"To the best of its knowledge and belief, the hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded is true, accurate, and complete as of the date indicated."																			
hospital name: Haxtun Hospital District	last updated on: 7/3/2024	version: 2.0.0	hospital location: Haxtun Hospital District	"hospital address: 235 W Fletcher, Haxtun, CO, 80731"	license number|CO: 10112														
description	code|1	code|1|type	code|2	code|2|type	modifiers	setting	standard charge|gross	standard charge|discounted cash	standard charge|Aetna|Default|methodology	standard charge|Aetna|Default|negotiated dollar	standard charge|Aetna|Default|negotiated percentage	standard charge|Blue Cross Blue Shield of CO|Default|methodology	standard charge|Blue Cross Blue Shield of CO|Default|negotiated dollar	standard charge|Blue Cross Blue Shield of CO|Default|negotiated percentage	standard charge|Cigna|Default|methodology	standard charge|Cigna|Default|negotiated dollar	standard charge|Cigna|Default|negotiated percentage	standard charge|min	standard charge|max
ACU ROOM	120	RC				inpatient	1511	1133.25	Percent of Total Billed Charges	1438.47	95.2	Percent of Total Billed Charges	1328.92	87.95	Percent of Total Billed Charges	1246.58	82.5	1133.25	1511
SNF SWING BED (MCAID)	119	RC				inpatient	1511	1133.25	Percent of Total Billed Charges	1438.47	95.2	Percent of Total Billed Charges	1328.92	87.95	Percent of Total Billed Charges	1246.58	82.5	1133.25	1511
SNF ROOM	120	RC				inpatient	1511	1133.25	Percent of Total Billed Charges	1438.47	95.2	Percent of Total Billed Charges	1328.92	87.95	Percent of Total Billed Charges	1246.58	82.5	1133.25	1511
UNNA BOOT APPLICATION	29580	HCPCS	761	RC		both	255	191.25	Percent of Total Billed Charges	242.76	95.2	Percent of Total Billed Charges	224.27	87.95	Percent of Total Billed Charges	210.38	82.5	191.25	255
TREATMENT ROOM	99211	HCPCS	761	RC		both	139	104.25	Percent of Total Billed Charges	132.33	95.2	Percent of Total Billed Charges	122.25	87.95	Percent of Total Billed Charges	114.68	82.5	104.25	139
IV PUSH SINGLE OR INIT SUB/DRUG (OP NURSING)	96374	HCPCS	260	RC		both	172	129	Percent of Total Billed Charges	163.74	95.2	Percent of Total Billed Charges	151.27	87.95	Percent of Total Billed Charges	141.9	82.5	129	172
PORT FLUSH (IRRIGATION OF IMPLANTED VENOUS ACCESS DEVICE)	96523	HCPCS	761	RC		both	92	69	Percent of Total Billed Charges	87.58	95.2	Percent of Total Billed Charges	80.91	87.95	Percent of Total Billed Charges	75.9	82.5	69	92
BLADDER SCAN	51798	HCPCS	761	RC		both	228	171	Percent of Total Billed Charges	217.06	95.2	Percent of Total Billed Charges	200.53	87.95	Percent of Total Billed Charges	188.1	82.5	171	228
IV PUSH-EACH ADDITIONAL NEW DRUG (OP SERVICES)	96375	HCPCS	260	RC		outpatient	134	100.5	Percent of Total Billed Charges	127.57	95.2	Percent of Total Billed Charges	117.85	87.95	Percent of Total Billed Charges	110.55	82.5	100.5	134
"CONCURRENT INFUSION, NEW DRUG"	96368	HCPCS	260	RC		both	61	45.75	Percent of Total Billed Charges	58.07	95.2	Percent of Total Billed Charges	53.65	87.95	Percent of Total Billed Charges	50.33	82.5	45.75	61
NEB TREATMENT (OP NURSING)	94640	HCPCS	410	RC		both	43	32.25	Percent of Total Billed Charges	40.94	95.2	Percent of Total Billed Charges	37.82	87.95	Percent of Total Billed Charges	35.48	82.5	32.25	43
IVPB ADDITIONAL DRUG	96367	HCPCS	260	RC		both	61	45.75	Percent of Total Billed Charges	58.07	95.2	Percent of Total Billed Charges	53.65	87.95	Percent of Total Billed Charges	50.33	82.5	45.75	61
"INTUBATION, ENDOTRACHEAL, EMERGENCY PROCEDURE"	31500	HCPCS	361	RC		both	172	129	Percent of Total Billed Charges	163.74	95.2	Percent of Total Billed Charges	151.27	87.95	Percent of Total Billed Charges	141.9	82.5	129	172
INSERTION OF NON-TUNNELED CENTRALLY INSERTED CENTR	36556	HCPCS	761	RC		both	257	192.75	Percent of Total Billed Charges	244.66	95.2	Percent of Total Billed Charges	226.03	87.95	Percent of Total Billed Charges	212.03	82.5	192.75	257
DECLOTTING BY THROMBOLYTIC AGENT OF IMPLANTED VASCULAR ACCESS DEVICE OR CATHETER	36593	HCPCS	761	RC		both	1056	792	Percent of Total Billed Charges	1005.31	95.2	Percent of Total Billed Charges	928.75	87.95	Percent of Total Billed Charges	871.2	82.5	792	1056
INSERTION OF NON-TUNNELED CENTRALLY INSERTED CENTR	36556	HCPCS	761	RC		both	9384	7038	Percent of Total Billed Charges	8933.57	95.2	Percent of Total Billed Charges	8253.23	87.95	Percent of Total Billed Charges	7741.8	82.5	7038	9384
IV ADMIN 1ST HR INFUSION (OP NURSING SERVICES)	96365	HCPCS	260	RC		both	407	305.25	Percent of Total Billed Charges	387.46	95.2	Percent of Total Billed Charges	357.96	87.95	Percent of Total Billed Charges	335.78	82.5	305.25	407
IV ADMIN ADD HR INFUSION (OP NURSING)	96366	HCPCS	260	RC		both	187	140.25	Percent of Total Billed Charges	178.02	95.2	Percent of Total Billed Charges	164.47	87.95	Percent of Total Billed Charges	154.28	82.5	140.25	187
IV PUSH EACH ADD SAME DRUG	96376	HCPCS	260	RC		both	95	71.25	Percent of Total Billed Charges	90.44	95.2	Percent of Total Billed Charges	83.55	87.95	Percent of Total Billed Charges	78.38	82.5	71.25	95
IV ADMIN 1ST HR HYDRATION (OP NURSING)	96360	HCPCS	260	RC		both	402	301.5	Percent of Total Billed Charges	382.7	95.2	Percent of Total Billed Charges	353.56	87.95	Percent of Total Billed Charges	331.65	82.5	301.5	402
IV ADIMN ADD HR HYDRATION (OP NURSING)	96361	HCPCS	260	RC		both	181	135.75	Percent of Total Billed Charges	172.31	95.2	Percent of Total Billed Charges	159.19	87.95	Percent of Total Billed Charges	149.33	82.5	135.75	181
TRIGGER POINT INJ 1 OR 2	20552	HCPCS	500	RC		both	398	298.5	Percent of Total Billed Charges	378.9	95.2	Percent of Total Billed Charges	350.04	87.95	Percent of Total Billed Charges	328.35	82.5	298.5	398
TRIGGER POINT INJ 3 OR MORE	20553	HCPCS	500	RC		both	301	225.75	Percent of Total Billed Charges	286.55	95.2	Percent of Total Billed Charges	264.73	87.95	Percent of Total Billed Charges	248.33	82.5	225.75	301
JOINT INJECTION MAJOR	20610	HCPCS	982	RC		both	540	405	Percent of Total Billed Charges	514.08	95.2	Percent of Total Billed Charges	474.93	87.95	Percent of Total Billed Charges	445.5	82.5	405	540
INSERT STRAIGHT CATH	51701	HCPCS	761	RC		both	123	92.25	Percent of Total Billed Charges	117.1	95.2	Percent of Total Billed Charges	108.18	87.95	Percent of Total Billed Charges	101.48	82.5	92.25	123
BLOOD ADMINISTRATION	36430	HCPCS	391	RC		both	975	731.25	Percent of Total Billed Charges	928.2	95.2	Percent of Total Billed Charges	857.51	87.95	Percent of Total Billed Charges	804.38	82.5	731.25	975
THER. INJ. SQ/IM (OP)	96372	HCPCS	761	RC		both	166	124.5	Percent of Total Billed Charges	158.03	95.2	Percent of Total Billed Charges	146	87.95	Percent of Total Billed Charges	136.95	82.5	124.5	166
SPIROMETRY	94010	HCPCS	410	RC		both	356	267	Percent of Total Billed Charges	338.91	95.2	Percent of Total Billed Charges	313.1	87.95	Percent of Total Billed Charges	293.7	82.5	267	356
INSTERTION OF PICC WITHOUT SUBCUTANEOUS PORT OR PUMP (OPN)	36573	HCPCS	761	RC		both	4659	3494.25	Percent of Total Billed Charges	4435.37	95.2	Percent of Total Billed Charges	4097.59	87.95	Percent of Total Billed Charges	3843.68	82.5	3494.25	4659
INSTERTION OF PICC WITHOUT SUBCUTANEOUS PORT OR PUMP (OPN)	36573	HCPCS	960	RC		both	370	277.5	Percent of Total Billed Charges	352.24	95.2	Percent of Total Billed Charges	325.42	87.95	Percent of Total Billed Charges	305.25	82.5	277.5	370
REMOVAL OF PICC LINE (OPN)	36589	HCPCS	960	RC		both	585	438.75	Percent of Total Billed Charges	556.92	95.2	Percent of Total Billed Charges	514.51	87.95	Percent of Total Billed Charges	482.63	82.5	438.75	585
REMOVAL OF PICC LINE (OPN)	36589	HCPCS	360	RC		both	1791	1343.25	Percent of Total Billed Charges	1705.03	95.2	Percent of Total Billed Charges	1575.18	87.95	Percent of Total Billed Charges	1477.58	82.5	1343.25	1791
PUNCH BX SKIN SINGLE LESION	11104	HCPCS	761	RC		both	1175	881.25	Percent of Total Billed Charges	1118.6	95.2	Percent of Total Billed Charges	1033.41	87.95	Percent of Total Billed Charges	969.38	82.5	881.25	1175
PUNCH BX SKIN EACH SEP/ADDL	11105	HCPCS	761	RC		both	79	59.25	Percent of Total Billed Charges	75.21	95.2	Percent of Total Billed Charges	69.48	87.95	Percent of Total Billed Charges	65.18	82.5	59.25	79
IRRIGATION OF BLADDER	51700	HCPCS	761	RC		both	706	529.5	Percent of Total Billed Charges	672.11	95.2	Percent of Total Billed Charges	620.93	87.95	Percent of Total Billed Charges	582.45	82.5	529.5	706
INSERT TEMP BLADDER CATH	51702	HCPCS	761	RC		both	365	273.75	Percent of Total Billed Charges	347.48	95.2	Percent of Total Billed Charges	321.02	87.95	Percent of Total Billed Charges	301.13	82.5	273.75	365
INSERT BLADDER CATH COMPLEX	51703	HCPCS	761	RC		both	446	334.5	Percent of Total Billed Charges	424.59	95.2	Percent of Total Billed Charges	392.26	87.95	Percent of Total Billed Charges	367.95	82.5	334.5	446
ER-LEVEL I	99281	HCPCS	450	RC		outpatient	255	191.25	Percent of Total Billed Charges	242.76	95.2	Percent of Total Billed Charges	224.27	87.95	Percent of Total Billed Charges	210.38	82.5	191.25	255
ER-LEVEL II	99282	HCPCS	450	RC		outpatient	436	327	Percent of Total Billed Charges	415.07	95.2	Percent of Total Billed Charges	383.46	87.95	Percent of Total Billed Charges	359.7	82.5	327	436
ER-LEVEL III	99283	HCPCS	450	RC		outpatient	735	551.25	Percent of Total Billed Charges	699.72	95.2	Percent of Total Billed Charges	646.43	87.95	Percent of Total Billed Charges	606.38	82.5	551.25	735
ER-LEVEL IV	99284	HCPCS	450	RC		outpatient	1161	870.75	Percent of Total Billed Charges	1105.27	95.2	Percent of Total Billed Charges	1021.1	87.95	Percent of Total Billed Charges	957.83	82.5	870.75	1161
TREATMENT ROOM	99211	HCPCS	450	RC		outpatient	139	104.25	Percent of Total Billed Charges	132.33	95.2	Percent of Total Billed Charges	122.25	87.95	Percent of Total Billed Charges	114.68	82.5	104.25	139
INSERT CATH - COMPLICATED	51703	HCPCS	450	RC		outpatient	288	216	Percent of Total Billed Charges	274.18	95.2	Percent of Total Billed Charges	253.3	87.95	Percent of Total Billed Charges	237.6	82.5	216	288
ER-LEVEL V	99285	HCPCS	450	RC		outpatient	2481	1860.75	Percent of Total Billed Charges	2361.91	95.2	Percent of Total Billed Charges	2182.04	87.95	Percent of Total Billed Charges	2046.83	82.5	1860.75	2481
IV ADMIN 1ST HR INFUSION (ER)	96365	HCPCS	450	RC		outpatient	407	305.25	Percent of Total Billed Charges	387.46	95.2	Percent of Total Billed Charges	357.96	87.95	Percent of Total Billed Charges	335.78	82.5	305.25	407
IV ADMIN ADD HR INFUSION (ER)	96366	HCPCS	450	RC		outpatient	187	140.25	Percent of Total Billed Charges	178.02	95.2	Percent of Total Billed Charges	164.47	87.95	Percent of Total Billed Charges	154.28	82.5	140.25	187
IV ADMIN 1ST HR HYDRATION (ER)	96360	HCPCS	450	RC		outpatient	402	301.5	Percent of Total Billed Charges	382.7	95.2	Percent of Total Billed Charges	353.56	87.95	Percent of Total Billed Charges	331.65	82.5	301.5	402
IV ADIMN ADD HR HYDRATION (ER)	96361	HCPCS	450	RC		outpatient	181	135.75	Percent of Total Billed Charges	172.31	95.2	Percent of Total Billed Charges	159.19	87.95	Percent of Total Billed Charges	149.33	82.5	135.75	181
CATHETER SIMPLE	51702	HCPCS	450	RC		outpatient	156	117	Percent of Total Billed Charges	148.51	95.2	Percent of Total Billed Charges	137.2	87.95	Percent of Total Billed Charges	128.7	82.5	117	156
INSERT STRAIGHT CATH	51701	HCPCS	450	RC		outpatient	123	92.25	Percent of Total Billed Charges	117.1	95.2	Percent of Total Billed Charges	108.18	87.95	Percent of Total Billed Charges	101.48	82.5	92.25	123
BLOOD ADMINISTRATION	36430	HCPCS	450	RC		outpatient	975	731.25	Percent of Total Billed Charges	928.2	95.2	Percent of Total Billed Charges	857.51	87.95	Percent of Total Billed Charges	804.38	82.5	731.25	975
IV PUSH SINGLE OR INIT SUB/DRUG (ER)	96374	HCPCS	450	RC		outpatient	172	129	Percent of Total Billed Charges	163.74	95.2	Percent of Total Billed Charges	151.27	87.95	Percent of Total Billed Charges	141.9	82.5	129	172
IV PUSH EACH ADD SAM DRUG	96376	HCPCS	450	RC		outpatient	95	71.25	Percent of Total Billed Charges	90.44	95.2	Percent of Total Billed Charges	83.55	87.95	Percent of Total Billed Charges	78.38	82.5	71.25	95
THER. INJ. SQ/IM (ER)	96372	HCPCS	450	RC		outpatient	166	124.5	Percent of Total Billed Charges	158.03	95.2	Percent of Total Billed Charges	146	87.95	Percent of Total Billed Charges	136.95	82.5	124.5	166
IV PUSH-EACH ADDITIONAL NEW DRUG (ER)	96375	HCPCS	450	RC		outpatient	134	100.5	Percent of Total Billed Charges	127.57	95.2	Percent of Total Billed Charges	117.85	87.95	Percent of Total Billed Charges	110.55	82.5	100.5	134
UNNA BOOT APPLICATION	29580	HCPCS	450	RC		outpatient	255	191.25	Percent of Total Billed Charges	242.76	95.2	Percent of Total Billed Charges	224.27	87.95	Percent of Total Billed Charges	210.38	82.5	191.25	255
NEB TREATMENT (ER)	94640	HCPCS	450	RC		outpatient	43	32.25	Percent of Total Billed Charges	40.94	95.2	Percent of Total Billed Charges	37.82	87.95	Percent of Total Billed Charges	35.48	82.5	32.25	43
REMOVAL FB XTRNL EYE EMBED SCJNCI/SCLERAL NONPERFOR	65210	HCPCS	450	RC		outpatient	150	112.5	Percent of Total Billed Charges	142.8	95.2	Percent of Total Billed Charges	131.93	87.95	Percent of Total Billed Charges	123.75	82.5	112.5	150
CRITICAL CARE ILL/INJURED PATIENT INT 30-74 MIN	99291	HCPCS	981	RC		outpatient	1786	1339.5	Percent of Total Billed Charges	1700.27	95.2	Percent of Total Billed Charges	1570.79	87.95	Percent of Total Billed Charges	1473.45	82.5	1339.5	1786
CRITICAL CARE ILL/INJURED PATIENT ADDL 30 MIN	99292	HCPCS	981	RC		outpatient	437	327.75	Percent of Total Billed Charges	416.02	95.2	Percent of Total Billed Charges	384.34	87.95	Percent of Total Billed Charges	360.53	82.5	327.75	437
"CLOSED TREATMENT OF METACARPOPHALANGEAL DISLOCATION, SINGLE WITH MANIPULATION, W/O ANESTHESIA"	26700	HCPCS	450	RC		outpatient	684	513	Percent of Total Billed Charges	651.17	95.2	Percent of Total Billed Charges	601.58	87.95	Percent of Total Billed Charges	564.3	82.5	513	684
CPR	92950	HCPCS	450	RC		outpatient	2936	2202	Percent of Total Billed Charges	2795.07	95.2	Percent of Total Billed Charges	2582.21	87.95	Percent of Total Billed Charges	2422.2	82.5	2202	2936
TREAT ANKLE DISLOCATION	27842	HCPCS	450	RC		outpatient	4613	3459.75	Percent of Total Billed Charges	4391.58	95.2	Percent of Total Billed Charges	4057.13	87.95	Percent of Total Billed Charges	3805.73	82.5	3459.75	4613
INSERTION OF CHEST TUBE	32551	HCPCS	981	RC		outpatient	4523	3392.25	Percent of Total Billed Charges	4305.9	95.2	Percent of Total Billed Charges	3977.98	87.95	Percent of Total Billed Charges	3731.48	82.5	3392.25	4523
INSERTION OF CHEST TUBE	32551	HCPCS	450	RC		outpatient	658	493.5	Percent of Total Billed Charges	626.42	95.2	Percent of Total Billed Charges	578.71	87.95	Percent of Total Billed Charges	542.85	82.5	493.5	658
TRAUMA TEAM ACTIVATION	99283	HCPCS	684	RC		outpatient	1189	891.75	Percent of Total Billed Charges	1131.93	95.2	Percent of Total Billed Charges	1045.73	87.95	Percent of Total Billed Charges	980.93	82.5	891.75	1189
"ANOSCOPY, DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN BY BRUSHING OR WASHING WHEN PERFORMED"	46600	HCPCS	450	RC		outpatient	371	278.25	Percent of Total Billed Charges	353.19	95.2	Percent of Total Billed Charges	326.29	87.95	Percent of Total Billed Charges	306.08	82.5	278.25	371
"ANOSCOPY, DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN BY BRUSHING OR WASHING WHEN PERFORMED"	46600	HCPCS	981	RC		outpatient	143	107.25	Percent of Total Billed Charges	136.14	95.2	Percent of Total Billed Charges	125.77	87.95	Percent of Total Billed Charges	117.98	82.5	107.25	143
"CLOSED TREATMENT OF FEMORAL SHAFT FRACTURE, WITH MANIPULATION"	27502	HCPCS	450	RC		outpatient	4616	3462	Percent of Total Billed Charges	4394.43	95.2	Percent of Total Billed Charges	4059.77	87.95	Percent of Total Billed Charges	3808.2	82.5	3462	4616
"CLOSED TREATMENT OF SHOULDER DISLOCATION, WITH MANIPULATION; REQUIRING ANESTHESIA"	23655	HCPCS	450	RC		outpatient	4616	3462	Percent of Total Billed Charges	4394.43	95.2	Percent of Total Billed Charges	4059.77	87.95	Percent of Total Billed Charges	3808.2	82.5	3462	4616
PLACEMENT OF NEEDLE FOR INTRAOSSEOUS INFUSION	36680	HCPCS	450	RC		outpatient	874	655.5	Percent of Total Billed Charges	832.05	95.2	Percent of Total Billed Charges	768.68	87.95	Percent of Total Billed Charges	721.05	82.5	655.5	874
FLUORESCEIN	92235	HCPCS	450	RC		outpatient	882	661.5	Percent of Total Billed Charges	839.66	95.2	Percent of Total Billed Charges	775.72	87.95	Percent of Total Billed Charges	727.65	82.5	661.5	882
ER LEVEL 1	99281	HCPCS	981	RC		outpatient	212	159	Percent of Total Billed Charges	201.82	95.2	Percent of Total Billed Charges	186.45	87.95	Percent of Total Billed Charges	174.9	82.5	159	212
ER LEVEL II	99282	HCPCS	981	RC		outpatient	284	213	Percent of Total Billed Charges	270.37	95.2	Percent of Total Billed Charges	249.78	87.95	Percent of Total Billed Charges	234.3	82.5	213	284
ER LEVEL III	99283	HCPCS	981	RC		outpatient	426	319.5	Percent of Total Billed Charges	405.55	95.2	Percent of Total Billed Charges	374.67	87.95	Percent of Total Billed Charges	351.45	82.5	319.5	426
ER LEVEL IV	99284	HCPCS	981	RC		outpatient	634	475.5	Percent of Total Billed Charges	603.57	95.2	Percent of Total Billed Charges	557.6	87.95	Percent of Total Billed Charges	523.05	82.5	475.5	634
ER LEVEL V	99285	HCPCS	981	RC		outpatient	943	707.25	Percent of Total Billed Charges	897.74	95.2	Percent of Total Billed Charges	829.37	87.95	Percent of Total Billed Charges	777.98	82.5	707.25	943
THER. INJ. SQ/IM (PS)	96372	HCPCS	981	RC		inpatient	166	124.5	Percent of Total Billed Charges	158.03	95.2	Percent of Total Billed Charges	146	87.95	Percent of Total Billed Charges	136.95	82.5	124.5	166
"ARTHROCENTESIS, ASPIRATION AND/OR INJECTION, MAJOR JOINT OR BURSA"	20610	HCPCS	981	RC		outpatient	540	405	Percent of Total Billed Charges	514.08	95.2	Percent of Total Billed Charges	474.93	87.95	Percent of Total Billed Charges	445.5	82.5	405	540
TRIGGER POINT INJ 1 OR 2	20552	HCPCS	981	RC		outpatient	398	298.5	Percent of Total Billed Charges	378.9	95.2	Percent of Total Billed Charges	350.04	87.95	Percent of Total Billed Charges	328.35	82.5	298.5	398
TRIGGER POINT INJ 3 OR MORE	20553	HCPCS	981	RC		outpatient	301	225.75	Percent of Total Billed Charges	286.55	95.2	Percent of Total Billed Charges	264.73	87.95	Percent of Total Billed Charges	248.33	82.5	225.75	301
"LAC, SIMPLE 20.1-30.0 CM SCALP, NECK, TRUNK, EXTREMITIES"	12006	HCPCS	981	RC		outpatient	819	614.25	Percent of Total Billed Charges	779.69	95.2	Percent of Total Billed Charges	720.31	87.95	Percent of Total Billed Charges	675.68	82.5	614.25	819
CAST LONG LEG	29365	HCPCS	981	RC		outpatient	364	273	Percent of Total Billed Charges	346.53	95.2	Percent of Total Billed Charges	320.14	87.95	Percent of Total Billed Charges	300.3	82.5	273	364
"LAC INTERM <2.5CM, NECK, HANDS, FEET"	12041	HCPCS	981	RC		outpatient	654	490.5	Percent of Total Billed Charges	622.61	95.2	Percent of Total Billed Charges	575.19	87.95	Percent of Total Billed Charges	539.55	82.5	490.5	654
"CLOSED TREATMENT OF METACARPOPHALANGEAL DISLOCATION, SINGLE WITH MANIPULATION, W/O ANESTHESIA"	26700	HCPCS	981	RC		outpatient	1340	1005	Percent of Total Billed Charges	1275.68	95.2	Percent of Total Billed Charges	1178.53	87.95	Percent of Total Billed Charges	1105.5	82.5	1005	1340
CPR	92950	HCPCS	981	RC		outpatient	1580	1185	Percent of Total Billed Charges	1504.16	95.2	Percent of Total Billed Charges	1389.61	87.95	Percent of Total Billed Charges	1303.5	82.5	1185	1580
I&D ABCESS-SIMPLE	10060	HCPCS	981	RC		outpatient	296	222	Percent of Total Billed Charges	281.79	95.2	Percent of Total Billed Charges	260.33	87.95	Percent of Total Billed Charges	244.2	82.5	222	296
SPLINT-APPLY FINGER	29130	HCPCS	981	RC		outpatient	161	120.75	Percent of Total Billed Charges	153.27	95.2	Percent of Total Billed Charges	141.6	87.95	Percent of Total Billed Charges	132.83	82.5	120.75	161
SPLINT-APPLY LONG ARM	29105	HCPCS	981	RC		outpatient	224	168	Percent of Total Billed Charges	213.25	95.2	Percent of Total Billed Charges	197.01	87.95	Percent of Total Billed Charges	184.8	82.5	168	224
SPLINT-APPLY LONG LEG	29505	HCPCS	981	RC		outpatient	215	161.25	Percent of Total Billed Charges	204.68	95.2	Percent of Total Billed Charges	189.09	87.95	Percent of Total Billed Charges	177.38	82.5	161.25	215
SPLINT-APPLY SHORT ARM	29125	HCPCS	981	RC		outpatient	192	144	Percent of Total Billed Charges	182.78	95.2	Percent of Total Billed Charges	168.86	87.95	Percent of Total Billed Charges	158.4	82.5	144	192
SPLINT-APPLY SHORT LEG	29515	HCPCS	981	RC		outpatient	161	120.75	Percent of Total Billed Charges	153.27	95.2	Percent of Total Billed Charges	141.6	87.95	Percent of Total Billed Charges	132.83	82.5	120.75	161
LAC INTERM 2.6-5 CM FACE	12052	HCPCS	981	RC		outpatient	851	638.25	Percent of Total Billed Charges	810.15	95.2	Percent of Total Billed Charges	748.45	87.95	Percent of Total Billed Charges	702.08	82.5	638.25	851
"SIMPLE REPAIR OF SUPERFICIAL WOUND FACE, EARS, EYELIDS, NOSE-2.5CM OR LESS"	12011	HCPCS	981	RC		outpatient	160	120	Percent of Total Billed Charges	152.32	95.2	Percent of Total Billed Charges	140.72	87.95	Percent of Total Billed Charges	132	82.5	120	160
LAC INTERM 7.6-12.5 FACE	12054	HCPCS	981	RC		outpatient	1221	915.75	Percent of Total Billed Charges	1162.39	95.2	Percent of Total Billed Charges	1073.87	87.95	Percent of Total Billed Charges	1007.33	82.5	915.75	1221
SIMPLE REPAIR-SUPERFICIAL WOUNDS 2.6CM-7.5CM	12002	HCPCS	981	RC		outpatient	517	387.75	Percent of Total Billed Charges	492.18	95.2	Percent of Total Billed Charges	454.7	87.95	Percent of Total Billed Charges	426.53	82.5	387.75	517
SIMPLE REPAIR OF SUPERFICIAL WOUNDS-2.5 CM OR LESS	12001	HCPCS	981	RC		outpatient	431	323.25	Percent of Total Billed Charges	410.31	95.2	Percent of Total Billed Charges	379.06	87.95	Percent of Total Billed Charges	355.58	82.5	323.25	431
REPAIR INTERMEDIATE SCALP AND/OR EXTREMETIES-7.6CM TO 12.5 CM	12034	HCPCS	981	RC		outpatient	620	465	Percent of Total Billed Charges	590.24	95.2	Percent of Total Billed Charges	545.29	87.95	Percent of Total Billed Charges	511.5	82.5	465	620
"SIMPLE REPAIR SUPERFICIAL WOUND FACE, EAR, NOSE 2.6-5.0 CM"	12013	HCPCS	981	RC		outpatient	732	549	Percent of Total Billed Charges	696.86	95.2	Percent of Total Billed Charges	643.79	87.95	Percent of Total Billed Charges	603.9	82.5	549	732
FLUORESCEIN	92235	HCPCS	981	RC	TC	outpatient	408	306	Percent of Total Billed Charges	388.42	95.2	Percent of Total Billed Charges	358.84	87.95	Percent of Total Billed Charges	336.6	82.5	306	408
"PF, PF, SF-NEW (SC)"	99201	HCPCS	510	RC		outpatient	72	54	Percent of Total Billed Charges	68.54	95.2	Percent of Total Billed Charges	63.32	87.95	Percent of Total Billed Charges	59.4	82.5	54	72
"PF, PF, SF-NEW (SC)"	99201	HCPCS	960	RC		outpatient	244	183	Percent of Total Billed Charges	232.29	95.2	Percent of Total Billed Charges	214.6	87.95	Percent of Total Billed Charges	201.3	82.5	183	244
"PF, PF, SF-ESTAB (SC)"	99212	HCPCS	960	RC		outpatient	151	113.25	Percent of Total Billed Charges	143.75	95.2	Percent of Total Billed Charges	132.8	87.95	Percent of Total Billed Charges	124.58	82.5	113.25	151
"EP, EP, SF-LC-NEW (SC)"	99202	HCPCS	960	RC		outpatient	260	195	Percent of Total Billed Charges	247.52	95.2	Percent of Total Billed Charges	228.67	87.95	Percent of Total Billed Charges	214.5	82.5	195	260
"EP, EP, SF-LC-ESTAB (SC)"	99213	HCPCS	960	RC		outpatient	184	138	Percent of Total Billed Charges	175.17	95.2	Percent of Total Billed Charges	161.83	87.95	Percent of Total Billed Charges	151.8	82.5	138	184
"D,D, LC-MC-NEW (SC)"	99203	HCPCS	960	RC		outpatient	308	231	Percent of Total Billed Charges	293.22	95.2	Percent of Total Billed Charges	270.89	87.95	Percent of Total Billed Charges	254.1	82.5	231	308
"D,D,LC-MC-ESTAB (SC)"	99214	HCPCS	960	RC		outpatient	246	184.5	Percent of Total Billed Charges	234.19	95.2	Percent of Total Billed Charges	216.36	87.95	Percent of Total Billed Charges	202.95	82.5	184.5	246
"C, C, MC-HC-NEW (SC)"	99204	HCPCS	960	RC		outpatient	361	270.75	Percent of Total Billed Charges	343.67	95.2	Percent of Total Billed Charges	317.5	87.95	Percent of Total Billed Charges	297.83	82.5	270.75	361
"C, C, MC-HC-ESTAB (SC)"	99215	HCPCS	960	RC		outpatient	379	284.25	Percent of Total Billed Charges	360.81	95.2	Percent of Total Billed Charges	333.33	87.95	Percent of Total Billed Charges	312.68	82.5	284.25	379
"C,C,HC-NEW (SC)"	99205	HCPCS	960	RC		outpatient	467	350.25	Percent of Total Billed Charges	444.58	95.2	Percent of Total Billed Charges	410.73	87.95	Percent of Total Billed Charges	385.28	82.5	350.25	467
"PF, PF, SF-NEW (SC)"	99201	HCPCS	510	RC		outpatient	171	128.25	Percent of Total Billed Charges	162.79	95.2	Percent of Total Billed Charges	150.39	87.95	Percent of Total Billed Charges	141.08	82.5	128.25	171
OFFICE OUTPATIENT VISIT II (SC)	99212	HCPCS	960	RC		outpatient	46	34.5	Percent of Total Billed Charges	43.79	95.2	Percent of Total Billed Charges	40.46	87.95	Percent of Total Billed Charges	37.95	82.5	34.5	46
OFFICE OUTPATIENT VISIT II (SC)	99212	HCPCS	510	RC		outpatient	106	79.5	Percent of Total Billed Charges	100.91	95.2	Percent of Total Billed Charges	93.23	87.95	Percent of Total Billed Charges	87.45	82.5	79.5	106
"EP, EP, SF-LC-NEW (SC)"	99202	HCPCS	510	RC		outpatient	183	137.25	Percent of Total Billed Charges	174.22	95.2	Percent of Total Billed Charges	160.95	87.95	Percent of Total Billed Charges	150.98	82.5	137.25	183
"EP, EP, SF-LC-NEW (SC)"	99202	HCPCS	960	RC		outpatient	79	59.25	Percent of Total Billed Charges	75.21	95.2	Percent of Total Billed Charges	69.48	87.95	Percent of Total Billed Charges	65.18	82.5	59.25	79
"D,D, LC-MC-NEW (SC)"	99203	HCPCS	960	RC		outpatient	215	161.25	Percent of Total Billed Charges	204.68	95.2	Percent of Total Billed Charges	189.09	87.95	Percent of Total Billed Charges	177.38	82.5	161.25	215
"D,D, LC-MC-NEW (SC)"	99203	HCPCS	360	RC		outpatient	92	69	Percent of Total Billed Charges	87.58	95.2	Percent of Total Billed Charges	80.91	87.95	Percent of Total Billed Charges	75.9	82.5	69	92
"C, C, MC-HC-NEW (SC)"	99204	HCPCS	510	RC		outpatient	253	189.75	Percent of Total Billed Charges	240.86	95.2	Percent of Total Billed Charges	222.51	87.95	Percent of Total Billed Charges	208.73	82.5	189.75	253
"C, C, MC-HC-NEW (SC)"	99204	HCPCS	960	RC		outpatient	108	81	Percent of Total Billed Charges	102.82	95.2	Percent of Total Billed Charges	94.99	87.95	Percent of Total Billed Charges	89.1	82.5	81	108
"C,C,HC-NEW (SC)"	99205	HCPCS	510	RC		outpatient	327	245.25	Percent of Total Billed Charges	311.3	95.2	Percent of Total Billed Charges	287.6	87.95	Percent of Total Billed Charges	269.78	82.5	245.25	327
"C,C,HC-NEW (SC)"	99205	HCPCS	960	RC		outpatient	142	106.5	Percent of Total Billed Charges	135.18	95.2	Percent of Total Billed Charges	124.89	87.95	Percent of Total Billed Charges	117.15	82.5	106.5	142
"EP, EP, SF-LC-ESTAB (SC)"	99213	HCPCS	510	RC		outpatient	129	96.75	Percent of Total Billed Charges	122.81	95.2	Percent of Total Billed Charges	113.46	87.95	Percent of Total Billed Charges	106.43	82.5	96.75	129
"EP, EP, SF-LC-ESTAB (SC)"	99213	HCPCS	360	RC		outpatient	57	42.75	Percent of Total Billed Charges	54.26	95.2	Percent of Total Billed Charges	50.13	87.95	Percent of Total Billed Charges	47.03	82.5	42.75	57
"D,D,LC-MC-ESTAB (SC)"	99214	HCPCS	510	RC		outpatient	172	129	Percent of Total Billed Charges	163.74	95.2	Percent of Total Billed Charges	151.27	87.95	Percent of Total Billed Charges	141.9	82.5	129	172
"D,D,LC-MC-ESTAB (SC)"	99214	HCPCS	960	RC		outpatient	74	55.5	Percent of Total Billed Charges	70.45	95.2	Percent of Total Billed Charges	65.08	87.95	Percent of Total Billed Charges	61.05	82.5	55.5	74
SACROILLIAC JOINT INJ BILATERAL	27096	HCPCS	360	RC	50	outpatient	2439	1829.25	Percent of Total Billed Charges	2321.93	95.2	Percent of Total Billed Charges	2145.1	87.95	Percent of Total Billed Charges	2012.18	82.5	1829.25	2439
"C, C, MC-HC-ESTAB (SC)"	99215	HCPCS	510	RC		outpatient	265	198.75	Percent of Total Billed Charges	252.28	95.2	Percent of Total Billed Charges	233.07	87.95	Percent of Total Billed Charges	218.63	82.5	198.75	265
"C, C, MC-HC-ESTAB (SC)"	99215	HCPCS	960	RC		outpatient	113	84.75	Percent of Total Billed Charges	107.58	95.2	Percent of Total Billed Charges	99.38	87.95	Percent of Total Billed Charges	93.23	82.5	84.75	113
TRIGGER POINT INJ 1 OR 2 MUSCLES (SC)	20552	HCPCS	510	RC		outpatient	120	90	Percent of Total Billed Charges	114.24	95.2	Percent of Total Billed Charges	105.54	87.95	Percent of Total Billed Charges	99	82.5	90	120
TRIGGER POINT INJ 1 OR 2 MUSCLES (SC)	20552	HCPCS	960	RC		outpatient	280	210	Percent of Total Billed Charges	266.56	95.2	Percent of Total Billed Charges	246.26	87.95	Percent of Total Billed Charges	231	82.5	210	280
MODERATE SEDATION INITIAL 15 MINS >5 YRS OLD	99151	HCPCS	370	RC		outpatient	146	109.5	Percent of Total Billed Charges	138.99	95.2	Percent of Total Billed Charges	128.41	87.95	Percent of Total Billed Charges	120.45	82.5	109.5	146
MODERATE SEDATION INITIAL 15 MINS <5 YRS OLD	99152	HCPCS	370	RC		outpatient	146	109.5	Percent of Total Billed Charges	138.99	95.2	Percent of Total Billed Charges	128.41	87.95	Percent of Total Billed Charges	120.45	82.5	109.5	146
MODERATE SEDATION EACH ADDITIONAL 15 MINS	99153	HCPCS	370	RC		outpatient	33	24.75	Percent of Total Billed Charges	31.42	95.2	Percent of Total Billed Charges	29.02	87.95	Percent of Total Billed Charges	27.23	82.5	24.75	33
EXTREMITY VEINS DUPLEX LIMITED UNILATERAL (SC)	93971	HCPCS	921	RC		outpatient	339	254.25	Percent of Total Billed Charges	322.73	95.2	Percent of Total Billed Charges	298.15	87.95	Percent of Total Billed Charges	279.68	82.5	254.25	339
EXTREMITY VEINS DUPLEX LIMITED UNILATERAL (SC)	93971	HCPCS	960	RC		outpatient	792	594	Percent of Total Billed Charges	753.98	95.2	Percent of Total Billed Charges	696.56	87.95	Percent of Total Billed Charges	653.4	82.5	594	792
TRIGGER POINT INJ 1 OR 2 MUSCLES (SC)	20552	HCPCS	360	RC		outpatient	120	90	Percent of Total Billed Charges	114.24	95.2	Percent of Total Billed Charges	105.54	87.95	Percent of Total Billed Charges	99	82.5	90	120
TRIGGER POINT INJ 1 OR 2 MUSCLES (SC)	20552	HCPCS	960	RC		outpatient	558	418.5	Percent of Total Billed Charges	531.22	95.2	Percent of Total Billed Charges	490.76	87.95	Percent of Total Billed Charges	460.35	82.5	418.5	558
DUP-SCANXTR VEINS COMPLETE BILATERAL STUDY	93970	HCPCS	960	RC	26	outpatient	180	135	Percent of Total Billed Charges	171.36	95.2	Percent of Total Billed Charges	158.31	87.95	Percent of Total Billed Charges	148.5	82.5	135	180
EVLT FIRST VEIN	36478	HCPCS	960	RC	50	outpatient	1306	979.5	Percent of Total Billed Charges	1243.31	95.2	Percent of Total Billed Charges	1148.63	87.95	Percent of Total Billed Charges	1077.45	82.5	979.5	1306
SACROILLIAC JOINT INJ BILATERAL	27096	HCPCS	960	RC	50	outpatient	700	525	Percent of Total Billed Charges	666.4	95.2	Percent of Total Billed Charges	615.65	87.95	Percent of Total Billed Charges	577.5	82.5	525	700
"DEBRIDEMENT, SUBCUTANEOUS TISSUE (INCLUDES EPIDERMIS AND DERMIS, IF PERFORMED) FIRST 20 SQ CM OR LESS)"	11042	HCPCS	960	RC		outpatient	603	452.25	Percent of Total Billed Charges	574.06	95.2	Percent of Total Billed Charges	530.34	87.95	Percent of Total Billed Charges	497.48	82.5	452.25	603
"DEBRIDEMENT, SUBCUTANEOUS TISSUE (INCLUDES EPIDERMIS AND DERMIS, IF PERFORMED) FIRST 20 SQ CM OR LESS)"	11042	HCPCS	960	RC		outpatient	422	316.5	Percent of Total Billed Charges	401.74	95.2	Percent of Total Billed Charges	371.15	87.95	Percent of Total Billed Charges	348.15	82.5	316.5	422
"DEBRIDEMENT, SUBCUTANEOUS TISSUE (INCLUDES EPIDERMIS AND DERMIS, IF PERFORMED) FIRST 20 SQ CM OR LESS)"	11042	HCPCS	360	RC		outpatient	182	136.5	Percent of Total Billed Charges	173.26	95.2	Percent of Total Billed Charges	160.07	87.95	Percent of Total Billed Charges	150.15	82.5	136.5	182
CT SCAN FOR NEEDLE BIOPSY	77012	HCPCS	350	RC	26	outpatient	435	326.25	Percent of Total Billed Charges	414.12	95.2	Percent of Total Billed Charges	382.58	87.95	Percent of Total Billed Charges	358.88	82.5	326.25	435
CT SCAN FOR NEEDLE BIOPSY	77012	HCPCS	350	RC	TC	outpatient	428	321	Percent of Total Billed Charges	407.46	95.2	Percent of Total Billed Charges	376.43	87.95	Percent of Total Billed Charges	353.1	82.5	321	428
MNT INITL INDIV ASSMNT INTERVENTION 15 MIN	97802	HCPCS	942	RC		outpatient	111	83.25	Percent of Total Billed Charges	105.67	95.2	Percent of Total Billed Charges	97.62	87.95	Percent of Total Billed Charges	91.58	82.5	83.25	111
MNT REASSMT/INTEVNTN INDIV 15 MINS	97803	HCPCS	942	RC		outpatient	95	71.25	Percent of Total Billed Charges	90.44	95.2	Percent of Total Billed Charges	83.55	87.95	Percent of Total Billed Charges	78.38	82.5	71.25	95
"DIABETES OUTPATIENT SELF-MANAGEMENT TRAINING SERVICES, INDIVIDUAL PER 30 MINS"	G0108	HCPCS	942	RC		outpatient	186	139.5	Percent of Total Billed Charges	177.07	95.2	Percent of Total Billed Charges	163.59	87.95	Percent of Total Billed Charges	153.45	82.5	139.5	186
COMPLX CHRONI CARE W/O PT VISIT	99487	HCPCS	510	RC		outpatient	456	342	Percent of Total Billed Charges	434.11	95.2	Percent of Total Billed Charges	401.05	87.95	Percent of Total Billed Charges	376.2	82.5	342	456
CMPLX CHRON CARE W/O PT VISIT	99487	HCPCS	960	RC		outpatient	320	240	Percent of Total Billed Charges	304.64	95.2	Percent of Total Billed Charges	281.44	87.95	Percent of Total Billed Charges	264	82.5	240	320
CMPLX CHRON CARE W/O PT VISIT	99487	HCPCS	510	RC		outpatient	138	103.5	Percent of Total Billed Charges	131.38	95.2	Percent of Total Billed Charges	121.37	87.95	Percent of Total Billed Charges	113.85	82.5	103.5	138
ORTHOTICS - PART 1	500	RC				outpatient	125	93.75	Percent of Total Billed Charges	119	95.2	Percent of Total Billed Charges	109.94	87.95	Percent of Total Billed Charges	103.13	82.5	93.75	125
ORTHOTICS - PART 2	500	RC				outpatient	120	90	Percent of Total Billed Charges	114.24	95.2	Percent of Total Billed Charges	105.54	87.95	Percent of Total Billed Charges	99	82.5	90	120
ARTHROCENTESIS ASPIRAT/INJ INTERMEDIATE JOINT (SC)	20605	HCPCS	960	RC		outpatient	865	648.75	Percent of Total Billed Charges	823.48	95.2	Percent of Total Billed Charges	760.77	87.95	Percent of Total Billed Charges	713.63	82.5	648.75	865
ARTHROCENTESIS ASPIRAT/INJ MAJOR JOINT (SC)	20610	HCPCS	960	RC		outpatient	540	405	Percent of Total Billed Charges	514.08	95.2	Percent of Total Billed Charges	474.93	87.95	Percent of Total Billed Charges	445.5	82.5	405	540
SCLERO SINGLE LEVEL BILATERAL (SC)	36470	HCPCS	360	RC		outpatient	912	684	Percent of Total Billed Charges	868.22	95.2	Percent of Total Billed Charges	802.1	87.95	Percent of Total Billed Charges	752.4	82.5	684	912
INJECTION SINGLE TENDON ORIGIN/INSERTION (SC)	20551	HCPCS	960	RC		outpatient	149	111.75	Percent of Total Billed Charges	141.85	95.2	Percent of Total Billed Charges	131.05	87.95	Percent of Total Billed Charges	122.93	82.5	111.75	149
TRIGGER POINT INJ 1 OR 2 MUSCLES (SC)	20552	HCPCS	960	RC		outpatient	398	298.5	Percent of Total Billed Charges	378.9	95.2	Percent of Total Billed Charges	350.04	87.95	Percent of Total Billed Charges	328.35	82.5	298.5	398
TRIGGER POINT INJ 3 OR MORE MUSCLES	20553	HCPCS	960	RC		outpatient	299	224.25	Percent of Total Billed Charges	284.65	95.2	Percent of Total Billed Charges	262.97	87.95	Percent of Total Billed Charges	246.68	82.5	224.25	299
INJECTION 1 TENDON SHEATH/LIGAMENT (SC)	20550	HCPCS	960	RC		outpatient	299	224.25	Percent of Total Billed Charges	284.65	95.2	Percent of Total Billed Charges	262.97	87.95	Percent of Total Billed Charges	246.68	82.5	224.25	299
"ARTHROCENTESIS, ASPIRATION AND /OR INJECTION MAJOR JOINT  WITH ULTRASOUND GUIDANCE (SC)"	20611	HCPCS	960	RC		outpatient	953	714.75	Percent of Total Billed Charges	907.26	95.2	Percent of Total Billed Charges	838.16	87.95	Percent of Total Billed Charges	786.23	82.5	714.75	953
LUMBAR OR THORACIC SYMPATHETIC BLOCK UNILATERAL (SC)	64520	HCPCS	960	RC		outpatient	529	396.75	Percent of Total Billed Charges	503.61	95.2	Percent of Total Billed Charges	465.26	87.95	Percent of Total Billed Charges	436.43	82.5	396.75	529
LUMBAR OR THORACIC SYMPATHETIC BLOCK BILATERAL (SC)	64520	HCPCS	960	RC		outpatient	1058	793.5	Percent of Total Billed Charges	1007.22	95.2	Percent of Total Billed Charges	930.51	87.95	Percent of Total Billed Charges	872.85	82.5	793.5	1058
"ARTHROCENTESIS, ASPIRATION AND /OR INJECTION MAJOR JOINT  WITH ULTRASOUND GUIDANCE (SC)"	20611	HCPCS	360	RC		outpatient	1336	1002	Percent of Total Billed Charges	1271.87	95.2	Percent of Total Billed Charges	1175.01	87.95	Percent of Total Billed Charges	1102.2	82.5	1002	1336
"ARTHROCENTESIS, ASPIRATION AND /OR INJECTION MAJOR JOINT  WITH ULTRASOUND GUIDANCE (SC)"	20611	HCPCS	960	RC		outpatient	572	429	Percent of Total Billed Charges	544.54	95.2	Percent of Total Billed Charges	503.07	87.95	Percent of Total Billed Charges	471.9	82.5	429	572
INJECTION OF SCLEROSANT; SINGLE INCOMPETENT VEIN	36470	HCPCS	360	RC		outpatient	639	479.25	Percent of Total Billed Charges	608.33	95.2	Percent of Total Billed Charges	562	87.95	Percent of Total Billed Charges	527.18	82.5	479.25	639
INJECTION OF SCLEROSANT; SINGLE INCOMPETENT VEIN	36470	HCPCS	960	RC		outpatient	274	205.5	Percent of Total Billed Charges	260.85	95.2	Percent of Total Billed Charges	240.98	87.95	Percent of Total Billed Charges	226.05	82.5	205.5	274
FINE NEEDLE ASPIRATION BX W/US GDN 1ST LESION	10005	HCPCS	360	RC		outpatient	630	472.5	Percent of Total Billed Charges	599.76	95.2	Percent of Total Billed Charges	554.09	87.95	Percent of Total Billed Charges	519.75	82.5	472.5	630
FINE NEEDLE ASPIRATION BX W/US GDN 1ST LESION	10005	HCPCS	960	RC		outpatient	1471	1103.25	Percent of Total Billed Charges	1400.39	95.2	Percent of Total Billed Charges	1293.74	87.95	Percent of Total Billed Charges	1213.58	82.5	1103.25	1471
EVLT SECOND VEIN (SC)	36479	HCPCS	360	RC		outpatient	290	217.5	Percent of Total Billed Charges	276.08	95.2	Percent of Total Billed Charges	255.06	87.95	Percent of Total Billed Charges	239.25	82.5	217.5	290
EVLT FIRST VEIN	36478	HCPCS	360	RC		outpatient	3951	2963.25	Percent of Total Billed Charges	3761.35	95.2	Percent of Total Billed Charges	3474.9	87.95	Percent of Total Billed Charges	3259.58	82.5	2963.25	3951
SCLERO SINGLE LEVEL	36470	HCPCS	360	RC		outpatient	458	343.5	Percent of Total Billed Charges	436.02	95.2	Percent of Total Billed Charges	402.81	87.95	Percent of Total Billed Charges	377.85	82.5	343.5	458
SCLERO MULTIPLE LEVEL	36471	HCPCS	360	RC		outpatient	1127	845.25	Percent of Total Billed Charges	1072.9	95.2	Percent of Total Billed Charges	991.2	87.95	Percent of Total Billed Charges	929.78	82.5	845.25	1127
STAB PHLEBECTOMY 10-20	37765	HCPCS	360	RC		outpatient	1458	1093.5	Percent of Total Billed Charges	1388.02	95.2	Percent of Total Billed Charges	1282.31	87.95	Percent of Total Billed Charges	1202.85	82.5	1093.5	1458
STAB PHLEBECTOMY >20	37766	HCPCS	360	RC		outpatient	1406	1054.5	Percent of Total Billed Charges	1338.51	95.2	Percent of Total Billed Charges	1236.58	87.95	Percent of Total Billed Charges	1159.95	82.5	1054.5	1406
SACROILLIAC JOINT INJ UNILATERAL	27096	HCPCS	360	RC		outpatient	1220	915	Percent of Total Billed Charges	1161.44	95.2	Percent of Total Billed Charges	1072.99	87.95	Percent of Total Billed Charges	1006.5	82.5	915	1220
FINE NEEDLE ASPIRATION W / IMAGING	10022	HCPCS	361	RC		outpatient	1184	888	Percent of Total Billed Charges	1127.17	95.2	Percent of Total Billed Charges	1041.33	87.95	Percent of Total Billed Charges	976.8	82.5	888	1184
SCLERO MULTIPLE LEVEL	36471	HCPCS	960	RC		outpatient	618	463.5	Percent of Total Billed Charges	588.34	95.2	Percent of Total Billed Charges	543.53	87.95	Percent of Total Billed Charges	509.85	82.5	463.5	618
ARTHROCENTESIS ASPIRAT/INJ SMALL JOINT	20600	HCPCS	960	RC		outpatient	329	246.75	Percent of Total Billed Charges	313.21	95.2	Percent of Total Billed Charges	289.36	87.95	Percent of Total Billed Charges	271.43	82.5	246.75	329
EVLT FIRST VEIN	36478	HCPCS	960	RC		outpatient	673	504.75	Percent of Total Billed Charges	640.7	95.2	Percent of Total Billed Charges	591.9	87.95	Percent of Total Billed Charges	555.23	82.5	504.75	673
EVLT SECOND VEIN	36479	HCPCS	960	RC		outpatient	618	463.5	Percent of Total Billed Charges	588.34	95.2	Percent of Total Billed Charges	543.53	87.95	Percent of Total Billed Charges	509.85	82.5	463.5	618
"LESION 3.1-4 CM FACE EAR, MALIGNANT"	11644	HCPCS	960	RC		outpatient	363	272.25	Percent of Total Billed Charges	345.58	95.2	Percent of Total Billed Charges	319.26	87.95	Percent of Total Billed Charges	299.48	82.5	272.25	363
"LESION 3.1-4 CM FACE EAR, MALIGNANT"	11644	HCPCS	360	RC		outpatient	846	634.5	Percent of Total Billed Charges	805.39	95.2	Percent of Total Billed Charges	744.06	87.95	Percent of Total Billed Charges	697.95	82.5	634.5	846
"LESION 3.1-4 CM FACE EAR, MALIGNANT"	11644	HCPCS	960	RC		outpatient	1211	908.25	Percent of Total Billed Charges	1152.87	95.2	Percent of Total Billed Charges	1065.07	87.95	Percent of Total Billed Charges	999.08	82.5	908.25	1211
SCLERO SINGLE LEVEL	36470	HCPCS	960	RC		outpatient	311	233.25	Percent of Total Billed Charges	296.07	95.2	Percent of Total Billed Charges	273.52	87.95	Percent of Total Billed Charges	256.58	82.5	233.25	311
STAB PHLEBECTOMY 10-20	37765	HCPCS	960	RC		outpatient	505	378.75	Percent of Total Billed Charges	480.76	95.2	Percent of Total Billed Charges	444.15	87.95	Percent of Total Billed Charges	416.63	82.5	378.75	505
STAB PHLEBECTOMY >20	37766	HCPCS	960	RC		outpatient	1368	1026	Percent of Total Billed Charges	1302.34	95.2	Percent of Total Billed Charges	1203.16	87.95	Percent of Total Billed Charges	1128.6	82.5	1026	1368
SACROILLIAC JOINT INJ UNILATERAL	27096	HCPCS	960	RC		outpatient	361	270.75	Percent of Total Billed Charges	343.67	95.2	Percent of Total Billed Charges	317.5	87.95	Percent of Total Billed Charges	297.83	82.5	270.75	361
INJ TRIGEMINAL NERVE ANY DIV/BRANCH	64400	HCPCS	960	RC		outpatient	477	357.75	Percent of Total Billed Charges	454.1	95.2	Percent of Total Billed Charges	419.52	87.95	Percent of Total Billed Charges	393.53	82.5	357.75	477
INJ GREATER OCCIPITAL NERVE	64405	HCPCS	960	RC		outpatient	336	252	Percent of Total Billed Charges	319.87	95.2	Percent of Total Billed Charges	295.51	87.95	Percent of Total Billed Charges	277.2	82.5	252	336
ASP FINE NDL W/IMAGE	10022	HCPCS	975	RC		outpatient	416	312	Percent of Total Billed Charges	396.03	95.2	Percent of Total Billed Charges	365.87	87.95	Percent of Total Billed Charges	343.2	82.5	312	416
INJ PERIPHERIAL NERVE (LESSER OCCIPITAL)	64450	HCPCS	960	RC		outpatient	140	105	Percent of Total Billed Charges	133.28	95.2	Percent of Total Billed Charges	123.13	87.95	Percent of Total Billed Charges	115.5	82.5	105	140
PARAVERTEVRAL FACET JOINT WITH IMAGING GUIDANCE LUMBAR OR SACRAL SINGLE LEVEL	64493	HCPCS	960	RC		outpatient	489	366.75	Percent of Total Billed Charges	465.53	95.2	Percent of Total Billed Charges	430.08	87.95	Percent of Total Billed Charges	403.43	82.5	366.75	489
SCLERO MULTIPLE LEVEL BILATERAL	36471	HCPCS	360	RC	50	outpatient	2251	1688.25	Percent of Total Billed Charges	2142.95	95.2	Percent of Total Billed Charges	1979.75	87.95	Percent of Total Billed Charges	1857.08	82.5	1688.25	2251
PARAVERTEVRAL FACET JOINT WITH IMAGING GUIDANCE LUMBAR OR SACRAL SINGLE LEVEL-BILATERAL	64493	HCPCS	960	RC	50	outpatient	979	734.25	Percent of Total Billed Charges	932.01	95.2	Percent of Total Billed Charges	861.03	87.95	Percent of Total Billed Charges	807.68	82.5	734.25	979
PARAVERTEVRAL FACET JOINT WITH IMAGING GUIDANCE LUMBAR OR SACRAL SECOND LEVEL-BILATERAL	64494	HCPCS	960	RC	50	outpatient	491	368.25	Percent of Total Billed Charges	467.43	95.2	Percent of Total Billed Charges	431.83	87.95	Percent of Total Billed Charges	405.08	82.5	368.25	491
PARAVERTEVRAL FACET JOINT WITH IMAGING GUIDANCE LUMBAR OR SACRAL THIRD & ANY ADDITIONAL LEVEL-BILATERAL	64495	HCPCS	960	RC	50	outpatient	491	368.25	Percent of Total Billed Charges	467.43	95.2	Percent of Total Billed Charges	431.83	87.95	Percent of Total Billed Charges	405.08	82.5	368.25	491
INJ GREATER OCCIPITAL NERVE BILATERAL (SC)	64405	HCPCS	960	RC		outpatient	671	503.25	Percent of Total Billed Charges	638.79	95.2	Percent of Total Billed Charges	590.14	87.95	Percent of Total Billed Charges	553.58	82.5	503.25	671
INJ PERIPHERIAL NERVE (LESSER OCCIPITAL) BILATERAL (SC)	64450	HCPCS	960	RC		outpatient	277	207.75	Percent of Total Billed Charges	263.7	95.2	Percent of Total Billed Charges	243.62	87.95	Percent of Total Billed Charges	228.53	82.5	207.75	277
EVLT FIRST VEIN	36478	HCPCS	360	RC	50	outpatient	7902	5926.5	Percent of Total Billed Charges	7522.7	95.2	Percent of Total Billed Charges	6949.81	87.95	Percent of Total Billed Charges	6519.15	82.5	5926.5	7902
PARTIAL REMOVAL OF FOOT BONE	28122	HCPCS	360	RC		outpatient	6564	4923	Percent of Total Billed Charges	6248.93	95.2	Percent of Total Billed Charges	5773.04	87.95	Percent of Total Billed Charges	5415.3	82.5	4923	6564
REPAIR OF LEG TENDON EACH	27658	HCPCS	360	RC		outpatient	6564	4923	Percent of Total Billed Charges	6248.93	95.2	Percent of Total Billed Charges	5773.04	87.95	Percent of Total Billed Charges	5415.3	82.5	4923	6564
REPAIR OF LEG TENDON EACH	27659	HCPCS	360	RC		outpatient	14528	10896	Percent of Total Billed Charges	13830.66	95.2	Percent of Total Billed Charges	12777.38	87.95	Percent of Total Billed Charges	11985.6	82.5	10896	14528
REMOVAL OF FOOT LESION	28090	HCPCS	360	RC		outpatient	3229	2421.75	Percent of Total Billed Charges	3074.01	95.2	Percent of Total Billed Charges	2839.91	87.95	Percent of Total Billed Charges	2663.93	82.5	2421.75	3229
PARTIAL REMOVAL OF FOOT BONE	28122	HCPCS	960	RC		outpatient	2813	2109.75	Percent of Total Billed Charges	2677.98	95.2	Percent of Total Billed Charges	2474.03	87.95	Percent of Total Billed Charges	2320.73	82.5	2109.75	2813
REPAIR OF LEG TENDON EACH	27658	HCPCS	960	RC		outpatient	2813	2109.75	Percent of Total Billed Charges	2677.98	95.2	Percent of Total Billed Charges	2474.03	87.95	Percent of Total Billed Charges	2320.73	82.5	2109.75	2813
REPAIR OF LEG TENDON EACH	27659	HCPCS	960	RC		outpatient	6227	4670.25	Percent of Total Billed Charges	5928.1	95.2	Percent of Total Billed Charges	5476.65	87.95	Percent of Total Billed Charges	5137.28	82.5	4670.25	6227
REMOVAL OF FOOT LESION	28090	HCPCS	960	RC		outpatient	1383	1037.25	Percent of Total Billed Charges	1316.62	95.2	Percent of Total Billed Charges	1216.35	87.95	Percent of Total Billed Charges	1140.98	82.5	1037.25	1383
"TENOTOMY, PERCUTANEOUS, TOE; SINGLE TENDON"	28010	HCPCS	510	RC		outpatient	623	467.25	Percent of Total Billed Charges	593.1	95.2	Percent of Total Billed Charges	547.93	87.95	Percent of Total Billed Charges	513.98	82.5	467.25	623
"TENOTOMY, PERCUTANEOUS, TOE; SINGLE TENDON"	28010	HCPCS	983	RC		outpatient	4519	3389.25	Percent of Total Billed Charges	4302.09	95.2	Percent of Total Billed Charges	3974.46	87.95	Percent of Total Billed Charges	3728.18	82.5	3389.25	4519
"TENOTOMY, PERCUTANEOUS, TOE; MULTIPLE TENDONS"	28011	HCPCS	983	RC		outpatient	3229	2421.75	Percent of Total Billed Charges	3074.01	95.2	Percent of Total Billed Charges	2839.91	87.95	Percent of Total Billed Charges	2663.93	82.5	2421.75	3229
"TENOTOMY, PERCUTANEOUS, TOE; MULTIPLE TENDONS"	28011	HCPCS	510	RC		outpatient	1383	1037.25	Percent of Total Billed Charges	1316.62	95.2	Percent of Total Billed Charges	1216.35	87.95	Percent of Total Billed Charges	1140.98	82.5	1037.25	1383
"TENOTOMY, PERCUTANEOUS, TOE; SINGLE TENDON"	28010	HCPCS	510	RC		outpatient	5142	3856.5	Percent of Total Billed Charges	4895.18	95.2	Percent of Total Billed Charges	4522.39	87.95	Percent of Total Billed Charges	4242.15	82.5	3856.5	5142
"TENOTOMY, PERCUTANEOUS, TOE; MULTIPLE TENDON"	28011	HCPCS	983	RC		outpatient	4613	3459.75	Percent of Total Billed Charges	4391.58	95.2	Percent of Total Billed Charges	4057.13	87.95	Percent of Total Billed Charges	3805.73	82.5	3459.75	4613
REAGENT STRIP/BLOOD GLUCOSE	82948	HCPCS	300	RC		outpatient	9	6.75	Percent of Total Billed Charges	8.57	95.2	Percent of Total Billed Charges	7.92	87.95	Percent of Total Billed Charges	7.43	82.5	6.75	9
EXC H-F-NK-SP B9-MARG3.1-4	11424	HCPCS	360	RC		outpatient	4523	3392.25	Percent of Total Billed Charges	4305.9	95.2	Percent of Total Billed Charges	3977.98	87.95	Percent of Total Billed Charges	3731.48	82.5	3392.25	4523
EXC H-F-NK-SP B9-MARG3.1-4	11424	HCPCS	960	RC		outpatient	597	447.75	Percent of Total Billed Charges	568.34	95.2	Percent of Total Billed Charges	525.06	87.95	Percent of Total Billed Charges	492.53	82.5	447.75	597
TENDON SHEATH INCISION	26055	HCPCS	960	RC		outpatient	4613	3459.75	Percent of Total Billed Charges	4391.58	95.2	Percent of Total Billed Charges	4057.13	87.95	Percent of Total Billed Charges	3805.73	82.5	3459.75	4613
TENDON SHEATH INCISION	26055	HCPCS	360	RC		outpatient	1905	1428.75	Percent of Total Billed Charges	1813.56	95.2	Percent of Total Billed Charges	1675.45	87.95	Percent of Total Billed Charges	1571.63	82.5	1428.75	1905
LIGATION OF HEMORRHOID(S)	46221	HCPCS	360	RC		both	721	540.75	Percent of Total Billed Charges	686.39	95.2	Percent of Total Billed Charges	634.12	87.95	Percent of Total Billed Charges	594.83	82.5	540.75	721
LIGATION OF HEMORRHOID(S)	46221	HCPCS	960	RC		outpatient	1841	1380.75	Percent of Total Billed Charges	1752.63	95.2	Percent of Total Billed Charges	1619.16	87.95	Percent of Total Billed Charges	1518.83	82.5	1380.75	1841
LIGATION OF HEMORRHOID(S)	46221	HCPCS	360	RC		outpatient	789	591.75	Percent of Total Billed Charges	751.13	95.2	Percent of Total Billed Charges	693.93	87.95	Percent of Total Billed Charges	650.93	82.5	591.75	789
"INJECTION, ANESTHETIC AGENT(S) AND/OR STEROID, INTERCOSTAL NERVE, SINGLE LEVEL (SC)"	64420	HCPCS	972	RC		outpatient	1473	1104.75	Percent of Total Billed Charges	1402.3	95.2	Percent of Total Billed Charges	1295.5	87.95	Percent of Total Billed Charges	1215.23	82.5	1104.75	1473
"INJECTION, ANESTHETIC AGENT(S) AND/OR STEROID, INTERCOSTAL NERVE, SINGLE LEVEL (SC)"	64420	HCPCS	360	RC		outpatient	631	473.25	Percent of Total Billed Charges	600.71	95.2	Percent of Total Billed Charges	554.96	87.95	Percent of Total Billed Charges	520.58	82.5	473.25	631
ENDOVENOUS ABLATION THERAPY OR INCOMPETENT VEIN	36482	HCPCS	960	RC		outpatient	6846	5134.5	Percent of Total Billed Charges	6517.39	95.2	Percent of Total Billed Charges	6021.06	87.95	Percent of Total Billed Charges	5647.95	82.5	5134.5	6846
ENDOVENOUS ABLATION THERAPY OR INCOMPETENT VEIN	36482	HCPCS	360	RC		outpatient	2239	1679.25	Percent of Total Billed Charges	2131.53	95.2	Percent of Total Billed Charges	1969.2	87.95	Percent of Total Billed Charges	1847.18	82.5	1679.25	2239
ENDOVENOUS ABLATION THERAPY OR INCOMPETENT VEIN - ADDITIONAL	36483	HCPCS	360	RC		outpatient	286	214.5	Percent of Total Billed Charges	272.27	95.2	Percent of Total Billed Charges	251.54	87.95	Percent of Total Billed Charges	235.95	82.5	214.5	286
ENDOVENOUS ABLATION THERAPY OR INCOMPETENT VEIN - ADDITIONAL	36483	HCPCS	960	RC		outpatient	286	214.5	Percent of Total Billed Charges	272.27	95.2	Percent of Total Billed Charges	251.54	87.95	Percent of Total Billed Charges	235.95	82.5	214.5	286
INSTERTION OF PICC WITHOUT SUBCUTANEOUS PORT OR PUMP (SC)	36573	HCPCS	761	RC		outpatient	4659	3494.25	Percent of Total Billed Charges	4435.37	95.2	Percent of Total Billed Charges	4097.59	87.95	Percent of Total Billed Charges	3843.68	82.5	3494.25	4659
INSTERTION OF PICC WITHOUT SUBCUTANEOUS PORT OR PUMP (SC)	36573	HCPCS	960	RC		outpatient	370	277.5	Percent of Total Billed Charges	352.24	95.2	Percent of Total Billed Charges	325.42	87.95	Percent of Total Billed Charges	305.25	82.5	277.5	370
REMOVAL OF PICC LINE (SC)	36589	HCPCS	960	RC		outpatient	585	438.75	Percent of Total Billed Charges	556.92	95.2	Percent of Total Billed Charges	514.51	87.95	Percent of Total Billed Charges	482.63	82.5	438.75	585
REMOVAL OF PICC LINE (SC)	36589	HCPCS	360	RC		outpatient	1791	1343.25	Percent of Total Billed Charges	1705.03	95.2	Percent of Total Billed Charges	1575.18	87.95	Percent of Total Billed Charges	1477.58	82.5	1343.25	1791
CYGNUS MATRIX AMNION (VIVEX)	Q4199	HCPCS	636	RC		outpatient	1000	750	Percent of Total Billed Charges	952	95.2	Percent of Total Billed Charges	879.5	87.95	Percent of Total Billed Charges	825	82.5	750	1000
"APPLICATION OF SKIN SUBSTITUTE GRAFT TRUNK, ARMS, LEGS FIRST 25 SQ CM OR LESS"	15271	HCPCS	510	RC		outpatient	5675	4256.25	Percent of Total Billed Charges	5402.6	95.2	Percent of Total Billed Charges	4991.16	87.95	Percent of Total Billed Charges	4681.88	82.5	4256.25	5675
"APPLICATION OF SKIN SUBSTITUTE GRAFT TRUNK, ARMS, LEGS FIRST 25 SQ CM OR LESS"	15271	HCPCS	982	RC		outpatient	361	270.75	Percent of Total Billed Charges	343.67	95.2	Percent of Total Billed Charges	317.5	87.95	Percent of Total Billed Charges	297.83	82.5	270.75	361
"APPLICATION OF SKIN SUBSTITUTE GRAFT TRUNK, ARMS, LEGS  FIRST 100 SQ CM"	15273	HCPCS	510	RC		outpatient	11669	8751.75	Percent of Total Billed Charges	11108.89	95.2	Percent of Total Billed Charges	10262.89	87.95	Percent of Total Billed Charges	9626.93	82.5	8751.75	11669
"APPLICATION OF SKIN SUBSTITUTE GRAFT TRUNK, ARMS, LEGS  FIRST 100 SQ CM"	15273	HCPCS	982	RC		outpatient	843	632.25	Percent of Total Billed Charges	802.54	95.2	Percent of Total Billed Charges	741.42	87.95	Percent of Total Billed Charges	695.48	82.5	632.25	843
APPLICATION OF SKIN SUBSTITUTE GRAFT FACE/NK/HF/G UPTO 100SQ CM	15275	HCPCS	510	RC		outpatient	5675	4256.25	Percent of Total Billed Charges	5402.6	95.2	Percent of Total Billed Charges	4991.16	87.95	Percent of Total Billed Charges	4681.88	82.5	4256.25	5675
APPLICATION OF SKIN SUBSTITUTE GRAFT FACE/NK/HF/G UPTO 100SQ CM	15275	HCPCS	982	RC		outpatient	411	308.25	Percent of Total Billed Charges	391.27	95.2	Percent of Total Billed Charges	361.47	87.95	Percent of Total Billed Charges	339.08	82.5	308.25	411
APPLICATION OF SKIN SUBSTITUTE GRAFT F/N/HF/G CHILD	15277	HCPCS	510	RC		outpatient	5675	4256.25	Percent of Total Billed Charges	5402.6	95.2	Percent of Total Billed Charges	4991.16	87.95	Percent of Total Billed Charges	4681.88	82.5	4256.25	5675
APPLICATION OF SKIN SUBSTITUTE GRAFT F/N/HF/G CHILD	15277	HCPCS	982	RC		outpatient	963	722.25	Percent of Total Billed Charges	916.78	95.2	Percent of Total Billed Charges	846.96	87.95	Percent of Total Billed Charges	794.48	82.5	722.25	963
EXCISION FOOT/BONE TUM SC<1.5 CM	28043	HCPCS	360	RC		outpatient	4662	3496.5	Percent of Total Billed Charges	4438.22	95.2	Percent of Total Billed Charges	4100.23	87.95	Percent of Total Billed Charges	3846.15	82.5	3496.5	4662
EXCISION FOOT/BONE TUM SC<1.5 CM	28043	HCPCS	960	RC		outpatient	1106	829.5	Percent of Total Billed Charges	1052.91	95.2	Percent of Total Billed Charges	972.73	87.95	Percent of Total Billed Charges	912.45	82.5	829.5	1106
"INJECTION, ANTIESTHETIC AGENTS, STEROID (SC)"	64454	HCPCS	510	RC		outpatient	2043	1532.25	Percent of Total Billed Charges	1944.94	95.2	Percent of Total Billed Charges	1796.82	87.95	Percent of Total Billed Charges	1685.48	82.5	1532.25	2043
"INJECTION, ANTIESTHETIC AGENTS, STEROID (SC)"	64454	HCPCS	360	RC		outpatient	245	183.75	Percent of Total Billed Charges	233.24	95.2	Percent of Total Billed Charges	215.48	87.95	Percent of Total Billed Charges	202.13	82.5	183.75	245
"UNDER INTRODUCTION/INJECTION OF ANESTHETIC AGENT (NERVE BLOCK), DIAGNOSTIC OR THERAPEUTIC PROCEDURES ON THE SOMATIC NERVES (SC)"	64451	HCPCS	360	RC		outpatient	347	260.25	Percent of Total Billed Charges	330.34	95.2	Percent of Total Billed Charges	305.19	87.95	Percent of Total Billed Charges	286.28	82.5	260.25	347
"UNDER INTRODUCTION/INJECTION OF ANESTHETIC AGENT (NERVE BLOCK), DIAGNOSTIC OR THERAPEUTIC PROCEDURES ON THE SOMATIC NERVES (SC)"	64451	HCPCS	510	RC		outpatient	2043	1532.25	Percent of Total Billed Charges	1944.94	95.2	Percent of Total Billed Charges	1796.82	87.95	Percent of Total Billed Charges	1685.48	82.5	1532.25	2043
"INJECTION, ANTIESTHETIC AGENTS, STEROID (SC)"	64454	HCPCS	360	RC		outpatient	2288	1716	Percent of Total Billed Charges	2178.18	95.2	Percent of Total Billed Charges	2012.3	87.95	Percent of Total Billed Charges	1887.6	82.5	1716	2288
REMOVAL OF FOOT FASCIA	28062	HCPCS	360	RC		outpatient	9376	7032	Percent of Total Billed Charges	8925.95	95.2	Percent of Total Billed Charges	8246.19	87.95	Percent of Total Billed Charges	7735.2	82.5	7032	9376
REMOVAL OF FOOT FASCIA	28062	HCPCS	960	RC		outpatient	1213	909.75	Percent of Total Billed Charges	1154.78	95.2	Percent of Total Billed Charges	1066.83	87.95	Percent of Total Billed Charges	1000.73	82.5	909.75	1213
PARTIAL REMOVAL FOOT FASCIA	28060	HCPCS	360	RC		outpatient	1078	808.5	Percent of Total Billed Charges	1026.26	95.2	Percent of Total Billed Charges	948.1	87.95	Percent of Total Billed Charges	889.35	82.5	808.5	1078
PARTIAL REMOVAL FOOT FASCIA	28060	HCPCS	960	RC		outpatient	9376	7032	Percent of Total Billed Charges	8925.95	95.2	Percent of Total Billed Charges	8246.19	87.95	Percent of Total Billed Charges	7735.2	82.5	7032	9376
SKIN SUB GRAFT T/A/L ADD-ON	15272	HCPCS	510	RC		outpatient	53	39.75	Percent of Total Billed Charges	50.46	95.2	Percent of Total Billed Charges	46.61	87.95	Percent of Total Billed Charges	43.73	82.5	39.75	53
SKIN SUB GRAFT T/A/L ADD-ON	15272	HCPCS	982	RC		outpatient	49	36.75	Percent of Total Billed Charges	46.65	95.2	Percent of Total Billed Charges	43.1	87.95	Percent of Total Billed Charges	40.43	82.5	36.75	49
INCISION OF FOOT FASCIA (SC)	28008	HCPCS	360	RC		outpatient	9377	7032.75	Percent of Total Billed Charges	8926.9	95.2	Percent of Total Billed Charges	8247.07	87.95	Percent of Total Billed Charges	7736.03	82.5	7032.75	9377
INCISION OF FOOT FASCIA (SC)	28008	HCPCS	960	RC		outpatient	884	663	Percent of Total Billed Charges	841.57	95.2	Percent of Total Billed Charges	777.48	87.95	Percent of Total Billed Charges	729.3	82.5	663	884
INTERLAMINAR CERVICAL INJECTION (SC)	64479	HCPCS	960	RC		outpatient	2685	2013.75	Percent of Total Billed Charges	2556.12	95.2	Percent of Total Billed Charges	2361.46	87.95	Percent of Total Billed Charges	2215.13	82.5	2013.75	2685
INTERLAMINAR CERVICAL INJECTION (SC)	64479	HCPCS	360	RC		outpatient	389	291.75	Percent of Total Billed Charges	370.33	95.2	Percent of Total Billed Charges	342.13	87.95	Percent of Total Billed Charges	320.93	82.5	291.75	389
REMOVE FOREIGN BODY (SC)	10120	HCPCS	360	RC		outpatient	1175	881.25	Percent of Total Billed Charges	1118.6	95.2	Percent of Total Billed Charges	1033.41	87.95	Percent of Total Billed Charges	969.38	82.5	881.25	1175
REMOVE FOREIGN BODY (SC)	10120	HCPCS	981	RC		outpatient	314	235.5	Percent of Total Billed Charges	298.93	95.2	Percent of Total Billed Charges	276.16	87.95	Percent of Total Billed Charges	259.05	82.5	235.5	314
CYGNUS DUAL AMNIOTIC (VIVEX)	Q4282	HCPCS	636	RC		outpatient	1848	1386	Percent of Total Billed Charges	1759.3	95.2	Percent of Total Billed Charges	1625.32	87.95	Percent of Total Billed Charges	1524.6	82.5	1386	1848
"REMOVAL OF DEVITALIZED TISSUE FROM WOUND(S), NON-SELECTIVE DEBRIDEMENT, WITHOUT ANESTHESIA (EG, WET-TO-MOIST DRESSINGS, ENZYMATIC, ABRASION, LARVAL THERAPY), INCLUDING TOPICAL APPLICATION(S), WOUND ASSESSMENT, AND INSTRUCTION(S) FOR ONGOING CARE, PER SESSION"	97602	HCPCS	960	RC		outpatient	398	298.5	Percent of Total Billed Charges	378.9	95.2	Percent of Total Billed Charges	350.04	87.95	Percent of Total Billed Charges	328.35	82.5	298.5	398
"REMOVAL OF DEVITALIZED TISSUE FROM WOUND(S), NON-SELECTIVE DEBRIDEMENT, WITHOUT ANESTHESIA (EG, WET-TO-MOIST DRESSINGS, ENZYMATIC, ABRASION, LARVAL THERAPY), INCLUDING TOPICAL APPLICATION(S), WOUND ASSESSMENT, AND INSTRUCTION(S) FOR ONGOING CARE, PER SESSION"	97602	HCPCS	360	RC		outpatient	171	128.25	Percent of Total Billed Charges	162.79	95.2	Percent of Total Billed Charges	150.39	87.95	Percent of Total Billed Charges	141.08	82.5	128.25	171
PALINGEN MEMBRANE	Q4173	HCPCS	636	RC		outpatient	953	714.75	Percent of Total Billed Charges	907.26	95.2	Percent of Total Billed Charges	838.16	87.95	Percent of Total Billed Charges	786.23	82.5	714.75	953
"REMOVAL OF DEVITALIZED TISSUE FROM WOUND(S), NON-SELECTIVE DEBRIDEMENT, WITHOUT ANESTHESIA (EG, WET-TO-MOIST DRESSINGS, ENZYMATIC, ABRASION, LARVAL THERAPY), INCLUDING TOPICAL APPLICATION(S), WOUND ASSESSMENT, AND INSTRUCTION(S) FOR ONGOING CARE, PER SESSION"	97602	HCPCS	510	RC		outpatient	569	426.75	Percent of Total Billed Charges	541.69	95.2	Percent of Total Billed Charges	500.44	87.95	Percent of Total Billed Charges	469.43	82.5	426.75	569
PATIAL AMPUTATION OF TOE (SC)	28825	HCPCS	510	RC		outpatient	6476.47	4857.35	Percent of Total Billed Charges	6165.6	95.2	Percent of Total Billed Charges	5696.06	87.95	Percent of Total Billed Charges	5343.09	82.5	4857.35	6476.47
PATIAL AMPUTATION OF TOE (SC)	28825	HCPCS	983	RC		outpatient	2775.63	2081.72	Percent of Total Billed Charges	2642.4	95.2	Percent of Total Billed Charges	2441.17	87.95	Percent of Total Billed Charges	2289.89	82.5	2081.72	2775.63
PATIAL AMPUTATION OF TOE (SC)	28825	HCPCS	510	RC		outpatient	9252.09	6939.07	Percent of Total Billed Charges	8807.99	95.2	Percent of Total Billed Charges	8137.21	87.95	Percent of Total Billed Charges	7632.97	82.5	6939.07	9252.09
DIAGNOSTIC (BASELINE)	95810	HCPCS	920	RC		outpatient	4311	3233.25	Percent of Total Billed Charges	4104.07	95.2	Percent of Total Billed Charges	3791.52	87.95	Percent of Total Billed Charges	3556.58	82.5	3233.25	4311
CPAP TITRATION OR SPLIT NIGHT	95811	HCPCS	920	RC		outpatient	4656	3492	Percent of Total Billed Charges	4432.51	95.2	Percent of Total Billed Charges	4094.95	87.95	Percent of Total Billed Charges	3841.2	82.5	3492	4656
MRI BRAIN W/WO	70553	HCPCS	610	RC	TC	both	3809	2856.75	Percent of Total Billed Charges	3626.17	95.2	Percent of Total Billed Charges	3350.02	87.95	Percent of Total Billed Charges	3142.43	82.5	2856.75	3809
MRI LOWER EXT JOINT W/O	73721	HCPCS	610	RC	TC	both	3253	2439.75	Percent of Total Billed Charges	3096.86	95.2	Percent of Total Billed Charges	2861.01	87.95	Percent of Total Billed Charges	2683.73	82.5	2439.75	3253
MRI PELVIS W/O	72195	HCPCS	610	RC	TC	both	2898	2173.5	Percent of Total Billed Charges	2758.9	95.2	Percent of Total Billed Charges	2548.79	87.95	Percent of Total Billed Charges	2390.85	82.5	2173.5	2898
MRI BRAIN W/O	70551	HCPCS	610	RC	TC	both	3268	2451	Percent of Total Billed Charges	3111.14	95.2	Percent of Total Billed Charges	2874.21	87.95	Percent of Total Billed Charges	2696.1	82.5	2451	3268
MRA NECK W/WO	70549	HCPCS	610	RC	TC	both	2906	2179.5	Percent of Total Billed Charges	2766.51	95.2	Percent of Total Billed Charges	2555.83	87.95	Percent of Total Billed Charges	2397.45	82.5	2179.5	2906
"MRI ORBIT, FACE, NECK W/O"	70540	HCPCS	610	RC	TC	both	2844	2133	Percent of Total Billed Charges	2707.49	95.2	Percent of Total Billed Charges	2501.3	87.95	Percent of Total Billed Charges	2346.3	82.5	2133	2844
"MRI ORBIT, FACE, NECK W/WO"	70543	HCPCS	610	RC	TC	both	2959	2219.25	Percent of Total Billed Charges	2816.97	95.2	Percent of Total Billed Charges	2602.44	87.95	Percent of Total Billed Charges	2441.18	82.5	2219.25	2959
MRA HEAD W/O	70544	HCPCS	610	RC	TC	both	3117	2337.75	Percent of Total Billed Charges	2967.38	95.2	Percent of Total Billed Charges	2741.4	87.95	Percent of Total Billed Charges	2571.53	82.5	2337.75	3117
MRA HEAD W/WO	70546	HCPCS	610	RC	TC	both	3166	2374.5	Percent of Total Billed Charges	3014.03	95.2	Percent of Total Billed Charges	2784.5	87.95	Percent of Total Billed Charges	2611.95	82.5	2374.5	3166
MRA NECK W/O	70547	HCPCS	610	RC	TC	both	3061	2295.75	Percent of Total Billed Charges	2914.07	95.2	Percent of Total Billed Charges	2692.15	87.95	Percent of Total Billed Charges	2525.33	82.5	2295.75	3061
MRA NECK W/	70548	HCPCS	610	RC	TC	both	3427	2570.25	Percent of Total Billed Charges	3262.5	95.2	Percent of Total Billed Charges	3014.05	87.95	Percent of Total Billed Charges	2827.28	82.5	2570.25	3427
MRI ABDOMEN W/O	74181	HCPCS	610	RC	TC	both	3129	2346.75	Percent of Total Billed Charges	2978.81	95.2	Percent of Total Billed Charges	2751.96	87.95	Percent of Total Billed Charges	2581.43	82.5	2346.75	3129
MRI ABDOMEN W/WO	74183	HCPCS	610	RC	TC	both	3873	2904.75	Percent of Total Billed Charges	3687.1	95.2	Percent of Total Billed Charges	3406.3	87.95	Percent of Total Billed Charges	3195.23	82.5	2904.75	3873
MRA ABDOMEN W/ OR W/O	74185	HCPCS	610	RC	TC	both	3471	2603.25	Percent of Total Billed Charges	3304.39	95.2	Percent of Total Billed Charges	3052.74	87.95	Percent of Total Billed Charges	2863.58	82.5	2603.25	3471
MRI LOWER EXT NON JOINT W/O	73718	HCPCS	610	RC	TC	both	3051	2288.25	Percent of Total Billed Charges	2904.55	95.2	Percent of Total Billed Charges	2683.35	87.95	Percent of Total Billed Charges	2517.08	82.5	2288.25	3051
MRI LOWER EXT NON JOINT W/WO	73720	HCPCS	610	RC	TC	both	3873	2904.75	Percent of Total Billed Charges	3687.1	95.2	Percent of Total Billed Charges	3406.3	87.95	Percent of Total Billed Charges	3195.23	82.5	2904.75	3873
MRI LOWER EXT JOINT W/WO	73723	HCPCS	610	RC	TC	both	3962	2971.5	Percent of Total Billed Charges	3771.82	95.2	Percent of Total Billed Charges	3484.58	87.95	Percent of Total Billed Charges	3268.65	82.5	2971.5	3962
MRA LOW EXT W OR W/O	73725	HCPCS	610	RC	TC	both	3491	2618.25	Percent of Total Billed Charges	3323.43	95.2	Percent of Total Billed Charges	3070.33	87.95	Percent of Total Billed Charges	2880.08	82.5	2618.25	3491
MRI UPPER EXT NON JOINT W/O	73218	HCPCS	610	RC	TC	both	3143	2357.25	Percent of Total Billed Charges	2992.14	95.2	Percent of Total Billed Charges	2764.27	87.95	Percent of Total Billed Charges	2592.98	82.5	2357.25	3143
MRI UPPER EXT NON JOINT W/WO	73220	HCPCS	610	RC	TC	both	4051	3038.25	Percent of Total Billed Charges	3856.55	95.2	Percent of Total Billed Charges	3562.85	87.95	Percent of Total Billed Charges	3342.08	82.5	3038.25	4051
MRI UPPER EXT JOINT W/O	73221	HCPCS	610	RC	TC	both	3253	2439.75	Percent of Total Billed Charges	3096.86	95.2	Percent of Total Billed Charges	2861.01	87.95	Percent of Total Billed Charges	2683.73	82.5	2439.75	3253
MRI UPPER EXT JOINT W/WO	73223	HCPCS	614	RC	TC	both	3621	2715.75	Percent of Total Billed Charges	3447.19	95.2	Percent of Total Billed Charges	3184.67	87.95	Percent of Total Billed Charges	2987.33	82.5	2715.75	3621
MRI CERVICAL SPINE W/O	72141	HCPCS	610	RC	TC	both	3292	2469	Percent of Total Billed Charges	3133.98	95.2	Percent of Total Billed Charges	2895.31	87.95	Percent of Total Billed Charges	2715.9	82.5	2469	3292
MRI CERVICAL SPINE W/WO	72156	HCPCS	610	RC	TC	both	3809	2856.75	Percent of Total Billed Charges	3626.17	95.2	Percent of Total Billed Charges	3350.02	87.95	Percent of Total Billed Charges	3142.43	82.5	2856.75	3809
MRI THORACIC SPINE W/O	72146	HCPCS	610	RC	TC	both	3418	2563.5	Percent of Total Billed Charges	3253.94	95.2	Percent of Total Billed Charges	3006.13	87.95	Percent of Total Billed Charges	2819.85	82.5	2563.5	3418
MRI THORACIC SPINE W/WO	72157	HCPCS	610	RC	TC	both	4097	3072.75	Percent of Total Billed Charges	3900.34	95.2	Percent of Total Billed Charges	3603.31	87.95	Percent of Total Billed Charges	3380.03	82.5	3072.75	4097
MRI LUMBAR SPINE W/WO	72158	HCPCS	610	RC	TC	both	4304	3228	Percent of Total Billed Charges	4097.41	95.2	Percent of Total Billed Charges	3785.37	87.95	Percent of Total Billed Charges	3550.8	82.5	3228	4304
MRA SPINE W/ OR W/O	72159	HCPCS	610	RC	TC	both	3192	2394	Percent of Total Billed Charges	3038.78	95.2	Percent of Total Billed Charges	2807.36	87.95	Percent of Total Billed Charges	2633.4	82.5	2394	3192
MRI PELVIS W/WO	72197	HCPCS	610	RC	TC	both	3652	2739	Percent of Total Billed Charges	3476.7	95.2	Percent of Total Billed Charges	3211.93	87.95	Percent of Total Billed Charges	3012.9	82.5	2739	3652
MRA PELVIS W/OR W/O	72198	HCPCS	610	RC	TC	both	3297	2472.75	Percent of Total Billed Charges	3138.74	95.2	Percent of Total Billed Charges	2899.71	87.95	Percent of Total Billed Charges	2720.03	82.5	2472.75	3297
MRI CHEST W/O	71550	HCPCS	610	RC	TC	both	2940	2205	Percent of Total Billed Charges	2798.88	95.2	Percent of Total Billed Charges	2585.73	87.95	Percent of Total Billed Charges	2425.5	82.5	2205	2940
MRI LUMBAR SPINE W/O	72148	HCPCS	610	RC	TC	both	3240	2430	Percent of Total Billed Charges	3084.48	95.2	Percent of Total Billed Charges	2849.58	87.95	Percent of Total Billed Charges	2673	82.5	2430	3240
XR ABD 1 VIEW	74018	HCPCS	320	RC	TC	both	297	222.75	Percent of Total Billed Charges	282.74	95.2	Percent of Total Billed Charges	261.21	87.95	Percent of Total Billed Charges	245.03	82.5	222.75	297
XR ABD 2 VIEW	74019	HCPCS	320	RC	TC	both	396	297	Percent of Total Billed Charges	376.99	95.2	Percent of Total Billed Charges	348.28	87.95	Percent of Total Billed Charges	326.7	82.5	297	396
XR L-SPINE BENDING	72120	HCPCS	320	RC	TC	both	425	318.75	Percent of Total Billed Charges	404.6	95.2	Percent of Total Billed Charges	373.79	87.95	Percent of Total Billed Charges	350.63	82.5	318.75	425
XR SKULL <4 VIEWS	70250	HCPCS	320	RC	TC	both	390	292.5	Percent of Total Billed Charges	371.28	95.2	Percent of Total Billed Charges	343.01	87.95	Percent of Total Billed Charges	321.75	82.5	292.5	390
XR HIP/PELVIS 1 VIEW	73501	HCPCS	320	RC	TC	both	319	239.25	Percent of Total Billed Charges	303.69	95.2	Percent of Total Billed Charges	280.56	87.95	Percent of Total Billed Charges	263.18	82.5	239.25	319
XR ELBOW COMPLETE	73080	HCPCS	320	RC	TC	both	345	258.75	Percent of Total Billed Charges	328.44	95.2	Percent of Total Billed Charges	303.43	87.95	Percent of Total Billed Charges	284.63	82.5	258.75	345
XR T-SPINE COMPLETE	72072	HCPCS	320	RC	TC	both	554	415.5	Percent of Total Billed Charges	527.41	95.2	Percent of Total Billed Charges	487.24	87.95	Percent of Total Billed Charges	457.05	82.5	415.5	554
XR WRIST 2 V	73100	HCPCS	320	RC	TC	both	280	210	Percent of Total Billed Charges	266.56	95.2	Percent of Total Billed Charges	246.26	87.95	Percent of Total Billed Charges	231	82.5	210	280
XR ANKLE 2 V	73600	HCPCS	320	RC	TC	both	273	204.75	Percent of Total Billed Charges	259.9	95.2	Percent of Total Billed Charges	240.1	87.95	Percent of Total Billed Charges	225.23	82.5	204.75	273
XR FOOT 2 VIEW	73620	HCPCS	320	RC	TC	both	260	195	Percent of Total Billed Charges	247.52	95.2	Percent of Total Billed Charges	228.67	87.95	Percent of Total Billed Charges	214.5	82.5	195	260
XR SKELET SURV ADLT	77075	HCPCS	320	RC	TC	both	970	727.5	Percent of Total Billed Charges	923.44	95.2	Percent of Total Billed Charges	853.12	87.95	Percent of Total Billed Charges	800.25	82.5	727.5	970
TTE COMPLETE WITH DOPPLER AND COLOR FLOW WITH CONTRAST	C8929	HCPCS	320	RC		both	1432	1074	Percent of Total Billed Charges	1363.26	95.2	Percent of Total Billed Charges	1259.44	87.95	Percent of Total Billed Charges	1181.4	82.5	1074	1432
XR NOSE TO RECTUM 1V	76010	HCPCS	320	RC	TC	both	268	201	Percent of Total Billed Charges	255.14	95.2	Percent of Total Billed Charges	235.71	87.95	Percent of Total Billed Charges	221.1	82.5	201	268
XR L-SPINE COMPLETE	72110	HCPCS	320	RC	TC	both	695	521.25	Percent of Total Billed Charges	661.64	95.2	Percent of Total Billed Charges	611.25	87.95	Percent of Total Billed Charges	573.38	82.5	521.25	695
XR PELVIS	72170	HCPCS	320	RC	TC	both	358	268.5	Percent of Total Billed Charges	340.82	95.2	Percent of Total Billed Charges	314.86	87.95	Percent of Total Billed Charges	295.35	82.5	268.5	358
XR SI JOINTS	72200	HCPCS	320	RC	TC	both	364	273	Percent of Total Billed Charges	346.53	95.2	Percent of Total Billed Charges	320.14	87.95	Percent of Total Billed Charges	300.3	82.5	273	364
XR MANDIBLE COMPLETE	70110	HCPCS	320	RC	TC	both	410	307.5	Percent of Total Billed Charges	390.32	95.2	Percent of Total Billed Charges	360.6	87.95	Percent of Total Billed Charges	338.25	82.5	307.5	410
XR FACIAL BONES <3 V	70140	HCPCS	320	RC	TC	both	326	244.5	Percent of Total Billed Charges	310.35	95.2	Percent of Total Billed Charges	286.72	87.95	Percent of Total Billed Charges	268.95	82.5	244.5	326
XR FACIAL BONES >3 V	70150	HCPCS	320	RC	TC	both	407	305.25	Percent of Total Billed Charges	387.46	95.2	Percent of Total Billed Charges	357.96	87.95	Percent of Total Billed Charges	335.78	82.5	305.25	407
XR NASAL BONES	70160	HCPCS	320	RC	TC	both	298	223.5	Percent of Total Billed Charges	283.7	95.2	Percent of Total Billed Charges	262.09	87.95	Percent of Total Billed Charges	245.85	82.5	223.5	298
XR SINUS COMPLETE	70220	HCPCS	320	RC	TC	both	407	305.25	Percent of Total Billed Charges	387.46	95.2	Percent of Total Billed Charges	357.96	87.95	Percent of Total Billed Charges	335.78	82.5	305.25	407
XR SKULL COMPLETE	70260	HCPCS	320	RC	TC	both	505	378.75	Percent of Total Billed Charges	480.76	95.2	Percent of Total Billed Charges	444.15	87.95	Percent of Total Billed Charges	416.63	82.5	378.75	505
XR SOFT TISSUE NECK	70360	HCPCS	320	RC	TC	both	317	237.75	Percent of Total Billed Charges	301.78	95.2	Percent of Total Billed Charges	278.8	87.95	Percent of Total Billed Charges	261.53	82.5	237.75	317
XR CHEST 1 VIEW	71045	HCPCS	320	RC	TC	both	291	218.25	Percent of Total Billed Charges	277.03	95.2	Percent of Total Billed Charges	255.93	87.95	Percent of Total Billed Charges	240.08	82.5	218.25	291
XR CHEST 2 VIEW	71046	HCPCS	320	RC	TC	both	375	281.25	Percent of Total Billed Charges	357	95.2	Percent of Total Billed Charges	329.81	87.95	Percent of Total Billed Charges	309.38	82.5	281.25	375
XR RIBS UNI W/PA	71101	HCPCS	320	RC	TC	both	314	235.5	Percent of Total Billed Charges	298.93	95.2	Percent of Total Billed Charges	276.16	87.95	Percent of Total Billed Charges	259.05	82.5	235.5	314
XR STERNUM	71120	HCPCS	320	RC	TC	both	341	255.75	Percent of Total Billed Charges	324.63	95.2	Percent of Total Billed Charges	299.91	87.95	Percent of Total Billed Charges	281.33	82.5	255.75	341
XR C-SPINE COMPLETE	72050	HCPCS	320	RC	TC	both	639	479.25	Percent of Total Billed Charges	608.33	95.2	Percent of Total Billed Charges	562	87.95	Percent of Total Billed Charges	527.18	82.5	479.25	639
XR T-SPINE 2 VIEW	72070	HCPCS	320	RC	TC	both	440	330	Percent of Total Billed Charges	418.88	95.2	Percent of Total Billed Charges	386.98	87.95	Percent of Total Billed Charges	363	82.5	330	440
XR SCOLIOSIS SURVEY	72081	HCPCS	320	RC	TC	both	392	294	Percent of Total Billed Charges	373.18	95.2	Percent of Total Billed Charges	344.76	87.95	Percent of Total Billed Charges	323.4	82.5	294	392
XR SACRUM/COCCYX	72220	HCPCS	320	RC	TC	both	427	320.25	Percent of Total Billed Charges	406.5	95.2	Percent of Total Billed Charges	375.55	87.95	Percent of Total Billed Charges	352.28	82.5	320.25	427
XR L-SPINE 2 VIEW	72100	HCPCS	320	RC	TC	both	483	362.25	Percent of Total Billed Charges	459.82	95.2	Percent of Total Billed Charges	424.8	87.95	Percent of Total Billed Charges	398.48	82.5	362.25	483
XR CLAVICLE	73000	HCPCS	320	RC	TC	both	302	226.5	Percent of Total Billed Charges	287.5	95.2	Percent of Total Billed Charges	265.61	87.95	Percent of Total Billed Charges	249.15	82.5	226.5	302
XR SINUS <3 VIEW	70210	HCPCS	320	RC	TC	both	267	200.25	Percent of Total Billed Charges	254.18	95.2	Percent of Total Billed Charges	234.83	87.95	Percent of Total Billed Charges	220.28	82.5	200.25	267
XR SCAPULA	73010	HCPCS	320	RC	TC	both	316	237	Percent of Total Billed Charges	300.83	95.2	Percent of Total Billed Charges	277.92	87.95	Percent of Total Billed Charges	260.7	82.5	237	316
XR SHOULDER COMPLETE	73030	HCPCS	320	RC	TC	both	327	245.25	Percent of Total Billed Charges	311.3	95.2	Percent of Total Billed Charges	287.6	87.95	Percent of Total Billed Charges	269.78	82.5	245.25	327
XR HUMERUS	73060	HCPCS	320	RC	TC	both	336	252	Percent of Total Billed Charges	319.87	95.2	Percent of Total Billed Charges	295.51	87.95	Percent of Total Billed Charges	277.2	82.5	252	336
XR ELBOW 2 VIEW	73070	HCPCS	320	RC	TC	both	318	238.5	Percent of Total Billed Charges	302.74	95.2	Percent of Total Billed Charges	279.68	87.95	Percent of Total Billed Charges	262.35	82.5	238.5	318
XR FOREARM	73090	HCPCS	320	RC	TC	both	305	228.75	Percent of Total Billed Charges	290.36	95.2	Percent of Total Billed Charges	268.25	87.95	Percent of Total Billed Charges	251.63	82.5	228.75	305
XR WRIST COMPLETE	73110	HCPCS	320	RC	TC	both	321	240.75	Percent of Total Billed Charges	305.59	95.2	Percent of Total Billed Charges	282.32	87.95	Percent of Total Billed Charges	264.83	82.5	240.75	321
XR HAND 2 VIEW	73120	HCPCS	320	RC	TC	both	269	201.75	Percent of Total Billed Charges	256.09	95.2	Percent of Total Billed Charges	236.59	87.95	Percent of Total Billed Charges	221.93	82.5	201.75	269
XR HAND COMPLETE	73130	HCPCS	320	RC	TC	both	327	245.25	Percent of Total Billed Charges	311.3	95.2	Percent of Total Billed Charges	287.6	87.95	Percent of Total Billed Charges	269.78	82.5	245.25	327
XR FINGER	73140	HCPCS	320	RC	TC	both	276	207	Percent of Total Billed Charges	262.75	95.2	Percent of Total Billed Charges	242.74	87.95	Percent of Total Billed Charges	227.7	82.5	207	276
XR HIP COMP W/PELVIS	73502	HCPCS	320	RC	TC	both	444	333	Percent of Total Billed Charges	422.69	95.2	Percent of Total Billed Charges	390.5	87.95	Percent of Total Billed Charges	366.3	82.5	333	444
XR HIP BI W/PELVIS	73521	HCPCS	320	RC	TC	both	513	384.75	Percent of Total Billed Charges	488.38	95.2	Percent of Total Billed Charges	451.18	87.95	Percent of Total Billed Charges	423.23	82.5	384.75	513
XR FEMUR	73552	HCPCS	320	RC	TC	both	390	292.5	Percent of Total Billed Charges	371.28	95.2	Percent of Total Billed Charges	343.01	87.95	Percent of Total Billed Charges	321.75	82.5	292.5	390
XR KNEE <2 VIEW	73560	HCPCS	320	RC	TC	both	354	265.5	Percent of Total Billed Charges	337.01	95.2	Percent of Total Billed Charges	311.34	87.95	Percent of Total Billed Charges	292.05	82.5	265.5	354
XR KNEE 3 VIEW	73562	HCPCS	320	RC	TC	both	404	303	Percent of Total Billed Charges	384.61	95.2	Percent of Total Billed Charges	355.32	87.95	Percent of Total Billed Charges	333.3	82.5	303	404
XR TIB-FIB	73590	HCPCS	320	RC	TC	both	348	261	Percent of Total Billed Charges	331.3	95.2	Percent of Total Billed Charges	306.07	87.95	Percent of Total Billed Charges	287.1	82.5	261	348
XR ANKLE COMPLETE	73610	HCPCS	320	RC	TC	both	352	264	Percent of Total Billed Charges	335.1	95.2	Percent of Total Billed Charges	309.58	87.95	Percent of Total Billed Charges	290.4	82.5	264	352
XR FOOT 3 VIEW	73630	HCPCS	320	RC	TC	both	347	260.25	Percent of Total Billed Charges	330.34	95.2	Percent of Total Billed Charges	305.19	87.95	Percent of Total Billed Charges	286.28	82.5	260.25	347
XR CALCANEUS	73650	HCPCS	320	RC	TC	both	287	215.25	Percent of Total Billed Charges	273.22	95.2	Percent of Total Billed Charges	252.42	87.95	Percent of Total Billed Charges	236.78	82.5	215.25	287
XR TOE	73660	HCPCS	320	RC	TC	both	289	216.75	Percent of Total Billed Charges	275.13	95.2	Percent of Total Billed Charges	254.18	87.95	Percent of Total Billed Charges	238.43	82.5	216.75	289
XR ABD 2V+PA CHEST	74022	HCPCS	320	RC	TC	both	519	389.25	Percent of Total Billed Charges	494.09	95.2	Percent of Total Billed Charges	456.46	87.95	Percent of Total Billed Charges	428.18	82.5	389.25	519
XR SKELE SRVY INFNT	77076	HCPCS	320	RC	TC	both	460	345	Percent of Total Billed Charges	437.92	95.2	Percent of Total Billed Charges	404.57	87.95	Percent of Total Billed Charges	379.5	82.5	345	460
XR BONE AGE SURVEY	77072	HCPCS	320	RC	TC	both	327	245.25	Percent of Total Billed Charges	311.3	95.2	Percent of Total Billed Charges	287.6	87.95	Percent of Total Billed Charges	269.78	82.5	245.25	327
XR ORBITS COMPLETE	70200	HCPCS	320	RC	TC	both	433	324.75	Percent of Total Billed Charges	412.22	95.2	Percent of Total Billed Charges	380.82	87.95	Percent of Total Billed Charges	357.23	82.5	324.75	433
XR KNEE 4 VIEW	73564	HCPCS	320	RC	TC	both	452	339	Percent of Total Billed Charges	430.3	95.2	Percent of Total Billed Charges	397.53	87.95	Percent of Total Billed Charges	372.9	82.5	339	452
XR CHEST DECUBITUS	71035	HCPCS	320	RC	TC	both	410	307.5	Percent of Total Billed Charges	390.32	95.2	Percent of Total Billed Charges	360.6	87.95	Percent of Total Billed Charges	338.25	82.5	307.5	410
XR RIBS BI W/PA CHST	71111	HCPCS	320	RC	TC	both	557	417.75	Percent of Total Billed Charges	530.26	95.2	Percent of Total Billed Charges	489.88	87.95	Percent of Total Billed Charges	459.53	82.5	417.75	557
XR SC JOINTS	71130	HCPCS	320	RC	TC	both	330	247.5	Percent of Total Billed Charges	314.16	95.2	Percent of Total Billed Charges	290.24	87.95	Percent of Total Billed Charges	272.25	82.5	247.5	330
XR FEMUR 1 VIEW	73551	HCPCS	320	RC	TC	both	278	208.5	Percent of Total Billed Charges	264.66	95.2	Percent of Total Billed Charges	244.5	87.95	Percent of Total Billed Charges	229.35	82.5	208.5	278
XR AC JNTS W/WO WT'S	73050	HCPCS	320	RC	TC	both	439	329.25	Percent of Total Billed Charges	417.93	95.2	Percent of Total Billed Charges	386.1	87.95	Percent of Total Billed Charges	362.18	82.5	329.25	439
XR C-SPINE <3 VIEWS	72040	HCPCS	320	RC	TC	both	401	300.75	Percent of Total Billed Charges	381.75	95.2	Percent of Total Billed Charges	352.68	87.95	Percent of Total Billed Charges	330.83	82.5	300.75	401
XR SHOULDER 1 VIEW	73020	HCPCS	320	RC	TC	both	242	181.5	Percent of Total Billed Charges	230.38	95.2	Percent of Total Billed Charges	212.84	87.95	Percent of Total Billed Charges	199.65	82.5	181.5	242
DEXA	77080	HCPCS	320	RC	TC	outpatient	591	443.25	Percent of Total Billed Charges	562.63	95.2	Percent of Total Billed Charges	519.78	87.95	Percent of Total Billed Charges	487.58	82.5	443.25	591
XR L-SPINE COMP+BEND	72114	HCPCS	320	RC	TC	both	755	566.25	Percent of Total Billed Charges	718.76	95.2	Percent of Total Billed Charges	664.02	87.95	Percent of Total Billed Charges	622.88	82.5	566.25	755
XR LOWER EXT INFANT 2 VIEW	73592	HCPCS	320	RC	TC	both	323	242.25	Percent of Total Billed Charges	307.5	95.2	Percent of Total Billed Charges	284.08	87.95	Percent of Total Billed Charges	266.48	82.5	242.25	323
XR UPPER EXT INFANT 2 VIEW	73092	HCPCS	320	RC	TC	both	336	252	Percent of Total Billed Charges	319.87	95.2	Percent of Total Billed Charges	295.51	87.95	Percent of Total Billed Charges	277.2	82.5	252	336
XR RIBS BILATERA	71110	HCPCS	320	RC	TC	outpatient	314	235.5	Percent of Total Billed Charges	298.93	95.2	Percent of Total Billed Charges	276.16	87.95	Percent of Total Billed Charges	259.05	82.5	235.5	314
XR RIBS UNILATERAL	71100	HCPCS	402	RC	TC	both	260	195	Percent of Total Billed Charges	247.52	95.2	Percent of Total Billed Charges	228.67	87.95	Percent of Total Billed Charges	214.5	82.5	195	260
DEXA SCAN (APPENDICULAR)	77081	HCPCS	320	RC	TC	outpatient	268	201	Percent of Total Billed Charges	255.14	95.2	Percent of Total Billed Charges	235.71	87.95	Percent of Total Billed Charges	221.1	82.5	201	268
US AAA SCREENING	76706	HCPCS	402	RC	TC	both	537	402.75	Percent of Total Billed Charges	511.22	95.2	Percent of Total Billed Charges	472.29	87.95	Percent of Total Billed Charges	443.03	82.5	402.75	537
US RENAL ARTERIAL DOPPLER COMPLETE	93975	HCPCS	921	RC	TC	both	972	729	Percent of Total Billed Charges	925.34	95.2	Percent of Total Billed Charges	854.87	87.95	Percent of Total Billed Charges	801.9	82.5	729	972
US ARTERIAL UPPER EXT BILAT	93930	HCPCS	921	RC	TC	both	1074	805.5	Percent of Total Billed Charges	1022.45	95.2	Percent of Total Billed Charges	944.58	87.95	Percent of Total Billed Charges	886.05	82.5	805.5	1074
US ARTERIAL UPPER EXT UNILATERAL	93931	HCPCS	921	RC	TC	both	788	591	Percent of Total Billed Charges	750.18	95.2	Percent of Total Billed Charges	693.05	87.95	Percent of Total Billed Charges	650.1	82.5	591	788
US ARTERIAL LOWER EXT BILAT	93925	HCPCS	921	RC	TC	both	961	720.75	Percent of Total Billed Charges	914.87	95.2	Percent of Total Billed Charges	845.2	87.95	Percent of Total Billed Charges	792.83	82.5	720.75	961
US OB 1ST TRIMESTER	76801	HCPCS	402	RC	TC	both	664	498	Percent of Total Billed Charges	632.13	95.2	Percent of Total Billed Charges	583.99	87.95	Percent of Total Billed Charges	547.8	82.5	498	664
US BIOPHYSICAL PROFILE	76819	HCPCS	402	RC	TC	both	628	471	Percent of Total Billed Charges	597.86	95.2	Percent of Total Billed Charges	552.33	87.95	Percent of Total Billed Charges	518.1	82.5	471	628
US OB TVU	76817	HCPCS	402	RC	TC	both	752	564	Percent of Total Billed Charges	715.9	95.2	Percent of Total Billed Charges	661.38	87.95	Percent of Total Billed Charges	620.4	82.5	564	752
US GROIN	76882	HCPCS	402	RC	TC	both	716	537	Percent of Total Billed Charges	681.63	95.2	Percent of Total Billed Charges	629.72	87.95	Percent of Total Billed Charges	590.7	82.5	537	716
US PELVIC LIMITED	76857	HCPCS	402	RC	TC	both	725	543.75	Percent of Total Billed Charges	690.2	95.2	Percent of Total Billed Charges	637.64	87.95	Percent of Total Billed Charges	598.13	82.5	543.75	725
US EXTREMITY NON-VASCULAR COMPLETE	76881	HCPCS	402	RC	TC	both	796	597	Percent of Total Billed Charges	757.79	95.2	Percent of Total Billed Charges	700.08	87.95	Percent of Total Billed Charges	656.7	82.5	597	796
US NEEDLE GUIDE	76942	HCPCS	320	RC	TC	both	723	542.25	Percent of Total Billed Charges	688.3	95.2	Percent of Total Billed Charges	635.88	87.95	Percent of Total Billed Charges	596.48	82.5	542.25	723
UNDER DIAGNOSTIC ULTRASOUND PROCEDURES OF THE HEAD AND NECK	76536	HCPCS	921	RC	26	both	146	109.5	Percent of Total Billed Charges	138.99	95.2	Percent of Total Billed Charges	128.41	87.95	Percent of Total Billed Charges	120.45	82.5	109.5	146
US OB 2/3RD TRIMESTER TRANSABD SINGLE GEST	76810	HCPCS	402	RC	TC	both	483	362.25	Percent of Total Billed Charges	459.82	95.2	Percent of Total Billed Charges	424.8	87.95	Percent of Total Billed Charges	398.48	82.5	362.25	483
US ARTERIAL LOWER EXT UNILAT	93926	HCPCS	921	RC	TC	both	737	552.75	Percent of Total Billed Charges	701.62	95.2	Percent of Total Billed Charges	648.19	87.95	Percent of Total Billed Charges	608.03	82.5	552.75	737
US OB 2ND/3RD TRIMESTER TRANSABD SINGLE GEST	76805	HCPCS	402	RC	TC	both	878	658.5	Percent of Total Billed Charges	835.86	95.2	Percent of Total Billed Charges	772.2	87.95	Percent of Total Billed Charges	724.35	82.5	658.5	878
AAA US INTERPRETATION	76706	HCPCS	402	RC	26	both	386	289.5	Percent of Total Billed Charges	367.47	95.2	Percent of Total Billed Charges	339.49	87.95	Percent of Total Billed Charges	318.45	82.5	289.5	386
US ABDOMINAL COMPLETE	76700	HCPCS	402	RC	TC	both	849	636.75	Percent of Total Billed Charges	808.25	95.2	Percent of Total Billed Charges	746.7	87.95	Percent of Total Billed Charges	700.43	82.5	636.75	849
US ABDOMINAL LIMITED	76705	HCPCS	402	RC	TC	both	767	575.25	Percent of Total Billed Charges	730.18	95.2	Percent of Total Billed Charges	674.58	87.95	Percent of Total Billed Charges	632.78	82.5	575.25	767
US RENAL / RETROPERITONEAL COMPLETE	76770	HCPCS	402	RC	TC	both	835	626.25	Percent of Total Billed Charges	794.92	95.2	Percent of Total Billed Charges	734.38	87.95	Percent of Total Billed Charges	688.88	82.5	626.25	835
US RENAL / RETROPERITONEAL LIMITED	76775	HCPCS	402	RC	TC	both	713	534.75	Percent of Total Billed Charges	678.78	95.2	Percent of Total Billed Charges	627.08	87.95	Percent of Total Billed Charges	588.23	82.5	534.75	713
US OB LIMITED	76815	HCPCS	402	RC	TC	both	636	477	Percent of Total Billed Charges	605.47	95.2	Percent of Total Billed Charges	559.36	87.95	Percent of Total Billed Charges	524.7	82.5	477	636
US PELVIC COMPLETE NO OB	76856	HCPCS	402	RC	TC	both	860	645	Percent of Total Billed Charges	818.72	95.2	Percent of Total Billed Charges	756.37	87.95	Percent of Total Billed Charges	709.5	82.5	645	860
US THYROID	76536	HCPCS	402	RC	TC	both	796	597	Percent of Total Billed Charges	757.79	95.2	Percent of Total Billed Charges	700.08	87.95	Percent of Total Billed Charges	656.7	82.5	597	796
US TVU	76830	HCPCS	402	RC	TC	both	852	639	Percent of Total Billed Charges	811.1	95.2	Percent of Total Billed Charges	749.33	87.95	Percent of Total Billed Charges	702.9	82.5	639	852
CAROTID DUPLEX COMPLETE	93880	HCPCS	921	RC	TC	both	1054	790.5	Percent of Total Billed Charges	1003.41	95.2	Percent of Total Billed Charges	926.99	87.95	Percent of Total Billed Charges	869.55	82.5	790.5	1054
US VENOUS DUPLEX UPPER EXT BILATERAL	93970	HCPCS	921	RC	TC	both	1360	1020	Percent of Total Billed Charges	1294.72	95.2	Percent of Total Billed Charges	1196.12	87.95	Percent of Total Billed Charges	1122	82.5	1020	1360
US VENOUS DUPLEX UPPER EXT	93971	HCPCS	921	RC	TC	both	953	714.75	Percent of Total Billed Charges	907.26	95.2	Percent of Total Billed Charges	838.16	87.95	Percent of Total Billed Charges	786.23	82.5	714.75	953
US SCROTUM	76870	HCPCS	402	RC	TC	both	839	629.25	Percent of Total Billed Charges	798.73	95.2	Percent of Total Billed Charges	737.9	87.95	Percent of Total Billed Charges	692.18	82.5	629.25	839
US SOFT TISSUE (EXTREMITY/AXILLARY) LIMITED	76882	HCPCS	402	RC	TC	both	716	537	Percent of Total Billed Charges	681.63	95.2	Percent of Total Billed Charges	629.72	87.95	Percent of Total Billed Charges	590.7	82.5	537	716
US OB FOLLOW-UP	76816	HCPCS	402	RC	TC	both	720	540	Percent of Total Billed Charges	685.44	95.2	Percent of Total Billed Charges	633.24	87.95	Percent of Total Billed Charges	594	82.5	540	720
US OB 1ST TRIMESTER	76802	HCPCS	402	RC	TC	both	438	328.5	Percent of Total Billed Charges	416.98	95.2	Percent of Total Billed Charges	385.22	87.95	Percent of Total Billed Charges	361.35	82.5	328.5	438
US HEAD/NECH SOFT TISSUE	76536	HCPCS	402	RC	TC	both	796	597	Percent of Total Billed Charges	757.79	95.2	Percent of Total Billed Charges	700.08	87.95	Percent of Total Billed Charges	656.7	82.5	597	796
US VENOUS DUPLEX LOWER EXT BILATERAL	93971	HCPCS	921	RC	TC	both	1360	1020	Percent of Total Billed Charges	1294.72	95.2	Percent of Total Billed Charges	1196.12	87.95	Percent of Total Billed Charges	1122	82.5	1020	1360
US VENOUS DUPLEX LOWER EXT	93971	HCPCS	921	RC	TC	both	953	714.75	Percent of Total Billed Charges	907.26	95.2	Percent of Total Billed Charges	838.16	87.95	Percent of Total Billed Charges	786.23	82.5	714.75	953
CTA CHEST	71275	HCPCS	352	RC	TC	both	3638	2728.5	Percent of Total Billed Charges	3463.38	95.2	Percent of Total Billed Charges	3199.62	87.95	Percent of Total Billed Charges	3001.35	82.5	2728.5	3638
CT FLUORO NEEDLE GUIDE	77003	HCPCS	320	RC		both	1107	830.25	Percent of Total Billed Charges	1053.86	95.2	Percent of Total Billed Charges	973.61	87.95	Percent of Total Billed Charges	913.28	82.5	830.25	1107
CTA NECK	70498	HCPCS	351	RC	TC	both	2976	2232	Percent of Total Billed Charges	2833.15	95.2	Percent of Total Billed Charges	2617.39	87.95	Percent of Total Billed Charges	2455.2	82.5	2232	2976
CTA HEAD	70496	HCPCS	351	RC	TC	both	3434	2575.5	Percent of Total Billed Charges	3269.17	95.2	Percent of Total Billed Charges	3020.2	87.95	Percent of Total Billed Charges	2833.05	82.5	2575.5	3434
CTA PELVIS	72191	HCPCS	352	RC	TC	both	2464	1848	Percent of Total Billed Charges	2345.73	95.2	Percent of Total Billed Charges	2167.09	87.95	Percent of Total Billed Charges	2032.8	82.5	1848	2464
CTA ABDOMEN	74175	HCPCS	352	RC	TC	both	3702	2776.5	Percent of Total Billed Charges	3524.3	95.2	Percent of Total Billed Charges	3255.91	87.95	Percent of Total Billed Charges	3054.15	82.5	2776.5	3702
CT TEMPORAL BONES W/WO	70482	HCPCS	351	RC	TC	both	2202	1651.5	Percent of Total Billed Charges	2096.3	95.2	Percent of Total Billed Charges	1936.66	87.95	Percent of Total Billed Charges	1816.65	82.5	1651.5	2202
CTA RUNOFF	75635	HCPCS	352	RC	TC	both	3530	2647.5	Percent of Total Billed Charges	3360.56	95.2	Percent of Total Billed Charges	3104.64	87.95	Percent of Total Billed Charges	2912.25	82.5	2647.5	3530
CT CERVICAL SPINE W/WO	72127	HCPCS	352	RC	TC	both	2311	1733.25	Percent of Total Billed Charges	2200.07	95.2	Percent of Total Billed Charges	2032.52	87.95	Percent of Total Billed Charges	1906.58	82.5	1733.25	2311
CT LUMBAR SPINE W/WO	72133	HCPCS	352	RC	TC	both	2311	1733.25	Percent of Total Billed Charges	2200.07	95.2	Percent of Total Billed Charges	2032.52	87.95	Percent of Total Billed Charges	1906.58	82.5	1733.25	2311
CT HEAD WO	70450	HCPCS	351	RC	TC	both	2366	1774.5	Percent of Total Billed Charges	2252.43	95.2	Percent of Total Billed Charges	2080.9	87.95	Percent of Total Billed Charges	1951.95	82.5	1774.5	2366
CT HEAD W/WO	70470	HCPCS	351	RC	TC	both	2311	1733.25	Percent of Total Billed Charges	2200.07	95.2	Percent of Total Billed Charges	2032.52	87.95	Percent of Total Billed Charges	1906.58	82.5	1733.25	2311
CT ORBIT/IAC WO	70480	HCPCS	351	RC	TC	both	2143	1607.25	Percent of Total Billed Charges	2040.14	95.2	Percent of Total Billed Charges	1884.77	87.95	Percent of Total Billed Charges	1767.98	82.5	1607.25	2143
CT ORBIT/IAC BILAT W/WO	70482	HCPCS	351	RC	TC	both	2311	1733.25	Percent of Total Billed Charges	2200.07	95.2	Percent of Total Billed Charges	2032.52	87.95	Percent of Total Billed Charges	1906.58	82.5	1733.25	2311
CT NECK SOFT TISSUE WO	70490	HCPCS	351	RC	TC	both	2310	1732.5	Percent of Total Billed Charges	2199.12	95.2	Percent of Total Billed Charges	2031.65	87.95	Percent of Total Billed Charges	1905.75	82.5	1732.5	2310
CT NECK SOFT TISSUE W/	70491	HCPCS	351	RC	TC	both	2721	2040.75	Percent of Total Billed Charges	2590.39	95.2	Percent of Total Billed Charges	2393.12	87.95	Percent of Total Billed Charges	2244.83	82.5	2040.75	2721
CT NECK SOFT TISSUE W/WO	70492	HCPCS	351	RC	TC	both	3167	2375.25	Percent of Total Billed Charges	3014.98	95.2	Percent of Total Billed Charges	2785.38	87.95	Percent of Total Billed Charges	2612.78	82.5	2375.25	3167
CT CHEST WO	71250	HCPCS	352	RC	TC	both	2645	1983.75	Percent of Total Billed Charges	2518.04	95.2	Percent of Total Billed Charges	2326.28	87.95	Percent of Total Billed Charges	2182.13	82.5	1983.75	2645
CT CHEST W/	71260	HCPCS	352	RC	TC	both	2901	2175.75	Percent of Total Billed Charges	2761.75	95.2	Percent of Total Billed Charges	2551.43	87.95	Percent of Total Billed Charges	2393.33	82.5	2175.75	2901
CT CHEST W/WO	71270	HCPCS	352	RC	TC	both	3283	2462.25	Percent of Total Billed Charges	3125.42	95.2	Percent of Total Billed Charges	2887.4	87.95	Percent of Total Billed Charges	2708.48	82.5	2462.25	3283
CT ABDOMEN WO	74150	HCPCS	352	RC	TC	both	2240	1680	Percent of Total Billed Charges	2132.48	95.2	Percent of Total Billed Charges	1970.08	87.95	Percent of Total Billed Charges	1848	82.5	1680	2240
CT ABDOMEN W/	74160	HCPCS	352	RC	TC	both	2665	1998.75	Percent of Total Billed Charges	2537.08	95.2	Percent of Total Billed Charges	2343.87	87.95	Percent of Total Billed Charges	2198.63	82.5	1998.75	2665
CT ABDOMEN W/WO	74170	HCPCS	352	RC	TC	both	3017	2262.75	Percent of Total Billed Charges	2872.18	95.2	Percent of Total Billed Charges	2653.45	87.95	Percent of Total Billed Charges	2489.03	82.5	2262.75	3017
CT PELVIS WO	72192	HCPCS	352	RC	TC	both	2550	1912.5	Percent of Total Billed Charges	2427.6	95.2	Percent of Total Billed Charges	2242.73	87.95	Percent of Total Billed Charges	2103.75	82.5	1912.5	2550
CT PELVIS W/	72193	HCPCS	352	RC	TC	both	2663	1997.25	Percent of Total Billed Charges	2535.18	95.2	Percent of Total Billed Charges	2342.11	87.95	Percent of Total Billed Charges	2196.98	82.5	1997.25	2663
CT PELVIS W/WO	72194	HCPCS	352	RC	TC	both	2967	2225.25	Percent of Total Billed Charges	2824.58	95.2	Percent of Total Billed Charges	2609.48	87.95	Percent of Total Billed Charges	2447.78	82.5	2225.25	2967
CT CERVICAL SPINE W/	72126	HCPCS	352	RC	TC	both	2226	1669.5	Percent of Total Billed Charges	2119.15	95.2	Percent of Total Billed Charges	1957.77	87.95	Percent of Total Billed Charges	1836.45	82.5	1669.5	2226
CT CERVICAL SPINE WO	72125	HCPCS	352	RC	TC	both	2795	2096.25	Percent of Total Billed Charges	2660.84	95.2	Percent of Total Billed Charges	2458.2	87.95	Percent of Total Billed Charges	2305.88	82.5	2096.25	2795
CT THORACIC SPINE WO	72128	HCPCS	352	RC	TC	both	2689	2016.75	Percent of Total Billed Charges	2559.93	95.2	Percent of Total Billed Charges	2364.98	87.95	Percent of Total Billed Charges	2218.43	82.5	2016.75	2689
CT THORACIC SPINE W/	72129	HCPCS	352	RC	TC	both	2226	1669.5	Percent of Total Billed Charges	2119.15	95.2	Percent of Total Billed Charges	1957.77	87.95	Percent of Total Billed Charges	1836.45	82.5	1669.5	2226
CT LUMBAR SPINE WO	72131	HCPCS	352	RC	TC	both	2718	2038.5	Percent of Total Billed Charges	2587.54	95.2	Percent of Total Billed Charges	2390.48	87.95	Percent of Total Billed Charges	2242.35	82.5	2038.5	2718
CT LUMBAR SPINE W/	72132	HCPCS	352	RC	TC	both	2226	1669.5	Percent of Total Billed Charges	2119.15	95.2	Percent of Total Billed Charges	1957.77	87.95	Percent of Total Billed Charges	1836.45	82.5	1669.5	2226
CT UPPER EXT WO	73200	HCPCS	352	RC	TC	both	2143	1607.25	Percent of Total Billed Charges	2040.14	95.2	Percent of Total Billed Charges	1884.77	87.95	Percent of Total Billed Charges	1767.98	82.5	1607.25	2143
CT UPPER EXT W/	73201	HCPCS	350	RC	TC	both	2161	1620.75	Percent of Total Billed Charges	2057.27	95.2	Percent of Total Billed Charges	1900.6	87.95	Percent of Total Billed Charges	1782.83	82.5	1620.75	2161
CT UPPER EXT W/WO	73202	HCPCS	352	RC	TC	both	2311	1733.25	Percent of Total Billed Charges	2200.07	95.2	Percent of Total Billed Charges	2032.52	87.95	Percent of Total Billed Charges	1906.58	82.5	1733.25	2311
CT LOWER EXT WO	73700	HCPCS	352	RC	TC	both	2497	1872.75	Percent of Total Billed Charges	2377.14	95.2	Percent of Total Billed Charges	2196.11	87.95	Percent of Total Billed Charges	2060.03	82.5	1872.75	2497
CT LOWER EXT W/	73701	HCPCS	352	RC	TC	both	2226	1669.5	Percent of Total Billed Charges	2119.15	95.2	Percent of Total Billed Charges	1957.77	87.95	Percent of Total Billed Charges	1836.45	82.5	1669.5	2226
CT LOWER EXT W/WO	73702	HCPCS	352	RC	TC	both	2311	1733.25	Percent of Total Billed Charges	2200.07	95.2	Percent of Total Billed Charges	2032.52	87.95	Percent of Total Billed Charges	1906.58	82.5	1733.25	2311
CT MAXILLOFACIAL WO	70486	HCPCS	351	RC	TC	both	2212	1659	Percent of Total Billed Charges	2105.82	95.2	Percent of Total Billed Charges	1945.45	87.95	Percent of Total Billed Charges	1824.9	82.5	1659	2212
CT MAXILLOFACIAL W/	70487	HCPCS	351	RC	TC	both	2522	1891.5	Percent of Total Billed Charges	2400.94	95.2	Percent of Total Billed Charges	2218.1	87.95	Percent of Total Billed Charges	2080.65	82.5	1891.5	2522
CT MAXILLOFACIAL W/WO	70488	HCPCS	351	RC	TC	both	2311	1733.25	Percent of Total Billed Charges	2200.07	95.2	Percent of Total Billed Charges	2032.52	87.95	Percent of Total Billed Charges	1906.58	82.5	1733.25	2311
CT THORACIC SPINE W/WO	72130	HCPCS	352	RC	TC	both	2311	1733.25	Percent of Total Billed Charges	2200.07	95.2	Percent of Total Billed Charges	2032.52	87.95	Percent of Total Billed Charges	1906.58	82.5	1733.25	2311
CT ABDOMEN/PELVIS W/	74177	HCPCS	352	RC	TC	both	3569	2676.75	Percent of Total Billed Charges	3397.69	95.2	Percent of Total Billed Charges	3138.94	87.95	Percent of Total Billed Charges	2944.43	82.5	2676.75	3569
CT ABDOMEN/PELVIS WO	74176	HCPCS	352	RC	TC	both	3104	2328	Percent of Total Billed Charges	2955.01	95.2	Percent of Total Billed Charges	2729.97	87.95	Percent of Total Billed Charges	2560.8	82.5	2328	3104
CT ABDOMEN/PELVIS W/WO	74178	HCPCS	352	RC	TC	both	5804	4353	Percent of Total Billed Charges	5525.41	95.2	Percent of Total Billed Charges	5104.62	87.95	Percent of Total Billed Charges	4788.3	82.5	4353	5804
CTA ABDOMEN/PELVIS	74174	HCPCS	352	RC	TC	both	3530	2647.5	Percent of Total Billed Charges	3360.56	95.2	Percent of Total Billed Charges	3104.64	87.95	Percent of Total Billed Charges	2912.25	82.5	2647.5	3530
CT LUNG CANCER SCREENING	71271	HCPCS	351	RC	TC	both	321	240.75	Percent of Total Billed Charges	305.59	95.2	Percent of Total Billed Charges	282.32	87.95	Percent of Total Billed Charges	264.83	82.5	240.75	321
CT UROGRAM	74178	HCPCS	352	RC	TC	both	5804	4353	Percent of Total Billed Charges	5525.41	95.2	Percent of Total Billed Charges	5104.62	87.95	Percent of Total Billed Charges	4788.3	82.5	4353	5804
CT HEAD W/	70460	HCPCS	350	RC	TC	both	2892	2169	Percent of Total Billed Charges	2753.18	95.2	Percent of Total Billed Charges	2543.51	87.95	Percent of Total Billed Charges	2385.9	82.5	2169	2892
MCT INTERPRETATION	93228	HCPCS	985	RC		outpatient	112	84	Percent of Total Billed Charges	106.62	95.2	Percent of Total Billed Charges	98.5	87.95	Percent of Total Billed Charges	92.4	82.5	84	112
EVENT MONITOR	93268	HCPCS	731	RC		outpatient	830	622.5	Percent of Total Billed Charges	790.16	95.2	Percent of Total Billed Charges	729.99	87.95	Percent of Total Billed Charges	684.75	82.5	622.5	830
HOLTER MONITOR	93224	HCPCS	731	RC		outpatient	331	248.25	Percent of Total Billed Charges	315.11	95.2	Percent of Total Billed Charges	291.11	87.95	Percent of Total Billed Charges	273.08	82.5	248.25	331
MCT ANALYSIS	93229	HCPCS	732	RC		outpatient	4082	3061.5	Percent of Total Billed Charges	3886.06	95.2	Percent of Total Billed Charges	3590.12	87.95	Percent of Total Billed Charges	3367.65	82.5	3061.5	4082
HOLTER MONITOR EXTENDED	93241	HCPCS	732	RC		outpatient	147	110.25	Percent of Total Billed Charges	139.94	95.2	Percent of Total Billed Charges	129.29	87.95	Percent of Total Billed Charges	121.28	82.5	110.25	147
HOLTER MONITOR EXTENDED	93245	HCPCS	732	RC		outpatient	242	181.5	Percent of Total Billed Charges	230.38	95.2	Percent of Total Billed Charges	212.84	87.95	Percent of Total Billed Charges	199.65	82.5	181.5	242
ECG MONIT/REPRT UP TO 48 HRS	93225	HCPCS	731	RC		outpatient	373	279.75	Percent of Total Billed Charges	355.1	95.2	Percent of Total Billed Charges	328.05	87.95	Percent of Total Billed Charges	307.73	82.5	279.75	373
US ECHO COMPLETE W	C8929	HCPCS	483	RC	TC	outpatient	2528	1896	Percent of Total Billed Charges	2406.66	95.2	Percent of Total Billed Charges	2223.38	87.95	Percent of Total Billed Charges	2085.6	82.5	1896	2528
US ECHO COMPLETE WO	93306	HCPCS	483	RC	TC	outpatient	2437	1827.75	Percent of Total Billed Charges	2320.02	95.2	Percent of Total Billed Charges	2143.34	87.95	Percent of Total Billed Charges	2010.53	82.5	1827.75	2437
US ECHO LIMITED WO	93308	HCPCS	483	RC	TC	outpatient	1286	964.5	Percent of Total Billed Charges	1224.27	95.2	Percent of Total Billed Charges	1131.04	87.95	Percent of Total Billed Charges	1060.95	82.5	964.5	1286
US ECHO LIMITED W	C8924	HCPCS	483	RC	TC	outpatient	1436	1077	Percent of Total Billed Charges	1367.07	95.2	Percent of Total Billed Charges	1262.96	87.95	Percent of Total Billed Charges	1184.7	82.5	1077	1436
EKG-HOSPITAL	93005	HCPCS	730	RC		both	294	220.5	Percent of Total Billed Charges	279.89	95.2	Percent of Total Billed Charges	258.57	87.95	Percent of Total Billed Charges	242.55	82.5	220.5	294
ELECTROCARDIOGRAM REPORT	93010	HCPCS	985	RC		both	37	27.75	Percent of Total Billed Charges	35.22	95.2	Percent of Total Billed Charges	32.54	87.95	Percent of Total Billed Charges	30.53	82.5	27.75	37
US ECHO DEFINITY INJECTION	96379	HCPCS	260	RC		outpatient	249	186.75	Percent of Total Billed Charges	237.05	95.2	Percent of Total Billed Charges	219	87.95	Percent of Total Billed Charges	205.43	82.5	186.75	249
COLONOSCOPY	45378	HCPCS	975	RC		outpatient	1852	1389	Percent of Total Billed Charges	1763.1	95.2	Percent of Total Billed Charges	1628.83	87.95	Percent of Total Billed Charges	1527.9	82.5	1389	1852
COLONOSCOPY	45378	HCPCS	360	RC		outpatient	2912	2184	Percent of Total Billed Charges	2772.22	95.2	Percent of Total Billed Charges	2561.1	87.95	Percent of Total Billed Charges	2402.4	82.5	2184	2912
COLONOSCOPY W/ BIOPSY	45380	HCPCS	975	RC		outpatient	2140	1605	Percent of Total Billed Charges	2037.28	95.2	Percent of Total Billed Charges	1882.13	87.95	Percent of Total Billed Charges	1765.5	82.5	1605	2140
COLONOSCOPY W/ BIOPSY	45380	HCPCS	360	RC		outpatient	3384	2538	Percent of Total Billed Charges	3221.57	95.2	Percent of Total Billed Charges	2976.23	87.95	Percent of Total Billed Charges	2791.8	82.5	2538	3384
SCREENING COLONOSCOPY	G0121	HCPCS	975	RC		outpatient	1852	1389	Percent of Total Billed Charges	1763.1	95.2	Percent of Total Billed Charges	1628.83	87.95	Percent of Total Billed Charges	1527.9	82.5	1389	1852
SCREENING COLONOSCOPY	G0121	HCPCS	360	RC		outpatient	2912	2184	Percent of Total Billed Charges	2772.22	95.2	Percent of Total Billed Charges	2561.1	87.95	Percent of Total Billed Charges	2402.4	82.5	2184	2912
COLORECTAL CANCER SCREENING; COLONOSCOPY	G0105	HCPCS	360	RC		outpatient	2912	2184	Percent of Total Billed Charges	2772.22	95.2	Percent of Total Billed Charges	2561.1	87.95	Percent of Total Billed Charges	2402.4	82.5	2184	2912
COLORECTAL CANCER SCREENING; COLONOSCOPY	G0121	HCPCS	975	RC		outpatient	1852	1389	Percent of Total Billed Charges	1763.1	95.2	Percent of Total Billed Charges	1628.83	87.95	Percent of Total Billed Charges	1527.9	82.5	1389	1852
COLONOSCOPY WITH SNARES	45385	HCPCS	975	RC		outpatient	2064	1548	Percent of Total Billed Charges	1964.93	95.2	Percent of Total Billed Charges	1815.29	87.95	Percent of Total Billed Charges	1702.8	82.5	1548	2064
"COLONOSCOPY WITH REMOVAL OF TUMOR(S), POLYPS(S), OR OTHER LESION(S) BY HOT FORCEPS"	45385	HCPCS	360	RC		outpatient	3384	2538	Percent of Total Billed Charges	3221.57	95.2	Percent of Total Billed Charges	2976.23	87.95	Percent of Total Billed Charges	2791.8	82.5	2538	3384
COLONOSCOPY WITH REMOVAL BY HOT BIOPSY FORCEPS	45384	HCPCS	360	RC		outpatient	2920	2190	Percent of Total Billed Charges	2779.84	95.2	Percent of Total Billed Charges	2568.14	87.95	Percent of Total Billed Charges	2409	82.5	2190	2920
COLONOSCOPY WITH REMOVAL BY HOT BIOPSY FORCEPS	45384	HCPCS	975	RC		outpatient	1665	1248.75	Percent of Total Billed Charges	1585.08	95.2	Percent of Total Billed Charges	1464.37	87.95	Percent of Total Billed Charges	1373.63	82.5	1248.75	1665
EGD WITH BIOPSY	43239	HCPCS	975	RC		outpatient	1297	972.75	Percent of Total Billed Charges	1234.74	95.2	Percent of Total Billed Charges	1140.71	87.95	Percent of Total Billed Charges	1070.03	82.5	972.75	1297
ESOPHAGOGASTRODUOENOSCOPY TRANSORAL DIAGNOSITC	43235	HCPCS	360	RC		outpatient	1329	996.75	Percent of Total Billed Charges	1265.21	95.2	Percent of Total Billed Charges	1168.86	87.95	Percent of Total Billed Charges	1096.43	82.5	996.75	1329
"ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL, DIAG"	43235	HCPCS	960	RC		outpatient	930	697.5	Percent of Total Billed Charges	885.36	95.2	Percent of Total Billed Charges	817.94	87.95	Percent of Total Billed Charges	767.25	82.5	697.5	930
"ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL, DIAG"	43235	HCPCS	360	RC		outpatient	399	299.25	Percent of Total Billed Charges	379.85	95.2	Percent of Total Billed Charges	350.92	87.95	Percent of Total Billed Charges	329.18	82.5	299.25	399
COLONOSCOPY	G0121	HCPCS	975	RC		outpatient	1852	1389	Percent of Total Billed Charges	1763.1	95.2	Percent of Total Billed Charges	1628.83	87.95	Percent of Total Billed Charges	1527.9	82.5	1389	1852
COLONOSCOPY	G0121	HCPCS	360	RC		outpatient	2912	2184	Percent of Total Billed Charges	2772.22	95.2	Percent of Total Billed Charges	2561.1	87.95	Percent of Total Billed Charges	2402.4	82.5	2184	2912
COLONOSCOPY W/BAND LIGATION	45398	HCPCS	360	RC		outpatient	3373	2529.75	Percent of Total Billed Charges	3211.1	95.2	Percent of Total Billed Charges	2966.55	87.95	Percent of Total Billed Charges	2782.73	82.5	2529.75	3373
COLONOSCOPY W/BAND LIGATION	45398	HCPCS	975	RC		outpatient	3373.08	2529.81	Percent of Total Billed Charges	3211.17	95.2	Percent of Total Billed Charges	2966.62	87.95	Percent of Total Billed Charges	2782.79	82.5	2529.81	3373.08
EGD WITH BIOPSY	43239	HCPCS	360	RC		outpatient	1734	1300.5	Percent of Total Billed Charges	1650.77	95.2	Percent of Total Billed Charges	1525.05	87.95	Percent of Total Billed Charges	1430.55	82.5	1300.5	1734
UNDER ANESTHESIA FOR PROCEDURES ON THE LOWER ABDOMEN	811	HCPCS	964	RC		outpatient	97	72.75	Percent of Total Billed Charges	92.34	95.2	Percent of Total Billed Charges	85.31	87.95	Percent of Total Billed Charges	80.03	82.5	72.75	97
SCREENING COLONOSCOPY	812	HCPCS	964	RC		outpatient	93	69.75	Percent of Total Billed Charges	88.54	95.2	Percent of Total Billed Charges	81.79	87.95	Percent of Total Billed Charges	76.73	82.5	69.75	93
ANESTHESIA FOR ALL PROCEDURES ON THE INTEGUMENTARY	300	HCPCS	964	RC		outpatient	99	74.25	Percent of Total Billed Charges	94.25	95.2	Percent of Total Billed Charges	87.07	87.95	Percent of Total Billed Charges	81.68	82.5	74.25	99
EGD ANESTHESIA	731	HCPCS	964	RC		outpatient	97	72.75	Percent of Total Billed Charges	92.34	95.2	Percent of Total Billed Charges	85.31	87.95	Percent of Total Billed Charges	80.03	82.5	72.75	97
UPPER AND LOWER ENDOSCOPY	813	HCPCS	964	RC		outpatient	93	69.75	Percent of Total Billed Charges	88.54	95.2	Percent of Total Billed Charges	81.79	87.95	Percent of Total Billed Charges	76.73	82.5	69.75	93
ANESTHESIA FOR OPEN PROCEDURES	1480	HCPCS	964	RC		outpatient	97	72.75	Percent of Total Billed Charges	92.34	95.2	Percent of Total Billed Charges	85.31	87.95	Percent of Total Billed Charges	80.03	82.5	72.75	97
ANESTHESIA FOR PROCEDURES ON THE INTEGUMENTARYSYSTEM OF EXTREMITIES	400	HCPCS	964	RC		outpatient	98	73.5	Percent of Total Billed Charges	93.3	95.2	Percent of Total Billed Charges	86.19	87.95	Percent of Total Billed Charges	80.85	82.5	73.5	98
"ANESTHESIA FOR ALL PROCEDURES ON NERVES, MUSCLES, TENDON, FASCIA"	1810	HCPCS	964	RC		outpatient	97	72.75	Percent of Total Billed Charges	92.34	95.2	Percent of Total Billed Charges	85.31	87.95	Percent of Total Billed Charges	80.03	82.5	72.75	97
ANESTHESIA LOWER LEG SURGERY	1470	HCPCS	964	RC		outpatient	97	72.75	Percent of Total Billed Charges	92.34	95.2	Percent of Total Billed Charges	85.31	87.95	Percent of Total Billed Charges	80.03	82.5	72.75	97
ANESTHESIA FOR LOWER LEG (BELOW KNEE)	1474	HCPCS	964	RC		outpatient	97	72.75	Percent of Total Billed Charges	92.34	95.2	Percent of Total Billed Charges	85.31	87.95	Percent of Total Billed Charges	80.03	82.5	72.75	97
RF GUIDED NEEDLE PLACEMENT (F)	77002	HCPCS	972	RC		outpatient	364	273	Percent of Total Billed Charges	346.53	95.2	Percent of Total Billed Charges	320.14	87.95	Percent of Total Billed Charges	300.3	82.5	273	364
RF GUIDED NEEDLE PLACEMENT (F)	77002	HCPCS	320	RC		outpatient	156	117	Percent of Total Billed Charges	148.51	95.2	Percent of Total Billed Charges	137.2	87.95	Percent of Total Billed Charges	128.7	82.5	117	156
PARAVERTEVRAL FACET JOINT WITH IMAGING GUIDANCE LUMBAR OR SACRAL THIRD & ANY ADDITIONAL LEVEL (F)	64495	HCPCS	320	RC		outpatient	172	129	Percent of Total Billed Charges	163.74	95.2	Percent of Total Billed Charges	151.27	87.95	Percent of Total Billed Charges	141.9	82.5	129	172
PARAVERTEVRAL FACET JOINT WITH IMAGING GUIDANCE LUMBAR OR SACRAL THIRD & ANY ADDITIONAL LEVEL (F)	64495	HCPCS	960	RC		outpatient	172	129	Percent of Total Billed Charges	163.74	95.2	Percent of Total Billed Charges	151.27	87.95	Percent of Total Billed Charges	141.9	82.5	129	172
PARAVERTEVRAL FACET JOINT WITH IMAGING GUIDANCE LUMBAR OR SACRAL SECOND LEVEL (F)	64494	HCPCS	960	RC		outpatient	172	129	Percent of Total Billed Charges	163.74	95.2	Percent of Total Billed Charges	151.27	87.95	Percent of Total Billed Charges	141.9	82.5	129	172
PARAVERTEVRAL FACET JOINT WITH IMAGING GUIDANCE LUMBAR OR SACRAL SECOND LEVEL (F)	64494	HCPCS	320	RC		outpatient	172	129	Percent of Total Billed Charges	163.74	95.2	Percent of Total Billed Charges	151.27	87.95	Percent of Total Billed Charges	141.9	82.5	129	172
INJECTION TRANSLAMINAR ESI LUMBAR/SACRAL (F)	62323	HCPCS	960	RC		outpatient	1473	1104.75	Percent of Total Billed Charges	1402.3	95.2	Percent of Total Billed Charges	1295.5	87.95	Percent of Total Billed Charges	1215.23	82.5	1104.75	1473
INJECTION TRANSLAMINAR ESI LUMBAR/SACRAL (F)	62323	HCPCS	360	RC		outpatient	631	473.25	Percent of Total Billed Charges	600.71	95.2	Percent of Total Billed Charges	554.96	87.95	Percent of Total Billed Charges	520.58	82.5	473.25	631
PARAVERTEVRAL FACET JOINT WITH IMAGING GUIDANCE LUMBAR OR SACRAL SINGLE LEVEL (F)	64493	HCPCS	320	RC		outpatient	818	613.5	Percent of Total Billed Charges	778.74	95.2	Percent of Total Billed Charges	719.43	87.95	Percent of Total Billed Charges	674.85	82.5	613.5	818
PARAVERTEVRAL FACET JOINT WITH IMAGING GUIDANCE LUMBAR OR SACRAL SINGLE LEVEL (F)	64493	HCPCS	960	RC		outpatient	1910	1432.5	Percent of Total Billed Charges	1818.32	95.2	Percent of Total Billed Charges	1679.85	87.95	Percent of Total Billed Charges	1575.75	82.5	1432.5	1910
DRAIN/INJ JOINT/BURSA W/O US (F)	20610	HCPCS	972	RC		outpatient	606	454.5	Percent of Total Billed Charges	576.91	95.2	Percent of Total Billed Charges	532.98	87.95	Percent of Total Billed Charges	499.95	82.5	454.5	606
DRAIN/INJ JOINT/BURSA W/O US (F)	20610	HCPCS	360	RC		outpatient	259	194.25	Percent of Total Billed Charges	246.57	95.2	Percent of Total Billed Charges	227.79	87.95	Percent of Total Billed Charges	213.68	82.5	194.25	259
NJX AA&/STRD NTRCOST NRV 1 (F)	64420	HCPCS	960	RC		outpatient	1473	1104.75	Percent of Total Billed Charges	1402.3	95.2	Percent of Total Billed Charges	1295.5	87.95	Percent of Total Billed Charges	1215.23	82.5	1104.75	1473
"INJECTION, ANESTHETIC AGENT(S) AND/OR STEROID, INTERCOSTAL NERVE, SINGLE LEVEL (F)"	64420	HCPCS	360	RC		outpatient	631	473.25	Percent of Total Billed Charges	600.71	95.2	Percent of Total Billed Charges	554.96	87.95	Percent of Total Billed Charges	520.58	82.5	473.25	631
DRAIN/INJ JOINT/BURSA W/O US (F)	20600	HCPCS	972	RC		outpatient	606	454.5	Percent of Total Billed Charges	576.91	95.2	Percent of Total Billed Charges	532.98	87.95	Percent of Total Billed Charges	499.95	82.5	454.5	606
DRAIN/INJ JOINT/BURSA W/O US (F)	20600	HCPCS	360	RC		outpatient	259	194.25	Percent of Total Billed Charges	246.57	95.2	Percent of Total Billed Charges	227.79	87.95	Percent of Total Billed Charges	213.68	82.5	194.25	259
DRAIN/INJ JOINT/BURSA W/O US (F)	20605	HCPCS	972	RC		outpatient	606	454.5	Percent of Total Billed Charges	576.91	95.2	Percent of Total Billed Charges	532.98	87.95	Percent of Total Billed Charges	499.95	82.5	454.5	606
DRAIN/INJ JOINT/BURSA W/O US (F)	20605	HCPCS	360	RC		outpatient	259	194.25	Percent of Total Billed Charges	246.57	95.2	Percent of Total Billed Charges	227.79	87.95	Percent of Total Billed Charges	213.68	82.5	194.25	259
TRIGGER POINT INJ 1 OR 2 MUSCLES (F)	20552	HCPCS	960	RC		outpatient	866	649.5	Percent of Total Billed Charges	824.43	95.2	Percent of Total Billed Charges	761.65	87.95	Percent of Total Billed Charges	714.45	82.5	649.5	866
TRIGGER POINT INJ 1 OR 2 MUSCLES (F)	20552	HCPCS	360	RC		outpatient	223	167.25	Percent of Total Billed Charges	212.3	95.2	Percent of Total Billed Charges	196.13	87.95	Percent of Total Billed Charges	183.98	82.5	167.25	223
"INJECTION, OF DIAG OR THERAPUTIC, SUBSTANCES WITH IMAGING (FL)"	62321	HCPCS	360	RC		outpatient	2104	1578	Percent of Total Billed Charges	2003.01	95.2	Percent of Total Billed Charges	1850.47	87.95	Percent of Total Billed Charges	1735.8	82.5	1578	2104
"INJECTION, OF DIAG OR THERAPUTIC, SUBSTANCES WITH IMAGING (FL)"	62321	HCPCS	960	RC		outpatient	466	349.5	Percent of Total Billed Charges	443.63	95.2	Percent of Total Billed Charges	409.85	87.95	Percent of Total Billed Charges	384.45	82.5	349.5	466
INJECTION TRANSFORAMINAL EPIDURAL WITH IMAGING LUMBAR/SACRAL (F)	64483	HCPCS	960	RC		outpatient	2728	2046	Percent of Total Billed Charges	2597.06	95.2	Percent of Total Billed Charges	2399.28	87.95	Percent of Total Billed Charges	2250.6	82.5	2046	2728
INJECTION TRANSFORAMINAL EPIDURAL WITH IMAGING LUMBAR/SACRAL (F)	64483	HCPCS	360	RC		outpatient	480	360	Percent of Total Billed Charges	456.96	95.2	Percent of Total Billed Charges	422.16	87.95	Percent of Total Billed Charges	396	82.5	360	480
INJ PARAVERT F JNT C/T 1 LEVEL (F)	64490	HCPCS	960	RC		outpatient	2728	2046	Percent of Total Billed Charges	2597.06	95.2	Percent of Total Billed Charges	2399.28	87.95	Percent of Total Billed Charges	2250.6	82.5	2046	2728
INJ PARAVERT F JNT C/T 1 LEVEL (F)	64490	HCPCS	360	RC		outpatient	456	342	Percent of Total Billed Charges	434.11	95.2	Percent of Total Billed Charges	401.05	87.95	Percent of Total Billed Charges	376.2	82.5	342	456
INJECTION WITH IMAGING GUIDANCE LUMBAR OR SACARAL (F)	64484	HCPCS	360	RC		outpatient	227	170.25	Percent of Total Billed Charges	216.1	95.2	Percent of Total Billed Charges	199.65	87.95	Percent of Total Billed Charges	187.28	82.5	170.25	227
INJECTION WITH IMAGING GUIDANCE LUMBAR OR SACARAL (F)	64484	HCPCS	964	RC		outpatient	482	361.5	Percent of Total Billed Charges	458.86	95.2	Percent of Total Billed Charges	423.92	87.95	Percent of Total Billed Charges	397.65	82.5	361.5	482
INJECTION TRANSLAMINAR ESI LUMBAR/SACRAL (F)	62323	HCPCS	960	RC		outpatient	2104	1578	Percent of Total Billed Charges	2003.01	95.2	Percent of Total Billed Charges	1850.47	87.95	Percent of Total Billed Charges	1735.8	82.5	1578	2104
"EVALUATION OF AUDITORY REHABILITATION STATUS, FIRST HOUR"	92626	HCPCS	444	RC		both	222	166.5	Percent of Total Billed Charges	211.34	95.2	Percent of Total Billed Charges	195.25	87.95	Percent of Total Billed Charges	183.15	82.5	166.5	222
ACTIVASE 100MG VIAL (1 MG)	J2997	HCPCS	636	RC		both	132	99	Percent of Total Billed Charges	125.66	95.2	Percent of Total Billed Charges	116.09	87.95	Percent of Total Billed Charges	108.9	82.5	99	132
LIDOCAINE HCL 1% 50 MG / SYRINGE (10MG)	J2001	HCPCS	636	RC		both	1.4	1.05	Percent of Total Billed Charges	1.33	95.2	Percent of Total Billed Charges	1.23	87.95	Percent of Total Billed Charges	1.16	82.5	1.05	1.4
ADENOSINE 12 MG/4 ML SYRINGE (6MG)	J0153	HCPCS	636	RC		both	15.6	11.7	Percent of Total Billed Charges	14.85	95.2	Percent of Total Billed Charges	13.72	87.95	Percent of Total Billed Charges	12.87	82.5	11.7	15.6
NALOXONE 0.4 MG/ML (1MG)	J2310	HCPCS	636	RC		both	18.53	13.9	Percent of Total Billed Charges	17.64	95.2	Percent of Total Billed Charges	16.3	87.95	Percent of Total Billed Charges	15.29	82.5	13.9	18.53
IMIPENEM-CILASTATIN 500 MG VIAL (250 MG)	J0743	HCPCS	636	RC		both	30	22.5	Percent of Total Billed Charges	28.56	95.2	Percent of Total Billed Charges	26.39	87.95	Percent of Total Billed Charges	24.75	82.5	22.5	30
MIDAZOLAM 2 MG/1 VIAL	J2250	HCPCS	636	RC		both	0.39	0.29	Percent of Total Billed Charges	0.37	95.2	Percent of Total Billed Charges	0.34	87.95	Percent of Total Billed Charges	0.32	82.5	0.29	0.39
DAPTOMYCIN 500MG VIAL (1 MG)	J0878	HCPCS	636	RC		both	1.51	1.13	Percent of Total Billed Charges	1.44	95.2	Percent of Total Billed Charges	1.33	87.95	Percent of Total Billed Charges	1.25	82.5	1.13	1.51
PERFOROMIST 20 MCG/2 ML SOLN	J7606	HCPCS	636	RC		both	558.53	418.9	Percent of Total Billed Charges	531.72	95.2	Percent of Total Billed Charges	491.23	87.95	Percent of Total Billed Charges	460.79	82.5	418.9	558.53
ZOLEDRONIC ACID-MANNITOL IV (RECLAST) (1 MG)	J3489	HCPCS	636	RC		both	144	108	Percent of Total Billed Charges	137.09	95.2	Percent of Total Billed Charges	126.65	87.95	Percent of Total Billed Charges	118.8	82.5	108	144
ceFAZolin 1 GM VIAL (500 MG)	J0690	HCPCS	636	RC		both	2.31	1.73	Percent of Total Billed Charges	2.2	95.2	Percent of Total Billed Charges	2.03	87.95	Percent of Total Billed Charges	1.91	82.5	1.73	2.31
ADENOSINE 12 MG/4 ML VIAL (6MG)	J0150	HCPCS	636	RC		both	13.14	9.86	Percent of Total Billed Charges	12.51	95.2	Percent of Total Billed Charges	11.56	87.95	Percent of Total Billed Charges	10.84	82.5	9.86	13.14
"Levemir 100 UNITS/ML, 10 mL (5 units)"	J1815	HCPCS	636	RC		both	3	2.25	Percent of Total Billed Charges	2.86	95.2	Percent of Total Billed Charges	2.64	87.95	Percent of Total Billed Charges	2.48	82.5	2.25	3
"SODIUM CHLORIDE 0.9% SOLUTION 1 g, 250 mL"	J7050	HCPCS	636	RC		both	12	9	Percent of Total Billed Charges	11.42	95.2	Percent of Total Billed Charges	10.55	87.95	Percent of Total Billed Charges	9.9	82.5	9	12
"OFIRMEV 1,000 MG/100 ML VIAL (10MG)"	J0131	HCPCS	636	RC		both	1.92	1.44	Percent of Total Billed Charges	1.83	95.2	Percent of Total Billed Charges	1.69	87.95	Percent of Total Billed Charges	1.58	82.5	1.44	1.92
SALINE 0.9% 500 mL	J7040	HCPCS	636	RC		both	14	10.5	Percent of Total Billed Charges	13.33	95.2	Percent of Total Billed Charges	12.31	87.95	Percent of Total Billed Charges	11.55	82.5	10.5	14
PROMETHAZINE HCL 25 MG/1 AMPULE	J2550	HCPCS	636	RC		both	1.58	1.19	Percent of Total Billed Charges	1.5	95.2	Percent of Total Billed Charges	1.39	87.95	Percent of Total Billed Charges	1.3	82.5	1.19	1.58
"FLUCONAZOLE-NACL 200 MG/100 ML 1 ea, 100 mL  (00409-4688-16)"	J1450	HCPCS	636	RC		both	21	15.75	Percent of Total Billed Charges	19.99	95.2	Percent of Total Billed Charges	18.47	87.95	Percent of Total Billed Charges	17.33	82.5	15.75	21
"ADRENALIN 1 MG/ML VIAL 1 mg, 1 mL"	J0171	HCPCS	636	RC		both	2	1.5	Percent of Total Billed Charges	1.9	95.2	Percent of Total Billed Charges	1.76	87.95	Percent of Total Billed Charges	1.65	82.5	1.5	2
"Bicillin L-A 1,200,000 UNITS 1 unit, 2 mL"	J0561	HCPCS	636	RC		both	31.05	23.29	Percent of Total Billed Charges	29.56	95.2	Percent of Total Billed Charges	27.31	87.95	Percent of Total Billed Charges	25.62	82.5	23.29	31.05
"LINEZOLID 600 MG/300 ML-D5W 200 mg, 300 mL"	J2020	HCPCS	636	RC		both	52	39	Percent of Total Billed Charges	49.5	95.2	Percent of Total Billed Charges	45.73	87.95	Percent of Total Billed Charges	42.9	82.5	39	52
PROPOFOL 200 MG/20 ML VIAL 10 mg	J2704	HCPCS	636	RC		both	1	0.75	Percent of Total Billed Charges	0.95	95.2	Percent of Total Billed Charges	0.88	87.95	Percent of Total Billed Charges	0.83	82.5	0.75	1
"HumuLIN 70-30 VIAL 1 ea, 10 mL"	J1815	HCPCS	636	RC		both	11	8.25	Percent of Total Billed Charges	10.47	95.2	Percent of Total Billed Charges	9.67	87.95	Percent of Total Billed Charges	9.08	82.5	8.25	11
QUELICIN 200 MG/1 VIAL (20 MG)	J0330	HCPCS	636	RC		both	23.02	17.27	Percent of Total Billed Charges	21.92	95.2	Percent of Total Billed Charges	20.25	87.95	Percent of Total Billed Charges	18.99	82.5	17.27	23.02
"MAGNESIUM SULFATE 50% VIAL 1 mg, 10 mL"	J3475	HCPCS	636	RC		both	1	0.75	Percent of Total Billed Charges	0.95	95.2	Percent of Total Billed Charges	0.88	87.95	Percent of Total Billed Charges	0.83	82.5	0.75	1
"ADENOSINE 6 MG/2 ML SYRINGE 1 mg, 2 mL"	J0153	HCPCS	636	RC		both	2	1.5	Percent of Total Billed Charges	1.9	95.2	Percent of Total Billed Charges	1.76	87.95	Percent of Total Billed Charges	1.65	82.5	1.5	2
VANCOMYCIN 1 GM VIAL (500 MG)	J3370	HCPCS	636	RC		both	16.25	12.19	Percent of Total Billed Charges	15.47	95.2	Percent of Total Billed Charges	14.29	87.95	Percent of Total Billed Charges	13.41	82.5	12.19	16.25
LOVENOX 40MG/0.4ML SYRINGE (00075-8014-01)	J1650	HCPCS	636	RC		both	19.85	14.89	Percent of Total Billed Charges	18.9	95.2	Percent of Total Billed Charges	17.46	87.95	Percent of Total Billed Charges	16.38	82.5	14.89	19.85
"ERTAPENEM 1 GRAM VIAL 1 mg, 1 each"	J1335	HCPCS	636	RC		both	1194	895.5	Percent of Total Billed Charges	1136.69	95.2	Percent of Total Billed Charges	1050.12	87.95	Percent of Total Billed Charges	985.05	82.5	895.5	1194
"RHOGAM ULTRA-FILTERED PLUS SYR 300 mcg, 1 each (00562-7805-05)"	J2790	HCPCS	636	RC		both	212	159	Percent of Total Billed Charges	201.82	95.2	Percent of Total Billed Charges	186.45	87.95	Percent of Total Billed Charges	174.9	82.5	159	212
"DEPO-MedroL 80 MG/ML VIAL 80 mL, 1 mL"	J1040	HCPCS	636	RC		both	49	36.75	Percent of Total Billed Charges	46.65	95.2	Percent of Total Billed Charges	43.1	87.95	Percent of Total Billed Charges	40.43	82.5	36.75	49
"ORPHENADRINE 30 MG/ML VIAL 60 mg, 2 mL"	J2360	HCPCS	636	RC		both	56	42	Percent of Total Billed Charges	53.31	95.2	Percent of Total Billed Charges	49.25	87.95	Percent of Total Billed Charges	46.2	82.5	42	56
"levETIRAcetam 500 MG/5 ML VIAL 5 mL, 5 mL"	J1953	HCPCS	636	RC		both	0.37	0.28	Percent of Total Billed Charges	0.35	95.2	Percent of Total Billed Charges	0.33	87.95	Percent of Total Billed Charges	0.31	82.5	0.28	0.37
EPINEPHRINE 1:1000 1 MG/1 AMPULE (0.1 MG)	J0171	HCPCS	636	RC		both	2.52	1.89	Percent of Total Billed Charges	2.4	95.2	Percent of Total Billed Charges	2.22	87.95	Percent of Total Billed Charges	2.08	82.5	1.89	2.52
"POTASSIUM CL 20 MEQ/100 ML SOL 2 mEq, 100 mL"	J3480	HCPCS	636	RC		both	2	1.5	Percent of Total Billed Charges	1.9	95.2	Percent of Total Billed Charges	1.76	87.95	Percent of Total Billed Charges	1.65	82.5	1.5	2
"BUDESONIDE 0.5 MG/2 ML SUSP 2 mL, 2 mL"	J7626	HCPCS	636	RC		both	28	21	Percent of Total Billed Charges	26.66	95.2	Percent of Total Billed Charges	24.63	87.95	Percent of Total Billed Charges	23.1	82.5	21	28
DEXAMETHASONE 4 MG/ML VIAL	J1100	HCPCS	636	RC		both	0.37	0.28	Percent of Total Billed Charges	0.35	95.2	Percent of Total Billed Charges	0.33	87.95	Percent of Total Billed Charges	0.31	82.5	0.28	0.37
GLUCAGEN KIT 1 MG/1 VIAL	J1610	HCPCS	636	RC		both	205.92	154.44	Percent of Total Billed Charges	196.04	95.2	Percent of Total Billed Charges	181.11	87.95	Percent of Total Billed Charges	169.88	82.5	154.44	205.92
HALOPERIDOL 5 MG/1 VIAL	J1630	HCPCS	636	RC		both	1.44	1.08	Percent of Total Billed Charges	1.37	95.2	Percent of Total Billed Charges	1.27	87.95	Percent of Total Billed Charges	1.19	82.5	1.08	1.44
HEPARIN SODIUM FLUSH 500 UNITS/1 EACH (10 UNITS)	J1642	HCPCS	636	RC		both	0.72	0.54	Percent of Total Billed Charges	0.69	95.2	Percent of Total Billed Charges	0.63	87.95	Percent of Total Billed Charges	0.59	82.5	0.54	0.72
HEPARIN SODIUM 10000 UNIT/1 VIAL (1000 UNITS)	J1644	HCPCS	636	RC		both	1.32	0.99	Percent of Total Billed Charges	1.26	95.2	Percent of Total Billed Charges	1.16	87.95	Percent of Total Billed Charges	1.09	82.5	0.99	1.32
MAGNESIUM SULFATE 50% 1 GM/1 VIAL (500 MG)	J3475	HCPCS	636	RC		both	0.95	0.71	Percent of Total Billed Charges	0.9	95.2	Percent of Total Billed Charges	0.84	87.95	Percent of Total Billed Charges	0.78	82.5	0.71	0.95
NALOXONE HCL 2 MG/1 SYRINGE (1 MG)	J2310	HCPCS	636	RC		both	39.6	29.7	Percent of Total Billed Charges	37.7	95.2	Percent of Total Billed Charges	34.83	87.95	Percent of Total Billed Charges	32.67	82.5	29.7	39.6
"Penicillin G Potassium 5 MM/1 VIAL (600,000 UNITS)"	J2540	HCPCS	636	RC		both	14.47	10.85	Percent of Total Billed Charges	13.78	95.2	Percent of Total Billed Charges	12.73	87.95	Percent of Total Billed Charges	11.94	82.5	10.85	14.47
METOCLOPRAMIDE 10 MG/2 ML VIAL	J2765	HCPCS	636	RC		both	1.33	1	Percent of Total Billed Charges	1.27	95.2	Percent of Total Billed Charges	1.17	87.95	Percent of Total Billed Charges	1.1	82.5	1	1.33
SOLU-MEDROL 40 MG(METHYLPREDNISOLONE)/1 VIAL	J2920	HCPCS	636	RC		both	5.89	4.42	Percent of Total Billed Charges	5.61	95.2	Percent of Total Billed Charges	5.18	87.95	Percent of Total Billed Charges	4.86	82.5	4.42	5.89
Kenalog-40 200 MG/VIAL (10 MG)	J3301	HCPCS	636	RC		both	7	5.25	Percent of Total Billed Charges	6.66	95.2	Percent of Total Billed Charges	6.16	87.95	Percent of Total Billed Charges	5.78	82.5	5.25	7
CEFTRIAXONE 1 GM VIAL (250 MG)	J0696	HCPCS	636	RC		both	23	17.25	Percent of Total Billed Charges	21.9	95.2	Percent of Total Billed Charges	20.23	87.95	Percent of Total Billed Charges	18.98	82.5	17.25	23
HUMALOG 100 UNIT/1 ML (5 UNITS)	J1815	HCPCS	636	RC		both	4.95	3.71	Percent of Total Billed Charges	4.71	95.2	Percent of Total Billed Charges	4.35	87.95	Percent of Total Billed Charges	4.08	82.5	3.71	4.95
MORPHINE SULFATE 4 MG/ML VIAL	J2270	HCPCS	636	RC		both	2.26	1.7	Percent of Total Billed Charges	2.15	95.2	Percent of Total Billed Charges	1.99	87.95	Percent of Total Billed Charges	1.86	82.5	1.7	2.26
DIAZEPAM 10 MG/1 SYRINGE (5 MG)	J3360	HCPCS	636	RC		both	27.47	20.6	Percent of Total Billed Charges	26.15	95.2	Percent of Total Billed Charges	24.16	87.95	Percent of Total Billed Charges	22.66	82.5	20.6	27.47
HYDROXYZINE HCL 25 MG/1 VIAL	J3410	HCPCS	636	RC		both	5.31	3.98	Percent of Total Billed Charges	5.06	95.2	Percent of Total Billed Charges	4.67	87.95	Percent of Total Billed Charges	4.38	82.5	3.98	5.31
AZITHROMYCIN I.V. 500 MG VIAL	J0456	HCPCS	636	RC		both	8.91	6.68	Percent of Total Billed Charges	8.48	95.2	Percent of Total Billed Charges	7.84	87.95	Percent of Total Billed Charges	7.35	82.5	6.68	8.91
ENOXAPARIN SODIUM 40 MG/1 SYRINGE (10 MG)	J1650	HCPCS	636	RC		both	6.4	4.8	Percent of Total Billed Charges	6.09	95.2	Percent of Total Billed Charges	5.63	87.95	Percent of Total Billed Charges	5.28	82.5	4.8	6.4
LEVOFLOXACIN / DEXTROSE 5% PIGGYBACK 500 MG/1 EACH (250 MG)	J1956	HCPCS	636	RC		both	7.34	5.51	Percent of Total Billed Charges	6.99	95.2	Percent of Total Billed Charges	6.46	87.95	Percent of Total Billed Charges	6.06	82.5	5.51	7.34
FUROSEMIDE 20 MG/1 VIAL	J1940	HCPCS	636	RC		both	4.94	3.71	Percent of Total Billed Charges	4.7	95.2	Percent of Total Billed Charges	4.34	87.95	Percent of Total Billed Charges	4.08	82.5	3.71	4.94
VITAMIN K-1 10 MG/ML AMPUL (1 MG)	J3430	HCPCS	636	RC		both	45.32	33.99	Percent of Total Billed Charges	43.14	95.2	Percent of Total Billed Charges	39.86	87.95	Percent of Total Billed Charges	37.39	82.5	33.99	45.32
PIPERACIL-TAZOBACT  3.375 GM VIAL (1 G/0.125 G)	J2543	HCPCS	636	RC		both	3.43	2.57	Percent of Total Billed Charges	3.27	95.2	Percent of Total Billed Charges	3.02	87.95	Percent of Total Billed Charges	2.83	82.5	2.57	3.43
SOLU-MEDROL (METHYLPREDNISOLONE)125 MG/1 VIAL	J2919	HCPCS	636	RC		both	10	7.5	Percent of Total Billed Charges	9.52	95.2	Percent of Total Billed Charges	8.8	87.95	Percent of Total Billed Charges	8.25	82.5	7.5	10
GENTAMICIN 80 MG/1 VIAL	J1580	HCPCS	636	RC		both	3.88	2.91	Percent of Total Billed Charges	3.69	95.2	Percent of Total Billed Charges	3.41	87.95	Percent of Total Billed Charges	3.2	82.5	2.91	3.88
TENECTEPLASE 50 MG/1 EACH (1 MG) 50242-0120-47	J3101	HCPCS	636	RC		both	254	190.5	Percent of Total Billed Charges	241.81	95.2	Percent of Total Billed Charges	223.39	87.95	Percent of Total Billed Charges	209.55	82.5	190.5	254
ADENOCARD 6 MG/2 ML SYRINGE	J0153	HCPCS	636	RC		both	32	24	Percent of Total Billed Charges	30.46	95.2	Percent of Total Billed Charges	28.14	87.95	Percent of Total Billed Charges	26.4	82.5	24	32
AMPICILIN SODIUM / SULBACTAM 1.50 GM/1 VIA	J0295	HCPCS	636	RC		both	22	16.5	Percent of Total Billed Charges	20.94	95.2	Percent of Total Billed Charges	19.35	87.95	Percent of Total Billed Charges	18.15	82.5	16.5	22
LORAZEPAM 2 MG/ML VIAL	J2060	HCPCS	636	RC		both	2.17	1.63	Percent of Total Billed Charges	2.07	95.2	Percent of Total Billed Charges	1.91	87.95	Percent of Total Billed Charges	1.79	82.5	1.63	2.17
METRONIDAZOLE 500 MG/100 ML (00338-9541-24)	J1836	HCPCS	636	RC		both	2.17	1.63	Percent of Total Billed Charges	2.07	95.2	Percent of Total Billed Charges	1.91	87.95	Percent of Total Billed Charges	1.79	82.5	1.63	2.17
KETOROLAC TROMETHAMINE 30 MG/1 VIAL (15 MG)	J1885	HCPCS	636	RC		both	1.8	1.35	Percent of Total Billed Charges	1.71	95.2	Percent of Total Billed Charges	1.58	87.95	Percent of Total Billed Charges	1.49	82.5	1.35	1.8
CYANOCOBALAMIN 1000 MCG/1 VIAL	J3420	HCPCS	636	RC		both	1	0.75	Percent of Total Billed Charges	0.95	95.2	Percent of Total Billed Charges	0.88	87.95	Percent of Total Billed Charges	0.83	82.5	0.75	1
DIPHENHYDRAMINE HCL 50 MG/1 VIAL	J1200	HCPCS	636	RC		both	25	18.75	Percent of Total Billed Charges	23.8	95.2	Percent of Total Billed Charges	21.99	87.95	Percent of Total Billed Charges	20.63	82.5	18.75	25
ZYVOX 600 MG/300 ML IV SOLN (200 MG)	J2020	HCPCS	636	RC		both	38	28.5	Percent of Total Billed Charges	36.18	95.2	Percent of Total Billed Charges	33.42	87.95	Percent of Total Billed Charges	31.35	82.5	28.5	38
PREDNISOLONE OS 15 MG/5 ML (5 MG)	J7510	HCPCS	636	RC		both	2.41	1.81	Percent of Total Billed Charges	2.29	95.2	Percent of Total Billed Charges	2.12	87.95	Percent of Total Billed Charges	1.99	82.5	1.81	2.41
Lantus Subcutaneous 100 unit/mL (5 UNITS)	J1815	HCPCS	636	RC		both	1.62	1.22	Percent of Total Billed Charges	1.54	95.2	Percent of Total Billed Charges	1.42	87.95	Percent of Total Billed Charges	1.34	82.5	1.22	1.62
CEFEPIME HCL 1 GM VIAL (500 MG)	J0692	HCPCS	636	RC		both	25.41	19.06	Percent of Total Billed Charges	24.19	95.2	Percent of Total Billed Charges	22.35	87.95	Percent of Total Billed Charges	20.96	82.5	19.06	25.41
SUMATRIPTAN 6 MG/1 VIAL	J3030	HCPCS	636	RC		both	122.5	91.88	Percent of Total Billed Charges	116.62	95.2	Percent of Total Billed Charges	107.74	87.95	Percent of Total Billed Charges	101.06	82.5	91.88	122.5
ONDANSETRON HCL 4 MG/2 ML VIAL (1 MG)	J2405	HCPCS	636	RC		both	0.29	0.22	Percent of Total Billed Charges	0.28	95.2	Percent of Total Billed Charges	0.26	87.95	Percent of Total Billed Charges	0.24	82.5	0.22	0.29
HYDROMORPHONE HCL 2 MG/1 VIAL (00641-6151-01)	J1170	HCPCS	636	RC		both	14	10.5	Percent of Total Billed Charges	13.33	95.2	Percent of Total Billed Charges	12.31	87.95	Percent of Total Billed Charges	11.55	82.5	10.5	14
THIAMINE HCL 200 MG/1 VIAL (100 MG)	J3411	HCPCS	636	RC		both	12.44	9.33	Percent of Total Billed Charges	11.84	95.2	Percent of Total Billed Charges	10.94	87.95	Percent of Total Billed Charges	10.26	82.5	9.33	12.44
ENOXAPARIN SODIUM 30 MG/1 SYRINGE (10 MG)	J1650	HCPCS	636	RC		both	26.76	20.07	Percent of Total Billed Charges	25.48	95.2	Percent of Total Billed Charges	23.54	87.95	Percent of Total Billed Charges	22.08	82.5	20.07	26.76
HEPARIN SODIUM 1000 UNITS/1 VIAL	J1644	HCPCS	636	RC		both	2.88	2.16	Percent of Total Billed Charges	2.74	95.2	Percent of Total Billed Charges	2.53	87.95	Percent of Total Billed Charges	2.38	82.5	2.16	2.88
ENOXAPARIN SODIUM 100 MG/1 SYRINGE (10 MG)	J1650	HCPCS	636	RC		both	6	4.5	Percent of Total Billed Charges	5.71	95.2	Percent of Total Billed Charges	5.28	87.95	Percent of Total Billed Charges	4.95	82.5	4.5	6
LOVENOX 30MG/0.3ML SYRINGE (10ML)	J1650	HCPCS	636	RC		both	8	6	Percent of Total Billed Charges	7.62	95.2	Percent of Total Billed Charges	7.04	87.95	Percent of Total Billed Charges	6.6	82.5	6	8
"Lovenox 60 MG/0.6 ML SYRINGE 1 mL, 0.6 mL"	J1650	HCPCS	636	RC		both	6.41	4.81	Percent of Total Billed Charges	6.1	95.2	Percent of Total Billed Charges	5.64	87.95	Percent of Total Billed Charges	5.29	82.5	4.81	6.41
CATHFLO ACTIVASE 2MG VIAL (1 MG)	J2997	HCPCS	636	RC		both	184	138	Percent of Total Billed Charges	175.17	95.2	Percent of Total Billed Charges	161.83	87.95	Percent of Total Billed Charges	151.8	82.5	138	184
AMIODARONE 150 MG/3 ML VIAL (30 MG)	J0282	HCPCS	636	RC		both	0.34	0.26	Percent of Total Billed Charges	0.32	95.2	Percent of Total Billed Charges	0.3	87.95	Percent of Total Billed Charges	0.28	82.5	0.26	0.34
ATROPINE SULFATE 1 MG/1 SYRINGE	J0461	HCPCS	636	RC		both	1	0.75	Percent of Total Billed Charges	0.95	95.2	Percent of Total Billed Charges	0.88	87.95	Percent of Total Billed Charges	0.83	82.5	0.75	1
SODIUM CHLORIDE 0.9% 1000 ML/1 EACH	J7030	HCPCS	636	RC		both	14	10.5	Percent of Total Billed Charges	13.33	95.2	Percent of Total Billed Charges	12.31	87.95	Percent of Total Billed Charges	11.55	82.5	10.5	14
DEXTROSE 5%-0.9% NACL IV SOLN (500 ML)	J7042	HCPCS	636	RC		both	3.15	2.36	Percent of Total Billed Charges	3	95.2	Percent of Total Billed Charges	2.77	87.95	Percent of Total Billed Charges	2.6	82.5	2.36	3.15
LACTATED RINGERS SOLUTION 1000 ML	J7120	HCPCS	636	RC		both	1.9	1.43	Percent of Total Billed Charges	1.81	95.2	Percent of Total Billed Charges	1.67	87.95	Percent of Total Billed Charges	1.57	82.5	1.43	1.9
DOPAMINE HCL / D5W PIGGYBACK 400 MG/1 EACH (40 MG)	J1265	HCPCS	636	RC		both	15.54	11.66	Percent of Total Billed Charges	14.79	95.2	Percent of Total Billed Charges	13.67	87.95	Percent of Total Billed Charges	12.82	82.5	11.66	15.54
FENTANYL 100 MCG/2 ML VIAL	J3010	HCPCS	636	RC		both	1.51	1.13	Percent of Total Billed Charges	1.44	95.2	Percent of Total Billed Charges	1.33	87.95	Percent of Total Billed Charges	1.25	82.5	1.13	1.51
Humulin R per 5 units	J1815	HCPCS	636	RC		both	35	26.25	Percent of Total Billed Charges	33.32	95.2	Percent of Total Billed Charges	30.78	87.95	Percent of Total Billed Charges	28.88	82.5	26.25	35
"EPINEPHRINE 1:10,000 1 MG/1 SYRINGE (0.1 MG)"	J0171	HCPCS	636	RC		both	7.2	5.4	Percent of Total Billed Charges	6.85	95.2	Percent of Total Billed Charges	6.33	87.95	Percent of Total Billed Charges	5.94	82.5	5.4	7.2
POTASSIUM CHLORIDE PIGGYBACK 10 MEQ/100 ML (2 MEQ)	J3480	HCPCS	636	RC		both	3.17	2.38	Percent of Total Billed Charges	3.02	95.2	Percent of Total Billed Charges	2.79	87.95	Percent of Total Billed Charges	2.62	82.5	2.38	3.17
DOBUTAMINE HCL / D5W PIGGYBACK 250 MG/1 EACH	J1250	HCPCS	636	RC		both	11.09	8.32	Percent of Total Billed Charges	10.56	95.2	Percent of Total Billed Charges	9.75	87.95	Percent of Total Billed Charges	9.15	82.5	8.32	11.09
SOLU-MEDROL 1 G (1000 MG) VIAL	J2930	HCPCS	636	RC		both	44.33	33.25	Percent of Total Billed Charges	42.2	95.2	Percent of Total Billed Charges	38.99	87.95	Percent of Total Billed Charges	36.57	82.5	33.25	44.33
LIDOCAINE HCL / D5W PIGGYBACK 2 G/1 EACH (10 MG)	J2001	HCPCS	636	RC		both	7.38	5.54	Percent of Total Billed Charges	7.03	95.2	Percent of Total Billed Charges	6.49	87.95	Percent of Total Billed Charges	6.09	82.5	5.54	7.38
INFED 100 MG/1 VIAL (50 MG)	J1750	HCPCS	636	RC		both	28.86	21.65	Percent of Total Billed Charges	27.47	95.2	Percent of Total Billed Charges	25.38	87.95	Percent of Total Billed Charges	23.81	82.5	21.65	28.86
HYDRALAZINE HCL 20 MG/1 VIAL	J0360	HCPCS	636	RC		both	127.73	95.8	Percent of Total Billed Charges	121.6	95.2	Percent of Total Billed Charges	112.34	87.95	Percent of Total Billed Charges	105.38	82.5	95.8	127.73
DEXTROSE 5%-WATER IV SOLN	J7060	HCPCS	636	RC		both	1.53	1.15	Percent of Total Billed Charges	1.46	95.2	Percent of Total Billed Charges	1.35	87.95	Percent of Total Billed Charges	1.26	82.5	1.15	1.53
CIPROFLOXACIN-D5W 400 MG/200 ML (200 MG)	J0744	HCPCS	636	RC		both	10.48	7.86	Percent of Total Billed Charges	9.98	95.2	Percent of Total Billed Charges	9.22	87.95	Percent of Total Billed Charges	8.65	82.5	7.86	10.48
LEVOFLOXACIN / DEXTROSE 5% PIGGYBACK 250 MG/1 EACH	J1956	HCPCS	636	RC		both	8.4	6.3	Percent of Total Billed Charges	8	95.2	Percent of Total Billed Charges	7.39	87.95	Percent of Total Billed Charges	6.93	82.5	6.3	8.4
"DOBUTamine 250 MG/20 ML VIAL 250 mg, 20 mL (250 mg)"	J1250	HCPCS	636	RC		both	16.65	12.49	Percent of Total Billed Charges	15.85	95.2	Percent of Total Billed Charges	14.64	87.95	Percent of Total Billed Charges	13.74	82.5	12.49	16.65
"levoFLOXacin 750 MG/150 ML-D5W 1 ea, 150 mL"	J1956	HCPCS	636	RC		both	6.5	4.88	Percent of Total Billed Charges	6.19	95.2	Percent of Total Billed Charges	5.72	87.95	Percent of Total Billed Charges	5.36	82.5	4.88	6.5
"SYNVISC-ONE SYRINGE 1 mg, 6 mL"	J7325	HCPCS	636	RC		both	69.01	51.76	Percent of Total Billed Charges	65.7	95.2	Percent of Total Billed Charges	60.69	87.95	Percent of Total Billed Charges	56.93	82.5	51.76	69.01
"MEROPENEM IV 1 GRAM VIAL (100 mg), 1 each (00409-3412-10)"	J2185	HCPCS	636	RC		both	6	4.5	Percent of Total Billed Charges	5.71	95.2	Percent of Total Billed Charges	5.28	87.95	Percent of Total Billed Charges	4.95	82.5	4.5	6
"VENOFER 100 MG/5 ML VIAL 1 mg, 5 mL"	J1756	HCPCS	636	RC		both	1.32	0.99	Percent of Total Billed Charges	1.26	95.2	Percent of Total Billed Charges	1.16	87.95	Percent of Total Billed Charges	1.09	82.5	0.99	1.32
"ZIPRASIDONE 20 MG/ML VIAL 10 mcg, 1 each"	J3486	HCPCS	636	RC		both	56.4	42.3	Percent of Total Billed Charges	53.69	95.2	Percent of Total Billed Charges	49.6	87.95	Percent of Total Billed Charges	46.53	82.5	42.3	56.4
"RITUXAN 500 MG/50 ML VIAL 50 mg, 50 mL"	J9312	HCPCS	636	RC		both	146.56	109.92	Percent of Total Billed Charges	139.53	95.2	Percent of Total Billed Charges	128.9	87.95	Percent of Total Billed Charges	120.91	82.5	109.92	146.56
"REMICADE 100 MG VIAL, 10 mg"	J1745	HCPCS	636	RC		both	238.23	178.67	Percent of Total Billed Charges	226.79	95.2	Percent of Total Billed Charges	209.52	87.95	Percent of Total Billed Charges	196.54	82.5	178.67	238.23
"LIDOCAINE HCL 2% 100 MG/5 ML 10 mg, 5 mL"	J2001	HCPCS	636	RC		both	1.44	1.08	Percent of Total Billed Charges	1.37	95.2	Percent of Total Billed Charges	1.27	87.95	Percent of Total Billed Charges	1.19	82.5	1.08	1.44
"SODIUM CHLORIDE 3% IV SOLN 1 mL, 500 mL"	J7131	HCPCS	636	RC		both	0.04	0.03	Percent of Total Billed Charges	0.04	95.2	Percent of Total Billed Charges	0.04	87.95	Percent of Total Billed Charges	0.03	82.5	0.03	0.04
"CALCIUM GLUC 1,000MG/50ML-NACL 10 mL, 50 mL"	J0610	HCPCS	636	RC		both	11.85	8.89	Percent of Total Billed Charges	11.28	95.2	Percent of Total Billed Charges	10.42	87.95	Percent of Total Billed Charges	9.78	82.5	8.89	11.85
"protamine 10 MG/ML VIAL 10 mg, 25 mL"	J2720	HCPCS	636	RC		both	3.54	2.66	Percent of Total Billed Charges	3.37	95.2	Percent of Total Billed Charges	3.11	87.95	Percent of Total Billed Charges	2.92	82.5	2.66	3.54
"Pitocin 10 UNIT/ML VIAL 10 unit, 1 mL"	J2590	HCPCS	636	RC		both	10.8	8.1	Percent of Total Billed Charges	10.28	95.2	Percent of Total Billed Charges	9.5	87.95	Percent of Total Billed Charges	8.91	82.5	8.1	10.8
"ADMELOG 100 UNIT/ML VIAL 5 unit, 3 mL"	J1815	HCPCS	636	RC		both	1.57	1.18	Percent of Total Billed Charges	1.49	95.2	Percent of Total Billed Charges	1.38	87.95	Percent of Total Billed Charges	1.3	82.5	1.18	1.57
"PRIVIGEN 10% VIAL 500 mg, 400 mL"	J1459	HCPCS	636	RC		both	113.1	84.83	Percent of Total Billed Charges	107.67	95.2	Percent of Total Billed Charges	99.47	87.95	Percent of Total Billed Charges	93.31	82.5	84.83	113.1
"ATROPINE 0.4 MG/ML VIAL 1 mg, 1 mL"	J0461	HCPCS	636	RC		both	0.9	0.68	Percent of Total Billed Charges	0.86	95.2	Percent of Total Billed Charges	0.79	87.95	Percent of Total Billed Charges	0.74	82.5	0.68	0.9
"cefTAZidime 2 GM VIAL 500 mg, 1 each"	J0713	HCPCS	636	RC		both	7.5	5.63	Percent of Total Billed Charges	7.14	95.2	Percent of Total Billed Charges	6.6	87.95	Percent of Total Billed Charges	6.19	82.5	5.63	7.5
"morphine SULFATE 2 MG/ML VIAL 2 mg, 1 mL"	J2270	HCPCS	636	RC		both	14	10.5	Percent of Total Billed Charges	13.33	95.2	Percent of Total Billed Charges	12.31	87.95	Percent of Total Billed Charges	11.55	82.5	10.5	14
"ketorolac 30 MG/ML SYRINGE 30 mg, 1 mL"	J1885	HCPCS	636	RC		both	8	6	Percent of Total Billed Charges	7.62	95.2	Percent of Total Billed Charges	7.04	87.95	Percent of Total Billed Charges	6.6	82.5	6	8
TEFLARO 400 MG VIAL	J0712	HCPCS	636	RC		both	10	7.5	Percent of Total Billed Charges	9.52	95.2	Percent of Total Billed Charges	8.8	87.95	Percent of Total Billed Charges	8.25	82.5	7.5	10
PROMETHAZINE 50MG/ML	J2550	HCPCS	636	RC		both	12	9	Percent of Total Billed Charges	11.42	95.2	Percent of Total Billed Charges	10.55	87.95	Percent of Total Billed Charges	9.9	82.5	9	12
CLONIDINE 1000MCG/10ML	J0735	HCPCS	636	RC		both	63	47.25	Percent of Total Billed Charges	59.98	95.2	Percent of Total Billed Charges	55.41	87.95	Percent of Total Billed Charges	51.98	82.5	47.25	63
DILAUDID 2MG/ML SYRINGE	J1170	HCPCS	636	RC		both	20	15	Percent of Total Billed Charges	19.04	95.2	Percent of Total Billed Charges	17.59	87.95	Percent of Total Billed Charges	16.5	82.5	15	20
HYDROMORPHONE 2MG/ML CARPUJCT	J1170	HCPCS	636	RC		both	15	11.25	Percent of Total Billed Charges	14.28	95.2	Percent of Total Billed Charges	13.19	87.95	Percent of Total Billed Charges	12.38	82.5	11.25	15
DAMETHASONE 10MG/ML (63323-0506-01)	J1100	HCPCS	636	RC		both	23	17.25	Percent of Total Billed Charges	21.9	95.2	Percent of Total Billed Charges	20.23	87.95	Percent of Total Billed Charges	18.98	82.5	17.25	23
CELIAN REFLEX CASCADE	82784	HCPCS	300	RC		both	29	21.75	Percent of Total Billed Charges	27.61	95.2	Percent of Total Billed Charges	25.51	87.95	Percent of Total Billed Charges	23.93	82.5	21.75	29
THYROTROPIN RECP AB	83520	HCPCS	300	RC		both	135	101.25	Percent of Total Billed Charges	128.52	95.2	Percent of Total Billed Charges	118.73	87.95	Percent of Total Billed Charges	111.38	82.5	101.25	135
LOVENOX 120MG/0.8ML SYRINGE (00075-8022-10)	J1650	HCPCS	636	RC		both	5	3.75	Percent of Total Billed Charges	4.76	95.2	Percent of Total Billed Charges	4.4	87.95	Percent of Total Billed Charges	4.13	82.5	3.75	5
ZERBAXA 1.5G VIAL (67919-0030-01)	J0695	HCPCS	636	RC		both	15	11.25	Percent of Total Billed Charges	14.28	95.2	Percent of Total Billed Charges	13.19	87.95	Percent of Total Billed Charges	12.38	82.5	11.25	15
ROPIVACAINE 0.5% 150 MG/30 ML	J2795	HCPCS	636	RC		both	1	0.75	Percent of Total Billed Charges	0.95	95.2	Percent of Total Billed Charges	0.88	87.95	Percent of Total Billed Charges	0.83	82.5	0.75	1
"CELESTONE SOLUSPAN 30 MG/5 ML 1 mg, 5 mL"	J0702	HCPCS	636	RC		both	9	6.75	Percent of Total Billed Charges	8.57	95.2	Percent of Total Billed Charges	7.92	87.95	Percent of Total Billed Charges	7.43	82.5	6.75	9
"LACTATED RINGERS INJECTION 500 mL, 500 mL"	J7120	HCPCS	636	RC		both	1	0.75	Percent of Total Billed Charges	0.95	95.2	Percent of Total Billed Charges	0.88	87.95	Percent of Total Billed Charges	0.83	82.5	0.75	1
"methylPREDNISolone 40 MG/ML VL 40 mg, 1 mL"	J1010	HCPCS	636	RC		both	29	21.75	Percent of Total Billed Charges	27.61	95.2	Percent of Total Billed Charges	25.51	87.95	Percent of Total Billed Charges	23.93	82.5	21.75	29
RED BLOOD CELLS	P9016	HCPCS	390	RC		both	543	407.25	Percent of Total Billed Charges	516.94	95.2	Percent of Total Billed Charges	477.57	87.95	Percent of Total Billed Charges	447.98	82.5	407.25	543
BODY FLUID CYTOLOGY	88108	HCPCS	311	RC		both	182	136.5	Percent of Total Billed Charges	173.26	95.2	Percent of Total Billed Charges	160.07	87.95	Percent of Total Billed Charges	150.15	82.5	136.5	182
CYTOPATHOLOGY NON-GYN	88104	HCPCS	311	RC		both	75	56.25	Percent of Total Billed Charges	71.4	95.2	Percent of Total Billed Charges	65.96	87.95	Percent of Total Billed Charges	61.88	82.5	56.25	75
BLOOD CULTURE ID PCR	87150	HCPCS	306	RC		both	166	124.5	Percent of Total Billed Charges	158.03	95.2	Percent of Total Billed Charges	146	87.95	Percent of Total Billed Charges	136.95	82.5	124.5	166
BROCCOLI IGE	86003	HCPCS	302	RC		both	77	57.75	Percent of Total Billed Charges	73.3	95.2	Percent of Total Billed Charges	67.72	87.95	Percent of Total Billed Charges	63.53	82.5	57.75	77
CASHEW IGE	86003	HCPCS	302	RC		both	67	50.25	Percent of Total Billed Charges	63.78	95.2	Percent of Total Billed Charges	58.93	87.95	Percent of Total Billed Charges	55.28	82.5	50.25	67
COW CASEIN	86003	HCPCS	302	RC		both	60	45	Percent of Total Billed Charges	57.12	95.2	Percent of Total Billed Charges	52.77	87.95	Percent of Total Billed Charges	49.5	82.5	45	60
GINGER IGE	86003	HCPCS	302	RC		both	119	89.25	Percent of Total Billed Charges	113.29	95.2	Percent of Total Billed Charges	104.66	87.95	Percent of Total Billed Charges	98.18	82.5	89.25	119
LETTUCE IGE	86003	HCPCS	302	RC		both	60	45	Percent of Total Billed Charges	57.12	95.2	Percent of Total Billed Charges	52.77	87.95	Percent of Total Billed Charges	49.5	82.5	45	60
PISTACHIO IGE	86003	HCPCS	302	RC		both	67	50.25	Percent of Total Billed Charges	63.78	95.2	Percent of Total Billed Charges	58.93	87.95	Percent of Total Billed Charges	55.28	82.5	50.25	67
"ENTEROVIRUS RNA BY PCR, SERUM"	87498	HCPCS	300	RC		both	323	242.25	Percent of Total Billed Charges	307.5	95.2	Percent of Total Billed Charges	284.08	87.95	Percent of Total Billed Charges	266.48	82.5	242.25	323
"EIA CLOSTRIDIUM DIFFICIL, PCR"	87324	HCPCS	300	RC		both	48	36	Percent of Total Billed Charges	45.7	95.2	Percent of Total Billed Charges	42.22	87.95	Percent of Total Billed Charges	39.6	82.5	36	48
INFECTIOUS AGENT ANTIGEN	87449	HCPCS	300	RC		both	58	43.5	Percent of Total Billed Charges	55.22	95.2	Percent of Total Billed Charges	51.01	87.95	Percent of Total Billed Charges	47.85	82.5	43.5	58
"RESPIRATORY VIRUS, MULTIPLE TYPES"	87633	HCPCS	300	RC		both	368	276	Percent of Total Billed Charges	350.34	95.2	Percent of Total Billed Charges	323.66	87.95	Percent of Total Billed Charges	303.6	82.5	276	368
BACTERIAL SENSITIVITY	87186	HCPCS	300	RC		both	29	21.75	Percent of Total Billed Charges	27.61	95.2	Percent of Total Billed Charges	25.51	87.95	Percent of Total Billed Charges	23.93	82.5	21.75	29
BLOOD DRAW FROM PORT	36591	HCPCS	300	RC		both	59	44.25	Percent of Total Billed Charges	56.17	95.2	Percent of Total Billed Charges	51.89	87.95	Percent of Total Billed Charges	48.68	82.5	44.25	59
PNEUMOCYSTIS JIROVECII BY PCR	87798	HCPCS	300	RC		both	645	483.75	Percent of Total Billed Charges	614.04	95.2	Percent of Total Billed Charges	567.28	87.95	Percent of Total Billed Charges	532.13	82.5	483.75	645
"SYPHILLIS ANTIBODIES, IGG"	86780	HCPCS	300	RC		both	83	62.25	Percent of Total Billed Charges	79.02	95.2	Percent of Total Billed Charges	73	87.95	Percent of Total Billed Charges	68.48	82.5	62.25	83
BLOOD ARSENIC	82175	HCPCS	301	RC		both	144	108	Percent of Total Billed Charges	137.09	95.2	Percent of Total Billed Charges	126.65	87.95	Percent of Total Billed Charges	118.8	82.5	108	144
PARANEOPLASTIC ANTIBODY	86255	HCPCS	300	RC		both	188	141	Percent of Total Billed Charges	178.98	95.2	Percent of Total Billed Charges	165.35	87.95	Percent of Total Billed Charges	155.1	82.5	141	188
PARANEOPLASTIC ANTIBODY PANEL	83516	HCPCS	302	RC		both	188	141	Percent of Total Billed Charges	178.98	95.2	Percent of Total Billed Charges	165.35	87.95	Percent of Total Billed Charges	155.1	82.5	141	188
UA DIPSTICK	81002	HCPCS	307	RC	QW	both	23	17.25	Percent of Total Billed Charges	21.9	95.2	Percent of Total Billed Charges	20.23	87.95	Percent of Total Billed Charges	18.98	82.5	17.25	23
HTLV 1	86689	HCPCS	300	RC		both	53	39.75	Percent of Total Billed Charges	50.46	95.2	Percent of Total Billed Charges	46.61	87.95	Percent of Total Billed Charges	43.73	82.5	39.75	53
HTLV 2	86790	HCPCS	300	RC		both	53	39.75	Percent of Total Billed Charges	50.46	95.2	Percent of Total Billed Charges	46.61	87.95	Percent of Total Billed Charges	43.73	82.5	39.75	53
"CALPROTECTIN, FECAL"	83993	HCPCS	300	RC		both	579	434.25	Percent of Total Billed Charges	551.21	95.2	Percent of Total Billed Charges	509.23	87.95	Percent of Total Billed Charges	477.68	82.5	434.25	579
FEDERAL EXPRESS CHGS	99001	HCPCS	300	RC		both	85	63.75	Percent of Total Billed Charges	80.92	95.2	Percent of Total Billed Charges	74.76	87.95	Percent of Total Billed Charges	70.13	82.5	63.75	85
STREP PNEUMOCCAL AB TITER	86317	HCPCS	302	RC		both	9	6.75	Percent of Total Billed Charges	8.57	95.2	Percent of Total Billed Charges	7.92	87.95	Percent of Total Billed Charges	7.43	82.5	6.75	9
DIPTHERIA AB	86317	HCPCS	302	RC		both	129	96.75	Percent of Total Billed Charges	122.81	95.2	Percent of Total Billed Charges	113.46	87.95	Percent of Total Billed Charges	106.43	82.5	96.75	129
TETANUS AB	86317	HCPCS	302	RC		both	127	95.25	Percent of Total Billed Charges	120.9	95.2	Percent of Total Billed Charges	111.7	87.95	Percent of Total Billed Charges	104.78	82.5	95.25	127
"AMINO ACIDS QUANT, PLASMA"	82139	HCPCS	300	RC		both	540	405	Percent of Total Billed Charges	514.08	95.2	Percent of Total Billed Charges	474.93	87.95	Percent of Total Billed Charges	445.5	82.5	405	540
NATURAL KILLER CELLS	86357	HCPCS	302	RC		both	109	81.75	Percent of Total Billed Charges	103.77	95.2	Percent of Total Billed Charges	95.87	87.95	Percent of Total Billed Charges	89.93	82.5	81.75	109
LACOSAMIDE (VIMPAT) LEVEL	80339	HCPCS	301	RC		both	146	109.5	Percent of Total Billed Charges	138.99	95.2	Percent of Total Billed Charges	128.41	87.95	Percent of Total Billed Charges	120.45	82.5	109.5	146
"BILIRUBIN, DIRECT (IN-HOUSE)"	82248	HCPCS	301	RC		both	24	18	Percent of Total Billed Charges	22.85	95.2	Percent of Total Billed Charges	21.11	87.95	Percent of Total Billed Charges	19.8	82.5	18	24
HEPATITIS A IGM	86709	HCPCS	300	RC		both	80	60	Percent of Total Billed Charges	76.16	95.2	Percent of Total Billed Charges	70.36	87.95	Percent of Total Billed Charges	66	82.5	60	80
ADH/VASOPRESSIN	84588	HCPCS	300	RC		both	197	147.75	Percent of Total Billed Charges	187.54	95.2	Percent of Total Billed Charges	173.26	87.95	Percent of Total Billed Charges	162.53	82.5	147.75	197
BK VIRUS QUANT	87799	HCPCS	300	RC		both	285	213.75	Percent of Total Billed Charges	271.32	95.2	Percent of Total Billed Charges	250.66	87.95	Percent of Total Billed Charges	235.13	82.5	213.75	285
"AMINO ACID URINE, QUANT"	82139	HCPCS	300	RC		both	484	363	Percent of Total Billed Charges	460.77	95.2	Percent of Total Billed Charges	425.68	87.95	Percent of Total Billed Charges	399.3	82.5	363	484
"HEPATITIS B CORE, IGM"	86705	HCPCS	300	RC		both	105	78.75	Percent of Total Billed Charges	99.96	95.2	Percent of Total Billed Charges	92.35	87.95	Percent of Total Billed Charges	86.63	82.5	78.75	105
PROCALCITONIN	84145	HCPCS	300	RC		both	121	90.75	Percent of Total Billed Charges	115.19	95.2	Percent of Total Billed Charges	106.42	87.95	Percent of Total Billed Charges	99.83	82.5	90.75	121
"FECAL FAT, QUALITATIVE"	82705	HCPCS	300	RC		both	47	35.25	Percent of Total Billed Charges	44.74	95.2	Percent of Total Billed Charges	41.34	87.95	Percent of Total Billed Charges	38.78	82.5	35.25	47
FECAL REDUCING SUBSTANCES	84376	HCPCS	300	RC		both	72	54	Percent of Total Billed Charges	68.54	95.2	Percent of Total Billed Charges	63.32	87.95	Percent of Total Billed Charges	59.4	82.5	54	72
GENE MUTATION DETECTION  JAK2 V617F	300	RC				both	1043	782.25	Percent of Total Billed Charges	992.94	95.2	Percent of Total Billed Charges	917.32	87.95	Percent of Total Billed Charges	860.48	82.5	782.25	1043
"SEROTONIN, WHOLE BLOOD"	84260	HCPCS	300	RC		both	222	166.5	Percent of Total Billed Charges	211.34	95.2	Percent of Total Billed Charges	195.25	87.95	Percent of Total Billed Charges	183.15	82.5	166.5	222
"STYCHNINE, SERUM"	300	RC				both	541	405.75	Percent of Total Billed Charges	515.03	95.2	Percent of Total Billed Charges	475.81	87.95	Percent of Total Billed Charges	446.33	82.5	405.75	541
PHOSPHOLIPASE A2 (PLA2R) AB	86255	HCPCS	300	RC		both	547	410.25	Percent of Total Billed Charges	520.74	95.2	Percent of Total Billed Charges	481.09	87.95	Percent of Total Billed Charges	451.28	82.5	410.25	547
PHOSPHOLIPASE A2 (PLA2R) AB	86256	HCPCS	300	RC		both	547	410.25	Percent of Total Billed Charges	520.74	95.2	Percent of Total Billed Charges	481.09	87.95	Percent of Total Billed Charges	451.28	82.5	410.25	547
TSH-ULTRA SENSITIVE	84443	HCPCS	300	RC		both	144	108	Percent of Total Billed Charges	137.09	95.2	Percent of Total Billed Charges	126.65	87.95	Percent of Total Billed Charges	118.8	82.5	108	144
CDPHE	87635	HCPCS	300	RC		both	162	121.5	Percent of Total Billed Charges	154.22	95.2	Percent of Total Billed Charges	142.48	87.95	Percent of Total Billed Charges	133.65	82.5	121.5	162
RESPIRATORY PATHOGEN PANEL	0202U	HCPCS	300	RC		both	432	324	Percent of Total Billed Charges	411.26	95.2	Percent of Total Billed Charges	379.94	87.95	Percent of Total Billed Charges	356.4	82.5	324	432
C-DIFF TOXIN DNA CONFIRMATION	87493	HCPCS	300	RC		both	179	134.25	Percent of Total Billed Charges	170.41	95.2	Percent of Total Billed Charges	157.43	87.95	Percent of Total Billed Charges	147.68	82.5	134.25	179
CDPHE-MEDICARE	U0001	HCPCS	300	RC		both	177	132.75	Percent of Total Billed Charges	168.5	95.2	Percent of Total Billed Charges	155.67	87.95	Percent of Total Billed Charges	146.03	82.5	132.75	177
"CYSTIC FIBROSIS PANEL, 165 VARIANTS"	81220	HCPCS	300	RC		both	419	314.25	Percent of Total Billed Charges	398.89	95.2	Percent of Total Billed Charges	368.51	87.95	Percent of Total Billed Charges	345.68	82.5	314.25	419
"LYSOZYME, SERUM"	85549	HCPCS	300	RC		both	143	107.25	Percent of Total Billed Charges	136.14	95.2	Percent of Total Billed Charges	125.77	87.95	Percent of Total Billed Charges	117.98	82.5	107.25	143
ESBL DETECTION	87184	HCPCS	300	RC		both	35	26.25	Percent of Total Billed Charges	33.32	95.2	Percent of Total Billed Charges	30.78	87.95	Percent of Total Billed Charges	28.88	82.5	26.25	35
"SMITH ENA AB, IGG"	86235	HCPCS	300	RC		both	96	72	Percent of Total Billed Charges	91.39	95.2	Percent of Total Billed Charges	84.43	87.95	Percent of Total Billed Charges	79.2	82.5	72	96
VITAMIN E SERUM	84446	HCPCS	300	RC		both	67	50.25	Percent of Total Billed Charges	63.78	95.2	Percent of Total Billed Charges	58.93	87.95	Percent of Total Billed Charges	55.28	82.5	50.25	67
LYME DISEASE BY PCR	87476	HCPCS	300	RC		both	165	123.75	Percent of Total Billed Charges	157.08	95.2	Percent of Total Billed Charges	145.12	87.95	Percent of Total Billed Charges	136.13	82.5	123.75	165
RBC ANTIGEN TYPING	86905	HCPCS	390	RC		both	968	726	Percent of Total Billed Charges	921.54	95.2	Percent of Total Billed Charges	851.36	87.95	Percent of Total Billed Charges	798.6	82.5	726	968
CMP (IN-HOUSE)	80053	HCPCS	300	RC		both	208	156	Percent of Total Billed Charges	198.02	95.2	Percent of Total Billed Charges	182.94	87.95	Percent of Total Billed Charges	171.6	82.5	156	208
BMP (IN-HOUSE)	80048	HCPCS	300	RC		both	169	126.75	Percent of Total Billed Charges	160.89	95.2	Percent of Total Billed Charges	148.64	87.95	Percent of Total Billed Charges	139.43	82.5	126.75	169
MAGNESIUM SERUM (IN-HOUSE)	83735	HCPCS	300	RC		both	111	83.25	Percent of Total Billed Charges	105.67	95.2	Percent of Total Billed Charges	97.62	87.95	Percent of Total Billed Charges	91.58	82.5	83.25	111
CRP (IN-HOUSE)	86140	HCPCS	300	RC		both	122	91.5	Percent of Total Billed Charges	116.14	95.2	Percent of Total Billed Charges	107.3	87.95	Percent of Total Billed Charges	100.65	82.5	91.5	122
LIPID (IN-HOUSE)	80061	HCPCS	300	RC		both	145	108.75	Percent of Total Billed Charges	138.04	95.2	Percent of Total Billed Charges	127.53	87.95	Percent of Total Billed Charges	119.63	82.5	108.75	145
RENAL PROFILE (IN-HOUSE)	80069	HCPCS	301	RC		both	293	219.75	Percent of Total Billed Charges	278.94	95.2	Percent of Total Billed Charges	257.69	87.95	Percent of Total Billed Charges	241.73	82.5	219.75	293
AMYLASE SERUM (IN-HOUSE)	82150	HCPCS	300	RC		both	111	83.25	Percent of Total Billed Charges	105.67	95.2	Percent of Total Billed Charges	97.62	87.95	Percent of Total Billed Charges	91.58	82.5	83.25	111
MOLECULAR PATHOLOGY TIER 2 (RBC PHENOTYPING)	81403	HCPCS	300	RC		both	620	465	Percent of Total Billed Charges	590.24	95.2	Percent of Total Billed Charges	545.29	87.95	Percent of Total Billed Charges	511.5	82.5	465	620
"ANTITHROMBIN, ANTIGEN (AT3)"	85301	HCPCS	300	RC		both	50	37.5	Percent of Total Billed Charges	47.6	95.2	Percent of Total Billed Charges	43.98	87.95	Percent of Total Billed Charges	41.25	82.5	37.5	50
URIC ACID SERUM (IN-HOUSE)	84550	HCPCS	300	RC		both	71	53.25	Percent of Total Billed Charges	67.59	95.2	Percent of Total Billed Charges	62.44	87.95	Percent of Total Billed Charges	58.58	82.5	53.25	71
LACTIC ACID (IN-HOUSE)	83605	HCPCS	300	RC		both	166	124.5	Percent of Total Billed Charges	158.03	95.2	Percent of Total Billed Charges	146	87.95	Percent of Total Billed Charges	136.95	82.5	124.5	166
CHLORIDE 24 HR URINE (IN-HOUSE)	82436	HCPCS	300	RC		both	103	77.25	Percent of Total Billed Charges	98.06	95.2	Percent of Total Billed Charges	90.59	87.95	Percent of Total Billed Charges	84.98	82.5	77.25	103
URINE ELECTROLYTES PANEL RANDOM  (IN-HOUSE)	80051	HCPCS	300	RC		both	25	18.75	Percent of Total Billed Charges	23.8	95.2	Percent of Total Billed Charges	21.99	87.95	Percent of Total Billed Charges	20.63	82.5	18.75	25
BUN SERUM (IN-HOUSE)	84520	HCPCS	300	RC		both	70	52.5	Percent of Total Billed Charges	66.64	95.2	Percent of Total Billed Charges	61.57	87.95	Percent of Total Billed Charges	57.75	82.5	52.5	70
BUN URINE RANDOM  (IN-HOUSE)	84520	HCPCS	300	RC		both	70	52.5	Percent of Total Billed Charges	66.64	95.2	Percent of Total Billed Charges	61.57	87.95	Percent of Total Billed Charges	57.75	82.5	52.5	70
BUN URINE 24 HR  (IN-HOUSE)	84520	HCPCS	300	RC		both	70	52.5	Percent of Total Billed Charges	66.64	95.2	Percent of Total Billed Charges	61.57	87.95	Percent of Total Billed Charges	57.75	82.5	52.5	70
CALCIUM SERUM (IN-HOUSE)	82310	HCPCS	300	RC		both	70	52.5	Percent of Total Billed Charges	66.64	95.2	Percent of Total Billed Charges	61.57	87.95	Percent of Total Billed Charges	57.75	82.5	52.5	70
CALCIUM RANDOM URINE (IN HOUSE)	82340	HCPCS	300	RC		both	22	16.5	Percent of Total Billed Charges	20.94	95.2	Percent of Total Billed Charges	19.35	87.95	Percent of Total Billed Charges	18.15	82.5	16.5	22
24 HR URIC ACID-URINE (IN-HOUSE)	84560	HCPCS	300	RC		both	103	77.25	Percent of Total Billed Charges	98.06	95.2	Percent of Total Billed Charges	90.59	87.95	Percent of Total Billed Charges	84.98	82.5	77.25	103
24 HR URINE AMYLASE (IN-HOUSE)	82150	HCPCS	300	RC		both	30	22.5	Percent of Total Billed Charges	28.56	95.2	Percent of Total Billed Charges	26.39	87.95	Percent of Total Billed Charges	24.75	82.5	22.5	30
RANDOM URINE AMYLASE (IN-HOUSE)	82150	HCPCS	300	RC		both	30	22.5	Percent of Total Billed Charges	28.56	95.2	Percent of Total Billed Charges	26.39	87.95	Percent of Total Billed Charges	24.75	82.5	22.5	30
GLUCOSE TOLERANCE EA 3 SPECIMENS (IN-HOUSE)	82952	HCPCS	300	RC		both	70	52.5	Percent of Total Billed Charges	66.64	95.2	Percent of Total Billed Charges	61.57	87.95	Percent of Total Billed Charges	57.75	82.5	52.5	70
GLUCOSE TOLERANCE TEST 1 HOUR (IN-HOUSE)	82951	HCPCS	300	RC		both	104	78	Percent of Total Billed Charges	99.01	95.2	Percent of Total Billed Charges	91.47	87.95	Percent of Total Billed Charges	85.8	82.5	78	104
GLUCOSE 24 HR URINE (IN-HOUSE)	82945	HCPCS	300	RC		both	14	10.5	Percent of Total Billed Charges	13.33	95.2	Percent of Total Billed Charges	12.31	87.95	Percent of Total Billed Charges	11.55	82.5	10.5	14
GLUCOSE RANDOM URINE  (IN-HOUSE)	82945	HCPCS	300	RC		both	14	10.5	Percent of Total Billed Charges	13.33	95.2	Percent of Total Billed Charges	12.31	87.95	Percent of Total Billed Charges	11.55	82.5	10.5	14
PHOSPHOROUS SERUM (IN-HOUSE)	84100	HCPCS	300	RC		both	70	52.5	Percent of Total Billed Charges	66.64	95.2	Percent of Total Billed Charges	61.57	87.95	Percent of Total Billed Charges	57.75	82.5	52.5	70
PHOSPHORUS 24 HR URINE  (IN-HOUSE)	84105	HCPCS	300	RC		both	104	78	Percent of Total Billed Charges	99.01	95.2	Percent of Total Billed Charges	91.47	87.95	Percent of Total Billed Charges	85.8	82.5	78	104
BILIRUBIN TOTAL (IN-HOUSE)	82247	HCPCS	300	RC		both	70	52.5	Percent of Total Billed Charges	66.64	95.2	Percent of Total Billed Charges	61.57	87.95	Percent of Total Billed Charges	57.75	82.5	52.5	70
FERRITIN (BACKUP)	82728	HCPCS	301	RC		both	154	115.5	Percent of Total Billed Charges	146.61	95.2	Percent of Total Billed Charges	135.44	87.95	Percent of Total Billed Charges	127.05	82.5	115.5	154
MICROALBUMIN 24 HR  (IN-HOUSE)	82043	HCPCS	300	RC		both	123	92.25	Percent of Total Billed Charges	117.1	95.2	Percent of Total Billed Charges	108.18	87.95	Percent of Total Billed Charges	101.48	82.5	92.25	123
"CREATININE, SERUM (IN-HOUSE)"	82565	HCPCS	300	RC		both	70	52.5	Percent of Total Billed Charges	66.64	95.2	Percent of Total Billed Charges	61.57	87.95	Percent of Total Billed Charges	57.75	82.5	52.5	70
MYELIN ASSOCIATED GLYCOPROTEIN (MAG) ANTIBODY	83516	HCPCS	302	RC		both	135	101.25	Percent of Total Billed Charges	128.52	95.2	Percent of Total Billed Charges	118.73	87.95	Percent of Total Billed Charges	111.38	82.5	101.25	135
ALBUMIN SERUM (BACKUP)	82040	HCPCS	300	RC	QW	both	70	52.5	Percent of Total Billed Charges	66.64	95.2	Percent of Total Billed Charges	61.57	87.95	Percent of Total Billed Charges	57.75	82.5	52.5	70
ALKALINE PHOSPHATASE SERUM (BACKUP)	84075	HCPCS	300	RC	QW	both	70	52.5	Percent of Total Billed Charges	66.64	95.2	Percent of Total Billed Charges	61.57	87.95	Percent of Total Billed Charges	57.75	82.5	52.5	70
AMYLASE SERUM (BACKUP)	82150	HCPCS	300	RC	QW	both	111	83.25	Percent of Total Billed Charges	105.67	95.2	Percent of Total Billed Charges	97.62	87.95	Percent of Total Billed Charges	91.58	82.5	83.25	111
BILIRUBIN TOTAL (BACKUP)	82247	HCPCS	300	RC	QW	both	70	52.5	Percent of Total Billed Charges	66.64	95.2	Percent of Total Billed Charges	61.57	87.95	Percent of Total Billed Charges	57.75	82.5	52.5	70
BUN SERUM (BACKUP)	84520	HCPCS	300	RC	QW	both	70	52.5	Percent of Total Billed Charges	66.64	95.2	Percent of Total Billed Charges	61.57	87.95	Percent of Total Billed Charges	57.75	82.5	52.5	70
CALCIUM SERUM (BACKUP)	82310	HCPCS	300	RC	QW	both	70	52.5	Percent of Total Billed Charges	66.64	95.2	Percent of Total Billed Charges	61.57	87.95	Percent of Total Billed Charges	57.75	82.5	52.5	70
CK (BACKUP)	82550	HCPCS	300	RC	QW	both	111	83.25	Percent of Total Billed Charges	105.67	95.2	Percent of Total Billed Charges	97.62	87.95	Percent of Total Billed Charges	91.58	82.5	83.25	111
"CREATININE, SERUM (BACKUP)"	82565	HCPCS	300	RC	QW	both	70	52.5	Percent of Total Billed Charges	66.64	95.2	Percent of Total Billed Charges	61.57	87.95	Percent of Total Billed Charges	57.75	82.5	52.5	70
GLUCOSE SERUM (BACKUP)	82947	HCPCS	300	RC	QW	both	70	52.5	Percent of Total Billed Charges	66.64	95.2	Percent of Total Billed Charges	61.57	87.95	Percent of Total Billed Charges	57.75	82.5	52.5	70
VARICELLA ZOSTER AB IGG	86787	HCPCS	300	RC		both	158	118.5	Percent of Total Billed Charges	150.42	95.2	Percent of Total Billed Charges	138.96	87.95	Percent of Total Billed Charges	130.35	82.5	118.5	158
(SGOT) AST	84450	HCPCS	300	RC	QW	both	79	59.25	Percent of Total Billed Charges	75.21	95.2	Percent of Total Billed Charges	69.48	87.95	Percent of Total Billed Charges	65.18	82.5	59.25	79
PHOSPHOROUS SERUM (BACKUP)	84100	HCPCS	300	RC	QW	both	70	52.5	Percent of Total Billed Charges	66.64	95.2	Percent of Total Billed Charges	61.57	87.95	Percent of Total Billed Charges	57.75	82.5	52.5	70
TOTAL PROTEIN SERUM (BACKUP)	84155	HCPCS	300	RC	QW	both	78	58.5	Percent of Total Billed Charges	74.26	95.2	Percent of Total Billed Charges	68.6	87.95	Percent of Total Billed Charges	64.35	82.5	58.5	78
URIC ACID SERUM (BACKUP)	84550	HCPCS	300	RC	QW	both	71	53.25	Percent of Total Billed Charges	67.59	95.2	Percent of Total Billed Charges	62.44	87.95	Percent of Total Billed Charges	58.58	82.5	53.25	71
SODIUM SERUM (BACKUP)	84295	HCPCS	300	RC	QW	both	70	52.5	Percent of Total Billed Charges	66.64	95.2	Percent of Total Billed Charges	61.57	87.95	Percent of Total Billed Charges	57.75	82.5	52.5	70
POTASSIUM SERUM (BACKUP)	84132	HCPCS	300	RC	QW	both	87	65.25	Percent of Total Billed Charges	82.82	95.2	Percent of Total Billed Charges	76.52	87.95	Percent of Total Billed Charges	71.78	82.5	65.25	87
CHLORIDE SERUM (BACKUP)	82435	HCPCS	300	RC	QW	both	70	52.5	Percent of Total Billed Charges	66.64	95.2	Percent of Total Billed Charges	61.57	87.95	Percent of Total Billed Charges	57.75	82.5	52.5	70
CARBON DIOXIDE CO2 (BACKUP)	82374	HCPCS	300	RC	QW	both	84	63	Percent of Total Billed Charges	79.97	95.2	Percent of Total Billed Charges	73.88	87.95	Percent of Total Billed Charges	69.3	82.5	63	84
SURMONTIL LEVEL	82542	HCPCS	301	RC		both	137	102.75	Percent of Total Billed Charges	130.42	95.2	Percent of Total Billed Charges	120.49	87.95	Percent of Total Billed Charges	113.03	82.5	102.75	137
IMIPRAMINE	80335	HCPCS	301	RC		both	151	113.25	Percent of Total Billed Charges	143.75	95.2	Percent of Total Billed Charges	132.8	87.95	Percent of Total Billed Charges	124.58	82.5	113.25	151
PARATHYROID HORMONE LEVEL	83970	HCPCS	300	RC		both	329	246.75	Percent of Total Billed Charges	313.21	95.2	Percent of Total Billed Charges	289.36	87.95	Percent of Total Billed Charges	271.43	82.5	246.75	329
EVEROLIMUS (AFINITOR)	80169	HCPCS	300	RC		both	140	105	Percent of Total Billed Charges	133.28	95.2	Percent of Total Billed Charges	123.13	87.95	Percent of Total Billed Charges	115.5	82.5	105	140
O.B. PROFILE	80055	HCPCS	301	RC		both	416	312	Percent of Total Billed Charges	396.03	95.2	Percent of Total Billed Charges	365.87	87.95	Percent of Total Billed Charges	343.2	82.5	312	416
EPSTEIN-BARR VIRUS NUCLEA	86664	HCPCS	300	RC		both	194	145.5	Percent of Total Billed Charges	184.69	95.2	Percent of Total Billed Charges	170.62	87.95	Percent of Total Billed Charges	160.05	82.5	145.5	194
BODY FLUID CRYSTALS	89060	HCPCS	300	RC		both	87	65.25	Percent of Total Billed Charges	82.82	95.2	Percent of Total Billed Charges	76.52	87.95	Percent of Total Billed Charges	71.78	82.5	65.25	87
CYCLOSPORINE	80158	HCPCS	300	RC		both	226	169.5	Percent of Total Billed Charges	215.15	95.2	Percent of Total Billed Charges	198.77	87.95	Percent of Total Billed Charges	186.45	82.5	169.5	226
ARTERIAL BLOOD GAS (ABG)	82803	HCPCS	300	RC	QW	both	292	219	Percent of Total Billed Charges	277.98	95.2	Percent of Total Billed Charges	256.81	87.95	Percent of Total Billed Charges	240.9	82.5	219	292
OCCULT BLOOD	82270	HCPCS	300	RC	QW	both	64	48	Percent of Total Billed Charges	60.93	95.2	Percent of Total Billed Charges	56.29	87.95	Percent of Total Billed Charges	52.8	82.5	48	64
NASAL SMEAR	89190	HCPCS	300	RC		both	128	96	Percent of Total Billed Charges	121.86	95.2	Percent of Total Billed Charges	112.58	87.95	Percent of Total Billed Charges	105.6	82.5	96	128
GRAM STAIN	87205	HCPCS	300	RC		both	104	78	Percent of Total Billed Charges	99.01	95.2	Percent of Total Billed Charges	91.47	87.95	Percent of Total Billed Charges	85.8	82.5	78	104
WHITE BLOOD COUNT	85048	HCPCS	300	RC		both	70	52.5	Percent of Total Billed Charges	66.64	95.2	Percent of Total Billed Charges	61.57	87.95	Percent of Total Billed Charges	57.75	82.5	52.5	70
HEP C (RIBA)	86803	HCPCS	300	RC		both	364	273	Percent of Total Billed Charges	346.53	95.2	Percent of Total Billed Charges	320.14	87.95	Percent of Total Billed Charges	300.3	82.5	273	364
RED BLOOD COUNT	85041	HCPCS	300	RC		both	64	48	Percent of Total Billed Charges	60.93	95.2	Percent of Total Billed Charges	56.29	87.95	Percent of Total Billed Charges	52.8	82.5	48	64
HEMATOCRIT (HCT)	85014	HCPCS	300	RC		both	64	48	Percent of Total Billed Charges	60.93	95.2	Percent of Total Billed Charges	56.29	87.95	Percent of Total Billed Charges	52.8	82.5	48	64
THYROGLOBULIN QUANTITATIVE	84432	HCPCS	301	RC		both	79	59.25	Percent of Total Billed Charges	75.21	95.2	Percent of Total Billed Charges	69.48	87.95	Percent of Total Billed Charges	65.18	82.5	59.25	79
AEROBIC CULTURE	87070	HCPCS	300	RC		both	110	82.5	Percent of Total Billed Charges	104.72	95.2	Percent of Total Billed Charges	96.75	87.95	Percent of Total Billed Charges	90.75	82.5	82.5	110
"MYCOPLASMA PNEUMONIAE AB, IGG AND IGM"	86738	HCPCS	270	RC		both	179	134.25	Percent of Total Billed Charges	170.41	95.2	Percent of Total Billed Charges	157.43	87.95	Percent of Total Billed Charges	147.68	82.5	134.25	179
SODIUM RANDOM URINE  (IN-HOUSE)	84300	HCPCS	300	RC		both	104	78	Percent of Total Billed Charges	99.01	95.2	Percent of Total Billed Charges	91.47	87.95	Percent of Total Billed Charges	85.8	82.5	78	104
PLATLETE COUNT	85027	HCPCS	300	RC		both	78	58.5	Percent of Total Billed Charges	74.26	95.2	Percent of Total Billed Charges	68.6	87.95	Percent of Total Billed Charges	64.35	82.5	58.5	78
PROTIME PT/INR	85610	HCPCS	300	RC	QW	both	118	88.5	Percent of Total Billed Charges	112.34	95.2	Percent of Total Billed Charges	103.78	87.95	Percent of Total Billed Charges	97.35	82.5	88.5	118
PTT	85730	HCPCS	300	RC		both	127	95.25	Percent of Total Billed Charges	120.9	95.2	Percent of Total Billed Charges	111.7	87.95	Percent of Total Billed Charges	104.78	82.5	95.25	127
POTASSIUM RANDOM URINE (IN-HOUSE)	84133	HCPCS	300	RC		both	99	74.25	Percent of Total Billed Charges	94.25	95.2	Percent of Total Billed Charges	87.07	87.95	Percent of Total Billed Charges	81.68	82.5	74.25	99
CHLAMYDIA TRACHOMATIS	87591	HCPCS	300	RC		both	82	61.5	Percent of Total Billed Charges	78.06	95.2	Percent of Total Billed Charges	72.12	87.95	Percent of Total Billed Charges	67.65	82.5	61.5	82
URINALYSIS DIP STICK AUTOMATED WITHOUT MICROSCOPY	81003	HCPCS	307	RC		both	53	39.75	Percent of Total Billed Charges	50.46	95.2	Percent of Total Billed Charges	46.61	87.95	Percent of Total Billed Charges	43.73	82.5	39.75	53
RHEUMATOID FACTOR	86431	HCPCS	300	RC		both	104	78	Percent of Total Billed Charges	99.01	95.2	Percent of Total Billed Charges	91.47	87.95	Percent of Total Billed Charges	85.8	82.5	78	104
MONO TEST	86308	HCPCS	300	RC		both	104	78	Percent of Total Billed Charges	99.01	95.2	Percent of Total Billed Charges	91.47	87.95	Percent of Total Billed Charges	85.8	82.5	78	104
BLOOD TYPING ABO	86900	HCPCS	300	RC		both	78	58.5	Percent of Total Billed Charges	74.26	95.2	Percent of Total Billed Charges	68.6	87.95	Percent of Total Billed Charges	64.35	82.5	58.5	78
DIRECT COOMBS	86880	HCPCS	390	RC		both	120	90	Percent of Total Billed Charges	114.24	95.2	Percent of Total Billed Charges	105.54	87.95	Percent of Total Billed Charges	99	82.5	90	120
IS CROSSMATCH PER UNIT	86920	HCPCS	300	RC		both	490	367.5	Percent of Total Billed Charges	466.48	95.2	Percent of Total Billed Charges	430.96	87.95	Percent of Total Billed Charges	404.25	82.5	367.5	490
BFP/CELL COUNT	89051	HCPCS	300	RC		both	114	85.5	Percent of Total Billed Charges	108.53	95.2	Percent of Total Billed Charges	100.26	87.95	Percent of Total Billed Charges	94.05	82.5	85.5	114
BFP/GLUCOSE	82945	HCPCS	301	RC		both	49	36.75	Percent of Total Billed Charges	46.65	95.2	Percent of Total Billed Charges	43.1	87.95	Percent of Total Billed Charges	40.43	82.5	36.75	49
BFP/PROTEIN	84157	HCPCS	300	RC		both	83	62.25	Percent of Total Billed Charges	79.02	95.2	Percent of Total Billed Charges	73	87.95	Percent of Total Billed Charges	68.48	82.5	62.25	83
AMMONIA (NH3-IN-HOUSE)	82140	HCPCS	301	RC		both	170	127.5	Percent of Total Billed Charges	161.84	95.2	Percent of Total Billed Charges	149.52	87.95	Percent of Total Billed Charges	140.25	82.5	127.5	170
SYPR/TOTAL PROTEIN	84165	HCPCS	300	RC		both	143	107.25	Percent of Total Billed Charges	136.14	95.2	Percent of Total Billed Charges	125.77	87.95	Percent of Total Billed Charges	117.98	82.5	107.25	143
N TELOPEPTIDE LEVEL 1	82523	HCPCS	301	RC		both	312	234	Percent of Total Billed Charges	297.02	95.2	Percent of Total Billed Charges	274.4	87.95	Percent of Total Billed Charges	257.4	82.5	234	312
VANCOMYCIN (IN-HOUSE)	80202	HCPCS	301	RC		both	193	144.75	Percent of Total Billed Charges	183.74	95.2	Percent of Total Billed Charges	169.74	87.95	Percent of Total Billed Charges	159.23	82.5	144.75	193
T8	86360	HCPCS	300	RC		both	140	105	Percent of Total Billed Charges	133.28	95.2	Percent of Total Billed Charges	123.13	87.95	Percent of Total Billed Charges	115.5	82.5	105	140
HEP B / COMP 3	86705	HCPCS	300	RC		both	95	71.25	Percent of Total Billed Charges	90.44	95.2	Percent of Total Billed Charges	83.55	87.95	Percent of Total Billed Charges	78.38	82.5	71.25	95
HEP A / COMP 4	86709	HCPCS	300	RC		both	104	78	Percent of Total Billed Charges	99.01	95.2	Percent of Total Billed Charges	91.47	87.95	Percent of Total Billed Charges	85.8	82.5	78	104
EGG WHITE ALLERGY	86003	HCPCS	300	RC		both	64	48	Percent of Total Billed Charges	60.93	95.2	Percent of Total Billed Charges	56.29	87.95	Percent of Total Billed Charges	52.8	82.5	48	64
EGG YOLK ALLERGY	86003	HCPCS	300	RC		both	57	42.75	Percent of Total Billed Charges	54.26	95.2	Percent of Total Billed Charges	50.13	87.95	Percent of Total Billed Charges	47.03	82.5	42.75	57
"LYMPHOCYTE TRANSFORMATION, T CELLS~"	86359	HCPCS	300	RC		both	119	89.25	Percent of Total Billed Charges	113.29	95.2	Percent of Total Billed Charges	104.66	87.95	Percent of Total Billed Charges	98.18	82.5	89.25	119
N TELOPEPTIDE LEVEL 2	82570	HCPCS	301	RC		both	210	157.5	Percent of Total Billed Charges	199.92	95.2	Percent of Total Billed Charges	184.7	87.95	Percent of Total Billed Charges	173.25	82.5	157.5	210
LDL (IN-HOUSE)	83721	HCPCS	301	RC		both	71	53.25	Percent of Total Billed Charges	67.59	95.2	Percent of Total Billed Charges	62.44	87.95	Percent of Total Billed Charges	58.58	82.5	53.25	71
"AMPLIFIED PROBE TECHNIQUE, EACH"	87798	HCPCS	300	RC		both	184	138	Percent of Total Billed Charges	175.17	95.2	Percent of Total Billed Charges	161.83	87.95	Percent of Total Billed Charges	151.8	82.5	138	184
CHLAMYDIA PNEUMONIAE	87486	HCPCS	300	RC		both	368	276	Percent of Total Billed Charges	350.34	95.2	Percent of Total Billed Charges	323.66	87.95	Percent of Total Billed Charges	303.6	82.5	276	368
MYCOPLASMA PNEUMONIAE	87581	HCPCS	300	RC		outpatient	368	276	Percent of Total Billed Charges	350.34	95.2	Percent of Total Billed Charges	323.66	87.95	Percent of Total Billed Charges	303.6	82.5	276	368
"HORSE DANDER, IGE"	86003	HCPCS	302	RC		both	17	12.75	Percent of Total Billed Charges	16.18	95.2	Percent of Total Billed Charges	14.95	87.95	Percent of Total Billed Charges	14.03	82.5	12.75	17
RESPIRATORY REGION XI ROCKY MNT PANEL	82785	HCPCS	300	RC		both	55	41.25	Percent of Total Billed Charges	52.36	95.2	Percent of Total Billed Charges	48.37	87.95	Percent of Total Billed Charges	45.38	82.5	41.25	55
"FOOD PANEL II, IGE"	82785	HCPCS	300	RC		both	55	41.25	Percent of Total Billed Charges	52.36	95.2	Percent of Total Billed Charges	48.37	87.95	Percent of Total Billed Charges	45.38	82.5	41.25	55
"FOOD ALLERGY PANEL II, I"	86003	HCPCS	300	RC		both	17	12.75	Percent of Total Billed Charges	16.18	95.2	Percent of Total Billed Charges	14.95	87.95	Percent of Total Billed Charges	14.03	82.5	12.75	17
COLLAGEN/N TELO PEP	83516	HCPCS	302	RC		both	235	176.25	Percent of Total Billed Charges	223.72	95.2	Percent of Total Billed Charges	206.68	87.95	Percent of Total Billed Charges	193.88	82.5	176.25	235
SEROTONIN METABOL 5-HIAA	83497	HCPCS	301	RC		both	71	53.25	Percent of Total Billed Charges	67.59	95.2	Percent of Total Billed Charges	62.44	87.95	Percent of Total Billed Charges	58.58	82.5	53.25	71
FIBRINOGEN	85384	HCPCS	300	RC		both	32	24	Percent of Total Billed Charges	30.46	95.2	Percent of Total Billed Charges	28.14	87.95	Percent of Total Billed Charges	26.4	82.5	24	32
VON WILLEBRAND FACTOR	85244	HCPCS	300	RC		both	65	48.75	Percent of Total Billed Charges	61.88	95.2	Percent of Total Billed Charges	57.17	87.95	Percent of Total Billed Charges	53.63	82.5	48.75	65
ERYTHROPOIETIN	82668	HCPCS	301	RC		both	151	113.25	Percent of Total Billed Charges	143.75	95.2	Percent of Total Billed Charges	132.8	87.95	Percent of Total Billed Charges	124.58	82.5	113.25	151
SOMATOMEDIN LEVEL INSULIN LIKE GROWTH	84305	HCPCS	300	RC		both	258	193.5	Percent of Total Billed Charges	245.62	95.2	Percent of Total Billed Charges	226.91	87.95	Percent of Total Billed Charges	212.85	82.5	193.5	258
THERAPEUTIC PHLEBOTOMY	99195	HCPCS	300	RC		both	213	159.75	Percent of Total Billed Charges	202.78	95.2	Percent of Total Billed Charges	187.33	87.95	Percent of Total Billed Charges	175.73	82.5	159.75	213
ANTIBODY SCREEN	86850	HCPCS	300	RC		both	235	176.25	Percent of Total Billed Charges	223.72	95.2	Percent of Total Billed Charges	206.68	87.95	Percent of Total Billed Charges	193.88	82.5	176.25	235
ACID FAST STAIN	88312	HCPCS	300	RC		both	89	66.75	Percent of Total Billed Charges	84.73	95.2	Percent of Total Billed Charges	78.28	87.95	Percent of Total Billed Charges	73.43	82.5	66.75	89
ETOH SERUM ALCOHOL (IN-HOUSE)	80320	HCPCS	301	RC		both	216	162	Percent of Total Billed Charges	205.63	95.2	Percent of Total Billed Charges	189.97	87.95	Percent of Total Billed Charges	178.2	82.5	162	216
ANTIBODY I.D.	86021	HCPCS	300	RC		both	160	120	Percent of Total Billed Charges	152.32	95.2	Percent of Total Billed Charges	140.72	87.95	Percent of Total Billed Charges	132	82.5	120	160
ASCORBIC ACID (VIT. C)	82180	HCPCS	301	RC		both	192	144	Percent of Total Billed Charges	182.78	95.2	Percent of Total Billed Charges	168.86	87.95	Percent of Total Billed Charges	158.4	82.5	144	192
FACTOR V	85220	HCPCS	300	RC		both	433	324.75	Percent of Total Billed Charges	412.22	95.2	Percent of Total Billed Charges	380.82	87.95	Percent of Total Billed Charges	357.23	82.5	324.75	433
BETA-HCG (SEND OUT)	84702	HCPCS	300	RC		both	70	52.5	Percent of Total Billed Charges	66.64	95.2	Percent of Total Billed Charges	61.57	87.95	Percent of Total Billed Charges	57.75	82.5	52.5	70
COMPLIMENT FIXATION	86171	HCPCS	300	RC		both	137	102.75	Percent of Total Billed Charges	130.42	95.2	Percent of Total Billed Charges	120.49	87.95	Percent of Total Billed Charges	113.03	82.5	102.75	137
URINE CREATININE CLEARANCE	82575	HCPCS	301	RC		both	144	108	Percent of Total Billed Charges	137.09	95.2	Percent of Total Billed Charges	126.65	87.95	Percent of Total Billed Charges	118.8	82.5	108	144
COXSACKIE VIRUS A&B	87250	HCPCS	300	RC		both	192	144	Percent of Total Billed Charges	182.78	95.2	Percent of Total Billed Charges	168.86	87.95	Percent of Total Billed Charges	158.4	82.5	144	192
C REACTIVE PROTEIN (BACKUP)	86140	HCPCS	300	RC	QW	both	122	91.5	Percent of Total Billed Charges	116.14	95.2	Percent of Total Billed Charges	107.3	87.95	Percent of Total Billed Charges	100.65	82.5	91.5	122
ALDOLASE	82085	HCPCS	310	RC		both	104	78	Percent of Total Billed Charges	99.01	95.2	Percent of Total Billed Charges	91.47	87.95	Percent of Total Billed Charges	85.8	82.5	78	104
"CULTURE, SMEAR"	87205	HCPCS	300	RC		both	89	66.75	Percent of Total Billed Charges	84.73	95.2	Percent of Total Billed Charges	78.28	87.95	Percent of Total Billed Charges	73.43	82.5	66.75	89
"CULTURE, BLOOD"	87040	HCPCS	300	RC		both	251	188.25	Percent of Total Billed Charges	238.95	95.2	Percent of Total Billed Charges	220.75	87.95	Percent of Total Billed Charges	207.08	82.5	188.25	251
SENSITIVITY	87181	HCPCS	300	RC		both	104	78	Percent of Total Billed Charges	99.01	95.2	Percent of Total Billed Charges	91.47	87.95	Percent of Total Billed Charges	85.8	82.5	78	104
FUNGUS ISO. SMEAR	87205	HCPCS	300	RC		both	144	108	Percent of Total Billed Charges	137.09	95.2	Percent of Total Billed Charges	126.65	87.95	Percent of Total Billed Charges	118.8	82.5	108	144
CYTOPATHOLOGY/VAG SMEAR	88150	HCPCS	300	RC		both	78	58.5	Percent of Total Billed Charges	74.26	95.2	Percent of Total Billed Charges	68.6	87.95	Percent of Total Billed Charges	64.35	82.5	58.5	78
"PLEURAL PERICARD, CYTOPTH"	88161	HCPCS	300	RC		both	137	102.75	Percent of Total Billed Charges	130.42	95.2	Percent of Total Billed Charges	120.49	87.95	Percent of Total Billed Charges	113.03	82.5	102.75	137
"CULTURE, SPUTUM"	87070	HCPCS	300	RC		both	144	108	Percent of Total Billed Charges	137.09	95.2	Percent of Total Billed Charges	126.65	87.95	Percent of Total Billed Charges	118.8	82.5	108	144
DIGOXIN (LANOXIN IN-HOUSE)	80162	HCPCS	301	RC		both	164	123	Percent of Total Billed Charges	156.13	95.2	Percent of Total Billed Charges	144.24	87.95	Percent of Total Billed Charges	135.3	82.5	123	164
DRUG SCREEN URINE-SENDOUT	80305	HCPCS	301	RC		both	252	189	Percent of Total Billed Charges	239.9	95.2	Percent of Total Billed Charges	221.63	87.95	Percent of Total Billed Charges	207.9	82.5	189	252
ESTRADIAL 17 BETA	82677	HCPCS	301	RC		both	133	99.75	Percent of Total Billed Charges	126.62	95.2	Percent of Total Billed Charges	116.97	87.95	Percent of Total Billed Charges	109.73	82.5	99.75	133
ETHOSUXIMIDE	80168	HCPCS	301	RC		both	151	113.25	Percent of Total Billed Charges	143.75	95.2	Percent of Total Billed Charges	132.8	87.95	Percent of Total Billed Charges	124.58	82.5	113.25	151
FEBRILE AGGLUTINONS	86000	HCPCS	300	RC		both	151	113.25	Percent of Total Billed Charges	143.75	95.2	Percent of Total Billed Charges	132.8	87.95	Percent of Total Billed Charges	124.58	82.5	113.25	151
FERRITIN (IN-HOUSE)	82728	HCPCS	301	RC		both	154	115.5	Percent of Total Billed Charges	146.61	95.2	Percent of Total Billed Charges	135.44	87.95	Percent of Total Billed Charges	127.05	82.5	115.5	154
"FIBRINOGEN, ACTIVITY"	85384	HCPCS	300	RC		both	128	96	Percent of Total Billed Charges	121.86	95.2	Percent of Total Billed Charges	112.58	87.95	Percent of Total Billed Charges	105.6	82.5	96	128
FOLATE SERUM (IN-HOUSE)	82746	HCPCS	301	RC		both	171	128.25	Percent of Total Billed Charges	162.79	95.2	Percent of Total Billed Charges	150.39	87.95	Percent of Total Billed Charges	141.08	82.5	128.25	171
G6 PD	82955	HCPCS	301	RC		both	118	88.5	Percent of Total Billed Charges	112.34	95.2	Percent of Total Billed Charges	103.78	87.95	Percent of Total Billed Charges	97.35	82.5	88.5	118
HDL (BACKUP)	83718	HCPCS	300	RC	QW	both	68	51	Percent of Total Billed Charges	64.74	95.2	Percent of Total Billed Charges	59.81	87.95	Percent of Total Billed Charges	56.1	82.5	51	68
HEPATITIS B S-ANTIGEN	87340	HCPCS	300	RC		both	143	107.25	Percent of Total Billed Charges	136.14	95.2	Percent of Total Billed Charges	125.77	87.95	Percent of Total Billed Charges	117.98	82.5	107.25	143
5 HIAA (SERONTIN)	84260	HCPCS	300	RC		both	252	189	Percent of Total Billed Charges	239.9	95.2	Percent of Total Billed Charges	221.63	87.95	Percent of Total Billed Charges	207.9	82.5	189	252
HLA B 27	81374	HCPCS	310	RC		both	698	523.5	Percent of Total Billed Charges	664.5	95.2	Percent of Total Billed Charges	613.89	87.95	Percent of Total Billed Charges	575.85	82.5	523.5	698
VITAMIN D TOTAL (IN-HOUSE)	82306	HCPCS	300	RC		both	226	169.5	Percent of Total Billed Charges	215.15	95.2	Percent of Total Billed Charges	198.77	87.95	Percent of Total Billed Charges	186.45	82.5	169.5	226
IMMUNO ELECTROPHORESIS	86320	HCPCS	300	RC		both	226	169.5	Percent of Total Billed Charges	215.15	95.2	Percent of Total Billed Charges	198.77	87.95	Percent of Total Billed Charges	186.45	82.5	169.5	226
LIPASE (IN-HOUSE)	83690	HCPCS	300	RC		both	131	98.25	Percent of Total Billed Charges	124.71	95.2	Percent of Total Billed Charges	115.21	87.95	Percent of Total Billed Charges	108.08	82.5	98.25	131
MALARIA SMEAR	87207	HCPCS	300	RC		both	104	78	Percent of Total Billed Charges	99.01	95.2	Percent of Total Billed Charges	91.47	87.95	Percent of Total Billed Charges	85.8	82.5	78	104
MEBARAL	80299	HCPCS	301	RC		both	137	102.75	Percent of Total Billed Charges	130.42	95.2	Percent of Total Billed Charges	120.49	87.95	Percent of Total Billed Charges	113.03	82.5	102.75	137
PRIMIDONE (MYSOLINE)	80188	HCPCS	301	RC		both	151	113.25	Percent of Total Billed Charges	143.75	95.2	Percent of Total Billed Charges	132.8	87.95	Percent of Total Billed Charges	124.58	82.5	113.25	151
OVA & PARASITES SCREEN	87328	HCPCS	300	RC		both	133	99.75	Percent of Total Billed Charges	126.62	95.2	Percent of Total Billed Charges	116.97	87.95	Percent of Total Billed Charges	109.73	82.5	99.75	133
"PKU, NEWBORN SCREENING PANEL"	84030	HCPCS	300	RC		both	169	126.75	Percent of Total Billed Charges	160.89	95.2	Percent of Total Billed Charges	148.64	87.95	Percent of Total Billed Charges	139.43	82.5	126.75	169
PERIPHERAL BLOOD SMEAR PATHOLOGIST CHARGE	85060	HCPCS	300	RC		both	144	108	Percent of Total Billed Charges	137.09	95.2	Percent of Total Billed Charges	126.65	87.95	Percent of Total Billed Charges	118.8	82.5	108	144
PHENOBARBITAL LEVEL	80184	HCPCS	301	RC		both	182	136.5	Percent of Total Billed Charges	173.26	95.2	Percent of Total Billed Charges	160.07	87.95	Percent of Total Billed Charges	150.15	82.5	136.5	182
"TOTAL PROTEIN ELECTROPHESIS, SERUM"	84155	HCPCS	300	RC		both	66	49.5	Percent of Total Billed Charges	62.83	95.2	Percent of Total Billed Charges	58.05	87.95	Percent of Total Billed Charges	54.45	82.5	49.5	66
SALICYLATE SERUM (IN-HOUSE)	80299	HCPCS	301	RC		both	207	155.25	Percent of Total Billed Charges	197.06	95.2	Percent of Total Billed Charges	182.06	87.95	Percent of Total Billed Charges	170.78	82.5	155.25	207
STONE ANALYSIS	82370	HCPCS	301	RC		both	137	102.75	Percent of Total Billed Charges	130.42	95.2	Percent of Total Billed Charges	120.49	87.95	Percent of Total Billed Charges	113.03	82.5	102.75	137
T4 (TOTAL THYROXINE)	84436	HCPCS	300	RC		both	103	77.25	Percent of Total Billed Charges	98.06	95.2	Percent of Total Billed Charges	90.59	87.95	Percent of Total Billed Charges	84.98	82.5	77.25	103
T3 UPTAKE	84479	HCPCS	300	RC		both	104	78	Percent of Total Billed Charges	99.01	95.2	Percent of Total Billed Charges	91.47	87.95	Percent of Total Billed Charges	85.8	82.5	78	104
THEOPHYLLINE	80198	HCPCS	301	RC		both	144	108	Percent of Total Billed Charges	137.09	95.2	Percent of Total Billed Charges	126.65	87.95	Percent of Total Billed Charges	118.8	82.5	108	144
TOBRAMYCIN	80200	HCPCS	301	RC		both	151	113.25	Percent of Total Billed Charges	143.75	95.2	Percent of Total Billed Charges	132.8	87.95	Percent of Total Billed Charges	124.58	82.5	113.25	151
VMA (URINE)	84585	HCPCS	300	RC		both	118	88.5	Percent of Total Billed Charges	112.34	95.2	Percent of Total Billed Charges	103.78	87.95	Percent of Total Billed Charges	97.35	82.5	88.5	118
VITAMIN B12 (IN-HOUSE)	82607	HCPCS	300	RC		both	180	135	Percent of Total Billed Charges	171.36	95.2	Percent of Total Billed Charges	158.31	87.95	Percent of Total Billed Charges	148.5	82.5	135	180
ROTA VIRUS	87425	HCPCS	300	RC		both	118	88.5	Percent of Total Billed Charges	112.34	95.2	Percent of Total Billed Charges	103.78	87.95	Percent of Total Billed Charges	97.35	82.5	88.5	118
TISSUE BIOPSY 2	88302	HCPCS	300	RC		both	86	64.5	Percent of Total Billed Charges	81.87	95.2	Percent of Total Billed Charges	75.64	87.95	Percent of Total Billed Charges	70.95	82.5	64.5	86
CLONOPIN	82542	HCPCS	301	RC		both	179	134.25	Percent of Total Billed Charges	170.41	95.2	Percent of Total Billed Charges	157.43	87.95	Percent of Total Billed Charges	147.68	82.5	134.25	179
C.E.A.	82378	HCPCS	300	RC		both	184	138	Percent of Total Billed Charges	175.17	95.2	Percent of Total Billed Charges	161.83	87.95	Percent of Total Billed Charges	151.8	82.5	138	184
QUINIDINE	80194	HCPCS	301	RC		both	118	88.5	Percent of Total Billed Charges	112.34	95.2	Percent of Total Billed Charges	103.78	87.95	Percent of Total Billed Charges	97.35	82.5	88.5	118
17 KETO STEROIDS	83586	HCPCS	301	RC		both	144	108	Percent of Total Billed Charges	137.09	95.2	Percent of Total Billed Charges	126.65	87.95	Percent of Total Billed Charges	118.8	82.5	108	144
TESTOSTERONE LEVEL FREE	84402	HCPCS	300	RC		both	214	160.5	Percent of Total Billed Charges	203.73	95.2	Percent of Total Billed Charges	188.21	87.95	Percent of Total Billed Charges	176.55	82.5	160.5	214
PROCAINAMIDE	80190	HCPCS	301	RC		both	144	108	Percent of Total Billed Charges	137.09	95.2	Percent of Total Billed Charges	126.65	87.95	Percent of Total Billed Charges	118.8	82.5	108	144
PROLACTIN LEVEL	84146	HCPCS	300	RC		both	187	140.25	Percent of Total Billed Charges	178.02	95.2	Percent of Total Billed Charges	164.47	87.95	Percent of Total Billed Charges	154.28	82.5	140.25	187
VENIPUNCTURE	36415	HCPCS	300	RC		both	44	33	Percent of Total Billed Charges	41.89	95.2	Percent of Total Billed Charges	38.7	87.95	Percent of Total Billed Charges	36.3	82.5	33	44
ARTERIAL PUNCTURE	36600	HCPCS	360	RC		both	104	78	Percent of Total Billed Charges	99.01	95.2	Percent of Total Billed Charges	91.47	87.95	Percent of Total Billed Charges	85.8	82.5	78	104
BETA 2 MICROGLOBULIN	82232	HCPCS	301	RC		both	179	134.25	Percent of Total Billed Charges	170.41	95.2	Percent of Total Billed Charges	157.43	87.95	Percent of Total Billed Charges	147.68	82.5	134.25	179
URINE TOTAL PROTEIN RANDOM (IN-HOUSE)	84156	HCPCS	300	RC		both	86	64.5	Percent of Total Billed Charges	81.87	95.2	Percent of Total Billed Charges	75.64	87.95	Percent of Total Billed Charges	70.95	82.5	64.5	86
"EPSTEIN-BARR VIRUS,VIRUL"	86665	HCPCS	300	RC		both	202	151.5	Percent of Total Billed Charges	192.3	95.2	Percent of Total Billed Charges	177.66	87.95	Percent of Total Billed Charges	166.65	82.5	151.5	202
URINE CREATININE 24 HR (IN-HOUSE)	82570	HCPCS	301	RC		both	104	78	Percent of Total Billed Charges	99.01	95.2	Percent of Total Billed Charges	91.47	87.95	Percent of Total Billed Charges	85.8	82.5	78	104
URINE CREATININE RANDOM (BACKUP)	82570	HCPCS	301	RC	QW	both	104	78	Percent of Total Billed Charges	99.01	95.2	Percent of Total Billed Charges	91.47	87.95	Percent of Total Billed Charges	85.8	82.5	78	104
HEMOGLOBIN A1C (IN-HOUSE)	83036	HCPCS	300	RC		both	114	85.5	Percent of Total Billed Charges	108.53	95.2	Percent of Total Billed Charges	100.26	87.95	Percent of Total Billed Charges	94.05	82.5	85.5	114
TROPONIN-I (IN-HOUSE)	84484	HCPCS	300	RC		both	253	189.75	Percent of Total Billed Charges	240.86	95.2	Percent of Total Billed Charges	222.51	87.95	Percent of Total Billed Charges	208.73	82.5	189.75	253
NT-PRO BNP (IN-HOUSE)	83880	HCPCS	300	RC		both	332	249	Percent of Total Billed Charges	316.06	95.2	Percent of Total Billed Charges	291.99	87.95	Percent of Total Billed Charges	273.9	82.5	249	332
CRP (BACKUP)	86140	HCPCS	300	RC	QW	both	122	91.5	Percent of Total Billed Charges	116.14	95.2	Percent of Total Billed Charges	107.3	87.95	Percent of Total Billed Charges	100.65	82.5	91.5	122
ALBUMIN SERUM (IN-HOUSE)	82040	HCPCS	300	RC		both	70	52.5	Percent of Total Billed Charges	66.64	95.2	Percent of Total Billed Charges	61.57	87.95	Percent of Total Billed Charges	57.75	82.5	52.5	70
CARBON DIOXIDE CO2 (IN-HOUSE)	82374	HCPCS	300	RC		both	84	63	Percent of Total Billed Charges	79.97	95.2	Percent of Total Billed Charges	73.88	87.95	Percent of Total Billed Charges	69.3	82.5	63	84
CHLORIDE SERUM (IN-HOUSE)	82435	HCPCS	300	RC		both	70	52.5	Percent of Total Billed Charges	66.64	95.2	Percent of Total Billed Charges	61.57	87.95	Percent of Total Billed Charges	57.75	82.5	52.5	70
POTASSIUM SERUM (IN-HOUSE)	84132	HCPCS	300	RC		both	87	65.25	Percent of Total Billed Charges	82.82	95.2	Percent of Total Billed Charges	76.52	87.95	Percent of Total Billed Charges	71.78	82.5	65.25	87
SODIUM SERUM (IN-HOUSE)	84295	HCPCS	300	RC		both	70	52.5	Percent of Total Billed Charges	66.64	95.2	Percent of Total Billed Charges	61.57	87.95	Percent of Total Billed Charges	57.75	82.5	52.5	70
URINE ELECTROLYTES PANEL 24 HR (IN-HOUSE)	80051	HCPCS	300	RC		both	25	18.75	Percent of Total Billed Charges	23.8	95.2	Percent of Total Billed Charges	21.99	87.95	Percent of Total Billed Charges	20.63	82.5	18.75	25
GLUCOSE SERUM (IN-HOUSE)	82947	HCPCS	300	RC		both	70	52.5	Percent of Total Billed Charges	66.64	95.2	Percent of Total Billed Charges	61.57	87.95	Percent of Total Billed Charges	57.75	82.5	52.5	70
GLUCOSE TOLERANCE TEST 2 HOUR (BACKUP)	82951	HCPCS	300	RC	QW	both	104	78	Percent of Total Billed Charges	99.01	95.2	Percent of Total Billed Charges	91.47	87.95	Percent of Total Billed Charges	85.8	82.5	78	104
GLUCOSE TOLERANCE TEST 2 HOUR (IN-HOUSE)	82951	HCPCS	300	RC		both	104	78	Percent of Total Billed Charges	99.01	95.2	Percent of Total Billed Charges	91.47	87.95	Percent of Total Billed Charges	85.8	82.5	78	104
GLUCOSE TOLERANCE TEST 4 HOUR (BACKUP)	82952	HCPCS	300	RC	QW	both	20	15	Percent of Total Billed Charges	19.04	95.2	Percent of Total Billed Charges	17.59	87.95	Percent of Total Billed Charges	16.5	82.5	15	20
GLUCOSE TOLERANCE TEST 4 HOUR (IN-HOUSE)	82952	HCPCS	300	RC		both	20	15	Percent of Total Billed Charges	19.04	95.2	Percent of Total Billed Charges	17.59	87.95	Percent of Total Billed Charges	16.5	82.5	15	20
GLUCOSE TOLERANCE TEST 5 HOUR (BACKUP)	82952	HCPCS	300	RC	QW	both	20	15	Percent of Total Billed Charges	19.04	95.2	Percent of Total Billed Charges	17.59	87.95	Percent of Total Billed Charges	16.5	82.5	15	20
GLUCOSE TOLERANCE TEST 5 HOUR (IN-HOUSE)	82952	HCPCS	300	RC		both	20	15	Percent of Total Billed Charges	19.04	95.2	Percent of Total Billed Charges	17.59	87.95	Percent of Total Billed Charges	16.5	82.5	15	20
CHOLESTEROL (IN-HOUSE)	82465	HCPCS	300	RC		both	70	52.5	Percent of Total Billed Charges	66.64	95.2	Percent of Total Billed Charges	61.57	87.95	Percent of Total Billed Charges	57.75	82.5	52.5	70
HDL (IN-HOUSE)	83718	HCPCS	300	RC		both	68	51	Percent of Total Billed Charges	64.74	95.2	Percent of Total Billed Charges	59.81	87.95	Percent of Total Billed Charges	56.1	82.5	51	68
WHEAT IGE	86003	HCPCS	300	RC		both	25	18.75	Percent of Total Billed Charges	23.8	95.2	Percent of Total Billed Charges	21.99	87.95	Percent of Total Billed Charges	20.63	82.5	18.75	25
TOTAL PROTEIN SERUM (IN-HOUSE)	84155	HCPCS	300	RC		both	78	58.5	Percent of Total Billed Charges	74.26	95.2	Percent of Total Billed Charges	68.6	87.95	Percent of Total Billed Charges	64.35	82.5	58.5	78
ALKALINE PHOSPHATASE SERUM (IN-HOUSE)	84075	HCPCS	300	RC		both	70	52.5	Percent of Total Billed Charges	66.64	95.2	Percent of Total Billed Charges	61.57	87.95	Percent of Total Billed Charges	57.75	82.5	52.5	70
ALT SERUM (IN-HOUSE)	84460	HCPCS	300	RC		both	70	52.5	Percent of Total Billed Charges	66.64	95.2	Percent of Total Billed Charges	61.57	87.95	Percent of Total Billed Charges	57.75	82.5	52.5	70
AST SERUM (IN -HOUSE)	84450	HCPCS	300	RC		both	79	59.25	Percent of Total Billed Charges	75.21	95.2	Percent of Total Billed Charges	69.48	87.95	Percent of Total Billed Charges	65.18	82.5	59.25	79
LIVER FUNCTION PROFILE (IN-HOUSE)	80076	HCPCS	300	RC		both	164	123	Percent of Total Billed Charges	156.13	95.2	Percent of Total Billed Charges	144.24	87.95	Percent of Total Billed Charges	135.3	82.5	123	164
ELECTROLYTE PROFILE (IN-HOUSE)	80051	HCPCS	300	RC		both	127	95.25	Percent of Total Billed Charges	120.9	95.2	Percent of Total Billed Charges	111.7	87.95	Percent of Total Billed Charges	104.78	82.5	95.25	127
HCG QUANT (IN-HOUSE)	84702	HCPCS	300	RC		both	70	52.5	Percent of Total Billed Charges	66.64	95.2	Percent of Total Billed Charges	61.57	87.95	Percent of Total Billed Charges	57.75	82.5	52.5	70
COVID 19 (IN-HOUSE)	87635	HCPCS	300	RC	QW	both	162	121.5	Percent of Total Billed Charges	154.22	95.2	Percent of Total Billed Charges	142.48	87.95	Percent of Total Billed Charges	133.65	82.5	121.5	162
MAGNESIUM URINE RANDOM (IN-HOUSE)	83735	HCPCS	300	RC		both	111	83.25	Percent of Total Billed Charges	105.67	95.2	Percent of Total Billed Charges	97.62	87.95	Percent of Total Billed Charges	91.58	82.5	83.25	111
MAGNESIUM URINE 24 HR (IN-HOUSE)	83735	HCPCS	300	RC		both	111	83.25	Percent of Total Billed Charges	105.67	95.2	Percent of Total Billed Charges	97.62	87.95	Percent of Total Billed Charges	91.58	82.5	83.25	111
CK (IN-HOUSE)	82550	HCPCS	300	RC		both	111	83.25	Percent of Total Billed Charges	105.67	95.2	Percent of Total Billed Charges	97.62	87.95	Percent of Total Billed Charges	91.58	82.5	83.25	111
HIV PANEL	87389	HCPCS	300	RC		both	112	84	Percent of Total Billed Charges	106.62	95.2	Percent of Total Billed Charges	98.5	87.95	Percent of Total Billed Charges	92.4	82.5	84	112
"HIV 1,2 ANTIGEN"	87390	HCPCS	300	RC		both	83	62.25	Percent of Total Billed Charges	79.02	95.2	Percent of Total Billed Charges	73	87.95	Percent of Total Billed Charges	68.48	82.5	62.25	83
HIV-1 ANTIBODY	86701	HCPCS	300	RC		both	42	31.5	Percent of Total Billed Charges	39.98	95.2	Percent of Total Billed Charges	36.94	87.95	Percent of Total Billed Charges	34.65	82.5	31.5	42
HIV-2 ANTIBODY	86702	HCPCS	300	RC		both	64	48	Percent of Total Billed Charges	60.93	95.2	Percent of Total Billed Charges	56.29	87.95	Percent of Total Billed Charges	52.8	82.5	48	64
"BLOOD, OCCULT, BY FECAL HEMOGLOBIN DETERMINATION B"	82274	HCPCS	300	RC	QW	both	75	56.25	Percent of Total Billed Charges	71.4	95.2	Percent of Total Billed Charges	65.96	87.95	Percent of Total Billed Charges	61.88	82.5	56.25	75
BK VIRUS URINE PCR	87798	HCPCS	300	RC		both	148	111	Percent of Total Billed Charges	140.9	95.2	Percent of Total Billed Charges	130.17	87.95	Percent of Total Billed Charges	122.1	82.5	111	148
GRAPEFRUIT ALLERGY	86003	HCPCS	300	RC		both	26	19.5	Percent of Total Billed Charges	24.75	95.2	Percent of Total Billed Charges	22.87	87.95	Percent of Total Billed Charges	21.45	82.5	19.5	26
COW MILK ALLERGY	86003	HCPCS	300	RC		both	26	19.5	Percent of Total Billed Charges	24.75	95.2	Percent of Total Billed Charges	22.87	87.95	Percent of Total Billed Charges	21.45	82.5	19.5	26
HUNTINGON DISEASE	81271	HCPCS	310	RC		both	468	351	Percent of Total Billed Charges	445.54	95.2	Percent of Total Billed Charges	411.61	87.95	Percent of Total Billed Charges	386.1	82.5	351	468
APIXABAN LEVEL	G0480	HCPCS	300	RC		both	401	300.75	Percent of Total Billed Charges	381.75	95.2	Percent of Total Billed Charges	352.68	87.95	Percent of Total Billed Charges	330.83	82.5	300.75	401
DEAMINATED GLIADIN IGA/IGG ANTIBODIES	83516	HCPCS	300	RC		both	55	41.25	Percent of Total Billed Charges	52.36	95.2	Percent of Total Billed Charges	48.37	87.95	Percent of Total Billed Charges	45.38	82.5	41.25	55
TISSUE TRANSGLUTAMINASE IGG AB	86364	HCPCS	300	RC		both	180	135	Percent of Total Billed Charges	171.36	95.2	Percent of Total Billed Charges	158.31	87.95	Percent of Total Billed Charges	148.5	82.5	135	180
ENDOMYSIAL ANTIBODIES IGA	86231	HCPCS	300	RC		both	58	43.5	Percent of Total Billed Charges	55.22	95.2	Percent of Total Billed Charges	51.01	87.95	Percent of Total Billed Charges	47.85	82.5	43.5	58
BODY FLUID CELL COUNT	89051	HCPCS	300	RC		both	27	20.25	Percent of Total Billed Charges	25.7	95.2	Percent of Total Billed Charges	23.75	87.95	Percent of Total Billed Charges	22.28	82.5	20.25	27
MITOCHONDRIAL ANTIBODY	83516	HCPCS	300	RC		both	55	41.25	Percent of Total Billed Charges	52.36	95.2	Percent of Total Billed Charges	48.37	87.95	Percent of Total Billed Charges	45.38	82.5	41.25	55
PANCREATIC ELASTASE FECAL	82653	HCPCS	300	RC		both	62	46.5	Percent of Total Billed Charges	59.02	95.2	Percent of Total Billed Charges	54.53	87.95	Percent of Total Billed Charges	51.15	82.5	46.5	62
COVID 19 IGG/IGM AB (IN-HOUSE)	86769	HCPCS	300	RC		both	145	108.75	Percent of Total Billed Charges	138.04	95.2	Percent of Total Billed Charges	127.53	87.95	Percent of Total Billed Charges	119.63	82.5	108.75	145
TISSUE CONSULT	310	RC				both	110	82.5	Percent of Total Billed Charges	104.72	95.2	Percent of Total Billed Charges	96.75	87.95	Percent of Total Billed Charges	90.75	82.5	82.5	110
IMMUNOHISTO CHEMISTRY	88341	HCPCS	310	RC		both	229	171.75	Percent of Total Billed Charges	218.01	95.2	Percent of Total Billed Charges	201.41	87.95	Percent of Total Billed Charges	188.93	82.5	171.75	229
FECAL SODIUM	84302	HCPCS	300	RC		both	24	18	Percent of Total Billed Charges	22.85	95.2	Percent of Total Billed Charges	21.11	87.95	Percent of Total Billed Charges	19.8	82.5	18	24
FECAL CHLORIDE	82438	HCPCS	300	RC		both	24	18	Percent of Total Billed Charges	22.85	95.2	Percent of Total Billed Charges	21.11	87.95	Percent of Total Billed Charges	19.8	82.5	18	24
PARASITE EXAM FOR IDENTIFICATION	87168	HCPCS	300	RC		outpatient	22	16.5	Percent of Total Billed Charges	20.94	95.2	Percent of Total Billed Charges	19.35	87.95	Percent of Total Billed Charges	18.15	82.5	16.5	22
STREPTOCOCCUS PNEUMONIAE URINE	87899	HCPCS	300	RC		both	57	42.75	Percent of Total Billed Charges	54.26	95.2	Percent of Total Billed Charges	50.13	87.95	Percent of Total Billed Charges	47.03	82.5	42.75	57
ALLERGEN SPECIFIC IGE	86003	HCPCS	300	RC		both	20	15	Percent of Total Billed Charges	19.04	95.2	Percent of Total Billed Charges	17.59	87.95	Percent of Total Billed Charges	16.5	82.5	15	20
THYROXINE BINDING GLOBULIN	84442	HCPCS	300	RC		both	50	37.5	Percent of Total Billed Charges	47.6	95.2	Percent of Total Billed Charges	43.98	87.95	Percent of Total Billed Charges	41.25	82.5	37.5	50
I-STAT CHEM 8	80047	HCPCS	300	RC		both	45	33.75	Percent of Total Billed Charges	42.84	95.2	Percent of Total Billed Charges	39.58	87.95	Percent of Total Billed Charges	37.13	82.5	33.75	45
POLICE DEPARTMENT VENIPUNCTURE (AFTER HOURS)	300	RC				both	83	62.25	Percent of Total Billed Charges	79.02	95.2	Percent of Total Billed Charges	73	87.95	Percent of Total Billed Charges	68.48	82.5	62.25	83
POLICE DEPARTMENT VENIPUNCTURE (BUSINESS HOURS)	300	RC				both	57	42.75	Percent of Total Billed Charges	54.26	95.2	Percent of Total Billed Charges	50.13	87.95	Percent of Total Billed Charges	47.03	82.5	42.75	57
IGG SUBCLASS 4	82787	HCPCS	300	RC		both	27	20.25	Percent of Total Billed Charges	25.7	95.2	Percent of Total Billed Charges	23.75	87.95	Percent of Total Billed Charges	22.28	82.5	20.25	27
CELIAC DISEASE PROF/AB	86255	HCPCS	300	RC		both	40	30	Percent of Total Billed Charges	38.08	95.2	Percent of Total Billed Charges	35.18	87.95	Percent of Total Billed Charges	33	82.5	30	40
CELIAC DIS PROF/IMMUNOAS	83516	HCPCS	300	RC		both	39	29.25	Percent of Total Billed Charges	37.13	95.2	Percent of Total Billed Charges	34.3	87.95	Percent of Total Billed Charges	32.18	82.5	29.25	39
CELIAC DISEASE PROF/AB	86255	HCPCS	300	RC		both	39	29.25	Percent of Total Billed Charges	37.13	95.2	Percent of Total Billed Charges	34.3	87.95	Percent of Total Billed Charges	32.18	82.5	29.25	39
DAT PHLEBOTOMY KIT CHARGE	99000	HCPCS	300	RC		both	35	26.25	Percent of Total Billed Charges	33.32	95.2	Percent of Total Billed Charges	30.78	87.95	Percent of Total Billed Charges	28.88	82.5	26.25	35
T CELLS TOTAL COUNT (RITUXAN THERAPY PANEL)	86359	HCPCS	300	RC		both	125	93.75	Percent of Total Billed Charges	119	95.2	Percent of Total Billed Charges	109.94	87.95	Percent of Total Billed Charges	103.13	82.5	93.75	125
B CELLS TOTAL COUNT (RITUXAN THERAPY PANEL)	86355	HCPCS	300	RC		both	125	93.75	Percent of Total Billed Charges	119	95.2	Percent of Total Billed Charges	109.94	87.95	Percent of Total Billed Charges	103.13	82.5	93.75	125
ANABOLIC STEROIDS 1 OR 2	80327	HCPCS	301	RC		both	210	157.5	Percent of Total Billed Charges	199.92	95.2	Percent of Total Billed Charges	184.7	87.95	Percent of Total Billed Charges	173.25	82.5	157.5	210
EPSTEIN BARR VIRUS	86663	HCPCS	300	RC		both	202	151.5	Percent of Total Billed Charges	192.3	95.2	Percent of Total Billed Charges	177.66	87.95	Percent of Total Billed Charges	166.65	82.5	151.5	202
HEMOGLOBIN A1C (BACKUP)	83036	HCPCS	300	RC	QW	both	114	85.5	Percent of Total Billed Charges	108.53	95.2	Percent of Total Billed Charges	100.26	87.95	Percent of Total Billed Charges	94.05	82.5	85.5	114
FECAL FAT QUANITITATIVE	82710	HCPCS	301	RC		both	294	220.5	Percent of Total Billed Charges	279.89	95.2	Percent of Total Billed Charges	258.57	87.95	Percent of Total Billed Charges	242.55	82.5	220.5	294
CAROTENE LEVEL	82380	HCPCS	301	RC		both	82	61.5	Percent of Total Billed Charges	78.06	95.2	Percent of Total Billed Charges	72.12	87.95	Percent of Total Billed Charges	67.65	82.5	61.5	82
GASTRIN LEVEL	82941	HCPCS	301	RC		both	154	115.5	Percent of Total Billed Charges	146.61	95.2	Percent of Total Billed Charges	135.44	87.95	Percent of Total Billed Charges	127.05	82.5	115.5	154
AHG CROSSMATCH	86885	HCPCS	300	RC		both	490	367.5	Percent of Total Billed Charges	466.48	95.2	Percent of Total Billed Charges	430.96	87.95	Percent of Total Billed Charges	404.25	82.5	367.5	490
RUBELLA TITER (HAI)	86280	HCPCS	300	RC		both	104	78	Percent of Total Billed Charges	99.01	95.2	Percent of Total Billed Charges	91.47	87.95	Percent of Total Billed Charges	85.8	82.5	78	104
KETONE BODY(S) QUALITATIVE	82009	HCPCS	310	RC		both	49	36.75	Percent of Total Billed Charges	46.65	95.2	Percent of Total Billed Charges	43.1	87.95	Percent of Total Billed Charges	40.43	82.5	36.75	49
CATECHOLAMINE-BLOOD	82383	HCPCS	301	RC		both	144	108	Percent of Total Billed Charges	137.09	95.2	Percent of Total Billed Charges	126.65	87.95	Percent of Total Billed Charges	118.8	82.5	108	144
CARBON MONOXIDE	82375	HCPCS	301	RC		both	110	82.5	Percent of Total Billed Charges	104.72	95.2	Percent of Total Billed Charges	96.75	87.95	Percent of Total Billed Charges	90.75	82.5	82.5	110
HAPTOGLOBIN	83010	HCPCS	301	RC		both	143	107.25	Percent of Total Billed Charges	136.14	95.2	Percent of Total Billed Charges	125.77	87.95	Percent of Total Billed Charges	117.98	82.5	107.25	143
"CLOTTING INHIBITORS OR ANTICOAGULANTS; ANTITHROMBIN III, ACTIVITY"	85300	HCPCS	300	RC		both	214	160.5	Percent of Total Billed Charges	203.73	95.2	Percent of Total Billed Charges	188.21	87.95	Percent of Total Billed Charges	176.55	82.5	160.5	214
LUTEINIZING  HORMONE (LH)	83002	HCPCS	301	RC		both	151	113.25	Percent of Total Billed Charges	143.75	95.2	Percent of Total Billed Charges	132.8	87.95	Percent of Total Billed Charges	124.58	82.5	113.25	151
ESTROGEN TOTAL AND FRACTIONATED	82671	HCPCS	301	RC		both	329	246.75	Percent of Total Billed Charges	313.21	95.2	Percent of Total Billed Charges	289.36	87.95	Percent of Total Billed Charges	271.43	82.5	246.75	329
FOLLICLE STIM. HORMONE	83001	HCPCS	301	RC		both	151	113.25	Percent of Total Billed Charges	143.75	95.2	Percent of Total Billed Charges	132.8	87.95	Percent of Total Billed Charges	124.58	82.5	113.25	151
VALPROIC ACID (DIPROPYLACETIC ACID) TOTAL	80164	HCPCS	301	RC		both	188	141	Percent of Total Billed Charges	178.98	95.2	Percent of Total Billed Charges	165.35	87.95	Percent of Total Billed Charges	155.1	82.5	141	188
CYTOPATHOLOGY; SPUTUM	88108	HCPCS	300	RC		both	118	88.5	Percent of Total Billed Charges	112.34	95.2	Percent of Total Billed Charges	103.78	87.95	Percent of Total Billed Charges	97.35	82.5	88.5	118
AFP QUAD SCREEN	81511	HCPCS	310	RC		both	277	207.75	Percent of Total Billed Charges	263.7	95.2	Percent of Total Billed Charges	243.62	87.95	Percent of Total Billed Charges	228.53	82.5	207.75	277
"AGGLUTININS, COLD"	86156	HCPCS	300	RC		both	110	82.5	Percent of Total Billed Charges	104.72	95.2	Percent of Total Billed Charges	96.75	87.95	Percent of Total Billed Charges	90.75	82.5	82.5	110
LITHIUM	80178	HCPCS	301	RC		both	111	83.25	Percent of Total Billed Charges	105.67	95.2	Percent of Total Billed Charges	97.62	87.95	Percent of Total Billed Charges	91.58	82.5	83.25	111
"PORPHYRINS, URINE"	84120	HCPCS	300	RC		both	128	96	Percent of Total Billed Charges	121.86	95.2	Percent of Total Billed Charges	112.58	87.95	Percent of Total Billed Charges	105.6	82.5	96	128
RPR-SYPHILIS SEROLOGY	86592	HCPCS	300	RC		both	68	51	Percent of Total Billed Charges	64.74	95.2	Percent of Total Billed Charges	59.81	87.95	Percent of Total Billed Charges	56.1	82.5	51	68
CHOLESTEROL (BACKUP)	82465	HCPCS	300	RC	QW	both	70	52.5	Percent of Total Billed Charges	66.64	95.2	Percent of Total Billed Charges	61.57	87.95	Percent of Total Billed Charges	57.75	82.5	52.5	70
THYROID MICROSOMAL ANTI	86376	HCPCS	300	RC		both	144	108	Percent of Total Billed Charges	137.09	95.2	Percent of Total Billed Charges	126.65	87.95	Percent of Total Billed Charges	118.8	82.5	108	144
ACID FAST BACTERIA CULT	87040	HCPCS	300	RC		both	184	138	Percent of Total Billed Charges	175.17	95.2	Percent of Total Billed Charges	161.83	87.95	Percent of Total Billed Charges	151.8	82.5	138	184
DELTA AMINOLEVULINIC ACID	82135	HCPCS	301	RC		both	128	96	Percent of Total Billed Charges	121.86	95.2	Percent of Total Billed Charges	112.58	87.95	Percent of Total Billed Charges	105.6	82.5	96	128
PORPHOBILINOGEN 24HR URIN	84110	HCPCS	300	RC		both	69	51.75	Percent of Total Billed Charges	65.69	95.2	Percent of Total Billed Charges	60.69	87.95	Percent of Total Billed Charges	56.93	82.5	51.75	69
MAGNESIUM SERUM (BACKUP)	83735	HCPCS	300	RC		both	111	83.25	Percent of Total Billed Charges	105.67	95.2	Percent of Total Billed Charges	97.62	87.95	Percent of Total Billed Charges	91.58	82.5	83.25	111
CHLOINESTERASE-SERUM	82480	HCPCS	301	RC		both	128	96	Percent of Total Billed Charges	121.86	95.2	Percent of Total Billed Charges	112.58	87.95	Percent of Total Billed Charges	105.6	82.5	96	128
CSF CULTURE	87070	HCPCS	300	RC		both	104	78	Percent of Total Billed Charges	99.01	95.2	Percent of Total Billed Charges	91.47	87.95	Percent of Total Billed Charges	85.8	82.5	78	104
LDH ISOENZYMES	83625	HCPCS	301	RC		both	25	18.75	Percent of Total Billed Charges	23.8	95.2	Percent of Total Billed Charges	21.99	87.95	Percent of Total Billed Charges	20.63	82.5	18.75	25
ANTITHYROID ANTIBODY	86800	HCPCS	300	RC		both	128	96	Percent of Total Billed Charges	121.86	95.2	Percent of Total Billed Charges	112.58	87.95	Percent of Total Billed Charges	105.6	82.5	96	128
BENCE JONES PROTEIN	84165	HCPCS	300	RC		both	160	120	Percent of Total Billed Charges	152.32	95.2	Percent of Total Billed Charges	140.72	87.95	Percent of Total Billed Charges	132	82.5	120	160
CSF FUNGUS & CULTURE	87070	HCPCS	300	RC		both	104	78	Percent of Total Billed Charges	99.01	95.2	Percent of Total Billed Charges	91.47	87.95	Percent of Total Billed Charges	85.8	82.5	78	104
POTASSIUM 24 HR URINE (IN-HOUSE)	84133	HCPCS	300	RC		both	49	36.75	Percent of Total Billed Charges	46.65	95.2	Percent of Total Billed Charges	43.1	87.95	Percent of Total Billed Charges	40.43	82.5	36.75	49
SODIUM 24 HR URINE (IN-HOUSE)	84300	HCPCS	300	RC		both	70	52.5	Percent of Total Billed Charges	66.64	95.2	Percent of Total Billed Charges	61.57	87.95	Percent of Total Billed Charges	57.75	82.5	52.5	70
TRIGLYCERIDES (IN-HOUSE)	84478	HCPCS	300	RC		both	78	58.5	Percent of Total Billed Charges	74.26	95.2	Percent of Total Billed Charges	68.6	87.95	Percent of Total Billed Charges	64.35	82.5	58.5	78
LEGIONELLA STAIN	86256	HCPCS	300	RC		both	151	113.25	Percent of Total Billed Charges	143.75	95.2	Percent of Total Billed Charges	132.8	87.95	Percent of Total Billed Charges	124.58	82.5	113.25	151
ALT SERUM (BACKUP)	84460	HCPCS	300	RC	QW	both	70	52.5	Percent of Total Billed Charges	66.64	95.2	Percent of Total Billed Charges	61.57	87.95	Percent of Total Billed Charges	57.75	82.5	52.5	70
GGT (BACKUP)	82977	HCPCS	300	RC	QW	both	84	63	Percent of Total Billed Charges	79.97	95.2	Percent of Total Billed Charges	73.88	87.95	Percent of Total Billed Charges	69.3	82.5	63	84
LEAD CHILD SERUM	83655	HCPCS	301	RC		both	47	35.25	Percent of Total Billed Charges	44.74	95.2	Percent of Total Billed Charges	41.34	87.95	Percent of Total Billed Charges	38.78	82.5	35.25	47
LACTOFERRIN FECAL	83630	HCPCS	300	RC		both	92	69	Percent of Total Billed Charges	87.58	95.2	Percent of Total Billed Charges	80.91	87.95	Percent of Total Billed Charges	75.9	82.5	69	92
PROGESTERONE LEVEL	84144	HCPCS	300	RC		both	151	113.25	Percent of Total Billed Charges	143.75	95.2	Percent of Total Billed Charges	132.8	87.95	Percent of Total Billed Charges	124.58	82.5	113.25	151
INDIA INK PREP	87210	HCPCS	300	RC		both	49	36.75	Percent of Total Billed Charges	46.65	95.2	Percent of Total Billed Charges	43.1	87.95	Percent of Total Billed Charges	40.43	82.5	36.75	49
SERUM PREGNANCY QUALITATIVE	84703	HCPCS	300	RC		both	155	116.25	Percent of Total Billed Charges	147.56	95.2	Percent of Total Billed Charges	136.32	87.95	Percent of Total Billed Charges	127.88	82.5	116.25	155
"DHEA, SULFATE"	82627	HCPCS	301	RC		both	213	159.75	Percent of Total Billed Charges	202.78	95.2	Percent of Total Billed Charges	187.33	87.95	Percent of Total Billed Charges	175.73	82.5	159.75	213
ACETAMINOPHEN SERUM (IN-HOUSE)	80329	HCPCS	301	RC		both	287	215.25	Percent of Total Billed Charges	273.22	95.2	Percent of Total Billed Charges	252.42	87.95	Percent of Total Billed Charges	236.78	82.5	215.25	287
METANEPHRINES(URINE 24 HR	83835	HCPCS	300	RC		both	279	209.25	Percent of Total Billed Charges	265.61	95.2	Percent of Total Billed Charges	245.38	87.95	Percent of Total Billed Charges	230.18	82.5	209.25	279
"OSMOLATILY, URINE"	83935	HCPCS	300	RC		both	111	83.25	Percent of Total Billed Charges	105.67	95.2	Percent of Total Billed Charges	97.62	87.95	Percent of Total Billed Charges	91.58	82.5	83.25	111
TOTAL PSA (IN-HOUSE)	84153	HCPCS	300	RC		both	151	113.25	Percent of Total Billed Charges	143.75	95.2	Percent of Total Billed Charges	132.8	87.95	Percent of Total Billed Charges	124.58	82.5	113.25	151
CERULOPLASMIN	82390	HCPCS	301	RC		both	64	48	Percent of Total Billed Charges	60.93	95.2	Percent of Total Billed Charges	56.29	87.95	Percent of Total Billed Charges	52.8	82.5	48	64
ANTIMITOCONDRIAL AB	83516	HCPCS	302	RC		both	189	141.75	Percent of Total Billed Charges	179.93	95.2	Percent of Total Billed Charges	166.23	87.95	Percent of Total Billed Charges	155.93	82.5	141.75	189
"CULTURE, URINE (MICRO)"	87086	HCPCS	300	RC		both	111	83.25	Percent of Total Billed Charges	105.67	95.2	Percent of Total Billed Charges	97.62	87.95	Percent of Total Billed Charges	91.58	82.5	83.25	111
"CULTURE, WOUND"	87070	HCPCS	300	RC		both	144	108	Percent of Total Billed Charges	137.09	95.2	Percent of Total Billed Charges	126.65	87.95	Percent of Total Billed Charges	118.8	82.5	108	144
HEPATITIS CORE AB	86704	HCPCS	300	RC		both	160	120	Percent of Total Billed Charges	152.32	95.2	Percent of Total Billed Charges	140.72	87.95	Percent of Total Billed Charges	132	82.5	120	160
RBC ANTIBODY ID	86870	HCPCS	390	RC		both	184	138	Percent of Total Billed Charges	175.17	95.2	Percent of Total Billed Charges	161.83	87.95	Percent of Total Billed Charges	151.8	82.5	138	184
ANTI THYROGLOBLIN AB	86800	HCPCS	300	RC		both	121	90.75	Percent of Total Billed Charges	115.19	95.2	Percent of Total Billed Charges	106.42	87.95	Percent of Total Billed Charges	99.83	82.5	90.75	121
PHENYTOIN (DILANTIN IN-HOUSE)	80185	HCPCS	301	RC		both	189	141.75	Percent of Total Billed Charges	179.93	95.2	Percent of Total Billed Charges	166.23	87.95	Percent of Total Billed Charges	155.93	82.5	141.75	189
"HIV 1,2 SCREEN"	86703	HCPCS	300	RC		both	131	98.25	Percent of Total Billed Charges	124.71	95.2	Percent of Total Billed Charges	115.21	87.95	Percent of Total Billed Charges	108.08	82.5	98.25	131
RUBELLA SCREEN	86762	HCPCS	300	RC		both	89	66.75	Percent of Total Billed Charges	84.73	95.2	Percent of Total Billed Charges	78.28	87.95	Percent of Total Billed Charges	73.43	82.5	66.75	89
ANA SCREEN (REFLEX)	86038	HCPCS	300	RC		both	127	95.25	Percent of Total Billed Charges	120.9	95.2	Percent of Total Billed Charges	111.7	87.95	Percent of Total Billed Charges	104.78	82.5	95.25	127
CARBAMAZEPINE (TEGR)	80156	HCPCS	301	RC		both	169	126.75	Percent of Total Billed Charges	160.89	95.2	Percent of Total Billed Charges	148.64	87.95	Percent of Total Billed Charges	139.43	82.5	126.75	169
ACTH (ADRENOCORTICOTROPIC HORMONE)	82024	HCPCS	300	RC		both	226	169.5	Percent of Total Billed Charges	215.15	95.2	Percent of Total Billed Charges	198.77	87.95	Percent of Total Billed Charges	186.45	82.5	169.5	226
CHLIONESTERASE-RBC	82482	HCPCS	301	RC		both	113	84.75	Percent of Total Billed Charges	107.58	95.2	Percent of Total Billed Charges	99.38	87.95	Percent of Total Billed Charges	93.23	82.5	84.75	113
"ALDOSTERONE, SERUM"	82088	HCPCS	310	RC		both	195	146.25	Percent of Total Billed Charges	185.64	95.2	Percent of Total Billed Charges	171.5	87.95	Percent of Total Billed Charges	160.88	82.5	146.25	195
"CATECHOLAMINE, URINE"	82382	HCPCS	301	RC		both	163	122.25	Percent of Total Billed Charges	155.18	95.2	Percent of Total Billed Charges	143.36	87.95	Percent of Total Billed Charges	134.48	82.5	122.25	163
ESR (SED RATE)	85651	HCPCS	300	RC		both	84	63	Percent of Total Billed Charges	79.97	95.2	Percent of Total Billed Charges	73.88	87.95	Percent of Total Billed Charges	69.3	82.5	63	84
GROWTH HORMONE	83003	HCPCS	301	RC		both	144	108	Percent of Total Billed Charges	137.09	95.2	Percent of Total Billed Charges	126.65	87.95	Percent of Total Billed Charges	118.8	82.5	108	144
LACTIC ACID (BACKUP)	83605	HCPCS	300	RC	QW	both	166	124.5	Percent of Total Billed Charges	158.03	95.2	Percent of Total Billed Charges	146	87.95	Percent of Total Billed Charges	136.95	82.5	124.5	166
T3 TOTAL	84480	HCPCS	300	RC		both	145	108.75	Percent of Total Billed Charges	138.04	95.2	Percent of Total Billed Charges	127.53	87.95	Percent of Total Billed Charges	119.63	82.5	108.75	145
BLEEDING TIME	85002	HCPCS	300	RC		both	110	82.5	Percent of Total Billed Charges	104.72	95.2	Percent of Total Billed Charges	96.75	87.95	Percent of Total Billed Charges	90.75	82.5	82.5	110
HEMOGLOBIN (HGB)	85018	HCPCS	300	RC		both	53	39.75	Percent of Total Billed Charges	50.46	95.2	Percent of Total Billed Charges	46.61	87.95	Percent of Total Billed Charges	43.73	82.5	39.75	53
"THROMBIN TIME, PLASMA"	85670	HCPCS	300	RC		both	137	102.75	Percent of Total Billed Charges	130.42	95.2	Percent of Total Billed Charges	120.49	87.95	Percent of Total Billed Charges	113.03	82.5	102.75	137
"CULTURE, FUNGAL"	87101	HCPCS	300	RC		both	140	105	Percent of Total Billed Charges	133.28	95.2	Percent of Total Billed Charges	123.13	87.95	Percent of Total Billed Charges	115.5	82.5	105	140
"CULTURE, VIRAL"	87250	HCPCS	300	RC		both	226	169.5	Percent of Total Billed Charges	215.15	95.2	Percent of Total Billed Charges	198.77	87.95	Percent of Total Billed Charges	186.45	82.5	169.5	226
SPERM COUNT	89321	HCPCS	300	RC		both	84	63	Percent of Total Billed Charges	79.97	95.2	Percent of Total Billed Charges	73.88	87.95	Percent of Total Billed Charges	69.3	82.5	63	84
UA COMPLETE	81001	HCPCS	300	RC		both	79	59.25	Percent of Total Billed Charges	75.21	95.2	Percent of Total Billed Charges	69.48	87.95	Percent of Total Billed Charges	65.18	82.5	59.25	79
TISSUE BIOPSY 4	88305	HCPCS	300	RC		both	188	141	Percent of Total Billed Charges	178.98	95.2	Percent of Total Billed Charges	165.35	87.95	Percent of Total Billed Charges	155.1	82.5	141	188
ANTIDEPRESSANT TRICYCLIC AND OTHER CYCLICALS 1 OR 2	80335	HCPCS	301	RC		both	151	113.25	Percent of Total Billed Charges	143.75	95.2	Percent of Total Billed Charges	132.8	87.95	Percent of Total Billed Charges	124.58	82.5	113.25	151
ANA PROFILE	86235	HCPCS	300	RC		both	81	60.75	Percent of Total Billed Charges	77.11	95.2	Percent of Total Billed Charges	71.24	87.95	Percent of Total Billed Charges	66.83	82.5	60.75	81
"VITAMIN B1, WHOLE BLOOD"	84425	HCPCS	300	RC		both	267	200.25	Percent of Total Billed Charges	254.18	95.2	Percent of Total Billed Charges	234.83	87.95	Percent of Total Billed Charges	220.28	82.5	200.25	267
"PROTEIN ELECTROPHORESIS, SERUM"	84165	HCPCS	300	RC		both	80	60	Percent of Total Billed Charges	76.16	95.2	Percent of Total Billed Charges	70.36	87.95	Percent of Total Billed Charges	66	82.5	60	80
CSFP3/GLUCOSE	82945	HCPCS	301	RC		both	49	36.75	Percent of Total Billed Charges	46.65	95.2	Percent of Total Billed Charges	43.1	87.95	Percent of Total Billed Charges	40.43	82.5	36.75	49
PRESUMPTIVE DRUG CLASS SCREENING PROCEDURES	80307	HCPCS	301	RC		both	254	190.5	Percent of Total Billed Charges	241.81	95.2	Percent of Total Billed Charges	223.39	87.95	Percent of Total Billed Charges	209.55	82.5	190.5	254
URINE DRUG SCREEN (IN-HOUSE)	80305	HCPCS	301	RC		both	83	62.25	Percent of Total Billed Charges	79.02	95.2	Percent of Total Billed Charges	73	87.95	Percent of Total Billed Charges	68.48	82.5	62.25	83
GLUCOSE TOLERANCE 3 TEST HOUR (IN-HOUSE)	82951	HCPCS	300	RC		both	70	52.5	Percent of Total Billed Charges	66.64	95.2	Percent of Total Billed Charges	61.57	87.95	Percent of Total Billed Charges	57.75	82.5	52.5	70
LIPID PANEL (BACKUP)	80061	HCPCS	300	RC	QW	both	145	108.75	Percent of Total Billed Charges	138.04	95.2	Percent of Total Billed Charges	127.53	87.95	Percent of Total Billed Charges	119.63	82.5	108.75	145
FECAL FATS	89125	HCPCS	300	RC		both	49	36.75	Percent of Total Billed Charges	46.65	95.2	Percent of Total Billed Charges	43.1	87.95	Percent of Total Billed Charges	40.43	82.5	36.75	49
GENITAL CULTURE	87070	HCPCS	300	RC		both	110	82.5	Percent of Total Billed Charges	104.72	95.2	Percent of Total Billed Charges	96.75	87.95	Percent of Total Billed Charges	90.75	82.5	82.5	110
ORGANIC ACIDS SCR MAYO	83918	HCPCS	300	RC		both	310	232.5	Percent of Total Billed Charges	295.12	95.2	Percent of Total Billed Charges	272.65	87.95	Percent of Total Billed Charges	255.75	82.5	232.5	310
CA 19-9	86301	HCPCS	302	RC		both	179	134.25	Percent of Total Billed Charges	170.41	95.2	Percent of Total Billed Charges	157.43	87.95	Percent of Total Billed Charges	147.68	82.5	134.25	179
GENC. GENITAL CULT. 1	87070	HCPCS	300	RC		both	104	78	Percent of Total Billed Charges	99.01	95.2	Percent of Total Billed Charges	91.47	87.95	Percent of Total Billed Charges	85.8	82.5	78	104
GENC. GENITAL CULT 2	87205	HCPCS	300	RC		both	104	78	Percent of Total Billed Charges	99.01	95.2	Percent of Total Billed Charges	91.47	87.95	Percent of Total Billed Charges	85.8	82.5	78	104
TISSUE BIOPSY 3	88304	HCPCS	300	RC		both	104	78	Percent of Total Billed Charges	99.01	95.2	Percent of Total Billed Charges	91.47	87.95	Percent of Total Billed Charges	85.8	82.5	78	104
MEGALOBLASTIC ANEMIA 1&2	83918	HCPCS	300	RC		both	310	232.5	Percent of Total Billed Charges	295.12	95.2	Percent of Total Billed Charges	272.65	87.95	Percent of Total Billed Charges	255.75	82.5	232.5	310
"OSMOLALITY, SERUM"	83930	HCPCS	300	RC		both	78	58.5	Percent of Total Billed Charges	74.26	95.2	Percent of Total Billed Charges	68.6	87.95	Percent of Total Billed Charges	64.35	82.5	58.5	78
INSULIN GROWTH FACTOR BINDING PROTEIN 3	82397	HCPCS	301	RC		both	218	163.5	Percent of Total Billed Charges	207.54	95.2	Percent of Total Billed Charges	191.73	87.95	Percent of Total Billed Charges	179.85	82.5	163.5	218
FACTOR V111 (AHG)	85240	HCPCS	300	RC		both	244	183	Percent of Total Billed Charges	232.29	95.2	Percent of Total Billed Charges	214.6	87.95	Percent of Total Billed Charges	201.3	82.5	183	244
FEP	84202	HCPCS	300	RC		both	70	52.5	Percent of Total Billed Charges	66.64	95.2	Percent of Total Billed Charges	61.57	87.95	Percent of Total Billed Charges	57.75	82.5	52.5	70
STREP SCREEN	87430	HCPCS	300	RC		both	95	71.25	Percent of Total Billed Charges	90.44	95.2	Percent of Total Billed Charges	83.55	87.95	Percent of Total Billed Charges	78.38	82.5	71.25	95
RENIN ACTIVITY	84244	HCPCS	300	RC		both	193	144.75	Percent of Total Billed Charges	183.74	95.2	Percent of Total Billed Charges	169.74	87.95	Percent of Total Billed Charges	159.23	82.5	144.75	193
PREALBUMIN SERUM	84134	HCPCS	300	RC		both	144	108	Percent of Total Billed Charges	137.09	95.2	Percent of Total Billed Charges	126.65	87.95	Percent of Total Billed Charges	118.8	82.5	108	144
IRON BINDING CAPACITY (IN-HOUSE)	83550	HCPCS	301	RC		both	101	75.75	Percent of Total Billed Charges	96.15	95.2	Percent of Total Billed Charges	88.83	87.95	Percent of Total Billed Charges	83.33	82.5	75.75	101
TSHL (IN-HOUSE)	84443	HCPCS	300	RC		both	148	111	Percent of Total Billed Charges	140.9	95.2	Percent of Total Billed Charges	130.17	87.95	Percent of Total Billed Charges	122.1	82.5	111	148
RANDOM URIC ACID-URINE (IN-HOUSE)	84560	HCPCS	300	RC		both	103	77.25	Percent of Total Billed Charges	98.06	95.2	Percent of Total Billed Charges	90.59	87.95	Percent of Total Billed Charges	84.98	82.5	77.25	103
URINE CREATININE RANDOM (IN-HOUSE)	82570	HCPCS	301	RC		both	104	78	Percent of Total Billed Charges	99.01	95.2	Percent of Total Billed Charges	91.47	87.95	Percent of Total Billed Charges	85.8	82.5	78	104
URINE TOTAL PROTEIN 24 HR (IN-HOUSE)	84156	HCPCS	300	RC		both	86	64.5	Percent of Total Billed Charges	81.87	95.2	Percent of Total Billed Charges	75.64	87.95	Percent of Total Billed Charges	70.95	82.5	64.5	86
HEPATITIS C ANTIBODY	86803	HCPCS	300	RC	QW	both	154	115.5	Percent of Total Billed Charges	146.61	95.2	Percent of Total Billed Charges	135.44	87.95	Percent of Total Billed Charges	127.05	82.5	115.5	154
CA 125	86304	HCPCS	300	RC		both	204	153	Percent of Total Billed Charges	194.21	95.2	Percent of Total Billed Charges	179.42	87.95	Percent of Total Billed Charges	168.3	82.5	153	204
DEXAMETHASONE	82542	HCPCS	301	RC		both	332	249	Percent of Total Billed Charges	316.06	95.2	Percent of Total Billed Charges	291.99	87.95	Percent of Total Billed Charges	273.9	82.5	249	332
MICROALBUMIN RANDOM (IN-HOUSE)	82043	HCPCS	301	RC		both	184	138	Percent of Total Billed Charges	175.17	95.2	Percent of Total Billed Charges	161.83	87.95	Percent of Total Billed Charges	151.8	82.5	138	184
RENAL PROFILE (BACKUP)	80069	HCPCS	301	RC	QW	both	293	219.75	Percent of Total Billed Charges	278.94	95.2	Percent of Total Billed Charges	257.69	87.95	Percent of Total Billed Charges	241.73	82.5	219.75	293
GLUCOSE TOLERANCE TEST 1 HOUR (BACKUP)	82951	HCPCS	300	RC	QW	both	101	75.75	Percent of Total Billed Charges	96.15	95.2	Percent of Total Billed Charges	88.83	87.95	Percent of Total Billed Charges	83.33	82.5	75.75	101
ANAEROBIC BACTERIA CULTURE	87075	HCPCS	300	RC		both	151	113.25	Percent of Total Billed Charges	143.75	95.2	Percent of Total Billed Charges	132.8	87.95	Percent of Total Billed Charges	124.58	82.5	113.25	151
ANTI TPO ANTIBODY (MAB)	86376	HCPCS	300	RC		both	144	108	Percent of Total Billed Charges	137.09	95.2	Percent of Total Billed Charges	126.65	87.95	Percent of Total Billed Charges	118.8	82.5	108	144
ANTI TSI ANTIBODY (TSIM)	84445	HCPCS	300	RC		both	293	219.75	Percent of Total Billed Charges	278.94	95.2	Percent of Total Billed Charges	257.69	87.95	Percent of Total Billed Charges	241.73	82.5	219.75	293
PH MISC. FLUID	83986	HCPCS	300	RC		both	44	33	Percent of Total Billed Charges	41.89	95.2	Percent of Total Billed Charges	38.7	87.95	Percent of Total Billed Charges	36.3	82.5	33	44
RUBELLA SCREEN	86762	HCPCS	300	RC		both	137	102.75	Percent of Total Billed Charges	130.42	95.2	Percent of Total Billed Charges	120.49	87.95	Percent of Total Billed Charges	113.03	82.5	102.75	137
RETIC COUNT (RTIC)	85046	HCPCS	300	RC		both	27	20.25	Percent of Total Billed Charges	25.7	95.2	Percent of Total Billed Charges	23.75	87.95	Percent of Total Billed Charges	22.28	82.5	20.25	27
FLDC/FLUID CULTURE 1	87070	HCPCS	300	RC		both	144	108	Percent of Total Billed Charges	137.09	95.2	Percent of Total Billed Charges	126.65	87.95	Percent of Total Billed Charges	118.8	82.5	108	144
PROTIME REFERENCE LAB	85610	HCPCS	300	RC		both	200	150	Percent of Total Billed Charges	190.4	95.2	Percent of Total Billed Charges	175.9	87.95	Percent of Total Billed Charges	165	82.5	150	200
CALCIUM IONIZED (IN HOUSE)	82330	HCPCS	301	RC	QW	both	160	120	Percent of Total Billed Charges	152.32	95.2	Percent of Total Billed Charges	140.72	87.95	Percent of Total Billed Charges	132	82.5	120	160
CALCULATED LDH (BACKUP)	83615	HCPCS	301	RC		both	83	62.25	Percent of Total Billed Charges	79.02	95.2	Percent of Total Billed Charges	73	87.95	Percent of Total Billed Charges	68.48	82.5	62.25	83
FLDC/FLUID CULTURE 2	87205	HCPCS	300	RC		both	72	54	Percent of Total Billed Charges	68.54	95.2	Percent of Total Billed Charges	63.32	87.95	Percent of Total Billed Charges	59.4	82.5	54	72
"CORTISOL (SERUM), R, AM, PM"	82533	HCPCS	301	RC		both	179	134.25	Percent of Total Billed Charges	170.41	95.2	Percent of Total Billed Charges	157.43	87.95	Percent of Total Billed Charges	147.68	82.5	134.25	179
VENOUS BLOOD GAS	82803	HCPCS	301	RC	QW	both	292	219	Percent of Total Billed Charges	277.98	95.2	Percent of Total Billed Charges	256.81	87.95	Percent of Total Billed Charges	240.9	82.5	219	292
BRUCELLA IGG IGM	86622	HCPCS	300	RC		both	214	160.5	Percent of Total Billed Charges	203.73	95.2	Percent of Total Billed Charges	188.21	87.95	Percent of Total Billed Charges	176.55	82.5	160.5	214
CMV PCR	87497	HCPCS	300	RC		both	310	232.5	Percent of Total Billed Charges	295.12	95.2	Percent of Total Billed Charges	272.65	87.95	Percent of Total Billed Charges	255.75	82.5	232.5	310
TOPIRAMATE	80201	HCPCS	301	RC		both	285	213.75	Percent of Total Billed Charges	271.32	95.2	Percent of Total Billed Charges	250.66	87.95	Percent of Total Billed Charges	235.13	82.5	213.75	285
C-REACTIVE PROTEIN (QUANT) REF	86140	HCPCS	300	RC		both	122	91.5	Percent of Total Billed Charges	116.14	95.2	Percent of Total Billed Charges	107.3	87.95	Percent of Total Billed Charges	100.65	82.5	91.5	122
CANCER ANTIGEN 27-29	86300	HCPCS	300	RC		both	236	177	Percent of Total Billed Charges	224.67	95.2	Percent of Total Billed Charges	207.56	87.95	Percent of Total Billed Charges	194.7	82.5	177	236
ANITGLOMERULAR BASEMENT MEMBRANE ANTIBODIES	83516	HCPCS	302	RC		both	189	141.75	Percent of Total Billed Charges	179.93	95.2	Percent of Total Billed Charges	166.23	87.95	Percent of Total Billed Charges	155.93	82.5	141.75	189
HYPERSENSITIVITY PNEUMONITIS (FARMER'S LUNG)	86331	HCPCS	300	RC		both	184	138	Percent of Total Billed Charges	175.17	95.2	Percent of Total Billed Charges	161.83	87.95	Percent of Total Billed Charges	151.8	82.5	138	184
METHELYNETETRADLYDROFOLATE GENETICS	86890	HCPCS	300	RC		both	635	476.25	Percent of Total Billed Charges	604.52	95.2	Percent of Total Billed Charges	558.48	87.95	Percent of Total Billed Charges	523.88	82.5	476.25	635
URINE EOSINOPHIL	87205	HCPCS	300	RC		both	53	39.75	Percent of Total Billed Charges	50.46	95.2	Percent of Total Billed Charges	46.61	87.95	Percent of Total Billed Charges	43.73	82.5	39.75	53
"EHRLICHIA CHAFEENSIS & ANAPLASMA PHAGOCTOPHILUM IGG, IGM"	86666	HCPCS	300	RC		both	1611	1208.25	Percent of Total Billed Charges	1533.67	95.2	Percent of Total Billed Charges	1416.87	87.95	Percent of Total Billed Charges	1329.08	82.5	1208.25	1611
BABESIA MICROTI	86753	HCPCS	300	RC		both	689	516.75	Percent of Total Billed Charges	655.93	95.2	Percent of Total Billed Charges	605.98	87.95	Percent of Total Billed Charges	568.43	82.5	516.75	689
H. PYLORI BREATH TEST (ANALYSIS)	83013	HCPCS	309	RC		both	203	152.25	Percent of Total Billed Charges	193.26	95.2	Percent of Total Billed Charges	178.54	87.95	Percent of Total Billed Charges	167.48	82.5	152.25	203
H. PYLORI BREATH TEST (COLLECTION)	83014	HCPCS	309	RC		both	26	19.5	Percent of Total Billed Charges	24.75	95.2	Percent of Total Billed Charges	22.87	87.95	Percent of Total Billed Charges	21.45	82.5	19.5	26
H. PYLORI BREATH TEST PROFILE	83013	HCPCS	301	RC		both	227	170.25	Percent of Total Billed Charges	216.1	95.2	Percent of Total Billed Charges	199.65	87.95	Percent of Total Billed Charges	187.28	82.5	170.25	227
COPPER 24H URINE	82525	HCPCS	301	RC		both	171	128.25	Percent of Total Billed Charges	162.79	95.2	Percent of Total Billed Charges	150.39	87.95	Percent of Total Billed Charges	141.08	82.5	128.25	171
ANTINEUTROPHIL ANTIBODIES	86255	HCPCS	300	RC		both	184	138	Percent of Total Billed Charges	175.17	95.2	Percent of Total Billed Charges	161.83	87.95	Percent of Total Billed Charges	151.8	82.5	138	184
C4 COMPLEMENT	86160	HCPCS	300	RC		both	122	91.5	Percent of Total Billed Charges	116.14	95.2	Percent of Total Billed Charges	107.3	87.95	Percent of Total Billed Charges	100.65	82.5	91.5	122
PSA SCREENING (IN-HOUSE)	G0103	HCPCS	300	RC		both	166	124.5	Percent of Total Billed Charges	158.03	95.2	Percent of Total Billed Charges	146	87.95	Percent of Total Billed Charges	136.95	82.5	124.5	166
ANTI SCL 70	86235	HCPCS	300	RC		both	140	105	Percent of Total Billed Charges	133.28	95.2	Percent of Total Billed Charges	123.13	87.95	Percent of Total Billed Charges	115.5	82.5	105	140
ANTI RNA POLYMERASE	86038	HCPCS	300	RC		both	192	144	Percent of Total Billed Charges	182.78	95.2	Percent of Total Billed Charges	168.86	87.95	Percent of Total Billed Charges	158.4	82.5	144	192
ANTI CENTROMER	86255	HCPCS	300	RC		both	186	139.5	Percent of Total Billed Charges	177.07	95.2	Percent of Total Billed Charges	163.59	87.95	Percent of Total Billed Charges	153.45	82.5	139.5	186
ESTRADIOL SERUM	82670	HCPCS	301	RC		both	188	141	Percent of Total Billed Charges	178.98	95.2	Percent of Total Billed Charges	165.35	87.95	Percent of Total Billed Charges	155.1	82.5	141	188
PARVOVIRUS ANTIBODY B19 IGM	86747	HCPCS	300	RC		both	364	273	Percent of Total Billed Charges	346.53	95.2	Percent of Total Billed Charges	320.14	87.95	Percent of Total Billed Charges	300.3	82.5	273	364
CMV ANTIBODIES IGG	86644	HCPCS	300	RC		both	146	109.5	Percent of Total Billed Charges	138.99	95.2	Percent of Total Billed Charges	128.41	87.95	Percent of Total Billed Charges	120.45	82.5	109.5	146
CMV ANTIBODIES IGM	86645	HCPCS	300	RC		both	165	123.75	Percent of Total Billed Charges	157.08	95.2	Percent of Total Billed Charges	145.12	87.95	Percent of Total Billed Charges	136.13	82.5	123.75	165
OSTEOCALCIN	83937	HCPCS	300	RC		both	137	102.75	Percent of Total Billed Charges	130.42	95.2	Percent of Total Billed Charges	120.49	87.95	Percent of Total Billed Charges	113.03	82.5	102.75	137
SJORGEN'S ANTIBODIES	86235	HCPCS	300	RC		both	128	96	Percent of Total Billed Charges	121.86	95.2	Percent of Total Billed Charges	112.58	87.95	Percent of Total Billed Charges	105.6	82.5	96	128
URINE CYTOLOGY	88108	HCPCS	300	RC		both	131	98.25	Percent of Total Billed Charges	124.71	95.2	Percent of Total Billed Charges	115.21	87.95	Percent of Total Billed Charges	108.08	82.5	98.25	131
HFE(HEMOCHROMATOSIS) GENE ANALYSIS COMMON VARIANTS	81256	HCPCS	310	RC		both	606	454.5	Percent of Total Billed Charges	576.91	95.2	Percent of Total Billed Charges	532.98	87.95	Percent of Total Billed Charges	499.95	82.5	454.5	606
"CULTURE, NASAL"	87070	HCPCS	300	RC		both	95	71.25	Percent of Total Billed Charges	90.44	95.2	Percent of Total Billed Charges	83.55	87.95	Percent of Total Billed Charges	78.38	82.5	71.25	95
CANIDIA SPECIFIC IGG	86628	HCPCS	300	RC		both	221	165.75	Percent of Total Billed Charges	210.39	95.2	Percent of Total Billed Charges	194.37	87.95	Percent of Total Billed Charges	182.33	82.5	165.75	221
CANDIDA SPECIFIC IGM	86628	HCPCS	300	RC		both	221	165.75	Percent of Total Billed Charges	210.39	95.2	Percent of Total Billed Charges	194.37	87.95	Percent of Total Billed Charges	182.33	82.5	165.75	221
CANDIDA SPECIFIC IGA	86628	HCPCS	300	RC		both	221	165.75	Percent of Total Billed Charges	210.39	95.2	Percent of Total Billed Charges	194.37	87.95	Percent of Total Billed Charges	182.33	82.5	165.75	221
"BRUCELLA ABORTUS,IGM"	86622	HCPCS	300	RC		both	104	78	Percent of Total Billed Charges	99.01	95.2	Percent of Total Billed Charges	91.47	87.95	Percent of Total Billed Charges	85.8	82.5	78	104
TISSUE TRANSGLUTAMINASE	86364	HCPCS	300	RC		both	118	88.5	Percent of Total Billed Charges	112.34	95.2	Percent of Total Billed Charges	103.78	87.95	Percent of Total Billed Charges	97.35	82.5	88.5	118
URINE 5-HIAA	81005	HCPCS	307	RC		both	95	71.25	Percent of Total Billed Charges	90.44	95.2	Percent of Total Billed Charges	83.55	87.95	Percent of Total Billed Charges	78.38	82.5	71.25	95
URINE ELE FRAC	84166	HCPCS	300	RC		both	84	63	Percent of Total Billed Charges	79.97	95.2	Percent of Total Billed Charges	73.88	87.95	Percent of Total Billed Charges	69.3	82.5	63	84
URINE IMM ELECTPHSIS	86334	HCPCS	300	RC		both	95	71.25	Percent of Total Billed Charges	90.44	95.2	Percent of Total Billed Charges	83.55	87.95	Percent of Total Billed Charges	78.38	82.5	71.25	95
ARTERIAL OR VENOUS	82800	HCPCS	301	RC		both	70	52.5	Percent of Total Billed Charges	66.64	95.2	Percent of Total Billed Charges	61.57	87.95	Percent of Total Billed Charges	57.75	82.5	52.5	70
ORGANISM ID	87077	HCPCS	300	RC		both	38	28.5	Percent of Total Billed Charges	36.18	95.2	Percent of Total Billed Charges	33.42	87.95	Percent of Total Billed Charges	31.35	82.5	28.5	38
METHYLMALONIC ACID	83921	HCPCS	300	RC		both	391	293.25	Percent of Total Billed Charges	372.23	95.2	Percent of Total Billed Charges	343.88	87.95	Percent of Total Billed Charges	322.58	82.5	293.25	391
"CATECHOL,UR,VMA-FRACTIONA"	82384	HCPCS	301	RC		both	110	82.5	Percent of Total Billed Charges	104.72	95.2	Percent of Total Billed Charges	96.75	87.95	Percent of Total Billed Charges	90.75	82.5	82.5	110
CHLAMYDIA TRACHOMATIS	87491	HCPCS	300	RC		both	82	61.5	Percent of Total Billed Charges	78.06	95.2	Percent of Total Billed Charges	72.12	87.95	Percent of Total Billed Charges	67.65	82.5	61.5	82
LAMOTRIGINE/LAMICTAL	80175	HCPCS	301	RC		both	271	203.25	Percent of Total Billed Charges	257.99	95.2	Percent of Total Billed Charges	238.34	87.95	Percent of Total Billed Charges	223.58	82.5	203.25	271
"DHEA, SERUM"	82626	HCPCS	301	RC		both	287	215.25	Percent of Total Billed Charges	273.22	95.2	Percent of Total Billed Charges	252.42	87.95	Percent of Total Billed Charges	236.78	82.5	215.25	287
ALPHA-1-ANTITRYPSIN	82103	HCPCS	300	RC		both	100	75	Percent of Total Billed Charges	95.2	95.2	Percent of Total Billed Charges	87.95	87.95	Percent of Total Billed Charges	82.5	82.5	75	100
"DRUG SCREEN ANY NUMBER OF DRUG CLASSES, PRESUMPTIVE SINGLE OR MULTIPLE DRUG CLASS METHOD"	80305	HCPCS	301	RC		both	239	179.25	Percent of Total Billed Charges	227.53	95.2	Percent of Total Billed Charges	210.2	87.95	Percent of Total Billed Charges	197.18	82.5	179.25	239
"HEP C VIRUS RNA,QUAL"	87521	HCPCS	300	RC		both	351	263.25	Percent of Total Billed Charges	334.15	95.2	Percent of Total Billed Charges	308.7	87.95	Percent of Total Billed Charges	289.58	82.5	263.25	351
ACT PROTEIN C RESIS	85307	HCPCS	300	RC		both	244	183	Percent of Total Billed Charges	232.29	95.2	Percent of Total Billed Charges	214.6	87.95	Percent of Total Billed Charges	201.3	82.5	183	244
FACTOR X	85260	HCPCS	300	RC		both	500	375	Percent of Total Billed Charges	476	95.2	Percent of Total Billed Charges	439.75	87.95	Percent of Total Billed Charges	412.5	82.5	375	500
DIMERIC INHIBIN A	86336	HCPCS	300	RC		both	41	30.75	Percent of Total Billed Charges	39.03	95.2	Percent of Total Billed Charges	36.06	87.95	Percent of Total Billed Charges	33.83	82.5	30.75	41
ABO RH + TYPE	86901	HCPCS	300	RC		both	78	58.5	Percent of Total Billed Charges	74.26	95.2	Percent of Total Billed Charges	68.6	87.95	Percent of Total Billed Charges	64.35	82.5	58.5	78
URINE TOTAL PROTEIN 24 HR (IN-HOUSE)	84156	HCPCS	300	RC		both	84	63	Percent of Total Billed Charges	79.97	95.2	Percent of Total Billed Charges	73.88	87.95	Percent of Total Billed Charges	69.3	82.5	63	84
PROINSULIN	84206	HCPCS	300	RC		both	513	384.75	Percent of Total Billed Charges	488.38	95.2	Percent of Total Billed Charges	451.18	87.95	Percent of Total Billed Charges	423.23	82.5	384.75	513
TOXOPLASMOSIS AB IGM	86778	HCPCS	300	RC		both	123	92.25	Percent of Total Billed Charges	117.1	95.2	Percent of Total Billed Charges	108.18	87.95	Percent of Total Billed Charges	101.48	82.5	92.25	123
HERPES I&II IGG	86694	HCPCS	300	RC		both	104	78	Percent of Total Billed Charges	99.01	95.2	Percent of Total Billed Charges	91.47	87.95	Percent of Total Billed Charges	85.8	82.5	78	104
HERPES SIMPLEX I IGG/IGM	86695	HCPCS	300	RC		both	276	207	Percent of Total Billed Charges	262.75	95.2	Percent of Total Billed Charges	242.74	87.95	Percent of Total Billed Charges	227.7	82.5	207	276
THROAT CULTURE	87081	HCPCS	300	RC		both	144	108	Percent of Total Billed Charges	137.09	95.2	Percent of Total Billed Charges	126.65	87.95	Percent of Total Billed Charges	118.8	82.5	108	144
"HYDROXYCORT, URINE"	83491	HCPCS	301	RC		both	144	108	Percent of Total Billed Charges	137.09	95.2	Percent of Total Billed Charges	126.65	87.95	Percent of Total Billed Charges	118.8	82.5	108	144
FT4 (FREE THYROXINE IN-HOUSE)	84439	HCPCS	300	RC		both	129	96.75	Percent of Total Billed Charges	122.81	95.2	Percent of Total Billed Charges	113.46	87.95	Percent of Total Billed Charges	106.43	82.5	96.75	129
GAMMAGLOBULIN SUBCLASSES EXCEPT IGE	82784	HCPCS	301	RC		both	44	33	Percent of Total Billed Charges	41.89	95.2	Percent of Total Billed Charges	38.7	87.95	Percent of Total Billed Charges	36.3	82.5	33	44
BMP (BACKUP)	80048	HCPCS	300	RC	QW	both	169	126.75	Percent of Total Billed Charges	160.89	95.2	Percent of Total Billed Charges	148.64	87.95	Percent of Total Billed Charges	139.43	82.5	126.75	169
ELECTROLYTE PROFILE (BACKUP)	80051	HCPCS	300	RC	QW	both	127	95.25	Percent of Total Billed Charges	120.9	95.2	Percent of Total Billed Charges	111.7	87.95	Percent of Total Billed Charges	104.78	82.5	95.25	127
CMP (BACKUP)	80053	HCPCS	300	RC	QW	both	201	150.75	Percent of Total Billed Charges	191.35	95.2	Percent of Total Billed Charges	176.78	87.95	Percent of Total Billed Charges	165.83	82.5	150.75	201
CBC W/O DIFF	85027	HCPCS	300	RC		both	111	83.25	Percent of Total Billed Charges	105.67	95.2	Percent of Total Billed Charges	97.62	87.95	Percent of Total Billed Charges	91.58	82.5	83.25	111
GLUCAGON	82943	HCPCS	301	RC		both	123	92.25	Percent of Total Billed Charges	117.1	95.2	Percent of Total Billed Charges	108.18	87.95	Percent of Total Billed Charges	101.48	82.5	92.25	123
GIARDIA LAMBLIA ANT	87329	HCPCS	300	RC		both	113	84.75	Percent of Total Billed Charges	107.58	95.2	Percent of Total Billed Charges	99.38	87.95	Percent of Total Billed Charges	93.23	82.5	84.75	113
ACETYLCHOLINE RECEP	84238	HCPCS	300	RC		both	300	225	Percent of Total Billed Charges	285.6	95.2	Percent of Total Billed Charges	263.85	87.95	Percent of Total Billed Charges	247.5	82.5	225	300
ANTI CARDIOLIPIN ANTIBODY	86148	HCPCS	300	RC		both	281	210.75	Percent of Total Billed Charges	267.51	95.2	Percent of Total Billed Charges	247.14	87.95	Percent of Total Billed Charges	231.83	82.5	210.75	281
LIVER FUNCTION PROFILE (BACKUP)	80076	HCPCS	300	RC	QW	both	158	118.5	Percent of Total Billed Charges	150.42	95.2	Percent of Total Billed Charges	138.96	87.95	Percent of Total Billed Charges	130.35	82.5	118.5	158
IMMUNOELECTROPH. URINE	84165	HCPCS	300	RC		both	151	113.25	Percent of Total Billed Charges	143.75	95.2	Percent of Total Billed Charges	132.8	87.95	Percent of Total Billed Charges	124.58	82.5	113.25	151
LYME DISEASE W/REF TO W BLOT	86618	HCPCS	300	RC		both	184	138	Percent of Total Billed Charges	175.17	95.2	Percent of Total Billed Charges	161.83	87.95	Percent of Total Billed Charges	151.8	82.5	138	184
"URINE ARSENIC, QUANTITATIVE"	82175	HCPCS	301	RC		both	356	267	Percent of Total Billed Charges	338.91	95.2	Percent of Total Billed Charges	313.1	87.95	Percent of Total Billed Charges	293.7	82.5	267	356
LEAD ADULT SERUM	83655	HCPCS	301	RC		both	98	73.5	Percent of Total Billed Charges	93.3	95.2	Percent of Total Billed Charges	86.19	87.95	Percent of Total Billed Charges	80.85	82.5	73.5	98
URINE MERCURY	83825	HCPCS	300	RC		both	80	60	Percent of Total Billed Charges	76.16	95.2	Percent of Total Billed Charges	70.36	87.95	Percent of Total Billed Charges	66	82.5	60	80
CKMB	82553	HCPCS	300	RC	QW	both	215	161.25	Percent of Total Billed Charges	204.68	95.2	Percent of Total Billed Charges	189.09	87.95	Percent of Total Billed Charges	177.38	82.5	161.25	215
MYOGLOBIN	83874	HCPCS	300	RC		both	243	182.25	Percent of Total Billed Charges	231.34	95.2	Percent of Total Billed Charges	213.72	87.95	Percent of Total Billed Charges	200.48	82.5	182.25	243
TROPONIN-I (BACKUP)	84484	HCPCS	300	RC	QW	both	253	189.75	Percent of Total Billed Charges	240.86	95.2	Percent of Total Billed Charges	222.51	87.95	Percent of Total Billed Charges	208.73	82.5	189.75	253
HOMOCYSTEINE LEVEL	83090	HCPCS	301	RC		both	292	219	Percent of Total Billed Charges	277.98	95.2	Percent of Total Billed Charges	256.81	87.95	Percent of Total Billed Charges	240.9	82.5	219	292
RUBEOLA ANTIBOD. IGG	86765	HCPCS	300	RC		both	140	105	Percent of Total Billed Charges	133.28	95.2	Percent of Total Billed Charges	123.13	87.95	Percent of Total Billed Charges	115.5	82.5	105	140
TRANSFERRIN	84466	HCPCS	300	RC		both	95	71.25	Percent of Total Billed Charges	90.44	95.2	Percent of Total Billed Charges	83.55	87.95	Percent of Total Billed Charges	78.38	82.5	71.25	95
MICROALBUMIN RANDOM (IN-HOUSE)	82043	HCPCS	300	RC		both	123	92.25	Percent of Total Billed Charges	117.1	95.2	Percent of Total Billed Charges	108.18	87.95	Percent of Total Billed Charges	101.48	82.5	92.25	123
"BILIRUBIN, DIRECT (BACKUP)"	82248	HCPCS	301	RC		both	24	18	Percent of Total Billed Charges	22.85	95.2	Percent of Total Billed Charges	21.11	87.95	Percent of Total Billed Charges	19.8	82.5	18	24
SCLERODERMA PANEL COMP 2	86235	HCPCS	300	RC		both	140	105	Percent of Total Billed Charges	133.28	95.2	Percent of Total Billed Charges	123.13	87.95	Percent of Total Billed Charges	115.5	82.5	105	140
DISK CONFIRMATORY TESTING	87184	HCPCS	300	RC		both	25	18.75	Percent of Total Billed Charges	23.8	95.2	Percent of Total Billed Charges	21.99	87.95	Percent of Total Billed Charges	20.63	82.5	18.75	25
MS PANEL/ COMP 5-6	83916	HCPCS	300	RC		both	235	176.25	Percent of Total Billed Charges	223.72	95.2	Percent of Total Billed Charges	206.68	87.95	Percent of Total Billed Charges	193.88	82.5	176.25	235
GROUP B STREP SCREEN	87801	HCPCS	300	RC		both	343	257.25	Percent of Total Billed Charges	326.54	95.2	Percent of Total Billed Charges	301.67	87.95	Percent of Total Billed Charges	282.98	82.5	257.25	343
PROTEIN C ANTIGEN	85302	HCPCS	300	RC		both	364	273	Percent of Total Billed Charges	346.53	95.2	Percent of Total Billed Charges	320.14	87.95	Percent of Total Billed Charges	300.3	82.5	273	364
PROTEIN S/TOTAL	85305	HCPCS	300	RC		both	255	191.25	Percent of Total Billed Charges	242.76	95.2	Percent of Total Billed Charges	224.27	87.95	Percent of Total Billed Charges	210.38	82.5	191.25	255
PROTEIN S/FREE	85306	HCPCS	300	RC		both	339	254.25	Percent of Total Billed Charges	322.73	95.2	Percent of Total Billed Charges	298.15	87.95	Percent of Total Billed Charges	279.68	82.5	254.25	339
RSV ANTIGEN SCREEN	87807	HCPCS	300	RC		both	160	120	Percent of Total Billed Charges	152.32	95.2	Percent of Total Billed Charges	140.72	87.95	Percent of Total Billed Charges	132	82.5	120	160
CRYOGLOBULINS	82595	HCPCS	301	RC		both	99	74.25	Percent of Total Billed Charges	94.25	95.2	Percent of Total Billed Charges	87.07	87.95	Percent of Total Billed Charges	81.68	82.5	74.25	99
FT3 (FREE TRIIODOTHYRONINE IN-HOUSE)	84481	HCPCS	300	RC		both	257	192.75	Percent of Total Billed Charges	244.66	95.2	Percent of Total Billed Charges	226.03	87.95	Percent of Total Billed Charges	212.03	82.5	192.75	257
CRYPTOSPORIDIUM	87328	HCPCS	300	RC		both	113	84.75	Percent of Total Billed Charges	107.58	95.2	Percent of Total Billed Charges	99.38	87.95	Percent of Total Billed Charges	93.23	82.5	84.75	113
HEP C GENO/COMP 4-5	87798	HCPCS	300	RC		both	267	200.25	Percent of Total Billed Charges	254.18	95.2	Percent of Total Billed Charges	234.83	87.95	Percent of Total Billed Charges	220.28	82.5	200.25	267
"UREA NITROGEN, URINE"	84540	HCPCS	300	RC		both	64	48	Percent of Total Billed Charges	60.93	95.2	Percent of Total Billed Charges	56.29	87.95	Percent of Total Billed Charges	52.8	82.5	48	64
C3 COMPLEMENT	86160	HCPCS	300	RC		both	113	84.75	Percent of Total Billed Charges	107.58	95.2	Percent of Total Billed Charges	99.38	87.95	Percent of Total Billed Charges	93.23	82.5	84.75	113
FLU TEST A&B	87804	HCPCS	300	RC		both	127	95.25	Percent of Total Billed Charges	120.9	95.2	Percent of Total Billed Charges	111.7	87.95	Percent of Total Billed Charges	104.78	82.5	95.25	127
CARNITINE	82379	HCPCS	301	RC		both	70	52.5	Percent of Total Billed Charges	66.64	95.2	Percent of Total Billed Charges	61.57	87.95	Percent of Total Billed Charges	57.75	82.5	52.5	70
HEP C VIRAL LOAD PCR	87522	HCPCS	300	RC		both	380	285	Percent of Total Billed Charges	361.76	95.2	Percent of Total Billed Charges	334.21	87.95	Percent of Total Billed Charges	313.5	82.5	285	380
"ENDOMYSIAL IGA, IGG AB"	86255	HCPCS	300	RC		both	235	176.25	Percent of Total Billed Charges	223.72	95.2	Percent of Total Billed Charges	206.68	87.95	Percent of Total Billed Charges	193.88	82.5	176.25	235
TESTOSTERONE LEVEL TOTAL	84403	HCPCS	300	RC		both	169	126.75	Percent of Total Billed Charges	160.89	95.2	Percent of Total Billed Charges	148.64	87.95	Percent of Total Billed Charges	139.43	82.5	126.75	169
IRON SERUM (IN-HOUSE)	83540	HCPCS	301	RC		both	78	58.5	Percent of Total Billed Charges	74.26	95.2	Percent of Total Billed Charges	68.6	87.95	Percent of Total Billed Charges	64.35	82.5	58.5	78
ANTI DNA	86225	HCPCS	300	RC		both	108	81	Percent of Total Billed Charges	102.82	95.2	Percent of Total Billed Charges	94.99	87.95	Percent of Total Billed Charges	89.1	82.5	81	108
HEP BE AG	87350	HCPCS	300	RC		both	160	120	Percent of Total Billed Charges	152.32	95.2	Percent of Total Billed Charges	140.72	87.95	Percent of Total Billed Charges	132	82.5	120	160
ANTI SMOOTH MUSCLE	86255	HCPCS	300	RC		both	196	147	Percent of Total Billed Charges	186.59	95.2	Percent of Total Billed Charges	172.38	87.95	Percent of Total Billed Charges	161.7	82.5	147	196
"COMPLEMENT, TOTAL"	86162	HCPCS	300	RC		both	200	150	Percent of Total Billed Charges	190.4	95.2	Percent of Total Billed Charges	175.9	87.95	Percent of Total Billed Charges	165	82.5	150	200
MYCOPHENOLIC ACID	80180	HCPCS	300	RC		both	405	303.75	Percent of Total Billed Charges	385.56	95.2	Percent of Total Billed Charges	356.2	87.95	Percent of Total Billed Charges	334.13	82.5	303.75	405
Q FEVER ANTIBODY	86638	HCPCS	300	RC		both	110	82.5	Percent of Total Billed Charges	104.72	95.2	Percent of Total Billed Charges	96.75	87.95	Percent of Total Billed Charges	90.75	82.5	82.5	110
URINE PREGNANCY QUALITATIVE	81025	HCPCS	307	RC	QW	both	128	96	Percent of Total Billed Charges	121.86	95.2	Percent of Total Billed Charges	112.58	87.95	Percent of Total Billed Charges	105.6	82.5	96	128
S PNEUMO 1 IGG	86609	HCPCS	300	RC		both	104	78	Percent of Total Billed Charges	99.01	95.2	Percent of Total Billed Charges	91.47	87.95	Percent of Total Billed Charges	85.8	82.5	78	104
S PNEUMO 3 IGG	86609	HCPCS	300	RC		both	101	75.75	Percent of Total Billed Charges	96.15	95.2	Percent of Total Billed Charges	88.83	87.95	Percent of Total Billed Charges	83.33	82.5	75.75	101
S PNEUMO 4 IGG	86609	HCPCS	300	RC		both	101	75.75	Percent of Total Billed Charges	96.15	95.2	Percent of Total Billed Charges	88.83	87.95	Percent of Total Billed Charges	83.33	82.5	75.75	101
S PNEUMO 6B IGG	86609	HCPCS	300	RC		both	101	75.75	Percent of Total Billed Charges	96.15	95.2	Percent of Total Billed Charges	88.83	87.95	Percent of Total Billed Charges	83.33	82.5	75.75	101
S PNEUMO 7F IGG	86609	HCPCS	300	RC		both	104	78	Percent of Total Billed Charges	99.01	95.2	Percent of Total Billed Charges	91.47	87.95	Percent of Total Billed Charges	85.8	82.5	78	104
S PNEUMO 8 IGG	86609	HCPCS	300	RC		both	104	78	Percent of Total Billed Charges	99.01	95.2	Percent of Total Billed Charges	91.47	87.95	Percent of Total Billed Charges	85.8	82.5	78	104
S PNEUMO 9N IGG	86609	HCPCS	300	RC		both	104	78	Percent of Total Billed Charges	99.01	95.2	Percent of Total Billed Charges	91.47	87.95	Percent of Total Billed Charges	85.8	82.5	78	104
S PNEUMO 12F IGG	86609	HCPCS	300	RC		both	104	78	Percent of Total Billed Charges	99.01	95.2	Percent of Total Billed Charges	91.47	87.95	Percent of Total Billed Charges	85.8	82.5	78	104
S PNEUMO 14 IGG	86609	HCPCS	300	RC		both	104	78	Percent of Total Billed Charges	99.01	95.2	Percent of Total Billed Charges	91.47	87.95	Percent of Total Billed Charges	85.8	82.5	78	104
S PNEUMO 18C IGG	86609	HCPCS	300	RC		both	104	78	Percent of Total Billed Charges	99.01	95.2	Percent of Total Billed Charges	91.47	87.95	Percent of Total Billed Charges	85.8	82.5	78	104
S PNEUMO 19F IGG	86609	HCPCS	300	RC		both	104	78	Percent of Total Billed Charges	99.01	95.2	Percent of Total Billed Charges	91.47	87.95	Percent of Total Billed Charges	85.8	82.5	78	104
PSA FREE	84154	HCPCS	300	RC		both	287	215.25	Percent of Total Billed Charges	273.22	95.2	Percent of Total Billed Charges	252.42	87.95	Percent of Total Billed Charges	236.78	82.5	215.25	287
C-PEPTIDE	84681	HCPCS	300	RC		both	184	138	Percent of Total Billed Charges	175.17	95.2	Percent of Total Billed Charges	161.83	87.95	Percent of Total Billed Charges	151.8	82.5	138	184
CBC W/DIFF	85025	HCPCS	300	RC		both	121	90.75	Percent of Total Billed Charges	115.19	95.2	Percent of Total Billed Charges	106.42	87.95	Percent of Total Billed Charges	99.83	82.5	90.75	121
CALCIUM  24 HR URINE (IN-HOUSE)	82340	HCPCS	301	RC		both	75	56.25	Percent of Total Billed Charges	71.4	95.2	Percent of Total Billed Charges	65.96	87.95	Percent of Total Billed Charges	61.88	82.5	56.25	75
NTX (COLLAGEN CROSS LINK)	82523	HCPCS	301	RC		both	160	120	Percent of Total Billed Charges	152.32	95.2	Percent of Total Billed Charges	140.72	87.95	Percent of Total Billed Charges	132	82.5	120	160
URINE IMMUNOELECTRO COMP1	86325	HCPCS	300	RC		both	118	88.5	Percent of Total Billed Charges	112.34	95.2	Percent of Total Billed Charges	103.78	87.95	Percent of Total Billed Charges	97.35	82.5	88.5	118
MERCURY / BLOOD	83825	HCPCS	300	RC		both	212	159	Percent of Total Billed Charges	201.82	95.2	Percent of Total Billed Charges	186.45	87.95	Percent of Total Billed Charges	174.9	82.5	159	212
ANTINEUTROPHIL CYTOPOASMIC	86255	HCPCS	300	RC		both	484	363	Percent of Total Billed Charges	460.77	95.2	Percent of Total Billed Charges	425.68	87.95	Percent of Total Billed Charges	399.3	82.5	363	484
"TRYPSIN, SERUM"	83519	HCPCS	302	RC		both	221	165.75	Percent of Total Billed Charges	210.39	95.2	Percent of Total Billed Charges	194.37	87.95	Percent of Total Billed Charges	182.33	82.5	165.75	221
"IMMUNOFIXATION, SERUM"	86334	HCPCS	300	RC		both	212	159	Percent of Total Billed Charges	201.82	95.2	Percent of Total Billed Charges	186.45	87.95	Percent of Total Billed Charges	174.9	82.5	159	212
ANGIOTENSIN CONVERTING ENZYME SERUM	82164	HCPCS	301	RC		both	332	249	Percent of Total Billed Charges	316.06	95.2	Percent of Total Billed Charges	291.99	87.95	Percent of Total Billed Charges	273.9	82.5	249	332
WET PREP	87210	HCPCS	300	RC		both	75	56.25	Percent of Total Billed Charges	71.4	95.2	Percent of Total Billed Charges	65.96	87.95	Percent of Total Billed Charges	61.88	82.5	56.25	75
BONE SPEC ALKALINE	84080	HCPCS	300	RC		both	184	138	Percent of Total Billed Charges	175.17	95.2	Percent of Total Billed Charges	161.83	87.95	Percent of Total Billed Charges	151.8	82.5	138	184
CITRATE URINE SODIUM	82507	HCPCS	301	RC		both	267	200.25	Percent of Total Billed Charges	254.18	95.2	Percent of Total Billed Charges	234.83	87.95	Percent of Total Billed Charges	220.28	82.5	200.25	267
HEP B SURFACE ANTIBODY	86706	HCPCS	300	RC		both	144	108	Percent of Total Billed Charges	137.09	95.2	Percent of Total Billed Charges	126.65	87.95	Percent of Total Billed Charges	118.8	82.5	108	144
OXALATE-URINE	83945	HCPCS	300	RC		both	158	118.5	Percent of Total Billed Charges	150.42	95.2	Percent of Total Billed Charges	138.96	87.95	Percent of Total Billed Charges	130.35	82.5	118.5	158
HEPATITS PANEL	80074	HCPCS	301	RC		both	224	168	Percent of Total Billed Charges	213.25	95.2	Percent of Total Billed Charges	197.01	87.95	Percent of Total Billed Charges	184.8	82.5	168	224
ASO TITER	86060	HCPCS	300	RC		both	111	83.25	Percent of Total Billed Charges	105.67	95.2	Percent of Total Billed Charges	97.62	87.95	Percent of Total Billed Charges	91.58	82.5	83.25	111
RBC ANTIBODY TITER	86886	HCPCS	302	RC		both	49	36.75	Percent of Total Billed Charges	46.65	95.2	Percent of Total Billed Charges	43.1	87.95	Percent of Total Billed Charges	40.43	82.5	36.75	49
ANTI HISTONE	83516	HCPCS	302	RC		both	189	141.75	Percent of Total Billed Charges	179.93	95.2	Percent of Total Billed Charges	166.23	87.95	Percent of Total Billed Charges	155.93	82.5	141.75	189
LIPOPROTEIN (A)	82172	HCPCS	301	RC		both	95	71.25	Percent of Total Billed Charges	90.44	95.2	Percent of Total Billed Charges	83.55	87.95	Percent of Total Billed Charges	78.38	82.5	71.25	95
GAMMAGLOBULIN IGE	82785	HCPCS	301	RC		both	78	58.5	Percent of Total Billed Charges	74.26	95.2	Percent of Total Billed Charges	68.6	87.95	Percent of Total Billed Charges	64.35	82.5	58.5	78
W NILE VIRUS IGM	86788	HCPCS	300	RC		both	172	129	Percent of Total Billed Charges	163.74	95.2	Percent of Total Billed Charges	151.27	87.95	Percent of Total Billed Charges	141.9	82.5	129	172
W NILE VIRUS IGG	86789	HCPCS	300	RC		both	172	129	Percent of Total Billed Charges	163.74	95.2	Percent of Total Billed Charges	151.27	87.95	Percent of Total Billed Charges	141.9	82.5	129	172
MUMPS ANTIBODY	86735	HCPCS	300	RC		both	138	103.5	Percent of Total Billed Charges	131.38	95.2	Percent of Total Billed Charges	121.37	87.95	Percent of Total Billed Charges	113.85	82.5	103.5	138
FRUCTOSAMINE	82985	HCPCS	301	RC		both	64	48	Percent of Total Billed Charges	60.93	95.2	Percent of Total Billed Charges	56.29	87.95	Percent of Total Billed Charges	52.8	82.5	48	64
"QUANTITATION OF THERAPEUTIC DRUG, NOT ELSEWHERE SPECIFIED"	80299	HCPCS	301	RC		both	226	169.5	Percent of Total Billed Charges	215.15	95.2	Percent of Total Billed Charges	198.77	87.95	Percent of Total Billed Charges	186.45	82.5	169.5	226
"SULFATE, QUANT"	84392	HCPCS	300	RC		both	103	77.25	Percent of Total Billed Charges	98.06	95.2	Percent of Total Billed Charges	90.59	87.95	Percent of Total Billed Charges	84.98	82.5	77.25	103
CA 15-3 (LASA)	86300	HCPCS	300	RC		both	128	96	Percent of Total Billed Charges	121.86	95.2	Percent of Total Billed Charges	112.58	87.95	Percent of Total Billed Charges	105.6	82.5	96	128
"CULTURE, VIRAL HERPES SIM"	87252	HCPCS	300	RC		both	258	193.5	Percent of Total Billed Charges	245.62	95.2	Percent of Total Billed Charges	226.91	87.95	Percent of Total Billed Charges	212.85	82.5	193.5	258
"VITAMIN D3 (1,25 DIHYDROXY)"	82652	HCPCS	300	RC		both	337	252.75	Percent of Total Billed Charges	320.82	95.2	Percent of Total Billed Charges	296.39	87.95	Percent of Total Billed Charges	278.03	82.5	252.75	337
ALKALINE PHOSPHATASE ISOENZYMES	84080	HCPCS	300	RC		both	58	43.5	Percent of Total Billed Charges	55.22	95.2	Percent of Total Billed Charges	51.01	87.95	Percent of Total Billed Charges	47.85	82.5	43.5	58
CO-OXIMETRY	83050	HCPCS	301	RC		both	49	36.75	Percent of Total Billed Charges	46.65	95.2	Percent of Total Billed Charges	43.1	87.95	Percent of Total Billed Charges	40.43	82.5	36.75	49
FECAL POTASSIUM	84999	HCPCS	300	RC		both	51	38.25	Percent of Total Billed Charges	48.55	95.2	Percent of Total Billed Charges	44.85	87.95	Percent of Total Billed Charges	42.08	82.5	38.25	51
CALCITONIN	82308	HCPCS	301	RC		both	161	120.75	Percent of Total Billed Charges	153.27	95.2	Percent of Total Billed Charges	141.6	87.95	Percent of Total Billed Charges	132.83	82.5	120.75	161
B-NATRIURETIC PEPTIDE (BNP) (BACKUP)	83880	HCPCS	300	RC	QW	both	332	249	Percent of Total Billed Charges	316.06	95.2	Percent of Total Billed Charges	291.99	87.95	Percent of Total Billed Charges	273.9	82.5	249	332
"HELICOBACTER, S1"	88312	HCPCS	300	RC		both	142	106.5	Percent of Total Billed Charges	135.18	95.2	Percent of Total Billed Charges	124.89	87.95	Percent of Total Billed Charges	117.15	82.5	106.5	142
TISSUE BIOPSY 5	88307	HCPCS	300	RC		both	245	183.75	Percent of Total Billed Charges	233.24	95.2	Percent of Total Billed Charges	215.48	87.95	Percent of Total Billed Charges	202.13	82.5	183.75	245
S-2 ALCIAN BLUE	88313	HCPCS	300	RC		both	91	68.25	Percent of Total Billed Charges	86.63	95.2	Percent of Total Billed Charges	80.03	87.95	Percent of Total Billed Charges	75.08	82.5	68.25	91
CLINICAL PATHOLOGY CONSULTATION LIMITED	80500	HCPCS	310	RC		both	64	48	Percent of Total Billed Charges	60.93	95.2	Percent of Total Billed Charges	56.29	87.95	Percent of Total Billed Charges	52.8	82.5	48	64
INSULIN SERUM (TOTAL)	83525	HCPCS	301	RC		both	152	114	Percent of Total Billed Charges	144.7	95.2	Percent of Total Billed Charges	133.68	87.95	Percent of Total Billed Charges	125.4	82.5	114	152
ZINC (SERUM)	84630	HCPCS	300	RC		both	84	63	Percent of Total Billed Charges	79.97	95.2	Percent of Total Billed Charges	73.88	87.95	Percent of Total Billed Charges	69.3	82.5	63	84
"CYCLIC CITRULLINATED PEPTIDE ANTIBODY, IGG"	86200	HCPCS	300	RC		both	182	136.5	Percent of Total Billed Charges	173.26	95.2	Percent of Total Billed Charges	160.07	87.95	Percent of Total Billed Charges	150.15	82.5	136.5	182
PLATELET COUNT-MANUAL	85032	HCPCS	300	RC		both	64	48	Percent of Total Billed Charges	60.93	95.2	Percent of Total Billed Charges	56.29	87.95	Percent of Total Billed Charges	52.8	82.5	48	64
SIROLIMUS (RAPANYCIN	80195	HCPCS	301	RC		both	358	268.5	Percent of Total Billed Charges	340.82	95.2	Percent of Total Billed Charges	314.86	87.95	Percent of Total Billed Charges	295.35	82.5	268.5	358
"ALLERGEN SPECIFIC IGG QUANTITATIVE OR SEMIQUANTITATIVE, EACH ALLERGEN"	86001	HCPCS	300	RC		both	84	63	Percent of Total Billed Charges	79.97	95.2	Percent of Total Billed Charges	73.88	87.95	Percent of Total Billed Charges	69.3	82.5	63	84
CANDIDA IGE	86003	HCPCS	300	RC		both	70	52.5	Percent of Total Billed Charges	66.64	95.2	Percent of Total Billed Charges	61.57	87.95	Percent of Total Billed Charges	57.75	82.5	52.5	70
CADMIUM	82300	HCPCS	301	RC		both	118	88.5	Percent of Total Billed Charges	112.34	95.2	Percent of Total Billed Charges	103.78	87.95	Percent of Total Billed Charges	97.35	82.5	88.5	118
CHLORIDE RANDOM URINE (IN-HOUSE)	82436	HCPCS	301	RC		both	103	77.25	Percent of Total Billed Charges	98.06	95.2	Percent of Total Billed Charges	90.59	87.95	Percent of Total Billed Charges	84.98	82.5	77.25	103
URINE BODY FLUID	83986	HCPCS	300	RC		both	38	28.5	Percent of Total Billed Charges	36.18	95.2	Percent of Total Billed Charges	33.42	87.95	Percent of Total Billed Charges	31.35	82.5	28.5	38
PHOSPHORUS RANDOM URINE (IN-HOUSE)	84105	HCPCS	300	RC		both	104	78	Percent of Total Billed Charges	99.01	95.2	Percent of Total Billed Charges	91.47	87.95	Percent of Total Billed Charges	85.8	82.5	78	104
"IMMUNOFIXATION, URINE"	86335	HCPCS	300	RC		both	151	113.25	Percent of Total Billed Charges	143.75	95.2	Percent of Total Billed Charges	132.8	87.95	Percent of Total Billed Charges	124.58	82.5	113.25	151
INSULIN ANTIBODIES	86337	HCPCS	300	RC		both	137	102.75	Percent of Total Billed Charges	130.42	95.2	Percent of Total Billed Charges	120.49	87.95	Percent of Total Billed Charges	113.03	82.5	102.75	137
HEPATITIS A ANTIBODIES	86708	HCPCS	300	RC		both	161	120.75	Percent of Total Billed Charges	153.27	95.2	Percent of Total Billed Charges	141.6	87.95	Percent of Total Billed Charges	132.83	82.5	120.75	161
"CORTISOL, URINE 24 HR"	82530	HCPCS	301	RC		both	95	71.25	Percent of Total Billed Charges	90.44	95.2	Percent of Total Billed Charges	83.55	87.95	Percent of Total Billed Charges	78.38	82.5	71.25	95
NPT PROCOLLAGEN	82523	HCPCS	301	RC		both	563	422.25	Percent of Total Billed Charges	535.98	95.2	Percent of Total Billed Charges	495.16	87.95	Percent of Total Billed Charges	464.48	82.5	422.25	563
TISSUE BIOPSY 7	88307	HCPCS	300	RC		both	245	183.75	Percent of Total Billed Charges	233.24	95.2	Percent of Total Billed Charges	215.48	87.95	Percent of Total Billed Charges	202.13	82.5	183.75	245
GLINADIN ANTI/PROF IGG	83516	HCPCS	302	RC		both	210	157.5	Percent of Total Billed Charges	199.92	95.2	Percent of Total Billed Charges	184.7	87.95	Percent of Total Billed Charges	173.25	82.5	157.5	210
TACROLIMUS	80197	HCPCS	301	RC		both	267	200.25	Percent of Total Billed Charges	254.18	95.2	Percent of Total Billed Charges	234.83	87.95	Percent of Total Billed Charges	220.28	82.5	200.25	267
PREGNENOLONE	84140	HCPCS	300	RC		both	392	294	Percent of Total Billed Charges	373.18	95.2	Percent of Total Billed Charges	344.76	87.95	Percent of Total Billed Charges	323.4	82.5	294	392
MRSA CULTURE	87081	HCPCS	306	RC		both	101	75.75	Percent of Total Billed Charges	96.15	95.2	Percent of Total Billed Charges	88.83	87.95	Percent of Total Billed Charges	83.33	82.5	75.75	101
"BETA 2 GLYCOPRO I, AB"	86146	HCPCS	300	RC		both	312	234	Percent of Total Billed Charges	297.02	95.2	Percent of Total Billed Charges	274.4	87.95	Percent of Total Billed Charges	257.4	82.5	234	312
PERTUSSIS SWAB PCR	87798	HCPCS	300	RC		both	389	291.75	Percent of Total Billed Charges	370.33	95.2	Percent of Total Billed Charges	342.13	87.95	Percent of Total Billed Charges	320.93	82.5	291.75	389
BORDETELLA PERTUSSIS SWAB	87798	HCPCS	300	RC		both	151	113.25	Percent of Total Billed Charges	143.75	95.2	Percent of Total Billed Charges	132.8	87.95	Percent of Total Billed Charges	124.58	82.5	113.25	151
SCHISTOSOMA AB IGE	86003	HCPCS	300	RC		both	88	66	Percent of Total Billed Charges	83.78	95.2	Percent of Total Billed Charges	77.4	87.95	Percent of Total Billed Charges	72.6	82.5	66	88
SCHISTOSMA AB IGG	86682	HCPCS	300	RC		both	538	403.5	Percent of Total Billed Charges	512.18	95.2	Percent of Total Billed Charges	473.17	87.95	Percent of Total Billed Charges	443.85	82.5	403.5	538
"COPPER, SERUM"	82525	HCPCS	301	RC		both	103	77.25	Percent of Total Billed Charges	98.06	95.2	Percent of Total Billed Charges	90.59	87.95	Percent of Total Billed Charges	84.98	82.5	77.25	103
CULTURE STOOL CAMPYLOBACT	87046	HCPCS	300	RC		both	84	63	Percent of Total Billed Charges	79.97	95.2	Percent of Total Billed Charges	73.88	87.95	Percent of Total Billed Charges	69.3	82.5	63	84
H. PYLORI STOOL ANTIGEN	87338	HCPCS	300	RC	QW	both	211	158.25	Percent of Total Billed Charges	200.87	95.2	Percent of Total Billed Charges	185.57	87.95	Percent of Total Billed Charges	174.08	82.5	158.25	211
PROTEIN C ACTIVITY DEFIC	85303	HCPCS	300	RC		both	137	102.75	Percent of Total Billed Charges	130.42	95.2	Percent of Total Billed Charges	120.49	87.95	Percent of Total Billed Charges	113.03	82.5	102.75	137
ELECTROPHORESIS	83883	HCPCS	300	RC		both	281	210.75	Percent of Total Billed Charges	267.51	95.2	Percent of Total Billed Charges	247.14	87.95	Percent of Total Billed Charges	231.83	82.5	210.75	281
HEPARIN ANTI-XA FACTOR	85520	HCPCS	300	RC		both	226	169.5	Percent of Total Billed Charges	215.15	95.2	Percent of Total Billed Charges	198.77	87.95	Percent of Total Billed Charges	186.45	82.5	169.5	226
TOXOPLASMOSIS AB IGG	86777	HCPCS	300	RC		both	114	85.5	Percent of Total Billed Charges	108.53	95.2	Percent of Total Billed Charges	100.26	87.95	Percent of Total Billed Charges	94.05	82.5	85.5	114
NEUROMYELITIS OPTICA	86255	HCPCS	300	RC		both	1147	860.25	Percent of Total Billed Charges	1091.94	95.2	Percent of Total Billed Charges	1008.79	87.95	Percent of Total Billed Charges	946.28	82.5	860.25	1147
INTRINSIC FACTOR ANTIBODY	86340	HCPCS	300	RC		both	216	162	Percent of Total Billed Charges	205.63	95.2	Percent of Total Billed Charges	189.97	87.95	Percent of Total Billed Charges	178.2	82.5	162	216
GASTRICULT(OCULT BLOD OTH	82271	HCPCS	301	RC		both	62	46.5	Percent of Total Billed Charges	59.02	95.2	Percent of Total Billed Charges	54.53	87.95	Percent of Total Billed Charges	51.15	82.5	46.5	62
ACTIVATED NATURAL KILLER	86367	HCPCS	300	RC		both	226	169.5	Percent of Total Billed Charges	215.15	95.2	Percent of Total Billed Charges	198.77	87.95	Percent of Total Billed Charges	186.45	82.5	169.5	226
INTERLEUKIN-6 ULTRASENSITIVE	83520	HCPCS	300	RC		both	547	410.25	Percent of Total Billed Charges	520.74	95.2	Percent of Total Billed Charges	481.09	87.95	Percent of Total Billed Charges	451.28	82.5	410.25	547
"ESTRONE, SERUM"	82679	HCPCS	300	RC		both	348	261	Percent of Total Billed Charges	331.3	95.2	Percent of Total Billed Charges	306.07	87.95	Percent of Total Billed Charges	287.1	82.5	261	348
SEX HORMONE BINDING GLOBULIN	84270	HCPCS	300	RC		both	212	159	Percent of Total Billed Charges	201.82	95.2	Percent of Total Billed Charges	186.45	87.95	Percent of Total Billed Charges	174.9	82.5	159	212
STONE ANALYSIS	82360	HCPCS	301	RC		both	193	144.75	Percent of Total Billed Charges	183.74	95.2	Percent of Total Billed Charges	169.74	87.95	Percent of Total Billed Charges	159.23	82.5	144.75	193
VW FACTOR ANTIGEN	85246	HCPCS	300	RC		both	322	241.5	Percent of Total Billed Charges	306.54	95.2	Percent of Total Billed Charges	283.2	87.95	Percent of Total Billed Charges	265.65	82.5	241.5	322
VW FACTOR ACTIVITY - RISTOCETIN CO-FACTOR	85245	HCPCS	300	RC		both	322	241.5	Percent of Total Billed Charges	306.54	95.2	Percent of Total Billed Charges	283.2	87.95	Percent of Total Billed Charges	265.65	82.5	241.5	322
"RUSSELL VIPER VENOM TIME, DILUTED"	85613	HCPCS	300	RC		both	171	128.25	Percent of Total Billed Charges	162.79	95.2	Percent of Total Billed Charges	150.39	87.95	Percent of Total Billed Charges	141.08	82.5	128.25	171
HERPES SIMPLEX VIRUS I&II	87529	HCPCS	300	RC		both	326	244.5	Percent of Total Billed Charges	310.35	95.2	Percent of Total Billed Charges	286.72	87.95	Percent of Total Billed Charges	268.95	82.5	244.5	326
VARICELLA ZOSTER IGM	86787	HCPCS	300	RC		both	95	71.25	Percent of Total Billed Charges	90.44	95.2	Percent of Total Billed Charges	83.55	87.95	Percent of Total Billed Charges	78.38	82.5	71.25	95
HUMAN  HERPES VIRUS 6 DNA	87532	HCPCS	300	RC		both	1006	754.5	Percent of Total Billed Charges	957.71	95.2	Percent of Total Billed Charges	884.78	87.95	Percent of Total Billed Charges	829.95	82.5	754.5	1006
ARBOVIRUS IGG/ENCEPHALIT	86651	HCPCS	300	RC		both	64	48	Percent of Total Billed Charges	60.93	95.2	Percent of Total Billed Charges	56.29	87.95	Percent of Total Billed Charges	52.8	82.5	48	64
ARBOVIRUS IGG/ENCEPHALIT	86652	HCPCS	300	RC		both	64	48	Percent of Total Billed Charges	60.93	95.2	Percent of Total Billed Charges	56.29	87.95	Percent of Total Billed Charges	52.8	82.5	48	64
ARBOVIRUS IGG/EHCEPHALIT	86654	HCPCS	300	RC		both	64	48	Percent of Total Billed Charges	60.93	95.2	Percent of Total Billed Charges	56.29	87.95	Percent of Total Billed Charges	52.8	82.5	48	64
ARBOVIRUS IGM/ENCEPHALIT	86651	HCPCS	300	RC		both	110	82.5	Percent of Total Billed Charges	104.72	95.2	Percent of Total Billed Charges	96.75	87.95	Percent of Total Billed Charges	90.75	82.5	82.5	110
ARBOVIRUS IGM/ENCEPHALIT	86652	HCPCS	300	RC		both	110	82.5	Percent of Total Billed Charges	104.72	95.2	Percent of Total Billed Charges	96.75	87.95	Percent of Total Billed Charges	90.75	82.5	82.5	110
ARBOVIRUS IGM/ENCEPHALIT	86653	HCPCS	300	RC		both	110	82.5	Percent of Total Billed Charges	104.72	95.2	Percent of Total Billed Charges	96.75	87.95	Percent of Total Billed Charges	90.75	82.5	82.5	110
ARBOVIRUS IGM/ENCEPHALIT	86654	HCPCS	300	RC		both	110	82.5	Percent of Total Billed Charges	104.72	95.2	Percent of Total Billed Charges	96.75	87.95	Percent of Total Billed Charges	90.75	82.5	82.5	110
MS PANEL	83873	HCPCS	300	RC		both	72	54	Percent of Total Billed Charges	68.54	95.2	Percent of Total Billed Charges	63.32	87.95	Percent of Total Billed Charges	59.4	82.5	54	72
CHLAMYDIA PSITTACI IGG	86631	HCPCS	300	RC		both	251	188.25	Percent of Total Billed Charges	238.95	95.2	Percent of Total Billed Charges	220.75	87.95	Percent of Total Billed Charges	207.08	82.5	188.25	251
CHLAMYDIA PSITTACI IGM	86632	HCPCS	300	RC		both	257	192.75	Percent of Total Billed Charges	244.66	95.2	Percent of Total Billed Charges	226.03	87.95	Percent of Total Billed Charges	212.03	82.5	192.75	257
C REACTIVE PROTEIN (CARD)	86141	HCPCS	300	RC		both	103	77.25	Percent of Total Billed Charges	98.06	95.2	Percent of Total Billed Charges	90.59	87.95	Percent of Total Billed Charges	84.98	82.5	77.25	103
KEPPRA	80177	HCPCS	301	RC		both	255	191.25	Percent of Total Billed Charges	242.76	95.2	Percent of Total Billed Charges	224.27	87.95	Percent of Total Billed Charges	210.38	82.5	191.25	255
LIPOPROTEIN	83701	HCPCS	301	RC		both	95	71.25	Percent of Total Billed Charges	90.44	95.2	Percent of Total Billed Charges	83.55	87.95	Percent of Total Billed Charges	78.38	82.5	71.25	95
REVERSE T3	84482	HCPCS	300	RC		both	475	356.25	Percent of Total Billed Charges	452.2	95.2	Percent of Total Billed Charges	417.76	87.95	Percent of Total Billed Charges	391.88	82.5	356.25	475
AMEBIASIS ANTIBODIES	86753	HCPCS	300	RC		both	196	147	Percent of Total Billed Charges	186.59	95.2	Percent of Total Billed Charges	172.38	87.95	Percent of Total Billed Charges	161.7	82.5	147	196
LYME DISEASE WESTERN BLOT CSF	86617	HCPCS	300	RC		both	317	237.75	Percent of Total Billed Charges	301.78	95.2	Percent of Total Billed Charges	278.8	87.95	Percent of Total Billed Charges	261.53	82.5	237.75	317
HERPES SIMPLEX II IGG/IGM	86696	HCPCS	300	RC		both	114	85.5	Percent of Total Billed Charges	108.53	95.2	Percent of Total Billed Charges	100.26	87.95	Percent of Total Billed Charges	94.05	82.5	85.5	114
5' NUCLEOTIBASE ASSAY	83915	HCPCS	300	RC		both	83	62.25	Percent of Total Billed Charges	79.02	95.2	Percent of Total Billed Charges	73	87.95	Percent of Total Billed Charges	68.48	82.5	62.25	83
KOH PREPARATION	87210	HCPCS	300	RC		both	40	30	Percent of Total Billed Charges	38.08	95.2	Percent of Total Billed Charges	35.18	87.95	Percent of Total Billed Charges	33	82.5	30	40
CARDIOLIPIN ANTIBODY EACH IG CLASS	86147	HCPCS	300	RC		both	322	241.5	Percent of Total Billed Charges	306.54	95.2	Percent of Total Billed Charges	283.2	87.95	Percent of Total Billed Charges	265.65	82.5	241.5	322
CENTRAL LINE C&S	87070	HCPCS	300	RC		both	120	90	Percent of Total Billed Charges	114.24	95.2	Percent of Total Billed Charges	105.54	87.95	Percent of Total Billed Charges	99	82.5	90	120
ANTI JO 1 ANTIBODY	86235	HCPCS	300	RC		both	140	105	Percent of Total Billed Charges	133.28	95.2	Percent of Total Billed Charges	123.13	87.95	Percent of Total Billed Charges	115.5	82.5	105	140
ANTI MI2 ANTIBODY	86235	HCPCS	300	RC		both	253	189.75	Percent of Total Billed Charges	240.86	95.2	Percent of Total Billed Charges	222.51	87.95	Percent of Total Billed Charges	208.73	82.5	189.75	253
ANTI SIGNAL RECOGN. PART	86235	HCPCS	300	RC		both	243	182.25	Percent of Total Billed Charges	231.34	95.2	Percent of Total Billed Charges	213.72	87.95	Percent of Total Billed Charges	200.48	82.5	182.25	243
CHROMOSOME STUDY ADDL H	88289	HCPCS	300	RC		both	134	100.5	Percent of Total Billed Charges	127.57	95.2	Percent of Total Billed Charges	117.85	87.95	Percent of Total Billed Charges	110.55	82.5	100.5	134
CHROMOSOME ANALYSIS ADD	88285	HCPCS	300	RC		both	305	228.75	Percent of Total Billed Charges	290.36	95.2	Percent of Total Billed Charges	268.25	87.95	Percent of Total Billed Charges	251.63	82.5	228.75	305
CHROMOSOME KARYOTYPE EACH STUDY	88280	HCPCS	300	RC		both	253	189.75	Percent of Total Billed Charges	240.86	95.2	Percent of Total Billed Charges	222.51	87.95	Percent of Total Billed Charges	208.73	82.5	189.75	253
CHROMOSOME ANALYSIS 5 C	88261	HCPCS	300	RC		both	712	534	Percent of Total Billed Charges	677.82	95.2	Percent of Total Billed Charges	626.2	87.95	Percent of Total Billed Charges	587.4	82.5	534	712
TISSUE CULT. LYMPHOCY	88230	HCPCS	300	RC		both	977	732.75	Percent of Total Billed Charges	930.1	95.2	Percent of Total Billed Charges	859.27	87.95	Percent of Total Billed Charges	806.03	82.5	732.75	977
"NEISSERIA G, AMP PROBE"	87590	HCPCS	300	RC		both	101	75.75	Percent of Total Billed Charges	96.15	95.2	Percent of Total Billed Charges	88.83	87.95	Percent of Total Billed Charges	83.33	82.5	75.75	101
TUMOR NECROSIS FACTOR 2	83520	HCPCS	300	RC		both	529	396.75	Percent of Total Billed Charges	503.61	95.2	Percent of Total Billed Charges	465.26	87.95	Percent of Total Billed Charges	436.43	82.5	396.75	529
URINE ORGANISM ID	87088	HCPCS	300	RC		both	99	74.25	Percent of Total Billed Charges	94.25	95.2	Percent of Total Billed Charges	87.07	87.95	Percent of Total Billed Charges	81.68	82.5	74.25	99
C-TELOPEPTIDE SERUM	82523	HCPCS	301	RC		both	312	234	Percent of Total Billed Charges	297.02	95.2	Percent of Total Billed Charges	274.4	87.95	Percent of Total Billed Charges	257.4	82.5	234	312
C1 ESTERACE FUNCTIONAL	86161	HCPCS	300	RC		both	80	60	Percent of Total Billed Charges	76.16	95.2	Percent of Total Billed Charges	70.36	87.95	Percent of Total Billed Charges	66	82.5	60	80
URINE IODINE	83789	HCPCS	300	RC		both	166	124.5	Percent of Total Billed Charges	158.03	95.2	Percent of Total Billed Charges	146	87.95	Percent of Total Billed Charges	136.95	82.5	124.5	166
C1Q BINDING	86332	HCPCS	300	RC		both	92	69	Percent of Total Billed Charges	87.58	95.2	Percent of Total Billed Charges	80.91	87.95	Percent of Total Billed Charges	75.9	82.5	69	92
FACTOR XII ACTIVITY	85280	HCPCS	300	RC		both	336	252	Percent of Total Billed Charges	319.87	95.2	Percent of Total Billed Charges	295.51	87.95	Percent of Total Billed Charges	277.2	82.5	252	336
"FLOW CYTOMETRY, TECH COMPONENT, FIRST MARKER~"	88184	HCPCS	311	RC		both	975	731.25	Percent of Total Billed Charges	928.2	95.2	Percent of Total Billed Charges	857.51	87.95	Percent of Total Billed Charges	804.38	82.5	731.25	975
FLOW CYTOMERTRY EACH ADD MARKER	88185	HCPCS	311	RC		both	34	25.5	Percent of Total Billed Charges	32.37	95.2	Percent of Total Billed Charges	29.9	87.95	Percent of Total Billed Charges	28.05	82.5	25.5	34
HEPRIN INDUCED PLATELET	86022	HCPCS	300	RC		both	596	447	Percent of Total Billed Charges	567.39	95.2	Percent of Total Billed Charges	524.18	87.95	Percent of Total Billed Charges	491.7	82.5	447	596
SICKLING RBC REDUCE	85660	HCPCS	300	RC		both	58	43.5	Percent of Total Billed Charges	55.22	95.2	Percent of Total Billed Charges	51.01	87.95	Percent of Total Billed Charges	47.85	82.5	43.5	58
HMGP CHROMOTOGRAPHY	83021	HCPCS	301	RC		both	103	77.25	Percent of Total Billed Charges	98.06	95.2	Percent of Total Billed Charges	90.59	87.95	Percent of Total Billed Charges	84.98	82.5	77.25	103
VIT A RETINOL	84590	HCPCS	300	RC		both	109	81.75	Percent of Total Billed Charges	103.77	95.2	Percent of Total Billed Charges	95.87	87.95	Percent of Total Billed Charges	89.93	82.5	81.75	109
PARVOVIRUS ANTIBODY B19 IGG/IGM	86747	HCPCS	300	RC		both	364	273	Percent of Total Billed Charges	346.53	95.2	Percent of Total Billed Charges	320.14	87.95	Percent of Total Billed Charges	300.3	82.5	273	364
UA MICROSCOPIC	81015	HCPCS	307	RC		both	49	36.75	Percent of Total Billed Charges	46.65	95.2	Percent of Total Billed Charges	43.1	87.95	Percent of Total Billed Charges	40.43	82.5	36.75	49
LEGIONELLA ANTIBODIES	86713	HCPCS	300	RC		both	145	108.75	Percent of Total Billed Charges	138.04	95.2	Percent of Total Billed Charges	127.53	87.95	Percent of Total Billed Charges	119.63	82.5	108.75	145
COCCIDIODIES ANTIBODIES	86635	HCPCS	300	RC		both	123	92.25	Percent of Total Billed Charges	117.1	95.2	Percent of Total Billed Charges	108.18	87.95	Percent of Total Billed Charges	101.48	82.5	92.25	123
"BILE ACIDS, SERUM"	82239	HCPCS	301	RC		both	79	59.25	Percent of Total Billed Charges	75.21	95.2	Percent of Total Billed Charges	69.48	87.95	Percent of Total Billed Charges	65.18	82.5	59.25	79
IMMUNOHISTHEM STAIN	88342	HCPCS	300	RC		both	197	147.75	Percent of Total Billed Charges	187.54	95.2	Percent of Total Billed Charges	173.26	87.95	Percent of Total Billed Charges	162.53	82.5	147.75	197
PINWORM PREP	87172	HCPCS	300	RC		both	82	61.5	Percent of Total Billed Charges	78.06	95.2	Percent of Total Billed Charges	72.12	87.95	Percent of Total Billed Charges	67.65	82.5	61.5	82
CULTURE STOOL SHIGA TOX	87899	HCPCS	300	RC		both	92	69	Percent of Total Billed Charges	87.58	95.2	Percent of Total Billed Charges	80.91	87.95	Percent of Total Billed Charges	75.9	82.5	69	92
CULTURE STOOL CONCENTRA	87015	HCPCS	300	RC		both	61	45.75	Percent of Total Billed Charges	58.07	95.2	Percent of Total Billed Charges	53.65	87.95	Percent of Total Billed Charges	50.33	82.5	45.75	61
FREE KAPPA & LAMBDA LIGHT CHAINS	83521	HCPCS	300	RC		both	281	210.75	Percent of Total Billed Charges	267.51	95.2	Percent of Total Billed Charges	247.14	87.95	Percent of Total Billed Charges	231.83	82.5	210.75	281
MONOCLONAL PROTEIN STUDY URINE RANDOM	86320	HCPCS	300	RC		both	166	124.5	Percent of Total Billed Charges	158.03	95.2	Percent of Total Billed Charges	146	87.95	Percent of Total Billed Charges	136.95	82.5	124.5	166
MONOCLONAL PROTEIN STUDY URINE 24 HOUR	86320	HCPCS	300	RC		both	166	124.5	Percent of Total Billed Charges	158.03	95.2	Percent of Total Billed Charges	146	87.95	Percent of Total Billed Charges	136.95	82.5	124.5	166
"DRUG SCREEN SINGLE DRUG CLASS, BY INSTRUMENTED TEST SYSTEMS"	80306	HCPCS	301	RC		both	375	281.25	Percent of Total Billed Charges	357	95.2	Percent of Total Billed Charges	329.81	87.95	Percent of Total Billed Charges	309.38	82.5	281.25	375
ETHYL SULFATE	80306	HCPCS	301	RC		both	318	238.5	Percent of Total Billed Charges	302.74	95.2	Percent of Total Billed Charges	279.68	87.95	Percent of Total Billed Charges	262.35	82.5	238.5	318
ALPHA-FETOPROTEIN (AFP) TUMOR MARKER	82105	HCPCS	310	RC		both	80	60	Percent of Total Billed Charges	76.16	95.2	Percent of Total Billed Charges	70.36	87.95	Percent of Total Billed Charges	66	82.5	60	80
LAE- LATEX ALLERGY SPECIFIC IGE	86003	HCPCS	300	RC		both	105	78.75	Percent of Total Billed Charges	99.96	95.2	Percent of Total Billed Charges	92.35	87.95	Percent of Total Billed Charges	86.63	82.5	78.75	105
QUANTIFERON GOLD TB	86480	HCPCS	300	RC		both	364	273	Percent of Total Billed Charges	346.53	95.2	Percent of Total Billed Charges	320.14	87.95	Percent of Total Billed Charges	300.3	82.5	273	364
CAPILLARY FINGERSTICK	36416	HCPCS	300	RC		both	35	26.25	Percent of Total Billed Charges	33.32	95.2	Percent of Total Billed Charges	30.78	87.95	Percent of Total Billed Charges	28.88	82.5	26.25	35
ANTI DOUBLE STRANDED DNA BY IMMUNOFLUORESCENCE USING CRITHIDIA	86235	HCPCS	300	RC		both	196	147	Percent of Total Billed Charges	186.59	95.2	Percent of Total Billed Charges	172.38	87.95	Percent of Total Billed Charges	161.7	82.5	147	196
TISSUE EXAM BY PATHOLOGIST	88305	HCPCS	314	RC		both	188	141	Percent of Total Billed Charges	178.98	95.2	Percent of Total Billed Charges	165.35	87.95	Percent of Total Billed Charges	155.1	82.5	141	188
MYCOPLASMA SERUM	86738	HCPCS	300	RC		both	67	50.25	Percent of Total Billed Charges	63.78	95.2	Percent of Total Billed Charges	58.93	87.95	Percent of Total Billed Charges	55.28	82.5	50.25	67
"RICKETTSIA ANTIBODIES, IGG AND IGM"	86757	HCPCS	300	RC		both	97	72.75	Percent of Total Billed Charges	92.34	95.2	Percent of Total Billed Charges	85.31	87.95	Percent of Total Billed Charges	80.03	82.5	72.75	97
LIQUID PAP	88142	HCPCS	311	RC		both	79	59.25	Percent of Total Billed Charges	75.21	95.2	Percent of Total Billed Charges	69.48	87.95	Percent of Total Billed Charges	65.18	82.5	59.25	79
SLIDE PAP	88164	HCPCS	311	RC		both	57	42.75	Percent of Total Billed Charges	54.26	95.2	Percent of Total Billed Charges	50.13	87.95	Percent of Total Billed Charges	47.03	82.5	42.75	57
TSH RECEPTOR ANTIBODY	83519	HCPCS	302	RC		both	95	71.25	Percent of Total Billed Charges	90.44	95.2	Percent of Total Billed Charges	83.55	87.95	Percent of Total Billed Charges	78.38	82.5	71.25	95
TISSUE BIOPSY 1	88300	HCPCS	300	RC		both	30	22.5	Percent of Total Billed Charges	28.56	95.2	Percent of Total Billed Charges	26.39	87.95	Percent of Total Billed Charges	24.75	82.5	22.5	30
TISSUE BIOPSY 6	88309	HCPCS	300	RC		both	259	194.25	Percent of Total Billed Charges	246.57	95.2	Percent of Total Billed Charges	227.79	87.95	Percent of Total Billed Charges	213.68	82.5	194.25	259
TDP PROFILE	86317	HCPCS	310	RC		both	154	115.5	Percent of Total Billed Charges	146.61	95.2	Percent of Total Billed Charges	135.44	87.95	Percent of Total Billed Charges	127.05	82.5	115.5	154
CYTOPATHOLOGY FINE NEEDLE ASPIRATE	88173	HCPCS	300	RC		both	97	72.75	Percent of Total Billed Charges	92.34	95.2	Percent of Total Billed Charges	85.31	87.95	Percent of Total Billed Charges	80.03	82.5	72.75	97
"DRUG(S) OR SUBSTANCE(S) DEFINITIVE, QUALITATIVE OR QUANTITATIVE NOT OTHERWISE SPECIFIED, 7 OR MORE"	80377	HCPCS	301	RC		both	302	226.5	Percent of Total Billed Charges	287.5	95.2	Percent of Total Billed Charges	265.61	87.95	Percent of Total Billed Charges	249.15	82.5	226.5	302
"HUMAN PAPILLOMA VIRUS, HIGH RISK"	87624	HCPCS	311	RC		both	137	102.75	Percent of Total Billed Charges	130.42	95.2	Percent of Total Billed Charges	120.49	87.95	Percent of Total Billed Charges	113.03	82.5	102.75	137
STOOL PATHOGENS BY PCR	87507	HCPCS	300	RC		both	807	605.25	Percent of Total Billed Charges	768.26	95.2	Percent of Total Billed Charges	709.76	87.95	Percent of Total Billed Charges	665.78	82.5	605.25	807
FRANCISELLA TULARENSIS ANTIBODIES	86668	HCPCS	300	RC		both	361	270.75	Percent of Total Billed Charges	343.67	95.2	Percent of Total Billed Charges	317.5	87.95	Percent of Total Billed Charges	297.83	82.5	270.75	361
"HEAVY METAL SCREEN , QUANTITATIVE, EACH"	83018	HCPCS	301	RC		both	63	47.25	Percent of Total Billed Charges	59.98	95.2	Percent of Total Billed Charges	55.41	87.95	Percent of Total Billed Charges	51.98	82.5	47.25	63
ALLERGEN SPECIFIC IGE EACH ALLERGEN QUANTITATIVE/SEMIQUANTITATIVE	86003	HCPCS	300	RC		both	25	18.75	Percent of Total Billed Charges	23.8	95.2	Percent of Total Billed Charges	21.99	87.95	Percent of Total Billed Charges	20.63	82.5	18.75	25
"EXTRACTABLE NUCLEAR ANTIGEN, ANTIBODY TO, ANY METHOD, EACH ANTIBODY"	86235	HCPCS	302	RC		both	46	34.5	Percent of Total Billed Charges	43.79	95.2	Percent of Total Billed Charges	40.46	87.95	Percent of Total Billed Charges	37.95	82.5	34.5	46
IMMUNOASSAY FOR ANALYTE OTHER THAN INFECTIOUS AGENT ANTIBODY OR INFECTIOUS AGENT ANTIGEN MULTIPLE STEP METHOD	83516	HCPCS	302	RC		both	75	56.25	Percent of Total Billed Charges	71.4	95.2	Percent of Total Billed Charges	65.96	87.95	Percent of Total Billed Charges	61.88	82.5	56.25	75
"CANNABINOIDS, NATURAL"	80349	HCPCS	301	RC		both	123	92.25	Percent of Total Billed Charges	117.1	95.2	Percent of Total Billed Charges	108.18	87.95	Percent of Total Billed Charges	101.48	82.5	92.25	123
"HYDROXYPROGESTERONE, 17-D~"	83498	HCPCS	301	RC		both	85	63.75	Percent of Total Billed Charges	80.92	95.2	Percent of Total Billed Charges	74.76	87.95	Percent of Total Billed Charges	70.13	82.5	63.75	85
D DIMER (IN-HOUSE)	85379	HCPCS	300	RC	QW	both	85	63.75	Percent of Total Billed Charges	80.92	95.2	Percent of Total Billed Charges	74.76	87.95	Percent of Total Billed Charges	70.13	82.5	63.75	85
"F2(PROTHROMBIN, COAGULATION FACTOR II) GENE ANALYSIS, A VARIANT"	81240	HCPCS	310	RC		both	516	387	Percent of Total Billed Charges	491.23	95.2	Percent of Total Billed Charges	453.82	87.95	Percent of Total Billed Charges	425.7	82.5	387	516
"MTHFR(5,10-METHYLENETETRAHYDROFOLATE REDUCTASE) GENE ANALYSIS COMMON VARIANTS"	81291	HCPCS	310	RC		both	334	250.5	Percent of Total Billed Charges	317.97	95.2	Percent of Total Billed Charges	293.75	87.95	Percent of Total Billed Charges	275.55	82.5	250.5	334
PRETREATMENT OF RBCS FOR USE IN RBC ANTIBODY DETECTION	86970	HCPCS	300	RC		both	5	3.75	Percent of Total Billed Charges	4.76	95.2	Percent of Total Billed Charges	4.4	87.95	Percent of Total Billed Charges	4.13	82.5	3.75	5
"LYMPHOCYTE TRANSFORMATION, B CELLS~"	86355	HCPCS	300	RC		both	112	84	Percent of Total Billed Charges	106.62	95.2	Percent of Total Billed Charges	98.5	87.95	Percent of Total Billed Charges	92.4	82.5	84	112
"HEMOGLOBIN; BY COPPER SULFATE METHOD, NON-AUTOMATED F(FETAL), CHEMICAL"	83030	HCPCS	301	RC		both	152	114	Percent of Total Billed Charges	144.7	95.2	Percent of Total Billed Charges	133.68	87.95	Percent of Total Billed Charges	125.4	82.5	114	152
COCONUT ALLERGY	86001	HCPCS	300	RC		both	81	60.75	Percent of Total Billed Charges	77.11	95.2	Percent of Total Billed Charges	71.24	87.95	Percent of Total Billed Charges	66.83	82.5	60.75	81
ALMOND ALLERGY	86003	HCPCS	300	RC		both	84	63	Percent of Total Billed Charges	79.97	95.2	Percent of Total Billed Charges	73.88	87.95	Percent of Total Billed Charges	69.3	82.5	63	84
RICE ALLERGY	86001	HCPCS	300	RC		both	84	63	Percent of Total Billed Charges	79.97	95.2	Percent of Total Billed Charges	73.88	87.95	Percent of Total Billed Charges	69.3	82.5	63	84
HISTAMINE	83088	HCPCS	301	RC		both	744	558	Percent of Total Billed Charges	708.29	95.2	Percent of Total Billed Charges	654.35	87.95	Percent of Total Billed Charges	613.8	82.5	558	744
"RESPIRATORY VIRUS, 12-25 TARGETS"	87633	HCPCS	300	RC		both	1002	751.5	Percent of Total Billed Charges	953.9	95.2	Percent of Total Billed Charges	881.26	87.95	Percent of Total Billed Charges	826.65	82.5	751.5	1002
"CHLAMYDIA PNEUMONIAE, AMPLIFIED PROBE TECHNIQUE"	87486	HCPCS	300	RC		both	86	64.5	Percent of Total Billed Charges	81.87	95.2	Percent of Total Billed Charges	75.64	87.95	Percent of Total Billed Charges	70.95	82.5	64.5	86
"MYCOPLASMA PNEUMONIAE, AMPLIFIED PROBE TECHNIQUE"	87581	HCPCS	300	RC		both	86	64.5	Percent of Total Billed Charges	81.87	95.2	Percent of Total Billed Charges	75.64	87.95	Percent of Total Billed Charges	70.95	82.5	64.5	86
HEPATITIS B DNA QUANT BY PCR	87517	HCPCS	300	RC		both	648	486	Percent of Total Billed Charges	616.9	95.2	Percent of Total Billed Charges	569.92	87.95	Percent of Total Billed Charges	534.6	82.5	486	648
VARICELLA ZOSTER QUALITATIVE PCR	87798	HCPCS	300	RC		both	309	231.75	Percent of Total Billed Charges	294.17	95.2	Percent of Total Billed Charges	271.77	87.95	Percent of Total Billed Charges	254.93	82.5	231.75	309
INFLUENZA A&B BY PCR	87502	HCPCS	300	RC	QW	both	301	225.75	Percent of Total Billed Charges	286.55	95.2	Percent of Total Billed Charges	264.73	87.95	Percent of Total Billed Charges	248.33	82.5	225.75	301
STREP A BY PCR	87651	HCPCS	300	RC	QW	both	110	82.5	Percent of Total Billed Charges	104.72	95.2	Percent of Total Billed Charges	96.75	87.95	Percent of Total Billed Charges	90.75	82.5	82.5	110
RSV BY PCR	87634	HCPCS	300	RC	QW	both	221	165.75	Percent of Total Billed Charges	210.39	95.2	Percent of Total Billed Charges	194.37	87.95	Percent of Total Billed Charges	182.33	82.5	165.75	221
"COVID-19 ANTIBODY, IGG"	86769	HCPCS	300	RC		both	161	120.75	Percent of Total Billed Charges	153.27	95.2	Percent of Total Billed Charges	141.6	87.95	Percent of Total Billed Charges	132.83	82.5	120.75	161
"HANTAVIRUS ANTIBODY IGG, IGM"	86790	HCPCS	300	RC		both	62	46.5	Percent of Total Billed Charges	59.02	95.2	Percent of Total Billed Charges	54.53	87.95	Percent of Total Billed Charges	51.15	82.5	46.5	62
S-2 PAS STAIN	88312	HCPCS	300	RC		both	165	123.75	Percent of Total Billed Charges	157.08	95.2	Percent of Total Billed Charges	145.12	87.95	Percent of Total Billed Charges	136.13	82.5	123.75	165
ID BY NUCLEIC ACID	87154	HCPCS	300	RC		both	117	87.75	Percent of Total Billed Charges	111.38	95.2	Percent of Total Billed Charges	102.9	87.95	Percent of Total Billed Charges	96.53	82.5	87.75	117
LEPTIN	83520	HCPCS	300	RC		both	221	165.75	Percent of Total Billed Charges	210.39	95.2	Percent of Total Billed Charges	194.37	87.95	Percent of Total Billed Charges	182.33	82.5	165.75	221
VITAMIN B6	84207	HCPCS	300	RC		both	95	71.25	Percent of Total Billed Charges	90.44	95.2	Percent of Total Billed Charges	83.55	87.95	Percent of Total Billed Charges	78.38	82.5	71.25	95
SHIGELLA SENSITIVITIES	87045	HCPCS	300	RC		both	32	24	Percent of Total Billed Charges	30.46	95.2	Percent of Total Billed Charges	28.14	87.95	Percent of Total Billed Charges	26.4	82.5	24	32
MONOCLONAL GAMMOPATHY	83520	HCPCS	300	RC		both	58	43.5	Percent of Total Billed Charges	55.22	95.2	Percent of Total Billed Charges	51.01	87.95	Percent of Total Billed Charges	47.85	82.5	43.5	58
MONOCLONAL GAMMOPATHY	84155	HCPCS	300	RC		both	12	9	Percent of Total Billed Charges	11.42	95.2	Percent of Total Billed Charges	10.55	87.95	Percent of Total Billed Charges	9.9	82.5	9	12
MONOCLONAL GAMMOPATHY	84165	HCPCS	300	RC		both	36	27	Percent of Total Billed Charges	34.27	95.2	Percent of Total Billed Charges	31.66	87.95	Percent of Total Billed Charges	29.7	82.5	27	36
MONOCLONAL GAMMOPATHY	0077U	HCPCS	300	RC		both	53	39.75	Percent of Total Billed Charges	50.46	95.2	Percent of Total Billed Charges	46.61	87.95	Percent of Total Billed Charges	43.73	82.5	39.75	53
PRO-PEPTIDE TYPE 1 COLLAGEN	83519	HCPCS	300	RC		both	62	46.5	Percent of Total Billed Charges	59.02	95.2	Percent of Total Billed Charges	54.53	87.95	Percent of Total Billed Charges	51.15	82.5	46.5	62
COVID-19 IGG (SPIKE) SEMI-QUANT BY CIA	86769	HCPCS	300	RC		both	142	106.5	Percent of Total Billed Charges	135.18	95.2	Percent of Total Billed Charges	124.89	87.95	Percent of Total Billed Charges	117.15	82.5	106.5	142
"APIXABAN, PLASMA"	80375	HCPCS	300	RC		both	391	293.25	Percent of Total Billed Charges	372.23	95.2	Percent of Total Billed Charges	343.88	87.95	Percent of Total Billed Charges	322.58	82.5	293.25	391
ACETYLCHOLINE RECEPTORS ANTIBODY REFLUX PANEL	83519	HCPCS	300	RC		both	62	46.5	Percent of Total Billed Charges	59.02	95.2	Percent of Total Billed Charges	54.53	87.95	Percent of Total Billed Charges	51.15	82.5	46.5	62
ACETYLCHOLINE RECEPTORS ANTIBODY REFLUX PANEL	83516	HCPCS	300	RC		both	38	28.5	Percent of Total Billed Charges	36.18	95.2	Percent of Total Billed Charges	33.42	87.95	Percent of Total Billed Charges	31.35	82.5	28.5	38
GANGLIOSIDE ANTIBODY	83516	HCPCS	300	RC		both	38	28.5	Percent of Total Billed Charges	36.18	95.2	Percent of Total Billed Charges	33.42	87.95	Percent of Total Billed Charges	31.35	82.5	28.5	38
HIGH SENSITIVITY TROPONIN	84484	HCPCS	300	RC		both	40	30	Percent of Total Billed Charges	38.08	95.2	Percent of Total Billed Charges	35.18	87.95	Percent of Total Billed Charges	33	82.5	30	40
ESR	85652	HCPCS	300	RC		both	11	8.25	Percent of Total Billed Charges	10.47	95.2	Percent of Total Billed Charges	9.67	87.95	Percent of Total Billed Charges	9.08	82.5	8.25	11
BINAX -ANTIGEN TEST	87426	HCPCS	300	RC		both	49	36.75	Percent of Total Billed Charges	46.65	95.2	Percent of Total Billed Charges	43.1	87.95	Percent of Total Billed Charges	40.43	82.5	36.75	49
ANTIPROTEINASE 3 ANTIBODY	83516	HCPCS	300	RC		both	38	28.5	Percent of Total Billed Charges	36.18	95.2	Percent of Total Billed Charges	33.42	87.95	Percent of Total Billed Charges	31.35	82.5	28.5	38
ANCA SCREEN EACH ANTIBODY	86036	HCPCS	300	RC		both	38	28.5	Percent of Total Billed Charges	36.18	95.2	Percent of Total Billed Charges	33.42	87.95	Percent of Total Billed Charges	31.35	82.5	28.5	38
RBC FOLATES	82747	HCPCS	300	RC		both	100	75	Percent of Total Billed Charges	95.2	95.2	Percent of Total Billed Charges	87.95	87.95	Percent of Total Billed Charges	82.5	82.5	75	100
NICOTINE AND METABOLITES	80323	HCPCS	300	RC		outpatient	86	64.5	Percent of Total Billed Charges	81.87	95.2	Percent of Total Billed Charges	75.64	87.95	Percent of Total Billed Charges	70.95	82.5	64.5	86
FACTOR V LEIDEN	81241	HCPCS	300	RC		both	238	178.5	Percent of Total Billed Charges	226.58	95.2	Percent of Total Billed Charges	209.32	87.95	Percent of Total Billed Charges	196.35	82.5	178.5	238
PATHOLOGY INTERPRETATION	81219	HCPCS	300	RC		both	395	296.25	Percent of Total Billed Charges	376.04	95.2	Percent of Total Billed Charges	347.4	87.95	Percent of Total Billed Charges	325.88	82.5	296.25	395
LUPUS PT	85611	HCPCS	300	RC		both	13	9.75	Percent of Total Billed Charges	12.38	95.2	Percent of Total Billed Charges	11.43	87.95	Percent of Total Billed Charges	10.73	82.5	9.75	13
PROTEIN C ACTIVITY	85303	HCPCS	300	RC		both	44	33	Percent of Total Billed Charges	41.89	95.2	Percent of Total Billed Charges	38.7	87.95	Percent of Total Billed Charges	36.3	82.5	33	44
TPMT	82657	HCPCS	300	RC		both	70	52.5	Percent of Total Billed Charges	66.64	95.2	Percent of Total Billed Charges	61.57	87.95	Percent of Total Billed Charges	57.75	82.5	52.5	70
"ZINK,RBC"	84630	HCPCS	300	RC		both	36	27	Percent of Total Billed Charges	34.27	95.2	Percent of Total Billed Charges	31.66	87.95	Percent of Total Billed Charges	29.7	82.5	27	36
"MAGNESIUM, RBC"	83735	HCPCS	300	RC		both	21	15.75	Percent of Total Billed Charges	19.99	95.2	Percent of Total Billed Charges	18.47	87.95	Percent of Total Billed Charges	17.33	82.5	15.75	21
SYNOVIAL FLUID CULTURE	87075	HCPCS	300	RC		outpatient	29	21.75	Percent of Total Billed Charges	27.61	95.2	Percent of Total Billed Charges	25.51	87.95	Percent of Total Billed Charges	23.93	82.5	21.75	29
CREATINE 24 HR URINE	82540	HCPCS	300	RC		both	15	11.25	Percent of Total Billed Charges	14.28	95.2	Percent of Total Billed Charges	13.19	87.95	Percent of Total Billed Charges	12.38	82.5	11.25	15
ASSAY OF GGT	82977	HCPCS	300	RC		both	49	36.75	Percent of Total Billed Charges	46.65	95.2	Percent of Total Billed Charges	43.1	87.95	Percent of Total Billed Charges	40.43	82.5	36.75	49
LIVER FIBROIS CRHINIC VIRAL HEPATITIS	83883	HCPCS	300	RC		both	112	84	Percent of Total Billed Charges	106.62	95.2	Percent of Total Billed Charges	98.5	87.95	Percent of Total Billed Charges	92.4	82.5	84	112
INSULIN-LIKE GROWTH FACTOR 1	83519	HCPCS	300	RC		both	210	157.5	Percent of Total Billed Charges	199.92	95.2	Percent of Total Billed Charges	184.7	87.95	Percent of Total Billed Charges	173.25	82.5	157.5	210
PROTEIN ELECTROPHORESIS URINE	84156	HCPCS	300	RC		both	16	12	Percent of Total Billed Charges	15.23	95.2	Percent of Total Billed Charges	14.07	87.95	Percent of Total Billed Charges	13.2	82.5	12	16
ANA IFA TITER (RPS)	86256	HCPCS	300	RC		both	77	57.75	Percent of Total Billed Charges	73.3	95.2	Percent of Total Billed Charges	67.72	87.95	Percent of Total Billed Charges	63.53	82.5	57.75	77
ANA IFA W/ REFLEX	86255	HCPCS	300	RC		both	77	57.75	Percent of Total Billed Charges	73.3	95.2	Percent of Total Billed Charges	67.72	87.95	Percent of Total Billed Charges	63.53	82.5	57.75	77
SCLERODERMA ANTIBODY	86235	HCPCS	300	RC		both	59	44.25	Percent of Total Billed Charges	56.17	95.2	Percent of Total Billed Charges	51.89	87.95	Percent of Total Billed Charges	48.68	82.5	44.25	59
PROPRANOLOL	80375	HCPCS	300	RC		both	105	78.75	Percent of Total Billed Charges	99.96	95.2	Percent of Total Billed Charges	92.35	87.95	Percent of Total Billed Charges	86.63	82.5	78.75	105
HEP C VIRUS HIGH-REF GEN	87902	HCPCS	300	RC		both	811	608.25	Percent of Total Billed Charges	772.07	95.2	Percent of Total Billed Charges	713.27	87.95	Percent of Total Billed Charges	669.08	82.5	608.25	811
GROUP B STREP CULTURE	87081	HCPCS	300	RC		both	21	15.75	Percent of Total Billed Charges	19.99	95.2	Percent of Total Billed Charges	18.47	87.95	Percent of Total Billed Charges	17.33	82.5	15.75	21
PHOSPHATIDYL ETHANOL	80321	HCPCS	300	RC		both	261	195.75	Percent of Total Billed Charges	248.47	95.2	Percent of Total Billed Charges	229.55	87.95	Percent of Total Billed Charges	215.33	82.5	195.75	261
FUNGAL IDENTIFICATION	87107	HCPCS	300	RC		both	80	60	Percent of Total Billed Charges	76.16	95.2	Percent of Total Billed Charges	70.36	87.95	Percent of Total Billed Charges	66	82.5	60	80
FLUOROQUINOLONE-RESISTANT ORGANISM CULTURE	87081	HCPCS	300	RC		both	131	98.25	Percent of Total Billed Charges	124.71	95.2	Percent of Total Billed Charges	115.21	87.95	Percent of Total Billed Charges	108.08	82.5	98.25	131
SMEAR REVIEW	85008	HCPCS	300	RC		both	11	8.25	Percent of Total Billed Charges	10.47	95.2	Percent of Total Billed Charges	9.67	87.95	Percent of Total Billed Charges	9.08	82.5	8.25	11
"THC METABOLITE, SERUM QUANTITATIVE"	80349	HCPCS	300	RC		both	105	78.75	Percent of Total Billed Charges	99.96	95.2	Percent of Total Billed Charges	92.35	87.95	Percent of Total Billed Charges	86.63	82.5	78.75	105
"ARSENIC EXPOSURE PROF, UR"	82570	HCPCS	300	RC		both	117	87.75	Percent of Total Billed Charges	111.38	95.2	Percent of Total Billed Charges	102.9	87.95	Percent of Total Billed Charges	96.53	82.5	87.75	117
"ARSENIC FRACTIONATION, URINE"	82175	HCPCS	300	RC		both	137	102.75	Percent of Total Billed Charges	130.42	95.2	Percent of Total Billed Charges	120.49	87.95	Percent of Total Billed Charges	113.03	82.5	102.75	137
"COCAINE METABOLITE, SERUM"	80353	HCPCS	300	RC		both	75	56.25	Percent of Total Billed Charges	71.4	95.2	Percent of Total Billed Charges	65.96	87.95	Percent of Total Billed Charges	61.88	82.5	56.25	75
GLIADIN IGG & IGA	86258	HCPCS	300	RC		both	55	41.25	Percent of Total Billed Charges	52.36	95.2	Percent of Total Billed Charges	48.37	87.95	Percent of Total Billed Charges	45.38	82.5	41.25	55
MONOCLONAL GAMMOPATHY	83521	HCPCS	300	RC		both	55	41.25	Percent of Total Billed Charges	52.36	95.2	Percent of Total Billed Charges	48.37	87.95	Percent of Total Billed Charges	45.38	82.5	41.25	55
MONOCLONAL GAMMOPATHY	86334	HCPCS	300	RC		both	70	52.5	Percent of Total Billed Charges	66.64	95.2	Percent of Total Billed Charges	61.57	87.95	Percent of Total Billed Charges	57.75	82.5	52.5	70
ANCA ASSOCIATED VASCULAR	83516	HCPCS	300	RC		both	37	27.75	Percent of Total Billed Charges	35.22	95.2	Percent of Total Billed Charges	32.54	87.95	Percent of Total Billed Charges	30.53	82.5	27.75	37
ANCA ASSOCIATED VASCULAR	86036	HCPCS	300	RC		both	39	29.25	Percent of Total Billed Charges	37.13	95.2	Percent of Total Billed Charges	34.3	87.95	Percent of Total Billed Charges	32.18	82.5	29.25	39
MYELOPEROXIDASE (MPO) ANTIBODY RPS)	83516	HCPCS	300	RC		both	35	26.25	Percent of Total Billed Charges	33.32	95.2	Percent of Total Billed Charges	30.78	87.95	Percent of Total Billed Charges	28.88	82.5	26.25	35
LACOSAMIDE	80235	HCPCS	300	RC		both	88	66	Percent of Total Billed Charges	83.78	95.2	Percent of Total Billed Charges	77.4	87.95	Percent of Total Billed Charges	72.6	82.5	66	88
CYSTATIN	82610	HCPCS	300	RC		both	61	45.75	Percent of Total Billed Charges	58.07	95.2	Percent of Total Billed Charges	53.65	87.95	Percent of Total Billed Charges	50.33	82.5	45.75	61
"ORANGE, IGE"	86003	HCPCS	300	RC		both	22	16.5	Percent of Total Billed Charges	20.94	95.2	Percent of Total Billed Charges	19.35	87.95	Percent of Total Billed Charges	18.15	82.5	16.5	22
"LEMON, IGE"	86003	HCPCS	300	RC		both	22	16.5	Percent of Total Billed Charges	20.94	95.2	Percent of Total Billed Charges	19.35	87.95	Percent of Total Billed Charges	18.15	82.5	16.5	22
"LIME, IGE"	86003	HCPCS	300	RC		both	22	16.5	Percent of Total Billed Charges	20.94	95.2	Percent of Total Billed Charges	19.35	87.95	Percent of Total Billed Charges	18.15	82.5	16.5	22
"CRANBERRY, IGE"	86003	HCPCS	300	RC		both	22	16.5	Percent of Total Billed Charges	20.94	95.2	Percent of Total Billed Charges	19.35	87.95	Percent of Total Billed Charges	18.15	82.5	16.5	22
FACTOR II ACTIVITY	85210	HCPCS	300	RC		both	42	31.5	Percent of Total Billed Charges	39.98	95.2	Percent of Total Billed Charges	36.94	87.95	Percent of Total Billed Charges	34.65	82.5	31.5	42
MRSA PCR	87641	HCPCS	300	RC		both	113	84.75	Percent of Total Billed Charges	107.58	95.2	Percent of Total Billed Charges	99.38	87.95	Percent of Total Billed Charges	93.23	82.5	84.75	113
"URINE DRUG SCREEN, AUTOMATED"	80305	HCPCS	300	RC		both	45	33.75	Percent of Total Billed Charges	42.84	95.2	Percent of Total Billed Charges	39.58	87.95	Percent of Total Billed Charges	37.13	82.5	33.75	45
DETECT AGENT NOS DNA MP	87798	HCPCS	300	RC		both	108	81	Percent of Total Billed Charges	102.82	95.2	Percent of Total Billed Charges	94.99	87.95	Percent of Total Billed Charges	89.1	82.5	81	108
SYPHILIS TEST NON-TREP QUANT	86593	HCPCS	300	RC		both	107	80.25	Percent of Total Billed Charges	101.86	95.2	Percent of Total Billed Charges	94.11	87.95	Percent of Total Billed Charges	88.28	82.5	80.25	107
ADULT FOOD ALLERGY PANEL 1	86003	HCPCS	300	RC		both	17	12.75	Percent of Total Billed Charges	16.18	95.2	Percent of Total Billed Charges	14.95	87.95	Percent of Total Billed Charges	14.03	82.5	12.75	17
ALLERGENS RESPIRATORY PANEL REGION 9	82785	HCPCS	300	RC		both	55	41.25	Percent of Total Billed Charges	52.36	95.2	Percent of Total Billed Charges	48.37	87.95	Percent of Total Billed Charges	45.38	82.5	41.25	55
ALLERGENS RESPIRATORY PANEL REGION 9	86003	HCPCS	300	RC		both	17	12.75	Percent of Total Billed Charges	16.18	95.2	Percent of Total Billed Charges	14.95	87.95	Percent of Total Billed Charges	14.03	82.5	12.75	17
HEPATITIS B VIRUS GENOTYPE	87912	HCPCS	300	RC		both	811	608.25	Percent of Total Billed Charges	772.07	95.2	Percent of Total Billed Charges	713.27	87.95	Percent of Total Billed Charges	669.08	82.5	608.25	811
HAPATITIS BE VIRUS ANTIBODY (RPS)	86707	HCPCS	300	RC		both	37	27.75	Percent of Total Billed Charges	35.22	95.2	Percent of Total Billed Charges	32.54	87.95	Percent of Total Billed Charges	30.53	82.5	27.75	37
CHROMOGRANIN A (RPS)	86316	HCPCS	300	RC		both	65	48.75	Percent of Total Billed Charges	61.88	95.2	Percent of Total Billed Charges	57.17	87.95	Percent of Total Billed Charges	53.63	82.5	48.75	65
SOMATOSTATIN (RPS)	84307	HCPCS	300	RC		both	58	43.5	Percent of Total Billed Charges	55.22	95.2	Percent of Total Billed Charges	51.01	87.95	Percent of Total Billed Charges	47.85	82.5	43.5	58
VASOACTIVE INTESTINAL POLYPEPTIDE (VIP) (RPS)	84586	HCPCS	300	RC		both	111	83.25	Percent of Total Billed Charges	105.67	95.2	Percent of Total Billed Charges	97.62	87.95	Percent of Total Billed Charges	91.58	82.5	83.25	111
ANTINEUTROPHIL ANTIBODY	86021	HCPCS	300	RC		both	269	201.75	Percent of Total Billed Charges	256.09	95.2	Percent of Total Billed Charges	236.59	87.95	Percent of Total Billed Charges	221.93	82.5	201.75	269
FUNGUS CULTURE	87102	HCPCS	300	RC		both	82	61.5	Percent of Total Billed Charges	78.06	95.2	Percent of Total Billed Charges	72.12	87.95	Percent of Total Billed Charges	67.65	82.5	61.5	82
SOMATOSTATIN	84307	HCPCS	300	RC		both	257	192.75	Percent of Total Billed Charges	244.66	95.2	Percent of Total Billed Charges	226.03	87.95	Percent of Total Billed Charges	212.03	82.5	192.75	257
CHROMOGRANIN A	86316	HCPCS	300	RC		both	100	75	Percent of Total Billed Charges	95.2	95.2	Percent of Total Billed Charges	87.95	87.95	Percent of Total Billed Charges	82.5	82.5	75	100
VASOACTIVE INTESTINAL PEPTIDE	84586	HCPCS	300	RC		both	100	75	Percent of Total Billed Charges	95.2	95.2	Percent of Total Billed Charges	87.95	87.95	Percent of Total Billed Charges	82.5	82.5	75	100
ANTIMITOCHRONDRIAL	86381	HCPCS	300	RC		both	86	64.5	Percent of Total Billed Charges	81.87	95.2	Percent of Total Billed Charges	75.64	87.95	Percent of Total Billed Charges	70.95	82.5	64.5	86
ANTI SMOOTH MUSCLE	86015	HCPCS	300	RC		both	103	77.25	Percent of Total Billed Charges	98.06	95.2	Percent of Total Billed Charges	90.59	87.95	Percent of Total Billed Charges	84.98	82.5	77.25	103
ADAMTS13 ACTIVITY	85397	HCPCS	300	RC		both	461	345.75	Percent of Total Billed Charges	438.87	95.2	Percent of Total Billed Charges	405.45	87.95	Percent of Total Billed Charges	380.33	82.5	345.75	461
"CARBAMAZEPINE, FREE"	80157	HCPCS	300	RC		both	116	87	Percent of Total Billed Charges	110.43	95.2	Percent of Total Billed Charges	102.02	87.95	Percent of Total Billed Charges	95.7	82.5	87	116
VANCOMYCIN TROUGH	80202	HCPCS	301	RC		both	193	144.75	Percent of Total Billed Charges	183.74	95.2	Percent of Total Billed Charges	169.74	87.95	Percent of Total Billed Charges	159.23	82.5	144.75	193
VANCOMYCIN PEAK	80202	HCPCS	301	RC		both	193	144.75	Percent of Total Billed Charges	183.74	95.2	Percent of Total Billed Charges	169.74	87.95	Percent of Total Billed Charges	159.23	82.5	144.75	193
FOOD PANEL 1	82785	HCPCS	300	RC		both	51	38.25	Percent of Total Billed Charges	48.55	95.2	Percent of Total Billed Charges	44.85	87.95	Percent of Total Billed Charges	42.08	82.5	38.25	51
THROMBOPLASTIN TIME PARTIAL	85732	HCPCS	300	RC		both	65	48.75	Percent of Total Billed Charges	61.88	95.2	Percent of Total Billed Charges	57.17	87.95	Percent of Total Billed Charges	53.63	82.5	48.75	65
TICK BORNE DISEASE PANEL	87798	HCPCS	300	RC		both	113	84.75	Percent of Total Billed Charges	107.58	95.2	Percent of Total Billed Charges	99.38	87.95	Percent of Total Billed Charges	93.23	82.5	84.75	113
"LEGIONELLA P., UR AG"	87449	HCPCS	300	RC		both	38	28.5	Percent of Total Billed Charges	36.18	95.2	Percent of Total Billed Charges	33.42	87.95	Percent of Total Billed Charges	31.35	82.5	28.5	38
FACTOR VIII ANTIGEN	85244	HCPCS	300	RC		both	64	48	Percent of Total Billed Charges	60.93	95.2	Percent of Total Billed Charges	56.29	87.95	Percent of Total Billed Charges	52.8	82.5	48	64
IMMUNOASSAY NONANTIBODY	86364	HCPCS	300	RC		both	57	42.75	Percent of Total Billed Charges	54.26	95.2	Percent of Total Billed Charges	50.13	87.95	Percent of Total Billed Charges	47.03	82.5	42.75	57
FACTOR XII ACTIVITY	85280	HCPCS	300	RC		both	61	45.75	Percent of Total Billed Charges	58.07	95.2	Percent of Total Billed Charges	53.65	87.95	Percent of Total Billed Charges	50.33	82.5	45.75	61
TREATMENT OF SWALLOWING DYSFUNCTION AND/OR ORAL FUNCTION FOR FEEDING	92526	HCPCS	440	RC	GN	both	266	199.5	Percent of Total Billed Charges	253.23	95.2	Percent of Total Billed Charges	233.95	87.95	Percent of Total Billed Charges	219.45	82.5	199.5	266
EVALUATION OF ORAL AND PHARYNGEAL SWALLOWING FUNCTION	92610	HCPCS	440	RC	GN	both	240	180	Percent of Total Billed Charges	228.48	95.2	Percent of Total Billed Charges	211.08	87.95	Percent of Total Billed Charges	198	82.5	180	240
"TREATMENT OF SPEECH, LANGUAGE VOICE, COMMUNICATION AND/OR AUDITORY PROCESSING"	92507	HCPCS	440	RC	GN	both	239	179.25	Percent of Total Billed Charges	227.53	95.2	Percent of Total Billed Charges	210.2	87.95	Percent of Total Billed Charges	197.18	82.5	179.25	239
"TREATMENT OF SPEECH, LANGUAGE,....GROUP, TWO OR MORE INDIVIDUALS"	92508	HCPCS	440	RC	GN	both	75	56.25	Percent of Total Billed Charges	71.4	95.2	Percent of Total Billed Charges	65.96	87.95	Percent of Total Billed Charges	61.88	82.5	56.25	75
"DEVELOPMENT OF COGNITIVE SKILLS TO IMPROVE ATTENTION, MEMORY, PROBLEM SOLVING, DIRECT ONE ON ONE PATIENT CONTACT EACH 15 MINS"	97532	HCPCS	440	RC		both	138	103.5	Percent of Total Billed Charges	131.38	95.2	Percent of Total Billed Charges	121.37	87.95	Percent of Total Billed Charges	113.85	82.5	103.5	138
SENSORY INTEGRATIVE TECHNIQUES TO ENHANCE SENSORY PROCESSING EACH 15 MINS	97533	HCPCS	440	RC		both	98	73.5	Percent of Total Billed Charges	93.3	95.2	Percent of Total Billed Charges	86.19	87.95	Percent of Total Billed Charges	80.85	82.5	73.5	98
"EVALUATION OF SPEECH FLUENCY (EG, STUTTERING, CLUTTERING)"	92521	HCPCS	440	RC	GN	both	320	240	Percent of Total Billed Charges	304.64	95.2	Percent of Total Billed Charges	281.44	87.95	Percent of Total Billed Charges	264	82.5	240	320
"EVALUATION OF SPEECH SOUND PRODUCTION (EG, ARTICULATION, PHONOLOGICAL PROCESS)"	92522	HCPCS	440	RC	GN	both	349	261.75	Percent of Total Billed Charges	332.25	95.2	Percent of Total Billed Charges	306.95	87.95	Percent of Total Billed Charges	287.93	82.5	261.75	349
"EVALUATION OF SPEECH SOUND PRODUCTION (EG, ARTICULATION, PHONOLOGICAL PROCESS)"	92523	HCPCS	444	RC	GN	both	711	533.25	Percent of Total Billed Charges	676.87	95.2	Percent of Total Billed Charges	625.32	87.95	Percent of Total Billed Charges	586.58	82.5	533.25	711
BEHAVIORAL & QUANTITATIVE ANALYSIS OF VOICE RESONANCE	92524	HCPCS	440	RC	GN	both	343	257.25	Percent of Total Billed Charges	326.54	95.2	Percent of Total Billed Charges	301.67	87.95	Percent of Total Billed Charges	282.98	82.5	257.25	343
AUDITORY REHABILITATION; PRE-LINGUAL HEARING LOSS	92630	HCPCS	440	RC		both	212	159	Percent of Total Billed Charges	201.82	95.2	Percent of Total Billed Charges	186.45	87.95	Percent of Total Billed Charges	174.9	82.5	159	212
AUDITORY REHABILITATION; POST-LINGUAL HEARING LOSS	92633	HCPCS	440	RC		both	212	159	Percent of Total Billed Charges	201.82	95.2	Percent of Total Billed Charges	186.45	87.95	Percent of Total Billed Charges	174.9	82.5	159	212
"ASSESSMENT OF APHASIA WITH INTERPRETATION AND REPORT, PER HOUR"	96105	HCPCS	440	RC	GN	both	306	229.5	Percent of Total Billed Charges	291.31	95.2	Percent of Total Billed Charges	269.13	87.95	Percent of Total Billed Charges	252.45	82.5	229.5	306
DEVELOPMENTAL SCREENING WITH INTERPRETATION AND REPORT	96111	HCPCS	440	RC		both	152	114	Percent of Total Billed Charges	144.7	95.2	Percent of Total Billed Charges	133.68	87.95	Percent of Total Billed Charges	125.4	82.5	114	152
"DEVELOPMENTAL TESTING, WITH INTERPRETATION REPORT"	96111	HCPCS	440	RC		both	379	284.25	Percent of Total Billed Charges	360.81	95.2	Percent of Total Billed Charges	333.33	87.95	Percent of Total Billed Charges	312.68	82.5	284.25	379
STANDARDIZED COGNITIVE PERFORMANCE TESTING PER HOUR	96125	HCPCS	440	RC	GN	both	332	249	Percent of Total Billed Charges	316.06	95.2	Percent of Total Billed Charges	291.99	87.95	Percent of Total Billed Charges	273.9	82.5	249	332
EVALUATION FOR USE/FITTING OF VOICE PROSTHETIC DEVICE TO SUPPLEMENT ORAL SPEECH	92597	HCPCS	444	RC		both	203	152.25	Percent of Total Billed Charges	193.26	95.2	Percent of Total Billed Charges	178.54	87.95	Percent of Total Billed Charges	167.48	82.5	152.25	203
EVALUATION FOR PRESCRIPTION OF NON-SPEECH-FACE TO FACE WITH PATIENT-FIRST HOUR	92605	HCPCS	444	RC	GN	both	266	199.5	Percent of Total Billed Charges	253.23	95.2	Percent of Total Billed Charges	233.95	87.95	Percent of Total Billed Charges	219.45	82.5	199.5	266
EVALUATION FOR PRESCRIPTION OF NON-SPEECH-FACE TO FACE WITH PATIENT-EACH ADD'L 30 MINUTES	92618	HCPCS	444	RC	GN	both	91	68.25	Percent of Total Billed Charges	86.63	95.2	Percent of Total Billed Charges	80.03	87.95	Percent of Total Billed Charges	75.08	82.5	68.25	91
THERAPEUTIC SERVICES FOR THE USE OF NON-SPEECH-PROGRAMMING AND MODIFICATION	92606	HCPCS	440	RC	GN	both	238	178.5	Percent of Total Billed Charges	226.58	95.2	Percent of Total Billed Charges	209.32	87.95	Percent of Total Billed Charges	196.35	82.5	178.5	238
EVALUATION FOR PRESCRIPTION FOR SPEECH-GENERATING FACE TO FACE FIRST HOUR	92607	HCPCS	444	RC	GN	both	387	290.25	Percent of Total Billed Charges	368.42	95.2	Percent of Total Billed Charges	340.37	87.95	Percent of Total Billed Charges	319.28	82.5	290.25	387
EVALUATION FOR PRESCRIPTION FOR SPEECH-GENERATING FACE TO FACE EACH ADD'L 30 MINS	92608	HCPCS	444	RC		both	148	111	Percent of Total Billed Charges	140.9	95.2	Percent of Total Billed Charges	130.17	87.95	Percent of Total Billed Charges	122.1	82.5	111	148
THERAPEUTIC SERVICES FOR THE USE OF SPEECH-GENERATING DEVICE	92609	HCPCS	440	RC	GN	both	309	231.75	Percent of Total Billed Charges	294.17	95.2	Percent of Total Billed Charges	271.77	87.95	Percent of Total Billed Charges	254.93	82.5	231.75	309
TELEPHONE ASSESSMENT & MANAGEMENT SERVICE PROVIDED 5-10 MIN OF MEDICAL DISCUSSION	98966	HCPCS	440	RC		both	41	30.75	Percent of Total Billed Charges	39.03	95.2	Percent of Total Billed Charges	36.06	87.95	Percent of Total Billed Charges	33.83	82.5	30.75	41
TELEPHONE ASSESSMENT & MANAGEMENT SERVICE PROVIDED 11-20 MINUTES MEDICAL DISCUSSION	98967	HCPCS	440	RC		both	79	59.25	Percent of Total Billed Charges	75.21	95.2	Percent of Total Billed Charges	69.48	87.95	Percent of Total Billed Charges	65.18	82.5	59.25	79
TELEPHONE ASSESSMENT & MANAGEMENT SERVICE PROVIDED 21-30 MIN OF MEDICAL DISCUSSION	98968	HCPCS	440	RC		both	114	85.5	Percent of Total Billed Charges	108.53	95.2	Percent of Total Billed Charges	100.26	87.95	Percent of Total Billed Charges	94.05	82.5	85.5	114
ONLINE ASSESEMENT & MANAGEMENT SERVICES PROVIDED	98969	HCPCS	440	RC		both	64	48	Percent of Total Billed Charges	60.93	95.2	Percent of Total Billed Charges	56.29	87.95	Percent of Total Billed Charges	52.8	82.5	48	64
MEDICAL TEAM CONFERENCE WITH INTERDISCIPLINARY TEAM 30 MINS OR MORE	99366	HCPCS	440	RC	GN	both	129	96.75	Percent of Total Billed Charges	122.81	95.2	Percent of Total Billed Charges	113.46	87.95	Percent of Total Billed Charges	106.43	82.5	96.75	129
MEDICAL TEAM CONFERENCE WITH INTERDISCIPLINARY TEAM-FAMILY NOT PRESENT 30 MINS OR MORE	99368	HCPCS	440	RC	GN	both	110	82.5	Percent of Total Billed Charges	104.72	95.2	Percent of Total Billed Charges	96.75	87.95	Percent of Total Billed Charges	90.75	82.5	82.5	110
EVALUATION PT	97001	HCPCS	429	RC		both	168	126	Percent of Total Billed Charges	159.94	95.2	Percent of Total Billed Charges	147.76	87.95	Percent of Total Billed Charges	138.6	82.5	126	168
ELECTRO-STIM UNATTENDED	G0283	HCPCS	429	RC	GP	both	91	68.25	Percent of Total Billed Charges	86.63	95.2	Percent of Total Billed Charges	80.03	87.95	Percent of Total Billed Charges	75.08	82.5	68.25	91
ELECTRO-STIM UNATTENDED	97014	HCPCS	429	RC	GP	both	91	68.25	Percent of Total Billed Charges	86.63	95.2	Percent of Total Billed Charges	80.03	87.95	Percent of Total Billed Charges	75.08	82.5	68.25	91
APPLICATION OF PARAFFIN BATH TO 1 OR MORE AREAS	97018	HCPCS	429	RC	GP	both	78	58.5	Percent of Total Billed Charges	74.26	95.2	Percent of Total Billed Charges	68.6	87.95	Percent of Total Billed Charges	64.35	82.5	58.5	78
DEBRIDMENT FIRST 20 SQUARE CM OR LESS	97597	HCPCS	429	RC	GP	both	62	46.5	Percent of Total Billed Charges	59.02	95.2	Percent of Total Billed Charges	54.53	87.95	Percent of Total Billed Charges	51.15	82.5	46.5	62
APPLICATION OF WHIRLPOOL TO 1 OR MORE AREAS	97022	HCPCS	429	RC	GP	both	48	36	Percent of Total Billed Charges	45.7	95.2	Percent of Total Billed Charges	42.22	87.95	Percent of Total Billed Charges	39.6	82.5	36	48
"ELECT STIM, MANUAL 15 MIN"	97032	HCPCS	429	RC	GP	both	84	63	Percent of Total Billed Charges	79.97	95.2	Percent of Total Billed Charges	73.88	87.95	Percent of Total Billed Charges	69.3	82.5	63	84
GAIT TRAINING EA. 15 MIN	97116	HCPCS	429	RC	GP	both	117	87.75	Percent of Total Billed Charges	111.38	95.2	Percent of Total Billed Charges	102.9	87.95	Percent of Total Billed Charges	96.53	82.5	87.75	117
"IONTOPHORESIS, 15 MIN"	97033	HCPCS	429	RC	GP	both	82	61.5	Percent of Total Billed Charges	78.06	95.2	Percent of Total Billed Charges	72.12	87.95	Percent of Total Billed Charges	67.65	82.5	61.5	82
"MASSAGE, 15 MIN"	97124	HCPCS	429	RC	GP	both	79	59.25	Percent of Total Billed Charges	75.21	95.2	Percent of Total Billed Charges	69.48	87.95	Percent of Total Billed Charges	65.18	82.5	59.25	79
THERAPEUTIC ACTIVITY 15 M	97530	HCPCS	429	RC	GP	both	120	90	Percent of Total Billed Charges	114.24	95.2	Percent of Total Billed Charges	105.54	87.95	Percent of Total Billed Charges	99	82.5	90	120
DRY NEEDLING (TDN) WITH EVAL	97799	HCPCS	420	RC		both	85	63.75	Percent of Total Billed Charges	80.92	95.2	Percent of Total Billed Charges	74.76	87.95	Percent of Total Billed Charges	70.13	82.5	63.75	85
"ULTRASOUND, 15 MIN."	97035	HCPCS	429	RC	GP	both	91	68.25	Percent of Total Billed Charges	86.63	95.2	Percent of Total Billed Charges	80.03	87.95	Percent of Total Billed Charges	75.08	82.5	68.25	91
DRY NEEDLING LEVEL 3 (TDN-CPM)	97799	HCPCS	420	RC		both	30	22.5	Percent of Total Billed Charges	28.56	95.2	Percent of Total Billed Charges	26.39	87.95	Percent of Total Billed Charges	24.75	82.5	22.5	30
"ORTHOTICS TRNG, 15 MIN"	97760	HCPCS	429	RC	GP	both	49	36.75	Percent of Total Billed Charges	46.65	95.2	Percent of Total Billed Charges	43.1	87.95	Percent of Total Billed Charges	40.43	82.5	36.75	49
APPLICATION OF SURFACE (TRANSCUTANEOUS) NEUROSTIMULATOR (TENS)	64550	HCPCS	429	RC	GP	both	42	31.5	Percent of Total Billed Charges	39.98	95.2	Percent of Total Billed Charges	36.94	87.95	Percent of Total Billed Charges	34.65	82.5	31.5	42
PROSTHESIS TRNG 15 MIN	97762	HCPCS	429	RC	GP	both	48	36	Percent of Total Billed Charges	45.7	95.2	Percent of Total Billed Charges	42.22	87.95	Percent of Total Billed Charges	39.6	82.5	36	48
NEUROMUSCULAR RE-ED	97112	HCPCS	429	RC	GP	both	110	82.5	Percent of Total Billed Charges	104.72	95.2	Percent of Total Billed Charges	96.75	87.95	Percent of Total Billed Charges	90.75	82.5	82.5	110
THERAPEUTIC EXERCISE	97110	HCPCS	429	RC	GP	both	120	90	Percent of Total Billed Charges	114.24	95.2	Percent of Total Billed Charges	105.54	87.95	Percent of Total Billed Charges	99	82.5	90	120
ADL/HOME MGMT TRAINING 15	97535	HCPCS	429	RC	GP	both	128	96	Percent of Total Billed Charges	121.86	95.2	Percent of Total Billed Charges	112.58	87.95	Percent of Total Billed Charges	105.6	82.5	96	128
DRY NEEDLING LEVEL 1 (TDN-CPM)	97799	HCPCS	420	RC		both	10	7.5	Percent of Total Billed Charges	9.52	95.2	Percent of Total Billed Charges	8.8	87.95	Percent of Total Billed Charges	8.25	82.5	7.5	10
DRY NEEDLING LEVEL 2 (TDN-CPM)	97799	HCPCS	420	RC		both	20	15	Percent of Total Billed Charges	19.04	95.2	Percent of Total Billed Charges	17.59	87.95	Percent of Total Billed Charges	16.5	82.5	15	20
MASSAGE THERAPY 30 MIN. (CPM)	97799	HCPCS	420	RC		both	45	33.75	Percent of Total Billed Charges	42.84	95.2	Percent of Total Billed Charges	39.58	87.95	Percent of Total Billed Charges	37.13	82.5	33.75	45
MASSAGE THERAPY 60 MIN. (CPM)	97799	HCPCS	420	RC		both	60	45	Percent of Total Billed Charges	57.12	95.2	Percent of Total Billed Charges	52.77	87.95	Percent of Total Billed Charges	49.5	82.5	45	60
BOCES-THERAPEUTIC EXERCISE	97110	HCPCS	429	RC		both	39	29.25	Percent of Total Billed Charges	37.13	95.2	Percent of Total Billed Charges	34.3	87.95	Percent of Total Billed Charges	32.18	82.5	29.25	39
MUSCLE TESTING MANUAL WITH REPORT EXTREMITY OR TRUNK	95831	HCPCS	429	RC	GP	both	53	39.75	Percent of Total Billed Charges	50.46	95.2	Percent of Total Billed Charges	46.61	87.95	Percent of Total Billed Charges	43.73	82.5	39.75	53
TATTOOING INTRADERMAL TO CORRECT SKIN COLOR 6.0 CM/<	761	RC				both	1737	1302.75	Percent of Total Billed Charges	1653.62	95.2	Percent of Total Billed Charges	1527.69	87.95	Percent of Total Billed Charges	1433.03	82.5	1302.75	1737
TATTOOING INTRADERMAL TO CORRECT SKN COLOR 6.1-20.0CM	11921	HCPCS	761	RC		both	1737	1302.75	Percent of Total Billed Charges	1653.62	95.2	Percent of Total Billed Charges	1527.69	87.95	Percent of Total Billed Charges	1433.03	82.5	1302.75	1737
TATTOOING INTRADERMAL TO CORRECT SKIN COLOR EA 20.0CM	11922	HCPCS	761	RC		both	209	156.75	Percent of Total Billed Charges	198.97	95.2	Percent of Total Billed Charges	183.82	87.95	Percent of Total Billed Charges	172.43	82.5	156.75	209
TRX PERSONALIZED PROGRAM DEVELOPMENT	429	RC				both	111	83.25	Percent of Total Billed Charges	105.67	95.2	Percent of Total Billed Charges	97.62	87.95	Percent of Total Billed Charges	91.58	82.5	83.25	111
LOW LEVEL LASER	97026	HCPCS	429	RC	GP	both	47	35.25	Percent of Total Billed Charges	44.74	95.2	Percent of Total Billed Charges	41.34	87.95	Percent of Total Billed Charges	38.78	82.5	35.25	47
KT TAPING-PRE-ATHLETIC EVENT	429	RC				both	5	3.75	Percent of Total Billed Charges	4.76	95.2	Percent of Total Billed Charges	4.4	87.95	Percent of Total Billed Charges	4.13	82.5	3.75	5
SHORT WAVE DIATHERMY	97024	HCPCS	429	RC	GP	both	15	11.25	Percent of Total Billed Charges	14.28	95.2	Percent of Total Billed Charges	13.19	87.95	Percent of Total Billed Charges	12.38	82.5	11.25	15
KT TAPING APPLICATION AND INSTRUCTION AND KT ROLL	429	RC				both	26	19.5	Percent of Total Billed Charges	24.75	95.2	Percent of Total Billed Charges	22.87	87.95	Percent of Total Billed Charges	21.45	82.5	19.5	26
HAXTUN HEALTH PUNCH CARD	429	RC				both	57	42.75	Percent of Total Billed Charges	54.26	95.2	Percent of Total Billed Charges	50.13	87.95	Percent of Total Billed Charges	47.03	82.5	42.75	57
PILATES PERSONALIZED PROGRAM DEVELOPMENT	429	RC				both	111	83.25	Percent of Total Billed Charges	105.67	95.2	Percent of Total Billed Charges	97.62	87.95	Percent of Total Billed Charges	91.58	82.5	83.25	111
30 MIN MASSAGE-GIFT CERTIFICATE	429	RC				both	47	35.25	Percent of Total Billed Charges	44.74	95.2	Percent of Total Billed Charges	41.34	87.95	Percent of Total Billed Charges	38.78	82.5	35.25	47
60 MIN MASSAGE-GIFT CERTIFICATE	429	RC				both	63	47.25	Percent of Total Billed Charges	59.98	95.2	Percent of Total Billed Charges	55.41	87.95	Percent of Total Billed Charges	51.98	82.5	47.25	63
THERAPEUTIC ELECTRIC SIMULATION (15 MINS)	429	RC				both	16	12	Percent of Total Billed Charges	15.23	95.2	Percent of Total Billed Charges	14.07	87.95	Percent of Total Billed Charges	13.2	82.5	12	16
MANUAL THERAPY 15MIN	97140	HCPCS	429	RC	GP	both	123	92.25	Percent of Total Billed Charges	117.1	95.2	Percent of Total Billed Charges	108.18	87.95	Percent of Total Billed Charges	101.48	82.5	92.25	123
RE-EVALUATION	97164	HCPCS	429	RC	GP	both	132	99	Percent of Total Billed Charges	125.66	95.2	Percent of Total Billed Charges	116.09	87.95	Percent of Total Billed Charges	108.9	82.5	99	132
PHONOPHORESIS 15 MIN	97139	HCPCS	429	RC	GP	both	88	66	Percent of Total Billed Charges	83.78	95.2	Percent of Total Billed Charges	77.4	87.95	Percent of Total Billed Charges	72.6	82.5	66	88
WOUND CARE	97602	HCPCS	429	RC	GP	both	195	146.25	Percent of Total Billed Charges	185.64	95.2	Percent of Total Billed Charges	171.5	87.95	Percent of Total Billed Charges	160.88	82.5	146.25	195
WHEELCHAIR TRNG 15 MIN	97542	HCPCS	429	RC	GP	both	48	36	Percent of Total Billed Charges	45.7	95.2	Percent of Total Billed Charges	42.22	87.95	Percent of Total Billed Charges	39.6	82.5	36	48
PHYSICAL PERFORMANCE TEST	97750	HCPCS	429	RC	GP	both	15	11.25	Percent of Total Billed Charges	14.28	95.2	Percent of Total Billed Charges	13.19	87.95	Percent of Total Billed Charges	12.38	82.5	11.25	15
RANGE OF MOTION	95851	HCPCS	429	RC	GP	both	48	36	Percent of Total Billed Charges	45.7	95.2	Percent of Total Billed Charges	42.22	87.95	Percent of Total Billed Charges	39.6	82.5	36	48
APPLICATION OF VASOPNEUMATIC DEVICE TO 1 OR MORE AREAS	97016	HCPCS	429	RC	GP	both	61	45.75	Percent of Total Billed Charges	58.07	95.2	Percent of Total Billed Charges	53.65	87.95	Percent of Total Billed Charges	50.33	82.5	45.75	61
PHYSICAL THERAPY EVAL LOW COMPLEXITY	97161	HCPCS	420	RC	GP	both	168	126	Percent of Total Billed Charges	159.94	95.2	Percent of Total Billed Charges	147.76	87.95	Percent of Total Billed Charges	138.6	82.5	126	168
PHYSICAL THERAPY EVAL MODERATE COMPLEXITY	97162	HCPCS	424	RC	GP	both	209	156.75	Percent of Total Billed Charges	198.97	95.2	Percent of Total Billed Charges	183.82	87.95	Percent of Total Billed Charges	172.43	82.5	156.75	209
PHYSICAL THERAPY EVAL HIGH COMPLEXITY	97163	HCPCS	424	RC	GP	both	251	188.25	Percent of Total Billed Charges	238.95	95.2	Percent of Total Billed Charges	220.75	87.95	Percent of Total Billed Charges	207.08	82.5	188.25	251
"MASSAGE, 15 MIN"	97124	HCPCS	429	RC	GP	both	69	51.75	Percent of Total Billed Charges	65.69	95.2	Percent of Total Billed Charges	60.69	87.95	Percent of Total Billed Charges	56.93	82.5	51.75	69
"ULTRASOUND, 15 MIN."	97035	HCPCS	429	RC	GP	both	30	22.5	Percent of Total Billed Charges	28.56	95.2	Percent of Total Billed Charges	26.39	87.95	Percent of Total Billed Charges	24.75	82.5	22.5	30
PHONOPHORESIS 15 MIN	97139	HCPCS	429	RC	GP	both	59	44.25	Percent of Total Billed Charges	56.17	95.2	Percent of Total Billed Charges	51.89	87.95	Percent of Total Billed Charges	48.68	82.5	44.25	59
"ELECT STIM, MANUAL 15 MIN"	97032	HCPCS	429	RC	GP	both	35	26.25	Percent of Total Billed Charges	33.32	95.2	Percent of Total Billed Charges	30.78	87.95	Percent of Total Billed Charges	28.88	82.5	26.25	35
GIFT CERTIFICATE - 30 MIN SESSION	429	RC				both	49	36.75	Percent of Total Billed Charges	46.65	95.2	Percent of Total Billed Charges	43.1	87.95	Percent of Total Billed Charges	40.43	82.5	36.75	49
GIFT CERTIFICATE - 60 MIN SESSION	429	RC				both	67	50.25	Percent of Total Billed Charges	63.78	95.2	Percent of Total Billed Charges	58.93	87.95	Percent of Total Billed Charges	55.28	82.5	50.25	67
CUPPING	429	RC				both	48	36	Percent of Total Billed Charges	45.7	95.2	Percent of Total Billed Charges	42.22	87.95	Percent of Total Billed Charges	39.6	82.5	36	48
THERAPEUTIC EXERCISE (CP)	97110	HCPCS	429	RC	GP	both	61	45.75	Percent of Total Billed Charges	58.07	95.2	Percent of Total Billed Charges	53.65	87.95	Percent of Total Billed Charges	50.33	82.5	45.75	61
NEUROMUSCULAR RE-ED (CP)	97112	HCPCS	429	RC	GP	both	71	53.25	Percent of Total Billed Charges	67.59	95.2	Percent of Total Billed Charges	62.44	87.95	Percent of Total Billed Charges	58.58	82.5	53.25	71
MANUAL THERAPY 15MIN (CP)	97140	HCPCS	429	RC	GP	both	57	42.75	Percent of Total Billed Charges	54.26	95.2	Percent of Total Billed Charges	50.13	87.95	Percent of Total Billed Charges	47.03	82.5	42.75	57
"PHYSICAL THERAPY EVAL MODERATE COMPLEXITY	(CP)"	97162	HCPCS	424	RC	GP	both	187	140.25	Percent of Total Billed Charges	178.02	95.2	Percent of Total Billed Charges	164.47	87.95	Percent of Total Billed Charges	154.28	82.5	140.25	187
THERAPEUTIC ACTIVITY 15 M (CP)	97530	HCPCS	429	RC	GP	both	101	75.75	Percent of Total Billed Charges	96.15	95.2	Percent of Total Billed Charges	88.83	87.95	Percent of Total Billed Charges	83.33	82.5	75.75	101
PHYSICAL THERAPY EVAL LOW COMPLEXITY (CP)	97161	HCPCS	424	RC	GP	both	140	105	Percent of Total Billed Charges	133.28	95.2	Percent of Total Billed Charges	123.13	87.95	Percent of Total Billed Charges	115.5	82.5	105	140
PHYSICAL THERAPY EVAL HIGH COMPLEXITY (CP)	97163	HCPCS	424	RC	GP	both	221	165.75	Percent of Total Billed Charges	210.39	95.2	Percent of Total Billed Charges	194.37	87.95	Percent of Total Billed Charges	182.33	82.5	165.75	221
TRIGGER POINT DRY NEEDLING 1-2 MUSCLE INSERTIONS	20560	HCPCS	429	RC		both	79	59.25	Percent of Total Billed Charges	75.21	95.2	Percent of Total Billed Charges	69.48	87.95	Percent of Total Billed Charges	65.18	82.5	59.25	79
TRIGGER POINT DRY NEEDLING 3+ MUSCLE INSERTIONS	20561	HCPCS	429	RC	GP	both	79	59.25	Percent of Total Billed Charges	75.21	95.2	Percent of Total Billed Charges	69.48	87.95	Percent of Total Billed Charges	65.18	82.5	59.25	79
CANALITH REPOSITIONING	95992	HCPCS	420	RC	GP	both	115	86.25	Percent of Total Billed Charges	109.48	95.2	Percent of Total Billed Charges	101.14	87.95	Percent of Total Billed Charges	94.88	82.5	86.25	115
SELF CARE/HOME MANAGEMENT EACH 15 MIN	97535	HCPCS	420	RC	GP	both	128	96	Percent of Total Billed Charges	121.86	95.2	Percent of Total Billed Charges	112.58	87.95	Percent of Total Billed Charges	105.6	82.5	96	128
APPLICATION OF PARAFFIN BATH TO 1 OR MORE AREAS	97018	HCPCS	430	RC	GO	both	78	58.5	Percent of Total Billed Charges	74.26	95.2	Percent of Total Billed Charges	68.6	87.95	Percent of Total Billed Charges	64.35	82.5	58.5	78
APPLICATION OF WHIRLPOOL TO 1 OR MORE AREAS	97022	HCPCS	430	RC		both	54	40.5	Percent of Total Billed Charges	51.41	95.2	Percent of Total Billed Charges	47.49	87.95	Percent of Total Billed Charges	44.55	82.5	40.5	54
APPLICATION OF ELECTO STIMU MANUAL EACH 15 MIN	97032	HCPCS	430	RC	GO	both	40	30	Percent of Total Billed Charges	38.08	95.2	Percent of Total Billed Charges	35.18	87.95	Percent of Total Billed Charges	33	82.5	30	40
SENSORY INTEGRATIVE TECHNIQUES  EACH 15 MIN	97533	HCPCS	430	RC	GO	both	201	150.75	Percent of Total Billed Charges	191.35	95.2	Percent of Total Billed Charges	176.78	87.95	Percent of Total Billed Charges	165.83	82.5	150.75	201
GAIT TRAINING EACH 15 MIN	97116	HCPCS	430	RC		both	117	87.75	Percent of Total Billed Charges	111.38	95.2	Percent of Total Billed Charges	102.9	87.95	Percent of Total Billed Charges	96.53	82.5	87.75	117
IONTOPHORESIS EACH 15 MIN	97033	HCPCS	430	RC		both	61	45.75	Percent of Total Billed Charges	58.07	95.2	Percent of Total Billed Charges	53.65	87.95	Percent of Total Billed Charges	50.33	82.5	45.75	61
MASSAGE THERAPY  EACH 15 MIN	97124	HCPCS	430	RC		both	93	69.75	Percent of Total Billed Charges	88.54	95.2	Percent of Total Billed Charges	81.79	87.95	Percent of Total Billed Charges	76.73	82.5	69.75	93
THERAPEUTIC EXERCISE EACH 15 MIN	97110	HCPCS	430	RC	GO	both	120	90	Percent of Total Billed Charges	114.24	95.2	Percent of Total Billed Charges	105.54	87.95	Percent of Total Billed Charges	99	82.5	90	120
ORTHOTIC MANAGEMENT AND TRAINING AND PROSTHETIC TRAINING	97763	HCPCS	430	RC	GO	both	168	126	Percent of Total Billed Charges	159.94	95.2	Percent of Total Billed Charges	147.76	87.95	Percent of Total Billed Charges	138.6	82.5	126	168
ULTRASOUND EACH 15 MIN	97035	HCPCS	430	RC		both	53	39.75	Percent of Total Billed Charges	50.46	95.2	Percent of Total Billed Charges	46.61	87.95	Percent of Total Billed Charges	43.73	82.5	39.75	53
COMMUNITY/WORK REINTEGRATION TRAINING EACH 15 MIN	97537	HCPCS	430	RC		both	100	75	Percent of Total Billed Charges	95.2	95.2	Percent of Total Billed Charges	87.95	87.95	Percent of Total Billed Charges	82.5	82.5	75	100
MANUAL THERAPY TECHNIQUES  EACH 15 MIN	97140	HCPCS	430	RC	GO	both	85	63.75	Percent of Total Billed Charges	80.92	95.2	Percent of Total Billed Charges	74.76	87.95	Percent of Total Billed Charges	70.13	82.5	63.75	85
PROSTHESIS TRAINING EACH 15 MIN	97761	HCPCS	430	RC		both	48	36	Percent of Total Billed Charges	45.7	95.2	Percent of Total Billed Charges	42.22	87.95	Percent of Total Billed Charges	39.6	82.5	36	48
NEUROMUSCULAR RE-EDUCATION  EACH 15 MIN	97112	HCPCS	430	RC	GO	both	107	80.25	Percent of Total Billed Charges	101.86	95.2	Percent of Total Billed Charges	94.11	87.95	Percent of Total Billed Charges	88.28	82.5	80.25	107
APPLICATION OF VASOPNEUMATIC DEVICE TO 1 OR MORE AREAS	97016	HCPCS	430	RC		both	61	45.75	Percent of Total Billed Charges	58.07	95.2	Percent of Total Billed Charges	53.65	87.95	Percent of Total Billed Charges	50.33	82.5	45.75	61
SELF CARE/HOME MANAGEMENT EACH 15 MIN (ADL)	97535	HCPCS	430	RC	GO	both	128	96	Percent of Total Billed Charges	121.86	95.2	Percent of Total Billed Charges	112.58	87.95	Percent of Total Billed Charges	105.6	82.5	96	128
COGNITIVE SKILLS DEVELOPMENT  EACH 15 MIN	97129	HCPCS	430	RC	GO	both	80	60	Percent of Total Billed Charges	76.16	95.2	Percent of Total Billed Charges	70.36	87.95	Percent of Total Billed Charges	66	82.5	60	80
ORTHOTIC MANAGEMENT INITIAL ENCOUNTER	97760	HCPCS	430	RC	GO	both	151	113.25	Percent of Total Billed Charges	143.75	95.2	Percent of Total Billed Charges	132.8	87.95	Percent of Total Billed Charges	124.58	82.5	113.25	151
CONTRAST BATH	97034	HCPCS	430	RC		both	57	42.75	Percent of Total Billed Charges	54.26	95.2	Percent of Total Billed Charges	50.13	87.95	Percent of Total Billed Charges	47.03	82.5	42.75	57
RE-EVALUATION	97168	HCPCS	430	RC	GO	both	216	162	Percent of Total Billed Charges	205.63	95.2	Percent of Total Billed Charges	189.97	87.95	Percent of Total Billed Charges	178.2	82.5	162	216
THERAPEUTIC ACTIVITIES EACH 15 MIN	97530	HCPCS	430	RC	GO	both	120	90	Percent of Total Billed Charges	114.24	95.2	Percent of Total Billed Charges	105.54	87.95	Percent of Total Billed Charges	99	82.5	90	120
WHEELCHAIR MANAGEMENT EACH 15 MIN	97542	HCPCS	430	RC		both	100	75	Percent of Total Billed Charges	95.2	95.2	Percent of Total Billed Charges	87.95	87.95	Percent of Total Billed Charges	82.5	82.5	75	100
WORK HARDENING/ CONDITIONING (2HR)	97545	HCPCS	430	RC		both	192	144	Percent of Total Billed Charges	182.78	95.2	Percent of Total Billed Charges	168.86	87.95	Percent of Total Billed Charges	158.4	82.5	144	192
WORK HARDENING/CONDITIONING ADD'L HR	97546	HCPCS	430	RC		both	99	74.25	Percent of Total Billed Charges	94.25	95.2	Percent of Total Billed Charges	87.07	87.95	Percent of Total Billed Charges	81.68	82.5	74.25	99
ORTHOTIC-PROSTH CHECKOUT EACH 15 MIN	97762	HCPCS	430	RC		both	49	36.75	Percent of Total Billed Charges	46.65	95.2	Percent of Total Billed Charges	43.1	87.95	Percent of Total Billed Charges	40.43	82.5	36.75	49
OCCUPATIONAL THERAPY EVAL LOW COMPLEXITY	97165	HCPCS	434	RC	GO	both	315	236.25	Percent of Total Billed Charges	299.88	95.2	Percent of Total Billed Charges	277.04	87.95	Percent of Total Billed Charges	259.88	82.5	236.25	315
OCCUPATIONAL THERAPY EVAL MODERATE COMPLEXITY	97166	HCPCS	434	RC	GO	both	315	236.25	Percent of Total Billed Charges	299.88	95.2	Percent of Total Billed Charges	277.04	87.95	Percent of Total Billed Charges	259.88	82.5	236.25	315
OCCUPATIONAL THERAPY EVAL HIGH COMPLEXITY	97167	HCPCS	434	RC	GO	both	315	236.25	Percent of Total Billed Charges	299.88	95.2	Percent of Total Billed Charges	277.04	87.95	Percent of Total Billed Charges	259.88	82.5	236.25	315
AMB-NON EMERG(BLS)	A0428	HCPCS	540	RC		both	681	510.75	Percent of Total Billed Charges	648.31	95.2	Percent of Total Billed Charges	598.94	87.95	Percent of Total Billed Charges	561.83	82.5	510.75	681
"AMBULANCE RESPONSE AND TREATMENT, NO TRANSPORT"	A0998	HCPCS	540	RC		both	301	225.75	Percent of Total Billed Charges	286.55	95.2	Percent of Total Billed Charges	264.73	87.95	Percent of Total Billed Charges	248.33	82.5	225.75	301
AMB-EMERG (BLS)	A0429	HCPCS	540	RC		both	907	680.25	Percent of Total Billed Charges	863.46	95.2	Percent of Total Billed Charges	797.71	87.95	Percent of Total Billed Charges	748.28	82.5	680.25	907
AMB-MILEAGE/PER MILE	A0425	HCPCS	540	RC		both	42	31.5	Percent of Total Billed Charges	39.98	95.2	Percent of Total Billed Charges	36.94	87.95	Percent of Total Billed Charges	34.65	82.5	31.5	42
AMB-NON-EMERG(ALS)	A0426	HCPCS	540	RC		both	947	710.25	Percent of Total Billed Charges	901.54	95.2	Percent of Total Billed Charges	832.89	87.95	Percent of Total Billed Charges	781.28	82.5	710.25	947
AMB-EMERG (ALS)	A0427	HCPCS	540	RC		both	1136	852	Percent of Total Billed Charges	1081.47	95.2	Percent of Total Billed Charges	999.11	87.95	Percent of Total Billed Charges	937.2	82.5	852	1136
AMBULANCE TRANSPORT (AIRLIFE)	A0429	HCPCS	540	RC		both	2808	2106	Percent of Total Billed Charges	2673.22	95.2	Percent of Total Billed Charges	2469.64	87.95	Percent of Total Billed Charges	2316.6	82.5	2106	2808
OBSERVATION HOURLY	G0378	HCPCS	762	RC		inpatient	99	74.25	Percent of Total Billed Charges	94.25	95.2	Percent of Total Billed Charges	87.07	87.95	Percent of Total Billed Charges	81.68	82.5	74.25	99
OBSERVATION ADMIT	G0378	HCPCS	762	RC		inpatient	393	294.75	Percent of Total Billed Charges	374.14	95.2	Percent of Total Billed Charges	345.64	87.95	Percent of Total Billed Charges	324.23	82.5	294.75	393
"ROUND ECU D,D,MC"	99309	HCPCS	987	RC		outpatient	381	285.75	Percent of Total Billed Charges	362.71	95.2	Percent of Total Billed Charges	335.09	87.95	Percent of Total Billed Charges	314.33	82.5	285.75	381
"SSB ADMIT C,C,HC"	99306	HCPCS	987	RC		inpatient	644	483	Percent of Total Billed Charges	613.09	95.2	Percent of Total Billed Charges	566.4	87.95	Percent of Total Billed Charges	531.3	82.5	483	644
"ROUND ECU P,P,SF"	99307	HCPCS	987	RC		outpatient	229	171.75	Percent of Total Billed Charges	218.01	95.2	Percent of Total Billed Charges	201.41	87.95	Percent of Total Billed Charges	188.93	82.5	171.75	229
"ROUND ECU E,E,LC"	99308	HCPCS	987	RC		outpatient	305	228.75	Percent of Total Billed Charges	290.36	95.2	Percent of Total Billed Charges	268.25	87.95	Percent of Total Billed Charges	251.63	82.5	228.75	305
DEPO MEDROL	J1030	HCPCS	636	RC		outpatient	27	20.25	Percent of Total Billed Charges	25.7	95.2	Percent of Total Billed Charges	23.75	87.95	Percent of Total Billed Charges	22.28	82.5	20.25	27
INJECTION INTRALESIONAL UP TO & INCLUD 7 LESIONS	11900	HCPCS	983	RC		outpatient	113	84.75	Percent of Total Billed Charges	107.58	95.2	Percent of Total Billed Charges	99.38	87.95	Percent of Total Billed Charges	93.23	82.5	84.75	113
"CRYO .6-1CM TRK, ARM, LEG, MALIGNANT"	17261	HCPCS	983	RC		outpatient	216	162	Percent of Total Billed Charges	205.63	95.2	Percent of Total Billed Charges	189.97	87.95	Percent of Total Billed Charges	178.2	82.5	162	216
TX OF DISTAL RADIAL FRACTURE	25600	HCPCS	983	RC		outpatient	545	408.75	Percent of Total Billed Charges	518.84	95.2	Percent of Total Billed Charges	479.33	87.95	Percent of Total Billed Charges	449.63	82.5	408.75	545
TX OF NAVICULAR FRACTURE	25622	HCPCS	983	RC		outpatient	570	427.5	Percent of Total Billed Charges	542.64	95.2	Percent of Total Billed Charges	501.32	87.95	Percent of Total Billed Charges	470.25	82.5	427.5	570
TX CARPAL BONE FRACTURE	25630	HCPCS	983	RC		outpatient	515	386.25	Percent of Total Billed Charges	490.28	95.2	Percent of Total Billed Charges	452.94	87.95	Percent of Total Billed Charges	424.88	82.5	386.25	515
ECU DISCHARGE <30 MINS	99315	HCPCS	987	RC		outpatient	381	285.75	Percent of Total Billed Charges	362.71	95.2	Percent of Total Billed Charges	335.09	87.95	Percent of Total Billed Charges	314.33	82.5	285.75	381
SAME DAY ADMIT/DISCHARGE IP/OBS MED	99235	HCPCS	987	RC		inpatient	756	567	Percent of Total Billed Charges	719.71	95.2	Percent of Total Billed Charges	664.9	87.95	Percent of Total Billed Charges	623.7	82.5	567	756
ECU  DISCHARGE >30 MIN	99316	HCPCS	987	RC		outpatient	456	342	Percent of Total Billed Charges	434.11	95.2	Percent of Total Billed Charges	401.05	87.95	Percent of Total Billed Charges	376.2	82.5	342	456
"HOSP. ADMIT C,C,SF-LC"	99221	HCPCS	987	RC		inpatient	467	350.25	Percent of Total Billed Charges	444.58	95.2	Percent of Total Billed Charges	410.73	87.95	Percent of Total Billed Charges	385.28	82.5	350.25	467
"HOSP. ADMIT C,C,MC"	99222	HCPCS	987	RC		inpatient	567	425.25	Percent of Total Billed Charges	539.78	95.2	Percent of Total Billed Charges	498.68	87.95	Percent of Total Billed Charges	467.78	82.5	425.25	567
"HOSP. ADMIT C,C,HC"	99223	HCPCS	987	RC		inpatient	644	483	Percent of Total Billed Charges	613.09	95.2	Percent of Total Billed Charges	566.4	87.95	Percent of Total Billed Charges	531.3	82.5	483	644
"ROUND IP P,P,LC"	99231	HCPCS	987	RC		inpatient	229	171.75	Percent of Total Billed Charges	218.01	95.2	Percent of Total Billed Charges	201.41	87.95	Percent of Total Billed Charges	188.93	82.5	171.75	229
"ROUND IP EP,EP,MC"	99232	HCPCS	987	RC		inpatient	305	228.75	Percent of Total Billed Charges	290.36	95.2	Percent of Total Billed Charges	268.25	87.95	Percent of Total Billed Charges	251.63	82.5	228.75	305
"ROUND IP D,D,HC"	99233	HCPCS	987	RC		inpatient	381	285.75	Percent of Total Billed Charges	362.71	95.2	Percent of Total Billed Charges	335.09	87.95	Percent of Total Billed Charges	314.33	82.5	285.75	381
HOSPITAL DISCHARGE <30 MINUTES	99238	HCPCS	987	RC		inpatient	381	285.75	Percent of Total Billed Charges	362.71	95.2	Percent of Total Billed Charges	335.09	87.95	Percent of Total Billed Charges	314.33	82.5	285.75	381
SAME DAY ADMIT/DISCHARGE IP/OBS HIGH	99236	HCPCS	987	RC		inpatient	832	624	Percent of Total Billed Charges	792.06	95.2	Percent of Total Billed Charges	731.74	87.95	Percent of Total Billed Charges	686.4	82.5	624	832
HOSPITAL DISCHARGE  >30 MINUTE	99239	HCPCS	987	RC		inpatient	456	342	Percent of Total Billed Charges	434.11	95.2	Percent of Total Billed Charges	401.05	87.95	Percent of Total Billed Charges	376.2	82.5	342	456
SAME DAY ADMIT/DISCHARGE IP/OBS LOW	99234	HCPCS	987	RC		inpatient	681	510.75	Percent of Total Billed Charges	648.31	95.2	Percent of Total Billed Charges	598.94	87.95	Percent of Total Billed Charges	561.83	82.5	510.75	681
ANNUAL ECU PE	99318	HCPCS	987	RC		outpatient	343	257.25	Percent of Total Billed Charges	326.54	95.2	Percent of Total Billed Charges	301.67	87.95	Percent of Total Billed Charges	282.98	82.5	257.25	343
"SSB ADMIT  D/C, D/C, LC"	99304	HCPCS	987	RC		inpatient	494	370.5	Percent of Total Billed Charges	470.29	95.2	Percent of Total Billed Charges	434.47	87.95	Percent of Total Billed Charges	407.55	82.5	370.5	494
"SSB ADMIT C,C,MC"	99305	HCPCS	987	RC		inpatient	567	425.25	Percent of Total Billed Charges	539.78	95.2	Percent of Total Billed Charges	498.68	87.95	Percent of Total Billed Charges	467.78	82.5	425.25	567
"ROUND ECU C,C,HC"	99310	HCPCS	987	RC		outpatient	418	313.5	Percent of Total Billed Charges	397.94	95.2	Percent of Total Billed Charges	367.63	87.95	Percent of Total Billed Charges	344.85	82.5	313.5	418
"SSB/ECU ADMIT C,C,HC"	99306	HCPCS	987	RC		inpatient	644	483	Percent of Total Billed Charges	613.09	95.2	Percent of Total Billed Charges	566.4	87.95	Percent of Total Billed Charges	531.3	82.5	483	644
SSB DISCHARGE <30 MINS	99315	HCPCS	987	RC		inpatient	381	285.75	Percent of Total Billed Charges	362.71	95.2	Percent of Total Billed Charges	335.09	87.95	Percent of Total Billed Charges	314.33	82.5	285.75	381
SSB/ECU  DISCHARGE >30 MIN	99316	HCPCS	987	RC		inpatient	456	342	Percent of Total Billed Charges	434.11	95.2	Percent of Total Billed Charges	401.05	87.95	Percent of Total Billed Charges	376.2	82.5	342	456
"ROUND SSB/ECU C,C,HC"	99310	HCPCS	987	RC		inpatient	418	313.5	Percent of Total Billed Charges	397.94	95.2	Percent of Total Billed Charges	367.63	87.95	Percent of Total Billed Charges	344.85	82.5	313.5	418
"ROUND SSB/ECU D,D,MC"	99309	HCPCS	987	RC		inpatient	381	285.75	Percent of Total Billed Charges	362.71	95.2	Percent of Total Billed Charges	335.09	87.95	Percent of Total Billed Charges	314.33	82.5	285.75	381
"ROUND SSB/ECU E,E,LC"	99308	HCPCS	987	RC		inpatient	305	228.75	Percent of Total Billed Charges	290.36	95.2	Percent of Total Billed Charges	268.25	87.95	Percent of Total Billed Charges	251.63	82.5	228.75	305
"ROUND SSB/ECU P,P,SF"	99307	HCPCS	987	RC		inpatient	229	171.75	Percent of Total Billed Charges	218.01	95.2	Percent of Total Billed Charges	201.41	87.95	Percent of Total Billed Charges	188.93	82.5	171.75	229
"SSB/ECU ADMIT C,C,MC"	99305	HCPCS	987	RC		inpatient	567	425.25	Percent of Total Billed Charges	539.78	95.2	Percent of Total Billed Charges	498.68	87.95	Percent of Total Billed Charges	467.78	82.5	425.25	567
"SSB/ECU ADMIT  D/C, D/C, LC"	99304	HCPCS	987	RC		inpatient	494	370.5	Percent of Total Billed Charges	470.29	95.2	Percent of Total Billed Charges	434.47	87.95	Percent of Total Billed Charges	407.55	82.5	370.5	494
"ECU ADMIT  D/C, D/C, LC"	99304	HCPCS	987	RC		outpatient	494	370.5	Percent of Total Billed Charges	470.29	95.2	Percent of Total Billed Charges	434.47	87.95	Percent of Total Billed Charges	407.55	82.5	370.5	494
I&D ABSCESS SIMPLE (ECU)	10060	HCPCS	987	RC		outpatient	296	222	Percent of Total Billed Charges	281.79	95.2	Percent of Total Billed Charges	260.33	87.95	Percent of Total Billed Charges	244.2	82.5	222	296
PARENTHESIS	49082	HCPCS	987	RC		inpatient	717	537.75	Percent of Total Billed Charges	682.58	95.2	Percent of Total Billed Charges	630.6	87.95	Percent of Total Billed Charges	591.53	82.5	537.75	717
PUNCH BX SKIN EACH SEP/ADDL	11105	HCPCS	969	RC		inpatient	77	57.75	Percent of Total Billed Charges	73.3	95.2	Percent of Total Billed Charges	67.72	87.95	Percent of Total Billed Charges	63.53	82.5	57.75	77
PUNCH BX SKIN SINGLE LESION	11104	HCPCS	969	RC		inpatient	140	105	Percent of Total Billed Charges	133.28	95.2	Percent of Total Billed Charges	123.13	87.95	Percent of Total Billed Charges	115.5	82.5	105	140
EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 3. 1-4 .OCM	11424	HCPCS	960	RC		outpatient	549	411.75	Percent of Total Billed Charges	522.65	95.2	Percent of Total Billed Charges	482.85	87.95	Percent of Total Billed Charges	452.93	82.5	411.75	549
EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 3. 1-4 .OCM	11424	HCPCS	360	RC		outpatient	236	177	Percent of Total Billed Charges	224.67	95.2	Percent of Total Billed Charges	207.56	87.95	Percent of Total Billed Charges	194.7	82.5	177	236