Specialty Practices (non-surgical)

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Service Description	CPT Code	Charge Type	Speciality Practice Price
TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN TDN RPR PP	24359	Prof	$1523.15
TOMOGRAPHY,INTRAVASCULAR,OPTICAL COHERENCE,INITIAL PP	92978	Prof	$203.03
TOMOSYNTHESIS,DIGITAL,BIL PP	77062	Prof	$69.55
TOMOSYNTHESIS,DIGITAL,BIL,SCREENING PP	77063	Prof	$69.55
TOMOSYNTHESIS,DIGITAL,UNIL PP	77061	Prof	$69.55
TONSILLECTOMY & ADENOIDECTOMY AGE 12/>	42821	Prof	$696.57
TONSILLECTOMY,PRIMARY/SECONDARY,=> 12YO PP	42826	Prof	$574.59
tooth reimplantation and/or stabilization of accidentally evulsed or displaced tooth PP	D7270	Prof	$636.49
topical application of fluoride - excluding varnish PP	D1208	Prof	$39.11
topical application of fluoride varnish PP	D1206	Prof	$42.00
TOT ABD HYSTERECT & RAD DISSECT,DEBULK,W/PELVIC LYMPHADENECT PP	58954	Prof	$5254.77
TOT DISC ARTHRP ANT APPR DISC 2ND LEVEL CERVICAL PP	22858	Prof	$1198.94
TOT DISC ARTHRP ART DISC ANT APPRO 1 NTRSPC CRV PP	22856	Prof	$4070.28
TOT DISC ARTHRP ART DISC ANT APPRO 1 NTRSPC LMBR PP	22857	Prof	$4513.26
TOTAL ABDOMINAL HYSTERECTOMY PP	58150	Prof	$2473.84
TOTAL HYSTERECTOMY/CERVICECTOMY PP	58240	Prof	$6984.96
TOTAL THYROID LOBECTOMY,UNILATERAL PP	60220	Prof	$1726.98
TOTAL THYROID LOBECTOMY,W CONTRALATERAL LOBECTOMY,UNILATERAL PP	60225	Prof	$2140.00
TOXOID ADMIN,1 VACCINE	90471	Tech	$26.75
TOXOID ADMIN,1 VACCINE MAU PP	90471	Prof	$26.75