Sr. # CPT Codes Billing Charge Price

1

10060

$1,052.90

2

10061

$1,052.90

3

10080

$1,052.90

4

10120

$1,052.90

5

10121

$1,050.00

6

10160

$500.00

7

11000

$1,050.00

8

11042

$1,050.00

9

11719

$350.00

10

11730

$1,137.60

11

11740

$540.00

12

11750

$1,050.00

13

11982

$1,135.00

14

12001

$615.00

15

12002

$615.00

16

12004

$595.00

17

12005

$595.00

18

12011

$1,135.00

19

12013

$1,050.00

20

12014

$1,050.00

21

12032

$1,000.00

22

12041

$1,470.00

23

12042

$1,575.00

24

12044

$1,050.00

25

12051

$1,470.00

26

12052

$1,135.00

27

13120

$1,135.00

28

13152

$1,135.00

29

15850

$855.00

30

16000

$1,260.00

31

16020

$1,135.00

32

19000

$2,520.00

33

19100

$2,520.00

34

20550

$850.00

35

20600

$1,000.00

36

20605

$1,050.00

37

20610

$1,050.00

38

23550

$850.00

39

23650

$1,050.00

40

23665

$1,260.00

41

24105

$950.00

42

24640

$1,050.00

43

26010

$1,050.00

44

26725

$1,050.00

45

28190

$1,260.00

46

29075

$915.00

47

29086

$885.00

48

29105

$990.00

49

29125

$845.00

50

29126

$899.00

51

29130

$486.00

52

29131

$546.00

53

29240

$1,050.00

54

29280

$1,050.00

55

29450

$1,050.00

56

29505

$784.00

57

29515

$849.00

58

29530

$1,700.00

59

29540

$1,135.00

60

29550

$1,135.00

61

29700

$1,050.00

62

30300

$1,260.00

63

30901

$1,260.00

64

30905

$1,260.00

65

3120F

$230.00

66

31541

$1,000.00

67

33512

$2,520.00

68

36000

$170.00

69

36010

$570.00

70

36410

$315.00

71

36415

$380.00

72

36416

$570.00

73

36555

$750.00

74

36572

$500.00

75

36600

$750.00

76

43752

$1,943.00

77

51702

$1,050.00

78

51703

$1,050.00

79

57415

$1,050.00

80

58301

$1,050.00

81

64450

$1,135.00

82

64451

$500.00

83

65205

$1,260.00

84

65210

$1,050.00

85

65220

$1,135.00

86

65222

$1,260.00

87

65435

$1,135.00

88

69200

$1,135.00

89

69209

$1,135.00

90

69210

$1,260.00

91

70030

$1,825.00

92

70110

$2,115.00

93

70130

$1,520.00

94

70140

$1,995.00

95

70150

$1,995.00

96

70160

$2,520.00

97

70200

$2,520.00

98

70210

$2,520.00

99

70220

$2,520.00

100

70250

$2,270.00

101

70260

$2,270.00

102

70330

$2,520.00

103

70360

$2,520.00

104

70450

$5,670.00

105

70460

$5,670.00

106

70470

$5,670.00

107

70480

$5,670.00

108

70481

$5,670.00

109

70482

$5,670.00

110

70486

$5,670.00

111

70487

$5,670.00

112

70488

$5,040.00

113

70490

$5,040.00

114

70491

$5,670.00

115

70492

$5,040.00

116

70496

$5,040.00

117

70498

$5,040.00

118

71010

$2,270.00

119

71020

$2,270.00

120

71035

$2,520.00

121

71045

$1,975.00

122

71046

$2,520.00

123

71047

$2,520.00

124

71048

$2,520.00

125

71100

$1,895.00

126

71101

$2,195.00

127

71110

$2,520.00

128

71111

$2,520.00

129

71120

$2,520.00

130

71250

$5,670.00

131

71260

$5,670.00

132

71270

$5,670.00

133

71275

$5,670.00

134

72020

$2,520.00

135

72040

$2,520.00

136

72050

$2,520.75

137

72052

$2,520.75

138

72070

$2,520.00

139

72072

$2,520.00

140

72074

$2,520.00

141

72080

$2,520.00

142

72082

$2,520.00

143

72100

$2,715.35

144

72110

$2,975.50

145

72114

$2,520.00

146

72120

$2,520.00

147

72125

$5,670.00

148

72126

$5,040.00

149

72127

$5,775.00

150

72128

$5,670.00

151

72129

$5,040.00

152

72130

$5,670.00

153

72131

$5,670.00

154

72132

$5,670.00

155

72133

$5,670.00

156

72170

$1,759.50

157

72190

$1,845.00

158

72192

$5,670.00

159

72193

$5,689.00

160

72220

$2,520.00

161

72270

$2,520.00

162

73000

$2,520.00

163

73010

$2,520.00

164

73020

$1,899.50

165

73030

$2,695.59

166

73050

$2,520.00

167

73060

$2,520.00

168

73070

$2,520.00

169

73080

$2,520.00

170

73090

$2,520.00

171

73100

$2,520.00

172

73110

$2,637.00

173

73120

$2,153.00

174

73130

$2,520.00

175

73140

$1,895.00

176

73200

$5,670.00

177

73201

$5,670.00

178

73202

$5,670.00

179

73501

$1,750.00

180

73502

$2,520.00

181

73503

$2,520.00

182

73510

$1,795.00

183

73522

$2,520.00

184

73551

$1,100.00

185

73552

$1,985.00

186

73560

$1,680.00

187

73562

$2,750.00

188

73564

$2,520.00

189

73565

$2,520.00

190

73590

$2,520.00

191

73592

$2,520.00

192

73600

$2,520.00

193

73610

$2,520.00

194

73620

$2,115.00

195

73630

$2,250.00

196

73650

$2,520.00

197

73660

$1,466.95

198

73700

$6,670.00

199

73701

$6,475.00

200

73718

$6,511.35

201

74000

$2,520.00

202

74018

$1,785.00

203

74019

$1,715.00

204

74020

$2,520.00

205

74021

$1,990.50

206

74022

$1,895.50

207

74150

$5,980.80

208

74160

$5,980.80

209

74174

$5,670.00

210

74175

$5,975.00

211

74176

$5,670.00

212

74177

$5,670.00

213

74178

$5,675.00

214

74190

$2,520.00

215

74240

$2,520.00

216

74241

$2,520.00

217

74245

$2,520.00

218

74250

$2,520.00

219

74251

$2,520.00

220

74328

$3,568.00

221

74329

$2,520.00

222

74330

$2,738.00

223

74340

$1,250.00

224

74440

$2,520.00

225

76380

$5,670.00

226

76536

$2,520.00

227

76604

$2,270.00

228

76641

$1,570.00

229

76642

$995.00

230

76700

$2,686.67

231

76705

$3,335.50

232

76770

$1,794.00

233

76775

$2,520.00

234

76801

$2,270.00

235

76802

$975.00

236

76805

$2,520.00

237

76810

$2,520.00

238

76816

$1,545.00

239

76817

$2,520.00

240

76830

$2,673.50

241

76856

$2,520.00

242

76857

$2,270.00

243

76870

$3,045.00

244

76881

$2,520.00

245

76882

$1,150.00

246

80047

$1,295.00

247

80048

$1,192.00

248

80051

$450.00

249

80053

$1,495.00

250

80061

$1,260.00

251

80076

$1,215.00

252

80102

$230.00

253

80299

$850.00

254

80305

$411.00

255

80307

$630.00

256

80320

$570.00

257

80324

$630.00

258

80329

$570.00

259

80335

$230.00

260

80345

$630.00

261

80346

$630.00

262

80347

$525.00

263

80348

$525.00

264

80349

$400.00

265

80351

$630.00

266

80352

$170.00

267

80353

$630.00

268

80356

$115.00

269

80358

$630.00

270

80359

$630.00

271

80361

$630.00

272

80362

$570.00

273

80365

$630.00

274

80366

$285.00

275

80367

$230.00

276

80373

$570.00

277

80374

$570.00

278

81000

$425.00

279

81001

$575.00

280

81002

$250.00

281

81003

$454.00

282

81025

$570.00

283

82010

$318.00

284

82040

$170.00

285

82075

$500.00

286

82150

$477.00

287

82247

$305.00

288

82248

$375.00

289

82270

$1,260.00

290

82272

$1,260.00

291

82310

$420.00

292

82330

$420.00

293

82374

$420.00

294

82435

$335.00

295

82465

$450.00

296

82533

$340.00

297

82550

$390.00

298

82553

$650.00

299

82565

$350.00

300

82747

$298.50

301

82784

$675.00

302

82803

$541.00

303

82945

$395.00

304

82947

$230.00

305

82948

$570.00

306

82962

$150.00

307

82977

$500.00

308

83009

$505.00

309

83013

$570.00

310

83036

$275.00

311

83525

$285.00

312

83605

$475.00

313

83615

$500.00

314

83690

$463.00

315

83718

$350.00

316

83735

$500.00

317

83874

$650.00

318

83880

$880.00

319

83992

$450.00

320

84075

$255.00

321

84100

$243.00

322

84132

$375.00

323

84155

$289.00

324

84157

$354.00

325

84295

$289.00

326

84436

$365.00

327

84439

$448.00

328

84443

$645.00

329

84450

$297.00

330

84460

$250.00

331

84478

$715.00

332

84479

$335.00

333

84480

$570.00

334

84481

$475.00

335

84484

$879.00

336

84512

$340.00

337

84520

$359.00

338

84550

$570.00

339

84702

$980.00

340

84703

$850.00

341

85025

$1,260.00

342

85027

$340.00

343

85379

$875.00

344

85610

$778.40

345

85651

$570.00

346

85652

$140.00

347

85730

$299.00

348

86038

$342.50

349

86039

$434.00

350

86060

$155.00

351

86140

$420.00

352

86235

$570.00

353

86308

$436.85

354

86328

$300.00

355

86431

$256.00

356

86677

$570.00

357

86689

$387.75

358

86701

$525.00

359

86901

$850.00

360

87015

$286.75

361

87040

$385.79

362

87045

$794.00

363

87070

$510.00

364

87075

$570.00

365

87076

$430.00

366

87077

$570.00

367

87081

$570.00

368

87086

$387.50

369

87088

$286.89

370

87205

$349.75

371

87338

$630.00

372

87420

$475.00

373

87426

$300.00

374

87486

$400.00

375

87491

$630.00

376

87581

$300.00

377

87591

$340.00

378

87633

$600.00

379

87635

$500.00

380

87798

$400.00

381

87804

$478.80

382

87806

$1,050.00

383

87807

$630.00

384

87880

$865.20

385

89051

$414.40

386

89055

$570.00

387

89240

$204.95

388

90471

$252.75

389

90472

$350.00

390

90714

$672.00

391

90715

$630.00

392

93000

$630.00

393

93005

$800.00

394

93010

$800.00

395

93040

$800.00

396

93042

$630.00

397

93224

$1,010.00

398

93307

$2,400.00

399

93631

$760.00

400

93880

$2,051.00

401

93922

$2,434.15

402

93923

$2,520.00

403

93925

$2,975.33

404

93926

$2,270.00

405

93930

$2,733.00

406

93931

$2,479.85

407

93970

$2,879.55

408

93971

$2,520.00

409

93975

$3,179.50

410

93980

$1,733.20

411

94640

$289.00

412

94760

$380.80

413

94761

$340.00

414

94762

$570.00

415

96360

$1,260.00

416

96361

$595.00

417

96365

$1,260.00

418

96366

$781.20

419

96367

$1,038.80

420

96368

$800.00

421

96372

$1,260.00

422

96374

$1,030.40

423

96375

$705.60

424

96376

$711.20

425

96377

$800.00

426

97010

$142.80

427

97116

$649.60

428

97542

$512.40

429

97597

$995.75

430

98925

$200.00

431

99000

$850.00

432

99024

$760.00

433

99070

$250.00

434

99151

$525.00

435

99173

$1,510.00

436

99217

$1,500.00

437

99218

$2,100.00

438

99219

$2,100.00

439

99220

$2,100.00

440

99234

$2,100.00

441

99235

$2,100.00

442

99236

$2,100.00

443

99281

$999.01

444

99282

$2,256.00

445

99283

$4,200.00

446

99284

$4,500.00

447

99285

$5,000.00

448

99291

$3,996.00

449

99292

$2,094.40

450

A0382

$75.00

451

A0394

$75.00

452

A4206

$125.00

453

A4207

$90.00

454

A4208

$125.00

455

A4209

$125.00

456

A4210

$125.00

457

A4211

$90.00

458

A4212

$125.00

459

A4213

$125.00

460

A4215

$125.00

461

A4216

$125.00

462

A4217

$90.00

463

A4221

$125.00

464

A4224

$125.00

465

A4232

$90.00

466

A4244

$125.00

467

A4245

$125.00

468

A4246

$125.00

469

A4247

$75.00

470

A4248

$125.00

471

A4253

$75.00

472

A4281

$125.00

473

A4283

$125.00

474

A4300

$90.00

475

A4310

$125.00

476

A4314

$125.00

477

A4315

$90.00

478

A4322

$115.00

479

A4327

$125.00

480

A4332

$75.00

481

A4338

$115.00

482

A4352

$90.00

483

A4353

$125.00

484

A4358

$125.00

485

A4369

$125.00

486

A4402

$90.00

487

A4406

$90.00

488

A4450

$125.00

489

A4452

$125.00

490

A4458

$115.00

491

A4461

$125.00

492

A4465

$90.00

493

A4470

$75.00

494

A4550

$125.00

495

A4554

$75.00

496

A4556

$125.00

497

A4558

$115.00

498

A4562

$90.00

499

A4565

$125.00

500

A4566

$90.00

501

A4570

$375.00

502

A4580

$115.00

503

A4606

$125.00

504

A4613

$125.00

505

A4615

$125.00

506

A4616

$90.00

507

A4620

$125.00

508

A4628

$125.00

509

A4629

$75.00

510

A4635

$500.00

511

A4649

$125.00

512

A4653

$75.00

513

A4657

$125.00

514

A4670

$125.00

515

A4673

$125.00

516

A4750

$75.00

517

A4770

$125.00

518

A4927

$45.00

519

A4930

$45.00

520

A5112

$125.00

521

A5120

$125.00

522

A5126

$125.00

523

A6021

$115.00

524

A6196

$125.00

525

A6203

$125.00

526

A6208

$125.00

527

A6209

$125.00

528

A6212

$90.00

529

A6216

$125.00

530

A6217

$125.00

531

A6218

$90.00

532

A6219

$90.00

533

A6220

$90.00

534

A6221

$75.00

535

A6222

$90.00

536

A6223

$75.00

537

A6224

$125.00

538

A6231

$125.00

539

A6233

$125.00

540

A6235

$75.00

541

A6238

$75.00

542

A6239

$90.00

543

A6246

$125.00

544

A6248

$125.00

545

A6250

$125.00

546

A6251

$125.00

547

A6252

$125.00

548

A6253

$125.00

549

A6254

$125.00

550

A6255

$90.00

551

A6257

$125.00

552

A6258

$125.00

553

A6266

$125.00

554

A6402

$125.00

555

A6403

$90.00

556

A6404

$125.00

557

A6407

$90.00

558

A6412

$75.00

559

A6413

$125.00

560

A6441

$90.00

561

A6442

$115.00

562

A6445

$125.00

563

A6446

$125.00

564

A6447

$75.00

565

A6448

$125.00

566

A6449

$115.00

567

A6450

$90.00

568

A6453

$125.00

569

A6454

$90.00

570

A6455

$125.00

571

A6456

$125.00

572

A6457

$125.00

573

A6530

$75.00

574

A6545

$90.00

575

A7000

$125.00

576

A7001

$125.00

577

A7002

$125.00

578

A7003

$125.00

579

A7004

$125.00

580

A7005

$125.00

581

A7006

$75.00

582

A7015

$90.00

583

A7030

$90.00

584

A7031

$125.00

585

A7046

$125.00

586

A7047

$125.00

587

A9150

$75.00

588

A9270

$90.00

589

A9273

$125.00

590

A9281

$125.00

591

B4082

$250.00

592

C1722

$2,150.00

593

C1751

$2,120.00

594

C1781

$1,541.00

595

C2618

$340.00

596

C9285

$85.00

597

E0110

$699.75

598

E0114

$795.80

599

E0116

$599.75

600

E0168

$380.00

601

E0240

$115.00

602

E0275

$230.00

603

E0325

$145.00

604

E0326

$145.00

605

E0487

$350.00

606

E0570

$910.00

607

E0607

$570.00

608

E0625

$455.00

609

G0168

$380.00

610

G0378

$2,520.00

611

G0402

$2,100.00

612

G6058

$570.00

613

G8598

$60.00

614

G8601

$1,135.00

615

G8602

$1,135.00

616

J0120

$190.00

617

J0129

$190.00

618

J0131

$30.00

619

J0153

$115.00

620

J0171

$190.00

621

J0282

$115.00

622

J0290

$50.00

623

J0360

$190.00

624

J0456

$190.00

625

J0461

$60.00

626

J0500

$225.85

627

J0561

$190.00

628

J0610

$30.00

629

J0690

$190.00

630

J0696

$190.00

631

J0697

$115.00

632

J0735

$115.00

633

J0744

$190.00

634

J1020

$90.00

635

J1030

$100.00

636

J1040

$100.00

637

J1100

$20.00

638

J1170

$190.00

639

J1200

$50.00

640

J1550

$30.00

641

J1610

$491.00

642

J1631

$315.00

643

J1642

$29.00

644

J1644

$190.00

645

J1650

$142.00

646

J1741

$115.00

647

J1810

$115.00

648

J1815

$50.00

649

J1817

$115.00

650

J1885

$95.00

651

J1930

$290.53

652

J1940

$165.00

653

J1956

$190.00

654

J2001

$129.00

655

J2060

$190.00

656

J2175

$115.00

657

J2250

$190.00

658

J2270

$190.00

659

J2274

$190.00

660

J2360

$190.00

661

J2405

$20.00

662

J2410

$115.00

663

J2425

$115.00

664

J2504

$115.00

665

J2543

$190.00

666

J2550

$144.00

667

J2704

$115.00

668

J2765

$190.00

669

J2780

$115.00

670

J2800

$385.00

671

J2920

$137.50

672

J2930

$190.00

673

J3010

$190.00

674

J3030

$315.00

675

J3260

$440.00

676

J3301

$50.00

677

J3360

$153.00

678

J3370

$190.00

679

J3430

$299.00

680

J3475

$115.00

681

J3480

$125.00

682

J3490

$30.00

683

J7030

$246.40

684

J7040

$221.00

685

J7042

$260.40

686

J7050

$250.00

687

J7060

$250.00

688

J7070

$115.00

689

J7120

$250.00

690

J7121

$250.00

691

J7131

$115.00

692

J7192

$115.00

693

J7313

$115.00

694

J7510

$10.00

695

J7611

$190.00

696

J7613

$190.00

697

J7614

$190.00

698

J7615

$190.00

699

J7620

$190.00

700

J7631

$115.00

701

J7637

$115.00

702

J7644

$190.00

703

J7682

$115.00

704

J7699

$115.00

705

J8498

$115.00

706

J8499

$115.00

707

J9206

$115.00

708

L0112

$1,135.00

709

L0120

$645.00

710

L0150

$150.00

711

L0172

$150.00

712

L0174

$1,260.00

713

L1810

$1,560.00

714

L1830

$529.50

715

L1902

$65.00

716

L2360

$469.75

717

L3031

$575.00

718

L3201

$425.00

719

L3209

$425.00

720

L3250

$575.00

721

L3260

$650.00

722

L3310

$415.00

723

L3500

$390.00

724

L3540

$575.00

725

L3650

$125.00

726

L3660

$575.00

727

L3670

$672.50

728

L3720

$975.00

729

L3807

$500.00

730

L3808

$1,890.00

731

L3809

$1,890.00

732

L3905

$1,890.00

733

L3906

$1,890.00

734

L3908

$195.00

735

L4350

$265.00

736

L4360

$275.00

737

L4361

$275.00

738

L4386

$275.00

739

L4387

$275.00

740

L4398

$153.00

741

L4631

$275.00

742

P9612

$115.00

743

Q0144

$570.00

744

Q0169

$115.00

745

Q4001

$1,010.00

746

Q4006

$1,010.00

747

Q4018

$340.00

748

Q4019

$800.00

749

Q4020

$680.00

750

Q4021

$735.00

751

Q4022

$570.00

752

Q4023

$570.00

753

Q4024

$570.00

754

Q4042

$1,010.00

755

Q4046

$1,010.00

756

Q4049

$112.50

757

Q9962

$570.00

758

Q9963

$230.00

759

Q9967

$15.00

760

S0020

$175.00

761

S0028

$125.00

762

S0030

$125.00

763

S0077

$125.00

764

S0164

$125.00

765

S0630

$340.00

766

S1015

$75.00

767

S8100

$125.00

768

S8101

$125.00

769

S8430

$75.00

770

S8431

$95.00

771

S8451

$125.00

772

U0001

$250.00

total point emergency room logo