Standard Charge Information Augusta
Service Charge Description Code CDM 3/1/2023 Rate
- Room & Board 11100001 HC R&B - PRIVATE $853
- Room & Board 11900001 HC R&B - SWING BED PRIVATE $662
- Room & Board 20600001 HC R&B - TELEMETRY $1,430
- Room & Board 12100001 HC R&B - SEMIPRIVATE $853
- Room & Board 17000001 HC R&B - WELL BABY $648
- Room & Board 17100001 HC R&B - NURSERY LVL 1 $978
- Room & Board 17200001 HC R&B - NURSERY LVL 2 $1,317
- Room & Board 17300001 HC R&B - NURSERY LVL 3 $1,761
- Room & Board 17400001 HC R&B - NURSERY LVL 4 $2,389
- Room & Board 20000001 HC R&B - ICU $2,314
- Room & Board 21000001 HC R&B - CCU $2,389
- Room & Board 21400001 HC R&B - PCU $1,910
- Supplements 25000042 HC ENSURE CLEAR $7
- Supplements 25000043 HC ENSURE ENLIVE $4
- Supplements 25000044 HC ENSURE COMPACT $1
- Supplements 25000045 HC JEVITY 1.5-LITER $7
- Supplements 25000046 HC JEVITY 1.5-CAN $4
- Supplements 25000047 HC SUPLENA (CANS) $4
- Supplements 25000048 HC GELATEIN 20 $5
- Supplements 25000003 HC NEPRO (CANS) $4
- Supplements 25000004 HC PULMOCARE/CAN $7
- Supplements 25000005 HC GLUCERNA 1.5 CAN $4
- Supplements 25000007 HC GLUCERNA 1.5 LITER $14
- Supplements 25000008 HC PULMOCARE/LITER $31
- Supplements 25000010 HC GREAT SHAKES $1
- Supplements 25000011 HC JEVITY 1.2-LITER $7
- Supplements 25000012 HC JEVITY 1.2-CAN $7
- Supplements 25000014 HC NUTRIHEP-TF (CANS) $22
- Supplements 25000015 HC GLUCERNA SHAKES (CANS) $4
- Supplements 25000018 HC NEPRO (LITER) $11
- Supplements 25000021 HC ENTERAL SUPPLEMENT (OLD NAME JUVEN) $8
- Supplements 25000022 HC MCT OIL TABLESPOON $5
- Supplements 25000023 HC OSMOLITE 1 CAL 8 OZ CAN $4
- Supplements 25000024 HC OSMOLITE 1 CAL LITER $7
- Supplements 25000026 HC POLYCOSE 1 TABLESPOON $4
- Supplements 25000028 HC TWOCAL HN 8 OZ CAN $4
- Supplements 25000029 HC TWOCAL HN LITER $5
- Supplements 25000030 HC JUICE NUTRITIONAL 206 $14
- Supplements 25000031 HC FIBERBASICS $5
- Supplements 25000033 HC ENSURE PLUS $4
- Supplements 25000034 HC MAGIC CUPS MEAL REPLACEMENT $5
- Supplements 25000036 HC PROSOURCE PLUS LIQUID PROTEIN $7
- Supplements 25000037 HC BODY QUEST PROTEIN SUPPLEMENT $5
- Supplements 25000038 HC NUTRITIONAL SUPP VITAL 1.2 CAN $12
- Supplements 25000039 HC NUTRITIONAL SUPP VITAL 1.2 LTR $36
- Supplements 25000041 HC ENSURE (CANS) $4
- Supplements 25000049 HC CORE POWER ELITE HI PROT MILKSHAKE $7
- Supplements 25000050 HC ENSURE CLEAR NUTRITION DRINK (PRE-SURGERY) $4
- Supplements 25000051 HC VITAL HIGH PROTEIN CAN $12
- Supplements 25000052 HC VITAL HIGH PROTEIN LTR $36
- Supplements 25000053 HC PREMIER PROTEIN BOTTLE (SUMMERVILLE ONLY) $7
- Supplements 25000054 HC ENSURE SURGERY : IMMUNONUTRITION SHAKE $3
- Supplements 25000055 HC ENSURE MAX PROTEIN (SUMMERVILLE ONLY) $7
- Radiopharm Drugs 25500001 HC RADIONUCLIDE SESTAMIBI $495
- Radiopharm Drugs 25500003 HC RADIONUCLIDE TETROFOSMIN $560
- Radiopharm Drugs 25500004 HC RADIONUCLIDE THALLIUM $643
- Radiopharm Drugs 25500005 HC RADIONUCLIDE PROSTASCINT $7,551
- Radiopharm Drugs 25500006 HC RADIONUCLIDE NEOTECT $4,510
- Radiopharm Drugs 25500007 HC RADIONUCLIDE CHOLETEC $217
- Radiopharm Drugs 25500008 HC RADIONUCLIDE ALBUMIN MAA $324
- Radiopharm Drugs 25500009 HC RADIONUCLIDE TC99M SULFUR COLL $324
- Radiopharm Drugs 25500010 HC RADIONUCLIDE INDIUM III OXINE $4,162
- Radiopharm Drugs 25500011 HC RADIONUCLIDE INDIUM 111 DPTA $2,900
- Radiopharm Drugs 25500012 HC RADIONUCLIDE FDG/DOSE 4-40 MCI $1,385
- Radiopharm Drugs 25500013 HC RADIONUCLIDE RCM/CR 51 $1,685
- Radiopharm Drugs 25500014 HC RADIONUCLIDE PV/I 125 $799
- Radiopharm Drugs 25500015 HC RADIONUCLIDE GALLIUM $495
- Radiopharm Drugs 25500016 HC RADIONUCLIDE TC99M LABELED RBC $392
- Radiopharm Drugs 25500017 HC RADIONUCLIDE RENAL MAG 3 $598
- Radiopharm Drugs 25500018 HC RADIONUCLIDE TC99 / NEUTROSPEC $3,983
- Radiopharm Drugs 25500019 HC RADIONUCLIDE TC HMPAO $2,568
- Radiopharm Drugs 25500020 HC RADIONUCLIDE IN 111 OCTREOTIDE $8,735
- Radiopharm Drugs 25500023 HC RADIONUCLIDE SESTAMIBI $495
- Radiopharm Drugs 25500024 HC RADIONUCLIDE TC99M TETROFOSMIN $560
- Radiopharm Drugs 25500025 HC RADIONUCLIDE THALLIUM $643
- Radiopharm Drugs 25500026 HC RADIONUCLIDE TC99M ULTRATAG LABELED RBC $392
- Radiopharm Drugs 25500027 HC RADIONUCLIDE TC99M PENTETATE =< 25 MCI $217
- Radiopharm Drugs 25500028 HC RADIONUCLIDE I131 PER 1 UCI TO 100 UCI $217
- Radiopharm Drugs 25500029 HC RADIONUCLIDE IODINE I-131 IODIDE CAP DX PER 1 MCI $217
- Radiopharm Drugs 25500036 HC RADIONUCLIDE TC99M ULTRATAG LABELED RBC $392
- Radiopharm Drugs 25500039 HC RADIONUCLIDE TC99M PYROPHOSPHATE =<25 MCI $473
- IV Therapy 26000026 HC HYDRATION INFUSION EACH ADDL HOUR $95
- IV Therapy 26000027 HC THERAP INFUSION INITIAL HOUR $437
- IV Therapy 26000028 HC THERAP INFUSION EACH ADDL HOUR $95
- IV Therapy 26000029 HC INFUSION ADDL SEQUENTIAL HOUR $95
- IV Therapy 26000030 HC TX/PRO/DX INJ SAME DRUG ADDON $255
- IV Therapy 26000031 HC THER/DIAG CONCURRENT INF $95
- IV Therapy 26000034 HC THER/DIAG CONCURRENT INF - ER $95
- IV Therapy 26000035 HC TX/PRO/DX INJ SAME DRUG ADDON - ER $255
- IV Therapy 26000001 HC PICC LINE INSERTION $2,835
- IV Therapy 26000002 HC PICC LINE REPLACEMENT $2,835
- IV Therapy 26000003 HC DECLOT VASCULAR DEVICE $540
- IV Therapy 26000005 HC REFILL IMPLANT PUMP/RESERVOIR $356
- IV Therapy 26000006 HC HYDRATION INFUSION INITIAL HOUR $437
- IV Therapy 26000007 HC HYDRATION INFUSION EACH ADDL HOUR $95
- IV Therapy 26000008 HC INFUSION INITIAL HOUR $437
- IV Therapy 26000009 HC INFUSION EACH ADDL HOUR $95
- IV Therapy 26000010 HC INFUSION ADDL SEQUENTIAL HOUR $109
- IV Therapy 26000011 HC IV TX- INITIATION IV ACCESS $85
- IV Therapy 26000012 HC MIDLINE CATHETER INSERTION $159
- IV Therapy 26000013 HC IVAD ACCESS $65
- IV Therapy 26000014 HC THER/DIAG CONCURRENT INF $95
- IV Therapy 26000015 HC TX/PRO/DX INJ SAME DRUG ADDON $255
- IV Therapy 26000016 HC IV TX- INITIATION IV ACCESS $85
- IV Therapy 26000017 HC MIDLINE CATHETER INSERTION $159
- IV Therapy 26000022 HC DECLOT VASCULAR DEVICE $340
- IV Therapy 26000023 HC IVAD ACCESS $65
- IV Therapy 26000024 HC DECLOT VASCULAR DEVICE $340
- IV Therapy 26000025 HC HYDRATION INFUSION INITIAL HOUR $437
- Laboratory 30000058 HC LBA COLLECTION FEE (UHMC) $109
- Laboratory 30000001 HC VENIPUNCTURE ROUTINE $24
- Laboratory 30000052 HC BLOOD COLLECTION FROM PORT $198
- Laboratory 30000053 HC COLLECT BLOOD FROM PICC $93
- Laboratory 30000078 HC COV-19 AMP PRB HGH THRUPUT WITHIN 2 DAYS COLLECT $34
- Laboratory 30100001 HC ALCOHOL BREATH TEST INITIAL $138
- Laboratory 30200129 HC TB INTRADERMAL TEST $31
- Diagnostic Radiology Imaging 32000407 HC SCOLIOSIS/THORACOLUMBAR STAND 2-3 VIEWS $630
- Diagnostic Radiology Imaging 32000408 HC SCOLIOSIS/THORACOLUMBAR STAND 4-5 VIEWS $738
- Diagnostic Radiology Imaging 32000409 HC SCOLIOSIS/THORACOLUMBAR MIN 6 VIEWS (INCL. SUPINE & STAND) $846
- Diagnostic Radiology Imaging 32000410 HC HIP UNILAT W PELVIS MINIMUM 4 VIEWS $628
- Diagnostic Radiology Imaging 32000413 HC FEMUR AP/LATERAL MIN 2 VIEWS $509
- Diagnostic Radiology Imaging 32000414 HC GASTRIC EMPTYING IMAG STDY W SM BOWEL TRANSIT $598
- Diagnostic Radiology Imaging 32000415 HC GASTRIC EMPTYING IMAG STDY W SM BOWEL & COLON TRANSIT $792
- Diagnostic Radiology Imaging 32000420 HC PELVIS / HIPS,INFANT MIN 5 VIEWS BILAT $756
- Diagnostic Radiology Imaging 36000732 HC MYELOGRAPHY VIA LUMBAR INJ, CERVICAL $2,790
- Diagnostic Radiology Imaging 32000001 HC CISTERNOGRAPHY $963
- Diagnostic Radiology Imaging 32000002 HC EYE FOREIGN BODY DETECTION $963
- Diagnostic Radiology Imaging 32000003 HC MANDIBLE < 4 VIEWS $335
- Diagnostic Radiology Imaging 32000004 HC MANDIBLE MINIMUM 4 VIEWS $414
- Diagnostic Radiology Imaging 32000005 HC MASTOIDS COMPLETE $522
- Diagnostic Radiology Imaging 32000006 HC INTERNAL AUDITORY CANAL $522
- Diagnostic Radiology Imaging 32000007 HC FACIAL BONES < THREE VIEWS $329
- Diagnostic Radiology Imaging 32000008 HC FACIAL BONES, MINIMUM 3 VIEWS $695
- Diagnostic Radiology Imaging 32000009 HC NASAL BONES MINIMUM 3 VIEWS $323
- Diagnostic Radiology Imaging 32000010 HC OPTIC FORAMINA $454
- Diagnostic Radiology Imaging 32000011 HC ORBITS MINIMUM 4 VIEWS $489
- Diagnostic Radiology Imaging 32000012 HC SINUSES <3 VIEWS $529
- Diagnostic Radiology Imaging 32000013 HC SINUSES MINIMUM 3 VIEWS $695
- Diagnostic Radiology Imaging 32000014 HC SELLA TURCIA $377
- Diagnostic Radiology Imaging 32000015 HC SKULL LESS THAN FOUR VIEWS $529
- Diagnostic Radiology Imaging 32000016 HC SKULLS MINIMUM 4 VIEWS $695
- Diagnostic Radiology Imaging 32000017 HC TEMPEROMANDIBULAR JOINTS $522
- Diagnostic Radiology Imaging 32000018 HC PANOREX/ORTHOPANTOGRAM $197
- Diagnostic Radiology Imaging 32000019 HC NECK FOR SOFT TISSUE $273
- Diagnostic Radiology Imaging 32000020 HC PHARYNX AND LARYNX W FLUORO $427
- Diagnostic Radiology Imaging 32000022 HC PORTABLE CHEST FRONTAL SINGLE VIEW $325
- Diagnostic Radiology Imaging 32000023 HC XRAY EXAM CHEST 2 VIEWS $329
- Diagnostic Radiology Imaging 32000024 HC XRAY EXAM CHEST 3 VIEWS $439
- Diagnostic Radiology Imaging 32000026 HC CHEST 2 VIEWS W/FLUORO $520
- Diagnostic Radiology Imaging 32000027 HC XRAY CHEST 4+ VIEWS $481
- Diagnostic Radiology Imaging 32000028 HC CHEST 4 OR MORE VIEWS W/FLUORO $605
- Diagnostic Radiology Imaging 32000031 HC RIBS-UNILATERAL $431
- Diagnostic Radiology Imaging 32000032 HC RIBS-UNI W PA CHEST $608
- Diagnostic Radiology Imaging 32000033 HC RIBS-BILATERAL $431
- Diagnostic Radiology Imaging 32000034 HC RIBS-BIL W PA CHEST $791
- Diagnostic Radiology Imaging 32000035 HC STERNUM MINIMUM 2 VIEWS $394
- Diagnostic Radiology Imaging 32000036 HC STERNOCLAVICULAR JOINTS 3 VIEW $466
- Diagnostic Radiology Imaging 32000037 HC SPINE ENTIRE AP/LAT $779
- Diagnostic Radiology Imaging 32000038 HC CERVICAL SPINE,SINGLE VIEW $333
- Diagnostic Radiology Imaging 32000039 HC SPINE SINGLE VIEW $369
- Diagnostic Radiology Imaging 32000040 HC CERVICAL SPINE 2-3 VIEWS $435
- Diagnostic Radiology Imaging 32000041 HC CERVICAL SPINE,MINIMUM 4 VIEWS $609
- Diagnostic Radiology Imaging 32000042 HC CERVICAL SPINE WITH FLEX/EXTEN $745
- Diagnostic Radiology Imaging 32000043 HC SCOLIOSIS/THORACOLUMBAR 1 VIEW (INCL SUPINE & STAND) $522
- Diagnostic Radiology Imaging 32000044 HC THORACIC SPINE AP AND LAT $576
- Diagnostic Radiology Imaging 32000045 HC THORACOLUMBAR AP / LATERAL $576
- Diagnostic Radiology Imaging 32000046 HC SCOLIOSIS SERIES SUPINE/ERECT $922
- Diagnostic Radiology Imaging 32000047 HC LUMBAR SPINE AP / LATERAL $570
- Diagnostic Radiology Imaging 32000048 HC LUMBAR SPINE COMPLETE W OBL $791
- Diagnostic Radiology Imaging 32000049 HC LUMBAR SPINE COMPLETE W BENDIN $922
- Diagnostic Radiology Imaging 32000050 HC LUMBAR BENDING ONLY, MINIMUM 4 $576
- Diagnostic Radiology Imaging 32000051 HC PELVIS AP $398
- Diagnostic Radiology Imaging 32000052 HC PELVIS MINIMUM 3 VIEWS $691
- Diagnostic Radiology Imaging 32000053 HC SACRO-ILIAC JOINTS 3 VIEWS $454
- Diagnostic Radiology Imaging 32000054 HC SACRUM OR COCCYX 2 VIEWS $454
- Diagnostic Radiology Imaging 32000060 HC PERQ VERTEBROPLASTY, CERVICOTHORACIC $4,626
- Diagnostic Radiology Imaging 32000061 HC DISCOGRAPHY, LUMBAR $3,077
- Diagnostic Radiology Imaging 32000062 HC CLAVICLE COMPLETE $475
- Diagnostic Radiology Imaging 32000063 HC CLAVICLE, BILATERAL $930
- Diagnostic Radiology Imaging 32000064 HC SCAPULA COMPLETE $394
- Diagnostic Radiology Imaging 32000065 HC SCAPULA, BILATERAL $892
- Diagnostic Radiology Imaging 32000066 HC SHOULDER ONE VIEW $333
- Diagnostic Radiology Imaging 32000067 HC SHOULDER, ONE VIEW BILATERAL $655
- Diagnostic Radiology Imaging 32000068 HC SHOULDER 2 VIEWS $479
- Diagnostic Radiology Imaging 32000069 HC SHOULDER TWO VIEWS, BILATERAL $941
- Diagnostic Radiology Imaging 32000070 HC ACROMIO-CLAVICULAR JOINTS $424
- Diagnostic Radiology Imaging 32000071 HC HUMERUS MINIMUM 2 VIEWS $369
- Diagnostic Radiology Imaging 32000072 HC HUMERUS, BILATERAL $720
- Diagnostic Radiology Imaging 32000073 HC ELBOW AP / LATERAL $333
- Diagnostic Radiology Imaging 32000074 HC ELBOW, TWO VIEWS BILATERAL $655
- Diagnostic Radiology Imaging 32000075 HC ELBOW,MINIMUM 3 VIEWS $369
- Diagnostic Radiology Imaging 32000076 HC ELBOW, THREE VIEWS BILATERAL $720
- Diagnostic Radiology Imaging 32000077 HC FOREARM AP / LATERAL $369
- Diagnostic Radiology Imaging 32000078 HC FOREARM, BILATERAL $720
- Diagnostic Radiology Imaging 32000079 HC UPPER EXTREMITY INFANT $333
- Diagnostic Radiology Imaging 32000080 HC UPPER EXTREMITY INFANT BILATERAL $655
- Diagnostic Radiology Imaging 32000081 HC WRIST MINIMUM 2 VIEWS $333
- Diagnostic Radiology Imaging 32000082 HC WRIST TWO VIEWS, BILATERAL $655
- Diagnostic Radiology Imaging 32000083 HC WRIST MINIMUM 3 VIEWS $369
- Diagnostic Radiology Imaging 32000084 HC WRIST, THREE VIEWS BILATERAL $720
- Diagnostic Radiology Imaging 32000085 HC HAND 2 VIEWS $333
- Diagnostic Radiology Imaging 32000086 HC HAND, TWO VIEW BILATERAL $655
- Diagnostic Radiology Imaging 32000087 HC HAND MINIMUM 3 VIEWS $369
- Diagnostic Radiology Imaging 32000088 HC HAND, THREE VIEW BILATERAL $720
- Diagnostic Radiology Imaging 32000089 HC FINGER(S) MINIMUM 2 VIEWS $316
- Diagnostic Radiology Imaging 32000090 HC HIP UNILATERAL 1 VIEW $398
- Diagnostic Radiology Imaging 32000091 HC HIP UNILAT COMPLETE MIN 2 VIEWS $513
- Diagnostic Radiology Imaging 32000092 HC HIPS BILAT & PELVIS MIN 2 VIEWS $564
- Diagnostic Radiology Imaging 32000093 HC PELVIS AND BILAT HIPS 2 VIEWS $691
- Diagnostic Radiology Imaging 32000094 HC ARTHROGRAM HIP $911
- Diagnostic Radiology Imaging 32000095 HC HIP 1 VIEW/OR $513
- Diagnostic Radiology Imaging 32000096 HC PELVIS / HIPS,INFANT MIN 2 VIEWS BILAT $369
- Diagnostic Radiology Imaging 32000098 HC FEMUR AP / LATERAL 1 VIEW $394
- Diagnostic Radiology Imaging 32000099 HC FEMUR, BILATERAL 2 or > VIEWS $767
- Diagnostic Radiology Imaging 32000100 HC XRAY KNEE 1 OR 2 VIEWS $369
- Diagnostic Radiology Imaging 32000101 HC XRAY KNEE 1 OR 2 VIEWS $720
- Diagnostic Radiology Imaging 32000102 HC KNEE MINIMUM 3 VIEWS $433
- Diagnostic Radiology Imaging 32000103 HC KNEE, THREE VIEWS BILATERAL $853
- Diagnostic Radiology Imaging 32000104 HC KNEE TUNNEL/PATELLAR/STANDING $433
- Diagnostic Radiology Imaging 32000105 HC KNEE COMPLETE W/MULTI VIEWS $502
- Diagnostic Radiology Imaging 32000106 HC KNEE, MULTI VIEW BILATERAL $977
- Diagnostic Radiology Imaging 32000107 HC KNEES STANDING AP $369
- Diagnostic Radiology Imaging 32000108 HC TIBIA/FIBULA AP / LATERAL $369
- Diagnostic Radiology Imaging 32000109 HC TIBIA/FIBULA, BILATERAL $720
- Diagnostic Radiology Imaging 32000110 HC LOWER EXTREMITY,INFANT 2V $333
- Diagnostic Radiology Imaging 32000111 HC LOWER EXTREMITY,INFANT 2V BILATERAL $655
- Diagnostic Radiology Imaging 32000112 HC ANKLE 2 VIEWS $333
- Diagnostic Radiology Imaging 32000113 HC ANKLE, TWO VIEWS BILATERAL $655
- Diagnostic Radiology Imaging 32000114 HC ANKLE 3 VIEWS $369
- Diagnostic Radiology Imaging 32000115 HC ANKLE, THREE VIEWS BILATERAL $720
- Diagnostic Radiology Imaging 32000116 HC FOOT 2 VIEWS $333
- Diagnostic Radiology Imaging 32000117 HC FOOT, TWO VIEWS BILATERAL $655
- Diagnostic Radiology Imaging 32000118 HC FOOT MINIMUM 3 VIEWS $369
- Diagnostic Radiology Imaging 32000119 HC FOOT, THREE VIEWS BILATERAL $720
- Diagnostic Radiology Imaging 32000120 HC CALCANEOUS/OS CAL.MIN.2 VIEW $333
- Diagnostic Radiology Imaging 32000121 HC CALCANEOUS/OS CALCIS BILATERAL $655
- Diagnostic Radiology Imaging 32000122 HC TOES MINIMUM 2 VIEWS $344
- Diagnostic Radiology Imaging 32000123 HC TOES, BILATERAL $655
- Diagnostic Radiology Imaging 32000124 HC XRAY EXAM ABDOMEN 1 VIEW $273
- Diagnostic Radiology Imaging 32000126 HC XRAY ABDOMEN 2 VIEWS $495
- Diagnostic Radiology Imaging 32000127 HC XRAY ABDOMEN 3+ VIEWS $520
- Diagnostic Radiology Imaging 32000128 HC ABDOMEN SERIES W PA CHEST $748
- Diagnostic Radiology Imaging 32000129 HC ESOPHAGUS,BARIUM SWALLOW $648
- Diagnostic Radiology Imaging 32000130 HC XRAY XM UPR GI TRC 1CNTRST $1,519
- Diagnostic Radiology Imaging 32000131 HC XRAY SM INTEST F-THRU STUDY $1,137
- Diagnostic Radiology Imaging 32000132 HC XRAY XM UPR GI TRC 2CNTRST $1,137
- Diagnostic Radiology Imaging 32000134 HC SMALL BOWEL SERIES $707
- Diagnostic Radiology Imaging 32000135 HC SMALL BOWEL SERIES ENTEROCLYSIS $1,494
- Diagnostic Radiology Imaging 32000136 HC COLON,BARIUM ENEMA $1,139
- Diagnostic Radiology Imaging 32000137 HC COLON,BARIUM AIR CONTRAST $1,305
- Diagnostic Radiology Imaging 32000138 HC THERAPEUTIC ENEMA $1,231
- Diagnostic Radiology Imaging 32000139 HC GALLBLADDER SERIES $555
- Diagnostic Radiology Imaging 32000141 HC OR CHOLANGIOGRAM $285
- Diagnostic Radiology Imaging 32000142 HC OR CHOLANGIOGRAM ADDTNL SET $285
- Diagnostic Radiology Imaging 32000145 HC BILIARY STONE RETREIVAL OR REMOVAL $533
- Diagnostic Radiology Imaging 32000146 HC ERCP/BILIARY $822
- Diagnostic Radiology Imaging 32000146 HC ERCP BILIARY (REDUCED SVC) $822
- Diagnostic Radiology Imaging 32000147 HC ERCP/PANCREATIC $822
- Diagnostic Radiology Imaging 32000147 HC ERCP PANCREATIC (REDUCED SVC) $822
- Diagnostic Radiology Imaging 32000148 HC ERCP/BILIARY / PANCREATIC $822
- Diagnostic Radiology Imaging 32000148 HC ERCP BILIARY/PANCR REDUCED SVC $822
- Diagnostic Radiology Imaging 32000149 HC GI TUBE PLACEMENT WITH FLUOROSCOPY $555
- Diagnostic Radiology Imaging 32000150 HC PERC PLACEMENT ENTEROCLYSIS TUBE $571
- Diagnostic Radiology Imaging 32000151 HC ESOPHAGEAL DILATION $822
- Diagnostic Radiology Imaging 32000152 HC ARTHROGRAM TMJ $564
- Diagnostic Radiology Imaging 32000153 HC TRANSHEPATIC DUCT DILATION $910
- Diagnostic Radiology Imaging 32000154 HC INTRAVENOUS PYELOGRAM $868
- Diagnostic Radiology Imaging 32000155 HC RETRO PYELOGRAM UNILATERAL $702
- Diagnostic Radiology Imaging 32000156 HC UROGRAPHY, ANTEGRADE $431
- Diagnostic Radiology Imaging 32000157 HC VASOGRAM/OR $471
- Diagnostic Radiology Imaging 32000158 HC CYSTOGRAM/RETROGRADE URETHROGRAM $589
- Diagnostic Radiology Imaging 32000159 HC RENAL CYST STUDY TRANSLUMBAR $571
- Diagnostic Radiology Imaging 32000161 HC PELVIMETRY $427
- Diagnostic Radiology Imaging 32000162 HC VAGINOGRAM/PERINEOGRAM $512
- Diagnostic Radiology Imaging 32000163 HC THORACIC AORTOGRAM WO SERIALOGRAPHY $3,729
- Diagnostic Radiology Imaging 32000164 HC THORACIC AORTOGRAM $3,729
- Diagnostic Radiology Imaging 32000165 HC ABDOMINAL AORTOGRAM $3,729
- Diagnostic Radiology Imaging 32000166 HC ABDOMINAL ART W/FEMORAL RUNOFF $3,729
- Diagnostic Radiology Imaging 32000176 HC SELECTIVE SPINAL ANGIOGRAM $3,599
- Diagnostic Radiology Imaging 32000177 HC EXTREMITY ANGIOGRAM UNILATERAL $3,765
- Diagnostic Radiology Imaging 32000178 HC ARTERIOGRAM EXTREMITIES BILAT $3,599
- Diagnostic Radiology Imaging 32000181 HC VISCERAL SELECTIVE SINGLE VES. $3,599
- Diagnostic Radiology Imaging 32000182 HC ADRENAL SELECTIVE UNILATERAL $3,599
- Diagnostic Radiology Imaging 32000183 HC ADRENAL SELECTIVE BILATERAL $3,599
- Diagnostic Radiology Imaging 32000184 HC PELVIC ANGIOGRAM $3,599
- Diagnostic Radiology Imaging 32000185 HC PULMONARY ANGIOGRAM UNILATERAL $3,729
- Diagnostic Radiology Imaging 32000186 HC PULMONARY ANGIOGRAM BILATERAL $3,729
- Diagnostic Radiology Imaging 32000187 HC ANGIOGRAPHY PULM NON-SELECTIVE $2,206
- Diagnostic Radiology Imaging 32000188 HC INTERNAL MAMMARY ANGIOGRAM $2,537
- Diagnostic Radiology Imaging 32000189 HC ANGIO SELECTIVE ADDITIONAL VESSEL $2,241
- Diagnostic Radiology Imaging 32000190 HC ANGIOGRAPHY, AV SHUNT $1,798
