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Charge Master – Frontline ER Richmond – 01/05/2024

CPT CodeDescriptionCharge Amount
0202UCOVID-19 BioFire Respiratory Panel 2.1 (RP2.1) Testing$2,550.77
10060INCISION/DRAINAGE ABSCESS$1,662.80
10061INS/DRAIN ABSCESS COMPL$2,634.00
10080INCISION & DRAINAGE PILONIDAL CYST SIMPLE$2,042.91
10081I&D PILONIDAL CST COMP$6,514.99
10120I & RMVL SUB-CUT SIMPLE$2,763.00
10121I & RMVL FB, SUB-CUT,COMP$13,253.00
10140I&D HEMATOMA SEROMA/FLUID COLLECTION$16,139.30
10160PUNCTURE ASP OF ABSCESS$1,565.00
10180Incision and drainage, complex, postoperative wound infecti…$13,429.00
11010DBRDMT W/RMVL FM FX&/DISLC SKIN&SUBQ TISSUS$9,150.60
11042DBRD SKN SUBQ TISSUE$5,214.02
11043DEBRIDEMENT MUSCLE & FASCIA 20 SQ CM/<$6,821.00
11045DBRDMT SUBCUTANEOUS TISSUE EA ADDL 20 SQ CM$1,943.00
11200RMVL SKIN TAGS$2,138.17
11730AVULSION/1-NAIL PLATE$1,701.14
11732AVULSION NAIL PLATE PARTIAL/COMP SIMPLE EA ADDL$528.00
11740EVAC SUBUNGUAL HEMATOMA$760.00
11750EXC NAIL PART/COMP$6,767.00
11760REPAIR NAIL BED$8,549.00
12001LACERATION REPAIR$1,143.98
12002REPAIR LAC SCALP 2.6-7.5$1,150.81
12004REPAIR LAC SCALP 7.6-12.5$1,170.04
12005REPAIR LAC,SCALP 12.6-20C$1,176.00
12006SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 20.1-30.0CM$1,946.00
12007SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK >30.0CM$2,540.00
12011REPAIR LAC FACE LESS THAN 2.5 CM$1,119.40
12013REPAIR LAC FACE 2.6-5.0CM$1,151.40
12014REPAIR LAC FACE 5.1-7.5CM$1,558.00
12015SIMPLE REPAIR F/E/E/N/L/M 7.6CM-12.5 CM$1,638.00
12020TX SUPERFICIAL WOUND DEHISCENCE SIMPLE CLOSURE$3,785.00
12031LYR CLSR S/A/T/E 2.5CM$1,915.00
12032REPAIR-INT SCALP 2.6-7.5$2,273.00
12034INTERM RPR SCLP/TRNK/EXTR$3,165.00
12035REPAIR INTERM S/A/T/E 12.$3,932.00
12041LAYER CLSR NECK/HAND 2.6$1,456.64
12042REPAIR LAC HAND/FOOT 2.6-$1,546.44
12044LYR CLSR N/H/F/ETRNL GENT$2,725.00
12051LAYER CLSR OF WND NCK/HND$1,868.08
12052LYR CLSR WOUND 2.6-5.0FAC$1,915.00
12053LYR CLSR F/E/E/N/L/M&/MUC$2,188.00
12054REPAIR INTERMEDIATE F/E/E/N/L/M&MUC 7.6-12.5CM$2,621.00
13101REPAIR COMPLEX TRUNK 2.6-7.5 CM$11,504.00
13121RPR CMPX SCALP ARM2.6-7.5$4,622.00
13122CMPLX RPR ADD 5 CM OR LES$1,846.73
13131REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 1.1-2.5 CM$2,831.00
13132RPR CMPX FOREHEAD/CHECK/C$3,937.00
13133REPAIR COMPLEX F/C/C/M/N/AX/G/H/F EA ADDL 5 CM/<$3,256.41
13151CMPX RPR EYE NOSE 1.1-2.5$4,087.00
13152RPR CPLX E/N/E/L 2.6-7.5$4,967.00
16000BURN, INITIAL TREATMENT$1,631.80
16020BURN, DRESSING/DBRDMNT-SM$1,510.00
16030DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ LARGE$3,353.15
17250UMBILICAL CAUTERIZATION$1,454.69
19020MASTOTOMY W/EXPLORATION/DRAINAGE ABSCESS DEEP$15,871.14
20103EXPLORATION PENETRATING WOUND SPX EXTREMITY$9,778.00
20520REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE$6,102.00
20525RMVL FOREIGN BODY MUSCLE/TENDON SHEATH DEEP/COMP$14,267.00
20552TRIGGER POINT INJ 1-2 MUS$7,891.00
20605ARTHROCENTESIS, MED JOINT$4,695.00
20610ARTHROCENTESIS, LG JOINT$5,568.00
20611Arthrocentesis, aspiration and/or injection, major joint or…$3,964.00
21320CLOSED TX NASAL BONE FX W/MNPJ W/STABILIZATION$10,273.00
21480CLDS TX TEMP DISLOCATION$1,842.00
21485CLOSED TX TEMPOROMANDIBULAR DISLC COMP 1ST/SBSQ$11,643.00
23600CLTX PROX HUMRL FX WO MAN$2,165.12
23605CLTX PRX HMRL FX MNPJ+-TRACT$6,012.00
23650SHOULDER DISLOCATION TRMT$1,815.67
23655CLSD TX SHOULDER DISLC W/MANIPULATION REQ ANES$8,747.56
23665CLTX SHOULDER DISLC W/FX HUMERAL TUBRST W/MANJ$3,471.00
23931INCISION&DRAINAGE UPPER ARM/ELBOW BURSA$7,329.00
24505CLTX HUMERAL SHFT FX W/MANJ W/WO SKELETAL TRACJ$5,048.00
24535CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/MANJ$8,585.00
24565CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/MANJ$7,263.00
24600CLSD TX ELBOW DISLOCAT$1,342.06
24605Treatment of closed elbow dislocation; requiring anesthesia$7,607.77
24620CLOSED TX MONTEGGIA FX DISLOCATION ELBOW W/MANJ$5,184.95
24640RADIAL HEAD SUBLUX. CHILD$1,247.63
24650CLTX RDL HEAD FX WO MANP$2,565.91
24655CLOSED TX RADIAL HEAD/NECK FX W/MANIPULATION$6,529.00
24675CLOSED TX ULNAR FRACTURE PROXIMAL END W/MANJ$7,129.00
25505CLSD TX RAD SHAFT W/MANIP$5,809.00
25520CLTX RDL SHFT FX&CLTX DISLC DSTL RAD/ULN JT$7,090.00
25535CLOSED TREATMENT OF ULNAR SHAFT FRACTURE, WITH MANIPULATION$6,488.00
25565CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/MANJ$3,153.55
25600CLSD TX DISTAL RAD FX WO$4,425.76
25605CLSD TX DISTAL RAD FX$2,551.27
25607OPTX DSTL RADL X-ARTIC FX/EPIPHYSL SEP$25,284.00
25652OPEN TREATMENT ULNAR STYLOID FRACTURE$18,687.50
25675CLOSED TX DISTAL RADIOULNAR DISLOCATION W/MANJ$3,542.20
26010I & D FINGER ABSCESS,SIMP$1,022.78
26011DRAINAGE FINGER ABSCESS COMPLICATED$7,507.16
26600CLSD TX METACARPAL FX$1,843.74
26605CLSD TX MEDICARPAL FX$2,841.00
26700CLS TX MCP DISLOCATION$1,990.00
26725CLTX PHLNGL FX PROX/MIDDL$2,191.26
26735OPEN TX PHALANGEAL SHAFT FRACTURE PROX/MIDDLE EA$25,284.00
26742CLTX ARTCLR FX INVG MTCARPHLNGL/IPHAL JT W/MANJ$6,712.00
26746OPEN TX ARTICULAR FRACTURE MCP/IP JOINT EA$16,463.00
26750CLS TX FX FINGER/THUMB$1,552.20
26755CLTX DSTL PHLNGL FX FNGR/$2,085.52
26765OPEN TX DISTAL PHALANGEAL FRACTURE EACH$13,312.00
26770TREAT FINGER DISLOC FINGE$1,535.83
26775Closed treatment of interphalangeal joint dislocation, sing…$3,665.00
27550CLOSED TX KNEE DISLOCATION W/O ANESTHESIA$2,303.00
27560CLTX PATELLAR DISLC W/O A$1,917.56
27750Closed treatment of tibial shaft fracture (with or without fibular fracture); without manipulation$4,062.50
27752CLTX TIBL SFT FX W/MANP$8,065.00
27762CLTX MEDIAL MALLS FX W/MANJ W/WO SKN/SKEL TRACJ$7,043.00
27788CLTX DSTL FIBULAR FX LAT MALLS W/MANJ$3,198.93
27792Open treatment of distal fibular fracture (lateral malleolu…$25,063.00
27810CLTX BIMAL ANKLE FX W/POT$4,919.00
27818CLTX TRIMALLEOLAR ANKLE FX W/MANIPULATION$3,435.14
27840CLOSED TX ANKLE DISLOCATI$3,642.60
27842CLTX ANKLE DISLC REQ ANES W/WO PRQ SKEL FIXJ$15,556.02
28190RMVL FB BODY FOOT SUBQ$6,856.00
28192RMVL FB FOOT DEEP$16,549.65
28495CLTX FX GRT TOE PHLX/PHLG W/MANJ$2,652.67
28515FX CARE PHALANX NOT GREAT$2,356.00
28660CLSD TX PIP JNT DISLOCATI$1,636.18
29105LONG ARM SPLINT$829.00
29125SHORT ARM SPLINT$753.22
29126SHORT ARM SPLINT DYNAMIC$1,071.00
29130APPLICATION FINGER SPLINT$625.00
29240STRPG SHO$797.00
29280STRAPPING HAND/FINGER$646.00
29505LONG LEG SPLINT$1,099.00
29515SHORT LEG SPLINT$1,026.37
29530STRAPPING KNEE$805.00
29550STRAPPING TOES$836.00
30300RMVL FOREIGN BODY NASAL$685.91
30901NASAL PACKING$1,023.89
30903CTRL NSL HEMRRG ANT CPLX$3,209.00
30905CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY 1ST$1,370.00
30906CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY SUBSQ$1,791.00
31500INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE$1,213.09
31502TRACHEOTOMY TUBE CHANGE PRIOR TO FISTULA TRACT$1,942.00
32550INSERTION INDWELLING TUNNELED PLEURAL CATHETER$20,534.31
32551TUBE THORACOSTOMY INCLUDES WATER SEAL$3,465.00
32556PERQ DRAINAGE PLEURA INSERT CATH W/O IMAGING$8,060.39
36000INTRODUCTION OF NEEDLE/IN$350.26
36005NJX PX XTR VNGRPH W/INTRO NDL/INTRACATH$4,393.00
36410VENIPUNCTURE, 3 YRS OR OLDER$765.01
36415VENIPUNCTURE$74.85
36416COLL CAPILLARY BLG SPEC$82.50
36556Insertion of non-tunneled centrally inserted central venous…$6,684.99
36558INSERT TUNNELED CV CATH – INSJ TUN CTR CVC W/O SUBQ POR$13,386.49
36569INSERTION PICC W/O IMG GDN 5 YR/>$8,161.08
36589RMVL TUN CVC W/O SUBQ PORT/PMP$7,102.88
36591COLLECT BLOOD FROM IMPLAN$735.89
36592COLLECT BLOOD FROM CATHETER VENOUS NOS$702.84
36680PLACEMENT NEEDLE INTRAOSSEOUS INFUSION$1,091.83
40650RPR LIP FULL THICKNESS$5,063.00
40800DRG ABSC CST HMTMA VESTIBULE MOUTH SMPL$3,008.19
41250RPR LAC 2.5 CM/< MOUTH&/ANT TWO-THIRDS TONG$1,653.69
41800DRNG ABSC DENTOALVEOLAR S$1,558.00
42700I&D ABSC PRITONSILLAR$2,929.00
43752NASO/ORO-GASTRIC TUBE PLMT REQ PHYS&FLUOR GDNCE$2,787.02
43753GASTRIC INTUBATION AND ASPIRATION THERAPUETIC, NECESSATING …$976.00
45915RMVL FECAL IMPACTION/FB SPX UNDER ANES$9,348.00
46040I&D ISCHIOR/PRIRC ABSC SP$12,172.00
46050INC/DRAIN PERIANAL ABS SU$5,126.00
46083INCISION THROM HEMORRHOID$1,571.00
49083ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE$6,502.68
49505RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE$25,524.60
51700BLDR IRR SMPL LVG&/INSTLJ$1,902.92
51701INSR NONDWELLING BLDR CAT$680.91
51702INSERTION BLADDER CATH$664.00
51703INSERT BLADDER CATH COMPL$844.76
54220IRRIGATION CORPORA CAVERNOSA PRIAPISM$2,403.92
54235NJX C/P/A CAVERNOSA W/PHARMACOLOGIC AGT$1,419.87
54437REPAIR OF TRAUMATIC CORPOREAL TEAR(S)$25,072.78
54450FORESKN MANJ W/LSS PREPUTIAL ADS&STRETCHING$4,025.00
55100DRAINAGE SCROTAL WALL ABSCESS$6,504.55
56405INC/DRAIN VULVA/PERINEAL$2,036.47
56420I & D BARTHOLIN ABSCESS$1,694.00
57410PELVIC EXAMINATION W/ANESTHESIA OTHER THAN LOCAL$13,698.75
58301REMOVAL INTRAUTERINE DEVICE IUD$14,504.00
59025FTL NON-STRS TST$1,670.13
62270SPINAL PUNCTURE,LUMBAR$3,147.32
62272THERAPEUTIC SPINAL PUNCTURE DRAINAGE CSF$3,759.11
64400NJX ANES TRIGEMINAL NRV ANY DIV/BRANCH$2,474.37
64405INJECTION AA&/STRD GREATER OCCIPITAL NERVE$4,308.53
64450INJ ANESTHETIC AGENT$2,131.06
65205REMOVAL FB EYE-SUPERFCL$1,275.00
65210RMVL FB XTRNL EYE EMBED SCJNCL/SCLERAL NONPERFOR$2,119.65
65220RMVL FB EYE W/O SLIT LAMP$1,561.00
65222RMVL FB EYE$1,681.00
67700I&D ABSCESS EYELID$1,658.00
69000Drainage external ear $3,343.00
69200RMVL FOREIGN BODY EAR$826.00
69205RMVL FB XTRNL AUD CANAL A$9,924.00
69209REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE, UNILATERAL$766.00
69210RMVL IMPACTED CERUMEN$671.70
70100XRAY MANDIBLE LESS THAN 4 VIEWS$1,716.86
70110XRAY MANDIBLE MIN 4 VIEWS$1,709.01
70130RADEX MASTOIDS COMPL MINIMUM 3 VIEWS PR SIDE$1,335.29
70140XRAY FACIAL BONES LESS THAN 3 VIEW$1,838.76
70150XRAY FACIAL BONES GREATER THAN 3 VIEW$1,699.89
70160Radiologic examination, nasal bones, complete, minimum of 3…$1,286.15
70200RAD EXAM ORBIT COMP.$2,352.18
70210RADEX SINUSES PARANASAL <3 VIEWS$1,100.47
70220RAD EXAM SINUS COMPLETE$1,324.00
70250SKULL LESS THAN 4 VIEWS$1,542.89
70260RAD EXAM SKULL COMPLETE$1,988.00
70330RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH BILAT$1,415.89
70360RAD EXAM NECK,SOFT TISSUE$986.98
70450COMPUTED TOMOGRAPHY HD/BR$6,000.35
70460TOMOGRAPHY HEAD/BRAIN WIT$6,473.78
70470COMPUTED TOMOGRAPHY HEAD/$7,290.89
70480CT ORBIT SELLA/POST FOSSA$5,449.04
70481CT ORBIT SELLA/POST FOSSA$6,918.53
70482CT ORBIT SELLA/POST FOSSA/EAR W/O & W/CONTR MATR$8,800.75
70486CT MAXLFCL AREA C-MATRL$6,491.00
70487CT MAXLFCL AREA C+ MATRL$8,034.29
70488CT MAXILLOFACIAL W/O & W/CONTRAST MATERIAL$7,129.51
70490CT NECK WO CONTRAST$5,581.92
70491CT SOFT TISS NCK C+MATRL$6,970.56
70492CT SOFT TISSUE NECK W/O & W/CONTRAST MATERIAL$6,402.00
70496CTA HEAD C-/C+$6,569.35
70498CT ANGIOGRAPHY NECK W/CONTRAST/NONCONTRAST$6,650.72
71045Radiologic examination, chest ; single view$1,119.00
71046CHEST XRAY 2 VIEWS$1,410.15
71047Radiologic examination, chest ; 3 views$1,428.00
71100RIBS UNILATERAL 2 VIEWS$1,689.49
71101RIB UNILATERAL W CHEST$1,643.78
71110RIBS BILATERAL 3 VIEWS$2,887.49
71111RIBS BILATERAL W/CHEST$3,412.26
71120Radiologic examination; sternum, minimum of 2 views$1,314.73
71250CT CHEST W/O CONTRAST$5,793.47
71260CT THORAX W/CONTRAST$7,325.61
71270CT THORAX WO CONTRAST$8,569.40
71275CT ANGIOGRAPHY$7,192.43
72020Radiologic examination, spine, single view, specify level$714.00
72040SPINE, CERVICAL 2/3 VIEWS$1,387.03
72050SPINE, CERVICAL MIN 4VIEW$2,298.95
72052SPINE CERV. COMP FLEX/EXT$2,879.53
72070SPINE THORACIC 2 VIEWS$1,864.83
72072SPINE THORACIC 3 VIEWS$2,042.75
72074RAD EXAN SPINE THROAC 4 V$1,605.93
72080RADEX SPINE THORACOLUMBAR JUNCTION MIN 2 VIEWS$1,490.51
72082RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 2/3 VW$2,390.99
72100SPINE LUMBO. MIN 4 VIEWS$1,655.93
72110LUMBAR X-RAY 4 VIEWS RADEX SPI LUMBOSAC MINIMUM 4 VIEWS$2,484.48
72125COMPUTED TOMOGRAPHY CERVI$5,904.47
72126CT CRV SPI C+MATRL$7,249.92
72127CT CRV SPI C-/C+$8,780.00
72128CT THRC SPI C-MATRL$7,830.72
72129CT THRC SPI C+ MATRL$7,320.41
72131CT L SPINE WO CONTRST$7,131.83
72132CT LMBR SPI C+ MATRL$7,215.83
72133CT LUMBAR SPINE W/O & W/CONTRAST MATERIAL$7,493.00
72170RAD EXAM PELVIS 1/2 VEIW$1,155.29
72190RADEX PELVIS COMPL MIN 3$1,417.68
72192CT PELVIS WO CONTRAST$6,238.31
72193TOMOGRAPHY PELVIS WCONTRS$7,003.32
72220XRAY COCCYX/SACRUM$1,341.14
73000XRAY CLAVICLE 2 VIEWS$1,342.35
73010SCAPULA COMPLETE$1,508.15
73020RADEX SHO 1 VIEW$1,044.62
73030SHOULDR COMPLETE 2 VIEWS$1,605.00
73060XRAY HUMERUS MIN 2 VIEWS$1,305.02
73070XRAY ELBOW 2 VIEWS$1,451.65
73080XRAY ELBOW GREATER THAN 3 VIEWS-COMP$1,505.02
73090XRAY FOREARM AP & LAT$1,232.77
73092Radiologic examination; upper extremity, infant, minimum of…$997.00
73100XRAY WRIST AP & LAT VIEW$1,236.77
73110XRAY WRIST/COMP MIN 3 VIE$1,514.00
73120XRAY HAND AP & LAT$1,236.00
73130XRAY HAND MIN 3 VIEWS$1,421.75
73140XRAY FINGER MIN 2 VIEWS$1,096.72
73200CT UPPR EXTR WO CNTRS$6,051.50
73201CT UPPER EXTREMITY W/CONTRAST MATERIAL$6,125.59
73202CT UPPER EXTREMITY W/O & W/CONTRAST MATERIAL$8,139.25
73501RADEX HIP UNILATERAL WITH PELVIS 1 VIEW$899.68
73502RADIOLOGIC EXAMINATION, HIP, UNILATERAL, WITH PELVIS WHEN P…$1,331.50
73503RADEX HIP UNILATERAL WITH PELVIS MINIMUM 4 VIEWS$3,029.65
73521Radiologic examination, hips, bilateral, with pelvis when p…$2,996.00
73522RADEX HIPS BILATERAL WITH PELVIS 3-4 VIEWS$2,699.97
73523Radiologic examination, hips, bilateral, with pelvis when p…$3,139.00
73551RADIOLOGIC EXAMINATION FEMUR 1 VIEW$1,650.00
73552FEMUR; MIN 2 VIEWS$1,720.31
73560XRAY KNEE, SUNRISE VIEW$1,151.00
73562XRAY KNEE MIN 3 VIEWS$1,668.26
73564RAD EXAM KNEE 4 OR MORE$2,035.51
73590XRAY TIBIA/FIBULA AP/LAT$1,407.38
73592RADEX LOWER EXTREMITY INFANT MINIMUM 2 VIEWS$1,182.06
73600XRAY ANKLE 2 VIEWS$1,177.62
73610XRAY ANKLE 3 VIEWS/COMPLE$1,412.56
73620XRAY FOOT MIN 2 VIEWS$1,321.00
73630XRAY FOOT MIN 3 VIEWS$1,883.00
73650RAD EXAN HEEL MIN 2 VIEWS$1,057.85
73660XRAY TOES, MIN 2 VIEWS$1,088.51
73700CT LWR EXTR WO CONTRAST$5,608.28
73701CT LWR EXT W CONT$7,054.52
73702CT LXTR C-/C+$7,201.81
73706CT ANGIOGRAPHY LOWER EXTREMITY$13,771.00
74018Radiologic examination, abdomen; 1 view$1,063.05
74019Radiologic examination, abdomen; 2 views$1,484.30
74021Radiologic examination, abdomen; 3 or more views$1,639.76
74022RAD EXAM COMPLETE ABD$1,705.16
74150COMPUTED TOMOGRAPHY ABD$7,791.41
74160TOMOGRAPHY ABD W/CONTRAST$8,410.50
74170TOMOGRAPHY ABD W/OCONTRAS$9,068.43
74174CT ANGIO ABD&PLVIS CNTRST MTRL W/WO CNTRST IMG$15,775.03
74175CT ANGIO ABDOMEN W/CONTRA$9,171.00
74176COMP TOMOG AB/PEL W/O CON$9,914.62
74177COMP TOMO AB/PELV W/OCONT$10,986.69
74178CT ABD & PELVIS 1 PLUS SECTION/REGNS$13,343.04
74220RADIOLOGIC EXAM ESOPHAGUS SINGLE CONTRAST STUDY$2,001.14
74240RADEX GI TRACT UPPER W/WO DELAYED IMAGES W/O KUB$3,088.48
74246Radiologic examination, gastrointestinal tract, upper, air …$2,527.30
74250RADEX SMALL INTESTINE W/MULTIPLE SERIAL IMAGES$2,411.38
74328ENDOSCOPIC CATHJ BILIARY DUCTAL SYSTEM RS&I$2,853.66
74330CMBN NDSC CATHJ BILIARY&PNCRTC DUCTAL SYS RS&I$5,004.85
74340INTRO LONG GI TUBE W/MULT FLUORO & IMAGES RS&I$2,242.00
75574CT CORONARY$6,053.46
75635CTA ABDL AORTA&BI ILIOFEM W/CONTRAST&POSTP$7,566.54
76010RADEX FROM NOSE RECTUM FOREIGN BODY 1 VIEW CHLD$979.00
763763D RNDR I&R CT MRI US/OTH$1,871.83
76536ULTRASOUND, SOFT TISSUES OF HEAD AND NECK$2,623.06
76604US CHEST REAL TIME W/IMAGE DOCUMENTATION$1,716.51
76641US BREAST UNI REAL TIME WITH IMAGE COMPLETE$2,739.00
76642US BREAST UNI REAL TIME WITH IMAGE LIMITED$2,766.31
76700US ABDOMINAL R-T W/IMAGE$3,749.11
76705US ABDOMINAL$2,913.68
76770US RETROPERITONEAL R-T W/$3,104.40
76775US RPR B-SCAN&/R-T IMG LMTD$2,902.50
76801ULTRASOUND 14 WK TABDL 1/1ST GESTATION$2,905.05
76802US PREG UTERUS 14 WK TRANSABDL EACH GESTATION$1,469.12
76805US PG UTER F&MAT AFTER 1S$3,004.33
76810US PREG UTERUS > 1ST TRIMESTER ABDL EA GESTATIO$2,164.13
76815ULTRASND PG UTER$2,534.91
76816US PREG UTERUS REAL TIME F/U TRNSABDL PER FETUS$2,425.15
76817UT PG UTER R-T IMG TRVG$2,833.44
76830TRANSVAGINAL ULTRASOUND$2,491.27
76856US PELVIC NONOB REAL-TIME$3,110.49
76857PEL NONOB B-SCAN&/R-T IMG LMTD/F-UP+C97$2,144.27
76870US SCROTUM&CNTS$2,692.89
76881US EXTREMITY NON-VASC REAL-TIME IMG COMPL$2,977.21
76882ULTRASOUND, EXTREMITY, NON VASCULAR$2,783.68
76937Us guide vascular access$2,026.00
76942ULTRASONIC GUIDANCE FOR NEEDLE PLCMNT, IMGNG SUPERVSN AND I…$3,311.72
78315B1&/JT IMG 3 PHASE STD$5,640.00
80047BASIC METABOLIC PANEL CALCIUM IONIZED$417.90
80048METABOLIC PANEL BASIC$839.17
80051ELECTROLYTE PANEL$781.42
80053METABOLIC COMPRE PANEL$1,187.55
80061LIPID PROFILE III$798.10
80074HEPATITIS PANEL$1,262.45
80076HEPATIC FUNCTION PANEL$792.48
80143Acetaminophen$616.04
80175DRUG SCREEN QUANTITATIVE LAMOTRIGINE$116.22
80177DRUG SCREEN QUANTITATIVE LEVETIRACETAM$351.00
80178LITHIUM$330.30
80197TACROLIMUS$754.71
80202VANCOMYCIN PEAK$408.10
80305DRUG TEST, PRESUMPTIVE, ANY NUMBER OF DRUG CLASSES, ANY NUM…$728.58
80307DRUG TEST PRSMV INSTRMNT CHEMISTRY ANALYZERS$935.00
80320DRUG SCREEN$526.91
80329DRUG SCREEN$356.69
80349DRUG SCREENING CANNABINOIDS NATURAL$853.71
80353DRUG SCREENING COCAINE$853.71
80361DRUG SCREENING OPIATES 1 OR MORE$853.71
81001U/A DIP STICK$485.32
81003U/A W/O MICRO DIPSTICK$255.32
81005Urinalysis; qualitative or semiquantitative, except immunoa…$65.67
81025PREG.TST URINE VISUAL$491.11
81240F2 GENE ANALYSIS 20210G >A VARIANT$786.05
82010KETONE BODIES SERUM QUANTITATIVE$288.04
82040ALBUMIN; SERUM$201.28
82075ALCOHOL BREATH TEST$262.92
82140Ammonia$365.00
82150AMYLASE$523.51
82247BILIRUBIN TOTAL$256.60
82248BILIRUBIN DIRECT$306.65
82270OCCULT BLOOD$240.31
82271BLOOD OCCULT PEROXIDASE ACTV QUAL OTHER SOURCES$148.87
82272BLD OCLT PEROXIDASE ACTV$114.93
82310CALCIUM$212.00
82330CALCIUM IONIZED$339.21
82374CARBON DIOXIDE BICARBONATE$199.00
82375Under Chemistry Procedures$455.11
82435CHLORIDE BLD$168.82
82465CHOLESTEROL SERUM/WHOLE BLOOD TOTAL$175.12
82533CORTISOL TOTAL$454.90
82550CREATINE CK-TOTAL$343.57
82553CREATINE CKMB$541.53
82565CREATININE$314.93
82607VITAMIN B-12$268.08
82728ASSAY OF FERRITIN$555.00
82746ASSAY OF FOLIC ACID SERUM$294.42
82747ASSAY OF FOLIC ACID RBC$470.56
82784IGC IMMUNOGLOBULIN$433.13
82785GAMMAGLOBULIN (IMMUNOGLOBULIN); IGE$262.68
82800GASES BLD PH ONLY$163.18
82803BLOOD GASES ANY COMBINATION PH PCO2 PO2 CO2 HCO3$659.49
82805Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (…$824.41
82945GLUCOSE BODY FLUID OTHER THAN BLOOD$311.95
82947GLUCOSE$284.83
82948GLUCOSE BLOOD REAGET STR$203.32
82977GLUTAMYLTRANSFERASE-GTT$216.42
83036HEMOGLOBIN GLYCOSYLATED A1C$291.00
83050Under Chemistry Procedures$550.24
83520IMMUNOASSAY ANALYTE QUANTITIATIVE NOS$461.34
83525ASSAY OF INSULIN TOTAL$360.19
83540IRON-TOTAL$241.98
83550IRON BINDING CAPACITY$356.00
83605ASSAY OF LACTATE$259.81
83615Lactate dehydrogenase (LD), (LDH);$293.00
83690LIPASE$469.00
83735MAGNESIUM$340.00
83874MYOGLOBIN$309.47
83880B-TYPE NATRIURETIC$542.32
83992ASSAY OF PHENCYCLIDINE$459.69
84075ALK PHOS/PROFILE OR PANEL$270.00
84100ASSAY OF PHOSPHORUS INORGANIC$239.00
84132POTASSIUM SERUM PLASMA/WHOLE BLOOD$298.00
84153Prostate specific antigen (PSA); total$368.00
84155PROTEIN,TOTAL,EXCEPT REFR$223.80
84157PROTEIN TOTAL XCPT REFRACTOMETRY OTH SRC$256.54
84165PROTEIN ELECTROPHORESIS$468.95
84295SODIUM; SERUM$153.00
84403Testosterone; total$560.52
84436THYRIXINE TOTAL$278.07
84439THYROXINE-FREE$389.05
84443Thyroid stimulating hormone (TSH)$440.69
84450Transferase; aspartate amino (AST) (SGOT)$343.09
84460ALT-TRANSFERASE;ALANINE$355.77
84478ASSAY OF TRIGLYCERIDES$287.37
84479THYROID HORMONE$541.28
84480T3 TOTAL$482.60
84481ASSAY OF TRIIODOTHYRONINE T3 FREE$618.77
84484TROPONIN I$583.78
84520Urea nitrogen; quantitative$233.22
84550URIC ACID$343.51
84560URIC ACID OTH SRC$248.16
84702HCG QUANTATIVE$554.98
84703PREGNANCY TEST BLOOD$527.57
85014HEMATOCRIT$121.51
85018HEMOGLOBIN$116.93
85025Blood count; complete (CBC)$361.01
85027CBC W/O DIFF$258.71
85044RETICULOCYTE COUNT$71.64
85347COAGJ TM ACTIVATED$326.63
85379D-DIMER$593.59
85384FIBRINOGEN ACTIVITY$412.13
85397Coagulation and fibrinolysis, functional activity, not othe…$777.10
85610PROTHROMBIN TIME$306.02
85651SEDIMENTATION RATE NONAUT$202.85
85652SED RATE ERYTHROCYTE NON$215.19
85730THROMBOPLASTIN TIME PART$317.85
86038ANTINUCLEAR AB$410.17
86039ANTINUCLEAR AB TITER$616.32
86060ANTISTREPTOLYSIN O TITER$373.13
86140C REACTIVE PROTEIN$259.98
86235EXTRACTABLE NUCLEAR ANTIGEN ANTIBODY ANY METHOD$472.85
86256SMOOTH MUSCLE AB TITER$568.46
86308MONO,HETEROPHILE ANTIBODI$342.87
86328COVID-19 RAPID ANTIBODY TEST SINGLE METHOD$100.00
86360T CELLS; ABSOLUTE CD4 AND CD8 COUNT, INCLUDING RATIO$1,301.46
86376Microsomal antibodies (eg, thyroid or liver-kidney), each$325.78
86403MONO SPOT$362.35
86430RHEUMATOID FACTOR$157.87
86431RHEUMATOID FACTOR QUANTITATIVE$376.55
86592Syphilis test, non-treponemal antibody; qualitative (eg, VD…$290.05
86593Syphilis test, non-treponemal antibody; quantitative$276.11
86617Antibody; Borrelia burgdorferi (Lyme disease) confirmatory …$546.00
86631ANTB CHLAMYDIA$183.00
86644ANTIBODY CYTOMEGALOVIRUS CMV$501.81
86645ANTIBODY CYTOMEGALOVIRUS CMV IGM$613.92
86664EPSTEIN-BARR VIRUS EBNA$350.11
86677ANTIBODY HELICOBACTER PYLORI$387.83
86689ANTB HTLV/HIV ANTB CONFIRMATION TST$593.00
86695Antibody; herpes simplex, type 1$347.98
86696Antibody; herpes simplex, type 2$408.32
86701HIV SERUM$767.00
86704HEPATITIS B CORE ANTIBODY HBCAB TOTAL$529.00
86705HEPATITIS B CORE IGM$306.46
86706HEPATITIS B SURF ANTIBODY HBSAB$447.00
86708HEPATITIS A ANTIBODY HAAB$312.00
86709HEPATITIS ANTIBODY HAAB IGM ANTIBODY$323.87
86757ANTIBODY RICKETTSIA$288.05
86769COVID-19 RAPID ANTIBODY TEST MULTIPLE STEP METHOD$100.00
86780TP-Under Qualitative or Semi quantitative Immunologists-$187.31
86803HEPATITIS C ANTIBODY$439.00
86850ANTB SCR RBC EA SERUM TQ$315.78
86900Blood typing, serologic; ABO$310.13
86901RH FACTOR-BLOOD$236.89
87015CONCENTRATION INFECTIOUS AGENTS$162.82
87040BLOOD CULTURE$631.00
87045CUL BACT STOOL AEROBIC ISOL SALMONELLA&SHIGELL$570.47
87046Culture, bacterial; stool, aerobic, additional pathogens, i…$377.36
87070CULTURE BODY FLUID$467.00
87075CULTURE ANAEROBIC$701.00
87076CUL BACT ANAEROBIC ADDL METHS DEFINITIVE EA ISOL$393.03
87077CUL BACT AEROBIC ADDL METHS DEFINITIVE EA ISOL$326.00
87081CULTURE, BACTERIAL-SCREEN$357.89
87086URINE CULTURE$449.32
87088CULTURE BCT ISOL&PRSMPTV$505.99
87106CUL FNGI DEFINITIVE ID EA ORGANISM YEAST$302.06
87110CHLAMYDIA CULTURE$562.00
87140Culture, typing; immunofluorescent method, each antiserum$194.00
87177Ova and parasites, direct smears, concentration and identif…$498.48
87186Susceptibility studies, antimicrobial agent$307.46
87205SMR PRIM SRC GRAM/GIEMSA STAIN BCT FUNGI/CELL$282.00
87207SMR PRIM SRC SPEC STAIN$310.44
87209SMR PRIM SRC CPLX SPEC STAIN OVA&PARASITS$468.89
87210WET SMEAR$263.25
87252VIRUS TISS CUL INOCULATION CYTOPATHIC EFFECT$359.53
87255Herpes Simplex Virus Culture with Reflex Typing$689.85
87324IAAD IA CLOSTRIDIUM DIFFICILE TOXIN$274.91
87338IAAD IA HPYLORI STOOL$302.04
87340IAAD IA HEPATITIS B SURFACE ANTIGEN$451.00
87341IAAD IA HEPATITIS B SURFACE AG NEUTRALIZATION$476.27
87389infection agent etc$279.65
87400INFLUENZA A&B$405.86
87420IAAD IA RESPIRATORY SYNCTIAL VIRUS$522.54
87425IAAD IA ROTAVIRUS$491.75
87426COVID-19 RAPID ANTIGEN TESTING$446.62
87430INF AGT IMMUNO STREP A$221.00
87486IADNA CHLAMYDIA PNEUMONIAE AMPLIFIED PROBE TQ$285.00
87491IADNA CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE TQ$477.19
87493INF AGENT DET NUC ACID CLOSTRIDIUM AMP PROBE$556.31
87506IADNA-DNA/RNA GI PTHGN MULTIPLEX PROBE TQ 6-11$1,498.51
87507IADNA-DNA/RNA GI PTHGN MULTIPLEX PROBE TQ 12-25$3,160.95
87522Infectious agent detection by nucleic acid (DNA or RNA); he…$1,416.35
87529IADNA HERPES SOMPLX VIRUS AMPLIFIED PROBE TQ$1,150.41
87581IADNA MYCOPLSM PNEUMONIAE AMPLIFIED PROBE TQ$1,665.64
87591IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ$447.57
87633IADNA RESPIRATRY PROBE & REV TRNSCR 12-25 TARGET$3,757.00
87635Infectious agent detection by nucleic acid (DNA or RNA); se…$275.00
87660IADNA TRICHOMONAS VAGINALIS DIRECT PROBE TQ$471.63
87661IADNA TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECH$486.92
87798IADNA NOS AMPLIFIED PROBE TQ EACH ORGANISM$672.62
87804INFLUENZA IMMUNOASSAY OPT$378.23
87807INF AGT DET IMNAS OPT RSV$348.97
87880RAPID STREP-BETA STREP$335.45
88305PATH SURG LEVEL IV$1,222.55
89050CELL COUNT MISCELLANEOUS BODY FLUIDS$445.15
89051CELL COUNT MISC BODY FLUIDS W/DIFFERENTIAL COUNT$527.00
89055LEUKOCYTE ASSMT FECAL QUAL/SEMIQUANTITATIVE$295.32
89060CRYSTAL INDENTIFICATION$267.06
90471IMMUN ADM 1 VAC$356.68
90472IM ADM PRQ ID SUBQ/IM NJXS EA VACCINE$154.56
90714TETANUS DIPHTHERIA TOXOID$638.00
90715TDAP VACCINE$547.02
92950Cardiopulmonary resuscitation (eg, in cardiac arrest)$2,738.00
92960CARDIOVERSION ELECTIVE ARRHYT XTRNL$4,586.90
93005Electrocardiogram, routine ECG with at least 12 leads; trac…$1,011.32
93017CV STRS TST XERS&/OR RX CONT ECG TRCG ONLY$4,759.05
93041RHYTHEM ECG 1-3 LDS$503.64
93303COMPLETE TTHRC ECHO CONGENITAL CARDIAC ANOMALY$6,128.85
93306ECHO TEST$7,760.32
93307ECHO TRANSTHORAC R-T 2D W/WO M-MODE REC COMP$5,627.00
93308ECHO TRANSTHORC R-T 2D W/WO M-MODE REC F-UP/LMTD$2,277.11
93320DOPPLER ECHOCARD PULSE WAVE W/SPECTRAL DISPLAY$2,469.25
93325DOP ECHOCARD COLOR FLOW VELOCITY MAPPING$1,508.77
93351ECHO TTHRC R-T 2D-+M-MODE REST&STRS CONT ECG$8,973.75
93880DUP-SCAN XTRC ART COMPL B$3,894.94
93882DUP-SCAN XTRC ART UNI/LMTD STD$2,806.00
93922NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL$6,328.44
93925DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY$3,347.82
93926DOPPLER-DUP-SCAN LXTR ART/ARTL BPGS UNI/LMTD STD$2,425.62
93930DUP-SCAN UXTR ART/ARTL BPGS COMPL BI STUDY$3,525.00
93931DUP-SCAN UXTR ART/ARTL BPGS UNI/LMTD STD$2,203.43
93970DUP-SCAN XTR VEINS COMPL$4,238.00
93971DPLX SCN EXTRM VEINS$2,961.51
93975DUPLEX SCAN OF ARTERIAL INFLOW AND VENOUS OUTFLOW OF ABD, P…$4,816.86
93976DUPLEX SCAN- LIMITED$2,686.00
94010SPIROMETRY W/RECORD$1,742.74
94150Vital capacity test$1,031.74
94640NEBULIZER TREATMENT$762.00
94644INHALATION TREATMENT – CONTINUOUS 1ST HR$757.25
94660CPAP VENTILATION CPAP INITIATION&MGMT$1,855.11
94664DEMO&/EVAL OF PT UTILIZ$351.62
94760EAR OR PULSE OXIMETRY$249.04
94761N-INVAS EAR/PLS OXIMTRY F$501.00
94762NONINVASIVE EAR/PULSE OXIMETRY OVERNIGHT MONITOR$1,171.95
96360IV INFUS INIT 31 MIN 1 HR$1,464.84
96361IV INFUS HYDR EA ADD’T HR$597.33
96365IV INFUSION THERAPY/PROPH$1,467.74
96366IV INFUS THER PROPH/DX EA$688.00
96367IV NFS THER PROPH/DX ADDL$1,486.18
96368IV NFS TX PROPHYLAXIS/DX$1,128.35
96372THERAPEUTIC PROPHYLACTIC/$583.04
96374THER PROPH/DX NJX IV PUSH$753.31
96375THER PROPH/DX NJX EA SEQL$621.20
96376SUB INFU EA ADD IV PUSH$471.15
97116THER PX 1/> AREAS EA 15 MIN GAIT TRAINJ W/STAIR$330.24
97140MANUAL THERAPY TQS 1/> REGIONS EACH 15 MINUTES$450.45
97166OCCUPATIONAL THERAPY EVAL MOD COMPLEX 45 MINS$1,062.60
97597DEBRIDEMENT OPEN WOUND 20 SQ CM/<$1,053.00
99000SPECIMEN HANDLING$53.00
99001COC COLLECITON ONLY$142.88
99070SUPPLIES&MATERIALS ABOVE or BEYOND PROV BY PHYS or QHP$117.03
99151MOD SED SAME PHYS/QHP INITIAL 15 MINS <5 YRS$1,099.00
99152MOD SED SAME PHYS/QHP INITIAL 15 MINS 5/> YRS$2,852.00
99153Moderate sedation services provided by the same physician o…$286.59
99156MOD SED OTHER PHYS/QHP INITIAL 15 MINS 5/> YRS$756.60
99157MOD SED OTHER PHYS/QHP EACH ADDL 15 MINS$186.00
99173SCREENING TEST OF VISION$761.53
99281E/M VISIT LEVEL 1 TECH COMP$1,000.00
99282E/M VISIT LEVEL 2 TECH COMP$1,965.24
99283E/M VISIT LEVEL 3 TECH COMP$3,485.69
99284E/M VISIT LEVEL 4 TECH COMP$5,681.64
99285E/M VISIT LEVEL 5 TECH COMP$7,635.21
99291CRITICAL CARE 30-74 MIN$10,658.97
99292CRITICAL CARE ADD 30 MIN$2,865.36
G0378HOSPITAL OBSERVATION SERVICES PER HOUR$2,500.00
J0131INJECTION, ACETAMINOPHEN, 10 MG$48.13
J0153ADENOSINE INJ 1MG$50.30
J0171ADRENALIN EPINEPHRINE INJECT$50.30
J0282INJ AMIODARONE HYDROCHLOR$32.59
J0290AMPICILLIN 500 MG INJ$79.00
J0295INJ AMPCLLN SODIUM/SULBA$64.62
J0330SUCCINYLCHOLINE CHLO 20MG$121.80
J0360HYDRALAZINE HCL INJ UP TO 20MG$162.55
J0456INJ AZITHROMYCIN 500MG$106.99
J0461INJ ATROPINE SULFATE 0.01$22.13
J0500DICYCLOMINE HCL 20MG$557.51
J0515Injection, benztropine mesylate, per 1 mg$390.46
J0561INJECTION PENICILLIN G BENZATHINE 100,000 UNITS$215.93
J0595STADOL$65.00
J0690KEFZOL 1 GR VIAL$34.00
J0692INJ CEFEPIME HCI 500MG$62.78
J0696ROCEPHIN 250 MG$49.21
J0735CLONIDINE 1MG$177.31
J0744CIPRO 200MG$85.77
J0780COMPAZINE 10 MG$156.16
J1030DEPO MEDROL 40 MG/ML$68.63
J1040METHYLPREDNISOLONE 80MG$119.76
J1100DECADRON 4 MG VIAL$21.98
J1110dihydroergotamine mesylate$1,259.92
J1165DILANTIN 100 MG VIAL$20.45
J1170DILAUDID 4 MG$61.48
J1200BENADRYL 50MG$40.82
J1335ERTAPENEM INJECTION$605.36
J1580GARAMYCIN,GENTAMICIN 80MG$61.96
J1610GLUCOGAN 1 MG VIAL$1,555.50
J1630HALOPERIDOL INJECTION$63.94
J1642HEPARIN SODIUM PER 10 UNI$12.11
J1644INJ HEPARIN SOD PER 1000$78.18
J1650ENOXAPARIN SODIUM 10MG$159.24
J1670TETANUS INJECTION$4,732.95
J1815INJ INSULIN PER 5 UNITS$23.74
J1885TORADOL INJ 15 MG$45.64
J1940LASIX 40 MG IV VIAL$46.86
J1956LEVOFLOXACIN 250 MG$78.35
J2001LIDOCAINE HCI 10MG$19.77
J2060ATIVAN 2ML SYRUP$51.89
J2150MANNITOL INJECTION$45.38
J2175DEMEROL 50 MG SYRINGE$59.82
J2250MIDAZOLAM HCI PER 1 MG$19.19
J2270INJ MORPHINE SULFATE 10 M$46.30
J2274INJ MORPHINE PF EPID ITHC$80.50
J2300NUBAIN 10MG AMP$102.25
J2310INJ NALOXONE HCL 1MG$210.81
J2360ORPHENADRINE CITRATE 60MG$140.03
J2370NEO-SYNEPHRINE UP TO 1 ML$96.16
J2405ONDANSETRON HCI, PER MG$18.94
J2543ZOSYN – PIPERACILLIN/TAZOBACTAM$75.76
J2550PHENERGAN 50 MG$49.68
J2704INJ, PROPOFOL, 10 MG$25.40
J2765METOCLOPRAMIDE HCL 10MG$34.76
J2770Quinupristin/dalfopristin$1,656.91
J2790RHOGAM INJECTION$339.05
J2800METHOCARBAMOL INJECTION$344.59
J2920SOLU-MEDROL 40MG$122.10
J2930SOLU-MEDROL 125 MG$110.69
J3010INJ FENTANYL CITRATE .1MG$22.78
J3030IMITREX 6MG VIAL$167.37
J3105INJECTION, TREBUTALINE SULFATE, UP TO 1 MG$72.76
J3230THOROZINE 50 MG$347.06
J3360VALIUM INJ 5 MG$157.22
J3370VANCOMYCIN HCI INJ 500MG$198.77
J3410VISTERIL INJ 50 MG$74.46
J3411INJ THIAMINE 100 MG$89.60
J3430INJECTION, (PHYTONADIONE) VITAMIN K, PER 1 MG$101.43
J3475MAGNESIUM SULFATE 2CC AMP$50.15
J3480POTASSIUM CHLORIDE 2 MG$35.12
J3486GEODON – ZIPRASIDONE MESYLATE 10MG$272.18
J3490UNCLASSIFIED DRUGS$458.39
J7030INFUS NORM SALINE 1000CC$104.54
J7040INFUS NORM SALINE 500ML$92.06
J70425% DEXTROSE$74.31
J7050INFS NORM SALINE 250CC$97.51
J7060INFUSION D5W 250ML$93.48
J7070INFUSION D5W 1000ML$62.50
J7120RINGER’S LACTATE INFUS$188.27
J71215% DEXTROSE IN LAC RINGERS$242.92
J7510PREDNISOLONE ORAL 5 MG$7.72
J7512PREDNISONE 5 MG$6.62
J7607LEVALBUTEROL COMP CON$27.71
J7613ALBUT INHAL NON-CP 1MG$36.89
J7614ALBUTEROL ALL FOMULATIONS$27.52
J7620ALBUTEROL 2.5 MG ATROVENT$36.89
J7644IPRATROPIUM BROMIDE INHAL$53.75
J7699NOC DRUGS INHAL SOL ADMIN$38.19
J8499NONCHEMOTHERAPEUTIC ORAL$73.09
J8540DEXAMETHASONE, ORAL .25MG$14.82
L0120CERVICAL FLEX NONADJ COLL$244.41
L0150CERV SEMI-RIG ADJ MOLDED CHN$368.00
L0464TLSO 4MOD SACRO-SCAP PRE$9,421.00
L1600Hip orthosis (HO), abduction control of hip joints, flexible, Frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise$234.82
L1830KNEE IMMOBOLIZER$224.00
L3260SURGICAL BOOT/SHOE$228.41
L3620Transfer of an orthosis from one shoe to another, solid stirrup, existing$359.00
L3650SO FIGURE EIGHT ABDUCTION$654.91
L3660SO 8 AB RSTR CAN/WEB PRE OTS$686.43
L3908WRIST EXTN CONTROL COCKUP$228.41
L3913Hand-finger orthosis (HFO), without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment$733.00
L4350AIR SPLINT$888.41
L8501Tracheostomy speaking valve$762.17
M0243Intravenous infusion, casirivimab and imdevimab, includes i…$1,200.00
M0245Intravenous infusion, bamlanivimab and etesevimab, includes…$1,200.00
Q9966LOCM 200-299MG ML IODINE, 1ML$12.63
Q9967LOW OSMOLAR CNTRS MAT$13.00
S0028INJECT FAMOTIDINE 20 MG$62.06
S0119ZOFRAN, 4MG, ORAL$161.73
S0164PROTONIX PANTROPRAZOLE 40MG$256.01
S5000PRESCRIPTION DRUG GENERIC$14.15
S5001PRESCRIPTION DRUG BAND NM$17.93
S8451SPLINT WRIST OR ANKLE$169.68
U0002SARS-CoV-2/2019-nCoV (COVID-19), any technique, multiple ty…$150.00

Looking for an emergency care near you? At Frontline ER Richmond and Houston we are beyond urgent care and  proud to offer 24 hour emergency care for the entire Richmond, Southwest Houston and Mission Bend community. Our emergency room in 77407 is equipped with state-of-the-art medical equipment, allowing us to diagnose with a higher efficiency along with providing immediate and effective emergency care in Richmond and Houston for a range of illnesses, injuries and traumatic events. At Frontline emergency care in Richmond, our board-certified emergency doctors near you have over 100 years of combined experience with providing emergency care and are dedicated to helping the Richmond, Southwest Houston and Mission Bend community in their time of need.