Service Description CPT Code Charge Type Surgical Practice Price
INITIAL PRENATAL PP 59899 Prof $463.98
INITIAL SET-UP/PROGRAMMING,WEARABLE ICD PROF PPG 93745 Prof $95.76
INITIAL SET-UP/PROGRAMMING,WEARABLE ICD TECH PP 93745 Tech $41.04
INITIAL VISIT PER DAY,NORMAL NEWBORN INFANT PP 99460 Prof $286.14
INITIAL VISIT PER DAY,NORMAL NEWBORN,SAME DAY ADMIT/DISCHARGE PP 99463 Prof $330.60
INJ METHYLPRED, 20MG MAU PP J1020 Prof $19.38
INJ METHYLPREDNISOLONE, 40MG MAU PP J1030 Prof $19.38
INJ METHYLPREDNISOLONE, 80MG MAU PP J1040 Prof $34.20
INJ TX,PROP,DX EA IVP NEW SUBS 96375 Tech $137.44
INJ TX,PROP,DX EA IVP NEW SUBS PP 96375 Tech $147.06
INJ, CERTRIAXONE SODIUM 250MG MAU PP J0696 Prof $11.40
INJ, HYDROMORPHONE, 4 MG MAU PP J1170 Prof $11.40
INJ,ADRENAL EPINEPHRINE,0.1MG MAU PP J0171 Prof $1.14
INJ,DEXAMETHASONE,1MG MAU PP J1100 Prof $3.42
INJ,DIPHENHYDRAMINE 50MG IV MAU PP J1200 Prof $18.24
INJ,DX/TX,PARAV JT,IMG,2ND,LUMB/SAC BIL PP 64494 Prof $256.50
INJ,DX/TX,PARAV JT,IMG,=>3RD,LUMB/SAC BIL PP 64495 Prof $259.92
INJ,DX/TX,PARAV JT,IMG,SING,LUMB/SAC BIL PP 64493 Prof $451.44
INJ,INSULIN MAU PP J1815 Prof $11.40
INJ,MORPHINE 10MG MAU PP J2270 Prof $11.40
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