hospital_name,last_updated_on,version,hospital_location,hospital_address,license_number|SC,"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.",,,,,,,,,,,,,,,,,,,,,,,,
Allendale County Hospital,2024-07-01,2.0.0,Allendale County Hospital,"1787 Allendale-Fairfax Hwy Fairfax, SC 29827",576001334,TRUE,,,,,,,,,,,,,,,,,,,,,,,,
SERVICE DESCRIPTION,CATEGORY,BILLING MSDRG | CPT | HCPCS,ITEM/SERVICE DESCRIPTION,BILLING REVENUE CODE,GROSS CHARGES,AETNA MEDICARE OPEN PLAN,AETNA MEDICARE OPEN reimbursement method,ALLWELL MEDICARE PLAN,ALLWELL MEDICARE reimbursement method,DEVOTED HEALTH PLAN,DEVOTED HEALTH reimbursement method,EMBLEM HEALTH PLAN,EMBLEM HEALTH reimbursement method,EON HEALTH PLAN,EON HEALTH reimbursement method,FREEDOM HEALTH PLAN,FREEDOM HEALTH reimbursement method,HEALTHSUN HEALTH PLAN PLAN,HEALTHSUN HEALTH PLAN reimbursement method,HUMANA GOLD PLAN,HUMANA GOLD reimbursement method,PRUITT HEALTH PREMIER PLAN,PRUITT HEALTH PREMIER reimbursement method,UNITED HEALTHCARE MEDICARE SOLUTIONS PLAN,UNITED HEALTHCARE MEDICARE SOLUTIONS reimbursement method,WELLCARE MEDICARE ADVANTAGE PLAN,WELLCARE MEDICARE ADVANTAGE reimbursement method,De-Identified Minimum Negotiated Rate,De-Identified Maximum Negotiated Rate,DISCOUNTED CASH PRICE
Outpatient Medical Services,LAB,86376,(LKM) ANTIBODIES,300,$98.00 ,$43.12,44% of total billed charges which is 100% CMS Medicare rate,$43.12,44% of total billed charges which is 100% CMS Medicare rate,$43.12,44% of total billed charges which is 100% CMS Medicare rate,$43.12,44% of total billed charges which is 100% CMS Medicare rate,$43.12,44% of total billed charges which is 100% CMS Medicare rate,$43.12,44% of total billed charges which is 100% CMS Medicare rate,$43.12,44% of total billed charges which is 100% CMS Medicare rate,$43.12,44% of total billed charges which is 100% CMS Medicare rate,$43.12,44% of total billed charges which is 100% CMS Medicare rate,$43.12,44% of total billed charges which is 100% CMS Medicare rate,$43.12,44% of total billed charges which is 100% CMS Medicare rate,$43.12,$43.12,$83.30 
Outpatient Medical Services,LAB,86922,4 UNIT XM - ANTIGLOB,300,$230.00 ,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,$101.20,$195.50 
Outpatient Medical Services,LAB,86920,4 UNIT XM - IM SPIN,300,$230.00 ,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,$101.20,$195.50 
Outpatient Medical Services,LAB,86921,4 UNIT XM - INCUB,300,$230.00 ,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,$101.20,$195.50 
Outpatient Medical Services,LAB,86900,ABO TYPE,300,$43.00 ,$18.92,44% of total billed charges which is 100% CMS Medicare rate,$18.92,44% of total billed charges which is 100% CMS Medicare rate,$18.92,44% of total billed charges which is 100% CMS Medicare rate,$18.92,44% of total billed charges which is 100% CMS Medicare rate,$18.92,44% of total billed charges which is 100% CMS Medicare rate,$18.92,44% of total billed charges which is 100% CMS Medicare rate,$18.92,44% of total billed charges which is 100% CMS Medicare rate,$18.92,44% of total billed charges which is 100% CMS Medicare rate,$18.92,44% of total billed charges which is 100% CMS Medicare rate,$18.92,44% of total billed charges which is 100% CMS Medicare rate,$18.92,44% of total billed charges which is 100% CMS Medicare rate,$18.92,$18.92,$36.55 
Outpatient Medical Services,LAB,82009,ACETONE-SERUM QUALITATIVE,301,$29.00 ,$12.76,44% of total billed charges which is 100% CMS Medicare rate,$12.76,44% of total billed charges which is 100% CMS Medicare rate,$12.76,44% of total billed charges which is 100% CMS Medicare rate,$12.76,44% of total billed charges which is 100% CMS Medicare rate,$12.76,44% of total billed charges which is 100% CMS Medicare rate,$12.76,44% of total billed charges which is 100% CMS Medicare rate,$12.76,44% of total billed charges which is 100% CMS Medicare rate,$12.76,44% of total billed charges which is 100% CMS Medicare rate,$12.76,44% of total billed charges which is 100% CMS Medicare rate,$12.76,44% of total billed charges which is 100% CMS Medicare rate,$12.76,44% of total billed charges which is 100% CMS Medicare rate,$12.76,$12.76,$24.65 
Outpatient Medical Services,LAB,84238,ACETYLCHOLINE RECEPTOR AB,301,$286.00 ,$125.84,44% of total billed charges which is 100% CMS Medicare rate,$125.84,44% of total billed charges which is 100% CMS Medicare rate,$125.84,44% of total billed charges which is 100% CMS Medicare rate,$125.84,44% of total billed charges which is 100% CMS Medicare rate,$125.84,44% of total billed charges which is 100% CMS Medicare rate,$125.84,44% of total billed charges which is 100% CMS Medicare rate,$125.84,44% of total billed charges which is 100% CMS Medicare rate,$125.84,44% of total billed charges which is 100% CMS Medicare rate,$125.84,44% of total billed charges which is 100% CMS Medicare rate,$125.84,44% of total billed charges which is 100% CMS Medicare rate,$125.84,44% of total billed charges which is 100% CMS Medicare rate,$125.84,$125.84,$243.10 
Outpatient Medical Services,LAB,82024,ACTH LEVEL,301,$234.00 ,$102.96,44% of total billed charges which is 100% CMS Medicare rate,$102.96,44% of total billed charges which is 100% CMS Medicare rate,$102.96,44% of total billed charges which is 100% CMS Medicare rate,$102.96,44% of total billed charges which is 100% CMS Medicare rate,$102.96,44% of total billed charges which is 100% CMS Medicare rate,$102.96,44% of total billed charges which is 100% CMS Medicare rate,$102.96,44% of total billed charges which is 100% CMS Medicare rate,$102.96,44% of total billed charges which is 100% CMS Medicare rate,$102.96,44% of total billed charges which is 100% CMS Medicare rate,$102.96,44% of total billed charges which is 100% CMS Medicare rate,$102.96,44% of total billed charges which is 100% CMS Medicare rate,$102.96,$102.96,$198.90 
Outpatient Medical Services,LAB,82030,"ADENOSINE, 5-MONO CYCLIC",300,$224.00 ,$98.56,44% of total billed charges which is 100% CMS Medicare rate,$98.56,44% of total billed charges which is 100% CMS Medicare rate,$98.56,44% of total billed charges which is 100% CMS Medicare rate,$98.56,44% of total billed charges which is 100% CMS Medicare rate,$98.56,44% of total billed charges which is 100% CMS Medicare rate,$98.56,44% of total billed charges which is 100% CMS Medicare rate,$98.56,44% of total billed charges which is 100% CMS Medicare rate,$98.56,44% of total billed charges which is 100% CMS Medicare rate,$98.56,44% of total billed charges which is 100% CMS Medicare rate,$98.56,44% of total billed charges which is 100% CMS Medicare rate,$98.56,44% of total billed charges which is 100% CMS Medicare rate,$98.56,$98.56,$190.40 
Outpatient Medical Services,LAB,82105,AFP TETRA PROFILE,300,$431.00 ,$189.64,44% of total billed charges which is 100% CMS Medicare rate,$189.64,44% of total billed charges which is 100% CMS Medicare rate,$189.64,44% of total billed charges which is 100% CMS Medicare rate,$189.64,44% of total billed charges which is 100% CMS Medicare rate,$189.64,44% of total billed charges which is 100% CMS Medicare rate,$189.64,44% of total billed charges which is 100% CMS Medicare rate,$189.64,44% of total billed charges which is 100% CMS Medicare rate,$189.64,44% of total billed charges which is 100% CMS Medicare rate,$189.64,44% of total billed charges which is 100% CMS Medicare rate,$189.64,44% of total billed charges which is 100% CMS Medicare rate,$189.64,44% of total billed charges which is 100% CMS Medicare rate,$189.64,$189.64,$366.35 
Outpatient Medical Services,LAB,82040,ALBUMIN LEVEL SERUM,301,$41.00 ,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,$18.04,$34.85 
Outpatient Medical Services,LAB,80320,ALCOHOL BLOOD,301,$107.00 ,$47.08,44% of total billed charges which is 100% CMS Medicare rate,$47.08,44% of total billed charges which is 100% CMS Medicare rate,$47.08,44% of total billed charges which is 100% CMS Medicare rate,$47.08,44% of total billed charges which is 100% CMS Medicare rate,$47.08,44% of total billed charges which is 100% CMS Medicare rate,$47.08,44% of total billed charges which is 100% CMS Medicare rate,$47.08,44% of total billed charges which is 100% CMS Medicare rate,$47.08,44% of total billed charges which is 100% CMS Medicare rate,$47.08,44% of total billed charges which is 100% CMS Medicare rate,$47.08,44% of total billed charges which is 100% CMS Medicare rate,$47.08,44% of total billed charges which is 100% CMS Medicare rate,$47.08,$47.08,$90.95 
Outpatient Medical Services,LAB,82085,ALDOLASE,301,$64.00 ,$28.16,44% of total billed charges which is 100% CMS Medicare rate,$28.16,44% of total billed charges which is 100% CMS Medicare rate,$28.16,44% of total billed charges which is 100% CMS Medicare rate,$28.16,44% of total billed charges which is 100% CMS Medicare rate,$28.16,44% of total billed charges which is 100% CMS Medicare rate,$28.16,44% of total billed charges which is 100% CMS Medicare rate,$28.16,44% of total billed charges which is 100% CMS Medicare rate,$28.16,44% of total billed charges which is 100% CMS Medicare rate,$28.16,44% of total billed charges which is 100% CMS Medicare rate,$28.16,44% of total billed charges which is 100% CMS Medicare rate,$28.16,44% of total billed charges which is 100% CMS Medicare rate,$28.16,$28.16,$54.40 
Outpatient Medical Services,LAB,86003,ALLERGEN PROFILE PERENNIA,300,$522.00 ,$229.68,44% of total billed charges which is 100% CMS Medicare rate,$229.68,44% of total billed charges which is 100% CMS Medicare rate,$229.68,44% of total billed charges which is 100% CMS Medicare rate,$229.68,44% of total billed charges which is 100% CMS Medicare rate,$229.68,44% of total billed charges which is 100% CMS Medicare rate,$229.68,44% of total billed charges which is 100% CMS Medicare rate,$229.68,44% of total billed charges which is 100% CMS Medicare rate,$229.68,44% of total billed charges which is 100% CMS Medicare rate,$229.68,44% of total billed charges which is 100% CMS Medicare rate,$229.68,44% of total billed charges which is 100% CMS Medicare rate,$229.68,44% of total billed charges which is 100% CMS Medicare rate,$229.68,$229.68,$443.70 
Outpatient Medical Services,LAB,82140,"AMMONIA, PLASMA",301,$91.00 ,$40.04,44% of total billed charges which is 100% CMS Medicare rate,$40.04,44% of total billed charges which is 100% CMS Medicare rate,$40.04,44% of total billed charges which is 100% CMS Medicare rate,$40.04,44% of total billed charges which is 100% CMS Medicare rate,$40.04,44% of total billed charges which is 100% CMS Medicare rate,$40.04,44% of total billed charges which is 100% CMS Medicare rate,$40.04,44% of total billed charges which is 100% CMS Medicare rate,$40.04,44% of total billed charges which is 100% CMS Medicare rate,$40.04,44% of total billed charges which is 100% CMS Medicare rate,$40.04,44% of total billed charges which is 100% CMS Medicare rate,$40.04,44% of total billed charges which is 100% CMS Medicare rate,$40.04,$40.04,$77.35 
Outpatient Medical Services,LAB,82150,AMYLASE SERUM,301,$52.00 ,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,$22.88,$44.20 
Outpatient Medical Services,LAB,86255,ANCA,302,$368.00 ,$161.92,44% of total billed charges which is 100% CMS Medicare rate,$161.92,44% of total billed charges which is 100% CMS Medicare rate,$161.92,44% of total billed charges which is 100% CMS Medicare rate,$161.92,44% of total billed charges which is 100% CMS Medicare rate,$161.92,44% of total billed charges which is 100% CMS Medicare rate,$161.92,44% of total billed charges which is 100% CMS Medicare rate,$161.92,44% of total billed charges which is 100% CMS Medicare rate,$161.92,44% of total billed charges which is 100% CMS Medicare rate,$161.92,44% of total billed charges which is 100% CMS Medicare rate,$161.92,44% of total billed charges which is 100% CMS Medicare rate,$161.92,44% of total billed charges which is 100% CMS Medicare rate,$161.92,$161.92,$312.80 
Outpatient Medical Services,LAB,82157,ANDROSTENEDIONE,301,$317.00 ,$139.48,44% of total billed charges which is 100% CMS Medicare rate,$139.48,44% of total billed charges which is 100% CMS Medicare rate,$139.48,44% of total billed charges which is 100% CMS Medicare rate,$139.48,44% of total billed charges which is 100% CMS Medicare rate,$139.48,44% of total billed charges which is 100% CMS Medicare rate,$139.48,44% of total billed charges which is 100% CMS Medicare rate,$139.48,44% of total billed charges which is 100% CMS Medicare rate,$139.48,44% of total billed charges which is 100% CMS Medicare rate,$139.48,44% of total billed charges which is 100% CMS Medicare rate,$139.48,44% of total billed charges which is 100% CMS Medicare rate,$139.48,44% of total billed charges which is 100% CMS Medicare rate,$139.48,$139.48,$269.45 
Outpatient Medical Services,LAB,85025,"Complete blood cell count, with differential white blood cells, automated",305,$68.00 ,$29.92,44% of total billed charges which is 100% CMS Medicare rate,$29.92,44% of total billed charges which is 100% CMS Medicare rate,$29.92,44% of total billed charges which is 100% CMS Medicare rate,$29.92,44% of total billed charges which is 100% CMS Medicare rate,$29.92,44% of total billed charges which is 100% CMS Medicare rate,$29.92,44% of total billed charges which is 100% CMS Medicare rate,$29.92,44% of total billed charges which is 100% CMS Medicare rate,$29.92,44% of total billed charges which is 100% CMS Medicare rate,$29.92,44% of total billed charges which is 100% CMS Medicare rate,$29.92,44% of total billed charges which is 100% CMS Medicare rate,$29.92,44% of total billed charges which is 100% CMS Medicare rate,$29.92,$29.92,$57.80 
Outpatient Medical Services,LAB,83550,Blood test that measures the amount of iron carried in the blood,301,$52.00 ,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,$22.88,$44.20 
Outpatient Medical Services,LAB,82136,"Anemia, Megaloblastic Ser",300,$316.00 ,$139.04,44% of total billed charges which is 100% CMS Medicare rate,$139.04,44% of total billed charges which is 100% CMS Medicare rate,$139.04,44% of total billed charges which is 100% CMS Medicare rate,$139.04,44% of total billed charges which is 100% CMS Medicare rate,$139.04,44% of total billed charges which is 100% CMS Medicare rate,$139.04,44% of total billed charges which is 100% CMS Medicare rate,$139.04,44% of total billed charges which is 100% CMS Medicare rate,$139.04,44% of total billed charges which is 100% CMS Medicare rate,$139.04,44% of total billed charges which is 100% CMS Medicare rate,$139.04,44% of total billed charges which is 100% CMS Medicare rate,$139.04,44% of total billed charges which is 100% CMS Medicare rate,$139.04,$139.04,$268.60 
Outpatient Medical Services,LAB,83516,Chemical test of the blood to measure presence or concentration of a substance in the blood,301,$149.00 ,$65.56,44% of total billed charges which is 100% CMS Medicare rate,$65.56,44% of total billed charges which is 100% CMS Medicare rate,$65.56,44% of total billed charges which is 100% CMS Medicare rate,$65.56,44% of total billed charges which is 100% CMS Medicare rate,$65.56,44% of total billed charges which is 100% CMS Medicare rate,$65.56,44% of total billed charges which is 100% CMS Medicare rate,$65.56,44% of total billed charges which is 100% CMS Medicare rate,$65.56,44% of total billed charges which is 100% CMS Medicare rate,$65.56,44% of total billed charges which is 100% CMS Medicare rate,$65.56,44% of total billed charges which is 100% CMS Medicare rate,$65.56,44% of total billed charges which is 100% CMS Medicare rate,$65.56,$65.56,$126.65 
Outpatient Medical Services,LAB,86022,ANTI PLATELET AB,302,$450.00 ,$198.00,44% of total billed charges which is 100% CMS Medicare rate,$198.00,44% of total billed charges which is 100% CMS Medicare rate,$198.00,44% of total billed charges which is 100% CMS Medicare rate,$198.00,44% of total billed charges which is 100% CMS Medicare rate,$198.00,44% of total billed charges which is 100% CMS Medicare rate,$198.00,44% of total billed charges which is 100% CMS Medicare rate,$198.00,44% of total billed charges which is 100% CMS Medicare rate,$198.00,44% of total billed charges which is 100% CMS Medicare rate,$198.00,44% of total billed charges which is 100% CMS Medicare rate,$198.00,44% of total billed charges which is 100% CMS Medicare rate,$198.00,44% of total billed charges which is 100% CMS Medicare rate,$198.00,$198.00,$382.50 
Outpatient Medical Services,LAB,86850,Blood test to screen for antibodies that could harm red blood cells,300,$48.00 ,$21.12,44% of total billed charges which is 100% CMS Medicare rate,$21.12,44% of total billed charges which is 100% CMS Medicare rate,$21.12,44% of total billed charges which is 100% CMS Medicare rate,$21.12,44% of total billed charges which is 100% CMS Medicare rate,$21.12,44% of total billed charges which is 100% CMS Medicare rate,$21.12,44% of total billed charges which is 100% CMS Medicare rate,$21.12,44% of total billed charges which is 100% CMS Medicare rate,$21.12,44% of total billed charges which is 100% CMS Medicare rate,$21.12,44% of total billed charges which is 100% CMS Medicare rate,$21.12,44% of total billed charges which is 100% CMS Medicare rate,$21.12,44% of total billed charges which is 100% CMS Medicare rate,$21.12,$21.12,$40.80 
Outpatient Medical Services,LAB,84588,ANTIDIURETIC HORMONE,301,$228.00 ,$100.32,44% of total billed charges which is 100% CMS Medicare rate,$100.32,44% of total billed charges which is 100% CMS Medicare rate,$100.32,44% of total billed charges which is 100% CMS Medicare rate,$100.32,44% of total billed charges which is 100% CMS Medicare rate,$100.32,44% of total billed charges which is 100% CMS Medicare rate,$100.32,44% of total billed charges which is 100% CMS Medicare rate,$100.32,44% of total billed charges which is 100% CMS Medicare rate,$100.32,44% of total billed charges which is 100% CMS Medicare rate,$100.32,44% of total billed charges which is 100% CMS Medicare rate,$100.32,44% of total billed charges which is 100% CMS Medicare rate,$100.32,44% of total billed charges which is 100% CMS Medicare rate,$100.32,$100.32,$193.80 
Outpatient Medical Services,LAB,87077,Test of a wound for type of bacterial infection,306,$58.00 ,$25.52,44% of total billed charges which is 100% CMS Medicare rate,$25.52,44% of total billed charges which is 100% CMS Medicare rate,$25.52,44% of total billed charges which is 100% CMS Medicare rate,$25.52,44% of total billed charges which is 100% CMS Medicare rate,$25.52,44% of total billed charges which is 100% CMS Medicare rate,$25.52,44% of total billed charges which is 100% CMS Medicare rate,$25.52,44% of total billed charges which is 100% CMS Medicare rate,$25.52,44% of total billed charges which is 100% CMS Medicare rate,$25.52,44% of total billed charges which is 100% CMS Medicare rate,$25.52,44% of total billed charges which is 100% CMS Medicare rate,$25.52,44% of total billed charges which is 100% CMS Medicare rate,$25.52,$25.52,$49.30 
Outpatient Medical Services,LAB,87070,Test of body fluid other than blood to assess for bacteria,306,$87.00 ,$38.28,44% of total billed charges which is 100% CMS Medicare rate,$38.28,44% of total billed charges which is 100% CMS Medicare rate,$38.28,44% of total billed charges which is 100% CMS Medicare rate,$38.28,44% of total billed charges which is 100% CMS Medicare rate,$38.28,44% of total billed charges which is 100% CMS Medicare rate,$38.28,44% of total billed charges which is 100% CMS Medicare rate,$38.28,44% of total billed charges which is 100% CMS Medicare rate,$38.28,44% of total billed charges which is 100% CMS Medicare rate,$38.28,44% of total billed charges which is 100% CMS Medicare rate,$38.28,44% of total billed charges which is 100% CMS Medicare rate,$38.28,44% of total billed charges which is 100% CMS Medicare rate,$38.28,$38.28,$73.95 
Outpatient Medical Services,LAB,87186,A test used to determine which medications work on bacteria for fungi,306,$46.00 ,$20.24,44% of total billed charges which is 100% CMS Medicare rate,$20.24,44% of total billed charges which is 100% CMS Medicare rate,$20.24,44% of total billed charges which is 100% CMS Medicare rate,$20.24,44% of total billed charges which is 100% CMS Medicare rate,$20.24,44% of total billed charges which is 100% CMS Medicare rate,$20.24,44% of total billed charges which is 100% CMS Medicare rate,$20.24,44% of total billed charges which is 100% CMS Medicare rate,$20.24,44% of total billed charges which is 100% CMS Medicare rate,$20.24,44% of total billed charges which is 100% CMS Medicare rate,$20.24,44% of total billed charges which is 100% CMS Medicare rate,$20.24,44% of total billed charges which is 100% CMS Medicare rate,$20.24,$20.24,$39.10 
Outpatient Medical Services,LAB,86146,BETA 2 GLYCOPROTEIN I ABS,302,$244.00 ,$107.36,44% of total billed charges which is 100% CMS Medicare rate,$107.36,44% of total billed charges which is 100% CMS Medicare rate,$107.36,44% of total billed charges which is 100% CMS Medicare rate,$107.36,44% of total billed charges which is 100% CMS Medicare rate,$107.36,44% of total billed charges which is 100% CMS Medicare rate,$107.36,44% of total billed charges which is 100% CMS Medicare rate,$107.36,44% of total billed charges which is 100% CMS Medicare rate,$107.36,44% of total billed charges which is 100% CMS Medicare rate,$107.36,44% of total billed charges which is 100% CMS Medicare rate,$107.36,44% of total billed charges which is 100% CMS Medicare rate,$107.36,44% of total billed charges which is 100% CMS Medicare rate,$107.36,$107.36,$207.40 
Outpatient Medical Services,LAB,82247,BILIRUBIN TOTAL,301,$41.00 ,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,$18.04,$34.85 
Outpatient Medical Services,LAB,82248,Measurement of direct bilirubin,301,$41.00 ,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,$18.04,$34.85 
Outpatient Medical Services,LAB,87799,BK PCR QNT (PLASMA),305,$795.00 ,$349.80,44% of total billed charges which is 100% CMS Medicare rate,$349.80,44% of total billed charges which is 100% CMS Medicare rate,$349.80,44% of total billed charges which is 100% CMS Medicare rate,$349.80,44% of total billed charges which is 100% CMS Medicare rate,$349.80,44% of total billed charges which is 100% CMS Medicare rate,$349.80,44% of total billed charges which is 100% CMS Medicare rate,$349.80,44% of total billed charges which is 100% CMS Medicare rate,$349.80,44% of total billed charges which is 100% CMS Medicare rate,$349.80,44% of total billed charges which is 100% CMS Medicare rate,$349.80,44% of total billed charges which is 100% CMS Medicare rate,$349.80,44% of total billed charges which is 100% CMS Medicare rate,$349.80,$349.80,$675.75 
Outpatient Medical Services,LAB,85027,"Complete blood count, automated",305,$52.00 ,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,$22.88,$44.20 
Outpatient Medical Services,LAB,80048,Basic metabolic panel,301,$91.00 ,$40.04,44% of total billed charges which is 100% CMS Medicare rate,$40.04,44% of total billed charges which is 100% CMS Medicare rate,$40.04,44% of total billed charges which is 100% CMS Medicare rate,$40.04,44% of total billed charges which is 100% CMS Medicare rate,$40.04,44% of total billed charges which is 100% CMS Medicare rate,$40.04,44% of total billed charges which is 100% CMS Medicare rate,$40.04,44% of total billed charges which is 100% CMS Medicare rate,$40.04,44% of total billed charges which is 100% CMS Medicare rate,$40.04,44% of total billed charges which is 100% CMS Medicare rate,$40.04,44% of total billed charges which is 100% CMS Medicare rate,$40.04,44% of total billed charges which is 100% CMS Medicare rate,$40.04,$40.04,$77.35 
Outpatient Medical Services,LAB,83880,Blood test used to diagnose heart failure,301,$197.00 ,$86.68,44% of total billed charges which is 100% CMS Medicare rate,$86.68,44% of total billed charges which is 100% CMS Medicare rate,$86.68,44% of total billed charges which is 100% CMS Medicare rate,$86.68,44% of total billed charges which is 100% CMS Medicare rate,$86.68,44% of total billed charges which is 100% CMS Medicare rate,$86.68,44% of total billed charges which is 100% CMS Medicare rate,$86.68,44% of total billed charges which is 100% CMS Medicare rate,$86.68,44% of total billed charges which is 100% CMS Medicare rate,$86.68,44% of total billed charges which is 100% CMS Medicare rate,$86.68,44% of total billed charges which is 100% CMS Medicare rate,$86.68,44% of total billed charges which is 100% CMS Medicare rate,$86.68,$86.68,$167.45 
Outpatient Medical Services,LAB,84520,BUN,301,$41.00 ,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,$18.04,$34.85 
Outpatient Medical Services,LAB,87449,C DIFF ANTIGEN,306,$50.00 ,$22.00,44% of total billed charges which is 100% CMS Medicare rate,$22.00,44% of total billed charges which is 100% CMS Medicare rate,$22.00,44% of total billed charges which is 100% CMS Medicare rate,$22.00,44% of total billed charges which is 100% CMS Medicare rate,$22.00,44% of total billed charges which is 100% CMS Medicare rate,$22.00,44% of total billed charges which is 100% CMS Medicare rate,$22.00,44% of total billed charges which is 100% CMS Medicare rate,$22.00,44% of total billed charges which is 100% CMS Medicare rate,$22.00,44% of total billed charges which is 100% CMS Medicare rate,$22.00,44% of total billed charges which is 100% CMS Medicare rate,$22.00,44% of total billed charges which is 100% CMS Medicare rate,$22.00,$22.00,$42.50 
Outpatient Medical Services,LAB,86140,C REACTIVE PROTEIN-S OUT,302,$52.00 ,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,$22.88,$44.20 
Outpatient Medical Services,LAB,86300,Blood test to monitor breast cancer,302,$114.00 ,$50.16,44% of total billed charges which is 100% CMS Medicare rate,$50.16,44% of total billed charges which is 100% CMS Medicare rate,$50.16,44% of total billed charges which is 100% CMS Medicare rate,$50.16,44% of total billed charges which is 100% CMS Medicare rate,$50.16,44% of total billed charges which is 100% CMS Medicare rate,$50.16,44% of total billed charges which is 100% CMS Medicare rate,$50.16,44% of total billed charges which is 100% CMS Medicare rate,$50.16,44% of total billed charges which is 100% CMS Medicare rate,$50.16,44% of total billed charges which is 100% CMS Medicare rate,$50.16,44% of total billed charges which is 100% CMS Medicare rate,$50.16,44% of total billed charges which is 100% CMS Medicare rate,$50.16,$50.16,$96.90 
Outpatient Medical Services,LAB,82308,CALCITONIN,301,$178.00 ,$78.32,44% of total billed charges which is 100% CMS Medicare rate,$78.32,44% of total billed charges which is 100% CMS Medicare rate,$78.32,44% of total billed charges which is 100% CMS Medicare rate,$78.32,44% of total billed charges which is 100% CMS Medicare rate,$78.32,44% of total billed charges which is 100% CMS Medicare rate,$78.32,44% of total billed charges which is 100% CMS Medicare rate,$78.32,44% of total billed charges which is 100% CMS Medicare rate,$78.32,44% of total billed charges which is 100% CMS Medicare rate,$78.32,44% of total billed charges which is 100% CMS Medicare rate,$78.32,44% of total billed charges which is 100% CMS Medicare rate,$78.32,44% of total billed charges which is 100% CMS Medicare rate,$78.32,$78.32,$151.30 
Outpatient Medical Services,LAB,82330,CALCIUM IONIZED,301,$95.00 ,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,$41.80,$80.75 
Outpatient Medical Services,LAB,82310,CALCIUM SERUM,301,$41.00 ,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,$18.04,$34.85 
Outpatient Medical Services,LAB,82340,"CALCIUM URINE, TIMED SPEC",301,$41.00 ,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,$18.04,$34.85 
Outpatient Medical Services,LAB,82373,Carbohydrate Def Trans,301,$340.00 ,$149.60,44% of total billed charges which is 100% CMS Medicare rate,$149.60,44% of total billed charges which is 100% CMS Medicare rate,$149.60,44% of total billed charges which is 100% CMS Medicare rate,$149.60,44% of total billed charges which is 100% CMS Medicare rate,$149.60,44% of total billed charges which is 100% CMS Medicare rate,$149.60,44% of total billed charges which is 100% CMS Medicare rate,$149.60,44% of total billed charges which is 100% CMS Medicare rate,$149.60,44% of total billed charges which is 100% CMS Medicare rate,$149.60,44% of total billed charges which is 100% CMS Medicare rate,$149.60,44% of total billed charges which is 100% CMS Medicare rate,$149.60,44% of total billed charges which is 100% CMS Medicare rate,$149.60,$149.60,$289.00 
Outpatient Medical Services,LAB,86147,Blood test to determine cause of inappropriate blood clot formation,302,$104.00 ,$45.76,44% of total billed charges which is 100% CMS Medicare rate,$45.76,44% of total billed charges which is 100% CMS Medicare rate,$45.76,44% of total billed charges which is 100% CMS Medicare rate,$45.76,44% of total billed charges which is 100% CMS Medicare rate,$45.76,44% of total billed charges which is 100% CMS Medicare rate,$45.76,44% of total billed charges which is 100% CMS Medicare rate,$45.76,44% of total billed charges which is 100% CMS Medicare rate,$45.76,44% of total billed charges which is 100% CMS Medicare rate,$45.76,44% of total billed charges which is 100% CMS Medicare rate,$45.76,44% of total billed charges which is 100% CMS Medicare rate,$45.76,44% of total billed charges which is 100% CMS Medicare rate,$45.76,$45.76,$88.40 
Outpatient Medical Services,LAB,82384,CATECHOL FRACT PLASMA,300,$242.00 ,$106.48,44% of total billed charges which is 100% CMS Medicare rate,$106.48,44% of total billed charges which is 100% CMS Medicare rate,$106.48,44% of total billed charges which is 100% CMS Medicare rate,$106.48,44% of total billed charges which is 100% CMS Medicare rate,$106.48,44% of total billed charges which is 100% CMS Medicare rate,$106.48,44% of total billed charges which is 100% CMS Medicare rate,$106.48,44% of total billed charges which is 100% CMS Medicare rate,$106.48,44% of total billed charges which is 100% CMS Medicare rate,$106.48,44% of total billed charges which is 100% CMS Medicare rate,$106.48,44% of total billed charges which is 100% CMS Medicare rate,$106.48,44% of total billed charges which is 100% CMS Medicare rate,$106.48,$106.48,$205.70 
Outpatient Medical Services,LAB,82553,Blood test to detect heart enzymes,301,$76.00 ,$33.44,44% of total billed charges which is 100% CMS Medicare rate,$33.44,44% of total billed charges which is 100% CMS Medicare rate,$33.44,44% of total billed charges which is 100% CMS Medicare rate,$33.44,44% of total billed charges which is 100% CMS Medicare rate,$33.44,44% of total billed charges which is 100% CMS Medicare rate,$33.44,44% of total billed charges which is 100% CMS Medicare rate,$33.44,44% of total billed charges which is 100% CMS Medicare rate,$33.44,44% of total billed charges which is 100% CMS Medicare rate,$33.44,44% of total billed charges which is 100% CMS Medicare rate,$33.44,44% of total billed charges which is 100% CMS Medicare rate,$33.44,44% of total billed charges which is 100% CMS Medicare rate,$33.44,$33.44,$64.60 
Outpatient Medical Services,LAB,80053,"Blood test, comprehensive group of blood chemicals",301,$190.00 ,$83.60,44% of total billed charges which is 100% CMS Medicare rate,$83.60,44% of total billed charges which is 100% CMS Medicare rate,$83.60,44% of total billed charges which is 100% CMS Medicare rate,$83.60,44% of total billed charges which is 100% CMS Medicare rate,$83.60,44% of total billed charges which is 100% CMS Medicare rate,$83.60,44% of total billed charges which is 100% CMS Medicare rate,$83.60,44% of total billed charges which is 100% CMS Medicare rate,$83.60,44% of total billed charges which is 100% CMS Medicare rate,$83.60,44% of total billed charges which is 100% CMS Medicare rate,$83.60,44% of total billed charges which is 100% CMS Medicare rate,$83.60,44% of total billed charges which is 100% CMS Medicare rate,$83.60,$83.60,$161.50 
Outpatient Medical Services,LAB,87496,CMV DNA QUANTIATION,300,$288.00 ,$126.72,44% of total billed charges which is 100% CMS Medicare rate,$126.72,44% of total billed charges which is 100% CMS Medicare rate,$126.72,44% of total billed charges which is 100% CMS Medicare rate,$126.72,44% of total billed charges which is 100% CMS Medicare rate,$126.72,44% of total billed charges which is 100% CMS Medicare rate,$126.72,44% of total billed charges which is 100% CMS Medicare rate,$126.72,44% of total billed charges which is 100% CMS Medicare rate,$126.72,44% of total billed charges which is 100% CMS Medicare rate,$126.72,44% of total billed charges which is 100% CMS Medicare rate,$126.72,44% of total billed charges which is 100% CMS Medicare rate,$126.72,44% of total billed charges which is 100% CMS Medicare rate,$126.72,$126.72,$244.80 
Outpatient Medical Services,LAB,87497,CMV QUANT PCR,300,$459.00 ,$201.96,44% of total billed charges which is 100% CMS Medicare rate,$201.96,44% of total billed charges which is 100% CMS Medicare rate,$201.96,44% of total billed charges which is 100% CMS Medicare rate,$201.96,44% of total billed charges which is 100% CMS Medicare rate,$201.96,44% of total billed charges which is 100% CMS Medicare rate,$201.96,44% of total billed charges which is 100% CMS Medicare rate,$201.96,44% of total billed charges which is 100% CMS Medicare rate,$201.96,44% of total billed charges which is 100% CMS Medicare rate,$201.96,44% of total billed charges which is 100% CMS Medicare rate,$201.96,44% of total billed charges which is 100% CMS Medicare rate,$201.96,44% of total billed charges which is 100% CMS Medicare rate,$201.96,$201.96,$390.15 
Outpatient Medical Services,LAB,86160,COMPLEMENT C4A,300,$216.00 ,$95.04,44% of total billed charges which is 100% CMS Medicare rate,$95.04,44% of total billed charges which is 100% CMS Medicare rate,$95.04,44% of total billed charges which is 100% CMS Medicare rate,$95.04,44% of total billed charges which is 100% CMS Medicare rate,$95.04,44% of total billed charges which is 100% CMS Medicare rate,$95.04,44% of total billed charges which is 100% CMS Medicare rate,$95.04,44% of total billed charges which is 100% CMS Medicare rate,$95.04,44% of total billed charges which is 100% CMS Medicare rate,$95.04,44% of total billed charges which is 100% CMS Medicare rate,$95.04,44% of total billed charges which is 100% CMS Medicare rate,$95.04,44% of total billed charges which is 100% CMS Medicare rate,$95.04,$95.04,$183.60 
Outpatient Medical Services,LAB,84681,C-PEPTIDE,301,$114.00 ,$50.16,44% of total billed charges which is 100% CMS Medicare rate,$50.16,44% of total billed charges which is 100% CMS Medicare rate,$50.16,44% of total billed charges which is 100% CMS Medicare rate,$50.16,44% of total billed charges which is 100% CMS Medicare rate,$50.16,44% of total billed charges which is 100% CMS Medicare rate,$50.16,44% of total billed charges which is 100% CMS Medicare rate,$50.16,44% of total billed charges which is 100% CMS Medicare rate,$50.16,44% of total billed charges which is 100% CMS Medicare rate,$50.16,44% of total billed charges which is 100% CMS Medicare rate,$50.16,44% of total billed charges which is 100% CMS Medicare rate,$50.16,44% of total billed charges which is 100% CMS Medicare rate,$50.16,$50.16,$96.90 
Outpatient Medical Services,LAB,82550,CPK CK,301,$41.00 ,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,$18.04,$34.85 
Outpatient Medical Services,LAB,82552,CPK ISOENZYMES,301,$69.00 ,$30.36,44% of total billed charges which is 100% CMS Medicare rate,$30.36,44% of total billed charges which is 100% CMS Medicare rate,$30.36,44% of total billed charges which is 100% CMS Medicare rate,$30.36,44% of total billed charges which is 100% CMS Medicare rate,$30.36,44% of total billed charges which is 100% CMS Medicare rate,$30.36,44% of total billed charges which is 100% CMS Medicare rate,$30.36,44% of total billed charges which is 100% CMS Medicare rate,$30.36,44% of total billed charges which is 100% CMS Medicare rate,$30.36,44% of total billed charges which is 100% CMS Medicare rate,$30.36,44% of total billed charges which is 100% CMS Medicare rate,$30.36,44% of total billed charges which is 100% CMS Medicare rate,$30.36,$30.36,$58.65 
Outpatient Medical Services,LAB,82575,CREATININE CLEARANCE,301,$58.00 ,$25.52,44% of total billed charges which is 100% CMS Medicare rate,$25.52,44% of total billed charges which is 100% CMS Medicare rate,$25.52,44% of total billed charges which is 100% CMS Medicare rate,$25.52,44% of total billed charges which is 100% CMS Medicare rate,$25.52,44% of total billed charges which is 100% CMS Medicare rate,$25.52,44% of total billed charges which is 100% CMS Medicare rate,$25.52,44% of total billed charges which is 100% CMS Medicare rate,$25.52,44% of total billed charges which is 100% CMS Medicare rate,$25.52,44% of total billed charges which is 100% CMS Medicare rate,$25.52,44% of total billed charges which is 100% CMS Medicare rate,$25.52,44% of total billed charges which is 100% CMS Medicare rate,$25.52,$25.52,$49.30 
Outpatient Medical Services,LAB,82565,CREATININE SERUM,301,$41.00 ,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,$18.04,$34.85 
Outpatient Medical Services,LAB,82570,Test to measure creatinine in the urine,301,$41.00 ,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,$18.04,$34.85 
Outpatient Medical Services,LAB,87081,Medical test to find an infection,310,$350.00 ,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,$154.00,$297.50 
Outpatient Medical Services,LAB,82595,CRYOGLOBULIN,300,$46.00 ,$20.24,44% of total billed charges which is 100% CMS Medicare rate,$20.24,44% of total billed charges which is 100% CMS Medicare rate,$20.24,44% of total billed charges which is 100% CMS Medicare rate,$20.24,44% of total billed charges which is 100% CMS Medicare rate,$20.24,44% of total billed charges which is 100% CMS Medicare rate,$20.24,44% of total billed charges which is 100% CMS Medicare rate,$20.24,44% of total billed charges which is 100% CMS Medicare rate,$20.24,44% of total billed charges which is 100% CMS Medicare rate,$20.24,44% of total billed charges which is 100% CMS Medicare rate,$20.24,44% of total billed charges which is 100% CMS Medicare rate,$20.24,44% of total billed charges which is 100% CMS Medicare rate,$20.24,$20.24,$39.10 
Outpatient Medical Services,LAB,87040,Blood test to screen for bacteria in the blood,306,$95.00 ,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,$41.80,$80.75 
Outpatient Medical Services,LAB,81220,CYSTIC FIBROSIS PROFILE,300,$374.00 ,$164.56,44% of total billed charges which is 100% CMS Medicare rate,$164.56,44% of total billed charges which is 100% CMS Medicare rate,$164.56,44% of total billed charges which is 100% CMS Medicare rate,$164.56,44% of total billed charges which is 100% CMS Medicare rate,$164.56,44% of total billed charges which is 100% CMS Medicare rate,$164.56,44% of total billed charges which is 100% CMS Medicare rate,$164.56,44% of total billed charges which is 100% CMS Medicare rate,$164.56,44% of total billed charges which is 100% CMS Medicare rate,$164.56,44% of total billed charges which is 100% CMS Medicare rate,$164.56,44% of total billed charges which is 100% CMS Medicare rate,$164.56,44% of total billed charges which is 100% CMS Medicare rate,$164.56,$164.56,$317.90 
Outpatient Medical Services,LAB,80164,DEPAKENE (VALPROIC ACID),301,$83.00 ,$36.52,44% of total billed charges which is 100% CMS Medicare rate,$36.52,44% of total billed charges which is 100% CMS Medicare rate,$36.52,44% of total billed charges which is 100% CMS Medicare rate,$36.52,44% of total billed charges which is 100% CMS Medicare rate,$36.52,44% of total billed charges which is 100% CMS Medicare rate,$36.52,44% of total billed charges which is 100% CMS Medicare rate,$36.52,44% of total billed charges which is 100% CMS Medicare rate,$36.52,44% of total billed charges which is 100% CMS Medicare rate,$36.52,44% of total billed charges which is 100% CMS Medicare rate,$36.52,44% of total billed charges which is 100% CMS Medicare rate,$36.52,44% of total billed charges which is 100% CMS Medicare rate,$36.52,$36.52,$70.55 
Outpatient Medical Services,LAB,82626,DHEA,300,$273.00 ,$120.12,44% of total billed charges which is 100% CMS Medicare rate,$120.12,44% of total billed charges which is 100% CMS Medicare rate,$120.12,44% of total billed charges which is 100% CMS Medicare rate,$120.12,44% of total billed charges which is 100% CMS Medicare rate,$120.12,44% of total billed charges which is 100% CMS Medicare rate,$120.12,44% of total billed charges which is 100% CMS Medicare rate,$120.12,44% of total billed charges which is 100% CMS Medicare rate,$120.12,44% of total billed charges which is 100% CMS Medicare rate,$120.12,44% of total billed charges which is 100% CMS Medicare rate,$120.12,44% of total billed charges which is 100% CMS Medicare rate,$120.12,44% of total billed charges which is 100% CMS Medicare rate,$120.12,$120.12,$232.05 
Outpatient Medical Services,LAB,80162,DIGOXIN,301,$83.00 ,$36.52,44% of total billed charges which is 100% CMS Medicare rate,$36.52,44% of total billed charges which is 100% CMS Medicare rate,$36.52,44% of total billed charges which is 100% CMS Medicare rate,$36.52,44% of total billed charges which is 100% CMS Medicare rate,$36.52,44% of total billed charges which is 100% CMS Medicare rate,$36.52,44% of total billed charges which is 100% CMS Medicare rate,$36.52,44% of total billed charges which is 100% CMS Medicare rate,$36.52,44% of total billed charges which is 100% CMS Medicare rate,$36.52,44% of total billed charges which is 100% CMS Medicare rate,$36.52,44% of total billed charges which is 100% CMS Medicare rate,$36.52,44% of total billed charges which is 100% CMS Medicare rate,$36.52,$36.52,$70.55 
Outpatient Medical Services,LAB,80185,DILANTIN/PHENYTOIN,301,$83.00 ,$36.52,44% of total billed charges which is 100% CMS Medicare rate,$36.52,44% of total billed charges which is 100% CMS Medicare rate,$36.52,44% of total billed charges which is 100% CMS Medicare rate,$36.52,44% of total billed charges which is 100% CMS Medicare rate,$36.52,44% of total billed charges which is 100% CMS Medicare rate,$36.52,44% of total billed charges which is 100% CMS Medicare rate,$36.52,44% of total billed charges which is 100% CMS Medicare rate,$36.52,44% of total billed charges which is 100% CMS Medicare rate,$36.52,44% of total billed charges which is 100% CMS Medicare rate,$36.52,44% of total billed charges which is 100% CMS Medicare rate,$36.52,44% of total billed charges which is 100% CMS Medicare rate,$36.52,$36.52,$70.55 
Outpatient Medical Services,LAB,80101,DRUG PROFILE BLOOD (PAT),300,$388.00 ,$170.72,44% of total billed charges which is 100% CMS Medicare rate,$170.72,44% of total billed charges which is 100% CMS Medicare rate,$170.72,44% of total billed charges which is 100% CMS Medicare rate,$170.72,44% of total billed charges which is 100% CMS Medicare rate,$170.72,44% of total billed charges which is 100% CMS Medicare rate,$170.72,44% of total billed charges which is 100% CMS Medicare rate,$170.72,44% of total billed charges which is 100% CMS Medicare rate,$170.72,44% of total billed charges which is 100% CMS Medicare rate,$170.72,44% of total billed charges which is 100% CMS Medicare rate,$170.72,44% of total billed charges which is 100% CMS Medicare rate,$170.72,44% of total billed charges which is 100% CMS Medicare rate,$170.72,$170.72,$329.80 
Outpatient Medical Services,LAB,86666,"EHRLICHIOSIS, HUMAN GRAN",302,$245.00 ,$107.80,44% of total billed charges which is 100% CMS Medicare rate,$107.80,44% of total billed charges which is 100% CMS Medicare rate,$107.80,44% of total billed charges which is 100% CMS Medicare rate,$107.80,44% of total billed charges which is 100% CMS Medicare rate,$107.80,44% of total billed charges which is 100% CMS Medicare rate,$107.80,44% of total billed charges which is 100% CMS Medicare rate,$107.80,44% of total billed charges which is 100% CMS Medicare rate,$107.80,44% of total billed charges which is 100% CMS Medicare rate,$107.80,44% of total billed charges which is 100% CMS Medicare rate,$107.80,44% of total billed charges which is 100% CMS Medicare rate,$107.80,44% of total billed charges which is 100% CMS Medicare rate,$107.80,$107.80,$208.25 
Outpatient Medical Services,LAB,80051,"Blood test panel for electrolytes (sodium potassium, chloride, carbon dioxide)",301,$53.00 ,$23.32,44% of total billed charges which is 100% CMS Medicare rate,$23.32,44% of total billed charges which is 100% CMS Medicare rate,$23.32,44% of total billed charges which is 100% CMS Medicare rate,$23.32,44% of total billed charges which is 100% CMS Medicare rate,$23.32,44% of total billed charges which is 100% CMS Medicare rate,$23.32,44% of total billed charges which is 100% CMS Medicare rate,$23.32,44% of total billed charges which is 100% CMS Medicare rate,$23.32,44% of total billed charges which is 100% CMS Medicare rate,$23.32,44% of total billed charges which is 100% CMS Medicare rate,$23.32,44% of total billed charges which is 100% CMS Medicare rate,$23.32,44% of total billed charges which is 100% CMS Medicare rate,$23.32,$23.32,$45.05 
Outpatient Medical Services,LAB,82664,ELECTROPHORETIC TECHNIQUE,301,$210.00 ,$92.40,44% of total billed charges which is 100% CMS Medicare rate,$92.40,44% of total billed charges which is 100% CMS Medicare rate,$92.40,44% of total billed charges which is 100% CMS Medicare rate,$92.40,44% of total billed charges which is 100% CMS Medicare rate,$92.40,44% of total billed charges which is 100% CMS Medicare rate,$92.40,44% of total billed charges which is 100% CMS Medicare rate,$92.40,44% of total billed charges which is 100% CMS Medicare rate,$92.40,44% of total billed charges which is 100% CMS Medicare rate,$92.40,44% of total billed charges which is 100% CMS Medicare rate,$92.40,44% of total billed charges which is 100% CMS Medicare rate,$92.40,44% of total billed charges which is 100% CMS Medicare rate,$92.40,$92.40,$178.50 
Outpatient Medical Services,LAB,86235,EXTRACTABLE NUCLEAR ANTIG,302,$262.00 ,$115.28,44% of total billed charges which is 100% CMS Medicare rate,$115.28,44% of total billed charges which is 100% CMS Medicare rate,$115.28,44% of total billed charges which is 100% CMS Medicare rate,$115.28,44% of total billed charges which is 100% CMS Medicare rate,$115.28,44% of total billed charges which is 100% CMS Medicare rate,$115.28,44% of total billed charges which is 100% CMS Medicare rate,$115.28,44% of total billed charges which is 100% CMS Medicare rate,$115.28,44% of total billed charges which is 100% CMS Medicare rate,$115.28,44% of total billed charges which is 100% CMS Medicare rate,$115.28,44% of total billed charges which is 100% CMS Medicare rate,$115.28,44% of total billed charges which is 100% CMS Medicare rate,$115.28,$115.28,$222.70 
Outpatient Medical Services,LAB,81241,FACTOR V LEIDEN MUTA ANAL,301,$383.00 ,$168.52,44% of total billed charges which is 100% CMS Medicare rate,$168.52,44% of total billed charges which is 100% CMS Medicare rate,$168.52,44% of total billed charges which is 100% CMS Medicare rate,$168.52,44% of total billed charges which is 100% CMS Medicare rate,$168.52,44% of total billed charges which is 100% CMS Medicare rate,$168.52,44% of total billed charges which is 100% CMS Medicare rate,$168.52,44% of total billed charges which is 100% CMS Medicare rate,$168.52,44% of total billed charges which is 100% CMS Medicare rate,$168.52,44% of total billed charges which is 100% CMS Medicare rate,$168.52,44% of total billed charges which is 100% CMS Medicare rate,$168.52,44% of total billed charges which is 100% CMS Medicare rate,$168.52,$168.52,$325.55 
Outpatient Medical Services,LAB,85230,FACTOR VII ACTIVITY,300,$271.00 ,$119.24,44% of total billed charges which is 100% CMS Medicare rate,$119.24,44% of total billed charges which is 100% CMS Medicare rate,$119.24,44% of total billed charges which is 100% CMS Medicare rate,$119.24,44% of total billed charges which is 100% CMS Medicare rate,$119.24,44% of total billed charges which is 100% CMS Medicare rate,$119.24,44% of total billed charges which is 100% CMS Medicare rate,$119.24,44% of total billed charges which is 100% CMS Medicare rate,$119.24,44% of total billed charges which is 100% CMS Medicare rate,$119.24,44% of total billed charges which is 100% CMS Medicare rate,$119.24,44% of total billed charges which is 100% CMS Medicare rate,$119.24,44% of total billed charges which is 100% CMS Medicare rate,$119.24,$119.24,$230.35 
Outpatient Medical Services,LAB,85240,FACTOR VIII (AHG) 1 STAGE,305,$345.00 ,$151.80,44% of total billed charges which is 100% CMS Medicare rate,$151.80,44% of total billed charges which is 100% CMS Medicare rate,$151.80,44% of total billed charges which is 100% CMS Medicare rate,$151.80,44% of total billed charges which is 100% CMS Medicare rate,$151.80,44% of total billed charges which is 100% CMS Medicare rate,$151.80,44% of total billed charges which is 100% CMS Medicare rate,$151.80,44% of total billed charges which is 100% CMS Medicare rate,$151.80,44% of total billed charges which is 100% CMS Medicare rate,$151.80,44% of total billed charges which is 100% CMS Medicare rate,$151.80,44% of total billed charges which is 100% CMS Medicare rate,$151.80,44% of total billed charges which is 100% CMS Medicare rate,$151.80,$151.80,$293.25 
Outpatient Medical Services,LAB,85246,"FACTOR VIII,VW FACTOR ANT",305,$345.00 ,$151.80,44% of total billed charges which is 100% CMS Medicare rate,$151.80,44% of total billed charges which is 100% CMS Medicare rate,$151.80,44% of total billed charges which is 100% CMS Medicare rate,$151.80,44% of total billed charges which is 100% CMS Medicare rate,$151.80,44% of total billed charges which is 100% CMS Medicare rate,$151.80,44% of total billed charges which is 100% CMS Medicare rate,$151.80,44% of total billed charges which is 100% CMS Medicare rate,$151.80,44% of total billed charges which is 100% CMS Medicare rate,$151.80,44% of total billed charges which is 100% CMS Medicare rate,$151.80,44% of total billed charges which is 100% CMS Medicare rate,$151.80,44% of total billed charges which is 100% CMS Medicare rate,$151.80,$151.80,$293.25 
Outpatient Medical Services,LAB,85245,"FACTOR VIII,VW RISTOCETIN",305,$345.00 ,$151.80,44% of total billed charges which is 100% CMS Medicare rate,$151.80,44% of total billed charges which is 100% CMS Medicare rate,$151.80,44% of total billed charges which is 100% CMS Medicare rate,$151.80,44% of total billed charges which is 100% CMS Medicare rate,$151.80,44% of total billed charges which is 100% CMS Medicare rate,$151.80,44% of total billed charges which is 100% CMS Medicare rate,$151.80,44% of total billed charges which is 100% CMS Medicare rate,$151.80,44% of total billed charges which is 100% CMS Medicare rate,$151.80,44% of total billed charges which is 100% CMS Medicare rate,$151.80,44% of total billed charges which is 100% CMS Medicare rate,$151.80,44% of total billed charges which is 100% CMS Medicare rate,$151.80,$151.80,$293.25 
Outpatient Medical Services,LAB,85260,FACTOR X ACTIVITY,305,$263.00 ,$115.72,44% of total billed charges which is 100% CMS Medicare rate,$115.72,44% of total billed charges which is 100% CMS Medicare rate,$115.72,44% of total billed charges which is 100% CMS Medicare rate,$115.72,44% of total billed charges which is 100% CMS Medicare rate,$115.72,44% of total billed charges which is 100% CMS Medicare rate,$115.72,44% of total billed charges which is 100% CMS Medicare rate,$115.72,44% of total billed charges which is 100% CMS Medicare rate,$115.72,44% of total billed charges which is 100% CMS Medicare rate,$115.72,44% of total billed charges which is 100% CMS Medicare rate,$115.72,44% of total billed charges which is 100% CMS Medicare rate,$115.72,44% of total billed charges which is 100% CMS Medicare rate,$115.72,$115.72,$223.55 
Outpatient Medical Services,LAB,82728,Test to determine level of iron in the blood,301,$79.00 ,$34.76,44% of total billed charges which is 100% CMS Medicare rate,$34.76,44% of total billed charges which is 100% CMS Medicare rate,$34.76,44% of total billed charges which is 100% CMS Medicare rate,$34.76,44% of total billed charges which is 100% CMS Medicare rate,$34.76,44% of total billed charges which is 100% CMS Medicare rate,$34.76,44% of total billed charges which is 100% CMS Medicare rate,$34.76,44% of total billed charges which is 100% CMS Medicare rate,$34.76,44% of total billed charges which is 100% CMS Medicare rate,$34.76,44% of total billed charges which is 100% CMS Medicare rate,$34.76,44% of total billed charges which is 100% CMS Medicare rate,$34.76,44% of total billed charges which is 100% CMS Medicare rate,$34.76,$34.76,$67.15 
Outpatient Medical Services,LAB,85379,"FIB DEG, D-DIMER, QUAL",305,$198.00 ,$87.12,44% of total billed charges which is 100% CMS Medicare rate,$87.12,44% of total billed charges which is 100% CMS Medicare rate,$87.12,44% of total billed charges which is 100% CMS Medicare rate,$87.12,44% of total billed charges which is 100% CMS Medicare rate,$87.12,44% of total billed charges which is 100% CMS Medicare rate,$87.12,44% of total billed charges which is 100% CMS Medicare rate,$87.12,44% of total billed charges which is 100% CMS Medicare rate,$87.12,44% of total billed charges which is 100% CMS Medicare rate,$87.12,44% of total billed charges which is 100% CMS Medicare rate,$87.12,44% of total billed charges which is 100% CMS Medicare rate,$87.12,44% of total billed charges which is 100% CMS Medicare rate,$87.12,$87.12,$168.30 
Outpatient Medical Services,LAB,82746,FOLATE (SERUM),301,$89.00 ,$39.16,44% of total billed charges which is 100% CMS Medicare rate,$39.16,44% of total billed charges which is 100% CMS Medicare rate,$39.16,44% of total billed charges which is 100% CMS Medicare rate,$39.16,44% of total billed charges which is 100% CMS Medicare rate,$39.16,44% of total billed charges which is 100% CMS Medicare rate,$39.16,44% of total billed charges which is 100% CMS Medicare rate,$39.16,44% of total billed charges which is 100% CMS Medicare rate,$39.16,44% of total billed charges which is 100% CMS Medicare rate,$39.16,44% of total billed charges which is 100% CMS Medicare rate,$39.16,44% of total billed charges which is 100% CMS Medicare rate,$39.16,44% of total billed charges which is 100% CMS Medicare rate,$39.16,$39.16,$75.65 
Outpatient Medical Services,LAB,83883,"FREE K+L LT CHAINS,QN,(S)",300,$280.00 ,$123.20,44% of total billed charges which is 100% CMS Medicare rate,$123.20,44% of total billed charges which is 100% CMS Medicare rate,$123.20,44% of total billed charges which is 100% CMS Medicare rate,$123.20,44% of total billed charges which is 100% CMS Medicare rate,$123.20,44% of total billed charges which is 100% CMS Medicare rate,$123.20,44% of total billed charges which is 100% CMS Medicare rate,$123.20,44% of total billed charges which is 100% CMS Medicare rate,$123.20,44% of total billed charges which is 100% CMS Medicare rate,$123.20,44% of total billed charges which is 100% CMS Medicare rate,$123.20,44% of total billed charges which is 100% CMS Medicare rate,$123.20,44% of total billed charges which is 100% CMS Medicare rate,$123.20,$123.20,$238.00 
Outpatient Medical Services,LAB,84439,Blood test to evaluate thyroid function,301,$52.00 ,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,$22.88,$44.20 
Outpatient Medical Services,LAB,83001,Test of hormone in the blood,301,$107.00 ,$47.08,44% of total billed charges which is 100% CMS Medicare rate,$47.08,44% of total billed charges which is 100% CMS Medicare rate,$47.08,44% of total billed charges which is 100% CMS Medicare rate,$47.08,44% of total billed charges which is 100% CMS Medicare rate,$47.08,44% of total billed charges which is 100% CMS Medicare rate,$47.08,44% of total billed charges which is 100% CMS Medicare rate,$47.08,44% of total billed charges which is 100% CMS Medicare rate,$47.08,44% of total billed charges which is 100% CMS Medicare rate,$47.08,44% of total billed charges which is 100% CMS Medicare rate,$47.08,44% of total billed charges which is 100% CMS Medicare rate,$47.08,44% of total billed charges which is 100% CMS Medicare rate,$47.08,$47.08,$90.95 
Outpatient Medical Services,LAB,83519,GAD-65 AUTO Ab,301,$175.00 ,$77.00,44% of total billed charges which is 100% CMS Medicare rate,$77.00,44% of total billed charges which is 100% CMS Medicare rate,$77.00,44% of total billed charges which is 100% CMS Medicare rate,$77.00,44% of total billed charges which is 100% CMS Medicare rate,$77.00,44% of total billed charges which is 100% CMS Medicare rate,$77.00,44% of total billed charges which is 100% CMS Medicare rate,$77.00,44% of total billed charges which is 100% CMS Medicare rate,$77.00,44% of total billed charges which is 100% CMS Medicare rate,$77.00,44% of total billed charges which is 100% CMS Medicare rate,$77.00,44% of total billed charges which is 100% CMS Medicare rate,$77.00,44% of total billed charges which is 100% CMS Medicare rate,$77.00,$77.00,$148.75 
Outpatient Medical Services,LAB,87491,Test that detects Chlamydia,300,$259.00 ,$113.96,44% of total billed charges which is 100% CMS Medicare rate,$113.96,44% of total billed charges which is 100% CMS Medicare rate,$113.96,44% of total billed charges which is 100% CMS Medicare rate,$113.96,44% of total billed charges which is 100% CMS Medicare rate,$113.96,44% of total billed charges which is 100% CMS Medicare rate,$113.96,44% of total billed charges which is 100% CMS Medicare rate,$113.96,44% of total billed charges which is 100% CMS Medicare rate,$113.96,44% of total billed charges which is 100% CMS Medicare rate,$113.96,44% of total billed charges which is 100% CMS Medicare rate,$113.96,44% of total billed charges which is 100% CMS Medicare rate,$113.96,44% of total billed charges which is 100% CMS Medicare rate,$113.96,$113.96,$220.15 
Outpatient Medical Services,LAB,87901,GENOSURE,300,$662.00 ,$291.28,44% of total billed charges which is 100% CMS Medicare rate,$291.28,44% of total billed charges which is 100% CMS Medicare rate,$291.28,44% of total billed charges which is 100% CMS Medicare rate,$291.28,44% of total billed charges which is 100% CMS Medicare rate,$291.28,44% of total billed charges which is 100% CMS Medicare rate,$291.28,44% of total billed charges which is 100% CMS Medicare rate,$291.28,44% of total billed charges which is 100% CMS Medicare rate,$291.28,44% of total billed charges which is 100% CMS Medicare rate,$291.28,44% of total billed charges which is 100% CMS Medicare rate,$291.28,44% of total billed charges which is 100% CMS Medicare rate,$291.28,44% of total billed charges which is 100% CMS Medicare rate,$291.28,$291.28,$562.70 
Outpatient Medical Services,LAB,80170,GENTAMICIN LEVEL,301,$102.00 ,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,$44.88,$86.70 
Outpatient Medical Services,LAB,82947,Quantitative measure of glucose build up in the blood over time,301,$41.00 ,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,$18.04,$34.85 
Outpatient Medical Services,LAB,83003,"GROWTH HORMONE,HUMAN(HGH)",301,$130.00 ,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,$57.20,$110.50 
Outpatient Medical Services,LAB,87338,H PYLORI STOOL ANTIGEN,306,$227.00 ,$99.88,44% of total billed charges which is 100% CMS Medicare rate,$99.88,44% of total billed charges which is 100% CMS Medicare rate,$99.88,44% of total billed charges which is 100% CMS Medicare rate,$99.88,44% of total billed charges which is 100% CMS Medicare rate,$99.88,44% of total billed charges which is 100% CMS Medicare rate,$99.88,44% of total billed charges which is 100% CMS Medicare rate,$99.88,44% of total billed charges which is 100% CMS Medicare rate,$99.88,44% of total billed charges which is 100% CMS Medicare rate,$99.88,44% of total billed charges which is 100% CMS Medicare rate,$99.88,44% of total billed charges which is 100% CMS Medicare rate,$99.88,44% of total billed charges which is 100% CMS Medicare rate,$99.88,$99.88,$192.95 
Outpatient Medical Services,LAB,84702,hCG QUANTITATIVE,301,$118.00 ,$51.92,44% of total billed charges which is 100% CMS Medicare rate,$51.92,44% of total billed charges which is 100% CMS Medicare rate,$51.92,44% of total billed charges which is 100% CMS Medicare rate,$51.92,44% of total billed charges which is 100% CMS Medicare rate,$51.92,44% of total billed charges which is 100% CMS Medicare rate,$51.92,44% of total billed charges which is 100% CMS Medicare rate,$51.92,44% of total billed charges which is 100% CMS Medicare rate,$51.92,44% of total billed charges which is 100% CMS Medicare rate,$51.92,44% of total billed charges which is 100% CMS Medicare rate,$51.92,44% of total billed charges which is 100% CMS Medicare rate,$51.92,44% of total billed charges which is 100% CMS Medicare rate,$51.92,$51.92,$100.30 
Outpatient Medical Services,LAB,87902,HCV GENOTYPE,300,$640.00 ,$281.60,44% of total billed charges which is 100% CMS Medicare rate,$281.60,44% of total billed charges which is 100% CMS Medicare rate,$281.60,44% of total billed charges which is 100% CMS Medicare rate,$281.60,44% of total billed charges which is 100% CMS Medicare rate,$281.60,44% of total billed charges which is 100% CMS Medicare rate,$281.60,44% of total billed charges which is 100% CMS Medicare rate,$281.60,44% of total billed charges which is 100% CMS Medicare rate,$281.60,44% of total billed charges which is 100% CMS Medicare rate,$281.60,44% of total billed charges which is 100% CMS Medicare rate,$281.60,44% of total billed charges which is 100% CMS Medicare rate,$281.60,44% of total billed charges which is 100% CMS Medicare rate,$281.60,$281.60,$544.00 
Outpatient Medical Services,LAB,87521,"HCV, RNA Qual",300,$640.00 ,$281.60,44% of total billed charges which is 100% CMS Medicare rate,$281.60,44% of total billed charges which is 100% CMS Medicare rate,$281.60,44% of total billed charges which is 100% CMS Medicare rate,$281.60,44% of total billed charges which is 100% CMS Medicare rate,$281.60,44% of total billed charges which is 100% CMS Medicare rate,$281.60,44% of total billed charges which is 100% CMS Medicare rate,$281.60,44% of total billed charges which is 100% CMS Medicare rate,$281.60,44% of total billed charges which is 100% CMS Medicare rate,$281.60,44% of total billed charges which is 100% CMS Medicare rate,$281.60,44% of total billed charges which is 100% CMS Medicare rate,$281.60,44% of total billed charges which is 100% CMS Medicare rate,$281.60,$281.60,$544.00 
Outpatient Medical Services,LAB,83718,Blood test to measure the level of lipoproteins in the blood,301,$51.00 ,$22.44,44% of total billed charges which is 100% CMS Medicare rate,$22.44,44% of total billed charges which is 100% CMS Medicare rate,$22.44,44% of total billed charges which is 100% CMS Medicare rate,$22.44,44% of total billed charges which is 100% CMS Medicare rate,$22.44,44% of total billed charges which is 100% CMS Medicare rate,$22.44,44% of total billed charges which is 100% CMS Medicare rate,$22.44,44% of total billed charges which is 100% CMS Medicare rate,$22.44,44% of total billed charges which is 100% CMS Medicare rate,$22.44,44% of total billed charges which is 100% CMS Medicare rate,$22.44,44% of total billed charges which is 100% CMS Medicare rate,$22.44,44% of total billed charges which is 100% CMS Medicare rate,$22.44,$22.44,$43.35 
Outpatient Medical Services,LAB,85014,HEMATOCRIT,305,$29.00 ,$12.76,44% of total billed charges which is 100% CMS Medicare rate,$12.76,44% of total billed charges which is 100% CMS Medicare rate,$12.76,44% of total billed charges which is 100% CMS Medicare rate,$12.76,44% of total billed charges which is 100% CMS Medicare rate,$12.76,44% of total billed charges which is 100% CMS Medicare rate,$12.76,44% of total billed charges which is 100% CMS Medicare rate,$12.76,44% of total billed charges which is 100% CMS Medicare rate,$12.76,44% of total billed charges which is 100% CMS Medicare rate,$12.76,44% of total billed charges which is 100% CMS Medicare rate,$12.76,44% of total billed charges which is 100% CMS Medicare rate,$12.76,44% of total billed charges which is 100% CMS Medicare rate,$12.76,$12.76,$24.65 
Outpatient Medical Services,LAB,83051,HEMOBLOBIN FREE PLASMA,300,$91.00 ,$40.04,44% of total billed charges which is 100% CMS Medicare rate,$40.04,44% of total billed charges which is 100% CMS Medicare rate,$40.04,44% of total billed charges which is 100% CMS Medicare rate,$40.04,44% of total billed charges which is 100% CMS Medicare rate,$40.04,44% of total billed charges which is 100% CMS Medicare rate,$40.04,44% of total billed charges which is 100% CMS Medicare rate,$40.04,44% of total billed charges which is 100% CMS Medicare rate,$40.04,44% of total billed charges which is 100% CMS Medicare rate,$40.04,44% of total billed charges which is 100% CMS Medicare rate,$40.04,44% of total billed charges which is 100% CMS Medicare rate,$40.04,44% of total billed charges which is 100% CMS Medicare rate,$40.04,$40.04,$77.35 
Outpatient Medical Services,LAB,85018,Blood test to measure levels of hemoglobin,305,$29.00 ,$12.76,44% of total billed charges which is 100% CMS Medicare rate,$12.76,44% of total billed charges which is 100% CMS Medicare rate,$12.76,44% of total billed charges which is 100% CMS Medicare rate,$12.76,44% of total billed charges which is 100% CMS Medicare rate,$12.76,44% of total billed charges which is 100% CMS Medicare rate,$12.76,44% of total billed charges which is 100% CMS Medicare rate,$12.76,44% of total billed charges which is 100% CMS Medicare rate,$12.76,44% of total billed charges which is 100% CMS Medicare rate,$12.76,44% of total billed charges which is 100% CMS Medicare rate,$12.76,44% of total billed charges which is 100% CMS Medicare rate,$12.76,44% of total billed charges which is 100% CMS Medicare rate,$12.76,$12.76,$24.65 
Outpatient Medical Services,LAB,83036,Blood test to measure average blood glucose levels for past 2-3 months,301,$57.00 ,$25.08,44% of total billed charges which is 100% CMS Medicare rate,$25.08,44% of total billed charges which is 100% CMS Medicare rate,$25.08,44% of total billed charges which is 100% CMS Medicare rate,$25.08,44% of total billed charges which is 100% CMS Medicare rate,$25.08,44% of total billed charges which is 100% CMS Medicare rate,$25.08,44% of total billed charges which is 100% CMS Medicare rate,$25.08,44% of total billed charges which is 100% CMS Medicare rate,$25.08,44% of total billed charges which is 100% CMS Medicare rate,$25.08,44% of total billed charges which is 100% CMS Medicare rate,$25.08,44% of total billed charges which is 100% CMS Medicare rate,$25.08,44% of total billed charges which is 100% CMS Medicare rate,$25.08,$25.08,$48.45 
Outpatient Medical Services,LAB,85660,HEMOGLOBIN SOLUBILITY,305,$90.00 ,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,$39.60,$76.50 
Outpatient Medical Services,LAB,86708,Blood test indicating infection with Hepatitis A,302,$115.00 ,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,$50.60,$97.75 
Outpatient Medical Services,LAB,86709,HEP A AB- IGM,302,$82.00 ,$36.08,44% of total billed charges which is 100% CMS Medicare rate,$36.08,44% of total billed charges which is 100% CMS Medicare rate,$36.08,44% of total billed charges which is 100% CMS Medicare rate,$36.08,44% of total billed charges which is 100% CMS Medicare rate,$36.08,44% of total billed charges which is 100% CMS Medicare rate,$36.08,44% of total billed charges which is 100% CMS Medicare rate,$36.08,44% of total billed charges which is 100% CMS Medicare rate,$36.08,44% of total billed charges which is 100% CMS Medicare rate,$36.08,44% of total billed charges which is 100% CMS Medicare rate,$36.08,44% of total billed charges which is 100% CMS Medicare rate,$36.08,44% of total billed charges which is 100% CMS Medicare rate,$36.08,$36.08,$69.70 
Outpatient Medical Services,LAB,86704,Blood test indicating infection with Hepatitis B,302,$114.00 ,$50.16,44% of total billed charges which is 100% CMS Medicare rate,$50.16,44% of total billed charges which is 100% CMS Medicare rate,$50.16,44% of total billed charges which is 100% CMS Medicare rate,$50.16,44% of total billed charges which is 100% CMS Medicare rate,$50.16,44% of total billed charges which is 100% CMS Medicare rate,$50.16,44% of total billed charges which is 100% CMS Medicare rate,$50.16,44% of total billed charges which is 100% CMS Medicare rate,$50.16,44% of total billed charges which is 100% CMS Medicare rate,$50.16,44% of total billed charges which is 100% CMS Medicare rate,$50.16,44% of total billed charges which is 100% CMS Medicare rate,$50.16,44% of total billed charges which is 100% CMS Medicare rate,$50.16,$50.16,$96.90 
Outpatient Medical Services,LAB,86705,HEP B CORE AB- IGM,302,$64.00 ,$28.16,44% of total billed charges which is 100% CMS Medicare rate,$28.16,44% of total billed charges which is 100% CMS Medicare rate,$28.16,44% of total billed charges which is 100% CMS Medicare rate,$28.16,44% of total billed charges which is 100% CMS Medicare rate,$28.16,44% of total billed charges which is 100% CMS Medicare rate,$28.16,44% of total billed charges which is 100% CMS Medicare rate,$28.16,44% of total billed charges which is 100% CMS Medicare rate,$28.16,44% of total billed charges which is 100% CMS Medicare rate,$28.16,44% of total billed charges which is 100% CMS Medicare rate,$28.16,44% of total billed charges which is 100% CMS Medicare rate,$28.16,44% of total billed charges which is 100% CMS Medicare rate,$28.16,$28.16,$54.40 
Outpatient Medical Services,LAB,86706,HEP B SURF ANTIBODY(HBsAb,302,$69.00 ,$30.36,44% of total billed charges which is 100% CMS Medicare rate,$30.36,44% of total billed charges which is 100% CMS Medicare rate,$30.36,44% of total billed charges which is 100% CMS Medicare rate,$30.36,44% of total billed charges which is 100% CMS Medicare rate,$30.36,44% of total billed charges which is 100% CMS Medicare rate,$30.36,44% of total billed charges which is 100% CMS Medicare rate,$30.36,44% of total billed charges which is 100% CMS Medicare rate,$30.36,44% of total billed charges which is 100% CMS Medicare rate,$30.36,44% of total billed charges which is 100% CMS Medicare rate,$30.36,44% of total billed charges which is 100% CMS Medicare rate,$30.36,44% of total billed charges which is 100% CMS Medicare rate,$30.36,$30.36,$58.65 
Outpatient Medical Services,LAB,86707,HEP BE ANTIBODY,300,$77.00 ,$33.88,44% of total billed charges which is 100% CMS Medicare rate,$33.88,44% of total billed charges which is 100% CMS Medicare rate,$33.88,44% of total billed charges which is 100% CMS Medicare rate,$33.88,44% of total billed charges which is 100% CMS Medicare rate,$33.88,44% of total billed charges which is 100% CMS Medicare rate,$33.88,44% of total billed charges which is 100% CMS Medicare rate,$33.88,44% of total billed charges which is 100% CMS Medicare rate,$33.88,44% of total billed charges which is 100% CMS Medicare rate,$33.88,44% of total billed charges which is 100% CMS Medicare rate,$33.88,44% of total billed charges which is 100% CMS Medicare rate,$33.88,44% of total billed charges which is 100% CMS Medicare rate,$33.88,$33.88,$65.45 
Outpatient Medical Services,LAB,86804,"HEP C ANTIB, CONF RIBA",302,$337.00 ,$148.28,44% of total billed charges which is 100% CMS Medicare rate,$148.28,44% of total billed charges which is 100% CMS Medicare rate,$148.28,44% of total billed charges which is 100% CMS Medicare rate,$148.28,44% of total billed charges which is 100% CMS Medicare rate,$148.28,44% of total billed charges which is 100% CMS Medicare rate,$148.28,44% of total billed charges which is 100% CMS Medicare rate,$148.28,44% of total billed charges which is 100% CMS Medicare rate,$148.28,44% of total billed charges which is 100% CMS Medicare rate,$148.28,44% of total billed charges which is 100% CMS Medicare rate,$148.28,44% of total billed charges which is 100% CMS Medicare rate,$148.28,44% of total billed charges which is 100% CMS Medicare rate,$148.28,$148.28,$286.45 
Outpatient Medical Services,LAB,87522,"HEP C, RNA PCR QUANT",306,$355.00 ,$156.20,44% of total billed charges which is 100% CMS Medicare rate,$156.20,44% of total billed charges which is 100% CMS Medicare rate,$156.20,44% of total billed charges which is 100% CMS Medicare rate,$156.20,44% of total billed charges which is 100% CMS Medicare rate,$156.20,44% of total billed charges which is 100% CMS Medicare rate,$156.20,44% of total billed charges which is 100% CMS Medicare rate,$156.20,44% of total billed charges which is 100% CMS Medicare rate,$156.20,44% of total billed charges which is 100% CMS Medicare rate,$156.20,44% of total billed charges which is 100% CMS Medicare rate,$156.20,44% of total billed charges which is 100% CMS Medicare rate,$156.20,44% of total billed charges which is 100% CMS Medicare rate,$156.20,$156.20,$301.75 
Outpatient Medical Services,LAB,80076,Liver function blood test panel,301,$129.00 ,$56.76,44% of total billed charges which is 100% CMS Medicare rate,$56.76,44% of total billed charges which is 100% CMS Medicare rate,$56.76,44% of total billed charges which is 100% CMS Medicare rate,$56.76,44% of total billed charges which is 100% CMS Medicare rate,$56.76,44% of total billed charges which is 100% CMS Medicare rate,$56.76,44% of total billed charges which is 100% CMS Medicare rate,$56.76,44% of total billed charges which is 100% CMS Medicare rate,$56.76,44% of total billed charges which is 100% CMS Medicare rate,$56.76,44% of total billed charges which is 100% CMS Medicare rate,$56.76,44% of total billed charges which is 100% CMS Medicare rate,$56.76,44% of total billed charges which is 100% CMS Medicare rate,$56.76,$56.76,$109.65 
Outpatient Medical Services,LAB,86803,Blood test to determine infection with Hepatitis C,302,$74.00 ,$32.56,44% of total billed charges which is 100% CMS Medicare rate,$32.56,44% of total billed charges which is 100% CMS Medicare rate,$32.56,44% of total billed charges which is 100% CMS Medicare rate,$32.56,44% of total billed charges which is 100% CMS Medicare rate,$32.56,44% of total billed charges which is 100% CMS Medicare rate,$32.56,44% of total billed charges which is 100% CMS Medicare rate,$32.56,44% of total billed charges which is 100% CMS Medicare rate,$32.56,44% of total billed charges which is 100% CMS Medicare rate,$32.56,44% of total billed charges which is 100% CMS Medicare rate,$32.56,44% of total billed charges which is 100% CMS Medicare rate,$32.56,44% of total billed charges which is 100% CMS Medicare rate,$32.56,$32.56,$62.90 
Outpatient Medical Services,LAB,80074,Acute hepatitis panel,301,$213.00 ,$93.72,44% of total billed charges which is 100% CMS Medicare rate,$93.72,44% of total billed charges which is 100% CMS Medicare rate,$93.72,44% of total billed charges which is 100% CMS Medicare rate,$93.72,44% of total billed charges which is 100% CMS Medicare rate,$93.72,44% of total billed charges which is 100% CMS Medicare rate,$93.72,44% of total billed charges which is 100% CMS Medicare rate,$93.72,44% of total billed charges which is 100% CMS Medicare rate,$93.72,44% of total billed charges which is 100% CMS Medicare rate,$93.72,44% of total billed charges which is 100% CMS Medicare rate,$93.72,44% of total billed charges which is 100% CMS Medicare rate,$93.72,44% of total billed charges which is 100% CMS Medicare rate,$93.72,$93.72,$181.05 
Outpatient Medical Services,LAB,86689,HIV - WEST BLOT,302,$242.00 ,$106.48,44% of total billed charges which is 100% CMS Medicare rate,$106.48,44% of total billed charges which is 100% CMS Medicare rate,$106.48,44% of total billed charges which is 100% CMS Medicare rate,$106.48,44% of total billed charges which is 100% CMS Medicare rate,$106.48,44% of total billed charges which is 100% CMS Medicare rate,$106.48,44% of total billed charges which is 100% CMS Medicare rate,$106.48,44% of total billed charges which is 100% CMS Medicare rate,$106.48,44% of total billed charges which is 100% CMS Medicare rate,$106.48,44% of total billed charges which is 100% CMS Medicare rate,$106.48,44% of total billed charges which is 100% CMS Medicare rate,$106.48,44% of total billed charges which is 100% CMS Medicare rate,$106.48,$106.48,$205.70 
Outpatient Medical Services,LAB,87535,"HIV 1, AMP PROB TECHNIQUE",300,$230.00 ,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,$101.20,$195.50 
Outpatient Medical Services,LAB,87797,HIV- VIRAL LOAD -DETECT,306,$345.00 ,$151.80,44% of total billed charges which is 100% CMS Medicare rate,$151.80,44% of total billed charges which is 100% CMS Medicare rate,$151.80,44% of total billed charges which is 100% CMS Medicare rate,$151.80,44% of total billed charges which is 100% CMS Medicare rate,$151.80,44% of total billed charges which is 100% CMS Medicare rate,$151.80,44% of total billed charges which is 100% CMS Medicare rate,$151.80,44% of total billed charges which is 100% CMS Medicare rate,$151.80,44% of total billed charges which is 100% CMS Medicare rate,$151.80,44% of total billed charges which is 100% CMS Medicare rate,$151.80,44% of total billed charges which is 100% CMS Medicare rate,$151.80,44% of total billed charges which is 100% CMS Medicare rate,$151.80,$151.80,$293.25 
Outpatient Medical Services,LAB,86812,HLA B27,302,$212.00 ,$93.28,44% of total billed charges which is 100% CMS Medicare rate,$93.28,44% of total billed charges which is 100% CMS Medicare rate,$93.28,44% of total billed charges which is 100% CMS Medicare rate,$93.28,44% of total billed charges which is 100% CMS Medicare rate,$93.28,44% of total billed charges which is 100% CMS Medicare rate,$93.28,44% of total billed charges which is 100% CMS Medicare rate,$93.28,44% of total billed charges which is 100% CMS Medicare rate,$93.28,44% of total billed charges which is 100% CMS Medicare rate,$93.28,44% of total billed charges which is 100% CMS Medicare rate,$93.28,44% of total billed charges which is 100% CMS Medicare rate,$93.28,44% of total billed charges which is 100% CMS Medicare rate,$93.28,$93.28,$180.20 
Outpatient Medical Services,LAB,83090,HOMOCYSTINE (SERUM),301,$229.00 ,$100.76,44% of total billed charges which is 100% CMS Medicare rate,$100.76,44% of total billed charges which is 100% CMS Medicare rate,$100.76,44% of total billed charges which is 100% CMS Medicare rate,$100.76,44% of total billed charges which is 100% CMS Medicare rate,$100.76,44% of total billed charges which is 100% CMS Medicare rate,$100.76,44% of total billed charges which is 100% CMS Medicare rate,$100.76,44% of total billed charges which is 100% CMS Medicare rate,$100.76,44% of total billed charges which is 100% CMS Medicare rate,$100.76,44% of total billed charges which is 100% CMS Medicare rate,$100.76,44% of total billed charges which is 100% CMS Medicare rate,$100.76,44% of total billed charges which is 100% CMS Medicare rate,$100.76,$100.76,$194.65 
Outpatient Medical Services,LAB,87621,"HPV, HYBRID CAP II",306,$244.00 ,$107.36,44% of total billed charges which is 100% CMS Medicare rate,$107.36,44% of total billed charges which is 100% CMS Medicare rate,$107.36,44% of total billed charges which is 100% CMS Medicare rate,$107.36,44% of total billed charges which is 100% CMS Medicare rate,$107.36,44% of total billed charges which is 100% CMS Medicare rate,$107.36,44% of total billed charges which is 100% CMS Medicare rate,$107.36,44% of total billed charges which is 100% CMS Medicare rate,$107.36,44% of total billed charges which is 100% CMS Medicare rate,$107.36,44% of total billed charges which is 100% CMS Medicare rate,$107.36,44% of total billed charges which is 100% CMS Medicare rate,$107.36,44% of total billed charges which is 100% CMS Medicare rate,$107.36,$107.36,$207.40 
Outpatient Medical Services,LAB,87798,HTLV-I/II LYMPHOTROPIC,300,$513.00 ,$225.72,44% of total billed charges which is 100% CMS Medicare rate,$225.72,44% of total billed charges which is 100% CMS Medicare rate,$225.72,44% of total billed charges which is 100% CMS Medicare rate,$225.72,44% of total billed charges which is 100% CMS Medicare rate,$225.72,44% of total billed charges which is 100% CMS Medicare rate,$225.72,44% of total billed charges which is 100% CMS Medicare rate,$225.72,44% of total billed charges which is 100% CMS Medicare rate,$225.72,44% of total billed charges which is 100% CMS Medicare rate,$225.72,44% of total billed charges which is 100% CMS Medicare rate,$225.72,44% of total billed charges which is 100% CMS Medicare rate,$225.72,44% of total billed charges which is 100% CMS Medicare rate,$225.72,$225.72,$436.05 
Outpatient Medical Services,LAB,86341,IA2 AUTO ANTIBODIES,300,$265.00 ,$116.60,44% of total billed charges which is 100% CMS Medicare rate,$116.60,44% of total billed charges which is 100% CMS Medicare rate,$116.60,44% of total billed charges which is 100% CMS Medicare rate,$116.60,44% of total billed charges which is 100% CMS Medicare rate,$116.60,44% of total billed charges which is 100% CMS Medicare rate,$116.60,44% of total billed charges which is 100% CMS Medicare rate,$116.60,44% of total billed charges which is 100% CMS Medicare rate,$116.60,44% of total billed charges which is 100% CMS Medicare rate,$116.60,44% of total billed charges which is 100% CMS Medicare rate,$116.60,44% of total billed charges which is 100% CMS Medicare rate,$116.60,44% of total billed charges which is 100% CMS Medicare rate,$116.60,$116.60,$225.25 
Outpatient Medical Services,LAB,84305,IGF -1,301,$259.00 ,$113.96,44% of total billed charges which is 100% CMS Medicare rate,$113.96,44% of total billed charges which is 100% CMS Medicare rate,$113.96,44% of total billed charges which is 100% CMS Medicare rate,$113.96,44% of total billed charges which is 100% CMS Medicare rate,$113.96,44% of total billed charges which is 100% CMS Medicare rate,$113.96,44% of total billed charges which is 100% CMS Medicare rate,$113.96,44% of total billed charges which is 100% CMS Medicare rate,$113.96,44% of total billed charges which is 100% CMS Medicare rate,$113.96,44% of total billed charges which is 100% CMS Medicare rate,$113.96,44% of total billed charges which is 100% CMS Medicare rate,$113.96,44% of total billed charges which is 100% CMS Medicare rate,$113.96,$113.96,$220.15 
Outpatient Medical Services,LAB,82784,Test to determine levels of immunoglobulins in the blood,301,$104.00 ,$45.76,44% of total billed charges which is 100% CMS Medicare rate,$45.76,44% of total billed charges which is 100% CMS Medicare rate,$45.76,44% of total billed charges which is 100% CMS Medicare rate,$45.76,44% of total billed charges which is 100% CMS Medicare rate,$45.76,44% of total billed charges which is 100% CMS Medicare rate,$45.76,44% of total billed charges which is 100% CMS Medicare rate,$45.76,44% of total billed charges which is 100% CMS Medicare rate,$45.76,44% of total billed charges which is 100% CMS Medicare rate,$45.76,44% of total billed charges which is 100% CMS Medicare rate,$45.76,44% of total billed charges which is 100% CMS Medicare rate,$45.76,44% of total billed charges which is 100% CMS Medicare rate,$45.76,$45.76,$88.40 
Outpatient Medical Services,LAB,82785,IMMUNOGLOBULIN IGE,301,$104.00 ,$45.76,44% of total billed charges which is 100% CMS Medicare rate,$45.76,44% of total billed charges which is 100% CMS Medicare rate,$45.76,44% of total billed charges which is 100% CMS Medicare rate,$45.76,44% of total billed charges which is 100% CMS Medicare rate,$45.76,44% of total billed charges which is 100% CMS Medicare rate,$45.76,44% of total billed charges which is 100% CMS Medicare rate,$45.76,44% of total billed charges which is 100% CMS Medicare rate,$45.76,44% of total billed charges which is 100% CMS Medicare rate,$45.76,44% of total billed charges which is 100% CMS Medicare rate,$45.76,44% of total billed charges which is 100% CMS Medicare rate,$45.76,44% of total billed charges which is 100% CMS Medicare rate,$45.76,$45.76,$88.40 
Outpatient Medical Services,LAB,87804,Flu test,306,$162.00 ,$71.28,44% of total billed charges which is 100% CMS Medicare rate,$71.28,44% of total billed charges which is 100% CMS Medicare rate,$71.28,44% of total billed charges which is 100% CMS Medicare rate,$71.28,44% of total billed charges which is 100% CMS Medicare rate,$71.28,44% of total billed charges which is 100% CMS Medicare rate,$71.28,44% of total billed charges which is 100% CMS Medicare rate,$71.28,44% of total billed charges which is 100% CMS Medicare rate,$71.28,44% of total billed charges which is 100% CMS Medicare rate,$71.28,44% of total billed charges which is 100% CMS Medicare rate,$71.28,44% of total billed charges which is 100% CMS Medicare rate,$71.28,44% of total billed charges which is 100% CMS Medicare rate,$71.28,$71.28,$137.70 
Outpatient Medical Services,LAB,86337,INSULIN AUTOANTIBODIES,300,$202.00 ,$88.88,44% of total billed charges which is 100% CMS Medicare rate,$88.88,44% of total billed charges which is 100% CMS Medicare rate,$88.88,44% of total billed charges which is 100% CMS Medicare rate,$88.88,44% of total billed charges which is 100% CMS Medicare rate,$88.88,44% of total billed charges which is 100% CMS Medicare rate,$88.88,44% of total billed charges which is 100% CMS Medicare rate,$88.88,44% of total billed charges which is 100% CMS Medicare rate,$88.88,44% of total billed charges which is 100% CMS Medicare rate,$88.88,44% of total billed charges which is 100% CMS Medicare rate,$88.88,44% of total billed charges which is 100% CMS Medicare rate,$88.88,44% of total billed charges which is 100% CMS Medicare rate,$88.88,$88.88,$171.70 
Outpatient Medical Services,LAB,83540,Blood test to measure the amount of iron that is in transit in the body,301,$41.00 ,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,$18.04,$34.85 
Outpatient Medical Services,LAB,83605,LACTIC ACID,301,$89.00 ,$39.16,44% of total billed charges which is 100% CMS Medicare rate,$39.16,44% of total billed charges which is 100% CMS Medicare rate,$39.16,44% of total billed charges which is 100% CMS Medicare rate,$39.16,44% of total billed charges which is 100% CMS Medicare rate,$39.16,44% of total billed charges which is 100% CMS Medicare rate,$39.16,44% of total billed charges which is 100% CMS Medicare rate,$39.16,44% of total billed charges which is 100% CMS Medicare rate,$39.16,44% of total billed charges which is 100% CMS Medicare rate,$39.16,44% of total billed charges which is 100% CMS Medicare rate,$39.16,44% of total billed charges which is 100% CMS Medicare rate,$39.16,44% of total billed charges which is 100% CMS Medicare rate,$39.16,$39.16,$75.65 
Outpatient Medical Services,LAB,83615,LDH ( LD),301,$41.00 ,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,$18.04,$34.85 
Outpatient Medical Services,LAB,83721,LDL CHOLESTEROL (DIRECT),300,$93.00 ,$40.92,44% of total billed charges which is 100% CMS Medicare rate,$40.92,44% of total billed charges which is 100% CMS Medicare rate,$40.92,44% of total billed charges which is 100% CMS Medicare rate,$40.92,44% of total billed charges which is 100% CMS Medicare rate,$40.92,44% of total billed charges which is 100% CMS Medicare rate,$40.92,44% of total billed charges which is 100% CMS Medicare rate,$40.92,44% of total billed charges which is 100% CMS Medicare rate,$40.92,44% of total billed charges which is 100% CMS Medicare rate,$40.92,44% of total billed charges which is 100% CMS Medicare rate,$40.92,44% of total billed charges which is 100% CMS Medicare rate,$40.92,44% of total billed charges which is 100% CMS Medicare rate,$40.92,$40.92,$79.05 
Outpatient Medical Services,LAB,83655,Blood test to determine the concentration of lead in the blood,301,$95.00 ,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,$41.80,$80.75 
Outpatient Medical Services,LAB,83002,Test of hormone in the blood,301,$89.00 ,$39.16,44% of total billed charges which is 100% CMS Medicare rate,$39.16,44% of total billed charges which is 100% CMS Medicare rate,$39.16,44% of total billed charges which is 100% CMS Medicare rate,$39.16,44% of total billed charges which is 100% CMS Medicare rate,$39.16,44% of total billed charges which is 100% CMS Medicare rate,$39.16,44% of total billed charges which is 100% CMS Medicare rate,$39.16,44% of total billed charges which is 100% CMS Medicare rate,$39.16,44% of total billed charges which is 100% CMS Medicare rate,$39.16,44% of total billed charges which is 100% CMS Medicare rate,$39.16,44% of total billed charges which is 100% CMS Medicare rate,$39.16,44% of total billed charges which is 100% CMS Medicare rate,$39.16,$39.16,$75.65 
Outpatient Medical Services,LAB,83690,LIPASE,301,$57.00 ,$25.08,44% of total billed charges which is 100% CMS Medicare rate,$25.08,44% of total billed charges which is 100% CMS Medicare rate,$25.08,44% of total billed charges which is 100% CMS Medicare rate,$25.08,44% of total billed charges which is 100% CMS Medicare rate,$25.08,44% of total billed charges which is 100% CMS Medicare rate,$25.08,44% of total billed charges which is 100% CMS Medicare rate,$25.08,44% of total billed charges which is 100% CMS Medicare rate,$25.08,44% of total billed charges which is 100% CMS Medicare rate,$25.08,44% of total billed charges which is 100% CMS Medicare rate,$25.08,44% of total billed charges which is 100% CMS Medicare rate,$25.08,44% of total billed charges which is 100% CMS Medicare rate,$25.08,$25.08,$48.45 
Outpatient Medical Services,LAB,80061,"Blood test, lipids (cholesterol and triglycerides)",301,$85.00 ,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,$37.40,$72.25 
Outpatient Medical Services,LAB,80178,LITHIUM LEVEL,301,$55.00 ,$24.20,44% of total billed charges which is 100% CMS Medicare rate,$24.20,44% of total billed charges which is 100% CMS Medicare rate,$24.20,44% of total billed charges which is 100% CMS Medicare rate,$24.20,44% of total billed charges which is 100% CMS Medicare rate,$24.20,44% of total billed charges which is 100% CMS Medicare rate,$24.20,44% of total billed charges which is 100% CMS Medicare rate,$24.20,44% of total billed charges which is 100% CMS Medicare rate,$24.20,44% of total billed charges which is 100% CMS Medicare rate,$24.20,44% of total billed charges which is 100% CMS Medicare rate,$24.20,44% of total billed charges which is 100% CMS Medicare rate,$24.20,44% of total billed charges which is 100% CMS Medicare rate,$24.20,$24.20,$46.75 
Outpatient Medical Services,LAB,86618,LYME DISEASE TOTAL-REFLEX,302,$253.00 ,$111.32,44% of total billed charges which is 100% CMS Medicare rate,$111.32,44% of total billed charges which is 100% CMS Medicare rate,$111.32,44% of total billed charges which is 100% CMS Medicare rate,$111.32,44% of total billed charges which is 100% CMS Medicare rate,$111.32,44% of total billed charges which is 100% CMS Medicare rate,$111.32,44% of total billed charges which is 100% CMS Medicare rate,$111.32,44% of total billed charges which is 100% CMS Medicare rate,$111.32,44% of total billed charges which is 100% CMS Medicare rate,$111.32,44% of total billed charges which is 100% CMS Medicare rate,$111.32,44% of total billed charges which is 100% CMS Medicare rate,$111.32,44% of total billed charges which is 100% CMS Medicare rate,$111.32,$111.32,$215.05 
Outpatient Medical Services,LAB,86617,LYME'S DISEASE CSF,302,$219.00 ,$96.36,44% of total billed charges which is 100% CMS Medicare rate,$96.36,44% of total billed charges which is 100% CMS Medicare rate,$96.36,44% of total billed charges which is 100% CMS Medicare rate,$96.36,44% of total billed charges which is 100% CMS Medicare rate,$96.36,44% of total billed charges which is 100% CMS Medicare rate,$96.36,44% of total billed charges which is 100% CMS Medicare rate,$96.36,44% of total billed charges which is 100% CMS Medicare rate,$96.36,44% of total billed charges which is 100% CMS Medicare rate,$96.36,44% of total billed charges which is 100% CMS Medicare rate,$96.36,44% of total billed charges which is 100% CMS Medicare rate,$96.36,44% of total billed charges which is 100% CMS Medicare rate,$96.36,$96.36,$186.15 
Outpatient Medical Services,LAB,87556,M TUBERCULOSIS DETECTION,300,$296.00 ,$130.24,44% of total billed charges which is 100% CMS Medicare rate,$130.24,44% of total billed charges which is 100% CMS Medicare rate,$130.24,44% of total billed charges which is 100% CMS Medicare rate,$130.24,44% of total billed charges which is 100% CMS Medicare rate,$130.24,44% of total billed charges which is 100% CMS Medicare rate,$130.24,44% of total billed charges which is 100% CMS Medicare rate,$130.24,44% of total billed charges which is 100% CMS Medicare rate,$130.24,44% of total billed charges which is 100% CMS Medicare rate,$130.24,44% of total billed charges which is 100% CMS Medicare rate,$130.24,44% of total billed charges which is 100% CMS Medicare rate,$130.24,44% of total billed charges which is 100% CMS Medicare rate,$130.24,$130.24,$251.60 
Outpatient Medical Services,LAB,87206,MAC AFB REFLEX ID,300,$300.00 ,$132.00,44% of total billed charges which is 100% CMS Medicare rate,$132.00,44% of total billed charges which is 100% CMS Medicare rate,$132.00,44% of total billed charges which is 100% CMS Medicare rate,$132.00,44% of total billed charges which is 100% CMS Medicare rate,$132.00,44% of total billed charges which is 100% CMS Medicare rate,$132.00,44% of total billed charges which is 100% CMS Medicare rate,$132.00,44% of total billed charges which is 100% CMS Medicare rate,$132.00,44% of total billed charges which is 100% CMS Medicare rate,$132.00,44% of total billed charges which is 100% CMS Medicare rate,$132.00,44% of total billed charges which is 100% CMS Medicare rate,$132.00,44% of total billed charges which is 100% CMS Medicare rate,$132.00,$132.00,$255.00 
Outpatient Medical Services,LAB,83735,MAGNESIUM (SERUM),301,$52.00 ,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,$22.88,$44.20 
Outpatient Medical Services,LAB,83835,METANEPHRINES QV PLASMA,300,$280.00 ,$123.20,44% of total billed charges which is 100% CMS Medicare rate,$123.20,44% of total billed charges which is 100% CMS Medicare rate,$123.20,44% of total billed charges which is 100% CMS Medicare rate,$123.20,44% of total billed charges which is 100% CMS Medicare rate,$123.20,44% of total billed charges which is 100% CMS Medicare rate,$123.20,44% of total billed charges which is 100% CMS Medicare rate,$123.20,44% of total billed charges which is 100% CMS Medicare rate,$123.20,44% of total billed charges which is 100% CMS Medicare rate,$123.20,44% of total billed charges which is 100% CMS Medicare rate,$123.20,44% of total billed charges which is 100% CMS Medicare rate,$123.20,44% of total billed charges which is 100% CMS Medicare rate,$123.20,$123.20,$238.00 
Outpatient Medical Services,LAB,83921,METHYLMALONIC ACID SERUM,301,$329.00 ,$144.76,44% of total billed charges which is 100% CMS Medicare rate,$144.76,44% of total billed charges which is 100% CMS Medicare rate,$144.76,44% of total billed charges which is 100% CMS Medicare rate,$144.76,44% of total billed charges which is 100% CMS Medicare rate,$144.76,44% of total billed charges which is 100% CMS Medicare rate,$144.76,44% of total billed charges which is 100% CMS Medicare rate,$144.76,44% of total billed charges which is 100% CMS Medicare rate,$144.76,44% of total billed charges which is 100% CMS Medicare rate,$144.76,44% of total billed charges which is 100% CMS Medicare rate,$144.76,44% of total billed charges which is 100% CMS Medicare rate,$144.76,44% of total billed charges which is 100% CMS Medicare rate,$144.76,$144.76,$279.65 
Outpatient Medical Services,LAB,82043,Urine test to measure albumin,301,$97.00 ,$42.68,44% of total billed charges which is 100% CMS Medicare rate,$42.68,44% of total billed charges which is 100% CMS Medicare rate,$42.68,44% of total billed charges which is 100% CMS Medicare rate,$42.68,44% of total billed charges which is 100% CMS Medicare rate,$42.68,44% of total billed charges which is 100% CMS Medicare rate,$42.68,44% of total billed charges which is 100% CMS Medicare rate,$42.68,44% of total billed charges which is 100% CMS Medicare rate,$42.68,44% of total billed charges which is 100% CMS Medicare rate,$42.68,44% of total billed charges which is 100% CMS Medicare rate,$42.68,44% of total billed charges which is 100% CMS Medicare rate,$42.68,44% of total billed charges which is 100% CMS Medicare rate,$42.68,$42.68,$82.45 
Outpatient Medical Services,LAB,86735,MMR IMMUNITY,300,$232.00 ,$102.08,44% of total billed charges which is 100% CMS Medicare rate,$102.08,44% of total billed charges which is 100% CMS Medicare rate,$102.08,44% of total billed charges which is 100% CMS Medicare rate,$102.08,44% of total billed charges which is 100% CMS Medicare rate,$102.08,44% of total billed charges which is 100% CMS Medicare rate,$102.08,44% of total billed charges which is 100% CMS Medicare rate,$102.08,44% of total billed charges which is 100% CMS Medicare rate,$102.08,44% of total billed charges which is 100% CMS Medicare rate,$102.08,44% of total billed charges which is 100% CMS Medicare rate,$102.08,44% of total billed charges which is 100% CMS Medicare rate,$102.08,44% of total billed charges which is 100% CMS Medicare rate,$102.08,$102.08,$197.20 
Outpatient Medical Services,LAB,89190,NASAL SMEAR FOR EOS,309,$52.00 ,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,$22.88,$44.20 
Outpatient Medical Services,LAB,80055,Obstetric blood test panel,301,$214.00 ,$94.16,44% of total billed charges which is 100% CMS Medicare rate,$94.16,44% of total billed charges which is 100% CMS Medicare rate,$94.16,44% of total billed charges which is 100% CMS Medicare rate,$94.16,44% of total billed charges which is 100% CMS Medicare rate,$94.16,44% of total billed charges which is 100% CMS Medicare rate,$94.16,44% of total billed charges which is 100% CMS Medicare rate,$94.16,44% of total billed charges which is 100% CMS Medicare rate,$94.16,44% of total billed charges which is 100% CMS Medicare rate,$94.16,44% of total billed charges which is 100% CMS Medicare rate,$94.16,44% of total billed charges which is 100% CMS Medicare rate,$94.16,44% of total billed charges which is 100% CMS Medicare rate,$94.16,$94.16,$181.90 
Outpatient Medical Services,LAB,82272,"OCCULT BLOOD, 1-3 TESTS",301,$540.00 ,$237.60,44% of total billed charges which is 100% CMS Medicare rate,$237.60,44% of total billed charges which is 100% CMS Medicare rate,$237.60,44% of total billed charges which is 100% CMS Medicare rate,$237.60,44% of total billed charges which is 100% CMS Medicare rate,$237.60,44% of total billed charges which is 100% CMS Medicare rate,$237.60,44% of total billed charges which is 100% CMS Medicare rate,$237.60,44% of total billed charges which is 100% CMS Medicare rate,$237.60,44% of total billed charges which is 100% CMS Medicare rate,$237.60,44% of total billed charges which is 100% CMS Medicare rate,$237.60,44% of total billed charges which is 100% CMS Medicare rate,$237.60,44% of total billed charges which is 100% CMS Medicare rate,$237.60,$237.60,$459.00 
Outpatient Medical Services,LAB,83919,ORGANIC ACID URINE,300,$229.00 ,$100.76,44% of total billed charges which is 100% CMS Medicare rate,$100.76,44% of total billed charges which is 100% CMS Medicare rate,$100.76,44% of total billed charges which is 100% CMS Medicare rate,$100.76,44% of total billed charges which is 100% CMS Medicare rate,$100.76,44% of total billed charges which is 100% CMS Medicare rate,$100.76,44% of total billed charges which is 100% CMS Medicare rate,$100.76,44% of total billed charges which is 100% CMS Medicare rate,$100.76,44% of total billed charges which is 100% CMS Medicare rate,$100.76,44% of total billed charges which is 100% CMS Medicare rate,$100.76,44% of total billed charges which is 100% CMS Medicare rate,$100.76,44% of total billed charges which is 100% CMS Medicare rate,$100.76,$100.76,$194.65 
Outpatient Medical Services,LAB,83918,ORGANIC ACID/QUAN/EA SPEC,301,$494.00 ,$217.36,44% of total billed charges which is 100% CMS Medicare rate,$217.36,44% of total billed charges which is 100% CMS Medicare rate,$217.36,44% of total billed charges which is 100% CMS Medicare rate,$217.36,44% of total billed charges which is 100% CMS Medicare rate,$217.36,44% of total billed charges which is 100% CMS Medicare rate,$217.36,44% of total billed charges which is 100% CMS Medicare rate,$217.36,44% of total billed charges which is 100% CMS Medicare rate,$217.36,44% of total billed charges which is 100% CMS Medicare rate,$217.36,44% of total billed charges which is 100% CMS Medicare rate,$217.36,44% of total billed charges which is 100% CMS Medicare rate,$217.36,44% of total billed charges which is 100% CMS Medicare rate,$217.36,$217.36,$419.90 
Outpatient Medical Services,LAB,80184,PHENOBARBITAL,301,$83.00 ,$36.52,44% of total billed charges which is 100% CMS Medicare rate,$36.52,44% of total billed charges which is 100% CMS Medicare rate,$36.52,44% of total billed charges which is 100% CMS Medicare rate,$36.52,44% of total billed charges which is 100% CMS Medicare rate,$36.52,44% of total billed charges which is 100% CMS Medicare rate,$36.52,44% of total billed charges which is 100% CMS Medicare rate,$36.52,44% of total billed charges which is 100% CMS Medicare rate,$36.52,44% of total billed charges which is 100% CMS Medicare rate,$36.52,44% of total billed charges which is 100% CMS Medicare rate,$36.52,44% of total billed charges which is 100% CMS Medicare rate,$36.52,44% of total billed charges which is 100% CMS Medicare rate,$36.52,$36.52,$70.55 
Outpatient Medical Services,LAB,84100,PHOSPHORUS SERUM,301,$41.00 ,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,$18.04,$34.85 
Outpatient Medical Services,LAB,86317,PNEUMOCOCCAL ANTIBODIES,302,$672.00 ,$295.68,44% of total billed charges which is 100% CMS Medicare rate,$295.68,44% of total billed charges which is 100% CMS Medicare rate,$295.68,44% of total billed charges which is 100% CMS Medicare rate,$295.68,44% of total billed charges which is 100% CMS Medicare rate,$295.68,44% of total billed charges which is 100% CMS Medicare rate,$295.68,44% of total billed charges which is 100% CMS Medicare rate,$295.68,44% of total billed charges which is 100% CMS Medicare rate,$295.68,44% of total billed charges which is 100% CMS Medicare rate,$295.68,44% of total billed charges which is 100% CMS Medicare rate,$295.68,44% of total billed charges which is 100% CMS Medicare rate,$295.68,44% of total billed charges which is 100% CMS Medicare rate,$295.68,$295.68,$571.20 
Outpatient Medical Services,LAB,86658,POLIOVIRUS IMMUNE STATUS,300,$359.00 ,$157.96,44% of total billed charges which is 100% CMS Medicare rate,$157.96,44% of total billed charges which is 100% CMS Medicare rate,$157.96,44% of total billed charges which is 100% CMS Medicare rate,$157.96,44% of total billed charges which is 100% CMS Medicare rate,$157.96,44% of total billed charges which is 100% CMS Medicare rate,$157.96,44% of total billed charges which is 100% CMS Medicare rate,$157.96,44% of total billed charges which is 100% CMS Medicare rate,$157.96,44% of total billed charges which is 100% CMS Medicare rate,$157.96,44% of total billed charges which is 100% CMS Medicare rate,$157.96,44% of total billed charges which is 100% CMS Medicare rate,$157.96,44% of total billed charges which is 100% CMS Medicare rate,$157.96,$157.96,$305.15 
Outpatient Medical Services,LAB,84703,Blood test to assess for pregnancy,301,$102.00 ,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,$44.88,$86.70 
Outpatient Medical Services,LAB,81025,Urine pregnancy test,301,$52.00 ,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,$22.88,$44.20 
Outpatient Medical Services,LAB,84206,PRO INSULIN,300,$233.00 ,$102.52,44% of total billed charges which is 100% CMS Medicare rate,$102.52,44% of total billed charges which is 100% CMS Medicare rate,$102.52,44% of total billed charges which is 100% CMS Medicare rate,$102.52,44% of total billed charges which is 100% CMS Medicare rate,$102.52,44% of total billed charges which is 100% CMS Medicare rate,$102.52,44% of total billed charges which is 100% CMS Medicare rate,$102.52,44% of total billed charges which is 100% CMS Medicare rate,$102.52,44% of total billed charges which is 100% CMS Medicare rate,$102.52,44% of total billed charges which is 100% CMS Medicare rate,$102.52,44% of total billed charges which is 100% CMS Medicare rate,$102.52,44% of total billed charges which is 100% CMS Medicare rate,$102.52,$102.52,$198.05 
Outpatient Medical Services,LAB,84146,PROLACTIN,301,$133.00 ,$58.52,44% of total billed charges which is 100% CMS Medicare rate,$58.52,44% of total billed charges which is 100% CMS Medicare rate,$58.52,44% of total billed charges which is 100% CMS Medicare rate,$58.52,44% of total billed charges which is 100% CMS Medicare rate,$58.52,44% of total billed charges which is 100% CMS Medicare rate,$58.52,44% of total billed charges which is 100% CMS Medicare rate,$58.52,44% of total billed charges which is 100% CMS Medicare rate,$58.52,44% of total billed charges which is 100% CMS Medicare rate,$58.52,44% of total billed charges which is 100% CMS Medicare rate,$58.52,44% of total billed charges which is 100% CMS Medicare rate,$58.52,44% of total billed charges which is 100% CMS Medicare rate,$58.52,$58.52,$113.05 
Outpatient Medical Services,LAB,85306,"PROTEIN S, FREE",305,$237.00 ,$104.28,44% of total billed charges which is 100% CMS Medicare rate,$104.28,44% of total billed charges which is 100% CMS Medicare rate,$104.28,44% of total billed charges which is 100% CMS Medicare rate,$104.28,44% of total billed charges which is 100% CMS Medicare rate,$104.28,44% of total billed charges which is 100% CMS Medicare rate,$104.28,44% of total billed charges which is 100% CMS Medicare rate,$104.28,44% of total billed charges which is 100% CMS Medicare rate,$104.28,44% of total billed charges which is 100% CMS Medicare rate,$104.28,44% of total billed charges which is 100% CMS Medicare rate,$104.28,44% of total billed charges which is 100% CMS Medicare rate,$104.28,44% of total billed charges which is 100% CMS Medicare rate,$104.28,$104.28,$201.45 
Outpatient Medical Services,LAB,85305,"PROTEIN S, TOTAL",305,$655.00 ,$288.20,44% of total billed charges which is 100% CMS Medicare rate,$288.20,44% of total billed charges which is 100% CMS Medicare rate,$288.20,44% of total billed charges which is 100% CMS Medicare rate,$288.20,44% of total billed charges which is 100% CMS Medicare rate,$288.20,44% of total billed charges which is 100% CMS Medicare rate,$288.20,44% of total billed charges which is 100% CMS Medicare rate,$288.20,44% of total billed charges which is 100% CMS Medicare rate,$288.20,44% of total billed charges which is 100% CMS Medicare rate,$288.20,44% of total billed charges which is 100% CMS Medicare rate,$288.20,44% of total billed charges which is 100% CMS Medicare rate,$288.20,44% of total billed charges which is 100% CMS Medicare rate,$288.20,$288.20,$556.75 
Outpatient Medical Services,LAB,84155,"PROTEIN;TOTAL, SERUM",301,$41.00 ,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,$18.04,$34.85 
Outpatient Medical Services,LAB,84156,"PROTEIN;TOTAL, URINE",301,$41.00 ,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,$18.04,$34.85 
Outpatient Medical Services,LAB,85610,"Blood test, clotting time",305,$52.00 ,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,$22.88,$44.20 
Outpatient Medical Services,LAB,G0103,Prostate cancer screening; prostate specific antigen test (psa),300,$92.00 ,$40.48,44% of total billed charges which is 100% CMS Medicare rate,$40.48,44% of total billed charges which is 100% CMS Medicare rate,$40.48,44% of total billed charges which is 100% CMS Medicare rate,$40.48,44% of total billed charges which is 100% CMS Medicare rate,$40.48,44% of total billed charges which is 100% CMS Medicare rate,$40.48,44% of total billed charges which is 100% CMS Medicare rate,$40.48,44% of total billed charges which is 100% CMS Medicare rate,$40.48,44% of total billed charges which is 100% CMS Medicare rate,$40.48,44% of total billed charges which is 100% CMS Medicare rate,$40.48,44% of total billed charges which is 100% CMS Medicare rate,$40.48,44% of total billed charges which is 100% CMS Medicare rate,$40.48,$40.48,$78.20 
Outpatient Medical Services,LAB,84154,PSA (prostate specific antigen) measurement,301,$109.00 ,$47.96,44% of total billed charges which is 100% CMS Medicare rate,$47.96,44% of total billed charges which is 100% CMS Medicare rate,$47.96,44% of total billed charges which is 100% CMS Medicare rate,$47.96,44% of total billed charges which is 100% CMS Medicare rate,$47.96,44% of total billed charges which is 100% CMS Medicare rate,$47.96,44% of total billed charges which is 100% CMS Medicare rate,$47.96,44% of total billed charges which is 100% CMS Medicare rate,$47.96,44% of total billed charges which is 100% CMS Medicare rate,$47.96,44% of total billed charges which is 100% CMS Medicare rate,$47.96,44% of total billed charges which is 100% CMS Medicare rate,$47.96,44% of total billed charges which is 100% CMS Medicare rate,$47.96,$47.96,$92.65 
Outpatient Medical Services,LAB,84153,PSA (prostate specific antigen),300,$92.00 ,$40.48,44% of total billed charges which is 100% CMS Medicare rate,$40.48,44% of total billed charges which is 100% CMS Medicare rate,$40.48,44% of total billed charges which is 100% CMS Medicare rate,$40.48,44% of total billed charges which is 100% CMS Medicare rate,$40.48,44% of total billed charges which is 100% CMS Medicare rate,$40.48,44% of total billed charges which is 100% CMS Medicare rate,$40.48,44% of total billed charges which is 100% CMS Medicare rate,$40.48,44% of total billed charges which is 100% CMS Medicare rate,$40.48,44% of total billed charges which is 100% CMS Medicare rate,$40.48,44% of total billed charges which is 100% CMS Medicare rate,$40.48,44% of total billed charges which is 100% CMS Medicare rate,$40.48,$40.48,$78.20 
Outpatient Medical Services,LAB,83970,"PTH, BIO-INTACT",301,$219.00 ,$96.36,44% of total billed charges which is 100% CMS Medicare rate,$96.36,44% of total billed charges which is 100% CMS Medicare rate,$96.36,44% of total billed charges which is 100% CMS Medicare rate,$96.36,44% of total billed charges which is 100% CMS Medicare rate,$96.36,44% of total billed charges which is 100% CMS Medicare rate,$96.36,44% of total billed charges which is 100% CMS Medicare rate,$96.36,44% of total billed charges which is 100% CMS Medicare rate,$96.36,44% of total billed charges which is 100% CMS Medicare rate,$96.36,44% of total billed charges which is 100% CMS Medicare rate,$96.36,44% of total billed charges which is 100% CMS Medicare rate,$96.36,44% of total billed charges which is 100% CMS Medicare rate,$96.36,$96.36,$186.15 
Outpatient Medical Services,LAB,85730,Coagulation assessment blood test,305,$52.00 ,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,$22.88,$44.20 
Outpatient Medical Services,LAB,84207,PYRIDOXAL PHOS (VIT B-6),301,$271.00 ,$119.24,44% of total billed charges which is 100% CMS Medicare rate,$119.24,44% of total billed charges which is 100% CMS Medicare rate,$119.24,44% of total billed charges which is 100% CMS Medicare rate,$119.24,44% of total billed charges which is 100% CMS Medicare rate,$119.24,44% of total billed charges which is 100% CMS Medicare rate,$119.24,44% of total billed charges which is 100% CMS Medicare rate,$119.24,44% of total billed charges which is 100% CMS Medicare rate,$119.24,44% of total billed charges which is 100% CMS Medicare rate,$119.24,44% of total billed charges which is 100% CMS Medicare rate,$119.24,44% of total billed charges which is 100% CMS Medicare rate,$119.24,44% of total billed charges which is 100% CMS Medicare rate,$119.24,$119.24,$230.35 
Outpatient Medical Services,LAB,86480,QUANTIFERON TB GOLD,309,$227.00 ,$99.88,44% of total billed charges which is 100% CMS Medicare rate,$99.88,44% of total billed charges which is 100% CMS Medicare rate,$99.88,44% of total billed charges which is 100% CMS Medicare rate,$99.88,44% of total billed charges which is 100% CMS Medicare rate,$99.88,44% of total billed charges which is 100% CMS Medicare rate,$99.88,44% of total billed charges which is 100% CMS Medicare rate,$99.88,44% of total billed charges which is 100% CMS Medicare rate,$99.88,44% of total billed charges which is 100% CMS Medicare rate,$99.88,44% of total billed charges which is 100% CMS Medicare rate,$99.88,44% of total billed charges which is 100% CMS Medicare rate,$99.88,44% of total billed charges which is 100% CMS Medicare rate,$99.88,$99.88,$192.95 
Outpatient Medical Services,LAB,80299,QUANTITATION OF DRUG,301,$176.00 ,$77.44,44% of total billed charges which is 100% CMS Medicare rate,$77.44,44% of total billed charges which is 100% CMS Medicare rate,$77.44,44% of total billed charges which is 100% CMS Medicare rate,$77.44,44% of total billed charges which is 100% CMS Medicare rate,$77.44,44% of total billed charges which is 100% CMS Medicare rate,$77.44,44% of total billed charges which is 100% CMS Medicare rate,$77.44,44% of total billed charges which is 100% CMS Medicare rate,$77.44,44% of total billed charges which is 100% CMS Medicare rate,$77.44,44% of total billed charges which is 100% CMS Medicare rate,$77.44,44% of total billed charges which is 100% CMS Medicare rate,$77.44,44% of total billed charges which is 100% CMS Medicare rate,$77.44,$77.44,$149.60 
Outpatient Medical Services,LAB,80307,Testing for presence of drug,301,$218.00 ,$95.92,44% of total billed charges which is 100% CMS Medicare rate,$95.92,44% of total billed charges which is 100% CMS Medicare rate,$95.92,44% of total billed charges which is 100% CMS Medicare rate,$95.92,44% of total billed charges which is 100% CMS Medicare rate,$95.92,44% of total billed charges which is 100% CMS Medicare rate,$95.92,44% of total billed charges which is 100% CMS Medicare rate,$95.92,44% of total billed charges which is 100% CMS Medicare rate,$95.92,44% of total billed charges which is 100% CMS Medicare rate,$95.92,44% of total billed charges which is 100% CMS Medicare rate,$95.92,44% of total billed charges which is 100% CMS Medicare rate,$95.92,44% of total billed charges which is 100% CMS Medicare rate,$95.92,$95.92,$185.30 
Outpatient Medical Services,LAB,P9016,"RBC, LEUKOCYTES REDUCED 1",390,$575.00 ,$253.00,44% of total billed charges which is 100% CMS Medicare rate,$253.00,44% of total billed charges which is 100% CMS Medicare rate,$253.00,44% of total billed charges which is 100% CMS Medicare rate,$253.00,44% of total billed charges which is 100% CMS Medicare rate,$253.00,44% of total billed charges which is 100% CMS Medicare rate,$253.00,44% of total billed charges which is 100% CMS Medicare rate,$253.00,44% of total billed charges which is 100% CMS Medicare rate,$253.00,44% of total billed charges which is 100% CMS Medicare rate,$253.00,44% of total billed charges which is 100% CMS Medicare rate,$253.00,44% of total billed charges which is 100% CMS Medicare rate,$253.00,44% of total billed charges which is 100% CMS Medicare rate,$253.00,$253.00,$488.75 
Outpatient Medical Services,LAB,80069,Kidney function panel test,301,$96.00 ,$42.24,44% of total billed charges which is 100% CMS Medicare rate,$42.24,44% of total billed charges which is 100% CMS Medicare rate,$42.24,44% of total billed charges which is 100% CMS Medicare rate,$42.24,44% of total billed charges which is 100% CMS Medicare rate,$42.24,44% of total billed charges which is 100% CMS Medicare rate,$42.24,44% of total billed charges which is 100% CMS Medicare rate,$42.24,44% of total billed charges which is 100% CMS Medicare rate,$42.24,44% of total billed charges which is 100% CMS Medicare rate,$42.24,44% of total billed charges which is 100% CMS Medicare rate,$42.24,44% of total billed charges which is 100% CMS Medicare rate,$42.24,44% of total billed charges which is 100% CMS Medicare rate,$42.24,$42.24,$81.60 
Outpatient Medical Services,LAB,85044,RETICULOCYTE COUNT,305,$52.00 ,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,$22.88,$44.20 
Outpatient Medical Services,LAB,84482,"REVERSE T3, SERUM",300,$220.00 ,$96.80,44% of total billed charges which is 100% CMS Medicare rate,$96.80,44% of total billed charges which is 100% CMS Medicare rate,$96.80,44% of total billed charges which is 100% CMS Medicare rate,$96.80,44% of total billed charges which is 100% CMS Medicare rate,$96.80,44% of total billed charges which is 100% CMS Medicare rate,$96.80,44% of total billed charges which is 100% CMS Medicare rate,$96.80,44% of total billed charges which is 100% CMS Medicare rate,$96.80,44% of total billed charges which is 100% CMS Medicare rate,$96.80,44% of total billed charges which is 100% CMS Medicare rate,$96.80,44% of total billed charges which is 100% CMS Medicare rate,$96.80,44% of total billed charges which is 100% CMS Medicare rate,$96.80,$96.80,$187.00 
Outpatient Medical Services,LAB,86901,RH TYPE,300,$35.00 ,$15.40,44% of total billed charges which is 100% CMS Medicare rate,$15.40,44% of total billed charges which is 100% CMS Medicare rate,$15.40,44% of total billed charges which is 100% CMS Medicare rate,$15.40,44% of total billed charges which is 100% CMS Medicare rate,$15.40,44% of total billed charges which is 100% CMS Medicare rate,$15.40,44% of total billed charges which is 100% CMS Medicare rate,$15.40,44% of total billed charges which is 100% CMS Medicare rate,$15.40,44% of total billed charges which is 100% CMS Medicare rate,$15.40,44% of total billed charges which is 100% CMS Medicare rate,$15.40,44% of total billed charges which is 100% CMS Medicare rate,$15.40,44% of total billed charges which is 100% CMS Medicare rate,$15.40,$15.40,$29.75 
Outpatient Medical Services,LAB,87389,Test for HIV,302,$750.00 ,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,$330.00,$637.50 
Outpatient Medical Services,LAB,85651,SEDRATE NON-AUTOMATED,305,$41.00 ,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,$18.04,$34.85 
Outpatient Medical Services,LAB,84260,"SEROTONIN, SERUM",301,$322.00 ,$141.68,44% of total billed charges which is 100% CMS Medicare rate,$141.68,44% of total billed charges which is 100% CMS Medicare rate,$141.68,44% of total billed charges which is 100% CMS Medicare rate,$141.68,44% of total billed charges which is 100% CMS Medicare rate,$141.68,44% of total billed charges which is 100% CMS Medicare rate,$141.68,44% of total billed charges which is 100% CMS Medicare rate,$141.68,44% of total billed charges which is 100% CMS Medicare rate,$141.68,44% of total billed charges which is 100% CMS Medicare rate,$141.68,44% of total billed charges which is 100% CMS Medicare rate,$141.68,44% of total billed charges which is 100% CMS Medicare rate,$141.68,44% of total billed charges which is 100% CMS Medicare rate,$141.68,$141.68,$273.70 
Outpatient Medical Services,LAB,88313,Blood test to assist with diagnosis,312,$247.00 ,$108.68,44% of total billed charges which is 100% CMS Medicare rate,$108.68,44% of total billed charges which is 100% CMS Medicare rate,$108.68,44% of total billed charges which is 100% CMS Medicare rate,$108.68,44% of total billed charges which is 100% CMS Medicare rate,$108.68,44% of total billed charges which is 100% CMS Medicare rate,$108.68,44% of total billed charges which is 100% CMS Medicare rate,$108.68,44% of total billed charges which is 100% CMS Medicare rate,$108.68,44% of total billed charges which is 100% CMS Medicare rate,$108.68,44% of total billed charges which is 100% CMS Medicare rate,$108.68,44% of total billed charges which is 100% CMS Medicare rate,$108.68,44% of total billed charges which is 100% CMS Medicare rate,$108.68,$108.68,$209.95 
Outpatient Medical Services,LAB,87045,"STOOL, AEROBIC,/ISOLATION",306,$58.00 ,$25.52,44% of total billed charges which is 100% CMS Medicare rate,$25.52,44% of total billed charges which is 100% CMS Medicare rate,$25.52,44% of total billed charges which is 100% CMS Medicare rate,$25.52,44% of total billed charges which is 100% CMS Medicare rate,$25.52,44% of total billed charges which is 100% CMS Medicare rate,$25.52,44% of total billed charges which is 100% CMS Medicare rate,$25.52,44% of total billed charges which is 100% CMS Medicare rate,$25.52,44% of total billed charges which is 100% CMS Medicare rate,$25.52,44% of total billed charges which is 100% CMS Medicare rate,$25.52,44% of total billed charges which is 100% CMS Medicare rate,$25.52,44% of total billed charges which is 100% CMS Medicare rate,$25.52,$25.52,$49.30 
Outpatient Medical Services,LAB,88304,SURGICAL PATHOLOGY L-3,310,$155.25 ,$68.31,44% of total billed charges which is 100% CMS Medicare rate,$68.31,44% of total billed charges which is 100% CMS Medicare rate,$68.31,44% of total billed charges which is 100% CMS Medicare rate,$68.31,44% of total billed charges which is 100% CMS Medicare rate,$68.31,44% of total billed charges which is 100% CMS Medicare rate,$68.31,44% of total billed charges which is 100% CMS Medicare rate,$68.31,44% of total billed charges which is 100% CMS Medicare rate,$68.31,44% of total billed charges which is 100% CMS Medicare rate,$68.31,44% of total billed charges which is 100% CMS Medicare rate,$68.31,44% of total billed charges which is 100% CMS Medicare rate,$68.31,44% of total billed charges which is 100% CMS Medicare rate,$68.31,$68.31,$131.96 
Outpatient Medical Services,LAB,88305,Test of tissues for diagnosis of abnormalities,310,$187.50 ,$82.50,44% of total billed charges which is 100% CMS Medicare rate,$82.50,44% of total billed charges which is 100% CMS Medicare rate,$82.50,44% of total billed charges which is 100% CMS Medicare rate,$82.50,44% of total billed charges which is 100% CMS Medicare rate,$82.50,44% of total billed charges which is 100% CMS Medicare rate,$82.50,44% of total billed charges which is 100% CMS Medicare rate,$82.50,44% of total billed charges which is 100% CMS Medicare rate,$82.50,44% of total billed charges which is 100% CMS Medicare rate,$82.50,44% of total billed charges which is 100% CMS Medicare rate,$82.50,44% of total billed charges which is 100% CMS Medicare rate,$82.50,44% of total billed charges which is 100% CMS Medicare rate,$82.50,$82.50,$159.38 
Outpatient Medical Services,LAB,84436,Blood test to measure a type of thyroid hormone,301,$52.00 ,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,44% of total billed charges which is 100% CMS Medicare rate,$22.88,$22.88,$44.20 
Outpatient Medical Services,LAB,86359,T4 CELL COUNT,300,$405.00 ,$178.20,44% of total billed charges which is 100% CMS Medicare rate,$178.20,44% of total billed charges which is 100% CMS Medicare rate,$178.20,44% of total billed charges which is 100% CMS Medicare rate,$178.20,44% of total billed charges which is 100% CMS Medicare rate,$178.20,44% of total billed charges which is 100% CMS Medicare rate,$178.20,44% of total billed charges which is 100% CMS Medicare rate,$178.20,44% of total billed charges which is 100% CMS Medicare rate,$178.20,44% of total billed charges which is 100% CMS Medicare rate,$178.20,44% of total billed charges which is 100% CMS Medicare rate,$178.20,44% of total billed charges which is 100% CMS Medicare rate,$178.20,44% of total billed charges which is 100% CMS Medicare rate,$178.20,$178.20,$344.25 
Outpatient Medical Services,LAB,80197,Test is used to measure the amount of the drug in the blood to determine whether the concentration has reached a therapeutic level and is below the to,301,$218.00 ,$95.92,44% of total billed charges which is 100% CMS Medicare rate,$95.92,44% of total billed charges which is 100% CMS Medicare rate,$95.92,44% of total billed charges which is 100% CMS Medicare rate,$95.92,44% of total billed charges which is 100% CMS Medicare rate,$95.92,44% of total billed charges which is 100% CMS Medicare rate,$95.92,44% of total billed charges which is 100% CMS Medicare rate,$95.92,44% of total billed charges which is 100% CMS Medicare rate,$95.92,44% of total billed charges which is 100% CMS Medicare rate,$95.92,44% of total billed charges which is 100% CMS Medicare rate,$95.92,44% of total billed charges which is 100% CMS Medicare rate,$95.92,44% of total billed charges which is 100% CMS Medicare rate,$95.92,$95.92,$185.30 
Outpatient Medical Services,LAB,84402,TESTOSTERONE FREE,301,$218.00 ,$95.92,44% of total billed charges which is 100% CMS Medicare rate,$95.92,44% of total billed charges which is 100% CMS Medicare rate,$95.92,44% of total billed charges which is 100% CMS Medicare rate,$95.92,44% of total billed charges which is 100% CMS Medicare rate,$95.92,44% of total billed charges which is 100% CMS Medicare rate,$95.92,44% of total billed charges which is 100% CMS Medicare rate,$95.92,44% of total billed charges which is 100% CMS Medicare rate,$95.92,44% of total billed charges which is 100% CMS Medicare rate,$95.92,44% of total billed charges which is 100% CMS Medicare rate,$95.92,44% of total billed charges which is 100% CMS Medicare rate,$95.92,44% of total billed charges which is 100% CMS Medicare rate,$95.92,$95.92,$185.30 
Outpatient Medical Services,LAB,84403,TESTOSTERONE SERUM TOTAL,301,$159.00 ,$69.96,44% of total billed charges which is 100% CMS Medicare rate,$69.96,44% of total billed charges which is 100% CMS Medicare rate,$69.96,44% of total billed charges which is 100% CMS Medicare rate,$69.96,44% of total billed charges which is 100% CMS Medicare rate,$69.96,44% of total billed charges which is 100% CMS Medicare rate,$69.96,44% of total billed charges which is 100% CMS Medicare rate,$69.96,44% of total billed charges which is 100% CMS Medicare rate,$69.96,44% of total billed charges which is 100% CMS Medicare rate,$69.96,44% of total billed charges which is 100% CMS Medicare rate,$69.96,44% of total billed charges which is 100% CMS Medicare rate,$69.96,44% of total billed charges which is 100% CMS Medicare rate,$69.96,$69.96,$135.15 
Outpatient Medical Services,LAB,85670,"THROMBIN TIME, PLASMA",305,$41.00 ,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,$18.04,$34.85 
Outpatient Medical Services,LAB,84432,THYROGLOBULIN QUANT,300,$208.00 ,$91.52,44% of total billed charges which is 100% CMS Medicare rate,$91.52,44% of total billed charges which is 100% CMS Medicare rate,$91.52,44% of total billed charges which is 100% CMS Medicare rate,$91.52,44% of total billed charges which is 100% CMS Medicare rate,$91.52,44% of total billed charges which is 100% CMS Medicare rate,$91.52,44% of total billed charges which is 100% CMS Medicare rate,$91.52,44% of total billed charges which is 100% CMS Medicare rate,$91.52,44% of total billed charges which is 100% CMS Medicare rate,$91.52,44% of total billed charges which is 100% CMS Medicare rate,$91.52,44% of total billed charges which is 100% CMS Medicare rate,$91.52,44% of total billed charges which is 100% CMS Medicare rate,$91.52,$91.52,$176.80 
Outpatient Medical Services,LAB,84445,THYROID STIM IMMUNOGLOB,300,$248.00 ,$109.12,44% of total billed charges which is 100% CMS Medicare rate,$109.12,44% of total billed charges which is 100% CMS Medicare rate,$109.12,44% of total billed charges which is 100% CMS Medicare rate,$109.12,44% of total billed charges which is 100% CMS Medicare rate,$109.12,44% of total billed charges which is 100% CMS Medicare rate,$109.12,44% of total billed charges which is 100% CMS Medicare rate,$109.12,44% of total billed charges which is 100% CMS Medicare rate,$109.12,44% of total billed charges which is 100% CMS Medicare rate,$109.12,44% of total billed charges which is 100% CMS Medicare rate,$109.12,44% of total billed charges which is 100% CMS Medicare rate,$109.12,44% of total billed charges which is 100% CMS Medicare rate,$109.12,$109.12,$210.80 
Outpatient Medical Services,LAB,83520,THYROTROPIN RECEPTOR AB,300,$155.00 ,$68.20,44% of total billed charges which is 100% CMS Medicare rate,$68.20,44% of total billed charges which is 100% CMS Medicare rate,$68.20,44% of total billed charges which is 100% CMS Medicare rate,$68.20,44% of total billed charges which is 100% CMS Medicare rate,$68.20,44% of total billed charges which is 100% CMS Medicare rate,$68.20,44% of total billed charges which is 100% CMS Medicare rate,$68.20,44% of total billed charges which is 100% CMS Medicare rate,$68.20,44% of total billed charges which is 100% CMS Medicare rate,$68.20,44% of total billed charges which is 100% CMS Medicare rate,$68.20,44% of total billed charges which is 100% CMS Medicare rate,$68.20,44% of total billed charges which is 100% CMS Medicare rate,$68.20,$68.20,$131.75 
Outpatient Medical Services,LAB,80201,"TOPAMAX LEVEL, TOPIRAMATE",301,$311.00 ,$136.84,44% of total billed charges which is 100% CMS Medicare rate,$136.84,44% of total billed charges which is 100% CMS Medicare rate,$136.84,44% of total billed charges which is 100% CMS Medicare rate,$136.84,44% of total billed charges which is 100% CMS Medicare rate,$136.84,44% of total billed charges which is 100% CMS Medicare rate,$136.84,44% of total billed charges which is 100% CMS Medicare rate,$136.84,44% of total billed charges which is 100% CMS Medicare rate,$136.84,44% of total billed charges which is 100% CMS Medicare rate,$136.84,44% of total billed charges which is 100% CMS Medicare rate,$136.84,44% of total billed charges which is 100% CMS Medicare rate,$136.84,44% of total billed charges which is 100% CMS Medicare rate,$136.84,$136.84,$264.35 
Outpatient Medical Services,LAB,84484,Blood test to measure a certain protein in the blood to determine heart muscle damage,301,$87.00 ,$38.28,44% of total billed charges which is 100% CMS Medicare rate,$38.28,44% of total billed charges which is 100% CMS Medicare rate,$38.28,44% of total billed charges which is 100% CMS Medicare rate,$38.28,44% of total billed charges which is 100% CMS Medicare rate,$38.28,44% of total billed charges which is 100% CMS Medicare rate,$38.28,44% of total billed charges which is 100% CMS Medicare rate,$38.28,44% of total billed charges which is 100% CMS Medicare rate,$38.28,44% of total billed charges which is 100% CMS Medicare rate,$38.28,44% of total billed charges which is 100% CMS Medicare rate,$38.28,44% of total billed charges which is 100% CMS Medicare rate,$38.28,44% of total billed charges which is 100% CMS Medicare rate,$38.28,$38.28,$73.95 
Outpatient Medical Services,LAB,84443,"Blood test, thyroid stimulating hormone (TSH)",301,$79.00 ,$34.76,44% of total billed charges which is 100% CMS Medicare rate,$34.76,44% of total billed charges which is 100% CMS Medicare rate,$34.76,44% of total billed charges which is 100% CMS Medicare rate,$34.76,44% of total billed charges which is 100% CMS Medicare rate,$34.76,44% of total billed charges which is 100% CMS Medicare rate,$34.76,44% of total billed charges which is 100% CMS Medicare rate,$34.76,44% of total billed charges which is 100% CMS Medicare rate,$34.76,44% of total billed charges which is 100% CMS Medicare rate,$34.76,44% of total billed charges which is 100% CMS Medicare rate,$34.76,44% of total billed charges which is 100% CMS Medicare rate,$34.76,44% of total billed charges which is 100% CMS Medicare rate,$34.76,$34.76,$67.15 
Outpatient Medical Services,LAB,84550,"URIC ACID, SERUM",301,$41.00 ,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,$18.04,$34.85 
Outpatient Medical Services,LAB,84560,"URIC ACID, URINE",301,$41.00 ,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,44% of total billed charges which is 100% CMS Medicare rate,$18.04,$18.04,$34.85 
Outpatient Medical Services,LAB,81001,Manual urinalysis test with examination with or without using microscope,307,$45.00 ,$19.80,44% of total billed charges which is 100% CMS Medicare rate,$19.80,44% of total billed charges which is 100% CMS Medicare rate,$19.80,44% of total billed charges which is 100% CMS Medicare rate,$19.80,44% of total billed charges which is 100% CMS Medicare rate,$19.80,44% of total billed charges which is 100% CMS Medicare rate,$19.80,44% of total billed charges which is 100% CMS Medicare rate,$19.80,44% of total billed charges which is 100% CMS Medicare rate,$19.80,44% of total billed charges which is 100% CMS Medicare rate,$19.80,44% of total billed charges which is 100% CMS Medicare rate,$19.80,44% of total billed charges which is 100% CMS Medicare rate,$19.80,44% of total billed charges which is 100% CMS Medicare rate,$19.80,$19.80,$38.25 
Outpatient Medical Services,LAB,81003,Automated urinalysis test,307,$29.00 ,$12.76,44% of total billed charges which is 100% CMS Medicare rate,$12.76,44% of total billed charges which is 100% CMS Medicare rate,$12.76,44% of total billed charges which is 100% CMS Medicare rate,$12.76,44% of total billed charges which is 100% CMS Medicare rate,$12.76,44% of total billed charges which is 100% CMS Medicare rate,$12.76,44% of total billed charges which is 100% CMS Medicare rate,$12.76,44% of total billed charges which is 100% CMS Medicare rate,$12.76,44% of total billed charges which is 100% CMS Medicare rate,$12.76,44% of total billed charges which is 100% CMS Medicare rate,$12.76,44% of total billed charges which is 100% CMS Medicare rate,$12.76,44% of total billed charges which is 100% CMS Medicare rate,$12.76,$12.76,$24.65 
Outpatient Medical Services,LAB,87086,Culture of the urine to determine number of bacteria,306,$58.00 ,$25.52,44% of total billed charges which is 100% CMS Medicare rate,$25.52,44% of total billed charges which is 100% CMS Medicare rate,$25.52,44% of total billed charges which is 100% CMS Medicare rate,$25.52,44% of total billed charges which is 100% CMS Medicare rate,$25.52,44% of total billed charges which is 100% CMS Medicare rate,$25.52,44% of total billed charges which is 100% CMS Medicare rate,$25.52,44% of total billed charges which is 100% CMS Medicare rate,$25.52,44% of total billed charges which is 100% CMS Medicare rate,$25.52,44% of total billed charges which is 100% CMS Medicare rate,$25.52,44% of total billed charges which is 100% CMS Medicare rate,$25.52,44% of total billed charges which is 100% CMS Medicare rate,$25.52,$25.52,$49.30 
Outpatient Medical Services,LAB,80305,URINE DRUG SCREEN/9 PANEL,300,$212.00 ,$93.28,44% of total billed charges which is 100% CMS Medicare rate,$93.28,44% of total billed charges which is 100% CMS Medicare rate,$93.28,44% of total billed charges which is 100% CMS Medicare rate,$93.28,44% of total billed charges which is 100% CMS Medicare rate,$93.28,44% of total billed charges which is 100% CMS Medicare rate,$93.28,44% of total billed charges which is 100% CMS Medicare rate,$93.28,44% of total billed charges which is 100% CMS Medicare rate,$93.28,44% of total billed charges which is 100% CMS Medicare rate,$93.28,44% of total billed charges which is 100% CMS Medicare rate,$93.28,44% of total billed charges which is 100% CMS Medicare rate,$93.28,44% of total billed charges which is 100% CMS Medicare rate,$93.28,$93.28,$180.20 
Outpatient Medical Services,LAB,81050,URINE- VOL MEASUREMENT,301,$23.00 ,$10.12,44% of total billed charges which is 100% CMS Medicare rate,$10.12,44% of total billed charges which is 100% CMS Medicare rate,$10.12,44% of total billed charges which is 100% CMS Medicare rate,$10.12,44% of total billed charges which is 100% CMS Medicare rate,$10.12,44% of total billed charges which is 100% CMS Medicare rate,$10.12,44% of total billed charges which is 100% CMS Medicare rate,$10.12,44% of total billed charges which is 100% CMS Medicare rate,$10.12,44% of total billed charges which is 100% CMS Medicare rate,$10.12,44% of total billed charges which is 100% CMS Medicare rate,$10.12,44% of total billed charges which is 100% CMS Medicare rate,$10.12,44% of total billed charges which is 100% CMS Medicare rate,$10.12,$10.12,$19.55 
Outpatient Medical Services,LAB,83701,VAP CHOLESTEROL PROF,300,$314.00 ,$138.16,44% of total billed charges which is 100% CMS Medicare rate,$138.16,44% of total billed charges which is 100% CMS Medicare rate,$138.16,44% of total billed charges which is 100% CMS Medicare rate,$138.16,44% of total billed charges which is 100% CMS Medicare rate,$138.16,44% of total billed charges which is 100% CMS Medicare rate,$138.16,44% of total billed charges which is 100% CMS Medicare rate,$138.16,44% of total billed charges which is 100% CMS Medicare rate,$138.16,44% of total billed charges which is 100% CMS Medicare rate,$138.16,44% of total billed charges which is 100% CMS Medicare rate,$138.16,44% of total billed charges which is 100% CMS Medicare rate,$138.16,44% of total billed charges which is 100% CMS Medicare rate,$138.16,$138.16,$266.90 
Outpatient Medical Services,LAB,82607,Blood test to measure B-12,301,$69.00 ,$30.36,44% of total billed charges which is 100% CMS Medicare rate,$30.36,44% of total billed charges which is 100% CMS Medicare rate,$30.36,44% of total billed charges which is 100% CMS Medicare rate,$30.36,44% of total billed charges which is 100% CMS Medicare rate,$30.36,44% of total billed charges which is 100% CMS Medicare rate,$30.36,44% of total billed charges which is 100% CMS Medicare rate,$30.36,44% of total billed charges which is 100% CMS Medicare rate,$30.36,44% of total billed charges which is 100% CMS Medicare rate,$30.36,44% of total billed charges which is 100% CMS Medicare rate,$30.36,44% of total billed charges which is 100% CMS Medicare rate,$30.36,44% of total billed charges which is 100% CMS Medicare rate,$30.36,$30.36,$58.65 
Outpatient Medical Services,LAB,82652,"VITAMIN D1, 25 DIHYDROXY",301,$230.00 ,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,44% of total billed charges which is 100% CMS Medicare rate,$101.20,$101.20,$195.50 
Outpatient Medical Services,LAB,82306,Blood test to monitor vitamin D levels,301,$324.00 ,$142.56,44% of total billed charges which is 100% CMS Medicare rate,$142.56,44% of total billed charges which is 100% CMS Medicare rate,$142.56,44% of total billed charges which is 100% CMS Medicare rate,$142.56,44% of total billed charges which is 100% CMS Medicare rate,$142.56,44% of total billed charges which is 100% CMS Medicare rate,$142.56,44% of total billed charges which is 100% CMS Medicare rate,$142.56,44% of total billed charges which is 100% CMS Medicare rate,$142.56,44% of total billed charges which is 100% CMS Medicare rate,$142.56,44% of total billed charges which is 100% CMS Medicare rate,$142.56,44% of total billed charges which is 100% CMS Medicare rate,$142.56,44% of total billed charges which is 100% CMS Medicare rate,$142.56,$142.56,$275.40 
Outpatient Medical Services,LAB,84446,VITAMIN E,300,$102.00 ,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,$44.88,$86.70 
Outpatient Medical Services,LAB,84597,VITAMIN K LEVEL,300,$347.00 ,$152.68,44% of total billed charges which is 100% CMS Medicare rate,$152.68,44% of total billed charges which is 100% CMS Medicare rate,$152.68,44% of total billed charges which is 100% CMS Medicare rate,$152.68,44% of total billed charges which is 100% CMS Medicare rate,$152.68,44% of total billed charges which is 100% CMS Medicare rate,$152.68,44% of total billed charges which is 100% CMS Medicare rate,$152.68,44% of total billed charges which is 100% CMS Medicare rate,$152.68,44% of total billed charges which is 100% CMS Medicare rate,$152.68,44% of total billed charges which is 100% CMS Medicare rate,$152.68,44% of total billed charges which is 100% CMS Medicare rate,$152.68,44% of total billed charges which is 100% CMS Medicare rate,$152.68,$152.68,$294.95 
Outpatient Medical Services,LAB,85048,WBC COUNT AUTOMATED,305,$46.00 ,$20.24,44% of total billed charges which is 100% CMS Medicare rate,$20.24,44% of total billed charges which is 100% CMS Medicare rate,$20.24,44% of total billed charges which is 100% CMS Medicare rate,$20.24,44% of total billed charges which is 100% CMS Medicare rate,$20.24,44% of total billed charges which is 100% CMS Medicare rate,$20.24,44% of total billed charges which is 100% CMS Medicare rate,$20.24,44% of total billed charges which is 100% CMS Medicare rate,$20.24,44% of total billed charges which is 100% CMS Medicare rate,$20.24,44% of total billed charges which is 100% CMS Medicare rate,$20.24,44% of total billed charges which is 100% CMS Medicare rate,$20.24,44% of total billed charges which is 100% CMS Medicare rate,$20.24,$20.24,$39.10 
Outpatient Medical Services,RADIOLOGY,74019,"ABD, 2 VIEWS",320,$180.00 ,$79.20,44% of total billed charges which is 100% CMS Medicare rate,$79.20,44% of total billed charges which is 100% CMS Medicare rate,$79.20,44% of total billed charges which is 100% CMS Medicare rate,$79.20,44% of total billed charges which is 100% CMS Medicare rate,$79.20,44% of total billed charges which is 100% CMS Medicare rate,$79.20,44% of total billed charges which is 100% CMS Medicare rate,$79.20,44% of total billed charges which is 100% CMS Medicare rate,$79.20,44% of total billed charges which is 100% CMS Medicare rate,$79.20,44% of total billed charges which is 100% CMS Medicare rate,$79.20,44% of total billed charges which is 100% CMS Medicare rate,$79.20,44% of total billed charges which is 100% CMS Medicare rate,$79.20,$79.20,$153.00 
Outpatient Medical Services,RADIOLOGY,74018,"ABD, SINGLE VIEW",320,$150.00 ,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,$66.00,$127.50 
Outpatient Medical Services,RADIOLOGY,74176,CT of abdomen and pelvis without dye,352,"$1,500.00 ",$660.00,44% of total billed charges which is 100% CMS Medicare rate,$660.00,44% of total billed charges which is 100% CMS Medicare rate,$660.00,44% of total billed charges which is 100% CMS Medicare rate,$660.00,44% of total billed charges which is 100% CMS Medicare rate,$660.00,44% of total billed charges which is 100% CMS Medicare rate,$660.00,44% of total billed charges which is 100% CMS Medicare rate,$660.00,44% of total billed charges which is 100% CMS Medicare rate,$660.00,44% of total billed charges which is 100% CMS Medicare rate,$660.00,44% of total billed charges which is 100% CMS Medicare rate,$660.00,44% of total billed charges which is 100% CMS Medicare rate,$660.00,44% of total billed charges which is 100% CMS Medicare rate,$660.00,$660.00,"$1,275.00 "
Outpatient Medical Services,RADIOLOGY,74177,CT scan of abdomen and pelvis with contrast,352,"$1,550.00 ",$682.00,44% of total billed charges which is 100% CMS Medicare rate,$682.00,44% of total billed charges which is 100% CMS Medicare rate,$682.00,44% of total billed charges which is 100% CMS Medicare rate,$682.00,44% of total billed charges which is 100% CMS Medicare rate,$682.00,44% of total billed charges which is 100% CMS Medicare rate,$682.00,44% of total billed charges which is 100% CMS Medicare rate,$682.00,44% of total billed charges which is 100% CMS Medicare rate,$682.00,44% of total billed charges which is 100% CMS Medicare rate,$682.00,44% of total billed charges which is 100% CMS Medicare rate,$682.00,44% of total billed charges which is 100% CMS Medicare rate,$682.00,44% of total billed charges which is 100% CMS Medicare rate,$682.00,$682.00,"$1,317.50 "
Outpatient Medical Services,RADIOLOGY,74178,"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections ",352,"$2,300.00 ","$1,012.00",44% of total billed charges which is 100% CMS Medicare rate,"$1,012.00",44% of total billed charges which is 100% CMS Medicare rate,"$1,012.00",44% of total billed charges which is 100% CMS Medicare rate,"$1,012.00",44% of total billed charges which is 100% CMS Medicare rate,"$1,012.00",44% of total billed charges which is 100% CMS Medicare rate,"$1,012.00",44% of total billed charges which is 100% CMS Medicare rate,"$1,012.00",44% of total billed charges which is 100% CMS Medicare rate,"$1,012.00",44% of total billed charges which is 100% CMS Medicare rate,"$1,012.00",44% of total billed charges which is 100% CMS Medicare rate,"$1,012.00",44% of total billed charges which is 100% CMS Medicare rate,"$1,012.00",44% of total billed charges which is 100% CMS Medicare rate,"$1,012.00","$1,012.00","$1,955.00 "
Outpatient Medical Services,RADIOLOGY,74150,CT of abdomen without dye,352,$750.00 ,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,$330.00,$637.50 
Outpatient Medical Services,RADIOLOGY,74160,CT of abdomen with dye,352,$775.00 ,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,$341.00,$658.75 
Outpatient Medical Services,RADIOLOGY,74170,CT of abdomen with and without dye,352,"$1,150.00 ",$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,$506.00,$977.50 
Outpatient Medical Services,RADIOLOGY,74022,Serial radiologic examination of the abdomen,320,$220.00 ,$96.80,44% of total billed charges which is 100% CMS Medicare rate,$96.80,44% of total billed charges which is 100% CMS Medicare rate,$96.80,44% of total billed charges which is 100% CMS Medicare rate,$96.80,44% of total billed charges which is 100% CMS Medicare rate,$96.80,44% of total billed charges which is 100% CMS Medicare rate,$96.80,44% of total billed charges which is 100% CMS Medicare rate,$96.80,44% of total billed charges which is 100% CMS Medicare rate,$96.80,44% of total billed charges which is 100% CMS Medicare rate,$96.80,44% of total billed charges which is 100% CMS Medicare rate,$96.80,44% of total billed charges which is 100% CMS Medicare rate,$96.80,44% of total billed charges which is 100% CMS Medicare rate,$96.80,$96.80,$187.00 
Outpatient Medical Services,RADIOLOGY,73610,Radiologic examination of the ankle with 3 views,320,$105.00 ,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,$46.20,$89.25 
Outpatient Medical Services,RADIOLOGY,73600,Radiologic examination of the ankle with 2 views,320,$90.00 ,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,$39.60,$76.50 
Outpatient Medical Services,RADIOLOGY,93925,ART LOWER EXT BILAT,921,$355.00 ,$156.20,44% of total billed charges which is 100% CMS Medicare rate,$156.20,44% of total billed charges which is 100% CMS Medicare rate,$156.20,44% of total billed charges which is 100% CMS Medicare rate,$156.20,44% of total billed charges which is 100% CMS Medicare rate,$156.20,44% of total billed charges which is 100% CMS Medicare rate,$156.20,44% of total billed charges which is 100% CMS Medicare rate,$156.20,44% of total billed charges which is 100% CMS Medicare rate,$156.20,44% of total billed charges which is 100% CMS Medicare rate,$156.20,44% of total billed charges which is 100% CMS Medicare rate,$156.20,44% of total billed charges which is 100% CMS Medicare rate,$156.20,44% of total billed charges which is 100% CMS Medicare rate,$156.20,$156.20,$301.75 
Outpatient Medical Services,RADIOLOGY,93931,ART UPPER EXT UNILAT,921,$185.00 ,$81.40,44% of total billed charges which is 100% CMS Medicare rate,$81.40,44% of total billed charges which is 100% CMS Medicare rate,$81.40,44% of total billed charges which is 100% CMS Medicare rate,$81.40,44% of total billed charges which is 100% CMS Medicare rate,$81.40,44% of total billed charges which is 100% CMS Medicare rate,$81.40,44% of total billed charges which is 100% CMS Medicare rate,$81.40,44% of total billed charges which is 100% CMS Medicare rate,$81.40,44% of total billed charges which is 100% CMS Medicare rate,$81.40,44% of total billed charges which is 100% CMS Medicare rate,$81.40,44% of total billed charges which is 100% CMS Medicare rate,$81.40,44% of total billed charges which is 100% CMS Medicare rate,$81.40,$81.40,$157.25 
Outpatient Medical Services,RADIOLOGY,74270,BARIUM ENEMA,320,$275.00 ,$121.00,44% of total billed charges which is 100% CMS Medicare rate,$121.00,44% of total billed charges which is 100% CMS Medicare rate,$121.00,44% of total billed charges which is 100% CMS Medicare rate,$121.00,44% of total billed charges which is 100% CMS Medicare rate,$121.00,44% of total billed charges which is 100% CMS Medicare rate,$121.00,44% of total billed charges which is 100% CMS Medicare rate,$121.00,44% of total billed charges which is 100% CMS Medicare rate,$121.00,44% of total billed charges which is 100% CMS Medicare rate,$121.00,44% of total billed charges which is 100% CMS Medicare rate,$121.00,44% of total billed charges which is 100% CMS Medicare rate,$121.00,44% of total billed charges which is 100% CMS Medicare rate,$121.00,$121.00,$233.75 
Outpatient Medical Services,RADIOLOGY,77072,BONE AGE STUDIES,320,$85.00 ,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,$37.40,$72.25 
Outpatient Medical Services,RADIOLOGY,77080,Scan to measure bone mineral density (BMD) at the spine and hip,320,$206.00 ,$90.64,44% of total billed charges which is 100% CMS Medicare rate,$90.64,44% of total billed charges which is 100% CMS Medicare rate,$90.64,44% of total billed charges which is 100% CMS Medicare rate,$90.64,44% of total billed charges which is 100% CMS Medicare rate,$90.64,44% of total billed charges which is 100% CMS Medicare rate,$90.64,44% of total billed charges which is 100% CMS Medicare rate,$90.64,44% of total billed charges which is 100% CMS Medicare rate,$90.64,44% of total billed charges which is 100% CMS Medicare rate,$90.64,44% of total billed charges which is 100% CMS Medicare rate,$90.64,44% of total billed charges which is 100% CMS Medicare rate,$90.64,44% of total billed charges which is 100% CMS Medicare rate,$90.64,$90.64,$175.10 
Outpatient Medical Services,RADIOLOGY,77073,BONE LENGTH STUDIES,320,$200.00 ,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,$88.00,$170.00 
Outpatient Medical Services,RADIOLOGY,77075,BONE SURVEY COMPLETE,320,$415.00 ,$182.60,44% of total billed charges which is 100% CMS Medicare rate,$182.60,44% of total billed charges which is 100% CMS Medicare rate,$182.60,44% of total billed charges which is 100% CMS Medicare rate,$182.60,44% of total billed charges which is 100% CMS Medicare rate,$182.60,44% of total billed charges which is 100% CMS Medicare rate,$182.60,44% of total billed charges which is 100% CMS Medicare rate,$182.60,44% of total billed charges which is 100% CMS Medicare rate,$182.60,44% of total billed charges which is 100% CMS Medicare rate,$182.60,44% of total billed charges which is 100% CMS Medicare rate,$182.60,44% of total billed charges which is 100% CMS Medicare rate,$182.60,44% of total billed charges which is 100% CMS Medicare rate,$182.60,$182.60,$352.75 
Outpatient Medical Services,RADIOLOGY,77074,BONE SURVEY LIMITED,320,$295.00 ,$129.80,44% of total billed charges which is 100% CMS Medicare rate,$129.80,44% of total billed charges which is 100% CMS Medicare rate,$129.80,44% of total billed charges which is 100% CMS Medicare rate,$129.80,44% of total billed charges which is 100% CMS Medicare rate,$129.80,44% of total billed charges which is 100% CMS Medicare rate,$129.80,44% of total billed charges which is 100% CMS Medicare rate,$129.80,44% of total billed charges which is 100% CMS Medicare rate,$129.80,44% of total billed charges which is 100% CMS Medicare rate,$129.80,44% of total billed charges which is 100% CMS Medicare rate,$129.80,44% of total billed charges which is 100% CMS Medicare rate,$129.80,44% of total billed charges which is 100% CMS Medicare rate,$129.80,$129.80,$250.75 
Outpatient Medical Services,RADIOLOGY,72052,C SPINE 6 OR MORE VIEWS,320,$195.00 ,$85.80,44% of total billed charges which is 100% CMS Medicare rate,$85.80,44% of total billed charges which is 100% CMS Medicare rate,$85.80,44% of total billed charges which is 100% CMS Medicare rate,$85.80,44% of total billed charges which is 100% CMS Medicare rate,$85.80,44% of total billed charges which is 100% CMS Medicare rate,$85.80,44% of total billed charges which is 100% CMS Medicare rate,$85.80,44% of total billed charges which is 100% CMS Medicare rate,$85.80,44% of total billed charges which is 100% CMS Medicare rate,$85.80,44% of total billed charges which is 100% CMS Medicare rate,$85.80,44% of total billed charges which is 100% CMS Medicare rate,$85.80,44% of total billed charges which is 100% CMS Medicare rate,$85.80,$85.80,$165.75 
Outpatient Medical Services,RADIOLOGY,72050,"Radiologic examination of the neck/spine, 4-5 views",320,$150.00 ,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,$66.00,$127.50 
Outpatient Medical Services,RADIOLOGY,72020,C SPINE PAR SINGLE VIEW,320,$98.00 ,$43.12,44% of total billed charges which is 100% CMS Medicare rate,$43.12,44% of total billed charges which is 100% CMS Medicare rate,$43.12,44% of total billed charges which is 100% CMS Medicare rate,$43.12,44% of total billed charges which is 100% CMS Medicare rate,$43.12,44% of total billed charges which is 100% CMS Medicare rate,$43.12,44% of total billed charges which is 100% CMS Medicare rate,$43.12,44% of total billed charges which is 100% CMS Medicare rate,$43.12,44% of total billed charges which is 100% CMS Medicare rate,$43.12,44% of total billed charges which is 100% CMS Medicare rate,$43.12,44% of total billed charges which is 100% CMS Medicare rate,$43.12,44% of total billed charges which is 100% CMS Medicare rate,$43.12,$43.12,$83.30 
Outpatient Medical Services,RADIOLOGY,72125,CERVICAL SPINE - PLAIN,352,$750.00 ,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,$330.00,$637.50 
Outpatient Medical Services,RADIOLOGY,72040,"Radiologic examination of the neck/spine, 2-3 views",320,$150.00 ,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,$66.00,$127.50 
Outpatient Medical Services,RADIOLOGY,71250,CT scan of the thorax without dye,352,$750.00 ,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,$330.00,$637.50 
Outpatient Medical Services,RADIOLOGY,71046,"2 views, front and back",324,$225.00 ,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,$99.00,$191.25 
Outpatient Medical Services,RADIOLOGY,71030,CHEST COMPLETE MIN 4 VIEWS,324,$225.00 ,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,$99.00,$191.25 
Outpatient Medical Services,RADIOLOGY,71260,CT scan of the thorax with dye,352,$775.00 ,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,$341.00,$658.75 
Outpatient Medical Services,RADIOLOGY,71270,CHEST W/WO CONTRAST,352,"$1,150.00 ",$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,$506.00,$977.50 
Outpatient Medical Services,RADIOLOGY,71045,Single view,324,$90.00 ,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,$39.60,$76.50 
Outpatient Medical Services,RADIOLOGY,73000,Radiologic examination of the collar bone,320,$115.00 ,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,$50.60,$97.75 
Outpatient Medical Services,RADIOLOGY,72220,COCCYX MIN 2 VWS,320,$115.00 ,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,$50.60,$97.75 
Outpatient Medical Services,RADIOLOGY,70481,CT - Sella Turcica with Contrast,351,$775.00 ,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,$341.00,$658.75 
Outpatient Medical Services,RADIOLOGY,70496,CT Angio Brain,350,"$1,812.50 ",$797.50,44% of total billed charges which is 100% CMS Medicare rate,$797.50,44% of total billed charges which is 100% CMS Medicare rate,$797.50,44% of total billed charges which is 100% CMS Medicare rate,$797.50,44% of total billed charges which is 100% CMS Medicare rate,$797.50,44% of total billed charges which is 100% CMS Medicare rate,$797.50,44% of total billed charges which is 100% CMS Medicare rate,$797.50,44% of total billed charges which is 100% CMS Medicare rate,$797.50,44% of total billed charges which is 100% CMS Medicare rate,$797.50,44% of total billed charges which is 100% CMS Medicare rate,$797.50,44% of total billed charges which is 100% CMS Medicare rate,$797.50,44% of total billed charges which is 100% CMS Medicare rate,$797.50,$797.50,"$1,540.63 "
Outpatient Medical Services,RADIOLOGY,70498,CT Angio Neck,350,"$1,885.00 ",$829.40,44% of total billed charges which is 100% CMS Medicare rate,$829.40,44% of total billed charges which is 100% CMS Medicare rate,$829.40,44% of total billed charges which is 100% CMS Medicare rate,$829.40,44% of total billed charges which is 100% CMS Medicare rate,$829.40,44% of total billed charges which is 100% CMS Medicare rate,$829.40,44% of total billed charges which is 100% CMS Medicare rate,$829.40,44% of total billed charges which is 100% CMS Medicare rate,$829.40,44% of total billed charges which is 100% CMS Medicare rate,$829.40,44% of total billed charges which is 100% CMS Medicare rate,$829.40,44% of total billed charges which is 100% CMS Medicare rate,$829.40,44% of total billed charges which is 100% CMS Medicare rate,$829.40,$829.40,"$1,602.25 "
Outpatient Medical Services,RADIOLOGY,70480,CT ORBIT MASTOID PLAIN,351,$550.00 ,$242.00,44% of total billed charges which is 100% CMS Medicare rate,$242.00,44% of total billed charges which is 100% CMS Medicare rate,$242.00,44% of total billed charges which is 100% CMS Medicare rate,$242.00,44% of total billed charges which is 100% CMS Medicare rate,$242.00,44% of total billed charges which is 100% CMS Medicare rate,$242.00,44% of total billed charges which is 100% CMS Medicare rate,$242.00,44% of total billed charges which is 100% CMS Medicare rate,$242.00,44% of total billed charges which is 100% CMS Medicare rate,$242.00,44% of total billed charges which is 100% CMS Medicare rate,$242.00,44% of total billed charges which is 100% CMS Medicare rate,$242.00,44% of total billed charges which is 100% CMS Medicare rate,$242.00,$242.00,$467.50 
Outpatient Medical Services,RADIOLOGY,93306,"Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function",480,$950.00 ,$418.00,44% of total billed charges which is 100% CMS Medicare rate,$418.00,44% of total billed charges which is 100% CMS Medicare rate,$418.00,44% of total billed charges which is 100% CMS Medicare rate,$418.00,44% of total billed charges which is 100% CMS Medicare rate,$418.00,44% of total billed charges which is 100% CMS Medicare rate,$418.00,44% of total billed charges which is 100% CMS Medicare rate,$418.00,44% of total billed charges which is 100% CMS Medicare rate,$418.00,44% of total billed charges which is 100% CMS Medicare rate,$418.00,44% of total billed charges which is 100% CMS Medicare rate,$418.00,44% of total billed charges which is 100% CMS Medicare rate,$418.00,44% of total billed charges which is 100% CMS Medicare rate,$418.00,$418.00,$807.50 
Outpatient Medical Services,RADIOLOGY,73080,"Radiologic examination, elbow; 3 or more views",320,$100.00 ,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,$44.00,$85.00 
Outpatient Medical Services,RADIOLOGY,73070,"Radiologic examination, elbow; 2 views",320,$90.00 ,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,$39.60,$76.50 
Outpatient Medical Services,RADIOLOGY,70140,FACIAL BONES 3 VWS OR <,320,$145.00 ,$63.80,44% of total billed charges which is 100% CMS Medicare rate,$63.80,44% of total billed charges which is 100% CMS Medicare rate,$63.80,44% of total billed charges which is 100% CMS Medicare rate,$63.80,44% of total billed charges which is 100% CMS Medicare rate,$63.80,44% of total billed charges which is 100% CMS Medicare rate,$63.80,44% of total billed charges which is 100% CMS Medicare rate,$63.80,44% of total billed charges which is 100% CMS Medicare rate,$63.80,44% of total billed charges which is 100% CMS Medicare rate,$63.80,44% of total billed charges which is 100% CMS Medicare rate,$63.80,44% of total billed charges which is 100% CMS Medicare rate,$63.80,44% of total billed charges which is 100% CMS Medicare rate,$63.80,$63.80,$123.25 
Outpatient Medical Services,RADIOLOGY,70150,FACIAL BONES COMP MIN 3VS,320,$145.00 ,$63.80,44% of total billed charges which is 100% CMS Medicare rate,$63.80,44% of total billed charges which is 100% CMS Medicare rate,$63.80,44% of total billed charges which is 100% CMS Medicare rate,$63.80,44% of total billed charges which is 100% CMS Medicare rate,$63.80,44% of total billed charges which is 100% CMS Medicare rate,$63.80,44% of total billed charges which is 100% CMS Medicare rate,$63.80,44% of total billed charges which is 100% CMS Medicare rate,$63.80,44% of total billed charges which is 100% CMS Medicare rate,$63.80,44% of total billed charges which is 100% CMS Medicare rate,$63.80,44% of total billed charges which is 100% CMS Medicare rate,$63.80,44% of total billed charges which is 100% CMS Medicare rate,$63.80,$63.80,$123.25 
Outpatient Medical Services,RADIOLOGY,73552,FEMUR RIGHT 2 VWS,320,$115.00 ,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,$50.60,$97.75 
Outpatient Medical Services,RADIOLOGY,73140,Radiologic examination of the finger(s),320,$75.00 ,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,$33.00,$63.75 
Outpatient Medical Services,RADIOLOGY,73630,Radiologic examination of the foot with 3 or more views,320,$110.00 ,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,$48.40,$93.50 
Outpatient Medical Services,RADIOLOGY,73620,"Radiologic examination, foot; 2 views",320,$95.00 ,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,$41.80,$80.75 
Outpatient Medical Services,RADIOLOGY,73090,Radiologic examination of the forearm,320,$102.00 ,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,$44.88,$86.70 
Outpatient Medical Services,RADIOLOGY,73130,X-ray of the hand with 3 or more views,320,$105.00 ,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,$46.20,$89.25 
Outpatient Medical Services,RADIOLOGY,73120,X-ray of the hand with 2 views,320,$105.00 ,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,$46.20,$89.25 
Outpatient Medical Services,RADIOLOGY,70450,CT scan head or brain without dye,351,$750.00 ,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,$330.00,$637.50 
Outpatient Medical Services,RADIOLOGY,70460,HEAD/BRAIN W/CONTRAST,351,$775.00 ,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,$341.00,$658.75 
Outpatient Medical Services,RADIOLOGY,70470,HEAD/BRAIN W/WO CONTRAST,351,"$1,125.00 ",$495.00,44% of total billed charges which is 100% CMS Medicare rate,$495.00,44% of total billed charges which is 100% CMS Medicare rate,$495.00,44% of total billed charges which is 100% CMS Medicare rate,$495.00,44% of total billed charges which is 100% CMS Medicare rate,$495.00,44% of total billed charges which is 100% CMS Medicare rate,$495.00,44% of total billed charges which is 100% CMS Medicare rate,$495.00,44% of total billed charges which is 100% CMS Medicare rate,$495.00,44% of total billed charges which is 100% CMS Medicare rate,$495.00,44% of total billed charges which is 100% CMS Medicare rate,$495.00,44% of total billed charges which is 100% CMS Medicare rate,$495.00,44% of total billed charges which is 100% CMS Medicare rate,$495.00,$495.00,$956.25 
Outpatient Medical Services,RADIOLOGY,73650,Radiologic examination of the heel,320,$105.00 ,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,$46.20,$89.25 
Outpatient Medical Services,RADIOLOGY,73501,HIP LT-1 VW UNI,320,$110.00 ,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,$48.40,$93.50 
Outpatient Medical Services,RADIOLOGY,73502,HIP RIGHT COMPLETE MIN 2V,320,$110.00 ,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,$48.40,$93.50 
Outpatient Medical Services,RADIOLOGY,73521,HIPS BILATERAL MIN 2 V EA,320,$140.00 ,$61.60,44% of total billed charges which is 100% CMS Medicare rate,$61.60,44% of total billed charges which is 100% CMS Medicare rate,$61.60,44% of total billed charges which is 100% CMS Medicare rate,$61.60,44% of total billed charges which is 100% CMS Medicare rate,$61.60,44% of total billed charges which is 100% CMS Medicare rate,$61.60,44% of total billed charges which is 100% CMS Medicare rate,$61.60,44% of total billed charges which is 100% CMS Medicare rate,$61.60,44% of total billed charges which is 100% CMS Medicare rate,$61.60,44% of total billed charges which is 100% CMS Medicare rate,$61.60,44% of total billed charges which is 100% CMS Medicare rate,$61.60,44% of total billed charges which is 100% CMS Medicare rate,$61.60,$61.60,$119.00 
Outpatient Medical Services,RADIOLOGY,73060,HUMERUS RT UPPER ARM M/2V,320,$110.00 ,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,$48.40,$93.50 
Outpatient Medical Services,RADIOLOGY,73562,Radiologic examination of the knee with 3 views,320,$150.00 ,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,$66.00,$127.50 
Outpatient Medical Services,RADIOLOGY,73564,Radiologic examination of the knee with 4 or more views,320,$130.00 ,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,$57.20,$110.50 
Outpatient Medical Services,RADIOLOGY,73560,Radiologic examination of the knee with 1 or 2 views,320,$115.00 ,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,$50.60,$97.75 
Outpatient Medical Services,RADIOLOGY,73565,Radiologic examination of both knees,320,$350.00 ,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,$154.00,$297.50 
Outpatient Medical Services,RADIOLOGY,72100,X-ray of the lower spine 2-3 views,320,$150.00 ,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,$66.00,$127.50 
Outpatient Medical Services,RADIOLOGY,72114,L SPINE COMP MIN 6 VWS,320,$215.00 ,$94.60,44% of total billed charges which is 100% CMS Medicare rate,$94.60,44% of total billed charges which is 100% CMS Medicare rate,$94.60,44% of total billed charges which is 100% CMS Medicare rate,$94.60,44% of total billed charges which is 100% CMS Medicare rate,$94.60,44% of total billed charges which is 100% CMS Medicare rate,$94.60,44% of total billed charges which is 100% CMS Medicare rate,$94.60,44% of total billed charges which is 100% CMS Medicare rate,$94.60,44% of total billed charges which is 100% CMS Medicare rate,$94.60,44% of total billed charges which is 100% CMS Medicare rate,$94.60,44% of total billed charges which is 100% CMS Medicare rate,$94.60,44% of total billed charges which is 100% CMS Medicare rate,$94.60,$94.60,$182.75 
Outpatient Medical Services,RADIOLOGY,72110,"X-ray of lower and sacral spine, minimum of 4 views",320,$215.00 ,$94.60,44% of total billed charges which is 100% CMS Medicare rate,$94.60,44% of total billed charges which is 100% CMS Medicare rate,$94.60,44% of total billed charges which is 100% CMS Medicare rate,$94.60,44% of total billed charges which is 100% CMS Medicare rate,$94.60,44% of total billed charges which is 100% CMS Medicare rate,$94.60,44% of total billed charges which is 100% CMS Medicare rate,$94.60,44% of total billed charges which is 100% CMS Medicare rate,$94.60,44% of total billed charges which is 100% CMS Medicare rate,$94.60,44% of total billed charges which is 100% CMS Medicare rate,$94.60,44% of total billed charges which is 100% CMS Medicare rate,$94.60,44% of total billed charges which is 100% CMS Medicare rate,$94.60,$94.60,$182.75 
Outpatient Medical Services,RADIOLOGY,73700,CT scan of leg without dye,352,$750.00 ,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,$330.00,$637.50 
Outpatient Medical Services,RADIOLOGY,73701,LOW EXTREMITY W/CONTRAST,352,$775.00 ,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,$341.00,$658.75 
Outpatient Medical Services,RADIOLOGY,72131,CT scan of lower spine without dye,352,$750.00 ,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,$330.00,$637.50 
Outpatient Medical Services,RADIOLOGY,77065,"Diagnostic mammography, including computer-aided detection (cad) when performed; unilateral",401,$200.00 ,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,$88.00,$170.00 
Outpatient Medical Services,RADIOLOGY,77066,"Diagnostic mammography, including computer-aided detection (cad) when performed; bilateral",401,$225.00 ,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,$99.00,$191.25 
Outpatient Medical Services,RADIOLOGY,77067,Mammography of both breasts-2 or more views,403,$225.00 ,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,$99.00,$191.25 
Outpatient Medical Services,RADIOLOGY,70110,MANDIBLE COMP MIN 4 VWS,320,$120.00 ,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,$52.80,$102.00 
Outpatient Medical Services,RADIOLOGY,70100,MANDIBLE PARTIAL >4 VWS,320,$105.00 ,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,$46.20,$89.25 
Outpatient Medical Services,RADIOLOGY,70130,MASTOIDS COMP MIN 3 VWS,320,$105.00 ,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,$46.20,$89.25 
Outpatient Medical Services,RADIOLOGY,70486,CT Scan of the face and jaw without dye,351,$750.00 ,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,$330.00,$637.50 
Outpatient Medical Services,RADIOLOGY,70487,MAXILLOFACIAL W/ CONTRAST,351,$750.00 ,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,$330.00,$637.50 
Outpatient Medical Services,RADIOLOGY,70488,MAXILO/SINUSES W/WO CONTR,351,$550.00 ,$242.00,44% of total billed charges which is 100% CMS Medicare rate,$242.00,44% of total billed charges which is 100% CMS Medicare rate,$242.00,44% of total billed charges which is 100% CMS Medicare rate,$242.00,44% of total billed charges which is 100% CMS Medicare rate,$242.00,44% of total billed charges which is 100% CMS Medicare rate,$242.00,44% of total billed charges which is 100% CMS Medicare rate,$242.00,44% of total billed charges which is 100% CMS Medicare rate,$242.00,44% of total billed charges which is 100% CMS Medicare rate,$242.00,44% of total billed charges which is 100% CMS Medicare rate,$242.00,44% of total billed charges which is 100% CMS Medicare rate,$242.00,44% of total billed charges which is 100% CMS Medicare rate,$242.00,$242.00,$467.50 
Outpatient Medical Services,RADIOLOGY,70544,MRA HEAD W/O CONT,610,"$1,230.00 ",$541.20,44% of total billed charges which is 100% CMS Medicare rate,$541.20,44% of total billed charges which is 100% CMS Medicare rate,$541.20,44% of total billed charges which is 100% CMS Medicare rate,$541.20,44% of total billed charges which is 100% CMS Medicare rate,$541.20,44% of total billed charges which is 100% CMS Medicare rate,$541.20,44% of total billed charges which is 100% CMS Medicare rate,$541.20,44% of total billed charges which is 100% CMS Medicare rate,$541.20,44% of total billed charges which is 100% CMS Medicare rate,$541.20,44% of total billed charges which is 100% CMS Medicare rate,$541.20,44% of total billed charges which is 100% CMS Medicare rate,$541.20,44% of total billed charges which is 100% CMS Medicare rate,$541.20,$541.20,"$1,045.50 "
Outpatient Medical Services,RADIOLOGY,70545,"MRA, HEAD W/ CONTRAST",610,"$1,250.00 ",$550.00,44% of total billed charges which is 100% CMS Medicare rate,$550.00,44% of total billed charges which is 100% CMS Medicare rate,$550.00,44% of total billed charges which is 100% CMS Medicare rate,$550.00,44% of total billed charges which is 100% CMS Medicare rate,$550.00,44% of total billed charges which is 100% CMS Medicare rate,$550.00,44% of total billed charges which is 100% CMS Medicare rate,$550.00,44% of total billed charges which is 100% CMS Medicare rate,$550.00,44% of total billed charges which is 100% CMS Medicare rate,$550.00,44% of total billed charges which is 100% CMS Medicare rate,$550.00,44% of total billed charges which is 100% CMS Medicare rate,$550.00,44% of total billed charges which is 100% CMS Medicare rate,$550.00,$550.00,"$1,062.50 "
Outpatient Medical Services,RADIOLOGY,70360,NECK FOR SOFT TISSUE,320,$65.00 ,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,$28.60,$55.25 
Outpatient Medical Services,RADIOLOGY,70160,NOSE COMP MIN 3 VWS,320,$95.00 ,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,$41.80,$80.75 
Outpatient Medical Services,RADIOLOGY,70190,OPTIC FORAMINA,320,$55.00 ,$24.20,44% of total billed charges which is 100% CMS Medicare rate,$24.20,44% of total billed charges which is 100% CMS Medicare rate,$24.20,44% of total billed charges which is 100% CMS Medicare rate,$24.20,44% of total billed charges which is 100% CMS Medicare rate,$24.20,44% of total billed charges which is 100% CMS Medicare rate,$24.20,44% of total billed charges which is 100% CMS Medicare rate,$24.20,44% of total billed charges which is 100% CMS Medicare rate,$24.20,44% of total billed charges which is 100% CMS Medicare rate,$24.20,44% of total billed charges which is 100% CMS Medicare rate,$24.20,44% of total billed charges which is 100% CMS Medicare rate,$24.20,44% of total billed charges which is 100% CMS Medicare rate,$24.20,$24.20,$46.75 
Outpatient Medical Services,RADIOLOGY,70200,ORBITS COMP MIN 4 VWS,320,$130.00 ,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,$57.20,$110.50 
Outpatient Medical Services,RADIOLOGY,72192,CT of pelvis without dye,352,$750.00 ,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,$330.00,$637.50 
Outpatient Medical Services,RADIOLOGY,72170,Radiologic examination of the pelvis,320,$90.00 ,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,$39.60,$76.50 
Outpatient Medical Services,RADIOLOGY,72193,"CT scan, pelvis, with contrast",352,$775.00 ,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,$341.00,$658.75 
Outpatient Medical Services,RADIOLOGY,72194,PELVIS W/WO CONTRAST,352,"$1,150.00 ",$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,$506.00,$977.50 
Outpatient Medical Services,RADIOLOGY,71035,READ CHEST/LAT.DECUBISTUS,972,$98.00 ,N/A,not separately reimburseable,N/A,not separately reimburseable,N/A,not separately reimburseable,N/A,not separately reimburseable,N/A,not separately reimburseable,N/A,not separately reimburseable,N/A,not separately reimburseable,N/A,not separately reimburseable,N/A,not separately reimburseable,N/A,not separately reimburseable,N/A,not separately reimburseable,N/A,N/A,$83.30 
Outpatient Medical Services,RADIOLOGY,93926,READ-ART LOW EXT UNILAT,972,$150.00 ,$6.18,115% CMS Medicare RBRVS fee schedule,$6.18,115% CMS Medicare RBRVS fee schedule,$6.18,115% CMS Medicare RBRVS fee schedule,$6.18,115% CMS Medicare RBRVS fee schedule,$6.18,115% CMS Medicare RBRVS fee schedule,$6.18,115% CMS Medicare RBRVS fee schedule,$6.18,115% CMS Medicare RBRVS fee schedule,$6.18,115% CMS Medicare RBRVS fee schedule,$6.18,115% CMS Medicare RBRVS fee schedule,$6.18,115% CMS Medicare RBRVS fee schedule,$6.18,115% CMS Medicare RBRVS fee schedule,$6.18,$6.18,$127.50 
Outpatient Medical Services,RADIOLOGY,71111,RIBS BILATERAL MIN 4 VWS,320,$155.00 ,$68.20,44% of total billed charges which is 100% CMS Medicare rate,$68.20,44% of total billed charges which is 100% CMS Medicare rate,$68.20,44% of total billed charges which is 100% CMS Medicare rate,$68.20,44% of total billed charges which is 100% CMS Medicare rate,$68.20,44% of total billed charges which is 100% CMS Medicare rate,$68.20,44% of total billed charges which is 100% CMS Medicare rate,$68.20,44% of total billed charges which is 100% CMS Medicare rate,$68.20,44% of total billed charges which is 100% CMS Medicare rate,$68.20,44% of total billed charges which is 100% CMS Medicare rate,$68.20,44% of total billed charges which is 100% CMS Medicare rate,$68.20,44% of total billed charges which is 100% CMS Medicare rate,$68.20,$68.20,$131.75 
Outpatient Medical Services,RADIOLOGY,71101,Radiologic examination of one side of the chest/ribs,320,$135.00 ,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,$59.40,$114.75 
Outpatient Medical Services,RADIOLOGY,73010,SCAPULA-LEFT COMPLETE,320,$115.00 ,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,$50.60,$97.75 
Outpatient Medical Services,RADIOLOGY,73020,SHOULDER 1 VW RT,320,$115.00 ,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,$50.60,$97.75 
Outpatient Medical Services,RADIOLOGY,73030,Radiologic examination of the shoulder,320,$120.00 ,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,$52.80,$102.00 
Outpatient Medical Services,RADIOLOGY,70220,SINUSES COMP MIN 3 VWS,320,$140.00 ,$61.60,44% of total billed charges which is 100% CMS Medicare rate,$61.60,44% of total billed charges which is 100% CMS Medicare rate,$61.60,44% of total billed charges which is 100% CMS Medicare rate,$61.60,44% of total billed charges which is 100% CMS Medicare rate,$61.60,44% of total billed charges which is 100% CMS Medicare rate,$61.60,44% of total billed charges which is 100% CMS Medicare rate,$61.60,44% of total billed charges which is 100% CMS Medicare rate,$61.60,44% of total billed charges which is 100% CMS Medicare rate,$61.60,44% of total billed charges which is 100% CMS Medicare rate,$61.60,44% of total billed charges which is 100% CMS Medicare rate,$61.60,44% of total billed charges which is 100% CMS Medicare rate,$61.60,$61.60,$119.00 
Outpatient Medical Services,RADIOLOGY,70210,SINUSES-ROUTINE <3 VWS,320,$51.00 ,$22.44,44% of total billed charges which is 100% CMS Medicare rate,$22.44,44% of total billed charges which is 100% CMS Medicare rate,$22.44,44% of total billed charges which is 100% CMS Medicare rate,$22.44,44% of total billed charges which is 100% CMS Medicare rate,$22.44,44% of total billed charges which is 100% CMS Medicare rate,$22.44,44% of total billed charges which is 100% CMS Medicare rate,$22.44,44% of total billed charges which is 100% CMS Medicare rate,$22.44,44% of total billed charges which is 100% CMS Medicare rate,$22.44,44% of total billed charges which is 100% CMS Medicare rate,$22.44,44% of total billed charges which is 100% CMS Medicare rate,$22.44,44% of total billed charges which is 100% CMS Medicare rate,$22.44,$22.44,$43.35 
Outpatient Medical Services,RADIOLOGY,70250,SKULL < 4 VIEWS,320,$115.00 ,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,$50.60,$97.75 
Outpatient Medical Services,RADIOLOGY,70260,SKULL COMP MIN 4 VWS,320,$170.00 ,$74.80,44% of total billed charges which is 100% CMS Medicare rate,$74.80,44% of total billed charges which is 100% CMS Medicare rate,$74.80,44% of total billed charges which is 100% CMS Medicare rate,$74.80,44% of total billed charges which is 100% CMS Medicare rate,$74.80,44% of total billed charges which is 100% CMS Medicare rate,$74.80,44% of total billed charges which is 100% CMS Medicare rate,$74.80,44% of total billed charges which is 100% CMS Medicare rate,$74.80,44% of total billed charges which is 100% CMS Medicare rate,$74.80,44% of total billed charges which is 100% CMS Medicare rate,$74.80,44% of total billed charges which is 100% CMS Medicare rate,$74.80,44% of total billed charges which is 100% CMS Medicare rate,$74.80,$74.80,$144.50 
Outpatient Medical Services,RADIOLOGY,70490,SOFT TISSUE NECK - PLAIN,351,$750.00 ,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,$330.00,$637.50 
Outpatient Medical Services,RADIOLOGY,70491,CT scan of neck with dye,351,$775.00 ,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,$341.00,$658.75 
Outpatient Medical Services,RADIOLOGY,70492,SOFT TISSUE NECK W/WO CON,351,"$1,125.00 ",$495.00,44% of total billed charges which is 100% CMS Medicare rate,$495.00,44% of total billed charges which is 100% CMS Medicare rate,$495.00,44% of total billed charges which is 100% CMS Medicare rate,$495.00,44% of total billed charges which is 100% CMS Medicare rate,$495.00,44% of total billed charges which is 100% CMS Medicare rate,$495.00,44% of total billed charges which is 100% CMS Medicare rate,$495.00,44% of total billed charges which is 100% CMS Medicare rate,$495.00,44% of total billed charges which is 100% CMS Medicare rate,$495.00,44% of total billed charges which is 100% CMS Medicare rate,$495.00,44% of total billed charges which is 100% CMS Medicare rate,$495.00,44% of total billed charges which is 100% CMS Medicare rate,$495.00,$495.00,$956.25 
Outpatient Medical Services,RADIOLOGY,71130,STERNOCLAVICULAR JT M3V R,320,$115.00 ,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,$50.60,$97.75 
Outpatient Medical Services,RADIOLOGY,71120,STERNUM MIN 2 VWS,320,$125.00 ,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,$55.00,$106.25 
Outpatient Medical Services,RADIOLOGY,70330,TEMPORAMANDIBULAR JNT BIL,320,$105.00 ,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,$46.20,$89.25 
Outpatient Medical Services,RADIOLOGY,72072,"Radiologic examination of the middle spine, 3 views",320,$135.00 ,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,$59.40,$114.75 
Outpatient Medical Services,RADIOLOGY,72070,"Radiologic examination of the middle spine, 2 views",320,$115.00 ,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,$50.60,$97.75 
Outpatient Medical Services,RADIOLOGY,72128,THORACIC SPINE W/O CONTRA,352,$750.00 ,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,$330.00,$637.50 
Outpatient Medical Services,RADIOLOGY,72080,THORACOLUMBAR SP-SCOLIOSI,320,$135.00 ,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,$59.40,$114.75 
Outpatient Medical Services,RADIOLOGY,73590,Radiologic examination of the lower leg,320,$115.00 ,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,$50.60,$97.75 
Outpatient Medical Services,RADIOLOGY,73200,UP EXTREMITY - PLAIN,352,$750.00 ,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,$330.00,$637.50 
Outpatient Medical Services,RADIOLOGY,76700,Ultrasound of abdomen with all areas scanned,402,$270.00 ,$118.80,44% of total billed charges which is 100% CMS Medicare rate,$118.80,44% of total billed charges which is 100% CMS Medicare rate,$118.80,44% of total billed charges which is 100% CMS Medicare rate,$118.80,44% of total billed charges which is 100% CMS Medicare rate,$118.80,44% of total billed charges which is 100% CMS Medicare rate,$118.80,44% of total billed charges which is 100% CMS Medicare rate,$118.80,44% of total billed charges which is 100% CMS Medicare rate,$118.80,44% of total billed charges which is 100% CMS Medicare rate,$118.80,44% of total billed charges which is 100% CMS Medicare rate,$118.80,44% of total billed charges which is 100% CMS Medicare rate,$118.80,44% of total billed charges which is 100% CMS Medicare rate,$118.80,$118.80,$229.50 
Outpatient Medical Services,RADIOLOGY,76641,"US BREAST, COMPLETE",402,$360.00 ,$158.40,44% of total billed charges which is 100% CMS Medicare rate,$158.40,44% of total billed charges which is 100% CMS Medicare rate,$158.40,44% of total billed charges which is 100% CMS Medicare rate,$158.40,44% of total billed charges which is 100% CMS Medicare rate,$158.40,44% of total billed charges which is 100% CMS Medicare rate,$158.40,44% of total billed charges which is 100% CMS Medicare rate,$158.40,44% of total billed charges which is 100% CMS Medicare rate,$158.40,44% of total billed charges which is 100% CMS Medicare rate,$158.40,44% of total billed charges which is 100% CMS Medicare rate,$158.40,44% of total billed charges which is 100% CMS Medicare rate,$158.40,44% of total billed charges which is 100% CMS Medicare rate,$158.40,$158.40,$306.00 
Outpatient Medical Services,RADIOLOGY,93880,Study of vessels on both sides of the head and neck,921,$285.00 ,$125.40,44% of total billed charges which is 100% CMS Medicare rate,$125.40,44% of total billed charges which is 100% CMS Medicare rate,$125.40,44% of total billed charges which is 100% CMS Medicare rate,$125.40,44% of total billed charges which is 100% CMS Medicare rate,$125.40,44% of total billed charges which is 100% CMS Medicare rate,$125.40,44% of total billed charges which is 100% CMS Medicare rate,$125.40,44% of total billed charges which is 100% CMS Medicare rate,$125.40,44% of total billed charges which is 100% CMS Medicare rate,$125.40,44% of total billed charges which is 100% CMS Medicare rate,$125.40,44% of total billed charges which is 100% CMS Medicare rate,$125.40,44% of total billed charges which is 100% CMS Medicare rate,$125.40,$125.40,$242.25 
Outpatient Medical Services,RADIOLOGY,93308,US Echo Limited,402,$700.00 ,$308.00,44% of total billed charges which is 100% CMS Medicare rate,$308.00,44% of total billed charges which is 100% CMS Medicare rate,$308.00,44% of total billed charges which is 100% CMS Medicare rate,$308.00,44% of total billed charges which is 100% CMS Medicare rate,$308.00,44% of total billed charges which is 100% CMS Medicare rate,$308.00,44% of total billed charges which is 100% CMS Medicare rate,$308.00,44% of total billed charges which is 100% CMS Medicare rate,$308.00,44% of total billed charges which is 100% CMS Medicare rate,$308.00,44% of total billed charges which is 100% CMS Medicare rate,$308.00,44% of total billed charges which is 100% CMS Medicare rate,$308.00,44% of total billed charges which is 100% CMS Medicare rate,$308.00,$308.00,$595.00 
Outpatient Medical Services,RADIOLOGY,76705,A diagnostic procedure that allows a provider to see the organs and other structures in the abdomen,402,$240.00 ,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,$105.60,$204.00 
Outpatient Medical Services,RADIOLOGY,76815,Ultrasound of fetus with limited views,402,$220.00 ,$96.80,44% of total billed charges which is 100% CMS Medicare rate,$96.80,44% of total billed charges which is 100% CMS Medicare rate,$96.80,44% of total billed charges which is 100% CMS Medicare rate,$96.80,44% of total billed charges which is 100% CMS Medicare rate,$96.80,44% of total billed charges which is 100% CMS Medicare rate,$96.80,44% of total billed charges which is 100% CMS Medicare rate,$96.80,44% of total billed charges which is 100% CMS Medicare rate,$96.80,44% of total billed charges which is 100% CMS Medicare rate,$96.80,44% of total billed charges which is 100% CMS Medicare rate,$96.80,44% of total billed charges which is 100% CMS Medicare rate,$96.80,44% of total billed charges which is 100% CMS Medicare rate,$96.80,$96.80,$187.00 
Outpatient Medical Services,RADIOLOGY,76856,Complete ultrasound of the pelvis,402,$240.00 ,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,$105.60,$204.00 
Outpatient Medical Services,RADIOLOGY,76770,Ultrasound of back wall of the abdomen with all areas viewed,402,$240.00 ,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,$105.60,$204.00 
Outpatient Medical Services,RADIOLOGY,76881,US SOFT TISSUE,402,$240.00 ,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,$105.60,$204.00 
Outpatient Medical Services,RADIOLOGY,76536,Ultrasound of head and neck,402,$240.00 ,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,$105.60,$204.00 
Outpatient Medical Services,RADIOLOGY,76830,Ultrasound of the pelvis through vagina,402,$240.00 ,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,44% of total billed charges which is 100% CMS Medicare rate,$105.60,$105.60,$204.00 
Outpatient Medical Services,RADIOLOGY,93971,One sided or limited bilateral study,921,$285.00 ,$125.40,44% of total billed charges which is 100% CMS Medicare rate,$125.40,44% of total billed charges which is 100% CMS Medicare rate,$125.40,44% of total billed charges which is 100% CMS Medicare rate,$125.40,44% of total billed charges which is 100% CMS Medicare rate,$125.40,44% of total billed charges which is 100% CMS Medicare rate,$125.40,44% of total billed charges which is 100% CMS Medicare rate,$125.40,44% of total billed charges which is 100% CMS Medicare rate,$125.40,44% of total billed charges which is 100% CMS Medicare rate,$125.40,44% of total billed charges which is 100% CMS Medicare rate,$125.40,44% of total billed charges which is 100% CMS Medicare rate,$125.40,44% of total billed charges which is 100% CMS Medicare rate,$125.40,$125.40,$242.25 
Outpatient Medical Services,RADIOLOGY,93970,Complete bilateral study of the extremities,921,$125.00 ,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,$55.00,$106.25 
Outpatient Medical Services,RADIOLOGY,73110,Up to 3 views,320,$95.00 ,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,$41.80,$80.75 
Outpatient Medical Services,RADIOLOGY,73100,3 or more views,320,$85.00 ,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,$37.40,$72.25 
Outpatient Medical Services,RADIOLOGY,71048,4 or more views,324,$225.00 ,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,$99.00,$191.25 
Outpatient Medical Services,RADIOLOGY,72040,"Radiologic examination of the neck/spine, 2-3 views",320,$150.00 ,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,$66.00,$127.50 
Outpatient Medical Services,RADIOLOGY,72040,"Radiologic examination of the neck/spine, 2-3 views",972,$110.00 ,$1.65,115% CMS Medicare RBRVS fee schedule,$1.65,115% CMS Medicare RBRVS fee schedule,$1.65,115% CMS Medicare RBRVS fee schedule,$1.65,115% CMS Medicare RBRVS fee schedule,$1.65,115% CMS Medicare RBRVS fee schedule,$1.65,115% CMS Medicare RBRVS fee schedule,$1.65,115% CMS Medicare RBRVS fee schedule,$1.65,115% CMS Medicare RBRVS fee schedule,$1.65,115% CMS Medicare RBRVS fee schedule,$1.65,115% CMS Medicare RBRVS fee schedule,$1.65,115% CMS Medicare RBRVS fee schedule,$1.65,$1.65,$93.50 
Outpatient Medical Services,RADIOLOGY,72050,"Radiologic examination of the neck/spine, 4-5 views",320,$150.00 ,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,$66.00,$127.50 
Outpatient Medical Services,RADIOLOGY,72050,"Radiologic examination of the neck/spine, 4-5 views",972,$150.00 ,$2.04,115% CMS Medicare RBRVS fee schedule,$2.04,115% CMS Medicare RBRVS fee schedule,$2.04,115% CMS Medicare RBRVS fee schedule,$2.04,115% CMS Medicare RBRVS fee schedule,$2.04,115% CMS Medicare RBRVS fee schedule,$2.04,115% CMS Medicare RBRVS fee schedule,$2.04,115% CMS Medicare RBRVS fee schedule,$2.04,115% CMS Medicare RBRVS fee schedule,$2.04,115% CMS Medicare RBRVS fee schedule,$2.04,115% CMS Medicare RBRVS fee schedule,$2.04,115% CMS Medicare RBRVS fee schedule,$2.04,$2.04,$127.50 
Outpatient Medical Services,RADIOLOGY,72052,C SPINE 6 OR MORE VIEWS,320,$195.00 ,$85.80,44% of total billed charges which is 100% CMS Medicare rate,$85.80,44% of total billed charges which is 100% CMS Medicare rate,$85.80,44% of total billed charges which is 100% CMS Medicare rate,$85.80,44% of total billed charges which is 100% CMS Medicare rate,$85.80,44% of total billed charges which is 100% CMS Medicare rate,$85.80,44% of total billed charges which is 100% CMS Medicare rate,$85.80,44% of total billed charges which is 100% CMS Medicare rate,$85.80,44% of total billed charges which is 100% CMS Medicare rate,$85.80,44% of total billed charges which is 100% CMS Medicare rate,$85.80,44% of total billed charges which is 100% CMS Medicare rate,$85.80,44% of total billed charges which is 100% CMS Medicare rate,$85.80,$85.80,$165.75 
Outpatient Medical Services,RADIOLOGY,72052,READ-C SPINE 6 OR MORE VWS,972,$195.00 ,$2.56,115% CMS Medicare RBRVS fee schedule,$2.56,115% CMS Medicare RBRVS fee schedule,$2.56,115% CMS Medicare RBRVS fee schedule,$2.56,115% CMS Medicare RBRVS fee schedule,$2.56,115% CMS Medicare RBRVS fee schedule,$2.56,115% CMS Medicare RBRVS fee schedule,$2.56,115% CMS Medicare RBRVS fee schedule,$2.56,115% CMS Medicare RBRVS fee schedule,$2.56,115% CMS Medicare RBRVS fee schedule,$2.56,115% CMS Medicare RBRVS fee schedule,$2.56,115% CMS Medicare RBRVS fee schedule,$2.56,$2.56,$165.75 
Outpatient Medical Services,RADIOLOGY,72070,"Radiologic examination of the middle spine, 2 views",320,$115.00 ,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,$50.60,$97.75 
Outpatient Medical Services,RADIOLOGY,72070,"Radiologic examination of the middle spine, 2 views",972,$115.00 ,$1.47,115% CMS Medicare RBRVS fee schedule,$1.47,115% CMS Medicare RBRVS fee schedule,$1.47,115% CMS Medicare RBRVS fee schedule,$1.47,115% CMS Medicare RBRVS fee schedule,$1.47,115% CMS Medicare RBRVS fee schedule,$1.47,115% CMS Medicare RBRVS fee schedule,$1.47,115% CMS Medicare RBRVS fee schedule,$1.47,115% CMS Medicare RBRVS fee schedule,$1.47,115% CMS Medicare RBRVS fee schedule,$1.47,115% CMS Medicare RBRVS fee schedule,$1.47,115% CMS Medicare RBRVS fee schedule,$1.47,$1.47,$97.75 
Outpatient Medical Services,RADIOLOGY,72072,"Radiologic examination of the middle spine, 3 views",320,$135.00 ,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,$59.40,$114.75 
Outpatient Medical Services,RADIOLOGY,72072,"Radiologic examination of the middle spine, 3 views",972,$135.00 ,$1.65,115% CMS Medicare RBRVS fee schedule,$1.65,115% CMS Medicare RBRVS fee schedule,$1.65,115% CMS Medicare RBRVS fee schedule,$1.65,115% CMS Medicare RBRVS fee schedule,$1.65,115% CMS Medicare RBRVS fee schedule,$1.65,115% CMS Medicare RBRVS fee schedule,$1.65,115% CMS Medicare RBRVS fee schedule,$1.65,115% CMS Medicare RBRVS fee schedule,$1.65,115% CMS Medicare RBRVS fee schedule,$1.65,115% CMS Medicare RBRVS fee schedule,$1.65,115% CMS Medicare RBRVS fee schedule,$1.65,$1.65,$114.75 
Outpatient Medical Services,RADIOLOGY,72080,THORACOLUMBAR SP-SCOLIOSI,320,$135.00 ,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,44% of total billed charges which is 100% CMS Medicare rate,$59.40,$59.40,$114.75 
Outpatient Medical Services,RADIOLOGY,72080,READ-THORACOLUMBAR SP-SCO,972,$135.00 ,$1.52,115% CMS Medicare RBRVS fee schedule,$1.52,115% CMS Medicare RBRVS fee schedule,$1.52,115% CMS Medicare RBRVS fee schedule,$1.52,115% CMS Medicare RBRVS fee schedule,$1.52,115% CMS Medicare RBRVS fee schedule,$1.52,115% CMS Medicare RBRVS fee schedule,$1.52,115% CMS Medicare RBRVS fee schedule,$1.52,115% CMS Medicare RBRVS fee schedule,$1.52,115% CMS Medicare RBRVS fee schedule,$1.52,115% CMS Medicare RBRVS fee schedule,$1.52,115% CMS Medicare RBRVS fee schedule,$1.52,$1.52,$114.75 
Outpatient Medical Services,RADIOLOGY,72082,ENTIRE SPINE AP/LAT,320,$350.00 ,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,$154.00,$297.50 
Outpatient Medical Services,RADIOLOGY,72082,READ-PAR SINGLE V,972,$98.00 ,$2.77,115% CMS Medicare RBRVS fee schedule,$2.77,115% CMS Medicare RBRVS fee schedule,$2.77,115% CMS Medicare RBRVS fee schedule,$2.77,115% CMS Medicare RBRVS fee schedule,$2.77,115% CMS Medicare RBRVS fee schedule,$2.77,115% CMS Medicare RBRVS fee schedule,$2.77,115% CMS Medicare RBRVS fee schedule,$2.77,115% CMS Medicare RBRVS fee schedule,$2.77,115% CMS Medicare RBRVS fee schedule,$2.77,115% CMS Medicare RBRVS fee schedule,$2.77,115% CMS Medicare RBRVS fee schedule,$2.77,$2.77,$83.30 
Outpatient Medical Services,RADIOLOGY,72100,X-ray of the lower spine 2-3 views,320,$150.00 ,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,$66.00,$127.50 
Outpatient Medical Services,RADIOLOGY,72100,X-ray of the lower spine 2-3 views,320,$150.00 ,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,$66.00,$127.50 
Outpatient Medical Services,RADIOLOGY,72100,X-ray of the lower spine 2-3 views,972,$115.00 ,$1.66,115% CMS Medicare RBRVS fee schedule,$1.66,115% CMS Medicare RBRVS fee schedule,$1.66,115% CMS Medicare RBRVS fee schedule,$1.66,115% CMS Medicare RBRVS fee schedule,$1.66,115% CMS Medicare RBRVS fee schedule,$1.66,115% CMS Medicare RBRVS fee schedule,$1.66,115% CMS Medicare RBRVS fee schedule,$1.66,115% CMS Medicare RBRVS fee schedule,$1.66,115% CMS Medicare RBRVS fee schedule,$1.66,115% CMS Medicare RBRVS fee schedule,$1.66,115% CMS Medicare RBRVS fee schedule,$1.66,$1.66,$97.75 
Outpatient Medical Services,RADIOLOGY,72110,"X-ray of lower and sacral spine, minimum of 4 views",320,$215.00 ,$94.60,44% of total billed charges which is 100% CMS Medicare rate,$94.60,44% of total billed charges which is 100% CMS Medicare rate,$94.60,44% of total billed charges which is 100% CMS Medicare rate,$94.60,44% of total billed charges which is 100% CMS Medicare rate,$94.60,44% of total billed charges which is 100% CMS Medicare rate,$94.60,44% of total billed charges which is 100% CMS Medicare rate,$94.60,44% of total billed charges which is 100% CMS Medicare rate,$94.60,44% of total billed charges which is 100% CMS Medicare rate,$94.60,44% of total billed charges which is 100% CMS Medicare rate,$94.60,44% of total billed charges which is 100% CMS Medicare rate,$94.60,44% of total billed charges which is 100% CMS Medicare rate,$94.60,$94.60,$182.75 
Outpatient Medical Services,RADIOLOGY,72110,"X-ray of lower and sacral spine, minimum of 4 views",972,$215.00 ,$1.99,115% CMS Medicare RBRVS fee schedule,$1.99,115% CMS Medicare RBRVS fee schedule,$1.99,115% CMS Medicare RBRVS fee schedule,$1.99,115% CMS Medicare RBRVS fee schedule,$1.99,115% CMS Medicare RBRVS fee schedule,$1.99,115% CMS Medicare RBRVS fee schedule,$1.99,115% CMS Medicare RBRVS fee schedule,$1.99,115% CMS Medicare RBRVS fee schedule,$1.99,115% CMS Medicare RBRVS fee schedule,$1.99,115% CMS Medicare RBRVS fee schedule,$1.99,115% CMS Medicare RBRVS fee schedule,$1.99,$1.99,$182.75 
Outpatient Medical Services,RADIOLOGY,72114,L SPINE COMP MIN 6 VWS,320,$215.00 ,$94.60,44% of total billed charges which is 100% CMS Medicare rate,$94.60,44% of total billed charges which is 100% CMS Medicare rate,$94.60,44% of total billed charges which is 100% CMS Medicare rate,$94.60,44% of total billed charges which is 100% CMS Medicare rate,$94.60,44% of total billed charges which is 100% CMS Medicare rate,$94.60,44% of total billed charges which is 100% CMS Medicare rate,$94.60,44% of total billed charges which is 100% CMS Medicare rate,$94.60,44% of total billed charges which is 100% CMS Medicare rate,$94.60,44% of total billed charges which is 100% CMS Medicare rate,$94.60,44% of total billed charges which is 100% CMS Medicare rate,$94.60,44% of total billed charges which is 100% CMS Medicare rate,$94.60,$94.60,$182.75 
Outpatient Medical Services,RADIOLOGY,72125,CERVICAL SPINE - PLAIN,352,$750.00 ,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,$330.00,$637.50 
Outpatient Medical Services,RADIOLOGY,72125,READ-CT SPINE - PLAIN,972,$150.00 ,$5.38,115% CMS Medicare RBRVS fee schedule,$5.38,115% CMS Medicare RBRVS fee schedule,$5.38,115% CMS Medicare RBRVS fee schedule,$5.38,115% CMS Medicare RBRVS fee schedule,$5.38,115% CMS Medicare RBRVS fee schedule,$5.38,115% CMS Medicare RBRVS fee schedule,$5.38,115% CMS Medicare RBRVS fee schedule,$5.38,115% CMS Medicare RBRVS fee schedule,$5.38,115% CMS Medicare RBRVS fee schedule,$5.38,115% CMS Medicare RBRVS fee schedule,$5.38,115% CMS Medicare RBRVS fee schedule,$5.38,$5.38,$127.50 
Outpatient Medical Services,RADIOLOGY,72128,THORACIC SPINE W/O CONTRA,352,$750.00 ,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,$330.00,$637.50 
Outpatient Medical Services,RADIOLOGY,72128,READ-THORACIC SPINE PLAIN,972,$150.00 ,$5.37,115% CMS Medicare RBRVS fee schedule,$5.37,115% CMS Medicare RBRVS fee schedule,$5.37,115% CMS Medicare RBRVS fee schedule,$5.37,115% CMS Medicare RBRVS fee schedule,$5.37,115% CMS Medicare RBRVS fee schedule,$5.37,115% CMS Medicare RBRVS fee schedule,$5.37,115% CMS Medicare RBRVS fee schedule,$5.37,115% CMS Medicare RBRVS fee schedule,$5.37,115% CMS Medicare RBRVS fee schedule,$5.37,115% CMS Medicare RBRVS fee schedule,$5.37,115% CMS Medicare RBRVS fee schedule,$5.37,$5.37,$127.50 
Outpatient Medical Services,RADIOLOGY,72131,CT scan of lower spine without dye,352,$750.00 ,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,$330.00,$637.50 
Outpatient Medical Services,RADIOLOGY,72131,CT scan of lower spine without dye,972,$150.00 ,$5.35,115% CMS Medicare RBRVS fee schedule,$5.35,115% CMS Medicare RBRVS fee schedule,$5.35,115% CMS Medicare RBRVS fee schedule,$5.35,115% CMS Medicare RBRVS fee schedule,$5.35,115% CMS Medicare RBRVS fee schedule,$5.35,115% CMS Medicare RBRVS fee schedule,$5.35,115% CMS Medicare RBRVS fee schedule,$5.35,115% CMS Medicare RBRVS fee schedule,$5.35,115% CMS Medicare RBRVS fee schedule,$5.35,115% CMS Medicare RBRVS fee schedule,$5.35,115% CMS Medicare RBRVS fee schedule,$5.35,$5.35,$127.50 
Outpatient Medical Services,RADIOLOGY,72133,LUMBAR SPINE - W/WO CONTR,352,"$1,500.00 ",$660.00,44% of total billed charges which is 100% CMS Medicare rate,$660.00,44% of total billed charges which is 100% CMS Medicare rate,$660.00,44% of total billed charges which is 100% CMS Medicare rate,$660.00,44% of total billed charges which is 100% CMS Medicare rate,$660.00,44% of total billed charges which is 100% CMS Medicare rate,$660.00,44% of total billed charges which is 100% CMS Medicare rate,$660.00,44% of total billed charges which is 100% CMS Medicare rate,$660.00,44% of total billed charges which is 100% CMS Medicare rate,$660.00,44% of total billed charges which is 100% CMS Medicare rate,$660.00,44% of total billed charges which is 100% CMS Medicare rate,$660.00,44% of total billed charges which is 100% CMS Medicare rate,$660.00,$660.00,"$1,275.00 "
Outpatient Medical Services,RADIOLOGY,72133,READ-LUMBAR SP-W/WO CONTR,972,$300.00 ,$8.13,115% CMS Medicare RBRVS fee schedule,$8.13,115% CMS Medicare RBRVS fee schedule,$8.13,115% CMS Medicare RBRVS fee schedule,$8.13,115% CMS Medicare RBRVS fee schedule,$8.13,115% CMS Medicare RBRVS fee schedule,$8.13,115% CMS Medicare RBRVS fee schedule,$8.13,115% CMS Medicare RBRVS fee schedule,$8.13,115% CMS Medicare RBRVS fee schedule,$8.13,115% CMS Medicare RBRVS fee schedule,$8.13,115% CMS Medicare RBRVS fee schedule,$8.13,115% CMS Medicare RBRVS fee schedule,$8.13,$8.13,$255.00 
Outpatient Medical Services,RADIOLOGY,72170,Radiologic examination of the pelvis,320,$90.00 ,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,$39.60,$76.50 
Outpatient Medical Services,RADIOLOGY,72170,Radiologic examination of the pelvis,972,$90.00 ,$1.33,115% CMS Medicare RBRVS fee schedule,$1.33,115% CMS Medicare RBRVS fee schedule,$1.33,115% CMS Medicare RBRVS fee schedule,$1.33,115% CMS Medicare RBRVS fee schedule,$1.33,115% CMS Medicare RBRVS fee schedule,$1.33,115% CMS Medicare RBRVS fee schedule,$1.33,115% CMS Medicare RBRVS fee schedule,$1.33,115% CMS Medicare RBRVS fee schedule,$1.33,115% CMS Medicare RBRVS fee schedule,$1.33,115% CMS Medicare RBRVS fee schedule,$1.33,115% CMS Medicare RBRVS fee schedule,$1.33,$1.33,$76.50 
Outpatient Medical Services,RADIOLOGY,72192,CT of pelvis without dye,352,$750.00 ,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,$330.00,$637.50 
Outpatient Medical Services,RADIOLOGY,72192,CT of pelvis without dye,972,$150.00 ,$5.75,115% CMS Medicare RBRVS fee schedule,$5.75,115% CMS Medicare RBRVS fee schedule,$5.75,115% CMS Medicare RBRVS fee schedule,$5.75,115% CMS Medicare RBRVS fee schedule,$5.75,115% CMS Medicare RBRVS fee schedule,$5.75,115% CMS Medicare RBRVS fee schedule,$5.75,115% CMS Medicare RBRVS fee schedule,$5.75,115% CMS Medicare RBRVS fee schedule,$5.75,115% CMS Medicare RBRVS fee schedule,$5.75,115% CMS Medicare RBRVS fee schedule,$5.75,115% CMS Medicare RBRVS fee schedule,$5.75,$5.75,$127.50 
Outpatient Medical Services,RADIOLOGY,72193,"CT scan, pelvis, with contrast",352,$775.00 ,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,$341.00,$658.75 
Outpatient Medical Services,RADIOLOGY,72193,"CT scan, pelvis, with contrast",972,$150.00 ,$8.73,115% CMS Medicare RBRVS fee schedule,$8.73,115% CMS Medicare RBRVS fee schedule,$8.73,115% CMS Medicare RBRVS fee schedule,$8.73,115% CMS Medicare RBRVS fee schedule,$8.73,115% CMS Medicare RBRVS fee schedule,$8.73,115% CMS Medicare RBRVS fee schedule,$8.73,115% CMS Medicare RBRVS fee schedule,$8.73,115% CMS Medicare RBRVS fee schedule,$8.73,115% CMS Medicare RBRVS fee schedule,$8.73,115% CMS Medicare RBRVS fee schedule,$8.73,115% CMS Medicare RBRVS fee schedule,$8.73,$8.73,$127.50 
Outpatient Medical Services,RADIOLOGY,72194,PELVIS W/WO CONTRAST,352,"$1,150.00 ",$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,$506.00,$977.50 
Outpatient Medical Services,RADIOLOGY,72194,READ-PELVIS W/WO CONTRAST,972,$150.00 ,$9.40,115% CMS Medicare RBRVS fee schedule,$9.40,115% CMS Medicare RBRVS fee schedule,$9.40,115% CMS Medicare RBRVS fee schedule,$9.40,115% CMS Medicare RBRVS fee schedule,$9.40,115% CMS Medicare RBRVS fee schedule,$9.40,115% CMS Medicare RBRVS fee schedule,$9.40,115% CMS Medicare RBRVS fee schedule,$9.40,115% CMS Medicare RBRVS fee schedule,$9.40,115% CMS Medicare RBRVS fee schedule,$9.40,115% CMS Medicare RBRVS fee schedule,$9.40,115% CMS Medicare RBRVS fee schedule,$9.40,$9.40,$127.50 
Outpatient Medical Services,RADIOLOGY,72202,SACROILIACS 3 OR MORE VWS,320,$120.00 ,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,$52.80,$102.00 
Outpatient Medical Services,RADIOLOGY,72202,READ-SACROILIACS- > 3 V,972,$120.00 ,$1.64,115% CMS Medicare RBRVS fee schedule,$1.64,115% CMS Medicare RBRVS fee schedule,$1.64,115% CMS Medicare RBRVS fee schedule,$1.64,115% CMS Medicare RBRVS fee schedule,$1.64,115% CMS Medicare RBRVS fee schedule,$1.64,115% CMS Medicare RBRVS fee schedule,$1.64,115% CMS Medicare RBRVS fee schedule,$1.64,115% CMS Medicare RBRVS fee schedule,$1.64,115% CMS Medicare RBRVS fee schedule,$1.64,115% CMS Medicare RBRVS fee schedule,$1.64,115% CMS Medicare RBRVS fee schedule,$1.64,$1.64,$102.00 
Outpatient Medical Services,RADIOLOGY,72220,COCCYX MIN 2 VWS,320,$115.00 ,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,$50.60,$97.75 
Outpatient Medical Services,RADIOLOGY,72220,SACRUM MIN 2 VWS,320,$115.00 ,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,$50.60,$97.75 
Outpatient Medical Services,RADIOLOGY,72220,READ-COCCYX MIN 2 VWS,972,$115.00 ,$1.46,115% CMS Medicare RBRVS fee schedule,$1.46,115% CMS Medicare RBRVS fee schedule,$1.46,115% CMS Medicare RBRVS fee schedule,$1.46,115% CMS Medicare RBRVS fee schedule,$1.46,115% CMS Medicare RBRVS fee schedule,$1.46,115% CMS Medicare RBRVS fee schedule,$1.46,115% CMS Medicare RBRVS fee schedule,$1.46,115% CMS Medicare RBRVS fee schedule,$1.46,115% CMS Medicare RBRVS fee schedule,$1.46,115% CMS Medicare RBRVS fee schedule,$1.46,115% CMS Medicare RBRVS fee schedule,$1.46,$1.46,$97.75 
Outpatient Medical Services,RADIOLOGY,72220,READ-SACRUM MIN 2 VWS,972,$115.00 ,$1.46,115% CMS Medicare RBRVS fee schedule,$1.46,115% CMS Medicare RBRVS fee schedule,$1.46,115% CMS Medicare RBRVS fee schedule,$1.46,115% CMS Medicare RBRVS fee schedule,$1.46,115% CMS Medicare RBRVS fee schedule,$1.46,115% CMS Medicare RBRVS fee schedule,$1.46,115% CMS Medicare RBRVS fee schedule,$1.46,115% CMS Medicare RBRVS fee schedule,$1.46,115% CMS Medicare RBRVS fee schedule,$1.46,115% CMS Medicare RBRVS fee schedule,$1.46,115% CMS Medicare RBRVS fee schedule,$1.46,$1.46,$97.75 
Outpatient Medical Services,RADIOLOGY,73000,Radiologic examination of the collar bone,320,$115.00 ,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,$50.60,$97.75 
Outpatient Medical Services,RADIOLOGY,73000,Radiologic examination of the collar bone,320,$115.00 ,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,$50.60,$97.75 
Outpatient Medical Services,RADIOLOGY,73000,Radiologic examination of the collar bone,972,$115.00 ,$1.46,115% CMS Medicare RBRVS fee schedule,$1.46,115% CMS Medicare RBRVS fee schedule,$1.46,115% CMS Medicare RBRVS fee schedule,$1.46,115% CMS Medicare RBRVS fee schedule,$1.46,115% CMS Medicare RBRVS fee schedule,$1.46,115% CMS Medicare RBRVS fee schedule,$1.46,115% CMS Medicare RBRVS fee schedule,$1.46,115% CMS Medicare RBRVS fee schedule,$1.46,115% CMS Medicare RBRVS fee schedule,$1.46,115% CMS Medicare RBRVS fee schedule,$1.46,115% CMS Medicare RBRVS fee schedule,$1.46,$1.46,$97.75 
Outpatient Medical Services,RADIOLOGY,73010,SCAPULA-LEFT COMPLETE,320,$115.00 ,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,$50.60,$97.75 
Outpatient Medical Services,RADIOLOGY,73010,SCAPULA RT-COMPLETE,320,$115.00 ,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,$50.60,$97.75 
Outpatient Medical Services,RADIOLOGY,73010,READ-SCAPULA COMPLETE,972,$115.00 ,$1.22,115% CMS Medicare RBRVS fee schedule,$1.22,115% CMS Medicare RBRVS fee schedule,$1.22,115% CMS Medicare RBRVS fee schedule,$1.22,115% CMS Medicare RBRVS fee schedule,$1.22,115% CMS Medicare RBRVS fee schedule,$1.22,115% CMS Medicare RBRVS fee schedule,$1.22,115% CMS Medicare RBRVS fee schedule,$1.22,115% CMS Medicare RBRVS fee schedule,$1.22,115% CMS Medicare RBRVS fee schedule,$1.22,115% CMS Medicare RBRVS fee schedule,$1.22,115% CMS Medicare RBRVS fee schedule,$1.22,$1.22,$97.75 
Outpatient Medical Services,RADIOLOGY,73020,SHOULDER 1 VW RT,320,$115.00 ,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,$50.60,$97.75 
Outpatient Medical Services,RADIOLOGY,73020,SHOULDER 1 VW LT,320,$115.00 ,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,$50.60,$97.75 
Outpatient Medical Services,RADIOLOGY,73020,READ-SHOULDER 1 VW,972,$115.00 ,$1.15,115% CMS Medicare RBRVS fee schedule,$1.15,115% CMS Medicare RBRVS fee schedule,$1.15,115% CMS Medicare RBRVS fee schedule,$1.15,115% CMS Medicare RBRVS fee schedule,$1.15,115% CMS Medicare RBRVS fee schedule,$1.15,115% CMS Medicare RBRVS fee schedule,$1.15,115% CMS Medicare RBRVS fee schedule,$1.15,115% CMS Medicare RBRVS fee schedule,$1.15,115% CMS Medicare RBRVS fee schedule,$1.15,115% CMS Medicare RBRVS fee schedule,$1.15,115% CMS Medicare RBRVS fee schedule,$1.15,$1.15,$97.75 
Outpatient Medical Services,RADIOLOGY,73030,Radiologic examination of the shoulder,320,$120.00 ,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,$52.80,$102.00 
Outpatient Medical Services,RADIOLOGY,73030,Radiologic examination of the shoulder,320,$120.00 ,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,44% of total billed charges which is 100% CMS Medicare rate,$52.80,$52.80,$102.00 
Outpatient Medical Services,RADIOLOGY,73030,Radiologic examination of the shoulder,972,$120.00 ,$1.52,115% CMS Medicare RBRVS fee schedule,$1.52,115% CMS Medicare RBRVS fee schedule,$1.52,115% CMS Medicare RBRVS fee schedule,$1.52,115% CMS Medicare RBRVS fee schedule,$1.52,115% CMS Medicare RBRVS fee schedule,$1.52,115% CMS Medicare RBRVS fee schedule,$1.52,115% CMS Medicare RBRVS fee schedule,$1.52,115% CMS Medicare RBRVS fee schedule,$1.52,115% CMS Medicare RBRVS fee schedule,$1.52,115% CMS Medicare RBRVS fee schedule,$1.52,115% CMS Medicare RBRVS fee schedule,$1.52,$1.52,$102.00 
Outpatient Medical Services,RADIOLOGY,73050,A C JOINTS BILAT,320,$125.00 ,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,$55.00,$106.25 
Outpatient Medical Services,RADIOLOGY,73050,READ-AC JOINTS BILAT,972,$125.00 ,$1.36,115% CMS Medicare RBRVS fee schedule,$1.36,115% CMS Medicare RBRVS fee schedule,$1.36,115% CMS Medicare RBRVS fee schedule,$1.36,115% CMS Medicare RBRVS fee schedule,$1.36,115% CMS Medicare RBRVS fee schedule,$1.36,115% CMS Medicare RBRVS fee schedule,$1.36,115% CMS Medicare RBRVS fee schedule,$1.36,115% CMS Medicare RBRVS fee schedule,$1.36,115% CMS Medicare RBRVS fee schedule,$1.36,115% CMS Medicare RBRVS fee schedule,$1.36,115% CMS Medicare RBRVS fee schedule,$1.36,$1.36,$106.25 
Outpatient Medical Services,RADIOLOGY,73060,HUMERUS RT UPPER ARM M/2V,320,$110.00 ,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,$48.40,$93.50 
Outpatient Medical Services,RADIOLOGY,73060,HUMERUS LT UPPER ARM M/2V,320,$110.00 ,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,$48.40,$93.50 
Outpatient Medical Services,RADIOLOGY,73060,READ-HUMERUS MIN 2 VWS,972,$110.00 ,$1.44,115% CMS Medicare RBRVS fee schedule,$1.44,115% CMS Medicare RBRVS fee schedule,$1.44,115% CMS Medicare RBRVS fee schedule,$1.44,115% CMS Medicare RBRVS fee schedule,$1.44,115% CMS Medicare RBRVS fee schedule,$1.44,115% CMS Medicare RBRVS fee schedule,$1.44,115% CMS Medicare RBRVS fee schedule,$1.44,115% CMS Medicare RBRVS fee schedule,$1.44,115% CMS Medicare RBRVS fee schedule,$1.44,115% CMS Medicare RBRVS fee schedule,$1.44,115% CMS Medicare RBRVS fee schedule,$1.44,$1.44,$93.50 
Outpatient Medical Services,RADIOLOGY,73070,"Radiologic examination, elbow; 2 views",320,$90.00 ,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,$39.60,$76.50 
Outpatient Medical Services,RADIOLOGY,73070,"Radiologic examination, elbow; 2 views",320,$90.00 ,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,$39.60,$76.50 
Outpatient Medical Services,RADIOLOGY,73070,"Radiologic examination, elbow; 2 views",972,$90.00 ,$1.36,115% CMS Medicare RBRVS fee schedule,$1.36,115% CMS Medicare RBRVS fee schedule,$1.36,115% CMS Medicare RBRVS fee schedule,$1.36,115% CMS Medicare RBRVS fee schedule,$1.36,115% CMS Medicare RBRVS fee schedule,$1.36,115% CMS Medicare RBRVS fee schedule,$1.36,115% CMS Medicare RBRVS fee schedule,$1.36,115% CMS Medicare RBRVS fee schedule,$1.36,115% CMS Medicare RBRVS fee schedule,$1.36,115% CMS Medicare RBRVS fee schedule,$1.36,115% CMS Medicare RBRVS fee schedule,$1.36,$1.36,$76.50 
Outpatient Medical Services,RADIOLOGY,73080,"Radiologic examination, elbow; 3 or more views",320,$100.00 ,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,$44.00,$85.00 
Outpatient Medical Services,RADIOLOGY,73080,"Radiologic examination, elbow; 3 or more views",320,$100.00 ,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,$44.00,$85.00 
Outpatient Medical Services,RADIOLOGY,73080,"Radiologic examination, elbow; 3 or more views",972,$100.00 ,$1.47,115% CMS Medicare RBRVS fee schedule,$1.47,115% CMS Medicare RBRVS fee schedule,$1.47,115% CMS Medicare RBRVS fee schedule,$1.47,115% CMS Medicare RBRVS fee schedule,$1.47,115% CMS Medicare RBRVS fee schedule,$1.47,115% CMS Medicare RBRVS fee schedule,$1.47,115% CMS Medicare RBRVS fee schedule,$1.47,115% CMS Medicare RBRVS fee schedule,$1.47,115% CMS Medicare RBRVS fee schedule,$1.47,115% CMS Medicare RBRVS fee schedule,$1.47,115% CMS Medicare RBRVS fee schedule,$1.47,$1.47,$85.00 
Outpatient Medical Services,RADIOLOGY,73090,Radiologic examination of the forearm,320,$102.00 ,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,$44.88,$86.70 
Outpatient Medical Services,RADIOLOGY,73090,Radiologic examination of the forearm,320,$102.00 ,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,44% of total billed charges which is 100% CMS Medicare rate,$44.88,$44.88,$86.70 
Outpatient Medical Services,RADIOLOGY,73090,Radiologic examination of the forearm,972,$102.00 ,$1.36,115% CMS Medicare RBRVS fee schedule,$1.36,115% CMS Medicare RBRVS fee schedule,$1.36,115% CMS Medicare RBRVS fee schedule,$1.36,115% CMS Medicare RBRVS fee schedule,$1.36,115% CMS Medicare RBRVS fee schedule,$1.36,115% CMS Medicare RBRVS fee schedule,$1.36,115% CMS Medicare RBRVS fee schedule,$1.36,115% CMS Medicare RBRVS fee schedule,$1.36,115% CMS Medicare RBRVS fee schedule,$1.36,115% CMS Medicare RBRVS fee schedule,$1.36,115% CMS Medicare RBRVS fee schedule,$1.36,$1.36,$86.70 
Outpatient Medical Services,RADIOLOGY,73092,UPPER EXTRM INFANT MN 2VL,320,$80.00 ,$35.20,44% of total billed charges which is 100% CMS Medicare rate,$35.20,44% of total billed charges which is 100% CMS Medicare rate,$35.20,44% of total billed charges which is 100% CMS Medicare rate,$35.20,44% of total billed charges which is 100% CMS Medicare rate,$35.20,44% of total billed charges which is 100% CMS Medicare rate,$35.20,44% of total billed charges which is 100% CMS Medicare rate,$35.20,44% of total billed charges which is 100% CMS Medicare rate,$35.20,44% of total billed charges which is 100% CMS Medicare rate,$35.20,44% of total billed charges which is 100% CMS Medicare rate,$35.20,44% of total billed charges which is 100% CMS Medicare rate,$35.20,44% of total billed charges which is 100% CMS Medicare rate,$35.20,$35.20,$68.00 
Outpatient Medical Services,RADIOLOGY,73092,UPPER EXTRM INFANT MN 2VR,320,$80.00 ,$35.20,44% of total billed charges which is 100% CMS Medicare rate,$35.20,44% of total billed charges which is 100% CMS Medicare rate,$35.20,44% of total billed charges which is 100% CMS Medicare rate,$35.20,44% of total billed charges which is 100% CMS Medicare rate,$35.20,44% of total billed charges which is 100% CMS Medicare rate,$35.20,44% of total billed charges which is 100% CMS Medicare rate,$35.20,44% of total billed charges which is 100% CMS Medicare rate,$35.20,44% of total billed charges which is 100% CMS Medicare rate,$35.20,44% of total billed charges which is 100% CMS Medicare rate,$35.20,44% of total billed charges which is 100% CMS Medicare rate,$35.20,44% of total billed charges which is 100% CMS Medicare rate,$35.20,$35.20,$68.00 
Outpatient Medical Services,RADIOLOGY,73092,READ-UPP EXT INFANT MIN 2,972,$80.00 ,$1.43,115% CMS Medicare RBRVS fee schedule,$1.43,115% CMS Medicare RBRVS fee schedule,$1.43,115% CMS Medicare RBRVS fee schedule,$1.43,115% CMS Medicare RBRVS fee schedule,$1.43,115% CMS Medicare RBRVS fee schedule,$1.43,115% CMS Medicare RBRVS fee schedule,$1.43,115% CMS Medicare RBRVS fee schedule,$1.43,115% CMS Medicare RBRVS fee schedule,$1.43,115% CMS Medicare RBRVS fee schedule,$1.43,115% CMS Medicare RBRVS fee schedule,$1.43,115% CMS Medicare RBRVS fee schedule,$1.43,$1.43,$68.00 
Outpatient Medical Services,RADIOLOGY,73100,3 or more views,320,$85.00 ,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,$37.40,$72.25 
Outpatient Medical Services,RADIOLOGY,73100,3 or more views,320,$85.00 ,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,$37.40,$72.25 
Outpatient Medical Services,RADIOLOGY,73100,3 or more views,972,$85.00 ,$1.49,115% CMS Medicare RBRVS fee schedule,$1.49,115% CMS Medicare RBRVS fee schedule,$1.49,115% CMS Medicare RBRVS fee schedule,$1.49,115% CMS Medicare RBRVS fee schedule,$1.49,115% CMS Medicare RBRVS fee schedule,$1.49,115% CMS Medicare RBRVS fee schedule,$1.49,115% CMS Medicare RBRVS fee schedule,$1.49,115% CMS Medicare RBRVS fee schedule,$1.49,115% CMS Medicare RBRVS fee schedule,$1.49,115% CMS Medicare RBRVS fee schedule,$1.49,115% CMS Medicare RBRVS fee schedule,$1.49,$1.49,$72.25 
Outpatient Medical Services,RADIOLOGY,73110,Up to 3 views,320,$95.00 ,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,$41.80,$80.75 
Outpatient Medical Services,RADIOLOGY,73110,Up to 3 views,320,$95.00 ,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,$41.80,$80.75 
Outpatient Medical Services,RADIOLOGY,73110,Up to 3 views,972,$95.00 ,$1.69,115% CMS Medicare RBRVS fee schedule,$1.69,115% CMS Medicare RBRVS fee schedule,$1.69,115% CMS Medicare RBRVS fee schedule,$1.69,115% CMS Medicare RBRVS fee schedule,$1.69,115% CMS Medicare RBRVS fee schedule,$1.69,115% CMS Medicare RBRVS fee schedule,$1.69,115% CMS Medicare RBRVS fee schedule,$1.69,115% CMS Medicare RBRVS fee schedule,$1.69,115% CMS Medicare RBRVS fee schedule,$1.69,115% CMS Medicare RBRVS fee schedule,$1.69,115% CMS Medicare RBRVS fee schedule,$1.69,$1.69,$80.75 
Outpatient Medical Services,RADIOLOGY,73110,Up to 3 views,972,$95.00 ,$1.69,115% CMS Medicare RBRVS fee schedule,$1.69,115% CMS Medicare RBRVS fee schedule,$1.69,115% CMS Medicare RBRVS fee schedule,$1.69,115% CMS Medicare RBRVS fee schedule,$1.69,115% CMS Medicare RBRVS fee schedule,$1.69,115% CMS Medicare RBRVS fee schedule,$1.69,115% CMS Medicare RBRVS fee schedule,$1.69,115% CMS Medicare RBRVS fee schedule,$1.69,115% CMS Medicare RBRVS fee schedule,$1.69,115% CMS Medicare RBRVS fee schedule,$1.69,115% CMS Medicare RBRVS fee schedule,$1.69,$1.69,$80.75 
Outpatient Medical Services,RADIOLOGY,73120,X-ray of the hand with 2 views,320,$105.00 ,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,$46.20,$89.25 
Outpatient Medical Services,RADIOLOGY,73120,X-ray of the hand with 2 views,320,$105.00 ,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,$46.20,$89.25 
Outpatient Medical Services,RADIOLOGY,73120,X-ray of the hand with 2 views,972,$105.00 ,$1.43,115% CMS Medicare RBRVS fee schedule,$1.43,115% CMS Medicare RBRVS fee schedule,$1.43,115% CMS Medicare RBRVS fee schedule,$1.43,115% CMS Medicare RBRVS fee schedule,$1.43,115% CMS Medicare RBRVS fee schedule,$1.43,115% CMS Medicare RBRVS fee schedule,$1.43,115% CMS Medicare RBRVS fee schedule,$1.43,115% CMS Medicare RBRVS fee schedule,$1.43,115% CMS Medicare RBRVS fee schedule,$1.43,115% CMS Medicare RBRVS fee schedule,$1.43,115% CMS Medicare RBRVS fee schedule,$1.43,$1.43,$89.25 
Outpatient Medical Services,RADIOLOGY,73130,X-ray of the hand with 3 or more views,320,$105.00 ,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,$46.20,$89.25 
Outpatient Medical Services,RADIOLOGY,73130,X-ray of the hand with 3 or more views,320,$105.00 ,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,$46.20,$89.25 
Outpatient Medical Services,RADIOLOGY,73130,X-ray of the hand with 3 or more views,972,$105.00 ,$1.58,115% CMS Medicare RBRVS fee schedule,$1.58,115% CMS Medicare RBRVS fee schedule,$1.58,115% CMS Medicare RBRVS fee schedule,$1.58,115% CMS Medicare RBRVS fee schedule,$1.58,115% CMS Medicare RBRVS fee schedule,$1.58,115% CMS Medicare RBRVS fee schedule,$1.58,115% CMS Medicare RBRVS fee schedule,$1.58,115% CMS Medicare RBRVS fee schedule,$1.58,115% CMS Medicare RBRVS fee schedule,$1.58,115% CMS Medicare RBRVS fee schedule,$1.58,115% CMS Medicare RBRVS fee schedule,$1.58,$1.58,$89.25 
Outpatient Medical Services,RADIOLOGY,73140,Radiologic examination of the finger(s),320,$75.00 ,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,$33.00,$63.75 
Outpatient Medical Services,RADIOLOGY,73140,Radiologic examination of the finger(s),320,$75.00 ,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,$33.00,$63.75 
Outpatient Medical Services,RADIOLOGY,73140,Radiologic examination of the finger(s),320,$75.00 ,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,$33.00,$63.75 
Outpatient Medical Services,RADIOLOGY,73140,Radiologic examination of the finger(s),320,$75.00 ,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,$33.00,$63.75 
Outpatient Medical Services,RADIOLOGY,73140,Radiologic examination of the finger(s),320,$75.00 ,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,$33.00,$63.75 
Outpatient Medical Services,RADIOLOGY,73140,Radiologic examination of the finger(s),320,$75.00 ,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,$33.00,$63.75 
Outpatient Medical Services,RADIOLOGY,73140,Radiologic examination of the finger(s),320,$75.00 ,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,$33.00,$63.75 
Outpatient Medical Services,RADIOLOGY,73140,Radiologic examination of the finger(s),320,$75.00 ,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,$33.00,$63.75 
Outpatient Medical Services,RADIOLOGY,73140,Radiologic examination of the finger(s),320,$75.00 ,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,$33.00,$63.75 
Outpatient Medical Services,RADIOLOGY,73140,Radiologic examination of the finger(s),320,$75.00 ,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,44% of total billed charges which is 100% CMS Medicare rate,$33.00,$33.00,$63.75 
Outpatient Medical Services,RADIOLOGY,73140,Radiologic examination of the finger(s),972,$75.00 ,$1.61,115% CMS Medicare RBRVS fee schedule,$1.61,115% CMS Medicare RBRVS fee schedule,$1.61,115% CMS Medicare RBRVS fee schedule,$1.61,115% CMS Medicare RBRVS fee schedule,$1.61,115% CMS Medicare RBRVS fee schedule,$1.61,115% CMS Medicare RBRVS fee schedule,$1.61,115% CMS Medicare RBRVS fee schedule,$1.61,115% CMS Medicare RBRVS fee schedule,$1.61,115% CMS Medicare RBRVS fee schedule,$1.61,115% CMS Medicare RBRVS fee schedule,$1.61,115% CMS Medicare RBRVS fee schedule,$1.61,$1.61,$63.75 
Outpatient Medical Services,RADIOLOGY,73200,UP EXTREMITY - PLAIN,352,$750.00 ,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,$330.00,$637.50 
Outpatient Medical Services,RADIOLOGY,73200,READ-UPPER EXTRE PLAIN,972,$150.00 ,$6.26,115% CMS Medicare RBRVS fee schedule,$6.26,115% CMS Medicare RBRVS fee schedule,$6.26,115% CMS Medicare RBRVS fee schedule,$6.26,115% CMS Medicare RBRVS fee schedule,$6.26,115% CMS Medicare RBRVS fee schedule,$6.26,115% CMS Medicare RBRVS fee schedule,$6.26,115% CMS Medicare RBRVS fee schedule,$6.26,115% CMS Medicare RBRVS fee schedule,$6.26,115% CMS Medicare RBRVS fee schedule,$6.26,115% CMS Medicare RBRVS fee schedule,$6.26,115% CMS Medicare RBRVS fee schedule,$6.26,$6.26,$127.50 
Outpatient Medical Services,RADIOLOGY,73501,HIP LT-1 VW UNI,320,$110.00 ,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,$48.40,$93.50 
Outpatient Medical Services,RADIOLOGY,73501,HIP RT-1 VW UNI,320,$110.00 ,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,$48.40,$93.50 
Outpatient Medical Services,RADIOLOGY,73501,READ-HIP 1 VIEW,972,$110.00 ,$1.47,115% CMS Medicare RBRVS fee schedule,$1.47,115% CMS Medicare RBRVS fee schedule,$1.47,115% CMS Medicare RBRVS fee schedule,$1.47,115% CMS Medicare RBRVS fee schedule,$1.47,115% CMS Medicare RBRVS fee schedule,$1.47,115% CMS Medicare RBRVS fee schedule,$1.47,115% CMS Medicare RBRVS fee schedule,$1.47,115% CMS Medicare RBRVS fee schedule,$1.47,115% CMS Medicare RBRVS fee schedule,$1.47,115% CMS Medicare RBRVS fee schedule,$1.47,115% CMS Medicare RBRVS fee schedule,$1.47,$1.47,$93.50 
Outpatient Medical Services,RADIOLOGY,73502,HIP RIGHT COMPLETE MIN 2V,320,$110.00 ,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,$48.40,$93.50 
Outpatient Medical Services,RADIOLOGY,73502,HIP LEFT COMPLETE MIN 2VW,320,$110.00 ,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,$48.40,$93.50 
Outpatient Medical Services,RADIOLOGY,73502,PELVIS/HIPS CHILD MIN 2VW,320,$115.00 ,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,$50.60,$97.75 
Outpatient Medical Services,RADIOLOGY,73502,"READ- HIP,  COMP 2 VIEWS",972,$110.00 ,$1.87,115% CMS Medicare RBRVS fee schedule,$1.87,115% CMS Medicare RBRVS fee schedule,$1.87,115% CMS Medicare RBRVS fee schedule,$1.87,115% CMS Medicare RBRVS fee schedule,$1.87,115% CMS Medicare RBRVS fee schedule,$1.87,115% CMS Medicare RBRVS fee schedule,$1.87,115% CMS Medicare RBRVS fee schedule,$1.87,115% CMS Medicare RBRVS fee schedule,$1.87,115% CMS Medicare RBRVS fee schedule,$1.87,115% CMS Medicare RBRVS fee schedule,$1.87,115% CMS Medicare RBRVS fee schedule,$1.87,$1.87,$93.50 
Outpatient Medical Services,RADIOLOGY,73502,READ-PELVIS/HIPS CHILD 2V,972,$115.00 ,$1.87,115% CMS Medicare RBRVS fee schedule,$1.87,115% CMS Medicare RBRVS fee schedule,$1.87,115% CMS Medicare RBRVS fee schedule,$1.87,115% CMS Medicare RBRVS fee schedule,$1.87,115% CMS Medicare RBRVS fee schedule,$1.87,115% CMS Medicare RBRVS fee schedule,$1.87,115% CMS Medicare RBRVS fee schedule,$1.87,115% CMS Medicare RBRVS fee schedule,$1.87,115% CMS Medicare RBRVS fee schedule,$1.87,115% CMS Medicare RBRVS fee schedule,$1.87,115% CMS Medicare RBRVS fee schedule,$1.87,$1.87,$97.75 
Outpatient Medical Services,RADIOLOGY,73521,HIPS BILATERAL MIN 2 V EA,320,$140.00 ,$61.60,44% of total billed charges which is 100% CMS Medicare rate,$61.60,44% of total billed charges which is 100% CMS Medicare rate,$61.60,44% of total billed charges which is 100% CMS Medicare rate,$61.60,44% of total billed charges which is 100% CMS Medicare rate,$61.60,44% of total billed charges which is 100% CMS Medicare rate,$61.60,44% of total billed charges which is 100% CMS Medicare rate,$61.60,44% of total billed charges which is 100% CMS Medicare rate,$61.60,44% of total billed charges which is 100% CMS Medicare rate,$61.60,44% of total billed charges which is 100% CMS Medicare rate,$61.60,44% of total billed charges which is 100% CMS Medicare rate,$61.60,44% of total billed charges which is 100% CMS Medicare rate,$61.60,$61.60,$119.00 
Outpatient Medical Services,RADIOLOGY,73521,READ-HIPS BILAT MIN 2 EAC,972,$140.00 ,$1.70,115% CMS Medicare RBRVS fee schedule,$1.70,115% CMS Medicare RBRVS fee schedule,$1.70,115% CMS Medicare RBRVS fee schedule,$1.70,115% CMS Medicare RBRVS fee schedule,$1.70,115% CMS Medicare RBRVS fee schedule,$1.70,115% CMS Medicare RBRVS fee schedule,$1.70,115% CMS Medicare RBRVS fee schedule,$1.70,115% CMS Medicare RBRVS fee schedule,$1.70,115% CMS Medicare RBRVS fee schedule,$1.70,115% CMS Medicare RBRVS fee schedule,$1.70,115% CMS Medicare RBRVS fee schedule,$1.70,$1.70,$119.00 
Outpatient Medical Services,RADIOLOGY,73552,FEMUR RIGHT 2 VWS,320,$115.00 ,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,$50.60,$97.75 
Outpatient Medical Services,RADIOLOGY,73552,FEMUR LEFT 2 VWS,320,$115.00 ,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,$50.60,$97.75 
Outpatient Medical Services,RADIOLOGY,73552,READ-FEMUR 2 VIEWS,972,$115.00 ,$1.54,115% CMS Medicare RBRVS fee schedule,$1.54,115% CMS Medicare RBRVS fee schedule,$1.54,115% CMS Medicare RBRVS fee schedule,$1.54,115% CMS Medicare RBRVS fee schedule,$1.54,115% CMS Medicare RBRVS fee schedule,$1.54,115% CMS Medicare RBRVS fee schedule,$1.54,115% CMS Medicare RBRVS fee schedule,$1.54,115% CMS Medicare RBRVS fee schedule,$1.54,115% CMS Medicare RBRVS fee schedule,$1.54,115% CMS Medicare RBRVS fee schedule,$1.54,115% CMS Medicare RBRVS fee schedule,$1.54,$1.54,$97.75 
Outpatient Medical Services,RADIOLOGY,73560,Radiologic examination of the knee with 1 or 2 views,320,$115.00 ,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,$50.60,$97.75 
Outpatient Medical Services,RADIOLOGY,73560,Radiologic examination of the knee with 1 or 2 views,320,$115.00 ,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,$50.60,$97.75 
Outpatient Medical Services,RADIOLOGY,73560,Radiologic examination of the knee with 1 or 2 views,972,$115.00 ,$1.50,115% CMS Medicare RBRVS fee schedule,$1.50,115% CMS Medicare RBRVS fee schedule,$1.50,115% CMS Medicare RBRVS fee schedule,$1.50,115% CMS Medicare RBRVS fee schedule,$1.50,115% CMS Medicare RBRVS fee schedule,$1.50,115% CMS Medicare RBRVS fee schedule,$1.50,115% CMS Medicare RBRVS fee schedule,$1.50,115% CMS Medicare RBRVS fee schedule,$1.50,115% CMS Medicare RBRVS fee schedule,$1.50,115% CMS Medicare RBRVS fee schedule,$1.50,115% CMS Medicare RBRVS fee schedule,$1.50,$1.50,$97.75 
Outpatient Medical Services,RADIOLOGY,73562,Radiologic examination of the knee with 3 views,320,$150.00 ,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,$66.00,$127.50 
Outpatient Medical Services,RADIOLOGY,73562,Radiologic examination of the knee with 3 views,320,$150.00 ,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,$66.00,$127.50 
Outpatient Medical Services,RADIOLOGY,73562,Radiologic examination of the knee with 3 views,972,$115.00 ,$1.69,115% CMS Medicare RBRVS fee schedule,$1.69,115% CMS Medicare RBRVS fee schedule,$1.69,115% CMS Medicare RBRVS fee schedule,$1.69,115% CMS Medicare RBRVS fee schedule,$1.69,115% CMS Medicare RBRVS fee schedule,$1.69,115% CMS Medicare RBRVS fee schedule,$1.69,115% CMS Medicare RBRVS fee schedule,$1.69,115% CMS Medicare RBRVS fee schedule,$1.69,115% CMS Medicare RBRVS fee schedule,$1.69,115% CMS Medicare RBRVS fee schedule,$1.69,115% CMS Medicare RBRVS fee schedule,$1.69,$1.69,$97.75 
Outpatient Medical Services,RADIOLOGY,73564,Radiologic examination of the knee with 4 or more views,320,$130.00 ,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,$57.20,$110.50 
Outpatient Medical Services,RADIOLOGY,73564,Radiologic examination of the knee with 4 or more views,320,$130.00 ,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,44% of total billed charges which is 100% CMS Medicare rate,$57.20,$57.20,$110.50 
Outpatient Medical Services,RADIOLOGY,73564,Radiologic examination of the knee with 4 or more views,972,$130.00 ,$1.86,115% CMS Medicare RBRVS fee schedule,$1.86,115% CMS Medicare RBRVS fee schedule,$1.86,115% CMS Medicare RBRVS fee schedule,$1.86,115% CMS Medicare RBRVS fee schedule,$1.86,115% CMS Medicare RBRVS fee schedule,$1.86,115% CMS Medicare RBRVS fee schedule,$1.86,115% CMS Medicare RBRVS fee schedule,$1.86,115% CMS Medicare RBRVS fee schedule,$1.86,115% CMS Medicare RBRVS fee schedule,$1.86,115% CMS Medicare RBRVS fee schedule,$1.86,115% CMS Medicare RBRVS fee schedule,$1.86,$1.86,$110.50 
Outpatient Medical Services,RADIOLOGY,73564,Radiologic examination of the knee with 4 or more views,320,$260.00 ,$114.40,44% of total billed charges which is 100% CMS Medicare rate,$114.40,44% of total billed charges which is 100% CMS Medicare rate,$114.40,44% of total billed charges which is 100% CMS Medicare rate,$114.40,44% of total billed charges which is 100% CMS Medicare rate,$114.40,44% of total billed charges which is 100% CMS Medicare rate,$114.40,44% of total billed charges which is 100% CMS Medicare rate,$114.40,44% of total billed charges which is 100% CMS Medicare rate,$114.40,44% of total billed charges which is 100% CMS Medicare rate,$114.40,44% of total billed charges which is 100% CMS Medicare rate,$114.40,44% of total billed charges which is 100% CMS Medicare rate,$114.40,44% of total billed charges which is 100% CMS Medicare rate,$114.40,$114.40,$221.00 
Outpatient Medical Services,RADIOLOGY,73565,Radiologic examination of both knees,320,$350.00 ,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,$154.00,$297.50 
Outpatient Medical Services,RADIOLOGY,73565,Radiologic examination of both knees,972,$150.00 ,$1.66,115% CMS Medicare RBRVS fee schedule,$1.66,115% CMS Medicare RBRVS fee schedule,$1.66,115% CMS Medicare RBRVS fee schedule,$1.66,115% CMS Medicare RBRVS fee schedule,$1.66,115% CMS Medicare RBRVS fee schedule,$1.66,115% CMS Medicare RBRVS fee schedule,$1.66,115% CMS Medicare RBRVS fee schedule,$1.66,115% CMS Medicare RBRVS fee schedule,$1.66,115% CMS Medicare RBRVS fee schedule,$1.66,115% CMS Medicare RBRVS fee schedule,$1.66,115% CMS Medicare RBRVS fee schedule,$1.66,$1.66,$127.50 
Outpatient Medical Services,RADIOLOGY,73590,Radiologic examination of the lower leg,320,$115.00 ,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,$50.60,$97.75 
Outpatient Medical Services,RADIOLOGY,73590,Radiologic examination of the lower leg,320,$115.00 ,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,$50.60,$97.75 
Outpatient Medical Services,RADIOLOGY,73590,Radiologic examination of the lower leg,972,$115.00 ,$1.43,115% CMS Medicare RBRVS fee schedule,$1.43,115% CMS Medicare RBRVS fee schedule,$1.43,115% CMS Medicare RBRVS fee schedule,$1.43,115% CMS Medicare RBRVS fee schedule,$1.43,115% CMS Medicare RBRVS fee schedule,$1.43,115% CMS Medicare RBRVS fee schedule,$1.43,115% CMS Medicare RBRVS fee schedule,$1.43,115% CMS Medicare RBRVS fee schedule,$1.43,115% CMS Medicare RBRVS fee schedule,$1.43,115% CMS Medicare RBRVS fee schedule,$1.43,115% CMS Medicare RBRVS fee schedule,$1.43,$1.43,$97.75 
Outpatient Medical Services,RADIOLOGY,73592,LOWER EXTRM INFANT MN 2VL,320,$80.00 ,$35.20,44% of total billed charges which is 100% CMS Medicare rate,$35.20,44% of total billed charges which is 100% CMS Medicare rate,$35.20,44% of total billed charges which is 100% CMS Medicare rate,$35.20,44% of total billed charges which is 100% CMS Medicare rate,$35.20,44% of total billed charges which is 100% CMS Medicare rate,$35.20,44% of total billed charges which is 100% CMS Medicare rate,$35.20,44% of total billed charges which is 100% CMS Medicare rate,$35.20,44% of total billed charges which is 100% CMS Medicare rate,$35.20,44% of total billed charges which is 100% CMS Medicare rate,$35.20,44% of total billed charges which is 100% CMS Medicare rate,$35.20,44% of total billed charges which is 100% CMS Medicare rate,$35.20,$35.20,$68.00 
Outpatient Medical Services,RADIOLOGY,73592,LOWER EXTRM INFANT MN 2VR,320,$80.00 ,$35.20,44% of total billed charges which is 100% CMS Medicare rate,$35.20,44% of total billed charges which is 100% CMS Medicare rate,$35.20,44% of total billed charges which is 100% CMS Medicare rate,$35.20,44% of total billed charges which is 100% CMS Medicare rate,$35.20,44% of total billed charges which is 100% CMS Medicare rate,$35.20,44% of total billed charges which is 100% CMS Medicare rate,$35.20,44% of total billed charges which is 100% CMS Medicare rate,$35.20,44% of total billed charges which is 100% CMS Medicare rate,$35.20,44% of total billed charges which is 100% CMS Medicare rate,$35.20,44% of total billed charges which is 100% CMS Medicare rate,$35.20,44% of total billed charges which is 100% CMS Medicare rate,$35.20,$35.20,$68.00 
Outpatient Medical Services,RADIOLOGY,73592,READ-LOW EXTRE INFANT 2 V,972,$80.00 ,$1.43,115% CMS Medicare RBRVS fee schedule,$1.43,115% CMS Medicare RBRVS fee schedule,$1.43,115% CMS Medicare RBRVS fee schedule,$1.43,115% CMS Medicare RBRVS fee schedule,$1.43,115% CMS Medicare RBRVS fee schedule,$1.43,115% CMS Medicare RBRVS fee schedule,$1.43,115% CMS Medicare RBRVS fee schedule,$1.43,115% CMS Medicare RBRVS fee schedule,$1.43,115% CMS Medicare RBRVS fee schedule,$1.43,115% CMS Medicare RBRVS fee schedule,$1.43,115% CMS Medicare RBRVS fee schedule,$1.43,$1.43,$68.00 
Outpatient Medical Services,RADIOLOGY,73600,Radiologic examination of the ankle with 2 views,320,$90.00 ,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,$39.60,$76.50 
Outpatient Medical Services,RADIOLOGY,73600,Radiologic examination of the ankle with 2 views,320,$90.00 ,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,44% of total billed charges which is 100% CMS Medicare rate,$39.60,$39.60,$76.50 
Outpatient Medical Services,RADIOLOGY,73600,Radiologic examination of the ankle with 2 views,972,$90.00 ,$1.45,115% CMS Medicare RBRVS fee schedule,$1.45,115% CMS Medicare RBRVS fee schedule,$1.45,115% CMS Medicare RBRVS fee schedule,$1.45,115% CMS Medicare RBRVS fee schedule,$1.45,115% CMS Medicare RBRVS fee schedule,$1.45,115% CMS Medicare RBRVS fee schedule,$1.45,115% CMS Medicare RBRVS fee schedule,$1.45,115% CMS Medicare RBRVS fee schedule,$1.45,115% CMS Medicare RBRVS fee schedule,$1.45,115% CMS Medicare RBRVS fee schedule,$1.45,115% CMS Medicare RBRVS fee schedule,$1.45,$1.45,$76.50 
Outpatient Medical Services,RADIOLOGY,73610,Radiologic examination of the ankle with 3 views,320,$105.00 ,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,$46.20,$89.25 
Outpatient Medical Services,RADIOLOGY,73610,Radiologic examination of the ankle with 3 views,320,$105.00 ,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,$46.20,$89.25 
Outpatient Medical Services,RADIOLOGY,73610,Radiologic examination of the ankle with 3 views,972,$105.00 ,$1.57,115% CMS Medicare RBRVS fee schedule,$1.57,115% CMS Medicare RBRVS fee schedule,$1.57,115% CMS Medicare RBRVS fee schedule,$1.57,115% CMS Medicare RBRVS fee schedule,$1.57,115% CMS Medicare RBRVS fee schedule,$1.57,115% CMS Medicare RBRVS fee schedule,$1.57,115% CMS Medicare RBRVS fee schedule,$1.57,115% CMS Medicare RBRVS fee schedule,$1.57,115% CMS Medicare RBRVS fee schedule,$1.57,115% CMS Medicare RBRVS fee schedule,$1.57,115% CMS Medicare RBRVS fee schedule,$1.57,$1.57,$89.25 
Outpatient Medical Services,RADIOLOGY,73620,"Radiologic examination, foot; 2 views",320,$95.00 ,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,$41.80,$80.75 
Outpatient Medical Services,RADIOLOGY,73620,"Radiologic examination, foot; 2 views",320,$95.00 ,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,44% of total billed charges which is 100% CMS Medicare rate,$41.80,$41.80,$80.75 
Outpatient Medical Services,RADIOLOGY,73620,"Radiologic examination, foot; 2 views",972,$95.00 ,$1.35,115% CMS Medicare RBRVS fee schedule,$1.35,115% CMS Medicare RBRVS fee schedule,$1.35,115% CMS Medicare RBRVS fee schedule,$1.35,115% CMS Medicare RBRVS fee schedule,$1.35,115% CMS Medicare RBRVS fee schedule,$1.35,115% CMS Medicare RBRVS fee schedule,$1.35,115% CMS Medicare RBRVS fee schedule,$1.35,115% CMS Medicare RBRVS fee schedule,$1.35,115% CMS Medicare RBRVS fee schedule,$1.35,115% CMS Medicare RBRVS fee schedule,$1.35,115% CMS Medicare RBRVS fee schedule,$1.35,$1.35,$80.75 
Outpatient Medical Services,RADIOLOGY,73630,Radiologic examination of the foot with 3 or more views,320,$110.00 ,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,$48.40,$93.50 
Outpatient Medical Services,RADIOLOGY,73630,Radiologic examination of the foot with 3 or more views,320,$105.00 ,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,$46.20,$89.25 
Outpatient Medical Services,RADIOLOGY,73630,Radiologic examination of the foot with 3 or more views,972,$105.00 ,$1.50,115% CMS Medicare RBRVS fee schedule,$1.50,115% CMS Medicare RBRVS fee schedule,$1.50,115% CMS Medicare RBRVS fee schedule,$1.50,115% CMS Medicare RBRVS fee schedule,$1.50,115% CMS Medicare RBRVS fee schedule,$1.50,115% CMS Medicare RBRVS fee schedule,$1.50,115% CMS Medicare RBRVS fee schedule,$1.50,115% CMS Medicare RBRVS fee schedule,$1.50,115% CMS Medicare RBRVS fee schedule,$1.50,115% CMS Medicare RBRVS fee schedule,$1.50,115% CMS Medicare RBRVS fee schedule,$1.50,$1.50,$89.25 
Outpatient Medical Services,RADIOLOGY,73650,Radiologic examination of the heel,320,$105.00 ,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,$46.20,$89.25 
Outpatient Medical Services,RADIOLOGY,73650,Radiologic examination of the heel,320,$105.00 ,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,$46.20,$89.25 
Outpatient Medical Services,RADIOLOGY,73650,Radiologic examination of the heel,972,$105.00 ,$1.35,115% CMS Medicare RBRVS fee schedule,$1.35,115% CMS Medicare RBRVS fee schedule,$1.35,115% CMS Medicare RBRVS fee schedule,$1.35,115% CMS Medicare RBRVS fee schedule,$1.35,115% CMS Medicare RBRVS fee schedule,$1.35,115% CMS Medicare RBRVS fee schedule,$1.35,115% CMS Medicare RBRVS fee schedule,$1.35,115% CMS Medicare RBRVS fee schedule,$1.35,115% CMS Medicare RBRVS fee schedule,$1.35,115% CMS Medicare RBRVS fee schedule,$1.35,115% CMS Medicare RBRVS fee schedule,$1.35,$1.35,$89.25 
Outpatient Medical Services,RADIOLOGY,73660,Radiologic examination of the toe(s),320,$65.00 ,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,$28.60,$55.25 
Outpatient Medical Services,RADIOLOGY,73660,Radiologic examination of the toe(s),320,$65.00 ,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,$28.60,$55.25 
Outpatient Medical Services,RADIOLOGY,73660,Radiologic examination of the toe(s),320,$65.00 ,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,$28.60,$55.25 
Outpatient Medical Services,RADIOLOGY,73660,Radiologic examination of the toe(s),320,$65.00 ,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,$28.60,$55.25 
Outpatient Medical Services,RADIOLOGY,73660,Radiologic examination of the toe(s),320,$65.00 ,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,$28.60,$55.25 
Outpatient Medical Services,RADIOLOGY,73660,Radiologic examination of the toe(s),320,$65.00 ,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,$28.60,$55.25 
Outpatient Medical Services,RADIOLOGY,73660,Radiologic examination of the toe(s),320,$65.00 ,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,$28.60,$55.25 
Outpatient Medical Services,RADIOLOGY,73660,Radiologic examination of the toe(s),320,$65.00 ,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,$28.60,$55.25 
Outpatient Medical Services,RADIOLOGY,73660,Radiologic examination of the toe(s),320,$65.00 ,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,$28.60,$55.25 
Outpatient Medical Services,RADIOLOGY,73660,Radiologic examination of the toe(s),320,$65.00 ,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,$28.60,$55.25 
Outpatient Medical Services,RADIOLOGY,73660,Radiologic examination of the toe(s),972,$65.00 ,$1.36,115% CMS Medicare RBRVS fee schedule,$1.36,115% CMS Medicare RBRVS fee schedule,$1.36,115% CMS Medicare RBRVS fee schedule,$1.36,115% CMS Medicare RBRVS fee schedule,$1.36,115% CMS Medicare RBRVS fee schedule,$1.36,115% CMS Medicare RBRVS fee schedule,$1.36,115% CMS Medicare RBRVS fee schedule,$1.36,115% CMS Medicare RBRVS fee schedule,$1.36,115% CMS Medicare RBRVS fee schedule,$1.36,115% CMS Medicare RBRVS fee schedule,$1.36,115% CMS Medicare RBRVS fee schedule,$1.36,$1.36,$55.25 
Outpatient Medical Services,RADIOLOGY,73700,CT scan of leg without dye,352,$750.00 ,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,$330.00,$637.50 
Outpatient Medical Services,RADIOLOGY,73700,CT scan of leg without dye,972,$150.00 ,$5.36,115% CMS Medicare RBRVS fee schedule,$5.36,115% CMS Medicare RBRVS fee schedule,$5.36,115% CMS Medicare RBRVS fee schedule,$5.36,115% CMS Medicare RBRVS fee schedule,$5.36,115% CMS Medicare RBRVS fee schedule,$5.36,115% CMS Medicare RBRVS fee schedule,$5.36,115% CMS Medicare RBRVS fee schedule,$5.36,115% CMS Medicare RBRVS fee schedule,$5.36,115% CMS Medicare RBRVS fee schedule,$5.36,115% CMS Medicare RBRVS fee schedule,$5.36,115% CMS Medicare RBRVS fee schedule,$5.36,$5.36,$127.50 
Outpatient Medical Services,RADIOLOGY,73701,LOW EXTREMITY W/CONTRAST,352,$775.00 ,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,$341.00,$658.75 
Outpatient Medical Services,RADIOLOGY,73701,EXTERMITIES W/CONTRAST,352,$475.00 ,$209.00,44% of total billed charges which is 100% CMS Medicare rate,$209.00,44% of total billed charges which is 100% CMS Medicare rate,$209.00,44% of total billed charges which is 100% CMS Medicare rate,$209.00,44% of total billed charges which is 100% CMS Medicare rate,$209.00,44% of total billed charges which is 100% CMS Medicare rate,$209.00,44% of total billed charges which is 100% CMS Medicare rate,$209.00,44% of total billed charges which is 100% CMS Medicare rate,$209.00,44% of total billed charges which is 100% CMS Medicare rate,$209.00,44% of total billed charges which is 100% CMS Medicare rate,$209.00,44% of total billed charges which is 100% CMS Medicare rate,$209.00,44% of total billed charges which is 100% CMS Medicare rate,$209.00,$209.00,$403.75 
Outpatient Medical Services,RADIOLOGY,73701,READ-LOWER EXTRE W/CONT,972,$150.00 ,$6.97,115% CMS Medicare RBRVS fee schedule,$6.97,115% CMS Medicare RBRVS fee schedule,$6.97,115% CMS Medicare RBRVS fee schedule,$6.97,115% CMS Medicare RBRVS fee schedule,$6.97,115% CMS Medicare RBRVS fee schedule,$6.97,115% CMS Medicare RBRVS fee schedule,$6.97,115% CMS Medicare RBRVS fee schedule,$6.97,115% CMS Medicare RBRVS fee schedule,$6.97,115% CMS Medicare RBRVS fee schedule,$6.97,115% CMS Medicare RBRVS fee schedule,$6.97,115% CMS Medicare RBRVS fee schedule,$6.97,$6.97,$127.50 
Outpatient Medical Services,RADIOLOGY,74018,"ABD, SINGLE VIEW",320,$150.00 ,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,44% of total billed charges which is 100% CMS Medicare rate,$66.00,$66.00,$127.50 
Outpatient Medical Services,RADIOLOGY,74018,N/A,320,$110.00 ,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,44% of total billed charges which is 100% CMS Medicare rate,$48.40,$48.40,$93.50 
Outpatient Medical Services,RADIOLOGY,74018,"READ-ABD, SINGLE VIEW",972,$98.00 ,$1.39,115% CMS Medicare RBRVS fee schedule,$1.39,115% CMS Medicare RBRVS fee schedule,$1.39,115% CMS Medicare RBRVS fee schedule,$1.39,115% CMS Medicare RBRVS fee schedule,$1.39,115% CMS Medicare RBRVS fee schedule,$1.39,115% CMS Medicare RBRVS fee schedule,$1.39,115% CMS Medicare RBRVS fee schedule,$1.39,115% CMS Medicare RBRVS fee schedule,$1.39,115% CMS Medicare RBRVS fee schedule,$1.39,115% CMS Medicare RBRVS fee schedule,$1.39,115% CMS Medicare RBRVS fee schedule,$1.39,$1.39,$83.30 
Outpatient Medical Services,RADIOLOGY,74018,READ-ABD FLAT PLT KUB,972,$98.00 ,$1.39,115% CMS Medicare RBRVS fee schedule,$1.39,115% CMS Medicare RBRVS fee schedule,$1.39,115% CMS Medicare RBRVS fee schedule,$1.39,115% CMS Medicare RBRVS fee schedule,$1.39,115% CMS Medicare RBRVS fee schedule,$1.39,115% CMS Medicare RBRVS fee schedule,$1.39,115% CMS Medicare RBRVS fee schedule,$1.39,115% CMS Medicare RBRVS fee schedule,$1.39,115% CMS Medicare RBRVS fee schedule,$1.39,115% CMS Medicare RBRVS fee schedule,$1.39,115% CMS Medicare RBRVS fee schedule,$1.39,$1.39,$83.30 
Outpatient Medical Services,RADIOLOGY,74019,"ABD, 2 VIEWS",320,$180.00 ,$79.20,44% of total billed charges which is 100% CMS Medicare rate,$79.20,44% of total billed charges which is 100% CMS Medicare rate,$79.20,44% of total billed charges which is 100% CMS Medicare rate,$79.20,44% of total billed charges which is 100% CMS Medicare rate,$79.20,44% of total billed charges which is 100% CMS Medicare rate,$79.20,44% of total billed charges which is 100% CMS Medicare rate,$79.20,44% of total billed charges which is 100% CMS Medicare rate,$79.20,44% of total billed charges which is 100% CMS Medicare rate,$79.20,44% of total billed charges which is 100% CMS Medicare rate,$79.20,44% of total billed charges which is 100% CMS Medicare rate,$79.20,44% of total billed charges which is 100% CMS Medicare rate,$79.20,$79.20,$153.00 
Outpatient Medical Services,RADIOLOGY,74019,"ABD, 2 VIEWS",320,$180.00 ,$79.20,44% of total billed charges which is 100% CMS Medicare rate,$79.20,44% of total billed charges which is 100% CMS Medicare rate,$79.20,44% of total billed charges which is 100% CMS Medicare rate,$79.20,44% of total billed charges which is 100% CMS Medicare rate,$79.20,44% of total billed charges which is 100% CMS Medicare rate,$79.20,44% of total billed charges which is 100% CMS Medicare rate,$79.20,44% of total billed charges which is 100% CMS Medicare rate,$79.20,44% of total billed charges which is 100% CMS Medicare rate,$79.20,44% of total billed charges which is 100% CMS Medicare rate,$79.20,44% of total billed charges which is 100% CMS Medicare rate,$79.20,44% of total billed charges which is 100% CMS Medicare rate,$79.20,$79.20,$153.00 
Outpatient Medical Services,RADIOLOGY,74019,"READ-ABD, 2 VIEWS",972,$180.00 ,$1.57,115% CMS Medicare RBRVS fee schedule,$1.57,115% CMS Medicare RBRVS fee schedule,$1.57,115% CMS Medicare RBRVS fee schedule,$1.57,115% CMS Medicare RBRVS fee schedule,$1.57,115% CMS Medicare RBRVS fee schedule,$1.57,115% CMS Medicare RBRVS fee schedule,$1.57,115% CMS Medicare RBRVS fee schedule,$1.57,115% CMS Medicare RBRVS fee schedule,$1.57,115% CMS Medicare RBRVS fee schedule,$1.57,115% CMS Medicare RBRVS fee schedule,$1.57,115% CMS Medicare RBRVS fee schedule,$1.57,$1.57,$153.00 
Outpatient Medical Services,RADIOLOGY,74022,Serial radiologic examination of the abdomen,320,$220.00 ,$96.80,44% of total billed charges which is 100% CMS Medicare rate,$96.80,44% of total billed charges which is 100% CMS Medicare rate,$96.80,44% of total billed charges which is 100% CMS Medicare rate,$96.80,44% of total billed charges which is 100% CMS Medicare rate,$96.80,44% of total billed charges which is 100% CMS Medicare rate,$96.80,44% of total billed charges which is 100% CMS Medicare rate,$96.80,44% of total billed charges which is 100% CMS Medicare rate,$96.80,44% of total billed charges which is 100% CMS Medicare rate,$96.80,44% of total billed charges which is 100% CMS Medicare rate,$96.80,44% of total billed charges which is 100% CMS Medicare rate,$96.80,44% of total billed charges which is 100% CMS Medicare rate,$96.80,$96.80,$187.00 
Outpatient Medical Services,RADIOLOGY,74022,Serial radiologic examination of the abdomen,972,$220.00 ,$2.22,115% CMS Medicare RBRVS fee schedule,$2.22,115% CMS Medicare RBRVS fee schedule,$2.22,115% CMS Medicare RBRVS fee schedule,$2.22,115% CMS Medicare RBRVS fee schedule,$2.22,115% CMS Medicare RBRVS fee schedule,$2.22,115% CMS Medicare RBRVS fee schedule,$2.22,115% CMS Medicare RBRVS fee schedule,$2.22,115% CMS Medicare RBRVS fee schedule,$2.22,115% CMS Medicare RBRVS fee schedule,$2.22,115% CMS Medicare RBRVS fee schedule,$2.22,115% CMS Medicare RBRVS fee schedule,$2.22,$2.22,$187.00 
Outpatient Medical Services,RADIOLOGY,74150,CT of abdomen without dye,352,$750.00 ,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,44% of total billed charges which is 100% CMS Medicare rate,$330.00,$330.00,$637.50 
Outpatient Medical Services,RADIOLOGY,74150,CT of abdomen without dye,972,$150.00 ,$5.85,115% CMS Medicare RBRVS fee schedule,$5.85,115% CMS Medicare RBRVS fee schedule,$5.85,115% CMS Medicare RBRVS fee schedule,$5.85,115% CMS Medicare RBRVS fee schedule,$5.85,115% CMS Medicare RBRVS fee schedule,$5.85,115% CMS Medicare RBRVS fee schedule,$5.85,115% CMS Medicare RBRVS fee schedule,$5.85,115% CMS Medicare RBRVS fee schedule,$5.85,115% CMS Medicare RBRVS fee schedule,$5.85,115% CMS Medicare RBRVS fee schedule,$5.85,115% CMS Medicare RBRVS fee schedule,$5.85,$5.85,$127.50 
Outpatient Medical Services,RADIOLOGY,74160,CT of abdomen with dye,352,$775.00 ,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,44% of total billed charges which is 100% CMS Medicare rate,$341.00,$341.00,$658.75 
Outpatient Medical Services,RADIOLOGY,74160,CT of abdomen with dye,972,$150.00 ,$9.13,115% CMS Medicare RBRVS fee schedule,$9.13,115% CMS Medicare RBRVS fee schedule,$9.13,115% CMS Medicare RBRVS fee schedule,$9.13,115% CMS Medicare RBRVS fee schedule,$9.13,115% CMS Medicare RBRVS fee schedule,$9.13,115% CMS Medicare RBRVS fee schedule,$9.13,115% CMS Medicare RBRVS fee schedule,$9.13,115% CMS Medicare RBRVS fee schedule,$9.13,115% CMS Medicare RBRVS fee schedule,$9.13,115% CMS Medicare RBRVS fee schedule,$9.13,115% CMS Medicare RBRVS fee schedule,$9.13,$9.13,$127.50 
Outpatient Medical Services,RADIOLOGY,74170,CT of abdomen with and without dye,352,"$1,150.00 ",$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,44% of total billed charges which is 100% CMS Medicare rate,$506.00,$506.00,$977.50 
Outpatient Medical Services,RADIOLOGY,74170,CT of abdomen with and without dye,972,$150.00 ,$9.95,115% CMS Medicare RBRVS fee schedule,$9.95,115% CMS Medicare RBRVS fee schedule,$9.95,115% CMS Medicare RBRVS fee schedule,$9.95,115% CMS Medicare RBRVS fee schedule,$9.95,115% CMS Medicare RBRVS fee schedule,$9.95,115% CMS Medicare RBRVS fee schedule,$9.95,115% CMS Medicare RBRVS fee schedule,$9.95,115% CMS Medicare RBRVS fee schedule,$9.95,115% CMS Medicare RBRVS fee schedule,$9.95,115% CMS Medicare RBRVS fee schedule,$9.95,115% CMS Medicare RBRVS fee schedule,$9.95,$9.95,$127.50 
Outpatient Medical Services,RADIOLOGY,74176,CT of abdomen and pelvis without dye,352,"$1,500.00 ",$660.00,44% of total billed charges which is 100% CMS Medicare rate,$660.00,44% of total billed charges which is 100% CMS Medicare rate,$660.00,44% of total billed charges which is 100% CMS Medicare rate,$660.00,44% of total billed charges which is 100% CMS Medicare rate,$660.00,44% of total billed charges which is 100% CMS Medicare rate,$660.00,44% of total billed charges which is 100% CMS Medicare rate,$660.00,44% of total billed charges which is 100% CMS Medicare rate,$660.00,44% of total billed charges which is 100% CMS Medicare rate,$660.00,44% of total billed charges which is 100% CMS Medicare rate,$660.00,44% of total billed charges which is 100% CMS Medicare rate,$660.00,44% of total billed charges which is 100% CMS Medicare rate,$660.00,$660.00,"$1,275.00 "
Outpatient Medical Services,RADIOLOGY,74176,CT of abdomen and pelvis without dye,972,$300.00 ,$8.30,115% CMS Medicare RBRVS fee schedule,$8.30,115% CMS Medicare RBRVS fee schedule,$8.30,115% CMS Medicare RBRVS fee schedule,$8.30,115% CMS Medicare RBRVS fee schedule,$8.30,115% CMS Medicare RBRVS fee schedule,$8.30,115% CMS Medicare RBRVS fee schedule,$8.30,115% CMS Medicare RBRVS fee schedule,$8.30,115% CMS Medicare RBRVS fee schedule,$8.30,115% CMS Medicare RBRVS fee schedule,$8.30,115% CMS Medicare RBRVS fee schedule,$8.30,115% CMS Medicare RBRVS fee schedule,$8.30,$8.30,$255.00 
Outpatient Medical Services,RADIOLOGY,74177,CT scan of abdomen and pelvis with contrast,352,"$1,550.00 ",$682.00,44% of total billed charges which is 100% CMS Medicare rate,$682.00,44% of total billed charges which is 100% CMS Medicare rate,$682.00,44% of total billed charges which is 100% CMS Medicare rate,$682.00,44% of total billed charges which is 100% CMS Medicare rate,$682.00,44% of total billed charges which is 100% CMS Medicare rate,$682.00,44% of total billed charges which is 100% CMS Medicare rate,$682.00,44% of total billed charges which is 100% CMS Medicare rate,$682.00,44% of total billed charges which is 100% CMS Medicare rate,$682.00,44% of total billed charges which is 100% CMS Medicare rate,$682.00,44% of total billed charges which is 100% CMS Medicare rate,$682.00,44% of total billed charges which is 100% CMS Medicare rate,$682.00,$682.00,"$1,317.50 "
Outpatient Medical Services,RADIOLOGY,74177,CT scan of abdomen and pelvis with contrast,972,$200.00 ,$11.70,115% CMS Medicare RBRVS fee schedule,$11.70,115% CMS Medicare RBRVS fee schedule,$11.70,115% CMS Medicare RBRVS fee schedule,$11.70,115% CMS Medicare RBRVS fee schedule,$11.70,115% CMS Medicare RBRVS fee schedule,$11.70,115% CMS Medicare RBRVS fee schedule,$11.70,115% CMS Medicare RBRVS fee schedule,$11.70,115% CMS Medicare RBRVS fee schedule,$11.70,115% CMS Medicare RBRVS fee schedule,$11.70,115% CMS Medicare RBRVS fee schedule,$11.70,115% CMS Medicare RBRVS fee schedule,$11.70,$11.70,$170.00 
Outpatient Medical Services,RADIOLOGY,74178,"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections ",352,"$2,300.00 ","$1,012.00",44% of total billed charges which is 100% CMS Medicare rate,"$1,012.00",44% of total billed charges which is 100% CMS Medicare rate,"$1,012.00",44% of total billed charges which is 100% CMS Medicare rate,"$1,012.00",44% of total billed charges which is 100% CMS Medicare rate,"$1,012.00",44% of total billed charges which is 100% CMS Medicare rate,"$1,012.00",44% of total billed charges which is 100% CMS Medicare rate,"$1,012.00",44% of total billed charges which is 100% CMS Medicare rate,"$1,012.00",44% of total billed charges which is 100% CMS Medicare rate,"$1,012.00",44% of total billed charges which is 100% CMS Medicare rate,"$1,012.00",44% of total billed charges which is 100% CMS Medicare rate,"$1,012.00",44% of total billed charges which is 100% CMS Medicare rate,"$1,012.00","$1,012.00","$1,955.00 "
Outpatient Medical Services,RADIOLOGY,74178,"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections ",972,$200.00 ,$13.30,115% CMS Medicare RBRVS fee schedule,$13.30,115% CMS Medicare RBRVS fee schedule,$13.30,115% CMS Medicare RBRVS fee schedule,$13.30,115% CMS Medicare RBRVS fee schedule,$13.30,115% CMS Medicare RBRVS fee schedule,$13.30,115% CMS Medicare RBRVS fee schedule,$13.30,115% CMS Medicare RBRVS fee schedule,$13.30,115% CMS Medicare RBRVS fee schedule,$13.30,115% CMS Medicare RBRVS fee schedule,$13.30,115% CMS Medicare RBRVS fee schedule,$13.30,115% CMS Medicare RBRVS fee schedule,$13.30,$13.30,$170.00 
Outpatient Medical Services,RADIOLOGY,74210,READ-PHARNYX/CERV ESOP,972,$105.00 ,$3.74,115% CMS Medicare RBRVS fee schedule,$3.74,115% CMS Medicare RBRVS fee schedule,$3.74,115% CMS Medicare RBRVS fee schedule,$3.74,115% CMS Medicare RBRVS fee schedule,$3.74,115% CMS Medicare RBRVS fee schedule,$3.74,115% CMS Medicare RBRVS fee schedule,$3.74,115% CMS Medicare RBRVS fee schedule,$3.74,115% CMS Medicare RBRVS fee schedule,$3.74,115% CMS Medicare RBRVS fee schedule,$3.74,115% CMS Medicare RBRVS fee schedule,$3.74,115% CMS Medicare RBRVS fee schedule,$3.74,$3.74,$89.25 
Outpatient Medical Services,RADIOLOGY,74270,BARIUM ENEMA,320,$275.00 ,$121.00,44% of total billed charges which is 100% CMS Medicare rate,$121.00,44% of total billed charges which is 100% CMS Medicare rate,$121.00,44% of total billed charges which is 100% CMS Medicare rate,$121.00,44% of total billed charges which is 100% CMS Medicare rate,$121.00,44% of total billed charges which is 100% CMS Medicare rate,$121.00,44% of total billed charges which is 100% CMS Medicare rate,$121.00,44% of total billed charges which is 100% CMS Medicare rate,$121.00,44% of total billed charges which is 100% CMS Medicare rate,$121.00,44% of total billed charges which is 100% CMS Medicare rate,$121.00,44% of total billed charges which is 100% CMS Medicare rate,$121.00,44% of total billed charges which is 100% CMS Medicare rate,$121.00,$121.00,$233.75 
Outpatient Medical Services,RADIOLOGY,74270,READ-BARIUM ENEMA,972,$275.00 ,$5.93,115% CMS Medicare RBRVS fee schedule,$5.93,115% CMS Medicare RBRVS fee schedule,$5.93,115% CMS Medicare RBRVS fee schedule,$5.93,115% CMS Medicare RBRVS fee schedule,$5.93,115% CMS Medicare RBRVS fee schedule,$5.93,115% CMS Medicare RBRVS fee schedule,$5.93,115% CMS Medicare RBRVS fee schedule,$5.93,115% CMS Medicare RBRVS fee schedule,$5.93,115% CMS Medicare RBRVS fee schedule,$5.93,115% CMS Medicare RBRVS fee schedule,$5.93,115% CMS Medicare RBRVS fee schedule,$5.93,$5.93,$233.75 
Outpatient Medical Services,RADIOLOGY,74290,READ-GALLBLADDER,972,$170.00 ,$3.18,115% CMS Medicare RBRVS fee schedule,$3.18,115% CMS Medicare RBRVS fee schedule,$3.18,115% CMS Medicare RBRVS fee schedule,$3.18,115% CMS Medicare RBRVS fee schedule,$3.18,115% CMS Medicare RBRVS fee schedule,$3.18,115% CMS Medicare RBRVS fee schedule,$3.18,115% CMS Medicare RBRVS fee schedule,$3.18,115% CMS Medicare RBRVS fee schedule,$3.18,115% CMS Medicare RBRVS fee schedule,$3.18,115% CMS Medicare RBRVS fee schedule,$3.18,115% CMS Medicare RBRVS fee schedule,$3.18,$3.18,$144.50 
Outpatient Medical Services,RADIOLOGY,74400,IVP,320,$350.00 ,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,$154.00,$297.50 
Outpatient Medical Services,RADIOLOGY,74400,READ-IVP,972,$350.00 ,$5.11,115% CMS Medicare RBRVS fee schedule,$5.11,115% CMS Medicare RBRVS fee schedule,$5.11,115% CMS Medicare RBRVS fee schedule,$5.11,115% CMS Medicare RBRVS fee schedule,$5.11,115% CMS Medicare RBRVS fee schedule,$5.11,115% CMS Medicare RBRVS fee schedule,$5.11,115% CMS Medicare RBRVS fee schedule,$5.11,115% CMS Medicare RBRVS fee schedule,$5.11,115% CMS Medicare RBRVS fee schedule,$5.11,115% CMS Medicare RBRVS fee schedule,$5.11,115% CMS Medicare RBRVS fee schedule,$5.11,$5.11,$297.50 
Outpatient Medical Services,RADIOLOGY,76010,NOSE-RECTUM/CHILD FORIE B,320,$100.00 ,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,$44.00,$85.00 
Outpatient Medical Services,RADIOLOGY,76010,READ-NOSE-RECT CHILD F B,972,$90.00 ,$1.37,115% CMS Medicare RBRVS fee schedule,$1.37,115% CMS Medicare RBRVS fee schedule,$1.37,115% CMS Medicare RBRVS fee schedule,$1.37,115% CMS Medicare RBRVS fee schedule,$1.37,115% CMS Medicare RBRVS fee schedule,$1.37,115% CMS Medicare RBRVS fee schedule,$1.37,115% CMS Medicare RBRVS fee schedule,$1.37,115% CMS Medicare RBRVS fee schedule,$1.37,115% CMS Medicare RBRVS fee schedule,$1.37,115% CMS Medicare RBRVS fee schedule,$1.37,115% CMS Medicare RBRVS fee schedule,$1.37,$1.37,$76.50 
Outpatient Medical Services,RADIOLOGY,76377,CT RECONSTRUCTION,351,$350.00 ,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,44% of total billed charges which is 100% CMS Medicare rate,$154.00,$154.00,$297.50 
Outpatient Medical Services,RADIOLOGY,76377,READ-CT RECONSTRUCTION,972,$150.00 ,$4.12,115% CMS Medicare RBRVS fee schedule,$4.12,115% CMS Medicare RBRVS fee schedule,$4.12,115% CMS Medicare RBRVS fee schedule,$4.12,115% CMS Medicare RBRVS fee schedule,$4.12,115% CMS Medicare RBRVS fee schedule,$4.12,115% CMS Medicare RBRVS fee schedule,$4.12,115% CMS Medicare RBRVS fee schedule,$4.12,115% CMS Medicare RBRVS fee schedule,$4.12,115% CMS Medicare RBRVS fee schedule,$4.12,115% CMS Medicare RBRVS fee schedule,$4.12,115% CMS Medicare RBRVS fee schedule,$4.12,$4.12,$127.50 
Outpatient Medical Services,RADIOLOGY,77065,"Diagnostic mammography, including computer-aided detection (cad) when performed; unilateral",401,$200.00 ,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,$88.00,$170.00 
Outpatient Medical Services,RADIOLOGY,77065,"Diagnostic mammography, including computer-aided detection (cad) when performed; unilateral",401,$200.00 ,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,$88.00,$170.00 
Outpatient Medical Services,RADIOLOGY,77065,"Diagnostic mammography, including computer-aided detection (cad) when performed; unilateral",972,$100.00 ,$4.87,115% CMS Medicare RBRVS fee schedule,$4.87,115% CMS Medicare RBRVS fee schedule,$4.87,115% CMS Medicare RBRVS fee schedule,$4.87,115% CMS Medicare RBRVS fee schedule,$4.87,115% CMS Medicare RBRVS fee schedule,$4.87,115% CMS Medicare RBRVS fee schedule,$4.87,115% CMS Medicare RBRVS fee schedule,$4.87,115% CMS Medicare RBRVS fee schedule,$4.87,115% CMS Medicare RBRVS fee schedule,$4.87,115% CMS Medicare RBRVS fee schedule,$4.87,115% CMS Medicare RBRVS fee schedule,$4.87,$4.87,$85.00 
Outpatient Medical Services,RADIOLOGY,77066,"Diagnostic mammography, including computer-aided detection (cad) when performed; bilateral",401,$225.00 ,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,$99.00,$191.25 
Outpatient Medical Services,RADIOLOGY,77066,"Diagnostic mammography, including computer-aided detection (cad) when performed; bilateral",401,$225.00 ,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,$99.00,$191.25 
Outpatient Medical Services,RADIOLOGY,77066,"Diagnostic mammography, including computer-aided detection (cad) when performed; bilateral",972,$125.00 ,$6.35,115% CMS Medicare RBRVS fee schedule,$6.35,115% CMS Medicare RBRVS fee schedule,$6.35,115% CMS Medicare RBRVS fee schedule,$6.35,115% CMS Medicare RBRVS fee schedule,$6.35,115% CMS Medicare RBRVS fee schedule,$6.35,115% CMS Medicare RBRVS fee schedule,$6.35,115% CMS Medicare RBRVS fee schedule,$6.35,115% CMS Medicare RBRVS fee schedule,$6.35,115% CMS Medicare RBRVS fee schedule,$6.35,115% CMS Medicare RBRVS fee schedule,$6.35,115% CMS Medicare RBRVS fee schedule,$6.35,$6.35,$106.25 
Outpatient Medical Services,RADIOLOGY,77067,Mammography of both breasts-2 or more views,403,$225.00 ,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,$99.00,$191.25 
Outpatient Medical Services,RADIOLOGY,77067,Mammography of both breasts-2 or more views,403,$225.00 ,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,$99.00,$191.25 
Outpatient Medical Services,RADIOLOGY,77067,Mammography of both breasts-2 or more views,403,$225.00 ,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,44% of total billed charges which is 100% CMS Medicare rate,$99.00,$99.00,$191.25 
Outpatient Medical Services,RADIOLOGY,77067,Mammography of both breasts-2 or more views,972,$125.00 ,$4.94,115% CMS Medicare RBRVS fee schedule,$4.94,115% CMS Medicare RBRVS fee schedule,$4.94,115% CMS Medicare RBRVS fee schedule,$4.94,115% CMS Medicare RBRVS fee schedule,$4.94,115% CMS Medicare RBRVS fee schedule,$4.94,115% CMS Medicare RBRVS fee schedule,$4.94,115% CMS Medicare RBRVS fee schedule,$4.94,115% CMS Medicare RBRVS fee schedule,$4.94,115% CMS Medicare RBRVS fee schedule,$4.94,115% CMS Medicare RBRVS fee schedule,$4.94,115% CMS Medicare RBRVS fee schedule,$4.94,$4.94,$106.25 
Outpatient Medical Services,RADIOLOGY,77067,Mammography of both breasts-2 or more views,972,$125.00 ,$4.94,115% CMS Medicare RBRVS fee schedule,$4.94,115% CMS Medicare RBRVS fee schedule,$4.94,115% CMS Medicare RBRVS fee schedule,$4.94,115% CMS Medicare RBRVS fee schedule,$4.94,115% CMS Medicare RBRVS fee schedule,$4.94,115% CMS Medicare RBRVS fee schedule,$4.94,115% CMS Medicare RBRVS fee schedule,$4.94,115% CMS Medicare RBRVS fee schedule,$4.94,115% CMS Medicare RBRVS fee schedule,$4.94,115% CMS Medicare RBRVS fee schedule,$4.94,115% CMS Medicare RBRVS fee schedule,$4.94,$4.94,$106.25 
Outpatient Medical Services,RADIOLOGY,77072,BONE AGE STUDIES,320,$85.00 ,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,44% of total billed charges which is 100% CMS Medicare rate,$37.40,$37.40,$72.25 
Outpatient Medical Services,RADIOLOGY,77072,READ-BONE AGE STUDIES,972,$85.00 ,$1.28,115% CMS Medicare RBRVS fee schedule,$1.28,115% CMS Medicare RBRVS fee schedule,$1.28,115% CMS Medicare RBRVS fee schedule,$1.28,115% CMS Medicare RBRVS fee schedule,$1.28,115% CMS Medicare RBRVS fee schedule,$1.28,115% CMS Medicare RBRVS fee schedule,$1.28,115% CMS Medicare RBRVS fee schedule,$1.28,115% CMS Medicare RBRVS fee schedule,$1.28,115% CMS Medicare RBRVS fee schedule,$1.28,115% CMS Medicare RBRVS fee schedule,$1.28,115% CMS Medicare RBRVS fee schedule,$1.28,$1.28,$72.25 
Outpatient Medical Services,RADIOLOGY,77073,BONE LENGTH STUDIES,320,$200.00 ,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,44% of total billed charges which is 100% CMS Medicare rate,$88.00,$88.00,$170.00 
Outpatient Medical Services,RADIOLOGY,77073,READ-BONE LENGTH STUDIES,972,$100.00 ,$2.09,115% CMS Medicare RBRVS fee schedule,$2.09,115% CMS Medicare RBRVS fee schedule,$2.09,115% CMS Medicare RBRVS fee schedule,$2.09,115% CMS Medicare RBRVS fee schedule,$2.09,115% CMS Medicare RBRVS fee schedule,$2.09,115% CMS Medicare RBRVS fee schedule,$2.09,115% CMS Medicare RBRVS fee schedule,$2.09,115% CMS Medicare RBRVS fee schedule,$2.09,115% CMS Medicare RBRVS fee schedule,$2.09,115% CMS Medicare RBRVS fee schedule,$2.09,115% CMS Medicare RBRVS fee schedule,$2.09,$2.09,$85.00 
Outpatient Medical Services,RADIOLOGY,77074,BONE SURVEY LIMITED,320,$295.00 ,$129.80,44% of total billed charges which is 100% CMS Medicare rate,$129.80,44% of total billed charges which is 100% CMS Medicare rate,$129.80,44% of total billed charges which is 100% CMS Medicare rate,$129.80,44% of total billed charges which is 100% CMS Medicare rate,$129.80,44% of total billed charges which is 100% CMS Medicare rate,$129.80,44% of total billed charges which is 100% CMS Medicare rate,$129.80,44% of total billed charges which is 100% CMS Medicare rate,$129.80,44% of total billed charges which is 100% CMS Medicare rate,$129.80,44% of total billed charges which is 100% CMS Medicare rate,$129.80,44% of total billed charges which is 100% CMS Medicare rate,$129.80,44% of total billed charges which is 100% CMS Medicare rate,$129.80,$129.80,$250.75 
Outpatient Medical Services,RADIOLOGY,77074,READ-BONE SURVEY LIMITED,972,$125.00 ,$2.65,115% CMS Medicare RBRVS fee schedule,$2.65,115% CMS Medicare RBRVS fee schedule,$2.65,115% CMS Medicare RBRVS fee schedule,$2.65,115% CMS Medicare RBRVS fee schedule,$2.65,115% CMS Medicare RBRVS fee schedule,$2.65,115% CMS Medicare RBRVS fee schedule,$2.65,115% CMS Medicare RBRVS fee schedule,$2.65,115% CMS Medicare RBRVS fee schedule,$2.65,115% CMS Medicare RBRVS fee schedule,$2.65,115% CMS Medicare RBRVS fee schedule,$2.65,115% CMS Medicare RBRVS fee schedule,$2.65,$2.65,$106.25 
Outpatient Medical Services,RADIOLOGY,77075,BONE SURVEY COMPLETE,320,$415.00 ,$182.60,44% of total billed charges which is 100% CMS Medicare rate,$182.60,44% of total billed charges which is 100% CMS Medicare rate,$182.60,44% of total billed charges which is 100% CMS Medicare rate,$182.60,44% of total billed charges which is 100% CMS Medicare rate,$182.60,44% of total billed charges which is 100% CMS Medicare rate,$182.60,44% of total billed charges which is 100% CMS Medicare rate,$182.60,44% of total billed charges which is 100% CMS Medicare rate,$182.60,44% of total billed charges which is 100% CMS Medicare rate,$182.60,44% of total billed charges which is 100% CMS Medicare rate,$182.60,44% of total billed charges which is 100% CMS Medicare rate,$182.60,44% of total billed charges which is 100% CMS Medicare rate,$182.60,$182.60,$352.75 
Outpatient Medical Services,RADIOLOGY,77075,READ-BONE SURVEY COMPLETE,972,$250.00 ,$4.15,115% CMS Medicare RBRVS fee schedule,$4.15,115% CMS Medicare RBRVS fee schedule,$4.15,115% CMS Medicare RBRVS fee schedule,$4.15,115% CMS Medicare RBRVS fee schedule,$4.15,115% CMS Medicare RBRVS fee schedule,$4.15,115% CMS Medicare RBRVS fee schedule,$4.15,115% CMS Medicare RBRVS fee schedule,$4.15,115% CMS Medicare RBRVS fee schedule,$4.15,115% CMS Medicare RBRVS fee schedule,$4.15,115% CMS Medicare RBRVS fee schedule,$4.15,115% CMS Medicare RBRVS fee schedule,$4.15,$4.15,$212.50 
Outpatient Medical Services,RADIOLOGY,77080,Scan to measure bone mineral density (BMD) at the spine and hip,320,$206.00 ,$90.64,44% of total billed charges which is 100% CMS Medicare rate,$90.64,44% of total billed charges which is 100% CMS Medicare rate,$90.64,44% of total billed charges which is 100% CMS Medicare rate,$90.64,44% of total billed charges which is 100% CMS Medicare rate,$90.64,44% of total billed charges which is 100% CMS Medicare rate,$90.64,44% of total billed charges which is 100% CMS Medicare rate,$90.64,44% of total billed charges which is 100% CMS Medicare rate,$90.64,44% of total billed charges which is 100% CMS Medicare rate,$90.64,44% of total billed charges which is 100% CMS Medicare rate,$90.64,44% of total billed charges which is 100% CMS Medicare rate,$90.64,44% of total billed charges which is 100% CMS Medicare rate,$90.64,$90.64,$175.10 
Outpatient Medical Services,RADIOLOGY,77080,Scan to measure bone mineral density (BMD) at the spine and hip,972,$206.00 ,$1.63,115% CMS Medicare RBRVS fee schedule,$1.63,115% CMS Medicare RBRVS fee schedule,$1.63,115% CMS Medicare RBRVS fee schedule,$1.63,115% CMS Medicare RBRVS fee schedule,$1.63,115% CMS Medicare RBRVS fee schedule,$1.63,115% CMS Medicare RBRVS fee schedule,$1.63,115% CMS Medicare RBRVS fee schedule,$1.63,115% CMS Medicare RBRVS fee schedule,$1.63,115% CMS Medicare RBRVS fee schedule,$1.63,115% CMS Medicare RBRVS fee schedule,$1.63,115% CMS Medicare RBRVS fee schedule,$1.63,$1.63,$175.10 
Outpatient Medical Services,RADIOLOGY,78582,VQ SCAN VENT & PERFUSION IMAGING,341,"$1,525.00 ",$671.00,44% of total billed charges which is 100% CMS Medicare rate,$671.00,44% of total billed charges which is 100% CMS Medicare rate,$671.00,44% of total billed charges which is 100% CMS Medicare rate,$671.00,44% of total billed charges which is 100% CMS Medicare rate,$671.00,44% of total billed charges which is 100% CMS Medicare rate,$671.00,44% of total billed charges which is 100% CMS Medicare rate,$671.00,44% of total billed charges which is 100% CMS Medicare rate,$671.00,44% of total billed charges which is 100% CMS Medicare rate,$671.00,44% of total billed charges which is 100% CMS Medicare rate,$671.00,44% of total billed charges which is 100% CMS Medicare rate,$671.00,44% of total billed charges which is 100% CMS Medicare rate,$671.00,$671.00,"$1,296.25 "
Outpatient Medical Services,Respiratory,94640,AEROSOL TX/DEMO/EVAL PT U,410,$125.00 ,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,$55.00,$106.25 
Outpatient Medical Services,Respiratory,94640,AEROSOL TX/DEMO/EVAL PT U,410,$125.00 ,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,44% of total billed charges which is 100% CMS Medicare rate,$55.00,$55.00,$106.25 
Outpatient Medical Services,Respiratory,36600,ARTERIAL PUNCTURE WITHDRAW BLOOD,410,$105.00 ,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,44% of total billed charges which is 100% CMS Medicare rate,$46.20,$46.20,$89.25 
Outpatient Medical Services,Respiratory,94645,"CONT INHALATION AEROSOL TREAT, ADDT HOUR",410,$115.00 ,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,$50.60,$97.75 
Outpatient Medical Services,Respiratory,94762,CONTINOUS PULSE OX OVERNI,460,$100.00 ,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,44% of total billed charges which is 100% CMS Medicare rate,$44.00,$44.00,$85.00 
Outpatient Medical Services,Respiratory,94660,CPAP INITIATION/MNGMENT,410,$300.00 ,$132.00,44% of total billed charges which is 100% CMS Medicare rate,$132.00,44% of total billed charges which is 100% CMS Medicare rate,$132.00,44% of total billed charges which is 100% CMS Medicare rate,$132.00,44% of total billed charges which is 100% CMS Medicare rate,$132.00,44% of total billed charges which is 100% CMS Medicare rate,$132.00,44% of total billed charges which is 100% CMS Medicare rate,$132.00,44% of total billed charges which is 100% CMS Medicare rate,$132.00,44% of total billed charges which is 100% CMS Medicare rate,$132.00,44% of total billed charges which is 100% CMS Medicare rate,$132.00,44% of total billed charges which is 100% CMS Medicare rate,$132.00,44% of total billed charges which is 100% CMS Medicare rate,$132.00,$132.00,$255.00 
Outpatient Medical Services,Respiratory,94644,"INHALATION TREATMENT, ACUTE AIRWAY OBSTR",410,$115.00 ,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,44% of total billed charges which is 100% CMS Medicare rate,$50.60,$50.60,$97.75 
Outpatient Medical Services,Respiratory,94002,INITIAL VENTIL ASSIST,410,$300.00 ,$132.00,44% of total billed charges which is 100% CMS Medicare rate,$132.00,44% of total billed charges which is 100% CMS Medicare rate,$132.00,44% of total billed charges which is 100% CMS Medicare rate,$132.00,44% of total billed charges which is 100% CMS Medicare rate,$132.00,44% of total billed charges which is 100% CMS Medicare rate,$132.00,44% of total billed charges which is 100% CMS Medicare rate,$132.00,44% of total billed charges which is 100% CMS Medicare rate,$132.00,44% of total billed charges which is 100% CMS Medicare rate,$132.00,44% of total billed charges which is 100% CMS Medicare rate,$132.00,44% of total billed charges which is 100% CMS Medicare rate,$132.00,44% of total billed charges which is 100% CMS Medicare rate,$132.00,$132.00,$255.00 
Outpatient Medical Services,Respiratory,31500,INTUBATION,410,$325.00 ,$143.00,44% of total billed charges which is 100% CMS Medicare rate,$143.00,44% of total billed charges which is 100% CMS Medicare rate,$143.00,44% of total billed charges which is 100% CMS Medicare rate,$143.00,44% of total billed charges which is 100% CMS Medicare rate,$143.00,44% of total billed charges which is 100% CMS Medicare rate,$143.00,44% of total billed charges which is 100% CMS Medicare rate,$143.00,44% of total billed charges which is 100% CMS Medicare rate,$143.00,44% of total billed charges which is 100% CMS Medicare rate,$143.00,44% of total billed charges which is 100% CMS Medicare rate,$143.00,44% of total billed charges which is 100% CMS Medicare rate,$143.00,44% of total billed charges which is 100% CMS Medicare rate,$143.00,$143.00,$276.25 
Outpatient Medical Services,Respiratory,94375,Graphical representation of inspiration and expiration,460,$265.00 ,$116.60,44% of total billed charges which is 100% CMS Medicare rate,$116.60,44% of total billed charges which is 100% CMS Medicare rate,$116.60,44% of total billed charges which is 100% CMS Medicare rate,$116.60,44% of total billed charges which is 100% CMS Medicare rate,$116.60,44% of total billed charges which is 100% CMS Medicare rate,$116.60,44% of total billed charges which is 100% CMS Medicare rate,$116.60,44% of total billed charges which is 100% CMS Medicare rate,$116.60,44% of total billed charges which is 100% CMS Medicare rate,$116.60,44% of total billed charges which is 100% CMS Medicare rate,$116.60,44% of total billed charges which is 100% CMS Medicare rate,$116.60,44% of total billed charges which is 100% CMS Medicare rate,$116.60,$116.60,$225.25 
Outpatient Medical Services,Respiratory,94664,PATIENT DEMO/EVALUATION (AEROSOL OR MDI),410,$305.00 ,$134.20,44% of total billed charges which is 100% CMS Medicare rate,$134.20,44% of total billed charges which is 100% CMS Medicare rate,$134.20,44% of total billed charges which is 100% CMS Medicare rate,$134.20,44% of total billed charges which is 100% CMS Medicare rate,$134.20,44% of total billed charges which is 100% CMS Medicare rate,$134.20,44% of total billed charges which is 100% CMS Medicare rate,$134.20,44% of total billed charges which is 100% CMS Medicare rate,$134.20,44% of total billed charges which is 100% CMS Medicare rate,$134.20,44% of total billed charges which is 100% CMS Medicare rate,$134.20,44% of total billed charges which is 100% CMS Medicare rate,$134.20,44% of total billed charges which is 100% CMS Medicare rate,$134.20,$134.20,$259.25 
Outpatient Medical Services,Respiratory,94010,Test to determine how well oxygen moves from the lungs to the blood stream,460,$65.00 ,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,44% of total billed charges which is 100% CMS Medicare rate,$28.60,$28.60,$55.25 
Outpatient Medical Services,BEHAVIORAL,90832,"Psychotherapy, 30 minute",900,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,BEHAVIORAL,90834,"Psychotherapy, 45 minutes",900,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,BEHAVIORAL,90837,"Psychotherapy, 60 minutes",900,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,BEHAVIORAL,90846,"Family psychotherapy, not including patient, 50 minutes",900,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,BEHAVIORAL,90847,"Family psychotherapy, including patient, 50 min",900,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,BEHAVIORAL,90853,Group psychotherapy,900,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OFFICE VISIT,99203,"New patient office or other outpatient visit, typically 30 min",761,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OFFICE VISIT,99204,"New patient office of other outpatient visit, typically 45 min",761,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OFFICE VISIT,99205,"New patient office of other outpatient visit, typically 60 min",761,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OFFICE VISIT,99243,"Patient office consultation, typically 40 min",761,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OFFICE VISIT,99244,"Patient office consultation, typically 60 min",761,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OFFICE VISIT,99385,"Initial new patient preventive medicine evaluation, for those ages 18 to 39",761,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OFFICE VISIT,99386,"Initial new patient preventive medicine evaluation, for those ages 40 to 64",761,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,LAB,81000,Manual urinalysis test with examination using microscope,300,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,LAB,81002,Automated urinalysis test,300,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,RADIOLOGY,70553,MRI scan of brain before and after contrast,610,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,RADIOLOGY,72148,MRI scan of lower spinal canal ,610,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,RADIOLOGY,73721,MRI scan of leg joint,610,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,RADIOLOGY,76805,"Abdominal ultrasound of pregnant uterus, greater or equal to 14 weeks 0 days, single or first fetus",402,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,RADIOLOGY,19120,"Removal of 1 or more breast growth, open procedure",360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,29826,Shaving of shoulder bone using an endoscope,360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,29881,Removal of one knee cartilage using an endoscope,360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,42820,Removal of tonsils and adenoid glands patient younger than age 12,360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,43235,"Diagnostic examination of esophagus, stomach, and/or upper small bowel using an endoscop",360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,43239,"Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope",360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,45378,Diagnostic examination of large bowel using an endoscope,360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,45380,Biopsy of large bowel using an endoscope,360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,45385,Removal of polyps or growths of large bowel using an endoscope,360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,45391,Ultrasound examination of lower large bowel using an endoscope,360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,47562,Removal of gallbladder using an endoscope,360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,49505,Repair of groin hernia patient age 5 or older,360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,55700,Biopsy of prostate gland,360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,55866,Surgical removal of prostate and surrounding lymph nodes using an endoscope,360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,59400,"Routine obstetric care for vaginal delivery, including pre-and post-delivery care",720,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,59510,"Routine obstetric care for cesarean delivery, including pre-and post-delivery care",720,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,59610,Routine obstetric care for vaginal delivery after prior cesarean delivery including pre-and post-delivery care,720,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,62323,Injection of substance into spinal canal of lower back or sacrum using imaging guidanc,360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,62322,Injection of substance into spinal canal of lower back or sacrum using imaging guidanc,360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,64483,Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance,360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,66821,Removal of recurring cataract in lens capsule using laser,360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,66984,Removal of cataract with insertion of lens,360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,ECCG,93000,"Electrocardiogram, routine, with interpretation and report",730,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,CARDIOLOGY,93452,Insertion of catheter into left heart for diagnosis,480,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,SLEEP STUDY,95810,Sleep study,920,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,PHYSICAL THERAPY,97110,"Physical therapy, therapeutic exercise",420,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Inpatient Medical Services,INPATIENT PROCEDURES,216,Cardiac valve and other major cardiothoracic procedures with cardiac catheterization with major complications or comorbidities,100,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Inpatient Medical Services,INPATIENT PROCEDURES,460,Spinal fusion except cervical without major comorbid conditions or complications,100,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Inpatient Medical Services,INPATIENT PROCEDURES,470,Major joint replacement or reattachment of lower extremity without major comorbid conditions or complications,100,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Inpatient Medical Services,INPATIENT PROCEDURES,473,Cervical spinal fusion without comorbid conditions or major comorbid conditions or complications,100,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Inpatient Medical Services,INPATIENT PROCEDURES,743,Uterine and adnexa procedures for non-malignancy without comorbid conditions or major comorbid conditions or complications,100,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A