Charges as of 5/26/2020

ROOM AND BOARD (PER DAY CHARGES)PRIVATE 1062.00SEMI-PRIVATE 1001.00OB 1001.00NURSERY 835.00BIRTHING ROOM 2671.00SWING BED - SEMI PRIVATE 1001.00SWING BED - PRIVATE 1062.00INTERMEDIATE ICU 1564.00

MEDICAL SURGICAL ADMINISTRATION FLU VACCINE 35ADMINISTRATION PNEUMONIA VACCI 35ARTHROCENTESIS/ASPIRATION/INJ; MAJOR JNT 603BLADDER SCAN 58BLOOD TRANSFUSION 1 UNIT 125BLOOD TRANSFUSION 2 UNITS 187BLOOD TRANSFUSION 3 UNITS 251BLOOD TRANSFUSION 4 UNITS 314BLOOD TRANSFUSION 5 UNITS 373BLOOD TRANSFUSION 6/+ UNITS 440BONE MARROW BX NONPRO FEE 160CENTRAL LINE PLACEMENT 1129CHEMO IM/SUBQ INJ HORMONAL 73CHEMO IM/SUBQ INJ NONHORMONAL 74CHEMO INTRAVENOUS PUSH EA ADDI 84CHEMO INTRAVENOUS PUSH SINGLE 84CHEMO IV INF >8 HRS REQ PUMP 859CHEMO IV INF UP TO 1 HR DIFFERENT 144CHEMO IV INFUSION EA ADDL HR 124CHEMO IV INFUSION UP TO 1 HR 145EA ADDIT SEQUENTIAL IV PUSH 94EA ADDIT SEQUENTIAL IV PUSH SAME DRUG 94EA ADDIT SEQUENTIAL IV PUSH SAME DRUG 94

FACILITY CHARGES

EST PT COMP/HIGH/40 MIN 142EST PT DET/MOD/25 MIN 123EST PT EXP FP/LOW/15 MIN 74EST PT MINIMAL 5 MIN 53EST PT PROB FOC/SF/10 MIN 64GYN EXAM 87HYDRATION THERAPY EA ADD HOUR 125HYDRATION THERAPY UP TO 1 HR 212IM INJECTION ANTIBIOTIC 89IMMUN/VACCINE ADMIN.EA ADDITIO 35IMMUN/VACCINE ADMINIS SINGLE 35INJECTION IM/SUBQ 38IV INFU ADD SEQ UP TO 1 HOUR 216IV INFUSION CONCURRENT 212IV INFUSION CONCURRENT 201IV THERAPY 1ST HOUR 212IV THERAPY EA ADD HR UP TO 8 125MIDLINE PLACEMENT 939OBSERVATION PER HOUR 42PAP 85PICC LINE PLACEMENT 1119PLATELET TRANSFUSION 1 10 UNIT 440PLATELET TRANSFUSION 10+ UNITS 697RECOVERY OUTPT 1 2 HRS 244RECOVERY OUTPT 3 5 HRS 409RECOVERY OUTPT 6+ HOURS 492THER PROPH DX INJ IV PUSH 1 89TREATMENT ROOM 15 MIN 84TREATMENT ROOM 30 MIN 165TREATMENT ROOM 45 MIN 249TREATMENT ROOM 60 MIN 331

SURGERY OR LEVEL 1 1771OR LEVEL 2 2811OR LEVEL 3 3734OR LEVEL 4 4558OR LEVEL 5 5682OR LEVEL 1 EACH ADDITIONAL 15 MINUTES 623OR LEVEL 2 EACH ADDITIONAL 15 MINUTES 812OR LEVEL 3 EACH ADDITIONAL 15 MINUTES 1052OR LEVEL 4 EACH ADDITIONAL 15 MINUTES 1329OR LEVEL 5 EACH ADDITIONAL 15 MINUTES 1727OR LEVEL 1 FIRST ADDTL PROCEDURE 428OR LEVEL 2 SECOND ADDTL PROCEDURE 428US GUIDE FOR NEEDLE BIOPSY 489OB ANESTHESIA FLAT RATE 348GENERAL ANESTHESIA FIRST 30 MINS 129GENERAL ANESTHESIA EA ADDITIONAL 15 MINS 39MAC ANESTHESIA FIRST 30 MINUTES 105MAC ANESTHESIA EACH ADDITIONAL 15 MINUTE 33

REGIONAL ANESTHESIA FIRST 30 MINUTES 78REGIONAL ANESTHESIA EA ADDITIONAL 15 MIN 27LOCAL ANESTHESIA FIRST 30 MINUTES 34LOCAL ANESTHESIA EACH ADDITIONAL 15 MINS 13RECOVERY RM FIRST 1/2 HR 736RECOVERY RM ADDITIONAL 15 MINUTES 357PAR PHASE II 337PAR PHASE II EXTENDED 99

EMERGENCY EMERGENCY RM LEVEL 1 176EMERGENCY RM LEVEL 2 307EMERGENCY RM LEVEL 3 483EMERGENCY RM LEVEL 4 739EMERGENCY RM LEVEL 5 1125ER LEVEL 6 EA ADDIT 30 MIN 441ER LEVEL 6 CRIT CARE 30 74 MIN 2374APP FINGER SPLINT;STATIC LT 2ND DIGIT 72APP FINGER SPLINT;STATIC LT 3RD DIGIT 72APP FINGER SPLINT;STATIC LT 4TH DIGIT 72APP FINGER SPLINT;STATIC LT 4TH DIGIT 72APP FINGER SPLINT;STATIC LT THUMB 72APP FINGER SPLINT;STATIC RT 2ND DIGIT 72APP FINGER SPLINT;STATIC RT 3RD DIGIT 72APP FINGER SPLINT;STATIC RT 4TH DIGIT 72APP FINGER SPLINT;STATIC RT 5TH DIGIT 72APP FINGER SPLINT;STATIC RT THUMB 72APP LONG ARM SPLINT (SHOULDER-HAND) LT 126APP LONG ARM SPLINT (SHOULDER-HAND) RT 126APP SHRT ARM SPLNT (FRAR-HAND);STATIC LT 85APP SHRT ARM SPLNT (FRAR-HAND);STATIC RT 85APPLICATION LONG LEG SPLINT LT 101APPLICATION LONG LEG SPLINT RT 101APPLICATION SHORT LEG SPLINT LT 106APPLICATION SHORT LEG SPLINT RT 106ARTHROCENTESIS/ASP/INJ MJR JNT B/L 952ARTHROCENTESIS/ASP/INJ MJR JNT LT 635ARTHROCENTESIS/ASP/INJ MJR JNT RT 635AVUL NAIL PLATE/PART-COMP/SIMP EA ADD 83AVULSION OF NAIL PLATE/PART/COMP SIM/SIN 158BLADDER IRRIGATION, SIMPLE, LAVAGE C/OR 127BLEP, DRAIN ABSCESS EYELID LOWER LEFT 195BLEP, DRAIN ABSCESS EYELID LOWER RIGHT 195BLEP, DRAIN ABSCESS EYELID UPPER RIGHT 195BLEP, DRAIN ABSCESS EYELID UPPER RIGHT 195BLOOD ADMIN 1 UNIT 131BLOOD ADMIN 2 UNITS 197BLOOD ADMIN 3 UNITS 265BLOOD ADMIN 4 UNITS 331BLOOD ADMIN 5 UNITS 394BLOOD ADMIN 6+ UNITS 464

CARDIOVERSION ELECTIVE 891CHANGE OF CYSTOSTOMY TUBE; SIMPLE 357CHANGE OF GASTROSTOMY TUBE PERCUTANEOUS 129CL TX DISTAL RADIOULNAR DSL W MAN LT 863CL TX DISTAL RADIOULNAR DSL W MAN RT 863CL TX ACETABULUM FX W/ MAN LT 877CL TX ACETABULUM FX W/ MAN RT 877CL TX ACETABULUM FX WO MANIPULATIONQ 968CL TX ANKLE DISLOCAT W ANESTHESIA LT 669CL TX ANKLE DISLOCAT W ANESTHESIA RT 669CL TX ANKLE DISLOCAT WO ANESTHESIA LT 669CL TX ANKLE DISLOCAT WO ANESTHESIA RT 669CL TX ART FX MTCRPPH OR INTER PHAL W MAN 561CL TX BIMALLEOLAR ANK FX WO MANIPULATION 418CL TX BIMALLEOLAR ANKLE FX W MANIPU BIL 1497CL TX BIMALLEOLAR ANKLE FX W MANIPU LT 749CL TX BIMALLEOLAR ANKLE FX W MANIPU RT 749CL TX DISTAL FIBULAR FX W MAN-LT 649CL TX DISTAL FIBULAR FX W MAN-RT 649CL TX DISTAL FIBULAR FX WO MANIPULATION 418CL TX DISTAL PHALANGEAL FX, WO MANIPULA 250CL TX DISTAL PHALANGEAL FX/FNG-THMB WOM 454CL TX DR FX/EPIPHY SEP/TX FX U STY WO/MA 387CL TX DRFX/EPIP SEP/FX ULNR STY/W MAN LT 1009CL TX DRFX/EPIP SEP/FX ULNR STY/W MAN RT 1009CL TX ELBOW DSLCT W/ ANESTH LT 5422CL TX ELBOW DSLCT W/ ANESTH RT 5422CL TX FEML FX W MAN W W/O SKTL TRCT B/L 2514CL TX FEML FX W MAN W W/O SKTL TRCT LT 1676CL TX FEML FX W MANIP W W/O SKTL TRCT RT 1676CL TX FEMORAL FX PROXIMAL END NECK WO MA 817CL TX FEMORAL SHAFT FX WO MANIPULATION 894CL TX FMRL FX DSTL END MDL/LAT CNDLE WOM 873CL TX FMRL FX DSTL END MED/LAT CNDL WMAN 1392CL TX FMRL FX PROXIMAL END HEAD WO MANIP 774CL TX FMRL SFT FX WMANP W WO SK/SKTL TRC 1615CL TX FX GRT TOE PHLX/PHLG W/MANJ LT 233CL TX FX GRT TOE PHLX/PHLG W/MANJ RT 233CL TX FX PHALANX NOT GREAT TOE W/ MAN 218CL TX FX WT BEARING TIBIA W/WO A WTRX MA 962CL TX HIP DISLOCAT TRAUMATIC W ANEST LT 744CL TX HIP DISLOCAT TRAUMATIC W ANEST RT 744CL TX HIP DISLOCAT TRAUMATIC WO ANEST LT 550CL TX HIP DISLOCAT TRAUMATIC WO ANEST RT 550CL TX HUM EPIC FX MED/LAT WO MANIPULATIO 414CL TX HUMERAL SHAFT FX; W/MAN;W W/O SK T 750CL TX INTERPHAL JNT DSLCT W/MAN ANES 469CL TX INTERPHALANGEAL JNT DSLCTN; WO ANT 185CL TX INTRPHLNGL JNT DSLCT SNG WMAN WOA 441CL TX KNEE DISLOCATION WO ANESTHESIA LT 839CL TX KNEE DISLOCATION WO ANESTHESIA RT 839CL TX MEDIAL MALLEOLUS FX WO MANIP 444

CL TX METACARPAL FX SING W/MANIP EA BONE 419CL TX METACARPAL FX, SNGL/WO MANIP EA BN 357CL TX MTACRPOPHALNGL DSLCT W/MAN ANES 537CL TX MTACRPOPHALNGL SIN;W MAN;WO ANEST 537CL TX MTP JNT DSLCTN W/O ANES 711CL TX OF CLAVICLE FX W/O MANIPULATION 307CL TX OF CLAVICLE FX WITH MANIPULATION 537CL TX OF FX OF GREAT TOE, PHALANX OR PHA 168CL TX OF FX, PHALAN X, OTHER THAN GR TOE 168CL TX OF HUMERAL EPIC FX MED/LAT W/MANIP 811CL TX OF HUMERAL SHAFT FX W/O MANIPULATI 475CL TX OF MEDIAL MALLEOLUS FX W/MAN W/WO 786CL TX OF SHOULDER DISLOCAT, WITH FX G LT 616CL TX OF SHOULDER DISLOCAT, WITH FX G RT 616CL TX OF ULNAR STYLOID FX B/L 1066CL TX OF ULNAR STYLOID FX LT 711CL TX OF ULNAR STYLOID FX RT 711CL TX PATELLAR DISLOCAT W ANESTHESIA LT 753CL TX PATELLAR DISLOCAT W ANESTHESIA RT 753CL TX PATELLAR DISLOCAT WO ANESTHESIA LT 559CL TX PATELLAR DISLOCAT WO ANESTHESIA RT 559CL TX PATELLAR FX WO MANIPULATION 420CL TX PELVIC RING FX DSLOC,DIAST,WO MANI 876CL TX PHALANGEAL SHAFT FX,PROXIMAL W/MAN 500CL TX POST HP ARTHRPLSTY DISLOC W/ANT LT 1119CL TX POST HP ARTHRPLSTY DISLOC W/ANT RT 1119CL TX POST HP ARTHRPLSTY DISLOC WO/AN LT 753CL TX POST HP ARTHRPLSTY DISLOC WO/AN RT 753CL TX POSTERIOR MALLEOLUS FX W MANIPLTN 720CL TX POSTERIOR MALLEOLUS FX WO MANIP 360CL TX PROXIMAL FIBULA.SHFT FX WO MANIP 392CL TX PROXIMAL HUMERUS FX W/MANJ 702CL TX PRX END ULNA W/DS RD HEAD W/MAN LT 1002CL TX PRX END ULNA W/DS RD HEAD W/MAN RT 1002CL TX RAD HD SBLXTN CHILD,NM ELB W/MANIP 174CL TX RAD HD SBLXTN CHILD,NM ELB W/MANIP 174CL TX RAD HEAD/NECK FX WITH MANIPULATION 645CL TX RADIAL & ULNAR SHAFT FX WO MANIPUL 360CL TX RADIAL HEAD/NECK FX W/O MANIPULATI 320CL TX RADIAL SHAFT FX WITH MANIPULATION 762CL TX RADIAL SHAFT FX WITHOUT MANIPULATI 361CL TX RADIAL/ULNAR SHAFT FX WITH MAN LT 819CL TX RADIAL/ULNAR SHAFT FX WITH MAN RT 819CL TX SHLDR DISLOCAT W/MAN W/ANES B/L 1002CL TX SHLDR DISLOCAT W/MAN W/ANES LT 668CL TX SHLDR DISLOCAT W/MAN W/ANES RT 668CL TX SHLDR DISLOCAT W/MAN W/O ANES B/L 982CL TX SHLDR DISLOCAT W/MAN W/O ANES LT 495CL TX SHLDR DISLOCAT W/MAN W/O ANES RT 495CL TX TARSOMETATARSAL JNT DSLCT W/ ANES 945CL TX TEMPOROMANDIBULAR DISLOCATION; INI 85CL TX TIBIAL FX PROXIMAL PLATEAU WO MANI 571

CL TX TIBIAL SHAFT FX W MANIPULATION 468CL TX TRIMALLEOLAR ANKLE FX WO MANIPULAT 425CL TX TRIMALLEOLOR ANKLE FX; W/MANIPU BL 1226CL TX TRIMALLEOLOR ANKLE FX; W/MANIPU LT 817CL TX TRIMALLEOLOR ANKLE FX; W/MANIPU RT 817CL TX ULNAR FX FX PROXIMAL W/MANIPULATIO 690CL TX ULNAR FX PROX WITHOUT MANIPULATION 374CL TX ULNAR SHAFT FX WITH MANIPULATION 751CL TX ULNAR SHAFT FX WO MANIPULATION 310CL TX W/MANIPULAT OF TIBIAL SHAFT W/F LT 755CL TX W/MANIPULAT OF TIBIAL SHAFT W/F RT 755CLOSED TX OF TALUS FX; WITH MANIPULATION 508CNTRL NASAL HEMORRHAGE ANTER CMPLX 50 368CNTRL NASAL HEMORRHAGE ANTER CMPLX LT 245CNTRL NASAL HEMORRHAGE ANTER CMPLX RT 245CNTRL NSL HMRRHG PSTR PACK/CAUT INITIAL 305COLLECTION OF BLOOD SPECIMAN VIA CATH 26CONTROL NASAL HEMORRHAGE ANTERIOR CMPLX 245CONTROL NASAL HEMORRHAGE ANTR SIMPLE BIL 279CONTROL NASAL HEMORRHAGE ANTR SIMPLE LT 186CONTROL NASAL HEMORRHAGE ANTR SIMPLE RT 186CONTROL NASAL HMRRHG PST SUBSEQ 295DEBRI;SKIN & SUBCUT TISSUE 1ST 20 SQ CM 114DEBRIDEMENT INCLUDING REMOVAL OF FOREIGN 602DEBRIDEMENT OF NAIL(S) BY ANY METHOD 1-5 46DRAIN ABSCESS CYST HEMATUMA FRM DENTOAL 184DRAIN EXT EAR ABSCESS/HEMATOMA COMPLICAT 316DRAIN/INJ INTMD JNT/BURSA W/US B/L 1214DRAIN/INJ INTMD JNT/BURSA W/US LT 810DRAIN/INJ INTMD JNT/BURSA W/US RT 810DRAIN/INJ MAJOR JNT/BURSA W/US B/L 1214DRAIN/INJ MAJOR JNT/BURSA W/US LT 810DRAIN/INJ MAJOR JNT/BURSA W/US RT 810DRAINAGE ABCS,CYST, HMTMA VST MTH SIMPLE 202DRAINAGE ABSCESS PALATE, UVULA 161DRAINAGE EXT EAR ABSCESS/HEMATOMA SIMPLE 320DRAINAGE OF FINGER ABSCESS; COMPLICATED 311DRAINAGE OF FINGER ABSCESS; SIMPLE 225DRESSING AND/OR DEBRIDEMENT OF PART-THIC 116EA ADDIT SEQUENTIAL IV PUSH 100EA ADDIT SEQUENTIAL IV PUSH SAME DRUG 100EMERGENCY RM - TRIAGE ONLY 71EVACUATION SUBUNGAL HEMATOMA 50EXC MALIGNANT LESION W/ MARGIN .5CM OR< 456EXCISION NAIL MATNX PERMANENT REMOVAL 272EXCISION OF PILONIDAL CYST/SINUS SIMPLE 379EXCISION OF THROMBOSED HEMORRHOID EXTERN 228EXCISION PILONIDAL CYST/SINUS COMPLICATE 1038EXCISION PILONIDAL CYST/SINUS EXTENSIVE 860EXPLOR OF PENETRATE WND ABD/FLANK/BACK 568EXPLORATION OF PENETRATING WND, CHEST 464EXPLORATION OF PENETRATING WND, NECK 862

EXPLORE PNTRATE WND EXTREMITY 575GASTRIC INTUBAT & ASPIRA W/PHYS SKILL/LA 64HEMORRHORDECTOMY INTERNAL BY LIGATION 267HYDRATION THERAPY EACH ADD HR 131HYDRATION THERAPY UP TO 1 HR 131I & D EPIDID/TSTIS 270I & D PERIANAL ABSCESS 172I&D DEEP ABSC/HEMA SOFT TISSUE NECK/THOR 558IMMUN/VACCINE ADMIN EA ADDIT 37IMMUN/VACCINE ADMIN ONE 37INCISION & DRAIN ABCESS;SIMPLE/SINGLE 249INCISION & DRAIN ABSCESS;COMPLICATE/MULT 300INCISION & DRAIN HEMATOMA,SEROMA/FLUID C 288INCISION & DRAIN PILONIDAL CYST/COMPLICA 354INCISION & DRAIN PILONIDAL CYST/SIMPLE 259INCISION & DRAINAGE OF BARTHOLIN GLAND 192INCISION & DRAINAGE OF ISCHIORECTAL/PERI 772INCISION & DRAINAGE OF VULVA PERINEAL AB 233INCISION & REMOVE FB/SUBCUT TISS/COMPL 365INCISION & REMOVE FB/SUBCUT TISS/SIMPLE 172INCISION THROMBOSED HEMORRHOID EXTERNAL 203INJ ANESTH AGT OTH PERIPHERAL NERVE BRNC 635INJ ANESTHETIC AGENT TRIGEMINAL NERVE 771INJECTION ANESTHETIC AGENT FACIAL NERVE 259INJECTION ANESTHETIC AGENT GREATER OCCIP 118INJECTION EPIDURAL BLOOD/CLOT PATCH 1661INJECTION IM/SUBQ 93INSERT NON-DWELLING BLADDER CATH STRAIT 72INSERT PICC W/ IMAGE GUIDE >5 YRS 2604INSERT TCICVC WO PRT/PMP >5 YRS 869INSERT TEMP INDWELLING BLADDER CATH SIMP 72INSERTION NTCICVC >5 YRS 366INSERTION OF PICC ACCESS DEVICE WITH 935INTRA ARTER INJ THER PROPH DIA 91INTUBATION ENDOTRACIAL ER PROCEDURE 309IV INFU ADD SEQ UP TO 1 HOUR 228IV INFUSION CONCURRENT 224IV THERAPY 1ST HOUR 224IV THERAPY EA ADD HR UP TO 8 131MOD SED SAME PHY ADDTL 15 MIN >5YRS 176MOD SED SAME PHY INIT 15 MIN >5YRS 265NSRT PICC WO SBCTNS PT/PMP >5 YRS 300OPEN TX OF INTERPHALANGEAL JNT DISLOCATI 918PLACEMENT OF NEEDLE FOR INTRAOSSEOUS INF 167PUNCTURE ASPIRATION OF ABSCESS, HEMATOMA 179REMOVAL FOREIGN BODY FOOT COMPLICATED LT 833REMOVAL FOREIGN BODY FOOT COMPLICATED RT 833REMOVAL FOREIGN BODY FOOT, DEEP 1011REMOVAL FOREIGN BODY FOOT, DEEP LT 674REMOVAL FOREIGN BODY FOOT, DEEP RT 674REMOVAL FOREIGN BODY, FT SUBCUTANEOUS LT 285REMOVAL FOREIGN BODY, FT SUBCUTANEOUS RT 285

REMOVAL OF FECAL IMPACTION/FOREIGN BODY 443REPAIR BLODD VESSEL, DIRECT; LOWER EXT 112REPAIR COMPLEX SCALP, ARMS, LEGS 2.6-7.5 658REPAIR NAIL BED 233REPAIR, EXTENSOR TENDON, PRIM OR SECOND 644REPLANTATION, DIGIT, EXCLUDING THUMB 248RMVL EMBED FOREIGN BODY EYELID LOW LT 193RMVL EMBED FOREIGN BODY EYELID LOW RT 193RMVL EMBED FOREIGN BODY EYELID UP LT 193RMVL EMBED FOREIGN BODY EYELID UP RT 193RMVL FB INTRANASAL OFC TYPE PROCEDURE 324RMVL FB WITH MUSCLE/TENDON SHEATH/SIMPLE 271RMVL FB, INTRAOCULAR; FROM ANTE CHAM LT 1054RMVL FB, INTRAOCULAR; FROM ANTER CHAM 50 1506RMVL FB, INTRAOCULAR; FROM ANTER CHAM RT 1054RMVL FORGN BDY EXT EYE CNJNCT SPRFCL 50 180RMVL FORGN BDY EXT EYE CNJNCT SPRFCL LT 120RMVL FORGN BDY EXT EYE CNJNCT SPRFCL RT 120RMVL FRGN BD EXT AUD CANAL W/O ANES B/L 337RMVL FRGN BD EXT AUD CANAL W/O ANES LT 225RMVL FRGN BD EXT AUD CANAL W/O ANES RT 225RMVL FRGN BD EXT EYE CRNL W SLT LMP 50 235RMVL FRGN BD EXT EYE CRNL W SLT LMP LT 156RMVL FRGN BD EXT EYE CRNL W SLT LMP RT 156RMVL FRGN BD EXT EYE CRNL WO SLT LMP 50 172RMVL FRGN BD EXT EYE CRNL WO SLT LMP LT 114RMVL FRGN BD EXT EYE CRNL WO SLT LMP RT 114RMVL IMPACT CERUMEN IRR/LVG BILAT 62RMVL IMPACT CERUMEN IRR/LVG UNILAT 41RMVL IMPACTED CERUMEN 1 OR BOTH EARS 89RMVL SKIN TAGS (FIRST 15) 555RMVL TNNLD CNTRL VN ACC DVC W/SBCTNS 603RPR CMPLX FCCMNAGHF 2.6-7.5 923RPR CMPLX FCCMNAGHF EA ADD 5CM< 329RPR COMPLEX E,N,E AND/OR L;EAC ADD 5CM< 331RPR COMPLEX EYELID/NOSE/EAR/LIP 2.6-7.5C 885RPR COMPLEX FCCMNAGHF 1.1-2.5CM 555RPR COMPLEX SAL EA ADD 5CM< 225RPR COMPLEX SCALP, ARMS, LEGS 1.1-2.5CM 459RPR COMPLX EYELID/NOSE/EAR/LIP 1.1-2.5CM 623RPR INTER WND FEENLM <2.5CM 358RPR INTER WND FEENLM >30.0CM 859RPR INTER WND FEENLM 12.6-20.0CM 638RPR INTER WND FEENLM 2.6-5.0CM 404RPR INTER WND FEENLM 20.1 - 30.0CM 754RPR INTER WND FEENLM 5.1-7.5CM 453RPR INTER WND FEENLM 7.6 - 12.5CM 499RPR INTER WND NHFG <2.5CM 343RPR INTER WND NHFG >30.00CM 670RPR INTER WND NHFG 12.6-20.0CM 525RPR INTER WND NHFG 2.6-7.5CM 396RPR INTER WND NHFG 20.1 - 30.0CM 613

RPR INTER WND NHFG 7.6-12.5CM 455RPR INTER WND SATE <2.5CM 312RPR INTER WND SATE >30.0CM 673RPR INTER WND SATE 12.6 - 20.0CM 495RPR INTER WND SATE 2.6 - 7.5CM 357RPR INTER WND SATE 20.1 - 30.0CM 585RPR INTER WND SATE 7.6 - 12.5CM 422RPR LAC => 2.5CM MOUTH FLR/TONGUE 273RPR LAC => 2.5CM MTH FLR/ PSTR TNG 649RPR LIP FULL THICKNESS HALF/<VERTICAL HE 615SHAVING OF EPIDERMAL/DERMAL LESION,<.5CM 75SIMP REPAIR SUPER WOUND FEENLM <2.5CM 256SIMP REPAIR SUPER WOUND FEENLM 2.6-5CM 288SIMP REPAIR SUPER WOUND FEENLM 5.1-7.5CM 357SIMP REPAIR SUPER WOUND SNGTE >30.0CM 593SIMP REPAIR SUPER WOUND SNGTE 20.1-30.CM 529SIMP REPAIR SUPER WOUND SNGTE 7.6-12.5CM 326SIMP RPR SPRFCL WND FEENLM >30.0CM 796SIMP RPR SPRFCL WND FEENLM 12.6-20CM 567SIMP RPR SPRFCL WND FEENLM 20.1-30CM 678SIMP RPR SPRFCL WND FEENLM 7.6-12.5CM 463SIMP RPR SUPER WOUND SNGTE 12.6 - 20CM 415SIMPLE REPAIR SUPER WOUND/SNGTHF<2.5CM 248SIMPLE REPAIR SUPER WOUNDS SNGTE 2.6-7.5 271SPINAL PUNCTURE LUMBAR DIAGNOSTIC 1661TEMP TRANSCUTANEOUS PACING 552THER PROPH DX INJ IV PUSH 1 93TRACHEOSTOMY, ER PRCDR; CRICOTHYROID MEM 512TRIGGER PT INJ 1 OR 2 MUSC GRP 635TRIGGER PT INJ 3 OR MORE MUSCLES 771TUBE THORACOSTOMY INCLUDE WATER SEAL 387TX CL ELBOW DISLOCAT; W/O ANESTHESIA LT 614TX CL ELBOW DISLOCAT; W/O ANESTHESIA RT 614TX SPRFCL WND DEHISCENCE;SIMP CLOSURE 380TX SPRFCL WND DEHISCENCES; W/ PACKING 270ULTRASONIC GUIDE NEEDLE PLACEMENT 506US ABDOMINAL REAL TIME LIMITED 507US CHEST/MEDIASTINUM REAL TIME 293US GUIDE VASC ACCESS 79US JOINT NONVAS EXT REAL TIME 278US LOWER EXTREMITY ARTERIES UNIL/LTD 506US PREG UTERUS REAL TIME LIMITED 355US PREG UTERUS REAL TIME TRANSVAG 664US RETROPERITONEAL REAL TIME LIMITED 507WEDGE EXCISION OF SKIN OF NAIL FOLD 104

NUTRITION SERVICESNUTRITION.THER.INITIAL INDIV. 64NUT THERAPY REASSESSMENT INDIV 29NUTRITION THERAPY GROUP 45NUT THERAPY REASSESSMENT-INDIV PER 15 MI 29

NUTRITION THERAPY-GROUP PER 30 MIN 45NUTRITION THER INITIAL-INDIV PER 15 MIN 64

LABORATORY 11-DESOXYCORTISOL 8417 HYDROXYPROGESTERONE SERUM 7517-HYDROXYPREGNENOLONE MS 1142 HOUR PPBS 6921 HYDROXYLASE ANTIBODIES 37124 HOUR CATECHOLAMINES URINE 9124 HR URINE PROTEIN 64ACE SERUM 94ACETAMINOPHEN 94ACETYICHDINE MODULATING ANTIBODIES 225ACETYICHOLINE BLOCKING ANTIBODIES 130ACETYLCHOLINE BINDING RECEPTOR 334ACID FAST CULTURE AND SMEAR 128ACID FAST SMEAR 37ACTH 170ACTIVATED PTT 57ADDERAL, URINE 286AEROBIC BLOOD CULTURE 108AEROBIC PEDIATRIC BLOOD CULTURE 108AEROBIC ROUTINE WITHOUT GRAM STAIN 139AFP MATERNAL ONLY 94AFP TUMOR MARKER 94ALBUMIN 71ALBUMIN CSF 58ALCOHOL ETHANOL SERUM 61ALCOHOL URINE 27ALDOLASE 82ALDOSTERONE BLOOD 162ALDOSTERONE/RENIN RATIO 211ALK PHOS ISOENZYME 137ALKALINE PHOSPHATASE 71ALLERGEN NUT PANEL 32ALPHA 1 ANTITRYPSIN 85ALPHA 1 ANTITRYPSIN PHENOTYPE 72ALPHA 1 ANTRYPSIN STOOL 85ALPHA 2 MACROGLOBULIN 293ALPHA GALACTOSE IGE 208ALTERNARIA 23AMINO ACID QUAL PROFILE 76AMINOLEVULINIC ACID ALA 103AMMONIA 75AMNISURE 127AMYLASE 77ANA 105ANA REFLEX IF POSITIVE 100ANAEROBE CULTURE 137ANDROSTENEDIONE 148

ANGIOTENSIN CONVERTING ENZYME CSF 94ANTI CENTROMERE 95ANTI DNA DOUBLE STRAND 85ANTI DNA SINGLE STRAND 35ANTI ENDOMYSIAL, IgA 58ANTI GLIADIN IGA 39ANTI GLIADIN IGG 39ANTI GLOMERULAR BASEMENT MEM. 96ANTI HISTONE 71ANTI JO 1 ANTIBODY 80ANTI MITOCHONDRIAL ANTIBODY QT 100ANTI MULLERIAN HORMONE 128ANTI PHOSPHOLIP IGG/IGM 81ANTI PS/PT ABS IGM 75ANTI RNP 100ANTI SMITH 48ANTI SMOOTH 69ANTI SSB 83ANTI-ADALIMUMAB ANTIBODY 48ANTIADRENAL ABS QUANTITATIVE 155ANTICARDIOLIPIN AB IGA, QN 95ANTICARDIOLIPIN AB IGG, QN 95ANTICARDIOLIPIN AB IGM,QN 95ANTICHROMETIN ANTIBODIES 67ANTINEUTROPHIL CYTOPLAMIC ANTIBODIES 503ANTIRIBOSOMAL P ANTIBODY 150ANTITHROMBIN ACTIVITY 299ANTITHROMBIN ANTIGEN 301APIXABAN 57APOLIPOPROTEIN A-1 60ARSENIC WHOLE BLOOD 60ASO TITER 100ASPERGILLUS ANTIBODY 38ATOPOBIUM VAGINAE 132B PERTUSSIS AND B PARAPERTUSSIS PCR 144B PERTUSSIS IGA AB 274B PERTUSSIS IGG AB 274B TYPE NATRIURETIC PEPTIDE 215BASIC METABOLIC PANEL 82BB ANTIBODY SCREEN 95BB COMPATIBILITY IS 36BB COOMBS DIRECT 80BB CROSSMATCH 95BB FETAL SCREEN MATERNAL 77BB KLEIHAUER BETKE 94BB PLASMA FF THAWINGEACH 29BB PLASMA FRESH FROZEN 140BB PLT PHERESIS IRRADIATED 1054BB PLT PHERESIS LEUKO RED IRRADIA 1254BB PLT PHERESIS LEUKO REDUCED 1234BB PRBC LEUKO REDUCED 307BB PRBC LEUKO REDUCED IRRADIATED 384

BB RH FACTOR 34BB TYPE 77BCR/ABL1 MAJOR BREAKPOINT (PATHOLOGY) 656BCR/ABL1 MINOR BREAKPOINT (PATHOLOGY) 579BECKMAN ASSAY COMPREHENSIVE THYROGLOBULI 72BETA 2 GLYCOPROTEIN IGA 95BETA 2 GLYCOPROTEIN IGG 95BETA 2 GLYCOPROTEIN IGM 95BETA 2 MICROGLOBULIN SERUM 64BETA HCG QUANT 141BETA HCG TUMOR MARKER 100BETA HYDROXYBUTYRATE 37BHCG SERUM, QUALITATIVE PREGNANCY 105BILE ACIDS TOTAL 45BILIRUBIN DIRECT 71BILIRUBIN NEONATAL 85BILIRUBIN TOTAL 71BIOTINIDASE 127BK Virus BY PCR 461BLASTOMYCES ANTIBODY 38BODY FLUID ALBUMIN 26BODY FLUID AMYLASE 37BODY FLUID CELL COUNT 34BODY FLUID GLUCOSE 26BODY FLUID PROTEIN 26BONE MARROW 211BONE MARROW CELL BLOCK 384BONE MARROW DECALCIFICATION 32BONE MARROW PERIPHERAL SMEAR 32BONE MARROW SMEAR INTERP 58BORDETELLA PERTUSIS BY PCR 140BORDETELLA PERTUSUS IGM 69BREAST IMMUNOASSAY 383BRUCELLA IgG ANTIBODY 70BRUCELLA IgM ANTIBODY 70BUN 69BUPRENORPHINE URINE 458BVAB-2 132C ALBICANS + C GLABRATA, NAA 264C DIFF PCR 416C DIFFICILE TOXIN A/B 71C ESTERASE INHIBITOR 38C PEPTIDE 64C1 FUNCTION 280C1Q QUANTITATIVE 48C2 COMPLEMENT 38C201-IGE CEPHALOSPORIN-DRUG 32C3 COMPLEMENT 53C4 COMPLIMENT 61CA 15 3 42CA 27.29 75CA19 9 46

CADMIUM BLOOD 47CALCIUM IONIZED 60CALCIUM TOTAL 71CALCIUM URINE 24 HOUR 53CALPROTECTIN 305CANCER ANTIGEN 125 116CAPILLARY PUNCTURE HEEL/FINGE 34CARBAMAZEPINE FREE 112CARBON DIOXIDE 71CARBON MONOXID QUANT 58CARCINEOMBRYO ANTIGEN CEA 133CAT SCRATCH PANEL 44CATECHOLAMINES FRACTIONATION 24 HR UR 170CATECHOLAMINES PLASMA 98CBC WITH DIFF 85CBC, W/O DIFF 42CBC/DIFF and PLATELET 86CELIA Comprehen-gladin,tTG,IgA,edomysial 260CELIAC DX PROFILE 98CELIAC SCREEN (includes gliadin,tTG IgA) 75CELL COUNT SEROUS FLUID 112CELL CT SYNOVIAL W/O CRYSTALS 180CERULOPLASMIN 60CH50 COMPLEMENT 59CHLAMYDIA DNA (in-house testing) 71CHLAMYDIA APTIMA PROBE 75CHLAMYDIA PNEUMONIAE IGA 109CHLAMYDIA PNEUMONIAE IgG 109CHLAMYDIA PNEUMONIAE IGM 104CHLAMYDIA PNEUMONIAE, AMPLIFIED PROBE 140CHLAMYDIA TRACHOMATIS IgG 109CHLORIDE 46CHLORIDE URINE 48CHOLESTEROL 69CHROMIUM BLOOD 249CHROMOGRANIN A 189CITRIC ACID, URINE 24 HOUR 154CLONAZEPAM LEVEL URINE 70CLOTEST (HELICOBACTER PYLORI) 43CMV IGM 43CMV PCR QUAL 350CMV QUAN DNA PCR PLASMA 161CMV QUAN DNA PCR URINE 637COCCIDIOIDES ANTIBODY 38COMPREHENSIVE METABOLIC PANEL 151COOMBS DIRECT (LAB CORP) 80COPPER PLASMA 100COPPER URINE 44CORDARONE 243CORTISOL 102CORTISOL 3 SPECIMENS 139CORTISOL AM 102

CORTISOL DEXAMETHASONE REFLEX 73CORTISOL PM 100CORTISOL URINE 77CORTISONE SERUM 326COVID19 300CPK ISOENZYMES 72CPK MB 65CPK/CKI TOTAL 48CREATINE URINE 43CREATININE 71CREATININE URINE 24 HOUR 94CREATININE URINE RANDOM 31CRP 80CRP CARDIAC RISK/HIGH SENS 80CRYPTOSPORIDIUM ANTIGEN 119CRYSTAL ID BY POLARIZED LIGHT 41CSF IGG INDEX 177CSF IGG SYNTHESIS RATE 170CSF/ BF CULTURE 149CYCLIC CITRULLINATED PEPTIDE 182CYCLOSPORIN LEVEL 105CYSTATIN C 71CYSTIC FIBROSIS PANEL 1 178CYSTINE 24 HR URINE QUANT. 207CYTOCHROME P450 2D6 GENO 1831CYTOMEGALOVIRUS CMV 80CYTOMEGALOVIRUS DNA CMV 158CYTOPATH CELL BLOCK 371CYTOPATH OTHER SOURCE PREP 131D DIMER QUANTITATIVE 83D002-IGE D FARINAE 32DEPAKENE 103DEXAMETHASONE 127DHEA 139DHEA S 136DIGOXIN 114DILANTIN FREE/TOTAL 50DILANTIN, TOTAL 102DILUTE PROTHROMBIN TIME 37DIPSTICK URINE 8DIPTHERIA ANTIBODY 91DIRECT LDL CHOLESTEROL 64DRUG SCREEN 13 W/CONF WB 508DRUG SCREEN 16 W/REFLEX WHOLE BLOOD 501DRUG SCREEN SERUM MULTIPLE 542DRUGS OF ABUSE 10 SERUM 485E001-IGE CAT DANDER 32E005-IGE DOG DANDER 32E072-IGE MOUSE URINE 32ELECTROLYTE PANEL 48ELECTROPHORESIS HEMOGLOBIN 141ELECTROPHORESIS PROTEIN SERUM 46

ELECTROPHORESIS PROTEIN URINE,RANDOM 69ENCEPHALITIS CALIFORNIA/LACROSS 71ENCEPHALITIS EASTERN EQUINE IgG/IgM 71ENCEPHALITIS ST LOUIS IgG/IgM 71ENCEPHALITIS WESTERN EQUINE IgG/IgM 129ENTEROVIRUS PCR 447EOSIN URINE 8EOSINOPHIL COUNT 21EPSTEIN BARR EA IGG 77EPSTEIN BARR QUANT BY PCR 494EPSTEIN BARR VCA IgG 75EPSTEIN BARR VCA IgM 75EPSTEIN-VARR VIRUS NUCLEAR ANTIGEN ANTIB 50ERYTHROPOETEIN 80ESR SED RATE AUTOMATED 47ESTRADIOL 43ESTRADIOL (SENSITIVE) 64ESTRIOL 176ESTROGENS TOTAL SERUM 253EXL TROPONIN QUANT 114F002-IGE MILK 32F004-IGE WHEAT 32F008-IGE CORN 32F013-IGE PEANUT 32F013-IGG4 PEANUT 23F014-IGE SOYBEAN 32F017-IGE HAZELNUT/FILBERT 32F018-IGE BRAZIL NUT 32F020-IGE ALMOND 32F023-IGE CRAB 32F024-IGE SHRIMP 32F026-IGE PORK 32F027-IGE BEEF 32F044-IGE STRAWBERRY 32F080-IGE LOBSTER 32F093-IGE CHOCOLATE/CACAO 32F201-IGE PECAN NUT 32F202-IGE CASHEW NUT 32F203-IGE PISTACHIO NUT 32F207-IGE CLAM 32F245-IGE EGG, WHOLE 32F253-IGE PINON (PINE NUT) 32F256-IGE WALNUT FOOD 32F290-IGE OYSTER 32F299-IGE SWEET CHESTNUT 32F338-IGE SCALLOP 32F352-IGE ARA H 8 67F422-IGE ARA H 1 67F423-IGE ARA H 2 67F424-IGE ARA H 3 67F427-IGE ARA H 9 67FACTOR 8 INHIBITOR 499

FACTOR II ACTIVITY 72FACTOR INHIBITOR 75FACTOR V ACTIVITY 155FACTOR V MUTATION 229FACTOR VII ACTIVITY 114FACTOR VIII ACTIVITY 148FACTOR VIII vWF ANTIGEN 190FACTOR VIII vWF MULTIMETRIC ANALYS 46FACTOR XII ACTIVITY 229FACTOR-VON WILLEBRAND PROFILE 252FATS FECES QUALITATIVE 35FECAL IMMUNOCHEMICAL TEST 102FECAL WBCS 58FERRITIN 85FETAL FIBRONECTIN 421FIBRINOGEN 94FILMARRAY BLOOD CULTURE ID 1896FINGER STICK GLUCOSE 15FK506 402FLOW CYTOMETRY INTERPRET 9 15 MARKERS 64FLUORESCENT ANTIBODY 137FOLATE SERUM FOLIC ACID 102FOLLICLE STIM HORMONE FSH 86FRACTIONATED ESTROGEN 355FRAGILE X DNA SCREEN (PRENATAL) 278FREE FATTY ACID TOTAL 72FREE LIGHT CHAINS,SERUM 132FROZEN SECTION 111FROZEN SECTION MULTIPLE 41FUNGAL ANTIBODIES 41FUNGAL CULTURE/SMEAR 139FUNGAL SMEAR 29FUNGUS CULTURE SKIN,HAIR,NAILS 207FX02-IGE FOOD MIX (SEAFOODS) 32G002-IGE BERMUDA GRASS 32G008-IGE BLUEGRASS, KENTUCKY 32G6PD QUANTITATIVE 48GABAPENTIN SERUM 163GAD ANTIBODY 140GALACTOSE 1 PHOS.-URIDYL QUANT 176GASTRIN 113GC 71GC PROBE, APTIMA 75GC BY DNA 77GC DNA (in house testing) 71GENERAL HEALTH PANEL 367GENITAL CULTURE 218GENTAMICIN 128GENTAMICIN PEAK 128GENTAMICIN RANDOM 128GENTAMICIN TROUGH 128GGT 71

GIARDIA ANTIGEN 119GLUCOSE 69GLUCOSE BODY FLUID 50GLUCOSE SPINAL FLUID 80GLUCOSE TOLERANCE 1 HR 136GLUCOSE TOLERANCE 2 HR 136GLUCOSE TOLERANCE 3 HR 286GLUTEN SENSITIVITY CASCADE TEST 122GONADOTROPIN-RELEASING HORMONE 380GRAM STAIN BLD/CSF 29GROUP A STREP CULTURE 21GROUP B BETA STREP + RFLX 36GROWTH HORMONE 43H. PYLORI AG STOOL 105H. PYLORI BREATH TEST 303HAPTOGLOBIN 64HCV RNA BY PCR QN REX GENOTYPING 496HCV RNA PCR QL (RFX TO QUANT) 560HELICOBACTER IGA ONLY 96HELICOBACTOR IGG ONLY 96HELICOBACTOR, IGM ONLY 96HEMATOCRIT 43HEMOCHROMATOSIS PANEL 197HEMOGLOBIN 43HEMOGLOBIN A1C GLYCOHEMOGL 76HEPARIN ANTI FACTOR Xa 181HEPARIN ASSOCIATED ANTIBODY 359HEPATIC FUNCTION PANEL 98HEPATIC/RENAL COMBO PANEL 98HEPATITIS A ANTIBODY 148HEPATITIS A ANTIBODY IGM 75HEPATITIS ACUTE SCREEN 213HEPATITIS B ANTIGEN SURFACE 20HEPATITIS B CORE, IgM ANTIBODY 75HEPATITIS B CORE, TOTAL ANTIBODY 85HEPATITIS B REAL TIME PCR 177HEPATITIS B SURFACE AB QUAL 49HEPATITIS B SURFACE AB QUANT 70HEPATITIS B SURFACE ANTIBODY 47HEPATITIS BE ANTIBODY 47HEPATITIS BE ANTIGEN 75HEPATITIS C AMPLIFICATION 86HEPATITIS C ANTIBODY 75HEPATITIS C ANTIBODY WITH REFLEX TO VERI 71HEPATITIS C GENOTYPING 603HEPATITIS C NUCLEIC ACID ISOLATION 86HEPATITIS C PCR/RNA QUAL 589HEPATITIS C PCR/RNA, VIRAL LOAD 640HEPATITIS C RNA QUALITATIVE 314HEPATITIS C RNA QUANT/VIRAL 522HEPATITIS E ANTIBODY 43HERPES CULTURE 235

HERPES I AND 2 IGM SPLIT 41HERPES I IgG 41HERPES II IgG 97HERPES II IgM 97HERPES SIMPLEX BY PCR 211HERPES SIMPLEX VIRUS TYPE 2 IGG SPECIFIC 41HISTOPLASMA ANTIBODY 38HISTOPLASMA ANTIGEN URINE 189HISTOPLASMA SERUM ANTIGEN 177HIV 1 IMMUNOASSAY 159HIV RNA REAL TIME PCR 288HIV Screen 4th Gen wRfx 105HIV,QUANTITATIVE PCR,graph 299HLA B27 103HLA B51 518HOMOCYSTINE PLASMA 68HOMOCYSTINE URINE 209HPA-1A (PLA1 PLT AG) GENO 551HSV CULTURE WITH TYPING 44HSV TYPE 1 IGG SPECIFIC ANTIBODIES 29HUMAN PAPILLOMA VIRUS HIGH RISK 227HUMIRA / ADALIMUMAB 57HUNTINGTON DX MUTATION 540HYDROCODONE, URINE 157IGA 34IGE 98IgFBP 3 181IGG 43IgG SUBCLASSES 1 2 3 4 103IGM 34IMMUNO ELECTROPHORESIS SERUM 162IMMUNO ELECTROPHORESIS SP FL 98IMMUNO ELECTROPHORESIS URINE 145IMMUNOHISTOCHEMICAL STAIN 197IMMUNO-REACTIVE TRYPSIONOGEN 76INFLUENZA A/B ANTIGEN, NASAL 80INFLUENZA B ANTIGEN 80INHIBIN A 408INJECTION IM/SUBQ 92INSITU HYDRID FISH EA ADDTL (PATH) 574INSITU HYDRID FISH INITIAL (PATH) 574INSULIN AUTO ANTIBODY 155INSULIN FREE AND TOTAL 36INSULIN LIKE GROWTH FACTOR I 107INSULIN TOTAL 37INTERPRETATION AND REPORT 48INTRINSIC ANTIBODY 203IODINE BLOOD 82IRON 85IRON BINDING CAPACITY (TIBC) 88JC VIRUS 539K082-IGE LATEX 32

KEPPRA 157KOH PREP 42LACTIC ACID 44LACTOFERRIN 98LAMICTAL LTG 153LDH / LDI 46LDH ISOENZYMES 105LEAD 24 URINE 55LEAD ADULT 96LEAD PEDIATRIC 96LEGIONELLA URINE, ANTIGEN 111LIPASE 72LIPID PANEL 96LIPOPROTEIN A 180LITHIUM 94LIVER-KIDNEY MICROSOMAL ANTIBODY 29LUPUS ANTICOAGULANT 210LUTENIZING HORMONE LH 155LYMES DISEASE ANTIBODIES 76LYMES DISEASE ANTIBODY WITH REFLEX TO WE 72LYMES DISEASE BY PCR CSF OR WHOLE BLOOD 407LYMES DISEASE WESTERN BLOT SERUM 181LYSOSOMAL ACID LIPASE (LAL) 447LYSOZYME MURAMIDASE 60M006-IGE ALTERNARIA ALTERNATA 32MAGNESIUM 44MAGNESIUM URINE 24 HOUR 58MATERNIT21 PLUS CORE 2311MEGASPHAERA 132MERCURY 24 URINE 73MERCURY BLOOD 116METANEPHRINES 24HR URINE QUAN 162METANEPHRINES PLASMA 294METHANOL 71METHEMOGLOBIN - HGB, BLOOD 34METHYLMALONIC ACID SERUM QUANT 149METHYLPHENIDATE, URINE 308MIXING STUDIES PT 42MIXING STUDIES PTT 42MOLECULAR DIAG AMPLIFICATION 98MOLECULAR DIAG EXTRACTION 34MONO QUALITATIVE WITH REFLEX 260MONO TEST 77MRSA MSSA CULTURE 89MTHFR MOLECULAR DIAG PANEL 197MUMPS IgG IMMUNE STATUS 94MUMPS IgG/IgM ANTIBODIES 80MYCOPLASM PNEUMONIA IgG 59MYCOPLASMA PNEUMOMNIAE IGM 38MYCOPLASMA PNEUMONIAE, AMPLIFIED PROBE 140MYELIN BASIC PROTEIN 64MYOGLOBIN URINE 65

MYOGLOBIN SERUM 59NMR 141NSA NEUTROPHIL SPECIFIC ANTIB 77NUCLEIC ACID 1ST 2 13OCCULT BLOOD SLIDES 1 3-CANCER SCREENING 46OCCULT BLOOD-OTHER THAN CANCER SCREENING 46OLIOGCLONAL BANDING 85OPIATES 1 OR MORE CONFIRMATION URINE 250ORGANIC ACID, QUAL PROFILE 143ORGANISM ID, BACTERIA 67OSMOLALITY BLOOD 105OVA AND PARASITES 116OXALATE URINE 24 HOUR 80OXYCODONE QUANT SERUM W/CONFI 301OXYCODONE QUANT URINE 128PANCREATIC ELASTASE 1 312PARANEOPLASTIC PROFILE 1 434PARASITE ID, WORM 149PARATHORMONE N 249PARATHYROID RELATED PEPTID HOR 82PCR 36PCR HEP C INTERPRETATION 86PHENOBARBITAL 102PHOSPHADITYLSERINE IgG,IgM,IgA 256PHOSPHATIDYLETHANOL 117PHOSPHOLIPID 128PHOSPHORUS 71PHOSPHORUS URINE 24 HOUR 43PIN 4 405PLASMINOGEN ACTIVATOR INHIBITO 282PLATELET (ALLO) ANTIBODY PROFILE 314PLATELET COUNT AUTOMATED 47PLATLET AB AUTO 308PORPHOBILINOGEN RANDOM URINE 41POTASSIUM 46POTASSIUM URINE 46POTASSIUM URINE 24 46PR3 ANTIBODIES 96PRE-ALBUMIN 46PREGNANCY URINE 105PRENATAL PROFILE 141PROCALCITONIN 202PROGESTERONE SERUM 100PROINSULIN 75PROLACTIN 180PROTEIN C ACTIVATED RESISTANCE 80PROTEIN C ANTIGEN 321PROTEIN C FUNCTIONAL ACTIVITY 91PROTEIN ELECTROPHORESIS 24 HOUR URINE 69PROTEIN S ANTIGEN/TOTAL/FREE 267PROTEIN S FREE 58PROTEIN S FUNCTIONAL 111

PROTEIN SPINAL FLUID 36PROTHROMBIN MUTATION 154PROTHROMBIN TIME 32PSA DIAGNOSTIC 159PSA FREE (INCLUDES TOTAL) 133PSA SCREENING 159QUANTIFERON TB GOLD PLUS 91RA FACTOR (rheumatoid factor) 38RAPID STREP SCREEN 110RAPUMUNE 182RAST ALLERGEN 34RBC MAGNESIUM 14REFERENCE GRAM STAIN 30REFLEX HEPATITIS SCREEN W/HCV 213RENAL CALCULUS ANALYSIS 288RENAL FUNCTION PANEL 79RENAL/HEPATIC COMBO PANEL 79RENIN 149RENIN RATIO 211RESPIRATORY VIRAL PANEL, PCR 1667RETICULOYCTE COUNT 44RHEUMATOID ARTHRITIS 53RHOGAM 332RICKETTSI ANTIBODIES 79RISPERDAL/RISPERDONE 180RIVAROXABAN (XARELTO) 245ROCKY MOUNTAIN FEVER IgG 80ROCKY MOUNTAIN FEVER IGM 80ROMA TESTING 662ROTA VIRUS 61RPR 35RPR REFLEX CONFIRM 19RSV RESP. SYNCYTIAL VIRUS 85RUBELLA 77RUBEOLA IgG 77RUBEOLA IGM 73RUSSELL VIPER DILUTE 36SALICYLATE 100SALIVARY CORTISOL FREE 291SCLERODERMA AB SCI 70 37SCREENING OCCULT BLOOD-CANCER SCREENING 46SELENIUM 249SENSITIVITY MIC 39SEPERATION, HIGH RESOLUTION 66SEPTIN 9 GENE METHYLATION 191SEROTONIN SERUM 94SEX HORMONE BINDING GLOBULIN 183SGOT AST 69SGPT ALTI 65SICKLE CELL SCREEN 75SJOGREN'S ANTI-SSA 83SKIN SCRAPING ECTOPARASITE 97

SMITH/RNP ANTIBODIES 67SMN1 ANALYSIS 556SODIUM 46SODIUM RANDOM URINE 86SODIUM URINE 24 HR 60SPECIAL STAIN GROUP 1 250SPECIAL STAIN GROUP 2 212SPERM COUNT POST VASECTOMY 71SPINAL FLUID CELL COUNT 35SPUTUM CULTURE with Gram Stain 139STOOL CULTURE 149STREP GROUP B CULTURE 40SUBSEQUENT IMMUNOHISTOCHEMICAL STAIN 207SURG PATH G AND M EXAM LEVEL 2 190SURG PATH G AND M EXAM LEVEL 3 213SURG PATH G AND M EXAM LEVEL 4 335SURG PATH G AND M EXAM LEVEL 5 441SURG PATH G AND M EXAM LEVEL 6 601SURG PATH GROSS LEVEL 1 76SUSCEPTIBILITY AEROBIC + ANAEROBIC 38SYNOVIAL CELL CT W/CRYSTALS 264T CELL ABSOLUTE CD4 COUNT 119T CELLS ABSOLUTE CD4/CD8 W/RAT 461T007-IGE OAK, WHITE 32T008-IGE AMERICAN ELM 32T3 FREE TRIODOTHYRONINE 139T3 REVERSE 58T3 TOTAL 76T3 UPTAKE 86T4 94T4 FREE 83T4 FREE DIALYSIS 83TEGRETOL CARBAMAZEPINE 75TESTOSTERONE FREE(includes Total) 110TESTOSTERONE TOTAL 94TETANUS ANTIBODY 60TGAB + THYROGLOBULIN 246THEOPHYLLINE 64THERAPEUTIC PHLEBOTOMY 41THIN PREP NON GYN 224THIN PREP PAP 129THROMBIC RISK PROFILE COMPREHENSIVE 3060THROMBOPLASTINS INHIB TISSUE 293THYROGLOBULIN 77THYROGLOBULIN ANTIBODY 75THYROID ANTIBODY 128THYROID PEROXIDASE 120THYROID PEROXIDASE ANTIBODIES 128THYROID STIMULATING IMMUNOGLO 171THYROTROPIN RECEPTOR AB 16THYROXINE BINDING GLOBULIN 74TISSUE TRANSGLUTAMINASE IGA ONLY 98

TOBRAMYCIN 137TOBRAMYCIN PEAK 138TOBRAMYCIN TROUGH 138TOPIRAMATE 108TOTAL PROTEIN 69TOTAL PROTEIN BODY FLUID 46TOUCH PREP ADDITIONAL SITE 69TOUCH PREP INITIAL SITE 111TOX 1 - DRUG SCREEN, PRESUMPTIVE, CHEM A 218TOX 10 BUPRENORPHINE 26TOX 11 COCAINE 26TOX 12 FENTANYL 26TOX 13 GABAPENTIN, NON BLOOD 26TOX 14 KATAMINE / NORKETAMINE 26TOX 15 METHADONE 26TOX 16 METHYLENEDIOXYAMPHETAMINES 26TOX 17 METHYLPHENIDATE 26TOX 18 OPIATES, 1 OR MORE 26TOX 19 OPIOIDS / OPIATE ANALOGS 5 OR MOR 26TOX 2 AMPHETAMINES, 5 OR MORE 26TOX 20 OXYCODONE 26TOX 21 PREGABALIN 26TOX 22 PROPOXYPHENE 26TOX 23 SEDATIVE HYPNOTICS (NON BENZODIAZ 26TOX 24 SKELETAL MUSCLE RELAXANTS 3 OR MO 26TOX 25 STIMULANTS, SYNTHETIC 26TOX 26 TAPENTADOL 26TOX 27 TRAMADOL 26TOX 28 DRUGS/SUBSTANCES DEFINITIVE 7 OR< 26TOX 29 PHENCYCLIDINE (PCP) 26TOX 3 ANALGESICS, 6 OR MORE 26TOX 30 AMPHETAMINES 1 OR 2 26TOX 4 ANTIDEPRESSANTS SEROTON 6 OR MORE 26TOX 5 ANTIDEPRESSANTS TRICYCLI 6 OR MORE 26TOX 6 ANTIDEPRESSANTS, NOT SPECIFIED 26TOX 7 ANTIEPILEPTICS NOT SPECI 7 OR MORE 26TOX 8 ANTIPSYCHOTICS NOT SPECI 7 OR MORE 26TOX 9 BENZODIAZEPINES 1-12 26TOXOPLASMA IGG 111TOXOPLASMA IGM 111TPMT ENZYME ACTIVIITY 247TRANSFERRIN 71TREPONEMA PALLIDUM ANTIBODIES 50TRICHOMONAS VAGINALIS 70TRICHROME STAIN O AND P 90TRIGLYCERIDES 71TRILEPTAL OXYCARBAZEPIME 129TRYPTASE 171TSH 3RD GENERATION 145TSH RECEPTOR ANTIBODY 84TSH THYROID STIM HORMONE 84U-CORD 14 PANEL 493

UPPER RESPIRATORY CULTURE 96URIC ACID 71URIC ACID URINE 24 HOUR 44URINALYSIS NO MICRO 38URINALYSIS, W/MICROSCOPY 65URINE RANDOM IMMUNO ELECT/PROTEIN 111URINE CATECHOLAMINES RANDOM 96URINE CREATININE CLEARANCE 94URINE CULTURE 65URINE DRUG SCREEN STAT 183URINE MICROALBUMIN QUANT 58URINE OSMOLALITY 105URINE PORPHYRINS RANDOM 64URINE RANDOM PROTEIN 64VALPROIC ACID 81VANCOMYCIN 100VANCOMYCIN TROUGH 100VANILLYLMANDELIC ACID 24 HOUR URINE 100VARICELLA ZOSTER IGG IMMUNE 80VARICELLA ZOSTER IGM 38VARICELLA ZOSTER VIRUS BY PCR 206VASOPRESSIN LEVEL ADH 46VDRL CSF 32VDRL SERUM 31VENI PUNCTURE 22VENIPUNCTURE 26VIRAL CULTURE RAPID RESPIRATORY 131VIRAL CULTURE, GENERAL 136VISCOSITY 37VITAMIN A RETINOL 42VITAMIN B1 Whole Blood 128VITAMIN B12 94VITAMIN B2 RIBOFLAVIN 119VITAMIN B5 52VITAMIN B6 86VITAMIN B7 145VITAMIN D 1,25 DIHYDRO 183VITAMIN D 25 HYDROXY 135VITAMIN E 203VITAMIN K 167VMA URINE RANDOM 105VOLATILES BLOOD or URINE 48VWF ACTIVITY 145W001-IGE D PTERONYSSINUS 32W001-IGE RAGWEED, SHORT 32W009-IGE PLANTAIN, ENGLISH 32WBC DIFFERENTIAL 58WEST NILE IGG,IGM SERUM 61WEST NILE IGM SERUM 61WET MOUNT 58WHITE BLOOD COUNT 36YERSINA 44

ZINC 48ZONEGRAM 170ZYPREXA 224

PHYSICAL THERAPYPT ADL TRNG EA 15 MIN 87PT ASST TCH ASMNT EA15M 208PT BWC WRK HRD/COND 15 MIN EA 38PT CANALITH REPOSITIONING PROCEDURE 117PT COMM/WRK REINTIG/15M 137PT DIATHERMY 91PT ELEC STIM (SUPV) 121PT ELEC STIM EA 15M 148PT ESTIM(SUPV) SEP SITE 91PT EVAL PT-HIGH COMPLEXITY 261PT EVAL PT-LOW COMPLEXITY 259PT EVAL PT-MODERATE COMPLEXITY 252PT EX (THER)EA15M SEP 110PT EX (THERA) EA 15 MIN 123PT GRP THER (2 OR MORE) 99PT GT TRNG EA 15 MIN 89PT IONTO EA 15 MIN 86PT LASER 135PT LASER THERAPY 80PT MAN TECH W/MASS/15M 124PT MASSAGE Q 15 MIN 114PT MOLD & FIT SUPPORT 84PT NEUROMUSC RE-ED/15M 116PT ORTHTIC EVAL/15 MIN 141PT PARAFFIN BATH 114PT PRFRMNC TEST W/WRITTEN REPORT/15 MINS 101PT PRSTHTC TRNG Q15M 86PT RE-EVAL PT 110PT SENS INTEGR TCH/15M 137PT TENS TX SUPV 163PT THERAPEUTIC ACT/15M 158PT TRACTION MECH 158PT TRACTION MECH 158PT US EA 15 MIN 148PT VASOPNEUMATIC DEVICE 66PT WHLCHAIR MGMT/15M 77PT WRK HRD/COND/EACH ADDL HR 302PT WRK HRD/RCN INTL 2H 285WOUND DEBRID 238WOUND DEBRID 20 CM 218

SPEECH THERAPYST ASSMT OF APHASIA/HR 351ST AUDIO SCREENING 50ST BHVRL & QLTV ANLYSS VOICE & RESONANCE 259

ST COGN RETRG ADDTL15 MIN 62ST COGN RETRG INITIAL 15 MIN 62ST EV SPCH DEV/ADDT 30M 128ST EVAL OF VCE PRSTHTC 366ST EVAL SPCH DVC 1ST HR 606ST MBS 309ST NASOPHARYNGOSCOPY W/SCOPE 300ST NEUROBEH TSTG INTERP/REP/HR 337ST REMVL IMPCTD CERUMEN 160ST SPCH EVAL OF SPEECH FLUENCY 259ST SPCH EVAL SND PRDCTN W/LNG CMP EX 366ST SPCH EVAL SOUND PRODUCTION 366ST SPCH GRP THER/15 MINS 86ST SPCH THER 143ST SWALL EVAL 252ST SWALL THER 143ST TRNG&FTTNG SPCH GEN 299

OCCUPATIONAL THERAPYOT ADL TRAINING EA 15 MIN 88OT BWC WRK HRD/RCN 15 MIN EA 38OT COMM/WRK REINTIG/15M 137OT ELEC STIM CNSTNT/15M 148OT ESTIM SUPV 121OT EVAL OT HIGH COMPLEXITY 261OT EVAL OT LOW COMPLEXITY 261OT EVAL OT MODERATE COMPLEXITY 261OT EX (THERA) EA 15 MIN 114OT GT TRNG EA 15 MIN 89OT IONTO EA 15 MIN 87OT LASER THERAPY 34OT MYOFACL REL/15M 116OT NEUROMUSC RE-ED/15M 116OT ORTHOTIC EVALUATION 142OT ORTHTC TRNG Q 15M 84OT PARAFFIN BATH 116OT PRFRMNC TEST W/WRITTEN REPORT/15 MINS 101OT PRSTHTC TRNG Q 15 M 86OT RE EVAL OT 110OT SENS INTEGR TCH/15M 129OT THERAPEUTIC ACT/15M 158OT US EA 15 MIN 148OT WHLCHAIR MGMT/15M 77OT WRK HRD/RCN INTL 2H 285OT WRK HRD/RCN/ADDL HR 288WOUND DEBRID 238

RADIOLOGYAAS 362ABD 1V 256

ABD 2V 320ABD 3V OR > 457ARTHRO INJ ELBOW BILAT 333ARTHRO INJ ELBOW LT 221ARTHRO INJ ELBOW RT 221ARTHRO INJ HIP BILAT 331ARTHRO INJ HIP LT 227ARTHRO INJ HIP RT 227ARTHRO INJ KNEE BILAT 246ARTHRO INJ KNEE LT 163ARTHRO INJ KNEE RT 163ARTHRO INJ SHOULDER BILAT 249ARTHRO INJ SHOULDER LT 165ARTHRO INJ SHOULDER RT 165ARTHRO INJ WRIST BILAT 364ARTHRO INJ WRIST LT 243ARTHRO INJ WRIST RT 243BE 497BE W/ AIR 497BE W/ GASTROGRAFIN 497BONE AGE STUDIES 693BONE LENGTH 302BONE SURVEY COMPLETE 672CERVICAL SPINE 1V 279CERVICAL SPINE 2-3V 256CERVICAL SPINE 4 OR 5 VIEW 490CERVICAL SPINE 6V OR > 525CHEST 1V 205CHEST 2V 219CHEST 3V 232CHEST 4V OR MORE 256CHEST PORTABLE 1V 205CHOL/T TUBE 318CHOL/T TUBE INTRAOP 161CHOL/T TUBE INTRAOP ADDITIONAL 161CONTRAST 310CONTRAST OMNIPAQUE 240 10ML 310CONTRAST OMNIPAQUE 300 100ML 310CONTRAST OMNIPAQUE 350 100ML 310CONTRAST OMNIPAQUE 350 50ML 310CONTRAST OMNIPAQUE 350 75ML 310CREATININE CLEARANCE 76CYSTOGRAM MIN 3V 343DEXA HFV 155DEXA SPINE/HIPS 537ERCP 610ESOPHOGRAM 310EXT AC JTS BILAT 249EXT ANKLE 1V BILAT 178EXT ANKLE 1V LT 103EXT ANKLE 1V RT 103EXT ANKLE 2V BILAT 228

EXT ANKLE 2V LT 153EXT ANKLE 2V RT 153EXT ANKLE MIN 3V BILAT 283EXT ANKLE MIN 3V LT 210EXT ANKLE MIN 3V RT 210EXT CALCAN MIN 2V BILAT 283EXT CALCAN MIN 2V LT 194EXT CALCAN MIN 2V RT 194EXT CLAVICLE BILAT 283EXT CLAVICLE LT 194EXT CLAVICLE RT 194EXT ELBOW 2V BILAT 275EXT ELBOW 2V LT 148EXT ELBOW 2V RT 148EXT ELBOW MIN 3V BILAT 283EXT ELBOW MIN 3V LT 194EXT ELBOW MIN 3V RT 194EXT FEMUR 1V BILAT 221EXT FEMUR 1V LT 140EXT FEMUR 1V RT 140EXT FEMUR 2V BILAT 408EXT FEMUR 2V LT 292EXT FEMUR 2V RT 292EXT FINGER MIN 2V BILAT 332EXT FINGER(S) MIN 2V LT 232EXT FINGER(S) MIN 2V RT 232EXT FOOT 2V BILAT 235EXT FOOT 2V LT 197EXT FOOT 2V RT 197EXT FOOT MIN 3V BILAT 320EXT FOOT MIN 3V LT 295EXT FOOT MIN 3V RT 295EXT FOREARM 1V BILAT 187EXT FOREARM 1V LT 103EXT FOREARM 1V RT 103EXT FOREARM 2V BILAT 283EXT FOREARM 2V LT 205EXT FOREARM 2V RT 205EXT HAND 2V BILAT 249EXT HAND 2V LT 232EXT HAND 2V RT 232EXT HAND 3V BILAT 345EXT HAND 3V LT 295EXT HAND 3V RT 295EXT HIP 1V LT 122EXT HIP 1V RT 122EXT HIP 2-3V LT 269EXT HIP 2-3V RT 269EXT HUMERUS MIN 2V BILAT 345EXT HUMERUS MIN 2V LT 230EXT HUMERUS MIN 2V RT 230EXT KNEE 1-2V BILAT 438

EXT KNEE 1-2V LT 292EXT KNEE 1-2V RT 292EXT KNEE 3V BILAT 323EXT KNEE 3V LT 256EXT KNEE 3V RT 256EXT KNEE 4V OR > BIL 469EXT KNEE 4V OR > LT 399EXT KNEE 4V OR > RT 399EXT KNEE BILAT STANDING AP 279EXT LOW INFANT MIN 2V BILATERAL 334EXT LOW INFANT MIN 2V LT 222EXT LOW INFANT MIN 2V RT 222EXT SC JOINTS MIN 3 VIEWS 249EXT SCAPULA BILAT 283EXT SCAPULA LT 205EXT SCAPULA RT 205EXT SHOULDER 1V BIL 283EXT SHOULDER 1V LT 205EXT SHOULDER 1V RT 205EXT SHOULDER 2V BIL 283EXT SHOULDER 2V LT 231EXT SHOULDER 2V RT 231EXT SHOULDER 3V BIL 395EXT SHOULDER 3V LT 261EXT SHOULDER 3V RT 261EXT SHOULDER 4V OR > RT 295EXT SHOULDER 4V OR MORE BILAT 444EXT SHOULDER 4V OR MORE LT 295EXT TIB/FIB 1V BILAT 302EXT TIB/FIB 1V LT 201EXT TIB/FIB 1V RT 201EXT TIB/FIB 2V BILAT 329EXT TIB/FIB 2V LT 219EXT TIB/FIB 2V RT 219EXT TOE(S) MIN 2V BILAT 146EXT TOE(S) MIN 2V LT 232EXT TOE(S) MIN 2V RT 232EXT UP INFANT MIN 2V BILAT 334EXT UP INFANT MIN 2V LT 222EXT UP INFANT MIN 2V RT 222EXT WRIST 1V BILAT 221EXT WRIST 1V LT 109EXT WRIST 1V RT 109EXT WRIST 2V BILAT 250EXT WRIST 2V LT 232EXT WRIST 2V RT 232EXT WRIST MIN 3V BILAT 323EXT WRIST MIN 3V LT 256EXT WRIST MIN 3V RT 256FACIAL BONES < 3V 241FACIAL BONES MIN 3V 256FLUORO CONTRAST INJ PORT 662

FLUORO FOR CENTRAL VENOUS ACCESS DEVICE 527FLUORO FOR SPINAL INJECTION 81FLUORO GUID INJ 537FLUORO W/ RAD 527FLUORO W/O RAD 527HIP/SHOULDER/KNEE JOINT INJECTION BILAT 682HIP/SHOULDER/KNEE JOINT INJECTION LT 665HIP/SHOULDER/KNEE JOINT INJECTION RT 665INJ CYSTO/VOIDING URETHROCYSTO 896INJ FOR HSG 135INJ PROCEURE FOR CT MYELOGRAM 239INJECTION HIP BILAT 537INJECTION HIP LT 537INJECTION HIP RT 537INJECTION KNEE BILAT 537INJECTION KNEE LT 537INJECTION KNEE RT 537INJECTION SHOULDER BILAT 537INJECTION SHOULDER LT 537INJECTION SHOULDER RT 537IVP 497LUMBAR SPINE 1V 279LUMBAR SPINE 2 OR 3V 362LUMBAR SPINE MIN 4V 403MANDIBLE <4V 221MASTOIDS MIN 3V 250MODIFIED VIDEO SWALLOW 310NASAL BONES MIN 3V 167NECK ST 2V 210ORBIT < 4V BILAT - OPTIC FORAMINA 363ORBIT < 4V LT - OPTIC FORAMINA 194ORBIT < 4V RT - OPTIC FORAMINA 194ORBIT FOREIGN BODY 253ORBIT MIN 4V BILAT 355ORBIT MIN 4V LT 222ORBIT MIN 4V RT 222PELVIS AND HIP 1V LT 413PELVIS AND HIP 1V RT 413PELVIS AND HIP 2-3V LT 413PELVIS AND HIP 2-3V RT 413PELVIS AND HIPS 2V BILAT 275PELVIS AP 1 OR 2V 189PELVIS COMPLETE MIN 3V 283PERC DRAIN ABSC 711RETRO.PYELOGRAM W/ OR W/O KUB 343RIBS 2V LT 256RIBS 2V RT 256RIBS 3V BILAT 302RIBS W/ PA CXR MIN 4V BILAT 283RIBS W/PA CXR MIN 3V LT 320RIBS W/PA CXR MIN 3V RT 320SAC/COCCYX MIN 2V 350

SALPINGOGRAM 403SBFT 620SCOLIOSIS SERIES 1V 379SCOLIOSIS SERIES 2-3V 457SI JTS MIN 3V 275SINUS <3V 249SINUS MIN 3V 256SKULL < 4V 189SKULL MIN 4V 269SMALL INTESTINE FOLLOW-THRU STUDY 309SPINAL PUNCTURE DIAG 1606SPINAL PUNCTURE THERAPEUTIC 1606STERNUM MIN 2V 256THORACIC SPINE 2v 210THORACIC SPINE MIN 4V 263TMJ BILAT 552TMJ LT 279TMJ RT 279UGI W/ AIR 403UGI W/O AIR 405VAGINOGRAM 329VCU 355

COMPUTERIZED TOMOGRAPHY (CT)CT 3D RENDER 1 940CT ABD HEMANGIOMA PROTOCOL WWO 1912CT ABD W 1535CT ABD WO 1278CT ABD WWO 1912CT ABD/PEL W 3022CT ABD/PEL WO 2208CT ABD/PEL WWO 2933CT ABDOMEN BIOPSY 2557CT ADRENAL PROTOCOL WO 1278CT ADRENAL PROTOCOL WWO W/DELAY 1912CT ANKLE BILAT W 1945CT ANKLE BILAT WO 2918CT ANKLE BILAT WWO 2779CT ANKLE LT W 1375CT ANKLE LT WO 1375CT ANKLE LT WWO 1668CT ANKLE RT W 1668CT ANKLE RT WO 1375CT ANKLE RT WWO 1668CT ARTHRO ELBOW BILAT 1726CT ARTHRO ELBOW LT 992CT ARTHRO ELBOW RT 992CT ARTHRO HIP BILAT 4260CT ARTHRO HIP LT 4260CT ARTHRO HIP RT 4260CT ARTHRO KNEE BILAT 4260

CT ARTHRO KNEE LT 1040CT ARTHRO KNEE RT 1040CT ARTHRO SHOULDER BILAT 1726CT ARTHRO SHOULDER LT 2485CT ARTHRO SHOULDER RT 2485CT ARTHRO WRIST BILAT 1040CT ARTHRO WRIST LT 2485CT ARTHRO WRIST RT 1040CT CALCIUM SCORING 99CT CERVICAL SP WWO 1945CT CERVICAL SPINE W 1644CT CERVICAL SPINE WO 1278CT CHEST HIGH RESOLUTION 1278CT CHEST W 1375CT CHEST WO 1278CT CHEST WWO 1510CT CLAVICLE BILAT W 2498CT CLAVICLE BILAT WO 1807CT CLAVICLE LT W 1668CT CLAVICLE LT WO 1278CT CLAVICLE LT WWO 1945CT CLAVICLE RT W 1668CT CLAVICLE RT WO 1278CT CLAVICLE RT WWO 1945CT ELBOW BILAT W 2498CT ELBOW BILAT WO 1807CT ELBOW LT W 1668CT ELBOW LT WO 1278CT ELBOW LT WWO 1945CT ELBOW RT W 1668CT ELBOW RT WO 1278CT ELBOW RT WWO 1945CT FACIAL BONES W 1644CT FACIAL BONES WO 1644CT FACIAL BONES WWO 1912CT FEMUR BILAT W 1945CT FEMUR BILAT WO 2918CT FEMUR BILAT WWO 2779CT FEMUR LT W 1375CT FEMUR LT WO 1375CT FEMUR LT WWO 1668CT FEMUR RT W 1668CT FEMUR RT WO 1375CT FEMUR RT WWO 1668CT FOOT BILAT W 1945CT FOOT BILAT WO 2918CT FOOT BILAT WWO 2779CT FOOT LT W 1375CT FOOT LT WO 1375CT FOOT LT WWO 1668CT FOOT RT W 1668CT FOOT RT WO 1375

CT FOOT RT WWO 1668CT FOREARM BILAT W 2498CT FOREARM BILAT WO 1807CT FOREARM LT W 1668CT FOREARM LT WO 1278CT FOREARM LT WWO 1945CT FOREARM RT W 1668CT FOREARM RT WO 1278CT FOREARM RT WWO 1945CT GUIDANCE FOR CYST ASPIRATIO 1577CT HAND BILAT W 2498CT HAND BILAT WO 1807CT HAND LT W 1668CT HAND LT WO 1278CT HAND LT WWO 1945CT HAND RT W 1668CT HAND RT WO 1278CT HAND RT WWO 1945CT HEAD OR BRAIN W 1668CT HEAD OR BRAIN WO 1278CT HEAD OR BRAIN WWO 1912CT HIP BILAT W 1945CT HIP BILAT WO 2918CT HIP BILAT WWO 2779CT HIP LT W 1375CT HIP LT WO 1375CT HIP LT WWO 1668CT HIP RT W 1668CT HIP RT WO 1375CT HIP RT WWO 1668CT HUMERUS BILAT W 2498CT HUMERUS BILAT WO 1807CT HUMERUS LT W 1668CT HUMERUS LT WO 1278CT HUMERUS LT WWO 1945CT HUMERUS RT W 1668CT HUMERUS RT WO 1278CT HUMERUS RT WWO 1945CT KNEE BILAT W 1945CT KNEE BILAT WO 2918CT KNEE BILAT WWO 2779CT KNEE LT W 1375CT KNEE LT WO 1375CT KNEE LT WWO 1668CT KNEE RT W 1668CT KNEE RT WO 1375CT KNEE RT WWO 1668CT LIVER BIOPSY 2557CT LIVER MULTIPHASE 1912CT LUMBAR SP WWO 1912CT LUMBAR SPINE W 1668CT LUMBAR SPINE WO 1375

CT LUNG BIOPSY 2557CT MAXILLOFACIAL W 1644CT MAXILLOFACIAL WWO 1912CT ORBIT SELLA POS.FOSSA WO 1250CT ORBIT SELLA POS.FOSSA WWO 1530CT ORBIT SELLA W 1375CT OUT/MID/IN EAR WO 1375CT PANCREAS WWO W/DELAY 1912CT PELVIC BIOPSY 2557CT PELVIS W 1442CT PELVIS WO 1241CT PELVIS WWO 1375CT RENAL BIOPSY 2557CT RENAL PROTOCOL WWO 1912CT SHOULDER BILAT W 2498CT SHOULDER BILAT WO 1807CT SHOULDER LT W 1668CT SHOULDER LT WO 1278CT SHOULDER LT WWO 1945CT SHOULDER RT W 1668CT SHOULDER RT WO 1278CT SHOULDER RT WWO 1945CT SINUSES W 1644CT SINUSES WO 1644CT SINUSES WWO 1912CT SOFT TISSUE NECK W 1644CT SOFT TISSUE NECK WO 1375CT SOFT TISSUE NECK WWO 1912CT STONE SEARCH 2415CT TEMPORAL BONES W 1375CT TEMPORAL BONES WO 1250CT TEMPORAL BONES WWO 1530CT THORACIC SP WWO 1945CT THORACIC SPINE W 1668CT THORACIC SPINE WO 1278CT TIB/FIB BILAT W 1945CT TIB/FIB BILAT WO 2918CT TIB/FIB BILAT WWO 2779CT TIB/FIB LT W 1375CT TIB/FIB LT WO 1375CT TIB/FIB LT WWO 1668CT TIB/FIB RT W 1668CT TIB/FIB RT WO 1375CT TIB/FIB RT WWO 1668CT WRIST BILAT W 2498CT WRIST BILAT WO 1807CT WRIST LT W 1668CT WRIST LT WO 1278CT WRIST LT WWO 1945CT WRIST RT W 1668CT WRIST RT WO 1278CT WRIST RT WWO 1945

CTA ABD W 1644CTA ABD WWO 2279CTA ABD/PEL W 2329CTA CAROTIDS W 3119CTA CHEST PE W 1644CTA CHEST WWO 2279CTA HEAD/BRAIN W 1679CTA LOW BILAT EXT W/ IV CONTRAST W/PP 265CTA LOW LT EXT W/ IV CONTRAST W/PP 265CTA LOW RT EXT W/ IV CONTRAST W/PP 265CTA RUN OFF W 2557CTA UPPER EXTREMITY W 2345

MAMMOGRAPHYMAMMO BILAT BREAST NL--INITIAL LESION 739MAMMO BR XR TISSUE SPEC 124MAMMO BREAST NL --ADDITIONAL LESION 456MAMMO BREAST NL LT--INITIAL LESION 456MAMMO BREAST NL RT-INITIAL LESION 456MAMMO DIG 2V LT 212MAMMO DIG 2V RT 212MAMMO DIG DIAG BILAT 350MAMMO DIG SC MAST LT 218MAMMO DIG SC MAST RT 218MAMMO DIG SCREEN 4V 218MAMMO TOMO DIAG BILAT 80MAMMO TOMO DIAG LT 80MAMMO TOMO DIAG RT 80MAMMO TOMO SCREEN BILAT 80MAMMO TOMO SCREEN LT 80MAMMO TOMO SCREEN RT 80

ULTRASOUNDUS 4D/3D 99US AAA SCREENING 490US ABD COMP 711US ABD LTD 490US AORTA 490US AXILLA BILAT 492US AXILLA LT 328US AXILLA RT 328US BLADDER PRE/POST VOID 189US BPP 480US BPP EACH ADDITIONAL GESTATION 455US BREAST COMP BILAT 609US BREAST COMP LT 323US BREAST COMP RT 323US BREAST LTD BILAT 320US BREAST LTD LT 213US BREAST LTD RT 213

US BREAST/AXILLA BIOPSY LT 489US BREAST/AXILLA BIOPSY RT 489US BX AXILLARY LT 5583US BX AXILLARY RT 5583US BX INGUINAL LT 5583US BX INGUINAL RT 5583US BX SOFT TISSUE ABD 863US ELASTO 1ST LESION 497US ELASTO EA ADDL LESION 249US FOR POSITION DET/EXT VERSIO 343US GUIDANCE (OR) TC ONLY 362US GUIDANCE AMNIO 460US GUIDE FOR NEEDLE BIOPSY 489US LIVER ELASTOGRAPHY 497US NEEDLE LOC ADDITIONAL LESION 464US NEEDLE LOC BREAST BILATERAL 695US NEEDLE LOC BREAST LT 464US NEEDLE LOC BREAST RT 464US OB >14 WKS ADDITIONAL GEST 641US OB >14 WKS SINGLE 641US OB 1ST TRIMESTER <14 WKS ADDITIONAL G 641US OB 1ST TRIMESTER <14 WKS SINGLE 641US OB F/U 349US OB F/U EACH ADDITION FETUS 349US OB LTD - 1 OR MORE FETUSES 370US PARACENTESIS W/ IMAGE GUIDE 3092US PELVIS 611US PELVIS LIMITED OR FOLLOW UP 605US RENAL/BLADDER 505US SCROTUM 605US SOFT TISSUE ABD 490US SOFT TISSUE BACK UPPER 283US SOFT TISSUE CHEST 283US SOFT TISSUE HEAD 605US SOFT TISSUE LOW EXT LT 269US SOFT TISSUE LOW EXT RT 269US SOFT TISSUE NECK 605US SOFT TISSUE UPP EXT LT 269US SOFT TISSUE UPP EXT RT 269US THORACENTESIS W/ IMAGE GUIDE 2517US THYROID 605US THYROID FNA BIOPSY 2352US THYROID FNA BIOPSY ADDTL LESION 1176US TRANSVAGINAL NON OB 605US TRANSVAGINAL OB 641

POSITRON EMISSION TOMOGRAPHY (PET)PET SCAN SKULL TO MID THIGH 4027PET SCAN WHOLE BODY 4027FDG-18 135

MAGNETIC RESONANCE IMAGING (MRI)MRA ABD W/ 2485MRA ABD W/O 2485MRA ABD W/WO 2819MRA BRAIN W/ 2485MRA BRAIN W/O 2485MRA BRAIN W/WO 2485MRA CHEST W/ 2485MRA CHEST W/O 2485MRA CHEST W/WO 2819MRA LOW EX BILAT W/ 3559MRA LOW EX BILAT W/O 2485MRA LOW EX BILAT W/WO 2819MRA LOW EX LT W/ 2485MRA LOW EX LT W/O 2485MRA LOW EX LT W/WO 2485MRA LOW EX RT W/ 2485MRA LOW EX RT W/O 2485MRA LOW EX RT W/WO 2485MRA NECK W/ 2485MRA NECK W/O 2485MRA NECK W/WO 2485MRA PELVIS W/ 2485MRA PELVIS W/O 2485MRA PELVIS W/WO 2485MRA SPINE W/ 2485MRA UP EX BI W/ 2819MRA UP EX LT W/ 2485MRA UP EX RT W/ 2485MRCP 2485MRI ABD W/ 2485MRI ABD W/O 2485MRI ABD W/WO 2485MRI ANKLE BILAT W/ 2819MRI ANKLE BILAT W/O 2819MRI ANKLE BILAT W/WO 2819MRI ANKLE LT W/ 2485MRI ANKLE LT W/O 2485MRI ANKLE LT W/WO 2485MRI ANKLE RT W/ 2485MRI ANKLE RT W/O 2485MRI ANKLE RT W/WO 2485MRI ARTHRO ELBOW BILAT 1726MRI ARTHRO ELBOW LT 992MRI ARTHRO ELBOW RT 992MRI ARTHRO HIP BILAT 4260MRI ARTHRO HIP LT 2912MRI ARTHRO HIP RT 2912MRI ARTHRO KNEE BILAT 4260MRI ARTHRO KNEE LT 1040MRI ARTHRO KNEE RT 2485

MRI ARTHRO SHOULDER BILAT 1726MRI ARTHRO SHOULDER LT 2912MRI ARTHRO SHOULDER RT 2912MRI ARTHRO WRIST BILAT 4260MRI ARTHRO WRIST LT 2485MRI ARTHRO WRIST RT 2485MRI BRAIN (W/STEM) W/ 2485MRI BRAIN (W/STEM) W/O 2485MRI BRAIN (W/STEM) W/WO 2819MRI BRAIN IAC W/WO 2819MRI BRAIN SELLA W/WO 2819MRI CERVICAL W/ 2485MRI CERVICAL W/O 2485MRI CERVICAL W/WO 2819MRI CHEST W/ 2485MRI CHEST W/O 2485MRI CHEST W/WO 2485MRI CONTRAST EOVIST 280MRI CONTRAST PROHANCE 10ML 280MRI CONTRAST PROHANCE 15ML 280MRI CONTRAST PROHANCE 20ML 280MRI ELBOW BILAT W/ 2398MRI ELBOW BILAT W/O 2398MRI ELBOW BILAT W/WO 2485MRI ELBOW LT W/ 2012MRI ELBOW LT W/O 2012MRI ELBOW LT W/WO 2485MRI ELBOW RT W/ 2012MRI ELBOW RT W/O 2012MRI ELBOW RT W/WO 2485MRI FEMUR BILAT W/ 2819MRI FEMUR BILAT W/O 2819MRI FEMUR BILAT W/WO 2415MRI FEMUR LT W/ 2485MRI FEMUR LT W/O 2485MRI FEMUR LT W/WO 2415MRI FEMUR RT W/ 2485MRI FEMUR RT W/O 2485MRI FEMUR RT W/WO 2415MRI FOOT BILAT W/ 2819MRI FOOT BILAT W/O 2819MRI FOOT BILAT W/WO 2819MRI FOOT LT W/ 2485MRI FOOT LT W/O 2485MRI FOOT LT W/WO 2485MRI FOOT RT W/ 2485MRI FOOT RT W/O 2485MRI FOOT RT W/WO 2485MRI FOREARM BILAT W/ 2819MRI FOREARM BILAT W/O 2819MRI FOREARM BILAT W/WO 2819MRI FOREARM LT W/ 2485

MRI FOREARM LT W/O 2485MRI FOREARM LT W/WO 2415MRI FOREARM RT W/ 2485MRI FOREARM RT W/O 2485MRI FOREARM RT W/WO 2415MRI HAND BILAT W/O 2398MRI HAND BILAT W/WO 2485MRI HAND LT W/ 2012MRI HAND LT W/O 2012MRI HAND LT W/WO 2485MRI HAND RT W/ 2012MRI HAND RT W/O 2012MRI HAND RT W/WO 2485MRI HIP BILAT W/ 2819MRI HIP BILAT W/O 2819MRI HIP BILAT W/WO 2819MRI HIP LT W/ 2485MRI HIP LT W/O 2485MRI HIP LT WWO 2485MRI HIP RT W/ 2485MRI HIP RT W/O 2485MRI HIP RT W/WO 2485MRI HUMERUS BILAT W/ 2819MRI HUMERUS BILAT W/O 2819MRI HUMERUS BILAT W/WO 2819MRI HUMERUS LT W/ 2485MRI HUMERUS LT W/O 2485MRI HUMERUS LT W/WO 2415MRI HUMERUS RT W/ 2485MRI HUMERUS RT W/O 2485MRI HUMERUS RT W/WO 2415MRI KNEE BILAT W/ 2819MRI KNEE BILAT W/O 2819MRI KNEE BILAT W/WO 2819MRI KNEE LT W/ 2485MRI KNEE LT W/O 2485MRI KNEE LT W/WO 2485MRI KNEE RT W/ 2485MRI KNEE RT W/O 2485MRI KNEE RT W/WO 2485MRI LUMBAR W/ 2485MRI LUMBAR W/O 2485MRI LUMBAR W/WO 2819MRI ORB,FACE,NK W/ 2485MRI ORB,FACE,NK W/O 2485MRI ORB,FACE,NK W/WO 2485MRI PELVIS W/ 2683MRI PELVIS W/O 2485MRI PELVIS W/WO 2819MRI SHOULDER BILAT W/ 2398MRI SHOULDER BILAT W/O 2398MRI SHOULDER BILAT W/WO 2485

MRI SHOULDER LT W/ 2012MRI SHOULDER LT W/O 2012MRI SHOULDER LT W/WO 2485MRI SHOULDER RT W/ 2012MRI SHOULDER RT W/O 2012MRI SHOULDER RT W/WO 2485MRI THORACIC W/ 2485MRI THORACIC W/O 2485MRI THORACIC W/WO 2819MRI TIB/FIB BILAT W/ 2819MRI TIB/FIB BILAT W/O 2819MRI TIB/FIB BILAT W/WO 2415MRI TIB/FIB LT W/ 2485MRI TIB/FIB LT W/O 2819MRI TIB/FIB LT W/WO 2415MRI TIB/FIB RT W/ 2485MRI TIB/FIB RT W/O 2485MRI TIB/FIB RT W/WO 2415MRI TMJ 2012MRI WRIST BILAT W/ 2398MRI WRIST BILAT W/O 2398MRI WRIST BILAT W/WO 2485MRI WRIST LT W/O 2012MRI WRIST LT W/WO 2485MRI WRIST LT WITH 2012MRI WRIST RT W/O 2012MRI WRIST RT W/WO 2485MRI WRIST RT WITH 2012MRV BRAIN W/O 2485MRV BRAIN W/WO 2485

NUCLEAER RADIOLOGY CARDIOL.SESTAMIBI Tc99m 2 DOSE 914CARDIOLITE DIAGNOSTIC INJECTIO 1023CERETEC INJECTION 2230I 123 CAPSULES 360NM BONE/JOINT IMAG 3 PHASE 777NM BONE/JOINT IMAG. WHOLE BODY 704NM BONE/JOINT IMAGE LIMITED AREA 704NM BONE/JT IMAGE TOMOGRAPHSPECT 707NM GASTRIC EMPTY 921NM GI BLEEDING IMAGING 933NM HIDA W/CCK 1055NM HIDA W/FATTY MEAL 1055NM HIDA W/O CCK 1055NM LIVER AND SPLEEN IMAGING 921NM LYMPHATIC/NODES IMAGING 1214NM MUGA 844NM MYOCARD PERF SPECT SINGLE 2042NM MYOCARD PERF SPECT MULT.STU 3064NM PARATHYROID IMAGING W/ SPECT 458

NM PULMONARY PERFUSION IMAGING 764NM PULMONARY VENTILATION IMAGING 764NM RENAL SCAN FLOW AND FUNCT 1055NM RENAL SCAN-MULIT W/WO PHARM INTERVENT 1098NM THYROID IMAGING WITH UPTAKE 435NM VQ PULM.PERF/VENT MULTI 1868TC MYOVIEW DIAGN INJECTION-1 DOSE 750TC MYOVIEW DIAGN INJECTION-2 DOSE 1729Tc99m DISOFENIN DIAG INJECT 505Tc99m DTPA DIAG INJECT 505Tc99m MAA DIAG INJECTION 505Tc99m MDP DIAG. INJECTION 505Tc99m SULFAR COLLOID DIAG INJ 360Tc99MAG 3 DIAG INJECTION 505TCM99NAT04 DIAG. INJECTION 360

VASCULAR LAB CHARGESDEFINITY CONTRAST 380DUPLEX SCAN OF AORTA 532PAD SCREENING 75US 2 D ECHO LIMITED 641US 2 D ECHO LIMITED WITH CONTRAST 641US 2D/M MODE WITH STRESS 818US 2D/M MODE WITH STRESS WITH CONTRAST 818US CER. EXAM DIRECT DUPLEX SCAN 852US CONGENITAL ECHO 1338US CONGENITAL ECHO WITH CONTRAST 1338US CW DOPPLER LIMITED 318US DIRECT DUPLEX SCAN LIM.UNILAT 423US DUP SCAN ARTERIAL IN/OUTFLOW 252US ECHO 2D/M MODE ONLY 1337US ECHO STRESS TRACING ONLY 634US ECHOCARDIOGRAM 2D/M MODE 1055US ECHOCARDIOGRAM 2D/M MODE W/CONTRAST 1055US ECHOCARDIOGRAM C.W. DOPPLER 379US ECHOCARDIOGRAM COLOR FLOW 308US ECHOCARDIOGRAM ECG TRACING 98US LOW EXT ART AORTA ILIAC IMAG 376US LOW EXT ART DUPLEX SCAN BILAT 403US LOW EXT ART LIMITED 403US LOW EXT ART UNILATERAL/LIMITED 521US LOW EXT GRAFT SURV DUPLX BILATERAL 432US LOW EXT GRAFT SURV DUPLX LEFT 288US LOW EXT GRAFT SURV DUPLX RIGHT 288US LOW EXT UNILAT VENOUS LEFT 721US LOW EXT UNILAT VENOUS RIGHT 721US LOW EXT VEN DUPLEX SCAN BILAT 403US LOW EXT VEN PHYSIOLOGIC 362US LOW EXT VEN VENA CAVA ILIAC 408US STRESS ECHO LIMITED 1214US STRESS ECHO LIMITED WITH CONTRAST 1214

US UNILATERAL VENOUS ONE EXTREM. 735US UP EXT ART DUPLEX SCAN BILAT 403US UP EXT VEN DUPLEX SCAN BILAT 406US UP EXT VEN PHYSIOLOGIC 362US UPPER EXT DUPLEX 665US UPPER EXT DUPLEX LEFT 443US UPPER EXT DUPLEX RIGHT 443US UPPER EXT GRAFT SURV DUPLX 288US UPPER EXT UNILAT VENOUS LEFT 721US UPPER EXT VENOUS UNILAT RIGHT 721VEIN MAPPING PRE OP FOR HEMO DIALYSIS 403

CARDIOPULMONARYABG W/ DIRECT MEASURE 64ARTERIAL BLOOD GAS 287ARTERIAL PUNCTURE 63ATTENDANCE & STABILIZATION NB 231CALCIUM IONIZED 60CAPILLARY BLOOD COLLECTION 63CAPILLARY BLOOD GAS 278CARBON MONOXIDE TESTING 64CARDIAC EVENT INTERP FEE 41CARDIAC EVENT MTR 185CHEST PHYSIOTHERAPY INITIAL (NON PEP) 97CHEST PHYSIOTHERAPY SUBSEQUENT (NON PEP) 64CORD ARTERIAL 287CORD VENOUS 287CPR 311D L C O 190ECG RHYTHM STRIP 102EKG 180EKG INTERPRETATION FEE 38ENDOTRACHEAL INTUBATION EMERGENCY 325ETC O2 W/ CANNULA 35HOLTER MONITOR INTERP FEE 38HOLTER MONITOR RECORDING 389HOLTER MONITOR SCAN ANALYSIS W/REPORT 408NEWBORN RESUSCITATION 311NONINVASIVE VENT CPAP INITIAL 461NONINVASIVE VENT CPAP SUBSEQUE 94OXYGEN CONCENTRATION ANALYSIS 46OXYGEN PER HOUR 12PACER CHECK 70PLETHYSMOGRAPHY, TL BDY, TRACE 270POST CARDIOVERSION EKG 180PULSE OXIMETRY EVALUATION 64SMOKING CESSATION EDUCATION 3-10 MINS 53SPIROMETRY BEFORE/AFTER 287SPIROMETRY FVC 170SPIROMETRY SVC 170SPUTUM INDUCTION INITIAL W/ TREATMENT 64

STRESS TEST ONLY CARDIOPUL 1148STRESS TEST ONLY CARDIOPUL INCOMPLETE 1098SUCTION ONLY 584SVN/MDI INITIAL 123SVN/MDI LVL 1 (1-4 TREATMENTS) 357SVN/MDI LVL 2 (4-8 TREATMENTS) 716SVN/MDI LVL 3 (>8 TREATMENTS) 914VAPOTHERM INITIAL 461VAPOTHERM SUBSEQUENT 94VENOUS BLOOD GAS - pH ONLY 278VENT CONTINUOUS INITIAL 816VENT CONTINUOUS SUBSEQUENT 672WALK TEST 6 MIN 324

ENDOSCOPYBONE MARROW BIOPSY 168BRONCHOSCOPE USE 194BRONCHOSCOPY 2293BRONCHOSCOPY W/ BIOPSY 2418COLON W/BX W/EGD W/DILAT & BX 4610COLON W/POLY W/EGD W/DILA & BX 4815COLON/SIGMOID SCOPE USE 194COLONOSCOPY 1777COLONOSCOPY ATTEMPTED 830COLONOSCOPY HIGH RISK PT ONLY 1777COLONOSCOPY INCOMPLETE 830COLONOSCOPY NON HIGH RISK PT ONLY 1777COLONOSCOPY W/ POLYPECTOMY 2789COLONOSCOPY W/BIOPSY 2595COLONOSCOPY W/EGD W/BX 4008COLONOSCOPY W/EGD W/O BIOPSIES 3404COLONOSCOPY W/HEAT PROB/SCL TH 2785COLONOSCOPY W/POLYP W/EGD W/DI 4411COLONOSCOPY W/POLYP/W/EGD/WBX 4409COLONOSCOPY W/POLYPECTOMY & BX 2996COLONOSCOPY WITH DILATION 2566COLONOSCOPY WITH HEAT PROBE 1995EGD DIAGNOSTIC FOR CAPSULE PLACEMENT 2595EGD W/ CAPSULE PLACEMENT 2595EGD W/ ESOPHAGEAL DILATATION 1771EGD W/ HEATER PROBE 1995EGD W/ POLYPECTOMY 2785EGD W/ POLYPECTOMY & BIOPSY 2996EGD W/ SCLERAL THERAPY 2566EGD W/BX & HEAT PROBE 2785EGD WITH BIOPSY 2595EGD WITH BX & ESOP.DILATATION 2628ENDO CAPSULE 1364ENDO CAPSULE PLACED BY EGD 1364GASTROINTESTINAL TRANSIT & PRESSURE STOM 744GASTROSCOPE 1777

GASTROSCOPE USE 194GLUCOSE MONITORING 407MONITOR ENDO 675MONITOR MAC 337PEG 1567RECOVERY OUTPT 1-2 HRS 252RECOVERY OUTPT 3-5 HRS 423REMOVAL OF FECAL IMPACTION/FOREIGN BODY 435REPLACEMENT PEG TUBE W/O EGD 375SIGMOIDOSCOPE 668SIGMOIDOSCOPE WITH HEAT PROBE 1995SIGMOIDOSCOPY FLEX.SCREENING 282SIGMOIDOSCOPY W/ POLYPECTOMY 1110SIGMOIDOSCOPY W/POLYPECTMY &BX 1336SIGMOIDOSCPY VIA BARIUM ENEMA 331SIGMOIOSCOPY WITH BX 896

PATHWAYS TO WELLNESS (INTENSIVE OUTPATIENT PSYCH)PSYCH DIAGNOSTIC EVAL (W/O MED) 394PSYCH DIAGNOSTIC EVAL (W/ MED) 394GROUP THERAPY 236INDIVIDUAL THERAPY 16-37 MIN 394INDIVIDUAL THERAPY 38-52 MIN 394INDIVIDUAL THERAPY 53-67 MIN 394PSYCHOTHERAPY FOR CRISIS, FIRST 60 MIN 394FAMILY THERAPY W/O PATIENT 394FAMILY THERAPY W/ PATIENT 394OUTPATIENT CLINIC VISIT (MCR) 348

PAIN MANAGEMENTANALYZE INF PUMP W PRG 672ANALYZE INF PUMP W/O PRG 672ANALYZE NEUROSTIM CPLX RPRG 1ST HR 296ANALYZE NEUROSTIM NO PROGRAM 254ANALYZE NEUROSTIM RE-PROG 296ASPIRATE/INJ GANGLION CYST 623CARPAL TUNNEL INJECTION 642CHEMODENERVATION MUSCLE MIGRAINE 623CHEMODENERVATION MUSCLE NECK-DYSTONIA 623CHEMODENERVATION OF 1 EXTREMITY (1-4 MUS 1630CHEMODENERVATION TRUNK MUSCLES 623DESTR PARAVERTEBRAL NERVE CT 3878DESTR PARAVERTEBRAL NRV L/S 3878DESTR W NEUROLYT INTERCOST NRV 2290DESTR W NEUROLYT TRIGEM NERVE 2290DESTROY W NEUROLYTIC OTHER PERIPH NRV 2290DRAIN CEREBRO SPINAL FLUID 1630DRAIN/INJECT JOINT/BURSA BI LG 623FACETTE CER/THORA LEV 1 2290FACETTE LUM/SACRAL LV1 2290

FLURO UP TO ONE HOUR 534FORAMEN EPIDURAL INJ C/T ADD ON 813FORAMEN EPIDURAL INJ L/S ADD ON 813HOSP OUTPT CLINIC VISIT ASSESSMENT & MGM 285HYPOGASTRIC PLEXUS BLOCK 2290INJ ANESTH; GREATER OCCIPITAL NERVE 623INJ ANESTH;TRIGEMINAL NERVE 623INJ MORTON'S NEUROMA 623INJ NEUROLYT; EPID LUMB/CAUDAL 2290INJ OCCLUDED AV MALFORM 1630INJ TENDON SHEATH/LIGAMENT-PC 623INJ TENDON-ORIGIN/INSERT-PC 623INJECT INTO DISK LESION 3878INJECTION BURSA/JOINT LARGE-PC 623INJECTION BURSA/JOINT MED-PC 623INJECTION BURSA/JOINT SM W/US GUIDE-PC 623INJECTION BURSA/JOINT SMALL-PC 623INJECTION IM/SUBQ 39INJECTION SACROILIAC JOINT/ 1871INSERT SPINAL CANAL CATH (PUMP OR STIMUL 9459LEVEL 1 VISIT EST PT 101LEVEL 1 VISIT NEW PT 111LEVEL 2 VISIT EST PT 150LEVEL 2 VISIT NEW PT 168LEVEL 3 VISIT EST PT 223LEVEL 3 VISIT NEW PT 251LEVEL 4 VISIT EST PT 261LEVEL 4 VISIT NEW PT 312LEVEL 5 VISIT EST PT 306LEVEL 5 VISIT NEW PT 334NB AXILLARY 1630NB FEMORAL 1630NB ILIOINGUINAL-ILOHYPOGAST-PC 1630NB INTERCOSTAL MULTIPLE 1630NB INTERCOSTAL SINGLE 1630NB OTHER PERIPHERAL 623NB SCIATIC 1630NB STELLATE GANGLION 1630NB SUPRASCAPULAR 1630NERVE BLOCK CAROTID SINUS S/P 623NERVE BLOCK INJ CELIAC PELUS 2290NERVE BLOCK INJ PUDENDAL 1630NERVE BLOCK INJ SPL ACCESSOR 1038NERVE BLOCK INJ VAGUS 623NERVE TREATMENT INJ OF PUDENDA 2290NERVE TX INJ OF CELIAC PLEXUS 2290NERVE(S) RELIEVE PRESSURE 3878NERVOUS SYSTEM UNLIST PROC-PC 623PARAVERTEBRAL INJ CERV/THOR 2ND LEVEL 509PARAVERTEBRAL INJ CERV/THOR 3RD & ADD LE 509PARAVERTEBRAL INJ LUMBAR/SAC 2ND LEVEL 509PARAVERTEBRAL INJ LUMBAR/SAC 3RD & ADD L 509

PERCUTANEOUS DISKECTOMY 9459PNXR SHUNT TUBING/RSVR ASPIR/N 1344PUMP REFILL & MAINT SPINAL 781REMOVE NEURO ELECTRODE LEADS 3878REMOVE SPINAL CANAL CATH 3878REMOVE SPINAL INFUSION DEVICE 9459RETROBULBAR INJECTION 728REVISE SPINE ELTRD PERQ ARAY 14604REVISE/REMOVE NEURORECIEVER 6095SACROILIAC JT INJ C ARM BIL-PC 1630SGL NBI BRACHIAL PLEXUS 2290SPHENOPALATINE GANGLION BLOCK 623SPINAL BLOOD PATCH-PC 1630SPINAL PUNCTURE, LUMBAR-PC 1630SYMPATHET BLOCK THOR/LUMB/CAUD 1630TRANSFOR EPI INJ LUMB/SACL1 1630TRANSFORAM EPI INJ CER/THOR 1630TRIGGER POINT INJ-1 OR 2 MUSCL 623TRIGGER POINT INJ-3 OR MORE MUSCL 623TX SPINAL CORD LESION CER/THOR 2290TX SPINAL CORD LESION SUBR 2290

OUTPATIENT SERVICES & IV THERAPYADMINISTRATION FLU VACCINE 36ADMINISTRATION PNEUMONIA VACCI 36ARTHROCENTESIS/ASPIRATION/INJ; MAJOR JNT 623BLADDER INSTALLATION 579BLADDER INSTILLATION ANTINEOPL 704BLOOD TRANSFUSION 1 UNIT 129BLOOD TRANSFUSION 2 UNITS 193BLOOD TRANSFUSION 3 UNITS 259CARDIOVERSION 784CAST ARM 53CAST CHILD VERY SMALL 42CAST ELBOW 42CAST HAND & WRIST 42CAST KNEE TO FOOT 53CAST LEG FULL 67CAST RM/CAST REMOVAL 104CENTRAL LINE PLACEMENT 1168CLINIC TREATMENT ROOM 14COLLECTION OF BLOOD SPECIMAN VIA CATH 26CYSTOSCOPY 704EA ADDIT SEQUENTIAL IV PUSH 98EA ADDIT SEQUENTIAL IV PUSH 98EA ADDIT SEQUENTIAL IV PUSH SAME DRUG 98EST PT COMP H&P/HIGH/40 MIN 306EST PT COMP H&P/HIGH/40 MIN 91EST PT DET H&P/MOD/25 MIN 261EST PT DET H&P/MOD/25 MIN 83EST PT EXP FP H&P/LOW/15 MIN 77

EST PT EXP PF H&P/LOW/15 MIN 223EST PT MINIMAL 5 MIN 101EST PT MINIMAL 5 MIN 55EST PT PROB.FOC H&P/SF/10 MIN 150EST PT PROBL FOC H&P/SF/10 MIN 64EYE ARGON LASER TRABECU BILAT 2474EYE ARGON LASER TRABECULO LEFT 1649EYE ARGON LASER TRABECULO RT 1649EYE LASER IRIDOTOMY Y&A-LT 1703EYE LASER IRIDOTOMY Y&A-RIGHT 1703EYE LASER IRIDOTOMY-BILATERAL 2555EYE LASER PANRETINAL PHOTO RT 1651EYE LASER PANRETINAL PHOTO-BIL 2477EYE LASER PANRETINAL PHOTO-LT 1651EYE LASER POST CAPSUL RIGHT 1809EYE LASER POST CAPSULO YAG-LT 1806EYE LASER POST CAPSULOT BILAT 2714FOLEY CATH INSERTION 71GYN EXAM 88HYDRATION THERAPY EA ADD HR 129HYDRATION THERAPY UP TO 1 HR OP 129IM INJ ANTINEOPLASTIC HORMONAL 77IM INJ ANTINEOPLASTIC NONHORM 77IM INJECTION ANTIBIOTIC 92IMMUN/VACCINE ADMINISTRATION 1 36IMMUNIZATION/VACCINE ADMIN EA ADDL 36INJECTION IM/SUBQ 39INJECTION IM/SUBQ 39IV THERAPY 1ST HOUR 219IV THERAPY EA ADD HR UP TO 8 129LONG ARM CAST RM/INITIAL 191LONG ARM CAST RM/REPAIR 191LONG ARM SPLINT/INITIAL 150LONG ARM SPLINT/REPAIR 109LONG LEG CAST RM/INITIAL 191LONG LEG CAST RM/REPAIR 191LONG LEG SPLINT/INITIAL 150LONG LEG SPLINT/REPAIR 109NEUROSTIMULATOR 2955NEW PT COMP H&P/HIGH/60 MIN 334NEW PT COMP H&P/HIGH/60 MIN 331NEW PT COMP H&P/MOD/45 MIN 312NEW PT COMP H&P/MOD/45 MIN 309NEW PT DETAIL H&P/LOW/30 MIN 251NEW PT DETAIL H&P/LOW/30 MIN 92NEW PT EXP PF H&P/SF/20 MIN 168NEW PT EXP PF H&P/SF/20 MIN 86NEW PT PF H&P/SF DEC/10MIN 111NEW PT PF H/P SF DEC MAKING/10 77PAP 88PICC LINE PLACEMENT 1157PLATELET TRANSFUSION 1-10UNITS 456

RECOVERY OUTPT 1 - 2 HRS 252RECOVERY OUTPT 3 - 5 HRS 423REPLACEMENT CATHETER ONLY OF CENTRAL VEN 437SHORT ARM CAST RM/INITIAL 191SHORT ARM CAST RM/REPAIR 191SHORT ARM SPLINT/INITIAL 150SHORT ARM SPLINT/REPAIR 109SHORT LEG CAST RM/INITIAL 191SHORT LEG CAST RM/REPAIR 191SHORT LEG SPLINT/INITIAL 150SHORT LEG SPLINT/REPAIR 109SPLINT REMOVAL 88THER PROPH DX INJ IV PUSH 1 92THER PROPH DX INJ IV PUSH 1 92TREATMENT ROOM 15 MINUTES 84TREATMENT ROOM 15 MINUTES 88TREATMENT ROOM 30 MINUTES 164TREATMENT ROOM 30 MINUTES 173TREATMENT ROOM 45 MINUTES 248TREATMENT ROOM 45 MINUTES 263TREATMENT ROOM 60 MINUTES 330TREATMENT ROOM 60 MINUTES 348URINE DIPSTICK 8VENIPUNCTURE 26

ONCOLOGYADMINISTRATION FLU VACCINE 36ADMINISTRATION PNEUMONIA VACCI 36APPLICATION ON-BODY INJECTION 39BLOOD TRANSFUSION 1 UNIT 129BLOOD TRANSFUSION 2 UNITS 193BLOOD TRANSFUSION 3 UNITS 259BLOOD TRANSFUSION 4 UNITS 324BLOOD TRANSFUSION 5 UNITS 386BLOOD TRANSFUSION 6+UNITS 456BONE MARROW BX NONPRO FEE 166CENTRAL LINE TC 1168CHEMO IM/SUBQ INJ HORMONAL 76CHEMO IM/SUBQ NONHORMONAL 77CHEMO INTRAVENOUS PUSH SINGLE 87CHEMO IV INF UP TO 1 HR DIFFERENT 148CHEMO IV INF> 8 HRS W/ PUMP 889CHEMO IV INFUSION EA ADDL HR 128CHEMO IV INFUSION UP TO 1 HR 150CHEMO IV PUSH EA ADDITIONAL 87CONFCONSULT PF H&P/SF DEC 81CONFIRM CONSULT COMP H&P/HIGH 154CONFIRM CONSULT COMP H&P/MOD 135CONFIRM CONSULT DETH&P/LOW 101CONFIRM CONSULT EXP PF H&P/SF 89CONSULT COMP H&P/HIGH/80 154

CONSULT COMP H&P/MOD/60 135CONSULT DET H&P/LOW/40 101CONSULT EXPPF H&P/SF/30 89CONSULT PF H&P/SF/15 81EA ADDIT SEQUENTIAL IV PUSH 98EA ADDIT SEQUENTIAL IV PUSH SAME DRUG 98EST PT EXP PF H&P/LOW/15 101EST PT MINIMAL 5MIN 80EST PT PF H&P/SF MED DEC 10 89ESTPT COMPH&P/HI MEDDEC/40 154ESTPT DETH&P/MODMEDDEC/25 135HYDRATION THERAPY EA ADDL HR 129HYDRATION THERAPY UP TO 1 HR 129IMMUN/VACCINE ADMIN SINGLE 34INJECTION IM/SUBQ 39INJECTION SUBQ OR IM ANTIBIOTI 92IV INFU ADD SEQ UP TO 1 HOUR 224IV INFU ADD SEQ UP TO 1 HOUR 224IV INFUSION CONCURRENT 219IV THERAPY 1ST HOUR 219IV THERAPY EA ADD HR UP TO 8 129NEW PT COMP H&P/HI MED DEC.60 331NEW PT COMP H&P/MOD MED DEC 45 309NEW PT DET H&P/LOW MED DEC 30 101NEW PT EXP PF H&P/SF/20 MIN 89NEW PT PF H&P/SF/10 MIN 64PICC LINE 1157PLATELETS 1 10 UNITS 458PLATELETS 10+ UNITS 722REFILL & MAINT OF PORT PUMP 138REFILL & MAINT OF IMPL PUMP 166SCF/VENI PUNCTURE 26THER PROPH DX INJ IV PUSH 1 92TREATMENT ROOM LEVEL 1 15MIN 89TREATMENT ROOM LEVEL 2 30MIN 181TREATMENT ROOM LEVEL 3 45MIN 271TREATMENT ROOM LEVEL 4 60MIN 355UNLISED CHEMOTHERAPY PROCEDURE 120

DIABETES PROGRAMDSMT RD GROUP PER 30 MINUTES 64DSMT RD INDIVIDUAL PER 30 MIN 84DSMT RN GROUP PER 30 MINUTES 61DSMT RN INDIVIDUAL PER 30 MIN 84NUTRI THER INIT INDIV/15MIN 64NUTRI THER REASS INDIV/15MIN 29NUTRI THERAPY GROUP PER 30 MIN 45

OBSTETRICSAMNIOCENTESIS 210

BIRTHING ROOM 2671CIRCUMCISION NEWBORN 359EA ADDIT SEQUENTIAL IV PUSH 96EA ADDIT SEQUENTIAL IV PUSH SAME DRUG 96EXTERNAL CEPHALIC VERSION 1908HEARING SCREEN DPOAE 34HYDRATION THERAPY EA ADDIT HR 127HYDRATION THERAPY UP TO 1 HR 127IM INJECTION OUTPT ONLY 37IV INFU ADD SEQ UP TO 1 HOUR 219IV INFUSION CONCURRENT 215IV THERAPY 1ST HOUR 215IV THERAPY EA ADD HR UP TO 8 127LACTATION CONSULT/EDUCATION 90NON STRESS TEST 308NST TWIN GESTATION A 191NST TWIN GESTATION B 191OB VISIT COMPREHENSIVE (1) 923OB VISIT DETAILED (2) 735OB VISIT EXPANDED (3) 495OB VISIT FOCUSED (4) 268OB VISIT MINIMAL (5) 108THER PROPH DX INJ IV PUSH 1 91

EMERGENCY - PROFESSIONALER RM TRIAGE ONLY - PROFESSIONAL 69ER RM LEVEL 1 - PROFESSIONAL 69ER RM LEVEL 2 - PROFESSIONAL 135ER RM LEVEL 3 - PROFESSIONAL 202ER RM LEVEL 4 - PROFESSIONAL 383ER RM LEVEL 5 - PROFESSIONAL 565ER LEVEL 6 CC 30-74 MIN PROFESSIONAL 722ER LEVEL 6 EA ADDIT 30 MIN -PROFESSIONAL 362ANOSCOPY DX W/COLLJ SPEC BR/WAS SPX 165APP FINGER SPLINT;STATIC LT 2ND DIGIT 95APP FINGER SPLINT;STATIC LT 3RD DIGIT 95APP FINGER SPLINT;STATIC LT 4TH DIGIT 95APP FINGER SPLINT;STATIC LT 5TH DIGIT 95APP FINGER SPLINT;STATIC LT THUMB 95APP FINGER SPLINT;STATIC RT 2ND DIGIT 95APP FINGER SPLINT;STATIC RT 3RD DIGIT 95APP FINGER SPLINT;STATIC RT 4TH DIGIT 95APP FINGER SPLINT;STATIC RT 5TH DIGIT 95APP FINGER SPLINT;STATIC RT THUMB 95APP LONG ARM SPLINT (SHOULDER - HAND) LT 251APP LONG ARM SPLINT (SHOULDER - HAND) RT 251APP SHRT ARM SPLNT (FRAR-HAND) STATIC LT 196APP SHRT ARM SPLNT (FRAR-HAND) STATIC RT 196

PROFESSIONAL CHARGES

APPLICATION SHORT LEG B/L 343APPLICATION SHORT LEG LT 228APPLICATION SHORT LEG RT 228APPLICATION SPLINT LONG LEG BILAT 402APPLICATION SPLINT LONG LEG LT 268APPLICATION SPLINT LONG LEG RT 268ARTERIAL CATH/CANN CUTDOWN 350ARTERIAL CATH/CANN PERCUTANEOUS 147ARTERIAL PUNCTURE, W/DRAW OF BLOOD 59ARTHROCENTESIS/ASP/INJ MJR JNT B/L 227ARTHROCENTESIS/ASP/INJ MJR JNT LT 151ARTHROCENTESIS/ASP/INJ MJR JNT RT 151AVULSION OF NAIL PLATE/PART/COMP SIM/SIN 333BLEP, DRAIN ABSCESS EYELID LOWER LEFT 828BLEP, DRAIN ABSCESS EYELID LOWER RIGHT 828BLEP, DRAIN ABSCESS EYELID UPPER LEFT 828BLEP, DRAIN ABSCESS EYELID UPPER RIGHT 828CARDIOPULMONARY RESUSCITATION (CPR) 614CARDIOVERSION ELECTIVE 357CHANGE GASTROSTOMY TUBE PERCUTANEOUS 1520CL TX ACETABULUM FX W/MAN LT 3080CL TX ACETABULUM FX W/MAN RT 3080CL TX ANKLE DSLCT W/O ANES B/L 1787CL TX ANKLE DSLCT W/O ANES LT 1191CL TX ANKLE DSLCT W/O ANES RT 1191CL TX ART FX MTCRPPH OR INTER PHAL W MAN 1150CL TX BIMALLEOLAR ANKLE FX W MAN LT 1453CL TX BIMALLEOLAR ANKLE FX W MAN RT 1453CL TX DISTAL FIBULAR FX W/MAN LT 1311CL TX DISTAL FIBULAR FX W/MAN RT 1311CL TX DISTAL RADIOULNAR DISL W/MAN LT 1202CL TX DISTAL RADIOULNAR DISL W/MAN RT 1202CL TX DRFX/EPIP SEP/FX ULNR STY W MAN LT 1678CL TX DRFX/EPIP SEP/FX ULNR STY W MAN RT 1678CL TX ELBOW DSLCT W/ ANESTH LT 1419CL TX ELBOW DSLCT W/ ANESTH RT 1419CL TX FEML FX W MAN W W/O SKTL TRCT B/L 3649CL TX FEML FX W MAN W W/O SKTL TRCT LT 2432CL TX FEML FX W MAN W W/O SKTL TRCT RT 2432CL TX FR PHALANX NOT GREAT TOE W/ MAN 503CL TX FX GRT TOE PHLX/PHLG W/MANJ LT 567CL TX FX GRT TOE PHLX/PHLG W/MANJ RT 567CL TX INTERPHAL JNT DSLCT W/MAN ANES 1188CL TX IPJ DSLCT SNG WMAN WOA LT 2ND DIGI 814CL TX IPJ DSLCT SNG WMAN WOA LT 2ND TOE 814CL TX IPJ DSLCT SNG WMAN WOA LT 3RD DIGI 814CL TX IPJ DSLCT SNG WMAN WOA LT 3RD TOE 814CL TX IPJ DSLCT SNG WMAN WOA LT 4TH DIGI 814CL TX IPJ DSLCT SNG WMAN WOA LT 4TH TOE 814CL TX IPJ DSLCT SNG WMAN WOA LT 5TH DIGI 814CL TX IPJ DSLCT SNG WMAN WOA LT 5TH TOE 814CL TX IPJ DSLCT SNG WMAN WOA LT GRT TOE 814

CL TX IPJ DSLCT SNG WMAN WOA LT THUMB 814CL TX IPJ DSLCT SNG WMAN WOA RT 2ND DIGI 814CL TX IPJ DSLCT SNG WMAN WOA RT 2ND TOE 814CL TX IPJ DSLCT SNG WMAN WOA RT 3RD DIGI 814CL TX IPJ DSLCT SNG WMAN WOA RT 3RD TOE 814CL TX IPJ DSLCT SNG WMAN WOA RT 4TH DIGI 814CL TX IPJ DSLCT SNG WMAN WOA RT 4TH TOE 814CL TX IPJ DSLCT SNG WMAN WOA RT 5TH DIGI 814CL TX IPJ DSLCT SNG WMAN WOA RT 5TH TOE 814CL TX IPJ DSLCT SNG WMAN WOA RT GRT TOE 814CL TX IPJ DSLCT SNG WMAN WOA RT THUMB 814CL TX METACARPAL FX SING W/MANIP EA BONE 991CL TX MTACRPOPHALNGL DSLCT W/MAN ANES 1297CL TX MTP JNT DSLCTN W/O ANES 503CL TX OF ULNAR STYLOID FX B/L 1527CL TX OF ULNAR STYLOID FX LT 1017CL TX OF ULNAR STYLOID FX RT 1017CL TX PATELLAR DSLCT WO ANES LT 1137CL TX PATELLAR DSLCT WO ANES RT 1137CL TX PHALANGEAL SHAFT FX,PROXIMAL W/MAN 1044CL TX POST HP ARTHPLASTY DISLOC W/ANT LT 3047CL TX POST HP ARTHPLASTY DISLOC W/ANT RT 3047CL TX POST HP ARTRPLSTY DISC W/O ANES LT 1832CL TX POST HP ARTRPLSTY DISC W/O ANES RT 1832CL TX RAD HD SBLXTN CH,NM ELB W/MAN B/L 376CL TX RAD HD SBLXTN CH,NM ELB W/MAN LT 251CL TX RAD HD SBLXTN CH,NM ELB W/MAN RT 251CL TX RADIAL HEAD/NECK FX W/O MAN LT 708CL TX RADIAL HEAD/NECK FX W/O MAN RT 708CL TX RADIAL SHAFT FX W/ MAN BILAT 6570CL TX RADIAL SHAFT FX W/ MAN LT 4381CL TX RADIAL SHAFT FX W/ MAN RT 4381CL TX RADIAL/ULNAR SHAFT FX W/ MAN LT 1597CL TX RADIAL/ULNAR SHAFT FX W/ MAN RT 1597CL TX SHLDR DISLOCAT W/MAN W/O ANES B/L 1384CL TX SHLDR DISLOCAT W/MAN W/O ANES LT 923CL TX SHLDR DISLOCAT W/MAN W/O ANES RT 923CL TX SHLDR DSLCT W/MAN W/ANES B/L 1934CL TX SHLDR DSLCT W/MAN W/ANES LT 1289CL TX SHLDR DSLCT W/MAN W/ANES RT 1289CL TX TARSOMETATARSAL JNT DSLCT W/ ANES 1024CL TX TEMPOROMANDIBULAR DISLOCATION;INI 183CL TX TIBAL SHAFT W/ MAN LT 1670CL TX TIBAL SHAFT W/ MAN RT 1670CL TX TRIMALLEOLAR ANKLE FX; W/MANIPU BL 2327CL TX TRIMALLEOLAR ANKLE FX; W/MANIPU LT 1551CL TX TRIMALLEOLAR ANKLE FX; W/MANIPU RT 1551CNTRL NSL HEMORRHAGE ANTR COMPLEX B/L 988CNTRL NSL HEMORRHAGE ANTR COMPLEX LT 658CNTRL NSL HEMORRHAGE ANTR COMPLEX RT 658CNTRL NSL HEMORRHAGE ANTR SIMPLE B/L 279CNTRL NSL HEMORRHAGE ANTR SIMPLE LT 186

CNTRL NSL HEMORRHAGE ANTR SIMPLE RT 186CNTRL NSL HMRRHG PSTR PACK/CAUT INITIAL 995DRAIN ABSCESS/CYST/HMTMA DENTOALVEOLAR 518DRAIN EXT EAR ABSCESS/HEMATOMA COMPLICAT 662DRAIN EXT EAR ABSCESS/HEMATOMA SIMP B/L 570DRAIN EXT EAR ABSCESS/HEMATOMA SIMP LT 380DRAIN EXT EAR ABSCESS/HEMATOMA SIMP RT 380DRAIN/INJ INTMD JNT/BURSA W/ US B/L 244DRAIN/INJ INTMD JNT/BURSA W/ US LT 163DRAIN/INJ INTMD JNT/BURSA W/ US RT 163DRAIN/INJ MAJOR JNT/BURSA W/ US B/L 434DRAIN/INJ MAJOR JNT/BURSA W/ US LT 289DRAIN/INJ MAJOR JNT/BURSA W/ US RT 289EVACUATION SUBUNGUAL HEMATOMA 156EXCISION OF NAIL & MATRIX PERM RMVL 476INCISION & DRAIN ABSCESS;COMPLICATE/MULT 578INCISION & DRAIN ABSCESS;SIMPLE/SINGLE 312INCISION & DRAIN HEMATOMA SEROMA/FLUID C 513INCISION & DRAIN PILONIDAL CYST/SIMP 558INCISION & DRAIN VULVA PERINEAL ABSCESS 338INCISION & REMOVE FB/SUBCUT TISS/SIMPLE 482INCISION AND DRAINAGE BARTHOLIN GLAND 387INCISION THROMBOSED HEMORRHOID EXTERNAL 562INJ ANESTHETIC AGENT TRIGEMINAL NERVE 236INJECTION ANESTHETIC AGENT FACIAL NERVE 445INSERT PICC W/ IMAGE GUIDE > 5 YRS 1183INSERT TEMP INDWELLING BLADDER CATH SIMP 117INSERTION NTCICVC >5 YRS 432INTUBATION ENDOTRACIAL ER PROCEDURE 467IRRIGATION CORPORA CAVERNOSA PROAPISM 442MOD SED OTHER PHYS/QHP INTL 15MIN 5/>YRS 248MOD SED SAME PHYS/QHP INTL 15 MIN 5/>YRS 162NERVE BLOCK INJ OTHER PERIPHERAL B/L 379NERVE BLOCK INJ OTHER PERIPHERAL LT 252NERVE BLOCK INJ OTHER PERIPHERAL RT 252OBS CARE DISCHARGE DAY MGMT 235OBS CARE DISCHARGE DAY MGMT HIGH 70 MIN 602OBS CARE DISCHARGE DAY MGMT LOW 30 MIN 323OBS CARE DISCHARGE DAY MGMT MOD 50 MIN 439OBS INPATIENT CARE HIGH 55 MIN 706OBS INPATIENT CARE LOW 40 MIN 431OBS INPATIENT CARE MOD 50 MIN 547PLACE NEEDLE FOR INTRAOSSEOUS INFUSION 194REPAIR COMPLEX SCALP ARM LEG 2.6-7.5CM 1320RMVL EMBED FOREIGN BODY EYELID LOW LT 761RMVL EMBED FOREIGN BODY EYELID LOW RT 761RMVL EMBED FOREIGN BODY EYELID UP LT 761RMVL EMBED FOREIGN BODY EYELID UP RT 761RMVL FB CORNEAL W/ SLIT LAMP B/L 323RMVL FB CORNEAL W/ SLIT LAMP LT 215RMVL FB CORNEAL W/ SLIT LAMP RT 215RMVL FB CORNEAL W/O SLIT LAMP B/L 274

RMVL FB CORNEAL W/O SLIT LAMP LT 183RMVL FB CORNEAL W/O SLIT LAMP RT 183RMVL FB INTRANASAL OFC TYPE PROCEDURE 549RMVL FORGN BDY EXT EYE CONJNCT SPRFCL BL 211RMVL FORGN BDY EXT EYE CONJNCT SPRFCL LT 141RMVL FORGN BDY EXT EYE CONJNCT SPRFCL RT 141RMVL FRGN BD EXT AUD CANAL W/O ANES B/L 389RMVL FRGN BD EXT AUD CANAL W/O ANES LT 258RMVL FRGN BD EXT AUD CANAL W/O ANES RT 258RMVL IMPACT CERUMEN IRR/LVG BILAT 63RMVL IMPACT CERUMEN IRR/LVG UNILAT 42RMVL IMPACT CERUMEN W/ INSTRUM UNILATE 154RMVL SKIN TAGS (FIRST 15) 270RPR INTER WND FEENLM <2.5CM 812RPR INTER WND FEENLM >30.0CM 1828RPR INTER WND FEENLM 12.6 - 20.0CM 1722RPR INTER WND FEENLM 2.6 - 5.0 921RPR INTER WND FEENLM 20.1 - 30.0CM 1722RPR INTER WND FEENLM 5.1 - 7.5CM 1075RPR INTER WND FEENLM 7.6 -12.5CM 1462RPR INTER WND NHFG <2.5CM 749RPR INTER WND NHFG >30.0CM 1635RPR INTER WND NHFG 12.6 - 2.0CM 1234RPR INTER WND NHFG 2.6-7.5CM 649RPR INTER WND NHFG 20.1 - 30.0CM 1487RPR INTER WND NHFG 7.6 - 12.5CM 1118RPR INTER WND SATE <2.5CM 727RPR INTER WND SATE >30.0CM 1483RPR INTER WND SATE 12.6 - 20.0CM 1177RPR INTER WND SATE 2.6 - 7.5CM 928RPR INTER WND SATE 20.1 - 30.0CM 1307RPR INTER WND SATE 7.6 - 12.5CM 977RPR LAC => 2.5CM MOUTH FLR/TONGUE 837RPR LAC => 2.5CM MTH FLR/ PSTR TNG 938SBSQ OBSERVATION CARE/DAY HIGH 35 MIN 338SBSQ OBSERVATION CARE/DAY LOW 15 MIN 129SBSQ OBSERVATION CARE/DAY MOD 25 MIN 236SIMP REPAIR SUPER WOUND FEENLM 5.1-7.5CM 431SIMP RPR SPRFCL WND FEENLM 7.6-12.5CM 520SIMP RPR SUPER WOUND FEENLM <2.5CM 202SIMP RPR SUPER WOUND FEENLM 2.6-5CM 210SIMP RPR SUPER WOUND SNAGTEHF 2.6-7.5 201SIMP RPR SUPER WOUND SNAGTEHF 7.6-12.5CM 240SIMP RPR SUPER WOUND SNAGTEHF<2.5CM 166SIMP RPR SUPER WOUND SNGTE 12.6 - 20CM 509SPINAL PUNCTURE LUMBAR DIAGNOSTIC 293TRIGGER PT INJ 1 OR 2 MUSC GRP 124TRIGGER PT INJ 3 OR MORE MUSCLES 203TUBE THORACOSTOMY INCLUDE WATER SEAL 521ULTRASONIC GUIDE NEEDLE PLACEMENT 102US ABDOMINAL REAL TIME LIMITED 92US CHEST/MEDIASTINUM REAL TIME 86

US GUIDE VASC ACCESS 46US JOINT NONVAS EXT REAL TIME LIMITED 78US LOWER EXTREMITY ARTERIES UNIL/LTD 77US PREG UTERUS REAL TIME LIMITED 103US PREG UTERUS REAL TIME TRANSVAG 120US RETROPERITONEAL LIMITED REAL TIME 91VAGINAL DELIVERY ONLY 2602

ONCOLOGY - PROFESSIONALNEW PT PROB FOC. STFWD 10 78NEW PT EXP. STFWD 20 109NEW PT DETAILED LOW 30 146NEW PT COMPREHENSIVE MOD 45 219NEW PT COMPREHENSIVE HIGH 60 252EST PT MINIMAL 5 44EST PT FOCUSED STFWD 10M 66EST PT EXPANDED LOW 15 89EST PT DETAILED MOD 25 146EST PT COMPREHENSIVE HIGH 40 219BONE MARROW ASPIR. & BX 337BONE MARROW ASPIR. & BX PC 313BONE MARROW ASPIR.ONLY PC 260BONE MARROW ASPIRATION 260BONE MARROW BX 260BONE MARROW BX PC ONLY 260C CONSULT COMPREH HIGH 271C CONSULT COMPREH. MODERATE 236C CONSULT DETAILED LOW 156C CONSULT EXPAND STFWD LOW 117C CONSULT PROB FOC STFWD MIN 80COM.CONSULT PROB FOC STFWD MIN 80COMPRE.CONS. EXPAND. STFWD LOW 117COMPRE.CONSULT DETAILED LOW 156CONFIRM CONSULT COMPREH HIGH 271CONFIRM CONSULT COMPREH MODERA 236EST PT COMPREHENSIVE HIGH 40 236EST PT DETAILED MOD 25 152EST PT EXPANDED LOW 15 96EST PT FOCUSED STFWD 10 71EST PT MINIMAL 5 51FOLLOWUP I/P CONSULT 10 MIN 77FOLLOWUP I/P CONSULT 10 MIN 86FOLLOWUP I/P CONSULT 20 MIN 132FOLLOWUP I/P CONSULT 20 MIN 148FOLLOWUP I/P CONSULT 30 MIN 173FOLLOWUP I/P CONSULT 30 MIN 192HOME HEALTH CERTIFICATION 117HOME HEALTH CERTIFICATION 131HOME HEALTH RECERTIFICATION 86HOME HEALTH RECERTIFICATION 99HOME VISIT COMP EXAM 75 M 361

HOME VISIT COMP EXAM 75 MIN 399HOME VISIT COMPREHENSIVE 60 MI 336HOME VISIT COMPREHENSIVE 60M 300HOME VISIT DETAILED 45 MIN 247HOME VISIT DETAILED 45 MIN 273HOME VISIT EST PAT 15 MIN 99HOME VISIT EST PAT 15 MIN 109HOME VISIT EST PAT HI CPLX 293HOME VISIT EST PAT HI CPLX 323HOME VISIT EST PAT LOW 25 MIN 137HOME VISIT EST PAT LOW 25 MIN 151HOME VISIT EST PAT MOD CPLX 208HOME VISIT EST PAT MOD CPLX 231HOME VISIT NEW PATIENT 20 MIN 117HOME VISIT NEW PATIENT 20 MIN 131HOME VISIT NEW PATIENT 30 MIN 165HOME VISIT NEW PATIENT 30 MIN 185HOSP DC DAY MGMT < 30 MIN 156HOSP DC DAY MGMT < 30 MIN 175HOSPITAL DC MGMT >30 MIN 187HOSPITAL DC MGMT >30 MIN 208IM INJ ANTINEOPLASTIC HORMONAL 74INITIAL HOSP CARE HI CPX 70 M 317INITIAL HOSP CARE HI CPX 70 MI 377INITIAL HOSP CARE LOW CPX 30 M 152INITIAL HOSP CARE LOW CPX 30 M 175INITIAL HOSP CARE MOD CPX 50 M 243INITIAL HOSP CARE MOD CPX 50 M 290INITIAL I/P CONSULT 110 MIN 428INITIAL I/P CONSULT 110 MIN 487INITIAL I/P CONSULT 20 MIN 127INITIAL I/P CONSULT 20 MIN 142INITIAL I/P CONSULT 40 MIN 187INITIAL I/P CONSULT 40 MIN 201INITIAL I/P CONSULT 55 MIN 247INITIAL I/P CONSULT 55 MIN 273INITIAL I/P CONSULT 80 MIN 331INITIAL I/P CONSULT 80 MIN 360INITIAL OBS HIGH COMPLEX 340INITIAL OBS HIGH COMPLEX 377INITIAL OBS LOW COMPLEX 165INITIAL OBS LOW COMPLEX 185INITIAL OBS MODERATE COMPLEX 260INITIAL OBS MODERATE COMPLEX 290NEW PT COMP NF ASSESSMENT HI 221NEW PT COMP NF ASSESSMENT HI 245NEW PT COMP NF ASSESSMENT MOD 165NEW PT COMP NF ASSESSMENT MOD 185NEW PT COMP NF PT LOW COMPLX 127NEW PT COMP NF PT LOW COMPLX 142NEW PT COMPREHENSIVE MOD 45 233NEW PT COMPRHENSIVE HIGH 60 275

NEW PT DETAILED LOW 30 154NEW PT EXP STFWD 20 120NEW PT PROB FOC STFWD 10 81O CONSULT COMPREH HIGH 80 300O CONSULT COMPREH MOD 60 275O CONSULT COMPREH. MOD 60 271O CONSULT DETAILED LOW 40 218O CONSULT EXPANDED STFWD 30 169O CONSULT PRO FOC STFWD 15 127O CONSULT PRO FOC STFWD 15 129O ONSULT COMPREH HIGH 80 295O. CONSULT DETAILED LOW 40 214O. CONSULT EXPANDED STFWD 30 165OBS I/P HOSP CARE HIGH COMPLX 421OBS I/P HOSP CARE HIGH COMPLX 448OBS I/P HOSP CARE LOW COMPLX 266OBS I/P HOSP CARE MOD COMPLX 345OBS I/P HOSP CARE MOD COMPLX 369OBS/IP HOSP CARE LOW COMPLX 260OBSERVATION CARE DISCHARGE 154OBSERVATION CARE DISCHARGE 156PHYS SUPV HOME PATIENT 156PHYS SUPV NURSING FACILITY PT 156SUBSEQ HOSP CARE HI CPX 35 MIN 165SUBSEQ HOSP CARE HI CPX 35 MIN 182SUBSEQ HOSP CARE LOW CPX 15 96SUBSEQ HOSP CARE LOW CPX 15 101SUBSEQ HOSP CARE MOD CPX 25 M 138SUBSEQ HOSP CARE MOD CPX 25 MIN 150SUBSEQUENT NF VISIT DISCH >30 156SUBSEQUENT NF VISIT DISCH >30 159SUBSEQUENT NF VISIT DISCHARGE 127SUBSEQUENT NF VISIT DISCHARGE 129SUBSEQUENT NF VISIT HI 148SUBSEQUENT NF VISIT HI 150SUBSEQUENT NF VISIT LOW 80SUBSEQUENT NF VISIT LOW 81SUBSEQUENT NF VISIT MODERATE 107SUBSEQUENT NF VISIT MODERATE 108

NEPHROLOGY - PROFESSIONALARTERY-VEIN AUTOGRAFT 2444ARTERY-VEIN NON AUTOGRAFT 2052AV FUSION DIRECT ANY SITE 2042EST PT OFFICE VISIT 10 MIN 76EST PT OFFICE VISIT 15 MIN 152EST PT OFFICE VISIT 25 MIN 235EST PT OFFICE VISIT 25 MIN W/ MOD 24 235EST PT OFFICE VISIT 40 MIN 331EST PT OFFICE VISIT 40 MIN W/ MOD 24 331EST PT OFFICE VISIT 5 MIN 27

INJECTION EXT VENOGRAPHY 149INSET TUNNELED CV CATH 1027INTRO CATH DIALYSIS CIRCUIT 518INTRO CATH DIALYSIS CIRCUIT 742IP CONSULT COMP, HIGH COMPLEX 1173IP CONSULT COMP, MOD COMPLEX 839IP CONSULT DETAILED, LOW COMPLEX 531IP INITIAL COMP, HIGH COMPLEX 605IP INITIAL COMP, MOD COMPLEX 413IP INITIAL DETAILED, STRAIGHTFORWARD 306IP SUBSQ DETAILED, HIGH COMPLEX 310IP SUBSQ EXPANDED, MOD COMPLEX 217IP SUBSQ FOCUSED, STRAIGHTFORWARD 117NEW PT OFFICE VISIT 10 MIN 80NEW PT OFFICE VISIT 20 MIN 151NEW PT OFFICE VISIT 30 MIN 227NEW PT OFFICE VISIT 45 MIN 385NEW PT OFFICE VISIT 60 MIN 502OBS VISIT EST PT COMP, HIGH COMPLEX 331OBS VISIT EST PT DETAILED, MOD COMPLEX 235OBS VISIT EST PT EXPAND, LOW COMPLEX 152OBS VISIT NEW PT COMP, HIGH COMPLEX 502OBS VISIT NEW PT COMP, MOD COMPLEX 385OBS VISIT NEW PT DETAILED, LOW COMPLEX 227OP CONSULT COMP, HIGH COMPLEX 1164OP CONSULT COMP, MOD COMPLEX 855OP CONSULT DETAILED, LOW COMPLEX 531OPEN THROMBECT AV FISTULA 1893REMOVAL TUNNELED CV CATH 416RENAL BIOPSY PERQ 391REPLACE TUNNELED CV CATH 559THRMBC/NFS DIALYSIS CIRCUIT 1372US GUIDE FOR BIOPSY 97VESSEL MAPPING HEMO ACCESS 37

PAIN MANAGEMENT - PROFESSIONALPOST-UP FOLLOW-UP VISIT 230NEW PATIENT LEVEL 2 VISIT 230NEW PATIENT LEVEL 3 VISIT 332NEW PATIENT LEVEL 4 VISIT 508NEW PATIENT LEVEL 5 VISIT 642EST PATIENT LEVEL 1 VISIT 65EST PATIENT LEVEL 2 VISIT 134EST PATIENT LEVEL 3 VISIT 224EST PATIENT LEVEL 4 VISIT 331EST PATIENT LEVEL 5 VISIT 447INJ TENDON / LIGAMENT / CYST 185INJ TRIGGER POINT, 1-2 MUSCLES 170INJ TRIGGER POINT, 3 OR MORE MUSCLES 196DRAIN / INJECT JOINT / BURSA SMALL LT 149DRAIN / INJECT JOINT / BURSA SMALL RT 149

DRAIN / INJECT JOINT / BURSA SMALL B/L 224DRAIN / INJ JNT / BURSA SMALL LT W/US 223DRAIN / INJ JNT / BURSA SMALL RT W/US 223DRAIN / INJ JNT / BURSA SMALL B/L W/US 334DRAIN / INJECT JOINT / BURSA MED LT 156DRAIN / INJECT JOINT / BURSA MED RT 156DRAIN / INJECT JOINT / BURSA MED B/L 235DRAIN / INJ JNT / BURSA MED LT W/US 248DRAIN / INJ JNT / BURSA MED RT W/US 248DRAIN / INJ JNT / BURSA MED B/L W/US 372DRAIN / INJECT JOINT / BURSA LRG LT 188DRAIN / INJECT JOINT / BURSA LRG RT 188DRAIN / INJECT JOINT / BURSA LRG B/L 281DRAIN / INJ JNT / BURSA LRG LT W/US 280DRAIN / INJ JNT / BURSA LRG RT W/US 280DRAIN / INJ JNT / BURSA LRG B/L W/US 420INJECT SACROILIAC JNT LT (FLOURO INC) 486INJECT SACROILIAC JNT RT (FLOURO INC) 486INJECT SACROILIAC JNT B/L (FLOURO INC) 730EPIDURAL CER/THOR (W/O GUIDE) 510EPIDURAL CER/THOR (W/ GUIDE) 753EPIDURAL LUM/SAC (W/O GUIDE) 478EPIDURAL LUM/SAC (W/ GUIDE) 742NERVE BLOCK INJ TRIGEMINAL 402NERVE BLOCK INJ OCCIPITAL 316NERVE BLOCK INJ BRACHIAL PLEXUS 365NERVE BLOCK INJ SUPRASCAPULAR 359NERVE BLOCK INJ INTERCOSTAL SINGLE 343NERVE BLOCK INJ INTERCOSTAL MULTI LT 464NERVE BLOCK INJ INTERCOSTAL MULTI RT 464NERVE BLOCK INJ INTERCOST MULTI B/L 696NERVE BLOCK INJ ILIO-ING/HYPOG LT 416NERVE BLOCK INJ ILIO-ING/HYPOG RT 416NERVE BLOCK INJ ILIO-ING/HYPOG B/L 623NERVE BLOCK INJ OTHER PERIPHERAL LT 245NERVE BLOCK INJ OTHER PERIPHERAL RT 245NERVE BLOCK INJ OTHER PERIPHERAL B/L 368FORAMIN EPID INJ CER/THOR LT FLOURO INC 718FORAMIN EPID INJ CER/THOR RT FLOURO INC 718FORAMIN EPID INJ CER/THO B/L FLOURO INC 1077FORAMIN EPID INJ C/T LT ADD'L FLOURO INC 348FORAMIN EPID INJ C/T RT ADD'L FLOURO INC 348FORAMIN EPID INJ C/T B/L ADD'L FLOUR INC 522FORAMIN EPID INJ LUM/SAC LT FLOURO INC 665FORAMIN EPID INJ LUM/SAC RT FLOURO INC 665FORAMIN EPID INJ LUM/SAC BILAT FLOUR INC 996FORAMIN EPID INJ L/S LT ADD'L FLOURO INC 282FORAMIN EPID INJ L/C RT ADD'L FLOURO INC 282FORAMIN EPID INJ L/S BIL ADD'L FLOUR INC 424MBB CER/THOR LT (FLOURO INC) 579MBB CER/THOR RT (FLOURO INC) 579MBB CER/THOR B/L (FLOURO INC) 867

MBB CER/THOR 2ND LVL LT (FLOURO INC) 288MBB CER/THOR 2ND LVL RT (FLOURO INC) 288MBB CER/THOR 2ND LVL B/L (FLOURO INC) 432MBB CER/THOR 3ND LVL LT (FLOURO INC) 290MBB CER/THOR 3ND LVL RT (FLOURO INC) 290MBB CER/THOR 3ND LVL B/L (FLOURO INC) 435MBB LUM/SAC LT (FLOURO INC) 523MBB LUM/SAC RT (FLOURO INC) 523MBB LUM/SAC B/L (FLOURO INC) 784MBB LUM/SAC 2ND LVL LT (FLOURO INC) 265MBB LUM/SAC 2ND LVL RT (FLOURO INC) 265MBB LUM/SAC 2ND LVL B/L (FLOURO INC) 398MBB LUM/SAC 3ND LVL LT (FLOURO INC) 265MBB LUM/SAC 3ND LVL RT (FLOURO INC) 265MBB LUM/SAC 3ND LVL B/L (FLOURO INC) 398NERVE BLOCK STELLATE GANGLION LT 389NERVE BLOCK STELLATE GANGLION RT 389NERVE BLOCK STELLATE GANGLION B/L 584NERVE BLOCK LUM/THOR SYMPATHETIC LT 568NERVE BLOCK LUM/THOR SYMPATHETIC RT 568NERVE BLOCK LUM/THOR SYMPATHETIC B/L 853NERVE BLOCK CELIAC PLEXUS 573CHEMODENERVATION MUSCLE MIGRAINE 461CHEMODENERVATION MUSCLE NECK DYSTONIA 440RFA CER/THOR LT (FLOURO INC) 1279RFA CER/THOR RT (FLOURO INC) 1279RFA CER/THOR B/L (FLOURO INC) 1918RFA CER/THOR ADD'L LT (FLOURO INC) 571RFA CER/THOR ADD'L RT (FLOURO INC) 571RFA CER/THOR ADD'L B/L (FLOURO INC) 857RFA LUM/SAC LT (FLOURO INC) 1264RFA LUM/SAC RT (FLOURO INC) 1264RFA LUM/SAC B/L (FLOURO INC) 1896RFA LUM/SAC ADD'L LT (FLOURO INC) 519RFA LUM/SAC ADD'L RT (FLOURO INC) 519RFA LUM/SAC ADD'L B/L (FLOURO INC) 777RFA OTHER PERIPHERAL NERVE LT 404RFA OTHER PERIPHERAL NERVE RT 404RFA OTHER PERIPHERAL NERVE B/L 607CHEMODENERVATION 1 EXT (1-4 MUSCLE) 447CHEMODENERVATION TRUCK (1-5 MUSCLES) 447ULTRASONIC GUIDANCE FOR NEEDLE PLACEMENT 108FLUOROGUIDE INJ FOR SPINE 168FLUOROGUIDE INJ FOR NEEDLE PLACEMENT 166