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Average Charges Billed to Insurance Companies

Effective 12/18. Prices are subject to change without notice.

Diagnostic Imaging (Xray/MRI), Laboratory Tests, Inpatient Room Rate and Surgery/Anesthesia Charges

CHARGE DESCRIPTION DEPARTMENT RATE
Ultrasnd Guide Interscale ANES $603.64
Ultrasnd Guide Needle Pla ANES $603.64
Anesthesia 1st Hour ANES $1,091.09
Anesthesia Ea Add 15 Min ANES $109.11
Platelets, Pheresis, Lr BB $2,535.16
Fresh Frozen Plasma/Unit BB $209.43
Arc Blood / Prbc Lr BB $465.14
Ekg CARD $123.50
CT Abdomen W/O Contrast CT $1,444.25
CT Neck Soft Tissue W/O Contrast CT $1,444.25
CT Upper Extremity, Left, W/O Contrast CT $1,444.25
CT Sinus/ Facial Bones W/O Contrast CT $1,444.25
CT Upper Extremity, Left, W/ Contrast CT $1,444.25
CT Upper Extremity, Right, W/ Contrast CT $1,444.25
CT Lumbar Spine W/ Contrast CT $1,444.25
CT Thoracic Spine W/ Contrast CT $1,444.25
CT Temporal Bones/Orbits Bil W & W/O Con CT $1,920.85
CT Lower Extremity, Right, W/ & W/O Cont CT $1,920.85
CT Thoracic Spine W/ & W/O Contrast CT $1,920.85
CT Lumbar Spine W/ & W/O Contrast CT $1,920.85
CT Cervical Spine W/ & W/O Contrast CT $1,920.85
CT Abdomen, W/ & W/O Contrast CT $1,920.85
CT Chest, W/ & W/O Contrast CT $1,920.85
CTA Chest W/ May Include W/O CT $2,501.30
CTA Head W/ May Include W/O CT $2,501.30
CTA Neck W/ May Include W/O CT $2,501.30
CT Upper Extremity, Right, W/O Contrast CT $1,444.25
CT Temporal Bones/Orbit Bil W/O Contrast CT $1,444.25
CT Abdomen/Pelvis W/O Contrast CT $1,512.03
CT Abdomen/Pelvis, W/ IV Contrast CT $2,338.52
CT Brain, W/ & W/O Contrast CT $1,902.85
CT Abdomen/Pelvis, W/ & W/O Contrast CT $2,607.07
CT Chest, With IV Contrast CT $1,444.25
CT Chest W/O Contrast CT $1,444.25
CT Guided Needle Placement CT $1,980.73
CT Pelvis W/O Contrast CT $1,444.25
CT Thoracic Spine (Post Myelo) CT $1,980.73
CT Thoracic Spine W/O Contrast CT $1,444.25
CT Cervical Spine (Post Myelo) CT $1,980.73
CT Brain W/O Contrast CT $1,444.25
CT Lumbar Spine (Post Myelo) CT $1,980.73
CT Lower Extremity, Right, W/O Contrast CT $1,444.25
CT Cervical Spine W/O Contrast CT $1,444.25
CT Lower Extremity, Left, W/O Contrast CT $1,444.25
CT Lumbar Spine W/O Contrast CT $1,444.25
IgE (Immunoglobulin E) LAB $60.96
Complement, Total LAB $75.27
Protein LAB $13.59
Mitochondrial Ab LAB $117.19
Amylase Serum LAB $65.82
Anti-Dsdna LAB $139.50
Anti-Smooth Muscle Ab LAB $122.43
Lyme Disease Antibodies LAB $173.02
Crystal (Fluid) LAB $72.62
Dhea-Sulfate LAB $225.80
Genital Culture LAB $87.43
Lipase LAB $69.93
Varicella Zoster IgG LAB $130.86
Barbiturates LAB $46.74
Cocaine/Metabolite LAB $38.01
Csf Vdrl LAB $43.37
Nicotine (Urine) LAB $75.96
Cryptococcal Ag LAB $138.72
Immunohistochem Ea, Morph LAB $495.39
Anca LAB $61.47
Nicotin- Metabolite Serum LAB $95.20
Hla B27 LAB $255.49
Shbg LAB $134.67
Surgical Path Decal LAB $71.76
Stain-Group I LAB $110.96
Acute Hepatitis Panel LAB $483.69
Albumin LAB $50.31
Urine Albumin LAB $21.42
Creatinine Ratio LAB $19.17
Ferritin LAB $138.37
Fsh LAB $188.75
Fungus Id LAB $104.86
Glucose LAB $39.82
Igg Quant LAB $94.44
Iron Binding . (Tibc) LAB $88.77
Psa LAB $186.83
Progesterone LAB $211.85
Prolactin LAB $196.83
Renal Function Panel LAB $88.21
T3 Free LAB $172.09
T4 LAB $69.86
Testosterone Free LAB $258.61
Amphetamine/Methamphe 1-2 LAB $63.45
Csf Igg Quantive LAB $94.44
Albumin (Csf) LAB $52.50
Quantiferon Tb Test LAB $253.05
Estrone LAB $83.16
Body Fluid Protein LAB $44.64
Body Fluid Glucose LAB $59.52
Cortisol Plasma LAB $165.58
Parathyroid Horm, Intact LAB $419.22
Benzodiazepines;1-12 LAB $75.51
Rheumatoid Factor; Quant LAB $57.68
T4 Free Direct LAB $91.61
Testosterone Total LAB $262.22
Uric Acid LAB $45.92
Vitamin B12 (Cobalamin) LAB $145.45
Oligoclonal Banding (Csf) LAB $204.19
Surgical Path Leveliii LAB $237.12
Bilirubin Total LAB $50.94
Body Fluid Cell Count LAB $55.98
Wbc Count(Hematology) LAB $25.86
Csf Glucose LAB $39.82
Csf Cell Count LAB $55.98
Csf Protein LAB $37.20
Cannabinoids, natural LAB $46.77
Ana LAB $122.72
Bun LAB $40.03
Estradiol LAB $283.83
Hep B Surface Antibody LAB $109.11
Acid Fast Bacilli Cult LAB $109.75
Beta - Hcg: Serum Quant LAB $152.90
Culture, Fungi LAB $141.70
Liver Panel LAB $82.96
Vancomycin LAB $137.66
Arterial Puncture LAB $12.76
Sgpt LAB $53.77
Creatinine LAB $52.01
Plt LAB $113.36
Saccomanno Smear LAB $207.60
Oxymorphone LAB $78.78
Blood Gas I-Stat LAB $162.60
Albumin 250ml 5% LAB $495.81
Pregnancy Test(Serum) LAB $64.26
Anaerobic Orgs. Id LAB $82.05
Cbc With Manual Diff LAB $47.26
Crp (Hs) LAB $141.70
Hep B Surf. Ag LAB $104.93
Hepatitis C Antibody LAB $144.96
Lipid Panel LAB $136.10
Vit D 25-Hydroxyl LAB $300.62
Hiv-1 Antibodies LAB $141.70
Surgical Path Level V LAB $366.73
Tsh LAB $170.61
Bleeding Time LAB $45.70
Blood Culture LAB $104.86
Sur(Immunocytochem) First LAB $99.87
Crp LAB $21.12
Opiates 1 Or More LAB $78.78
Troponin I Istat LAB $99.90
Hgb A1c LAB $98.63
Surg Path Level Iv-Prosta LAB $237.12
Coagulase Test LAB $51.37
Surgical Path Level Iv LAB $237.12
Drug Test Definit 1-7 Mcr LAB $116.31
Aerobic Bact Id Except Ua LAB $82.05
Sur(Immunocytochem) Addl LAB $99.87
Sedimentation Rate LAB $36.00
Sodium LAB $48.89
Manual Diffential LAB $37.20
Cult Bact Urine Routine LAB $81.97
Hemogram With Platelets LAB $65.75
Comp Test I.S. Technique LAB $212.55
Comp. Test Antiglbn Tech LAB $191.30
Comp. Test Incub. Techniq LAB $177.13
Antibody Screen LAB $111.95
Rho (D) LAB $73.69
Blood Type; Abo LAB $30.33
Antibiotic Sens Microtite LAB $87.78
Drug Screen, Qualita, Mul LAB $296.88
Potassium LAB $46.69
Stone Analysis LAB $204.00
Anaerobic Culture LAB $141.70
Gram Stain LAB $43.37
Aerobic Culture LAB $141.70
Ptt LAB $60.94
Ua Non-Auto W/Microscopy LAB $31.39
Pregnancy Urine LAB $64.26
Prothrombin Time LAB $39.89
Urinalysis LAB $26.00
Magnesium LAB $68.09
Hematocrit LAB $24.09
Hgb LAB $24.09
Compreh Metab Panel LAB $141.70
Cbc Auto Diff LAB $47.26
Basic Metabolic LAB $86.02
Venipuncture/Finger Stick LAB $21.26
MRI Elbow Left W/O Contrast MRI $1,133.05
MRI Humerus Right W/O Contrast MRI $1,133.05
MRI Hand Right W/O Contrast MRI $1,133.05
MRI Hand Left W/O Contrast MRI $1,133.05
MRI Ankle Right W/O Contrast MRI $1,133.05
MRI Foot Right W/O Contrast MRI $1,133.05
MRI Foot Left W/ Contrast MRI $1,133.05
MRI Humerus Right W/ & W/O Contrast MRI $1,506.96
MRI Hand Left W/ & W/O Contrast MRI $1,506.96
MRI Hip Left W/ & W/O Contrast MRI $1,506.96
MRI Knee Right W/ & W/O Contrast MRI $1,506.96
MRI Orbit/Face/ Neck W/O Contrast MRI $2,719.31
MRI Chest W/O Contrast MRI $2,719.31
MRI Lumbar Spine W/ Contrast MRI $2,719.31
MRI Pelvis W/ Contrast MRI $2,719.31
MRI Abdomen W/O Contrast MRI $2,719.31
MRA Brain W/ Contrast MRI $2,719.31
MRA Neck W/ Contrast MRI $2,719.31
MRI Chest W/ & W/O Contrast MRI $3,616.68
MRI Abdomen W/ & W/O Contrast MRI $3,616.68
MRA Brain W/ & W/O Contrast MRI $3,616.68
MRI Elbow Right W/O Contrast MRI $1,133.05
MRI Wrist Right W/O Contrast MRI $1,133.05
MRI Hip Right W/ & W/O Contrast MRI $1,506.96
MRI Femur Left W/ & W/O Contrast MRI $1,506.96
MRI Orbit/Face/Neck W/ & W/O Contrast MRI $3,616.68
MRI Hip Right W/ Contrast MRI $1,133.05
MRI Foot Left W/O Contrast MRI $1,133.05
MRI Shoulder Right W/ Contrast MRI $1,133.05
MRI Shoulder Left W/ Contrast MRI $1,133.05
MRI Hip Left W/O Contrast MRI $1,133.05
MRI Pelvis W/ & W/O Contrast MRI $3,616.68
MRI Hip Right W/O Contrast MRI $1,133.05
MRI Hip Left W/ Contrast MRI $1,133.05
MRA Brain W/O Contrast MRI $2,719.31
MRI Pelvis W/O Contrast MRI $2,719.31
MRI Shoulder Left W/O Contrast MRI $1,133.05
MRI Shoulder Right W/O Contrast MRI $1,133.05
MRI Brain W/O Contrast MRI $2,719.31
MRI Knee Left W/O Contrast MRI $1,133.05
MRI Knee Right W/O Contrast MRI $1,133.05
MRI Thoracic Spine W/ & W/O Contrast MRI $3,616.68
MRI Thoracic Spine W/O Contrast MRI $2,719.31
MRI Cervical Spine W/ & W/O Contrast MRI $3,616.68
MRI Brain W/ & W/O Contrast MRI $3,918.49
MRI Lumbar Spine W/ & W/O Contrast MRI $3,616.68
MRI Cervical Spine W/O Contrast MRI $2,719.31
MRI Lumbar Spine W/O Contrast MRI $2,719.31
Myelogram Lumbar Spine, Different Physic MYLO $1,529.11
Myelogram Thoracic Spine, Same Physician MYLO $1,679.52
Myelogram Cervical/ Thoracic Spine, Same MYLO $1,679.52
Myelogram Thoracic/ Lumbar Spine, Same P MYLO $1,679.52
Myelogram Cerv/ Thor/ Lumb Spine Same P MYLO $1,679.52
Myelogram Cervical/ Lumbar Spine, Same P MYLO $1,679.52
Myelogram Cervical Spine, Same Physician MYLO $1,679.52
Myelogram Lumbar Spine, Same Physician MYLO $1,679.52
Iv Infus > 8 Hrs Portable/Implant Pump NUR $760.89
Iv Push Ea Add Seq New Rx NUR $62.17
Ther/Pro/Dx Ivp Sgl/Initi NUR $62.17
Observation 1st Hr NUR $250.00
Iv Push Ea Add Seq Sam Rx NUR $62.17
Adm Influenza Vaccine NUR $162.60
Obs Sub Day Add Hr NUR $41.25
Obs 1st Day @ Add Hr NUR $41.25
Adm Pneumococal Vaccine NUR $162.60
Cpm Daily Charge NUR $75.00
Foot Pump Daily NUR $45.90
Pca Pump Daily NUR $56.95
Iv Pump Daily NUR $22.62
Med/Surg Private Room NUR $990.00
Scd Pump Daily NUR $45.90
Ot Eval, Mod Complexity OT $327.33
Ot Eval, Low Complexity OT $297.57
Aspiration Facet Joint Synovial Cyst PAIN $384.99
Brachial Plexus PAIN $1,476.69
Carpal Tunnel Inj Single PAIN $693.00
Cervical Plexus Injection PAIN $1,482.84
Destruct Neur Agt 2/3 Foramen Oval_Monit PAIN $4,394.94
Intermed Jnt/Bursa Wo Us PAIN $384.99
Intralesional < 7 Lesions PAIN $136.43
Iv Push Ea Add Seq New Rx PAIN $62.17
Liolinguinal Block PAIN $1,051.11
Ppump Analysis Only PAIN $383.50
Prudendal Nerve Block PAIN $1,051.11
Single Inj/Baclofen W Image Guide PAIN $1,062.60
Single Inj/Baclofen W/O Image Guide PAIN $1,062.60
Snrb L/S Ea Add Lvl #1 PAIN $350.37
Spinal Punct Lumb Diag PAIN $2,452.74
Stim Trial Lead Revision PAIN $630.12
Coccyx Injection PAIN $401.93
Erector Spinae Plane Block PAIN $384.99
RFA Trigeminal Nerv PAIN $1,834.20
Sclatic Block PAIN $1,051.11
Simple Ns Prog 1st Hour PAIN $229.48
Stellate Gang (Cerv Symp) PAIN $1,051.11
Celiac Piexus PAIN $1,476.69
Femoral Nerve Block PAIN $1,051.11
Intercostal, Multiple PAIN $1,051.11
RFA Intercostal Nerve PAIN $1,476.69
Seroma Aspiration PAIN $260.00
Snrb L/S Single PAIN $1,051.11
Transforaminal C/T Single PAIN $1,051.11
1 Ld Stim Trial Time 15 M PAIN $1,137.50
Facet/MBNB C/T 3rd & add?l level(s) PAIN $492.25
Ganglion Impar Symp Block PAIN $401.93
Lumbar (Paravertebrl Sym) PAIN $1,051.11
Major Joint/Bursa W/Ultrasound PAIN $602.88
1 Ld Stim Trial 1st 1/2 H PAIN $12,675.00
Ppump Reprog W/ Analy PAIN $383.50
Botox Inj Facial Cerv Bil PAIN $401.93
Injection Hip Arthrogram PAIN $571.00
Injection Shoulder Arthrogram PAIN $571.00
Iv Inf Ther/Prop Ea Add PAIN $15.00
Side Port Study Pain Mgmt PAIN $322.29
Axillary Nerve Block PAIN $1,051.11
Botox Injection-Cervical PAIN $401.93
Trigeminat, Any Branch PAIN $384.99
Cons Sedation Same Phy Add'L 15 Min PAIN $75.00
Epidural Blood Patch PAIN $937.60
Piriformis Block PAIN $1,051.11
E & M Est Outpt - Detailed PAIN $192.00
2ld Stim Trial Time 15 Mi PAIN $2,275.00
Ther/Pro/Dx Ivp Sgl/Initi PAIN $62.17
Tpi, 3 Muscles #sites() PAIN $384.99
Tendon Sheath Inj, Ligament PAIN $384.99
Facet/MBNB L/S 3rd & add?l level(s) PAIN $492.25
E & M Est Outpt - Expanded PAIN $162.00
Interscalene Block PAIN $1,476.69
Iv Inf Ther/Prop Ini 1 Hr PAIN $157.00
Greater Occipital PAIN $602.88
Epidural Steroid Inj W/Imag Guide Thor PAIN $1,062.60
E & M Est Outpt - Focused PAIN $123.00
Trnsfrmnl L/S Ea Add Lvl1 PAIN $350.37
Epidural Steroid Inj W/Imag Guide Caudl PAIN $1,062.60
Tpi, 1-2 Muscles #sites() PAIN $384.99
Rfa Periph Nerv/Si Joint PAIN $1,476.69
Facet/MBNB C/T 2nd level PAIN $492.25
Discogram, Lumbar Rad Supervision Interp PAIN $4,355.03
Omnipaque 240/20ML / ML PAIN $7.50
Rfa Facet Cerv/Thor Singl PAIN $2,501.37
Injection, Discogram Lumbar Ea Level PAIN $1,170.00
Rfa Facet Cerv/Thor Ea Ad PAIN $880.00
Omnipague 300/10ML / ML PAIN $7.50
Sacroixac Joint Inj PAIN $2,301.65
E & M Est Outpt - Minimal PAIN $114.65
Facet/MBNB C/T single PAIN $1,476.69
2ld Stim Trial 1st 1/2 Hr PAIN $18,460.00
Ppump Refill/Reprog Phys PAIN $767.00
Major Joint/Bursa W/O Us PAIN $602.88
Rfa Factet Lumbar Single PAIN $2,501.37
Facet/MBNB L/S 2nd level PAIN $492.25
Rfa Facet Lumbar Ea Addl PAIN $880.00
Epidural Steroid Inj W/Imag Guide Cerv PAIN $1,062.60
Facet/MBNB L/S single PAIN $1,476.69
Transforaminal L/S Single PAIN $1,051.11
Othr Peripheral Nrv Blck PAIN $401.93
Cons Sedation Same Phy 5y 1st 15 Min PAIN $227.50
Epidural Steroid Inj W/Imag Guide Lmbr PAIN $1,062.60
Celiac Plexus Inj PCTR $2,299.80
Conscious Sedation Same Phy 5y 1st 15min PCTR $257.58
Office/Outpt High Complexity, New PCTR $449.38
Paravertebral Facet W/Imag L/S 3+ Lev PCTR $621.30
Sciatic Nerve Inj Single PCTR $1,825.57
Spin/Brain Pump Refill/Main Req Skill Ph PCTR $847.70
Tendon Sheath Inj, Ligament PCTR $846.80
Tobacco Cessation Counseling <3 min to 1 PCTR $55.88
Transforaminal Epid W Imag Gui C/T Addl PCTR $505.60
Nurse Visit PCTR $140.54
Us Guid Needle Plcmt Imag Superv/Interpr PCTR $747.42
Office/Outpt Problem Focused, New PCTR $174.32
Pudendal Nerve Injection PCTR $2,249.39
Single Tendon Origin/Insertion PCTR $828.14
Intercostal Nerve Inj Single PCTR $1,813.44
Ilioinguinal, Iliohypogastric Nerves Inj PCTR $1,876.97
Aspirat/Inj Intermed Joint/Bursa W/O Us PCTR $841.58
Discogram, Lumbar Rad Supervisio/Interpr PCTR $5,339.70
Inject For Discography Ea Level, Lumbar PCTR $1,588.10
Greater Occipital Nerve Inj PCTR $901.33
Perc Implant Neurostim Electrode, Epid PCTR $9,838.41
Stellate Ganglion Inj PCTR $2,255.20
Ther/Proph Dx Ing/Sub/Im PCTR $232.58
Paravertebral Facet W/Imag C/T 3+ Lev PCTR $641.93
Paravertebral Sympathetic Inj Lum/Thor PCTR $2,273.70
Transforaminal Epid W Imag Gui C/T, Sgl PCTR $2,396.75
Transforaminal Epid W Imag Gui L/S Addl PCTR $478.05
Office/Outpt Moerate Complexity, New PCTR $373.52
Intercostal Nerve Inj Multiple PCTR $2,301.20
Rfa Intercostal Nerve PCTR $2,597.54
Trigger Point Inj 1-2 Muscles PCTR $843.28
Pump Reprog W/Analysis PCTR $907.15
Rfa Facet Cerv/Thor Ea Addl PCTR $1,047.88
Fluoroguide For Spine/Therapeu Inject PCTR $824.14
Rfa Peripheral Nerve/Si Joint PCTR $2,300.85
Sacroiliac Joint Inj PCTR $955.53
Office/Outpt Expand Problem Foc, New PCTR $220.36
Fluoroguide Needle Plcmt PCTR $820.97
Aspirat/Inj Major Joint/Bursa W/O Us PCTR $862.70
Paravertebral Facet W/Imag C/T 2 Lev PCTR $640.30
Rfa Facet Lumbar Ea Addl PCTR $1,026.68
Rfa Facet Lumbar Sgl PCTR $5,624.64
Rfa Facet Cerv/Thor Sgl PCTR $5,632.22
Trigger Point Inj 3+ Muscles PCTR $856.00
Other Peripheral Nerve Branch Inj PCTR $1,772.66
Paravertebral Facet W/Imag L/S 2 Lev PCTR $619.68
Paravertebral Facet W/Imag L/S 1 Lev PCTR $2,297.67
Transforaminal Epid W Imag Gui L/S, Sgl PCTR $2,350.00
Office/Outpt Expand Problem Foc Estab PCTR $171.90
Office/Outpt Problem Focused, Establish PCTR $140.54
Paravertebral Facet W/Imag C/T 1 Lev PCTR $2,336.07
Office/Outpt Low Complexity, New PCTR $270.46
Office/Outpt Moderate Complexity, Estab PCTR $275.22
Epidural Steroid Inj/W Imag Gu Cerv/Thor PCTR $1,916.84
Epidural Steroid Inj/W Imag Guid Lumbar PCTR $1,893.77
Office/Outpt Low Complexity, Establish PCTR $221.48
Abdominal Wound Pocket Revision PCTR - HSP $229.55
Destruct Neur Agt 2/3 Foramen Oval_Monit PCTR - HSP $1,155.23
Hospital Discharge Day Management PCTR - HSP $142.06
Intralesional < 7 Lesions PCTR - HSP $76.10
Ppump Analysis Only PCTR - HSP $62.38
Removal Spinal Neuro Stim Electrode Perc PCTR - HSP $784.08
Removal Subcutaneous Reservoir/Pump Intr PCTR - HSP $708.25
Simple Ns Prog 1st Hour PCTR - HSP $100.30
Stim Trial Lead Revision PCTR - HSP $170.55
Carpal Tunnel Injection PCTR - HSP $139.08
Fluoroguide Needle Plcmt PCTR - HSP $217.33
Implant Neurostimulator Elect Array Perc PCTR - HSP $826.60
Intercostal Nerve Inj Single PCTR - HSP $165.08
Office/Outpt Problem Focused, New PCTR - HSP $51.72
Revise/Remove Spine Neuro Stim Gen/ Rec PCTR - HSP $888.13
RFA Trigeminal Nerv PCTR - HSP $542.23
Pudendal Nerve Injection PCTR - HSP $198.43
Single Tendon Origin/Insertion PCTR - HSP $104.73
Stellate Ganglion Inj PCTR - HSP $178.68
Tendon Sheath Inj, Ligament PCTR - HSP $96.05
Aspirat/Inj Small Joint/Bursa W/O Us PCTR - HSP $86.83
Ganglion Impar Symp Block PCTR - HSP $170.55
Ilioinguinal, Iliohypogastric Nerves Inj PCTR - HSP $228.60
Major Joint/Bursa W/Ultrasound PCTR - HSP $149.38
Perc Vertebral Augmentation T/L Ea Addl PCTR - HSP $545.88
Perc Vertebral Augmentation, Lumbar PCTR - HSP $1,174.78
Seroma Aspiration PCTR - HSP $229.55
Aspirat/Inj Intermed Joint/Bursa W/O Us PCTR - HSP $90.83
Celiac Plexus Inj PCTR - HSP $223.28
Transforaminal Epid W Imag Gui C/T, Sgl PCTR - HSP $320.23
Sciatic Nerve Inj Single PCTR - HSP $177.20
Botox Inj Facial Cerv Bil PCTR - HSP $294.63
RFA Intercostal Nerve PCTR - HSP $412.95
Chemodenervation Musc Neck Dystonia PCTR - HSP $259.08
Trigeminal Nerve Inj, Any Branch PCTR - HSP $170.55
Perc Vertebral Augmentation, Thoracic PCTR - HSP $1,262.35
Office/Outpt Moerate Complexity, New PCTR - HSP $250.92
Pump Reprog W/Analysis PCTR - HSP $86.10
Epidural Blood Patch Inj PCTR - HSP $278.65
Implant/Revise Of Cath Via Pump wo Lami PCTR - HSP $960.78
Paravertebral Sympathetic Inj Lum/Thor PCTR - HSP $197.18
Implant/Replace Dev Program Inc Prepare PCTR - HSP $920.78
Paravertebral Facet W/Imag C/T 3+ Lev PCTR - HSP $149.68
Discogram, Lumbar Rad Supervisio/Interpr PCTR - HSP $105.58
Intercostal Nerve Inj Multiple PCTR - HSP $224.68
Office/Outpt Expand Problem Foc, New PCTR - HSP $97.76
Greater Occipital Nerve Inj PCTR - HSP $150.58
Paravertebral Facet W/Imag L/S 3+ Lev PCTR - HSP $129.05
Laminectomy Implant Neurostim Elect Plat PCTR - HSP $1,964.25
Transforaminal Epid W Imag Gui L/S Addl PCTR - HSP $127.68
Trigger Point Inj 1-2 Muscles PCTR - HSP $92.53
Insrt/Redo Spine Neuro Stim Generator PCTR - HSP $874.10
Rfa Facet Cerv/Thor Ea Addl PCTR - HSP $167.88
Inject For Discography Ea Level, Lumbar PCTR - HSP $418.10
Trigger Point Inj 3+ Muscles PCTR - HSP $105.25
Rfa Peripheral Nerve/Si Joint PCTR - HSP $224.33
Paravertebral Facet W/Imag C/T 2 Lev PCTR - HSP $148.05
Rfa Facet Cerv/Thor Sgl PCTR - HSP $551.10
Anl Sp Inf Pmp W/Mdreprg & Fil PCTR - HSP $113.83
Office/Outpt Problem Focused, Establish PCTR - HSP $17.94
Aspirat/Inj Major Joint/Bursa W/O Us PCTR - HSP $111.95
Office/Outpt Low Complexity, New PCTR - HSP $147.86
Sacroiliac Joint Inj PCTR - HSP $204.78
Rfa Facet Lumbar Sgl PCTR - HSP $543.53
Other Peripheral Nerve Branch Inj PCTR - HSP $124.29
Office/Outpt Expand Problem Foc Estab PCTR - HSP $49.30
Perc Implant Neurostim Electrode, Epid PCTR - HSP $1,005.20
Rfa Facet Lumbar Ea Addl PCTR - HSP $146.68
Paravertebral Facet W/Imag C/T 1 Lev PCTR - HSP $259.55
Office/Outpt Moderate Complexity, Estab PCTR - HSP $152.62
Paravertebral Facet W/Imag L/S 2 Lev PCTR - HSP $127.43
Paravertebral Facet W/Imag L/S 1 Lev PCTR - HSP $221.15
Conscious Sedation Same Phy 5y 1st 15min PCTR - HSP $30.08
Epidural Steroid Inj/W Imag Gu Cerv/Thor PCTR - HSP $268.48
Transforaminal Epid W Imag Gui L/S, Sgl PCTR - HSP $273.48
Office/Outpt Low Complexity, Establish PCTR - HSP $98.88
Epidural Steroid Inj/W Imag Guid Lumbar PCTR - HSP $245.40
Extend Care Op Rad 1st Hr PPOP $195.00
Extend Care Op Rad Ea Add PPOP $65.00
Extended Recovery Rm 1 Hr PPOP $195.00
Recovery Room 1st Hour PPOP $390.00
Recovery Rm Ea Add 15 Min PPOP $39.00
Extended Rec Rm Ea Add Hr PPOP $65.00
Pt Crutch Training 1/4 Hr PT $73.69
Pt Re-Evaluation PT $144.76
Pt Eval, Mod Complexity PT $327.33
Ot Ther Exercise 1/4 Hour PT $73.69
Ot Adl Training 1/4 Hour PT $73.69
Pt Gait Training 1/4 Hour PT $73.69
Pt Ther Exercise 1/4 Hour PT $73.69
Therapeutic Activ, 15 Min PT $105.33
Pt Eval, Low Complexity PT $297.57
XR Clavicle Left RAD $332.05
XR Elbow Left 3 Views RAD $332.05
XR Elbow Right 3 Views RAD $332.05
XR Forearm Left 2 Views RAD $332.05
XR Forearm Right 2 Views RAD $332.05
XR Humerus Left 2+ Views RAD $332.05
XR Humerus Right 2+ Views RAD $332.05
XR Ribs Right W/ PA Chest 3+ Views RAD $332.05
XR Tibia Fibula Right RAD $332.05
XR Wrist Right 3+ Views RAD $332.05
XR Elbow Right 2 Views RAD $332.05
XR Foot Left 2 Views RAD $332.05
XR Foot Right 2 Views RAD $332.05
XR Hand Right 2 Views RAD $332.05
XR Ribs Uniliateral 1 View LT-Mod 52 RAD $340.08
XR Ribs Unilateral 1 View RT-Mod 52 RAD $340.08
XR Hips Bilateral 3-4view May Inc Pelvis RAD $562.66
XR Abdomen 3 + View RAD $332.05
XR Foot Right 3 Views RAD $332.05
XR Knee Left 4+ Views RAD $332.05
XR Wrist Left 3+ Views RAD $332.05
XR Ankle Right 2 Views RAD $332.05
XR Clavicle Right RAD $332.05
XR Hand Right 3 Views RAD $332.05
XR Elbow Left 2 Views RAD $332.05
XR Knee Right 4+ Views RAD $261.60
XR Abdomen 2 view RAD $332.05
XR Foot Left 3 Views RAD $332.05
XR Wrist Left 2 Views RAD $332.05
XR Sacroiliac Joints 3+ Views RAD $332.05
XR Hand Left 3 Views RAD $332.05
XR Knee Right 3 Views RAD $332.05
XR Ankle Left 3 Views RAD $332.05
XR Ankle Right 3 Views RAD $332.05
XR Knee Left 3 Views RAD $332.05
XR Eye Exam For Foreign Body RAD $332.05
XR Knee 1-2 Views Bilateral RAD $332.05
XR Hip Left 2-3 Views May Inc Pelvis RAD $332.05
XR Thoracic Spine 3 Views RAD $332.05
XR Ribs Unilateral 2 Views RAD $261.60
XR Skull 1-3 Views RAD $332.05
XR Shoulder Left 2+ Views RAD $332.05
XR Wrist Right 2 Views RAD $332.05
XR Hip Right 2-3 Views May Inc Pelvis RAD $332.05
XR L-Spine 1 View - Addl 3 RAD $332.05
XR Sacrum Coccyx 1 View RAD $332.05
XR Thoracolumbar 1 View RAD $332.05
XR Cervical Spine 6+ Views RAD $560.74
XR Shoulder Right 2+ Views RAD $332.05
XR Shoulder Right 1 View RAD $332.05
XR Shoulder Left 1 View RAD $332.05
XR Thoracic Spine 4+ Views RAD $332.05
XR Ribs Uniliateral 1 View RAD $340.08
XR Thoracolumbar 2+ Views RAD $332.05
XR Lumbar Spine 6+ Views RAD $560.74
XR Chest, 2 Views RAD $332.05
XR Chest, 1 View RAD $332.05
XR Cervical Spine 4+ Views RAD $560.74
XR Hips Bilateral 2 Views May Inc Pelvis RAD $562.66
XR Abdomen 1 view RAD $332.05
XR Hip Left 1 View May Include Pelvis RAD $332.05
XR Sacrum Coccyx 2+ Views RAD $332.05
XR Hip Right 1 View May Include Pelvis RAD $332.05
XR Sacroiliac Joints 1-2 Views RAD $332.05
XR C-Spine 1 View - Addl 3 RAD $332.05
XR Pelvis 1-2 Views RAD $332.05
XR Thoracic Spine 2 Views RAD $332.05
XR Lumbar Spine 4+ Views RAD $560.74
XR Knee Right 1-2 Views RAD $332.05
XR Knee Left 1-2 Views RAD $332.05
XR Thoracic Spine 1 View RAD $332.05
XR L-Spine 1 View - Addl 2 RAD $332.05
XR C-Spine 1 View - Addl 2 RAD $332.05
XR Cervical Spine 2-3 Views RAD $332.05
XR Cervical Spine 1 View RAD $332.05
XR Lumbar Spine 1 View RAD $332.05
XR Lumbar Spine 2-3 Views RAD $332.05
Fluoro Guided Needle Placement RADF $603.64
Fluoro Guidance & Localization RADF $603.64
Fluoro 1st Hour RADF $603.64
Conscious Sedation 1st 15 Minutes RADN $227.50
E & M Outpatient Focused RADN $123.00
E & M Outpatient Expanded RADN $162.00
E & M Outpatient Detailed RADN $192.00
Conscious Sedation Each Add. 15 Minutes RADN $75.00
E & M Outpatient Minimal RADN $114.65
US Retroperitoneal Real Time w Image Do RADP $312.30
Ultrasound, breast, unilateral complete RADP $324.03
Flex Endoscop Eval Swallow Cine or Video RADP $199.86
Venous Doppler Bilateral RADP $1,046.29
Venous Doppler Right RADP $1,046.29
Lumbar Puncture Diagnostic RADP $2,250.22
Venous Doppler Left RADP $1,046.29
Injection Shoulder Arthrogram RADP $571.00
Injection Hip Arthrogram RADP $571.00
Lumbar Puncture Theraputic RADP $2,250.22
Fine Needle Aspiration W/ Imaging RADP $982.86
Retrograde Pyelogram RADP $1,149.12
Omniscan 5ML / ML RADS $7.50
Gadavist (100) Injection, 0.1 ml RADS $3.36
Vpaq 320/150ml / Ml RADS $7.50
Gadavist (75) Injection, 0.1ml RADS $3.69
Omnip 350/100ML / ML RADS $7.50
Omnip 300/10ML / ML RADS $7.50
Vpaq 320/100ml / Ml RADS $7.50
Omnip 240/20ML / ML RADS $7.50
Omniscan 20ML / ML RADS $7.50
OR Level 1 First 30 Min SURG $2,125.50
OR Level 1 Ea Add 15 Min SURG $531.38
OR Level 2 1st 30 Minutes SURG $2,834.00
OR Level 2 Ea Add 15 Min SURG $637.65
OR Level 3 First 30 Min SURG $3,542.50
OR Level 3 Ea Add 15 Min SURG $708.50
OR Level 4 1st 30 Min SURG $3,542.50
OR Level 4 Ea Add 15 Min SURG $708.50
OR Level 5 1st 30 Min SURG $4,251.00
OR Level 5 Ea Add 15 Min SURG $708.50
OR Level 6 1st 30 Min SURG $4,251.00
OR Level 6 Ea Add 15 Min SURG $850.20
OR Level 7 1st 30 Min SURG $4,959.50
OR Level 7 Ea Add 15 Min SURG $991.90
OR Level 8 1st 30 Min SURG $4,959.50
OR Level 8 Ea Add 15 Min SURG $991.90
OR Level 9 1st 30 Min SURG $5,668.00
OR Level 9 Ea Add 15 Min SURG $1,027.33
OR Level 10 1st 30 Min SURG $6,376.50
OR Level 10 Ea Add 15 SURG $1,062.75