LOCATION : west-chase-houston-hospital,Unnamed: 1,Date: 1/1/2025,Unnamed: 3,Unnamed: 4,Aetna,Unnamed: 6,Cigna,BCBS,Unnamed: 9,Unnamed: 10,Unnamed: 11,Unnamed: 12
CMS 70,Evaluation & management services,CPT/HCPCS/DRG,Standard Charge,Cash Price,PPO,Advantage,,PPO,Blue Essentials,Blue Advantage,Min Neg Chg,Max Neg Chg
cms 70,Abdominal ultrasound of pregnant uterus (greater or equal to 14 weeks 0 days) single or first fetus,76805,2865.56,194.5825,91.608,112.51,188.2959078,128.8211,116.5972,106.2539,91.608,188.2959078
cms 70,"Electrocardiogram, routine, with interpretation and report",93000,324.5,0,0,0,0,17.23,17.23,17.23,0,17.23
cms 70,PSA (prostate specific antigen),84153,447.15,0,18.264,0,0,22.71,22.71,22.71,0,22.71
cms 70,"Removal of 1 or more breast growth, open procedure",19120,35395.825,5643.75,2000,2816.01,2800,5046.504,4500.936,3300.6864,2000,5046.504
cms 70,Manual urinalysis test with examination using microscope,81000,168.37,0,3.228,0,0,4.02,4.02,4.02,0,4.02
cms 70,"CT scan, pelvis, with contrast",72193,5119.55,319.2525,194.352,201.74,630.89299,374.0552,336.1442,288.1236,194.352,630.89299
cms 70,Removal of tonsils and adenoid glands patient younger than age 12,42820,51203.67286,9089.9725,2000,4424.23,2800,8026.7615,7159.0035,5249.9359,2000,8026.7615
cms 70,"Diagnostic examination of esophagus, stomach, and/or upper small bowel using an endoscope",43235,18761.746,1446.1825,1200,761.55,1800,1375.4565,1226.7585,899.6229,761.55,1800
cms 70,Automated urinalysis test,81002,168.37,0,2.796,0,0,3.48,3.48,3.48,0,3.48
cms 70,Removal of gallbladder using an endoscope,47562,91908.98364,9043.4575,2200,4595.85,7603,8304.058,7406.322,5431.3028,2200,8304.058
cms 70,"Blood test, lipids (cholesterol and triglycerides)",80061,363.54,0,13.296,0,0,16.53,16.53,16.53,0,16.53
cms 70,Coagulation assessment blood test,85730,212.29,0,5.964,0,0,7.42,7.42,7.42,0,7.42
cms 70,Repair of groin hernia patient age 5 years or older,49505,59829.35893,5686.3625,2200,2947.32,3300,5385.646,4803.414,3522.5036,2200,5385.646
cms 70,Biopsy of prostate gland,55700,40303.83286,3200.1375,1500,1739.75,2400,3137.008,2797.872,2051.7728,1500,3137.008
cms 70,"Blood test, thyroid stimulating hormone (TSH)",84443,344.4,0,16.68,0,0,20.75,20.75,20.75,0,20.75
cms 70,MRI scan of brain before and after contrast,70553,10265.45,658.1575,368.46,385.88,1137.58736,675.4276,606.9721,520.2618,368.46,1137.58736
cms 70,Manual urinalysis test with examination using microscope,81001,111.73,0,3.156,0,0,3.92,3.92,3.92,0,3.92
cms 70,Shaving of shoulder bone using an endoscope,29826,58715.49533,0,2000,0,7965,0,0,0,0,7965
cms 70,Removal of polyps or growths of large bowel using an endoscope,45385,18498.21176,1853.355,1500,979.79,2400,1732.3215,1545.0435,1133.0319,979.79,2400
cms 70,"X-Ray, lower back, minimum four views",72110,2019.18,194.5825,32.496,112.51,187.107921,156.8102,141.9304,129.3398,32.496,187.107921
cms 70,Injection of substance into spinal canal of lower back or sacrum using imaging guidance,62323,20144.26314,1134.91,1200,598.81,1800,1005.253,896.577,657.4898,598.81,1800
cms 70,"Complete blood count, automated",85027,194.4,0,6.42,0,0,7.98,7.98,7.98,0,7.98
cms 70,MRI scan of leg joint,73721,6086.21,411.25,236.556,230.56,578.69357,343.8188,308.9723,264.8334,230.56,578.69357
cms 70,Ultrasound of abdomen,76700,2865.56,194.5825,81.816,112.51,188.2959078,156.8102,141.9304,129.3398,81.816,188.2959078
cms 70,Removal of one knee cartilage using an endoscope,29881,37613.52614,5061.49,4000,2623.34,7965,4893.6755,4364.6295,3200.7283,2623.34,7965
cms 70,Ultrasound pelvis through vagina,76830,1248.19,194.5825,87.06,112.51,188.2959078,122.4232,110.8064,100.9768,87.06,188.2959078
cms 70,Diagnostic examination of large bowel using an endoscope,45378,13653.7181,1418.34,1500,744.89,2400,1313.463,1171.467,859.0758,744.89,2400
cms 70,"CT scan, head or brain, without contrast",70450,4514.09,194.5825,85.032,112.51,284.39684,169.4008,152.2318,130.4844,85.032,284.39684
cms 70,MRI scan of lower spinal canal,72148,8385.37,411.25,209.916,230.56,579.59356,343.8188,308.9723,264.8334,209.916,579.59356
cms 70,Biopsy of large bowel using an endoscope,45380,17336.79606,1853.355,1500,979.79,2400,1732.3215,1545.0435,1133.0319,979.79,2400
cms 70,Automated urinalysis test,81003,168.37,0,2.232,0,0,2.77,2.77,2.77,0,2.77
cms 70,CT scan of abdomen and pelvis with contrast,74177,11827.03,658.1575,255.576,385.88,630.89299,374.0552,336.1442,288.1236,255.576,630.89299
cms 70,Liver function blood test panel,80076,374,0,8.112,0,0,10.09,10.09,10.09,0,10.09
cms 70,Basic metabolic panel,80048,395.75,0,8.388,0,0,10.44,10.44,10.44,0,10.44
cms 70,"Physical therapy, therapeutic exercise",97110,156,0,0,0,0,31.22,31.22,31.22,0,31.22
cms 70,"Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope",43239,19385.27279,1446.1825,1500,761.55,2400,1375.4565,1226.7585,899.6229,761.55,2400
cms 70,"Blood test, clotting time",85610,225.01,0,3.9,0,0,4.85,4.85,4.85,0,4.85
cms 70,Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance,64483,20524.15768,1471.2775,1200,764.84,1800,1243.533,1109.097,813.3378,764.84,1800
cms 70,"Blood test, comprehensive group of blood chemicals",80053,713.29,0,10.488,0,0,13.04,13.04,13.04,0,13.04
cms 70,"Complete blood cell count, with differential white blood cells, automated",85025,267.87,0,7.716,0,0,9.59,9.59,9.59,0,9.59
cms 70,Spinal fusion except cervical without major comorbid conditions or complications (MCC),460,247592.025,52891.25,37000,23235.77212,26367,52891.25,47602.125,47602.125,23235.77212,52891.25
cms 70,Major joint replacement or reattachment of lower extremity without major comorbid conditions or complications (MCC),470,141319.0205,26066.38,17122,11451.2791,20286,26066.38,23459.742,23459.742,11451.2791,26066.38
cms 70,Cervical spinal fusion without comorbid conditions (CC) or major comorbid conditions or complications (MCC),473,233078.0038,31084.99,17122,13656.01577,22630,31084.99,27976.491,27976.491,13656.01577,31084.99
cms 70,Uterine and adnexa procedures for non-malignancy without comorbid conditions (CC) or major comorbid conditions or complications (MCC),743,99137.12192,9649.94,9514,6420.266844,6932,9649.94,8684.946,6395.7348,6395.7348,9649.94
cms 70,Ultrasound examination of lower large bowel using an endoscope,45391,SERVICE NOT PROVIDED,,,,,,,,,
cms 70,Surgical removal of prostate and surrounding lymph nodes using an endoscope,55866,SERVICE NOT PROVIDED,,,,,,,,,
cms 70,"Routine obstetric care for vaginal delivery, including pre-and post-delivery care",59400,SERVICE NOT PROVIDED,,,,,,,,,
cms 70,"Routine obstetric care for cesarean delivery, including pre-and post-delivery care",59510,SERVICE NOT PROVIDED,,,,,,,,,
cms 70,Routine obstetric care for vaginal delivery after prior cesarean delivery including pre-and post-delivery care,59610,SERVICE NOT PROVIDED,,,,,,,,,
cms 70,Injection of substance into spinal canal of lower back or sacrum using imaging guidance,62322,SERVICE NOT PROVIDED,,,,,,,,,
cms 70,Removal of recurring cataract in lens capsule using laser,66821,SERVICE NOT PROVIDED,,,,,,,,,
cms 70,Removal of cataract with insertion of lens,66984,SERVICE NOT PROVIDED,,,,,,,,,
cms 70,Mammography of one breast,77065,SERVICE NOT PROVIDED,,,,,,,,,
cms 70,Mammography of both breasts,77066,SERVICE NOT PROVIDED,,,,,,,,,
cms 70,"Mammography, screening, bilateral",77067,SERVICE NOT PROVIDED,,,,,,,,,
cms 70,Obstetric blood test panel,80055,SERVICE NOT PROVIDED,,,,,,,,,
cms 70,Kidney function panel test,80069,SERVICE NOT PROVIDED,,,,,,,,,
cms 70,PSA (prostate specific antigen),84154,SERVICE NOT PROVIDED,,,,,,,,,
cms 70,"Psychotherapy, 30 min",90832,SERVICE NOT PROVIDED,,,,,,,,,
cms 70,"Psychotherapy, 45 min",90834,SERVICE NOT PROVIDED,,,,,,,,,
cms 70,"Psychotherapy, 60 min",90837,SERVICE NOT PROVIDED,,,,,,,,,
cms 70,"Family psychotherapy, not including patient, 50 min",90846,SERVICE NOT PROVIDED,,,,,,,,,
cms 70,"Family psychotherapy, including patient, 50 min",90847,SERVICE NOT PROVIDED,,,,,,,,,
cms 70,Group psychotherapy,90853,SERVICE NOT PROVIDED,,,,,,,,,
cms 70,Insertion of catheter into left heart for diagnosis,93452,SERVICE NOT PROVIDED,,,,,,,,,
cms 70,Sleep study,95810,SERVICE NOT PROVIDED,,,,,,,,,
cms 70,"New patient office or other outpatient visit, typically 30 min",99203,SERVICE NOT PROVIDED,,,,,,,,,
cms 70,"New patient office of other outpatient visit, typically 45 min",99204,SERVICE NOT PROVIDED,,,,,,,,,
cms 70,"New patient office of other outpatient visit, typically 60 min",99205,SERVICE NOT PROVIDED,,,,,,,,,
cms 70,"Patient office consultation, typically 40 min",99243,SERVICE NOT PROVIDED,,,,,,,,,
cms 70,"Patient office consultation, typically 60 min",99244,SERVICE NOT PROVIDED,,,,,,,,,
cms 70,Initial new patient preventive medicine evaluation (18-39 years),99385,SERVICE NOT PROVIDED,,,,,,,,,
cms 70,Initial new patient preventive medicine evaluation (40-64 years),99386,SERVICE NOT PROVIDED,,,,,,,,,
cms 70,Cardiac valve and other major cardiothoracic procedures with cardiac catheterization with major complications or comorbidities,216,SERVICE NOT PROVIDED,,,,,,,,,
HOSPITAL SELECTED SHOPPABLE,"3D RENDERING WITH INTERPRETATION AND REPORTING OF COMPUTED TOMOGRAPHY, MAGNETIC RESONANCE IMAGING, ULTRASOUND, OR OTHER TOMOGRAPHIC MODALITY; NOT REQUIRING IMAGE POSTPROCESSING ON AN INDEPENDENT WORKSTATION",76376,1855.01,0,15.588,0,0,20.1872,18.1412,15.5496,0,20.1872
HOSPITAL SELECTED SHOPPABLE,ADD SUPPLIES MATERIAL&STAFF PHE INFEC DISEAS,99072,80,0,0,0,0,0,0,0,0,0
HOSPITAL SELECTED SHOPPABLE,AMMONIA,82140,250.38,0,14.46,0,0,17.99,17.99,17.99,0,17.99
HOSPITAL SELECTED SHOPPABLE,AMYLASE,82150,292,0,6.432,0,0,8,8,8,0,8
HOSPITAL SELECTED SHOPPABLE,"ANTIBODY SCREEN, RBC, EACH SERUM TECHNIQUE",86850,248.73,88.8125,7.86,50.98,0,44.7,44.7,44.7,0,50.98
HOSPITAL SELECTED SHOPPABLE,"ANTIBODY; HERPES SIMPLEX, TYPE 1",86695,225,0,13.092,0,0,16.28,16.28,16.28,0,16.28
HOSPITAL SELECTED SHOPPABLE,ANTINUCLEAR ANTIBODIES (ANA);,86038,207.75,0,12,0,0,14.92,14.92,14.92,0,14.92
HOSPITAL SELECTED SHOPPABLE,"BASIC METABOLIC PANEL (CALCIUM, IONIZED) THIS PANEL MUST INCLUDE THE FOLLOWING: CALCIUM, IONIZED (82330) CARBON DIOXIDE (82374) CHLORIDE (82435) CREATININE (82565) GLUCOSE (82947) POTASSIUM (84132) SODIUM (84295) UREA NITROGEN (BUN) (84520)",80047,334.45,0,11.04,0,0,13.73,13.73,13.73,0,13.73
HOSPITAL SELECTED SHOPPABLE,BILIRUBIN; TOTAL,82247,102.17,0,4.98,0,0,6.19,6.19,6.19,0,6.19
HOSPITAL SELECTED SHOPPABLE,"BLOOD (WHOLE), FOR TRANSFUSION, PER UNIT",P9010,1150,268.0475,0,111.18,0,0,0,0,0,111.18
HOSPITAL SELECTED SHOPPABLE,BLOOD COUNT; HEMATOCRIT (HCT),85014,133.62,0,2.352,0,0,2.93,2.93,2.93,0,2.93
HOSPITAL SELECTED SHOPPABLE,BLOOD COUNT; HEMOGLOBIN (HGB),85018,133.62,0,2.352,0,0,2.93,2.93,2.93,0,2.93
HOSPITAL SELECTED SHOPPABLE,"BLOOD, OCCULT, BY PEROXIDASE ACTIVITY (EG, GUAIAC), QUALITATIVE, FECES, 1-3 SIMULTANEOUS DETERMINATIONS, PERFORMED FOR OTHER THAN COLORECTAL NEOPLASM SCREENING",82272,415.01,0,3.396,0,0,4.23,4.23,4.23,0,4.23
HOSPITAL SELECTED SHOPPABLE,"BLOOD, OCCULT, BY PEROXIDASE ACTIVITY (EG, GUAIAC), QUALITATIVE; FECES, CONSECUTIVE COLLECTED SPECIMENS WITH SINGLE DETERMINATION, FOR COLORECTAL NEOPLASM SCREENING (IE, PATIENT WAS PROVIDED 3 CARDS OR SINGLE TRIPLE CARD FOR CONSECUTIVE COLLECTION)",82270,198.98,0,3.516,0,0,4.38,4.38,4.38,0,4.38
HOSPITAL SELECTED SHOPPABLE,BUVICAINE LIPOSOME (EXPAREL) (PER MG),C9290,82,0,0,0,0,0,0,0,0,0
HOSPITAL SELECTED SHOPPABLE,CALCIUM; TOTAL,82310,116.13,0,5.124,0,0,6.37,6.37,6.37,0,6.37
HOSPITAL SELECTED SHOPPABLE,CARCINOEMBRYONIC ANTIGEN (CEA),82378,326,0,18.816,0,0,23.41,23.41,23.41,0,23.41
HOSPITAL SELECTED SHOPPABLE,"CHOLANGIOGRAPHY AND/OR PANCREATOGRAPHY; INTRAOPERATIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION",74300,1382.45,0,33.792,0,0,25.5642,23.1384,21.0858,0,33.792
HOSPITAL SELECTED SHOPPABLE,"CLINDAMYCIN PHOSPHATE, 300 MG INJECTION",S0077,41.85,0,0,0,0,0,0,0,0,0
HOSPITAL SELECTED SHOPPABLE,COAGULATION TIME; ACTIVATED,85347,73.13,0,4.224,0,0,5.26,5.26,5.26,0,5.26
HOSPITAL SELECTED SHOPPABLE,"COMPUTED TOMOGRAPHIC ANGIOGRAPHY, ABDOMINAL AORTA AND BILATERAL ILIOFEMORAL LOWER EXTREMITY RUNOFF, WITH CONTRAST MATERIAL(S), INCLUDING NONCONTRAST IMAGES, IF PERFORMED, AND IMAGE POSTPROCESSING",75635,7068.81,319.2525,288.42,201.74,629.993,374.0552,336.1442,288.1236,201.74,629.993
HOSPITAL SELECTED SHOPPABLE,"COMPUTED TOMOGRAPHIC ANGIOGRAPHY, CHEST (NONCORONARY), WITH CONTRAST MATERIAL(S), INCLUDING NONCONTRAST IMAGES, IF PERFORMED, AND IMAGE POSTPROCESSING",71275,6080.17,319.2525,242.4,201.74,629.993,374.0552,336.1442,288.1236,201.74,629.993
HOSPITAL SELECTED SHOPPABLE,"COMPUTED TOMOGRAPHIC ANGIOGRAPHY, HEAD, WITH CONTRAST MATERIAL(S), INCLUDING NONCONTRAST IMAGES, IF PERFORMED, AND IMAGE POSTPROCESSING",70496,7000.13,319.2525,238.284,201.74,629.993,374.0552,336.1442,288.1236,201.74,629.993
HOSPITAL SELECTED SHOPPABLE,"COMPUTED TOMOGRAPHIC ANGIOGRAPHY, NECK, WITH CONTRAST MATERIAL(S), INCLUDING NONCONTRAST IMAGES, IF PERFORMED, AND IMAGE POSTPROCESSING",70498,7009.88,319.2525,237.468,201.74,629.993,374.0552,336.1442,288.1236,201.74,629.993
HOSPITAL SELECTED SHOPPABLE,"COMPUTED TOMOGRAPHY, ABDOMEN AND PELVIS; WITHOUT CONTRAST MATERIAL",74176,10697.15,411.25,131.472,230.56,578.69357,343.8188,308.9723,264.8334,131.472,578.69357
HOSPITAL SELECTED SHOPPABLE,"COMPUTED TOMOGRAPHY, ABDOMEN AND PELVIS; WITHOUT CONTRAST MATERIAL IN ONE OR BOTH BODY REGIONS, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS IN ONE OR BOTH BODY REGIONS",74178,12554.73,658.1575,288.42,385.88,629.993,374.0552,336.1442,288.1236,288.1236,629.993
HOSPITAL SELECTED SHOPPABLE,"COMPUTED TOMOGRAPHY, ABDOMEN; WITH CONTRAST MATERIAL(S)",74160,6581.44,319.2525,193.932,201.74,630.89299,374.0552,336.1442,288.1236,193.932,630.89299
HOSPITAL SELECTED SHOPPABLE,"COMPUTED TOMOGRAPHY, ABDOMEN; WITHOUT CONTRAST MATERIAL",74150,5966.27,194.5825,104.352,112.51,285.29683,169.4008,152.2318,130.4844,104.352,285.29683
HOSPITAL SELECTED SHOPPABLE,"COMPUTED TOMOGRAPHY, ABDOMEN; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS",74170,7261.96,319.2525,223.116,201.74,630.89299,374.0552,336.1442,288.1236,201.74,630.89299
HOSPITAL SELECTED SHOPPABLE,"COMPUTED TOMOGRAPHY, CERVICAL SPINE; WITHOUT CONTRAST MATERIAL",72125,8000.07,194.5825,130.656,112.51,285.29683,169.4008,152.2318,130.4844,112.51,285.29683
HOSPITAL SELECTED SHOPPABLE,"COMPUTED TOMOGRAPHY, CERVICAL SPINE; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS",72127,6823.6,319.2525,239.964,201.74,630.89299,374.0552,336.1442,288.1236,201.74,630.89299
HOSPITAL SELECTED SHOPPABLE,"COMPUTED TOMOGRAPHY, HEAD OR BRAIN; WITH  & WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS",70470,6101.33,319.2525,148.32,201.74,629.993,374.0552,336.1442,288.1236,148.32,629.993
HOSPITAL SELECTED SHOPPABLE,"COMPUTED TOMOGRAPHY, LOWER EXTREMITY; WITHOUT CONTRAST MATERIAL",73700,4308.73,194.5825,130.656,112.51,285.29683,169.4008,152.2318,130.4844,112.51,285.29683
HOSPITAL SELECTED SHOPPABLE,"COMPUTED TOMOGRAPHY, LUMBAR SPINE; WITHOUT CONTRAST MATERIAL",72131,6489.81,194.5825,130.656,112.51,285.29683,169.4008,152.2318,130.4844,112.51,285.29683
HOSPITAL SELECTED SHOPPABLE,"COMPUTED TOMOGRAPHY, MAXILLOFACIAL AREA; WITHOUT CONTRAST MATERIAL",70486,4885.73,194.5825,111.744,112.51,285.29683,169.4008,152.2318,130.4844,111.744,285.29683
HOSPITAL SELECTED SHOPPABLE,"COMPUTED TOMOGRAPHY, MAXILLOFACIAL AREA; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS",70488,6249.52,319.2525,163.116,201.74,629.993,374.0552,336.1442,288.1236,163.116,629.993
HOSPITAL SELECTED SHOPPABLE,"COMPUTED TOMOGRAPHY, ORBIT, SELLA, OR POSTERIOR FOSSA OR OUTER, MIDDLE, OR INNER EAR; WITHOUT CONTRAST MATERIAL",70480,4776.56,194.5825,130.656,112.51,285.29683,169.4008,152.2318,130.4844,112.51,285.29683
HOSPITAL SELECTED SHOPPABLE,"COMPUTED TOMOGRAPHY, PELVIS; WITHOUT CONTRAST MATERIAL",72192,4701.87,194.5825,105.996,112.51,285.29683,169.4008,152.2318,130.4844,105.996,285.29683
HOSPITAL SELECTED SHOPPABLE,"COMPUTED TOMOGRAPHY, PELVIS; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS",72194,6484.06,319.2525,230.928,201.74,630.89299,374.0552,336.1442,288.1236,201.74,630.89299
HOSPITAL SELECTED SHOPPABLE,"COMPUTED TOMOGRAPHY, SOFT TISSUE NECK; WITH CONTRAST MATERIAL(S)",70491,5119.55,319.2525,155.304,201.74,629.993,374.0552,336.1442,288.1236,155.304,629.993
HOSPITAL SELECTED SHOPPABLE,"COMPUTED TOMOGRAPHY, SOFT TISSUE NECK; WITHOUT CONTRAST MATERIAL",70490,5140.3,194.5825,120.372,112.51,285.29683,169.4008,152.2318,130.4844,112.51,285.29683
HOSPITAL SELECTED SHOPPABLE,"COMPUTED TOMOGRAPHY, THORACIC SPINE; WITHOUT CONTRAST MATERIAL",72128,6342.97,194.5825,130.656,112.51,285.29683,169.4008,152.2318,130.4844,112.51,285.29683
HOSPITAL SELECTED SHOPPABLE,"COMPUTED TOMOGRAPHY, THORAX; WITH CONTRAST MATERIAL(S)",71260,6089.75,319.2525,155.724,201.74,629.993,374.0552,336.1442,288.1236,155.724,629.993
HOSPITAL SELECTED SHOPPABLE,"COMPUTED TOMOGRAPHY, THORAX; WITHOUT CONTRAST MATERIAL",71250,4593.9,194.5825,121.2,112.51,285.29683,169.4008,152.2318,130.4844,112.51,285.29683
HOSPITAL SELECTED SHOPPABLE,"COMPUTED TOMOGRAPHY, THORAX; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS",71270,6208.61,319.2525,192.708,201.74,630.89299,374.0552,336.1442,288.1236,192.708,630.89299
HOSPITAL SELECTED SHOPPABLE,"COMPUTED TOMOGRAPHY, UPPER EXTREMITY; WITHOUT CONTRAST MATERIAL",73200,3344.18,194.5825,130.656,112.51,285.29683,169.4008,152.2318,130.4844,112.51,285.29683
HOSPITAL SELECTED SHOPPABLE,CORTISOL; TOTAL,82533,280.13,0,16.176,0,0,20.12,20.12,20.12,0,20.12
HOSPITAL SELECTED SHOPPABLE,C-REACTIVE PROTEIN;,86140,160.75,0,5.136,0,0,6.39,6.39,6.39,0,6.39
HOSPITAL SELECTED SHOPPABLE,C-REACTIVE PROTEIN; HIGH SENSITIVITY (HSCRP),86141,222.5,0,12.852,0,0,15.98,15.98,15.98,0,15.98
HOSPITAL SELECTED SHOPPABLE,CREATINE,82540,89.55,0,4.596,0,0,5.72,5.72,5.72,0,5.72
HOSPITAL SELECTED SHOPPABLE,"CREATINE KINASE (CK), (CPK); TOTAL",82550,310.2,0,6.468,0,0,8.04,8.04,8.04,0,8.04
HOSPITAL SELECTED SHOPPABLE,CRM SETUP TRAINING,97039,150,0,0,0,0,11.13,11.13,11.13,0,11.13
HOSPITAL SELECTED SHOPPABLE,"CT THORAX, LOW DOSE FOR LUNG CANCER SCREENING, WITHOUT CONTRAST",71271,5500.77,194.5825,0,0,0,0,0,0,0,0
HOSPITAL SELECTED SHOPPABLE,"CT, SOFT TISSUE NECK, W/ WO",70492,6650.4,319.2525,189.828,201.74,630.89299,374.0552,336.1442,288.1236,189.828,630.89299
HOSPITAL SELECTED SHOPPABLE,"CULTURE, BACTERIAL; QUANTITATIVE, AEROBIC WITH ISOLATION AND PRESUMPTIVE IDENTIFICATION OF ISOLATES, ANY SOURCE EXCEPT URINE, BLOOD OR STOOL",87071,224.75,0,9.372,0,0,11.66,11.66,11.66,0,11.66
HOSPITAL SELECTED SHOPPABLE,"CULTURE, BACTERIAL; STOOL, AEROBIC, WITH ISOLATION AND PRELIMINARY EXAMINATION (EG, KIA, LIA), SALMONELLA AND SHIGELLA SPECIES",87045,336.74,0,9.372,0,0,11.66,11.66,11.66,0,11.66
HOSPITAL SELECTED SHOPPABLE,"CULTURE, CHLAMYDIA, ANY SOURCE",87255,339.74,0,33.612,,0,41.81,41.81,41.81,0,41.81
HOSPITAL SELECTED SHOPPABLE,"CULTURE, PRESUMPTIVE, PATHOGENIC ORGANISMS, SCREENING ONLY;",87081,265.35,0,6.576,0,0,8.18,8.18,8.18,0,8.18
HOSPITAL SELECTED SHOPPABLE,"CULTURE, TUBERCLE OR OTHER ACID-FAST BACILLI (EG, TB, AFB, MYCOBACTERIA) ANY SOURCE, WITH ISOLATION AND PRESUMPTIVE IDENTIFICATION OF ISOLATES",87116,349.74,0,10.728,0,0,13.34,13.34,13.34,0,13.34
HOSPITAL SELECTED SHOPPABLE,DECALCIFICATION PROCEDURE (LIST SEPARATELY IN ADDITION TO CODE FOR SURGICAL PATHOLOGY EXAMINATION),88311,74.11,0,7.596,,0,9.33,9.33,9.33,0,9.33
HOSPITAL SELECTED SHOPPABLE,"DRUG SCREEN, QUALITATIVE; SINGLE DRUG CLASS METHOD (EG, IMMUNOASSAY, ENZYME ASSAY), EACH DRUG CLASS",80101,246.45,0,0,0,0,0,0,0,0,0
HOSPITAL SELECTED SHOPPABLE,"DRUG TEST, PRESUMPTIVE, ANY NUMBER DRUG CLASSES, ANY NUMBER OF DEVICES OR PROCEDURES CAPABLE OF BEING READ BY DIRECT OPTICAL OBESERVATION ONLY.",80305,238.5,0,10.824,0,0,13.46,13.46,13.46,0,13.46
HOSPITAL SELECTED SHOPPABLE,"DUPLEX SCAN OF AORTA, INFERIOR VENA CAVA, ILIAC VASCULATURE, OR BYPASS GRAFTS; COMPLETE STUDY",93978,2324,411.25,0,0,0,0,0,0,0,0
HOSPITAL SELECTED SHOPPABLE,DUPLEX SCAN OF EXTRACRANIAL ARTERIES; COMPLETE BILATERAL STUDY,93880,2019.18,411.25,0,230.56,381.9377562,118.07,118.07,118.07,0,381.9377562
HOSPITAL SELECTED SHOPPABLE,DUPLEX SCAN OF EXTREMITY VEINS INCLUDING RESPONSES TO COMPRESSION AND OTHER MANEUVERS; COMPLETE BILATERAL STUDY,93970,2196.14,411.25,0,230.56,381.9377562,166.16,166.16,166.16,0,381.9377562
HOSPITAL SELECTED SHOPPABLE,DUPLEX SCAN OF EXTREMITY VEINS INCLUDING RESPONSES TO COMPRESSION AND OTHER MANEUVERS; UNILATERAL OR LIMITED STUDY,93971,1465.63,194.5825,0,112.51,188.2959078,100.49,100.49,100.49,0,188.2959078
HOSPITAL SELECTED SHOPPABLE,DUPLEX SCAN OF LOWER EXTREMITY ARTERIES OR ARTERIAL BYPASS GRAFTS; COMPLETE BILATERAL STUDY,93925,2865.56,411.25,0,230.56,381.3437628,226.82,226.82,226.82,0,381.3437628
HOSPITAL SELECTED SHOPPABLE,DUPLEX SCAN OF LOWER EXTREMITY ARTERIES OR ARTERIAL BYPASS GRAFTS; UNILATERAL OR LIMITED STUDY,93926,3049.75,194.5825,0,112.51,187.7019144,118.43,118.43,118.43,0,187.7019144
HOSPITAL SELECTED SHOPPABLE,"ED  VISIT FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES THESE 3 KEY COMPONENTS: AN EXPANDED PROBLEM FOCUSED HISTORY; AN EXPANDED PROBLEM FOCUSED EXAMINATION; AND MEDICAL DECISION MAKING OF MODERATE COMPLEXITY. COUNSELING AND/OR COORDINAT",99283,1879.14,413.6125,1050,222.99,1173,938,847,658,222.99,1173
HOSPITAL SELECTED SHOPPABLE,"ED VISIT FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES THESE 3 KEY COMPONENTS WITHIN THE CONSTRAINTS IMPOSED BY THE URGENCY OF THE PATIENT'S CLINICAL CONDITION AND/OR MENTAL STATUS: A COMPREHENSIVE HISTORY; A COMPREHENSIVE EXAMINATION; A",99285,3635,933.2225,2400,525.3,3088,3160,2840,2200,525.3,3160
HOSPITAL SELECTED SHOPPABLE,"ED VISIT FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES THESE 3 KEY COMPONENTS: A DETAILED HISTORY; A DETAILED EXAMINATION; AND MEDICAL DECISION MAKING OF MODERATE COMPLEXITY. COUNSELING AND/OR COORDINATION OF CARE WITH OTHER PROVIDERS OR",99284,2689,650.16,1900,360.37,2000,1760,1580,1240,360.37,2000
HOSPITAL SELECTED SHOPPABLE,"ED VISIT FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES THESE 3 KEY COMPONENTS: A PROBLEM FOCUSED HISTORY; A PROBLEM FOCUSED EXAMINATION; AND STRAIGHTFORWARD MEDICAL DECISION MAKING. COUNSELING AND/OR COORDINATION OF CARE WITH OTHER PROVI",99281,499,129.64,270,69.73,485,180,162,126,69.73,485
HOSPITAL SELECTED SHOPPABLE,"ED VISIT FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES THESE 3 KEY COMPONENTS: AN EXPANDED PROBLEM FOCUSED HISTORY; AN EXPANDED PROBLEM FOCUSED EXAMINATION; AND MEDICAL DECISION MAKING OF LOW COMPLEXITY. COUNSELING AND/OR COORDINATION OF",99282,842,234.7625,475,127.96,850,600,540,420,127.96,850
HOSPITAL SELECTED SHOPPABLE,"EKG ELECTROCARDIOGRAM, ROUTINE ECG WITH AT LEAST 12 LEADS; TRACING ONLY, WITHOUT INTERPRETATION AND REPORT",93005,558.18,99.4875,0,55.9,0,55.96,55.96,55.96,0,55.96
HOSPITAL SELECTED SHOPPABLE,FERRITIN,82728,403.25,0,13.536,0,0,16.83,16.83,16.83,0,16.83
HOSPITAL SELECTED SHOPPABLE,"FLUORODEOXYGLUCOSE F-18 FDG, DIAGNOSTIC, PER STUDY DOSE, UP TO 45 MILLICURIES",A9552,3750,0,0,0,0,0,0,0,0,0
HOSPITAL SELECTED SHOPPABLE,"FLUOROSCOPIC GUIDANCE AND LOCALIZATION OF NEEDLE OR CATHETER TIP FOR SPINE OR PARASPINOUS DIAGNOSTIC OR THERAPEUTIC INJECTION PROCEDURES (EPIDURAL, TRANSFORAMINAL EPIDURAL, SUBARACHNOID, PARAVERTEBRAL FACET JOINT, PARAVERTEBRAL FACET JOINT NERVE, OR SACR",77003,1228.92,0,63.624,0,0,89.4884,80.9968,73.8116,0,89.4884
HOSPITAL SELECTED SHOPPABLE,"FLUOROSCOPIC GUIDANCE FOR NEEDLE PLACEMENT (EG, BIOPSY, ASPIRATION, INJECTION, LOCALIZATION DEVICE)",77002,1302.27,0,65.376,0,0,91.9407,83.2164,75.8343,0,91.9407
HOSPITAL SELECTED SHOPPABLE,"FLUOROSCOPY (SEPARATE PROCEDURE), UP TO 1 HOUR PHYSICIAN TIME, OTHER THAN 71023 OR 71034 (EG, CARDIAC FLUOROSCOPY)",76000,1200.65,411.25,38.448,230.56,380.155776,54.0876,48.9552,44.6124,38.448,380.155776
HOSPITAL SELECTED SHOPPABLE,"GASES, BLOOD, ANY COMBINATION OF PH, PCO2, PO2, CO2, HCO3 (INCLUDING CALCULATED O2 SATURATION);",82803,501.68,0,0,0,0,0,0,0,0,0
HOSPITAL SELECTED SHOPPABLE,"GLUCOSE, BLOOD BY GLUCOSE MONITORING DEVICE(S) CLEARED BY THE FDA SPECIFICALLY FOR HOME USE",82962,283.05,0,2.64,0,0,3.28,3.28,3.28,0,3.28
HOSPITAL SELECTED SHOPPABLE,"GONADOTROPIN, CHORIONIC, (HCG); QUALITATIVE",84703,278.58,0,7.464,0,0,9.29,9.29,9.29,0,9.29
HOSPITAL SELECTED SHOPPABLE,HEMOGLOBIN; GLYCOSYLATED (A1C),83036,188.7,0,9.636,0,0,11.99,11.99,11.99,0,11.99
HOSPITAL SELECTED SHOPPABLE,HEPATITIS C ANTIBODY;,86803,245.25,0,14.16,0,0,17.61,17.61,17.61,0,17.61
HOSPITAL SELECTED SHOPPABLE,"HEPATOBILIARY SYSTEM IMAGING, INCLUDING GALLBLADDER WHEN PRESENT;",78226,7068.81,673.7325,303.12,353.49,573.7976244,426.2892,385.8384,351.6108,303.12,573.7976244
HOSPITAL SELECTED SHOPPABLE,"HEPATOBILIARY SYSTEM IMAGING, INCLUDING GALLBLADDER WHEN PRESENT; WITH PHARMACOLOGIC INTERVENTION, INCLUDING QUANTITATIVE MEASUREMENT(S) WHEN PERFORMED",78227,7068.81,874.615,415.716,455.52,744.2737302,584.6064,529.1328,482.1936,415.716,744.2737302
HOSPITAL SELECTED SHOPPABLE,"HOSPITAL OUTPATIENT CLINIC VISIT SPECIMEN COLLECTION FOR SEVERE ACUTE RESPIRATORY SYNDROME CORONAVIRUS 2, ANY SOURCE   ",C9803,648.64,44.1525,0,0,0,0,0,0,0,0
HOSPITAL SELECTED SHOPPABLE,IMMUNIZATION ADMINISTRATION (INCLUDES PERCUTANEOUS INTRADERMAL SUBCUTANEOUS OR INTRAMUSCULAR INJECTIONS); 1 VACCINE (SINGLE OR COMBINATION VACCINE/TOXOID),90471,324,110.81,0,59.75,0,58.2,58.2,58.2,0,59.75
HOSPITAL SELECTED SHOPPABLE,"IMMUNIZATION ADMINISTRATION (INCLUDES PERCUTANEOUS, INTRADERMAL, SUBCUTANEOUS, OR INTRAMUSCULAR INJECTIONS); EACH ADDITIONAL VACCINE (SINGLE OR COMBINATION VACCINE/TOXOID) (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)",90472,157.75,0,0,0,0,12.92,12.92,12.92,0,12.92
HOSPITAL SELECTED SHOPPABLE,"IMMUNOHISTOCHEMISTRY (INCLUDING TISSUE IMMUNOPEROXIDASE), EACH ANTIBODY",88342,608.28,266.56,60.312,144.73,0,215.43,215.43,215.43,0,215.43
HOSPITAL SELECTED SHOPPABLE,"IMMUNOHISTOCHEMISTRY OR IMMONOCYTOCHEMISTRY, PER SPECIMAN;EACH ADDITIONAL SINGLE ANTIBODY STAIN PROCEDURE",88341,608.28,0,52.728,0,0,64.6,64.6,64.6,0,64.6
HOSPITAL SELECTED SHOPPABLE,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE-STEP METHOD; HEPATITIS B SURFACE ANTIGEN (HBSAG)",87340,210.5,0,10.248,0,0,12.75,12.75,12.75,0,12.75
HOSPITAL SELECTED SHOPPABLE,"INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITIVE OR SERMEQUANTITITAVE",87426,615,0,0,0,0,0,0,0,0,0
HOSPITAL SELECTED SHOPPABLE,INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATION; INFLUENZA,87804,221.95,0,13.308,0,0,16.55,16.55,16.55,0,16.55
HOSPITAL SELECTED SHOPPABLE,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HEPATITIS C, QUANTIFICATION",87522,583.8,0,42.516,0,0,52.88,52.88,52.88,0,52.88
HOSPITAL SELECTED SHOPPABLE,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HIV-1, QUANTIFICATION",87536,1462.95,0,84.468,0,0,105.06,105.06,105.06,0,105.06
HOSPITAL SELECTED SHOPPABLE,INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); RESPIRATORY VIRUS (EG ADENOVIRUS INFLUENZA VIRUS CORONAVIRUS METAPNEUMOVIRUS PARAINFLUENZA VIRUS RESPIRATORY SYNCYTIAL VIRUS RHINOVIRUS) INCLUDES MULTIPLEX REVERSE TRANSCRIPTION WHEN PERFORMED AND ,87633,8575.8,0,413.7,0,0,514.55,514.55,514.55,0,514.55
HOSPITAL SELECTED SHOPPABLE,INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA/RNA) SEVERE ACUTE COVID 2 - PROB TECHNIQUE,87635,336.25,0,0,0,0,0,0,0,0,0
HOSPITAL SELECTED SHOPPABLE,"INJECTION, BUPIVICAINE HYDROCHLORIDE, 30 ML",S0020,61.25,0,0,0,0,0,0,0,0,0
HOSPITAL SELECTED SHOPPABLE,"INJECTION, METRONIDAZOLE, 500 MG",S0030,247.35,0,0,0,0,0,0,0,0,0
HOSPITAL SELECTED SHOPPABLE,"INJECTION, PANTOPRAZOLE SODIUM, 40 MG",S0164,253.5,0,0,0,0,0,0,0,0,0
HOSPITAL SELECTED SHOPPABLE,"INTRAVENOUS INFUSION, FOR THERAPY, PROPHYLAXIS, OR DIAGNOSIS (SPECIFY SUBSTANCE OR DRUG); ADDITIONAL SEQUENTIAL INFUSION OF A NEW DRUG/SUBSTANCE, UP TO 1 HOUR (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)",96367,579.4,110.81,0,59.75,0,31.94,31.94,31.94,0,59.75
HOSPITAL SELECTED SHOPPABLE,"INTRAVENOUS INFUSION, FOR THERAPY, PROPHYLAXIS, OR DIAGNOSIS (SPECIFY SUBSTANCE OR DRUG); EACH ADDITIONAL HOUR (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCE48486",96366,324.5,71.5225,0,37.88,0,22.25,22.25,22.25,0,37.88
HOSPITAL SELECTED SHOPPABLE,"INTRAVENOUS INFUSION, FOR THERAPY, PROPHYLAXIS, OR DIAGNOSIS (SPECIFY SUBSTANCE OR DRUG); INITIAL, UP TO 1 HOUR",96365,945.63,365.6275,0,187.18,0,73.93,73.93,73.93,0,187.18
HOSPITAL SELECTED SHOPPABLE,"INTRAVENOUS INFUSION, HYDRATION; EACH ADDITIONAL HOUR (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)",96361,345.4,71.5225,0,37.88,0,14,14,14,0,37.88
HOSPITAL SELECTED SHOPPABLE,"INTRAVENOUS INFUSION, HYDRATION; INITIAL, 31 MINUTES TO 1 HOUR48483",96360,732.5,365.6275,0,187.18,0,47.37,47.37,47.37,0,187.18
HOSPITAL SELECTED SHOPPABLE,IRON,83540,200.81,0,6.42,0,0,7.99,7.99,7.99,0,7.99
HOSPITAL SELECTED SHOPPABLE,IRON BINDING CAPACITY,83550,209.7,0,8.676,0,0,10.79,10.79,10.79,0,10.79
HOSPITAL SELECTED SHOPPABLE,LAB BLOOD TYPING; ABO,86900,307.75,201.53,2.964,106.48,0,105.04,105.04,105.04,0,106.48
HOSPITAL SELECTED SHOPPABLE,LAB BLOOD TYPING; RH (D),86901,194.25,60.4975,2.964,32.12,0,31.8,31.8,31.8,0,32.12
HOSPITAL SELECTED SHOPPABLE,"LAB CREATINE KINASE (CK), (CPK); MB FRACTION ONLY",82553,344.4,0,11.46,0,0,14.26,14.26,14.26,0,14.26
HOSPITAL SELECTED SHOPPABLE,LAB CREATININE; BLOOD,82565,191.34,0,5.088,0,0,6.33,6.33,6.33,0,6.33
HOSPITAL SELECTED SHOPPABLE,"LAB CULTURE, BACTERIAL; AEROBIC ISOLATE, ADDITIONAL METHODS REQUIRED FOR DEFINITIVE IDENTIFICATION, EACH ISOLATE",87077,222.3,0,8.016,0,0,9.97,9.97,9.97,0,9.97
HOSPITAL SELECTED SHOPPABLE,"LAB CULTURE, BACTERIAL; ANAEROBIC ISOLATE, ADDITIONAL METHODS REQUIRED FOR DEFINITIVE IDENTIFICATION, EACH ISOLATE",87076,403.2,0,8.016,0,0,9.97,9.97,9.97,0,9.97
HOSPITAL SELECTED SHOPPABLE,"LAB CULTURE, BACTERIAL; ANY OTHER SOURCE EXCEPT URINE, BLOOD OR STOOL, AEROBIC, WITH ISOLATION AND PRESUMPTIVE IDENTIFICATION OF ISOLATES",87070,301,0,8.556,0,0,10.64,10.64,10.64,0,10.64
HOSPITAL SELECTED SHOPPABLE,"LAB CULTURE, BACTERIAL; ANY SOURCE, EXCEPT BLOOD, ANAEROBIC WITH ISOLATION AND PRESUMPTIVE IDENTIFICATION OF ISOLATES",87075,375.02,0,9.396,0,0,11.69,11.69,11.69,0,11.69
HOSPITAL SELECTED SHOPPABLE,"LAB CULTURE, BACTERIAL; BLOOD, AEROBIC, WITH ISOLATION AND PRESUMPTIVE IDENTIFICATION OF ISOLATES (INCLUDES ANAEROBIC CULTURE, IF APPROPRIATE)",87040,378,0,10.248,0,0,12.74,12.74,12.74,0,12.74
HOSPITAL SELECTED SHOPPABLE,"LAB CULTURE, BACTERIAL; QUANTITATIVE COLONY COUNT, URINE",87086,252.91,0,8.004,0,0,9.96,9.96,9.96,0,9.96
HOSPITAL SELECTED SHOPPABLE,"LAB CULTURE, BACTERIAL; WITH ISOLATION AND PRESUMPTIVE IDENTIFICATION OF EACH ISOLATE, URINE",87088,139.13,0,8.028,0,0,9.99,9.99,9.99,0,9.99
HOSPITAL SELECTED SHOPPABLE,"LAB FIBRIN DEGRADATION PRODUCTS, D-DIMER; QUANTITATIVE",85379,413.72,0,10.104,0,0,12.56,12.56,12.56,0,12.56
HOSPITAL SELECTED SHOPPABLE,LAB INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATION; RESPIRATORY SYNCYTIAL VIRUS,87807,2895.6,0,11.904,0,0,14.8,14.8,14.8,0,14.8
HOSPITAL SELECTED SHOPPABLE,"LAB INFECTIOUS AGENT DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATION; STREPTOCOCCUS, GROUP A",87880,206.13,0,13.296,0,0,16.53,16.53,16.53,0,16.53
HOSPITAL SELECTED SHOPPABLE,LAB NATRIURETIC PEPTIDE,83880,583.25,0,33.684,0,0,41.9,41.9,41.9,0,41.9
HOSPITAL SELECTED SHOPPABLE,"LAB TROPONIN, QUANTITATIVE",84484,344.4,0,10.02,0,0,12.47,12.47,12.47,0,12.47
HOSPITAL SELECTED SHOPPABLE,"LAB URINALYSIS; QUALITATIVE OR SEMIQUANTITATIVE, EXCEPT IMMUNOASSAYS",81005,84.33,0,2.148,0,0,2.67,2.67,2.67,0,2.67
HOSPITAL SELECTED SHOPPABLE,"LAB URINE PREGNANCY TEST, BY VISUAL COLOR COMPARISON METHODS",81025,124.12,0,6.924,0,0,8.61,8.61,8.61,0,8.61
HOSPITAL SELECTED SHOPPABLE,LACTATE (LACTIC ACID),83605,248.25,0,10.608,0,0,13.19,13.19,13.19,0,13.19
HOSPITAL SELECTED SHOPPABLE,"LACTATE DEHYDROGENASE (LD), (LDH);",83615,206.38,0,5.988,0,0,7.45,7.45,7.45,0,7.45
HOSPITAL SELECTED SHOPPABLE,"LEVEL I - SURGICAL PATHOLOGY, GROSS EXAMINATION ONLY",88300,209.83,44.1525,9.936,17.17,0,17.47,17.47,17.47,0,17.47
HOSPITAL SELECTED SHOPPABLE,"LEVEL II - SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAMINATION APPENDIX, INCIDENTAL FALLOPIAN TUBE, STERILIZATION FINGERS/TOES, AMPUTATION, TRAUMATIC FORESKIN, NEWBORN HERNIA SAC, ANY LOCATION HYDROCELE SAC NERVE SKIN, PLASTIC REPAIR SYMPATHETIC GANGLI",88302,392.17,44.1525,19.608,32.12,0,31.8,31.8,31.8,0,32.12
HOSPITAL SELECTED SHOPPABLE,"LEVEL III - SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAMINATION ABORTION, INDUCED ABSCESS ANEURYSM - ARTERIAL/VENTRICULAR ANUS, TAG APPENDIX, OTHER THAN INCIDENTAL ARTERY, ATHEROMATOUS PLAQUE BARTHOLIN'S GLAND CYST BONE FRAGMENT(S), OTHER THAN PATHOLOG",88304,454.73,88.8125,24,50.98,0,44.7,44.7,44.7,0,50.98
HOSPITAL SELECTED SHOPPABLE,"LEVEL IV - SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAMINATION ABORTION - SPONTANEOUS/MISSED ARTERY, BIOPSY BONE MARROW, BIOPSY BONE EXOSTOSIS BRAIN/MENINGES, OTHER THAN FOR TUMOR RESECTION BREAST, BIOPSY, NOT REQUIRING MICROSCOPIC EVALUATION OF SURGIC",88305,879.38,88.8125,24.588,50.98,0,44.7,44.7,44.7,0,50.98
HOSPITAL SELECTED SHOPPABLE,"LEVEL V - SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAMINATION ADRENAL, RESECTION BONE - BIOPSY/CURETTINGS BONE FRAGMENT(S), PATHOLOGIC FRACTURE BRAIN, BIOPSY BRAIN/MENINGES, TUMOR RESECTION BREAST, EXCISION OF LESION, REQUIRING MICROSCOPIC EVALUATION O",88307,848.86,520.5375,148.164,274.22,0,215.43,215.43,215.43,0,274.22
HOSPITAL SELECTED SHOPPABLE,LIPASE,83690,191.34,0,6.84,0,0,8.51,8.51,8.51,0,8.51
HOSPITAL SELECTED SHOPPABLE,MAGNESIUM,83735,206.64,0,6.648,0,0,8.27,8.27,8.27,0,8.27
HOSPITAL SELECTED SHOPPABLE,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, ABDOMEN; WITHOUT CONTRAST MATERIAL(S)",74181,6668.26,411.25,292.416,230.56,579.59356,343.8188,308.9723,264.8334,230.56,579.59356
HOSPITAL SELECTED SHOPPABLE,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, ABDOMEN; WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY WITH CONTRAST MATERIAL(S) AND FURTHER SEQUENCES",74183,10265.45,658.1575,443.052,385.88,1138.48735,675.4276,606.9721,520.2618,385.88,1138.48735
HOSPITAL SELECTED SHOPPABLE,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF LOWER EXTREMITY; WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES",73723,10265.45,658.1575,506.784,385.88,1138.48735,675.4276,606.9721,520.2618,385.88,1138.48735
HOSPITAL SELECTED SHOPPABLE,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF UPPER EXTREMITY; WITHOUT CONTRAST MATERIAL(S)",73221,6086.21,411.25,236.556,230.56,578.69357,343.8188,308.9723,264.8334,230.56,578.69357
HOSPITAL SELECTED SHOPPABLE,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF UPPER EXTREMITY; WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES",73223,10265.45,658.1575,507.276,385.88,1138.48735,675.4276,606.9721,520.2618,385.88,1138.48735
HOSPITAL SELECTED SHOPPABLE,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, BRAIN (INCLUDING BRAIN STEM); WITHOUT CONTRAST MATERIAL",70551,6086.21,411.25,218.808,230.56,579.59356,343.8188,308.9723,264.8334,218.808,579.59356
HOSPITAL SELECTED SHOPPABLE,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, LOWER EXTREMITY OTHER THAN JOINT; WITHOUT CONTRAST MATERIAL(S)",73718,6916.44,411.25,318.6,230.56,579.59356,343.8188,308.9723,264.8334,230.56,579.59356
HOSPITAL SELECTED SHOPPABLE,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, LOWER EXTREMITY OTHER THAN JOINT; WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES",73720,10265.45,658.1575,444.54,385.88,1138.48735,675.4276,606.9721,520.2618,385.88,1138.48735
HOSPITAL SELECTED SHOPPABLE,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, PELVIS; WITHOUT CONTRAST MATERIAL(S)",72195,8079.63,411.25,318.6,230.56,579.59356,343.8188,308.9723,264.8334,230.56,579.59356
HOSPITAL SELECTED SHOPPABLE,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, PELVIS; WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES",72197,10265.45,658.1575,441.576,385.88,1138.48735,675.4276,606.9721,520.2618,385.88,1138.48735
HOSPITAL SELECTED SHOPPABLE,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, CERVICAL; WITHOUT CONTRAST MATERIAL",72141,8785.87,411.25,209.916,230.56,579.59356,343.8188,308.9723,264.8334,209.916,579.59356
HOSPITAL SELECTED SHOPPABLE,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, THORACIC; WITHOUT CONTRAST MATERIAL",72146,3208.54,411.25,210.408,230.56,579.59356,343.8188,308.9723,264.8334,210.408,579.59356
HOSPITAL SELECTED SHOPPABLE,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES; CERVICAL",72156,10265.45,658.1575,371.424,385.88,1137.58736,675.4276,606.9721,520.2618,371.424,1137.58736
HOSPITAL SELECTED SHOPPABLE,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES; LUMBAR",72158,12203.69,658.1575,369.936,385.88,1137.58736,675.4276,606.9721,520.2618,369.936,1137.58736
HOSPITAL SELECTED SHOPPABLE,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES; THORACIC",72157,10265.45,658.1575,372.408,385.88,1137.58736,675.4276,606.9721,520.2618,372.408,1137.58736
HOSPITAL SELECTED SHOPPABLE,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, UPPER EXTREMITY, OTHER THAN JOINT; WITHOUT CONTRAST MATERIAL(S)",73218,7490.16,411.25,319.056,230.56,579.59356,343.8188,308.9723,264.8334,230.56,579.59356
HOSPITAL SELECTED SHOPPABLE,"MAGNETIC RESONANCE (EG, PROTON) IMAGING, UPPER EXTREMITY, OTHER THAN JOINT; WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES",73220,10265.45,658.1575,548.28,385.88,1138.48735,675.4276,606.9721,520.2618,385.88,1138.48735
HOSPITAL SELECTED SHOPPABLE,"MAGNETIC RESONANCE ANGIOGRAPHY, NECK; WITHOUT CONTRAST MATERIAL(S)",70547,6366.88,411.25,319.056,230.56,579.59356,343.8188,308.9723,264.8334,230.56,579.59356
HOSPITAL SELECTED SHOPPABLE,"MISCELLANEOUS DME SUPPLY, ACCESSORY, AND/OR SERVICE COMPONENT OF ANOTHER HCPCS CODE",A9900,45.5,0,0,0,0,0,0,0,0,0
HOSPITAL SELECTED SHOPPABLE,MOD SED SAME PHYS/QHP EA  ,99153,221.95,0,0,0,0,11.13,11.13,11.13,0,11.13
HOSPITAL SELECTED SHOPPABLE,MYOGLOBIN,83874,225.01,0,12.828,0,0,15.95,15.95,15.95,0,15.95
HOSPITAL SELECTED SHOPPABLE,NON-PRESCRIPTION DRUGS,A9150,9.75,0,0,0,0,0,0,0,0,0
HOSPITAL SELECTED SHOPPABLE,PARATHORMONE (PARATHYROID HORMONE),83970,709.25,0,40.968,0,0,50.96,50.96,50.96,0,50.96
HOSPITAL SELECTED SHOPPABLE,PHENYTOIN; FREE,80186,283.2,0,13.656,0,0,16.99,16.99,16.99,0,16.99
HOSPITAL SELECTED SHOPPABLE,PHENYTOIN; TOTAL,80185,243.1,0,13.152,0,0,16.36,16.36,16.36,0,16.36
HOSPITAL SELECTED SHOPPABLE,PHOSPHORUS INORGANIC (PHOSPHATE);,84100,174.74,0,4.704,0,0,5.85,5.85,5.85,0,5.85
HOSPITAL SELECTED SHOPPABLE,POSITRON EMISSION TOMOGRAPHY (PET) WITH CONCURRENTLY ACQUIRED COMPUTED TOMOGRAPHY (CT) FOR ATTENUATION CORRECTION AND ANATOMICAL LOCALIZATION IMAGING; SKULL BASE TO MID-THIGH,78815,27332.39,2645.23,1050,1375.54,2272.024755,2031.6552,1825.7442,1564.9236,1050,2272.024755
HOSPITAL SELECTED SHOPPABLE,POSITRON EMISSION TOMOGRAPHY (PET) WITH CONCURRENTLY ACQUIRED COMPUTED TOMOGRAPHY (CT) FOR ATTENUATION CORRECTION AND ANATOMICAL LOCALIZATION IMAGING; WHOLE BODY,78816,27332.39,2645.23,1050,1375.54,2272.024755,2031.6552,1825.7442,1564.9236,1050,2272.024755
HOSPITAL SELECTED SHOPPABLE,POTASSIUM; SERUM,84132,170.74,0,4.572,0,0,5.68,5.68,5.68,0,5.68
HOSPITAL SELECTED SHOPPABLE,PREALBUMIN,84134,170.74,0,14.484,0,0,18.01,18.01,18.01,0,18.01
HOSPITAL SELECTED SHOPPABLE,"PROTEIN, TOTAL, EXCEPT BY REFRACTOMETRY; OTHER SOURCE (EG, SYNOVIAL FLUID, CEREBROSPINAL FLUID)",84157,524.1,0,3.648,0,0,4.53,4.53,4.53,0,4.53
HOSPITAL SELECTED SHOPPABLE,"PROTEIN, TOTAL, EXCEPT BY REFRACTOMETRY; SERUM",84155,63,0,3.648,0,0,4.53,4.53,4.53,0,4.53
HOSPITAL SELECTED SHOPPABLE,PT EVAL LOW COMPLEX 20 MIN,97161,1759.71,0,0,0,0,85.42,85.42,85.42,0,85.42
HOSPITAL SELECTED SHOPPABLE,"PT SELF-CARE/HOME MANAGEMENT TRAINING (EG, ACTIVITIES OF DAILY LIVING (ADL) AND COMPENSATORY TRAINING, MEAL PREPARATION, SAFETY PROCEDURES, AND INSTRUCTIONS IN USE OF ASSISTIVE TECHNOLOGY DEVICES/ADAPTIVE EQUIPMENT) DIRECT ONE-ON-ONE CONTACT BY PROVIDER,",97535,151.25,0,0,,0,35.17,35.17,35.17,0,35.17
HOSPITAL SELECTED SHOPPABLE,"PT THERAPEUTIC ACTIVITIES, DIRECT (ONE-ON-ONE) PATIENT CONTACT BY THE PROVIDER (USE OF DYNAMIC ACTIVITIES TO IMPROVE FUNCTIONAL PERFORMANCE), EACH 15 MINUTES",97530,127,0,0,,0,41.27,41.27,41.27,0,41.27
HOSPITAL SELECTED SHOPPABLE,"PT THERAPEUTIC PROCEDURE, ONE OR MORE AREAS, EACH 15 MINUTES; GAIT TRAINING (INCLUDES STAIR CLIMBING)",97116,165.25,0,0,,0,30.86,30.86,30.86,0,30.86
HOSPITAL SELECTED SHOPPABLE,"RADIOLOGIC EXAMINATION, ANKLE; COMPLETE, MINIMUM OF THREE VIEWS",73610,1261.61,144.5675,22.356,62.3,100.978878,85.1044,77.0288,70.1956,22.356,100.978878
HOSPITAL SELECTED SHOPPABLE,"RADIOLOGIC EXAMINATION, ANKLE; TWO VIEWS",73600,1261.61,144.5675,20.964,62.3,100.978878,85.1044,77.0288,70.1956,20.964,100.978878
HOSPITAL SELECTED SHOPPABLE,"RADIOLOGIC EXAMINATION, CHEST, TWO VIEWS, FRONTAL AND LATERAL;",71020,1261.61,0,0,0,0,0,0,0,0,0
HOSPITAL SELECTED SHOPPABLE,"RADIOLOGIC EXAMINATION, ELBOW; COMPLETE, MINIMUM OF THREE VIEWS",73080,1171.94,144.5675,22.356,62.3,100.978878,85.1044,77.0288,70.1956,22.356,100.978878
HOSPITAL SELECTED SHOPPABLE,"RADIOLOGIC EXAMINATION, ELBOW; TWO VIEWS",73070,1261.61,144.5675,18.864,62.3,100.3848846,85.1044,77.0288,70.1956,18.864,100.3848846
HOSPITAL SELECTED SHOPPABLE,"RADIOLOGIC EXAMINATION, FINGER(S), MINIMUM OF TWO VIEWS",73140,1641.81,144.5675,24.804,62.3,100.978878,85.1044,77.0288,70.1956,24.804,100.978878
HOSPITAL SELECTED SHOPPABLE,"RADIOLOGIC EXAMINATION, FOOT; COMPLETE, MINIMUM OF THREE VIEWS",73630,1008.78,144.5675,20.604,62.3,100.978878,85.1044,77.0288,70.1956,20.604,100.978878
HOSPITAL SELECTED SHOPPABLE,"RADIOLOGIC EXAMINATION, FOOT; TWO VIEWS",73620,1261.61,144.5675,18.156,62.3,100.3848846,85.1044,77.0288,70.1956,18.156,100.3848846
HOSPITAL SELECTED SHOPPABLE,"RADIOLOGIC EXAMINATION, HAND; MINIMUM OF THREE VIEWS",73130,2019.18,144.5675,22.704,62.3,100.978878,85.1044,77.0288,70.1956,22.704,100.978878
HOSPITAL SELECTED SHOPPABLE,"RADIOLOGIC EXAMINATION, HAND; TWO VIEWS",73120,1641.81,194.5825,19.56,112.51,185.3259408,156.8102,141.9304,129.3398,19.56,185.3259408
HOSPITAL SELECTED SHOPPABLE,"RADIOLOGIC EXAMINATION, KNEE; COMPLETE, FOUR OR MORE VIEWS",73564,2019.18,194.5825,27.948,112.51,186.5139276,156.8102,141.9304,129.3398,27.948,186.5139276
HOSPITAL SELECTED SHOPPABLE,"RADIOLOGIC EXAMINATION, KNEE; ONE OR TWO VIEWS",73560,2019.18,144.5675,22.356,62.3,100.978878,85.1044,77.0288,70.1956,22.356,100.978878
HOSPITAL SELECTED SHOPPABLE,"RADIOLOGIC EXAMINATION, KNEE; THREE VIEWS",73562,2019.18,144.5675,25.86,62.3,100.978878,85.1044,77.0288,70.1956,25.86,100.978878
HOSPITAL SELECTED SHOPPABLE,"RADIOLOGIC EXAMINATION, PELVIS; ONE OR TWO VIEWS",72170,1453.48,194.5825,22.704,112.51,185.9199342,156.8102,141.9304,129.3398,22.704,185.9199342
HOSPITAL SELECTED SHOPPABLE,"RADIOLOGIC EXAMINATION, RIBS, BILATERAL; THREE VIEWS",71110,2019.18,194.5825,24.804,112.51,186.5139276,156.8102,141.9304,129.3398,24.804,186.5139276
HOSPITAL SELECTED SHOPPABLE,"RADIOLOGIC EXAMINATION, RIBS, UNILATERAL; INCLUDING POSTEROANTERIOR CHEST, MINIMUM OF THREE VIEWS",71101,2019.18,194.5825,24.108,112.51,185.9199342,156.8102,141.9304,129.3398,24.108,185.9199342
HOSPITAL SELECTED SHOPPABLE,"RADIOLOGIC EXAMINATION, RIBS, UNILATERAL; TWO VIEWS",71100,1261.61,144.5675,21.66,62.3,100.978878,85.1044,77.0288,70.1956,21.66,100.978878
HOSPITAL SELECTED SHOPPABLE,"RADIOLOGIC EXAMINATION, SACRUM AND COCCYX, MINIMUM OF TWO VIEWS",72220,1261.61,144.5675,19.212,62.3,100.3848846,85.1044,77.0288,70.1956,19.212,100.3848846
HOSPITAL SELECTED SHOPPABLE,"RADIOLOGIC EXAMINATION, SHOULDER; COMPLETE, MINIMUM OF TWO VIEWS",73030,1261.61,144.5675,19.56,62.3,100.978878,85.1044,77.0288,70.1956,19.56,100.978878
HOSPITAL SELECTED SHOPPABLE,"RADIOLOGIC EXAMINATION, SHOULDER; ONE VIEW",73020,1261.61,144.5675,14.664,62.3,99.7908912,85.1044,77.0288,70.1956,14.664,99.7908912
HOSPITAL SELECTED SHOPPABLE,"RADIOLOGIC EXAMINATION, SINUSES, PARANASAL, COMPLETE, MINIMUM OF THREE VIEWS",70220,1261.61,144.5675,24.456,62.3,100.978878,85.1044,77.0288,70.1956,24.456,100.978878
HOSPITAL SELECTED SHOPPABLE,"RADIOLOGIC EXAMINATION, SMALL INTESTINE, INCLUDES MULTIPLE SERIAL FILMS;",74250,2160.91,319.2525,78.66,112.51,188.2959078,156.8102,141.9304,129.3398,78.66,188.2959078
HOSPITAL SELECTED SHOPPABLE,"RADIOLOGIC EXAMINATION, SPINE, CERVICAL; COMPLETE, INCLUDING OBLIQUE AND FLEXION AND/OR EXTENSION STUDIES",72052,2019.18,194.5825,37.044,112.51,187.107921,156.8102,141.9304,129.3398,37.044,187.107921
HOSPITAL SELECTED SHOPPABLE,"RADIOLOGIC EXAMINATION, SPINE, CERVICAL; MINIMUM OF FOUR VIEWS",72050,1326.58,194.5825,29.004,112.51,186.5139276,156.8102,141.9304,129.3398,29.004,186.5139276
HOSPITAL SELECTED SHOPPABLE,"RADIOLOGIC EXAMINATION, SPINE, CERVICAL; TWO OR THREE VIEWS",72040,2019.18,144.5675,21.66,62.3,100.978878,85.1044,77.0288,70.1956,21.66,100.978878
HOSPITAL SELECTED SHOPPABLE,"RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL, BENDING VIEWS ONLY, MINIMUM OF FOUR VIEWS",72120,13053.45,194.5825,29.004,112.51,186.5139276,156.8102,141.9304,129.3398,29.004,186.5139276
HOSPITAL SELECTED SHOPPABLE,"RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; COMPLETE, INCLUDING BENDING VIEWS",72114,1261.61,194.5825,44.388,112.51,187.107921,156.8102,141.9304,129.3398,44.388,187.107921
HOSPITAL SELECTED SHOPPABLE,"RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; TWO OR THREE VIEWS",72100,2019.18,194.5825,23.412,112.51,185.9199342,156.8102,141.9304,129.3398,23.412,185.9199342
HOSPITAL SELECTED SHOPPABLE,"RADIOLOGIC EXAMINATION, SPINE, SINGLE VIEW, SPECIFY LEVEL",72020,2019.18,144.5675,14.316,62.3,99.7908912,85.1044,77.0288,70.1956,14.316,99.7908912
HOSPITAL SELECTED SHOPPABLE,"RADIOLOGIC EXAMINATION, SPINE; THORACIC, MINIMUM OF FOUR VIEWS",72074,2019.18,194.5825,27.6,112.51,186.5139276,156.8102,141.9304,129.3398,27.6,186.5139276
HOSPITAL SELECTED SHOPPABLE,"RADIOLOGIC EXAMINATION, SPINE; THORACIC, THREE VIEWS",72072,2019.18,194.5825,23.412,112.51,185.9199342,156.8102,141.9304,129.3398,23.412,185.9199342
HOSPITAL SELECTED SHOPPABLE,"RADIOLOGIC EXAMINATION, SPINE; THORACIC, TWO VIEWS",72070,2019.18,194.5825,22.356,112.51,185.9199342,156.8102,141.9304,129.3398,22.356,185.9199342
HOSPITAL SELECTED SHOPPABLE,"RADIOLOGIC EXAMINATION, WRIST; COMPLETE, MINIMUM OF THREE VIEWS",73110,1368,144.5675,25.86,62.3,100.978878,85.1044,77.0288,70.1956,25.86,100.978878
HOSPITAL SELECTED SHOPPABLE,"RADIOLOGIC EXAMINATION, WRIST; TWO VIEWS",73100,1261.61,144.5675,22.356,62.3,100.978878,85.1044,77.0288,70.1956,22.356,100.978878
HOSPITAL SELECTED SHOPPABLE,"RADIOLOGIC EXAMINATION; CLAVICLE, COMPLETE",73000,2019.18,144.5675,19.212,62.3,100.3848846,85.1044,77.0288,70.1956,19.212,100.3848846
HOSPITAL SELECTED SHOPPABLE,"RADIOLOGIC EXAMINATION; FOREARM, TWO VIEWS",73090,2019.18,144.5675,17.112,62.3,100.3848846,85.1044,77.0288,70.1956,17.112,100.3848846
HOSPITAL SELECTED SHOPPABLE,"RADIOLOGIC EXAMINATION; HUMERUS, MINIMUM OF TWO VIEWS",73060,1261.61,144.5675,20.256,62.3,100.978878,85.1044,77.0288,70.1956,20.256,100.978878
HOSPITAL SELECTED SHOPPABLE,"RADIOLOGIC EXAMINATION; TIBIA AND FIBULA, TWO VIEWS",73590,1261.61,144.5675,19.908,62.3,100.978878,85.1044,77.0288,70.1956,19.908,100.978878
HOSPITAL SELECTED SHOPPABLE,RADIOPHARMACEUTICAL DIAGNOSTIC NOT OTHERWISE CLASSIFIED,A4641,139.35,0,0,0,0,0,0,0,0,0
HOSPITAL SELECTED SHOPPABLE,SARS-COV-2 NEC,0240U,713.15,0,0,0,0,0,0,0,0,0
HOSPITAL SELECTED SHOPPABLE,"SCREENING TEST OF VISUAL ACUITY, QUANTITATIVE, BILATERAL",99173,382.66,0,0,0,0,3.23,3.23,3.23,0,3.23
HOSPITAL SELECTED SHOPPABLE,"SEDIMENTATION RATE, ERYTHROCYTE; AUTOMATED",85652,122.39,0,2.676,0,0,3.33,3.33,3.33,0,3.33
HOSPITAL SELECTED SHOPPABLE,"SMEAR, PRIMARY SOURCE WITH INTERPRETATION; FLUORESCENT AND/OR ACID FAST STAIN FOR BACTERIA, FUNGI, PARASITES, VIRUSES OR CELL TYPES",87206,110.85,0,5.352,0,0,6.65,6.65,6.65,0,6.65
HOSPITAL SELECTED SHOPPABLE,"SMEAR, PRIMARY SOURCE WITH INTERPRETATION; GRAM OR GIEMSA STAIN FOR BACTERIA, FUNGI, OR CELL TYPES",87205,73.38,0,4.236,0,0,5.27,5.27,5.27,0,5.27
HOSPITAL SELECTED SHOPPABLE,"SPECIAL STAINS (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY SERVICE); GROUP I FOR MICROORGANISMS (EG, GRIDLEY, ACID FAST, METHENAMINE SILVER), EACH",88312,326.29,88.8125,57.972,50.98,0,44.7,44.7,44.7,0,57.972
HOSPITAL SELECTED SHOPPABLE,"SPECIAL STAINS (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY SERVICE); GROUP II, ALL OTHER (EG, IRON, TRICHROME), EXCEPT IMMUNOCYTOCHEMISTRY AND IMMUNOPEROXIDASE STAINS, EACH",88313,351.89,60.4975,48.312,32.12,0,31.8,31.8,31.8,0,48.312
HOSPITAL SELECTED SHOPPABLE,SYPHILIS TEST; QUANTITATIVE,86593,75.63,0,4.368,0,0,5.44,5.44,5.44,0,5.44
HOSPITAL SELECTED SHOPPABLE,"TECHNETIUM TC-99M MEBROFENIN, DIAGNOSTIC, PER STUDY DOSE, UP TO 15 MILLICURIES",A9537,63.56,0,0,0,0,0,0,0,0,0
HOSPITAL SELECTED SHOPPABLE,"TETANUS, DIPHTHERIA TOXOIDS AND ACELLULAR PERTUSSIS VACCINE (TDAP), WHEN ADMINISTERED TO INDIVIDUALS 7 YEARS OR OLDER, FOR INTRAMUSCULAR USE",90715,422.49,0,0,0,0,0,0,0,0,0
HOSPITAL SELECTED SHOPPABLE,"THERAPEUTIC, PROPHYLACTIC, OR DIAGNOSTIC INJECTION (SPECIFY SUBSTANCE OR DRUG); EACH ADDITIONAL SEQUENTIAL INTRAVENOUS PUSH OF A NEW SUBSTANCE/DRUG (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)",96375,1406.25,71.5225,0,37.88,0,18.3,18.3,18.3,0,37.88
HOSPITAL SELECTED SHOPPABLE,"THERAPEUTIC, PROPHYLACTIC, OR DIAGNOSTIC INJECTION (SPECIFY SUBSTANCE OR DRUG); EACH ADDITIONAL SEQUENTIAL INTRAVENOUS PUSH OF THE SAME SUBSTANCE/DRUG PROVIDED IN A FACILITY (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)",96376,289.29,0,0,0,0,22.97,22.97,22.97,0,22.97
HOSPITAL SELECTED SHOPPABLE,"THERAPEUTIC, PROPHYLACTIC, OR DIAGNOSTIC INJECTION (SPECIFY SUBSTANCE OR DRUG); INTRAVENOUS PUSH, SINGLE OR INITIAL SUBSTANCE/DRUG",96374,719.75,365.6275,0,187.18,0,47.01,47.01,47.01,0,187.18
HOSPITAL SELECTED SHOPPABLE,"THERAPEUTIC, PROPHYLACTIC, OR DIAGNOSTIC INJECTION (SPECIFY SUBSTANCE OR DRUG); SUBCUTANEOUS OR INTRAMUSCULAR",96372,324,110.81,0,59.75,0,58.2,58.2,58.2,0,59.75
HOSPITAL SELECTED SHOPPABLE,THYROXINE; FREE,84439,209.7,0,8.952,0,0,11.13,11.13,11.13,0,11.13
HOSPITAL SELECTED SHOPPABLE,TRIIODOTHYRONINE T3; FREE,84481,291.13,0,16.824,0,0,20.92,20.92,20.92,0,20.92
HOSPITAL SELECTED SHOPPABLE,"TROPONIN, QUALITATIVE",84512,202.43,0,8.112,0,0,10.09,10.09,10.09,0,10.09
HOSPITAL SELECTED SHOPPABLE,"ULTRASONIC GUIDANCE FOR NEEDLE PLACEMENT (EG, BIOPSY, ASPIRATION, INJECTION, LOCALIZATION DEVICE), IMAGING SUPERVISION AND INTERPRETATION",76942,2589,0,27.252,0,0,38.3463,34.7076,31.6287,0,38.3463
HOSPITAL SELECTED SHOPPABLE,ULTRASOUND EXTREMITY NONVASCULAR REAL-TIME WITH IMAGE DOCUMENTATION; LIMITED ANATOMIC SPECIFIC,76882,1520.97,194.5825,32.844,112.51,187.107921,156.8102,141.9304,129.3398,32.844,187.107921
HOSPITAL SELECTED SHOPPABLE,"ULTRASOUND, ABDOMINAL, REAL TIME WITH IMAGE DOCUMENTATION; LIMITED (EG, SINGLE ORGAN, QUADRANT, FOLLOW-UP)",76705,1594.29,194.5825,61.884,112.51,187.7019144,156.8102,141.9304,129.3398,61.884,187.7019144
HOSPITAL SELECTED SHOPPABLE,"ULTRASOUND, EXTREMITY, NONVASCULAR, REAL-TIME WITH IMAGE DOCUMENTATION; COMPLETE",76881,2009.44,194.5825,69.576,112.51,187.7019144,97.8454,88.5608,80.7046,69.576,187.7019144
HOSPITAL SELECTED SHOPPABLE,"ULTRASOUND, PELVIC (NONOBSTETRIC), REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE",76856,2044.21,194.5825,75.516,112.51,187.7019144,156.8102,141.9304,129.3398,75.516,187.7019144
HOSPITAL SELECTED SHOPPABLE,"ULTRASOUND, PELVIC (NONOBSTETRIC), REAL TIME WITH IMAGE DOCUMENTATION; LIMITED OR FOLLOW-UP (EG, FOR FOLLICLES)",76857,2550.43,194.5825,23.412,112.51,185.9199342,156.8102,141.9304,129.3398,23.412,185.9199342
HOSPITAL SELECTED SHOPPABLE,"ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTATION, FIRST TRIMESTER FETAL NUCHAL TRANSLUCENCY MEASUREMENT, TRANSABDOMINAL OR TRANSVAGINAL APPROACH; SINGLE OR FIRST GESTATION",76813,2865.56,194.5825,61.176,112.51,0,156.8102,141.9304,129.3398,0,156.8102
HOSPITAL SELECTED SHOPPABLE,"ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTATION, LIMITED (EG, FETAL HEART BEAT, PLACENTAL LOCATION, FETAL POSITION AND/OR QUALITATIVE AMNIOTIC FLUID VOLUME), ONE OR MORE FETUSES",76815,2300,194.5825,51.732,112.51,187.7019144,156.8102,141.9304,129.3398,51.732,187.7019144
HOSPITAL SELECTED SHOPPABLE,"ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTATION, TRANSVAGINAL",76817,2865.56,194.5825,59.076,112.51,187.7019144,156.8102,141.9304,129.3398,59.076,187.7019144
HOSPITAL SELECTED SHOPPABLE,"ULTRASOUND, RETROPERITONEAL (EG, RENAL, AORTA, NODES), REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE",76770,2865.56,194.5825,76.212,112.51,188.2959078,156.8102,141.9304,129.3398,76.212,188.2959078
HOSPITAL SELECTED SHOPPABLE,"ULTRASOUND, RETROPERITONEAL (EG, RENAL, AORTA, NODES), REAL TIME WITH IMAGE DOCUMENTATION; LIMITED",76775,1754.99,194.5825,29.004,112.51,186.5139276,156.8102,141.9304,129.3398,29.004,186.5139276
HOSPITAL SELECTED SHOPPABLE,"ULTRASOUND, SCROTUM AND CONTENTS",76870,1589.75,194.5825,35.652,112.51,187.107921,156.8102,141.9304,129.3398,35.652,187.107921
HOSPITAL SELECTED SHOPPABLE,"ULTRASOUND, SOFT TISSUES OF HEAD AND NECK (EG, THYROID, PARATHYROID, PAROTID), REAL TIME WITH IMAGE DOCUMENTATION",76536,2865.56,194.5825,88.104,112.51,188.2959078,156.8102,141.9304,129.3398,88.104,188.2959078
HOSPITAL SELECTED SHOPPABLE,"ULTRASOUND, TRANSRECTAL;",76872,2865.56,194.5825,62.58,112.51,187.7019144,88.0088,79.6576,72.5912,62.58,187.7019144
HOSPITAL SELECTED SHOPPABLE,"UNLISTED ULTRASOUND PROCEDURE (EG, DIAGNOSTIC, INTERVENTIONAL)",76999,1948.41,144.5675,0,62.3,0,85.1044,77.0288,70.1956,0,85.1044
HOSPITAL SELECTED SHOPPABLE,URIC ACID; BLOOD,84550,318.02,0,4.488,0,0,5.58,5.58,5.58,0,5.58
HOSPITAL SELECTED SHOPPABLE,URIC ACID; OTHER SOURCE,84560,179.54,0,4.716,0,0,5.86,5.86,5.86,0,5.86
HOSPITAL SELECTED SHOPPABLE,URINALYSIS; MICROSCOPIC ONLY,81015,124.12,0,3.024,0,0,3.76,3.76,3.76,0,3.76
HOSPITAL SELECTED SHOPPABLE,"UROGRAPHY, RETROGRADE, WITH OR WITHOUT KUB",74420,5636.56,658.1575,443.448,385.88,752.5896378,623.4459,564.2868,514.2291,385.88,752.5896378
HOSPITAL SELECTED SHOPPABLE,VANCOMYCIN,80202,1764.75,0,13.44,0,0,16.72,16.72,16.72,0,16.72
HOSPITAL SELECTED SHOPPABLE,XRAY- CHEST; SINGLE VIEW,71045,659.92,144.5675,12.564,62.3,99.1968978,85.1044,77.0288,70.1956,12.564,99.1968978
HOSPITAL SELECTED SHOPPABLE,"X-RAY, ABDOMEN; 1 VIEW",74018,994.92,144.5675,17.808,62.3,100.3848846,85.1044,77.0288,70.1956,17.808,100.3848846
HOSPITAL SELECTED SHOPPABLE,"X-RAY, ABDOMEN; 2 VIEW",74019,729.95,194.5825,21.312,112.51,185.9199342,156.8102,141.9304,129.3398,21.312,185.9199342
HOSPITAL SELECTED SHOPPABLE,"X-RAY, CHEST; 2 VIEWS",71046,839.3,144.5675,19.212,62.3,100.3848846,85.1044,77.0288,70.1956,19.212,100.3848846
HOSPITAL SELECTED SHOPPABLE,"XRAY, FEMUR, 2 VIEWS",73552,1261.61,144.5675,23.052,62.3,100.978878,85.1044,77.0288,70.1956,23.052,100.978878
HOSPITAL SELECTED SHOPPABLE,"XRAY, HIP, UNILATERAL, WITH PELVIS WHEN PERFORMED, 1 VIEW",73501,2571.81,144.5675,20.256,62.3,100.978878,85.1044,77.0288,70.1956,20.256,100.978878
HOSPITAL SELECTED SHOPPABLE,"XRAY, HIP, UNILATERAL, WITH PELVIS WHEN PERFORMED, 2-3 VIEWS",73502,1154.99,144.5675,29.7,62.3,101.5728714,85.1044,77.0288,70.1956,29.7,101.5728714
HOSPITAL SELECTED SHOPPABLE,"XRAY, HIPS, BILATERAL WITH PELVIS WHEN PERFORMED; 3-4 VIEWS",73522,2019.18,194.5825,33.204,112.51,187.107921,156.8102,141.9304,129.3398,33.204,187.107921
HOSPITAL SELECTED SHOPPABLE,"XRAY, HIPS, BILATERAL WITH PELVIS WHEN PERFORMED; MIN 5 VIEWS",73523,2939.07,194.5825,39.84,112.51,187.107921,56.0467,50.7284,46.2283,39.84,187.107921