,"$2,065.00",$846.65,"$2,003.05",$846.65,"$1,765.58",$846.65,$142.16,$846.65,"$2,003.05",$846.65,"$2,065.00",$846.65,$846.65,"$2,003.05"
4920440AS,0975,49204,,,,,N/A,N/A,OPEN RESTRUCTION/EXCISION  ~AS,"$3,023.79","$2,247.75","$1,228.77","$2,997.00","$1,228.77","$2,907.09","$1,228.77","$2,562.44","$1,228.77","$2,003.98","$1,228.77","$2,907.09","$1,228.77","$2,997.00","$1,228.77","$1,228.77","$2,907.09"
4925540AS,0975,49255,,,,,N/A,N/A,REMOVAL OF OMENTUM         ~AS,"$1,478.10","$1,098.75",$6.65,"$1,465.00",$6.65,"$1,421.05",$6.65,"$1,252.58",$6.65,$994.00,$6.65,"$1,421.05",$6.65,"$1,465.00",$6.65,$6.65,"$1,421.05"
49320AS40,0975,49320,,,,,N/A,N/A,LAPAROSCOPY SEP PROCEDURE  ~AS,$618.48,$459.75,$251.33,"$1,332.82",$251.33,$594.61,$251.33,$524.12,$251.33,"$1,332.82",$251.33,$594.61,$251.33,$613.00,$251.33,$251.33,$594.61
4932240AS,0975,49322,,,,,N/A,N/A,"LAPAROSCOPY, ASPIRATION    ~AS",$827.33,$615.00,$336.20,$820.00,$336.20,$795.40,$336.20,$701.10,$336.20,$581.93,$336.20,$795.40,$336.20,$820.00,$336.20,$336.20,$795.40
4950540AS,0975,49505,,,,,N/A,N/A,PRP I/HERN INIT REDUC >5 YR~AS,"$1,083.60",$805.50,$44.34,"$1,074.00",$44.34,"$1,041.78",$44.34,$918.27,$44.34,$52.19,$44.34,"$1,041.78",$44.34,"$1,074.00",$44.34,$44.34,"$1,041.78"
4950740AS,0975,49507,,,,,N/A,N/A,PRP I/HERN INIT BLOCK >5 YR~AS,"$1,340.88",$996.75,$544.89,"$1,329.00",$544.89,"$1,289.13",$544.89,"$1,136.30",$544.89,$880.74,$544.89,"$1,289.13",$544.89,"$1,329.00",$544.89,$544.89,"$1,289.13"
49507AS40,0975,49507,,,,,N/A,N/A,PRP I/HERN INIT BLOCK >5 YR~AS,"$1,340.88",$996.75,$544.89,"$1,329.00",$544.89,"$1,289.13",$544.89,"$1,136.30",$544.89,$880.74,$544.89,"$1,289.13",$544.89,"$1,329.00",$544.89,$544.89,"$1,289.13"
4952040AS,0975,49520,,,,,N/A,N/A,"REREPAIR ING HERNIA, REDUCE~AS","$1,344.92",$999.75,$546.53,"$1,333.00",$546.53,"$1,293.01",$546.53,"$1,139.72",$546.53,$988.12,$546.53,"$1,293.01",$546.53,"$1,333.00",$546.53,$546.53,"$1,293.01"
49520AS40,0975,49520,,,,,N/A,N/A,"REREPAIR ING HERNIA, REDUCE~AS","$1,344.92",$999.75,$546.53,"$1,333.00",$546.53,"$1,293.01",$546.53,"$1,139.72",$546.53,$988.12,$546.53,"$1,293.01",$546.53,"$1,333.00",$546.53,$546.53,"$1,293.01"
49521AS40,0975,49521,,,,,N/A,N/A,REREPAIRING HERNIA BLOCKED ~AS,"$1,762.62","$1,310.25",$716.27,"$1,747.00",$716.27,"$1,694.59",$716.27,"$1,493.00",$716.27,"$1,064.24",$716.27,"$1,694.59",$716.27,"$1,747.00",$716.27,$716.27,"$1,694.59"
4952540AS,0975,49525,,,,,N/A,N/A,"REPAIR ING HERNIA, SLIDING ~AS","$1,206.69",$897.00,$49.36,"$1,204.49",$49.36,"$1,160.12",$49.36,"$1,022.58",$49.36,"$1,204.49",$49.36,"$1,160.12",$49.36,"$1,196.00",$49.36,$49.36,"$1,160.12"
49550AS40,0975,49550,,,,,N/A,N/A,"RPR REM HERNIA, INIT, REDUC~AS","$1,217.79",$905.25,$494.87,"$1,207.00",$494.87,"$1,170.79",$494.87,"$1,031.99",$494.87,$966.31,$494.87,"$1,170.79",$494.87,"$1,207.00",$494.87,$494.87,"$1,170.79"
49553AS40,0975,49553,,,,,N/A,N/A,REMOVAL OF SMALL INTESTINE ~AS,"$1,177.43",$875.25,$478.47,"$1,167.00",$478.47,"$1,131.99",$478.47,$997.79,$478.47,$971.55,$478.47,"$1,131.99",$478.47,"$1,167.00",$478.47,$478.47,"$1,131.99"
4956040AS,0975,49560,,,,,N/A,N/A,"RPR VENTRAL HERN INIT,REDUC~AS","$1,598.16","$1,188.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
49560AS40,0975,49560,,,,,N/A,N/A,"RPR VENTRAL HERN INIT,REDUC~AS","$1,598.16","$1,188.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4956140AS,0975,49561,,,,,N/A,N/A,"RPR VENTRAL HERN INIT,BLOCK~AS","$1,942.21","$1,443.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
49561AS40,0975,49561,,,,,N/A,N/A,"RPR VENTRAL HERN INIT,BLOCK~AS","$1,942.21","$1,443.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4956540AS,0975,49565,,,,,N/A,N/A,"REREPAIR VENTRL HERN,REDUCE~AS","$1,765.65","$1,312.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
49565AS40,0975,49565,,,,,N/A,N/A,"REREPAIR VENTRL HERN, REDUC~AS","$1,765.65","$1,312.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4956640AS,0975,49566,,,,,N/A,N/A,"REREPAIR VENTRL HERN, BLOCK~AS","$1,964.41","$1,460.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
49566AS40,0975,49566,,,,,N/A,N/A,"REREPAIR VENTRL HERN,BLOCK ~AS","$1,964.41","$1,460.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4956840AS,0975,49568,,,,,N/A,N/A,HERNIA REPAIR W/MESH       ~AS,$630.59,$468.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
49568AS40,0975,49568,,,,,N/A,N/A,HERNIA REPAIR W/MESH       ~AS,$630.59,$468.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
49570AS40,0975,49570,,,,,N/A,N/A,HERNIA REPAIR EPIGASTRIC   ~AS,$823.30,$612.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4958540AS,0975,49585,,,,,N/A,N/A,"RPR UMBIL HERN, REDUC > 5YR~AS",$908.05,$675.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
49585AS40,0975,49585,,,,,N/A,N/A,"RPR UMBIL HERN, REDUC > 5YR~AS",$908.05,$675.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4958740AS,0975,49587,,,,,N/A,N/A,"RPR UMBIL HERN, BLOCK >5YR ~AS","$1,078.56",$801.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4965040AS,0975,49650,,,,,N/A,N/A,LAP INGUINAL HERNIA REPAIR ~AS,$845.49,$628.50,$343.58,$838.00,$343.58,$812.86,$343.58,$716.49,$343.58,$838.00,$343.58,$812.86,$343.58,$838.00,$343.58,$343.58,$812.86
49651AS40,0975,49651,,,,,N/A,N/A,REPAIR RECUR INGUIN HERNIA  AS,"$1,036.18",$770.25,$421.70,"$1,027.00",$421.70,$996.19,$421.70,$878.09,$421.70,$729.43,$421.70,$996.19,$421.70,"$1,027.00",$421.70,$421.70,$996.19
49652AS40,0975,49652,,,,,N/A,N/A,LAP HERNIA REPAIR          ~AS,"$1,393.35","$1,035.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4965340AS,0975,49653,,,,,N/A,N/A,LAP VENT/ABD HERN PROC COMP~AS,"$1,696.03","$1,260.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
49654AS40,0975,49654,,,,,N/A,N/A,"LAPAROSCOPY,SURG REPAIR    ~AS","$1,634.48","$1,215.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
49655AS40,0975,49655,,,,,N/A,N/A,LAP HERNIA INCAR OR STRANG ~AS,"$1,378.21","$1,024.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
49900AS40,0975,49900,,,,,N/A,N/A,SURGICAL REPAIR ABD WALL   ~AS,"$1,636.50","$1,216.50",$665.20,"$1,622.00",$665.20,"$1,573.34",$665.20,"$1,386.81",$665.20,$949.27,$665.20,"$1,573.34",$665.20,"$1,622.00",$665.20,$665.20,"$1,573.34"
4990540AS,0975,49905,,,,,N/A,N/A,OMENTAL FLAP INTRA-ABDOM   ~AS,$845.49,$628.50,$343.58,"$1,378.50",$343.58,$812.86,$343.58,$716.49,$343.58,"$1,378.50",$343.58,$812.86,$343.58,$838.00,$343.58,$343.58,$812.86
5054540AS,0975,50545,,,,,N/A,N/A,LAPARO RADICAL NEPHRECTOMY ~AS,"$3,113.59","$2,314.50",$245.73,"$3,086.00","$1,265.26","$2,993.42","$1,265.26","$2,638.53","$1,265.26",$245.73,"$1,265.26","$2,993.42","$1,265.26","$3,086.00","$1,265.26","$1,265.26","$2,993.42"
50546AS40,0975,50546,,,,,N/A,N/A,LAP. NEPHRECTOMY           ~AS,"$2,430.54","$1,806.75",$11.85,"$2,409.00",$11.85,"$2,336.73",$11.85,"$2,059.70",$11.85,"$2,177.95",$11.85,"$2,336.73",$11.85,"$2,409.00",$11.85,$11.85,"$2,336.73"
51040AS40,0975,51040,,,,,N/A,N/A,CYSTOSTOMY WITH DRAINAGE   ~AS,$721.39,$536.25,$293.15,$715.00,$293.15,$693.55,$293.15,$611.33,$293.15,$715.00,$293.15,$693.55,$293.15,$715.00,$293.15,$293.15,$693.55
51050AS40,0975,51050,,,,,N/A,N/A,REMOVAL OF BLADDER STONE   ~AS,$960.51,$714.00,$39.32,$952.00,$39.32,$923.44,$39.32,$813.96,$39.32,$820.73,$39.32,$923.44,$39.32,$952.00,$39.32,$39.32,$923.44
51500AS40,0975,51500,,,,,N/A,N/A,REMOVAL OF BLADDER CYST    ~AS,"$1,430.68","$1,063.50",$236.79,"$1,418.00",N/A,"$1,375.46",N/A,"$1,212.39",N/A,$236.79,N/A,"$1,375.46",N/A,"$1,418.00",N/A,N/A,"$1,375.46"
5224040AS,0975,52240,,,,,N/A,N/A,LARGE BLADDER TUMORS       ~AS,"$1,224.85",$910.50,$467.53,"$1,214.00",$497.74,"$1,177.58",$497.74,"$1,037.97",$497.74,$467.53,$497.74,"$1,177.58",$497.74,"$1,214.00",$497.74,$497.74,"$1,177.58"
54405AS40,0975,54405,,,,,N/A,N/A,INSERT OFMULT-COMP INF PROS~AS,"$1,607.24","$1,194.75",$119.27,"$1,593.00",N/A,"$1,545.21",N/A,"$1,362.02",N/A,$119.27,N/A,"$1,545.21",N/A,"$1,593.00",N/A,N/A,"$1,545.21"
5552040AS,0975,55520,,,,,N/A,N/A,REMOVAL  SPERM CORD LESION ~AS,$881.81,$655.50,$358.34,$874.00,$358.34,$847.78,$358.34,$747.27,$358.34,$644.75,$358.34,$847.78,$358.34,$874.00,$358.34,$358.34,$847.78
5584540AS,0975,55845,,,,,N/A,N/A,EXTENSIVE PROSTATE SURGERY ~AS,"$3,417.28","$2,540.25","$1,388.67","$3,387.00","$1,388.67","$3,285.39","$1,388.67","$2,895.89","$1,388.67","$1,545.89","$1,388.67","$3,285.39","$1,388.67","$3,387.00","$1,388.67","$1,388.67","$3,285.39"
55845AS40,0975,55845,,,,,N/A,N/A,EXTENSIVE PROSTATE SURGRY AS~G,"$3,417.28","$2,540.25","$1,388.67","$3,387.00","$1,388.67","$3,285.39","$1,388.67","$2,895.89","$1,388.67","$1,545.89","$1,388.67","$3,285.39","$1,388.67","$3,387.00","$1,388.67","$1,388.67","$3,285.39"
55845AS40B,0975,55845,,,,,N/A,N/A,EXTENSIVE PROSTATE SURGRY AS~P,"$3,417.28","$2,540.25","$1,388.67","$3,387.00","$1,388.67","$3,285.39","$1,388.67","$2,895.89","$1,388.67","$1,545.89","$1,388.67","$3,285.39","$1,388.67","$3,387.00","$1,388.67","$1,388.67","$3,285.39"
5724040AS,0975,57240,,,,,N/A,N/A,REPAIR BLADDER & VAGINA    ~AS,$932.26,$693.00,$378.84,$924.00,$378.84,$896.28,$378.84,$790.02,$378.84,$546.82,$378.84,$896.28,$378.84,$924.00,$378.84,$378.84,$896.28
5728840AS,0975,57288,,,,,N/A,N/A,REPAIR BLADDER DEFECT      ~AS,"$1,780.78","$1,323.75",$723.65,"$1,765.00",$723.65,"$1,712.05",$723.65,"$1,509.08",$723.65,"$1,223.80",$723.65,"$1,712.05",$723.65,"$1,765.00",$723.65,$723.65,"$1,712.05"
5866040AS,0975,58660,,,,,N/A,N/A,"LAPAROSCOPY, LYSIS         ~AS","$1,575.96","$1,171.50",$64.42,"$1,562.00",$64.42,"$1,515.14",$64.42,"$1,335.51",$64.42,$124.93,$64.42,"$1,515.14",$64.42,"$1,562.00",$64.42,$64.42,"$1,515.14"
5866140AS,0975,58661,,,,,N/A,N/A,LAPAROSCOPY REMOVE ADNEXA  ~AS,"$1,539.64","$1,144.50",$625.66,"$1,526.00",$625.66,"$1,480.22",$625.66,"$1,304.73",$625.66,"$1,119.07",$625.66,"$1,480.22",$625.66,"$1,526.00",$625.66,$625.66,"$1,480.22"
5915140AS,0975,59151,,,,,N/A,N/A,TREAT ECTOPIC PREGNANCY    ~AS,"$1,728.31","$1,284.75",$805.11,"$1,713.00",N/A,"$1,661.61",N/A,"$1,510.79",N/A,$805.11,N/A,"$1,661.61",N/A,"$1,713.00",N/A,N/A,"$1,661.61"
6470845AS,0975,64708,,,,,N/A,N/A,REVISE ARM/LEG NERVE       ~AS,"$1,046.27",$777.75,$423.48,"$1,037.00",$425.17,"$1,005.89",$425.17,$548.01,$425.17,$423.48,$425.17,"$1,005.89",$425.17,"$1,037.00",$425.17,$425.17,"$1,005.89"
64718AS45,0975,64718,,,,,N/A,N/A,Revise Ulnar Nerve Elbow   ~as,$0.00,$0.00,$462.89,"$1,129.00",$462.89,"$1,095.13",$462.89,$734.47,$462.89,$662.10,$462.89,"$1,095.13",$462.89,"$1,129.00",$462.89,$462.89,"$1,095.13"
64719AS45,0975,64719,,,,,N/A,N/A,Neurplsty Ulnar Nerve Wrist~as,$0.00,$0.00,$0.00,$780.71,N/A,$0.00,N/A,$539.23,N/A,$780.71,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
6485745AS,0975,64857,,,,,N/A,N/A,REPAIR ARM/LEG NERVE       ~AS,"$2,302.40","$1,711.50",$898.49,"$2,282.00",$935.62,"$2,213.54",$935.62,"$1,463.29",$935.62,$898.49,$935.62,"$2,213.54",$935.62,"$2,282.00",$935.62,$935.62,"$2,213.54"
4500402B,0981,10060,,,,,N/A,N/A,INC I&D ABSCESS SML    10060~P,$352.12,$261.75,$8.77,$197.00,$8.77,N/A,$8.77,$168.44,$8.77,$177.59,$8.77,N/A,$8.77,$197.00,$8.77,$8.77,N/A
4500404B,0981,10061,,,,,N/A,N/A,INC I&D ABSCESS LRG    10061~P,$597.29,$444.00,$15.60,$366.00,$15.60,$355.02,$15.60,$312.93,$15.60,$312.38,$15.60,$355.02,$15.60,$366.00,$15.60,$15.60,$355.02
4500405B,0981,10080,,,,,N/A,N/A,INC PILONIDAL CYST     10080~P,$372.30,$276.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501008B,0981,10081,,,,,N/A,N/A,I&D PILONIDAL AB CMP   10081~P,$618.48,$459.75,$152.52,$372.00,$152.52,$360.84,$152.52,$318.06,$152.52,$293.55,$152.52,$360.84,$152.52,$372.00,$152.52,$152.52,$360.84
4500213B,0981,10120,,,,,N/A,N/A,RMV FB SIMPLE          10120~P,$343.04,$255.00,$83.64,$204.00,$83.64,$197.88,$83.64,$174.42,$83.64,$179.14,$83.64,$197.88,$83.64,$204.00,$83.64,$83.64,$197.88
4500267B,0981,10121,,,,,N/A,N/A,RMV FB COMPLEX         10121~P,$677.00,$503.25,$172.61,$421.00,$172.61,$408.37,$172.61,$359.96,$172.61,$314.50,$172.61,$408.37,$172.61,$421.00,$172.61,$172.61,$408.37
4500406B,0981,10140,,,,,N/A,N/A,INC I&D HEMATOMA SIM   10140~P,$439.90,$327.00,$117.26,$266.00,$117.26,$258.02,$117.26,$227.43,$117.26,$202.56,$117.26,$258.02,$117.26,$266.00,$117.26,$117.26,$258.02
4500424B,0981,10160,,,,,N/A,N/A,I&D ASPIR ABSCESS      10160~P,$357.16,$265.50,$16.72,$392.00,$16.72,$380.24,$16.72,$335.16,$16.72,$162.64,$16.72,$380.24,$16.72,$392.00,$16.72,$16.72,$380.24
4510180B,0981,10180,,,,,N/A,N/A,I&D COMP POSTOP WOUND INFECT~P,$618.48,$459.75,$163.59,$399.00,$163.59,$387.03,$163.59,$341.15,$163.59,$301.36,$163.59,$387.03,$163.59,$399.00,$163.59,$163.59,$387.03
4500418B,0981,11000,,,,,N/A,N/A,DEBRIDMENT INFCT SKIN  11000~P,$117.04,$87.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500421B,0981,11010,,,,,N/A,N/A,DEBRIDE INFECTED SKIN  11010~P,"$1,028.11",$764.25,$239.30,$583.00,$239.30,$565.51,$239.30,$498.47,$239.30,$283.64,$239.30,$565.51,$239.30,$583.00,$239.30,$239.30,$565.51
4511012B,0981,11012,,,,,N/A,N/A,"DBRDE ON FX-SKN,SUB,MS 11012~P","$1,562.85","$1,161.75",$419.43,"$1,023.00",$419.43,$992.31,$419.43,$874.67,$419.43,$427.36,$419.43,$992.31,$419.43,"$1,023.00",$419.43,$419.43,$992.31
4511042B,0981,11042,,,,,N/A,N/A,"DEBRIDE, SKIN + SUBQ   11042~P",$180.60,$134.25,$61.50,$150.00,$61.50,$145.50,$61.50,$128.25,$61.50,$62.57,$61.50,$145.50,$61.50,$150.00,$61.50,$61.50,$145.50
4511043B,0981,11043,,,,,N/A,N/A,"DEBRIDE,SKN, SUB & MUS 11043~P",$456.04,$339.00,$159.32,$390.00,$159.90,$378.30,$159.90,$333.45,$159.90,$159.32,$159.90,$378.30,$159.90,$390.00,$159.90,$159.90,$378.30
4511044B,0981,11044,,,,,N/A,N/A,"DBR,SKN,SUB,MSCL,BONE  11044~P",$778.90,$579.00,$231.11,$634.00,$259.94,$614.98,$259.94,$542.07,$259.94,$231.11,$259.94,$614.98,$259.94,$634.00,$259.94,$259.94,$614.98
4511055B,0981,11055,,,,,N/A,N/A,PARNG/CUTNG CORN/CALLS 11055~P,$81.72,$60.75,$16.62,$65.00,$26.65,$63.05,$26.65,$55.58,$26.65,$16.62,$26.65,$63.05,$26.65,$65.00,$26.65,$26.65,$63.05
4511200B,0981,11200,,,,,N/A,N/A,RMVL SKIN TAGS;15 OR<  11200~P,$268.38,$199.50,$58.63,$143.00,$58.63,$138.71,$58.63,$122.27,$58.63,$78.65,$58.63,$138.71,$58.63,$143.00,$58.63,$58.63,$138.71
4511300B,0981,11300,,,,,N/A,N/A,SKIN LESION REMOVAL         ~P,$103.92,$77.25,$35.19,$107.00,$43.87,$103.79,$43.87,$91.49,$43.87,$35.19,$43.87,$103.79,$43.87,$107.00,$43.87,$43.87,$103.79
4500428B,0981,11400,,,,,N/A,N/A,EXC BNGN LES 0-0.5 CM  11140~P,$295.62,$219.75,$66.10,$161.00,$66.10,$156.17,$66.10,$137.66,$66.10,$87.14,$66.10,$156.17,$66.10,$161.00,$66.10,$66.10,$156.17
4500429B,0981,11401,,,,,N/A,N/A,EXC BGN LES .6-1.0 CM  11401~P,$380.37,$282.75,$86.51,$211.00,$86.51,$204.67,$86.51,$180.11,$86.51,$109.64,$86.51,$204.67,$86.51,$211.00,$86.51,$86.51,$204.67
4511441B,0981,11441,,,,,N/A,N/A,EXCISED DIAMETER 0.6-1.0CM~P,$209.86,$156.00,$113.16,$276.00,$113.16,$267.72,$113.16,$235.98,$113.16,$137.29,$113.16,$267.72,$113.16,$276.00,$113.16,$113.16,$267.72
45011719B,0981,11719,,,,,N/A,N/A,TRIM OF NONDYSTROPHIC NAILS ~P,$34.30,$25.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
45011720B,0981,11720,,,,,N/A,N/A,DEBRIDE NAILS ANY METHD 1-5 ~P,$58.52,$43.50,$14.76,$36.00,$14.76,$34.92,$14.76,$30.78,$14.76,$15.15,$14.76,$34.92,$14.76,$36.00,$14.76,$14.76,$34.92
45011721B,0981,11721,,,,,N/A,N/A,DEBRIDE NAILS ANY METHD >6  ~P,$94.84,$70.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500432B,0981,11730,,,,,N/A,N/A,AVULSION OF NAIL       11730~P,$203.81,$151.50,$0.00,$56.22,N/A,$0.00,N/A,$0.00,N/A,$56.22,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
4500407B,0981,11740,,,,,N/A,N/A,INC SUB UNG HEMATOMA   11740~P,$127.13,$94.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500434B,0981,11750,,,,,N/A,N/A,EXC NAIL & MATRIX      11750~P,$645.72,$480.00,$138.17,$337.00,$138.17,$326.89,$138.17,$288.14,$138.17,$174.56,$138.17,$326.89,$138.17,$337.00,$138.17,$138.17,$326.89
4500419B,0981,11760,,,,,N/A,N/A,RECON NAIL BED SIMPLE  11760~P,$488.33,$363.00,$79.54,$194.14,$79.54,$188.18,$79.54,$165.87,$79.54,$194.14,$79.54,$188.18,$79.54,$194.00,$79.54,$79.54,$188.18
4511765B,0981,11765,,,,,N/A,N/A,WEDGE EXC SKIN OF NAIL      ~P,$274.43,$204.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4511770B,0981,11770,,,,,N/A,N/A,EXC OF PILONIDAL CYST SIMP  ~P,$625.54,$465.00,$159.80,$388.00,$159.80,$376.36,$159.80,$331.74,$159.80,$314.73,$159.80,$376.36,$159.80,$388.00,$159.80,$159.80,$376.36
4500601B,0981,12001,,,,,N/A,N/A,LAC REPAIR 2.5CM OR <  12001~P,$208.85,$155.25,$45.36,$199.00,$81.59,$193.03,$81.59,$170.15,$81.59,$45.36,$81.59,$193.03,$81.59,$199.00,$81.59,$81.59,$193.03
4500603B,0981,12002,,,,,N/A,N/A,REP LAC 2.6-7.5 CM     12002~P,$266.36,$198.00,$17.10,$261.00,$17.10,$253.17,$17.10,$223.16,$17.10,$59.83,$17.10,$253.17,$17.10,$261.00,$17.10,$17.10,$253.17
4500606B,0981,12004,,,,,N/A,N/A,REP LAC 7.6-12.5 CM    12004~P,$321.85,$239.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500607B,0981,12005,,,,,N/A,N/A,REP LAC 12.6-20.0 CM   12005~P,$416.69,$309.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500608B,0981,12006,,,,,N/A,N/A,REP LAC 20.1-30.0 CM   12006~P,"$1,398.39","$1,039.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500609B,0981,12007,,,,,N/A,N/A,REPAIR LAC >30CM       12007~P,"$1,511.39","$1,123.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500633B,0981,12011,,,,,N/A,N/A,REPAIR  LAC 2.5 OR <   12011~P,$918.14,$682.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500634B,0981,12013,,,,,N/A,N/A,RPR OF LAC 2.6-5.0 CM  12013~P,$973.63,$723.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500636B,0981,12014,,,,,N/A,N/A,REPAIR LAC 5.1-7.5 CM  12014~P,"$1,080.57",$803.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500637B,0981,12015,,,,,N/A,N/A,REP LAC 7.6-12.5 CM    12015~P,"$1,233.93",$917.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500638B,0981,12016,,,,,N/A,N/A,2 LYR CLOS 20.1-30 CM  12046~P,"$1,415.54","$1,052.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500639B,0981,12017,,,,,N/A,N/A,REP LAC 20.1-30        12017~P,$634.62,$471.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500640B,0981,12018,,,,,N/A,N/A,REP LAC >30 CM         12018~P,$749.64,$557.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4512020B,0981,12020,,,,,N/A,N/A,"SMP CLSRE,WOUND DEHISC 12020~P",$682.04,$507.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4512021B,0981,12021,,,,,N/A,N/A,CLOSURE OF SPLIT WOUND 12021~P,$505.48,$375.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500610B,0981,12031,,,,,N/A,N/A,2LYR CLOS 2.5CM        12031~P,$604.36,$449.25,$119.72,$292.00,$119.72,$283.24,$119.72,$249.66,$119.72,$258.03,$119.72,$283.24,$119.72,$292.00,$119.72,$119.72,$283.24
4500611B,0981,12032,,,,,N/A,N/A,2LYR CLOS 2.6-7.5 CM   12032~P,$728.45,$541.50,$161.13,$393.00,$161.13,$381.21,$161.13,$336.02,$161.13,$323.30,$161.13,$381.21,$161.13,$393.00,$161.13,$161.13,$381.21
4500613B,0981,12034,,,,,N/A,N/A,2 LYR CLOS 7.6-12.5CM  12034~P,$754.69,$561.00,$168.10,$410.00,$168.10,$397.70,$168.10,$350.55,$168.10,$348.85,$168.10,$397.70,$168.10,$410.00,$168.10,$168.10,$397.70
4500614B,0981,12035,,,,,N/A,N/A,2 LYR CLOS 12.6-20     12035~P,$866.68,$644.25,$197.21,$481.00,$197.21,$466.57,$197.21,$411.26,$197.21,$407.81,$197.21,$466.57,$197.21,$481.00,$197.21,$197.21,$466.57
4500615B,0981,12036,,,,,N/A,N/A,2 LYR CLOS 20.1-30CM   12036~P,$988.76,$735.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500616B,0981,12037,,,,,N/A,N/A,2 LYR CLOS > 30CM      12037~P,"$1,144.14",$850.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500625B,0981,12041,,,,,N/A,N/A,2 LYR CLOS 2.5CM OR <  12041~P,$637.65,$474.00,$134.48,$328.00,$134.48,$318.16,$134.48,$280.44,$134.48,$246.94,$134.48,$318.16,$134.48,$328.00,$134.48,$134.48,$318.16
4500627B,0981,12042,,,,,N/A,N/A,2 LYR CLOS 2.6-7.5C    12042~P,$740.56,$550.50,$159.90,$390.00,$159.90,$378.30,$159.90,$333.45,$159.90,$333.41,$159.90,$378.30,$159.90,$390.00,$159.90,$159.90,$378.30
4500629B,0981,12044,,,,,N/A,N/A,2 LYR CLOS 7.6-12.5    12044~P,$784.96,$583.50,$182.40,$444.00,$182.40,$430.68,$182.40,$379.62,$182.40,$361.63,$182.40,$430.68,$182.40,$444.00,$182.40,$182.40,$430.68
4500630B,0981,12045,,,,,N/A,N/A,2 LYR CLOS 12.6-20     12045~P,$888.88,$660.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500631B,0981,12046,,,,,N/A,N/A,2LYR CLOS 20.1-30 CM   12046~P,"$1,616.32","$1,201.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500632B,0981,12047,,,,,N/A,N/A,2 LYR CLOS >30CM       12047~P,"$1,129.00",$839.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500641B,0981,12051,,,,,N/A,N/A,2 LYR CLOS 2.5 CM <    12051~P,$677.00,$503.25,$149.65,$365.00,$149.65,$354.05,$149.65,$312.08,$149.65,$287.31,$149.65,$354.05,$149.65,$365.00,$149.65,$149.65,$354.05
4500642B,0981,12052,,,,,N/A,N/A,2 LYR CLOS 2.5 CM <    12052~P,$812.20,$603.75,$159.90,$390.00,$159.90,$378.30,$159.90,$333.45,$159.90,$339.25,$159.90,$378.30,$159.90,$390.00,$159.90,$159.90,$378.30
4500644B,0981,12053,,,,,N/A,N/A,2 LYR CLOS 5.1-7.5 CM  12053~P,$801.10,$595.50,$179.58,$438.00,$179.58,$424.86,$179.58,$374.49,$179.58,$365.16,$179.58,$424.86,$179.58,$438.00,$179.58,$179.58,$424.86
4500645B,0981,12054,,,,,N/A,N/A,2 LYR CLOS 7.6-12.5    12054~P,$839.44,$624.00,$195.16,$476.00,$195.16,$461.72,$195.16,$406.98,$195.16,$368.30,$195.16,$461.72,$195.16,$476.00,$195.16,$195.16,$461.72
4500646B,0981,12055,,,,,N/A,N/A,2 LYR CLOS 12.6-20 CM  12055~P,$884.84,$657.75,$252.56,$616.00,$252.56,N/A,$252.56,$526.68,$252.56,$503.70,$252.56,N/A,$252.56,$616.00,$252.56,$252.56,N/A
4500647B,0981,12056,,,,,N/A,N/A,2 LYR CLOS 20.1-30CM   12056~P,"$1,273.28",$946.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500648B,0981,12057,,,,,N/A,N/A,2 LYR CLOS >30 CM      12057~P,"$1,408.48","$1,047.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500653B,0981,13101,,,,,N/A,N/A,COMP REPAIR 2.5-7.5 CM 13101~P,"$1,059.39",$787.50,$25.51,$611.00,$25.51,$592.67,$25.51,$522.41,$25.51,$426.93,$25.51,$592.67,$25.51,$611.00,$25.51,$25.51,$592.67
4500658B,0981,13120,,,,,N/A,N/A,COMP REP SCLP/ARM/LEG  13120~P,"$1,207.70",$897.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500659B,0981,13121,,,,,N/A,N/A,COMP REPSCLP/ARM/LEG   13121~P,"$1,214.76",$903.00,$269.37,$657.00,$269.37,$637.29,$269.37,$561.74,$269.37,$440.29,$269.37,$637.29,$269.37,$657.00,$269.37,$269.37,$637.29
4500655B,0981,13132,,,,,N/A,N/A,COMP REP 2.6-7.5 CM    13132~P,"$1,748.49","$1,299.75",$26.35,$635.00,$26.35,$615.95,$26.35,$542.93,$26.35,$515.68,$26.35,$615.95,$26.35,$635.00,$26.35,$26.35,$615.95
4500503B,0981,16000,,,,,N/A,N/A,1ST DEGREE BURN INT    16000~P,$175.56,$130.50,$45.51,$111.00,$45.51,$107.67,$45.51,$94.91,$45.51,$46.41,$45.51,$107.67,$45.51,$111.00,$45.51,$45.51,$107.67
4500504B,0981,16020,,,,,N/A,N/A,DEBRIDE SML BURN       16020~P,$219.95,$163.50,$53.71,$131.00,$53.71,$127.07,$53.71,$112.01,$53.71,$93.42,$53.71,$127.07,$53.71,$131.00,$53.71,$53.71,$127.07
4500505B,0981,16025,,,,,N/A,N/A,DEBRMT OF MEDIUM BURNS 16025~P,$425.77,$316.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500506B,0981,16030,,,,,N/A,N/A,DEBRIDMNT OF LGE BURNS 1603O~P,$485.30,$360.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500507B,0981,16035,,,,,N/A,N/A,ESCHAROTOMY            16035~P,$747.62,$555.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4517250B,0981,17250,,,,,N/A,N/A,CAUTERIZATION CHEMICAL 17250~P,$152.35,$113.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4502012B,0981,20102,,,,,N/A,N/A,WOUND EXPLORATN ABMN   201O2~P,$911.07,$677.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4502013B,0981,20103,,,,,N/A,N/A,WOUND EXPLORATN  EXTRY 201O3~P,"$1,274.29",$947.25,$336.20,$820.00,$336.20,$795.40,$336.20,$701.10,$336.20,$612.09,$336.20,$795.40,$336.20,$820.00,$336.20,$336.20,$795.40
4500211B,0981,20520,,,,,N/A,N/A,RMV FB MUSCLE TEN/SH   20520~P,$530.70,$394.50,$144.32,$362.00,$144.32,$351.14,$144.32,$309.51,$144.32,$264.30,$144.32,$351.14,$144.32,$362.00,$144.32,$144.32,$351.14
4500227B,0981,20525,,,,,N/A,N/A,FB REMVL MUSCLE CMPLX  20525~P,$908.05,$675.00,$236.16,$578.00,$236.16,$560.66,$236.16,$494.19,$236.16,$439.37,$236.16,$560.66,$236.16,$578.00,$236.16,$236.16,$560.66
4500229B,0981,20550,,,,,N/A,N/A,INJECTION TENDON SHTH  20550~P,$159.41,$118.50,$41.41,$101.00,$41.41,$97.97,$41.41,$86.36,$41.41,$69.22,$41.41,$97.97,$41.41,$101.00,$41.41,$41.41,$97.97
4520551B,0981,20551,,,,,N/A,N/A,INJ: SNGLTNDN ORGN     20551~P,$179.59,$133.50,$69.85,$337.00,$125.87,$326.89,$125.87,$288.14,$125.87,$69.85,$125.87,$326.89,$125.87,$337.00,$125.87,$125.87,$326.89
4520552B,0981,20552,,,,,N/A,N/A,INJ: TRIGER POINTS     20552~P,$160.42,$119.25,$34.30,$590.00,$34.30,$572.30,$34.30,$504.45,$34.30,$67.34,$34.30,$572.30,$34.30,$590.00,$34.30,$34.30,$572.30
4520553B,0981,20553,,,,,N/A,N/A,INJ: TRIGER POINTS     20553~P,$160.42,$119.25,$76.14,$590.00,N/A,$572.30,N/A,$504.45,N/A,$76.14,N/A,$572.30,N/A,$590.00,N/A,N/A,$572.30
4500202B,0981,20600,,,,,N/A,N/A,ARTHRO SM JOINT        20600~P,$151.34,$112.50,$39.36,$96.00,$39.36,$93.12,$39.36,$82.08,$39.36,$63.57,$39.36,$93.12,$39.36,$96.00,$39.36,$39.36,$93.12
4500205B,0981,20605,,,,,N/A,N/A,ARTHRO INTER JOINT     20605~P,$439.90,$327.00,$39.77,$99.00,$39.77,$96.03,$39.77,$84.65,$39.77,$66.08,$39.77,$96.03,$39.77,$99.00,$39.77,$39.77,$96.03
4500208B,0981,20610,,,,,N/A,N/A,ARTHRO MAJOR JOINT     20610~P,$192.71,$143.25,$51.25,$125.00,$51.25,$121.25,$51.25,$106.88,$51.25,$80.71,$51.25,$121.25,$51.25,$125.00,$51.25,$51.25,$121.25
4521315B,0981,21315,,,,,N/A,N/A,CLSED TREAT OF NASAL BONE FX~P,$114.01,$84.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4521320B,0981,21320,,,,,N/A,N/A,FRACTURE/DISLOC PROC ON HEAD~P,$114.01,$84.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4521480B,0981,21480,,,,,N/A,N/A,RESET DISLOCATED JAW   21480~P,$127.13,$94.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500337B,0981,21820,,,,,N/A,N/A,FX STERNUM CLOSED    21820  ~P,$513.55,$381.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500339B,0981,22310,,,,,N/A,N/A,FX VERTEBRAL BODY    2231054~P,"$1,004.90",$747.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500279B,0981,23330,,,,,N/A,N/A,RMV FB SHLDR SUBCUT    23330~P,$546.85,$406.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500340B,0981,23500,,,,,N/A,N/A,FX CLAVICLE CLOSED     23500~P,$777.89,$578.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500341B,0981,23505,,,,,N/A,N/A,FX CLAVICLE W MANPLTN  23505~P,"$1,181.47",$878.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500342B,0981,23520,,,,,N/A,N/A,DSLST CLAVICULAR     2352054~P,$820.27,$609.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4523525B,0981,23525,,,,,N/A,N/A,CLSD TX STERNO CLAV    23525~P,"$1,211.74",$900.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500316B,0981,23540,,,,,N/A,N/A,DISC CLSD AC JOIN    2354054~P,$791.01,$588.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4523545B,0981,23545,,,,,N/A,N/A,TREAT CLAVICLE DISLOCATION  ~P,$760.74,$565.50,$251.74,$251.74,$251.74,N/A,$251.74,N/A,$251.74,N/A,$251.74,N/A,$251.74,N/A,$251.74,$251.74,N/A
4500343B,0981,23570,,,,,N/A,N/A,FX SCAPULA CLOS      2357054~P,$840.45,$624.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500344B,0981,23600,,,,,N/A,N/A,FX HUMERAL NC CLOSE  2360054~P,"$1,070.49",$795.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500345B,0981,23620,,,,,N/A,N/A,FX GRT ERTUBEROSITY  23620  ~P,$901.99,$670.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500317B,0981,23650,,,,,N/A,N/A,CLSD SHLDER W/O ANS  2365054~P,$980.69,$729.00,$171.38,"$1,367.70",$171.38,"$1,367.70",$171.38,$357.39,$171.38,$528.05,$171.38,"$1,367.70",$171.38,$418.00,$171.38,$171.38,"$1,367.70"
4500346B,0981,23655,,,,,N/A,N/A,DISLOC SHLDR W ANES  2365554~P,"$1,408.48","$1,047.00",$336.20,$820.00,$336.20,$405.46,$336.20,$701.10,$336.20,$735.61,$336.20,$405.46,$336.20,$820.00,$336.20,$336.20,$405.46
4523931B,0981,23931,,,,,N/A,N/A,I&D UPPER ARMS; BURSA  23931~P,$600.32,$446.25,$128.33,$479.18,$128.33,$479.18,$128.33,$267.62,$128.33,$286.94,$128.33,$479.18,$128.33,$313.00,$128.33,$128.33,$479.18
4500298B,0981,24200,,,,,N/A,N/A,REM FB UPPER ARM/ELBW  24200~P,$506.49,$376.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500347B,0981,24500,,,,,N/A,N/A,FX HUMERALSHAFT CLSD 2450054~P,"$1,140.10",$847.50,$264.86,$646.00,$264.86,$626.62,$264.86,$552.33,$264.86,$602.39,$264.86,$626.62,$264.86,$646.00,$264.86,$264.86,$626.62
4502453B,0981,24530,,,,,N/A,N/A,FX HUMRL TRNSCNDY LA 2453054~P,"$1,218.80",$906.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4502456B,0981,24560,,,,,N/A,N/A,FX HUMERALEPCONDYLAR 2456054~P,"$1,005.91",$747.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500318B,0981,24600,,,,,N/A,N/A,DISC CLSD ELBOW      2460054~P,"$1,173.40",$872.25,$295.20,$720.00,$295.20,$698.40,$295.20,$615.60,$295.20,$606.06,$295.20,$698.40,$295.20,$720.00,$295.20,$295.20,$698.40
4500348B,0981,24605,,,,,N/A,N/A,DISLOC ELBOW W ANES  2460554~P,"$1,672.82","$1,243.50",$415.33,"$1,013.00",$415.33,$982.61,$415.33,$866.12,$415.33,$861.15,$415.33,$982.61,$415.33,"$1,013.00",$415.33,$415.33,$982.61
4500319B,0981,24640,,,,,N/A,N/A,DISC RAD HEAD SU CH  2464054~P,$323.87,$240.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500349B,0981,24650,,,,,N/A,N/A,FX RADL HEAD W/OMANI 2465054~P,$841.46,$625.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4502467B,0981,24670,,,,,N/A,N/A,FX PROXIMAL ULNA     2467054~P,$927.22,$689.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500350B,0981,25500,,,,,N/A,N/A,FX RADIAL SHAFT      2550054~P,$869.71,$646.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500351B,0981,25530,,,,,N/A,N/A,FX ULNAR SHAFT       25530~P,$831.37,$618.00,$189.42,$462.00,$189.42,$448.14,$189.42,$395.01,$189.42,$441.10,$189.42,$448.14,$189.42,$462.00,$189.42,$189.42,$448.14
4500352B,0981,25560,,,,,N/A,N/A,FX ULNAR & RADIA SFT 25560  ~P,$868.70,$645.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500353B,0981,25600,,,,,N/A,N/A,FX DISTAL SHAFT      25600  ~P,$941.34,$699.75,$215.25,$585.83,$215.25,$509.25,$215.25,$448.88,$215.25,$585.83,$215.25,$509.25,$215.25,$525.00,$215.25,$215.25,$509.25
4500354B,0981,25622,,,,,N/A,N/A,FX CARPAL SCAPHOID   2562254~P,$969.59,$720.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4525630B,0981,25630,,,,,N/A,N/A,CLSED FX CARPAL BONE W/O MAN~P,$962.53,$715.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500355B,0981,25650,,,,,N/A,N/A,FX ULNAR STYLOID     2565054~P,"$1,055.35",$784.50,$239.30,$583.00,$239.30,$565.51,$239.30,$498.47,$239.30,$553.52,$239.30,$565.51,$239.30,$583.00,$239.30,$239.30,$565.51
4500356B,0981,25690,,,,,N/A,N/A,DISLOCATION LUNATE     25690~P,"$1,705.11","$1,267.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500408B,0981,26010,,,,,N/A,N/A,I&D FINGER ABS SIMPL   26010~P,$495.39,$368.25,$126.69,$126.69,$126.69,N/A,$126.69,N/A,$126.69,N/A,$126.69,N/A,$126.69,N/A,$126.69,$126.69,N/A
4500657B,0981,26410,,,,,N/A,N/A,EXT TEND REP DORS HD 2641054~P,"$2,059.25","$1,530.75",$623.20,$623.20,$623.20,N/A,$623.20,N/A,$623.20,N/A,$623.20,N/A,$623.20,N/A,$623.20,$623.20,N/A
4500656B,0981,26418,,,,,N/A,N/A,EXT TEND REP DORS FG 2641854~P,"$2,092.54","$1,555.50",$464.53,$464.53,$464.53,N/A,$464.53,N/A,$464.53,N/A,$464.53,N/A,$464.53,N/A,$464.53,$464.53,N/A
4500331B,0981,26600,,,,,N/A,N/A,CL/FX METACARPAL SG  26600  ~P,$955.47,$710.25,$216.89,$216.89,$216.89,N/A,$216.89,N/A,$216.89,N/A,$216.89,N/A,$216.89,N/A,$216.89,$216.89,N/A
4526605B,0981,26605,,,,,N/A,N/A,TREAT METACARPAL FRACTURE   ~P,$586.19,$435.75,$249.69,$249.69,$249.69,N/A,$249.69,N/A,$249.69,N/A,$249.69,N/A,$249.69,N/A,$249.69,$249.69,N/A
4500320B,0981,26641,,,,,N/A,N/A,DISC CARPOMET THUMB  2664154~P,"$1,175.42",$873.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500357B,0981,26645,,,,,N/A,N/A,FX CARPOMETACARPAL   2664554~P,"$1,378.21","$1,024.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500441B,0981,26670,,,,,N/A,N/A,DSLC CARPOMETACARPAL 2667054~P,"$1,062.41",$789.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500321B,0981,26700,,,,,N/A,N/A,DIS CARPOMETACARPAL  26700  ~P,"$1,052.32",$782.25,$249.69,$249.69,$249.69,N/A,$249.69,N/A,$249.69,N/A,$249.69,N/A,$249.69,N/A,$249.69,$249.69,N/A
4500442B,0981,26705,,,,,N/A,N/A,DSLC MP FGR W ANEST  2670554~P,"$1,348.95","$1,002.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500332B,0981,26720,,,,,N/A,N/A,CL/FX PHALANGEAL EA  2672054~P,$641.69,$477.00,$145.14,$145.14,$145.14,N/A,$145.14,N/A,$145.14,N/A,$145.14,N/A,$145.14,N/A,$145.14,$145.14,N/A
4500358B,0981,26725,,,,,N/A,N/A,FX PHLNGEAL SHFT/MA  2672554~P,"$1,085.62",$807.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500359B,0981,26727,,,,,N/A,N/A,FX PHALANGEALSHFT/PRCT 26727~P,"$1,701.07","$1,264.50",$439.11,$439.11,$439.11,N/A,$439.11,N/A,$439.11,N/A,$439.11,N/A,$439.11,N/A,$439.11,$439.11,N/A
4500333B,0981,26750,,,,,N/A,N/A,CL/FX DISTAL PHAL E  26750  ~P,$638.66,$474.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500360B,0981,26755,,,,,N/A,N/A,FX DSTL PHLNX MANI   2675554~P,$968.58,$720.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500361B,0981,26765,,,,,N/A,N/A,FX PHLNX DISTAL OPN         ~P,"$1,771.70","$1,317.00",$47.13,$47.13,$47.13,N/A,$47.13,N/A,$47.13,N/A,$47.13,N/A,$47.13,N/A,$47.13,$47.13,N/A
4500325B,0981,26770,,,,,N/A,N/A,DISC IPJOINTS FINGER  26770 ~P,$883.83,$657.00,$27.50,$27.50,$27.50,N/A,$27.50,N/A,$27.50,N/A,$27.50,N/A,$27.50,N/A,$27.50,$27.50,N/A
4500362B,0981,26775,,,,,N/A,N/A,DSLC IP FINGER WANEST  26775~P,"$1,226.87",$912.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500219B,0981,27086,,,,,N/A,N/A,RMV FB PELVIS/HIP      27086~P,$543.82,$404.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500363B,0981,27200,,,,,N/A,N/A,FX COCCYX CLOSED     2720054~P,$660.86,$491.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4527265B,0981,27265,,,,,N/A,N/A,CLSD HIP RDS/P RPLMT   27265~P,"$1,419.58","$1,055.25",$375.56,$375.56,$375.56,N/A,$375.56,N/A,$375.56,N/A,$375.56,N/A,$375.56,N/A,$375.56,$375.56,N/A
4527508B,0981,27508,,,,,N/A,N/A,TREATMENT OF THIGH FRACTURE ~P,"$1,243.01",$924.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500369B,0981,27520,,,,,N/A,N/A,FX PATELLA           2752054~P,"$1,045.26",$777.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4527530B,0981,27530,,,,,N/A,N/A,CLSD TMT TBL FRX PRCML 27530~P,"$1,321.71",$982.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500322B,0981,27550,,,,,N/A,N/A,CLSD TRMT TIBIAL SHAFT 27750~P,"$1,651.63","$1,227.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500323B,0981,27560,,,,,N/A,N/A,DISCLOCATION PTLLR   2756054~P,"$1,237.97",$920.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500370B,0981,27560,,,,,N/A,N/A,DISLOCATION PATELLA  2756054~P,"$1,237.97",$920.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500436B,0981,27603,,,,,N/A,N/A,I&D ABSCSS ANKLE/LEG 2760354~P,"$1,431.69","$1,064.25",$414.51,"$1,011.00",$414.51,$980.67,$414.51,$864.41,$414.51,$699.71,$414.51,$980.67,$414.51,"$1,011.00",$414.51,$414.51,$980.67
4500371B,0981,27750,,,,,N/A,N/A,FX TIBIAL SHAFT      2775054~P,"$1,129.00",$839.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500372B,0981,27760,,,,,N/A,N/A,FX DISTAL MEDIAL MA  2776054~P,"$1,082.59",$804.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4527767B,0981,27767,,,,,N/A,N/A,CLOSED TREAT POST MAL FX    ~P,$780.92,$580.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4527768B,0981,27768,,,,,N/A,N/A,TX POST MALL FX        27768~P,"$1,534.60","$1,140.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500373B,0981,27780,,,,,N/A,N/A,FX FIBULA            2778054~P,$979.68,$728.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4527786B,0981,27786,,,,,N/A,N/A,CLSD TX DISTAL FIBULA FX    ~P,$712.31,$529.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4527810B,0981,27810,,,,,N/A,N/A,TREATMENT OF ANKLE FRACTURE ~P,"$1,012.98",$753.00,$256.66,$764.31,$256.66,$607.22,$256.66,$535.23,$256.66,$764.31,$256.66,$607.22,$256.66,$626.00,$256.66,$256.66,$607.22
4527818B,0981,27818,,,,,N/A,N/A,TRMNT ANKLE FRACTURE 2781854-P,"$1,573.95","$1,170.00",$41.41,"$1,001.00",$41.41,$970.97,$41.41,$855.86,$41.41,$783.77,$41.41,$970.97,$41.41,"$1,001.00",$41.41,$41.41,$970.97
4500324B,0981,27840,,,,,N/A,N/A,DISC ANKLE           2784054~P,"$1,289.43",$958.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500223B,0981,28190,,,,,N/A,N/A,RMV FB FOOT SUBCUT   2819054~P,$504.47,$375.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500228B,0981,28192,,,,,N/A,N/A,RMV FB FOOT DEEP       28192~P,"$1,184.50",$880.50,$318.16,$776.00,$318.16,$752.72,$318.16,$663.48,$318.16,$559.29,$318.16,$752.72,$318.16,$776.00,$318.16,$318.16,$752.72
45028400B,0981,28400,,,,,N/A,N/A,"CLSD TX CALCANL FX,W/OMANIP ~P",$792.02,$588.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4528430B,0981,28430,,,,,N/A,N/A,TREATMENT OF FX/DISL FOOT/TOE,$586.19,$435.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500375B,0981,28450,,,,,N/A,N/A,FX TARSAL            2845054~P,$693.14,$515.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500328B,0981,28470,,,,,N/A,N/A,CL/FX METATARSAL E   28470  ~P,$691.12,$513.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4501328B,0981,28470,,,,,N/A,N/A,CL/FX METATARSAL EA    28470~P,$484.29,$360.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4528475B,0981,28475,,,,,N/A,N/A,TREATMENT OF METATARSAL FX  ~P,$314.79,$234.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500329B,0981,28490,,,,,N/A,N/A,CL/FX GREAT TOE      28490  ~P,$448.98,$333.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500330B,0981,28510,,,,,N/A,N/A,CL/FX OTHER TOES     2851054~P,$433.84,$322.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500376B,0981,28515,,,,,N/A,N/A,FX OTHER TOE W MANIP 2851554~P,$523.64,$389.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500377B,0981,28530,,,,,N/A,N/A,FX SESAMOID          2853054~P,$382.39,$284.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500327B,0981,28630,,,,,N/A,N/A,DISC MTP JOINT         28630~P,$406.60,$302.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500326B,0981,28660,,,,,N/A,N/A,DISC IPJOINTS TOES   2866054~P,$321.85,$239.25,$77.90,$190.00,$77.90,$184.30,$77.90,$162.45,$77.90,$164.42,$77.90,$184.30,$77.90,$190.00,$77.90,$77.90,$184.30
4500382B,0981,28665,,,,,N/A,N/A,DISLOCATION TOE W ANES 28665~P,$499.43,$371.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4529065B,0981,29065,,,,,N/A,N/A,LONG ARM CAST APPLICATION   ~P,$206.83,$153.75,$98.40,$240.00,$98.40,$232.80,$98.40,$205.20,$98.40,$120.15,$98.40,$232.80,$98.40,$240.00,$98.40,$98.40,$232.80
4529075B,0981,29075,,,,,N/A,N/A,SHORT ARM CAST APPLICATION  ~P,$187.66,$139.50,$56.58,$138.00,$56.58,$133.86,$56.58,$117.99,$56.58,$110.37,$56.58,$133.86,$56.58,$138.00,$56.58,$56.58,$133.86
4500383B,0981,29105,,,,,N/A,N/A,LONG ARM SPLINT APP    29105~P,$221.97,$165.00,$54.12,$132.00,$54.12,$128.04,$54.12,$112.86,$54.12,$73.88,$54.12,$128.04,$54.12,$132.00,$54.12,$54.12,$128.04
4500384B,0981,29125,,,,,N/A,N/A,SHORT ARM SPLINT APP   29125~P,$168.49,$125.25,$36.49,$93.00,$36.49,$90.21,$36.49,$79.52,$36.49,$70.50,$36.49,$90.21,$36.49,$93.00,$36.49,$36.49,$90.21
4500385B,0981,29130,,,,,N/A,N/A,FINGERS/HAND SPLT APP  29130~P,$114.01,$84.75,$26.65,$65.00,$26.65,$63.05,$26.65,$55.58,$26.65,$50.99,$26.65,$63.05,$26.65,$65.00,$26.65,$26.65,$63.05
4500388B,0981,29240,,,,,N/A,N/A,SHOULDER SPLINT APP    29240~P,$170.51,$126.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500387B,0981,29260,,,,,N/A,N/A,ELBOW/WRIST SPLT APP   29260~P,$144.28,$107.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500389B,0981,29280,,,,,N/A,N/A,STRAPPING FNGR/HAND    29280~P,$141.25,$105.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4529345B,0981,29345,,,,,N/A,N/A,LONG LEG CAST APPLICATION   ~P,$300.66,$223.50,$96.35,$235.00,$96.35,$227.95,$96.35,$200.93,$96.35,$175.91,$96.35,$227.95,$96.35,$235.00,$96.35,$96.35,$227.95
4529405B,0981,29405,,,,,N/A,N/A,SHORT LEG CAST APPLICATION  ~P,$180.60,$134.25,$12.90,$150.00,$12.90,$145.50,$12.90,$128.25,$12.90,$103.99,$12.90,$145.50,$12.90,$150.00,$12.90,$12.90,$145.50
4500390B,0981,29505,,,,,N/A,N/A,LONG LEG SPLINT APP    29505~P,$179.59,$133.50,$41.00,$100.00,$41.00,$97.00,$41.00,$85.50,$41.00,$91.41,$41.00,$97.00,$41.00,$100.00,$41.00,$41.00,$97.00
4500391B,0981,29515,,,,,N/A,N/A,SHORT LEG SPLINT APP   29515~P,$189.68,$141.00,$46.74,$114.00,$46.74,$110.58,$46.74,$97.47,$46.74,$86.92,$46.74,$110.58,$46.74,$114.00,$46.74,$46.74,$110.58
4500392B,0981,29530,,,,,N/A,N/A,STRAPPING KNEE         29530~P,$144.28,$107.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500393B,0981,29540,,,,,N/A,N/A,STRAPPING ANKLE/FOOT   29540~P,$95.85,$71.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500394B,0981,29550,,,,,N/A,N/A,STRAPPING TOES         29550~P,$69.62,$51.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
45029581B,0981,29581,,,,,N/A,N/A,MULTI DRESSING LEG BELW KNEE~P,$51.46,$38.25,$39.36,$96.00,$39.36,$93.12,$39.36,$82.08,$39.36,$49.74,$39.36,$93.12,$39.36,$96.00,$39.36,$39.36,$93.12
4529584B,0981,29584,,,,,N/A,N/A,"JONES DRESS,UPR ARM TO HAND ~P",$73.65,$54.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500396B,0981,29700,,,,,N/A,N/A,REMOVAL BIVALVE CAST   29700~P,$133.18,$99.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4529700B,0981,29700,,,,,N/A,N/A,"CAST REMOVAL,BOOT OR BODY   ~P",$101.90,$75.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500397B,0981,29705,,,,,N/A,N/A,REM FULL ARM/LEG CAST  29705~P,$249.21,$185.25,$51.25,$125.00,$51.25,$121.25,$51.25,$106.88,$51.25,$80.72,$51.25,$121.25,$51.25,$125.00,$51.25,$51.25,$121.25
4500266B,0981,30300,,,,,N/A,N/A,RMV FB INTRANASAL      30300~P,$473.19,$351.75,$184.93,"$1,010.00",N/A,$979.70,N/A,$863.55,N/A,$184.93,N/A,$979.70,N/A,"$1,010.00",N/A,N/A,$979.70
4530300B,0981,30300,,,,,N/A,N/A,"FB REMOVAL,INTRANASAL  30300~P",$473.19,$351.75,$184.93,"$1,010.00",N/A,$979.70,N/A,$863.55,N/A,$184.93,N/A,$979.70,N/A,"$1,010.00",N/A,N/A,$979.70
4500012B,0981,30901,,,,,N/A,N/A,EPISTAXIS CTRL NASAL   30901~P,$219.95,$163.50,$83.33,$741.00,N/A,$718.77,N/A,$633.56,N/A,$83.33,N/A,$718.77,N/A,$741.00,N/A,N/A,$718.77
4500113,0981,30903,,,,,N/A,N/A,EPISTAXIS CAUTERY/PKG  30903~P,$754.69,$561.00,$114.78,"$1,572.00",N/A,"$1,524.84",N/A,"$1,344.06",N/A,$114.78,N/A,"$1,524.84",N/A,"$1,572.00",N/A,N/A,"$1,524.84"
4500114B,0981,30905,,,,,N/A,N/A,EPISTAXIS PSTERR PCKG  30905~P,$383.40,$285.00,$156.57,"$1,082.00",N/A,"$1,049.54",N/A,$925.11,N/A,$156.57,N/A,"$1,049.54",N/A,"$1,082.00",N/A,N/A,"$1,049.54"
4500016B,0981,31500,,,,,N/A,N/A,ENDOTRACHEAL INTUB     31500~P,$409.63,$304.50,$62.32,"$1,667.00",$62.32,"$1,616.99",$62.32,"$1,425.29",$62.32,$210.87,$62.32,"$1,616.99",$62.32,"$1,667.00",$62.32,$62.32,"$1,616.99"
4503150B,0981,31505,,,,,N/A,N/A,INDIRECT LARYNGOSCOPY  31505~P,$193.72,$144.00,$72.95,$477.00,N/A,$462.69,N/A,$407.84,N/A,$72.95,N/A,$462.69,N/A,$477.00,N/A,N/A,$462.69
4500115B,0981,31511,,,,,N/A,N/A,LARYNGOSCOPY FB REMOV  31511~P,$416.69,$309.75,$196.94,$911.00,N/A,$883.67,N/A,$778.91,N/A,$196.94,N/A,$883.67,N/A,$911.00,N/A,N/A,$883.67
4500116B,0981,31515,,,,,N/A,N/A,DIRECT LARYNGOSCOPY    31515~P,$416.69,$309.75,$165.03,"$4,524.00",N/A,"$4,388.28",N/A,"$3,868.02",N/A,$165.03,N/A,"$4,388.28",N/A,"$4,524.00",N/A,N/A,"$4,388.28"
4500117B,0981,31525,,,,,N/A,N/A,LARYNGOSCOPY DIAGNOSTC 31525~P,$607.38,$451.50,$236.75,"$4,978.00",N/A,"$4,828.66",N/A,"$4,256.19",N/A,$236.75,N/A,"$4,828.66",N/A,"$4,978.00",N/A,N/A,"$4,828.66"
4500118B,0981,31575,,,,,N/A,N/A,DRT FLEX LARYNGOSCOPY  31575~P,$296.63,$220.50,$100.23,$677.00,N/A,$656.69,N/A,$578.84,N/A,$100.23,N/A,$656.69,N/A,$677.00,N/A,N/A,$656.69
4500019B,0981,31603,,,,,N/A,N/A,TRACHEOSTOMY-TRANSTR   31603~P,$831.37,$618.00,$474.79,"$4,557.00",N/A,"$4,420.29",N/A,"$3,896.24",N/A,$474.79,N/A,"$4,420.29",N/A,"$4,557.00",N/A,N/A,"$4,420.29"
4500063B,0981,31605,,,,,N/A,N/A,TRACHEOSTOMY-CRIC/MB   31605~P,$675.99,$502.50,$185.73,$488.64,$185.73,$439.41,$185.73,$387.32,$185.73,$488.64,$185.73,$439.41,$185.73,$453.00,$185.73,$185.73,$439.41
4500119B,0981,31622,,,,,N/A,N/A,BRONCHOSCOPY           31622~P,$551.89,$410.25,$197.53,$359.00,N/A,$348.23,N/A,$306.95,N/A,$197.53,N/A,$348.23,N/A,$359.00,N/A,N/A,$348.23
4500057B,0981,32000,,,,,N/A,N/A,Thoracentesis/Aspir    32554~p,$296.63,$220.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4503200B,0981,32002,,,,,N/A,N/A,Thoracentesis          32554~p,$470.17,$349.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500070,0981,32160,,,,,N/A,N/A,THORACOTOMY-CARDIAC,"$2,857.32","$2,124.00","$1,353.41","$2,832.00",N/A,"$2,747.04",N/A,"$2,421.36",N/A,"$1,353.41",N/A,"$2,747.04",N/A,"$2,832.00",N/A,N/A,"$2,747.04"
4532551B,0981,32551,,,,,N/A,N/A,TUBE THORACOSTOMY      32551~P,$710.29,$528.00,$174.25,$425.00,$174.25,$412.25,$174.25,$363.38,$174.25,$267.10,$174.25,$412.25,$174.25,$425.00,$174.25,$174.25,$412.25
45032554B,0981,32554,,,,,N/A,N/A,PERICARDIOCENTESIS          ~P,$304.70,$226.50,$155.38,"$1,018.00",$417.38,$987.46,$417.38,$870.39,$417.38,$155.38,$417.38,$987.46,$417.38,"$1,018.00",$417.38,$417.38,$987.46
4532555B,0981,32555,,,,,N/A,N/A,THORACENTESIS W/IMAG GUIDAN~P,$470.17,$349.50,$192.61,$718.00,$294.38,$696.46,$294.38,$613.89,$294.38,$192.61,$294.38,$696.46,$294.38,$718.00,$294.38,$294.38,$696.46
4500120B,0981,33210,,,,,N/A,N/A,TRANSVENO TMP PCMKR  3321054~P,$691.12,$513.75,$143.91,$351.00,$143.91,$340.47,$143.91,$300.11,$143.91,$275.25,$143.91,$340.47,$143.91,$351.00,$143.91,$143.91,$340.47
4535207B,0981,35207,,,,,N/A,N/A,"SURG REPAIR HAND,FINGER     ~P","$2,107.68","$1,566.75",$675.27,"$1,647.00",$675.27,"$1,597.59",$675.27,"$1,408.19",$675.27,"$1,310.50",$675.27,"$1,597.59",$675.27,"$1,647.00",$675.27,$675.27,"$1,597.59"
4500122,0981,36010,,,,,N/A,N/A,INT. CATHETER INF/SUP  36010~P,$470.17,$349.50,$185.72,$466.00,N/A,$452.02,N/A,$398.43,N/A,$185.72,N/A,$452.02,N/A,$466.00,N/A,N/A,$452.02
4500123,0981,36410,,,,,N/A,N/A,VENIPUNCTURE>3 REQ.    36410~P,$90.80,$67.50,$15.71,$46.00,N/A,$44.62,N/A,$39.33,N/A,$15.71,N/A,$44.62,N/A,$46.00,N/A,N/A,$44.62
4536555B,0981,36555,,,,,N/A,N/A,CENTRAL LINE INSERTION 36555~P,$493.37,$366.75,$143.35,"$3,359.00",N/A,"$3,258.23",N/A,"$2,871.95",N/A,$143.35,N/A,"$3,258.23",N/A,"$3,359.00",N/A,N/A,"$3,258.23"
4536556B,0981,36556,,,,,N/A,N/A,CENTRAL LINE INSERTION 36556~P,$493.37,$366.75,$142.40,$419.00,$171.79,$406.43,$171.79,$358.25,$171.79,$142.40,$171.79,$406.43,$171.79,$419.00,$171.79,$171.79,$406.43
4536573B,0981,36573,,,,,N/A,N/A,PICC 5YRS>                  ~P,$208.85,$155.25,$142.32,"$1,645.74","$1,645.74",$794.43,"$1,645.74",$700.25,"$1,645.74",$142.32,"$1,645.74",$794.43,"$1,645.74",$819.00,"$1,645.74","$1,645.74",$794.43
4500092,0981,36600,,,,,N/A,N/A,ER ABG DRAW FEE        36600~P,$209.86,$156.00,$26.61,$208.00,$85.28,$201.76,$85.28,$177.84,$85.28,$26.61,$85.28,$201.76,$85.28,$208.00,$85.28,$85.28,$201.76
4536620B,0981,36620,,,,,N/A,N/A,ARTERIAL CATH               ~P,$198.76,$147.75,$53.71,$131.00,$53.71,$127.07,$53.71,$112.01,$53.71,$75.19,$53.71,$127.07,$53.71,$131.00,$53.71,$53.71,$127.07
4500127B,0981,37785,,,,,N/A,N/A,LIG VARICOSE VEINS     37785~P,$997.84,$741.75,$429.04,"$3,907.00",N/A,"$3,789.79",N/A,"$3,340.49",N/A,$429.04,N/A,"$3,789.79",N/A,"$3,907.00",N/A,N/A,"$3,789.79"
4500268B,0981,40804,,,,,N/A,N/A,FB REM MOUTH EMBDED  4080454~P,$498.42,$370.50,$174.27,"$1,094.00",N/A,"$1,061.18",N/A,$935.37,N/A,$174.27,N/A,"$1,061.18",N/A,"$1,094.00",N/A,N/A,"$1,061.18"
4500661B,0981,41250,,,,,N/A,N/A,REP FLR MTH 0-2.5CM    41250~P,$546.85,$406.50,$232.76,$633.00,N/A,$614.01,N/A,$541.22,N/A,$232.76,N/A,$614.01,N/A,$633.00,N/A,N/A,$614.01
4500457B,0981,42700,,,,,N/A,N/A,I&D PERITONSILLARABS 4270054~P,$523.64,$389.25,$203.90,$633.00,N/A,$614.01,N/A,$541.22,N/A,$203.90,N/A,$614.01,N/A,$633.00,N/A,N/A,$614.01
4500226B,0981,42809,,,,,N/A,N/A,RMVL FB PHARYNX        42809~P,$498.42,$370.50,$188.52,$633.00,N/A,$614.01,N/A,$541.22,N/A,$188.52,N/A,$614.01,N/A,$633.00,N/A,N/A,$614.01
4542960B,0981,42960,,,,,N/A,N/A,CONTRL THROAT BLEEDING 42960~P,$645.72,$480.00,$245.37,"$1,102.00",N/A,"$1,068.94",N/A,$942.21,N/A,$245.37,N/A,"$1,068.94",N/A,"$1,102.00",N/A,N/A,"$1,068.94"
45043753B,0981,43753,,,,,N/A,N/A,"GASTRIC INTUB/ASP,INC LAVAGE~P",$77.69,$57.75,$17.22,$42.00,$17.22,$40.74,$17.22,$35.91,$17.22,$36.73,$17.22,$40.74,$17.22,$42.00,$17.22,$17.22,$40.74
4543762B,0981,43762,,,,,N/A,N/A,REPLACE GASTROSTOMY TUBE,$336.99,$250.50,$19.65,$465.00,$19.65,$451.05,$19.65,$397.58,$19.65,$63.34,$19.65,$451.05,$19.65,$465.00,$19.65,$19.65,$451.05
4500461B,0981,46040,,,,,N/A,N/A,I&D ISCHIORCTL ABSCSS  46040~P,"$1,452.87","$1,080.00",$311.60,"$1,440.00",$311.60,"$1,396.80",$311.60,"$1,231.20",$311.60,$408.89,$311.60,"$1,396.80",$311.60,"$1,440.00",$311.60,$311.60,"$1,396.80"
4500413B,0981,46050,,,,,N/A,N/A,I&D PERIANAL ABS       46050~P,$351.11,$261.00,$87.74,$725.44,$87.74,$217.28,$87.74,$191.52,$87.74,$725.44,$87.74,$217.28,$87.74,$224.00,$87.74,$87.74,$217.28
4500415B,0981,46083,,,,,N/A,N/A,INCISE THROM HEM EXT   46083~P,$391.47,$291.00,$13.32,$267.07,$13.32,$244.44,$13.32,$215.46,$13.32,$267.07,$13.32,$244.44,$13.32,$252.00,$13.32,$13.32,$244.44
4500053,0981,46600,,,,,N/A,N/A,ANOSCOPY DIAGNOSTIC    46600~P,$150.33,$111.75,$48.79,$192.32,$48.79,$115.43,$48.79,$101.75,$48.79,$192.32,$48.79,$115.43,$48.79,$119.00,$48.79,$48.79,$115.43
4500058B,0981,49080,,,,,N/A,N/A,Abdml Paracentesis          ~p,$255.26,$189.75,"$1,002.98","$2,672.18",N/A,"$1,002.98",N/A,$884.07,N/A,"$2,672.18",N/A,"$1,002.98",N/A,"$1,034.00",N/A,N/A,"$1,002.98"
4500467B,0981,51700,,,,,N/A,N/A,BLADDER IRRIGATION     51700~P,$178.58,$132.75,$92.25,$225.00,$92.25,$218.25,$92.25,$192.38,$92.25,$104.39,$92.25,$218.25,$92.25,$225.00,$92.25,$92.25,$218.25
4500469,0981,51701,,,,,N/A,N/A,BLADDER CATH STRAIGHT  51701~P,$147.31,$109.50,$48.79,$119.00,$48.79,$115.43,$48.79,$101.75,$48.79,$49.87,$48.79,$115.43,$48.79,$119.00,$48.79,$48.79,$115.43
4500470B,0981,51702,,,,,N/A,N/A,BLDDR CATH BALLOON   5170254~P,$125.11,$93.00,$41.35,$124.00,$59.86,$120.28,$59.86,$106.02,$59.86,$41.35,$59.86,$120.28,$59.86,$124.00,$59.86,$59.86,$120.28
4551702B,0981,51702,,,,,N/A,N/A,"FOLEY,SIMPLE INSERTION 51702~P",$125.11,$93.00,$41.35,$124.00,$59.86,$120.28,$59.86,$106.02,$59.86,$41.35,$59.86,$120.28,$59.86,$124.00,$59.86,$59.86,$120.28
4551703B,0981,51703,,,,,N/A,N/A,"FOLEY, COMPLEX INSERT  51703~P",$461.09,$342.75,$41.02,$239.00,$97.99,$231.83,$97.99,$204.35,$97.99,$41.02,$97.99,$231.83,$97.99,$239.00,$97.99,$97.99,$231.83
4500468B,0981,51705,,,,,N/A,N/A,CHANGE OF CYSTOSTOMY   51705~P,$267.37,$198.75,$76.67,$187.00,$76.67,$181.39,$76.67,$159.89,$76.67,$124.30,$76.67,$181.39,$76.67,$187.00,$76.67,$76.67,$181.39
4554700B,0981,54700,,,,,N/A,N/A,"I&D DEPID,TESTES/SCROTAL ABS~P",$754.69,$561.00,$482.09,$708.97,N/A,$482.09,N/A,$424.94,N/A,$708.97,N/A,$482.09,N/A,$497.00,N/A,N/A,$482.09
4555100B,0981,55100,,,,,N/A,N/A,I&D SCROTAL WALL ABSCESS    ~P,$590.23,$438.75,$228.78,$840.86,$228.78,$541.26,$228.78,$477.09,$228.78,$840.86,$228.78,$541.26,$228.78,$558.00,$228.78,$228.78,$541.26
4556405B,0981,56405,,,,,N/A,N/A,I & D OF VULVA/PERINEUM     ~P,$227.01,$168.75,$264.81,$273.00,N/A,$264.81,N/A,$233.42,N/A,N/A,N/A,$264.81,N/A,$273.00,N/A,N/A,$264.81
4500417B,0981,56420,,,,,N/A,N/A,I&D BARTHOL CYST AB  5642054~P,$347.08,$258.00,$207.94,$888.00,N/A,$861.36,N/A,$759.24,N/A,$207.94,N/A,$861.36,N/A,$888.00,N/A,N/A,$861.36
4500021B,0981,57020,,,,,N/A,N/A,COLPOCENTESIS (SEPPR)  57020~P,$305.71,$227.25,$185.70,"$1,872.00",N/A,"$1,815.84",N/A,"$1,600.56",N/A,$185.70,N/A,"$1,815.84",N/A,"$1,872.00",N/A,N/A,"$1,815.84"
4500128,0981,59409,,,,,N/A,N/A,VAGINAL DELIVERY,"$2,722.12","$2,023.50",$0.00,"$2,370.70",N/A,$0.00,N/A,$0.00,N/A,"$2,370.70",N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
4500026B,0981,59409,,,,,N/A,N/A,ER VAGINAL DELIVER   5940954~P,"$2,638.38","$1,961.25",$0.00,"$2,370.70",N/A,$0.00,N/A,$0.00,N/A,"$2,370.70",N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
4500056B,0981,62270,,,,,N/A,N/A,SPINAL PUNCTURE LMB    62270~P,$296.63,$220.50,$83.35,$207.00,$88.97,$200.79,$88.97,$176.99,$88.97,$83.35,$88.97,$200.79,$88.97,$207.00,$88.97,$88.97,$200.79
4562328B,0981,62328,,,,,N/A,N/A,SPINAL PUNCTURE             ~P,$610.41,$453.75,$133.78,$730.00,N/A,$708.10,N/A,$624.15,N/A,$133.78,N/A,$708.10,N/A,$730.00,N/A,N/A,$708.10
4562329B,0981,62329,,,,,N/A,N/A,SPINAL PUNCTURE             ~P,$610.41,$453.75,$113.34,$653.00,$267.73,$633.41,$267.73,$558.32,$267.73,$113.34,$267.73,$633.41,$267.73,$653.00,$267.73,$267.73,$633.41
4500133B,0981,64450,,,,,N/A,N/A,PERIPHERAL NERVE BLOCK 64450~P,$263.33,$195.75,$68.47,$167.00,$68.47,$161.99,$68.47,$127.02,$68.47,$78.69,$68.47,$161.99,$68.47,$167.00,$68.47,$68.47,$161.99
4564505B,0981,64505,,,,,N/A,N/A,SPHENOPALATINE GANGLION     ~P,$318.83,$237.00,$67.93,$590.00,$241.90,$572.30,$241.90,$172.74,$241.90,$67.93,$241.90,$572.30,$241.90,$590.00,$241.90,$241.90,$572.30
4500273B,0981,65205,,,,,N/A,N/A,CONJUNCT SUPERFIC    6520554~P,$169.50,$126.00,$148.18,$669.00,N/A,$648.93,N/A,$96.00,N/A,$148.18,N/A,$648.93,N/A,$669.00,N/A,N/A,$648.93
4500277B,0981,65210,,,,,N/A,N/A,CONJUNCT EMBEDDED      65210~P,$201.79,$150.00,$51.07,$729.00,N/A,$707.13,N/A,$129.44,N/A,$51.07,N/A,$707.13,N/A,$729.00,N/A,N/A,$707.13
4500134B,0981,65220,,,,,N/A,N/A,FB REMOVAL CORNEA      65220~P,$101.90,$75.75,$63.95,$558.00,N/A,$541.26,N/A,$138.77,N/A,$63.95,N/A,$541.26,N/A,$558.00,N/A,N/A,$541.26
4500283B,0981,65222,,,,,N/A,N/A,CORNEAL W/SLIT LAMP    65222~P,$220.96,$164.25,$71.83,$758.00,N/A,$735.26,N/A,$156.75,N/A,$71.83,N/A,$735.26,N/A,$758.00,N/A,N/A,$735.26
4500135B,0981,67938,,,,,N/A,N/A,FB REMOVAL EMBD EYELD  67938~P,$421.74,$313.50,$765.30,"$1,051.00",N/A,"$1,019.47",N/A,$398.27,N/A,$765.30,N/A,"$1,019.47",N/A,"$1,051.00",N/A,N/A,"$1,019.47"
4500420B,0981,69000,,,,,N/A,N/A,I&D EXT EAR ABS        69000~P,$448.98,$333.75,$440.61,$974.00,N/A,$944.78,N/A,$220.11,N/A,$440.61,N/A,$944.78,N/A,$974.00,N/A,N/A,$944.78
4500224B,0981,69200,,,,,N/A,N/A,RMV FB EX AUDIT CANA   69200~P,$221.97,$165.00,$389.82,$548.00,N/A,$531.56,N/A,$156.88,N/A,$389.82,N/A,$531.56,N/A,$548.00,N/A,N/A,$531.56
4569209B,0981,69209,,,,,N/A,N/A,REMOVAL IMP CERUMEN FLUSHING~P,$42.38,$31.50,$145.00,$210.00,N/A,$203.70,N/A,$16.02,N/A,$145.00,N/A,$203.70,N/A,$210.00,N/A,N/A,$203.70
4500217B,0981,69210,,,,,N/A,N/A,RMV IMPACT CERUMEN     69210~P,$95.85,$71.25,$23.19,$359.00,N/A,$348.23,N/A,$71.60,N/A,$23.19,N/A,$348.23,N/A,$359.00,N/A,N/A,$348.23
4576512B,0981,76512,,,,,N/A,N/A,"OPHTH US, B W/NON-QUANT A   ~P",$291.58,$216.75,$119.72,$119.72,$119.72,N/A,$119.72,N/A,$119.72,N/A,$119.72,N/A,$119.72,N/A,$119.72,$119.72,N/A
4576536B,0981,76536,,,,,N/A,N/A,US EXAM OF HEAD AND NECK    ~P,$73.65,$54.75,$113.98,$113.98,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,$113.98,N/A
4576604B,0981,76604,,,,,N/A,N/A,"US EXAM, CHEST, B-SCAN      ~P",$124.10,$92.25,$87.33,$87.33,$87.33,N/A,$87.33,N/A,$87.33,N/A,$87.33,N/A,$87.33,N/A,$87.33,$87.33,N/A
4576642B,0981,76642,,,,,N/A,N/A,UNILATERAL LIMITED BREAST UL~P,$147.31,$109.50,$19.24,$19.24,$19.24,N/A,$19.24,N/A,$19.24,N/A,$19.24,N/A,$19.24,N/A,$19.24,$19.24,N/A
4576705B,0981,76705,,,,,N/A,N/A,ABD ULTRASOUND-1 ORGAN      ~P,$70.63,$52.50,$25.82,$25.82,$25.82,N/A,$25.82,N/A,$25.82,N/A,$25.82,N/A,$25.82,N/A,$25.82,$25.82,N/A
4576775B,0981,76775,,,,,N/A,N/A,US RETRO PERI LIMITED       ~P,$177.57,$132.00,$177.12,$177.12,$177.12,N/A,$177.12,N/A,$177.12,N/A,$177.12,N/A,$177.12,N/A,$177.12,$177.12,N/A
4576815B,0981,76815,,,,,N/A,N/A,"OB US, LIMITED, FETUS(S)    ~P",$175.56,$130.50,$99.22,$99.22,$99.22,N/A,$99.22,N/A,$99.22,N/A,$99.22,N/A,$99.22,N/A,$99.22,$99.22,N/A
4576817B,0981,76817,,,,,N/A,N/A,"TRANSVAGINAL US, OBSTETRIC  ~P",$190.69,$141.75,$14.14,$14.14,$14.14,N/A,$14.14,N/A,$14.14,N/A,$14.14,N/A,$14.14,N/A,$14.14,$14.14,N/A
4576830B,0981,76830,,,,,N/A,N/A,"TRANSVAGINAL US, NON-OB     ~P",$237.10,$176.25,$119.72,$119.72,$119.72,N/A,$119.72,N/A,$119.72,N/A,$119.72,N/A,$119.72,N/A,$119.72,$119.72,N/A
4576857B,0981,76857,,,,,N/A,N/A,US EXAM PELVIC LIMITED      ~P,$170.51,$126.75,$91.20,$91.20,$91.20,N/A,$91.20,N/A,$91.20,N/A,$91.20,N/A,$91.20,N/A,$91.20,$91.20,N/A
4576870B,0981,76870,,,,,N/A,N/A,US SCROTUM                  ~P,$90.80,$67.50,$17.10,$17.10,$17.10,N/A,$17.10,N/A,$17.10,N/A,$17.10,N/A,$17.10,N/A,$17.10,$17.10,N/A
4576882B,0981,76882,,,,,N/A,N/A,US EXTREMITY NON-VASC REAL-T~P,$53.47,$39.75,$1.25,$1.25,$1.25,N/A,$1.25,N/A,$1.25,N/A,$1.25,N/A,$1.25,N/A,$1.25,$1.25,N/A
4576937B,0981,76937,,,,,N/A,N/A,"US GUIDE, VASCULAR ACCESS   ~P",$59.53,$44.25,$143.91,$143.91,$143.91,N/A,$143.91,N/A,$143.91,N/A,$143.91,N/A,$143.91,N/A,$143.91,$143.91,N/A
4576942B,0981,76942,,,,,N/A,N/A,US GUIDANCE NEEDLE PLCMNT   ~P,$70.63,$52.50,$89.79,$89.79,$89.79,N/A,$89.79,N/A,$89.79,N/A,$89.79,N/A,$89.79,N/A,$89.79,$89.79,N/A
4577001A,0981,77001,,,,,N/A,N/A,FLUOROGUIDE FOR VEIN DEVICE,$272.41,$202.50,$453.50,$453.50,$453.50,N/A,$453.50,N/A,$453.50,N/A,$453.50,N/A,$453.50,N/A,$453.50,$453.50,N/A
9890472B,0981,90472,,,,,N/A,N/A,ADD'L VACCINE ADMINISTRATION~P,$51.46,$38.25,$16.96,$181.00,$22.14,$175.57,$22.14,N/A,$22.14,$16.96,$22.14,$175.57,$22.14,$181.00,$22.14,$22.14,$175.57
4500155B,0981,92950,,,,,N/A,N/A,CARDIOPULMONARY RESUS  92950~P,$656.82,$488.25,$69.28,"$1,932.00",N/A,"$1,874.04",N/A,N/A,N/A,$69.28,N/A,"$1,874.04",N/A,"$1,932.00",N/A,N/A,"$1,874.04"
4500156B,0981,92953,,,,,N/A,N/A,TRANSCUTANEU TMP PCMKR 92953~P,$51.46,$38.25,$385.42,"$1,717.00",N/A,"$1,665.49",N/A,N/A,N/A,$385.42,N/A,"$1,665.49",N/A,"$1,717.00",N/A,N/A,"$1,665.49"
4502156B,0981,92953,,,,,N/A,N/A,TEMPORARY PACEMAKER    92953~P,$51.46,$38.25,$385.42,"$1,717.00",N/A,"$1,665.49",N/A,N/A,N/A,$385.42,N/A,"$1,665.49",N/A,"$1,717.00",N/A,N/A,"$1,665.49"
4500157B,0981,92960,,,,,N/A,N/A,CARDIOVERSION          92960~P,$493.37,$366.75,$1.90,$372.00,$81.55,$360.84,$81.55,N/A,$81.55,$1.90,$81.55,$360.84,$81.55,$372.00,$81.55,$81.55,$360.84
4500158B,0981,92977,,,,,N/A,N/A,THROMBOLYSIS           92977~P,$358.17,$266.25,$69.30,"$1,683.00",$69.30,"$1,632.51",$69.30,N/A,$69.30,$229.37,$69.30,"$1,632.51",$69.30,"$1,683.00",$69.30,$69.30,"$1,632.51"
4593288B,0981,93288,,,,,N/A,N/A,PACE MAKER DEVICE EVAL      ~P,$55.49,$41.25,$31.16,$113.20,$31.16,$83.42,$31.16,N/A,$31.16,$113.20,$31.16,$83.42,$31.16,$86.00,$31.16,$31.16,$83.42
4593308B,0981,93308,,,,,N/A,N/A,ECHO EXAM OF HEART          ~P,$105.94,$78.75,$25.82,$310.19,$25.82,$251.23,$25.82,N/A,$25.82,$310.19,$25.82,$251.23,$25.82,$259.00,$25.82,$25.82,$251.23
4593971B,0981,93971,,,,,N/A,N/A,EXTREMITY STUDY             ~P,$227.01,$168.75,$184.90,$416.00,$184.90,$403.52,$184.90,N/A,$184.90,$227.72,$184.90,$403.52,$184.90,$416.00,$184.90,$184.90,$403.52
4593979B,0981,93979,,,,,N/A,N/A,VASCULAR STUDY              ~P,$52.46,$39.00,$7.93,$218.48,$7.93,$194.00,$7.93,N/A,$7.93,$218.48,$7.93,$194.00,$7.93,$200.00,$7.93,$7.93,$194.00
4595992B,0981,95992,,,,,N/A,N/A,CANALITH REPOSITIONING PROC ~P,$70.63,$52.50,$36.80,$75.00,$36.80,$72.75,$36.80,N/A,$36.80,$52.58,$36.80,$72.75,$36.80,$75.00,$36.80,$36.80,$72.75
9759760,0981,97597,,,,,N/A,N/A,DEBRIDEMENT SKIN         97597,$250.22,$186.00,$14.55,$170.00,$14.55,$164.90,$14.55,N/A,$14.55,N/A,$14.55,$164.90,$14.55,$170.00,$14.55,$14.55,$164.90
4597597B,0981,97597,,,,,N/A,N/A,"DEBRIDEMENT OPEN WOUND,20CM<~P",$90.80,$67.50,$14.55,$170.00,$14.55,$164.90,$14.55,N/A,$14.55,N/A,$14.55,$164.90,$14.55,$170.00,$14.55,$14.55,$164.90
4597598B,0981,97598,,,,,N/A,N/A,DEBRIDEMENT OPEN WOUND      ~P,$35.31,$26.25,$16.31,$391.00,$16.31,$379.27,$16.31,N/A,$16.31,$40.95,$16.31,$379.27,$16.31,$391.00,$16.31,$16.31,$379.27
4597607B,0981,97607,,,,,N/A,N/A,NEG. PRESSURE WOUND THERAPY ~P,$68.61,$51.00,$31.82,$148.00,$64.78,$143.56,$64.78,N/A,$64.78,$31.82,$64.78,$143.56,$64.78,$148.00,$64.78,$64.78,$143.56
4500239,0981,99217,,,,,N/A,N/A,ER OBSERVATION         99217~P,$267.37,$198.75,N/A,N/A,N/A,N/A,N/A,$58.97,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500218,0981,99218,,,,,N/A,N/A,ED OBSERVATION       9921825~P,$249.21,$185.25,N/A,N/A,N/A,N/A,N/A,$58.97,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500221,0981,99218,,,,,N/A,N/A,ED OBSERVATON          99218~P,$249.21,$185.25,N/A,N/A,N/A,N/A,N/A,$95.56,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500237,0981,99219,,,,,N/A,N/A,ED OBSERVATON          99219~P,$409.63,$304.50,N/A,N/A,N/A,N/A,N/A,$58.97,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500238,0981,99219,,,,,N/A,N/A,ED OBSERVATON        9921925~P,$409.63,$304.50,N/A,N/A,N/A,N/A,N/A,$95.56,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500220,0981,99220,,,,,N/A,N/A,ED OBSERVATON          99220~P,$571.06,$424.50,N/A,N/A,N/A,N/A,N/A,$58.97,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500222,0981,99220,,,,,N/A,N/A,ED OBSERVATON        9922025~P,$571.06,$424.50,N/A,N/A,N/A,N/A,N/A,$95.56,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500232,0981,99234,,,,,N/A,N/A,ED OBSERVATON        9923425~P,$571.06,$424.50,$101.51,$360.00,$147.60,$349.20,$147.60,N/A,$147.60,$101.51,$147.60,$349.20,$147.60,$360.00,$147.60,$147.60,$349.20
4500234,0981,99234,,,,,N/A,N/A,ED OBSERVATON          99234~P,$495.39,$368.25,$101.51,$360.00,$147.60,$349.20,$147.60,N/A,$147.60,$101.51,$147.60,$349.20,$147.60,$360.00,$147.60,$147.60,$349.20
4500231,0981,99235,,,,,N/A,N/A,ED OBSERVATON          99235~P,$648.75,$482.25,$128.81,$476.00,$195.16,$461.72,$195.16,N/A,$195.16,$128.81,$195.16,$461.72,$195.16,$476.00,$195.16,$195.16,$461.72
4500235,0981,99235,,,,,N/A,N/A,ER OBSV 99235~P,"$1,203.67",$894.75,$128.81,$476.00,$195.16,$461.72,$195.16,N/A,$195.16,$128.81,$195.16,$461.72,$195.16,$476.00,$195.16,$195.16,$461.72
4500233,0981,99236,,,,,N/A,N/A,ED OBSERVATON        9923625~P,$807.15,$600.00,$164.22,$528.00,$243.13,$512.16,$243.13,N/A,$243.13,$164.22,$243.13,$512.16,$243.13,$528.00,$243.13,$243.13,$512.16
4500236,0981,99236,,,,,N/A,N/A,ED OBSERVATON          99236~P,$807.15,$600.00,$164.22,$528.00,$243.13,$512.16,$243.13,N/A,$243.13,$164.22,$243.13,$512.16,$243.13,$528.00,$243.13,$243.13,$512.16
4500101,0981,99281,,,,,N/A,N/A,PROF FEE 1             99281~P,$88.79,$66.00,$28.29,$449.00,$28.29,$435.53,$28.29,N/A,$28.29,$196.81,$28.29,$435.53,$28.29,$449.00,$28.29,$28.29,$435.53
4500108,0981,99281,,,,,N/A,N/A,PROF FEE I           9928125~P,$88.79,$66.00,$28.29,$449.00,$28.29,$435.53,$28.29,N/A,$28.29,$196.81,$28.29,$435.53,$28.29,$449.00,$28.29,$28.29,$435.53
459928127,0981,99281,,,,,N/A,N/A,PRO FEE I            9928127~P,$88.79,$66.00,$28.29,$449.00,$28.29,$435.53,$28.29,N/A,$28.29,$196.81,$28.29,$435.53,$28.29,$449.00,$28.29,$28.29,$435.53
4500101CS,0981,99281,,,,,N/A,N/A,PROF FEE 1           99281CS~P,$88.79,$66.00,$28.29,$449.00,$28.29,$435.53,$28.29,N/A,$28.29,$196.81,$28.29,$435.53,$28.29,$449.00,$28.29,$28.29,$435.53
4500108CS,0981,99281,,,,,N/A,N/A,PROF FEE I         9928125CS~P,$88.79,$66.00,$28.29,$449.00,$28.29,$435.53,$28.29,N/A,$28.29,$196.81,$28.29,$435.53,$28.29,$449.00,$28.29,$28.29,$435.53
4500102,0981,99282,,,,,N/A,N/A,PROF FEE 2             99282~P,$159.41,$118.50,$5.43,$449.00,$5.43,$435.53,$5.43,N/A,$5.43,$21.65,$5.43,$435.53,$5.43,$449.00,$5.43,$5.43,$435.53
4500109,0981,99282,,,,,N/A,N/A,PROF FEE II          9928225~P,$159.41,$118.50,$5.43,$449.00,$5.43,$435.53,$5.43,N/A,$5.43,$21.65,$5.43,$435.53,$5.43,$449.00,$5.43,$5.43,$435.53
459928227,0981,99282,,,,,N/A,N/A,PROF FEE 2           9928227~P,$159.41,$118.50,$5.43,$449.00,$5.43,$435.53,$5.43,N/A,$5.43,$21.65,$5.43,$435.53,$5.43,$449.00,$5.43,$5.43,$435.53
4500102CS,0981,99282,,,,,N/A,N/A,PROF FEE 2           99282CS~P,$159.41,$118.50,$5.43,$449.00,$5.43,$435.53,$5.43,N/A,$5.43,$21.65,$5.43,$435.53,$5.43,$449.00,$5.43,$5.43,$435.53
4500109CS,0981,99282,,,,,N/A,N/A,PROF FEE II        9928225CS~P,$159.41,$118.50,$5.43,$449.00,$5.43,$435.53,$5.43,N/A,$5.43,$21.65,$5.43,$435.53,$5.43,$449.00,$5.43,$5.43,$435.53
4500103,0981,99283,,,,,N/A,N/A,PROF FEE 3             99283~P,$518.60,$385.50,$41.90,$804.00,$48.79,$779.88,$48.79,N/A,$48.79,$41.90,$48.79,$779.88,$48.79,$804.00,$48.79,$48.79,$779.88
4500110,0981,99283,,,,,N/A,N/A,PROF FEE  III        9928325~P,$518.60,$385.50,$41.90,$804.00,$48.79,$779.88,$48.79,N/A,$48.79,$41.90,$48.79,$779.88,$48.79,$804.00,$48.79,$48.79,$779.88
459928327,0981,99283,,,,,N/A,N/A,PRO FEE 3            9928327~P,$235.08,$174.75,$41.90,$804.00,$48.79,$779.88,$48.79,N/A,$48.79,$41.90,$48.79,$779.88,$48.79,$804.00,$48.79,$48.79,$779.88
4500103CS,0981,99283,,,,,N/A,N/A,PROF FEE 3           99283CS~P,$518.60,$385.50,$41.90,$804.00,$48.79,$779.88,$48.79,N/A,$48.79,$41.90,$48.79,$779.88,$48.79,$804.00,$48.79,$48.79,$779.88
4500110CS,0981,99283,,,,,N/A,N/A,PROF FEE  III      9928325CS~P,$518.60,$385.50,$41.90,$804.00,$48.79,$779.88,$48.79,N/A,$48.79,$41.90,$48.79,$779.88,$48.79,$804.00,$48.79,$48.79,$779.88
4500104,0981,99284,,,,,N/A,N/A,PRO FEE 4              99284~P,$577.11,$429.00,$70.74,"$1,208.00",$95.53,"$1,171.76",$95.53,N/A,$95.53,$70.74,$95.53,"$1,171.76",$95.53,"$1,208.00",$95.53,$95.53,"$1,171.76"
4500111,0981,99284,,,,,N/A,N/A,PRO FEE IV           9928425~P,$577.11,$429.00,$70.74,"$1,208.00",$95.53,"$1,171.76",$95.53,N/A,$95.53,$70.74,$95.53,"$1,171.76",$95.53,"$1,208.00",$95.53,$95.53,"$1,171.76"
459928427,0981,99284,,,,,N/A,N/A,PRO FEE 4            9928427~P,$437.88,$325.50,$70.74,"$1,208.00",$95.53,"$1,171.76",$95.53,N/A,$95.53,$70.74,$95.53,"$1,171.76",$95.53,"$1,208.00",$95.53,$95.53,"$1,171.76"
4500104CS,0981,99284,,,,,N/A,N/A,PRO FEE 4            99284CS~P,$577.11,$429.00,$70.74,"$1,208.00",$95.53,"$1,171.76",$95.53,N/A,$95.53,$70.74,$95.53,"$1,171.76",$95.53,"$1,208.00",$95.53,$95.53,"$1,171.76"
4500111CS,0981,99284,,,,,N/A,N/A,PRO FEE IV         9928425CS~P,$577.11,$429.00,$70.74,"$1,208.00",$95.53,"$1,171.76",$95.53,N/A,$95.53,$70.74,$95.53,"$1,171.76",$95.53,"$1,208.00",$95.53,$95.53,"$1,171.76"
4500105,0981,99285,,,,,N/A,N/A,PRO FEE 5              99285~P,$635.63,$472.50,$120.19,"$1,208.00",$145.96,"$1,171.76",$145.96,N/A,$145.96,$120.19,$145.96,"$1,171.76",$145.96,"$1,208.00",$145.96,$145.96,"$1,171.76"
4500112,0981,99285,,,,,N/A,N/A,PROF FEE V           9928525~P,$635.63,$472.50,$120.19,"$1,208.00",$145.96,"$1,171.76",$145.96,N/A,$145.96,$120.19,$145.96,"$1,171.76",$145.96,"$1,208.00",$145.96,$145.96,"$1,171.76"
459928527,0981,99285,,,,,N/A,N/A,PRO FEE 5           9928527~P,$635.63,$472.50,$120.19,"$1,208.00",$145.96,"$1,171.76",$145.96,N/A,$145.96,$120.19,$145.96,"$1,171.76",$145.96,"$1,208.00",$145.96,$145.96,"$1,171.76"
4500105CS,0981,99285,,,,,N/A,N/A,PRO FEE 5            99285CS~P,$635.63,$472.50,$120.19,"$1,208.00",$145.96,"$1,171.76",$145.96,N/A,$145.96,$120.19,$145.96,"$1,171.76",$145.96,"$1,208.00",$145.96,$145.96,"$1,171.76"
4500112CS,0981,99285,,,,,N/A,N/A,PROF FEE V         9928525CS~P,$635.63,$472.50,$120.19,"$1,208.00",$145.96,"$1,171.76",$145.96,N/A,$145.96,$120.19,$145.96,"$1,171.76",$145.96,"$1,208.00",$145.96,$145.96,"$1,171.76"
4500004B,0981,99291,,,,,N/A,N/A,CRITICAL CARE        9929125~P,$814.21,$605.25,$174.83,"$1,885.00",$225.91,"$1,828.45",$225.91,N/A,$225.91,$174.83,$225.91,"$1,828.45",$225.91,"$1,885.00",$225.91,$225.91,"$1,828.45"
4500004BCS,0981,99291,,,,,N/A,N/A,CRITICAL CARE      9929125CS~P,$814.21,$605.25,$174.83,"$1,885.00",$225.91,"$1,828.45",$225.91,N/A,$225.91,$174.83,$225.91,"$1,828.45",$225.91,"$1,885.00",$225.91,$225.91,"$1,828.45"
4500005B,0981,99291,,,,,N/A,N/A,CRITICAL CARE        9929125~P,$814.21,$605.25,$174.83,"$1,885.00",$225.91,"$1,828.45",$225.91,N/A,$225.91,$174.83,$225.91,"$1,828.45",$225.91,"$1,885.00",$225.91,$225.91,"$1,828.45"
4500008B,0981,99292,,,,,N/A,N/A,CRITICAL CARE 30 MIN   99292~P,$411.65,$306.00,$215.40,$556.00,$227.96,$539.32,$227.96,N/A,$227.96,$215.40,$227.96,$539.32,$227.96,$556.00,$227.96,$227.96,$539.32
4500171,0981,99354,,,,,N/A,N/A,PROLONGED SERVICE      99354~P,$380.37,$282.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4500172,0981,99355,,,,,N/A,N/A,PROLONGED ADD 1/2 HR   99355~P,$340.01,$252.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4599406,0981,99406,,,,,N/A,N/A,SMOKING & TOB CESS VISIT3-10MI,$41.37,$30.75,$39.77,$100.16,N/A,$39.77,N/A,N/A,N/A,$100.16,N/A,$39.77,N/A,$41.00,N/A,N/A,$39.77
4599407,0981,99407,,,,,N/A,N/A,SMOKING & TOB CESS VISIT>10MIN,$79.71,$59.25,$12.30,$12.30,N/A,N/A,N/A,N/A,N/A,$12.30,N/A,N/A,N/A,N/A,N/A,N/A,N/A
5100001A,0981,99420,,,,,N/A,N/A,PHYSICAL EXAM (RC),$38.34,$28.50,$31.80,$38.00,N/A,$36.86,N/A,N/A,N/A,$31.80,N/A,$36.86,N/A,$38.00,N/A,N/A,$36.86
1000540B,0983,10005,,,,,N/A,N/A,NEEDLE ASPIRATION BIOPSY    ~P,$263.33,$195.75,$17.10,$17.10,$17.10,N/A,$17.10,N/A,$17.10,N/A,$17.10,N/A,$17.10,N/A,$17.10,$17.10,N/A
1002140B,0983,10021,,,,,N/A,N/A,"SKIN,SUB INCISION & DRAIN   ~P",$135.20,$100.50,$93.14,$430.00,N/A,$417.10,N/A,$367.65,N/A,$93.14,N/A,$417.10,N/A,$430.00,N/A,N/A,$417.10
1006040B,0983,10060,,,,,N/A,N/A,DRAINAGE OF SKIN ABSCESS    ~P,$176.56,$131.25,$8.77,$197.00,$8.77,N/A,$8.77,$168.44,$8.77,$177.59,$8.77,N/A,$8.77,$197.00,$8.77,$8.77,N/A
10060LSC,0983,10060,,,,,N/A,N/A,DRAINAGE OF SKIN ABSCESS,$233.07,$173.25,$8.77,$197.00,$8.77,N/A,$8.77,$168.44,$8.77,$177.59,$8.77,N/A,$8.77,$197.00,$8.77,$8.77,N/A
1006140B,0983,10061,,,,,N/A,N/A,DRAINAGE OF SKIN ABSCESS    ~P,$307.73,$228.75,$15.60,$366.00,$15.60,$355.02,$15.60,$312.93,$15.60,$312.38,$15.60,$355.02,$15.60,$366.00,$15.60,$15.60,$355.02
1006145B,0983,10061,,,,,N/A,N/A,DRAINAGE OF SKIN ABSCESS    ~P,$339.00,$252.00,$15.60,$366.00,$15.60,$355.02,$15.60,$312.93,$15.60,$312.38,$15.60,$355.02,$15.60,$366.00,$15.60,$15.60,$355.02
5110061B,0983,10061,,,,,N/A,N/A,"I & D, COMPLICATED          ~P",$291.58,$216.75,$15.60,$366.00,$15.60,$355.02,$15.60,$312.93,$15.60,$312.38,$15.60,$355.02,$15.60,$366.00,$15.60,$15.60,$355.02
10080LSC,0983,10080,,,,,N/A,N/A,DRAINAGE OF SKIN ABSCESS,$286.54,$213.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
1008140B,0983,10081,,,,,N/A,N/A,DRAINAGE OF PILONIDAL CYST  ~P,$375.33,$279.00,$152.52,$372.00,$152.52,$360.84,$152.52,$318.06,$152.52,$293.55,$152.52,$360.84,$152.52,$372.00,$152.52,$152.52,$360.84
1012040B,0983,10120,,,,,N/A,N/A,REMOVE FOREIGN BODY         ~P,$205.82,$153.00,$83.64,$204.00,$83.64,$197.88,$83.64,$174.42,$83.64,$179.14,$83.64,$197.88,$83.64,$204.00,$83.64,$83.64,$197.88
1012045B,0983,10120,,,,,N/A,N/A,"INSCN & REML FORGN BDY,SUBQ ~P",$206.83,$153.75,$83.64,$204.00,$83.64,$197.88,$83.64,$174.42,$83.64,$179.14,$83.64,$197.88,$83.64,$204.00,$83.64,$83.64,$197.88
1012140B,0983,10121,,,,,N/A,N/A,REMOVE FOREIGN BODY         ~P,$424.76,$315.75,$172.61,$421.00,$172.61,$408.37,$172.61,$359.96,$172.61,$314.50,$172.61,$408.37,$172.61,$421.00,$172.61,$172.61,$408.37
1012145B,0983,10121,,,,,N/A,N/A,"INSCN & REML FORGN BDY,COMP ~P",$424.76,$315.75,$172.61,$421.00,$172.61,$408.37,$172.61,$359.96,$172.61,$314.50,$172.61,$408.37,$172.61,$421.00,$172.61,$172.61,$408.37
1014040B,0983,10140,,,,,N/A,N/A,DRAINAGE OF HEMATOMA/FLUID  ~P,$222.98,$165.75,$117.26,$266.00,$117.26,$258.02,$117.26,$227.43,$117.26,$202.56,$117.26,$258.02,$117.26,$266.00,$117.26,$117.26,$258.02
1014045B,0983,10140,,,,,N/A,N/A,DRAINAGE OF HEMATOMA/FLUID  ~P,$222.98,$165.75,$117.26,$266.00,$117.26,$258.02,$117.26,$227.43,$117.26,$202.56,$117.26,$258.02,$117.26,$266.00,$117.26,$117.26,$258.02
1016040B,0983,10160,,,,,N/A,N/A,PUNCTURE ASPIRA OF ABSCESS  ~P,$188.67,$140.25,$16.72,$392.00,$16.72,$380.24,$16.72,$335.16,$16.72,$162.64,$16.72,$380.24,$16.72,$392.00,$16.72,$16.72,$380.24
1016045B,0983,10160,,,,,N/A,N/A,PUNCTURE ASPIRA OF ABSCESS  ~P,$188.67,$140.25,$16.72,$392.00,$16.72,$380.24,$16.72,$335.16,$16.72,$162.64,$16.72,$380.24,$16.72,$392.00,$16.72,$16.72,$380.24
1018040B,0983,10180,,,,,N/A,N/A,"COMPLEX DRAINAGE, WOUND     ~P",$329.92,$245.25,$163.59,$399.00,$163.59,$387.03,$163.59,$341.15,$163.59,$301.36,$163.59,$387.03,$163.59,$399.00,$163.59,$163.59,$387.03
1100140B,0983,11001,,,,,N/A,N/A,DEBRIDEMENT                 ~P,$21.19,$15.75,$14.79,$42.00,$16.81,$40.74,$16.81,$35.91,$16.81,$14.79,$16.81,$40.74,$16.81,$42.00,$16.81,$16.81,$40.74
1100440B,0983,11004,,,,,N/A,N/A,DEBRIDE GENITALIA & PERINEUM~P,"$1,332.81",$990.75,$541.61,"$1,321.00",$541.61,"$1,281.37",$541.61,"$1,129.46",$541.61,$582.94,$541.61,"$1,281.37",$541.61,"$1,321.00",$541.61,$541.61,"$1,281.37"
1100540B,0983,11005,,,,,N/A,N/A,DEBRIDE ABDOM WALL          ~P,"$1,811.05","$1,346.25",$735.95,"$1,795.00",$735.95,"$1,741.15",$735.95,"$1,534.73",$735.95,$787.18,$735.95,"$1,741.15",$735.95,"$1,795.00",$735.95,$735.95,"$1,741.15"
1100840B,0983,11008,,,,,N/A,N/A,REMOVE MESH FROM ABD WALL   ~P,$671.95,$499.50,$273.60,$666.00,$273.60,$646.02,$273.60,$569.43,$273.60,$276.48,$273.60,$646.02,$273.60,$666.00,$273.60,$273.60,$646.02
1101045B,0983,11010,,,,,N/A,N/A,DEBRIDEMENT                 ~P,$588.21,$437.25,$239.30,$583.00,$239.30,$565.51,$239.30,$498.47,$239.30,$283.64,$239.30,$565.51,$239.30,$583.00,$239.30,$239.30,$565.51
1101145B,0983,11011,,,,,N/A,N/A,"DEBRIDE SKIN/MUSCLE, FX     ~P",$677.00,$503.25,$284.54,$284.54,$284.54,N/A,$284.54,N/A,$284.54,N/A,$284.54,N/A,$284.54,N/A,$284.54,$284.54,N/A
1101245B,0983,11012,,,,,N/A,N/A,"DEBRIDE SKIN/MUSCLE/BONE, FX~P","$1,032.15",$767.25,$419.43,"$1,023.00",$419.43,$992.31,$419.43,$874.67,$419.43,$427.36,$419.43,$992.31,$419.43,"$1,023.00",$419.43,$419.43,$992.31
1104240B,0983,11042,,,,,N/A,N/A,DEBRIDE SKIN/TISSUE         ~P,$84.75,$63.00,$61.50,$150.00,$61.50,$145.50,$61.50,$128.25,$61.50,$62.57,$61.50,$145.50,$61.50,$150.00,$61.50,$61.50,$145.50
1104245B,0983,11042,,,,,N/A,N/A,DEBRIDEMENT                 ~P,$84.75,$63.00,$61.50,$150.00,$61.50,$145.50,$61.50,$128.25,$61.50,$62.57,$61.50,$145.50,$61.50,$150.00,$61.50,$61.50,$145.50
11042LSC,0983,11042,,,,,N/A,N/A,DEBRIDE SKIN/TISSUE,$317.82,$236.25,$61.50,$150.00,$61.50,$145.50,$61.50,$128.25,$61.50,$62.57,$61.50,$145.50,$61.50,$150.00,$61.50,$61.50,$145.50
1104340B,0983,11043,,,,,N/A,N/A,"DEBRID,MUSCLE FIRST 20SQ CM ~P",$393.49,$292.50,$159.32,$390.00,$159.90,$378.30,$159.90,$333.45,$159.90,$159.32,$159.90,$378.30,$159.90,$390.00,$159.90,$159.90,$378.30
1104345B,0983,11043,,,,,N/A,N/A,DEBRDMNT MUS/FAS FIR 20SQCM<~P,$393.49,$292.50,$159.32,$390.00,$159.90,$378.30,$159.90,$333.45,$159.90,$159.32,$159.90,$378.30,$159.90,$390.00,$159.90,$159.90,$378.30
1104440B,0983,11044,,,,,N/A,N/A,DEBRIDE TISSUE/MUSCLE/BONE  ~P,$639.67,$475.50,$231.11,$634.00,$259.94,$614.98,$259.94,$542.07,$259.94,$231.11,$259.94,$614.98,$259.94,$634.00,$259.94,$259.94,$614.98
1104445B,0983,11044,,,,,N/A,N/A,"DEBRIDEMENT,BONE            ~P",$639.67,$475.50,$231.11,$634.00,$259.94,$614.98,$259.94,$542.07,$259.94,$231.11,$259.94,$614.98,$259.94,$634.00,$259.94,$259.94,$614.98
1104540B,0983,11045,,,,,N/A,N/A,DBRDMT SUBC TISSUE ADD 20SQ ~P,$40.36,$30.00,$22.55,$55.00,$22.55,$53.35,$22.55,$47.03,$22.55,$26.85,$22.55,$53.35,$22.55,$55.00,$22.55,$22.55,$53.35
1104640B,0983,11046,,,,,N/A,N/A,EACH ADDITIONAL 20SQ CM     ~P,$74.66,$55.50,$3.34,$74.00,$3.34,$71.78,$3.34,$63.27,$3.34,$56.68,$3.34,$71.78,$3.34,$74.00,$3.34,$3.34,$71.78
1104740B,0983,11047,,,,,N/A,N/A,DEB BONE ADD-ON             ~P,$161.43,$120.00,$53.13,$186.00,$53.13,$180.42,$53.13,$159.03,$53.13,$99.26,$53.13,$180.42,$53.13,$186.00,$53.13,$53.13,$180.42
1105545B,0983,11055,,,,,N/A,N/A,TRIM SKIN LESION            ~P,$65.58,$48.75,$16.62,$65.00,$26.65,$63.05,$26.65,$55.58,$26.65,$16.62,$26.65,$63.05,$26.65,$65.00,$26.65,$26.65,$63.05
1105645B,0983,11056,,,,,N/A,N/A,"TRIM SKIN LESION, 2 TO 4    ~P",$76.68,$57.00,$23.23,$124.00,$31.16,$120.28,$31.16,$106.02,$31.16,$23.23,$31.16,$120.28,$31.16,$124.00,$31.16,$31.16,$120.28
1105745B,0983,11057,,,,,N/A,N/A,"TRIM SKIN LESION, OVER 4    ~P",$84.75,$63.00,$30.05,$84.00,$34.44,$81.48,$34.44,$71.82,$34.44,$30.05,$34.44,$81.48,$34.44,$84.00,$34.44,$34.44,$81.48
1110240B,0983,11102,,,,,N/A,N/A,SKIN BIOPSY                 ~P,$162.44,$120.75,$82.41,$82.41,$82.41,N/A,$82.41,N/A,$82.41,N/A,$82.41,N/A,$82.41,N/A,$82.41,$82.41,N/A
1110340B,0983,11103,,,,,N/A,N/A,SKIN BIOPSY EA SEPARATE     ~P,$99.89,$74.25,$44.69,$44.69,$44.69,N/A,$44.69,N/A,$44.69,N/A,$44.69,N/A,$44.69,N/A,$44.69,$44.69,N/A
1110440B,0983,11104,,,,,N/A,N/A,PUNCH BIOPSY                ~P,$201.79,$150.00,$13.73,$13.73,$13.73,N/A,$13.73,N/A,$13.73,N/A,$13.73,N/A,$13.73,N/A,$13.73,$13.73,N/A
1110540B,0983,11105,,,,,N/A,N/A,PUNCH BIOPSY EA SEPARATE    ~P,$100.89,$75.00,$5.84,$5.84,$5.84,N/A,$5.84,N/A,$5.84,N/A,$5.84,N/A,$5.84,N/A,$5.84,$5.84,N/A
1110640B,0983,11106,,,,,N/A,N/A,INCISIONAL BIOPSY           ~P,$258.29,$192.00,$125.46,$125.46,$125.46,N/A,$125.46,N/A,$125.46,N/A,$125.46,N/A,$125.46,N/A,$125.46,$125.46,N/A
1110740B,0983,11107,,,,,N/A,N/A,INCISIONAL BIOPSY EA SEPART ~P,$100.89,$75.00,$6.27,$6.27,$6.27,N/A,$6.27,N/A,$6.27,N/A,$6.27,N/A,$6.27,N/A,$6.27,$6.27,N/A
1120040B,0983,11200,,,,,N/A,N/A,REMOVAL OF SKIN TAGS        ~P,$132.17,$98.25,$58.63,$143.00,$58.63,$138.71,$58.63,$122.27,$58.63,$78.65,$58.63,$138.71,$58.63,$143.00,$58.63,$58.63,$138.71
1120140B,0983,11201,,,,,N/A,N/A,REMOVAL SKIN TAG EA ADD 10  ~P,$27.24,$20.25,$16.99,$45.00,$18.45,$43.65,$18.45,$38.48,$18.45,$16.99,$18.45,$43.65,$18.45,$45.00,$18.45,$18.45,$43.65
1130040B,0983,11300,,,,,N/A,N/A,SHAVE SKIN LESION           ~P,$103.92,$77.25,$35.19,$107.00,$43.87,$103.79,$43.87,$91.49,$43.87,$35.19,$43.87,$103.79,$43.87,$107.00,$43.87,$43.87,$103.79
1130140B,0983,11301,,,,,N/A,N/A,SHAVE SKIM LESION           ~P,$104.93,$78.00,$49.61,$121.00,$49.61,$117.37,$49.61,$103.46,$49.61,$53.29,$49.61,$117.37,$49.61,$121.00,$49.61,$49.61,$117.37
1130240B,0983,11302,,,,,N/A,N/A,SHAVE SKIN LESION           ~P,$145.29,$108.00,$62.52,$154.00,$63.14,$149.38,$63.14,$131.67,$63.14,$62.52,$63.14,$149.38,$63.14,$154.00,$63.14,$63.14,$149.38
1130540B,0983,11305,,,,,N/A,N/A,SHAV EPDRML LESN 0.5CM LESS ~P,$108.97,$81.00,$39.44,$233.00,$95.53,$226.01,$95.53,$199.22,$95.53,$39.44,$95.53,$226.01,$95.53,$233.00,$95.53,$95.53,$226.01
1130640B,0983,11306,,,,,N/A,N/A,SHAV EPDRML LESN 0.6-1.0CM  ~P,$104.93,$78.00,$51.45,$233.00,$93.89,$226.01,$93.89,$199.22,$93.89,$51.45,$93.89,$226.01,$93.89,$233.00,$93.89,$93.89,$226.01
1130740B,0983,11307,,,,,N/A,N/A,SHAVE SKIN LESION           ~P,$129.14,$96.00,$62.73,$153.00,$62.73,$148.41,$62.73,$130.82,$62.73,$66.19,$62.73,$148.41,$62.73,$153.00,$62.73,$62.73,$148.41
1130840B,0983,11308,,,,,N/A,N/A,SHAVE SKIN LESION           ~P,$161.43,$120.00,$75.05,$189.00,$77.49,$183.33,$77.49,$161.50,$77.49,$75.05,$77.49,$183.33,$77.49,$189.00,$77.49,$77.49,$183.33
1131040B,0983,11310,,,,,N/A,N/A,SHAVIN LESION DIAM 0.5 OR < ~P,$84.75,$63.00,$47.41,$182.00,$74.62,$176.54,$74.62,$155.61,$74.62,$47.41,$74.62,$176.54,$74.62,$182.00,$74.62,$74.62,$176.54
1131140B,0983,11311,,,,,N/A,N/A,SHAVE SKIN LESION           ~P,$121.07,$90.00,$59.40,$144.00,$59.40,$139.68,$59.40,$123.12,$59.40,$65.51,$59.40,$139.68,$59.40,$144.00,$59.40,$59.40,$139.68
1131240B,0983,11312,,,,,N/A,N/A,SHAVE SKIN LESION           ~P,$141.25,$105.00,$77.47,$232.00,$95.12,$225.04,$95.12,$198.36,$95.12,$77.47,$95.12,$225.04,$95.12,$232.00,$95.12,$95.12,$225.04
1140040B,0983,11400,,,,,N/A,N/A,EXC TR-EXT B9+MARG 0.5 < CM ~P,$144.28,$107.25,$66.10,$161.00,$66.10,$156.17,$66.10,$137.66,$66.10,$87.14,$66.10,$156.17,$66.10,$161.00,$66.10,$66.10,$156.17
1140140B,0983,11401,,,,,N/A,N/A,EXC TR-EXT B9+MARG 0.6-1 CM ~P,$190.69,$141.75,$86.51,$211.00,$86.51,$204.67,$86.51,$180.11,$86.51,$109.64,$86.51,$204.67,$86.51,$211.00,$86.51,$86.51,$204.67
1140240B,0983,11402,,,,,N/A,N/A,EXC TR-EXT B9+MARG 1.1-2 CM ~P,$209.86,$156.00,$99.22,$242.00,$99.22,$234.74,$99.22,$206.91,$99.22,$120.39,$99.22,$234.74,$99.22,$242.00,$99.22,$99.22,$234.74
1140245B,0983,11402,,,,,N/A,N/A,EXC TR-EXT B9+MARG 1.1-2 CM ~P,$209.86,$156.00,$99.22,$242.00,$99.22,$234.74,$99.22,$206.91,$99.22,$120.39,$99.22,$234.74,$99.22,$242.00,$99.22,$99.22,$234.74
1140340B,0983,11403,,,,,N/A,N/A,EXC TR-EXT B9+MARG 2.1-3 CM ~P,$266.36,$198.00,$118.49,$289.00,$118.49,$280.33,$118.49,$247.10,$118.49,$154.18,$118.49,$280.33,$118.49,$289.00,$118.49,$118.49,$280.33
1140345B,0983,11403,,,,,N/A,N/A,EXC TR-EXT B9+MARG 2.1-3 CM ~P,$25.22,$18.75,$118.49,$289.00,$118.49,$280.33,$118.49,$247.10,$118.49,$154.18,$118.49,$280.33,$118.49,$289.00,$118.49,$118.49,$280.33
1140440B,0983,11404,,,,,N/A,N/A,EXC TR-EXT B9+MARG 3.1-4CM  ~P,$295.62,$219.75,$133.25,$215.00,$133.25,$208.55,$133.25,$183.83,$133.25,$169.43,$133.25,$208.55,$133.25,$215.00,$133.25,$133.25,$208.55
1140445B,0983,11404,,,,,N/A,N/A,EXC TR-EXT B9+MARG 3.1-4CM  ~P,$295.62,$219.75,$133.25,$215.00,$133.25,$208.55,$133.25,$183.83,$133.25,$169.43,$133.25,$208.55,$133.25,$215.00,$133.25,$133.25,$208.55
1140640B,0983,11406,,,,,N/A,N/A,EXC TR-EXT B9+MARG > 4.0 CM ~P,$381.38,$283.50,$129.56,$418.00,$129.56,$405.46,$129.56,$357.39,$129.56,$255.59,$129.56,$405.46,$129.56,$418.00,$129.56,$129.56,$405.46
1140645B,0983,11406,,,,,N/A,N/A,EXC TR-EXT B9+MARG > 4.0 CM ~P,$381.38,$283.50,$129.56,$418.00,$129.56,$405.46,$129.56,$357.39,$129.56,$255.59,$129.56,$405.46,$129.56,$418.00,$129.56,$129.56,$405.46
1142040B,0983,11420,,,,,N/A,N/A,EXCISION .5CM OR LESS       ~P,$152.35,$113.25,$86.04,$179.00,$114.39,$173.63,$114.39,$153.05,$114.39,$86.04,$114.39,$173.63,$114.39,$179.00,$114.39,$114.39,$173.63
1142045B,0983,11420,,,,,N/A,N/A,EXCISION .5CM OR LESS       ~P,$152.35,$113.25,$86.04,$179.00,$114.39,$173.63,$114.39,$153.05,$114.39,$86.04,$114.39,$173.63,$114.39,$179.00,$114.39,$114.39,$173.63
1142140B,0983,11421,,,,,N/A,N/A,EXC H-F-NK-SP B9+MARG 0.3-1 ~P,$206.83,$153.75,$96.76,$236.00,$96.76,$228.92,$96.76,$201.78,$96.76,$113.89,$96.76,$228.92,$96.76,$236.00,$96.76,$96.76,$228.92
1142145B,0983,11421,,,,,N/A,N/A,EXC H-F-NK-SP B9+MARG 0.6-1 ~P,$206.83,$153.75,$96.76,$236.00,$96.76,$228.92,$96.76,$201.78,$96.76,$113.89,$96.76,$228.92,$96.76,$236.00,$96.76,$96.76,$228.92
1142240B,0983,11422,,,,,N/A,N/A,EXC H-F-NK-SP B9+MARG 1.1-2 ~P,$249.21,$185.25,$113.16,$276.00,$113.16,$267.72,$113.16,$235.98,$113.16,$141.01,$113.16,$267.72,$113.16,$276.00,$113.16,$113.16,$267.72
1142245B,0983,11422,,,,,N/A,N/A,EXC H-F-NK-SP B9+MARG 1.1-2 ~P,$249.21,$185.25,$113.16,$276.00,$113.16,$267.72,$113.16,$235.98,$113.16,$141.01,$113.16,$267.72,$113.16,$276.00,$113.16,$113.16,$267.72
1142340B,0983,11423,,,,,N/A,N/A,EXC H-F-NK-SP B9+MARG 2.1-3 ~P,$290.57,$216.00,$133.25,$325.00,$133.25,$315.25,$133.25,$277.88,$133.25,$161.73,$133.25,$315.25,$133.25,$325.00,$133.25,$133.25,$315.25
1142440B,0983,11424,,,,,N/A,N/A,EXC H-F-NK-SP B9+MARG 3.1-4 ~P,$302.68,$225.00,$154.57,$377.00,$154.57,$365.69,$154.57,$322.34,$154.57,$183.80,$154.57,$365.69,$154.57,$377.00,$154.57,$154.57,$365.69
1142445B,0983,11424,,,,,N/A,N/A,EXC H-F-NK-SP B9+MARG 3.1-4 ~P,$302.68,$225.00,$154.57,$377.00,$154.57,$365.69,$154.57,$322.34,$154.57,$183.80,$154.57,$365.69,$154.57,$377.00,$154.57,$154.57,$365.69
1142640B,0983,11426,,,,,N/A,N/A,EXC H-F-NK-SP B9+MARG > 4 CM~P,$508.51,$378.00,$227.14,$227.14,$227.14,N/A,$227.14,N/A,$227.14,N/A,$227.14,N/A,$227.14,N/A,$227.14,$227.14,N/A
1142645B,0983,11426,,,,,N/A,N/A,EXC H-F-NK-SP B9+MARG > 4CM ~P,$508.51,$378.00,$227.14,$227.14,$227.14,N/A,$227.14,N/A,$227.14,N/A,$227.14,N/A,$227.14,N/A,$227.14,$227.14,N/A
1144040B,0983,11440,,,,,N/A,N/A,"EXCISION,OTHER BENIGN LESION~P",$168.49,$125.25,$56.17,$167.00,$56.17,$161.99,$56.17,$142.79,$56.17,$109.55,$56.17,$161.99,$56.17,$167.00,$56.17,$56.17,$161.99
1144045B,0983,11440,,,,,N/A,N/A,EXC FACE-MM B9+MARG 0.5 < CM~P,$168.49,$125.25,$56.17,$167.00,$56.17,$161.99,$56.17,$142.79,$56.17,$109.55,$56.17,$161.99,$56.17,$167.00,$56.17,$56.17,$161.99
1144140B,0983,11441,,,,,N/A,N/A,EXC FACE-MM B9+MARG 0.6-1  ~P,$242.15,$180.00,$113.16,$276.00,$113.16,$267.72,$113.16,$235.98,$113.16,$137.29,$113.16,$267.72,$113.16,$276.00,$113.16,$113.16,$267.72
1144240B,0983,11442,,,,,N/A,N/A,EXC FACE-MM 1.1 TO 2.0 CM   ~P,$279.48,$207.75,$113.57,$277.00,$113.57,$268.69,$113.57,$236.84,$113.57,$151.35,$113.57,$268.69,$113.57,$277.00,$113.57,$113.57,$268.69
1144340B,0983,11443,,,,,N/A,N/A,EXCISED DIAMETER 2.1-3.0 CM ~P,$181.61,$135.00,$185.17,$760.00,$311.60,$737.20,$311.60,$649.80,$311.60,$185.17,$311.60,$737.20,$311.60,$760.00,$311.60,$311.60,$737.20
1144440B,0983,11444,,,,,N/A,N/A,EXC OF BENIGN LES 3.1>4.0CM ~P,$434.85,$323.25,$176.71,$431.00,$176.71,$418.07,$176.71,$368.51,$176.71,$234.52,$176.71,$418.07,$176.71,$431.00,$176.71,$176.71,$418.07
1145140B,0983,11451,,,,,N/A,N/A,"REMOVAL, SWEAT GLAND LESION ~P",$590.23,$438.75,$252.15,$615.00,$252.15,$596.55,$252.15,$525.83,$252.15,$556.60,$252.15,$596.55,$252.15,$615.00,$252.15,$252.15,$596.55
1146240B,0983,11462,,,,,N/A,N/A,TREAT OF HIDRADENITIS       ~P,$476.22,$354.00,$193.52,$472.00,$193.52,$457.84,$193.52,$403.56,$193.52,$416.86,$193.52,$457.84,$193.52,$472.00,$193.52,$193.52,$457.84
1160040B,0983,11600,,,,,N/A,N/A,EXCISION MAL LESION         ~P,$243.15,$180.75,$98.81,$241.00,$98.81,$233.77,$98.81,$206.06,$98.81,$127.42,$98.81,$233.77,$98.81,$241.00,$98.81,$98.81,$233.77
1160140B,0983,11601,,,,,N/A,N/A,EXC TR-EXT MLG+MARG 0.6-1   ~P,$279.48,$207.75,$114.80,$280.00,$114.80,N/A,$114.80,$239.40,$114.80,$154.33,$114.80,N/A,$114.80,$280.00,$114.80,$114.80,N/A
1106240B,0983,11602,,,,,N/A,N/A,EXC TR-EXT MLG+MARG 1.1-2   ~P,$253.24,$188.25,$122.18,$299.00,$122.18,$290.03,$122.18,$255.65,$122.18,$167.92,$122.18,$290.03,$122.18,$299.00,$122.18,$122.18,$290.03
1160240B,0983,11602,,,,,N/A,N/A,EXC TR-EXT MLG+MARG 1.1-2   ~P,$281.49,$209.25,$122.18,$299.00,$122.18,$290.03,$122.18,$255.65,$122.18,$167.92,$122.18,$290.03,$122.18,$299.00,$122.18,$122.18,$290.03
1160340B,0983,11603,,,,,N/A,N/A,EXC TR-EXT MLG+MARG 2.1-3   ~P,$312.77,$232.50,$134.48,$328.00,$134.48,$318.16,$134.48,$280.44,$134.48,$200.22,$134.48,$318.16,$134.48,$328.00,$134.48,$134.48,$318.16
1160440B,0983,11604,,,,,N/A,N/A,EXC MALIG LESION 3.1-4.0CM  ~P,$411.65,$306.00,$167.28,$408.00,$167.28,$395.76,$167.28,$348.84,$167.28,$220.67,$167.28,$395.76,$167.28,$408.00,$167.28,$167.28,$395.76
1160640B,0983,11606,,,,,N/A,N/A,EXCISED DIAMETER OVER 4.0CM ~P,$735.52,$546.75,$298.89,$729.00,$298.89,$707.13,$298.89,$623.30,$298.89,$326.60,$298.89,$707.13,$298.89,$729.00,$298.89,$298.89,$707.13
1162040B,0983,11620,,,,,N/A,N/A,SKIN LESION REMOVAL         ~P,$243.15,$180.75,$98.81,$241.00,$98.81,$233.77,$98.81,$206.06,$98.81,$128.15,$98.81,$233.77,$98.81,$241.00,$98.81,$98.81,$233.77
1162045B,0983,11620,,,,,N/A,N/A,SKIN LESION REMOVAL         ~P,$243.15,$180.75,$98.81,$241.00,$98.81,$233.77,$98.81,$206.06,$98.81,$128.15,$98.81,$233.77,$98.81,$241.00,$98.81,$98.81,$233.77
1162140B,0983,11621,,,,,N/A,N/A,EXC H-F-NK-SP MLG+MAR 0.6-1 ~P,$258.29,$192.00,$114.39,$279.00,$114.39,$270.63,$114.39,$238.55,$114.39,$154.69,$114.39,$270.63,$114.39,$279.00,$114.39,$114.39,$270.63
1162240B,0983,11622,,,,,N/A,N/A,EXC H-F-NK-SP MLG+MAR 1.1-2 ~P,$324.88,$241.50,$132.20,$324.00,$132.20,$314.28,$132.20,$277.02,$132.20,$175.47,$132.20,$314.28,$132.20,$324.00,$132.20,$132.20,$314.28
1162340B,0983,11623,,,,,N/A,N/A,EXCISION OF MAL LESIONS     ~P,$408.62,$303.75,$166.50,$407.00,$166.50,$394.79,$166.50,$347.99,$166.50,$217.26,$166.50,$394.79,$166.50,$407.00,$166.50,$166.50,$394.79
1162440B,0983,11624,,,,,N/A,N/A,EXC H-F-NK-SP MLG+MAR3.1-4.0~P,$463.10,$344.25,$188.19,$459.00,$188.19,$445.23,$188.19,$392.45,$188.19,$245.79,$188.19,$445.23,$188.19,$459.00,$188.19,$188.19,$445.23
1162640B,0983,11626,,,,,N/A,N/A,EXC MAL LESION DIA >4 CM    ~P,$569.04,$423.00,$231.24,$231.24,$231.24,N/A,$231.24,N/A,$231.24,N/A,$231.24,N/A,$231.24,N/A,$231.24,$231.24,N/A
1164040B,0983,11640,,,,,N/A,N/A,EXC FACE-MM MALIG+MARG 0.5< ~P,$287.55,$213.75,$116.85,$285.00,$116.85,$276.45,$116.85,$243.68,$116.85,$131.46,$116.85,$276.45,$116.85,$285.00,$116.85,$116.85,$276.45
1164140B,0983,11641,,,,,N/A,N/A,EXC FACE-MM MALG+MARG 0.6-1 ~P,$298.65,$222.00,$14.22,$342.00,$14.22,$331.74,$14.22,$292.41,$14.22,$161.15,$14.22,$331.74,$14.22,$342.00,$14.22,$14.22,$331.74
1164240B,0983,11642,,,,,N/A,N/A,EXC FACEMM MALG+MARG1.1-2.0 ~P,$350.10,$260.25,$142.27,$347.00,$142.27,$336.59,$142.27,$296.69,$142.27,$188.63,$142.27,$336.59,$142.27,$347.00,$142.27,$142.27,$336.59
1164340B,0983,11643,,,,,N/A,N/A,EX MALIG LESION 2.1 - 3.0CM ~P,$448.98,$333.75,$182.45,$445.00,$182.45,$431.65,$182.45,$380.48,$182.45,$235.78,$182.45,$431.65,$182.45,$445.00,$182.45,$182.45,$431.65
1164440B,0983,11644,,,,,N/A,N/A,EXC FACE-MM MALIG+MARG 3.1-4~P,$675.99,$502.50,$274.70,$670.00,$274.70,N/A,$274.70,$572.85,$274.70,$292.21,$274.70,N/A,$274.70,$670.00,$274.70,$274.70,N/A
1164640B,0983,11646,,,,,N/A,N/A,SKIN LESION REMOVAL >4.0CM  ~P,$793.03,$589.50,$322.26,$786.00,$322.26,$762.42,$322.26,$672.03,$322.26,$403.91,$322.26,$762.42,$322.26,$786.00,$322.26,$322.26,$762.42
1172040B,0983,11720,,,,,N/A,N/A,DEBRIDEMENT OF NAIL         ~P,$36.32,$27.00,$14.76,$36.00,$14.76,$34.92,$14.76,$30.78,$14.76,$15.15,$14.76,$34.92,$14.76,$36.00,$14.76,$14.76,$34.92
11730LSS,0983,11730,,,,,N/A,N/A,REMOVAL OF NAIL PLATE,$182.62,$135.75,$0.00,$56.22,N/A,$0.00,N/A,$0.00,N/A,$56.22,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
1175045B,0983,11750,,,,,N/A,N/A,REMOVAL OF NAIL BED         ~P,$333.96,$248.25,$138.17,$337.00,$138.17,$326.89,$138.17,$288.14,$138.17,$174.56,$138.17,$326.89,$138.17,$337.00,$138.17,$138.17,$326.89
1176045B,0983,11760,,,,,N/A,N/A,REPAIR OF NAIL BED          ~P,$195.73,$145.50,$79.54,$194.14,$79.54,$188.18,$79.54,$165.87,$79.54,$194.14,$79.54,$188.18,$79.54,$194.00,$79.54,$79.54,$188.18
1177040B,0983,11770,,,,,N/A,N/A,REMOVAL OF PILONIDAL LESION ~P,$335.98,$249.75,$159.80,$388.00,$159.80,$376.36,$159.80,$331.74,$159.80,$314.73,$159.80,$376.36,$159.80,$388.00,$159.80,$159.80,$376.36
1177140B,0983,11771,,,,,N/A,N/A,TREATMENT PILONIDAL CYST EXT~P,$856.59,$636.75,$348.90,$849.00,$348.90,$823.53,$348.90,$725.90,$348.90,$753.19,$348.90,$823.53,$348.90,$849.00,$348.90,$348.90,$823.53
1177240B,0983,11772,,,,,N/A,N/A,REMOVAL OF PILONIDAL LESION ~P,"$1,026.09",$762.75,$463.30,"$1,130.00",$463.30,"$1,096.10",$463.30,$966.15,$463.30,$997.43,$463.30,"$1,096.10",$463.30,"$1,130.00",$463.30,$463.30,"$1,096.10"
1190040B,0983,11900,,,,,N/A,N/A,INJ INTRALESIONAL UP 7 LES  ~P,$161.43,$120.00,$31.16,$174.00,$71.34,$168.78,$71.34,$148.77,$71.34,$31.16,$71.34,$168.78,$71.34,$174.00,$71.34,$71.34,$168.78
1200140B,0983,12001,,,,,N/A,N/A,SUTURING SUPERFICIAL WOUNDS ~P,$200.78,$149.25,$45.36,$199.00,$81.59,$193.03,$81.59,$170.15,$81.59,$45.36,$81.59,$193.03,$81.59,$199.00,$81.59,$81.59,$193.03
5112001B,0983,12001,,,,,N/A,N/A,LAC REPAIR 2.5CM OR <  12001,$211.88,$157.50,$45.36,$199.00,$81.59,$193.03,$81.59,$170.15,$81.59,$45.36,$81.59,$193.03,$81.59,$199.00,$81.59,$81.59,$193.03
1200240B,0983,12002,,,,,N/A,N/A,REPAIR SUPERFICIAL WOUND (S)~P,$219.95,$163.50,$17.10,$261.00,$17.10,$253.17,$17.10,$223.16,$17.10,$59.83,$17.10,$253.17,$17.10,$261.00,$17.10,$17.10,$253.17
1200245B,0983,12002,,,,,N/A,N/A,REPAIR SUPERFICIAL WOUND (S)~P,$219.95,$163.50,$17.10,$261.00,$17.10,$253.17,$17.10,$223.16,$17.10,$59.83,$17.10,$253.17,$17.10,$261.00,$17.10,$17.10,$253.17
1203140B,0983,12031,,,,,N/A,N/A,LAYER CLOSURE OF WOUND(S)   ~P,$276.45,$205.50,$119.72,$292.00,$119.72,$283.24,$119.72,$249.66,$119.72,$258.03,$119.72,$283.24,$119.72,$292.00,$119.72,$119.72,$283.24
1203240B,0983,12032,,,,,N/A,N/A,LAYER CLOSURE OF WOUND(S)   ~P,$369.27,$274.50,$161.13,$393.00,$161.13,$381.21,$161.13,$336.02,$161.13,$323.30,$161.13,$381.21,$161.13,$393.00,$161.13,$161.13,$381.21
1203245B,0983,12032,,,,,N/A,N/A,LAYER CLOSURE OF WOUND(S)   ~P,$369.27,$274.50,$161.13,$393.00,$161.13,$381.21,$161.13,$336.02,$161.13,$323.30,$161.13,$381.21,$161.13,$393.00,$161.13,$161.13,$381.21
1203440B,0983,12034,,,,,N/A,N/A,LAYER CLOSURE OF WOUNDS(S)  ~P,$257.28,$191.25,$168.10,$410.00,$168.10,$397.70,$168.10,$350.55,$168.10,$348.85,$168.10,$397.70,$168.10,$410.00,$168.10,$168.10,$397.70
1203445B,0983,12034,,,,,N/A,N/A,LAYER CLOSURE OF WOUNDS(S)  ~P,$257.28,$191.25,$168.10,$410.00,$168.10,$397.70,$168.10,$350.55,$168.10,$348.85,$168.10,$397.70,$168.10,$410.00,$168.10,$168.10,$397.70
1203540B,0983,12035,,,,,N/A,N/A,REPAIR WOUND 12.6 TO 20.0CM ~P,$485.30,$360.75,$197.21,$481.00,$197.21,$466.57,$197.21,$411.26,$197.21,$407.81,$197.21,$466.57,$197.21,$481.00,$197.21,$197.21,$466.57
1203545B,0983,12035,,,,,N/A,N/A,REPAIR WOUND 12.6 TO 20.0CM ~G,$485.30,$360.75,$197.21,$481.00,$197.21,$466.57,$197.21,$411.26,$197.21,$407.81,$197.21,$466.57,$197.21,$481.00,$197.21,$197.21,$466.57
1204140B,0983,12041,,,,,N/A,N/A,LAYER CLOSURE OF WOUNDS(S)  ~P,$322.86,$240.00,$134.48,$328.00,$134.48,$318.16,$134.48,$280.44,$134.48,$246.94,$134.48,$318.16,$134.48,$328.00,$134.48,$134.48,$318.16
1204145B,0983,12041,,,,,N/A,N/A,LAYER CLOSURE OF WOUNDS(S)  ~P,$322.86,$240.00,$134.48,$328.00,$134.48,$318.16,$134.48,$280.44,$134.48,$246.94,$134.48,$318.16,$134.48,$328.00,$134.48,$134.48,$318.16
1204240B,0983,12042,,,,,N/A,N/A,LAYER CLOSURE OF WOUNDS(S)  ~P,$377.34,$280.50,$159.90,$390.00,$159.90,$378.30,$159.90,$333.45,$159.90,$333.41,$159.90,$378.30,$159.90,$390.00,$159.90,$159.90,$378.30
1204245B,0983,12042,,,,,N/A,N/A,LAYER CLOSURE OF WOUNDS     ~P,$377.34,$280.50,$159.90,$390.00,$159.90,$378.30,$159.90,$333.45,$159.90,$333.41,$159.90,$378.30,$159.90,$390.00,$159.90,$159.90,$378.30
1204440B,0983,12044,,,,,N/A,N/A,LAYER CLOSURE OF WOUND(S)   ~P,$407.61,$303.00,$182.40,$444.00,$182.40,$430.68,$182.40,$379.62,$182.40,$361.63,$182.40,$430.68,$182.40,$444.00,$182.40,$182.40,$430.68
1205140B,0983,12051,,,,,N/A,N/A,LAYER CLOSURE OF WOUNDS(S)  ~P,$211.88,$157.50,$149.65,$365.00,$149.65,$354.05,$149.65,$312.08,$149.65,$287.31,$149.65,$354.05,$149.65,$365.00,$149.65,$149.65,$354.05
1205240B,0983,12052,,,,,N/A,N/A,LAYER CLOSURE OF WOUNDS(S)  ~P,$350.10,$260.25,$159.90,$390.00,$159.90,$378.30,$159.90,$333.45,$159.90,$339.25,$159.90,$378.30,$159.90,$390.00,$159.90,$159.90,$378.30
1205340B,0983,12053,,,,,N/A,N/A,REPAIR SCALP WOUND 5.1CM-7.5~P,$441.92,$328.50,$179.58,$438.00,$179.58,$424.86,$179.58,$374.49,$179.58,$365.16,$179.58,$424.86,$179.58,$438.00,$179.58,$179.58,$424.86
1205540B,0983,12055,,,,,N/A,N/A,LAYER CLOSURE OF WOUND(S)   ~P,$605.36,$450.00,$252.56,$616.00,$252.56,N/A,$252.56,$526.68,$252.56,$503.70,$252.56,N/A,$252.56,$616.00,$252.56,$252.56,N/A
1310040B,0983,13100,,,,,N/A,N/A,REPAIR OF WOUND OR LESION   ~P,$444.94,$330.75,$26.64,$504.00,$26.64,$488.88,$26.64,$430.92,$26.64,$342.33,$26.64,$488.88,$26.64,$504.00,$26.64,$26.64,$488.88
1310140B,0983,13101,,,,,N/A,N/A,REPAIR OF WOUND OR LESION   ~P,$542.81,$403.50,$25.51,$611.00,$25.51,$592.67,$25.51,$522.41,$25.51,$426.93,$25.51,$592.67,$25.51,$611.00,$25.51,$25.51,$592.67
1312140B,0983,13121,,,,,N/A,N/A,REPAIR OF WOUND OR LESION   ~P,$621.51,$462.00,$269.37,$657.00,$269.37,$637.29,$269.37,$561.74,$269.37,$440.29,$269.37,$637.29,$269.37,$657.00,$269.37,$269.37,$637.29
1312240B,0983,13122,,,,,N/A,N/A,REPAIR EA ADDT 5CM OR LESS  ~P,$198.76,$147.75,$8.77,$197.00,$8.77,$191.09,$8.77,$168.44,$8.77,$140.28,$8.77,$191.09,$8.77,$197.00,$8.77,$8.77,$191.09
1313145B,0983,13131,,,,,N/A,N/A,REPAIR OF WOUND OR LESION   ~P,$603.35,$448.50,$245.18,$598.00,$245.18,$580.06,$245.18,$511.29,$245.18,$413.25,$245.18,$580.06,$245.18,$598.00,$245.18,$245.18,$580.06
1313240B,0983,13132,,,,,N/A,N/A,SUTURING OF WOUNDS 2.6CM-7.5~P,$640.68,$476.25,$26.35,$635.00,$26.35,$615.95,$26.35,$542.93,$26.35,$515.68,$26.35,$615.95,$26.35,$635.00,$26.35,$26.35,$615.95
1313245B,0983,13132,,,,,N/A,N/A,SUTURING OF WOUNDS 2.6CM-7.5~P,$640.68,$476.25,$26.35,$635.00,$26.35,$615.95,$26.35,$542.93,$26.35,$515.68,$26.35,$615.95,$26.35,$635.00,$26.35,$26.35,$615.95
1313340B,0983,13133,,,,,N/A,N/A,EA ADDITIONAL 5CM OR LESS   ~P,$266.36,$198.00,$18.24,$264.00,$18.24,$256.08,$18.24,$225.72,$18.24,$213.86,$18.24,$256.08,$18.24,$264.00,$18.24,$18.24,$256.08
1313345B,0983,13133,,,,,N/A,N/A,EA ADDITIONAL 5CM OR LESS   ~P,$266.36,$198.00,$18.24,$264.00,$18.24,$256.08,$18.24,$225.72,$18.24,$213.86,$18.24,$256.08,$18.24,$264.00,$18.24,$18.24,$256.08
1316040B,0983,13160,,,,,N/A,N/A,LATE CLOSURE OF WOUND       ~P,"$1,677.87","$1,247.25",$681.83,"$1,663.00",$681.83,N/A,$681.83,"$1,421.87",$681.83,"$1,352.96",$681.83,N/A,$681.83,"$1,663.00",$681.83,$681.83,N/A
1316045B,0983,13160,,,,,N/A,N/A,SECOND CLOSURE OF SURG WOUND~P,"$1,153.22",$857.25,$681.83,"$1,663.00",$681.83,N/A,$681.83,"$1,421.87",$681.83,"$1,352.96",$681.83,N/A,$681.83,"$1,663.00",$681.83,$681.83,N/A
1400040B,0983,14000,,,,,N/A,N/A,SKIN TISSUE REARRANGEMENT   ~P,"$1,008.94",$750.00,$431.73,"$1,053.00",$431.73,"$1,021.41",$431.73,$900.32,$431.73,$518.43,$431.73,"$1,021.41",$431.73,"$1,053.00",$431.73,$431.73,"$1,021.41"
1402040B,0983,14020,,,,,N/A,N/A,SKIN TISSUE REARRANGEMENT   ~P,"$1,224.85",$910.50,$497.74,"$1,214.00",$497.74,"$1,177.58",$497.74,"$1,037.97",$497.74,$585.12,$497.74,"$1,177.58",$497.74,"$1,214.00",$497.74,$497.74,"$1,177.58"
1430140B,0983,14301,,,,,N/A,N/A,ADJAC TISSUE TRANS 30-60CM  ~P,"$1,785.82","$1,327.50",$725.70,"$1,770.00",$725.70,"$1,716.90",$725.70,"$1,513.35",$725.70,$898.67,$725.70,"$1,716.90",$725.70,"$1,770.00",$725.70,$725.70,"$1,716.90"
1430240B,0983,14302,,,,,N/A,N/A,ADJT TIS/TRNSFR EA ADD'L30CM~P,$413.67,$307.50,$178.35,$435.00,$178.35,$421.95,$178.35,$371.93,$178.35,$222.31,$178.35,$421.95,$178.35,$435.00,$178.35,$178.35,$421.95
1500240B,0983,15002,,,,,N/A,N/A,PREP SITE                   ~P,$396.51,$294.75,$179.58,$438.00,$179.58,$424.86,$179.58,$374.49,$179.58,$227.08,$179.58,$424.86,$179.58,$438.00,$179.58,$179.58,$424.86
1500245B,0983,15002,,,,,N/A,N/A,PREP SITE                   ~P,$396.51,$294.75,$179.58,$438.00,$179.58,$424.86,$179.58,$374.49,$179.58,$227.08,$179.58,$424.86,$179.58,$438.00,$179.58,$179.58,$424.86
1500340B,0983,15003,,,,,N/A,N/A,PREP SITE EA ADD 100SQ CM   ~P,$168.49,$125.25,$46.30,$167.00,$68.47,$161.99,$68.47,$142.79,$68.47,$46.30,$68.47,$161.99,$68.47,$167.00,$68.47,$68.47,$161.99
1510040B,0983,15100,,,,,N/A,N/A,SKIN SPLIT GRAFT            ~P,"$1,346.93","$1,001.25",$648.21,"$1,581.00",$648.21,N/A,$648.21,"$1,351.76",$648.21,$739.25,$648.21,N/A,$648.21,"$1,581.00",$648.21,$648.21,N/A
1513040B,0983,15130,,,,,N/A,N/A,"DERM AUTOGRAFT, TRNK/ARM/LEG~P","$1,109.83",$825.00,$477.65,$477.65,$477.65,N/A,$477.65,N/A,$477.65,N/A,$477.65,N/A,$477.65,N/A,$477.65,$477.65,N/A
1520040B,0983,15200,,,,,N/A,N/A,FULL THICKNESS GRAFT        ~P,"$1,356.02","$1,008.00",$551.40,"$1,344.00",$551.40,"$1,303.68",$551.40,"$1,149.12",$551.40,$695.38,$551.40,"$1,303.68",$551.40,"$1,344.00",$551.40,$551.40,"$1,303.68"
1522040B,0983,15220,,,,,N/A,N/A,SKIN GRAFTS                 ~P,"$1,244.02",$924.75,$55.53,"$1,233.00",$55.53,"$1,196.01",$55.53,"$1,054.22",$55.53,$633.37,$55.53,"$1,196.01",$55.53,"$1,233.00",$55.53,$55.53,"$1,196.01"
1524040B,0983,15240,,,,,N/A,N/A,SKIN GRAFT FULL THICKNESS   ~P,"$1,611.28","$1,197.75",$654.77,"$1,597.00",$654.77,"$1,549.09",$654.77,"$1,365.44",$654.77,$825.53,$654.77,"$1,549.09",$654.77,"$1,597.00",$654.77,$654.77,"$1,549.09"
1527140B,0983,15271,,,,,N/A,N/A,SKIN SUB GRAFT TRNK/ARM/LEG ~P,$170.51,$126.75,$69.29,$169.00,$69.29,$163.93,$69.29,$144.50,$69.29,$86.48,$69.29,$163.93,$69.29,$169.00,$69.29,$69.29,$163.93
1573440B,0983,15734,,,,,N/A,N/A,MUSCLE MYOCUTANEOUS TRUNK   ~P,"$2,867.41","$2,131.50","$1,165.22","$2,842.00","$1,165.22","$2,756.74","$1,165.22","$2,429.91","$1,165.22","$1,547.67","$1,165.22","$2,756.74","$1,165.22","$2,842.00","$1,165.22","$1,165.22","$2,756.74"
1576940B,0983,15769,,,,,N/A,N/A,GRAFTING OF SOFT TISSUE     ~P,$948.40,$705.00,$395.65,$395.65,$395.65,N/A,$395.65,N/A,$395.65,N/A,$395.65,N/A,$395.65,N/A,$395.65,$395.65,N/A
1593140B,0983,15931,,,,,N/A,N/A,"EXC,PRESSURE ULCER W/PRIM CL~P","$1,311.62",$975.00,$533.00,"$1,300.00",$533.00,"$1,261.00",$533.00,"$1,111.50",$533.00,$726.49,$533.00,"$1,261.00",$533.00,"$1,300.00",$533.00,$533.00,"$1,261.00"
1593340B,0983,15933,,,,,N/A,N/A,"EXC, PRESS ULCER W/OSTECTOMY~P","$1,632.46","$1,213.50",$663.38,"$1,618.00",$663.38,"$1,569.46",$663.38,"$1,383.39",$663.38,$896.79,$663.38,"$1,569.46",$663.38,"$1,618.00",$663.38,$663.38,"$1,569.46"
1600040B,0983,16000,,,,,N/A,N/A,BURNS INITIAL TREATMENT     ~P,$111.99,$83.25,$45.51,$111.00,$45.51,$107.67,$45.51,$94.91,$45.51,$46.41,$45.51,$107.67,$45.51,$111.00,$45.51,$45.51,$107.67
1602040B,0983,16020,,,,,N/A,N/A,TREATMENT OF BURN(S)        ~P,$121.07,$90.00,$53.71,$131.00,$53.71,$127.07,$53.71,$112.01,$53.71,$93.42,$53.71,$127.07,$53.71,$131.00,$53.71,$53.71,$127.07
1700040B,0983,17000,,,,,N/A,N/A,DESTROY BEN/PREMLG LESION   ~P,$104.93,$78.00,$44.28,$108.00,$44.28,$104.76,$44.28,$92.34,$44.28,$56.51,$44.28,$104.76,$44.28,$108.00,$44.28,$44.28,$104.76
1700340B,0983,17003,,,,,N/A,N/A,"DESTROY LESIONS, 2-14       ~P",$5.04,$3.75,$2.20,$22.00,$9.43,$21.34,$9.43,$18.81,$9.43,$2.20,$9.43,$21.34,$9.43,$22.00,$9.43,$9.43,$21.34
1711040B,0983,17110,,,,,N/A,N/A,"DESTRUCT LESION, 1-14       ~P",$121.07,$90.00,$56.58,$138.00,$56.58,$133.86,$56.58,$117.99,$56.58,$69.20,$56.58,$133.86,$56.58,$138.00,$56.58,$56.58,$133.86
17110LSC,0983,17110,,,,,N/A,N/A,"DESTRUCT LESION, 1-14",$155.38,$115.50,$56.58,$138.00,$56.58,$133.86,$56.58,$117.99,$56.58,$69.20,$56.58,$133.86,$56.58,$138.00,$56.58,$56.58,$133.86
1726140B,0983,17261,,,,,N/A,N/A,DESTRUT MAL LESION 0.6>1.0CM~P,$181.61,$135.00,$158.26,$158.26,$158.26,N/A,$158.26,N/A,$158.26,N/A,$158.26,N/A,$158.26,N/A,$158.26,$158.26,N/A
1728040B,0983,17280,,,,,N/A,N/A,"DESTRUCTION,MALIG LESION    ~P",$179.59,$133.50,$72.98,$178.00,$72.98,$172.66,$72.98,$152.19,$72.98,$90.12,$72.98,$172.66,$72.98,$178.00,$72.98,$72.98,$172.66
1728140B,0983,17281,,,,,N/A,N/A,DESTRUCT MAL LES 0.6-1.0 CM ~P,$247.19,$183.75,$22.99,$539.00,$22.99,$522.83,$22.99,$460.85,$22.99,$122.70,$22.99,$522.83,$22.99,$539.00,$22.99,$22.99,$522.83
1902040B,0983,19020,,,,,N/A,N/A,INCISION OF BREAST LESION   ~P,$565.01,$420.00,$239.85,$585.00,$239.85,$567.45,$239.85,$500.18,$239.85,$530.19,$239.85,$567.45,$239.85,$585.00,$239.85,$239.85,$567.45
1908340B,0983,19083,,,,,N/A,N/A,"BIOPSY BREAST 1ST LESION,INC~P","$1,085.62",$807.00,$264.57,"$1,076.00",$441.16,"$1,043.72",$441.16,$919.98,$441.16,$264.57,$441.16,"$1,043.72",$441.16,"$1,076.00",$441.16,$441.16,"$1,043.72"
1908440B,0983,19084,,,,,N/A,N/A,BIOPSY BREAST EA ADD LESION ~P,$648.75,$482.25,$131.94,$675.00,$276.75,$654.75,$276.75,$577.13,$276.75,$131.94,$276.75,$654.75,$276.75,$675.00,$276.75,$276.75,$654.75
1910040B,0983,19100,,,,,N/A,N/A,BX BREAST PERCUT W/O IMAGE  ~P,$144.28,$107.25,$72.16,$176.00,$72.16,$170.72,$72.16,$150.48,$72.16,$115.44,$72.16,$170.72,$72.16,$176.00,$72.16,$72.16,$170.72
1911040B,0983,19110,,,,,N/A,N/A,NIPPLE EXPLORATION          ~P,$612.43,$455.25,$276.34,$674.00,$276.34,$653.78,$276.34,$576.27,$276.34,$596.36,$276.34,$653.78,$276.34,$674.00,$276.34,$276.34,$653.78
1912040B,0983,19120,,,,,N/A,N/A,EXC OF CYST. FIBRO          ~P,$824.30,$612.75,$334.97,$817.00,$334.97,$792.49,$334.97,$698.54,$334.97,$702.84,$334.97,$792.49,$334.97,$817.00,$334.97,$334.97,$792.49
1912540B,0983,19125,,,,,N/A,N/A,"EXCISION, BREAST LESION     ~P",$830.36,$617.25,$365.72,$882.00,$365.72,$855.54,$365.72,$754.11,$365.72,$776.74,$365.72,$855.54,$365.72,$882.00,$365.72,$365.72,$855.54
1930140B,0983,19301,,,,,N/A,N/A,"MASTECTOMY, PARTIAL         ~P","$1,198.62",$891.00,$487.80,"$1,188.00",$487.80,"$1,152.36",$487.80,"$1,015.74",$487.80,"$1,108.82",$487.80,"$1,152.36",$487.80,"$1,188.00",$487.80,$487.80,"$1,152.36"
1930340B,0983,19303,,,,,N/A,N/A,"MASTECTOMY,SIMPLE, COMPLETE ~P","$2,021.92","$1,503.00",$821.64,"$2,004.00",$821.64,"$1,943.88",$821.64,"$1,713.42",$821.64,"$1,609.59",$821.64,"$1,943.88",$821.64,"$2,004.00",$821.64,$821.64,"$1,943.88"
1930540B,0983,19305,,,,,N/A,N/A,MAST RAD W/PECTORAL MUSC AX ~P,"$2,147.02","$1,596.00",$872.48,"$2,128.00",$872.48,"$2,064.16",$872.48,"$1,819.44",$872.48,"$1,925.79",$872.48,"$2,064.16",$872.48,"$2,128.00",$872.48,$872.48,"$2,064.16"
1930740B,0983,19307,,,,,N/A,N/A,"MAST, MOD RAD               ~P","$2,034.02","$1,512.00",$826.56,"$2,016.00",$826.56,"$1,955.52",$826.56,"$1,723.68",$826.56,"$1,992.24",$826.56,"$1,955.52",$826.56,"$2,016.00",$826.56,$826.56,"$1,955.52"
2010040B,0983,20100,,,,,N/A,N/A,"EXPLORE WOUND, NECK         ~P","$1,386.28","$1,030.50",$563.34,"$1,374.00",$563.34,"$1,332.78",$563.34,"$1,174.77",$563.34,"$1,058.65",$563.34,"$1,332.78",$563.34,"$1,374.00",$563.34,$563.34,"$1,332.78"
2010340B,0983,20103,,,,,N/A,N/A,"EXPLORE WOUND, EXTREMITY    ~P",$807.15,$600.00,$336.20,$820.00,$336.20,$795.40,$336.20,$701.10,$336.20,$612.09,$336.20,$795.40,$336.20,$820.00,$336.20,$336.20,$795.40
2010345B,0983,20103,,,,,N/A,N/A,"EXPLORE WOUND, EXTREMITY    ~P",$807.15,$600.00,$336.20,$820.00,$336.20,$795.40,$336.20,$701.10,$336.20,$612.09,$336.20,$795.40,$336.20,$820.00,$336.20,$336.20,$795.40
2020540B,0983,20205,,,,,N/A,N/A,DEEP MUSCLE BIOPSY          ~P,$340.01,$252.75,$138.17,$337.00,$138.17,$326.89,$138.17,$288.14,$138.17,$268.61,$138.17,$326.89,$138.17,$337.00,$138.17,$138.17,$326.89
2020640B,0983,20206,,,,,N/A,N/A,"NEEDLE BIOPSY, MUSCLE       ~P",$262.32,$195.00,$101.92,$300.00,$123.00,$291.00,$123.00,$256.50,$123.00,$101.92,$123.00,$291.00,$123.00,$300.00,$123.00,$123.00,$291.00
2022545B,0983,20225,,,,,N/A,N/A,PERCUTANEOUS BONE BIOPSY    ~P,"$1,060.40",$788.25,$43.91,"$1,051.00",$43.91,"$1,019.47",$43.91,$898.61,$43.91,$231.66,$43.91,"$1,019.47",$43.91,"$1,051.00",$43.91,$43.91,"$1,019.47"
2024045B,0983,20240,,,,,N/A,N/A,"BONE BIOPSY, EXCISIONAL     ~P",$504.47,$375.00,$222.63,$543.00,$222.63,$526.71,$222.63,$464.27,$222.63,$253.74,$222.63,$526.71,$222.63,$543.00,$222.63,$222.63,$526.71
2024545B,0983,20245,,,,,N/A,N/A,"BONE BIOPSY, EXCISIONAL     ~P","$1,311.62",$975.00,$554.73,"$1,353.00",$554.73,"$1,312.41",$554.73,"$1,156.82",$554.73,$612.94,$554.73,"$1,312.41",$554.73,"$1,353.00",$554.73,$554.73,"$1,312.41"
2052045B,0983,20520,,,,,N/A,N/A,REMOVAL FOREIGN BODY        ~P,$285.53,$212.25,$144.32,$362.00,$144.32,$351.14,$144.32,$309.51,$144.32,$264.30,$144.32,$351.14,$144.32,$362.00,$144.32,$144.32,$351.14
20520LSC,0983,20520,,,,,N/A,N/A,REMOVAL OF FOREIGN BODY,$357.16,$265.50,$144.32,$362.00,$144.32,$351.14,$144.32,$309.51,$144.32,$264.30,$144.32,$351.14,$144.32,$362.00,$144.32,$144.32,$351.14
2052545B,0983,20525,,,,,N/A,N/A,REMOVAL FOREIGN BODY        ~P,$466.13,$346.50,$236.16,$578.00,$236.16,$560.66,$236.16,$494.19,$236.16,$439.37,$236.16,$560.66,$236.16,$578.00,$236.16,$236.16,$560.66
2052645B,0983,20526,,,,,N/A,N/A,"THER INJECTION, CARP TUNNEL ~P",$100.89,$75.00,$56.99,$56.99,$56.99,N/A,$56.99,N/A,$56.99,N/A,$56.99,N/A,$56.99,N/A,$56.99,$56.99,N/A
2055045B,0983,20550,,,,,N/A,N/A,INJ TENDON SHEATH/LIGAMENT  ~P,$101.90,$75.75,$41.41,$101.00,$41.41,$97.97,$41.41,$86.36,$41.41,$69.22,$41.41,$97.97,$41.41,$101.00,$41.41,$41.41,$97.97
2055145B,0983,20551,,,,,N/A,N/A,INJ TENDON ORIGIN/INSERTION ~P,$80.72,$60.00,$69.85,$337.00,$125.87,$326.89,$125.87,$288.14,$125.87,$69.85,$125.87,$326.89,$125.87,$337.00,$125.87,$125.87,$326.89
2055240B,0983,20552,,,,,N/A,N/A,INJ TRIGGER POINT           ~P,$83.74,$62.25,$34.30,$590.00,$34.30,$572.30,$34.30,$504.45,$34.30,$67.34,$34.30,$572.30,$34.30,$590.00,$34.30,$34.30,$572.30
2055245B,0983,20552,,,,,N/A,N/A,INJ TRIGGER POINT           ~P,$83.74,$62.25,$34.30,$590.00,$34.30,$572.30,$34.30,$504.45,$34.30,$67.34,$34.30,$572.30,$34.30,$590.00,$34.30,$34.30,$572.30
2060045B,0983,20600,,,,,N/A,N/A,"DRAIN/INJECT, JOINT BURSA   ~P",$76.68,$57.00,$39.36,$96.00,$39.36,$93.12,$39.36,$82.08,$39.36,$63.57,$39.36,$93.12,$39.36,$96.00,$39.36,$39.36,$93.12
2060545B,0983,20605,,,,,N/A,N/A,"DRAIN/INJECT, JOINT BURSA   ~P",$78.70,$58.50,$39.77,$99.00,$39.77,$96.03,$39.77,$84.65,$39.77,$66.08,$39.77,$96.03,$39.77,$99.00,$39.77,$39.77,$96.03
2061045B,0983,20610,,,,,N/A,N/A,"DRAIN/INKECT, JOINT/BURSA   ~P",$94.84,$70.50,$51.25,$125.00,$51.25,$121.25,$51.25,$106.88,$51.25,$80.71,$51.25,$121.25,$51.25,$125.00,$51.25,$51.25,$121.25
2061145B,0983,20611,,,,,N/A,N/A,"Drain/Inject, Joint/Bursa W/~p",$171.52,$127.50,$75.30,$75.30,$75.30,N/A,$75.30,N/A,$75.30,N/A,$75.30,N/A,$75.30,N/A,$75.30,$75.30,N/A
2067045B,0983,20670,,,,,N/A,N/A,REMOVAL OF SUPPORT IMPLANT  ~P,$589.22,$438.00,$259.91,$668.00,$273.88,$647.96,$273.88,$571.14,$273.88,$259.91,$273.88,$647.96,$273.88,$668.00,$273.88,$273.88,$647.96
2068045B,0983,20680,,,,,N/A,N/A,REMOVAL OF SUPPORT IMPLANT  ~P,$634.62,$471.75,$272.24,$748.19,$272.24,$644.08,$272.24,$567.72,$272.24,$748.19,$272.24,$644.08,$272.24,$664.00,$272.24,$272.24,$644.08
2069045B,0983,20690,,,,,N/A,N/A,APPLY BONE FIXATION DEVICE  ~P,"$1,109.83",$825.00,$457.56,"$1,116.00",$457.56,"$1,082.52",$457.56,$954.18,$457.56,"$1,059.90",$457.56,"$1,082.52",$457.56,"$1,116.00",$457.56,$457.56,"$1,082.52"
2069445B,0983,20694,,,,,N/A,N/A,PROD RELATE TO BONY FIXATION~P,$683.05,$507.75,$277.57,$677.00,$277.57,$656.69,$277.57,$578.84,$277.57,$607.17,$277.57,$656.69,$277.57,$677.00,$277.57,$277.57,$656.69
2070045B,0983,20700,,,,,N/A,N/A,MANUAL DRUG DELIVERY DEVICE ~P,$171.52,$127.50,$78.72,$78.72,$78.72,N/A,$78.72,N/A,$78.72,N/A,$78.72,N/A,$78.72,N/A,$78.72,$78.72,N/A
2070245B,0983,20702,,,,,N/A,N/A,DRUG DELIVERY DEVICE        ~P,$280.49,$208.50,$113.98,$113.98,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,$113.98,N/A
2070445B,0983,20704,,,,,N/A,N/A,Insertion Drug Del Device   ~p,$252.24,$187.50,$118.90,$118.90,$118.90,N/A,$118.90,N/A,$118.90,N/A,$118.90,N/A,$118.90,N/A,$118.90,$118.90,N/A
2070545B,0983,20705,,,,,N/A,N/A,REMOVAL DRUG DEL DEVICE     ~P,$216.92,$161.25,$98.40,$98.40,$98.40,N/A,$98.40,N/A,$98.40,N/A,$98.40,N/A,$98.40,N/A,$98.40,$98.40,N/A
2090045B,0983,20900,,,,,N/A,N/A,BONE & TISSUE AUTOGRAFTS    ~P,"$1,067.46",$793.50,$323.14,"$1,058.00",$433.78,"$1,026.26",$433.78,$904.59,$433.78,$323.14,$433.78,"$1,026.26",$433.78,"$1,058.00",$433.78,$433.78,"$1,026.26"
2090245B,0983,20902,,,,,N/A,N/A,REMOVAL OF BONE FOR GRAFT   ~P,"$1,311.62",$975.00,$491.83,"$1,300.00",$558.42,"$1,261.00",$558.42,"$1,111.50",$558.42,$491.83,$558.42,"$1,261.00",$558.42,"$1,300.00",$558.42,$558.42,"$1,261.00"
2098545B,0983,20985,,,,,N/A,N/A,CPTR SURGICAL NAVIGATION    ~P,$242.15,$180.00,$115.62,$282.00,$115.62,$273.54,$115.62,$241.11,$115.62,$254.79,$115.62,$273.54,$115.62,$282.00,$115.62,$115.62,$273.54
2101140B,0983,21011,,,,,N/A,N/A,EXCISION TUMOR SOFT TIS FACE~P,$519.60,$386.25,$211.15,$515.00,$211.15,$499.55,$211.15,$440.33,$211.15,$460.90,$211.15,$499.55,$211.15,$515.00,$211.15,$211.15,$499.55
2101240B,0983,21012,,,,,N/A,N/A,EXCISION 2CM>               ~P,$675.99,$502.50,$274.70,$670.00,$274.70,$649.90,$274.70,$572.85,$274.70,$601.38,$274.70,$649.90,$274.70,$670.00,$274.70,$274.70,$649.90
2101440B,0983,21014,,,,,N/A,N/A,EXCISION 2CM OR GREATER     ~P,$748.63,$556.50,$34.22,$928.77,$34.22,$719.74,$34.22,$634.41,$34.22,$928.77,$34.22,$719.74,$34.22,$742.00,$34.22,$34.22,$719.74
2150140B,0983,21501,,,,,N/A,N/A,DRAIN NECK/CHEST LESION     ~P,$696.17,$517.50,$291.10,$710.00,$291.10,$688.70,$291.10,$607.05,$291.10,$587.41,$291.10,$688.70,$291.10,$710.00,$291.10,$291.10,$688.70
2155240B,0983,21552,,,,,N/A,N/A,EXCISION TUMOR 3CM OR >     ~P,$634.62,$471.75,$257.89,$789.32,$257.89,$610.13,$257.89,$537.80,$257.89,$789.32,$257.89,$610.13,$257.89,$629.00,$257.89,$257.89,$610.13
2155540B,0983,21555,,,,,N/A,N/A,EXCISION TUMOR NECK         ~P,$675.99,$502.50,$274.70,$670.00,$274.70,$649.90,$274.70,$572.85,$274.70,$544.37,$274.70,$649.90,$274.70,$670.00,$274.70,$274.70,$649.90
2160140B,0983,21601,,,,,N/A,N/A,EXCISION CHEST WALL TUMOR   ~P,"$2,320.56","$1,725.00",$958.17,$958.17,$958.17,N/A,$958.17,N/A,$958.17,N/A,$958.17,N/A,$958.17,N/A,$958.17,$958.17,N/A
2160240B,0983,21602,,,,,N/A,N/A,EXCISION CHEST WALL TUMOR   ~P,"$3,127.71","$2,325.00","$1,292.32","$1,292.32","$1,292.32",N/A,"$1,292.32",N/A,"$1,292.32",N/A,"$1,292.32",N/A,"$1,292.32",N/A,"$1,292.32","$1,292.32",N/A
2160340B,0983,21603,,,,,N/A,N/A,EXCISION CHEST WALL TUMOR   ~P,"$3,430.40","$2,550.00","$1,426.80","$1,426.80","$1,426.80",N/A,"$1,426.80",N/A,"$1,426.80",N/A,"$1,426.80",N/A,"$1,426.80",N/A,"$1,426.80","$1,426.80",N/A
2181140B,0983,21811,,,,,N/A,N/A,OPEN TREAT OF RIB FX 1-3    ~P,"$1,151.20",$855.75,$467.81,$467.81,$467.81,N/A,$467.81,N/A,$467.81,N/A,$467.81,N/A,$467.81,N/A,$467.81,$467.81,N/A
2192040B,0983,21920,,,,,N/A,N/A,BIOP SOFT TISSUE BACK/FLANK ~P,$339.00,$252.00,$137.76,$336.00,$137.76,$325.92,$137.76,$287.28,$137.76,$279.11,$137.76,$325.92,$137.76,$336.00,$137.76,$137.76,$325.92
2193140B,0983,21931,,,,,N/A,N/A,EXC BACK LES SC 3 CM/>      ~P,$914.10,$679.50,$371.46,$906.00,$371.46,N/A,$371.46,$774.63,$371.46,$830.07,$371.46,N/A,$371.46,$906.00,$371.46,$371.46,N/A
2193240B,0983,21932,,,,,N/A,N/A,EXC BACK TUM DEEP < 5 CM    ~P,"$1,281.35",$952.50,$52.70,"$1,270.00",$52.70,"$1,231.90",$52.70,"$1,085.85",$52.70,"$1,170.27",$52.70,"$1,231.90",$52.70,"$1,270.00",$52.70,$52.70,"$1,231.90"
2193340B,0983,21933,,,,,N/A,N/A,EXC BACK TUM DEEP 5 CM/>    ~P,"$1,433.70","$1,065.75",$582.61,"$1,421.00",$582.61,"$1,378.37",$582.61,"$1,214.96",$582.61,"$1,302.58",$582.61,"$1,378.37",$582.61,"$1,421.00",$582.61,$582.61,"$1,378.37"
2290040B,0983,22900,,,,,N/A,N/A,EXC TUMOR DEEP < 5CM        ~P,$968.58,$720.00,$393.60,$998.06,$393.60,$931.20,$393.60,$820.80,$393.60,$998.06,$393.60,$931.20,$393.60,$960.00,$393.60,$393.60,$931.20
2290140B,0983,22901,,,,,N/A,N/A,EXC ABDL TUM DEEP 5 CM/>    ~P,"$1,230.91",$915.00,$524.39,"$1,279.00",$524.39,"$1,240.63",$524.39,"$1,093.55",$524.39,"$1,175.89",$524.39,"$1,240.63",$524.39,"$1,279.00",$524.39,$524.39,"$1,240.63"
2290240B,0983,22902,,,,,N/A,N/A,EXC ABD LES SC < 3 CM       ~P,$640.68,$476.25,$26.35,$635.00,$26.35,$615.95,$26.35,$542.93,$26.35,$591.02,$26.35,$615.95,$26.35,$635.00,$26.35,$26.35,$615.95
2290340B,0983,22903,,,,,N/A,N/A,EXCISION 3CM >              ~P,$619.49,$460.50,$251.74,$777.73,$251.74,$595.58,$251.74,$524.97,$251.74,$777.73,$251.74,$595.58,$251.74,$614.00,$251.74,$251.74,$595.58
2302045B,0983,23020,,,,,N/A,N/A,RELEASE SHOULDER JOINT      ~P,"$1,573.95","$1,170.00",$639.60,"$1,560.00",$639.60,"$1,513.20",$639.60,"$1,333.80",$639.60,"$1,232.01",$639.60,"$1,513.20",$639.60,"$1,560.00",$639.60,$639.60,"$1,513.20"
2303040B,0983,23030,,,,,N/A,N/A,DRAIN SHOULDER LESION       ~P,$634.62,$471.75,$273.60,$666.00,$273.60,$646.02,$273.60,$569.43,$273.60,$452.84,$273.60,$646.02,$273.60,$666.00,$273.60,$273.60,$646.02
2304445B,0983,23044,,,,,N/A,N/A,EXPLORATORY SHOULDER SURGERY~P,"$1,210.73",$900.00,$524.39,"$1,279.00",$524.39,"$1,240.63",$524.39,"$1,093.55",$524.39,"$1,007.25",$524.39,"$1,240.63",$524.39,"$1,279.00",$524.39,$524.39,"$1,240.63"
2306645B,0983,23066,,,,,N/A,N/A,BIOPSY SHOULDER TISUES      ~P,$637.65,$474.00,$313.24,$764.00,$313.24,$741.08,$313.24,$653.22,$313.24,$657.02,$313.24,$741.08,$313.24,$764.00,$313.24,$313.24,$741.08
2307145B,0983,23071,,,,,N/A,N/A,EXCISION TUMOR SOFT TISSUE S~P,$788.99,$586.50,$33.87,$807.00,$33.87,$782.79,$33.87,$689.99,$33.87,$744.53,$33.87,$782.79,$33.87,$807.00,$33.87,$33.87,$782.79
2307645B,0983,23076,,,,,N/A,N/A,EXCISION SOFT TISSUE TUMOR  ~P,"$1,088.65",$809.25,$442.39,"$1,079.00",$442.39,"$1,046.63",$442.39,$922.55,$442.39,$963.40,$442.39,"$1,046.63",$442.39,"$1,079.00",$442.39,$442.39,"$1,046.63"
2312045B,0983,23120,,,,,N/A,N/A,"PARTIAL REMOVAL,COLLAR BONE ~P","$1,292.45",$960.75,$525.21,"$1,281.00",$525.21,"$1,242.57",$525.21,"$1,095.26",$525.21,"$1,052.56",$525.21,"$1,242.57",$525.21,"$1,281.00",$525.21,$525.21,"$1,242.57"
2313045B,0983,23130,,,,,N/A,N/A,"REMOVE SHOULDER BONE,PART   ~P","$1,397.38","$1,038.75",$567.85,"$1,385.00",$567.85,"$1,343.45",$567.85,"$1,184.18",$567.85,"$1,106.71",$567.85,"$1,343.45",$567.85,"$1,385.00",$567.85,$567.85,"$1,343.45"
2314045B,0983,23140,,,,,N/A,N/A,REMOVAL OF BONE LESION      ~P,"$1,109.83",$825.00,$469.40,"$1,144.00",$469.40,"$1,109.68",$469.40,$978.12,$469.40,$995.25,$469.40,"$1,109.68",$469.40,"$1,144.00",$469.40,$469.40,"$1,109.68"
2335045B,0983,23350,,,,,N/A,N/A,INJECTION FOR SHOULDER X-RAY~P,$357.16,$265.50,$89.34,$354.00,$145.14,$343.38,$145.14,$302.67,$145.14,$89.34,$145.14,$343.38,$145.14,$354.00,$145.14,$145.14,$343.38
2340545B,0983,23405,,,,,N/A,N/A,"REPAIR,REV/RECON TENOTOMY   ~P","$1,198.62",$891.00,$487.80,"$1,188.00",$487.80,"$1,152.36",$487.80,"$1,015.74",$487.80,"$1,109.72",$487.80,"$1,152.36",$487.80,"$1,188.00",$487.80,$487.80,"$1,152.36"
2341045B,0983,23410,,,,,N/A,N/A,"REPAIR ROTATOR CUFF,ACUTE   ~P","$2,088.51","$1,552.50",$848.70,"$2,070.00",$848.70,"$2,007.90",$848.70,"$1,769.85",$848.70,"$1,462.58",$848.70,"$2,007.90",$848.70,"$2,070.00",$848.70,$848.70,"$2,007.90"
2341245B,0983,23412,,,,,N/A,N/A,"REPAIR ROTATOR CUFF,CHRONIC ~P","$2,218.66","$1,649.25",$91.59,"$2,199.00",$91.59,"$2,133.03",$91.59,"$1,880.15",$91.59,"$1,518.96",$91.59,"$2,133.03",$91.59,"$2,199.00",$91.59,$91.59,"$2,133.03"
2341545B,0983,23415,,,,,N/A,N/A,RELEASE SHOULDER LIGAMENT   ~P,"$1,715.20","$1,275.00",$697.00,"$1,700.00",$697.00,"$1,649.00",$697.00,"$1,453.50",$697.00,"$1,247.75",$697.00,"$1,649.00",$697.00,"$1,700.00",$697.00,$697.00,"$1,649.00"
2342045B,0983,23420,,,,,N/A,N/A,"SHOULDER, REPAIR OF         ~P","$2,304.42","$1,713.00",$936.44,"$2,284.00",$936.44,"$2,215.48",$936.44,"$1,952.82",$936.44,"$1,734.29",$936.44,"$2,215.48",$936.44,"$2,284.00",$936.44,$936.44,"$2,215.48"
2343045B,0983,23430,,,,,N/A,N/A,REPAIR BICEPS TENDON        ~P,"$1,727.31","$1,284.00",$71.92,"$1,712.00",$71.92,"$1,660.64",$71.92,"$1,463.76",$71.92,"$1,330.25",$71.92,"$1,660.64",$71.92,"$1,712.00",$71.92,$71.92,"$1,660.64"
2344045B,0983,23440,,,,,N/A,N/A,REMOVE/TRANSPLANT TENDON    ~P,"$1,790.87","$1,331.25",$727.75,"$1,775.00",$727.75,"$1,721.75",$727.75,"$1,517.63",$727.75,"$1,348.25",$727.75,"$1,721.75",$727.75,"$1,775.00",$727.75,$727.75,"$1,721.75"
2345545B,0983,23455,,,,,N/A,N/A,REPAIR SHOULDER CAPSULE     ~P,"$2,375.04","$1,765.50",$965.14,"$2,354.00",$965.14,"$2,283.38",$965.14,"$2,012.67",$965.14,"$1,767.45",$965.14,"$2,283.38",$965.14,"$2,354.00",$965.14,$965.14,"$2,283.38"
2347045B,0983,23470,,,,,N/A,N/A,RECONSTRUCT SHOULDER JOINT  ~P,"$2,815.95","$2,093.25","$1,144.31","$2,791.00","$1,144.31","$2,707.27","$1,144.31","$2,386.31","$1,144.31","$2,131.98","$1,144.31","$2,707.27","$1,144.31","$2,791.00","$1,144.31","$1,144.31","$2,707.27"
2347245B,0983,23472,,,,,N/A,N/A,RECONSTRUCT SHOULDER JOINT  ~P,"$3,405.17","$2,531.25","$1,383.75","$3,375.00","$1,383.75","$3,273.75","$1,383.75","$2,885.63","$1,383.75","$2,567.40","$1,383.75","$3,273.75","$1,383.75","$3,375.00","$1,383.75","$1,383.75","$3,273.75"
2348545B,0983,23485,,,,,N/A,N/A,REVISION OF COLLAR BONE     ~P,"$2,231.78","$1,659.00",$96.92,"$2,212.00",$96.92,"$2,145.64",$96.92,"$1,891.26",$96.92,"$1,688.16",$96.92,"$2,145.64",$96.92,"$2,212.00",$96.92,$96.92,"$2,145.64"
2351545B,0983,23515,,,,,N/A,N/A,TREAT CLAVICLE FRACTURE     ~P,"$1,331.80",$990.00,$541.20,"$1,334.00",$541.20,"$1,293.98",$541.20,"$1,140.57",$541.20,"$1,286.98",$541.20,"$1,293.98",$541.20,"$1,334.00",$541.20,$541.20,"$1,293.98"
2354545B,0983,23545,,,,,N/A,N/A,TREAT CLAVICLE DISLOCATION  ~P,$605.36,$450.00,$251.74,$251.74,$251.74,N/A,$251.74,N/A,$251.74,N/A,$251.74,N/A,$251.74,N/A,$251.74,$251.74,N/A
2355045B,0983,23550,,,,,N/A,N/A,TREAT CLAVICLE DISLOCATION  ~P,"$1,210.73",$900.00,$526.44,"$1,284.00",$526.44,"$1,245.48",$526.44,"$1,097.82",$526.44,"$1,025.77",$526.44,"$1,245.48",$526.44,"$1,284.00",$526.44,$526.44,"$1,245.48"
2355245B,0983,23552,,,,,N/A,N/A,TREAT CLAVICLE DISLOCATION  ~P,"$1,412.52","$1,050.00",$61.90,"$1,400.00",$61.90,"$1,358.00",$61.90,"$1,197.00",$61.90,"$1,171.41",$61.90,"$1,358.00",$61.90,"$1,400.00",$61.90,$61.90,"$1,358.00"
2360545B,0983,23605,,,,,N/A,N/A,CLOSED TMT HUMERAL FRACTURE ~P,$828.34,$615.75,$336.61,$821.00,$336.61,N/A,$336.61,$701.96,$336.61,$771.52,$336.61,N/A,$336.61,$821.00,$336.61,$336.61,N/A
2361545B,0983,23615,,,,,N/A,N/A,"TREATMENT,HUMERUS FRX       ~P","$1,729.32","$1,285.50",$72.74,"$1,714.00",$72.74,$796.37,$72.74,"$1,465.47",$72.74,"$1,575.63",$72.74,$796.37,$72.74,"$1,714.00",$72.74,$72.74,$796.37
2363045B,0983,23630,,,,,N/A,N/A,TREAT HUMERUS FRACTURE      ~P,"$1,422.61","$1,057.50",$578.10,"$1,662.58",$578.10,"$1,662.58",$578.10,"$1,205.55",$578.10,"$1,393.29",$578.10,"$1,662.58",$578.10,"$1,410.00",$578.10,$578.10,"$1,662.58"
2365045B,0983,23650,,,,,N/A,N/A,CLOSED TREATMENT OF SHOULDER~P,$421.74,$313.50,$171.38,"$1,367.70",$171.38,"$1,367.70",$171.38,$357.39,$171.38,$528.05,$171.38,"$1,367.70",$171.38,$418.00,$171.38,$171.38,"$1,367.70"
2365545B,0983,23655,,,,,N/A,N/A,TREAT SHOULDER DISLOCATION  ~P,$827.33,$615.00,$336.20,$820.00,$336.20,$405.46,$336.20,$701.10,$336.20,$735.61,$336.20,$405.46,$336.20,$820.00,$336.20,$336.20,$405.46
2366545B,0983,23665,,,,,N/A,N/A,TREAT DISLOCATION/FRACTURE  ~P,$807.15,$600.00,$352.60,$860.00,$352.60,$795.40,$352.60,$735.30,$352.60,$718.27,$352.60,$795.40,$352.60,$860.00,$352.60,$352.60,$795.40
2370045B,0983,23700,,,,,N/A,N/A,FIXATION OF SHOULDER        ~P,$447.97,$333.00,$182.40,$834.20,$182.40,$834.20,$182.40,$379.62,$182.40,$349.14,$182.40,$834.20,$182.40,$444.00,$182.40,$182.40,$834.20
2393040B,0983,23930,,,,,N/A,N/A,DRAINAGE OF ARM LESION      ~P,$498.42,$370.50,$22.54,$494.00,$22.54,$430.68,$22.54,$422.37,$22.54,$384.32,$22.54,$430.68,$22.54,$494.00,$22.54,$22.54,$430.68
2393145B,0983,23931,,,,,N/A,N/A,INCISION BURSA              ~P,$315.80,$234.75,$128.33,$479.18,$128.33,$479.18,$128.33,$267.62,$128.33,$286.94,$128.33,$479.18,$128.33,$313.00,$128.33,$128.33,$479.18
2407140B,0983,24071,,,,,N/A,N/A,EXC ARM/ELBOW LES SC 3 CM/> ~P,$793.03,$589.50,$303.61,$786.00,$322.26,$303.61,$322.26,$672.03,$322.26,$719.94,$322.26,$303.61,$322.26,$786.00,$322.26,$322.26,$303.61
2407545B,0983,24075,,,,,N/A,N/A,EXCISION SOFT TISSUE TUMOR  ~P,$665.90,$495.00,$27.60,$762.42,$27.60,$762.42,$27.60,$564.30,$27.60,$587.20,$27.60,$762.42,$27.60,$660.00,$27.60,$27.60,$762.42
2407645B,0983,24076,,,,,N/A,N/A,REMOVE ARM/ELBOW LESION     ~P,"$1,060.40",$788.25,$43.91,"$1,051.00",$43.91,$640.20,$43.91,$898.61,$43.91,$968.80,$43.91,$640.20,$43.91,"$1,051.00",$43.91,$43.91,$640.20
2410145B,0983,24101,,,,,N/A,N/A,EXPLORE/TREAT ELBOW JOINT   ~P,"$1,008.94",$750.00,$466.17,"$1,137.00",$466.17,N/A,$466.17,$972.14,$466.17,$905.22,$466.17,N/A,$466.17,"$1,137.00",$466.17,$466.17,N/A
2410545B,0983,24105,,,,,N/A,N/A,REMOVAL ELBOW BURSA         ~P,$755.70,$561.75,$37.90,$749.00,$37.90,$726.53,$37.90,$640.40,$37.90,$647.73,$37.90,$726.53,$37.90,$749.00,$37.90,$37.90,$726.53
2411045B,0983,24110,,,,,N/A,N/A,REMOVE HUMERUS LESION       ~P,"$1,311.62",$975.00,$544.70,"$1,327.00",$544.70,"$1,287.19",$544.70,"$1,134.59",$544.70,"$1,041.86",$544.70,"$1,287.19",$544.70,"$1,327.00",$544.70,$544.70,"$1,287.19"
2412045B,0983,24120,,,,,N/A,N/A,REMOVE ELBOW LESION         ~P,"$1,195.59",$888.75,$485.85,"$1,185.00",$485.85,"$1,149.45",$485.85,"$1,013.18",$485.85,$956.02,$485.85,"$1,149.45",$485.85,"$1,185.00",$485.85,$485.85,"$1,149.45"
2413045B,0983,24130,,,,,N/A,N/A,REMOVAL OF HEAD OF RADIUS   ~P,"$1,165.33",$866.25,$473.55,"$1,155.00",$473.55,"$1,120.35",$473.55,$987.53,$473.55,$917.79,$473.55,"$1,120.35",$473.55,"$1,155.00",$473.55,$473.55,"$1,120.35"
2414045B,0983,24140,,,,,N/A,N/A,PARTIAL REMOVAL OF ARM BONE ~P,"$1,686.95","$1,254.00",$73.97,"$1,717.00",$73.97,"$1,665.49",$73.97,"$1,468.04",$73.97,"$1,257.88",$73.97,"$1,665.49",$73.97,"$1,717.00",$73.97,$73.97,"$1,665.49"
2414745B,0983,24147,,,,,N/A,N/A,PARTIAL EXCISION            ~P,"$1,254.11",$932.25,$59.63,"$1,243.00",$59.63,"$1,205.71",$59.63,"$1,062.77",$59.63,"$1,129.18",$59.63,"$1,205.71",$59.63,"$1,243.00",$59.63,$59.63,"$1,205.71"
2414945B,0983,24149,,,,,N/A,N/A,RADICAL RESECTION ELBOW     ~P,"$2,458.79","$1,827.75",$999.17,"$2,437.00",$999.17,"$2,363.89",$999.17,"$2,083.64",$999.17,"$2,099.54",$999.17,"$2,363.89",$999.17,"$2,437.00",$999.17,$999.17,"$2,363.89"
2431045B,0983,24310,,,,,N/A,N/A,REVISION OF ARM TENDON      ~P,"$1,049.30",$780.00,$445.67,"$1,087.00",$445.67,"$1,054.39",$445.67,$929.39,$445.67,$851.67,$445.67,"$1,054.39",$445.67,"$1,087.00",$445.67,$445.67,"$1,054.39"
2434145B,0983,24341,,,,,N/A,N/A,REPAIR ARM TENDON/MUSCLE    ~P,"$1,450.86","$1,078.50",$61.80,"$1,488.00",$61.80,"$1,443.36",$61.80,"$1,272.24",$61.80,"$1,335.71",$61.80,"$1,443.36",$61.80,"$1,488.00",$61.80,$61.80,"$1,443.36"
2434245B,0983,24342,,,,,N/A,N/A,REPAIR OF RUPTURED TENDON   ~P,"$1,490.20","$1,107.75",$65.57,"$1,477.00",$65.57,"$1,432.69",$65.57,"$1,262.84",$65.57,"$1,385.54",$65.57,"$1,432.69",$65.57,"$1,477.00",$65.57,$65.57,"$1,432.69"
2434345B,0983,24343,,,,,N/A,N/A,REPR ELBOW LAT LIGMNT W/TISS~P,"$1,595.13","$1,185.75",$648.21,"$1,581.00",$648.21,"$1,533.57",$648.21,"$1,351.76",$648.21,"$1,278.50",$648.21,"$1,533.57",$648.21,"$1,581.00",$648.21,$648.21,"$1,533.57"
2435745B,0983,24357,,,,,N/A,N/A,"TENOTOMY, ELBOW, TENNIS     ~P",$934.28,$694.50,$379.66,$926.00,$379.66,$898.22,$379.66,$791.73,$379.66,$757.18,$379.66,$898.22,$379.66,$926.00,$379.66,$379.66,$898.22
2435845B,0983,24358,,,,,N/A,N/A,TNOT ELBOW LATAL/MEDIAL DEBR~P,$993.81,$738.75,$451.00,"$1,007.00",$451.00,$976.79,$451.00,$860.99,$451.00,$948.23,$451.00,$976.79,$451.00,"$1,007.00",$451.00,$451.00,$976.79
2435945B,0983,24359,,,,,N/A,N/A,REPAIR ELBOW DEB/ATTCH OPEN ~P,"$1,131.02",$840.75,$459.61,"$1,185.24",$459.61,"$1,087.37",$459.61,$958.46,$459.61,"$1,185.24",$459.61,"$1,087.37",$459.61,"$1,121.00",$459.61,$459.61,"$1,087.37"
2443045B,0983,24430,,,,,N/A,N/A,REPAIR NON/MAL UNION HUMERUS~P,"$2,111.71","$1,569.75",$858.13,"$2,093.00",$858.13,"$2,030.21",$858.13,"$1,789.52",$858.13,"$1,877.28",$858.13,"$2,030.21",$858.13,"$2,093.00",$858.13,$858.13,"$2,030.21"
2443545B,0983,24435,,,,,N/A,N/A,REPAIR/RECON ELBOW/UPPER ARM~P,"$2,173.26","$1,615.50",$883.14,"$2,154.00",$883.14,"$2,089.38",$883.14,"$1,841.67",$883.14,"$1,924.66",$883.14,"$2,089.38",$883.14,"$2,154.00",$883.14,$883.14,"$2,089.38"
2450045B,0983,24500,,,,,N/A,N/A,TREAT HUMERUS FRACTURE      ~P,$625.54,$465.00,$264.86,$646.00,$264.86,$626.62,$264.86,$552.33,$264.86,$602.39,$264.86,$626.62,$264.86,$646.00,$264.86,$264.86,$626.62
2450545B,0983,24505,,,,,N/A,N/A,TREAT HUMERUS FRACTURE      ~P,$969.59,$720.75,$394.10,$991.00,$394.10,$961.27,$394.10,$847.31,$394.10,$814.80,$394.10,$961.27,$394.10,$991.00,$394.10,$394.10,$961.27
2451545B,0983,24515,,,,,N/A,N/A,TREAT HUMERUS FRACTURE      ~P,"$2,006.78","$1,491.75",$815.49,"$1,989.00",$815.49,"$1,929.33",$815.49,"$1,700.60",$815.49,"$1,570.71",$815.49,"$1,929.33",$815.49,"$1,989.00",$815.49,$815.49,"$1,929.33"
2451645B,0983,24516,,,,,N/A,N/A,TREAT OF HUMERAL SHAFT FX   ~P,"$1,325.75",$985.50,$538.74,"$1,531.87",$538.74,"$1,274.58",$538.74,"$1,123.47",$538.74,"$1,531.87",$538.74,"$1,274.58",$538.74,"$1,314.00",$538.74,$538.74,"$1,274.58"
2453845B,0983,24538,,,,,N/A,N/A,TREAT HUMERUS FRACTURE      ~P,"$1,724.28","$1,281.75",$7.69,"$1,709.00",$7.69,"$1,657.73",$7.69,"$1,461.20",$7.69,"$1,400.73",$7.69,"$1,657.73",$7.69,"$1,709.00",$7.69,$7.69,"$1,657.73"
2460045B,0983,24600,,,,,N/A,N/A,TREAT ELBOW DISLOCATION     ~P,$603.35,$448.50,$295.20,$720.00,$295.20,$698.40,$295.20,$615.60,$295.20,$606.06,$295.20,$698.40,$295.20,$720.00,$295.20,$295.20,$698.40
2460545B,0983,24605,,,,,N/A,N/A,TREAT ELBOW DISLOCATION     ~P,"$1,022.06",$759.75,$415.33,"$1,013.00",$415.33,$982.61,$415.33,$866.12,$415.33,$861.15,$415.33,$982.61,$415.33,"$1,013.00",$415.33,$415.33,$982.61
2463545B,0983,24635,,,,,N/A,N/A,OPEN TREATMENT FX ELBOW     ~P,"$1,340.88",$996.75,$544.89,"$1,329.00",$544.89,"$1,289.13",$544.89,"$1,136.30",$544.89,"$1,209.60",$544.89,"$1,289.13",$544.89,"$1,329.00",$544.89,$544.89,"$1,289.13"
2465545B,0983,24655,,,,,N/A,N/A,TREAT RADIUS FRACTURE       ~P,$867.69,$645.00,$352.60,$860.00,$352.60,$834.20,$352.60,$735.30,$352.60,$723.58,$352.60,$834.20,$352.60,$860.00,$352.60,$352.60,$834.20
2466545B,0983,24665,,,,,N/A,N/A,OPEN TRT RADIAL HEAD/NECK FX~P,$857.60,$637.50,$348.50,"$1,181.08",$348.50,$824.50,$348.50,$726.75,$348.50,"$1,181.08",$348.50,$824.50,$348.50,$850.00,$348.50,$348.50,$824.50
2468545B,0983,24685,,,,,N/A,N/A,OPEN TREATMENT OF ULNAR FX  ~P,"$1,243.01",$924.00,$55.12,"$1,232.00",$55.12,"$1,195.04",$55.12,"$1,053.36",$55.12,"$1,173.61",$55.12,"$1,195.04",$55.12,"$1,232.00",$55.12,$55.12,"$1,195.04"
2500045B,0983,25000,,,,,N/A,N/A,INCISION TENDON SHEATH      ~P,$953.45,$708.75,$387.45,$945.00,$387.45,$916.65,$387.45,$807.98,$387.45,$621.52,$387.45,$916.65,$387.45,$945.00,$387.45,$387.45,$916.65
2500145B,0983,25001,,,,,N/A,N/A,INCISE FLEXOR CARPI RADIALS ~P,$718.37,$534.00,$291.92,$712.00,$291.92,$690.64,$291.92,$608.76,$291.92,$623.48,$291.92,$690.64,$291.92,$712.00,$291.92,$291.92,$690.64
2504045B,0983,25040,,,,,N/A,N/A,EXPLORE/TREAT WRIST JOINT   ~P,"$1,370.14","$1,018.50",$556.78,"$1,358.00",$556.78,"$1,317.26",$556.78,"$1,161.09",$556.78,"$1,004.32",$556.78,"$1,317.26",$556.78,"$1,358.00",$556.78,$556.78,"$1,317.26"
2507345B,0983,25073,,,,,N/A,N/A,EXC FOREARM TUM DEEP 3 CM/> ~P,"$1,044.25",$776.25,$424.35,"$1,035.00",$424.35,"$1,003.95",$424.35,$884.93,$424.35,$955.26,$424.35,"$1,003.95",$424.35,"$1,035.00",$424.35,$424.35,"$1,003.95"
2507545B,0983,25075,,,,,N/A,N/A,REMOVAL FOREARM LESION SUB  ~P,$616.46,$458.25,$364.90,$890.00,$364.90,$863.30,$364.90,$760.95,$364.90,$564.50,$364.90,$863.30,$364.90,$890.00,$364.90,$364.90,$863.30
2507645B,0983,25076,,,,,N/A,N/A,REMOVAL FOREARM LESION DEEP ~P,"$1,311.62",$975.00,$546.53,"$1,333.00",$546.53,"$1,293.01",$546.53,"$1,139.72",$546.53,$925.58,$546.53,"$1,293.01",$546.53,"$1,333.00",$546.53,$546.53,"$1,293.01"
2510145B,0983,25101,,,,,N/A,N/A,PROC OF BONES ARM/WRIST     ~P,$814.21,$605.25,$33.87,$807.00,$33.87,$782.79,$33.87,$689.99,$33.87,$728.87,$33.87,$782.79,$33.87,$807.00,$33.87,$33.87,$782.79
2510545B,0983,25105,,,,,N/A,N/A,REMOVE WRIST JOINT LINING   ~P,"$1,190.55",$885.00,$53.48,$53.48,$53.48,N/A,$53.48,N/A,$53.48,N/A,$53.48,N/A,$53.48,N/A,$53.48,$53.48,N/A
2511045B,0983,25110,,,,,N/A,N/A,"EXC,LESION TENDON SHEATH    ~P",$684.06,$508.50,$277.98,$678.00,$277.98,$657.66,$277.98,$579.69,$277.98,$620.66,$277.98,$657.66,$277.98,$678.00,$277.98,$277.98,$657.66
2511140B,0983,25111,,,,,N/A,N/A,REMOVE WRIST TENDON LESION  ~P,$758.72,$564.00,$38.32,$752.00,$38.32,$729.44,$38.32,$642.96,$38.32,$584.76,$38.32,$729.44,$38.32,$752.00,$38.32,$38.32,$729.44
2511145B,0983,25111,,,,,N/A,N/A,REMOVE WRIST TENDON LESION  ~P,$758.72,$564.00,$38.32,$752.00,$38.32,$729.44,$38.32,$642.96,$38.32,$584.76,$38.32,$729.44,$38.32,$752.00,$38.32,$38.32,$729.44
2511245B,0983,25112,,,,,N/A,N/A,"EXCISION, RECURRENT         ~P",$736.53,$547.50,$299.30,$730.00,$299.30,$708.10,$299.30,$624.15,$299.30,$700.40,$299.30,$708.10,$299.30,$730.00,$299.30,$299.30,$708.10
2511545B,0983,25115,,,,,N/A,N/A,REMOVE WRIST/FOREARM LESION ~P,"$2,132.90","$1,585.50",$866.74,"$2,114.00",$866.74,"$2,050.58",$866.74,"$1,807.47",$866.74,"$1,354.55",$866.74,"$2,050.58",$866.74,"$2,114.00",$866.74,$866.74,"$2,050.58"
2511645B,0983,25116,,,,,N/A,N/A,REMOVE WRIST/FOREARM LESION ~P,"$1,887.73","$1,403.25","$1,083.30","$1,871.00",N/A,"$1,814.87",N/A,"$1,599.71",N/A,"$1,083.30",N/A,"$1,814.87",N/A,"$1,871.00",N/A,N/A,"$1,814.87"
2511845B,0983,25118,,,,,N/A,N/A,SYN EXT TENDON SHEATH WRIST ~P,$749.64,$557.25,$34.63,$743.00,$34.63,$720.71,$34.63,$635.27,$34.63,$689.10,$34.63,$720.71,$34.63,$743.00,$34.63,$34.63,$720.71
2513045B,0983,25130,,,,,N/A,N/A,REMOVAL OF WRIST LESION     ~P,"$1,099.74",$817.50,$446.90,"$1,090.00",$446.90,"$1,057.30",$446.90,$931.95,$446.90,$812.75,$446.90,"$1,057.30",$446.90,"$1,090.00",$446.90,$446.90,"$1,057.30"
2515045B,0983,25150,,,,,N/A,N/A,PARTIAL REMOVAL OF ULNA     ~P,"$1,311.62",$975.00,$587.53,"$1,433.00",$587.53,"$1,390.01",$587.53,"$1,225.22",$587.53,"$1,019.15",$587.53,"$1,390.01",$587.53,"$1,433.00",$587.53,$587.53,"$1,390.01"
2521045B,0983,25210,,,,,N/A,N/A,REMOVAL OF WRIST BONE       ~P,"$1,190.55",$885.00,$53.89,"$1,229.00",$53.89,"$1,192.13",$53.89,"$1,050.80",$53.89,$886.28,$53.89,"$1,192.13",$53.89,"$1,229.00",$53.89,$53.89,"$1,192.13"
2524845B,0983,25248,,,,,N/A,N/A,REMOVE FOREARM FOREIGN BODY ~P,"$1,272.27",$945.75,$517.10,"$1,261.00",$517.10,"$1,223.17",$517.10,"$1,078.16",$517.10,$750.73,$517.10,"$1,223.17",$517.10,"$1,261.00",$517.10,$517.10,"$1,223.17"
2525945B,0983,25259,,,,,N/A,N/A,MANIPULATION OF WRIST       ~P,$832.38,$618.75,$338.25,$825.00,$338.25,$800.25,$338.25,$705.38,$338.25,$774.34,$338.25,$800.25,$338.25,$825.00,$338.25,$338.25,$800.25
2527045B,0983,25270,,,,,N/A,N/A,REPAIR FOREARM TENDON/MUSCLE~P,"$1,677.87","$1,247.25",$681.83,"$1,663.00",$681.83,"$1,613.11",$681.83,"$1,421.87",$681.83,$888.61,$681.83,"$1,613.11",$681.83,"$1,663.00",$681.83,$681.83,"$1,613.11"
2527545B,0983,25275,,,,,N/A,N/A,REPAIR FOREARM TENDON SHEATH~P,"$1,500.29","$1,115.25",$619.92,"$1,512.00",$619.92,"$1,466.64",$619.92,N/A,$619.92,"$1,203.50",$619.92,"$1,466.64",$619.92,"$1,512.00",$619.92,$619.92,"$1,466.64"
2529545B,0983,25295,,,,,N/A,N/A,RELEASE WRIST/FOREARM TENDON~P,"$1,715.20","$1,275.00",$78.70,"$1,727.00",$78.70,"$1,675.19",$78.70,"$1,476.59",$78.70,$947.42,$78.70,"$1,675.19",$78.70,"$1,727.00",$78.70,$78.70,"$1,675.19"
2531045B,0983,25310,,,,,N/A,N/A,TENDON TRANSPLT/TRANSFER    ~P,"$1,225.86",$911.25,$498.15,"$1,215.00",$498.15,"$1,178.55",$498.15,"$1,038.83",$498.15,"$1,114.17",$498.15,"$1,178.55",$498.15,"$1,215.00",$498.15,$498.15,"$1,178.55"
2533245B,0983,25332,,,,,N/A,N/A,REPAIR/RECONST FOREARM/WRIST~P,"$1,691.99","$1,257.75",$687.57,"$1,677.00",$687.57,"$1,626.69",$687.57,"$1,433.84",$687.57,"$1,507.77",$687.57,"$1,626.69",$687.57,"$1,677.00",$687.57,$687.57,"$1,626.69"
2539045B,0983,25390,,,,,N/A,N/A,SHORTEN RADIUS OR ULNA      ~P,"$2,293.32","$1,704.75","$1,362.43","$2,323.00","$1,362.43","$2,253.31","$1,362.43","$1,986.17","$1,362.43","$1,376.41","$1,362.43","$2,253.31","$1,362.43","$2,323.00","$1,362.43","$1,362.43","$2,253.31"
2540045B,0983,25400,,,,,N/A,N/A,REPAIR RADIUS OR ULNA       ~P,"$2,421.46","$1,800.00",$997.53,"$2,433.00",$997.53,"$2,360.01",$997.53,"$2,080.22",$997.53,"$1,434.39",$997.53,"$2,360.01",$997.53,"$2,433.00",$997.53,$997.53,"$2,360.01"
2540545B,0983,25405,,,,,N/A,N/A,REPAIR/GRAFT RADIUS OR ULNA ~P,"$2,925.93","$2,175.00","$1,211.55","$2,955.00","$1,211.55","$2,866.35","$1,211.55",N/A,"$1,211.55","$1,848.04","$1,211.55","$2,866.35","$1,211.55","$2,955.00","$1,211.55","$1,211.55","$2,866.35"
2542545B,0983,25425,,,,,N/A,N/A,REPAIR/GRAFT RADIUS OR ULNA ~P,"$3,127.71","$2,325.00",$139.13,"$3,193.00",$139.13,"$3,097.21",$139.13,"$2,730.02",$139.13,"$1,716.92",$139.13,"$3,097.21",$139.13,"$3,193.00",$139.13,$139.13,"$3,097.21"
2544545B,0983,25445,,,,,N/A,N/A,REPAIR/RECONSTRUCTION       ~P,"$1,434.71","$1,066.50",$583.20,"$1,422.00",$583.20,"$1,379.34",$583.20,"$1,215.81",$583.20,"$1,288.95",$583.20,"$1,379.34",$583.20,"$1,422.00",$583.20,$583.20,"$1,379.34"
2544745B,0983,25447,,,,,N/A,N/A,REPAIR WRIST JOINT (S)      ~P,"$1,807.01","$1,343.25",$734.31,"$1,791.00",$734.31,"$1,737.27",$734.31,"$1,531.31",$734.31,"$1,486.10",$734.31,"$1,737.27",$734.31,"$1,791.00",$734.31,$734.31,"$1,737.27"
2551545B,0983,25515,,,,,N/A,N/A,TREAT FRACTURE OF RADIUS    ~P,"$1,513.41","$1,125.00",$645.34,"$1,574.00",$645.34,"$1,526.78",$645.34,"$1,345.77",$645.34,"$1,198.46",$645.34,"$1,526.78",$645.34,"$1,574.00",$645.34,$645.34,"$1,526.78"
2553045B,0983,25530,,,,,N/A,N/A,TREAT FRACTURE OF ULNA      ~P,$466.13,$346.50,$189.42,$462.00,$189.42,$448.14,$189.42,$395.01,$189.42,$441.10,$189.42,$448.14,$189.42,$462.00,$189.42,$189.42,$448.14
2554545B,0983,25545,,,,,N/A,N/A,TREAT FRACTURE OF ULNA      ~P,"$1,577.98","$1,173.00",$641.24,"$1,564.00",$641.24,"$1,517.08",$641.24,"$1,337.22",$641.24,"$1,119.11",$641.24,"$1,517.08",$641.24,"$1,564.00",$641.24,$641.24,"$1,517.08"
2556545B,0983,25565,,,,,N/A,N/A,TREAT FRACTURE RADIUS & ULNA~P,"$1,008.94",$750.00,$425.99,"$1,039.00",$425.99,"$1,007.83",$425.99,$888.35,$425.99,$835.25,$425.99,"$1,007.83",$425.99,"$1,039.00",$425.99,$425.99,"$1,007.83"
2557545B,0983,25575,,,,,N/A,N/A,TREAT FRACTURE RADIUS/ULNA  ~P,"$1,898.83","$1,411.50",$771.62,"$1,882.00",$771.62,"$1,825.54",$771.62,"$1,609.11",$771.62,"$1,613.56",$771.62,"$1,825.54",$771.62,"$1,882.00",$771.62,$771.62,"$1,825.54"
2560045B,0983,25600,,,,,N/A,N/A,"TREATMENT,RADIUS/ULNA FRX   ~P",$470.17,$349.50,$215.25,$585.83,$215.25,$509.25,$215.25,$448.88,$215.25,$585.83,$215.25,$509.25,$215.25,$525.00,$215.25,$215.25,$509.25
2560545B,0983,25605,,,,,N/A,N/A,"TREATMENT,RADIUS/ULNA FRX   ~P","$1,405.45","$1,044.75",$599.42,"$1,462.00",$599.42,"$1,418.14",$599.42,"$1,250.01",$599.42,$920.22,$599.42,"$1,418.14",$599.42,"$1,462.00",$599.42,$599.42,"$1,418.14"
2560645B,0983,25606,,,,,N/A,N/A,CLSD RDTN INT.FIX RAIUS/ULMA~P,"$1,490.20","$1,107.75",$65.57,"$1,477.00",$65.57,"$1,432.69",$65.57,"$1,262.84",$65.57,"$1,194.73",$65.57,"$1,432.69",$65.57,"$1,477.00",$65.57,$65.57,"$1,432.69"
2560745B,0983,25607,,,,,N/A,N/A,OPTX DSTL RADL EX ARTIC FX  ~P,"$1,389.31","$1,032.75",$564.57,"$1,377.00",$564.57,"$1,335.69",$564.57,"$1,177.34",$564.57,"$1,321.95",$564.57,"$1,335.69",$564.57,"$1,377.00",$564.57,$564.57,"$1,335.69"
2560845B,0983,25608,,,,,N/A,N/A,OPTX DSTL RADL I ARTIC FX   ~P,"$1,475.07","$1,096.50",$599.42,"$1,477.18",$599.42,"$1,418.14",$599.42,"$1,250.01",$599.42,"$1,477.18",$599.42,"$1,418.14",$599.42,"$1,462.00",$599.42,$599.42,"$1,418.14"
2560945B,0983,25609,,,,,N/A,N/A,OPTMT DSTL RADL I-ARTIC FRX ~P,"$1,878.65","$1,396.50",$763.42,"$1,875.15",$763.42,"$1,806.14",$763.42,"$1,592.01",$763.42,"$1,875.15",$763.42,"$1,806.14",$763.42,"$1,862.00",$763.42,$763.42,"$1,806.14"
2562845B,0983,25628,,,,,N/A,N/A,TREAT WRIST BONE FRACTURE   ~P,"$1,513.41","$1,125.00",$627.30,"$1,530.00",$627.30,"$1,484.10",$627.30,"$1,308.15",$627.30,"$1,290.87",$627.30,"$1,484.10",$627.30,"$1,530.00",$627.30,$627.30,"$1,484.10"
2564545B,0983,25645,,,,,N/A,N/A,TREAT WRIST BONE FRACTURE   ~P,"$1,271.26",$945.00,$536.28,"$1,308.00",$536.28,"$1,268.76",$536.28,"$1,118.34",$536.28,"$1,024.61",$536.28,"$1,268.76",$536.28,"$1,308.00",$536.28,$536.28,"$1,268.76"
2565045B,0983,25650,,,,,N/A,N/A,TREAT WRIST BONE FRACTURE   ~P,$537.77,$399.75,$239.30,$583.00,$239.30,$565.51,$239.30,$498.47,$239.30,$553.52,$239.30,$565.51,$239.30,$583.00,$239.30,$239.30,$565.51
2565145B,0983,25651,,,,,N/A,N/A,PIN ULNAR STYLOID FRACTURE  ~P,"$1,000.87",$744.00,$416.97,"$1,017.00",$416.97,$986.49,$416.97,$869.54,$416.97,$881.90,$416.97,$986.49,$416.97,"$1,017.00",$416.97,$416.97,$986.49
2565245B,0983,25652,,,,,N/A,N/A,TREAT FRACTURE ULNAR STYLOID~P,"$1,311.62",$975.00,$562.93,"$1,373.00",$562.93,"$1,331.81",$562.93,"$1,173.92",$562.93,"$1,116.59",$562.93,"$1,331.81",$562.93,"$1,373.00",$562.93,$562.93,"$1,331.81"
2580045B,0983,25800,,,,,N/A,N/A,FUSION WRIST JOINT          ~P,"$1,788.85","$1,329.75",$726.93,"$1,773.00",$726.93,"$1,719.81",$726.93,"$1,515.92",$726.93,"$1,310.69",$726.93,"$1,719.81",$726.93,"$1,773.00",$726.93,$726.93,"$1,719.81"
2582045B,0983,25820,,,,,N/A,N/A,WRIST FUSION LIMITED        ~P,"$1,226.87",$912.00,$498.56,"$1,216.00",$498.56,"$1,179.52",$498.56,"$1,039.68",$498.56,"$1,164.62",$498.56,"$1,179.52",$498.56,"$1,216.00",$498.56,$498.56,"$1,179.52"
2601045B,0983,26010,,,,,N/A,N/A,INCISION DR OF FINGER       ~P,$311.76,$231.75,$126.69,$126.69,$126.69,N/A,$126.69,N/A,$126.69,N/A,$126.69,N/A,$126.69,N/A,$126.69,$126.69,N/A
2601145B,0983,26011,,,,,N/A,N/A,DRAINAGE OF FINGER ABSCESS  ~P,$555.93,$413.25,$235.75,$235.75,$235.75,N/A,$235.75,N/A,$235.75,N/A,$235.75,N/A,$235.75,N/A,$235.75,$235.75,N/A
2602045B,0983,26020,,,,,N/A,N/A,INCISION DR TEND DIGIT/PALM ~P,$874.75,$650.25,$355.47,$355.47,$355.47,N/A,$355.47,N/A,$355.47,N/A,$355.47,N/A,$355.47,N/A,$355.47,$355.47,N/A
2603745B,0983,26037,,,,,N/A,N/A,DECOMPRESS FINGERS/HAND     ~P,"$1,288.42",$957.75,$523.57,$523.57,$523.57,N/A,$523.57,N/A,$523.57,N/A,$523.57,N/A,$523.57,N/A,$523.57,$523.57,N/A
2604045B,0983,26040,,,,,N/A,N/A,RELEASE PALM CONTRACTURE    ~P,$675.99,$502.50,$283.31,$283.31,$283.31,N/A,$283.31,N/A,$283.31,N/A,$283.31,N/A,$283.31,N/A,$283.31,$283.31,N/A
2605545B,0983,26055,,,,,N/A,N/A,INCISE FINGER TENDON SHEATH ~P,$551.89,$410.25,$41.00,$41.00,$41.00,N/A,$41.00,N/A,$41.00,N/A,$41.00,N/A,$41.00,N/A,$41.00,$41.00,N/A
2607545B,0983,26075,,,,,N/A,N/A,INCISION TENDON             ~P,$672.96,$500.25,$273.47,$273.47,$273.47,N/A,$273.47,N/A,$273.47,N/A,$273.47,N/A,$273.47,N/A,$273.47,$273.47,N/A
2611145B,0983,26111,,,,,N/A,N/A,EXCISE TUMOR HAND/FINGER    ~P,$765.79,$569.25,$311.19,$311.19,$311.19,N/A,$311.19,N/A,$311.19,N/A,$311.19,N/A,$311.19,N/A,$311.19,$311.19,N/A
2611545B,0983,26115,,,,,N/A,N/A,REMOVAL HAND LESION SUBCUT  ~P,$645.72,$480.00,$33.50,$33.50,$33.50,N/A,$33.50,N/A,$33.50,N/A,$33.50,N/A,$33.50,N/A,$33.50,$33.50,N/A
2611645B,0983,26116,,,,,N/A,N/A,REMOVAL HAND LESION DEEP    ~P,"$1,088.65",$809.25,$442.39,$442.39,$442.39,N/A,$442.39,N/A,$442.39,N/A,$442.39,N/A,$442.39,N/A,$442.39,$442.39,N/A
2612145B,0983,26121,,,,,N/A,N/A,RELEASE PALM CONTRACTURE    ~P,"$1,374.18","$1,021.50",$558.42,$558.42,$558.42,N/A,$558.42,N/A,$558.42,N/A,$558.42,N/A,$558.42,N/A,$558.42,$558.42,N/A
2612345B,0983,26123,,,,,N/A,N/A,EXC FASC W/RELEASE SING DIG ~P,"$1,587.06","$1,179.75",$644.93,$644.93,$644.93,N/A,$644.93,N/A,$644.93,N/A,$644.93,N/A,$644.93,N/A,$644.93,$644.93,N/A
2612545B,0983,26125,,,,,N/A,N/A,FASCIECTOMY EA ADD DIGIT    ~P,$534.74,$397.50,$217.30,$217.30,$217.30,N/A,$217.30,N/A,$217.30,N/A,$217.30,N/A,$217.30,N/A,$217.30,$217.30,N/A
2614045B,0983,26140,,,,,N/A,N/A,"REVISE FINGER JOINT, EACH   ~P","$1,155.24",$858.75,$469.45,$469.45,$469.45,N/A,$469.45,N/A,$469.45,N/A,$469.45,N/A,$469.45,N/A,$469.45,$469.45,N/A
2614545B,0983,26145,,,,,N/A,N/A,"SYN,TEND SHEATH PALM/FINGER ~P","$1,080.57",$803.25,$439.11,$439.11,$439.11,N/A,$439.11,N/A,$439.11,N/A,$439.11,N/A,$439.11,N/A,$439.11,$439.11,N/A
2616040B,0983,26160,,,,,N/A,N/A,REMOVE TENDON SHEATH LESION ~P,"$1,016.00",$755.25,$447.72,$447.72,$447.72,N/A,$447.72,N/A,$447.72,N/A,$447.72,N/A,$447.72,N/A,$447.72,$447.72,N/A
2616045B,0983,26160,,,,,N/A,N/A,REMOVE TENDON SHEATH LESION ~P,"$1,016.00",$755.25,$447.72,$447.72,$447.72,N/A,$447.72,N/A,$447.72,N/A,$447.72,N/A,$447.72,N/A,$447.72,$447.72,N/A
2621045B,0983,26210,,,,,N/A,N/A,REMOVAL OF FINGER LESION    ~P,$948.40,$705.00,$45.49,$45.49,$45.49,N/A,$45.49,N/A,$45.49,N/A,$45.49,N/A,$45.49,N/A,$45.49,$45.49,N/A
2623045B,0983,26230,,,,,N/A,N/A,PARTIAL REMOVAL HAND BONE   ~P,"$1,160.28",$862.50,$471.50,$471.50,$471.50,N/A,$471.50,N/A,$471.50,N/A,$471.50,N/A,$471.50,N/A,$471.50,$471.50,N/A
2623545B,0983,26235,,,,,N/A,N/A,"PARTIAL REMOVAL, FINGER BONE~P","$1,137.08",$845.25,$462.70,$462.70,$462.70,N/A,$462.70,N/A,$462.70,N/A,$462.70,N/A,$462.70,N/A,$462.70,$462.70,N/A
2623645B,0983,26236,,,,,N/A,N/A,"PARTIAL REMOVAL, FINGER BONE~P",$958.49,$712.50,$47.95,$47.95,$47.95,N/A,$47.95,N/A,$47.95,N/A,$47.95,N/A,$47.95,N/A,$47.95,$47.95,N/A
2634045B,0983,26340,,,,,N/A,N/A,REPAIR FINGER/HAND          ~P,$667.92,$496.50,$271.42,$271.42,$271.42,N/A,$271.42,N/A,$271.42,N/A,$271.42,N/A,$271.42,N/A,$271.42,$271.42,N/A
2635045B,0983,26350,,,,,N/A,N/A,REPAIR FINGER/HAND TENDON   ~P,"$1,816.09","$1,350.00",$774.90,$774.90,$774.90,N/A,$774.90,N/A,$774.90,N/A,$774.90,N/A,$774.90,N/A,$774.90,$774.90,N/A
2635645B,0983,26356,,,,,N/A,N/A,REPAIR FINGER/HAND TENDON   ~P,"$2,451.72","$1,822.50",$996.30,$996.30,$996.30,N/A,$996.30,N/A,$996.30,N/A,$996.30,N/A,$996.30,N/A,$996.30,$996.30,N/A
2637045B,0983,26370,,,,,N/A,N/A,REPAIR FINGER/HAND TENDON   ~P,"$2,064.29","$1,534.50",$838.86,$838.86,$838.86,N/A,$838.86,N/A,$838.86,N/A,$838.86,N/A,$838.86,N/A,$838.86,$838.86,N/A
2637345B,0983,26373,,,,,N/A,N/A,REPAIR FINGER/HAND TENDON   ~P,"$2,219.67","$1,650.00",$92.00,$92.00,$92.00,N/A,$92.00,N/A,$92.00,N/A,$92.00,N/A,$92.00,N/A,$92.00,$92.00,N/A
2641045B,0983,26410,,,,,N/A,N/A,REPAIR HAND TENDON          ~P,"$1,513.41","$1,125.00",$623.20,$623.20,$623.20,N/A,$623.20,N/A,$623.20,N/A,$623.20,N/A,$623.20,N/A,$623.20,$623.20,N/A
2641245B,0983,26412,,,,,N/A,N/A,REPAIRW/FREE GRAFT EA TENDON~P,"$1,342.90",$998.25,$545.71,$545.71,$545.71,N/A,$545.71,N/A,$545.71,N/A,$545.71,N/A,$545.71,N/A,$545.71,$545.71,N/A
2641545B,0983,26415,,,,,N/A,N/A,"EXCISION, HAND/FINGER TENDON~P","$1,816.09","$1,350.00",$76.96,$76.96,$76.96,N/A,$76.96,N/A,$76.96,N/A,$76.96,N/A,$76.96,N/A,$76.96,$76.96,N/A
2641845B,0983,26418,,,,,N/A,N/A,REPAIR FINGER/HAND          ~P,"$1,143.13",$849.75,$464.53,$464.53,$464.53,N/A,$464.53,N/A,$464.53,N/A,$464.53,N/A,$464.53,N/A,$464.53,$464.53,N/A
2643745B,0983,26437,,,,,N/A,N/A,REALIGNMENT OF TENDONS      ~P,"$1,618.34","$1,203.00",$657.64,$657.64,$657.64,N/A,$657.64,N/A,$657.64,N/A,$657.64,N/A,$657.64,N/A,$657.64,$657.64,N/A
2644045B,0983,26440,,,,,N/A,N/A,RELEASE PALM/FINGER TENDON  ~P,"$1,705.11","$1,267.50",$692.90,$692.90,$692.90,N/A,$692.90,N/A,$692.90,N/A,$692.90,N/A,$692.90,N/A,$692.90,$692.90,N/A
2644545B,0983,26445,,,,,N/A,N/A,RELEASE HAND/FINGER TENDON  ~P,"$1,608.25","$1,195.50",$653.54,$653.54,$653.54,N/A,$653.54,N/A,$653.54,N/A,$653.54,N/A,$653.54,N/A,$653.54,$653.54,N/A
2645045B,0983,26450,,,,,N/A,N/A,"TENOTOMY,FLEX,PALM EA TENDON~P",$792.02,$588.75,$321.85,$321.85,$321.85,N/A,$321.85,N/A,$321.85,N/A,$321.85,N/A,$321.85,N/A,$321.85,$321.85,N/A
2645545B,0983,26455,,,,,N/A,N/A,"TENOTOMY,FLEX,FNGER EA TEND ~P",$791.01,$588.00,$321.44,$321.44,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,N/A,$321.44,$321.44,N/A
2646045B,0983,26460,,,,,N/A,N/A,"TENTMY,EXT,HAND,FIN,EA TEND ~P",$770.83,$573.00,$313.24,$313.24,$313.24,N/A,$313.24,N/A,$313.24,N/A,$313.24,N/A,$313.24,N/A,$313.24,$313.24,N/A
2648045B,0983,26480,,,,,N/A,N/A,REPAIR WRIST JOINT (S)      ~P,"$1,444.80","$1,074.00",$587.12,$587.12,$587.12,N/A,$587.12,N/A,$587.12,N/A,$587.12,N/A,$587.12,N/A,$587.12,$587.12,N/A
2648345B,0983,26483,,,,,N/A,N/A,TRANSFER OF TENDON W/GRAFT  ~P,"$1,660.72","$1,234.50",$674.86,$674.86,$674.86,N/A,$674.86,N/A,$674.86,N/A,$674.86,N/A,$674.86,N/A,$674.86,$674.86,N/A
2652545B,0983,26525,,,,,N/A,N/A,RELEASE FINGER CONTRACTURE  ~P,"$1,784.81","$1,326.75",$725.29,$725.29,$725.29,N/A,$725.29,N/A,$725.29,N/A,$725.29,N/A,$725.29,N/A,$725.29,$725.29,N/A
2654045B,0983,26540,,,,,N/A,N/A,REPAIR HAND JOINT           ~P,"$1,506.35","$1,119.75",$612.13,$612.13,$612.13,N/A,$612.13,N/A,$612.13,N/A,$612.13,N/A,$612.13,N/A,$612.13,$612.13,N/A
2654145B,0983,26541,,,,,N/A,N/A,REPAIR HAND JOINT W/GRAFT   ~P,"$2,057.23","$1,529.25",$835.99,$835.99,$835.99,N/A,$835.99,N/A,$835.99,N/A,$835.99,N/A,$835.99,N/A,$835.99,$835.99,N/A
2660045B,0983,26600,,,,,N/A,N/A,TREAT METACARPAL FRACTURE   ~P,$512.54,$381.00,$216.89,$216.89,$216.89,N/A,$216.89,N/A,$216.89,N/A,$216.89,N/A,$216.89,N/A,$216.89,$216.89,N/A
2660545B,0983,26605,,,,,N/A,N/A,TREATMENT OF METACARPAL FX  ~P,$521.62,$387.75,$249.69,$249.69,$249.69,N/A,$249.69,N/A,$249.69,N/A,$249.69,N/A,$249.69,N/A,$249.69,$249.69,N/A
2660845B,0983,26608,,,,,N/A,N/A,TREAT METACARPAL FRACTURE   ~P,"$1,096.72",$815.25,$445.67,$445.67,$445.67,N/A,$445.67,N/A,$445.67,N/A,$445.67,N/A,$445.67,N/A,$445.67,$445.67,N/A
2661545B,0983,26615,,,,,N/A,N/A,TREAT METACARPAL FRACTURE   ~P,"$1,008.94",$750.00,$41.00,$41.00,$41.00,N/A,$41.00,N/A,$41.00,N/A,$41.00,N/A,$41.00,N/A,$41.00,$41.00,N/A
2665045B,0983,26650,,,,,N/A,N/A,TREAT THUMB FRACTURE        ~P,"$1,109.83",$825.00,$476.42,$476.42,$476.42,N/A,$476.42,N/A,$476.42,N/A,$476.42,N/A,$476.42,N/A,$476.42,$476.42,N/A
2667645B,0983,26676,,,,,N/A,N/A,PIN HAND DISLOCATION        ~P,"$1,151.20",$855.75,$467.81,$467.81,$467.81,N/A,$467.81,N/A,$467.81,N/A,$467.81,N/A,$467.81,N/A,$467.81,$467.81,N/A
2670045B,0983,26700,,,,,N/A,N/A,TREAT KNUCKLE DISLOCATION   ~P,$614.44,$456.75,$249.69,$249.69,$249.69,N/A,$249.69,N/A,$249.69,N/A,$249.69,N/A,$249.69,N/A,$249.69,$249.69,N/A
2672045B,0983,26720,,,,,N/A,N/A,"TREAT FINGER FRACTURE, EACH ~P",$343.04,$255.00,$145.14,$145.14,$145.14,N/A,$145.14,N/A,$145.14,N/A,$145.14,N/A,$145.14,N/A,$145.14,$145.14,N/A
2672745B,0983,26727,,,,,N/A,N/A,TREAT FINGER FRACTURE EACH  ~P,"$1,080.57",$803.25,$439.11,$439.11,$439.11,N/A,$439.11,N/A,$439.11,N/A,$439.11,N/A,$439.11,N/A,$439.11,$439.11,N/A
2673545B,0983,26735,,,,,N/A,N/A,OPEN TREATMENT PHALANGEAL FX~P,"$1,203.67",$894.75,$489.13,$489.13,$489.13,N/A,$489.13,N/A,$489.13,N/A,$489.13,N/A,$489.13,N/A,$489.13,$489.13,N/A
2674045B,0983,26740,,,,,N/A,N/A,"TREAT FINGER FRACTURE, EACH ~P",$423.75,$315.00,$177.53,$177.53,$177.53,N/A,$177.53,N/A,$177.53,N/A,$177.53,N/A,$177.53,N/A,$177.53,$177.53,N/A
2674245B,0983,26742,,,,,N/A,N/A,TREATMENT OF FX/DISLOC HAND ~P,$672.96,$500.25,$273.47,$273.47,$273.47,N/A,$273.47,N/A,$273.47,N/A,$273.47,N/A,$273.47,N/A,$273.47,$273.47,N/A
2674645B,0983,26746,,,,,N/A,N/A,FRACTURE/DISLOCATION        ~P,"$1,389.31","$1,032.75",$564.57,$564.57,$564.57,N/A,$564.57,N/A,$564.57,N/A,$564.57,N/A,$564.57,N/A,$564.57,$564.57,N/A
2675645B,0983,26756,,,,,N/A,N/A,PIN FINGER FRACTURE EACH    ~P,$951.43,$707.25,$386.63,$386.63,$386.63,N/A,$386.63,N/A,$386.63,N/A,$386.63,N/A,$386.63,N/A,$386.63,$386.63,N/A
2676545B,0983,26765,,,,,N/A,N/A,TREATMENT OF FX FINGER/HAND ~P,"$1,001.88",$744.75,$47.13,$47.13,$47.13,N/A,$47.13,N/A,$47.13,N/A,$47.13,N/A,$47.13,N/A,$47.13,$47.13,N/A
2677045B,0983,26770,,,,,N/A,N/A,TREAT FINGER DISLOCATION    ~P,$494.38,$367.50,$27.50,$27.50,$27.50,N/A,$27.50,N/A,$27.50,N/A,$27.50,N/A,$27.50,N/A,$27.50,$27.50,N/A
2678545B,0983,26785,,,,,N/A,N/A,TREAT FINGER DISLOCATION    ~P,$826.32,$614.25,$335.79,$335.79,$335.79,N/A,$335.79,N/A,$335.79,N/A,$335.79,N/A,$335.79,N/A,$335.79,$335.79,N/A
2684145B,0983,26841,,,,,N/A,N/A,FUSION OF THUMB             ~P,"$1,900.84","$1,413.00",$772.44,$772.44,$772.44,N/A,$772.44,N/A,$772.44,N/A,$772.44,N/A,$772.44,N/A,$772.44,$772.44,N/A
2686045B,0983,26860,,,,,N/A,N/A,ARTH INTERPHALANGEAL JOINT  ~P,"$1,107.82",$823.50,$45.18,$45.18,$45.18,N/A,$45.18,N/A,$45.18,N/A,$45.18,N/A,$45.18,N/A,$45.18,$45.18,N/A
2695145B,0983,26951,,,,,N/A,N/A,AMPUTATION FINGER/THUMB     ~P,"$1,368.12","$1,017.00",$555.96,$555.96,$555.96,N/A,$555.96,N/A,$555.96,N/A,$555.96,N/A,$555.96,N/A,$555.96,$555.96,N/A
2695245B,0983,26952,,,,,N/A,N/A,AMP FIN/THUM W/LOC ADV FLAP ~P,"$1,267.23",$942.00,$514.96,$514.96,$514.96,N/A,$514.96,N/A,$514.96,N/A,$514.96,N/A,$514.96,N/A,$514.96,$514.96,N/A
2699045B,0983,26990,,,,,N/A,N/A,DRAINAGE OF PELVIS LESION   ~P,"$1,392.34","$1,035.00",$565.80,$565.80,$565.80,N/A,$565.80,N/A,$565.80,N/A,$565.80,N/A,$565.80,N/A,$565.80,$565.80,N/A
2700145B,0983,27001,,,,,N/A,N/A,INCISION OF HIP TENDON      ~P,"$1,244.02",$924.75,$970.09,"$1,233.00",N/A,"$1,196.01",N/A,"$1,054.22",N/A,$970.09,N/A,"$1,196.01",N/A,"$1,233.00",N/A,N/A,"$1,196.01"
2700645B,0983,27006,,,,,N/A,N/A,INCISION OF HIP TENDON      ~P,"$3,375.91","$2,509.50","$1,290.32","$3,346.00","$1,371.86","$3,245.62","$1,371.86","$2,860.83","$1,371.86","$1,290.32","$1,371.86","$3,245.62","$1,371.86","$3,346.00","$1,371.86","$1,371.86","$3,245.62"
2702545B,0983,27025,,,,,N/A,N/A,INCISION OF HIP/THIGH FASCIA~P,"$1,878.65","$1,396.50",$763.42,"$1,862.00",$763.42,"$1,806.14",$763.42,"$1,592.01",$763.42,"$1,638.46",$763.42,"$1,806.14",$763.42,"$1,862.00",$763.42,$763.42,"$1,806.14"
2703045B,0983,27030,,,,,N/A,N/A,DRAINAGE OF HIP JOINT       ~P,"$2,167.20","$1,611.00",$88.68,"$2,148.00",$88.68,"$2,083.56",$88.68,"$1,836.54",$88.68,"$1,666.79",$88.68,"$2,083.56",$88.68,"$2,148.00",$88.68,$88.68,"$2,083.56"
2703345B,0983,27033,,,,,N/A,N/A,SURG INCISION OF HIP        ~P,"$1,941.20","$1,443.00",$788.84,"$1,924.00",$788.84,"$1,866.28",$788.84,"$1,645.02",$788.84,"$1,730.10",$788.84,"$1,866.28",$788.84,"$1,924.00",$788.84,$788.84,"$1,866.28"
2704540B,0983,27045,,,,,N/A,N/A,"REMOVE TURMOR, HIP/PELV 5CM>~P","$1,373.17","$1,020.75",$558.10,"$1,361.00",$558.10,"$1,320.17",$558.10,"$1,163.66",$558.10,"$1,301.99",$558.10,"$1,320.17",$558.10,"$1,361.00",$558.10,$558.10,"$1,320.17"
2704545B,0983,27045,,,,,N/A,N/A,"REMOVE TURMOR, HIP/PELV 5CM>~P","$1,373.17","$1,020.75",$558.10,"$1,361.00",$558.10,"$1,320.17",$558.10,"$1,163.66",$558.10,"$1,301.99",$558.10,"$1,320.17",$558.10,"$1,361.00",$558.10,$558.10,"$1,320.17"
2704745B,0983,27047,,,,,N/A,N/A,REMOVE HIP/PELVIS LESION    ~P,$735.52,$546.75,$471.91,"$1,151.00",$471.91,"$1,116.47",$471.91,$984.11,$471.91,$638.52,$471.91,"$1,116.47",$471.91,"$1,151.00",$471.91,$471.91,"$1,116.47"
2704845B,0983,27048,,,,,N/A,N/A,"EXCISION,TUMOR,SOFT TISS <CM~P",$865.67,$643.50,$351.78,"$1,084.29",$351.78,$832.26,$351.78,$733.59,$351.78,"$1,084.29",$351.78,$832.26,$351.78,$858.00,$351.78,$351.78,$832.26
2706245B,0983,27062,,,,,N/A,N/A,REMOVE FEMUR LESION/BURSA   ~P,"$1,002.89",$745.50,$47.54,$994.00,$47.54,$964.18,$47.54,$849.87,$47.54,$816.93,$47.54,$964.18,$47.54,$994.00,$47.54,$47.54,$964.18
2706645B,0983,27066,,,,,N/A,N/A,REMOVAL OF HIP BONE LESION  ~P,"$1,790.87","$1,331.25",$727.75,"$1,775.00",$727.75,"$1,721.75",$727.75,"$1,517.63",$727.75,"$1,457.56",$727.75,"$1,721.75",$727.75,"$1,775.00",$727.75,$727.75,"$1,721.75"
2709145B,0983,27091,,,,,N/A,N/A,REMOVAL OF HIP PROSTHESIS   ~P,"$3,430.40","$2,550.00",$141.81,"$3,441.00",$141.81,"$3,337.77",$141.81,"$2,942.06",$141.81,"$2,818.59",$141.81,"$3,337.77",$141.81,"$3,441.00",$141.81,$141.81,"$3,337.77"
2709345B,0983,27093,,,,,N/A,N/A,INJECTION PRODCEDURE FOR HIP~P,$538.77,$400.50,$122.56,$534.00,$218.94,$517.98,$218.94,$456.57,$218.94,$122.56,$218.94,$517.98,$218.94,$534.00,$218.94,$218.94,$517.98
2709545B,0983,27095,,,,,N/A,N/A,INJECTION FOR HIP W/ANES    ~P,$514.56,$382.50,$29.10,$510.00,$29.10,$494.70,$29.10,$436.05,$29.10,$146.79,$29.10,$494.70,$29.10,$510.00,$29.10,$29.10,$494.70
2710045B,0983,27100,,,,,N/A,N/A,TRANSFER OF ADB MUSCLE      ~P,"$1,257.14",$934.50,$51.86,"$1,480.37",$51.86,"$1,208.62",$51.86,"$1,065.33",$51.86,"$1,480.37",$51.86,"$1,208.62",$51.86,"$1,246.00",$51.86,$51.86,"$1,208.62"
2712545B,0983,27125,,,,,N/A,N/A,"REPAIR,REVISION,PARTIAL HIP ~P","$2,168.21","$1,611.75",$881.90,"$2,149.00",$881.90,"$2,084.53",$881.90,"$1,837.40",$881.90,"$2,008.52",$881.90,"$2,084.53",$881.90,"$2,149.00",$881.90,$881.90,"$2,084.53"
2713045B,0983,27130,,,,,N/A,N/A,TOTAL HIP ARTHROPLASTY      ~P,"$3,206.41","$2,383.50",$132.98,"$6,356.00",$132.98,"$6,165.32",$132.98,"$5,434.38",$132.98,"$2,277.00",$132.98,"$6,165.32",$132.98,"$6,356.00",$132.98,$132.98,"$6,165.32"
2713245B,0983,27132,,,,,N/A,N/A,TOTAL HIP ARTHROPLASTY      ~P,"$3,735.10","$2,776.50","$1,517.82","$3,702.00","$1,517.82","$3,590.94","$1,517.82","$3,165.21","$1,517.82","$2,956.85","$1,517.82","$3,590.94","$1,517.82","$3,702.00","$1,517.82","$1,517.82","$3,590.94"
2713445B,0983,27134,,,,,N/A,N/A,REVISION TOTAL HIP BOTH COMP~P,"$3,724.00","$2,768.25","$1,513.31","$6,391.00","$1,513.31","$6,199.27","$1,513.31","$5,464.31","$1,513.31","$3,367.07","$1,513.31","$6,199.27","$1,513.31","$6,391.00","$1,513.31","$1,513.31","$6,199.27"
2713745B,0983,27137,,,,,N/A,N/A,REVISE HIP JOINT REPLACEMENT~P,"$3,329.50","$2,475.00","$1,369.40","$3,340.00","$1,369.40","$3,239.80","$1,369.40","$2,855.70","$1,369.40","$2,594.63","$1,369.40","$3,239.80","$1,369.40","$3,340.00","$1,369.40","$1,369.40","$3,239.80"
2713845B,0983,27138,,,,,N/A,N/A,REPAIR FEMORAL COMP ONLY    ~P,"$3,510.10","$2,609.25","$1,426.39","$3,479.00","$1,426.39","$3,374.63","$1,426.39","$2,974.55","$1,426.39","$2,695.36","$1,426.39","$3,374.63","$1,426.39","$3,479.00","$1,426.39","$1,426.39","$3,374.63"
2718745B,0983,27187,,,,,N/A,N/A,REINFORCE HIP BONES         ~P,"$2,320.56","$1,725.00",$943.00,"$2,300.00",$943.00,"$2,231.00",$943.00,"$1,966.50",$943.00,"$1,770.71",$943.00,"$2,231.00",$943.00,"$2,300.00",$943.00,$943.00,"$2,231.00"
2721545B,0983,27215,,,,,N/A,N/A,TREAT PELVIC FRACTURE(S)    ~P,"$1,614.30","$1,200.00",$671.58,"$1,638.00",$671.58,"$1,588.86",$671.58,"$1,400.49",$671.58,"$1,087.36",$671.58,"$1,588.86",$671.58,"$1,638.00",$671.58,$671.58,"$1,588.86"
2723545B,0983,27235,,,,,N/A,N/A,TREAT THIGH FRACTURE        ~P,"$2,123.82","$1,578.75",$863.50,"$2,105.00",$863.50,"$2,041.85",$863.50,"$1,799.78",$863.50,"$1,613.93",$863.50,"$2,041.85",$863.50,"$2,105.00",$863.50,$863.50,"$2,041.85"
2723645B,0983,27236,,,,,N/A,N/A,TOTAL HIP ARTHROPLASTY      ~P,"$2,554.64","$1,899.00",$138.12,"$2,532.00",$138.12,"$2,456.04",$138.12,"$2,164.86",$138.12,"$2,117.70",$138.12,"$2,456.04",$138.12,"$2,532.00",$138.12,$138.12,"$2,456.04"
2724045B,0983,27240,,,,,N/A,N/A,Treat Thigh Fracture        ~p,"$2,097.59","$1,559.25",$852.39,"$2,079.00",$852.39,"$2,016.63",$852.39,"$1,777.55",$852.39,"$1,706.85",$852.39,"$2,016.63",$852.39,"$2,079.00",$852.39,$852.39,"$2,016.63"
2724445B,0983,27244,,,,,N/A,N/A,"TREATMENT, THIGH FRX        ~P","$2,609.12","$1,939.50",$16.26,"$2,586.00",$16.26,"$2,508.42",$16.26,"$2,211.03",$16.26,"$2,178.93",$16.26,"$2,508.42",$16.26,"$2,586.00",$16.26,$16.26,"$2,508.42"
2724545B,0983,27245,,,,,N/A,N/A,"TREATMENT, THIGH FRX        ~P","$3,266.95","$2,428.50","$1,327.58","$3,238.00","$1,327.58","$3,140.86","$1,327.58","$2,768.49","$1,327.58","$2,176.95","$1,327.58","$3,140.86","$1,327.58","$3,238.00","$1,327.58","$1,327.58","$3,140.86"
2724845B,0983,27248,,,,,N/A,N/A,TREAT THIGH FRACTURE        ~P,"$1,782.80","$1,325.25",$724.47,"$1,767.00",$724.47,"$1,713.99",$724.47,"$1,510.79",$724.47,"$1,326.94",$724.47,"$1,713.99",$724.47,"$1,767.00",$724.47,$724.47,"$1,713.99"
2725245B,0983,27252,,,,,N/A,N/A,TREAT HIP DISLOCATION       ~P,"$1,699.05","$1,263.00",$69.44,"$1,684.00",$69.44,"$1,633.48",$69.44,"$1,439.82",$69.44,"$1,345.24",$69.44,"$1,633.48",$69.44,"$1,684.00",$69.44,$69.44,"$1,633.48"
2726545B,0983,27265,,,,,N/A,N/A,TREAT HIP DISLOCATION       ~P,$898.97,$668.25,$375.56,$375.56,$375.56,N/A,$375.56,N/A,$375.56,N/A,$375.56,N/A,$375.56,N/A,$375.56,$375.56,N/A
2726645B,0983,27266,,,,,N/A,N/A,TREATMENT OF FX/DISLOC HIP ~P,"$1,172.39",$871.50,$476.42,$476.42,$476.42,N/A,$476.42,N/A,$476.42,N/A,$476.42,N/A,$476.42,N/A,$476.42,$476.42,N/A
2727545B,0983,27275,,,,,N/A,N/A,MANIPULATION HIP JOINT      ~P,$367.25,$273.00,$149.24,$364.00,$149.24,$353.08,$149.24,$311.22,$149.24,$330.11,$149.24,$353.08,$149.24,$364.00,$149.24,$149.24,$353.08
2730140B,0983,27301,,,,,N/A,N/A,INCISION/DRAINAGE           ~P,$984.73,$732.00,$4.16,$976.00,$4.16,$946.72,$4.16,$834.48,$4.16,$902.72,$4.16,$946.72,$4.16,$976.00,$4.16,$4.16,$946.72
2730145B,0983,27301,,,,,N/A,N/A,INCISION/DRAINAGE           ~P,$984.73,$732.00,$4.16,$976.00,$4.16,$946.72,$4.16,$834.48,$4.16,$902.72,$4.16,$946.72,$4.16,$976.00,$4.16,$4.16,$946.72
2730545B,0983,27305,,,,,N/A,N/A,INCISE THIGH TEND & FASCIA  ~P,$901.99,$670.50,$366.54,$894.00,$366.54,$867.18,$366.54,$764.37,$366.54,$864.42,$366.54,$867.18,$366.54,$894.00,$366.54,$366.54,$867.18
2731045B,0983,27310,,,,,N/A,N/A,EXPLORATION OF KNEE JOINT   ~P,"$1,609.26","$1,196.25",$653.95,"$1,595.00",$653.95,"$1,547.15",$653.95,"$1,363.73",$653.95,"$1,306.80",$653.95,"$1,547.15",$653.95,"$1,595.00",$653.95,$653.95,"$1,547.15"
2732340B,0983,27323,,,,,N/A,N/A,BIOPSY THIGH OR KNEE        ~P,$391.47,$291.00,$159.80,$388.00,$159.80,$376.36,$159.80,$331.74,$159.80,$312.70,$159.80,$376.36,$159.80,$388.00,$159.80,$159.80,$376.36
2732445B,0983,27324,,,,,N/A,N/A,"BIOPSY, THIGH SOFT TISSUES  ~P",$711.30,$528.75,$289.50,$726.74,$289.50,$683.85,$289.50,$602.78,$289.50,$726.74,$289.50,$683.85,$289.50,$705.00,$289.50,$289.50,$683.85
2732740B,0983,27327,,,,,N/A,N/A,"REPAIR,REV/RECON TENOTOMY   ~P",$606.37,$450.75,$246.41,$601.00,$246.41,$582.97,$246.41,$513.86,$246.41,$557.48,$246.41,$582.97,$246.41,$601.00,$246.41,$246.41,$582.97
2732745B,0983,27327,,,,,N/A,N/A,"REPAIR,REV/RECON TENOTOMY   ~P",$606.37,$450.75,$246.41,$601.00,$246.41,$582.97,$246.41,$513.86,$246.41,$557.48,$246.41,$582.97,$246.41,$601.00,$246.41,$246.41,$582.97
2732845B,0983,27328,,,,,N/A,N/A,EXC THIGH/KNEE TUM DEEP<5CM ~P,"$1,065.44",$792.00,$432.96,"$1,105.23",$432.96,"$1,024.32",$432.96,$902.88,$432.96,"$1,105.23",$432.96,"$1,024.32",$432.96,"$1,056.00",$432.96,$432.96,"$1,024.32"
2733145B,0983,27331,,,,,N/A,N/A,EXPLORE/TREAT KNEE JOINT   ~P,"$1,008.94",$750.00,$41.00,"$1,075.00",$41.00,"$1,042.75",$41.00,$919.13,$41.00,$854.91,$41.00,"$1,042.75",$41.00,"$1,075.00",$41.00,$41.00,"$1,042.75"
2733245B,0983,27332,,,,,N/A,N/A,RESECTION PROC THIGH/KNEE   ~P,"$1,297.50",$964.50,$527.26,"$1,286.00",$527.26,"$1,247.42",$527.26,"$1,099.53",$527.26,"$1,155.08",$527.26,"$1,247.42",$527.26,"$1,286.00",$527.26,$527.26,"$1,247.42"
2733445B,0983,27334,,,,,N/A,N/A,REMOVE KNEE JOINT LINING    ~P,"$1,496.26","$1,112.25",$624.43,"$1,523.00",$624.43,"$1,477.31",$624.43,"$1,302.17",$624.43,"$1,226.00",$624.43,"$1,477.31",$624.43,"$1,523.00",$624.43,$624.43,"$1,477.31"
2733545B,0983,27335,,,,,N/A,N/A,RESECTION PROC THIGH/KNEE   ~P,"$1,524.51","$1,133.25",$619.51,"$1,511.00",$619.51,"$1,465.67",$619.51,"$1,291.91",$619.51,"$1,367.13",$619.51,"$1,465.67",$619.51,"$1,511.00",$619.51,$619.51,"$1,465.67"
2733740B,0983,27337,,,,,N/A,N/A,EXCISION 3CM OR GREATER     ~P,$597.29,$444.00,$328.41,$742.65,$328.41,$574.24,$328.41,$506.16,$328.41,$742.65,$328.41,$574.24,$328.41,$592.00,$328.41,$328.41,$574.24
2733745B,0983,27337,,,,,N/A,N/A,EXC THIGH/KNEE LES>3CM      ~P,$808.16,$600.75,$328.41,$742.65,$328.41,$574.24,$328.41,$506.16,$328.41,$742.65,$328.41,$574.24,$328.41,$592.00,$328.41,$328.41,$574.24
2734045B,0983,27340,,,,,N/A,N/A,"EXCISION, PREPATELLR BURSA  ~P",$702.22,$522.00,$285.36,$696.00,$285.36,$675.12,$285.36,$595.08,$285.36,$673.01,$285.36,$675.12,$285.36,$696.00,$285.36,$285.36,$675.12
2734545B,0983,27345,,,,,N/A,N/A,REMOVAL OF KNEE CYST        ~P,"$1,107.82",$823.50,$45.18,"$1,098.00",$45.18,"$1,065.06",$45.18,$938.79,$45.18,$869.73,$45.18,"$1,065.06",$45.18,"$1,098.00",$45.18,$45.18,"$1,065.06"
2734745B,0983,27347,,,,,N/A,N/A,EXC OF LESION               ~P,$759.73,$564.75,$38.73,$945.78,$38.73,$730.41,$38.73,$643.82,$38.73,$945.78,$38.73,$730.41,$38.73,$753.00,$38.73,$38.73,$730.41
2735045B,0983,27350,,,,,N/A,N/A,PATELLECTOMY OR HEMI        ~P,"$1,313.64",$976.50,$533.82,"$1,302.00",$533.82,"$1,262.94",$533.82,"$1,113.21",$533.82,"$1,169.35",$533.82,"$1,262.94",$533.82,"$1,302.00",$533.82,$533.82,"$1,262.94"
2735545B,0983,27355,,,,,N/A,N/A,REMOVE FEMUR LESION         ~P,"$1,311.62",$975.00,$558.42,"$1,362.00",$558.42,"$1,321.14",$558.42,"$1,164.51",$558.42,"$1,085.40",$558.42,"$1,321.14",$558.42,"$1,362.00",$558.42,$558.42,"$1,321.14"
2736045B,0983,27360,,,,,N/A,N/A,"PART EXCIS BONE, FEMR,TIB   ~P","$1,625.40","$1,208.25",$66.51,"$1,611.00",$66.51,"$1,562.67",$66.51,"$1,377.41",$66.51,"$1,607.43",$66.51,"$1,562.67",$66.51,"$1,611.00",$66.51,$66.51,"$1,562.67"
2737245B,0983,27372,,,,,N/A,N/A,REMOVAL OF FOREIGN BODY     ~P,$751.66,$558.75,$376.79,$919.00,$376.79,$891.43,$376.79,$785.75,$376.79,$716.24,$376.79,$891.43,$376.79,$919.00,$376.79,$376.79,$891.43
2738045B,0983,27380,,,,,N/A,N/A,TENDON REPAIR               ~P,"$1,372.16","$1,020.00",$557.60,"$1,360.00",$557.60,"$1,319.20",$557.60,"$1,162.80",$557.60,"$1,116.10",$557.60,"$1,319.20",$557.60,"$1,360.00",$557.60,$557.60,"$1,319.20"
2738545B,0983,27385,,,,,N/A,N/A,REPAIR THIGH MUSCLE         ~P,"$1,464.98","$1,089.00",$595.32,"$1,452.00",$595.32,"$1,408.44",$595.32,"$1,241.46",$595.32,"$1,087.66",$595.32,"$1,408.44",$595.32,"$1,452.00",$595.32,$595.32,"$1,408.44"
2738645B,0983,27386,,,,,N/A,N/A,REPAIR/GRAFT OF THIGH MUSCLE~P,"$1,911.94","$1,421.25",$776.95,"$1,895.00",$776.95,"$1,838.15",$776.95,"$1,620.23",$776.95,"$1,536.11",$776.95,"$1,838.15",$776.95,"$1,895.00",$776.95,$776.95,"$1,838.15"
2740545B,0983,27405,,,,,N/A,N/A,REPAIR OF KNEE LIGAMENT     ~P,"$1,291.44",$960.00,$524.80,"$1,280.00",$524.80,"$1,241.60",$524.80,"$1,094.40",$524.80,"$1,209.76",$524.80,"$1,241.60",$524.80,"$1,280.00",$524.80,$524.80,"$1,241.60"
2740745B,0983,27407,,,,,N/A,N/A,REPAIR OF KNEE LIGAMENT     ~P,"$1,715.20","$1,275.00",$72.78,"$1,758.00",$72.78,"$1,705.26",$72.78,"$1,503.09",$72.78,"$1,422.10",$72.78,"$1,705.26",$72.78,"$1,758.00",$72.78,$72.78,"$1,705.26"
2740945B,0983,27409,,,,,N/A,N/A,REPAIR/RECONST OF FEMUR/KNEE~P,"$1,946.25","$1,446.75",$79.89,"$1,929.00",$79.89,"$1,871.13",$79.89,"$1,649.30",$79.89,"$1,722.59",$79.89,"$1,871.13",$79.89,"$1,929.00",$79.89,$79.89,"$1,871.13"
2741845B,0983,27418,,,,,N/A,N/A,REPAIR DEGENERATED KNEECAP  ~P,"$1,816.09","$1,350.00",$766.70,"$1,940.00",$766.70,"$1,881.80",$766.70,"$1,658.70",$766.70,"$1,483.96",$766.70,"$1,881.80",$766.70,"$1,940.00",$766.70,$766.70,"$1,881.80"
2742045B,0983,27420,,,,,N/A,N/A,REVISION OF UNSTABLE KNEECAP~P,"$1,712.17","$1,272.75",$695.77,"$1,697.30",$695.77,"$1,646.38",$695.77,"$1,451.19",$695.77,"$1,327.63",$695.77,"$1,646.38",$695.77,"$1,697.30",$695.77,$695.77,"$1,646.38"
2742545B,0983,27425,,,,,N/A,N/A,LAT RETINACULAR RELEASE OPEN~P,"$1,019.03",$757.50,$814.80,"$1,010.00",N/A,$979.70,N/A,$863.55,N/A,$814.80,N/A,$979.70,N/A,"$1,010.00",N/A,N/A,$979.70
2742745B,0983,27427,,,,,N/A,N/A,RECONSTRUCTION KNEE         ~P,"$1,638.52","$1,218.00",$665.84,"$1,624.00",$665.84,"$1,575.28",$665.84,"$1,388.52",$665.84,"$1,273.76",$665.84,"$1,575.28",$665.84,"$1,624.00",$665.84,$665.84,"$1,575.28"
2742945B,0983,27429,,,,,N/A,N/A,"RECONSTRUCTION, KNEE        ~P","$2,623.24","$1,950.00",$184.45,"$2,645.00",$184.45,"$2,565.65",$184.45,"$2,261.48",$184.45,"$2,235.51",$184.45,"$2,565.65",$184.45,"$2,645.00",$184.45,$184.45,"$2,565.65"
2743045B,0983,27430,,,,,N/A,N/A,"REPAIR, QUADRICEPSPLATY     ~P","$1,412.52","$1,050.00",$574.00,"$1,400.00",$574.00,"$1,358.00",$574.00,"$1,197.00",$574.00,"$1,325.84",$574.00,"$1,358.00",$574.00,"$1,400.00",$574.00,$574.00,"$1,358.00"
2743745B,0983,27437,,,,,N/A,N/A,"ARTHROPLASTY,PATELLA        ~P","$1,001.88",$744.75,$47.13,"$1,182.09",$47.13,$963.21,$47.13,$849.02,$47.13,"$1,182.09",$47.13,$963.21,$47.13,$993.00,$47.13,$47.13,$963.21
2743845B,0983,27438,,,,,N/A,N/A,REPAIR/RECONST FEMUR/KNEE   ~P,"$1,696.03","$1,260.75",$689.21,"$1,681.00",$689.21,"$1,630.57",$689.21,"$1,437.26",$689.21,"$1,497.85",$689.21,"$1,630.57",$689.21,"$1,681.00",$689.21,$689.21,"$1,630.57"
2744145B,0983,27441,,,,,N/A,N/A,REVISION OF KNEE JOINT      ~P,"$1,614.30","$1,200.00",$684.70,"$1,670.00",$684.70,N/A,$684.70,"$1,427.85",$684.70,"$1,468.22",$684.70,N/A,$684.70,"$1,670.00",$684.70,$684.70,N/A
2744245B,0983,27442,,,,,N/A,N/A,REVISION OF KNEE JOINT      ~P,"$1,916.99","$1,425.00",$89.34,"$1,974.00",$89.34,"$1,914.78",$89.34,"$1,687.77",$89.34,"$1,550.91",$89.34,"$1,914.78",$89.34,"$1,974.00",$89.34,$89.34,"$1,914.78"
2744345B,0983,27443,,,,,N/A,N/A,REVISION OF KNEE JOINT      ~P,"$1,816.09","$1,350.00",$763.10,"$1,861.00",$763.10,"$1,805.17",$763.10,"$1,687.77",$763.10,"$1,455.56",$763.10,"$1,805.17",$763.10,"$1,861.00",$763.10,$763.10,"$1,805.17"
2744645B,0983,27446,,,,,N/A,N/A,REVISION OF KNEE JOINT      ~P,"$2,522.35","$1,875.00",$156.57,"$5,277.00",$156.57,"$5,118.69",$156.57,"$4,511.84",$156.57,"$2,046.18",$156.57,"$5,118.69",$156.57,"$5,277.00",$156.57,$156.57,"$5,118.69"
2744745B,0983,27447,,,,,N/A,N/A,TOTAL KNEE ARTHROPLASTY     ~P,"$4,035.76","$3,000.00",$164.00,"$4,000.00",$164.00,"$3,880.00",$164.00,"$3,420.00",$164.00,"$2,274.40",$164.00,"$3,880.00",$164.00,"$4,000.00",$164.00,$164.00,"$3,880.00"
2745045B,0983,27450,,,,,N/A,N/A,INCISION OF THIGH           ~P,"$2,298.37","$1,708.50",$954.48,"$2,328.00",$954.48,"$2,258.16",$954.48,"$1,990.44",$954.48,"$1,807.24",$954.48,"$2,258.16",$954.48,"$2,328.00",$954.48,$954.48,"$2,258.16"
2745545B,0983,27455,,,,,N/A,N/A,REALIGNMENT OF KNEE         ~P,"$2,171.24","$1,614.00",$882.32,"$2,152.00",$882.32,"$2,087.44",$882.32,"$1,839.96",$882.32,"$1,708.43",$882.32,"$2,087.44",$882.32,"$2,152.00",$882.32,$882.32,"$2,087.44"
2747045B,0983,27470,,,,,N/A,N/A,REPAIR OF THIGH             ~P,"$2,623.24","$1,950.00",$183.63,"$2,643.00",$183.63,"$2,563.71",$183.63,"$2,259.77",$183.63,"$2,093.29",$183.63,"$2,563.71",$183.63,"$2,643.00",$183.63,$183.63,"$2,563.71"
2747245B,0983,27472,,,,,N/A,N/A,REPAIR/GRAFT OF THIGH       ~P,"$2,825.03","$2,100.00","$1,182.44","$2,884.00","$1,182.44","$2,797.48","$1,182.44","$2,465.82","$1,182.44","$2,242.67","$1,182.44","$2,797.48","$1,182.44","$2,884.00","$1,182.44","$1,182.44","$2,797.48"
2747745B,0983,27477,,,,,N/A,N/A,REPAIR/RECONST FEMUR/KNEE   ~P,"$1,475.07","$1,096.50",$599.42,"$1,462.00",$599.42,"$1,418.14",$599.42,"$1,250.01",$599.42,"$1,308.85",$599.42,"$1,418.14",$599.42,"$1,462.00",$599.42,$599.42,"$1,418.14"
2748645B,0983,27486,,,,,N/A,N/A,REVISE/REPLACE KNEE JOINT   ~P,"$3,140.83","$2,334.75","$1,276.33","$3,113.00","$1,276.33","$3,019.61","$1,276.33","$2,661.62","$1,276.33","$2,489.29","$1,276.33","$3,019.61","$1,276.33","$3,113.00","$1,276.33","$1,276.33","$3,019.61"
2748745B,0983,27487,,,,,N/A,N/A,REVISE/REPLACE KNEE JOINT   ~P,"$4,014.57","$2,984.25","$1,631.39","$3,979.00","$1,631.39","$3,859.63","$1,631.39","$3,402.05","$1,631.39","$3,102.29","$1,631.39","$3,859.63","$1,631.39","$3,979.00","$1,631.39","$1,631.39","$3,859.63"
2748845B,0983,27488,,,,,N/A,N/A,REMOVAL OF KNEE PROSTHESIS  ~P,"$2,627.28","$1,953.00",$167.64,"$2,604.00",$167.64,"$2,525.88",$167.64,"$2,226.42",$167.64,"$2,129.82",$167.64,"$2,525.88",$167.64,"$2,604.00",$167.64,$167.64,"$2,525.88"
2749545B,0983,27495,,,,,N/A,N/A,REINFORCE THIGH             ~P,"$2,581.88","$1,919.25",$149.19,"$2,559.00",$149.19,"$2,482.23",$149.19,"$2,187.95",$149.19,"$2,006.28",$149.19,"$2,482.23",$149.19,"$2,559.00",$149.19,$149.19,"$2,482.23"
2750645B,0983,27506,,,,,N/A,N/A,"TREATMENT, THIGH FRX        ~P","$2,892.63","$2,150.25","$1,175.47","$2,867.00","$1,175.47","$2,780.99","$1,175.47","$2,451.29","$1,175.47","$2,372.89","$1,175.47","$2,780.99","$1,175.47","$2,867.00","$1,175.47","$1,175.47","$2,780.99"
2750745B,0983,27507,,,,,N/A,N/A,OPEN TREATMENT OF FEMORAL FX~P,"$1,874.61","$1,393.50",$761.78,"$1,858.00",$761.78,"$1,802.26",$761.78,"$1,588.59",$761.78,"$1,719.64",$761.78,"$1,802.26",$761.78,"$1,858.00",$761.78,$761.78,"$1,802.26"
2750945B,0983,27509,,,,,N/A,N/A,TREATMENT OF THIGH FRACTURE ~P,"$1,412.52","$1,050.00",$64.75,"$1,475.00",$64.75,"$1,430.75",$64.75,"$1,261.13",$64.75,"$1,210.03",$64.75,"$1,430.75",$64.75,"$1,475.00",$64.75,$64.75,"$1,430.75"
2751045B,0983,27510,,,,,N/A,N/A,TREATMENT OF THIGH FRACTURE ~P,"$1,569.91","$1,167.00",$637.96,"$1,556.00",$637.96,"$1,509.32",$637.96,"$1,330.38",$637.96,"$1,213.54",$637.96,"$1,509.32",$637.96,"$1,556.00",$637.96,$637.96,"$1,509.32"
2751145B,0983,27511,,,,,N/A,N/A,TREATMENT OF FEMORAL        ~P,"$1,408.48","$1,047.00",$572.36,"$1,768.82",$572.36,"$1,354.12",$572.36,"$1,193.58",$572.36,"$1,768.82",$572.36,"$1,354.12",$572.36,"$1,396.00",$572.36,$572.36,"$1,354.12"
2751345B,0983,27513,,,,,N/A,N/A,"TREATMENT, THIGH FRX        ~P","$3,038.93","$2,259.00","$1,234.92","$3,012.00","$1,234.92","$2,921.64","$1,234.92","$2,575.26","$1,234.92","$2,191.13","$1,234.92","$2,921.64","$1,234.92","$3,012.00","$1,234.92","$1,234.92","$2,921.64"
2751445B,0983,27514,,,,,N/A,N/A,OPEN TREAT OF FEMORAL FX    ~P,"$1,949.27","$1,449.00",$792.12,"$1,932.00",$792.12,"$1,874.04",$792.12,"$1,651.86",$792.12,"$1,716.21",$792.12,"$1,874.04",$792.12,"$1,932.00",$792.12,$792.12,"$1,874.04"
2752445B,0983,27524,,,,,N/A,N/A,"TREATMENT, KNEECAP FRX      ~P","$1,741.43","$1,294.50",$77.66,"$1,726.00",$77.66,"$1,674.22",$77.66,"$1,475.73",$77.66,"$1,344.24",$77.66,"$1,674.22",$77.66,"$1,726.00",$77.66,$77.66,"$1,674.22"
2753245B,0983,27532,,,,,N/A,N/A,TREAT KNEE FRACTURE         ~P,"$1,309.60",$973.50,$532.18,"$1,298.00",$532.18,"$1,259.06",$532.18,"$1,109.79",$532.18,"$1,033.50",$532.18,"$1,259.06",$532.18,"$1,298.00",$532.18,$532.18,"$1,259.06"
2753545B,0983,27535,,,,,N/A,N/A,TREATMENT OPEN FX TIBIAL    ~P,"$1,818.11","$1,351.50",$738.82,"$1,802.00",$738.82,"$1,747.94",$738.82,"$1,540.71",$738.82,"$1,595.11",$738.82,"$1,747.94",$738.82,"$1,802.00",$738.82,$738.82,"$1,747.94"
2753645B,0983,27536,,,,,N/A,N/A,TREATMENT OF FX             ~P,"$2,413.38","$1,794.00",$98.72,"$2,392.00",$98.72,"$2,320.24",$98.72,"$2,045.16",$98.72,"$2,103.70",$98.72,"$2,320.24",$98.72,"$2,392.00",$98.72,$98.72,"$2,320.24"
2754045B,0983,27540,,,,,N/A,N/A,TREAT KNEE FRACTURE         ~P,"$2,164.18","$1,608.75",$879.45,"$2,145.00",$879.45,"$2,080.65",$879.45,"$1,833.98",$879.45,"$1,451.89",$879.45,"$2,080.65",$879.45,"$2,145.00",$879.45,$879.45,"$2,080.65"
2755245B,0983,27552,,,,,N/A,N/A,FX OR DISLOC REQUIR ANES    ~P,"$1,190.55",$885.00,$483.80,"$1,180.00",$483.80,"$1,144.60",$483.80,"$1,008.90",$483.80,"$1,134.98",$483.80,"$1,144.60",$483.80,"$1,180.00",$483.80,$483.80,"$1,144.60"
2756245B,0983,27562,,,,,N/A,N/A,TREAT KNEECAP DISLOCATION   ~P,$948.40,$705.00,$47.95,$995.00,$47.95,$965.15,$47.95,$850.73,$47.95,$878.82,$47.95,$965.15,$47.95,$995.00,$47.95,$47.95,$965.15
2757045B,0983,27570,,,,,N/A,N/A,FIXATION OF KNEE JOINT      ~P,$335.98,$249.75,$136.53,$333.00,$136.53,$323.01,$136.53,$284.72,$136.53,$271.21,$136.53,$323.01,$136.53,$333.00,$136.53,$136.53,$323.01
2759045B,0983,27590,,,,,N/A,N/A,AMPUTATION AT FEMUR OR KNEE ~P,"$1,621.37","$1,205.25",$658.87,"$1,607.00",$658.87,"$1,558.79",$658.87,"$1,373.99",$658.87,"$1,371.97",$658.87,"$1,558.79",$658.87,"$1,607.00",$658.87,$658.87,"$1,558.79"
2760045B,0983,27600,,,,,N/A,N/A,DECOMPRESSION OF LOWER LEG  ~P,$967.57,$719.25,$393.19,$959.00,$393.19,$930.23,$393.19,$819.95,$393.19,$714.89,$393.19,$930.23,$393.19,$959.00,$393.19,$393.19,$930.23
2760245B,0983,27602,,,,,N/A,N/A,DECOMPRESSION OF LOWER LEG  ~P,"$1,170.37",$870.00,$482.98,"$1,178.00",$482.98,"$1,142.66",$482.98,"$1,007.19",$482.98,$842.64,$482.98,"$1,142.66",$482.98,"$1,178.00",$482.98,$482.98,"$1,142.66"
2760345B,0983,27603,,,,,N/A,N/A,INCISIONAL PROD LOW LEG/ANK ~P,"$1,020.04",$758.25,$414.51,"$1,011.00",$414.51,$980.67,$414.51,$864.41,$414.51,$699.71,$414.51,$980.67,$414.51,"$1,011.00",$414.51,$414.51,$980.67
2760645B,0983,27606,,,,,N/A,N/A,INCISION OF ACHILLES TENDON ~P,$675.99,$502.50,$291.10,$710.00,$291.10,$688.70,$291.10,$607.05,$291.10,$490.01,$291.10,$688.70,$291.10,$710.00,$291.10,$291.10,$688.70
2761045B,0983,27610,,,,,N/A,N/A,EXPLORE/TREAT ANKLE JOINT   ~P,"$1,462.96","$1,087.50",$594.50,"$1,450.00",$594.50,"$1,406.50",$594.50,"$1,239.75",$594.50,"$1,161.53",$594.50,"$1,406.50",$594.50,"$1,450.00",$594.50,$594.50,"$1,406.50"
2761845B,0983,27618,,,,,N/A,N/A,REMOVE LOWER LEG LESION     ~P,$807.15,$600.00,$349.32,$852.00,$349.32,$826.44,$349.32,$728.46,$349.32,$543.92,$349.32,$826.44,$349.32,$852.00,$349.32,$349.32,$826.44
2761945B,0983,27619,,,,,N/A,N/A,EXC LEG/ANK TUMOR <5 CM     ~P,"$1,036.18",$770.25,$421.70,"$1,027.00",$421.70,$996.19,$421.70,$878.09,$421.70,$822.07,$421.70,$996.19,$421.70,"$1,027.00",$421.70,$421.70,$996.19
2762045B,0983,27620,,,,,N/A,N/A,EXPLORE/TREAT ANKLE LOINT   ~P,"$1,085.62",$807.00,$441.16,"$1,027.00",$441.16,$996.19,$441.16,$878.09,$441.16,$809.48,$441.16,$996.19,$441.16,"$1,027.00",$441.16,$441.16,$996.19
2763045B,0983,27630,,,,,N/A,N/A,BONE/JOINT PROD ANKLE/LEG   ~P,"$1,144.14",$850.50,$464.94,"$1,134.00",$464.94,"$1,099.98",$464.94,$969.57,$464.94,$647.21,$464.94,"$1,099.98",$464.94,"$1,134.00",$464.94,$464.94,"$1,099.98"
2763245B,0983,27632,,,,,N/A,N/A,EXC LEG/ANKLE LES SC 3 CM/> ~P,$817.24,$607.50,$332.10,$810.00,$332.10,$785.70,$332.10,$692.55,$332.10,$731.88,$332.10,$785.70,$332.10,$810.00,$332.10,$332.10,$785.70
2763445B,0983,27634,,,,,N/A,N/A,EXC LEG/ANKLE TUM DEP 5 CM/>~P,"$1,311.62",$975.00,$547.76,"$1,336.00",$547.76,"$1,295.92",$547.76,"$1,142.28",$547.76,"$1,203.82",$547.76,"$1,295.92",$547.76,"$1,336.00",$547.76,$547.76,"$1,295.92"
2763545B,0983,27635,,,,,N/A,N/A,EXCISION/CURETTAGE OF BONE  ~P,"$1,383.26","$1,028.25",$562.11,"$1,371.00",$562.11,"$1,329.87",$562.11,"$1,172.21",$562.11,"$1,043.19",$562.11,"$1,329.87",$562.11,"$1,371.00",$562.11,$562.11,"$1,329.87"
2763745B,0983,27637,,,,,N/A,N/A,REMOVE/GRAFT LEG BONE LESION~P,"$1,715.20","$1,275.00",$72.74,"$1,714.00",$72.74,"$1,662.58",$72.74,"$1,465.47",$72.74,"$1,325.48",$72.74,"$1,662.58",$72.74,"$1,714.00",$72.74,$72.74,"$1,662.58"
2764045B,0983,27640,,,,,N/A,N/A,PARTIAL REMOVAL OF TIBIA    ~P,"$2,017.88","$1,500.00",$836.40,"$2,040.00",$836.40,"$1,978.80",$836.40,"$1,744.20",$836.40,"$1,483.30",$836.40,"$1,978.80",$836.40,"$2,040.00",$836.40,$836.40,"$1,978.80"
2764145B,0983,27641,,,,,N/A,N/A,PARTIAL REMOVAL OF FIBULA   ~P,"$1,614.30","$1,200.00",$678.14,"$1,654.00",$678.14,"$1,604.38",$678.14,"$1,414.17",$678.14,"$1,172.81",$678.14,"$1,604.38",$678.14,"$1,654.00",$678.14,$678.14,"$1,604.38"
2765045B,0983,27650,,,,,N/A,N/A,REPAIR ACHILLES TENDON      ~P,"$1,641.55","$1,220.25",$667.70,"$1,627.00",$667.70,"$1,578.19",$667.70,"$1,391.09",$667.70,"$1,182.58",$667.70,"$1,578.19",$667.70,"$1,627.00",$667.70,$667.70,"$1,578.19"
2765245B,0983,27652,,,,,N/A,N/A,REPAIR/GRAFT ACHILLES TENDON~P,"$1,715.20","$1,275.00",$712.17,"$1,737.00",$712.17,"$1,684.89",$712.17,"$1,485.14",$712.17,"$1,190.05",$712.17,"$1,684.89",$712.17,"$1,737.00",$712.17,$712.17,"$1,684.89"
2765445B,0983,27654,,,,,N/A,N/A,REPAIR/RECON LOWER LEG      ~P,"$1,444.80","$1,074.00",$587.12,"$1,432.00",$587.12,"$1,389.04",$587.12,"$1,224.36",$587.12,"$1,274.95",$587.12,"$1,389.04",$587.12,"$1,432.00",$587.12,$587.12,"$1,389.04"
2765845B,0983,27658,,,,,N/A,N/A,"REPAIR, FLEXORTENDON, LEG   ~P",$862.64,$641.25,$35.55,$855.00,$35.55,$829.35,$35.55,$731.03,$35.55,$664.00,$35.55,$829.35,$35.55,$855.00,$35.55,$35.55,$829.35
2766445B,0983,27664,,,,,N/A,N/A,REPAIR EXTENSOR TENDON      ~P,$851.55,$633.00,$346.40,$844.00,$346.40,$818.68,$346.40,$721.62,$346.40,$650.81,$346.40,$818.68,$346.40,$844.00,$346.40,$346.40,$818.68
2767645B,0983,27676,,,,,N/A,N/A,"REPR,DSLC PRSNL TENDW/FIB OS~P","$1,202.66",$894.00,$488.72,"$1,192.00",$488.72,"$1,156.24",$488.72,"$1,019.16",$488.72,"$1,071.91",$488.72,"$1,156.24",$488.72,"$1,192.00",$488.72,$488.72,"$1,156.24"
2768045B,0983,27680,,,,,N/A,N/A,RELEASE OF LOWER LEG TENDON ~P,"$1,032.15",$767.25,$419.43,"$1,023.00",$419.43,$992.31,$419.43,$874.67,$419.43,$753.16,$419.43,$992.31,$419.43,"$1,023.00",$419.43,$419.43,$992.31
2768545B,0983,27685,,,,,N/A,N/A,"REPAIR, FLEXORTENDON, LEG   ~P",$868.70,$645.75,$353.10,$861.00,$353.10,$835.17,$353.10,$736.16,$353.10,$833.17,$353.10,$835.17,$353.10,$861.00,$353.10,$353.10,$835.17
2768745B,0983,27687,,,,,N/A,N/A,REVISION OF CALF TENDON     ~P,"$1,098.74",$816.75,$446.49,"$1,089.00",$446.49,"$1,056.33",$446.49,$931.10,$446.49,$814.76,$446.49,"$1,056.33",$446.49,"$1,089.00",$446.49,$446.49,"$1,056.33"
2769145B,0983,27691,,,,,N/A,N/A,REPAIR/RECONST LEG/ANKLE    ~P,"$1,518.45","$1,128.75",$617.50,"$1,505.00",$617.50,"$1,459.85",$617.50,"$1,286.78",$617.50,"$1,332.52",$617.50,"$1,459.85",$617.50,"$1,505.00",$617.50,$617.50,"$1,459.85"
2769545B,0983,27695,,,,,N/A,N/A,REPAIR OF ANKLE LIGAMENT    ~P,"$1,176.42",$874.50,$478.60,"$1,166.00",$478.60,"$1,131.02",$478.60,$996.93,$478.60,$853.56,$478.60,"$1,131.02",$478.60,"$1,166.00",$478.60,$478.60,"$1,131.02"
2772045B,0983,27720,,,,,N/A,N/A,REPAIR OF TIBIA             ~P,"$2,023.93","$1,504.50",$822.46,"$2,006.00",$822.46,"$1,945.82",$822.46,"$1,715.13",$822.46,"$1,560.00",$822.46,"$1,945.82",$822.46,"$2,006.00",$822.46,$822.46,"$1,945.82"
2772645B,0983,27726,,,,,N/A,N/A,REPAIR FIBULA NONUNION      ~P,"$1,816.09","$1,350.00",$758.90,$758.90,$758.90,N/A,$758.90,N/A,$758.90,N/A,$758.90,N/A,$758.90,N/A,$758.90,$758.90,N/A
2775245B,0983,27752,,,,,N/A,N/A,TREATMENT TIBIA FRACTURE    ~P,$916.12,$681.00,$444.44,"$1,084.00",$444.44,"$1,051.48",$444.44,$926.82,$444.44,$882.83,$444.44,"$1,051.48",$444.44,"$1,084.00",$444.44,$444.44,"$1,051.48"
2775645B,0983,27756,,,,,N/A,N/A,PRCTNEOUS SKLTAL FIX OF TIB ~P,"$1,120.93",$833.25,$455.51,"$1,111.00",$455.51,"$1,077.67",$455.51,$949.91,$455.51,"$1,033.60",$455.51,"$1,077.67",$455.51,"$1,111.00",$455.51,$455.51,"$1,077.67"
2775845B,0983,27758,,,,,N/A,N/A,OPEN TRTMENT TIBIAL SHAFT FX~P,"$1,729.32","$1,285.50",$72.74,"$1,714.00",$72.74,"$1,662.58",$72.74,"$1,465.47",$72.74,"$1,596.00",$72.74,"$1,662.58",$72.74,"$1,714.00",$72.74,$72.74,"$1,662.58"
2775945B,0983,27759,,,,,N/A,N/A,"TREATMENT,OF TIBIAL SHAFT FX~T","$2,302.40","$1,711.50",$935.62,"$2,282.00",$935.62,"$2,213.54",$935.62,"$1,951.11",$935.62,"$1,774.28",$935.62,"$2,213.54",$935.62,"$2,282.00",$935.62,$935.62,"$2,213.54"
2776645B,0983,27766,,,,,N/A,N/A,TREATMENT OF ANKLE FRACTURE ~P,"$1,435.72","$1,067.25",$63.93,"$1,473.00",$63.93,"$1,428.81",$63.93,"$1,259.42",$63.93,"$1,085.87",$63.93,"$1,428.81",$63.93,"$1,473.00",$63.93,$63.93,"$1,428.81"
2776945B,0983,27769,,,,,N/A,N/A,OPTX POST ANKLE FX          ~P,"$1,311.62",$975.00,$572.77,"$1,397.00",$572.77,"$1,355.09",$572.77,"$1,194.44",$572.77,"$1,305.54",$572.77,"$1,355.09",$572.77,"$1,397.00",$572.77,$572.77,"$1,355.09"
2778145B,0983,27781,,,,,N/A,N/A,TREATMENT OF FIBULA FRACTURE~P,$827.33,$615.00,$348.90,$829.00,$348.90,$804.13,$348.90,$708.80,$348.90,$721.52,$348.90,$804.13,$348.90,$829.00,$348.90,$348.90,$804.13
2778845B,0983,27788,,,,,N/A,N/A,TREATMENT OF ANKLE FRACTURE ~P,$862.64,$641.25,$694.74,$855.00,N/A,$829.35,N/A,$731.03,N/A,$694.74,N/A,$829.35,N/A,$855.00,N/A,N/A,$829.35
2779245B,0983,27792,,,,,N/A,N/A,TREATMENT OF ANKLE FRACTURE ~P,"$1,392.34","$1,035.00",$565.80,"$1,380.00",$565.80,"$1,338.60",$565.80,"$1,179.90",$565.80,"$1,156.52",$565.80,"$1,338.60",$565.80,"$1,380.00",$565.80,$565.80,"$1,338.60"
2781045B,0983,27810,,,,,N/A,N/A,FX/DISLOC W/MANIPULATION    ~P,$631.60,$469.50,$256.66,$764.31,$256.66,$607.22,$256.66,$535.23,$256.66,$764.31,$256.66,$607.22,$256.66,$626.00,$256.66,$256.66,$607.22
2781445B,0983,27814,,,,,N/A,N/A,TREATMENT OF ANKLE FRACTURE ~P,"$1,838.29","$1,366.50",$747.20,"$1,822.00",$747.20,"$1,767.34",$747.20,"$1,557.81",$747.20,"$1,367.87",$747.20,"$1,767.34",$747.20,"$1,822.00",$747.20,$747.20,"$1,767.34"
2781845B,0983,27818,,,,,N/A,N/A,CLOSED FX TRIMALL ANKLEW/MAL~P,"$1,009.95",$750.75,$41.41,"$1,001.00",$41.41,$970.97,$41.41,$855.86,$41.41,$783.77,$41.41,$970.97,$41.41,"$1,001.00",$41.41,$41.41,$970.97
2782245B,0983,27822,,,,,N/A,N/A,TREATMENT OF ANKLE FRACTURE ~P,"$2,057.23","$1,529.25",$835.99,"$2,039.00",$835.99,"$1,977.83",$835.99,"$1,743.35",$835.99,"$1,570.90",$835.99,"$1,977.83",$835.99,"$2,039.00",$835.99,$835.99,"$1,977.83"
2782345B,0983,27823,,,,,N/A,N/A,TREATMENT OF FRACTURE       ~P,"$1,932.12","$1,436.25",$785.15,"$1,915.00",$785.15,"$1,857.55",$785.15,"$1,637.33",$785.15,"$1,765.45",$785.15,"$1,857.55",$785.15,"$1,915.00",$785.15,$785.15,"$1,857.55"
2782545B,0983,27825,,,,,N/A,N/A,TREAT LOWER LEG FRACTURE    ~P,"$1,100.75",$818.25,$447.31,"$1,091.00",$447.31,"$1,058.27",$447.31,$932.81,$447.31,$880.73,$447.31,"$1,058.27",$447.31,"$1,091.00",$447.31,$447.31,"$1,058.27"
2782745B,0983,27827,,,,,N/A,N/A,TREAT LOWER LEG FRACTURE    ~P,"$2,183.35","$1,623.00",$887.24,"$2,164.00",$887.24,"$2,099.08",$887.24,"$1,850.22",$887.24,"$2,003.42",$887.24,"$2,099.08",$887.24,"$2,164.00",$887.24,$887.24,"$2,099.08"
2782845B,0983,27828,,,,,N/A,N/A,TREATMENT OF FX/DISLOC FOOT ~P,"$2,615.17","$1,944.00",$162.72,"$2,592.00",$162.72,"$2,514.24",$162.72,"$2,216.16",$162.72,"$2,370.79",$162.72,"$2,514.24",$162.72,"$2,592.00",$162.72,$162.72,"$2,514.24"
2782945B,0983,27829,,,,,N/A,N/A,TREAT LOWER LEG JOINT       ~P,"$1,159.27",$861.75,$471.90,"$1,275.22",$471.90,"$1,114.53",$471.90,$982.40,$471.90,"$1,275.22",$471.90,"$1,114.53",$471.90,"$1,149.00",$471.90,$471.90,"$1,114.53"
2784845B,0983,27848,,,,,N/A,N/A,TREAT ANKLE DISLOCATION     ~P,"$1,916.99","$1,425.00",$89.34,$89.34,$89.34,N/A,$89.34,N/A,$89.34,N/A,$89.34,N/A,$89.34,N/A,$89.34,$89.34,N/A
2786045B,0983,27860,,,,,N/A,N/A,FIXATION OF ANKLE JOINT     ~P,$403.58,$300.00,$300.83,$410.00,N/A,$397.70,N/A,$350.55,N/A,$300.83,N/A,$397.70,N/A,$410.00,N/A,N/A,$397.70
2787045B,0983,27870,,,,,N/A,N/A,"FUSION OF ANKLE JOINT, OPEN ~P","$2,335.70","$1,736.25",$949.15,$949.15,$949.15,N/A,$949.15,N/A,$949.15,N/A,$949.15,N/A,$949.15,N/A,$949.15,$949.15,N/A
2788040B,0983,27880,,,,,N/A,N/A,AMPUTATION OF LOWER LEG   ~P,"$1,715.20","$1,275.00",$736.36,"$2,315.00",$736.36,"$2,245.55",$736.36,"$1,979.33",$736.36,"$1,573.34",$736.36,"$2,245.55",$736.36,"$2,315.00",$736.36,$736.36,"$2,245.55"
2788440B,0983,27884,,,,,N/A,N/A,AMPUTATION FOLLOW-UP SURGERY~P,"$1,329.78",$988.50,$54.38,"$1,318.00",$54.38,"$1,278.46",$54.38,"$1,126.89",$54.38,"$1,008.71",$54.38,"$1,278.46",$54.38,"$1,318.00",$54.38,$54.38,"$1,278.46"
2800845B,0983,28008,,,,,N/A,N/A,INCISION OF FOOT FASCIA     ~P,$725.43,$539.25,$294.79,$719.00,$294.79,$697.43,$294.79,$614.75,$294.79,$530.91,$294.79,$697.43,$294.79,$719.00,$294.79,$294.79,$697.43
2801045B,0983,28010,,,,,N/A,N/A,INCISION OF TOE TENDON      ~P,$408.62,$303.75,$2.90,$490.00,$2.90,$475.30,$2.90,$418.95,$2.90,$372.35,$2.90,$475.30,$2.90,$490.00,$2.90,$2.90,$475.30
2802045B,0983,28020,,,,,N/A,N/A,EXPLORATION OF FOOT JOINT   ~P,$827.33,$615.00,$352.19,$859.00,$352.19,$833.23,$352.19,$734.45,$352.19,$656.90,$352.19,$833.23,$352.19,$859.00,$352.19,$352.19,$833.23
2803545B,0983,28035,,,,,N/A,N/A,DECOMPRESSION TIBIA NERVE   ~P,$694.15,$516.00,$394.42,$862.00,$394.42,$836.14,$394.42,$737.01,$394.42,$639.30,$394.42,$836.14,$394.42,$862.00,$394.42,$394.42,$836.14
2803945B,0983,28039,,,,,N/A,N/A,EXCISION 1.5CM OR >         ~P,$668.93,$497.25,$271.83,$663.00,$271.83,$643.11,$271.83,$566.87,$271.83,$618.69,$271.83,$643.11,$271.83,$663.00,$271.83,$271.83,$643.11
2804345B,0983,28043,,,,,N/A,N/A,EXCISION OF FOOT LESION     ~P,$521.62,$387.75,$257.70,$627.00,$257.70,$608.19,$257.70,$536.09,$257.70,$466.89,$257.70,$608.19,$257.70,$627.00,$257.70,$257.70,$608.19
2806045B,0983,28060,,,,,N/A,N/A,"PARTIAL REMOVAL, FOOT FASCIA~P",$863.65,$642.00,$35.96,$856.00,$35.96,$830.32,$35.96,$731.88,$35.96,$647.57,$35.96,$830.32,$35.96,$856.00,$35.96,$35.96,$830.32
2808045B,0983,28080,,,,,N/A,N/A,REMOVAL OF FOOT LESION      ~P,$628.57,$467.25,$277.57,$277.57,$277.57,N/A,$277.57,N/A,$277.57,N/A,$277.57,N/A,$277.57,N/A,$277.57,$277.57,N/A
2808845B,0983,28088,,,,,N/A,N/A,EXCISE FOOT TENDON SHEATH   ~P,$706.26,$525.00,$298.48,$728.00,$298.48,$706.16,$298.48,$622.44,$298.48,$506.14,$298.48,$706.16,$298.48,$728.00,$298.48,$298.48,$706.16
2810345B,0983,28103,,,,,N/A,N/A,RESECTION PROC  FOOT/TOES   ~P,$801.10,$595.50,$325.54,$764.00,$325.54,$741.08,$325.54,$653.22,$325.54,$697.19,$325.54,$741.08,$325.54,$764.00,$325.54,$325.54,$741.08
2810845B,0983,28108,,,,,N/A,N/A,REMOVAL OF FOOT LESION      ~P,$561.98,$417.75,$284.95,$695.00,$284.95,$674.15,$284.95,$594.23,$284.95,$515.66,$284.95,$674.15,$284.95,$695.00,$284.95,$284.95,$674.15
2811045B,0983,28110,,,,,N/A,N/A,PART REMOVAL OF METATARSAL  ~P,$561.98,$417.75,$28.85,$695.00,$28.85,$674.15,$28.85,$594.23,$28.85,$520.24,$28.85,$674.15,$28.85,$695.00,$28.85,$28.85,$674.15
2812245B,0983,28112,,,,,N/A,N/A,TARSAL OR METATARSAL BONE   ~P,$753.68,$560.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
2811845B,0983,28118,,,,,N/A,N/A,REMOVAL OF HEEL BONE        ~P,$797.06,$592.50,$397.70,$970.00,$397.70,$940.90,$397.70,$829.35,$397.70,$750.92,$397.70,$940.90,$397.70,$970.00,$397.70,$397.70,$940.90
2811945B,0983,28119,,,,,N/A,N/A,"EXCISION, FOR SPUR          ~P",$707.27,$525.75,$287.41,$701.00,$287.41,$679.97,$287.41,$599.36,$287.41,$648.64,$287.41,$679.97,$287.41,$701.00,$287.41,$287.41,$679.97
2819245B,0983,28192,,,,,N/A,N/A,REMOVAL OF FOOT FOREIGN BODY~P,$756.71,$562.50,$318.16,$776.00,$318.16,$752.72,$318.16,$663.48,$318.16,$559.29,$318.16,$752.72,$318.16,$776.00,$318.16,$318.16,$752.72
2822645B,0983,28226,,,,,N/A,N/A,RELEASE OF FOOT TENDONS     ~P,$726.44,$540.00,$317.34,$317.34,$317.34,N/A,$317.34,N/A,$317.34,N/A,$317.34,N/A,$317.34,N/A,$317.34,$317.34,N/A
2823845B,0983,28238,,,,,N/A,N/A,REVISION OF FOOT TENDON     ~P,"$1,109.83",$825.00,$489.95,"$1,195.00",$489.95,"$1,159.15",$489.95,"$1,021.73",$489.95,$865.91,$489.95,"$1,159.15",$489.95,"$1,195.00",$489.95,$489.95,"$1,159.15"
2828045B,0983,28280,,,,,N/A,N/A,FUSION OF TOES              ~P,$699.20,$519.75,$371.87,$907.00,$371.87,$879.79,$371.87,$775.49,$371.87,$620.35,$371.87,$879.79,$371.87,$907.00,$371.87,$371.87,$879.79
2828545B,0983,28285,,,,,N/A,N/A,REPAIR IF HAMMERTOE         ~P,$624.53,$464.25,$684.58,$752.00,N/A,$729.44,N/A,$642.96,N/A,$684.58,N/A,$729.44,N/A,$752.00,N/A,N/A,$729.44
2828945B,0983,28289,,,,,N/A,N/A,REPAIR OF HALLUX RIGIDUS    ~P,"$1,212.75",$901.50,$492.82,"$1,202.00",$492.82,"$1,165.94",$492.82,"$1,027.71",$492.82,$820.25,$492.82,"$1,165.94",$492.82,"$1,202.00",$492.82,$492.82,"$1,165.94"
2829145B,0983,28291,,,,,N/A,N/A,REPAIR/RECONST FOOT/TOE     ~P,"$1,445.81","$1,074.75",$587.53,$587.53,$587.53,N/A,$587.53,N/A,$587.53,N/A,$587.53,N/A,$587.53,N/A,$587.53,$587.53,N/A
2829545B,0983,28295,,,,,N/A,N/A,REPAIR/RECONST FOOT/TOE     ~P,"$1,263.19",$939.00,$513.32,$513.32,$513.32,N/A,$513.32,N/A,$513.32,N/A,$513.32,N/A,$513.32,N/A,$513.32,$513.32,N/A
2829645B,0983,28296,,,,,N/A,N/A,CORRECTION BUNION           ~P,"$1,387.29","$1,031.25",$563.75,"$1,375.00",$563.75,"$1,333.75",$563.75,"$1,175.63",$563.75,$918.57,$563.75,"$1,333.75",$563.75,"$1,375.00",$563.75,$563.75,"$1,333.75"
2829745B,0983,28297,,,,,N/A,N/A,CORRECTION OF BUNION        ~P,"$1,412.52","$1,050.00",$596.96,"$1,502.00",$596.96,"$1,456.94",$596.96,"$1,284.21",$596.96,"$1,078.57",$596.96,"$1,456.94",$596.96,"$1,502.00",$596.96,$596.96,"$1,456.94"
2830045B,0983,28300,,,,,N/A,N/A,INCISION OF HEEL BONE       ~P,"$1,583.03","$1,176.75",$643.29,"$1,569.00",$643.29,"$1,521.93",$643.29,"$1,341.50",$643.29,"$1,161.14",$643.29,"$1,521.93",$643.29,"$1,569.00",$643.29,$643.29,"$1,521.93"
2844545B,0983,28445,,,,,N/A,N/A,TREAT ANKLE FRACTURE        ~P,"$2,499.14","$1,857.75",$136.70,"$2,527.00",$136.70,"$2,451.19",$136.70,"$2,160.59",$136.70,"$1,830.34",$136.70,"$2,451.19",$136.70,"$2,527.00",$136.70,$136.70,"$2,451.19"
2847645B,0983,28476,,,,,N/A,N/A,TREAT METATARSAL FRACTURE   ~P,$766.79,$570.00,$318.98,$778.00,$318.98,$754.66,$318.98,$665.19,$318.98,$697.37,$318.98,$754.66,$318.98,$778.00,$318.98,$318.98,$754.66
2850545B,0983,28505,,,,,N/A,N/A,TREAT BIG TOE FRACTURE      ~P,$929.23,$690.75,$398.11,$971.00,$398.11,$941.87,$398.11,$830.21,$398.11,$890.10,$398.11,$941.87,$398.11,$971.00,$398.11,$398.11,$941.87
2866045B,0983,28660,,,,,N/A,N/A,TREAT TOE DISLOCATION       ~P,$181.61,$135.00,$77.90,$190.00,$77.90,$184.30,$77.90,$162.45,$77.90,$164.42,$77.90,$184.30,$77.90,$190.00,$77.90,$77.90,$184.30
2870545B,0983,28705,,,,,N/A,N/A,ARTHRODESIS PANTALAR        ~P,"$1,998.71","$1,485.75",$812.21,"$2,167.93",$812.21,"$1,921.57",$812.21,"$1,693.76",$812.21,"$2,167.93",$812.21,"$1,921.57",$812.21,"$1,981.00",$812.21,$812.21,"$1,921.57"
2871545B,0983,28715,,,,,N/A,N/A,FUSION OF FOOT BONES        ~P,"$2,118.77","$1,575.00",$886.83,"$2,163.00",$886.83,"$2,098.11",$886.83,"$1,849.37",$886.83,"$1,680.91",$886.83,"$2,098.11",$886.83,"$2,163.00",$886.83,$886.83,"$2,098.11"
2872545B,0983,28725,,,,,N/A,N/A,ARTHRODESIS FOOT/TOE SUBTAL ~P,"$1,559.82","$1,159.50",$633.45,"$1,546.00",$633.45,"$1,499.62",$633.45,"$1,321.83",$633.45,"$1,388.80",$633.45,"$1,499.62",$633.45,"$1,546.00",$633.45,$633.45,"$1,499.62"
2873045B,0983,28730,,,,,N/A,N/A,ARTHRODESIS OF FOOT         ~P,"$1,830.22","$1,360.50",$743.74,"$1,814.00",$743.74,"$1,759.58",$743.74,"$1,550.97",$743.74,"$1,312.57",$743.74,"$1,759.58",$743.74,"$1,814.00",$743.74,$743.74,"$1,759.58"
2875045B,0983,28750,,,,,N/A,N/A,FUSION OF BIG TOE JOINT     ~P,"$1,430.68","$1,063.50",$581.38,"$1,418.00",$581.38,"$1,375.46",$581.38,"$1,212.39",$581.38,"$1,040.51",$581.38,"$1,375.46",$581.38,"$1,418.00",$581.38,$581.38,"$1,375.46"
2882040B,0983,28820,,,,,N/A,N/A,AMPUTATION OF TOE           ~P,$774.87,$576.00,$314.88,$768.00,$314.88,$744.96,$314.88,$656.64,$314.88,$320.60,$314.88,$744.96,$314.88,$768.00,$314.88,$314.88,$744.96
2882045B,0983,28820,,,,,N/A,N/A,AMPUTATION OF TOE           ~P,$774.87,$576.00,$314.88,$768.00,$314.88,$744.96,$314.88,$656.64,$314.88,$320.60,$314.88,$744.96,$314.88,$768.00,$314.88,$314.88,$744.96
2882540B,0983,28825,,,,,N/A,N/A,REPAIR RECONSTR OF FOOT/TOE ~P,$758.72,$564.00,$38.32,$752.00,$38.32,$729.44,$38.32,$642.96,$38.32,$311.09,$38.32,$729.44,$38.32,$752.00,$38.32,$38.32,$729.44
2882545B,0983,28825,,,,,N/A,N/A,REPAIR RECONSTR OF FOOT/TOE ~P,$758.72,$564.00,$38.32,$752.00,$38.32,$729.44,$38.32,$642.96,$38.32,$311.09,$38.32,$729.44,$38.32,$752.00,$38.32,$38.32,$729.44
2906545B,0983,29065,,,,,N/A,N/A,APPL CAST SHOULDER TO HAND  ~P,$80.72,$60.00,$98.40,$240.00,$98.40,$232.80,$98.40,$205.20,$98.40,$120.15,$98.40,$232.80,$98.40,$240.00,$98.40,$98.40,$232.80
2907545B,0983,29075,,,,,N/A,N/A,"APPLICATION CAST, FOREARM   ~P",$114.01,$84.75,$56.58,$138.00,$56.58,$133.86,$56.58,$117.99,$56.58,$110.37,$56.58,$133.86,$56.58,$138.00,$56.58,$56.58,$133.86
2908545B,0983,29085,,,,,N/A,N/A,"APPLICATION CAST,HAND/WRIST ~P",$80.72,$60.00,$57.40,$240.00,$57.40,$232.80,$57.40,$205.20,$57.40,$118.54,$57.40,$232.80,$57.40,$240.00,$57.40,$57.40,$232.80
2910545B,0983,29105,,,,,N/A,N/A,"APPLICATION SPLINT,LONG ARM ~P",$110.98,$82.50,$54.12,$132.00,$54.12,$128.04,$54.12,$112.86,$54.12,$73.88,$54.12,$128.04,$54.12,$132.00,$54.12,$54.12,$128.04
2912545B,0983,29125,,,,,N/A,N/A,"APPLICATION SPLINT,FOREARM  ~P",$79.71,$59.25,$36.49,$93.00,$36.49,$90.21,$36.49,$79.52,$36.49,$70.50,$36.49,$90.21,$36.49,$93.00,$36.49,$36.49,$90.21
2913045B,0983,29130,,,,,N/A,N/A,APPLICATION OF FINGER SPLINT~P,$55.49,$41.25,$26.65,$65.00,$26.65,$63.05,$26.65,$55.58,$26.65,$50.99,$26.65,$63.05,$26.65,$65.00,$26.65,$26.65,$63.05
2934545B,0983,29345,,,,,N/A,N/A,"APPLICATION CAST, LONG LEG  ~P",$189.68,$141.00,$96.35,$235.00,$96.35,$227.95,$96.35,$200.93,$96.35,$175.91,$96.35,$227.95,$96.35,$235.00,$96.35,$96.35,$227.95
2936545B,0983,29365,,,,,N/A,N/A,APPLICATION LONG LEG CAST   ~P,$164.46,$122.25,$153.10,$204.00,N/A,$197.88,N/A,$174.42,N/A,$153.10,N/A,$197.88,N/A,$204.00,N/A,N/A,$197.88
2940545B,0983,29405,,,,,N/A,N/A,"APPLICATION CAST,SHORT LEG  ~P",$120.06,$89.25,$12.90,$150.00,$12.90,$145.50,$12.90,$128.25,$12.90,$103.99,$12.90,$145.50,$12.90,$150.00,$12.90,$12.90,$145.50
2942545B,0983,29425,,,,,N/A,N/A,APPLY SHORT LEG CAST        ~P,$131.16,$97.50,$53.30,$130.00,$53.30,$126.10,$53.30,$111.15,$53.30,$97.25,$53.30,$126.10,$53.30,$130.00,$53.30,$53.30,$126.10
2950545B,0983,29505,,,,,N/A,N/A,APPLICATION OF SPLINT       ~P,$100.89,$75.00,$41.00,$100.00,$41.00,$97.00,$41.00,$85.50,$41.00,$91.41,$41.00,$97.00,$41.00,$100.00,$41.00,$41.00,$97.00
2951545B,0983,29515,,,,,N/A,N/A,"APPLICATION SPLINT,LOWER LEG~P",$93.83,$69.75,$46.74,$114.00,$46.74,$110.58,$46.74,$97.47,$46.74,$86.92,$46.74,$110.58,$46.74,$114.00,$46.74,$46.74,$110.58
2958040B,0983,29580,,,,,N/A,N/A,UNNA BOOT                   ~P,$89.80,$66.75,$36.49,$89.00,$36.49,$86.33,$36.49,$76.10,$36.49,$46.77,$36.49,$86.33,$36.49,$89.00,$36.49,$36.49,$86.33
2958140B,0983,29581,,,,,N/A,N/A,APPLY MULTLAY COMPRS LWR LEG~P,$96.86,$72.00,$39.36,$96.00,$39.36,$93.12,$39.36,$82.08,$39.36,$49.74,$39.36,$93.12,$39.36,$96.00,$39.36,$39.36,$93.12
2958145B,0983,29581,,,,,N/A,N/A,APPLY MULTLAY COMPRS LWR LEG~P,$96.86,$72.00,$39.36,$96.00,$39.36,$93.12,$39.36,$82.08,$39.36,$49.74,$39.36,$93.12,$39.36,$96.00,$39.36,$39.36,$93.12
2970545B,0983,29705,,,,,N/A,N/A,REM FULL ARM/LEG CAST       ~P,$110.98,$82.50,$51.25,$125.00,$51.25,$121.25,$51.25,$106.88,$51.25,$80.72,$51.25,$121.25,$51.25,$125.00,$51.25,$51.25,$121.25
2973045B,0983,29730,,,,,N/A,N/A,REMOVAL OF SMALL INTESTINE  ~P,$108.97,$81.00,$77.57,$108.00,N/A,$104.76,N/A,$92.34,N/A,$77.57,N/A,$104.76,N/A,$108.00,N/A,N/A,$104.76
2980545B,0983,29805,,,,,N/A,N/A,SHOULDER ARTHROSCOPY DX     ~P,"$1,099.74",$817.50,$446.90,"$1,090.00",$446.90,"$1,057.30",$446.90,$931.95,$446.90,$844.40,$446.90,"$1,057.30",$446.90,"$1,090.00",$446.90,$446.90,"$1,057.30"
2980645B,0983,29806,,,,,N/A,N/A,SHOULDER ARTHROSCOPY/SURGERY~P,"$2,400.27","$1,784.25",$991.79,"$2,419.00",$991.79,"$2,346.43",$991.79,"$2,068.25",$991.79,"$1,882.69",$991.79,"$2,346.43",$991.79,"$2,419.00",$991.79,$991.79,"$2,346.43"
2980745B,0983,29807,,,,,N/A,N/A,SHOULDER ARTHROSCOPY/SURGERY~P,"$2,320.56","$1,725.00",$966.37,"$2,357.00",$966.37,"$2,286.29",$966.37,"$2,015.24",$966.37,"$1,840.50",$966.37,"$2,286.29",$966.37,"$2,357.00",$966.37,$966.37,"$2,286.29"
2981945B,0983,29819,,,,,N/A,N/A,SHOULDER ARTHROSCOPY/SURG   ~P,"$1,311.62",$975.00,$558.10,"$1,361.00",$558.10,"$1,320.17",$558.10,"$1,163.66",$558.10,"$1,053.07",$558.10,"$1,320.17",$558.10,"$1,361.00",$558.10,$558.10,"$1,320.17"
2982045B,0983,29820,,,,,N/A,N/A,SHOULDER ARTHROSCOPY/SURGERY~P,"$1,210.73",$900.00,$514.55,"$1,255.00",$514.55,"$1,217.35",$514.55,"$1,073.03",$514.55,$963.35,$514.55,"$1,217.35",$514.55,"$1,255.00",$514.55,$514.55,"$1,217.35"
2982245B,0983,29822,,,,,N/A,N/A,"DEBRIDEMENT,LIMITED         ~P","$1,150.19",$855.00,$467.40,"$1,140.00",$467.40,"$1,105.80",$467.40,$974.70,$467.40,$970.19,$467.40,"$1,105.80",$467.40,"$1,140.00",$467.40,$467.40,"$1,105.80"
2982345B,0983,29823,,,,,N/A,N/A,"DEBRIDEMENT, EXTENSIVE      ~P","$1,257.14",$934.50,$51.86,"$1,246.00",$51.86,"$1,208.62",$51.86,"$1,065.33",$51.86,"$1,060.96",$51.86,"$1,208.62",$51.86,"$1,246.00",$51.86,$51.86,"$1,208.62"
2982445B,0983,29824,,,,,N/A,N/A,SHOULDER ARTHROSCOPY/SURGERY~P,"$1,442.78","$1,072.50",$61.49,"$1,489.00",$61.49,"$1,444.33",$61.49,"$1,273.10",$61.49,"$1,210.58",$61.49,"$1,444.33",$61.49,"$1,489.00",$61.49,$61.49,"$1,444.33"
2982545B,0983,29825,,,,,N/A,N/A,SHOULDER ARTHROSCOPY/SURGERY~P,"$1,311.62",$975.00,$556.78,"$1,358.00",$556.78,"$1,317.26",$556.78,"$1,161.09",$556.78,"$1,052.71",$556.78,"$1,317.26",$556.78,"$1,358.00",$556.78,$556.78,"$1,317.26"
2982645B,0983,29826,,,,,N/A,N/A,SHOULDER ARTHROSCOPY SURGERY~P,"$1,576.97","$1,172.25",$64.83,$64.83,$64.83,N/A,$64.83,N/A,$64.83,N/A,$64.83,N/A,$64.83,N/A,$64.83,$64.83,N/A
2982745B,0983,29827,,,,,N/A,N/A,ARTHO PROC W/ROT CUFF REPAIR~P,"$2,134.92","$1,587.00",$867.56,"$2,116.00",$867.56,"$2,052.52",$867.56,"$1,809.18",$867.56,"$1,902.15",$867.56,"$2,052.52",$867.56,"$2,116.00",$867.56,$867.56,"$2,052.52"
2982845B,0983,29828,,,,,N/A,N/A,ARTHROSCOPY SHOULDER BICEPS ~P,"$1,715.20","$1,275.00",$727.75,"$1,775.00",$727.75,"$1,721.75",$727.75,"$1,517.63",$727.75,"$1,633.34",$727.75,"$1,721.75",$727.75,"$1,775.00",$727.75,$727.75,"$1,721.75"
2983745B,0983,29837,,,,,N/A,N/A,ELBOW ARTHROSCOPY/SURGERY   ~P,"$1,204.67",$895.50,$53.89,"$1,229.00",$53.89,"$1,192.13",$53.89,"$1,050.80",$53.89,$946.39,$53.89,"$1,192.13",$53.89,"$1,229.00",$53.89,$53.89,"$1,192.13"
2984845B,0983,29848,,,,,N/A,N/A,WRIST ENDOSCOPY SURGERY     ~P,"$1,046.27",$777.75,$425.17,"$1,037.00",$425.17,"$1,005.89",$425.17,$886.64,$425.17,$916.72,$425.17,"$1,005.89",$425.17,"$1,037.00",$425.17,$425.17,"$1,005.89"
2986245B,0983,29862,,,,,N/A,N/A,HIP ARTHROSCOPY/SURGERY     ~P,"$1,757.57","$1,306.50",$714.22,"$1,742.00",$714.22,"$1,689.74",$714.22,"$1,489.41",$714.22,"$1,452.19",$714.22,"$1,689.74",$714.22,"$1,742.00",$714.22,$714.22,"$1,689.74"
2986345B,0983,29863,,,,,N/A,N/A,HIP ARTHROSCOPY/SURGERY     ~P,"$1,743.45","$1,296.00",$78.48,"$1,728.00",$78.48,"$1,676.16",$78.48,"$1,477.44",$78.48,"$1,449.40",$78.48,"$1,676.16",$78.48,"$1,728.00",$78.48,$78.48,"$1,676.16"
2986845B,0983,29868,,,,,N/A,N/A,"MENISCAL TRNSPL, KNEE W/SCPE~P","$3,884.42","$2,887.50","$1,578.50","$3,850.00","$1,578.50","$3,734.50","$1,578.50","$3,291.75","$1,578.50","$2,956.01","$1,578.50","$3,734.50","$1,578.50","$3,850.00","$1,578.50","$1,578.50","$3,734.50"
2987045B,0983,29870,,,,,N/A,N/A,KNEE ARTHROSCOPY DX         ~P,$761.75,$566.25,$384.58,$928.00,$384.58,$900.16,$384.58,$793.44,$384.58,$728.83,$384.58,$900.16,$384.58,$928.00,$384.58,$384.58,$900.16
2987145B,0983,29871,,,,,N/A,N/A,KNEE ARTHROSCOPY/DRAINAGE   ~P,"$1,184.50",$880.50,$481.34,"$1,174.00",$481.34,"$1,138.78",$481.34,"$1,003.77",$481.34,$920.81,$481.34,"$1,138.78",$481.34,"$1,174.00",$481.34,$481.34,"$1,138.78"
2987345B,0983,29873,,,,,N/A,N/A,KNEE ARTHROSCOPY/SURGERY    ~P,"$1,191.56",$885.75,$484.21,"$1,181.00",$484.21,"$1,145.57",$484.21,"$1,009.75",$484.21,$962.09,$484.21,"$1,145.57",$484.21,"$1,181.00",$484.21,$484.21,"$1,145.57"
2987445B,0983,29874,,,,,N/A,N/A,KNEE ARTHROSCOPY/SURGERY    ~P,"$1,245.03",$925.50,$55.94,"$1,234.00",$55.94,"$1,196.98",$55.94,"$1,055.07",$55.94,$961.46,$55.94,"$1,196.98",$55.94,"$1,234.00",$55.94,$55.94,"$1,196.98"
2987545B,0983,29875,,,,,N/A,N/A,KNEE ARTHROSCOPY/SURGERY    ~P,"$1,210.73",$900.00,$492.00,"$1,200.00",$492.00,"$1,164.00",$492.00,"$1,026.00",$492.00,$889.47,$492.00,"$1,164.00",$492.00,"$1,200.00",$492.00,$492.00,"$1,164.00"
2987645B,0983,29876,,,,,N/A,N/A,KNEE ARTHROSCOPY/SURGERY    ~P,"$1,423.61","$1,058.25",$578.51,"$1,411.00",$578.51,"$1,368.67",$578.51,"$1,206.40",$578.51,"$1,167.18",$578.51,"$1,368.67",$578.51,"$1,411.00",$578.51,$578.51,"$1,368.67"
2987745B,0983,29877,,,,,N/A,N/A,KNEE ARTHROSCOPY/SURGERY    ~P,"$1,342.90",$998.25,$545.71,"$1,331.00",$545.71,"$1,291.07",$545.71,"$1,138.01",$545.71,"$1,111.07",$545.71,"$1,291.07",$545.71,"$1,331.00",$545.71,$545.71,"$1,291.07"
2987945B,0983,29879,,,,,N/A,N/A,KNEE ARTHROSCOPY/SURGERY    ~P,"$1,446.82","$1,075.50",$587.94,"$1,434.00",$587.94,"$1,390.98",$587.94,"$1,226.07",$587.94,"$1,181.45",$587.94,"$1,390.98",$587.94,"$1,434.00",$587.94,$587.94,"$1,390.98"
2988045B,0983,29880,,,,,N/A,N/A,KNEE ARTHROSCOPY/SURGERY    ~P,"$1,513.41","$1,125.00",$615.00,"$1,500.00",$615.00,"$1,455.00",$615.00,"$1,282.50",$615.00,"$1,006.29",$615.00,"$1,455.00",$615.00,"$1,500.00",$615.00,$615.00,"$1,455.00"
2988145B,0983,29881,,,,,N/A,N/A,KNEE ARTHROSCOPY/SURGERY    ~P,"$1,816.09","$1,350.00",$738.00,"$1,800.00",$738.00,"$1,746.00",$738.00,"$1,539.00",$738.00,$970.82,$738.00,"$1,746.00",$738.00,"$1,800.00",$738.00,$738.00,"$1,746.00"
2988345B,0983,29883,,,,,N/A,N/A,KNEE ARTHROSCOPY/SURGERY    ~P,"$1,869.57","$1,389.75",$78.23,"$1,903.00",$78.23,"$1,845.91",$78.23,"$1,627.07",$78.23,"$1,494.00",$78.23,"$1,845.91",$78.23,"$1,903.00",$78.23,$78.23,"$1,845.91"
2988445B,0983,29884,,,,,N/A,N/A,KNEE ARTHROSCOPY/SURGERY    ~P,"$1,336.85",$993.75,$543.25,"$1,325.00",$543.25,"$1,285.25",$543.25,"$1,132.88",$543.25,"$1,106.94",$543.25,"$1,285.25",$543.25,"$1,325.00",$543.25,$543.25,"$1,285.25"
2988745B,0983,29887,,,,,N/A,N/A,KNEE ARTHROSCOPY/SURGERY    ~P,"$1,618.34","$1,203.00",$657.64,"$1,604.00",$657.64,"$1,555.88",$657.64,"$1,371.42",$657.64,"$1,343.27",$657.64,"$1,555.88",$657.64,"$1,604.00",$657.64,$657.64,"$1,555.88"
2988845B,0983,29888,,,,,N/A,N/A,KNEE ARTHROSCOPY/SURGERY    ~P,"$2,308.45","$1,716.00",$938.80,"$2,288.00",$938.80,"$2,219.36",$938.80,"$1,956.24",$938.80,"$1,739.99",$938.80,"$2,219.36",$938.80,"$2,288.00",$938.80,$938.80,"$2,219.36"
2988945B,0983,29889,,,,,N/A,N/A,KNEE ARTHROSCOPY/SURGERY    ~P,"$2,717.08","$2,019.75",$114.13,"$2,693.00",$114.13,"$2,612.21",$114.13,"$2,302.52",$114.13,"$2,174.96",$114.13,"$2,612.21",$114.13,"$2,693.00",$114.13,$114.13,"$2,612.21"
2989145B,0983,29891,,,,,N/A,N/A,ANKLE ARTHROSCOPY/SURGERY   ~P,"$1,514.42","$1,125.75",$615.41,"$1,501.00",$615.41,"$1,455.97",$615.41,"$1,283.36",$615.41,"$1,200.24",$615.41,"$1,455.97",$615.41,"$1,501.00",$615.41,$615.41,"$1,455.97"
2989545B,0983,29895,,,,,N/A,N/A,ANKLE ARTHROSCOPY/SURGERY   ~P,"$1,187.52",$882.75,$482.57,"$1,177.00",$482.57,"$1,141.69",$482.57,"$1,006.34",$482.57,$838.17,$482.57,"$1,141.69",$482.57,"$1,177.00",$482.57,$482.57,"$1,141.69"
2989745B,0983,29897,,,,,N/A,N/A,ANKLE ARTHROSCOPY/SURGERY   ~P,"$1,244.02",$924.75,$55.53,"$1,233.00",$55.53,"$1,196.01",$55.53,"$1,054.22",$55.53,$888.00,$55.53,"$1,196.01",$55.53,"$1,233.00",$55.53,$55.53,"$1,196.01"
2989845B,0983,29898,,,,,N/A,N/A,ANKLE ARTHROSCOPY/SURGERY   ~P,"$1,383.26","$1,028.25","$1,003.11","$1,371.00",N/A,"$1,329.87",N/A,"$1,172.21",N/A,"$1,003.11",N/A,"$1,329.87",N/A,"$1,371.00",N/A,N/A,"$1,329.87"
2991445B,0983,29914,,,,,N/A,N/A,ARTHROSCOPY HIP W/FEMORO    ~P,"$1,983.58","$1,474.50",$86.60,"$1,966.00",$86.60,"$1,907.02",$86.60,"$1,680.93",$86.60,"$1,774.20",$86.60,"$1,907.02",$86.60,"$1,966.00",$86.60,$86.60,"$1,907.02"
2991545B,0983,29915,,,,,N/A,N/A,ARTHROSCOPY HIP W/ACETABULOP~P,"$2,020.91","$1,502.25",$821.23,"$2,003.00",$821.23,"$1,942.91",$821.23,"$1,712.57",$821.23,"$1,816.29",$821.23,"$1,942.91",$821.23,"$2,003.00",$821.23,$821.23,"$1,942.91"
2991645B,0983,29916,,,,,N/A,N/A,ARTHROSCOPY HIP W/LABRAL REP~P,"$2,020.91","$1,502.25",$821.23,"$2,003.00",$821.23,"$1,942.91",$821.23,"$1,712.57",$821.23,"$1,817.11",$821.23,"$1,942.91",$821.23,"$2,003.00",$821.23,$821.23,"$1,942.91"
3150040B,0983,31500,,,,,N/A,N/A,INTROD INTUBATION           ~P,$153.36,$114.00,$62.32,"$1,667.00",$62.32,"$1,616.99",$62.32,"$1,425.29",$62.32,$210.87,$62.32,"$1,616.99",$62.32,"$1,667.00",$62.32,$62.32,"$1,616.99"
3157640B,0983,31576,,,,,N/A,N/A,LARYNGOSCOPY WITH BIOPSY    ~P,$305.71,$227.25,$124.23,$303.00,$124.23,$293.91,$124.23,$259.07,$124.23,$176.20,$124.23,$293.91,$124.23,$303.00,$124.23,$124.23,$293.91
3160540B,0983,31605,,,,,N/A,N/A,INCISION OF WINDPIPE        ~P,$431.83,$321.00,$185.73,$488.64,$185.73,$439.41,$185.73,$387.32,$185.73,$488.64,$185.73,$439.41,$185.73,$453.00,$185.73,$185.73,$439.41
3162240B,0983,31622,,,,,N/A,N/A,ENDOSCOPY LUNG              ~P,$362.21,$269.25,$197.53,$359.00,N/A,$348.23,N/A,$306.95,N/A,$197.53,N/A,$348.23,N/A,$359.00,N/A,N/A,$348.23
3162340B,0983,31623,,,,,N/A,N/A,ENDOSCOPY OF LUNG           ~P,$378.35,$281.25,$153.75,$375.00,$153.75,$363.75,$153.75,$320.63,$153.75,$199.97,$153.75,$363.75,$153.75,$375.00,$153.75,$153.75,$363.75
3180040B,0983,31800,,,,,N/A,N/A,REPAIR OF WINDPIPE INJURY   ~P,"$1,551.75","$1,153.50",$63.58,"$1,538.00",$63.58,"$1,491.86",$63.58,"$1,314.99",$63.58,"$1,103.15",$63.58,"$1,491.86",$63.58,"$1,538.00",$63.58,$63.58,"$1,491.86"
3255040B,0983,32550,,,,,N/A,N/A,INSERTION OF PLEURAL CATH   ~P,$852.55,$633.75,$354.12,$987.00,$363.67,$957.39,$363.67,$843.89,$363.67,$354.12,$363.67,$957.39,$363.67,$987.00,$363.67,$363.67,$957.39
3255140B,0983,32551,,,,,N/A,N/A,INSERTION OF CHEST TUBE     ~P,$428.80,$318.75,$174.25,$425.00,$174.25,$412.25,$174.25,$363.38,$174.25,$267.10,$174.25,$412.25,$174.25,$425.00,$174.25,$174.25,$412.25
3255240B,0983,32552,,,,,N/A,N/A,REMOVAL CHEST TUBE/CATHETER ~P,$322.86,$240.00,$131.20,$320.00,$131.20,$310.40,$131.20,$273.60,$131.20,$275.07,$131.20,$310.40,$131.20,$320.00,$131.20,$131.20,$310.40
3255440B,0983,32554,,,,,N/A,N/A,INTRO & REMOVAL THORAQCENT  ~P,"$1,027.10",$763.50,$155.38,"$1,018.00",$417.38,$987.46,$417.38,$870.39,$417.38,$155.38,$417.38,$987.46,$417.38,"$1,018.00",$417.38,$417.38,$987.46
3255540B,0983,32555,,,,,N/A,N/A,THORAQCENTESIS W/IMAG GUIDAN~P,$724.42,$538.50,$192.61,$718.00,$294.38,$696.46,$294.38,$613.89,$294.38,$192.61,$294.38,$696.46,$294.38,$718.00,$294.38,$294.38,$696.46
3255640B,0983,32556,,,,,N/A,N/A,PLEURAL ASP/DRAINAGE        ~P,$762.76,$567.00,$39.96,$756.00,$39.96,$733.32,$39.96,$646.38,$39.96,$213.31,$39.96,$733.32,$39.96,$756.00,$39.96,$39.96,$733.32
3260840B,0983,32608,,,,,N/A,N/A,THORACOSCOPY W/BX NODULE    ~P,$736.53,$547.50,$299.30,$299.30,$299.30,N/A,$299.30,N/A,$299.30,N/A,$299.30,N/A,$299.30,N/A,$299.30,$299.30,N/A
3260940B,0983,32609,,,,,N/A,N/A,THORACO W/BIOPSYIES PLEURA  ~P,$509.51,$378.75,$27.50,$27.50,$27.50,N/A,$27.50,N/A,$27.50,N/A,$27.50,N/A,$27.50,N/A,$27.50,$27.50,N/A
3301640B,0983,33016,,,,,N/A,N/A,PERICARDIUM                 ~P,$403.58,$300.00,$19.65,$19.65,$19.65,N/A,$19.65,N/A,$19.65,N/A,$19.65,N/A,$19.65,N/A,$19.65,$19.65,N/A
3320740B,0983,33207,,,,,N/A,N/A,INSERTION OF HEART PACEMAKER~P,"$1,187.52",$882.75,$482.57,"$1,177.00",$482.57,"$1,141.69",$482.57,"$1,006.34",$482.57,$820.60,$482.57,"$1,141.69",$482.57,"$1,177.00",$482.57,$482.57,"$1,141.69"
3320840B,0983,33208,,,,,N/A,N/A,INSERTION OF HEART PACEMAKER~P,"$1,205.68",$896.25,$489.95,"$1,195.00",$489.95,"$1,159.15",$489.95,"$1,021.73",$489.95,$890.47,$489.95,"$1,159.15",$489.95,"$1,195.00",$489.95,$489.95,"$1,159.15"
3321040B,0983,33210,,,,,N/A,N/A,INSERT/REPLACE TEMP ELECTR  ~P,$354.14,$263.25,$143.91,$351.00,$143.91,$340.47,$143.91,$300.11,$143.91,$275.25,$143.91,$340.47,$143.91,$351.00,$143.91,$143.91,$340.47
3321240B,0983,33212,,,,,N/A,N/A,INSERTION OF PULSE GENERATOR~P,$807.15,$600.00,$554.29,$825.00,N/A,$800.25,N/A,$705.38,N/A,$554.29,N/A,$800.25,N/A,$825.00,N/A,N/A,$800.25
3321640B,0983,33216,,,,,N/A,N/A,INSERTION OF PACEMAKER      ~P,$754.69,$561.00,$36.68,$748.00,$36.68,$725.56,$36.68,$639.54,$36.68,$640.60,$36.68,$725.56,$36.68,$748.00,$36.68,$36.68,$725.56
3322740B,0983,33227,,,,,N/A,N/A,REMOVE&REPLACE PM GEN SINGL~P,$653.79,$486.00,$265.68,$648.00,$265.68,$628.56,$265.68,$554.04,$265.68,$582.47,$265.68,$628.56,$265.68,$648.00,$265.68,$265.68,$628.56
3322840B,0983,33228,,,,,N/A,N/A,REMOVAL OF PACEMAKER DUAL   ~P,$736.53,$547.50,$299.30,$730.00,$299.30,$708.10,$299.30,$624.15,$299.30,$609.24,$299.30,$708.10,$299.30,$730.00,$299.30,$299.30,$708.10
3323440B,0983,33234,,,,,N/A,N/A,REMOVAL OF PACEMAKER        ~P,$978.67,$727.50,$397.70,$970.00,$397.70,$940.90,$397.70,$829.35,$397.70,$834.67,$397.70,$940.90,$397.70,$970.00,$397.70,$397.70,$940.90
3324140B,0983,33241,,,,,N/A,N/A,REMOVE PULSE GENERATOR      ~P,$550.88,$409.50,$234.11,$571.00,$234.11,$553.87,$234.11,$488.21,$234.11,$371.46,$234.11,$553.87,$234.11,$571.00,$234.11,$234.11,$553.87
3520640B,0983,35206,,,,,N/A,N/A,REPR BLOOD VESSEL UPPER EXT~P,"$1,894.79","$1,408.50",$769.98,"$1,878.00",$769.98,"$1,821.66",$769.98,"$1,605.69",$769.98,"$1,321.26",$769.98,"$1,821.66",$769.98,"$1,878.00",$769.98,$769.98,"$1,821.66"
3520740B,0983,35207,,,,,N/A,N/A,REPAIR BLOOD VESSEL LESION  ~P,"$1,614.30","$1,200.00",$675.27,"$1,647.00",$675.27,"$1,597.59",$675.27,"$1,408.19",$675.27,"$1,310.50",$675.27,"$1,597.59",$675.27,"$1,647.00",$675.27,$675.27,"$1,597.59"
3520745B,0983,35207,,,,,N/A,N/A,REPAIR BLOOD VESSEL LESION  ~P,"$1,614.30","$1,200.00",$675.27,"$1,647.00",$675.27,"$1,597.59",$675.27,"$1,408.19",$675.27,"$1,310.50",$675.27,"$1,597.59",$675.27,"$1,647.00",$675.27,$675.27,"$1,597.59"
3522645B,0983,35226,,,,,N/A,N/A,REPAIR BLOOD VESSEL LESION  ~P,"$2,095.57","$1,557.75",$851.57,$851.57,$851.57,N/A,$851.57,N/A,$851.57,N/A,$851.57,N/A,$851.57,N/A,$851.57,$851.57,N/A
3584040B,0983,35840,,,,,N/A,N/A,EX EXPLOR REPAIR REV ABDOMEN~P,"$1,279.34",$951.00,$519.88,"$2,045.11",$519.88,"$1,229.96",$519.88,"$1,084.14",$519.88,"$2,045.11",$519.88,"$1,229.96",$519.88,"$1,268.00",$519.88,$519.88,"$1,229.96"
3614040B,0983,36140,,,,,N/A,N/A,INSERT NEEDLE EXTREM ARTERY~P,$597.29,$444.00,$150.87,$592.00,$242.72,$574.24,$242.72,$506.16,$242.72,$150.87,$242.72,$574.24,$242.72,$592.00,$242.72,$242.72,$574.24
3647140B,0983,36471,,,,,N/A,N/A,INJECTION THERAPY OF VEINS  ~P,$221.97,$165.00,$97.99,$239.00,$97.99,$231.83,$97.99,$204.35,$97.99,$125.22,$97.99,$231.83,$97.99,$239.00,$97.99,$97.99,$231.83
3647540B,0983,36475,,,,,N/A,N/A,DESTRUCTION OF VEINS        ~P,"$3,372.89","$2,507.25",$137.63,"$3,343.00",$137.63,"$3,242.71",$137.63,"$2,858.27",$137.63,$460.12,$137.63,"$3,242.71",$137.63,"$3,343.00",$137.63,$137.63,"$3,242.71"
3655640B,0983,36556,,,,,N/A,N/A,INSERT NON-TUNNEL CV CATH   ~P,$386.42,$287.25,$142.40,$419.00,$171.79,$406.43,$171.79,$358.25,$171.79,$142.40,$171.79,$406.43,$171.79,$419.00,$171.79,$171.79,$406.43
3655840B,0983,36558,,,,,N/A,N/A,INSERT TUNNELED CATHETER    ~P,"$1,050.31",$780.75,$439.20,"$1,041.00",N/A,"$1,009.77",N/A,$890.06,N/A,$439.20,N/A,"$1,009.77",N/A,"$1,041.00",N/A,N/A,"$1,009.77"
3656140B,0983,36561,,,,,N/A,N/A,INSERT TUNNELED CV CATH     ~P,"$1,624.39","$1,207.50",$563.14,"$1,755.00",$719.55,"$1,702.35",$719.55,"$1,500.53",$719.55,$563.14,$719.55,"$1,702.35",$719.55,"$1,755.00",$719.55,$719.55,"$1,702.35"
3656940B,0983,36569,,,,,N/A,N/A,Insert Picc Cath            ~p,$220.96,$164.25,$97.58,$230.00,$97.58,$223.10,$97.58,$196.65,$97.58,$158.03,$97.58,$223.10,$97.58,$230.00,$97.58,$97.58,$223.10
3657640B,0983,36576,,,,,N/A,N/A,REPAIR TUNNELED CV CATH     ~P,$528.68,$393.00,$241.90,$590.00,$241.90,$572.30,$241.90,$504.45,$241.90,$309.99,$241.90,$572.30,$241.90,$590.00,$241.90,$241.90,$572.30
3658040B,0983,36580,,,,,N/A,N/A,REPLACE CENT VENOUS CATH    ~P,$484.29,$360.00,$110.91,$480.00,$196.80,$465.60,$196.80,$410.40,$196.80,$110.91,$196.80,$465.60,$196.80,$480.00,$196.80,$196.80,$465.60
3658240B,0983,36582,,,,,N/A,N/A,REPLACEMENT PORT A CATH    ~ P,"$1,813.07","$1,347.75",$485.10,"$1,797.00",$736.77,"$1,743.09",$736.77,"$1,536.44",$736.77,$485.10,$736.77,"$1,743.09",$736.77,"$1,797.00",$736.77,$736.77,"$1,743.09"
3658940B,0983,36589,,,,,N/A,N/A,REMOVAL OF TUNNELED CV CATH ~P,$243.15,$180.75,$25.51,$241.00,$25.51,$233.77,$25.51,$206.06,$25.51,$233.69,$25.51,$233.77,$25.51,$241.00,$25.51,$25.51,$233.77
3659040B,0983,36590,,,,,N/A,N/A,REMVL OF TUNNEL CENT VENOUS ~P,$484.29,$360.00,$196.80,$480.00,$196.80,$465.60,$196.80,$410.40,$196.80,$319.87,$196.80,$465.60,$196.80,$480.00,$196.80,$196.80,$465.60
3659340B,0983,36593,,,,,N/A,N/A,DECLOT VASCULAR DEVICE      ~P,$51.46,$38.25,$25.10,"$1,130.00",$25.10,"$1,096.10",$25.10,$966.15,$25.10,$57.22,$25.10,"$1,096.10",$25.10,"$1,130.00",$25.10,$25.10,"$1,096.10"
3662040B,0983,36620,,,,,N/A,N/A,"INSERTION CATHETER, ARTERY  ~P",$132.17,$98.25,$53.71,$131.00,$53.71,$127.07,$53.71,$112.01,$53.71,$75.19,$53.71,$127.07,$53.71,$131.00,$53.71,$53.71,$127.07
3760940B,0983,37609,,,,,N/A,N/A,LIGATION OR BX TEMP ARTERY  ~P,$472.18,$351.00,$191.88,$468.00,$191.88,$453.96,$191.88,$400.14,$191.88,$344.94,$191.88,$453.96,$191.88,$468.00,$191.88,$191.88,$453.96
3771840B,0983,37718,,,,,N/A,N/A,LIGATE/STRIP SHORT LEG VEIN ~P,$908.05,$675.00,$377.20,$920.00,$377.20,$892.40,$377.20,$786.60,$377.20,$701.60,$377.20,$892.40,$377.20,$920.00,$377.20,$377.20,$892.40
3772240B,0983,37722,,,,,N/A,N/A,LIGATE/STRIP LONG LEG VEIN  ~P,$983.72,$731.25,$399.75,$975.00,$399.75,$945.75,$399.75,$833.63,$399.75,$776.42,$399.75,$945.75,$399.75,$975.00,$399.75,$399.75,$945.75
3776540B,0983,37765,,,,,N/A,N/A,PHLEB VEINS -EXTREM- TO 20  ~P,$817.24,$607.50,$332.10,$810.00,$332.10,$785.70,$332.10,$692.55,$332.10,$448.73,$332.10,$785.70,$332.10,$810.00,$332.10,$332.10,$785.70
3810040B,0983,38100,,,,,N/A,N/A,"REMOVAL OF SPLEEN, TOTAL    ~P","$1,976.51","$1,469.25",$83.19,"$1,959.00",$83.19,"$1,900.23",$83.19,"$1,674.95",$83.19,"$1,925.94",$83.19,"$1,900.23",$83.19,"$1,959.00",$83.19,$83.19,"$1,900.23"
3822140B,0983,38221,,,,,N/A,N/A,BONE MARROW PROC BIOPSY     ~P,$240.13,$178.50,$97.58,$238.00,$97.58,$230.86,$97.58,$203.49,$97.58,$119.68,$97.58,$230.86,$97.58,$238.00,$97.58,$97.58,$230.86
3850040B,0983,38500,,,,,N/A,N/A,BIOPSY OR EXC OF LYMPH NODE ~P,$477.23,$354.75,$193.93,$473.00,$193.93,$458.81,$193.93,$404.42,$193.93,$430.35,$193.93,$458.81,$193.93,$473.00,$193.93,$193.93,$458.81
3850540B,0983,38505,,,,,N/A,N/A,EXC OF LYMPH BY NEEDLE      ~P,$188.67,$140.25,$76.67,$187.00,$76.67,$181.39,$76.67,$159.89,$76.67,$118.57,$76.67,$181.39,$76.67,$187.00,$76.67,$76.67,$181.39
3851040B,0983,38510,,,,,N/A,N/A,"BIOPSY/REMOVAL, LYMPH NODES ~P",$799.08,$594.00,$382.12,$932.00,$382.12,$904.04,$382.12,$796.86,$382.12,$705.14,$382.12,$904.04,$382.12,$932.00,$382.12,$382.12,$904.04
3852540B,0983,38525,,,,,N/A,N/A,"BIOPSY/REMOVAL, LYMPH NODES ~P",$618.48,$459.75,$329.64,$805.00,$329.64,$780.85,$329.64,$688.28,$329.64,$741.20,$329.64,$780.85,$329.64,$805.00,$329.64,$329.64,$780.85
3853140B,0983,38531,,,,,N/A,N/A,BIOPSY/EXCISION             ~P,$807.15,$600.00,$359.16,$876.00,$359.16,$849.72,$359.16,$748.98,$359.16,$750.21,$359.16,$849.72,$359.16,$876.00,$359.16,$359.16,$849.72
3879240B,0983,38792,,,,,N/A,N/A,EXCISION OPN DEEP AXIL NODE ~P,$91.81,$68.25,$41.80,$294.00,$41.80,$285.18,$41.80,$251.37,$41.80,$55.97,$41.80,$285.18,$41.80,$294.00,$41.80,$41.80,$285.18
3890040B,0983,38900,,,,,N/A,N/A,CANNULATION/INJECT/PROC     ~P,$270.40,$201.00,$228.13,$268.00,N/A,$259.96,N/A,$229.14,N/A,$228.13,N/A,$259.96,N/A,$268.00,N/A,N/A,$259.96
3950140B,0983,39501,,,,,N/A,N/A,REPAIR DIAPHRAGM LACERATION ~P,"$1,874.61","$1,393.50",$761.78,"$1,858.00",$761.78,"$1,802.26",$761.78,"$1,588.59",$761.78,"$1,464.65",$761.78,"$1,802.26",$761.78,"$1,858.00",$761.78,$761.78,"$1,802.26"
4083045B,0983,40830,,,,,N/A,N/A,REPAIR MOUTH LACERATION     ~P,$332.95,$247.50,$146.78,$358.00,$146.78,$347.26,$146.78,$306.09,$146.78,$251.48,$146.78,$347.26,$146.78,$358.00,$146.78,$146.78,$347.26
4542000B,0983,42000,,,,,N/A,N/A,DRAINAGE MOUTH ROOF LESION  ~P,$382.39,$284.25,$155.39,$624.00,$155.39,$605.28,$155.39,$533.52,$155.39,$159.98,$155.39,$605.28,$155.39,$624.00,$155.39,$155.39,$605.28
4242040B,0983,42420,,,,,N/A,N/A,EXCISE PAROTID GLAND/LESION ~P,"$2,471.90","$1,837.50",$14.50,"$2,450.00",$14.50,"$2,376.50",$14.50,"$2,094.75",$14.50,"$1,771.70",$14.50,"$2,376.50",$14.50,"$2,450.00",$14.50,$14.50,"$2,376.50"
4321540B,0983,43215,,,,,N/A,N/A,ESOPHAGUS ENDOSCOPY         ~P,$587.20,$436.50,$238.23,$582.00,$238.62,$564.54,$238.62,$497.61,$238.62,$238.23,$238.62,$564.54,$238.62,$582.00,$238.62,$238.62,$564.54
4322040B,0983,43220,,,,,N/A,N/A,ENDO W/TRANS BALLOON DIL    ~P,"$1,640.54","$1,219.50",$200.03,"$1,626.00",$666.66,"$1,577.22",$666.66,"$1,390.23",$666.66,$200.03,$666.66,"$1,577.22",$666.66,"$1,626.00",$666.66,$666.66,"$1,577.22"
4323340B,0983,43233,,,,,N/A,N/A,ENDOSCOPIC PROC W/DILATION  ~P,$472.18,$351.00,$191.88,$468.00,$191.88,$453.96,$191.88,$400.14,$191.88,$386.82,$191.88,$453.96,$191.88,$468.00,$191.88,$191.88,$453.96
4323540B,0983,43235,,,,,N/A,N/A,"UPPER GI ENDOSCOPY, DIAG    ~P",$449.99,$334.50,$182.86,$482.00,$182.86,$467.54,$182.86,$412.11,$182.86,$208.11,$182.86,$467.54,$182.86,$482.00,$182.86,$182.86,$467.54
4323640B,0983,43236,,,,,N/A,N/A,UPPR GI SCOPE W/SUBMUC INJ  ~P,$363.22,$270.00,$158.67,$387.00,$158.67,$375.39,$158.67,$330.89,$158.67,$234.89,$158.67,$375.39,$158.67,$387.00,$158.67,$158.67,$375.39
4323940B,0983,43239,,,,,N/A,N/A,"UPPER GI ENDOSCOPY, BIOPSY  ~P",$531.71,$395.25,$233.70,$570.00,$233.70,$552.90,$233.70,$487.35,$233.70,$234.89,$233.70,$552.90,$233.70,$570.00,$233.70,$233.70,$552.90
4324540B,0983,43245,,,,,N/A,N/A,UPPR GI SCOPE DILATE STRICTR~P,$887.87,$660.00,$36.80,$880.00,$36.80,$853.60,$36.80,$752.40,$36.80,$298.06,$36.80,$853.60,$36.80,$880.00,$36.80,$36.80,$853.60
4324640B,0983,43246,,,,,N/A,N/A,UP ENDOS W/PLCMNT GAST TUBE ~P,$496.40,$369.00,$21.72,$492.00,$21.72,$477.24,$21.72,$420.66,$21.72,$337.72,$21.72,$477.24,$21.72,$492.00,$21.72,$21.72,$477.24
4324740B,0983,43247,,,,,N/A,N/A,OPERATIVE UPPER GI ENOSCOPY ~P,$585.19,$435.00,$237.80,$580.00,$237.80,$562.60,$237.80,$495.90,$237.80,$299.96,$237.80,$562.60,$237.80,$580.00,$237.80,$237.80,$562.60
4324940B,0983,43249,,,,,N/A,N/A,"ESOPH ENDOSCOPY, DILATION   ~P","$1,564.87","$1,163.25",$260.65,"$1,551.00",$635.91,"$1,504.47",$635.91,"$1,326.11",$635.91,$260.65,$635.91,"$1,504.47",$635.91,"$1,551.00",$635.91,$635.91,"$1,504.47"
4325040B,0983,43250,,,,,N/A,N/A,ENDO PROC W/ REMOVAL TUMOR  ~P,$656.82,$488.25,$266.91,$651.00,$266.91,$631.47,$266.91,$556.61,$266.91,$288.19,$266.91,$631.47,$266.91,$651.00,$266.91,$266.91,$631.47
4325140B,0983,43251,,,,,N/A,N/A,ENDOSCOPIC PROC REMOVE TUMOR~P,$721.39,$536.25,$293.15,$715.00,$293.15,$693.55,$293.15,$611.33,$293.15,$332.50,$293.15,$693.55,$293.15,$715.00,$293.15,$293.15,$693.55
4325540B,0983,43255,,,,,N/A,N/A,OPERATIVE UPPER GI ENDOSCOPY~P,$679.02,$504.75,$275.93,$673.00,$275.93,$652.81,$275.93,$575.42,$275.93,$340.31,$275.93,$652.81,$275.93,$673.00,$275.93,$275.93,$652.81
4333240B,0983,43332,,,,,N/A,N/A,TRANSAB ESOPH HIAT HERN RPR ~P,"$2,241.86","$1,666.50",$911.20,"$2,222.00",$911.20,"$2,155.34",$911.20,"$1,899.81",$911.20,"$1,923.18",$911.20,"$2,155.34",$911.20,"$2,222.00",$911.20,$911.20,"$2,155.34"
4350040B,0983,43500,,,,,N/A,N/A,SURGICAL OPENING OF STOMACH ~P,"$1,530.56","$1,137.75",$621.97,"$1,517.00",$621.97,"$1,471.49",$621.97,"$1,297.04",$621.97,"$1,318.05",$621.97,"$1,471.49",$621.97,"$1,517.00",$621.97,$621.97,"$1,471.49"
4350140B,0983,43501,,,,,N/A,N/A,SURGICAL REPAIR OF STOMACH  ~P,"$2,712.03","$2,016.00",$112.80,"$2,688.00",$112.80,"$2,607.36",$112.80,"$2,298.24",$112.80,"$2,257.29",$112.80,"$2,607.36",$112.80,"$2,688.00",$112.80,$112.80,"$2,607.36"
4360540B,0983,43605,,,,,N/A,N/A,BIOPSY OF STOMACH           ~P,"$1,651.63","$1,227.75",$671.17,"$1,637.00",$671.17,"$1,587.89",$671.17,"$1,399.64",$671.17,"$1,406.53",$671.17,"$1,587.89",$671.17,"$1,637.00",$671.17,$671.17,"$1,587.89"
4361140B,0983,43611,,,,,N/A,N/A,GASTRIC INCISIONAL/RESECTION~P,"$2,406.32","$1,788.75",$977.85,"$2,385.00",$977.85,"$2,313.45",$977.85,"$2,039.18",$977.85,"$2,048.98",$977.85,"$2,313.45",$977.85,"$2,385.00",$977.85,$977.85,"$2,313.45"
4363240B,0983,43632,,,,,N/A,N/A,"REMOVAL OF STOMACH, PARTIAL ~P","$3,834.98","$2,850.75","$1,558.41","$3,801.00","$1,558.41","$3,686.97","$1,558.41","$3,249.86","$1,558.41","$3,388.28","$1,558.41","$3,686.97","$1,558.41","$3,801.00","$1,558.41","$1,558.41","$3,686.97"
4375340B,0983,43753,,,,,N/A,N/A,NON SURGICAL GASTRIC TUBE   ~P,$42.38,$31.50,$17.22,$42.00,$17.22,$40.74,$17.22,$35.91,$17.22,$36.73,$17.22,$40.74,$17.22,$42.00,$17.22,$17.22,$40.74
4376240B,0983,43762,,,,,N/A,N/A,REPLACE OF GASTROSTOMY TUBE ~P,$443.93,$330.00,$19.65,$465.00,$19.65,$451.05,$19.65,$397.58,$19.65,$63.34,$19.65,$451.05,$19.65,$465.00,$19.65,$19.65,$451.05
4376340B,0983,43763,,,,,N/A,N/A,REQ REVISION GASTROSTOMY TRA~P,$181.61,$135.00,$73.80,$180.00,$73.80,$174.60,$73.80,$153.90,$73.80,$141.99,$73.80,$174.60,$73.80,$180.00,$73.80,$73.80,$174.60
4383040B,0983,43830,,,,,N/A,N/A,PLACE GASTROSTOMY TUBE      ~P,"$1,369.13","$1,017.75",$556.37,"$1,357.00",$556.37,"$1,316.29",$556.37,"$1,160.24",$556.37,"$1,186.26",$556.37,"$1,316.29",$556.37,"$1,357.00",$556.37,$556.37,"$1,316.29"
4384040B,0983,43840,,,,,N/A,N/A,REPAIR OF STOMACH LESION    ~P,"$2,132.90","$1,585.50",$866.74,"$2,275.04",$866.74,"$2,050.58",$866.74,"$1,807.47",$866.74,"$2,275.04",$866.74,"$2,050.58",$866.74,"$2,114.00",$866.74,$866.74,"$2,050.58"
4400540B,0983,44005,,,,,N/A,N/A,FREEING OF BOWEL ADHESION   ~P,"$2,194.44","$1,631.25",$891.75,"$2,175.00",$891.75,"$2,109.75",$891.75,"$1,859.63",$891.75,"$1,827.76",$891.75,"$2,109.75",$891.75,"$2,175.00",$891.75,$891.75,"$2,109.75"
4402040B,0983,44020,,,,,N/A,N/A,INC ENTEROTOMY SM INTEST    ~P,"$1,361.06","$1,011.75",$553.90,"$1,633.36",$553.90,"$1,308.53",$553.90,"$1,153.40",$553.90,"$1,633.36",$553.90,"$1,308.53",$553.90,"$1,349.00",$553.90,$553.90,"$1,308.53"
4405040B,0983,44050,,,,,N/A,N/A,REDUCE BOWEL OBSTRUCTION    ~P,"$1,910.93","$1,420.50",$776.54,"$1,894.00",$776.54,"$1,837.18",$776.54,"$1,619.37",$776.54,"$1,567.88",$776.54,"$1,837.18",$776.54,"$1,894.00",$776.54,$776.54,"$1,837.18"
4405540B,0983,44055,,,,,N/A,N/A,CORRECT MALROTATION OF BOWEL~P,"$2,938.03","$2,184.00","$1,193.92","$2,912.00","$1,193.92","$2,824.64","$1,193.92","$2,489.76","$1,193.92","$2,487.25","$1,193.92","$2,824.64","$1,193.92","$2,912.00","$1,193.92","$1,193.92","$2,824.64"
4412040B,0983,44120,,,,,N/A,N/A,REMOVAL OF SMALL INTESTINE  ~P,"$2,300.38","$1,710.00",$934.80,"$2,280.00",$934.80,"$2,211.60",$934.80,"$1,949.40",$934.80,"$2,042.68",$934.80,"$2,211.60",$934.80,"$2,280.00",$934.80,$934.80,"$2,211.60"
4412140B,0983,44121,,,,,N/A,N/A,REMOVAL OF SMALL INTESTINE  ~P,$573.08,$426.00,$232.88,$568.00,$232.88,$550.96,$232.88,$485.64,$232.88,$400.81,$232.88,$550.96,$232.88,$568.00,$232.88,$232.88,$550.96
4412540B,0983,44125,,,,,N/A,N/A,EXCISION W/ENTEROSTOMY      ~P,"$1,650.63","$1,227.00",$67.76,"$1,972.68",$67.76,"$1,586.92",$67.76,"$1,398.78",$67.76,"$1,972.68",$67.76,"$1,586.92",$67.76,"$1,636.00",$67.76,$67.76,"$1,586.92"
4413040B,0983,44130,,,,,N/A,N/A,BOWEL TO BOWEL FUSION       ~P,"$1,976.51","$1,469.25",$83.19,"$2,202.29",$83.19,"$1,900.23",$83.19,"$1,674.95",$83.19,"$2,202.29",$83.19,"$1,900.23",$83.19,"$1,959.00",$83.19,$83.19,"$1,900.23"
4413940B,0983,44139,,,,,N/A,N/A,MOBILIAZTION OF SPLENIC     ~P,$229.03,$170.25,$93.70,$227.00,$93.70,$220.19,$93.70,$194.09,$93.70,$200.32,$93.70,$220.19,$93.70,$227.00,$93.70,$93.70,$220.19
4414040B,0983,44140,,,,,N/A,N/A,PARTIAL REMOVAL OF COLON    ~P,"$2,832.09","$2,105.25",$115.87,"$2,807.00",$115.87,"$2,722.79",$115.87,"$2,399.99",$115.87,"$2,246.58",$115.87,"$2,722.79",$115.87,"$2,807.00",$115.87,$115.87,"$2,722.79"
4414140B,0983,44141,,,,,N/A,N/A,COLON RESECT W/SKIN COLOS   ~P,"$3,612.01","$2,685.00","$1,467.80","$3,580.00","$1,467.80","$3,472.60","$1,467.80","$3,060.90","$1,467.80","$3,054.98","$1,467.80","$3,472.60","$1,467.80","$3,580.00","$1,467.80","$1,467.80","$3,472.60"
4414340B,0983,44143,,,,,N/A,N/A,COLON RESECTION w/END COLOST~P,"$3,289.14","$2,445.00","$1,336.60","$3,260.00","$1,336.60",N/A,"$1,336.60","$2,787.30","$1,336.60","$2,783.08","$1,336.60",N/A,"$1,336.60","$3,260.00","$1,336.60","$1,336.60",N/A
4414440B,0983,44144,,,,,N/A,N/A,COLON RESECTION PROCEDURE   ~P,"$3,499.00","$2,601.00","$1,421.88","$3,468.00","$1,421.88","$3,363.96","$1,421.88","$2,965.14","$1,421.88","$2,956.79","$1,421.88","$3,363.96","$1,421.88","$3,468.00","$1,421.88","$1,421.88","$3,363.96"
4414540B,0983,44145,,,,,N/A,N/A,PARTIAL REMOVAL OF COLON    ~P,"$3,147.89","$2,340.00","$1,279.20","$3,120.00","$1,279.20","$3,026.40","$1,279.20","$2,667.60","$1,279.20","$2,763.00","$1,279.20","$3,026.40","$1,279.20","$3,120.00","$1,279.20","$1,279.20","$3,026.40"
4415040B,0983,44150,,,,,N/A,N/A,REMOVAL OF COLON            ~P,"$3,577.70","$2,659.50","$1,453.86","$3,546.00","$1,453.86","$3,439.62","$1,453.86","$3,031.83","$1,453.86","$3,128.14","$1,453.86","$3,439.62","$1,453.86","$3,546.00","$1,453.86","$1,453.86","$3,439.62"
4416040B,0983,44160,,,,,N/A,N/A,REMOVAL OF COLON            ~P,"$2,517.31","$1,871.25",$122.95,"$2,495.00",$122.95,"$2,420.15",$122.95,"$2,133.23",$122.95,"$2,077.94",$122.95,"$2,420.15",$122.95,"$2,495.00",$122.95,$122.95,"$2,420.15"
4418040B,0983,44180,,,,,N/A,N/A,"LAPARO, SURG, ENTEROLYSIS   ~P","$1,727.31","$1,284.00",$71.92,"$1,712.00",$71.92,"$1,660.64",$71.92,"$1,463.76",$71.92,"$1,541.10",$71.92,"$1,660.64",$71.92,"$1,712.00",$71.92,$71.92,"$1,660.64"
4418840B,0983,44188,,,,,N/A,N/A,LAP COLOSTOMY               ~P,"$2,441.63","$1,815.00",$992.20,"$2,420.00",$992.20,"$2,347.40",$992.20,"$2,069.10",$992.20,"$2,055.70",$992.20,"$2,347.40",$992.20,"$2,420.00",$992.20,$992.20,"$2,347.40"
4420240B,0983,44202,,,,,N/A,N/A,LAP ENTEROSTOMY PROCEDURE   ~P,"$2,738.26","$2,035.50","$1,112.74","$2,714.00","$1,112.74","$2,632.58","$1,112.74","$2,320.47","$1,112.74","$2,318.59","$1,112.74","$2,632.58","$1,112.74","$2,714.00","$1,112.74","$1,112.74","$2,632.58"
4420440B,0983,44204,,,,,N/A,N/A,LAPARO PARTIAL COLECTOMY    ~P,"$2,156.10","$1,602.75","$2,072.89","$2,571.24",N/A,"$2,072.89",N/A,"$1,827.14",N/A,"$2,571.24",N/A,"$2,072.89",N/A,"$2,137.00",N/A,N/A,"$2,072.89"
4420540B,0983,44205,,,,,N/A,N/A,COLECTOMY                   ~P,"$2,659.57","$1,977.00",$18.76,"$2,636.00",$18.76,"$2,556.92",$18.76,"$2,253.78",$18.76,"$2,236.50",$18.76,"$2,556.92",$18.76,"$2,636.00",$18.76,$18.76,"$2,556.92"
4420640B,0983,44206,,,,,N/A,N/A,LAP PART COLECTOMY W/STOMA  ~P,"$3,652.36","$2,715.00","$1,484.20","$3,620.00","$1,484.20","$3,511.40","$1,484.20","$3,095.10","$1,484.20","$2,925.76","$1,484.20","$3,511.40","$1,484.20","$3,620.00","$1,484.20","$1,484.20","$3,511.40"
4420740B,0983,44207,,,,,N/A,N/A,COLOECTOMY PART W/ANASTOM   ~P,"$3,634.20","$2,701.50","$1,476.82","$3,602.00","$1,476.82","$3,493.94","$1,476.82","$3,079.71","$1,476.82","$3,034.95","$1,476.82","$3,493.94","$1,476.82","$3,602.00","$1,476.82","$1,476.82","$3,493.94"
4421340B,0983,44213,,,,,N/A,N/A,LAP ENTEROSTOMY PROCEDURE   ~P,$379.36,$282.00,$154.16,$376.00,$154.16,$364.72,$154.16,$321.48,$154.16,$311.48,$154.16,$364.72,$154.16,$376.00,$154.16,$154.16,$364.72
4422740B,0983,44227,,,,,N/A,N/A,LAP ENTEROSTOMY PROC        ~P,"$3,302.26","$2,454.75","$2,780.56","$3,273.00",N/A,"$3,174.81",N/A,"$2,798.42",N/A,"$2,780.56",N/A,"$3,174.81",N/A,"$3,273.00",N/A,N/A,"$3,174.81"
4431040B,0983,44310,,,,,N/A,N/A,ILEOSTOMY/JEJUNOSTOMY       ~P,"$2,118.77","$1,575.00",$878.22,"$2,142.00",$878.22,"$2,077.74",$878.22,"$1,831.41",$878.22,"$1,743.30",$878.22,"$2,077.74",$878.22,"$2,142.00",$878.22,$878.22,"$2,077.74"
4431240B,0983,44312,,,,,N/A,N/A,REVISION OF ILEOSTOMY       ~P,"$1,109.83",$825.00,$464.12,"$1,132.00",$464.12,"$1,098.04",$464.12,$967.86,$464.12,"$1,006.54",$464.12,"$1,098.04",$464.12,"$1,132.00",$464.12,$464.12,"$1,098.04"
4432040B,0983,44320,,,,,N/A,N/A,COLOSTOMY                   ~P,"$2,614.16","$1,943.25",$162.31,"$2,591.00",$162.31,"$2,513.27",$162.31,"$2,215.31",$162.31,"$2,013.77",$162.31,"$2,513.27",$162.31,"$2,591.00",$162.31,$162.31,"$2,513.27"
4434640B,0983,44346,,,,,N/A,N/A,OPEN ENTEROSTOMY PROCEDURE  ~P,"$2,377.06","$1,767.00",$965.96,"$2,356.00",$965.96,"$2,285.32",$965.96,"$2,014.38",$965.96,"$1,985.81",$965.96,"$2,285.32",$965.96,"$2,356.00",$965.96,$965.96,"$2,285.32"
4438640B,0983,44386,,,,,N/A,N/A,"ENDOSCOPY, BOWEL POUCH/BIOP ~P",$262.32,$195.00,$150.67,$282.00,N/A,$273.54,N/A,$241.11,N/A,$150.67,N/A,$273.54,N/A,$282.00,N/A,N/A,$273.54
4438840B,0983,44388,,,,,N/A,N/A,COLONSCOPY THROUGH STOMA    ~P,$456.04,$339.00,$185.32,$452.00,$185.32,$438.44,$185.32,$386.46,$185.32,$263.98,$185.32,$438.44,$185.32,$452.00,$185.32,$185.32,$438.44
4438940B,0983,44389,,,,,N/A,N/A,ENDOSCOPY WITH BIOPSY       ~P,$560.97,$417.00,$227.96,$556.00,$227.96,$539.32,$227.96,$475.38,$227.96,$291.29,$227.96,$539.32,$227.96,$556.00,$227.96,$227.96,$539.32
4439440B,0983,44394,,,,,N/A,N/A,REMOVAL OF TUMOR BY SNARE   ~P,$705.25,$524.25,$286.59,$699.00,$286.59,$678.03,$286.59,$597.65,$286.59,$381.00,$286.59,$678.03,$286.59,$699.00,$286.59,$286.59,$678.03
4440440B,0983,44404,,,,,N/A,N/A,COLONOSCOPY W/INJECTION     ~P,$893.92,$664.50,$290.94,$886.00,$363.26,$859.42,$363.26,$757.53,$363.26,$290.94,$363.26,$859.42,$363.26,$886.00,$363.26,$363.26,$859.42
4460240B,0983,44602,,,,,N/A,N/A,SUTURE OF SM INTESTINE      ~G,"$2,623.24","$1,950.00",$166.00,"$2,600.00",$166.00,"$2,522.00",$166.00,"$2,223.00",$166.00,"$2,349.64",$166.00,"$2,522.00",$166.00,"$2,600.00",$166.00,$166.00,"$2,522.00"
4460340B,0983,44603,,,,,N/A,N/A,"SUTURE, SMALL INTESTINE     ~P","$3,253.83","$2,418.75","$1,322.25","$3,225.00","$1,322.25","$3,128.25","$1,322.25","$2,757.38","$1,322.25","$2,704.19","$1,322.25","$3,128.25","$1,322.25","$3,225.00","$1,322.25","$1,322.25","$3,128.25"
4460440B,0983,44604,,,,,N/A,N/A,SUTURE OF LARGE INTESTINE   ~P,"$1,472.04","$1,094.25",$598.19,"$1,768.11",$598.19,"$1,415.23",$598.19,"$1,247.45",$598.19,"$1,768.11",$598.19,"$1,415.23",$598.19,"$1,459.00",$598.19,$598.19,"$1,415.23"
4462040B,0983,44620,,,,,N/A,N/A,REPAIR BOWEL OPENING        ~P,"$1,476.08","$1,097.25",$599.83,"$1,463.00",$599.83,"$1,419.11",$599.83,"$1,250.87",$599.83,"$1,452.50",$599.83,"$1,419.11",$599.83,"$1,463.00",$599.83,$599.83,"$1,419.11"
4462540B,0983,44625,,,,,N/A,N/A,REPAIR W/RESEC & ANASTOM    ~P,"$1,916.99","$1,425.00",$779.00,"$1,900.00",$779.00,"$1,843.00",$779.00,"$162,450.00",$779.00,"$1,697.74",$779.00,"$1,843.00",$779.00,"$1,900.00",$779.00,$779.00,"$1,843.00"
4464040B,0983,44640,,,,,N/A,N/A,CLOS OF INTSTNL CUTNS FSTL  ~P,"$2,637.37","$1,960.50",$171.74,"$2,614.00",$171.74,"$2,535.58",$171.74,"$2,234.97",$171.74,"$2,335.57",$171.74,"$2,535.58",$171.74,"$2,614.00",$171.74,$171.74,"$2,535.58"
4466040B,0983,44660,,,,,N/A,N/A,REPAIR BOWEL-BLADDER FISTU  ~P,"$2,813.93","$2,091.75","$1,143.49","$2,789.00","$1,143.49","$2,705.33","$1,143.49","$2,384.60","$1,143.49","$2,246.06","$1,143.49","$2,705.33","$1,143.49","$2,789.00","$1,143.49","$1,143.49","$2,705.33"
4470140B,0983,44701,,,,,N/A,N/A,INTESTINAL PROCEDURE        ~P,$330.93,$246.00,$134.48,$328.00,$134.48,$318.16,$134.48,$280.44,$134.48,$280.73,$134.48,$318.16,$134.48,$328.00,$134.48,$134.48,$318.16
4479940B,0983,44799,,,,,N/A,N/A,Unlisted Procedure Intestine~p,$0.00,$0.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4485040B,0983,44850,,,,,N/A,N/A,REPAIR OF MESENTERY         ~P,"$1,460.95","$1,086.00",$61.80,"$1,488.00",$61.80,"$1,443.36",$61.80,"$1,272.24",$61.80,"$1,255.57",$61.80,"$1,443.36",$61.80,"$1,488.00",$61.80,$61.80,"$1,443.36"
4495040B,0983,44950,,,,,N/A,N/A,APPENDECTOMY                ~P,$896.95,$666.75,$364.49,"$1,078.45",$364.49,$862.33,$364.49,$760.10,$364.49,"$1,078.45",$364.49,$862.33,$364.49,$889.00,$364.49,$364.49,$862.33
4495540B,0983,44955,,,,,N/A,N/A,APPENDECTOMY ADD-ON         ~P,$218.94,$162.75,$88.97,$217.00,$88.97,$210.49,$88.97,$185.54,$88.97,$138.96,$88.97,$210.49,$88.97,$217.00,$88.97,$88.97,$210.49
4496040B,0983,44960,,,,,N/A,N/A,APPENDECTOMY                ~P,"$1,689.97","$1,256.25",$686.75,"$1,675.00",$686.75,"$1,624.75",$686.75,"$1,432.13",$686.75,"$1,470.11",$686.75,"$1,624.75",$686.75,"$1,675.00",$686.75,$686.75,"$1,624.75"
4497040B,0983,44970,,,,,N/A,N/A,"LAPAROSCOPY, APPENDECTOMY   ~P","$1,221.83",$908.25,$496.51,"$1,211.00",$496.51,"$1,174.67",$496.51,"$1,035.41",$496.51,"$1,013.09",$496.51,"$1,174.67",$496.51,"$1,211.00",$496.51,$496.51,"$1,174.67"
4500040B,0983,45000,,,,,N/A,N/A,DRAINAGE OF PELVIC ABSCESS  ~P,$797.06,$592.50,$332.10,$810.00,$332.10,$785.70,$332.10,$692.55,$332.10,$724.70,$332.10,$785.70,$332.10,$810.00,$332.10,$332.10,$785.70
4510040B,0983,45100,,,,,N/A,N/A,BIOPSY OF RECTUM            ~P,$579.13,$430.50,$235.34,$574.00,$235.34,$556.78,$235.34,$490.77,$235.34,$513.44,$235.34,$556.78,$235.34,$574.00,$235.34,$235.34,$556.78
4511140B,0983,45111,,,,,N/A,N/A,OPEN/TRANSRECTAL PROCEDURE  ~P,"$2,188.39","$1,626.75",$889.29,"$2,169.00",$889.29,"$2,103.93",$889.29,"$1,854.50",$889.29,"$1,827.92",$889.29,"$2,103.93",$889.29,"$2,169.00",$889.29,$889.29,"$2,103.93"
4513040B,0983,45130,,,,,N/A,N/A,EXCISION .5CM OR LESS       ~P,"$1,552.76","$1,154.25",$63.99,"$1,826.36",$63.99,"$1,492.83",$63.99,"$1,315.85",$63.99,"$1,826.36",$63.99,"$1,492.83",$63.99,"$1,539.00",$63.99,$63.99,"$1,492.83"
4517140B,0983,45171,,,,,N/A,N/A,EXCISION OF RECTAL TUMOR    ~P,"$1,184.50",$880.50,$481.34,"$1,174.00",$481.34,"$1,138.78",$481.34,"$1,003.77",$481.34,"$1,063.91",$481.34,"$1,138.78",$481.34,"$1,174.00",$481.34,$481.34,"$1,138.78"
4519040B,0983,45190,,,,,N/A,N/A,"DESTRUCTION, RECTAL TUMOR   ~P","$1,311.62",$975.00,$554.32,"$1,352.00",$554.32,"$1,311.44",$554.32,"$1,155.96",$554.32,"$1,210.16",$554.32,"$1,311.44",$554.32,"$1,352.00",$554.32,$554.32,"$1,311.44"
4530540B,0983,45305,,,,,N/A,N/A,PROCTOSIGMOIDOSCOPY W/BX    ~P,$187.66,$139.50,$122.85,$211.00,N/A,$204.67,N/A,$180.41,N/A,$122.85,N/A,$204.67,N/A,$211.00,N/A,N/A,$204.67
4531740B,0983,45317,,,,,N/A,N/A,RIGID PROCTOSIG W/CONT BLEED~P,$248.20,$184.50,$1.86,$246.00,$1.86,$238.62,$1.86,$210.33,$1.86,$186.21,$1.86,$238.62,$1.86,$246.00,$1.86,$1.86,$238.62
4533040B,0983,45330,,,,,N/A,N/A,"SIGMOID, FLEXIBLE, DIAG     ~P",$195.73,$145.50,$79.54,$194.00,$79.54,$188.18,$79.54,$165.87,$79.54,$94.53,$79.54,$188.18,$79.54,$194.00,$79.54,$79.54,$188.18
4533140B,0983,45331,,,,,N/A,N/A,SIGMOIDOSCOPY AND BIOPSY    ~P,$285.53,$212.25,$116.30,$283.00,$116.30,$274.51,$116.30,$241.97,$116.30,$122.00,$116.30,$274.51,$116.30,$283.00,$116.30,$116.30,$274.51
4533440B,0983,45334,,,,,N/A,N/A,FLEXIBLE SIGMOIDOSCOPY      ~P,$547.85,$407.25,$199.27,$543.00,N/A,$526.71,N/A,$464.27,N/A,$199.27,N/A,$526.71,N/A,$543.00,N/A,N/A,$526.71
4533540B,0983,45335,,,,,N/A,N/A,SIGMOID W/DIR SUBMUCOSAL    ~P,$392.48,$291.75,$112.99,$389.00,$159.49,$377.33,$159.49,$332.60,$159.49,$112.99,$159.49,$377.33,$159.49,$389.00,$159.49,$159.49,$377.33
4533840B,0983,45338,,,,,N/A,N/A,FLEXIBLE SIGMOIDO PROC      ~P,$454.02,$337.50,$184.50,$450.00,$184.50,$436.50,$184.50,$384.75,$184.50,$203.90,$184.50,$436.50,$184.50,$450.00,$184.50,$184.50,$436.50
4535040B,0983,45350,,,,,N/A,N/A,SIGMOIDOSCOPY W/ BAND LIGATION,$740.56,$550.50,$3.94,$734.00,$3.94,$711.98,$3.94,$627.57,$3.94,$170.68,$3.94,$711.98,$3.94,$734.00,$3.94,$3.94,$711.98
4537840B,0983,45378,,,,,N/A,N/A,DIAGNOSTIC COLONOSCOPY      ~P,$550.88,$409.50,$248.50,$546.00,$248.50,$529.62,$248.50,$466.83,$248.50,$313.95,$248.50,$529.62,$248.50,$546.00,$248.50,$248.50,$529.62
4538040B,0983,45380,,,,,N/A,N/A,COLONOSCOPY AND BIOPSY      ~P,$587.20,$436.50,$0.00,$650.00,$266.50,$0.00,$266.50,$555.75,$266.50,$485.35,$266.50,$0.00,$266.50,$650.00,$266.50,$266.50,$0.00
4538140B,0983,45381,,,,,N/A,N/A,"COLONOSCOPY, SUBMUCOUS INJ  ~P",$597.29,$444.00,$27.60,$654.00,$27.60,$630.50,$27.60,$559.17,$27.60,$340.74,$27.60,$630.50,$27.60,$654.00,$27.60,$27.60,$630.50
4538240B,0983,45382,,,,,N/A,N/A,ENDOSCOPY W/CONTR BLEEDING  ~P,$852.55,$633.75,$346.45,$845.00,$346.45,$634.38,$346.45,$722.48,$346.45,$439.38,$346.45,$634.38,$346.45,$845.00,$346.45,$346.45,$634.38
4538440B,0983,45384,,,,,N/A,N/A,LESION REMOVAL COLONOSCOPY  ~P,$656.82,$488.25,$299.71,$819.65,$299.71,$819.65,$299.71,$625.01,$299.71,$384.59,$299.71,$819.65,$299.71,$731.00,$299.71,$299.71,$819.65
4538540B,0983,45385,,,,,N/A,N/A,LESION REMOVAL COLONOSCOPY  ~P,$658.84,$489.75,$3.94,$734.00,$3.94,$709.07,$3.94,$627.57,$3.94,$638.99,$3.94,$709.07,$3.94,$734.00,$3.94,$3.94,$709.07
4538640B,0983,45386,,,,,N/A,N/A,COLONOSCOPY DILATE STRICTURE~P,$897.96,$667.50,$358.59,$940.00,$385.40,$711.98,$385.40,$803.70,$385.40,$358.59,$385.40,$711.98,$385.40,$940.00,$385.40,$385.40,$711.98
4538840B,0983,45388,,,,,N/A,N/A,COLONOSCOPY w/ABLATION TUMOR~P,"$2,807.88","$2,087.25",$458.34,"$2,811.00","$1,152.51",$911.80,"$1,152.51","$2,403.41","$1,152.51",$458.34,"$1,152.51",$911.80,"$1,152.51","$2,811.00","$1,152.51","$1,152.51",$911.80
4539340B,0983,45393,,,,,N/A,N/A,COLONOSCOPY W/DECOMPRESSION ~P,$504.47,$375.00,$217.30,"$2,726.67",$217.30,"$2,726.67",$217.30,$453.15,$217.30,$427.68,$217.30,"$2,726.67",$217.30,$530.00,$217.30,$217.30,"$2,726.67"
4539840B,0983,45398,,,,,N/A,N/A,COLONOSCOPY W/BAND          ~P,$740.56,$550.50,$3.94,$734.00,$3.94,$514.10,$3.94,$627.57,$3.94,$396.43,$3.94,$514.10,$3.94,$734.00,$3.94,$3.94,$514.10
4555040B,0983,45550,,,,,N/A,N/A,REPAIR RECTUM/REMOVE SIGMOID~P,"$3,026.82","$2,250.00","$1,245.58","$3,038.00","$1,245.58","$2,946.86","$1,245.58","$2,597.49","$1,245.58","$2,467.05","$1,245.58","$2,946.86","$1,245.58","$3,038.00","$1,245.58","$1,245.58","$2,946.86"
4599040B,0983,45990,,,,,N/A,N/A,"SURG DX EXAM, ANORECTAL     ~P",$211.88,$157.50,$93.89,$396.07,$93.89,$222.13,$93.89,$195.80,$93.89,$396.07,$93.89,$222.13,$93.89,$229.00,$93.89,$93.89,$222.13
4602040B,0983,46020,,,,,N/A,N/A,PLACEMENT OF SETON          ~P,$453.01,$336.75,$177.35,$449.00,$184.90,$435.53,$184.90,$383.90,$184.90,$177.35,$184.90,$435.53,$184.90,$449.00,$184.90,$184.90,$435.53
4604040B,0983,46040,,,,,N/A,N/A,INCISION & DRAIN ABCESS     ~P,$766.79,$570.00,$311.60,"$1,440.00",$311.60,"$1,396.80",$311.60,"$1,231.20",$311.60,$408.89,$311.60,"$1,396.80",$311.60,"$1,440.00",$311.60,$311.60,"$1,396.80"
4605040B,0983,46050,,,,,N/A,N/A,INCISION OF ANAL ABSCESS    ~P,$195.73,$145.50,$87.74,$725.44,$87.74,$217.28,$87.74,$191.52,$87.74,$725.44,$87.74,$217.28,$87.74,$224.00,$87.74,$87.74,$217.28
4608040B,0983,46080,,,,,N/A,N/A,SURG INCISION SPHINCTER     ~P,$317.82,$236.25,$129.15,$315.00,$129.15,$305.55,$129.15,$269.33,$129.15,$170.87,$129.15,$305.55,$129.15,$315.00,$129.15,$129.15,$305.55
4608340B,0983,46083,,,,,N/A,N/A,SURG INCISION OF THROMBOSED ~P,$254.25,$189.00,$13.32,$267.07,$13.32,$244.44,$13.32,$215.46,$13.32,$267.07,$13.32,$244.44,$13.32,$252.00,$13.32,$13.32,$244.44
4620040B,0983,46200,,,,,N/A,N/A,REMOVAL OF ANAL FISSURE     ~P,$605.36,$450.00,$186.83,$623.00,$255.43,$604.31,$255.43,N/A,$255.43,$186.83,$255.43,$604.31,$255.43,$623.00,$255.43,$255.43,$604.31
4622140B,0983,46221,,,,,N/A,N/A,LIGATION OF HEMORRHOID(S)   ~P,$301.67,$224.25,$144.73,$353.00,$144.73,$342.41,$144.73,$301.82,$144.73,$205.55,$144.73,$342.41,$144.73,$353.00,$144.73,$144.73,$342.41
4625040B,0983,46250,,,,,N/A,N/A,HEMORRHOIDECTOMY            ~P,$616.46,$458.25,$25.51,$611.00,$25.51,$592.67,$25.51,$522.41,$25.51,$293.96,$25.51,$592.67,$25.51,$611.00,$25.51,$25.51,$592.67
4625540B,0983,46255,,,,,N/A,N/A,HEMORRHOIDECTOMY            ~P,$643.70,$478.50,$286.18,$698.00,$286.18,$677.06,$286.18,$596.79,$286.18,$548.66,$286.18,$677.06,$286.18,$698.00,$286.18,$286.18,$677.06
4625740B,0983,46257,,,,,N/A,N/A,HEMORRHOIDECTOMY            ~P,$580.14,$431.25,$235.75,$611.82,$235.75,$557.75,$235.75,$491.63,$235.75,$611.82,$235.75,$557.75,$235.75,$575.00,$235.75,$235.75,$557.75
4626040B,0983,46260,,,,,N/A,N/A,HEMORRHOIDECTOMY            ~P,$908.05,$675.00,$369.00,$369.00,$369.00,N/A,$369.00,N/A,$369.00,N/A,$369.00,N/A,$369.00,N/A,$369.00,$369.00,N/A
4626140B,0983,46261,,,,,N/A,N/A,HEMORRHOIDECTOMY            ~P,$722.40,$537.00,$293.56,$293.56,$293.56,N/A,$293.56,N/A,$293.56,N/A,$293.56,N/A,$293.56,N/A,$293.56,$293.56,N/A
4627040B,0983,46270,,,,,N/A,N/A,RESECTION OF ANAL FISTULA   ~P,$781.93,$581.25,$317.75,$775.00,$317.75,$751.75,$317.75,$662.63,$317.75,$734.37,$317.75,$751.75,$317.75,$775.00,$317.75,$317.75,$751.75
4627540B,0983,46275,,,,,N/A,N/A,REMOVAL OF ANAL FISTULA     ~P,$796.05,$591.75,$323.49,$789.00,$323.49,$765.33,$323.49,$674.60,$323.49,$685.63,$323.49,$765.33,$323.49,$789.00,$323.49,$323.49,$765.33
4628040B,0983,46280,,,,,N/A,N/A,REMOVAL OF ANAL FISTULA     ~P,$847.51,$630.00,$366.95,$895.00,$366.95,$868.15,$366.95,$765.23,$366.95,$722.55,$366.95,$868.15,$366.95,$895.00,$366.95,$366.95,$868.15
4632040B,0983,46320,,,,,N/A,N/A,REMOVAL OF HEMORRHOID CLOT  ~P,$201.79,$150.00,$95.53,$821.79,$95.53,$226.01,$95.53,$199.22,$95.53,$821.79,$95.53,$226.01,$95.53,$233.00,$95.53,$95.53,$226.01
4660040B,0983,46600,,,,,N/A,N/A,DIAGNOSTIC ANOSCOPY         ~P,$113.00,$84.00,$48.79,$192.32,$48.79,$115.43,$48.79,$101.75,$48.79,$192.32,$48.79,$115.43,$48.79,$119.00,$48.79,$48.79,$115.43
4660640B,0983,46606,,,,,N/A,N/A,ANOSCOPY AND BIOPSY         ~P,$265.35,$197.25,$17.83,$263.00,$17.83,$255.11,$17.83,$224.87,$17.83,$68.60,$17.83,$255.11,$17.83,$263.00,$17.83,$17.83,$255.11
4661040B,0983,46610,,,,,N/A,N/A,"ANOSCOPY, REMOVE LESION     ~P",$284.52,$211.50,$127.40,$305.00,$129.15,$295.85,$129.15,$260.78,$129.15,$127.40,$129.15,$295.85,$129.15,$305.00,$129.15,$129.15,$295.85
4661140B,0983,46611,,,,,N/A,N/A,ANOSCOPIC PROCEDURE         ~P,$306.72,$228.00,$124.64,$304.00,$124.64,$294.88,$124.64,$259.92,$124.64,$134.69,$124.64,$294.88,$124.64,$304.00,$124.64,$124.64,$294.88
4661440B,0983,46614,,,,,N/A,N/A,ANOSCOPIC PROCEDURE         ~P,$271.40,$201.75,$11.29,$269.00,$11.29,$260.93,$11.29,$230.00,$11.29,$135.73,$11.29,$260.93,$11.29,$269.00,$11.29,$11.29,$260.93
4692240B,0983,46922,,,,,N/A,N/A,EXCISION OF ANAL LESION(S)  ~P,$271.40,$201.75,$107.92,$300.00,$123.00,$291.00,$123.00,$256.50,$123.00,$107.92,$123.00,$291.00,$123.00,$300.00,$123.00,$123.00,$291.00
4692440B,0983,46924,,,,,N/A,N/A,"DESTRUCTION OF LESION,ANUS  ~P","$1,075.53",$799.50,$232.25,"$1,066.00",$437.60,"$1,034.02",$437.60,$911.43,$437.60,$232.25,$437.60,"$1,034.02",$437.60,"$1,066.00",$437.60,$437.60,"$1,034.02"
4693040B,0983,46930,,,,,N/A,N/A,DESTROY INTERNAL HEMORRHOIDS~P,$296.63,$220.50,$12.54,$306.24,$12.54,$285.18,$12.54,$251.37,$12.54,$306.24,$12.54,$285.18,$12.54,$294.00,$12.54,$12.54,$285.18
4694640B,0983,46946,,,,,N/A,N/A,LIGATION OF HEMORRHOIDS     ~P,$403.58,$300.00,$189.42,$462.00,$189.42,$448.14,$189.42,$395.01,$189.42,$265.71,$189.42,$448.14,$189.42,$462.00,$189.42,$189.42,$448.14
4694840B,0983,46948,,,,,N/A,N/A,HEMORRHOIDECTOMY            ~P,$837.42,$622.50,$362.44,$884.00,$362.44,$857.48,$362.44,$755.82,$362.44,$662.75,$362.44,$857.48,$362.44,$884.00,$362.44,$362.44,$857.48
4700040B,0983,47000,,,,,N/A,N/A,NEEDLE BIOPSY OF LIVER      ~P,$398.53,$296.25,$161.95,$768.05,$161.95,$383.15,$161.95,$337.73,$161.95,$768.05,$161.95,$383.15,$161.95,$395.00,$161.95,$161.95,$383.15
4700140B,0983,47001,,,,,N/A,N/A,NEEDLE BIOPSY OF LIVER      ~P,$202.80,$150.75,$82.41,$201.00,$82.41,$194.97,$82.41,$171.86,$82.41,$149.98,$82.41,$194.97,$82.41,$201.00,$82.41,$82.41,$194.97
4710040B,0983,47100,,,,,N/A,N/A,WEDGE BIOPSY OF LIVER       ~P,"$1,686.95","$1,254.00",$171.65,"$1,672.00",N/A,"$1,621.84",N/A,"$1,429.56",N/A,$171.65,N/A,"$1,621.84",N/A,"$1,672.00",N/A,N/A,"$1,621.84"
4756240B,0983,47562,,,,,N/A,N/A,LAPAROSCOPIC CHOLECYSTECTOMY~P,"$1,535.61","$1,141.50",$119.85,"$1,522.00",$624.20,"$1,476.34",$624.20,"$1,301.31",$624.20,$119.85,$624.20,"$1,476.34",$624.20,"$1,522.00",$624.20,$624.20,"$1,476.34"
4756340B,0983,47563,,,,,N/A,N/A,LAPARO CHOLECYSTECTOMY/GRAPH~P,"$1,647.60","$1,224.75",$669.53,"$1,633.00",$669.53,"$1,584.01",$669.53,"$1,396.22",$669.53,"$1,108.95",$669.53,"$1,584.01",$669.53,"$1,633.00",$669.53,$669.53,"$1,584.01"
4756440B,0983,47564,,,,,N/A,N/A,CHOL W/EXPLOR OF COM DUCT   ~P,"$2,192.43","$1,629.75",$89.93,"$2,173.00",$89.93,"$2,107.81",$89.93,"$1,857.92",$89.93,"$1,206.63",$89.93,"$2,107.81",$89.93,"$2,173.00",$89.93,$89.93,"$2,107.81"
4760040B,0983,47600,,,,,N/A,N/A,REMOVAL OF GALLBLADDER      ~P,"$1,883.69","$1,400.25",$765.47,"$1,875.98",$765.47,"$1,810.99",$765.47,"$1,596.29",$765.47,"$1,875.98",$765.47,"$1,810.99",$765.47,"$1,867.00",$765.47,$765.47,"$1,810.99"
4760540B,0983,47605,,,,,N/A,N/A,CHOLECYSECTOMY W/CHOLNGIGRPY~P,"$1,868.56","$1,389.00",$759.32,"$1,852.00",$759.32,"$1,796.44",$759.32,"$1,583.46",$759.32,"$1,794.51",$759.32,"$1,796.44",$759.32,"$1,852.00",$759.32,$759.32,"$1,796.44"
4761040B,0983,47610,,,,,N/A,N/A,CHOLE W/EXPLO COMMON DUCT   ~P,"$2,465.85","$1,833.00",$12.40,"$2,444.00",$12.40,"$2,370.68",$12.40,"$2,089.62",$12.40,"$1,890.03",$12.40,"$2,370.68",$12.40,"$2,444.00",$12.40,$12.40,"$2,370.68"
4778040B,0983,47780,,,,,N/A,N/A,ANASTOMOSIS ROYX-EN-Y       ~P,"$4,660.29","$3,464.25","$1,893.79","$4,619.00","$1,893.79","$4,480.43","$1,893.79","$3,949.25","$1,893.79","$2,100.11","$1,893.79","$4,480.43","$1,893.79","$4,619.00","$1,893.79","$1,893.79","$4,480.43"
4900040B,0983,49000,,,,,N/A,N/A,EXPLORATION OF ABDOMEN      ~P,"$1,626.41","$1,209.00",$66.92,"$1,881.85",$66.92,"$1,563.64",$66.92,"$1,378.26",$66.92,"$1,881.85",$66.92,"$1,563.64",$66.92,"$1,612.00",$66.92,$66.92,"$1,563.64"
4900240B,0983,49002,,,,,N/A,N/A,REOPENING OF ABDOMEN        ~P,"$1,983.58","$1,474.50",$86.60,"$1,966.00",$86.60,"$1,907.02",$86.60,"$1,680.93",$86.60,"$1,290.76",$86.60,"$1,907.02",$86.60,"$1,966.00",$86.60,$86.60,"$1,907.02"
4901040B,0983,49010,,,,,N/A,N/A,EXPLORATION BEHIND ABDOMEN  ~P,"$1,729.32","$1,285.50",$72.74,"$1,748.29",$72.74,"$1,662.58",$72.74,"$1,465.47",$72.74,"$1,748.29",$72.74,"$1,662.58",$72.74,"$1,714.00",$72.74,$72.74,"$1,662.58"
4908240B,0983,49082,,,,,N/A,N/A,ABD PARACENTESIS            ~P,$210.87,$156.75,$85.69,$209.00,$85.69,$202.73,$85.69,$178.70,$85.69,N/A,$85.69,$202.73,$85.69,$209.00,$85.69,$85.69,$202.73
4908340B,0983,49083,,,,,N/A,N/A,EXPL. & DRAIN PROC W/IMAG   ~P,$389.45,$289.50,$123.62,$386.00,$158.26,$374.42,$158.26,$330.03,$158.26,$123.62,$158.26,$374.42,$158.26,$386.00,$158.26,$158.26,$374.42
4908440B,0983,49084,,,,,N/A,N/A,EXPLORATORY/DRAINAGE PROC   ~P,$204.81,$152.25,$83.23,$203.00,$83.23,$196.91,$83.23,$173.57,$83.23,$180.72,$83.23,$196.91,$83.23,$203.00,$83.23,$83.23,$196.91
4918040B,0983,49180,,,,,N/A,N/A,"BIOPSY, ABDOMINAL MASS      ~P",$384.41,$285.75,$166.46,$406.00,$166.46,$393.82,$166.46,$347.13,$166.46,$179.64,$166.46,$393.82,$166.46,$406.00,$166.46,$166.46,$393.82
4920340B,0983,49203,,,,,N/A,N/A,EXC ABD TUM 5 CM OR LESS    ~P,"$2,083.46","$1,548.75",$142.16,"$2,065.00",$846.65,"$2,003.05",$846.65,"$1,765.58",$846.65,$142.16,$846.65,"$2,003.05",$846.65,"$2,065.00",$846.65,$846.65,"$2,003.05"
4920440B,0983,49204,,,,,N/A,N/A,OPEN RESTRUCTION/EXCISION   ~P,"$3,023.79","$2,247.75","$1,228.77","$2,997.00","$1,228.77","$2,907.09","$1,228.77","$2,562.44","$1,228.77","$2,003.98","$1,228.77","$2,907.09","$1,228.77","$2,997.00","$1,228.77","$1,228.77","$2,907.09"
4925540B,0983,49255,,,,,N/A,N/A,REMOVAL OF OMENTUM          ~P,"$1,478.10","$1,098.75",$6.65,"$1,465.00",$6.65,"$1,421.05",$6.65,"$1,252.58",$6.65,$994.00,$6.65,"$1,421.05",$6.65,"$1,465.00",$6.65,$6.65,"$1,421.05"
4932040B,0983,49320,,,,,N/A,N/A,LAPAROSCOPY SEP PROCEDURE   ~P,$618.48,$459.75,$251.33,"$1,332.82",$251.33,$594.61,$251.33,$524.12,$251.33,"$1,332.82",$251.33,$594.61,$251.33,$613.00,$251.33,$251.33,$594.61
4932240B,0983,49322,,,,,N/A,N/A,"LAPAROSCOPY, ASPIRATION     ~P",$827.33,$615.00,$336.20,$820.00,$336.20,$795.40,$336.20,$701.10,$336.20,$581.93,$336.20,$795.40,$336.20,$820.00,$336.20,$336.20,$795.40
4940240B,0983,49402,,,,,N/A,N/A,"REMOVE FOREIGN BODY, ADBOMEN~P","$1,614.30","$1,200.00",$631.27,"$1,614.00",$661.74,"$1,565.58",$661.74,"$1,379.97",$661.74,$631.27,$661.74,"$1,565.58",$661.74,"$1,614.00",$661.74,$661.74,"$1,565.58"
4940540B,0983,49405,,,,,N/A,N/A,IMAGE GUIDED FLUID COLL     ~P,"$1,037.19",$771.00,$421.48,"$1,434.34",$421.48,$997.16,$421.48,$878.94,$421.48,"$1,434.34",$421.48,$997.16,$421.48,"$1,028.00",$421.48,$421.48,$997.16
4942240B,0983,49422,,,,,N/A,N/A,REMOVE PERM CANNULA/CATHETER~P,$872.73,$648.75,$331.36,$865.00,$354.65,$839.05,$354.65,$739.58,$354.65,$331.36,$354.65,$839.05,$354.65,$865.00,$354.65,$354.65,$839.05
4944140B,0983,49441,,,,,N/A,N/A,PLACE DUOD/JEJ TUBE PERC~P,$506.49,$376.50,$25.82,$502.00,$25.82,$486.94,$25.82,$429.21,$25.82,$368.89,$25.82,$486.94,$25.82,$502.00,$25.82,$25.82,$486.94
4945040B,0983,49450,,,,,N/A,N/A,REPLACE G/C TUBE PERC       ~P,$825.31,$613.50,$344.40,$344.40,$344.40,N/A,$344.40,N/A,$344.40,N/A,$344.40,N/A,$344.40,N/A,$344.40,$344.40,N/A
4945140B,0983,49451,,,,,N/A,N/A,REPLACE DUOD/JEJ TUBE PERC  ~P,$871.72,$648.00,$364.49,$889.00,$364.49,$862.33,$364.49,$760.10,$364.49,$403.12,$364.49,$862.33,$364.49,$889.00,$364.49,$364.49,$862.33
4950540B,0983,49505,,,,,N/A,N/A,PRP I/HERN INIT REDUC >5 YR ~P,"$1,083.60",$805.50,$44.34,"$1,074.00",$44.34,"$1,041.78",$44.34,$918.27,$44.34,$52.19,$44.34,"$1,041.78",$44.34,"$1,074.00",$44.34,$44.34,"$1,041.78"
4950740B,0983,49507,,,,,N/A,N/A,PRP I/HERN INIT REDUC >5 YR ~P,"$1,340.88",$996.75,$544.89,"$1,329.00",$544.89,"$1,289.13",$544.89,"$1,136.30",$544.89,$880.74,$544.89,"$1,289.13",$544.89,"$1,329.00",$544.89,$544.89,"$1,289.13"
4952040B,0983,49520,,,,,N/A,N/A,"REREPAIR ING HERNIA, REDUCE ~P","$1,344.92",$999.75,$546.53,"$1,333.00",$546.53,"$1,293.01",$546.53,"$1,139.72",$546.53,$988.12,$546.53,"$1,293.01",$546.53,"$1,333.00",$546.53,$546.53,"$1,293.01"
4952140B,0983,49521,,,,,N/A,N/A,REREPAIRING HERNIA BLOCKED  ~P,"$1,762.62","$1,310.25",$716.27,"$1,747.00",$716.27,"$1,694.59",$716.27,"$1,493.00",$716.27,"$1,064.24",$716.27,"$1,694.59",$716.27,"$1,747.00",$716.27,$716.27,"$1,694.59"
4952540B,0983,49525,,,,,N/A,N/A,"REPAIR ING HERNIA, SLIDING  ~P","$1,206.69",$897.00,$49.36,"$1,204.49",$49.36,"$1,160.12",$49.36,"$1,022.58",$49.36,"$1,204.49",$49.36,"$1,160.12",$49.36,"$1,196.00",$49.36,$49.36,"$1,160.12"
4955040B,0983,49550,,,,,N/A,N/A,"RPR REM HERNIA, INIT, REDUCE~P","$1,217.79",$905.25,$494.87,"$1,207.00",$494.87,"$1,170.79",$494.87,"$1,031.99",$494.87,$966.31,$494.87,"$1,170.79",$494.87,"$1,207.00",$494.87,$494.87,"$1,170.79"
4955340B,0983,49553,,,,,N/A,N/A,REMOVAL OF SMALL INTESTINE  ~P,"$1,177.43",$875.25,$478.47,"$1,167.00",$478.47,"$1,131.99",$478.47,$997.79,$478.47,$971.55,$478.47,"$1,131.99",$478.47,"$1,167.00",$478.47,$478.47,"$1,131.99"
4956040B,0983,49560,,,,,N/A,N/A,"RPR VENTRAL HERN INIT, REDUC~P","$1,598.16","$1,188.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4956140B,0983,49561,,,,,N/A,N/A,"RPR VENTRAL HERN INIT, BLOCK~P","$1,942.21","$1,443.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4956540B,0983,49565,,,,,N/A,N/A,"REREPAIR VENTRL HERN, REDUCE~P","$1,765.65","$1,312.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4956640B,0983,49566,,,,,N/A,N/A,"REREPAIR VENTRL HERN, BLOCK ~P","$1,964.41","$1,460.25",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4956840B,0983,49568,,,,,N/A,N/A,HERNIA REPAIR W/MESH        ~P,$630.59,$468.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4957040B,0983,49570,,,,,N/A,N/A,HERNIA REPAIR EPIGASTRIC    ~P,$823.30,$612.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4958540B,0983,49585,,,,,N/A,N/A,"RPR UMBIL HERN, REDUC > 5YR ~P",$908.05,$675.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4958740B,0983,49587,,,,,N/A,N/A,"RPR UMBIL HERN, BLOCK > 5 YR~P","$1,078.56",$801.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4965040B,0983,49650,,,,,N/A,N/A,LAP ING HERNIA REPAIR INIT  ~P,$797.06,$592.50,$343.58,$838.00,$343.58,$812.86,$343.58,$716.49,$343.58,$838.00,$343.58,$812.86,$343.58,$838.00,$343.58,$343.58,$812.86
4965140B,0983,49651,,,,,N/A,N/A,REPAIR RECUR INGUIN HERNIA  ~P,"$1,036.18",$770.25,$421.70,"$1,027.00",$421.70,$996.19,$421.70,$878.09,$421.70,$729.43,$421.70,$996.19,$421.70,"$1,027.00",$421.70,$421.70,$996.19
4965240B,0983,49652,,,,,N/A,N/A,LAP HERNIA REPAIR           ~P,"$1,393.35","$1,035.75",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4965340B,0983,49653,,,,,N/A,N/A,LAP VENT/ABD HERN PROC COMP ~P,"$1,654.66","$1,230.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4965440B,0983,49654,,,,,N/A,N/A,"LAPAROSCOPY,SURG REPAIR     ~G","$1,634.48","$1,215.00",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4965540B,0983,49655,,,,,N/A,N/A,LAPAROSCOPY INCARCERATED    ~P,"$1,378.21","$1,024.50",N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4990040B,0983,49900,,,,,N/A,N/A,SURGICAL REPAIR ABD WALL    ~P,"$1,636.50","$1,216.50",$665.20,"$1,622.00",$665.20,"$1,573.34",$665.20,"$1,386.81",$665.20,$949.27,$665.20,"$1,573.34",$665.20,"$1,622.00",$665.20,$665.20,"$1,573.34"
4990540B,0983,49905,,,,,N/A,N/A,OMENTAL FLAP INTRA-ABDOM    ~P,$807.15,$600.00,$343.58,"$1,378.50",$343.58,$812.86,$343.58,$716.49,$343.58,"$1,378.50",$343.58,$812.86,$343.58,$838.00,$343.58,$343.58,$812.86
5008040B,0983,50080,,,,,N/A,N/A,PERCUT NEPHROSTOLITHOMTOMY  ~P,"$1,966.42","$1,461.75",$586.20,"$1,949.00",$799.90,"$1,890.53",$799.90,"$1,666.40",$799.90,$586.20,$799.90,"$1,890.53",$799.90,"$1,949.00",$799.90,$799.90,"$1,890.53"
5038540B,0983,50385,,,,,N/A,N/A,CHANGE STENT VIA TRANSURETH ~P,$433.84,$322.50,$188.60,"$1,420.18",$188.60,$446.20,$188.60,$393.30,$188.60,"$1,420.18",$188.60,$446.20,$188.60,$460.00,$188.60,$188.60,$446.20
5043140B,0983,50431,,,,,N/A,N/A,PERCUTANEOUS & INJECTION PRO~P,$758.72,$564.00,$38.32,$752.00,$38.32,$729.44,$38.32,$642.96,$38.32,$355.30,$38.32,$729.44,$38.32,$752.00,$38.32,$38.32,$729.44
5054540B,0983,50545,,,,,N/A,N/A,LAPARO RADICAL NEPHRECTOMY  ~P,"$3,113.59","$2,314.50",$245.73,"$3,086.00","$1,265.26","$2,993.42","$1,265.26","$2,638.53","$1,265.26",$245.73,"$1,265.26","$2,993.42","$1,265.26","$3,086.00","$1,265.26","$1,265.26","$2,993.42"
5059040B,0983,50590,,,,,N/A,N/A,FRAGMENTING OF KIDNEY STONE ~P,"$1,270.26",$944.25,$527.26,"$1,962.52",$527.26,"$1,247.42",$527.26,"$1,099.53",$527.26,"$1,962.52",$527.26,"$1,247.42",$527.26,"$1,286.00",$527.26,$527.26,"$1,247.42"
5104040B,0983,51040,,,,,N/A,N/A,CYSTOSTOMY WITH DRAINAGE    ~P,$721.39,$536.25,$293.15,$715.00,$293.15,$693.55,$293.15,$611.33,$293.15,$715.00,$293.15,$693.55,$293.15,$715.00,$293.15,$293.15,$693.55
5104540B,0983,51045,,,,,N/A,N/A,CYSTOSTOMY                  ~P,"$1,000.87",$744.00,$46.72,$992.00,$46.72,$962.24,$46.72,$848.16,$46.72,$478.69,$46.72,$962.24,$46.72,$992.00,$46.72,$46.72,$962.24
5105040B,0983,51050,,,,,N/A,N/A,REMOVAL OF BLADDER STONE    ~P,$960.51,$714.00,$39.32,$952.00,$39.32,$923.44,$39.32,$813.96,$39.32,$820.73,$39.32,$923.44,$39.32,$952.00,$39.32,$39.32,$923.44
5110240B,0983,51102,,,,,N/A,N/A,CYSTOSCOPY                  ~P,$308.74,$229.50,$147.19,$775.35,$147.19,$348.23,$147.19,$306.95,$147.19,$775.35,$147.19,$348.23,$147.19,$359.00,$147.19,$147.19,$348.23
5150040B,0983,51500,,,,,N/A,N/A,REMOVAL OF BLADDER CYST     ~P,"$1,430.68","$1,063.50",$236.79,"$1,418.00",N/A,"$1,375.46",N/A,"$1,212.39",N/A,$236.79,N/A,"$1,375.46",N/A,"$1,418.00",N/A,N/A,"$1,375.46"
5161040B,0983,51610,,,,,N/A,N/A,"INTRODUCTION, INJ PROCEDURE ~P",$301.67,$224.25,$122.59,"$1,045.14",$122.59,$290.03,$122.59,$255.65,$122.59,"$1,045.14",$122.59,$290.03,$122.59,$299.00,$122.59,$122.59,$290.03
5170040B,0983,51700,,,,,N/A,N/A,BLADDER IRRIGATION          ~P,$70.63,$52.50,$92.25,$225.00,$92.25,$218.25,$92.25,$192.38,$92.25,$104.39,$92.25,$218.25,$92.25,$225.00,$92.25,$92.25,$218.25
5170140B,0983,51701,,,,,N/A,N/A,INSERT BLADDER CATHETER     ~P,$108.97,$81.00,$48.79,$119.00,$48.79,$115.43,$48.79,$101.75,$48.79,$49.87,$48.79,$115.43,$48.79,$119.00,$48.79,$48.79,$115.43
5170240B,0983,51702,,,,,N/A,N/A,INSERT TEMP BLADDER CATH    ~P,$139.23,$103.50,$41.35,$124.00,$59.86,$120.28,$59.86,$106.02,$59.86,$41.35,$59.86,$120.28,$59.86,$124.00,$59.86,$59.86,$120.28
5170340B,0983,51703,,,,,N/A,N/A,"INTRO COMPL ALT ANA, FX CATH~P",$241.14,$179.25,$41.02,$239.00,$97.99,$231.83,$97.99,$204.35,$97.99,$41.02,$97.99,$231.83,$97.99,$239.00,$97.99,$97.99,$231.83
5170345B,0983,51703,,,,,N/A,N/A,"INTRO COMPL ALT ANA, FX CATH~P",$241.14,$179.25,$41.02,$239.00,$97.99,$231.83,$97.99,$204.35,$97.99,$41.02,$97.99,$231.83,$97.99,$239.00,$97.99,$97.99,$231.83
5170540B,0983,51705,,,,,N/A,N/A,CHANGE OF BLADDER TUBE      ~P,$175.56,$130.50,$76.67,$187.00,$76.67,$181.39,$76.67,$159.89,$76.67,$124.30,$76.67,$181.39,$76.67,$187.00,$76.67,$76.67,$181.39
5171040B,0983,51710,,,,,N/A,N/A,CHANGE OF BLADDER TUBE      ~P,$235.08,$174.75,$12.50,$250.00,$12.50,$242.50,$12.50,$213.75,$12.50,$84.12,$12.50,$242.50,$12.50,$250.00,$12.50,$12.50,$242.50
5171540B,0983,51715,,,,,N/A,N/A,ENDOSCOPIC INJECT OF IMPLANT~P,$480.26,$357.00,$129.45,$476.00,$195.16,$461.72,$195.16,$406.98,$195.16,$129.45,$195.16,$461.72,$195.16,$476.00,$195.16,$195.16,$461.72
5172040B,0983,51720,,,,,N/A,N/A,TREATMENT OF BLADDER LESION ~P,$170.51,$126.75,$93.89,$325.02,$93.89,$241.53,$93.89,$212.90,$93.89,$325.02,$93.89,$241.53,$93.89,$249.00,$93.89,$93.89,$241.53
5172640B,0983,51726,,,,,N/A,N/A,COMPLEX CYSTOMETROGRAM      ~P,$178.58,$132.75,$71.04,$630.00,$258.30,$611.10,$258.30,$538.65,$258.30,$71.04,$258.30,$611.10,$258.30,$630.00,$258.30,$258.30,$611.10
5172840B,0983,51728,,,,,N/A,N/A,CYSTOMETROGRAM W/VP         ~P,$215.91,$160.50,$239.44,$584.00,$239.44,$566.48,$239.44,$499.32,$239.44,$518.32,$239.44,$566.48,$239.44,$584.00,$239.44,$239.44,$566.48
5172940B,0983,51729,,,,,N/A,N/A,CYSTOMETROGRAM W/ VP&UP     ~P,$282.50,$210.00,$223.45,$629.63,$223.45,$528.65,$223.45,$465.98,$223.45,$629.63,$223.45,$528.65,$223.45,$545.00,$223.45,$223.45,$528.65
5174140B,0983,51741,,,,,N/A,N/A,"ELECTRO-UROFLOWMETRY, FIRST ~P",$120.06,$89.25,$164.90,$666.43,N/A,$164.90,N/A,$145.35,N/A,$666.43,N/A,$164.90,N/A,$170.00,N/A,N/A,$164.90
5178440B,0983,51784,,,,,N/A,N/A,ANAL/URINARY MUSCLE STUDY   ~P,$159.41,$118.50,$23.00,$402.00,$164.82,$389.94,$164.82,$343.71,$164.82,$23.00,$164.82,$389.94,$164.82,$402.00,$164.82,$164.82,$389.94
5179740B,0983,51797,,,,,N/A,N/A,INTRAABDONINAL PRESSURE TEST~P,$481.26,$357.75,$110.04,$670.00,$274.70,$649.90,$274.70,$572.85,$274.70,$110.04,$274.70,$649.90,$274.70,$670.00,$274.70,$274.70,$649.90
5186040B,0983,51860,,,,,N/A,N/A,REPAIR OF BLADDER WOUND     ~P,"$1,614.30","$1,200.00",$17.13,"$1,663.00",$681.83,"$1,613.11",$681.83,"$1,421.87",$681.83,$17.13,$681.83,"$1,613.11",$681.83,"$1,663.00",$681.83,$681.83,"$1,613.11"
5200040B,0983,52000,,,,,N/A,N/A,CYSTOSCOPY                  ~P,$283.51,$210.75,$123.82,"$1,217.63",$123.82,$292.94,$123.82,$258.21,$123.82,"$1,217.63",$123.82,$292.94,$123.82,$302.00,$123.82,$123.82,$292.94
5200140B,0983,52001,,,,,N/A,N/A,CYSTOURETHROSCOPY W/IRRIG   ~P,$751.66,$558.75,$35.45,$745.00,$35.45,$722.65,$35.45,$636.98,$35.45,$130.67,$35.45,$722.65,$35.45,$745.00,$35.45,$35.45,$722.65
5200540B,0983,52005,,,,,N/A,N/A,CYSTCSCOPY & URETER CATHETER~P,$579.13,$430.50,$246.82,$605.00,$246.82,$586.85,$246.82,$517.28,$246.82,$465.79,$246.82,$586.85,$246.82,$605.00,$246.82,$246.82,$586.85
5220440B,0983,52204,,,,,N/A,N/A,CYSTOSCOPY                  ~P,$942.35,$700.50,$215.62,$946.00,N/A,$917.62,N/A,$808.83,N/A,$215.62,N/A,$917.62,N/A,$946.00,N/A,N/A,$917.62
5221440B,0983,52214,,,,,N/A,N/A,"CYSTOURETHROSCOPY, W/FULGUR ~P","$1,774.73","$1,319.25",$229.35,"$1,759.00",$721.19,"$1,706.23",$721.19,"$1,503.95",$721.19,$229.35,$721.19,"$1,706.23",$721.19,"$1,759.00",$721.19,$721.19,"$1,706.23"
5222440B,0983,52224,,,,,N/A,N/A,CYSTO W/TREATMENT           ~P,"$1,883.69","$1,400.25",$285.98,"$1,867.00",$765.47,"$1,810.99",$765.47,"$1,596.29",$765.47,$285.98,$765.47,"$1,810.99",$765.47,"$1,867.00",$765.47,$765.47,"$1,810.99"
5223440B,0983,52234,,,,,N/A,N/A,CYSTOSCOPY AND TREATMENT    ~P,$592.25,$440.25,$24.67,$587.00,$24.67,$569.39,$24.67,$501.89,$24.67,$330.14,$24.67,$569.39,$24.67,$587.00,$24.67,$24.67,$569.39
5223540B,0983,52235,,,,,N/A,N/A,CYSTOSCOPY AND TREATMENT    ~P,$693.14,$515.25,$281.67,$687.00,$281.67,$666.39,$281.67,$587.39,$281.67,$398.47,$281.67,$666.39,$281.67,$687.00,$281.67,$281.67,$666.39
5224040B,0983,52240,,,,,N/A,N/A,LARGE BLADDER TUMORS        ~P,"$1,174.41",$873.00,$467.53,"$1,214.00",$497.74,"$1,177.58",$497.74,"$1,037.97",$497.74,$467.53,$497.74,"$1,177.58",$497.74,"$1,214.00",$497.74,$497.74,"$1,177.58"
5227640B,0983,52276,,,,,N/A,N/A,CYSTOSCOPY AND TREATMENT    ~P,$638.66,$474.75,$259.53,$633.00,$259.53,$614.01,$259.53,$541.22,$259.53,$402.27,$259.53,$614.01,$259.53,$633.00,$259.53,$259.53,$614.01
5228140B,0983,52281,,,,,N/A,N/A,CYSTOSCOPY AND TREATMENT    ~P,$670.95,$498.75,$289.50,$705.00,$289.50,$683.85,$289.50,$602.78,$289.50,$428.82,$289.50,$683.85,$289.50,$705.00,$289.50,$289.50,$683.85
5228740B,0983,52287,,,,,N/A,N/A,CYSTOURETHROSCOPY INJ CHEMO ~P,$386.42,$287.25,$157.30,$383.00,$157.30,$371.51,$157.30,$327.47,$157.30,$246.80,$157.30,$371.51,$157.30,$383.00,$157.30,$157.30,$371.51
5231040B,0983,52310,,,,,N/A,N/A,CYSTOSCOPY AND TREATMENT    ~P,$462.09,$343.50,$25.41,$501.00,$25.41,$485.97,$25.41,$428.36,$25.41,$274.57,$25.41,$485.97,$25.41,$501.00,$25.41,$25.41,$485.97
5231540B,0983,52315,,,,,N/A,N/A,CYSTOSCOPY AND TREATMENT    ~P,$942.35,$700.50,$245.39,$990.00,$446.90,$960.30,$446.90,$846.45,$446.90,$245.39,$446.90,$960.30,$446.90,$990.00,$446.90,$446.90,$960.30
5231740B,0983,52317,,,,,N/A,N/A,REMOVE BLADDER STONE        ~P,"$1,908.91","$1,419.00",$82.82,"$2,002.00",$82.82,"$1,941.94",$82.82,"$1,711.71",$82.82,$445.44,$82.82,"$1,941.94",$82.82,"$2,002.00",$82.82,$82.82,"$1,941.94"
5231840B,0983,52318,,,,,N/A,N/A,REMOVE BLADDER STONE        ~P,"$1,155.24",$858.75,$469.45,"$1,145.00",$469.45,"$1,110.65",$469.45,$978.98,$469.45,$562.38,$469.45,"$1,110.65",$469.45,"$1,145.00",$469.45,$469.45,"$1,110.65"
5232040B,0983,52320,,,,,N/A,N/A,CYSTOSCOPY AND TREATMENT    ~P,$504.47,$375.00,$241.90,$767.72,$241.90,$572.30,$241.90,$504.45,$241.90,$767.72,$241.90,$572.30,$241.90,$590.00,$241.90,$241.90,$572.30
5233040B,0983,52330,,,,,N/A,N/A,CYSTRTHRSCPY MANI W/O RE CAL~P,"$1,597.15","$1,187.25",$519.04,"$1,583.00",$649.30,"$1,535.51",$649.30,"$1,353.47",$649.30,$519.04,$649.30,"$1,535.51",$649.30,"$1,583.00",$649.30,$649.30,"$1,535.51"
5233240B,0983,52332,,,,,N/A,N/A,CYSTOSCOPY AND TREATMENT    ~P,$915.11,$680.25,$387.40,$944.00,$387.40,$915.68,$387.40,$807.12,$387.40,$427.08,$387.40,$915.68,$387.40,$944.00,$387.40,$387.40,$915.68
5234140B,0983,52341,,,,,N/A,N/A,CYSTO W/URETER STRICTURE TX ~P,$771.84,$573.75,$252.34,$765.00,$313.65,$742.05,$313.65,$654.08,$313.65,$252.34,$313.65,$742.05,$313.65,$765.00,$313.65,$313.65,$742.05
5234440B,0983,52344,,,,,N/A,N/A,CYST W/URETER TREATMENT     ~P,$775.87,$576.75,$315.29,$769.00,$315.29,$745.93,$315.29,$657.50,$315.29,$460.25,$315.29,$745.93,$315.29,$769.00,$315.29,$315.29,$745.93
5234540B,0983,52345,,,,,N/A,N/A,CYSTO/URETERO W/UP STRICTURE~P,"$1,048.29",$779.25,$425.99,"$1,039.00",$425.99,"$1,007.83",$425.99,$888.35,$425.99,$597.86,$425.99,"$1,007.83",$425.99,"$1,039.00",$425.99,$425.99,"$1,007.83"
5235140B,0983,52351,,,,,N/A,N/A,CYSTOURETERO & OR PYELOSCOPE~P,$752.67,$559.50,$35.86,$746.00,$35.86,$723.62,$35.86,$637.83,$35.86,$723.40,$35.86,$723.62,$35.86,$746.00,$35.86,$35.86,$723.62
5235240B,0983,52352,,,,,N/A,N/A,CYSTOURETERO W/STONE REMOVE ~P,$881.81,$655.50,$358.34,$874.00,$358.34,$847.78,$358.34,$747.27,$358.34,$490.19,$358.34,$847.78,$358.34,$874.00,$358.34,$358.34,$847.78
5235340B,0983,52353,,,,,N/A,N/A,CYSTOURETERO W/LITHOTRIPSY  ~P,"$1,017.01",$756.00,$413.28,"$1,008.00",$413.28,$977.76,$413.28,$861.84,$413.28,$573.72,$413.28,$977.76,$413.28,"$1,008.00",$413.28,$413.28,$977.76
5235440B,0983,52354,,,,,N/A,N/A,URETER BX OR FULGURATION    ~P,$838.43,$623.25,$34.71,$831.00,$34.71,$806.07,$34.71,$710.51,$34.71,$635.16,$34.71,$806.07,$34.71,$831.00,$34.71,$34.71,$806.07
5235640B,0983,52356,,,,,N/A,N/A,URETEROSCOPY W/LITHO&INDWELL~P,$836.41,$621.75,$339.89,$829.00,$339.89,$804.13,$339.89,$708.80,$339.89,$676.26,$339.89,$804.13,$339.89,$829.00,$339.89,$339.89,$804.13
5245040B,0983,52450,,,,,N/A,N/A,INCISION OF PROSTATE        ~P,"$1,008.94",$750.00,$43.90,"$1,049.00",$43.90,"$1,017.53",$43.90,$896.90,$43.90,$673.94,$43.90,"$1,017.53",$43.90,"$1,049.00",$43.90,$43.90,"$1,017.53"
5250040B,0983,52500,,,,,N/A,N/A,REVISION OF BLADDER NECK    ~P,"$1,109.83",$825.00,$471.50,"$1,150.00",$471.50,"$1,115.50",$471.50,$983.25,$471.50,$776.44,$471.50,"$1,115.50",$471.50,"$1,150.00",$471.50,$471.50,"$1,115.50"
5260140B,0983,52601,,,,,N/A,N/A,PROSTATECTOMY (TURP)        ~P,"$1,476.08","$1,097.25",$599.83,"$1,463.00",$599.83,"$1,419.11",$599.83,"$1,250.87",$599.83,$805.80,$599.83,"$1,419.11",$599.83,"$1,463.00",$599.83,$599.83,"$1,419.11"
5263040B,0983,52630,,,,,N/A,N/A,REMOVE PROSTATE REGROWTH    ~P,"$1,097.73",$816.00,$446.80,"$1,191.66",$446.80,"$1,055.36",$446.80,$930.24,$446.80,"$1,191.66",$446.80,"$1,055.36",$446.80,"$1,088.00",$446.80,$446.80,"$1,055.36"
5264040B,0983,52640,,,,,N/A,N/A,POST-OP BLADDER NECK CONTR  ~P,$897.96,$667.50,$364.90,$890.00,$364.90,$863.30,$364.90,$760.95,$364.90,$663.13,$364.90,$863.30,$364.90,$890.00,$364.90,$364.90,$863.30
5264840B,0983,52648,,,,,N/A,N/A,LASER SURGERY OF PROSTATE   ~P,"$2,089.51","$1,553.25",$525.69,"$2,157.00",$884.37,"$2,092.29",$884.37,"$1,844.24",$884.37,$525.69,$884.37,"$2,092.29",$884.37,"$2,157.00",$884.37,$884.37,"$2,092.29"
5320040B,0983,53200,,,,,N/A,N/A,BIOPSY OF URETHRA           ~P,$335.98,$249.75,$154.57,"$1,132.55",$154.57,$365.69,$154.57,$322.34,$154.57,"$1,132.55",$154.57,$365.69,$154.57,$377.00,$154.57,$154.57,$365.69
5321540B,0983,53215,,,,,N/A,N/A,EXCISION MALE               ~P,"$2,080.43","$1,546.50",$230.58,"$2,062.00",$845.42,"$2,000.14",$845.42,"$1,763.01",$845.42,$230.58,$845.42,"$2,000.14",$845.42,"$2,062.00",$845.42,$845.42,"$2,000.14"
5322040B,0983,53220,,,,,N/A,N/A,EXC OR FULG OF CA OF URETHRA~P,$910.06,$676.50,$369.82,"$1,515.04",$369.82,$874.94,$369.82,$771.21,$369.82,"$1,515.04",$369.82,$874.94,$369.82,$902.00,$369.82,$369.82,$874.94
5326540B,0983,53265,,,,,N/A,N/A,TREATMENT OF URETHRA LESION ~P,$403.58,$300.00,$174.25,$741.52,$174.25,$412.25,$174.25,$363.38,$174.25,$741.52,$174.25,$412.25,$174.25,$425.00,$174.25,$174.25,$412.25
5360040B,0983,53600,,,,,N/A,N/A,DILATE URETHRA STRICTURE    ~P,$135.20,$100.50,$63.55,$308.34,$63.55,$150.35,$63.55,$132.53,$63.55,$308.34,$63.55,$150.35,$63.55,$155.00,$63.55,$63.55,$150.35
5360140B,0983,53601,,,,,N/A,N/A,DILATION URETHIAL SUBSEQ    ~P,$145.29,$108.00,$59.40,$144.00,$59.40,$139.68,$59.40,$123.12,$59.40,$103.63,$59.40,$139.68,$59.40,$144.00,$59.40,$59.40,$139.68
5360540B,0983,53605,,,,,N/A,N/A,DILATION OF URETHRAL STRCT  ~P,$131.16,$97.50,$53.30,$130.00,$53.30,$126.10,$53.30,$111.15,$53.30,$87.09,$53.30,$126.10,$53.30,$130.00,$53.30,$53.30,$126.10
5366040B,0983,53660,,,,,N/A,N/A,DILATION FEMALE URETHRA     ~P,$130.15,$96.75,$52.89,$129.00,$52.89,$125.13,$52.89,$110.30,$52.89,$104.53,$52.89,$125.13,$52.89,$129.00,$52.89,$52.89,$125.13
5389940B,0983,53899,,,,,N/A,N/A,BLADDER BOTOX INJECTION     ~P,$657.83,$489.00,$67.82,$652.00,N/A,$632.44,N/A,$557.46,N/A,$67.82,N/A,$632.44,N/A,$652.00,N/A,N/A,$632.44
5400140B,0983,54001,,,,,N/A,N/A,SLITTING OF PREPUCE         ~P,$404.58,$300.75,$0.00,$401.00,N/A,$388.97,N/A,$342.86,N/A,$0.00,N/A,$388.97,N/A,$401.00,N/A,N/A,$388.97
5406040B,0983,54060,,,,,N/A,N/A,EXCISION OF PENIS LESION(S) ~P,$265.35,$197.25,$119.72,$292.00,$119.72,$283.24,$119.72,$249.66,$119.72,$229.79,$119.72,$283.24,$119.72,$292.00,$119.72,$119.72,$283.24
5406540B,0983,54065,,,,,N/A,N/A,"DESTRUCTION, PENIS LESION(S)~P",$302.68,$225.00,$138.99,$339.00,$138.99,$328.83,$138.99,$289.85,$138.99,$214.33,$138.99,$328.83,$138.99,$339.00,$138.99,$138.99,$328.83
5410040B,0983,54100,,,,,N/A,N/A,EXCISION BIOPSY OF PENIS    ~P,$269.39,$200.25,$19.47,$267.00,$19.47,$258.99,$19.47,$228.29,$19.47,N/A,$19.47,$258.99,$19.47,$267.00,$19.47,$19.47,$258.99
5416140B,0983,54161,,,,,N/A,N/A,CIRCUMCISION                ~P,$455.03,$338.25,$158.20,$451.00,$184.91,$437.47,$184.91,$385.61,$184.91,$158.20,$184.91,$437.47,$184.91,$451.00,$184.91,$184.91,$437.47
5416240B,0983,54162,,,,,N/A,N/A,LYSIS PENIL CIRCUMIC LESION ~P,$424.76,$315.75,$178.76,$436.00,$178.76,$422.92,$178.76,$372.78,$178.76,$323.24,$178.76,$422.92,$178.76,$436.00,$178.76,$178.76,$422.92
5420040B,0983,54200,,,,,N/A,N/A,INJ PROCEDURE FOR PEYRONIE  ~P,$171.52,$127.50,$77.80,$327.88,$77.80,$182.36,$77.80,$160.74,$77.80,$327.88,$77.80,$182.36,$77.80,$188.00,$77.80,$77.80,$182.36
4554220B,0983,54220,,,,,N/A,N/A,IRRIGAT OF CORPORA CAVERNOSA~P,$384.41,$285.75,$140.97,$356.00,$145.96,$345.32,$145.96,$304.38,$145.96,$140.97,$145.96,$345.32,$145.96,$356.00,$145.96,$145.96,$345.32
5422040B,0983,54220,,,,,N/A,N/A,TREATMENT OF PENIS LESION   ~P,$359.18,$267.00,$140.97,$356.00,$145.96,$345.32,$145.96,$304.38,$145.96,$140.97,$145.96,$345.32,$145.96,$356.00,$145.96,$145.96,$345.32
5423540B,0983,54235,,,,,N/A,N/A,PENILE INJECTION            ~P,$149.32,$111.00,$6.68,$216.27,$6.68,$143.56,$6.68,$126.54,$6.68,$216.27,$6.68,$143.56,$6.68,$148.00,$6.68,$6.68,$143.56
5440540B,0983,54405,,,,,N/A,N/A,INSERT OF MULT-COMP INF PROS~P,"$1,607.24","$1,194.75",$119.27,"$1,593.00",N/A,"$1,545.21",N/A,"$1,362.02",N/A,$119.27,N/A,"$1,545.21",N/A,"$1,593.00",N/A,N/A,"$1,545.21"
5450540B,0983,54505,,,,,N/A,N/A,BIOPSY OF TESTIS            ~P,$501.44,$372.75,$482.09,"$1,470.40",N/A,$482.09,N/A,$424.94,N/A,"$1,470.40",N/A,$482.09,N/A,$497.00,N/A,N/A,$482.09
5453040B,0983,54530,,,,,N/A,N/A,"ORCHIECTOMY, RADIAL         ~P","$1,202.66",$894.00,$345.08,"$1,192.00",N/A,"$1,156.24",N/A,"$1,019.16",N/A,$345.08,N/A,"$1,156.24",N/A,"$1,192.00",N/A,N/A,"$1,156.24"
5470040B,0983,54700,,,,,N/A,N/A,I&D EPIDIDYMIS              ~P,$501.44,$372.75,$482.09,$708.97,N/A,$482.09,N/A,$424.94,N/A,$708.97,N/A,$482.09,N/A,$497.00,N/A,N/A,$482.09
5480040B,0983,54800,,,,,N/A,N/A,BIOPSY OF EPIDIDYMIS        ~P,$292.59,$217.50,$295.85,$350.13,N/A,$295.85,N/A,$260.78,N/A,$350.13,N/A,$295.85,N/A,$305.00,N/A,N/A,$295.85
5484040B,0983,54840,,,,,N/A,N/A,REMOVE EPIDIDYMIS LESION    ~P,$706.26,$525.00,$134.83,$203.71,N/A,$134.83,N/A,$118.85,N/A,$203.71,N/A,$134.83,N/A,$139.00,N/A,N/A,$134.83
5486040B,0983,54860,,,,,N/A,N/A,REMOVAL OF EPIDIDYMIS       ~P,$898.97,$668.25,$530.62,$891.00,N/A,$864.27,N/A,$761.81,N/A,$530.62,N/A,$864.27,N/A,$891.00,N/A,N/A,$864.27
5500040B,0983,55000,,,,,N/A,N/A,DRAINAGE OF HYDROCELE       ~P,$178.58,$132.75,$193.03,$689.10,N/A,$193.03,N/A,$170.15,N/A,$689.10,N/A,$193.03,N/A,$199.00,N/A,N/A,$193.03
5504040B,0983,55040,,,,,N/A,N/A,REMOVAL OF HYDROCELE        ~P,$773.86,$575.25,$137.63,$767.00,$314.47,$743.99,$314.47,$655.79,$314.47,$137.63,$314.47,$743.99,$314.47,$767.00,$314.47,$314.47,$743.99
5504140B,0983,55041,,,,,N/A,N/A,REMOVAL OF HYDROCELES       ~P,"$1,049.30",$780.00,$446.80,"$1,040.00",$446.80,"$1,008.80",$446.80,$889.20,$446.80,$556.84,$446.80,"$1,008.80",$446.80,"$1,040.00",$446.80,$446.80,"$1,008.80"
5510040B,0983,55100,,,,,N/A,N/A,I&D SCROTAL ABSCESS         ~P,$562.99,$418.50,$228.78,$840.86,$228.78,$541.26,$228.78,$477.09,$228.78,$840.86,$228.78,$541.26,$228.78,$558.00,$228.78,$228.78,$541.26
5515040B,0983,55150,,,,,N/A,N/A,REMOVAL OF SCROTUM          ~P,"$1,008.94",$750.00,$274.13,"$1,027.00",$421.70,$996.19,$421.70,$878.09,$421.70,$274.13,$421.70,$996.19,$421.70,"$1,027.00",$421.70,$421.70,$996.19
5517540B,0983,55175,,,,,N/A,N/A,REVISION OF SCROTUM         ~P,$706.26,$525.00,$313.65,$808.94,$313.65,$742.05,$313.65,$654.08,$313.65,$808.94,$313.65,$742.05,$313.65,$765.00,$313.65,$313.65,$742.05
5525040B,0983,55250,,,,,N/A,N/A,REMOVAL OF SPERM DUCT(S)    ~P,$797.06,$592.50,$334.15,$835.00,$334.15,$809.95,$334.15,$713.93,$334.15,$599.85,$334.15,$809.95,$334.15,$835.00,$334.15,$334.15,$809.95
5552040B,0983,55520,,,,,N/A,N/A,REMOVAL OF SPERM CORD LESION~P,$857.60,$637.50,$358.34,$874.00,$358.34,$847.78,$358.34,$747.27,$358.34,$644.75,$358.34,$847.78,$358.34,$874.00,$358.34,$358.34,$847.78
5553040B,0983,55530,,,,,N/A,N/A,REVISE SPERMATIC CORD VEINS ~P,$786.97,$585.00,$33.50,$805.00,$33.50,$780.85,$33.50,$688.28,$33.50,$744.28,$33.50,$780.85,$33.50,$805.00,$33.50,$33.50,$780.85
5553540B,0983,55535,,,,,N/A,N/A,REVISE SPERMATIC CORD VEINS ~P,$908.05,$675.00,$379.25,$925.00,$379.25,$897.25,$379.25,$790.88,$379.25,$579.50,$379.25,$897.25,$379.25,$925.00,$379.25,$379.25,$897.25
5570040B,0983,55700,,,,,N/A,N/A,BIOPSY OF PROSTATE          ~P,$317.82,$236.25,$133.66,$707.45,$133.66,$316.22,$133.66,$278.73,$133.66,$707.45,$133.66,$316.22,$133.66,$326.00,$133.66,$133.66,$316.22
5583140B,0983,55831,,,,,N/A,N/A,REMOVAL OF PROSTATE         ~P,"$2,085.48","$1,550.25",$847.47,"$2,067.00",$847.47,"$2,004.99",$847.47,"$1,767.29",$847.47,"$1,429.45",$847.47,"$2,004.99",$847.47,"$2,067.00",$847.47,$847.47,"$2,004.99"
5584540B,0983,55845,,,,,N/A,N/A,EXTENSIVE PROSTATE SURGERY  ~P,"$3,417.28","$2,540.25","$1,388.67","$3,387.00","$1,388.67","$3,285.39","$1,388.67","$2,895.89","$1,388.67","$1,545.89","$1,388.67","$3,285.39","$1,388.67","$3,387.00","$1,388.67","$1,388.67","$3,285.39"
5713540B,0983,57135,,,,,N/A,N/A,REMOVE VAGINA LESION        ~P,$411.65,$306.00,$167.28,$284.95,$167.28,N/A,$167.28,$0.00,$167.28,$284.95,$167.28,N/A,$167.28,N/A,$167.28,$167.28,N/A
5724040B,0983,57240,,,,,N/A,N/A,REPAIR BLADDER & VAGINA     ~P,$932.26,$693.00,$378.84,$924.00,$378.84,$896.28,$378.84,$790.02,$378.84,$546.82,$378.84,$896.28,$378.84,$924.00,$378.84,$378.84,$896.28
5728740B,0983,57287,,,,,N/A,N/A,REVISE/REMOVE SLING REPAIR  ~P,"$1,469.02","$1,092.00",$617.46,"$1,506.00",$617.46,"$1,460.82",$617.46,"$1,287.63",$617.46,"$1,147.66",$617.46,"$1,460.82",$617.46,"$1,506.00",$617.46,$617.46,"$1,460.82"
5728840B,0983,57288,,,,,N/A,N/A,REPAIR BLADDER DEFECT       ~P,"$1,780.78","$1,323.75",$723.65,"$1,765.00",$723.65,"$1,712.05",$723.65,"$1,509.08",$723.65,"$1,223.80",$723.65,"$1,712.05",$723.65,"$1,765.00",$723.65,$723.65,"$1,712.05"
5818040B,0983,58180,,,,,N/A,N/A,PARTIAL HYSTERECTOMY        ~P,"$2,154.09","$1,601.25",$875.35,"$2,135.00",$875.35,"$2,070.95",$875.35,"$1,825.43",$875.35,"$1,668.24",$875.35,"$2,070.95",$875.35,"$2,135.00",$875.35,$875.35,"$2,070.95"
5866040B,0983,58660,,,,,N/A,N/A,"LAPAROSCOPY, LYSIS          ~P","$1,575.96","$1,171.50",$64.42,"$1,562.00",$64.42,"$1,515.14",$64.42,"$1,335.51",$64.42,$124.93,$64.42,"$1,515.14",$64.42,"$1,562.00",$64.42,$64.42,"$1,515.14"
5866140B,0983,58661,,,,,N/A,N/A,LAPAROSCOPY REMOVE ADNEXA   ~P,"$1,539.64","$1,144.50",$625.66,"$1,526.00",$625.66,"$1,480.22",$625.66,"$1,304.73",$625.66,"$1,119.07",$625.66,"$1,480.22",$625.66,"$1,526.00",$625.66,$625.66,"$1,480.22"
5872040B,0983,58720,,,,,N/A,N/A,SALP/OOPHORECTOMY COMP/PART ~P,"$1,416.55","$1,053.00",$575.64,"$1,312.18",$575.64,N/A,$575.64,$0.00,$575.64,"$1,312.18",$575.64,N/A,$575.64,N/A,$575.64,$575.64,N/A
5951440B,0983,59514,,,,,N/A,N/A,CESAREAN DELIVERY ONLY      ~P,"$2,205.54","$1,639.50","$2,126.26","$2,604.92","$2,126.26",N/A,"$2,126.26",$0.00,"$2,126.26","$2,604.92","$2,126.26",N/A,"$2,126.26",N/A,"$2,126.26","$2,126.26",N/A
6227050B,0983,62270,,,,,N/A,N/A,"SPINAL FLUID TAP, DIAGNOSTIC~P",$202.80,$150.75,$83.35,$207.00,$88.97,$200.79,$88.97,$176.99,$88.97,$83.35,$88.97,$200.79,$88.97,$207.00,$88.97,$88.97,$200.79
6227250B,0983,62272,,,,,N/A,N/A,DRAIN CEREBRO SPINAL FLUID  ~P,$255.26,$189.75,$78.63,$291.00,$119.31,$282.27,$119.31,$248.81,$119.31,$78.63,$119.31,$282.27,$119.31,$291.00,$119.31,$119.31,$282.27
6232950B,0983,62329,,,,,N/A,N/A,SPINAL PUNCTURE             ~P,$605.36,$450.00,$113.34,$653.00,$267.73,$633.41,$267.73,$558.32,$267.73,$113.34,$267.73,$633.41,$267.73,$653.00,$267.73,$267.73,$633.41
6236540B,0983,62365,,,,,N/A,N/A,REMOVE SPINE INFUSION DEVICE~P,$811.19,$603.00,$35.14,$854.00,$35.14,$828.38,$35.14,$730.17,$35.14,$495.12,$35.14,$828.38,$35.14,$854.00,$35.14,$35.14,$828.38
4564405B,0983,64405,,,,,N/A,N/A,OCCIPITAL NERVE BLOCK       ~P,$193.72,$144.00,$63.43,$233.00,$68.47,$226.01,$68.47,$134.99,$68.47,$63.43,$68.47,$226.01,$68.47,$233.00,$68.47,$68.47,$226.01
6440550B,0983,64405,,,,,N/A,N/A,"N BLOCK INJ, OCCIPITAL      ~P",$147.31,$109.50,$63.43,$233.00,$68.47,$226.01,$68.47,$134.99,$68.47,$63.43,$68.47,$226.01,$68.47,$233.00,$68.47,$68.47,$226.01
6445040B,0983,64450,,,,,N/A,N/A,"N BLOCK, OTHER PERIPHERAL   ~P",$136.21,$101.25,$68.47,$167.00,$68.47,$161.99,$68.47,$127.02,$68.47,$78.69,$68.47,$161.99,$68.47,$167.00,$68.47,$68.47,$161.99
6445050B,0983,64450,,,,,N/A,N/A,"N BLOCK, OTHER PERIPHERAL   ~P",$136.21,$101.25,$68.47,$167.00,$68.47,$161.99,$68.47,$127.02,$68.47,$78.69,$68.47,$161.99,$68.47,$167.00,$68.47,$68.47,$161.99
6445545B,0983,64455,,,,,N/A,N/A,INJ ANES/STEROID PLANTAR    ~P,$76.68,$57.00,$38.13,$105.79,$38.13,$90.21,$38.13,$58.84,$38.13,$105.79,$38.13,$90.21,$38.13,$93.00,$38.13,$38.13,$90.21
6456640B,0983,64566,,,,,N/A,N/A,"POST TIB NEUROSTIM,PRG NEED~P",$202.80,$150.75,$82.41,$201.00,$82.41,$194.97,$82.41,$136.58,$82.41,$122.70,$82.41,$194.97,$82.41,$201.00,$82.41,$82.41,$194.97
6458540B,0983,64585,,,,,N/A,N/A,REVISE/REMOVE NEUROELECTRODE~P,$716.35,$532.50,$39.35,$735.00,$55.35,$712.95,$55.35,$376.31,$55.35,$39.35,$55.35,$712.95,$55.35,$735.00,$55.35,$55.35,$712.95
6459540B,0983,64595,,,,,N/A,N/A,REVISE/REMOVE NEURORECEIVER ~P,$687.09,$510.75,$186.60,$701.00,$287.41,$679.97,$287.41,$533.93,$287.41,$186.60,$287.41,$679.97,$287.41,$701.00,$287.41,$287.41,$679.97
6461250B,0983,64612,,,,,N/A,N/A,CHEMODENERVATION OF MUSCLE  ~P,$293.60,$218.25,$138.70,$572.00,$234.52,$554.84,$234.52,$207.89,$234.52,$138.70,$234.52,$554.84,$234.52,$572.00,$234.52,$234.52,$554.84
6470845B,0983,64708,,,,,N/A,N/A,REVISE ARM/LEG NERVE        ~P,"$1,046.27",$777.75,$423.48,"$1,037.00",$425.17,"$1,005.89",$425.17,$548.01,$425.17,$423.48,$425.17,"$1,005.89",$425.17,"$1,037.00",$425.17,$425.17,"$1,005.89"
6471845B,0983,64718,,,,,N/A,N/A,REVISE ULNAR NERVE ELBOW    ~P,"$1,139.09",$846.75,$462.89,"$1,129.00",$462.89,"$1,095.13",$462.89,$734.47,$462.89,$662.10,$462.89,"$1,095.13",$462.89,"$1,129.00",$462.89,$462.89,"$1,095.13"
6472145B,0983,64721,,,,,N/A,N/A,CARPAL TUNNEL SURGERY       ~P,"$1,203.67",$894.75,$489.13,"$1,193.00",$489.13,"$1,157.21",$489.13,$956.76,$489.13,$529.35,$489.13,"$1,157.21",$489.13,"$1,193.00",$489.13,$489.13,"$1,157.21"
6483145B,0983,64831,,,,,N/A,N/A,REPAIR OF DIGIT NERVE       ~P,"$1,569.91","$1,167.00",$567.43,"$1,556.00",$637.96,"$1,509.32",$637.96,$823.94,$637.96,$567.43,$637.96,"$1,509.32",$637.96,"$1,556.00",$637.96,$637.96,"$1,509.32"
6485745B,0983,64857,,,,,N/A,N/A,REPAIR ARM/LEG NERVE        ~P,"$2,302.40","$1,711.50",$898.49,"$2,282.00",$935.62,"$2,213.54",$935.62,"$1,463.29",$935.62,$898.49,$935.62,"$2,213.54",$935.62,"$2,282.00",$935.62,$935.62,"$2,213.54"
9572450B,0983,65724,,,,,N/A,N/A,EEG 60-74 HOURS             ~P,$605.36,$450.00,$88.84,$600.00,N/A,$582.00,N/A,N/A,N/A,$88.84,N/A,$582.00,N/A,$600.00,N/A,N/A,$582.00
69210LSC,0983,69210,,,,,N/A,N/A,REMOVE IMPACTED EAR WAX,$103.92,$77.25,$23.19,$359.00,N/A,$348.23,N/A,$71.60,N/A,$23.19,N/A,$348.23,N/A,$359.00,N/A,N/A,$348.23
7600045B,0983,76000,,,,,N/A,N/A,FLUOROSCOPE EXAMINATION     ~P,$144.28,$107.25,$566.21,$566.21,$566.21,N/A,$566.21,N/A,$566.21,N/A,$566.21,N/A,$566.21,N/A,$566.21,$566.21,N/A
7653640B,0983,76536,,,,,N/A,N/A,"ULTRASOUND NECK,THORAX,ABD  ~P",$192.71,$143.25,$113.98,$113.98,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,N/A,$113.98,$113.98,N/A
7660440B,0983,76604,,,,,N/A,N/A,"ULTRASOUND, CHEST           ~P",$54.48,$40.50,$87.33,$87.33,$87.33,N/A,$87.33,N/A,$87.33,N/A,$87.33,N/A,$87.33,N/A,$87.33,$87.33,N/A
7664140B,0983,76641,,,,,N/A,N/A,"ULTRASOUND, BREAST          ~P",$180.60,$134.25,$79.54,$79.54,$79.54,N/A,$79.54,N/A,$79.54,N/A,$79.54,N/A,$79.54,N/A,$79.54,$79.54,N/A
7664240B,0983,76642,,,,,N/A,N/A,ULTRASOUND LIMITED          ~P,$55.49,$41.25,$19.24,$19.24,$19.24,N/A,$19.24,N/A,$19.24,N/A,$19.24,N/A,$19.24,N/A,$19.24,$19.24,N/A
7664540B,0983,76645,,,,,N/A,N/A,US EXAM                     ~P,$180.60,$134.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7670540B,0983,76705,,,,,N/A,N/A,US ABD LIMITED              ~P,$369.27,$274.50,$25.82,$25.82,$25.82,N/A,$25.82,N/A,$25.82,N/A,$25.82,N/A,$25.82,N/A,$25.82,$25.82,N/A
7677540B,0983,76775,,,,,N/A,N/A,US RETRO PERI LIMITED       ~P,$368.26,$273.75,$177.12,$177.12,$177.12,N/A,$177.12,N/A,$177.12,N/A,$177.12,N/A,$177.12,N/A,$177.12,$177.12,N/A
7685740B,0983,76857,,,,,N/A,N/A,US EXAN PELVIC LIMITED      ~P,$40.36,$30.00,$91.20,$91.20,$91.20,N/A,$91.20,N/A,$91.20,N/A,$91.20,N/A,$91.20,N/A,$91.20,$91.20,N/A
7687240B,0983,76872,,,,,N/A,N/A,US. TRANSRECTAL             ~P,$167.48,$124.50,$68.60,$68.60,$68.60,N/A,$68.60,N/A,$68.60,N/A,$68.60,N/A,$68.60,N/A,$68.60,$68.60,N/A
7688240B,0983,76882,,,,,N/A,N/A,ULTRASOUND LIMITED          ~P,$49.44,$36.75,$1.25,$1.25,$1.25,N/A,$1.25,N/A,$1.25,N/A,$1.25,N/A,$1.25,N/A,$1.25,$1.25,N/A
7694240B,0983,76942,,,,,N/A,N/A,ECHO GUIDE FOR BIOPSY       ~P,$220.96,$164.25,$89.79,$89.79,$89.79,N/A,$89.79,N/A,$89.79,N/A,$89.79,N/A,$89.79,N/A,$89.79,$89.79,N/A
7700140B,0983,77001,,,,,N/A,N/A,FLUOR GID CTR VAD PLMT RPLT ~P,$242.15,$180.00,$453.50,$453.50,$453.50,N/A,$453.50,N/A,$453.50,N/A,$453.50,N/A,$453.50,N/A,$453.50,$453.50,N/A
7700245B,0983,77002,,,,,N/A,N/A,FLURO GUIDE NEEDLE PLACEMENT~P,$153.36,$114.00,$282.80,$282.80,$282.80,N/A,$282.80,N/A,$282.80,N/A,$282.80,N/A,$282.80,N/A,$282.80,$282.80,N/A
7707145B,0983,77071,,,,,N/A,N/A,X-RAY STRESS VIEW           ~P,$121.07,$90.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
7845234B,0983,78452,,,,,N/A,N/A,MPI MULTIPLE STUDIES        ~P,"$1,144.14",$850.50,$464.94,$464.94,$464.94,N/A,$464.94,N/A,$464.94,N/A,$464.94,N/A,$464.94,N/A,$464.94,$464.94,N/A
90471LSC,0983,90471,,,,,N/A,N/A,IMMUNIZATION ADMIN,$52.46,$39.00,$23.78,$181.00,$23.78,$175.57,$23.78,N/A,$23.78,N/A,$23.78,$175.57,$23.78,$181.00,$23.78,$23.78,$175.57
9058640B,0983,90586,,,,,N/A,N/A,Bcg Per Vial                ~p,$0.00,$0.00,$12.77,$272.00,N/A,$263.84,N/A,N/A,N/A,$12.77,N/A,$263.84,N/A,$272.00,N/A,N/A,$263.84
9296034B,0983,92960,,,,,N/A,N/A,CARDIOVERSION               ~P,$375.33,$279.00,$1.90,$372.00,$81.55,$360.84,$81.55,N/A,$81.55,$1.90,$81.55,$360.84,$81.55,$372.00,$81.55,$81.55,$360.84
9301634B,0983,93016,,,,,N/A,N/A,STRESS SUPERVISION          ~P,$68.61,$51.00,$0.00,$151.10,$27.88,$0.00,$27.88,N/A,$27.88,$151.10,$27.88,$0.00,$27.88,N/A,$27.88,$27.88,$0.00
9301834B,0983,93018,,,,,N/A,N/A,STRESS INTER/REPORT         ~P,$46.41,$34.50,$44.62,$74.25,N/A,$44.62,N/A,N/A,N/A,$74.25,N/A,$44.62,N/A,$46.00,N/A,N/A,$44.62
9304034B,0983,93040,,,,,N/A,N/A,"EKG RHYTHM,1,3LEADS,W/I&R   ~P",$42.38,$31.50,$17.22,$42.00,$17.22,$40.74,$17.22,N/A,$17.22,$30.80,$17.22,$40.74,$17.22,$42.00,$17.22,$17.22,$40.74
9322734B,0983,93227,,,,,N/A,N/A,HOLTER INTER                ~P,$76.68,$57.00,$31.16,$76.00,$31.16,$73.72,$31.16,N/A,$31.16,$42.69,$31.16,$73.72,$31.16,$76.00,$31.16,$31.16,$73.72
9322834B,0983,93228,,,,,N/A,N/A,CER INTER                   ~P,$59.53,$44.25,$24.19,$59.00,$24.19,$57.23,$24.19,N/A,$24.19,$39.69,$24.19,$57.23,$24.19,$59.00,$24.19,$24.19,$57.23
9324834B,0983,93248,,,,,N/A,N/A,14 DAY CARDIAC MONITORING   ~P,$62.55,$46.50,$25.42,$62.00,$25.42,$60.14,$25.42,N/A,$25.42,$54.30,$25.42,$60.14,$25.42,$62.00,$25.42,$25.42,$60.14
9326034B,0983,93260,,,,,N/A,N/A,SUBCUTANEOUS LEAD DEFIB     ~P,$91.81,$68.25,$56.58,$138.00,$56.58,$133.86,$56.58,N/A,$56.58,$57.16,$56.58,$133.86,$56.58,$138.00,$56.58,$56.58,$133.86
9327234B,0983,93272,,,,,N/A,N/A,"ECG/REVIEW, INTER ONLY      ~P",$76.68,$57.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9327934B,0983,93279,,,,,N/A,N/A,PM DEVICE PROGR EVAL        ~P,$69.62,$51.75,$18.96,$87.00,N/A,$84.39,N/A,N/A,N/A,$18.96,N/A,$84.39,N/A,$87.00,N/A,N/A,$84.39
9328034B,0983,93280,,,,,N/A,N/A,PM DEVICE PROGR EVAL        ~P,$111.99,$83.25,$54.94,$142.11,$54.94,$114.46,$54.94,N/A,$54.94,$142.11,$54.94,$114.46,$54.94,$118.00,$54.94,$54.94,$114.46
9328040B,0983,93280,,,,,N/A,N/A,PACEMAKER DEV PROG EVAL DUAL~P,$119.05,$88.50,$54.94,$142.11,$54.94,$114.46,$54.94,N/A,$54.94,$142.11,$54.94,$114.46,$54.94,$118.00,$54.94,$54.94,$114.46
9328134B,0983,93281,,,,,N/A,N/A,PM DEVIC PROG EVAL MULT LEAD~P,$128.14,$95.25,$151.32,$168.15,N/A,$151.32,N/A,N/A,N/A,$168.15,N/A,$151.32,N/A,$156.00,N/A,N/A,$151.32
9328234B,0983,93282,,,,,N/A,N/A,"ICD DEVICE PROG EVAL,1SNGL  ~P",$116.03,$86.25,$11.89,$179.27,$11.89,$139.68,$11.89,N/A,$11.89,$179.27,$11.89,$139.68,$11.89,$144.00,$11.89,$11.89,$139.68
9328334B,0983,93283,,,,,N/A,N/A,"ICD DEVICE PROG EVAL,DUAL   ~P",$150.33,$111.75,$75.85,$185.00,$75.85,$179.45,$75.85,N/A,$75.85,$170.37,$75.85,$179.45,$75.85,$185.00,$75.85,$75.85,$179.45
9328434B,0983,93284,,,,,N/A,N/A,"ICD DEVICE PROG EVAL,MULT   ~P",$160.42,$119.25,$84.50,$208.91,$84.50,$198.85,$84.50,N/A,$84.50,$208.91,$84.50,$198.85,$84.50,$205.00,$84.50,$84.50,$198.85
9328534B,0983,93285,,,,,N/A,N/A,ILR DEVICE EVAL PROG        ~P,$18.16,$13.50,$34.92,$225.95,$84.50,$34.92,$84.50,N/A,$84.50,$225.95,$84.50,$34.92,$84.50,$36.00,$84.50,$84.50,$34.92
9328634B,0983,93286,,,,,N/A,N/A,PERI-PROCEDURAL DEVICE EVAL ~P,$32.29,$24.00,$18.86,$127.28,$18.86,$44.62,$18.86,N/A,$18.86,$127.28,$18.86,$44.62,$18.86,$46.00,$18.86,$18.86,$44.62
9328734B,0983,93287,,,,,N/A,N/A,PERI-PRCDRL DF EVAL         ~P,$49.44,$36.75,$42.23,$103.00,$42.23,$99.91,$42.23,N/A,$42.23,$97.22,$42.23,$99.91,$42.23,$103.00,$42.23,$42.23,$99.91
9328834B,0983,93288,,,,,N/A,N/A,PM DEVICE EVAL IN PERSON    ~P,$70.63,$52.50,$31.16,$113.20,$31.16,$83.42,$31.16,N/A,$31.16,$113.20,$31.16,$83.42,$31.16,$86.00,$31.16,$31.16,$83.42
9328840B,0983,93288,,,,,N/A,N/A,PACEMAKER DEVICE EVAL/PERSON~P,$76.68,$57.00,$31.16,$113.20,$31.16,$83.42,$31.16,N/A,$31.16,$113.20,$31.16,$83.42,$31.16,$86.00,$31.16,$31.16,$83.42
9328934B,0983,93289,,,,,N/A,N/A,ICD DEVICE INTERRAGATE      ~P,$116.03,$86.25,$61.91,$151.00,$61.91,$146.47,$61.91,N/A,$61.91,$117.97,$61.91,$146.47,$61.91,$151.00,$61.91,$61.91,$146.47
9329134B,0983,93291,,,,,N/A,N/A,ILR DEVICE INTERRAGATE      ~P,$67.60,$50.25,$34.85,$153.32,$34.85,$82.45,$34.85,N/A,$34.85,$153.32,$34.85,$82.45,$34.85,$85.00,$34.85,$34.85,$82.45
9329434B,0983,93294,,,,,N/A,N/A,PM DEVICE INTERRAGATE REMOTE~P,$57.51,$42.75,$3.75,$103.89,$3.75,$72.75,$3.75,N/A,$3.75,$103.89,$3.75,$72.75,$3.75,$75.00,$3.75,$3.75,$72.75
9329440B,0983,93294,,,,,N/A,N/A,INTERRO EVAL REMOTE </90    ~P,$65.58,$48.75,$3.75,$103.89,$3.75,$72.75,$3.75,N/A,$3.75,$103.89,$3.75,$72.75,$3.75,$75.00,$3.75,$3.75,$72.75
9329534B,0983,93295,,,,,N/A,N/A,ICD DEVICE INTERROGAT REMOTE~P,$73.65,$54.75,$35.26,$86.00,$35.26,$83.42,$35.26,N/A,$35.26,$63.93,$35.26,$83.42,$35.26,$86.00,$35.26,$35.26,$83.42
9329634B,0983,93296,,,,,N/A,N/A,PM/ICD REMOTE TECH SERV     ~P,$60.54,$45.00,$24.60,$79.17,$24.60,$58.20,$24.60,N/A,$24.60,$79.17,$24.60,$58.20,$24.60,$60.00,$24.60,$24.60,$58.20
9329640B,0983,93296,,,,,N/A,N/A,PM/ICD REMOTE TECH SERV     ~P,$60.54,$45.00,$24.60,$79.17,$24.60,$58.20,$24.60,N/A,$24.60,$79.17,$24.60,$58.20,$24.60,$60.00,$24.60,$24.60,$58.20
9329834B,0983,93298,,,,,N/A,N/A,ILR DEVICE INTERROGAT REMOTE~P,$56.50,$42.00,$22.96,$56.00,$22.96,$54.32,$22.96,N/A,$22.96,$54.55,$22.96,$54.32,$22.96,$56.00,$22.96,$22.96,$54.32
9330634B,0983,93306,,,,,N/A,N/A,ECHO READING                ~P,$485.30,$360.75,$197.21,$481.00,$197.21,$466.57,$197.21,N/A,$197.21,$439.60,$197.21,$466.57,$197.21,$481.00,$197.21,$197.21,$466.57
9330734B,0983,93307,,,,,N/A,N/A,ECHO EXAM OF HEART          ~P,$452.01,$336.00,$148.82,$473.00,$193.52,$458.81,$193.52,N/A,$193.52,$148.82,$193.52,$458.81,$193.52,$473.00,$193.52,$193.52,$458.81
9330834B,0983,93308,,,,,N/A,N/A,ECHO EXAM OF HEART          ~P,$242.15,$180.00,$25.82,$310.19,$25.82,$251.23,$25.82,N/A,$25.82,$310.19,$25.82,$251.23,$25.82,$259.00,$25.82,$25.82,$251.23
9331234B,0983,93312,,,,,N/A,N/A,ECHO TRANSESOPHAGEAL        ~P,$631.60,$469.50,$217.75,$711.00,$476.10,$689.67,$476.10,N/A,$476.10,$217.75,$476.10,$689.67,$476.10,$711.00,$476.10,$476.10,$689.67
9335034B,0983,93350,,,,,N/A,N/A,STRESS ECHO                 ~P,$471.17,$350.25,$21.74,$467.00,$21.74,$452.99,$21.74,N/A,$21.74,$54.13,$21.74,$452.99,$21.74,$467.00,$21.74,$21.74,$452.99
9388040B,0983,93880,,,,,N/A,N/A,NONINVASIVE TESTS ARTERIES  ~P,$325.89,$242.25,$19.37,$323.00,$132.43,$313.31,$132.43,N/A,$132.43,$19.37,$132.43,$313.31,$132.43,$323.00,$132.43,$132.43,$313.31
9388240B,0983,93882,,,,,N/A,N/A,NONINVASIVE TESTS ARTERIES  ~P,$247.19,$183.75,$1.45,$245.00,$1.45,$237.65,$1.45,N/A,$1.45,$231.93,$1.45,$237.65,$1.45,$245.00,$1.45,$1.45,$237.65
9392240B,0983,93922,,,,,N/A,N/A,NONINVASIVE VASCULAR STUDIES~P,$156.39,$116.25,$73.39,$179.00,$73.39,$173.63,$73.39,N/A,$73.39,$150.58,$73.39,$173.63,$73.39,$179.00,$73.39,$73.39,$173.63
9397140B,0983,93971,,,,,N/A,N/A,UNILATERAL OR LIMITED STUDY ~P,$45.40,$33.75,$184.90,$416.00,$184.90,$403.52,$184.90,N/A,$184.90,$227.72,$184.90,$403.52,$184.90,$416.00,$184.90,$184.90,$403.52
94150LSC,0983,94150,,,,,N/A,N/A,PEAK FLOW TEST,$31.28,$23.25,$30.07,$93.89,$93.89,$30.07,$93.89,N/A,$93.89,$82.20,$93.89,$30.07,$93.89,$31.00,$93.89,$93.89,$30.07
94640LSC,0983,94640,,,,,N/A,N/A,AIRWAY INHALATION TREATMENT,$61.55,$45.75,$207.98,$218.00,N/A,$211.46,N/A,N/A,N/A,$207.98,N/A,$211.46,N/A,$218.00,N/A,N/A,$211.46
94760LSC,0983,94760,,,,,N/A,N/A,MEASURE BLOOD OXYGEN LEVEL,$31.28,$23.25,$59.40,$144.00,$59.40,$139.68,$59.40,N/A,$59.40,$78.75,$59.40,$139.68,$59.40,$144.00,$59.40,$59.40,$139.68
95115LSC,0983,95115,,,,,N/A,N/A,"IMMUNOTHERAPY, ONE INJECTION",$42.38,$31.50,$37.52,$37.52,N/A,N/A,N/A,N/A,N/A,$37.52,N/A,N/A,N/A,N/A,N/A,N/A,N/A
95117LSC,0983,95117,,,,,N/A,N/A,IMMUNOTHERAPY INJECTIONS,$49.44,$36.75,$9.86,$9.86,N/A,N/A,N/A,N/A,N/A,$9.86,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9571750B,0983,95717,,,,,N/A,N/A,EEG 2-12 HOURS W/O VIDEO    ~P,$209.86,$156.00,$201.76,$387.71,N/A,$201.76,N/A,N/A,N/A,$387.71,N/A,$201.76,N/A,$208.00,N/A,N/A,$201.76
9571850B,0983,95718,,,,,N/A,N/A,EEG 2-12 HOURS W/VIDEO      ~P,$275.44,$204.75,$132.21,$273.00,N/A,$264.81,N/A,N/A,N/A,$132.21,N/A,$264.81,N/A,$273.00,N/A,N/A,$264.81
9571950B,0983,95719,,,,,N/A,N/A,EEG 12-26 HOURS W/O VIDEO   ~P,$323.87,$240.75,$174.79,$321.00,N/A,$311.37,N/A,N/A,N/A,$174.79,N/A,$311.37,N/A,$321.00,N/A,N/A,$311.37
9572050B,0983,95720,,,,,N/A,N/A,EEG 12-26 HOURS W/VIDEO     ~P,$426.78,$317.25,$204.54,$423.00,N/A,$410.31,N/A,N/A,N/A,$204.54,N/A,$410.31,N/A,$423.00,N/A,N/A,$410.31
9572150B,0983,95721,,,,,N/A,N/A,EEG UP TO 60HRS W/O VIDEO   ~P,$403.58,$300.00,$269.04,$400.00,N/A,$388.00,N/A,N/A,N/A,$269.04,N/A,$388.00,N/A,$400.00,N/A,N/A,$388.00
9572250B,0983,95722,,,,,N/A,N/A,EEG >36HR UP TO 60HRS       ~P,$454.02,$337.50,$269.50,$450.00,N/A,$436.50,N/A,N/A,N/A,$269.50,N/A,$436.50,N/A,$450.00,N/A,N/A,$436.50
9572350B,0983,95723,,,,,N/A,N/A,EEG > 60HRS                 ~P,$524.65,$390.00,$50.44,$328.26,N/A,$50.44,N/A,N/A,N/A,$328.26,N/A,$50.44,N/A,$52.00,N/A,N/A,$50.44
9581350B,0983,95813,,,,,N/A,N/A,"EEG, OVER 1 HOUR            ~P",$485.30,$360.75,$465.20,$509.00,N/A,$493.73,N/A,N/A,N/A,$465.20,N/A,$493.73,N/A,$509.00,N/A,N/A,$493.73
9581650B,0983,95816,,,,,N/A,N/A,"EEG, AWAKE AND DROWSY       ~P",$377.34,$280.50,$362.78,$571.81,N/A,$362.78,N/A,N/A,N/A,$571.81,N/A,$362.78,N/A,$374.00,N/A,N/A,$362.78
9581950B,0983,95819,,,,,N/A,N/A,"EEG, AWAKE AND ASLEEP       ~P",$403.58,$300.00,$430.68,$509.00,N/A,$430.68,N/A,N/A,N/A,$509.00,N/A,$430.68,N/A,$444.00,N/A,N/A,$430.68
9582250B,0983,95822,,,,,N/A,N/A,"EEG, COMA OR SLEEP ONLY     ~P",$682.04,$507.00,$610.89,$701.00,N/A,$679.97,N/A,N/A,N/A,$610.89,N/A,$679.97,N/A,$701.00,N/A,N/A,$679.97
9583050B,0983,95830,,,,,N/A,N/A,INSERT ELECTRODES FOR EEG   ~P,$213.90,$159.00,$269.66,$556.95,N/A,$269.66,N/A,N/A,N/A,$556.95,N/A,$269.66,N/A,$278.00,N/A,N/A,$269.66
9586050B,0983,95860,,,,,N/A,N/A,"MUSCLE TEST, ONE LIMB       ~P",$105.94,$78.75,$169.75,$175.00,N/A,$169.75,N/A,N/A,N/A,$175.00,N/A,$169.75,N/A,$175.00,N/A,N/A,$169.75
9586150B,0983,95861,,,,,N/A,N/A,"MUSCLE TEST, 2 LIMBS        ~P",$146.30,$108.75,$159.87,$260.00,N/A,$252.20,N/A,N/A,N/A,$159.87,N/A,$252.20,N/A,$260.00,N/A,N/A,$252.20
9586950B,0983,95869,,,,,N/A,N/A,"MUSCLE TEST, THOR PARASPINAL~P",$70.63,$52.50,$135.80,$230.91,N/A,$135.80,N/A,N/A,N/A,$230.91,N/A,$135.80,N/A,$140.00,N/A,N/A,$135.80
9587050B,0983,95870,,,,,N/A,N/A,"MUSCLE TEST, NONPARASPINAL  ~P",$75.67,$56.25,$116.40,$137.70,N/A,$116.40,N/A,N/A,N/A,$137.70,N/A,$116.40,N/A,$120.00,N/A,N/A,$116.40
9587450B,0983,95874,,,,,N/A,N/A,NEEDLE ELECTROM FOR GUIDANCE~P,$120.06,$89.25,$115.43,$122.95,N/A,$115.43,N/A,N/A,N/A,$122.95,N/A,$115.43,N/A,$119.00,N/A,N/A,$115.43
9588550B,0983,95885,,,,,N/A,N/A,"NEEDLE EMG,EA EXTREMITY     ~P",$35.31,$26.25,$108.64,$112.00,N/A,$108.64,N/A,N/A,N/A,$111.82,N/A,$108.64,N/A,$112.00,N/A,N/A,$108.64
9588650B,0983,95886,,,,,N/A,N/A,"NEEDLE EMG, COMPLETE        ~P",$94.84,$70.50,$89.69,$175.00,N/A,$169.75,N/A,N/A,N/A,$89.69,N/A,$169.75,N/A,$175.00,N/A,N/A,$169.75
9588750B,0983,95887,,,,,N/A,N/A,"NEEDLE EMG,NON-EXT DONEW/NCD~P",$74.66,$55.50,$137.02,$156.00,N/A,$151.32,N/A,N/A,N/A,$137.02,N/A,$151.32,N/A,$156.00,N/A,N/A,$151.32
9590750B,0983,95907,,,,,N/A,N/A,NERVE CONDUCTION STUDY 1-2  ~P,$174.55,$129.75,$118.58,$236.00,N/A,$228.92,N/A,N/A,N/A,$118.58,N/A,$228.92,N/A,$236.00,N/A,N/A,$228.92
9590850B,0983,95908,,,,,N/A,N/A,NERVE CONDUCTION STUDY 3-4  ~P,$216.92,$161.25,$127.13,$291.00,N/A,$282.27,N/A,N/A,N/A,$127.13,N/A,$282.27,N/A,$291.00,N/A,N/A,$282.27
9590950B,0983,95909,,,,,N/A,N/A,NERVE CONDUCTION STUDY 5-6  ~P,$259.30,$192.75,$160.58,$348.00,N/A,$337.56,N/A,N/A,N/A,$160.58,N/A,$337.56,N/A,$348.00,N/A,N/A,$337.56
9591050B,0983,95910,,,,,N/A,N/A,NERVE CONDUCTION STUDY 7-8  ~P,$343.04,$255.00,$191.92,$458.00,N/A,$444.26,N/A,N/A,N/A,$191.92,N/A,$444.26,N/A,$458.00,N/A,N/A,$444.26
9591150B,0983,95911,,,,,N/A,N/A,NERVE CONDUCTION STUDY 9-10 ~P,$422.75,$314.25,$251.96,$555.00,N/A,$538.35,N/A,N/A,N/A,$251.96,N/A,$538.35,N/A,$555.00,N/A,N/A,$538.35
9591250B,0983,95912,,,,,N/A,N/A,NERVE CONDUCTION STUDY 11-12~P,$499.43,$371.25,$302.45,$649.00,N/A,$629.53,N/A,N/A,N/A,$302.45,N/A,$629.53,N/A,$649.00,N/A,N/A,$629.53
9591350B,0983,95913,,,,,N/A,N/A,NERVE CONDUCT STUDY 13 OR > ~P,$585.19,$435.00,$349.58,$752.00,N/A,$729.44,N/A,N/A,N/A,$349.58,N/A,$729.44,N/A,$752.00,N/A,N/A,$729.44
9592350B,0983,95923,,,,,N/A,N/A,SSR NERVE TEST              ~P,$161.43,$120.00,$223.10,$405.87,N/A,$223.10,N/A,N/A,N/A,$405.87,N/A,$223.10,N/A,$230.00,N/A,N/A,$223.10
9597050,0983,95970,,,,,N/A,N/A,NEURO W/O REPROG,$209.86,$156.00,$17.83,$263.00,$17.83,$255.11,$17.83,N/A,$17.83,N/A,$17.83,$255.11,$17.83,$263.00,$17.83,$17.83,$255.11
9597150B,0983,95971,,,,,N/A,N/A,NEURO W/ REPROGRAMMING      ~P,$292.59,$217.50,$24.55,$358.00,$146.78,$347.26,$146.78,N/A,$146.78,$24.55,$146.78,$347.26,$146.78,$358.00,$146.78,$146.78,$347.26
96372LSC,0983,96372,,,,,N/A,N/A,INJECTIONS,$68.61,$51.00,$24.15,$283.72,$283.72,N/A,$283.72,N/A,$283.72,$24.15,$283.72,N/A,$283.72,$185.00,$283.72,$283.72,N/A
9640140B,0983,96401,,,,,N/A,N/A,Chemo Administration        ~p,$0.00,$0.00,$11.79,$328.00,$134.48,$318.16,$134.48,N/A,$134.48,$11.79,$134.48,$318.16,$134.48,$328.00,$134.48,$134.48,$318.16
9759740B,0983,97597,,,,,N/A,N/A,DEBRIDEMENT WOUND 20 SQ CM< ~P,$65.58,$48.75,$14.55,$170.00,$14.55,$164.90,$14.55,N/A,$14.55,N/A,$14.55,$164.90,$14.55,$170.00,$14.55,$14.55,$164.90
9759745B,0983,97597,,,,,N/A,N/A,ACTIVE WOUND CARE DEBRID    ~P,$65.58,$48.75,$14.55,$170.00,$14.55,$164.90,$14.55,N/A,$14.55,N/A,$14.55,$164.90,$14.55,$170.00,$14.55,$14.55,$164.90
9759840B,0983,97598,,,,,N/A,N/A,ACTIVE WOUND CARE           ~P,$149.32,$111.00,$16.31,$391.00,$16.31,$379.27,$16.31,N/A,$16.31,$40.95,$16.31,$379.27,$16.31,$391.00,$16.31,$16.31,$379.27
9760540B,0983,97605,,,,,N/A,N/A,ACTIVE WOUND CARE NEG PRESS ~P,$68.61,$51.00,$27.88,$96.58,$27.88,$65.96,$27.88,N/A,$27.88,$96.58,$27.88,$65.96,$27.88,$68.00,$27.88,$27.88,$65.96
9760545B,0983,97605,,,,,N/A,N/A,ACTIVE WOUND CARE NEG PRESS ~P,$68.61,$51.00,$27.88,$96.58,$27.88,$65.96,$27.88,N/A,$27.88,$96.58,$27.88,$65.96,$27.88,$68.00,$27.88,$27.88,$65.96
9760640B,0983,97606,,,,,N/A,N/A,"NEG PRESS WOUND TX, > 50 CM ~P",$50.45,$37.50,$24.60,$60.00,$24.60,$58.20,$24.60,N/A,$24.60,$29.00,$24.60,$58.20,$24.60,$60.00,$24.60,$24.60,$58.20
9760740B,0983,97607,,,,,N/A,N/A,Neg. Pressure Wound Therapy ~p,$64.57,$48.00,$31.82,$148.00,$64.78,$143.56,$64.78,N/A,$64.78,$31.82,$64.78,$143.56,$64.78,$148.00,$64.78,$64.78,$143.56
9760745B,0983,97607,,,,,N/A,N/A,NEG. PRESSURE WOUND THERAPY ~P,$64.57,$48.00,$31.82,$148.00,$64.78,$143.56,$64.78,N/A,$64.78,$31.82,$64.78,$143.56,$64.78,$148.00,$64.78,$64.78,$143.56
9902434B,0983,99024,,,,,N/A,N/A,No Charge/Post Op Visit     ~p,$0.00,$0.00,$0.00,$42.59,N/A,$0.00,N/A,N/A,N/A,$42.59,N/A,$0.00,N/A,N/A,N/A,N/A,$0.00
9920234B,0983,99202,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT,NEW ~P",$110.98,$82.50,$0.00,$113.00,$52.89,$109.61,$52.89,$134.79,$52.89,$0.00,$52.89,$109.61,$52.89,$113.00,$52.89,$52.89,$109.61
9920240B,0983,99202,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT, NEW~P",$97.87,$72.75,$0.00,$113.00,$52.89,$109.61,$52.89,$244.38,$52.89,$0.00,$52.89,$109.61,$52.89,$113.00,$52.89,$52.89,$109.61
9920245B,0983,99202,,,,,N/A,N/A,OFFICE/OUTPATIENT VISIT NEW ~P,$97.87,$72.75,$0.00,$113.00,$52.89,$109.61,$52.89,$134.79,$52.89,$0.00,$52.89,$109.61,$52.89,$113.00,$52.89,$52.89,$109.61
9920250B,0983,99202,,,,,N/A,N/A,OFFICE/OUTPATIENT VISIT NEW ~P,$97.87,$72.75,$0.00,$113.00,$52.89,$109.61,$52.89,$244.38,$52.89,$0.00,$52.89,$109.61,$52.89,$113.00,$52.89,$52.89,$109.61
99202LSC,0983,99202,,,,,N/A,N/A,OFFICE/OUTPATIENT VISIT NEW,$180.60,$134.25,$0.00,$113.00,$52.89,$109.61,$52.89,$90.78,$52.89,$0.00,$52.89,$109.61,$52.89,$113.00,$52.89,$52.89,$109.61
9920334B,0983,99203,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT,NEW ~P",$114.01,$84.75,$48.70,$170.00,$69.70,$164.90,$69.70,$90.78,$69.70,$48.70,$69.70,$164.90,$69.70,$170.00,$69.70,$69.70,$164.90
9920340B,0983,99203,,,,,N/A,N/A,"OFFICE/OUTPT VISIT, NEW     ~P",$100.89,$75.00,$48.70,$170.00,$69.70,$164.90,$69.70,$192.79,$69.70,$48.70,$69.70,$164.90,$69.70,$170.00,$69.70,$69.70,$164.90
9920345B,0983,99203,,,,,N/A,N/A,OFFICE/OUTPATIENT VISIT NEW ~P,$100.89,$75.00,$48.70,$170.00,$69.70,$164.90,$69.70,$90.78,$69.70,$48.70,$69.70,$164.90,$69.70,$170.00,$69.70,$69.70,$164.90
9920350B,0983,99203,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT, NEW~P",$100.89,$75.00,$48.70,$170.00,$69.70,$164.90,$69.70,$192.79,$69.70,$48.70,$69.70,$164.90,$69.70,$170.00,$69.70,$69.70,$164.90
99203LSC,0983,99203,,,,,N/A,N/A,OFFICE/OUTPATIENT VISIT NEW,$208.85,$155.25,$48.70,$170.00,$69.70,$164.90,$69.70,$244.38,$69.70,$48.70,$69.70,$164.90,$69.70,$170.00,$69.70,$69.70,$164.90
9920434B,0983,99204,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT,NEW ~P",$193.72,$144.00,$82.46,$240.00,$98.40,$232.80,$98.40,$244.38,$98.40,$82.46,$98.40,$232.80,$98.40,$240.00,$98.40,$98.40,$232.80
9920440B,0983,99204,,,,,N/A,N/A,OFFICE/OUTPATIENT VISIT NEW ~P,$171.52,$127.50,$82.46,$240.00,$98.40,$232.80,$98.40,$134.79,$98.40,$82.46,$98.40,$232.80,$98.40,$240.00,$98.40,$98.40,$232.80
9920445B,0983,99204,,,,,N/A,N/A,OFFICE/OUTPATIENT VISIT NEW ~P,$171.52,$127.50,$82.46,$240.00,$98.40,$232.80,$98.40,$244.38,$98.40,$82.46,$98.40,$232.80,$98.40,$240.00,$98.40,$98.40,$232.80
9920450B,0983,99204,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT, NEW~P",$171.52,$127.50,$82.46,$240.00,$98.40,$232.80,$98.40,$134.79,$98.40,$82.46,$98.40,$232.80,$98.40,$240.00,$98.40,$98.40,$232.80
99204LSC,0983,99204,,,,,N/A,N/A,OFFICE/OUTPATIENT VISIT NEW,$308.74,$229.50,$82.46,$240.00,$98.40,$232.80,$98.40,$192.79,$98.40,$82.46,$98.40,$232.80,$98.40,$240.00,$98.40,$98.40,$232.80
9920534B,0983,99205,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT,NEW ~P",$191.70,$142.50,$127.10,$326.00,$127.10,$316.22,$127.10,N/A,$127.10,$134.46,$127.10,$316.22,$127.10,$326.00,$127.10,$127.10,$316.22
9920540B,0983,99205,,,,,N/A,N/A,OFFICE/OUTPATIENT VISIT NEW ~P,$191.70,$142.50,$127.10,$326.00,$127.10,$316.22,$127.10,N/A,$127.10,$134.46,$127.10,$316.22,$127.10,$326.00,$127.10,$127.10,$316.22
9920545B,0983,99205,,,,,N/A,N/A,OFFICE/OUTPATIENT VISIT NEW ~P,$191.70,$142.50,$127.10,$326.00,$127.10,$316.22,$127.10,N/A,$127.10,$134.46,$127.10,$316.22,$127.10,$326.00,$127.10,$127.10,$316.22
9920550B,0983,99205,,,,,N/A,N/A,OFFICE/OUTPATIENT VISIT  NEW~P,$191.70,$142.50,$127.10,$326.00,$127.10,$316.22,$127.10,N/A,$127.10,$134.46,$127.10,$316.22,$127.10,$326.00,$127.10,$127.10,$316.22
99205LSC,0983,99205,,,,,N/A,N/A,OFFICE/OUTPATIENT VISIT NEW,$408.62,$303.75,$127.10,$326.00,$127.10,$316.22,$127.10,N/A,$127.10,$134.46,$127.10,$316.22,$127.10,$326.00,$127.10,$127.10,$316.22
9921134B,0983,99211,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT, EST~P",$57.51,$42.75,$24.19,$182.62,$24.19,$57.23,$24.19,$231.34,$24.19,$182.62,$24.19,$57.23,$24.19,$59.00,$24.19,$24.19,$57.23
9921140B,0983,99211,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT, EST~P",$50.45,$37.50,$24.19,$182.62,$24.19,$57.23,$24.19,$82.17,$24.19,$182.62,$24.19,$57.23,$24.19,$59.00,$24.19,$24.19,$57.23
9921145B,0983,99211,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT, EST~P",$50.45,$37.50,$24.19,$182.62,$24.19,$57.23,$24.19,N/A,$24.19,$182.62,$24.19,$57.23,$24.19,$59.00,$24.19,$24.19,$57.23
9921150B,0983,99211,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT, EST~P",$59.53,$44.25,$24.19,$182.62,$24.19,$57.23,$24.19,N/A,$24.19,$182.62,$24.19,$57.23,$24.19,$59.00,$24.19,$24.19,$57.23
99211LSC,0983,99211,,,,,N/A,N/A,OFFICE/OUTPATIENT VISIT EST,$100.89,$75.00,$24.19,$182.62,$24.19,$57.23,$24.19,N/A,$24.19,$182.62,$24.19,$57.23,$24.19,$59.00,$24.19,$24.19,$57.23
9921234B,0983,99212,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT, EST~P",$56.50,$42.00,$8.95,$59.00,$24.19,$57.23,$24.19,$158.99,$24.19,$8.95,$24.19,$57.23,$24.19,$59.00,$24.19,$24.19,$57.23
9921240B,0983,99212,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT, EST~P",$49.44,$36.75,$8.95,$59.00,$24.19,$57.23,$24.19,$117.63,$24.19,$8.95,$24.19,$57.23,$24.19,$59.00,$24.19,$24.19,$57.23
9921245B,0983,99212,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT, EST~P",$49.44,$36.75,$8.95,$59.00,$24.19,$57.23,$24.19,$231.34,$24.19,$8.95,$24.19,$57.23,$24.19,$59.00,$24.19,$24.19,$57.23
9921250B,0983,99212,,,,,N/A,N/A,OFFICE/OUTPATIENT VISIT EST ~P,$49.44,$36.75,$8.95,$59.00,$24.19,$57.23,$24.19,$82.17,$24.19,$8.95,$24.19,$57.23,$24.19,$59.00,$24.19,$24.19,$57.23
99212LSC,0983,99212,,,,,N/A,N/A,OFFICE/OUTPATIENT VISIT EST,$118.05,$87.75,$8.95,$59.00,$24.19,$57.23,$24.19,$117.88,$24.19,$8.95,$24.19,$57.23,$24.19,$59.00,$24.19,$24.19,$57.23
9921334B,0983,99213,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT, EST~P",$83.74,$62.25,$35.65,$98.00,$45.92,$95.06,$45.92,$158.99,$45.92,$35.65,$45.92,$95.06,$45.92,$98.00,$45.92,$45.92,$95.06
9921340B,0983,99213,,,,,N/A,N/A,OFFICE/OUTPATIENT VISIT EST ~P,$73.65,$54.75,$35.65,$98.00,$45.92,$95.06,$45.92,$117.63,$45.92,$35.65,$45.92,$95.06,$45.92,$98.00,$45.92,$45.92,$95.06
9921345B,0983,99213,,,,,N/A,N/A,OFFICE/OUTPATIENT VISIT EST ~P,$73.65,$54.75,$35.65,$98.00,$45.92,$95.06,$45.92,$231.34,$45.92,$35.65,$45.92,$95.06,$45.92,$98.00,$45.92,$45.92,$95.06
9921350B,0983,99213,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT,EST ~P",$73.65,$54.75,$35.65,$98.00,$45.92,$95.06,$45.92,$82.17,$45.92,$35.65,$45.92,$95.06,$45.92,$98.00,$45.92,$45.92,$95.06
99213LSC,0983,99213,,,,,N/A,N/A,OFFICE/OUTPATIENT VISIT EST,$122.08,$90.75,$35.65,$98.00,$45.92,$95.06,$45.92,$117.88,$45.92,$35.65,$45.92,$95.06,$45.92,$98.00,$45.92,$45.92,$95.06
9921434B,0983,99214,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT, EST~P",$110.98,$82.50,$66.76,$170.00,$69.70,$164.90,$69.70,$223.43,$69.70,$66.76,$69.70,$164.90,$69.70,$170.00,$69.70,$69.70,$164.90
9921440B,0983,99214,,,,,N/A,N/A,OFFICE/OUTPATIENT VISIT EST ~P,$110.98,$82.50,$66.76,$170.00,$69.70,$164.90,$69.70,$164.07,$69.70,$66.76,$69.70,$164.90,$69.70,$170.00,$69.70,$69.70,$164.90
9921445B,0983,99214,,,,,N/A,N/A,OFFICE/OUTPATIENT VISIT EST ~P,$110.98,$82.50,$66.76,$170.00,$69.70,$164.90,$69.70,$44.22,$69.70,$66.76,$69.70,$164.90,$69.70,$170.00,$69.70,$69.70,$164.90
9921450B,0983,99214,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT, EST~P",$110.98,$82.50,$66.76,$170.00,$69.70,$164.90,$69.70,$117.88,$69.70,$66.76,$69.70,$164.90,$69.70,$170.00,$69.70,$69.70,$164.90
99214LSC,0983,99214,,,,,N/A,N/A,OFFICE/OUTPATIENT VISIT EST,$189.68,$141.00,$66.76,$170.00,$69.70,$164.90,$69.70,N/A,$69.70,$66.76,$69.70,$164.90,$69.70,$170.00,$69.70,$69.70,$164.90
9921534B,0983,99215,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT, EST~P",$161.43,$120.00,$95.53,$230.00,$95.53,$223.10,$95.53,$111.06,$95.53,$98.71,$95.53,$223.10,$95.53,$230.00,$95.53,$95.53,$223.10
9921540B,0983,99215,,,,,N/A,N/A,"OFFICE/OUTPT VISIT, EST     ~P",$161.43,$120.00,$95.53,$230.00,$95.53,$223.10,$95.53,$223.43,$95.53,$98.71,$95.53,$223.10,$95.53,$230.00,$95.53,$95.53,$223.10
9921545B,0983,99215,,,,,N/A,N/A,OFFICE/OUTPATIENT VISIT EST ~P,$161.43,$120.00,$95.53,$230.00,$95.53,$223.10,$95.53,$164.07,$95.53,$98.71,$95.53,$223.10,$95.53,$230.00,$95.53,$95.53,$223.10
9921550B,0983,99215,,,,,N/A,N/A,"OFFICE/OUTPATIENT VISIT, EST~P",$161.43,$120.00,$95.53,$230.00,$95.53,$223.10,$95.53,$44.22,$95.53,$98.71,$95.53,$223.10,$95.53,$230.00,$95.53,$95.53,$223.10
99215LSC,0983,99215,,,,,N/A,N/A,OFFICE/OUTPATIENT VISIT EST,$286.54,$213.00,$95.53,$230.00,$95.53,$223.10,$95.53,$82.17,$95.53,$98.71,$95.53,$223.10,$95.53,$230.00,$95.53,$95.53,$223.10
9921734B,0983,99217,,,,,N/A,N/A,OBSERVATION CARE DISCHARGE  ~P,$192.71,$143.25,N/A,N/A,N/A,N/A,N/A,$135.61,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9921740B,0983,99217,,,,,N/A,N/A,OBSERVATION CARE DISCHARGE  ~P,$170.51,$126.75,N/A,N/A,N/A,N/A,N/A,$189.12,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9921745B,0983,99217,,,,,N/A,N/A,OBSERVATION CARE DISCHARGE  ~P,$170.51,$126.75,N/A,N/A,N/A,N/A,N/A,$100.44,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9921834B,0983,99218,,,,,N/A,N/A,OBSERVATION CARE            ~P,$182.62,$135.75,N/A,N/A,N/A,N/A,N/A,$100.44,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9921840B,0983,99218,,,,,N/A,N/A,OBSERVATION CARE            ~P,$162.44,$120.75,N/A,N/A,N/A,N/A,N/A,$111.06,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9921845B,0983,99218,,,,,N/A,N/A,OBSERVATION CARE            ~P,$162.44,$120.75,N/A,N/A,N/A,N/A,N/A,$158.99,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9921934B,0983,99219,,,,,N/A,N/A,OBSERVATION CARE            ~P,$301.67,$224.25,N/A,N/A,N/A,N/A,N/A,$111.06,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9921940B,0983,99219,,,,,N/A,N/A,OBSERVATION CARE            ~P,$268.38,$199.50,N/A,N/A,N/A,N/A,N/A,$158.99,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9921945B,0983,99219,,,,,N/A,N/A,OBSERVATION CARE            ~P,$268.38,$199.50,N/A,N/A,N/A,N/A,N/A,$223.43,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9922034B,0983,99220,,,,,N/A,N/A,OBSERVATION CARE            ~P,$332.95,$247.50,N/A,N/A,N/A,N/A,N/A,$100.44,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9922040B,0983,99220,,,,,N/A,N/A,INITIAL OBSERV CARE         ~P,$296.63,$220.50,N/A,N/A,N/A,N/A,N/A,$111.06,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9922045B,0983,99220,,,,,N/A,N/A,INITIAL OBSERV CARE         ~P,$296.63,$220.50,N/A,N/A,N/A,N/A,N/A,$158.99,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9922050B,0983,99220,,,,,N/A,N/A,OBSERVATION CARE            ~P,$376.33,$279.75,N/A,N/A,N/A,N/A,N/A,$223.43,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9922134B,0983,99221,,,,,N/A,N/A,Initial Inpt/Observ Hosp    ~p,$185.64,$138.00,$66.83,$163.00,$66.83,$158.11,$66.83,$100.44,$66.83,$145.27,$66.83,$158.11,$66.83,$163.00,$66.83,$66.83,$158.11
9922140B,0983,99221,,,,,N/A,N/A,Initial Inpt/Observ Hosp    ~p,$164.46,$122.25,$66.83,$163.00,$66.83,$158.11,$66.83,$158.99,$66.83,$145.27,$66.83,$158.11,$66.83,$163.00,$66.83,$66.83,$158.11
9922145B,0983,99221,,,,,N/A,N/A,Initial Inpt/Observ Hosp    ~p,$164.46,$122.25,$66.83,$163.00,$66.83,$158.11,$66.83,$117.63,$66.83,$145.27,$66.83,$158.11,$66.83,$163.00,$66.83,$66.83,$158.11
9922150B,0983,99221,,,,,N/A,N/A,Initial Inpt/Observ Hosp    ~p,$191.70,$142.50,$66.83,$163.00,$66.83,$158.11,$66.83,$231.34,$66.83,$145.27,$66.83,$158.11,$66.83,$163.00,$66.83,$66.83,$158.11
9922234B,0983,99222,,,,,N/A,N/A,Initial Inpt/Observ Hosp    ~p,$261.32,$194.25,$94.30,$259.00,$94.30,$251.23,$94.30,$189.12,$94.30,$98.50,$94.30,$251.23,$94.30,$259.00,$94.30,$94.30,$251.23
9922240B,0983,99222,,,,,N/A,N/A,Initial Inpt/Observ Hosp    ~p,$232.06,$172.50,$94.30,$259.00,$94.30,$251.23,$94.30,$111.06,$94.30,$98.50,$94.30,$251.23,$94.30,$259.00,$94.30,$94.30,$251.23
9922245B,0983,99222,,,,,N/A,N/A,Initial Inpt/Observ Hosp    ~p,$116.03,$86.25,$94.30,$259.00,$94.30,$251.23,$94.30,$223.43,$94.30,$98.50,$94.30,$251.23,$94.30,$259.00,$94.30,$94.30,$251.23
9922250B,0983,99222,,,,,N/A,N/A,Initial Inpt/Observ Hosp    ~p,$116.03,$86.25,$94.30,$259.00,$94.30,$251.23,$94.30,$164.07,$94.30,$98.50,$94.30,$251.23,$94.30,$259.00,$94.30,$94.30,$251.23
9922334B,0983,99223,,,,,N/A,N/A,INITIAL HOSPITAL CARE       ~P,$375.33,$279.00,$133.36,$165.00,$135.30,$160.05,$135.30,$189.12,$135.30,$133.36,$135.30,$160.05,$135.30,$165.00,$135.30,$135.30,$160.05
9922340B,0983,99223,,,,,N/A,N/A,INITIAL HOSPITAL CARE       ~P,$166.48,$123.75,$133.36,$165.00,$135.30,$160.05,$135.30,$111.06,$135.30,$133.36,$135.30,$160.05,$135.30,$165.00,$135.30,$135.30,$160.05
9922345B,0983,99223,,,,,N/A,N/A,INITIAL HOSPITAL CARE       ~P,$166.48,$123.75,$133.36,$165.00,$135.30,$160.05,$135.30,$223.43,$135.30,$133.36,$135.30,$160.05,$135.30,$165.00,$135.30,$135.30,$160.05
9922350B,0983,99223,,,,,N/A,N/A,INITIAL HOSPITAL CARE       ~P,$166.48,$123.75,$133.36,$165.00,$135.30,$160.05,$135.30,$164.07,$135.30,$133.36,$135.30,$160.05,$135.30,$165.00,$135.30,$135.30,$160.05
9922440B,0983,99224,,,,,N/A,N/A,SUB OBV-LOW COMPLEXITY      ~P,$357.16,$265.50,N/A,N/A,N/A,N/A,N/A,$95.56,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9922445B,0983,99224,,,,,N/A,N/A,SUB OBV-LOW COMPLEXITY      ~P,$357.16,$265.50,N/A,N/A,N/A,N/A,N/A,$135.61,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9922540B,0983,99225,,,,,N/A,N/A,SUB OBV-MOD COMPLEXITY      ~P,$472.18,$351.00,N/A,N/A,N/A,N/A,N/A,$95.56,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9922545B,0983,99225,,,,,N/A,N/A,SUB OBV-MOD COMPLEXITY      ~P,$472.18,$351.00,N/A,N/A,N/A,N/A,N/A,$135.61,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9922550B,0983,99225,,,,,N/A,N/A,SUB OBV-MOD COMPLEXITY      ~P,$472.18,$351.00,N/A,N/A,N/A,N/A,N/A,$189.12,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9922640B,0983,99226,,,,,N/A,N/A,SUB OBV-HIGH COMPLEXITY     ~P,$588.21,$437.25,N/A,N/A,N/A,N/A,N/A,$95.56,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9922650B,0983,99226,,,,,N/A,N/A,SUB OBV-HIGH COMPLEXITY     ~P,$588.21,$437.25,N/A,N/A,N/A,N/A,N/A,$135.61,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9923134B,0983,99231,,,,,N/A,N/A,SUBSEQUENT HOSPITAL CARE    ~P,$80.72,$60.00,$34.30,$196.72,$34.30,$80.51,$34.30,$158.99,$34.30,$196.72,$34.30,$80.51,$34.30,$83.00,$34.30,$34.30,$80.51
9923140B,0983,99231,,,,,N/A,N/A,SUBSEQUENT HOSPITAL CARE    ~P,$70.63,$52.50,$34.30,$196.72,$34.30,$80.51,$34.30,$117.63,$34.30,$196.72,$34.30,$80.51,$34.30,$83.00,$34.30,$34.30,$80.51
9923145B,0983,99231,,,,,N/A,N/A,SUBSEQUENT HOSPITAL CARE    ~P,$70.63,$52.50,$34.30,$196.72,$34.30,$80.51,$34.30,$231.34,$34.30,$196.72,$34.30,$80.51,$34.30,$83.00,$34.30,$34.30,$80.51
9923150B,0983,99231,,,,,N/A,N/A,SUBSEQUENT HOSPITAL CARE    ~P,$70.63,$52.50,$34.30,$196.72,$34.30,$80.51,$34.30,$82.17,$34.30,$196.72,$34.30,$80.51,$34.30,$83.00,$34.30,$34.30,$80.51
9923234B,0983,99232,,,,,N/A,N/A,SUBSEQUENT HOSPITAL CARE    ~P,$137.22,$102.00,$37.75,$152.00,$62.32,$147.44,$62.32,N/A,$62.32,$37.75,$62.32,$147.44,$62.32,$152.00,$62.32,$62.32,$147.44
9923240B,0983,99232,,,,,N/A,N/A,SUBSEQUENT HOSPITAL CARE    ~P,$92.82,$69.00,$37.75,$152.00,$62.32,$147.44,$62.32,N/A,$62.32,$37.75,$62.32,$147.44,$62.32,$152.00,$62.32,$62.32,$147.44
9923245B,0983,99232,,,,,N/A,N/A,SUBSEQUENT HOSPITAL CARE    ~P,$92.82,$69.00,$37.75,$152.00,$62.32,$147.44,$62.32,N/A,$62.32,$37.75,$62.32,$147.44,$62.32,$152.00,$62.32,$62.32,$147.44
9923250B,0983,99232,,,,,N/A,N/A,SUBSEQUENT HOSPITAL CARE    ~P,$92.82,$69.00,$37.75,$152.00,$62.32,$147.44,$62.32,N/A,$62.32,$37.75,$62.32,$147.44,$62.32,$152.00,$62.32,$62.32,$147.44
9923334B,0983,99233,,,,,N/A,N/A,SUBSEQUENT HOSPITAL CARE    ~P,$135.20,$100.50,$70.61,$219.00,$89.79,$212.43,$89.79,N/A,$89.79,$70.61,$89.79,$212.43,$89.79,$219.00,$89.79,$89.79,$212.43
9923340B,0983,99233,,,,,N/A,N/A,SUBSEQUENT HOSPITAL CARE    ~P,$135.20,$100.50,$70.61,$219.00,$89.79,$212.43,$89.79,N/A,$89.79,$70.61,$89.79,$212.43,$89.79,$219.00,$89.79,$89.79,$212.43
9923345B,0983,99233,,,,,N/A,N/A,SUBSEQUENT HOSPITAL CARE    ~P,$135.20,$100.50,$70.61,$219.00,$89.79,$212.43,$89.79,N/A,$89.79,$70.61,$89.79,$212.43,$89.79,$219.00,$89.79,$89.79,$212.43
9923350B,0983,99233,,,,,N/A,N/A,SUBSEQUENT HOSPITAL CARE    ~P,$85.76,$63.75,$70.61,$219.00,$89.79,$212.43,$89.79,N/A,$89.79,$70.61,$89.79,$212.43,$89.79,$219.00,$89.79,$89.79,$212.43
9923434B,0983,99234,,,,,N/A,N/A,OBSERV/HOSP SAME DATE       ~P,$363.22,$270.00,$101.51,$360.00,$147.60,$349.20,$147.60,N/A,$147.60,$101.51,$147.60,$349.20,$147.60,$360.00,$147.60,$147.60,$349.20
9923534B,0983,99235,,,,,N/A,N/A,OBSERV/HOSP SAME DATE       ~P,$480.26,$357.00,$128.81,$476.00,$195.16,$461.72,$195.16,N/A,$195.16,$128.81,$195.16,$461.72,$195.16,$476.00,$195.16,$195.16,$461.72
9923540B,0983,99235,,,,,N/A,N/A,OBSERV/HOSP SAME DATE       ~P,$427.79,$318.00,$128.81,$476.00,$195.16,$461.72,$195.16,N/A,$195.16,$128.81,$195.16,$461.72,$195.16,$476.00,$195.16,$195.16,$461.72
9923634B,0983,99236,,,,,N/A,N/A,OBSERV/HOSP SAME DATE       ~P,$598.30,$444.75,$164.22,$528.00,$243.13,$512.16,$243.13,N/A,$243.13,$164.22,$243.13,$512.16,$243.13,$528.00,$243.13,$243.13,$512.16
9923640B,0983,99236,,,,,N/A,N/A,OBSERV/HOSP SAME DATE       ~P,$532.72,$396.00,$164.22,$528.00,$243.13,$512.16,$243.13,N/A,$243.13,$164.22,$243.13,$512.16,$243.13,$528.00,$243.13,$243.13,$512.16
9923834B,0983,99238,,,,,N/A,N/A,HOSPITAL DISCHARGE DAY      ~P,$137.22,$102.00,$114.39,$210.77,$114.39,$116.40,$114.39,N/A,$114.39,$210.77,$114.39,$116.40,$114.39,$120.00,$114.39,$114.39,$116.40
9923840B,0983,99238,,,,,N/A,N/A,HOSPITAL DISCHARGE DAY      ~P,$121.07,$90.00,$114.39,$210.77,$114.39,$116.40,$114.39,N/A,$114.39,$210.77,$114.39,$116.40,$114.39,$120.00,$114.39,$114.39,$116.40
9923845B,0983,99238,,,,,N/A,N/A,HOSPITAL DISCHARGE DAY      ~P,$60.54,$45.00,$114.39,$210.77,$114.39,$116.40,$114.39,N/A,$114.39,$210.77,$114.39,$116.40,$114.39,$120.00,$114.39,$114.39,$116.40
9923934B,0983,99239,,,,,N/A,N/A,HOSPITAL DISCHARGE DAY      ~P,$281.49,$209.25,$11.68,$279.00,$11.68,$270.63,$11.68,N/A,$11.68,$71.11,$11.68,$270.63,$11.68,$279.00,$11.68,$11.68,$270.63
9923940B,0983,99239,,,,,N/A,N/A,INITIAL HOSPITAL CARE       ~P,$250.22,$186.00,$11.68,$279.00,$11.68,$270.63,$11.68,N/A,$11.68,$71.11,$11.68,$270.63,$11.68,$279.00,$11.68,$11.68,$270.63
9923945B,0983,99239,,,,,N/A,N/A,HOSPITAL DISCHARGE DAY,$232.06,$172.50,$11.68,$279.00,$11.68,$270.63,$11.68,N/A,$11.68,$71.11,$11.68,$270.63,$11.68,$279.00,$11.68,$11.68,$270.63
9924140B,0983,99241,,,,,N/A,N/A,OFFICE CONSULTATION,$71.63,$53.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9924145B,0983,99241,,,,,N/A,N/A,OFFICE CONSULTATION,$71.63,$53.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9924150B,0983,99241,,,,,N/A,N/A,OFFICE CONSULTATION         ~P,$71.63,$53.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9924240B,0983,99242,,,,,N/A,N/A,OFFICE CONSULTATION         ~P,$131.16,$97.50,$104.82,$130.00,N/A,$126.10,N/A,N/A,N/A,$104.82,N/A,$126.10,N/A,$130.00,N/A,N/A,$126.10
9924245B,0983,99242,,,,,N/A,N/A,OFFICE CONSULTATION         ~P,$131.16,$97.50,$104.82,$130.00,N/A,$126.10,N/A,N/A,N/A,$104.82,N/A,$126.10,N/A,$130.00,N/A,N/A,$126.10
99242S40B,0983,99242,,,,,N/A,N/A,OFFICE CONSULTATION         ~P,$131.16,$97.50,$104.82,$130.00,N/A,$126.10,N/A,N/A,N/A,$104.82,N/A,$126.10,N/A,$130.00,N/A,N/A,$126.10
9924340B,0983,99243,,,,,N/A,N/A,OFFICE CONSULTATION         ~P,$174.55,$129.75,$66.95,$130.00,N/A,$126.10,N/A,N/A,N/A,$66.95,N/A,$126.10,N/A,$130.00,N/A,N/A,$126.10
9924345B,0983,99243,,,,,N/A,N/A,"CONSULT, OFFICE             ~P",$174.55,$129.75,$66.95,$130.00,N/A,$126.10,N/A,N/A,N/A,$66.95,N/A,$126.10,N/A,$130.00,N/A,N/A,$126.10
9924350B,0983,99243,,,,,N/A,N/A,OFFICE CONSULTATION         ~P,$174.55,$129.75,$66.95,$130.00,N/A,$126.10,N/A,N/A,N/A,$66.95,N/A,$126.10,N/A,$130.00,N/A,N/A,$126.10
9924434B,0983,99244,,,,,N/A,N/A,OFFICE CONSULTATION         ~P,$260.31,$193.50,$93.66,$248.00,N/A,$240.56,N/A,N/A,N/A,$93.66,N/A,$240.56,N/A,$248.00,N/A,N/A,$240.56
9924440B,0983,99244,,,,,N/A,N/A,OFFICE CONSULTATION         ~P,$250.22,$186.00,$93.66,$248.00,N/A,$240.56,N/A,N/A,N/A,$93.66,N/A,$240.56,N/A,$248.00,N/A,N/A,$240.56
9924445B,0983,99244,,,,,N/A,N/A,OFFICE CONSULTATION         ~P,$250.22,$186.00,$93.66,$248.00,N/A,$240.56,N/A,N/A,N/A,$93.66,N/A,$240.56,N/A,$248.00,N/A,N/A,$240.56
9924450B,0983,99244,,,,,N/A,N/A,OFFICE CONSULTATION         ~P,$250.22,$186.00,$93.66,$248.00,N/A,$240.56,N/A,N/A,N/A,$93.66,N/A,$240.56,N/A,$248.00,N/A,N/A,$240.56
99244S40B,0983,99244,,,,,N/A,N/A,OFFICE CONSULTATION         ~P,$250.22,$186.00,$93.66,$248.00,N/A,$240.56,N/A,N/A,N/A,$93.66,N/A,$240.56,N/A,$248.00,N/A,N/A,$240.56
9924534B,0983,99245,,,,,N/A,N/A,OFFICE CONSULTATION         ~P,$331.94,$246.75,$150.61,$316.00,N/A,$306.52,N/A,N/A,N/A,$150.61,N/A,$306.52,N/A,$316.00,N/A,N/A,$306.52
9924540B,0983,99245,,,,,N/A,N/A,OFFICE CONSULTATION         ~P,$318.83,$237.00,$150.61,$316.00,N/A,$306.52,N/A,N/A,N/A,$150.61,N/A,$306.52,N/A,$316.00,N/A,N/A,$306.52
9924550B,0983,99245,,,,,N/A,N/A,OFFICE CONSULTATION         ~P,$318.83,$237.00,$150.61,$316.00,N/A,$306.52,N/A,N/A,N/A,$150.61,N/A,$306.52,N/A,$316.00,N/A,N/A,$306.52
99245S40B,0983,99245,,,,,N/A,N/A,OFFICE CONSULTATION         ~P,$318.83,$237.00,$150.61,$316.00,N/A,$306.52,N/A,N/A,N/A,$150.61,N/A,$306.52,N/A,$316.00,N/A,N/A,$306.52
9925450B,0983,99245,,,,,N/A,N/A,INITIAL INPATIENT CONSULT   ~P,$318.83,$237.00,$150.61,$316.00,N/A,$306.52,N/A,N/A,N/A,$150.61,N/A,$306.52,N/A,$316.00,N/A,N/A,$306.52
9925140B,0983,99251,,,,,N/A,N/A,INITIAL INPATIENT CONSULT   ~P,$172.53,$128.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9925234B,0983,99252,,,,,N/A,N/A,INITIAL INPATIENT CONSULT   ~P,$179.59,$133.50,$172.66,$186.26,N/A,$172.66,N/A,N/A,N/A,$186.26,N/A,$172.66,N/A,$178.00,N/A,N/A,$172.66
9925240B,0983,99252,,,,,N/A,N/A,INITIAL INPATIENT CONSULT   ~P,$154.37,$114.75,$172.66,$186.26,N/A,$172.66,N/A,N/A,N/A,$186.26,N/A,$172.66,N/A,$178.00,N/A,N/A,$172.66
9925334B,0983,99253,,,,,N/A,N/A,INITIAL INPATIENT CONSULT   ~P,$246.18,$183.00,$73.30,$234.00,N/A,$226.98,N/A,N/A,N/A,$73.30,N/A,$226.98,N/A,$234.00,N/A,N/A,$226.98
9925340B,0983,99253,,,,,N/A,N/A,INITIAL INPATIENT CONSULT   ~P,$215.91,$160.50,$73.30,$234.00,N/A,$226.98,N/A,N/A,N/A,$73.30,N/A,$226.98,N/A,$234.00,N/A,N/A,$226.98
9925440B,0983,99254,,,,,N/A,N/A,INITIAL INPATIENT CONSULT   ~P,$312.77,$232.50,$112.66,$336.00,N/A,$325.92,N/A,N/A,N/A,$112.66,N/A,$325.92,N/A,$336.00,N/A,N/A,$325.92
9925534B,0983,99255,,,,,N/A,N/A,INITIAL INPATIENT CONSULT   ~P,$503.46,$374.25,$163.41,$462.00,N/A,$448.14,N/A,N/A,N/A,$163.41,N/A,$448.14,N/A,$462.00,N/A,N/A,$448.14
9925550B,0983,99255,,,,,N/A,N/A,INITIAL INPATIENT CONSULT   ~P,$466.13,$346.50,$163.41,$462.00,N/A,$448.14,N/A,N/A,N/A,$163.41,N/A,$448.14,N/A,$462.00,N/A,N/A,$448.14
9928134B,0983,99281,,,,,N/A,N/A,ER DEPART VISIT E&M         ~P,$69.62,$51.75,$28.29,$449.00,$28.29,$435.53,$28.29,N/A,$28.29,$196.81,$28.29,$435.53,$28.29,$449.00,$28.29,$28.29,$435.53
9928145B,0983,99281,,,,,N/A,N/A,ER DEPART VISIT E&M         ~P,$42.38,$31.50,$28.29,$449.00,$28.29,$435.53,$28.29,N/A,$28.29,$196.81,$28.29,$435.53,$28.29,$449.00,$28.29,$28.29,$435.53
9928234B,0983,99282,,,,,N/A,N/A,ER DEPART VISIT E&M         ~P,$124.10,$92.25,$5.43,$449.00,$5.43,$435.53,$5.43,N/A,$5.43,$21.65,$5.43,$435.53,$5.43,$449.00,$5.43,$5.43,$435.53
9928240B,0983,99282,,,,,N/A,N/A,NEW OR EST PATIENT E&M      ~P,$78.70,$58.50,$5.43,$449.00,$5.43,$435.53,$5.43,N/A,$5.43,$21.65,$5.43,$435.53,$5.43,$449.00,$5.43,$5.43,$435.53
9928334B,0983,99283,,,,,N/A,N/A,Er Depart Visit E&M         ~p,$0.00,$0.00,$41.90,$804.00,$48.79,$779.88,$48.79,N/A,$48.79,$41.90,$48.79,$779.88,$48.79,$804.00,$48.79,$48.79,$779.88
9928340B,0983,99283,,,,,N/A,N/A,EMERGENCY DEPARTMENT E&M    ~P,$457.05,$339.75,$41.90,$804.00,$48.79,$779.88,$48.79,N/A,$48.79,$41.90,$48.79,$779.88,$48.79,$804.00,$48.79,$48.79,$779.88
9928345B,0983,99283,,,,,N/A,N/A,EMERGENCY DEPARTMENT E&M    ~P,$457.05,$339.75,$41.90,$804.00,$48.79,$779.88,$48.79,N/A,$48.79,$41.90,$48.79,$779.88,$48.79,$804.00,$48.79,$48.79,$779.88
9928350B,0983,99283,,,,,N/A,N/A,EMERGENCY DEPART VISIT E&M  ~P,$120.06,$89.25,$41.90,$804.00,$48.79,$779.88,$48.79,N/A,$48.79,$41.90,$48.79,$779.88,$48.79,$804.00,$48.79,$48.79,$779.88
9928440B,0983,99284,,,,,N/A,N/A,EMERGENCY DEPT VISIT        ~P,$231.05,$171.75,$70.74,"$1,208.00",$95.53,"$1,171.76",$95.53,N/A,$95.53,$70.74,$95.53,"$1,171.76",$95.53,"$1,208.00",$95.53,$95.53,"$1,171.76"
9928445B,0983,99284,,,,,N/A,N/A,EMERGENCY DEPARTMENT VISIT  ~P,$235.08,$174.75,$70.74,"$1,208.00",$95.53,"$1,171.76",$95.53,N/A,$95.53,$70.74,$95.53,"$1,171.76",$95.53,"$1,208.00",$95.53,$95.53,"$1,171.76"
9928540B,0983,99285,,,,,N/A,N/A,EMERGENCY DEPT VISIT        ~P,$359.18,$267.00,$120.19,"$1,208.00",$145.96,"$1,171.76",$145.96,N/A,$145.96,$120.19,$145.96,"$1,171.76",$145.96,"$1,208.00",$145.96,$145.96,"$1,171.76"
9928545B,0983,99285,,,,,N/A,N/A,EMERGENCY DEPT VISIT        ~P,$359.18,$267.00,$120.19,"$1,208.00",$145.96,"$1,171.76",$145.96,N/A,$145.96,$120.19,$145.96,"$1,171.76",$145.96,"$1,208.00",$145.96,$145.96,"$1,171.76"
9929134B,0983,99291,,,,,N/A,N/A,"CRITICAL CARE, FIRST HOUR   ~P",$491.35,$365.25,$174.83,"$1,885.00",$225.91,"$1,828.45",$225.91,N/A,$225.91,$174.83,$225.91,"$1,828.45",$225.91,"$1,885.00",$225.91,$225.91,"$1,828.45"
9929140B,0983,99291,,,,,N/A,N/A,"CRITICAL CARE, FIRST HOUR   ~P",$437.88,$325.50,$174.83,"$1,885.00",$225.91,"$1,828.45",$225.91,N/A,$225.91,$174.83,$225.91,"$1,828.45",$225.91,"$1,885.00",$225.91,$225.91,"$1,828.45"
4500008BCS,0983,99292,,,,,N/A,N/A,CRITICAL CARE 30 MIN 99292CS~P,$411.65,$306.00,$215.40,$556.00,$227.96,$539.32,$227.96,N/A,$227.96,$215.40,$227.96,$539.32,$227.96,$556.00,$227.96,$227.96,$539.32
9929234B,0983,99292,,,,,N/A,N/A,CRITICAL CARE ADDL 30 MIN   ~P,$335.98,$249.75,$215.40,$556.00,$227.96,$539.32,$227.96,N/A,$227.96,$215.40,$227.96,$539.32,$227.96,$556.00,$227.96,$227.96,$539.32
9929240B,0983,99292,,,,,N/A,N/A,CRITICAL CARE ADDL 30 MIN   ~P,$299.66,$222.75,$215.40,$556.00,$227.96,$539.32,$227.96,N/A,$227.96,$215.40,$227.96,$539.32,$227.96,$556.00,$227.96,$227.96,$539.32
9930440B,0983,99304,,,,,N/A,N/A,NURSING FACILITY CARE       ~P,$131.16,$97.50,$5.33,$130.00,$5.33,$126.10,$5.33,N/A,$5.33,$108.15,$5.33,$126.10,$5.33,$130.00,$5.33,$5.33,$126.10
9930445B,0983,99304,,,,,N/A,N/A,NURSING FACILITY CARE       ~P,$131.16,$97.50,$5.33,$130.00,$5.33,$126.10,$5.33,N/A,$5.33,$108.15,$5.33,$126.10,$5.33,$130.00,$5.33,$5.33,$126.10
9930450B,0983,99304,,,,,N/A,N/A,NURSING FACILITY CARE       ~P,$131.16,$97.50,$5.33,$130.00,$5.33,$126.10,$5.33,N/A,$5.33,$108.15,$5.33,$126.10,$5.33,$130.00,$5.33,$5.33,$126.10
9930540,0983,99305,,,,,N/A,N/A,INITIAL: MODERATE COMPEXITY:35,$241.14,$179.25,$88.31,$239.00,$97.99,$231.83,$97.99,N/A,$97.99,$88.31,$97.99,$231.83,$97.99,$239.00,$97.99,$97.99,$231.83
9930545,0983,99305,,,,,N/A,N/A,INITIAL: MODERATE COMPEXITY:35,$241.14,$179.25,$88.31,$239.00,$97.99,$231.83,$97.99,N/A,$97.99,$88.31,$97.99,$231.83,$97.99,$239.00,$97.99,$97.99,$231.83
9930550,0983,99305,,,,,N/A,N/A,INITIAL: MODERATE COMPEXITY:35,$241.14,$179.25,$88.31,$239.00,$97.99,$231.83,$97.99,N/A,$97.99,$88.31,$97.99,$231.83,$97.99,$239.00,$97.99,$97.99,$231.83
9930640B,0983,99306,,,,,N/A,N/A,"NURSING FACILITY CARE, INIT ~P",$230.04,$171.00,$56.99,$239.00,$56.99,$231.83,$56.99,N/A,$56.99,$127.62,$56.99,$231.83,$56.99,$239.00,$56.99,$56.99,$231.83
9930645B,0983,99306,,,,,N/A,N/A,"NURSING FACILITY CARE, INIT ~P",$230.04,$171.00,$56.99,$239.00,$56.99,$231.83,$56.99,N/A,$56.99,$127.62,$56.99,$231.83,$56.99,$239.00,$56.99,$56.99,$231.83
9930650B,0983,99306,,,,,N/A,N/A,"NURSING FACILITY CARE, INIT ~P",$241.14,$179.25,$56.99,$239.00,$56.99,$231.83,$56.99,N/A,$56.99,$127.62,$56.99,$231.83,$56.99,$239.00,$56.99,$56.99,$231.83
9930740,0983,99307,,,,,N/A,N/A,STRFWD/LOW COMPLEXITY MDM:15,$82.73,$61.50,$33.62,$163.98,$33.62,$79.54,$33.62,N/A,$33.62,$163.98,$33.62,$79.54,$33.62,$82.00,$33.62,$33.62,$79.54
9930745,0983,99307,,,,,N/A,N/A,STRFWD/LOW COMPLEXITY MDM:15,$82.73,$61.50,$33.62,$163.98,$33.62,$79.54,$33.62,N/A,$33.62,$163.98,$33.62,$79.54,$33.62,$82.00,$33.62,$33.62,$79.54
9930750,0983,99307,,,,,N/A,N/A,STRFWD/LOW COMPLEXITY MDM:15,$82.73,$61.50,$33.62,$163.98,$33.62,$79.54,$33.62,N/A,$33.62,$163.98,$33.62,$79.54,$33.62,$82.00,$33.62,$33.62,$79.54
9930840B,0983,99308,,,,,N/A,N/A,"NURSING FAC CARE, SUBSEQ    ~P",$94.84,$70.50,$43.36,$126.00,$51.66,$122.22,$51.66,N/A,$51.66,$43.36,$51.66,$122.22,$51.66,$126.00,$51.66,$51.66,$122.22
9930845B,0983,99308,,,,,N/A,N/A,"NURSING FAC CARE, SUBSEQ    ~P",$94.84,$70.50,$43.36,$126.00,$51.66,$122.22,$51.66,N/A,$51.66,$43.36,$51.66,$122.22,$51.66,$126.00,$51.66,$51.66,$122.22
9930850B,0983,99308,,,,,N/A,N/A,"NURSING FAC CARE, SUBSEQ    ~P",$127.13,$94.50,$43.36,$126.00,$51.66,$122.22,$51.66,N/A,$51.66,$43.36,$51.66,$122.22,$51.66,$126.00,$51.66,$51.66,$122.22
9930940,0983,99309,,,,,N/A,N/A,"NURSING FAC CARE, SUBSEQ",$177.57,$132.00,$67.96,$176.00,$72.16,$170.72,$72.16,N/A,$72.16,$67.96,$72.16,$170.72,$72.16,$176.00,$72.16,$72.16,$170.72
9931050,0983,99310,,,,,N/A,N/A,"NURSING FAC CARE, SUBSEQ    ~P",$272.41,$202.50,$11.70,$270.00,$11.70,$261.90,$11.70,N/A,$11.70,$89.87,$11.70,$261.90,$11.70,$270.00,$11.70,$11.70,$261.90
9931040B,0983,99310,,,,,N/A,N/A,"NURSING FAC CARE, SUBSEQ    ~P",$272.41,$202.50,$11.70,$270.00,$11.70,$261.90,$11.70,N/A,$11.70,$89.87,$11.70,$261.90,$11.70,$270.00,$11.70,$11.70,$261.90
9931540,0983,99315,,,,,N/A,N/A,DISCHARGE DAY MANAGEMENT,$149.32,$111.00,$6.68,$148.00,$6.68,$143.56,$6.68,N/A,$6.68,$133.23,$6.68,$143.56,$6.68,$148.00,$6.68,$6.68,$143.56
9931545,0983,99315,,,,,N/A,N/A,DISCHARGE DAY MANAGEMENT,$149.32,$111.00,$6.68,$148.00,$6.68,$143.56,$6.68,N/A,$6.68,$133.23,$6.68,$143.56,$6.68,$148.00,$6.68,$6.68,$143.56
9931640,0983,99316,,,,,N/A,N/A,NURSING FAC DISCHARGE DAY,$199.77,$148.50,$71.81,$198.00,$81.18,$192.06,$81.18,N/A,$81.18,$71.81,$81.18,$192.06,$81.18,$198.00,$81.18,$81.18,$192.06
9934340B,0983,99343,,,,,N/A,N/A,"HOME VISIT, NEW PATIENT     ~P",$300.66,$223.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9934740B,0983,99347,,,,,N/A,N/A,"HOME VISIT, EST PATIENT    ~P",$110.98,$82.50,$45.10,$216.58,$45.10,$106.70,$45.10,N/A,$45.10,$216.58,$45.10,$106.70,$45.10,$110.00,$45.10,$45.10,$106.70
9934840B,0983,99348,,,,,N/A,N/A,"HOME VISIT, EST PATIENT     ~P",$151.34,$112.50,$7.11,$171.00,$7.11,$165.87,$7.11,N/A,$7.11,$54.21,$7.11,$165.87,$7.11,$171.00,$7.11,$7.11,$165.87
9934950,0983,99349,,,,,N/A,N/A,HOME VISIT EST. PT,$255.26,$189.75,$0.00,$82.66,$13.73,$0.00,$13.73,N/A,$13.73,$82.66,$13.73,$0.00,$13.73,N/A,$13.73,$13.73,$0.00
9935440B,0983,99354,,,,,N/A,N/A,"PROLONGED SERVICE, OFFICE   ~P",$179.59,$133.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9935450B,0983,99354,,,,,N/A,N/A,"PROLONGED SERVICE, OFFICE   ~P",$179.59,$133.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9935540B,0983,99355,,,,,N/A,N/A,"PROLONGED SERVICE, OFFICE   ~P",$401.56,$298.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9935550B,0983,99355,,,,,N/A,N/A,"PROLONGED SERVICE, OFFICE   ~P",$223.98,$166.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9935845,0983,99358,,,,,N/A,N/A,PROLONG SERV W/O CONTACT,$134.19,$99.75,$129.01,$175.93,N/A,$129.01,N/A,N/A,N/A,$175.93,N/A,$129.01,N/A,$133.00,N/A,N/A,$129.01
9935850,0983,99358,,,,,N/A,N/A,PROLONG SERV W/O CONTACT,$134.19,$99.75,$129.01,$175.93,N/A,$129.01,N/A,N/A,N/A,$175.93,N/A,$129.01,N/A,$133.00,N/A,N/A,$129.01
99384LSC,0983,99384,,,,,N/A,N/A,PREVENTIVE VISIT NEW 12-17,$189.68,$141.00,$85.41,$85.41,N/A,N/A,N/A,N/A,N/A,$85.41,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99385LSC,0983,99385,,,,,N/A,N/A,PREVENTIVE VISIT NEW 18-39,$191.70,$142.50,$100.16,$100.16,N/A,N/A,N/A,N/A,N/A,$100.16,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99386LSC,0983,99386,,,,,N/A,N/A,PREVENTIVE VISIT NEW 40-64,$220.96,$164.25,$96.11,$96.11,N/A,N/A,N/A,N/A,N/A,$96.11,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99394LSC,0983,99394,,,,,N/A,N/A,PREVENTIVE VISIT EST 12-17,$176.56,$131.25,$75.40,$75.40,N/A,N/A,N/A,N/A,N/A,$75.40,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99395LSC,0983,99395,,,,,N/A,N/A,PREVENTATIVE EXAM AGE 18-39,$178.58,$132.75,$85.41,$85.41,N/A,N/A,N/A,N/A,N/A,$85.41,N/A,N/A,N/A,N/A,N/A,N/A,N/A
99396LSC,0983,99396,,,,,N/A,N/A,PREVENTATIVE EXAM AGE 40-64,$197.75,$147.00,$87.86,$87.86,N/A,N/A,N/A,N/A,N/A,$87.86,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9941750B,0983,99417,,,,,N/A,N/A,Prolonged Services          ~p,$50.45,$37.50,$5.25,$64.00,N/A,N/A,N/A,N/A,N/A,$5.25,N/A,N/A,N/A,$64.00,N/A,N/A,N/A
9942134,0983,99421,,,,,N/A,N/A,DIGITAL E&M 5-10 MIN,$52.46,$39.00,$21.32,$52.00,$21.32,$50.44,$21.32,N/A,$21.32,N/A,$21.32,$50.44,$21.32,$52.00,$21.32,$21.32,$50.44
9942140,0983,99421,,,,,N/A,N/A,DIGITAL E&M 5-10 MIN,$50.45,$37.50,$21.32,$52.00,$21.32,$50.44,$21.32,N/A,$21.32,N/A,$21.32,$50.44,$21.32,$52.00,$21.32,$21.32,$50.44
9942145,0983,99421,,,,,N/A,N/A,DIGITAL E&M 5-10 MIN,$50.45,$37.50,$21.32,$52.00,$21.32,$50.44,$21.32,N/A,$21.32,N/A,$21.32,$50.44,$21.32,$52.00,$21.32,$21.32,$50.44
9942150,0983,99421,,,,,N/A,N/A,DIGITAL E&M 5-10 MIN,$50.45,$37.50,$21.32,$52.00,$21.32,$50.44,$21.32,N/A,$21.32,N/A,$21.32,$50.44,$21.32,$52.00,$21.32,$21.32,$50.44
9942234,0983,99422,,,,,N/A,N/A,DIGITAL E&M 11-20 MIN,$52.46,$39.00,$12.65,$52.00,$21.32,$50.44,$21.32,N/A,$21.32,$12.65,$21.32,$50.44,$21.32,$52.00,$21.32,$21.32,$50.44
9942240,0983,99422,,,,,N/A,N/A,DIGITAL E&M 11-20 MIN,$50.45,$37.50,$12.65,$52.00,$21.32,$50.44,$21.32,N/A,$21.32,$12.65,$21.32,$50.44,$21.32,$52.00,$21.32,$21.32,$50.44
9942245,0983,99422,,,,,N/A,N/A,DIGITAL E&M 11-20 MIN,$50.45,$37.50,$12.65,$52.00,$21.32,$50.44,$21.32,N/A,$21.32,$12.65,$21.32,$50.44,$21.32,$52.00,$21.32,$21.32,$50.44
9942250,0983,99422,,,,,N/A,N/A,DIGITAL E&M 11-20 MIN,$50.45,$37.50,$12.65,$52.00,$21.32,$50.44,$21.32,N/A,$21.32,$12.65,$21.32,$50.44,$21.32,$52.00,$21.32,$21.32,$50.44
9942334,0983,99423,,,,,N/A,N/A,DIGITAL E&M 21 MIN,$62.55,$46.50,$25.42,$62.00,$25.42,$60.14,$25.42,N/A,$25.42,$25.65,$25.42,$60.14,$25.42,$62.00,$25.42,$25.42,$60.14
9942340,0983,99423,,,,,N/A,N/A,DIGITAL E&M 21 MIN,$59.53,$44.25,$25.42,$62.00,$25.42,$60.14,$25.42,N/A,$25.42,$25.65,$25.42,$60.14,$25.42,$62.00,$25.42,$25.42,$60.14
9942345,0983,99423,,,,,N/A,N/A,DIGITAL E&M 21 MIN,$59.53,$44.25,$25.42,$62.00,$25.42,$60.14,$25.42,N/A,$25.42,$25.65,$25.42,$60.14,$25.42,$62.00,$25.42,$25.42,$60.14
9942350,0983,99423,,,,,N/A,N/A,DIGITAL E&M 21 MIN,$59.53,$44.25,$25.42,$62.00,$25.42,$60.14,$25.42,N/A,$25.42,$25.65,$25.42,$60.14,$25.42,$62.00,$25.42,$25.42,$60.14
9944134,0983,99441,,,,,N/A,N/A,TELEPHONE EVALUATION 5-10 MINS,$52.46,$39.00,$21.32,$52.00,$21.32,$50.44,$21.32,N/A,$21.32,$27.75,$21.32,$50.44,$21.32,$52.00,$21.32,$21.32,$50.44
9944140,0983,99441,,,,,N/A,N/A,TELEPHONE EVALUATION 5-10 MINS,$50.45,$37.50,$21.32,$52.00,$21.32,$50.44,$21.32,N/A,$21.32,$27.75,$21.32,$50.44,$21.32,$52.00,$21.32,$21.32,$50.44
9944145,0983,99441,,,,,N/A,N/A,TELEPHONE EVALUATION 5-10 MINS,$50.45,$37.50,$21.32,$52.00,$21.32,$50.44,$21.32,N/A,$21.32,$27.75,$21.32,$50.44,$21.32,$52.00,$21.32,$21.32,$50.44
9944150,0983,99441,,,,,N/A,N/A,TELEPHONE EVALUATION 5-10 MINS,$50.45,$37.50,$21.32,$52.00,$21.32,$50.44,$21.32,N/A,$21.32,$27.75,$21.32,$50.44,$21.32,$52.00,$21.32,$21.32,$50.44
99441LSC,0983,99441,,,,,N/A,N/A,TELEPHONE EVALUATION 5-10 MIN,$50.45,$37.50,$21.32,$52.00,$21.32,$50.44,$21.32,N/A,$21.32,$27.75,$21.32,$50.44,$21.32,$52.00,$21.32,$21.32,$50.44
9944234,0983,99442,,,,,N/A,N/A,TELEPHONE EVALUATION 11-20 MIN,$80.72,$60.00,$31.16,$76.00,$31.16,$73.72,$31.16,N/A,$31.16,$35.65,$31.16,$73.72,$31.16,$76.00,$31.16,$31.16,$73.72
9944240,0983,99442,,,,,N/A,N/A,TELEPHONE EVALUATION 11-20 MIN,$76.68,$57.00,$31.16,$76.00,$31.16,$73.72,$31.16,N/A,$31.16,$35.65,$31.16,$73.72,$31.16,$76.00,$31.16,$31.16,$73.72
9944245,0983,99442,,,,,N/A,N/A,TELEPHONE EVALUATION 11-20 MIN,$50.45,$37.50,$31.16,$76.00,$31.16,$73.72,$31.16,N/A,$31.16,$35.65,$31.16,$73.72,$31.16,$76.00,$31.16,$31.16,$73.72
9944250,0983,99442,,,,,N/A,N/A,TELEPHONE EVALUATION 11-20 MIN,$50.45,$37.50,$31.16,$76.00,$31.16,$73.72,$31.16,N/A,$31.16,$35.65,$31.16,$73.72,$31.16,$76.00,$31.16,$31.16,$73.72
99442LSC,0983,99442,,,,,N/A,N/A,TELEPHONE EVALUATION 11-20 MIN,$76.68,$57.00,$31.16,$76.00,$31.16,$73.72,$31.16,N/A,$31.16,$35.65,$31.16,$73.72,$31.16,$76.00,$31.16,$31.16,$73.72
9944334,0983,99443,,,,,N/A,N/A,TELEPHONE EVALUATION 21-30 MIN,$116.03,$86.25,$47.15,$110.00,$47.15,$106.70,$47.15,N/A,$47.15,$66.96,$47.15,$106.70,$47.15,$110.00,$47.15,$47.15,$106.70
9944340,0983,99443,,,,,N/A,N/A,TELEPHONE EVALUATION 21-30 MIN,$110.98,$82.50,$47.15,$110.00,$47.15,$106.70,$47.15,N/A,$47.15,$66.96,$47.15,$106.70,$47.15,$110.00,$47.15,$47.15,$106.70
9944345,0983,99443,,,,,N/A,N/A,TELEPHONE EVALUATION 21-30 MIN,$50.45,$37.50,$47.15,$110.00,$47.15,$106.70,$47.15,N/A,$47.15,$66.96,$47.15,$106.70,$47.15,$110.00,$47.15,$47.15,$106.70
9944350,0983,99443,,,,,N/A,N/A,TELEPHONE EVALUATION 21-30 MIN,$110.98,$82.50,$47.15,$110.00,$47.15,$106.70,$47.15,N/A,$47.15,$66.96,$47.15,$106.70,$47.15,$110.00,$47.15,$47.15,$106.70
99443LSC,0983,99443,,,,,N/A,N/A,TELEPHONE EVALUATION 21-30 MIN,$110.98,$82.50,$47.15,$110.00,$47.15,$106.70,$47.15,N/A,$47.15,$66.96,$47.15,$106.70,$47.15,$110.00,$47.15,$47.15,$106.70
9944745B,0983,99447,,,,,N/A,N/A,ONLINE/TELEPHONE CONSULT    ~P,$63.56,$47.25,$29.93,$98.91,$29.93,$70.81,$29.93,N/A,$29.93,$98.91,$29.93,$70.81,$29.93,$73.00,$29.93,$29.93,$70.81
0298T34B,0983,0298T,,,,,N/A,N/A,14 DAY CARDIAC MONITORING   ~P,$62.55,$46.50,$0.00,$62.00,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
G010440B,0983,G0104,,,,,N/A,N/A,COLORECTAL CA SCREENING;FLEX~P,$110.98,$82.50,$133.86,$187.25,$187.25,$133.86,$187.25,N/A,$187.25,$138.00,$187.25,$133.86,$187.25,$138.00,$187.25,$187.25,$133.86
G010540B,0983,G0105,,,,,N/A,N/A,COLRECT/CA SCREEN COLON HIGH~P,$435.86,$324.00,$338.14,$432.00,$338.14,$419.04,$338.14,N/A,$338.14,$432.00,$338.14,$419.04,$338.14,$432.00,$338.14,$338.14,$419.04
G012140B,0983,G0121,,,,,N/A,N/A,COLRECT/CA SCREEN COLON HIGH~P,$435.86,$324.00,$338.33,$491.00,$338.33,$476.27,$338.33,N/A,$338.33,$491.00,$338.33,$476.27,$338.33,$491.00,$338.33,$338.33,$476.27
G036440B,0983,G0364,,,,,N/A,N/A,BONE MARROW ASPIRATION      ~P,$18.16,$13.50,$18.00,$18.00,N/A,N/A,N/A,N/A,N/A,$18.00,N/A,N/A,N/A,$18.00,N/A,N/A,N/A
G201034,0983,G2010,,,,,N/A,N/A,REMOTE EVALUATION,$52.46,$39.00,$12.03,$52.00,$12.03,$50.44,$12.03,N/A,$12.03,$52.00,$12.03,$50.44,$12.03,$52.00,$12.03,$12.03,$50.44
G201040,0983,G2010,,,,,N/A,N/A,REMOTE EVALUATION,$50.45,$37.50,$12.03,$52.00,$12.03,$50.44,$12.03,N/A,$12.03,$52.00,$12.03,$50.44,$12.03,$52.00,$12.03,$12.03,$50.44
G201045,0983,G2010,,,,,N/A,N/A,REMOTE EVALUATION,$50.45,$37.50,$12.03,$52.00,$12.03,$50.44,$12.03,N/A,$12.03,$52.00,$12.03,$50.44,$12.03,$52.00,$12.03,$12.03,$50.44
G201050,0983,G2010,,,,,N/A,N/A,REMOTE EVALUATION,$50.45,$37.50,$12.03,$52.00,$12.03,$50.44,$12.03,N/A,$12.03,$52.00,$12.03,$50.44,$12.03,$52.00,$12.03,$12.03,$50.44
G201234,0983,G2012,,,,,N/A,N/A,TECHNOLOGY-BASED SERVICES,$52.46,$39.00,$13.91,$50.00,$13.91,$48.50,$13.91,N/A,$13.91,$50.00,$13.91,$48.50,$13.91,$50.00,$13.91,$13.91,$48.50
G201240,0983,G2012,,,,,N/A,N/A,TECHNOLOGY-BASED SERVICES,$50.45,$37.50,$13.91,$50.00,$13.91,$48.50,$13.91,N/A,$13.91,$50.00,$13.91,$48.50,$13.91,$50.00,$13.91,$13.91,$48.50
G201245,0983,G2012,,,,,N/A,N/A,TECHNOLOGY-BASED SERVICES,$50.45,$37.50,$13.91,$50.00,$13.91,$48.50,$13.91,N/A,$13.91,$50.00,$13.91,$48.50,$13.91,$50.00,$13.91,$13.91,$48.50
G201250,0983,G2012,,,,,N/A,N/A,TECHNOLOGY-BASED SERVICES,$50.45,$37.50,$13.91,$50.00,$13.91,$48.50,$13.91,N/A,$13.91,$50.00,$13.91,$48.50,$13.91,$50.00,$13.91,$13.91,$48.50
G2012LSC,0983,G2012,,,,,N/A,N/A,TECHNOLOGY-BASED SERVICES,$50.45,$37.50,$13.91,$50.00,$13.91,$48.50,$13.91,N/A,$13.91,$50.00,$13.91,$48.50,$13.91,$50.00,$13.91,$13.91,$48.50
G221234B,0983,G2212,,,,,N/A,N/A,PROLONGED SERVICES          ~P,$50.45,$37.50,$31.54,$64.00,$31.54,$62.08,$31.54,N/A,$31.54,$64.00,$31.54,$62.08,$31.54,$64.00,$31.54,$31.54,$62.08
G221240B,0983,G2212,,,,,N/A,N/A,PROLONGED SERVICES          ~P,$64.57,$48.00,$31.54,$64.00,$31.54,$62.08,$31.54,N/A,$31.54,$64.00,$31.54,$62.08,$31.54,$64.00,$31.54,$31.54,$62.08
G221245B,0983,G2212,,,,,N/A,N/A,PROLONGED SERVICES          ~P,$50.45,$37.50,$31.54,$64.00,$31.54,$62.08,$31.54,N/A,$31.54,$64.00,$31.54,$62.08,$31.54,$64.00,$31.54,$31.54,$62.08
G221250B,0983,G2212,,,,,N/A,N/A,PROLONGED SERVICES          ~P,$50.45,$37.50,$31.54,$64.00,$31.54,$62.08,$31.54,N/A,$31.54,$64.00,$31.54,$62.08,$31.54,$64.00,$31.54,$31.54,$62.08
27441,0986,27441,,,,,N/A,N/A,REVISION OF KNEE JOINT,"$1,684.93","$1,252.50",$684.70,"$1,670.00",$684.70,N/A,$684.70,"$1,427.85",$684.70,"$1,468.22",$684.70,N/A,$684.70,"$1,670.00",$684.70,$684.70,N/A
99222,0987,99222,,,,,N/A,N/A,Initial Inpt/Observ Hospital,$232.06,$172.50,$94.30,$259.00,$94.30,$251.23,$94.30,$164.07,$94.30,$98.50,$94.30,$251.23,$94.30,$259.00,$94.30,$94.30,$251.23
99223,0987,99223,,,,,N/A,N/A,INITIAL HOSPITAL CARE,$332.95,$247.50,$133.36,$165.00,$135.30,$160.05,$135.30,$231.34,$135.30,$133.36,$135.30,$160.05,$135.30,$165.00,$135.30,$135.30,$160.05
99231,0987,99231,,,,,N/A,N/A,SUBSEQUENT HOSPITAL CARE,$83.74,$62.25,$34.30,$196.72,$34.30,$80.51,$34.30,$189.12,$34.30,$196.72,$34.30,$80.51,$34.30,$83.00,$34.30,$34.30,$80.51
V5014,0988,V5014,,,,,N/A,N/A,Repair/Modification Of Heari,$0.00,$0.00,$0.00,$0.00,N/A,$0.00,N/A,N/A,N/A,$0.00,N/A,$0.00,N/A,$0.00,N/A,N/A,$0.00
V5160,0988,V5160,,,,,N/A,N/A,"DISPENSING FEE, BINAURAL","$1,210.73",$900.00,"$1,164.00","$1,200.00",N/A,"$1,164.00",N/A,N/A,N/A,"$1,200.00",N/A,"$1,164.00",N/A,"$1,200.00",N/A,N/A,"$1,164.00"
V5171,0988,V5171,,,,,N/A,N/A,"HEARING AID, MONAURAL (ITE)","$1,210.73",$900.00,"$1,164.00","$1,200.00",N/A,"$1,164.00",N/A,N/A,N/A,"$1,200.00",N/A,"$1,164.00",N/A,"$1,200.00",N/A,N/A,"$1,164.00"
V5221,0988,V5221,,,,,N/A,N/A,HEARING AID BINAURAL BTE/BTE,"$1,816.09","$1,350.00","$1,746.00","$1,800.00",N/A,"$1,746.00",N/A,N/A,N/A,"$1,800.00",N/A,"$1,746.00",N/A,"$1,800.00",N/A,N/A,"$1,746.00"
V5240,0988,V5240,,,,,N/A,N/A,DISPENSING FEE BINAURAL BTE,$605.36,$450.00,$582.00,$600.00,N/A,$582.00,N/A,N/A,N/A,$600.00,N/A,$582.00,N/A,$600.00,N/A,N/A,$582.00
V5241,0988,V5241,,,,,N/A,N/A,"DISPENSING FEE, MONAURAL HEA",$605.36,$450.00,$582.00,$600.00,N/A,$582.00,N/A,N/A,N/A,$600.00,N/A,$582.00,N/A,$600.00,N/A,N/A,$582.00
V5252,0988,V5252,,,,,N/A,N/A,HEARING AID BIAURAL ITE,$908.05,$675.00,$873.00,$900.00,N/A,$873.00,N/A,N/A,N/A,$900.00,N/A,$873.00,N/A,$900.00,N/A,N/A,$873.00
V5255,0988,V5255,,,,,N/A,N/A,HEARING AID MONAURAL ITC,$908.05,$675.00,$873.00,$900.00,N/A,$873.00,N/A,N/A,N/A,$900.00,N/A,$873.00,N/A,$900.00,N/A,N/A,$873.00
V5254,0988,V5256,,,,,N/A,N/A,HEARING AID DIGITAL MONAURAL,$908.05,$675.00,$873.00,$900.00,N/A,$873.00,N/A,N/A,N/A,$900.00,N/A,$873.00,N/A,$900.00,N/A,N/A,$873.00
V5256,0988,V5256,,,,,N/A,N/A,"HEARING AID, DIGITAL, MONAUR",$908.05,$675.00,$873.00,$900.00,N/A,$873.00,N/A,N/A,N/A,$900.00,N/A,$873.00,N/A,$900.00,N/A,N/A,$873.00
V5257,0988,V5257,,,,,N/A,N/A,"HEARING AID, DIGITAL, MONAUR",$908.05,$675.00,$873.00,$900.00,N/A,$873.00,N/A,N/A,N/A,$900.00,N/A,$873.00,N/A,$900.00,N/A,N/A,$873.00
V5258,0988,V5258,,,,,N/A,N/A,HEARING AID BINAURAL CIC,"$1,916.99","$1,425.00","$1,843.00","$1,900.00",N/A,"$1,843.00",N/A,N/A,N/A,"$1,900.00",N/A,"$1,843.00",N/A,"$1,900.00",N/A,N/A,"$1,843.00"
V5259,0988,V5259,,,,,N/A,N/A,HEARING AID BINAURAL ITC,"$1,916.99","$1,425.00","$1,843.00","$1,900.00",N/A,"$1,843.00",N/A,N/A,N/A,"$1,900.00",N/A,"$1,843.00",N/A,"$1,900.00",N/A,N/A,"$1,843.00"
V5260,0988,V5260,,,,,N/A,N/A,"HEARING AID DIGITAL, BINAURA","$1,916.99","$1,425.00","$1,843.00","$1,900.00",N/A,"$1,843.00",N/A,N/A,N/A,"$1,900.00",N/A,"$1,843.00",N/A,"$1,900.00",N/A,N/A,"$1,843.00"
V5261,0988,V5261,,,,,N/A,N/A,"HEARING AID DIGITAL, BINAURA","$1,916.99","$1,425.00","$1,843.00","$1,900.00",N/A,"$1,843.00",N/A,N/A,N/A,"$1,900.00",N/A,"$1,843.00",N/A,"$1,900.00",N/A,N/A,"$1,843.00"
V5264,0988,V5264,,,,,N/A,N/A,"EAR MOLD INSERT, NOT DISPOSA",$80.72,$60.00,$77.60,$80.00,N/A,$77.60,N/A,N/A,N/A,$80.00,N/A,$77.60,N/A,$80.00,N/A,N/A,$77.60
V529940,0990,V5299,,,,,N/A,N/A,HEARING SERVICES MISCELLANEOUS,$50.45,$37.50,$0.00,$50.00,$0.00,$48.50,$0.00,N/A,$0.00,$50.00,$0.00,$48.50,$0.00,$50.00,$0.00,$0.00,$48.50
4200071,0990,,,,,,N/A,N/A,PEDICURE,$156.39,$116.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
4200271,0990,,,,,,N/A,N/A,PEDICURE,$156.39,$116.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9900004,0990,,,,,,N/A,N/A,ANSWERING SERVICE,$43.38,$32.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9900007,0990,,,,,,N/A,N/A,TELEPHONE EXTENSION,$25.22,$18.75,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9900016,0990,,,,,,N/A,N/A,BILLING SERVICES,$15.13,$11.25,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
9900019,0990,,,,,,N/A,N/A,BIO-HAZARD CHARGE,$2.02,$1.50,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A,N/A
,,,,,,,,,,,,,,,,,,,,,,,,,,
Anesthesia Rates,,,,,,,,,,,,,,,,,,,,,,,,,,
CPT Code,Base Units,Service Description,,,,,,,,Gross Charge,Discounted Cash Price,Minimum Negotiated Charge,Maximum Negotiated Charge,AARP-MedicareComplete UnitedHealthCare Rate (Plan: Medicare Advantage),AETNA Rate,AETNA Medicare Advantage Rate (Plan: Medicare Advantage),BCBSVT Rate,Vermont Blue Advantage Rate (Plan: Medicare Advantage),CIGNA Rate,CIGNA HealthSpring Rate (Plan: Medicare Advantage),Harvard Pilgrim HealthCare Rate,Harvard Pilgrim Stride Rate (Plan: Medicare Advantage),MVP HealthCare Rate,MVP HealthCare (Plan: Medicare Advantage),UHC MedicareComplete Rate (Plan: Medicare Advantage),United Healthcare Rate
,,,,,,,,,,,,,,,,,,,,,,,,,,
00100,5,SALIVARY GLANDS INCLUD BIOPSY,,,,,,,,$350.00,$262.50,$49.67,$339.50,$102.60,$339.50,$102.60,$49.67,$102.60,$245.00,$102.60,N/A,$102.60,$225.00,$102.60,$102.60,N/A
00120,5,"EXTERIOR,MIDDLE,INNER EAR NO",,,,,,,,$350.00,$262.50,$49.67,$339.50,$102.60,$339.50,$102.60,$49.67,$102.60,$245.00,$102.60,N/A,$102.60,$225.00,$102.60,$102.60,N/A
00126,4,TYMPANOTOMY,,,,,,,,$280.00,$210.00,$49.67,$271.60,$82.08,$271.60,$82.08,$49.67,$82.08,$196.00,$82.08,N/A,$82.08,$180.00,$82.08,$82.08,N/A
00140,5,EYE NON-SPECIFIED,,,,,,,,$350.00,$262.50,$49.67,$339.50,$102.60,$339.50,$102.60,$49.67,$102.60,$245.00,$102.60,N/A,$102.60,$225.00,$102.60,$102.60,N/A
00142,4,LENS SURGERY,,,,,,,,$280.00,$210.00,$49.67,$271.60,$82.08,$271.60,$82.08,$49.67,$82.08,$196.00,$82.08,N/A,$82.08,$180.00,$82.08,$82.08,N/A
00145,6,VITREORETINAL SURGERY,,,,,,,,$420.00,$315.00,$49.67,$407.40,$123.12,$407.40,$123.12,$49.67,$123.12,$294.00,$123.12,N/A,$123.12,$270.00,$123.12,$123.12,N/A
00160,5,NOSE AND SINUSES NON-SPECIFI,,,,,,,,$350.00,$262.50,$49.67,$339.50,$102.60,$339.50,$102.60,$49.67,$102.60,$245.00,$102.60,N/A,$102.60,$225.00,$102.60,$102.60,N/A
00170,5,INTRORAL PROCEDURES NON-SPEC,,,,,,,,$350.00,$262.50,$49.67,$339.50,$102.60,$339.50,$102.60,$49.67,$102.60,$245.00,$102.60,N/A,$102.60,$225.00,$102.60,$102.60,N/A
00210,11,INTRACRANIAL NON-SPECIFIED,,,,,,,,$770.00,$577.50,$49.67,$746.90,$225.72,$746.90,$225.72,$49.67,$225.72,$539.00,$225.72,N/A,$225.72,$495.00,$225.72,$225.72,N/A
00300,5,NECK HEAD AND POSTERIOR TRUN,,,,,,,,$350.00,$262.50,$49.67,$339.50,$102.60,$339.50,$102.60,$49.67,$102.60,$245.00,$102.60,N/A,$102.60,$225.00,$102.60,$102.60,N/A
00320,6,ESOPHAGUS THYROID LARNYX TRA,,,,,,,,$420.00,$315.00,$49.67,$407.40,$123.12,$407.40,$123.12,$49.67,$123.12,$294.00,$123.12,N/A,$123.12,$270.00,$123.12,$123.12,N/A
00352,5,MAJOR VESSELS OF NECK SIMPLE,,,,,,,,$350.00,$262.50,$49.67,$339.50,$102.60,$339.50,$102.60,$49.67,$102.60,$245.00,$102.60,N/A,$102.60,$225.00,$102.60,$102.60,N/A
00400,3,INTEGUMENTARY SYS OF EXT AND,,,,,,,,$210.00,$157.50,$49.67,$203.70,$61.56,$203.70,$61.56,$49.67,$61.56,$147.00,$61.56,N/A,$61.56,$135.00,$61.56,$61.56,N/A
00402,5,RECONSTRUCTION OF BREAST,,,,,,,,$350.00,$262.50,$49.67,$339.50,$102.60,$339.50,$102.60,$49.67,$102.60,$245.00,$102.60,N/A,$102.60,$225.00,$102.60,$102.60,N/A
00404,5,RADICAL OR MODIFIED RAD PROC,,,,,,,,$350.00,$262.50,$49.67,$339.50,$102.60,$339.50,$102.60,$49.67,$102.60,$245.00,$102.60,N/A,$102.60,$225.00,$102.60,$102.60,N/A
00410,4,ELECTRICAL CONVERSION ARRHYT,,,,,,,,$280.00,$210.00,$49.67,$271.60,$82.08,$271.60,$82.08,$49.67,$82.08,$196.00,$82.08,N/A,$82.08,$180.00,$82.08,$82.08,N/A
00450,5,CLAVICLE AND SCAPULA NONSPECIF,,,,,,,,$350.00,$262.50,$49.67,$339.50,$102.60,$339.50,$102.60,$49.67,$102.60,$245.00,$102.60,N/A,$102.60,$225.00,$102.60,$102.60,N/A
00472,10,THORACOPLASTY,,,,,,,,$700.00,$525.00,$49.67,$679.00,$205.20,$679.00,$205.20,$49.67,$205.20,$490.00,$205.20,N/A,$205.20,$450.00,$205.20,$205.20,N/A
00520,6,ANES FOR CLOSED CHEST PROC,,,,,,,,$420.00,$315.00,$49.67,$407.40,$123.12,$407.40,$123.12,$49.67,$123.12,$294.00,$123.12,N/A,$123.12,$270.00,$123.12,$123.12,N/A
00524,4,PNEUMOCENTESIS,,,,,,,,$280.00,$210.00,$49.67,$271.60,$82.08,$271.60,$82.08,$49.67,$82.08,$196.00,$82.08,N/A,$82.08,$180.00,$82.08,$82.08,N/A
00529,11,Mediastinoscopy DX Thorascopy,,,,,,,,$770.00,$577.50,$49.67,$746.90,$225.72,$746.90,$225.72,$49.67,$225.72,$539.00,$225.72,N/A,$225.72,$495.00,$225.72,$225.72,N/A
00530,4,TRANSVENOUS PACEMAKER INSERT,,,,,,,,$280.00,$210.00,$49.67,$271.60,$82.08,$271.60,$82.08,$49.67,$82.08,$196.00,$82.08,N/A,$82.08,$180.00,$82.08,$82.08,N/A
00532,4,CENTRAL VENOUS CIRCULATION,,,,,,,,$280.00,$210.00,$49.67,$271.60,$82.08,$271.60,$82.08,$49.67,$82.08,$196.00,$82.08,N/A,$82.08,$180.00,$82.08,$82.08,N/A
00540,12,THORACOTOMY NON-SPECIFIED,,,,,,,,$840.00,$630.00,$49.67,$814.80,$246.24,$814.80,$246.24,$49.67,$246.24,$588.00,$246.24,N/A,$246.24,$540.00,$246.24,$246.24,N/A
00542,15,THORACTOMY DECORTICATION,,,,,,,,"$1,050.00",$787.50,$49.67,"$1,018.50",$307.80,"$1,018.50",$307.80,$49.67,$307.80,$735.00,$307.80,N/A,$307.80,$675.00,$307.80,$307.80,N/A
00635,4,DIAGN OR THERA LUMBAR PUNCTU,,,,,,,,$280.00,$210.00,$49.67,$271.60,$82.08,$271.60,$82.08,$49.67,$82.08,$196.00,$82.08,N/A,$82.08,$180.00,$82.08,$82.08,N/A
00731,5,UPPER GASTROINT ENDOSCOP PRO,,,,,,,,$350.00,$262.50,$49.67,$339.50,$102.60,$339.50,$102.60,$49.67,$102.60,$245.00,$102.60,N/A,$102.60,N/A,$102.60,$102.60,N/A
00740,5,UPPER GASTROINT ENDOSCOPIC P,,,,,,,,$350.00,$262.50,$49.67,$339.50,$102.60,$339.50,$102.60,$49.67,$102.60,$245.00,$102.60,N/A,$102.60,N/A,$102.60,$102.60,N/A
00750,4,HERNIA REPAIR UPPER ABDOMEN,,,,,,,,$280.00,$210.00,$49.67,$271.60,$82.08,$271.60,$82.08,$49.67,$82.08,$196.00,$82.08,N/A,$82.08,$180.00,$82.08,$82.08,N/A
00752,6,LUMBAR AND VENTAL HERNIA,,,,,,,,$420.00,$315.00,$49.67,$407.40,$123.12,$407.40,$123.12,$49.67,$123.12,$294.00,$123.12,N/A,$123.12,$270.00,$123.12,$123.12,N/A
00790,7,INTRAPERITONEAL UPPER ABDOME,,,,,,,,$490.00,$367.50,$49.67,$475.30,$143.64,$475.30,$143.64,$49.67,$143.64,$343.00,$143.64,N/A,$143.64,$315.00,$143.64,$143.64,N/A
00800,4,LOWER ANTERIOR ABDOMINAL WAL,,,,,,,,$280.00,$210.00,$49.67,$271.60,$82.08,$271.60,$82.08,$49.67,$82.08,$196.00,$82.08,N/A,$82.08,$180.00,$82.08,$82.08,N/A
00811,4,LOWER INTESTINAL ENDOSCOP PR,,,,,,,,$280.00,$210.00,$49.67,$271.60,$82.08,$271.60,$82.08,$49.67,$82.08,$196.00,$82.08,N/A,$82.08,N/A,$82.08,$82.08,N/A
00812,3,SCREENING COLONOSCOPY,,,,,,,,$210.00,$157.50,$49.67,$203.70,$61.56,$203.70,$61.56,$49.67,$61.56,$147.00,$61.56,N/A,$61.56,N/A,$61.56,$61.56,N/A
00813,5,UPPER & LOWER GASTROINT ENDO,,,,,,,,$350.00,$262.50,$49.67,$339.50,$102.60,$339.50,$102.60,$49.67,$102.60,$245.00,$102.60,N/A,$102.60,N/A,$102.60,$102.60,N/A
00830,4,HERNIA REPAIR LOWER ABDOMEN,,,,,,,,$280.00,$210.00,$49.67,$271.60,$82.08,$271.60,$82.08,$49.67,$82.08,$196.00,$82.08,N/A,$82.08,$180.00,$82.08,$82.08,N/A
00832,6,VENTRAL AND INCISIONAL HERNI,,,,,,,,$420.00,$315.00,$49.67,$407.40,$123.12,$407.40,$123.12,$49.67,$123.12,$294.00,$123.12,N/A,$123.12,$270.00,$123.12,$123.12,N/A
00840,6,LOWER ABDOMEN INCLUDING LAPA,,,,,,,,$420.00,$315.00,$49.67,$407.40,$123.12,$407.40,$123.12,$49.67,$123.12,$294.00,$123.12,N/A,$123.12,$270.00,$123.12,$123.12,N/A
00846,8,RADICAL HYSTERECTOMY,,,,,,,,$560.00,$420.00,$49.67,$543.20,$164.16,$543.20,$164.16,$49.67,$164.16,$392.00,$164.16,N/A,$164.16,$360.00,$164.16,$164.16,N/A
00851,6,ANES FOR TUBAL LIGATION/TRAN,,,,,,,,$420.00,$315.00,$49.67,$407.40,$123.12,$407.40,$123.12,$49.67,$123.12,$294.00,$123.12,N/A,$123.12,$270.00,$123.12,$123.12,N/A
00860,6,EXTRAPERITONEAL LOWER ABD IN,,,,,,,,$420.00,$315.00,$49.67,$407.40,$123.12,$407.40,$123.12,$49.67,$123.12,$294.00,$123.12,N/A,$123.12,$270.00,$123.12,$123.12,N/A
00865,7,RADICAL PROSTATECTOMY,,,,,,,,$490.00,$367.50,$49.67,$475.30,$143.64,$475.30,$143.64,$49.67,$143.64,$343.00,$143.64,N/A,$143.64,$315.00,$143.64,$143.64,N/A
00872,7,LITHOTRIPSY,,,,,,,,$490.00,$367.50,$49.67,$475.30,$143.64,$475.30,$143.64,$49.67,$143.64,$343.00,$143.64,N/A,$143.64,$315.00,$143.64,$143.64,N/A
00902,5,ANORECTAL INCLUDING ENDOSCOP,,,,,,,,$350.00,$262.50,$49.67,$339.50,$102.60,$339.50,$102.60,$49.67,$102.60,$245.00,$102.60,N/A,$102.60,$225.00,$102.60,$102.60,N/A
00906,4,VULVECTOMY,,,,,,,,$280.00,$210.00,$49.67,$271.60,$82.08,$271.60,$82.08,$49.67,$82.08,$196.00,$82.08,N/A,$82.08,$180.00,$82.08,$82.08,N/A
00910,3,TRANSURETHRAL PROC NON-SPECI,,,,,,,,$210.00,$157.50,$49.67,$203.70,$61.56,$203.70,$61.56,$49.67,$61.56,$147.00,$61.56,N/A,$61.56,$135.00,$61.56,$61.56,N/A
00912,5,TRANSURETHRAL RESECTION OF B,,,,,,,,$350.00,$262.50,$49.67,$339.50,$102.60,$339.50,$102.60,$49.67,$102.60,$245.00,$102.60,N/A,$102.60,$225.00,$102.60,$102.60,N/A
00914,5,TRANSURETHRAL RESECTION PROS,,,,,,,,$350.00,$262.50,$49.67,$339.50,$102.60,$339.50,$102.60,$49.67,$102.60,$245.00,$102.60,N/A,$102.60,$225.00,$102.60,$102.60,N/A
00918,5,POST TRANSURETRAL BLEEDING W,,,,,,,,$350.00,$262.50,$49.67,$339.50,$102.60,$339.50,$102.60,$49.67,$102.60,$245.00,$102.60,N/A,$102.60,$225.00,$102.60,$102.60,N/A
00920,3,MALE EXT GENITALIA NON-SPECI,,,,,,,,$210.00,$157.50,$49.67,$203.70,$61.56,$203.70,$61.56,$49.67,$61.56,$147.00,$61.56,N/A,$61.56,$135.00,$61.56,$61.56,N/A
00921,3,ANESTHESIA FOR VASECTOMY,,,,,,,,$210.00,$157.50,$49.67,$203.70,$61.56,$203.70,$61.56,$49.67,$61.56,$147.00,$61.56,N/A,$61.56,$135.00,$61.56,$61.56,N/A
00926,4,RADICAL ORCHIECTOMY INGUINAL,,,,,,,,$280.00,$210.00,$49.67,$271.60,$82.08,$271.60,$82.08,$49.67,$82.08,$196.00,$82.08,N/A,$82.08,$180.00,$82.08,$82.08,N/A
00930,4,ORCHIOPEXY UNI OR BILATERAL,,,,,,,,$280.00,$210.00,$49.67,$271.60,$82.08,$271.60,$82.08,$49.67,$82.08,$196.00,$82.08,N/A,$82.08,$180.00,$82.08,$82.08,N/A
00940,3,VAGINAL PROCEDURES NON-SPECI,,,,,,,,$210.00,$157.50,$49.67,$203.70,$61.56,$203.70,$61.56,$49.67,$61.56,$147.00,$61.56,N/A,$61.56,$135.00,$61.56,$61.56,N/A
00942,4,"COLPTOMY,COLPECTOMY,COLPORRH",,,,,,,,$280.00,$210.00,$49.67,$271.60,$82.08,$271.60,$82.08,$49.67,$82.08,$196.00,$82.08,N/A,$82.08,$180.00,$82.08,$82.08,N/A
00944,6,VAGINAL HYSTERECTOMY,,,,,,,,$420.00,$315.00,$49.67,$407.40,$123.12,$407.40,$123.12,$49.67,$123.12,$294.00,$123.12,N/A,$123.12,$270.00,$123.12,$123.12,N/A
00948,4,CERVICAL CERCLAGE,,,,,,,,$280.00,$210.00,$49.67,$271.60,$82.08,$271.60,$82.08,$49.67,$82.08,$196.00,$82.08,N/A,$82.08,$180.00,$82.08,$82.08,N/A
00952,4,HYSTEROSCOPY AND/OR HYSTEROS,,,,,,,,$280.00,$210.00,$49.67,$271.60,$82.08,$271.60,$82.08,$49.67,$82.08,$196.00,$82.08,N/A,$82.08,$180.00,$82.08,$82.08,N/A
01120,6,BONY PELVIS,,,,,,,,$420.00,$315.00,$49.67,$407.40,$123.12,$407.40,$123.12,$49.67,$123.12,$294.00,$123.12,N/A,$123.12,$270.00,$123.12,$123.12,N/A
01200,4,CLOSED PROC HIP JOINT,,,,,,,,$280.00,$210.00,$49.67,$271.60,$82.08,$271.60,$82.08,$49.67,$82.08,$196.00,$82.08,N/A,$82.08,$180.00,$82.08,$82.08,N/A
01202,4,ARTHROSCOPIC HIP JOINT,,,,,,,,$280.00,$210.00,$49.67,$271.60,$82.08,$271.60,$82.08,$49.67,$82.08,$196.00,$82.08,N/A,$82.08,$180.00,$82.08,$82.08,N/A
01210,6,OPEN PROC HIP JOINT NON-SPEC,,,,,,,,$420.00,$315.00,$49.67,$407.40,$123.12,$407.40,$123.12,$49.67,$123.12,$294.00,$123.12,N/A,$123.12,$270.00,$123.12,$123.12,N/A
01214,8,TOTAL HIP REPLACEMENT,,,,,,,,$560.00,$420.00,$49.67,$543.20,$164.16,$543.20,$164.16,$49.67,$164.16,$392.00,$164.16,N/A,$164.16,$360.00,$164.16,$164.16,N/A
01215,10,REVISION OF TOTAL HIP ARTHRO,,,,,,,,$700.00,$525.00,$49.67,$679.00,$205.20,$679.00,$205.20,$49.67,$205.20,$490.00,$205.20,N/A,$205.20,$450.00,$205.20,$205.20,N/A
01220,4,CLOSED PROC UPPER 2/3 FEMUR,,,,,,,,$280.00,$210.00,$49.67,$271.60,$82.08,$271.60,$82.08,$49.67,$82.08,$196.00,$82.08,N/A,$82.08,$180.00,$82.08,$82.08,N/A
01230,6,OPEN PROC UPPER 2/3 FEMUE NO,,,,,,,,$420.00,$315.00,$49.67,$407.40,$123.12,$407.40,$123.12,$49.67,$123.12,$294.00,$123.12,N/A,$123.12,$270.00,$123.12,$123.12,N/A
01232,5,UPPER LEG AMPUTATION,,,,,,,,$350.00,$262.50,$49.67,$339.50,$102.60,$339.50,$102.60,$49.67,$102.60,$245.00,$102.60,N/A,$102.60,$225.00,$102.60,$102.60,N/A
01250,4,"UPPER LEG NERVES,MUSCLES,TEN",,,,,,,,$280.00,$210.00,$49.67,$271.60,$82.08,$271.60,$82.08,$49.67,$82.08,$196.00,$82.08,N/A,$82.08,$180.00,$82.08,$82.08,N/A
01260,3,ANES PROCEDURE INVOL VEINS,,,,,,,,$210.00,$157.50,$49.67,$203.70,$61.56,$203.70,$61.56,$49.67,$61.56,$147.00,$61.56,N/A,$61.56,$135.00,$61.56,$61.56,N/A
01320,4,"KNEE NERVES,MUSCLES,TENDONS,",,,,,,,,$280.00,$210.00,$49.67,$271.60,$82.08,$271.60,$82.08,$49.67,$82.08,$196.00,$82.08,N/A,$82.08,$180.00,$82.08,$82.08,N/A
01340,4,CLOSED PROC LOWER 1/3 FEMUR,,,,,,,,$280.00,$210.00,$49.67,$271.60,$82.08,$271.60,$82.08,$49.67,$82.08,$196.00,$82.08,N/A,$82.08,$180.00,$82.08,$82.08,N/A
01360,5,OPEN PROC LOWER 1/3 FEMUR,,,,,,,,$350.00,$262.50,$49.67,$339.50,$102.60,$339.50,$102.60,$49.67,$102.60,$245.00,$102.60,N/A,$102.60,$225.00,$102.60,$102.60,N/A
01380,3,CLOSED PROC KNEE JOINT,,,,,,,,$210.00,$157.50,$49.67,$203.70,$61.56,$203.70,$61.56,$49.67,$61.56,$147.00,$61.56,N/A,$61.56,$135.00,$61.56,$61.56,N/A
01390,3,"CLOSED PROC UPPER TIBIS,FIBU",,,,,,,,$210.00,$157.50,$49.67,$203.70,$61.56,$203.70,$61.56,$49.67,$61.56,$147.00,$61.56,N/A,$61.56,$135.00,$61.56,$61.56,N/A
01392,4,"OPEN PROC UPPER TIBIA,FIBULA",,,,,,,,$280.00,$210.00,$49.67,$271.60,$82.08,$271.60,$82.08,$49.67,$82.08,$196.00,$82.08,N/A,$82.08,$180.00,$82.08,$82.08,N/A
01400,4,OPEN PROC KNEE JOINT NON-SPE,,,,,,,,$280.00,$210.00,$49.67,$271.60,$82.08,$271.60,$82.08,$49.67,$82.08,$196.00,$82.08,N/A,$82.08,$180.00,$82.08,$82.08,N/A
01402,7,TOTAL KNEE REPLACEMENT,,,,,,,,$490.00,$367.50,$49.67,$475.30,$143.64,$475.30,$143.64,$49.67,$143.64,$343.00,$143.64,N/A,$143.64,$315.00,$143.64,$143.64,N/A
01420,3,"CAST APPL,REMOVAL, OR REPAIR",,,,,,,,$210.00,$157.50,$49.67,$203.70,$61.56,$203.70,$61.56,$49.67,$61.56,$147.00,$61.56,N/A,$61.56,$135.00,$61.56,$61.56,N/A
01462,3,"CLOSED PROC LOWER LEG,ANKLE,",,,,,,,,$210.00,$157.50,$49.67,$203.70,$61.56,$203.70,$61.56,$49.67,$61.56,$147.00,$61.56,N/A,$61.56,$135.00,$61.56,$61.56,N/A
01464,3,ARTHROSCOPIC PROC ANKLE JOINT,,,,,,,,$210.00,$157.50,$49.67,$203.70,$61.56,$203.70,$61.56,$49.67,$61.56,$147.00,$61.56,N/A,$61.56,$135.00,$61.56,$61.56,N/A
01470,3,"LOWER LEG,FOOT,ANKLE NERVES,",,,,,,,,$210.00,$157.50,$49.67,$203.70,$61.56,$203.70,$61.56,$49.67,$61.56,$147.00,$61.56,N/A,$61.56,$135.00,$61.56,$61.56,N/A
01472,5,REPAIR RUPT ACHILLES TENDON,,,,,,,,$350.00,$262.50,$49.67,$339.50,$102.60,$339.50,$102.60,$49.67,$102.60,$245.00,$102.60,N/A,$102.60,$225.00,$102.60,$102.60,N/A
01480,3,"OPEN PROC BONES LOWER LEG,AN",,,,,,,,$210.00,$157.50,$49.67,$203.70,$61.56,$203.70,$61.56,$49.67,$61.56,$147.00,$61.56,N/A,$61.56,$135.00,$61.56,$61.56,N/A
01482,4,"RADICAL RESECTION LOWER LEG,AN",,,,,,,,$280.00,$210.00,$49.67,$271.60,$82.08,$271.60,$82.08,$49.67,$82.08,$196.00,$82.08,N/A,$82.08,$180.00,$82.08,$82.08,N/A
01484,4,OSTEOTOMY OR OSTEOPLASTY TIBIA,,,,,,,,$280.00,$210.00,$49.67,$271.60,$82.08,$271.60,$82.08,$49.67,$82.08,$196.00,$82.08,N/A,$82.08,$180.00,$82.08,$82.08,N/A
01520,3,LOWER LEG VEINS NON-SPECIFIE,,,,,,,,$210.00,$157.50,$49.67,$203.70,$61.56,$203.70,$61.56,$49.67,$61.56,$147.00,$61.56,N/A,$61.56,$135.00,$61.56,$61.56,N/A
01610,5,"SHOULDER NERVES,MUSCLES,TEND",,,,,,,,$350.00,$262.50,$49.67,$339.50,$102.60,$339.50,$102.60,$49.67,$102.60,$245.00,$102.60,N/A,$102.60,$225.00,$102.60,$102.60,N/A
01620,4,"CLOSED PROC HUMERAL HEAD,NEC",,,,,,,,$280.00,$210.00,$49.67,$271.60,$82.08,$271.60,$82.08,$49.67,$82.08,$196.00,$82.08,N/A,$82.08,$180.00,$82.08,$82.08,N/A
01630,5,"OPEN PROC HEAD,NECK, SHOULDE",,,,,,,,$350.00,$262.50,$49.67,$339.50,$102.60,$339.50,$102.60,$49.67,$102.60,$245.00,$102.60,N/A,$102.60,$225.00,$102.60,$102.60,N/A
01638,10,TOTAL SHOULER REPLACEMENT,,,,,,,,$700.00,$525.00,$49.67,$679.00,$205.20,$679.00,$205.20,$49.67,$205.20,$490.00,$205.20,N/A,$205.20,$450.00,$205.20,$205.20,N/A
01710,3,"UPPER ARM/ELBOW NERVES,MUSCL",,,,,,,,$210.00,$157.50,$49.67,$203.70,$61.56,$203.70,$61.56,$49.67,$61.56,$147.00,$61.56,N/A,$61.56,$135.00,$61.56,$61.56,N/A
01730,3,CLOSED PROC HUMEROUS AND ELBOW,,,,,,,,$210.00,$157.50,$49.67,$203.70,$61.56,$203.70,$61.56,$49.67,$61.56,$147.00,$61.56,N/A,$61.56,$135.00,$61.56,$61.56,N/A
01740,4,OPEN PROC HUMERUS ELBOW NON-,,,,,,,,$280.00,$210.00,$49.67,$271.60,$82.08,$271.60,$82.08,$49.67,$82.08,$196.00,$82.08,N/A,$82.08,$180.00,$82.08,$82.08,N/A
01742,5,OSTEOTOMY OF HUMEROUS,,,,,,,,$350.00,$262.50,$49.67,$339.50,$102.60,$339.50,$102.60,$49.67,$102.60,$245.00,$102.60,N/A,$102.60,$225.00,$102.60,$102.60,N/A
01810,3,"FOREARM,WRIST,HAND NERVES,MU",,,,,,,,$210.00,$157.50,$49.67,$203.70,$61.56,$203.70,$61.56,$49.67,$61.56,$147.00,$61.56,N/A,$61.56,$135.00,$61.56,$61.56,N/A
01820,3,"CLOSED PROC RADIUS,ULNA,WRIS",,,,,,,,$210.00,$157.50,$49.67,$203.70,$61.56,$203.70,$61.56,$49.67,$61.56,$147.00,$61.56,N/A,$61.56,$135.00,$61.56,$61.56,N/A
01830,3,"OPEN PROC RADIUS,ULNA,WRIST,",,,,,,,,$210.00,$157.50,$49.67,$203.70,$61.56,$203.70,$61.56,$49.67,$61.56,$147.00,$61.56,N/A,$61.56,$135.00,$61.56,$61.56,N/A
01922,7,NON-INVASIVE IMAG OR RDTN THPY,,,,,,,,$490.00,$367.50,$49.67,$475.30,$143.64,$475.30,$143.64,$49.67,$143.64,$343.00,$143.64,N/A,$143.64,$315.00,$143.64,$143.64,N/A
01960,5,ANES. FOR PLANNED VAGINAL DE,,,,,,,,$350.00,$262.50,$49.67,$339.50,$102.60,$339.50,$102.60,$49.67,$102.60,$245.00,$102.60,N/A,$102.60,$225.00,$102.60,$102.60,N/A
01961,7,ANES. FOR CESAREAN DELIVERY,,,,,,,,$490.00,$367.50,$49.67,$475.30,$143.64,$475.30,$143.64,$49.67,$143.64,$343.00,$143.64,N/A,$143.64,$315.00,$143.64,$143.64,N/A
01965,4,ANESTHESIA FOR INCOM/MISSED,,,,,,,,$280.00,$210.00,$49.67,$271.60,$82.08,$271.60,$82.08,$49.67,$82.08,$196.00,$82.08,N/A,$82.08,$180.00,$82.08,$82.08,N/A
01967,5,INTRATHECAL ANESTHESIA FOR V,,,,,,,,$350.00,$262.50,$49.67,$339.50,$102.60,$339.50,$102.60,$49.67,$102.60,$245.00,$102.60,N/A,$102.60,$225.00,$102.60,$102.60,N/A
01968,2,CESAREAN DELIV FOLLOWING NEU,,,,,,,,$140.00,$105.00,$41.04,$135.80,$41.04,$135.80,$41.04,$49.67,$41.04,$98.00,$41.04,N/A,$41.04,$135.00,$41.04,$41.04,N/A
,,,,,,,,,,,,,,,,,,,,,,,,,,
Pharmacy Rates,,,,,,,,,,,,,,,,,,,,,,,,,,
CDM Item Number,Revenue Code,Service ID,,,,,,,Service Description,Gross Charge,Discounted Cash Price,Minimum Negotiated Charge,Maximum Negotiated Charge,AARP-MedicareComplete UnitedHealthCare Rate (Plan: Medicare Advantage),AETNA Rate,AETNA Medicare Advantage Rate (Plan: Medicare Advantage),Vermont Blue Advantage Rate (Plan: Medicare Advantage),Blue Cross Blue Shield of VT Rates,CIGNA Rate,CIGNA HealthSpring Rate (Plan: Medicare Advantage),Harvard Pilgrim HealthCare Rate,Harvard Pilgrim Stride Rate (Plan: Medicare Advantage),MVP HealthCare Rate,MVP HealthCare (Plan: Medicare Advantage),UHC MedicareComplete Rate (Plan: Medicare Advantage),United Healthcare Rate
,,,,,,,,,,,,,,,,,,,,,,,,,,
2536960,0636,J0129,,,,,,,Abatacept 250 MG VIAL,"$3,192.20","$2,197.68","$1,201.40","$2,842.33","$1,308.80","$3,096.44","$1,308.80","$1,308.80","$2,793.18","$2,713.37","$1,308.80","$2,968.75","$1,308.80","$3,032.59","$1,308.80","$1,308.80","$3,032.59"
2540680,0250,,,,,,,,Acamprosate 333 MG TABCR,$40.30,$27.74,$15.17,$35.88,$16.52,$39.09,$16.52,$16.52,$35.26,$34.25,$16.52,$37.48,$16.52,$38.28,$16.52,$16.52,$38.28
2533850,0259,,,,,,,,Acarbose 25 MG TAB,$5.59,$3.85,$2.10,$4.98,$2.29,$5.42,$2.29,$2.29,$4.89,$4.75,$2.29,$5.20,$2.29,$5.31,$2.29,$2.29,$5.31
2523274,0250,,,,,,,,Acetam 300 MG/Codeine 30 MG 1,$2.94,$2.03,$1.11,$2.62,$1.21,$2.85,$1.21,$1.21,$2.57,$2.50,$1.21,$2.74,$1.21,$2.79,$1.21,$1.21,$2.79
2523273,0250,,,,,,,,Acetam 300 MG/Codeine 30mg 5,$2.94,$2.03,$1.11,$2.62,$1.21,$2.85,$1.21,$1.21,$2.57,$2.50,$1.21,$2.74,$1.21,$2.79,$1.21,$1.21,$2.79
2501020,0250,,,,,,,,ACETAMINOPHEN,$34.94,$24.05,$13.15,$31.11,$14.32,$33.89,$14.32,$14.32,$30.57,$29.70,$14.32,$32.49,$14.32,$33.19,$14.32,$14.32,$33.19
2543270,0636,C9283,,,,,,,Acetaminophen 1000 Mg/100 Ml V,$131.62,$90.62,$49.54,$117.20,$53.96,$127.67,$53.96,$53.96,$115.17,$111.88,$53.96,$122.41,$53.96,$125.04,$53.96,$53.96,$125.04
2536830,0250,,,,,,,,Acetaminophen 12 MG/Codeine 12,$26.70,$18.38,$10.05,$23.77,$10.95,$25.90,$10.95,$10.95,$23.36,$22.70,$10.95,$24.83,$10.95,$25.37,$10.95,$10.95,$25.37
2501090,0259,,,,,,,,Acetaminophen 120 MG SUPP,$5.73,$3.95,$2.16,$5.10,$2.35,$5.56,$2.35,$2.35,$5.01,$4.87,$2.35,$5.33,$2.35,$5.44,$2.35,$2.35,$5.44
2523512,0250,,,,,,,,ACETAMINOPHEN 250MG/ASPIRIN TA,$0.46,$0.32,$0.17,$0.41,$0.19,$0.44,$0.19,$0.19,$0.40,$0.39,$0.19,$0.43,$0.19,$0.43,$0.19,$0.19,$0.43
2501050,0259,,,,,,,,Acetaminophen 300 MG/Codeine 1,$2.59,$1.79,$0.98,$2.31,$1.06,$2.51,$1.06,$1.06,$2.27,$2.20,$1.06,$2.41,$1.06,$2.46,$1.06,$1.06,$2.46
2501060,0259,,,,,,,,Acetaminophen 300 Mg/Codeine 3,$2.51,$1.73,$0.94,$2.23,$1.03,$2.43,$1.03,$1.03,$2.19,$2.13,$1.03,$2.33,$1.03,$2.38,$1.03,$1.03,$2.38
2523567,0250,,,,,,,,ACETAMINOPHEN 300MG/CODEINE 30,$31.51,$21.69,$11.86,$28.05,$12.92,$30.56,$12.92,$12.92,$27.57,$26.78,$12.92,$29.30,$12.92,$29.93,$12.92,$12.92,$29.93
2522856,0250,,,,,,,,Acetaminophen 325 MG SUPP,$15.14,$10.43,$5.70,$13.48,$6.21,$14.69,$6.21,$6.21,$13.25,$12.87,$6.21,$14.08,$6.21,$14.39,$6.21,$6.21,$14.39
2501030,0259,,,,,,,,Acetaminophen 325 MG TAB,$0.10,$0.07,$0.04,$0.09,$0.04,$0.10,$0.04,$0.04,$0.09,$0.08,$0.04,$0.09,$0.04,$0.09,$0.04,$0.04,$0.09
2501040,0250,,,,,,,,Acetaminophen 500 MG TAB,$0.60,$0.41,$0.23,$0.53,$0.25,$0.58,$0.25,$0.25,$0.52,$0.51,$0.25,$0.56,$0.25,$0.57,$0.25,$0.25,$0.57
2501100,0259,,,,,,,,Acetaminophen 650 Mg Supp,$6.58,$4.53,$2.48,$5.86,$2.70,$6.38,$2.70,$2.70,$5.76,$5.59,$2.70,$6.12,$2.70,$6.25,$2.70,$2.70,$6.25
2522857,0250,,,,,,,,Acetaminophen 80 MG CHEW,$0.94,$0.65,$0.35,$0.83,$0.38,$0.91,$0.38,$0.38,$0.82,$0.80,$0.38,$0.87,$0.38,$0.89,$0.38,$0.38,$0.89
2537250,0259,,,,,,,,Acetaminophen Solution 160 MG/,$34.96,$24.07,$13.16,$31.13,$14.33,$33.91,$14.33,$14.33,$30.59,$29.72,$14.33,$32.51,$14.33,$33.21,$14.33,$14.33,$33.21
2534700,0259,,,,,,,,Acetaminophen Solution 650 MG/,$30.96,$21.32,$11.65,$27.57,$12.69,$30.03,$12.69,$12.69,$27.09,$26.32,$12.69,$28.79,$12.69,$29.41,$12.69,$12.69,$29.41
2501070,0259,,,,,,,,acetaZOLAMIDE 250 MG TAB,$7.56,$5.21,$2.85,$6.73,$3.10,$7.33,$3.10,$3.10,$6.62,$6.43,$3.10,$7.03,$3.10,$7.18,$3.10,$3.10,$7.18
2509990,0636,J1120,,,,,,,acetaZOLAMIDE 500 MG VIAL,$383.58,$264.08,$144.36,$341.54,$157.27,$372.07,$157.27,$157.27,$335.63,$326.04,$157.27,$356.73,$157.27,$364.40,$157.27,$157.27,$364.40
2515010,0259,,,,,,,,Acetic Acid/HC Otic 10 ML BTL,$551.00,$379.34,$207.37,$490.61,$225.91,$534.47,$225.91,$225.91,$482.12,$468.35,$225.91,$512.43,$225.91,$523.45,$225.91,$225.91,$523.45
2536270,0636,J0132,,,,,,,Acetylcysteine *i.V.* 6000 Mg/,$347.15,$239.00,$130.65,$309.10,$142.33,$336.73,$142.33,$142.33,$303.75,$295.08,$142.33,$322.85,$142.33,$329.79,$142.33,$142.33,$329.79
2516550,0636,J7608,,,,,,,Acetylcysteine 20% *ORAL/INHAL,$283.36,$195.08,$106.65,$252.31,$116.18,$274.86,$116.18,$116.18,$247.94,$240.86,$116.18,$263.53,$116.18,$269.20,$116.18,$116.18,$269.20
2523486,0250,,,,,,,,ACETYLCYSTEINE 600 MG CAP,$1.56,$1.07,$0.59,$1.39,$0.64,$1.51,$0.64,$0.64,$1.36,$1.32,$0.64,$1.45,$0.64,$1.48,$0.64,$0.64,$1.48
2523107,0250,,,,,,,,ACLIDINIUM BROM 400MCG 30 PUFF,$520.47,$358.32,$195.88,$463.43,$213.39,$504.86,$213.39,$213.39,$455.41,$442.40,$213.39,$484.04,$213.39,$494.45,$213.39,$213.39,$494.45
2501150,0259,,,,,,,,Acyclovir 200 MG CAP,$2.18,$1.50,$0.82,$1.94,$0.89,$2.11,$0.89,$0.89,$1.91,$1.85,$0.89,$2.03,$0.89,$2.07,$0.89,$0.89,$2.07
2538240,0250,,,,,,,,Acyclovir 400 MG TAB,$9.09,$6.26,$3.42,$8.09,$3.73,$8.81,$3.73,$3.73,$7.95,$7.72,$3.73,$8.45,$3.73,$8.63,$3.73,$3.73,$8.63
2515480,0259,,,,,,,,Acyclovir 5% OINT 15 GM TUBE,$203.97,$140.42,$76.76,$181.61,$83.63,$197.85,$83.63,$83.63,$178.47,$173.37,$83.63,$189.69,$83.63,$193.77,$83.63,$83.63,$193.77
2523116,0250,,,,,,,,ACYCLOVIR 5% OINT 5 GM TUBE,$501.48,$345.25,$188.74,$446.52,$205.61,$486.44,$205.61,$205.61,$438.80,$426.26,$205.61,$466.38,$205.61,$476.41,$205.61,$205.61,$476.41
2510000,0636,J0133,,,,,,,Acyclovir 500 MG VIAL,$100.29,$69.05,$37.74,$89.30,$41.12,$97.28,$41.12,$41.12,$87.75,$85.25,$41.12,$93.27,$41.12,$95.28,$41.12,$41.12,$95.28
2539740,0636,J0135,,,,,,,Adalimumab 40 MG/0.8 ML TWO SY,"$7,333.19","$5,048.55","$2,759.87","$6,529.46","$3,006.61","$7,113.19","$3,006.61","$3,006.61","$6,416.54","$6,233.21","$3,006.61","$6,819.86","$3,006.61","$6,966.53","$3,006.61","$3,006.61","$6,966.53"
2541240,0250,,,,,,,,ADDERAL 10MG,$7.09,$4.88,$2.67,$6.31,$2.91,$6.88,$2.91,$2.91,$6.21,$6.03,$2.91,$6.60,$2.91,$6.74,$2.91,$2.91,$6.74
2509620,0250,,,,,,,,Adenosin 6 MG/2 ML VIAL,$40.44,$27.84,$15.22,$36.01,$16.58,$39.23,$16.58,$16.58,$35.38,$34.37,$16.58,$37.61,$16.58,$38.42,$16.58,$16.58,$38.42
2530070,0259,,,,,,,,ADVAIR 250/50 DISKUS 60 DISK,$755.11,$519.86,$284.19,$672.35,$309.59,$732.45,$309.59,$309.59,$660.72,$641.84,$309.59,$702.25,$309.59,$717.35,$309.59,$309.59,$717.35
2530080,0259,,,,,,,,ADVAIR 500/50 DISKUS 60 DISK,$975.85,$671.83,$367.27,$868.90,$400.10,$946.58,$400.10,$400.10,$853.87,$829.47,$400.10,$907.54,$400.10,$927.06,$400.10,$400.10,$927.06
2523022,0250,,,,,,,,Albumin Human 25% 100 ML BAG,$566.48,$389.99,$213.20,$504.39,$232.26,$549.48,$232.26,$232.26,$495.67,$481.51,$232.26,$526.82,$232.26,$538.15,$232.26,$232.26,$538.15
2527110,0250,,,,,,,,Albumin Human 25% 100 ML VIAL,$524.18,$360.87,$197.28,$466.73,$214.91,$508.45,$214.91,$214.91,$458.65,$445.55,$214.91,$487.48,$214.91,$497.97,$214.91,$214.91,$497.97
2510010,0259,,,,,,,,Albuterol 2 MG/5 ML,$1.12,$0.77,$0.42,$1.00,$0.46,$1.09,$0.46,$0.46,$0.98,$0.95,$0.46,$1.04,$0.46,$1.07,$0.46,$0.46,$1.07
2515450,0636,J7603,,,,,,,Albuterol 3 Ml Inh Soln Vial,$4.31,$2.97,$1.62,$3.84,$1.77,$4.18,$1.77,$1.77,$3.77,$3.67,$1.77,$4.01,$1.77,$4.10,$1.77,$1.77,$4.10
2525270,0636,J7602,,,,,,,Albuterol 5 Mg/Ml Inh Soln,$74.68,$51.41,$28.11,$66.49,$30.62,$72.44,$30.62,$30.62,$65.34,$63.48,$30.62,$69.45,$30.62,$70.94,$30.62,$30.62,$70.94
2537480,0250,,,,,,,,Albuterol Hfa 18 Gm 200 Puff I,$456.80,$314.48,$171.92,$406.73,$187.29,$443.09,$187.29,$187.29,$399.70,$388.28,$187.29,$424.82,$187.29,$433.96,$187.29,$187.29,$433.96
2538420,0250,,,,,,,,Albuterol HFA 8 GM 60 PUFF INH,$305.81,$210.53,$115.09,$272.29,$125.38,$296.63,$125.38,$125.38,$267.58,$259.93,$125.38,$284.40,$125.38,$290.52,$125.38,$125.38,$290.52
2536580,0250,,,,,,,,Albuterol Hfa 8.5 Gm 200 Puff,$360.84,$248.42,$135.80,$321.29,$147.95,$350.02,$147.95,$147.95,$315.74,$306.72,$147.95,$335.58,$147.95,$342.80,$147.95,$147.95,$342.80
2528350,0636,J7620,,,,,,,Albuterol/Ipratropium 3 Ml Upd,$5.98,$4.12,$2.25,$5.33,$2.45,$5.80,$2.45,$2.45,$5.23,$5.08,$2.45,$5.56,$2.45,$5.68,$2.45,$2.45,$5.68
2528970,0259,,,,,,,,Alendronate 35 MG TAB,$7.80,$5.37,$2.94,$6.95,$3.20,$7.57,$3.20,$3.20,$6.83,$6.63,$3.20,$7.25,$3.20,$7.41,$3.20,$3.20,$7.41
2528000,0259,,,,,,,,Alendronate 70 MG TAB,$10.36,$7.13,$3.90,$9.22,$4.25,$10.05,$4.25,$4.25,$9.07,$8.81,$4.25,$9.63,$4.25,$9.84,$4.25,$4.25,$9.84
2509210,0259,,,,,,,,Allopurinol 100 Mg Tab,$5.28,$3.64,$1.99,$4.70,$2.17,$5.13,$2.17,$2.17,$4.62,$4.49,$2.17,$4.91,$2.17,$5.02,$2.17,$2.17,$5.02
2509220,0259,,,,,,,,Allopurinol 300 MG TAB,$7.54,$5.19,$2.84,$6.71,$3.09,$7.31,$3.09,$3.09,$6.60,$6.41,$3.09,$7.01,$3.09,$7.16,$3.09,$3.09,$7.16
2522500,0636,,,,,,,,Alpha-1-Proteinase Inhibitor V,"$1,727.47","$1,189.28",$650.14,"$1,538.14",$708.26,"$1,675.65",$708.26,$708.26,"$1,511.54","$1,468.35",$708.26,"$1,606.55",$708.26,"$1,641.10",$708.26,$708.26,"$1,641.10"
2522858,0250,,,,,,,,Alprazolam 0.25 Mg Tab,$0.72,$0.50,$0.27,$0.64,$0.29,$0.70,$0.29,$0.29,$0.63,$0.61,$0.29,$0.67,$0.29,$0.68,$0.29,$0.29,$0.68
2523278,0250,,,,,,,,"ALPRAZolam 0.25 MG TAB, 1 TAB/",$0.94,$0.65,$0.35,$0.83,$0.38,$0.91,$0.38,$0.38,$0.82,$0.80,$0.38,$0.87,$0.38,$0.89,$0.38,$0.38,$0.89
2509040,0259,,,,,,,,ALPRAZolam 0.5 MG TAB,$0.77,$0.53,$0.29,$0.69,$0.32,$0.75,$0.32,$0.32,$0.68,$0.66,$0.32,$0.72,$0.32,$0.73,$0.32,$0.32,$0.73
2527040,0250,,,,,,,,Alprostadil 500 MCG/ML AMP,$519.37,$357.56,$195.47,$462.45,$212.94,$503.79,$212.94,$212.94,$454.45,$441.47,$212.94,$483.02,$212.94,$493.40,$212.94,$212.94,$493.40
2509610,0636,J2996,,,,,,,Alteplase 100 Mg Vial,"$15,628.09","$10,759.19","$5,881.69","$13,915.22","$6,407.52","$15,159.24","$6,407.52","$6,407.52","$13,674.58","$13,283.87","$6,407.52","$14,534.12","$6,407.52","$14,846.68","$6,407.52","$6,407.52","$14,846.68"
2529030,0636,J2997,,,,,,,Alteplase 2 MG VIAL,$631.22,$434.57,$237.56,$562.04,$258.80,$612.28,$258.80,$258.80,$552.32,$536.54,$258.80,$587.03,$258.80,$599.66,$258.80,$258.80,$599.66
2509780,0259,,,,,,,,Aluminum Hydroxide 320 MG/5 ML,$0.20,$0.14,$0.07,$0.17,$0.08,$0.19,$0.08,$0.08,$0.17,$0.17,$0.08,$0.18,$0.08,$0.19,$0.08,$0.08,$0.19
2523357,0250,,,,,,,,ALVIMOPAN 12 MG CAP,$630.80,$434.27,$237.40,$561.66,$258.63,$611.87,$258.63,$258.63,$551.95,$536.18,$258.63,$586.64,$258.63,$599.26,$258.63,$258.63,$599.26
2508110,0259,,,,,,,,Amantadine 100 MG CAP,$15.27,$10.52,$5.75,$13.60,$6.26,$14.82,$6.26,$6.26,$13.36,$12.98,$6.26,$14.20,$6.26,$14.51,$6.26,$6.26,$14.51
2539470,0636,J0282,,,,,,,Amdiodarone 900 MG/18 ML VIAL,$215.11,$148.10,$80.96,$191.54,$88.20,$208.66,$88.20,$88.20,$188.22,$182.85,$88.20,$200.06,$88.20,$204.36,$88.20,$88.20,$204.36
2523052,0250,,,,,,,,Amdiodarone in Dextrose 360 MG,$315.52,$217.22,$118.75,$280.94,$129.36,$306.06,$129.36,$129.36,$276.08,$268.19,$129.36,$293.44,$129.36,$299.75,$129.36,$129.36,$299.75
2530610,0259,,,,,,,,aMILoride HCL 5 MG TAB,$4.01,$2.76,$1.51,$3.57,$1.64,$3.89,$1.64,$1.64,$3.51,$3.41,$1.64,$3.73,$1.64,$3.81,$1.64,$1.64,$3.81
2540100,0250,,,,,,,,Amino Acids 4.25%/D10w 1000 Ml,$389.62,$268.24,$146.64,$346.92,$159.75,$377.94,$159.75,$159.75,$340.92,$331.18,$159.75,$362.35,$159.75,$370.14,$159.75,$159.75,$370.14
2523114,0250,,,,,,,,AMINO ACIDS 4.25%/D5W 1000ML,$305.08,$210.03,$114.82,$271.64,$125.08,$295.92,$125.08,$125.08,$266.94,$259.31,$125.08,$283.72,$125.08,$289.82,$125.08,$125.08,$289.82
2540110,0250,,,,,,,,Amino Acids 5%/D15W 1000 ML BA,$317.64,$218.68,$119.54,$282.82,$130.23,$308.11,$130.23,$130.23,$277.93,$269.99,$130.23,$295.40,$130.23,$301.75,$130.23,$130.23,$301.75
2523113,0250,,,,,,,,AMINO ACIDS 5%/D15W 2000ML BAG,$454.66,$313.01,$171.11,$404.83,$186.41,$441.02,$186.41,$186.41,$397.83,$386.46,$186.41,$422.83,$186.41,$431.93,$186.41,$186.41,$431.93
2509740,0250,,,,,,,,Aminocaprioc Acid 5000 MG/20 M,$161.63,$111.28,$60.83,$143.92,$66.27,$156.79,$66.27,$66.27,$141.43,$137.39,$66.27,$150.32,$66.27,$153.55,$66.27,$66.27,$153.55
2509760,0636,J0280,,,,,,,AMINOPHYLLINE,$202.30,$139.28,$76.14,$180.13,$82.94,$196.23,$82.94,$82.94,$177.01,$171.96,$82.94,$188.14,$82.94,$192.19,$82.94,$82.94,$192.19
2509770,0636,J0280,,,,,,,Aminophylline 500 Mg/20 Ml Via,$134.62,$92.68,$50.66,$119.86,$55.19,$130.58,$55.19,$55.19,$117.79,$114.42,$55.19,$125.19,$55.19,$127.89,$55.19,$55.19,$127.89
2527420,0250,,,,,,,,Amiodarone 150 Mg/3 Ml Vial,$81.35,$56.00,$30.61,$72.43,$33.35,$78.91,$33.35,$33.35,$71.18,$69.14,$33.35,$75.65,$33.35,$77.28,$33.35,$33.35,$77.28
2503030,0259,,,,,,,,Amiodarone 200 MG TAB,$7.97,$5.49,$3.00,$7.10,$3.27,$7.74,$3.27,$3.27,$6.98,$6.78,$3.27,$7.42,$3.27,$7.58,$3.27,$3.27,$7.58
2503870,0259,,,,,,,,Amitriptyline 10 MG TAB,$2.33,$1.61,$0.88,$2.08,$0.96,$2.26,$0.96,$0.96,$2.04,$1.98,$0.96,$2.17,$0.96,$2.21,$0.96,$0.96,$2.21
2503910,0259,,,,,,,,Amitriptyline 25 MG TAB,$7.94,$5.47,$2.99,$7.07,$3.26,$7.70,$3.26,$3.26,$6.95,$6.75,$3.26,$7.39,$3.26,$7.54,$3.26,$3.26,$7.54
2503880,0259,,,,,,,,Amitriptyline 50 MG TAB,$8.21,$5.66,$3.09,$7.31,$3.37,$7.97,$3.37,$3.37,$7.19,$6.98,$3.37,$7.64,$3.37,$7.80,$3.37,$3.37,$7.80
2506450,0259,,,,,,,,amLODIPine 10 MG TAB,$1.33,$0.92,$0.50,$1.18,$0.54,$1.29,$0.54,$0.54,$1.16,$1.13,$0.54,$1.24,$0.54,$1.26,$0.54,$0.54,$1.26
2516540,0259,,,,,,,,amLODIPine 2.5 MG TAB,$2.58,$1.78,$0.97,$2.30,$1.06,$2.50,$1.06,$1.06,$2.26,$2.19,$1.06,$2.40,$1.06,$2.45,$1.06,$1.06,$2.45
2506440,0259,,,,,,,,amLODIPine 5 MG TAB,$1.39,$0.96,$0.52,$1.24,$0.57,$1.35,$0.57,$0.57,$1.22,$1.19,$0.57,$1.30,$0.57,$1.32,$0.57,$0.57,$1.32
2515580,0259,,,,,,,,Ammonia Inhalation AMP,$7.02,$4.83,$2.64,$6.25,$2.88,$6.81,$2.88,$2.88,$6.14,$5.96,$2.88,$6.52,$2.88,$6.66,$2.88,$2.88,$6.66
2523266,0250,,,,,,,,"Amox. 875/Clav. 125, 2 TABS/BT",$13.48,$9.28,$5.07,$12.00,$5.53,$13.07,$5.53,$5.53,$11.79,$11.45,$5.53,$12.53,$5.53,$12.80,$5.53,$5.53,$12.80
2526360,0259,,,,,,,,Amoxicillin 125 MG/5 ML 100ML,$55.31,$38.08,$20.82,$49.25,$22.68,$53.65,$22.68,$22.68,$48.40,$47.01,$22.68,$51.44,$22.68,$52.54,$22.68,$22.68,$52.54
2525140,0259,,,,,,,,Amoxicillin 200 MG/5 ML,$59.49,$40.96,$22.39,$52.97,$24.39,$57.71,$24.39,$24.39,$52.06,$50.57,$24.39,$55.33,$24.39,$56.52,$24.39,$24.39,$56.52
2521090,0259,,,,,,,,Amoxicillin 200/Clav. 28.5 50,$90.83,$62.54,$34.19,$80.88,$37.24,$88.11,$37.24,$37.24,$79.48,$77.21,$37.24,$84.48,$37.24,$86.29,$37.24,$37.24,$86.29
2523566,0250,,,,,,,,AMOXICILLIN 200MG/5ML 75ML BTL,$42.16,$29.03,$15.87,$37.54,$17.29,$40.89,$17.29,$17.29,$36.89,$35.84,$17.29,$39.21,$17.29,$40.05,$17.29,$17.29,$40.05
2501550,0259,,,,,,,,Amoxicillin 250 MG CAP,$5.59,$3.85,$2.10,$4.98,$2.29,$5.42,$2.29,$2.29,$4.89,$4.75,$2.29,$5.20,$2.29,$5.31,$2.29,$2.29,$5.31
2501540,0259,,,,,,,,Amoxicillin 250 MG CHEW,$5.23,$3.60,$1.97,$4.66,$2.14,$5.07,$2.14,$2.14,$4.58,$4.44,$2.14,$4.86,$2.14,$4.97,$2.14,$2.14,$4.97
2523268,0250,,,,,,,,"Amoxicillin 250 MG CHEW, 2 TAB",$6.55,$4.51,$2.46,$5.83,$2.68,$6.35,$2.68,$2.68,$5.73,$5.57,$2.68,$6.09,$2.68,$6.22,$2.68,$2.68,$6.22
2526350,0259,,,,,,,,Amoxicillin 250 Mg/5 Ml 100ml,$35.87,$24.70,$13.50,$31.94,$14.71,$34.80,$14.71,$14.71,$31.39,$30.49,$14.71,$33.36,$14.71,$34.08,$14.71,$14.71,$34.08
2522859,0250,,,,,,,,Amoxicillin 250 MG/5 ML 150 ML,$90.29,$62.16,$33.98,$80.39,$37.02,$87.58,$37.02,$37.02,$79.00,$76.75,$37.02,$83.97,$37.02,$85.77,$37.02,$37.02,$85.77
2524320,0259,,,,,,,,Amoxicillin 400/Clav. 57 100 M,$172.99,$119.09,$65.10,$154.03,$70.92,$167.80,$70.92,$70.92,$151.36,$147.04,$70.92,$160.88,$70.92,$164.34,$70.92,$70.92,$164.34
2501560,0259,,,,,,,,Amoxicillin 500 MG CAP,$1.68,$1.16,$0.63,$1.49,$0.69,$1.63,$0.69,$0.69,$1.47,$1.43,$0.69,$1.56,$0.69,$1.59,$0.69,$0.69,$1.59
2501990,0259,,,,,,,,Amoxicillin 500/Clav. 125 TAB,$8.97,$6.17,$3.37,$7.98,$3.68,$8.70,$3.68,$3.68,$7.85,$7.62,$3.68,$8.34,$3.68,$8.52,$3.68,$3.68,$8.52
2531920,0259,,,,,,,,Amoxicillin 600/Clav. 42.9 75,$104.59,$72.01,$39.36,$93.13,$42.88,$101.46,$42.88,$42.88,$91.52,$88.90,$42.88,$97.27,$42.88,$99.36,$42.88,$42.88,$99.36
2531010,0259,,,,,,,,Amoxicillin 875 MG TAB,$8.30,$5.72,$3.12,$7.39,$3.40,$8.05,$3.40,$3.40,$7.26,$7.06,$3.40,$7.72,$3.40,$7.89,$3.40,$3.40,$7.89
2502000,0259,,,,,,,,Amoxicillin 875/Clav. 125 TAB,$8.24,$5.67,$3.10,$7.33,$3.38,$7.99,$3.38,$3.38,$7.21,$7.00,$3.38,$7.66,$3.38,$7.82,$3.38,$3.38,$7.82
2592960,0250,,,,,,,,Amoxicillin Suspension 400 Mg/,$172.99,$119.09,$65.10,$154.03,$70.92,$167.80,$70.92,$70.92,$151.36,$147.04,$70.92,$160.88,$70.92,$164.34,$70.92,$70.92,$164.34
2530590,0259,,,,,,,,Amphet Asp/Amphet/D-Amphet 20m,$12.95,$8.92,$4.87,$11.53,$5.31,$12.56,$5.31,$5.31,$11.33,$11.01,$5.31,$12.05,$5.31,$12.31,$5.31,$5.31,$12.31
2523539,0636,J0289,,,,,,,Amphotericin B Liposome 50mg V,$651.42,$448.47,$245.16,$580.02,$267.08,$631.88,$267.08,$267.08,$569.99,$553.70,$267.08,$605.82,$267.08,$618.85,$267.08,$267.08,$618.85
2592860,0250,,,,,,,,Ampicillin 1 GM VIAL,$77.16,$53.12,$29.04,$68.71,$31.64,$74.85,$31.64,$31.64,$67.52,$65.59,$31.64,$71.76,$31.64,$73.30,$31.64,$31.64,$73.30
2510070,0636,J0290,,,,,,,Ampicillin 2 GM VIAL,$143.88,$99.05,$54.15,$128.11,$58.99,$139.56,$58.99,$58.99,$125.89,$122.30,$58.99,$133.81,$58.99,$136.68,$58.99,$58.99,$136.68
2506470,0259,,,,,,,,Ampicillin 500 Mg Cap,$8.08,$5.57,$3.04,$7.20,$3.31,$7.84,$3.31,$3.31,$7.07,$6.87,$3.31,$7.52,$3.31,$7.68,$3.31,$3.31,$7.68
2522861,0250,,,,,,,,Ampicillin 500 MG VIAL,$60.30,$41.51,$22.69,$53.69,$24.72,$58.49,$24.72,$24.72,$52.76,$51.25,$24.72,$56.08,$24.72,$57.28,$24.72,$24.72,$57.28
2510040,0636,J0290,,,,,,,AMPICILLIN SODIUM,$57.74,$39.75,$21.73,$51.41,$23.67,$56.01,$23.67,$23.67,$50.52,$49.08,$23.67,$53.70,$23.67,$54.85,$23.67,$23.67,$54.85
2510080,0636,J0295,,,,,,,Ampicillin/Sulbactam 1.5 GM VI,$100.48,$69.17,$37.81,$89.46,$41.19,$97.46,$41.19,$41.19,$87.92,$85.40,$41.19,$93.44,$41.19,$95.45,$41.19,$41.19,$95.45
2510090,0636,J0295,,,,,,,Ampicillin/Sulbactam 3 Gm Vial,$260.44,$179.30,$98.02,$231.90,$106.78,$252.63,$106.78,$106.78,$227.89,$221.38,$106.78,$242.21,$106.78,$247.42,$106.78,$106.78,$247.42
2521820,0259,,,,,,,,Anastrozole 1 MG TAB,$2.47,$1.70,$0.93,$2.20,$1.01,$2.40,$1.01,$1.01,$2.16,$2.10,$1.01,$2.30,$1.01,$2.35,$1.01,$1.01,$2.35
2523053,0250,,,,,,,,Apixaban 5 MG TAB,$110.88,$76.34,$41.73,$98.73,$45.46,$107.55,$45.46,$45.46,$97.02,$94.25,$45.46,$103.12,$45.46,$105.34,$45.46,$45.46,$105.34
2523106,0250,,,,,,,,APIXOBAN 2.5 MG TAB,$110.88,$76.34,$41.73,$98.73,$45.46,$107.55,$45.46,$45.46,$97.02,$94.25,$45.46,$103.12,$45.46,$105.34,$45.46,$45.46,$105.34
2537590,0259,,,,,,,,Aquaphor Ointment 99 Gm Jar,$103.14,$71.01,$38.82,$91.84,$42.29,$100.05,$42.29,$42.29,$90.25,$87.67,$42.29,$95.92,$42.29,$97.99,$42.29,$42.29,$97.99
2530380,0636,C9121,,,,,,,Argatroban 250000 Mcg/2.5 Ml V,$777.34,$535.16,$292.56,$692.14,$318.71,$754.02,$318.71,$318.71,$680.17,$660.74,$318.71,$722.93,$318.71,$738.47,$318.71,$318.71,$738.47
2531260,0259,,,,,,,,ARIPiprazole 15 MG TAB,$5.12,$3.53,$1.93,$4.56,$2.10,$4.97,$2.10,$2.10,$4.48,$4.35,$2.10,$4.76,$2.10,$4.86,$2.10,$2.10,$4.86
2539770,0250,,,,,,,,ARIPiprazole 2 MG TAB,$5.33,$3.67,$2.00,$4.74,$2.18,$5.17,$2.18,$2.18,$4.66,$4.53,$2.18,$4.95,$2.18,$5.06,$2.18,$2.18,$5.06
2533750,0259,,,,,,,,ARIPiprazole 5 MG TAB,$4.34,$2.99,$1.63,$3.86,$1.78,$4.21,$1.78,$1.78,$3.79,$3.69,$1.78,$4.03,$1.78,$4.12,$1.78,$1.78,$4.12
2509900,0250,,,,,,,,Ascorbic Acid 25000 MG/50 ML V,$845.36,$581.99,$318.16,$752.71,$346.60,$820.00,$346.60,$346.60,$739.69,$718.56,$346.60,$786.19,$346.60,$803.10,$346.60,$346.60,$803.10
2501800,0259,,,,,,,,Ascorbic Acid 500 MG TAB,$0.58,$0.40,$0.22,$0.51,$0.24,$0.56,$0.24,$0.24,$0.51,$0.49,$0.24,$0.54,$0.24,$0.55,$0.24,$0.24,$0.55
2501850,0259,,,,,,,,Aspirin 300 MG SUPP,$21.72,$14.96,$8.18,$19.34,$8.91,$21.07,$8.91,$8.91,$19.01,$18.46,$8.91,$20.20,$8.91,$20.64,$8.91,$8.91,$20.64
2501840,0259,,,,,,,,Aspirin 325 MG TAB,$1.39,$0.96,$0.52,$1.24,$0.57,$1.35,$0.57,$0.57,$1.22,$1.19,$0.57,$1.30,$0.57,$1.32,$0.57,$0.57,$1.32
2501900,0259,,,,,,,,Aspirin 81 MG CHEW,$1.74,$1.20,$0.66,$1.55,$0.71,$1.69,$0.71,$0.71,$1.53,$1.48,$0.71,$1.62,$0.71,$1.66,$0.71,$0.71,$1.66
2501890,0259,,,,,,,,Aspirin E.C. 325 MG TABEC,$0.36,$0.25,$0.14,$0.32,$0.15,$0.35,$0.15,$0.15,$0.31,$0.31,$0.15,$0.33,$0.15,$0.34,$0.15,$0.15,$0.34
2501880,0259,,,,,,,,Aspirin E.C. 81 MG TABEC,$0.85,$0.59,$0.32,$0.76,$0.35,$0.82,$0.35,$0.35,$0.74,$0.72,$0.35,$0.79,$0.35,$0.81,$0.35,$0.35,$0.81
2508260,0259,,,,,,,,Atenolol 25 MG TAB,$3.80,$2.62,$1.43,$3.39,$1.56,$3.69,$1.56,$1.56,$3.33,$3.23,$1.56,$3.54,$1.56,$3.61,$1.56,$1.56,$3.61
2508250,0259,,,,,,,,Atenolol 50 MG TAB,$1.96,$1.35,$0.74,$1.75,$0.80,$1.90,$0.80,$0.80,$1.72,$1.67,$0.80,$1.82,$0.80,$1.86,$0.80,$0.80,$1.86
2520960,0250,,,,,,,,Atorvastatin 10 MG TAB,$2.73,$1.88,$1.03,$2.43,$1.12,$2.65,$1.12,$1.12,$2.39,$2.32,$1.12,$2.54,$1.12,$2.60,$1.12,$1.12,$2.60
2520970,0259,,,,,,,,Atorvastatin 20 MG TAB,$3.48,$2.39,$1.31,$3.09,$1.42,$3.37,$1.42,$1.42,$3.04,$2.95,$1.42,$3.23,$1.42,$3.30,$1.42,$1.42,$3.30
2522840,0259,,,,,,,,Atorvastatin 40 MG TAB,$3.81,$2.63,$1.44,$3.40,$1.56,$3.70,$1.56,$1.56,$3.34,$3.24,$1.56,$3.55,$1.56,$3.62,$1.56,$1.56,$3.62
2509930,0250,,,,,,,,Atropine 0.4 MG/ML VIAL,$132.09,$90.94,$49.71,$117.61,$54.16,$128.13,$54.16,$54.16,$115.58,$112.28,$54.16,$122.84,$54.16,$125.49,$54.16,$54.16,$125.49
2523005,0250,,,,,,,,Atropine 1 MG/10 ML SYR,$203.19,$139.89,$76.47,$180.92,$83.31,$197.10,$83.31,$83.31,$177.80,$172.72,$83.31,$188.97,$83.31,$193.04,$83.31,$83.31,$193.04
2523440,0250,,,,,,,,Atropine 1 MG/ML VIAL,$169.00,$116.35,$63.60,$150.48,$69.29,$163.93,$69.29,$69.29,$147.87,$143.65,$69.29,$157.17,$69.29,$160.55,$69.29,$69.29,$160.55
2526820,0259,,,,,,,,Atropine 1% 5 ML BTL,$324.67,$223.52,$122.19,$289.09,$133.12,$314.93,$133.12,$133.12,$284.09,$275.97,$133.12,$301.95,$133.12,$308.44,$133.12,$133.12,$308.44
2523167,0250,,,,,,,,ATROPINE 1% OPHTH SOL 15ML BTL,$569.18,$391.85,$214.21,$506.80,$233.36,$552.10,$233.36,$233.36,$498.03,$483.80,$233.36,$529.34,$233.36,$540.72,$233.36,$233.36,$540.72
2523391,0250,,,,,,,,ATROPINE 8 MG/20 ML VIAL,$76.80,$52.88,$28.91,$68.39,$31.49,$74.50,$31.49,$31.49,$67.20,$65.28,$31.49,$71.43,$31.49,$72.96,$31.49,$31.49,$72.96
2504620,0636,J7500,,,,,,,azaTHIOprine 50 MG TAB,$4.66,$3.21,$1.75,$4.15,$1.91,$4.52,$1.91,$1.91,$4.08,$3.96,$1.91,$4.34,$1.91,$4.43,$1.91,$1.91,$4.43
2522690,0259,,,,,,,,Azithromycin 100 MG/5 ML,$355.70,$244.88,$133.87,$316.71,$145.84,$345.03,$145.84,$145.84,$311.24,$302.34,$145.84,$330.80,$145.84,$337.91,$145.84,$145.84,$337.91
2521150,0259,,,,,,,,Azithromycin 200 Mg/5 Ml,$122.86,$84.59,$46.24,$109.40,$50.37,$119.18,$50.37,$50.37,$107.50,$104.43,$50.37,$114.26,$50.37,$116.72,$50.37,$50.37,$116.72
2521940,0259,,,,,,,,Azithromycin 200 MG/5 ML,$134.99,$92.93,$50.80,$120.19,$55.34,$130.94,$55.34,$55.34,$118.11,$114.74,$55.34,$125.54,$55.34,$128.24,$55.34,$55.34,$128.24
2509120,0259,,,,,,,,Azithromycin 250 MG TAB,$22.13,$15.23,$8.33,$19.70,$9.07,$21.46,$9.07,$9.07,$19.36,$18.81,$9.07,$20.58,$9.07,$21.02,$9.07,$9.07,$21.02
2521330,0636,J0456,,,,,,,Azithromycin 500 Mg Vial,$85.45,$58.83,$32.16,$76.09,$35.04,$82.89,$35.04,$35.04,$74.77,$72.63,$35.04,$79.47,$35.04,$81.18,$35.04,$35.04,$81.18
2537290,0250,,,,,,,,Aztreonam 1000 MG VIAL,$304.05,$209.33,$114.43,$270.73,$124.66,$294.93,$124.66,$124.66,$266.05,$258.44,$124.66,$282.77,$124.66,$288.85,$124.66,$124.66,$288.85
2523352,0250,,,,,,,,"Aztreonam 2,000 Mg Vial",$477.03,$328.41,$179.53,$424.74,$195.58,$462.72,$195.58,$195.58,$417.40,$405.47,$195.58,$443.63,$195.58,$453.18,$195.58,$195.58,$453.18
2515490,0259,,,,,,,,Bacitracin 1 PKT,$2.87,$1.97,$1.08,$2.55,$1.17,$2.78,$1.17,$1.17,$2.51,$2.44,$1.17,$2.66,$1.17,$2.72,$1.17,$1.17,$2.72
2515510,0259,,,,,,,,Bacitracin 30 GM TUBE,$43.09,$29.66,$16.22,$38.36,$17.67,$41.79,$17.67,$17.67,$37.70,$36.62,$17.67,$40.07,$17.67,$40.93,$17.67,$17.67,$40.93
2515520,0259,,,,,,,,Bacitracin Ophth Oint 3.5 GM T,$633.90,$436.41,$238.57,$564.42,$259.90,$614.88,$259.90,$259.90,$554.66,$538.82,$259.90,$589.53,$259.90,$602.21,$259.90,$259.90,$602.21
2515530,0259,,,,,,,,Bacitracin/Polymyxin 3.5 GM TU,$107.12,$73.75,$40.32,$95.38,$43.92,$103.91,$43.92,$43.92,$93.73,$91.05,$43.92,$99.62,$43.92,$101.76,$43.92,$43.92,$101.76
2515550,0259,,,,,,,,Bacitracin/Polymyxin 30 GM TUB,$52.87,$36.40,$19.90,$47.07,$21.68,$51.28,$21.68,$21.68,$46.26,$44.94,$21.68,$49.17,$21.68,$50.23,$21.68,$21.68,$50.23
2502090,0259,,,,,,,,Baclofen 10 MG TAB,$7.82,$5.39,$2.94,$6.96,$3.21,$7.59,$3.21,$3.21,$6.84,$6.65,$3.21,$7.27,$3.21,$7.43,$3.21,$3.21,$7.43
2523182,0636,J0475,,,,,,,"Baclofen 40,000 Mcg/20ml Syr","$1,989.41","$1,369.61",$748.72,"$1,771.37",$815.66,"$1,929.73",$815.66,$815.66,"$1,740.73","$1,691.00",$815.66,"$1,850.15",$815.66,"$1,889.94",$815.66,$815.66,"$1,889.94"
2522864,0250,,,,,,,,Bag Balm 10 OZ CAN,$92.28,$63.53,$34.73,$82.17,$37.84,$89.51,$37.84,$37.84,$80.75,$78.44,$37.84,$85.82,$37.84,$87.67,$37.84,$37.84,$87.67
2518210,0250,,,,,,,,Balanced Salt Soln.-PLUS 500 M,$509.45,$350.73,$191.73,$453.61,$208.87,$494.16,$208.87,$208.87,$445.77,$433.03,$208.87,$473.79,$208.87,$483.97,$208.87,$208.87,$483.97
2518200,0259,,,,,,,,Balanced Salt Solution 15 ML B,$92.22,$63.49,$34.71,$82.11,$37.81,$89.45,$37.81,$37.81,$80.69,$78.39,$37.81,$85.76,$37.81,$87.61,$37.81,$37.81,$87.61
2523569,0250,,,,,,,,Baloxavir Marboxil 40mg Tab,$603.56,$415.52,$227.15,$537.41,$247.46,$585.45,$247.46,$247.46,$528.12,$513.03,$247.46,$561.31,$247.46,$573.38,$247.46,$247.46,$573.38
2583570,0250,,,,,,,,Baloxavir Marboxil 80mg Tab,$603.56,$415.52,$227.15,$537.41,$247.46,$585.45,$247.46,$247.46,$528.12,$513.03,$247.46,$561.31,$247.46,$573.38,$247.46,$247.46,$573.38
2533490,0250,,,,,,,,BALSALAZIDE 750MG,$33.30,$22.93,$12.53,$29.65,$13.65,$32.30,$13.65,$13.65,$29.14,$28.31,$13.65,$30.97,$13.65,$31.64,$13.65,$13.65,$31.64
2523448,0250,,,,,,,,BAMLANIVIMAB 700 MG/20ML VIAL,$43.58,$30.00,$16.40,$38.80,$17.87,$42.27,$17.87,$17.87,$38.13,$37.04,$17.87,$40.53,$17.87,$41.40,$17.87,$17.87,$41.40
2523503,0250,,,,,,,,BARICITINIB 2 MG TAB,$534.58,$368.03,$201.19,$475.99,$219.18,$518.54,$219.18,$219.18,$467.76,$454.39,$219.18,$497.16,$219.18,$507.85,$219.18,$219.18,$507.85
2523483,0250,,,,,,,,BARICITNIB 1 MG TAB,$534.41,$367.91,$201.13,$475.83,$219.11,$518.37,$219.11,$219.11,$467.60,$454.24,$219.11,$497.00,$219.11,$507.68,$219.11,$219.11,$507.68
2538130,0250,,,,,,,,Baza Protect Cream 57 GM TUBE,$121.60,$83.72,$45.76,$108.27,$49.86,$117.95,$49.86,$49.86,$106.40,$103.36,$49.86,$113.09,$49.86,$115.52,$49.86,$49.86,$115.52
2544250,0636,J9031,,,,,,,Bcg Live 50 Mg Vial,$617.26,$424.96,$232.31,$549.61,$253.08,$598.75,$253.08,$253.08,$540.11,$524.68,$253.08,$574.06,$253.08,$586.40,$253.08,$253.08,$586.40
2523513,0250,Q0222,,,,,,,BEBTELOVIMAB 175 MG/2 ML VIAL,"$5,421.94","$3,732.75","$2,040.57","$4,827.69","$2,223.00","$5,259.29","$2,223.00","$2,223.00","$4,744.20","$4,608.65","$2,223.00","$5,042.41","$2,223.00","$5,150.85","$2,223.00","$2,223.00","$5,150.85"
2543320,0259,,,,,,,,Beclomethasone HFA 40MCG 8.7 G,$601.45,$414.07,$226.36,$535.53,$246.59,$583.40,$246.59,$246.59,$526.27,$511.23,$246.59,$559.35,$246.59,$571.37,$246.59,$246.59,$571.37
2523144,0636,J0490,,,,,,,Belimumab 120 MG VIAL,"$1,877.07","$1,292.27",$706.44,"$1,671.34",$769.60,"$1,820.76",$769.60,$769.60,"$1,642.44","$1,595.51",$769.60,"$1,745.67",$769.60,"$1,783.22",$769.60,$769.60,"$1,783.22"
2523145,0636,J0490,,,,,,,Belimumab 400 Mg Vial,"$5,105.18","$3,514.67","$1,921.35","$4,545.64","$2,093.12","$4,952.02","$2,093.12","$2,093.12","$4,467.03","$4,339.40","$2,093.12","$4,747.82","$2,093.12","$4,849.92","$2,093.12","$2,093.12","$4,849.92"
2521570,0259,,,,,,,,Ben Gay Greaseless CR 57 GM TU,$86.11,$59.28,$32.41,$76.67,$35.30,$83.52,$35.30,$35.30,$75.34,$73.19,$35.30,$80.08,$35.30,$81.80,$35.30,$35.30,$81.80
2505320,0259,,,,,,,,Benazepril 10 MG TAB,$2.16,$1.49,$0.81,$1.92,$0.88,$2.09,$0.88,$0.88,$1.89,$1.83,$0.88,$2.01,$0.88,$2.05,$0.88,$0.88,$2.05
2515630,0259,,,,,,,,Benzocaine 20% 60 ML CAN,$282.69,$194.62,$106.39,$251.71,$115.90,$274.21,$115.90,$115.90,$247.35,$240.29,$115.90,$262.90,$115.90,$268.55,$115.90,$115.90,$268.55
2593190,0250,,,,,,,,Benzocaine 20% Gel 30 GM JAR,$124.86,$85.96,$46.99,$111.17,$51.19,$121.11,$51.19,$51.19,$109.25,$106.13,$51.19,$116.12,$51.19,$118.61,$51.19,$51.19,$118.61
2502760,0259,,,,,,,,Benzocaine 5 Mg Lozg,$2.89,$1.99,$1.09,$2.57,$1.18,$2.80,$1.18,$1.18,$2.53,$2.45,$1.18,$2.68,$1.18,$2.74,$1.18,$1.18,$2.74
2523449,0250,,,,,,,,BENZOCAINE/MENTHOL SPRAY 78 GM,$89.04,$61.30,$33.51,$79.28,$36.51,$86.37,$36.51,$36.51,$77.91,$75.68,$36.51,$82.80,$36.51,$84.58,$36.51,$36.51,$84.58
2524640,0259,,,,,,,,Benzocaine/Menthol-SF LOZG,$2.71,$1.87,$1.02,$2.42,$1.11,$2.63,$1.11,$1.11,$2.37,$2.31,$1.11,$2.52,$1.11,$2.58,$1.11,$1.11,$2.58
2519450,0259,,,,,,,,Benzoin Tincture 60 ML BTL,$111.47,$76.74,$41.95,$99.25,$45.70,$108.12,$45.70,$45.70,$97.53,$94.75,$45.70,$103.66,$45.70,$105.89,$45.70,$45.70,$105.89
2502190,0259,,,,,,,,Benzonatate 100 MG CAP,$8.70,$5.99,$3.28,$7.75,$3.57,$8.44,$3.57,$3.57,$7.62,$7.40,$3.57,$8.10,$3.57,$8.27,$3.57,$3.57,$8.27
2535600,0250,,,,,,,,Benzonatate 200 MG CAP,$5.53,$3.81,$2.08,$4.93,$2.27,$5.37,$2.27,$2.27,$4.84,$4.70,$2.27,$5.15,$2.27,$5.26,$2.27,$2.27,$5.26
2502910,0259,,,,,,,,Benztropine 1 MG TAB,$7.69,$5.30,$2.89,$6.85,$3.15,$7.46,$3.15,$3.15,$6.73,$6.54,$3.15,$7.15,$3.15,$7.31,$3.15,$3.15,$7.31
2510150,0636,J0515,,,,,,,Benztropine 2 Mg/2 Ml Amp,$494.42,$340.39,$186.08,$440.23,$202.71,$479.59,$202.71,$202.71,$432.62,$420.26,$202.71,$459.81,$202.71,$469.70,$202.71,$202.71,$469.70
2522670,0259,,,,,,,,"Beta-Carotene(A) w/C,E, & Mine",$1.70,$1.17,$0.64,$1.51,$0.70,$1.65,$0.70,$0.70,$1.49,$1.44,$0.70,$1.58,$0.70,$1.61,$0.70,$0.70,$1.61
2532360,0259,,,,,,,,BETADINE SOLUTION 4 OZ,$33.30,$22.93,$12.53,$29.65,$13.65,$32.30,$13.65,$13.65,$29.14,$28.31,$13.65,$30.97,$13.65,$31.64,$13.65,$13.65,$31.64
2521610,0259,,,,,,,,Betagan 0.5% 5ml,$164.64,$113.35,$61.96,$146.60,$67.50,$159.70,$67.50,$67.50,$144.06,$139.94,$67.50,$153.12,$67.50,$156.41,$67.50,$67.50,$156.41
2528020,0636,,,,,,,,Betamet Acet/Betamet Na Ph Inj,$160.94,$110.80,$60.57,$143.30,$65.98,$156.11,$65.98,$65.98,$140.82,$136.80,$65.98,$149.67,$65.98,$152.89,$65.98,$65.98,$152.89
2515690,0259,,,,,,,,Betamethasone Dip. 0.05% CR 15,$72.90,$50.19,$27.44,$64.91,$29.89,$70.72,$29.89,$29.89,$63.79,$61.97,$29.89,$67.80,$29.89,$69.26,$29.89,$29.89,$69.26
2515670,0259,,,,,,,,Betamethasone Dip. 0.05% OINT,$473.81,$326.20,$178.32,$421.88,$194.26,$459.60,$194.26,$194.26,$414.59,$402.74,$194.26,$440.65,$194.26,$450.12,$194.26,$194.26,$450.12
2531250,0259,,,,,,,,Betaxolol 0.5% 5 Ml Btl,$608.60,$419.00,$229.05,$541.90,$249.53,$590.35,$249.53,$249.53,$532.53,$517.31,$249.53,$566.00,$249.53,$578.17,$249.53,$249.53,$578.17
2524500,0259,,,,,,,,Betaxolol 10 MG TAB,$8.92,$6.14,$3.36,$7.94,$3.66,$8.65,$3.66,$3.66,$7.81,$7.58,$3.66,$8.30,$3.66,$8.48,$3.66,$3.66,$8.48
2523533,0636,J0565,,,,,,,BEZLOTOXUMAB 1000MG/40 ML VIAL,"$9,440.62","$6,499.42","$3,553.01","$8,405.91","$3,870.65","$9,157.40","$3,870.65","$3,870.65","$8,260.54","$8,024.53","$3,870.65","$8,779.78","$3,870.65","$8,968.59","$3,870.65","$3,870.65","$8,968.59"
2529520,0259,,,,,,,,Bicalutamide 50 MG TAB,$4.10,$2.82,$1.54,$3.65,$1.68,$3.97,$1.68,$1.68,$3.58,$3.48,$1.68,$3.81,$1.68,$3.89,$1.68,$1.68,$3.89
2522995,0250,,,,,,,,Bimatoprost 0.01% 2.5 Ml Btl,$795.81,$547.88,$299.51,$708.59,$326.28,$771.93,$326.28,$326.28,$696.33,$676.44,$326.28,$740.10,$326.28,$756.02,$326.28,$326.28,$756.02
2523168,0250,,,,,,,,Biotene Mouthwash 237 Ml Btl,$64.53,$44.42,$24.28,$57.45,$26.46,$62.59,$26.46,$26.46,$56.46,$54.85,$26.46,$60.01,$26.46,$61.30,$26.46,$26.46,$61.30
2503700,0259,,,,,,,,Bisacodyl 10 MG SUPP,$5.66,$3.90,$2.13,$5.04,$2.32,$5.49,$2.32,$2.32,$4.96,$4.82,$2.32,$5.27,$2.32,$5.38,$2.32,$2.32,$5.38
2522867,0250,,,,,,,,Bisacodyl 5 MG TABEC,$0.59,$0.41,$0.22,$0.52,$0.24,$0.57,$0.24,$0.24,$0.51,$0.50,$0.24,$0.55,$0.24,$0.56,$0.24,$0.24,$0.56
2510190,0259,,,,,,,,Bismuth Subsalicylate SUSP 15,$54.88,$37.79,$20.66,$48.87,$22.50,$53.24,$22.50,$22.50,$48.02,$46.65,$22.50,$51.04,$22.50,$52.14,$22.50,$22.50,$52.14
2520510,0259,,,,,,,,Bismuth Subsalicylate TAB,$1.05,$0.72,$0.39,$0.93,$0.43,$1.01,$0.43,$0.43,$0.92,$0.89,$0.43,$0.97,$0.43,$0.99,$0.43,$0.43,$0.99
2510200,0636,J9040,,,,,,,Bleomycin 15 Units Vial,$293.33,$201.95,$110.40,$261.18,$120.27,$284.53,$120.27,$120.27,$256.67,$249.33,$120.27,$272.80,$120.27,$278.67,$120.27,$120.27,$278.67
2519490,0636,J0585,,,,,,,Botulinum Toxin Type A 100 UNI,"$2,074.17","$1,427.97",$780.62,"$1,846.84",$850.41,"$2,011.95",$850.41,$850.41,"$1,814.90","$1,763.05",$850.41,"$1,928.98",$850.41,"$1,970.47",$850.41,$850.41,"$1,970.47"
2541590,0636,J0585,,,,,,,Botulinum Toxin Type A 50 Unit,"$1,110.87",$764.78,$418.08,$989.12,$455.46,"$1,077.55",$455.46,$455.46,$972.01,$944.24,$455.46,"$1,033.11",$455.46,"$1,055.33",$455.46,$455.46,"$1,055.33"
2523159,0250,,,,,,,,BOTULINUM TOXIN TYPEA UN VIA,"$3,400.28","$2,340.93","$1,279.71","$3,027.60","$1,394.11","$3,298.27","$1,394.11","$1,394.11","$2,975.24","$2,890.24","$1,394.11","$3,162.26","$1,394.11","$3,230.26","$1,394.11","$1,394.11","$3,230.26"
2530790,0259,,,,,,,,Brimonidine 0.15% 5 ML BTL,$599.21,$412.53,$225.52,$533.54,$245.68,$581.24,$245.68,$245.68,$524.31,$509.33,$245.68,$557.27,$245.68,$569.25,$245.68,$245.68,$569.25
2526830,0250,,,,,,,,BRINZOLAMIDE OPTH SOLN 10 ML,$628.41,$432.63,$236.50,$559.53,$257.65,$609.56,$257.65,$257.65,$549.86,$534.15,$257.65,$584.42,$257.65,$596.99,$257.65,$257.65,$596.99
2506680,0259,,,,,,,,Bromocriptine 2.5 MG TAB,$58.09,$39.99,$21.86,$51.72,$23.82,$56.34,$23.82,$23.82,$50.83,$49.37,$23.82,$54.02,$23.82,$55.18,$23.82,$23.82,$55.18
2526700,0636,J7633,,,,,,,Budesonide 0.25 MG/2 ML UPD VI,$132.63,$91.31,$49.92,$118.10,$54.38,$128.66,$54.38,$54.38,$116.06,$112.74,$54.38,$123.35,$54.38,$126.00,$54.38,$54.38,$126.00
2526710,0636,J7626,,,,,,,Budesonide 0.5 Mg/2 Ml Upd Via,$101.71,$70.02,$38.28,$90.56,$41.70,$98.66,$41.70,$41.70,$88.99,$86.45,$41.70,$94.59,$41.70,$96.62,$41.70,$41.70,$96.62
2536570,0250,,,,,,,,BUDESONIDE 3MG CAP,$47.73,$32.86,$17.96,$42.50,$19.57,$46.29,$19.57,$19.57,$41.76,$40.57,$19.57,$44.39,$19.57,$45.34,$19.57,$19.57,$45.34
2537780,0250,,,,,,,,Budesonide Flexhaler 180 MCG 1,$755.89,$520.40,$284.48,$673.04,$309.92,$733.21,$309.92,$309.92,$661.40,$642.51,$309.92,$702.98,$309.92,$718.10,$309.92,$309.92,$718.10
2525600,0259,,,,,,,,Budesonide Nasal SPRAY 8.6 GM,$154.52,$106.38,$58.15,$137.58,$63.35,$149.88,$63.35,$63.35,$135.21,$131.34,$63.35,$143.70,$63.35,$146.79,$63.35,$63.35,$146.79
2539400,0250,,,,,,,,Budesonide/Formoterol 160/4.5,$433.39,$298.37,$163.11,$385.89,$177.69,$420.38,$177.69,$177.69,$379.21,$368.38,$177.69,$403.05,$177.69,$411.72,$177.69,$177.69,$411.72
2539420,0250,,,,,,,,Budesonide/Formoterol 80/4.5 6,$433.39,$298.37,$163.11,$385.89,$177.69,$420.38,$177.69,$177.69,$379.21,$368.38,$177.69,$403.05,$177.69,$411.72,$177.69,$177.69,$411.72
2522869,0250,,,,,,,,Buffered Lidocaine 1% 22 ML VI,$2.72,$1.88,$1.03,$2.43,$1.12,$2.64,$1.12,$1.12,$2.38,$2.31,$1.12,$2.53,$1.12,$2.59,$1.12,$1.12,$2.59
2523413,0250,,,,,,,,BUJPRENORPHINE/NALOXONE 8MG/2M,$152.32,$104.87,$57.33,$135.63,$62.45,$147.75,$62.45,$62.45,$133.28,$129.47,$62.45,$141.66,$62.45,$144.70,$62.45,$62.45,$144.70
2522871,0250,,,,,,,,Bumetanide 1 MG TAB,$8.85,$6.09,$3.33,$7.88,$3.63,$8.58,$3.63,$3.63,$7.74,$7.52,$3.63,$8.23,$3.63,$8.40,$3.63,$3.63,$8.40
2531190,0250,,,,,,,,Bumetanide 1 MG/4 ML VIAL,$101.63,$69.97,$38.25,$90.49,$41.67,$98.58,$41.67,$41.67,$88.93,$86.39,$41.67,$94.52,$41.67,$96.55,$41.67,$41.67,$96.55
2523092,0250,,,,,,,,Bumetanide 2.5 MG/10 ML VIAL,$107.95,$74.32,$40.63,$96.12,$44.26,$104.71,$44.26,$44.26,$94.46,$91.76,$44.26,$100.39,$44.26,$102.55,$44.26,$44.26,$102.55
2523315,0252,,,,,,,,Bupivaca 0.25% multi-dose50ml,$186.17,$128.17,$70.06,$165.76,$76.33,$180.58,$76.33,$76.33,$162.90,$158.24,$76.33,$173.14,$76.33,$176.86,$76.33,$76.33,$176.86
2540570,0250,,,,,,,,Bupivacaine 0.25% 10 ML VIAL-P,$119.67,$82.39,$45.04,$106.55,$49.06,$116.08,$49.06,$49.06,$104.71,$101.72,$49.06,$111.29,$49.06,$113.69,$49.06,$49.06,$113.69
2512720,0250,,,,,,,,Bupivacaine 0.25% 30 Ml Vial,$71.63,$49.31,$26.96,$63.78,$29.37,$69.48,$29.37,$29.37,$62.67,$60.88,$29.37,$66.61,$29.37,$68.05,$29.37,$29.37,$68.05
2523214,0250,,,,,,,,Bupivacaine 0.25% W/EPI 10 ML,$66.01,$45.44,$24.84,$58.77,$27.06,$64.03,$27.06,$27.06,$57.76,$56.11,$27.06,$61.39,$27.06,$62.71,$27.06,$27.06,$62.71
2521180,0250,,,,,,,,Bupivacaine 0.25% W/EPI 30 ML,$154.08,$106.08,$57.99,$137.20,$63.17,$149.46,$63.17,$63.17,$134.82,$130.97,$63.17,$143.30,$63.17,$146.38,$63.17,$63.17,$146.38
2523219,0250,,,,,,,,BUPIVACAINE 0.25%W/EPI50MLVIAL,$185.25,$127.54,$69.72,$164.95,$75.95,$179.69,$75.95,$75.95,$162.10,$157.46,$75.95,$172.28,$75.95,$175.99,$75.95,$75.95,$175.99
2524890,0250,,,,,,,,Bupivacaine 0.5% 10 ML VIAL-PF,$66.32,$45.66,$24.96,$59.05,$27.19,$64.33,$27.19,$27.19,$58.03,$56.37,$27.19,$61.68,$27.19,$63.01,$27.19,$27.19,$63.01
2512730,0250,,,,,,,,Bupivacaine 0.5% 30 Ml Vial,$135.40,$93.22,$50.96,$120.56,$55.51,$131.34,$55.51,$55.51,$118.48,$115.09,$55.51,$125.92,$55.51,$128.63,$55.51,$55.51,$128.63
2512770,0250,,,,,,,,Bupivacaine 0.5% 50 ML MULTI-D,$84.83,$58.40,$31.93,$75.53,$34.78,$82.29,$34.78,$34.78,$74.23,$72.11,$34.78,$78.89,$34.78,$80.59,$34.78,$34.78,$80.59
2523396,0250,,,,,,,,BUPIVACAINE 0.5% W/EPI 10 ML,$108.83,$74.93,$40.96,$96.90,$44.62,$105.57,$44.62,$44.62,$95.23,$92.51,$44.62,$101.21,$44.62,$103.39,$44.62,$44.62,$103.39
2512800,0250,,,,,,,,Bupivacaine 0.5% W/Epi 30 Ml V,$210.00,$144.58,$79.04,$186.99,$86.10,$203.70,$86.10,$86.10,$183.75,$178.50,$86.10,$195.30,$86.10,$199.50,$86.10,$86.10,$199.50
2523218,0250,,,,,,,,Bupivacaine 0.5% W/EPI 50 ML V,$214.49,$147.67,$80.72,$190.98,$87.94,$208.06,$87.94,$87.94,$187.68,$182.32,$87.94,$199.48,$87.94,$203.77,$87.94,$87.94,$203.77
2583330,0250,,,,,,,,Bupivacaine 0.75%/Dext. 8.25%,$123.18,$84.80,$46.36,$109.68,$50.50,$119.48,$50.50,$50.50,$107.78,$104.70,$50.50,$114.56,$50.50,$117.02,$50.50,$50.50,$117.02
2523301,0250,,,,,,,,Bupivacaine LIPOSOME/PF 133 MG,$762.49,$524.94,$286.97,$678.92,$312.62,$739.62,$312.62,$312.62,$667.18,$648.12,$312.62,$709.12,$312.62,$724.37,$312.62,$312.62,$724.37
2544160,0250,,,,,,,,Bupivacaine LIPOSOME/PF 266 MG,"$1,255.23",$864.17,$472.41,"$1,117.65",$514.64,"$1,217.57",$514.64,$514.64,"$1,098.32","$1,066.94",$514.64,"$1,167.36",$514.64,"$1,192.47",$514.64,$514.64,"$1,192.47"
2540640,0250,,,,,,,,Buprenorphine  8 MG SUBLINGUAL,$24.71,$17.01,$9.30,$22.00,$10.13,$23.97,$10.13,$10.13,$21.62,$21.00,$10.13,$22.98,$10.13,$23.47,$10.13,$10.13,$23.47
2523468,0636,Q9991,,,,,,,BUPRENORPHINE 100 MG/0.5ML SYR,"$4,554.41","$3,135.50","$1,714.07","$4,055.24","$1,867.31","$4,417.78","$1,867.31","$1,867.31","$3,985.11","$3,871.25","$1,867.31","$4,235.60","$1,867.31","$4,326.69","$1,867.31","$1,867.31","$4,326.69"
2540140,0250,,,,,,,,Buprenorphine 2 MG SUBLINGUAL,$6.63,$4.57,$2.50,$5.91,$2.72,$6.44,$2.72,$2.72,$5.81,$5.64,$2.72,$6.17,$2.72,$6.30,$2.72,$2.72,$6.30
2523439,0250,,,,,,,,BUPRENORPHINE HCL 0.30 MG/ML V,$222.60,$153.25,$83.78,$198.20,$91.26,$215.92,$91.26,$91.26,$194.77,$189.21,$91.26,$207.02,$91.26,$211.47,$91.26,$91.26,$211.47
2523248,0250,,,,,,,,Buprenorphine/Naloxone 12 mg/3,$149.85,$103.16,$56.40,$133.42,$61.44,$145.35,$61.44,$61.44,$131.12,$127.37,$61.44,$139.36,$61.44,$142.35,$61.44,$61.44,$142.35
2539390,0250,,,,,,,,Buprenorphine/Naloxone 2 MG/0.,$12.07,$8.31,$4.54,$10.75,$4.95,$11.71,$4.95,$4.95,$10.56,$10.26,$4.95,$11.23,$4.95,$11.47,$4.95,$4.95,$11.47
2523414,0250,,,,,,,,BUPRENORPHINE/NALOXONE 2MG/0.5,$51.27,$35.30,$19.29,$45.65,$21.02,$49.73,$21.02,$21.02,$44.86,$43.58,$21.02,$47.68,$21.02,$48.70,$21.02,$21.02,$48.70
2523415,0250,,,,,,,,BUPRENORPHINE/NALOXONE 4MG/1MG,$90.27,$62.15,$33.97,$80.37,$37.01,$87.56,$37.01,$37.01,$78.98,$76.73,$37.01,$83.95,$37.01,$85.75,$37.01,$37.01,$85.75
2534120,0259,,,,,,,,Buprenorphine/Naloxone 8 MG/2,$86.80,$59.76,$32.67,$77.29,$35.59,$84.20,$35.59,$35.59,$75.95,$73.78,$35.59,$80.73,$35.59,$82.46,$35.59,$35.59,$82.46
2542110,0250,,,,,,,,Buprenorphine/Naloxone 8 mg/2,$86.80,$59.76,$32.67,$77.29,$35.59,$84.20,$35.59,$35.59,$75.95,$73.78,$35.59,$80.73,$35.59,$82.46,$35.59,$35.59,$82.46
2509000,0259,,,,,,,,buPROPion 100 MG TAB,$3.98,$2.74,$1.50,$3.54,$1.63,$3.86,$1.63,$1.63,$3.48,$3.38,$1.63,$3.70,$1.63,$3.78,$1.63,$1.63,$3.78
2508990,0259,,,,,,,,buPROPion 75 MG TAB,$16.85,$11.60,$6.34,$15.01,$6.91,$16.35,$6.91,$6.91,$14.75,$14.33,$6.91,$15.67,$6.91,$16.01,$6.91,$6.91,$16.01
2521250,0259,,,,,,,,buPROPion-CR 100 MG TABCR,$5.39,$3.71,$2.03,$4.80,$2.21,$5.23,$2.21,$2.21,$4.72,$4.58,$2.21,$5.02,$2.21,$5.12,$2.21,$2.21,$5.12
2521990,0259,,,,,,,,buPROPion-CR 150 MG TABCR,$9.37,$6.45,$3.53,$8.34,$3.84,$9.09,$3.84,$3.84,$8.20,$7.96,$3.84,$8.71,$3.84,$8.90,$3.84,$3.84,$8.90
2533550,0259,,,,,,,,buPROPion-XL 150 MG TABCR,$13.20,$9.09,$4.97,$11.76,$5.41,$12.81,$5.41,$5.41,$11.55,$11.22,$5.41,$12.28,$5.41,$12.54,$5.41,$5.41,$12.54
2522872,0250,,,,,,,,busPIRone 15 MG TAB,$8.46,$5.83,$3.19,$7.54,$3.47,$8.21,$3.47,$3.47,$7.41,$7.19,$3.47,$7.87,$3.47,$8.04,$3.47,$3.47,$8.04
2502320,0259,,,,,,,,Buspirone 5 Mg Tab,$1.88,$1.30,$0.71,$1.68,$0.77,$1.83,$0.77,$0.77,$1.65,$1.60,$0.77,$1.75,$0.77,$1.79,$0.77,$0.77,$1.79
2501120,0259,,,,,,,,Butalbital/Acetaminophen/Caffe,$12.50,$8.60,$4.70,$11.13,$5.12,$12.12,$5.12,$5.12,$10.93,$10.62,$5.12,$11.62,$5.12,$11.87,$5.12,$5.12,$11.87
2522873,0250,,,,,,,,Butorphanol 2 MG/1 ML VIAL,$141.10,$97.14,$53.10,$125.63,$57.85,$136.87,$57.85,$57.85,$123.46,$119.93,$57.85,$131.22,$57.85,$134.04,$57.85,$57.85,$134.04
2522875,0250,,,,,,,,CADD Pump Cassette 100ML DEVIC,$188.20,$129.57,$70.83,$167.58,$77.16,$182.56,$77.16,$77.16,$164.68,$159.97,$77.16,$175.03,$77.16,$178.79,$77.16,$77.16,$178.79
2523091,0250,,,,,,,,CADD Pump Cassette 250ML DEVIC,$221.28,$152.34,$83.28,$197.03,$90.72,$214.64,$90.72,$90.72,$193.62,$188.09,$90.72,$205.79,$90.72,$210.21,$90.72,$90.72,$210.21
2522876,0250,,,,,,,,CADD Pump Cassette 50 ML DEVIC,$43.58,$30.00,$16.40,$38.80,$17.87,$42.27,$17.87,$17.87,$38.13,$37.04,$17.87,$40.53,$17.87,$41.40,$17.87,$17.87,$41.40
2531140,0259,,,,,,,,CADEXOMER IODINE GEL 40G,$310.84,$214.00,$116.99,$276.77,$127.44,$301.51,$127.44,$127.44,$271.98,$264.21,$127.44,$289.08,$127.44,$295.30,$127.44,$127.44,$295.30
2532620,0636,J0706,,,,,,,Caffeine Citrated 60 MG/3 ML V,$369.93,$254.68,$139.22,$329.38,$151.67,$358.83,$151.67,$151.67,$323.69,$314.44,$151.67,$344.03,$151.67,$351.43,$151.67,$151.67,$351.43
2535760,0259,,,,,,,,Caffeine/Sodium Benzoate 500 M,$337.23,$232.17,$126.92,$300.27,$138.27,$327.12,$138.27,$138.27,$295.08,$286.65,$138.27,$313.63,$138.27,$320.37,$138.27,$138.27,$320.37
2516600,0259,,,,,,,,Calamine 160 ML BTL,$34.00,$23.41,$12.80,$30.27,$13.94,$32.98,$13.94,$13.94,$29.75,$28.90,$13.94,$31.62,$13.94,$32.30,$13.94,$13.94,$32.30
2512710,0636,J0630,,,,,,,Calcitonin-Salmon 200 UNITS/ML,"$2,821.57","$1,942.52","$1,061.91","$2,512.32","$1,156.84","$2,736.92","$1,156.84","$1,156.84","$2,468.87","$2,398.33","$1,156.84","$2,624.06","$1,156.84","$2,680.49","$1,156.84","$1,156.84","$2,680.49"
2532610,0259,,,,,,,,"Calcitonin-Salmon, Synthetic 3",$361.15,$248.63,$135.92,$321.56,$148.07,$350.31,$148.07,$148.07,$316.00,$306.97,$148.07,$335.87,$148.07,$343.09,$148.07,$148.07,$343.09
2507610,0259,,,,,,,,Calcitriol 0.25 Mcg Cap,$45.81,$31.54,$17.24,$40.79,$18.78,$44.43,$18.78,$18.78,$40.08,$38.94,$18.78,$42.60,$18.78,$43.52,$18.78,$18.78,$43.52
2521790,0259,,,,,,,,Calcium 600mg/Vit D 200U TAB,$0.39,$0.27,$0.15,$0.35,$0.16,$0.38,$0.16,$0.16,$0.34,$0.33,$0.16,$0.36,$0.16,$0.37,$0.16,$0.16,$0.37
2534030,0250,,,,,,,,Calcium Acetate 667 MG GEL CAP,$31.05,$21.38,$11.69,$27.65,$12.73,$30.12,$12.73,$12.73,$27.17,$26.39,$12.73,$28.87,$12.73,$29.50,$12.73,$12.73,$29.50
2508680,0259,,,,,,,,Calcium Carbonate *TUMS* 500 M,$1.79,$1.23,$0.67,$1.59,$0.73,$1.73,$0.73,$0.73,$1.56,$1.52,$0.73,$1.66,$0.73,$1.70,$0.73,$0.73,$1.70
2506560,0259,,,,,,,,Calcium Carbonate 1.25 GM TAB,$0.69,$0.47,$0.26,$0.61,$0.28,$0.67,$0.28,$0.28,$0.60,$0.58,$0.28,$0.64,$0.28,$0.65,$0.28,$0.28,$0.65
2521800,0259,,,,,,,,Calcium Carbonate 1.5 G TAB,$0.44,$0.30,$0.16,$0.39,$0.18,$0.42,$0.18,$0.18,$0.38,$0.37,$0.18,$0.41,$0.18,$0.41,$0.18,$0.18,$0.41
2510290,0250,,,,,,,,Calcium Chloride 1000 MG/10 ML,$181.10,$124.68,$68.16,$161.25,$74.25,$175.67,$74.25,$74.25,$158.46,$153.94,$74.25,$168.42,$74.25,$172.05,$74.25,$74.25,$172.05
2522874,0250,,,,,,,,Calcium Chloride 1000 MG/10 ML,$187.03,$128.76,$70.39,$166.53,$76.68,$181.42,$76.68,$76.68,$163.65,$158.97,$76.68,$173.94,$76.68,$177.68,$76.68,$76.68,$177.68
2526940,0250,,,,,,,,Calcium Citrate 950 MG TAB,$0.49,$0.34,$0.18,$0.44,$0.20,$0.48,$0.20,$0.20,$0.43,$0.42,$0.20,$0.46,$0.20,$0.47,$0.20,$0.20,$0.47
2539810,0250,,,,,,,,Calcium Citrate/Cholecalcifero,$6.50,$4.48,$2.45,$5.79,$2.67,$6.31,$2.67,$2.67,$5.69,$5.53,$2.67,$6.05,$2.67,$6.18,$2.67,$2.67,$6.18
2523509,0250,,,,,,,,CALCIUM GLUCONATE 4.65 MEQ/10,$179.28,$123.43,$67.47,$159.63,$73.51,$173.90,$73.51,$73.51,$156.87,$152.39,$73.51,$166.73,$73.51,$170.32,$73.51,$73.51,$170.32
2534600,0636,J0610,,,,,,,Calcium Gluconate 4.65 Meq/10,$203.03,$139.78,$76.41,$180.78,$83.24,$196.94,$83.24,$83.24,$177.65,$172.58,$83.24,$188.82,$83.24,$192.88,$83.24,$83.24,$192.88
2523508,0250,,,,,,,,CALCIUM GLUCONATE IN NACL 1GM,$117.37,$80.81,$44.17,$104.51,$48.12,$113.85,$48.12,$48.12,$102.70,$99.77,$48.12,$109.16,$48.12,$111.50,$48.12,$48.12,$111.50
2522070,0250,,,,,,,,Calcium Polycarbophil 625 MG T,$2.69,$1.85,$1.01,$2.40,$1.10,$2.61,$1.10,$1.10,$2.35,$2.29,$1.10,$2.50,$1.10,$2.56,$1.10,$1.10,$2.56
2525280,0250,,,,,,,,Candida Albicans 0.1 ML DOSE,$329.84,$227.08,$124.14,$293.69,$135.23,$319.94,$135.23,$135.23,$288.61,$280.36,$135.23,$306.75,$135.23,$313.35,$135.23,$135.23,$313.35
2532020,0259,,,,,,,,Capsaicin 0.075% 60 GM TUBE,$91.13,$62.74,$34.30,$81.14,$37.36,$88.39,$37.36,$37.36,$79.74,$77.46,$37.36,$84.75,$37.36,$86.57,$37.36,$37.36,$86.57
2502430,0259,,,,,,,,Captopril 12.5 MG TAB,$17.27,$11.89,$6.50,$15.37,$7.08,$16.75,$7.08,$7.08,$15.11,$14.68,$7.08,$16.06,$7.08,$16.40,$7.08,$7.08,$16.40
2512690,0250,,,,,,,,Carbachol 1.5 ML VIAL,$230.18,$158.47,$86.63,$204.95,$94.37,$223.27,$94.37,$94.37,$201.41,$195.65,$94.37,$214.07,$94.37,$218.67,$94.37,$94.37,$218.67
2508210,0259,,,,,,,,carBAMazepine 100 MG CHEW,$8.45,$5.82,$3.18,$7.53,$3.47,$8.20,$3.47,$3.47,$7.40,$7.19,$3.47,$7.86,$3.47,$8.03,$3.47,$3.47,$8.03
2512700,0259,,,,,,,,carBAMazepine 100 MG/5 ML,$3.40,$2.34,$1.28,$3.03,$1.39,$3.30,$1.39,$1.39,$2.97,$2.89,$1.39,$3.16,$1.39,$3.23,$1.39,$1.39,$3.23
2508200,0259,,,,,,,,carBAMazepine 200 MG TAB,$11.99,$8.26,$4.51,$10.68,$4.92,$11.63,$4.92,$4.92,$10.50,$10.20,$4.92,$11.15,$4.92,$11.39,$4.92,$4.92,$11.39
2508220,0259,,,,,,,,carBAMazepine-CR 100 MG TABCR,$10.41,$7.17,$3.92,$9.27,$4.27,$10.10,$4.27,$4.27,$9.11,$8.85,$4.27,$9.69,$4.27,$9.89,$4.27,$4.27,$9.89
2539540,0250,,,,,,,,carBAMazepine-CR 300 MG CAPCR,$38.73,$26.66,$14.58,$34.48,$15.88,$37.57,$15.88,$15.88,$33.89,$32.92,$15.88,$36.02,$15.88,$36.79,$15.88,$15.88,$36.79
2516630,0259,,,,,,,,Carbamide Peroxide 15 ML BTL,$21.90,$15.08,$8.24,$19.50,$8.98,$21.24,$8.98,$8.98,$19.16,$18.61,$8.98,$20.36,$8.98,$20.80,$8.98,$8.98,$20.80
2507850,0259,,,,,,,,Carbidopa 10/Levodopa 100 Tab,$5.59,$3.85,$2.10,$4.98,$2.29,$5.42,$2.29,$2.29,$4.89,$4.75,$2.29,$5.20,$2.29,$5.31,$2.29,$2.29,$5.31
2507830,0259,,,,,,,,Carbidopa 25/Levodopa 100 CR T,$5.59,$3.85,$2.10,$4.98,$2.29,$5.42,$2.29,$2.29,$4.89,$4.75,$2.29,$5.20,$2.29,$5.31,$2.29,$2.29,$5.31
2543340,0250,,,,,,,,Carbidopa 25/Levodopa 100 O.D.,$15.40,$10.61,$5.80,$13.72,$6.32,$14.94,$6.32,$6.32,$13.48,$13.09,$6.32,$14.33,$6.32,$14.63,$6.32,$6.32,$14.63
2507860,0259,,,,,,,,Carbidopa 25/Levodopa 100 TAB,$3.07,$2.12,$1.16,$2.74,$1.26,$2.98,$1.26,$1.26,$2.69,$2.61,$1.26,$2.86,$1.26,$2.92,$1.26,$1.26,$2.92
2507870,0259,,,,,,,,Carbidopa 25/Levodopa 250 TAB,$3.95,$2.72,$1.49,$3.52,$1.62,$3.84,$1.62,$1.62,$3.46,$3.36,$1.62,$3.68,$1.62,$3.76,$1.62,$1.62,$3.76
2507840,0259,,,,,,,,Carbidopa 50/Levodopa 200 CR T,$8.93,$6.15,$3.36,$7.95,$3.66,$8.67,$3.66,$3.66,$7.82,$7.59,$3.66,$8.31,$3.66,$8.49,$3.66,$3.66,$8.49
2510340,0250,,,,,,,,Carboprost 250 MCG/ML AMP,$987.36,$679.75,$371.60,$879.14,$404.82,$957.74,$404.82,$404.82,$863.94,$839.25,$404.82,$918.24,$404.82,$937.99,$404.82,$404.82,$937.99
2507990,0259,,,,,,,,Carisoprodol 350 MG TAB,$1.45,$1.00,$0.55,$1.29,$0.59,$1.41,$0.59,$0.59,$1.27,$1.23,$0.59,$1.35,$0.59,$1.38,$0.59,$0.59,$1.38
2523610,0259,,,,,,,,CARVEDILOL 12.5MG,$1.19,$0.82,$0.45,$1.06,$0.49,$1.15,$0.49,$0.49,$1.04,$1.01,$0.49,$1.10,$0.49,$1.13,$0.49,$0.49,$1.13
2534350,0259,,,,,,,,Carvedilol 25 MG TAB,$1.50,$1.04,$0.57,$1.34,$0.62,$1.46,$0.62,$0.62,$1.32,$1.28,$0.62,$1.40,$0.62,$1.43,$0.62,$0.62,$1.43
2522080,0259,,,,,,,,Carvedilol 3.125 MG TAB,$1.84,$1.27,$0.69,$1.64,$0.75,$1.79,$0.75,$0.75,$1.61,$1.56,$0.75,$1.71,$0.75,$1.75,$0.75,$0.75,$1.75
2521130,0259,,,,,,,,Carvedilol 6.25 MG TAB,$0.42,$0.29,$0.16,$0.38,$0.17,$0.41,$0.17,$0.17,$0.37,$0.36,$0.17,$0.40,$0.17,$0.40,$0.17,$0.17,$0.40
2523451,0250,,,,,,,,CASIRIVIMAB 300MG/2.5ML VIAL,$43.58,$30.00,$16.40,$38.80,$17.87,$42.27,$17.87,$17.87,$38.13,$37.04,$17.87,$40.53,$17.87,$41.40,$17.87,$17.87,$41.40
2523482,0250,,,,,,,,CASIRIVIMAB 600 MG/IMDEVIMAB,$43.58,$30.00,$16.40,$38.80,$17.87,$42.27,$17.87,$17.87,$38.13,$37.04,$17.87,$40.53,$17.87,$41.40,$17.87,$17.87,$41.40
2503710,0259,,,,,,,,Cefadroxil 500 MG CAP,$7.11,$4.90,$2.68,$6.33,$2.92,$6.90,$2.92,$2.92,$6.22,$6.05,$2.92,$6.62,$2.92,$6.76,$2.92,$2.92,$6.76
2523521,0250,,,,,,,,CEFAXOLIN/NS 3GM/100 ML BAG,$233.76,$160.94,$87.98,$208.14,$95.84,$226.75,$95.84,$95.84,$204.54,$198.70,$95.84,$217.40,$95.84,$222.08,$95.84,$95.84,$222.08
2523323,0250,,,,,,,,CEFAZOLIN 1000 MG ADD-VANT VIA,$94.69,$65.19,$35.64,$84.31,$38.82,$91.85,$38.82,$38.82,$82.85,$80.49,$38.82,$88.06,$38.82,$89.96,$38.82,$38.82,$89.96
2509800,0636,J0690,,,,,,,Cefazolin 1000 Mg Vial,$78.10,$53.77,$29.39,$69.54,$32.02,$75.76,$32.02,$32.02,$68.34,$66.38,$32.02,$72.63,$32.02,$74.19,$32.02,$32.02,$74.19
2583540,0250,,,,,,,,CEFAZOLIN 10GM VIAL,$142.01,$97.77,$53.45,$126.45,$58.23,$137.75,$58.23,$58.23,$124.26,$120.71,$58.23,$132.07,$58.23,$134.91,$58.23,$58.23,$134.91
2520700,0636,J0690,,,,,,,ceFAZolin 500 MG VIAL,$78.10,$53.77,$29.39,$69.54,$32.02,$75.76,$32.02,$32.02,$68.34,$66.38,$32.02,$72.63,$32.02,$74.19,$32.02,$32.02,$74.19
2533450,0636,J0690,,,,,,,ceFAZolin-Duplex 1 GM/50 ML BA,$139.06,$95.74,$52.34,$123.82,$57.02,$134.89,$57.02,$57.02,$121.68,$118.20,$57.02,$129.33,$57.02,$132.11,$57.02,$57.02,$132.11
2522877,0636,J0690,,,,,,,ceFAZolin-Duplex 2 GM/50 ML BA,$166.31,$114.50,$62.59,$148.08,$68.19,$161.32,$68.19,$68.19,$145.52,$141.36,$68.19,$154.67,$68.19,$157.99,$68.19,$68.19,$157.99
2526930,0250,,,,,,,,Cefdinir 125 MG/5 ML 60 ML BTL,$352.32,$242.56,$132.60,$313.71,$144.45,$341.75,$144.45,$144.45,$308.28,$299.47,$144.45,$327.66,$144.45,$334.71,$144.45,$144.45,$334.71
2536610,0250,,,,,,,,Cefdinir 250 Mg/5 Ml 60 Ml Btl,$205.44,$141.44,$77.32,$182.92,$84.23,$199.28,$84.23,$84.23,$179.76,$174.62,$84.23,$191.06,$84.23,$195.17,$84.23,$84.23,$195.17
2536620,0250,,,,,,,,Cefdinir 300 MG CAP,$20.10,$13.84,$7.56,$17.90,$8.24,$19.50,$8.24,$8.24,$17.59,$17.08,$8.24,$18.69,$8.24,$19.09,$8.24,$8.24,$19.09
2523139,0250,,,,,,,,Cefepime 1 Gm Vial,$144.18,$99.26,$54.26,$128.38,$59.11,$139.86,$59.11,$59.11,$126.16,$122.55,$59.11,$134.09,$59.11,$136.97,$59.11,$59.11,$136.97
2523138,0250,,,,,,,,CEFEPIME 2 GM VIAL,$135.40,$93.22,$50.96,$120.56,$55.51,$131.34,$55.51,$55.51,$118.48,$115.09,$55.51,$125.92,$55.51,$128.63,$55.51,$55.51,$128.63
2510390,0250,,,,,,,,cefoTEtan 1 GM VIAL,$196.75,$135.45,$74.05,$175.18,$80.67,$190.84,$80.67,$80.67,$172.15,$167.23,$80.67,$182.97,$80.67,$186.91,$80.67,$80.67,$186.91
2510410,0636,J0694,,,,,,,ceFOXItin 1 GM VIAL,$120.29,$82.82,$45.27,$107.11,$49.32,$116.68,$49.32,$49.32,$105.26,$102.25,$49.32,$111.87,$49.32,$114.28,$49.32,$49.32,$114.28
2523306,0250,,,,,,,,ceFOXItin 2 GM VIAL,$135.49,$93.28,$50.99,$120.64,$55.55,$131.42,$55.55,$55.55,$118.55,$115.17,$55.55,$126.00,$55.55,$128.71,$55.55,$55.55,$128.71
2536380,0636,J0694,,,,,,,ceFOXItin-DUPLEX 1 G/50 ML BAG,$130.05,$89.54,$48.95,$115.80,$53.32,$126.15,$53.32,$53.32,$113.80,$110.54,$53.32,$120.95,$53.32,$123.55,$53.32,$53.32,$123.55
2536390,0636,J0694,,,,,,,ceFOXItin-DUPLEX 2 G/50 ML BAG,$270.59,$186.29,$101.84,$240.93,$110.94,$262.47,$110.94,$110.94,$236.76,$230.00,$110.94,$251.64,$110.94,$257.06,$110.94,$110.94,$257.06
2533180,0259,,,,,,,,Cefpodoxime 200 MG TAB,$97.22,$66.93,$36.59,$86.56,$39.86,$94.30,$39.86,$39.86,$85.07,$82.64,$39.86,$90.41,$39.86,$92.36,$39.86,$39.86,$92.36
2523338,0636,J0712,,,,,,,CEFTAROLINE 400MG VIAL,$754.80,$519.65,$284.07,$672.07,$309.47,$732.16,$309.47,$309.47,$660.45,$641.58,$309.47,$701.97,$309.47,$717.06,$309.47,$309.47,$717.06
2510430,0636,J0713,,,,,,,cefTAZidime 1000 MG VIAL,$124.93,$86.01,$47.02,$111.24,$51.22,$121.18,$51.22,$51.22,$109.32,$106.19,$51.22,$116.19,$51.22,$118.69,$51.22,$51.22,$118.69
2523410,0636,,,,,,,,Ceftazidime 2000 Mg Vial,$141.83,$97.64,$53.38,$126.28,$58.15,$137.57,$58.15,$58.15,$124.10,$120.55,$58.15,$131.90,$58.15,$134.74,$58.15,$58.15,$134.74
2523325,0250,,,,,,,,cefTAZidime/avibactam 2.5 GM V,"$1,154.81",$795.03,$434.62,"$1,028.24",$473.47,"$1,120.16",$473.47,$473.47,"$1,010.46",$981.59,$473.47,"$1,073.97",$473.47,"$1,097.07",$473.47,$473.47,"$1,097.07"
2510460,0636,J0696,,,,,,,cefTRIAXone 1 GM VIAL,$71.27,$49.07,$26.82,$63.46,$29.22,$69.13,$29.22,$29.22,$62.36,$60.58,$29.22,$66.28,$29.22,$67.71,$29.22,$29.22,$67.71
2534870,0636,J0696,,,,,,,Ceftriaxone 1 Gm/50 Ml Bag,$169.16,$116.46,$63.66,$150.62,$69.36,$164.09,$69.36,$69.36,$148.02,$143.79,$69.36,$157.32,$69.36,$160.70,$69.36,$69.36,$160.70
2510470,0636,J0696,,,,,,,cefTRIAXone 2 GM VIAL,$95.77,$65.93,$36.04,$85.27,$39.27,$92.90,$39.27,$39.27,$83.80,$81.40,$39.27,$89.07,$39.27,$90.98,$39.27,$39.27,$90.98
2591140,0250,,,,,,,,CEFTRIAXONE 2 GM/50ML BAG,$225.54,$155.27,$84.88,$200.82,$92.47,$218.77,$92.47,$92.47,$197.35,$191.71,$92.47,$209.75,$92.47,$214.26,$92.47,$92.47,$214.26
2510440,0636,J0696,,,,,,,cefTRIAXone 250 MG VIAL,$55.45,$38.18,$20.87,$49.37,$22.73,$53.79,$22.73,$22.73,$48.52,$47.13,$22.73,$51.57,$22.73,$52.68,$22.73,$22.73,$52.68
2510450,0636,J0696,,,,,,,cefTRIAXone 500 MG VIAL,$60.81,$41.87,$22.89,$54.15,$24.93,$58.99,$24.93,$24.93,$53.21,$51.69,$24.93,$56.55,$24.93,$57.77,$24.93,$24.93,$57.77
2502680,0259,,,,,,,,Cefuroxime 250 MG TAB,$8.25,$5.68,$3.10,$7.34,$3.38,$8.00,$3.38,$3.38,$7.22,$7.01,$3.38,$7.67,$3.38,$7.83,$3.38,$3.38,$7.83
2502690,0259,,,,,,,,Cefuroxime 500 MG TAB,$35.88,$24.71,$13.51,$31.95,$14.71,$34.81,$14.71,$14.71,$31.40,$30.50,$14.71,$33.37,$14.71,$34.09,$14.71,$14.71,$34.09
2510480,0636,J0697,,,,,,,Cefuroxime 750 Mg Vial,$171.83,$118.30,$64.67,$153.00,$70.45,$166.68,$70.45,$70.45,$150.35,$146.06,$70.45,$159.80,$70.45,$163.24,$70.45,$70.45,$163.24
2523330,0259,,,,,,,,Celecoxib 100 MG CAP,$20.45,$14.08,$7.70,$18.21,$8.38,$19.83,$8.38,$8.38,$17.89,$17.38,$8.38,$19.02,$8.38,$19.43,$8.38,$8.38,$19.43
2523340,0259,,,,,,,,Celecoxib 200 MG CAP,$29.74,$20.48,$11.19,$26.48,$12.19,$28.85,$12.19,$12.19,$26.02,$25.28,$12.19,$27.66,$12.19,$28.25,$12.19,$12.19,$28.25
2510500,0250,,,,,,,,"Cellulose,Oxidized 2X3 PKT",$639.65,$440.37,$240.74,$569.55,$262.26,$620.46,$262.26,$262.26,$559.70,$543.70,$262.26,$594.88,$262.26,$607.67,$262.26,$262.26,$607.67
2522965,0250,,,,,,,,"Cellulose,Oxidized 4X8 1 PKT E",$561.47,$386.54,$211.31,$499.93,$230.20,$544.62,$230.20,$230.20,$491.28,$477.25,$230.20,$522.16,$230.20,$533.39,$230.20,$230.20,$533.39
2504880,0259,,,,,,,,Cephalexin 250 MG CAP,$3.56,$2.45,$1.34,$3.17,$1.46,$3.46,$1.46,$1.46,$3.12,$3.03,$1.46,$3.31,$1.46,$3.38,$1.46,$1.46,$3.38
2526380,0259,,,,,,,,Cephalexin 250 MG/5 ML 100 ML,$155.40,$106.99,$58.49,$138.37,$63.72,$150.74,$63.72,$63.72,$135.98,$132.09,$63.72,$144.52,$63.72,$147.63,$63.72,$63.72,$147.63
2504890,0259,,,,,,,,Cephalexin 500 Mg Cap,$2.04,$1.40,$0.77,$1.81,$0.84,$1.98,$0.84,$0.84,$1.78,$1.73,$0.84,$1.89,$0.84,$1.94,$0.84,$0.84,$1.94
2523261,0250,,,,,,,,"Cephalexin 500 MG CAP, 2 CAPS/",$7.11,$4.90,$2.68,$6.33,$2.92,$6.90,$2.92,$2.92,$6.22,$6.05,$2.92,$6.62,$2.92,$6.76,$2.92,$2.92,$6.76
2538260,0250,,,,,,,,"Cephalexin 500 MG CAP, 4 CAPS/",$2.16,$1.49,$0.81,$1.92,$0.88,$2.09,$0.88,$0.88,$1.89,$1.83,$0.88,$2.01,$0.88,$2.05,$0.88,$0.88,$2.05
2534620,0259,,,,,,,,Cetaphil Moisturizing CREAM 85,$84.21,$57.98,$31.69,$74.98,$34.53,$81.68,$34.53,$34.53,$73.68,$71.58,$34.53,$78.32,$34.53,$80.00,$34.53,$34.53,$80.00
2522878,0250,,,,,,,,Cetaphil Moisturizing Lotion 2,$97.35,$67.02,$36.64,$86.68,$39.91,$94.43,$39.91,$39.91,$85.18,$82.75,$39.91,$90.53,$39.91,$92.48,$39.91,$39.91,$92.48
2522140,0259,,,,,,,,Cetirizine 10 MG TAB,$1.87,$1.29,$0.71,$1.67,$0.77,$1.82,$0.77,$0.77,$1.64,$1.59,$0.77,$1.74,$0.77,$1.78,$0.77,$0.77,$1.78
2520320,0259,,,,,,,,Charcoal/Aqueous 50 GM TUBE,$350.71,$241.45,$131.99,$312.27,$143.79,$340.19,$143.79,$143.79,$306.87,$298.10,$143.79,$326.16,$143.79,$333.18,$143.79,$143.79,$333.18
2520310,0259,,,,,,,,Charcoal/Sorbitol 50 GM TUBE,$257.38,$177.20,$96.87,$229.17,$105.53,$249.66,$105.53,$105.53,$225.21,$218.77,$105.53,$239.36,$105.53,$244.51,$105.53,$105.53,$244.51
2517850,0259,,,,,,,,Chloraseptic Spray 180 ML BTL,$39.83,$27.42,$14.99,$35.46,$16.33,$38.63,$16.33,$16.33,$34.85,$33.85,$16.33,$37.04,$16.33,$37.84,$16.33,$16.33,$37.84
2522879,0250,,,,,,,,chlordiazePOXIDE 25 MG CAP,$11.45,$7.88,$4.31,$10.19,$4.69,$11.11,$4.69,$4.69,$10.02,$9.73,$4.69,$10.65,$4.69,$10.88,$4.69,$4.69,$10.88
2505210,0259,,,,,,,,chlordiazePOXIDE 5 MG CAP,$4.13,$2.84,$1.55,$3.68,$1.69,$4.00,$1.69,$1.69,$3.61,$3.51,$1.69,$3.84,$1.69,$3.92,$1.69,$1.69,$3.92
2515840,0259,,,,,,,,Chlorhexidine 4%,$44.72,$30.79,$16.83,$39.82,$18.34,$43.38,$18.34,$18.34,$39.13,$38.01,$18.34,$41.59,$18.34,$42.48,$18.34,$18.34,$42.48
2537300,0250,,,,,,,,Chlorhexidine 4% 15 ML PKT,$16.07,$11.06,$6.05,$14.31,$6.59,$15.59,$6.59,$6.59,$14.06,$13.66,$6.59,$14.94,$6.59,$15.27,$6.59,$6.59,$15.27
2515850,0259,,,,,,,,Chlorhexidine 4% 960 ML BTL,$171.40,$118.00,$64.51,$152.61,$70.27,$166.25,$70.27,$70.27,$149.97,$145.69,$70.27,$159.40,$70.27,$162.83,$70.27,$70.27,$162.83
2515830,0259,,,,,,,,Chlorhexidine GLUC. 0.12% 480,$47.52,$32.72,$17.88,$42.31,$19.48,$46.09,$19.48,$19.48,$41.58,$40.39,$19.48,$44.19,$19.48,$45.14,$19.48,$19.48,$45.14
2523228,0250,,,,,,,,Chlorhexidine Gluconate 0.12%,$44.72,$30.79,$16.83,$39.82,$18.34,$43.38,$18.34,$18.34,$39.13,$38.01,$18.34,$41.59,$18.34,$42.48,$18.34,$18.34,$42.48
2522955,0250,,,,,,,,Chloroprocaine -MPF 3% 20ML VI,$289.07,$199.01,$108.79,$257.39,$118.52,$280.40,$118.52,$118.52,$252.94,$245.71,$118.52,$268.84,$118.52,$274.62,$118.52,$118.52,$274.62
2523496,0250,,,,,,,,CHLOROTHIAZIDE 500 MG VIAL,$347.05,$238.93,$130.61,$309.01,$142.29,$336.64,$142.29,$142.29,$303.67,$294.99,$142.29,$322.76,$142.29,$329.70,$142.29,$142.29,$329.70
2508390,0259,,,,,,,,Chlorpromazine 25 Mg Tab,$52.16,$35.91,$19.63,$46.44,$21.39,$50.60,$21.39,$21.39,$45.64,$44.34,$21.39,$48.51,$21.39,$49.55,$21.39,$21.39,$49.55
2510560,0636,J3230,,,,,,,Chlorpromazine 25 Mg/Ml Amp,$367.37,$252.92,$138.26,$327.10,$150.62,$356.35,$150.62,$150.62,$321.45,$312.26,$150.62,$341.65,$150.62,$349.00,$150.62,$150.62,$349.00
2529840,0259,,,,,,,,Chlorthalidone 25 Mg Tab,$10.57,$7.28,$3.98,$9.41,$4.33,$10.25,$4.33,$4.33,$9.25,$8.98,$4.33,$9.83,$4.33,$10.04,$4.33,$4.33,$10.04
2522967,0250,,,,,,,,Cholecalciferol (Vitamin D3) 4,$0.23,$0.16,$0.09,$0.20,$0.09,$0.22,$0.09,$0.09,$0.20,$0.19,$0.09,$0.21,$0.09,$0.22,$0.09,$0.09,$0.22
2527150,0259,,,,,,,,Cholestyramine/Aspartame 210 G,$599.81,$412.94,$225.74,$534.07,$245.92,$581.82,$245.92,$245.92,$524.84,$509.84,$245.92,$557.83,$245.92,$569.82,$245.92,$245.92,$569.82
2528580,0259,,,,,,,,Cholestyramine/Aspartame PKT,$44.35,$30.53,$16.69,$39.49,$18.18,$43.02,$18.18,$18.18,$38.81,$37.70,$18.18,$41.25,$18.18,$42.13,$18.18,$18.18,$42.13
2515870,0259,,,,,,,,Cholestyramine/Sucrose 378 GM,$325.92,$224.38,$122.66,$290.19,$133.63,$316.14,$133.63,$133.63,$285.18,$277.03,$133.63,$303.10,$133.63,$309.62,$133.63,$133.63,$309.62
2524720,0259,,,,,,,,Cilostazol 100 MG TAB,$2.67,$1.84,$1.00,$2.38,$1.09,$2.59,$1.09,$1.09,$2.34,$2.27,$1.09,$2.48,$1.09,$2.54,$1.09,$1.09,$2.54
2508130,0259,,,,,,,,Cimetidine 300 MG TAB,$8.07,$5.56,$3.04,$7.19,$3.31,$7.83,$3.31,$3.31,$7.06,$6.86,$3.31,$7.51,$3.31,$7.67,$3.31,$3.31,$7.67
2538080,0250,,,,,,,,Cinacalcet 30 MG TABLET,$174.05,$119.83,$65.51,$154.98,$71.36,$168.83,$71.36,$71.36,$152.30,$147.95,$71.36,$161.87,$71.36,$165.35,$71.36,$71.36,$165.35
2538300,0250,,,,,,,,Ciprofloxacin 0.3% 2.5 ML BTL,$176.07,$121.22,$66.26,$156.77,$72.19,$170.79,$72.19,$72.19,$154.06,$149.66,$72.19,$163.74,$72.19,$167.27,$72.19,$72.19,$167.27
2523331,0250,,,,,,,,CIPROFLOXACIN 0.3% 5ML BTL,$99.53,$68.52,$37.46,$88.62,$40.81,$96.54,$40.81,$40.81,$87.09,$84.60,$40.81,$92.56,$40.81,$94.55,$40.81,$40.81,$94.55
2528920,0636,J0744,,,,,,,Ciprofloxacin 200 Mg/100 Ml Ba,$49.21,$33.88,$18.52,$43.81,$20.18,$47.73,$20.18,$20.18,$43.06,$41.83,$20.18,$45.76,$20.18,$46.75,$20.18,$20.18,$46.75
2502770,0259,,,,,,,,Ciprofloxacin 250 MG TAB,$2.24,$1.55,$0.84,$2.00,$0.92,$2.18,$0.92,$0.92,$1.96,$1.91,$0.92,$2.09,$0.92,$2.13,$0.92,$0.92,$2.13
2533340,0259,,,,,,,,Ciprofloxacin 250 Mg/5 Ml 100m,$543.64,$374.27,$204.60,$484.06,$222.89,$527.33,$222.89,$222.89,$475.69,$462.10,$222.89,$505.59,$222.89,$516.46,$222.89,$222.89,$516.46
2519290,0636,J0744,,,,,,,Ciprofloxacin 400 MG/200 ML BA,$56.19,$38.69,$21.15,$50.03,$23.04,$54.51,$23.04,$23.04,$49.17,$47.76,$23.04,$52.26,$23.04,$53.38,$23.04,$23.04,$53.38
2502780,0259,,,,,,,,Ciprofloxacin 500 Mg Tab,$6.11,$4.21,$2.30,$5.44,$2.51,$5.93,$2.51,$2.51,$5.35,$5.19,$2.51,$5.68,$2.51,$5.81,$2.51,$2.51,$5.81
2523263,0250,,,,,,,,"CIPROFLOXACIN 500MG TAB, 2TABS",$3.73,$2.57,$1.40,$3.32,$1.53,$3.61,$1.53,$1.53,$3.26,$3.17,$1.53,$3.46,$1.53,$3.54,$1.53,$1.53,$3.54
2534650,0259,,,,,,,,Ciprofloxacin/Dexameth. 7.5 ML,$530.10,$364.95,$199.51,$472.00,$217.34,$514.20,$217.34,$217.34,$463.84,$450.59,$217.34,$492.99,$217.34,$503.60,$217.34,$217.34,$503.60
2528720,0259,,,,,,,,Ciprofloxacin/Hc 10 Ml Btl,"$1,221.54",$840.98,$459.73,"$1,087.66",$500.83,"$1,184.90",$500.83,$500.83,"$1,068.85","$1,038.31",$500.83,"$1,136.04",$500.83,"$1,160.47",$500.83,$500.83,"$1,160.47"
2528880,0259,,,,,,,,Citalopram 10 MG TAB,$1.21,$0.83,$0.46,$1.08,$0.50,$1.17,$0.50,$0.50,$1.06,$1.03,$0.50,$1.12,$0.50,$1.15,$0.50,$0.50,$1.15
2524000,0259,,,,,,,,Citalopram 20 MG TAB,$1.03,$0.71,$0.39,$0.92,$0.42,$1.00,$0.42,$0.42,$0.91,$0.88,$0.42,$0.96,$0.42,$0.98,$0.42,$0.42,$0.98
2502230,0259,,,,,,,,Clarithromycin 500 MG TAB,$18.93,$13.04,$7.13,$16.86,$7.76,$18.37,$7.76,$7.76,$16.57,$16.09,$7.76,$17.61,$7.76,$17.99,$7.76,$7.76,$17.99
2502820,0259,,,,,,,,Clindamycin 150 MG CAP,$2.06,$1.42,$0.77,$1.83,$0.84,$2.00,$0.84,$0.84,$1.80,$1.75,$0.84,$1.91,$0.84,$1.96,$0.84,$0.84,$1.96
2523262,0250,,,,,,,,"Clindamycin 150 MG CAP, 12 CAP",$2.90,$2.00,$1.09,$2.58,$1.19,$2.81,$1.19,$1.19,$2.54,$2.46,$1.19,$2.69,$1.19,$2.75,$1.19,$1.19,$2.75
2502830,0259,,,,,,,,Clindamycin 300 MG CAP,$17.16,$11.81,$6.46,$15.28,$7.03,$16.64,$7.03,$7.03,$15.01,$14.58,$7.03,$15.96,$7.03,$16.30,$7.03,$7.03,$16.30
2535270,0259,,,,,,,,Clindamycin 300 MG/50 ML BAG,$72.27,$49.76,$27.20,$64.35,$29.63,$70.10,$29.63,$29.63,$63.24,$61.43,$29.63,$67.21,$29.63,$68.66,$29.63,$29.63,$68.66
2533620,0250,,,,,,,,Clindamycin 600 MG/50 ML BAG,$80.56,$55.46,$30.32,$71.73,$33.03,$78.14,$33.03,$33.03,$70.49,$68.48,$33.03,$74.92,$33.03,$76.53,$33.03,$33.03,$76.53
2522280,0250,,,,,,,,Clindamycin 900 MG/50 ML BAG,$99.00,$68.16,$37.26,$88.15,$40.59,$96.03,$40.59,$40.59,$86.63,$84.15,$40.59,$92.07,$40.59,$94.05,$40.59,$40.59,$94.05
2510650,0250,,,,,,,,Clindamycin 900 Mg/6 Ml Vial,$135.78,$93.48,$51.10,$120.90,$55.67,$131.71,$55.67,$55.67,$118.81,$115.42,$55.67,$126.28,$55.67,$128.99,$55.67,$55.67,$128.99
2516640,0259,,,,,,,,Clindamycin SUSP. 75 MG/5 ML B,$312.56,$215.18,$117.63,$278.30,$128.15,$303.18,$128.15,$128.15,$273.49,$265.68,$128.15,$290.68,$128.15,$296.93,$128.15,$128.15,$296.93
2521000,0259,,,,,,,,Clobetasol 0.05% CREAM 15 GM T,$98.09,$67.53,$36.92,$87.34,$40.22,$95.15,$40.22,$40.22,$85.83,$83.38,$40.22,$91.22,$40.22,$93.19,$40.22,$40.22,$93.19
2504930,0259,,,,,,,,Clonazepam 0.5 Mg Tab,$10.97,$7.55,$4.13,$9.77,$4.50,$10.64,$4.50,$4.50,$9.60,$9.32,$4.50,$10.20,$4.50,$10.42,$4.50,$4.50,$10.42
2504920,0259,,,,,,,,clonazePAM 1 MG TAB,$8.12,$5.59,$3.05,$7.23,$3.33,$7.87,$3.33,$3.33,$7.10,$6.90,$3.33,$7.55,$3.33,$7.71,$3.33,$3.33,$7.71
2519500,0259,,,,,,,,cloNIDine 0.1 MG PATCH,$155.65,$107.16,$58.58,$138.59,$63.82,$150.98,$63.82,$63.82,$136.20,$132.31,$63.82,$144.76,$63.82,$147.87,$63.82,$63.82,$147.87
2502620,0259,,,,,,,,cloNIDine 0.1 MG TAB,$5.66,$3.90,$2.13,$5.04,$2.32,$5.49,$2.32,$2.32,$4.96,$4.82,$2.32,$5.27,$2.32,$5.38,$2.32,$2.32,$5.38
2523141,0250,,,,,,,,Clonidine Npres-Fr 1000mcg/Ml,$448.07,$308.48,$168.63,$398.96,$183.71,$434.63,$183.71,$183.71,$392.06,$380.86,$183.71,$416.71,$183.71,$425.67,$183.71,$183.71,$425.67
2539050,0250,,,,,,,,Clopidogrel 300 MG TAB,$143.35,$98.69,$53.95,$127.64,$58.78,$139.05,$58.78,$58.78,$125.43,$121.85,$58.78,$133.32,$58.78,$136.19,$58.78,$58.78,$136.19
2522470,0259,,,,,,,,Clopidogrel 75 MG TAB,$3.28,$2.26,$1.23,$2.92,$1.34,$3.18,$1.34,$1.34,$2.87,$2.79,$1.34,$3.05,$1.34,$3.12,$1.34,$1.34,$3.12
2515940,0259,,,,,,,,Clotrimazole 1% 15 Gm Tube,$39.64,$27.29,$14.92,$35.30,$16.25,$38.45,$16.25,$16.25,$34.69,$33.70,$16.25,$36.87,$16.25,$37.66,$16.25,$16.25,$37.66
2592880,0250,,,,,,,,Clotrimazole 10 MG TROCHE,$14.55,$10.02,$5.48,$12.96,$5.97,$14.12,$5.97,$5.97,$12.74,$12.37,$5.97,$13.54,$5.97,$13.83,$5.97,$5.97,$13.83
2515900,0259,,,,,,,,Clotrimazole/Betamet Diprop Cr,$229.21,$157.80,$86.26,$204.09,$93.98,$222.33,$93.98,$93.98,$200.56,$194.83,$93.98,$213.17,$93.98,$217.75,$93.98,$93.98,$217.75
2523398,0250,,,,,,,,CLOZAPINE 100MG TAB,$19.20,$13.22,$7.22,$17.09,$7.87,$18.62,$7.87,$7.87,$16.80,$16.32,$7.87,$17.85,$7.87,$18.24,$7.87,$7.87,$18.24
2523397,0250,,,,,,,,Clozapine 25mg Tab,$7.28,$5.01,$2.74,$6.48,$2.98,$7.06,$2.98,$2.98,$6.37,$6.19,$2.98,$6.77,$2.98,$6.91,$2.98,$2.98,$6.91
2516010,0259,,,,,,,,Cocaine 4% 4 ML BTL,$651.18,$448.31,$245.07,$579.81,$266.98,$631.64,$266.98,$266.98,$569.78,$553.50,$266.98,$605.60,$266.98,$618.62,$266.98,$266.98,$618.62
2502940,0259,,,,,,,,Colchicine 0.6 MG TAB,$28.18,$19.40,$10.61,$25.09,$11.55,$27.34,$11.55,$11.55,$24.66,$23.96,$11.55,$26.21,$11.55,$26.77,$11.55,$11.55,$26.77
2502950,0259,,,,,,,,Colestipol 1 GM TAB,$14.21,$9.78,$5.35,$12.65,$5.82,$13.78,$5.82,$5.82,$12.43,$12.07,$5.82,$13.21,$5.82,$13.50,$5.82,$5.82,$13.50
2512910,0259,,,,,,,,Colyte 4000 ML BTL,$150.73,$103.77,$56.73,$134.21,$61.80,$146.21,$61.80,$61.80,$131.89,$128.12,$61.80,$140.18,$61.80,$143.19,$61.80,$61.80,$143.19
2592870,0250,,,,,,,,Compounding Vehicle SUSP NO.7,$0.81,$0.56,$0.30,$0.72,$0.33,$0.78,$0.33,$0.33,$0.71,$0.69,$0.33,$0.75,$0.33,$0.77,$0.33,$0.33,$0.77
2523026,0250,,,,,,,,Conivaptan/D5W 20 MG/100 ML BA,"$2,464.63","$1,696.78",$927.57,"$2,194.50","$1,010.50","$2,390.69","$1,010.50","$1,010.50","$2,156.55","$2,094.93","$1,010.50","$2,292.10","$1,010.50","$2,341.39","$1,010.50","$1,010.50","$2,341.39"
2583200,0636,J7300,,,,,,,Copper 1 EACH IUD-Paragard,"$1,465.22","$1,008.74",$551.44,"$1,304.63",$600.74,"$1,421.26",$600.74,$600.74,"$1,282.07","$1,245.44",$600.74,"$1,362.66",$600.74,"$1,391.96",$600.74,$600.74,"$1,391.96"
2517460,0259,,,,,,,,Cortisporin OTIC SOL 10 ML BTL,$577.55,$397.61,$217.36,$514.25,$236.79,$560.22,$236.79,$236.79,$505.35,$490.91,$236.79,$537.12,$236.79,$548.67,$236.79,$236.79,$548.67
2517470,0259,,,,,,,,Cortisporin OTIC SUSP 10 ML BT,$546.93,$376.54,$205.84,$486.99,$224.24,$530.53,$224.24,$224.24,$478.57,$464.89,$224.24,$508.65,$224.24,$519.59,$224.24,$224.24,$519.59
2510710,0636,J0833,,,,,,,Cosyntropin 0.25 Mg Vial,$288.33,$198.50,$108.51,$256.73,$118.22,$279.68,$118.22,$118.22,$252.29,$245.08,$118.22,$268.15,$118.22,$273.91,$118.22,$118.22,$273.91
2526620,0259,,,,,,,,"Creon, Lipase 12,000 CAPCR",$76.41,$52.61,$28.76,$68.04,$31.33,$74.12,$31.33,$31.33,$66.86,$64.95,$31.33,$71.06,$31.33,$72.59,$31.33,$31.33,$72.59
2538960,0250,,,,,,,,"Creon, Lipase 6,000 CAPCR",$42.50,$29.26,$15.99,$37.84,$17.42,$41.22,$17.42,$17.42,$37.19,$36.12,$17.42,$39.52,$17.42,$40.37,$17.42,$17.42,$40.37
2523386,0250,,,,,,,,CUPRIC CHLORIDE 4 MG/10 ML VIA,$304.67,$209.75,$114.66,$271.28,$124.92,$295.53,$124.92,$124.92,$266.59,$258.97,$124.92,$283.35,$124.92,$289.44,$124.92,$124.92,$289.44
2522881,0250,,,,,,,,Cyanocobalamin 100 Mcg Tablet,$3.31,$2.28,$1.25,$2.95,$1.36,$3.21,$1.36,$1.36,$2.90,$2.82,$1.36,$3.08,$1.36,$3.15,$1.36,$1.36,$3.15
2520220,0636,J3420,,,,,,,Cyanocobalamin 1000 Mcg/Ml Via,$66.37,$45.69,$24.98,$59.09,$27.21,$64.38,$27.21,$27.21,$58.07,$56.41,$27.21,$61.72,$27.21,$63.05,$27.21,$27.21,$63.05
2510740,0636,J3470,,,,,,,Cyanocobalamin 30000 MCG/30 ML,$195.27,$134.44,$73.49,$173.87,$80.06,$189.42,$80.06,$80.06,$170.87,$165.98,$80.06,$181.61,$80.06,$185.51,$80.06,$80.06,$185.51
2508940,0259,,,,,,,,Cyanocobalamin 500 MCG TAB,$2.57,$1.77,$0.97,$2.29,$1.05,$2.49,$1.05,$1.05,$2.25,$2.19,$1.05,$2.39,$1.05,$2.44,$1.05,$1.05,$2.44
2504220,0259,,,,,,,,Cyclobenzaprine 10 MG TAB,$3.86,$2.66,$1.45,$3.43,$1.58,$3.74,$1.58,$1.58,$3.37,$3.28,$1.58,$3.59,$1.58,$3.66,$1.58,$1.58,$3.66
2523279,0250,,,,,,,,"Cyclobenzaprine 10 MG TAB, 3 T",$1.03,$0.71,$0.39,$0.92,$0.42,$1.00,$0.42,$0.42,$0.91,$0.88,$0.42,$0.96,$0.42,$0.98,$0.42,$0.42,$0.98
2515980,0259,,,,,,,,Cyclopentolate 1% 2 ML BTL,$160.83,$110.72,$60.53,$143.20,$65.94,$156.00,$65.94,$65.94,$140.72,$136.70,$65.94,$149.57,$65.94,$152.79,$65.94,$65.94,$152.79
2536850,0250,,,,,,,,Cyclosporine 0.4 Ml Ophth Vial,$87.05,$59.93,$32.76,$77.51,$35.69,$84.44,$35.69,$35.69,$76.17,$74.00,$35.69,$80.96,$35.69,$82.70,$35.69,$35.69,$82.70
2509270,0259,,,,,,,,Cyproheptadine 4 MG TAB,$2.37,$1.64,$0.89,$2.11,$0.97,$2.30,$0.97,$0.97,$2.08,$2.02,$0.97,$2.21,$0.97,$2.26,$0.97,$0.97,$2.26
2523186,0250,,,,,,,,Dabigatran 110 Mg Capsule,$108.11,$74.43,$40.69,$96.26,$44.33,$104.87,$44.33,$44.33,$94.60,$91.90,$44.33,$100.54,$44.33,$102.71,$44.33,$44.33,$102.71
2541580,0250,,,,,,,,Dabigatran 75 MG CAPSULE,$108.11,$74.43,$40.69,$96.26,$44.33,$104.87,$44.33,$44.33,$94.60,$91.90,$44.33,$100.54,$44.33,$102.71,$44.33,$44.33,$102.71
2530960,0259,,,,,,,,Dakin's Solution 0.25% 473 ML,$179.50,$123.58,$67.56,$159.83,$73.60,$174.12,$73.60,$73.60,$157.06,$152.58,$73.60,$166.94,$73.60,$170.53,$73.60,$73.60,$170.53
2530950,0259,,,,,,,,Dakin's Solution 0.5% 473 ML B,$179.50,$123.58,$67.56,$159.83,$73.60,$174.12,$73.60,$73.60,$157.06,$152.58,$73.60,$166.94,$73.60,$170.53,$73.60,$73.60,$170.53
2523354,0636,J0875,,,,,,,Dalbavancin 500 MG VIAL,"$3,852.09","$2,651.98","$1,449.75","$3,429.89","$1,579.36","$3,736.52","$1,579.36","$1,579.36","$3,370.58","$3,274.27","$1,579.36","$3,582.44","$1,579.36","$3,659.48","$1,579.36","$1,579.36","$3,659.48"
2522885,0250,,,,,,,,Dantrolene 20 MG VIAL,$637.30,$438.75,$239.85,$567.45,$261.29,$618.18,$261.29,$261.29,$557.64,$541.70,$261.29,$592.69,$261.29,$605.43,$261.29,$261.29,$605.43
2523231,0636,,,,,,,,Dantrolene 250 MG VIAL,"$5,090.10","$3,504.29","$1,915.68","$4,532.22","$2,086.94","$4,937.40","$2,086.94","$2,086.94","$4,453.84","$4,326.59","$2,086.94","$4,733.79","$2,086.94","$4,835.60","$2,086.94","$2,086.94","$4,835.60"
2523421,0250,,,,,,,,DAPTOMYCIN 350 MG VIAL,$347.26,$239.07,$130.69,$309.20,$142.38,$336.84,$142.38,$142.38,$303.85,$295.17,$142.38,$322.95,$142.38,$329.89,$142.38,$142.38,$329.89
2523176,0636,J0878,,,,,,,Daptomycin 500 Mg Vial,$261.19,$179.82,$98.30,$232.57,$107.09,$253.36,$107.09,$107.09,$228.55,$222.02,$107.09,$242.91,$107.09,$248.13,$107.09,$107.09,$248.13
2541750,0636,J0881,,,,,,,Darbepoetin 100 MCG SYR,"$1,386.92",$954.83,$521.97,"$1,234.91",$568.64,"$1,345.31",$568.64,$568.64,"$1,213.55","$1,178.88",$568.64,"$1,289.83",$568.64,"$1,317.57",$568.64,$568.64,"$1,317.57"
2541760,0636,J0881,,,,,,,Darbepoetin 150 MCG SYR,"$1,904.69","$1,311.29",$716.84,"$1,695.93",$780.92,"$1,847.54",$780.92,$780.92,"$1,666.60","$1,618.98",$780.92,"$1,771.36",$780.92,"$1,809.45",$780.92,$780.92,"$1,809.45"
2541770,0636,J0881,,,,,,,Darbepoetin 200 MCG SYR,"$2,332.12","$1,605.56",$877.70,"$2,076.52",$956.17,"$2,262.16",$956.17,$956.17,"$2,040.61","$1,982.30",$956.17,"$2,168.87",$956.17,"$2,215.52",$956.17,$956.17,"$2,215.52"
2541730,0636,J0881,,,,,,,Darbepoetin 25 Mcg Syr,$689.25,$474.52,$259.40,$613.71,$282.59,$668.57,$282.59,$282.59,$603.10,$585.86,$282.59,$641.00,$282.59,$654.79,$282.59,$282.59,$654.79
2541780,0636,J0881,,,,,,,Darbepoetin 300 MCG SYR,"$3,110.93","$2,141.73","$1,170.81","$2,769.97","$1,275.48","$3,017.61","$1,275.48","$1,275.48","$2,722.07","$2,644.29","$1,275.48","$2,893.17","$1,275.48","$2,955.39","$1,275.48","$1,275.48","$2,955.39"
2541800,0636,J0881,,,,,,,Darbepoetin 40 MCG SYR,$615.47,$423.72,$231.63,$548.01,$252.34,$597.00,$252.34,$252.34,$538.53,$523.15,$252.34,$572.38,$252.34,$584.69,$252.34,$252.34,$584.69
2523232,0636,J0881,,,,,,,Darbepoetin 500 MCG SYR,"$5,120.90","$3,525.50","$1,927.27","$4,559.64","$2,099.57","$4,967.27","$2,099.57","$2,099.57","$4,480.79","$4,352.76","$2,099.57","$4,762.44","$2,099.57","$4,864.85","$2,099.57","$2,099.57","$4,864.85"
2541740,0636,J0881,,,,,,,Darbepoetin 60 Mcg Syr,"$1,494.43","$1,028.84",$562.43,"$1,330.64",$612.72,"$1,449.60",$612.72,$612.72,"$1,307.62","$1,270.26",$612.72,"$1,389.82",$612.72,"$1,419.71",$612.72,$612.72,"$1,419.71"
2510870,0636,J0895,,,,,,,Deferoxamine 500 Mg Vial,$219.67,$151.23,$82.67,$195.59,$90.06,$213.08,$90.06,$90.06,$192.21,$186.72,$90.06,$204.29,$90.06,$208.68,$90.06,$90.06,$208.68
2523153,0636,J0897,,,,,,,DENOSUMAB 120 MG VIAL,"$6,703.55","$4,615.07","$2,522.91","$5,968.83","$2,748.45","$6,502.44","$2,748.45","$2,748.45","$5,865.60","$5,698.01","$2,748.45","$6,234.30","$2,748.45","$6,368.37","$2,748.45","$2,748.45","$6,368.37"
2523073,0636,J0897,,,,,,,Denosumab 60 Mg/Ml Syr,"$3,783.70","$2,604.90","$1,424.01","$3,369.00","$1,551.32","$3,670.19","$1,551.32","$1,551.32","$3,310.74","$3,216.15","$1,551.32","$3,518.84","$1,551.32","$3,594.52","$1,551.32","$1,551.32","$3,594.52"
2516690,0250,,,,,,,,Desflurane 240 ML BTL,$163.69,$112.70,$61.61,$145.75,$67.11,$158.78,$67.11,$67.11,$143.23,$139.14,$67.11,$152.23,$67.11,$155.51,$67.11,$67.11,$155.51
2506390,0259,,,,,,,,Desipramine 10 Mg Tab,$4.75,$3.27,$1.79,$4.23,$1.95,$4.61,$1.95,$1.95,$4.16,$4.04,$1.95,$4.42,$1.95,$4.51,$1.95,$1.95,$4.51
2535870,0250,,,,,,,,Desmopressin 0.2 Mg Tab,$8.19,$5.64,$3.08,$7.29,$3.36,$7.95,$3.36,$3.36,$7.17,$6.96,$3.36,$7.62,$3.36,$7.78,$3.36,$3.36,$7.78
2521680,0636,J2597,,,,,,,Desmopressin 40 MCG/10 ML VIAL,$840.44,$578.60,$316.30,$748.33,$344.58,$815.23,$344.58,$344.58,$735.38,$714.37,$344.58,$781.61,$344.58,$798.42,$344.58,$344.58,$798.42
2522250,0636,J8540,,,,,,,Dexamethasone 1 MG TAB,$5.72,$3.94,$2.15,$5.09,$2.34,$5.55,$2.34,$2.34,$5.00,$4.86,$2.34,$5.32,$2.34,$5.43,$2.34,$2.34,$5.43
2527670,0636,J1100,,,,,,,Dexamethasone 10 MG/ML VIAL,$62.02,$42.70,$23.34,$55.22,$25.43,$60.16,$25.43,$25.43,$54.27,$52.72,$25.43,$57.68,$25.43,$58.92,$25.43,$25.43,$58.92
2503310,0636,J8540,,,,,,,Dexamethasone 4 MG TAB,$18.23,$12.55,$6.86,$16.23,$7.47,$17.68,$7.47,$7.47,$15.95,$15.49,$7.47,$16.95,$7.47,$17.31,$7.47,$7.47,$17.31
2529490,0636,J1100,,,,,,,Dexamethasone 4 Mg/Ml Vial,$54.18,$37.30,$20.39,$48.24,$22.21,$52.55,$22.21,$22.21,$47.40,$46.05,$22.21,$50.38,$22.21,$51.47,$22.21,$22.21,$51.47
2516040,0259,,,,,,,,Dexamethasone NA PHOS. 0.1% 5,$129.02,$88.82,$48.56,$114.88,$52.90,$125.15,$52.90,$52.90,$112.89,$109.66,$52.90,$119.99,$52.90,$122.57,$52.90,$52.90,$122.57
2523076,0250,,,,,,,,Dexamethasone Sod. Phos./Pres-,$97.93,$67.42,$36.85,$87.19,$40.15,$94.99,$40.15,$40.15,$85.69,$83.24,$40.15,$91.07,$40.15,$93.03,$40.15,$40.15,$93.03
2523036,0250,,,,,,,,Dexlansoprazole 30 MG CAP,$111.64,$76.86,$42.02,$99.41,$45.77,$108.29,$45.77,$45.77,$97.69,$94.90,$45.77,$103.83,$45.77,$106.06,$45.77,$45.77,$106.06
2523401,0250,,,,,,,,Dexmedetomidien N Saline 400,$243.80,$167.84,$91.75,$217.08,$99.96,$236.48,$99.96,$99.96,$213.32,$207.23,$99.96,$226.73,$99.96,$231.61,$99.96,$99.96,$231.61
2544350,0250,,,,,,,,Dexmedetomidine 200 MCG/2 ML V,$134.12,$92.33,$50.48,$119.42,$54.99,$130.09,$54.99,$54.99,$117.35,$114.00,$54.99,$124.73,$54.99,$127.41,$54.99,$54.99,$127.41
2523388,0250,,,,,,,,DEXMEDETOMIDINE IN 0.9% NACI80,$217.00,$149.39,$81.67,$193.21,$88.97,$210.49,$88.97,$88.97,$189.87,$184.45,$88.97,$201.81,$88.97,$206.15,$88.97,$88.97,$206.15
2503450,0259,,,,,,,,Dextroamphetamine 5 MG TAB,$2.75,$1.89,$1.03,$2.44,$1.13,$2.66,$1.13,$1.13,$2.40,$2.33,$1.13,$2.55,$1.13,$2.61,$1.13,$1.13,$2.61
2522888,0250,,,,,,,,Dextromethorphan 30 MG/5 ML ML,$1.05,$0.72,$0.39,$0.93,$0.43,$1.01,$0.43,$0.43,$0.92,$0.89,$0.43,$0.97,$0.43,$0.99,$0.43,$0.43,$0.99
2523555,0250,,,,,,,,Dextrose 1-2 Gm/3 Ml Oiral Gel,$53.69,$36.96,$20.20,$47.80,$22.01,$52.08,$22.01,$22.01,$46.97,$45.63,$22.01,$49.93,$22.01,$51.00,$22.01,$22.01,$51.00
2529460,0259,,,,,,,,Dextrose 25%-Water 10 ML SYR,$165.12,$113.68,$62.14,$147.02,$67.70,$160.17,$67.70,$67.70,$144.48,$140.35,$67.70,$153.56,$67.70,$156.86,$67.70,$67.70,$156.86
2518880,0250,,,,,,,,Dextrose 5%-Water 100 ML BAG,$83.69,$57.62,$31.50,$74.52,$34.31,$81.18,$34.31,$34.31,$73.23,$71.13,$34.31,$77.83,$34.31,$79.50,$34.31,$34.31,$79.50
2518840,0250,,,,,,,,Dextrose 5%-Water 250 ML BAG,$45.36,$31.23,$17.07,$40.39,$18.60,$44.00,$18.60,$18.60,$39.69,$38.56,$18.60,$42.19,$18.60,$43.09,$18.60,$18.60,$43.09
2518870,0250,,,,,,,,Dextrose 5%-Water 50 ML BAG,$69.43,$47.80,$26.13,$61.82,$28.47,$67.34,$28.47,$28.47,$60.75,$59.01,$28.47,$64.57,$28.47,$65.96,$28.47,$28.47,$65.96
2511050,0250,,,,,,,,Dextrose 50%-Water 25 GM/50 ML,$218.78,$150.62,$82.34,$194.81,$89.70,$212.22,$89.70,$89.70,$191.44,$185.97,$89.70,$203.47,$89.70,$207.84,$89.70,$89.70,$207.84
2522981,0250,,,,,,,,Dextrose 50%-Water 25 GM/50 ML,$87.10,$59.96,$32.78,$77.55,$35.71,$84.48,$35.71,$35.71,$76.21,$74.03,$35.71,$81.00,$35.71,$82.74,$35.71,$35.71,$82.74
2519220,0250,,,,,,,,Dextrose 50%-Water 500 ML BAG,$43.58,$30.00,$16.40,$38.80,$17.87,$42.27,$17.87,$17.87,$38.13,$37.04,$17.87,$40.53,$17.87,$41.40,$17.87,$17.87,$41.40
2510980,0636,J3360,,,,,,,Diazepam 10 Mg/2 Ml Syr,$282.50,$194.49,$106.32,$251.54,$115.83,$274.03,$115.83,$115.83,$247.19,$240.13,$115.83,$262.73,$115.83,$268.38,$115.83,$115.83,$268.38
2508770,0259,,,,,,,,Diazepam 2 MG TAB,$1.19,$0.82,$0.45,$1.06,$0.49,$1.15,$0.49,$0.49,$1.04,$1.01,$0.49,$1.10,$0.49,$1.13,$0.49,$0.49,$1.13
2537700,0250,,,,,,,,Diazepam 2.5 MG RECTAL GEL,$634.52,$436.84,$238.80,$564.98,$260.15,$615.49,$260.15,$260.15,$555.21,$539.34,$260.15,$590.10,$260.15,$602.79,$260.15,$260.15,$602.79
2508780,0259,,,,,,,,Diazepam 5 MG TAB,$1.03,$0.71,$0.39,$0.92,$0.42,$1.00,$0.42,$0.42,$0.91,$0.88,$0.42,$0.96,$0.42,$0.98,$0.42,$0.42,$0.98
2544150,0250,,,,,,,,Diazepam 50 MG/10 ML ML,$73.44,$50.56,$27.64,$65.39,$30.11,$71.23,$30.11,$30.11,$64.26,$62.42,$30.11,$68.30,$30.11,$69.76,$30.11,$30.11,$69.76
2516050,0259,,,,,,,,Dibucaine 1% 30 GM TUBE,$95.32,$65.63,$35.88,$84.88,$39.08,$92.46,$39.08,$39.08,$83.41,$81.02,$39.08,$88.65,$39.08,$90.56,$39.08,$39.08,$90.56
2523379,0250,,,,,,,,DIBUCAINE 1% 30 GM TUBE,$58.87,$40.53,$22.16,$52.42,$24.14,$57.11,$24.14,$24.14,$51.51,$50.04,$24.14,$54.75,$24.14,$55.93,$24.14,$24.14,$55.93
2538630,0250,,,,,,,,DICLOFENAC 1% GEL 100 GM TUBE,$68.29,$47.02,$25.70,$60.81,$28.00,$66.25,$28.00,$28.00,$59.76,$58.05,$28.00,$63.51,$28.00,$64.88,$28.00,$28.00,$64.88
2523191,0250,,,,,,,,Diclofenac 1.3% Patch,$97.37,$67.04,$36.65,$86.70,$39.92,$94.45,$39.92,$39.92,$85.20,$82.76,$39.92,$90.55,$39.92,$92.50,$39.92,$39.92,$92.50
2502610,0259,,,,,,,,DICLOFENAC POTASSIUM,$6.47,$4.46,$2.44,$5.76,$2.65,$6.28,$2.65,$2.65,$5.66,$5.50,$2.65,$6.02,$2.65,$6.15,$2.65,$2.65,$6.15
2508970,0259,,,,,,,,Diclofenac Sodium 50 MG TABEC,$3.89,$2.68,$1.46,$3.46,$1.59,$3.77,$1.59,$1.59,$3.40,$3.31,$1.59,$3.62,$1.59,$3.69,$1.59,$1.59,$3.69
2508980,0259,,,,,,,,Diclofenac Sodium 75 MG TABEC,$3.73,$2.57,$1.40,$3.32,$1.53,$3.61,$1.53,$1.53,$3.26,$3.17,$1.53,$3.46,$1.53,$3.54,$1.53,$1.53,$3.54
2526980,0250,,,,,,,,Diclofenac/Misoprostol 1 TABEC,$57.89,$39.86,$21.79,$51.55,$23.74,$56.15,$23.74,$23.74,$50.65,$49.21,$23.74,$53.84,$23.74,$55.00,$23.74,$23.74,$55.00
2503770,0259,,,,,,,,Dicloxacillin 250 MG CAP,$9.14,$6.29,$3.44,$8.14,$3.75,$8.87,$3.75,$3.75,$8.00,$7.77,$3.75,$8.50,$3.75,$8.68,$3.75,$3.75,$8.68
2502170,0259,,,,,,,,Dicyclomine 10 MG CAP,$2.43,$1.67,$0.91,$2.16,$1.00,$2.36,$1.00,$1.00,$2.13,$2.06,$1.00,$2.26,$1.00,$2.31,$1.00,$1.00,$2.31
2502180,0259,,,,,,,,Dicyclomine 20 MG TAB,$7.89,$5.43,$2.97,$7.02,$3.23,$7.65,$3.23,$3.23,$6.90,$6.70,$3.23,$7.34,$3.23,$7.49,$3.23,$3.23,$7.49
2511010,0259,,,,,,,,Digoxin 0.05 MG/ML ML,$35.80,$24.65,$13.47,$31.87,$14.68,$34.72,$14.68,$14.68,$31.32,$30.43,$14.68,$33.29,$14.68,$34.01,$14.68,$14.68,$34.01
2504990,0259,,,,,,,,Digoxin 0.125 MG TAB,$7.56,$5.21,$2.85,$6.73,$3.10,$7.33,$3.10,$3.10,$6.62,$6.43,$3.10,$7.03,$3.10,$7.18,$3.10,$3.10,$7.18
2505000,0259,,,,,,,,Digoxin 0.25 MG TAB,$9.64,$6.64,$3.63,$8.58,$3.95,$9.35,$3.95,$3.95,$8.44,$8.20,$3.95,$8.97,$3.95,$9.16,$3.95,$3.95,$9.16
2511000,0636,J1160,,,,,,,Digoxin 0.5 Mg/2 Ml Amp,$104.53,$71.96,$39.34,$93.07,$42.86,$101.39,$42.86,$42.86,$91.46,$88.85,$42.86,$97.21,$42.86,$99.30,$42.86,$42.86,$99.30
2511020,0636,J1162,,,,,,,Digoxin Immune Fab 40 Mg Vial,"$5,656.07","$3,893.93","$2,128.68","$5,036.15","$2,318.99","$5,486.38","$2,318.99","$2,318.99","$4,949.06","$4,807.66","$2,318.99","$5,260.14","$2,318.99","$5,373.26","$2,318.99","$2,318.99","$5,373.26"
2511040,0636,J1110,,,,,,,Dihydroergotamine 1 MG/ML AMP,$477.06,$328.43,$179.54,$424.77,$195.59,$462.75,$195.59,$195.59,$417.43,$405.50,$195.59,$443.67,$195.59,$453.21,$195.59,$195.59,$453.21
2533940,0250,,,,,,,,Diltiazem 100 MG ADD-VANTAGE V,$279.98,$192.75,$105.37,$249.29,$114.79,$271.58,$114.79,$114.79,$244.98,$237.98,$114.79,$260.38,$114.79,$265.98,$114.79,$114.79,$265.98
2541020,0250,,,,,,,,DILTIAZEM 125MG/25ML VIAL,$144.51,$99.49,$54.39,$128.67,$59.25,$140.17,$59.25,$59.25,$126.45,$122.83,$59.25,$134.39,$59.25,$137.28,$59.25,$59.25,$137.28
2521750,0250,,,,,,,,Diltiazem 25 MG/5 ML VIAL,$98.97,$68.14,$37.25,$88.12,$40.58,$96.00,$40.58,$40.58,$86.60,$84.13,$40.58,$92.04,$40.58,$94.02,$40.58,$40.58,$94.02
2502480,0259,,,,,,,,Diltiazem 30 MG TAB,$1.86,$1.28,$0.70,$1.66,$0.76,$1.81,$0.76,$0.76,$1.63,$1.58,$0.76,$1.73,$0.76,$1.77,$0.76,$0.76,$1.77
2502490,0259,,,,,,,,Diltiazem 60 MG TAB,$3.48,$2.39,$1.31,$3.09,$1.42,$3.37,$1.42,$1.42,$3.04,$2.95,$1.42,$3.23,$1.42,$3.30,$1.42,$1.42,$3.30
2520330,0259,,,,,,,,Diltiazem CD 120 MG CAPCR,$5.07,$3.49,$1.91,$4.51,$2.08,$4.91,$2.08,$2.08,$4.43,$4.31,$2.08,$4.71,$2.08,$4.81,$2.08,$2.08,$4.81
2520350,0259,,,,,,,,Diltiazem CD 180 MG CAPCR,$5.59,$3.85,$2.10,$4.98,$2.29,$5.42,$2.29,$2.29,$4.89,$4.75,$2.29,$5.20,$2.29,$5.31,$2.29,$2.29,$5.31
2520370,0259,,,,,,,,Diltiazem CD 300 MG CAPCR,$38.19,$26.30,$14.37,$34.01,$15.66,$37.05,$15.66,$15.66,$33.42,$32.47,$15.66,$35.52,$15.66,$36.28,$15.66,$15.66,$36.28
2511030,0250,,,,,,,,DILTIAZEM HCL,$119.41,$82.21,$44.94,$106.32,$48.96,$115.83,$48.96,$48.96,$104.48,$101.50,$48.96,$111.05,$48.96,$113.44,$48.96,$48.96,$113.44
2522887,0250,,,,,,,,Dimenhydrinate 50 MG TABLET,$1.17,$0.80,$0.44,$1.04,$0.48,$1.13,$0.48,$0.48,$1.02,$0.99,$0.48,$1.08,$0.48,$1.11,$0.48,$0.48,$1.11
2521700,0250,,,,,,,,Dimercaprol 100 MG/ML AMP,$584.25,$402.23,$219.88,$520.21,$239.54,$566.72,$239.54,$239.54,$511.21,$496.61,$239.54,$543.35,$239.54,$555.03,$239.54,$239.54,$555.03
2502710,0250,,,,,,,,Dinoprostone-CERVICAL 10 MG VS,"$1,540.29","$1,060.42",$579.69,"$1,371.47",$631.52,"$1,494.08",$631.52,$631.52,"$1,347.76","$1,309.25",$631.52,"$1,432.47",$631.52,"$1,463.28",$631.52,$631.52,"$1,463.28"
2523008,0250,,,,,,,,"Diph,Pertuss(Acell),Tet Vac/Pf",$368.99,$254.03,$138.87,$328.55,$151.29,$357.92,$151.29,$151.29,$322.87,$313.64,$151.29,$343.16,$151.29,$350.54,$151.29,$151.29,$350.54
2523027,0250,,,,,,,,"Diph,Pertuss(Acell),Tet Vac/Pf",$324.61,$223.48,$122.17,$289.03,$133.09,$314.87,$133.09,$133.09,$284.03,$275.92,$133.09,$301.89,$133.09,$308.38,$133.09,$133.09,$308.38
2537130,0250,,,,,,,,diphenhydrAMINE /ZINC ACET CR,$38.19,$26.30,$14.37,$34.01,$15.66,$37.05,$15.66,$15.66,$33.42,$32.47,$15.66,$35.52,$15.66,$36.28,$15.66,$15.66,$36.28
2511060,0259,,,,,,,,diphenhydrAMINE 12.5 MG/5 ML,$0.29,$0.20,$0.11,$0.26,$0.12,$0.29,$0.12,$0.12,$0.26,$0.25,$0.12,$0.27,$0.12,$0.28,$0.12,$0.12,$0.28
2502150,0259,,,,,,,,diphenhydrAMINE 25 MG CAP,$0.63,$0.44,$0.24,$0.56,$0.26,$0.61,$0.26,$0.26,$0.55,$0.54,$0.26,$0.59,$0.26,$0.60,$0.26,$0.26,$0.60
2534710,0259,,,,,,,,diphenhydrAMINE 25 MG/10 ML BT,$41.39,$28.49,$15.58,$36.85,$16.97,$40.14,$16.97,$16.97,$36.21,$35.18,$16.97,$38.49,$16.97,$39.32,$16.97,$16.97,$39.32
2509980,0636,J1200,,,,,,,diphenhydrAMINE 50 MG/ML VIAL,$96.76,$66.62,$36.42,$86.16,$39.67,$93.86,$39.67,$39.67,$84.67,$82.25,$39.67,$89.99,$39.67,$91.92,$39.67,$39.67,$91.92
2505260,0259,,,,,,,,Diphenoxylate/Atropine TAB,$8.22,$5.66,$3.10,$7.32,$3.37,$7.98,$3.37,$3.37,$7.20,$6.99,$3.37,$7.65,$3.37,$7.81,$3.37,$3.37,$7.81
2522977,0250,,,,,,,,"Diphth, Pertuss, Tet Vaccine 0",$139.62,$96.12,$52.55,$124.32,$57.24,$135.43,$57.24,$57.24,$122.17,$118.67,$57.24,$129.84,$57.24,$132.64,$57.24,$57.24,$132.64
2534540,0259,,,,,,,,Divalproex 125 MG SPRINKLE,$13.20,$9.09,$4.97,$11.76,$5.41,$12.81,$5.41,$5.41,$11.55,$11.22,$5.41,$12.28,$5.41,$12.54,$5.41,$5.41,$12.54
2503390,0259,,,,,,,,Divalproex 125 Mg Tabec,$0.84,$0.58,$0.32,$0.75,$0.34,$0.81,$0.34,$0.34,$0.73,$0.71,$0.34,$0.78,$0.34,$0.80,$0.34,$0.34,$0.80
2503400,0259,,,,,,,,Divalproex 250 MG TABEC,$2.69,$1.85,$1.01,$2.40,$1.10,$2.61,$1.10,$1.10,$2.35,$2.29,$1.10,$2.50,$1.10,$2.56,$1.10,$1.10,$2.56
2503410,0259,,,,,,,,Divalproex 500 Mg Tabec,$6.24,$4.30,$2.35,$5.56,$2.56,$6.05,$2.56,$2.56,$5.46,$5.31,$2.56,$5.81,$2.56,$5.93,$2.56,$2.56,$5.93
2532500,0259,,,,,,,,Divalproex Sodium 250 MG TAB.E,$6.86,$4.73,$2.58,$6.11,$2.81,$6.66,$2.81,$2.81,$6.01,$5.83,$2.81,$6.38,$2.81,$6.52,$2.81,$2.81,$6.52
2522957,0250,,,,,,,,Divalproex Sodium 500 MG TAB.E,$36.44,$25.09,$13.71,$32.45,$14.94,$35.35,$14.94,$14.94,$31.89,$30.97,$14.94,$33.89,$14.94,$34.62,$14.94,$14.94,$34.62
2527160,0636,J1250,,,,,,,DOBUTamine 250 MG/250 ML BAG,$95.66,$65.86,$36.00,$85.18,$39.22,$92.79,$39.22,$39.22,$83.70,$81.31,$39.22,$88.96,$39.22,$90.88,$39.22,$39.22,$90.88
2523409,0250,,,,,,,,DOBUTAMINE 500 MG/250 ML BAG,$154.46,$106.34,$58.13,$137.53,$63.33,$149.82,$63.33,$63.33,$135.15,$131.29,$63.33,$143.64,$63.33,$146.73,$63.33,$63.33,$146.73
2529140,0259,,,,,,,,Docosanol 10% CREAM 2 GM TUBE,$263.70,$181.55,$99.24,$234.80,$108.12,$255.79,$108.12,$108.12,$230.74,$224.15,$108.12,$245.24,$108.12,$250.52,$108.12,$108.12,$250.52
2502920,0259,,,,,,,,Docusate Sodium 100 MG CAP,$0.90,$0.62,$0.34,$0.81,$0.37,$0.88,$0.37,$0.37,$0.79,$0.77,$0.37,$0.84,$0.37,$0.86,$0.37,$0.37,$0.86
2529290,0259,,,,,,,,Docusate Sodium 100 MG/10 ML B,$8.85,$6.09,$3.33,$7.88,$3.63,$8.58,$3.63,$3.63,$7.74,$7.52,$3.63,$8.23,$3.63,$8.40,$3.63,$3.63,$8.40
2523322,0250,,,,,,,,Dofetilide 250 MCC CAP,$6.70,$4.61,$2.52,$5.97,$2.75,$6.50,$2.75,$2.75,$5.86,$5.69,$2.75,$6.23,$2.75,$6.36,$2.75,$2.75,$6.36
2514970,0259,,,,,,,,Domeboro TABEF,$13.66,$9.41,$5.14,$12.16,$5.60,$13.25,$5.60,$5.60,$11.95,$11.61,$5.60,$12.70,$5.60,$12.98,$5.60,$5.60,$12.98
2522180,0259,,,,,,,,Donepezil 5 MG TAB,$6.45,$4.44,$2.43,$5.74,$2.64,$6.26,$2.64,$2.64,$5.64,$5.48,$2.64,$6.00,$2.64,$6.13,$2.64,$2.64,$6.13
2523690,0636,J1265,,,,,,,DOPamine 400 MG/250 ML BAG,$136.10,$93.70,$51.22,$121.18,$55.80,$132.02,$55.80,$55.80,$119.09,$115.68,$55.80,$126.57,$55.80,$129.29,$55.80,$55.80,$129.29
2511160,0636,J1265,,,,,,,DOPamine 400 MG/5 ML VIAL,$87.40,$60.17,$32.89,$77.82,$35.84,$84.78,$35.84,$35.84,$76.48,$74.29,$35.84,$81.28,$35.84,$83.03,$35.84,$35.84,$83.03
2523492,0636,J7639,,,,,,,DORNASE ALFA 2.5 MG/2.5ML VIAL,$548.35,$377.51,$206.37,$488.25,$224.82,$531.90,$224.82,$224.82,$479.81,$466.10,$224.82,$509.97,$224.82,$520.93,$224.82,$224.82,$520.93
2520260,0259,,,,,,,,Dorzolamide 2% 10 ML BTL,$166.11,$114.36,$62.52,$147.91,$68.11,$161.13,$68.11,$68.11,$145.35,$141.19,$68.11,$154.48,$68.11,$157.81,$68.11,$68.11,$157.81
2533000,0259,,,,,,,,Doxazosin 1 MG TAB,$8.34,$5.75,$3.14,$7.43,$3.42,$8.09,$3.42,$3.42,$7.30,$7.09,$3.42,$7.76,$3.42,$7.93,$3.42,$3.42,$7.93
2502590,0259,,,,,,,,Doxazosin 2 MG TAB,$9.83,$6.77,$3.70,$8.75,$4.03,$9.53,$4.03,$4.03,$8.60,$8.35,$4.03,$9.14,$4.03,$9.34,$4.03,$4.03,$9.34
2501300,0259,,,,,,,,Doxepin 10 Mg Cap,$10.16,$7.00,$3.83,$9.05,$4.17,$9.86,$4.17,$4.17,$8.89,$8.64,$4.17,$9.45,$4.17,$9.66,$4.17,$4.17,$9.66
2523309,0250,,,,,,,,Doxepin 10 MG/ML Solution,$3.15,$2.17,$1.18,$2.80,$1.29,$3.05,$1.29,$1.29,$2.75,$2.68,$1.29,$2.93,$1.29,$2.99,$1.29,$1.29,$2.99
2522891,0250,,,,,,,,Doxepin 25 MG CAPSULE,$11.48,$7.91,$4.32,$10.22,$4.71,$11.14,$4.71,$4.71,$10.05,$9.76,$4.71,$10.68,$4.71,$10.91,$4.71,$4.71,$10.91
2523043,0250,,,,,,,,Doxepin 50 MG CAP,$20.73,$14.27,$7.80,$18.46,$8.50,$20.11,$8.50,$8.50,$18.14,$17.62,$8.50,$19.28,$8.50,$19.69,$8.50,$8.50,$19.69
2508890,0259,,,,,,,,Doxycycline 100 MG TAB,$5.01,$3.45,$1.89,$4.46,$2.05,$4.86,$2.05,$2.05,$4.38,$4.26,$2.05,$4.66,$2.05,$4.76,$2.05,$2.05,$4.76
2511180,0250,,,,,,,,Doxycycline 100 MG VIAL,$213.54,$147.02,$80.37,$190.14,$87.55,$207.14,$87.55,$87.55,$186.85,$181.51,$87.55,$198.60,$87.55,$202.87,$87.55,$87.55,$202.87
2508880,0259,,,,,,,,DOXYCYCLINE HYCLATE,$28.63,$19.71,$10.77,$25.49,$11.74,$27.77,$11.74,$11.74,$25.05,$24.34,$11.74,$26.63,$11.74,$27.20,$11.74,$11.74,$27.20
2523258,0250,,,,,,,,"Doxycycline Hyclate 100 MG, 2",$15.12,$10.41,$5.69,$13.46,$6.20,$14.67,$6.20,$6.20,$13.23,$12.85,$6.20,$14.06,$6.20,$14.36,$6.20,$6.20,$14.36
2523049,0250,,,,,,,,Doxycycline Monohydrate 25 MG/,$181.96,$125.27,$68.48,$162.02,$74.60,$176.50,$74.60,$74.60,$159.22,$154.67,$74.60,$169.23,$74.60,$172.86,$74.60,$74.60,$172.86
2531060,0259,,,,,,,,Dronabinol 2.5 MG CAP,$31.44,$21.65,$11.83,$27.99,$12.89,$30.50,$12.89,$12.89,$27.51,$26.72,$12.89,$29.24,$12.89,$29.87,$12.89,$12.89,$29.87
2541310,0250,,,,,,,,Dronedarone 400 MG TABLET,$160.81,$110.71,$60.52,$143.18,$65.93,$155.98,$65.93,$65.93,$140.71,$136.69,$65.93,$149.55,$65.93,$152.77,$65.93,$65.93,$152.77
2511190,0636,J1790,,,,,,,Droperidol 5 Mg/2 Ml Vial,$285.95,$196.86,$107.62,$254.61,$117.24,$277.37,$117.24,$117.24,$250.20,$243.05,$117.24,$265.93,$117.24,$271.65,$117.24,$117.24,$271.65
2535430,0250,,,,,,,,DULoxetine 20 MG CAP,$26.60,$18.32,$10.01,$23.69,$10.91,$25.81,$10.91,$10.91,$23.28,$22.61,$10.91,$24.74,$10.91,$25.27,$10.91,$10.91,$25.27
2534150,0259,,,,,,,,Duloxetine 30 Mg Cap,$3.50,$2.41,$1.32,$3.11,$1.43,$3.39,$1.43,$1.43,$3.06,$2.97,$1.43,$3.25,$1.43,$3.32,$1.43,$1.43,$3.32
2544030,0250,,,,,,,,Duovisc Viscoelastic System Ki,$870.68,$599.42,$327.68,$775.25,$356.98,$844.56,$356.98,$356.98,$761.85,$740.08,$356.98,$809.73,$356.98,$827.15,$356.98,$356.98,$827.15
2534910,0259,,,,,,,,Dutaseride 0.5 MG CAP,$4.19,$2.89,$1.58,$3.73,$1.72,$4.07,$1.72,$1.72,$3.67,$3.57,$1.72,$3.90,$1.72,$3.98,$1.72,$1.72,$3.98
2517140,0259,,,,,,,,D-Xylose 25 GM JAR,$35.46,$24.41,$13.35,$31.57,$14.54,$34.40,$14.54,$14.54,$31.03,$30.14,$14.54,$32.98,$14.54,$33.69,$14.54,$14.54,$33.69
2583400,0636,J1300,,,,,,,ECULIZUMAB 300 MG/30 ML,"$18,618.13","$12,817.70","$7,007.01","$16,577.55","$7,633.43","$18,059.59","$7,633.43","$7,633.43","$16,290.86","$15,825.41","$7,633.43","$17,314.86","$7,633.43","$17,687.22","$7,633.43","$7,633.43","$17,687.22"
2523523,0636,J3590,,,,,,,EFGARTIGIMOD ALFA-FCAB 400MG,"$13,655.63","$9,401.25","$5,139.35","$12,158.95","$5,598.81","$13,245.96","$5,598.81","$5,598.81","$11,948.68","$11,607.28","$5,598.81","$12,699.73","$5,598.81","$12,972.85","$5,598.81","$5,598.81","$12,972.85"
2583490,0250,,,,,,,,EHACRYNIC ACID 25 MG TAB,$41.92,$28.86,$15.78,$37.33,$17.19,$40.66,$17.19,$17.19,$36.68,$35.63,$17.19,$38.99,$17.19,$39.82,$17.19,$17.19,$39.82
2516750,0250,,,,,,,,"Electrolyte SOLUTION,INJ 20 ML",$154.57,$106.42,$58.17,$137.63,$63.38,$149.94,$63.38,$63.38,$135.25,$131.39,$63.38,$143.75,$63.38,$146.85,$63.38,$63.38,$146.85
2536690,0250,,,,,,,,"Electrolyte SOLUTION,ORAL 1000",$77.94,$53.66,$29.33,$69.39,$31.95,$75.60,$31.95,$31.95,$68.19,$66.25,$31.95,$72.48,$31.95,$74.04,$31.95,$31.95,$74.04
2532280,0259,,,,,,,,Electrolyte-FREEZER POP,$6.46,$4.45,$2.43,$5.75,$2.65,$6.27,$2.65,$2.65,$5.65,$5.49,$2.65,$6.01,$2.65,$6.14,$2.65,$2.65,$6.14
2583500,0250,,,,,,,,EMPAGLIFOZIN 10 MG TAB,$164.48,$113.24,$61.90,$146.45,$67.44,$159.54,$67.44,$67.44,$143.92,$139.81,$67.44,$152.96,$67.44,$156.25,$67.44,$67.44,$156.25
2523501,0250,,,,,,,,EMPAGLIFOZIN 25 MG TAB,$164.53,$113.27,$61.92,$146.50,$67.46,$159.60,$67.46,$67.46,$143.97,$139.85,$67.46,$153.01,$67.46,$156.31,$67.46,$67.46,$156.31
2523216,0250,,,,,,,,EMPTY EVAC CONTAINER 150ML BAG,$101.48,$69.86,$38.19,$90.36,$41.61,$98.43,$41.61,$41.61,$88.79,$86.26,$41.61,$94.37,$41.61,$96.40,$41.61,$41.61,$96.40
2532720,0250,,,,,,,,Empty Evacuated Container 1000,$191.92,$132.13,$72.23,$170.88,$78.69,$186.16,$78.69,$78.69,$167.93,$163.13,$78.69,$178.49,$78.69,$182.32,$78.69,$78.69,$182.32
2532730,0250,,,,,,,,Empty Evacuated Container 10ML,$21.16,$14.57,$7.96,$18.84,$8.67,$20.52,$8.67,$8.67,$18.51,$17.98,$8.67,$19.68,$8.67,$20.10,$8.67,$8.67,$20.10
2533400,0250,,,,,,,,Empty Evacuated Container 250,$107.00,$73.67,$40.27,$95.27,$43.87,$103.79,$43.87,$43.87,$93.63,$90.95,$43.87,$99.51,$43.87,$101.65,$43.87,$43.87,$101.65
2532710,0250,,,,,,,,Empty Evacuated Container 500M,$157.76,$108.61,$59.37,$140.47,$64.68,$153.02,$64.68,$64.68,$138.04,$134.09,$64.68,$146.71,$64.68,$149.87,$64.68,$64.68,$149.87
2523088,0250,,,,,,,,Emtricitabine/Tenofovir 200mg,$17.99,$12.38,$6.77,$16.01,$7.37,$17.45,$7.37,$7.37,$15.74,$15.29,$7.37,$16.73,$7.37,$17.09,$7.37,$7.37,$17.09
2508830,0259,,,,,,,,Enalapril 5 MG TAB,$8.80,$6.06,$3.31,$7.84,$3.61,$8.54,$3.61,$3.61,$7.70,$7.48,$3.61,$8.19,$3.61,$8.36,$3.61,$3.61,$8.36
2511210,0250,,,,,,,,Enalaprilat 2.5 MG/2 ML VIAL,$162.16,$111.64,$61.03,$144.38,$66.48,$157.29,$66.48,$66.48,$141.89,$137.83,$66.48,$150.81,$66.48,$154.05,$66.48,$66.48,$154.05
2522939,0250,,,,,,,,Endoscopic Marker 5 ML SYR,$394.93,$271.89,$148.63,$351.64,$161.92,$383.08,$161.92,$161.92,$345.56,$335.69,$161.92,$367.28,$161.92,$375.18,$161.92,$161.92,$375.18
2529400,0259,,,,,,,,ENERGIX-B 20 MCG/ML SYRINGE,$445.96,$307.02,$167.84,$397.08,$182.84,$432.58,$182.84,$182.84,$390.21,$379.06,$182.84,$414.74,$182.84,$423.66,$182.84,$182.84,$423.66
2522540,0636,,,,,,,,Enoxaparin 100 Mg/Ml Syr,$154.64,$106.46,$58.20,$137.69,$63.40,$150.00,$63.40,$63.40,$135.31,$131.44,$63.40,$143.82,$63.40,$146.91,$63.40,$63.40,$146.91
2529090,0636,J1650,,,,,,,Enoxaparin 120 MG/0.8 ML SYR,$164.05,$112.94,$61.74,$146.07,$67.26,$159.13,$67.26,$67.26,$143.55,$139.44,$67.26,$152.57,$67.26,$155.85,$67.26,$67.26,$155.85
2529100,0636,J1650,,,,,,,Enoxaparin 150 MG/ML SYR,$168.06,$115.70,$63.25,$149.64,$68.91,$163.02,$68.91,$68.91,$147.05,$142.85,$68.91,$156.30,$68.91,$159.66,$68.91,$68.91,$159.66
2511220,0636,J1650,,,,,,,Enoxaparin 30 MG/0.3 ML SYR,$101.19,$69.67,$38.08,$90.10,$41.49,$98.16,$41.49,$41.49,$88.55,$86.02,$41.49,$94.11,$41.49,$96.13,$41.49,$41.49,$96.13
2522510,0636,J1650,,,,,,,Enoxaparin 40 Mg/0.4 Ml Syr,$66.87,$46.04,$25.17,$59.54,$27.42,$64.86,$27.42,$27.42,$58.51,$56.84,$27.42,$62.19,$27.42,$63.52,$27.42,$27.42,$63.52
2522520,0636,J1650,,,,,,,Enoxaparin 60 MG/0.6 ML SYR,$85.09,$58.58,$32.03,$75.77,$34.89,$82.54,$34.89,$34.89,$74.46,$72.33,$34.89,$79.14,$34.89,$80.84,$34.89,$34.89,$80.84
2522530,0636,J1650,,,,,,,Enoxaparin 80 MG/0.8 ML SYR,$107.34,$73.90,$40.40,$95.57,$44.01,$104.12,$44.01,$44.01,$93.92,$91.24,$44.01,$99.82,$44.01,$101.97,$44.01,$44.01,$101.97
2583040,0250,,,,,,,,ePHEDrine 25 MG/5 ML Syringe,$206.06,$141.86,$77.55,$183.48,$84.48,$199.88,$84.48,$84.48,$180.30,$175.15,$84.48,$191.64,$84.48,$195.76,$84.48,$84.48,$195.76
2511230,0250,,,,,,,,ePHEDrine 50 MG/ML AMP,$200.46,$138.01,$75.44,$178.49,$82.19,$194.45,$82.19,$82.19,$175.40,$170.39,$82.19,$186.43,$82.19,$190.44,$82.19,$82.19,$190.44
2523149,0250,,,,,,,,ePHEDrine 50 MG/ML AMP,$386.42,$266.03,$145.43,$344.07,$158.43,$374.83,$158.43,$158.43,$338.12,$328.46,$158.43,$359.37,$158.43,$367.10,$158.43,$158.43,$367.10
2522030,0636,J0170,,,,,,,Epinephrine 0.3 Mg/Syr Kit,$556.67,$383.24,$209.51,$495.66,$228.24,$539.97,$228.24,$228.24,$487.09,$473.17,$228.24,$517.71,$228.24,$528.84,$228.24,$228.24,$528.84
2511260,0250,,,,,,,,Epinephrine 1 Mg/10 Ml Syr,$188.44,$129.74,$70.92,$167.79,$77.26,$182.79,$77.26,$77.26,$164.89,$160.18,$77.26,$175.25,$77.26,$179.02,$77.26,$77.26,$179.02
2509630,0636,J0170,,,,,,,Epinephrine 1 Mg/Ml Amp,$113.45,$78.11,$42.70,$101.02,$46.51,$110.05,$46.51,$46.51,$99.27,$96.43,$46.51,$105.51,$46.51,$107.78,$46.51,$46.51,$107.78
2511250,0636,J0170,,,,,,,Epinephrine 1 Mg/Ml Amp,$194.47,$133.88,$73.19,$173.15,$79.73,$188.63,$79.73,$79.73,$170.16,$165.30,$79.73,$180.86,$79.73,$184.75,$79.73,$79.73,$184.75
2523559,0250,,,,,,,,EPINEPHRINE 10MG/10ML VIAL,$140.63,$96.82,$52.93,$125.22,$57.66,$136.41,$57.66,$57.66,$123.05,$119.54,$57.66,$130.79,$57.66,$133.60,$57.66,$57.66,$133.60
2523558,0250,,,,,,,,EPINEPHRINE 1MG/10ML VIAL,$124.24,$85.53,$46.76,$110.62,$50.94,$120.51,$50.94,$50.94,$108.71,$105.60,$50.94,$115.54,$50.94,$118.02,$50.94,$50.94,$118.02
2537620,0250,,,,,,,,ePINEPHrine 30 MG/30 ML VIAL,$146.15,$100.62,$55.01,$130.14,$59.92,$141.77,$59.92,$59.92,$127.88,$124.23,$59.92,$135.92,$59.92,$138.85,$59.92,$59.92,$138.85
2529530,0259,,,,,,,,ePINEPHrine for Inhalation 0.5,$27.94,$19.24,$10.52,$24.88,$11.46,$27.10,$11.46,$11.46,$24.45,$23.75,$11.46,$25.99,$11.46,$26.55,$11.46,$11.46,$26.55
2521410,0636,J0170,,,,,,,Epipen Jr,$558.58,$384.56,$210.22,$497.36,$229.02,$541.82,$229.02,$229.02,$488.76,$474.79,$229.02,$519.48,$229.02,$530.65,$229.02,$229.02,$530.65
2517190,0259,,,,,,,,Epsom Salt 454 G JAR,$37.74,$25.98,$14.20,$33.60,$15.47,$36.60,$15.47,$15.47,$33.02,$32.08,$15.47,$35.10,$15.47,$35.85,$15.47,$15.47,$35.85
2523573,0250,,,,,,,,Eptinezumab-Jjmr 100mg/Ml Vial,"$4,252.89","$2,927.91","$1,600.59","$3,786.76","$1,743.68","$4,125.30","$1,743.68","$1,743.68","$3,721.28","$3,614.95","$1,743.68","$3,955.18","$1,743.68","$4,040.24","$1,743.68","$1,743.68","$4,040.24"
2502420,0259,,,,,,,,Ergocalciferol 50000 UNITS CAP,$3.46,$2.39,$1.30,$3.08,$1.42,$3.36,$1.42,$1.42,$3.03,$2.94,$1.42,$3.22,$1.42,$3.29,$1.42,$1.42,$3.29
2516740,0259,,,,,,,,Ergocalciferol 8000 UNITS/ML B,$510.49,$351.45,$192.13,$454.54,$209.30,$495.18,$209.30,$209.30,$446.68,$433.92,$209.30,$474.76,$209.30,$484.97,$209.30,$209.30,$484.97
2535900,0636,J1335,,,,,,,Ertapenem 1 GM VIAL,$342.22,$235.61,$128.80,$304.72,$140.31,$331.96,$140.31,$140.31,$299.45,$290.89,$140.31,$318.27,$140.31,$325.11,$140.31,$140.31,$325.11
2511320,0636,J1364,,,,,,,Erythromycin 500 Mg Vial,$659.28,$453.89,$248.12,$587.02,$270.31,$639.50,$270.31,$270.31,$576.87,$560.39,$270.31,$613.13,$270.31,$626.32,$270.31,$270.31,$626.32
2527410,0259,,,,,,,,Erythromycin Ophth Oint 1 GM T,$98.83,$68.04,$37.20,$88.00,$40.52,$95.87,$40.52,$40.52,$86.48,$84.01,$40.52,$91.91,$40.52,$93.89,$40.52,$40.52,$93.89
2516160,0259,,,,,,,,Erythromycin Ophth Oint 3.5 GM,$173.89,$119.72,$65.44,$154.83,$71.29,$168.67,$71.29,$71.29,$152.15,$147.81,$71.29,$161.72,$71.29,$165.20,$71.29,$71.29,$165.20
2530440,0259,,,,,,,,Escitalopram 10 MG TAB,$2.53,$1.74,$0.95,$2.25,$1.04,$2.45,$1.04,$1.04,$2.21,$2.15,$1.04,$2.35,$1.04,$2.40,$1.04,$1.04,$2.40
2531490,0259,,,,,,,,Escitalopram 20 MG TAB,$3.28,$2.26,$1.23,$2.92,$1.34,$3.18,$1.34,$1.34,$2.87,$2.79,$1.34,$3.05,$1.34,$3.12,$1.34,$1.34,$3.12
2524370,0250,,,,,,,,Esmolol 100 MG/10 ML VIAL,$92.21,$63.48,$34.70,$82.10,$37.80,$89.44,$37.80,$37.80,$80.68,$78.38,$37.80,$85.75,$37.80,$87.60,$37.80,$37.80,$87.60
2538810,0250,,,,,,,,Esmolol 2500 Mg/250 Ml Bag,$510.92,$351.74,$192.29,$454.92,$209.48,$495.59,$209.48,$209.48,$447.05,$434.28,$209.48,$475.15,$209.48,$485.37,$209.48,$209.48,$485.37
2529680,0259,,,,,,,,Esomeprazole 20 MG CAPCR,$8.40,$5.78,$3.16,$7.48,$3.44,$8.15,$3.44,$3.44,$7.35,$7.14,$3.44,$7.81,$3.44,$7.98,$3.44,$3.44,$7.98
2544080,0250,,,,,,,,ESOMEPRAZOLE 20MG VIAL,$139.74,$96.20,$52.59,$124.42,$57.29,$135.55,$57.29,$57.29,$122.27,$118.78,$57.29,$129.96,$57.29,$132.75,$57.29,$57.29,$132.75
2528460,0259,,,,,,,,Esomeprazole 40 MG CAPCR,$11.04,$7.60,$4.15,$9.83,$4.52,$10.70,$4.52,$4.52,$9.66,$9.38,$4.52,$10.26,$4.52,$10.48,$4.52,$4.52,$10.48
2523336,0250,,,,,,,,ESOMEPRAZOLE ORAL SUSPEN 40MG,$160.50,$110.50,$60.41,$142.91,$65.81,$155.69,$65.81,$65.81,$140.44,$136.43,$65.81,$149.27,$65.81,$152.48,$65.81,$65.81,$152.48
2504040,0259,,,,,,,,Estradiol 0.5 MG TAB,$1.31,$0.90,$0.49,$1.16,$0.54,$1.27,$0.54,$0.54,$1.14,$1.11,$0.54,$1.22,$0.54,$1.24,$0.54,$0.54,$1.24
2504050,0259,,,,,,,,Estradiol 1 MG TAB,$1.42,$0.98,$0.53,$1.26,$0.58,$1.37,$0.58,$0.58,$1.24,$1.20,$0.58,$1.32,$0.58,$1.35,$0.58,$0.58,$1.35
2511370,0636,J1410,,,,,,,"Estrogens, Conjugated 25 Mg Vi","$1,184.07",$815.18,$445.63,"$1,054.29",$485.47,"$1,148.55",$485.47,$485.47,"$1,036.06","$1,006.46",$485.47,"$1,101.18",$485.47,"$1,124.87",$485.47,$485.47,"$1,124.87"
2520630,0259,,,,,,,,"Estrogens, conjugated 42.5 GM","$1,365.20",$939.88,$513.80,"$1,215.57",$559.73,"$1,324.25",$559.73,$559.73,"$1,194.55","$1,160.42",$559.73,"$1,269.64",$559.73,"$1,296.94",$559.73,$559.73,"$1,296.94"
2534470,0259,,,,,,,,Eszopiclone 2 MG TAB,$5.66,$3.90,$2.13,$5.04,$2.32,$5.49,$2.32,$2.32,$4.96,$4.82,$2.32,$5.27,$2.32,$5.38,$2.32,$2.32,$5.38
2534410,0259,,,,,,,,Eszopiclone 3 MG TAB,$4.24,$2.92,$1.59,$3.77,$1.74,$4.11,$1.74,$1.74,$3.71,$3.60,$1.74,$3.94,$1.74,$4.03,$1.74,$1.74,$4.03
2534790,0259,,,,,,,,Etanercept 50 MG SYR,"$2,571.60","$1,770.43",$967.83,"$2,289.75","$1,054.36","$2,494.46","$1,054.36","$1,054.36","$2,250.15","$2,185.86","$1,054.36","$2,391.59","$1,054.36","$2,443.02","$1,054.36","$1,054.36","$2,443.02"
2523462,0250,,,,,,,,ETESEVIMAB 700 MG/20 ML VIAL,$43.58,$30.00,$16.40,$38.80,$17.87,$42.27,$17.87,$17.87,$38.13,$37.04,$17.87,$40.53,$17.87,$41.40,$17.87,$17.87,$41.40
2516200,0259,,,,,,,,Ethyl Chloride 120 ML BTL,$267.40,$184.10,$100.64,$238.10,$109.64,$259.38,$109.64,$109.64,$233.98,$227.29,$109.64,$248.69,$109.64,$254.03,$109.64,$109.64,$254.03
2524310,0250,,,,,,,,Etomidate 20 Mg/10 Ml Vial,$97.73,$67.28,$36.78,$87.02,$40.07,$94.80,$40.07,$40.07,$85.51,$83.07,$40.07,$90.89,$40.07,$92.84,$40.07,$40.07,$92.84
2523565,0250,,,,,,,,ETOMIDATE 40MG/20 ML VIAL,$119.29,$82.13,$44.90,$106.22,$48.91,$115.71,$48.91,$48.91,$104.38,$101.40,$48.91,$110.94,$48.91,$113.32,$48.91,$48.91,$113.32
2523242,0250,,,,,,,,ETONOGESTREL 68 MG IMPLANT,"$2,484.76","$1,710.64",$935.15,"$2,212.42","$1,018.75","$2,410.22","$1,018.75","$1,018.75","$2,174.16","$2,112.04","$1,018.75","$2,310.82","$1,018.75","$2,360.52","$1,018.75","$1,018.75","$2,360.52"
2517270,0259,,,,,,,,Eucerin 120 GM JAR,$122.59,$84.40,$46.14,$109.15,$50.26,$118.91,$50.26,$50.26,$107.27,$104.20,$50.26,$114.01,$50.26,$116.46,$50.26,$50.26,$116.46
2531020,0259,,,,,,,,Ezetimibe 10 MG TAB,$3.36,$2.31,$1.26,$2.99,$1.38,$3.25,$1.38,$1.38,$2.94,$2.85,$1.38,$3.12,$1.38,$3.19,$1.38,$1.38,$3.19
2523365,0250,,,,,,,,"FACTOR XA,INACT-ZHZO 200MG VIA","$7,685.55","$5,291.14","$2,892.49","$6,843.20","$3,151.08","$7,454.99","$3,151.08","$3,151.08","$6,724.86","$6,532.72","$3,151.08","$7,147.56","$3,151.08","$7,301.28","$3,151.08","$3,151.08","$7,301.28"
2504100,0259,,,,,,,,Famciclovir 500 MG TAB,$13.51,$9.30,$5.08,$12.03,$5.54,$13.10,$5.54,$5.54,$11.82,$11.48,$5.54,$12.56,$5.54,$12.83,$5.54,$5.54,$12.83
2506740,0259,,,,,,,,Famotidine 20 MG TAB,$1.59,$1.10,$0.60,$1.42,$0.65,$1.54,$0.65,$0.65,$1.39,$1.35,$0.65,$1.48,$0.65,$1.51,$0.65,$0.65,$1.51
2527610,0250,,,,,,,,Famotidine 20 MG/2 ML VIAL,$58.69,$40.40,$22.09,$52.25,$24.06,$56.93,$24.06,$24.06,$51.35,$49.88,$24.06,$54.58,$24.06,$55.75,$24.06,$24.06,$55.75
2516250,0250,,,,,,,,Famotidine 20 MG/50 ML BAG,$71.56,$49.27,$26.93,$63.72,$29.34,$69.42,$29.34,$29.34,$62.62,$60.83,$29.34,$66.55,$29.34,$67.98,$29.34,$29.34,$67.98
2522894,0250,,,,,,,,Famotidine 40 MG/5 ML ML,$279.26,$192.26,$105.10,$248.65,$114.50,$270.88,$114.50,$114.50,$244.35,$237.37,$114.50,$259.71,$114.50,$265.29,$114.50,$114.50,$265.29
2523515,0250,,,,,,,,FAT EMULSION 10 GM/100 ML 20%,$246.05,$169.40,$92.60,$219.08,$100.88,$238.67,$100.88,$100.88,$215.30,$209.14,$100.88,$228.83,$100.88,$233.75,$100.88,$100.88,$233.75
2523488,0250,,,,,,,,FAT EMULSION 20 GM/100 ML 20%,$168.41,$115.94,$63.38,$149.95,$69.05,$163.36,$69.05,$69.05,$147.36,$143.15,$69.05,$156.62,$69.05,$159.99,$69.05,$69.05,$159.99
2523487,0250,,,,,,,,FAT EMULSION 50 GM/250 ML 20%,$165.00,$113.60,$62.10,$146.92,$67.65,$160.05,$67.65,$67.65,$144.38,$140.25,$67.65,$153.45,$67.65,$156.75,$67.65,$67.65,$156.75
2519240,0250,,,,,,,,Fat Emulsions 20% 250 Ml Btl,$169.49,$116.69,$63.79,$150.91,$69.49,$164.40,$69.49,$69.49,$148.30,$144.07,$69.49,$157.62,$69.49,$161.01,$69.49,$69.49,$161.01
2504120,0259,,,,,,,,Felbamate 600 MG TAB,$97.90,$67.40,$36.85,$87.17,$40.14,$94.97,$40.14,$40.14,$85.67,$83.22,$40.14,$91.05,$40.14,$93.01,$40.14,$40.14,$93.01
2522895,0250,,,,,,,,Felodipine 2.5 MG TABCR,$7.06,$4.86,$2.66,$6.29,$2.89,$6.85,$2.89,$2.89,$6.18,$6.00,$2.89,$6.57,$2.89,$6.71,$2.89,$2.89,$6.71
2534850,0250,,,,,,,,"Fenofibrate, Micronized 145 MG",$15.07,$10.37,$5.67,$13.42,$6.18,$14.61,$6.18,$6.18,$13.18,$12.81,$6.18,$14.01,$6.18,$14.31,$6.18,$6.18,$14.31
2535850,0250,,,,,,,,"Fenofibrate, Micronized 48 MG",$4.13,$2.84,$1.55,$3.68,$1.69,$4.00,$1.69,$1.69,$3.61,$3.51,$1.69,$3.84,$1.69,$3.92,$1.69,$1.69,$3.92
2519640,0259,,,,,,,,Fentanyl 100 Mcg Patch,$173.89,$119.72,$65.44,$154.83,$71.29,$168.67,$71.29,$71.29,$152.15,$147.81,$71.29,$161.72,$71.29,$165.20,$71.29,$71.29,$165.20
2536490,0636,J3010,,,,,,,fentaNYL 100 MCG/2 ML VIAL,$56.31,$38.77,$21.19,$50.14,$23.09,$54.62,$23.09,$23.09,$49.27,$47.86,$23.09,$52.37,$23.09,$53.50,$23.09,$23.09,$53.50
2538620,0636,J3010,,,,,,,fentaNYL 1000 MCG/20 ML VIAL,$52.60,$36.21,$19.79,$46.83,$21.56,$51.02,$21.56,$21.56,$46.02,$44.71,$21.56,$48.91,$21.56,$49.97,$21.56,$21.56,$49.97
2536760,0250,,,,,,,,fentaNYL 12 MCG PATCH,$67.12,$46.21,$25.26,$59.76,$27.52,$65.10,$27.52,$27.52,$58.73,$57.05,$27.52,$62.42,$27.52,$63.76,$27.52,$27.52,$63.76
2519610,0259,,,,,,,,fentaNYL 25 MCG PATCH,$41.83,$28.80,$15.74,$37.25,$17.15,$40.58,$17.15,$17.15,$36.60,$35.56,$17.15,$38.90,$17.15,$39.74,$17.15,$17.15,$39.74
2536540,0636,J3010,,,,,,,fentaNYL 250 MCG/5 ML VIAL,$97.32,$67.00,$36.63,$86.65,$39.90,$94.40,$39.90,$39.90,$85.15,$82.72,$39.90,$90.50,$39.90,$92.45,$39.90,$39.90,$92.45
2522947,0250,,,,,,,,fentaNYL 2500 MCG/50 ML DEVI,$377.26,$259.73,$141.98,$335.91,$154.68,$365.94,$154.68,$154.68,$330.10,$320.67,$154.68,$350.85,$154.68,$358.40,$154.68,$154.68,$358.40
2523568,0250,,,,,,,,Fentanyl 2500mcg/50ml Vial,$372.72,$256.60,$140.27,$331.87,$152.81,$361.53,$152.81,$152.81,$326.13,$316.81,$152.81,$346.63,$152.81,$354.08,$152.81,$152.81,$354.08
2519620,0259,,,,,,,,Fentanyl 50 Mcg Patch,$122.83,$84.56,$46.23,$109.37,$50.36,$119.14,$50.36,$50.36,$107.48,$104.41,$50.36,$114.23,$50.36,$116.69,$50.36,$50.36,$116.69
2523009,0250,,,,,,,,FentaNYL 500 MCG/10 ML VIAL,$86.84,$59.78,$32.68,$77.32,$35.60,$84.23,$35.60,$35.60,$75.98,$73.81,$35.60,$80.76,$35.60,$82.49,$35.60,$35.60,$82.49
2519630,0259,,,,,,,,Fentanyl 75 Mcg Patch,$187.89,$129.35,$70.71,$167.30,$77.03,$182.25,$77.03,$77.03,$164.40,$159.71,$77.03,$174.74,$77.03,$178.49,$77.03,$77.03,$178.49
2523096,0250,,,,,,,,FentaNYL/BUPIvacaine 2 mcg/ml,$374.76,$258.01,$141.04,$333.69,$153.65,$363.52,$153.65,$153.65,$327.92,$318.55,$153.65,$348.53,$153.65,$356.03,$153.65,$153.65,$356.03
2523097,0250,,,,,,,,FentaNYL/BUPIvacaine 4 mcg/ml,$374.76,$258.01,$141.04,$333.69,$153.65,$363.52,$153.65,$153.65,$327.92,$318.55,$153.65,$348.53,$153.65,$356.03,$153.65,$153.65,$356.03
2523305,0250,,,,,,,,Fentanyl/Ropivacaine 2 Mcg/Ml,$631.99,$435.10,$237.85,$562.73,$259.12,$613.03,$259.12,$259.12,$552.99,$537.19,$259.12,$587.75,$259.12,$600.39,$259.12,$259.12,$600.39
2523458,0250,,,,,,,,FERRIC CARBOXYMALTOSE 750MG/15,"$2,569.57","$1,769.03",$967.07,"$2,287.94","$1,053.52","$2,492.48","$1,053.52","$1,053.52","$2,248.37","$2,184.13","$1,053.52","$2,389.70","$1,053.52","$2,441.09","$1,053.52","$1,053.52","$2,441.09"
2523564,0636,J1437,,,,,,,FERRIC DERISOMALTOSE 1000MG/10,"$5,860.24","$4,034.50","$2,205.53","$5,217.95","$2,402.70","$5,684.43","$2,402.70","$2,402.70","$5,127.71","$4,981.21","$2,402.70","$5,450.03","$2,402.70","$5,567.23","$2,402.70","$2,402.70","$5,567.23"
2504150,0259,,,,,,,,Ferrous Gluconate 324 MG TAB,$1.23,$0.85,$0.46,$1.10,$0.50,$1.19,$0.50,$0.50,$1.08,$1.05,$0.50,$1.14,$0.50,$1.17,$0.50,$0.50,$1.17
2507960,0259,,,,,,,,Ferrous Sulfate 142 MG TABCR,$3.06,$2.11,$1.15,$2.73,$1.26,$2.97,$1.26,$1.26,$2.68,$2.60,$1.26,$2.85,$1.26,$2.91,$1.26,$1.26,$2.91
2511400,0259,,,,,,,,Ferrous Sulfate 220 MG/5 ML,$0.17,$0.12,$0.07,$0.16,$0.07,$0.17,$0.07,$0.07,$0.15,$0.15,$0.07,$0.16,$0.07,$0.17,$0.07,$0.07,$0.17
2504170,0259,,,,,,,,Ferrous Sulfate 325 MG TAB,$0.46,$0.32,$0.17,$0.41,$0.19,$0.44,$0.19,$0.19,$0.40,$0.39,$0.19,$0.43,$0.19,$0.43,$0.19,$0.19,$0.43
2516210,0259,,,,,,,,Ferrous Sulfate 75 MG/0.6 ML,$48.91,$33.68,$18.41,$43.55,$20.05,$47.45,$20.05,$20.05,$42.80,$41.58,$20.05,$45.49,$20.05,$46.47,$20.05,$20.05,$46.47
2523542,0250,,,,,,,,FERUMOXYTOL 510 MG/17 ML VIAL,$827.17,$569.47,$311.31,$736.51,$339.14,$802.36,$339.14,$339.14,$723.77,$703.09,$339.14,$769.27,$339.14,$785.81,$339.14,$339.14,$785.81
2525520,0259,,,,,,,,Fexofenadine 180 MG TAB,$6.55,$4.51,$2.46,$5.83,$2.68,$6.35,$2.68,$2.68,$5.73,$5.57,$2.68,$6.09,$2.68,$6.22,$2.68,$2.68,$6.22
2523320,0259,,,,,,,,Fidaxomicin 200 MG TAB,$779.25,$536.48,$293.27,$693.84,$319.49,$755.87,$319.49,$319.49,$681.84,$662.36,$319.49,$724.70,$319.49,$740.29,$319.49,$319.49,$740.29
2523098,0250,,,,,,,,Filgrastim 300 MCG/0.5 ML SYR,"$1,075.01",$740.09,$404.58,$957.19,$440.75,"$1,042.76",$440.75,$440.75,$940.63,$913.76,$440.75,$999.76,$440.75,"$1,021.26",$440.75,$440.75,"$1,021.26"
2523077,0250,,,,,,,,Filgrastim 480 MCG/0.8 ML SYR,"$1,471.45","$1,013.03",$553.79,"$1,310.18",$603.30,"$1,427.31",$603.30,$603.30,"$1,287.52","$1,250.73",$603.30,"$1,368.45",$603.30,"$1,397.88",$603.30,$603.30,"$1,397.88"
2523282,0636,96372,,,,,,,Filgrastim-Sndz 300 Mcg/0.5 Ml,$596.13,$410.41,$224.36,$530.79,$244.41,$578.25,$244.41,$244.41,$521.61,$506.71,$244.41,$554.40,$244.41,$566.32,$244.41,$244.41,$566.32
2523356,0250,,,,,,,,FILGRASTIM-SNDZ 4880 MCG/.8ML,$581.58,$400.39,$218.88,$517.83,$238.45,$564.13,$238.45,$238.45,$508.88,$494.34,$238.45,$540.87,$238.45,$552.50,$238.45,$238.45,$552.50
2507250,0259,,,,,,,,Finasteride 5 MG TAB,$12.57,$8.66,$4.73,$11.19,$5.15,$12.19,$5.15,$5.15,$11.00,$10.69,$5.15,$11.69,$5.15,$11.94,$5.15,$5.15,$11.94
2511070,0259,,,,,,,,Flavored Diluent 500 ML,$0.53,$0.37,$0.20,$0.48,$0.22,$0.52,$0.22,$0.22,$0.47,$0.45,$0.22,$0.50,$0.22,$0.51,$0.22,$0.22,$0.51
2522896,0250,,,,,,,,Flavoxate 100 MG TABLET,$21.95,$15.11,$8.26,$19.55,$9.00,$21.29,$9.00,$9.00,$19.21,$18.66,$9.00,$20.41,$9.00,$20.85,$9.00,$9.00,$20.85
2508170,0259,,,,,,,,Flecainide 100 MG TAB,$13.16,$9.06,$4.95,$11.72,$5.40,$12.77,$5.40,$5.40,$11.51,$11.19,$5.40,$12.24,$5.40,$12.50,$5.40,$5.40,$12.50
2523478,0636,90686,,,,,,,FLU VACCIN QS 2021-22(6MOS UP),$38.13,$26.25,$14.35,$33.95,$15.63,$36.99,$15.63,$15.63,$33.36,$32.41,$15.63,$35.46,$15.63,$36.22,$15.63,$15.63,$36.22
2523424,0636,90682,,,,,,,FLU VACCINE QS 2020-21 18YR UP,$80.62,$55.50,$30.34,$71.78,$33.05,$78.20,$33.05,$33.05,$70.54,$68.52,$33.05,$74.97,$33.05,$76.58,$33.05,$33.05,$76.58
2523426,0636,90756,,,,,,,FLU VACCINE QS 2020-21 4YR UP,$38.13,$26.25,$14.35,$33.95,$15.63,$36.99,$15.63,$15.63,$33.36,$32.41,$15.63,$35.46,$15.63,$36.22,$15.63,$15.63,$36.22
2523428,0636,90662,,,,,,,FLU VACCINE QS 2020-21 65YR UP,$77.35,$53.25,$29.11,$68.87,$31.71,$75.03,$31.71,$31.71,$67.68,$65.75,$31.71,$71.93,$31.71,$73.48,$31.71,$31.71,$73.48
2523425,0636,90686,,,,,,,FLU VACCINE QS 2020-21 6MOS UP,$38.13,$26.25,$14.35,$33.95,$15.63,$36.99,$15.63,$15.63,$33.36,$32.41,$15.63,$35.46,$15.63,$36.22,$15.63,$15.63,$36.22
2523427,0636,90686,,,,,,,FLU VACCINE QS 2020-21 6MOS UP,$38.13,$26.25,$14.35,$33.95,$15.63,$36.99,$15.63,$15.63,$33.36,$32.41,$15.63,$35.46,$15.63,$36.22,$15.63,$15.63,$36.22
2523489,0636,90682,,,,,,,FLU VACCINE QS 2021-22(18 UP),$80.62,$55.50,$30.34,$71.78,$33.05,$78.20,$33.05,$33.05,$70.54,$68.52,$33.05,$74.97,$33.05,$76.58,$33.05,$33.05,$76.58
2523481,0636,90756,,,,,,,FLU VACCINE QS 2021-22(2YR UP),$38.13,$26.25,$14.35,$33.95,$15.63,$36.99,$15.63,$15.63,$33.36,$32.41,$15.63,$35.46,$15.63,$36.22,$15.63,$15.63,$36.22
2583550,0636,90686,,,,,,,FLU VACCINE QS 2022-23 6MON UP,$38.13,$26.25,$14.35,$33.95,$15.63,$36.99,$15.63,$15.63,$33.36,$32.41,$15.63,$35.46,$15.63,$36.22,$15.63,$15.63,$36.22
2523552,0636,90688,,,,,,,FLU VACCINE QS 2022-23 6MON>,$38.13,$26.25,$14.35,$33.95,$15.63,$36.99,$15.63,$15.63,$33.36,$32.41,$15.63,$35.46,$15.63,$36.22,$15.63,$15.63,$36.22
2523548,0636,90686,,,,,,,FLU VACCINE QS 2022-23(6MOSUP),$38.13,$26.25,$14.35,$33.95,$15.63,$36.99,$15.63,$15.63,$33.36,$32.41,$15.63,$35.46,$15.63,$36.22,$15.63,$15.63,$36.22
2523485,0636,90662,,,,,,,FLU VACCINE QS HD 2021-22(65UP,$77.35,$53.25,$29.11,$68.87,$31.71,$75.03,$31.71,$31.71,$67.68,$65.75,$31.71,$71.93,$31.71,$73.48,$31.71,$31.71,$73.48
2523551,0636,90662,,,,,,,FLU VACCINE QS HD 2022-23 65>,$77.35,$53.25,$29.11,$68.87,$31.71,$75.03,$31.71,$31.71,$67.68,$65.75,$31.71,$71.93,$31.71,$73.48,$31.71,$31.71,$73.48
2522550,0259,,,,,,,,Fluconazole 10 MG/ML Susp,$332.52,$228.92,$125.14,$296.07,$136.33,$322.54,$136.33,$136.33,$290.95,$282.64,$136.33,$309.24,$136.33,$315.89,$136.33,$136.33,$315.89
2503530,0259,,,,,,,,Fluconazole 100 Mg Tab,$45.94,$31.63,$17.29,$40.90,$18.84,$44.56,$18.84,$18.84,$40.20,$39.05,$18.84,$42.72,$18.84,$43.64,$18.84,$18.84,$43.64
2523240,0259,,,,,,,,Fluconazole 150 MG TAB,$29.29,$20.17,$11.02,$26.08,$12.01,$28.42,$12.01,$12.01,$25.63,$24.90,$12.01,$27.24,$12.01,$27.83,$12.01,$12.01,$27.83
2519300,0636,J1450,,,,,,,Fluconazole 200 Mg/100 Ml Bag,$111.76,$76.94,$42.06,$99.51,$45.82,$108.41,$45.82,$45.82,$97.79,$95.00,$45.82,$103.94,$45.82,$106.17,$45.82,$45.82,$106.17
2504230,0259,,,,,,,,Fludrocortisone 0.1 MG TAB,$14.45,$9.95,$5.44,$12.86,$5.92,$14.01,$5.92,$5.92,$12.64,$12.28,$5.92,$13.43,$5.92,$13.72,$5.92,$5.92,$13.72
2511440,0250,,,,,,,,Flumazenil 0.5 MG/5 ML VIAL,$96.83,$66.66,$36.44,$86.21,$39.70,$93.92,$39.70,$39.70,$84.72,$82.30,$39.70,$90.05,$39.70,$91.98,$39.70,$39.70,$91.98
2516280,0259,,,,,,,,Fluocinonide 0.05% CR 15 GM TU,$159.95,$110.12,$60.20,$142.42,$65.58,$155.15,$65.58,$65.58,$139.95,$135.95,$65.58,$148.75,$65.58,$151.95,$65.58,$65.58,$151.95
2516310,0259,J9999,,,,,,,Fluocinonide/Emollient CR 15 G,$200.31,$137.90,$75.39,$178.35,$82.13,$194.30,$82.13,$82.13,$175.27,$170.26,$82.13,$186.29,$82.13,$190.29,$82.13,$82.13,$190.29
2512930,0250,,,,,,,,Fluorescein 5 ML AMP,$104.45,$71.91,$39.31,$93.00,$42.83,$101.32,$42.83,$42.83,$91.40,$88.78,$42.83,$97.14,$42.83,$99.23,$42.83,$42.83,$99.23
2532820,0250,,,,,,,,Fluorescein STRIPS 100/BOX,$3.89,$2.68,$1.46,$3.46,$1.59,$3.77,$1.59,$1.59,$3.40,$3.31,$1.59,$3.62,$1.59,$3.69,$1.59,$1.59,$3.69
2537340,0250,,,,,,,,FLUoxetine 10 MG TAB,$3.73,$2.57,$1.40,$3.32,$1.53,$3.61,$1.53,$1.53,$3.26,$3.17,$1.53,$3.46,$1.53,$3.54,$1.53,$1.53,$3.54
2507270,0259,,,,,,,,FLUoxetine 20 MG CAP,$1.71,$1.18,$0.64,$1.52,$0.70,$1.66,$0.70,$0.70,$1.50,$1.45,$0.70,$1.59,$0.70,$1.62,$0.70,$0.70,$1.62
2523308,0250,,,,,,,,FLUOXETINE 4 MG/ML SOLUTION,$7.82,$5.39,$2.94,$6.96,$3.21,$7.59,$3.21,$3.21,$6.84,$6.65,$3.21,$7.27,$3.21,$7.43,$3.21,$3.21,$7.43
2522898,0250,,,,,,,,Fluticasone 110MCG HFA 12 GM 1,$815.09,$561.15,$306.76,$725.75,$334.19,$790.64,$334.19,$334.19,$713.20,$692.83,$334.19,$758.03,$334.19,$774.33,$334.19,$334.19,$774.33
2510640,0259,,,,,,,,Fluticasone 220MCG HFA 12 GM 1,$836.10,$575.62,$314.67,$744.47,$342.80,$811.02,$342.80,$342.80,$731.59,$710.69,$342.80,$777.58,$342.80,$794.30,$342.80,$342.80,$794.30
2510260,0259,,,,,,,,Fluticasone 44MCG HFA 10.6 GM,$597.67,$411.47,$224.93,$532.16,$245.04,$579.74,$245.04,$245.04,$522.96,$508.02,$245.04,$555.83,$245.04,$567.78,$245.04,$245.04,$567.78
2519770,0259,,,,,,,,Fluticasone NASAL SPRAY 16 GM,$112.19,$77.24,$42.22,$99.89,$46.00,$108.82,$46.00,$46.00,$98.16,$95.36,$46.00,$104.33,$46.00,$106.58,$46.00,$46.00,$106.58
2538680,0250,,,,,,,,Fluticasone/Salmeterol 100/50,$540.63,$372.20,$203.47,$481.37,$221.66,$524.41,$221.66,$221.66,$473.05,$459.53,$221.66,$502.78,$221.66,$513.59,$221.66,$221.66,$513.59
2523029,0250,,,,,,,,Fluticasone/Salmeterol 115/21,$703.32,$484.20,$264.70,$626.23,$288.36,$682.22,$288.36,$288.36,$615.40,$597.82,$288.36,$654.08,$288.36,$668.15,$288.36,$288.36,$668.15
2523422,0250,,,,,,,,FLUTICASONE/SALMETEROL 115/21,"$1,280.69",$881.69,$481.99,"$1,140.32",$525.08,"$1,242.27",$525.08,$525.08,"$1,120.60","$1,088.58",$525.08,"$1,191.04",$525.08,"$1,216.65",$525.08,$525.08,"$1,216.65"
2523210,0259,,,,,,,,Fluticasone/Salmeterol 230/21,$937.92,$645.71,$352.99,$835.12,$384.55,$909.78,$384.55,$384.55,$820.68,$797.23,$384.55,$872.26,$384.55,$891.02,$384.55,$384.55,$891.02
2538660,0250,,,,,,,,Fluticasone/Salmeterol 250/50,$552.21,$380.17,$207.82,$491.68,$226.40,$535.64,$226.40,$226.40,$483.18,$469.38,$226.40,$513.55,$226.40,$524.60,$226.40,$226.40,$524.60
2538670,0250,,,,,,,,Fluticasone/Salmeterol 500/50,$802.35,$552.38,$301.97,$714.41,$328.97,$778.28,$328.97,$328.97,$702.06,$682.00,$328.97,$746.19,$328.97,$762.24,$328.97,$328.97,$762.24
2538780,0250,,,,,,,,FLUTICASONE/SALMETEROL HFA 230,"$1,616.97","$1,113.21",$608.55,"$1,439.75",$662.96,"$1,568.47",$662.96,$662.96,"$1,414.85","$1,374.43",$662.96,"$1,503.79",$662.96,"$1,536.13",$662.96,$662.96,"$1,536.13"
2523193,0250,,,,,,,,Fluticasone/Vilanterol 100-25,$497.07,$342.21,$187.07,$442.59,$203.80,$482.16,$203.80,$203.80,$434.94,$422.51,$203.80,$462.28,$203.80,$472.22,$203.80,$203.80,$472.22
2523194,0250,,,,,,,,Fluticasone/Vilanterol 200-25,$684.89,$471.52,$257.76,$609.83,$280.81,$664.35,$280.81,$280.81,$599.28,$582.16,$280.81,$636.95,$280.81,$650.65,$280.81,$280.81,$650.65
2504250,0259,,,,,,,,Folic Acid 1 MG TAB,$2.80,$1.93,$1.05,$2.49,$1.15,$2.72,$1.15,$1.15,$2.45,$2.38,$1.15,$2.60,$1.15,$2.66,$1.15,$1.15,$2.66
2511470,0250,,,,,,,,Folic Acid 50 MG/10 ML VIAL,$93.31,$64.24,$35.12,$83.08,$38.26,$90.51,$38.26,$38.26,$81.64,$79.31,$38.26,$86.78,$38.26,$88.64,$38.26,$38.26,$88.64
2523335,0636,J1451,,,,,,,FOMEPIZOLE 1.5 GM1.5 ML VIAL,"$1,743.03","$1,199.99",$656.00,"$1,551.99",$714.64,"$1,690.74",$714.64,$714.64,"$1,525.15","$1,481.57",$714.64,"$1,621.02",$714.64,"$1,655.88",$714.64,$714.64,"$1,655.88"
2530470,0636,J1652,,,,,,,Fondaparinux 2.5 MG SYR,$142.93,$98.40,$53.79,$127.26,$58.60,$138.64,$58.60,$58.60,$125.06,$121.49,$58.60,$132.92,$58.60,$135.78,$58.60,$58.60,$135.78
2543500,0250,,,,,,,,Fosfomycin Tromethamine 3 G Pa,$269.56,$185.58,$101.45,$240.02,$110.52,$261.47,$110.52,$110.52,$235.87,$229.13,$110.52,$250.69,$110.52,$256.08,$110.52,$110.52,$256.08
2505790,0259,,,,,,,,Fosinopril 20 MG TAB,$2.66,$1.83,$1.00,$2.37,$1.09,$2.58,$1.09,$1.09,$2.33,$2.26,$1.09,$2.47,$1.09,$2.53,$1.09,$1.09,$2.53
2543700,0250,,,,,,,,Fosphenytoin 500 MG/10 ML VIAL,$218.15,$150.19,$82.10,$194.24,$89.44,$211.61,$89.44,$89.44,$190.88,$185.43,$89.44,$202.88,$89.44,$207.24,$89.44,$89.44,$207.24
2511500,0636,J1940,,,,,,,Furosemide 100 MG/10 ML VIAL,$84.66,$58.28,$31.86,$75.38,$34.71,$82.12,$34.71,$34.71,$74.08,$71.96,$34.71,$78.73,$34.71,$80.42,$34.71,$34.71,$80.42
2505050,0259,,,,,,,,Furosemide 20 Mg Tab,$1.92,$1.32,$0.72,$1.71,$0.79,$1.86,$0.79,$0.79,$1.68,$1.63,$0.79,$1.78,$0.79,$1.82,$0.79,$0.79,$1.82
2511480,0636,J1940,,,,,,,Furosemide 20 Mg/2 Ml Vial,$59.98,$41.30,$22.57,$53.41,$24.59,$58.18,$24.59,$24.59,$52.48,$50.99,$24.59,$55.78,$24.59,$56.98,$24.59,$24.59,$56.98
2505030,0259,,,,,,,,Furosemide 40 MG TAB,$1.41,$0.97,$0.53,$1.25,$0.58,$1.36,$0.58,$0.58,$1.23,$1.19,$0.58,$1.31,$0.58,$1.34,$0.58,$0.58,$1.34
2511490,0636,J1940,,,,,,,Furosemide 40 Mg/4 Ml Vial,$62.03,$42.71,$23.35,$55.23,$25.43,$60.17,$25.43,$25.43,$54.28,$52.73,$25.43,$57.69,$25.43,$58.93,$25.43,$25.43,$58.93
2505040,0259,,,,,,,,Furosemide 80 MG TAB,$2.63,$1.81,$0.99,$2.34,$1.08,$2.55,$1.08,$1.08,$2.30,$2.23,$1.08,$2.44,$1.08,$2.49,$1.08,$1.08,$2.49
2506200,0259,,,,,,,,Gabapentin 100 MG CAP,$1.78,$1.22,$0.67,$1.58,$0.73,$1.72,$0.73,$0.73,$1.55,$1.51,$0.73,$1.65,$0.73,$1.69,$0.73,$0.73,$1.69
2506210,0259,,,,,,,,Gabapentin 300 Mg Cap,$0.88,$0.61,$0.33,$0.79,$0.36,$0.86,$0.36,$0.36,$0.77,$0.75,$0.36,$0.82,$0.36,$0.84,$0.36,$0.36,$0.84
2506220,0259,,,,,,,,Gabapentin 400 MG CAP,$1.76,$1.22,$0.66,$1.57,$0.72,$1.71,$0.72,$0.72,$1.54,$1.50,$0.72,$1.64,$0.72,$1.68,$0.72,$0.72,$1.68
2532830,0259,,,,,,,,Gabapentin 600 MG TAB,$11.16,$7.68,$4.20,$9.93,$4.57,$10.82,$4.57,$4.57,$9.76,$9.48,$4.57,$10.37,$4.57,$10.60,$4.57,$4.57,$10.60
2536110,0250,,,,,,,,Gabapentin 800 MG TAB,$7.72,$5.32,$2.91,$6.88,$3.17,$7.49,$3.17,$3.17,$6.76,$6.57,$3.17,$7.18,$3.17,$7.34,$3.17,$3.17,$7.34
2527810,0250,,,,,,,,Gelatin SPONGE 12-7 MM PKT,$132.80,$91.43,$49.98,$118.24,$54.45,$128.81,$54.45,$54.45,$116.20,$112.88,$54.45,$123.50,$54.45,$126.16,$54.45,$54.45,$126.16
2523516,0250,,,,,,,,Gelatin Sponge Size 50 Pkt,$270.63,$186.32,$101.85,$240.97,$110.96,$262.51,$110.96,$110.96,$236.80,$230.03,$110.96,$251.68,$110.96,$257.10,$110.96,$110.96,$257.10
2523368,0636,J9201,,,,,,,GEMCITABINE 2 GM VIAL,$366.17,$252.09,$137.81,$326.04,$150.13,$355.18,$150.13,$150.13,$320.40,$311.24,$150.13,$340.54,$150.13,$347.86,$150.13,$150.13,$347.86
2505280,0259,,,,,,,,Gemfibrozil 600 MG TAB,$2.49,$1.72,$0.94,$2.22,$1.02,$2.42,$1.02,$1.02,$2.18,$2.12,$1.02,$2.32,$1.02,$2.37,$1.02,$1.02,$2.37
2511520,0636,J1580,,,,,,,Gentamicin 20 MG/2 ML VIAL,$82.43,$56.75,$31.02,$73.40,$33.80,$79.96,$33.80,$33.80,$72.13,$70.07,$33.80,$76.66,$33.80,$78.31,$33.80,$33.80,$78.31
2511510,0636,J1580,,,,,,,Gentamicin 80 MG/2 ML VIAL,$112.10,$77.18,$42.19,$99.81,$45.96,$108.74,$45.96,$45.96,$98.09,$95.28,$45.96,$104.25,$45.96,$106.49,$45.96,$45.96,$106.49
2509810,0636,J1580,,,,,,,Gentamicin 800 MG/20 ML VIAL,$292.37,$201.29,$110.04,$260.33,$119.87,$283.60,$119.87,$119.87,$255.83,$248.52,$119.87,$271.91,$119.87,$277.75,$119.87,$119.87,$277.75
2592900,0250,,,,,,,,Gentamicin OPHTH. OINT. 3.5 GM,$300.15,$206.64,$112.96,$267.25,$123.06,$291.15,$123.06,$123.06,$262.63,$255.13,$123.06,$279.14,$123.06,$285.14,$123.06,$123.06,$285.14
2516400,0259,,,,,,,,GENTAMICIN SULFATE,$70.60,$48.61,$26.57,$62.87,$28.95,$68.49,$28.95,$28.95,$61.78,$60.01,$28.95,$65.66,$28.95,$67.07,$28.95,$28.95,$67.07
2538370,0250,,,,,,,,Glimepiride 1 MG TAB,$0.86,$0.59,$0.32,$0.77,$0.35,$0.83,$0.35,$0.35,$0.75,$0.73,$0.35,$0.80,$0.35,$0.82,$0.35,$0.35,$0.82
2522750,0259,,,,,,,,Glimepiride 2 MG TAB,$1.02,$0.71,$0.39,$0.91,$0.42,$0.99,$0.42,$0.42,$0.90,$0.87,$0.42,$0.95,$0.42,$0.97,$0.42,$0.42,$0.97
2504340,0259,,,,,,,,glipiZIDE 10 MG TAB,$0.87,$0.60,$0.33,$0.78,$0.36,$0.85,$0.36,$0.36,$0.76,$0.74,$0.36,$0.81,$0.36,$0.83,$0.36,$0.36,$0.83
2504330,0259,,,,,,,,glipiZIDE 5 MG TAB,$4.95,$3.41,$1.86,$4.40,$2.03,$4.80,$2.03,$2.03,$4.33,$4.20,$2.03,$4.60,$2.03,$4.70,$2.03,$2.03,$4.70
2522830,0259,,,,,,,,glipiZIDE C.R. 10 MG TABCR,$3.26,$2.24,$1.23,$2.90,$1.34,$3.16,$1.34,$1.34,$2.85,$2.77,$1.34,$3.03,$1.34,$3.09,$1.34,$1.34,$3.09
2526450,0259,,,,,,,,glipiZIDE C.R. 2.5 MG TABCR,$18.23,$12.55,$6.86,$16.23,$7.47,$17.68,$7.47,$7.47,$15.95,$15.49,$7.47,$16.95,$7.47,$17.31,$7.47,$7.47,$17.31
2504350,0259,,,,,,,,glipiZIDE C.R. 5 MG TABCR,$1.91,$1.31,$0.72,$1.70,$0.78,$1.85,$0.78,$0.78,$1.67,$1.62,$0.78,$1.77,$0.78,$1.81,$0.78,$0.78,$1.81
2537910,0636,J1610,,,,,,,Glucagon 1 MG KIT,$519.95,$357.96,$195.68,$462.96,$213.18,$504.35,$213.18,$213.18,$454.96,$441.96,$213.18,$483.55,$213.18,$493.95,$213.18,$213.18,$493.95
2527560,0250,,,,,,,,Glucosamine 500 MG CAP,$1.30,$0.89,$0.49,$1.15,$0.53,$1.26,$0.53,$0.53,$1.13,$1.10,$0.53,$1.21,$0.53,$1.23,$0.53,$0.53,$1.23
2527580,0250,,,,,,,,Glucosamine/Chondroitin CAP,$5.43,$3.74,$2.04,$4.83,$2.22,$5.26,$2.22,$2.22,$4.75,$4.61,$2.22,$5.05,$2.22,$5.15,$2.22,$2.22,$5.15
2520030,0259,,,,,,,,Glucose Oral Solution 15 GM/37,$61.38,$42.26,$23.10,$54.65,$25.16,$59.54,$25.16,$25.16,$53.70,$52.17,$25.16,$57.08,$25.16,$58.31,$25.16,$25.16,$58.31
2503460,0259,,,,,,,,glyBURIDE 2.5 MG TAB,$2.16,$1.49,$0.81,$1.92,$0.88,$2.09,$0.88,$0.88,$1.89,$1.83,$0.88,$2.01,$0.88,$2.05,$0.88,$0.88,$2.05
2503470,0259,,,,,,,,glyBURIDE 5 MG TAB,$3.91,$2.69,$1.47,$3.48,$1.60,$3.79,$1.60,$1.60,$3.42,$3.32,$1.60,$3.64,$1.60,$3.72,$1.60,$1.60,$3.72
2536590,0250,,,,,,,,Glycerin 120 ML BTL,$57.81,$39.80,$21.76,$51.48,$23.70,$56.08,$23.70,$23.70,$50.59,$49.14,$23.70,$53.77,$23.70,$54.92,$23.70,$23.70,$54.92
2504370,0259,,,,,,,,Glycerin Adult Suppository,$2.04,$1.40,$0.77,$1.81,$0.84,$1.98,$0.84,$0.84,$1.78,$1.73,$0.84,$1.89,$0.84,$1.94,$0.84,$0.84,$1.94
2504360,0259,,,,,,,,Glycerin Pedi Suppository,$2.26,$1.55,$0.85,$2.01,$0.92,$2.19,$0.92,$0.92,$1.97,$1.92,$0.92,$2.10,$0.92,$2.14,$0.92,$0.92,$2.14
2511540,0250,,,,,,,,Glycopyrrolate 0.2 MG/1 ML VIA,$70.87,$48.79,$26.67,$63.10,$29.05,$68.74,$29.05,$29.05,$62.01,$60.24,$29.05,$65.90,$29.05,$67.32,$29.05,$29.05,$67.32
2543870,0250,,,,,,,,Glycopyrrolate 1 MG TAB,$2.22,$1.53,$0.84,$1.98,$0.91,$2.16,$0.91,$0.91,$1.94,$1.89,$0.91,$2.07,$0.91,$2.11,$0.91,$0.91,$2.11
2523202,0636,J1602,,,,,,,GOLIMUMAB 50 MG/4ML VIAL,"$4,716.60","$3,247.16","$1,775.11","$4,199.65","$1,933.81","$4,575.10","$1,933.81","$1,933.81","$4,127.03","$4,009.11","$1,933.81","$4,386.44","$1,933.81","$4,480.77","$1,933.81","$1,933.81","$4,480.77"
2523840,0259,,,,,,,,Golytely 4000 ML BTL,$274.11,$188.72,$103.16,$244.07,$112.39,$265.89,$112.39,$112.39,$239.85,$233.00,$112.39,$254.93,$112.39,$260.41,$112.39,$112.39,$260.41
2522902,0250,,,,,,,,guaiFENesin 200 MG/10 ML BTL,$11.96,$8.24,$4.50,$10.65,$4.90,$11.60,$4.90,$4.90,$10.47,$10.17,$4.90,$11.12,$4.90,$11.36,$4.90,$4.90,$11.36
2523130,0259,,,,,,,,Guaifenesin 600 Mg Tabcr,$11.79,$8.12,$4.44,$10.50,$4.83,$11.43,$4.83,$4.83,$10.31,$10.02,$4.83,$10.96,$4.83,$11.20,$4.83,$4.83,$11.20
2529480,0259,,,,,,,,guaiFENesin/CODEINE PHOSPHATE,$10.74,$7.40,$4.04,$9.56,$4.40,$10.42,$4.40,$4.40,$9.40,$9.13,$4.40,$9.99,$4.40,$10.20,$4.40,$4.40,$10.20
2539080,0250,,,,,,,,Guaifenesin/D-Methorphan Hb 5,$29.28,$20.16,$11.02,$26.07,$12.01,$28.40,$12.01,$12.01,$25.62,$24.89,$12.01,$27.23,$12.01,$27.82,$12.01,$12.01,$27.82
2539060,0250,,,,,,,,guanFACINE 1 MG TAB,$4.41,$3.04,$1.66,$3.93,$1.81,$4.28,$1.81,$1.81,$3.86,$3.75,$1.81,$4.10,$1.81,$4.19,$1.81,$1.81,$4.19
2538930,0250,,,,,,,,Haemoph B Polysac Conj-Tet Tox,$167.43,$115.27,$63.01,$149.08,$68.65,$162.41,$68.65,$68.65,$146.50,$142.32,$68.65,$155.71,$68.65,$159.06,$68.65,$68.65,$159.06
2504420,0259,,,,,,,,Haloperidol 0.5 MG TAB,$6.24,$4.30,$2.35,$5.56,$2.56,$6.05,$2.56,$2.56,$5.46,$5.31,$2.56,$5.81,$2.56,$5.93,$2.56,$2.56,$5.93
2520400,0259,,,,,,,,Haloperidol 1 MG TAB,$8.86,$6.10,$3.33,$7.89,$3.63,$8.59,$3.63,$3.63,$7.75,$7.53,$3.63,$8.24,$3.63,$8.41,$3.63,$3.63,$8.41
2511690,0259,,,,,,,,Haloperidol 2 MG/ML,$3.77,$2.60,$1.42,$3.36,$1.55,$3.66,$1.55,$1.55,$3.30,$3.20,$1.55,$3.51,$1.55,$3.58,$1.55,$1.55,$3.58
2504450,0259,,,,,,,,Haloperidol 5 MG TAB,$12.43,$8.56,$4.68,$11.07,$5.10,$12.06,$5.10,$5.10,$10.88,$10.57,$5.10,$11.56,$5.10,$11.81,$5.10,$5.10,$11.81
2511700,0636,J1630,,,,,,,Haloperidol 5 MG/ML VIAL,$55.53,$38.23,$20.90,$49.44,$22.77,$53.86,$22.77,$22.77,$48.59,$47.20,$22.77,$51.64,$22.77,$52.75,$22.77,$22.77,$52.75
2523154,0250,,,,,,,,HALOPERIDOL CONC 10MG/5 ML BTL,$48.70,$33.53,$18.33,$43.36,$19.97,$47.24,$19.97,$19.97,$42.61,$41.39,$19.97,$45.29,$19.97,$46.26,$19.97,$19.97,$46.26
2522946,0250,,,,,,,,Haloperidol DECANOATE 100 MG/1,$283.10,$194.90,$106.55,$252.07,$116.07,$274.61,$116.07,$116.07,$247.71,$240.64,$116.07,$263.29,$116.07,$268.95,$116.07,$116.07,$268.95
2536820,0250,,,,,,,,Hamamelis Leaf/Glycerin 100 EA,$76.67,$52.79,$28.86,$68.27,$31.44,$74.37,$31.44,$31.44,$67.09,$65.17,$31.44,$71.30,$31.44,$72.84,$31.44,$31.44,$72.84
2523014,0250,,,,,,,,Hemostatic Matrix 10 ML SYR,"$1,456.41","$1,002.67",$548.12,"$1,296.78",$597.13,"$1,412.72",$597.13,$597.13,"$1,274.36","$1,237.95",$597.13,"$1,354.46",$597.13,"$1,383.59",$597.13,$597.13,"$1,383.59"
2522897,0250,,,,,,,,Hemostatic Matrix 5 ML SYR,$703.65,$484.43,$264.82,$626.53,$288.50,$682.54,$288.50,$288.50,$615.70,$598.11,$288.50,$654.40,$288.50,$668.47,$288.50,$288.50,$668.47
2523303,0250,,,,,,,,"Heparin 1,000 UNITS/ML VIAL",$105.61,$72.71,$39.75,$94.03,$43.30,$102.44,$43.30,$43.30,$92.41,$89.77,$43.30,$98.21,$43.30,$100.33,$43.30,$43.30,$100.33
2529670,0636,J1644,,,,,,,Heparin 2000 UNITS/2 ML VIAL,$148.23,$102.05,$55.79,$131.99,$60.78,$143.79,$60.78,$60.78,$129.71,$126.00,$60.78,$137.86,$60.78,$140.82,$60.78,$60.78,$140.82
2537890,0636,J1644,,,,,,,Heparin 20000 UNITS/ML VIAL,$158.63,$109.21,$59.70,$141.24,$65.04,$153.87,$65.04,$65.04,$138.80,$134.83,$65.04,$147.52,$65.04,$150.70,$65.04,$65.04,$150.70
2543520,0250,,,,,,,,Heparin 25000 Units/250 Ml Bag,$186.27,$128.24,$70.10,$165.85,$76.37,$180.68,$76.37,$76.37,$162.98,$158.33,$76.37,$173.23,$76.37,$176.95,$76.37,$76.37,$176.95
2523042,0250,,,,,,,,Heparin 50 UNIT/5 ML SYR,$52.64,$36.24,$19.81,$46.87,$21.58,$51.06,$21.58,$21.58,$46.06,$44.74,$21.58,$48.96,$21.58,$50.01,$21.58,$21.58,$50.01
2541040,0250,,,,,,,,Heparin 500 UNITS/5 ML SYRINGE,$54.80,$37.73,$20.62,$48.79,$22.47,$53.15,$22.47,$22.47,$47.95,$46.58,$22.47,$50.96,$22.47,$52.06,$22.47,$22.47,$52.06
2511760,0636,J1644,,,,,,,Heparin 5000 Units/Ml Vial,$75.01,$51.64,$28.23,$66.78,$30.75,$72.76,$30.75,$30.75,$65.63,$63.75,$30.75,$69.75,$30.75,$71.25,$30.75,$30.75,$71.25
2523304,0250,,,,,,,,Heparin Pres-Free 100 UNITS/ML,$69.35,$47.75,$26.10,$61.75,$28.43,$67.27,$28.43,$28.43,$60.68,$58.95,$28.43,$64.50,$28.43,$65.88,$28.43,$28.43,$65.88
2522090,0250,,,,,,,,Hepatitis A Virus Vaccine 1.44,$557.30,$383.68,$209.74,$496.22,$228.49,$540.59,$228.49,$228.49,$487.64,$473.71,$228.49,$518.29,$228.49,$529.44,$228.49,$228.49,$529.44
2523246,0636,90744,,,,,,,Hepatitis B Virus Vaccine 10 M,$250.08,$172.17,$94.12,$222.67,$102.53,$242.58,$102.53,$102.53,$218.82,$212.57,$102.53,$232.58,$102.53,$237.58,$102.53,$102.53,$237.58
2540190,0250,,,,,,,,Hepatitis B Virus Vaccine 20 M,$628.12,$432.43,$236.39,$559.27,$257.53,$609.27,$257.53,$257.53,$549.60,$533.90,$257.53,$584.15,$257.53,$596.71,$257.53,$257.53,$596.71
2530510,0250,,,,,,,,Hepatitis B/Hepatitis A Vaccin,$650.19,$447.62,$244.70,$578.93,$266.58,$630.68,$266.58,$266.58,$568.91,$552.66,$266.58,$604.67,$266.58,$617.68,$266.58,$266.58,$617.68
2511820,0636,J1571,,,,,,,Hepatitis-B Immune Globulin 1,$586.82,$404.00,$220.85,$522.50,$240.59,$569.21,$240.59,$240.59,$513.46,$498.79,$240.59,$545.74,$240.59,$557.48,$240.59,$240.59,$557.48
2523085,0252,,,,,,,,Honey 15 ML TUBE,$86.29,$59.41,$32.48,$76.83,$35.38,$83.70,$35.38,$35.38,$75.50,$73.35,$35.38,$80.25,$35.38,$81.98,$35.38,$35.38,$81.98
2523511,0636,90651,,,,,,,HUMAN PAPILLOMA VIRUS VAC 9-VA,$895.24,$616.33,$336.93,$797.12,$367.05,$868.38,$367.05,$367.05,$783.33,$760.95,$367.05,$832.57,$367.05,$850.47,$367.05,$367.05,$850.47
2523129,0250,,,,,,,,"HUMAN PROTHROMBIN 1,703 U VIAL","$5,508.38","$3,792.26","$2,073.10","$4,904.65","$2,258.43","$5,343.13","$2,258.43","$2,258.43","$4,819.83","$4,682.12","$2,258.43","$5,122.79","$2,258.43","$5,232.96","$2,258.43","$2,258.43","$5,232.96"
2523434,0636,C9132,,,,,,,HUMAN PROTHROMBIN COMPLEX 500U,"$2,885.40","$1,986.46","$1,085.93","$2,569.15","$1,183.01","$2,798.83","$1,183.01","$1,183.01","$2,524.72","$2,452.59","$1,183.01","$2,683.42","$1,183.01","$2,741.13","$1,183.01","$1,183.01","$2,741.13"
2523298,0250,,,,,,,,HYALURONATE  SOD STAB630MG/3ML,"$2,595.15","$1,786.64",$976.69,"$2,310.71","$1,064.01","$2,517.29","$1,064.01","$1,064.01","$2,270.75","$2,205.87","$1,064.01","$2,413.49","$1,064.01","$2,465.39","$1,064.01","$1,064.01","$2,465.39"
2523411,0250,,,,,,,,HYALURONATE SODIUM 10 MG/ML SY,$577.12,$397.32,$217.20,$513.87,$236.62,$559.81,$236.62,$236.62,$504.98,$490.55,$236.62,$536.72,$236.62,$548.26,$236.62,$236.62,$548.26
2522906,0250,,,,,,,,Hyaluronate Sodium 14 MG/ML SY,$467.89,$322.12,$176.09,$416.61,$191.83,$453.85,$191.83,$191.83,$409.40,$397.70,$191.83,$435.13,$191.83,$444.49,$191.83,$191.83,$444.49
2523034,0250,,,,,,,,Hyaluronate Sodium Dual Pack K,$475.74,$327.53,$179.05,$423.60,$195.05,$461.47,$195.05,$195.05,$416.27,$404.38,$195.05,$442.44,$195.05,$451.95,$195.05,$195.05,$451.95
2523156,0636,J7324,,,,,,,"Hyaluronate sodium, stabilized","$1,991.62","$1,371.14",$749.55,"$1,773.33",$816.56,"$1,931.87",$816.56,$816.56,"$1,742.67","$1,692.88",$816.56,"$1,852.21",$816.56,"$1,892.04",$816.56,$816.56,"$1,892.04"
2511680,0636,J3470,,,,,,,Hyaluronidase,$381.76,$262.82,$143.68,$339.92,$156.52,$370.31,$156.52,$156.52,$334.04,$324.49,$156.52,$355.04,$156.52,$362.67,$156.52,$156.52,$362.67
2501710,0259,,,,,,,,hydrALAZINE 10 MG TAB,$1.83,$1.26,$0.69,$1.63,$0.75,$1.78,$0.75,$0.75,$1.60,$1.56,$0.75,$1.70,$0.75,$1.74,$0.75,$0.75,$1.74
2511870,0636,J0360,,,,,,,hydrALAZINE 20 MG/ML VIAL,$109.39,$75.31,$41.17,$97.40,$44.85,$106.11,$44.85,$44.85,$95.71,$92.98,$44.85,$101.73,$44.85,$103.92,$44.85,$44.85,$103.92
2501720,0259,,,,,,,,hydrALAZINE 25 MG TAB,$3.00,$2.06,$1.13,$2.67,$1.23,$2.91,$1.23,$1.23,$2.62,$2.55,$1.23,$2.79,$1.23,$2.85,$1.23,$1.23,$2.85
2533320,0259,,,,,,,,Hydrochlorothiazide 12.5 MG CA,$1.38,$0.95,$0.52,$1.23,$0.57,$1.34,$0.57,$0.57,$1.21,$1.18,$0.57,$1.29,$0.57,$1.31,$0.57,$0.57,$1.31
2504500,0259,,,,,,,,Hydrochlorothiazide 25 MG TAB,$2.91,$2.00,$1.09,$2.59,$1.19,$2.82,$1.19,$1.19,$2.55,$2.47,$1.19,$2.71,$1.19,$2.76,$1.19,$1.19,$2.76
2541460,0250,,,,,,,,HYDROcodone 10/Acetaminophen 3,$1.86,$1.28,$0.70,$1.66,$0.76,$1.81,$0.76,$0.76,$1.63,$1.58,$0.76,$1.73,$0.76,$1.77,$0.76,$0.76,$1.77
2536470,0250,,,,,,,,HYDROcodone 5/Acetaminophen 32,$7.46,$5.14,$2.81,$6.64,$3.06,$7.24,$3.06,$3.06,$6.53,$6.34,$3.06,$6.94,$3.06,$7.09,$3.06,$3.06,$7.09
2538270,0250,,,,,,,,HYDROcodone 7.5/Acetaminophen,$3.00,$2.06,$1.13,$2.67,$1.23,$2.91,$1.23,$1.23,$2.62,$2.55,$1.23,$2.79,$1.23,$2.85,$1.23,$1.23,$2.85
2593050,0250,,,,,,,,HYDROcodone 7.5/Acetaminophen,$79.66,$54.84,$29.98,$70.93,$32.66,$77.27,$32.66,$32.66,$69.70,$67.71,$32.66,$74.08,$32.66,$75.67,$32.66,$32.66,$75.67
2523549,0250,,,,,,,,HYDROCODONE/ACETAMINOPHEN 7.5M,$2.30,$1.58,$0.87,$2.05,$0.94,$2.23,$0.94,$0.94,$2.01,$1.95,$0.94,$2.14,$0.94,$2.18,$0.94,$0.94,$2.18
2511670,0259,,,,,,,,HYDROcodone/Homatropine SYRUP,$1.07,$0.74,$0.40,$0.95,$0.44,$1.04,$0.44,$0.44,$0.93,$0.91,$0.44,$0.99,$0.44,$1.01,$0.44,$0.44,$1.01
2522892,0250,,,,,,,,Hydrocolloid Dressing 30 GM TU,$44.19,$30.42,$16.63,$39.34,$18.12,$42.86,$18.12,$18.12,$38.66,$37.56,$18.12,$41.09,$18.12,$41.98,$18.12,$18.12,$41.98
2514910,0259,,,,,,,,Hydrocortisone 1% CR 30 GM TUB,$47.11,$32.43,$17.73,$41.94,$19.31,$45.69,$19.31,$19.31,$41.22,$40.04,$19.31,$43.81,$19.31,$44.75,$19.31,$19.31,$44.75
2543420,0250,,,,,,,,Hydrocortisone 1% RECTAL 30 GM,$184.89,$127.29,$69.59,$164.63,$75.81,$179.35,$75.81,$75.81,$161.78,$157.16,$75.81,$171.95,$75.81,$175.65,$75.81,$75.81,$175.65
2531780,0259,,,,,,,,Hydrocortisone 10 MG TAB,$5.27,$3.63,$1.98,$4.69,$2.16,$5.11,$2.16,$2.16,$4.61,$4.48,$2.16,$4.90,$2.16,$5.01,$2.16,$2.16,$5.01
2516460,0259,,,,,,,,Hydrocortisone 100 MG/60 ML BT,$324.19,$223.19,$122.01,$288.66,$132.92,$314.47,$132.92,$132.92,$283.67,$275.57,$132.92,$301.50,$132.92,$307.98,$132.92,$132.92,$307.98
2528810,0259,,,,,,,,Hydrocortisone 2.5% CR 30 GM T,$73.19,$50.39,$27.54,$65.16,$30.01,$70.99,$30.01,$30.01,$64.04,$62.21,$30.01,$68.06,$30.01,$69.53,$30.01,$30.01,$69.53
2525545,0250,,,,,,,,Hydrocortisone 2.5% OINT 20 GM,$36.57,$25.18,$13.76,$32.56,$14.99,$35.47,$14.99,$14.99,$32.00,$31.09,$14.99,$34.01,$14.99,$34.74,$14.99,$14.99,$34.74
2520270,0259,,,,,,,,Hydrocortisone 2.5% RECTAL 30,$270.44,$186.19,$101.78,$240.80,$110.88,$262.33,$110.88,$110.88,$236.64,$229.88,$110.88,$251.51,$110.88,$256.92,$110.88,$110.88,$256.92
2509300,0259,,,,,,,,Hydrocortisone 25 MG SUPP,$50.52,$34.78,$19.01,$44.98,$20.71,$49.00,$20.71,$20.71,$44.20,$42.94,$20.71,$46.98,$20.71,$47.99,$20.71,$20.71,$47.99
2511620,0636,J1720,,,,,,,Hydrocortisone SOD SUC. 100 MG,$295.10,$203.16,$111.06,$262.75,$120.99,$286.24,$120.99,$120.99,$258.21,$250.83,$120.99,$274.44,$120.99,$280.34,$120.99,$120.99,$280.34
2516870,0259,,,,,,,,Hydrogen Peroxide 3% 480 ML BT,$14.03,$9.66,$5.28,$12.49,$5.75,$13.61,$5.75,$5.75,$12.28,$11.93,$5.75,$13.05,$5.75,$13.33,$5.75,$5.75,$13.33
2522908,0250,,,,,,,,HYDROmorphone 10 MG/50 ML -PCA,$333.99,$229.94,$125.70,$297.38,$136.94,$323.97,$136.94,$136.94,$292.24,$283.89,$136.94,$310.61,$136.94,$317.29,$136.94,$136.94,$317.29
2522451,0250,,,,,,,,HYDROMORPHONE 10MG/ML VIAL,$108.14,$74.45,$40.70,$96.29,$44.34,$104.90,$44.34,$44.34,$94.63,$91.92,$44.34,$100.57,$44.34,$102.74,$44.34,$44.34,$102.74
2503570,0259,,,,,,,,HYDROmorphone 2 MG TAB,$3.08,$2.12,$1.16,$2.75,$1.26,$2.99,$1.26,$1.26,$2.70,$2.62,$1.26,$2.87,$1.26,$2.93,$1.26,$1.26,$2.93
2536370,0636,J1170,,,,,,,Hydromorphone 2 Mg/Ml Syr,$83.08,$57.20,$31.27,$73.97,$34.06,$80.59,$34.06,$34.06,$72.69,$70.62,$34.06,$77.26,$34.06,$78.92,$34.06,$34.06,$78.92
2540900,0250,,,,,,,,HYDROmorphone 2 MG/ML VIAL,$59.10,$40.69,$22.24,$52.62,$24.23,$57.33,$24.23,$24.23,$51.71,$50.23,$24.23,$54.96,$24.23,$56.14,$24.23,$24.23,$56.14
2503580,0259,,,,,,,,HYDROmorphone 4 MG TAB,$3.45,$2.38,$1.30,$3.07,$1.42,$3.35,$1.42,$1.42,$3.02,$2.94,$1.42,$3.21,$1.42,$3.28,$1.42,$1.42,$3.28
2535630,0636,J1170,,,,,,,HYDROmorphone 50 MG/5 ML AMP,$201.53,$138.74,$75.85,$179.44,$82.63,$195.48,$82.63,$82.63,$176.34,$171.30,$82.63,$187.42,$82.63,$191.45,$82.63,$82.63,$191.45
2523233,0250,,,,,,,,Hydromorphone 500mg/50 Ml Vial,$644.36,$443.61,$242.51,$573.74,$264.19,$625.03,$264.19,$264.19,$563.81,$547.70,$264.19,$599.25,$264.19,$612.14,$264.19,$264.19,$612.14
2523140,0259,,,,,,,,HYDROQUINONE 4% CR,$48.52,$33.41,$18.26,$43.20,$19.89,$47.07,$19.89,$19.89,$42.46,$41.24,$19.89,$45.13,$19.89,$46.10,$19.89,$19.89,$46.10
2523124,0250,,,,,,,,HYDROXOCOBALAMIN 5 GM VIAL,"$2,572.59","$1,771.10",$968.20,"$2,290.63","$1,054.76","$2,495.41","$1,054.76","$1,054.76","$2,251.01","$2,186.70","$1,054.76","$2,392.50","$1,054.76","$2,443.96","$1,054.76","$1,054.76","$2,443.96"
2509310,0259,,,,,,,,Hydroxychloroquine 200 MG TAB,$11.91,$8.20,$4.48,$10.60,$4.88,$11.55,$4.88,$4.88,$10.42,$10.12,$4.88,$11.07,$4.88,$11.31,$4.88,$4.88,$11.31
2523332,0636,J1729,,,,,,,HYDROXYPROGEST CAPROAT/250 MG,"$1,316.05",$906.04,$495.30,"$1,171.81",$539.58,"$1,276.57",$539.58,$539.58,"$1,151.54","$1,118.64",$539.58,"$1,223.93",$539.58,"$1,250.25",$539.58,$539.58,"$1,250.25"
2516900,0259,,,,,,,,Hydroxypropylmethylcellulose 1,$109.29,$75.24,$41.13,$97.31,$44.81,$106.01,$44.81,$44.81,$95.63,$92.90,$44.81,$101.64,$44.81,$103.82,$44.81,$44.81,$103.82
2504490,0259,J9999,,,,,,,Hydroxyurea 500 MG CAP,$6.19,$4.26,$2.33,$5.51,$2.54,$6.00,$2.54,$2.54,$5.41,$5.26,$2.54,$5.75,$2.54,$5.88,$2.54,$2.54,$5.88
2511900,0636,J3410,,,,,,,Hydroxyzine 25 Mg/Ml Vial,$221.00,$152.15,$83.17,$196.77,$90.61,$214.37,$90.61,$90.61,$193.37,$187.85,$90.61,$205.53,$90.61,$209.95,$90.61,$90.61,$209.95
2501910,0259,,,,,,,,hydrOXYzine HCL 10 MG TAB,$2.61,$1.80,$0.98,$2.33,$1.07,$2.54,$1.07,$1.07,$2.29,$2.22,$1.07,$2.43,$1.07,$2.48,$1.07,$1.07,$2.48
2501920,0259,,,,,,,,hydrOXYzine HCL 25 MG TAB,$3.83,$2.64,$1.44,$3.41,$1.57,$3.72,$1.57,$1.57,$3.36,$3.26,$1.57,$3.57,$1.57,$3.64,$1.57,$1.57,$3.64
2540910,0250,,,,,,,,hydrOXYzine HCL 50 MG TAB,$1.37,$0.95,$0.52,$1.22,$0.56,$1.33,$0.56,$0.56,$1.20,$1.17,$0.56,$1.28,$0.56,$1.30,$0.56,$0.56,$1.30
2508920,0259,,,,,,,,hydrOXYzine PAMOATE 25 MG CAP,$1.66,$1.14,$0.62,$1.47,$0.68,$1.61,$0.68,$0.68,$1.45,$1.41,$0.68,$1.54,$0.68,$1.57,$0.68,$0.68,$1.57
2522989,0250,,,,,,,,HYLAN G-F 20 48 MG/6 ML SYR,"$1,412.40",$972.37,$531.56,"$1,257.60",$579.08,"$1,370.02",$579.08,$579.08,"$1,235.85","$1,200.54",$579.08,"$1,313.53",$579.08,"$1,341.78",$579.08,$579.08,"$1,341.78"
2504540,0259,,,,,,,,Hyoscyamine 0.125 MG TAB,$1.99,$1.37,$0.75,$1.78,$0.82,$1.93,$0.82,$0.82,$1.74,$1.69,$0.82,$1.85,$0.82,$1.89,$0.82,$0.82,$1.89
2543460,0250,,,,,,,,Hyoscyamine 0.125 MG TAB.SUBL,$3.25,$2.24,$1.22,$2.89,$1.33,$3.15,$1.33,$1.33,$2.84,$2.76,$1.33,$3.02,$1.33,$3.08,$1.33,$1.33,$3.08
2523111,0250,,,,,,,,HYOSCYAMINE 0.5MG/ML AMP,$491.12,$338.12,$184.84,$437.30,$201.36,$476.39,$201.36,$201.36,$429.73,$417.45,$201.36,$456.74,$201.36,$466.57,$201.36,$201.36,$466.57
2523028,0250,J1740,,,,,,,Ibandronate Sodium 3 MG/3 ML S,$470.70,$324.05,$177.15,$419.11,$192.99,$456.58,$192.99,$192.99,$411.86,$400.09,$192.99,$437.75,$192.99,$447.16,$192.99,$192.99,$447.16
2534740,0259,,,,,,,,Ibuprofen 100 MG/5 ML,$16.93,$11.66,$6.37,$15.07,$6.94,$16.42,$6.94,$6.94,$14.81,$14.39,$6.94,$15.74,$6.94,$16.08,$6.94,$6.94,$16.08
2523175,0250,,,,,,,,Ibuprofen 100 MG/5 ML 120ML BT,$16.93,$11.66,$6.37,$15.07,$6.94,$16.42,$6.94,$6.94,$14.81,$14.39,$6.94,$15.74,$6.94,$16.08,$6.94,$6.94,$16.08
2501350,0259,,,,,,,,Ibuprofen 200 Mg Tab,$0.94,$0.65,$0.35,$0.83,$0.38,$0.91,$0.38,$0.38,$0.82,$0.80,$0.38,$0.87,$0.38,$0.89,$0.38,$0.38,$0.89
2505840,0259,,,,,,,,Ibuprofen 400 MG TAB,$1.02,$0.71,$0.39,$0.91,$0.42,$0.99,$0.42,$0.42,$0.90,$0.87,$0.42,$0.95,$0.42,$0.97,$0.42,$0.42,$0.97
2505830,0259,,,,,,,,Ibuprofen 600 MG TAB,$1.57,$1.08,$0.59,$1.40,$0.64,$1.52,$0.64,$0.64,$1.37,$1.33,$0.64,$1.46,$0.64,$1.49,$0.64,$0.64,$1.49
2523275,0250,,,,,,,,"Ibuprofen 600 MG TAB, 6 TABS/B",$1.67,$1.15,$0.63,$1.48,$0.68,$1.62,$0.68,$0.68,$1.46,$1.42,$0.68,$1.55,$0.68,$1.58,$0.68,$0.68,$1.58
2505810,0259,,,,,,,,Ibuprofen 800 MG TAB,$1.37,$0.95,$0.52,$1.22,$0.56,$1.33,$0.56,$0.56,$1.20,$1.17,$0.56,$1.28,$0.56,$1.30,$0.56,$0.56,$1.30
2527100,0636,,,,,,,,Ibutilide 1 Mg/10 Ml Vial,$567.24,$390.52,$213.48,$505.07,$232.57,$550.22,$232.57,$232.57,$496.33,$482.15,$232.57,$527.53,$232.57,$538.88,$232.57,$232.57,$538.88
2523157,0250,,,,,,,,Idarucizumab 2.5 GM/50 ML VIAL,"$4,619.06","$3,180.00","$1,738.40","$4,112.80","$1,893.81","$4,480.48","$1,893.81","$1,893.81","$4,041.67","$3,926.20","$1,893.81","$4,295.72","$1,893.81","$4,388.10","$1,893.81","$1,893.81","$4,388.10"
2523452,0250,,,,,,,,IMDEVIMAB 300MG/2.5 ML VIAL,$43.58,$30.00,$16.40,$38.80,$17.87,$42.27,$17.87,$17.87,$38.13,$37.04,$17.87,$40.53,$17.87,$41.40,$17.87,$17.87,$41.40
2511950,0636,J0743,,,,,,,Imipenem/Cilastatin 500 MG VIA,$222.64,$153.28,$83.79,$198.24,$91.28,$215.96,$91.28,$91.28,$194.81,$189.24,$91.28,$207.06,$91.28,$211.51,$91.28,$91.28,$211.51
2522910,0259,,,,,,,,Imipramine 10 MG TABLET,$1.78,$1.22,$0.67,$1.58,$0.73,$1.72,$0.73,$0.73,$1.55,$1.51,$0.73,$1.65,$0.73,$1.69,$0.73,$0.73,$1.69
2522911,0250,,,,,,,,Imipramine 25 MG TABLET,$5.24,$3.61,$1.97,$4.67,$2.15,$5.08,$2.15,$2.15,$4.59,$4.45,$2.15,$4.87,$2.15,$4.98,$2.15,$2.15,$4.98
2512000,0636,,,,,,,,Immune Globulin 10 Gm/100 Ml V,"$2,240.41","$1,542.41",$843.19,"$1,994.85",$918.57,"$2,173.19",$918.57,$918.57,"$1,960.35","$1,904.34",$918.57,"$2,083.58",$918.57,"$2,128.39",$918.57,$918.57,"$2,128.39"
2523285,0636,J1459,,,,,,,Immune Globulin 10 GM/100 ML V,"$2,198.06","$1,513.26",$827.25,"$1,957.15",$901.20,"$2,132.12",$901.20,$901.20,"$1,923.30","$1,868.35",$901.20,"$2,044.20",$901.20,"$2,088.16",$901.20,$901.20,"$2,088.16"
2523378,0636,J1569,,,,,,,IMMUNE GLOBULIN 10 GM/100ML,"$3,412.46","$2,349.32","$1,284.29","$3,038.45","$1,399.11","$3,310.08","$1,399.11","$1,399.11","$2,985.90","$2,900.59","$1,399.11","$3,173.59","$1,399.11","$3,241.84","$1,399.11","$1,399.11","$3,241.84"
2523283,0636,J1459,,,,,,,Immune Globulin 20 GM/200 ML V,"$3,769.84","$2,595.35","$1,418.79","$3,356.66","$1,545.63","$3,656.74","$1,545.63","$1,545.63","$3,298.61","$3,204.36","$1,545.63","$3,505.95","$1,545.63","$3,581.34","$1,545.63","$1,545.63","$3,581.34"
2536040,0636,,,,,,,,Immune Globulin 20 Gm/200 Ml V,"$5,211.78","$3,588.06","$1,961.47","$4,640.56","$2,136.83","$5,055.42","$2,136.83","$2,136.83","$4,560.30","$4,430.01","$2,136.83","$4,846.95","$2,136.83","$4,951.19","$2,136.83","$2,136.83","$4,951.19"
2523286,0636,J1459,,,,,,,Immune Globulin 40 GM/400 ML V,"$7,220.07","$4,970.68","$2,717.30","$6,428.74","$2,960.23","$7,003.47","$2,960.23","$2,960.23","$6,317.57","$6,137.06","$2,960.23","$6,714.67","$2,960.23","$6,859.07","$2,960.23","$2,960.23","$6,859.07"
2511990,0636,J1561,,,,,,,Immune Globulin 5 GM/50 ML VIA,"$1,711.80","$1,178.49",$644.24,"$1,524.18",$701.84,"$1,660.44",$701.84,$701.84,"$1,497.82","$1,455.03",$701.84,"$1,591.97",$701.84,"$1,626.21",$701.84,$701.84,"$1,626.21"
2523284,0636,J1459,,,,,,,Immune Globulin 5 GM/50 ML VIA,"$1,289.49",$887.75,$485.30,"$1,148.16",$528.69,"$1,250.81",$528.69,$528.69,"$1,128.30","$1,096.07",$528.69,"$1,199.23",$528.69,"$1,225.02",$528.69,$528.69,"$1,225.02"
2505350,0259,,,,,,,,Indapamide 2.5 MG TAB,$5.32,$3.66,$2.00,$4.73,$2.18,$5.16,$2.18,$2.18,$4.65,$4.52,$2.18,$4.94,$2.18,$5.05,$2.18,$2.18,$5.05
2523377,0250,,,,,,,,INDIGOTINDISULFONATE SODIUM 8%,$656.94,$452.27,$247.24,$584.94,$269.35,$637.23,$269.35,$269.35,$574.82,$558.40,$269.35,$610.96,$269.35,$624.09,$269.35,$269.35,$624.09
2523506,0250,,,,,,,,INDOCYANINE GREEN 25 MG VIAL,$624.66,$430.05,$235.09,$556.20,$256.11,$605.92,$256.11,$256.11,$546.58,$530.96,$256.11,$580.94,$256.11,$593.43,$256.11,$256.11,$593.43
2504710,0259,,,,,,,,Indomethacin 25 MG CAP,$2.61,$1.80,$0.98,$2.33,$1.07,$2.54,$1.07,$1.07,$2.29,$2.22,$1.07,$2.43,$1.07,$2.48,$1.07,$1.07,$2.48
2525370,0636,J1745,,,,,,,inFLIXimab 100 MG VIAL,"$3,034.35","$2,089.01","$1,141.99","$2,701.78","$1,244.08","$2,943.32","$1,244.08","$1,244.08","$2,655.06","$2,579.20","$1,244.08","$2,821.94","$1,244.08","$2,882.63","$1,244.08","$1,244.08","$2,882.63"
2523254,0636,J1745,,,,,,,InFLIXimab-ABDA 100 MG VIAL,"$1,370.89",$943.79,$515.94,"$1,220.64",$562.06,"$1,329.76",$562.06,$562.06,"$1,199.53","$1,165.26",$562.06,"$1,274.93",$562.06,"$1,302.35",$562.06,$562.06,"$1,302.35"
2535330,0250,,,,,,,,Insulin Asp Prt/Insulin Aspart,$221.50,$152.49,$83.36,$197.22,$90.81,$214.85,$90.81,$90.81,$193.81,$188.27,$90.81,$205.99,$90.81,$210.42,$90.81,$90.81,$210.42
2534370,0636,J1815,,,,,,,Insulin Aspart 100 UNITS/ML UN,$1.87,$1.29,$0.71,$1.67,$0.77,$1.82,$0.77,$0.77,$1.64,$1.59,$0.77,$1.74,$0.77,$1.78,$0.77,$0.77,$1.78
2535020,0250,,,,,,,,Insulin Aspart 300 UNITS/3 ML,$302.12,$208.00,$113.71,$269.01,$123.87,$293.06,$123.87,$123.87,$264.36,$256.80,$123.87,$280.97,$123.87,$287.02,$123.87,$123.87,$287.02
2539840,0250,,,,,,,,Insulin Detemir 300 UNITS/3 ML,$454.55,$312.94,$171.07,$404.73,$186.37,$440.92,$186.37,$186.37,$397.73,$386.37,$186.37,$422.73,$186.37,$431.82,$186.37,$186.37,$431.82
2528260,0636,J1815,,,,,,,Insulin Glargine 100 UNITS/ML,$45.21,$31.13,$17.02,$40.26,$18.54,$43.85,$18.54,$18.54,$39.56,$38.43,$18.54,$42.05,$18.54,$42.95,$18.54,$18.54,$42.95
2537140,0250,,,,,,,,Insulin Glargine 300 Units/3 M,$308.83,$212.62,$116.23,$274.99,$126.62,$299.57,$126.62,$126.62,$270.23,$262.51,$126.62,$287.22,$126.62,$293.39,$126.62,$126.62,$293.39
2523185,0250,,,,,,,,Insulin Glulisine 300 UNITS/3,$406.76,$280.04,$153.09,$362.18,$166.77,$394.56,$166.77,$166.77,$355.92,$345.75,$166.77,$378.29,$166.77,$386.42,$166.77,$166.77,$386.42
2553060,0250,,,,,,,,Insulin NPH-Human 300 UNITS/3,$190.06,$130.85,$71.53,$169.23,$77.92,$184.36,$77.92,$77.92,$166.30,$161.55,$77.92,$176.75,$77.92,$180.55,$77.92,$77.92,$180.55
2523358,0250,,,,,,,,INSULIN REG-HUMAN 1500 UN/3 ML,"$1,017.66",$700.61,$383.00,$906.13,$417.24,$987.13,$417.24,$417.24,$890.46,$865.01,$417.24,$946.43,$417.24,$966.78,$417.24,$417.24,$966.78
2523383,0250,,,,,,,,INSULIN REGULAR IN 0.9%NACL100,$285.03,$196.23,$107.27,$253.79,$116.86,$276.48,$116.86,$116.86,$249.40,$242.28,$116.86,$265.08,$116.86,$270.78,$116.86,$116.86,$270.78
2523072,0250,,,,,,,,Insulin REGULAR-Human 100 UNIT,$43.94,$30.25,$16.54,$39.12,$18.01,$42.62,$18.01,$18.01,$38.44,$37.35,$18.01,$40.86,$18.01,$41.74,$18.01,$18.01,$41.74
2523061,0250,,,,,,,,"Insulin, 70/30-Human 300 UNITS",$190.38,$131.07,$71.65,$169.52,$78.06,$184.67,$78.06,$78.06,$166.59,$161.83,$78.06,$177.06,$78.06,$180.86,$78.06,$78.06,$180.86
2523031,0636,,,,,,,,"Interferon Alfa-2B, Recomb. 50","$3,964.64","$2,729.47","$1,492.11","$3,530.11","$1,625.50","$3,845.70","$1,625.50","$1,625.50","$3,469.06","$3,369.95","$1,625.50","$3,687.12","$1,625.50","$3,766.41","$1,625.50","$1,625.50","$3,766.41"
2524940,0259,,,,,,,,Ipratropium 0.06% 15 ML BTL,$299.21,$206.00,$112.61,$266.42,$122.68,$290.24,$122.68,$122.68,$261.81,$254.33,$122.68,$278.27,$122.68,$284.25,$122.68,$122.68,$284.25
2519780,0636,J7644,,,,,,,Ipratropium 0.5 MG/2.5 ML UPD,$4.66,$3.21,$1.75,$4.15,$1.91,$4.52,$1.91,$1.91,$4.08,$3.96,$1.91,$4.34,$1.91,$4.43,$1.91,$1.91,$4.43
2522972,0250,,,,,,,,Ipratropium/Albuterol 4 GM 120,"$1,186.20",$816.65,$446.43,"$1,056.19",$486.34,"$1,150.62",$486.34,$486.34,"$1,037.93","$1,008.27",$486.34,"$1,103.17",$486.34,"$1,126.89",$486.34,$486.34,"$1,126.89"
2534820,0259,,,,,,,,Ipratropiumi HFA 12.9 GM 200 P,"$1,428.32",$983.33,$537.56,"$1,271.78",$585.61,"$1,385.47",$585.61,$585.61,"$1,249.78","$1,214.07",$585.61,"$1,328.34",$585.61,"$1,356.91",$585.61,$585.61,"$1,356.91"
2522660,0259,,,,,,,,Irbesartan 75 MG TAB,$4.09,$2.81,$1.54,$3.64,$1.67,$3.96,$1.67,$1.67,$3.57,$3.47,$1.67,$3.80,$1.67,$3.88,$1.67,$1.67,$3.88
2532030,0636,J1756,,,,,,,Iron Sucrose Complex 100 MG/5,$361.36,$248.78,$136.00,$321.76,$148.16,$350.52,$148.16,$148.16,$316.19,$307.16,$148.16,$336.07,$148.16,$343.30,$148.16,$148.16,$343.30
2504770,0259,,,,,,,,Isoniazid 300 MG TAB,$8.76,$6.03,$3.30,$7.80,$3.59,$8.50,$3.59,$3.59,$7.66,$7.44,$3.59,$8.15,$3.59,$8.32,$3.59,$3.59,$8.32
2538950,0250,,,,,,,,Isopropyl Alcohol-Sterile 70%,$168.28,$115.85,$63.33,$149.84,$68.99,$163.23,$68.99,$68.99,$147.24,$143.04,$68.99,$156.50,$68.99,$159.87,$68.99,$68.99,$159.87
2504820,0259,,,,,,,,Isosorbide Dinitrate 10 MG TAB,$12.68,$8.73,$4.77,$11.29,$5.20,$12.30,$5.20,$5.20,$11.10,$10.78,$5.20,$11.79,$5.20,$12.05,$5.20,$5.20,$12.05
2541690,0250,,,,,,,,Isosorbide Mononitrate 10 MG T,$2.70,$1.86,$1.02,$2.41,$1.11,$2.62,$1.11,$1.11,$2.36,$2.30,$1.11,$2.51,$1.11,$2.57,$1.11,$1.11,$2.57
2504750,0259,,,,,,,,Isosorbide Mononitrate 20 MG T,$2.72,$1.88,$1.03,$2.43,$1.12,$2.64,$1.12,$1.12,$2.38,$2.31,$1.12,$2.53,$1.12,$2.59,$1.12,$1.12,$2.59
2529690,0259,,,,,,,,Isosorbide Mononitrate 30 MG T,$8.16,$5.62,$3.07,$7.27,$3.35,$7.91,$3.35,$3.35,$7.14,$6.94,$3.35,$7.59,$3.35,$7.75,$3.35,$3.35,$7.75
2504580,0259,,,,,,,,Isosorbide Mononitrate 60 MG T,$3.21,$2.21,$1.21,$2.86,$1.32,$3.12,$1.32,$1.32,$2.81,$2.73,$1.32,$2.99,$1.32,$3.05,$1.32,$1.32,$3.05
2523347,0250,,,,,,,,IVERMECTIN 0.5% 117 GM TUBE,"$1,164.21",$801.50,$438.15,"$1,036.61",$477.33,"$1,129.28",$477.33,$477.33,"$1,018.68",$989.58,$477.33,"$1,082.71",$477.33,"$1,106.00",$477.33,$477.33,"$1,106.00"
2523389,0250,,,,,,,,Ketamine 50 Mg/5 Ml Syringe,$161.20,$110.98,$60.67,$143.53,$66.09,$156.36,$66.09,$66.09,$141.05,$137.02,$66.09,$149.91,$66.09,$153.14,$66.09,$66.09,$153.14
2523169,0250,,,,,,,,Ketamine 500 MG/10 ML VIAL,$136.18,$93.75,$51.25,$121.25,$55.83,$132.09,$55.83,$55.83,$119.15,$115.75,$55.83,$126.64,$55.83,$129.37,$55.83,$55.83,$129.37
2512310,0250,,,,,,,,Ketamine 500 MG/5 ML VIAL,$160.94,$110.80,$60.57,$143.30,$65.98,$156.11,$65.98,$65.98,$140.82,$136.80,$65.98,$149.67,$65.98,$152.89,$65.98,$65.98,$152.89
2583560,0250,,,,,,,,KETAMINE 50MG/5ML VIAL,$127.37,$87.69,$47.94,$113.41,$52.22,$123.55,$52.22,$52.22,$111.45,$108.27,$52.22,$118.46,$52.22,$121.00,$52.22,$52.22,$121.00
2522913,0250,,,,,,,,Ketoconazole 2% CREAM 15 GM TU,$190.17,$130.92,$71.57,$169.32,$77.97,$184.46,$77.97,$77.97,$166.39,$161.64,$77.97,$176.85,$77.97,$180.66,$77.97,$77.97,$180.66
2516960,0259,,,,,,,,Ketorolac 0.5% 5 ML BTL,$130.11,$89.57,$48.97,$115.85,$53.34,$126.20,$53.34,$53.34,$113.84,$110.59,$53.34,$121.00,$53.34,$123.60,$53.34,$53.34,$123.60
2508580,0259,,,,,,,,Ketorolac 10 MG TAB,$17.04,$11.73,$6.41,$15.17,$6.99,$16.53,$6.99,$6.99,$14.91,$14.48,$6.99,$15.85,$6.99,$16.19,$6.99,$6.99,$16.19
2512260,0636,J1885,,,,,,,Ketorolac 15 Mg/Ml Vial,$62.35,$42.92,$23.46,$55.51,$25.56,$60.48,$25.56,$25.56,$54.55,$52.99,$25.56,$57.98,$25.56,$59.23,$25.56,$25.56,$59.23
2512270,0636,J1885,,,,,,,Ketorolac 30 Mg/Ml Vial,$58.47,$40.25,$22.00,$52.06,$23.97,$56.71,$23.97,$23.97,$51.16,$49.70,$23.97,$54.38,$23.97,$55.54,$23.97,$23.97,$55.54
2512280,0636,J1885,,,,,,,Ketorolac 60 MG/2 ML VIAL,$70.33,$48.42,$26.47,$62.62,$28.84,$68.22,$28.84,$28.84,$61.54,$59.78,$28.84,$65.41,$28.84,$66.82,$28.84,$28.84,$66.82
2537420,0250,,,,,,,,Ketorolac LS 0.4% OPHTH SOL 5,$321.56,$221.38,$121.02,$286.31,$131.84,$311.91,$131.84,$131.84,$281.36,$273.32,$131.84,$299.05,$131.84,$305.48,$131.84,$131.84,$305.48
2523374,0250,,,,,,,,"L. Acidophilus, Casei, Rhamnos",$40.74,$28.05,$15.33,$36.28,$16.70,$39.52,$16.70,$16.70,$35.65,$34.63,$16.70,$37.89,$16.70,$38.71,$16.70,$16.70,$38.71
2506320,0259,,,,,,,,Labetalol 100 MG TAB,$6.13,$4.22,$2.31,$5.46,$2.51,$5.95,$2.51,$2.51,$5.37,$5.21,$2.51,$5.70,$2.51,$5.83,$2.51,$2.51,$5.83
2512290,0250,,,,,,,,Labetalol 100 MG/20 ML VIAL,$112.08,$77.16,$42.18,$99.79,$45.95,$108.72,$45.95,$45.95,$98.07,$95.27,$45.95,$104.23,$45.95,$106.47,$45.95,$45.95,$106.47
2543770,0250,,,,,,,,LABETALOL 200 MG/40 ML VIAL,$126.12,$86.83,$47.47,$112.30,$51.71,$122.34,$51.71,$51.71,$110.35,$107.20,$51.71,$117.29,$51.71,$119.81,$51.71,$51.71,$119.81
2523830,0259,,,,,,,,Lachydrin 12% LOTION 225 GM BT,$64.32,$44.28,$24.21,$57.27,$26.37,$62.39,$26.37,$26.37,$56.28,$54.67,$26.37,$59.82,$26.37,$61.10,$26.37,$26.37,$61.10
2523256,0250,,,,,,,,Lacosamide 100 MG TAB,$233.02,$160.43,$87.70,$207.48,$95.54,$226.03,$95.54,$95.54,$203.89,$198.07,$95.54,$216.71,$95.54,$221.37,$95.54,$95.54,$221.37
2523366,0250,,,,,,,,LACOSAMIDE 200 MG/20 ML VIAL,$502.31,$345.82,$189.05,$447.26,$205.95,$487.24,$205.95,$205.95,$439.52,$426.96,$205.95,$467.15,$205.95,$477.20,$205.95,$205.95,$477.20
2517000,0259,,,,,,,,Lacri-Lube 3.5 GM TUBE,$120.15,$82.72,$45.22,$106.98,$49.26,$116.55,$49.26,$49.26,$105.13,$102.13,$49.26,$111.74,$49.26,$114.14,$49.26,$49.26,$114.14
2521140,0259,,,,,,,,Lactase Enzyme CAP,$4.59,$3.16,$1.73,$4.08,$1.88,$4.45,$1.88,$1.88,$4.01,$3.90,$1.88,$4.27,$1.88,$4.36,$1.88,$1.88,$4.36
2541070,0250,,,,,,,,Lactobacillus 1 GRAM GRANULES,$30.17,$20.77,$11.35,$26.86,$12.37,$29.26,$12.37,$12.37,$26.39,$25.64,$12.37,$28.05,$12.37,$28.66,$12.37,$12.37,$28.66
2529060,0259,,,,,,,,Lactobacillus Acidophilus CAP,$4.91,$3.38,$1.85,$4.37,$2.01,$4.77,$2.01,$2.01,$4.30,$4.18,$2.01,$4.57,$2.01,$4.67,$2.01,$2.01,$4.67
2531000,0259,,,,,,,,Lactulose 20 GM/30 ML BTL,$11.19,$7.70,$4.21,$9.96,$4.59,$10.85,$4.59,$4.59,$9.79,$9.51,$4.59,$10.40,$4.59,$10.63,$4.59,$4.59,$10.63
2520980,0259,,,,,,,,LAMISIL CR 30G,$117.62,$80.98,$44.27,$104.73,$48.23,$114.09,$48.23,$48.23,$102.92,$99.98,$48.23,$109.39,$48.23,$111.74,$48.23,$48.23,$111.74
2531680,0259,,,,,,,,lamoTRIgine 100 MG TAB,$3.21,$2.21,$1.21,$2.86,$1.32,$3.12,$1.32,$1.32,$2.81,$2.73,$1.32,$2.99,$1.32,$3.05,$1.32,$1.32,$3.05
2524250,0259,,,,,,,,lamoTRIgine 25 MG TAB,$0.89,$0.62,$0.34,$0.80,$0.37,$0.87,$0.37,$0.37,$0.78,$0.76,$0.37,$0.83,$0.37,$0.85,$0.37,$0.37,$0.85
2507040,0259,,,,,,,,Lansoprazole 30 MG CAPCR,$1.80,$1.24,$0.68,$1.60,$0.74,$1.74,$0.74,$0.74,$1.57,$1.53,$0.74,$1.67,$0.74,$1.71,$0.74,$0.74,$1.71
2520660,0259,,,,,,,,Latanoprost 0.005% 2.5 Ml Btl,$124.86,$85.96,$46.99,$111.17,$51.19,$121.11,$51.19,$51.19,$109.25,$106.13,$51.19,$116.12,$51.19,$118.61,$51.19,$51.19,$118.61
2527180,0259,,,,,,,,Letrozole 2.5 MG TAB,$2.69,$1.85,$1.01,$2.40,$1.10,$2.61,$1.10,$1.10,$2.35,$2.29,$1.10,$2.50,$1.10,$2.56,$1.10,$1.10,$2.56
2512340,0636,J0640,,,,,,,Leucovorin 100 MG VIAL,$137.85,$94.91,$51.88,$122.74,$56.52,$133.72,$56.52,$56.52,$120.62,$117.17,$56.52,$128.20,$56.52,$130.96,$56.52,$56.52,$130.96
2524300,0636,J1950,,,,,,,Leuprolide 11.25 MG VIAL,"$2,653.85","$1,827.05",$998.79,"$2,362.99","$1,088.08","$2,574.24","$1,088.08","$1,088.08","$2,322.12","$2,255.78","$1,088.08","$2,468.08","$1,088.08","$2,521.16","$1,088.08","$1,088.08","$2,521.16"
2523431,0636,J9217,,,,,,,Leuprolide 22.5 Mg Syringe,"$1,176.33",$809.85,$442.72,"$1,047.41",$482.30,"$1,141.04",$482.30,$482.30,"$1,029.29",$999.88,$482.30,"$1,093.99",$482.30,"$1,117.52",$482.30,$482.30,"$1,117.52"
2521190,0636,J9218,,,,,,,Leuprolide 22.5 Mg Vial,"$1,546.63","$1,064.78",$582.08,"$1,377.12",$634.12,"$1,500.23",$634.12,$634.12,"$1,353.30","$1,314.64",$634.12,"$1,438.37",$634.12,"$1,469.30",$634.12,$634.12,"$1,469.30"
2512360,0636,J9999,,,,,,,Leuprolide 3.75 Mg Kit,"$2,148.43","$1,479.09",$808.57,"$1,912.96",$880.86,"$2,083.97",$880.86,$880.86,"$1,879.87","$1,826.16",$880.86,"$1,998.04",$880.86,"$2,041.01",$880.86,$880.86,"$2,041.01"
2528100,0636,J9218,,,,,,,Leuprolide 30 MG VIAL,"$1,657.70","$1,141.25",$623.88,"$1,476.01",$679.66,"$1,607.97",$679.66,$679.66,"$1,450.48","$1,409.04",$679.66,"$1,541.66",$679.66,"$1,574.81",$679.66,$679.66,"$1,574.81"
2523361,0636,J9217,,,,,,,Leuprolide 45 Mg Kit,"$2,616.72","$1,801.49",$984.81,"$2,329.92","$1,072.85","$2,538.22","$1,072.85","$1,072.85","$2,289.63","$2,224.21","$1,072.85","$2,433.55","$1,072.85","$2,485.88","$1,072.85","$1,072.85","$2,485.88"
2512350,0636,J9217,,,,,,,Leuprolide 7.5 Mg Kit,$627.42,$431.95,$236.13,$558.65,$257.24,$608.60,$257.24,$257.24,$548.99,$533.31,$257.24,$583.50,$257.24,$596.05,$257.24,$257.24,$596.05
2523423,0250,,,,,,,,LEUPROLIDE 7.5 MG SYRINGE,$597.54,$411.38,$224.89,$532.05,$244.99,$579.61,$244.99,$244.99,$522.84,$507.91,$244.99,$555.71,$244.99,$567.66,$244.99,$244.99,$567.66
2524480,0636,J7603,,,,,,,Levalbuterol 0.63 Mg/3 Ml Upd,$37.27,$25.66,$14.03,$33.18,$15.28,$36.15,$15.28,$15.28,$32.61,$31.68,$15.28,$34.66,$15.28,$35.40,$15.28,$15.28,$35.40
2524490,0636,J7603,,,,,,,Levalbuterol 1.25 Mg/3 Ml Upd,$29.53,$20.33,$11.12,$26.30,$12.11,$28.65,$12.11,$12.11,$25.84,$25.10,$12.11,$27.47,$12.11,$28.06,$12.11,$12.11,$28.06
2536410,0250,,,,,,,,Levalbuterol HFA 15 GM INH,$486.18,$334.71,$182.97,$432.89,$199.33,$471.59,$199.33,$199.33,$425.41,$413.25,$199.33,$452.15,$199.33,$461.87,$199.33,$199.33,$461.87
2535310,0250,,,,,,,,LevETIRAcetam 250 MG TAB,$2.87,$1.97,$1.08,$2.55,$1.17,$2.78,$1.17,$1.17,$2.51,$2.44,$1.17,$2.66,$1.17,$2.72,$1.17,$1.17,$2.72
2536600,0636,J1953,,,,,,,LevETIRAcetam 500 MG/5 ML VIAL,$71.76,$49.40,$27.01,$63.89,$29.42,$69.61,$29.42,$29.42,$62.79,$60.99,$29.42,$66.74,$29.42,$68.17,$29.42,$29.42,$68.17
2538180,0250,,,,,,,,LEVETIRACETAM 500MG TAB,$28.18,$19.40,$10.61,$25.09,$11.55,$27.34,$11.55,$11.55,$24.66,$23.96,$11.55,$26.21,$11.55,$26.77,$11.55,$11.55,$26.77
2523069,0250,,,,,,,,Levetiracetam Oral Solution 10,$0.73,$0.50,$0.27,$0.65,$0.30,$0.71,$0.30,$0.30,$0.64,$0.62,$0.30,$0.68,$0.30,$0.69,$0.30,$0.30,$0.69
2523250,0259,,,,,,,,LEVOCABASTINE 0.05% 5ML,$45.08,$31.04,$16.97,$40.14,$18.48,$43.73,$18.48,$18.48,$39.44,$38.32,$18.48,$41.92,$18.48,$42.83,$18.48,$18.48,$42.83
2523054,0250,,,,,,,,"levOCARNitine 1,000 MG/5 ML VI",$137.99,$95.00,$51.93,$122.87,$56.58,$133.85,$56.58,$56.58,$120.75,$117.30,$56.58,$128.33,$56.58,$131.09,$56.58,$56.58,$131.09
2530390,0259,,,,,,,,levOCARNitine 330 MG TAB,$18.01,$12.40,$6.78,$16.03,$7.38,$17.47,$7.38,$7.38,$15.76,$15.31,$7.38,$16.75,$7.38,$17.11,$7.38,$7.38,$17.11
2529390,0259,,,,,,,,Levofloxacin 250 MG TAB,$7.89,$5.43,$2.97,$7.02,$3.23,$7.65,$3.23,$3.23,$6.90,$6.70,$3.23,$7.34,$3.23,$7.49,$3.23,$3.23,$7.49
2525190,0636,J1956,,,,,,,Levofloxacin 250 MG/50 ML BAG,$32.85,$22.61,$12.36,$29.25,$13.47,$31.86,$13.47,$13.47,$28.74,$27.92,$13.47,$30.55,$13.47,$31.20,$13.47,$13.47,$31.20
2525180,0259,,,,,,,,Levofloxacin 500 MG TAB,$8.65,$5.96,$3.26,$7.70,$3.55,$8.39,$3.55,$3.55,$7.57,$7.35,$3.55,$8.04,$3.55,$8.22,$3.55,$3.55,$8.22
2525200,0636,J1956,,,,,,,Levofloxacin 500 MG/100 ML BAG,$44.23,$30.45,$16.65,$39.38,$18.13,$42.90,$18.13,$18.13,$38.70,$37.60,$18.13,$41.13,$18.13,$42.02,$18.13,$18.13,$42.02
2536560,0636,J1956,,,,,,,Levofloxacin 750 MG/150 ML BAG,$47.47,$32.68,$17.86,$42.26,$19.46,$46.04,$19.46,$19.46,$41.53,$40.35,$19.46,$44.14,$19.46,$45.09,$19.46,$19.46,$45.09
2523514,0636,J7297,,,,,,,LEVONORGESTREL 1 EA IUD LILETT,"$2,476.55","$1,704.99",$932.06,"$2,205.12","$1,015.39","$2,402.26","$1,015.39","$1,015.39","$2,166.99","$2,105.07","$1,015.39","$2,303.20","$1,015.39","$2,352.73","$1,015.39","$1,015.39","$2,352.73"
2523497,0636,J7296,,,,,,,LEVONORGESTREL 1 EACH IUD,"$2,777.59","$1,912.24","$1,045.36","$2,473.16","$1,138.81","$2,694.26","$1,138.81","$1,138.81","$2,430.39","$2,360.95","$1,138.81","$2,583.16","$1,138.81","$2,638.71","$1,138.81","$1,138.81","$2,638.71"
2523201,0636,J7302,,,,,,,Levonorgestrel 1 EACH IUD-Mire,"$2,777.59","$1,912.24","$1,045.36","$2,473.16","$1,138.81","$2,694.26","$1,138.81","$1,138.81","$2,430.39","$2,360.95","$1,138.81","$2,583.16","$1,138.81","$2,638.71","$1,138.81","$1,138.81","$2,638.71"
2523199,0636,J7301,,,,,,,Levonorgestrel 1 EACH IUD-Skyl,"$2,560.28","$1,762.63",$963.57,"$2,279.66","$1,049.71","$2,483.47","$1,049.71","$1,049.71","$2,240.24","$2,176.23","$1,049.71","$2,381.06","$1,049.71","$2,432.26","$1,049.71","$1,049.71","$2,432.26"
2531570,0259,,,,,,,,Levonorgestrel 1.5 MG KIT/PACK,$126.48,$87.08,$47.60,$112.62,$51.86,$122.68,$51.86,$51.86,$110.67,$107.51,$51.86,$117.63,$51.86,$120.16,$51.86,$51.86,$120.16
2505130,0259,,,,,,,,Levothyroxine 100 MCG TAB,$10.20,$7.02,$3.84,$9.08,$4.18,$9.89,$4.18,$4.18,$8.92,$8.67,$4.18,$9.48,$4.18,$9.69,$4.18,$4.18,$9.69
2522914,0250,,,,,,,,Levothyroxine 100 MCG VIAL,$647.60,$445.85,$243.73,$576.63,$265.52,$628.18,$265.52,$265.52,$566.65,$550.46,$265.52,$602.27,$265.52,$615.22,$265.52,$265.52,$615.22
2522230,0259,,,,,,,,Levothyroxine 112 MCG TAB,$10.95,$7.54,$4.12,$9.75,$4.49,$10.62,$4.49,$4.49,$9.58,$9.31,$4.49,$10.18,$4.49,$10.40,$4.49,$4.49,$10.40
2505140,0259,,,,,,,,Levothyroxine 125 MCG TAB,$8.19,$5.64,$3.08,$7.29,$3.36,$7.95,$3.36,$3.36,$7.17,$6.96,$3.36,$7.62,$3.36,$7.78,$3.36,$3.36,$7.78
2521650,0259,,,,,,,,Levothyroxine 137 Mcg Tab,$9.19,$6.33,$3.46,$8.19,$3.77,$8.92,$3.77,$3.77,$8.05,$7.82,$3.77,$8.55,$3.77,$8.73,$3.77,$3.77,$8.73
2505150,0259,,,,,,,,Levothyroxine 150 MCG TAB,$8.37,$5.76,$3.15,$7.45,$3.43,$8.12,$3.43,$3.43,$7.32,$7.11,$3.43,$7.78,$3.43,$7.95,$3.43,$3.43,$7.95
2505160,0259,,,,,,,,Levothyroxine 175 MCG TAB,$10.24,$7.05,$3.85,$9.12,$4.20,$9.93,$4.20,$4.20,$8.96,$8.70,$4.20,$9.52,$4.20,$9.73,$4.20,$4.20,$9.73
2505170,0259,,,,,,,,Levothyroxine 200 MCG TAB,$9.85,$6.78,$3.71,$8.77,$4.04,$9.55,$4.04,$4.04,$8.62,$8.37,$4.04,$9.16,$4.04,$9.36,$4.04,$4.04,$9.36
2505100,0259,,,,,,,,Levothyroxine 25 MCG TAB,$5.66,$3.90,$2.13,$5.04,$2.32,$5.49,$2.32,$2.32,$4.96,$4.82,$2.32,$5.27,$2.32,$5.38,$2.32,$2.32,$5.38
2505110,0259,,,,,,,,Levothyroxine 50 MCG TAB,$8.06,$5.55,$3.03,$7.18,$3.31,$7.82,$3.31,$3.31,$7.05,$6.85,$3.31,$7.50,$3.31,$7.66,$3.31,$3.31,$7.66
2505120,0259,,,,,,,,Levothyroxine 75 MCG TAB,$9.16,$6.31,$3.45,$8.16,$3.76,$8.89,$3.76,$3.76,$8.02,$7.79,$3.76,$8.52,$3.76,$8.70,$3.76,$3.76,$8.70
2505190,0259,,,,,,,,Levothyroxine 88 MCG TAB,$9.41,$6.48,$3.54,$8.38,$3.86,$9.13,$3.86,$3.86,$8.24,$8.00,$3.86,$8.75,$3.86,$8.94,$3.86,$3.86,$8.94
2513110,0250,,,,,,,,Lidocaine 0.5% 50 ML VIAL,$92.49,$63.68,$34.81,$82.35,$37.92,$89.72,$37.92,$37.92,$80.93,$78.62,$37.92,$86.02,$37.92,$87.87,$37.92,$37.92,$87.87
2523296,0250,,,,,,,,Lidocaine 0.5% Multi-Dose 50 M,$92.51,$63.69,$34.82,$82.37,$37.93,$89.74,$37.93,$37.93,$80.95,$78.64,$37.93,$86.04,$37.93,$87.89,$37.93,$37.93,$87.89
2536810,0250,,,,,,,,Lidocaine 1% 10 ML MULTI-DOSE,$86.96,$59.87,$32.73,$77.43,$35.65,$84.35,$35.65,$35.65,$76.09,$73.91,$35.65,$80.87,$35.65,$82.61,$35.65,$35.65,$82.61
2543780,0250,,,,,,,,Lidocaine 1% 20 ML VIAL,$62.14,$42.78,$23.39,$55.33,$25.48,$60.28,$25.48,$25.48,$54.37,$52.82,$25.48,$57.79,$25.48,$59.03,$25.48,$25.48,$59.03
2513060,0250,,,,,,,,Lidocaine 1% 5 Ml Vial,$96.68,$66.56,$36.39,$86.09,$39.64,$93.78,$39.64,$39.64,$84.60,$82.18,$39.64,$89.92,$39.64,$91.85,$39.64,$39.64,$91.85
2512990,0250,,,,,,,,Lidocaine 1% 50 ML VIAL,$99.20,$68.30,$37.33,$88.33,$40.67,$96.22,$40.67,$40.67,$86.80,$84.32,$40.67,$92.26,$40.67,$94.24,$40.67,$40.67,$94.24
2523257,0250,,,,,,,,Lidocaine 1% Pres-Free 2 ML VI,$84.58,$58.23,$31.83,$75.31,$34.68,$82.04,$34.68,$34.68,$74.01,$71.89,$34.68,$78.66,$34.68,$80.35,$34.68,$34.68,$80.35
2523045,0250,,,,,,,,Lidocaine 1% Pres-Free 30 Ml V,$172.52,$118.77,$64.93,$153.61,$70.73,$167.34,$70.73,$70.73,$150.95,$146.64,$70.73,$160.44,$70.73,$163.89,$70.73,$70.73,$163.89
2523292,0250,,,,,,,,"Lidocaine 1% w/Epi 1/100,000 1",$99.38,$68.42,$37.40,$88.48,$40.74,$96.39,$40.74,$40.74,$86.95,$84.47,$40.74,$92.42,$40.74,$94.41,$40.74,$40.74,$94.41
2541680,0250,,,,,,,,"Lidocaine 1% W/Epi 1/100,000 2",$69.43,$47.80,$26.13,$61.82,$28.47,$67.34,$28.47,$28.47,$60.75,$59.01,$28.47,$64.57,$28.47,$65.96,$28.47,$28.47,$65.96
2513010,0250,,,,,,,,"Lidocaine 1% w/Epi 1/100,000 3",$105.72,$72.78,$39.79,$94.13,$43.34,$102.54,$43.34,$43.34,$92.50,$89.86,$43.34,$98.32,$43.34,$100.43,$43.34,$43.34,$100.43
2523527,0250,,,,,,,,LIDOCAINE 1% W/EPI 1/100000 50,$144.02,$99.15,$54.20,$128.23,$59.05,$139.70,$59.05,$59.05,$126.02,$122.42,$59.05,$133.94,$59.05,$136.82,$59.05,$59.05,$136.82
2523227,0250,,,,,,,,"Lidocaine 1% w/Epi 1/200,000 1",$167.15,$115.07,$62.91,$148.83,$68.53,$162.13,$68.53,$68.53,$146.25,$142.07,$68.53,$155.45,$68.53,$158.79,$68.53,$68.53,$158.79
2523295,0250,,,,,,,,"Lidocaine 1% w/Epi 1/200,000 2",$173.01,$119.11,$65.11,$154.05,$70.93,$167.82,$70.93,$70.93,$151.38,$147.06,$70.93,$160.90,$70.93,$164.36,$70.93,$70.93,$164.36
2513080,0250,,,,,,,,Lidocaine 100 MG/5 ML SYR,$135.63,$93.38,$51.05,$120.77,$55.61,$131.56,$55.61,$55.61,$118.68,$115.29,$55.61,$126.14,$55.61,$128.85,$55.61,$55.61,$128.85
2543740,0250,,,,,,,,Lidocaine 2% 20 Ml Vial,$62.81,$43.25,$23.64,$55.93,$25.75,$60.93,$25.75,$25.75,$54.96,$53.39,$25.75,$58.42,$25.75,$59.67,$25.75,$25.75,$59.67
2513000,0250,,,,,,,,Lidocaine 2% 50 Ml Vial,$116.79,$80.41,$43.96,$103.99,$47.89,$113.29,$47.89,$47.89,$102.20,$99.28,$47.89,$108.62,$47.89,$110.95,$47.89,$47.89,$110.95
2528290,0250,,,,,,,,Lidocaine 2% Jelly 11 Ml Syr,$91.90,$63.27,$34.59,$81.83,$37.68,$89.14,$37.68,$37.68,$80.41,$78.12,$37.68,$85.47,$37.68,$87.31,$37.68,$37.68,$87.31
2523288,0250,,,,,,,,Lidocaine 2% Jelly 6 ML SYR,$98.61,$67.89,$37.11,$87.80,$40.43,$95.65,$40.43,$40.43,$86.29,$83.82,$40.43,$91.71,$40.43,$93.68,$40.43,$40.43,$93.68
2523537,0250,,,,,,,,LIDOCAINE 2% MULIT-DOSE 2ML VI,$84.80,$58.38,$31.91,$75.50,$34.77,$82.25,$34.77,$34.77,$74.20,$72.08,$34.77,$78.86,$34.77,$80.56,$34.77,$34.77,$80.56
2523255,0250,,,,,,,,LIDOCAINE 2% PRES-FREE 2MLVIAL,$84.80,$58.38,$31.91,$75.50,$34.77,$82.25,$34.77,$34.77,$74.20,$72.08,$34.77,$78.86,$34.77,$80.56,$34.77,$34.77,$80.56
2529740,0250,,,,,,,,Lidocaine 2% Pres-Free 5 Ml Vi,$101.61,$69.95,$38.24,$90.47,$41.66,$98.56,$41.66,$41.66,$88.91,$86.37,$41.66,$94.50,$41.66,$96.53,$41.66,$41.66,$96.53
2536150,0252,,,,,,,,LIDOCAINE 2% VISCOUS 100ML BTL,$2.37,$1.64,$0.89,$2.11,$0.97,$2.30,$0.97,$0.97,$2.08,$2.02,$0.97,$2.21,$0.97,$2.26,$0.97,$0.97,$2.26
2523469,0250,,,,,,,,"LIDOCAINE 2% W/EPI 1/100,000",$121.45,$83.61,$45.71,$108.14,$49.79,$117.80,$49.79,$49.79,$106.27,$103.23,$49.79,$112.95,$49.79,$115.37,$49.79,$49.79,$115.37
2513030,0250,,,,,,,,"Lidocaine 2% W/Epi 1/100,000 2",$98.90,$68.09,$37.22,$88.06,$40.55,$95.93,$40.55,$40.55,$86.53,$84.06,$40.55,$91.97,$40.55,$93.95,$40.55,$40.55,$93.95
2513040,0250,,,,,,,,"Lidocaine 2% W/Epi 1/200,000",$203.82,$140.32,$76.71,$181.48,$83.56,$197.70,$83.56,$83.56,$178.34,$173.24,$83.56,$189.55,$83.56,$193.63,$83.56,$83.56,$193.63
2519100,0636,J2001,,,,,,,Lidocaine 2000 MG/500 ML BAG,$106.82,$73.54,$40.20,$95.11,$43.79,$103.61,$43.79,$43.79,$93.46,$90.79,$43.79,$99.34,$43.79,$101.47,$43.79,$43.79,$101.47
2513090,0250,,,,,,,,Lidocaine 4% 5 ML AMP,$99.72,$68.66,$37.53,$88.79,$40.89,$96.73,$40.89,$40.89,$87.26,$84.77,$40.89,$92.74,$40.89,$94.74,$40.89,$40.89,$94.74
2522959,0250,,,,,,,,Lidocaine 4% Cream 5 GM TUBE,$82.87,$57.05,$31.19,$73.79,$33.98,$80.38,$33.98,$33.98,$72.51,$70.44,$33.98,$77.07,$33.98,$78.73,$33.98,$33.98,$78.73
2522970,0259,,,,,,,,Lidocaine 4% Topical Solution,$12.08,$8.32,$4.55,$10.76,$4.95,$11.72,$4.95,$4.95,$10.57,$10.27,$4.95,$11.24,$4.95,$11.48,$4.95,$4.95,$11.48
2532420,0259,,,,,,,,Lidocaine 5% PATCH,$30.12,$20.74,$11.34,$26.82,$12.35,$29.22,$12.35,$12.35,$26.36,$25.60,$12.35,$28.01,$12.35,$28.62,$12.35,$12.35,$28.62
2517110,0250,,,,,,,,Lidocaine VISCOUS 2% 20 ML BTL,$19.42,$13.37,$7.31,$17.30,$7.96,$18.84,$7.96,$7.96,$17.00,$16.51,$7.96,$18.06,$7.96,$18.45,$7.96,$7.96,$18.45
2523313,0250,,,,,,,,Lidocaine/Epinephri/Tetracaine,$171.69,$118.20,$64.62,$152.87,$70.39,$166.54,$70.39,$70.39,$150.23,$145.94,$70.39,$159.67,$70.39,$163.10,$70.39,$70.39,$163.10
2517020,0259,,,,,,,,Lidocaine/Prilocaine Cream 5 G,$100.03,$68.87,$37.65,$89.07,$41.01,$97.03,$41.01,$41.01,$87.53,$85.02,$41.01,$93.03,$41.01,$95.03,$41.01,$41.01,$95.03
2583340,0250,,,,,,,,"Lidocaine1.5%w/epi1/200,00 30m",$134.24,$92.42,$50.52,$119.52,$55.04,$130.21,$55.04,$55.04,$117.46,$114.10,$55.04,$124.84,$55.04,$127.52,$55.04,$55.04,$127.52
2523068,0636,J2001,,,,,,,LIDOCANE 100MG/5ML SYR,$134.05,$92.29,$50.45,$119.36,$54.96,$130.03,$54.96,$54.96,$117.29,$113.94,$54.96,$124.67,$54.96,$127.35,$54.96,$54.96,$127.35
2520240,0259,,,,,,,,Lindane 1% SHAMPOO 60 ML BTL,$462.03,$318.08,$173.89,$411.39,$189.43,$448.16,$189.43,$189.43,$404.27,$392.72,$189.43,$429.68,$189.43,$438.92,$189.43,$189.43,$438.92
2536090,0250,,,,,,,,Linezolid 600 MG TAB,$52.35,$36.04,$19.70,$46.61,$21.46,$50.78,$21.46,$21.46,$45.80,$44.49,$21.46,$48.68,$21.46,$49.73,$21.46,$21.46,$49.73
2534520,0636,J2020,,,,,,,Linezolid 600 MG/300 ML BAG,$148.13,$101.98,$55.75,$131.89,$60.73,$143.68,$60.73,$60.73,$129.61,$125.91,$60.73,$137.76,$60.73,$140.72,$60.73,$60.73,$140.72
2523121,0250,,,,,,,,LIOTHYONINE 5 MCG TAB,$9.90,$6.82,$3.73,$8.82,$4.06,$9.61,$4.06,$4.06,$8.66,$8.42,$4.06,$9.21,$4.06,$9.41,$4.06,$4.06,$9.41
2523404,0250,,,,,,,,LISDEXAMPHETAMINE 40 MG CAP,$159.47,$109.79,$60.02,$141.99,$65.38,$154.68,$65.38,$65.38,$139.53,$135.55,$65.38,$148.30,$65.38,$151.49,$65.38,$65.38,$151.49
2523525,0250,,,,,,,,LISEXAMPHETAMINE 60 MG CAP,$159.47,$109.79,$60.02,$141.99,$65.38,$154.68,$65.38,$65.38,$139.53,$135.55,$65.38,$148.30,$65.38,$151.49,$65.38,$65.38,$151.49
2507090,0259,,,,,,,,Lisinopril 10 MG TAB,$0.98,$0.68,$0.37,$0.87,$0.40,$0.95,$0.40,$0.40,$0.86,$0.83,$0.40,$0.91,$0.40,$0.93,$0.40,$0.40,$0.93
2507100,0259,,,,,,,,Lisinopril 20 MG TAB,$1.25,$0.86,$0.47,$1.12,$0.51,$1.22,$0.51,$0.51,$1.10,$1.06,$0.51,$1.17,$0.51,$1.19,$0.51,$0.51,$1.19
2507080,0259,,,,,,,,Lisinopril 5 MG TAB,$1.19,$0.82,$0.45,$1.06,$0.49,$1.15,$0.49,$0.49,$1.04,$1.01,$0.49,$1.10,$0.49,$1.13,$0.49,$0.49,$1.13
2504020,0259,,,,,,,,LITHIUM CARBONATE,$1.75,$1.21,$0.66,$1.56,$0.72,$1.70,$0.72,$0.72,$1.53,$1.49,$0.72,$1.63,$0.72,$1.67,$0.72,$0.72,$1.67
2509340,0259,,,,,,,,Lithium Carbonate 150 MG CAP,$1.36,$0.94,$0.51,$1.21,$0.56,$1.32,$0.56,$0.56,$1.19,$1.16,$0.56,$1.27,$0.56,$1.29,$0.56,$0.56,$1.29
2540230,0250,,,,,,,,Lithium Carbonate 300 MG TABCR,$3.75,$2.58,$1.41,$3.34,$1.54,$3.64,$1.54,$1.54,$3.28,$3.19,$1.54,$3.49,$1.54,$3.56,$1.54,$1.54,$3.56
2504030,0259,,,,,,,,Lithium Carbonate 450 MG TABCR,$3.03,$2.09,$1.14,$2.70,$1.24,$2.94,$1.24,$1.24,$2.65,$2.57,$1.24,$2.82,$1.24,$2.88,$1.24,$1.24,$2.88
2504610,0259,,,,,,,,Loperamide 2 MG CAP,$11.54,$7.94,$4.34,$10.27,$4.73,$11.19,$4.73,$4.73,$10.09,$9.81,$4.73,$10.73,$4.73,$10.96,$4.73,$4.73,$10.96
2502800,0259,,,,,,,,Loratidine 10 MG TAB,$6.26,$4.31,$2.36,$5.58,$2.57,$6.08,$2.57,$2.57,$5.48,$5.32,$2.57,$5.83,$2.57,$5.95,$2.57,$2.57,$5.95
2501940,0259,,,,,,,,Lorazepam 0.5 Mg Tab,$0.82,$0.56,$0.31,$0.73,$0.33,$0.79,$0.33,$0.33,$0.71,$0.69,$0.33,$0.76,$0.33,$0.78,$0.33,$0.33,$0.78
2501930,0250,,,,,,,,LORazepam 1 MG TAB,$1.29,$0.89,$0.48,$1.14,$0.53,$1.25,$0.53,$0.53,$1.12,$1.09,$0.53,$1.20,$0.53,$1.22,$0.53,$0.53,$1.22
2542180,0250,,,,,,,,LORazepam 2 MG/1 ML Oral Conce,$6.31,$4.34,$2.37,$5.62,$2.59,$6.12,$2.59,$2.59,$5.52,$5.36,$2.59,$5.87,$2.59,$5.99,$2.59,$2.59,$5.99
2533590,0636,J2060,,,,,,,Lorazepam 2 Mg/Ml Vial,$54.19,$37.31,$20.39,$48.25,$22.22,$52.56,$22.22,$22.22,$47.41,$46.06,$22.22,$50.39,$22.22,$51.48,$22.22,$22.22,$51.48
2544110,0250,,,,,,,,LORazepam 20 MG/10 ML VIAL,$65.14,$44.84,$24.51,$58.00,$26.71,$63.18,$26.71,$26.71,$56.99,$55.36,$26.71,$60.58,$26.71,$61.88,$26.71,$26.71,$61.88
2509370,0250,,,,,,,,Losartan 25 MG TAB,$14.08,$9.69,$5.30,$12.53,$5.77,$13.65,$5.77,$5.77,$12.32,$11.96,$5.77,$13.09,$5.77,$13.37,$5.77,$5.77,$13.37
2503130,0259,,,,,,,,Losartan 50 MG TAB,$6.29,$4.33,$2.37,$5.60,$2.58,$6.10,$2.58,$2.58,$5.50,$5.34,$2.58,$5.85,$2.58,$5.97,$2.58,$2.58,$5.97
2533730,0259,,,,,,,,Loteprednol 0.5% OPHTH SUSP 5,$587.55,$404.50,$221.13,$523.15,$240.89,$569.92,$240.89,$240.89,$514.10,$499.41,$240.89,$546.42,$240.89,$558.17,$240.89,$240.89,$558.17
2505670,0259,,,,,,,,Lovastatin 20 MG TAB,$2.17,$1.49,$0.82,$1.93,$0.89,$2.10,$0.89,$0.89,$1.90,$1.84,$0.89,$2.02,$0.89,$2.06,$0.89,$0.89,$2.06
2505680,0259,,,,,,,,Lovastatin 40 MG TAB,$1.54,$1.06,$0.58,$1.37,$0.63,$1.49,$0.63,$0.63,$1.34,$1.31,$0.63,$1.43,$0.63,$1.46,$0.63,$0.63,$1.46
2520760,0259,,,,,,,,Lubriderm 480 ML BTL,$90.66,$62.42,$34.12,$80.72,$37.17,$87.94,$37.17,$37.17,$79.33,$77.06,$37.17,$84.31,$37.17,$86.13,$37.17,$37.17,$86.13
2537440,0250,,,,,,,,LUGOL'S SOLUTION 14ML,$292.67,$201.49,$110.15,$260.59,$119.99,$283.89,$119.99,$119.99,$256.08,$248.77,$119.99,$272.18,$119.99,$278.03,$119.99,$119.99,$278.03
2523166,0250,,,,,,,,LURASIDONE 40 MG TAB,$441.74,$304.12,$166.25,$393.33,$181.11,$428.49,$181.11,$181.11,$386.52,$375.48,$181.11,$410.82,$181.11,$419.65,$181.11,$181.11,$419.65
2505410,0259,,,,,,,,MacroBID 100 MG CAP,$23.13,$15.92,$8.70,$20.59,$9.48,$22.43,$9.48,$9.48,$20.24,$19.66,$9.48,$21.51,$9.48,$21.97,$9.48,$9.48,$21.97
2523269,0250,,,,,,,,"MacroBID 100 MG CAP, 2 CAPS/BT",$26.79,$18.44,$10.08,$23.85,$10.98,$25.98,$10.98,$10.98,$23.44,$22.77,$10.98,$24.91,$10.98,$25.45,$10.98,$10.98,$25.45
2523004,0250,,,,,,,,Magic Mouthwash 119 ML BTL,$601.16,$413.87,$226.25,$535.28,$246.48,$583.13,$246.48,$246.48,$526.02,$510.99,$246.48,$559.08,$246.48,$571.11,$246.48,$246.48,$571.11
2523074,0250,,,,,,,,"Magnesium Chloride 10,000 mg/5",$195.75,$134.77,$73.67,$174.30,$80.26,$189.88,$80.26,$80.26,$171.29,$166.39,$80.26,$182.05,$80.26,$185.97,$80.26,$80.26,$185.97
2507980,0259,,,,,,,,Magnesium Chloride 64 MG TABCR,$1.54,$1.06,$0.58,$1.37,$0.63,$1.49,$0.63,$0.63,$1.34,$1.31,$0.63,$1.43,$0.63,$1.46,$0.63,$0.63,$1.46
2513120,0259,,,,,,,,Magnesium Citrate 300 ML BTL,$38.89,$26.78,$14.64,$34.63,$15.95,$37.72,$15.95,$15.95,$34.03,$33.06,$15.95,$36.17,$15.95,$36.95,$15.95,$15.95,$36.95
2537070,0250,,,,,,,,Magnesium Gluconate 500 MG TAB,$3.48,$2.39,$1.31,$3.09,$1.42,$3.37,$1.42,$1.42,$3.04,$2.95,$1.42,$3.23,$1.42,$3.30,$1.42,$1.42,$3.30
2524690,0259,,,,,,,,Magnesium Lactate-SR 84 MG TAB,$6.47,$4.46,$2.44,$5.76,$2.65,$6.28,$2.65,$2.65,$5.66,$5.50,$2.65,$6.02,$2.65,$6.15,$2.65,$2.65,$6.15
2523100,0259,,,,,,,,Magnesium Oxide 400 MG TAB,$1.34,$0.92,$0.50,$1.19,$0.55,$1.30,$0.55,$0.55,$1.17,$1.14,$0.55,$1.25,$0.55,$1.27,$0.55,$0.55,$1.27
2537560,0636,J3475,,,,,,,Magnesium Sulfate 1 G/100 ML B,$51.37,$35.36,$19.33,$45.74,$21.06,$49.82,$21.06,$21.06,$44.94,$43.66,$21.06,$47.77,$21.06,$48.80,$21.06,$21.06,$48.80
2541330,0250,,,,,,,,Magnesium Sulfate 2 G/50 Ml Ba,$67.36,$46.37,$25.35,$59.98,$27.62,$65.34,$27.62,$27.62,$58.94,$57.25,$27.62,$62.64,$27.62,$63.99,$27.62,$27.62,$63.99
2534590,0636,J3475,,,,,,,Magnesium Sulfate 20 G/500 ML,$137.73,$94.82,$51.84,$122.64,$56.47,$133.60,$56.47,$56.47,$120.52,$117.07,$56.47,$128.09,$56.47,$130.85,$56.47,$56.47,$130.85
2527170,0636,J3475,,,,,,,Magnesium Sulfate 4 G/100 ML B,$50.71,$34.91,$19.09,$45.15,$20.79,$49.19,$20.79,$20.79,$44.37,$43.10,$20.79,$47.16,$20.79,$48.18,$20.79,$20.79,$48.18
2521368,0250,,,,,,,,MAGNESIUM SULFATE 40.6MEQ/10ML,$75.31,$51.85,$28.34,$67.06,$30.88,$73.05,$30.88,$30.88,$65.90,$64.01,$30.88,$70.04,$30.88,$71.54,$30.88,$30.88,$71.54
2513200,0250,,,,,,,,Magnesium Sulfate 8.12 MEQ/2 M,$75.31,$51.85,$28.34,$67.06,$30.88,$73.05,$30.88,$30.88,$65.90,$64.01,$30.88,$70.04,$30.88,$71.54,$30.88,$30.88,$71.54
2519090,0250,,,,,,,,Mannitol 20% 500 ML BAG,$242.98,$167.28,$91.45,$216.35,$99.62,$235.69,$99.62,$99.62,$212.61,$206.53,$99.62,$225.97,$99.62,$230.83,$99.62,$99.62,$230.83
2513210,0636,,,,,,,,Mannitol 25% 50 ML VIAL,$84.33,$58.06,$31.74,$75.09,$34.58,$81.80,$34.58,$34.58,$73.79,$71.68,$34.58,$78.43,$34.58,$80.11,$34.58,$34.58,$80.11
2521880,0250,,,,,,,,"Measles, Mumps, & Rubella Vacc",$557.02,$383.48,$209.64,$495.97,$228.38,$540.31,$228.38,$228.38,$487.39,$473.47,$228.38,$518.03,$228.38,$529.17,$228.38,$228.38,$529.17
2501670,0259,,,,,,,,Meclizine 12.5 MG TAB,$6.73,$4.64,$2.53,$5.99,$2.76,$6.53,$2.76,$2.76,$5.89,$5.72,$2.76,$6.26,$2.76,$6.40,$2.76,$2.76,$6.40
2501680,0259,,,,,,,,Meclizine 25 MG TAB,$8.62,$5.93,$3.24,$7.67,$3.53,$8.36,$3.53,$3.53,$7.54,$7.32,$3.53,$8.01,$3.53,$8.19,$3.53,$3.53,$8.19
2501190,0259,,,,,,,,medroxyPROGESTERone 10 MG TAB,$1.42,$0.98,$0.53,$1.26,$0.58,$1.37,$0.58,$0.58,$1.24,$1.20,$0.58,$1.32,$0.58,$1.35,$0.58,$0.58,$1.35
2512560,0636,J1050,,,,,,,Medroxyprogesterone 150 Mg/Ml,$315.20,$217.00,$118.63,$280.65,$129.23,$305.74,$129.23,$129.23,$275.80,$267.92,$129.23,$293.13,$129.23,$299.44,$129.23,$129.23,$299.44
2501210,0259,,,,,,,,medroxyPROGESTERone 5 MG TAB,$2.94,$2.03,$1.11,$2.62,$1.21,$2.85,$1.21,$1.21,$2.57,$2.50,$1.21,$2.74,$1.21,$2.79,$1.21,$1.21,$2.79
2521390,0250,J9999,,,,,,,MEGACE 40MG/ML SUSP,$2.81,$1.94,$1.06,$2.50,$1.15,$2.73,$1.15,$1.15,$2.46,$2.39,$1.15,$2.61,$1.15,$2.67,$1.15,$1.15,$2.67
2505540,0250,,,,,,,,Megestrol 40 MG TAB,$4.06,$2.80,$1.53,$3.62,$1.67,$3.94,$1.67,$1.67,$3.56,$3.45,$1.67,$3.78,$1.67,$3.86,$1.67,$1.67,$3.86
2522969,0250,,,,,,,,Melatonin 3 MG TABCR,$4.74,$3.26,$1.78,$4.22,$1.94,$4.60,$1.94,$1.94,$4.15,$4.03,$1.94,$4.41,$1.94,$4.50,$1.94,$1.94,$4.50
2534690,0259,,,,,,,,Meloxicam 15 MG TAB,$2.61,$1.80,$0.98,$2.33,$1.07,$2.54,$1.07,$1.07,$2.29,$2.22,$1.07,$2.43,$1.07,$2.48,$1.07,$1.07,$2.48
2536200,0250,,,,,,,,Memantine 5 MG TAB,$4.85,$3.34,$1.82,$4.32,$1.99,$4.70,$1.99,$1.99,$4.24,$4.12,$1.99,$4.51,$1.99,$4.61,$1.99,$1.99,$4.61
2523359,0250,,,,,,,,"MENINGOCOCCAL B VACCINE,4COMP",$567.47,$390.68,$213.57,$505.27,$232.66,$550.44,$232.66,$232.66,$496.53,$482.35,$232.66,$527.75,$232.66,$539.10,$232.66,$232.66,$539.10
2513170,0250,,,,,,,,"Meningococcal Vaccine A,C,Y,W-",$686.43,$472.58,$258.34,$611.20,$281.44,$665.84,$281.44,$281.44,$600.63,$583.47,$281.44,$638.38,$281.44,$652.11,$281.44,$281.44,$652.11
2540760,0250,,,,,,,,Meperidine 100 MG/ML VIAL,$94.34,$64.95,$35.51,$84.00,$38.68,$91.51,$38.68,$38.68,$82.55,$80.19,$38.68,$87.74,$38.68,$89.62,$38.68,$38.68,$89.62
2512570,0636,J2175,,,,,,,Meperidine 25 Mg/Ml Tubx,$130.30,$89.71,$49.04,$116.02,$53.42,$126.39,$53.42,$53.42,$114.02,$110.76,$53.42,$121.18,$53.42,$123.79,$53.42,$53.42,$123.79
2503370,0259,,,,,,,,Meperidine 50 MG TAB,$16.03,$11.03,$6.03,$14.27,$6.57,$15.54,$6.57,$6.57,$14.02,$13.62,$6.57,$14.90,$6.57,$15.22,$6.57,$6.57,$15.22
2512580,0636,J2175,,,,,,,Meperidine 50 Mg/Ml Tubx,$141.55,$97.45,$53.27,$126.03,$58.03,$137.30,$58.03,$58.03,$123.85,$120.31,$58.03,$131.64,$58.03,$134.47,$58.03,$58.03,$134.47
2523339,0636,J2182,,,,,,,MEPOLIZUMAB 100 MG VIAL,"$6,781.55","$4,668.77","$2,552.26","$6,038.28","$2,780.43","$6,578.10","$2,780.43","$2,780.43","$5,933.85","$5,764.32","$2,780.43","$6,306.84","$2,780.43","$6,442.47","$2,780.43","$2,780.43","$6,442.47"
2523466,0636,J2182,,,,,,,MEPOLIZUMAB 100 MG/ML SYR,"$7,798.47","$5,368.88","$2,934.99","$6,943.75","$3,197.37","$7,564.52","$3,197.37","$3,197.37","$6,823.66","$6,628.70","$3,197.37","$7,252.58","$3,197.37","$7,408.55","$3,197.37","$3,197.37","$7,408.55"
2507280,0250,,,,,,,,Mercaptopurine 50 MG TAB,$35.43,$24.39,$13.33,$31.54,$14.53,$34.36,$14.53,$14.53,$31.00,$30.11,$14.53,$32.95,$14.53,$33.66,$14.53,$14.53,$33.66
2523127,0250,,,,,,,,MEROPENEM 0.5 GM IV VIAL,$147.15,$101.30,$55.38,$131.02,$60.33,$142.73,$60.33,$60.33,$128.75,$125.07,$60.33,$136.85,$60.33,$139.79,$60.33,$60.33,$139.79
2523115,0250,,,,,,,,Meropenem 1gm I.V. Vial,$147.12,$101.29,$55.37,$131.00,$60.32,$142.71,$60.32,$60.32,$128.73,$125.05,$60.32,$136.82,$60.32,$139.77,$60.32,$60.32,$139.77
2538470,0250,,,,,,,,MESALAMINE 1.2 GM TAB,$57.14,$39.34,$21.50,$50.88,$23.43,$55.42,$23.43,$23.43,$50.00,$48.57,$23.43,$53.14,$23.43,$54.28,$23.43,$23.43,$54.28
2523221,0250,,,,,,,,Mesalamine 4 GM/60 ML BTL W/CL,$226.19,$155.72,$85.13,$201.40,$92.74,$219.41,$92.74,$92.74,$197.92,$192.26,$92.74,$210.36,$92.74,$214.88,$92.74,$92.74,$214.88
2536630,0250,,,,,,,,Metaxalone 800 MG TAB,$11.18,$7.70,$4.21,$9.95,$4.58,$10.84,$4.58,$4.58,$9.78,$9.50,$4.58,$10.39,$4.58,$10.62,$4.58,$4.58,$10.62
2509350,0259,,,,,,,,metFORMIN 500 MG TAB,$1.15,$0.80,$0.43,$1.03,$0.47,$1.12,$0.47,$0.47,$1.01,$0.98,$0.47,$1.07,$0.47,$1.10,$0.47,$0.47,$1.10
2509360,0259,,,,,,,,metFORMIN 850 MG TAB,$3.55,$2.45,$1.34,$3.16,$1.46,$3.44,$1.46,$1.46,$3.11,$3.02,$1.46,$3.30,$1.46,$3.37,$1.46,$1.46,$3.37
2528410,0259,,,,,,,,metFORMIN C.R. 500 MG TABCR,$0.87,$0.60,$0.33,$0.78,$0.36,$0.85,$0.36,$0.36,$0.76,$0.74,$0.36,$0.81,$0.36,$0.83,$0.36,$0.36,$0.83
2538740,0250,,,,,,,,metFORMIN C.R. 750 MG TABCR,$1.26,$0.87,$0.48,$1.13,$0.52,$1.23,$0.52,$0.52,$1.11,$1.07,$0.52,$1.18,$0.52,$1.20,$0.52,$0.52,$1.20
2512530,0250,,,,,,,,Methacholine 100 MG VIAL,$576.46,$396.86,$216.95,$513.28,$236.35,$559.16,$236.35,$236.35,$504.40,$489.99,$236.35,$536.10,$236.35,$547.63,$236.35,$236.35,$547.63
2503670,0259,,,,,,,,Methadone 10 MG TAB,$5.50,$3.79,$2.07,$4.90,$2.26,$5.34,$2.26,$2.26,$4.81,$4.68,$2.26,$5.12,$2.26,$5.23,$2.26,$2.26,$5.23
2503660,0259,,,,,,,,Methadone 5 MG TAB,$3.95,$2.72,$1.49,$3.52,$1.62,$3.84,$1.62,$1.62,$3.46,$3.36,$1.62,$3.68,$1.62,$3.76,$1.62,$1.62,$3.76
2526890,0250,,,,,,,,Methadone Liquid 10 MG/ML,$1.01,$0.70,$0.38,$0.90,$0.42,$0.98,$0.42,$0.42,$0.89,$0.86,$0.42,$0.94,$0.42,$0.96,$0.42,$0.42,$0.96
2522918,0250,,,,,,,,Methazolamide 25 MG TAB,$64.50,$44.41,$24.28,$57.43,$26.45,$62.57,$26.45,$26.45,$56.44,$54.83,$26.45,$59.99,$26.45,$61.28,$26.45,$26.45,$61.28
2508180,0259,,,,,,,,Methimazole 5 MG TAB,$7.33,$5.05,$2.76,$6.53,$3.01,$7.11,$3.01,$3.01,$6.42,$6.23,$3.01,$6.82,$3.01,$6.97,$3.01,$3.01,$6.97
2507580,0259,,,,,,,,Methocarbamol 500 MG TAB,$4.65,$3.20,$1.75,$4.14,$1.91,$4.51,$1.91,$1.91,$4.07,$3.95,$1.91,$4.33,$1.91,$4.42,$1.91,$1.91,$4.42
2520450,0259,,,,,,,,Methocarbamol 750 MG TAB,$5.11,$3.52,$1.92,$4.55,$2.09,$4.96,$2.09,$2.09,$4.47,$4.34,$2.09,$4.75,$2.09,$4.85,$2.09,$2.09,$4.85
2505650,0636,J8610,,,,,,,Methotrexate 2.5 MG TAB,$39.60,$27.26,$14.90,$35.26,$16.24,$38.41,$16.24,$16.24,$34.65,$33.66,$16.24,$36.83,$16.24,$37.62,$16.24,$16.24,$37.62
2512490,0636,J9250,,,,,,,Methotrexate 50 Mg/2 Ml Vial,$97.94,$67.43,$36.86,$87.20,$40.15,$95.00,$40.15,$40.15,$85.69,$83.25,$40.15,$91.08,$40.15,$93.04,$40.15,$40.15,$93.04
2523369,0250,,,,,,,,METHYLENE BLUE 0.5%% 10 ML AMP,$745.83,$513.47,$280.69,$664.08,$305.79,$723.45,$305.79,$305.79,$652.60,$633.95,$305.79,$693.62,$305.79,$708.53,$305.79,$305.79,$708.53
2505640,0259,,,,,,,,Methylergonovine 0.2 MG TAB,$193.70,$133.35,$72.90,$172.47,$79.42,$187.88,$79.42,$79.42,$169.48,$164.64,$79.42,$180.14,$79.42,$184.01,$79.42,$79.42,$184.01
2512470,0636,J2210,,,,,,,Methylergonovine 0.2 MG/ML AMP,$308.15,$212.15,$115.97,$274.37,$126.34,$298.90,$126.34,$126.34,$269.63,$261.93,$126.34,$286.58,$126.34,$292.74,$126.34,$126.34,$292.74
2538800,0250,,,,,,,,Methylnaltrexone 12 MG/0.6 ML,$566.97,$390.33,$213.38,$504.83,$232.46,$549.96,$232.46,$232.46,$496.10,$481.92,$232.46,$527.28,$232.46,$538.62,$232.46,$232.46,$538.62
2507520,0259,,,,,,,,Methylphenidate 10 MG TAB,$21.47,$14.78,$8.08,$19.12,$8.80,$20.83,$8.80,$8.80,$18.79,$18.25,$8.80,$19.97,$8.80,$20.40,$8.80,$8.80,$20.40
2527430,0250,,,,,,,,METHYLPHENIDATE 18 MG CR,$16.18,$11.14,$6.09,$14.40,$6.63,$15.69,$6.63,$6.63,$14.16,$13.75,$6.63,$15.05,$6.63,$15.37,$6.63,$6.63,$15.37
2505520,0636,J7509,,,,,,,methylPREDNISolone 4 MG TAB,$4.63,$3.19,$1.74,$4.12,$1.90,$4.49,$1.90,$1.90,$4.05,$3.94,$1.90,$4.31,$1.90,$4.40,$1.90,$1.90,$4.40
2520680,0636,J7509,,,,,,,methylPREDNISolone 4 MG TAB Do,$4.63,$3.19,$1.74,$4.12,$1.90,$4.49,$1.90,$1.90,$4.05,$3.94,$1.90,$4.31,$1.90,$4.40,$1.90,$1.90,$4.40
2522994,0250,,,,,,,,MethylPREDNISolone 8 MG TAB,$23.29,$16.04,$8.77,$20.74,$9.55,$22.59,$9.55,$9.55,$20.38,$19.80,$9.55,$21.66,$9.55,$22.13,$9.55,$9.55,$22.13
2512450,0636,J1030,,,,,,,methylPREDNISolone ACETATE 40,$128.98,$88.80,$48.54,$114.85,$52.88,$125.12,$52.88,$52.88,$112.86,$109.64,$52.88,$119.96,$52.88,$122.54,$52.88,$52.88,$122.54
2512460,0636,J1040,,,,,,,Methylprednisolone Acetate 80,$311.74,$214.62,$117.33,$277.58,$127.81,$302.39,$127.81,$127.81,$272.77,$264.98,$127.81,$289.92,$127.81,$296.16,$127.81,$127.81,$296.16
2512430,0636,J2930,,,,,,,methylPREDNISolone SUCC 1000 M,$205.72,$141.63,$77.42,$183.17,$84.35,$199.55,$84.35,$84.35,$180.01,$174.86,$84.35,$191.32,$84.35,$195.44,$84.35,$84.35,$195.44
2512420,0636,J2930,,,,,,,methylPREDNISolone SUCC 125 MG,$172.18,$118.54,$64.80,$153.31,$70.59,$167.01,$70.59,$70.59,$150.66,$146.35,$70.59,$160.13,$70.59,$163.57,$70.59,$70.59,$163.57
2512410,0250,,,,,,,,methylPREDNISolone SUCC 40 MG,$137.14,$94.42,$51.61,$122.11,$56.23,$133.03,$56.23,$56.23,$120.00,$116.57,$56.23,$127.54,$56.23,$130.29,$56.23,$56.23,$130.29
2507410,0259,,,,,,,,Metoclopramide 10 Mg Tab,$17.23,$11.87,$6.49,$15.35,$7.07,$16.72,$7.07,$7.07,$15.08,$14.65,$7.07,$16.03,$7.07,$16.37,$7.07,$7.07,$16.37
2513250,0636,J2765,,,,,,,Metoclopramide 10 Mg/2 Ml Vial,$66.02,$45.45,$24.85,$58.78,$27.07,$64.04,$27.07,$27.07,$57.77,$56.11,$27.07,$61.40,$27.07,$62.72,$27.07,$27.07,$62.72
2513230,0259,,,,,,,,Metoclopramide 5 MG/5 ML ML,$0.70,$0.48,$0.26,$0.62,$0.29,$0.68,$0.29,$0.29,$0.61,$0.59,$0.29,$0.65,$0.29,$0.66,$0.29,$0.29,$0.66
2509100,0259,,,,,,,,Metolazone 2.5 MG TAB,$12.63,$8.69,$4.75,$11.24,$5.18,$12.25,$5.18,$5.18,$11.05,$10.73,$5.18,$11.74,$5.18,$11.99,$5.18,$5.18,$11.99
2522916,0250,,,,,,,,Metoprolol 12.5 MG TAB,$0.65,$0.45,$0.25,$0.58,$0.27,$0.63,$0.27,$0.27,$0.57,$0.56,$0.27,$0.61,$0.27,$0.62,$0.27,$0.27,$0.62
2525380,0259,,,,,,,,Metoprolol 25 MG TAB,$1.21,$0.83,$0.46,$1.08,$0.50,$1.17,$0.50,$0.50,$1.06,$1.03,$0.50,$1.12,$0.50,$1.15,$0.50,$0.50,$1.15
2536260,0250,,,,,,,,Metoprolol 5 MG/5 ML VIAL,$56.02,$38.57,$21.08,$49.88,$22.97,$54.34,$22.97,$22.97,$49.01,$47.61,$22.97,$52.10,$22.97,$53.22,$22.97,$22.97,$53.22
2505290,0259,,,,,,,,Metoprolol 50 Mg Tab,$1.44,$0.99,$0.54,$1.28,$0.59,$1.39,$0.59,$0.59,$1.26,$1.22,$0.59,$1.34,$0.59,$1.37,$0.59,$0.59,$1.37
2508570,0259,,,,,,,,Metoprolol Cr 100 Mg Tabcr,$11.35,$7.82,$4.27,$10.11,$4.65,$11.01,$4.65,$4.65,$9.93,$9.65,$4.65,$10.56,$4.65,$10.78,$4.65,$4.65,$10.78
2529260,0259,,,,,,,,Metoprolol CR 25 MG TABCR,$9.99,$6.88,$3.76,$8.89,$4.10,$9.69,$4.10,$4.10,$8.74,$8.49,$4.10,$9.29,$4.10,$9.49,$4.10,$4.10,$9.49
2508560,0259,,,,,,,,Metoprolol CR 50 MG TABCR,$15.98,$11.00,$6.01,$14.23,$6.55,$15.50,$6.55,$6.55,$13.98,$13.58,$6.55,$14.86,$6.55,$15.18,$6.55,$6.55,$15.18
2526330,0259,,,,,,,,METROGEL 45G,$157.45,$108.40,$59.26,$140.19,$64.55,$152.73,$64.55,$64.55,$137.77,$133.83,$64.55,$146.43,$64.55,$149.58,$64.55,$64.55,$149.58
2534640,0259,,,,,,,,metroNIDAZOLE 0.75% CR. 45 G T,$355.23,$244.56,$133.69,$316.30,$145.64,$344.57,$145.64,$145.64,$310.83,$301.95,$145.64,$330.37,$145.64,$337.47,$145.64,$145.64,$337.47
2517210,0259,,,,,,,,metroNIDAZOLE 0.75% VAG 70 GM,$567.52,$390.71,$213.59,$505.32,$232.68,$550.50,$232.68,$232.68,$496.58,$482.39,$232.68,$527.80,$232.68,$539.15,$232.68,$232.68,$539.15
2504210,0259,,,,,,,,metroNIDAZOLE 250 MG TAB,$5.77,$3.98,$2.17,$5.14,$2.37,$5.60,$2.37,$2.37,$5.05,$4.91,$2.37,$5.37,$2.37,$5.49,$2.37,$2.37,$5.49
2504200,0259,,,,,,,,metroNIDAZOLE 500 MG TAB,$10.08,$6.94,$3.79,$8.97,$4.13,$9.77,$4.13,$4.13,$8.82,$8.57,$4.13,$9.37,$4.13,$9.57,$4.13,$4.13,$9.57
2523264,0250,,,,,,,,"metroNIDAZOLE 500 MG TAB, 3 TA",$3.89,$2.68,$1.46,$3.46,$1.59,$3.77,$1.59,$1.59,$3.40,$3.31,$1.59,$3.62,$1.59,$3.69,$1.59,$1.59,$3.69
2519320,0250,,,,,,,,metroNIDAZOLE 500 MG/100 ML BA,$57.64,$39.68,$21.69,$51.32,$23.63,$55.91,$23.63,$23.63,$50.44,$48.99,$23.63,$53.61,$23.63,$54.76,$23.63,$23.63,$54.76
2523048,0250,,,,,,,,Mexiletine 150 MG CAP,$15.63,$10.76,$5.88,$13.92,$6.41,$15.16,$6.41,$6.41,$13.68,$13.29,$6.41,$14.54,$6.41,$14.85,$6.41,$6.41,$14.85
2523456,0250,,,,,,,,MICAFUNGIN 100 MG VIAL,$721.23,$496.53,$271.44,$642.18,$295.70,$699.59,$295.70,$295.70,$631.07,$613.04,$295.70,$670.74,$295.70,$685.17,$295.70,$295.70,$685.17
2539690,0250,,,,,,,,Miconazole 2% CREAM 57 GM TUBE,$93.44,$64.33,$35.17,$83.20,$38.31,$90.63,$38.31,$38.31,$81.76,$79.42,$38.31,$86.90,$38.31,$88.77,$38.31,$38.31,$88.77
2517240,0259,,,,,,,,Miconazole 2% VAG 45 GM TUBE,$62.64,$43.13,$23.58,$55.78,$25.68,$60.76,$25.68,$25.68,$54.81,$53.24,$25.68,$58.26,$25.68,$59.51,$25.68,$25.68,$59.51
2533440,0250,,,,,,,,Microfibrillar Collagen 0.5 GM,$604.10,$415.90,$227.36,$537.89,$247.68,$585.98,$247.68,$247.68,$528.59,$513.49,$247.68,$561.82,$247.68,$573.90,$247.68,$247.68,$573.90
2517310,0250,,,,,,,,Microfibrillar Collagen-WEB 1,$632.79,$435.65,$238.15,$563.43,$259.44,$613.81,$259.44,$259.44,$553.69,$537.87,$259.44,$588.49,$259.44,$601.15,$259.44,$259.44,$601.15
2513300,0636,J2250,,,,,,,Midazolam 10 MG/10 ML,$46.30,$31.88,$17.43,$41.23,$18.98,$44.91,$18.98,$18.98,$40.51,$39.35,$18.98,$43.06,$18.98,$43.98,$18.98,$18.98,$43.98
2523197,0250,,,,,,,,Midazolam 10 MG/2 ML VIAL,$21.59,$14.87,$8.13,$19.23,$8.85,$20.94,$8.85,$8.85,$18.89,$18.35,$8.85,$20.08,$8.85,$20.51,$8.85,$8.85,$20.51
2526780,0250,,,,,,,,Midazolam 2 MG/1 ML SYRUP,$11.25,$7.75,$4.24,$10.02,$4.61,$10.92,$4.61,$4.61,$9.85,$9.57,$4.61,$10.47,$4.61,$10.69,$4.61,$4.61,$10.69
2522400,0636,J2250,,,,,,,Midazolam 2 Mg/2 Ml Vial,$51.91,$35.74,$19.54,$46.22,$21.28,$50.35,$21.28,$21.28,$45.42,$44.12,$21.28,$48.28,$21.28,$49.31,$21.28,$21.28,$49.31
2524930,0636,J2250,,,,,,,Midazolam 5 MG/5 ML VIAL,$73.46,$50.57,$27.65,$65.41,$30.12,$71.25,$30.12,$30.12,$64.28,$62.44,$30.12,$68.32,$30.12,$69.79,$30.12,$30.12,$69.79
2523403,0250,,,,,,,,MIDAZOLAM 5 MG/ML VIAL,$73.48,$50.59,$27.65,$65.43,$30.13,$71.28,$30.13,$30.13,$64.30,$62.46,$30.13,$68.34,$30.13,$69.81,$30.13,$30.13,$69.81
2544000,0250,,,,,,,,Midazolam 50 MG/10 ML VIAL,$87.85,$60.48,$33.06,$78.22,$36.02,$85.21,$36.02,$36.02,$76.87,$74.67,$36.02,$81.70,$36.02,$83.46,$36.02,$36.02,$83.46
2523289,0250,,,,,,,,Midazolam/Ketamine/Ondansetron,$256.79,$176.79,$96.65,$228.65,$105.29,$249.09,$105.29,$105.29,$224.69,$218.27,$105.29,$238.82,$105.29,$243.95,$105.29,$105.29,$243.95
2523930,0259,,,,,,,,Midodrine 2.5 MG TAB,$2.24,$1.55,$0.84,$2.00,$0.92,$2.18,$0.92,$0.92,$1.96,$1.91,$0.92,$2.09,$0.92,$2.13,$0.92,$0.92,$2.13
2523561,0250,,,,,,,,MIFEPRISTONE 200 MG TAB,$441.70,$304.09,$166.23,$393.29,$181.10,$428.45,$181.10,$181.10,$386.49,$375.44,$181.10,$410.78,$181.10,$419.61,$181.10,$181.10,$419.61
2513360,0259,,,,,,,,Milk of Magnesia 30 ML BTL,$29.89,$20.58,$11.25,$26.62,$12.26,$29.00,$12.26,$12.26,$26.16,$25.41,$12.26,$27.80,$12.26,$28.40,$12.26,$12.26,$28.40
2517290,0259,,,,,,,,Mineral Oil-Enema 133 ML BTL,$40.06,$27.58,$15.08,$35.67,$16.42,$38.86,$16.42,$16.42,$35.05,$34.05,$16.42,$37.25,$16.42,$38.05,$16.42,$16.42,$38.05
2513390,0259,,,,,,,,Mineral Oil-Sterile 10 ML VIAL,$250.66,$172.57,$94.34,$223.19,$102.77,$243.14,$102.77,$102.77,$219.33,$213.06,$102.77,$233.11,$102.77,$238.13,$102.77,$102.77,$238.13
2536730,0250,,,,,,,,Minoxidil 2.5 MG TAB,$2.69,$1.85,$1.01,$2.40,$1.10,$2.61,$1.10,$1.10,$2.35,$2.29,$1.10,$2.50,$1.10,$2.56,$1.10,$1.10,$2.56
2523349,0250,,,,,,,,MIRABEGRON 25 MG TABCR,$194.83,$134.13,$73.32,$173.47,$79.88,$188.98,$79.88,$79.88,$170.47,$165.60,$79.88,$181.19,$79.88,$185.09,$79.88,$79.88,$185.09
2523161,0250,,,,,,,,MIRABEGRON 50 MG TAB CR,$194.76,$134.09,$73.30,$173.42,$79.85,$188.92,$79.85,$79.85,$170.42,$165.55,$79.85,$181.13,$79.85,$185.02,$79.85,$79.85,$185.02
2524980,0259,,,,,,,,Mirtazapine 15 MG TAB,$2.89,$1.99,$1.09,$2.57,$1.18,$2.80,$1.18,$1.18,$2.53,$2.45,$1.18,$2.68,$1.18,$2.74,$1.18,$1.18,$2.74
2503180,0259,,,,,,,,Misoprostol 100 MCG TAB,$14.21,$9.78,$5.35,$12.65,$5.82,$13.78,$5.82,$5.82,$12.43,$12.07,$5.82,$13.21,$5.82,$13.50,$5.82,$5.82,$13.50
2503190,0259,,,,,,,,Misoprostol 200 MCG TAB,$15.38,$10.59,$5.79,$13.70,$6.31,$14.92,$6.31,$6.31,$13.46,$13.07,$6.31,$14.31,$6.31,$14.61,$6.31,$6.31,$14.61
2522919,0250,,,,,,,,Misoprostol 25 MCG TAB,$3.38,$2.33,$1.27,$3.01,$1.38,$3.28,$1.38,$1.38,$2.95,$2.87,$1.38,$3.14,$1.38,$3.21,$1.38,$1.38,$3.21
2522921,0250,,,,,,,,Misoprostol 50 MCG TAB,$6.75,$4.65,$2.54,$6.01,$2.77,$6.55,$2.77,$2.77,$5.91,$5.74,$2.77,$6.28,$2.77,$6.42,$2.77,$2.77,$6.42
2513330,0636,J9280,,,,,,,Mitomycin 20 MG VIAL,$703.82,$484.55,$264.88,$626.68,$288.57,$682.70,$288.57,$288.57,$615.84,$598.25,$288.57,$654.55,$288.57,$668.63,$288.57,$288.57,$668.63
2522730,0636,J9280,,,,,,,Mitomycin 40 MG VIAL,$502.18,$345.73,$189.00,$447.14,$205.89,$487.12,$205.89,$205.89,$439.41,$426.85,$205.89,$467.03,$205.89,$477.07,$205.89,$205.89,$477.07
2544170,0250,,,,,,,,Mitomycin 5 MG VIAL,$564.09,$388.35,$212.30,$502.27,$231.28,$547.17,$231.28,$231.28,$493.58,$479.48,$231.28,$524.60,$231.28,$535.89,$231.28,$231.28,$535.89
2538530,0250,,,,,,,,Modafinil 100 MG TAB,$7.44,$5.12,$2.80,$6.63,$3.05,$7.22,$3.05,$3.05,$6.51,$6.32,$3.05,$6.92,$3.05,$7.07,$3.05,$3.05,$7.07
2528170,0259,,,,,,,,MODAFINIL 200 MG,$30.98,$21.33,$11.66,$27.59,$12.70,$30.05,$12.70,$12.70,$27.11,$26.34,$12.70,$28.81,$12.70,$29.43,$12.70,$12.70,$29.43
2537880,0250,,,,,,,,Mometasone 220 MCG 14 DOSE INH,$406.05,$279.55,$152.82,$361.55,$166.48,$393.87,$166.48,$166.48,$355.30,$345.14,$166.48,$377.63,$166.48,$385.75,$166.48,$166.48,$385.75
2525570,0259,,,,,,,,Mometasone NASAL 17 GM BTL,$639.31,$440.14,$240.61,$569.24,$262.12,$620.13,$262.12,$262.12,$559.40,$543.42,$262.12,$594.56,$262.12,$607.35,$262.12,$262.12,$607.35
2521950,0259,,,,,,,,Montelukast 10 Mg Tab,$5.56,$3.83,$2.09,$4.95,$2.28,$5.39,$2.28,$2.28,$4.86,$4.72,$2.28,$5.17,$2.28,$5.28,$2.28,$2.28,$5.28
2521960,0259,,,,,,,,Montelukast 5 MG CHEW,$4.98,$3.43,$1.87,$4.43,$2.04,$4.83,$2.04,$2.04,$4.36,$4.23,$2.04,$4.63,$2.04,$4.73,$2.04,$2.04,$4.73
2507560,0259,,,,,,,,MORPHine 10 MG SUPP,$80.11,$55.16,$30.15,$71.33,$32.85,$77.71,$32.85,$32.85,$70.10,$68.10,$32.85,$74.51,$32.85,$76.11,$32.85,$32.85,$76.11
2513480,0259,,,,,,,,MORPHine 10 MG/5 SOLN. ML,$0.94,$0.65,$0.35,$0.83,$0.38,$0.91,$0.38,$0.38,$0.82,$0.80,$0.38,$0.87,$0.38,$0.89,$0.38,$0.38,$0.89
2539970,0250,,,,,,,,MORPHine 10 MG/5ML SOLN. 5ML,$29.33,$20.19,$11.04,$26.11,$12.02,$28.45,$12.02,$12.02,$25.66,$24.93,$12.02,$27.27,$12.02,$27.86,$12.02,$12.02,$27.86
2513460,0636,J2270,,,,,,,MORPHine 10 MG/ML TUBX,$74.67,$51.41,$28.10,$66.48,$30.61,$72.43,$30.61,$30.61,$65.33,$63.47,$30.61,$69.44,$30.61,$70.93,$30.61,$30.61,$70.93
2513500,0636,J2270,,,,,,,MORPHine 10 MG/ML VIAL,$78.24,$53.87,$29.45,$69.67,$32.08,$75.89,$32.08,$32.08,$68.46,$66.50,$32.08,$72.76,$32.08,$74.33,$32.08,$32.08,$74.33
2522420,0250,,,,,,,,Morphine 1000 Mg/20 Ml Vial,$216.74,$149.21,$81.57,$192.98,$88.86,$210.23,$88.86,$88.86,$189.64,$184.23,$88.86,$201.56,$88.86,$205.90,$88.86,$88.86,$205.90
2513490,0636,J2770,,,,,,,Morphine 10000 Mcg/10 Ml Amp,$135.83,$93.51,$51.12,$120.94,$55.69,$131.75,$55.69,$55.69,$118.85,$115.45,$55.69,$126.32,$55.69,$129.04,$55.69,$55.69,$129.04
2522340,0259,,,,,,,,MORPHine 15 MG TAB,$15.96,$10.99,$6.01,$14.21,$6.54,$15.48,$6.54,$6.54,$13.96,$13.57,$6.54,$14.84,$6.54,$15.16,$6.54,$6.54,$15.16
2513430,0636,J2270,,,,,,,MORPHine 2 MG/ML TUBX,$74.65,$51.39,$28.09,$66.46,$30.60,$72.41,$30.60,$30.60,$65.31,$63.45,$30.60,$69.42,$30.60,$70.91,$30.60,$30.60,$70.91
2583480,0250,,,,,,,,Morphine 2500 Mg/50 Ml Vial,$304.02,$209.30,$114.42,$270.70,$124.65,$294.90,$124.65,$124.65,$266.02,$258.42,$124.65,$282.74,$124.65,$288.82,$124.65,$124.65,$288.82
2533360,0259,,,,,,,,MORPHine 300 MG/20 ML VIAL,$56.06,$38.60,$21.10,$49.92,$22.98,$54.38,$22.98,$22.98,$49.05,$47.65,$22.98,$52.14,$22.98,$53.26,$22.98,$22.98,$53.26
2513440,0636,J2270,,,,,,,MORPHine 4 MG/ML TUBX,$74.65,$51.39,$28.09,$66.46,$30.60,$72.41,$30.60,$30.60,$65.31,$63.45,$30.60,$69.42,$30.60,$70.91,$30.60,$30.60,$70.91
2523247,0250,,,,,,,,MORPHine 4 MG/ML VIAL,$94.78,$65.25,$35.67,$84.39,$38.86,$91.93,$38.86,$38.86,$82.93,$80.56,$38.86,$88.14,$38.86,$90.04,$38.86,$38.86,$90.04
2522922,0250,,,,,,,,MORPHine 50 MG/50 ML -PCA,$271.62,$187.00,$102.23,$241.85,$111.36,$263.47,$111.36,$111.36,$237.67,$230.88,$111.36,$252.61,$111.36,$258.04,$111.36,$111.36,$258.04
2528160,0250,,,,,,,,MORPHine 5000 MCG/10 ML AMP,$194.00,$133.56,$73.01,$172.74,$79.54,$188.18,$79.54,$79.54,$169.75,$164.90,$79.54,$180.42,$79.54,$184.30,$79.54,$79.54,$184.30
2505890,0259,,,,,,,,MORPHine C.R. 100 MG TABCR,$43.75,$30.12,$16.47,$38.96,$17.94,$42.44,$17.94,$17.94,$38.28,$37.19,$17.94,$40.69,$17.94,$41.56,$17.94,$17.94,$41.56
2505860,0259,,,,,,,,MORPHine C.R. 15 MG TABCR,$49.08,$33.79,$18.47,$43.70,$20.12,$47.61,$20.12,$20.12,$42.94,$41.72,$20.12,$45.64,$20.12,$46.62,$20.12,$20.12,$46.62
2505870,0259,,,,,,,,MORPHine C.R. 30 MG TABCR,$74.65,$51.39,$28.09,$66.46,$30.60,$72.41,$30.60,$30.60,$65.31,$63.45,$30.60,$69.42,$30.60,$70.91,$30.60,$30.60,$70.91
2523062,0250,,,,,,,,MORPHine Oral Concentrate 100,$5.36,$3.69,$2.02,$4.77,$2.20,$5.20,$2.20,$2.20,$4.69,$4.56,$2.20,$4.98,$2.20,$5.09,$2.20,$2.20,$5.09
2539680,0250,,,,,,,,Mouthkote Oral Moisturizer 240,$102.02,$70.24,$38.40,$90.84,$41.83,$98.96,$41.83,$41.83,$89.27,$86.72,$41.83,$94.88,$41.83,$96.92,$41.83,$41.83,$96.92
2531770,0259,,,,,,,,Moxifloxacin 0.5% 3 ML BTL,$358.35,$246.71,$134.87,$319.07,$146.92,$347.60,$146.92,$146.92,$313.55,$304.60,$146.92,$333.26,$146.92,$340.43,$146.92,$146.92,$340.43
2529010,0259,,,,,,,,Moxifloxacin 400 MG TAB,$57.61,$39.66,$21.68,$51.29,$23.62,$55.88,$23.62,$23.62,$50.41,$48.97,$23.62,$53.57,$23.62,$54.73,$23.62,$23.62,$54.73
2583410,0250,,,,,,,,MOXIFLOXACIN-PF 1 MG/ML VIAL,$256.79,$176.79,$96.65,$228.65,$105.29,$249.09,$105.29,$105.29,$224.69,$218.27,$105.29,$238.82,$105.29,$243.95,$105.29,$105.29,$243.95
2517370,0259,,,,,,,,Multivitamin Drops 50 ML BTL,$119.61,$82.34,$45.01,$106.50,$49.04,$116.02,$49.04,$49.04,$104.65,$101.66,$49.04,$111.23,$49.04,$113.62,$49.04,$49.04,$113.62
2513520,0250,,,,,,,,Multivitamin Injection 10 Ml V,$180.48,$124.25,$67.92,$160.70,$74.00,$175.07,$74.00,$74.00,$157.92,$153.41,$74.00,$167.85,$74.00,$171.46,$74.00,$74.00,$171.46
2513510,0259,,,,,,,,Multivitamin Liquid 5 ML,$0.61,$0.42,$0.23,$0.54,$0.25,$0.59,$0.25,$0.25,$0.53,$0.52,$0.25,$0.57,$0.25,$0.58,$0.25,$0.25,$0.58
2536640,0250,,,,,,,,Multivitamin TAB,$0.65,$0.45,$0.25,$0.58,$0.27,$0.63,$0.27,$0.27,$0.57,$0.56,$0.27,$0.61,$0.27,$0.62,$0.27,$0.27,$0.62
2525120,0259,,,,,,,,Multivitamin w/Iron Drops 50 M,$137.70,$94.80,$51.82,$122.61,$56.46,$133.57,$56.46,$56.46,$120.49,$117.05,$56.46,$128.06,$56.46,$130.82,$56.46,$56.46,$130.82
2508340,0259,,,,,,,,Multivitamin w/Minerals TAB,$0.42,$0.29,$0.16,$0.38,$0.17,$0.41,$0.17,$0.17,$0.37,$0.36,$0.17,$0.40,$0.17,$0.40,$0.17,$0.17,$0.40
2530020,0259,,,,,,,,Mupirocin 2% 15 GM TUBE,$566.12,$389.75,$213.06,$504.07,$232.11,$549.13,$232.11,$232.11,$495.35,$481.20,$232.11,$526.49,$232.11,$537.81,$232.11,$232.11,$537.81
2517340,0259,,,,,,,,Mupirocin 2% 22 GM TUBE,$102.65,$70.67,$38.63,$91.40,$42.09,$99.57,$42.09,$42.09,$89.82,$87.26,$42.09,$95.47,$42.09,$97.52,$42.09,$42.09,$97.52
2538220,0636,J1517,,,,,,,Mycophenolate Mofetil 500 Mg T,$7.69,$5.30,$2.89,$6.85,$3.15,$7.46,$3.15,$3.15,$6.73,$6.54,$3.15,$7.15,$3.15,$7.31,$3.15,$3.15,$7.31
2540450,0250,,,,,,,,Mycophenolate Sodium 180 MG TA,$57.56,$39.63,$21.66,$51.25,$23.60,$55.84,$23.60,$23.60,$50.37,$48.93,$23.60,$53.53,$23.60,$54.69,$23.60,$23.60,$54.69
2535030,0259,,,,,,,,Mylanta Suspension 30 ML BTL,$35.20,$24.23,$13.25,$31.34,$14.43,$34.14,$14.43,$14.43,$30.80,$29.92,$14.43,$32.73,$14.43,$33.44,$14.43,$14.43,$33.44
2516270,0259,,,,,,,,Na Phosphate Enema 133 Ml Btl,$20.49,$14.11,$7.71,$18.25,$8.40,$19.88,$8.40,$8.40,$17.93,$17.42,$8.40,$19.06,$8.40,$19.47,$8.40,$8.40,$19.47
2518240,0259,,,,,,,,Na Phosphate Enema 66.6 ML BTL,$27.02,$18.60,$10.17,$24.06,$11.08,$26.21,$11.08,$11.08,$23.64,$22.96,$11.08,$25.13,$11.08,$25.67,$11.08,$11.08,$25.67
2507430,0259,,,,,,,,Nabumetone 500 MG TAB,$6.09,$4.19,$2.29,$5.42,$2.50,$5.91,$2.50,$2.50,$5.33,$5.18,$2.50,$5.66,$2.50,$5.79,$2.50,$2.50,$5.79
2507440,0259,,,,,,,,Nabumetone 750 MG TAB,$2.27,$1.56,$0.85,$2.02,$0.93,$2.20,$0.93,$0.93,$1.98,$1.93,$0.93,$2.11,$0.93,$2.15,$0.93,$0.93,$2.15
2523590,0259,,,,,,,,Nadolol 40 MG TAB,$2.14,$1.47,$0.80,$1.90,$0.88,$2.07,$0.88,$0.88,$1.87,$1.81,$0.88,$1.99,$0.88,$2.03,$0.88,$0.88,$2.03
2541430,0250,,,,,,,,Nalbuphine 10 MG/ML AMP,$109.80,$75.59,$41.32,$97.77,$45.02,$106.51,$45.02,$45.02,$96.08,$93.33,$45.02,$102.11,$45.02,$104.31,$45.02,$45.02,$104.31
2523080,0259,,,,,,,,Nalbuphine 20 mg/ml amp,$109.78,$75.58,$41.32,$97.75,$45.01,$106.49,$45.01,$45.01,$96.06,$93.31,$45.01,$102.09,$45.01,$104.29,$45.01,$45.01,$104.29
2513560,0636,J2310,,,,,,,Naloxone 0.4 MG/ML VIAL,$132.07,$90.92,$49.70,$117.59,$54.15,$128.11,$54.15,$54.15,$115.56,$112.26,$54.15,$122.82,$54.15,$125.46,$54.15,$54.15,$125.46
2513580,0636,J2310,,,,,,,Naloxone 2 MG/2 ML SYR,$228.22,$157.12,$85.89,$203.21,$93.57,$221.37,$93.57,$93.57,$199.69,$193.99,$93.57,$212.24,$93.57,$216.81,$93.57,$93.57,$216.81
2523158,0250,,,,,,,,NALOXONE 4 MG/SPRAY INHN,$501.25,$345.09,$188.65,$446.32,$205.51,$486.22,$205.51,$205.51,$438.60,$426.07,$205.51,$466.17,$205.51,$476.19,$205.51,$205.51,$476.19
2507490,0259,,,,,,,,NALTREXONE HCL,$18.68,$12.86,$7.03,$16.64,$7.66,$18.12,$7.66,$7.66,$16.35,$15.88,$7.66,$17.38,$7.66,$17.75,$7.66,$7.66,$17.75
2523243,0250,,,,,,,,Naltrexone Microspheres 380 MG,"$3,406.84","$2,345.45","$1,282.18","$3,033.44","$1,396.80","$3,304.63","$1,396.80","$1,396.80","$2,980.98","$2,895.81","$1,396.80","$3,168.36","$1,396.80","$3,236.50","$1,396.80","$1,396.80","$3,236.50"
2513610,0259,,,,,,,,Naproxen 125 MG/5 ML,$2.94,$2.03,$1.11,$2.62,$1.21,$2.85,$1.21,$1.21,$2.57,$2.50,$1.21,$2.74,$1.21,$2.79,$1.21,$1.21,$2.79
2506060,0259,,,,,,,,Naproxen 250 MG TAB,$0.87,$0.60,$0.33,$0.78,$0.36,$0.85,$0.36,$0.36,$0.76,$0.74,$0.36,$0.81,$0.36,$0.83,$0.36,$0.36,$0.83
2506070,0259,,,,,,,,Naproxen 375 MG TAB,$1.27,$0.88,$0.48,$1.13,$0.52,$1.24,$0.52,$0.52,$1.12,$1.08,$0.52,$1.19,$0.52,$1.21,$0.52,$0.52,$1.21
2506080,0259,,,,,,,,Naproxen 500 MG TAB,$3.22,$2.22,$1.21,$2.87,$1.32,$3.13,$1.32,$1.32,$2.82,$2.74,$1.32,$3.00,$1.32,$3.06,$1.32,$1.32,$3.06
2524920,0259,,,,,,,,Naproxen SODIUM 220 MG TAB,$2.63,$1.81,$0.99,$2.34,$1.08,$2.55,$1.08,$1.08,$2.30,$2.23,$1.08,$2.44,$1.08,$2.49,$1.08,$1.08,$2.49
2501600,0259,,,,,,,,Naproxen SODIUM 550 MG TAB,$9.31,$6.41,$3.51,$8.29,$3.82,$9.03,$3.82,$3.82,$8.15,$7.92,$3.82,$8.66,$3.82,$8.85,$3.82,$3.82,$8.85
2583416,0636,J2323,,,,,,,NATALIZUMAB 300 MG/15ML VIAL,"$15,167.74","$10,442.27","$5,708.44","$13,505.33","$6,218.77","$14,712.71","$6,218.77","$6,218.77","$13,271.77","$12,892.58","$6,218.77","$14,106.00","$6,218.77","$14,409.35","$6,218.77","$6,218.77","$14,409.35"
2520790,0259,,,,,,,,Neo/Polymix/Dexameth Ophth Oin,$205.73,$141.64,$77.43,$183.18,$84.35,$199.56,$84.35,$84.35,$180.02,$174.87,$84.35,$191.33,$84.35,$195.45,$84.35,$84.35,$195.45
2520780,0259,,,,,,,,Neo/Polymix/Dexameth Ophth Sol,$173.30,$119.31,$65.22,$154.31,$71.05,$168.10,$71.05,$71.05,$151.64,$147.31,$71.05,$161.17,$71.05,$164.64,$71.05,$71.05,$164.64
2517540,0259,,,,,,,,Neomycin/Bacitra/Polymyxin Oin,$78.31,$53.91,$29.47,$69.72,$32.11,$75.96,$32.11,$32.11,$68.52,$66.56,$32.11,$72.82,$32.11,$74.39,$32.11,$32.11,$74.39
2522975,0250,,,,,,,,Neomycin/Bacitracin/Polymixin,$3.18,$2.19,$1.20,$2.83,$1.30,$3.09,$1.30,$1.30,$2.78,$2.70,$1.30,$2.96,$1.30,$3.02,$1.30,$1.30,$3.02
2517510,0259,,,,,,,,Neomycin/Gramcidin/Polymyxin O,$316.15,$217.66,$118.99,$281.50,$129.62,$306.67,$129.62,$129.62,$276.64,$268.73,$129.62,$294.02,$129.62,$300.35,$129.62,$129.62,$300.35
2513620,0636,J2710,,,,,,,Neostigmine 10 Mg/10 Ml Vial,$293.21,$201.86,$110.35,$261.08,$120.22,$284.42,$120.22,$120.22,$256.56,$249.23,$120.22,$272.69,$120.22,$278.55,$120.22,$120.22,$278.55
2506170,0259,,,,,,,,Nephrocaps CAP,$10.27,$7.07,$3.87,$9.15,$4.21,$9.96,$4.21,$4.21,$8.99,$8.73,$4.21,$9.55,$4.21,$9.76,$4.21,$4.21,$9.76
2506240,0259,,,,,,,,Niacin 500 MG TAB,$0.42,$0.29,$0.16,$0.38,$0.17,$0.41,$0.17,$0.17,$0.37,$0.36,$0.17,$0.40,$0.17,$0.40,$0.17,$0.17,$0.40
2531590,0259,,,,,,,,Niacin 500 MG TABCR,$0.73,$0.50,$0.27,$0.65,$0.30,$0.71,$0.30,$0.30,$0.64,$0.62,$0.30,$0.68,$0.30,$0.69,$0.30,$0.30,$0.69
2541480,0250,,,,,,,,NiCARdipine 25 MG/10 ML VIAL,$205.11,$141.21,$77.19,$182.63,$84.10,$198.96,$84.10,$84.10,$179.47,$174.35,$84.10,$190.75,$84.10,$194.86,$84.10,$84.10,$194.86
2583313,0250,,,,,,,,Nicotine 10 Mg/Cartridge 30 Ca,$580.48,$399.63,$218.46,$516.85,$238.00,$563.06,$238.00,$238.00,$507.92,$493.40,$238.00,$539.84,$238.00,$551.45,$238.00,$238.00,$551.45
2520080,0259,,,,,,,,Nicotine 14 MG/24 HR PATCH,$55.07,$37.91,$20.73,$49.03,$22.58,$53.42,$22.58,$22.58,$48.19,$46.81,$22.58,$51.21,$22.58,$52.32,$22.58,$22.58,$52.32
2509400,0259,,,,,,,,Nicotine 2 Mg Gum,$4.54,$3.13,$1.71,$4.04,$1.86,$4.41,$1.86,$1.86,$3.97,$3.86,$1.86,$4.22,$1.86,$4.32,$1.86,$1.86,$4.32
2531390,0259,,,,,,,,Nicotine 2 MG LOZG,$10.64,$7.33,$4.01,$9.48,$4.36,$10.32,$4.36,$4.36,$9.31,$9.05,$4.36,$9.90,$4.36,$10.11,$4.36,$4.36,$10.11
2520090,0259,,,,,,,,Nicotine 21 MG/24 HR PATCH,$31.68,$21.81,$11.92,$28.21,$12.99,$30.73,$12.99,$12.99,$27.72,$26.93,$12.99,$29.46,$12.99,$30.10,$12.99,$12.99,$30.10
2528570,0259,,,,,,,,Nicotine 4 Mg Gum,$4.63,$3.19,$1.74,$4.12,$1.90,$4.49,$1.90,$1.90,$4.05,$3.94,$1.90,$4.31,$1.90,$4.40,$1.90,$1.90,$4.40
2531600,0259,,,,,,,,Nicotine 4 MG LOZG,$7.27,$5.00,$2.73,$6.47,$2.98,$7.05,$2.98,$2.98,$6.36,$6.18,$2.98,$6.76,$2.98,$6.90,$2.98,$2.98,$6.90
2520070,0259,,,,,,,,Nicotine 7 MG/24 HR PATCH,$37.03,$25.49,$13.94,$32.97,$15.18,$35.92,$15.18,$15.18,$32.40,$31.47,$15.18,$34.44,$15.18,$35.18,$15.18,$15.18,$35.18
2501260,0259,,,,,,,,NIFEdipine 10 MG CAP,$7.16,$4.93,$2.69,$6.37,$2.93,$6.94,$2.93,$2.93,$6.26,$6.08,$2.93,$6.66,$2.93,$6.80,$2.93,$2.93,$6.80
2501270,0259,,,,,,,,NIFEdipine-CR 30 MG TABCR,$22.13,$15.23,$8.33,$19.70,$9.07,$21.46,$9.07,$9.07,$19.36,$18.81,$9.07,$20.58,$9.07,$21.02,$9.07,$9.07,$21.02
2505430,0259,,,,,,,,Nitrofurantoin Macrocrystal 50,$12.14,$8.36,$4.57,$10.81,$4.98,$11.77,$4.98,$4.98,$10.62,$10.32,$4.98,$11.29,$4.98,$11.53,$4.98,$4.98,$11.53
2519650,0259,,,,,,,,Nitroglycerin 0.1 MG PATCH,$9.85,$6.78,$3.71,$8.77,$4.04,$9.55,$4.04,$4.04,$8.62,$8.37,$4.04,$9.16,$4.04,$9.36,$4.04,$4.04,$9.36
2506270,0259,,,,,,,,Nitroglycerin 0.3 MG TAB,$4.92,$3.39,$1.85,$4.38,$2.02,$4.78,$2.02,$2.02,$4.31,$4.19,$2.02,$4.58,$2.02,$4.68,$2.02,$2.02,$4.68
2519670,0259,,,,,,,,Nitroglycerin 0.4 MG PATCH,$9.39,$6.47,$3.53,$8.36,$3.85,$9.11,$3.85,$3.85,$8.22,$7.98,$3.85,$8.73,$3.85,$8.92,$3.85,$3.85,$8.92
2506280,0259,,,,,,,,Nitroglycerin 0.4 MG TAB,$6.42,$4.42,$2.41,$5.71,$2.63,$6.22,$2.63,$2.63,$5.61,$5.45,$2.63,$5.97,$2.63,$6.10,$2.63,$2.63,$6.10
2520470,0259,,,,,,,,Nitroglycerin 2% 1 INCH/1 GM P,$43.33,$29.83,$16.31,$38.58,$17.76,$42.03,$17.76,$17.76,$37.91,$36.83,$17.76,$40.29,$17.76,$41.16,$17.76,$17.76,$41.16
2522971,0250,,,,,,,,Nitroglycerin 50 MG/250 ML BTL,$214.25,$147.50,$80.63,$190.77,$87.84,$207.82,$87.84,$87.84,$187.47,$182.11,$87.84,$199.25,$87.84,$203.54,$87.84,$87.84,$203.54
2523571,0250,,,,,,,,Norepinephrien In D5w 8mg/250m,$332.47,$228.89,$125.13,$296.03,$136.31,$322.50,$136.31,$136.31,$290.91,$282.60,$136.31,$309.20,$136.31,$315.85,$136.31,$136.31,$315.85
2513650,0250,,,,,,,,Norepinephrine 4000 MCG/4 ML A,$129.76,$89.33,$48.84,$115.54,$53.20,$125.87,$53.20,$53.20,$113.54,$110.29,$53.20,$120.68,$53.20,$123.27,$53.20,$53.20,$123.27
2502060,0259,,,,,,,,Norethindrone 5 MG TAB,$11.18,$7.70,$4.21,$9.95,$4.58,$10.84,$4.58,$4.58,$9.78,$9.50,$4.58,$10.39,$4.58,$10.62,$4.58,$4.58,$10.62
2519350,0250,,,,,,,,Normal Saline 10 ML VIAL,$55.66,$38.32,$20.95,$49.56,$22.82,$53.99,$22.82,$22.82,$48.70,$47.31,$22.82,$51.76,$22.82,$52.87,$22.82,$22.82,$52.87
2536670,0250,,,,,,,,Normal Saline 100 ML ADD-VANTA,$112.98,$77.78,$42.52,$100.60,$46.32,$109.59,$46.32,$46.32,$98.86,$96.03,$46.32,$105.07,$46.32,$107.33,$46.32,$46.32,$107.33
2518960,0250,,,,,,,,Normal Saline 100 Ml Bag,$73.25,$50.43,$27.57,$65.22,$30.03,$71.05,$30.03,$30.03,$64.09,$62.26,$30.03,$68.12,$30.03,$69.59,$30.03,$30.03,$69.59
2525240,0250,,,,,,,,Normal Saline 100 Ml Bag,$97.97,$67.45,$36.87,$87.23,$40.17,$95.03,$40.17,$40.17,$85.72,$83.27,$40.17,$91.11,$40.17,$93.07,$40.17,$40.17,$93.07
2593180,0250,,,,,,,,Normal Saline 150 Ml Bag,$101.33,$69.76,$38.13,$90.22,$41.54,$98.29,$41.54,$41.54,$88.66,$86.13,$41.54,$94.23,$41.54,$96.26,$41.54,$41.54,$96.26
2523234,0250,,,,,,,,Normal Saline 20 ML VIAL,$67.54,$46.50,$25.42,$60.14,$27.69,$65.52,$27.69,$27.69,$59.10,$57.41,$27.69,$62.81,$27.69,$64.17,$27.69,$27.69,$64.17
2533980,0250,,,,,,,,Normal Saline 250 ML ADD-VANTA,$94.58,$65.12,$35.60,$84.22,$38.78,$91.74,$38.78,$38.78,$82.76,$80.39,$38.78,$87.96,$38.78,$89.85,$38.78,$38.78,$89.85
2518920,0250,,,,,,,,Normal Saline 250 Ml Bag,$28.23,$19.43,$10.62,$25.13,$11.57,$27.38,$11.57,$11.57,$24.70,$23.99,$11.57,$26.25,$11.57,$26.82,$11.57,$11.57,$26.82
2518950,0250,,,,,,,,Normal Saline 50 ML BAG,$74.60,$51.36,$28.08,$66.43,$30.59,$72.36,$30.59,$30.59,$65.28,$63.41,$30.59,$69.38,$30.59,$70.87,$30.59,$30.59,$70.87
2525230,0250,,,,,,,,Normal Saline 50 Ml Mini-Bag P,$97.97,$67.45,$36.87,$87.23,$40.17,$95.03,$40.17,$40.17,$85.72,$83.27,$40.17,$91.11,$40.17,$93.07,$40.17,$40.17,$93.07
2534090,0259,,,,,,,,Normal Saline 50 ML VIAL,$74.45,$51.26,$28.02,$66.29,$30.52,$72.22,$30.52,$30.52,$65.14,$63.28,$30.52,$69.24,$30.52,$70.73,$30.52,$30.52,$70.73
2527760,0250,,,,,,,,Normal Saline Flush 10 ML SYR,$4.53,$3.12,$1.71,$4.04,$1.86,$4.40,$1.86,$1.86,$3.97,$3.85,$1.86,$4.21,$1.86,$4.31,$1.86,$1.86,$4.31
2522909,0250,,,,,,,,Normal Saline Lock-I.I.D.,$43.58,$30.00,$16.40,$38.80,$17.87,$42.27,$17.87,$17.87,$38.13,$37.04,$17.87,$40.53,$17.87,$41.40,$17.87,$17.87,$41.40
2537170,0250,,,,,,,,Normal Saline-STERILE FIELD 0.,$12.11,$8.34,$4.56,$10.79,$4.97,$11.75,$4.97,$4.97,$10.60,$10.30,$4.97,$11.27,$4.97,$11.51,$4.97,$4.97,$11.51
2501000,0259,,,,,,,,Nortriptyline 10 MG CAP,$1.68,$1.16,$0.63,$1.49,$0.69,$1.63,$0.69,$0.69,$1.47,$1.43,$0.69,$1.56,$0.69,$1.59,$0.69,$0.69,$1.59
2502020,0259,,,,,,,,Nortriptyline 25 MG CAP,$2.30,$1.58,$0.87,$2.05,$0.94,$2.23,$0.94,$0.94,$2.01,$1.95,$0.94,$2.14,$0.94,$2.18,$0.94,$0.94,$2.18
2506620,0259,,,,,,,,Nortriptyline 50 MG CAP,$2.59,$1.79,$0.98,$2.31,$1.06,$2.51,$1.06,$1.06,$2.27,$2.20,$1.06,$2.41,$1.06,$2.46,$1.06,$1.06,$2.46
2521470,0259,,,,,,,,Nulytely 4000 ML BTL,$175.07,$120.53,$65.89,$155.88,$71.78,$169.81,$71.78,$71.78,$153.18,$148.81,$71.78,$162.81,$71.78,$166.31,$71.78,$71.78,$166.31
2517620,0259,,,,,,,,NYSTATIN,$1.47,$1.01,$0.55,$1.31,$0.60,$1.43,$0.60,$0.60,$1.29,$1.25,$0.60,$1.37,$0.60,$1.40,$0.60,$0.60,$1.40
2537060,0250,,,,,,,,Nystatin 500000 UNITS TAB,$21.66,$14.91,$8.15,$19.28,$8.88,$21.01,$8.88,$8.88,$18.95,$18.41,$8.88,$20.14,$8.88,$20.57,$8.88,$8.88,$20.57
2535480,0250,,,,,,,,Nystatin 500000 UNITS/5 ML SUS,$30.74,$21.17,$11.57,$27.37,$12.60,$29.82,$12.60,$12.60,$26.90,$26.13,$12.60,$28.59,$12.60,$29.21,$12.60,$12.60,$29.21
2522925,0250,,,,,,,,Nystatin CREAM 15 GM TUBE,$72.90,$50.19,$27.44,$64.91,$29.89,$70.72,$29.89,$29.89,$63.79,$61.97,$29.89,$67.80,$29.89,$69.26,$29.89,$29.89,$69.26
2517600,0259,,,,,,,,Nystatin CREAM 30 GM TUBE,$124.86,$85.96,$46.99,$111.17,$51.19,$121.11,$51.19,$51.19,$109.25,$106.13,$51.19,$116.12,$51.19,$118.61,$51.19,$51.19,$118.61
2523620,0259,,,,,,,,Nystatin OINT 15 GM TUBE,$190.62,$131.24,$71.74,$169.73,$78.16,$184.90,$78.16,$78.16,$166.80,$162.03,$78.16,$177.28,$78.16,$181.09,$78.16,$78.16,$181.09
2522926,0250,,,,,,,,Nystatin POWDER 15 GM JAR,$98.25,$67.64,$36.98,$87.48,$40.28,$95.31,$40.28,$40.28,$85.97,$83.52,$40.28,$91.38,$40.28,$93.34,$40.28,$40.28,$93.34
2535700,0250,,,,,,,,Nystatin POWDER 60 GM JAR,$258.12,$177.71,$97.15,$229.83,$105.83,$250.38,$105.83,$105.83,$225.86,$219.40,$105.83,$240.05,$105.83,$245.22,$105.83,$105.83,$245.22
2522923,0250,,,,,,,,Nystatin/Triamcinolone CREAM 1,$222.47,$153.16,$83.73,$198.08,$91.21,$215.79,$91.21,$91.21,$194.66,$189.10,$91.21,$206.89,$91.21,$211.34,$91.21,$91.21,$211.34
2523435,0636,J2350,,,,,,,OCRELIZUMAB 300 MG/ML VIAL,"$29,319.17","$20,184.86","$11,034.39","$26,105.75","$12,020.86","$28,439.60","$12,020.86","$12,020.86","$25,654.28","$24,921.30","$12,020.86","$27,266.83","$12,020.86","$27,853.22","$12,020.86","$12,020.86","$27,853.22"
2513660,0636,J2354,,,,,,,Octreotide 0.05 Mg/Ml Amp,$93.21,$64.17,$35.08,$82.99,$38.22,$90.41,$38.22,$38.22,$81.56,$79.23,$38.22,$86.68,$38.22,$88.55,$38.22,$38.22,$88.55
2513670,0636,J2354,,,,,,,Octreotide 0.1 Mg/Ml Amp,$97.29,$66.98,$36.62,$86.63,$39.89,$94.38,$39.89,$39.89,$85.13,$82.70,$39.89,$90.48,$39.89,$92.43,$39.89,$39.89,$92.43
2537180,0250,,,,,,,,Octreotide LAR 10 MG KIT,"$4,509.33","$3,104.46","$1,697.10","$4,015.10","$1,848.83","$4,374.05","$1,848.83","$1,848.83","$3,945.67","$3,832.93","$1,848.83","$4,193.68","$1,848.83","$4,283.87","$1,848.83","$1,848.83","$4,283.87"
2528110,0636,J2352,,,,,,,Octreotide Lar 20 Mg Kit,"$6,796.56","$4,679.11","$2,557.91","$6,051.65","$2,786.59","$6,592.66","$2,786.59","$2,786.59","$5,946.99","$5,777.08","$2,786.59","$6,320.80","$2,786.59","$6,456.73","$2,786.59","$2,786.59","$6,456.73"
2532850,0250,,,,,,,,Octreotide LAR 30 MG KIT,"$8,768.94","$6,037.00","$3,300.23","$7,807.85","$3,595.27","$8,505.87","$3,595.27","$3,595.27","$7,672.82","$7,453.60","$3,595.27","$8,155.11","$3,595.27","$8,330.49","$3,595.27","$3,595.27","$8,330.49"
2523198,0250,,,,,,,,Ofloxacin 0.3% OPHTH. 10 ML BT,$166.99,$114.97,$62.85,$148.69,$68.47,$161.98,$68.47,$68.47,$146.12,$141.95,$68.47,$155.30,$68.47,$158.64,$68.47,$68.47,$158.64
2517630,0259,,,,,,,,Ofloxacin 0.3% OPHTH. 5 ML BTL,$113.09,$77.86,$42.56,$100.70,$46.37,$109.70,$46.37,$46.37,$98.95,$96.13,$46.37,$105.17,$46.37,$107.44,$46.37,$46.37,$107.44
2522927,0250,,,,,,,,Ofloxacin 0.3% OTIC 5 ML BTL,$172.87,$119.01,$65.06,$153.92,$70.88,$167.68,$70.88,$70.88,$151.26,$146.94,$70.88,$160.77,$70.88,$164.22,$70.88,$70.88,$164.22
2522460,0259,,,,,,,,OLANZapine 10 MG TAB,$14.74,$10.15,$5.55,$13.12,$6.04,$14.30,$6.04,$6.04,$12.90,$12.53,$6.04,$13.71,$6.04,$14.00,$6.04,$6.04,$14.00
2532960,0250,,,,,,,,OLANZapine 10 MG VIAL,$255.92,$176.19,$96.32,$227.87,$104.93,$248.24,$104.93,$104.93,$223.93,$217.53,$104.93,$238.01,$104.93,$243.13,$104.93,$104.93,$243.13
2523150,0259,,,,,,,,OLANZapine 2.5 MG TAB,$2.17,$1.49,$0.82,$1.93,$0.89,$2.10,$0.89,$0.89,$1.90,$1.84,$0.89,$2.02,$0.89,$2.06,$0.89,$0.89,$2.06
2522450,0259,,,,,,,,OLANZapine 5 MG TAB,$6.86,$4.73,$2.58,$6.11,$2.81,$6.66,$2.81,$2.81,$6.01,$5.83,$2.81,$6.38,$2.81,$6.52,$2.81,$2.81,$6.52
2524850,0259,,,,,,,,Olopatadine 0.1% OPHTH SOL 5 M,$125.76,$86.58,$47.33,$111.98,$51.56,$121.99,$51.56,$51.56,$110.04,$106.90,$51.56,$116.96,$51.56,$119.47,$51.56,$51.56,$119.47
2538600,0250,,,,,,,,Omega-3 Fatty Acids 1000 MG CA,$2.95,$2.03,$1.11,$2.63,$1.21,$2.86,$1.21,$1.21,$2.58,$2.51,$1.21,$2.75,$1.21,$2.80,$1.21,$1.21,$2.80
2538820,0250,,,,,,,,OMEGA-3-ACID ETHYL ESTERS 1 GM,$3.31,$2.28,$1.25,$2.95,$1.36,$3.21,$1.36,$1.36,$2.90,$2.82,$1.36,$3.08,$1.36,$3.15,$1.36,$1.36,$3.15
2507060,0259,,,,,,,,OMEPRAZOLE 10 MG CAPCR,$5.10,$3.51,$1.92,$4.54,$2.09,$4.95,$2.09,$2.09,$4.46,$4.33,$2.09,$4.74,$2.09,$4.84,$2.09,$2.09,$4.84
2507050,0259,,,,,,,,Omeprazole 20 MG CAPCR,$8.27,$5.69,$3.11,$7.36,$3.39,$8.02,$3.39,$3.39,$7.23,$7.03,$3.39,$7.69,$3.39,$7.86,$3.39,$3.39,$7.86
2523136,0254,,,,,,,,Omnipaque 300 MG/ML 10 ML BTL,$43.58,$30.00,$16.40,$38.80,$17.87,$42.27,$17.87,$17.87,$38.13,$37.04,$17.87,$40.53,$17.87,$41.40,$17.87,$17.87,$41.40
2592950,0250,,,,,,,,Onabotulinumtoxina 200 UNIT VI,"$2,864.32","$1,971.95","$1,078.00","$2,550.38","$1,174.37","$2,778.39","$1,174.37","$1,174.37","$2,506.28","$2,434.67","$1,174.37","$2,663.81","$1,174.37","$2,721.10","$1,174.37","$1,174.37","$2,721.10"
2509170,0259,J8597,,,,,,,Ondansetron 4 Mg Tab,$7.83,$5.39,$2.95,$6.97,$3.21,$7.60,$3.21,$3.21,$6.85,$6.66,$3.21,$7.28,$3.21,$7.44,$3.21,$3.21,$7.44
2521230,0636,J2405,,,,,,,Ondansetron 4 MG/2 ML VIAL,$53.28,$36.68,$20.05,$47.44,$21.85,$51.68,$21.85,$21.85,$46.62,$45.29,$21.85,$49.55,$21.85,$50.62,$21.85,$21.85,$50.62
2543940,0250,,,,,,,,Ondansetron 40 MG/20 ML VIAL,$53.59,$36.89,$20.17,$47.71,$21.97,$51.98,$21.97,$21.97,$46.89,$45.55,$21.97,$49.84,$21.97,$50.91,$21.97,$21.97,$50.91
2528050,0259,J8597,,,,,,,Ondansetron O.D.T. 4 Mg Tabef,$4.77,$3.29,$1.80,$4.25,$1.96,$4.63,$1.96,$1.96,$4.18,$4.06,$1.96,$4.44,$1.96,$4.53,$1.96,$1.96,$4.53
2529280,0250,,,,,,,,"Ondansetron O.D.T. 4 MG TABEF,",$4.55,$3.14,$1.71,$4.05,$1.87,$4.42,$1.87,$1.87,$3.98,$3.87,$1.87,$4.23,$1.87,$4.33,$1.87,$1.87,$4.33
2526490,0259,J8597,,,,,,,Ondansetron SOLN 4 MG/5 ML,$6.02,$4.15,$2.27,$5.36,$2.47,$5.84,$2.47,$2.47,$5.27,$5.12,$2.47,$5.60,$2.47,$5.72,$2.47,$2.47,$5.72
2522929,0250,,,,,,,,ON-Q Bupivacaine 0.25% 270 ML,$645.31,$444.26,$242.86,$574.58,$264.58,$625.95,$264.58,$264.58,$564.64,$548.51,$264.58,$600.13,$264.58,$613.04,$264.58,$264.58,$613.04
2592930,0250,,,,,,,,ON-Q Bupivacaine 0.5% 270 ML D,$645.31,$444.26,$242.86,$574.58,$264.58,$625.95,$264.58,$264.58,$564.64,$548.51,$264.58,$600.13,$264.58,$613.04,$264.58,$264.58,$613.04
2523312,0250,,,,,,,,ON-Q Ropivacaine 0.2% 270 ML D,$909.54,$626.18,$342.31,$809.85,$372.91,$882.25,$372.91,$372.91,$795.85,$773.11,$372.91,$845.87,$372.91,$864.06,$372.91,$372.91,$864.06
2517640,0259,,,,,,,,Opium Tincture 118 ML,$55.03,$37.88,$20.71,$48.99,$22.56,$53.37,$22.56,$22.56,$48.15,$46.77,$22.56,$51.17,$22.56,$52.27,$22.56,$22.56,$52.27
2502130,0259,,,,,,,,Opium/Belladonna SUPP,$257.83,$177.50,$97.03,$229.57,$105.71,$250.09,$105.71,$105.71,$225.60,$219.15,$105.71,$239.78,$105.71,$244.94,$105.71,$105.71,$244.94
2523473,0636,J2360,,,,,,,Orphenadrine 60 Mg/2ml Vial,$106.97,$73.64,$40.26,$95.24,$43.86,$103.76,$43.86,$43.86,$93.60,$90.92,$43.86,$99.48,$43.86,$101.62,$43.86,$43.86,$101.62
2523102,0250,,,,,,,,Oseltamivir 30 Mg Cap,$189.46,$130.43,$71.30,$168.69,$77.68,$183.77,$77.68,$77.68,$165.78,$161.04,$77.68,$176.20,$77.68,$179.98,$77.68,$77.68,$179.98
2543860,0250,,,,,,,,Oseltamivir 6 Mg/Ml Suspension,$593.32,$408.47,$223.30,$528.29,$243.26,$575.52,$243.26,$243.26,$519.15,$504.32,$243.26,$551.79,$243.26,$563.65,$243.26,$243.26,$563.65
2529320,0259,,,,,,,,Oseltamivir 75 MG CAP,$34.45,$23.72,$12.96,$30.67,$14.12,$33.41,$14.12,$14.12,$30.14,$29.28,$14.12,$32.04,$14.12,$32.72,$14.12,$14.12,$32.72
2509950,0636,J2700,,,,,,,Oxacillin 1000 Mg Vial,$163.01,$112.22,$61.35,$145.14,$66.83,$158.12,$66.83,$66.83,$142.63,$138.56,$66.83,$151.60,$66.83,$154.86,$66.83,$66.83,$154.86
2509960,0636,J2700,,,,,,,Oxacillin 2 GM VIAL,$163.01,$112.22,$61.35,$145.14,$66.83,$158.12,$66.83,$66.83,$142.63,$138.56,$66.83,$151.60,$66.83,$154.86,$66.83,$66.83,$154.86
2507740,0259,,,,,,,,Oxazepam 10 MG CAP,$14.49,$9.98,$5.45,$12.90,$5.94,$14.05,$5.94,$5.94,$12.68,$12.32,$5.94,$13.47,$5.94,$13.76,$5.94,$5.94,$13.76
2507730,0259,,,,,,,,Oxazepam 15 MG CAP,$40.48,$27.87,$15.24,$36.05,$16.60,$39.27,$16.60,$16.60,$35.42,$34.41,$16.60,$37.65,$16.60,$38.46,$16.60,$16.60,$38.46
2530580,0259,,,,,,,,OXcarbazepine 150 MG TAB,$2.77,$1.91,$1.04,$2.46,$1.13,$2.68,$1.13,$1.13,$2.42,$2.35,$1.13,$2.57,$1.13,$2.63,$1.13,$1.13,$2.63
2503620,0259,,,,,,,,Oxybutynin 5 MG TAB,$8.50,$5.85,$3.20,$7.57,$3.48,$8.24,$3.48,$3.48,$7.44,$7.22,$3.48,$7.90,$3.48,$8.07,$3.48,$3.48,$8.07
2524830,0259,,,,,,,,Oxybutynin-CR 5 MG TABCR,$3.45,$2.38,$1.30,$3.07,$1.42,$3.35,$1.42,$1.42,$3.02,$2.94,$1.42,$3.21,$1.42,$3.28,$1.42,$1.42,$3.28
2541840,0250,,,,,,,,oxyCODONE 10 MG TAB,$10.07,$6.93,$3.79,$8.96,$4.13,$9.76,$4.13,$4.13,$8.81,$8.56,$4.13,$9.36,$4.13,$9.56,$4.13,$4.13,$9.56
2538700,0250,,,,,,,,oxyCODONE 15 MG TAB,$14.67,$10.10,$5.52,$13.07,$6.02,$14.23,$6.02,$6.02,$12.84,$12.47,$6.02,$13.65,$6.02,$13.94,$6.02,$6.02,$13.94
2543330,0250,,,,,,,,oxyCODONE 20 MG TAB,$7.44,$5.12,$2.80,$6.63,$3.05,$7.22,$3.05,$3.05,$6.51,$6.32,$3.05,$6.92,$3.05,$7.07,$3.05,$3.05,$7.07
2522931,0250,,,,,,,,oxyCODONE 30 MG TABLET,$15.48,$10.66,$5.83,$13.78,$6.35,$15.02,$6.35,$6.35,$13.55,$13.16,$6.35,$14.40,$6.35,$14.71,$6.35,$6.35,$14.71
2507640,0259,,,,,,,,Oxycodone 5 Mg Tab,$9.82,$6.76,$3.69,$8.74,$4.02,$9.52,$4.02,$4.02,$8.59,$8.34,$4.02,$9.13,$4.02,$9.32,$4.02,$4.02,$9.32
2523271,0250,,,,,,,,"oxyCODONE 5 MG TAB, 5 TABS/BTL",$5.39,$3.71,$2.03,$4.80,$2.21,$5.23,$2.21,$2.21,$4.72,$4.58,$2.21,$5.02,$2.21,$5.12,$2.21,$2.21,$5.12
2535390,0250,,,,,,,,oxyCODONE 5 MG/5 ML BTL,$72.67,$50.03,$27.35,$64.71,$29.80,$70.49,$29.80,$29.80,$63.59,$61.77,$29.80,$67.59,$29.80,$69.04,$29.80,$29.80,$69.04
2506760,0259,,,,,,,,oxyCODONE 5/Acetaminophen 325,$5.47,$3.77,$2.06,$4.87,$2.24,$5.30,$2.24,$2.24,$4.79,$4.65,$2.24,$5.09,$2.24,$5.20,$2.24,$2.24,$5.20
2506590,0259,,,,,,,,Oxycodone-Cr 10 Mg Tabcr,$76.14,$52.42,$28.65,$67.79,$31.22,$73.85,$31.22,$31.22,$66.62,$64.72,$31.22,$70.81,$31.22,$72.33,$31.22,$31.22,$72.33
2506600,0259,,,,,,,,oxyCODONE-CR 20 MG TABCR,$98.06,$67.51,$36.90,$87.31,$40.20,$95.12,$40.20,$40.20,$85.80,$83.35,$40.20,$91.19,$40.20,$93.15,$40.20,$40.20,$93.15
2517660,0259,,,,,,,,Oxymetazolone 0.05% SPRAY 15 M,$33.77,$23.25,$12.71,$30.07,$13.85,$32.76,$13.85,$13.85,$29.55,$28.71,$13.85,$31.41,$13.85,$32.08,$13.85,$13.85,$32.08
2523495,0250,,,,,,,,OXYMETAZOLONE 0.05% SPRAY 30ML,$45.42,$31.27,$17.09,$40.44,$18.62,$44.05,$18.62,$18.62,$39.74,$38.60,$18.62,$42.24,$18.62,$43.15,$18.62,$18.62,$43.15
2513700,0636,J2590,,,,,,,Oxytocin 10 Units/Ml Vial,$64.73,$44.57,$24.36,$57.64,$26.54,$62.79,$26.54,$26.54,$56.64,$55.02,$26.54,$60.20,$26.54,$61.50,$26.54,$26.54,$61.50
2523399,0250,,,,,,,,OXYTOCIN/NORMAL SALINE 30UN,$261.50,$180.03,$98.42,$232.84,$107.21,$253.65,$107.21,$107.21,$228.81,$222.27,$107.21,$243.19,$107.21,$248.42,$107.21,$107.21,$248.42
2534950,0250,,,,,,,,Pain Ease Spray 103.5 Ml Can,$31.37,$21.60,$11.81,$27.94,$12.86,$30.43,$12.86,$12.86,$27.45,$26.67,$12.86,$29.18,$12.86,$29.81,$12.86,$12.86,$29.81
2523519,0250,,,,,,,,PALIPERIDONE E.R. 1.5 MG TAB,$102.67,$70.68,$38.64,$91.41,$42.09,$99.59,$42.09,$42.09,$89.83,$87.27,$42.09,$95.48,$42.09,$97.53,$42.09,$42.09,$97.53
2523532,0250,,,,,,,,PALONOSETRON 0.25MG/5ML VIAL,$150.91,$103.90,$56.80,$134.37,$61.87,$146.39,$61.87,$61.87,$132.05,$128.28,$61.87,$140.35,$61.87,$143.37,$61.87,$61.87,$143.37
2521840,0636,J2430,,,,,,,Pamidronate 90 MG VIAL,$313.79,$216.03,$118.10,$279.40,$128.65,$304.38,$128.65,$128.65,$274.57,$266.72,$128.65,$291.83,$128.65,$298.10,$128.65,$128.65,$298.10
2533430,0259,,,,,,,,Pantoprazole 20 MG TABCR,$4.50,$3.10,$1.69,$4.01,$1.84,$4.36,$1.84,$1.84,$3.94,$3.82,$1.84,$4.18,$1.84,$4.27,$1.84,$1.84,$4.27
2526480,0259,,,,,,,,Pantoprazole 40 Mg Tabcr,$3.48,$2.39,$1.31,$3.09,$1.42,$3.37,$1.42,$1.42,$3.04,$2.95,$1.42,$3.23,$1.42,$3.30,$1.42,$1.42,$3.30
2527930,0250,,,,,,,,Pantoprazole 40 MG VIAL,$91.72,$63.14,$34.52,$81.66,$37.60,$88.97,$37.60,$37.60,$80.25,$77.96,$37.60,$85.30,$37.60,$87.13,$37.60,$37.60,$87.13
2517960,0259,,,,,,,,PARoxetine 10 MG TAB,$16.82,$11.58,$6.33,$14.98,$6.90,$16.32,$6.90,$6.90,$14.72,$14.30,$6.90,$15.64,$6.90,$15.98,$6.90,$6.90,$15.98
2506690,0259,,,,,,,,PARoxetine 20 MG TAB,$4.09,$2.81,$1.54,$3.64,$1.67,$3.96,$1.67,$1.67,$3.57,$3.47,$1.67,$3.80,$1.67,$3.88,$1.67,$1.67,$3.88
2523341,0250,,,,,,,,PATIROMER ORAL SUSP 8.4 GM PKT,$293.53,$202.08,$110.47,$261.36,$120.35,$284.72,$120.35,$120.35,$256.84,$249.50,$120.35,$272.98,$120.35,$278.85,$120.35,$120.35,$278.85
2530120,0636,C9119,,,,,,,Pegfilgrastim 6 Mg Syr,"$11,823.98","$8,140.25","$4,450.00","$10,528.05","$4,847.83","$11,469.26","$4,847.83","$4,847.83","$10,345.98","$10,050.38","$4,847.83","$10,996.30","$4,847.83","$11,232.78","$4,847.83","$4,847.83","$11,232.78"
2543670,0250,,,,,,,,Penciclovir 1% CREAM 5 GM TUBE,"$2,330.07","$1,604.15",$876.93,"$2,074.69",$955.33,"$2,260.17",$955.33,$955.33,"$2,038.81","$1,980.56",$955.33,"$2,166.97",$955.33,"$2,213.57",$955.33,$955.33,"$2,213.57"
2513780,0636,J0561,,,,,,,Penicillin G Benzathine 1200 M,$740.08,$509.51,$278.53,$658.97,$303.43,$717.88,$303.43,$303.43,$647.57,$629.07,$303.43,$688.28,$303.43,$703.08,$303.43,$303.43,$703.08
2513790,0636,J2540,,,,,,,Penicillin G POTASSIUM 5 MU VI,$151.48,$104.29,$57.01,$134.88,$62.11,$146.94,$62.11,$62.11,$132.55,$128.76,$62.11,$140.88,$62.11,$143.91,$62.11,$62.11,$143.91
2523526,0250,,,,,,,,"PENICILLIN GPOT 20,000,000 UN",$524.97,$361.42,$197.57,$467.43,$215.24,$509.22,$215.24,$215.24,$459.35,$446.23,$215.24,$488.22,$215.24,$498.72,$215.24,$215.24,$498.72
2522949,0250,,,,,,,,Penicillin V POTASSIUM 125 MG/,$122.14,$84.09,$45.97,$108.76,$50.08,$118.48,$50.08,$50.08,$106.88,$103.82,$50.08,$113.59,$50.08,$116.04,$50.08,$50.08,$116.04
2502210,0259,,,,,,,,Penicillin V POTASSIUM 250 MG,$1.88,$1.30,$0.71,$1.68,$0.77,$1.83,$0.77,$0.77,$1.65,$1.60,$0.77,$1.75,$0.77,$1.79,$0.77,$0.77,$1.79
2535670,0250,,,,,,,,Penicillin V Potassium 250 Mg/,$163.04,$112.25,$61.36,$145.17,$66.85,$158.15,$66.85,$66.85,$142.66,$138.58,$66.85,$151.63,$66.85,$154.89,$66.85,$66.85,$154.89
2502220,0259,,,,,,,,Penicillin V POTASSIUM 500 MG,$4.31,$2.97,$1.62,$3.84,$1.77,$4.18,$1.77,$1.77,$3.77,$3.67,$1.77,$4.01,$1.77,$4.10,$1.77,$1.77,$4.10
2523265,0250,,,,,,,,Penicillin V POTASSIUM 500 MG,$4.37,$3.01,$1.64,$3.89,$1.79,$4.24,$1.79,$1.79,$3.82,$3.71,$1.79,$4.06,$1.79,$4.15,$1.79,$1.79,$4.15
2523299,0250,,,,,,,,Perampanel 0.5 MG/ML Suspensio,$66.81,$46.00,$25.15,$59.49,$27.39,$64.81,$27.39,$27.39,$58.46,$56.79,$27.39,$62.14,$27.39,$63.47,$27.39,$27.39,$63.47
2525630,0259,,,,,,,,Permethrin Cream 60 GM TUBE,$237.28,$163.36,$89.30,$211.28,$97.29,$230.16,$97.29,$97.29,$207.62,$201.69,$97.29,$220.67,$97.29,$225.42,$97.29,$97.29,$225.42
2522978,0250,,,,,,,,PERPHENAZINE 2 MG TABLET,$6.31,$4.34,$2.37,$5.62,$2.59,$6.12,$2.59,$2.59,$5.52,$5.36,$2.59,$5.87,$2.59,$5.99,$2.59,$2.59,$5.99
2507290,0259,,,,,,,,Phenazopyridine 100 MG TAB,$5.88,$4.05,$2.21,$5.24,$2.41,$5.71,$2.41,$2.41,$5.15,$5.00,$2.41,$5.47,$2.41,$5.59,$2.41,$2.41,$5.59
2528270,0259,,,,,,,,"Phenazopyridine 100 MG TAB, 2",$13.90,$9.57,$5.23,$12.38,$5.70,$13.48,$5.70,$5.70,$12.16,$11.82,$5.70,$12.93,$5.70,$13.21,$5.70,$5.70,$13.21
2507300,0259,,,,,,,,Phenazopyridine 200 MG TAB,$7.78,$5.36,$2.93,$6.93,$3.19,$7.54,$3.19,$3.19,$6.81,$6.61,$3.19,$7.23,$3.19,$7.39,$3.19,$3.19,$7.39
2513910,0636,J2560,,,,,,,PHENobarbital 130 MG/ML VIAL,$564.37,$388.55,$212.40,$502.52,$231.39,$547.44,$231.39,$231.39,$493.83,$479.72,$231.39,$524.87,$231.39,$536.16,$231.39,$231.39,$536.16
2513900,0259,,,,,,,,PHENobarbital 20 MG/5 ML,$1.19,$0.82,$0.45,$1.06,$0.49,$1.15,$0.49,$0.49,$1.04,$1.01,$0.49,$1.10,$0.49,$1.13,$0.49,$0.49,$1.13
2506860,0259,,,,,,,,PHENobarbital 30 MG TAB,$6.50,$4.48,$2.45,$5.79,$2.67,$6.31,$2.67,$2.67,$5.69,$5.53,$2.67,$6.05,$2.67,$6.18,$2.67,$2.67,$6.18
2506880,0259,,,,,,,,PHENobarbital 60 MG TAB,$14.61,$10.06,$5.50,$13.01,$5.99,$14.17,$5.99,$5.99,$12.78,$12.42,$5.99,$13.59,$5.99,$13.88,$5.99,$5.99,$13.88
2506870,0259,,,,,,,,PHENobarbital 97.2 MG TAB,$7.85,$5.41,$2.96,$6.99,$3.22,$7.62,$3.22,$3.22,$6.87,$6.68,$3.22,$7.30,$3.22,$7.46,$3.22,$3.22,$7.46
2523493,0250,,,,,,,,PHENOL LIQUID 89% 1 EACH SWAB,$88.32,$60.80,$33.24,$78.64,$36.21,$85.67,$36.21,$36.21,$77.28,$75.07,$36.21,$82.14,$36.21,$83.90,$36.21,$36.21,$83.90
2523229,0636,J2760,,,,,,,Phentolamine Meslyate 5 MG VIA,"$1,494.14","$1,028.65",$562.33,"$1,330.38",$612.60,"$1,449.32",$612.60,$612.60,"$1,307.38","$1,270.02",$612.60,"$1,389.55",$612.60,"$1,419.44",$612.60,$612.60,"$1,419.44"
2513920,0636,J2370,,,,,,,Phenylephrine 10000 MCG/ML AMP,$96.96,$66.75,$36.49,$86.33,$39.75,$94.05,$39.75,$39.75,$84.84,$82.41,$39.75,$90.17,$39.75,$92.11,$39.75,$39.75,$92.11
2522170,0259,,,,,,,,PHENYLEPHRINE 2.5% 15ML,$297.13,$204.56,$111.83,$264.57,$121.82,$288.22,$121.82,$121.82,$259.99,$252.56,$121.82,$276.33,$121.82,$282.28,$121.82,$121.82,$282.28
2523066,0250,,,,,,,,PHENYLEPHRINE 400MCG/10ML SYR,$134.24,$92.42,$50.52,$119.52,$55.04,$130.21,$55.04,$55.04,$117.46,$114.10,$55.04,$124.84,$55.04,$127.52,$55.04,$55.04,$127.52
2523351,0250,,,,,,,,Phenylephrine 800 Mcg/10 Ml Sy,$194.49,$133.90,$73.20,$173.17,$79.74,$188.66,$79.74,$79.74,$170.18,$165.32,$79.74,$180.88,$79.74,$184.77,$79.74,$79.74,$184.77
2517790,0259,,,,,,,,Phenylephrine Ophth. 2.5% 2 ML,$297.34,$204.71,$111.91,$264.75,$121.91,$288.42,$121.91,$121.91,$260.17,$252.74,$121.91,$276.53,$121.91,$282.47,$121.91,$121.91,$282.47
2517730,0259,,,,,,,,Phenylephrine SPRAY 0.25% 15 M,$62.22,$42.83,$23.42,$55.40,$25.51,$60.35,$25.51,$25.51,$54.44,$52.88,$25.51,$57.86,$25.51,$59.10,$25.51,$25.51,$59.10
2517760,0259,,,,,,,,Phenylephrine SPRAY 0.5% 15 ML,$61.59,$42.41,$23.18,$54.84,$25.25,$59.75,$25.25,$25.25,$53.90,$52.36,$25.25,$57.28,$25.25,$58.51,$25.25,$25.25,$58.51
2517750,0259,,,,,,,,Phenylephrine SPRAY 1% 15 ML B,$69.13,$47.60,$26.02,$61.56,$28.34,$67.06,$28.34,$28.34,$60.49,$58.76,$28.34,$64.29,$28.34,$65.68,$28.34,$28.34,$65.68
2522912,0250,,,,,,,,Phenylephrine/ Lidocaine 1 EAC,$90.47,$62.29,$34.05,$80.56,$37.09,$87.76,$37.09,$37.09,$79.17,$76.90,$37.09,$84.14,$37.09,$85.95,$37.09,$37.09,$85.95
2523307,0250,,,,,,,,Phenylephrine/Lidocaine (15/10,$256.79,$176.79,$96.65,$228.65,$105.29,$249.09,$105.29,$105.29,$224.69,$218.27,$105.29,$238.82,$105.29,$243.95,$105.29,$105.29,$243.95
2513970,0636,J1165,,,,,,,Phenytoin 100 MG/2 ML VIAL,$68.19,$46.94,$25.66,$60.71,$27.96,$66.14,$27.96,$27.96,$59.66,$57.96,$27.96,$63.41,$27.96,$64.78,$27.96,$27.96,$64.78
2513980,0259,,,,,,,,Phenytoin 125 MG/5 ML SUSP,$2.19,$1.51,$0.82,$1.95,$0.90,$2.12,$0.90,$0.90,$1.92,$1.86,$0.90,$2.04,$0.90,$2.08,$0.90,$0.90,$2.08
2513960,0636,J1165,,,,,,,Phenytoin 250 Mg/5 Ml Vial,$78.83,$54.27,$29.67,$70.19,$32.32,$76.46,$32.32,$32.32,$68.98,$67.00,$32.32,$73.31,$32.32,$74.89,$32.32,$32.32,$74.89
2522800,0259,,,,,,,,Phenytoin 50 Mg Chew,$27.61,$19.01,$10.39,$24.58,$11.32,$26.78,$11.32,$11.32,$24.15,$23.46,$11.32,$25.67,$11.32,$26.23,$11.32,$11.32,$26.23
2503560,0259,,,,,,,,Phenytoin-EXTENDED 100 MG CAP,$8.43,$5.81,$3.17,$7.51,$3.46,$8.18,$3.46,$3.46,$7.38,$7.17,$3.46,$7.84,$3.46,$8.01,$3.46,$3.46,$8.01
2525390,0259,,,,,,,,Phenytoin-EXTENDED 30 MG CAP,$27.88,$19.19,$10.49,$24.82,$11.43,$27.04,$11.43,$11.43,$24.39,$23.70,$11.43,$25.93,$11.43,$26.48,$11.43,$11.43,$26.48
2540430,0250,,,,,,,,Phosphorus NEUTRAL 250 MG TABL,$7.31,$5.03,$2.75,$6.51,$3.00,$7.09,$3.00,$3.00,$6.40,$6.21,$3.00,$6.80,$3.00,$6.94,$3.00,$3.00,$6.94
2509840,0250,,,,,,,,Physostigmine 2 MG/2 ML AMP,$566.63,$390.10,$213.25,$504.53,$232.32,$549.63,$232.32,$232.32,$495.80,$481.64,$232.32,$526.97,$232.32,$538.30,$232.32,$232.32,$538.30
2509870,0636,J3430,,,,,,,Phytonadione 1 MG/0.5 ML AMP,$122.20,$84.13,$45.99,$108.80,$50.10,$118.53,$50.10,$50.10,$106.92,$103.87,$50.10,$113.64,$50.10,$116.09,$50.10,$50.10,$116.09
2509860,0636,J3430,,,,,,,Phytonadione 10 MG/ML AMP,$366.75,$252.49,$138.03,$326.55,$150.37,$355.74,$150.37,$150.37,$320.90,$311.73,$150.37,$341.07,$150.37,$348.41,$150.37,$150.37,$348.41
2522933,0250,,,,,,,,Phytonadione 5 MG TABLET,$332.57,$228.96,$125.16,$296.12,$136.35,$322.59,$136.35,$136.35,$291.00,$282.69,$136.35,$309.29,$136.35,$315.94,$136.35,$136.35,$315.94
2526750,0250,,,,,,,,Pilocarpine 5 MG TAB,$7.60,$5.24,$2.86,$6.77,$3.12,$7.38,$3.12,$3.12,$6.65,$6.46,$3.12,$7.07,$3.12,$7.22,$3.12,$3.12,$7.22
2508910,0259,,,,,,,,Pindolol 5 MG TAB,$23.05,$15.87,$8.68,$20.53,$9.45,$22.36,$9.45,$9.45,$20.17,$19.59,$9.45,$21.44,$9.45,$21.90,$9.45,$9.45,$21.90
2525080,0259,,,,,,,,Pioglitazone 15 MG TAB,$2.47,$1.70,$0.93,$2.20,$1.01,$2.40,$1.01,$1.01,$2.16,$2.10,$1.01,$2.30,$1.01,$2.35,$1.01,$1.01,$2.35
2523105,0250,,,,,,,,PIPERA/TAZOB ADD-VANT 3.375GM,$151.66,$104.41,$57.08,$135.03,$62.18,$147.11,$62.18,$62.18,$132.70,$128.91,$62.18,$141.04,$62.18,$144.07,$62.18,$62.18,$144.07
2523239,0250,,,,,,,,Piperacillin/Tazo./Dextrose 2.,$26.89,$18.51,$10.12,$23.94,$11.02,$26.08,$11.02,$11.02,$23.53,$22.85,$11.02,$25.00,$11.02,$25.54,$11.02,$11.02,$25.54
2523241,0250,,,,,,,,Piperacillin/Tazo./Dextrose 24,$75.39,$51.90,$28.37,$67.12,$30.91,$73.12,$30.91,$30.91,$65.96,$64.08,$30.91,$70.11,$30.91,$71.62,$30.91,$30.91,$71.62
2583240,0250,,,,,,,,Piperacillin/Tazo./Dextrose 3.,$52.73,$36.30,$19.84,$46.95,$21.62,$51.15,$21.62,$21.62,$46.14,$44.82,$21.62,$49.04,$21.62,$50.09,$21.62,$21.62,$50.09
2514000,0636,J2543,,,,,,,Piperacillin/Tazobactam 2.25 G,$101.63,$69.97,$38.25,$90.49,$41.67,$98.58,$41.67,$41.67,$88.93,$86.39,$41.67,$94.52,$41.67,$96.55,$41.67,$41.67,$96.55
2514010,0636,J2543,,,,,,,Piperacillin/Tazobactam 3.375,$96.30,$66.30,$36.24,$85.75,$39.48,$93.41,$39.48,$39.48,$84.27,$81.86,$39.48,$89.56,$39.48,$91.49,$39.48,$39.48,$91.49
2514690,0636,J2543,,,,,,,Piperacillin/Tazobactam 4.5 Gm,$117.15,$80.66,$44.09,$104.31,$48.03,$113.64,$48.03,$48.03,$102.51,$99.58,$48.03,$108.95,$48.03,$111.30,$48.03,$48.03,$111.30
2523117,0250,,,,,,,,PIPERACILLIN/TAZOBACTAM 40.5GM,$631.24,$434.58,$237.57,$562.06,$258.81,$612.30,$258.81,$258.81,$552.34,$536.56,$258.81,$587.06,$258.81,$599.68,$258.81,$258.81,$599.68
2523329,0250,,,,,,,,pium/Belladonna 30 MG/16.2 MG,$179.60,$123.65,$67.59,$159.91,$73.64,$174.21,$73.64,$73.64,$157.15,$152.66,$73.64,$167.03,$73.64,$170.62,$73.64,$73.64,$170.62
2523082,0250,,,,,,,,Pneumoc 13-VAL CONJ-DIP CRM/PF,$762.74,$525.11,$287.06,$679.15,$312.72,$739.86,$312.72,$312.72,$667.40,$648.33,$312.72,$709.35,$312.72,$724.61,$312.72,$312.72,$724.61
2523522,0250,,,,,,,,Pneumococcal 20-Val Vaccine .5,$893.58,$615.19,$336.30,$795.64,$366.37,$866.77,$366.37,$366.37,$781.88,$759.54,$366.37,$831.03,$366.37,$848.90,$366.37,$366.37,$848.90
2513990,0250,,,,,,,,Pneumococcal Vaccine 0.5 ML VI,$494.57,$340.49,$186.13,$440.36,$202.77,$479.73,$202.77,$202.77,$432.75,$420.38,$202.77,$459.95,$202.77,$469.84,$202.77,$202.77,$469.84
2529790,0259,,,,,,,,Polyethylene Glycol 3350 17 GM,$22.66,$15.60,$8.53,$20.18,$9.29,$21.98,$9.29,$9.29,$19.83,$19.26,$9.29,$21.07,$9.29,$21.53,$9.29,$9.29,$21.53
2541260,0250,,,,,,,,POLYETHYLENE GLYCOL 3350 POWDE,$77.10,$53.08,$29.02,$68.65,$31.61,$74.78,$31.61,$31.61,$67.46,$65.53,$31.61,$71.70,$31.61,$73.24,$31.61,$31.61,$73.24
2517940,0259,,,,,,,,Polymyxin B/Trimethoprim Ophth,$180.23,$124.08,$67.83,$160.48,$73.89,$174.82,$73.89,$73.89,$157.70,$153.20,$73.89,$167.61,$73.89,$171.22,$73.89,$73.89,$171.22
2514030,0250,,,,,,,,Potassium Acetate 40 MEQ/20 ML,$102.22,$70.37,$38.47,$91.02,$41.91,$99.15,$41.91,$41.91,$89.44,$86.89,$41.91,$95.06,$41.91,$97.11,$41.91,$41.91,$97.11
2523044,0250,,,,,,,,Potassium Bicarbonate/Cit AC 2,$14.45,$9.95,$5.44,$12.86,$5.92,$14.01,$5.92,$5.92,$12.64,$12.28,$5.92,$13.43,$5.92,$13.72,$5.92,$5.92,$13.72
2504870,0259,,,,,,,,Potassium Chloride,$8.25,$5.68,$3.10,$7.34,$3.38,$8.00,$3.38,$3.38,$7.22,$7.01,$3.38,$7.67,$3.38,$7.83,$3.38,$3.38,$7.83
2505720,0259,,,,,,,,Potassium Chloride 10 MEQ CAPC,$15.57,$10.72,$5.86,$13.86,$6.38,$15.10,$6.38,$6.38,$13.62,$13.23,$6.38,$14.48,$6.38,$14.79,$6.38,$6.38,$14.79
2504860,0259,,,,,,,,Potassium Chloride 10 Meq Tabc,$5.28,$3.64,$1.99,$4.70,$2.17,$5.13,$2.17,$2.17,$4.62,$4.49,$2.17,$4.91,$2.17,$5.02,$2.17,$2.17,$5.02
2533410,0636,J3480,,,,,,,Potassium Chloride 10 Meq/100,$53.20,$36.62,$20.02,$47.37,$21.81,$51.60,$21.81,$21.81,$46.55,$45.22,$21.81,$49.47,$21.81,$50.54,$21.81,$21.81,$50.54
2514060,0259,,,,,,,,Potassium Chloride 20 MEQ PKT,$59.96,$41.28,$22.57,$53.39,$24.58,$58.16,$24.58,$24.58,$52.47,$50.97,$24.58,$55.76,$24.58,$56.96,$24.58,$24.58,$56.96
2514050,0250,,,,,,,,Potassium Chloride 20 Meq/10 M,$81.13,$55.85,$30.53,$72.24,$33.26,$78.69,$33.26,$33.26,$70.99,$68.96,$33.26,$75.45,$33.26,$77.07,$33.26,$33.26,$77.07
2530460,0636,J3480,,,,,,,Potassium Chloride 20 Meq/100,$53.73,$36.99,$20.22,$47.84,$22.03,$52.12,$22.03,$22.03,$47.01,$45.67,$22.03,$49.97,$22.03,$51.04,$22.03,$22.03,$51.04
2541080,0250,,,,,,,,Potassium Phosphate 15 MM/5 ML,$231.20,$159.17,$87.01,$205.86,$94.79,$224.27,$94.79,$94.79,$202.30,$196.52,$94.79,$215.02,$94.79,$219.64,$94.79,$94.79,$219.64
2514120,0250,,,,,,,,Potassium Phosphate 45 MM/15 M,$229.02,$157.67,$86.19,$203.92,$93.90,$222.15,$93.90,$93.90,$200.40,$194.67,$93.90,$212.99,$93.90,$217.57,$93.90,$93.90,$217.57
2518030,0259,,,,,,,,Povidone-Iodine Oint 30 GM TUB,$24.69,$17.00,$9.29,$21.98,$10.12,$23.95,$10.12,$10.12,$21.60,$20.98,$10.12,$22.96,$10.12,$23.45,$10.12,$10.12,$23.45
2517970,0259,,,,,,,,Povidone-Iodine Ophth 30 ML BT,$158.88,$109.38,$59.79,$141.46,$65.14,$154.11,$65.14,$65.14,$139.02,$135.05,$65.14,$147.76,$65.14,$150.93,$65.14,$65.14,$150.93
2523196,0250,,,,,,,,Povidone-Iodine Scrub 120 ML B,$61.80,$42.55,$23.26,$55.03,$25.34,$59.95,$25.34,$25.34,$54.08,$52.53,$25.34,$57.48,$25.34,$58.71,$25.34,$25.34,$58.71
2517990,0259,,,,,,,,Povidone-Iodine SOL. PT,$104.22,$71.75,$39.22,$92.80,$42.73,$101.10,$42.73,$42.73,$91.20,$88.59,$42.73,$96.93,$42.73,$99.01,$42.73,$42.73,$99.01
2583470,0250,,,,,,,,POVIDONE-IODINE SOLN 237ML BTL,$54.27,$37.37,$20.43,$48.33,$22.25,$52.65,$22.25,$22.25,$47.49,$46.13,$22.25,$50.47,$22.25,$51.56,$22.25,$22.25,$51.56
2535130,0250,,,,,,,,Pramipexole 0.25 MG TAB,$5.55,$3.82,$2.09,$4.94,$2.27,$5.38,$2.27,$2.27,$4.85,$4.71,$2.27,$5.16,$2.27,$5.27,$2.27,$2.27,$5.27
2537210,0250,,,,,,,,Pramipexole 0.5 MG TAB,$0.70,$0.48,$0.26,$0.62,$0.29,$0.68,$0.29,$0.29,$0.61,$0.59,$0.29,$0.65,$0.29,$0.66,$0.29,$0.29,$0.66
2518090,0259,,,,,,,,Pramoxine/HC Acetate FOAM 10 G,$605.03,$416.54,$227.71,$538.72,$248.06,$586.88,$248.06,$248.06,$529.40,$514.28,$248.06,$562.68,$248.06,$574.78,$248.06,$248.06,$574.78
2506930,0259,,,,,,,,Pravastatin 20 MG TAB,$3.07,$2.12,$1.16,$2.74,$1.26,$2.98,$1.26,$1.26,$2.69,$2.61,$1.26,$2.86,$1.26,$2.92,$1.26,$1.26,$2.92
2506940,0259,,,,,,,,Pravastatin 40 MG TAB,$15.60,$10.74,$5.87,$13.89,$6.40,$15.13,$6.40,$6.40,$13.65,$13.26,$6.40,$14.51,$6.40,$14.82,$6.40,$6.40,$14.82
2505730,0259,,,,,,,,Prazosin 1 Mg Cap,$27.53,$18.95,$10.36,$24.51,$11.29,$26.70,$11.29,$11.29,$24.09,$23.40,$11.29,$25.60,$11.29,$26.15,$11.29,$11.29,$26.15
2505750,0259,,,,,,,,Prazosin 5 MG CAP,$8.39,$5.78,$3.16,$7.47,$3.44,$8.14,$3.44,$3.44,$7.34,$7.13,$3.44,$7.80,$3.44,$7.97,$3.44,$3.44,$7.97
2505740,0259,,,,,,,,PRAZOSIN HCL,$17.50,$12.05,$6.58,$15.58,$7.17,$16.97,$7.17,$7.17,$15.31,$14.87,$7.17,$16.27,$7.17,$16.62,$7.17,$7.17,$16.62
2523355,0250,,,,,,,,"PREDNI 1%, MOXIFLOX.5%,NEPAF",$457.29,$314.82,$172.10,$407.17,$187.49,$443.57,$187.49,$187.49,$400.13,$388.69,$187.49,$425.28,$187.49,$434.42,$187.49,$187.49,$434.42
2518060,0259,,,,,,,,prednisoLONE 0.12% 5 ML BTL,$597.32,$411.23,$224.80,$531.85,$244.90,$579.40,$244.90,$244.90,$522.65,$507.72,$244.90,$555.51,$244.90,$567.45,$244.90,$244.90,$567.45
2518070,0259,,,,,,,,prednisoLONE 1% 5 ML BTL,$326.55,$224.81,$122.90,$290.76,$133.88,$316.75,$133.88,$133.88,$285.73,$277.57,$133.88,$303.69,$133.88,$310.22,$133.88,$133.88,$310.22
2514150,0259,,,,,,,,prednisoLONE 15 MG/5 ML,$3.52,$2.42,$1.32,$3.13,$1.44,$3.41,$1.44,$1.44,$3.08,$2.99,$1.44,$3.27,$1.44,$3.34,$1.44,$1.44,$3.34
2528510,0259,,,,,,,,prednisoLONE SOD. PHOS. 1% 10,$414.99,$285.70,$156.18,$369.50,$170.14,$402.54,$170.14,$170.14,$363.11,$352.74,$170.14,$385.94,$170.14,$394.24,$170.14,$170.14,$394.24
2535610,0250,,,,,,,,prednisoLONE SOD. PHOS. 15 MG/,$3.13,$2.15,$1.18,$2.78,$1.28,$3.03,$1.28,$1.28,$2.74,$2.66,$1.28,$2.91,$1.28,$2.97,$1.28,$1.28,$2.97
2506480,0259,,,,,,,,predniSONE 1 MG TAB,$3.04,$2.09,$1.14,$2.71,$1.25,$2.95,$1.25,$1.25,$2.66,$2.58,$1.25,$2.83,$1.25,$2.89,$1.25,$1.25,$2.89
2503360,0636,J7506,,,,,,,Prednisone 10 Mg Tab,$2.82,$1.94,$1.06,$2.51,$1.16,$2.74,$1.16,$1.16,$2.47,$2.40,$1.16,$2.62,$1.16,$2.68,$1.16,$1.16,$2.68
2503350,0636,J7506,,,,,,,Prednisone 20 Mg Tab,$2.96,$2.04,$1.12,$2.64,$1.21,$2.87,$1.21,$1.21,$2.59,$2.52,$1.21,$2.76,$1.21,$2.82,$1.21,$1.21,$2.82
2503340,0636,J7506,,,,,,,Prednisone 5 Mg Tab,$2.42,$1.67,$0.91,$2.15,$0.99,$2.35,$0.99,$0.99,$2.12,$2.06,$0.99,$2.25,$0.99,$2.30,$0.99,$0.99,$2.30
2537090,0250,,,,,,,,Pregabalin 100 MG CAP,$8.82,$6.08,$3.32,$7.86,$3.62,$8.56,$3.62,$3.62,$7.72,$7.50,$3.62,$8.21,$3.62,$8.38,$3.62,$3.62,$8.38
2539010,0250,,,,,,,,Pregabalin 25 MG CAP,$10.71,$7.37,$4.03,$9.54,$4.39,$10.39,$4.39,$4.39,$9.37,$9.10,$4.39,$9.96,$4.39,$10.17,$4.39,$4.39,$10.17
2535640,0250,,,,,,,,Pregabalin 50 Mg Cap,$8.82,$6.08,$3.32,$7.86,$3.62,$8.56,$3.62,$3.62,$7.72,$7.50,$3.62,$8.21,$3.62,$8.38,$3.62,$3.62,$8.38
2507020,0259,,,,,,,,"Prenatal Multivitamin w/CA,FE",$0.86,$0.59,$0.32,$0.77,$0.35,$0.83,$0.35,$0.35,$0.75,$0.73,$0.35,$0.80,$0.35,$0.82,$0.35,$0.35,$0.82
2516480,0259,,,,,,,,Preparation H 28 GM TUBE,$107.67,$74.12,$40.52,$95.87,$44.14,$104.44,$44.14,$44.14,$94.21,$91.52,$44.14,$100.13,$44.14,$102.28,$44.14,$44.14,$102.28
2521120,0259,,,,,,,,Preparation H SUPP,$12.81,$8.82,$4.82,$11.41,$5.25,$12.43,$5.25,$5.25,$11.21,$10.89,$5.25,$11.91,$5.25,$12.17,$5.25,$5.25,$12.17
2539990,0250,,,,,,,,Preservision TABLET,$4.82,$3.32,$1.81,$4.29,$1.97,$4.67,$1.97,$1.97,$4.21,$4.09,$1.97,$4.48,$1.97,$4.57,$1.97,$1.97,$4.57
2506000,0259,,,,,,,,Primidone 250 MG TAB,$7.82,$5.39,$2.94,$6.96,$3.21,$7.59,$3.21,$3.21,$6.84,$6.65,$3.21,$7.27,$3.21,$7.43,$3.21,$3.21,$7.43
2506010,0259,,,,,,,,Primidone 50 MG TAB,$2.70,$1.86,$1.02,$2.41,$1.11,$2.62,$1.11,$1.11,$2.36,$2.30,$1.11,$2.51,$1.11,$2.57,$1.11,$1.11,$2.57
2502160,0259,,,,,,,,Probenecid 500 MG TAB,$11.07,$7.62,$4.17,$9.86,$4.54,$10.74,$4.54,$4.54,$9.68,$9.41,$4.54,$10.29,$4.54,$10.51,$4.54,$4.54,$10.51
2523432,0250,,,,,,,,Procainamide 1000 Mg/10ml Syr,$547.79,$377.13,$206.16,$487.75,$224.60,$531.36,$224.60,$224.60,$479.32,$465.62,$224.60,$509.45,$224.60,$520.40,$224.60,$224.60,$520.40
2503020,0259,,,,,,,,Prochlorperazine 10 MG TAB,$7.12,$4.91,$2.68,$6.34,$2.92,$6.91,$2.92,$2.92,$6.23,$6.06,$2.92,$6.63,$2.92,$6.77,$2.92,$2.92,$6.77
2520420,0636,J0780,,,,,,,Prochlorperazine 10 Mg/2 Ml Vi,$112.71,$77.60,$42.42,$100.36,$46.21,$109.33,$46.21,$46.21,$98.62,$95.80,$46.21,$104.82,$46.21,$107.07,$46.21,$46.21,$107.07
2503000,0250,J8498,,,,,,,Prochlorperazine 25 MG SUPP,$126.11,$86.82,$47.46,$112.29,$51.70,$122.33,$51.70,$51.70,$110.35,$107.19,$51.70,$117.28,$51.70,$119.80,$51.70,$51.70,$119.80
2503010,0259,,,,,,,,Prochlorperazine 5 MG TAB,$5.60,$3.86,$2.11,$4.99,$2.30,$5.43,$2.30,$2.30,$4.90,$4.76,$2.30,$5.21,$2.30,$5.32,$2.30,$2.30,$5.32
2506840,0636,J2550,,,,,,,Promethazine 12.5 MG SUPP,$107.72,$74.16,$40.54,$95.91,$44.17,$104.49,$44.17,$44.17,$94.25,$91.56,$44.17,$100.18,$44.17,$102.33,$44.17,$44.17,$102.33
2506830,0636,,,,,,,,Promethazine 25 MG SUPP,$95.15,$65.51,$35.81,$84.72,$39.01,$92.29,$39.01,$39.01,$83.25,$80.88,$39.01,$88.49,$39.01,$90.39,$39.01,$39.01,$90.39
2506820,0259,,,,,,,,Promethazine 25 MG TAB,$1.02,$0.71,$0.39,$0.91,$0.42,$0.99,$0.42,$0.42,$0.90,$0.87,$0.42,$0.95,$0.42,$0.97,$0.42,$0.42,$0.97
2523281,0250,,,,,,,,"Promethazine 25 MG TAB, 3 TABS",$1.53,$1.05,$0.57,$1.36,$0.63,$1.48,$0.63,$0.63,$1.33,$1.30,$0.63,$1.42,$0.63,$1.45,$0.63,$0.63,$1.45
2514260,0250,,,,,,,,Promethazine 25 MG/ML VIAL,$79.40,$54.66,$29.88,$70.69,$32.55,$77.01,$32.55,$32.55,$69.47,$67.49,$32.55,$73.84,$32.55,$75.43,$32.55,$32.55,$75.43
2514250,0259,,,,,,,,Promethazine 6.25 MG/5 ML,$2.53,$1.74,$0.95,$2.25,$1.04,$2.45,$1.04,$1.04,$2.21,$2.15,$1.04,$2.35,$1.04,$2.40,$1.04,$1.04,$2.40
2541890,0250,,,,,,,,Promethazine w/Codeine 5 ML BT,$2.77,$1.91,$1.04,$2.46,$1.13,$2.68,$1.13,$1.13,$2.42,$2.35,$1.13,$2.57,$1.13,$2.63,$1.13,$1.13,$2.63
2540820,0250,,,,,,,,Propofol 1000 Mg/100 Ml Vial,$150.89,$103.88,$56.79,$134.35,$61.87,$146.37,$61.87,$61.87,$132.03,$128.26,$61.87,$140.33,$61.87,$143.35,$61.87,$61.87,$143.35
2514290,0636,J2704,,,,,,,Propofol 200 Mg/20 Ml Vial,$82.42,$56.75,$31.02,$73.39,$33.79,$79.95,$33.79,$33.79,$72.12,$70.06,$33.79,$76.65,$33.79,$78.30,$33.79,$33.79,$78.30
2522935,0250,,,,,,,,Propofol 500 MG/50 ML VIAL,$87.35,$60.14,$32.87,$77.77,$35.81,$84.73,$35.81,$35.81,$76.43,$74.25,$35.81,$81.23,$35.81,$82.98,$35.81,$35.81,$82.98
2504630,0259,,,,,,,,Propranolol 10 MG TAB,$3.82,$2.63,$1.44,$3.40,$1.57,$3.71,$1.57,$1.57,$3.35,$3.25,$1.57,$3.56,$1.57,$3.63,$1.57,$1.57,$3.63
2504640,0259,,,,,,,,Propranolol 20 MG TAB,$20.16,$13.88,$7.59,$17.95,$8.27,$19.56,$8.27,$8.27,$17.64,$17.14,$8.27,$18.75,$8.27,$19.16,$8.27,$8.27,$19.16
2504650,0259,,,,,,,,Propranolol 40 MG TAB,$7.63,$5.25,$2.87,$6.79,$3.13,$7.40,$3.13,$3.13,$6.67,$6.48,$3.13,$7.09,$3.13,$7.24,$3.13,$3.13,$7.24
2522934,0250,,,,,,,,Propranolol 60 MG CAPCR,$36.33,$25.01,$13.67,$32.35,$14.90,$35.24,$14.90,$14.90,$31.79,$30.88,$14.90,$33.79,$14.90,$34.51,$14.90,$14.90,$34.51
2504680,0259,,,,,,,,PROPRANOLOL HCL,$4.19,$2.89,$1.58,$3.73,$1.72,$4.07,$1.72,$1.72,$3.67,$3.57,$1.72,$3.90,$1.72,$3.98,$1.72,$1.72,$3.98
2507240,0259,,,,,,,,Propylthiouracil 50 MG TAB,$39.36,$27.10,$14.81,$35.05,$16.14,$38.18,$16.14,$16.14,$34.44,$33.46,$16.14,$36.60,$16.14,$37.39,$16.14,$16.14,$37.39
2543950,0250,,,,,,,,Protamine Sulfate 50 MG/5 ML V,$202.52,$139.43,$76.22,$180.32,$83.03,$196.44,$83.03,$83.03,$177.20,$172.14,$83.03,$188.34,$83.03,$192.39,$83.03,$83.03,$192.39
2523395,0250,,,,,,,,PROTEIN NUTRITIONAL SUPPLE 1OZ,$47.49,$32.69,$17.87,$42.28,$19.47,$46.06,$19.47,$19.47,$41.55,$40.36,$19.47,$44.16,$19.47,$45.11,$19.47,$19.47,$45.11
2527360,0259,,,,,,,,Proventil Hfa Inhaler,$304.93,$209.93,$114.76,$271.51,$125.02,$295.79,$125.02,$125.02,$266.82,$259.19,$125.02,$283.59,$125.02,$289.69,$125.02,$125.02,$289.69
2523464,0250,,,,,,,,PRUCALOPRIDE 2 MG TAB,$209.91,$144.51,$79.00,$186.90,$86.06,$203.61,$86.06,$86.06,$183.67,$178.42,$86.06,$195.21,$86.06,$199.41,$86.06,$86.06,$199.41
2508060,0259,,,,,,,,Pseudoephedrine 30 MG TAB,$0.95,$0.65,$0.36,$0.84,$0.39,$0.92,$0.39,$0.39,$0.83,$0.81,$0.39,$0.88,$0.39,$0.90,$0.39,$0.39,$0.90
2514190,0259,,,,,,,,Psyllium Pkt,$9.09,$6.26,$3.42,$8.09,$3.73,$8.81,$3.73,$3.73,$7.95,$7.72,$3.73,$8.45,$3.73,$8.63,$3.73,$3.73,$8.63
2505630,0259,,,,,,,,Pyridostigmine 180 MG TABCR,$220.45,$151.77,$82.97,$196.29,$90.38,$213.84,$90.38,$90.38,$192.89,$187.38,$90.38,$205.02,$90.38,$209.43,$90.38,$90.38,$209.43
2505620,0259,,,,,,,,Pyridostigmine 60 Mg Tab,$22.01,$15.15,$8.28,$19.59,$9.02,$21.35,$9.02,$9.02,$19.26,$18.70,$9.02,$20.47,$9.02,$20.91,$9.02,$9.02,$20.91
2507320,0259,,,,,,,,Pyridoxine 100 MG TAB,$0.29,$0.20,$0.11,$0.26,$0.12,$0.29,$0.12,$0.12,$0.26,$0.25,$0.12,$0.27,$0.12,$0.28,$0.12,$0.12,$0.28
2532920,0250,,,,,,,,Pyridoxine 100 MG/ML 1 ML VIAL,$727.57,$500.90,$273.82,$647.82,$298.30,$705.74,$298.30,$298.30,$636.62,$618.43,$298.30,$676.64,$298.30,$691.19,$298.30,$298.30,$691.19
2523220,0259,,,,,,,,QUEtiapine 100 MG TAB,$7.95,$5.48,$2.99,$7.08,$3.26,$7.71,$3.26,$3.26,$6.96,$6.76,$3.26,$7.40,$3.26,$7.55,$3.26,$3.26,$7.55
2524390,0259,,,,,,,,QUEtiapine 25 MG TAB,$4.86,$3.35,$1.83,$4.33,$1.99,$4.71,$1.99,$1.99,$4.25,$4.13,$1.99,$4.52,$1.99,$4.62,$1.99,$1.99,$4.62
2528730,0259,,,,,,,,QUEtiapine 300 MG TAB,$5.98,$4.12,$2.25,$5.33,$2.45,$5.80,$2.45,$2.45,$5.23,$5.08,$2.45,$5.56,$2.45,$5.68,$2.45,$2.45,$5.68
2540620,0250,,,,,,,,QUEtiapine 300 MG TABCR,$8.63,$5.94,$3.25,$7.68,$3.54,$8.37,$3.54,$3.54,$7.55,$7.33,$3.54,$8.02,$3.54,$8.20,$3.54,$3.54,$8.20
2541450,0250,,,,,,,,QUEtiapine 50 MG TABCR,$3.28,$2.26,$1.23,$2.92,$1.34,$3.18,$1.34,$1.34,$2.87,$2.79,$1.34,$3.05,$1.34,$3.12,$1.34,$1.34,$3.12
2535910,0250,,,,,,,,QUETIAPINE 50MG TAB,$8.74,$6.02,$3.29,$7.78,$3.58,$8.47,$3.58,$3.58,$7.64,$7.43,$3.58,$8.13,$3.58,$8.30,$3.58,$3.58,$8.30
2533420,0259,,,,,,,,Quinapril 20 Mg Tab,$23.03,$15.86,$8.67,$20.51,$9.44,$22.34,$9.44,$9.44,$20.15,$19.58,$9.44,$21.42,$9.44,$21.88,$9.44,$9.44,$21.88
2523314,0250,,,,,,,,Rabies Immune Globulin 1500un,"$6,128.89","$4,219.45","$2,306.63","$5,457.15","$2,512.84","$5,945.02","$2,512.84","$2,512.84","$5,362.78","$5,209.55","$2,512.84","$5,699.87","$2,512.84","$5,822.44","$2,512.84","$2,512.84","$5,822.44"
2523327,0250,,,,,,,,Rabies Immune Globulin 300 Uni,"$1,613.67","$1,110.94",$607.31,"$1,436.81",$661.61,"$1,565.26",$661.61,$661.61,"$1,411.96","$1,371.62",$661.61,"$1,500.72",$661.61,"$1,532.99",$661.61,$661.61,"$1,532.99"
2514400,0636,90675,,,,,,,Rabies Vaccine 2.5 Units Vial,"$1,102.64",$759.11,$414.98,$981.79,$452.08,"$1,069.56",$452.08,$452.08,$964.81,$937.24,$452.08,"$1,025.45",$452.08,"$1,047.50",$452.08,$452.08,"$1,047.50"
2523640,0259,,,,,,,,Raloxifene 60 MG TAB,$24.95,$17.18,$9.39,$22.21,$10.23,$24.20,$10.23,$10.23,$21.83,$21.21,$10.23,$23.20,$10.23,$23.70,$10.23,$10.23,$23.70
2523087,0250,,,,,,,,Raltegravir potassium 400 mg T,$278.73,$191.90,$104.90,$248.18,$114.28,$270.37,$114.28,$114.28,$243.89,$236.92,$114.28,$259.22,$114.28,$264.80,$114.28,$114.28,$264.80
2522870,0259,,,,,,,,Ramipril 5 MG CAP,$7.60,$5.24,$2.86,$6.77,$3.12,$7.38,$3.12,$3.12,$6.65,$6.46,$3.12,$7.07,$3.12,$7.22,$3.12,$3.12,$7.22
2540290,0250,,,,,,,,RANOLAZINE 500MG TAB,$12.42,$8.55,$4.67,$11.06,$5.09,$12.05,$5.09,$5.09,$10.87,$10.56,$5.09,$11.55,$5.09,$11.80,$5.09,$5.09,$11.80
2537850,0250,,,,,,,,Refresh PLUS Eye Drops 0.4ml,$5.93,$4.08,$2.23,$5.28,$2.43,$5.75,$2.43,$2.43,$5.19,$5.04,$2.43,$5.51,$2.43,$5.63,$2.43,$2.43,$5.63
2517820,0259,,,,,,,,Refresh PM Eye Ointment 3.5 GM,$120.15,$82.72,$45.22,$106.98,$49.26,$116.55,$49.26,$49.26,$105.13,$102.13,$49.26,$111.74,$49.26,$114.14,$49.26,$49.26,$114.14
2540330,0636,J2785,,,,,,,Regadenoson 0.4 MG/5 ML SYR,$834.82,$574.73,$314.19,$743.32,$342.28,$809.77,$342.28,$342.28,$730.47,$709.60,$342.28,$776.38,$342.28,$793.08,$342.28,$342.28,$793.08
2583420,0636,J0248,,,,,,,REMDESIVIR (EUA) 100MG VIAL,"$1,777.03","$1,223.40",$668.79,"$1,582.26",$728.58,"$1,723.72",$728.58,$728.58,"$1,554.90","$1,510.47",$728.58,"$1,652.64",$728.58,"$1,688.18",$728.58,$728.58,"$1,688.18"
2523476,0250,,,,,,,,REMIFENTANIL 1 MG VIAL,$485.96,$334.56,$182.89,$432.70,$199.24,$471.38,$199.24,$199.24,$425.21,$413.07,$199.24,$451.94,$199.24,$461.66,$199.24,$199.24,$461.66
2507545,0510,25075,,,,,,,REMOVAL FOREARM LESION SUB  ~G,$969.57,$667.50,$364.90,$863.30,$397.52,$940.48,$397.52,$397.52,$848.37,$824.13,$397.52,$901.70,$397.52,$921.09,$397.52,$397.52,$921.09
2523471,0636,J2790,,,,,,,RHO(D) IMMUNE GLOBULIN 1500UN,$545.36,$375.46,$205.25,$485.59,$223.60,$529.00,$223.60,$223.60,$477.19,$463.56,$223.60,$507.19,$223.60,$518.10,$223.60,$223.60,$518.10
2593040,0250,,,,,,,,RHO(D) Immune Globulin 250 UNI,$357.57,$246.17,$134.57,$318.38,$146.61,$346.85,$146.61,$146.61,$312.88,$303.94,$146.61,$332.54,$146.61,$339.70,$146.61,$146.61,$339.70
2507500,0259,,,,,,,,Rifampin,$16.89,$11.63,$6.36,$15.04,$6.92,$16.38,$6.92,$6.92,$14.77,$14.35,$6.92,$15.70,$6.92,$16.04,$6.92,$6.92,$16.04
2528600,0259,,,,,,,,Rifampin 150 MG CAP,$22.01,$15.15,$8.28,$19.59,$9.02,$21.35,$9.02,$9.02,$19.26,$18.70,$9.02,$20.47,$9.02,$20.91,$9.02,$9.02,$20.91
2523143,0250,,,,,,,,RIFAXMIN 550 MG TAB,$567.78,$390.89,$213.69,$505.55,$232.79,$550.75,$232.79,$232.79,$496.81,$482.62,$232.79,$528.04,$232.79,$539.40,$232.79,$232.79,$539.40
2525640,0259,,,,,,,,risperiDONE 0.25 MG TAB,$4.61,$3.17,$1.73,$4.10,$1.89,$4.47,$1.89,$1.89,$4.03,$3.92,$1.89,$4.29,$1.89,$4.38,$1.89,$1.89,$4.38
2526560,0259,,,,,,,,risperiDONE 0.5 MG TAB,$4.78,$3.29,$1.80,$4.26,$1.96,$4.64,$1.96,$1.96,$4.18,$4.07,$1.96,$4.45,$1.96,$4.54,$1.96,$1.96,$4.54
2523406,0250,,,,,,,,RISPERIDONE 1 MG ODT 1 MG TABE,$311.54,$214.48,$117.25,$277.39,$127.73,$302.19,$127.73,$127.73,$272.59,$264.81,$127.73,$289.73,$127.73,$295.96,$127.73,$127.73,$295.96
2507510,0259,,,,,,,,risperiDONE 1 MG TAB,$2.43,$1.67,$0.91,$2.16,$1.00,$2.36,$1.00,$1.00,$2.13,$2.06,$1.00,$2.26,$1.00,$2.31,$1.00,$1.00,$2.31
2523445,0250,,,,,,,,RISPERIDONE MICROSPHERES 25MG/,"$1,570.98","$1,081.55",$591.24,"$1,398.80",$644.10,"$1,523.85",$644.10,$644.10,"$1,374.61","$1,335.33",$644.10,"$1,461.01",$644.10,"$1,492.43",$644.10,$644.10,"$1,492.43"
2522968,0636,,,,,,,,Rituximab 100 Mg/10 Ml Vial,"$2,333.03","$1,606.18",$878.04,"$2,077.32",$956.54,"$2,263.04",$956.54,$956.54,"$2,041.40","$1,983.07",$956.54,"$2,169.71",$956.54,"$2,216.38",$956.54,$956.54,"$2,216.38"
2522440,0636,,,,,,,,Rituximab 500 Mg/50 Ml Vial,"$11,302.22","$7,781.04","$4,253.64","$10,063.48","$4,633.91","$10,963.15","$4,633.91","$4,633.91","$9,889.44","$9,606.89","$4,633.91","$10,511.06","$4,633.91","$10,737.11","$4,633.91","$4,633.91","$10,737.11"
2523429,0636,Q5119,,,,,,,RITUXIMAB PVVR 500 MG/50ML VIA,"$6,635.82","$4,568.45","$2,497.42","$5,908.52","$2,720.69","$6,436.74","$2,720.69","$2,720.69","$5,806.34","$5,640.45","$2,720.69","$6,171.31","$2,720.69","$6,304.03","$2,720.69","$2,720.69","$6,304.03"
2583430,0636,Q5119,,,,,,,RITUZIMAB-PVVR 100MG/10ML VIAL,"$1,950.37","$1,342.74",$734.03,"$1,736.61",$799.65,"$1,891.86",$799.65,$799.65,"$1,706.58","$1,657.82",$799.65,"$1,813.85",$799.65,"$1,852.86",$799.65,$799.65,"$1,852.86"
2522963,0250,,,,,,,,Rivaroxaban 10 MG TABLET,$175.61,$120.90,$66.09,$156.36,$72.00,$170.34,$72.00,$72.00,$153.66,$149.27,$72.00,$163.32,$72.00,$166.83,$72.00,$72.00,$166.83
2523147,0250,,,,,,,,Rivaroxaban 15 MG TABLET,$175.61,$120.90,$66.09,$156.36,$72.00,$170.34,$72.00,$72.00,$153.66,$149.27,$72.00,$163.32,$72.00,$166.83,$72.00,$72.00,$166.83
2523387,0250,,,,,,,,RIVAROZABAN 2.5 MG TABLET,$103.25,$71.09,$38.86,$91.94,$42.33,$100.16,$42.33,$42.33,$90.35,$87.77,$42.33,$96.03,$42.33,$98.09,$42.33,$42.33,$98.09
2543440,0250,,,,,,,,Rivastigmine 1.5 MG CAP,$6.13,$4.22,$2.31,$5.46,$2.51,$5.95,$2.51,$2.51,$5.37,$5.21,$2.51,$5.70,$2.51,$5.83,$2.51,$2.51,$5.83
2527090,0250,,,,,,,,Rizatriptan 10 MG TAB,$32.38,$22.29,$12.19,$28.83,$13.27,$31.41,$13.27,$13.27,$28.33,$27.52,$13.27,$30.11,$13.27,$30.76,$13.27,$13.27,$30.76
2514370,0250,,,,,,,,Rocuronium 50 MG/5 ML VIAL,$85.45,$58.83,$32.16,$76.09,$35.04,$82.89,$35.04,$35.04,$74.77,$72.63,$35.04,$79.47,$35.04,$81.18,$35.04,$35.04,$81.18
2523067,0250,,,,,,,,ROCURONIUM 50MG/5ML SYR,$220.55,$151.84,$83.00,$196.38,$90.43,$213.93,$90.43,$90.43,$192.98,$187.47,$90.43,$205.11,$90.43,$209.52,$90.43,$90.43,$209.52
2523364,0250,,,,,,,,Roflumilast 500 Mcg Tab,$29.09,$20.03,$10.95,$25.90,$11.93,$28.21,$11.93,$11.93,$25.45,$24.72,$11.93,$27.05,$11.93,$27.63,$11.93,$11.93,$27.63
2523563,0636,J3590,,,,,,,ROMOSOZUMAB-AQQG 210MG/2.34ML,"$5,442.88","$3,747.17","$2,048.45","$4,846.33","$2,231.58","$5,279.60","$2,231.58","$2,231.58","$4,762.52","$4,626.45","$2,231.58","$5,061.88","$2,231.58","$5,170.74","$2,231.58","$2,231.58","$5,170.74"
2538450,0250,,,,,,,,rOPINIRole 0.5 MG TAB,$1.70,$1.17,$0.64,$1.51,$0.70,$1.65,$0.70,$0.70,$1.49,$1.44,$0.70,$1.58,$0.70,$1.61,$0.70,$0.70,$1.61
2528830,0259,,,,,,,,ROPINIROLE 1MG,$7.24,$4.99,$2.73,$6.45,$2.97,$7.03,$2.97,$2.97,$6.34,$6.16,$2.97,$6.74,$2.97,$6.88,$2.97,$2.97,$6.88
2524970,0250,,,,,,,,Ropivacaine 150 Mg/30 Ml Vial,$162.95,$112.19,$61.33,$145.09,$66.81,$158.06,$66.81,$66.81,$142.58,$138.51,$66.81,$151.55,$66.81,$154.80,$66.81,$66.81,$154.80
2524960,0250,,,,,,,,Ropivacaine 40 MG/20 ML VIAL,$153.47,$105.66,$57.76,$136.65,$62.92,$148.87,$62.92,$62.92,$134.29,$130.45,$62.92,$142.73,$62.92,$145.80,$62.92,$62.92,$145.80
2523557,0250,,,,,,,,ROPIVACAINE/CLONIDINE/KETO 50M,$432.49,$297.75,$162.77,$385.09,$177.32,$419.52,$177.32,$177.32,$378.43,$367.62,$177.32,$402.22,$177.32,$410.87,$177.32,$177.32,$410.87
2523528,0250,,,,,,,,ROPIVACAINE/EPI/CLONI/KETOR 50,$431.62,$297.15,$162.44,$384.31,$176.96,$418.67,$176.96,$176.96,$377.67,$366.88,$176.96,$401.41,$176.96,$410.04,$176.96,$176.96,$410.04
2523562,0250,,,,,,,,ROPIVACAINE/EPI/KETOROLAC 50ML,$428.40,$294.93,$161.23,$381.44,$175.64,$415.54,$175.64,$175.64,$374.85,$364.14,$175.64,$398.41,$175.64,$406.98,$175.64,$175.64,$406.98
2523524,0250,,,,,,,,ROPLVACAINE 0.1% 200ML CADD,$541.87,$373.05,$203.93,$482.48,$222.17,$525.61,$222.17,$222.17,$474.13,$460.59,$222.17,$503.94,$222.17,$514.77,$222.17,$222.17,$514.77
2533390,0259,,,,,,,,Rosuvastatin 10 Mg Tab,$23.99,$16.52,$9.03,$21.36,$9.84,$23.27,$9.84,$9.84,$20.99,$20.39,$9.84,$22.31,$9.84,$22.79,$9.84,$9.84,$22.79
2541050,0250,,,,,,,,Rosuvastatin 5 Mg Tab,$1.44,$0.99,$0.54,$1.28,$0.59,$1.39,$0.59,$0.59,$1.26,$1.22,$0.59,$1.34,$0.59,$1.37,$0.59,$0.59,$1.37
2523475,0250,,,,,,,,SACUBITRIL/VALSARTAN 24MG/26MG,$175.99,$121.16,$66.24,$156.70,$72.16,$170.71,$72.16,$72.16,$153.99,$149.59,$72.16,$163.67,$72.16,$167.19,$72.16,$72.16,$167.19
2523534,0250,,,,,,,,SACUBITRIL/VALSARTAN 49MG/51MG,$172.59,$118.82,$64.96,$153.68,$70.76,$167.42,$70.76,$70.76,$151.02,$146.70,$70.76,$160.51,$70.76,$163.96,$70.76,$70.76,$163.96
2526430,0250,,,,,,,,Salt Supplement (Buffered) Tab,$1.12,$0.77,$0.42,$1.00,$0.46,$1.09,$0.46,$0.46,$0.98,$0.95,$0.46,$1.04,$0.46,$1.07,$0.46,$0.46,$1.07
2531960,0259,,,,,,,,Santyl Oint. 30gm,$931.37,$641.21,$350.53,$829.29,$381.86,$903.43,$381.86,$381.86,$814.95,$791.67,$381.86,$866.18,$381.86,$884.80,$381.86,$381.86,$884.80
2523498,0636,J3590,,,,,,,SARILUMAB 200 MG/1.14 ML PEN,"$4,672.15","$3,216.56","$1,758.38","$4,160.08","$1,915.58","$4,531.99","$1,915.58","$1,915.58","$4,088.13","$3,971.33","$1,915.58","$4,345.10","$1,915.58","$4,438.55","$1,915.58","$1,915.58","$4,438.55"
2523477,0636,J3590,,,,,,,SARILUMAB 200MG/1.14ML SYRINGE,"$4,935.81","$3,398.07","$1,857.61","$4,394.84","$2,023.68","$4,787.74","$2,023.68","$2,023.68","$4,318.83","$4,195.44","$2,023.68","$4,590.30","$2,023.68","$4,689.02","$2,023.68","$2,023.68","$4,689.02"
2519920,0259,,,,,,,,Scopolamine 1.5 MG PATCH,$153.64,$105.77,$57.82,$136.80,$62.99,$149.03,$62.99,$62.99,$134.43,$130.59,$62.99,$142.88,$62.99,$145.96,$62.99,$62.99,$145.96
2507720,0259,,,,,,,,Senna TAB,$0.65,$0.45,$0.25,$0.58,$0.27,$0.63,$0.27,$0.27,$0.57,$0.56,$0.27,$0.61,$0.27,$0.62,$0.27,$0.27,$0.62
2531740,0259,,,,,,,,Sennosides/Docusate Sodium Tab,$2.30,$1.58,$0.87,$2.05,$0.94,$2.23,$0.94,$0.94,$2.01,$1.95,$0.94,$2.14,$0.94,$2.18,$0.94,$0.94,$2.18
2523230,0259,,,,,,,,SEROQUEL 200MG,$6.72,$4.63,$2.53,$5.98,$2.76,$6.52,$2.76,$2.76,$5.88,$5.71,$2.76,$6.25,$2.76,$6.39,$2.76,$2.76,$6.39
2534020,0250,,,,,,,,Sertraline 20 MG/ML ML,$13.97,$9.62,$5.26,$12.44,$5.73,$13.55,$5.73,$5.73,$12.22,$11.87,$5.73,$12.99,$5.73,$13.27,$5.73,$5.73,$13.27
2527710,0250,,,,,,,,Sertraline 25 MG TAB,$8.08,$5.57,$3.04,$7.20,$3.31,$7.84,$3.31,$3.31,$7.07,$6.87,$3.31,$7.52,$3.31,$7.68,$3.31,$3.31,$7.68
2509190,0259,,,,,,,,Sertraline 50 MG TAB,$5.81,$4.00,$2.19,$5.17,$2.38,$5.63,$2.38,$2.38,$5.08,$4.94,$2.38,$5.40,$2.38,$5.52,$2.38,$2.38,$5.52
2509200,0259,,,,,,,,SERTRALINE HCL,$8.40,$5.78,$3.16,$7.48,$3.44,$8.15,$3.44,$3.44,$7.35,$7.14,$3.44,$7.81,$3.44,$7.98,$3.44,$3.44,$7.98
2518180,0250,,,,,,,,Sevoflurane 250 ML BTL,$66.57,$45.83,$25.06,$59.28,$27.30,$64.58,$27.30,$27.30,$58.25,$56.59,$27.30,$61.91,$27.30,$63.24,$27.30,$27.30,$63.24
2519930,0259,,,,,,,,Silver Nitrate Stick,$14.14,$9.74,$5.32,$12.59,$5.80,$13.72,$5.80,$5.80,$12.37,$12.02,$5.80,$13.15,$5.80,$13.43,$5.80,$5.80,$13.43
2518150,0259,,,,,,,,Silver Sulfadiazene 1% 25 GM T,$55.52,$38.22,$20.89,$49.43,$22.76,$53.85,$22.76,$22.76,$48.58,$47.19,$22.76,$51.63,$22.76,$52.74,$22.76,$22.76,$52.74
2522938,0250,,,,,,,,SILVER SULFADIAZINE 1% 400 GM,$272.92,$187.89,$102.71,$243.00,$111.90,$264.73,$111.90,$111.90,$238.80,$231.98,$111.90,$253.81,$111.90,$259.27,$111.90,$111.90,$259.27
2538100,0250,,,,,,,,Simethicone 40 MG/0.6 ML 30ML,$34.00,$23.41,$12.80,$30.27,$13.94,$32.98,$13.94,$13.94,$29.75,$28.90,$13.94,$31.62,$13.94,$32.30,$13.94,$13.94,$32.30
2520430,0259,,,,,,,,Simethicone 80 MG CHEW,$0.54,$0.38,$0.21,$0.49,$0.22,$0.53,$0.22,$0.22,$0.48,$0.46,$0.22,$0.51,$0.22,$0.52,$0.22,$0.22,$0.52
2509150,0259,,,,,,,,Simvastatin 10 MG TAB,$2.05,$1.41,$0.77,$1.82,$0.84,$1.99,$0.84,$0.84,$1.79,$1.74,$0.84,$1.90,$0.84,$1.95,$0.84,$0.84,$1.95
2509160,0259,,,,,,,,Simvastatin 20 MG TAB,$2.26,$1.55,$0.85,$2.01,$0.92,$2.19,$0.92,$0.92,$1.97,$1.92,$0.92,$2.10,$0.92,$2.14,$0.92,$0.92,$2.14
2529190,0259,,,,,,,,Simvastatin 40 MG TAB,$2.69,$1.85,$1.01,$2.40,$1.10,$2.61,$1.10,$1.10,$2.35,$2.29,$1.10,$2.50,$1.10,$2.56,$1.10,$1.10,$2.56
2514320,0250,,,,,,,,Sincalide 5 MCG VIAL,$121.81,$83.86,$45.84,$108.46,$49.94,$118.15,$49.94,$49.94,$106.58,$103.53,$49.94,$113.28,$49.94,$115.72,$49.94,$49.94,$115.72
2540670,0250,,,,,,,,sitaGLIPtin 100 MG TAB,$212.76,$146.48,$80.07,$189.44,$87.23,$206.38,$87.23,$87.23,$186.16,$180.85,$87.23,$197.87,$87.23,$202.12,$87.23,$87.23,$202.12
2538490,0250,,,,,,,,sitaGLIPtin 25 MG TABLET,$186.30,$128.26,$70.11,$165.88,$76.38,$180.71,$76.38,$76.38,$163.01,$158.35,$76.38,$173.26,$76.38,$176.98,$76.38,$76.38,$176.98
2514440,0250,,,,,,,,Sodium Acetate 40 MEQ/20 ML VI,$101.83,$70.10,$38.32,$90.67,$41.75,$98.77,$41.75,$41.75,$89.10,$86.55,$41.75,$94.70,$41.75,$96.73,$41.75,$41.75,$96.73
2514470,0250,,,,,,,,Sodium Bicarbonate 10 MEQ/10 M,$229.51,$158.01,$86.38,$204.36,$94.10,$222.63,$94.10,$94.10,$200.83,$195.09,$94.10,$213.45,$94.10,$218.04,$94.10,$94.10,$218.04
2514490,0250,,,,,,,,Sodium Bicarbonate 5 MEQ/10 ML,$205.20,$141.27,$77.23,$182.71,$84.13,$199.04,$84.13,$84.13,$179.55,$174.42,$84.13,$190.84,$84.13,$194.94,$84.13,$84.13,$194.94
2514450,0250,,,,,,,,Sodium Bicarbonate 50 MEQ/50 M,$187.61,$129.16,$70.61,$167.04,$76.92,$181.98,$76.92,$76.92,$164.15,$159.46,$76.92,$174.47,$76.92,$178.23,$76.92,$76.92,$178.23
2514480,0250,,,,,,,,Sodium Bicarbonate 50 MEQ/50 M,$187.43,$129.04,$70.54,$166.89,$76.85,$181.81,$76.85,$76.85,$164.00,$159.32,$76.85,$174.31,$76.85,$178.06,$76.85,$76.85,$178.06
2509480,0259,,,,,,,,Sodium Bicarbonate 650 MG TAB,$0.15,$0.11,$0.06,$0.14,$0.06,$0.15,$0.06,$0.06,$0.13,$0.13,$0.06,$0.14,$0.06,$0.14,$0.06,$0.06,$0.14
2514460,0250,,,,,,,,Sodium Biphosphate 15 Mm/5 Ml,$263.04,$181.09,$98.99,$234.21,$107.84,$255.14,$107.84,$107.84,$230.16,$223.58,$107.84,$244.62,$107.84,$249.88,$107.84,$107.84,$249.88
2523416,0250,,,,,,,,SODIUM CHLO 0.9% INHAL 15ML,$39.75,$27.37,$14.96,$35.40,$16.30,$38.56,$16.30,$16.30,$34.78,$33.79,$16.30,$36.97,$16.30,$37.76,$16.30,$16.30,$37.76
2520480,0250,,,,,,,,Sodium Chloride 0.9% For Inhal,$2.33,$1.61,$0.88,$2.08,$0.96,$2.26,$0.96,$0.96,$2.04,$1.98,$0.96,$2.17,$0.96,$2.21,$0.96,$0.96,$2.21
2514500,0250,,,,,,,,Sodium Chloride 120 MEQ/30 ML,$141.36,$97.32,$53.20,$125.87,$57.96,$137.12,$57.96,$57.96,$123.69,$120.16,$57.96,$131.47,$57.96,$134.29,$57.96,$57.96,$134.29
2533910,0259,,,,,,,,Sodium Chloride 2% Ophth Soln,$205.73,$141.64,$77.43,$183.18,$84.35,$199.56,$84.35,$84.35,$180.02,$174.87,$84.35,$191.33,$84.35,$195.45,$84.35,$84.35,$195.45
2542170,0250,,,,,,,,Sodium Chloride 3% for Inhalat,$18.02,$12.41,$6.78,$16.04,$7.39,$17.48,$7.39,$7.39,$15.77,$15.32,$7.39,$16.76,$7.39,$17.12,$7.39,$7.39,$17.12
2523474,0250,,,,,,,,Sodium Chloride 7% Inhal 4ml V,$5.39,$3.71,$2.03,$4.80,$2.21,$5.23,$2.21,$2.21,$4.72,$4.58,$2.21,$5.02,$2.21,$5.12,$2.21,$2.21,$5.12
2518220,0259,,,,,,,,Sodium Chloride-Nasal SPRAY-AD,$13.74,$9.46,$5.17,$12.23,$5.63,$13.33,$5.63,$5.63,$12.02,$11.68,$5.63,$12.78,$5.63,$13.05,$5.63,$5.63,$13.05
2539950,0250,,,,,,,,Sodium Chloride-Nasal SPRAY-PE,$45.19,$31.11,$17.01,$40.24,$18.53,$43.83,$18.53,$18.53,$39.54,$38.41,$18.53,$42.03,$18.53,$42.93,$18.53,$18.53,$42.93
2532650,0259,,,,,,,,Sodium Citrate 30 ML BTL,$54.09,$37.24,$20.36,$48.16,$22.18,$52.47,$22.18,$22.18,$47.33,$45.98,$22.18,$50.30,$22.18,$51.38,$22.18,$22.18,$51.38
2523038,0250,J2916,,,,,,,Sodium Ferric Gluc62.5 MG/5 ML,$176.04,$121.19,$66.25,$156.74,$72.17,$170.76,$72.17,$72.17,$154.03,$149.63,$72.17,$163.71,$72.17,$167.23,$72.17,$72.17,$167.23
2539290,0250,,,,,,,,Sodium Morrhuate 1500 MG/30 ML,$502.21,$345.75,$189.01,$447.17,$205.91,$487.15,$205.91,$205.91,$439.44,$426.88,$205.91,$467.06,$205.91,$477.10,$205.91,$205.91,$477.10
2523123,0250,,,,,,,,SODIUM NITRATE 300 MG/10 ML VI,$43.58,$30.00,$16.40,$38.80,$17.87,$42.27,$17.87,$17.87,$38.13,$37.04,$17.87,$40.53,$17.87,$41.40,$17.87,$17.87,$41.40
2514510,0259,,,,,,,,Sodium Polystyrene Sulfonate 1,$6.26,$4.31,$2.36,$5.58,$2.57,$6.08,$2.57,$2.57,$5.48,$5.32,$2.57,$5.83,$2.57,$5.95,$2.57,$2.57,$5.95
2534460,0259,,,,,,,,Sodium Polystyrene Sulfonate 1,$238.72,$164.35,$89.84,$212.56,$97.88,$231.56,$97.88,$97.88,$208.88,$202.91,$97.88,$222.01,$97.88,$226.78,$97.88,$97.88,$226.78
2522964,0250,,,,,,,,Sodium Thiosulfate 12.5 Gm/50,$681.01,$468.84,$256.30,$606.37,$279.21,$660.58,$279.21,$279.21,$595.88,$578.85,$279.21,$633.34,$279.21,$646.96,$279.21,$279.21,$646.96
2523419,0250,,,,,,,,SODIUM ZIRCONIUM CYCLOSILICATE,$261.24,$179.85,$98.32,$232.61,$107.11,$253.40,$107.11,$107.11,$228.58,$222.05,$107.11,$242.95,$107.11,$248.18,$107.11,$107.11,$248.18
2537990,0250,,,,,,,,Solifenacin 5 MG TAB,$14.80,$10.19,$5.57,$13.18,$6.07,$14.36,$6.07,$6.07,$12.95,$12.58,$6.07,$13.77,$6.07,$14.06,$6.07,$6.07,$14.06
2536100,0250,,,,,,,,Sorbitol 70% 30 ML BTL,$37.50,$25.82,$14.11,$33.39,$15.37,$36.37,$15.37,$15.37,$32.81,$31.87,$15.37,$34.87,$15.37,$35.62,$15.37,$15.37,$35.62
2502200,0259,,,,,,,,Sotalol 80 MG TAB,$1.02,$0.71,$0.39,$0.91,$0.42,$0.99,$0.42,$0.42,$0.90,$0.87,$0.42,$0.95,$0.42,$0.97,$0.42,$0.42,$0.97
2523491,0250,Q0047,,,,,,,SOTROVIMAB 500 MG/8ML VIAL,$43.58,$30.00,$16.40,$38.80,$17.87,$42.27,$17.87,$17.87,$38.13,$37.04,$17.87,$40.53,$17.87,$41.40,$17.87,$17.87,$41.40
2501360,0259,,,,,,,,Spironolactone 25 MG TAB,$3.36,$2.31,$1.26,$2.99,$1.38,$3.25,$1.38,$1.38,$2.94,$2.85,$1.38,$3.12,$1.38,$3.19,$1.38,$1.38,$3.19
2501380,0259,,,,,,,,Spironolactone 50 MG TAB,$4.92,$3.39,$1.85,$4.38,$2.02,$4.78,$2.02,$2.02,$4.31,$4.19,$2.02,$4.58,$2.02,$4.68,$2.02,$2.02,$4.68
2523189,0250,,,,,,,,Succinylcholine 140 MG/7 ML SY,$306.10,$210.74,$115.20,$272.55,$125.50,$296.92,$125.50,$125.50,$267.84,$260.18,$125.50,$284.67,$125.50,$290.79,$125.50,$125.50,$290.79
2509820,0250,,,,,,,,Succinylcholine 200 MG/10 ML V,$186.09,$128.12,$70.04,$165.70,$76.30,$180.51,$76.30,$76.30,$162.83,$158.18,$76.30,$173.06,$76.30,$176.79,$76.30,$76.30,$176.79
2502460,0259,,,,,,,,Sucralfate 1 GM TAB,$5.89,$4.06,$2.22,$5.25,$2.42,$5.72,$2.42,$2.42,$5.16,$5.01,$2.42,$5.48,$2.42,$5.60,$2.42,$2.42,$5.60
2592940,0250,,,,,,,,Sucrose 24% SOLUTION 0.5 ML BT,$23.29,$16.04,$8.77,$20.74,$9.55,$22.59,$9.55,$9.55,$20.38,$19.80,$9.55,$21.66,$9.55,$22.13,$9.55,$9.55,$22.13
2543750,0250,,,,,,,,SUFentanil 100 MCG/2 ML AMP,$174.81,$120.35,$65.79,$155.65,$71.67,$169.56,$71.67,$71.67,$152.95,$148.58,$71.67,$162.57,$71.67,$166.06,$71.67,$71.67,$166.06
2523163,0250,,,,,,,,Sugammadex 200 Mg/2 Ml Vial,$514.85,$354.45,$193.77,$458.42,$211.09,$499.40,$211.09,$211.09,$450.49,$437.62,$211.09,$478.81,$211.09,$489.11,$211.09,$211.09,$489.11
2518320,0259,,,,,,,,Sulfacetamide 10% 15 ML BTL,$391.29,$269.39,$147.26,$348.40,$160.43,$379.55,$160.43,$160.43,$342.38,$332.60,$160.43,$363.90,$160.43,$371.73,$160.43,$160.43,$371.73
2514520,0259,,,,,,,,SULFAMETH/TRIMETH,$7.36,$5.07,$2.77,$6.56,$3.02,$7.14,$3.02,$3.02,$6.44,$6.26,$3.02,$6.85,$3.02,$7.00,$3.02,$3.02,$7.00
2502120,0259,,,,,,,,Sulfameth/Trimeth DS TAB,$3.33,$2.30,$1.25,$2.97,$1.37,$3.23,$1.37,$1.37,$2.92,$2.83,$1.37,$3.10,$1.37,$3.17,$1.37,$1.37,$3.17
2523259,0250,,,,,,,,"Sulfameth/Trimeth DS, 2 TABS/B",$2.87,$1.97,$1.08,$2.55,$1.17,$2.78,$1.17,$1.17,$2.51,$2.44,$1.17,$2.66,$1.17,$2.72,$1.17,$1.17,$2.72
2502110,0259,,,,,,,,Sulfameth/Trimeth REG STR TAB,$1.30,$0.89,$0.49,$1.15,$0.53,$1.26,$0.53,$0.53,$1.13,$1.10,$0.53,$1.21,$0.53,$1.23,$0.53,$0.53,$1.23
2539480,0250,,,,,,,,Sulfameth/Trimeth SUSP 20 ML B,$61.76,$42.52,$23.24,$54.99,$25.32,$59.91,$25.32,$25.32,$54.04,$52.49,$25.32,$57.44,$25.32,$58.67,$25.32,$25.32,$58.67
2522999,0250,,,,,,,,Sulfamethoxazole/Trimethoprim,$176.24,$121.34,$66.33,$156.93,$72.26,$170.96,$72.26,$72.26,$154.21,$149.81,$72.26,$163.91,$72.26,$167.43,$72.26,$72.26,$167.43
2502070,0259,,,,,,,,sulfaSALAzine 500 MG TAB,$3.78,$2.60,$1.42,$3.37,$1.55,$3.67,$1.55,$1.55,$3.31,$3.21,$1.55,$3.52,$1.55,$3.59,$1.55,$1.55,$3.59
2502080,0259,,,,,,,,sulfaSALAzine 500 MG TABEC,$4.25,$2.93,$1.60,$3.78,$1.74,$4.12,$1.74,$1.74,$3.72,$3.61,$1.74,$3.95,$1.74,$4.04,$1.74,$1.74,$4.04
2504600,0259,,,,,,,,SUMAtriptan 25 MG TAB,$20.68,$14.24,$7.78,$18.41,$8.48,$20.06,$8.48,$8.48,$18.09,$17.58,$8.48,$19.23,$8.48,$19.64,$8.48,$8.48,$19.64
2504590,0259,,,,,,,,Sumatriptan 50 Mg Tab,$32.64,$22.47,$12.28,$29.06,$13.38,$31.66,$13.38,$13.38,$28.56,$27.74,$13.38,$30.35,$13.38,$31.01,$13.38,$13.38,$31.01
2514540,0250,,,,,,,,SUMAtriptan 6 MG/0.5 ML VIAL,$139.69,$96.17,$52.57,$124.38,$57.27,$135.50,$57.27,$57.27,$122.23,$118.74,$57.27,$129.92,$57.27,$132.71,$57.27,$57.27,$132.71
2537750,0250,,,,,,,,SYMBICORT 160/4.5 10.2 GM INHL,$482.03,$331.85,$181.41,$429.20,$197.63,$467.57,$197.63,$197.63,$421.77,$409.72,$197.63,$448.28,$197.63,$457.93,$197.63,$197.63,$457.93
2539340,0250,,,,,,,,SYMBICORT 80/4.5 10.2 GM INHAL,"$1,059.17",$729.19,$398.62,$943.08,$434.26,"$1,027.39",$434.26,$434.26,$926.77,$900.29,$434.26,$985.03,$434.26,"$1,006.21",$434.26,$434.26,"$1,006.21"
2540420,0250,,,,,,,,Tacrolimus 0.5 MG CAP,$20.25,$13.94,$7.62,$18.03,$8.30,$19.64,$8.30,$8.30,$17.72,$17.21,$8.30,$18.83,$8.30,$19.24,$8.30,$8.30,$19.24
2522570,0250,,,,,,,,Tamsulosin 0.4 Mg Capcr,$1.91,$1.31,$0.72,$1.70,$0.78,$1.85,$0.78,$0.78,$1.67,$1.62,$0.78,$1.77,$0.78,$1.81,$0.78,$0.78,$1.81
2588450,0250,,,,,,,,TAPENTADOL I.R. 50MG TAB,$148.20,$102.03,$55.78,$131.96,$60.76,$143.76,$60.76,$60.76,$129.68,$125.97,$60.76,$137.83,$60.76,$140.79,$60.76,$60.76,$140.79
2516890,0259,,,,,,,,Tears Ophth Soln 15 ML BTL,$52.92,$36.44,$19.92,$47.12,$21.70,$51.34,$21.70,$21.70,$46.31,$44.98,$21.70,$49.22,$21.70,$50.28,$21.70,$21.70,$50.28
2507460,0259,,,,,,,,Temazepam 15 MG CAP,$1.99,$1.37,$0.75,$1.78,$0.82,$1.93,$0.82,$0.82,$1.74,$1.69,$0.82,$1.85,$0.82,$1.89,$0.82,$0.82,$1.89
2523446,0250,,,,,,,,TEMOZOLOMIDE 20MG CAP,$102.88,$70.83,$38.72,$91.61,$42.18,$99.80,$42.18,$42.18,$90.02,$87.45,$42.18,$95.68,$42.18,$97.74,$42.18,$42.18,$97.74
2523447,0250,,,,,,,,TEMPZOLOMIDE 140 MG CAP,$502.13,$345.69,$188.98,$447.09,$205.87,$487.06,$205.87,$205.87,$439.36,$426.81,$205.87,$466.98,$205.87,$477.02,$205.87,$205.87,$477.02
2540470,0636,J3101,,,,,,,Tenecteplase 1 Mg,"$14,466.04","$9,959.18","$5,444.35","$12,880.54","$5,931.08","$14,032.06","$5,931.08","$5,931.08","$12,657.79","$12,296.14","$5,931.08","$13,453.42","$5,931.08","$13,742.74","$5,931.08","$5,931.08","$13,742.74"
2532080,0259,,,,,,,,Terazosin 1 MG CAP,$2.15,$1.48,$0.81,$1.91,$0.88,$2.08,$0.88,$0.88,$1.88,$1.82,$0.88,$2.00,$0.88,$2.04,$0.88,$0.88,$2.04
2541140,0250,,,,,,,,Terazosin 2 MG CAP,$2.22,$1.53,$0.84,$1.98,$0.91,$2.16,$0.91,$0.91,$1.94,$1.89,$0.91,$2.07,$0.91,$2.11,$0.91,$0.91,$2.11
2532090,0259,,,,,,,,Terazosin 5 MG CAP,$2.31,$1.59,$0.87,$2.06,$0.95,$2.24,$0.95,$0.95,$2.02,$1.96,$0.95,$2.15,$0.95,$2.19,$0.95,$0.95,$2.19
2523010,0259,,,,,,,,Terbinafine 1% CREAM 15 GM TUB,$154.89,$106.64,$58.29,$137.91,$63.51,$150.24,$63.51,$63.51,$135.53,$131.66,$63.51,$144.05,$63.51,$147.15,$63.51,$63.51,$147.15
2504980,0259,,,,,,,,Terbinafine 250 MG TAB,$2.80,$1.93,$1.05,$2.49,$1.15,$2.72,$1.15,$1.15,$2.45,$2.38,$1.15,$2.60,$1.15,$2.66,$1.15,$1.15,$2.66
2514550,0250,,,,,,,,Terbutaline 1 MG/ML AMP,$77.58,$53.41,$29.20,$69.07,$31.81,$75.25,$31.81,$31.81,$67.88,$65.94,$31.81,$72.15,$31.81,$73.70,$31.81,$31.81,$73.70
2502260,0259,,,,,,,,Terbutaline 2.5 MG TAB,$53.81,$37.04,$20.25,$47.91,$22.06,$52.19,$22.06,$22.06,$47.08,$45.73,$22.06,$50.04,$22.06,$51.12,$22.06,$22.06,$51.12
2526570,0259,,,,,,,,Terconazole 80 MG VSUPP,$261.94,$180.33,$98.58,$233.23,$107.39,$254.08,$107.39,$107.39,$229.19,$222.65,$107.39,$243.60,$107.39,$248.84,$107.39,$107.39,$248.84
2538850,0250,,,,,,,,TESTOSTERONE CYPIONATE 200 MG/,$527.33,$363.05,$198.46,$469.54,$216.21,$511.51,$216.21,$216.21,$461.42,$448.23,$216.21,$490.42,$216.21,$500.97,$216.21,$216.21,$500.97
2523207,0250,,,,,,,,"Tetanus & Diphtheria Tox,ADULT",$325.95,$224.40,$122.67,$290.22,$133.64,$316.17,$133.64,$133.64,$285.20,$277.06,$133.64,$303.13,$133.64,$309.65,$133.64,$133.64,$309.65
2523019,0250,,,,,,,,Tetanus & Diphtheria Tox/Pf 0.,$339.72,$233.88,$127.85,$302.48,$139.28,$329.53,$139.28,$139.28,$297.25,$288.76,$139.28,$315.94,$139.28,$322.73,$139.28,$139.28,$322.73
2514600,0250,,,,,,,,Tetanus Immune Globulin 250 Un,"$1,684.44","$1,159.66",$633.95,"$1,499.82",$690.62,"$1,633.91",$690.62,$690.62,"$1,473.89","$1,431.77",$690.62,"$1,566.53",$690.62,"$1,600.22",$690.62,$690.62,"$1,600.22"
2539250,0250,,,,,,,,TETRACAINE 0.5% 15ML BTL,$177.62,$122.28,$66.85,$158.15,$72.82,$172.29,$72.82,$72.82,$155.41,$150.97,$72.82,$165.18,$72.82,$168.73,$72.82,$72.82,$168.73
2523195,0250,,,,,,,,Tetracaine 0.5% 4 ML BTL,$147.66,$101.66,$55.57,$131.47,$60.54,$143.23,$60.54,$60.54,$129.20,$125.51,$60.54,$137.32,$60.54,$140.27,$60.54,$60.54,$140.27
2508290,0259,,,,,,,,Theophylline 300 MG TABCR,$53.96,$37.15,$20.31,$48.04,$22.12,$52.34,$22.12,$22.12,$47.21,$45.86,$22.12,$50.18,$22.12,$51.26,$22.12,$22.12,$51.26
2508350,0259,,,,,,,,Thiamine 100 MG TAB,$3.54,$2.44,$1.33,$3.15,$1.45,$3.43,$1.45,$1.45,$3.10,$3.01,$1.45,$3.29,$1.45,$3.36,$1.45,$1.45,$3.36
2514630,0250,,,,,,,,Thiamine 200 MG/2 ML VIAL,$134.81,$92.81,$50.74,$120.04,$55.27,$130.77,$55.27,$55.27,$117.96,$114.59,$55.27,$125.38,$55.27,$128.07,$55.27,$55.27,$128.07
2514680,0259,,,,,,,,Thrombin 5 MU VIAL,$450.01,$309.81,$169.36,$400.69,$184.50,$436.51,$184.50,$184.50,$393.76,$382.51,$184.50,$418.51,$184.50,$427.51,$184.50,$184.50,$427.51
2501760,0259,,,,,,,,Thyroid 60 MG TAB,$2.64,$1.82,$0.99,$2.35,$1.08,$2.56,$1.08,$1.08,$2.31,$2.24,$1.08,$2.45,$1.08,$2.50,$1.08,$1.08,$2.50
2538980,0250,,,,,,,,THYROID 90MG,$31.25,$21.52,$11.76,$27.83,$12.81,$30.32,$12.81,$12.81,$27.35,$26.57,$12.81,$29.07,$12.81,$29.69,$12.81,$12.81,$29.69
2522996,0250,,,,,,,,Ticagrelor 90 MG TAB,$109.47,$75.37,$41.20,$97.48,$44.88,$106.19,$44.88,$44.88,$95.79,$93.05,$44.88,$101.81,$44.88,$104.00,$44.88,$44.88,$104.00
2518360,0259,,,,,,,,Timolol 0.25% 5 ML BTL,$100.34,$69.08,$37.77,$89.35,$41.14,$97.33,$41.14,$41.14,$87.80,$85.29,$41.14,$93.32,$41.14,$95.33,$41.14,$41.14,$95.33
2518380,0259,,,,,,,,Timolol 0.5% 5 ML BTL,$102.23,$70.38,$38.47,$91.02,$41.91,$99.16,$41.91,$41.91,$89.45,$86.89,$41.91,$95.07,$41.91,$97.12,$41.91,$41.91,$97.12
2583360,0250,,,,,,,,TIOTROPIUM BROMIDE-RESP10PUFF,$299.20,$205.99,$112.61,$266.41,$122.67,$290.23,$122.67,$122.67,$261.80,$254.32,$122.67,$278.26,$122.67,$284.24,$122.67,$122.67,$284.24
2523384,0250,,,,,,,,TIOTROPIUM/OLODATEROL 10 PUFF,$462.28,$318.26,$173.98,$411.61,$189.53,$448.41,$189.53,$189.53,$404.49,$392.93,$189.53,$429.92,$189.53,$439.16,$189.53,$189.53,$439.16
2523205,0250,,,,,,,,Tizanidine 2 MG TAB,$18.89,$13.01,$7.11,$16.82,$7.74,$18.32,$7.74,$7.74,$16.53,$16.06,$7.74,$17.57,$7.74,$17.95,$7.74,$7.74,$17.95
2562990,0250,,,,,,,,Tizanidine 4 MG TABLET,$8.50,$5.85,$3.20,$7.57,$3.48,$8.24,$3.48,$3.48,$7.44,$7.22,$3.48,$7.90,$3.48,$8.07,$3.48,$3.48,$8.07
2518420,0259,,,,,,,,Tobramycin 0.3% 3.5 GM TUBE,$791.30,$544.77,$297.81,$704.57,$324.43,$767.56,$324.43,$324.43,$692.38,$672.60,$324.43,$735.91,$324.43,$751.73,$324.43,$324.43,$751.73
2518430,0259,,,,,,,,Tobramycin 0.3% 5 ML BTL,$67.88,$46.73,$25.55,$60.44,$27.83,$65.84,$27.83,$27.83,$59.40,$57.70,$27.83,$63.13,$27.83,$64.49,$27.83,$27.83,$64.49
2518440,0250,,,,,,,,Tobramycin 1.2 GM VIAL,$547.09,$376.64,$205.90,$487.12,$224.31,$530.67,$224.31,$224.31,$478.70,$465.02,$224.31,$508.79,$224.31,$519.73,$224.31,$224.31,$519.73
2514700,0250,,,,,,,,Tobramycin 80 MG/2 ML VIAL,$61.51,$42.35,$23.15,$54.77,$25.22,$59.66,$25.22,$25.22,$53.82,$52.28,$25.22,$57.20,$25.22,$58.43,$25.22,$25.22,$58.43
2518400,0259,,,,,,,,Tobramycin/Dexameth 2.5 ML BTL,$329.25,$226.67,$123.91,$293.16,$134.99,$319.37,$134.99,$134.99,$288.09,$279.86,$134.99,$306.20,$134.99,$312.79,$134.99,$134.99,$312.79
2518410,0259,,,,,,,,Tobramycin/Dexameth 3.5 GM TUB,$791.04,$544.59,$297.71,$704.34,$324.32,$767.30,$324.32,$324.32,$692.16,$672.38,$324.32,$735.66,$324.32,$751.48,$324.32,$324.32,$751.48
2543960,0636,J3262,,,,,,,Tocilizumab 200 MG/10 ML ML,$578.44,$398.23,$217.70,$515.04,$237.16,$561.09,$237.16,$237.16,$506.13,$491.67,$237.16,$537.95,$237.16,$549.52,$237.16,$237.16,$549.52
2541600,0636,J3262,,,,,,,Tocilizumab 400 MG/20 ML ML,$578.28,$398.12,$217.64,$514.90,$237.09,$560.93,$237.09,$237.09,$505.99,$491.53,$237.09,$537.80,$237.09,$549.36,$237.09,$237.09,$549.36
2541610,0636,J3262,,,,,,,Tocilizumab 80 MG/4 ML ML,$578.44,$398.23,$217.70,$515.04,$237.16,$561.09,$237.16,$237.16,$506.13,$491.67,$237.16,$537.95,$237.16,$549.52,$237.16,$237.16,$549.52
2523502,0250,,,,,,,,TOFACITINIB 10 MG TAB,$556.76,$383.30,$209.54,$495.74,$228.27,$540.06,$228.27,$228.27,$487.16,$473.25,$228.27,$517.79,$228.27,$528.92,$228.27,$228.27,$528.92
2523400,0259,,,,,,,,Tolterodine 1 Mg Tab,$7.56,$5.21,$2.85,$6.73,$3.10,$7.33,$3.10,$3.10,$6.62,$6.43,$3.10,$7.03,$3.10,$7.18,$3.10,$3.10,$7.18
2529850,0259,,,,,,,,Tolterodine 2 MG CAPCR,$104.04,$71.63,$39.16,$92.64,$42.66,$100.92,$42.66,$42.66,$91.03,$88.43,$42.66,$96.76,$42.66,$98.84,$42.66,$42.66,$98.84
2527030,0250,,,,,,,,Topiramate 100 MG TAB,$1.66,$1.14,$0.62,$1.47,$0.68,$1.61,$0.68,$0.68,$1.45,$1.41,$0.68,$1.54,$0.68,$1.57,$0.68,$0.68,$1.57
2525740,0259,,,,,,,,Topiramate 25 MG TAB,$7.60,$5.24,$2.86,$6.77,$3.12,$7.38,$3.12,$3.12,$6.65,$6.46,$3.12,$7.07,$3.12,$7.22,$3.12,$3.12,$7.22
2535420,0250,,,,,,,,Topiramate 50 MG TAB,$17.84,$12.29,$6.72,$15.89,$7.32,$17.31,$7.32,$7.32,$15.61,$15.17,$7.32,$16.60,$7.32,$16.95,$7.32,$7.32,$16.95
2544300,0250,,,,,,,,Torsemide 100 MG TAB,$6.80,$4.68,$2.56,$6.05,$2.79,$6.59,$2.79,$2.79,$5.95,$5.78,$2.79,$6.32,$2.79,$6.46,$2.79,$2.79,$6.46
2527540,0250,,,,,,,,Torsemide 20 Mg Tab,$6.25,$4.31,$2.35,$5.57,$2.56,$6.07,$2.56,$2.56,$5.47,$5.32,$2.56,$5.82,$2.56,$5.94,$2.56,$2.56,$5.94
2514770,0250,,,,,,,,Trace Elements 1 Ml Vial,$308.10,$212.12,$115.96,$274.34,$126.32,$298.86,$126.32,$126.32,$269.59,$261.89,$126.32,$286.54,$126.32,$292.70,$126.32,$126.32,$292.70
2523024,0250,,,,,,,,Trace Elements Comb. No.1 10 M,$240.25,$165.40,$90.42,$213.91,$98.50,$233.04,$98.50,$98.50,$210.21,$204.21,$98.50,$223.43,$98.50,$228.23,$98.50,$98.50,$228.23
2523484,0250,,,,,,,,Trace Elements-Adult 1 Ml Vial,$308.10,$212.12,$115.96,$274.34,$126.32,$298.86,$126.32,$126.32,$269.59,$261.89,$126.32,$286.54,$126.32,$292.70,$126.32,$126.32,$292.70
2523436,0250,,,,,,,,TRACE ELEMENTS-PEDI 3ML VIAL,$196.10,$135.01,$73.80,$174.61,$80.40,$190.22,$80.40,$80.40,$171.59,$166.69,$80.40,$182.38,$80.40,$186.30,$80.40,$80.40,$186.30
2508690,0259,,,,,,,,traMADol 50 MG TAB,$2.32,$1.60,$0.87,$2.07,$0.95,$2.25,$0.95,$0.95,$2.03,$1.97,$0.95,$2.16,$0.95,$2.20,$0.95,$0.95,$2.20
2523276,0250,,,,,,,,"traMADol 50 MG TAB, 2 TABS/BTL",$1.22,$0.84,$0.46,$1.09,$0.50,$1.18,$0.50,$0.50,$1.07,$1.04,$0.50,$1.13,$0.50,$1.16,$0.50,$0.50,$1.16
2523055,0250,,,,,,,,"Tranexamic Acid 1,000 MG/10 ML",$106.15,$73.08,$39.95,$94.52,$43.52,$102.97,$43.52,$43.52,$92.88,$90.23,$43.52,$98.72,$43.52,$100.84,$43.52,$43.52,$100.84
2531630,0259,,,,,,,,Travoprost 0.004% Ophth Sol 2.,$655.17,$451.05,$246.57,$583.36,$268.62,$635.51,$268.62,$268.62,$573.27,$556.89,$268.62,$609.30,$268.62,$622.41,$268.62,$268.62,$622.41
2503440,0259,,,,,,,,Trazodone 100 Mg Tab,$2.17,$1.49,$0.82,$1.93,$0.89,$2.10,$0.89,$0.89,$1.90,$1.84,$0.89,$2.02,$0.89,$2.06,$0.89,$0.89,$2.06
2503430,0259,,,,,,,,traZODone 50 MG TAB,$2.17,$1.49,$0.82,$1.93,$0.89,$2.10,$0.89,$0.89,$1.90,$1.84,$0.89,$2.02,$0.89,$2.06,$0.89,$0.89,$2.06
2518650,0259,,,,,,,,Triamcinolone 0.025% CR 15 GM,$69.97,$48.17,$26.33,$62.30,$28.69,$67.87,$28.69,$28.69,$61.23,$59.48,$28.69,$65.07,$28.69,$66.47,$28.69,$28.69,$66.47
2514900,0259,,,,,,,,Triamcinolone 0.1% CR 15 GM TU,$54.09,$37.24,$20.36,$48.16,$22.18,$52.47,$22.18,$22.18,$47.33,$45.98,$22.18,$50.30,$22.18,$51.38,$22.18,$22.18,$51.38
2518600,0259,,,,,,,,Triamcinolone 0.1% Cr 80 Gm Tu,$96.63,$66.53,$36.37,$86.04,$39.62,$93.73,$39.62,$39.62,$84.55,$82.14,$39.62,$89.87,$39.62,$91.80,$39.62,$39.62,$91.80
2518670,0259,,,,,,,,Triamcinolone 0.1% LOT 60 ML B,$254.31,$175.08,$95.71,$226.44,$104.27,$246.68,$104.27,$104.27,$222.52,$216.16,$104.27,$236.51,$104.27,$241.59,$104.27,$104.27,$241.59
2518620,0259,,,,,,,,Triamcinolone 0.1% OINT 15 GM,$45.65,$31.43,$17.18,$40.64,$18.71,$44.28,$18.71,$18.71,$39.94,$38.80,$18.71,$42.45,$18.71,$43.36,$18.71,$18.71,$43.36
2514750,0250,,,,,,,,Triamcinolone 200 MG/5 ML VIAL,$475.29,$327.22,$178.88,$423.20,$194.87,$461.04,$194.87,$194.87,$415.88,$404.00,$194.87,$442.02,$194.87,$451.53,$194.87,$194.87,$451.53
2538720,0250,,,,,,,,Triamcinolone 40 MG/ML VIAL,$200.46,$138.01,$75.44,$178.49,$82.19,$194.45,$82.19,$82.19,$175.40,$170.39,$82.19,$186.43,$82.19,$190.44,$82.19,$82.19,$190.44
2514740,0250,,,,,,,,TRIAMCINOLONE ACETONIDE,$208.08,$143.25,$78.31,$185.27,$85.31,$201.83,$85.31,$85.31,$182.07,$176.86,$85.31,$193.51,$85.31,$197.67,$85.31,$85.31,$197.67
2540180,0250,,,,,,,,Triamcinolone Acetonide/Pf 40,$616.97,$424.76,$232.20,$549.35,$252.96,$598.46,$252.96,$252.96,$539.85,$524.43,$252.96,$573.78,$252.96,$586.12,$252.96,$252.96,$586.12
2503720,0259,,,,,,,,Triamterene 37.5/HCTZ 25 CAP,$3.06,$2.11,$1.15,$2.73,$1.26,$2.97,$1.26,$1.26,$2.68,$2.60,$1.26,$2.85,$1.26,$2.91,$1.26,$1.26,$2.91
2522991,0250,,,,,,,,TRICHLOROACETIC ACID 80% 15 ML,$480.33,$330.68,$180.77,$427.68,$196.93,$465.92,$196.93,$196.93,$420.29,$408.28,$196.93,$446.70,$196.93,$456.31,$196.93,$196.93,$456.31
2518740,0259,,,,,,,,Trifluridine 1% 7.5 ML BTL,$598.88,$412.30,$225.39,$533.24,$245.54,$580.91,$245.54,$245.54,$524.02,$509.04,$245.54,$556.95,$245.54,$568.93,$245.54,$245.54,$568.93
2501780,0259,,,,,,,,Trihexyphenidyl 2 MG TAB,$1.38,$0.95,$0.52,$1.23,$0.57,$1.34,$0.57,$0.57,$1.21,$1.18,$0.57,$1.29,$0.57,$1.31,$0.57,$0.57,$1.31
2593150,0259,,,,,,,,Trimethobenzamide 200 MG/2 ML,$394.20,$271.39,$148.36,$350.99,$161.62,$382.37,$161.62,$161.62,$344.92,$335.07,$161.62,$366.61,$161.62,$374.49,$161.62,$161.62,$374.49
2507180,0259,,,,,,,,Trimethoprim 100 MG TAB,$20.12,$13.85,$7.57,$17.92,$8.25,$19.52,$8.25,$8.25,$17.61,$17.10,$8.25,$18.71,$8.25,$19.12,$8.25,$8.25,$19.12
2523433,0250,,,,,,,,TROPICAM/PHENYLEPH (1/2.5%)5ML,$154.08,$106.08,$57.99,$137.20,$63.17,$149.46,$63.17,$63.17,$134.82,$130.97,$63.17,$143.30,$63.17,$146.38,$63.17,$63.17,$146.38
2518580,0259,,,,,,,,TROPICAMIDE 1%,$103.14,$71.01,$38.82,$91.84,$42.29,$100.05,$42.29,$42.29,$90.25,$87.67,$42.29,$95.92,$42.29,$97.99,$42.29,$42.29,$97.99
2521340,0259,,,,,,,,Tropicamide 1% OPHTH 2 ML BTL,$100.79,$69.39,$37.93,$89.74,$41.32,$97.77,$41.32,$41.32,$88.19,$85.67,$41.32,$93.74,$41.32,$95.75,$41.32,$41.32,$95.75
2543310,0250,,,,,,,,Trospium 20 MG TABLET,$8.94,$6.16,$3.37,$7.96,$3.67,$8.68,$3.67,$3.67,$7.83,$7.60,$3.67,$8.32,$3.67,$8.50,$3.67,$3.67,$8.50
2534260,0250,,,,,,,,Trypan Blue 0.06% 0.5 ML SYR,$684.52,$471.26,$257.62,$609.50,$280.66,$663.99,$280.66,$280.66,$598.96,$581.85,$280.66,$636.61,$280.66,$650.30,$280.66,$280.66,$650.30
2523302,0250,,,,,,,,Ttriamcinolone Acetonide Er Su,"$1,729.78","$1,190.87",$651.01,"$1,540.20",$709.21,"$1,677.89",$709.21,$709.21,"$1,513.56","$1,470.31",$709.21,"$1,608.70",$709.21,"$1,643.29",$709.21,$709.21,"$1,643.29"
2525300,0250,,,,,,,,"Tuberculin, Purified Protein 5",$152.78,$105.18,$57.50,$136.03,$62.64,$148.19,$62.64,$62.64,$133.68,$129.86,$62.64,$142.08,$62.64,$145.14,$62.64,$62.64,$145.14
2511660,0259,,,,,,,,Tussionex Susp 5 Ml,$8.98,$6.18,$3.38,$7.99,$3.68,$8.71,$3.68,$3.68,$7.85,$7.63,$3.68,$8.35,$3.68,$8.53,$3.68,$3.68,$8.53
2523192,0250,,,,,,,,Umeclidinium 7 CAP INHALER,$398.46,$274.32,$149.96,$354.79,$163.37,$386.51,$163.37,$163.37,$348.65,$338.69,$163.37,$370.57,$163.37,$378.54,$163.37,$163.37,$378.54
2501250,0259,,,,,,,,Ursodiol 300 MG CAP,$18.77,$12.92,$7.06,$16.71,$7.70,$18.21,$7.70,$7.70,$16.42,$15.95,$7.70,$17.46,$7.70,$17.83,$7.70,$7.70,$17.83
2523463,0636,J3358,,,,,,,USTEKINUMAB 130 MG/26 ML VIAL,"$4,640.18","$3,194.54","$1,746.35","$4,131.61","$1,902.47","$4,500.97","$1,902.47","$1,902.47","$4,060.16","$3,944.15","$1,902.47","$4,315.37","$1,902.47","$4,408.17","$1,902.47","$1,902.47","$4,408.17"
2527190,0259,,,,,,,,valACYclovir 1000 MG TAB,$10.92,$7.52,$4.11,$9.72,$4.48,$10.59,$4.48,$4.48,$9.55,$9.28,$4.48,$10.15,$4.48,$10.37,$4.48,$4.48,$10.37
2523530,0259,,,,,,,,valACYclovir 500 MG TAB,$6.75,$4.65,$2.54,$6.01,$2.77,$6.55,$2.77,$2.77,$5.91,$5.74,$2.77,$6.28,$2.77,$6.42,$2.77,$2.77,$6.42
2534480,0259,,,,,,,,valGANciclovir 450 MG TAB,$485.39,$334.17,$182.68,$432.19,$199.01,$470.83,$199.01,$199.01,$424.72,$412.58,$199.01,$451.42,$199.01,$461.12,$199.01,$199.01,$461.12
2531580,0250,,,,,,,,Valproate 500 MG/5 ML VIAL,$95.40,$65.68,$35.90,$84.94,$39.11,$92.54,$39.11,$39.11,$83.47,$81.09,$39.11,$88.72,$39.11,$90.63,$39.11,$39.11,$90.63
2523211,0250,,,,,,,,Valproate Sodium Syrup 250 MG/,$13.41,$9.23,$5.05,$11.94,$5.50,$13.01,$5.50,$5.50,$11.73,$11.40,$5.50,$12.47,$5.50,$12.74,$5.50,$5.50,$12.74
2503380,0259,,,,,,,,Valproic Acid 250 MG CAP,$2.78,$1.91,$1.05,$2.47,$1.14,$2.69,$1.14,$1.14,$2.43,$2.36,$1.14,$2.58,$1.14,$2.64,$1.14,$1.14,$2.64
2523465,0250,,,,,,,,VALSARTAN 40 MG TAB,$17.58,$12.11,$6.62,$15.66,$7.21,$17.06,$7.21,$7.21,$15.39,$14.95,$7.21,$16.35,$7.21,$16.70,$7.21,$7.21,$16.70
2531890,0259,,,,,,,,Valsartan 80 Mg Tab,$5.17,$3.56,$1.95,$4.61,$2.12,$5.02,$2.12,$2.12,$4.53,$4.40,$2.12,$4.81,$2.12,$4.92,$2.12,$2.12,$4.92
2533990,0250,,,,,,,,Vancomycin 1000 MG ADD-VANTAGE,$142.78,$98.30,$53.73,$127.13,$58.54,$138.49,$58.54,$58.54,$124.93,$121.36,$58.54,$132.78,$58.54,$135.64,$58.54,$58.54,$135.64
2514810,0250,,,,,,,,Vancomycin 1000 MG VIAL,$98.94,$68.12,$37.24,$88.10,$40.57,$95.97,$40.57,$40.57,$86.57,$84.10,$40.57,$92.01,$40.57,$93.99,$40.57,$40.57,$93.99
2532380,0259,,,,,,,,Vancomycin 125 MG CAP,$48.47,$33.37,$18.24,$43.16,$19.87,$47.01,$19.87,$19.87,$42.41,$41.20,$19.87,$45.07,$19.87,$46.04,$19.87,$19.87,$46.04
2508800,0259,,,,,,,,Vancomycin 250 MG CAP,$122.70,$84.47,$46.18,$109.25,$50.31,$119.02,$50.31,$50.31,$107.36,$104.29,$50.31,$114.11,$50.31,$116.56,$50.31,$50.31,$116.56
2514800,0250,,,,,,,,Vancomycin 500 MG VIAL,$176.70,$121.65,$66.50,$157.33,$72.45,$171.40,$72.45,$72.45,$154.61,$150.20,$72.45,$164.33,$72.45,$167.87,$72.45,$72.45,$167.87
2544450,0250,,,,,,,,Vancomycin 750 MG ADD-VANTAGE,$142.70,$98.24,$53.71,$127.06,$58.51,$138.42,$58.51,$58.51,$124.86,$121.30,$58.51,$132.71,$58.51,$135.57,$58.51,$58.51,$135.57
2523441,0250,,,,,,,,VANCOMYCIN/WATER 1.25GM/250ML,$220.94,$152.11,$83.15,$196.73,$90.59,$214.31,$90.59,$90.59,$193.32,$187.80,$90.59,$205.48,$90.59,$209.89,$90.59,$90.59,$209.89
2523442,0250,,,,,,,,VANCOMYCIN/WATER 1.5GM/300ML,$265.14,$182.54,$99.79,$236.08,$108.71,$257.18,$108.71,$108.71,$232.00,$225.37,$108.71,$246.58,$108.71,$251.88,$108.71,$108.71,$251.88
2523443,0250,,,,,,,,VANCOMYCIN/WATER 1.75GM/350ML,$309.34,$212.96,$116.42,$275.43,$126.83,$300.06,$126.83,$126.83,$270.67,$262.93,$126.83,$287.68,$126.83,$293.87,$126.83,$126.83,$293.87
2583440,0250,,,,,,,,VANCOMYCIN/WATER 1GM/200ML BAG,$176.77,$121.70,$66.53,$157.39,$72.47,$171.46,$72.47,$72.47,$154.67,$150.25,$72.47,$164.39,$72.47,$167.93,$72.47,$72.47,$167.93
2523444,0250,,,,,,,,VANCOMYCIN/WATER 2GM/400ML BAG,$353.52,$243.38,$133.05,$314.77,$144.94,$342.92,$144.94,$144.94,$309.33,$300.49,$144.94,$328.77,$144.94,$335.85,$144.94,$144.94,$335.85
2523572,0250,,,,,,,,Vancomycin/Water Peg 750mg/150,$163.48,$112.55,$61.52,$145.56,$67.02,$158.57,$67.02,$67.02,$143.04,$138.95,$67.02,$152.03,$67.02,$155.30,$67.02,$67.02,$155.30
2536180,0250,,,,,,,,Varenicline 1 Mg Tab,$175.88,$121.09,$66.19,$156.61,$72.11,$170.61,$72.11,$72.11,$153.90,$149.50,$72.11,$163.57,$72.11,$167.09,$72.11,$72.11,$167.09
2521640,0250,,,,,,,,Varicella Vaccine- Chicken Pox,$594.57,$409.34,$223.77,$529.41,$243.77,$576.74,$243.77,$243.77,$520.25,$505.39,$243.77,$552.95,$243.77,$564.84,$243.77,$243.77,$564.84
2523363,0250,,,,,,,,VARICELLA-ZOSTER GE/AS01B/PF50,$616.98,$424.76,$232.20,$549.36,$252.96,$598.47,$252.96,$252.96,$539.86,$524.43,$252.96,$573.79,$252.96,$586.13,$252.96,$252.96,$586.13
2514830,0250,,,,,,,,Vasopressin 20 UNITS/ML VIAL,$351.73,$242.15,$132.38,$313.18,$144.21,$341.18,$144.21,$144.21,$307.77,$298.97,$144.21,$327.11,$144.21,$334.15,$144.21,$144.21,$334.15
2514820,0250,,,,,,,,Vecuronium 10 MG VIAL,$122.24,$84.16,$46.01,$108.84,$50.12,$118.57,$50.12,$50.12,$106.96,$103.91,$50.12,$113.68,$50.12,$116.13,$50.12,$50.12,$116.13
2583210,0636,J3380,,,,,,,Vedolizumab 300 MG VIAL,"$15,084.57","$10,385.01","$5,677.14","$13,431.28","$6,184.68","$14,632.04","$6,184.68","$6,184.68","$13,199.00","$12,821.89","$6,184.68","$14,028.65","$6,184.68","$14,330.34","$6,184.68","$6,184.68","$14,330.34"
2522360,0259,,,,,,,,Venlafaxine 150 MG CAPCR,$2.87,$1.97,$1.08,$2.55,$1.17,$2.78,$1.17,$1.17,$2.51,$2.44,$1.17,$2.66,$1.17,$2.72,$1.17,$1.17,$2.72
2523940,0259,,,,,,,,Venlafaxine 37.5 MG CAPCR,$7.87,$5.42,$2.96,$7.00,$3.22,$7.63,$3.22,$3.22,$6.88,$6.69,$3.22,$7.31,$3.22,$7.47,$3.22,$3.22,$7.47
2503830,0259,,,,,,,,Venlafaxine 50 MG TAB,$1.84,$1.27,$0.69,$1.64,$0.75,$1.79,$0.75,$0.75,$1.61,$1.56,$0.75,$1.71,$0.75,$1.75,$0.75,$0.75,$1.75
2503840,0259,,,,,,,,Venlafaxine 75 MG TAB,$3.15,$2.17,$1.18,$2.80,$1.29,$3.05,$1.29,$1.29,$2.75,$2.68,$1.29,$2.93,$1.29,$2.99,$1.29,$1.29,$2.99
2524840,0259,,,,,,,,VENLAFLAXINE XR 75MG,$8.56,$5.90,$3.22,$7.62,$3.51,$8.31,$3.51,$3.51,$7.49,$7.28,$3.51,$7.96,$3.51,$8.13,$3.51,$3.51,$8.13
2514860,0250,,,,,,,,Verapamil 5 MG/2 ML VIAL,$201.83,$138.95,$75.96,$179.71,$82.75,$195.78,$82.75,$82.75,$176.60,$171.56,$82.75,$187.70,$82.75,$191.74,$82.75,$82.75,$191.74
2502370,0259,,,,,,,,Verapamil 80 MG TAB,$0.83,$0.57,$0.31,$0.74,$0.34,$0.80,$0.34,$0.34,$0.72,$0.70,$0.34,$0.77,$0.34,$0.79,$0.34,$0.34,$0.79
2502400,0259,,,,,,,,Verapamil C.R. 120 MG TABCR,$6.12,$4.22,$2.30,$5.45,$2.51,$5.94,$2.51,$2.51,$5.36,$5.20,$2.51,$5.69,$2.51,$5.82,$2.51,$2.51,$5.82
2502390,0259,,,,,,,,Verapamil C.R. 240 MG TABCR,$3.06,$2.11,$1.15,$2.73,$1.26,$2.97,$1.26,$1.26,$2.68,$2.60,$1.26,$2.85,$1.26,$2.91,$1.26,$1.26,$2.91
2502410,0259,,,,,,,,VERAPAMIL HCL,$3.46,$2.39,$1.30,$3.08,$1.42,$3.36,$1.42,$1.42,$3.03,$2.94,$1.42,$3.22,$1.42,$3.29,$1.42,$1.42,$3.29
2544060,0250,,,,,,,,Viscoat 0.5ML SYRINGE,$531.35,$365.81,$199.98,$473.12,$217.86,$515.41,$217.86,$217.86,$464.94,$451.65,$217.86,$494.16,$217.86,$504.79,$217.86,$217.86,$504.79
2536010,0250,,,,,,,,Vitamin A 10000 UNIT CAP,$0.31,$0.21,$0.11,$0.27,$0.13,$0.30,$0.13,$0.13,$0.27,$0.26,$0.13,$0.28,$0.13,$0.29,$0.13,$0.13,$0.29
2523137,0250,,,,,,,,VITAMIN B-COMPLEX 30 ML VIAL,$721.28,$496.57,$271.46,$642.23,$295.73,$699.64,$295.73,$295.73,$631.12,$613.09,$295.73,$670.79,$295.73,$685.22,$295.73,$295.73,$685.22
2539520,0250,,,,,,,,Vitamin D 1000 Units Tab,$0.31,$0.21,$0.11,$0.27,$0.13,$0.30,$0.13,$0.13,$0.27,$0.26,$0.13,$0.28,$0.13,$0.29,$0.13,$0.13,$0.29
2544050,0250,,,,,,,,Vitamin D 400 UNIT/1 ML DROPS,$137.53,$94.68,$51.76,$122.45,$56.39,$133.40,$56.39,$56.39,$120.34,$116.90,$56.39,$127.90,$56.39,$130.65,$56.39,$56.39,$130.65
2508950,0259,,,,,,,,Vitamin E 400 UNITS CAP,$4.43,$3.05,$1.67,$3.95,$1.82,$4.30,$1.82,$1.82,$3.88,$3.77,$1.82,$4.12,$1.82,$4.21,$1.82,$1.82,$4.21
2527780,0259,,,,,,,,Vitamins A & D OINT 60 GM TUBE,$80.28,$55.27,$30.21,$71.48,$32.91,$77.87,$32.91,$32.91,$70.24,$68.24,$32.91,$74.66,$32.91,$76.26,$32.91,$32.91,$76.26
2518800,0259,,,,,,,,"VITAMINS A,C,AND D",$3.67,$2.53,$1.38,$3.27,$1.51,$3.56,$1.51,$1.51,$3.21,$3.12,$1.51,$3.41,$1.51,$3.49,$1.51,$1.51,$3.49
2501450,0259,,,,,,,,Vitamins B Comp w/C TAB,$0.65,$0.45,$0.25,$0.58,$0.27,$0.63,$0.27,$0.27,$0.57,$0.56,$0.27,$0.61,$0.27,$0.62,$0.27,$0.27,$0.62
2523517,0250,,,,,,,,VORICONAZOLE 200 MG TAB,$125.58,$86.45,$47.26,$111.81,$51.49,$121.81,$51.49,$51.49,$109.88,$106.74,$51.49,$116.78,$51.49,$119.30,$51.49,$51.49,$119.30
2503070,0259,,,,,,,,Warfarin 1 MG TAB,$2.77,$1.91,$1.04,$2.46,$1.13,$2.68,$1.13,$1.13,$2.42,$2.35,$1.13,$2.57,$1.13,$2.63,$1.13,$1.13,$2.63
2503080,0259,,,,,,,,Warfarin 2 MG TAB,$3.93,$2.71,$1.48,$3.50,$1.61,$3.81,$1.61,$1.61,$3.44,$3.34,$1.61,$3.66,$1.61,$3.74,$1.61,$1.61,$3.74
2503120,0259,,,,,,,,Warfarin 2.5 MG TAB,$2.77,$1.91,$1.04,$2.46,$1.13,$2.68,$1.13,$1.13,$2.42,$2.35,$1.13,$2.57,$1.13,$2.63,$1.13,$1.13,$2.63
2525480,0259,,,,,,,,Warfarin 3 MG TAB,$2.77,$1.91,$1.04,$2.46,$1.13,$2.68,$1.13,$1.13,$2.42,$2.35,$1.13,$2.57,$1.13,$2.63,$1.13,$1.13,$2.63
2503060,0259,,,,,,,,Warfarin 4 MG TAB,$2.77,$1.91,$1.04,$2.46,$1.13,$2.68,$1.13,$1.13,$2.42,$2.35,$1.13,$2.57,$1.13,$2.63,$1.13,$1.13,$2.63
2503090,0259,,,,,,,,Warfarin 5 MG TAB,$3.24,$2.23,$1.22,$2.88,$1.33,$3.14,$1.33,$1.33,$2.83,$2.75,$1.33,$3.01,$1.33,$3.07,$1.33,$1.33,$3.07
2523118,0250,,,,,,,,WATER INJECTION STERIL 100MG,$111.35,$76.66,$41.91,$99.14,$45.65,$108.01,$45.65,$45.65,$97.43,$94.65,$45.65,$103.55,$45.65,$105.78,$45.65,$45.65,$105.78
2523287,0250,,,,,,,,"Water,Injection,Bacteriostatic",$75.08,$51.69,$28.26,$66.85,$30.78,$72.83,$30.78,$30.78,$65.70,$63.82,$30.78,$69.83,$30.78,$71.33,$30.78,$30.78,$71.33
2514890,0250,,,,,,,,"Water,Injection,Sterile 10 ML",$62.41,$42.97,$23.49,$55.57,$25.59,$60.54,$25.59,$25.59,$54.61,$53.05,$25.59,$58.04,$25.59,$59.29,$25.59,$25.59,$59.29
2522942,0250,,,,,,,,"Water,Injection,Sterile 1000 M",$116.48,$80.19,$43.84,$103.71,$47.76,$112.98,$47.76,$47.76,$101.92,$99.01,$47.76,$108.33,$47.76,$110.65,$47.76,$47.76,$110.65
2531240,0250,,,,,,,,"Water,Injection,Sterile 20 ML",$68.39,$47.09,$25.74,$60.90,$28.04,$66.34,$28.04,$28.04,$59.84,$58.13,$28.04,$63.61,$28.04,$64.97,$28.04,$28.04,$64.97
2520810,0250,,,,,,,,"Water,Injection,Sterile 50 ML",$88.91,$61.21,$33.46,$79.16,$36.45,$86.24,$36.45,$36.45,$77.79,$75.57,$36.45,$82.68,$36.45,$84.46,$36.45,$36.45,$84.46
2523071,0250,,,,,,,,WoundSeal Powder 1 EACH PACKAG,$24.58,$16.92,$9.25,$21.88,$10.08,$23.84,$10.08,$10.08,$21.50,$20.89,$10.08,$22.86,$10.08,$23.35,$10.08,$10.08,$23.35
2525550,0259,,,,,,,,Zaleplon 10 MG CAP,$5.35,$3.68,$2.01,$4.76,$2.19,$5.19,$2.19,$2.19,$4.68,$4.55,$2.19,$4.97,$2.19,$5.08,$2.19,$2.19,$5.08
2529120,0259,,,,,,,,Zaleplon 5 MG CAP,$4.53,$3.12,$1.71,$4.04,$1.86,$4.40,$1.86,$1.86,$3.97,$3.85,$1.86,$4.21,$1.86,$4.31,$1.86,$1.86,$4.31
2522974,0250,,,,,,,,Zanamivir 5 MG INHAL.CAP,$57.38,$39.50,$21.59,$51.09,$23.53,$55.66,$23.53,$23.53,$50.21,$48.77,$23.53,$53.36,$23.53,$54.51,$23.53,$23.53,$54.51
2523165,0250,,,,,,,,ZINC OXIDE 40% PASTE 56GM TUBE,$73.95,$50.91,$27.83,$65.84,$30.32,$71.73,$30.32,$30.32,$64.70,$62.86,$30.32,$68.77,$30.32,$70.25,$30.32,$30.32,$70.25
2517130,0259,,,,,,,,Zinc Oxide OINT 30 GM TUBE,$125.74,$86.57,$47.32,$111.96,$51.55,$121.97,$51.55,$51.55,$110.02,$106.88,$51.55,$116.94,$51.55,$119.45,$51.55,$51.55,$119.45
2523342,0250,,,,,,,,ZINC OXIDE OINT 56.7GM TUBE,$125.74,$86.57,$47.32,$111.96,$51.55,$121.97,$51.55,$51.55,$110.02,$106.88,$51.55,$116.94,$51.55,$119.45,$51.55,$51.55,$119.45
2513810,0250,,,,,,,,Zinc Sulfate 10 MG/10 ML VIAL,$64.99,$44.75,$24.46,$57.87,$26.65,$63.04,$26.65,$26.65,$56.87,$55.24,$26.65,$60.44,$26.65,$61.74,$26.65,$26.65,$61.74
2509110,0259,,,,,,,,Zinc Sulfate 220 MG CAP,$0.33,$0.23,$0.12,$0.29,$0.13,$0.32,$0.13,$0.13,$0.29,$0.28,$0.13,$0.30,$0.13,$0.31,$0.13,$0.13,$0.31
2534880,0259,,,,,,,,Ziprasidone 20 MG CAP,$8.99,$6.19,$3.38,$8.00,$3.68,$8.72,$3.68,$3.68,$7.86,$7.64,$3.68,$8.36,$3.68,$8.54,$3.68,$3.68,$8.54
2532580,0636,J3486,,,,,,,Ziprasidone 20 Mg Vial,$165.48,$113.93,$62.28,$147.34,$67.85,$160.52,$67.85,$67.85,$144.79,$140.66,$67.85,$153.90,$67.85,$157.21,$67.85,$67.85,$157.21
2537020,0250,,,,,,,,Ziprasidone 40 MG CAP,$47.67,$32.82,$17.94,$42.45,$19.55,$46.24,$19.55,$19.55,$41.71,$40.52,$19.55,$44.34,$19.55,$45.29,$19.55,$19.55,$45.29
2529890,0636,C9115,,,,,,,Zoledronic Acid 4 Mg Vial,$179.65,$123.68,$67.61,$159.96,$73.66,$174.26,$73.66,$73.66,$157.20,$152.71,$73.66,$167.08,$73.66,$170.67,$73.66,$73.66,$170.67
2544220,0636,J3487,,,,,,,Zoledronic Acid 4 Mg/100 Ml Bt,$346.76,$238.73,$130.50,$308.75,$142.17,$336.35,$142.17,$142.17,$303.41,$294.74,$142.17,$322.48,$142.17,$329.42,$142.17,$142.17,$329.42
2537510,0636,J3488,,,,,,,Zoledronic Acid 5 Mg/100ml Btl,$505.61,$348.09,$190.29,$450.20,$207.30,$490.44,$207.30,$207.30,$442.41,$429.77,$207.30,$470.22,$207.30,$480.33,$207.30,$207.30,$480.33
2501490,0259,,,,,,,,Zolpidem 10 MG TAB,$0.48,$0.33,$0.18,$0.43,$0.20,$0.46,$0.20,$0.20,$0.42,$0.41,$0.20,$0.45,$0.20,$0.46,$0.20,$0.20,$0.46
2501480,0259,,,,,,,,Zolpidem 5 MG TAB,$0.62,$0.43,$0.23,$0.55,$0.25,$0.60,$0.25,$0.25,$0.54,$0.53,$0.25,$0.58,$0.25,$0.59,$0.25,$0.25,$0.59
2535070,0250,,,,,,,,Zolpidem 6.25 MG TABCR,$5.24,$3.61,$1.97,$4.67,$2.15,$5.08,$2.15,$2.15,$4.59,$4.45,$2.15,$4.87,$2.15,$4.98,$2.15,$2.15,$4.98
2529410,0259,,,,,,,,Zonisamide 100 MG CAP,$10.48,$7.22,$3.94,$9.33,$4.30,$10.17,$4.30,$4.30,$9.17,$8.91,$4.30,$9.75,$4.30,$9.96,$4.30,$4.30,$9.96
2537870,0250,,,,,,,,Zonisamide 25 MG CAP,$1.92,$1.32,$0.72,$1.71,$0.79,$1.86,$0.79,$0.79,$1.68,$1.63,$0.79,$1.78,$0.79,$1.82,$0.79,$0.79,$1.82