Medical Procedure Pricing - Patient Resources | Revere Health
Procedure Pricing

Revere Health believes all patients should have access to information that helps them make educated healthcare decisions, including information about the cost of care. That’s why we’ve created pricing charts that highlight the most common procedures in each specialty and what they cost at any Revere Health location.

The pricing information below* represents the “sticker price” of a particular procedure or service for someone without insurance. Uninsured patients are eligible to receive a 30% discount on the sticker price for prompt payment. Patients with health insurance will typically be charged an amount less than the sticker price (the exact cost varies based on individual insurance plans).

The average patient experience also results in some additional testing or services that could appear on your bill. We’re happy to discuss the specifics of your bill with you if you have any questions.

Note: Drug/injection prices are listed per unit.

*These prices reflect our most current data and will be updated annually.

Office Visits

There are several different levels of office visits, and the price for each level of office visit is the same across all Revere Health specialties. Without seeing you in the exam room first, however, it’s difficult to know exactly which level of service will apply to your office visit.

A Level 1 visit is a simple visit that may not require the presence of a physician. A Level 5 visit involves a comprehensive evaluation of serious/worsening problems that require complex medical decision making. Your office visit could fit anywhere on this scale depending on your individual health situation.

New Patients Established Patients
CPT Code Price CPT Code Price
99201 (Level 1) $75 99211 (Level 1) $36
99202 (Level 2) $127 99212 (Level 2) $74
99203 (Level 3) $183 99213 (Level 3) $123
99204 (Level 4) $280 99214 (Level 4) $182
99205 (Level 5) $353 99215 (Level 5) $246
Other Office Visits
CPT Code
Code Description
Explanation
Price
99381
Init pm e/m new pat infant
Initial new patient preventive medicine evaluation in an infant younger than 1 year, including age- and gender-appropriate history and physical exam.
$164
99382
Init pm e/m new pat 1-4 yrs
Initial new patient preventive medicine evaluation in children ages 1 to 4, including age- and gender-appropriate history and physical exam.
$187
99383
Prev visit new age 5-11
New patient preventive medicine evaluation in children ages 5 to 11, including age- and gender-appropriate history and physical exam.
$179
99384
Prev visit new age 12-17
New patient preventive medicine evaluation in adolescents ages 12 to 17, including age- and gender-appropriate history and physical exam.
$214
99385
Prev visit new age 18-39
New patient preventive medicine evaluation in adults ages 18 to 39, including age- and gender-appropriate history and physical exam.
$211
99386
Prev visit new age 40-64
New patient preventive medicine evaluation in adults ages 40 to 64, including age- and gender-appropriate history and physical exam.
$267
99387
Init pm e/m new pat 65+ yrs
Initial new patient preventive medicine evaluation in adults over age 65, including age- and gender-appropriate history and physical exam.
$301
99391
Per pm reeval est pat infant
Established patient periodic preventive medicine examination in an infant younger than 1 year, including age- and gender-appropriate history and physical exam.
$142
99392
Prev visit est age 1-4
Established patient periodic preventive medicine examination in children ages 1 to 4, including age- and gender-appropriate history and physical exam.
$154
99393
Prev visit est age 5-11
Established patient periodic preventive medicine examination in children ages 5 to 11, including age- and gender-appropriate history and physical exam.
$153
99394
Prev visit est age 12-17
Established patient periodic preventive medicine examination in adolescents ages 12 to 17, including age- and gender-appropriate history and physical exam.
$187
99395
Prev visit est age 18-39
Established patient periodic preventive medicine examination in adults ages 18 to 39, including age- and gender-appropriate history and physical exam.
$170
99396
Prev visit est age 40-64
Established patient periodic preventive medicine examination in adults ages 40 to 64, including age- and gender-appropriate history and physical exam.
$202
99397
Per pm reeval est pat 65+ yr
Established patient periodic preventive medicine examination in adults over age 65, including age- and gender-appropriate history and physical exam.
$239
G0402
Initial preventive exam
Welcome to Medicare visit, a one-time appointment for patients new to Medicare to cover health history and create a prevention plan.
$311
G0438
Ppps, initial visit
Initial Annual Wellness Visit, the first yearly appointment to create a patient's personalized prevention plan.
$310
G0439
Ppps, subseq visit
Subsequent Annual Wellness Visits, yearly follow-up appointments to discuss and adjust a patient's personalized prevention plan (initial appointment).
$206

Search by Specialty

Adult Medicine
CPT Code
Code Description
Explanation
Price
99232
Subsequent hospital care
Follow up evaluation and management of a patient in the hospital requiring moderate-complexity medical decision making (Level 2).
$126
G0250
Md inr test revie inter mgmt
Physician review, interpretation and management of home INR testing (to monitor blood thinning medications).
$18
99231
Subsequent hospital care
Follow up evaluation and management of a patient in the hospital requiring low-complexity medical decision making (Level 1).
$69
99239
Hospital discharge day
Management of patient health on hospital discharge day.
$181
90662
Iiv no prsv increased ag im
Preservative-free, high-dose Fluzone (influenza) vaccine.
$65
G0008
Admin influenza virus vac
Administration of influenza (flu) vaccine
$19
J1030
Methylprednisolone 40 mg inj
Methylprednisolone injection (brand names: A-Methapred, Depo-Medrol, SoluMEDROL) typically used to treat pain and swelling.
$8
99223
Initial hospital care
Initial evaluation of a patient in the hospital requiring complex medical decision making and a comprehensive exam (Level 3).
$350
20610
Drain/inj joint/bursa w/o us
Fluid removal in a major joint without the use of ultrasound technology.
$162
90471
Immunization admin
A single immunization that does not involve face-to-face counseling.
$38
Allergy & Immunology
CPT Code
Code Description
Explanation
Price
95004
Percut allergy skin tests
Percutaneous (through the skin) allergy test in which a drop of a possible allergen is pricked or scratched into the skin. Charge is per allergen.
$10
95165
Antigen therapy services
Preparation by an allergist of an immunotherapy injection.
$30
95117
Immunotherapy injections
Multiple immunotherapy injections. Does not include preparation of vial.
$32
95115
Immunotherapy one injection
Single immunotherapy injection. Does not include preparation of vial.
$25
95044
Allergy patch tests
Allergy test in which a patch with a possible allergen is placed onto the skin. Charge is per allergen.
$13
95024
Icut allergy test drug/bug
Intradermal (between layers of skin) allergy test in which the extract of a possible allergen (medication or insect venom) is injected into the skin. Charge is per allergen.
$17
96372
Ther/proph/diag inj sc/im
Therapeutic, prophylactic and diagnostic injections and infusions used for treatment, prevention and diagnosis (excludes chemotherapy and other complex medications.
$42
95018
Perq&ic allg test drugs/biol
Skin allergy test to identify allergic reactions to medications or biologic agents used to treat or diagnose a disease.
$46
94010
Breathing capacity test
Non-invasive evaluation of how quickly and how much air you exhale.
$78
94060
Evaluation of wheezing
Breathing capacity test after receiving a medication that widens the air passages into the lungs.
$131
Cardiology
CPT Code
Code Description
Explanation
Price
93000
Electrocardiogram complete
Routine electrocardiogram (ECG or EKG) with interpretation.
$45
93224
Ecg monit/reprt up to 48 hrs
Electrocardiographic monitoring for 24 hours using a holter monitor (with physician review and interpretation).
$257
93306
Tte w/doppler complete
A procedure called a transthoracic echocardiogram that uses high-frequency sound waves to evaluate blood flow through the heart.
$527
93880
Extracranial bilat study
Ultrasound scanning of blood flow in the extracranial arteries (outside the brain) on both sides of head and neck.
$551
93015
Cardiovascular stress test
A test that monitors how the heart reacts to physical stress, typically using a treadmill or bicycle.
$210
78452
Ht muscle image spect mult
Physician interpretation of results from a myocardial perfusion imaging (MPI) test, which analyzes how the heart muscle functions.
$1,322
93970
Extremity study
Ultrasound study of the veins in the arms and legs to detect venous insufficiency or deep vein thrombosis (DVT).
$536
93923
Upr/lxtr art stdy 3+ lvls
Ultrasound study of the veins in the arms and legs (3 levels).
$400
93281
Pm device progr eval multi
Evaluation, testing and programming adjustment of pacemaker with physician analysis, review and report.
$166
93284
Prgrmg eval implantable dfb
Evaluation, testing and programming adjustment of defibrillator with physician analysis, review and report.
$219
Dermatology
CPT Code
Code Description
Explanation
Price
17003
Destruct premalg les 2-14
Destruction of 2-14 pre-cancerous skin lesions (abnormalities) through laser surgery, electrosurgery, cryosurgery (freezing) or curettement (scraping).
$19
95044
Allergy patch tests
Allergy test in which a patch with a possible allergen is placed onto the skin. Charge is per allergen.
$13
17000
Destruct premalg lesion
Destruction of a single precancerous skin lesion (abnormality) through laser surgery, electrosurgery, cryosurgery (freezing) or curettement (scraping).
$132
17110
Destruct b9 lesion 1-14
Destruction of 1 to 14 benign (non-cancerous) skin abnormalities other than skin tags or certain types of birthmarks.
$206
88305
Tissue exam by pathologist
Examination of sample tissue by a pathologist to diagnose or rule out certain conditions.
$160
11301
Shave skin lesion 0.6-1.0 cm
Shaving of skin lesions (abnormalities) on the skin for cosmetic or treatment purposes under local anesthesia.
$226
8830526
Tissue exam by pathologist
Interpretation of results from a pathologist tissue exam.
$82
17311
Mohs 1 stage h/n/hf/g
Mohs micrographic surgery, a procedure that involves removing one layer of skin cancer at a time for immediate examination of cancer cells.
$1,250
J3301
Triamcinolone acet inj nos
Injection of triamcinolone, a steroid that decreases inflammation (swelling).
$3
17312
Mohs addl stage
Additional stages required for a Mohs micrographic surgery, a procedure that involves removing one layer of skin cancer at a time for immediate examination of cancer cells.
$732
Endocrinology
CPT Code
Code Description
Explanation
Price
77080
Dxa bone density axial
Axial DEXA scan, a non-invasive imaging test that measures bone density in the axial skeleton, which includes, for example, the hips, pelvis and spine.
$179
95251
Cont gluc mntr analysis i&r
Analysis and interpretation of data from a continuous glucose monitor, a device that tracks your blood sugar.
$80
76536
Us exam of head and neck
Use of ultrasound technology to examine salivary glands, lymph nodes, lesions and the endocrine system.
$316
76942
Echo guide for biopsy
Use of ultrasound technology to guide the placement of a needle during a biopsy.
$362
95250
Cont gluc mntr phys/qhp eqp
Continuous glucose monitoring, including sensor placement, patient training, calibration, removal and downloading data from the monitor.
$317
96372
Ther/proph/diag inj sc/im
Therapeutic, prophylactic and diagnostic injections and infusions used for treatment, prevention and diagnosis (excludes chemotherapy and other complex medications.
$42
J0834
Inj., cosyntropin, 0.25 mg
Injection of cosyntropin (brand name: Cortrosyn) to diagnose adrenal gland disorders.
$141
G0103
Psa screening
A blood test used to screen for prostate cancer.
$44
77081
Dxa bone density/peripheral
Peripheral DEXA scan, a non-invasive imaging test that measures bone density in the lower arm, wrist, finger or heel using a portable DEXA machine.
$92
ENT
CPT Code
Code Description
Explanation
Price
69210
Remove impacted ear wax uni
Removal of earwax buildup.
$104
31505
Diagnostic laryngoscopy
Diagnostic examination of voice box using an endoscope, an instrument used to look inside the body.
$183
92567
Tympanometry
A test used to diagnose and monitor conditions of the middle ear.
$33
J0696
Ceftriaxone sodium injection
Antibacterial injection used to treat infection.
$31
92504
Ear microscopy examination
Examination of the ear using a microscope.
$63
42826
Removal of tonsils
Surgical removal of tonsils.
$527
69436
Create eardrum opening
Surgical opening of the eardrum and insertion of a ventilating tube, called a tympanostomy.
$1,179
30901
Control of nosebleed
Control of minor nosebleed that originates in the front of the nose (anterior).
$304
42820
Remove tonsils and adenoids
Surgical removal of tonsils and adenoids, a patch of tissue in the back of the throat.
$2,180
30520
Repair of nasal septum
A surgical procedure to correct a deviated septum, a condition in which the bone and cartilage that separates the nose is off center.
$4,700
Family Medicine
CPT Code
Code Description
Explanation
Price
J0897
Denosumab injection
Injection of denosumab (brand names: Prolia and Xgeva) to treat osteoporosis and high calcium levels and prevent fractures.
$22
96372
Ther/proph/diag inj sc/im
Therapeutic, prophylactic and diagnostic injections and infusions used for treatment, prevention and diagnosis (excludes chemotherapy and other complex medications.
$42
99231
Subsequent hospital care
Follow up evaluation and management of a patient in the hospital requiring low-complexity medical decision making (Level 1).
$69
J3301
Triamcinolone acet inj nos
Injection of triamcinolone, a steroid that decreases inflammation (swelling).
$3
90471
Immunization admin
Administration of a single immunization that does not involve face-to-face counseling.
$38
J0696
Ceftriaxone sodium injection
Antibacterial injection used to treat infection.
$31
90460
Im admin 1st/only component
Administration of initial immunization with physician counsel for patients age 18 and younger.
$44
90461
Im admin each addl component
Administration of additional immunizations with physician counsel for patients age 18 and younger.
$22
90472
Immunization admin each add
Administration of additional immunizations that do not involve face-to-face counseling.
$20
J1885
Ketorolac tromethamine inj
Injection of a nonsteroidal anti-inflammatory drug (NSAID) used for the short-term treatment of moderate to severe pain.
$16
87880
Strep a assay w/optic
Strep test that detects the presence of streptococcus bacteria using a throat swab.
$28
J1100
Dexamethasone sodium phos
Injection of dexamethasone, a steroid used to treat inflammation (swelling).
$7
85651
Rbc sed rate nonautomated
Red blood cell sedimentation test, a blood test that detects inflammatory activity in the body.
$7
J7325
Synvisc or synvisc-one
An injection used to treat osteoarthritis pain.
$25
Gastroenterology
CPT Code
Code Description
Explanation
Price
45378
Diagnostic colonoscopy
Diagnostic colonoscopy, a colonoscopy performed as the result of an abnormal test result, sign or symptom
$1462
43239
Egd biopsy single/multiple
EGD with biopsy, a procedure used to examine the esophagus, stomach and the upper part of the small intestine with the removal of tissues (biopsy) for testing.
$999
45380
Colonoscopy and biopsy
Colonoscopy with biopsy, a procedure used to examine the colon with the removal of tissues (biopsy) for testing.
$1,734
45385
Colonoscopy w/lesion removal
Colonoscopy with lesion removal, a procedure used to examine the colon with the removal of polyps, tumors or other lesions.
$ 2,058
43235
Egd diagnostic brush wash
A procedure used to examine the esophagus, stomach and the upper part of the small intestine with specimen collection.
$708
43249
Esoph egd dilation <30 mm
EGD with esophagus dilation, a procedure to widen a narrowed esophagus, which often occurs as the result of acid reflux.
$1,220
99232
Subsequent hospital care
Follow up evaluation and management of a patient in the hospital requiring moderate-complexity medical decision making (Level 2).
$126
99233
Subsequent hospital care
Follow up evaluation and management of a patient in the hospital requiring high-complexity medical decision making (Level 3).
$180
99222
Initial hospital care
Initial evaluation of a patient in the hospital requiring moderately complex medical decision making and a comprehensive exam (Level 2).
$237
G0121
Colon ca scrn not hi rsk ind
Screening colonoscopy, a colonoscopy for a low-risk individual without symptoms to screen for colorectal cancer and check for the presence of polyps.
$707
90471
Immunization admin
Administration of a single immunization that does not involve face-to-face counseling.
$38
Imaging
CPT Code
Code Description
Explanation
Price
72148TC
Mri lumbar spine w/o dye
MRI scan of the lower spinal canal (lower back) without contrast material (a substance used to enhance visibility of the body's internal structures).
$739
73721TC
Mri jnt of lwr extre w/o dye
MRI scan of joints in the body's lower extremities (i.e., hip, knee, ankle, foot, etc.) without contrast material (a substance used to enhance visibility of the body's internal structures).
$799
73221TC
Mri joint upr extrem w/o dye
MRI scan of joint in the body's upper extremities (i.e., shoulder, elbow, wrist, etc.) without contrast material (a substance used to enhance visibility of the body's internal structures).
$781
72141TC
Mri neck spine w/o dye
MRI scan of the neck and upper spine without contrast material (a substance used to enhance visibility of the body's internal structures).
$720
74177TC
Ct abd & pelv w/contrast
CT scan of the abdomen and pelvis region with contrast material (a substance used to enhance visibility of the body's internal structures).
$610
70553TC
Mri brain stem w/o & w/dye
MRI scan of the brain and brain stem before and after contrast (a substance used to enhance visibility of the body's internal structures).
$1,543
71260TC
Ct thorax w/dye
CT scan of the thorax (the chest area) with contrast material (a substance used to enhance visibility of the body's internal structures).
$464
72146TC
Mri chest spine w/o dye
MRI scan of the thoracic (chest area) of the spine without contrast material (a substance used to enhance visibility of the body's internal structures).
$739
74176TC
Ct abd & pelvis w/o contrast
CT scan of the abdomen and pelvis region without contrast material (a substance used to enhance visibility of the body's internal structures).
$303
73700TC
Ct lower extremity w/o dye
CT scan of the lower extremity (leg) without contrast material (a substance used to enhance visibility of the body's internal structures).
$363
72195TC
Mri pelvis w/o dye
MRI scan of the pelvis without contrast material (a substance used to enhance visibility of the body's internal structures).
$822
74178TC
Ct abd & pelv 1/> regns
CT scan of the abdomen and pelvis before and after contrast (a substance used to enhance visibility of the body's internal structures).
$698
70551TC
Mri brain stem w/o dye
MRI scan of the brain, including the brain stem, without contrast (a substance used to enhance visibility of the body's internal structures).
$826
71250TC
Ct thorax w/o dye
CT scan of the thorax (the chest area) without contrast material (a substance used to enhance visibility of the body's internal structures).
$372
77290TC
Set radiation therapy field
Complex management of radiation therapy for three or more treatment areas.
$1,156
70450TC
Ct head/brain w/o dye
CT scan of head or brain without contrast material (a substance used to enhance visibility of the body's internal structures).
$288
73718TC
Mri lower extremity w/o dye
MRI scan of the lower extremity (leg) without contrast material (a substance used to enhance visibility of the body's internal structures).
$819
Internal Medicine
CPT Code
Code Description
Explanation
Price
J0897
Denosumab injection
Injection of denosumab (brand names: Prolia and Xgeva) to treat osteoporosis and high calcium levels and prevent fractures.
$22
99233
Subsequent hospital care
Follow up evaluation and management of a patient in the hospital requiring high-complexity medical decision making (Level 3).
$180
96372
Ther/proph/diag inj sc/im
Therapeutic, prophylactic and diagnostic injections and infusions used for treatment, prevention and diagnosis (excludes chemotherapy and other complex medications.
$42
J3301
Triamcinolone acet inj nos
Injection of triamcinolone, a steroid that decreases inflammation (swelling).
$3
J1050
Medroxyprogesterone acetate
Depo-Provera injection, an injection used as a contraceptive (birth control) or to treat kidney cancer, endometrial cancer and pain caused by endometriosis.
$1
90662
Iiv no prsv increased ag im
Preservative-free, high-dose Fluzone (influenza) vaccine.
$65
G0008
Admin influenza virus vac
Administration of influenza (flu) vaccine.
$19
77080
Dxa bone density axial
Axial DEXA scan, a non-invasive imaging test that measures bone density in the axial skeleton, which includes, for example, the hips, pelvis and spine.
$179
J3420
Vitamin b12 injection
An Injection used to treat vitamin b-12 deficiency.
$5
90471
Immunization admin
A single immunization that does not involve face-to-face counseling.
$38
94664
Evaluate pt use of inhaler
The demonstration and/or evaluation of patient use of an inhaler.
$37
9581126
Polysom 6/>yrs cpap 4/> parm
Physician interpretation of a polysomnogram (sleep study) of patients age 6 and older with CPAP machine assistance.
$373
94762
Measure blood oxygen level
Non-invasive overnight measurement of oxygen levels in the blood using an ear or finger device.
$53
90688
Iiv4 vaccine splt 0.5 ml im
Split virus influenza vaccine, a type of influenza (flu) vaccine designed to cause fewer reactions at the injection site (e.g., swelling, rash, etc.).
$22
99304
Nursing facility care init
Initial evaluation and management of a patient in a nursing facility requiring low-complexity medical decision making.
$156
Lab
CPT Code
Code Description
Explanation
Price
36415
Routine venipuncture
Insertion of needle into vein for collection of blood samples.
$10
85025
Complete cbc w/auto diff wbc
Complete blood count, A blood test used to evaluate overall health.
$15
80053
Comprehen metabolic panel
A comprehensive panel that includes 14 blood tests, used for medical screening.
$22
80061
Lipid panel
A blood test that measures good and bad cholesterol and triglycerides (a type of fat in the blood).
$28
84443
Assay thyroid stim hormone
TSH test, a blood test that measures the amount of thyroid-stimulating hormone (TSH) in the blood.
$35
84439
Assay of free thyroxine
Free T4 test, a blood test that is used to help diagnose conditions of the thyroid.
$18
83036
Glycosylated hemoglobin test
A1c test, a blood test that measures glycosylated hemoglobin; used to diagnose and monitor diabetes.
$20
81003
Urinalysis auto w/o scope
Analysis of urine sample to diagnose UTIs, kidney disorders, liver problems, etc.
$6
82306
Vitamin d 25 hydroxy
A blood test that measures the amount of vitamin D in the body.
$62
80050
General health panel
A blood test that includes a complete blood count, a comprehensive metabolic panel and thyroid test.
$87
82570
Assay of urine creatinine
Creatinine urine test, a laboratory test that measures the amount of creatinine (a chemical waste product) in the urine.
$10
82607
Vitamin b-12
A blood test that measures the amount of vitamin b-12 in the body.
$31
85610QW
Prothrombin time
Laboratory test that calculates the average time it takes for your blood to clot.
$8
80048
Metabolic panel total ca
Basic metabolic panel, a blood test that measures blood sugar levels, electrolyte and fluid balance, and kidney function.
$18
84153
Assay of psa total
PSA test, a blood test that is used to screen for prostate cancer by measuring total prostate specific antigen (PSA).
$38
83615
Lactate (ld) (ldh) enzyme
LDH test, a blood test that measures lactate dehydrogenase in the body to looks for signs of damage to tissues in the body.
$12
82043
Ur albumin quantitative
A laboratory test that measures albumin levels, a protein found in the blood.
$13
87880
Strep a assay w/optic
Strep test that detects the presence of streptococcus bacteria using a throat swab.
$28
83540
Assay of iron
A blood test that measures iron levels in the blood to help diagnose anemia or other conditions.
$14
36416
Capillary blood draw
Sampling a small amount of blood from a puncture on the finger (finger prick), heel or earlobe.
$9
82728
Assay of ferritin
Ferritin test, a blood test that shows how much iron the body stores.
$28
83550
Iron binding test
A blood test that measures the blood's ability to attach itself to iron and transport it around the body.
$18
86140
C-reactive protein
A blood test that helps identify inflammation in the body.
$11
84403
Assay of total testosterone
A blood test that measures the amount of testosterone in the blood.
$54
81025
Urine pregnancy test
A laboratory test that evaluates the urine to look for signs of pregnancy.
$15
83735
Assay of magnesium
A blood test that measures the amount of magnesium in the blood.
$14
83970
Assay of parathormone
A blood test that measures the level of parathyroid hormone in the blood.
$86
85018
Hemoglobin
A blood test that measures the amount of hemoglobin (a protein that carries oxygen from your lungs to the rest of your body).
$6
Nephrology
CPT Code
Code Description
Explanation
Price
J0885
Epoetin alfa, non-esrd
Injection of epoetin alfa (brand names: Procrit and Epogen) to treat anemia in patients chronic kidney disease (non-end stage).
$17
90960
Esrd srv 4 visits p mo 20+
Monthly services (four or more visits per month) for patients with end-stage renal disease, including dialysis.
$528
99233
Subsequent hospital care
Follow up evaluation and management of a patient in the hospital requiring high-complexity medical decision making (Level 3).
$180
99232
Subsequent hospital care
Follow up evaluation and management of a patient in the hospital requiring moderate-complexity medical decision making (Level 2).
$126
90935
Hemodialysis one evaluation
Hemodialysis with a single physician evaluation.
$137
90961
Esrd srv 2-3 vsts p mo 20+
Monthly services (two - three visits per month) for patients with end-stage renal disease, including dialysis.
$443
90966
Esrd home pt serv p mo 20+
Monthly home dialysis services.
$442
99223
Initial hospital care
Initial evaluation of a patient in the hospital requiring complex medical decision making and a comprehensive exam (Level 3).
$350
90970
Esrd svc pr day pt 20+
Dialysis services per day (for less than full month service).
$15
G0008
Admin influenza virus vac
Administration of influenza vaccine.
$19
90653
Iiv adjuvant vaccine im
Inactivated influenza (flu) vaccine, a vaccine made from killed flu viruses.
$63
Neurology
CPT Code
Code Description
Explanation
Price
J0585
Injection,onabotulinumtoxina
Botox injection to treat muscle stiffness/spasm and migraines.
$10
95886
Musc test done w/n test comp
Muscle test, a test in which a needle is inserted directly into a muscle (needle EMG) and records the muscle's electrical activity.
$205
J3301
Triamcinolone acet inj nos
Injection of triamcinolone, a steroid that decreases inflammation (swelling).
$3
95923
Autonomic nrv syst funj test
A test that evaluates functions of the autonomic nervous system, which controls heart rate, body temperature, breathing rate, etc.
$284
J1885
Ketorolac tromethamine inj
Injection of a nonsteroidal anti-inflammatory drug (NSAID) used for the short-term treatment of moderate to severe pain.
$16
64615
Chemodenerv musc migraine
Chemodenervation, an injection procedure for the purposes of treating chronic migraines.
$339
95913
Nrv cndj test 13/> studies
13 or more nerve conduction studies, which are used to evaluate the function of motor and sensory nerves.
$674
64405
N block inj occipital
Occipital nerve block, an injection into the occipital nerves (located above the neck) to treat chronic headaches.
$284
9595126
Eeg monitoring/videorecord
Physician analysis and interpretation of results from an EEG video monitoring test, a test used to diagnose non-epileptic seizures.
$728
OBG/YN
CPT Code
Code Description
Explanation
Price
90471
Immunization admin
A single immunization that does not involve face-to-face counseling.
$38
59025
Fetal non-stress test
A screening test used to evaluate fetal oxygen supply. movement and heart rate.
$95
76811
Ob us detailed sngl fetus
Real-time ultrasound of the uterus for a single fetus with evaluation of fetal anatomical development.
$508
76856
Us exam pelvic complete
Nonobstetric ultrasound of the pelvis (i.e., ultrasounds unrelated to pregnancy care)
$301
76816
Ob us follow-up per fetus
Follow-up ultrasound for re-evaluation of fetal size.
$317
96372
Ther/proph/diag inj sc/im
Therapeutic, prophylactic and diagnostic injections and infusions used for treatment, prevention and diagnosis (excludes chemotherapy and other complex medications.
$42
58300
Insert intrauterine device
Insertion of an IUD, a small, contraceptive (birth control) device, into the uterus.
$176
59400
Obstetrical care
Routine care for pregnant women, including pre- and postpartum care and delivery.
$3,729
90715
Tdap vaccine 7 yrs/> im
A vaccine that prevents tetanus, diphtheria (bacterial infection of the nose and throat), and pertussis (whooping cough).
$55
58301
Remove intrauterine device
Removal of IUD, a small, contraceptive (birth control) device.
$190
76815
Ob us limited fetus(s)
Real-time ultrasound limited to the evaluation of the fetal heartbeat and position.
$233
90686
Iiv4 vacc no prsv 0.5 ml im
Split virus influenza vaccine, a type of preservative-free influenza (flu) vaccine designed to cause fewer reactions at the injection site (e.g., swelling, rash, etc.).
$28
Oncology
CPT Code
Code Description
Explanation
Price
J1439
Inj ferric carboxymaltos 1mg
Injection of ferric carboxymaltose (brand name: Injectafer) to treat iron deficiency anemia.
$1
J1442
Inj filgrastim excl biosimil
Injection of filgrastim (brand name: Neupogen) to treat a lack of white blood cells caused by cancer, chemotherapy, bone marrow transplant and other conditions.
$2
J0641
Levoleucovorin injection
Injection of levoleucovorin (brand names: Fusilev and Khapzory) to prevent the harmful effects of a cancer medicine called methotrexate.
$3
J9306
Injection, pertuzumab, 1 mg
Injection of pertuzumab (brand name: Perjeta) to treat breast cancer that has spread to other parts of the body.
$20
J9263
Oxaliplatin
Injection of oxaliplatin (brand name: Eloxatin) to treat advanced colorectal cancer.
$20
J3380
Injection, vedolizumab
Injection of vedolizumab (brand name: Entyvio) to treat Crohn's disease and ulcerative colitis in patients that have not had success with other medicines.
$23
J0897
Denosumab injection
Injection of denosumab (brand names: Prolia and Xgeva) to treat osteoporosis and high calcium levels and prevent fractures.
$22
J9267
Paclitaxel injection
Injection of paclitaxel (brand names: Nov-Onxol, Onxol, Paclitaxel Novaplus, Taxol) to treat advanced ovarian, breast and other cancers.
$1
J1756
Iron sucrose injection
Injection of iron sucrose (brand name: Venofer) to treat iron deficiency in patients with chronic kidney disease.
$2
J9025
Azacitidine injection
Injection of azacitidine (brand name: Vidaza) to treat a group of blood and bone marrow disorders.
$12
J2323
Natalizumab injection
Injection of natalizumab (brand name: Tysabri) to treat relapsing forms of MS (multiple sclerosis).
$22
J1453
Fosaprepitant injection
Injection of fosaprepitant (brand name: Emend) to prevent nausea and vomiting caused by chemotherapy.
$5
J1100
Dexamethasone sodium phos
Injection of dexamethasone, a steroid used to treat inflammation (swelling).
$7
J9171
Docetaxel injection
Injection of docetaxel (brand names: Docefrez and Taxotere) to treat a variety of cancers.
$43
J9355
Trastuzumab injection
Injection of trastuzumab (brand names: Herceptin, Herzuma, Ogivri, Ontruzant) to treat breast cancer.
$145
J1745
Infliximab not biosimil 10mg
Injection of infliximab to treat Crohn's disease, ulcerative colitis, rheumatoid arthritis and other conditions.
$141
J0885
Epoetin alfa, non-esrd
Injection of epoetin alfa (brand names: Procrit and Epogen) to treat anemia in patients chronic kidney disease (non-end stage).
$17
J9299
Injection, nivolumab
Injection of nivolumab (brand name: Opdivo) to treat melanoma (skin cancer).
$33
J9176
Injection, elotuzumab, 1mg
Injection of elotuzumab (brand name: Empliciti) to treat multiple myeloma, a cancer in the blood cells.
$8
Ophthalmology
CPT Code
Code Description
Explanation
Price
92015
Determine refractive state
Assessment of the eyes for prescription eyewear using a range of lens powers.
$118
92014
Eye exam&tx estab pt 1/>vst
Comprehensive eye and medical examination for an established patient.
$196
92004
Eye exam new patient
Comprehensive eye and medical examination for a new patient.
$245
92134
Cptr ophth dx img post segmt
Diagnostic imaging scan of the retina used to detect disease and assess eye health.
$89
92012
Eye exam establish patient
An eye and medical examination of a limited portion of the eye (does not include a complete visual examination).
$134
66984
Cataract surg w/iol 1 stage
Removal of cataract with the insertion of a prosthetic lens.
$1,408
92136
Ophthalmic biometry
Biometry eye test, a test that measures the shape and size of the eye.
$150
92133
Cmptr ophth img optic nerve
Diagnostic imaging scan of the optic nerve used to detect glaucoma.
$85
92083
Visual field examination(s)
An examination that measures the field of vision, including peripheral (side) vision, during daylight conditions.
$152
66821
After cataract laser surgery
A surgical procedure to treat haze that develops behind the lens after cataract surgery.
$681
Orthopedics
CPT Code
Code Description
Explanation
Price
J3301
Triamcinolone acet inj nos
Injection of triamcinolone, a steroid that decreases inflammation (swelling).
$3
20610
Drain/inj joint/bursa w/o us
Fluid removal in a major joint without the use of ultrasound technology.
$162
J0585
Injection,onabotulinumtoxina
Botox injection to treat muscle stiffness/spasm and migraines.
$10
J7325
Synvisc or synvisc-one
An injection used to treat osteoarthritis pain.
$25
73564
X-ray exam knee 4 or more
Complete X-ray examination of the knee with four or more views.
$114
73630
X-ray exam of foot
Complete X-ray examination of the foot with a minimum of three views.
$86
73030
X-ray exam of shoulder
Complete X-ray examination of the shoulder with a minimum of two views.
$83
73562
X-ray exam of knee 3
X-ray examination of the knee with three views.
$102
73140
X-ray exam of finger(s)
X-ray examination of one or more fingers with a minimum of two views.
$92
J0702
Betamethasone acet&sod phosp
Injection of betamethasone (brand name: Celestone Soluspan) to treat inflammation (swelling) and arthritis.
$11
J7323
Euflexxa inj per dose
Injection of Euflexxa to treat osteoarthritis pain.
$376
73100
X-ray exam of wrist
X-ray examination of the wrist with two views.
$88
73502
X-ray exam hip uni 2-3 views
X-ray examination of the hip and pelvis with two or three views.
$118
73610
X-ray exam of ankle
Complete X-ray examination of the ankle with a minimum of three views.
$92
72100
X-ray exam l-s spine 2/3 vws
X-ray examination of the lower spine with two or three views.
$100
20552
Inj trigger point 1/2 muscl
Trigger point injection, a procedure used to treat muscle pain (one to two muscles).
$120
20550
Inj tendon sheath/ligament
Tendon sheath and ligament injection, a procedure used to treat pain, caused by inflammation (swelling) or disease, in the structures surrounding tendons and joints.
$119
64483
Inj foramen epidural l/s
Epidural injection into the spine using the guidance of imaging technology
$709
73110
X-ray exam of wrist
Complete X-ray examination of the wrist with a minimum of three views.
$100
20600
Drain/inj joint/bursa w/o us
Fluid removal in a small joint (e.g., fingers or toes) without the use of ultrasound technology.
$112
Physical Therapy
CPT Code
Code Description
Explanation
Price
97110
Therapeutic exercises
Therapeutic physical therapy exercises in one or more areas.
$49
97010
Hot or cold packs therapy
Application of a hot or cold pack to one or more area.
$10
97140
Manual therapy 1/> regions
Therapeutic exercises in which a physical therapist manipulates and moves the muscles or joints.
$46
97530
Therapeutic activities
Physical therapy activities with direct, one-on-one patient contact.
$63
97161
Pt eval low complex 20 min
20-minute evaluation of physical therapy treatment for a patient with low complexity.
$135
97014
Electric stimulation therapy
A therapy in which electrodes are applied to the skin, sending electric pulses to the muscles (sometimes called E-stim)
$24
97022
Whirlpool therapy
A therapy that decreases pain and swelling, promotes wound healing and increases mobility.
$35
97113
Aquatic therapy/exercises
Exercises performed in water for physical rehabilitation.
$64
G0283
Elec stim other than wound
Non-wound care electrical Stimulation (E-stim), a therapy in which electrodes are applied to the skin, sending electric pulses to the muscles for therapy other than wound care.
$22
97162
Pt eval mod complex 30 min
30-minute evaluation of physical therapy treatment for a patient with moderate complexity.
$135
97035
Ultrasound therapy
A procedure in which a physical therapist uses ultrasound technology to reduce pain.
$22
97535
Self care mngment training
Self-care and home management training for patients who need help with activities of daily living.
$54
Radiation Oncology
CPT Code
Code Description
Explanation
Price
G6013
Radiation treatment delivery
The delivery of radiation treatment in three or more treatment areas.
$515
G6015
Radiation tx delivery imrt
IMRT (intensity modulated radiation therapy), a type of radiation therapy in which the intensity of the radiation beam is adapted to match the precise shape of a tumor and minimize tissue damage.
$881
G600226
Stereoscopic x-ray guidance
Interpretation of results from a stereoscopic X-ray, an imaging test that is used to identify the volume of radiation therapy needed.
$42
G6002
Stereoscopic x-ray guidance
An imaging test that is used to identify the volume of radiation therapy needed.
$190
77300
Radiation therapy dose plan
The measurement, calculation and assessment of radiation therapy doses.
$186
A9606
Radium ra223 dichloride ther
Injection of radium dichloride (brand name: Xofigo) to treat prostate cancer.
$182
77427
Radiation tx management x5
Management of five courses of radiation treatment.
$544
77336
Radiation physics consult
Consultation of radiation therapy including assessment of treatment and review of dose delivery.
$227
77334
Radiation treatment aid(s)
The design and construction of complex treatment devices that assist in radiation therapy.
$377
77417
Radiology port images(s)
X-ray images taken throughout radiation treatment to check the positioning of the radiation.
$45
Radiology
CPT Code
Code Description
Explanation
Price
77063
Breast tomosynthesis bi
Screening mammogram, a test used to detect breast cancer in women using radiographic (X-ray) technique.
$153
77067
Scr mammo bi incl cad
Screening 3D mammogram, a test used to detect breast cancer in women using tomosynthesis, a method that produces high-definition, 3D images; often used in conjunction with a typical mammography.
$374
7706726
Scr mammo bi incl cad
Physician interpretation of the results from a 3D mammogram, a test used to detect breast cancer.
$110
7706326
Breast tomosynthesis bi
Physician interpretation of the results from a mammogram, a test used to detect breast cancer.
$86
7045026
Ct head/brain w/o dye
Physician interpretation of the results from a CT scan of head or brain without contrast material (a substance used to enhance visibility of the body's internal structures).
$123
7417726
Ct abd & pelv w/contrast
Physician interpretation of the results from a CT scan of the abdomen and pelvis region with contrast material (a substance used to enhance visibility of the body's internal structures).
$264
73721
Mri jnt of lwr extre w/o dye
MRI scan of joints in the body's lower extremities (i.e., hip, knee, ankle, foot, etc.) without contrast material (a substance used to enhance visibility of the body's internal structures).
$930
72148
Mri lumbar spine w/o dye
MRI scan of the lower spinal canal without contrast material (a substance used to enhance visibility of the body's internal structures).
$875
J3301
Triamcinolone acet inj nos
Injection of triamcinolone, a steroid that decreases inflammation (swelling).
$3
74177
Ct abd & pelv w/contrast
CT scan of the abdomen and pelvis region with contrast material (a substance used to enhance visibility of the body's internal structures).
$875
J1100
Dexamethasone sodium phos
Injection of dexamethasone, a steroid used to treat inflammation (swelling).
$7
73221
Mri joint upr extrem w/o dye
MRI scan of joint in the body's upper extremities (i.e., shoulder, elbow, wrist, etc.) without contrast material (a substance used to enhance visibility of the body's internal structures).
$913
76705
Echo exam of abdomen
Real-time ultrasound exam of the abdomen to diagnose medical conditions.
$250
7685626
Us exam pelvic complete
Nonobstetric ultrasound of the pelvis (i.e., ultrasounds unrelated to pregnancy care)
$100
7417626
Ct abd & pelvis w/o contrast
Physician interpretation of the results from a CT scan of the abdomen and pelvis region without contrast material (a substance used to enhance visibility of the body's internal structures).
$252
70553
Mri brain stem w/o & w/dye
MRI scan of the brain and brain stem before and after contrast (a substance used to enhance visibility of the body's internal structures).
$1,696
A9579
Gad-base mr contrast nos,1ml
Injection of a contrast agent (a substance used to enhance visibility of the body's internal structures) to improve the quality of MRI images.
$11
77002
Needle localization by xray
The use of imaging technology to ensure precise placement of a needle for biopsy, injections, aspirations (removal of cells and fluids via suction), etc.
$278
Sleep
CPT Code
Code Description
Explanation
Price
95810TC
Polysom 6/> yrs 4/> param
A polysomnogram (sleep study) of patients age 6 and older that tracks four or more measures of sleep.
$1,139
95811TC
Polysom 6/>yrs cpap 4/> parm
A polysomnogram (sleep study) of patients age 6 and older with CPAP machine assistance that tracks four or more measures of sleep.
$1,250
95806TC
Sleep study unatt&resp efft
A polysomnogram (sleep study) conducted at home instead of at a sleep center.
$241
95805TC
Multiple sleep latency test
A test that measures alertness, how quickly you fall asleep and other measures of sleep to diagnose a sleep disorder.
$1,155
95807TC
Sleep study attended
A sleep study that also records breathing, heart rate and oxygen saturation, and is attended by a technologist.
$990
95808TC
Polysom any age 1-3> param
A polysomnogram (sleep study) of patients of any age that tracks one to three measures of sleep.
$1,355
Spine & Rehab
CPT Code
Code Description
Explanation
Price
97110
Therapeutic exercises
Therapeutic physical therapy exercises in one or more areas.
$49
97140
Manual therapy 1/> regions
Therapeutic exercises in which a physical therapist manipulates and moves the muscles or joints.
$46
G0283
Elec stim other than wound
Non-wound care electrical Stimulation (E-stim), a therapy in which electrodes are applied to the skin, sending electric pulses to the muscles for therapy other than wound care.
$22
97035
Ultrasound therapy
A procedure in which a physical therapist uses ultrasound technology to reduce pain.
$22
97014
Electric stimulation therapy
A therapy in which electrodes are applied to the skin, sending electric pulses to the muscles (sometimes called E-stim)
$24
97012
Mechanical traction therapy
A non-surgical procedure that treats lower back, neck, and radiating arm and leg pain.
$25
J0702
Betamethasone acet&sod phosp
Injection of betamethasone (brand name: Celestone Soluspan) to treat inflammation (swelling) and arthritis.
$11
J0586
Abobotulinumtoxina
Injection of abobotulinumtoxinA (brand name: Dysport) to treat muscle spasms.
$12
97162
Pt eval mod complex 30 min
30-minute evaluation of physical therapy treatment for a patient with moderate complexity.
$135
95911
Nrv cndj test 9-10 studies
Nine to 10 nerve conduction studies, which are used to evaluate the function of motor and sensory nerves.
$524
97010
Hot or cold packs therapy
Application of a hot or cold pack to one or more area.
$10
95886
Musc test done w/n test comp
A test in which a needle is inserted directly into a muscle (needle EMG) and records the muscle's electrical activity.
$205
97112
Neuromuscular reeducation
A therapeutic procedure to restore normal function of the nerves and muscles.
$56
62370
Anl sp inf pmp w/mdreprg&fil
Electronic analysis, reprogramming and refill of implanted pump used for epidural drug infusion.
$273
20552
Inj trigger point 1/2 muscl
Trigger point injection, a procedure used to treat muscle pain (one to two muscles).
$120
Surgery Center
CPT Code
Code Description
Explanation
Price
43239
Egd biopsy single/multiple
EGD with biopsy, a procedure used to examine the esophagus, stomach and the upper part of the small intestine with the removal of tissues (biopsy) for testing.
$999
45385
Colonoscopy w/lesion removal
Colonoscopy with lesion removal, a procedure used to examine the colon with the removal of polyps, tumors or other lesions.
$ 2,058
45380
Colonoscopy and biopsy
Colonoscopy with biopsy, a procedure used to examine the colon with the removal of tissues (biopsy) for testing.
$1,734
43249
Esoph egd dilation <30 mm
EGD with esophagus dilation, a procedure to widen a narrowed esophagus, which often occurs as the result of acid reflux.
$1,220
45378
Diagnostic colonoscopy
Diagnostic colonoscopy, a colonoscopy performed as the result of an abnormal test result, sign or symptom
$1462
30140
Resect inferior turbinate
Turbinate reduction surgery, the partial or complete removal of the structures in your nose that cleans the air that passes through the nostrils into the lungs.
$1,114
69436
Create eardrum opening
Surgical opening of the eardrum and insertion of a ventilating tube, called a tympanostomy.
$1,179
30520
Repair of nasal septum
A surgical procedure to correct a deviated septum, a condition in which the bone and cartilage that separates the nose is off center.
$4,700
29848
Wrist endoscopy/surgery
Surgical release of wrist ligament using an endoscope.
$2,529
29826
Shoulder arthroscopy/surgery
A minimally invasive procedure of the shoulder to treat shoulder impingement.
$3,237
19380
Revise breast reconstruction
Revision surgery after a breast reconstruction procedure
$3,924
29881
Knee arthroscopy/surgery
Minimally invasive knee surgery that involves shaving the meniscus and cartilage.
$3,199
42820
Remove tonsils and adenoids
Surgical removal of tonsils and adenoids, a patch of tissue in the back of the throat.
$2,180
Urgent Care
CPT Code
Code Description
Explanation
Price
J1885
Ketorolac tromethamine inj
Injection of a nonsteroidal anti-inflammatory drug (NSAID) used for the short-term treatment of moderate to severe pain.
$16
96372
Ther/proph/diag inj sc/im
Therapeutic, prophylactic and diagnostic injections and infusions used for treatment, prevention and diagnosis (excludes chemotherapy and other complex medications.
$42
J1100
Dexamethasone sodium phos
Injection of dexamethasone, a steroid used to treat inflammation (swelling).
$7
J0696
Ceftriaxone sodium injection
Antibacterial injection used to treat infection.
$31
J2405
Ondansetron hcl injection
Injection of ondansetron (brand name: Zofran) to reduce nausea.
$9
J0558
Peng benzathine/procaine inj
Injection of penicillin to treat moderate to severe bacterial infections.
$13
94640
Airway inhalation treatment
A procedure to treat the obstruction of airways or collect specimens for testing.
$47
J2550
Promethazine hcl injection
Injection of promethazine (brand names: Antinaus 50, Phenergan, Promacot, Prorex) to relieve or prevent allergic reactions.
$4
93000
Electrocardiogram complete
Routine electrocardiogram (ECG or EKG) with interpretation.
$45
J3301
Triamcinolone acet inj nos
Injection of triamcinolone, a steroid that decreases inflammation (swelling).
$3
90471
Immunization admin
A single immunization that does not involve face-to-face counseling.
$38
J7620
Albuterol ipratrop non-comp
Nebulizer treatment, use of the medication albuterol ipratropium (brand name: DuoNeb) to treat wheezing and shortness of breath.
$3
J1200
Diphenhydramine hcl injectio
Injection of diphenhydramine (brand name: Benadryl) to treat anaphylaxis (a life-threatening allergic reaction).
$4
90715
Tdap vaccine 7 yrs/> im
Tdap vaccine, a vaccine that prevents tetanus, diphtheria (bacterial infection of the nose and throat), and pertussis (whooping cough).
$55
A4565
Slings
A device to immobilize (support and keep still) injured parts of the body such as fractures or dislocations.
$19
12001
Rpr s/n/ax/gen/trnk 2.5cm/<
Treatment of a superficial (minor, occurring in the top layer of the skin) wound.
$267
J2300
Inj nalbuphine hydrochloride
An injection of nalbuphine hydrochloride (brand name: Nubain), which is a narcotic used to treat pain.
$9
Urology
CPT Code
Code Description
Explanation
Price
J0585
Injection,onabotulinumtoxina
Botox injection to treat muscle stiffness/spasm and migraines.
$10
J9155
Degarelix injection
Injection of degarelix (brand name: Firmagon) to treat advanced prostate cancer.
$6
51798
Us urine capacity measure
Measurement of bladder capacity (the maximum amount of urine the bladder can hold) using ultrasound technology.
$37
52000
Cystoscopy
Examination of the bladder and urethra using an endoscope, an instrument that allows a provider to look deep inside the body.
$434
J0696
Ceftriaxone sodium injection
Antibacterial injection used to treat infection.
$31
J3301
Triamcinolone acet inj nos
Steroid injection that decreases inflammation (swelling).
$3
J0775
Collagenase, clost hist inj
Injection of collagenase (brand name: Xiaflex) to treat Peyronie's disease.
$52
J3480
Inj potassium chloride
Injection of potassium chloride used to treat low levels of potassium in the blood.
$1
96372
Ther/proph/diag inj sc/im
Therapeutic, prophylactic and diagnostic injections and infusions used for treatment, prevention and diagnosis (excludes chemotherapy and other complex medications.
$42
51741
Electro-uroflowmetry first
Electronic assessment of urine flow.
$211
52332
Cystoscopy and treatment
Examination of the bladder and urethra (cystoscopy) with the insertion of a stent, a tube that supports the urinary duct (ureter).
$1,277
A4358
Urinary leg or abdomen bag
Urinary drainage bag, a bag attached to the leg or abdomen that collects urine through a catheter, a thin tube that drains urine from the bladder.
$12
50590
Fragmenting of kidney stone
A procedure that uses shock waves to break up kidney stones into small pieces that can pass through the body, called lithroscopy.
$1,742
Wellness Center
CPT Code
Code Description
Explanation
Price
97803
Med nutrition indiv subseq
Reassessment of a medical nutrition therapy plan (used to manage chronic conditions through an individual nutrition plan).
$51
97802
Medical nutrition indiv in
Initial assessment and development of a medical nutrition therapy plan (used to manage chronic conditions through an individual nutrition plan).
$59
90471
Immunization admin
Administration of a single immunization that does not involve face-to-face counseling.
$38
90688
Iiv4 vaccine splt 0.5 ml im
Split virus influenza vaccine, a type of influenza (flu) vaccine designed to cause fewer reactions at the injection site (e.g., swelling, rash, etc.).
$22
7045026
Ct head/brain w/o dye
Physician interpretation of the results from a CT scan of head or brain without contrast material (a substance used to enhance visibility of the body's internal structures).
$123