hospital_name,last_updated_on,version,hospital_location,hospital_address,license_number|MI,"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.",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
Eaton Rapids Medical Center,12/13/2024,2.0.0,Eaton Rapids Medical Center,"1500 S Main St Eaton Rapids, MI 48827",381559180,TRUE,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
SERVICE DESCRIPTION,CATEGORY,BILLING MSDRG | CPT | HCPCS,ITEM/SERVICE DESCRIPTION,BILLING REVENUE CODE,GROSS CHARGES,AETNA PLAN,AETNA REIMBURSEMENT METHOD,ASR PLAN,ASR REIMBURSEMENT METHOD, BCBS BCN PLAN,BCBS BCN REIMBURSEMENT METHOD,BCBS BPP PLAN,BCBS BPP REIMBURSEMENT METHOD,BCBS COMPLETE PLAN,BCBS COMPLETE REIMBURSEMENT METHOD,BCBS PPO PLAN,BCBS PPO REIMBURSEMENT METHOD,CIGNA PLAN,CIGNA REIMBURSEMENT METHOD,FIRST HEALTH PLAN,FIRST HEALTH REIMBURSED METHOD,HUMANA PLAN,HUMANA REIMBURSED METHOD,MCLAREN HMO PLAN,MCLAREN HMO REIMBURSED METHOD,MCLAREN MEDICAID PLAN,MCLAREN MEDICAID REIMBURSED METHOD,MCLAREN PPO PLAN,MCLAREN PPO REIMBURSED METHOD,MEDICARE PLAN,MEDICARE REIMBURSED METHOD,PHYSICIAN HEALTH NETWORK PLAN,PHYSICIAN HEALTH NETWORK REIMBURSED METHOD,PREFERRED PROVIDER ORGANIZATION OF MICHIGAN PLAN,PREFERRED PROVIDER ORGANIZATION OF MICHIGAN REIMBURSED METHOD,PRIORITY HEALTH HMO PLAN,PRIORITY HEALTH HMO REIMBURSED METHOD,PRIORITY HEALTH MEDICAID PLAN,PRIORITY HEALTH MEDICAID REIMBURSED METHOD,PRIORITY HEALTH MI CHILD PLAN,PRIORITY HEALTH MI CHILD REIMBURSED METHOD,PRIORITY HEALTH PPO PLAN,PRIORITY HEALTH PPO REIMBURSED METHOD,UHC PLAN,UHC REIMBURSEMENT METHOD,UHC MEDICAID PLAN,UHC MEDICAID REIMBURSEMENT METHOD,UHC MEDICAID CHIP PLAN,UHC MEDICAID CHIP REIMBURSEMENT METHOD,UHC MEDICAID CSHCS PLAN,UHC MEDICAID CSHCS REIMBURSEMENT METHOD,BCBS ADVANTAGE PPO MEDICARE PLAN,BCBS ADVANTAGE PPO MEDICARE REIMBURSED METHOD,BCBS BCN ADVANTAGE PPO MEDICARE PLAN,BCBS BCN ADVANTAGE PPO MEDICARE REIMBURSED METHOD,BCBS BCN ADVANTAGE MEDICARE PLAN,BCBS BCN ADVANTAGE MEDICARE REIMBURSED METHOD,HUMANA MEDICARE PLAN,HUMANA MEDICARE REIMBURSED METHOD,MCLAREN HEALTH MEDICARE PLAN,MCLAREN HEALTH MEDICARE REIMBURSED METHOD,UHC MEDICARE PLAN,UHC MEDICARE REIMBURSED METHOD,De-Identified Minimum Negotiated Rate,De-Identified Maximum Negotiated Rate,DISCOUNTED CASH PRICE
Outpatient Medical Services,surgical services,11406,"Exc Skin Benign >4Cm Trunk, Arm, Leg",360,"$4,199.92 ","$3,569.93 ",85% of Billed charges for outpatient setting,"$3,569.93 ",85% of Billed charges for outpatient setting,"$3,119.70 ",74.28% of Billed charges for outpatient setting,"$3,119.70 ",74.28% of Billed charges for outpatient setting,"$2,561.95 ",61% of Billed charges for outpatient setting,"$3,119.70 ",74.28% of Billed charges for outpatient setting,"$3,779.93 ",90% of Billed charges for outpatient setting,"$3,779.93 ",90% of Billed charges for outpatient setting,"$2,205.80 ",52.52% of charges,"$3,662.33 ",87.2% of Billed charges for outpatient setting,"$2,561.95 ",61% of Billed charges for outpatient setting,"$3,662.33 ",87.2% of Billed charges for outpatient setting,"$2,183.96 ",52% of charges,"$3,414.11 ",81.29% of Billed charges for outpatient setting,"$3,779.93 ",90% of Billed charges for outpatient setting,"$3,779.93 ",90% of Billed charges for outpatient setting,"$2,561.95 ",61% of Billed charges for outpatient setting,"$2,561.95 ",61% of Billed charges for outpatient setting,"$3,779.93 ",90% of Billed charges for outpatient setting,"$3,779.93 ",90% of Billed charges for outpatient setting,"$2,561.95 ",61% of Billed charges for outpatient setting,"$2,561.95 ",61% of Billed charges for outpatient setting,"$2,561.95 ",61% of Billed charges for outpatient setting,"$2,183.96 ",52% of charges,"$2,183.96 ",52% of charges,"$2,183.96 ",52% of charges,"$2,183.96 ",52% of charges,"$2,183.96 ",52% of charges,"$2,183.96 ",52% of charges,2183.9584,3779.93,"$3,359.94 "
Outpatient Medical Services,surgical services,19120,Excise Breast Cyst,360,"$3,292.77 ","$2,798.85 ",85% of Billed charges for outpatient setting,"$2,798.85 ",85% of Billed charges for outpatient setting,"$2,445.87 ",74.28% of Billed charges for outpatient setting,"$2,445.87 ",74.28% of Billed charges for outpatient setting,"$2,008.59 ",61% of Billed charges for outpatient setting,"$2,445.87 ",74.28% of Billed charges for outpatient setting,"$2,963.49 ",90% of Billed charges for outpatient setting,"$2,963.49 ",90% of Billed charges for outpatient setting,"$1,729.36 ",52.52% of charges,"$2,871.30 ",87.2% of Billed charges for outpatient setting,"$2,008.59 ",61% of Billed charges for outpatient setting,"$2,871.30 ",87.2% of Billed charges for outpatient setting,"$1,712.24 ",52% of charges,"$2,676.69 ",81.29% of Billed charges for outpatient setting,"$2,963.49 ",90% of Billed charges for outpatient setting,"$2,963.49 ",90% of Billed charges for outpatient setting,"$2,008.59 ",61% of Billed charges for outpatient setting,"$2,008.59 ",61% of Billed charges for outpatient setting,"$2,963.49 ",90% of Billed charges for outpatient setting,"$2,963.49 ",90% of Billed charges for outpatient setting,"$2,008.59 ",61% of Billed charges for outpatient setting,"$2,008.59 ",61% of Billed charges for outpatient setting,"$2,008.59 ",61% of Billed charges for outpatient setting,"$1,712.24 ",52% of charges,"$1,712.24 ",52% of charges,"$1,712.24 ",52% of charges,"$1,712.24 ",52% of charges,"$1,712.24 ",52% of charges,"$1,712.24 ",52% of charges,1712.2404,2963.49,"$2,634.22 "
Outpatient Medical Services,surgical services,20610,Arthrocentesis Aspir&/Inj Major Jt/Bursa W/O Us,360,"$2,947.00 ","$2,504.95 ",85% of Billed charges for outpatient setting,"$2,504.95 ",85% of Billed charges for outpatient setting,"$2,189.03 ",74.28% of Billed charges for outpatient setting,"$2,189.03 ",74.28% of Billed charges for outpatient setting,"$1,797.67 ",61% of Billed charges for outpatient setting,"$2,189.03 ",74.28% of Billed charges for outpatient setting,"$2,652.30 ",90% of Billed charges for outpatient setting,"$2,652.30 ",90% of Billed charges for outpatient setting,"$1,547.76 ",52.52% of charges,"$2,569.78 ",87.2% of Billed charges for outpatient setting,"$1,797.67 ",61% of Billed charges for outpatient setting,"$2,569.78 ",87.2% of Billed charges for outpatient setting,"$1,532.44 ",52% of charges,"$2,395.62 ",81.29% of Billed charges for outpatient setting,"$2,652.30 ",90% of Billed charges for outpatient setting,"$2,652.30 ",90% of Billed charges for outpatient setting,"$1,797.67 ",61% of Billed charges for outpatient setting,"$1,797.67 ",61% of Billed charges for outpatient setting,"$2,652.30 ",90% of Billed charges for outpatient setting,"$2,652.30 ",90% of Billed charges for outpatient setting,"$1,797.67 ",61% of Billed charges for outpatient setting,"$1,797.67 ",61% of Billed charges for outpatient setting,"$1,797.67 ",61% of Billed charges for outpatient setting,"$1,532.44 ",52% of charges,"$1,532.44 ",52% of charges,"$1,532.44 ",52% of charges,"$1,532.44 ",52% of charges,"$1,532.44 ",52% of charges,"$1,532.44 ",52% of charges,1532.44,2652.3,"$2,357.60 "
Outpatient Medical Services,surgical services,20680,Removal of Implant (Deep),360,"$24,510.10 ","$20,833.59 ",85% of Billed charges for outpatient setting,"$20,833.59 ",85% of Billed charges for outpatient setting,"$18,206.10 ",74.28% of Billed charges for outpatient setting,"$18,206.10 ",74.28% of Billed charges for outpatient setting,"$14,951.16 ",61% of Billed charges for outpatient setting,"$18,206.10 ",74.28% of Billed charges for outpatient setting,"$22,059.09 ",90% of Billed charges for outpatient setting,"$22,059.09 ",90% of Billed charges for outpatient setting,"$12,872.70 ",52.52% of charges,"$21,372.81 ",87.2% of Billed charges for outpatient setting,"$14,951.16 ",61% of Billed charges for outpatient setting,"$21,372.81 ",87.2% of Billed charges for outpatient setting,"$12,745.25 ",52% of charges,"$19,924.26 ",81.29% of Billed charges for outpatient setting,"$22,059.09 ",90% of Billed charges for outpatient setting,"$22,059.09 ",90% of Billed charges for outpatient setting,"$14,951.16 ",61% of Billed charges for outpatient setting,"$14,951.16 ",61% of Billed charges for outpatient setting,"$22,059.09 ",90% of Billed charges for outpatient setting,"$22,059.09 ",90% of Billed charges for outpatient setting,"$14,951.16 ",61% of Billed charges for outpatient setting,"$14,951.16 ",61% of Billed charges for outpatient setting,"$14,951.16 ",61% of Billed charges for outpatient setting,"$12,745.25 ",52% of charges,"$12,745.25 ",52% of charges,"$12,745.25 ",52% of charges,"$12,745.25 ",52% of charges,"$12,745.25 ",52% of charges,"$12,745.25 ",52% of charges,12745.252,22059.09,"$19,608.08 "
Outpatient Medical Services,surgical services,22869,Lumbar Insertion Of Interlaminar Interspinous Process Stabilization/Distraction Device With Imaging Second Level,360,"$23,451.49 ","$19,933.77 ",85% of Billed charges for outpatient setting,"$19,933.77 ",85% of Billed charges for outpatient setting,"$17,419.77 ",74.28% of Billed charges for outpatient setting,"$17,419.77 ",74.28% of Billed charges for outpatient setting,"$14,305.41 ",61% of Billed charges for outpatient setting,"$17,419.77 ",74.28% of Billed charges for outpatient setting,"$21,106.34 ",90% of Billed charges for outpatient setting,"$21,106.34 ",90% of Billed charges for outpatient setting,"$12,316.72 ",52.52% of charges,"$20,449.70 ",87.2% of Billed charges for outpatient setting,"$14,305.41 ",61% of Billed charges for outpatient setting,"$20,449.70 ",87.2% of Billed charges for outpatient setting,"$12,194.77 ",52% of charges,"$19,063.72 ",81.29% of Billed charges for outpatient setting,"$21,106.34 ",90% of Billed charges for outpatient setting,"$21,106.34 ",90% of Billed charges for outpatient setting,"$14,305.41 ",61% of Billed charges for outpatient setting,"$14,305.41 ",61% of Billed charges for outpatient setting,"$21,106.34 ",90% of Billed charges for outpatient setting,"$21,106.34 ",90% of Billed charges for outpatient setting,"$14,305.41 ",61% of Billed charges for outpatient setting,"$14,305.41 ",61% of Billed charges for outpatient setting,"$14,305.41 ",61% of Billed charges for outpatient setting,"$12,194.77 ",52% of charges,"$12,194.77 ",52% of charges,"$12,194.77 ",52% of charges,"$12,194.77 ",52% of charges,"$12,194.77 ",52% of charges,"$12,194.77 ",52% of charges,12194.7748,21106.34,"$18,761.19 "
Outpatient Medical Services,surgical services,22870,"Insertion Of Stabilization Device, Lumbar With Imaging",360,"$22,766.64 ","$19,351.64 ",85% of Billed charges for outpatient setting,"$19,351.64 ",85% of Billed charges for outpatient setting,"$16,911.06 ",74.28% of Billed charges for outpatient setting,"$16,911.06 ",74.28% of Billed charges for outpatient setting,"$13,887.65 ",61% of Billed charges for outpatient setting,"$16,911.06 ",74.28% of Billed charges for outpatient setting,"$20,489.98 ",90% of Billed charges for outpatient setting,"$20,489.98 ",90% of Billed charges for outpatient setting,"$11,957.04 ",52.52% of charges,"$19,852.51 ",87.2% of Billed charges for outpatient setting,"$13,887.65 ",61% of Billed charges for outpatient setting,"$19,852.51 ",87.2% of Billed charges for outpatient setting,"$11,838.65 ",52% of charges,"$18,507.00 ",81.29% of Billed charges for outpatient setting,"$20,489.98 ",90% of Billed charges for outpatient setting,"$20,489.98 ",90% of Billed charges for outpatient setting,"$13,887.65 ",61% of Billed charges for outpatient setting,"$13,887.65 ",61% of Billed charges for outpatient setting,"$20,489.98 ",90% of Billed charges for outpatient setting,"$20,489.98 ",90% of Billed charges for outpatient setting,"$13,887.65 ",61% of Billed charges for outpatient setting,"$13,887.65 ",61% of Billed charges for outpatient setting,"$13,887.65 ",61% of Billed charges for outpatient setting,"$11,838.65 ",52% of charges,"$11,838.65 ",52% of charges,"$11,838.65 ",52% of charges,"$11,838.65 ",52% of charges,"$11,838.65 ",52% of charges,"$11,838.65 ",52% of charges,11838.6528,20489.98,"$18,213.31 "
Outpatient Medical Services,surgical services,23120,Claviculectomy (Collarbone Removal); Partial,360,"$12,107.47 ","$10,291.35 ",85% of Billed charges for outpatient setting,"$10,291.35 ",85% of Billed charges for outpatient setting,"$8,993.43 ",74.28% of Billed charges for outpatient setting,"$8,993.43 ",74.28% of Billed charges for outpatient setting,"$7,385.56 ",61% of Billed charges for outpatient setting,"$8,993.43 ",74.28% of Billed charges for outpatient setting,"$10,896.72 ",90% of Billed charges for outpatient setting,"$10,896.72 ",90% of Billed charges for outpatient setting,"$6,358.84 ",52.52% of charges,"$10,557.71 ",87.2% of Billed charges for outpatient setting,"$7,385.56 ",61% of Billed charges for outpatient setting,"$10,557.71 ",87.2% of Billed charges for outpatient setting,"$6,295.88 ",52% of charges,"$9,842.16 ",81.29% of Billed charges for outpatient setting,"$10,896.72 ",90% of Billed charges for outpatient setting,"$10,896.72 ",90% of Billed charges for outpatient setting,"$7,385.56 ",61% of Billed charges for outpatient setting,"$7,385.56 ",61% of Billed charges for outpatient setting,"$10,896.72 ",90% of Billed charges for outpatient setting,"$10,896.72 ",90% of Billed charges for outpatient setting,"$7,385.56 ",61% of Billed charges for outpatient setting,"$7,385.56 ",61% of Billed charges for outpatient setting,"$7,385.56 ",61% of Billed charges for outpatient setting,"$6,295.88 ",52% of charges,"$6,295.88 ",52% of charges,"$6,295.88 ",52% of charges,"$6,295.88 ",52% of charges,"$6,295.88 ",52% of charges,"$6,295.88 ",52% of charges,6295.8844,10896.72,"$9,685.98 "
Outpatient Medical Services,surgical services,23125,Claviculectomy (Collarbone Removal); Total,360,"$15,509.32 ","$13,182.92 ",85% of Billed charges for outpatient setting,"$13,182.92 ",85% of Billed charges for outpatient setting,"$11,520.32 ",74.28% of Billed charges for outpatient setting,"$11,520.32 ",74.28% of Billed charges for outpatient setting,"$9,460.69 ",61% of Billed charges for outpatient setting,"$11,520.32 ",74.28% of Billed charges for outpatient setting,"$13,958.39 ",90% of Billed charges for outpatient setting,"$13,958.39 ",90% of Billed charges for outpatient setting,"$8,145.49 ",52.52% of charges,"$13,524.13 ",87.2% of Billed charges for outpatient setting,"$9,460.69 ",61% of Billed charges for outpatient setting,"$13,524.13 ",87.2% of Billed charges for outpatient setting,"$8,064.85 ",52% of charges,"$12,607.53 ",81.29% of Billed charges for outpatient setting,"$13,958.39 ",90% of Billed charges for outpatient setting,"$13,958.39 ",90% of Billed charges for outpatient setting,"$9,460.69 ",61% of Billed charges for outpatient setting,"$9,460.69 ",61% of Billed charges for outpatient setting,"$13,958.39 ",90% of Billed charges for outpatient setting,"$13,958.39 ",90% of Billed charges for outpatient setting,"$9,460.69 ",61% of Billed charges for outpatient setting,"$9,460.69 ",61% of Billed charges for outpatient setting,"$9,460.69 ",61% of Billed charges for outpatient setting,"$8,064.85 ",52% of charges,"$8,064.85 ",52% of charges,"$8,064.85 ",52% of charges,"$8,064.85 ",52% of charges,"$8,064.85 ",52% of charges,"$8,064.85 ",52% of charges,8064.8464,13958.39,"$12,407.46 "
Outpatient Medical Services,surgical services,23130,Shoulder Blade Repair Or Removal (Acromioplasty Or Acromionectomy) Partial,360,"$13,485.34 ","$11,462.54 ",85% of Billed charges for outpatient setting,"$11,462.54 ",85% of Billed charges for outpatient setting,"$10,016.91 ",74.28% of Billed charges for outpatient setting,"$10,016.91 ",74.28% of Billed charges for outpatient setting,"$8,226.06 ",61% of Billed charges for outpatient setting,"$10,016.91 ",74.28% of Billed charges for outpatient setting,"$12,136.81 ",90% of Billed charges for outpatient setting,"$12,136.81 ",90% of Billed charges for outpatient setting,"$7,082.50 ",52.52% of charges,"$11,759.22 ",87.2% of Billed charges for outpatient setting,"$8,226.06 ",61% of Billed charges for outpatient setting,"$11,759.22 ",87.2% of Billed charges for outpatient setting,"$7,012.38 ",52% of charges,"$10,962.23 ",81.29% of Billed charges for outpatient setting,"$12,136.81 ",90% of Billed charges for outpatient setting,"$12,136.81 ",90% of Billed charges for outpatient setting,"$8,226.06 ",61% of Billed charges for outpatient setting,"$8,226.06 ",61% of Billed charges for outpatient setting,"$12,136.81 ",90% of Billed charges for outpatient setting,"$12,136.81 ",90% of Billed charges for outpatient setting,"$8,226.06 ",61% of Billed charges for outpatient setting,"$8,226.06 ",61% of Billed charges for outpatient setting,"$8,226.06 ",61% of Billed charges for outpatient setting,"$7,012.38 ",52% of charges,"$7,012.38 ",52% of charges,"$7,012.38 ",52% of charges,"$7,012.38 ",52% of charges,"$7,012.38 ",52% of charges,"$7,012.38 ",52% of charges,7012.3768,12136.81,"$10,788.27 "
Outpatient Medical Services,surgical services,23412,Rotator Cuff Repair,360,"$13,796.24 ","$11,726.80 ",85% of Billed charges for outpatient setting,"$11,726.80 ",85% of Billed charges for outpatient setting,"$10,247.85 ",74.28% of Billed charges for outpatient setting,"$10,247.85 ",74.28% of Billed charges for outpatient setting,"$8,415.71 ",61% of Billed charges for outpatient setting,"$10,247.85 ",74.28% of Billed charges for outpatient setting,"$12,416.62 ",90% of Billed charges for outpatient setting,"$12,416.62 ",90% of Billed charges for outpatient setting,"$7,245.79 ",52.52% of charges,"$12,030.32 ",87.2% of Billed charges for outpatient setting,"$8,415.71 ",61% of Billed charges for outpatient setting,"$12,030.32 ",87.2% of Billed charges for outpatient setting,"$7,174.04 ",52% of charges,"$11,214.96 ",81.29% of Billed charges for outpatient setting,"$12,416.62 ",90% of Billed charges for outpatient setting,"$12,416.62 ",90% of Billed charges for outpatient setting,"$8,415.71 ",61% of Billed charges for outpatient setting,"$8,415.71 ",61% of Billed charges for outpatient setting,"$12,416.62 ",90% of Billed charges for outpatient setting,"$12,416.62 ",90% of Billed charges for outpatient setting,"$8,415.71 ",61% of Billed charges for outpatient setting,"$8,415.71 ",61% of Billed charges for outpatient setting,"$8,415.71 ",61% of Billed charges for outpatient setting,"$7,174.04 ",52% of charges,"$7,174.04 ",52% of charges,"$7,174.04 ",52% of charges,"$7,174.04 ",52% of charges,"$7,174.04 ",52% of charges,"$7,174.04 ",52% of charges,7174.0448,12416.62,"$11,036.99 "
Outpatient Medical Services,surgical services,23472,"Arthroplasty, Glenohumeral Joint",360,"$43,145.45 ","$36,673.63 ",85% of Billed charges for outpatient setting,"$36,673.63 ",85% of Billed charges for outpatient setting,"$32,048.44 ",74.28% of Billed charges for outpatient setting,"$32,048.44 ",74.28% of Billed charges for outpatient setting,"$26,318.72 ",61% of Billed charges for outpatient setting,"$32,048.44 ",74.28% of Billed charges for outpatient setting,"$38,830.91 ",90% of Billed charges for outpatient setting,"$38,830.91 ",90% of Billed charges for outpatient setting,"$22,659.99 ",52.52% of charges,"$37,622.83 ",87.2% of Billed charges for outpatient setting,"$26,318.72 ",61% of Billed charges for outpatient setting,"$37,622.83 ",87.2% of Billed charges for outpatient setting,"$22,435.63 ",52% of charges,"$35,072.94 ",81.29% of Billed charges for outpatient setting,"$38,830.91 ",90% of Billed charges for outpatient setting,"$38,830.91 ",90% of Billed charges for outpatient setting,"$26,318.72 ",61% of Billed charges for outpatient setting,"$26,318.72 ",61% of Billed charges for outpatient setting,"$38,830.91 ",90% of Billed charges for outpatient setting,"$38,830.91 ",90% of Billed charges for outpatient setting,"$26,318.72 ",61% of Billed charges for outpatient setting,"$26,318.72 ",61% of Billed charges for outpatient setting,"$26,318.72 ",61% of Billed charges for outpatient setting,"$22,435.63 ",52% of charges,"$22,435.63 ",52% of charges,"$22,435.63 ",52% of charges,"$22,435.63 ",52% of charges,"$22,435.63 ",52% of charges,"$22,435.63 ",52% of charges,22435.634,38830.91,"$34,516.36 "
Outpatient Medical Services,surgical services,23700,"Shoulder Manipulation, Including Application Of Fixation Apparatus",360,"$3,646.80 ","$3,099.78 ",85% of Billed charges for outpatient setting,"$3,099.78 ",85% of Billed charges for outpatient setting,"$2,708.84 ",74.28% of Billed charges for outpatient setting,"$2,708.84 ",74.28% of Billed charges for outpatient setting,"$2,224.55 ",61% of Billed charges for outpatient setting,"$2,708.84 ",74.28% of Billed charges for outpatient setting,"$3,282.12 ",90% of Billed charges for outpatient setting,"$3,282.12 ",90% of Billed charges for outpatient setting,"$1,915.30 ",52.52% of charges,"$3,180.01 ",87.2% of Billed charges for outpatient setting,"$2,224.55 ",61% of Billed charges for outpatient setting,"$3,180.01 ",87.2% of Billed charges for outpatient setting,"$1,896.34 ",52% of charges,"$2,964.48 ",81.29% of Billed charges for outpatient setting,"$3,282.12 ",90% of Billed charges for outpatient setting,"$3,282.12 ",90% of Billed charges for outpatient setting,"$2,224.55 ",61% of Billed charges for outpatient setting,"$2,224.55 ",61% of Billed charges for outpatient setting,"$3,282.12 ",90% of Billed charges for outpatient setting,"$3,282.12 ",90% of Billed charges for outpatient setting,"$2,224.55 ",61% of Billed charges for outpatient setting,"$2,224.55 ",61% of Billed charges for outpatient setting,"$2,224.55 ",61% of Billed charges for outpatient setting,"$1,896.34 ",52% of charges,"$1,896.34 ",52% of charges,"$1,896.34 ",52% of charges,"$1,896.34 ",52% of charges,"$1,896.34 ",52% of charges,"$1,896.34 ",52% of charges,1896.336,3282.12,"$2,917.44 "
Outpatient Medical Services,surgical services,26055,Incise Finger Tendon Sheath,360,"$4,394.83 ","$3,735.61 ",85% of Billed charges for outpatient setting,"$3,735.61 ",85% of Billed charges for outpatient setting,"$3,264.48 ",74.28% of Billed charges for outpatient setting,"$3,264.48 ",74.28% of Billed charges for outpatient setting,"$2,680.85 ",61% of Billed charges for outpatient setting,"$3,264.48 ",74.28% of Billed charges for outpatient setting,"$3,955.35 ",90% of Billed charges for outpatient setting,"$3,955.35 ",90% of Billed charges for outpatient setting,"$2,308.16 ",52.52% of charges,"$3,832.29 ",87.2% of Billed charges for outpatient setting,"$2,680.85 ",61% of Billed charges for outpatient setting,"$3,832.29 ",87.2% of Billed charges for outpatient setting,"$2,285.31 ",52% of charges,"$3,572.56 ",81.29% of Billed charges for outpatient setting,"$3,955.35 ",90% of Billed charges for outpatient setting,"$3,955.35 ",90% of Billed charges for outpatient setting,"$2,680.85 ",61% of Billed charges for outpatient setting,"$2,680.85 ",61% of Billed charges for outpatient setting,"$3,955.35 ",90% of Billed charges for outpatient setting,"$3,955.35 ",90% of Billed charges for outpatient setting,"$2,680.85 ",61% of Billed charges for outpatient setting,"$2,680.85 ",61% of Billed charges for outpatient setting,"$2,680.85 ",61% of Billed charges for outpatient setting,"$2,285.31 ",52% of charges,"$2,285.31 ",52% of charges,"$2,285.31 ",52% of charges,"$2,285.31 ",52% of charges,"$2,285.31 ",52% of charges,"$2,285.31 ",52% of charges,2285.3116,3955.35,"$3,515.86 "
Outpatient Medical Services,surgical services,27130,"Arthroscopy, Hip Total",360,"$27,455.41 ","$23,337.10 ",85% of Billed charges for outpatient setting,"$23,337.10 ",85% of Billed charges for outpatient setting,"$20,393.88 ",74.28% of Billed charges for outpatient setting,"$20,393.88 ",74.28% of Billed charges for outpatient setting,"$16,747.80 ",61% of Billed charges for outpatient setting,"$20,393.88 ",74.28% of Billed charges for outpatient setting,"$24,709.87 ",90% of Billed charges for outpatient setting,"$24,709.87 ",90% of Billed charges for outpatient setting,"$14,419.58 ",52.52% of charges,"$23,941.12 ",87.2% of Billed charges for outpatient setting,"$16,747.80 ",61% of Billed charges for outpatient setting,"$23,941.12 ",87.2% of Billed charges for outpatient setting,"$14,276.81 ",52% of charges,"$22,318.50 ",81.29% of Billed charges for outpatient setting,"$24,709.87 ",90% of Billed charges for outpatient setting,"$24,709.87 ",90% of Billed charges for outpatient setting,"$16,747.80 ",61% of Billed charges for outpatient setting,"$16,747.80 ",61% of Billed charges for outpatient setting,"$24,709.87 ",90% of Billed charges for outpatient setting,"$24,709.87 ",90% of Billed charges for outpatient setting,"$16,747.80 ",61% of Billed charges for outpatient setting,"$16,747.80 ",61% of Billed charges for outpatient setting,"$16,747.80 ",61% of Billed charges for outpatient setting,"$14,276.81 ",52% of charges,"$14,276.81 ",52% of charges,"$14,276.81 ",52% of charges,"$14,276.81 ",52% of charges,"$14,276.81 ",52% of charges,"$14,276.81 ",52% of charges,14276.8132,24709.87,"$21,964.33 "
Outpatient Medical Services,surgical services,27447,"Arthroscopy, Knee, Total",360,"$29,933.50 ","$25,443.48 ",85% of Billed charges for outpatient setting,"$25,443.48 ",85% of Billed charges for outpatient setting,"$22,234.60 ",74.28% of Billed charges for outpatient setting,"$22,234.60 ",74.28% of Billed charges for outpatient setting,"$18,259.44 ",61% of Billed charges for outpatient setting,"$22,234.60 ",74.28% of Billed charges for outpatient setting,"$26,940.15 ",90% of Billed charges for outpatient setting,"$26,940.15 ",90% of Billed charges for outpatient setting,"$15,721.07 ",52.52% of charges,"$26,102.01 ",87.2% of Billed charges for outpatient setting,"$18,259.44 ",61% of Billed charges for outpatient setting,"$26,102.01 ",87.2% of Billed charges for outpatient setting,"$15,565.42 ",52% of charges,"$24,332.94 ",81.29% of Billed charges for outpatient setting,"$26,940.15 ",90% of Billed charges for outpatient setting,"$26,940.15 ",90% of Billed charges for outpatient setting,"$18,259.44 ",61% of Billed charges for outpatient setting,"$18,259.44 ",61% of Billed charges for outpatient setting,"$26,940.15 ",90% of Billed charges for outpatient setting,"$26,940.15 ",90% of Billed charges for outpatient setting,"$18,259.44 ",61% of Billed charges for outpatient setting,"$18,259.44 ",61% of Billed charges for outpatient setting,"$18,259.44 ",61% of Billed charges for outpatient setting,"$15,565.42 ",52% of charges,"$15,565.42 ",52% of charges,"$15,565.42 ",52% of charges,"$15,565.42 ",52% of charges,"$15,565.42 ",52% of charges,"$15,565.42 ",52% of charges,15565.42,26940.15,"$23,946.80 "
Outpatient Medical Services,surgical services,27570,Manipulation Of Knee,360,"$5,718.28 ","$4,860.54 ",85% of Billed charges for outpatient setting,"$4,860.54 ",85% of Billed charges for outpatient setting,"$4,247.54 ",74.28% of Billed charges for outpatient setting,"$4,247.54 ",74.28% of Billed charges for outpatient setting,"$3,488.15 ",61% of Billed charges for outpatient setting,"$4,247.54 ",74.28% of Billed charges for outpatient setting,"$5,146.45 ",90% of Billed charges for outpatient setting,"$5,146.45 ",90% of Billed charges for outpatient setting,"$3,003.24 ",52.52% of charges,"$4,986.34 ",87.2% of Billed charges for outpatient setting,"$3,488.15 ",61% of Billed charges for outpatient setting,"$4,986.34 ",87.2% of Billed charges for outpatient setting,"$2,973.51 ",52% of charges,"$4,648.39 ",81.29% of Billed charges for outpatient setting,"$5,146.45 ",90% of Billed charges for outpatient setting,"$5,146.45 ",90% of Billed charges for outpatient setting,"$3,488.15 ",61% of Billed charges for outpatient setting,"$3,488.15 ",61% of Billed charges for outpatient setting,"$5,146.45 ",90% of Billed charges for outpatient setting,"$5,146.45 ",90% of Billed charges for outpatient setting,"$3,488.15 ",61% of Billed charges for outpatient setting,"$3,488.15 ",61% of Billed charges for outpatient setting,"$3,488.15 ",61% of Billed charges for outpatient setting,"$2,973.51 ",52% of charges,"$2,973.51 ",52% of charges,"$2,973.51 ",52% of charges,"$2,973.51 ",52% of charges,"$2,973.51 ",52% of charges,"$2,973.51 ",52% of charges,2973.5056,5146.45,"$4,574.62 "
Outpatient Medical Services,surgical services,29822,"Arthroscopy, Shoulder Debridement, Limited",360,"$13,827.06 ","$11,753.00 ",85% of Billed charges for outpatient setting,"$11,753.00 ",85% of Billed charges for outpatient setting,"$10,270.74 ",74.28% of Billed charges for outpatient setting,"$10,270.74 ",74.28% of Billed charges for outpatient setting,"$8,434.51 ",61% of Billed charges for outpatient setting,"$10,270.74 ",74.28% of Billed charges for outpatient setting,"$12,444.35 ",90% of Billed charges for outpatient setting,"$12,444.35 ",90% of Billed charges for outpatient setting,"$7,261.97 ",52.52% of charges,"$12,057.20 ",87.2% of Billed charges for outpatient setting,"$8,434.51 ",61% of Billed charges for outpatient setting,"$12,057.20 ",87.2% of Billed charges for outpatient setting,"$7,190.07 ",52% of charges,"$11,240.02 ",81.29% of Billed charges for outpatient setting,"$12,444.35 ",90% of Billed charges for outpatient setting,"$12,444.35 ",90% of Billed charges for outpatient setting,"$8,434.51 ",61% of Billed charges for outpatient setting,"$8,434.51 ",61% of Billed charges for outpatient setting,"$12,444.35 ",90% of Billed charges for outpatient setting,"$12,444.35 ",90% of Billed charges for outpatient setting,"$8,434.51 ",61% of Billed charges for outpatient setting,"$8,434.51 ",61% of Billed charges for outpatient setting,"$8,434.51 ",61% of Billed charges for outpatient setting,"$7,190.07 ",52% of charges,"$7,190.07 ",52% of charges,"$7,190.07 ",52% of charges,"$7,190.07 ",52% of charges,"$7,190.07 ",52% of charges,"$7,190.07 ",52% of charges,7190.0712,12444.35,"$11,061.65 "
Outpatient Medical Services,surgical services,29823,"Arthroscopy, Shoulder Debridement, Extensive",360,"$14,211.48 ","$12,079.76 ",85% of Billed charges for outpatient setting,"$12,079.76 ",85% of Billed charges for outpatient setting,"$10,556.29 ",74.28% of Billed charges for outpatient setting,"$10,556.29 ",74.28% of Billed charges for outpatient setting,"$8,669.00 ",61% of Billed charges for outpatient setting,"$10,556.29 ",74.28% of Billed charges for outpatient setting,"$12,790.33 ",90% of Billed charges for outpatient setting,"$12,790.33 ",90% of Billed charges for outpatient setting,"$7,463.87 ",52.52% of charges,"$12,392.41 ",87.2% of Billed charges for outpatient setting,"$8,669.00 ",61% of Billed charges for outpatient setting,"$12,392.41 ",87.2% of Billed charges for outpatient setting,"$7,389.97 ",52% of charges,"$11,552.51 ",81.29% of Billed charges for outpatient setting,"$12,790.33 ",90% of Billed charges for outpatient setting,"$12,790.33 ",90% of Billed charges for outpatient setting,"$8,669.00 ",61% of Billed charges for outpatient setting,"$8,669.00 ",61% of Billed charges for outpatient setting,"$12,790.33 ",90% of Billed charges for outpatient setting,"$12,790.33 ",90% of Billed charges for outpatient setting,"$8,669.00 ",61% of Billed charges for outpatient setting,"$8,669.00 ",61% of Billed charges for outpatient setting,"$8,669.00 ",61% of Billed charges for outpatient setting,"$7,389.97 ",52% of charges,"$7,389.97 ",52% of charges,"$7,389.97 ",52% of charges,"$7,389.97 ",52% of charges,"$7,389.97 ",52% of charges,"$7,389.97 ",52% of charges,7389.9696,12790.33,"$11,369.18 "
Outpatient Medical Services,surgical services,29824,"Arthroscopy, Shoulder Distal Claviculectomy",360,"$16,077.89 ","$13,666.21 ",85% of Billed charges for outpatient setting,"$13,666.21 ",85% of Billed charges for outpatient setting,"$11,942.66 ",74.28% of Billed charges for outpatient setting,"$11,942.66 ",74.28% of Billed charges for outpatient setting,"$9,807.51 ",61% of Billed charges for outpatient setting,"$11,942.66 ",74.28% of Billed charges for outpatient setting,"$14,470.10 ",90% of Billed charges for outpatient setting,"$14,470.10 ",90% of Billed charges for outpatient setting,"$8,444.11 ",52.52% of charges,"$14,019.92 ",87.2% of Billed charges for outpatient setting,"$9,807.51 ",61% of Billed charges for outpatient setting,"$14,019.92 ",87.2% of Billed charges for outpatient setting,"$8,360.50 ",52% of charges,"$13,069.72 ",81.29% of Billed charges for outpatient setting,"$14,470.10 ",90% of Billed charges for outpatient setting,"$14,470.10 ",90% of Billed charges for outpatient setting,"$9,807.51 ",61% of Billed charges for outpatient setting,"$9,807.51 ",61% of Billed charges for outpatient setting,"$14,470.10 ",90% of Billed charges for outpatient setting,"$14,470.10 ",90% of Billed charges for outpatient setting,"$9,807.51 ",61% of Billed charges for outpatient setting,"$9,807.51 ",61% of Billed charges for outpatient setting,"$9,807.51 ",61% of Billed charges for outpatient setting,"$8,360.50 ",52% of charges,"$8,360.50 ",52% of charges,"$8,360.50 ",52% of charges,"$8,360.50 ",52% of charges,"$8,360.50 ",52% of charges,"$8,360.50 ",52% of charges,8360.5028,14470.1,"$12,862.31 "
Outpatient Medical Services,surgical services,29826,"Arthroscopy, Shoulder With Decompression And Arch Ligament Release",360,"$14,521.12 ","$12,342.95 ",85% of Billed charges for outpatient setting,"$12,342.95 ",85% of Billed charges for outpatient setting,"$10,786.29 ",74.28% of Billed charges for outpatient setting,"$10,786.29 ",74.28% of Billed charges for outpatient setting,"$8,857.88 ",61% of Billed charges for outpatient setting,"$10,786.29 ",74.28% of Billed charges for outpatient setting,"$13,069.01 ",90% of Billed charges for outpatient setting,"$13,069.01 ",90% of Billed charges for outpatient setting,"$7,626.49 ",52.52% of charges,"$12,662.42 ",87.2% of Billed charges for outpatient setting,"$8,857.88 ",61% of Billed charges for outpatient setting,"$12,662.42 ",87.2% of Billed charges for outpatient setting,"$7,550.98 ",52% of charges,"$11,804.22 ",81.29% of Billed charges for outpatient setting,"$13,069.01 ",90% of Billed charges for outpatient setting,"$13,069.01 ",90% of Billed charges for outpatient setting,"$8,857.88 ",61% of Billed charges for outpatient setting,"$8,857.88 ",61% of Billed charges for outpatient setting,"$13,069.01 ",90% of Billed charges for outpatient setting,"$13,069.01 ",90% of Billed charges for outpatient setting,"$8,857.88 ",61% of Billed charges for outpatient setting,"$8,857.88 ",61% of Billed charges for outpatient setting,"$8,857.88 ",61% of Billed charges for outpatient setting,"$7,550.98 ",52% of charges,"$7,550.98 ",52% of charges,"$7,550.98 ",52% of charges,"$7,550.98 ",52% of charges,"$7,550.98 ",52% of charges,"$7,550.98 ",52% of charges,7550.9824,13069.01,"$11,616.90 "
Outpatient Medical Services,surgical services,29827,"Arthroscopy, Shoulder With Rotator Cuff Repair",360,"$16,932.20 ","$14,392.37 ",85% of Billed charges for outpatient setting,"$14,392.37 ",85% of Billed charges for outpatient setting,"$12,577.24 ",74.28% of Billed charges for outpatient setting,"$12,577.24 ",74.28% of Billed charges for outpatient setting,"$10,328.64 ",61% of Billed charges for outpatient setting,"$12,577.24 ",74.28% of Billed charges for outpatient setting,"$15,238.98 ",90% of Billed charges for outpatient setting,"$15,238.98 ",90% of Billed charges for outpatient setting,"$8,892.79 ",52.52% of charges,"$14,764.88 ",87.2% of Billed charges for outpatient setting,"$10,328.64 ",61% of Billed charges for outpatient setting,"$14,764.88 ",87.2% of Billed charges for outpatient setting,"$8,804.74 ",52% of charges,"$13,764.19 ",81.29% of Billed charges for outpatient setting,"$15,238.98 ",90% of Billed charges for outpatient setting,"$15,238.98 ",90% of Billed charges for outpatient setting,"$10,328.64 ",61% of Billed charges for outpatient setting,"$10,328.64 ",61% of Billed charges for outpatient setting,"$15,238.98 ",90% of Billed charges for outpatient setting,"$15,238.98 ",90% of Billed charges for outpatient setting,"$10,328.64 ",61% of Billed charges for outpatient setting,"$10,328.64 ",61% of Billed charges for outpatient setting,"$10,328.64 ",61% of Billed charges for outpatient setting,"$8,804.74 ",52% of charges,"$8,804.74 ",52% of charges,"$8,804.74 ",52% of charges,"$8,804.74 ",52% of charges,"$8,804.74 ",52% of charges,"$8,804.74 ",52% of charges,8804.744,15238.98,"$13,545.76 "
Outpatient Medical Services,surgical services,29875,"Arthroscopy, Knee With Joint Tissue Removal (Synovectomy)",360,"$5,693.79 ","$4,839.72 ",85% of Billed charges for outpatient setting,"$4,839.72 ",85% of Billed charges for outpatient setting,"$4,229.35 ",74.28% of Billed charges for outpatient setting,"$4,229.35 ",74.28% of Billed charges for outpatient setting,"$3,473.21 ",61% of Billed charges for outpatient setting,"$4,229.35 ",74.28% of Billed charges for outpatient setting,"$5,124.41 ",90% of Billed charges for outpatient setting,"$5,124.41 ",90% of Billed charges for outpatient setting,"$2,990.38 ",52.52% of charges,"$4,964.98 ",87.2% of Billed charges for outpatient setting,"$3,473.21 ",61% of Billed charges for outpatient setting,"$4,964.98 ",87.2% of Billed charges for outpatient setting,"$2,960.77 ",52% of charges,"$4,628.48 ",81.29% of Billed charges for outpatient setting,"$5,124.41 ",90% of Billed charges for outpatient setting,"$5,124.41 ",90% of Billed charges for outpatient setting,"$3,473.21 ",61% of Billed charges for outpatient setting,"$3,473.21 ",61% of Billed charges for outpatient setting,"$5,124.41 ",90% of Billed charges for outpatient setting,"$5,124.41 ",90% of Billed charges for outpatient setting,"$3,473.21 ",61% of Billed charges for outpatient setting,"$3,473.21 ",61% of Billed charges for outpatient setting,"$3,473.21 ",61% of Billed charges for outpatient setting,"$2,960.77 ",52% of charges,"$2,960.77 ",52% of charges,"$2,960.77 ",52% of charges,"$2,960.77 ",52% of charges,"$2,960.77 ",52% of charges,"$2,960.77 ",52% of charges,2960.7708,5124.41,"$4,555.03 "
Outpatient Medical Services,surgical services,29876,"Arthroscopy, Knee",360,"$5,348.92 ","$4,546.58 ",85% of Billed charges for outpatient setting,"$4,546.58 ",85% of Billed charges for outpatient setting,"$3,973.18 ",74.28% of Billed charges for outpatient setting,"$3,973.18 ",74.28% of Billed charges for outpatient setting,"$3,262.84 ",61% of Billed charges for outpatient setting,"$3,973.18 ",74.28% of Billed charges for outpatient setting,"$4,814.03 ",90% of Billed charges for outpatient setting,"$4,814.03 ",90% of Billed charges for outpatient setting,"$2,809.25 ",52.52% of charges,"$4,664.26 ",87.2% of Billed charges for outpatient setting,"$3,262.84 ",61% of Billed charges for outpatient setting,"$4,664.26 ",87.2% of Billed charges for outpatient setting,"$2,781.44 ",52% of charges,"$4,348.14 ",81.29% of Billed charges for outpatient setting,"$4,814.03 ",90% of Billed charges for outpatient setting,"$4,814.03 ",90% of Billed charges for outpatient setting,"$3,262.84 ",61% of Billed charges for outpatient setting,"$3,262.84 ",61% of Billed charges for outpatient setting,"$4,814.03 ",90% of Billed charges for outpatient setting,"$4,814.03 ",90% of Billed charges for outpatient setting,"$3,262.84 ",61% of Billed charges for outpatient setting,"$3,262.84 ",61% of Billed charges for outpatient setting,"$3,262.84 ",61% of Billed charges for outpatient setting,"$2,781.44 ",52% of charges,"$2,781.44 ",52% of charges,"$2,781.44 ",52% of charges,"$2,781.44 ",52% of charges,"$2,781.44 ",52% of charges,"$2,781.44 ",52% of charges,2781.4384,4814.03,"$4,279.14 "
Outpatient Medical Services,surgical services,29877,"Arthroscopy, Knee With Debridement Of Cartilage",360,"$5,439.89 ","$4,623.91 ",85% of Billed charges for outpatient setting,"$4,623.91 ",85% of Billed charges for outpatient setting,"$4,040.75 ",74.28% of Billed charges for outpatient setting,"$4,040.75 ",74.28% of Billed charges for outpatient setting,"$3,318.33 ",61% of Billed charges for outpatient setting,"$4,040.75 ",74.28% of Billed charges for outpatient setting,"$4,895.90 ",90% of Billed charges for outpatient setting,"$4,895.90 ",90% of Billed charges for outpatient setting,"$2,857.03 ",52.52% of charges,"$4,743.58 ",87.2% of Billed charges for outpatient setting,"$3,318.33 ",61% of Billed charges for outpatient setting,"$4,743.58 ",87.2% of Billed charges for outpatient setting,"$2,828.74 ",52% of charges,"$4,422.09 ",81.29% of Billed charges for outpatient setting,"$4,895.90 ",90% of Billed charges for outpatient setting,"$4,895.90 ",90% of Billed charges for outpatient setting,"$3,318.33 ",61% of Billed charges for outpatient setting,"$3,318.33 ",61% of Billed charges for outpatient setting,"$4,895.90 ",90% of Billed charges for outpatient setting,"$4,895.90 ",90% of Billed charges for outpatient setting,"$3,318.33 ",61% of Billed charges for outpatient setting,"$3,318.33 ",61% of Billed charges for outpatient setting,"$3,318.33 ",61% of Billed charges for outpatient setting,"$2,828.74 ",52% of charges,"$2,828.74 ",52% of charges,"$2,828.74 ",52% of charges,"$2,828.74 ",52% of charges,"$2,828.74 ",52% of charges,"$2,828.74 ",52% of charges,2828.7428,4895.9,"$4,351.91 "
Outpatient Medical Services,surgical services,29880,"Arthroscopy, Knee With Removal Of Meniscus, Debridement Of Articular Cartilage",360,"$5,653.77 ","$4,805.70 ",85% of Billed charges for outpatient setting,"$4,805.70 ",85% of Billed charges for outpatient setting,"$4,199.62 ",74.28% of Billed charges for outpatient setting,"$4,199.62 ",74.28% of Billed charges for outpatient setting,"$3,448.80 ",61% of Billed charges for outpatient setting,"$4,199.62 ",74.28% of Billed charges for outpatient setting,"$5,088.39 ",90% of Billed charges for outpatient setting,"$5,088.39 ",90% of Billed charges for outpatient setting,"$2,969.36 ",52.52% of charges,"$4,930.09 ",87.2% of Billed charges for outpatient setting,"$3,448.80 ",61% of Billed charges for outpatient setting,"$4,930.09 ",87.2% of Billed charges for outpatient setting,"$2,939.96 ",52% of charges,"$4,595.95 ",81.29% of Billed charges for outpatient setting,"$5,088.39 ",90% of Billed charges for outpatient setting,"$5,088.39 ",90% of Billed charges for outpatient setting,"$3,448.80 ",61% of Billed charges for outpatient setting,"$3,448.80 ",61% of Billed charges for outpatient setting,"$5,088.39 ",90% of Billed charges for outpatient setting,"$5,088.39 ",90% of Billed charges for outpatient setting,"$3,448.80 ",61% of Billed charges for outpatient setting,"$3,448.80 ",61% of Billed charges for outpatient setting,"$3,448.80 ",61% of Billed charges for outpatient setting,"$2,939.96 ",52% of charges,"$2,939.96 ",52% of charges,"$2,939.96 ",52% of charges,"$2,939.96 ",52% of charges,"$2,939.96 ",52% of charges,"$2,939.96 ",52% of charges,2939.9604,5088.39,"$4,523.02 "
Outpatient Medical Services,surgical services,29881,"Arthroscopy, Knee,  With Meniscus  Removal Including Debridement",360,"$6,232.19 ","$5,297.36 ",85% of Billed charges for outpatient setting,"$5,297.36 ",85% of Billed charges for outpatient setting,"$4,629.27 ",74.28% of Billed charges for outpatient setting,"$4,629.27 ",74.28% of Billed charges for outpatient setting,"$3,801.64 ",61% of Billed charges for outpatient setting,"$4,629.27 ",74.28% of Billed charges for outpatient setting,"$5,608.97 ",90% of Billed charges for outpatient setting,"$5,608.97 ",90% of Billed charges for outpatient setting,"$3,273.15 ",52.52% of charges,"$5,434.47 ",87.2% of Billed charges for outpatient setting,"$3,801.64 ",61% of Billed charges for outpatient setting,"$5,434.47 ",87.2% of Billed charges for outpatient setting,"$3,240.74 ",52% of charges,"$5,066.15 ",81.29% of Billed charges for outpatient setting,"$5,608.97 ",90% of Billed charges for outpatient setting,"$5,608.97 ",90% of Billed charges for outpatient setting,"$3,801.64 ",61% of Billed charges for outpatient setting,"$3,801.64 ",61% of Billed charges for outpatient setting,"$5,608.97 ",90% of Billed charges for outpatient setting,"$5,608.97 ",90% of Billed charges for outpatient setting,"$3,801.64 ",61% of Billed charges for outpatient setting,"$3,801.64 ",61% of Billed charges for outpatient setting,"$3,801.64 ",61% of Billed charges for outpatient setting,"$3,240.74 ",52% of charges,"$3,240.74 ",52% of charges,"$3,240.74 ",52% of charges,"$3,240.74 ",52% of charges,"$3,240.74 ",52% of charges,"$3,240.74 ",52% of charges,3240.7388,5608.97,"$4,985.75 "
Outpatient Medical Services,surgical services,44970,"Lap, Appendectomy",360,"$12,259.48 ","$10,420.56 ",85% of Billed charges for outpatient setting,"$10,420.56 ",85% of Billed charges for outpatient setting,"$9,106.34 ",74.28% of Billed charges for outpatient setting,"$9,106.34 ",74.28% of Billed charges for outpatient setting,"$7,478.28 ",61% of Billed charges for outpatient setting,"$9,106.34 ",74.28% of Billed charges for outpatient setting,"$11,033.53 ",90% of Billed charges for outpatient setting,"$11,033.53 ",90% of Billed charges for outpatient setting,"$6,438.68 ",52.52% of charges,"$10,690.27 ",87.2% of Billed charges for outpatient setting,"$7,478.28 ",61% of Billed charges for outpatient setting,"$10,690.27 ",87.2% of Billed charges for outpatient setting,"$6,374.93 ",52% of charges,"$9,965.73 ",81.29% of Billed charges for outpatient setting,"$11,033.53 ",90% of Billed charges for outpatient setting,"$11,033.53 ",90% of Billed charges for outpatient setting,"$7,478.28 ",61% of Billed charges for outpatient setting,"$7,478.28 ",61% of Billed charges for outpatient setting,"$11,033.53 ",90% of Billed charges for outpatient setting,"$11,033.53 ",90% of Billed charges for outpatient setting,"$7,478.28 ",61% of Billed charges for outpatient setting,"$7,478.28 ",61% of Billed charges for outpatient setting,"$7,478.28 ",61% of Billed charges for outpatient setting,"$6,374.93 ",52% of charges,"$6,374.93 ",52% of charges,"$6,374.93 ",52% of charges,"$6,374.93 ",52% of charges,"$6,374.93 ",52% of charges,"$6,374.93 ",52% of charges,6374.9296,11033.53,"$9,807.58 "
Outpatient Medical Services,surgical services,47562,"Lap, Cholecystectomy",360,"$10,232.29 ","$8,697.45 ",85% of Billed charges for outpatient setting,"$8,697.45 ",85% of Billed charges for outpatient setting,"$7,600.55 ",74.28% of Billed charges for outpatient setting,"$7,600.55 ",74.28% of Billed charges for outpatient setting,"$6,241.70 ",61% of Billed charges for outpatient setting,"$7,600.55 ",74.28% of Billed charges for outpatient setting,"$9,209.06 ",90% of Billed charges for outpatient setting,"$9,209.06 ",90% of Billed charges for outpatient setting,"$5,374.00 ",52.52% of charges,"$8,922.56 ",87.2% of Billed charges for outpatient setting,"$6,241.70 ",61% of Billed charges for outpatient setting,"$8,922.56 ",87.2% of Billed charges for outpatient setting,"$5,320.79 ",52% of charges,"$8,317.83 ",81.29% of Billed charges for outpatient setting,"$9,209.06 ",90% of Billed charges for outpatient setting,"$9,209.06 ",90% of Billed charges for outpatient setting,"$6,241.70 ",61% of Billed charges for outpatient setting,"$6,241.70 ",61% of Billed charges for outpatient setting,"$9,209.06 ",90% of Billed charges for outpatient setting,"$9,209.06 ",90% of Billed charges for outpatient setting,"$6,241.70 ",61% of Billed charges for outpatient setting,"$6,241.70 ",61% of Billed charges for outpatient setting,"$6,241.70 ",61% of Billed charges for outpatient setting,"$5,320.79 ",52% of charges,"$5,320.79 ",52% of charges,"$5,320.79 ",52% of charges,"$5,320.79 ",52% of charges,"$5,320.79 ",52% of charges,"$5,320.79 ",52% of charges,5320.7908,9209.06,"$8,185.83 "
Outpatient Medical Services,surgical services,49505,Prp I/Hern Init Reduc 5+ Yr,360,"$8,089.60 ","$6,876.16 ",85% of Billed charges for outpatient setting,"$6,876.16 ",85% of Billed charges for outpatient setting,"$6,008.95 ",74.28% of Billed charges for outpatient setting,"$6,008.95 ",74.28% of Billed charges for outpatient setting,"$4,934.66 ",61% of Billed charges for outpatient setting,"$6,008.95 ",74.28% of Billed charges for outpatient setting,"$7,280.64 ",90% of Billed charges for outpatient setting,"$7,280.64 ",90% of Billed charges for outpatient setting,"$4,248.66 ",52.52% of charges,"$7,054.13 ",87.2% of Billed charges for outpatient setting,"$4,934.66 ",61% of Billed charges for outpatient setting,"$7,054.13 ",87.2% of Billed charges for outpatient setting,"$4,206.59 ",52% of charges,"$6,576.04 ",81.29% of Billed charges for outpatient setting,"$7,280.64 ",90% of Billed charges for outpatient setting,"$7,280.64 ",90% of Billed charges for outpatient setting,"$4,934.66 ",61% of Billed charges for outpatient setting,"$4,934.66 ",61% of Billed charges for outpatient setting,"$7,280.64 ",90% of Billed charges for outpatient setting,"$7,280.64 ",90% of Billed charges for outpatient setting,"$4,934.66 ",61% of Billed charges for outpatient setting,"$4,934.66 ",61% of Billed charges for outpatient setting,"$4,934.66 ",61% of Billed charges for outpatient setting,"$4,206.59 ",52% of charges,"$4,206.59 ",52% of charges,"$4,206.59 ",52% of charges,"$4,206.59 ",52% of charges,"$4,206.59 ",52% of charges,"$4,206.59 ",52% of charges,4206.592,7280.64,"$6,471.68 "
Outpatient Medical Services,surgical services,49587,"Repair Umbilical Hernia, 5 Years Or Older, Incarcerated Or Strangulated",360,"$8,227.49 ","$6,993.37 ",85% of Billed charges for outpatient setting,"$6,993.37 ",85% of Billed charges for outpatient setting,"$6,111.38 ",74.28% of Billed charges for outpatient setting,"$6,111.38 ",74.28% of Billed charges for outpatient setting,"$5,018.77 ",61% of Billed charges for outpatient setting,"$6,111.38 ",74.28% of Billed charges for outpatient setting,"$7,404.74 ",90% of Billed charges for outpatient setting,"$7,404.74 ",90% of Billed charges for outpatient setting,"$4,321.08 ",52.52% of charges,"$7,174.37 ",87.2% of Billed charges for outpatient setting,"$5,018.77 ",61% of Billed charges for outpatient setting,"$7,174.37 ",87.2% of Billed charges for outpatient setting,"$4,278.29 ",52% of charges,"$6,688.13 ",81.29% of Billed charges for outpatient setting,"$7,404.74 ",90% of Billed charges for outpatient setting,"$7,404.74 ",90% of Billed charges for outpatient setting,"$5,018.77 ",61% of Billed charges for outpatient setting,"$5,018.77 ",61% of Billed charges for outpatient setting,"$7,404.74 ",90% of Billed charges for outpatient setting,"$7,404.74 ",90% of Billed charges for outpatient setting,"$5,018.77 ",61% of Billed charges for outpatient setting,"$5,018.77 ",61% of Billed charges for outpatient setting,"$5,018.77 ",61% of Billed charges for outpatient setting,"$4,278.29 ",52% of charges,"$4,278.29 ",52% of charges,"$4,278.29 ",52% of charges,"$4,278.29 ",52% of charges,"$4,278.29 ",52% of charges,"$4,278.29 ",52% of charges,4278.2948,7404.74,"$6,581.99 "
Outpatient Medical Services,surgical services,52000,Cystoscopy,360,"$3,797.92 ","$3,228.23 ",85% of Billed charges for outpatient setting,"$3,228.23 ",85% of Billed charges for outpatient setting,"$2,821.09 ",74.28% of Billed charges for outpatient setting,"$2,821.09 ",74.28% of Billed charges for outpatient setting,"$2,316.73 ",61% of Billed charges for outpatient setting,"$2,821.09 ",74.28% of Billed charges for outpatient setting,"$3,418.13 ",90% of Billed charges for outpatient setting,"$3,418.13 ",90% of Billed charges for outpatient setting,"$1,994.67 ",52.52% of charges,"$3,311.79 ",87.2% of Billed charges for outpatient setting,"$2,316.73 ",61% of Billed charges for outpatient setting,"$3,311.79 ",87.2% of Billed charges for outpatient setting,"$1,974.92 ",52% of charges,"$3,087.33 ",81.29% of Billed charges for outpatient setting,"$3,418.13 ",90% of Billed charges for outpatient setting,"$3,418.13 ",90% of Billed charges for outpatient setting,"$2,316.73 ",61% of Billed charges for outpatient setting,"$2,316.73 ",61% of Billed charges for outpatient setting,"$3,418.13 ",90% of Billed charges for outpatient setting,"$3,418.13 ",90% of Billed charges for outpatient setting,"$2,316.73 ",61% of Billed charges for outpatient setting,"$2,316.73 ",61% of Billed charges for outpatient setting,"$2,316.73 ",61% of Billed charges for outpatient setting,"$1,974.92 ",52% of charges,"$1,974.92 ",52% of charges,"$1,974.92 ",52% of charges,"$1,974.92 ",52% of charges,"$1,974.92 ",52% of charges,"$1,974.92 ",52% of charges,1974.9184,3418.13,"$3,038.34 "
Outpatient Medical Services,surgical services,52005,Cystourethroscopy With Ureteral Cath,360,"$4,932.11 ","$4,192.29 ",85% of Billed charges for outpatient setting,"$4,192.29 ",85% of Billed charges for outpatient setting,"$3,663.57 ",74.28% of Billed charges for outpatient setting,"$3,663.57 ",74.28% of Billed charges for outpatient setting,"$3,008.59 ",61% of Billed charges for outpatient setting,"$3,663.57 ",74.28% of Billed charges for outpatient setting,"$4,438.90 ",90% of Billed charges for outpatient setting,"$4,438.90 ",90% of Billed charges for outpatient setting,"$2,590.34 ",52.52% of charges,"$4,300.80 ",87.2% of Billed charges for outpatient setting,"$3,008.59 ",61% of Billed charges for outpatient setting,"$4,300.80 ",87.2% of Billed charges for outpatient setting,"$2,564.70 ",52% of charges,"$4,009.31 ",81.29% of Billed charges for outpatient setting,"$4,438.90 ",90% of Billed charges for outpatient setting,"$4,438.90 ",90% of Billed charges for outpatient setting,"$3,008.59 ",61% of Billed charges for outpatient setting,"$3,008.59 ",61% of Billed charges for outpatient setting,"$4,438.90 ",90% of Billed charges for outpatient setting,"$4,438.90 ",90% of Billed charges for outpatient setting,"$3,008.59 ",61% of Billed charges for outpatient setting,"$3,008.59 ",61% of Billed charges for outpatient setting,"$3,008.59 ",61% of Billed charges for outpatient setting,"$2,564.70 ",52% of charges,"$2,564.70 ",52% of charges,"$2,564.70 ",52% of charges,"$2,564.70 ",52% of charges,"$2,564.70 ",52% of charges,"$2,564.70 ",52% of charges,2564.6972,4438.9,"$3,945.69 "
Outpatient Medical Services,surgical services,52204,Cystoscopy W/ Biopsy(s),360,"$5,055.80 ","$4,297.43 ",85% of Billed charges for outpatient setting,"$4,297.43 ",85% of Billed charges for outpatient setting,"$3,755.45 ",74.28% of Billed charges for outpatient setting,"$3,755.45 ",74.28% of Billed charges for outpatient setting,"$3,084.04 ",61% of Billed charges for outpatient setting,"$3,755.45 ",74.28% of Billed charges for outpatient setting,"$4,550.22 ",90% of Billed charges for outpatient setting,"$4,550.22 ",90% of Billed charges for outpatient setting,"$2,655.31 ",52.52% of charges,"$4,408.66 ",87.2% of Billed charges for outpatient setting,"$3,084.04 ",61% of Billed charges for outpatient setting,"$4,408.66 ",87.2% of Billed charges for outpatient setting,"$2,629.02 ",52% of charges,"$4,109.86 ",81.29% of Billed charges for outpatient setting,"$4,550.22 ",90% of Billed charges for outpatient setting,"$4,550.22 ",90% of Billed charges for outpatient setting,"$3,084.04 ",61% of Billed charges for outpatient setting,"$3,084.04 ",61% of Billed charges for outpatient setting,"$4,550.22 ",90% of Billed charges for outpatient setting,"$4,550.22 ",90% of Billed charges for outpatient setting,"$3,084.04 ",61% of Billed charges for outpatient setting,"$3,084.04 ",61% of Billed charges for outpatient setting,"$3,084.04 ",61% of Billed charges for outpatient setting,"$2,629.02 ",52% of charges,"$2,629.02 ",52% of charges,"$2,629.02 ",52% of charges,"$2,629.02 ",52% of charges,"$2,629.02 ",52% of charges,"$2,629.02 ",52% of charges,2629.016,4550.22,"$4,044.64 "
Outpatient Medical Services,surgical services,52234,"Cystourethroscopy, With Fulguration And/Or Resection",360,"$5,943.92 ","$5,052.33 ",85% of Billed charges for outpatient setting,"$5,052.33 ",85% of Billed charges for outpatient setting,"$4,415.14 ",74.28% of Billed charges for outpatient setting,"$4,415.14 ",74.28% of Billed charges for outpatient setting,"$3,625.79 ",61% of Billed charges for outpatient setting,"$4,415.14 ",74.28% of Billed charges for outpatient setting,"$5,349.53 ",90% of Billed charges for outpatient setting,"$5,349.53 ",90% of Billed charges for outpatient setting,"$3,121.75 ",52.52% of charges,"$5,183.10 ",87.2% of Billed charges for outpatient setting,"$3,625.79 ",61% of Billed charges for outpatient setting,"$5,183.10 ",87.2% of Billed charges for outpatient setting,"$3,090.84 ",52% of charges,"$4,831.81 ",81.29% of Billed charges for outpatient setting,"$5,349.53 ",90% of Billed charges for outpatient setting,"$5,349.53 ",90% of Billed charges for outpatient setting,"$3,625.79 ",61% of Billed charges for outpatient setting,"$3,625.79 ",61% of Billed charges for outpatient setting,"$5,349.53 ",90% of Billed charges for outpatient setting,"$5,349.53 ",90% of Billed charges for outpatient setting,"$3,625.79 ",61% of Billed charges for outpatient setting,"$3,625.79 ",61% of Billed charges for outpatient setting,"$3,625.79 ",61% of Billed charges for outpatient setting,"$3,090.84 ",52% of charges,"$3,090.84 ",52% of charges,"$3,090.84 ",52% of charges,"$3,090.84 ",52% of charges,"$3,090.84 ",52% of charges,"$3,090.84 ",52% of charges,3090.8384,5349.53,"$4,755.14 "
Outpatient Medical Services,surgical services,52332,"Cystourethroscopy, With Insertion Of Indwelling Ureteral Stent",360,"$8,416.19 ","$7,153.76 ",85% of Billed charges for outpatient setting,"$7,153.76 ",85% of Billed charges for outpatient setting,"$6,251.55 ",74.28% of Billed charges for outpatient setting,"$6,251.55 ",74.28% of Billed charges for outpatient setting,"$5,133.88 ",61% of Billed charges for outpatient setting,"$6,251.55 ",74.28% of Billed charges for outpatient setting,"$7,574.57 ",90% of Billed charges for outpatient setting,"$7,574.57 ",90% of Billed charges for outpatient setting,"$4,420.18 ",52.52% of charges,"$7,338.92 ",87.2% of Billed charges for outpatient setting,"$5,133.88 ",61% of Billed charges for outpatient setting,"$7,338.92 ",87.2% of Billed charges for outpatient setting,"$4,376.42 ",52% of charges,"$6,841.52 ",81.29% of Billed charges for outpatient setting,"$7,574.57 ",90% of Billed charges for outpatient setting,"$7,574.57 ",90% of Billed charges for outpatient setting,"$5,133.88 ",61% of Billed charges for outpatient setting,"$5,133.88 ",61% of Billed charges for outpatient setting,"$7,574.57 ",90% of Billed charges for outpatient setting,"$7,574.57 ",90% of Billed charges for outpatient setting,"$5,133.88 ",61% of Billed charges for outpatient setting,"$5,133.88 ",61% of Billed charges for outpatient setting,"$5,133.88 ",61% of Billed charges for outpatient setting,"$4,376.42 ",52% of charges,"$4,376.42 ",52% of charges,"$4,376.42 ",52% of charges,"$4,376.42 ",52% of charges,"$4,376.42 ",52% of charges,"$4,376.42 ",52% of charges,4376.4188,7574.57,"$6,732.95 "
Outpatient Medical Services,surgical services,52352,"Cystourethroscopy, With Ureteroscopy And/Or Pyeloscopy",360,"$8,879.56 ","$7,547.63 ",85% of Billed charges for outpatient setting,"$7,547.63 ",85% of Billed charges for outpatient setting,"$6,595.74 ",74.28% of Billed charges for outpatient setting,"$6,595.74 ",74.28% of Billed charges for outpatient setting,"$5,416.53 ",61% of Billed charges for outpatient setting,"$6,595.74 ",74.28% of Billed charges for outpatient setting,"$7,991.60 ",90% of Billed charges for outpatient setting,"$7,991.60 ",90% of Billed charges for outpatient setting,"$4,663.54 ",52.52% of charges,"$7,742.98 ",87.2% of Billed charges for outpatient setting,"$5,416.53 ",61% of Billed charges for outpatient setting,"$7,742.98 ",87.2% of Billed charges for outpatient setting,"$4,617.37 ",52% of charges,"$7,218.19 ",81.29% of Billed charges for outpatient setting,"$7,991.60 ",90% of Billed charges for outpatient setting,"$7,991.60 ",90% of Billed charges for outpatient setting,"$5,416.53 ",61% of Billed charges for outpatient setting,"$5,416.53 ",61% of Billed charges for outpatient setting,"$7,991.60 ",90% of Billed charges for outpatient setting,"$7,991.60 ",90% of Billed charges for outpatient setting,"$5,416.53 ",61% of Billed charges for outpatient setting,"$5,416.53 ",61% of Billed charges for outpatient setting,"$5,416.53 ",61% of Billed charges for outpatient setting,"$4,617.37 ",52% of charges,"$4,617.37 ",52% of charges,"$4,617.37 ",52% of charges,"$4,617.37 ",52% of charges,"$4,617.37 ",52% of charges,"$4,617.37 ",52% of charges,4617.3712,7991.6,"$7,103.65 "
Outpatient Medical Services,surgical services,52356,"Cystourethroscopy, With Ureteroscopy And/Or Pyeloscopy With Stent Insertion",360,"$9,725.61 ","$8,266.77 ",85% of Billed charges for outpatient setting,"$8,266.77 ",85% of Billed charges for outpatient setting,"$7,224.18 ",74.28% of Billed charges for outpatient setting,"$7,224.18 ",74.28% of Billed charges for outpatient setting,"$5,932.62 ",61% of Billed charges for outpatient setting,"$7,224.18 ",74.28% of Billed charges for outpatient setting,"$8,753.05 ",90% of Billed charges for outpatient setting,"$8,753.05 ",90% of Billed charges for outpatient setting,"$5,107.89 ",52.52% of charges,"$8,480.73 ",87.2% of Billed charges for outpatient setting,"$5,932.62 ",61% of Billed charges for outpatient setting,"$8,480.73 ",87.2% of Billed charges for outpatient setting,"$5,057.32 ",52% of charges,"$7,905.95 ",81.29% of Billed charges for outpatient setting,"$8,753.05 ",90% of Billed charges for outpatient setting,"$8,753.05 ",90% of Billed charges for outpatient setting,"$5,932.62 ",61% of Billed charges for outpatient setting,"$5,932.62 ",61% of Billed charges for outpatient setting,"$8,753.05 ",90% of Billed charges for outpatient setting,"$8,753.05 ",90% of Billed charges for outpatient setting,"$5,932.62 ",61% of Billed charges for outpatient setting,"$5,932.62 ",61% of Billed charges for outpatient setting,"$5,932.62 ",61% of Billed charges for outpatient setting,"$5,057.32 ",52% of charges,"$5,057.32 ",52% of charges,"$5,057.32 ",52% of charges,"$5,057.32 ",52% of charges,"$5,057.32 ",52% of charges,"$5,057.32 ",52% of charges,5057.3172,8753.05,"$7,780.49 "
Outpatient Medical Services,surgical services,58558,Hysteroscopy Biopsy,360,"$7,945.96 ","$6,754.07 ",85% of Billed charges for outpatient setting,"$6,754.07 ",85% of Billed charges for outpatient setting,"$5,902.26 ",74.28% of Billed charges for outpatient setting,"$5,902.26 ",74.28% of Billed charges for outpatient setting,"$4,847.04 ",61% of Billed charges for outpatient setting,"$5,902.26 ",74.28% of Billed charges for outpatient setting,"$7,151.36 ",90% of Billed charges for outpatient setting,"$7,151.36 ",90% of Billed charges for outpatient setting,"$4,173.22 ",52.52% of charges,"$6,928.88 ",87.2% of Billed charges for outpatient setting,"$4,847.04 ",61% of Billed charges for outpatient setting,"$6,928.88 ",87.2% of Billed charges for outpatient setting,"$4,131.90 ",52% of charges,"$6,459.27 ",81.29% of Billed charges for outpatient setting,"$7,151.36 ",90% of Billed charges for outpatient setting,"$7,151.36 ",90% of Billed charges for outpatient setting,"$4,847.04 ",61% of Billed charges for outpatient setting,"$4,847.04 ",61% of Billed charges for outpatient setting,"$7,151.36 ",90% of Billed charges for outpatient setting,"$7,151.36 ",90% of Billed charges for outpatient setting,"$4,847.04 ",61% of Billed charges for outpatient setting,"$4,847.04 ",61% of Billed charges for outpatient setting,"$4,847.04 ",61% of Billed charges for outpatient setting,"$4,131.90 ",52% of charges,"$4,131.90 ",52% of charges,"$4,131.90 ",52% of charges,"$4,131.90 ",52% of charges,"$4,131.90 ",52% of charges,"$4,131.90 ",52% of charges,4131.8992,7151.36,"$6,356.77 "
Outpatient Medical Services,surgical services,62322,"Inj Lumbar/Sacral, W/Wo Contrast",360,"$1,957.71 ","$1,664.05 ",85% of Billed charges for outpatient setting,"$1,664.05 ",85% of Billed charges for outpatient setting,"$1,454.19 ",74.28% of Billed charges for outpatient setting,"$1,454.19 ",74.28% of Billed charges for outpatient setting,"$1,194.20 ",61% of Billed charges for outpatient setting,"$1,454.19 ",74.28% of Billed charges for outpatient setting,"$1,761.94 ",90% of Billed charges for outpatient setting,"$1,761.94 ",90% of Billed charges for outpatient setting,"$1,028.19 ",52.52% of charges,"$1,707.12 ",87.2% of Billed charges for outpatient setting,"$1,194.20 ",61% of Billed charges for outpatient setting,"$1,707.12 ",87.2% of Billed charges for outpatient setting,"$1,018.01 ",52% of charges,"$1,591.42 ",81.29% of Billed charges for outpatient setting,"$1,761.94 ",90% of Billed charges for outpatient setting,"$1,761.94 ",90% of Billed charges for outpatient setting,"$1,194.20 ",61% of Billed charges for outpatient setting,"$1,194.20 ",61% of Billed charges for outpatient setting,"$1,761.94 ",90% of Billed charges for outpatient setting,"$1,761.94 ",90% of Billed charges for outpatient setting,"$1,194.20 ",61% of Billed charges for outpatient setting,"$1,194.20 ",61% of Billed charges for outpatient setting,"$1,194.20 ",61% of Billed charges for outpatient setting,"$1,018.01 ",52% of charges,"$1,018.01 ",52% of charges,"$1,018.01 ",52% of charges,"$1,018.01 ",52% of charges,"$1,018.01 ",52% of charges,"$1,018.01 ",52% of charges,1018.0092,1761.94,"$1,566.17 "
Outpatient Medical Services,surgical services,62323,Njx Interlaminar Lmbr/Sac Singe-Shot,360,"$2,183.80 ","$1,856.23 ",85% of Billed charges for outpatient setting,"$1,856.23 ",85% of Billed charges for outpatient setting,"$1,622.13 ",74.28% of Billed charges for outpatient setting,"$1,622.13 ",74.28% of Billed charges for outpatient setting,"$1,332.12 ",61% of Billed charges for outpatient setting,"$1,622.13 ",74.28% of Billed charges for outpatient setting,"$1,965.42 ",90% of Billed charges for outpatient setting,"$1,965.42 ",90% of Billed charges for outpatient setting,"$1,146.93 ",52.52% of charges,"$1,904.27 ",87.2% of Billed charges for outpatient setting,"$1,332.12 ",61% of Billed charges for outpatient setting,"$1,904.27 ",87.2% of Billed charges for outpatient setting,"$1,135.58 ",52% of charges,"$1,775.21 ",81.29% of Billed charges for outpatient setting,"$1,965.42 ",90% of Billed charges for outpatient setting,"$1,965.42 ",90% of Billed charges for outpatient setting,"$1,332.12 ",61% of Billed charges for outpatient setting,"$1,332.12 ",61% of Billed charges for outpatient setting,"$1,965.42 ",90% of Billed charges for outpatient setting,"$1,965.42 ",90% of Billed charges for outpatient setting,"$1,332.12 ",61% of Billed charges for outpatient setting,"$1,332.12 ",61% of Billed charges for outpatient setting,"$1,332.12 ",61% of Billed charges for outpatient setting,"$1,135.58 ",52% of charges,"$1,135.58 ",52% of charges,"$1,135.58 ",52% of charges,"$1,135.58 ",52% of charges,"$1,135.58 ",52% of charges,"$1,135.58 ",52% of charges,1135.576,1965.42,"$1,747.04 "
Outpatient Medical Services,surgical services,62350,"Implantation Of Spinal Catheter, Without Laminectomy",360,"$23,410.67 ","$19,899.07 ",85% of Billed charges for outpatient setting,"$19,899.07 ",85% of Billed charges for outpatient setting,"$17,389.45 ",74.28% of Billed charges for outpatient setting,"$17,389.45 ",74.28% of Billed charges for outpatient setting,"$14,280.51 ",61% of Billed charges for outpatient setting,"$17,389.45 ",74.28% of Billed charges for outpatient setting,"$21,069.60 ",90% of Billed charges for outpatient setting,"$21,069.60 ",90% of Billed charges for outpatient setting,"$12,295.28 ",52.52% of charges,"$20,414.10 ",87.2% of Billed charges for outpatient setting,"$14,280.51 ",61% of Billed charges for outpatient setting,"$20,414.10 ",87.2% of Billed charges for outpatient setting,"$12,173.55 ",52% of charges,"$19,030.53 ",81.29% of Billed charges for outpatient setting,"$21,069.60 ",90% of Billed charges for outpatient setting,"$21,069.60 ",90% of Billed charges for outpatient setting,"$14,280.51 ",61% of Billed charges for outpatient setting,"$14,280.51 ",61% of Billed charges for outpatient setting,"$21,069.60 ",90% of Billed charges for outpatient setting,"$21,069.60 ",90% of Billed charges for outpatient setting,"$14,280.51 ",61% of Billed charges for outpatient setting,"$14,280.51 ",61% of Billed charges for outpatient setting,"$14,280.51 ",61% of Billed charges for outpatient setting,"$12,173.55 ",52% of charges,"$12,173.55 ",52% of charges,"$12,173.55 ",52% of charges,"$12,173.55 ",52% of charges,"$12,173.55 ",52% of charges,"$12,173.55 ",52% of charges,12173.5484,21069.6,"$18,728.54 "
Outpatient Medical Services,surgical services,62355,Removal Of  Implanted Spinal Catheter,360,"$6,952.34 ","$5,909.49 ",85% of Billed charges for outpatient setting,"$5,909.49 ",85% of Billed charges for outpatient setting,"$5,164.20 ",74.28% of Billed charges for outpatient setting,"$5,164.20 ",74.28% of Billed charges for outpatient setting,"$4,240.93 ",61% of Billed charges for outpatient setting,"$5,164.20 ",74.28% of Billed charges for outpatient setting,"$6,257.11 ",90% of Billed charges for outpatient setting,"$6,257.11 ",90% of Billed charges for outpatient setting,"$3,651.37 ",52.52% of charges,"$6,062.44 ",87.2% of Billed charges for outpatient setting,"$4,240.93 ",61% of Billed charges for outpatient setting,"$6,062.44 ",87.2% of Billed charges for outpatient setting,"$3,615.22 ",52% of charges,"$5,651.56 ",81.29% of Billed charges for outpatient setting,"$6,257.11 ",90% of Billed charges for outpatient setting,"$6,257.11 ",90% of Billed charges for outpatient setting,"$4,240.93 ",61% of Billed charges for outpatient setting,"$4,240.93 ",61% of Billed charges for outpatient setting,"$6,257.11 ",90% of Billed charges for outpatient setting,"$6,257.11 ",90% of Billed charges for outpatient setting,"$4,240.93 ",61% of Billed charges for outpatient setting,"$4,240.93 ",61% of Billed charges for outpatient setting,"$4,240.93 ",61% of Billed charges for outpatient setting,"$3,615.22 ",52% of charges,"$3,615.22 ",52% of charges,"$3,615.22 ",52% of charges,"$3,615.22 ",52% of charges,"$3,615.22 ",52% of charges,"$3,615.22 ",52% of charges,3615.2168,6257.11,"$5,561.87 "
Outpatient Medical Services,surgical services,62360,Insertion Or Replacement Of  Spinal Reservoir,360,"$17,942.80 ","$15,251.38 ",85% of Billed charges for outpatient setting,"$15,251.38 ",85% of Billed charges for outpatient setting,"$13,327.91 ",74.28% of Billed charges for outpatient setting,"$13,327.91 ",74.28% of Billed charges for outpatient setting,"$10,945.11 ",61% of Billed charges for outpatient setting,"$13,327.91 ",74.28% of Billed charges for outpatient setting,"$16,148.52 ",90% of Billed charges for outpatient setting,"$16,148.52 ",90% of Billed charges for outpatient setting,"$9,423.56 ",52.52% of charges,"$15,646.12 ",87.2% of Billed charges for outpatient setting,"$10,945.11 ",61% of Billed charges for outpatient setting,"$15,646.12 ",87.2% of Billed charges for outpatient setting,"$9,330.26 ",52% of charges,"$14,585.70 ",81.29% of Billed charges for outpatient setting,"$16,148.52 ",90% of Billed charges for outpatient setting,"$16,148.52 ",90% of Billed charges for outpatient setting,"$10,945.11 ",61% of Billed charges for outpatient setting,"$10,945.11 ",61% of Billed charges for outpatient setting,"$16,148.52 ",90% of Billed charges for outpatient setting,"$16,148.52 ",90% of Billed charges for outpatient setting,"$10,945.11 ",61% of Billed charges for outpatient setting,"$10,945.11 ",61% of Billed charges for outpatient setting,"$10,945.11 ",61% of Billed charges for outpatient setting,"$9,330.26 ",52% of charges,"$9,330.26 ",52% of charges,"$9,330.26 ",52% of charges,"$9,330.26 ",52% of charges,"$9,330.26 ",52% of charges,"$9,330.26 ",52% of charges,9330.256,16148.52,"$14,354.24 "
Outpatient Medical Services,surgical services,62362,Implantation Or Replacement Of Spinal Pump With Or Without Programming,360,"$24,273.10 ","$20,632.14 ",85% of Billed charges for outpatient setting,"$20,632.14 ",85% of Billed charges for outpatient setting,"$18,030.06 ",74.28% of Billed charges for outpatient setting,"$18,030.06 ",74.28% of Billed charges for outpatient setting,"$14,806.59 ",61% of Billed charges for outpatient setting,"$18,030.06 ",74.28% of Billed charges for outpatient setting,"$21,845.79 ",90% of Billed charges for outpatient setting,"$21,845.79 ",90% of Billed charges for outpatient setting,"$12,748.23 ",52.52% of charges,"$21,166.14 ",87.2% of Billed charges for outpatient setting,"$14,806.59 ",61% of Billed charges for outpatient setting,"$21,166.14 ",87.2% of Billed charges for outpatient setting,"$12,622.01 ",52% of charges,"$19,731.60 ",81.29% of Billed charges for outpatient setting,"$21,845.79 ",90% of Billed charges for outpatient setting,"$21,845.79 ",90% of Billed charges for outpatient setting,"$14,806.59 ",61% of Billed charges for outpatient setting,"$14,806.59 ",61% of Billed charges for outpatient setting,"$21,845.79 ",90% of Billed charges for outpatient setting,"$21,845.79 ",90% of Billed charges for outpatient setting,"$14,806.59 ",61% of Billed charges for outpatient setting,"$14,806.59 ",61% of Billed charges for outpatient setting,"$14,806.59 ",61% of Billed charges for outpatient setting,"$12,622.01 ",52% of charges,"$12,622.01 ",52% of charges,"$12,622.01 ",52% of charges,"$12,622.01 ",52% of charges,"$12,622.01 ",52% of charges,"$12,622.01 ",52% of charges,12622.012,21845.79,"$19,418.48 "
Outpatient Medical Services,surgical services,62365,Removal Of Pump Or Reservoir Intrathecal Or Epidural Infusion,360,"$7,747.51 ","$6,585.38 ",85% of Billed charges for outpatient setting,"$6,585.38 ",85% of Billed charges for outpatient setting,"$5,754.85 ",74.28% of Billed charges for outpatient setting,"$5,754.85 ",74.28% of Billed charges for outpatient setting,"$4,725.98 ",61% of Billed charges for outpatient setting,"$5,754.85 ",74.28% of Billed charges for outpatient setting,"$6,972.76 ",90% of Billed charges for outpatient setting,"$6,972.76 ",90% of Billed charges for outpatient setting,"$4,068.99 ",52.52% of charges,"$6,755.83 ",87.2% of Billed charges for outpatient setting,"$4,725.98 ",61% of Billed charges for outpatient setting,"$6,755.83 ",87.2% of Billed charges for outpatient setting,"$4,028.71 ",52% of charges,"$6,297.95 ",81.29% of Billed charges for outpatient setting,"$6,972.76 ",90% of Billed charges for outpatient setting,"$6,972.76 ",90% of Billed charges for outpatient setting,"$4,725.98 ",61% of Billed charges for outpatient setting,"$4,725.98 ",61% of Billed charges for outpatient setting,"$6,972.76 ",90% of Billed charges for outpatient setting,"$6,972.76 ",90% of Billed charges for outpatient setting,"$4,725.98 ",61% of Billed charges for outpatient setting,"$4,725.98 ",61% of Billed charges for outpatient setting,"$4,725.98 ",61% of Billed charges for outpatient setting,"$4,028.71 ",52% of charges,"$4,028.71 ",52% of charges,"$4,028.71 ",52% of charges,"$4,028.71 ",52% of charges,"$4,028.71 ",52% of charges,"$4,028.71 ",52% of charges,4028.7052,6972.76,"$6,198.01 "
Outpatient Medical Services,surgical services,63650,"Percut Implant Neuroelect, Epidural",360,"$59,902.45 ","$50,917.08 ",85% of Billed charges for outpatient setting,"$50,917.08 ",85% of Billed charges for outpatient setting,"$44,495.54 ",74.28% of Billed charges for outpatient setting,"$44,495.54 ",74.28% of Billed charges for outpatient setting,"$36,540.49 ",61% of Billed charges for outpatient setting,"$44,495.54 ",74.28% of Billed charges for outpatient setting,"$53,912.21 ",90% of Billed charges for outpatient setting,"$53,912.21 ",90% of Billed charges for outpatient setting,"$31,460.77 ",52.52% of charges,"$52,234.94 ",87.2% of Billed charges for outpatient setting,"$36,540.49 ",61% of Billed charges for outpatient setting,"$52,234.94 ",87.2% of Billed charges for outpatient setting,"$31,149.27 ",52% of charges,"$48,694.70 ",81.29% of Billed charges for outpatient setting,"$53,912.21 ",90% of Billed charges for outpatient setting,"$53,912.21 ",90% of Billed charges for outpatient setting,"$36,540.49 ",61% of Billed charges for outpatient setting,"$36,540.49 ",61% of Billed charges for outpatient setting,"$53,912.21 ",90% of Billed charges for outpatient setting,"$53,912.21 ",90% of Billed charges for outpatient setting,"$36,540.49 ",61% of Billed charges for outpatient setting,"$36,540.49 ",61% of Billed charges for outpatient setting,"$36,540.49 ",61% of Billed charges for outpatient setting,"$31,149.27 ",52% of charges,"$31,149.27 ",52% of charges,"$31,149.27 ",52% of charges,"$31,149.27 ",52% of charges,"$31,149.27 ",52% of charges,"$31,149.27 ",52% of charges,31149.274,53912.21,"$47,921.96 "
Outpatient Medical Services,surgical services,63661,"Removal Of Spinal Neurostimulator Electrode, Includes Fluoroscopy",360,"$11,150.88 ","$9,478.25 ",85% of Billed charges for outpatient setting,"$9,478.25 ",85% of Billed charges for outpatient setting,"$8,282.87 ",74.28% of Billed charges for outpatient setting,"$8,282.87 ",74.28% of Billed charges for outpatient setting,"$6,802.04 ",61% of Billed charges for outpatient setting,"$8,282.87 ",74.28% of Billed charges for outpatient setting,"$10,035.79 ",90% of Billed charges for outpatient setting,"$10,035.79 ",90% of Billed charges for outpatient setting,"$5,856.44 ",52.52% of charges,"$9,723.57 ",87.2% of Billed charges for outpatient setting,"$6,802.04 ",61% of Billed charges for outpatient setting,"$9,723.57 ",87.2% of Billed charges for outpatient setting,"$5,798.46 ",52% of charges,"$9,064.55 ",81.29% of Billed charges for outpatient setting,"$10,035.79 ",90% of Billed charges for outpatient setting,"$10,035.79 ",90% of Billed charges for outpatient setting,"$6,802.04 ",61% of Billed charges for outpatient setting,"$6,802.04 ",61% of Billed charges for outpatient setting,"$10,035.79 ",90% of Billed charges for outpatient setting,"$10,035.79 ",90% of Billed charges for outpatient setting,"$6,802.04 ",61% of Billed charges for outpatient setting,"$6,802.04 ",61% of Billed charges for outpatient setting,"$6,802.04 ",61% of Billed charges for outpatient setting,"$5,798.46 ",52% of charges,"$5,798.46 ",52% of charges,"$5,798.46 ",52% of charges,"$5,798.46 ",52% of charges,"$5,798.46 ",52% of charges,"$5,798.46 ",52% of charges,5798.4576,10035.79,"$8,920.70 "
Outpatient Medical Services,surgical services,63663,"Revision Of Spinal Neurostimulator Electrode, Including Fluoroscopy",360,"$65,210.87 ","$55,429.24 ",85% of Billed charges for outpatient setting,"$55,429.24 ",85% of Billed charges for outpatient setting,"$48,438.63 ",74.28% of Billed charges for outpatient setting,"$48,438.63 ",74.28% of Billed charges for outpatient setting,"$39,778.63 ",61% of Billed charges for outpatient setting,"$48,438.63 ",74.28% of Billed charges for outpatient setting,"$58,689.78 ",90% of Billed charges for outpatient setting,"$58,689.78 ",90% of Billed charges for outpatient setting,"$34,248.75 ",52.52% of charges,"$56,863.88 ",87.2% of Billed charges for outpatient setting,"$39,778.63 ",61% of Billed charges for outpatient setting,"$56,863.88 ",87.2% of Billed charges for outpatient setting,"$33,909.65 ",52% of charges,"$53,009.92 ",81.29% of Billed charges for outpatient setting,"$58,689.78 ",90% of Billed charges for outpatient setting,"$58,689.78 ",90% of Billed charges for outpatient setting,"$39,778.63 ",61% of Billed charges for outpatient setting,"$39,778.63 ",61% of Billed charges for outpatient setting,"$58,689.78 ",90% of Billed charges for outpatient setting,"$58,689.78 ",90% of Billed charges for outpatient setting,"$39,778.63 ",61% of Billed charges for outpatient setting,"$39,778.63 ",61% of Billed charges for outpatient setting,"$39,778.63 ",61% of Billed charges for outpatient setting,"$33,909.65 ",52% of charges,"$33,909.65 ",52% of charges,"$33,909.65 ",52% of charges,"$33,909.65 ",52% of charges,"$33,909.65 ",52% of charges,"$33,909.65 ",52% of charges,33909.6524,58689.78,"$52,168.70 "
Outpatient Medical Services,surgical services,63685,Spinal Neurostimulator Generator Or Receiver Insertion Or Replacement,360,"$65,892.69 ","$56,008.79 ",85% of Billed charges for outpatient setting,"$56,008.79 ",85% of Billed charges for outpatient setting,"$48,945.09 ",74.28% of Billed charges for outpatient setting,"$48,945.09 ",74.28% of Billed charges for outpatient setting,"$40,194.54 ",61% of Billed charges for outpatient setting,"$48,945.09 ",74.28% of Billed charges for outpatient setting,"$59,303.42 ",90% of Billed charges for outpatient setting,"$59,303.42 ",90% of Billed charges for outpatient setting,"$34,606.84 ",52.52% of charges,"$57,458.43 ",87.2% of Billed charges for outpatient setting,"$40,194.54 ",61% of Billed charges for outpatient setting,"$57,458.43 ",87.2% of Billed charges for outpatient setting,"$34,264.20 ",52% of charges,"$53,564.17 ",81.29% of Billed charges for outpatient setting,"$59,303.42 ",90% of Billed charges for outpatient setting,"$59,303.42 ",90% of Billed charges for outpatient setting,"$40,194.54 ",61% of Billed charges for outpatient setting,"$40,194.54 ",61% of Billed charges for outpatient setting,"$59,303.42 ",90% of Billed charges for outpatient setting,"$59,303.42 ",90% of Billed charges for outpatient setting,"$40,194.54 ",61% of Billed charges for outpatient setting,"$40,194.54 ",61% of Billed charges for outpatient setting,"$40,194.54 ",61% of Billed charges for outpatient setting,"$34,264.20 ",52% of charges,"$34,264.20 ",52% of charges,"$34,264.20 ",52% of charges,"$34,264.20 ",52% of charges,"$34,264.20 ",52% of charges,"$34,264.20 ",52% of charges,34264.1988,59303.42,"$52,714.15 "
Outpatient Medical Services,surgical services,63688,Spinal Neurostimulator Generator Or Receiver Revision Or Removal,360,"$23,606.02 ","$20,065.12 ",85% of Billed charges for outpatient setting,"$20,065.12 ",85% of Billed charges for outpatient setting,"$17,534.55 ",74.28% of Billed charges for outpatient setting,"$17,534.55 ",74.28% of Billed charges for outpatient setting,"$14,399.67 ",61% of Billed charges for outpatient setting,"$17,534.55 ",74.28% of Billed charges for outpatient setting,"$21,245.42 ",90% of Billed charges for outpatient setting,"$21,245.42 ",90% of Billed charges for outpatient setting,"$12,397.88 ",52.52% of charges,"$20,584.45 ",87.2% of Billed charges for outpatient setting,"$14,399.67 ",61% of Billed charges for outpatient setting,"$20,584.45 ",87.2% of Billed charges for outpatient setting,"$12,275.13 ",52% of charges,"$19,189.33 ",81.29% of Billed charges for outpatient setting,"$21,245.42 ",90% of Billed charges for outpatient setting,"$21,245.42 ",90% of Billed charges for outpatient setting,"$14,399.67 ",61% of Billed charges for outpatient setting,"$14,399.67 ",61% of Billed charges for outpatient setting,"$21,245.42 ",90% of Billed charges for outpatient setting,"$21,245.42 ",90% of Billed charges for outpatient setting,"$14,399.67 ",61% of Billed charges for outpatient setting,"$14,399.67 ",61% of Billed charges for outpatient setting,"$14,399.67 ",61% of Billed charges for outpatient setting,"$12,275.13 ",52% of charges,"$12,275.13 ",52% of charges,"$12,275.13 ",52% of charges,"$12,275.13 ",52% of charges,"$12,275.13 ",52% of charges,"$12,275.13 ",52% of charges,12275.1304,21245.42,"$18,884.82 "
Outpatient Medical Services,surgical services,64415,Sgl Nbi Brachial Plexus,360,"$14,804.36 ","$12,583.71 ",85% of Billed charges for outpatient setting,"$12,583.71 ",85% of Billed charges for outpatient setting,"$10,996.68 ",74.28% of Billed charges for outpatient setting,"$10,996.68 ",74.28% of Billed charges for outpatient setting,"$9,030.66 ",61% of Billed charges for outpatient setting,"$10,996.68 ",74.28% of Billed charges for outpatient setting,"$13,323.92 ",90% of Billed charges for outpatient setting,"$13,323.92 ",90% of Billed charges for outpatient setting,"$7,775.25 ",52.52% of charges,"$12,909.40 ",87.2% of Billed charges for outpatient setting,"$9,030.66 ",61% of Billed charges for outpatient setting,"$12,909.40 ",87.2% of Billed charges for outpatient setting,"$7,698.27 ",52% of charges,"$12,034.46 ",81.29% of Billed charges for outpatient setting,"$13,323.92 ",90% of Billed charges for outpatient setting,"$13,323.92 ",90% of Billed charges for outpatient setting,"$9,030.66 ",61% of Billed charges for outpatient setting,"$9,030.66 ",61% of Billed charges for outpatient setting,"$13,323.92 ",90% of Billed charges for outpatient setting,"$13,323.92 ",90% of Billed charges for outpatient setting,"$9,030.66 ",61% of Billed charges for outpatient setting,"$9,030.66 ",61% of Billed charges for outpatient setting,"$9,030.66 ",61% of Billed charges for outpatient setting,"$7,698.27 ",52% of charges,"$7,698.27 ",52% of charges,"$7,698.27 ",52% of charges,"$7,698.27 ",52% of charges,"$7,698.27 ",52% of charges,"$7,698.27 ",52% of charges,7698.2672,13323.92,"$11,843.49 "
Outpatient Medical Services,surgical services,64483,"Inject Anes/Steroid Foramen Lumbar/Sacral W Img Guide, 1 Level",360,"$2,099.94 ","$1,784.95 ",85% of Billed charges for outpatient setting,"$1,784.95 ",85% of Billed charges for outpatient setting,"$1,559.84 ",74.28% of Billed charges for outpatient setting,"$1,559.84 ",74.28% of Billed charges for outpatient setting,"$1,280.96 ",61% of Billed charges for outpatient setting,"$1,559.84 ",74.28% of Billed charges for outpatient setting,"$1,889.95 ",90% of Billed charges for outpatient setting,"$1,889.95 ",90% of Billed charges for outpatient setting,"$1,102.89 ",52.52% of charges,"$1,831.15 ",87.2% of Billed charges for outpatient setting,"$1,280.96 ",61% of Billed charges for outpatient setting,"$1,831.15 ",87.2% of Billed charges for outpatient setting,"$1,091.97 ",52% of charges,"$1,707.04 ",81.29% of Billed charges for outpatient setting,"$1,889.95 ",90% of Billed charges for outpatient setting,"$1,889.95 ",90% of Billed charges for outpatient setting,"$1,280.96 ",61% of Billed charges for outpatient setting,"$1,280.96 ",61% of Billed charges for outpatient setting,"$1,889.95 ",90% of Billed charges for outpatient setting,"$1,889.95 ",90% of Billed charges for outpatient setting,"$1,280.96 ",61% of Billed charges for outpatient setting,"$1,280.96 ",61% of Billed charges for outpatient setting,"$1,280.96 ",61% of Billed charges for outpatient setting,"$1,091.97 ",52% of charges,"$1,091.97 ",52% of charges,"$1,091.97 ",52% of charges,"$1,091.97 ",52% of charges,"$1,091.97 ",52% of charges,"$1,091.97 ",52% of charges,1091.9688,1889.95,"$1,679.95 "
Outpatient Medical Services,surgical services,64633,Dstr Nrolytc Agnt Parverteb Fct Sngl Crvcl/Thora,360,"$3,877.19 ","$3,295.61 ",85% of Billed charges for outpatient setting,"$3,295.61 ",85% of Billed charges for outpatient setting,"$2,879.98 ",74.28% of Billed charges for outpatient setting,"$2,879.98 ",74.28% of Billed charges for outpatient setting,"$2,365.09 ",61% of Billed charges for outpatient setting,"$2,879.98 ",74.28% of Billed charges for outpatient setting,"$3,489.47 ",90% of Billed charges for outpatient setting,"$3,489.47 ",90% of Billed charges for outpatient setting,"$2,036.30 ",52.52% of charges,"$3,380.91 ",87.2% of Billed charges for outpatient setting,"$2,365.09 ",61% of Billed charges for outpatient setting,"$3,380.91 ",87.2% of Billed charges for outpatient setting,"$2,016.14 ",52% of charges,"$3,151.77 ",81.29% of Billed charges for outpatient setting,"$3,489.47 ",90% of Billed charges for outpatient setting,"$3,489.47 ",90% of Billed charges for outpatient setting,"$2,365.09 ",61% of Billed charges for outpatient setting,"$2,365.09 ",61% of Billed charges for outpatient setting,"$3,489.47 ",90% of Billed charges for outpatient setting,"$3,489.47 ",90% of Billed charges for outpatient setting,"$2,365.09 ",61% of Billed charges for outpatient setting,"$2,365.09 ",61% of Billed charges for outpatient setting,"$2,365.09 ",61% of Billed charges for outpatient setting,"$2,016.14 ",52% of charges,"$2,016.14 ",52% of charges,"$2,016.14 ",52% of charges,"$2,016.14 ",52% of charges,"$2,016.14 ",52% of charges,"$2,016.14 ",52% of charges,2016.1388,3489.47,"$3,101.75 "
Outpatient Medical Services,surgical services,64634,Dstr Nrolytc Agnt Parverteb Fct Addl Crvcl/Thora,360,"$3,877.19 ","$3,295.61 ",85% of Billed charges for outpatient setting,"$3,295.61 ",85% of Billed charges for outpatient setting,"$2,879.98 ",74.28% of Billed charges for outpatient setting,"$2,879.98 ",74.28% of Billed charges for outpatient setting,"$2,365.09 ",61% of Billed charges for outpatient setting,"$2,879.98 ",74.28% of Billed charges for outpatient setting,"$3,489.47 ",90% of Billed charges for outpatient setting,"$3,489.47 ",90% of Billed charges for outpatient setting,"$2,036.30 ",52.52% of charges,"$3,380.91 ",87.2% of Billed charges for outpatient setting,"$2,365.09 ",61% of Billed charges for outpatient setting,"$3,380.91 ",87.2% of Billed charges for outpatient setting,"$2,016.14 ",52% of charges,"$3,151.77 ",81.29% of Billed charges for outpatient setting,"$3,489.47 ",90% of Billed charges for outpatient setting,"$3,489.47 ",90% of Billed charges for outpatient setting,"$2,365.09 ",61% of Billed charges for outpatient setting,"$2,365.09 ",61% of Billed charges for outpatient setting,"$3,489.47 ",90% of Billed charges for outpatient setting,"$3,489.47 ",90% of Billed charges for outpatient setting,"$2,365.09 ",61% of Billed charges for outpatient setting,"$2,365.09 ",61% of Billed charges for outpatient setting,"$2,365.09 ",61% of Billed charges for outpatient setting,"$2,016.14 ",52% of charges,"$2,016.14 ",52% of charges,"$2,016.14 ",52% of charges,"$2,016.14 ",52% of charges,"$2,016.14 ",52% of charges,"$2,016.14 ",52% of charges,2016.1388,3489.47,"$3,101.75 "
Outpatient Medical Services,surgical services,64636,Dstr Nrolytc Agnt Parverteb Fct Addl Lmbr/Sacral,360,"$4,228.32 ","$3,594.07 ",85% of Billed charges for outpatient setting,"$3,594.07 ",85% of Billed charges for outpatient setting,"$3,140.80 ",74.28% of Billed charges for outpatient setting,"$3,140.80 ",74.28% of Billed charges for outpatient setting,"$2,579.28 ",61% of Billed charges for outpatient setting,"$3,140.80 ",74.28% of Billed charges for outpatient setting,"$3,805.49 ",90% of Billed charges for outpatient setting,"$3,805.49 ",90% of Billed charges for outpatient setting,"$2,220.71 ",52.52% of charges,"$3,687.10 ",87.2% of Billed charges for outpatient setting,"$2,579.28 ",61% of Billed charges for outpatient setting,"$3,687.10 ",87.2% of Billed charges for outpatient setting,"$2,198.73 ",52% of charges,"$3,437.20 ",81.29% of Billed charges for outpatient setting,"$3,805.49 ",90% of Billed charges for outpatient setting,"$3,805.49 ",90% of Billed charges for outpatient setting,"$2,579.28 ",61% of Billed charges for outpatient setting,"$2,579.28 ",61% of Billed charges for outpatient setting,"$3,805.49 ",90% of Billed charges for outpatient setting,"$3,805.49 ",90% of Billed charges for outpatient setting,"$2,579.28 ",61% of Billed charges for outpatient setting,"$2,579.28 ",61% of Billed charges for outpatient setting,"$2,579.28 ",61% of Billed charges for outpatient setting,"$2,198.73 ",52% of charges,"$2,198.73 ",52% of charges,"$2,198.73 ",52% of charges,"$2,198.73 ",52% of charges,"$2,198.73 ",52% of charges,"$2,198.73 ",52% of charges,2198.7264,3805.49,"$3,382.66 "
Outpatient Medical Services,surgical services,64721,Neuroplasty; Median Nerve At Carp Tunnel,360,"$4,239.52 ","$3,603.59 ",85% of Billed charges for outpatient setting,"$3,603.59 ",85% of Billed charges for outpatient setting,"$3,149.12 ",74.28% of Billed charges for outpatient setting,"$3,149.12 ",74.28% of Billed charges for outpatient setting,"$2,586.11 ",61% of Billed charges for outpatient setting,"$3,149.12 ",74.28% of Billed charges for outpatient setting,"$3,815.57 ",90% of Billed charges for outpatient setting,"$3,815.57 ",90% of Billed charges for outpatient setting,"$2,226.60 ",52.52% of charges,"$3,696.86 ",87.2% of Billed charges for outpatient setting,"$2,586.11 ",61% of Billed charges for outpatient setting,"$3,696.86 ",87.2% of Billed charges for outpatient setting,"$2,204.55 ",52% of charges,"$3,446.31 ",81.29% of Billed charges for outpatient setting,"$3,815.57 ",90% of Billed charges for outpatient setting,"$3,815.57 ",90% of Billed charges for outpatient setting,"$2,586.11 ",61% of Billed charges for outpatient setting,"$2,586.11 ",61% of Billed charges for outpatient setting,"$3,815.57 ",90% of Billed charges for outpatient setting,"$3,815.57 ",90% of Billed charges for outpatient setting,"$2,586.11 ",61% of Billed charges for outpatient setting,"$2,586.11 ",61% of Billed charges for outpatient setting,"$2,586.11 ",61% of Billed charges for outpatient setting,"$2,204.55 ",52% of charges,"$2,204.55 ",52% of charges,"$2,204.55 ",52% of charges,"$2,204.55 ",52% of charges,"$2,204.55 ",52% of charges,"$2,204.55 ",52% of charges,2204.5504,3815.57,"$3,391.62 "
Outpatient Medical Services,surgical services,66984,Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis,360,"$6,156.33 ","$5,232.88 ",85% of Billed charges for outpatient setting,"$5,232.88 ",85% of Billed charges for outpatient setting,"$4,572.92 ",74.28% of Billed charges for outpatient setting,"$4,572.92 ",74.28% of Billed charges for outpatient setting,"$3,755.36 ",61% of Billed charges for outpatient setting,"$4,572.92 ",74.28% of Billed charges for outpatient setting,"$5,540.70 ",90% of Billed charges for outpatient setting,"$5,540.70 ",90% of Billed charges for outpatient setting,"$3,233.30 ",52.52% of charges,"$5,368.32 ",87.2% of Billed charges for outpatient setting,"$3,755.36 ",61% of Billed charges for outpatient setting,"$5,368.32 ",87.2% of Billed charges for outpatient setting,"$3,201.29 ",52% of charges,"$5,004.48 ",81.29% of Billed charges for outpatient setting,"$5,540.70 ",90% of Billed charges for outpatient setting,"$5,540.70 ",90% of Billed charges for outpatient setting,"$3,755.36 ",61% of Billed charges for outpatient setting,"$3,755.36 ",61% of Billed charges for outpatient setting,"$5,540.70 ",90% of Billed charges for outpatient setting,"$5,540.70 ",90% of Billed charges for outpatient setting,"$3,755.36 ",61% of Billed charges for outpatient setting,"$3,755.36 ",61% of Billed charges for outpatient setting,"$3,755.36 ",61% of Billed charges for outpatient setting,"$3,201.29 ",52% of charges,"$3,201.29 ",52% of charges,"$3,201.29 ",52% of charges,"$3,201.29 ",52% of charges,"$3,201.29 ",52% of charges,"$3,201.29 ",52% of charges,3201.2916,5540.7,"$4,925.06 "
Outpatient Medical Services,surgical services,Not Applic,Hip And Knee Replacement Or Reattachment,360,"$27,547.03 ","$23,414.98 ",85% of Billed charges for outpatient setting,"$23,414.98 ",85% of Billed charges for outpatient setting,"$20,461.93 ",74.28% of Billed charges for outpatient setting,"$20,461.93 ",74.28% of Billed charges for outpatient setting,"$16,803.69 ",61% of Billed charges for outpatient setting,"$20,461.93 ",74.28% of Billed charges for outpatient setting,"$24,792.33 ",90% of Billed charges for outpatient setting,"$24,792.33 ",90% of Billed charges for outpatient setting,"$14,467.70 ",52.52% of charges,"$24,021.01 ",87.2% of Billed charges for outpatient setting,"$16,803.69 ",61% of Billed charges for outpatient setting,"$24,021.01 ",87.2% of Billed charges for outpatient setting,"$14,324.46 ",52% of charges,"$22,392.98 ",81.29% of Billed charges for outpatient setting,"$24,792.33 ",90% of Billed charges for outpatient setting,"$24,792.33 ",90% of Billed charges for outpatient setting,"$16,803.69 ",61% of Billed charges for outpatient setting,"$16,803.69 ",61% of Billed charges for outpatient setting,"$24,792.33 ",90% of Billed charges for outpatient setting,"$24,792.33 ",90% of Billed charges for outpatient setting,"$16,803.69 ",61% of Billed charges for outpatient setting,"$16,803.69 ",61% of Billed charges for outpatient setting,"$16,803.69 ",61% of Billed charges for outpatient setting,"$14,324.46 ",52% of charges,"$14,324.46 ",52% of charges,"$14,324.46 ",52% of charges,"$14,324.46 ",52% of charges,"$14,324.46 ",52% of charges,"$14,324.46 ",52% of charges,14324.4556,24792.33,"$22,037.62 "
Outpatient Medical Services,speciliaty clinic,51798,Ultrasound Pv Residual Urine,920,$157.64 ,$133.99 ,85% of Billed charges for outpatient setting,$133.99 ,85% of Billed charges for outpatient setting,$117.09 ,74.28% of Billed charges for outpatient setting,$117.09 ,74.28% of Billed charges for outpatient setting,$96.16 ,61% of Billed charges for outpatient setting,$117.09 ,74.28% of Billed charges for outpatient setting,$141.88 ,90% of Billed charges for outpatient setting,$141.88 ,90% of Billed charges for outpatient setting,$82.79 ,52.52% of charges,$137.46 ,87.2% of Billed charges for outpatient setting,$96.16 ,61% of Billed charges for outpatient setting,$137.46 ,87.2% of Billed charges for outpatient setting,$81.97 ,52% of charges,$128.15 ,81.29% of Billed charges for outpatient setting,$141.88 ,90% of Billed charges for outpatient setting,$141.88 ,90% of Billed charges for outpatient setting,$96.16 ,61% of Billed charges for outpatient setting,$96.16 ,61% of Billed charges for outpatient setting,$141.88 ,90% of Billed charges for outpatient setting,$141.88 ,90% of Billed charges for outpatient setting,$96.16 ,61% of Billed charges for outpatient setting,$96.16 ,61% of Billed charges for outpatient setting,$96.16 ,61% of Billed charges for outpatient setting,$81.97 ,52% of charges,$81.97 ,52% of charges,$81.97 ,52% of charges,$81.97 ,52% of charges,$81.97 ,52% of charges,$81.97 ,52% of charges,81.9728,141.88,$126.11 
Outpatient Medical Services,speciliaty clinic,52000,Cystoscopy,761,$767.40 ,$652.29 ,85% of Billed charges for outpatient setting,$652.29 ,85% of Billed charges for outpatient setting,$570.02 ,74.28% of Billed charges for outpatient setting,$570.02 ,74.28% of Billed charges for outpatient setting,$468.11 ,61% of Billed charges for outpatient setting,$570.02 ,74.28% of Billed charges for outpatient setting,$690.66 ,90% of Billed charges for outpatient setting,$690.66 ,90% of Billed charges for outpatient setting,$403.04 ,52.52% of charges,$669.17 ,87.2% of Billed charges for outpatient setting,$468.11 ,61% of Billed charges for outpatient setting,$669.17 ,87.2% of Billed charges for outpatient setting,$399.05 ,52% of charges,$623.82 ,81.29% of Billed charges for outpatient setting,$690.66 ,90% of Billed charges for outpatient setting,$690.66 ,90% of Billed charges for outpatient setting,$468.11 ,61% of Billed charges for outpatient setting,$468.11 ,61% of Billed charges for outpatient setting,$690.66 ,90% of Billed charges for outpatient setting,$690.66 ,90% of Billed charges for outpatient setting,$468.11 ,61% of Billed charges for outpatient setting,$468.11 ,61% of Billed charges for outpatient setting,$468.11 ,61% of Billed charges for outpatient setting,$399.05 ,52% of charges,$399.05 ,52% of charges,$399.05 ,52% of charges,$399.05 ,52% of charges,$399.05 ,52% of charges,$399.05 ,52% of charges,399.048,690.66,$613.92 
Outpatient Medical Services,sleeper center,95806,Sleep Study Unatt&Resp Efft,920,$351.84 ,$299.06 ,85% of Billed charges for outpatient setting,$299.06 ,85% of Billed charges for outpatient setting,$261.35 ,74.28% of Billed charges for outpatient setting,$261.35 ,74.28% of Billed charges for outpatient setting,$214.62 ,61% of Billed charges for outpatient setting,$261.35 ,74.28% of Billed charges for outpatient setting,$316.66 ,90% of Billed charges for outpatient setting,$316.66 ,90% of Billed charges for outpatient setting,$184.79 ,52.52% of charges,$306.80 ,87.2% of Billed charges for outpatient setting,$214.62 ,61% of Billed charges for outpatient setting,$306.80 ,87.2% of Billed charges for outpatient setting,$182.96 ,52% of charges,$286.01 ,81.29% of Billed charges for outpatient setting,$316.66 ,90% of Billed charges for outpatient setting,$316.66 ,90% of Billed charges for outpatient setting,$214.62 ,61% of Billed charges for outpatient setting,$214.62 ,61% of Billed charges for outpatient setting,$316.66 ,90% of Billed charges for outpatient setting,$316.66 ,90% of Billed charges for outpatient setting,$214.62 ,61% of Billed charges for outpatient setting,$214.62 ,61% of Billed charges for outpatient setting,$214.62 ,61% of Billed charges for outpatient setting,$182.96 ,52% of charges,$182.96 ,52% of charges,$182.96 ,52% of charges,$182.96 ,52% of charges,$182.96 ,52% of charges,$182.96 ,52% of charges,182.9568,316.66,$281.47 
Outpatient Medical Services,Respiratory,94060,Eval Of Bronchospasm,460,$349.15 ,$296.78 ,85% of Billed charges for outpatient setting,$296.78 ,85% of Billed charges for outpatient setting,$259.35 ,74.28% of Billed charges for outpatient setting,$259.35 ,74.28% of Billed charges for outpatient setting,$212.98 ,61% of Billed charges for outpatient setting,$259.35 ,74.28% of Billed charges for outpatient setting,$314.24 ,90% of Billed charges for outpatient setting,$314.24 ,90% of Billed charges for outpatient setting,$183.37 ,52.52% of charges,$304.46 ,87.2% of Billed charges for outpatient setting,$212.98 ,61% of Billed charges for outpatient setting,$304.46 ,87.2% of Billed charges for outpatient setting,$181.56 ,52% of charges,$283.82 ,81.29% of Billed charges for outpatient setting,$314.24 ,90% of Billed charges for outpatient setting,$314.24 ,90% of Billed charges for outpatient setting,$212.98 ,61% of Billed charges for outpatient setting,$212.98 ,61% of Billed charges for outpatient setting,$314.24 ,90% of Billed charges for outpatient setting,$314.24 ,90% of Billed charges for outpatient setting,$212.98 ,61% of Billed charges for outpatient setting,$212.98 ,61% of Billed charges for outpatient setting,$212.98 ,61% of Billed charges for outpatient setting,$181.56 ,52% of charges,$181.56 ,52% of charges,$181.56 ,52% of charges,$181.56 ,52% of charges,$181.56 ,52% of charges,$181.56 ,52% of charges,181.558,314.24,$279.32 
Outpatient Medical Services,Respiratory,94726,Pulm Function Test,460,$276.51 ,$235.03 ,85% of Billed charges for outpatient setting,$235.03 ,85% of Billed charges for outpatient setting,$205.39 ,74.28% of Billed charges for outpatient setting,$205.39 ,74.28% of Billed charges for outpatient setting,$168.67 ,61% of Billed charges for outpatient setting,$205.39 ,74.28% of Billed charges for outpatient setting,$248.86 ,90% of Billed charges for outpatient setting,$248.86 ,90% of Billed charges for outpatient setting,$145.22 ,52.52% of charges,$241.12 ,87.2% of Billed charges for outpatient setting,$168.67 ,61% of Billed charges for outpatient setting,$241.12 ,87.2% of Billed charges for outpatient setting,$143.79 ,52% of charges,$224.77 ,81.29% of Billed charges for outpatient setting,$248.86 ,90% of Billed charges for outpatient setting,$248.86 ,90% of Billed charges for outpatient setting,$168.67 ,61% of Billed charges for outpatient setting,$168.67 ,61% of Billed charges for outpatient setting,$248.86 ,90% of Billed charges for outpatient setting,$248.86 ,90% of Billed charges for outpatient setting,$168.67 ,61% of Billed charges for outpatient setting,$168.67 ,61% of Billed charges for outpatient setting,$168.67 ,61% of Billed charges for outpatient setting,$143.79 ,52% of charges,$143.79 ,52% of charges,$143.79 ,52% of charges,$143.79 ,52% of charges,$143.79 ,52% of charges,$143.79 ,52% of charges,143.7852,248.86,$221.21 
Outpatient Medical Services,Radiology,19083,Breast 1St Lesion Ultrasound Image,361,$379.34 ,$322.44 ,85% of Billed charges for outpatient setting,$322.44 ,85% of Billed charges for outpatient setting,$281.77 ,74.28% of Billed charges for outpatient setting,$281.77 ,74.28% of Billed charges for outpatient setting,$231.40 ,61% of Billed charges for outpatient setting,$281.77 ,74.28% of Billed charges for outpatient setting,$341.41 ,90% of Billed charges for outpatient setting,$341.41 ,90% of Billed charges for outpatient setting,$199.23 ,52.52% of charges,$330.78 ,87.2% of Billed charges for outpatient setting,$231.40 ,61% of Billed charges for outpatient setting,$330.78 ,87.2% of Billed charges for outpatient setting,$197.26 ,52% of charges,$308.37 ,81.29% of Billed charges for outpatient setting,$341.41 ,90% of Billed charges for outpatient setting,$341.41 ,90% of Billed charges for outpatient setting,$231.40 ,61% of Billed charges for outpatient setting,$231.40 ,61% of Billed charges for outpatient setting,$341.41 ,90% of Billed charges for outpatient setting,$341.41 ,90% of Billed charges for outpatient setting,$231.40 ,61% of Billed charges for outpatient setting,$231.40 ,61% of Billed charges for outpatient setting,$231.40 ,61% of Billed charges for outpatient setting,$197.26 ,52% of charges,$197.26 ,52% of charges,$197.26 ,52% of charges,$197.26 ,52% of charges,$197.26 ,52% of charges,$197.26 ,52% of charges,197.2568,341.41,$303.47 
Outpatient Medical Services,Radiology,20610,Arthrocentesis Aspir&/Inj Major Jt/Bursa W/O Us,361,$540.91 ,$459.77 ,85% of Billed charges for outpatient setting,$459.77 ,85% of Billed charges for outpatient setting,$401.79 ,74.28% of Billed charges for outpatient setting,$401.79 ,74.28% of Billed charges for outpatient setting,$329.96 ,61% of Billed charges for outpatient setting,$401.79 ,74.28% of Billed charges for outpatient setting,$486.82 ,90% of Billed charges for outpatient setting,$486.82 ,90% of Billed charges for outpatient setting,$284.09 ,52.52% of charges,$471.67 ,87.2% of Billed charges for outpatient setting,$329.96 ,61% of Billed charges for outpatient setting,$471.67 ,87.2% of Billed charges for outpatient setting,$281.27 ,52% of charges,$439.71 ,81.29% of Billed charges for outpatient setting,$486.82 ,90% of Billed charges for outpatient setting,$486.82 ,90% of Billed charges for outpatient setting,$329.96 ,61% of Billed charges for outpatient setting,$329.96 ,61% of Billed charges for outpatient setting,$486.82 ,90% of Billed charges for outpatient setting,$486.82 ,90% of Billed charges for outpatient setting,$329.96 ,61% of Billed charges for outpatient setting,$329.96 ,61% of Billed charges for outpatient setting,$329.96 ,61% of Billed charges for outpatient setting,$281.27 ,52% of charges,$281.27 ,52% of charges,$281.27 ,52% of charges,$281.27 ,52% of charges,$281.27 ,52% of charges,$281.27 ,52% of charges,281.2732,486.82,$432.73 
Outpatient Medical Services,Radiology,49083,Abdom Paracentesis Dx/Ther W Imaging Guidance,339,$691.70 ,$587.95 ,85% of Billed charges for outpatient setting,$587.95 ,85% of Billed charges for outpatient setting,$513.79 ,74.28% of Billed charges for outpatient setting,$513.79 ,74.28% of Billed charges for outpatient setting,$421.94 ,61% of Billed charges for outpatient setting,$513.79 ,74.28% of Billed charges for outpatient setting,$622.53 ,90% of Billed charges for outpatient setting,$622.53 ,90% of Billed charges for outpatient setting,$363.28 ,52.52% of charges,$603.16 ,87.2% of Billed charges for outpatient setting,$421.94 ,61% of Billed charges for outpatient setting,$603.16 ,87.2% of Billed charges for outpatient setting,$359.68 ,52% of charges,$562.28 ,81.29% of Billed charges for outpatient setting,$622.53 ,90% of Billed charges for outpatient setting,$622.53 ,90% of Billed charges for outpatient setting,$421.94 ,61% of Billed charges for outpatient setting,$421.94 ,61% of Billed charges for outpatient setting,$622.53 ,90% of Billed charges for outpatient setting,$622.53 ,90% of Billed charges for outpatient setting,$421.94 ,61% of Billed charges for outpatient setting,$421.94 ,61% of Billed charges for outpatient setting,$421.94 ,61% of Billed charges for outpatient setting,$359.68 ,52% of charges,$359.68 ,52% of charges,$359.68 ,52% of charges,$359.68 ,52% of charges,$359.68 ,52% of charges,$359.68 ,52% of charges,359.684,622.53,$553.36 
Outpatient Medical Services,Radiology,55700,"Biopsy Of Prostate, Needle/Punch",361,$281.96 ,$239.67 ,85% of Billed charges for outpatient setting,$239.67 ,85% of Billed charges for outpatient setting,$209.44 ,74.28% of Billed charges for outpatient setting,$209.44 ,74.28% of Billed charges for outpatient setting,$172.00 ,61% of Billed charges for outpatient setting,$209.44 ,74.28% of Billed charges for outpatient setting,$253.76 ,90% of Billed charges for outpatient setting,$253.76 ,90% of Billed charges for outpatient setting,$148.09 ,52.52% of charges,$245.87 ,87.2% of Billed charges for outpatient setting,$172.00 ,61% of Billed charges for outpatient setting,$245.87 ,87.2% of Billed charges for outpatient setting,$146.62 ,52% of charges,$229.21 ,81.29% of Billed charges for outpatient setting,$253.76 ,90% of Billed charges for outpatient setting,$253.76 ,90% of Billed charges for outpatient setting,$172.00 ,61% of Billed charges for outpatient setting,$172.00 ,61% of Billed charges for outpatient setting,$253.76 ,90% of Billed charges for outpatient setting,$253.76 ,90% of Billed charges for outpatient setting,$172.00 ,61% of Billed charges for outpatient setting,$172.00 ,61% of Billed charges for outpatient setting,$172.00 ,61% of Billed charges for outpatient setting,$146.62 ,52% of charges,$146.62 ,52% of charges,$146.62 ,52% of charges,$146.62 ,52% of charges,$146.62 ,52% of charges,$146.62 ,52% of charges,146.6192,253.76,$225.57 
Outpatient Medical Services,Radiology,70030,X-Ray Eye For Foreign Body,320,$238.64 ,$202.84 ,85% of Billed charges for outpatient setting,$202.84 ,85% of Billed charges for outpatient setting,$177.26 ,74.28% of Billed charges for outpatient setting,$177.26 ,74.28% of Billed charges for outpatient setting,$145.57 ,61% of Billed charges for outpatient setting,$177.26 ,74.28% of Billed charges for outpatient setting,$214.78 ,90% of Billed charges for outpatient setting,$214.78 ,90% of Billed charges for outpatient setting,$125.33 ,52.52% of charges,$208.09 ,87.2% of Billed charges for outpatient setting,$145.57 ,61% of Billed charges for outpatient setting,$208.09 ,87.2% of Billed charges for outpatient setting,$124.09 ,52% of charges,$193.99 ,81.29% of Billed charges for outpatient setting,$214.78 ,90% of Billed charges for outpatient setting,$214.78 ,90% of Billed charges for outpatient setting,$145.57 ,61% of Billed charges for outpatient setting,$145.57 ,61% of Billed charges for outpatient setting,$214.78 ,90% of Billed charges for outpatient setting,$214.78 ,90% of Billed charges for outpatient setting,$145.57 ,61% of Billed charges for outpatient setting,$145.57 ,61% of Billed charges for outpatient setting,$145.57 ,61% of Billed charges for outpatient setting,$124.09 ,52% of charges,$124.09 ,52% of charges,$124.09 ,52% of charges,$124.09 ,52% of charges,$124.09 ,52% of charges,$124.09 ,52% of charges,124.0928,214.78,$190.91 
Outpatient Medical Services,Radiology,70110,X-Ray Exam Of Jaw 4+ Views,320,$286.74 ,$243.73 ,85% of Billed charges for outpatient setting,$243.73 ,85% of Billed charges for outpatient setting,$212.99 ,74.28% of Billed charges for outpatient setting,$212.99 ,74.28% of Billed charges for outpatient setting,$174.91 ,61% of Billed charges for outpatient setting,$212.99 ,74.28% of Billed charges for outpatient setting,$258.07 ,90% of Billed charges for outpatient setting,$258.07 ,90% of Billed charges for outpatient setting,$150.60 ,52.52% of charges,$250.04 ,87.2% of Billed charges for outpatient setting,$174.91 ,61% of Billed charges for outpatient setting,$250.04 ,87.2% of Billed charges for outpatient setting,$149.10 ,52% of charges,$233.09 ,81.29% of Billed charges for outpatient setting,$258.07 ,90% of Billed charges for outpatient setting,$258.07 ,90% of Billed charges for outpatient setting,$174.91 ,61% of Billed charges for outpatient setting,$174.91 ,61% of Billed charges for outpatient setting,$258.07 ,90% of Billed charges for outpatient setting,$258.07 ,90% of Billed charges for outpatient setting,$174.91 ,61% of Billed charges for outpatient setting,$174.91 ,61% of Billed charges for outpatient setting,$174.91 ,61% of Billed charges for outpatient setting,$149.10 ,52% of charges,$149.10 ,52% of charges,$149.10 ,52% of charges,$149.10 ,52% of charges,$149.10 ,52% of charges,$149.10 ,52% of charges,149.1048,258.07,$229.39 
Outpatient Medical Services,Radiology,70150,X-Ray Exam Of Facial Bones 3+ Views,320,$286.74 ,$243.73 ,85% of Billed charges for outpatient setting,$243.73 ,85% of Billed charges for outpatient setting,$212.99 ,74.28% of Billed charges for outpatient setting,$212.99 ,74.28% of Billed charges for outpatient setting,$174.91 ,61% of Billed charges for outpatient setting,$212.99 ,74.28% of Billed charges for outpatient setting,$258.07 ,90% of Billed charges for outpatient setting,$258.07 ,90% of Billed charges for outpatient setting,$150.60 ,52.52% of charges,$250.04 ,87.2% of Billed charges for outpatient setting,$174.91 ,61% of Billed charges for outpatient setting,$250.04 ,87.2% of Billed charges for outpatient setting,$149.10 ,52% of charges,$233.09 ,81.29% of Billed charges for outpatient setting,$258.07 ,90% of Billed charges for outpatient setting,$258.07 ,90% of Billed charges for outpatient setting,$174.91 ,61% of Billed charges for outpatient setting,$174.91 ,61% of Billed charges for outpatient setting,$258.07 ,90% of Billed charges for outpatient setting,$258.07 ,90% of Billed charges for outpatient setting,$174.91 ,61% of Billed charges for outpatient setting,$174.91 ,61% of Billed charges for outpatient setting,$174.91 ,61% of Billed charges for outpatient setting,$149.10 ,52% of charges,$149.10 ,52% of charges,$149.10 ,52% of charges,$149.10 ,52% of charges,$149.10 ,52% of charges,$149.10 ,52% of charges,149.1048,258.07,$229.39 
Outpatient Medical Services,Radiology,70160,X-Ray Exam Of Nasal Bones 3+ Views,320,$157.00 ,$133.45 ,85% of Billed charges for outpatient setting,$133.45 ,85% of Billed charges for outpatient setting,$116.62 ,74.28% of Billed charges for outpatient setting,$116.62 ,74.28% of Billed charges for outpatient setting,$95.77 ,61% of Billed charges for outpatient setting,$116.62 ,74.28% of Billed charges for outpatient setting,$141.30 ,90% of Billed charges for outpatient setting,$141.30 ,90% of Billed charges for outpatient setting,$82.46 ,52.52% of charges,$136.90 ,87.2% of Billed charges for outpatient setting,$95.77 ,61% of Billed charges for outpatient setting,$136.90 ,87.2% of Billed charges for outpatient setting,$81.64 ,52% of charges,$127.63 ,81.29% of Billed charges for outpatient setting,$141.30 ,90% of Billed charges for outpatient setting,$141.30 ,90% of Billed charges for outpatient setting,$95.77 ,61% of Billed charges for outpatient setting,$95.77 ,61% of Billed charges for outpatient setting,$141.30 ,90% of Billed charges for outpatient setting,$141.30 ,90% of Billed charges for outpatient setting,$95.77 ,61% of Billed charges for outpatient setting,$95.77 ,61% of Billed charges for outpatient setting,$95.77 ,61% of Billed charges for outpatient setting,$81.64 ,52% of charges,$81.64 ,52% of charges,$81.64 ,52% of charges,$81.64 ,52% of charges,$81.64 ,52% of charges,$81.64 ,52% of charges,81.64,141.3,$125.60 
Outpatient Medical Services,Radiology,70200,X-Ray Exam Of Eye Sockets 4+ Views,320,$286.74 ,$243.73 ,85% of Billed charges for outpatient setting,$243.73 ,85% of Billed charges for outpatient setting,$212.99 ,74.28% of Billed charges for outpatient setting,$212.99 ,74.28% of Billed charges for outpatient setting,$174.91 ,61% of Billed charges for outpatient setting,$212.99 ,74.28% of Billed charges for outpatient setting,$258.07 ,90% of Billed charges for outpatient setting,$258.07 ,90% of Billed charges for outpatient setting,$150.60 ,52.52% of charges,$250.04 ,87.2% of Billed charges for outpatient setting,$174.91 ,61% of Billed charges for outpatient setting,$250.04 ,87.2% of Billed charges for outpatient setting,$149.10 ,52% of charges,$233.09 ,81.29% of Billed charges for outpatient setting,$258.07 ,90% of Billed charges for outpatient setting,$258.07 ,90% of Billed charges for outpatient setting,$174.91 ,61% of Billed charges for outpatient setting,$174.91 ,61% of Billed charges for outpatient setting,$258.07 ,90% of Billed charges for outpatient setting,$258.07 ,90% of Billed charges for outpatient setting,$174.91 ,61% of Billed charges for outpatient setting,$174.91 ,61% of Billed charges for outpatient setting,$174.91 ,61% of Billed charges for outpatient setting,$149.10 ,52% of charges,$149.10 ,52% of charges,$149.10 ,52% of charges,$149.10 ,52% of charges,$149.10 ,52% of charges,$149.10 ,52% of charges,149.1048,258.07,$229.39 
Outpatient Medical Services,Radiology,70220,X-Ray Exam Of Sinuses 3+ Views,320,$286.74 ,$243.73 ,85% of Billed charges for outpatient setting,$243.73 ,85% of Billed charges for outpatient setting,$212.99 ,74.28% of Billed charges for outpatient setting,$212.99 ,74.28% of Billed charges for outpatient setting,$174.91 ,61% of Billed charges for outpatient setting,$212.99 ,74.28% of Billed charges for outpatient setting,$258.07 ,90% of Billed charges for outpatient setting,$258.07 ,90% of Billed charges for outpatient setting,$150.60 ,52.52% of charges,$250.04 ,87.2% of Billed charges for outpatient setting,$174.91 ,61% of Billed charges for outpatient setting,$250.04 ,87.2% of Billed charges for outpatient setting,$149.10 ,52% of charges,$233.09 ,81.29% of Billed charges for outpatient setting,$258.07 ,90% of Billed charges for outpatient setting,$258.07 ,90% of Billed charges for outpatient setting,$174.91 ,61% of Billed charges for outpatient setting,$174.91 ,61% of Billed charges for outpatient setting,$258.07 ,90% of Billed charges for outpatient setting,$258.07 ,90% of Billed charges for outpatient setting,$174.91 ,61% of Billed charges for outpatient setting,$174.91 ,61% of Billed charges for outpatient setting,$174.91 ,61% of Billed charges for outpatient setting,$149.10 ,52% of charges,$149.10 ,52% of charges,$149.10 ,52% of charges,$149.10 ,52% of charges,$149.10 ,52% of charges,$149.10 ,52% of charges,149.1048,258.07,$229.39 
Outpatient Medical Services,Radiology,70250,X-Ray Exam Of Skull <4 Views,320,$206.87 ,$175.84 ,85% of Billed charges for outpatient setting,$175.84 ,85% of Billed charges for outpatient setting,$153.66 ,74.28% of Billed charges for outpatient setting,$153.66 ,74.28% of Billed charges for outpatient setting,$126.19 ,61% of Billed charges for outpatient setting,$153.66 ,74.28% of Billed charges for outpatient setting,$186.18 ,90% of Billed charges for outpatient setting,$186.18 ,90% of Billed charges for outpatient setting,$108.65 ,52.52% of charges,$180.39 ,87.2% of Billed charges for outpatient setting,$126.19 ,61% of Billed charges for outpatient setting,$180.39 ,87.2% of Billed charges for outpatient setting,$107.57 ,52% of charges,$168.16 ,81.29% of Billed charges for outpatient setting,$186.18 ,90% of Billed charges for outpatient setting,$186.18 ,90% of Billed charges for outpatient setting,$126.19 ,61% of Billed charges for outpatient setting,$126.19 ,61% of Billed charges for outpatient setting,$186.18 ,90% of Billed charges for outpatient setting,$186.18 ,90% of Billed charges for outpatient setting,$126.19 ,61% of Billed charges for outpatient setting,$126.19 ,61% of Billed charges for outpatient setting,$126.19 ,61% of Billed charges for outpatient setting,$107.57 ,52% of charges,$107.57 ,52% of charges,$107.57 ,52% of charges,$107.57 ,52% of charges,$107.57 ,52% of charges,$107.57 ,52% of charges,107.5724,186.18,$165.50 
Outpatient Medical Services,Radiology,70330,X-Ray Tmj Bilat,320,$285.72 ,$242.86 ,85% of Billed charges for outpatient setting,$242.86 ,85% of Billed charges for outpatient setting,$212.23 ,74.28% of Billed charges for outpatient setting,$212.23 ,74.28% of Billed charges for outpatient setting,$174.29 ,61% of Billed charges for outpatient setting,$212.23 ,74.28% of Billed charges for outpatient setting,$257.15 ,90% of Billed charges for outpatient setting,$257.15 ,90% of Billed charges for outpatient setting,$150.06 ,52.52% of charges,$249.15 ,87.2% of Billed charges for outpatient setting,$174.29 ,61% of Billed charges for outpatient setting,$249.15 ,87.2% of Billed charges for outpatient setting,$148.57 ,52% of charges,$232.26 ,81.29% of Billed charges for outpatient setting,$257.15 ,90% of Billed charges for outpatient setting,$257.15 ,90% of Billed charges for outpatient setting,$174.29 ,61% of Billed charges for outpatient setting,$174.29 ,61% of Billed charges for outpatient setting,$257.15 ,90% of Billed charges for outpatient setting,$257.15 ,90% of Billed charges for outpatient setting,$174.29 ,61% of Billed charges for outpatient setting,$174.29 ,61% of Billed charges for outpatient setting,$174.29 ,61% of Billed charges for outpatient setting,$148.57 ,52% of charges,$148.57 ,52% of charges,$148.57 ,52% of charges,$148.57 ,52% of charges,$148.57 ,52% of charges,$148.57 ,52% of charges,148.5744,257.15,$228.58 
Outpatient Medical Services,Radiology,70360,X-Ray Neck Soft Tissue,320,$186.94 ,$158.90 ,85% of Billed charges for outpatient setting,$158.90 ,85% of Billed charges for outpatient setting,$138.86 ,74.28% of Billed charges for outpatient setting,$138.86 ,74.28% of Billed charges for outpatient setting,$114.03 ,61% of Billed charges for outpatient setting,$138.86 ,74.28% of Billed charges for outpatient setting,$168.25 ,90% of Billed charges for outpatient setting,$168.25 ,90% of Billed charges for outpatient setting,$98.18 ,52.52% of charges,$163.01 ,87.2% of Billed charges for outpatient setting,$114.03 ,61% of Billed charges for outpatient setting,$163.01 ,87.2% of Billed charges for outpatient setting,$97.21 ,52% of charges,$151.96 ,81.29% of Billed charges for outpatient setting,$168.25 ,90% of Billed charges for outpatient setting,$168.25 ,90% of Billed charges for outpatient setting,$114.03 ,61% of Billed charges for outpatient setting,$114.03 ,61% of Billed charges for outpatient setting,$168.25 ,90% of Billed charges for outpatient setting,$168.25 ,90% of Billed charges for outpatient setting,$114.03 ,61% of Billed charges for outpatient setting,$114.03 ,61% of Billed charges for outpatient setting,$114.03 ,61% of Billed charges for outpatient setting,$97.21 ,52% of charges,$97.21 ,52% of charges,$97.21 ,52% of charges,$97.21 ,52% of charges,$97.21 ,52% of charges,$97.21 ,52% of charges,97.2088,168.25,$149.55 
Outpatient Medical Services,Radiology,70450,"CT Scan, Head/Brain, W/O Contrast Matl",351,"$1,001.21 ",$851.03 ,85% of Billed charges for outpatient setting,$851.03 ,85% of Billed charges for outpatient setting,$743.70 ,74.28% of Billed charges for outpatient setting,$743.70 ,74.28% of Billed charges for outpatient setting,$610.74 ,61% of Billed charges for outpatient setting,$743.70 ,74.28% of Billed charges for outpatient setting,$901.09 ,90% of Billed charges for outpatient setting,$901.09 ,90% of Billed charges for outpatient setting,$525.84 ,52.52% of charges,$873.06 ,87.2% of Billed charges for outpatient setting,$610.74 ,61% of Billed charges for outpatient setting,$873.06 ,87.2% of Billed charges for outpatient setting,$520.63 ,52% of charges,$813.88 ,81.29% of Billed charges for outpatient setting,$901.09 ,90% of Billed charges for outpatient setting,$901.09 ,90% of Billed charges for outpatient setting,$610.74 ,61% of Billed charges for outpatient setting,$610.74 ,61% of Billed charges for outpatient setting,$901.09 ,90% of Billed charges for outpatient setting,$901.09 ,90% of Billed charges for outpatient setting,$610.74 ,61% of Billed charges for outpatient setting,$610.74 ,61% of Billed charges for outpatient setting,$610.74 ,61% of Billed charges for outpatient setting,$520.63 ,52% of charges,$520.63 ,52% of charges,$520.63 ,52% of charges,$520.63 ,52% of charges,$520.63 ,52% of charges,$520.63 ,52% of charges,520.6292,901.09,$800.97 
Outpatient Medical Services,Radiology,70460,CT Scan Head Contrast,351,"$1,135.35 ",$965.05 ,85% of Billed charges for outpatient setting,$965.05 ,85% of Billed charges for outpatient setting,$843.34 ,74.28% of Billed charges for outpatient setting,$843.34 ,74.28% of Billed charges for outpatient setting,$692.56 ,61% of Billed charges for outpatient setting,$843.34 ,74.28% of Billed charges for outpatient setting,"$1,021.82 ",90% of Billed charges for outpatient setting,"$1,021.82 ",90% of Billed charges for outpatient setting,$596.29 ,52.52% of charges,$990.03 ,87.2% of Billed charges for outpatient setting,$692.56 ,61% of Billed charges for outpatient setting,$990.03 ,87.2% of Billed charges for outpatient setting,$590.38 ,52% of charges,$922.93 ,81.29% of Billed charges for outpatient setting,"$1,021.82 ",90% of Billed charges for outpatient setting,"$1,021.82 ",90% of Billed charges for outpatient setting,$692.56 ,61% of Billed charges for outpatient setting,$692.56 ,61% of Billed charges for outpatient setting,"$1,021.82 ",90% of Billed charges for outpatient setting,"$1,021.82 ",90% of Billed charges for outpatient setting,$692.56 ,61% of Billed charges for outpatient setting,$692.56 ,61% of Billed charges for outpatient setting,$692.56 ,61% of Billed charges for outpatient setting,$590.38 ,52% of charges,$590.38 ,52% of charges,$590.38 ,52% of charges,$590.38 ,52% of charges,$590.38 ,52% of charges,$590.38 ,52% of charges,590.382,1021.82,$908.28 
Outpatient Medical Services,Radiology,70470,CT Scan Head Combo,351,"$1,425.48 ","$1,211.66 ",85% of Billed charges for outpatient setting,"$1,211.66 ",85% of Billed charges for outpatient setting,"$1,058.85 ",74.28% of Billed charges for outpatient setting,"$1,058.85 ",74.28% of Billed charges for outpatient setting,$869.54 ,61% of Billed charges for outpatient setting,"$1,058.85 ",74.28% of Billed charges for outpatient setting,"$1,282.93 ",90% of Billed charges for outpatient setting,"$1,282.93 ",90% of Billed charges for outpatient setting,$748.66 ,52.52% of charges,"$1,243.02 ",87.2% of Billed charges for outpatient setting,$869.54 ,61% of Billed charges for outpatient setting,"$1,243.02 ",87.2% of Billed charges for outpatient setting,$741.25 ,52% of charges,"$1,158.77 ",81.29% of Billed charges for outpatient setting,"$1,282.93 ",90% of Billed charges for outpatient setting,"$1,282.93 ",90% of Billed charges for outpatient setting,$869.54 ,61% of Billed charges for outpatient setting,$869.54 ,61% of Billed charges for outpatient setting,"$1,282.93 ",90% of Billed charges for outpatient setting,"$1,282.93 ",90% of Billed charges for outpatient setting,$869.54 ,61% of Billed charges for outpatient setting,$869.54 ,61% of Billed charges for outpatient setting,$869.54 ,61% of Billed charges for outpatient setting,$741.25 ,52% of charges,$741.25 ,52% of charges,$741.25 ,52% of charges,$741.25 ,52% of charges,$741.25 ,52% of charges,$741.25 ,52% of charges,741.2496,1282.93,"$1,140.38 "
Outpatient Medical Services,Radiology,70480,"CT Scan, Orbit/Sella/Post Fossa/Ear, W/O",351,"$1,001.21 ",$851.03 ,85% of Billed charges for outpatient setting,$851.03 ,85% of Billed charges for outpatient setting,$743.70 ,74.28% of Billed charges for outpatient setting,$743.70 ,74.28% of Billed charges for outpatient setting,$610.74 ,61% of Billed charges for outpatient setting,$743.70 ,74.28% of Billed charges for outpatient setting,$901.09 ,90% of Billed charges for outpatient setting,$901.09 ,90% of Billed charges for outpatient setting,$525.84 ,52.52% of charges,$873.06 ,87.2% of Billed charges for outpatient setting,$610.74 ,61% of Billed charges for outpatient setting,$873.06 ,87.2% of Billed charges for outpatient setting,$520.63 ,52% of charges,$813.88 ,81.29% of Billed charges for outpatient setting,$901.09 ,90% of Billed charges for outpatient setting,$901.09 ,90% of Billed charges for outpatient setting,$610.74 ,61% of Billed charges for outpatient setting,$610.74 ,61% of Billed charges for outpatient setting,$901.09 ,90% of Billed charges for outpatient setting,$901.09 ,90% of Billed charges for outpatient setting,$610.74 ,61% of Billed charges for outpatient setting,$610.74 ,61% of Billed charges for outpatient setting,$610.74 ,61% of Billed charges for outpatient setting,$520.63 ,52% of charges,$520.63 ,52% of charges,$520.63 ,52% of charges,$520.63 ,52% of charges,$520.63 ,52% of charges,$520.63 ,52% of charges,520.6292,901.09,$800.97 
Outpatient Medical Services,Radiology,70486,"CT Scan, Maxillofacial Area, W/O Contrast",351,"$1,001.21 ",$851.03 ,85% of Billed charges for outpatient setting,$851.03 ,85% of Billed charges for outpatient setting,$743.70 ,74.28% of Billed charges for outpatient setting,$743.70 ,74.28% of Billed charges for outpatient setting,$610.74 ,61% of Billed charges for outpatient setting,$743.70 ,74.28% of Billed charges for outpatient setting,$901.09 ,90% of Billed charges for outpatient setting,$901.09 ,90% of Billed charges for outpatient setting,$525.84 ,52.52% of charges,$873.06 ,87.2% of Billed charges for outpatient setting,$610.74 ,61% of Billed charges for outpatient setting,$873.06 ,87.2% of Billed charges for outpatient setting,$520.63 ,52% of charges,$813.88 ,81.29% of Billed charges for outpatient setting,$901.09 ,90% of Billed charges for outpatient setting,$901.09 ,90% of Billed charges for outpatient setting,$610.74 ,61% of Billed charges for outpatient setting,$610.74 ,61% of Billed charges for outpatient setting,$901.09 ,90% of Billed charges for outpatient setting,$901.09 ,90% of Billed charges for outpatient setting,$610.74 ,61% of Billed charges for outpatient setting,$610.74 ,61% of Billed charges for outpatient setting,$610.74 ,61% of Billed charges for outpatient setting,$520.63 ,52% of charges,$520.63 ,52% of charges,$520.63 ,52% of charges,$520.63 ,52% of charges,$520.63 ,52% of charges,$520.63 ,52% of charges,520.6292,901.09,$800.97 
Outpatient Medical Services,Radiology,70487,"CT Scan,  Face/Jaw Contrast",351,"$1,135.35 ",$965.05 ,85% of Billed charges for outpatient setting,$965.05 ,85% of Billed charges for outpatient setting,$843.34 ,74.28% of Billed charges for outpatient setting,$843.34 ,74.28% of Billed charges for outpatient setting,$692.56 ,61% of Billed charges for outpatient setting,$843.34 ,74.28% of Billed charges for outpatient setting,"$1,021.82 ",90% of Billed charges for outpatient setting,"$1,021.82 ",90% of Billed charges for outpatient setting,$596.29 ,52.52% of charges,$990.03 ,87.2% of Billed charges for outpatient setting,$692.56 ,61% of Billed charges for outpatient setting,$990.03 ,87.2% of Billed charges for outpatient setting,$590.38 ,52% of charges,$922.93 ,81.29% of Billed charges for outpatient setting,"$1,021.82 ",90% of Billed charges for outpatient setting,"$1,021.82 ",90% of Billed charges for outpatient setting,$692.56 ,61% of Billed charges for outpatient setting,$692.56 ,61% of Billed charges for outpatient setting,"$1,021.82 ",90% of Billed charges for outpatient setting,"$1,021.82 ",90% of Billed charges for outpatient setting,$692.56 ,61% of Billed charges for outpatient setting,$692.56 ,61% of Billed charges for outpatient setting,$692.56 ,61% of Billed charges for outpatient setting,$590.38 ,52% of charges,$590.38 ,52% of charges,$590.38 ,52% of charges,$590.38 ,52% of charges,$590.38 ,52% of charges,$590.38 ,52% of charges,590.382,1021.82,$908.28 
Outpatient Medical Services,Radiology,70490,"CT Scan, Soft Tissue Neck, W/O Contrast",351,$832.51 ,$707.63 ,85% of Billed charges for outpatient setting,$707.63 ,85% of Billed charges for outpatient setting,$618.39 ,74.28% of Billed charges for outpatient setting,$618.39 ,74.28% of Billed charges for outpatient setting,$507.83 ,61% of Billed charges for outpatient setting,$618.39 ,74.28% of Billed charges for outpatient setting,$749.26 ,90% of Billed charges for outpatient setting,$749.26 ,90% of Billed charges for outpatient setting,$437.23 ,52.52% of charges,$725.95 ,87.2% of Billed charges for outpatient setting,$507.83 ,61% of Billed charges for outpatient setting,$725.95 ,87.2% of Billed charges for outpatient setting,$432.91 ,52% of charges,$676.75 ,81.29% of Billed charges for outpatient setting,$749.26 ,90% of Billed charges for outpatient setting,$749.26 ,90% of Billed charges for outpatient setting,$507.83 ,61% of Billed charges for outpatient setting,$507.83 ,61% of Billed charges for outpatient setting,$749.26 ,90% of Billed charges for outpatient setting,$749.26 ,90% of Billed charges for outpatient setting,$507.83 ,61% of Billed charges for outpatient setting,$507.83 ,61% of Billed charges for outpatient setting,$507.83 ,61% of Billed charges for outpatient setting,$432.91 ,52% of charges,$432.91 ,52% of charges,$432.91 ,52% of charges,$432.91 ,52% of charges,$432.91 ,52% of charges,$432.91 ,52% of charges,432.9052,749.26,$666.01 
Outpatient Medical Services,Radiology,70491,CT Neck Tissue Contrast,350,$973.03 ,$827.08 ,85% of Billed charges for outpatient setting,$827.08 ,85% of Billed charges for outpatient setting,$722.77 ,74.28% of Billed charges for outpatient setting,$722.77 ,74.28% of Billed charges for outpatient setting,$593.55 ,61% of Billed charges for outpatient setting,$722.77 ,74.28% of Billed charges for outpatient setting,$875.73 ,90% of Billed charges for outpatient setting,$875.73 ,90% of Billed charges for outpatient setting,$511.04 ,52.52% of charges,$848.48 ,87.2% of Billed charges for outpatient setting,$593.55 ,61% of Billed charges for outpatient setting,$848.48 ,87.2% of Billed charges for outpatient setting,$505.98 ,52% of charges,$790.98 ,81.29% of Billed charges for outpatient setting,$875.73 ,90% of Billed charges for outpatient setting,$875.73 ,90% of Billed charges for outpatient setting,$593.55 ,61% of Billed charges for outpatient setting,$593.55 ,61% of Billed charges for outpatient setting,$875.73 ,90% of Billed charges for outpatient setting,$875.73 ,90% of Billed charges for outpatient setting,$593.55 ,61% of Billed charges for outpatient setting,$593.55 ,61% of Billed charges for outpatient setting,$593.55 ,61% of Billed charges for outpatient setting,$505.98 ,52% of charges,$505.98 ,52% of charges,$505.98 ,52% of charges,$505.98 ,52% of charges,$505.98 ,52% of charges,$505.98 ,52% of charges,505.9756,875.73,$778.42 
Outpatient Medical Services,Radiology,70496,CT Angiography Head,351,"$1,608.40 ","$1,367.14 ",85% of Billed charges for outpatient setting,"$1,367.14 ",85% of Billed charges for outpatient setting,"$1,194.72 ",74.28% of Billed charges for outpatient setting,"$1,194.72 ",74.28% of Billed charges for outpatient setting,$981.12 ,61% of Billed charges for outpatient setting,"$1,194.72 ",74.28% of Billed charges for outpatient setting,"$1,447.56 ",90% of Billed charges for outpatient setting,"$1,447.56 ",90% of Billed charges for outpatient setting,$844.73 ,52.52% of charges,"$1,402.52 ",87.2% of Billed charges for outpatient setting,$981.12 ,61% of Billed charges for outpatient setting,"$1,402.52 ",87.2% of Billed charges for outpatient setting,$836.37 ,52% of charges,"$1,307.47 ",81.29% of Billed charges for outpatient setting,"$1,447.56 ",90% of Billed charges for outpatient setting,"$1,447.56 ",90% of Billed charges for outpatient setting,$981.12 ,61% of Billed charges for outpatient setting,$981.12 ,61% of Billed charges for outpatient setting,"$1,447.56 ",90% of Billed charges for outpatient setting,"$1,447.56 ",90% of Billed charges for outpatient setting,$981.12 ,61% of Billed charges for outpatient setting,$981.12 ,61% of Billed charges for outpatient setting,$981.12 ,61% of Billed charges for outpatient setting,$836.37 ,52% of charges,$836.37 ,52% of charges,$836.37 ,52% of charges,$836.37 ,52% of charges,$836.37 ,52% of charges,$836.37 ,52% of charges,836.368,1447.56,"$1,286.72 "
Outpatient Medical Services,Radiology,70498,CT Angiography Neck,351,"$1,608.40 ","$1,367.14 ",85% of Billed charges for outpatient setting,"$1,367.14 ",85% of Billed charges for outpatient setting,"$1,194.72 ",74.28% of Billed charges for outpatient setting,"$1,194.72 ",74.28% of Billed charges for outpatient setting,$981.12 ,61% of Billed charges for outpatient setting,"$1,194.72 ",74.28% of Billed charges for outpatient setting,"$1,447.56 ",90% of Billed charges for outpatient setting,"$1,447.56 ",90% of Billed charges for outpatient setting,$844.73 ,52.52% of charges,"$1,402.52 ",87.2% of Billed charges for outpatient setting,$981.12 ,61% of Billed charges for outpatient setting,"$1,402.52 ",87.2% of Billed charges for outpatient setting,$836.37 ,52% of charges,"$1,307.47 ",81.29% of Billed charges for outpatient setting,"$1,447.56 ",90% of Billed charges for outpatient setting,"$1,447.56 ",90% of Billed charges for outpatient setting,$981.12 ,61% of Billed charges for outpatient setting,$981.12 ,61% of Billed charges for outpatient setting,"$1,447.56 ",90% of Billed charges for outpatient setting,"$1,447.56 ",90% of Billed charges for outpatient setting,$981.12 ,61% of Billed charges for outpatient setting,$981.12 ,61% of Billed charges for outpatient setting,$981.12 ,61% of Billed charges for outpatient setting,$836.37 ,52% of charges,$836.37 ,52% of charges,$836.37 ,52% of charges,$836.37 ,52% of charges,$836.37 ,52% of charges,$836.37 ,52% of charges,836.368,1447.56,"$1,286.72 "
Outpatient Medical Services,Radiology,70551,MRI Brain,611,"$1,825.31 ","$1,551.51 ",85% of Billed charges for outpatient setting,"$1,551.51 ",85% of Billed charges for outpatient setting,"$1,355.84 ",74.28% of Billed charges for outpatient setting,"$1,355.84 ",74.28% of Billed charges for outpatient setting,"$1,113.44 ",61% of Billed charges for outpatient setting,"$1,355.84 ",74.28% of Billed charges for outpatient setting,"$1,642.78 ",90% of Billed charges for outpatient setting,"$1,642.78 ",90% of Billed charges for outpatient setting,$958.65 ,52.52% of charges,"$1,591.67 ",87.2% of Billed charges for outpatient setting,"$1,113.44 ",61% of Billed charges for outpatient setting,"$1,591.67 ",87.2% of Billed charges for outpatient setting,$949.16 ,52% of charges,"$1,483.79 ",81.29% of Billed charges for outpatient setting,"$1,642.78 ",90% of Billed charges for outpatient setting,"$1,642.78 ",90% of Billed charges for outpatient setting,"$1,113.44 ",61% of Billed charges for outpatient setting,"$1,113.44 ",61% of Billed charges for outpatient setting,"$1,642.78 ",90% of Billed charges for outpatient setting,"$1,642.78 ",90% of Billed charges for outpatient setting,"$1,113.44 ",61% of Billed charges for outpatient setting,"$1,113.44 ",61% of Billed charges for outpatient setting,"$1,113.44 ",61% of Billed charges for outpatient setting,$949.16 ,52% of charges,$949.16 ,52% of charges,$949.16 ,52% of charges,$949.16 ,52% of charges,$949.16 ,52% of charges,$949.16 ,52% of charges,949.1612,1642.78,"$1,460.25 "
Outpatient Medical Services,Radiology,70553,MRI Brain Combo,611,"$2,447.37 ","$2,080.26 ",85% of Billed charges for outpatient setting,"$2,080.26 ",85% of Billed charges for outpatient setting,"$1,817.91 ",74.28% of Billed charges for outpatient setting,"$1,817.91 ",74.28% of Billed charges for outpatient setting,"$1,492.90 ",61% of Billed charges for outpatient setting,"$1,817.91 ",74.28% of Billed charges for outpatient setting,"$2,202.63 ",90% of Billed charges for outpatient setting,"$2,202.63 ",90% of Billed charges for outpatient setting,"$1,285.36 ",52.52% of charges,"$2,134.11 ",87.2% of Billed charges for outpatient setting,"$1,492.90 ",61% of Billed charges for outpatient setting,"$2,134.11 ",87.2% of Billed charges for outpatient setting,"$1,272.63 ",52% of charges,"$1,989.47 ",81.29% of Billed charges for outpatient setting,"$2,202.63 ",90% of Billed charges for outpatient setting,"$2,202.63 ",90% of Billed charges for outpatient setting,"$1,492.90 ",61% of Billed charges for outpatient setting,"$1,492.90 ",61% of Billed charges for outpatient setting,"$2,202.63 ",90% of Billed charges for outpatient setting,"$2,202.63 ",90% of Billed charges for outpatient setting,"$1,492.90 ",61% of Billed charges for outpatient setting,"$1,492.90 ",61% of Billed charges for outpatient setting,"$1,492.90 ",61% of Billed charges for outpatient setting,"$1,272.63 ",52% of charges,"$1,272.63 ",52% of charges,"$1,272.63 ",52% of charges,"$1,272.63 ",52% of charges,"$1,272.63 ",52% of charges,"$1,272.63 ",52% of charges,1272.6324,2202.63,"$1,957.90 "
Outpatient Medical Services,Radiology,71045,X-Ray Exam Chest 1 View,324,$117.08 ,$99.52 ,85% of Billed charges for outpatient setting,$99.52 ,85% of Billed charges for outpatient setting,$86.97 ,74.28% of Billed charges for outpatient setting,$86.97 ,74.28% of Billed charges for outpatient setting,$71.42 ,61% of Billed charges for outpatient setting,$86.97 ,74.28% of Billed charges for outpatient setting,$105.37 ,90% of Billed charges for outpatient setting,$105.37 ,90% of Billed charges for outpatient setting,$61.49 ,52.52% of charges,$102.09 ,87.2% of Billed charges for outpatient setting,$71.42 ,61% of Billed charges for outpatient setting,$102.09 ,87.2% of Billed charges for outpatient setting,$60.88 ,52% of charges,$95.17 ,81.29% of Billed charges for outpatient setting,$105.37 ,90% of Billed charges for outpatient setting,$105.37 ,90% of Billed charges for outpatient setting,$71.42 ,61% of Billed charges for outpatient setting,$71.42 ,61% of Billed charges for outpatient setting,$105.37 ,90% of Billed charges for outpatient setting,$105.37 ,90% of Billed charges for outpatient setting,$71.42 ,61% of Billed charges for outpatient setting,$71.42 ,61% of Billed charges for outpatient setting,$71.42 ,61% of Billed charges for outpatient setting,$60.88 ,52% of charges,$60.88 ,52% of charges,$60.88 ,52% of charges,$60.88 ,52% of charges,$60.88 ,52% of charges,$60.88 ,52% of charges,60.8816,105.37,$93.66 
Outpatient Medical Services,Radiology,71046,X-Ray Exam Chest 2 Views,324,$190.57 ,$161.98 ,85% of Billed charges for outpatient setting,$161.98 ,85% of Billed charges for outpatient setting,$141.56 ,74.28% of Billed charges for outpatient setting,$141.56 ,74.28% of Billed charges for outpatient setting,$116.25 ,61% of Billed charges for outpatient setting,$141.56 ,74.28% of Billed charges for outpatient setting,$171.51 ,90% of Billed charges for outpatient setting,$171.51 ,90% of Billed charges for outpatient setting,$100.09 ,52.52% of charges,$166.18 ,87.2% of Billed charges for outpatient setting,$116.25 ,61% of Billed charges for outpatient setting,$166.18 ,87.2% of Billed charges for outpatient setting,$99.10 ,52% of charges,$154.91 ,81.29% of Billed charges for outpatient setting,$171.51 ,90% of Billed charges for outpatient setting,$171.51 ,90% of Billed charges for outpatient setting,$116.25 ,61% of Billed charges for outpatient setting,$116.25 ,61% of Billed charges for outpatient setting,$171.51 ,90% of Billed charges for outpatient setting,$171.51 ,90% of Billed charges for outpatient setting,$116.25 ,61% of Billed charges for outpatient setting,$116.25 ,61% of Billed charges for outpatient setting,$116.25 ,61% of Billed charges for outpatient setting,$99.10 ,52% of charges,$99.10 ,52% of charges,$99.10 ,52% of charges,$99.10 ,52% of charges,$99.10 ,52% of charges,$99.10 ,52% of charges,99.0964,171.51,$152.46 
Outpatient Medical Services,Radiology,71047,X-Ray Exam Chest 3 Views,324,$230.39 ,$195.83 ,85% of Billed charges for outpatient setting,$195.83 ,85% of Billed charges for outpatient setting,$171.13 ,74.28% of Billed charges for outpatient setting,$171.13 ,74.28% of Billed charges for outpatient setting,$140.54 ,61% of Billed charges for outpatient setting,$171.13 ,74.28% of Billed charges for outpatient setting,$207.35 ,90% of Billed charges for outpatient setting,$207.35 ,90% of Billed charges for outpatient setting,$121.00 ,52.52% of charges,$200.90 ,87.2% of Billed charges for outpatient setting,$140.54 ,61% of Billed charges for outpatient setting,$200.90 ,87.2% of Billed charges for outpatient setting,$119.80 ,52% of charges,$187.28 ,81.29% of Billed charges for outpatient setting,$207.35 ,90% of Billed charges for outpatient setting,$207.35 ,90% of Billed charges for outpatient setting,$140.54 ,61% of Billed charges for outpatient setting,$140.54 ,61% of Billed charges for outpatient setting,$207.35 ,90% of Billed charges for outpatient setting,$207.35 ,90% of Billed charges for outpatient setting,$140.54 ,61% of Billed charges for outpatient setting,$140.54 ,61% of Billed charges for outpatient setting,$140.54 ,61% of Billed charges for outpatient setting,$119.80 ,52% of charges,$119.80 ,52% of charges,$119.80 ,52% of charges,$119.80 ,52% of charges,$119.80 ,52% of charges,$119.80 ,52% of charges,119.8028,207.35,$184.31 
Outpatient Medical Services,Radiology,71048,X-Ray Exam Chest 4+ Views,324,$302.03 ,$256.73 ,85% of Billed charges for outpatient setting,$256.73 ,85% of Billed charges for outpatient setting,$224.35 ,74.28% of Billed charges for outpatient setting,$224.35 ,74.28% of Billed charges for outpatient setting,$184.24 ,61% of Billed charges for outpatient setting,$224.35 ,74.28% of Billed charges for outpatient setting,$271.83 ,90% of Billed charges for outpatient setting,$271.83 ,90% of Billed charges for outpatient setting,$158.63 ,52.52% of charges,$263.37 ,87.2% of Billed charges for outpatient setting,$184.24 ,61% of Billed charges for outpatient setting,$263.37 ,87.2% of Billed charges for outpatient setting,$157.06 ,52% of charges,$245.52 ,81.29% of Billed charges for outpatient setting,$271.83 ,90% of Billed charges for outpatient setting,$271.83 ,90% of Billed charges for outpatient setting,$184.24 ,61% of Billed charges for outpatient setting,$184.24 ,61% of Billed charges for outpatient setting,$271.83 ,90% of Billed charges for outpatient setting,$271.83 ,90% of Billed charges for outpatient setting,$184.24 ,61% of Billed charges for outpatient setting,$184.24 ,61% of Billed charges for outpatient setting,$184.24 ,61% of Billed charges for outpatient setting,$157.06 ,52% of charges,$157.06 ,52% of charges,$157.06 ,52% of charges,$157.06 ,52% of charges,$157.06 ,52% of charges,$157.06 ,52% of charges,157.0556,271.83,$241.62 
Outpatient Medical Services,Radiology,71100,X-Ray Exam Of Ribs 2 Views Unilat,320,$209.63 ,$178.19 ,85% of Billed charges for outpatient setting,$178.19 ,85% of Billed charges for outpatient setting,$155.71 ,74.28% of Billed charges for outpatient setting,$155.71 ,74.28% of Billed charges for outpatient setting,$127.87 ,61% of Billed charges for outpatient setting,$155.71 ,74.28% of Billed charges for outpatient setting,$188.67 ,90% of Billed charges for outpatient setting,$188.67 ,90% of Billed charges for outpatient setting,$110.10 ,52.52% of charges,$182.80 ,87.2% of Billed charges for outpatient setting,$127.87 ,61% of Billed charges for outpatient setting,$182.80 ,87.2% of Billed charges for outpatient setting,$109.01 ,52% of charges,$170.41 ,81.29% of Billed charges for outpatient setting,$188.67 ,90% of Billed charges for outpatient setting,$188.67 ,90% of Billed charges for outpatient setting,$127.87 ,61% of Billed charges for outpatient setting,$127.87 ,61% of Billed charges for outpatient setting,$188.67 ,90% of Billed charges for outpatient setting,$188.67 ,90% of Billed charges for outpatient setting,$127.87 ,61% of Billed charges for outpatient setting,$127.87 ,61% of Billed charges for outpatient setting,$127.87 ,61% of Billed charges for outpatient setting,$109.01 ,52% of charges,$109.01 ,52% of charges,$109.01 ,52% of charges,$109.01 ,52% of charges,$109.01 ,52% of charges,$109.01 ,52% of charges,109.0076,188.67,$167.70 
Outpatient Medical Services,Radiology,71100,X-Ray Exam Of Ribs 2 Views Bilat,320,$419.21 ,$356.33 ,85% of Billed charges for outpatient setting,$356.33 ,85% of Billed charges for outpatient setting,$311.39 ,74.28% of Billed charges for outpatient setting,$311.39 ,74.28% of Billed charges for outpatient setting,$255.72 ,61% of Billed charges for outpatient setting,$311.39 ,74.28% of Billed charges for outpatient setting,$377.29 ,90% of Billed charges for outpatient setting,$377.29 ,90% of Billed charges for outpatient setting,$220.17 ,52.52% of charges,$365.55 ,87.2% of Billed charges for outpatient setting,$255.72 ,61% of Billed charges for outpatient setting,$365.55 ,87.2% of Billed charges for outpatient setting,$217.99 ,52% of charges,$340.78 ,81.29% of Billed charges for outpatient setting,$377.29 ,90% of Billed charges for outpatient setting,$377.29 ,90% of Billed charges for outpatient setting,$255.72 ,61% of Billed charges for outpatient setting,$255.72 ,61% of Billed charges for outpatient setting,$377.29 ,90% of Billed charges for outpatient setting,$377.29 ,90% of Billed charges for outpatient setting,$255.72 ,61% of Billed charges for outpatient setting,$255.72 ,61% of Billed charges for outpatient setting,$255.72 ,61% of Billed charges for outpatient setting,$217.99 ,52% of charges,$217.99 ,52% of charges,$217.99 ,52% of charges,$217.99 ,52% of charges,$217.99 ,52% of charges,$217.99 ,52% of charges,217.9892,377.29,$335.37 
Outpatient Medical Services,Radiology,71101,X-Ray Exam Of Ribs/Chest 3+ Views Unilat,320,$281.11 ,$238.94 ,85% of Billed charges for outpatient setting,$238.94 ,85% of Billed charges for outpatient setting,$208.81 ,74.28% of Billed charges for outpatient setting,$208.81 ,74.28% of Billed charges for outpatient setting,$171.48 ,61% of Billed charges for outpatient setting,$208.81 ,74.28% of Billed charges for outpatient setting,$253.00 ,90% of Billed charges for outpatient setting,$253.00 ,90% of Billed charges for outpatient setting,$147.64 ,52.52% of charges,$245.13 ,87.2% of Billed charges for outpatient setting,$171.48 ,61% of Billed charges for outpatient setting,$245.13 ,87.2% of Billed charges for outpatient setting,$146.18 ,52% of charges,$228.51 ,81.29% of Billed charges for outpatient setting,$253.00 ,90% of Billed charges for outpatient setting,$253.00 ,90% of Billed charges for outpatient setting,$171.48 ,61% of Billed charges for outpatient setting,$171.48 ,61% of Billed charges for outpatient setting,$253.00 ,90% of Billed charges for outpatient setting,$253.00 ,90% of Billed charges for outpatient setting,$171.48 ,61% of Billed charges for outpatient setting,$171.48 ,61% of Billed charges for outpatient setting,$171.48 ,61% of Billed charges for outpatient setting,$146.18 ,52% of charges,$146.18 ,52% of charges,$146.18 ,52% of charges,$146.18 ,52% of charges,$146.18 ,52% of charges,$146.18 ,52% of charges,146.1772,253,$224.89 
Outpatient Medical Services,Radiology,71111,X-Ray Exam Of Ribs/Chest 4+ Views Bilat,320,$399.10 ,$339.24 ,85% of Billed charges for outpatient setting,$339.24 ,85% of Billed charges for outpatient setting,$296.45 ,74.28% of Billed charges for outpatient setting,$296.45 ,74.28% of Billed charges for outpatient setting,$243.45 ,61% of Billed charges for outpatient setting,$296.45 ,74.28% of Billed charges for outpatient setting,$359.19 ,90% of Billed charges for outpatient setting,$359.19 ,90% of Billed charges for outpatient setting,$209.61 ,52.52% of charges,$348.02 ,87.2% of Billed charges for outpatient setting,$243.45 ,61% of Billed charges for outpatient setting,$348.02 ,87.2% of Billed charges for outpatient setting,$207.53 ,52% of charges,$324.43 ,81.29% of Billed charges for outpatient setting,$359.19 ,90% of Billed charges for outpatient setting,$359.19 ,90% of Billed charges for outpatient setting,$243.45 ,61% of Billed charges for outpatient setting,$243.45 ,61% of Billed charges for outpatient setting,$359.19 ,90% of Billed charges for outpatient setting,$359.19 ,90% of Billed charges for outpatient setting,$243.45 ,61% of Billed charges for outpatient setting,$243.45 ,61% of Billed charges for outpatient setting,$243.45 ,61% of Billed charges for outpatient setting,$207.53 ,52% of charges,$207.53 ,52% of charges,$207.53 ,52% of charges,$207.53 ,52% of charges,$207.53 ,52% of charges,$207.53 ,52% of charges,207.532,359.19,$319.28 
Outpatient Medical Services,Radiology,71120,X-Ray Exam Of Breastbone 2+ Views,320,$192.36 ,$163.51 ,85% of Billed charges for outpatient setting,$163.51 ,85% of Billed charges for outpatient setting,$142.89 ,74.28% of Billed charges for outpatient setting,$142.89 ,74.28% of Billed charges for outpatient setting,$117.34 ,61% of Billed charges for outpatient setting,$142.89 ,74.28% of Billed charges for outpatient setting,$173.12 ,90% of Billed charges for outpatient setting,$173.12 ,90% of Billed charges for outpatient setting,$101.03 ,52.52% of charges,$167.74 ,87.2% of Billed charges for outpatient setting,$117.34 ,61% of Billed charges for outpatient setting,$167.74 ,87.2% of Billed charges for outpatient setting,$100.03 ,52% of charges,$156.37 ,81.29% of Billed charges for outpatient setting,$173.12 ,90% of Billed charges for outpatient setting,$173.12 ,90% of Billed charges for outpatient setting,$117.34 ,61% of Billed charges for outpatient setting,$117.34 ,61% of Billed charges for outpatient setting,$173.12 ,90% of Billed charges for outpatient setting,$173.12 ,90% of Billed charges for outpatient setting,$117.34 ,61% of Billed charges for outpatient setting,$117.34 ,61% of Billed charges for outpatient setting,$117.34 ,61% of Billed charges for outpatient setting,$100.03 ,52% of charges,$100.03 ,52% of charges,$100.03 ,52% of charges,$100.03 ,52% of charges,$100.03 ,52% of charges,$100.03 ,52% of charges,100.0272,173.12,$153.89 
Outpatient Medical Services,Radiology,71130,X-Ray Exam Of Breastbone 3+ Views,320,$200.46 ,$170.39 ,85% of Billed charges for outpatient setting,$170.39 ,85% of Billed charges for outpatient setting,$148.90 ,74.28% of Billed charges for outpatient setting,$148.90 ,74.28% of Billed charges for outpatient setting,$122.28 ,61% of Billed charges for outpatient setting,$148.90 ,74.28% of Billed charges for outpatient setting,$180.41 ,90% of Billed charges for outpatient setting,$180.41 ,90% of Billed charges for outpatient setting,$105.28 ,52.52% of charges,$174.80 ,87.2% of Billed charges for outpatient setting,$122.28 ,61% of Billed charges for outpatient setting,$174.80 ,87.2% of Billed charges for outpatient setting,$104.24 ,52% of charges,$162.95 ,81.29% of Billed charges for outpatient setting,$180.41 ,90% of Billed charges for outpatient setting,$180.41 ,90% of Billed charges for outpatient setting,$122.28 ,61% of Billed charges for outpatient setting,$122.28 ,61% of Billed charges for outpatient setting,$180.41 ,90% of Billed charges for outpatient setting,$180.41 ,90% of Billed charges for outpatient setting,$122.28 ,61% of Billed charges for outpatient setting,$122.28 ,61% of Billed charges for outpatient setting,$122.28 ,61% of Billed charges for outpatient setting,$104.24 ,52% of charges,$104.24 ,52% of charges,$104.24 ,52% of charges,$104.24 ,52% of charges,$104.24 ,52% of charges,$104.24 ,52% of charges,104.2392,180.41,$160.37 
Outpatient Medical Services,Radiology,71250,"CT Scan, Thorax, W/O Contrast",352,$900.45 ,$765.38 ,85% of Billed charges for outpatient setting,$765.38 ,85% of Billed charges for outpatient setting,$668.85 ,74.28% of Billed charges for outpatient setting,$668.85 ,74.28% of Billed charges for outpatient setting,$549.27 ,61% of Billed charges for outpatient setting,$668.85 ,74.28% of Billed charges for outpatient setting,$810.41 ,90% of Billed charges for outpatient setting,$810.41 ,90% of Billed charges for outpatient setting,$472.92 ,52.52% of charges,$785.19 ,87.2% of Billed charges for outpatient setting,$549.27 ,61% of Billed charges for outpatient setting,$785.19 ,87.2% of Billed charges for outpatient setting,$468.23 ,52% of charges,$731.98 ,81.29% of Billed charges for outpatient setting,$810.41 ,90% of Billed charges for outpatient setting,$810.41 ,90% of Billed charges for outpatient setting,$549.27 ,61% of Billed charges for outpatient setting,$549.27 ,61% of Billed charges for outpatient setting,$810.41 ,90% of Billed charges for outpatient setting,$810.41 ,90% of Billed charges for outpatient setting,$549.27 ,61% of Billed charges for outpatient setting,$549.27 ,61% of Billed charges for outpatient setting,$549.27 ,61% of Billed charges for outpatient setting,$468.23 ,52% of charges,$468.23 ,52% of charges,$468.23 ,52% of charges,$468.23 ,52% of charges,$468.23 ,52% of charges,$468.23 ,52% of charges,468.234,810.41,$720.36 
Outpatient Medical Services,Radiology,71260,CT Scan Of Chest Contrast,352,"$1,158.95 ",$985.11 ,85% of Billed charges for outpatient setting,$985.11 ,85% of Billed charges for outpatient setting,$860.87 ,74.28% of Billed charges for outpatient setting,$860.87 ,74.28% of Billed charges for outpatient setting,$706.96 ,61% of Billed charges for outpatient setting,$860.87 ,74.28% of Billed charges for outpatient setting,"$1,043.06 ",90% of Billed charges for outpatient setting,"$1,043.06 ",90% of Billed charges for outpatient setting,$608.68 ,52.52% of charges,"$1,010.60 ",87.2% of Billed charges for outpatient setting,$706.96 ,61% of Billed charges for outpatient setting,"$1,010.60 ",87.2% of Billed charges for outpatient setting,$602.65 ,52% of charges,$942.11 ,81.29% of Billed charges for outpatient setting,"$1,043.06 ",90% of Billed charges for outpatient setting,"$1,043.06 ",90% of Billed charges for outpatient setting,$706.96 ,61% of Billed charges for outpatient setting,$706.96 ,61% of Billed charges for outpatient setting,"$1,043.06 ",90% of Billed charges for outpatient setting,"$1,043.06 ",90% of Billed charges for outpatient setting,$706.96 ,61% of Billed charges for outpatient setting,$706.96 ,61% of Billed charges for outpatient setting,$706.96 ,61% of Billed charges for outpatient setting,$602.65 ,52% of charges,$602.65 ,52% of charges,$602.65 ,52% of charges,$602.65 ,52% of charges,$602.65 ,52% of charges,$602.65 ,52% of charges,602.654,1043.06,$927.16 
Outpatient Medical Services,Radiology,71270,CT Thorax; W & Wo Contrast,352,"$1,450.86 ","$1,233.23 ",85% of Billed charges for outpatient setting,"$1,233.23 ",85% of Billed charges for outpatient setting,"$1,077.70 ",74.28% of Billed charges for outpatient setting,"$1,077.70 ",74.28% of Billed charges for outpatient setting,$885.02 ,61% of Billed charges for outpatient setting,"$1,077.70 ",74.28% of Billed charges for outpatient setting,"$1,305.77 ",90% of Billed charges for outpatient setting,"$1,305.77 ",90% of Billed charges for outpatient setting,$761.99 ,52.52% of charges,"$1,265.15 ",87.2% of Billed charges for outpatient setting,$885.02 ,61% of Billed charges for outpatient setting,"$1,265.15 ",87.2% of Billed charges for outpatient setting,$754.45 ,52% of charges,"$1,179.40 ",81.29% of Billed charges for outpatient setting,"$1,305.77 ",90% of Billed charges for outpatient setting,"$1,305.77 ",90% of Billed charges for outpatient setting,$885.02 ,61% of Billed charges for outpatient setting,$885.02 ,61% of Billed charges for outpatient setting,"$1,305.77 ",90% of Billed charges for outpatient setting,"$1,305.77 ",90% of Billed charges for outpatient setting,$885.02 ,61% of Billed charges for outpatient setting,$885.02 ,61% of Billed charges for outpatient setting,$885.02 ,61% of Billed charges for outpatient setting,$754.45 ,52% of charges,$754.45 ,52% of charges,$754.45 ,52% of charges,$754.45 ,52% of charges,$754.45 ,52% of charges,$754.45 ,52% of charges,754.4472,1305.77,"$1,160.69 "
Outpatient Medical Services,Radiology,71275,CT Angiography Chest,350,"$1,608.40 ","$1,367.14 ",85% of Billed charges for outpatient setting,"$1,367.14 ",85% of Billed charges for outpatient setting,"$1,194.72 ",74.28% of Billed charges for outpatient setting,"$1,194.72 ",74.28% of Billed charges for outpatient setting,$981.12 ,61% of Billed charges for outpatient setting,"$1,194.72 ",74.28% of Billed charges for outpatient setting,"$1,447.56 ",90% of Billed charges for outpatient setting,"$1,447.56 ",90% of Billed charges for outpatient setting,$844.73 ,52.52% of charges,"$1,402.52 ",87.2% of Billed charges for outpatient setting,$981.12 ,61% of Billed charges for outpatient setting,"$1,402.52 ",87.2% of Billed charges for outpatient setting,$836.37 ,52% of charges,"$1,307.47 ",81.29% of Billed charges for outpatient setting,"$1,447.56 ",90% of Billed charges for outpatient setting,"$1,447.56 ",90% of Billed charges for outpatient setting,$981.12 ,61% of Billed charges for outpatient setting,$981.12 ,61% of Billed charges for outpatient setting,"$1,447.56 ",90% of Billed charges for outpatient setting,"$1,447.56 ",90% of Billed charges for outpatient setting,$981.12 ,61% of Billed charges for outpatient setting,$981.12 ,61% of Billed charges for outpatient setting,$981.12 ,61% of Billed charges for outpatient setting,$836.37 ,52% of charges,$836.37 ,52% of charges,$836.37 ,52% of charges,$836.37 ,52% of charges,$836.37 ,52% of charges,$836.37 ,52% of charges,836.368,1447.56,"$1,286.72 "
Outpatient Medical Services,Radiology,72040,X-Ray Exam Neck Spine 2-3 View,320,$192.36 ,$163.51 ,85% of Billed charges for outpatient setting,$163.51 ,85% of Billed charges for outpatient setting,$142.89 ,74.28% of Billed charges for outpatient setting,$142.89 ,74.28% of Billed charges for outpatient setting,$117.34 ,61% of Billed charges for outpatient setting,$142.89 ,74.28% of Billed charges for outpatient setting,$173.12 ,90% of Billed charges for outpatient setting,$173.12 ,90% of Billed charges for outpatient setting,$101.03 ,52.52% of charges,$167.74 ,87.2% of Billed charges for outpatient setting,$117.34 ,61% of Billed charges for outpatient setting,$167.74 ,87.2% of Billed charges for outpatient setting,$100.03 ,52% of charges,$156.37 ,81.29% of Billed charges for outpatient setting,$173.12 ,90% of Billed charges for outpatient setting,$173.12 ,90% of Billed charges for outpatient setting,$117.34 ,61% of Billed charges for outpatient setting,$117.34 ,61% of Billed charges for outpatient setting,$173.12 ,90% of Billed charges for outpatient setting,$173.12 ,90% of Billed charges for outpatient setting,$117.34 ,61% of Billed charges for outpatient setting,$117.34 ,61% of Billed charges for outpatient setting,$117.34 ,61% of Billed charges for outpatient setting,$100.03 ,52% of charges,$100.03 ,52% of charges,$100.03 ,52% of charges,$100.03 ,52% of charges,$100.03 ,52% of charges,$100.03 ,52% of charges,100.0272,173.12,$153.89 
Outpatient Medical Services,Radiology,72050,X-Ray Exam Neck Spine 4/5 Views,320,$292.97 ,$249.02 ,85% of Billed charges for outpatient setting,$249.02 ,85% of Billed charges for outpatient setting,$217.62 ,74.28% of Billed charges for outpatient setting,$217.62 ,74.28% of Billed charges for outpatient setting,$178.71 ,61% of Billed charges for outpatient setting,$217.62 ,74.28% of Billed charges for outpatient setting,$263.67 ,90% of Billed charges for outpatient setting,$263.67 ,90% of Billed charges for outpatient setting,$153.87 ,52.52% of charges,$255.47 ,87.2% of Billed charges for outpatient setting,$178.71 ,61% of Billed charges for outpatient setting,$255.47 ,87.2% of Billed charges for outpatient setting,$152.34 ,52% of charges,$238.16 ,81.29% of Billed charges for outpatient setting,$263.67 ,90% of Billed charges for outpatient setting,$263.67 ,90% of Billed charges for outpatient setting,$178.71 ,61% of Billed charges for outpatient setting,$178.71 ,61% of Billed charges for outpatient setting,$263.67 ,90% of Billed charges for outpatient setting,$263.67 ,90% of Billed charges for outpatient setting,$178.71 ,61% of Billed charges for outpatient setting,$178.71 ,61% of Billed charges for outpatient setting,$178.71 ,61% of Billed charges for outpatient setting,$152.34 ,52% of charges,$152.34 ,52% of charges,$152.34 ,52% of charges,$152.34 ,52% of charges,$152.34 ,52% of charges,$152.34 ,52% of charges,152.3444,263.67,$234.38 
Outpatient Medical Services,Radiology,72052,X-Ray Exam Neck Spine 6/>Views,320,$351.03 ,$298.38 ,85% of Billed charges for outpatient setting,$298.38 ,85% of Billed charges for outpatient setting,$260.75 ,74.28% of Billed charges for outpatient setting,$260.75 ,74.28% of Billed charges for outpatient setting,$214.13 ,61% of Billed charges for outpatient setting,$260.75 ,74.28% of Billed charges for outpatient setting,$315.93 ,90% of Billed charges for outpatient setting,$315.93 ,90% of Billed charges for outpatient setting,$184.36 ,52.52% of charges,$306.10 ,87.2% of Billed charges for outpatient setting,$214.13 ,61% of Billed charges for outpatient setting,$306.10 ,87.2% of Billed charges for outpatient setting,$182.54 ,52% of charges,$285.35 ,81.29% of Billed charges for outpatient setting,$315.93 ,90% of Billed charges for outpatient setting,$315.93 ,90% of Billed charges for outpatient setting,$214.13 ,61% of Billed charges for outpatient setting,$214.13 ,61% of Billed charges for outpatient setting,$315.93 ,90% of Billed charges for outpatient setting,$315.93 ,90% of Billed charges for outpatient setting,$214.13 ,61% of Billed charges for outpatient setting,$214.13 ,61% of Billed charges for outpatient setting,$214.13 ,61% of Billed charges for outpatient setting,$182.54 ,52% of charges,$182.54 ,52% of charges,$182.54 ,52% of charges,$182.54 ,52% of charges,$182.54 ,52% of charges,$182.54 ,52% of charges,182.5356,315.93,$280.82 
Outpatient Medical Services,Radiology,72072,X-Ray Exam Of Thoracic Spine 3 Views,320,$235.01 ,$199.76 ,85% of Billed charges for outpatient setting,$199.76 ,85% of Billed charges for outpatient setting,$174.57 ,74.28% of Billed charges for outpatient setting,$174.57 ,74.28% of Billed charges for outpatient setting,$143.36 ,61% of Billed charges for outpatient setting,$174.57 ,74.28% of Billed charges for outpatient setting,$211.51 ,90% of Billed charges for outpatient setting,$211.51 ,90% of Billed charges for outpatient setting,$123.43 ,52.52% of charges,$204.93 ,87.2% of Billed charges for outpatient setting,$143.36 ,61% of Billed charges for outpatient setting,$204.93 ,87.2% of Billed charges for outpatient setting,$122.21 ,52% of charges,$191.04 ,81.29% of Billed charges for outpatient setting,$211.51 ,90% of Billed charges for outpatient setting,$211.51 ,90% of Billed charges for outpatient setting,$143.36 ,61% of Billed charges for outpatient setting,$143.36 ,61% of Billed charges for outpatient setting,$211.51 ,90% of Billed charges for outpatient setting,$211.51 ,90% of Billed charges for outpatient setting,$143.36 ,61% of Billed charges for outpatient setting,$143.36 ,61% of Billed charges for outpatient setting,$143.36 ,61% of Billed charges for outpatient setting,$122.21 ,52% of charges,$122.21 ,52% of charges,$122.21 ,52% of charges,$122.21 ,52% of charges,$122.21 ,52% of charges,$122.21 ,52% of charges,122.2052,211.51,$188.01 
Outpatient Medical Services,Radiology,72074,X-Ray Exam Of Thoracic Spine 4+ Views,320,$264.45 ,$224.78 ,85% of Billed charges for outpatient setting,$224.78 ,85% of Billed charges for outpatient setting,$196.43 ,74.28% of Billed charges for outpatient setting,$196.43 ,74.28% of Billed charges for outpatient setting,$161.31 ,61% of Billed charges for outpatient setting,$196.43 ,74.28% of Billed charges for outpatient setting,$238.01 ,90% of Billed charges for outpatient setting,$238.01 ,90% of Billed charges for outpatient setting,$138.89 ,52.52% of charges,$230.60 ,87.2% of Billed charges for outpatient setting,$161.31 ,61% of Billed charges for outpatient setting,$230.60 ,87.2% of Billed charges for outpatient setting,$137.51 ,52% of charges,$214.97 ,81.29% of Billed charges for outpatient setting,$238.01 ,90% of Billed charges for outpatient setting,$238.01 ,90% of Billed charges for outpatient setting,$161.31 ,61% of Billed charges for outpatient setting,$161.31 ,61% of Billed charges for outpatient setting,$238.01 ,90% of Billed charges for outpatient setting,$238.01 ,90% of Billed charges for outpatient setting,$161.31 ,61% of Billed charges for outpatient setting,$161.31 ,61% of Billed charges for outpatient setting,$161.31 ,61% of Billed charges for outpatient setting,$137.51 ,52% of charges,$137.51 ,52% of charges,$137.51 ,52% of charges,$137.51 ,52% of charges,$137.51 ,52% of charges,$137.51 ,52% of charges,137.514,238.01,$211.56 
Outpatient Medical Services,Radiology,72080,X-Ray Exam Of Middle/Lower Spine 2 Views,320,$250.37 ,$212.81 ,85% of Billed charges for outpatient setting,$212.81 ,85% of Billed charges for outpatient setting,$185.97 ,74.28% of Billed charges for outpatient setting,$185.97 ,74.28% of Billed charges for outpatient setting,$152.73 ,61% of Billed charges for outpatient setting,$185.97 ,74.28% of Billed charges for outpatient setting,$225.33 ,90% of Billed charges for outpatient setting,$225.33 ,90% of Billed charges for outpatient setting,$131.49 ,52.52% of charges,$218.32 ,87.2% of Billed charges for outpatient setting,$152.73 ,61% of Billed charges for outpatient setting,$218.32 ,87.2% of Billed charges for outpatient setting,$130.19 ,52% of charges,$203.53 ,81.29% of Billed charges for outpatient setting,$225.33 ,90% of Billed charges for outpatient setting,$225.33 ,90% of Billed charges for outpatient setting,$152.73 ,61% of Billed charges for outpatient setting,$152.73 ,61% of Billed charges for outpatient setting,$225.33 ,90% of Billed charges for outpatient setting,$225.33 ,90% of Billed charges for outpatient setting,$152.73 ,61% of Billed charges for outpatient setting,$152.73 ,61% of Billed charges for outpatient setting,$152.73 ,61% of Billed charges for outpatient setting,$130.19 ,52% of charges,$130.19 ,52% of charges,$130.19 ,52% of charges,$130.19 ,52% of charges,$130.19 ,52% of charges,$130.19 ,52% of charges,130.1924,225.33,$200.30 
Outpatient Medical Services,Radiology,72081,X-Ray Exam Entire Spi 1 View,320,$100.85 ,$85.72 ,85% of Billed charges for outpatient setting,$85.72 ,85% of Billed charges for outpatient setting,$74.91 ,74.28% of Billed charges for outpatient setting,$74.91 ,74.28% of Billed charges for outpatient setting,$61.52 ,61% of Billed charges for outpatient setting,$74.91 ,74.28% of Billed charges for outpatient setting,$90.77 ,90% of Billed charges for outpatient setting,$90.77 ,90% of Billed charges for outpatient setting,$52.97 ,52.52% of charges,$87.94 ,87.2% of Billed charges for outpatient setting,$61.52 ,61% of Billed charges for outpatient setting,$87.94 ,87.2% of Billed charges for outpatient setting,$52.44 ,52% of charges,$81.98 ,81.29% of Billed charges for outpatient setting,$90.77 ,90% of Billed charges for outpatient setting,$90.77 ,90% of Billed charges for outpatient setting,$61.52 ,61% of Billed charges for outpatient setting,$61.52 ,61% of Billed charges for outpatient setting,$90.77 ,90% of Billed charges for outpatient setting,$90.77 ,90% of Billed charges for outpatient setting,$61.52 ,61% of Billed charges for outpatient setting,$61.52 ,61% of Billed charges for outpatient setting,$61.52 ,61% of Billed charges for outpatient setting,$52.44 ,52% of charges,$52.44 ,52% of charges,$52.44 ,52% of charges,$52.44 ,52% of charges,$52.44 ,52% of charges,$52.44 ,52% of charges,52.442,90.77,$80.68 
Outpatient Medical Services,Radiology,72082,X-Ray Exam Entire Spi 2/3 View,320,$126.53 ,$107.55 ,85% of Billed charges for outpatient setting,$107.55 ,85% of Billed charges for outpatient setting,$93.99 ,74.28% of Billed charges for outpatient setting,$93.99 ,74.28% of Billed charges for outpatient setting,$77.18 ,61% of Billed charges for outpatient setting,$93.99 ,74.28% of Billed charges for outpatient setting,$113.88 ,90% of Billed charges for outpatient setting,$113.88 ,90% of Billed charges for outpatient setting,$66.45 ,52.52% of charges,$110.33 ,87.2% of Billed charges for outpatient setting,$77.18 ,61% of Billed charges for outpatient setting,$110.33 ,87.2% of Billed charges for outpatient setting,$65.80 ,52% of charges,$102.86 ,81.29% of Billed charges for outpatient setting,$113.88 ,90% of Billed charges for outpatient setting,$113.88 ,90% of Billed charges for outpatient setting,$77.18 ,61% of Billed charges for outpatient setting,$77.18 ,61% of Billed charges for outpatient setting,$113.88 ,90% of Billed charges for outpatient setting,$113.88 ,90% of Billed charges for outpatient setting,$77.18 ,61% of Billed charges for outpatient setting,$77.18 ,61% of Billed charges for outpatient setting,$77.18 ,61% of Billed charges for outpatient setting,$65.80 ,52% of charges,$65.80 ,52% of charges,$65.80 ,52% of charges,$65.80 ,52% of charges,$65.80 ,52% of charges,$65.80 ,52% of charges,65.7956,113.88,$101.22 
Outpatient Medical Services,Radiology,72100,X-Ray Exam Of Lower Spine 2-3 Views,320,$192.36 ,$163.51 ,85% of Billed charges for outpatient setting,$163.51 ,85% of Billed charges for outpatient setting,$142.89 ,74.28% of Billed charges for outpatient setting,$142.89 ,74.28% of Billed charges for outpatient setting,$117.34 ,61% of Billed charges for outpatient setting,$142.89 ,74.28% of Billed charges for outpatient setting,$173.12 ,90% of Billed charges for outpatient setting,$173.12 ,90% of Billed charges for outpatient setting,$101.03 ,52.52% of charges,$167.74 ,87.2% of Billed charges for outpatient setting,$117.34 ,61% of Billed charges for outpatient setting,$167.74 ,87.2% of Billed charges for outpatient setting,$100.03 ,52% of charges,$156.37 ,81.29% of Billed charges for outpatient setting,$173.12 ,90% of Billed charges for outpatient setting,$173.12 ,90% of Billed charges for outpatient setting,$117.34 ,61% of Billed charges for outpatient setting,$117.34 ,61% of Billed charges for outpatient setting,$173.12 ,90% of Billed charges for outpatient setting,$173.12 ,90% of Billed charges for outpatient setting,$117.34 ,61% of Billed charges for outpatient setting,$117.34 ,61% of Billed charges for outpatient setting,$117.34 ,61% of Billed charges for outpatient setting,$100.03 ,52% of charges,$100.03 ,52% of charges,$100.03 ,52% of charges,$100.03 ,52% of charges,$100.03 ,52% of charges,$100.03 ,52% of charges,100.0272,173.12,$153.89 
Outpatient Medical Services,Radiology,72110,X-Ray Exam Of Lower Spine 4+ Views,320,$292.97 ,$249.02 ,85% of Billed charges for outpatient setting,$249.02 ,85% of Billed charges for outpatient setting,$217.62 ,74.28% of Billed charges for outpatient setting,$217.62 ,74.28% of Billed charges for outpatient setting,$178.71 ,61% of Billed charges for outpatient setting,$217.62 ,74.28% of Billed charges for outpatient setting,$263.67 ,90% of Billed charges for outpatient setting,$263.67 ,90% of Billed charges for outpatient setting,$153.87 ,52.52% of charges,$255.47 ,87.2% of Billed charges for outpatient setting,$178.71 ,61% of Billed charges for outpatient setting,$255.47 ,87.2% of Billed charges for outpatient setting,$152.34 ,52% of charges,$238.16 ,81.29% of Billed charges for outpatient setting,$263.67 ,90% of Billed charges for outpatient setting,$263.67 ,90% of Billed charges for outpatient setting,$178.71 ,61% of Billed charges for outpatient setting,$178.71 ,61% of Billed charges for outpatient setting,$263.67 ,90% of Billed charges for outpatient setting,$263.67 ,90% of Billed charges for outpatient setting,$178.71 ,61% of Billed charges for outpatient setting,$178.71 ,61% of Billed charges for outpatient setting,$178.71 ,61% of Billed charges for outpatient setting,$152.34 ,52% of charges,$152.34 ,52% of charges,$152.34 ,52% of charges,$152.34 ,52% of charges,$152.34 ,52% of charges,$152.34 ,52% of charges,152.3444,263.67,$234.38 
Outpatient Medical Services,Radiology,72114,X-Ray Exam Of Lower Spine,320,$485.25 ,$412.46 ,85% of Billed charges for outpatient setting,$412.46 ,85% of Billed charges for outpatient setting,$360.44 ,74.28% of Billed charges for outpatient setting,$360.44 ,74.28% of Billed charges for outpatient setting,$296.00 ,61% of Billed charges for outpatient setting,$360.44 ,74.28% of Billed charges for outpatient setting,$436.73 ,90% of Billed charges for outpatient setting,$436.73 ,90% of Billed charges for outpatient setting,$254.85 ,52.52% of charges,$423.14 ,87.2% of Billed charges for outpatient setting,$296.00 ,61% of Billed charges for outpatient setting,$423.14 ,87.2% of Billed charges for outpatient setting,$252.33 ,52% of charges,$394.46 ,81.29% of Billed charges for outpatient setting,$436.73 ,90% of Billed charges for outpatient setting,$436.73 ,90% of Billed charges for outpatient setting,$296.00 ,61% of Billed charges for outpatient setting,$296.00 ,61% of Billed charges for outpatient setting,$436.73 ,90% of Billed charges for outpatient setting,$436.73 ,90% of Billed charges for outpatient setting,$296.00 ,61% of Billed charges for outpatient setting,$296.00 ,61% of Billed charges for outpatient setting,$296.00 ,61% of Billed charges for outpatient setting,$252.33 ,52% of charges,$252.33 ,52% of charges,$252.33 ,52% of charges,$252.33 ,52% of charges,$252.33 ,52% of charges,$252.33 ,52% of charges,252.33,436.73,$388.20 
Outpatient Medical Services,Radiology,72120,X-Ray Bend Only L-S Spine,320,$292.97 ,$249.02 ,85% of Billed charges for outpatient setting,$249.02 ,85% of Billed charges for outpatient setting,$217.62 ,74.28% of Billed charges for outpatient setting,$217.62 ,74.28% of Billed charges for outpatient setting,$178.71 ,61% of Billed charges for outpatient setting,$217.62 ,74.28% of Billed charges for outpatient setting,$263.67 ,90% of Billed charges for outpatient setting,$263.67 ,90% of Billed charges for outpatient setting,$153.87 ,52.52% of charges,$255.47 ,87.2% of Billed charges for outpatient setting,$178.71 ,61% of Billed charges for outpatient setting,$255.47 ,87.2% of Billed charges for outpatient setting,$152.34 ,52% of charges,$238.16 ,81.29% of Billed charges for outpatient setting,$263.67 ,90% of Billed charges for outpatient setting,$263.67 ,90% of Billed charges for outpatient setting,$178.71 ,61% of Billed charges for outpatient setting,$178.71 ,61% of Billed charges for outpatient setting,$263.67 ,90% of Billed charges for outpatient setting,$263.67 ,90% of Billed charges for outpatient setting,$178.71 ,61% of Billed charges for outpatient setting,$178.71 ,61% of Billed charges for outpatient setting,$178.71 ,61% of Billed charges for outpatient setting,$152.34 ,52% of charges,$152.34 ,52% of charges,$152.34 ,52% of charges,$152.34 ,52% of charges,$152.34 ,52% of charges,$152.34 ,52% of charges,152.3444,263.67,$234.38 
Outpatient Medical Services,Radiology,72125,"CT Scan, Cervical Spine, W/O Contrast",352,"$1,278.60 ","$1,086.81 ",85% of Billed charges for outpatient setting,"$1,086.81 ",85% of Billed charges for outpatient setting,$949.74 ,74.28% of Billed charges for outpatient setting,$949.74 ,74.28% of Billed charges for outpatient setting,$779.95 ,61% of Billed charges for outpatient setting,$949.74 ,74.28% of Billed charges for outpatient setting,"$1,150.74 ",90% of Billed charges for outpatient setting,"$1,150.74 ",90% of Billed charges for outpatient setting,$671.52 ,52.52% of charges,"$1,114.94 ",87.2% of Billed charges for outpatient setting,$779.95 ,61% of Billed charges for outpatient setting,"$1,114.94 ",87.2% of Billed charges for outpatient setting,$664.87 ,52% of charges,"$1,039.37 ",81.29% of Billed charges for outpatient setting,"$1,150.74 ",90% of Billed charges for outpatient setting,"$1,150.74 ",90% of Billed charges for outpatient setting,$779.95 ,61% of Billed charges for outpatient setting,$779.95 ,61% of Billed charges for outpatient setting,"$1,150.74 ",90% of Billed charges for outpatient setting,"$1,150.74 ",90% of Billed charges for outpatient setting,$779.95 ,61% of Billed charges for outpatient setting,$779.95 ,61% of Billed charges for outpatient setting,$779.95 ,61% of Billed charges for outpatient setting,$664.87 ,52% of charges,$664.87 ,52% of charges,$664.87 ,52% of charges,$664.87 ,52% of charges,$664.87 ,52% of charges,$664.87 ,52% of charges,664.872,1150.74,"$1,022.88 "
Outpatient Medical Services,Radiology,72126,CT Scan Cerv Spine Contrast,352,"$1,389.26 ","$1,180.87 ",85% of Billed charges for outpatient setting,"$1,180.87 ",85% of Billed charges for outpatient setting,"$1,031.94 ",74.28% of Billed charges for outpatient setting,"$1,031.94 ",74.28% of Billed charges for outpatient setting,$847.45 ,61% of Billed charges for outpatient setting,"$1,031.94 ",74.28% of Billed charges for outpatient setting,"$1,250.33 ",90% of Billed charges for outpatient setting,"$1,250.33 ",90% of Billed charges for outpatient setting,$729.64 ,52.52% of charges,"$1,211.43 ",87.2% of Billed charges for outpatient setting,$847.45 ,61% of Billed charges for outpatient setting,"$1,211.43 ",87.2% of Billed charges for outpatient setting,$722.42 ,52% of charges,"$1,129.33 ",81.29% of Billed charges for outpatient setting,"$1,250.33 ",90% of Billed charges for outpatient setting,"$1,250.33 ",90% of Billed charges for outpatient setting,$847.45 ,61% of Billed charges for outpatient setting,$847.45 ,61% of Billed charges for outpatient setting,"$1,250.33 ",90% of Billed charges for outpatient setting,"$1,250.33 ",90% of Billed charges for outpatient setting,$847.45 ,61% of Billed charges for outpatient setting,$847.45 ,61% of Billed charges for outpatient setting,$847.45 ,61% of Billed charges for outpatient setting,$722.42 ,52% of charges,$722.42 ,52% of charges,$722.42 ,52% of charges,$722.42 ,52% of charges,$722.42 ,52% of charges,$722.42 ,52% of charges,722.4152,1250.33,"$1,111.41 "
Outpatient Medical Services,Radiology,72128,"CT Scan, Thoracic Spine, W/O Contrast",352,"$1,104.53 ",$938.85 ,85% of Billed charges for outpatient setting,$938.85 ,85% of Billed charges for outpatient setting,$820.44 ,74.28% of Billed charges for outpatient setting,$820.44 ,74.28% of Billed charges for outpatient setting,$673.76 ,61% of Billed charges for outpatient setting,$820.44 ,74.28% of Billed charges for outpatient setting,$994.08 ,90% of Billed charges for outpatient setting,$994.08 ,90% of Billed charges for outpatient setting,$580.10 ,52.52% of charges,$963.15 ,87.2% of Billed charges for outpatient setting,$673.76 ,61% of Billed charges for outpatient setting,$963.15 ,87.2% of Billed charges for outpatient setting,$574.36 ,52% of charges,$897.87 ,81.29% of Billed charges for outpatient setting,$994.08 ,90% of Billed charges for outpatient setting,$994.08 ,90% of Billed charges for outpatient setting,$673.76 ,61% of Billed charges for outpatient setting,$673.76 ,61% of Billed charges for outpatient setting,$994.08 ,90% of Billed charges for outpatient setting,$994.08 ,90% of Billed charges for outpatient setting,$673.76 ,61% of Billed charges for outpatient setting,$673.76 ,61% of Billed charges for outpatient setting,$673.76 ,61% of Billed charges for outpatient setting,$574.36 ,52% of charges,$574.36 ,52% of charges,$574.36 ,52% of charges,$574.36 ,52% of charges,$574.36 ,52% of charges,$574.36 ,52% of charges,574.3556,994.08,$883.62 
Outpatient Medical Services,Radiology,72131,"CT Scan, Lumbar Spine, W/O Contrast",352,"$1,190.59 ","$1,012.00 ",85% of Billed charges for outpatient setting,"$1,012.00 ",85% of Billed charges for outpatient setting,$884.37 ,74.28% of Billed charges for outpatient setting,$884.37 ,74.28% of Billed charges for outpatient setting,$726.26 ,61% of Billed charges for outpatient setting,$884.37 ,74.28% of Billed charges for outpatient setting,"$1,071.53 ",90% of Billed charges for outpatient setting,"$1,071.53 ",90% of Billed charges for outpatient setting,$625.30 ,52.52% of charges,"$1,038.19 ",87.2% of Billed charges for outpatient setting,$726.26 ,61% of Billed charges for outpatient setting,"$1,038.19 ",87.2% of Billed charges for outpatient setting,$619.11 ,52% of charges,$967.83 ,81.29% of Billed charges for outpatient setting,"$1,071.53 ",90% of Billed charges for outpatient setting,"$1,071.53 ",90% of Billed charges for outpatient setting,$726.26 ,61% of Billed charges for outpatient setting,$726.26 ,61% of Billed charges for outpatient setting,"$1,071.53 ",90% of Billed charges for outpatient setting,"$1,071.53 ",90% of Billed charges for outpatient setting,$726.26 ,61% of Billed charges for outpatient setting,$726.26 ,61% of Billed charges for outpatient setting,$726.26 ,61% of Billed charges for outpatient setting,$619.11 ,52% of charges,$619.11 ,52% of charges,$619.11 ,52% of charges,$619.11 ,52% of charges,$619.11 ,52% of charges,$619.11 ,52% of charges,619.1068,1071.53,$952.47 
Outpatient Medical Services,Radiology,72132,CT Scan Lumbar Sp Contrast,352,"$1,253.19 ","$1,065.21 ",85% of Billed charges for outpatient setting,"$1,065.21 ",85% of Billed charges for outpatient setting,$930.87 ,74.28% of Billed charges for outpatient setting,$930.87 ,74.28% of Billed charges for outpatient setting,$764.45 ,61% of Billed charges for outpatient setting,$930.87 ,74.28% of Billed charges for outpatient setting,"$1,127.87 ",90% of Billed charges for outpatient setting,"$1,127.87 ",90% of Billed charges for outpatient setting,$658.18 ,52.52% of charges,"$1,092.78 ",87.2% of Billed charges for outpatient setting,$764.45 ,61% of Billed charges for outpatient setting,"$1,092.78 ",87.2% of Billed charges for outpatient setting,$651.66 ,52% of charges,"$1,018.72 ",81.29% of Billed charges for outpatient setting,"$1,127.87 ",90% of Billed charges for outpatient setting,"$1,127.87 ",90% of Billed charges for outpatient setting,$764.45 ,61% of Billed charges for outpatient setting,$764.45 ,61% of Billed charges for outpatient setting,"$1,127.87 ",90% of Billed charges for outpatient setting,"$1,127.87 ",90% of Billed charges for outpatient setting,$764.45 ,61% of Billed charges for outpatient setting,$764.45 ,61% of Billed charges for outpatient setting,$764.45 ,61% of Billed charges for outpatient setting,$651.66 ,52% of charges,$651.66 ,52% of charges,$651.66 ,52% of charges,$651.66 ,52% of charges,$651.66 ,52% of charges,$651.66 ,52% of charges,651.6588,1127.87,"$1,002.55 "
Outpatient Medical Services,Radiology,72141,"MRI,  Cerv Spine",612,"$1,701.13 ","$1,445.96 ",85% of Billed charges for outpatient setting,"$1,445.96 ",85% of Billed charges for outpatient setting,"$1,263.60 ",74.28% of Billed charges for outpatient setting,"$1,263.60 ",74.28% of Billed charges for outpatient setting,"$1,037.69 ",61% of Billed charges for outpatient setting,"$1,263.60 ",74.28% of Billed charges for outpatient setting,"$1,531.02 ",90% of Billed charges for outpatient setting,"$1,531.02 ",90% of Billed charges for outpatient setting,$893.43 ,52.52% of charges,"$1,483.39 ",87.2% of Billed charges for outpatient setting,"$1,037.69 ",61% of Billed charges for outpatient setting,"$1,483.39 ",87.2% of Billed charges for outpatient setting,$884.59 ,52% of charges,"$1,382.85 ",81.29% of Billed charges for outpatient setting,"$1,531.02 ",90% of Billed charges for outpatient setting,"$1,531.02 ",90% of Billed charges for outpatient setting,"$1,037.69 ",61% of Billed charges for outpatient setting,"$1,037.69 ",61% of Billed charges for outpatient setting,"$1,531.02 ",90% of Billed charges for outpatient setting,"$1,531.02 ",90% of Billed charges for outpatient setting,"$1,037.69 ",61% of Billed charges for outpatient setting,"$1,037.69 ",61% of Billed charges for outpatient setting,"$1,037.69 ",61% of Billed charges for outpatient setting,$884.59 ,52% of charges,$884.59 ,52% of charges,$884.59 ,52% of charges,$884.59 ,52% of charges,$884.59 ,52% of charges,$884.59 ,52% of charges,884.5876,1531.02,"$1,360.90 "
Outpatient Medical Services,Radiology,72146,"MRI,  Dorsal Spine",612,"$1,601.40 ","$1,361.19 ",85% of Billed charges for outpatient setting,"$1,361.19 ",85% of Billed charges for outpatient setting,"$1,189.52 ",74.28% of Billed charges for outpatient setting,"$1,189.52 ",74.28% of Billed charges for outpatient setting,$976.85 ,61% of Billed charges for outpatient setting,"$1,189.52 ",74.28% of Billed charges for outpatient setting,"$1,441.26 ",90% of Billed charges for outpatient setting,"$1,441.26 ",90% of Billed charges for outpatient setting,$841.06 ,52.52% of charges,"$1,396.42 ",87.2% of Billed charges for outpatient setting,$976.85 ,61% of Billed charges for outpatient setting,"$1,396.42 ",87.2% of Billed charges for outpatient setting,$832.73 ,52% of charges,"$1,301.78 ",81.29% of Billed charges for outpatient setting,"$1,441.26 ",90% of Billed charges for outpatient setting,"$1,441.26 ",90% of Billed charges for outpatient setting,$976.85 ,61% of Billed charges for outpatient setting,$976.85 ,61% of Billed charges for outpatient setting,"$1,441.26 ",90% of Billed charges for outpatient setting,"$1,441.26 ",90% of Billed charges for outpatient setting,$976.85 ,61% of Billed charges for outpatient setting,$976.85 ,61% of Billed charges for outpatient setting,$976.85 ,61% of Billed charges for outpatient setting,$832.73 ,52% of charges,$832.73 ,52% of charges,$832.73 ,52% of charges,$832.73 ,52% of charges,$832.73 ,52% of charges,$832.73 ,52% of charges,832.728,1441.26,"$1,281.12 "
Outpatient Medical Services,Radiology,72148,"MRI,  Lumbar Spine",612,"$1,789.19 ","$1,520.81 ",85% of Billed charges for outpatient setting,"$1,520.81 ",85% of Billed charges for outpatient setting,"$1,329.01 ",74.28% of Billed charges for outpatient setting,"$1,329.01 ",74.28% of Billed charges for outpatient setting,"$1,091.41 ",61% of Billed charges for outpatient setting,"$1,329.01 ",74.28% of Billed charges for outpatient setting,"$1,610.27 ",90% of Billed charges for outpatient setting,"$1,610.27 ",90% of Billed charges for outpatient setting,$939.68 ,52.52% of charges,"$1,560.17 ",87.2% of Billed charges for outpatient setting,"$1,091.41 ",61% of Billed charges for outpatient setting,"$1,560.17 ",87.2% of Billed charges for outpatient setting,$930.38 ,52% of charges,"$1,454.43 ",81.29% of Billed charges for outpatient setting,"$1,610.27 ",90% of Billed charges for outpatient setting,"$1,610.27 ",90% of Billed charges for outpatient setting,"$1,091.41 ",61% of Billed charges for outpatient setting,"$1,091.41 ",61% of Billed charges for outpatient setting,"$1,610.27 ",90% of Billed charges for outpatient setting,"$1,610.27 ",90% of Billed charges for outpatient setting,"$1,091.41 ",61% of Billed charges for outpatient setting,"$1,091.41 ",61% of Billed charges for outpatient setting,"$1,091.41 ",61% of Billed charges for outpatient setting,$930.38 ,52% of charges,$930.38 ,52% of charges,$930.38 ,52% of charges,$930.38 ,52% of charges,$930.38 ,52% of charges,$930.38 ,52% of charges,930.3788,1610.27,"$1,431.35 "
Outpatient Medical Services,Radiology,72156,"MRI,  Cerv Spine Combo",612,"$2,704.97 ","$2,299.22 ",85% of Billed charges for outpatient setting,"$2,299.22 ",85% of Billed charges for outpatient setting,"$2,009.25 ",74.28% of Billed charges for outpatient setting,"$2,009.25 ",74.28% of Billed charges for outpatient setting,"$1,650.03 ",61% of Billed charges for outpatient setting,"$2,009.25 ",74.28% of Billed charges for outpatient setting,"$2,434.47 ",90% of Billed charges for outpatient setting,"$2,434.47 ",90% of Billed charges for outpatient setting,"$1,420.65 ",52.52% of charges,"$2,358.73 ",87.2% of Billed charges for outpatient setting,"$1,650.03 ",61% of Billed charges for outpatient setting,"$2,358.73 ",87.2% of Billed charges for outpatient setting,"$1,406.58 ",52% of charges,"$2,198.87 ",81.29% of Billed charges for outpatient setting,"$2,434.47 ",90% of Billed charges for outpatient setting,"$2,434.47 ",90% of Billed charges for outpatient setting,"$1,650.03 ",61% of Billed charges for outpatient setting,"$1,650.03 ",61% of Billed charges for outpatient setting,"$2,434.47 ",90% of Billed charges for outpatient setting,"$2,434.47 ",90% of Billed charges for outpatient setting,"$1,650.03 ",61% of Billed charges for outpatient setting,"$1,650.03 ",61% of Billed charges for outpatient setting,"$1,650.03 ",61% of Billed charges for outpatient setting,"$1,406.58 ",52% of charges,"$1,406.58 ",52% of charges,"$1,406.58 ",52% of charges,"$1,406.58 ",52% of charges,"$1,406.58 ",52% of charges,"$1,406.58 ",52% of charges,1406.5844,2434.47,"$2,163.98 "
Outpatient Medical Services,Radiology,72157,"MRI,  Dorsal Spine Combo",612,"$2,704.97 ","$2,299.22 ",85% of Billed charges for outpatient setting,"$2,299.22 ",85% of Billed charges for outpatient setting,"$2,009.25 ",74.28% of Billed charges for outpatient setting,"$2,009.25 ",74.28% of Billed charges for outpatient setting,"$1,650.03 ",61% of Billed charges for outpatient setting,"$2,009.25 ",74.28% of Billed charges for outpatient setting,"$2,434.47 ",90% of Billed charges for outpatient setting,"$2,434.47 ",90% of Billed charges for outpatient setting,"$1,420.65 ",52.52% of charges,"$2,358.73 ",87.2% of Billed charges for outpatient setting,"$1,650.03 ",61% of Billed charges for outpatient setting,"$2,358.73 ",87.2% of Billed charges for outpatient setting,"$1,406.58 ",52% of charges,"$2,198.87 ",81.29% of Billed charges for outpatient setting,"$2,434.47 ",90% of Billed charges for outpatient setting,"$2,434.47 ",90% of Billed charges for outpatient setting,"$1,650.03 ",61% of Billed charges for outpatient setting,"$1,650.03 ",61% of Billed charges for outpatient setting,"$2,434.47 ",90% of Billed charges for outpatient setting,"$2,434.47 ",90% of Billed charges for outpatient setting,"$1,650.03 ",61% of Billed charges for outpatient setting,"$1,650.03 ",61% of Billed charges for outpatient setting,"$1,650.03 ",61% of Billed charges for outpatient setting,"$1,406.58 ",52% of charges,"$1,406.58 ",52% of charges,"$1,406.58 ",52% of charges,"$1,406.58 ",52% of charges,"$1,406.58 ",52% of charges,"$1,406.58 ",52% of charges,1406.5844,2434.47,"$2,163.98 "
Outpatient Medical Services,Radiology,72158,"MRI,  Lumbar Spine Combo",612,"$3,165.57 ","$2,690.73 ",85% of Billed charges for outpatient setting,"$2,690.73 ",85% of Billed charges for outpatient setting,"$2,351.39 ",74.28% of Billed charges for outpatient setting,"$2,351.39 ",74.28% of Billed charges for outpatient setting,"$1,931.00 ",61% of Billed charges for outpatient setting,"$2,351.39 ",74.28% of Billed charges for outpatient setting,"$2,849.01 ",90% of Billed charges for outpatient setting,"$2,849.01 ",90% of Billed charges for outpatient setting,"$1,662.56 ",52.52% of charges,"$2,760.38 ",87.2% of Billed charges for outpatient setting,"$1,931.00 ",61% of Billed charges for outpatient setting,"$2,760.38 ",87.2% of Billed charges for outpatient setting,"$1,646.10 ",52% of charges,"$2,573.29 ",81.29% of Billed charges for outpatient setting,"$2,849.01 ",90% of Billed charges for outpatient setting,"$2,849.01 ",90% of Billed charges for outpatient setting,"$1,931.00 ",61% of Billed charges for outpatient setting,"$1,931.00 ",61% of Billed charges for outpatient setting,"$2,849.01 ",90% of Billed charges for outpatient setting,"$2,849.01 ",90% of Billed charges for outpatient setting,"$1,931.00 ",61% of Billed charges for outpatient setting,"$1,931.00 ",61% of Billed charges for outpatient setting,"$1,931.00 ",61% of Billed charges for outpatient setting,"$1,646.10 ",52% of charges,"$1,646.10 ",52% of charges,"$1,646.10 ",52% of charges,"$1,646.10 ",52% of charges,"$1,646.10 ",52% of charges,"$1,646.10 ",52% of charges,1646.0964,2849.01,"$2,532.46 "
Outpatient Medical Services,Radiology,72170,X-Ray Exam Of Pelvis 1-2 Views,320,$148.82 ,$126.50 ,85% of Billed charges for outpatient setting,$126.50 ,85% of Billed charges for outpatient setting,$110.54 ,74.28% of Billed charges for outpatient setting,$110.54 ,74.28% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$110.54 ,74.28% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$78.16 ,52.52% of charges,$129.77 ,87.2% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$129.77 ,87.2% of Billed charges for outpatient setting,$77.39 ,52% of charges,$120.98 ,81.29% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$77.39 ,52% of charges,$77.39 ,52% of charges,$77.39 ,52% of charges,$77.39 ,52% of charges,$77.39 ,52% of charges,$77.39 ,52% of charges,77.3864,133.94,$119.06 
Outpatient Medical Services,Radiology,72190,X-Ray Exam Of Pelvis 3+ Views,320,$186.94 ,$158.90 ,85% of Billed charges for outpatient setting,$158.90 ,85% of Billed charges for outpatient setting,$138.86 ,74.28% of Billed charges for outpatient setting,$138.86 ,74.28% of Billed charges for outpatient setting,$114.03 ,61% of Billed charges for outpatient setting,$138.86 ,74.28% of Billed charges for outpatient setting,$168.25 ,90% of Billed charges for outpatient setting,$168.25 ,90% of Billed charges for outpatient setting,$98.18 ,52.52% of charges,$163.01 ,87.2% of Billed charges for outpatient setting,$114.03 ,61% of Billed charges for outpatient setting,$163.01 ,87.2% of Billed charges for outpatient setting,$97.21 ,52% of charges,$151.96 ,81.29% of Billed charges for outpatient setting,$168.25 ,90% of Billed charges for outpatient setting,$168.25 ,90% of Billed charges for outpatient setting,$114.03 ,61% of Billed charges for outpatient setting,$114.03 ,61% of Billed charges for outpatient setting,$168.25 ,90% of Billed charges for outpatient setting,$168.25 ,90% of Billed charges for outpatient setting,$114.03 ,61% of Billed charges for outpatient setting,$114.03 ,61% of Billed charges for outpatient setting,$114.03 ,61% of Billed charges for outpatient setting,$97.21 ,52% of charges,$97.21 ,52% of charges,$97.21 ,52% of charges,$97.21 ,52% of charges,$97.21 ,52% of charges,$97.21 ,52% of charges,97.2088,168.25,$149.55 
Outpatient Medical Services,Radiology,72192,"CT Scan, Pelvis, W/O Contrast",352,"$1,001.21 ",$851.03 ,85% of Billed charges for outpatient setting,$851.03 ,85% of Billed charges for outpatient setting,$743.70 ,74.28% of Billed charges for outpatient setting,$743.70 ,74.28% of Billed charges for outpatient setting,$610.74 ,61% of Billed charges for outpatient setting,$743.70 ,74.28% of Billed charges for outpatient setting,$901.09 ,90% of Billed charges for outpatient setting,$901.09 ,90% of Billed charges for outpatient setting,$525.84 ,52.52% of charges,$873.06 ,87.2% of Billed charges for outpatient setting,$610.74 ,61% of Billed charges for outpatient setting,$873.06 ,87.2% of Billed charges for outpatient setting,$520.63 ,52% of charges,$813.88 ,81.29% of Billed charges for outpatient setting,$901.09 ,90% of Billed charges for outpatient setting,$901.09 ,90% of Billed charges for outpatient setting,$610.74 ,61% of Billed charges for outpatient setting,$610.74 ,61% of Billed charges for outpatient setting,$901.09 ,90% of Billed charges for outpatient setting,$901.09 ,90% of Billed charges for outpatient setting,$610.74 ,61% of Billed charges for outpatient setting,$610.74 ,61% of Billed charges for outpatient setting,$610.74 ,61% of Billed charges for outpatient setting,$520.63 ,52% of charges,$520.63 ,52% of charges,$520.63 ,52% of charges,$520.63 ,52% of charges,$520.63 ,52% of charges,$520.63 ,52% of charges,520.6292,901.09,$800.97 
Outpatient Medical Services,Radiology,72193,CT Scan Of Pelvis Contrast,352,"$1,266.88 ","$1,076.85 ",85% of Billed charges for outpatient setting,"$1,076.85 ",85% of Billed charges for outpatient setting,$941.04 ,74.28% of Billed charges for outpatient setting,$941.04 ,74.28% of Billed charges for outpatient setting,$772.80 ,61% of Billed charges for outpatient setting,$941.04 ,74.28% of Billed charges for outpatient setting,"$1,140.19 ",90% of Billed charges for outpatient setting,"$1,140.19 ",90% of Billed charges for outpatient setting,$665.37 ,52.52% of charges,"$1,104.72 ",87.2% of Billed charges for outpatient setting,$772.80 ,61% of Billed charges for outpatient setting,"$1,104.72 ",87.2% of Billed charges for outpatient setting,$658.78 ,52% of charges,"$1,029.85 ",81.29% of Billed charges for outpatient setting,"$1,140.19 ",90% of Billed charges for outpatient setting,"$1,140.19 ",90% of Billed charges for outpatient setting,$772.80 ,61% of Billed charges for outpatient setting,$772.80 ,61% of Billed charges for outpatient setting,"$1,140.19 ",90% of Billed charges for outpatient setting,"$1,140.19 ",90% of Billed charges for outpatient setting,$772.80 ,61% of Billed charges for outpatient setting,$772.80 ,61% of Billed charges for outpatient setting,$772.80 ,61% of Billed charges for outpatient setting,$658.78 ,52% of charges,$658.78 ,52% of charges,$658.78 ,52% of charges,$658.78 ,52% of charges,$658.78 ,52% of charges,$658.78 ,52% of charges,658.7776,1140.19,"$1,013.50 "
Outpatient Medical Services,Radiology,72202,X-Ray Exam Sacroiliac Joints 3+ Views,320,$285.72 ,$242.86 ,85% of Billed charges for outpatient setting,$242.86 ,85% of Billed charges for outpatient setting,$212.23 ,74.28% of Billed charges for outpatient setting,$212.23 ,74.28% of Billed charges for outpatient setting,$174.29 ,61% of Billed charges for outpatient setting,$212.23 ,74.28% of Billed charges for outpatient setting,$257.15 ,90% of Billed charges for outpatient setting,$257.15 ,90% of Billed charges for outpatient setting,$150.06 ,52.52% of charges,$249.15 ,87.2% of Billed charges for outpatient setting,$174.29 ,61% of Billed charges for outpatient setting,$249.15 ,87.2% of Billed charges for outpatient setting,$148.57 ,52% of charges,$232.26 ,81.29% of Billed charges for outpatient setting,$257.15 ,90% of Billed charges for outpatient setting,$257.15 ,90% of Billed charges for outpatient setting,$174.29 ,61% of Billed charges for outpatient setting,$174.29 ,61% of Billed charges for outpatient setting,$257.15 ,90% of Billed charges for outpatient setting,$257.15 ,90% of Billed charges for outpatient setting,$174.29 ,61% of Billed charges for outpatient setting,$174.29 ,61% of Billed charges for outpatient setting,$174.29 ,61% of Billed charges for outpatient setting,$148.57 ,52% of charges,$148.57 ,52% of charges,$148.57 ,52% of charges,$148.57 ,52% of charges,$148.57 ,52% of charges,$148.57 ,52% of charges,148.5744,257.15,$228.58 
Outpatient Medical Services,Radiology,72220,X-Ray Exam Of Tailbone 2+ Views,320,$157.00 ,$133.45 ,85% of Billed charges for outpatient setting,$133.45 ,85% of Billed charges for outpatient setting,$116.62 ,74.28% of Billed charges for outpatient setting,$116.62 ,74.28% of Billed charges for outpatient setting,$95.77 ,61% of Billed charges for outpatient setting,$116.62 ,74.28% of Billed charges for outpatient setting,$141.30 ,90% of Billed charges for outpatient setting,$141.30 ,90% of Billed charges for outpatient setting,$82.46 ,52.52% of charges,$136.90 ,87.2% of Billed charges for outpatient setting,$95.77 ,61% of Billed charges for outpatient setting,$136.90 ,87.2% of Billed charges for outpatient setting,$81.64 ,52% of charges,$127.63 ,81.29% of Billed charges for outpatient setting,$141.30 ,90% of Billed charges for outpatient setting,$141.30 ,90% of Billed charges for outpatient setting,$95.77 ,61% of Billed charges for outpatient setting,$95.77 ,61% of Billed charges for outpatient setting,$141.30 ,90% of Billed charges for outpatient setting,$141.30 ,90% of Billed charges for outpatient setting,$95.77 ,61% of Billed charges for outpatient setting,$95.77 ,61% of Billed charges for outpatient setting,$95.77 ,61% of Billed charges for outpatient setting,$81.64 ,52% of charges,$81.64 ,52% of charges,$81.64 ,52% of charges,$81.64 ,52% of charges,$81.64 ,52% of charges,$81.64 ,52% of charges,81.64,141.3,$125.60 
Outpatient Medical Services,Radiology,73000,Clavicle Complete,320,$170.54 ,$144.96 ,85% of Billed charges for outpatient setting,$144.96 ,85% of Billed charges for outpatient setting,$126.68 ,74.28% of Billed charges for outpatient setting,$126.68 ,74.28% of Billed charges for outpatient setting,$104.03 ,61% of Billed charges for outpatient setting,$126.68 ,74.28% of Billed charges for outpatient setting,$153.49 ,90% of Billed charges for outpatient setting,$153.49 ,90% of Billed charges for outpatient setting,$89.57 ,52.52% of charges,$148.71 ,87.2% of Billed charges for outpatient setting,$104.03 ,61% of Billed charges for outpatient setting,$148.71 ,87.2% of Billed charges for outpatient setting,$88.68 ,52% of charges,$138.63 ,81.29% of Billed charges for outpatient setting,$153.49 ,90% of Billed charges for outpatient setting,$153.49 ,90% of Billed charges for outpatient setting,$104.03 ,61% of Billed charges for outpatient setting,$104.03 ,61% of Billed charges for outpatient setting,$153.49 ,90% of Billed charges for outpatient setting,$153.49 ,90% of Billed charges for outpatient setting,$104.03 ,61% of Billed charges for outpatient setting,$104.03 ,61% of Billed charges for outpatient setting,$104.03 ,61% of Billed charges for outpatient setting,$88.68 ,52% of charges,$88.68 ,52% of charges,$88.68 ,52% of charges,$88.68 ,52% of charges,$88.68 ,52% of charges,$88.68 ,52% of charges,88.6808,153.49,$136.43 
Outpatient Medical Services,Radiology,73010,Scapula Complete,320,$192.36 ,$163.51 ,85% of Billed charges for outpatient setting,$163.51 ,85% of Billed charges for outpatient setting,$142.89 ,74.28% of Billed charges for outpatient setting,$142.89 ,74.28% of Billed charges for outpatient setting,$117.34 ,61% of Billed charges for outpatient setting,$142.89 ,74.28% of Billed charges for outpatient setting,$173.12 ,90% of Billed charges for outpatient setting,$173.12 ,90% of Billed charges for outpatient setting,$101.03 ,52.52% of charges,$167.74 ,87.2% of Billed charges for outpatient setting,$117.34 ,61% of Billed charges for outpatient setting,$167.74 ,87.2% of Billed charges for outpatient setting,$100.03 ,52% of charges,$156.37 ,81.29% of Billed charges for outpatient setting,$173.12 ,90% of Billed charges for outpatient setting,$173.12 ,90% of Billed charges for outpatient setting,$117.34 ,61% of Billed charges for outpatient setting,$117.34 ,61% of Billed charges for outpatient setting,$173.12 ,90% of Billed charges for outpatient setting,$173.12 ,90% of Billed charges for outpatient setting,$117.34 ,61% of Billed charges for outpatient setting,$117.34 ,61% of Billed charges for outpatient setting,$117.34 ,61% of Billed charges for outpatient setting,$100.03 ,52% of charges,$100.03 ,52% of charges,$100.03 ,52% of charges,$100.03 ,52% of charges,$100.03 ,52% of charges,$100.03 ,52% of charges,100.0272,173.12,$153.89 
Outpatient Medical Services,Radiology,73030,X-Ray Exam Of Shoulder 2+ Views,320,$216.87 ,$184.34 ,85% of Billed charges for outpatient setting,$184.34 ,85% of Billed charges for outpatient setting,$161.09 ,74.28% of Billed charges for outpatient setting,$161.09 ,74.28% of Billed charges for outpatient setting,$132.29 ,61% of Billed charges for outpatient setting,$161.09 ,74.28% of Billed charges for outpatient setting,$195.18 ,90% of Billed charges for outpatient setting,$195.18 ,90% of Billed charges for outpatient setting,$113.90 ,52.52% of charges,$189.11 ,87.2% of Billed charges for outpatient setting,$132.29 ,61% of Billed charges for outpatient setting,$189.11 ,87.2% of Billed charges for outpatient setting,$112.77 ,52% of charges,$176.29 ,81.29% of Billed charges for outpatient setting,$195.18 ,90% of Billed charges for outpatient setting,$195.18 ,90% of Billed charges for outpatient setting,$132.29 ,61% of Billed charges for outpatient setting,$132.29 ,61% of Billed charges for outpatient setting,$195.18 ,90% of Billed charges for outpatient setting,$195.18 ,90% of Billed charges for outpatient setting,$132.29 ,61% of Billed charges for outpatient setting,$132.29 ,61% of Billed charges for outpatient setting,$132.29 ,61% of Billed charges for outpatient setting,$112.77 ,52% of charges,$112.77 ,52% of charges,$112.77 ,52% of charges,$112.77 ,52% of charges,$112.77 ,52% of charges,$112.77 ,52% of charges,112.7724,195.18,$173.50 
Outpatient Medical Services,Radiology,73050,ACJ Bilateral W/Wo Weights,320,$185.11 ,$157.34 ,85% of Billed charges for outpatient setting,$157.34 ,85% of Billed charges for outpatient setting,$137.50 ,74.28% of Billed charges for outpatient setting,$137.50 ,74.28% of Billed charges for outpatient setting,$112.92 ,61% of Billed charges for outpatient setting,$137.50 ,74.28% of Billed charges for outpatient setting,$166.60 ,90% of Billed charges for outpatient setting,$166.60 ,90% of Billed charges for outpatient setting,$97.22 ,52.52% of charges,$161.42 ,87.2% of Billed charges for outpatient setting,$112.92 ,61% of Billed charges for outpatient setting,$161.42 ,87.2% of Billed charges for outpatient setting,$96.26 ,52% of charges,$150.48 ,81.29% of Billed charges for outpatient setting,$166.60 ,90% of Billed charges for outpatient setting,$166.60 ,90% of Billed charges for outpatient setting,$112.92 ,61% of Billed charges for outpatient setting,$112.92 ,61% of Billed charges for outpatient setting,$166.60 ,90% of Billed charges for outpatient setting,$166.60 ,90% of Billed charges for outpatient setting,$112.92 ,61% of Billed charges for outpatient setting,$112.92 ,61% of Billed charges for outpatient setting,$112.92 ,61% of Billed charges for outpatient setting,$96.26 ,52% of charges,$96.26 ,52% of charges,$96.26 ,52% of charges,$96.26 ,52% of charges,$96.26 ,52% of charges,$96.26 ,52% of charges,96.2572,166.6,$148.09 
Outpatient Medical Services,Radiology,73060,X-Ray Exam Of Humerultrasound 2+ Views,320,$148.82 ,$126.50 ,85% of Billed charges for outpatient setting,$126.50 ,85% of Billed charges for outpatient setting,$110.54 ,74.28% of Billed charges for outpatient setting,$110.54 ,74.28% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$110.54 ,74.28% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$78.16 ,52.52% of charges,$129.77 ,87.2% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$129.77 ,87.2% of Billed charges for outpatient setting,$77.39 ,52% of charges,$120.98 ,81.29% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$77.39 ,52% of charges,$77.39 ,52% of charges,$77.39 ,52% of charges,$77.39 ,52% of charges,$77.39 ,52% of charges,$77.39 ,52% of charges,77.3864,133.94,$119.06 
Outpatient Medical Services,Radiology,73070,X-Ray Exam Of Elbow 2 Views,320,$148.82 ,$126.50 ,85% of Billed charges for outpatient setting,$126.50 ,85% of Billed charges for outpatient setting,$110.54 ,74.28% of Billed charges for outpatient setting,$110.54 ,74.28% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$110.54 ,74.28% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$78.16 ,52.52% of charges,$129.77 ,87.2% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$129.77 ,87.2% of Billed charges for outpatient setting,$77.39 ,52% of charges,$120.98 ,81.29% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$77.39 ,52% of charges,$77.39 ,52% of charges,$77.39 ,52% of charges,$77.39 ,52% of charges,$77.39 ,52% of charges,$77.39 ,52% of charges,77.3864,133.94,$119.06 
Outpatient Medical Services,Radiology,73080,X-Ray Exam Of Elbow 3+ Views Unilat,320,$210.45 ,$178.88 ,85% of Billed charges for outpatient setting,$178.88 ,85% of Billed charges for outpatient setting,$156.32 ,74.28% of Billed charges for outpatient setting,$156.32 ,74.28% of Billed charges for outpatient setting,$128.37 ,61% of Billed charges for outpatient setting,$156.32 ,74.28% of Billed charges for outpatient setting,$189.41 ,90% of Billed charges for outpatient setting,$189.41 ,90% of Billed charges for outpatient setting,$110.53 ,52.52% of charges,$183.51 ,87.2% of Billed charges for outpatient setting,$128.37 ,61% of Billed charges for outpatient setting,$183.51 ,87.2% of Billed charges for outpatient setting,$109.43 ,52% of charges,$171.07 ,81.29% of Billed charges for outpatient setting,$189.41 ,90% of Billed charges for outpatient setting,$189.41 ,90% of Billed charges for outpatient setting,$128.37 ,61% of Billed charges for outpatient setting,$128.37 ,61% of Billed charges for outpatient setting,$189.41 ,90% of Billed charges for outpatient setting,$189.41 ,90% of Billed charges for outpatient setting,$128.37 ,61% of Billed charges for outpatient setting,$128.37 ,61% of Billed charges for outpatient setting,$128.37 ,61% of Billed charges for outpatient setting,$109.43 ,52% of charges,$109.43 ,52% of charges,$109.43 ,52% of charges,$109.43 ,52% of charges,$109.43 ,52% of charges,$109.43 ,52% of charges,109.434,189.41,$168.36 
Outpatient Medical Services,Radiology,73080,X-Ray Exam Of Elbow 3+ Views Bilat,320,$420.87 ,$357.74 ,85% of Billed charges for outpatient setting,$357.74 ,85% of Billed charges for outpatient setting,$312.62 ,74.28% of Billed charges for outpatient setting,$312.62 ,74.28% of Billed charges for outpatient setting,$256.73 ,61% of Billed charges for outpatient setting,$312.62 ,74.28% of Billed charges for outpatient setting,$378.78 ,90% of Billed charges for outpatient setting,$378.78 ,90% of Billed charges for outpatient setting,$221.04 ,52.52% of charges,$367.00 ,87.2% of Billed charges for outpatient setting,$256.73 ,61% of Billed charges for outpatient setting,$367.00 ,87.2% of Billed charges for outpatient setting,$218.85 ,52% of charges,$342.13 ,81.29% of Billed charges for outpatient setting,$378.78 ,90% of Billed charges for outpatient setting,$378.78 ,90% of Billed charges for outpatient setting,$256.73 ,61% of Billed charges for outpatient setting,$256.73 ,61% of Billed charges for outpatient setting,$378.78 ,90% of Billed charges for outpatient setting,$378.78 ,90% of Billed charges for outpatient setting,$256.73 ,61% of Billed charges for outpatient setting,$256.73 ,61% of Billed charges for outpatient setting,$256.73 ,61% of Billed charges for outpatient setting,$218.85 ,52% of charges,$218.85 ,52% of charges,$218.85 ,52% of charges,$218.85 ,52% of charges,$218.85 ,52% of charges,$218.85 ,52% of charges,218.8524,378.78,$336.70 
Outpatient Medical Services,Radiology,73090,X-Ray Exam Of Forearm 2 Views Unilat,320,$148.82 ,$126.50 ,85% of Billed charges for outpatient setting,$126.50 ,85% of Billed charges for outpatient setting,$110.54 ,74.28% of Billed charges for outpatient setting,$110.54 ,74.28% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$110.54 ,74.28% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$78.16 ,52.52% of charges,$129.77 ,87.2% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$129.77 ,87.2% of Billed charges for outpatient setting,$77.39 ,52% of charges,$120.98 ,81.29% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$77.39 ,52% of charges,$77.39 ,52% of charges,$77.39 ,52% of charges,$77.39 ,52% of charges,$77.39 ,52% of charges,$77.39 ,52% of charges,77.3864,133.94,$119.06 
Outpatient Medical Services,Radiology,73090,X-Ray Exam Of Forearm 2 Views Bilat,320,$297.67 ,$253.02 ,85% of Billed charges for outpatient setting,$253.02 ,85% of Billed charges for outpatient setting,$221.11 ,74.28% of Billed charges for outpatient setting,$221.11 ,74.28% of Billed charges for outpatient setting,$181.58 ,61% of Billed charges for outpatient setting,$221.11 ,74.28% of Billed charges for outpatient setting,$267.90 ,90% of Billed charges for outpatient setting,$267.90 ,90% of Billed charges for outpatient setting,$156.34 ,52.52% of charges,$259.57 ,87.2% of Billed charges for outpatient setting,$181.58 ,61% of Billed charges for outpatient setting,$259.57 ,87.2% of Billed charges for outpatient setting,$154.79 ,52% of charges,$241.98 ,81.29% of Billed charges for outpatient setting,$267.90 ,90% of Billed charges for outpatient setting,$267.90 ,90% of Billed charges for outpatient setting,$181.58 ,61% of Billed charges for outpatient setting,$181.58 ,61% of Billed charges for outpatient setting,$267.90 ,90% of Billed charges for outpatient setting,$267.90 ,90% of Billed charges for outpatient setting,$181.58 ,61% of Billed charges for outpatient setting,$181.58 ,61% of Billed charges for outpatient setting,$181.58 ,61% of Billed charges for outpatient setting,$154.79 ,52% of charges,$154.79 ,52% of charges,$154.79 ,52% of charges,$154.79 ,52% of charges,$154.79 ,52% of charges,$154.79 ,52% of charges,154.7884,267.9,$238.14 
Outpatient Medical Services,Radiology,73092,X-Ray Exam Of Arm Infant 2+ Views,320,$148.82 ,$126.50 ,85% of Billed charges for outpatient setting,$126.50 ,85% of Billed charges for outpatient setting,$110.54 ,74.28% of Billed charges for outpatient setting,$110.54 ,74.28% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$110.54 ,74.28% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$78.16 ,52.52% of charges,$129.77 ,87.2% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$129.77 ,87.2% of Billed charges for outpatient setting,$77.39 ,52% of charges,$120.98 ,81.29% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$77.39 ,52% of charges,$77.39 ,52% of charges,$77.39 ,52% of charges,$77.39 ,52% of charges,$77.39 ,52% of charges,$77.39 ,52% of charges,77.3864,133.94,$119.06 
Outpatient Medical Services,Radiology,73100,X-Ray Exam Of Wrist 2 Views Unilat,320,$190.57 ,$161.98 ,85% of Billed charges for outpatient setting,$161.98 ,85% of Billed charges for outpatient setting,$141.56 ,74.28% of Billed charges for outpatient setting,$141.56 ,74.28% of Billed charges for outpatient setting,$116.25 ,61% of Billed charges for outpatient setting,$141.56 ,74.28% of Billed charges for outpatient setting,$171.51 ,90% of Billed charges for outpatient setting,$171.51 ,90% of Billed charges for outpatient setting,$100.09 ,52.52% of charges,$166.18 ,87.2% of Billed charges for outpatient setting,$116.25 ,61% of Billed charges for outpatient setting,$166.18 ,87.2% of Billed charges for outpatient setting,$99.10 ,52% of charges,$154.91 ,81.29% of Billed charges for outpatient setting,$171.51 ,90% of Billed charges for outpatient setting,$171.51 ,90% of Billed charges for outpatient setting,$116.25 ,61% of Billed charges for outpatient setting,$116.25 ,61% of Billed charges for outpatient setting,$171.51 ,90% of Billed charges for outpatient setting,$171.51 ,90% of Billed charges for outpatient setting,$116.25 ,61% of Billed charges for outpatient setting,$116.25 ,61% of Billed charges for outpatient setting,$116.25 ,61% of Billed charges for outpatient setting,$99.10 ,52% of charges,$99.10 ,52% of charges,$99.10 ,52% of charges,$99.10 ,52% of charges,$99.10 ,52% of charges,$99.10 ,52% of charges,99.0964,171.51,$152.46 
Outpatient Medical Services,Radiology,73100,X-Ray Exam Of Wrist 2 Views Bilat,320,$381.13 ,$323.96 ,85% of Billed charges for outpatient setting,$323.96 ,85% of Billed charges for outpatient setting,$283.10 ,74.28% of Billed charges for outpatient setting,$283.10 ,74.28% of Billed charges for outpatient setting,$232.49 ,61% of Billed charges for outpatient setting,$283.10 ,74.28% of Billed charges for outpatient setting,$343.02 ,90% of Billed charges for outpatient setting,$343.02 ,90% of Billed charges for outpatient setting,$200.17 ,52.52% of charges,$332.35 ,87.2% of Billed charges for outpatient setting,$232.49 ,61% of Billed charges for outpatient setting,$332.35 ,87.2% of Billed charges for outpatient setting,$198.19 ,52% of charges,$309.82 ,81.29% of Billed charges for outpatient setting,$343.02 ,90% of Billed charges for outpatient setting,$343.02 ,90% of Billed charges for outpatient setting,$232.49 ,61% of Billed charges for outpatient setting,$232.49 ,61% of Billed charges for outpatient setting,$343.02 ,90% of Billed charges for outpatient setting,$343.02 ,90% of Billed charges for outpatient setting,$232.49 ,61% of Billed charges for outpatient setting,$232.49 ,61% of Billed charges for outpatient setting,$232.49 ,61% of Billed charges for outpatient setting,$198.19 ,52% of charges,$198.19 ,52% of charges,$198.19 ,52% of charges,$198.19 ,52% of charges,$198.19 ,52% of charges,$198.19 ,52% of charges,198.1876,343.02,$304.90 
Outpatient Medical Services,Radiology,73110,X-Ray Exam Of Wrist 3+ Views Unilat,320,$206.87 ,$175.84 ,85% of Billed charges for outpatient setting,$175.84 ,85% of Billed charges for outpatient setting,$153.66 ,74.28% of Billed charges for outpatient setting,$153.66 ,74.28% of Billed charges for outpatient setting,$126.19 ,61% of Billed charges for outpatient setting,$153.66 ,74.28% of Billed charges for outpatient setting,$186.18 ,90% of Billed charges for outpatient setting,$186.18 ,90% of Billed charges for outpatient setting,$108.65 ,52.52% of charges,$180.39 ,87.2% of Billed charges for outpatient setting,$126.19 ,61% of Billed charges for outpatient setting,$180.39 ,87.2% of Billed charges for outpatient setting,$107.57 ,52% of charges,$168.16 ,81.29% of Billed charges for outpatient setting,$186.18 ,90% of Billed charges for outpatient setting,$186.18 ,90% of Billed charges for outpatient setting,$126.19 ,61% of Billed charges for outpatient setting,$126.19 ,61% of Billed charges for outpatient setting,$186.18 ,90% of Billed charges for outpatient setting,$186.18 ,90% of Billed charges for outpatient setting,$126.19 ,61% of Billed charges for outpatient setting,$126.19 ,61% of Billed charges for outpatient setting,$126.19 ,61% of Billed charges for outpatient setting,$107.57 ,52% of charges,$107.57 ,52% of charges,$107.57 ,52% of charges,$107.57 ,52% of charges,$107.57 ,52% of charges,$107.57 ,52% of charges,107.5724,186.18,$165.50 
Outpatient Medical Services,Radiology,73110,X-Ray Exam Of Wrist 3+ Views Biilat,320,$413.77 ,$351.70 ,85% of Billed charges for outpatient setting,$351.70 ,85% of Billed charges for outpatient setting,$307.35 ,74.28% of Billed charges for outpatient setting,$307.35 ,74.28% of Billed charges for outpatient setting,$252.40 ,61% of Billed charges for outpatient setting,$307.35 ,74.28% of Billed charges for outpatient setting,$372.39 ,90% of Billed charges for outpatient setting,$372.39 ,90% of Billed charges for outpatient setting,$217.31 ,52.52% of charges,$360.81 ,87.2% of Billed charges for outpatient setting,$252.40 ,61% of Billed charges for outpatient setting,$360.81 ,87.2% of Billed charges for outpatient setting,$215.16 ,52% of charges,$336.35 ,81.29% of Billed charges for outpatient setting,$372.39 ,90% of Billed charges for outpatient setting,$372.39 ,90% of Billed charges for outpatient setting,$252.40 ,61% of Billed charges for outpatient setting,$252.40 ,61% of Billed charges for outpatient setting,$372.39 ,90% of Billed charges for outpatient setting,$372.39 ,90% of Billed charges for outpatient setting,$252.40 ,61% of Billed charges for outpatient setting,$252.40 ,61% of Billed charges for outpatient setting,$252.40 ,61% of Billed charges for outpatient setting,$215.16 ,52% of charges,$215.16 ,52% of charges,$215.16 ,52% of charges,$215.16 ,52% of charges,$215.16 ,52% of charges,$215.16 ,52% of charges,215.1604,372.39,$331.02 
Outpatient Medical Services,Radiology,73120,X-Ray Exam Of Hand 2 Views,320,$124.37 ,$105.71 ,85% of Billed charges for outpatient setting,$105.71 ,85% of Billed charges for outpatient setting,$92.38 ,74.28% of Billed charges for outpatient setting,$92.38 ,74.28% of Billed charges for outpatient setting,$75.87 ,61% of Billed charges for outpatient setting,$92.38 ,74.28% of Billed charges for outpatient setting,$111.93 ,90% of Billed charges for outpatient setting,$111.93 ,90% of Billed charges for outpatient setting,$65.32 ,52.52% of charges,$108.45 ,87.2% of Billed charges for outpatient setting,$75.87 ,61% of Billed charges for outpatient setting,$108.45 ,87.2% of Billed charges for outpatient setting,$64.67 ,52% of charges,$101.10 ,81.29% of Billed charges for outpatient setting,$111.93 ,90% of Billed charges for outpatient setting,$111.93 ,90% of Billed charges for outpatient setting,$75.87 ,61% of Billed charges for outpatient setting,$75.87 ,61% of Billed charges for outpatient setting,$111.93 ,90% of Billed charges for outpatient setting,$111.93 ,90% of Billed charges for outpatient setting,$75.87 ,61% of Billed charges for outpatient setting,$75.87 ,61% of Billed charges for outpatient setting,$75.87 ,61% of Billed charges for outpatient setting,$64.67 ,52% of charges,$64.67 ,52% of charges,$64.67 ,52% of charges,$64.67 ,52% of charges,$64.67 ,52% of charges,$64.67 ,52% of charges,64.6724,111.93,$99.50 
Outpatient Medical Services,Radiology,73130,X-Ray Exam Of Hand 3+ Views Unilat,320,$152.47 ,$129.60 ,85% of Billed charges for outpatient setting,$129.60 ,85% of Billed charges for outpatient setting,$113.25 ,74.28% of Billed charges for outpatient setting,$113.25 ,74.28% of Billed charges for outpatient setting,$93.01 ,61% of Billed charges for outpatient setting,$113.25 ,74.28% of Billed charges for outpatient setting,$137.22 ,90% of Billed charges for outpatient setting,$137.22 ,90% of Billed charges for outpatient setting,$80.08 ,52.52% of charges,$132.95 ,87.2% of Billed charges for outpatient setting,$93.01 ,61% of Billed charges for outpatient setting,$132.95 ,87.2% of Billed charges for outpatient setting,$79.28 ,52% of charges,$123.94 ,81.29% of Billed charges for outpatient setting,$137.22 ,90% of Billed charges for outpatient setting,$137.22 ,90% of Billed charges for outpatient setting,$93.01 ,61% of Billed charges for outpatient setting,$93.01 ,61% of Billed charges for outpatient setting,$137.22 ,90% of Billed charges for outpatient setting,$137.22 ,90% of Billed charges for outpatient setting,$93.01 ,61% of Billed charges for outpatient setting,$93.01 ,61% of Billed charges for outpatient setting,$93.01 ,61% of Billed charges for outpatient setting,$79.28 ,52% of charges,$79.28 ,52% of charges,$79.28 ,52% of charges,$79.28 ,52% of charges,$79.28 ,52% of charges,$79.28 ,52% of charges,79.2844,137.22,$121.98 
Outpatient Medical Services,Radiology,73130,X-Ray Exam Of Hand 3+ Views Bilat,320,$304.93 ,$259.19 ,85% of Billed charges for outpatient setting,$259.19 ,85% of Billed charges for outpatient setting,$226.50 ,74.28% of Billed charges for outpatient setting,$226.50 ,74.28% of Billed charges for outpatient setting,$186.01 ,61% of Billed charges for outpatient setting,$226.50 ,74.28% of Billed charges for outpatient setting,$274.44 ,90% of Billed charges for outpatient setting,$274.44 ,90% of Billed charges for outpatient setting,$160.15 ,52.52% of charges,$265.90 ,87.2% of Billed charges for outpatient setting,$186.01 ,61% of Billed charges for outpatient setting,$265.90 ,87.2% of Billed charges for outpatient setting,$158.56 ,52% of charges,$247.88 ,81.29% of Billed charges for outpatient setting,$274.44 ,90% of Billed charges for outpatient setting,$274.44 ,90% of Billed charges for outpatient setting,$186.01 ,61% of Billed charges for outpatient setting,$186.01 ,61% of Billed charges for outpatient setting,$274.44 ,90% of Billed charges for outpatient setting,$274.44 ,90% of Billed charges for outpatient setting,$186.01 ,61% of Billed charges for outpatient setting,$186.01 ,61% of Billed charges for outpatient setting,$186.01 ,61% of Billed charges for outpatient setting,$158.56 ,52% of charges,$158.56 ,52% of charges,$158.56 ,52% of charges,$158.56 ,52% of charges,$158.56 ,52% of charges,$158.56 ,52% of charges,158.5636,274.44,$243.94 
Outpatient Medical Services,Radiology,73140,X-Ray Exam Of Finger(S) 2+ Views,320,$142.51 ,$121.13 ,85% of Billed charges for outpatient setting,$121.13 ,85% of Billed charges for outpatient setting,$105.86 ,74.28% of Billed charges for outpatient setting,$105.86 ,74.28% of Billed charges for outpatient setting,$86.93 ,61% of Billed charges for outpatient setting,$105.86 ,74.28% of Billed charges for outpatient setting,$128.26 ,90% of Billed charges for outpatient setting,$128.26 ,90% of Billed charges for outpatient setting,$74.85 ,52.52% of charges,$124.27 ,87.2% of Billed charges for outpatient setting,$86.93 ,61% of Billed charges for outpatient setting,$124.27 ,87.2% of Billed charges for outpatient setting,$74.11 ,52% of charges,$115.85 ,81.29% of Billed charges for outpatient setting,$128.26 ,90% of Billed charges for outpatient setting,$128.26 ,90% of Billed charges for outpatient setting,$86.93 ,61% of Billed charges for outpatient setting,$86.93 ,61% of Billed charges for outpatient setting,$128.26 ,90% of Billed charges for outpatient setting,$128.26 ,90% of Billed charges for outpatient setting,$86.93 ,61% of Billed charges for outpatient setting,$86.93 ,61% of Billed charges for outpatient setting,$86.93 ,61% of Billed charges for outpatient setting,$74.11 ,52% of charges,$74.11 ,52% of charges,$74.11 ,52% of charges,$74.11 ,52% of charges,$74.11 ,52% of charges,$74.11 ,52% of charges,74.1052,128.26,$114.01 
Outpatient Medical Services,Radiology,73200,"CT Scan, Upper Extremity, W/O Contrast",352,"$1,001.21 ",$851.03 ,85% of Billed charges for outpatient setting,$851.03 ,85% of Billed charges for outpatient setting,$743.70 ,74.28% of Billed charges for outpatient setting,$743.70 ,74.28% of Billed charges for outpatient setting,$610.74 ,61% of Billed charges for outpatient setting,$743.70 ,74.28% of Billed charges for outpatient setting,$901.09 ,90% of Billed charges for outpatient setting,$901.09 ,90% of Billed charges for outpatient setting,$525.84 ,52.52% of charges,$873.06 ,87.2% of Billed charges for outpatient setting,$610.74 ,61% of Billed charges for outpatient setting,$873.06 ,87.2% of Billed charges for outpatient setting,$520.63 ,52% of charges,$813.88 ,81.29% of Billed charges for outpatient setting,$901.09 ,90% of Billed charges for outpatient setting,$901.09 ,90% of Billed charges for outpatient setting,$610.74 ,61% of Billed charges for outpatient setting,$610.74 ,61% of Billed charges for outpatient setting,$901.09 ,90% of Billed charges for outpatient setting,$901.09 ,90% of Billed charges for outpatient setting,$610.74 ,61% of Billed charges for outpatient setting,$610.74 ,61% of Billed charges for outpatient setting,$610.74 ,61% of Billed charges for outpatient setting,$520.63 ,52% of charges,$520.63 ,52% of charges,$520.63 ,52% of charges,$520.63 ,52% of charges,$520.63 ,52% of charges,$520.63 ,52% of charges,520.6292,901.09,$800.97 
Outpatient Medical Services,Radiology,73201,CT Scan Of Arm Contrast,352,"$1,253.19 ","$1,065.21 ",85% of Billed charges for outpatient setting,"$1,065.21 ",85% of Billed charges for outpatient setting,$930.87 ,74.28% of Billed charges for outpatient setting,$930.87 ,74.28% of Billed charges for outpatient setting,$764.45 ,61% of Billed charges for outpatient setting,$930.87 ,74.28% of Billed charges for outpatient setting,"$1,127.87 ",90% of Billed charges for outpatient setting,"$1,127.87 ",90% of Billed charges for outpatient setting,$658.18 ,52.52% of charges,"$1,092.78 ",87.2% of Billed charges for outpatient setting,$764.45 ,61% of Billed charges for outpatient setting,"$1,092.78 ",87.2% of Billed charges for outpatient setting,$651.66 ,52% of charges,"$1,018.72 ",81.29% of Billed charges for outpatient setting,"$1,127.87 ",90% of Billed charges for outpatient setting,"$1,127.87 ",90% of Billed charges for outpatient setting,$764.45 ,61% of Billed charges for outpatient setting,$764.45 ,61% of Billed charges for outpatient setting,"$1,127.87 ",90% of Billed charges for outpatient setting,"$1,127.87 ",90% of Billed charges for outpatient setting,$764.45 ,61% of Billed charges for outpatient setting,$764.45 ,61% of Billed charges for outpatient setting,$764.45 ,61% of Billed charges for outpatient setting,$651.66 ,52% of charges,$651.66 ,52% of charges,$651.66 ,52% of charges,$651.66 ,52% of charges,$651.66 ,52% of charges,$651.66 ,52% of charges,651.6588,1127.87,"$1,002.55 "
Outpatient Medical Services,Radiology,73221,MRI Upper Extremity Combo Unilat,614,"$1,825.31 ","$1,551.51 ",85% of Billed charges for outpatient setting,"$1,551.51 ",85% of Billed charges for outpatient setting,"$1,355.84 ",74.28% of Billed charges for outpatient setting,"$1,355.84 ",74.28% of Billed charges for outpatient setting,"$1,113.44 ",61% of Billed charges for outpatient setting,"$1,355.84 ",74.28% of Billed charges for outpatient setting,"$1,642.78 ",90% of Billed charges for outpatient setting,"$1,642.78 ",90% of Billed charges for outpatient setting,$958.65 ,52.52% of charges,"$1,591.67 ",87.2% of Billed charges for outpatient setting,"$1,113.44 ",61% of Billed charges for outpatient setting,"$1,591.67 ",87.2% of Billed charges for outpatient setting,$949.16 ,52% of charges,"$1,483.79 ",81.29% of Billed charges for outpatient setting,"$1,642.78 ",90% of Billed charges for outpatient setting,"$1,642.78 ",90% of Billed charges for outpatient setting,"$1,113.44 ",61% of Billed charges for outpatient setting,"$1,113.44 ",61% of Billed charges for outpatient setting,"$1,642.78 ",90% of Billed charges for outpatient setting,"$1,642.78 ",90% of Billed charges for outpatient setting,"$1,113.44 ",61% of Billed charges for outpatient setting,"$1,113.44 ",61% of Billed charges for outpatient setting,"$1,113.44 ",61% of Billed charges for outpatient setting,$949.16 ,52% of charges,$949.16 ,52% of charges,$949.16 ,52% of charges,$949.16 ,52% of charges,$949.16 ,52% of charges,$949.16 ,52% of charges,949.1612,1642.78,"$1,460.25 "
Outpatient Medical Services,Radiology,73221,MRI Upper Extremity Combo Bilat,614,"$3,650.62 ","$3,103.03 ",85% of Billed charges for outpatient setting,"$3,103.03 ",85% of Billed charges for outpatient setting,"$2,711.68 ",74.28% of Billed charges for outpatient setting,"$2,711.68 ",74.28% of Billed charges for outpatient setting,"$2,226.88 ",61% of Billed charges for outpatient setting,"$2,711.68 ",74.28% of Billed charges for outpatient setting,"$3,285.56 ",90% of Billed charges for outpatient setting,"$3,285.56 ",90% of Billed charges for outpatient setting,"$1,917.31 ",52.52% of charges,"$3,183.34 ",87.2% of Billed charges for outpatient setting,"$2,226.88 ",61% of Billed charges for outpatient setting,"$3,183.34 ",87.2% of Billed charges for outpatient setting,"$1,898.32 ",52% of charges,"$2,967.59 ",81.29% of Billed charges for outpatient setting,"$3,285.56 ",90% of Billed charges for outpatient setting,"$3,285.56 ",90% of Billed charges for outpatient setting,"$2,226.88 ",61% of Billed charges for outpatient setting,"$2,226.88 ",61% of Billed charges for outpatient setting,"$3,285.56 ",90% of Billed charges for outpatient setting,"$3,285.56 ",90% of Billed charges for outpatient setting,"$2,226.88 ",61% of Billed charges for outpatient setting,"$2,226.88 ",61% of Billed charges for outpatient setting,"$2,226.88 ",61% of Billed charges for outpatient setting,"$1,898.32 ",52% of charges,"$1,898.32 ",52% of charges,"$1,898.32 ",52% of charges,"$1,898.32 ",52% of charges,"$1,898.32 ",52% of charges,"$1,898.32 ",52% of charges,1898.3224,3285.56,"$2,920.50 "
Outpatient Medical Services,Radiology,73501,X-Ray Exam Hip Uni 1 View,320,$93.70 ,$79.65 ,85% of Billed charges for outpatient setting,$79.65 ,85% of Billed charges for outpatient setting,$69.60 ,74.28% of Billed charges for outpatient setting,$69.60 ,74.28% of Billed charges for outpatient setting,$57.16 ,61% of Billed charges for outpatient setting,$69.60 ,74.28% of Billed charges for outpatient setting,$84.33 ,90% of Billed charges for outpatient setting,$84.33 ,90% of Billed charges for outpatient setting,$49.21 ,52.52% of charges,$81.71 ,87.2% of Billed charges for outpatient setting,$57.16 ,61% of Billed charges for outpatient setting,$81.71 ,87.2% of Billed charges for outpatient setting,$48.72 ,52% of charges,$76.17 ,81.29% of Billed charges for outpatient setting,$84.33 ,90% of Billed charges for outpatient setting,$84.33 ,90% of Billed charges for outpatient setting,$57.16 ,61% of Billed charges for outpatient setting,$57.16 ,61% of Billed charges for outpatient setting,$84.33 ,90% of Billed charges for outpatient setting,$84.33 ,90% of Billed charges for outpatient setting,$57.16 ,61% of Billed charges for outpatient setting,$57.16 ,61% of Billed charges for outpatient setting,$57.16 ,61% of Billed charges for outpatient setting,$48.72 ,52% of charges,$48.72 ,52% of charges,$48.72 ,52% of charges,$48.72 ,52% of charges,$48.72 ,52% of charges,$48.72 ,52% of charges,48.724,84.33,$74.96 
Outpatient Medical Services,Radiology,73502,X-Ray Exam Hip Uni 2-3 Views,320,$281.11 ,$238.94 ,85% of Billed charges for outpatient setting,$238.94 ,85% of Billed charges for outpatient setting,$208.81 ,74.28% of Billed charges for outpatient setting,$208.81 ,74.28% of Billed charges for outpatient setting,$171.48 ,61% of Billed charges for outpatient setting,$208.81 ,74.28% of Billed charges for outpatient setting,$253.00 ,90% of Billed charges for outpatient setting,$253.00 ,90% of Billed charges for outpatient setting,$147.64 ,52.52% of charges,$245.13 ,87.2% of Billed charges for outpatient setting,$171.48 ,61% of Billed charges for outpatient setting,$245.13 ,87.2% of Billed charges for outpatient setting,$146.18 ,52% of charges,$228.51 ,81.29% of Billed charges for outpatient setting,$253.00 ,90% of Billed charges for outpatient setting,$253.00 ,90% of Billed charges for outpatient setting,$171.48 ,61% of Billed charges for outpatient setting,$171.48 ,61% of Billed charges for outpatient setting,$253.00 ,90% of Billed charges for outpatient setting,$253.00 ,90% of Billed charges for outpatient setting,$171.48 ,61% of Billed charges for outpatient setting,$171.48 ,61% of Billed charges for outpatient setting,$171.48 ,61% of Billed charges for outpatient setting,$146.18 ,52% of charges,$146.18 ,52% of charges,$146.18 ,52% of charges,$146.18 ,52% of charges,$146.18 ,52% of charges,$146.18 ,52% of charges,146.1772,253,$224.89 
Outpatient Medical Services,Radiology,73521,X-Ray Exam Hips Bi 2 Views,320,$399.93 ,$339.94 ,85% of Billed charges for outpatient setting,$339.94 ,85% of Billed charges for outpatient setting,$297.07 ,74.28% of Billed charges for outpatient setting,$297.07 ,74.28% of Billed charges for outpatient setting,$243.96 ,61% of Billed charges for outpatient setting,$297.07 ,74.28% of Billed charges for outpatient setting,$359.94 ,90% of Billed charges for outpatient setting,$359.94 ,90% of Billed charges for outpatient setting,$210.04 ,52.52% of charges,$348.74 ,87.2% of Billed charges for outpatient setting,$243.96 ,61% of Billed charges for outpatient setting,$348.74 ,87.2% of Billed charges for outpatient setting,$207.96 ,52% of charges,$325.10 ,81.29% of Billed charges for outpatient setting,$359.94 ,90% of Billed charges for outpatient setting,$359.94 ,90% of Billed charges for outpatient setting,$243.96 ,61% of Billed charges for outpatient setting,$243.96 ,61% of Billed charges for outpatient setting,$359.94 ,90% of Billed charges for outpatient setting,$359.94 ,90% of Billed charges for outpatient setting,$243.96 ,61% of Billed charges for outpatient setting,$243.96 ,61% of Billed charges for outpatient setting,$243.96 ,61% of Billed charges for outpatient setting,$207.96 ,52% of charges,$207.96 ,52% of charges,$207.96 ,52% of charges,$207.96 ,52% of charges,$207.96 ,52% of charges,$207.96 ,52% of charges,207.9636,359.94,$319.94 
Outpatient Medical Services,Radiology,73552,X-Ray Exam Of Femur 2/>,320,$190.57 ,$161.98 ,85% of Billed charges for outpatient setting,$161.98 ,85% of Billed charges for outpatient setting,$141.56 ,74.28% of Billed charges for outpatient setting,$141.56 ,74.28% of Billed charges for outpatient setting,$116.25 ,61% of Billed charges for outpatient setting,$141.56 ,74.28% of Billed charges for outpatient setting,$171.51 ,90% of Billed charges for outpatient setting,$171.51 ,90% of Billed charges for outpatient setting,$100.09 ,52.52% of charges,$166.18 ,87.2% of Billed charges for outpatient setting,$116.25 ,61% of Billed charges for outpatient setting,$166.18 ,87.2% of Billed charges for outpatient setting,$99.10 ,52% of charges,$154.91 ,81.29% of Billed charges for outpatient setting,$171.51 ,90% of Billed charges for outpatient setting,$171.51 ,90% of Billed charges for outpatient setting,$116.25 ,61% of Billed charges for outpatient setting,$116.25 ,61% of Billed charges for outpatient setting,$171.51 ,90% of Billed charges for outpatient setting,$171.51 ,90% of Billed charges for outpatient setting,$116.25 ,61% of Billed charges for outpatient setting,$116.25 ,61% of Billed charges for outpatient setting,$116.25 ,61% of Billed charges for outpatient setting,$99.10 ,52% of charges,$99.10 ,52% of charges,$99.10 ,52% of charges,$99.10 ,52% of charges,$99.10 ,52% of charges,$99.10 ,52% of charges,99.0964,171.51,$152.46 
Outpatient Medical Services,Radiology,73560,X-Ray Exam Of Knee 1 Or 2,320,$148.82 ,$126.50 ,85% of Billed charges for outpatient setting,$126.50 ,85% of Billed charges for outpatient setting,$110.54 ,74.28% of Billed charges for outpatient setting,$110.54 ,74.28% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$110.54 ,74.28% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$78.16 ,52.52% of charges,$129.77 ,87.2% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$129.77 ,87.2% of Billed charges for outpatient setting,$77.39 ,52% of charges,$120.98 ,81.29% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$77.39 ,52% of charges,$77.39 ,52% of charges,$77.39 ,52% of charges,$77.39 ,52% of charges,$77.39 ,52% of charges,$77.39 ,52% of charges,77.3864,133.94,$119.06 
Outpatient Medical Services,Radiology,73562,X-Ray Knee 3 View Unilat,320,$200.46 ,$170.39 ,85% of Billed charges for outpatient setting,$170.39 ,85% of Billed charges for outpatient setting,$148.90 ,74.28% of Billed charges for outpatient setting,$148.90 ,74.28% of Billed charges for outpatient setting,$122.28 ,61% of Billed charges for outpatient setting,$148.90 ,74.28% of Billed charges for outpatient setting,$180.41 ,90% of Billed charges for outpatient setting,$180.41 ,90% of Billed charges for outpatient setting,$105.28 ,52.52% of charges,$174.80 ,87.2% of Billed charges for outpatient setting,$122.28 ,61% of Billed charges for outpatient setting,$174.80 ,87.2% of Billed charges for outpatient setting,$104.24 ,52% of charges,$162.95 ,81.29% of Billed charges for outpatient setting,$180.41 ,90% of Billed charges for outpatient setting,$180.41 ,90% of Billed charges for outpatient setting,$122.28 ,61% of Billed charges for outpatient setting,$122.28 ,61% of Billed charges for outpatient setting,$180.41 ,90% of Billed charges for outpatient setting,$180.41 ,90% of Billed charges for outpatient setting,$122.28 ,61% of Billed charges for outpatient setting,$122.28 ,61% of Billed charges for outpatient setting,$122.28 ,61% of Billed charges for outpatient setting,$104.24 ,52% of charges,$104.24 ,52% of charges,$104.24 ,52% of charges,$104.24 ,52% of charges,$104.24 ,52% of charges,$104.24 ,52% of charges,104.2392,180.41,$160.37 
Outpatient Medical Services,Radiology,73562,X-Ray Knee 3 View Bilat,320,$400.92 ,$340.78 ,85% of Billed charges for outpatient setting,$340.78 ,85% of Billed charges for outpatient setting,$297.80 ,74.28% of Billed charges for outpatient setting,$297.80 ,74.28% of Billed charges for outpatient setting,$244.56 ,61% of Billed charges for outpatient setting,$297.80 ,74.28% of Billed charges for outpatient setting,$360.83 ,90% of Billed charges for outpatient setting,$360.83 ,90% of Billed charges for outpatient setting,$210.56 ,52.52% of charges,$349.60 ,87.2% of Billed charges for outpatient setting,$244.56 ,61% of Billed charges for outpatient setting,$349.60 ,87.2% of Billed charges for outpatient setting,$208.48 ,52% of charges,$325.91 ,81.29% of Billed charges for outpatient setting,$360.83 ,90% of Billed charges for outpatient setting,$360.83 ,90% of Billed charges for outpatient setting,$244.56 ,61% of Billed charges for outpatient setting,$244.56 ,61% of Billed charges for outpatient setting,$360.83 ,90% of Billed charges for outpatient setting,$360.83 ,90% of Billed charges for outpatient setting,$244.56 ,61% of Billed charges for outpatient setting,$244.56 ,61% of Billed charges for outpatient setting,$244.56 ,61% of Billed charges for outpatient setting,$208.48 ,52% of charges,$208.48 ,52% of charges,$208.48 ,52% of charges,$208.48 ,52% of charges,$208.48 ,52% of charges,$208.48 ,52% of charges,208.4784,360.83,$320.74 
Outpatient Medical Services,Radiology,73564,X-Ray Exam Knee 4+ Views Unilat,320,$238.64 ,$202.84 ,85% of Billed charges for outpatient setting,$202.84 ,85% of Billed charges for outpatient setting,$177.26 ,74.28% of Billed charges for outpatient setting,$177.26 ,74.28% of Billed charges for outpatient setting,$145.57 ,61% of Billed charges for outpatient setting,$177.26 ,74.28% of Billed charges for outpatient setting,$214.78 ,90% of Billed charges for outpatient setting,$214.78 ,90% of Billed charges for outpatient setting,$125.33 ,52.52% of charges,$208.09 ,87.2% of Billed charges for outpatient setting,$145.57 ,61% of Billed charges for outpatient setting,$208.09 ,87.2% of Billed charges for outpatient setting,$124.09 ,52% of charges,$193.99 ,81.29% of Billed charges for outpatient setting,$214.78 ,90% of Billed charges for outpatient setting,$214.78 ,90% of Billed charges for outpatient setting,$145.57 ,61% of Billed charges for outpatient setting,$145.57 ,61% of Billed charges for outpatient setting,$214.78 ,90% of Billed charges for outpatient setting,$214.78 ,90% of Billed charges for outpatient setting,$145.57 ,61% of Billed charges for outpatient setting,$145.57 ,61% of Billed charges for outpatient setting,$145.57 ,61% of Billed charges for outpatient setting,$124.09 ,52% of charges,$124.09 ,52% of charges,$124.09 ,52% of charges,$124.09 ,52% of charges,$124.09 ,52% of charges,$124.09 ,52% of charges,124.0928,214.78,$190.91 
Outpatient Medical Services,Radiology,73564,X-Ray Exam Knee 4+ Views Bilat,320,$477.33 ,$405.73 ,85% of Billed charges for outpatient setting,$405.73 ,85% of Billed charges for outpatient setting,$354.56 ,74.28% of Billed charges for outpatient setting,$354.56 ,74.28% of Billed charges for outpatient setting,$291.17 ,61% of Billed charges for outpatient setting,$354.56 ,74.28% of Billed charges for outpatient setting,$429.60 ,90% of Billed charges for outpatient setting,$429.60 ,90% of Billed charges for outpatient setting,$250.69 ,52.52% of charges,$416.23 ,87.2% of Billed charges for outpatient setting,$291.17 ,61% of Billed charges for outpatient setting,$416.23 ,87.2% of Billed charges for outpatient setting,$248.21 ,52% of charges,$388.02 ,81.29% of Billed charges for outpatient setting,$429.60 ,90% of Billed charges for outpatient setting,$429.60 ,90% of Billed charges for outpatient setting,$291.17 ,61% of Billed charges for outpatient setting,$291.17 ,61% of Billed charges for outpatient setting,$429.60 ,90% of Billed charges for outpatient setting,$429.60 ,90% of Billed charges for outpatient setting,$291.17 ,61% of Billed charges for outpatient setting,$291.17 ,61% of Billed charges for outpatient setting,$291.17 ,61% of Billed charges for outpatient setting,$248.21 ,52% of charges,$248.21 ,52% of charges,$248.21 ,52% of charges,$248.21 ,52% of charges,$248.21 ,52% of charges,$248.21 ,52% of charges,248.2116,429.6,$381.86 
Outpatient Medical Services,Radiology,73565,Knee; Both Knees Standing Ap,320,$100.85 ,$85.72 ,85% of Billed charges for outpatient setting,$85.72 ,85% of Billed charges for outpatient setting,$74.91 ,74.28% of Billed charges for outpatient setting,$74.91 ,74.28% of Billed charges for outpatient setting,$61.52 ,61% of Billed charges for outpatient setting,$74.91 ,74.28% of Billed charges for outpatient setting,$90.77 ,90% of Billed charges for outpatient setting,$90.77 ,90% of Billed charges for outpatient setting,$52.97 ,52.52% of charges,$87.94 ,87.2% of Billed charges for outpatient setting,$61.52 ,61% of Billed charges for outpatient setting,$87.94 ,87.2% of Billed charges for outpatient setting,$52.44 ,52% of charges,$81.98 ,81.29% of Billed charges for outpatient setting,$90.77 ,90% of Billed charges for outpatient setting,$90.77 ,90% of Billed charges for outpatient setting,$61.52 ,61% of Billed charges for outpatient setting,$61.52 ,61% of Billed charges for outpatient setting,$90.77 ,90% of Billed charges for outpatient setting,$90.77 ,90% of Billed charges for outpatient setting,$61.52 ,61% of Billed charges for outpatient setting,$61.52 ,61% of Billed charges for outpatient setting,$61.52 ,61% of Billed charges for outpatient setting,$52.44 ,52% of charges,$52.44 ,52% of charges,$52.44 ,52% of charges,$52.44 ,52% of charges,$52.44 ,52% of charges,$52.44 ,52% of charges,52.442,90.77,$80.68 
Outpatient Medical Services,Radiology,73590,X-Ray Exam Of Lower Leg 2 Views Unilat,320,$152.47 ,$129.60 ,85% of Billed charges for outpatient setting,$129.60 ,85% of Billed charges for outpatient setting,$113.25 ,74.28% of Billed charges for outpatient setting,$113.25 ,74.28% of Billed charges for outpatient setting,$93.01 ,61% of Billed charges for outpatient setting,$113.25 ,74.28% of Billed charges for outpatient setting,$137.22 ,90% of Billed charges for outpatient setting,$137.22 ,90% of Billed charges for outpatient setting,$80.08 ,52.52% of charges,$132.95 ,87.2% of Billed charges for outpatient setting,$93.01 ,61% of Billed charges for outpatient setting,$132.95 ,87.2% of Billed charges for outpatient setting,$79.28 ,52% of charges,$123.94 ,81.29% of Billed charges for outpatient setting,$137.22 ,90% of Billed charges for outpatient setting,$137.22 ,90% of Billed charges for outpatient setting,$93.01 ,61% of Billed charges for outpatient setting,$93.01 ,61% of Billed charges for outpatient setting,$137.22 ,90% of Billed charges for outpatient setting,$137.22 ,90% of Billed charges for outpatient setting,$93.01 ,61% of Billed charges for outpatient setting,$93.01 ,61% of Billed charges for outpatient setting,$93.01 ,61% of Billed charges for outpatient setting,$79.28 ,52% of charges,$79.28 ,52% of charges,$79.28 ,52% of charges,$79.28 ,52% of charges,$79.28 ,52% of charges,$79.28 ,52% of charges,79.2844,137.22,$121.98 
Outpatient Medical Services,Radiology,73590,X-Ray Exam Of Lower Leg 2 Views Bilat,320,$304.93 ,$259.19 ,85% of Billed charges for outpatient setting,$259.19 ,85% of Billed charges for outpatient setting,$226.50 ,74.28% of Billed charges for outpatient setting,$226.50 ,74.28% of Billed charges for outpatient setting,$186.01 ,61% of Billed charges for outpatient setting,$226.50 ,74.28% of Billed charges for outpatient setting,$274.44 ,90% of Billed charges for outpatient setting,$274.44 ,90% of Billed charges for outpatient setting,$160.15 ,52.52% of charges,$265.90 ,87.2% of Billed charges for outpatient setting,$186.01 ,61% of Billed charges for outpatient setting,$265.90 ,87.2% of Billed charges for outpatient setting,$158.56 ,52% of charges,$247.88 ,81.29% of Billed charges for outpatient setting,$274.44 ,90% of Billed charges for outpatient setting,$274.44 ,90% of Billed charges for outpatient setting,$186.01 ,61% of Billed charges for outpatient setting,$186.01 ,61% of Billed charges for outpatient setting,$274.44 ,90% of Billed charges for outpatient setting,$274.44 ,90% of Billed charges for outpatient setting,$186.01 ,61% of Billed charges for outpatient setting,$186.01 ,61% of Billed charges for outpatient setting,$186.01 ,61% of Billed charges for outpatient setting,$158.56 ,52% of charges,$158.56 ,52% of charges,$158.56 ,52% of charges,$158.56 ,52% of charges,$158.56 ,52% of charges,$158.56 ,52% of charges,158.5636,274.44,$243.94 
Outpatient Medical Services,Radiology,73592,X-Ray Exam Of Leg Infant 2 Views,320,$148.82 ,$126.50 ,85% of Billed charges for outpatient setting,$126.50 ,85% of Billed charges for outpatient setting,$110.54 ,74.28% of Billed charges for outpatient setting,$110.54 ,74.28% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$110.54 ,74.28% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$78.16 ,52.52% of charges,$129.77 ,87.2% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$129.77 ,87.2% of Billed charges for outpatient setting,$77.39 ,52% of charges,$120.98 ,81.29% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$77.39 ,52% of charges,$77.39 ,52% of charges,$77.39 ,52% of charges,$77.39 ,52% of charges,$77.39 ,52% of charges,$77.39 ,52% of charges,77.3864,133.94,$119.06 
Outpatient Medical Services,Radiology,73600,X-Ray Exam Of ankle; 2 Views Unilat,320,$148.82 ,$126.50 ,85% of Billed charges for outpatient setting,$126.50 ,85% of Billed charges for outpatient setting,$110.54 ,74.28% of Billed charges for outpatient setting,$110.54 ,74.28% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$110.54 ,74.28% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$78.16 ,52.52% of charges,$129.77 ,87.2% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$129.77 ,87.2% of Billed charges for outpatient setting,$77.39 ,52% of charges,$120.98 ,81.29% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$77.39 ,52% of charges,$77.39 ,52% of charges,$77.39 ,52% of charges,$77.39 ,52% of charges,$77.39 ,52% of charges,$77.39 ,52% of charges,77.3864,133.94,$119.06 
Outpatient Medical Services,Radiology,73600,X-Ray Exam Of ankle; 2 Views Bilat,320,$297.66 ,$253.01 ,85% of Billed charges for outpatient setting,$253.01 ,85% of Billed charges for outpatient setting,$221.10 ,74.28% of Billed charges for outpatient setting,$221.10 ,74.28% of Billed charges for outpatient setting,$181.57 ,61% of Billed charges for outpatient setting,$221.10 ,74.28% of Billed charges for outpatient setting,$267.89 ,90% of Billed charges for outpatient setting,$267.89 ,90% of Billed charges for outpatient setting,$156.33 ,52.52% of charges,$259.56 ,87.2% of Billed charges for outpatient setting,$181.57 ,61% of Billed charges for outpatient setting,$259.56 ,87.2% of Billed charges for outpatient setting,$154.78 ,52% of charges,$241.97 ,81.29% of Billed charges for outpatient setting,$267.89 ,90% of Billed charges for outpatient setting,$267.89 ,90% of Billed charges for outpatient setting,$181.57 ,61% of Billed charges for outpatient setting,$181.57 ,61% of Billed charges for outpatient setting,$267.89 ,90% of Billed charges for outpatient setting,$267.89 ,90% of Billed charges for outpatient setting,$181.57 ,61% of Billed charges for outpatient setting,$181.57 ,61% of Billed charges for outpatient setting,$181.57 ,61% of Billed charges for outpatient setting,$154.78 ,52% of charges,$154.78 ,52% of charges,$154.78 ,52% of charges,$154.78 ,52% of charges,$154.78 ,52% of charges,$154.78 ,52% of charges,154.7832,267.89,$238.13 
Outpatient Medical Services,Radiology,73610,X-Ray Exam Of Ankle 3+ Views Unilat,320,$206.87 ,$175.84 ,85% of Billed charges for outpatient setting,$175.84 ,85% of Billed charges for outpatient setting,$153.66 ,74.28% of Billed charges for outpatient setting,$153.66 ,74.28% of Billed charges for outpatient setting,$126.19 ,61% of Billed charges for outpatient setting,$153.66 ,74.28% of Billed charges for outpatient setting,$186.18 ,90% of Billed charges for outpatient setting,$186.18 ,90% of Billed charges for outpatient setting,$108.65 ,52.52% of charges,$180.39 ,87.2% of Billed charges for outpatient setting,$126.19 ,61% of Billed charges for outpatient setting,$180.39 ,87.2% of Billed charges for outpatient setting,$107.57 ,52% of charges,$168.16 ,81.29% of Billed charges for outpatient setting,$186.18 ,90% of Billed charges for outpatient setting,$186.18 ,90% of Billed charges for outpatient setting,$126.19 ,61% of Billed charges for outpatient setting,$126.19 ,61% of Billed charges for outpatient setting,$186.18 ,90% of Billed charges for outpatient setting,$186.18 ,90% of Billed charges for outpatient setting,$126.19 ,61% of Billed charges for outpatient setting,$126.19 ,61% of Billed charges for outpatient setting,$126.19 ,61% of Billed charges for outpatient setting,$107.57 ,52% of charges,$107.57 ,52% of charges,$107.57 ,52% of charges,$107.57 ,52% of charges,$107.57 ,52% of charges,$107.57 ,52% of charges,107.5724,186.18,$165.50 
Outpatient Medical Services,Radiology,73610,X-Ray Exam Of Ankle 3+ Views Bilat,320,$413.77 ,$351.70 ,85% of Billed charges for outpatient setting,$351.70 ,85% of Billed charges for outpatient setting,$307.35 ,74.28% of Billed charges for outpatient setting,$307.35 ,74.28% of Billed charges for outpatient setting,$252.40 ,61% of Billed charges for outpatient setting,$307.35 ,74.28% of Billed charges for outpatient setting,$372.39 ,90% of Billed charges for outpatient setting,$372.39 ,90% of Billed charges for outpatient setting,$217.31 ,52.52% of charges,$360.81 ,87.2% of Billed charges for outpatient setting,$252.40 ,61% of Billed charges for outpatient setting,$360.81 ,87.2% of Billed charges for outpatient setting,$215.16 ,52% of charges,$336.35 ,81.29% of Billed charges for outpatient setting,$372.39 ,90% of Billed charges for outpatient setting,$372.39 ,90% of Billed charges for outpatient setting,$252.40 ,61% of Billed charges for outpatient setting,$252.40 ,61% of Billed charges for outpatient setting,$372.39 ,90% of Billed charges for outpatient setting,$372.39 ,90% of Billed charges for outpatient setting,$252.40 ,61% of Billed charges for outpatient setting,$252.40 ,61% of Billed charges for outpatient setting,$252.40 ,61% of Billed charges for outpatient setting,$215.16 ,52% of charges,$215.16 ,52% of charges,$215.16 ,52% of charges,$215.16 ,52% of charges,$215.16 ,52% of charges,$215.16 ,52% of charges,215.1604,372.39,$331.02 
Outpatient Medical Services,Radiology,73620,X-Ray Exam Of Foot; 2 Views Unilat,320,$148.82 ,$126.50 ,85% of Billed charges for outpatient setting,$126.50 ,85% of Billed charges for outpatient setting,$110.54 ,74.28% of Billed charges for outpatient setting,$110.54 ,74.28% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$110.54 ,74.28% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$78.16 ,52.52% of charges,$129.77 ,87.2% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$129.77 ,87.2% of Billed charges for outpatient setting,$77.39 ,52% of charges,$120.98 ,81.29% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$77.39 ,52% of charges,$77.39 ,52% of charges,$77.39 ,52% of charges,$77.39 ,52% of charges,$77.39 ,52% of charges,$77.39 ,52% of charges,77.3864,133.94,$119.06 
Outpatient Medical Services,Radiology,73620,X-Ray Exam Of Foot; 2 Views Bilat,320,$297.67 ,$253.02 ,85% of Billed charges for outpatient setting,$253.02 ,85% of Billed charges for outpatient setting,$221.11 ,74.28% of Billed charges for outpatient setting,$221.11 ,74.28% of Billed charges for outpatient setting,$181.58 ,61% of Billed charges for outpatient setting,$221.11 ,74.28% of Billed charges for outpatient setting,$267.90 ,90% of Billed charges for outpatient setting,$267.90 ,90% of Billed charges for outpatient setting,$156.34 ,52.52% of charges,$259.57 ,87.2% of Billed charges for outpatient setting,$181.58 ,61% of Billed charges for outpatient setting,$259.57 ,87.2% of Billed charges for outpatient setting,$154.79 ,52% of charges,$241.98 ,81.29% of Billed charges for outpatient setting,$267.90 ,90% of Billed charges for outpatient setting,$267.90 ,90% of Billed charges for outpatient setting,$181.58 ,61% of Billed charges for outpatient setting,$181.58 ,61% of Billed charges for outpatient setting,$267.90 ,90% of Billed charges for outpatient setting,$267.90 ,90% of Billed charges for outpatient setting,$181.58 ,61% of Billed charges for outpatient setting,$181.58 ,61% of Billed charges for outpatient setting,$181.58 ,61% of Billed charges for outpatient setting,$154.79 ,52% of charges,$154.79 ,52% of charges,$154.79 ,52% of charges,$154.79 ,52% of charges,$154.79 ,52% of charges,$154.79 ,52% of charges,154.7884,267.9,$238.14 
Outpatient Medical Services,Radiology,73630,X-Ray Exam Of Foot; 3+ Views Unilat,320,$206.87 ,$175.84 ,85% of Billed charges for outpatient setting,$175.84 ,85% of Billed charges for outpatient setting,$153.66 ,74.28% of Billed charges for outpatient setting,$153.66 ,74.28% of Billed charges for outpatient setting,$126.19 ,61% of Billed charges for outpatient setting,$153.66 ,74.28% of Billed charges for outpatient setting,$186.18 ,90% of Billed charges for outpatient setting,$186.18 ,90% of Billed charges for outpatient setting,$108.65 ,52.52% of charges,$180.39 ,87.2% of Billed charges for outpatient setting,$126.19 ,61% of Billed charges for outpatient setting,$180.39 ,87.2% of Billed charges for outpatient setting,$107.57 ,52% of charges,$168.16 ,81.29% of Billed charges for outpatient setting,$186.18 ,90% of Billed charges for outpatient setting,$186.18 ,90% of Billed charges for outpatient setting,$126.19 ,61% of Billed charges for outpatient setting,$126.19 ,61% of Billed charges for outpatient setting,$186.18 ,90% of Billed charges for outpatient setting,$186.18 ,90% of Billed charges for outpatient setting,$126.19 ,61% of Billed charges for outpatient setting,$126.19 ,61% of Billed charges for outpatient setting,$126.19 ,61% of Billed charges for outpatient setting,$107.57 ,52% of charges,$107.57 ,52% of charges,$107.57 ,52% of charges,$107.57 ,52% of charges,$107.57 ,52% of charges,$107.57 ,52% of charges,107.5724,186.18,$165.50 
Outpatient Medical Services,Radiology,73630,X-Ray Exam Of Foot; 3+ Views Bilat,320,$413.77 ,$351.70 ,85% of Billed charges for outpatient setting,$351.70 ,85% of Billed charges for outpatient setting,$307.35 ,74.28% of Billed charges for outpatient setting,$307.35 ,74.28% of Billed charges for outpatient setting,$252.40 ,61% of Billed charges for outpatient setting,$307.35 ,74.28% of Billed charges for outpatient setting,$372.39 ,90% of Billed charges for outpatient setting,$372.39 ,90% of Billed charges for outpatient setting,$217.31 ,52.52% of charges,$360.81 ,87.2% of Billed charges for outpatient setting,$252.40 ,61% of Billed charges for outpatient setting,$360.81 ,87.2% of Billed charges for outpatient setting,$215.16 ,52% of charges,$336.35 ,81.29% of Billed charges for outpatient setting,$372.39 ,90% of Billed charges for outpatient setting,$372.39 ,90% of Billed charges for outpatient setting,$252.40 ,61% of Billed charges for outpatient setting,$252.40 ,61% of Billed charges for outpatient setting,$372.39 ,90% of Billed charges for outpatient setting,$372.39 ,90% of Billed charges for outpatient setting,$252.40 ,61% of Billed charges for outpatient setting,$252.40 ,61% of Billed charges for outpatient setting,$252.40 ,61% of Billed charges for outpatient setting,$215.16 ,52% of charges,$215.16 ,52% of charges,$215.16 ,52% of charges,$215.16 ,52% of charges,$215.16 ,52% of charges,$215.16 ,52% of charges,215.1604,372.39,$331.02 
Outpatient Medical Services,Radiology,73650,"X-Ray Exam Of calcaneus, minimum of 2 views Unilat",320,$148.82 ,$126.50 ,85% of Billed charges for outpatient setting,$126.50 ,85% of Billed charges for outpatient setting,$110.54 ,74.28% of Billed charges for outpatient setting,$110.54 ,74.28% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$110.54 ,74.28% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$78.16 ,52.52% of charges,$129.77 ,87.2% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$129.77 ,87.2% of Billed charges for outpatient setting,$77.39 ,52% of charges,$120.98 ,81.29% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$133.94 ,90% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$90.78 ,61% of Billed charges for outpatient setting,$77.39 ,52% of charges,$77.39 ,52% of charges,$77.39 ,52% of charges,$77.39 ,52% of charges,$77.39 ,52% of charges,$77.39 ,52% of charges,77.3864,133.94,$119.06 
Outpatient Medical Services,Radiology,73650,"X-Ray Exam Of calcaneus, minimum of 2 views Bilat",320,$297.67 ,$253.02 ,85% of Billed charges for outpatient setting,$253.02 ,85% of Billed charges for outpatient setting,$221.11 ,74.28% of Billed charges for outpatient setting,$221.11 ,74.28% of Billed charges for outpatient setting,$181.58 ,61% of Billed charges for outpatient setting,$221.11 ,74.28% of Billed charges for outpatient setting,$267.90 ,90% of Billed charges for outpatient setting,$267.90 ,90% of Billed charges for outpatient setting,$156.34 ,52.52% of charges,$259.57 ,87.2% of Billed charges for outpatient setting,$181.58 ,61% of Billed charges for outpatient setting,$259.57 ,87.2% of Billed charges for outpatient setting,$154.79 ,52% of charges,$241.98 ,81.29% of Billed charges for outpatient setting,$267.90 ,90% of Billed charges for outpatient setting,$267.90 ,90% of Billed charges for outpatient setting,$181.58 ,61% of Billed charges for outpatient setting,$181.58 ,61% of Billed charges for outpatient setting,$267.90 ,90% of Billed charges for outpatient setting,$267.90 ,90% of Billed charges for outpatient setting,$181.58 ,61% of Billed charges for outpatient setting,$181.58 ,61% of Billed charges for outpatient setting,$181.58 ,61% of Billed charges for outpatient setting,$154.79 ,52% of charges,$154.79 ,52% of charges,$154.79 ,52% of charges,$154.79 ,52% of charges,$154.79 ,52% of charges,$154.79 ,52% of charges,154.7884,267.9,$238.14 
Outpatient Medical Services,Radiology,73660,X-Ray Exam Of Toe(S) 2+ Views,320,$120.74 ,$102.63 ,85% of Billed charges for outpatient setting,$102.63 ,85% of Billed charges for outpatient setting,$89.69 ,74.28% of Billed charges for outpatient setting,$89.69 ,74.28% of Billed charges for outpatient setting,$73.65 ,61% of Billed charges for outpatient setting,$89.69 ,74.28% of Billed charges for outpatient setting,$108.67 ,90% of Billed charges for outpatient setting,$108.67 ,90% of Billed charges for outpatient setting,$63.41 ,52.52% of charges,$105.29 ,87.2% of Billed charges for outpatient setting,$73.65 ,61% of Billed charges for outpatient setting,$105.29 ,87.2% of Billed charges for outpatient setting,$62.78 ,52% of charges,$98.15 ,81.29% of Billed charges for outpatient setting,$108.67 ,90% of Billed charges for outpatient setting,$108.67 ,90% of Billed charges for outpatient setting,$73.65 ,61% of Billed charges for outpatient setting,$73.65 ,61% of Billed charges for outpatient setting,$108.67 ,90% of Billed charges for outpatient setting,$108.67 ,90% of Billed charges for outpatient setting,$73.65 ,61% of Billed charges for outpatient setting,$73.65 ,61% of Billed charges for outpatient setting,$73.65 ,61% of Billed charges for outpatient setting,$62.78 ,52% of charges,$62.78 ,52% of charges,$62.78 ,52% of charges,$62.78 ,52% of charges,$62.78 ,52% of charges,$62.78 ,52% of charges,62.7848,108.67,$96.59 
Outpatient Medical Services,Radiology,73700,"CT Scan, Lower Extremity, W/O Contrast",352,"$1,001.21 ",$851.03 ,85% of Billed charges for outpatient setting,$851.03 ,85% of Billed charges for outpatient setting,$743.70 ,74.28% of Billed charges for outpatient setting,$743.70 ,74.28% of Billed charges for outpatient setting,$610.74 ,61% of Billed charges for outpatient setting,$743.70 ,74.28% of Billed charges for outpatient setting,$901.09 ,90% of Billed charges for outpatient setting,$901.09 ,90% of Billed charges for outpatient setting,$525.84 ,52.52% of charges,$873.06 ,87.2% of Billed charges for outpatient setting,$610.74 ,61% of Billed charges for outpatient setting,$873.06 ,87.2% of Billed charges for outpatient setting,$520.63 ,52% of charges,$813.88 ,81.29% of Billed charges for outpatient setting,$901.09 ,90% of Billed charges for outpatient setting,$901.09 ,90% of Billed charges for outpatient setting,$610.74 ,61% of Billed charges for outpatient setting,$610.74 ,61% of Billed charges for outpatient setting,$901.09 ,90% of Billed charges for outpatient setting,$901.09 ,90% of Billed charges for outpatient setting,$610.74 ,61% of Billed charges for outpatient setting,$610.74 ,61% of Billed charges for outpatient setting,$610.74 ,61% of Billed charges for outpatient setting,$520.63 ,52% of charges,$520.63 ,52% of charges,$520.63 ,52% of charges,$520.63 ,52% of charges,$520.63 ,52% of charges,$520.63 ,52% of charges,520.6292,901.09,$800.97 
Outpatient Medical Services,Radiology,73702,CT Scan Of Leg Combo,352,"$1,301.27 ","$1,106.08 ",85% of Billed charges for outpatient setting,"$1,106.08 ",85% of Billed charges for outpatient setting,$966.58 ,74.28% of Billed charges for outpatient setting,$966.58 ,74.28% of Billed charges for outpatient setting,$793.77 ,61% of Billed charges for outpatient setting,$966.58 ,74.28% of Billed charges for outpatient setting,"$1,171.14 ",90% of Billed charges for outpatient setting,"$1,171.14 ",90% of Billed charges for outpatient setting,$683.43 ,52.52% of charges,"$1,134.71 ",87.2% of Billed charges for outpatient setting,$793.77 ,61% of Billed charges for outpatient setting,"$1,134.71 ",87.2% of Billed charges for outpatient setting,$676.66 ,52% of charges,"$1,057.80 ",81.29% of Billed charges for outpatient setting,"$1,171.14 ",90% of Billed charges for outpatient setting,"$1,171.14 ",90% of Billed charges for outpatient setting,$793.77 ,61% of Billed charges for outpatient setting,$793.77 ,61% of Billed charges for outpatient setting,"$1,171.14 ",90% of Billed charges for outpatient setting,"$1,171.14 ",90% of Billed charges for outpatient setting,$793.77 ,61% of Billed charges for outpatient setting,$793.77 ,61% of Billed charges for outpatient setting,$793.77 ,61% of Billed charges for outpatient setting,$676.66 ,52% of charges,$676.66 ,52% of charges,$676.66 ,52% of charges,$676.66 ,52% of charges,$676.66 ,52% of charges,$676.66 ,52% of charges,676.6604,1171.14,"$1,041.02 "
Outpatient Medical Services,Radiology,73718,"MRI,  Lower Extrem",614,"$1,825.31 ","$1,551.51 ",85% of Billed charges for outpatient setting,"$1,551.51 ",85% of Billed charges for outpatient setting,"$1,355.84 ",74.28% of Billed charges for outpatient setting,"$1,355.84 ",74.28% of Billed charges for outpatient setting,"$1,113.44 ",61% of Billed charges for outpatient setting,"$1,355.84 ",74.28% of Billed charges for outpatient setting,"$1,642.78 ",90% of Billed charges for outpatient setting,"$1,642.78 ",90% of Billed charges for outpatient setting,$958.65 ,52.52% of charges,"$1,591.67 ",87.2% of Billed charges for outpatient setting,"$1,113.44 ",61% of Billed charges for outpatient setting,"$1,591.67 ",87.2% of Billed charges for outpatient setting,$949.16 ,52% of charges,"$1,483.79 ",81.29% of Billed charges for outpatient setting,"$1,642.78 ",90% of Billed charges for outpatient setting,"$1,642.78 ",90% of Billed charges for outpatient setting,"$1,113.44 ",61% of Billed charges for outpatient setting,"$1,113.44 ",61% of Billed charges for outpatient setting,"$1,642.78 ",90% of Billed charges for outpatient setting,"$1,642.78 ",90% of Billed charges for outpatient setting,"$1,113.44 ",61% of Billed charges for outpatient setting,"$1,113.44 ",61% of Billed charges for outpatient setting,"$1,113.44 ",61% of Billed charges for outpatient setting,$949.16 ,52% of charges,$949.16 ,52% of charges,$949.16 ,52% of charges,$949.16 ,52% of charges,$949.16 ,52% of charges,$949.16 ,52% of charges,949.1612,1642.78,"$1,460.25 "
Outpatient Medical Services,Radiology,73721,"MRI Lower Extrem Jt,  W/O Contrast Unilat",614,"$1,825.31 ","$1,551.51 ",85% of Billed charges for outpatient setting,"$1,551.51 ",85% of Billed charges for outpatient setting,"$1,355.84 ",74.28% of Billed charges for outpatient setting,"$1,355.84 ",74.28% of Billed charges for outpatient setting,"$1,113.44 ",61% of Billed charges for outpatient setting,"$1,355.84 ",74.28% of Billed charges for outpatient setting,"$1,642.78 ",90% of Billed charges for outpatient setting,"$1,642.78 ",90% of Billed charges for outpatient setting,$958.65 ,52.52% of charges,"$1,591.67 ",87.2% of Billed charges for outpatient setting,"$1,113.44 ",61% of Billed charges for outpatient setting,"$1,591.67 ",87.2% of Billed charges for outpatient setting,$949.16 ,52% of charges,"$1,483.79 ",81.29% of Billed charges for outpatient setting,"$1,642.78 ",90% of Billed charges for outpatient setting,"$1,642.78 ",90% of Billed charges for outpatient setting,"$1,113.44 ",61% of Billed charges for outpatient setting,"$1,113.44 ",61% of Billed charges for outpatient setting,"$1,642.78 ",90% of Billed charges for outpatient setting,"$1,642.78 ",90% of Billed charges for outpatient setting,"$1,113.44 ",61% of Billed charges for outpatient setting,"$1,113.44 ",61% of Billed charges for outpatient setting,"$1,113.44 ",61% of Billed charges for outpatient setting,$949.16 ,52% of charges,$949.16 ,52% of charges,$949.16 ,52% of charges,$949.16 ,52% of charges,$949.16 ,52% of charges,$949.16 ,52% of charges,949.1612,1642.78,"$1,460.25 "
Outpatient Medical Services,Radiology,73721,"MRI Lower Extrem Jt,  W/O Contrast Bilat",614,"$3,650.62 ","$3,103.03 ",85% of Billed charges for outpatient setting,"$3,103.03 ",85% of Billed charges for outpatient setting,"$2,711.68 ",74.28% of Billed charges for outpatient setting,"$2,711.68 ",74.28% of Billed charges for outpatient setting,"$2,226.88 ",61% of Billed charges for outpatient setting,"$2,711.68 ",74.28% of Billed charges for outpatient setting,"$3,285.56 ",90% of Billed charges for outpatient setting,"$3,285.56 ",90% of Billed charges for outpatient setting,"$1,917.31 ",52.52% of charges,"$3,183.34 ",87.2% of Billed charges for outpatient setting,"$2,226.88 ",61% of Billed charges for outpatient setting,"$3,183.34 ",87.2% of Billed charges for outpatient setting,"$1,898.32 ",52% of charges,"$2,967.59 ",81.29% of Billed charges for outpatient setting,"$3,285.56 ",90% of Billed charges for outpatient setting,"$3,285.56 ",90% of Billed charges for outpatient setting,"$2,226.88 ",61% of Billed charges for outpatient setting,"$2,226.88 ",61% of Billed charges for outpatient setting,"$3,285.56 ",90% of Billed charges for outpatient setting,"$3,285.56 ",90% of Billed charges for outpatient setting,"$2,226.88 ",61% of Billed charges for outpatient setting,"$2,226.88 ",61% of Billed charges for outpatient setting,"$2,226.88 ",61% of Billed charges for outpatient setting,"$1,898.32 ",52% of charges,"$1,898.32 ",52% of charges,"$1,898.32 ",52% of charges,"$1,898.32 ",52% of charges,"$1,898.32 ",52% of charges,"$1,898.32 ",52% of charges,1898.3224,3285.56,"$2,920.50 "
Outpatient Medical Services,Radiology,74018,X-Ray Exam Abdomen 1 View,320,$230.39 ,$195.83 ,85% of Billed charges for outpatient setting,$195.83 ,85% of Billed charges for outpatient setting,$171.13 ,74.28% of Billed charges for outpatient setting,$171.13 ,74.28% of Billed charges for outpatient setting,$140.54 ,61% of Billed charges for outpatient setting,$171.13 ,74.28% of Billed charges for outpatient setting,$207.35 ,90% of Billed charges for outpatient setting,$207.35 ,90% of Billed charges for outpatient setting,$121.00 ,52.52% of charges,$200.90 ,87.2% of Billed charges for outpatient setting,$140.54 ,61% of Billed charges for outpatient setting,$200.90 ,87.2% of Billed charges for outpatient setting,$119.80 ,52% of charges,$187.28 ,81.29% of Billed charges for outpatient setting,$207.35 ,90% of Billed charges for outpatient setting,$207.35 ,90% of Billed charges for outpatient setting,$140.54 ,61% of Billed charges for outpatient setting,$140.54 ,61% of Billed charges for outpatient setting,$207.35 ,90% of Billed charges for outpatient setting,$207.35 ,90% of Billed charges for outpatient setting,$140.54 ,61% of Billed charges for outpatient setting,$140.54 ,61% of Billed charges for outpatient setting,$140.54 ,61% of Billed charges for outpatient setting,$119.80 ,52% of charges,$119.80 ,52% of charges,$119.80 ,52% of charges,$119.80 ,52% of charges,$119.80 ,52% of charges,$119.80 ,52% of charges,119.8028,207.35,$184.31 
Outpatient Medical Services,Radiology,74019,X-Ray Exam Abdomen 2 Views,320,$274.86 ,$233.63 ,85% of Billed charges for outpatient setting,$233.63 ,85% of Billed charges for outpatient setting,$204.17 ,74.28% of Billed charges for outpatient setting,$204.17 ,74.28% of Billed charges for outpatient setting,$167.66 ,61% of Billed charges for outpatient setting,$204.17 ,74.28% of Billed charges for outpatient setting,$247.37 ,90% of Billed charges for outpatient setting,$247.37 ,90% of Billed charges for outpatient setting,$144.36 ,52.52% of charges,$239.68 ,87.2% of Billed charges for outpatient setting,$167.66 ,61% of Billed charges for outpatient setting,$239.68 ,87.2% of Billed charges for outpatient setting,$142.93 ,52% of charges,$223.43 ,81.29% of Billed charges for outpatient setting,$247.37 ,90% of Billed charges for outpatient setting,$247.37 ,90% of Billed charges for outpatient setting,$167.66 ,61% of Billed charges for outpatient setting,$167.66 ,61% of Billed charges for outpatient setting,$247.37 ,90% of Billed charges for outpatient setting,$247.37 ,90% of Billed charges for outpatient setting,$167.66 ,61% of Billed charges for outpatient setting,$167.66 ,61% of Billed charges for outpatient setting,$167.66 ,61% of Billed charges for outpatient setting,$142.93 ,52% of charges,$142.93 ,52% of charges,$142.93 ,52% of charges,$142.93 ,52% of charges,$142.93 ,52% of charges,$142.93 ,52% of charges,142.9272,247.37,$219.89 
Outpatient Medical Services,Radiology,74022,Compl Acute Abdomen,320,$390.95 ,$332.31 ,85% of Billed charges for outpatient setting,$332.31 ,85% of Billed charges for outpatient setting,$290.40 ,74.28% of Billed charges for outpatient setting,$290.40 ,74.28% of Billed charges for outpatient setting,$238.48 ,61% of Billed charges for outpatient setting,$290.40 ,74.28% of Billed charges for outpatient setting,$351.86 ,90% of Billed charges for outpatient setting,$351.86 ,90% of Billed charges for outpatient setting,$205.33 ,52.52% of charges,$340.91 ,87.2% of Billed charges for outpatient setting,$238.48 ,61% of Billed charges for outpatient setting,$340.91 ,87.2% of Billed charges for outpatient setting,$203.29 ,52% of charges,$317.80 ,81.29% of Billed charges for outpatient setting,$351.86 ,90% of Billed charges for outpatient setting,$351.86 ,90% of Billed charges for outpatient setting,$238.48 ,61% of Billed charges for outpatient setting,$238.48 ,61% of Billed charges for outpatient setting,$351.86 ,90% of Billed charges for outpatient setting,$351.86 ,90% of Billed charges for outpatient setting,$238.48 ,61% of Billed charges for outpatient setting,$238.48 ,61% of Billed charges for outpatient setting,$238.48 ,61% of Billed charges for outpatient setting,$203.29 ,52% of charges,$203.29 ,52% of charges,$203.29 ,52% of charges,$203.29 ,52% of charges,$203.29 ,52% of charges,$203.29 ,52% of charges,203.294,351.86,$312.76 
Outpatient Medical Services,Radiology,74150,"CT Scan, Abdomen, W/O Contrast",352,"$1,145.34 ",$973.54 ,85% of Billed charges for outpatient setting,$973.54 ,85% of Billed charges for outpatient setting,$850.76 ,74.28% of Billed charges for outpatient setting,$850.76 ,74.28% of Billed charges for outpatient setting,$698.66 ,61% of Billed charges for outpatient setting,$850.76 ,74.28% of Billed charges for outpatient setting,"$1,030.81 ",90% of Billed charges for outpatient setting,"$1,030.81 ",90% of Billed charges for outpatient setting,$601.53 ,52.52% of charges,$998.74 ,87.2% of Billed charges for outpatient setting,$698.66 ,61% of Billed charges for outpatient setting,$998.74 ,87.2% of Billed charges for outpatient setting,$595.58 ,52% of charges,$931.05 ,81.29% of Billed charges for outpatient setting,"$1,030.81 ",90% of Billed charges for outpatient setting,"$1,030.81 ",90% of Billed charges for outpatient setting,$698.66 ,61% of Billed charges for outpatient setting,$698.66 ,61% of Billed charges for outpatient setting,"$1,030.81 ",90% of Billed charges for outpatient setting,"$1,030.81 ",90% of Billed charges for outpatient setting,$698.66 ,61% of Billed charges for outpatient setting,$698.66 ,61% of Billed charges for outpatient setting,$698.66 ,61% of Billed charges for outpatient setting,$595.58 ,52% of charges,$595.58 ,52% of charges,$595.58 ,52% of charges,$595.58 ,52% of charges,$595.58 ,52% of charges,$595.58 ,52% of charges,595.5768,1030.81,$916.27 
Outpatient Medical Services,Radiology,74160,CT Scan Of Abdomen Contrast,352,"$1,375.67 ","$1,169.32 ",85% of Billed charges for outpatient setting,"$1,169.32 ",85% of Billed charges for outpatient setting,"$1,021.85 ",74.28% of Billed charges for outpatient setting,"$1,021.85 ",74.28% of Billed charges for outpatient setting,$839.16 ,61% of Billed charges for outpatient setting,"$1,021.85 ",74.28% of Billed charges for outpatient setting,"$1,238.10 ",90% of Billed charges for outpatient setting,"$1,238.10 ",90% of Billed charges for outpatient setting,$722.50 ,52.52% of charges,"$1,199.58 ",87.2% of Billed charges for outpatient setting,$839.16 ,61% of Billed charges for outpatient setting,"$1,199.58 ",87.2% of Billed charges for outpatient setting,$715.35 ,52% of charges,"$1,118.28 ",81.29% of Billed charges for outpatient setting,"$1,238.10 ",90% of Billed charges for outpatient setting,"$1,238.10 ",90% of Billed charges for outpatient setting,$839.16 ,61% of Billed charges for outpatient setting,$839.16 ,61% of Billed charges for outpatient setting,"$1,238.10 ",90% of Billed charges for outpatient setting,"$1,238.10 ",90% of Billed charges for outpatient setting,$839.16 ,61% of Billed charges for outpatient setting,$839.16 ,61% of Billed charges for outpatient setting,$839.16 ,61% of Billed charges for outpatient setting,$715.35 ,52% of charges,$715.35 ,52% of charges,$715.35 ,52% of charges,$715.35 ,52% of charges,$715.35 ,52% of charges,$715.35 ,52% of charges,715.3484,1238.1,"$1,100.54 "
Outpatient Medical Services,Radiology,74170,CT Abdomen W/ or W/O Contrast,352,"$1,593.27 ","$1,354.28 ",85% of Billed charges for outpatient setting,"$1,354.28 ",85% of Billed charges for outpatient setting,"$1,183.48 ",74.28% of Billed charges for outpatient setting,"$1,183.48 ",74.28% of Billed charges for outpatient setting,$971.89 ,61% of Billed charges for outpatient setting,"$1,183.48 ",74.28% of Billed charges for outpatient setting,"$1,433.94 ",90% of Billed charges for outpatient setting,"$1,433.94 ",90% of Billed charges for outpatient setting,$836.79 ,52.52% of charges,"$1,389.33 ",87.2% of Billed charges for outpatient setting,$971.89 ,61% of Billed charges for outpatient setting,"$1,389.33 ",87.2% of Billed charges for outpatient setting,$828.50 ,52% of charges,"$1,295.17 ",81.29% of Billed charges for outpatient setting,"$1,433.94 ",90% of Billed charges for outpatient setting,"$1,433.94 ",90% of Billed charges for outpatient setting,$971.89 ,61% of Billed charges for outpatient setting,$971.89 ,61% of Billed charges for outpatient setting,"$1,433.94 ",90% of Billed charges for outpatient setting,"$1,433.94 ",90% of Billed charges for outpatient setting,$971.89 ,61% of Billed charges for outpatient setting,$971.89 ,61% of Billed charges for outpatient setting,$971.89 ,61% of Billed charges for outpatient setting,$828.50 ,52% of charges,$828.50 ,52% of charges,$828.50 ,52% of charges,$828.50 ,52% of charges,$828.50 ,52% of charges,$828.50 ,52% of charges,828.5004,1433.94,"$1,274.62 "
Outpatient Medical Services,Radiology,74174,CT Angio Abd&Plvis Contrast Mtrl W/Wo Contrast Images,350,"$3,220.52 ","$2,737.44 ",85% of Billed charges for outpatient setting,"$2,737.44 ",85% of Billed charges for outpatient setting,"$2,392.20 ",74.28% of Billed charges for outpatient setting,"$2,392.20 ",74.28% of Billed charges for outpatient setting,"$1,964.52 ",61% of Billed charges for outpatient setting,"$2,392.20 ",74.28% of Billed charges for outpatient setting,"$2,898.47 ",90% of Billed charges for outpatient setting,"$2,898.47 ",90% of Billed charges for outpatient setting,"$1,691.42 ",52.52% of charges,"$2,808.29 ",87.2% of Billed charges for outpatient setting,"$1,964.52 ",61% of Billed charges for outpatient setting,"$2,808.29 ",87.2% of Billed charges for outpatient setting,"$1,674.67 ",52% of charges,"$2,617.96 ",81.29% of Billed charges for outpatient setting,"$2,898.47 ",90% of Billed charges for outpatient setting,"$2,898.47 ",90% of Billed charges for outpatient setting,"$1,964.52 ",61% of Billed charges for outpatient setting,"$1,964.52 ",61% of Billed charges for outpatient setting,"$2,898.47 ",90% of Billed charges for outpatient setting,"$2,898.47 ",90% of Billed charges for outpatient setting,"$1,964.52 ",61% of Billed charges for outpatient setting,"$1,964.52 ",61% of Billed charges for outpatient setting,"$1,964.52 ",61% of Billed charges for outpatient setting,"$1,674.67 ",52% of charges,"$1,674.67 ",52% of charges,"$1,674.67 ",52% of charges,"$1,674.67 ",52% of charges,"$1,674.67 ",52% of charges,"$1,674.67 ",52% of charges,1674.6704,2898.47,"$2,576.42 "
Outpatient Medical Services,Radiology,74175,CT Angio Abdom W/O & W/Dye,359,"$1,608.40 ","$1,367.14 ",85% of Billed charges for outpatient setting,"$1,367.14 ",85% of Billed charges for outpatient setting,"$1,194.72 ",74.28% of Billed charges for outpatient setting,"$1,194.72 ",74.28% of Billed charges for outpatient setting,$981.12 ,61% of Billed charges for outpatient setting,"$1,194.72 ",74.28% of Billed charges for outpatient setting,"$1,447.56 ",90% of Billed charges for outpatient setting,"$1,447.56 ",90% of Billed charges for outpatient setting,$844.73 ,52.52% of charges,"$1,402.52 ",87.2% of Billed charges for outpatient setting,$981.12 ,61% of Billed charges for outpatient setting,"$1,402.52 ",87.2% of Billed charges for outpatient setting,$836.37 ,52% of charges,"$1,307.47 ",81.29% of Billed charges for outpatient setting,"$1,447.56 ",90% of Billed charges for outpatient setting,"$1,447.56 ",90% of Billed charges for outpatient setting,$981.12 ,61% of Billed charges for outpatient setting,$981.12 ,61% of Billed charges for outpatient setting,"$1,447.56 ",90% of Billed charges for outpatient setting,"$1,447.56 ",90% of Billed charges for outpatient setting,$981.12 ,61% of Billed charges for outpatient setting,$981.12 ,61% of Billed charges for outpatient setting,$981.12 ,61% of Billed charges for outpatient setting,$836.37 ,52% of charges,$836.37 ,52% of charges,$836.37 ,52% of charges,$836.37 ,52% of charges,$836.37 ,52% of charges,$836.37 ,52% of charges,836.368,1447.56,"$1,286.72 "
Outpatient Medical Services,Radiology,74176,"CT Scan, Abdomen And Pelvis,  W/O Contrast",352,"$2,152.96 ","$1,830.02 ",85% of Billed charges for outpatient setting,"$1,830.02 ",85% of Billed charges for outpatient setting,"$1,599.22 ",74.28% of Billed charges for outpatient setting,"$1,599.22 ",74.28% of Billed charges for outpatient setting,"$1,313.31 ",61% of Billed charges for outpatient setting,"$1,599.22 ",74.28% of Billed charges for outpatient setting,"$1,937.66 ",90% of Billed charges for outpatient setting,"$1,937.66 ",90% of Billed charges for outpatient setting,"$1,130.73 ",52.52% of charges,"$1,877.38 ",87.2% of Billed charges for outpatient setting,"$1,313.31 ",61% of Billed charges for outpatient setting,"$1,877.38 ",87.2% of Billed charges for outpatient setting,"$1,119.54 ",52% of charges,"$1,750.14 ",81.29% of Billed charges for outpatient setting,"$1,937.66 ",90% of Billed charges for outpatient setting,"$1,937.66 ",90% of Billed charges for outpatient setting,"$1,313.31 ",61% of Billed charges for outpatient setting,"$1,313.31 ",61% of Billed charges for outpatient setting,"$1,937.66 ",90% of Billed charges for outpatient setting,"$1,937.66 ",90% of Billed charges for outpatient setting,"$1,313.31 ",61% of Billed charges for outpatient setting,"$1,313.31 ",61% of Billed charges for outpatient setting,"$1,313.31 ",61% of Billed charges for outpatient setting,"$1,119.54 ",52% of charges,"$1,119.54 ",52% of charges,"$1,119.54 ",52% of charges,"$1,119.54 ",52% of charges,"$1,119.54 ",52% of charges,"$1,119.54 ",52% of charges,1119.5392,1937.66,"$1,722.37 "
Outpatient Medical Services,Radiology,74177,"CT Scan, Abdomen And Pelvis,  W Contrast",352,"$2,248.33 ","$1,911.08 ",85% of Billed charges for outpatient setting,"$1,911.08 ",85% of Billed charges for outpatient setting,"$1,670.06 ",74.28% of Billed charges for outpatient setting,"$1,670.06 ",74.28% of Billed charges for outpatient setting,"$1,371.48 ",61% of Billed charges for outpatient setting,"$1,670.06 ",74.28% of Billed charges for outpatient setting,"$2,023.50 ",90% of Billed charges for outpatient setting,"$2,023.50 ",90% of Billed charges for outpatient setting,"$1,180.82 ",52.52% of charges,"$1,960.54 ",87.2% of Billed charges for outpatient setting,"$1,371.48 ",61% of Billed charges for outpatient setting,"$1,960.54 ",87.2% of Billed charges for outpatient setting,"$1,169.13 ",52% of charges,"$1,827.67 ",81.29% of Billed charges for outpatient setting,"$2,023.50 ",90% of Billed charges for outpatient setting,"$2,023.50 ",90% of Billed charges for outpatient setting,"$1,371.48 ",61% of Billed charges for outpatient setting,"$1,371.48 ",61% of Billed charges for outpatient setting,"$2,023.50 ",90% of Billed charges for outpatient setting,"$2,023.50 ",90% of Billed charges for outpatient setting,"$1,371.48 ",61% of Billed charges for outpatient setting,"$1,371.48 ",61% of Billed charges for outpatient setting,"$1,371.48 ",61% of Billed charges for outpatient setting,"$1,169.13 ",52% of charges,"$1,169.13 ",52% of charges,"$1,169.13 ",52% of charges,"$1,169.13 ",52% of charges,"$1,169.13 ",52% of charges,"$1,169.13 ",52% of charges,1169.1316,2023.5,"$1,798.66 "
Outpatient Medical Services,Radiology,74178,CT Abd & Pelv 1/> Regns,352,"$2,520.87 ","$2,142.74 ",85% of Billed charges for outpatient setting,"$2,142.74 ",85% of Billed charges for outpatient setting,"$1,872.50 ",74.28% of Billed charges for outpatient setting,"$1,872.50 ",74.28% of Billed charges for outpatient setting,"$1,537.73 ",61% of Billed charges for outpatient setting,"$1,872.50 ",74.28% of Billed charges for outpatient setting,"$2,268.78 ",90% of Billed charges for outpatient setting,"$2,268.78 ",90% of Billed charges for outpatient setting,"$1,323.96 ",52.52% of charges,"$2,198.20 ",87.2% of Billed charges for outpatient setting,"$1,537.73 ",61% of Billed charges for outpatient setting,"$2,198.20 ",87.2% of Billed charges for outpatient setting,"$1,310.85 ",52% of charges,"$2,049.22 ",81.29% of Billed charges for outpatient setting,"$2,268.78 ",90% of Billed charges for outpatient setting,"$2,268.78 ",90% of Billed charges for outpatient setting,"$1,537.73 ",61% of Billed charges for outpatient setting,"$1,537.73 ",61% of Billed charges for outpatient setting,"$2,268.78 ",90% of Billed charges for outpatient setting,"$2,268.78 ",90% of Billed charges for outpatient setting,"$1,537.73 ",61% of Billed charges for outpatient setting,"$1,537.73 ",61% of Billed charges for outpatient setting,"$1,537.73 ",61% of Billed charges for outpatient setting,"$1,310.85 ",52% of charges,"$1,310.85 ",52% of charges,"$1,310.85 ",52% of charges,"$1,310.85 ",52% of charges,"$1,310.85 ",52% of charges,"$1,310.85 ",52% of charges,1310.8524,2268.78,"$2,016.70 "
Outpatient Medical Services,Radiology,74183,"MRI,  Abdomen,  Combo",614,"$2,447.37 ","$2,080.26 ",85% of Billed charges for outpatient setting,"$2,080.26 ",85% of Billed charges for outpatient setting,"$1,817.91 ",74.28% of Billed charges for outpatient setting,"$1,817.91 ",74.28% of Billed charges for outpatient setting,"$1,492.90 ",61% of Billed charges for outpatient setting,"$1,817.91 ",74.28% of Billed charges for outpatient setting,"$2,202.63 ",90% of Billed charges for outpatient setting,"$2,202.63 ",90% of Billed charges for outpatient setting,"$1,285.36 ",52.52% of charges,"$2,134.11 ",87.2% of Billed charges for outpatient setting,"$1,492.90 ",61% of Billed charges for outpatient setting,"$2,134.11 ",87.2% of Billed charges for outpatient setting,"$1,272.63 ",52% of charges,"$1,989.47 ",81.29% of Billed charges for outpatient setting,"$2,202.63 ",90% of Billed charges for outpatient setting,"$2,202.63 ",90% of Billed charges for outpatient setting,"$1,492.90 ",61% of Billed charges for outpatient setting,"$1,492.90 ",61% of Billed charges for outpatient setting,"$2,202.63 ",90% of Billed charges for outpatient setting,"$2,202.63 ",90% of Billed charges for outpatient setting,"$1,492.90 ",61% of Billed charges for outpatient setting,"$1,492.90 ",61% of Billed charges for outpatient setting,"$1,492.90 ",61% of Billed charges for outpatient setting,"$1,272.63 ",52% of charges,"$1,272.63 ",52% of charges,"$1,272.63 ",52% of charges,"$1,272.63 ",52% of charges,"$1,272.63 ",52% of charges,"$1,272.63 ",52% of charges,1272.6324,2202.63,"$1,957.90 "
Outpatient Medical Services,Radiology,74220,Esophagram,320,$328.36 ,$279.11 ,85% of Billed charges for outpatient setting,$279.11 ,85% of Billed charges for outpatient setting,$243.91 ,74.28% of Billed charges for outpatient setting,$243.91 ,74.28% of Billed charges for outpatient setting,$200.30 ,61% of Billed charges for outpatient setting,$243.91 ,74.28% of Billed charges for outpatient setting,$295.52 ,90% of Billed charges for outpatient setting,$295.52 ,90% of Billed charges for outpatient setting,$172.45 ,52.52% of charges,$286.33 ,87.2% of Billed charges for outpatient setting,$200.30 ,61% of Billed charges for outpatient setting,$286.33 ,87.2% of Billed charges for outpatient setting,$170.75 ,52% of charges,$266.92 ,81.29% of Billed charges for outpatient setting,$295.52 ,90% of Billed charges for outpatient setting,$295.52 ,90% of Billed charges for outpatient setting,$200.30 ,61% of Billed charges for outpatient setting,$200.30 ,61% of Billed charges for outpatient setting,$295.52 ,90% of Billed charges for outpatient setting,$295.52 ,90% of Billed charges for outpatient setting,$200.30 ,61% of Billed charges for outpatient setting,$200.30 ,61% of Billed charges for outpatient setting,$200.30 ,61% of Billed charges for outpatient setting,$170.75 ,52% of charges,$170.75 ,52% of charges,$170.75 ,52% of charges,$170.75 ,52% of charges,$170.75 ,52% of charges,$170.75 ,52% of charges,170.7472,295.52,$262.69 
Outpatient Medical Services,Radiology,74241,X-Ray Upper Gi Tract + Kub,320,$400.92 ,$340.78 ,85% of Billed charges for outpatient setting,$340.78 ,85% of Billed charges for outpatient setting,$297.80 ,74.28% of Billed charges for outpatient setting,$297.80 ,74.28% of Billed charges for outpatient setting,$244.56 ,61% of Billed charges for outpatient setting,$297.80 ,74.28% of Billed charges for outpatient setting,$360.83 ,90% of Billed charges for outpatient setting,$360.83 ,90% of Billed charges for outpatient setting,$210.56 ,52.52% of charges,$349.60 ,87.2% of Billed charges for outpatient setting,$244.56 ,61% of Billed charges for outpatient setting,$349.60 ,87.2% of Billed charges for outpatient setting,$208.48 ,52% of charges,$325.91 ,81.29% of Billed charges for outpatient setting,$360.83 ,90% of Billed charges for outpatient setting,$360.83 ,90% of Billed charges for outpatient setting,$244.56 ,61% of Billed charges for outpatient setting,$244.56 ,61% of Billed charges for outpatient setting,$360.83 ,90% of Billed charges for outpatient setting,$360.83 ,90% of Billed charges for outpatient setting,$244.56 ,61% of Billed charges for outpatient setting,$244.56 ,61% of Billed charges for outpatient setting,$244.56 ,61% of Billed charges for outpatient setting,$208.48 ,52% of charges,$208.48 ,52% of charges,$208.48 ,52% of charges,$208.48 ,52% of charges,$208.48 ,52% of charges,$208.48 ,52% of charges,208.4784,360.83,$320.74 
Outpatient Medical Services,Radiology,74246,Contrast X-Ray Upper Gi Tract,320,$500.59 ,$425.50 ,85% of Billed charges for outpatient setting,$425.50 ,85% of Billed charges for outpatient setting,$371.84 ,74.28% of Billed charges for outpatient setting,$371.84 ,74.28% of Billed charges for outpatient setting,$305.36 ,61% of Billed charges for outpatient setting,$371.84 ,74.28% of Billed charges for outpatient setting,$450.53 ,90% of Billed charges for outpatient setting,$450.53 ,90% of Billed charges for outpatient setting,$262.91 ,52.52% of charges,$436.51 ,87.2% of Billed charges for outpatient setting,$305.36 ,61% of Billed charges for outpatient setting,$436.51 ,87.2% of Billed charges for outpatient setting,$260.31 ,52% of charges,$406.93 ,81.29% of Billed charges for outpatient setting,$450.53 ,90% of Billed charges for outpatient setting,$450.53 ,90% of Billed charges for outpatient setting,$305.36 ,61% of Billed charges for outpatient setting,$305.36 ,61% of Billed charges for outpatient setting,$450.53 ,90% of Billed charges for outpatient setting,$450.53 ,90% of Billed charges for outpatient setting,$305.36 ,61% of Billed charges for outpatient setting,$305.36 ,61% of Billed charges for outpatient setting,$305.36 ,61% of Billed charges for outpatient setting,$260.31 ,52% of charges,$260.31 ,52% of charges,$260.31 ,52% of charges,$260.31 ,52% of charges,$260.31 ,52% of charges,$260.31 ,52% of charges,260.3068,450.53,$400.47 
Outpatient Medical Services,Radiology,74280,Be Colon W Air & Barium,320,$536.81 ,$456.29 ,85% of Billed charges for outpatient setting,$456.29 ,85% of Billed charges for outpatient setting,$398.74 ,74.28% of Billed charges for outpatient setting,$398.74 ,74.28% of Billed charges for outpatient setting,$327.45 ,61% of Billed charges for outpatient setting,$398.74 ,74.28% of Billed charges for outpatient setting,$483.13 ,90% of Billed charges for outpatient setting,$483.13 ,90% of Billed charges for outpatient setting,$281.93 ,52.52% of charges,$468.10 ,87.2% of Billed charges for outpatient setting,$327.45 ,61% of Billed charges for outpatient setting,$468.10 ,87.2% of Billed charges for outpatient setting,$279.14 ,52% of charges,$436.37 ,81.29% of Billed charges for outpatient setting,$483.13 ,90% of Billed charges for outpatient setting,$483.13 ,90% of Billed charges for outpatient setting,$327.45 ,61% of Billed charges for outpatient setting,$327.45 ,61% of Billed charges for outpatient setting,$483.13 ,90% of Billed charges for outpatient setting,$483.13 ,90% of Billed charges for outpatient setting,$327.45 ,61% of Billed charges for outpatient setting,$327.45 ,61% of Billed charges for outpatient setting,$327.45 ,61% of Billed charges for outpatient setting,$279.14 ,52% of charges,$279.14 ,52% of charges,$279.14 ,52% of charges,$279.14 ,52% of charges,$279.14 ,52% of charges,$279.14 ,52% of charges,279.1412,483.13,$429.45 
Outpatient Medical Services,Radiology,76010,"X-ray Exam from nose to rectum for foreign body, single view, child",320,$107.95 ,$91.76 ,85% of Billed charges for outpatient setting,$91.76 ,85% of Billed charges for outpatient setting,$80.19 ,74.28% of Billed charges for outpatient setting,$80.19 ,74.28% of Billed charges for outpatient setting,$65.85 ,61% of Billed charges for outpatient setting,$80.19 ,74.28% of Billed charges for outpatient setting,$97.16 ,90% of Billed charges for outpatient setting,$97.16 ,90% of Billed charges for outpatient setting,$56.70 ,52.52% of charges,$94.13 ,87.2% of Billed charges for outpatient setting,$65.85 ,61% of Billed charges for outpatient setting,$94.13 ,87.2% of Billed charges for outpatient setting,$56.13 ,52% of charges,$87.75 ,81.29% of Billed charges for outpatient setting,$97.16 ,90% of Billed charges for outpatient setting,$97.16 ,90% of Billed charges for outpatient setting,$65.85 ,61% of Billed charges for outpatient setting,$65.85 ,61% of Billed charges for outpatient setting,$97.16 ,90% of Billed charges for outpatient setting,$97.16 ,90% of Billed charges for outpatient setting,$65.85 ,61% of Billed charges for outpatient setting,$65.85 ,61% of Billed charges for outpatient setting,$65.85 ,61% of Billed charges for outpatient setting,$56.13 ,52% of charges,$56.13 ,52% of charges,$56.13 ,52% of charges,$56.13 ,52% of charges,$56.13 ,52% of charges,$56.13 ,52% of charges,56.134,97.16,$86.36 
Outpatient Medical Services,Radiology,76536,Ultrasound Exam Of Head And Neck,402,$420.85 ,$357.72 ,85% of Billed charges for outpatient setting,$357.72 ,85% of Billed charges for outpatient setting,$312.61 ,74.28% of Billed charges for outpatient setting,$312.61 ,74.28% of Billed charges for outpatient setting,$256.72 ,61% of Billed charges for outpatient setting,$312.61 ,74.28% of Billed charges for outpatient setting,$378.77 ,90% of Billed charges for outpatient setting,$378.77 ,90% of Billed charges for outpatient setting,$221.03 ,52.52% of charges,$366.98 ,87.2% of Billed charges for outpatient setting,$256.72 ,61% of Billed charges for outpatient setting,$366.98 ,87.2% of Billed charges for outpatient setting,$218.84 ,52% of charges,$342.11 ,81.29% of Billed charges for outpatient setting,$378.77 ,90% of Billed charges for outpatient setting,$378.77 ,90% of Billed charges for outpatient setting,$256.72 ,61% of Billed charges for outpatient setting,$256.72 ,61% of Billed charges for outpatient setting,$378.77 ,90% of Billed charges for outpatient setting,$378.77 ,90% of Billed charges for outpatient setting,$256.72 ,61% of Billed charges for outpatient setting,$256.72 ,61% of Billed charges for outpatient setting,$256.72 ,61% of Billed charges for outpatient setting,$218.84 ,52% of charges,$218.84 ,52% of charges,$218.84 ,52% of charges,$218.84 ,52% of charges,$218.84 ,52% of charges,$218.84 ,52% of charges,218.842,378.77,$336.68 
Outpatient Medical Services,Radiology,76604,"Us,  Chest, Real Time",402,$326.64 ,$277.64 ,85% of Billed charges for outpatient setting,$277.64 ,85% of Billed charges for outpatient setting,$242.63 ,74.28% of Billed charges for outpatient setting,$242.63 ,74.28% of Billed charges for outpatient setting,$199.25 ,61% of Billed charges for outpatient setting,$242.63 ,74.28% of Billed charges for outpatient setting,$293.98 ,90% of Billed charges for outpatient setting,$293.98 ,90% of Billed charges for outpatient setting,$171.55 ,52.52% of charges,$284.83 ,87.2% of Billed charges for outpatient setting,$199.25 ,61% of Billed charges for outpatient setting,$284.83 ,87.2% of Billed charges for outpatient setting,$169.85 ,52% of charges,$265.53 ,81.29% of Billed charges for outpatient setting,$293.98 ,90% of Billed charges for outpatient setting,$293.98 ,90% of Billed charges for outpatient setting,$199.25 ,61% of Billed charges for outpatient setting,$199.25 ,61% of Billed charges for outpatient setting,$293.98 ,90% of Billed charges for outpatient setting,$293.98 ,90% of Billed charges for outpatient setting,$199.25 ,61% of Billed charges for outpatient setting,$199.25 ,61% of Billed charges for outpatient setting,$199.25 ,61% of Billed charges for outpatient setting,$169.85 ,52% of charges,$169.85 ,52% of charges,$169.85 ,52% of charges,$169.85 ,52% of charges,$169.85 ,52% of charges,$169.85 ,52% of charges,169.8528,293.98,$261.31 
Outpatient Medical Services,Radiology,76641,"Ultrasound,  Breast(S),  Real Time",402,$219.25 ,$186.36 ,85% of Billed charges for outpatient setting,$186.36 ,85% of Billed charges for outpatient setting,$162.86 ,74.28% of Billed charges for outpatient setting,$162.86 ,74.28% of Billed charges for outpatient setting,$133.74 ,61% of Billed charges for outpatient setting,$162.86 ,74.28% of Billed charges for outpatient setting,$197.33 ,90% of Billed charges for outpatient setting,$197.33 ,90% of Billed charges for outpatient setting,$115.15 ,52.52% of charges,$191.19 ,87.2% of Billed charges for outpatient setting,$133.74 ,61% of Billed charges for outpatient setting,$191.19 ,87.2% of Billed charges for outpatient setting,$114.01 ,52% of charges,$178.23 ,81.29% of Billed charges for outpatient setting,$197.33 ,90% of Billed charges for outpatient setting,$197.33 ,90% of Billed charges for outpatient setting,$133.74 ,61% of Billed charges for outpatient setting,$133.74 ,61% of Billed charges for outpatient setting,$197.33 ,90% of Billed charges for outpatient setting,$197.33 ,90% of Billed charges for outpatient setting,$133.74 ,61% of Billed charges for outpatient setting,$133.74 ,61% of Billed charges for outpatient setting,$133.74 ,61% of Billed charges for outpatient setting,$114.01 ,52% of charges,$114.01 ,52% of charges,$114.01 ,52% of charges,$114.01 ,52% of charges,$114.01 ,52% of charges,$114.01 ,52% of charges,114.01,197.33,$175.40 
Outpatient Medical Services,Radiology,76642,Ultrasound Breast Limited,402,$180.44 ,$153.37 ,85% of Billed charges for outpatient setting,$153.37 ,85% of Billed charges for outpatient setting,$134.03 ,74.28% of Billed charges for outpatient setting,$134.03 ,74.28% of Billed charges for outpatient setting,$110.07 ,61% of Billed charges for outpatient setting,$134.03 ,74.28% of Billed charges for outpatient setting,$162.40 ,90% of Billed charges for outpatient setting,$162.40 ,90% of Billed charges for outpatient setting,$94.77 ,52.52% of charges,$157.34 ,87.2% of Billed charges for outpatient setting,$110.07 ,61% of Billed charges for outpatient setting,$157.34 ,87.2% of Billed charges for outpatient setting,$93.83 ,52% of charges,$146.68 ,81.29% of Billed charges for outpatient setting,$162.40 ,90% of Billed charges for outpatient setting,$162.40 ,90% of Billed charges for outpatient setting,$110.07 ,61% of Billed charges for outpatient setting,$110.07 ,61% of Billed charges for outpatient setting,$162.40 ,90% of Billed charges for outpatient setting,$162.40 ,90% of Billed charges for outpatient setting,$110.07 ,61% of Billed charges for outpatient setting,$110.07 ,61% of Billed charges for outpatient setting,$110.07 ,61% of Billed charges for outpatient setting,$93.83 ,52% of charges,$93.83 ,52% of charges,$93.83 ,52% of charges,$93.83 ,52% of charges,$93.83 ,52% of charges,$93.83 ,52% of charges,93.8288,162.4,$144.35 
Outpatient Medical Services,Radiology,76700,"Ultrasound,  Abdom, B-Scan &/Or Real Time, Complete",402,$580.44 ,$493.37 ,85% of Billed charges for outpatient setting,$493.37 ,85% of Billed charges for outpatient setting,$431.15 ,74.28% of Billed charges for outpatient setting,$431.15 ,74.28% of Billed charges for outpatient setting,$354.07 ,61% of Billed charges for outpatient setting,$431.15 ,74.28% of Billed charges for outpatient setting,$522.40 ,90% of Billed charges for outpatient setting,$522.40 ,90% of Billed charges for outpatient setting,$304.85 ,52.52% of charges,$506.14 ,87.2% of Billed charges for outpatient setting,$354.07 ,61% of Billed charges for outpatient setting,$506.14 ,87.2% of Billed charges for outpatient setting,$301.83 ,52% of charges,$471.84 ,81.29% of Billed charges for outpatient setting,$522.40 ,90% of Billed charges for outpatient setting,$522.40 ,90% of Billed charges for outpatient setting,$354.07 ,61% of Billed charges for outpatient setting,$354.07 ,61% of Billed charges for outpatient setting,$522.40 ,90% of Billed charges for outpatient setting,$522.40 ,90% of Billed charges for outpatient setting,$354.07 ,61% of Billed charges for outpatient setting,$354.07 ,61% of Billed charges for outpatient setting,$354.07 ,61% of Billed charges for outpatient setting,$301.83 ,52% of charges,$301.83 ,52% of charges,$301.83 ,52% of charges,$301.83 ,52% of charges,$301.83 ,52% of charges,$301.83 ,52% of charges,301.8288,522.4,$464.35 
Outpatient Medical Services,Radiology,76705,"Us, Abdomen Limited",402,$490.63 ,$417.04 ,85% of Billed charges for outpatient setting,$417.04 ,85% of Billed charges for outpatient setting,$364.44 ,74.28% of Billed charges for outpatient setting,$364.44 ,74.28% of Billed charges for outpatient setting,$299.28 ,61% of Billed charges for outpatient setting,$364.44 ,74.28% of Billed charges for outpatient setting,$441.57 ,90% of Billed charges for outpatient setting,$441.57 ,90% of Billed charges for outpatient setting,$257.68 ,52.52% of charges,$427.83 ,87.2% of Billed charges for outpatient setting,$299.28 ,61% of Billed charges for outpatient setting,$427.83 ,87.2% of Billed charges for outpatient setting,$255.13 ,52% of charges,$398.83 ,81.29% of Billed charges for outpatient setting,$441.57 ,90% of Billed charges for outpatient setting,$441.57 ,90% of Billed charges for outpatient setting,$299.28 ,61% of Billed charges for outpatient setting,$299.28 ,61% of Billed charges for outpatient setting,$441.57 ,90% of Billed charges for outpatient setting,$441.57 ,90% of Billed charges for outpatient setting,$299.28 ,61% of Billed charges for outpatient setting,$299.28 ,61% of Billed charges for outpatient setting,$299.28 ,61% of Billed charges for outpatient setting,$255.13 ,52% of charges,$255.13 ,52% of charges,$255.13 ,52% of charges,$255.13 ,52% of charges,$255.13 ,52% of charges,$255.13 ,52% of charges,255.1276,441.57,$392.50 
Outpatient Medical Services,Radiology,76775,Ultrasound Exam Abdo Back Wall Lim,402,$490.63 ,$417.04 ,85% of Billed charges for outpatient setting,$417.04 ,85% of Billed charges for outpatient setting,$364.44 ,74.28% of Billed charges for outpatient setting,$364.44 ,74.28% of Billed charges for outpatient setting,$299.28 ,61% of Billed charges for outpatient setting,$364.44 ,74.28% of Billed charges for outpatient setting,$441.57 ,90% of Billed charges for outpatient setting,$441.57 ,90% of Billed charges for outpatient setting,$257.68 ,52.52% of charges,$427.83 ,87.2% of Billed charges for outpatient setting,$299.28 ,61% of Billed charges for outpatient setting,$427.83 ,87.2% of Billed charges for outpatient setting,$255.13 ,52% of charges,$398.83 ,81.29% of Billed charges for outpatient setting,$441.57 ,90% of Billed charges for outpatient setting,$441.57 ,90% of Billed charges for outpatient setting,$299.28 ,61% of Billed charges for outpatient setting,$299.28 ,61% of Billed charges for outpatient setting,$441.57 ,90% of Billed charges for outpatient setting,$441.57 ,90% of Billed charges for outpatient setting,$299.28 ,61% of Billed charges for outpatient setting,$299.28 ,61% of Billed charges for outpatient setting,$299.28 ,61% of Billed charges for outpatient setting,$255.13 ,52% of charges,$255.13 ,52% of charges,$255.13 ,52% of charges,$255.13 ,52% of charges,$255.13 ,52% of charges,$255.13 ,52% of charges,255.1276,441.57,$392.50 
Outpatient Medical Services,Radiology,76801,"Ultrasound,  Ob < 14 Wks,  Single Fetus",402,$183.56 ,$156.03 ,85% of Billed charges for outpatient setting,$156.03 ,85% of Billed charges for outpatient setting,$136.35 ,74.28% of Billed charges for outpatient setting,$136.35 ,74.28% of Billed charges for outpatient setting,$111.97 ,61% of Billed charges for outpatient setting,$136.35 ,74.28% of Billed charges for outpatient setting,$165.20 ,90% of Billed charges for outpatient setting,$165.20 ,90% of Billed charges for outpatient setting,$96.41 ,52.52% of charges,$160.06 ,87.2% of Billed charges for outpatient setting,$111.97 ,61% of Billed charges for outpatient setting,$160.06 ,87.2% of Billed charges for outpatient setting,$95.45 ,52% of charges,$149.22 ,81.29% of Billed charges for outpatient setting,$165.20 ,90% of Billed charges for outpatient setting,$165.20 ,90% of Billed charges for outpatient setting,$111.97 ,61% of Billed charges for outpatient setting,$111.97 ,61% of Billed charges for outpatient setting,$165.20 ,90% of Billed charges for outpatient setting,$165.20 ,90% of Billed charges for outpatient setting,$111.97 ,61% of Billed charges for outpatient setting,$111.97 ,61% of Billed charges for outpatient setting,$111.97 ,61% of Billed charges for outpatient setting,$95.45 ,52% of charges,$95.45 ,52% of charges,$95.45 ,52% of charges,$95.45 ,52% of charges,$95.45 ,52% of charges,$95.45 ,52% of charges,95.4512,165.2,$146.85 
Outpatient Medical Services,Radiology,76805,"Ultrasound,  Ob >/= 14 Wks,  Sngl Fetus",402,$570.47 ,$484.90 ,85% of Billed charges for outpatient setting,$484.90 ,85% of Billed charges for outpatient setting,$423.75 ,74.28% of Billed charges for outpatient setting,$423.75 ,74.28% of Billed charges for outpatient setting,$347.99 ,61% of Billed charges for outpatient setting,$423.75 ,74.28% of Billed charges for outpatient setting,$513.42 ,90% of Billed charges for outpatient setting,$513.42 ,90% of Billed charges for outpatient setting,$299.61 ,52.52% of charges,$497.45 ,87.2% of Billed charges for outpatient setting,$347.99 ,61% of Billed charges for outpatient setting,$497.45 ,87.2% of Billed charges for outpatient setting,$296.64 ,52% of charges,$463.74 ,81.29% of Billed charges for outpatient setting,$513.42 ,90% of Billed charges for outpatient setting,$513.42 ,90% of Billed charges for outpatient setting,$347.99 ,61% of Billed charges for outpatient setting,$347.99 ,61% of Billed charges for outpatient setting,$513.42 ,90% of Billed charges for outpatient setting,$513.42 ,90% of Billed charges for outpatient setting,$347.99 ,61% of Billed charges for outpatient setting,$347.99 ,61% of Billed charges for outpatient setting,$347.99 ,61% of Billed charges for outpatient setting,$296.64 ,52% of charges,$296.64 ,52% of charges,$296.64 ,52% of charges,$296.64 ,52% of charges,$296.64 ,52% of charges,$296.64 ,52% of charges,296.6444,513.42,$456.38 
Outpatient Medical Services,Radiology,76815,"Us, Pregnant Uterus, Limited,  1/> Fetuses",402,$400.92 ,$340.78 ,85% of Billed charges for outpatient setting,$340.78 ,85% of Billed charges for outpatient setting,$297.80 ,74.28% of Billed charges for outpatient setting,$297.80 ,74.28% of Billed charges for outpatient setting,$244.56 ,61% of Billed charges for outpatient setting,$297.80 ,74.28% of Billed charges for outpatient setting,$360.83 ,90% of Billed charges for outpatient setting,$360.83 ,90% of Billed charges for outpatient setting,$210.56 ,52.52% of charges,$349.60 ,87.2% of Billed charges for outpatient setting,$244.56 ,61% of Billed charges for outpatient setting,$349.60 ,87.2% of Billed charges for outpatient setting,$208.48 ,52% of charges,$325.91 ,81.29% of Billed charges for outpatient setting,$360.83 ,90% of Billed charges for outpatient setting,$360.83 ,90% of Billed charges for outpatient setting,$244.56 ,61% of Billed charges for outpatient setting,$244.56 ,61% of Billed charges for outpatient setting,$360.83 ,90% of Billed charges for outpatient setting,$360.83 ,90% of Billed charges for outpatient setting,$244.56 ,61% of Billed charges for outpatient setting,$244.56 ,61% of Billed charges for outpatient setting,$244.56 ,61% of Billed charges for outpatient setting,$208.48 ,52% of charges,$208.48 ,52% of charges,$208.48 ,52% of charges,$208.48 ,52% of charges,$208.48 ,52% of charges,$208.48 ,52% of charges,208.4784,360.83,$320.74 
Outpatient Medical Services,Radiology,76817,"Ultrasound, Pregnant Uterus, Transvaginal",402,$464.38 ,$394.72 ,85% of Billed charges for outpatient setting,$394.72 ,85% of Billed charges for outpatient setting,$344.94 ,74.28% of Billed charges for outpatient setting,$344.94 ,74.28% of Billed charges for outpatient setting,$283.27 ,61% of Billed charges for outpatient setting,$344.94 ,74.28% of Billed charges for outpatient setting,$417.94 ,90% of Billed charges for outpatient setting,$417.94 ,90% of Billed charges for outpatient setting,$243.89 ,52.52% of charges,$404.94 ,87.2% of Billed charges for outpatient setting,$283.27 ,61% of Billed charges for outpatient setting,$404.94 ,87.2% of Billed charges for outpatient setting,$241.48 ,52% of charges,$377.49 ,81.29% of Billed charges for outpatient setting,$417.94 ,90% of Billed charges for outpatient setting,$417.94 ,90% of Billed charges for outpatient setting,$283.27 ,61% of Billed charges for outpatient setting,$283.27 ,61% of Billed charges for outpatient setting,$417.94 ,90% of Billed charges for outpatient setting,$417.94 ,90% of Billed charges for outpatient setting,$283.27 ,61% of Billed charges for outpatient setting,$283.27 ,61% of Billed charges for outpatient setting,$283.27 ,61% of Billed charges for outpatient setting,$241.48 ,52% of charges,$241.48 ,52% of charges,$241.48 ,52% of charges,$241.48 ,52% of charges,$241.48 ,52% of charges,$241.48 ,52% of charges,241.4776,417.94,$371.50 
Outpatient Medical Services,Radiology,76830,"Echography, Transvaginal",402,$464.38 ,$394.72 ,85% of Billed charges for outpatient setting,$394.72 ,85% of Billed charges for outpatient setting,$344.94 ,74.28% of Billed charges for outpatient setting,$344.94 ,74.28% of Billed charges for outpatient setting,$283.27 ,61% of Billed charges for outpatient setting,$344.94 ,74.28% of Billed charges for outpatient setting,$417.94 ,90% of Billed charges for outpatient setting,$417.94 ,90% of Billed charges for outpatient setting,$243.89 ,52.52% of charges,$404.94 ,87.2% of Billed charges for outpatient setting,$283.27 ,61% of Billed charges for outpatient setting,$404.94 ,87.2% of Billed charges for outpatient setting,$241.48 ,52% of charges,$377.49 ,81.29% of Billed charges for outpatient setting,$417.94 ,90% of Billed charges for outpatient setting,$417.94 ,90% of Billed charges for outpatient setting,$283.27 ,61% of Billed charges for outpatient setting,$283.27 ,61% of Billed charges for outpatient setting,$417.94 ,90% of Billed charges for outpatient setting,$417.94 ,90% of Billed charges for outpatient setting,$283.27 ,61% of Billed charges for outpatient setting,$283.27 ,61% of Billed charges for outpatient setting,$283.27 ,61% of Billed charges for outpatient setting,$241.48 ,52% of charges,$241.48 ,52% of charges,$241.48 ,52% of charges,$241.48 ,52% of charges,$241.48 ,52% of charges,$241.48 ,52% of charges,241.4776,417.94,$371.50 
Outpatient Medical Services,Radiology,76856,"Echo, Pelvic (Nonobstetric)",402,$520.55 ,$442.47 ,85% of Billed charges for outpatient setting,$442.47 ,85% of Billed charges for outpatient setting,$386.66 ,74.28% of Billed charges for outpatient setting,$386.66 ,74.28% of Billed charges for outpatient setting,$317.54 ,61% of Billed charges for outpatient setting,$386.66 ,74.28% of Billed charges for outpatient setting,$468.50 ,90% of Billed charges for outpatient setting,$468.50 ,90% of Billed charges for outpatient setting,$273.39 ,52.52% of charges,$453.92 ,87.2% of Billed charges for outpatient setting,$317.54 ,61% of Billed charges for outpatient setting,$453.92 ,87.2% of Billed charges for outpatient setting,$270.69 ,52% of charges,$423.16 ,81.29% of Billed charges for outpatient setting,$468.50 ,90% of Billed charges for outpatient setting,$468.50 ,90% of Billed charges for outpatient setting,$317.54 ,61% of Billed charges for outpatient setting,$317.54 ,61% of Billed charges for outpatient setting,$468.50 ,90% of Billed charges for outpatient setting,$468.50 ,90% of Billed charges for outpatient setting,$317.54 ,61% of Billed charges for outpatient setting,$317.54 ,61% of Billed charges for outpatient setting,$317.54 ,61% of Billed charges for outpatient setting,$270.69 ,52% of charges,$270.69 ,52% of charges,$270.69 ,52% of charges,$270.69 ,52% of charges,$270.69 ,52% of charges,$270.69 ,52% of charges,270.686,468.5,$416.44 
Outpatient Medical Services,Radiology,76857,Ultrasound Exam Pelvic Limited,402,$429.05 ,$364.69 ,85% of Billed charges for outpatient setting,$364.69 ,85% of Billed charges for outpatient setting,$318.70 ,74.28% of Billed charges for outpatient setting,$318.70 ,74.28% of Billed charges for outpatient setting,$261.72 ,61% of Billed charges for outpatient setting,$318.70 ,74.28% of Billed charges for outpatient setting,$386.15 ,90% of Billed charges for outpatient setting,$386.15 ,90% of Billed charges for outpatient setting,$225.34 ,52.52% of charges,$374.13 ,87.2% of Billed charges for outpatient setting,$261.72 ,61% of Billed charges for outpatient setting,$374.13 ,87.2% of Billed charges for outpatient setting,$223.11 ,52% of charges,$348.77 ,81.29% of Billed charges for outpatient setting,$386.15 ,90% of Billed charges for outpatient setting,$386.15 ,90% of Billed charges for outpatient setting,$261.72 ,61% of Billed charges for outpatient setting,$261.72 ,61% of Billed charges for outpatient setting,$386.15 ,90% of Billed charges for outpatient setting,$386.15 ,90% of Billed charges for outpatient setting,$261.72 ,61% of Billed charges for outpatient setting,$261.72 ,61% of Billed charges for outpatient setting,$261.72 ,61% of Billed charges for outpatient setting,$223.11 ,52% of charges,$223.11 ,52% of charges,$223.11 ,52% of charges,$223.11 ,52% of charges,$223.11 ,52% of charges,$223.11 ,52% of charges,223.106,386.15,$343.24 
Outpatient Medical Services,Radiology,76870,Ultrasound Scrotum And Contents,402,$480.68 ,$408.58 ,85% of Billed charges for outpatient setting,$408.58 ,85% of Billed charges for outpatient setting,$357.05 ,74.28% of Billed charges for outpatient setting,$357.05 ,74.28% of Billed charges for outpatient setting,$293.21 ,61% of Billed charges for outpatient setting,$357.05 ,74.28% of Billed charges for outpatient setting,$432.61 ,90% of Billed charges for outpatient setting,$432.61 ,90% of Billed charges for outpatient setting,$252.45 ,52.52% of charges,$419.15 ,87.2% of Billed charges for outpatient setting,$293.21 ,61% of Billed charges for outpatient setting,$419.15 ,87.2% of Billed charges for outpatient setting,$249.95 ,52% of charges,$390.74 ,81.29% of Billed charges for outpatient setting,$432.61 ,90% of Billed charges for outpatient setting,$432.61 ,90% of Billed charges for outpatient setting,$293.21 ,61% of Billed charges for outpatient setting,$293.21 ,61% of Billed charges for outpatient setting,$432.61 ,90% of Billed charges for outpatient setting,$432.61 ,90% of Billed charges for outpatient setting,$293.21 ,61% of Billed charges for outpatient setting,$293.21 ,61% of Billed charges for outpatient setting,$293.21 ,61% of Billed charges for outpatient setting,$249.95 ,52% of charges,$249.95 ,52% of charges,$249.95 ,52% of charges,$249.95 ,52% of charges,$249.95 ,52% of charges,$249.95 ,52% of charges,249.9536,432.61,$384.54 
Outpatient Medical Services,Radiology,76882,"Us, Extremity, Nonvascular, Real-Time Image, Limited",402,$270.30 ,$229.76 ,85% of Billed charges for outpatient setting,$229.76 ,85% of Billed charges for outpatient setting,$200.78 ,74.28% of Billed charges for outpatient setting,$200.78 ,74.28% of Billed charges for outpatient setting,$164.88 ,61% of Billed charges for outpatient setting,$200.78 ,74.28% of Billed charges for outpatient setting,$243.27 ,90% of Billed charges for outpatient setting,$243.27 ,90% of Billed charges for outpatient setting,$141.96 ,52.52% of charges,$235.70 ,87.2% of Billed charges for outpatient setting,$164.88 ,61% of Billed charges for outpatient setting,$235.70 ,87.2% of Billed charges for outpatient setting,$140.56 ,52% of charges,$219.73 ,81.29% of Billed charges for outpatient setting,$243.27 ,90% of Billed charges for outpatient setting,$243.27 ,90% of Billed charges for outpatient setting,$164.88 ,61% of Billed charges for outpatient setting,$164.88 ,61% of Billed charges for outpatient setting,$243.27 ,90% of Billed charges for outpatient setting,$243.27 ,90% of Billed charges for outpatient setting,$164.88 ,61% of Billed charges for outpatient setting,$164.88 ,61% of Billed charges for outpatient setting,$164.88 ,61% of Billed charges for outpatient setting,$140.56 ,52% of charges,$140.56 ,52% of charges,$140.56 ,52% of charges,$140.56 ,52% of charges,$140.56 ,52% of charges,$140.56 ,52% of charges,140.556,243.27,$216.24 
Outpatient Medical Services,Radiology,77063,Breast Tomosynthesis (add on for 3D Mammo),403,$113.27 ,$96.28 ,85% of Billed charges for outpatient setting,$96.28 ,85% of Billed charges for outpatient setting,$84.14 ,74.28% of Billed charges for outpatient setting,$84.14 ,74.28% of Billed charges for outpatient setting,$69.09 ,61% of Billed charges for outpatient setting,$84.14 ,74.28% of Billed charges for outpatient setting,$101.94 ,90% of Billed charges for outpatient setting,$101.94 ,90% of Billed charges for outpatient setting,$59.49 ,52.52% of charges,$98.77 ,87.2% of Billed charges for outpatient setting,$69.09 ,61% of Billed charges for outpatient setting,$98.77 ,87.2% of Billed charges for outpatient setting,$58.90 ,52% of charges,$92.08 ,81.29% of Billed charges for outpatient setting,$101.94 ,90% of Billed charges for outpatient setting,$101.94 ,90% of Billed charges for outpatient setting,$69.09 ,61% of Billed charges for outpatient setting,$69.09 ,61% of Billed charges for outpatient setting,$101.94 ,90% of Billed charges for outpatient setting,$101.94 ,90% of Billed charges for outpatient setting,$69.09 ,61% of Billed charges for outpatient setting,$69.09 ,61% of Billed charges for outpatient setting,$69.09 ,61% of Billed charges for outpatient setting,$58.90 ,52% of charges,$58.90 ,52% of charges,$58.90 ,52% of charges,$58.90 ,52% of charges,$58.90 ,52% of charges,$58.90 ,52% of charges,58.9004,101.94,$90.62 
Outpatient Medical Services,Radiology,77065,Mammo Diagnostic Uni Digital,401,$280.24 ,$238.20 ,85% of Billed charges for outpatient setting,$238.20 ,85% of Billed charges for outpatient setting,$208.16 ,74.28% of Billed charges for outpatient setting,$208.16 ,74.28% of Billed charges for outpatient setting,$170.95 ,61% of Billed charges for outpatient setting,$208.16 ,74.28% of Billed charges for outpatient setting,$252.22 ,90% of Billed charges for outpatient setting,$252.22 ,90% of Billed charges for outpatient setting,$147.18 ,52.52% of charges,$244.37 ,87.2% of Billed charges for outpatient setting,$170.95 ,61% of Billed charges for outpatient setting,$244.37 ,87.2% of Billed charges for outpatient setting,$145.72 ,52% of charges,$227.81 ,81.29% of Billed charges for outpatient setting,$252.22 ,90% of Billed charges for outpatient setting,$252.22 ,90% of Billed charges for outpatient setting,$170.95 ,61% of Billed charges for outpatient setting,$170.95 ,61% of Billed charges for outpatient setting,$252.22 ,90% of Billed charges for outpatient setting,$252.22 ,90% of Billed charges for outpatient setting,$170.95 ,61% of Billed charges for outpatient setting,$170.95 ,61% of Billed charges for outpatient setting,$170.95 ,61% of Billed charges for outpatient setting,$145.72 ,52% of charges,$145.72 ,52% of charges,$145.72 ,52% of charges,$145.72 ,52% of charges,$145.72 ,52% of charges,$145.72 ,52% of charges,145.7248,252.22,$224.19 
Outpatient Medical Services,Radiology,77066,Mammo Dx Bilat Digital,401,$338.32 ,$287.57 ,85% of Billed charges for outpatient setting,$287.57 ,85% of Billed charges for outpatient setting,$251.30 ,74.28% of Billed charges for outpatient setting,$251.30 ,74.28% of Billed charges for outpatient setting,$206.38 ,61% of Billed charges for outpatient setting,$251.30 ,74.28% of Billed charges for outpatient setting,$304.49 ,90% of Billed charges for outpatient setting,$304.49 ,90% of Billed charges for outpatient setting,$177.69 ,52.52% of charges,$295.02 ,87.2% of Billed charges for outpatient setting,$206.38 ,61% of Billed charges for outpatient setting,$295.02 ,87.2% of Billed charges for outpatient setting,$175.93 ,52% of charges,$275.02 ,81.29% of Billed charges for outpatient setting,$304.49 ,90% of Billed charges for outpatient setting,$304.49 ,90% of Billed charges for outpatient setting,$206.38 ,61% of Billed charges for outpatient setting,$206.38 ,61% of Billed charges for outpatient setting,$304.49 ,90% of Billed charges for outpatient setting,$304.49 ,90% of Billed charges for outpatient setting,$206.38 ,61% of Billed charges for outpatient setting,$206.38 ,61% of Billed charges for outpatient setting,$206.38 ,61% of Billed charges for outpatient setting,$175.93 ,52% of charges,$175.93 ,52% of charges,$175.93 ,52% of charges,$175.93 ,52% of charges,$175.93 ,52% of charges,$175.93 ,52% of charges,175.9264,304.49,$270.66 
Outpatient Medical Services,Radiology,77067,"Mammogram,  Screening Unilat",403,$199.54 ,$169.61 ,85% of Billed charges for outpatient setting,$169.61 ,85% of Billed charges for outpatient setting,$148.22 ,74.28% of Billed charges for outpatient setting,$148.22 ,74.28% of Billed charges for outpatient setting,$121.72 ,61% of Billed charges for outpatient setting,$148.22 ,74.28% of Billed charges for outpatient setting,$179.59 ,90% of Billed charges for outpatient setting,$179.59 ,90% of Billed charges for outpatient setting,$104.80 ,52.52% of charges,$174.00 ,87.2% of Billed charges for outpatient setting,$121.72 ,61% of Billed charges for outpatient setting,$174.00 ,87.2% of Billed charges for outpatient setting,$103.76 ,52% of charges,$162.21 ,81.29% of Billed charges for outpatient setting,$179.59 ,90% of Billed charges for outpatient setting,$179.59 ,90% of Billed charges for outpatient setting,$121.72 ,61% of Billed charges for outpatient setting,$121.72 ,61% of Billed charges for outpatient setting,$179.59 ,90% of Billed charges for outpatient setting,$179.59 ,90% of Billed charges for outpatient setting,$121.72 ,61% of Billed charges for outpatient setting,$121.72 ,61% of Billed charges for outpatient setting,$121.72 ,61% of Billed charges for outpatient setting,$103.76 ,52% of charges,$103.76 ,52% of charges,$103.76 ,52% of charges,$103.76 ,52% of charges,$103.76 ,52% of charges,$103.76 ,52% of charges,103.7608,179.59,$159.63 
Outpatient Medical Services,Radiology,77067,"Mammogram,  Screening Bilat",403,$262.16 ,$222.84 ,85% of Billed charges for outpatient setting,$222.84 ,85% of Billed charges for outpatient setting,$194.73 ,74.28% of Billed charges for outpatient setting,$194.73 ,74.28% of Billed charges for outpatient setting,$159.92 ,61% of Billed charges for outpatient setting,$194.73 ,74.28% of Billed charges for outpatient setting,$235.94 ,90% of Billed charges for outpatient setting,$235.94 ,90% of Billed charges for outpatient setting,$137.69 ,52.52% of charges,$228.60 ,87.2% of Billed charges for outpatient setting,$159.92 ,61% of Billed charges for outpatient setting,$228.60 ,87.2% of Billed charges for outpatient setting,$136.32 ,52% of charges,$213.11 ,81.29% of Billed charges for outpatient setting,$235.94 ,90% of Billed charges for outpatient setting,$235.94 ,90% of Billed charges for outpatient setting,$159.92 ,61% of Billed charges for outpatient setting,$159.92 ,61% of Billed charges for outpatient setting,$235.94 ,90% of Billed charges for outpatient setting,$235.94 ,90% of Billed charges for outpatient setting,$159.92 ,61% of Billed charges for outpatient setting,$159.92 ,61% of Billed charges for outpatient setting,$159.92 ,61% of Billed charges for outpatient setting,$136.32 ,52% of charges,$136.32 ,52% of charges,$136.32 ,52% of charges,$136.32 ,52% of charges,$136.32 ,52% of charges,$136.32 ,52% of charges,136.3232,235.94,$209.73 
Outpatient Medical Services,Radiology,77072,X-Rays For Bone Age,320,$220.43 ,$187.37 ,85% of Billed charges for outpatient setting,$187.37 ,85% of Billed charges for outpatient setting,$163.74 ,74.28% of Billed charges for outpatient setting,$163.74 ,74.28% of Billed charges for outpatient setting,$134.46 ,61% of Billed charges for outpatient setting,$163.74 ,74.28% of Billed charges for outpatient setting,$198.39 ,90% of Billed charges for outpatient setting,$198.39 ,90% of Billed charges for outpatient setting,$115.77 ,52.52% of charges,$192.21 ,87.2% of Billed charges for outpatient setting,$134.46 ,61% of Billed charges for outpatient setting,$192.21 ,87.2% of Billed charges for outpatient setting,$114.62 ,52% of charges,$179.19 ,81.29% of Billed charges for outpatient setting,$198.39 ,90% of Billed charges for outpatient setting,$198.39 ,90% of Billed charges for outpatient setting,$134.46 ,61% of Billed charges for outpatient setting,$134.46 ,61% of Billed charges for outpatient setting,$198.39 ,90% of Billed charges for outpatient setting,$198.39 ,90% of Billed charges for outpatient setting,$134.46 ,61% of Billed charges for outpatient setting,$134.46 ,61% of Billed charges for outpatient setting,$134.46 ,61% of Billed charges for outpatient setting,$114.62 ,52% of charges,$114.62 ,52% of charges,$114.62 ,52% of charges,$114.62 ,52% of charges,$114.62 ,52% of charges,$114.62 ,52% of charges,114.6236,198.39,$176.34 
Outpatient Medical Services,Radiology,77073,"X-Rays,  Bone Length Studies",320,$272.18 ,$231.35 ,85% of Billed charges for outpatient setting,$231.35 ,85% of Billed charges for outpatient setting,$202.18 ,74.28% of Billed charges for outpatient setting,$202.18 ,74.28% of Billed charges for outpatient setting,$166.03 ,61% of Billed charges for outpatient setting,$202.18 ,74.28% of Billed charges for outpatient setting,$244.96 ,90% of Billed charges for outpatient setting,$244.96 ,90% of Billed charges for outpatient setting,$142.95 ,52.52% of charges,$237.34 ,87.2% of Billed charges for outpatient setting,$166.03 ,61% of Billed charges for outpatient setting,$237.34 ,87.2% of Billed charges for outpatient setting,$141.53 ,52% of charges,$221.26 ,81.29% of Billed charges for outpatient setting,$244.96 ,90% of Billed charges for outpatient setting,$244.96 ,90% of Billed charges for outpatient setting,$166.03 ,61% of Billed charges for outpatient setting,$166.03 ,61% of Billed charges for outpatient setting,$244.96 ,90% of Billed charges for outpatient setting,$244.96 ,90% of Billed charges for outpatient setting,$166.03 ,61% of Billed charges for outpatient setting,$166.03 ,61% of Billed charges for outpatient setting,$166.03 ,61% of Billed charges for outpatient setting,$141.53 ,52% of charges,$141.53 ,52% of charges,$141.53 ,52% of charges,$141.53 ,52% of charges,$141.53 ,52% of charges,$141.53 ,52% of charges,141.5336,244.96,$217.74 
Outpatient Medical Services,Radiology,77075,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton)",320,$400.92 ,$340.78 ,85% of Billed charges for outpatient setting,$340.78 ,85% of Billed charges for outpatient setting,$297.80 ,74.28% of Billed charges for outpatient setting,$297.80 ,74.28% of Billed charges for outpatient setting,$244.56 ,61% of Billed charges for outpatient setting,$297.80 ,74.28% of Billed charges for outpatient setting,$360.83 ,90% of Billed charges for outpatient setting,$360.83 ,90% of Billed charges for outpatient setting,$210.56 ,52.52% of charges,$349.60 ,87.2% of Billed charges for outpatient setting,$244.56 ,61% of Billed charges for outpatient setting,$349.60 ,87.2% of Billed charges for outpatient setting,$208.48 ,52% of charges,$325.91 ,81.29% of Billed charges for outpatient setting,$360.83 ,90% of Billed charges for outpatient setting,$360.83 ,90% of Billed charges for outpatient setting,$244.56 ,61% of Billed charges for outpatient setting,$244.56 ,61% of Billed charges for outpatient setting,$360.83 ,90% of Billed charges for outpatient setting,$360.83 ,90% of Billed charges for outpatient setting,$244.56 ,61% of Billed charges for outpatient setting,$244.56 ,61% of Billed charges for outpatient setting,$244.56 ,61% of Billed charges for outpatient setting,$208.48 ,52% of charges,$208.48 ,52% of charges,$208.48 ,52% of charges,$208.48 ,52% of charges,$208.48 ,52% of charges,$208.48 ,52% of charges,208.4784,360.83,$320.74 
Outpatient Medical Services,Radiology,77080,"Dexa, Bone Density,  1 + Site,  Axial Skeleton",320,$85.14 ,$72.37 ,85% of Billed charges for outpatient setting,$72.37 ,85% of Billed charges for outpatient setting,$63.24 ,74.28% of Billed charges for outpatient setting,$63.24 ,74.28% of Billed charges for outpatient setting,$51.94 ,61% of Billed charges for outpatient setting,$63.24 ,74.28% of Billed charges for outpatient setting,$76.63 ,90% of Billed charges for outpatient setting,$76.63 ,90% of Billed charges for outpatient setting,$44.72 ,52.52% of charges,$74.24 ,87.2% of Billed charges for outpatient setting,$51.94 ,61% of Billed charges for outpatient setting,$74.24 ,87.2% of Billed charges for outpatient setting,$44.27 ,52% of charges,$69.21 ,81.29% of Billed charges for outpatient setting,$76.63 ,90% of Billed charges for outpatient setting,$76.63 ,90% of Billed charges for outpatient setting,$51.94 ,61% of Billed charges for outpatient setting,$51.94 ,61% of Billed charges for outpatient setting,$76.63 ,90% of Billed charges for outpatient setting,$76.63 ,90% of Billed charges for outpatient setting,$51.94 ,61% of Billed charges for outpatient setting,$51.94 ,61% of Billed charges for outpatient setting,$51.94 ,61% of Billed charges for outpatient setting,$44.27 ,52% of charges,$44.27 ,52% of charges,$44.27 ,52% of charges,$44.27 ,52% of charges,$44.27 ,52% of charges,$44.27 ,52% of charges,44.2728,76.63,$68.11 
Outpatient Medical Services,Radiology,78227,Hepatobil Syst Image Inc Gb W/Pharma Intervenj,341,$670.25 ,$569.71 ,85% of Billed charges for outpatient setting,$569.71 ,85% of Billed charges for outpatient setting,$497.86 ,74.28% of Billed charges for outpatient setting,$497.86 ,74.28% of Billed charges for outpatient setting,$408.85 ,61% of Billed charges for outpatient setting,$497.86 ,74.28% of Billed charges for outpatient setting,$603.23 ,90% of Billed charges for outpatient setting,$603.23 ,90% of Billed charges for outpatient setting,$352.02 ,52.52% of charges,$584.46 ,87.2% of Billed charges for outpatient setting,$408.85 ,61% of Billed charges for outpatient setting,$584.46 ,87.2% of Billed charges for outpatient setting,$348.53 ,52% of charges,$544.85 ,81.29% of Billed charges for outpatient setting,$603.23 ,90% of Billed charges for outpatient setting,$603.23 ,90% of Billed charges for outpatient setting,$408.85 ,61% of Billed charges for outpatient setting,$408.85 ,61% of Billed charges for outpatient setting,$603.23 ,90% of Billed charges for outpatient setting,$603.23 ,90% of Billed charges for outpatient setting,$408.85 ,61% of Billed charges for outpatient setting,$408.85 ,61% of Billed charges for outpatient setting,$408.85 ,61% of Billed charges for outpatient setting,$348.53 ,52% of charges,$348.53 ,52% of charges,$348.53 ,52% of charges,$348.53 ,52% of charges,$348.53 ,52% of charges,$348.53 ,52% of charges,348.53,603.23,$536.20 
Outpatient Medical Services,Radiology,78306,"Bone Imaging,  Whole Body",341,$449.92 ,$382.43 ,85% of Billed charges for outpatient setting,$382.43 ,85% of Billed charges for outpatient setting,$334.20 ,74.28% of Billed charges for outpatient setting,$334.20 ,74.28% of Billed charges for outpatient setting,$274.45 ,61% of Billed charges for outpatient setting,$334.20 ,74.28% of Billed charges for outpatient setting,$404.93 ,90% of Billed charges for outpatient setting,$404.93 ,90% of Billed charges for outpatient setting,$236.30 ,52.52% of charges,$392.33 ,87.2% of Billed charges for outpatient setting,$274.45 ,61% of Billed charges for outpatient setting,$392.33 ,87.2% of Billed charges for outpatient setting,$233.96 ,52% of charges,$365.74 ,81.29% of Billed charges for outpatient setting,$404.93 ,90% of Billed charges for outpatient setting,$404.93 ,90% of Billed charges for outpatient setting,$274.45 ,61% of Billed charges for outpatient setting,$274.45 ,61% of Billed charges for outpatient setting,$404.93 ,90% of Billed charges for outpatient setting,$404.93 ,90% of Billed charges for outpatient setting,$274.45 ,61% of Billed charges for outpatient setting,$274.45 ,61% of Billed charges for outpatient setting,$274.45 ,61% of Billed charges for outpatient setting,$233.96 ,52% of charges,$233.96 ,52% of charges,$233.96 ,52% of charges,$233.96 ,52% of charges,$233.96 ,52% of charges,$233.96 ,52% of charges,233.9584,404.93,$359.94 
Outpatient Medical Services,Radiology,93925,Duplex Le Art/Bpg; Bilat,920,$640.80 ,$544.68 ,85% of Billed charges for outpatient setting,$544.68 ,85% of Billed charges for outpatient setting,$475.99 ,74.28% of Billed charges for outpatient setting,$475.99 ,74.28% of Billed charges for outpatient setting,$390.89 ,61% of Billed charges for outpatient setting,$475.99 ,74.28% of Billed charges for outpatient setting,$576.72 ,90% of Billed charges for outpatient setting,$576.72 ,90% of Billed charges for outpatient setting,$336.55 ,52.52% of charges,$558.78 ,87.2% of Billed charges for outpatient setting,$390.89 ,61% of Billed charges for outpatient setting,$558.78 ,87.2% of Billed charges for outpatient setting,$333.22 ,52% of charges,$520.91 ,81.29% of Billed charges for outpatient setting,$576.72 ,90% of Billed charges for outpatient setting,$576.72 ,90% of Billed charges for outpatient setting,$390.89 ,61% of Billed charges for outpatient setting,$390.89 ,61% of Billed charges for outpatient setting,$576.72 ,90% of Billed charges for outpatient setting,$576.72 ,90% of Billed charges for outpatient setting,$390.89 ,61% of Billed charges for outpatient setting,$390.89 ,61% of Billed charges for outpatient setting,$390.89 ,61% of Billed charges for outpatient setting,$333.22 ,52% of charges,$333.22 ,52% of charges,$333.22 ,52% of charges,$333.22 ,52% of charges,$333.22 ,52% of charges,$333.22 ,52% of charges,333.216,576.72,$512.64 
Outpatient Medical Services,Radiology,93971,"Duplex Extrem Venous, Uni Or Ltd",921,$290.36 ,$246.81 ,85% of Billed charges for outpatient setting,$246.81 ,85% of Billed charges for outpatient setting,$215.68 ,74.28% of Billed charges for outpatient setting,$215.68 ,74.28% of Billed charges for outpatient setting,$177.12 ,61% of Billed charges for outpatient setting,$215.68 ,74.28% of Billed charges for outpatient setting,$261.32 ,90% of Billed charges for outpatient setting,$261.32 ,90% of Billed charges for outpatient setting,$152.50 ,52.52% of charges,$253.19 ,87.2% of Billed charges for outpatient setting,$177.12 ,61% of Billed charges for outpatient setting,$253.19 ,87.2% of Billed charges for outpatient setting,$150.99 ,52% of charges,$236.03 ,81.29% of Billed charges for outpatient setting,$261.32 ,90% of Billed charges for outpatient setting,$261.32 ,90% of Billed charges for outpatient setting,$177.12 ,61% of Billed charges for outpatient setting,$177.12 ,61% of Billed charges for outpatient setting,$261.32 ,90% of Billed charges for outpatient setting,$261.32 ,90% of Billed charges for outpatient setting,$177.12 ,61% of Billed charges for outpatient setting,$177.12 ,61% of Billed charges for outpatient setting,$177.12 ,61% of Billed charges for outpatient setting,$150.99 ,52% of charges,$150.99 ,52% of charges,$150.99 ,52% of charges,$150.99 ,52% of charges,$150.99 ,52% of charges,$150.99 ,52% of charges,150.9872,261.32,$232.29 
Outpatient Medical Services,Radiology,71271,Low Dose Ct Scan (Ldct) For Lung Cancer Screening,350,$817.40 ,$694.79 ,85% of Billed charges for outpatient setting,$694.79 ,85% of Billed charges for outpatient setting,$607.16 ,74.28% of Billed charges for outpatient setting,$607.16 ,74.28% of Billed charges for outpatient setting,$498.61 ,61% of Billed charges for outpatient setting,$607.16 ,74.28% of Billed charges for outpatient setting,$735.66 ,90% of Billed charges for outpatient setting,$735.66 ,90% of Billed charges for outpatient setting,$429.30 ,52.52% of charges,$712.77 ,87.2% of Billed charges for outpatient setting,$498.61 ,61% of Billed charges for outpatient setting,$712.77 ,87.2% of Billed charges for outpatient setting,$425.05 ,52% of charges,$664.46 ,81.29% of Billed charges for outpatient setting,$735.66 ,90% of Billed charges for outpatient setting,$735.66 ,90% of Billed charges for outpatient setting,$498.61 ,61% of Billed charges for outpatient setting,$498.61 ,61% of Billed charges for outpatient setting,$735.66 ,90% of Billed charges for outpatient setting,$735.66 ,90% of Billed charges for outpatient setting,$498.61 ,61% of Billed charges for outpatient setting,$498.61 ,61% of Billed charges for outpatient setting,$498.61 ,61% of Billed charges for outpatient setting,$425.05 ,52% of charges,$425.05 ,52% of charges,$425.05 ,52% of charges,$425.05 ,52% of charges,$425.05 ,52% of charges,$425.05 ,52% of charges,425.048,735.66,$653.92 
Outpatient Medical Services,Radiology,76706,Ultrasound Screening Aorta,402,$490.63 ,$417.04 ,85% of Billed charges for outpatient setting,$417.04 ,85% of Billed charges for outpatient setting,$364.44 ,74.28% of Billed charges for outpatient setting,$364.44 ,74.28% of Billed charges for outpatient setting,$299.28 ,61% of Billed charges for outpatient setting,$364.44 ,74.28% of Billed charges for outpatient setting,$441.57 ,90% of Billed charges for outpatient setting,$441.57 ,90% of Billed charges for outpatient setting,$257.68 ,52.52% of charges,$427.83 ,87.2% of Billed charges for outpatient setting,$299.28 ,61% of Billed charges for outpatient setting,$427.83 ,87.2% of Billed charges for outpatient setting,$255.13 ,52% of charges,$398.83 ,81.29% of Billed charges for outpatient setting,$441.57 ,90% of Billed charges for outpatient setting,$441.57 ,90% of Billed charges for outpatient setting,$299.28 ,61% of Billed charges for outpatient setting,$299.28 ,61% of Billed charges for outpatient setting,$441.57 ,90% of Billed charges for outpatient setting,$441.57 ,90% of Billed charges for outpatient setting,$299.28 ,61% of Billed charges for outpatient setting,$299.28 ,61% of Billed charges for outpatient setting,$299.28 ,61% of Billed charges for outpatient setting,$255.13 ,52% of charges,$255.13 ,52% of charges,$255.13 ,52% of charges,$255.13 ,52% of charges,$255.13 ,52% of charges,$255.13 ,52% of charges,255.1276,441.57,$392.50 
Outpatient Medical Services,Radiology,93880,"Duplex Scan Extracranial, Bilat",921,$558.64 ,$474.84 ,85% of Billed charges for outpatient setting,$474.84 ,85% of Billed charges for outpatient setting,$414.96 ,74.28% of Billed charges for outpatient setting,$414.96 ,74.28% of Billed charges for outpatient setting,$340.77 ,61% of Billed charges for outpatient setting,$414.96 ,74.28% of Billed charges for outpatient setting,$502.78 ,90% of Billed charges for outpatient setting,$502.78 ,90% of Billed charges for outpatient setting,$293.40 ,52.52% of charges,$487.13 ,87.2% of Billed charges for outpatient setting,$340.77 ,61% of Billed charges for outpatient setting,$487.13 ,87.2% of Billed charges for outpatient setting,$290.49 ,52% of charges,$454.12 ,81.29% of Billed charges for outpatient setting,$502.78 ,90% of Billed charges for outpatient setting,$502.78 ,90% of Billed charges for outpatient setting,$340.77 ,61% of Billed charges for outpatient setting,$340.77 ,61% of Billed charges for outpatient setting,$502.78 ,90% of Billed charges for outpatient setting,$502.78 ,90% of Billed charges for outpatient setting,$340.77 ,61% of Billed charges for outpatient setting,$340.77 ,61% of Billed charges for outpatient setting,$340.77 ,61% of Billed charges for outpatient setting,$290.49 ,52% of charges,$290.49 ,52% of charges,$290.49 ,52% of charges,$290.49 ,52% of charges,$290.49 ,52% of charges,$290.49 ,52% of charges,290.4928,502.78,$446.91 
Outpatient Medical Services,Radiology,93970,"Duplex Extrem Venous, Bilat",920,$578.23 ,$491.50 ,85% of Billed charges for outpatient setting,$491.50 ,85% of Billed charges for outpatient setting,$429.51 ,74.28% of Billed charges for outpatient setting,$429.51 ,74.28% of Billed charges for outpatient setting,$352.72 ,61% of Billed charges for outpatient setting,$429.51 ,74.28% of Billed charges for outpatient setting,$520.41 ,90% of Billed charges for outpatient setting,$520.41 ,90% of Billed charges for outpatient setting,$303.69 ,52.52% of charges,$504.22 ,87.2% of Billed charges for outpatient setting,$352.72 ,61% of Billed charges for outpatient setting,$504.22 ,87.2% of Billed charges for outpatient setting,$300.68 ,52% of charges,$470.04 ,81.29% of Billed charges for outpatient setting,$520.41 ,90% of Billed charges for outpatient setting,$520.41 ,90% of Billed charges for outpatient setting,$352.72 ,61% of Billed charges for outpatient setting,$352.72 ,61% of Billed charges for outpatient setting,$520.41 ,90% of Billed charges for outpatient setting,$520.41 ,90% of Billed charges for outpatient setting,$352.72 ,61% of Billed charges for outpatient setting,$352.72 ,61% of Billed charges for outpatient setting,$352.72 ,61% of Billed charges for outpatient setting,$300.68 ,52% of charges,$300.68 ,52% of charges,$300.68 ,52% of charges,$300.68 ,52% of charges,$300.68 ,52% of charges,$300.68 ,52% of charges,300.6796,520.41,$462.58 
Outpatient Medical Services,Radiology,93978,Duplex A Ivc Il/Bpg; Compl,402,$490.63 ,$417.04 ,85% of Billed charges for outpatient setting,$417.04 ,85% of Billed charges for outpatient setting,$364.44 ,74.28% of Billed charges for outpatient setting,$364.44 ,74.28% of Billed charges for outpatient setting,$299.28 ,61% of Billed charges for outpatient setting,$364.44 ,74.28% of Billed charges for outpatient setting,$441.57 ,90% of Billed charges for outpatient setting,$441.57 ,90% of Billed charges for outpatient setting,$257.68 ,52.52% of charges,$427.83 ,87.2% of Billed charges for outpatient setting,$299.28 ,61% of Billed charges for outpatient setting,$427.83 ,87.2% of Billed charges for outpatient setting,$255.13 ,52% of charges,$398.83 ,81.29% of Billed charges for outpatient setting,$441.57 ,90% of Billed charges for outpatient setting,$441.57 ,90% of Billed charges for outpatient setting,$299.28 ,61% of Billed charges for outpatient setting,$299.28 ,61% of Billed charges for outpatient setting,$441.57 ,90% of Billed charges for outpatient setting,$441.57 ,90% of Billed charges for outpatient setting,$299.28 ,61% of Billed charges for outpatient setting,$299.28 ,61% of Billed charges for outpatient setting,$299.28 ,61% of Billed charges for outpatient setting,$255.13 ,52% of charges,$255.13 ,52% of charges,$255.13 ,52% of charges,$255.13 ,52% of charges,$255.13 ,52% of charges,$255.13 ,52% of charges,255.1276,441.57,$392.50 
Outpatient Medical Services,"Physical, Occupational, Cardiac",29240,Strapping Of Shoulder (PT),429,$117.04 ,$99.48 ,85% of Billed charges for outpatient setting,$99.48 ,85% of Billed charges for outpatient setting,$86.94 ,74.28% of Billed charges for outpatient setting,$86.94 ,74.28% of Billed charges for outpatient setting,$71.39 ,61% of Billed charges for outpatient setting,$86.94 ,74.28% of Billed charges for outpatient setting,$105.34 ,90% of Billed charges for outpatient setting,$105.34 ,90% of Billed charges for outpatient setting,$61.47 ,52.52% of charges,$102.06 ,87.2% of Billed charges for outpatient setting,$71.39 ,61% of Billed charges for outpatient setting,$102.06 ,87.2% of Billed charges for outpatient setting,$60.86 ,52% of charges,$95.14 ,81.29% of Billed charges for outpatient setting,$105.34 ,90% of Billed charges for outpatient setting,$105.34 ,90% of Billed charges for outpatient setting,$71.39 ,61% of Billed charges for outpatient setting,$71.39 ,61% of Billed charges for outpatient setting,$105.34 ,90% of Billed charges for outpatient setting,$105.34 ,90% of Billed charges for outpatient setting,$71.39 ,61% of Billed charges for outpatient setting,$71.39 ,61% of Billed charges for outpatient setting,$71.39 ,61% of Billed charges for outpatient setting,$60.86 ,52% of charges,$60.86 ,52% of charges,$60.86 ,52% of charges,$60.86 ,52% of charges,$60.86 ,52% of charges,$60.86 ,52% of charges,60.8608,105.34,$93.63 
Outpatient Medical Services,"Physical, Occupational, Cardiac",29240,Strapping Of Shoulder (OT),439,$117.04 ,$99.48 ,85% of Billed charges for outpatient setting,$99.48 ,85% of Billed charges for outpatient setting,$86.94 ,74.28% of Billed charges for outpatient setting,$86.94 ,74.28% of Billed charges for outpatient setting,$71.39 ,61% of Billed charges for outpatient setting,$86.94 ,74.28% of Billed charges for outpatient setting,$105.34 ,90% of Billed charges for outpatient setting,$105.34 ,90% of Billed charges for outpatient setting,$61.47 ,52.52% of charges,$102.06 ,87.2% of Billed charges for outpatient setting,$71.39 ,61% of Billed charges for outpatient setting,$102.06 ,87.2% of Billed charges for outpatient setting,$60.86 ,52% of charges,$95.14 ,81.29% of Billed charges for outpatient setting,$105.34 ,90% of Billed charges for outpatient setting,$105.34 ,90% of Billed charges for outpatient setting,$71.39 ,61% of Billed charges for outpatient setting,$71.39 ,61% of Billed charges for outpatient setting,$105.34 ,90% of Billed charges for outpatient setting,$105.34 ,90% of Billed charges for outpatient setting,$71.39 ,61% of Billed charges for outpatient setting,$71.39 ,61% of Billed charges for outpatient setting,$71.39 ,61% of Billed charges for outpatient setting,$60.86 ,52% of charges,$60.86 ,52% of charges,$60.86 ,52% of charges,$60.86 ,52% of charges,$60.86 ,52% of charges,$60.86 ,52% of charges,60.8608,105.34,$93.63 
Outpatient Medical Services,"Physical, Occupational, Cardiac",92507,"Speech/Hearing Therapy, Individual (ST)",441,$113.89 ,$96.81 ,85% of Billed charges for outpatient setting,$96.81 ,85% of Billed charges for outpatient setting,$84.60 ,74.28% of Billed charges for outpatient setting,$84.60 ,74.28% of Billed charges for outpatient setting,$69.47 ,61% of Billed charges for outpatient setting,$84.60 ,74.28% of Billed charges for outpatient setting,$102.50 ,90% of Billed charges for outpatient setting,$102.50 ,90% of Billed charges for outpatient setting,$59.82 ,52.52% of charges,$99.31 ,87.2% of Billed charges for outpatient setting,$69.47 ,61% of Billed charges for outpatient setting,$99.31 ,87.2% of Billed charges for outpatient setting,$59.22 ,52% of charges,$92.58 ,81.29% of Billed charges for outpatient setting,$102.50 ,90% of Billed charges for outpatient setting,$102.50 ,90% of Billed charges for outpatient setting,$69.47 ,61% of Billed charges for outpatient setting,$69.47 ,61% of Billed charges for outpatient setting,$102.50 ,90% of Billed charges for outpatient setting,$102.50 ,90% of Billed charges for outpatient setting,$69.47 ,61% of Billed charges for outpatient setting,$69.47 ,61% of Billed charges for outpatient setting,$69.47 ,61% of Billed charges for outpatient setting,$59.22 ,52% of charges,$59.22 ,52% of charges,$59.22 ,52% of charges,$59.22 ,52% of charges,$59.22 ,52% of charges,$59.22 ,52% of charges,59.2228,102.5,$91.11 
Outpatient Medical Services,"Physical, Occupational, Cardiac",93798,Cardiac Rehab/Monitor,943,$99.11 ,$84.24 ,85% of Billed charges for outpatient setting,$84.24 ,85% of Billed charges for outpatient setting,$73.62 ,74.28% of Billed charges for outpatient setting,$73.62 ,74.28% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$73.62 ,74.28% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$52.05 ,52.52% of charges,$86.42 ,87.2% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$86.42 ,87.2% of Billed charges for outpatient setting,$51.54 ,52% of charges,$80.57 ,81.29% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,51.5372,89.2,$79.29 
Outpatient Medical Services,"Physical, Occupational, Cardiac",97012,Mechanical Traction Therapy (PT),421,$79.18 ,$67.30 ,85% of Billed charges for outpatient setting,$67.30 ,85% of Billed charges for outpatient setting,$58.81 ,74.28% of Billed charges for outpatient setting,$58.81 ,74.28% of Billed charges for outpatient setting,$48.30 ,61% of Billed charges for outpatient setting,$58.81 ,74.28% of Billed charges for outpatient setting,$71.26 ,90% of Billed charges for outpatient setting,$71.26 ,90% of Billed charges for outpatient setting,$41.59 ,52.52% of charges,$69.04 ,87.2% of Billed charges for outpatient setting,$48.30 ,61% of Billed charges for outpatient setting,$69.04 ,87.2% of Billed charges for outpatient setting,$41.17 ,52% of charges,$64.37 ,81.29% of Billed charges for outpatient setting,$71.26 ,90% of Billed charges for outpatient setting,$71.26 ,90% of Billed charges for outpatient setting,$48.30 ,61% of Billed charges for outpatient setting,$48.30 ,61% of Billed charges for outpatient setting,$71.26 ,90% of Billed charges for outpatient setting,$71.26 ,90% of Billed charges for outpatient setting,$48.30 ,61% of Billed charges for outpatient setting,$48.30 ,61% of Billed charges for outpatient setting,$48.30 ,61% of Billed charges for outpatient setting,$41.17 ,52% of charges,$41.17 ,52% of charges,$41.17 ,52% of charges,$41.17 ,52% of charges,$41.17 ,52% of charges,$41.17 ,52% of charges,41.1736,71.26,$63.34 
Outpatient Medical Services,"Physical, Occupational, Cardiac",97014,Electric Stimulation Therapy (PT),421,$79.18 ,$67.30 ,85% of Billed charges for outpatient setting,$67.30 ,85% of Billed charges for outpatient setting,$58.81 ,74.28% of Billed charges for outpatient setting,$58.81 ,74.28% of Billed charges for outpatient setting,$48.30 ,61% of Billed charges for outpatient setting,$58.81 ,74.28% of Billed charges for outpatient setting,$71.26 ,90% of Billed charges for outpatient setting,$71.26 ,90% of Billed charges for outpatient setting,$41.59 ,52.52% of charges,$69.04 ,87.2% of Billed charges for outpatient setting,$48.30 ,61% of Billed charges for outpatient setting,$69.04 ,87.2% of Billed charges for outpatient setting,$41.17 ,52% of charges,$64.37 ,81.29% of Billed charges for outpatient setting,$71.26 ,90% of Billed charges for outpatient setting,$71.26 ,90% of Billed charges for outpatient setting,$48.30 ,61% of Billed charges for outpatient setting,$48.30 ,61% of Billed charges for outpatient setting,$71.26 ,90% of Billed charges for outpatient setting,$71.26 ,90% of Billed charges for outpatient setting,$48.30 ,61% of Billed charges for outpatient setting,$48.30 ,61% of Billed charges for outpatient setting,$48.30 ,61% of Billed charges for outpatient setting,$41.17 ,52% of charges,$41.17 ,52% of charges,$41.17 ,52% of charges,$41.17 ,52% of charges,$41.17 ,52% of charges,$41.17 ,52% of charges,41.1736,71.26,$63.34 
Outpatient Medical Services,"Physical, Occupational, Cardiac",97014,Electric Stimulation Therapy (OT),431,$79.18 ,$67.30 ,85% of Billed charges for outpatient setting,$67.30 ,85% of Billed charges for outpatient setting,$58.81 ,74.28% of Billed charges for outpatient setting,$58.81 ,74.28% of Billed charges for outpatient setting,$48.30 ,61% of Billed charges for outpatient setting,$58.81 ,74.28% of Billed charges for outpatient setting,$71.26 ,90% of Billed charges for outpatient setting,$71.26 ,90% of Billed charges for outpatient setting,$41.59 ,52.52% of charges,$69.04 ,87.2% of Billed charges for outpatient setting,$48.30 ,61% of Billed charges for outpatient setting,$69.04 ,87.2% of Billed charges for outpatient setting,$41.17 ,52% of charges,$64.37 ,81.29% of Billed charges for outpatient setting,$71.26 ,90% of Billed charges for outpatient setting,$71.26 ,90% of Billed charges for outpatient setting,$48.30 ,61% of Billed charges for outpatient setting,$48.30 ,61% of Billed charges for outpatient setting,$71.26 ,90% of Billed charges for outpatient setting,$71.26 ,90% of Billed charges for outpatient setting,$48.30 ,61% of Billed charges for outpatient setting,$48.30 ,61% of Billed charges for outpatient setting,$48.30 ,61% of Billed charges for outpatient setting,$41.17 ,52% of charges,$41.17 ,52% of charges,$41.17 ,52% of charges,$41.17 ,52% of charges,$41.17 ,52% of charges,$41.17 ,52% of charges,41.1736,71.26,$63.34 
Outpatient Medical Services,"Physical, Occupational, Cardiac",97018,Paraffin Bath Therapy (PT),421,$50.46 ,$42.89 ,85% of Billed charges for outpatient setting,$42.89 ,85% of Billed charges for outpatient setting,$37.48 ,74.28% of Billed charges for outpatient setting,$37.48 ,74.28% of Billed charges for outpatient setting,$30.78 ,61% of Billed charges for outpatient setting,$37.48 ,74.28% of Billed charges for outpatient setting,$45.41 ,90% of Billed charges for outpatient setting,$45.41 ,90% of Billed charges for outpatient setting,$26.50 ,52.52% of charges,$44.00 ,87.2% of Billed charges for outpatient setting,$30.78 ,61% of Billed charges for outpatient setting,$44.00 ,87.2% of Billed charges for outpatient setting,$26.24 ,52% of charges,$41.02 ,81.29% of Billed charges for outpatient setting,$45.41 ,90% of Billed charges for outpatient setting,$45.41 ,90% of Billed charges for outpatient setting,$30.78 ,61% of Billed charges for outpatient setting,$30.78 ,61% of Billed charges for outpatient setting,$45.41 ,90% of Billed charges for outpatient setting,$45.41 ,90% of Billed charges for outpatient setting,$30.78 ,61% of Billed charges for outpatient setting,$30.78 ,61% of Billed charges for outpatient setting,$30.78 ,61% of Billed charges for outpatient setting,$26.24 ,52% of charges,$26.24 ,52% of charges,$26.24 ,52% of charges,$26.24 ,52% of charges,$26.24 ,52% of charges,$26.24 ,52% of charges,26.2392,45.41,$40.37 
Outpatient Medical Services,"Physical, Occupational, Cardiac",97018,Paraffin Bath Therapy (OT),431,$50.46 ,$42.89 ,85% of Billed charges for outpatient setting,$42.89 ,85% of Billed charges for outpatient setting,$37.48 ,74.28% of Billed charges for outpatient setting,$37.48 ,74.28% of Billed charges for outpatient setting,$30.78 ,61% of Billed charges for outpatient setting,$37.48 ,74.28% of Billed charges for outpatient setting,$45.41 ,90% of Billed charges for outpatient setting,$45.41 ,90% of Billed charges for outpatient setting,$26.50 ,52.52% of charges,$44.00 ,87.2% of Billed charges for outpatient setting,$30.78 ,61% of Billed charges for outpatient setting,$44.00 ,87.2% of Billed charges for outpatient setting,$26.24 ,52% of charges,$41.02 ,81.29% of Billed charges for outpatient setting,$45.41 ,90% of Billed charges for outpatient setting,$45.41 ,90% of Billed charges for outpatient setting,$30.78 ,61% of Billed charges for outpatient setting,$30.78 ,61% of Billed charges for outpatient setting,$45.41 ,90% of Billed charges for outpatient setting,$45.41 ,90% of Billed charges for outpatient setting,$30.78 ,61% of Billed charges for outpatient setting,$30.78 ,61% of Billed charges for outpatient setting,$30.78 ,61% of Billed charges for outpatient setting,$26.24 ,52% of charges,$26.24 ,52% of charges,$26.24 ,52% of charges,$26.24 ,52% of charges,$26.24 ,52% of charges,$26.24 ,52% of charges,26.2392,45.41,$40.37 
Outpatient Medical Services,"Physical, Occupational, Cardiac",97033,Electric Current Therapy (PT),421,$99.11 ,$84.24 ,85% of Billed charges for outpatient setting,$84.24 ,85% of Billed charges for outpatient setting,$73.62 ,74.28% of Billed charges for outpatient setting,$73.62 ,74.28% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$73.62 ,74.28% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$52.05 ,52.52% of charges,$86.42 ,87.2% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$86.42 ,87.2% of Billed charges for outpatient setting,$51.54 ,52% of charges,$80.57 ,81.29% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,51.5372,89.2,$79.29 
Outpatient Medical Services,"Physical, Occupational, Cardiac",97033,Electric Current Therapy (OT),431,$99.11 ,$84.24 ,85% of Billed charges for outpatient setting,$84.24 ,85% of Billed charges for outpatient setting,$73.62 ,74.28% of Billed charges for outpatient setting,$73.62 ,74.28% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$73.62 ,74.28% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$52.05 ,52.52% of charges,$86.42 ,87.2% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$86.42 ,87.2% of Billed charges for outpatient setting,$51.54 ,52% of charges,$80.57 ,81.29% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,51.5372,89.2,$79.29 
Outpatient Medical Services,"Physical, Occupational, Cardiac",97035,Ultrasound Therapy (PT),421,$79.18 ,$67.30 ,85% of Billed charges for outpatient setting,$67.30 ,85% of Billed charges for outpatient setting,$58.81 ,74.28% of Billed charges for outpatient setting,$58.81 ,74.28% of Billed charges for outpatient setting,$48.30 ,61% of Billed charges for outpatient setting,$58.81 ,74.28% of Billed charges for outpatient setting,$71.26 ,90% of Billed charges for outpatient setting,$71.26 ,90% of Billed charges for outpatient setting,$41.59 ,52.52% of charges,$69.04 ,87.2% of Billed charges for outpatient setting,$48.30 ,61% of Billed charges for outpatient setting,$69.04 ,87.2% of Billed charges for outpatient setting,$41.17 ,52% of charges,$64.37 ,81.29% of Billed charges for outpatient setting,$71.26 ,90% of Billed charges for outpatient setting,$71.26 ,90% of Billed charges for outpatient setting,$48.30 ,61% of Billed charges for outpatient setting,$48.30 ,61% of Billed charges for outpatient setting,$71.26 ,90% of Billed charges for outpatient setting,$71.26 ,90% of Billed charges for outpatient setting,$48.30 ,61% of Billed charges for outpatient setting,$48.30 ,61% of Billed charges for outpatient setting,$48.30 ,61% of Billed charges for outpatient setting,$41.17 ,52% of charges,$41.17 ,52% of charges,$41.17 ,52% of charges,$41.17 ,52% of charges,$41.17 ,52% of charges,$41.17 ,52% of charges,41.1736,71.26,$63.34 
Outpatient Medical Services,"Physical, Occupational, Cardiac",97035,Ultrasound Therapy (OT),431,$99.11 ,$84.24 ,85% of Billed charges for outpatient setting,$84.24 ,85% of Billed charges for outpatient setting,$73.62 ,74.28% of Billed charges for outpatient setting,$73.62 ,74.28% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$73.62 ,74.28% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$52.05 ,52.52% of charges,$86.42 ,87.2% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$86.42 ,87.2% of Billed charges for outpatient setting,$51.54 ,52% of charges,$80.57 ,81.29% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,51.5372,89.2,$79.29 
Outpatient Medical Services,"Physical, Occupational, Cardiac",97110,Therapeutic Exercises (PT),421,$99.11 ,$84.24 ,85% of Billed charges for outpatient setting,$84.24 ,85% of Billed charges for outpatient setting,$73.62 ,74.28% of Billed charges for outpatient setting,$73.62 ,74.28% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$73.62 ,74.28% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$52.05 ,52.52% of charges,$86.42 ,87.2% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$86.42 ,87.2% of Billed charges for outpatient setting,$51.54 ,52% of charges,$80.57 ,81.29% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,51.5372,89.2,$79.29 
Outpatient Medical Services,"Physical, Occupational, Cardiac",97110,Therapeutic Exercises (ST),441,$92.33 ,$78.48 ,85% of Billed charges for outpatient setting,$78.48 ,85% of Billed charges for outpatient setting,$68.58 ,74.28% of Billed charges for outpatient setting,$68.58 ,74.28% of Billed charges for outpatient setting,$56.32 ,61% of Billed charges for outpatient setting,$68.58 ,74.28% of Billed charges for outpatient setting,$83.10 ,90% of Billed charges for outpatient setting,$83.10 ,90% of Billed charges for outpatient setting,$48.49 ,52.52% of charges,$80.51 ,87.2% of Billed charges for outpatient setting,$56.32 ,61% of Billed charges for outpatient setting,$80.51 ,87.2% of Billed charges for outpatient setting,$48.01 ,52% of charges,$75.06 ,81.29% of Billed charges for outpatient setting,$83.10 ,90% of Billed charges for outpatient setting,$83.10 ,90% of Billed charges for outpatient setting,$56.32 ,61% of Billed charges for outpatient setting,$56.32 ,61% of Billed charges for outpatient setting,$83.10 ,90% of Billed charges for outpatient setting,$83.10 ,90% of Billed charges for outpatient setting,$56.32 ,61% of Billed charges for outpatient setting,$56.32 ,61% of Billed charges for outpatient setting,$56.32 ,61% of Billed charges for outpatient setting,$48.01 ,52% of charges,$48.01 ,52% of charges,$48.01 ,52% of charges,$48.01 ,52% of charges,$48.01 ,52% of charges,$48.01 ,52% of charges,48.0116,83.1,$73.86 
Outpatient Medical Services,"Physical, Occupational, Cardiac",97110,Therapeutic Exercises (OT),431,$99.11 ,$84.24 ,85% of Billed charges for outpatient setting,$84.24 ,85% of Billed charges for outpatient setting,$73.62 ,74.28% of Billed charges for outpatient setting,$73.62 ,74.28% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$73.62 ,74.28% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$52.05 ,52.52% of charges,$86.42 ,87.2% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$86.42 ,87.2% of Billed charges for outpatient setting,$51.54 ,52% of charges,$80.57 ,81.29% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,51.5372,89.2,$79.29 
Outpatient Medical Services,"Physical, Occupational, Cardiac",97112,"Neuromusc Reeducation, 1+ Areas, Ea 15 Min (PT)",421,$98.14 ,$83.42 ,85% of Billed charges for outpatient setting,$83.42 ,85% of Billed charges for outpatient setting,$72.90 ,74.28% of Billed charges for outpatient setting,$72.90 ,74.28% of Billed charges for outpatient setting,$59.87 ,61% of Billed charges for outpatient setting,$72.90 ,74.28% of Billed charges for outpatient setting,$88.33 ,90% of Billed charges for outpatient setting,$88.33 ,90% of Billed charges for outpatient setting,$51.54 ,52.52% of charges,$85.58 ,87.2% of Billed charges for outpatient setting,$59.87 ,61% of Billed charges for outpatient setting,$85.58 ,87.2% of Billed charges for outpatient setting,$51.03 ,52% of charges,$79.78 ,81.29% of Billed charges for outpatient setting,$88.33 ,90% of Billed charges for outpatient setting,$88.33 ,90% of Billed charges for outpatient setting,$59.87 ,61% of Billed charges for outpatient setting,$59.87 ,61% of Billed charges for outpatient setting,$88.33 ,90% of Billed charges for outpatient setting,$88.33 ,90% of Billed charges for outpatient setting,$59.87 ,61% of Billed charges for outpatient setting,$59.87 ,61% of Billed charges for outpatient setting,$59.87 ,61% of Billed charges for outpatient setting,$51.03 ,52% of charges,$51.03 ,52% of charges,$51.03 ,52% of charges,$51.03 ,52% of charges,$51.03 ,52% of charges,$51.03 ,52% of charges,51.0328,88.33,$78.51 
Outpatient Medical Services,"Physical, Occupational, Cardiac",97112,"Neuromusc Reeducation, 1+ Areas, Ea 15 Min (OT)",431,$98.14 ,$83.42 ,85% of Billed charges for outpatient setting,$83.42 ,85% of Billed charges for outpatient setting,$72.90 ,74.28% of Billed charges for outpatient setting,$72.90 ,74.28% of Billed charges for outpatient setting,$59.87 ,61% of Billed charges for outpatient setting,$72.90 ,74.28% of Billed charges for outpatient setting,$88.33 ,90% of Billed charges for outpatient setting,$88.33 ,90% of Billed charges for outpatient setting,$51.54 ,52.52% of charges,$85.58 ,87.2% of Billed charges for outpatient setting,$59.87 ,61% of Billed charges for outpatient setting,$85.58 ,87.2% of Billed charges for outpatient setting,$51.03 ,52% of charges,$79.78 ,81.29% of Billed charges for outpatient setting,$88.33 ,90% of Billed charges for outpatient setting,$88.33 ,90% of Billed charges for outpatient setting,$59.87 ,61% of Billed charges for outpatient setting,$59.87 ,61% of Billed charges for outpatient setting,$88.33 ,90% of Billed charges for outpatient setting,$88.33 ,90% of Billed charges for outpatient setting,$59.87 ,61% of Billed charges for outpatient setting,$59.87 ,61% of Billed charges for outpatient setting,$59.87 ,61% of Billed charges for outpatient setting,$51.03 ,52% of charges,$51.03 ,52% of charges,$51.03 ,52% of charges,$51.03 ,52% of charges,$51.03 ,52% of charges,$51.03 ,52% of charges,51.0328,88.33,$78.51 
Outpatient Medical Services,"Physical, Occupational, Cardiac",97116,Gait Training Therapy (PT),421,$61.87 ,$52.59 ,85% of Billed charges for outpatient setting,$52.59 ,85% of Billed charges for outpatient setting,$45.96 ,74.28% of Billed charges for outpatient setting,$45.96 ,74.28% of Billed charges for outpatient setting,$37.74 ,61% of Billed charges for outpatient setting,$45.96 ,74.28% of Billed charges for outpatient setting,$55.68 ,90% of Billed charges for outpatient setting,$55.68 ,90% of Billed charges for outpatient setting,$32.49 ,52.52% of charges,$53.95 ,87.2% of Billed charges for outpatient setting,$37.74 ,61% of Billed charges for outpatient setting,$53.95 ,87.2% of Billed charges for outpatient setting,$32.17 ,52% of charges,$50.29 ,81.29% of Billed charges for outpatient setting,$55.68 ,90% of Billed charges for outpatient setting,$55.68 ,90% of Billed charges for outpatient setting,$37.74 ,61% of Billed charges for outpatient setting,$37.74 ,61% of Billed charges for outpatient setting,$55.68 ,90% of Billed charges for outpatient setting,$55.68 ,90% of Billed charges for outpatient setting,$37.74 ,61% of Billed charges for outpatient setting,$37.74 ,61% of Billed charges for outpatient setting,$37.74 ,61% of Billed charges for outpatient setting,$32.17 ,52% of charges,$32.17 ,52% of charges,$32.17 ,52% of charges,$32.17 ,52% of charges,$32.17 ,52% of charges,$32.17 ,52% of charges,32.1724,55.68,$49.50 
Outpatient Medical Services,"Physical, Occupational, Cardiac",97116,Gait Training Therapy (OT),431,$98.14 ,$83.42 ,85% of Billed charges for outpatient setting,$83.42 ,85% of Billed charges for outpatient setting,$72.90 ,74.28% of Billed charges for outpatient setting,$72.90 ,74.28% of Billed charges for outpatient setting,$59.87 ,61% of Billed charges for outpatient setting,$72.90 ,74.28% of Billed charges for outpatient setting,$88.33 ,90% of Billed charges for outpatient setting,$88.33 ,90% of Billed charges for outpatient setting,$51.54 ,52.52% of charges,$85.58 ,87.2% of Billed charges for outpatient setting,$59.87 ,61% of Billed charges for outpatient setting,$85.58 ,87.2% of Billed charges for outpatient setting,$51.03 ,52% of charges,$79.78 ,81.29% of Billed charges for outpatient setting,$88.33 ,90% of Billed charges for outpatient setting,$88.33 ,90% of Billed charges for outpatient setting,$59.87 ,61% of Billed charges for outpatient setting,$59.87 ,61% of Billed charges for outpatient setting,$88.33 ,90% of Billed charges for outpatient setting,$88.33 ,90% of Billed charges for outpatient setting,$59.87 ,61% of Billed charges for outpatient setting,$59.87 ,61% of Billed charges for outpatient setting,$59.87 ,61% of Billed charges for outpatient setting,$51.03 ,52% of charges,$51.03 ,52% of charges,$51.03 ,52% of charges,$51.03 ,52% of charges,$51.03 ,52% of charges,$51.03 ,52% of charges,51.0328,88.33,$78.51 
Outpatient Medical Services,"Physical, Occupational, Cardiac",97140,"Manual Ther Tech, 1+Regions, Ea 15 Min (PT)",421,$99.11 ,$84.24 ,85% of Billed charges for outpatient setting,$84.24 ,85% of Billed charges for outpatient setting,$73.62 ,74.28% of Billed charges for outpatient setting,$73.62 ,74.28% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$73.62 ,74.28% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$52.05 ,52.52% of charges,$86.42 ,87.2% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$86.42 ,87.2% of Billed charges for outpatient setting,$51.54 ,52% of charges,$80.57 ,81.29% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,51.5372,89.2,$79.29 
Outpatient Medical Services,"Physical, Occupational, Cardiac",97140,"Manual Ther Tech, 1+Regions, Ea 15 Min (OT)",431,$99.11 ,$84.24 ,85% of Billed charges for outpatient setting,$84.24 ,85% of Billed charges for outpatient setting,$73.62 ,74.28% of Billed charges for outpatient setting,$73.62 ,74.28% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$73.62 ,74.28% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$52.05 ,52.52% of charges,$86.42 ,87.2% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$86.42 ,87.2% of Billed charges for outpatient setting,$51.54 ,52% of charges,$80.57 ,81.29% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,51.5372,89.2,$79.29 
Outpatient Medical Services,"Physical, Occupational, Cardiac",97161,PT Eval Low Complex 20 Min,424,$213.72 ,$181.66 ,85% of Billed charges for outpatient setting,$181.66 ,85% of Billed charges for outpatient setting,$158.75 ,74.28% of Billed charges for outpatient setting,$158.75 ,74.28% of Billed charges for outpatient setting,$130.37 ,61% of Billed charges for outpatient setting,$158.75 ,74.28% of Billed charges for outpatient setting,$192.35 ,90% of Billed charges for outpatient setting,$192.35 ,90% of Billed charges for outpatient setting,$112.25 ,52.52% of charges,$186.36 ,87.2% of Billed charges for outpatient setting,$130.37 ,61% of Billed charges for outpatient setting,$186.36 ,87.2% of Billed charges for outpatient setting,$111.13 ,52% of charges,$173.73 ,81.29% of Billed charges for outpatient setting,$192.35 ,90% of Billed charges for outpatient setting,$192.35 ,90% of Billed charges for outpatient setting,$130.37 ,61% of Billed charges for outpatient setting,$130.37 ,61% of Billed charges for outpatient setting,$192.35 ,90% of Billed charges for outpatient setting,$192.35 ,90% of Billed charges for outpatient setting,$130.37 ,61% of Billed charges for outpatient setting,$130.37 ,61% of Billed charges for outpatient setting,$130.37 ,61% of Billed charges for outpatient setting,$111.13 ,52% of charges,$111.13 ,52% of charges,$111.13 ,52% of charges,$111.13 ,52% of charges,$111.13 ,52% of charges,$111.13 ,52% of charges,111.1344,192.35,$170.98 
Outpatient Medical Services,"Physical, Occupational, Cardiac",97162,PT Eval Mod Complex 30 Min,424,$213.72 ,$181.66 ,85% of Billed charges for outpatient setting,$181.66 ,85% of Billed charges for outpatient setting,$158.75 ,74.28% of Billed charges for outpatient setting,$158.75 ,74.28% of Billed charges for outpatient setting,$130.37 ,61% of Billed charges for outpatient setting,$158.75 ,74.28% of Billed charges for outpatient setting,$192.35 ,90% of Billed charges for outpatient setting,$192.35 ,90% of Billed charges for outpatient setting,$112.25 ,52.52% of charges,$186.36 ,87.2% of Billed charges for outpatient setting,$130.37 ,61% of Billed charges for outpatient setting,$186.36 ,87.2% of Billed charges for outpatient setting,$111.13 ,52% of charges,$173.73 ,81.29% of Billed charges for outpatient setting,$192.35 ,90% of Billed charges for outpatient setting,$192.35 ,90% of Billed charges for outpatient setting,$130.37 ,61% of Billed charges for outpatient setting,$130.37 ,61% of Billed charges for outpatient setting,$192.35 ,90% of Billed charges for outpatient setting,$192.35 ,90% of Billed charges for outpatient setting,$130.37 ,61% of Billed charges for outpatient setting,$130.37 ,61% of Billed charges for outpatient setting,$130.37 ,61% of Billed charges for outpatient setting,$111.13 ,52% of charges,$111.13 ,52% of charges,$111.13 ,52% of charges,$111.13 ,52% of charges,$111.13 ,52% of charges,$111.13 ,52% of charges,111.1344,192.35,$170.98 
Outpatient Medical Services,"Physical, Occupational, Cardiac",97165,OT Eval Low Complex 30 Min,434,$213.72 ,$181.66 ,85% of Billed charges for outpatient setting,$181.66 ,85% of Billed charges for outpatient setting,$158.75 ,74.28% of Billed charges for outpatient setting,$158.75 ,74.28% of Billed charges for outpatient setting,$130.37 ,61% of Billed charges for outpatient setting,$158.75 ,74.28% of Billed charges for outpatient setting,$192.35 ,90% of Billed charges for outpatient setting,$192.35 ,90% of Billed charges for outpatient setting,$112.25 ,52.52% of charges,$186.36 ,87.2% of Billed charges for outpatient setting,$130.37 ,61% of Billed charges for outpatient setting,$186.36 ,87.2% of Billed charges for outpatient setting,$111.13 ,52% of charges,$173.73 ,81.29% of Billed charges for outpatient setting,$192.35 ,90% of Billed charges for outpatient setting,$192.35 ,90% of Billed charges for outpatient setting,$130.37 ,61% of Billed charges for outpatient setting,$130.37 ,61% of Billed charges for outpatient setting,$192.35 ,90% of Billed charges for outpatient setting,$192.35 ,90% of Billed charges for outpatient setting,$130.37 ,61% of Billed charges for outpatient setting,$130.37 ,61% of Billed charges for outpatient setting,$130.37 ,61% of Billed charges for outpatient setting,$111.13 ,52% of charges,$111.13 ,52% of charges,$111.13 ,52% of charges,$111.13 ,52% of charges,$111.13 ,52% of charges,$111.13 ,52% of charges,111.1344,192.35,$170.98 
Outpatient Medical Services,"Physical, Occupational, Cardiac",97530,Therapeutic Activities (PT),421,$99.11 ,$84.24 ,85% of Billed charges for outpatient setting,$84.24 ,85% of Billed charges for outpatient setting,$73.62 ,74.28% of Billed charges for outpatient setting,$73.62 ,74.28% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$73.62 ,74.28% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$52.05 ,52.52% of charges,$86.42 ,87.2% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$86.42 ,87.2% of Billed charges for outpatient setting,$51.54 ,52% of charges,$80.57 ,81.29% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,51.5372,89.2,$79.29 
Outpatient Medical Services,"Physical, Occupational, Cardiac",97530,Therapeutic Activities (ST),441,$92.33 ,$78.48 ,85% of Billed charges for outpatient setting,$78.48 ,85% of Billed charges for outpatient setting,$68.58 ,74.28% of Billed charges for outpatient setting,$68.58 ,74.28% of Billed charges for outpatient setting,$56.32 ,61% of Billed charges for outpatient setting,$68.58 ,74.28% of Billed charges for outpatient setting,$83.10 ,90% of Billed charges for outpatient setting,$83.10 ,90% of Billed charges for outpatient setting,$48.49 ,52.52% of charges,$80.51 ,87.2% of Billed charges for outpatient setting,$56.32 ,61% of Billed charges for outpatient setting,$80.51 ,87.2% of Billed charges for outpatient setting,$48.01 ,52% of charges,$75.06 ,81.29% of Billed charges for outpatient setting,$83.10 ,90% of Billed charges for outpatient setting,$83.10 ,90% of Billed charges for outpatient setting,$56.32 ,61% of Billed charges for outpatient setting,$56.32 ,61% of Billed charges for outpatient setting,$83.10 ,90% of Billed charges for outpatient setting,$83.10 ,90% of Billed charges for outpatient setting,$56.32 ,61% of Billed charges for outpatient setting,$56.32 ,61% of Billed charges for outpatient setting,$56.32 ,61% of Billed charges for outpatient setting,$48.01 ,52% of charges,$48.01 ,52% of charges,$48.01 ,52% of charges,$48.01 ,52% of charges,$48.01 ,52% of charges,$48.01 ,52% of charges,48.0116,83.1,$73.86 
Outpatient Medical Services,"Physical, Occupational, Cardiac",97530,Therapeutic Activities (OT),431,$99.11 ,$84.24 ,85% of Billed charges for outpatient setting,$84.24 ,85% of Billed charges for outpatient setting,$73.62 ,74.28% of Billed charges for outpatient setting,$73.62 ,74.28% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$73.62 ,74.28% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$52.05 ,52.52% of charges,$86.42 ,87.2% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$86.42 ,87.2% of Billed charges for outpatient setting,$51.54 ,52% of charges,$80.57 ,81.29% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,51.5372,89.2,$79.29 
Outpatient Medical Services,"Physical, Occupational, Cardiac",97535,"Self Care/Home Mgmt Train, Ea 15 Min (PT)",421,$99.11 ,$84.24 ,85% of Billed charges for outpatient setting,$84.24 ,85% of Billed charges for outpatient setting,$73.62 ,74.28% of Billed charges for outpatient setting,$73.62 ,74.28% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$73.62 ,74.28% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$52.05 ,52.52% of charges,$86.42 ,87.2% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$86.42 ,87.2% of Billed charges for outpatient setting,$51.54 ,52% of charges,$80.57 ,81.29% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,51.5372,89.2,$79.29 
Outpatient Medical Services,"Physical, Occupational, Cardiac",97535,"Self Care/Home Mgmt Train, Ea 15 Min (ST)",441,$92.33 ,$78.48 ,85% of Billed charges for outpatient setting,$78.48 ,85% of Billed charges for outpatient setting,$68.58 ,74.28% of Billed charges for outpatient setting,$68.58 ,74.28% of Billed charges for outpatient setting,$56.32 ,61% of Billed charges for outpatient setting,$68.58 ,74.28% of Billed charges for outpatient setting,$83.10 ,90% of Billed charges for outpatient setting,$83.10 ,90% of Billed charges for outpatient setting,$48.49 ,52.52% of charges,$80.51 ,87.2% of Billed charges for outpatient setting,$56.32 ,61% of Billed charges for outpatient setting,$80.51 ,87.2% of Billed charges for outpatient setting,$48.01 ,52% of charges,$75.06 ,81.29% of Billed charges for outpatient setting,$83.10 ,90% of Billed charges for outpatient setting,$83.10 ,90% of Billed charges for outpatient setting,$56.32 ,61% of Billed charges for outpatient setting,$56.32 ,61% of Billed charges for outpatient setting,$83.10 ,90% of Billed charges for outpatient setting,$83.10 ,90% of Billed charges for outpatient setting,$56.32 ,61% of Billed charges for outpatient setting,$56.32 ,61% of Billed charges for outpatient setting,$56.32 ,61% of Billed charges for outpatient setting,$48.01 ,52% of charges,$48.01 ,52% of charges,$48.01 ,52% of charges,$48.01 ,52% of charges,$48.01 ,52% of charges,$48.01 ,52% of charges,48.0116,83.1,$73.86 
Outpatient Medical Services,"Physical, Occupational, Cardiac",97535,"Self Care/Home Mgmt Train, Ea 15 Min (OT)",431,$99.11 ,$84.24 ,85% of Billed charges for outpatient setting,$84.24 ,85% of Billed charges for outpatient setting,$73.62 ,74.28% of Billed charges for outpatient setting,$73.62 ,74.28% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$73.62 ,74.28% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$52.05 ,52.52% of charges,$86.42 ,87.2% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$86.42 ,87.2% of Billed charges for outpatient setting,$51.54 ,52% of charges,$80.57 ,81.29% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$89.20 ,90% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$60.46 ,61% of Billed charges for outpatient setting,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,$51.54 ,52% of charges,51.5372,89.2,$79.29 
Outpatient Medical Services,Other Services,90375,Rabies Immune Globulin 300 Unit/2Ml Ij Soln,636,$995.50 ,$846.18 ,85% of Billed charges for outpatient setting,$846.18 ,85% of Billed charges for outpatient setting,$739.46 ,74.28% of Billed charges for outpatient setting,$739.46 ,74.28% of Billed charges for outpatient setting,$607.26 ,61% of Billed charges for outpatient setting,$739.46 ,74.28% of Billed charges for outpatient setting,$895.95 ,90% of Billed charges for outpatient setting,$895.95 ,90% of Billed charges for outpatient setting,$522.84 ,52.52% of charges,$868.08 ,87.2% of Billed charges for outpatient setting,$607.26 ,61% of Billed charges for outpatient setting,$868.08 ,87.2% of Billed charges for outpatient setting,517.66,52% of charges,$809.24 ,81.29% of Billed charges for outpatient setting,$895.95 ,90% of Billed charges for outpatient setting,$895.95 ,90% of Billed charges for outpatient setting,$607.26 ,61% of Billed charges for outpatient setting,$607.26 ,61% of Billed charges for outpatient setting,$895.95 ,90% of Billed charges for outpatient setting,$895.95 ,90% of Billed charges for outpatient setting,$607.26 ,61% of Billed charges for outpatient setting,$607.26 ,61% of Billed charges for outpatient setting,$607.26 ,61% of Billed charges for outpatient setting,517.66,52% of charges,517.66,52% of charges,517.66,52% of charges,517.66,52% of charges,517.66,52% of charges,517.66,52% of charges,517.66,895.95,$796.40 
Outpatient Medical Services,Other Services,90675,Rabies Vaccine,636,$481.97 ,$409.67 ,85% of Billed charges for outpatient setting,$409.67 ,85% of Billed charges for outpatient setting,$358.01 ,74.28% of Billed charges for outpatient setting,$358.01 ,74.28% of Billed charges for outpatient setting,$294.00 ,61% of Billed charges for outpatient setting,$358.01 ,74.28% of Billed charges for outpatient setting,$433.77 ,90% of Billed charges for outpatient setting,$433.77 ,90% of Billed charges for outpatient setting,$253.13 ,52.52% of charges,$420.28 ,87.2% of Billed charges for outpatient setting,$294.00 ,61% of Billed charges for outpatient setting,$420.28 ,87.2% of Billed charges for outpatient setting,250.6244,52% of charges,$391.79 ,81.29% of Billed charges for outpatient setting,$433.77 ,90% of Billed charges for outpatient setting,$433.77 ,90% of Billed charges for outpatient setting,$294.00 ,61% of Billed charges for outpatient setting,$294.00 ,61% of Billed charges for outpatient setting,$433.77 ,90% of Billed charges for outpatient setting,$433.77 ,90% of Billed charges for outpatient setting,$294.00 ,61% of Billed charges for outpatient setting,$294.00 ,61% of Billed charges for outpatient setting,$294.00 ,61% of Billed charges for outpatient setting,250.6244,52% of charges,250.6244,52% of charges,250.6244,52% of charges,250.6244,52% of charges,250.6244,52% of charges,250.6244,52% of charges,250.6244,433.77,$385.58 
Outpatient Medical Services,Other Services,J0881,"Injection, Darbepoetin Alfa, 1 Microgram, Non End Stage Renal",636,$10.34 ,$8.79 ,85% of Billed charges for outpatient setting,$8.79 ,85% of Billed charges for outpatient setting,$7.68 ,74.28% of Billed charges for outpatient setting,$7.68 ,74.28% of Billed charges for outpatient setting,$6.31 ,61% of Billed charges for outpatient setting,$7.68 ,74.28% of Billed charges for outpatient setting,$9.31 ,90% of Billed charges for outpatient setting,$9.31 ,90% of Billed charges for outpatient setting,$5.43 ,52.52% of charges,$9.02 ,87.2% of Billed charges for outpatient setting,$6.31 ,61% of Billed charges for outpatient setting,$9.02 ,87.2% of Billed charges for outpatient setting,5.3768,52% of charges,$8.41 ,81.29% of Billed charges for outpatient setting,$9.31 ,90% of Billed charges for outpatient setting,$9.31 ,90% of Billed charges for outpatient setting,$6.31 ,61% of Billed charges for outpatient setting,$6.31 ,61% of Billed charges for outpatient setting,$9.31 ,90% of Billed charges for outpatient setting,$9.31 ,90% of Billed charges for outpatient setting,$6.31 ,61% of Billed charges for outpatient setting,$6.31 ,61% of Billed charges for outpatient setting,$6.31 ,61% of Billed charges for outpatient setting,5.3768,52% of charges,5.3768,52% of charges,5.3768,52% of charges,5.3768,52% of charges,5.3768,52% of charges,5.3768,52% of charges,5.3768,9.31,$8.27 
Outpatient Medical Services,Other Services,J0897,"Injection, Denosumab, 1 Mg",636,$30.13 ,$25.61 ,85% of Billed charges for outpatient setting,$25.61 ,85% of Billed charges for outpatient setting,$22.38 ,74.28% of Billed charges for outpatient setting,$22.38 ,74.28% of Billed charges for outpatient setting,$18.38 ,61% of Billed charges for outpatient setting,$22.38 ,74.28% of Billed charges for outpatient setting,$27.12 ,90% of Billed charges for outpatient setting,$27.12 ,90% of Billed charges for outpatient setting,$15.82 ,52.52% of charges,$26.27 ,87.2% of Billed charges for outpatient setting,$18.38 ,61% of Billed charges for outpatient setting,$26.27 ,87.2% of Billed charges for outpatient setting,15.6676,52% of charges,$24.49 ,81.29% of Billed charges for outpatient setting,$27.12 ,90% of Billed charges for outpatient setting,$27.12 ,90% of Billed charges for outpatient setting,$18.38 ,61% of Billed charges for outpatient setting,$18.38 ,61% of Billed charges for outpatient setting,$27.12 ,90% of Billed charges for outpatient setting,$27.12 ,90% of Billed charges for outpatient setting,$18.38 ,61% of Billed charges for outpatient setting,$18.38 ,61% of Billed charges for outpatient setting,$18.38 ,61% of Billed charges for outpatient setting,15.6676,52% of charges,15.6676,52% of charges,15.6676,52% of charges,15.6676,52% of charges,15.6676,52% of charges,15.6676,52% of charges,15.6676,27.12,$24.10 
Outpatient Medical Services,Other Services,J1200,"Injection, Diphenhydramine Hcl, Up To 50 Mg",636,$3.67 ,$3.12 ,85% of Billed charges for outpatient setting,$3.12 ,85% of Billed charges for outpatient setting,$2.73 ,74.28% of Billed charges for outpatient setting,$2.73 ,74.28% of Billed charges for outpatient setting,$2.24 ,61% of Billed charges for outpatient setting,$2.73 ,74.28% of Billed charges for outpatient setting,$3.30 ,90% of Billed charges for outpatient setting,$3.30 ,90% of Billed charges for outpatient setting,$1.93 ,52.52% of charges,$3.20 ,87.2% of Billed charges for outpatient setting,$2.24 ,61% of Billed charges for outpatient setting,$3.20 ,87.2% of Billed charges for outpatient setting,1.9084,52% of charges,$2.98 ,81.29% of Billed charges for outpatient setting,$3.30 ,90% of Billed charges for outpatient setting,$3.30 ,90% of Billed charges for outpatient setting,$2.24 ,61% of Billed charges for outpatient setting,$2.24 ,61% of Billed charges for outpatient setting,$3.30 ,90% of Billed charges for outpatient setting,$3.30 ,90% of Billed charges for outpatient setting,$2.24 ,61% of Billed charges for outpatient setting,$2.24 ,61% of Billed charges for outpatient setting,$2.24 ,61% of Billed charges for outpatient setting,1.9084,52% of charges,1.9084,52% of charges,1.9084,52% of charges,1.9084,52% of charges,1.9084,52% of charges,1.9084,52% of charges,1.9084,3.3,$2.94 
Outpatient Medical Services,Other Services,J1459,"Injection, Immune Globulin (Privigen), Intravenous, Non-Lyophilized (E.G., Liquid), 500 Mg",636,$101.64 ,$86.39 ,85% of Billed charges for outpatient setting,$86.39 ,85% of Billed charges for outpatient setting,$75.50 ,74.28% of Billed charges for outpatient setting,$75.50 ,74.28% of Billed charges for outpatient setting,$62.00 ,61% of Billed charges for outpatient setting,$75.50 ,74.28% of Billed charges for outpatient setting,$91.48 ,90% of Billed charges for outpatient setting,$91.48 ,90% of Billed charges for outpatient setting,$53.38 ,52.52% of charges,$88.63 ,87.2% of Billed charges for outpatient setting,$62.00 ,61% of Billed charges for outpatient setting,$88.63 ,87.2% of Billed charges for outpatient setting,52.8528,52% of charges,$82.62 ,81.29% of Billed charges for outpatient setting,$91.48 ,90% of Billed charges for outpatient setting,$91.48 ,90% of Billed charges for outpatient setting,$62.00 ,61% of Billed charges for outpatient setting,$62.00 ,61% of Billed charges for outpatient setting,$91.48 ,90% of Billed charges for outpatient setting,$91.48 ,90% of Billed charges for outpatient setting,$62.00 ,61% of Billed charges for outpatient setting,$62.00 ,61% of Billed charges for outpatient setting,$62.00 ,61% of Billed charges for outpatient setting,52.8528,52% of charges,52.8528,52% of charges,52.8528,52% of charges,52.8528,52% of charges,52.8528,52% of charges,52.8528,52% of charges,52.8528,91.48,$81.31 
Outpatient Medical Services,Other Services,J1756,"Injection, Iron Sucrose, 1 Mg",636,$0.73 ,$0.62 ,85% of Billed charges for outpatient setting,$0.62 ,85% of Billed charges for outpatient setting,$0.54 ,74.28% of Billed charges for outpatient setting,$0.54 ,74.28% of Billed charges for outpatient setting,$0.45 ,61% of Billed charges for outpatient setting,$0.54 ,74.28% of Billed charges for outpatient setting,$0.66 ,90% of Billed charges for outpatient setting,$0.66 ,90% of Billed charges for outpatient setting,$0.38 ,52.52% of charges,$0.64 ,87.2% of Billed charges for outpatient setting,$0.45 ,61% of Billed charges for outpatient setting,$0.64 ,87.2% of Billed charges for outpatient setting,0.3796,52% of charges,$0.59 ,81.29% of Billed charges for outpatient setting,$0.66 ,90% of Billed charges for outpatient setting,$0.66 ,90% of Billed charges for outpatient setting,$0.45 ,61% of Billed charges for outpatient setting,$0.45 ,61% of Billed charges for outpatient setting,$0.66 ,90% of Billed charges for outpatient setting,$0.66 ,90% of Billed charges for outpatient setting,$0.45 ,61% of Billed charges for outpatient setting,$0.45 ,61% of Billed charges for outpatient setting,$0.45 ,61% of Billed charges for outpatient setting,0.3796,52% of charges,0.3796,52% of charges,0.3796,52% of charges,0.3796,52% of charges,0.3796,52% of charges,0.3796,52% of charges,0.3796,0.66,$0.58 
Outpatient Medical Services,Other Services,96372,IM/SUBQ Injection Administration Fee,260,$49.41 ,$42.00 ,85% of Billed charges for outpatient setting,$42.00 ,85% of Billed charges for outpatient setting,$36.70 ,74.28% of Billed charges for outpatient setting,$36.70 ,74.28% of Billed charges for outpatient setting,$30.14 ,61% of Billed charges for outpatient setting,$36.70 ,74.28% of Billed charges for outpatient setting,$44.47 ,90% of Billed charges for outpatient setting,$44.47 ,90% of Billed charges for outpatient setting,$25.95 ,52.52% of charges,$43.09 ,87.2% of Billed charges for outpatient setting,$30.14 ,61% of Billed charges for outpatient setting,$43.09 ,87.2% of Billed charges for outpatient setting,$25.69 ,52% of charges,$40.17 ,81.29% of Billed charges for outpatient setting,$44.47 ,90% of Billed charges for outpatient setting,$44.47 ,90% of Billed charges for outpatient setting,$30.14 ,61% of Billed charges for outpatient setting,$30.14 ,61% of Billed charges for outpatient setting,$44.47 ,90% of Billed charges for outpatient setting,$44.47 ,90% of Billed charges for outpatient setting,$30.14 ,61% of Billed charges for outpatient setting,$30.14 ,61% of Billed charges for outpatient setting,$30.14 ,61% of Billed charges for outpatient setting,$25.69 ,52% of charges,$25.69 ,52% of charges,$25.69 ,52% of charges,$25.69 ,52% of charges,$25.69 ,52% of charges,$25.69 ,52% of charges,25.6932,44.47,$39.53 
Outpatient Medical Services,Other Services,96374,IV Push Administration Fee,260,$280.78 ,$238.66 ,85% of Billed charges for outpatient setting,$238.66 ,85% of Billed charges for outpatient setting,$208.56 ,74.28% of Billed charges for outpatient setting,$208.56 ,74.28% of Billed charges for outpatient setting,$171.28 ,61% of Billed charges for outpatient setting,$208.56 ,74.28% of Billed charges for outpatient setting,$252.70 ,90% of Billed charges for outpatient setting,$252.70 ,90% of Billed charges for outpatient setting,$147.47 ,52.52% of charges,$244.84 ,87.2% of Billed charges for outpatient setting,$171.28 ,61% of Billed charges for outpatient setting,$244.84 ,87.2% of Billed charges for outpatient setting,$146.01 ,52% of charges,$228.25 ,81.29% of Billed charges for outpatient setting,$252.70 ,90% of Billed charges for outpatient setting,$252.70 ,90% of Billed charges for outpatient setting,$171.28 ,61% of Billed charges for outpatient setting,$171.28 ,61% of Billed charges for outpatient setting,$252.70 ,90% of Billed charges for outpatient setting,$252.70 ,90% of Billed charges for outpatient setting,$171.28 ,61% of Billed charges for outpatient setting,$171.28 ,61% of Billed charges for outpatient setting,$171.28 ,61% of Billed charges for outpatient setting,$146.01 ,52% of charges,$146.01 ,52% of charges,$146.01 ,52% of charges,$146.01 ,52% of charges,$146.01 ,52% of charges,$146.01 ,52% of charges,146.0056,252.7,$224.62 
Outpatient Medical Services,Other Services,96375,Additional IV Push (Addtl New Drug),260,$105.85 ,$89.97 ,85% of Billed charges for outpatient setting,$89.97 ,85% of Billed charges for outpatient setting,$78.63 ,74.28% of Billed charges for outpatient setting,$78.63 ,74.28% of Billed charges for outpatient setting,$64.57 ,61% of Billed charges for outpatient setting,$78.63 ,74.28% of Billed charges for outpatient setting,$95.27 ,90% of Billed charges for outpatient setting,$95.27 ,90% of Billed charges for outpatient setting,$55.59 ,52.52% of charges,$92.30 ,87.2% of Billed charges for outpatient setting,$64.57 ,61% of Billed charges for outpatient setting,$92.30 ,87.2% of Billed charges for outpatient setting,$55.04 ,52% of charges,$86.05 ,81.29% of Billed charges for outpatient setting,$95.27 ,90% of Billed charges for outpatient setting,$95.27 ,90% of Billed charges for outpatient setting,$64.57 ,61% of Billed charges for outpatient setting,$64.57 ,61% of Billed charges for outpatient setting,$95.27 ,90% of Billed charges for outpatient setting,$95.27 ,90% of Billed charges for outpatient setting,$64.57 ,61% of Billed charges for outpatient setting,$64.57 ,61% of Billed charges for outpatient setting,$64.57 ,61% of Billed charges for outpatient setting,$55.04 ,52% of charges,$55.04 ,52% of charges,$55.04 ,52% of charges,$55.04 ,52% of charges,$55.04 ,52% of charges,$55.04 ,52% of charges,55.042,95.27,$84.68 
Outpatient Medical Services,Other Services,96376,Additional IV Push (Addtl Same Drug),260,$110.33 ,$93.78 ,85% of Billed charges for outpatient setting,$93.78 ,85% of Billed charges for outpatient setting,$81.95 ,74.28% of Billed charges for outpatient setting,$81.95 ,74.28% of Billed charges for outpatient setting,$67.30 ,61% of Billed charges for outpatient setting,$81.95 ,74.28% of Billed charges for outpatient setting,$99.30 ,90% of Billed charges for outpatient setting,$99.30 ,90% of Billed charges for outpatient setting,$57.95 ,52.52% of charges,$96.21 ,87.2% of Billed charges for outpatient setting,$67.30 ,61% of Billed charges for outpatient setting,$96.21 ,87.2% of Billed charges for outpatient setting,57.3716,52% of charges,$89.69 ,81.29% of Billed charges for outpatient setting,$99.30 ,90% of Billed charges for outpatient setting,$99.30 ,90% of Billed charges for outpatient setting,$67.30 ,61% of Billed charges for outpatient setting,$67.30 ,61% of Billed charges for outpatient setting,$99.30 ,90% of Billed charges for outpatient setting,$99.30 ,90% of Billed charges for outpatient setting,$67.30 ,61% of Billed charges for outpatient setting,$67.30 ,61% of Billed charges for outpatient setting,$67.30 ,61% of Billed charges for outpatient setting,57.3716,52% of charges,57.3716,52% of charges,57.3716,52% of charges,57.3716,52% of charges,57.3716,52% of charges,57.3716,52% of charges,57.3716,99.3,$88.26 
Outpatient Medical Services,Other Services,90471,Vaccine Administration (First),260,$41.12 ,$34.95 ,85% of Billed charges for outpatient setting,$34.95 ,85% of Billed charges for outpatient setting,$30.54 ,74.28% of Billed charges for outpatient setting,$30.54 ,74.28% of Billed charges for outpatient setting,$25.08 ,61% of Billed charges for outpatient setting,$30.54 ,74.28% of Billed charges for outpatient setting,$37.01 ,90% of Billed charges for outpatient setting,$37.01 ,90% of Billed charges for outpatient setting,$21.60 ,52.52% of charges,$35.86 ,87.2% of Billed charges for outpatient setting,$25.08 ,61% of Billed charges for outpatient setting,$35.86 ,87.2% of Billed charges for outpatient setting,$21.38 ,52% of charges,$33.43 ,81.29% of Billed charges for outpatient setting,$37.01 ,90% of Billed charges for outpatient setting,$37.01 ,90% of Billed charges for outpatient setting,$25.08 ,61% of Billed charges for outpatient setting,$25.08 ,61% of Billed charges for outpatient setting,$37.01 ,90% of Billed charges for outpatient setting,$37.01 ,90% of Billed charges for outpatient setting,$25.08 ,61% of Billed charges for outpatient setting,$25.08 ,61% of Billed charges for outpatient setting,$25.08 ,61% of Billed charges for outpatient setting,$21.38 ,52% of charges,$21.38 ,52% of charges,$21.38 ,52% of charges,$21.38 ,52% of charges,$21.38 ,52% of charges,$21.38 ,52% of charges,21.3824,37.01,$32.90 
Outpatient Medical Services,Other Services,96360,IV Hydration Initial,260,$249.90 ,$212.42 ,85% of Billed charges for outpatient setting,$212.42 ,85% of Billed charges for outpatient setting,$185.63 ,74.28% of Billed charges for outpatient setting,$185.63 ,74.28% of Billed charges for outpatient setting,$152.44 ,61% of Billed charges for outpatient setting,$185.63 ,74.28% of Billed charges for outpatient setting,$224.91 ,90% of Billed charges for outpatient setting,$224.91 ,90% of Billed charges for outpatient setting,$131.25 ,52.52% of charges,$217.91 ,87.2% of Billed charges for outpatient setting,$152.44 ,61% of Billed charges for outpatient setting,$217.91 ,87.2% of Billed charges for outpatient setting,$129.95 ,52% of charges,$203.14 ,81.29% of Billed charges for outpatient setting,$224.91 ,90% of Billed charges for outpatient setting,$224.91 ,90% of Billed charges for outpatient setting,$152.44 ,61% of Billed charges for outpatient setting,$152.44 ,61% of Billed charges for outpatient setting,$224.91 ,90% of Billed charges for outpatient setting,$224.91 ,90% of Billed charges for outpatient setting,$152.44 ,61% of Billed charges for outpatient setting,$152.44 ,61% of Billed charges for outpatient setting,$152.44 ,61% of Billed charges for outpatient setting,$129.95 ,52% of charges,$129.95 ,52% of charges,$129.95 ,52% of charges,$129.95 ,52% of charges,$129.95 ,52% of charges,$129.95 ,52% of charges,129.948,224.91,$199.92 
Outpatient Medical Services,Other Services,96361,IV Hydration (Each Additional),260,$143.02 ,$121.57 ,85% of Billed charges for outpatient setting,$121.57 ,85% of Billed charges for outpatient setting,$106.24 ,74.28% of Billed charges for outpatient setting,$106.24 ,74.28% of Billed charges for outpatient setting,$87.24 ,61% of Billed charges for outpatient setting,$106.24 ,74.28% of Billed charges for outpatient setting,$128.72 ,90% of Billed charges for outpatient setting,$128.72 ,90% of Billed charges for outpatient setting,$75.11 ,52.52% of charges,$124.71 ,87.2% of Billed charges for outpatient setting,$87.24 ,61% of Billed charges for outpatient setting,$124.71 ,87.2% of Billed charges for outpatient setting,$74.37 ,52% of charges,$116.26 ,81.29% of Billed charges for outpatient setting,$128.72 ,90% of Billed charges for outpatient setting,$128.72 ,90% of Billed charges for outpatient setting,$87.24 ,61% of Billed charges for outpatient setting,$87.24 ,61% of Billed charges for outpatient setting,$128.72 ,90% of Billed charges for outpatient setting,$128.72 ,90% of Billed charges for outpatient setting,$87.24 ,61% of Billed charges for outpatient setting,$87.24 ,61% of Billed charges for outpatient setting,$87.24 ,61% of Billed charges for outpatient setting,$74.37 ,52% of charges,$74.37 ,52% of charges,$74.37 ,52% of charges,$74.37 ,52% of charges,$74.37 ,52% of charges,$74.37 ,52% of charges,74.3704,128.72,$114.42 
Outpatient Medical Services,Other Services,96365,IV Medication Initial Hour,260,$249.90 ,$212.42 ,85% of Billed charges for outpatient setting,$212.42 ,85% of Billed charges for outpatient setting,$185.63 ,74.28% of Billed charges for outpatient setting,$185.63 ,74.28% of Billed charges for outpatient setting,$152.44 ,61% of Billed charges for outpatient setting,$185.63 ,74.28% of Billed charges for outpatient setting,$224.91 ,90% of Billed charges for outpatient setting,$224.91 ,90% of Billed charges for outpatient setting,$131.25 ,52.52% of charges,$217.91 ,87.2% of Billed charges for outpatient setting,$152.44 ,61% of Billed charges for outpatient setting,$217.91 ,87.2% of Billed charges for outpatient setting,$129.95 ,52% of charges,$203.14 ,81.29% of Billed charges for outpatient setting,$224.91 ,90% of Billed charges for outpatient setting,$224.91 ,90% of Billed charges for outpatient setting,$152.44 ,61% of Billed charges for outpatient setting,$152.44 ,61% of Billed charges for outpatient setting,$224.91 ,90% of Billed charges for outpatient setting,$224.91 ,90% of Billed charges for outpatient setting,$152.44 ,61% of Billed charges for outpatient setting,$152.44 ,61% of Billed charges for outpatient setting,$152.44 ,61% of Billed charges for outpatient setting,$129.95 ,52% of charges,$129.95 ,52% of charges,$129.95 ,52% of charges,$129.95 ,52% of charges,$129.95 ,52% of charges,$129.95 ,52% of charges,129.948,224.91,$199.92 
Outpatient Medical Services,Other Services,96366,"IV Medication (Addtl Hour, New Drug)",260,$143.02 ,$121.57 ,85% of Billed charges for outpatient setting,$121.57 ,85% of Billed charges for outpatient setting,$106.24 ,74.28% of Billed charges for outpatient setting,$106.24 ,74.28% of Billed charges for outpatient setting,$87.24 ,61% of Billed charges for outpatient setting,$106.24 ,74.28% of Billed charges for outpatient setting,$128.72 ,90% of Billed charges for outpatient setting,$128.72 ,90% of Billed charges for outpatient setting,$75.11 ,52.52% of charges,$124.71 ,87.2% of Billed charges for outpatient setting,$87.24 ,61% of Billed charges for outpatient setting,$124.71 ,87.2% of Billed charges for outpatient setting,$74.37 ,52% of charges,$116.26 ,81.29% of Billed charges for outpatient setting,$128.72 ,90% of Billed charges for outpatient setting,$128.72 ,90% of Billed charges for outpatient setting,$87.24 ,61% of Billed charges for outpatient setting,$87.24 ,61% of Billed charges for outpatient setting,$128.72 ,90% of Billed charges for outpatient setting,$128.72 ,90% of Billed charges for outpatient setting,$87.24 ,61% of Billed charges for outpatient setting,$87.24 ,61% of Billed charges for outpatient setting,$87.24 ,61% of Billed charges for outpatient setting,$74.37 ,52% of charges,$74.37 ,52% of charges,$74.37 ,52% of charges,$74.37 ,52% of charges,$74.37 ,52% of charges,$74.37 ,52% of charges,74.3704,128.72,$114.42 
Outpatient Medical Services,Other Services,96367,IV Medication Sequential (Addtl Hour Same Drug),260,$122.34 ,$103.99 ,85% of Billed charges for outpatient setting,$103.99 ,85% of Billed charges for outpatient setting,$90.87 ,74.28% of Billed charges for outpatient setting,$90.87 ,74.28% of Billed charges for outpatient setting,$74.63 ,61% of Billed charges for outpatient setting,$90.87 ,74.28% of Billed charges for outpatient setting,$110.11 ,90% of Billed charges for outpatient setting,$110.11 ,90% of Billed charges for outpatient setting,$64.25 ,52.52% of charges,$106.68 ,87.2% of Billed charges for outpatient setting,$74.63 ,61% of Billed charges for outpatient setting,$106.68 ,87.2% of Billed charges for outpatient setting,$63.62 ,52% of charges,$99.45 ,81.29% of Billed charges for outpatient setting,$110.11 ,90% of Billed charges for outpatient setting,$110.11 ,90% of Billed charges for outpatient setting,$74.63 ,61% of Billed charges for outpatient setting,$74.63 ,61% of Billed charges for outpatient setting,$110.11 ,90% of Billed charges for outpatient setting,$110.11 ,90% of Billed charges for outpatient setting,$74.63 ,61% of Billed charges for outpatient setting,$74.63 ,61% of Billed charges for outpatient setting,$74.63 ,61% of Billed charges for outpatient setting,$63.62 ,52% of charges,$63.62 ,52% of charges,$63.62 ,52% of charges,$63.62 ,52% of charges,$63.62 ,52% of charges,$63.62 ,52% of charges,63.6168,110.11,$97.87 
Outpatient Medical Services,Other Services,96368,Concurrent Infusion,260,$56.34 ,$47.89 ,85% of Billed charges for outpatient setting,$47.89 ,85% of Billed charges for outpatient setting,$41.85 ,74.28% of Billed charges for outpatient setting,$41.85 ,74.28% of Billed charges for outpatient setting,$34.37 ,61% of Billed charges for outpatient setting,$41.85 ,74.28% of Billed charges for outpatient setting,$50.71 ,90% of Billed charges for outpatient setting,$50.71 ,90% of Billed charges for outpatient setting,$29.59 ,52.52% of charges,$49.13 ,87.2% of Billed charges for outpatient setting,$34.37 ,61% of Billed charges for outpatient setting,$49.13 ,87.2% of Billed charges for outpatient setting,$29.30 ,52% of charges,$45.80 ,81.29% of Billed charges for outpatient setting,$50.71 ,90% of Billed charges for outpatient setting,$50.71 ,90% of Billed charges for outpatient setting,$34.37 ,61% of Billed charges for outpatient setting,$34.37 ,61% of Billed charges for outpatient setting,$50.71 ,90% of Billed charges for outpatient setting,$50.71 ,90% of Billed charges for outpatient setting,$34.37 ,61% of Billed charges for outpatient setting,$34.37 ,61% of Billed charges for outpatient setting,$34.37 ,61% of Billed charges for outpatient setting,$29.30 ,52% of charges,$29.30 ,52% of charges,$29.30 ,52% of charges,$29.30 ,52% of charges,$29.30 ,52% of charges,$29.30 ,52% of charges,29.2968,50.71,$45.07 
Outpatient Medical Services,Other Services,95810,"Polysomnography,  4 Or More",929,"$2,505.08 ","$2,129.32 ",85% of Billed charges for outpatient setting,"$2,129.32 ",85% of Billed charges for outpatient setting,"$1,860.77 ",74.28% of Billed charges for outpatient setting,"$1,860.77 ",74.28% of Billed charges for outpatient setting,"$1,528.10 ",61% of Billed charges for outpatient setting,"$1,860.77 ",74.28% of Billed charges for outpatient setting,"$2,254.57 ",90% of Billed charges for outpatient setting,"$2,254.57 ",90% of Billed charges for outpatient setting,"$1,315.67 ",52.52% of charges,"$2,184.43 ",87.2% of Billed charges for outpatient setting,"$1,528.10 ",61% of Billed charges for outpatient setting,"$2,184.43 ",87.2% of Billed charges for outpatient setting,"$1,302.64 ",52% of charges,"$2,036.38 ",81.29% of Billed charges for outpatient setting,"$2,254.57 ",90% of Billed charges for outpatient setting,"$2,254.57 ",90% of Billed charges for outpatient setting,"$1,528.10 ",61% of Billed charges for outpatient setting,"$1,528.10 ",61% of Billed charges for outpatient setting,"$2,254.57 ",90% of Billed charges for outpatient setting,"$2,254.57 ",90% of Billed charges for outpatient setting,"$1,528.10 ",61% of Billed charges for outpatient setting,"$1,528.10 ",61% of Billed charges for outpatient setting,"$1,528.10 ",61% of Billed charges for outpatient setting,"$1,302.64 ",52% of charges,"$1,302.64 ",52% of charges,"$1,302.64 ",52% of charges,"$1,302.64 ",52% of charges,"$1,302.64 ",52% of charges,"$1,302.64 ",52% of charges,1302.6416,2254.57,"$2,004.06 "
Outpatient Medical Services,Other Services,95811,Polysomnography W/Cpap,929,"$2,905.85 ","$2,469.97 ",85% of Billed charges for outpatient setting,"$2,469.97 ",85% of Billed charges for outpatient setting,"$2,158.47 ",74.28% of Billed charges for outpatient setting,"$2,158.47 ",74.28% of Billed charges for outpatient setting,"$1,772.57 ",61% of Billed charges for outpatient setting,"$2,158.47 ",74.28% of Billed charges for outpatient setting,"$2,615.27 ",90% of Billed charges for outpatient setting,"$2,615.27 ",90% of Billed charges for outpatient setting,"$1,526.15 ",52.52% of charges,"$2,533.90 ",87.2% of Billed charges for outpatient setting,"$1,772.57 ",61% of Billed charges for outpatient setting,"$2,533.90 ",87.2% of Billed charges for outpatient setting,"$1,511.04 ",52% of charges,"$2,362.17 ",81.29% of Billed charges for outpatient setting,"$2,615.27 ",90% of Billed charges for outpatient setting,"$2,615.27 ",90% of Billed charges for outpatient setting,"$1,772.57 ",61% of Billed charges for outpatient setting,"$1,772.57 ",61% of Billed charges for outpatient setting,"$2,615.27 ",90% of Billed charges for outpatient setting,"$2,615.27 ",90% of Billed charges for outpatient setting,"$1,772.57 ",61% of Billed charges for outpatient setting,"$1,772.57 ",61% of Billed charges for outpatient setting,"$1,772.57 ",61% of Billed charges for outpatient setting,"$1,511.04 ",52% of charges,"$1,511.04 ",52% of charges,"$1,511.04 ",52% of charges,"$1,511.04 ",52% of charges,"$1,511.04 ",52% of charges,"$1,511.04 ",52% of charges,1511.042,2615.27,"$2,324.68 "
Outpatient Medical Services,Nutrition Services,97802,"Med Nutr Ther,  1St,  Indiv,  Ea 15 Min",424,NA,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,NA,NA
Outpatient Medical Services,Nutrition Services,97803,"Med Nutr Ther,  Subsq,  Indiv,  Ea 15 Min",424,NA,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,Not Separately reimbursable,NA,NA,NA
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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
Outpatient Medical Services,LAB,80048,Basic metabolic panel,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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
Outpatient Medical Services,LAB,80053,"Blood test, comprehensive group of blood chemicals",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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
Outpatient Medical Services,LAB,80055,Obstetric blood test panel,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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
Outpatient Medical Services,LAB,80061,"Blood test, lipids",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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
Outpatient Medical Services,LAB,80069,Kidney function panel tes,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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
Outpatient Medical Services,LAB,80076,Liver function blood test panel,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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
Outpatient Medical Services,LAB,81001,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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
Outpatient Medical Services,LAB,81003,Prostate specific antigen,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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
Outpatient Medical Services,LAB,84443,"Blood test, thyroid stimulating hormone",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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
Outpatient Medical Services,LAB,85025,"Complete blood cell count, with differential white blood cells, automated",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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
Outpatient Medical Services,LAB,85027,"Complete blood count, automated",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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
Outpatient Medical Services,LAB,85610,"Blood test, clotting time",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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
Outpatient Medical Services,LAB,85730,Coagulation assessment blood 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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA
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,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,NA,NA,NA