CT Scan |
CT scan | CPT 70450 | $1,853 | |
CT scan of abdomen and pelvis with contrast | CPT 74177 | $4,785 | |
CT scan of pelvis with contrast | CPT 72193 | $1,639 | |
Ct abd & pelvis w/o contrast | CPT 74176 | $4,089 | |
Ct abdomen w/dye | CPT 74160 | $1,639 | |
Ct abdomen w/o & w/dye | CPT 74170 | $1,967 | |
Ct abdomen w/o dye | CPT 74150 | $1,008 | |
Ct angio abdom w/o & w/dye | CPT 74175 | $1,639 | |
Ct angio abdominal arteries | CPT 75635 | $1,639 | |
Ct angio lwr extr w/o&w/dye | CPT 73706 | $1,639 | |
Ct angio upr extrm w/o&w/dye | CPT 73206 | $1,639 | |
Ct angiograph pelv w/o&w/dye | CPT 72191 | $1,639 | |
Ct angiography chest | CPT 71275 | $2,798 | |
Ct angiography head | CPT 70496 | $1,639 | |
Ct angiography neck | CPT 70498 | $1,639 | |
Ct chest spine w/dye | CPT 72129 | $1,639 | |
Ct chest spine w/o & w/dye | CPT 72130 | $1,967 | |
Ct chest spine w/o dye | CPT 72128 | $1,008 | |
Ct head/brain w/dye | CPT 70460 | $1,976 | |
Ct head/brain w/o & w/dye | CPT 70470 | $2,448 | |
Ct lower extremity w/dye | CPT 73701 | $1,639 | |
Ct lower extremity w/o dye | CPT 73700 | $1,008 | |
Ct lumbar spine w/dye | CPT 72132 | $3,436 | |
Ct lumbar spine w/o & w/dye | CPT 72133 | $4,123 | |
Ct lumbar spine w/o dye | CPT 72131 | $1,008 | |
Ct lwr extremity w/o&w/dye | CPT 73702 | $1,967 | |
Ct maxillofacial w/dye | CPT 70487 | $2,056 | |
Ct maxillofacial w/o & w/dye | CPT 70488 | $2,473 | |
Ct maxillofacial w/o dye | CPT 70486 | $1,846 | |
Ct neck spine w/dye | CPT 72126 | $3,436 | |
Ct neck spine w/o & w/dye | CPT 72127 | $4,123 | |
Ct neck spine w/o dye | CPT 72125 | $2,685 | |
Ct pelvis w/o & w/dye | CPT 72194 | $1,967 | |
Ct pelvis w/o dye | CPT 72192 | $1,008 | |
Ct scan for needle biopsy | CPT 77012 | $1,266 | |
Ct sft tsue nck w/o & w/dye | CPT 70492 | $2,423 | |
Ct soft tissue neck w/dye | CPT 70491 | $2,016 | |
Ct soft tissue neck w/o dye | CPT 70490 | $1,671 | |
Ct thorax w/dye | CPT 71260 | $2,423 | |
Ct thorax w/o & w/dye | CPT 71270 | $2,907 | |
Ct thorax w/o dye | CPT 71250 | $1,830 | |
Clinic |
Initial new patient preventative medicine evaluation (18-3... | CPT 99385 | $338 | |
Initial new patient preventative medicine evaluation (40-6... | CPT 99386 | $298 | |
New patient office or other outpatient visit, 30 min | CPT 99203 | $191 | |
New patient office or other outpatient visit, 45 min | CPT 99204 | $292 | |
New patient office or other outpatient visit, 60 min | CPT 99205 | $369 | |
Patient office consultation, 40 min
(Not Offered) | CPT 99243 | - | - |
Patient office consultation, 60 min
(Not Offered) | CPT 99244 | - | - |
EEG |
Sleep study | CPT 95810 | $4,544 | |
EKG |
Electrocardiogram, routine, with interpretation and report | CPT 93000 | $296 | |
Imaging |
Abdomial ultrasound of pregnant uterus | CPT 76805 | $784 | |
Brain imaging (pet) | CPT 78608 | $5,772 | |
Echo exam uterus | CPT 76831 | $1,631 | |
Mammography of both breasts | CPT 77066 | $339 | |
Mammography of one breast | CPT 77065 | $278 | |
Mammography, screening, bilateral | CPT 77067 | $340 | |
Ob us < 14 wks single fetus | CPT 76801 | $784 | |
Ob us detailed sngl fetus | CPT 76811 | $1,631 | |
Ob us follow-up per fetus | CPT 76816 | $784 | |
Ob us limited fetus(s) | CPT 76815 | $784 | |
Pet image w/ct full body | CPT 78816 | $5,772 | |
Pet image w/ct skull-thigh | CPT 78815 | $5,772 | |
Transvaginal us obstetric | CPT 76817 | $784 | |
Ultrasound breast complete | CPT 76641 | $784 | |
Ultrasound breast limited | CPT 76642 | $558 | |
Ultrasound of abdomen | CPT 76700 | $784 | |
Ultrasound pelvis through vagina | CPT 76830 | $784 | |
Us exam pelvic complete | CPT 76856 | $941 | |
Us exam pelvic limited | CPT 76857 | $784 | |
Inpatient Procedures |
Cardiac valve or cardiothoracic procedure with cardiac cat...
(Not Offered) | DRG 216 | - | - |
Cervical spinal fusion without CC or MCC
(Not Offered) | DRG 473 | - | - |
Major joint replacement or reattachment of lower extremity... | DRG 470 | $51,224 | |
Spinal fusion except cervical without MCC
(Not Offered) | DRG 460 | - | - |
Uterine and adnexa procedures for non-malignancy without C... | DRG 743 | $34,084 | |
Laboratory |
Acute hepatitis panel | CPT 80074 | $428 | |
Ag detect nos ia mult | CPT 87449 | $107 | |
Alpha-1-antitrypsin total | CPT 82103 | $120 | |
Alpha-fetoprotein serum | CPT 82105 | $150 | |
Assay alkaline phosphatase | CPT 84075 | $46 | |
Assay blood carbon dioxide | CPT 82374 | $43 | |
Assay glucose blood quant | CPT 82947 | $35 | |
Assay of amylase | CPT 82150 | $58 | |
Assay of blood/uric acid | CPT 84550 | $40 | |
Assay of calcium | CPT 82310 | $46 | |
Assay of ck (cpk) | CPT 82550 | $58 | |
Assay of creatinine | CPT 82565 | $46 | |
Assay of digoxin total | CPT 80162 | $119 | |
Assay of estradiol | CPT 82670 | $251 | |
Assay of ferritin | CPT 82728 | $221 | |
Assay of folic acid serum | CPT 82746 | $132 | |
Assay of free thyroxine | CPT 84439 | $192 | |
Assay of ige | CPT 82785 | $148 | |
Assay of insulin | CPT 83525 | $102 | |
Assay of iron | CPT 83540 | $58 | |
Assay of lactic acid | CPT 83605 | $104 | |
Assay of lead | CPT 83655 | $108 | |
Assay of lipase | CPT 83690 | $149 | |
Assay of lipoprotein | CPT 83718 | $73 | |
Assay of lipoprotein(a) | CPT 83695 | $128 | |
Assay of magnesium | CPT 83735 | $143 | |
Assay of natriuretic peptide | CPT 83880 | $353 | |
Assay of prealbumin | CPT 84134 | $131 | |
Assay of protein other | CPT 84157 | $36 | |
Assay of protein urine | CPT 84156 | $33 | |
Assay of serum potassium | CPT 84132 | $42 | |
Assay of thyroid (t3 or t4) | CPT 84479 | $58 | |
Assay of total thyroxine | CPT 84436 | $61 | |
Assay of transferrin | CPT 84466 | $114 | |
Assay of triglycerides | CPT 84478 | $51 | |
Assay of troponin quant | CPT 84484 | $202 | |
Assay of urea nitrogen | CPT 84520 | $35 | |
Assay of urine potassium | CPT 84133 | $42 | |
Assay of urine/uric acid | CPT 84560 | $45 | |
Assay of vancomycin | CPT 80202 | $121 | |
Assay triiodothyronine (t3) | CPT 84480 | $127 | |
Automated diff wbc count | CPT 85004 | $58 | |
Automated leukocyte count | CPT 85048 | $22 | |
Automated platelet count | CPT 85049 | $40 | |
Automated reticulocyte count | CPT 85045 | $87 | |
Basic metabolic panel | CPT 80048 | $233 | |
Bilirubin direct | CPT 82248 | $45 | |
Bilirubin total | CPT 82247 | $45 | |
Blood test, clotting time | CPT 85610 | $129 | |
Blood test, comprehensive group of blood chemicals | CPT 80053 | $296 | |
Blood test, lipids | CPT 80061 | $202 | |
Blood test, thyroid stimulating hormone (TSH) | CPT 84443 | $236 | |
Blood typing serologic rh(d) | CPT 86901 | $75 | |
C diff amplified probe | CPT 87493 | $335 | |
C-reactive protein | CPT 86140 | $116 | |
COVID-19, AMPLIFIED PROBE TECHNIQUE | CPT 87635 | $235 | |
Carcinoembryonic antigen | CPT 82378 | $170 | |
Chlamydia culture | CPT 87110 | $176 | |
Chorionic gonadotropin assay | CPT 84703 | $133 | |
Chorionic gonadotropin test | CPT 84702 | $269 | |
Clostridium ag ia | CPT 87324 | $107 | |
Coagulation assessment blood test | CPT 85730 | $159 | |
Complete blood cell count (CBC), automated | CPT 85027 | $116 | |
Complete blood cell count (CBC), with differential white b... | CPT 85025 | $172 | |
Coombs test direct | CPT 86880 | $48 | |
Creatinine clearance test | CPT 82575 | $85 | |
Cytomegalovirus ag ia | CPT 87332 | $107 | |
Cytopath smear other source | CPT 88161 | $103 | |
Dipropylacetic acid free | CPT 80165 | $121 | |
Drug screen quantalcohols | CPT 80320 | $163 | |
Drug test prsmv chem anlyzr | CPT 80307 | $310 | |
Drug test prsmv instrmnt | CPT 80306 | $154 | |
Electrolyte panel | CPT 80051 | $63 | |
Fibrin degradation quant | CPT 85379 | $186 | |
Free assay (ft-3) | CPT 84481 | $152 | |
Fungi identification yeast | CPT 87106 | $92 | |
General health panel | CPT 80050 | $346 | |
Glucose test | CPT 82950 | $42 | |
Glycosylated hemoglobin test | CPT 83036 | $132 | |
Gtt-added samples | CPT 82952 | $35 | |
H pylori (c-13) breath | CPT 83013 | $606 | |
H pylori drug admin | CPT 83014 | $239 | |
Hematocrit | CPT 85014 | $64 | |
Hemoglobin | CPT 85018 | $70 | |
Hepatitis b dna amp probe | CPT 87516 | $315 | |
Hepatitis c ab test | CPT 86803 | $128 | |
Hepatitis c probe&rvrs trnsc | CPT 87521 | $315 | |
Hiv-1 probe&reverse trnscrpj | CPT 87535 | $315 | |
Hpylori stool ia | CPT 87338 | $129 | |
Hsv dna amp probe | CPT 87529 | $315 | |
Immunoassay tumor ca 125 | CPT 86304 | $187 | |
Immunoassay tumor ca 15-3 | CPT 86300 | $187 | |
Immunoassay tumor ca 19-9 | CPT 86301 | $187 | |
Iron binding test | CPT 83550 | $78 | |
Kidney function panel test | CPT 80069 | $78 | |
Liver function blood test | CPT 80076 | $313 | |
Microscopic exam of urine | CPT 81015 | $27 | |
Obstetric blood test panel | CPT 80055 | $430 | |
Occult bld feces 1-3 tests | CPT 82272 | $38 | |
Occult blood feces | CPT 82270 | $39 | |
Other source albumin quan ea | CPT 82042 | $70 | |
Ova and parasites smears | CPT 87177 | $80 | |
Pinworm exam | CPT 87172 | $38 | |
Psa screening | HCPCS G0103 | $173 | |
Resp virus 12-25 targets | CPT 87633 | $1,250 | |
Resp virus 3-5 targets | CPT 87631 | $427 | |
Resp virus 6-11 targets | CPT 87632 | $654 | |
Rheumatoid factor test qual | CPT 86430 | $55 | |
Routine venipuncture | CPT 36415 | $30 | |
Strep a ag ia | CPT 87430 | $151 | |
Strep b dna amp probe | CPT 87653 | $105 | |
Syphilis test non-trep qual | CPT 86592 | $38 | |
Syphilis test non-trep quant | CPT 86593 | $39 | |
Tb test cell immun measure | CPT 86480 | $557 | |
Total prostate-specific antigen (PSA) test | CPT 84153 | $165 | |
Total prostate-specific antigen (PSA) test | CPT 84154 | $165 | |
Transferase (ast) (sgot) | CPT 84450 | $46 | |
Ur albumin quantitative | CPT 82043 | $52 | |
Urinalysis | CPT 81005 | $19 | |
Urinalysis test | CPT 81002 | $20 | |
Urinalysis test | CPT 81003 | $20 | |
Urinalysis test using microscope | CPT 81001 | $98 | |
Urinalysis test using microscope
(Not Offered) | CPT 81000 | - | - |
Urine culture/colony count | CPT 87086 | $197 | |
Urine pregnancy test | CPT 81025 | $77 | |
Varicella zoster ag if | CPT 87290 | $120 | |
Vitamin b-12 | CPT 82607 | $234 | |
Vitamin d 25 hydroxy | CPT 82306 | $266 | |
West nile virus antibody | CPT 86789 | $129 | |
MRI |
MRI Scan | CPT 70553 | $4,123 | |
MRI scan of leg joint | CPT 73721 | $2,199 | |
MRI scan of lower spinal canal | CPT 72148 | $2,097 | |
Magnetic image jaw joint | CPT 70336 | $2,097 | |
Mri abdomen w/dye | CPT 74182 | $3,436 | |
Mri abdomen w/o & w/dye | CPT 74183 | $4,123 | |
Mri abdomen w/o dye | CPT 74181 | $2,097 | |
Mri brain stem w/dye | CPT 70552 | $3,436 | |
Mri brain stem w/o dye | CPT 70551 | $2,748 | |
Mri chest spine w/dye | CPT 72147 | $3,436 | |
Mri chest spine w/o & w/dye | CPT 72157 | $4,123 | |
Mri chest spine w/o dye | CPT 72146 | $2,097 | |
Mri chest w/dye | CPT 71551 | $2,516 | |
Mri chest w/o & w/dye | CPT 71552 | $3,436 | |
Mri chest w/o dye | CPT 71550 | $2,097 | |
Mri joint lwr extr w/o&w/dye | CPT 73723 | $3,436 | |
Mri joint of lwr extr w/dye | CPT 73722 | $2,749 | |
Mri joint upr extr w/o&w/dye | CPT 73223 | $3,436 | |
Mri joint upr extrem w/dye | CPT 73222 | $2,767 | |
Mri joint upr extrem w/o dye | CPT 73221 | $2,097 | |
Mri lower extremity w/dye | CPT 73719 | $2,767 | |
Mri lower extremity w/o dye | CPT 73718 | $2,097 | |
Mri lumbar spine w/dye | CPT 72149 | $3,436 | |
Mri lumbar spine w/o & w/dye | CPT 72158 | $4,123 | |
Mri lwr extremity w/o&w/dye | CPT 73720 | $3,436 | |
Mri neck spine w/dye | CPT 72142 | $3,436 | |
Mri neck spine w/o & w/dye | CPT 72156 | $4,123 | |
Mri neck spine w/o dye | CPT 72141 | $2,097 | |
Mri orbt/fac/nck w/o &w/dye | CPT 70543 | $4,123 | |
Mri pelvis w/dye | CPT 72196 | $3,436 | |
Mri pelvis w/o & w/dye | CPT 72197 | $4,123 | |
Mri pelvis w/o dye | CPT 72195 | $2,097 | |
Mri upper extremity w/o dye | CPT 73218 | $2,097 | |
Mri uppr extremity w/o&w/dye | CPT 73220 | $2,338 | |
Nuclear Medicine |
Parathyroid planar imaging | CPT 78070 | $1,472 | |
Thyroid imaging w/blood flow | CPT 78013 | $1,472 | |
Psychiatric |
Family psychotherapy, including patient, 50 min
(Not Offered) | CPT 90847 | - | - |
Family psychotherapy, not including patient, 50 min
(Not Offered) | CPT 90846 | - | - |
Group psychotherapy
(Not Offered) | CPT 90853 | - | - |
Psychotherapy, 30 min
(Not Offered) | CPT 90832 | - | - |
Psychotherapy, 45 min
(Not Offered) | CPT 90834 | - | - |
Psychotherapy, 60 min
(Not Offered) | CPT 90837 | - | - |
Radiology |
Contrast x-ray bladder | CPT 74430 | $1,909 | |
Contrast x-ray of hip | CPT 73525 | $1,909 | |
Contrast x-ray of knee joint | CPT 73580 | $1,909 | |
Contrast x-ray of shoulder | CPT 73040 | $1,145 | |
Contrast x-ray of wrist | CPT 73115 | $1,909 | |
Ct bone density axial | CPT 77078 | $555 | |
Dxa bone density axial | CPT 77080 | $560 | |
Dxa bone density study | CPT 77085 | $560 | |
Fluoroscopy <1 hr phys/qhp | CPT 76000 | $1,165 | |
Needle localization by xray | CPT 77002 | $680 | |
PATELLA BILAT 1-2V | CPT 73560 | $399 | |
X-Ray of lower back | CPT 72110 | $672 | |
X-ray bile ducts/pancreas | CPT 74300 | $719 | |
X-ray exam abdomen 2 views | CPT 74019 | $560 | |
X-ray exam abdomen 3+ views | CPT 74021 | $672 | |
X-ray exam breastbone 2/>vws | CPT 71120 | $399 | |
X-ray exam chest 1 view | CPT 71045 | $399 | |
X-ray exam chest 2 views | CPT 71046 | $478 | |
X-ray exam chest 3 views | CPT 71047 | $574 | |
X-ray exam chest 4+ views | CPT 71048 | $689 | |
X-ray exam complete abdomen | CPT 74022 | $560 | |
X-ray exam hip uni 2-3 views | CPT 73502 | $478 | |
X-ray exam hips bi 2 views | CPT 73521 | $560 | |
X-ray exam hips bi 3-4 views | CPT 73522 | $672 | |
X-ray exam l-s spine 2/3 vws | CPT 72100 | $560 | |
X-ray exam l-s spine bending | CPT 72114 | $806 | |
X-ray exam neck spine 2-3 vw | CPT 72040 | $478 | |
X-ray exam neck spine 4/5vws | CPT 72050 | $560 | |
X-ray exam neck spine 6/>vws | CPT 72052 | $672 | |
X-ray exam of ankle | CPT 73600 | $319 | |
X-ray exam of ankle | CPT 73610 | $399 | |
X-ray exam of collar bone | CPT 73000 | $399 | |
X-ray exam of elbow | CPT 73070 | $319 | |
X-ray exam of elbow | CPT 73080 | $399 | |
X-ray exam of facial bones | CPT 70150 | $560 | |
X-ray exam of femur 1 | CPT 73551 | $399 | |
X-ray exam of femur 2/> | CPT 73552 | $478 | |
X-ray exam of finger(s) | CPT 73140 | $399 | |
X-ray exam of foot | CPT 73620 | $319 | |
X-ray exam of foot | CPT 73630 | $399 | |
X-ray exam of forearm | CPT 73090 | $399 | |
X-ray exam of hand | CPT 73120 | $560 | |
X-ray exam of hand | CPT 73130 | $672 | |
X-ray exam of humerus | CPT 73060 | $399 | |
X-ray exam of knee 1 or 2 | CPT 73560 | $399 | |
X-ray exam of knee 3 | CPT 73562 | $478 | |
X-ray exam of knees | CPT 73565 | $399 | |
X-ray exam of leg infant | CPT 73592 | $399 | |
X-ray exam of lower leg | CPT 73590 | $399 | |
X-ray exam of neck | CPT 70360 | $399 | |
X-ray exam of pelvis | CPT 72170 | $448 | |
X-ray exam of pelvis | CPT 72190 | $560 | |
X-ray exam of shoulder | CPT 73030 | $478 | |
X-ray exam of shoulder | CPT 73020 | $399 | |
X-ray exam of shoulder blade | CPT 73010 | $560 | |
X-ray exam of toe(s) | CPT 73660 | $399 | |
X-ray exam of wrist | CPT 73100 | $319 | |
X-ray exam of wrist | CPT 73110 | $399 | |
X-ray exam ribs bil 3 views | CPT 71110 | $560 | |
X-ray exam sacrum tailbone | CPT 72220 | $399 | |
X-ray exam thorac spine 2vws | CPT 72070 | $560 | |
X-ray exam unilat ribs/chest | CPT 71101 | $560 | |
X-ray strenoclavic jt 3/>vws | CPT 71130 | $478 | |
X-ray urethra/bladder | CPT 74455 | $1,165 | |
X-ray xm colon 1cntrst std | CPT 74270 | $1,114 | |
X-ray xm esophagus 1cntrst | CPT 74220 | $911 | |
X-ray xm sm int 1cntrst std | CPT 74250 | $911 | |
X-ray xm swlng funcj c+ | CPT 74230 | $911 | |
X-ray xm upr gi trc 1cntrst | CPT 74240 | $911 | |
X-ray xm upr gi trc 2cntrst | CPT 74246 | $1,237 | |
Surgical Procedures |
Biopsy exam of esophagus, stomach or small bowel using an ... | CPT 43239 | $873 | |
Biopsy exam of large bowel using an endoscope | CPT 45380 | $1,033 | |
Biopsy of prostate gland
(Not Offered) | CPT 55700 | - | - |
Diagnostic exam of esophagus, stomach or small bowel using... | CPT 43235 | $653 | |
Diagnostic exam of large bowel using an endoscope | CPT 45378 | $886 | |
Injection(s) of anesthetic into lower spine using imaging ...
(Not Offered) | CPT 64483 | - | - |
Injection(s) of therapeutic substance | CPT 62322 | $1,875 | |
Injection(s) of therapeutic substance | CPT 62323 | $2,250 | |
Insertion of catheter into left heart for diagnosis
(Not Offered) | CPT 93542 | - | - |
Obstetric care, planned cesarean delivery
(Not Offered) | CPT 59510 | - | - |
Obstetric care, planned vaginal delivery
(Not Offered) | CPT 59400 | - | - |
Obstetric care, planned vaginal delivery (post delivery by...
(Not Offered) | CPT 59610 | - | - |
Removal of cataract with insertion of lens
(Not Offered) | CPT 66984 | - | - |
Removal of gallbladder using an endoscope | CPT 47562 | $1,546 | |
Removal of one knee cartilage using an endoscope | CPT 29881 | $2,638 | |
Removal of one or more breast growth, open procedure | CPT 19120 | $917 | |
Removal of polyps or growths of large bowel using an endos... | CPT 45385 | $1,125 | |
Removal of recurring cataract in lens capsule using laser | CPT 66821 | $1,520 | |
Removal of tonsils and adenoid glands, patient younger tha... | CPT 42820 | $8,442 | |
Repair of groin hernia patient age 5 years or older | CPT 49505 | $1,350 | |
Shaving of shoulder bone using endoscope | CPT 29826 | $455 | |
Surgical removal of prostate and surrounding lymph nodes u...
(Not Offered) | CPT 55866 | - | - |
Ultrasound examination of lower large bowel using an endos...
(Not Offered) | CPT 45391 | - | - |
Therapy |
Physical therapy, therapeutic exercise | CPT 97110 | $59 | |