Procedure Pricing
We want to help you make the best decisions for your health
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.
We're happy to discuss the specifics of your bill with you if you have any questions.
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 on everything but drugs. 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.
Financial Consideration
Financial issues should not prevent our community members from receiving the medical treatment they need. Revere Health is committed to helping everyone get care by offering financial assistance to those who qualify.
To apply for financial assistance, click the link below and fill out the form. Please return the form to charityapplication@reverehealth.com or to Patient Services: located at 1055 N 500 W Suite 102, Provo UT 84604.
Good Faith Estimate
Under federal law, patients can request a “Good Faith Estimate” of their bill before healthcare services are provided.
This estimate will explain how much your healthcare services or items will cost and will include related costs like medical tests, prescription drugs, equipment, and hospital fees.
Currently, this is only applicable for patients who don’t plan to use health insurance (self-pay) or who do not have health insurance (uninsured)*.
If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
Call 801-429-8000 for more information or if you would like to obtain a Good Faith Estimate from Revere Health.
*Some exceptions. For general questions or more information about your right to an estimate, visit www.cms.gov/nosurprises/consumers,
email FederalPPDRQuestions@cms.hhs.gov, or call 1-800-985-3059.
Estimado de buena fe
Llame al 801-429-8000 para obtener más información o si desea obtener un estimado de buena fe de Revere Health.
*Algunas excepciones. Para preguntas generales o más información sobre su derecho a un estimado, visite www.cms.gov/nosurprises/consumers, envíe un correo electrónico a FederalPPDRQuestions@cms.hhs.gov o llame al 1-800-985-3059.
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.
Established Patients
CPT CODE
Office Visit Complexity
Price
99211
Level 1
$39
99212
Level 2
$95
99213
Level 3
$153
99214
Level 4
$216
99215
Level 5
$304
New Patients
CPT CODE
Office Visit Complexity
Price
99201
Level 1
$82
99202
Level 2
$121
99203
Level 3
$187
99204
Level 4
$282
99205
Level 5
$372
Established Patients
CPT CODE
99211
Office Visit Complexity
Level 1
Price
$39
CPT CODE
99212
Office Visit Complexity
Level 2
Price
$95
CPT CODE
99213
Office Visit Complexity
Level 3
Price
$153
CPT CODE
99214
Office Visit Complexity
Level 4
Price
$216
CPT CODE
99215
Office Visit Complexity
Level 5
Price
$304
New Patients
CPT CODE
99201
Office Visit Complexity
Level 1
Price
$82
CPT CODE
99202
Office Visit Complexity
Level 2
Price
$121
CPT CODE
99203
Office Visit Complexity
Level 3
Price
$187
CPT CODE
99204
Office Visit Complexity
Level 4
Price
$282
CPT CODE
99205
Office Visit Complexity
Level 5
Price
$372
Search by Specialty
Adult and Adolescent Medicine
90471
Immunization admin
Administration of a single immunization that does not involve face-to-face counseling.
$19
20610
Drain/inj joint/bursa w/o us
Fluid removal in a major joint without the use of ultrasound technology.
$153
G0008
Admin influenza virus vac
Administration of influenza vaccine.
$19
99223
Initial hospital care
Initial evaluation of a patient in the hospital requiring complex medical decision making and a comprehensive exam (Level 3).
$325
99232
Subsequent hospital care
Follow up evaluation and management of a patient in the hospital requiring moderate-complexity medical decision making (Level 2).
$133
90662
Iiv no prsv increased ag im
Preservative-free, high-dose Fluzone (influenza) vaccine.
$98
99231
Subsequent hospital care
Follow up evaluation and management of a patient in the hospital requiring low-complexity medical decision making (Level 1).
$84
J1030
Methylprednisolone 40 mg inj
Methylprednisolone injection (brand names: A-Methapred, Depo-Medrol, SoluMEDROL) typically used to treat pain and swelling.
$10
99239
Hospital discharge day
Management of patient health on hospital discharge day.
$193
G0250
Md inr test revie inter mgmt
Physician review, interpretation and management of home INR testing (to monitor blood thinning medications).
$18
Allergy and Immunology
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.
$39
95044
Allergy patch tests
Allergy test in which a patch with a possible allergen is placed onto the skin. Charge is per allergen.
$13
94060
Evaluation of wheezing
Breathing capacity test after receiving a medication that widens the air passages into the lungs.
$123
94010
Breathing capacity test
Non-invasive evaluation of how quickly and how much air you exhale.
$73
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
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.
$18
95115
Immunotherapy one injection
Single immunotherapy injection. Does not include preparation of vial.
$25
95117
Immunotherapy injections
Multiple immunotherapy injections. Does not include preparation of vial.
$32
95165
Antigen therapy services
Preparation by an allergist of an immunotherapy injection.
$33
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.
$9
Dermatology
J3301
Triamcinolone acet inj nos
Steroid injection that decreases inflammation (swelling).
$2
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.
$767
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.
$1278
8830526
Tissue exam by pathologist
Interpretation of results from a pathologist tissue exam.
$74
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.
$234
88305
Tissue exam by pathologist
Examination of sample tissue by a pathologist to diagnose or rule out certain conditions.
$147
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.
$215
17000
Destruct premalg lesion
Destruction of a single precancerous skin lesion (abnormality) through laser surgery, electrosurgery, cryosurgery (freezing) or curettement (scraping).
$126
95044
Allergy patch tests
Allergy test in which a patch with a possible allergen is placed onto the skin. Charge is per allergen.
$13
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
Endocrinology
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.
$39
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.
$222
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.
$93
G0103
Psa screening
A blood test used to screen for prostate cancer.
$38
J0834
Inj. cosyntropin 0.25 mg
Injection of cosyntropin (brand name: Cortrosyn) to diagnose adrenal gland disorders.
$147
95250
Cont gluc mntr phys/qhp eqp
Continuous glucose monitoring, including sensor placement, patient training, calibration, removal and downloading data from the monitor.
$331
76942
Echo guide for biopsy
Use of ultrasound technology to guide the placement of a needle during a biopsy.
$333
76536
Us exam of head and neck
Use of ultrasound technology to examine salivary glands, lymph nodes, lesions and the endocrine system.
$322
95251
Cont gluc mntr analysis i&r
Analysis and interpretation of data from a continuous glucose monitor, a device that tracks your blood sugar.
$81
ENT
J0696
Ceftriaxone sodium injection
Antibacterial injection used to treat infection.
$31
42820
Remove tonsils and adenoids
Surgical removal of tonsils and adenoids, a patch of tissue in the back of the throat.
$626
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.
$1562
69436
Create eardrum opening
Surgical opening of the eardrum and insertion of a ventilating tube, called a tympanostomy.
$372
30901
Control of nosebleed
Control of minor nosebleed that originates in the front of the nose (anterior).
$357
42826
Removal of tonsils
Surgical removal of tonsils.
$549
92504
Ear microscopy examination
Examination of the ear using a microscope.
$66
92567
Tympanometry
A test used to diagnose and monitor conditions of the middle ear.
$38
31505
Diagnostic laryngoscopy
Diagnostic examination of voice box using an endoscope, an instrument used to look inside the body.
$205
69210
Remove impacted ear wax uni
Removal of earwax buildup.
$111
Family Medicine
90471
Immunization admin
Administration of a single immunization that does not involve face-to-face counseling.
$19
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.
$39
J3301
Triamcinolone acet inj nos
Steroid injection that decreases inflammation (swelling).
$2
J0696
Ceftriaxone sodium injection
Antibacterial injection used to treat infection.
$31
J1100
Dexamethasone sodium phos
Injection of dexamethasone, a steroid used to treat inflammation (swelling).
$7
J1885
Ketorolac tromethamine inj
Injection of a nonsteroidal anti-inflammatory drug (NSAID) used for the short-term treatment of moderate to severe pain.
$16
J7325
Synvisc or synvisc-one
An injection used to treat osteoarthritis pain.
$18
87880
Strep a assay w/optic
Strep test that detects the presence of streptococcus bacteria using a throat swab.
$28
J0897
Denosumab injection
Injection of denosumab (brand names: Prolia and Xgeva) to treat osteoporosis and high calcium levels and prevent fractures.
$32
85651
Rbc sed rate nonautomated
Red blood cell sedimentation test, a blood test that detects inflammatory activity in the body.
$7
90472
Immunization admin each add
Administration of additional immunizations that do not involve face-to-face counseling.
$22
90461
Im admin each addl component
Administration of additional immunizations with physician counsel for patients age 18 and younger.
$19
90460
Im admin 1st/only component
Administration of initial immunization with physician counsel for patients age 18 and younger.
$35
99231
Subsequent hospital care
Follow up evaluation and management of a patient in the hospital requiring low-complexity medical decision making (Level 1).
$84
G0439
Ppps subseq visit
Subsequent Annual Wellness Visits, yearly follow-up appointments to discuss and adjust a patient's personalized prevention plan (initial appointment).
$191
G0438
Ppps initial visit
Initial Annual Wellness Visit, the first yearly appointment to create a patient's personalized prevention plan.
$266
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.
$305
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.
$224
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.
$204
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.
$190
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.
$304
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.
$270
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.
$213
Gastroenterology
90471
Immunization admin
Administration of a single immunization that does not involve face-to-face counseling.
$19
45378
Diagnostic colonoscopy
Diagnostic colonoscopy, a colonoscopy performed as the result of an abnormal test result, sign or symptom
$926
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.
$3140
45380
Colonoscopy and biopsy
Colonoscopy with biopsy, a procedure used to examine the colon with the removal of tissues (biopsy) for testing.
$1190
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.
$1242
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.
$1036
99232
Subsequent hospital care
Follow up evaluation and management of a patient in the hospital requiring moderate-complexity medical decision making (Level 2).
$133
99233
Subsequent hospital care
Follow up evaluation and management of a patient in the hospital requiring high-complexity medical decision making (Level 3).
$201
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.
$724
99222
Initial hospital care
Initial evaluation of a patient in the hospital requiring moderately complex medical decision making and a comprehensive exam (Level 2).
$221
43235
Egd diagnostic brush wash
A procedure used to examine the esophagus, stomach and the upper part of the small intestine with specimen collection.
$811
General Cardiology
93000
Electrocardiogram complete
Routine electrocardiogram (ECG or EKG) with interpretation.
$48
93284
Prgrmg eval implantable dfb
Evaluation, testing and programming adjustment of defibrillator with physician analysis, review and report.
$241
93281
Pm device progr eval multi
Evaluation, testing and programming adjustment of pacemaker with physician analysis, review and report.
$191
93923
Upr/lxtr art stdy 3+ lvls
Ultrasound study of the veins in the arms and legs (3 levels).
$294
93970
Extremity study
Ultrasound study of the veins in the arms and legs to detect venous insufficiency or deep vein thrombosis (DVT).
$422
78452
Ht muscle image spect mult
Physician interpretation of results from a myocardial perfusion imaging (MPI) test, which analyzes how the heart muscle functions.
$1282
93015
Cardiovascular stress test
A test that monitors how the heart reacts to physical stress, typically using a treadmill or bicycle.
$206
93880
Extracranial bilat study
Ultrasound scanning of blood flow in the extracranial arteries (outside the brain) on both sides of head and neck.
$430
93306
Tte w/doppler complete
A procedure called a transthoracic echocardiogram that uses high-frequency sound waves to evaluate blood flow through the heart.
$526
93224
Ecg monit/reprt up to 48 hrs
Electrocardiographic monitoring for 24 hours using a holter monitor (with physician review and interpretation).
$285
Hematology-Medical Oncology
J1100
Dexamethasone sodium phos
Injection of dexamethasone, a steroid used to treat inflammation (swelling).
$7
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
J0897
Denosumab injection
Injection of denosumab (brand names: Prolia and Xgeva) to treat osteoporosis and high calcium levels and prevent fractures.
$32
J9176
Injection elotuzumab 1mg
Injection of elotuzumab (brand name: Empliciti) to treat multiple myeloma, a cancer in the blood cells.
$10
J9299
Injection nivolumab
Injection of nivolumab (brand name: Opdivo) to treat melanoma (skin cancer).
$44
J1745
Infliximab not biosimil 10mg
Injection of infliximab to treat Crohn's disease, ulcerative colitis, rheumatoid arthritis and other conditions.
$121
J9355
Inj trastuzumab excl biosimi
Injection of trastuzumab (brand names: Herceptin, Herzuma, Ogivri, Ontruzant) to treat breast cancer.
$142
J9171
Docetaxel injection
Injection of docetaxel (brand names: Docefrez and Taxotere) to treat a variety of cancers.
$28
J1453
Fosaprepitant injection
Injection of fosaprepitant (brand name: Emend) to prevent nausea and vomiting caused by chemotherapy.
$3
J2323
Natalizumab injection
Injection of natalizumab (brand name: Tysabri) to treat relapsing forms of MS (multiple sclerosis).
$35
J9025
Azacitidine injection
Injection of azacitidine (brand name: Vidaza) to treat a group of blood and bone marrow disorders.
$12
J1756
Iron sucrose injection
Injection of iron sucrose (brand name: Venofer) to treat iron deficiency in patients with chronic kidney disease.
$1
J9267
Paclitaxel injection
Injection of paclitaxel (brand names: Nov-Onxol, Onxol, Paclitaxel Novaplus, Taxol) to treat advanced ovarian, breast and other cancers.
$1
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.
$32
J9263
Oxaliplatin
Injection of oxaliplatin (brand name: Eloxatin) to treat advanced colorectal cancer.
$12
J9306
Injection pertuzumab 1 mg
Injection of pertuzumab (brand name: Perjeta) to treat breast cancer that has spread to other parts of the body.
$21
J0641
Inj levoleucovorin nos 0.5mg
Injection of levoleucovorin (brand names: Fusilev and Khapzory) to prevent the harmful effects of a cancer medicine called methotrexate.
$2
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
J1439
Inj ferric carboxymaltos 1mg
Injection of ferric carboxymaltose (brand name: Injectafer) to treat iron deficiency anemia.
$2
Imaging
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).
$832
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).
$334
77290TC
Set radiation therapy field
Complex management of radiation therapy for three or more treatment areas.
$1055
71250TC
Ct thorax dx c-
CT scan of the thorax (the chest area) without contrast material (a substance used to enhance visibility of the body's internal structures).
$423
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).
$843
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).
$737
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).
$836
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).
$354
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).
$307
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).
$877
71260TC
Ct thorax dx c+
CT scan of the thorax (the chest area) with contrast material (a substance used to enhance visibility of the body's internal structures).
$490
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).
$1646
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).
$653
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).
$810
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).
$821
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).
$826
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).
$877
Internal Medicine
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.).
$30
90471
Immunization admin
Administration of a single immunization that does not involve face-to-face counseling.
$19
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.
$39
J3301
Triamcinolone acet inj nos
Steroid injection that decreases inflammation (swelling).
$2
G0008
Admin influenza virus vac
Administration of influenza vaccine.
$19
99233
Subsequent hospital care
Follow up evaluation and management of a patient in the hospital requiring high-complexity medical decision making (Level 3).
$201
99304
Nursing facility care init
Initial evaluation and management of a patient in a nursing facility requiring low-complexity medical decision making.
$141
94762
Measure blood oxygen level
Non-invasive overnight measurement of oxygen levels in the blood using an ear or finger device.
$57
9581126
Polysom 6/>yrs cpap 4/> parm
Physician interpretation of a polysomnogram (sleep study) of patients age 6 and older with CPAP machine assistance.
$320
94664
Evaluate pt use of inhaler
The demonstration and/or evaluation of patient use of an inhaler.
$40
J3420
Vitamin b12 injection
An Injection used to treat vitamin b-12 deficiency.
$3
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.
$222
90662
Iiv no prsv increased ag im
Preservative-free, high-dose Fluzone (influenza) vaccine.
$98
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
J0897
Denosumab injection
Injection of denosumab (brand names: Prolia and Xgeva) to treat osteoporosis and high calcium levels and prevent fractures.
$32
Laboratory
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
83970
Assay of parathormone
A blood test that measures the level of parathyroid hormone in the blood.
$86
83735
Assay of magnesium
A blood test that measures the amount of magnesium in the blood.
$14
81025
Urine pregnancy test
A laboratory test that evaluates the urine to look for signs of pregnancy.
$15
84403
Assay of total testosterone
A blood test that measures the amount of testosterone in the blood.
$54
86140
C-reactive protein
A blood test that helps identify inflammation in the body.
$11
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
82728
Assay of ferritin
Ferritin test, a blood test that shows how much iron the body stores.
$28
36416
Capillary blood draw
Sampling a small amount of blood from a puncture on the finger (finger prick), heel or earlobe.
$9
83540
Assay of iron
A blood test that measures iron levels in the blood to help diagnose anemia or other conditions.
$14
87880
Strep a assay w/optic
Strep test that detects the presence of streptococcus bacteria using a throat swab.
$28
82043
Ur albumin quantitative
A laboratory test that measures albumin levels, a protein found in the blood.
$12
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
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
80048
Metabolic panel total ca
Basic metabolic panel, a blood test that measures blood sugar levels, electrolyte and fluid balance, and kidney function.
$18
85610QW
Prothrombin time
Laboratory test that calculates the average time it takes for your blood to clot.
$7
82607
Vitamin b-12
A blood test that measures the amount of vitamin b-12 in the body.
$31
82570
Assay of urine creatinine
Creatinine urine test, a laboratory test that measures the amount of creatinine (a chemical waste product) in the urine.
$9
80050
General health panel
A blood test that includes a complete blood count, a comprehensive metabolic panel and thyroid test.
$62
82306
Vitamin d 25 hydroxy
A blood test that measures the amount of vitamin D in the body.
$62
81003
Urinalysis auto w/o scope
Analysis of urine sample to diagnose UTIs, kidney disorders, liver problems, etc.
$5
83036
Glycosylated hemoglobin test
A1c test, a blood test that measures glycosylated hemoglobin; used to diagnose and monitor diabetes.
$20
84439
Assay of free thyroxine
Free T4 test, a blood test that is used to help diagnose conditions of the thyroid.
$18
84443
Assay thyroid stim hormone
TSH test, a blood test that measures the amount of thyroid-stimulating hormone (TSH) in the blood.
$35
80061
Lipid panel
A blood test that measures good and bad cholesterol and triglycerides (a type of fat in the blood).
$28
80053
Comprehen metabolic panel
A comprehensive panel that includes 14 blood tests, used for medical screening.
$22
85025
Complete cbc w/auto diff wbc
Complete blood count, A blood test used to evaluate overall health.
$13
36415
Routine venipuncture
Insertion of needle into vein for collection of blood samples.
$15
Nephrology
90653
Iiv adjuvant vaccine im
Inactivated influenza (flu) vaccine, a vaccine made from killed flu viruses.
$89
G0008
Admin influenza virus vac
Administration of influenza vaccine.
$19
90970
Esrd svc pr day pt 20+
Dialysis services per day (for less than full month service).
$18
99223
Initial hospital care
Initial evaluation of a patient in the hospital requiring complex medical decision making and a comprehensive exam (Level 3).
$325
90966
Esrd home pt serv p mo 20+
Monthly home dialysis services.
$570
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.
$570
90935
Hemodialysis one evaluation
Hemodialysis with a single physician evaluation.
$142
99232
Subsequent hospital care
Follow up evaluation and management of a patient in the hospital requiring moderate-complexity medical decision making (Level 2).
$133
99233
Subsequent hospital care
Follow up evaluation and management of a patient in the hospital requiring high-complexity medical decision making (Level 3).
$201
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.
$687
Neurology
J3301
Triamcinolone acet inj nos
Steroid injection that decreases inflammation (swelling).
$2
J0585
Injectiononabotulinumtoxina
Botox injection to treat muscle stiffness/spasm and migraines.
$10
J1885
Ketorolac tromethamine inj
Injection of a nonsteroidal anti-inflammatory drug (NSAID) used for the short-term treatment of moderate to severe pain.
$16
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.
$220
64405
Njx aa&/strd gr ocpl nrv
Occipital nerve block, an injection into the occipital nerves (located above the neck) to treat chronic headaches.
$254
95913
Nrv cndj test 13/> studies
13 or more nerve conduction studies, which are used to evaluate the function of motor and sensory nerves.
$656
64615
Chemodenerv musc migraine
Chemodenervation, an injection procedure for the purposes of treating chronic migraines.
$356
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.
$278
OB/GYN
90471
Immunization admin
Administration of a single immunization that does not involve face-to-face counseling.
$19
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.
$39
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).
$63
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.).
$31
76815
Ob us limited fetus(s)
Real-time ultrasound limited to the evaluation of the fetal heartbeat and position.
$238
58301
Remove intrauterine device
Removal of IUD, a small, contraceptive (birth control) device.
$227
59400
Obstetrical care
Routine care for pregnant women, including pre- and postpartum care and delivery.
$5010
58300
Insert intrauterine device
Insertion of an IUD, a small, contraceptive (birth control) device, into the uterus.
$224
76816
Ob us follow-up per fetus
Follow-up ultrasound for re-evaluation of fetal size.
$323
76856
Us exam pelvic complete
Nonobstetric ultrasound of the pelvis (i.e., ultrasounds unrelated to pregnancy care)
$308
76811
Ob us detailed sngl fetus
Real-time ultrasound of the uterus for a single fetus with evaluation of fetal anatomical development.
$524
59025
Fetal non-stress test
A screening test used to evaluate fetal oxygen supply. movement and heart rate.
$101
Ophthalmology
66821
After cataract laser surgery
A surgical procedure to treat haze that develops behind the lens after cataract surgery.
$712
92083
Visual field examination(s)
An examination that measures the field of vision, including peripheral (side) vision, during daylight conditions.
$144
92133
Cmptr ophth img optic nerve
Diagnostic imaging scan of the optic nerve used to detect glaucoma.
$83
92136
Ophthalmic biometry
Biometry eye test, a test that measures the shape and size of the eye.
$135
66984
Xcapsl ctrc rmvl w/o ecp
Removal of cataract with the insertion of a prosthetic lens.
$1311
92012
Eye exam establish patient
An eye and medical examination of a limited portion of the eye (does not include a complete visual examination).
$198
92134
Cptr ophth dx img post segmt
Diagnostic imaging scan of the retina used to detect disease and assess eye health.
$93
92004
Eye exam new patient
Comprehensive eye and medical examination for a new patient.
$343
92014
Eye exam&tx estab pt 1/>vst
Comprehensive eye and medical examination for an established patient.
$289
92015
Determine refractive state
Assessment of the eyes for prescription eyewear using a range of lens powers.
$117
Orthopedics
J3301
Triamcinolone acet inj nos
Steroid injection that decreases inflammation (swelling).
$2
J0585
Injectiononabotulinumtoxina
Botox injection to treat muscle stiffness/spasm and migraines.
$10
20552
Inj trigger point 1/2 muscl
Trigger point injection, a procedure used to treat muscle pain (one to two muscles).
$112
J0702
Betamethasone acet&sod phosp
Injection of betamethasone (brand name: Celestone Soluspan) to treat inflammation (swelling) and arthritis.
$11
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
73110
X-ray exam of wrist
Complete X-ray examination of the wrist with a minimum of three views.
$120
64483
Njx aa&/strd tfrm epi l/s 1
Epidural injection into the spine using the guidance of imaging technology
$746
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.
$123
72100
X-ray exam l-s spine 2/3 vws
X-ray examination of the lower spine with two or three views.
$117
73610
X-ray exam of ankle
Complete X-ray examination of the ankle with a minimum of three views.
$107
73502
X-ray exam hip uni 2-3 views
X-ray examination of the hip and pelvis with two or three views.
$139
73100
X-ray exam of wrist
X-ray examination of the wrist with two views.
$99
J7323
Euflexxa inj per dose
Injection of Euflexxa to treat osteoarthritis pain.
$202
73140
X-ray exam of finger(s)
X-ray examination of one or more fingers with a minimum of two views.
$111
73562
X-ray exam of knee 3
X-ray examination of the knee with three views.
$119
73030
X-ray exam of shoulder
Complete X-ray examination of the shoulder with a minimum of two views.
$102
73630
X-ray exam of foot
Complete X-ray examination of the foot with a minimum of three views.
$100
73564
X-ray exam knee 4 or more
Complete X-ray examination of the knee with four or more views.
$138
J7325
Synvisc or synvisc-one
An injection used to treat osteoarthritis pain.
$18
20610
Drain/inj joint/bursa w/o us
Fluid removal in a major joint without the use of ultrasound technology.
$153
Pediatrics
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.
$189
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.
$170
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.
$170
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.
$160
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.
$219
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.
$193
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.
$189
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.
$177
Radiation Oncology
77417
Radiology port images(s)
X-ray images taken throughout radiation treatment to check the positioning of the radiation.
$44
77334
Radiation treatment aid(s)
The design and construction of complex treatment devices that assist in radiation therapy.
$370
77336
Radiation physics consult
Consultation of radiation therapy including assessment of treatment and review of dose delivery.
$257
77427
Radiation tx management x5
Management of five courses of radiation treatment.
$571
A9606
Radium ra223 dichloride ther
Injection of radium dichloride (brand name: Xofigo) to treat prostate cancer.
$260
77300
Radiation therapy dose plan
The measurement, calculation and assessment of radiation therapy doses.
$195
G6002
Stereoscopic x-ray guidance
An imaging test that is used to identify the volume of radiation therapy needed.
$156
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.
$44
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.
$744
G6013
Radiation treatment delivery
The delivery of radiation treatment in three or more treatment areas.
$499
Radiology
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).
$120
J3301
Triamcinolone acet inj nos
Steroid injection that decreases inflammation (swelling).
$2
J1100
Dexamethasone sodium phos
Injection of dexamethasone, a steroid used to treat inflammation (swelling).
$7
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.
$338
A9579
Gad-base mr contrast nos1ml
Injection of a contrast agent (a substance used to enhance visibility of the body's internal structures) to improve the quality of MRI images.
$3
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).
$1877
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).
$246
7685626
Us exam pelvic complete
Nonobstetric ultrasound of the pelvis (i.e., ultrasounds unrelated to pregnancy care)
$97
76705
Echo exam of abdomen
Real-time ultrasound exam of the abdomen to diagnose medical conditions.
$255
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).
$914
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).
$910
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).
$1023
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).
$919
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).
$258
7706326
Breast tomosynthesis bi
Physician interpretation of the results from a mammogram, a test used to detect breast cancer.
$85
7706726
Scr mammo bi incl cad
Physician interpretation of the results from a 3D mammogram, a test used to detect breast cancer.
$108
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
77063
Breast tomosynthesis bi
Screening mammogram, a test used to detect breast cancer in women using radiographic (X-ray) technique.
$154
Sleep Medicine
95808TC
Polysom any age 1-3> param
A polysomnogram (sleep study) of patients of any age that tracks one to three measures of sleep.
$1115
95807TC
Sleep study attended
A sleep study that also records breathing, heart rate and oxygen saturation, and is attended by a technologist.
$788
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.
$993
95806TC
Sleep study unatt&resp efft
A polysomnogram (sleep study) conducted at home instead of at a sleep center.
$195
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.
$1191
95810TC
Polysom 6/> yrs 4/> param
A polysomnogram (sleep study) of patients age 6 and older that tracks four or more measures of sleep.
$1138
Spine and Rehab
97162
Pt eval mod complex 30 min
30-minute evaluation of physical therapy treatment for a patient with moderate complexity.
$169
97035
Ultrasound therapy
A procedure in which a physical therapist uses ultrasound technology to reduce pain.
$24
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.
$27
97014
Electric stimulation therapy
A therapy in which electrodes are applied to the skin, sending electric pulses to the muscles (sometimes called E-stim)
$23
97140
Manual therapy 1/> regions
Therapeutic exercises in which a physical therapist manipulates and moves the muscles or joints.
$46
20552
Inj trigger point 1/2 muscl
Trigger point injection, a procedure used to treat muscle pain (one to two muscles).
$112
97010
Hot or cold packs therapy
Application of a hot or cold pack to one or more area.
$11
97110
Therapeutic exercises
Therapeutic physical therapy exercises in one or more areas.
$49
62370
Anl sp inf pmp w/mdreprg&fil
Electronic analysis, reprogramming and refill of implanted pump used for epidural drug infusion.
$262
97112
Neuromuscular reeducation
A therapeutic procedure to restore normal function of the nerves and muscles.
$57
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.
$220
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.
$486
J0586
Abobotulinumtoxina
Injection of abobotulinumtoxinA (brand name: Dysport) to treat muscle spasms.
$12
J0702
Betamethasone acet&sod phosp
Injection of betamethasone (brand name: Celestone Soluspan) to treat inflammation (swelling) and arthritis.
$11
97012
Mechanical traction therapy
A non-surgical procedure that treats lower back, neck, and radiating arm and leg pain.
$24
Sports Fitness and Physical Therapy
97162
Pt eval mod complex 30 min
30-minute evaluation of physical therapy treatment for a patient with moderate complexity.
$169
97035
Ultrasound therapy
A procedure in which a physical therapist uses ultrasound technology to reduce pain.
$24
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.
$27
97535
Self care mngment training
Self-care and home management training for patients who need help with activities of daily living.
$55
97113
Aquatic therapy/exercises
Exercises performed in water for physical rehabilitation.
$61
97014
Electric stimulation therapy
A therapy in which electrodes are applied to the skin, sending electric pulses to the muscles (sometimes called E-stim)
$23
97022
Whirlpool therapy
A therapy that decreases pain and swelling, promotes wound healing and increases mobility.
$28
97140
Manual therapy 1/> regions
Therapeutic exercises in which a physical therapist manipulates and moves the muscles or joints.
$46
97161
Pt eval low complex 20 min
20-minute evaluation of physical therapy treatment for a patient with low complexity.
$169
97530
Therapeutic activities
Physical therapy activities with direct, one-on-one patient contact.
$61
97010
Hot or cold packs therapy
Application of a hot or cold pack to one or more area.
$11
97110
Therapeutic exercises
Therapeutic physical therapy exercises in one or more areas.
$49
Surgery Center
42820
Remove tonsils and adenoids
Surgical removal of tonsils and adenoids, a patch of tissue in the back of the throat.
$626
29881
Knee arthroscopy/surgery
Minimally invasive knee surgery that involves shaving the meniscus and cartilage.
$1309
19380
Revj reconstructed breast
Revision surgery after a breast reconstruction procedure
$2205
29826
Sho arthrs srg decompression
A minimally invasive procedure of the shoulder to treat shoulder impingement.
$1421
29848
Wrist endoscopy/surgery
Surgical release of wrist ligament using an endoscope.
$1644
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.
$1562
69436
Create eardrum opening
Surgical opening of the eardrum and insertion of a ventilating tube, called a tympanostomy.
$372
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.
$712
45378
Diagnostic colonoscopy
Diagnostic colonoscopy, a colonoscopy performed as the result of an abnormal test result, sign or symptom
$926
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.
$3140
45380
Colonoscopy and biopsy
Colonoscopy with biopsy, a procedure used to examine the colon with the removal of tissues (biopsy) for testing.
$1190
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.
$1242
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.
$1036
Urgent Care
90471
Immunization admin
Administration of a single immunization that does not involve face-to-face counseling.
$19
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.
$39
J3301
Triamcinolone acet inj nos
Steroid injection that decreases inflammation (swelling).
$2
J0696
Ceftriaxone sodium injection
Antibacterial injection used to treat infection.
$31
J2300
Inj nalbuphine hydrochloride
An injection of nalbuphine hydrochloride (brand name: Nubain), which is a narcotic used to treat pain.
$9
12001
Rpr s/n/ax/gen/trnk 2.5cm/<
Treatment of a superficial (minor, occurring in the top layer of the skin) wound.
$265
A4565
Slings
A device to immobilize (support and keep still) injured parts of the body such as fractures or dislocations.
$19
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).
$63
J1200
Diphenhydramine hcl injectio
Injection of diphenhydramine (brand name: Benadryl) to treat anaphylaxis (a life-threatening allergic reaction).
$4
J7620
Albuterol ipratrop non-comp
Nebulizer treatment, use of the medication albuterol ipratropium (brand name: DuoNeb) to treat wheezing and shortness of breath.
$3
93000
Electrocardiogram complete
Routine electrocardiogram (ECG or EKG) with interpretation.
$48
J2550
Promethazine hcl injection
Injection of promethazine (brand names: Antinaus 50, Phenergan, Promacot, Prorex) to relieve or prevent allergic reactions.
$5
94640
Airway inhalation treatment
A procedure to treat the obstruction of airways or collect specimens for testing.
$49
J0558
Peng benzathine/procaine inj
Injection of penicillin to treat moderate to severe bacterial infections.
$21
J2405
Ondansetron hcl injection
Injection of ondansetron (brand name: Zofran) to reduce nausea.
$8
J1100
Dexamethasone sodium phos
Injection of dexamethasone, a steroid used to treat inflammation (swelling).
$7
J1885
Ketorolac tromethamine inj
Injection of a nonsteroidal anti-inflammatory drug (NSAID) used for the short-term treatment of moderate to severe pain.
$16
Urology
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.
$1733
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
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).
$1273
51741
Electro-uroflowmetry first
Electronic assessment of urine flow.
$211
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.
$39
J3480
Inj potassium chloride
Injection of potassium chloride used to treat low levels of potassium in the blood.
$1
J0775
Collagenase clost hist inj
Injection of collagenase (brand name: Xiaflex) to treat Peyronie's disease.
$90
J3301
Triamcinolone acet inj nos
Steroid injection that decreases inflammation (swelling).
$2
J0696
Ceftriaxone sodium injection
Antibacterial injection used to treat infection.
$31
52000
Cystoscopy
Examination of the bladder and urethra using an endoscope, an instrument that allows a provider to look deep inside the body.
$570
51798
Us urine capacity measure
Measurement of bladder capacity (the maximum amount of urine the bladder can hold) using ultrasound technology.
$33
J9155
Degarelix injection
Injection of degarelix (brand name: Firmagon) to treat advanced prostate cancer.
$6
J0585
Injectiononabotulinumtoxina
Botox injection to treat muscle stiffness/spasm and migraines.
$10
Wellness Center
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).
$120
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.).
$30
90471
Immunization admin
Administration of a single immunization that does not involve face-to-face counseling.
$19
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).
$72
97803
Med nutrition indiv subseq
Reassessment of a medical nutrition therapy plan (used to manage chronic conditions through an individual nutrition plan).
$63
Adult and Adolescent Medicine
CPT CODE
90471
Code Description
Immunization admin
Explanation
Administration of a single immunization that does not involve face-to-face counseling.
Price
$19
CPT CODE
20610
Code Description
Drain/inj joint/bursa w/o us
Explanation
Fluid removal in a major joint without the use of ultrasound technology.
Price
$153
CPT CODE
G0008
Code Description
Admin influenza virus vac
Explanation
Administration of influenza vaccine.
Price
$19
CPT CODE
99223
Code Description
Initial hospital care
Explanation
Initial evaluation of a patient in the hospital requiring complex medical decision making and a comprehensive exam (Level 3).
Price
$325
CPT CODE
99232
Code Description
Subsequent hospital care
Explanation
Follow up evaluation and management of a patient in the hospital requiring moderate-complexity medical decision making (Level 2).
Price
$133
CPT CODE
90662
Code Description
Iiv no prsv increased ag im
Explanation
Preservative-free, high-dose Fluzone (influenza) vaccine.
Price
$98
CPT CODE
99231
Code Description
Subsequent hospital care
Explanation
Follow up evaluation and management of a patient in the hospital requiring low-complexity medical decision making (Level 1).
Price
$84
CPT CODE
J1030
Code Description
Methylprednisolone 40 mg inj
Explanation
Methylprednisolone injection (brand names: A-Methapred, Depo-Medrol, SoluMEDROL) typically used to treat pain and swelling.
Price
$10
CPT CODE
99239
Code Description
Hospital discharge day
Explanation
Management of patient health on hospital discharge day.
Price
$193
CPT CODE
G0250
Code Description
Md inr test revie inter mgmt
Explanation
Physician review, interpretation and management of home INR testing (to monitor blood thinning medications).
Price
$18
Allergy and Immunology
CPT CODE
96372
Code Description
Ther/proph/diag inj sc/im
Explanation
Therapeutic, prophylactic and diagnostic injections and infusions used for treatment, prevention and diagnosis (excludes chemotherapy and other complex medications.
Price
$39
CPT CODE
95044
Code Description
Allergy patch tests
Explanation
Allergy test in which a patch with a possible allergen is placed onto the skin. Charge is per allergen.
Price
$13
CPT CODE
94060
Code Description
Evaluation of wheezing
Explanation
Breathing capacity test after receiving a medication that widens the air passages into the lungs.
Price
$123
CPT CODE
94010
Code Description
Breathing capacity test
Explanation
Non-invasive evaluation of how quickly and how much air you exhale.
Price
$73
CPT CODE
95018
Code Description
Perq&ic allg test drugs/biol
Explanation
Skin allergy test to identify allergic reactions to medications or biologic agents used to treat or diagnose a disease.
Price
$46
CPT CODE
95024
Code Description
Icut allergy test drug/bug
Explanation
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.
Price
$18
CPT CODE
95115
Code Description
Immunotherapy one injection
Explanation
Single immunotherapy injection. Does not include preparation of vial.
Price
$25
CPT CODE
95117
Code Description
Immunotherapy injections
Explanation
Multiple immunotherapy injections. Does not include preparation of vial.
Price
$32
CPT CODE
95165
Code Description
Antigen therapy services
Explanation
Preparation by an allergist of an immunotherapy injection.
Price
$33
CPT CODE
95004
Code Description
Percut allergy skin tests
Explanation
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.
Price
$9
Dermatology
CPT CODE
J3301
Code Description
Triamcinolone acet inj nos
Explanation
Steroid injection that decreases inflammation (swelling).
Price
$2
CPT CODE
17312
Code Description
Mohs addl stage
Explanation
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.
Price
$767
CPT CODE
17311
Code Description
Mohs 1 stage h/n/hf/g
Explanation
Mohs micrographic surgery, a procedure that involves removing one layer of skin cancer at a time for immediate examination of cancer cells.
Price
$1278
CPT CODE
8830526
Code Description
Tissue exam by pathologist
Explanation
Interpretation of results from a pathologist tissue exam.
Price
$74
CPT CODE
11301
Code Description
Shave skin lesion 0.6-1.0 cm
Explanation
Shaving of skin lesions (abnormalities) on the skin for cosmetic or treatment purposes under local anesthesia.
Price
$234
CPT CODE
88305
Code Description
Tissue exam by pathologist
Explanation
Examination of sample tissue by a pathologist to diagnose or rule out certain conditions.
Price
$147
CPT CODE
17110
Code Description
Destruct b9 lesion 1-14
Explanation
Destruction of 1 to 14 benign (non-cancerous) skin abnormalities other than skin tags or certain types of birthmarks.
Price
$215
CPT CODE
17000
Code Description
Destruct premalg lesion
Explanation
Destruction of a single precancerous skin lesion (abnormality) through laser surgery, electrosurgery, cryosurgery (freezing) or curettement (scraping).
Price
$126
CPT CODE
95044
Code Description
Allergy patch tests
Explanation
Allergy test in which a patch with a possible allergen is placed onto the skin. Charge is per allergen.
Price
$13
CPT CODE
17003
Code Description
Destruct premalg les 2-14
Explanation
Destruction of 2-14 pre-cancerous skin lesions (abnormalities) through laser surgery, electrosurgery, cryosurgery (freezing) or curettement (scraping).
Price
$19
Endocrinology
CPT CODE
96372
Code Description
Ther/proph/diag inj sc/im
Explanation
Therapeutic, prophylactic and diagnostic injections and infusions used for treatment, prevention and diagnosis (excludes chemotherapy and other complex medications.
Price
$39
CPT CODE
77080
Code Description
Dxa bone density axial
Explanation
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.
Price
$222
CPT CODE
77081
Code Description
Dxa bone density/peripheral
Explanation
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.
Price
$93
CPT CODE
G0103
Code Description
Psa screening
Explanation
A blood test used to screen for prostate cancer.
Price
$38
CPT CODE
J0834
Code Description
Inj. cosyntropin 0.25 mg
Explanation
Injection of cosyntropin (brand name: Cortrosyn) to diagnose adrenal gland disorders.
Price
$147
CPT CODE
95250
Code Description
Cont gluc mntr phys/qhp eqp
Explanation
Continuous glucose monitoring, including sensor placement, patient training, calibration, removal and downloading data from the monitor.
Price
$331
CPT CODE
76942
Code Description
Echo guide for biopsy
Explanation
Use of ultrasound technology to guide the placement of a needle during a biopsy.
Price
$333
CPT CODE
76536
Code Description
Us exam of head and neck
Explanation
Use of ultrasound technology to examine salivary glands, lymph nodes, lesions and the endocrine system.
Price
$322
CPT CODE
95251
Code Description
Cont gluc mntr analysis i&r
Explanation
Analysis and interpretation of data from a continuous glucose monitor, a device that tracks your blood sugar.
Price
$81
ENT
CPT CODE
J0696
Code Description
Ceftriaxone sodium injection
Explanation
Antibacterial injection used to treat infection.
Price
$31
CPT CODE
42820
Code Description
Remove tonsils and adenoids
Explanation
Surgical removal of tonsils and adenoids, a patch of tissue in the back of the throat.
Price
$626
CPT CODE
30520
Code Description
Repair of nasal septum
Explanation
A surgical procedure to correct a deviated septum, a condition in which the bone and cartilage that separates the nose is off center.
Price
$1562
CPT CODE
69436
Code Description
Create eardrum opening
Explanation
Surgical opening of the eardrum and insertion of a ventilating tube, called a tympanostomy.
Price
$372
CPT CODE
30901
Code Description
Control of nosebleed
Explanation
Control of minor nosebleed that originates in the front of the nose (anterior).
Price
$357
CPT CODE
42826
Code Description
Removal of tonsils
Explanation
Surgical removal of tonsils.
Price
$549
CPT CODE
92504
Code Description
Ear microscopy examination
Explanation
Examination of the ear using a microscope.
Price
$66
CPT CODE
92567
Code Description
Tympanometry
Explanation
A test used to diagnose and monitor conditions of the middle ear.
Price
$38
CPT CODE
31505
Code Description
Diagnostic laryngoscopy
Explanation
Diagnostic examination of voice box using an endoscope, an instrument used to look inside the body.
Price
$205
CPT CODE
69210
Code Description
Remove impacted ear wax uni
Explanation
Removal of earwax buildup.
Price
$111
Family Medicine
CPT CODE
90471
Code Description
Immunization admin
Explanation
Administration of a single immunization that does not involve face-to-face counseling.
Price
$19
CPT CODE
96372
Code Description
Ther/proph/diag inj sc/im
Explanation
Therapeutic, prophylactic and diagnostic injections and infusions used for treatment, prevention and diagnosis (excludes chemotherapy and other complex medications.
Price
$39
CPT CODE
J3301
Code Description
Triamcinolone acet inj nos
Explanation
Steroid injection that decreases inflammation (swelling).
Price
$2
CPT CODE
J0696
Code Description
Ceftriaxone sodium injection
Explanation
Antibacterial injection used to treat infection.
Price
$31
CPT CODE
J1100
Code Description
Dexamethasone sodium phos
Explanation
Injection of dexamethasone, a steroid used to treat inflammation (swelling).
Price
$7
CPT CODE
J1885
Code Description
Ketorolac tromethamine inj
Explanation
Injection of a nonsteroidal anti-inflammatory drug (NSAID) used for the short-term treatment of moderate to severe pain.
Price
$16
CPT CODE
J7325
Code Description
Synvisc or synvisc-one
Explanation
An injection used to treat osteoarthritis pain.
Price
$18
CPT CODE
87880
Code Description
Strep a assay w/optic
Explanation
Strep test that detects the presence of streptococcus bacteria using a throat swab.
Price
$28
CPT CODE
J0897
Code Description
Denosumab injection
Explanation
Injection of denosumab (brand names: Prolia and Xgeva) to treat osteoporosis and high calcium levels and prevent fractures.
Price
$32
CPT CODE
85651
Code Description
Rbc sed rate nonautomated
Explanation
Red blood cell sedimentation test, a blood test that detects inflammatory activity in the body.
Price
$7
CPT CODE
90472
Code Description
Immunization admin each add
Explanation
Administration of additional immunizations that do not involve face-to-face counseling.
Price
$22
CPT CODE
90461
Code Description
Im admin each addl component
Explanation
Administration of additional immunizations with physician counsel for patients age 18 and younger.
Price
$19
CPT CODE
90460
Code Description
Im admin 1st/only component
Explanation
Administration of initial immunization with physician counsel for patients age 18 and younger.
Price
$35
CPT CODE
99231
Code Description
Subsequent hospital care
Explanation
Follow up evaluation and management of a patient in the hospital requiring low-complexity medical decision making (Level 1).
Price
$84
CPT CODE
G0439
Code Description
Ppps subseq visit
Explanation
Subsequent Annual Wellness Visits, yearly follow-up appointments to discuss and adjust a patient's personalized prevention plan (initial appointment).
Price
$191
CPT CODE
G0438
Code Description
Ppps initial visit
Explanation
Initial Annual Wellness Visit, the first yearly appointment to create a patient's personalized prevention plan.
Price
$266
CPT CODE
G0402
Code Description
Initial preventive exam
Explanation
Welcome to Medicare visit, a one-time appointment for patients new to Medicare to cover health history and create a prevention plan.
Price
$305
CPT CODE
99397
Code Description
Per pm reeval est pat 65+ yr
Explanation
Established patient periodic preventive medicine examination in adults over age 65, including age- and gender-appropriate history and physical exam.
Price
$224
CPT CODE
99396
Code Description
Prev visit est age 40-64
Explanation
Established patient periodic preventive medicine examination in adults ages 40 to 64, including age- and gender-appropriate history and physical exam.
Price
$204
CPT CODE
99395
Code Description
Prev visit est age 18-39
Explanation
Established patient periodic preventive medicine examination in adults ages 18 to 39, including age- and gender-appropriate history and physical exam.
Price
$190
CPT CODE
99387
Code Description
Init pm e/m new pat 65+ yrs
Explanation
Initial new patient preventive medicine evaluation in adults over age 65, including age- and gender-appropriate history and physical exam.
Price
$304
CPT CODE
99386
Code Description
Prev visit new age 40-64
Explanation
New patient preventive medicine evaluation in adults ages 40 to 64, including age- and gender-appropriate history and physical exam.
Price
$270
CPT CODE
99385
Code Description
Prev visit new age 18-39
Explanation
New patient preventive medicine evaluation in adults ages 18 to 39, including age- and gender-appropriate history and physical exam.
Price
$213
Gastroenterology
CPT CODE
90471
Code Description
Immunization admin
Explanation
Administration of a single immunization that does not involve face-to-face counseling.
Price
$19
CPT CODE
45378
Code Description
Diagnostic colonoscopy
Explanation
Diagnostic colonoscopy, a colonoscopy performed as the result of an abnormal test result, sign or symptom
Price
$926
CPT CODE
43249
Code Description
Esoph egd dilation <30 mm
Explanation
EGD with esophagus dilation, a procedure to widen a narrowed esophagus, which often occurs as the result of acid reflux.
Price
$3140
CPT CODE
45380
Code Description
Colonoscopy and biopsy
Explanation
Colonoscopy with biopsy, a procedure used to examine the colon with the removal of tissues (biopsy) for testing.
Price
$1190
CPT CODE
45385
Code Description
Colonoscopy w/lesion removal
Explanation
Colonoscopy with lesion removal, a procedure used to examine the colon with the removal of polyps, tumors or other lesions.
Price
$1242
CPT CODE
43239
Code Description
Egd biopsy single/multiple
Explanation
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.
Price
$1036
CPT CODE
99232
Code Description
Subsequent hospital care
Explanation
Follow up evaluation and management of a patient in the hospital requiring moderate-complexity medical decision making (Level 2).
Price
$133
CPT CODE
99233
Code Description
Subsequent hospital care
Explanation
Follow up evaluation and management of a patient in the hospital requiring high-complexity medical decision making (Level 3).
Price
$201
CPT CODE
G0121
Code Description
Colon ca scrn not hi rsk ind
Explanation
Screening colonoscopy, a colonoscopy for a low-risk individual without symptoms to screen for colorectal cancer and check for the presence of polyps.
Price
$724
CPT CODE
99222
Code Description
Initial hospital care
Explanation
Initial evaluation of a patient in the hospital requiring moderately complex medical decision making and a comprehensive exam (Level 2).
Price
$221
CPT CODE
43235
Code Description
Egd diagnostic brush wash
Explanation
A procedure used to examine the esophagus, stomach and the upper part of the small intestine with specimen collection.
Price
$811
General Cardiology
CPT CODE
93000
Code Description
Electrocardiogram complete
Explanation
Routine electrocardiogram (ECG or EKG) with interpretation.
Price
$48
CPT CODE
93284
Code Description
Prgrmg eval implantable dfb
Explanation
Evaluation, testing and programming adjustment of defibrillator with physician analysis, review and report.
Price
$241
CPT CODE
93281
Code Description
Pm device progr eval multi
Explanation
Evaluation, testing and programming adjustment of pacemaker with physician analysis, review and report.
Price
$191
CPT CODE
93923
Code Description
Upr/lxtr art stdy 3+ lvls
Explanation
Ultrasound study of the veins in the arms and legs (3 levels).
Price
$294
CPT CODE
93970
Code Description
Extremity study
Explanation
Ultrasound study of the veins in the arms and legs to detect venous insufficiency or deep vein thrombosis (DVT).
Price
$422
CPT CODE
78452
Code Description
Ht muscle image spect mult
Explanation
Physician interpretation of results from a myocardial perfusion imaging (MPI) test, which analyzes how the heart muscle functions.
Price
$1282
CPT CODE
93015
Code Description
Cardiovascular stress test
Explanation
A test that monitors how the heart reacts to physical stress, typically using a treadmill or bicycle.
Price
$206
CPT CODE
93880
Code Description
Extracranial bilat study
Explanation
Ultrasound scanning of blood flow in the extracranial arteries (outside the brain) on both sides of head and neck.
Price
$430
CPT CODE
93306
Code Description
Tte w/doppler complete
Explanation
A procedure called a transthoracic echocardiogram that uses high-frequency sound waves to evaluate blood flow through the heart.
Price
$526
CPT CODE
93224
Code Description
Ecg monit/reprt up to 48 hrs
Explanation
Electrocardiographic monitoring for 24 hours using a holter monitor (with physician review and interpretation).
Price
$285
Hematology-Medical Oncology
CPT CODE
J1100
Code Description
Dexamethasone sodium phos
Explanation
Injection of dexamethasone, a steroid used to treat inflammation (swelling).
Price
$7
CPT CODE
J0885
Code Description
Epoetin alfa non-esrd
Explanation
Injection of epoetin alfa (brand names: Procrit and Epogen) to treat anemia in patients chronic kidney disease (non-end stage).
Price
$17
CPT CODE
J0897
Code Description
Denosumab injection
Explanation
Injection of denosumab (brand names: Prolia and Xgeva) to treat osteoporosis and high calcium levels and prevent fractures.
Price
$32
CPT CODE
J9176
Code Description
Injection elotuzumab 1mg
Explanation
Injection of elotuzumab (brand name: Empliciti) to treat multiple myeloma, a cancer in the blood cells.
Price
$10
CPT CODE
J9299
Code Description
Injection nivolumab
Explanation
Injection of nivolumab (brand name: Opdivo) to treat melanoma (skin cancer).
Price
$44
CPT CODE
J1745
Code Description
Infliximab not biosimil 10mg
Explanation
Injection of infliximab to treat Crohn's disease, ulcerative colitis, rheumatoid arthritis and other conditions.
Price
$121
CPT CODE
J9355
Code Description
Inj trastuzumab excl biosimi
Explanation
Injection of trastuzumab (brand names: Herceptin, Herzuma, Ogivri, Ontruzant) to treat breast cancer.
Price
$142
CPT CODE
J9171
Code Description
Docetaxel injection
Explanation
Injection of docetaxel (brand names: Docefrez and Taxotere) to treat a variety of cancers.
Price
$28
CPT CODE
J1453
Code Description
Fosaprepitant injection
Explanation
Injection of fosaprepitant (brand name: Emend) to prevent nausea and vomiting caused by chemotherapy.
Price
$3
CPT CODE
J2323
Code Description
Natalizumab injection
Explanation
Injection of natalizumab (brand name: Tysabri) to treat relapsing forms of MS (multiple sclerosis).
Price
$35
CPT CODE
J9025
Code Description
Azacitidine injection
Explanation
Injection of azacitidine (brand name: Vidaza) to treat a group of blood and bone marrow disorders.
Price
$12
CPT CODE
J1756
Code Description
Iron sucrose injection
Explanation
Injection of iron sucrose (brand name: Venofer) to treat iron deficiency in patients with chronic kidney disease.
Price
$1
CPT CODE
J9267
Code Description
Paclitaxel injection
Explanation
Injection of paclitaxel (brand names: Nov-Onxol, Onxol, Paclitaxel Novaplus, Taxol) to treat advanced ovarian, breast and other cancers.
Price
$1
CPT CODE
J3380
Code Description
Injection vedolizumab
Explanation
Injection of vedolizumab (brand name: Entyvio) to treat Crohn's disease and ulcerative colitis in patients that have not had success with other medicines.
Price
$32
CPT CODE
J9263
Code Description
Oxaliplatin
Explanation
Injection of oxaliplatin (brand name: Eloxatin) to treat advanced colorectal cancer.
Price
$12
CPT CODE
J9306
Code Description
Injection pertuzumab 1 mg
Explanation
Injection of pertuzumab (brand name: Perjeta) to treat breast cancer that has spread to other parts of the body.
Price
$21
CPT CODE
J0641
Code Description
Inj levoleucovorin nos 0.5mg
Explanation
Injection of levoleucovorin (brand names: Fusilev and Khapzory) to prevent the harmful effects of a cancer medicine called methotrexate.
Price
$2
CPT CODE
J1442
Code Description
Inj filgrastim excl biosimil
Explanation
Injection of filgrastim (brand name: Neupogen) to treat a lack of white blood cells caused by cancer, chemotherapy, bone marrow transplant and other conditions.
Price
$2
CPT CODE
J1439
Code Description
Inj ferric carboxymaltos 1mg
Explanation
Injection of ferric carboxymaltose (brand name: Injectafer) to treat iron deficiency anemia.
Price
$2
Imaging
CPT CODE
73718TC
Code Description
Mri lower extremity w/o dye
Explanation
MRI scan of the lower extremity (leg) without contrast material (a substance used to enhance visibility of the body's internal structures).
Price
$832
CPT CODE
70450TC
Code Description
Ct head/brain w/o dye
Explanation
CT scan of head or brain without contrast material (a substance used to enhance visibility of the body's internal structures).
Price
$334
CPT CODE
77290TC
Code Description
Set radiation therapy field
Explanation
Complex management of radiation therapy for three or more treatment areas.
Price
$1055
CPT CODE
71250TC
Code Description
Ct thorax dx c-
Explanation
CT scan of the thorax (the chest area) without contrast material (a substance used to enhance visibility of the body's internal structures).
Price
$423
CPT CODE
70551TC
Code Description
Mri brain stem w/o dye
Explanation
MRI scan of the brain, including the brain stem, without contrast (a substance used to enhance visibility of the body's internal structures).
Price
$843
CPT CODE
74178TC
Code Description
Ct abd & pelv 1/> regns
Explanation
CT scan of the abdomen and pelvis before and after contrast (a substance used to enhance visibility of the body's internal structures).
Price
$737
CPT CODE
72195TC
Code Description
Mri pelvis w/o dye
Explanation
MRI scan of the pelvis without contrast material (a substance used to enhance visibility of the body's internal structures).
Price
$836
CPT CODE
73700TC
Code Description
Ct lower extremity w/o dye
Explanation
CT scan of the lower extremity (leg) without contrast material (a substance used to enhance visibility of the body's internal structures).
Price
$354
CPT CODE
74176TC
Code Description
Ct abd & pelvis w/o contrast
Explanation
CT scan of the abdomen and pelvis region without contrast material (a substance used to enhance visibility of the body's internal structures).
Price
$307
CPT CODE
72146TC
Code Description
Mri chest spine w/o dye
Explanation
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).
Price
$877
CPT CODE
71260TC
Code Description
Ct thorax dx c+
Explanation
CT scan of the thorax (the chest area) with contrast material (a substance used to enhance visibility of the body's internal structures).
Price
$490
CPT CODE
70553TC
Code Description
Mri brain stem w/o & w/dye
Explanation
MRI scan of the brain and brain stem before and after contrast (a substance used to enhance visibility of the body's internal structures).
Price
$1646
CPT CODE
74177TC
Code Description
Ct abd & pelv w/contrast
Explanation
CT scan of the abdomen and pelvis region with contrast material (a substance used to enhance visibility of the body's internal structures).
Price
$653
CPT CODE
72141TC
Code Description
Mri neck spine w/o dye
Explanation
MRI scan of the neck and upper spine without contrast material (a substance used to enhance visibility of the body's internal structures).
Price
$810
CPT CODE
73221TC
Code Description
Mri joint upr extrem w/o dye
Explanation
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).
Price
$821
CPT CODE
73721TC
Code Description
Mri jnt of lwr extre w/o dye
Explanation
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).
Price
$826
CPT CODE
72148TC
Code Description
Mri lumbar spine w/o dye
Explanation
MRI scan of the lower spinal canal (lower back) without contrast material (a substance used to enhance visibility of the body's internal structures).
Price
$877
Internal Medicine
CPT CODE
90688
Code Description
Iiv4 vaccine splt 0.5 ml im
Explanation
Split virus influenza vaccine, a type of influenza (flu) vaccine designed to cause fewer reactions at the injection site (e.g., swelling, rash, etc.).
Price
$30
CPT CODE
90471
Code Description
Immunization admin
Explanation
Administration of a single immunization that does not involve face-to-face counseling.
Price
$19
CPT CODE
96372
Code Description
Ther/proph/diag inj sc/im
Explanation
Therapeutic, prophylactic and diagnostic injections and infusions used for treatment, prevention and diagnosis (excludes chemotherapy and other complex medications.
Price
$39
CPT CODE
J3301
Code Description
Triamcinolone acet inj nos
Explanation
Steroid injection that decreases inflammation (swelling).
Price
$2
CPT CODE
G0008
Code Description
Admin influenza virus vac
Explanation
Administration of influenza vaccine.
Price
$19
CPT CODE
99233
Code Description
Subsequent hospital care
Explanation
Follow up evaluation and management of a patient in the hospital requiring high-complexity medical decision making (Level 3).
Price
$201
CPT CODE
99304
Code Description
Nursing facility care init
Explanation
Initial evaluation and management of a patient in a nursing facility requiring low-complexity medical decision making.
Price
$141
CPT CODE
94762
Code Description
Measure blood oxygen level
Explanation
Non-invasive overnight measurement of oxygen levels in the blood using an ear or finger device.
Price
$57
CPT CODE
9581126
Code Description
Polysom 6/>yrs cpap 4/> parm
Explanation
Physician interpretation of a polysomnogram (sleep study) of patients age 6 and older with CPAP machine assistance.
Price
$320
CPT CODE
94664
Code Description
Evaluate pt use of inhaler
Explanation
The demonstration and/or evaluation of patient use of an inhaler.
Price
$40
CPT CODE
J3420
Code Description
Vitamin b12 injection
Explanation
An Injection used to treat vitamin b-12 deficiency.
Price
$3
CPT CODE
77080
Code Description
Dxa bone density axial
Explanation
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.
Price
$222
CPT CODE
90662
Code Description
Iiv no prsv increased ag im
Explanation
Preservative-free, high-dose Fluzone (influenza) vaccine.
Price
$98
CPT CODE
J1050
Code Description
Medroxyprogesterone acetate
Explanation
Depo-Provera injection, an injection used as a contraceptive (birth control) or to treat kidney cancer, endometrial cancer and pain caused by endometriosis.
Price
$1
CPT CODE
J0897
Code Description
Denosumab injection
Explanation
Injection of denosumab (brand names: Prolia and Xgeva) to treat osteoporosis and high calcium levels and prevent fractures.
Price
$32
Laboratory
CPT CODE
85018
Code Description
Hemoglobin
Explanation
A blood test that measures the amount of hemoglobin (a protein that carries oxygen from your lungs to the rest of your body).
Price
$6
CPT CODE
83970
Code Description
Assay of parathormone
Explanation
A blood test that measures the level of parathyroid hormone in the blood.
Price
$86
CPT CODE
83735
Code Description
Assay of magnesium
Explanation
A blood test that measures the amount of magnesium in the blood.
Price
$14
CPT CODE
81025
Code Description
Urine pregnancy test
Explanation
A laboratory test that evaluates the urine to look for signs of pregnancy.
Price
$15
CPT CODE
84403
Code Description
Assay of total testosterone
Explanation
A blood test that measures the amount of testosterone in the blood.
Price
$54
CPT CODE
86140
Code Description
C-reactive protein
Explanation
A blood test that helps identify inflammation in the body.
Price
$11
CPT CODE
83550
Code Description
Iron binding test
Explanation
A blood test that measures the blood's ability to attach itself to iron and transport it around the body.
Price
$18
CPT CODE
82728
Code Description
Assay of ferritin
Explanation
Ferritin test, a blood test that shows how much iron the body stores.
Price
$28
CPT CODE
36416
Code Description
Capillary blood draw
Explanation
Sampling a small amount of blood from a puncture on the finger (finger prick), heel or earlobe.
Price
$9
CPT CODE
83540
Code Description
Assay of iron
Explanation
A blood test that measures iron levels in the blood to help diagnose anemia or other conditions.
Price
$14
CPT CODE
87880
Code Description
Strep a assay w/optic
Explanation
Strep test that detects the presence of streptococcus bacteria using a throat swab.
Price
$28
CPT CODE
82043
Code Description
Ur albumin quantitative
Explanation
A laboratory test that measures albumin levels, a protein found in the blood.
Price
$12
CPT CODE
83615
Code Description
Lactate (ld) (ldh) enzyme
Explanation
LDH test, a blood test that measures lactate dehydrogenase in the body to looks for signs of damage to tissues in the body.
Price
$12
CPT CODE
84153
Code Description
Assay of psa total
Explanation
PSA test, a blood test that is used to screen for prostate cancer by measuring total prostate specific antigen (PSA).
Price
$38
CPT CODE
80048
Code Description
Metabolic panel total ca
Explanation
Basic metabolic panel, a blood test that measures blood sugar levels, electrolyte and fluid balance, and kidney function.
Price
$18
CPT CODE
85610QW
Code Description
Prothrombin time
Explanation
Laboratory test that calculates the average time it takes for your blood to clot.
Price
$7
CPT CODE
82607
Code Description
Vitamin b-12
Explanation
A blood test that measures the amount of vitamin b-12 in the body.
Price
$31
CPT CODE
82570
Code Description
Assay of urine creatinine
Explanation
Creatinine urine test, a laboratory test that measures the amount of creatinine (a chemical waste product) in the urine.
Price
$9
CPT CODE
80050
Code Description
General health panel
Explanation
A blood test that includes a complete blood count, a comprehensive metabolic panel and thyroid test.
Price
$62
CPT CODE
82306
Code Description
Vitamin d 25 hydroxy
Explanation
A blood test that measures the amount of vitamin D in the body.
Price
$62
CPT CODE
81003
Code Description
Urinalysis auto w/o scope
Explanation
Analysis of urine sample to diagnose UTIs, kidney disorders, liver problems, etc.
Price
$5
CPT CODE
83036
Code Description
Glycosylated hemoglobin test
Explanation
A1c test, a blood test that measures glycosylated hemoglobin; used to diagnose and monitor diabetes.
Price
$20
CPT CODE
84439
Code Description
Assay of free thyroxine
Explanation
Free T4 test, a blood test that is used to help diagnose conditions of the thyroid.
Price
$18
CPT CODE
84443
Code Description
Assay thyroid stim hormone
Explanation
TSH test, a blood test that measures the amount of thyroid-stimulating hormone (TSH) in the blood.
Price
$35
CPT CODE
80061
Code Description
Lipid panel
Explanation
A blood test that measures good and bad cholesterol and triglycerides (a type of fat in the blood).
Price
$28
CPT CODE
80053
Code Description
Comprehen metabolic panel
Explanation
A comprehensive panel that includes 14 blood tests, used for medical screening.
Price
$22
CPT CODE
85025
Code Description
Complete cbc w/auto diff wbc
Explanation
Complete blood count, A blood test used to evaluate overall health.
Price
$13
CPT CODE
36415
Code Description
Routine venipuncture
Explanation
Insertion of needle into vein for collection of blood samples.
Price
$15
Nephrology
CPT CODE
90653
Code Description
Iiv adjuvant vaccine im
Explanation
Inactivated influenza (flu) vaccine, a vaccine made from killed flu viruses.
Price
$89
CPT CODE
G0008
Code Description
Admin influenza virus vac
Explanation
Administration of influenza vaccine.
Price
$19
CPT CODE
90970
Code Description
Esrd svc pr day pt 20+
Explanation
Dialysis services per day (for less than full month service).
Price
$18
CPT CODE
99223
Code Description
Initial hospital care
Explanation
Initial evaluation of a patient in the hospital requiring complex medical decision making and a comprehensive exam (Level 3).
Price
$325
CPT CODE
90966
Code Description
Esrd home pt serv p mo 20+
Explanation
Monthly home dialysis services.
Price
$570
CPT CODE
90961
Code Description
Esrd srv 2-3 vsts p mo 20+
Explanation
Monthly services (two - three visits per month) for patients with end-stage renal disease, including dialysis.
Price
$570
CPT CODE
90935
Code Description
Hemodialysis one evaluation
Explanation
Hemodialysis with a single physician evaluation.
Price
$142
CPT CODE
99232
Code Description
Subsequent hospital care
Explanation
Follow up evaluation and management of a patient in the hospital requiring moderate-complexity medical decision making (Level 2).
Price
$133
CPT CODE
99233
Code Description
Subsequent hospital care
Explanation
Follow up evaluation and management of a patient in the hospital requiring high-complexity medical decision making (Level 3).
Price
$201
CPT CODE
J0885
Code Description
Epoetin alfa non-esrd
Explanation
Injection of epoetin alfa (brand names: Procrit and Epogen) to treat anemia in patients chronic kidney disease (non-end stage).
Price
$17
CPT CODE
90960
Code Description
Esrd srv 4 visits p mo 20+
Explanation
Monthly services (four or more visits per month) for patients with end-stage renal disease, including dialysis.
Price
$687
Neurology
CPT CODE
J3301
Code Description
Triamcinolone acet inj nos
Explanation
Steroid injection that decreases inflammation (swelling).
Price
$2
CPT CODE
J0585
Code Description
Injectiononabotulinumtoxina
Explanation
Botox injection to treat muscle stiffness/spasm and migraines.
Price
$10
CPT CODE
J1885
Code Description
Ketorolac tromethamine inj
Explanation
Injection of a nonsteroidal anti-inflammatory drug (NSAID) used for the short-term treatment of moderate to severe pain.
Price
$16
CPT CODE
95886
Code Description
Musc test done w/n test comp
Explanation
A test in which a needle is inserted directly into a muscle (needle EMG) and records the muscle's electrical activity.
Price
$220
CPT CODE
64405
Code Description
Njx aa&/strd gr ocpl nrv
Explanation
Occipital nerve block, an injection into the occipital nerves (located above the neck) to treat chronic headaches.
Price
$254
CPT CODE
95913
Code Description
Nrv cndj test 13/> studies
Explanation
13 or more nerve conduction studies, which are used to evaluate the function of motor and sensory nerves.
Price
$656
CPT CODE
64615
Code Description
Chemodenerv musc migraine
Explanation
Chemodenervation, an injection procedure for the purposes of treating chronic migraines.
Price
$356
CPT CODE
95923
Code Description
Autonomic nrv syst funj test
Explanation
A test that evaluates functions of the autonomic nervous system, which controls heart rate, body temperature, breathing rate, etc.
Price
$278
OB/GYN
CPT CODE
90471
Code Description
Immunization admin
Explanation
Administration of a single immunization that does not involve face-to-face counseling.
Price
$19
CPT CODE
96372
Code Description
Ther/proph/diag inj sc/im
Explanation
Therapeutic, prophylactic and diagnostic injections and infusions used for treatment, prevention and diagnosis (excludes chemotherapy and other complex medications.
Price
$39
CPT CODE
90715
Code Description
Tdap vaccine 7 yrs/> im
Explanation
Tdap vaccine, a vaccine that prevents tetanus, diphtheria (bacterial infection of the nose and throat), and pertussis (whooping cough).
Price
$63
CPT CODE
90686
Code Description
Iiv4 vacc no prsv 0.5 ml im
Explanation
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.).
Price
$31
CPT CODE
76815
Code Description
Ob us limited fetus(s)
Explanation
Real-time ultrasound limited to the evaluation of the fetal heartbeat and position.
Price
$238
CPT CODE
58301
Code Description
Remove intrauterine device
Explanation
Removal of IUD, a small, contraceptive (birth control) device.
Price
$227
CPT CODE
59400
Code Description
Obstetrical care
Explanation
Routine care for pregnant women, including pre- and postpartum care and delivery.
Price
$5010
CPT CODE
58300
Code Description
Insert intrauterine device
Explanation
Insertion of an IUD, a small, contraceptive (birth control) device, into the uterus.
Price
$224
CPT CODE
76816
Code Description
Ob us follow-up per fetus
Explanation
Follow-up ultrasound for re-evaluation of fetal size.
Price
$323
CPT CODE
76856
Code Description
Us exam pelvic complete
Explanation
Nonobstetric ultrasound of the pelvis (i.e., ultrasounds unrelated to pregnancy care)
Price
$308
CPT CODE
76811
Code Description
Ob us detailed sngl fetus
Explanation
Real-time ultrasound of the uterus for a single fetus with evaluation of fetal anatomical development.
Price
$524
CPT CODE
59025
Code Description
Fetal non-stress test
Explanation
A screening test used to evaluate fetal oxygen supply. movement and heart rate.
Price
$101
Ophthalmology
CPT CODE
66821
Code Description
After cataract laser surgery
Explanation
A surgical procedure to treat haze that develops behind the lens after cataract surgery.
Price
$712
CPT CODE
92083
Code Description
Visual field examination(s)
Explanation
An examination that measures the field of vision, including peripheral (side) vision, during daylight conditions.
Price
$144
CPT CODE
92133
Code Description
Cmptr ophth img optic nerve
Explanation
Diagnostic imaging scan of the optic nerve used to detect glaucoma.
Price
$83
CPT CODE
92136
Code Description
Ophthalmic biometry
Explanation
Biometry eye test, a test that measures the shape and size of the eye.
Price
$135
CPT CODE
66984
Code Description
Xcapsl ctrc rmvl w/o ecp
Explanation
Removal of cataract with the insertion of a prosthetic lens.
Price
$1311
CPT CODE
92012
Code Description
Eye exam establish patient
Explanation
An eye and medical examination of a limited portion of the eye (does not include a complete visual examination).
Price
$198
CPT CODE
92134
Code Description
Cptr ophth dx img post segmt
Explanation
Diagnostic imaging scan of the retina used to detect disease and assess eye health.
Price
$93
CPT CODE
92004
Code Description
Eye exam new patient
Explanation
Comprehensive eye and medical examination for a new patient.
Price
$343
CPT CODE
92014
Code Description
Eye exam&tx estab pt 1/>vst
Explanation
Comprehensive eye and medical examination for an established patient.
Price
$289
CPT CODE
92015
Code Description
Determine refractive state
Explanation
Assessment of the eyes for prescription eyewear using a range of lens powers.
Price
$117
Orthopedics
CPT CODE
J3301
Code Description
Triamcinolone acet inj nos
Explanation
Steroid injection that decreases inflammation (swelling).
Price
$2
CPT CODE
J0585
Code Description
Injectiononabotulinumtoxina
Explanation
Botox injection to treat muscle stiffness/spasm and migraines.
Price
$10
CPT CODE
20552
Code Description
Inj trigger point 1/2 muscl
Explanation
Trigger point injection, a procedure used to treat muscle pain (one to two muscles).
Price
$112
CPT CODE
J0702
Code Description
Betamethasone acet&sod phosp
Explanation
Injection of betamethasone (brand name: Celestone Soluspan) to treat inflammation (swelling) and arthritis.
Price
$11
CPT CODE
20600
Code Description
Drain/inj joint/bursa w/o us
Explanation
Fluid removal in a small joint (e.g., fingers or toes) without the use of ultrasound technology.
Price
$112
CPT CODE
73110
Code Description
X-ray exam of wrist
Explanation
Complete X-ray examination of the wrist with a minimum of three views.
Price
$120
CPT CODE
64483
Code Description
Njx aa&/strd tfrm epi l/s 1
Explanation
Epidural injection into the spine using the guidance of imaging technology
Price
$746
CPT CODE
20550
Code Description
Inj tendon sheath/ligament
Explanation
Tendon sheath and ligament injection, a procedure used to treat pain, caused by inflammation (swelling) or disease, in the structures surrounding tendons and joints.
Price
$123
CPT CODE
72100
Code Description
X-ray exam l-s spine 2/3 vws
Explanation
X-ray examination of the lower spine with two or three views.
Price
$117
CPT CODE
73610
Code Description
X-ray exam of ankle
Explanation
Complete X-ray examination of the ankle with a minimum of three views.
Price
$107
CPT CODE
73502
Code Description
X-ray exam hip uni 2-3 views
Explanation
X-ray examination of the hip and pelvis with two or three views.
Price
$139
CPT CODE
73100
Code Description
X-ray exam of wrist
Explanation
X-ray examination of the wrist with two views.
Price
$99
CPT CODE
J7323
Code Description
Euflexxa inj per dose
Explanation
Injection of Euflexxa to treat osteoarthritis pain.
Price
$202
CPT CODE
73140
Code Description
X-ray exam of finger(s)
Explanation
X-ray examination of one or more fingers with a minimum of two views.
Price
$111
CPT CODE
73562
Code Description
X-ray exam of knee 3
Explanation
X-ray examination of the knee with three views.
Price
$119
CPT CODE
73030
Code Description
X-ray exam of shoulder
Explanation
Complete X-ray examination of the shoulder with a minimum of two views.
Price
$102
CPT CODE
73630
Code Description
X-ray exam of foot
Explanation
Complete X-ray examination of the foot with a minimum of three views.
Price
$100
CPT CODE
73564
Code Description
X-ray exam knee 4 or more
Explanation
Complete X-ray examination of the knee with four or more views.
Price
$138
CPT CODE
J7325
Code Description
Synvisc or synvisc-one
Explanation
An injection used to treat osteoarthritis pain.
Price
$18
CPT CODE
20610
Code Description
Drain/inj joint/bursa w/o us
Explanation
Fluid removal in a major joint without the use of ultrasound technology.
Price
$153
Pediatrics
CPT CODE
99394
Code Description
Prev visit est age 12-17
Explanation
Established patient periodic preventive medicine examination in adolescents ages 12 to 17, including age- and gender-appropriate history and physical exam.
Price
$189
CPT CODE
99393
Code Description
Prev visit est age 5-11
Explanation
Established patient periodic preventive medicine examination in children ages 5 to 11, including age- and gender-appropriate history and physical exam.
Price
$170
CPT CODE
99392
Code Description
Prev visit est age 1-4
Explanation
Established patient periodic preventive medicine examination in children ages 1 to 4, including age- and gender-appropriate history and physical exam.
Price
$170
CPT CODE
99391
Code Description
Per pm reeval est pat infant
Explanation
Established patient periodic preventive medicine examination in an infant younger than 1 year, including age- and gender-appropriate history and physical exam.
Price
$160
CPT CODE
99384
Code Description
Prev visit new age 12-17
Explanation
New patient preventive medicine evaluation in adolescents ages 12 to 17, including age- and gender-appropriate history and physical exam.
Price
$219
CPT CODE
99383
Code Description
Prev visit new age 5-11
Explanation
New patient preventive medicine evaluation in children ages 5 to 11, including age- and gender-appropriate history and physical exam.
Price
$193
CPT CODE
99382
Code Description
Init pm e/m new pat 1-4 yrs
Explanation
Initial new patient preventive medicine evaluation in children ages 1 to 4, including age- and gender-appropriate history and physical exam.
Price
$189
CPT CODE
99381
Code Description
Init pm e/m new pat infant
Explanation
Initial new patient preventive medicine evaluation in an infant younger than 1 year, including age- and gender-appropriate history and physical exam.
Price
$177
Radiation Oncology
CPT CODE
77417
Code Description
Radiology port images(s)
Explanation
X-ray images taken throughout radiation treatment to check the positioning of the radiation.
Price
$44
CPT CODE
77334
Code Description
Radiation treatment aid(s)
Explanation
The design and construction of complex treatment devices that assist in radiation therapy.
Price
$370
CPT CODE
77336
Code Description
Radiation physics consult
Explanation
Consultation of radiation therapy including assessment of treatment and review of dose delivery.
Price
$257
CPT CODE
77427
Code Description
Radiation tx management x5
Explanation
Management of five courses of radiation treatment.
Price
$571
CPT CODE
A9606
Code Description
Radium ra223 dichloride ther
Explanation
Injection of radium dichloride (brand name: Xofigo) to treat prostate cancer.
Price
$260
CPT CODE
77300
Code Description
Radiation therapy dose plan
Explanation
The measurement, calculation and assessment of radiation therapy doses.
Price
$195
CPT CODE
G6002
Code Description
Stereoscopic x-ray guidance
Explanation
An imaging test that is used to identify the volume of radiation therapy needed.
Price
$156
CPT CODE
G600226
Code Description
Stereoscopic x-ray guidance
Explanation
Interpretation of results from a stereoscopic X-ray, an imaging test that is used to identify the volume of radiation therapy needed.
Price
$44
CPT CODE
G6015
Code Description
Radiation tx delivery imrt
Explanation
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.
Price
$744
CPT CODE
G6013
Code Description
Radiation treatment delivery
Explanation
The delivery of radiation treatment in three or more treatment areas.
Price
$499
Radiology
CPT CODE
7045026
Code Description
Ct head/brain w/o dye
Explanation
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).
Price
$120
CPT CODE
J3301
Code Description
Triamcinolone acet inj nos
Explanation
Steroid injection that decreases inflammation (swelling).
Price
$2
CPT CODE
J1100
Code Description
Dexamethasone sodium phos
Explanation
Injection of dexamethasone, a steroid used to treat inflammation (swelling).
Price
$7
CPT CODE
77002
Code Description
Needle localization by xray
Explanation
The use of imaging technology to ensure precise placement of a needle for biopsy, injections, aspirations (removal of cells and fluids via suction), etc.
Price
$338
CPT CODE
A9579
Code Description
Gad-base mr contrast nos1ml
Explanation
Injection of a contrast agent (a substance used to enhance visibility of the body's internal structures) to improve the quality of MRI images.
Price
$3
CPT CODE
70553
Code Description
Mri brain stem w/o & w/dye
Explanation
MRI scan of the brain and brain stem before and after contrast (a substance used to enhance visibility of the body's internal structures).
Price
$1877
CPT CODE
7417626
Code Description
Ct abd & pelvis w/o contrast
Explanation
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).
Price
$246
CPT CODE
7685626
Code Description
Us exam pelvic complete
Explanation
Nonobstetric ultrasound of the pelvis (i.e., ultrasounds unrelated to pregnancy care)
Price
$97
CPT CODE
76705
Code Description
Echo exam of abdomen
Explanation
Real-time ultrasound exam of the abdomen to diagnose medical conditions.
Price
$255
CPT CODE
73221
Code Description
Mri joint upr extrem w/o dye
Explanation
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).
Price
$914
CPT CODE
74177
Code Description
Ct abd & pelv w/contrast
Explanation
CT scan of the abdomen and pelvis region with contrast material (a substance used to enhance visibility of the body's internal structures).
Price
$910
CPT CODE
72148
Code Description
Mri lumbar spine w/o dye
Explanation
MRI scan of the lower spinal canal without contrast material (a substance used to enhance visibility of the body's internal structures).
Price
$1023
CPT CODE
73721
Code Description
Mri jnt of lwr extre w/o dye
Explanation
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).
Price
$919
CPT CODE
7417726
Code Description
Ct abd & pelv w/contrast
Explanation
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).
Price
$258
CPT CODE
7706326
Code Description
Breast tomosynthesis bi
Explanation
Physician interpretation of the results from a mammogram, a test used to detect breast cancer.
Price
$85
CPT CODE
7706726
Code Description
Scr mammo bi incl cad
Explanation
Physician interpretation of the results from a 3D mammogram, a test used to detect breast cancer.
Price
$108
CPT CODE
77067
Code Description
Scr mammo bi incl cad
Explanation
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.
Price
$374
CPT CODE
77063
Code Description
Breast tomosynthesis bi
Explanation
Screening mammogram, a test used to detect breast cancer in women using radiographic (X-ray) technique.
Price
$154
Sleep Medicine
CPT CODE
95808TC
Code Description
Polysom any age 1-3> param
Explanation
A polysomnogram (sleep study) of patients of any age that tracks one to three measures of sleep.
Price
$1115
CPT CODE
95807TC
Code Description
Sleep study attended
Explanation
A sleep study that also records breathing, heart rate and oxygen saturation, and is attended by a technologist.
Price
$788
CPT CODE
95805TC
Code Description
Multiple sleep latency test
Explanation
A test that measures alertness, how quickly you fall asleep and other measures of sleep to diagnose a sleep disorder.
Price
$993
CPT CODE
95806TC
Code Description
Sleep study unatt&resp efft
Explanation
A polysomnogram (sleep study) conducted at home instead of at a sleep center.
Price
$195
CPT CODE
95811TC
Code Description
Polysom 6/>yrs cpap 4/> parm
Explanation
A polysomnogram (sleep study) of patients age 6 and older with CPAP machine assistance that tracks four or more measures of sleep.
Price
$1191
CPT CODE
95810TC
Code Description
Polysom 6/> yrs 4/> param
Explanation
A polysomnogram (sleep study) of patients age 6 and older that tracks four or more measures of sleep.
Price
$1138
Spine and Rehab
CPT CODE
97162
Code Description
Pt eval mod complex 30 min
Explanation
30-minute evaluation of physical therapy treatment for a patient with moderate complexity.
Price
$169
CPT CODE
97035
Code Description
Ultrasound therapy
Explanation
A procedure in which a physical therapist uses ultrasound technology to reduce pain.
Price
$24
CPT CODE
G0283
Code Description
Elec stim other than wound
Explanation
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.
Price
$27
CPT CODE
97014
Code Description
Electric stimulation therapy
Explanation
A therapy in which electrodes are applied to the skin, sending electric pulses to the muscles (sometimes called E-stim)
Price
$23
CPT CODE
97140
Code Description
Manual therapy 1/> regions
Explanation
Therapeutic exercises in which a physical therapist manipulates and moves the muscles or joints.
Price
$46
CPT CODE
20552
Code Description
Inj trigger point 1/2 muscl
Explanation
Trigger point injection, a procedure used to treat muscle pain (one to two muscles).
Price
$112
CPT CODE
97010
Code Description
Hot or cold packs therapy
Explanation
Application of a hot or cold pack to one or more area.
Price
$11
CPT CODE
97110
Code Description
Therapeutic exercises
Explanation
Therapeutic physical therapy exercises in one or more areas.
Price
$49
CPT CODE
62370
Code Description
Anl sp inf pmp w/mdreprg&fil
Explanation
Electronic analysis, reprogramming and refill of implanted pump used for epidural drug infusion.
Price
$262
CPT CODE
97112
Code Description
Neuromuscular reeducation
Explanation
A therapeutic procedure to restore normal function of the nerves and muscles.
Price
$57
CPT CODE
95886
Code Description
Musc test done w/n test comp
Explanation
A test in which a needle is inserted directly into a muscle (needle EMG) and records the muscle's electrical activity.
Price
$220
CPT CODE
95911
Code Description
Nrv cndj test 9-10 studies
Explanation
Nine to 10 nerve conduction studies, which are used to evaluate the function of motor and sensory nerves.
Price
$486
CPT CODE
J0586
Code Description
Abobotulinumtoxina
Explanation
Injection of abobotulinumtoxinA (brand name: Dysport) to treat muscle spasms.
Price
$12
CPT CODE
J0702
Code Description
Betamethasone acet&sod phosp
Explanation
Injection of betamethasone (brand name: Celestone Soluspan) to treat inflammation (swelling) and arthritis.
Price
$11
CPT CODE
97012
Code Description
Mechanical traction therapy
Explanation
A non-surgical procedure that treats lower back, neck, and radiating arm and leg pain.
Price
$24
Sports Fitness and Physical Therapy
CPT CODE
97162
Code Description
Pt eval mod complex 30 min
Explanation
30-minute evaluation of physical therapy treatment for a patient with moderate complexity.
Price
$169
CPT CODE
97035
Code Description
Ultrasound therapy
Explanation
A procedure in which a physical therapist uses ultrasound technology to reduce pain.
Price
$24
CPT CODE
G0283
Code Description
Elec stim other than wound
Explanation
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.
Price
$27
CPT CODE
97535
Code Description
Self care mngment training
Explanation
Self-care and home management training for patients who need help with activities of daily living.
Price
$55
CPT CODE
97113
Code Description
Aquatic therapy/exercises
Explanation
Exercises performed in water for physical rehabilitation.
Price
$61
CPT CODE
97014
Code Description
Electric stimulation therapy
Explanation
A therapy in which electrodes are applied to the skin, sending electric pulses to the muscles (sometimes called E-stim)
Price
$23
CPT CODE
97022
Code Description
Whirlpool therapy
Explanation
A therapy that decreases pain and swelling, promotes wound healing and increases mobility.
Price
$28
CPT CODE
97140
Code Description
Manual therapy 1/> regions
Explanation
Therapeutic exercises in which a physical therapist manipulates and moves the muscles or joints.
Price
$46
CPT CODE
97161
Code Description
Pt eval low complex 20 min
Explanation
20-minute evaluation of physical therapy treatment for a patient with low complexity.
Price
$169
CPT CODE
97530
Code Description
Therapeutic activities
Explanation
Physical therapy activities with direct, one-on-one patient contact.
Price
$61
CPT CODE
97010
Code Description
Hot or cold packs therapy
Explanation
Application of a hot or cold pack to one or more area.
Price
$11
CPT CODE
97110
Code Description
Therapeutic exercises
Explanation
Therapeutic physical therapy exercises in one or more areas.
Price
$49
Surgery Center
CPT CODE
42820
Code Description
Remove tonsils and adenoids
Explanation
Surgical removal of tonsils and adenoids, a patch of tissue in the back of the throat.
Price
$626
CPT CODE
29881
Code Description
Knee arthroscopy/surgery
Explanation
Minimally invasive knee surgery that involves shaving the meniscus and cartilage.
Price
$1309
CPT CODE
19380
Code Description
Revj reconstructed breast
Explanation
Revision surgery after a breast reconstruction procedure
Price
$2205
CPT CODE
29826
Code Description
Sho arthrs srg decompression
Explanation
A minimally invasive procedure of the shoulder to treat shoulder impingement.
Price
$1421
CPT CODE
29848
Code Description
Wrist endoscopy/surgery
Explanation
Surgical release of wrist ligament using an endoscope.
Price
$1644
CPT CODE
30520
Code Description
Repair of nasal septum
Explanation
A surgical procedure to correct a deviated septum, a condition in which the bone and cartilage that separates the nose is off center.
Price
$1562
CPT CODE
69436
Code Description
Create eardrum opening
Explanation
Surgical opening of the eardrum and insertion of a ventilating tube, called a tympanostomy.
Price
$372
CPT CODE
30140
Code Description
Resect inferior turbinate
Explanation
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.
Price
$712
CPT CODE
45378
Code Description
Diagnostic colonoscopy
Explanation
Diagnostic colonoscopy, a colonoscopy performed as the result of an abnormal test result, sign or symptom
Price
$926
CPT CODE
43249
Code Description
Esoph egd dilation <30 mm
Explanation
EGD with esophagus dilation, a procedure to widen a narrowed esophagus, which often occurs as the result of acid reflux.
Price
$3140
CPT CODE
45380
Code Description
Colonoscopy and biopsy
Explanation
Colonoscopy with biopsy, a procedure used to examine the colon with the removal of tissues (biopsy) for testing.
Price
$1190
CPT CODE
45385
Code Description
Colonoscopy w/lesion removal
Explanation
Colonoscopy with lesion removal, a procedure used to examine the colon with the removal of polyps, tumors or other lesions.
Price
$1242
CPT CODE
43239
Code Description
Egd biopsy single/multiple
Explanation
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.
Price
$1036
Urgent Care
CPT CODE
90471
Code Description
Immunization admin
Explanation
Administration of a single immunization that does not involve face-to-face counseling.
Price
$19
CPT CODE
96372
Code Description
Ther/proph/diag inj sc/im
Explanation
Therapeutic, prophylactic and diagnostic injections and infusions used for treatment, prevention and diagnosis (excludes chemotherapy and other complex medications.
Price
$39
CPT CODE
J3301
Code Description
Triamcinolone acet inj nos
Explanation
Steroid injection that decreases inflammation (swelling).
Price
$2
CPT CODE
J0696
Code Description
Ceftriaxone sodium injection
Explanation
Antibacterial injection used to treat infection.
Price
$31
CPT CODE
J2300
Code Description
Inj nalbuphine hydrochloride
Explanation
An injection of nalbuphine hydrochloride (brand name: Nubain), which is a narcotic used to treat pain.
Price
$9
CPT CODE
12001
Code Description
Rpr s/n/ax/gen/trnk 2.5cm/<
Explanation
Treatment of a superficial (minor, occurring in the top layer of the skin) wound.
Price
$265
CPT CODE
A4565
Code Description
Slings
Explanation
A device to immobilize (support and keep still) injured parts of the body such as fractures or dislocations.
Price
$19
CPT CODE
90715
Code Description
Tdap vaccine 7 yrs/> im
Explanation
Tdap vaccine, a vaccine that prevents tetanus, diphtheria (bacterial infection of the nose and throat), and pertussis (whooping cough).
Price
$63
CPT CODE
J1200
Code Description
Diphenhydramine hcl injectio
Explanation
Injection of diphenhydramine (brand name: Benadryl) to treat anaphylaxis (a life-threatening allergic reaction).
Price
$4
CPT CODE
J7620
Code Description
Albuterol ipratrop non-comp
Explanation
Nebulizer treatment, use of the medication albuterol ipratropium (brand name: DuoNeb) to treat wheezing and shortness of breath.
Price
$3
CPT CODE
93000
Code Description
Electrocardiogram complete
Explanation
Routine electrocardiogram (ECG or EKG) with interpretation.
Price
$48
CPT CODE
J2550
Code Description
Promethazine hcl injection
Explanation
Injection of promethazine (brand names: Antinaus 50, Phenergan, Promacot, Prorex) to relieve or prevent allergic reactions.
Price
$5
CPT CODE
94640
Code Description
Airway inhalation treatment
Explanation
A procedure to treat the obstruction of airways or collect specimens for testing.
Price
$49
CPT CODE
J0558
Code Description
Peng benzathine/procaine inj
Explanation
Injection of penicillin to treat moderate to severe bacterial infections.
Price
$21
CPT CODE
J2405
Code Description
Ondansetron hcl injection
Explanation
Injection of ondansetron (brand name: Zofran) to reduce nausea.
Price
$8
CPT CODE
J1100
Code Description
Dexamethasone sodium phos
Explanation
Injection of dexamethasone, a steroid used to treat inflammation (swelling).
Price
$7
CPT CODE
J1885
Code Description
Ketorolac tromethamine inj
Explanation
Injection of a nonsteroidal anti-inflammatory drug (NSAID) used for the short-term treatment of moderate to severe pain.
Price
$16
Urology
CPT CODE
50590
Code Description
Fragmenting of kidney stone
Explanation
A procedure that uses shock waves to break up kidney stones into small pieces that can pass through the body, called lithroscopy.
Price
$1733
CPT CODE
A4358
Code Description
Urinary leg or abdomen bag
Explanation
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.
Price
$12
CPT CODE
52332
Code Description
Cystoscopy and treatment
Explanation
Examination of the bladder and urethra (cystoscopy) with the insertion of a stent, a tube that supports the urinary duct (ureter).
Price
$1273
CPT CODE
51741
Code Description
Electro-uroflowmetry first
Explanation
Electronic assessment of urine flow.
Price
$211
CPT CODE
96372
Code Description
Ther/proph/diag inj sc/im
Explanation
Therapeutic, prophylactic and diagnostic injections and infusions used for treatment, prevention and diagnosis (excludes chemotherapy and other complex medications.
Price
$39
CPT CODE
J3480
Code Description
Inj potassium chloride
Explanation
Injection of potassium chloride used to treat low levels of potassium in the blood.
Price
$1
CPT CODE
J0775
Code Description
Collagenase clost hist inj
Explanation
Injection of collagenase (brand name: Xiaflex) to treat Peyronie's disease.
Price
$90
CPT CODE
J3301
Code Description
Triamcinolone acet inj nos
Explanation
Steroid injection that decreases inflammation (swelling).
Price
$2
CPT CODE
J0696
Code Description
Ceftriaxone sodium injection
Explanation
Antibacterial injection used to treat infection.
Price
$31
CPT CODE
52000
Code Description
Cystoscopy
Explanation
Examination of the bladder and urethra using an endoscope, an instrument that allows a provider to look deep inside the body.
Price
$570
CPT CODE
51798
Code Description
Us urine capacity measure
Explanation
Measurement of bladder capacity (the maximum amount of urine the bladder can hold) using ultrasound technology.
Price
$33
CPT CODE
J9155
Code Description
Degarelix injection
Explanation
Injection of degarelix (brand name: Firmagon) to treat advanced prostate cancer.
Price
$6
CPT CODE
J0585
Code Description
Injectiononabotulinumtoxina
Explanation
Botox injection to treat muscle stiffness/spasm and migraines.
Price
$10
Wellness Center
CPT CODE
7045026
Code Description
Ct head/brain w/o dye
Explanation
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).
Price
$120
CPT CODE
90688
Code Description
Iiv4 vaccine splt 0.5 ml im
Explanation
Split virus influenza vaccine, a type of influenza (flu) vaccine designed to cause fewer reactions at the injection site (e.g., swelling, rash, etc.).
Price
$30
CPT CODE
90471
Code Description
Immunization admin
Explanation
Administration of a single immunization that does not involve face-to-face counseling.
Price
$19
CPT CODE
97802
Code Description
Medical nutrition indiv in
Explanation
Initial assessment and development of a medical nutrition therapy plan (used to manage chronic conditions through an individual nutrition plan).
Price
$72
CPT CODE
97803
Code Description
Med nutrition indiv subseq
Explanation
Reassessment of a medical nutrition therapy plan (used to manage chronic conditions through an individual nutrition plan).
Price
$63