CT Scan |
CT scan | CPT 70450 | $927 | |
CT scan of abdomen and pelvis with contrast | CPT 74177 | $2,372 | |
CT scan of pelvis with contrast
(Not Offered) | CPT 72193 | - | - |
Ct abd & pelv 1/> regns | CPT 74178 | $3,035 | |
Ct abdomen w/dye | CPT 74160 | $1,575 | |
Ct angiography chest | CPT 71275 | $1,973 | |
Ct angiography head | CPT 70496 | $1,042 | |
Ct bone density axial | CPT 77078 | $499 | |
Ct chest spine w/o dye | CPT 72128 | $1,330 | |
Ct head/brain w/o & w/dye | CPT 70470 | $1,697 | |
Ct lower extremity w/o dye | CPT 73700 | $826 | |
Ct lumbar spine w/o dye | CPT 72131 | $1,250 | |
Ct maxillofacial w/dye | CPT 70487 | $1,130 | |
Ct maxillofacial w/o dye | CPT 70486 | $897 | |
Ct neck spine w/o dye | CPT 72125 | $1,253 | |
Ct pelvis w/o dye | CPT 72192 | $924 | |
Ct soft tissue neck w/dye | CPT 70491 | $966 | |
Ct soft tissue neck w/o dye | CPT 70490 | $755 | |
Ct thorax w/o dye | CPT 71250 | $980 | |
Ct upper extremity w/o dye | CPT 73200 | $941 | |
Cardiology |
Tte w/doppler complete | CPT 93306 | $1,272 | |
Clinic |
Initial new patient preventative medicine evaluation (18-3... | CPT 99385 | $674 | |
Initial new patient preventative medicine evaluation (40-6...
(Not Offered) | CPT 99386 | - | - |
New patient office or other outpatient visit, 30 min | CPT 99203 | $674 | |
New patient office or other outpatient visit, 45 min | CPT 99204 | $674 | |
New patient office or other outpatient visit, 60 min
(Not Offered) | CPT 99205 | - | - |
Patient office consultation, 40 min
(Not Offered) | CPT 99243 | - | - |
Patient office consultation, 60 min
(Not Offered) | CPT 99244 | - | - |
EEG |
Sleep study | CPT 95810 | $2,050 | |
EKG |
Electrocardiogram tracing | CPT 93005 | $145 | |
Electrocardiogram, routine, with interpretation and report | CPT 93000 | $78 | |
Emergency Room |
Catheterize for urine spec | HCPCS P9612 | $39 | |
Emergency dept visit | CPT 99284 | $532 | |
Emergency dept visit | CPT 99283 | $351 | |
Emergency dept visit | CPT 99282 | $208 | |
Emergency dept visit | CPT 99285 | $1,467 | |
Emergency dept visit | CPT 99281 | $132 | |
Inj trigger point 1/2 muscl | CPT 20552 | $258 | |
Insert temp bladder cath | CPT 51702 | $161 | |
Place needle in vein | CPT 36000 | $122 | |
Rmvl devital tis addl 20cm/< | CPT 97598 | $139 | |
Ther/proph/diag inj sc/im | CPT 96372 | $55 | |
Tx/pro/dx inj new drug addon | CPT 96375 | $128 | |
Tx/pro/dx inj same drug adon | CPT 96376 | $83 | |
IV Therapy |
Hydration iv infusion init | CPT 96360 | $77 | |
Ther/diag concurrent inf | CPT 96368 | $186 | |
Ther/proph/diag inj iv push | CPT 96374 | $200 | |
Ther/proph/diag iv inf addon | CPT 96366 | $36 | |
Ther/proph/diag iv inf init | CPT 96365 | $121 | |
Tx/proph/dg addl seq iv inf | CPT 96367 | $194 | |
Imaging |
Abdomial ultrasound of pregnant uterus
(Not Offered) | CPT 76805 | - | - |
Echo exam of abdomen | CPT 76705 | $259 | |
Mammography of both breasts
(Not Offered) | CPT 77066 | - | - |
Mammography of one breast
(Not Offered) | CPT 77065 | - | - |
Mammography, screening, bilateral
(Not Offered) | CPT 77067 | - | - |
Ob us < 14 wks single fetus | CPT 76801 | $376 | |
Ultrasound of abdomen | CPT 76700 | $394 | |
Ultrasound pelvis through vagina
(Not Offered) | CPT 76830 | - | - |
Us exam abdo back wall comp | CPT 76770 | $343 | |
Us exam of head and neck | CPT 76536 | $292 | |
Us exam pelvic complete | CPT 76856 | $317 | |
Us exam scrotum | CPT 76870 | $314 | |
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...
(Not Offered) | DRG 470 | - | - |
Spinal fusion except cervical without MCC
(Not Offered) | DRG 460 | - | - |
Uterine and adnexa procedures for non-malignancy without C...
(Not Offered) | DRG 743 | - | - |
Laboratory |
Ag detect nos ia mult | CPT 87449 | $46 | |
Alanine amino (alt) (sgpt) | CPT 84460 | $29 | |
Alpha-fetoprotein serum | CPT 82105 | $105 | |
Analgesics non-opioid 1 or 2 | CPT 80329 | $83 | |
Antinuclear antibodies | CPT 86038 | $69 | |
Antistreptolysin o titer | CPT 86060 | $41 | |
Assay dipropylacetic acd tot | CPT 80164 | $85 | |
Assay glucose blood quant | CPT 82947 | $34 | |
Assay of ammonia | CPT 82140 | $86 | |
Assay of amylase | CPT 82150 | $53 | |
Assay of blood pku | CPT 84030 | $116 | |
Assay of blood/uric acid | CPT 84550 | $37 | |
Assay of c-peptide | CPT 84681 | $156 | |
Assay of ck (cpk) | CPT 82550 | $44 | |
Assay of creatinine | CPT 82565 | $38 | |
Assay of digoxin total | CPT 80162 | $67 | |
Assay of estradiol | CPT 82670 | $67 | |
Assay of ferritin | CPT 82728 | $74 | |
Assay of folic acid serum | CPT 82746 | $72 | |
Assay of free testosterone | CPT 84402 | $62 | |
Assay of ggt | CPT 82977 | $48 | |
Assay of gonadotropin (fsh) | CPT 83001 | $45 | |
Assay of lactic acid | CPT 83605 | $62 | |
Assay of lipase | CPT 83690 | $71 | |
Assay of magnesium | CPT 83735 | $44 | |
Assay of natriuretic peptide | CPT 83880 | $170 | |
Assay of parathormone | CPT 83970 | $115 | |
Assay of phenytoin total | CPT 80185 | $70 | |
Assay of phosphorus | CPT 84100 | $34 | |
Assay of progesterone | CPT 84144 | $103 | |
Assay of prolactin | CPT 84146 | $105 | |
Assay of serum potassium | CPT 84132 | $29 | |
Assay of thyroid (t3 or t4) | CPT 84479 | $15 | |
Assay of total testosterone | CPT 84403 | $62 | |
Assay of total thyroxine | CPT 84436 | $53 | |
Assay of triglycerides | CPT 84478 | $40 | |
Assay of troponin quant | CPT 84484 | $76 | |
Assay of urea nitrogen | CPT 84520 | $43 | |
Assay of urine creatinine | CPT 82570 | $45 | |
Assay of vancomycin | CPT 80202 | $83 | |
Assay triiodothyronine (t3) | CPT 84480 | $89 | |
Basic metabolic panel | CPT 80048 | $81 | |
Bilirubin direct | CPT 82248 | $49 | |
Blood culture for bacteria | CPT 87040 | $78 | |
Blood smear interpretation | CPT 85060 | $59 | |
Blood test, clotting time | CPT 85610 | $41 | |
Blood test, comprehensive group of blood chemicals | CPT 80053 | $103 | |
Blood test, lipids | CPT 80061 | $90 | |
Blood test, thyroid stimulating hormone (TSH) | CPT 84443 | $41 | |
Blood typing serologic abo | CPT 86900 | $41 | |
Blood typing serologic rh(d) | CPT 86901 | $38 | |
Body fluid cell count | CPT 89051 | $40 | |
C-reactive protein | CPT 86140 | $59 | |
Capillary blood draw | CPT 36416 | $0 | |
Carcinoembryonic antigen | CPT 82378 | $97 | |
Ccp antibody | CPT 86200 | $81 | |
Chorionic gonadotropin assay | CPT 84703 | $46 | |
Chorionic gonadotropin test | CPT 84702 | $78 | |
Chylmd trach dna amp probe | CPT 87491 | $101 | |
Coagulation assessment blood test | CPT 85730 | $41 | |
Complement antigen | CPT 86160 | $69 | |
Complete blood cell count (CBC), automated
(Not Offered) | CPT 85027 | - | - |
Complete blood cell count (CBC), with differential white b... | CPT 85025 | $51 | |
Creatine mb fraction | CPT 82553 | $81 | |
Culture aerobic identify | CPT 87077 | $54 | |
Culture othr specimn aerobic | CPT 87070 | $57 | |
Culture screen only | CPT 87081 | $49 | |
Dehydroepiandrosterone | CPT 82626 | $142 | |
Dna antibody native | CPT 86225 | $109 | |
Drug assay cyclosporine | CPT 80158 | $85 | |
Drug test def 1-7 classes | HCPCS G0480 | $59 | |
Exam synovial fluid crystals | CPT 89060 | $53 | |
Feces culture aerobic bact | CPT 87045 | $55 | |
Fibrin degradation products | CPT 85362 | $76 | |
Free assay (ft-3) | CPT 84481 | $41 | |
Glucose tolerance test (gtt) | CPT 82951 | $82 | |
Glycosylated hemoglobin test | CPT 83036 | $72 | |
Helicobacter pylori antibody | CPT 86677 | $85 | |
Hematocrit | CPT 85014 | $27 | |
Hemoglobin | CPT 85018 | $27 | |
Hepatitis b surface ag ia | CPT 87340 | $71 | |
Hepatitis c ab test | CPT 86803 | $83 | |
Hepatitis c probe&rvrs trnsc | CPT 87521 | $212 | |
Hepatitis c revrs trnscrpj | CPT 87522 | $212 | |
Heterophile antibody screen | CPT 86308 | $62 | |
Hiv-1antibody | CPT 86701 | $81 | |
Hpylori stool ia | CPT 87338 | $92 | |
Iadna-dna/rna probe tq 12-25 | CPT 87507 | $420 | |
Immunoassay infectious agent | CPT 86317 | $61 | |
Immunoassay tumor ca 125 | CPT 86304 | $130 | |
Influenza virus antibody | CPT 86710 | $47 | |
Iron binding test | CPT 83550 | $59 | |
Kidney function panel test | CPT 80069 | $71 | |
Lactoferrin fecal (qual) | CPT 83630 | $57 | |
Liver function blood test | CPT 80076 | $80 | |
Manual cell count each | CPT 85032 | $130 | |
Manual reticulocyte count | CPT 85044 | $49 | |
Microbe susceptible mic | CPT 87186 | $59 | |
Microsomal antibody each | CPT 86376 | $59 | |
Mycoplasma antibody | CPT 86738 | $112 | |
Obstetric blood test panel
(Not Offered) | CPT 80055 | - | - |
Ova and parasites smears | CPT 87177 | $75 | |
Protein e-phoresis serum | CPT 84165 | $81 | |
Rbc antibody screen | CPT 86850 | $91 | |
Rbc sed rate automated | CPT 85652 | $65 | |
Reagent strip/blood glucose | CPT 82948 | $16 | |
Respiratory virus antibody | CPT 86756 | $70 | |
Rheumatoid factor quant | CPT 86431 | $53 | |
Rotavirus antibody | CPT 86759 | $76 | |
Rubella antibody | CPT 86762 | $49 | |
Smear gram stain | CPT 87205 | $57 | |
Stool cultr aerobic bact ea | CPT 87046 | $42 | |
Strep a ag ia | CPT 87430 | $43 | |
Syphilis test non-trep qual | CPT 86592 | $52 | |
Tissue exam by pathologist | CPT 88305 | $159 | |
Tissue exam by pathologist | CPT 88304 | $83 | |
Total cortisol | CPT 82533 | $91 | |
Total prostate-specific antigen (PSA) test | CPT 84153 | $44 | |
Total prostate-specific antigen (PSA) test
(Not Offered) | CPT 84154 | - | - |
Transferase (ast) (sgot) | CPT 84450 | $29 | |
Trichomonas vaginalis amplif | CPT 87661 | $57 | |
Ur albumin quantitative | CPT 82043 | $63 | |
Urinalysis test | CPT 81002 | $12 | |
Urinalysis test | CPT 81003 | $215 | |
Urinalysis test using microscope | CPT 81000 | $15 | |
Urinalysis test using microscope
(Not Offered) | CPT 81001 | - | - |
Urine culture/colony count | CPT 87086 | $50 | |
Vitamin d 25 hydroxy | CPT 82306 | $112 | |
Withdrawal of arterial blood | CPT 36600 | $46 | |
MRI |
MRI Scan | CPT 70553 | $3,065 | |
MRI scan of leg joint | CPT 73721 | $2,535 | |
MRI scan of lower spinal canal | CPT 72148 | $2,525 | |
Mri abdomen w/o & w/dye | CPT 74183 | $3,007 | |
Mri chest spine w/o dye | CPT 72146 | $2,535 | |
Mri neck spine w/o dye | CPT 72141 | $2,535 | |
Medical and Surgical Supplies |
Bedside drainage bag | HCPCS A4357 | $6 | |
Cath insertion tray w/bag | HCPCS A4354 | $13 | |
Disposable canister for pump | HCPCS A7000 | $37 | |
Dme supply or accessory, nos | HCPCS A9999 | $10 | |
Drug screen quantalcohols | CPT 80320 | $31 | |
Foam drg <=16 sq in w/border | HCPCS A6212 | $39 | |
Foam drsg <=16 sq in w/o bdr | HCPCS A6209 | $22 | |
Nasal/orogastric w/tube plmt | CPT 43752 | $6 | |
Neg pres wound ther drsg set | HCPCS A6550 | $40 | |
Non-covered item or service | HCPCS A9270 | $6 | |
Non-waterproof tape | HCPCS A4450 | $16 | |
Sterile water/saline, 500 ml | HCPCS A4217 | $10 | |
Zinc paste band w >=3"<5"/yd | HCPCS A6456 | $27 | |
Nuclear Medicine |
Bone imaging whole body | CPT 78306 | $1,106 | |
Hepatobil syst image w/drug | CPT 78227 | $812 | |
Ht muscle image spect mult | CPT 78452 | $3,041 | |
Iodine i-123 sod iodide mic | HCPCS A9516 | $152 | |
Tc99m mebrofenin | HCPCS A9537 | $155 | |
Tc99m medronate | HCPCS A9503 | $106 | |
Tc99m sestamibi | HCPCS A9500 | $97 | |
Other Diagnostic |
Extracranial bilat study | CPT 93880 | $800 | |
Extremity study | CPT 93971 | $407 | |
Extremity study | CPT 93970 | $363 | |
Fetal non-stress test | CPT 59025 | $386 | |
Polysom 6/>yrs cpap 4/> parm | CPT 95811 | $2,036 | |
Other Procedures and Observation |
Removal of nail bed | CPT 11750 | $204 | |
Other Therapeutic |
Blood transfusion service | CPT 36430 | $431 | |
Phlebotomy | CPT 99195 | $267 | |
Plasma 1 donor frz w/in 8 hr | HCPCS P9017 | $124 | |
Pharmacy |
5% dextrose/normal saline | HCPCS J7042 | $13 | |
Adrenalin epinephrine inject | HCPCS J0171 | $42 | |
Albuterol ipratrop non-comp | HCPCS J7620 | $8 | |
Amiodarone hcl | HCPCS J0282 | $11 | |
Azithromycin | HCPCS J0456 | $28 | |
Bumetanide 0.5 mg | HCPCS S0171 | $25 | |
Cefazolin sodium injection | HCPCS J0690 | $15 | |
Cefepime hcl for injection | HCPCS J0692 | $28 | |
Ceftriaxone sodium injection | HCPCS J0696 | $11 | |
Ciprofloxacin iv | HCPCS J0744 | $21 | |
D5w infusion | HCPCS J7070 | $14 | |
Dexamethasone sodium phos | HCPCS J1100 | $14 | |
Diazepam injection | HCPCS J3360 | $92 | |
Dicyclomine injection | HCPCS J0500 | $172 | |
Diphenhydramine hcl injectio | HCPCS J1200 | $13 | |
Drugs unclassified injection | HCPCS J3490 | $20 | |
Ertapenem injection | HCPCS J1335 | $398 | |
Fentanyl citrate injection | HCPCS J3010 | $11 | |
Fluphenazine decanoate 25 mg | HCPCS J2680 | $95 | |
Furosemide injection | HCPCS J1940 | $16 | |
Haloperidol decanoate inj | HCPCS J1631 | $28 | |
Hydromorphone injection | HCPCS J1170 | $14 | |
Hydroxyzine hcl injection | HCPCS J3410 | $71 | |
Iiv4 vaccine splt 0.5 ml im | CPT 90688 | $14 | |
Inj enoxaparin sodium | HCPCS J1650 | $147 | |
Inj heparin sodium per 10 u | HCPCS J1642 | $8 | |
Inj iron dextran | HCPCS J1750 | $95 | |
Inj midazolam hydrochloride | HCPCS J2250 | $13 | |
Inj naloxone hydrochloride | HCPCS J2310 | $53 | |
Inj, afstyla, 1 i.u. | HCPCS J7210 | $20 | |
Inj, propofol, 10 mg | HCPCS J2704 | $15 | |
Injection, clindamycin phosp | HCPCS S0077 | $17 | |
Injection, metronidazole | HCPCS S0030 | $12 | |
Ketorolac tromethamine inj | HCPCS J1885 | $11 | |
Levalbuterol non-comp unit | HCPCS J7614 | $26 | |
Levofloxacin injection | HCPCS J1956 | $50 | |
Lidocaine injection | HCPCS J2001 | $16 | |
Lorazepam injection | HCPCS J2060 | $13 | |
Meropenem | HCPCS J2185 | $173 | |
Methylprednisolone injection | HCPCS J2930 | $38 | |
Metoclopramide hcl injection | HCPCS J2765 | $12 | |
Morphine sulfate injection | HCPCS J2270 | $12 | |
Normal saline solution infus | HCPCS J7030 | $35 | |
Normal saline solution infus | HCPCS J7050 | $13 | |
Ondansetron hcl injection | HCPCS J2405 | $14 | |
Oral prescrip drug non chemo | HCPCS J8499 | $3 | |
Oxytocin injection | HCPCS J2590 | $11 | |
PROTONIX (PANTOPRAZOLE | HCPCS C9113 | $25 | |
Penicillin g benzathine inj | HCPCS J0561 | $306 | |
Phenytoin sodium injection | HCPCS J1165 | $11 | |
Piperacillin/tazobactam | HCPCS J2543 | $44 | |
Ppsv23 vacc 2 yrs+ subq/im | CPT 90732 | $179 | |
Prednisone ir or dr oral 1mg | HCPCS J7512 | $9 | |
Prochlorperazine injection | HCPCS J0780 | $69 | |
Promethazine hcl 12.5mg oral | HCPCS Q0169 | $4 | |
Promethazine hcl injection | HCPCS J2550 | $14 | |
Ranitidine hydrochloride inj | HCPCS J2780 | $49 | |
Regadenoson injection | HCPCS J2785 | $380 | |
Sincalide injection | HCPCS J2805 | $451 | |
Thiamine hcl 100 mg | HCPCS J3411 | $38 | |
Triamcinolone acet inj nos | HCPCS J3301 | $33 | |
Vancomycin hcl injection | HCPCS J3370 | $41 | |
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 | - | - |
Pulmonary Function |
Evaluation of wheezing | CPT 94060 | $329 | |
Measure blood oxygen level | CPT 94760 | $65 | |
Respiratory flow volume loop | CPT 94375 | $309 | |
Radiology |
X-Ray of lower back
(Not Offered) | CPT 72110 | - | - |
X-ray exam abdomen 1 view | CPT 74018 | $120 | |
X-ray exam abdomen 2 views | CPT 74019 | $159 | |
X-ray exam chest 1 view | CPT 71045 | $132 | |
X-ray exam chest 2 views | CPT 71046 | $152 | |
X-ray exam complete abdomen | CPT 74022 | $247 | |
X-ray exam l-s spine 2/3 vws | CPT 72100 | $169 | |
X-ray exam neck spine 2-3 vw | CPT 72040 | $161 | |
X-ray exam of pelvis | CPT 72170 | $136 | |
X-ray exam thorac spine 2vws | CPT 72070 | $166 | |
X-ray exam thorac spine 3vws | CPT 72072 | $206 | |
Respiratory |
Airway inhalation treatment | CPT 94640 | $209 | |
Chest wall manipulation | CPT 94667 | $83 | |
Insert emergency airway | CPT 31500 | $447 | |
Surgical Procedures |
Biopsy exam of esophagus, stomach or small bowel using an ... | CPT 43239 | $305 | |
Biopsy exam of large bowel using an endoscope
(Not Offered) | CPT 45380 | - | - |
Biopsy of prostate gland
(Not Offered) | CPT 55700 | - | - |
Diagnostic exam of esophagus, stomach or small bowel using... | CPT 43235 | $550 | |
Diagnostic exam of large bowel using an endoscope | CPT 45378 | $659 | |
Injection(s) of anesthetic into lower spine using imaging ...
(Not Offered) | CPT 64483 | - | - |
Injection(s) of therapeutic substance | CPT 62322 | $263 | |
Injection(s) of therapeutic substance
(Not Offered) | CPT 62323 | - | - |
Insert non-tunnel cv cath | CPT 36556 | $927 | |
Insertion of catheter into left heart for diagnosis
(Not Offered) | CPT 93542 | - | - |
Lap inc hernia repair | CPT 49654 | $1,862 | |
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 | $1,449 | |
Removal of one knee cartilage using an endoscope
(Not Offered) | CPT 29881 | - | - |
Removal of one or more breast growth, open procedure
(Not Offered) | CPT 19120 | - | - |
Removal of polyps or growths of large bowel using an endos...
(Not Offered) | CPT 45385 | - | - |
Removal of recurring cataract in lens capsule using laser
(Not Offered) | CPT 66821 | - | - |
Removal of tonsils and adenoid glands, patient younger tha...
(Not Offered) | CPT 42820 | - | - |
Repair of groin hernia patient age 5 years or older
(Not Offered) | CPT 49505 | - | - |
Rmvl devital tis 20 cm/< | CPT 97597 | $133 | |
Shaving of shoulder bone using endoscope
(Not Offered) | CPT 29826 | - | - |
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 | $76 | |
Uncategorized |
Immunization admin | CPT 90471 | $40 | |
Slings | HCPCS A4565 | $11 | |