hospital_name,last_updated_on,version,hospital_location,hospital_address,license_number|LA,"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.",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
Lake Charles Memorial Hospital,7/1/2024,2.0.0,Lake Charles Memorial Hospital|Lake Charles Memorial Hospital for Women,"1701 Oak Park Boulevard Lake Charles, LA 70601|1900 W. Gauthier Rd. Lake Charles. LA 70605",720551963,TRUE,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
SERVICE DESCRIPTION,CATEGORY,BILLING MSDRG | CPT | HCPCS,ITEM/SERVICE DESCRIPTION,BILLING REVENUE CODE,GROSS CHARGES,AETNA PLAN,AETNA REIMBURSEMENT METHOD,AETNA MEDICAID PLAN,AETNA MEDICAID REIMBURSEMENT METHOD,AETNA MEDICARE HMO PLAN,AETNA MEDICARE HMO REIMBURSEMENT METHOD,BCBS MEDICARE ADVANTAGE PLAN,BCBS MEDICARE ADVANTAGE REIMBURSEMENT METHOD,BLUE CROSS BLUE SHIELD LA PLAN,BLUE CROSS BLUE SHIELD LA REIMBURSEMENT METHOD,CIGNA PLAN,CIGNA REIMBURSEMENT METHOD,CIGNA BEHAVIORAL HEALTH PLAN,CIGNA BEHAVIORAL HEALTH REIMBURSEMENT METHOD,COUSHATTA TRIBE DEPT OF HEALTH PLAN,COUSHATTA TRIBE DEPT OF HEALTH REIMBURSEMENT METHOD,FIRST HEALTH PLAN,FIRST HEALTH REIMBURSEMENT METHOD,HUMANA PLAN,HUMANA REIMBURSEMENT METHOD,HUMANA MEDICARE PLAN,HUMANA MEDICARE REIMBURSEMENT METHOD,LWCC PLAN,LWCC REIMBURSEMENT METHOD,MEDICAID PLAN,MEDICAID REIMBURSEMENT METHOD,MEDICAID ADVANTAGE PLAN,MEDICAID ADVANTAGE REIMBURSEMENT METHOD,MEDICARE PLAN,MEDICARE REIMBURSEMENT METHOD,MEDICARE ADVANTAGE PLAN,MEDICARE ADVANTAGE REIMBURSEMENT METHOD,MERITAIN PLAN,MERITAIN REIMBURSEMENT METHOD,PHCS PLAN,PHCS REIMBURSEMENT METHOD,PPO PLUS  PLAN,PPO PLUS  REIMBURSEMENT METHOD,TRICARE PLAN,TRICARE REIMBURSEMENT METHOD,UNITED HEALTHCARE PLAN,UNITED HEALTHCARE REIMBURSEMENT METHOD,UNITED HEALTHCARE BEHAVORIAL HEALTH PLAN,UNITED HEALTHCARE BEHAVORIAL HEALTH REIMBURSEMENT METHOD,UNITED HEALTHCARE MEDICARE PLAN,UNITED HEALTHCARE MEDICARE REIMBURSEMENT METHOD,VANTAGE COMMERCIAL PLAN,VANTAGE COMMERCIAL REIMBURSEMENT METHOD,VERITY PLAN,VERITY REIMBURSEMENT METHOD,VETERANS CHOICE-TRIWEST PLAN,VETERANS CHOICE-TRIWEST REIMBURSEMENT METHOD,WORKERS COMPENSATION PLAN,WORKERS COMPENSATION REIMBURSEMENT METHOD,MEDICAID AMERIHEALTH CARITAS PLAN,REIMBURSEMENT METHOD,MEDICAID AMERIHEALTH PLAN,REIMBURSEMENT METHOD,MEDICAID UNITED HEALTHCARE PLAN,REIMBURSEMENT METHOD,MEDICAID LA HEALTHCARE CONNECT PLAN,REIMBURSEMENT METHOD,MEDICAID MAGELLAN PLAN,REIMBURSEMENT METHOD,MEDICAID TAKE CHARGE PLAN,REIMBURSEMENT METHOD,CHAMPUS VA PLAN,REIMBURSEMENT METHOD,CORRECT CARE MEDICARE ADVANTAGE PLAN,REIMBURSEMENT METHOD,CIGNA MEDICARE ACCESS PLAN,REIMBURSEMENT METHOD,VETERANS ADMINISTRATION PLAN,REIMBURSEMENT METHOD,STERLING HMO MEDICARE ADVANTAGE PLAN,REIMBURSEMENT METHOD,MEDICARE RAILROAD PLAN,REIMBURSEMENT METHOD,VANTAGE MEDICARE HMO PLAN,REIMBURSEMENT METHOD,WELLCARE MEDICARE ADVANTAGE PLAN,REIMBURSEMENT METHOD,De-Identified Minimum Negotiated Rate,De-Identified Maximum Negotiated Rate,DISCOUNTED CASH PRICE
Inpatient,Inpatient Cardiac,216,Cardiac valve and other major cardiothoracic procedures with cardiac catheterization with major complications or comorbidities,100,N/A,1000,100% of CMS IPPS rate,1211.29,100% of Medicaid Per Diem Rate,65448.7,100% of CMS IPPS rate,65448.7,100% of CMS IPPS rate,120321.01,100% of CMS IPPS rate,1300,100% of PER DIEM RATE,N/A,Not Applicable,124826.85,100% of CMS IPPS Rate,N/A,Not Applicable,124826.85,100% of CMS IPPS Rate,66801.9,102% of CMS IPPS Rate,1398.25,100% OF PER DIEM RATE,1211.29,100% of Medicaid Per Diem Rate,1211.29,100% of Medicaid Per Diem Rate,67660.21,100% of CMS IPPS Rate,65448.7,100% of CMS IPPS Rate,N/A,Not Applicable,2307,100% OF PER DIEM RATE,N/A,Not Applicable,67660.21,100% of CMS IPPS Rate,4273,Case rate,N/A,Not Applicable,65448.7,100% of CMS IPPS Rate,140001.49,215% of CMS IPPS Rate,78612.93,100% of CMS IPPS Rate,67660.21,100% of CMS IPPS Rate,1645,Case Rate,1211.29,100% of Medicaid Per Diem Rate,1211.29,100% of Medicaid Per Diem Rate,1211.29,100% of Medicaid Per Diem Rate,1211.29,100% of Medicaid Per Diem Rate,1211.29,100% of Medicaid Per Diem Rate,1211.29,100% of Medicaid Per Diem Rate,65448.7,100% of CMS IPPS Rate,65448.7,100% of CMS IPPS Rate,65448.7,100% of CMS IPPS Rate,65448.7,100% of CMS IPPS Rate,65448.7,100% of CMS IPPS Rate,65448.7,100% of CMS IPPS Rate,65448.7,100% of CMS IPPS Rate,65448.7,100% of CMS IPPS Rate,1000,140001.49,N/A
Inpatient,Inpatient Female Procedures,743,Uterine and adnexa procedures for non-malignancy,100,N/A,12935.38,100% of CMS IPPS rate,1211.29,100% of Medicaid Per Diem Rate,8717.48,100% of CMS IPPS rate,8717.48,100% of CMS IPPS rate,13576.61,100% of CMS IPPS rate,1300,100% of PER DIEM RATE,N/A,Not Applicable,14945.32,100% of CMS IPPS Rate,N/A,Not Applicable,14945.32,100% of CMS IPPS Rate,8897.13,102% of CMS IPPS Rate,1398.25,100% OF PER DIEM RATE,1211.29,100% of Medicaid Per Diem Rate,1211.29,100% of Medicaid Per Diem Rate,8982.26,100% of CMS IPPS Rate,8717.48,100% of CMS IPPS Rate,N/A,Not Applicable,1500,100% OF PER DIEM RATE,2752,100% OF PER DIEM RATE,8982.26,100% of CMS IPPS Rate,4273,Case rate,N/A,Not Applicable,8717.48,100% of CMS IPPS Rate,18657.19,215% of CMS IPPS Rate,9412.2,100% of CMS IPPS Rate,8982.26,100% of CMS IPPS Rate,1645,Case Rate,1211.29,100% of Medicaid Per Diem Rate,1211.29,100% of Medicaid Per Diem Rate,1211.29,100% of Medicaid Per Diem Rate,1211.29,100% of Medicaid Per Diem Rate,1211.29,100% of Medicaid Per Diem Rate,1211.29,100% of Medicaid Per Diem Rate,8717.48,100% of CMS IPPS Rate,8717.48,100% of CMS IPPS Rate,8717.48,100% of CMS IPPS Rate,8717.48,100% of CMS IPPS Rate,8717.48,100% of CMS IPPS Rate,8717.48,100% of CMS IPPS Rate,8717.48,100% of CMS IPPS Rate,8717.48,100% of CMS IPPS Rate,1211.29,18657.19,N/A
Inpatient,Inpatient Joint Procedures,470,Major joint replacement or reattachment of lower extremity,100,N/A,1000,100% of CMS IPPS rate,1211.29,100% of Medicaid Per Diem Rate,13496.6,100% of CMS IPPS rate,13496.6,100% of CMS IPPS rate,22775.1,100% of CMS IPPS rate,1300,100% of PER DIEM RATE,N/A,Not Applicable,24201.9,100% of CMS IPPS Rate,N/A,Not Applicable,24201.9,100% of CMS IPPS Rate,13775.11,102% of CMS IPPS Rate,1398.25,100% OF PER DIEM RATE,1211.29,100% of Medicaid Per Diem Rate,1211.29,100% of Medicaid Per Diem Rate,13925.38,100% of CMS IPPS Rate,13496.6,100% of CMS IPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,13925.38,100% of CMS IPPS Rate,4273,Case rate,N/A,Not Applicable,13496.6,100% of CMS IPPS Rate,28879.41,215% of CMS IPPS Rate,15241.77,100% of CMS IPPS Rate,13925.38,100% of CMS IPPS Rate,1645,Case Rate,1211.29,100% of Medicaid Per Diem Rate,1211.29,100% of Medicaid Per Diem Rate,1211.29,100% of Medicaid Per Diem Rate,1211.29,100% of Medicaid Per Diem Rate,1211.29,100% of Medicaid Per Diem Rate,1211.29,100% of Medicaid Per Diem Rate,13496.6,100% of CMS IPPS Rate,13496.6,100% of CMS IPPS Rate,13496.6,100% of CMS IPPS Rate,13496.6,100% of CMS IPPS Rate,13496.6,100% of CMS IPPS Rate,13496.6,100% of CMS IPPS Rate,13496.6,100% of CMS IPPS Rate,13496.6,100% of CMS IPPS Rate,1000,28879.41,N/A
Inpatient,Inpatient Spine,460,Spinal fusion except cervical,100,N/A,1000,100% of CMS IPPS rate,1211.29,100% of Medicaid Per Diem Rate,25291.34,100% of CMS IPPS rate,25291.34,100% of CMS IPPS rate,47109.44,100% of CMS IPPS rate,1300,100% of PER DIEM RATE,N/A,Not Applicable,47046.89,100% of CMS IPPS Rate,N/A,Not Applicable,47046.89,100% of CMS IPPS Rate,25813.84,102% of CMS IPPS Rate,1398.25,100% OF PER DIEM RATE,1211.29,100% of Medicaid Per Diem Rate,1211.29,100% of Medicaid Per Diem Rate,26124.85,100% of CMS IPPS Rate,25291.34,100% of CMS IPPS Rate,N/A,Not Applicable,1500,100% OF PER DIEM RATE,N/A,Not Applicable,26124.85,100% of CMS IPPS Rate,4273,Case rate,N/A,Not Applicable,25291.34,100% of CMS IPPS Rate,54107.57,215% of CMS IPPS Rate,29628.99,100% of CMS IPPS Rate,26124.85,100% of CMS IPPS Rate,1645,Case Rate,1211.29,100% of Medicaid Per Diem Rate,1211.29,100% of Medicaid Per Diem Rate,1211.29,100% of Medicaid Per Diem Rate,1211.29,100% of Medicaid Per Diem Rate,1211.29,100% of Medicaid Per Diem Rate,1211.29,100% of Medicaid Per Diem Rate,25291.34,100% of CMS IPPS Rate,25291.34,100% of CMS IPPS Rate,25291.34,100% of CMS IPPS Rate,25291.34,100% of CMS IPPS Rate,25291.34,100% of CMS IPPS Rate,25291.34,100% of CMS IPPS Rate,25291.34,100% of CMS IPPS Rate,25291.34,100% of CMS IPPS Rate,1000,54107.57,N/A
Inpatient,Inpatient Spine,473,Cervical spinal fusion,100,N/A,1000,100% of CMS IPPS rate,1211.29,100% of Medicaid Per Diem Rate,17340.75,100% of CMS IPPS rate,17340.75,100% of CMS IPPS rate,30429.92,100% of CMS IPPS rate,1300,100% of PER DIEM RATE,N/A,Not Applicable,31647.55,100% of CMS IPPS Rate,N/A,Not Applicable,31647.55,100% of CMS IPPS Rate,17698.78,102% of CMS IPPS Rate,1398.25,100% OF PER DIEM RATE,1211.29,100% of Medicaid Per Diem Rate,1211.29,100% of Medicaid Per Diem Rate,17901.44,100% of CMS IPPS Rate,17340.75,100% of CMS IPPS Rate,N/A,Not Applicable,1500,100% OF PER DIEM RATE,N/A,Not Applicable,17901.44,100% of CMS IPPS Rate,4273,Case rate,N/A,Not Applicable,17340.75,100% of CMS IPPS Rate,37101.79,215% of CMS IPPS Rate,19930.86,100% of CMS IPPS Rate,17901.44,100% of CMS IPPS Rate,1645,Case Rate,1211.29,100% of Medicaid Per Diem Rate,1211.29,100% of Medicaid Per Diem Rate,1211.29,100% of Medicaid Per Diem Rate,1211.29,100% of Medicaid Per Diem Rate,1211.29,100% of Medicaid Per Diem Rate,1211.29,100% of Medicaid Per Diem Rate,17340.75,100% of CMS IPPS Rate,17340.75,100% of CMS IPPS Rate,17340.75,100% of CMS IPPS Rate,17340.75,100% of CMS IPPS Rate,17340.75,100% of CMS IPPS Rate,17340.75,100% of CMS IPPS Rate,17340.75,100% of CMS IPPS Rate,17340.75,100% of CMS IPPS Rate,1000,37101.79,N/A
Outpatient,Cardiac,92921,92921 PRQ TRLUML CORONARY ANGIOPLASTY ADDL BRANCH,481,N/A,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2895,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2895,2895,N/A
Outpatient,Cardiac,92928,92928 PRQ TRLUML CORONARY STENT W/ANGIO ONE ART/BRNCH,481,N/A,34162.33,354% of CMS APC rate,N/A,Not Applicable,9650.37,100% of CMS OPPS Rate,N/A,Not Applicable,16286.63,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,17370.66,180% OF CMS OPPS RATE,N/A,Not Applicable,33776.32,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,9650.37,100% of CMS OPPS Rate,9650.37,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,9650.37,100% of CMS OPPS Rate,2895,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,9650.37,100% OF CMS OPPS Rate,22195.86,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,9650.37,100% of CMS OPPS Rate,9650.37,100% of CMS OPPS Rate,9650.37,100% of CMS OPPS Rate,9650.37,100% of CMS OPPS Rate,9650.37,100% of CMS OPPS Rate,9650.37,100% of CMS OPPS Rate,9650.37,100% of CMS OPPS Rate,9650.37,100% of CMS OPPS Rate,2895,34162.33,N/A
Outpatient,Cardiac,93005,"Electrocardiogram, routine, with interpretation and report",483,26,184.98,354% of CMS APC rate,4.07,100% of Medicaid LA Fee Schedule,52.25,100% of CMS OPPS Rate,26,100% of CMS OPPS Rate,114.1,203.89% of BCBS Fee Schedule,18.2,70% of total Billed Charges,19.5,75% of total Billed Charges,94.05,180% OF CMS OPPS RATE,20.8,80% of total Billed Charges,182.89,350% of CMS Opps rate,26,102% of CMS Opps rate,19.89,76.5% of total billed charges,4.07,100% of Medicaid LA Fee Schedule,4.07,100% of Medicaid LA Fee Schedule,52.25,100% of CMS OPPS Rate,52.25,100% of CMS OPPS Rate,11.7,45% of total billed charges,18.2,70% of total billed charges,15.6,60% of total billed charges,52.25,100% of CMS OPPS Rate,1196,Case rate,18.2,70% of total billed charges,52.25,100% OF CMS OPPS Rate,120.18,230% OF CMS OPPS Rate,12.48,48% of total Billed charges,26,100% OF CMS OPPS Rate,23.4,90% of total Billed charges,4.07,100% of Medicaid LA Fee Schedule,4.07,100% of Medicaid LA Fee Schedule,4.07,100% of Medicaid LA Fee Schedule,4.07,100% of Medicaid LA Fee Schedule,4.07,100% of Medicaid LA Fee Schedule,4.07,100% of Medicaid LA Fee Schedule,52.25,100% of CMS OPPS Rate,52.25,100% of CMS OPPS Rate,52.25,100% of CMS OPPS Rate,52.25,100% of CMS OPPS Rate,52.25,100% of CMS OPPS Rate,52.25,100% of CMS OPPS Rate,52.25,100% of CMS OPPS Rate,52.25,100% of CMS OPPS Rate,4.07,1196,15.6
Outpatient,Laboratory,80048,Basic metabolic panel,300,310.05,29.94,354% of CMS OPPS Rate,8.46,100% of Medicaid LA Fee Schedule,8.46,100% of CMS OPPS Rate,8.46,100% of CMS OPPS Rate,21.29,203.89% of BCBS Fee Schedule,217.04,70% of total Billed Charges,232.54,75% of total Billed Charges,15.22,180% OF CMS OPPS RATE,248.04,80% of total Billed Charges,29.61,350% of CMS Opps rate,8.62,102% of CMS Opps rate,237.19,76.5% of total billed charges,8.46,100% of Medicaid LA Fee Schedule,8.46,100% of Medicaid LA Fee Schedule,8.46,100% of CMS OPPS Rate,8.46,100% of CMS OPPS Rate,139.52,45% of total billed charges,217.04,70% of total billed charges,186.03,60% of total billed charges,8.46,100% of CMS OPPS Rate,9.4,90% OF UHC FEE SCHEDULE,217.04,70% of total billed charges,8.46,100% OF CMS OPPS Rate,19.45,230% OF CMS OPPS Rate,148.82,48% of total Billed charges,8.46,100% OF CMS OPPS Rate,279.05,90% of total Billed charges,8.46,100% of Medicaid LA Fee Schedule,8.46,100% of Medicaid LA Fee Schedule,8.46,100% of Medicaid LA Fee Schedule,8.46,100% of Medicaid LA Fee Schedule,8.46,100% of Medicaid LA Fee Schedule,8.46,100% of Medicaid LA Fee Schedule,8.46,100% of CMS OPPS Rate,8.46,100% of CMS OPPS Rate,8.46,100% of CMS OPPS Rate,8.46,100% of CMS OPPS Rate,8.46,100% of CMS OPPS Rate,8.46,100% of CMS OPPS Rate,8.46,100% of CMS OPPS Rate,8.46,100% of CMS OPPS Rate,8.46,279.05,186.03
Outpatient,Laboratory,80050,General health panel,300,323.1,58.16,18% of total billed charges for Outpatient Setting,45.54,100% of Medicaid LA Fee Schedule,58.16,18% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,226.17,70% of total Billed Charges,242.33,75% of total Billed Charges,161.55,50% of total Billed Charges,258.48,80% of total Billed Charges,193.86,60% of total Billed Charges,N/A,Not Applicable,247.17,76.5% of total billed charges,45.54,100% of Medicaid LA Fee Schedule,45.54,100% of Medicaid LA Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,145.4,45% of total billed charges,226.17,70% of total billed charges,193.86,60% of total billed charges,N/A,Not Applicable,122.78,38% of total billed charges,226.17,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,155.09,48% of total Billed charges,323.1,100% of total Billed charges,290.79,90% of total Billed charges,45.54,100% of Medicaid LA Fee Schedule,45.54,100% of Medicaid LA Fee Schedule,45.54,100% of Medicaid LA Fee Schedule,45.54,100% of Medicaid LA Fee Schedule,45.54,100% of Medicaid LA Fee Schedule,45.54,100% of Medicaid LA Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,45.54,323.1,193.86
Outpatient,Laboratory,80051,"Blood test panel for electrolytes (sodium potassium, chloride, carbon dioxide)",300,207.36,24.81,354% of CMS OPPS Rate,7.01,100% of Medicaid LA Fee Schedule,7.01,100% of CMS OPPS Rate,7.01,100% of CMS OPPS Rate,17.66,203.89% of BCBS Fee Schedule,145.15,70% of total Billed Charges,155.52,75% of total Billed Charges,12.61,180% OF CMS OPPS RATE,165.89,80% of total Billed Charges,24.53,350% of CMS Opps rate,7.15,102% of CMS Opps rate,158.63,76.5% of total billed charges,7.01,100% of Medicaid LA Fee Schedule,7.01,100% of Medicaid LA Fee Schedule,7.01,100% of CMS OPPS Rate,7.01,100% of CMS OPPS Rate,93.31,45% of total billed charges,145.15,70% of total billed charges,124.42,60% of total billed charges,7.01,100% of CMS OPPS Rate,7.79,90% OF UHC FEE SCHEDULE,145.15,70% of total billed charges,7.01,100% OF CMS OPPS Rate,16.12,230% OF CMS OPPS Rate,99.53,48% of total Billed charges,7.01,100% OF CMS OPPS Rate,186.62,90% of total Billed charges,7.01,100% of Medicaid LA Fee Schedule,7.01,100% of Medicaid LA Fee Schedule,7.01,100% of Medicaid LA Fee Schedule,7.01,100% of Medicaid LA Fee Schedule,7.01,100% of Medicaid LA Fee Schedule,7.01,100% of Medicaid LA Fee Schedule,7.01,100% of CMS OPPS Rate,7.01,100% of CMS OPPS Rate,7.01,100% of CMS OPPS Rate,7.01,100% of CMS OPPS Rate,7.01,100% of CMS OPPS Rate,7.01,100% of CMS OPPS Rate,7.01,100% of CMS OPPS Rate,7.01,100% of CMS OPPS Rate,7.01,186.62,124.42
Outpatient,Laboratory,80053,"Blood test, comprehensive group of blood chemicals",300,504.9,37.38,354% of CMS OPPS Rate,10.56,100% of Medicaid LA Fee Schedule,10.56,100% of CMS OPPS Rate,10.56,100% of CMS OPPS Rate,26.59,203.89% of BCBS Fee Schedule,353.43,70% of total Billed Charges,378.68,75% of total Billed Charges,19,180% OF CMS OPPS RATE,403.92,80% of total Billed Charges,36.96,350% of CMS Opps rate,10.77,102% of CMS Opps rate,386.25,76.5% of total billed charges,10.56,100% of Medicaid LA Fee Schedule,10.56,100% of Medicaid LA Fee Schedule,10.56,100% of CMS OPPS Rate,10.56,100% of CMS OPPS Rate,227.21,45% of total billed charges,353.43,70% of total billed charges,302.94,60% of total billed charges,10.56,100% of CMS OPPS Rate,11.74,90% OF UHC FEE SCHEDULE,353.43,70% of total billed charges,10.56,100% OF CMS OPPS Rate,24.28,230% OF CMS OPPS Rate,242.35,48% of total Billed charges,10.56,100% OF CMS OPPS Rate,454.41,90% of total Billed charges,10.56,100% of Medicaid LA Fee Schedule,10.56,100% of Medicaid LA Fee Schedule,10.56,100% of Medicaid LA Fee Schedule,10.56,100% of Medicaid LA Fee Schedule,10.56,100% of Medicaid LA Fee Schedule,10.56,100% of Medicaid LA Fee Schedule,10.56,100% of CMS OPPS Rate,10.56,100% of CMS OPPS Rate,10.56,100% of CMS OPPS Rate,10.56,100% of CMS OPPS Rate,10.56,100% of CMS OPPS Rate,10.56,100% of CMS OPPS Rate,10.56,100% of CMS OPPS Rate,10.56,100% of CMS OPPS Rate,10.56,454.41,302.94
Outpatient,Laboratory,80055,Obstetric blood test panel,300,638,169.24,354% of CMS OPPS Rate,24.01,100% of Medicaid LA Fee Schedule,47.81,100% of CMS OPPS Rate,47.81,100% of CMS OPPS Rate,120.34,203.89% of BCBS Fee Schedule,446.6,70% of total Billed Charges,478.5,75% of total Billed Charges,86.05,180% OF CMS OPPS RATE,510.4,80% of total Billed Charges,167.33,350% of CMS Opps rate,48.76,102% of CMS Opps rate,488.07,76.5% of total billed charges,24.01,100% of Medicaid LA Fee Schedule,24.01,100% of Medicaid LA Fee Schedule,47.81,100% of CMS OPPS Rate,47.81,100% of CMS OPPS Rate,287.1,45% of total billed charges,446.6,70% of total billed charges,382.8,60% of total billed charges,47.81,100% of CMS OPPS Rate,53.12,90% OF UHC FEE SCHEDULE,446.6,70% of total billed charges,47.81,100% OF CMS OPPS Rate,109.96,230% OF CMS OPPS Rate,306.24,48% of total Billed charges,47.81,100% OF CMS OPPS Rate,574.2,90% of total Billed charges,24.01,100% of Medicaid LA Fee Schedule,24.01,100% of Medicaid LA Fee Schedule,24.01,100% of Medicaid LA Fee Schedule,24.01,100% of Medicaid LA Fee Schedule,24.01,100% of Medicaid LA Fee Schedule,24.01,100% of Medicaid LA Fee Schedule,47.81,100% of CMS OPPS Rate,47.81,100% of CMS OPPS Rate,47.81,100% of CMS OPPS Rate,47.81,100% of CMS OPPS Rate,47.81,100% of CMS OPPS Rate,47.81,100% of CMS OPPS Rate,47.81,100% of CMS OPPS Rate,47.81,100% of CMS OPPS Rate,24.01,574.2,382.8
Outpatient,Laboratory,80061,"Blood test, lipids (cholesterol and triglycerides)",300,193.05,47.4,354% of CMS OPPS Rate,13.39,100% of Medicaid LA Fee Schedule,13.39,100% of CMS OPPS Rate,13.39,100% of CMS OPPS Rate,33.7,203.89% of BCBS Fee Schedule,135.14,70% of total Billed Charges,144.79,75% of total Billed Charges,24.1,180% OF CMS OPPS RATE,154.44,80% of total Billed Charges,46.86,350% of CMS Opps rate,13.65,102% of CMS Opps rate,147.68,76.5% of total billed charges,13.39,100% of Medicaid LA Fee Schedule,13.39,100% of Medicaid LA Fee Schedule,13.39,100% of CMS OPPS Rate,13.39,100% of CMS OPPS Rate,86.87,45% of total billed charges,135.14,70% of total billed charges,115.83,60% of total billed charges,13.39,100% of CMS OPPS Rate,14.88,90% OF UHC FEE SCHEDULE,135.14,70% of total billed charges,13.39,100% OF CMS OPPS Rate,30.79,230% OF CMS OPPS Rate,92.66,48% of total Billed charges,13.39,100% OF CMS OPPS Rate,173.75,90% of total Billed charges,13.39,100% of Medicaid LA Fee Schedule,13.39,100% of Medicaid LA Fee Schedule,13.39,100% of Medicaid LA Fee Schedule,13.39,100% of Medicaid LA Fee Schedule,13.39,100% of Medicaid LA Fee Schedule,13.39,100% of Medicaid LA Fee Schedule,13.39,100% of CMS OPPS Rate,13.39,100% of CMS OPPS Rate,13.39,100% of CMS OPPS Rate,13.39,100% of CMS OPPS Rate,13.39,100% of CMS OPPS Rate,13.39,100% of CMS OPPS Rate,13.39,100% of CMS OPPS Rate,13.39,100% of CMS OPPS Rate,13.39,173.75,115.83
Outpatient,Laboratory,80069,Kidney function panel test,300,273.15,30.72,354% of CMS OPPS Rate,8.68,100% of Medicaid LA Fee Schedule,8.68,100% of CMS OPPS Rate,8.68,100% of CMS OPPS Rate,21.86,203.89% of BCBS Fee Schedule,191.21,70% of total Billed Charges,204.86,75% of total Billed Charges,15.62,180% OF CMS OPPS RATE,218.52,80% of total Billed Charges,30.38,350% of CMS Opps rate,8.85,102% of CMS Opps rate,208.96,76.5% of total billed charges,8.68,100% of Medicaid LA Fee Schedule,8.68,100% of Medicaid LA Fee Schedule,8.68,100% of CMS OPPS Rate,8.68,100% of CMS OPPS Rate,122.92,45% of total billed charges,191.21,70% of total billed charges,163.89,60% of total billed charges,8.68,100% of CMS OPPS Rate,9.65,90% OF UHC FEE SCHEDULE,191.21,70% of total billed charges,8.68,100% OF CMS OPPS Rate,19.96,230% OF CMS OPPS Rate,131.11,48% of total Billed charges,8.68,100% OF CMS OPPS Rate,245.84,90% of total Billed charges,8.68,100% of Medicaid LA Fee Schedule,8.68,100% of Medicaid LA Fee Schedule,8.68,100% of Medicaid LA Fee Schedule,8.68,100% of Medicaid LA Fee Schedule,8.68,100% of Medicaid LA Fee Schedule,8.68,100% of Medicaid LA Fee Schedule,8.68,100% of CMS OPPS Rate,8.68,100% of CMS OPPS Rate,8.68,100% of CMS OPPS Rate,8.68,100% of CMS OPPS Rate,8.68,100% of CMS OPPS Rate,8.68,100% of CMS OPPS Rate,8.68,100% of CMS OPPS Rate,8.68,100% of CMS OPPS Rate,8.68,245.84,163.89
Outpatient,Laboratory,80074,Acute hepatitis panel,300,143,168.61,354% of CMS OPPS Rate,47.63,100% of Medicaid LA Fee Schedule,47.63,100% of CMS OPPS Rate,47.63,100% of CMS OPPS Rate,119.91,203.89% of BCBS Fee Schedule,100.1,70% of total Billed Charges,107.25,75% of total Billed Charges,85.73,180% OF CMS OPPS RATE,114.4,80% of total Billed Charges,166.7,350% of CMS Opps rate,48.58,102% of CMS Opps rate,109.4,76.5% of total billed charges,47.63,100% of Medicaid LA Fee Schedule,47.63,100% of Medicaid LA Fee Schedule,47.63,100% of CMS OPPS Rate,47.63,100% of CMS OPPS Rate,64.35,45% of total billed charges,100.1,70% of total billed charges,85.8,60% of total billed charges,47.63,100% of CMS OPPS Rate,52.93,90% OF UHC FEE SCHEDULE,100.1,70% of total billed charges,47.63,100% OF CMS OPPS Rate,109.54,230% OF CMS OPPS Rate,68.64,48% of total Billed charges,47.63,100% OF CMS OPPS Rate,128.7,90% of total Billed charges,47.63,100% of Medicaid LA Fee Schedule,47.63,100% of Medicaid LA Fee Schedule,47.63,100% of Medicaid LA Fee Schedule,47.63,100% of Medicaid LA Fee Schedule,47.63,100% of Medicaid LA Fee Schedule,47.63,100% of Medicaid LA Fee Schedule,47.63,100% of CMS OPPS Rate,47.63,100% of CMS OPPS Rate,47.63,100% of CMS OPPS Rate,47.63,100% of CMS OPPS Rate,47.63,100% of CMS OPPS Rate,47.63,100% of CMS OPPS Rate,47.63,100% of CMS OPPS Rate,47.63,100% of CMS OPPS Rate,47.63,168.61,85.8
Outpatient,Laboratory,80076,Liver function blood test panel,300,425.15,28.92,354% of CMS OPPS Rate,8.17,100% of Medicaid LA Fee Schedule,8.17,100% of CMS OPPS Rate,8.17,100% of CMS OPPS Rate,20.57,203.89% of BCBS Fee Schedule,297.61,70% of total Billed Charges,318.86,75% of total Billed Charges,14.7,180% OF CMS OPPS RATE,340.12,80% of total Billed Charges,28.59,350% of CMS Opps rate,8.33,102% of CMS Opps rate,325.24,76.5% of total billed charges,8.17,100% of Medicaid LA Fee Schedule,8.17,100% of Medicaid LA Fee Schedule,8.17,100% of CMS OPPS Rate,8.17,100% of CMS OPPS Rate,191.32,45% of total billed charges,297.61,70% of total billed charges,255.09,60% of total billed charges,8.17,100% of CMS OPPS Rate,9.08,90% OF UHC FEE SCHEDULE,297.61,70% of total billed charges,8.17,100% OF CMS OPPS Rate,18.79,230% OF CMS OPPS Rate,204.07,48% of total Billed charges,8.17,100% OF CMS OPPS Rate,382.64,90% of total Billed charges,8.17,100% of Medicaid LA Fee Schedule,8.17,100% of Medicaid LA Fee Schedule,8.17,100% of Medicaid LA Fee Schedule,8.17,100% of Medicaid LA Fee Schedule,8.17,100% of Medicaid LA Fee Schedule,8.17,100% of Medicaid LA Fee Schedule,8.17,100% of CMS OPPS Rate,8.17,100% of CMS OPPS Rate,8.17,100% of CMS OPPS Rate,8.17,100% of CMS OPPS Rate,8.17,100% of CMS OPPS Rate,8.17,100% of CMS OPPS Rate,8.17,100% of CMS OPPS Rate,8.17,100% of CMS OPPS Rate,8.17,382.64,255.09
Outpatient,Laboratory,80145,ADALIMUMAB,300,626,136.53,354% of CMS OPPS Rate,29.86,100% of Medicaid LA Fee Schedule,38.57,100% of CMS OPPS Rate,38.57,100% of CMS OPPS Rate,313,50% of total billed charges,438.2,70% of total Billed Charges,469.5,75% of total Billed Charges,69.42,180% OF CMS OPPS RATE,500.8,80% of total Billed Charges,134.99,350% of CMS Opps rate,39.34,102% of CMS Opps rate,478.89,76.5% of total billed charges,29.86,100% of Medicaid LA Fee Schedule,29.86,100% of Medicaid LA Fee Schedule,38.57,100% of CMS OPPS Rate,38.57,100% of CMS OPPS Rate,281.7,45% of total billed charges,438.2,70% of total billed charges,375.6,60% of total billed charges,38.57,100% of CMS OPPS Rate,34.71,90% OF UHC FEE SCHEDULE,438.2,70% of total billed charges,38.57,100% OF CMS OPPS Rate,88.71,230% OF CMS OPPS Rate,300.48,48% of total Billed charges,38.57,100% OF CMS OPPS Rate,563.4,90% of total Billed charges,29.86,100% of Medicaid LA Fee Schedule,29.86,100% of Medicaid LA Fee Schedule,29.86,100% of Medicaid LA Fee Schedule,29.86,100% of Medicaid LA Fee Schedule,29.86,100% of Medicaid LA Fee Schedule,29.86,100% of Medicaid LA Fee Schedule,38.57,100% of CMS OPPS Rate,38.57,100% of CMS OPPS Rate,38.57,100% of CMS OPPS Rate,38.57,100% of CMS OPPS Rate,38.57,100% of CMS OPPS Rate,38.57,100% of CMS OPPS Rate,38.57,100% of CMS OPPS Rate,38.57,100% of CMS OPPS Rate,29.86,563.4,375.6
Outpatient,Laboratory,80150,AMIKACIN DRUG ASSAY,300,167.4,53.38,354% of CMS OPPS Rate,14.18,100% of Medicaid LA Fee Schedule,15.08,100% of CMS OPPS Rate,15.08,100% of CMS OPPS Rate,37.94,203.89% of BCBS Fee Schedule,117.18,70% of total Billed Charges,125.55,75% of total Billed Charges,27.14,180% OF CMS OPPS RATE,133.92,80% of total Billed Charges,52.78,350% of CMS Opps rate,15.38,102% of CMS Opps rate,128.06,76.5% of total billed charges,14.18,100% of Medicaid LA Fee Schedule,14.18,100% of Medicaid LA Fee Schedule,15.08,100% of CMS OPPS Rate,15.08,100% of CMS OPPS Rate,75.33,45% of total billed charges,117.18,70% of total billed charges,100.44,60% of total billed charges,15.08,100% of CMS OPPS Rate,16.75,90% OF UHC FEE SCHEDULE,117.18,70% of total billed charges,15.08,100% OF CMS OPPS Rate,34.68,230% OF CMS OPPS Rate,80.35,48% of total Billed charges,15.08,100% OF CMS OPPS Rate,150.66,90% of total Billed charges,14.18,100% of Medicaid LA Fee Schedule,14.18,100% of Medicaid LA Fee Schedule,14.18,100% of Medicaid LA Fee Schedule,14.18,100% of Medicaid LA Fee Schedule,14.18,100% of Medicaid LA Fee Schedule,14.18,100% of Medicaid LA Fee Schedule,15.08,100% of CMS OPPS Rate,15.08,100% of CMS OPPS Rate,15.08,100% of CMS OPPS Rate,15.08,100% of CMS OPPS Rate,15.08,100% of CMS OPPS Rate,15.08,100% of CMS OPPS Rate,15.08,100% of CMS OPPS Rate,15.08,100% of CMS OPPS Rate,14.18,150.66,100.44
Outpatient,Laboratory,80156,CARBAMAZEPINE SERUM,300,213.75,51.57,354% of CMS OPPS Rate,14.18,100% of Medicaid LA Fee Schedule,14.57,100% of CMS OPPS Rate,14.57,100% of CMS OPPS Rate,36.66,203.89% of BCBS Fee Schedule,149.63,70% of total Billed Charges,160.31,75% of total Billed Charges,26.22,180% OF CMS OPPS RATE,171,80% of total Billed Charges,50.99,350% of CMS Opps rate,14.86,102% of CMS Opps rate,163.52,76.5% of total billed charges,14.18,100% of Medicaid LA Fee Schedule,14.18,100% of Medicaid LA Fee Schedule,14.57,100% of CMS OPPS Rate,14.57,100% of CMS OPPS Rate,96.19,45% of total billed charges,149.63,70% of total billed charges,128.25,60% of total billed charges,14.57,100% of CMS OPPS Rate,16.18,90% OF UHC FEE SCHEDULE,149.63,70% of total billed charges,14.57,100% OF CMS OPPS Rate,33.51,230% OF CMS OPPS Rate,102.6,48% of total Billed charges,14.57,100% OF CMS OPPS Rate,192.38,90% of total Billed charges,14.18,100% of Medicaid LA Fee Schedule,14.18,100% of Medicaid LA Fee Schedule,14.18,100% of Medicaid LA Fee Schedule,14.18,100% of Medicaid LA Fee Schedule,14.18,100% of Medicaid LA Fee Schedule,14.18,100% of Medicaid LA Fee Schedule,14.57,100% of CMS OPPS Rate,14.57,100% of CMS OPPS Rate,14.57,100% of CMS OPPS Rate,14.57,100% of CMS OPPS Rate,14.57,100% of CMS OPPS Rate,14.57,100% of CMS OPPS Rate,14.57,100% of CMS OPPS Rate,14.57,100% of CMS OPPS Rate,14.18,192.38,128.25
Outpatient,Laboratory,80157,CARBAMAXEPINE FREE,300,119.64,46.9,354% of CMS OPPS Rate,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,33.36,203.89% of BCBS Fee Schedule,83.75,70% of total Billed Charges,89.73,75% of total Billed Charges,23.85,180% OF CMS OPPS RATE,95.71,80% of total Billed Charges,46.37,350% of CMS Opps rate,13.51,102% of CMS Opps rate,91.52,76.5% of total billed charges,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,53.84,45% of total billed charges,83.75,70% of total billed charges,71.78,60% of total billed charges,13.25,100% of CMS OPPS Rate,14.72,90% OF UHC FEE SCHEDULE,83.75,70% of total billed charges,13.25,100% OF CMS OPPS Rate,30.47,230% OF CMS OPPS Rate,57.43,48% of total Billed charges,13.25,100% OF CMS OPPS Rate,107.68,90% of total Billed charges,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,107.68,71.78
Outpatient,Laboratory,80158,DRUG ASSAY CYCLOSPORINE,300,129.6,63.89,354% of CMS OPPS Rate,18.05,100% of Medicaid LA Fee Schedule,18.05,100% of CMS OPPS Rate,18.05,100% of CMS OPPS Rate,45.43,203.89% of BCBS Fee Schedule,90.72,70% of total Billed Charges,97.2,75% of total Billed Charges,32.49,180% OF CMS OPPS RATE,103.68,80% of total Billed Charges,63.17,350% of CMS Opps rate,18.41,102% of CMS Opps rate,99.14,76.5% of total billed charges,18.05,100% of Medicaid LA Fee Schedule,18.05,100% of Medicaid LA Fee Schedule,18.05,100% of CMS OPPS Rate,18.05,100% of CMS OPPS Rate,58.32,45% of total billed charges,90.72,70% of total billed charges,77.76,60% of total billed charges,18.05,100% of CMS OPPS Rate,20.05,90% OF UHC FEE SCHEDULE,90.72,70% of total billed charges,18.05,100% OF CMS OPPS Rate,41.51,230% OF CMS OPPS Rate,62.21,48% of total Billed charges,18.05,100% OF CMS OPPS Rate,116.64,90% of total Billed charges,18.05,100% of Medicaid LA Fee Schedule,18.05,100% of Medicaid LA Fee Schedule,18.05,100% of Medicaid LA Fee Schedule,18.05,100% of Medicaid LA Fee Schedule,18.05,100% of Medicaid LA Fee Schedule,18.05,100% of Medicaid LA Fee Schedule,18.05,100% of CMS OPPS Rate,18.05,100% of CMS OPPS Rate,18.05,100% of CMS OPPS Rate,18.05,100% of CMS OPPS Rate,18.05,100% of CMS OPPS Rate,18.05,100% of CMS OPPS Rate,18.05,100% of CMS OPPS Rate,18.05,100% of CMS OPPS Rate,18.05,116.64,77.76
Outpatient,Laboratory,80159,DRUG ASSAY CLOZAPINE,300,176,71.33,354% of CMS OPPS Rate,20.15,100% of Medicaid LA Fee Schedule,20.14,100% of CMS OPPS Rate,20.14,100% of CMS OPPS Rate,46.55,203.89% of BCBS Fee Schedule,123.2,70% of total Billed Charges,132,75% of total Billed Charges,36.26,180% OF CMS OPPS RATE,140.8,80% of total Billed Charges,70.52,350% of CMS Opps rate,20.55,102% of CMS Opps rate,134.64,76.5% of total billed charges,20.15,100% of Medicaid LA Fee Schedule,20.15,100% of Medicaid LA Fee Schedule,20.14,100% of CMS OPPS Rate,20.14,100% of CMS OPPS Rate,79.2,45% of total billed charges,123.2,70% of total billed charges,105.6,60% of total billed charges,20.14,100% of CMS OPPS Rate,20.55,90% OF UHC FEE SCHEDULE,123.2,70% of total billed charges,20.14,100% OF CMS OPPS Rate,46.34,230% OF CMS OPPS Rate,84.48,48% of total Billed charges,20.14,100% OF CMS OPPS Rate,158.4,90% of total Billed charges,20.15,100% of Medicaid LA Fee Schedule,20.15,100% of Medicaid LA Fee Schedule,20.15,100% of Medicaid LA Fee Schedule,20.15,100% of Medicaid LA Fee Schedule,20.15,100% of Medicaid LA Fee Schedule,20.15,100% of Medicaid LA Fee Schedule,20.14,100% of CMS OPPS Rate,20.14,100% of CMS OPPS Rate,20.14,100% of CMS OPPS Rate,20.14,100% of CMS OPPS Rate,20.14,100% of CMS OPPS Rate,20.14,100% of CMS OPPS Rate,20.14,100% of CMS OPPS Rate,20.14,100% of CMS OPPS Rate,20.14,158.4,105.6
Outpatient,Laboratory,80162,DIGOXIN SERUM,300,152.1,47.01,354% of CMS OPPS Rate,13.28,100% of Medicaid LA Fee Schedule,13.28,100% of CMS OPPS Rate,13.28,100% of CMS OPPS Rate,33.42,203.89% of BCBS Fee Schedule,106.47,70% of total Billed Charges,114.08,75% of total Billed Charges,23.9,180% OF CMS OPPS RATE,121.68,80% of total Billed Charges,46.48,350% of CMS Opps rate,13.54,102% of CMS Opps rate,116.36,76.5% of total billed charges,13.28,100% of Medicaid LA Fee Schedule,13.28,100% of Medicaid LA Fee Schedule,13.28,100% of CMS OPPS Rate,13.28,100% of CMS OPPS Rate,68.45,45% of total billed charges,106.47,70% of total billed charges,91.26,60% of total billed charges,13.28,100% of CMS OPPS Rate,14.75,90% OF UHC FEE SCHEDULE,106.47,70% of total billed charges,13.28,100% OF CMS OPPS Rate,30.54,230% OF CMS OPPS Rate,73.01,48% of total Billed charges,13.28,100% OF CMS OPPS Rate,136.89,90% of total Billed charges,13.28,100% of Medicaid LA Fee Schedule,13.28,100% of Medicaid LA Fee Schedule,13.28,100% of Medicaid LA Fee Schedule,13.28,100% of Medicaid LA Fee Schedule,13.28,100% of Medicaid LA Fee Schedule,13.28,100% of Medicaid LA Fee Schedule,13.28,100% of CMS OPPS Rate,13.28,100% of CMS OPPS Rate,13.28,100% of CMS OPPS Rate,13.28,100% of CMS OPPS Rate,13.28,100% of CMS OPPS Rate,13.28,100% of CMS OPPS Rate,13.28,100% of CMS OPPS Rate,13.28,100% of CMS OPPS Rate,13.28,136.89,91.26
Outpatient,Laboratory,80164,VALPROIC ACID,300,180.45,47.93,354% of CMS OPPS Rate,13.54,100% of Medicaid LA Fee Schedule,13.54,100% of CMS OPPS Rate,13.54,100% of CMS OPPS Rate,34.09,203.89% of BCBS Fee Schedule,126.32,70% of total Billed Charges,135.34,75% of total Billed Charges,24.37,180% OF CMS OPPS RATE,144.36,80% of total Billed Charges,47.39,350% of CMS Opps rate,13.81,102% of CMS Opps rate,138.04,76.5% of total billed charges,13.54,100% of Medicaid LA Fee Schedule,13.54,100% of Medicaid LA Fee Schedule,13.54,100% of CMS OPPS Rate,13.54,100% of CMS OPPS Rate,81.2,45% of total billed charges,126.32,70% of total billed charges,108.27,60% of total billed charges,13.54,100% of CMS OPPS Rate,15.05,90% OF UHC FEE SCHEDULE,126.32,70% of total billed charges,13.54,100% OF CMS OPPS Rate,31.14,230% OF CMS OPPS Rate,86.62,48% of total Billed charges,13.54,100% OF CMS OPPS Rate,162.41,90% of total Billed charges,13.54,100% of Medicaid LA Fee Schedule,13.54,100% of Medicaid LA Fee Schedule,13.54,100% of Medicaid LA Fee Schedule,13.54,100% of Medicaid LA Fee Schedule,13.54,100% of Medicaid LA Fee Schedule,13.54,100% of Medicaid LA Fee Schedule,13.54,100% of CMS OPPS Rate,13.54,100% of CMS OPPS Rate,13.54,100% of CMS OPPS Rate,13.54,100% of CMS OPPS Rate,13.54,100% of CMS OPPS Rate,13.54,100% of CMS OPPS Rate,13.54,100% of CMS OPPS Rate,13.54,100% of CMS OPPS Rate,13.54,162.41,108.27
Outpatient,Laboratory,80168,ETHOSUXIMIDE,300,164,57.84,354% of CMS OPPS Rate,16.34,100% of Medicaid LA Fee Schedule,16.34,100% of CMS OPPS Rate,16.34,100% of CMS OPPS Rate,41.12,203.89% of BCBS Fee Schedule,114.8,70% of total Billed Charges,123,75% of total Billed Charges,29.41,180% OF CMS OPPS RATE,131.2,80% of total Billed Charges,57.19,350% of CMS Opps rate,16.66,102% of CMS Opps rate,125.46,76.5% of total billed charges,16.34,100% of Medicaid LA Fee Schedule,16.34,100% of Medicaid LA Fee Schedule,16.34,100% of CMS OPPS Rate,16.34,100% of CMS OPPS Rate,73.8,45% of total billed charges,114.8,70% of total billed charges,98.4,60% of total billed charges,16.34,100% of CMS OPPS Rate,18.15,90% OF UHC FEE SCHEDULE,114.8,70% of total billed charges,16.34,100% OF CMS OPPS Rate,37.58,230% OF CMS OPPS Rate,78.72,48% of total Billed charges,16.34,100% OF CMS OPPS Rate,147.6,90% of total Billed charges,16.34,100% of Medicaid LA Fee Schedule,16.34,100% of Medicaid LA Fee Schedule,16.34,100% of Medicaid LA Fee Schedule,16.34,100% of Medicaid LA Fee Schedule,16.34,100% of Medicaid LA Fee Schedule,16.34,100% of Medicaid LA Fee Schedule,16.34,100% of CMS OPPS Rate,16.34,100% of CMS OPPS Rate,16.34,100% of CMS OPPS Rate,16.34,100% of CMS OPPS Rate,16.34,100% of CMS OPPS Rate,16.34,100% of CMS OPPS Rate,16.34,100% of CMS OPPS Rate,16.34,100% of CMS OPPS Rate,16.34,147.6,98.4
Outpatient,Laboratory,80170,GENTAMYCIN DRUG ASSAY,300,121.95,57.98,354% of CMS OPPS Rate,14.18,100% of Medicaid LA Fee Schedule,16.38,100% of CMS OPPS Rate,16.38,100% of CMS OPPS Rate,41.23,203.89% of BCBS Fee Schedule,85.37,70% of total Billed Charges,91.46,75% of total Billed Charges,29.48,180% OF CMS OPPS RATE,97.56,80% of total Billed Charges,57.33,350% of CMS Opps rate,16.7,102% of CMS Opps rate,93.29,76.5% of total billed charges,14.18,100% of Medicaid LA Fee Schedule,14.18,100% of Medicaid LA Fee Schedule,16.38,100% of CMS OPPS Rate,16.38,100% of CMS OPPS Rate,54.88,45% of total billed charges,85.37,70% of total billed charges,73.17,60% of total billed charges,16.38,100% of CMS OPPS Rate,18.2,90% OF UHC FEE SCHEDULE,85.37,70% of total billed charges,16.38,100% OF CMS OPPS Rate,37.67,230% OF CMS OPPS Rate,58.54,48% of total Billed charges,16.38,100% OF CMS OPPS Rate,109.76,90% of total Billed charges,14.18,100% of Medicaid LA Fee Schedule,14.18,100% of Medicaid LA Fee Schedule,14.18,100% of Medicaid LA Fee Schedule,14.18,100% of Medicaid LA Fee Schedule,14.18,100% of Medicaid LA Fee Schedule,14.18,100% of Medicaid LA Fee Schedule,16.38,100% of CMS OPPS Rate,16.38,100% of CMS OPPS Rate,16.38,100% of CMS OPPS Rate,16.38,100% of CMS OPPS Rate,16.38,100% of CMS OPPS Rate,16.38,100% of CMS OPPS Rate,16.38,100% of CMS OPPS Rate,16.38,100% of CMS OPPS Rate,14.18,109.76,73.17
Outpatient,Laboratory,80171,GABAPENTIN (NEURONTIN),300,88.65,76.71,354% of CMS OPPS Rate,16.76,100% of Medicaid LA Fee Schedule,21.67,100% of CMS OPPS Rate,21.67,100% of CMS OPPS Rate,44.18,203.89% of BCBS Fee Schedule,62.06,70% of total Billed Charges,66.49,75% of total Billed Charges,39,180% OF CMS OPPS RATE,70.92,80% of total Billed Charges,75.84,350% of CMS Opps rate,22.1,102% of CMS Opps rate,67.82,76.5% of total billed charges,16.76,100% of Medicaid LA Fee Schedule,16.76,100% of Medicaid LA Fee Schedule,21.67,100% of CMS OPPS Rate,21.67,100% of CMS OPPS Rate,39.89,45% of total billed charges,62.06,70% of total billed charges,53.19,60% of total billed charges,21.67,100% of CMS OPPS Rate,19.5,90% OF UHC FEE SCHEDULE,62.06,70% of total billed charges,21.67,100% OF CMS OPPS Rate,49.84,230% OF CMS OPPS Rate,42.55,48% of total Billed charges,21.67,100% OF CMS OPPS Rate,79.79,90% of total Billed charges,16.76,100% of Medicaid LA Fee Schedule,16.76,100% of Medicaid LA Fee Schedule,16.76,100% of Medicaid LA Fee Schedule,16.76,100% of Medicaid LA Fee Schedule,16.76,100% of Medicaid LA Fee Schedule,16.76,100% of Medicaid LA Fee Schedule,21.67,100% of CMS OPPS Rate,21.67,100% of CMS OPPS Rate,21.67,100% of CMS OPPS Rate,21.67,100% of CMS OPPS Rate,21.67,100% of CMS OPPS Rate,21.67,100% of CMS OPPS Rate,21.67,100% of CMS OPPS Rate,21.67,100% of CMS OPPS Rate,16.76,79.79,53.19
Outpatient,Laboratory,80175,LAMOTRIGINE,300,104,46.9,354% of CMS OPPS Rate,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,33.36,203.89% of BCBS Fee Schedule,72.8,70% of total Billed Charges,78,75% of total Billed Charges,23.85,180% OF CMS OPPS RATE,83.2,80% of total Billed Charges,46.37,350% of CMS Opps rate,13.51,102% of CMS Opps rate,79.56,76.5% of total billed charges,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,46.8,45% of total billed charges,72.8,70% of total billed charges,62.4,60% of total billed charges,13.25,100% of CMS OPPS Rate,14.72,90% OF UHC FEE SCHEDULE,72.8,70% of total billed charges,13.25,100% OF CMS OPPS Rate,30.47,230% OF CMS OPPS Rate,49.92,48% of total Billed charges,13.25,100% OF CMS OPPS Rate,93.6,90% of total Billed charges,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,93.6,62.4
Outpatient,Laboratory,80177,LEVETIRACETAM,300,204,46.9,354% of CMS OPPS Rate,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,33.36,203.89% of BCBS Fee Schedule,142.8,70% of total Billed Charges,153,75% of total Billed Charges,23.85,180% OF CMS OPPS RATE,163.2,80% of total Billed Charges,46.37,350% of CMS Opps rate,13.51,102% of CMS Opps rate,156.06,76.5% of total billed charges,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,91.8,45% of total billed charges,142.8,70% of total billed charges,122.4,60% of total billed charges,13.25,100% of CMS OPPS Rate,14.72,90% OF UHC FEE SCHEDULE,142.8,70% of total billed charges,13.25,100% OF CMS OPPS Rate,30.47,230% OF CMS OPPS Rate,97.92,48% of total Billed charges,13.25,100% OF CMS OPPS Rate,183.6,90% of total Billed charges,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,183.6,122.4
Outpatient,Laboratory,80178,LITHIUM SERUM,300,88.65,23.39,354% of CMS OPPS Rate,6.61,100% of Medicaid LA Fee Schedule,6.61,100% of CMS OPPS Rate,6.61,100% of CMS OPPS Rate,16.64,203.89% of BCBS Fee Schedule,62.06,70% of total Billed Charges,66.49,75% of total Billed Charges,11.89,180% OF CMS OPPS RATE,70.92,80% of total Billed Charges,23.13,350% of CMS Opps rate,6.74,102% of CMS Opps rate,67.82,76.5% of total billed charges,6.61,100% of Medicaid LA Fee Schedule,6.61,100% of Medicaid LA Fee Schedule,6.61,100% of CMS OPPS Rate,6.61,100% of CMS OPPS Rate,39.89,45% of total billed charges,62.06,70% of total billed charges,53.19,60% of total billed charges,6.61,100% of CMS OPPS Rate,7.34,90% OF UHC FEE SCHEDULE,62.06,70% of total billed charges,6.61,100% OF CMS OPPS Rate,15.2,230% OF CMS OPPS Rate,42.55,48% of total Billed charges,6.61,100% OF CMS OPPS Rate,79.79,90% of total Billed charges,6.61,100% of Medicaid LA Fee Schedule,6.61,100% of Medicaid LA Fee Schedule,6.61,100% of Medicaid LA Fee Schedule,6.61,100% of Medicaid LA Fee Schedule,6.61,100% of Medicaid LA Fee Schedule,6.61,100% of Medicaid LA Fee Schedule,6.61,100% of CMS OPPS Rate,6.61,100% of CMS OPPS Rate,6.61,100% of CMS OPPS Rate,6.61,100% of CMS OPPS Rate,6.61,100% of CMS OPPS Rate,6.61,100% of CMS OPPS Rate,6.61,100% of CMS OPPS Rate,6.61,100% of CMS OPPS Rate,6.61,79.79,53.19
Outpatient,Laboratory,80180,MYCOPHENODATE,300,244,63.89,354% of CMS OPPS Rate,18.05,100% of Medicaid LA Fee Schedule,18.05,100% of CMS OPPS Rate,18.05,100% of CMS OPPS Rate,45.43,203.89% of BCBS Fee Schedule,170.8,70% of total Billed Charges,183,75% of total Billed Charges,32.49,180% OF CMS OPPS RATE,195.2,80% of total Billed Charges,63.17,350% of CMS Opps rate,18.41,102% of CMS Opps rate,186.66,76.5% of total billed charges,18.05,100% of Medicaid LA Fee Schedule,18.05,100% of Medicaid LA Fee Schedule,18.05,100% of CMS OPPS Rate,18.05,100% of CMS OPPS Rate,109.8,45% of total billed charges,170.8,70% of total billed charges,146.4,60% of total billed charges,18.05,100% of CMS OPPS Rate,20.05,90% OF UHC FEE SCHEDULE,170.8,70% of total billed charges,18.05,100% OF CMS OPPS Rate,41.51,230% OF CMS OPPS Rate,117.12,48% of total Billed charges,18.05,100% OF CMS OPPS Rate,219.6,90% of total Billed charges,18.05,100% of Medicaid LA Fee Schedule,18.05,100% of Medicaid LA Fee Schedule,18.05,100% of Medicaid LA Fee Schedule,18.05,100% of Medicaid LA Fee Schedule,18.05,100% of Medicaid LA Fee Schedule,18.05,100% of Medicaid LA Fee Schedule,18.05,100% of CMS OPPS Rate,18.05,100% of CMS OPPS Rate,18.05,100% of CMS OPPS Rate,18.05,100% of CMS OPPS Rate,18.05,100% of CMS OPPS Rate,18.05,100% of CMS OPPS Rate,18.05,100% of CMS OPPS Rate,18.05,100% of CMS OPPS Rate,18.05,219.6,146.4
Outpatient,Laboratory,80183,"OXCARBAZEPINE, SERUM",300,104,46.9,354% of CMS OPPS Rate,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,33.36,203.89% of BCBS Fee Schedule,72.8,70% of total Billed Charges,78,75% of total Billed Charges,23.85,180% OF CMS OPPS RATE,83.2,80% of total Billed Charges,46.37,350% of CMS Opps rate,13.51,102% of CMS Opps rate,79.56,76.5% of total billed charges,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,46.8,45% of total billed charges,72.8,70% of total billed charges,62.4,60% of total billed charges,13.25,100% of CMS OPPS Rate,14.72,90% OF UHC FEE SCHEDULE,72.8,70% of total billed charges,13.25,100% OF CMS OPPS Rate,30.47,230% OF CMS OPPS Rate,49.92,48% of total Billed charges,13.25,100% OF CMS OPPS Rate,93.6,90% of total Billed charges,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,93.6,62.4
Outpatient,Laboratory,80184,PHENOBARBITAL SERUM,300,167.4,54.16,354% of CMS OPPS Rate,14.72,100% of Medicaid LA Fee Schedule,15.3,100% of CMS OPPS Rate,15.3,100% of CMS OPPS Rate,31.2,203.89% of BCBS Fee Schedule,117.18,70% of total Billed Charges,125.55,75% of total Billed Charges,27.54,180% OF CMS OPPS RATE,133.92,80% of total Billed Charges,53.55,350% of CMS Opps rate,15.6,102% of CMS Opps rate,128.06,76.5% of total billed charges,14.72,100% of Medicaid LA Fee Schedule,14.72,100% of Medicaid LA Fee Schedule,15.3,100% of CMS OPPS Rate,15.3,100% of CMS OPPS Rate,75.33,45% of total billed charges,117.18,70% of total billed charges,100.44,60% of total billed charges,15.3,100% of CMS OPPS Rate,13.77,90% OF UHC FEE SCHEDULE,117.18,70% of total billed charges,15.3,100% OF CMS OPPS Rate,35.19,230% OF CMS OPPS Rate,80.35,48% of total Billed charges,15.3,100% OF CMS OPPS Rate,150.66,90% of total Billed charges,14.72,100% of Medicaid LA Fee Schedule,14.72,100% of Medicaid LA Fee Schedule,14.72,100% of Medicaid LA Fee Schedule,14.72,100% of Medicaid LA Fee Schedule,14.72,100% of Medicaid LA Fee Schedule,14.72,100% of Medicaid LA Fee Schedule,15.3,100% of CMS OPPS Rate,15.3,100% of CMS OPPS Rate,15.3,100% of CMS OPPS Rate,15.3,100% of CMS OPPS Rate,15.3,100% of CMS OPPS Rate,15.3,100% of CMS OPPS Rate,15.3,100% of CMS OPPS Rate,15.3,100% of CMS OPPS Rate,13.77,150.66,100.44
Outpatient,Laboratory,80185,PHENYTOIN (DILANTIN) SERUM,300,167.4,46.9,354% of CMS OPPS Rate,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,33.36,203.89% of BCBS Fee Schedule,117.18,70% of total Billed Charges,125.55,75% of total Billed Charges,23.85,180% OF CMS OPPS RATE,133.92,80% of total Billed Charges,46.37,350% of CMS Opps rate,13.51,102% of CMS Opps rate,128.06,76.5% of total billed charges,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,75.33,45% of total billed charges,117.18,70% of total billed charges,100.44,60% of total billed charges,13.25,100% of CMS OPPS Rate,14.72,90% OF UHC FEE SCHEDULE,117.18,70% of total billed charges,13.25,100% OF CMS OPPS Rate,30.47,230% OF CMS OPPS Rate,80.35,48% of total Billed charges,13.25,100% OF CMS OPPS Rate,150.66,90% of total Billed charges,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,150.66,100.44
Outpatient,Laboratory,80186,"PHENYTOIN, FREE",300,54.9,48.71,354% of CMS OPPS Rate,13.76,100% of Medicaid LA Fee Schedule,13.76,100% of CMS OPPS Rate,13.76,100% of CMS OPPS Rate,34.64,203.89% of BCBS Fee Schedule,38.43,70% of total Billed Charges,41.18,75% of total Billed Charges,24.76,180% OF CMS OPPS RATE,43.92,80% of total Billed Charges,48.16,350% of CMS Opps rate,14.03,102% of CMS Opps rate,42,76.5% of total billed charges,13.76,100% of Medicaid LA Fee Schedule,13.76,100% of Medicaid LA Fee Schedule,13.76,100% of CMS OPPS Rate,13.76,100% of CMS OPPS Rate,24.71,45% of total billed charges,38.43,70% of total billed charges,32.94,60% of total billed charges,13.76,100% of CMS OPPS Rate,15.29,90% OF UHC FEE SCHEDULE,38.43,70% of total billed charges,13.76,100% OF CMS OPPS Rate,31.64,230% OF CMS OPPS Rate,26.35,48% of total Billed charges,13.76,100% OF CMS OPPS Rate,49.41,90% of total Billed charges,13.76,100% of Medicaid LA Fee Schedule,13.76,100% of Medicaid LA Fee Schedule,13.76,100% of Medicaid LA Fee Schedule,13.76,100% of Medicaid LA Fee Schedule,13.76,100% of Medicaid LA Fee Schedule,13.76,100% of Medicaid LA Fee Schedule,13.76,100% of CMS OPPS Rate,13.76,100% of CMS OPPS Rate,13.76,100% of CMS OPPS Rate,13.76,100% of CMS OPPS Rate,13.76,100% of CMS OPPS Rate,13.76,100% of CMS OPPS Rate,13.76,100% of CMS OPPS Rate,13.76,100% of CMS OPPS Rate,13.76,49.41,32.94
Outpatient,Laboratory,80187,POSACONAZOLE,300,342,95.96,354% of CMS OPPS Rate,20.98,100% of Medicaid LA Fee Schedule,27.11,100% of CMS OPPS Rate,27.11,100% of CMS OPPS Rate,171,50% of total billed charges,239.4,70% of total Billed Charges,256.5,75% of total Billed Charges,48.79,180% OF CMS OPPS RATE,273.6,80% of total Billed Charges,94.88,350% of CMS Opps rate,27.65,102% of CMS Opps rate,261.63,76.5% of total billed charges,20.98,100% of Medicaid LA Fee Schedule,20.98,100% of Medicaid LA Fee Schedule,27.11,100% of CMS OPPS Rate,27.11,100% of CMS OPPS Rate,153.9,45% of total billed charges,239.4,70% of total billed charges,205.2,60% of total billed charges,27.11,100% of CMS OPPS Rate,24.4,90% OF UHC FEE SCHEDULE,239.4,70% of total billed charges,27.11,100% OF CMS OPPS Rate,62.35,230% OF CMS OPPS Rate,164.16,48% of total Billed charges,27.11,100% OF CMS OPPS Rate,307.8,90% of total Billed charges,20.98,100% of Medicaid LA Fee Schedule,20.98,100% of Medicaid LA Fee Schedule,20.98,100% of Medicaid LA Fee Schedule,20.98,100% of Medicaid LA Fee Schedule,20.98,100% of Medicaid LA Fee Schedule,20.98,100% of Medicaid LA Fee Schedule,27.11,100% of CMS OPPS Rate,27.11,100% of CMS OPPS Rate,27.11,100% of CMS OPPS Rate,27.11,100% of CMS OPPS Rate,27.11,100% of CMS OPPS Rate,27.11,100% of CMS OPPS Rate,27.11,100% of CMS OPPS Rate,27.11,100% of CMS OPPS Rate,20.98,307.8,205.2
Outpatient,Laboratory,80188,PRIMIDONE,300,138.15,58.72,354% of CMS OPPS Rate,16.59,100% of Medicaid LA Fee Schedule,16.59,100% of CMS OPPS Rate,16.59,100% of CMS OPPS Rate,41.76,203.89% of BCBS Fee Schedule,96.71,70% of total Billed Charges,103.61,75% of total Billed Charges,29.86,180% OF CMS OPPS RATE,110.52,80% of total Billed Charges,58.06,350% of CMS Opps rate,16.92,102% of CMS Opps rate,105.68,76.5% of total billed charges,16.59,100% of Medicaid LA Fee Schedule,16.59,100% of Medicaid LA Fee Schedule,16.59,100% of CMS OPPS Rate,16.59,100% of CMS OPPS Rate,62.17,45% of total billed charges,96.71,70% of total billed charges,82.89,60% of total billed charges,16.59,100% of CMS OPPS Rate,18.43,90% OF UHC FEE SCHEDULE,96.71,70% of total billed charges,16.59,100% OF CMS OPPS Rate,38.15,230% OF CMS OPPS Rate,66.31,48% of total Billed charges,16.59,100% OF CMS OPPS Rate,124.34,90% of total Billed charges,16.59,100% of Medicaid LA Fee Schedule,16.59,100% of Medicaid LA Fee Schedule,16.59,100% of Medicaid LA Fee Schedule,16.59,100% of Medicaid LA Fee Schedule,16.59,100% of Medicaid LA Fee Schedule,16.59,100% of Medicaid LA Fee Schedule,16.59,100% of CMS OPPS Rate,16.59,100% of CMS OPPS Rate,16.59,100% of CMS OPPS Rate,16.59,100% of CMS OPPS Rate,16.59,100% of CMS OPPS Rate,16.59,100% of CMS OPPS Rate,16.59,100% of CMS OPPS Rate,16.59,100% of CMS OPPS Rate,16.59,124.34,82.89
Outpatient,Laboratory,80190,PRONESTYL (PROCAINAMIDE),300,158.5,212.4,354% of CMS OPPS Rate,21.2,100% of Medicaid LA Fee Schedule,60,100% of CMS OPPS Rate,60,100% of CMS OPPS Rate,122.33,203.89% of BCBS Fee Schedule,110.95,70% of total Billed Charges,118.88,75% of total Billed Charges,108,180% OF CMS OPPS RATE,126.8,80% of total Billed Charges,210,350% of CMS Opps rate,61.2,102% of CMS Opps rate,121.25,76.5% of total billed charges,21.2,100% of Medicaid LA Fee Schedule,21.2,100% of Medicaid LA Fee Schedule,60,100% of CMS OPPS Rate,60,100% of CMS OPPS Rate,71.33,45% of total billed charges,110.95,70% of total billed charges,95.1,60% of total billed charges,60,100% of CMS OPPS Rate,54,90% OF UHC FEE SCHEDULE,110.95,70% of total billed charges,60,100% OF CMS OPPS Rate,138,230% OF CMS OPPS Rate,76.08,48% of total Billed charges,60,100% OF CMS OPPS Rate,142.65,90% of total Billed charges,21.2,100% of Medicaid LA Fee Schedule,21.2,100% of Medicaid LA Fee Schedule,21.2,100% of Medicaid LA Fee Schedule,21.2,100% of Medicaid LA Fee Schedule,21.2,100% of Medicaid LA Fee Schedule,21.2,100% of Medicaid LA Fee Schedule,60,100% of CMS OPPS Rate,60,100% of CMS OPPS Rate,60,100% of CMS OPPS Rate,60,100% of CMS OPPS Rate,60,100% of CMS OPPS Rate,60,100% of CMS OPPS Rate,60,100% of CMS OPPS Rate,60,100% of CMS OPPS Rate,21.2,212.4,95.1
Outpatient,Laboratory,80195,ASSAY OF SIROLIMUS,300,139.05,48.6,354% of CMS OPPS Rate,13.73,100% of Medicaid LA Fee Schedule,13.73,100% of CMS OPPS Rate,13.73,100% of CMS OPPS Rate,34.58,203.89% of BCBS Fee Schedule,97.34,70% of total Billed Charges,104.29,75% of total Billed Charges,24.71,180% OF CMS OPPS RATE,111.24,80% of total Billed Charges,48.05,350% of CMS Opps rate,14,102% of CMS Opps rate,106.37,76.5% of total billed charges,13.73,100% of Medicaid LA Fee Schedule,13.73,100% of Medicaid LA Fee Schedule,13.73,100% of CMS OPPS Rate,13.73,100% of CMS OPPS Rate,62.57,45% of total billed charges,97.34,70% of total billed charges,83.43,60% of total billed charges,13.73,100% of CMS OPPS Rate,15.26,90% OF UHC FEE SCHEDULE,97.34,70% of total billed charges,13.73,100% OF CMS OPPS Rate,31.57,230% OF CMS OPPS Rate,66.74,48% of total Billed charges,13.73,100% OF CMS OPPS Rate,125.15,90% of total Billed charges,13.73,100% of Medicaid LA Fee Schedule,13.73,100% of Medicaid LA Fee Schedule,13.73,100% of Medicaid LA Fee Schedule,13.73,100% of Medicaid LA Fee Schedule,13.73,100% of Medicaid LA Fee Schedule,13.73,100% of Medicaid LA Fee Schedule,13.73,100% of CMS OPPS Rate,13.73,100% of CMS OPPS Rate,13.73,100% of CMS OPPS Rate,13.73,100% of CMS OPPS Rate,13.73,100% of CMS OPPS Rate,13.73,100% of CMS OPPS Rate,13.73,100% of CMS OPPS Rate,13.73,100% of CMS OPPS Rate,13.73,125.15,83.43
Outpatient,Laboratory,80197,Test is used to measure the amount of the drug in the blood to determine whether the concentration has reached a therapeutic level and is below the to,300,103.05,48.6,354% of CMS OPPS Rate,13.73,100% of Medicaid LA Fee Schedule,13.73,100% of CMS OPPS Rate,13.73,100% of CMS OPPS Rate,34.58,203.89% of BCBS Fee Schedule,72.14,70% of total Billed Charges,77.29,75% of total Billed Charges,24.71,180% OF CMS OPPS RATE,82.44,80% of total Billed Charges,48.05,350% of CMS Opps rate,14,102% of CMS Opps rate,78.83,76.5% of total billed charges,13.73,100% of Medicaid LA Fee Schedule,13.73,100% of Medicaid LA Fee Schedule,13.73,100% of CMS OPPS Rate,13.73,100% of CMS OPPS Rate,46.37,45% of total billed charges,72.14,70% of total billed charges,61.83,60% of total billed charges,13.73,100% of CMS OPPS Rate,15.26,90% OF UHC FEE SCHEDULE,72.14,70% of total billed charges,13.73,100% OF CMS OPPS Rate,31.57,230% OF CMS OPPS Rate,49.46,48% of total Billed charges,13.73,100% OF CMS OPPS Rate,92.75,90% of total Billed charges,13.73,100% of Medicaid LA Fee Schedule,13.73,100% of Medicaid LA Fee Schedule,13.73,100% of Medicaid LA Fee Schedule,13.73,100% of Medicaid LA Fee Schedule,13.73,100% of Medicaid LA Fee Schedule,13.73,100% of Medicaid LA Fee Schedule,13.73,100% of CMS OPPS Rate,13.73,100% of CMS OPPS Rate,13.73,100% of CMS OPPS Rate,13.73,100% of CMS OPPS Rate,13.73,100% of CMS OPPS Rate,13.73,100% of CMS OPPS Rate,13.73,100% of CMS OPPS Rate,13.73,100% of CMS OPPS Rate,13.73,92.75,61.83
Outpatient,Laboratory,80198,THEOPHYLLIN SERUM,300,121.5,50.05,354% of CMS OPPS Rate,14.14,100% of Medicaid LA Fee Schedule,14.14,100% of CMS OPPS Rate,14.14,100% of CMS OPPS Rate,35.6,203.89% of BCBS Fee Schedule,85.05,70% of total Billed Charges,91.13,75% of total Billed Charges,25.45,180% OF CMS OPPS RATE,97.2,80% of total Billed Charges,49.49,350% of CMS Opps rate,14.42,102% of CMS Opps rate,92.95,76.5% of total billed charges,14.14,100% of Medicaid LA Fee Schedule,14.14,100% of Medicaid LA Fee Schedule,14.14,100% of CMS OPPS Rate,14.14,100% of CMS OPPS Rate,54.68,45% of total billed charges,85.05,70% of total billed charges,72.9,60% of total billed charges,14.14,100% of CMS OPPS Rate,15.71,90% OF UHC FEE SCHEDULE,85.05,70% of total billed charges,14.14,100% OF CMS OPPS Rate,32.52,230% OF CMS OPPS Rate,58.32,48% of total Billed charges,14.14,100% OF CMS OPPS Rate,109.35,90% of total Billed charges,14.14,100% of Medicaid LA Fee Schedule,14.14,100% of Medicaid LA Fee Schedule,14.14,100% of Medicaid LA Fee Schedule,14.14,100% of Medicaid LA Fee Schedule,14.14,100% of Medicaid LA Fee Schedule,14.14,100% of Medicaid LA Fee Schedule,14.14,100% of CMS OPPS Rate,14.14,100% of CMS OPPS Rate,14.14,100% of CMS OPPS Rate,14.14,100% of CMS OPPS Rate,14.14,100% of CMS OPPS Rate,14.14,100% of CMS OPPS Rate,14.14,100% of CMS OPPS Rate,14.14,100% of CMS OPPS Rate,14.14,109.35,72.9
Outpatient,Laboratory,80200,TOBRAMYCIN DRUG ASSAY,300,121.95,57.1,354% of CMS OPPS Rate,14.18,100% of Medicaid LA Fee Schedule,16.13,100% of CMS OPPS Rate,16.13,100% of CMS OPPS Rate,40.59,203.89% of BCBS Fee Schedule,85.37,70% of total Billed Charges,91.46,75% of total Billed Charges,29.03,180% OF CMS OPPS RATE,97.56,80% of total Billed Charges,56.45,350% of CMS Opps rate,16.45,102% of CMS Opps rate,93.29,76.5% of total billed charges,14.18,100% of Medicaid LA Fee Schedule,14.18,100% of Medicaid LA Fee Schedule,16.13,100% of CMS OPPS Rate,16.13,100% of CMS OPPS Rate,54.88,45% of total billed charges,85.37,70% of total billed charges,73.17,60% of total billed charges,16.13,100% of CMS OPPS Rate,17.92,90% OF UHC FEE SCHEDULE,85.37,70% of total billed charges,16.13,100% OF CMS OPPS Rate,37.09,230% OF CMS OPPS Rate,58.54,48% of total Billed charges,16.13,100% OF CMS OPPS Rate,109.76,90% of total Billed charges,14.18,100% of Medicaid LA Fee Schedule,14.18,100% of Medicaid LA Fee Schedule,14.18,100% of Medicaid LA Fee Schedule,14.18,100% of Medicaid LA Fee Schedule,14.18,100% of Medicaid LA Fee Schedule,14.18,100% of Medicaid LA Fee Schedule,16.13,100% of CMS OPPS Rate,16.13,100% of CMS OPPS Rate,16.13,100% of CMS OPPS Rate,16.13,100% of CMS OPPS Rate,16.13,100% of CMS OPPS Rate,16.13,100% of CMS OPPS Rate,16.13,100% of CMS OPPS Rate,16.13,100% of CMS OPPS Rate,14.18,109.76,73.17
Outpatient,Laboratory,80201,"TOPIRAMATE, SERUM",300,140.5,42.19,354% of CMS OPPS Rate,11.92,100% of Medicaid LA Fee Schedule,11.92,100% of CMS OPPS Rate,11.92,100% of CMS OPPS Rate,30.01,203.89% of BCBS Fee Schedule,98.35,70% of total Billed Charges,105.38,75% of total Billed Charges,21.45,180% OF CMS OPPS RATE,112.4,80% of total Billed Charges,41.72,350% of CMS Opps rate,12.15,102% of CMS Opps rate,107.48,76.5% of total billed charges,11.92,100% of Medicaid LA Fee Schedule,11.92,100% of Medicaid LA Fee Schedule,11.92,100% of CMS OPPS Rate,11.92,100% of CMS OPPS Rate,63.23,45% of total billed charges,98.35,70% of total billed charges,84.3,60% of total billed charges,11.92,100% of CMS OPPS Rate,13.25,90% OF UHC FEE SCHEDULE,98.35,70% of total billed charges,11.92,100% OF CMS OPPS Rate,27.41,230% OF CMS OPPS Rate,67.44,48% of total Billed charges,11.92,100% OF CMS OPPS Rate,126.45,90% of total Billed charges,11.92,100% of Medicaid LA Fee Schedule,11.92,100% of Medicaid LA Fee Schedule,11.92,100% of Medicaid LA Fee Schedule,11.92,100% of Medicaid LA Fee Schedule,11.92,100% of Medicaid LA Fee Schedule,11.92,100% of Medicaid LA Fee Schedule,11.92,100% of CMS OPPS Rate,11.92,100% of CMS OPPS Rate,11.92,100% of CMS OPPS Rate,11.92,100% of CMS OPPS Rate,11.92,100% of CMS OPPS Rate,11.92,100% of CMS OPPS Rate,11.92,100% of CMS OPPS Rate,11.92,100% of CMS OPPS Rate,11.92,126.45,84.3
Outpatient,Laboratory,80202,VANCOMYCIN DRUG ASSAY,300,152.1,47.93,354% of CMS OPPS Rate,13.54,100% of Medicaid LA Fee Schedule,13.54,100% of CMS OPPS Rate,13.54,100% of CMS OPPS Rate,34.09,203.89% of BCBS Fee Schedule,106.47,70% of total Billed Charges,114.08,75% of total Billed Charges,24.37,180% OF CMS OPPS RATE,121.68,80% of total Billed Charges,47.39,350% of CMS Opps rate,13.81,102% of CMS Opps rate,116.36,76.5% of total billed charges,13.54,100% of Medicaid LA Fee Schedule,13.54,100% of Medicaid LA Fee Schedule,13.54,100% of CMS OPPS Rate,13.54,100% of CMS OPPS Rate,68.45,45% of total billed charges,106.47,70% of total billed charges,91.26,60% of total billed charges,13.54,100% of CMS OPPS Rate,15.05,90% OF UHC FEE SCHEDULE,106.47,70% of total billed charges,13.54,100% OF CMS OPPS Rate,31.14,230% OF CMS OPPS Rate,73.01,48% of total Billed charges,13.54,100% OF CMS OPPS Rate,136.89,90% of total Billed charges,13.54,100% of Medicaid LA Fee Schedule,13.54,100% of Medicaid LA Fee Schedule,13.54,100% of Medicaid LA Fee Schedule,13.54,100% of Medicaid LA Fee Schedule,13.54,100% of Medicaid LA Fee Schedule,13.54,100% of Medicaid LA Fee Schedule,13.54,100% of CMS OPPS Rate,13.54,100% of CMS OPPS Rate,13.54,100% of CMS OPPS Rate,13.54,100% of CMS OPPS Rate,13.54,100% of CMS OPPS Rate,13.54,100% of CMS OPPS Rate,13.54,100% of CMS OPPS Rate,13.54,100% of CMS OPPS Rate,13.54,136.89,91.26
Outpatient,Laboratory,80203,ZONISAMIDE,300,198,46.9,354% of CMS OPPS Rate,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,33.36,203.89% of BCBS Fee Schedule,138.6,70% of total Billed Charges,148.5,75% of total Billed Charges,23.85,180% OF CMS OPPS RATE,158.4,80% of total Billed Charges,46.37,350% of CMS Opps rate,13.51,102% of CMS Opps rate,151.47,76.5% of total billed charges,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,89.1,45% of total billed charges,138.6,70% of total billed charges,118.8,60% of total billed charges,13.25,100% of CMS OPPS Rate,14.72,90% OF UHC FEE SCHEDULE,138.6,70% of total billed charges,13.25,100% OF CMS OPPS Rate,30.47,230% OF CMS OPPS Rate,95.04,48% of total Billed charges,13.25,100% OF CMS OPPS Rate,178.2,90% of total Billed charges,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,178.2,118.8
Outpatient,Laboratory,80230,INFIXIMAB,300,404,136.53,354% of CMS OPPS Rate,29.86,100% of Medicaid LA Fee Schedule,38.57,100% of CMS OPPS Rate,38.57,100% of CMS OPPS Rate,202,50% of total billed charges,282.8,70% of total Billed Charges,303,75% of total Billed Charges,69.42,180% OF CMS OPPS RATE,323.2,80% of total Billed Charges,134.99,350% of CMS Opps rate,39.34,102% of CMS Opps rate,309.06,76.5% of total billed charges,29.86,100% of Medicaid LA Fee Schedule,29.86,100% of Medicaid LA Fee Schedule,38.57,100% of CMS OPPS Rate,38.57,100% of CMS OPPS Rate,181.8,45% of total billed charges,282.8,70% of total billed charges,242.4,60% of total billed charges,38.57,100% of CMS OPPS Rate,34.71,90% OF UHC FEE SCHEDULE,282.8,70% of total billed charges,38.57,100% OF CMS OPPS Rate,88.71,230% OF CMS OPPS Rate,193.92,48% of total Billed charges,38.57,100% OF CMS OPPS Rate,363.6,90% of total Billed charges,29.86,100% of Medicaid LA Fee Schedule,29.86,100% of Medicaid LA Fee Schedule,29.86,100% of Medicaid LA Fee Schedule,29.86,100% of Medicaid LA Fee Schedule,29.86,100% of Medicaid LA Fee Schedule,29.86,100% of Medicaid LA Fee Schedule,38.57,100% of CMS OPPS Rate,38.57,100% of CMS OPPS Rate,38.57,100% of CMS OPPS Rate,38.57,100% of CMS OPPS Rate,38.57,100% of CMS OPPS Rate,38.57,100% of CMS OPPS Rate,38.57,100% of CMS OPPS Rate,38.57,100% of CMS OPPS Rate,29.86,363.6,242.4
Outpatient,Laboratory,80299,"ANTIEPILEPTICS, OTHER",300,342,65.98,354% of CMS OPPS Rate,17.62,100% of Medicaid LA Fee Schedule,18.64,100% of CMS OPPS Rate,18.64,100% of CMS OPPS Rate,38.01,203.89% of BCBS Fee Schedule,239.4,70% of total Billed Charges,256.5,75% of total Billed Charges,33.55,180% OF CMS OPPS RATE,273.6,80% of total Billed Charges,65.24,350% of CMS Opps rate,19.01,102% of CMS Opps rate,261.63,76.5% of total billed charges,17.62,100% of Medicaid LA Fee Schedule,17.62,100% of Medicaid LA Fee Schedule,18.64,100% of CMS OPPS Rate,18.64,100% of CMS OPPS Rate,153.9,45% of total billed charges,239.4,70% of total billed charges,205.2,60% of total billed charges,18.64,100% of CMS OPPS Rate,16.78,90% OF UHC FEE SCHEDULE,239.4,70% of total billed charges,18.64,100% OF CMS OPPS Rate,42.87,230% OF CMS OPPS Rate,164.16,48% of total Billed charges,18.64,100% OF CMS OPPS Rate,307.8,90% of total Billed charges,17.62,100% of Medicaid LA Fee Schedule,17.62,100% of Medicaid LA Fee Schedule,17.62,100% of Medicaid LA Fee Schedule,17.62,100% of Medicaid LA Fee Schedule,17.62,100% of Medicaid LA Fee Schedule,17.62,100% of Medicaid LA Fee Schedule,18.64,100% of CMS OPPS Rate,18.64,100% of CMS OPPS Rate,18.64,100% of CMS OPPS Rate,18.64,100% of CMS OPPS Rate,18.64,100% of CMS OPPS Rate,18.64,100% of CMS OPPS Rate,18.64,100% of CMS OPPS Rate,18.64,100% of CMS OPPS Rate,16.78,307.8,205.2
Outpatient,Laboratory,80307,Testing for presence of drug,300,272,219.97,354% of CMS OPPS Rate,62.14,100% of Medicaid LA Fee Schedule,62.14,100% of CMS OPPS Rate,62.14,100% of CMS OPPS Rate,146.45,203.89% of BCBS Fee Schedule,190.4,70% of total Billed Charges,204,75% of total Billed Charges,111.85,180% OF CMS OPPS RATE,217.6,80% of total Billed Charges,217.49,350% of CMS Opps rate,63.38,102% of CMS Opps rate,208.08,76.5% of total billed charges,62.14,100% of Medicaid LA Fee Schedule,62.14,100% of Medicaid LA Fee Schedule,62.14,100% of CMS OPPS Rate,62.14,100% of CMS OPPS Rate,122.4,45% of total billed charges,190.4,70% of total billed charges,163.2,60% of total billed charges,62.14,100% of CMS OPPS Rate,64.65,90% OF UHC FEE SCHEDULE,190.4,70% of total billed charges,62.14,100% OF CMS OPPS Rate,142.92,230% OF CMS OPPS Rate,130.56,48% of total Billed charges,62.14,100% OF CMS OPPS Rate,244.8,90% of total Billed charges,62.14,100% of Medicaid LA Fee Schedule,62.14,100% of Medicaid LA Fee Schedule,62.14,100% of Medicaid LA Fee Schedule,62.14,100% of Medicaid LA Fee Schedule,62.14,100% of Medicaid LA Fee Schedule,62.14,100% of Medicaid LA Fee Schedule,62.14,100% of CMS OPPS Rate,62.14,100% of CMS OPPS Rate,62.14,100% of CMS OPPS Rate,62.14,100% of CMS OPPS Rate,62.14,100% of CMS OPPS Rate,62.14,100% of CMS OPPS Rate,62.14,100% of CMS OPPS Rate,62.14,100% of CMS OPPS Rate,62.14,244.8,163.2
Outpatient,Laboratory,80320,ALCOHOL-ETHYL,300,213.3,N/A,Not Applicable,33.42,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,44.86,203.89% of BCBS Fee Schedule,149.31,70% of total Billed Charges,159.98,75% of total Billed Charges,N/A,Not Applicable,170.64,80% of total Billed Charges,N/A,Not Applicable,N/A,Not Applicable,163.17,76.5% of total billed charges,33.42,15.67% of total Billed charges,33.42,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,95.99,45% of total billed charges,149.31,70% of total billed charges,127.98,60% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,149.31,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,102.38,48% of total Billed charges,N/A,Not Applicable,191.97,90% of total Billed charges,33.42,15.67% of total Billed charges,33.42,15.67% of total Billed charges,33.42,15.67% of total Billed charges,33.42,15.67% of total Billed charges,33.42,15.67% of total Billed charges,33.42,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,33.42,191.97,127.98
Outpatient,Laboratory,80321,ALCOHOL BIOMARKERS 1 OR 2,300,216,N/A,Not Applicable,33.85,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,44.86,203.89% of BCBS Fee Schedule,151.2,70% of total Billed Charges,162,75% of total Billed Charges,N/A,Not Applicable,172.8,80% of total Billed Charges,N/A,Not Applicable,N/A,Not Applicable,165.24,76.5% of total billed charges,33.85,15.67% of total Billed charges,33.85,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,97.2,45% of total billed charges,151.2,70% of total billed charges,129.6,60% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,151.2,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,103.68,48% of total Billed charges,N/A,Not Applicable,194.4,90% of total Billed charges,33.85,15.67% of total Billed charges,33.85,15.67% of total Billed charges,33.85,15.67% of total Billed charges,33.85,15.67% of total Billed charges,33.85,15.67% of total Billed charges,33.85,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,33.85,194.4,129.6
Outpatient,Laboratory,80323,ALKALOIDS OTHER,300,216,N/A,Not Applicable,33.85,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,44.86,203.89% of BCBS Fee Schedule,151.2,70% of total Billed Charges,162,75% of total Billed Charges,N/A,Not Applicable,172.8,80% of total Billed Charges,N/A,Not Applicable,N/A,Not Applicable,165.24,76.5% of total billed charges,33.85,15.67% of total Billed charges,33.85,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,97.2,45% of total billed charges,151.2,70% of total billed charges,129.6,60% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,151.2,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,103.68,48% of total Billed charges,N/A,Not Applicable,194.4,90% of total Billed charges,33.85,15.67% of total Billed charges,33.85,15.67% of total Billed charges,33.85,15.67% of total Billed charges,33.85,15.67% of total Billed charges,33.85,15.67% of total Billed charges,33.85,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,33.85,194.4,129.6
Outpatient,Laboratory,80324,AMPHETAMINE CONFIRM 1 OR 2,300,57.6,N/A,Not Applicable,9.03,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,44.86,203.89% of BCBS Fee Schedule,40.32,70% of total Billed Charges,43.2,75% of total Billed Charges,N/A,Not Applicable,46.08,80% of total Billed Charges,N/A,Not Applicable,N/A,Not Applicable,44.06,76.5% of total billed charges,9.03,15.67% of total Billed charges,9.03,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,25.92,45% of total billed charges,40.32,70% of total billed charges,34.56,60% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,40.32,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,27.65,48% of total Billed charges,N/A,Not Applicable,51.84,90% of total Billed charges,9.03,15.67% of total Billed charges,9.03,15.67% of total Billed charges,9.03,15.67% of total Billed charges,9.03,15.67% of total Billed charges,9.03,15.67% of total Billed charges,9.03,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,9.03,51.84,34.56
Outpatient,Laboratory,80325,AMPHETAMINE CONFIRMATION 2 OR 3,300,399.7,N/A,Not Applicable,62.63,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,44.86,203.89% of BCBS Fee Schedule,279.79,70% of total Billed Charges,299.78,75% of total Billed Charges,N/A,Not Applicable,319.76,80% of total Billed Charges,N/A,Not Applicable,N/A,Not Applicable,305.77,76.5% of total billed charges,62.63,15.67% of total Billed charges,62.63,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,179.87,45% of total billed charges,279.79,70% of total billed charges,239.82,60% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,279.79,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,191.86,48% of total Billed charges,N/A,Not Applicable,359.73,90% of total Billed charges,62.63,15.67% of total Billed charges,62.63,15.67% of total Billed charges,62.63,15.67% of total Billed charges,62.63,15.67% of total Billed charges,62.63,15.67% of total Billed charges,62.63,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,44.86,359.73,239.82
Outpatient,Laboratory,80327,ANABOLIC STEROIDS CONFIRM 1 OR 2,300,117.7,N/A,Not Applicable,18.44,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,44.86,203.89% of BCBS Fee Schedule,82.39,70% of total Billed Charges,88.28,75% of total Billed Charges,N/A,Not Applicable,94.16,80% of total Billed Charges,N/A,Not Applicable,N/A,Not Applicable,90.04,76.5% of total billed charges,18.44,15.67% of total Billed charges,18.44,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,52.97,45% of total billed charges,82.39,70% of total billed charges,70.62,60% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,82.39,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,56.5,48% of total Billed charges,N/A,Not Applicable,105.93,90% of total Billed charges,18.44,15.67% of total Billed charges,18.44,15.67% of total Billed charges,18.44,15.67% of total Billed charges,18.44,15.67% of total Billed charges,18.44,15.67% of total Billed charges,18.44,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,18.44,105.93,70.62
Outpatient,Laboratory,80329,ACETOMINOPHEN SERUM,300,193.05,N/A,Not Applicable,30.25,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,44.86,203.89% of BCBS Fee Schedule,135.14,70% of total Billed Charges,144.79,75% of total Billed Charges,N/A,Not Applicable,154.44,80% of total Billed Charges,N/A,Not Applicable,N/A,Not Applicable,147.68,76.5% of total billed charges,30.25,15.67% of total Billed charges,30.25,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,86.87,45% of total billed charges,135.14,70% of total billed charges,115.83,60% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,135.14,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,92.66,48% of total Billed charges,N/A,Not Applicable,173.75,90% of total Billed charges,30.25,15.67% of total Billed charges,30.25,15.67% of total Billed charges,30.25,15.67% of total Billed charges,30.25,15.67% of total Billed charges,30.25,15.67% of total Billed charges,30.25,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,30.25,173.75,115.83
Outpatient,Laboratory,80333,TOX - ANTIDEPRESSANTS PT. 1,300,186,N/A,Not Applicable,29.15,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,44.86,203.89% of BCBS Fee Schedule,130.2,70% of total Billed Charges,139.5,75% of total Billed Charges,N/A,Not Applicable,148.8,80% of total Billed Charges,N/A,Not Applicable,N/A,Not Applicable,142.29,76.5% of total billed charges,29.15,15.67% of total Billed charges,29.15,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,83.7,45% of total billed charges,130.2,70% of total billed charges,111.6,60% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,130.2,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,89.28,48% of total Billed charges,N/A,Not Applicable,167.4,90% of total Billed charges,29.15,15.67% of total Billed charges,29.15,15.67% of total Billed charges,29.15,15.67% of total Billed charges,29.15,15.67% of total Billed charges,29.15,15.67% of total Billed charges,29.15,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,29.15,167.4,111.6
Outpatient,Laboratory,80334,TOX - ANTIDEPRESSANTS SEROTONERGIC,300,206,N/A,Not Applicable,32.28,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,44.86,203.89% of BCBS Fee Schedule,144.2,70% of total Billed Charges,154.5,75% of total Billed Charges,N/A,Not Applicable,164.8,80% of total Billed Charges,N/A,Not Applicable,N/A,Not Applicable,157.59,76.5% of total billed charges,32.28,15.67% of total Billed charges,32.28,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,92.7,45% of total billed charges,144.2,70% of total billed charges,123.6,60% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,144.2,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,98.88,48% of total Billed charges,N/A,Not Applicable,185.4,90% of total Billed charges,32.28,15.67% of total Billed charges,32.28,15.67% of total Billed charges,32.28,15.67% of total Billed charges,32.28,15.67% of total Billed charges,32.28,15.67% of total Billed charges,32.28,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,32.28,185.4,123.6
Outpatient,Laboratory,80335,"ANTIDEPRESSANTS, TRICYCLIC 1 OR 2",300,81,N/A,Not Applicable,12.69,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,44.86,203.89% of BCBS Fee Schedule,56.7,70% of total Billed Charges,60.75,75% of total Billed Charges,N/A,Not Applicable,64.8,80% of total Billed Charges,N/A,Not Applicable,N/A,Not Applicable,61.97,76.5% of total billed charges,12.69,15.67% of total Billed charges,12.69,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,36.45,45% of total billed charges,56.7,70% of total billed charges,48.6,60% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,56.7,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,38.88,48% of total Billed charges,N/A,Not Applicable,72.9,90% of total Billed charges,12.69,15.67% of total Billed charges,12.69,15.67% of total Billed charges,12.69,15.67% of total Billed charges,12.69,15.67% of total Billed charges,12.69,15.67% of total Billed charges,12.69,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,12.69,72.9,48.6
Outpatient,Laboratory,80336,TOX - TRICYCLIC ANTIDEPRESSANT,300,109,N/A,Not Applicable,17.08,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,54.5,50% of total billed charges,76.3,70% of total Billed Charges,81.75,75% of total Billed Charges,N/A,Not Applicable,87.2,80% of total Billed Charges,N/A,Not Applicable,N/A,Not Applicable,83.39,76.5% of total billed charges,17.08,15.67% of total Billed charges,17.08,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,49.05,45% of total billed charges,76.3,70% of total billed charges,65.4,60% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,76.3,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,52.32,48% of total Billed charges,N/A,Not Applicable,98.1,90% of total Billed charges,17.08,15.67% of total Billed charges,17.08,15.67% of total Billed charges,17.08,15.67% of total Billed charges,17.08,15.67% of total Billed charges,17.08,15.67% of total Billed charges,17.08,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,17.08,98.1,65.4
Outpatient,Laboratory,80337,TOX - ANTIDEPRESSANTS TCA,300,109,N/A,Not Applicable,17.08,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,44.86,203.89% of BCBS Fee Schedule,76.3,70% of total Billed Charges,81.75,75% of total Billed Charges,N/A,Not Applicable,87.2,80% of total Billed Charges,N/A,Not Applicable,N/A,Not Applicable,83.39,76.5% of total billed charges,17.08,15.67% of total Billed charges,17.08,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,49.05,45% of total billed charges,76.3,70% of total billed charges,65.4,60% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,76.3,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,52.32,48% of total Billed charges,N/A,Not Applicable,98.1,90% of total Billed charges,17.08,15.67% of total Billed charges,17.08,15.67% of total Billed charges,17.08,15.67% of total Billed charges,17.08,15.67% of total Billed charges,17.08,15.67% of total Billed charges,17.08,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,17.08,98.1,65.4
Outpatient,Laboratory,80338,TOX - ANTIDEPRESSANTS,300,166,N/A,Not Applicable,26.01,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,44.86,203.89% of BCBS Fee Schedule,116.2,70% of total Billed Charges,124.5,75% of total Billed Charges,N/A,Not Applicable,132.8,80% of total Billed Charges,N/A,Not Applicable,N/A,Not Applicable,126.99,76.5% of total billed charges,26.01,15.67% of total Billed charges,26.01,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,74.7,45% of total billed charges,116.2,70% of total billed charges,99.6,60% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,116.2,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,79.68,48% of total Billed charges,N/A,Not Applicable,149.4,90% of total Billed charges,26.01,15.67% of total Billed charges,26.01,15.67% of total Billed charges,26.01,15.67% of total Billed charges,26.01,15.67% of total Billed charges,26.01,15.67% of total Billed charges,26.01,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,26.01,149.4,99.6
Outpatient,Laboratory,80342,OLANZAPINE,300,163,N/A,Not Applicable,25.54,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,44.86,203.89% of BCBS Fee Schedule,114.1,70% of total Billed Charges,122.25,75% of total Billed Charges,N/A,Not Applicable,130.4,80% of total Billed Charges,N/A,Not Applicable,N/A,Not Applicable,124.7,76.5% of total billed charges,25.54,15.67% of total Billed charges,25.54,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,73.35,45% of total billed charges,114.1,70% of total billed charges,97.8,60% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,114.1,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,78.24,48% of total Billed charges,N/A,Not Applicable,146.7,90% of total Billed charges,25.54,15.67% of total Billed charges,25.54,15.67% of total Billed charges,25.54,15.67% of total Billed charges,25.54,15.67% of total Billed charges,25.54,15.67% of total Billed charges,25.54,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,25.54,146.7,97.8
Outpatient,Laboratory,80345,BARBITURATES CONFIRM,300,147,N/A,Not Applicable,23.03,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,44.86,203.89% of BCBS Fee Schedule,102.9,70% of total Billed Charges,110.25,75% of total Billed Charges,N/A,Not Applicable,117.6,80% of total Billed Charges,N/A,Not Applicable,N/A,Not Applicable,112.46,76.5% of total billed charges,23.03,15.67% of total Billed charges,23.03,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,66.15,45% of total billed charges,102.9,70% of total billed charges,88.2,60% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,102.9,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,70.56,48% of total Billed charges,N/A,Not Applicable,132.3,90% of total Billed charges,23.03,15.67% of total Billed charges,23.03,15.67% of total Billed charges,23.03,15.67% of total Billed charges,23.03,15.67% of total Billed charges,23.03,15.67% of total Billed charges,23.03,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,23.03,132.3,88.2
Outpatient,Laboratory,80346,BENZODIAZAPINES CONFIRM 1,300,49.95,N/A,Not Applicable,7.83,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,44.86,203.89% of BCBS Fee Schedule,34.97,70% of total Billed Charges,37.46,75% of total Billed Charges,N/A,Not Applicable,39.96,80% of total Billed Charges,N/A,Not Applicable,N/A,Not Applicable,38.21,76.5% of total billed charges,7.83,15.67% of total Billed charges,7.83,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,22.48,45% of total billed charges,34.97,70% of total billed charges,29.97,60% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,34.97,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,23.98,48% of total Billed charges,N/A,Not Applicable,44.96,90% of total Billed charges,7.83,15.67% of total Billed charges,7.83,15.67% of total Billed charges,7.83,15.67% of total Billed charges,7.83,15.67% of total Billed charges,7.83,15.67% of total Billed charges,7.83,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,7.83,44.96,29.97
Outpatient,Laboratory,80348,BUPRENOPHINE,300,200,N/A,Not Applicable,31.34,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,44.86,203.89% of BCBS Fee Schedule,140,70% of total Billed Charges,150,75% of total Billed Charges,N/A,Not Applicable,160,80% of total Billed Charges,N/A,Not Applicable,N/A,Not Applicable,153,76.5% of total billed charges,31.34,15.67% of total Billed charges,31.34,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,90,45% of total billed charges,140,70% of total billed charges,120,60% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,140,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,96,48% of total Billed charges,N/A,Not Applicable,180,90% of total Billed charges,31.34,15.67% of total Billed charges,31.34,15.67% of total Billed charges,31.34,15.67% of total Billed charges,31.34,15.67% of total Billed charges,31.34,15.67% of total Billed charges,31.34,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,31.34,180,120
Outpatient,Laboratory,80349,"CANNABINOIDS, NATURAL CONFIRM",300,126.26,N/A,Not Applicable,19.78,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,44.86,203.89% of BCBS Fee Schedule,88.38,70% of total Billed Charges,94.7,75% of total Billed Charges,N/A,Not Applicable,101.01,80% of total Billed Charges,N/A,Not Applicable,N/A,Not Applicable,96.59,76.5% of total billed charges,19.78,15.67% of total Billed charges,19.78,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,56.82,45% of total billed charges,88.38,70% of total billed charges,75.76,60% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,88.38,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,60.6,48% of total Billed charges,N/A,Not Applicable,113.63,90% of total Billed charges,19.78,15.67% of total Billed charges,19.78,15.67% of total Billed charges,19.78,15.67% of total Billed charges,19.78,15.67% of total Billed charges,19.78,15.67% of total Billed charges,19.78,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,19.78,113.63,75.76
Outpatient,Laboratory,80352,CANNABINOIDS SYNTHETIC 7 OR MORE,300,160,N/A,Not Applicable,25.07,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,80,50% of total billed charges,112,70% of total Billed Charges,120,75% of total Billed Charges,N/A,Not Applicable,128,80% of total Billed Charges,N/A,Not Applicable,N/A,Not Applicable,122.4,76.5% of total billed charges,25.07,15.67% of total Billed charges,25.07,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,72,45% of total billed charges,112,70% of total billed charges,96,60% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,112,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,76.8,48% of total Billed charges,N/A,Not Applicable,144,90% of total Billed charges,25.07,15.67% of total Billed charges,25.07,15.67% of total Billed charges,25.07,15.67% of total Billed charges,25.07,15.67% of total Billed charges,25.07,15.67% of total Billed charges,25.07,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,25.07,144,96
Outpatient,Laboratory,80353,COCAINE CONFIRM,300,150,N/A,Not Applicable,23.51,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,44.86,203.89% of BCBS Fee Schedule,105,70% of total Billed Charges,112.5,75% of total Billed Charges,N/A,Not Applicable,120,80% of total Billed Charges,N/A,Not Applicable,N/A,Not Applicable,114.75,76.5% of total billed charges,23.51,15.67% of total Billed charges,23.51,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,67.5,45% of total billed charges,105,70% of total billed charges,90,60% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,105,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,72,48% of total Billed charges,N/A,Not Applicable,135,90% of total Billed charges,23.51,15.67% of total Billed charges,23.51,15.67% of total Billed charges,23.51,15.67% of total Billed charges,23.51,15.67% of total Billed charges,23.51,15.67% of total Billed charges,23.51,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,23.51,135,90
Outpatient,Laboratory,80354,TOX - FENTANYL,300,65,N/A,Not Applicable,10.19,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,44.86,203.89% of BCBS Fee Schedule,45.5,70% of total Billed Charges,48.75,75% of total Billed Charges,N/A,Not Applicable,52,80% of total Billed Charges,N/A,Not Applicable,N/A,Not Applicable,49.73,76.5% of total billed charges,10.19,15.67% of total Billed charges,10.19,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,29.25,45% of total billed charges,45.5,70% of total billed charges,39,60% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,45.5,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,31.2,48% of total Billed charges,N/A,Not Applicable,58.5,90% of total Billed charges,10.19,15.67% of total Billed charges,10.19,15.67% of total Billed charges,10.19,15.67% of total Billed charges,10.19,15.67% of total Billed charges,10.19,15.67% of total Billed charges,10.19,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,10.19,58.5,39
Outpatient,Laboratory,80355,TOX - GABAPENTIN,300,75,N/A,Not Applicable,11.75,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,44.86,203.89% of BCBS Fee Schedule,52.5,70% of total Billed Charges,56.25,75% of total Billed Charges,N/A,Not Applicable,60,80% of total Billed Charges,N/A,Not Applicable,N/A,Not Applicable,57.38,76.5% of total billed charges,11.75,15.67% of total Billed charges,11.75,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,33.75,45% of total billed charges,52.5,70% of total billed charges,45,60% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,52.5,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,36,48% of total Billed charges,N/A,Not Applicable,67.5,90% of total Billed charges,11.75,15.67% of total Billed charges,11.75,15.67% of total Billed charges,11.75,15.67% of total Billed charges,11.75,15.67% of total Billed charges,11.75,15.67% of total Billed charges,11.75,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,11.75,67.5,45
Outpatient,Laboratory,80356,TOX - HEROIN METABOLITE,300,70,N/A,Not Applicable,10.97,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,44.86,203.89% of BCBS Fee Schedule,49,70% of total Billed Charges,52.5,75% of total Billed Charges,N/A,Not Applicable,56,80% of total Billed Charges,N/A,Not Applicable,N/A,Not Applicable,53.55,76.5% of total billed charges,10.97,15.67% of total Billed charges,10.97,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,31.5,45% of total billed charges,49,70% of total billed charges,42,60% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,49,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,33.6,48% of total Billed charges,N/A,Not Applicable,63,90% of total Billed charges,10.97,15.67% of total Billed charges,10.97,15.67% of total Billed charges,10.97,15.67% of total Billed charges,10.97,15.67% of total Billed charges,10.97,15.67% of total Billed charges,10.97,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,10.97,63,42
Outpatient,Laboratory,80357,TOX - KETAMINE,300,70,N/A,Not Applicable,10.97,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,44.86,203.89% of BCBS Fee Schedule,49,70% of total Billed Charges,52.5,75% of total Billed Charges,N/A,Not Applicable,56,80% of total Billed Charges,N/A,Not Applicable,N/A,Not Applicable,53.55,76.5% of total billed charges,10.97,15.67% of total Billed charges,10.97,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,31.5,45% of total billed charges,49,70% of total billed charges,42,60% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,49,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,33.6,48% of total Billed charges,N/A,Not Applicable,63,90% of total Billed charges,10.97,15.67% of total Billed charges,10.97,15.67% of total Billed charges,10.97,15.67% of total Billed charges,10.97,15.67% of total Billed charges,10.97,15.67% of total Billed charges,10.97,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,10.97,63,42
Outpatient,Laboratory,80358,METHADONE,300,188,N/A,Not Applicable,29.46,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,44.86,203.89% of BCBS Fee Schedule,131.6,70% of total Billed Charges,141,75% of total Billed Charges,N/A,Not Applicable,150.4,80% of total Billed Charges,N/A,Not Applicable,N/A,Not Applicable,143.82,76.5% of total billed charges,29.46,15.67% of total Billed charges,29.46,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,84.6,45% of total billed charges,131.6,70% of total billed charges,112.8,60% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,131.6,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,90.24,48% of total Billed charges,N/A,Not Applicable,169.2,90% of total Billed charges,29.46,15.67% of total Billed charges,29.46,15.67% of total Billed charges,29.46,15.67% of total Billed charges,29.46,15.67% of total Billed charges,29.46,15.67% of total Billed charges,29.46,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,29.46,169.2,112.8
Outpatient,Laboratory,80359,METHYLENEDIOXYAMPHETAMINE QUANT,300,100,N/A,Not Applicable,15.67,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,44.86,203.89% of BCBS Fee Schedule,70,70% of total Billed Charges,75,75% of total Billed Charges,N/A,Not Applicable,80,80% of total Billed Charges,N/A,Not Applicable,N/A,Not Applicable,76.5,76.5% of total billed charges,15.67,15.67% of total Billed charges,15.67,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,45,45% of total billed charges,70,70% of total billed charges,60,60% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,70,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,48,48% of total Billed charges,N/A,Not Applicable,90,90% of total Billed charges,15.67,15.67% of total Billed charges,15.67,15.67% of total Billed charges,15.67,15.67% of total Billed charges,15.67,15.67% of total Billed charges,15.67,15.67% of total Billed charges,15.67,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,15.67,90,60
Outpatient,Laboratory,80360,TOX - METHYLPHENIDATE,300,140,N/A,Not Applicable,21.94,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,44.86,203.89% of BCBS Fee Schedule,98,70% of total Billed Charges,105,75% of total Billed Charges,N/A,Not Applicable,112,80% of total Billed Charges,N/A,Not Applicable,N/A,Not Applicable,107.1,76.5% of total billed charges,21.94,15.67% of total Billed charges,21.94,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,63,45% of total billed charges,98,70% of total billed charges,84,60% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,98,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,67.2,48% of total Billed charges,N/A,Not Applicable,126,90% of total Billed charges,21.94,15.67% of total Billed charges,21.94,15.67% of total Billed charges,21.94,15.67% of total Billed charges,21.94,15.67% of total Billed charges,21.94,15.67% of total Billed charges,21.94,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,21.94,126,84
Outpatient,Laboratory,80361,OPIATES CONFIRM,300,105,N/A,Not Applicable,16.45,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,44.86,203.89% of BCBS Fee Schedule,73.5,70% of total Billed Charges,78.75,75% of total Billed Charges,N/A,Not Applicable,84,80% of total Billed Charges,N/A,Not Applicable,N/A,Not Applicable,80.33,76.5% of total billed charges,16.45,15.67% of total Billed charges,16.45,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,47.25,45% of total billed charges,73.5,70% of total billed charges,63,60% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,73.5,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,50.4,48% of total Billed charges,N/A,Not Applicable,94.5,90% of total Billed charges,16.45,15.67% of total Billed charges,16.45,15.67% of total Billed charges,16.45,15.67% of total Billed charges,16.45,15.67% of total Billed charges,16.45,15.67% of total Billed charges,16.45,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,16.45,94.5,63
Outpatient,Laboratory,80362,OPIOIDS AND OPIATE ANALOGS 1 -2C,300,160,N/A,Not Applicable,25.07,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,44.86,203.89% of BCBS Fee Schedule,112,70% of total Billed Charges,120,75% of total Billed Charges,N/A,Not Applicable,128,80% of total Billed Charges,N/A,Not Applicable,N/A,Not Applicable,122.4,76.5% of total billed charges,25.07,15.67% of total Billed charges,25.07,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,72,45% of total billed charges,112,70% of total billed charges,96,60% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,112,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,76.8,48% of total Billed charges,N/A,Not Applicable,144,90% of total Billed charges,25.07,15.67% of total Billed charges,25.07,15.67% of total Billed charges,25.07,15.67% of total Billed charges,25.07,15.67% of total Billed charges,25.07,15.67% of total Billed charges,25.07,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,25.07,144,96
Outpatient,Laboratory,80363,TOX - OPIOIDS AND OPIATE ANALOGS,300,180,N/A,Not Applicable,28.21,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,44.86,203.89% of BCBS Fee Schedule,126,70% of total Billed Charges,135,75% of total Billed Charges,N/A,Not Applicable,144,80% of total Billed Charges,N/A,Not Applicable,N/A,Not Applicable,137.7,76.5% of total billed charges,28.21,15.67% of total Billed charges,28.21,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,81,45% of total billed charges,126,70% of total billed charges,108,60% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,126,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,86.4,48% of total Billed charges,N/A,Not Applicable,162,90% of total Billed charges,28.21,15.67% of total Billed charges,28.21,15.67% of total Billed charges,28.21,15.67% of total Billed charges,28.21,15.67% of total Billed charges,28.21,15.67% of total Billed charges,28.21,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,28.21,162,108
Outpatient,Laboratory,80364,TOX - OPIOIDS AND OPIATE ANALOGS 5 OR MO,300,200,N/A,Not Applicable,31.34,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,44.86,203.89% of BCBS Fee Schedule,140,70% of total Billed Charges,150,75% of total Billed Charges,N/A,Not Applicable,160,80% of total Billed Charges,N/A,Not Applicable,N/A,Not Applicable,153,76.5% of total billed charges,31.34,15.67% of total Billed charges,31.34,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,90,45% of total billed charges,140,70% of total billed charges,120,60% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,140,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,96,48% of total Billed charges,N/A,Not Applicable,180,90% of total Billed charges,31.34,15.67% of total Billed charges,31.34,15.67% of total Billed charges,31.34,15.67% of total Billed charges,31.34,15.67% of total Billed charges,31.34,15.67% of total Billed charges,31.34,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,31.34,180,120
Outpatient,Laboratory,80365,OXYCODONE CONFIRM,300,134,N/A,Not Applicable,21,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,44.86,203.89% of BCBS Fee Schedule,93.8,70% of total Billed Charges,100.5,75% of total Billed Charges,N/A,Not Applicable,107.2,80% of total Billed Charges,N/A,Not Applicable,N/A,Not Applicable,102.51,76.5% of total billed charges,21,15.67% of total Billed charges,21,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,60.3,45% of total billed charges,93.8,70% of total billed charges,80.4,60% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,93.8,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,64.32,48% of total Billed charges,N/A,Not Applicable,120.6,90% of total Billed charges,21,15.67% of total Billed charges,21,15.67% of total Billed charges,21,15.67% of total Billed charges,21,15.67% of total Billed charges,21,15.67% of total Billed charges,21,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,21,120.6,80.4
Outpatient,Laboratory,80366,TOX - PREGABALIN,300,50,N/A,Not Applicable,7.84,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,44.86,203.89% of BCBS Fee Schedule,35,70% of total Billed Charges,37.5,75% of total Billed Charges,N/A,Not Applicable,40,80% of total Billed Charges,N/A,Not Applicable,N/A,Not Applicable,38.25,76.5% of total billed charges,7.84,15.67% of total Billed charges,7.84,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,22.5,45% of total billed charges,35,70% of total billed charges,30,60% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,35,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,24,48% of total Billed charges,N/A,Not Applicable,45,90% of total Billed charges,7.84,15.67% of total Billed charges,7.84,15.67% of total Billed charges,7.84,15.67% of total Billed charges,7.84,15.67% of total Billed charges,7.84,15.67% of total Billed charges,7.84,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,7.84,45,30
Outpatient,Laboratory,80367,PROPOXYPHENE CONFIRM,300,190,N/A,Not Applicable,29.77,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,44.86,203.89% of BCBS Fee Schedule,133,70% of total Billed Charges,142.5,75% of total Billed Charges,N/A,Not Applicable,152,80% of total Billed Charges,N/A,Not Applicable,N/A,Not Applicable,145.35,76.5% of total billed charges,29.77,15.67% of total Billed charges,29.77,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,85.5,45% of total billed charges,133,70% of total billed charges,114,60% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,133,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,91.2,48% of total Billed charges,N/A,Not Applicable,171,90% of total Billed charges,29.77,15.67% of total Billed charges,29.77,15.67% of total Billed charges,29.77,15.67% of total Billed charges,29.77,15.67% of total Billed charges,29.77,15.67% of total Billed charges,29.77,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,29.77,171,114
Outpatient,Laboratory,80368,TOX - SLEEP AIDS,300,75,N/A,Not Applicable,11.75,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,44.86,203.89% of BCBS Fee Schedule,52.5,70% of total Billed Charges,56.25,75% of total Billed Charges,N/A,Not Applicable,60,80% of total Billed Charges,N/A,Not Applicable,N/A,Not Applicable,57.38,76.5% of total billed charges,11.75,15.67% of total Billed charges,11.75,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,33.75,45% of total billed charges,52.5,70% of total billed charges,45,60% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,52.5,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,36,48% of total Billed charges,N/A,Not Applicable,67.5,90% of total Billed charges,11.75,15.67% of total Billed charges,11.75,15.67% of total Billed charges,11.75,15.67% of total Billed charges,11.75,15.67% of total Billed charges,11.75,15.67% of total Billed charges,11.75,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,11.75,67.5,45
Outpatient,Laboratory,80369,"TOX - RELAXANTS, SKELETAL MUSCLE",300,175,N/A,Not Applicable,27.42,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,44.86,203.89% of BCBS Fee Schedule,122.5,70% of total Billed Charges,131.25,75% of total Billed Charges,N/A,Not Applicable,140,80% of total Billed Charges,N/A,Not Applicable,N/A,Not Applicable,133.88,76.5% of total billed charges,27.42,15.67% of total Billed charges,27.42,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,78.75,45% of total billed charges,122.5,70% of total billed charges,105,60% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,122.5,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,84,48% of total Billed charges,N/A,Not Applicable,157.5,90% of total Billed charges,27.42,15.67% of total Billed charges,27.42,15.67% of total Billed charges,27.42,15.67% of total Billed charges,27.42,15.67% of total Billed charges,27.42,15.67% of total Billed charges,27.42,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,27.42,157.5,105
Outpatient,Laboratory,80370,TOX -RELAXANTS SKELETAL MUSCLE 3 OR MORE,300,128,N/A,Not Applicable,20.06,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,44.86,203.89% of BCBS Fee Schedule,89.6,70% of total Billed Charges,96,75% of total Billed Charges,N/A,Not Applicable,102.4,80% of total Billed Charges,N/A,Not Applicable,N/A,Not Applicable,97.92,76.5% of total billed charges,20.06,15.67% of total Billed charges,20.06,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,57.6,45% of total billed charges,89.6,70% of total billed charges,76.8,60% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,89.6,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,61.44,48% of total Billed charges,N/A,Not Applicable,115.2,90% of total Billed charges,20.06,15.67% of total Billed charges,20.06,15.67% of total Billed charges,20.06,15.67% of total Billed charges,20.06,15.67% of total Billed charges,20.06,15.67% of total Billed charges,20.06,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,20.06,115.2,76.8
Outpatient,Laboratory,80371,"STIMULANTS, SYNTHETIC",300,256,N/A,Not Applicable,40.12,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,44.86,203.89% of BCBS Fee Schedule,179.2,70% of total Billed Charges,192,75% of total Billed Charges,N/A,Not Applicable,204.8,80% of total Billed Charges,N/A,Not Applicable,N/A,Not Applicable,195.84,76.5% of total billed charges,40.12,15.67% of total Billed charges,40.12,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,115.2,45% of total billed charges,179.2,70% of total billed charges,153.6,60% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,179.2,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,122.88,48% of total Billed charges,N/A,Not Applicable,230.4,90% of total Billed charges,40.12,15.67% of total Billed charges,40.12,15.67% of total Billed charges,40.12,15.67% of total Billed charges,40.12,15.67% of total Billed charges,40.12,15.67% of total Billed charges,40.12,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,40.12,230.4,153.6
Outpatient,Laboratory,80372,TOX - TAPENTADOL,300,149,N/A,Not Applicable,23.35,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,44.86,203.89% of BCBS Fee Schedule,104.3,70% of total Billed Charges,111.75,75% of total Billed Charges,N/A,Not Applicable,119.2,80% of total Billed Charges,N/A,Not Applicable,N/A,Not Applicable,113.99,76.5% of total billed charges,23.35,15.67% of total Billed charges,23.35,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,67.05,45% of total billed charges,104.3,70% of total billed charges,89.4,60% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,104.3,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,71.52,48% of total Billed charges,N/A,Not Applicable,134.1,90% of total Billed charges,23.35,15.67% of total Billed charges,23.35,15.67% of total Billed charges,23.35,15.67% of total Billed charges,23.35,15.67% of total Billed charges,23.35,15.67% of total Billed charges,23.35,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,23.35,134.1,89.4
Outpatient,Laboratory,80373,TOX - TRAMADOL,300,65,N/A,Not Applicable,10.19,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,44.86,203.89% of BCBS Fee Schedule,45.5,70% of total Billed Charges,48.75,75% of total Billed Charges,N/A,Not Applicable,52,80% of total Billed Charges,N/A,Not Applicable,N/A,Not Applicable,49.73,76.5% of total billed charges,10.19,15.67% of total Billed charges,10.19,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,29.25,45% of total billed charges,45.5,70% of total billed charges,39,60% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,45.5,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,31.2,48% of total Billed charges,N/A,Not Applicable,58.5,90% of total Billed charges,10.19,15.67% of total Billed charges,10.19,15.67% of total Billed charges,10.19,15.67% of total Billed charges,10.19,15.67% of total Billed charges,10.19,15.67% of total Billed charges,10.19,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,10.19,58.5,39
Outpatient,Laboratory,80374,STEREOISOMER ANALY SINGLE CLASS,300,222.9,N/A,Not Applicable,34.93,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,111.45,50% of total billed charges,156.03,70% of total Billed Charges,167.18,75% of total Billed Charges,N/A,Not Applicable,178.32,80% of total Billed Charges,N/A,Not Applicable,N/A,Not Applicable,170.52,76.5% of total billed charges,34.93,15.67% of total Billed charges,34.93,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,100.31,45% of total billed charges,156.03,70% of total billed charges,133.74,60% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,156.03,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,106.99,48% of total Billed charges,N/A,Not Applicable,200.61,90% of total Billed charges,34.93,15.67% of total Billed charges,34.93,15.67% of total Billed charges,34.93,15.67% of total Billed charges,34.93,15.67% of total Billed charges,34.93,15.67% of total Billed charges,34.93,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,34.93,200.61,133.74
Outpatient,Laboratory,80400,ACTH STIMULATION PANEL CORTISOL X2,300,221.95,115.47,354% of CMS OPPS Rate,32.62,100% of Medicaid LA Fee Schedule,32.61,100% of CMS OPPS Rate,32.61,100% of CMS OPPS Rate,82.11,203.89% of BCBS Fee Schedule,155.37,70% of total Billed Charges,166.46,75% of total Billed Charges,58.71,180% OF CMS OPPS RATE,177.56,80% of total Billed Charges,114.17,350% of CMS Opps rate,33.27,102% of CMS Opps rate,169.79,76.5% of total billed charges,32.62,100% of Medicaid LA Fee Schedule,32.62,100% of Medicaid LA Fee Schedule,32.61,100% of CMS OPPS Rate,32.61,100% of CMS OPPS Rate,99.88,45% of total billed charges,155.37,70% of total billed charges,133.17,60% of total billed charges,32.61,100% of CMS OPPS Rate,36.24,90% OF UHC FEE SCHEDULE,155.37,70% of total billed charges,32.61,100% OF CMS OPPS Rate,75.02,230% OF CMS OPPS Rate,106.54,48% of total Billed charges,32.61,100% OF CMS OPPS Rate,199.76,90% of total Billed charges,32.62,100% of Medicaid LA Fee Schedule,32.62,100% of Medicaid LA Fee Schedule,32.62,100% of Medicaid LA Fee Schedule,32.62,100% of Medicaid LA Fee Schedule,32.62,100% of Medicaid LA Fee Schedule,32.62,100% of Medicaid LA Fee Schedule,32.61,100% of CMS OPPS Rate,32.61,100% of CMS OPPS Rate,32.61,100% of CMS OPPS Rate,32.61,100% of CMS OPPS Rate,32.61,100% of CMS OPPS Rate,32.61,100% of CMS OPPS Rate,32.61,100% of CMS OPPS Rate,32.61,100% of CMS OPPS Rate,32.61,199.76,133.17
Outpatient,Laboratory,80500,CLINICAL PATHOLOGY CONSULT,300,630,N/A,Not Applicable,98.72,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,91.14,203.89% of BCBS Fee Schedule,441,70% of total Billed Charges,472.5,75% of total Billed Charges,N/A,Not Applicable,504,80% of total Billed Charges,N/A,Not Applicable,N/A,Not Applicable,481.95,76.5% of total billed charges,98.72,15.67% of total Billed charges,98.72,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,283.5,45% of total billed charges,441,70% of total billed charges,378,60% of total billed charges,N/A,Not Applicable,40.23,90% OF UHC FEE SCHEDULE,441,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,302.4,48% of total Billed charges,N/A,Not Applicable,567,90% of total Billed charges,98.72,15.67% of total Billed charges,98.72,15.67% of total Billed charges,98.72,15.67% of total Billed charges,98.72,15.67% of total Billed charges,98.72,15.67% of total Billed charges,98.72,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,40.23,567,378
Outpatient,Laboratory,81001,Manual urinalysis test with examination with or without using microscope,300,164.25,11.22,354% of CMS OPPS Rate,3.17,100% of Medicaid LA Fee Schedule,3.17,100% of CMS OPPS Rate,3.17,100% of CMS OPPS Rate,7.99,203.89% of BCBS Fee Schedule,114.98,70% of total Billed Charges,123.19,75% of total Billed Charges,5.7,180% OF CMS OPPS RATE,131.4,80% of total Billed Charges,11.09,350% of CMS Opps rate,3.23,102% of CMS Opps rate,125.65,76.5% of total billed charges,3.17,100% of Medicaid LA Fee Schedule,3.17,100% of Medicaid LA Fee Schedule,3.17,100% of CMS OPPS Rate,3.17,100% of CMS OPPS Rate,73.91,45% of total billed charges,114.98,70% of total billed charges,98.55,60% of total billed charges,3.17,100% of CMS OPPS Rate,3.53,90% OF UHC FEE SCHEDULE,114.98,70% of total billed charges,3.17,100% OF CMS OPPS Rate,7.29,230% OF CMS OPPS Rate,78.84,48% of total Billed charges,3.17,100% OF CMS OPPS Rate,147.83,90% of total Billed charges,3.17,100% of Medicaid LA Fee Schedule,3.17,100% of Medicaid LA Fee Schedule,3.17,100% of Medicaid LA Fee Schedule,3.17,100% of Medicaid LA Fee Schedule,3.17,100% of Medicaid LA Fee Schedule,3.17,100% of Medicaid LA Fee Schedule,3.17,100% of CMS OPPS Rate,3.17,100% of CMS OPPS Rate,3.17,100% of CMS OPPS Rate,3.17,100% of CMS OPPS Rate,3.17,100% of CMS OPPS Rate,3.17,100% of CMS OPPS Rate,3.17,100% of CMS OPPS Rate,3.17,100% of CMS OPPS Rate,3.17,147.83,98.55
Outpatient,Laboratory,81003,Automated urinalysis test,300,89.1,7.96,354% of CMS OPPS Rate,2.25,100% of Medicaid LA Fee Schedule,2.25,100% of CMS OPPS Rate,2.25,100% of CMS OPPS Rate,5.65,203.89% of BCBS Fee Schedule,62.37,70% of total Billed Charges,66.83,75% of total Billed Charges,4.05,180% OF CMS OPPS RATE,71.28,80% of total Billed Charges,7.87,350% of CMS Opps rate,2.29,102% of CMS Opps rate,68.16,76.5% of total billed charges,2.25,100% of Medicaid LA Fee Schedule,2.25,100% of Medicaid LA Fee Schedule,2.25,100% of CMS OPPS Rate,2.25,100% of CMS OPPS Rate,40.1,45% of total billed charges,62.37,70% of total billed charges,53.46,60% of total billed charges,2.25,100% of CMS OPPS Rate,2.49,90% OF UHC FEE SCHEDULE,62.37,70% of total billed charges,2.25,100% OF CMS OPPS Rate,5.17,230% OF CMS OPPS Rate,42.77,48% of total Billed charges,2.25,100% OF CMS OPPS Rate,80.19,90% of total Billed charges,2.25,100% of Medicaid LA Fee Schedule,2.25,100% of Medicaid LA Fee Schedule,2.25,100% of Medicaid LA Fee Schedule,2.25,100% of Medicaid LA Fee Schedule,2.25,100% of Medicaid LA Fee Schedule,2.25,100% of Medicaid LA Fee Schedule,2.25,100% of CMS OPPS Rate,2.25,100% of CMS OPPS Rate,2.25,100% of CMS OPPS Rate,2.25,100% of CMS OPPS Rate,2.25,100% of CMS OPPS Rate,2.25,100% of CMS OPPS Rate,2.25,100% of CMS OPPS Rate,2.25,100% of CMS OPPS Rate,2.25,80.19,53.46
Outpatient,Laboratory,81005,TOX - SPECIMEN VALIDITY 3,300,6,7.68,354% of CMS OPPS Rate,2.17,100% of Medicaid LA Fee Schedule,2.17,100% of CMS OPPS Rate,2.17,100% of CMS OPPS Rate,5.44,203.89% of BCBS Fee Schedule,4.2,70% of total Billed Charges,4.5,75% of total Billed Charges,3.9,180% OF CMS OPPS RATE,4.8,80% of total Billed Charges,7.59,350% of CMS Opps rate,2.21,102% of CMS Opps rate,4.59,76.5% of total billed charges,2.17,100% of Medicaid LA Fee Schedule,2.17,100% of Medicaid LA Fee Schedule,2.17,100% of CMS OPPS Rate,2.17,100% of CMS OPPS Rate,2.7,45% of total billed charges,4.2,70% of total billed charges,3.6,60% of total billed charges,2.17,100% of CMS OPPS Rate,2.4,90% OF UHC FEE SCHEDULE,4.2,70% of total billed charges,2.17,100% OF CMS OPPS Rate,4.99,230% OF CMS OPPS Rate,2.88,48% of total Billed charges,2.17,100% OF CMS OPPS Rate,5.4,90% of total Billed charges,2.17,100% of Medicaid LA Fee Schedule,2.17,100% of Medicaid LA Fee Schedule,2.17,100% of Medicaid LA Fee Schedule,2.17,100% of Medicaid LA Fee Schedule,2.17,100% of Medicaid LA Fee Schedule,2.17,100% of Medicaid LA Fee Schedule,2.17,100% of CMS OPPS Rate,2.17,100% of CMS OPPS Rate,2.17,100% of CMS OPPS Rate,2.17,100% of CMS OPPS Rate,2.17,100% of CMS OPPS Rate,2.17,100% of CMS OPPS Rate,2.17,100% of CMS OPPS Rate,2.17,100% of CMS OPPS Rate,2.17,7.68,3.6
Outpatient,Laboratory,81015,URINALYSIS-MICRO ONLY,300,78.3,10.79,354% of CMS OPPS Rate,3.05,100% of Medicaid LA Fee Schedule,3.05,100% of CMS OPPS Rate,3.05,100% of CMS OPPS Rate,7.67,203.89% of BCBS Fee Schedule,54.81,70% of total Billed Charges,58.73,75% of total Billed Charges,5.49,180% OF CMS OPPS RATE,62.64,80% of total Billed Charges,10.67,350% of CMS Opps rate,3.11,102% of CMS Opps rate,59.9,76.5% of total billed charges,3.05,100% of Medicaid LA Fee Schedule,3.05,100% of Medicaid LA Fee Schedule,3.05,100% of CMS OPPS Rate,3.05,100% of CMS OPPS Rate,35.24,45% of total billed charges,54.81,70% of total billed charges,46.98,60% of total billed charges,3.05,100% of CMS OPPS Rate,3.38,90% OF UHC FEE SCHEDULE,54.81,70% of total billed charges,3.05,100% OF CMS OPPS Rate,7.01,230% OF CMS OPPS Rate,37.58,48% of total Billed charges,3.05,100% OF CMS OPPS Rate,70.47,90% of total Billed charges,3.05,100% of Medicaid LA Fee Schedule,3.05,100% of Medicaid LA Fee Schedule,3.05,100% of Medicaid LA Fee Schedule,3.05,100% of Medicaid LA Fee Schedule,3.05,100% of Medicaid LA Fee Schedule,3.05,100% of Medicaid LA Fee Schedule,3.05,100% of CMS OPPS Rate,3.05,100% of CMS OPPS Rate,3.05,100% of CMS OPPS Rate,3.05,100% of CMS OPPS Rate,3.05,100% of CMS OPPS Rate,3.05,100% of CMS OPPS Rate,3.05,100% of CMS OPPS Rate,3.05,100% of CMS OPPS Rate,3.05,70.47,46.98
Outpatient,Laboratory,81050,VOLUME MEASURE URINE,300,11.25,12.88,354% of CMS OPPS Rate,3.64,100% of Medicaid LA Fee Schedule,3.64,100% of CMS OPPS Rate,3.64,100% of CMS OPPS Rate,7.56,203.89% of BCBS Fee Schedule,7.88,70% of total Billed Charges,8.44,75% of total Billed Charges,6.55,180% OF CMS OPPS RATE,9,80% of total Billed Charges,12.74,350% of CMS Opps rate,3.71,102% of CMS Opps rate,8.61,76.5% of total billed charges,3.64,100% of Medicaid LA Fee Schedule,3.64,100% of Medicaid LA Fee Schedule,3.64,100% of CMS OPPS Rate,3.64,100% of CMS OPPS Rate,5.06,45% of total billed charges,7.88,70% of total billed charges,6.75,60% of total billed charges,3.64,100% of CMS OPPS Rate,3.34,90% OF UHC FEE SCHEDULE,7.88,70% of total billed charges,3.64,100% OF CMS OPPS Rate,8.37,230% OF CMS OPPS Rate,5.4,48% of total Billed charges,3.64,100% OF CMS OPPS Rate,10.13,90% of total Billed charges,3.64,100% of Medicaid LA Fee Schedule,3.64,100% of Medicaid LA Fee Schedule,3.64,100% of Medicaid LA Fee Schedule,3.64,100% of Medicaid LA Fee Schedule,3.64,100% of Medicaid LA Fee Schedule,3.64,100% of Medicaid LA Fee Schedule,3.64,100% of CMS OPPS Rate,3.64,100% of CMS OPPS Rate,3.64,100% of CMS OPPS Rate,3.64,100% of CMS OPPS Rate,3.64,100% of CMS OPPS Rate,3.64,100% of CMS OPPS Rate,3.64,100% of CMS OPPS Rate,3.64,100% of CMS OPPS Rate,3.34,12.88,6.75
Outpatient,Laboratory,81161,DYSTROPHIN DELETION ANAL.,300,697.5,987.66,354% of CMS OPPS Rate,109.3,15.67% of total Billed charges,279,100% of CMS OPPS Rate,279,100% of CMS OPPS Rate,568.85,203.89% of BCBS Fee Schedule,488.25,70% of total Billed Charges,523.13,75% of total Billed Charges,502.2,180% OF CMS OPPS RATE,558,80% of total Billed Charges,976.5,350% of CMS Opps rate,284.58,102% of CMS Opps rate,533.59,76.5% of total billed charges,109.3,15.67% of total Billed charges,109.3,15.67% of total Billed charges,279,100% of CMS OPPS Rate,279,100% of CMS OPPS Rate,313.88,45% of total billed charges,488.25,70% of total billed charges,418.5,60% of total billed charges,279,100% of CMS OPPS Rate,251.1,90% OF UHC FEE SCHEDULE,488.25,70% of total billed charges,279,100% OF CMS OPPS Rate,641.7,230% OF CMS OPPS Rate,334.8,48% of total Billed charges,279,100% OF CMS OPPS Rate,627.75,90% of total Billed charges,109.3,15.67% of total Billed charges,109.3,15.67% of total Billed charges,109.3,15.67% of total Billed charges,109.3,15.67% of total Billed charges,109.3,15.67% of total Billed charges,109.3,15.67% of total Billed charges,279,100% of CMS OPPS Rate,279,100% of CMS OPPS Rate,279,100% of CMS OPPS Rate,279,100% of CMS OPPS Rate,279,100% of CMS OPPS Rate,279,100% of CMS OPPS Rate,279,100% of CMS OPPS Rate,279,100% of CMS OPPS Rate,109.3,987.66,418.5
Outpatient,Laboratory,81162,"BRCA1, BRCA2 FULL SEQUENCE ANALYSIS",300,5632.33,6460.07,354% of CMS OPPS Rate,1824.88,100% of Medicaid LA Fee Schedule,1824.88,100% of CMS OPPS Rate,1824.88,100% of CMS OPPS Rate,4593.5,203.89% of BCBS Fee Schedule,3942.63,70% of total Billed Charges,4224.25,75% of total Billed Charges,3284.78,180% OF CMS OPPS RATE,4505.86,80% of total Billed Charges,6387.08,350% of CMS Opps rate,1861.37,102% of CMS Opps rate,4308.73,76.5% of total billed charges,1824.88,100% of Medicaid LA Fee Schedule,1824.88,100% of Medicaid LA Fee Schedule,1824.88,100% of CMS OPPS Rate,1824.88,100% of CMS OPPS Rate,2534.55,45% of total billed charges,3942.63,70% of total billed charges,3379.4,60% of total billed charges,1824.88,100% of CMS OPPS Rate,2027.64,90% OF UHC FEE SCHEDULE,3942.63,70% of total billed charges,1824.88,100% OF CMS OPPS Rate,4197.22,230% OF CMS OPPS Rate,2703.52,48% of total Billed charges,1824.88,100% OF CMS OPPS Rate,5069.1,90% of total Billed charges,1824.88,100% of Medicaid LA Fee Schedule,1824.88,100% of Medicaid LA Fee Schedule,1824.88,100% of Medicaid LA Fee Schedule,1824.88,100% of Medicaid LA Fee Schedule,1824.88,100% of Medicaid LA Fee Schedule,1824.88,100% of Medicaid LA Fee Schedule,1824.88,100% of CMS OPPS Rate,1824.88,100% of CMS OPPS Rate,1824.88,100% of CMS OPPS Rate,1824.88,100% of CMS OPPS Rate,1824.88,100% of CMS OPPS Rate,1824.88,100% of CMS OPPS Rate,1824.88,100% of CMS OPPS Rate,1824.88,100% of CMS OPPS Rate,1824.88,6460.07,3379.4
Outpatient,Laboratory,81170,ABL 1 PROTO ONCOGENE 1,300,829.55,1062,354% of CMS OPPS Rate,232.2,100% of Medicaid LA Fee Schedule,300,100% of CMS OPPS Rate,300,100% of CMS OPPS Rate,611.67,203.89% of BCBS Fee Schedule,580.69,70% of total Billed Charges,622.16,75% of total Billed Charges,540,180% OF CMS OPPS RATE,663.64,80% of total Billed Charges,1050,350% of CMS Opps rate,306,102% of CMS Opps rate,634.61,76.5% of total billed charges,232.2,100% of Medicaid LA Fee Schedule,232.2,100% of Medicaid LA Fee Schedule,300,100% of CMS OPPS Rate,300,100% of CMS OPPS Rate,373.3,45% of total billed charges,580.69,70% of total billed charges,497.73,60% of total billed charges,300,100% of CMS OPPS Rate,270,90% OF UHC FEE SCHEDULE,580.69,70% of total billed charges,300,100% OF CMS OPPS Rate,690,230% OF CMS OPPS Rate,398.18,48% of total Billed charges,300,100% OF CMS OPPS Rate,746.6,90% of total Billed charges,232.2,100% of Medicaid LA Fee Schedule,232.2,100% of Medicaid LA Fee Schedule,232.2,100% of Medicaid LA Fee Schedule,232.2,100% of Medicaid LA Fee Schedule,232.2,100% of Medicaid LA Fee Schedule,232.2,100% of Medicaid LA Fee Schedule,300,100% of CMS OPPS Rate,300,100% of CMS OPPS Rate,300,100% of CMS OPPS Rate,300,100% of CMS OPPS Rate,300,100% of CMS OPPS Rate,300,100% of CMS OPPS Rate,300,100% of CMS OPPS Rate,300,100% of CMS OPPS Rate,232.2,1062,497.73
Outpatient,Laboratory,81206,BCR/ABL1 CHRONIC MYELO LEUKEMIA,300,700,580.41,354% of CMS OPPS Rate,141.01,100% of Medicaid LA Fee Schedule,163.96,100% of CMS OPPS Rate,163.96,100% of CMS OPPS Rate,412.71,203.89% of BCBS Fee Schedule,490,70% of total Billed Charges,525,75% of total Billed Charges,295.12,180% OF CMS OPPS RATE,560,80% of total Billed Charges,573.86,350% of CMS Opps rate,167.23,102% of CMS Opps rate,535.5,76.5% of total billed charges,141.01,100% of Medicaid LA Fee Schedule,141.01,100% of Medicaid LA Fee Schedule,163.96,100% of CMS OPPS Rate,163.96,100% of CMS OPPS Rate,315,45% of total billed charges,490,70% of total billed charges,420,60% of total billed charges,163.96,100% of CMS OPPS Rate,182.18,90% OF UHC FEE SCHEDULE,490,70% of total billed charges,163.96,100% OF CMS OPPS Rate,377.1,230% OF CMS OPPS Rate,336,48% of total Billed charges,163.96,100% OF CMS OPPS Rate,630,90% of total Billed charges,141.01,100% of Medicaid LA Fee Schedule,141.01,100% of Medicaid LA Fee Schedule,141.01,100% of Medicaid LA Fee Schedule,141.01,100% of Medicaid LA Fee Schedule,141.01,100% of Medicaid LA Fee Schedule,141.01,100% of Medicaid LA Fee Schedule,163.96,100% of CMS OPPS Rate,163.96,100% of CMS OPPS Rate,163.96,100% of CMS OPPS Rate,163.96,100% of CMS OPPS Rate,163.96,100% of CMS OPPS Rate,163.96,100% of CMS OPPS Rate,163.96,100% of CMS OPPS Rate,163.96,100% of CMS OPPS Rate,141.01,630,420
Outpatient,Laboratory,81207,BCR ALB1 ANALYSIS,300,768,512.73,354% of CMS OPPS Rate,124.56,100% of Medicaid LA Fee Schedule,144.84,100% of CMS OPPS Rate,144.84,100% of CMS OPPS Rate,364.58,203.89% of BCBS Fee Schedule,537.6,70% of total Billed Charges,576,75% of total Billed Charges,260.71,180% OF CMS OPPS RATE,614.4,80% of total Billed Charges,506.94,350% of CMS Opps rate,147.73,102% of CMS Opps rate,587.52,76.5% of total billed charges,124.56,100% of Medicaid LA Fee Schedule,124.56,100% of Medicaid LA Fee Schedule,144.84,100% of CMS OPPS Rate,144.84,100% of CMS OPPS Rate,345.6,45% of total billed charges,537.6,70% of total billed charges,460.8,60% of total billed charges,144.84,100% of CMS OPPS Rate,160.93,90% OF UHC FEE SCHEDULE,537.6,70% of total billed charges,144.84,100% OF CMS OPPS Rate,333.13,230% OF CMS OPPS Rate,368.64,48% of total Billed charges,144.84,100% OF CMS OPPS Rate,691.2,90% of total Billed charges,124.56,100% of Medicaid LA Fee Schedule,124.56,100% of Medicaid LA Fee Schedule,124.56,100% of Medicaid LA Fee Schedule,124.56,100% of Medicaid LA Fee Schedule,124.56,100% of Medicaid LA Fee Schedule,124.56,100% of Medicaid LA Fee Schedule,144.84,100% of CMS OPPS Rate,144.84,100% of CMS OPPS Rate,144.84,100% of CMS OPPS Rate,144.84,100% of CMS OPPS Rate,144.84,100% of CMS OPPS Rate,144.84,100% of CMS OPPS Rate,144.84,100% of CMS OPPS Rate,144.84,100% of CMS OPPS Rate,124.56,691.2,460.8
Outpatient,Laboratory,81210,BRAF (B-RAF PROTO ONCOGENE VIRUS B1),300,896,620.91,354% of CMS OPPS Rate,140.4,15.67% of total Billed charges,175.4,100% of CMS OPPS Rate,175.4,100% of CMS OPPS Rate,357.62,203.89% of BCBS Fee Schedule,627.2,70% of total Billed Charges,672,75% of total Billed Charges,315.72,180% OF CMS OPPS RATE,716.8,80% of total Billed Charges,613.9,350% of CMS Opps rate,178.9,102% of CMS Opps rate,685.44,76.5% of total billed charges,140.4,15.67% of total Billed charges,140.4,15.67% of total Billed charges,175.4,100% of CMS OPPS Rate,175.4,100% of CMS OPPS Rate,403.2,45% of total billed charges,627.2,70% of total billed charges,537.6,60% of total billed charges,175.4,100% of CMS OPPS Rate,157.86,90% OF UHC FEE SCHEDULE,627.2,70% of total billed charges,175.4,100% OF CMS OPPS Rate,403.42,230% OF CMS OPPS Rate,430.08,48% of total Billed charges,175.4,100% OF CMS OPPS Rate,806.4,90% of total Billed charges,140.4,15.67% of total Billed charges,140.4,15.67% of total Billed charges,140.4,15.67% of total Billed charges,140.4,15.67% of total Billed charges,140.4,15.67% of total Billed charges,140.4,15.67% of total Billed charges,175.4,100% of CMS OPPS Rate,175.4,100% of CMS OPPS Rate,175.4,100% of CMS OPPS Rate,175.4,100% of CMS OPPS Rate,175.4,100% of CMS OPPS Rate,175.4,100% of CMS OPPS Rate,175.4,100% of CMS OPPS Rate,175.4,100% of CMS OPPS Rate,140.4,806.4,537.6
Outpatient,Laboratory,81212,"BRCA1, BRCA2 BREAST CANCER 1 AND 2",300,1000,1557.6,354% of CMS OPPS Rate,170.92,100% of Medicaid LA Fee Schedule,440,100% of CMS OPPS Rate,440,100% of CMS OPPS Rate,897.12,203.89% of BCBS Fee Schedule,700,70% of total Billed Charges,750,75% of total Billed Charges,792,180% OF CMS OPPS RATE,800,80% of total Billed Charges,1540,350% of CMS Opps rate,448.8,102% of CMS Opps rate,765,76.5% of total billed charges,170.92,100% of Medicaid LA Fee Schedule,170.92,100% of Medicaid LA Fee Schedule,440,100% of CMS OPPS Rate,440,100% of CMS OPPS Rate,450,45% of total billed charges,700,70% of total billed charges,600,60% of total billed charges,440,100% of CMS OPPS Rate,396,90% OF UHC FEE SCHEDULE,700,70% of total billed charges,440,100% OF CMS OPPS Rate,1000,230% OF CMS OPPS Rate,480,48% of total Billed charges,440,100% OF CMS OPPS Rate,900,90% of total Billed charges,170.92,100% of Medicaid LA Fee Schedule,170.92,100% of Medicaid LA Fee Schedule,170.92,100% of Medicaid LA Fee Schedule,170.92,100% of Medicaid LA Fee Schedule,170.92,100% of Medicaid LA Fee Schedule,170.92,100% of Medicaid LA Fee Schedule,440,100% of CMS OPPS Rate,440,100% of CMS OPPS Rate,440,100% of CMS OPPS Rate,440,100% of CMS OPPS Rate,440,100% of CMS OPPS Rate,440,100% of CMS OPPS Rate,440,100% of CMS OPPS Rate,440,100% of CMS OPPS Rate,170.92,1557.6,600
Outpatient,Laboratory,81219,CALRETICULIN GENE ANALYSIS,300,834.2,430.57,354% of CMS OPPS Rate,130.72,15.67% of total Billed charges,121.63,100% of CMS OPPS Rate,121.63,100% of CMS OPPS Rate,306.16,203.89% of BCBS Fee Schedule,583.94,70% of total Billed Charges,625.65,75% of total Billed Charges,218.93,180% OF CMS OPPS RATE,667.36,80% of total Billed Charges,425.7,350% of CMS Opps rate,124.06,102% of CMS Opps rate,638.16,76.5% of total billed charges,130.72,15.67% of total Billed charges,130.72,15.67% of total Billed charges,121.63,100% of CMS OPPS Rate,121.63,100% of CMS OPPS Rate,375.39,45% of total billed charges,583.94,70% of total billed charges,500.52,60% of total billed charges,121.63,100% of CMS OPPS Rate,135.14,90% OF UHC FEE SCHEDULE,583.94,70% of total billed charges,121.63,100% OF CMS OPPS Rate,279.74,230% OF CMS OPPS Rate,400.42,48% of total Billed charges,121.63,100% OF CMS OPPS Rate,750.78,90% of total Billed charges,130.72,15.67% of total Billed charges,130.72,15.67% of total Billed charges,130.72,15.67% of total Billed charges,130.72,15.67% of total Billed charges,130.72,15.67% of total Billed charges,130.72,15.67% of total Billed charges,121.63,100% of CMS OPPS Rate,121.63,100% of CMS OPPS Rate,121.63,100% of CMS OPPS Rate,121.63,100% of CMS OPPS Rate,121.63,100% of CMS OPPS Rate,121.63,100% of CMS OPPS Rate,121.63,100% of CMS OPPS Rate,121.63,100% of CMS OPPS Rate,121.63,750.78,500.52
Outpatient,Laboratory,81220,CFTR CYSTIC FIBROSIS GENE ANALYSIS,300,1908,1970.36,354% of CMS OPPS Rate,289.36,100% of Medicaid LA Fee Schedule,556.6,100% of CMS OPPS Rate,556.6,100% of CMS OPPS Rate,1134.85,203.89% of BCBS Fee Schedule,1335.6,70% of total Billed Charges,1431,75% of total Billed Charges,1001.88,180% OF CMS OPPS RATE,1526.4,80% of total Billed Charges,1948.1,350% of CMS Opps rate,567.73,102% of CMS Opps rate,1459.62,76.5% of total billed charges,289.36,100% of Medicaid LA Fee Schedule,289.36,100% of Medicaid LA Fee Schedule,556.6,100% of CMS OPPS Rate,556.6,100% of CMS OPPS Rate,858.6,45% of total billed charges,1335.6,70% of total billed charges,1144.8,60% of total billed charges,556.6,100% of CMS OPPS Rate,500.94,90% OF UHC FEE SCHEDULE,1335.6,70% of total billed charges,556.6,100% OF CMS OPPS Rate,1280.18,230% OF CMS OPPS Rate,915.84,48% of total Billed charges,556.6,100% OF CMS OPPS Rate,1717.2,90% of total Billed charges,289.36,100% of Medicaid LA Fee Schedule,289.36,100% of Medicaid LA Fee Schedule,289.36,100% of Medicaid LA Fee Schedule,289.36,100% of Medicaid LA Fee Schedule,289.36,100% of Medicaid LA Fee Schedule,289.36,100% of Medicaid LA Fee Schedule,556.6,100% of CMS OPPS Rate,556.6,100% of CMS OPPS Rate,556.6,100% of CMS OPPS Rate,556.6,100% of CMS OPPS Rate,556.6,100% of CMS OPPS Rate,556.6,100% of CMS OPPS Rate,556.6,100% of CMS OPPS Rate,556.6,100% of CMS OPPS Rate,289.36,1970.36,1144.8
Outpatient,Laboratory,81228,CYTOGENETICS MICRO ARRAY ANALYSIS,300,3164,3186,354% of CMS OPPS Rate,495.8,15.67% of total Billed charges,900,100% of CMS OPPS Rate,900,100% of CMS OPPS Rate,1835.01,203.89% of BCBS Fee Schedule,2214.8,70% of total Billed Charges,2373,75% of total Billed Charges,1620,180% OF CMS OPPS RATE,2531.2,80% of total Billed Charges,3150,350% of CMS Opps rate,918,102% of CMS Opps rate,2420.46,76.5% of total billed charges,495.8,15.67% of total Billed charges,495.8,15.67% of total Billed charges,900,100% of CMS OPPS Rate,900,100% of CMS OPPS Rate,1423.8,45% of total billed charges,2214.8,70% of total billed charges,1898.4,60% of total billed charges,900,100% of CMS OPPS Rate,810,90% OF UHC FEE SCHEDULE,2214.8,70% of total billed charges,900,100% OF CMS OPPS Rate,2070,230% OF CMS OPPS Rate,1518.72,48% of total Billed charges,900,100% OF CMS OPPS Rate,2847.6,90% of total Billed charges,495.8,15.67% of total Billed charges,495.8,15.67% of total Billed charges,495.8,15.67% of total Billed charges,495.8,15.67% of total Billed charges,495.8,15.67% of total Billed charges,495.8,15.67% of total Billed charges,900,100% of CMS OPPS Rate,900,100% of CMS OPPS Rate,900,100% of CMS OPPS Rate,900,100% of CMS OPPS Rate,900,100% of CMS OPPS Rate,900,100% of CMS OPPS Rate,900,100% of CMS OPPS Rate,900,100% of CMS OPPS Rate,495.8,3186,1898.4
Outpatient,Laboratory,81229,CYTOGENOMIC C MICROARRAY,300,3480,4106.4,354% of CMS OPPS Rate,185.03,100% of Medicaid LA Fee Schedule,1160,100% of CMS OPPS Rate,1160,100% of CMS OPPS Rate,2365.12,203.89% of BCBS Fee Schedule,2436,70% of total Billed Charges,2610,75% of total Billed Charges,2088,180% OF CMS OPPS RATE,2784,80% of total Billed Charges,4060,350% of CMS Opps rate,1183.2,102% of CMS Opps rate,2662.2,76.5% of total billed charges,185.03,100% of Medicaid LA Fee Schedule,185.03,100% of Medicaid LA Fee Schedule,1160,100% of CMS OPPS Rate,1160,100% of CMS OPPS Rate,1566,45% of total billed charges,2436,70% of total billed charges,2088,60% of total billed charges,1160,100% of CMS OPPS Rate,1044,90% OF UHC FEE SCHEDULE,2436,70% of total billed charges,1160,100% OF CMS OPPS Rate,2668,230% OF CMS OPPS Rate,1670.4,48% of total Billed charges,1160,100% OF CMS OPPS Rate,3132,90% of total Billed charges,185.03,100% of Medicaid LA Fee Schedule,185.03,100% of Medicaid LA Fee Schedule,185.03,100% of Medicaid LA Fee Schedule,185.03,100% of Medicaid LA Fee Schedule,185.03,100% of Medicaid LA Fee Schedule,185.03,100% of Medicaid LA Fee Schedule,1160,100% of CMS OPPS Rate,1160,100% of CMS OPPS Rate,1160,100% of CMS OPPS Rate,1160,100% of CMS OPPS Rate,1160,100% of CMS OPPS Rate,1160,100% of CMS OPPS Rate,1160,100% of CMS OPPS Rate,1160,100% of CMS OPPS Rate,185.03,4106.4,2088
Outpatient,Laboratory,81235,EGFR (EPIDERMAL GROWTH FACTOR R),300,1253,1149.01,354% of CMS OPPS Rate,251.23,100% of Medicaid LA Fee Schedule,324.58,100% of CMS OPPS Rate,324.58,100% of CMS OPPS Rate,661.79,203.89% of BCBS Fee Schedule,877.1,70% of total Billed Charges,939.75,75% of total Billed Charges,584.24,180% OF CMS OPPS RATE,1002.4,80% of total Billed Charges,1136.03,350% of CMS Opps rate,331.07,102% of CMS Opps rate,958.55,76.5% of total billed charges,251.23,100% of Medicaid LA Fee Schedule,251.23,100% of Medicaid LA Fee Schedule,324.58,100% of CMS OPPS Rate,324.58,100% of CMS OPPS Rate,563.85,45% of total billed charges,877.1,70% of total billed charges,751.8,60% of total billed charges,324.58,100% of CMS OPPS Rate,292.12,90% OF UHC FEE SCHEDULE,877.1,70% of total billed charges,324.58,100% OF CMS OPPS Rate,746.53,230% OF CMS OPPS Rate,601.44,48% of total Billed charges,324.58,100% OF CMS OPPS Rate,1127.7,90% of total Billed charges,251.23,100% of Medicaid LA Fee Schedule,251.23,100% of Medicaid LA Fee Schedule,251.23,100% of Medicaid LA Fee Schedule,251.23,100% of Medicaid LA Fee Schedule,251.23,100% of Medicaid LA Fee Schedule,251.23,100% of Medicaid LA Fee Schedule,324.58,100% of CMS OPPS Rate,324.58,100% of CMS OPPS Rate,324.58,100% of CMS OPPS Rate,324.58,100% of CMS OPPS Rate,324.58,100% of CMS OPPS Rate,324.58,100% of CMS OPPS Rate,324.58,100% of CMS OPPS Rate,324.58,100% of CMS OPPS Rate,251.23,1149.01,751.8
Outpatient,Laboratory,81240,F2 PROTHROMBIN COAG FACTOR 2,300,294,232.54,354% of CMS OPPS Rate,46.07,15.67% of total Billed charges,65.69,100% of CMS OPPS Rate,65.69,100% of CMS OPPS Rate,133.94,203.89% of BCBS Fee Schedule,205.8,70% of total Billed Charges,220.5,75% of total Billed Charges,118.24,180% OF CMS OPPS RATE,235.2,80% of total Billed Charges,229.91,350% of CMS Opps rate,67,102% of CMS Opps rate,224.91,76.5% of total billed charges,46.07,15.67% of total Billed charges,46.07,15.67% of total Billed charges,65.69,100% of CMS OPPS Rate,65.69,100% of CMS OPPS Rate,132.3,45% of total billed charges,205.8,70% of total billed charges,176.4,60% of total billed charges,65.69,100% of CMS OPPS Rate,59.12,90% OF UHC FEE SCHEDULE,205.8,70% of total billed charges,65.69,100% OF CMS OPPS Rate,151.08,230% OF CMS OPPS Rate,141.12,48% of total Billed charges,65.69,100% OF CMS OPPS Rate,264.6,90% of total Billed charges,46.07,15.67% of total Billed charges,46.07,15.67% of total Billed charges,46.07,15.67% of total Billed charges,46.07,15.67% of total Billed charges,46.07,15.67% of total Billed charges,46.07,15.67% of total Billed charges,65.69,100% of CMS OPPS Rate,65.69,100% of CMS OPPS Rate,65.69,100% of CMS OPPS Rate,65.69,100% of CMS OPPS Rate,65.69,100% of CMS OPPS Rate,65.69,100% of CMS OPPS Rate,65.69,100% of CMS OPPS Rate,65.69,100% of CMS OPPS Rate,46.07,264.6,176.4
Outpatient,Laboratory,81241,F5 COAGULATION FACTOR V,300,294,259.72,354% of CMS OPPS Rate,55.03,100% of Medicaid LA Fee Schedule,73.37,100% of CMS OPPS Rate,73.37,100% of CMS OPPS Rate,153.81,203.89% of BCBS Fee Schedule,205.8,70% of total Billed Charges,220.5,75% of total Billed Charges,132.06,180% OF CMS OPPS RATE,235.2,80% of total Billed Charges,256.79,350% of CMS Opps rate,74.83,102% of CMS Opps rate,224.91,76.5% of total billed charges,55.03,100% of Medicaid LA Fee Schedule,55.03,100% of Medicaid LA Fee Schedule,73.37,100% of CMS OPPS Rate,73.37,100% of CMS OPPS Rate,132.3,45% of total billed charges,205.8,70% of total billed charges,176.4,60% of total billed charges,73.37,100% of CMS OPPS Rate,67.9,90% OF UHC FEE SCHEDULE,205.8,70% of total billed charges,73.37,100% OF CMS OPPS Rate,168.75,230% OF CMS OPPS Rate,141.12,48% of total Billed charges,73.37,100% OF CMS OPPS Rate,264.6,90% of total Billed charges,55.03,100% of Medicaid LA Fee Schedule,55.03,100% of Medicaid LA Fee Schedule,55.03,100% of Medicaid LA Fee Schedule,55.03,100% of Medicaid LA Fee Schedule,55.03,100% of Medicaid LA Fee Schedule,55.03,100% of Medicaid LA Fee Schedule,73.37,100% of CMS OPPS Rate,73.37,100% of CMS OPPS Rate,73.37,100% of CMS OPPS Rate,73.37,100% of CMS OPPS Rate,73.37,100% of CMS OPPS Rate,73.37,100% of CMS OPPS Rate,73.37,100% of CMS OPPS Rate,73.37,100% of CMS OPPS Rate,55.03,264.6,176.4
Outpatient,Laboratory,81243,FMR1 FRAGILE X MENTAL R GENE,300,303,201.92,354% of CMS OPPS Rate,47.48,15.67% of total Billed charges,57.04,100% of CMS OPPS Rate,57.04,100% of CMS OPPS Rate,116.3,203.89% of BCBS Fee Schedule,212.1,70% of total Billed Charges,227.25,75% of total Billed Charges,102.67,180% OF CMS OPPS RATE,242.4,80% of total Billed Charges,199.64,350% of CMS Opps rate,58.18,102% of CMS Opps rate,231.8,76.5% of total billed charges,47.48,15.67% of total Billed charges,47.48,15.67% of total Billed charges,57.04,100% of CMS OPPS Rate,57.04,100% of CMS OPPS Rate,136.35,45% of total billed charges,212.1,70% of total billed charges,181.8,60% of total billed charges,57.04,100% of CMS OPPS Rate,51.34,90% OF UHC FEE SCHEDULE,212.1,70% of total billed charges,57.04,100% OF CMS OPPS Rate,131.19,230% OF CMS OPPS Rate,145.44,48% of total Billed charges,57.04,100% OF CMS OPPS Rate,272.7,90% of total Billed charges,47.48,15.67% of total Billed charges,47.48,15.67% of total Billed charges,47.48,15.67% of total Billed charges,47.48,15.67% of total Billed charges,47.48,15.67% of total Billed charges,47.48,15.67% of total Billed charges,57.04,100% of CMS OPPS Rate,57.04,100% of CMS OPPS Rate,57.04,100% of CMS OPPS Rate,57.04,100% of CMS OPPS Rate,57.04,100% of CMS OPPS Rate,57.04,100% of CMS OPPS Rate,57.04,100% of CMS OPPS Rate,57.04,100% of CMS OPPS Rate,47.48,272.7,181.8
Outpatient,Laboratory,81244,FMR1 FRAGILE X M R EXPANDED SIZE,300,303,158.91,354% of CMS OPPS Rate,47.48,15.67% of total Billed charges,44.89,100% of CMS OPPS Rate,44.89,100% of CMS OPPS Rate,91.53,203.89% of BCBS Fee Schedule,212.1,70% of total Billed Charges,227.25,75% of total Billed Charges,80.8,180% OF CMS OPPS RATE,242.4,80% of total Billed Charges,157.11,350% of CMS Opps rate,45.78,102% of CMS Opps rate,231.8,76.5% of total billed charges,47.48,15.67% of total Billed charges,47.48,15.67% of total Billed charges,44.89,100% of CMS OPPS Rate,44.89,100% of CMS OPPS Rate,136.35,45% of total billed charges,212.1,70% of total billed charges,181.8,60% of total billed charges,44.89,100% of CMS OPPS Rate,40.4,90% OF UHC FEE SCHEDULE,212.1,70% of total billed charges,44.89,100% OF CMS OPPS Rate,103.24,230% OF CMS OPPS Rate,145.44,48% of total Billed charges,44.89,100% OF CMS OPPS Rate,272.7,90% of total Billed charges,47.48,15.67% of total Billed charges,47.48,15.67% of total Billed charges,47.48,15.67% of total Billed charges,47.48,15.67% of total Billed charges,47.48,15.67% of total Billed charges,47.48,15.67% of total Billed charges,44.89,100% of CMS OPPS Rate,44.89,100% of CMS OPPS Rate,44.89,100% of CMS OPPS Rate,44.89,100% of CMS OPPS Rate,44.89,100% of CMS OPPS Rate,44.89,100% of CMS OPPS Rate,44.89,100% of CMS OPPS Rate,44.89,100% of CMS OPPS Rate,40.4,272.7,181.8
Outpatient,Laboratory,81250,G6PD CATALYTIC SUBUNIT,300,598,207.05,354% of CMS OPPS Rate,93.71,15.67% of total Billed charges,58.49,100% of CMS OPPS Rate,58.49,100% of CMS OPPS Rate,119.26,203.89% of BCBS Fee Schedule,418.6,70% of total Billed Charges,448.5,75% of total Billed Charges,105.28,180% OF CMS OPPS RATE,478.4,80% of total Billed Charges,204.71,350% of CMS Opps rate,59.65,102% of CMS Opps rate,457.47,76.5% of total billed charges,93.71,15.67% of total Billed charges,93.71,15.67% of total Billed charges,58.49,100% of CMS OPPS Rate,58.49,100% of CMS OPPS Rate,269.1,45% of total billed charges,418.6,70% of total billed charges,358.8,60% of total billed charges,58.49,100% of CMS OPPS Rate,52.64,90% OF UHC FEE SCHEDULE,418.6,70% of total billed charges,58.49,100% OF CMS OPPS Rate,134.52,230% OF CMS OPPS Rate,287.04,48% of total Billed charges,58.49,100% OF CMS OPPS Rate,538.2,90% of total Billed charges,93.71,15.67% of total Billed charges,93.71,15.67% of total Billed charges,93.71,15.67% of total Billed charges,93.71,15.67% of total Billed charges,93.71,15.67% of total Billed charges,93.71,15.67% of total Billed charges,58.49,100% of CMS OPPS Rate,58.49,100% of CMS OPPS Rate,58.49,100% of CMS OPPS Rate,58.49,100% of CMS OPPS Rate,58.49,100% of CMS OPPS Rate,58.49,100% of CMS OPPS Rate,58.49,100% of CMS OPPS Rate,58.49,100% of CMS OPPS Rate,52.64,538.2,358.8
Outpatient,Laboratory,81256,HFE HEMOCHROMATOSIS GENE ANAL,300,424,231.37,354% of CMS OPPS Rate,66.44,15.67% of total Billed charges,65.36,100% of CMS OPPS Rate,65.36,100% of CMS OPPS Rate,164.52,203.89% of BCBS Fee Schedule,296.8,70% of total Billed Charges,318,75% of total Billed Charges,117.64,180% OF CMS OPPS RATE,339.2,80% of total Billed Charges,228.76,350% of CMS Opps rate,66.66,102% of CMS Opps rate,324.36,76.5% of total billed charges,66.44,15.67% of total Billed charges,66.44,15.67% of total Billed charges,65.36,100% of CMS OPPS Rate,65.36,100% of CMS OPPS Rate,190.8,45% of total billed charges,296.8,70% of total billed charges,254.4,60% of total billed charges,65.36,100% of CMS OPPS Rate,72.62,90% OF UHC FEE SCHEDULE,296.8,70% of total billed charges,65.36,100% OF CMS OPPS Rate,150.32,230% OF CMS OPPS Rate,203.52,48% of total Billed charges,65.36,100% OF CMS OPPS Rate,381.6,90% of total Billed charges,66.44,15.67% of total Billed charges,66.44,15.67% of total Billed charges,66.44,15.67% of total Billed charges,66.44,15.67% of total Billed charges,66.44,15.67% of total Billed charges,66.44,15.67% of total Billed charges,65.36,100% of CMS OPPS Rate,65.36,100% of CMS OPPS Rate,65.36,100% of CMS OPPS Rate,65.36,100% of CMS OPPS Rate,65.36,100% of CMS OPPS Rate,65.36,100% of CMS OPPS Rate,65.36,100% of CMS OPPS Rate,65.36,100% of CMS OPPS Rate,65.36,381.6,254.4
Outpatient,Laboratory,81257,HBA1/ HBA2 ALPHA GLOBIN 1 AND 2,300,920,362,354% of CMS OPPS Rate,144.16,15.67% of total Billed charges,102.26,100% of CMS OPPS Rate,102.26,100% of CMS OPPS Rate,208.5,203.89% of BCBS Fee Schedule,644,70% of total Billed Charges,690,75% of total Billed Charges,184.06,180% OF CMS OPPS RATE,736,80% of total Billed Charges,357.91,350% of CMS Opps rate,104.3,102% of CMS Opps rate,703.8,76.5% of total billed charges,144.16,15.67% of total Billed charges,144.16,15.67% of total Billed charges,102.26,100% of CMS OPPS Rate,102.26,100% of CMS OPPS Rate,414,45% of total billed charges,644,70% of total billed charges,552,60% of total billed charges,102.26,100% of CMS OPPS Rate,92.03,90% OF UHC FEE SCHEDULE,644,70% of total billed charges,102.26,100% OF CMS OPPS Rate,235.19,230% OF CMS OPPS Rate,441.6,48% of total Billed charges,102.26,100% OF CMS OPPS Rate,828,90% of total Billed charges,144.16,15.67% of total Billed charges,144.16,15.67% of total Billed charges,144.16,15.67% of total Billed charges,144.16,15.67% of total Billed charges,144.16,15.67% of total Billed charges,144.16,15.67% of total Billed charges,102.26,100% of CMS OPPS Rate,102.26,100% of CMS OPPS Rate,102.26,100% of CMS OPPS Rate,102.26,100% of CMS OPPS Rate,102.26,100% of CMS OPPS Rate,102.26,100% of CMS OPPS Rate,102.26,100% of CMS OPPS Rate,102.26,100% of CMS OPPS Rate,92.03,828,552
Outpatient,Laboratory,81261,B CELL (IGH GENE REARRANGEMENT),300,700,700.88,354% of CMS OPPS Rate,109.69,15.67% of total Billed charges,197.99,100% of CMS OPPS Rate,197.99,100% of CMS OPPS Rate,498.37,203.89% of BCBS Fee Schedule,490,70% of total Billed Charges,525,75% of total Billed Charges,356.38,180% OF CMS OPPS RATE,560,80% of total Billed Charges,692.96,350% of CMS Opps rate,201.94,102% of CMS Opps rate,535.5,76.5% of total billed charges,109.69,15.67% of total Billed charges,109.69,15.67% of total Billed charges,197.99,100% of CMS OPPS Rate,197.99,100% of CMS OPPS Rate,315,45% of total billed charges,490,70% of total billed charges,420,60% of total billed charges,197.99,100% of CMS OPPS Rate,219.99,90% OF UHC FEE SCHEDULE,490,70% of total billed charges,197.99,100% OF CMS OPPS Rate,455.37,230% OF CMS OPPS Rate,336,48% of total Billed charges,197.99,100% OF CMS OPPS Rate,630,90% of total Billed charges,109.69,15.67% of total Billed charges,109.69,15.67% of total Billed charges,109.69,15.67% of total Billed charges,109.69,15.67% of total Billed charges,109.69,15.67% of total Billed charges,109.69,15.67% of total Billed charges,197.99,100% of CMS OPPS Rate,197.99,100% of CMS OPPS Rate,197.99,100% of CMS OPPS Rate,197.99,100% of CMS OPPS Rate,197.99,100% of CMS OPPS Rate,197.99,100% of CMS OPPS Rate,197.99,100% of CMS OPPS Rate,197.99,100% of CMS OPPS Rate,109.69,700.88,420
Outpatient,Laboratory,81269,HBA1/HBA2 ALPHA GLOBIN GENE ANALYSIS,300,1187.34,716.49,354% of CMS OPPS Rate,186.06,15.67% of total Billed charges,202.4,100% of CMS OPPS Rate,202.4,100% of CMS OPPS Rate,412.67,203.89% of BCBS Fee Schedule,831.14,70% of total Billed Charges,890.51,75% of total Billed Charges,364.32,180% OF CMS OPPS RATE,949.87,80% of total Billed Charges,708.4,350% of CMS Opps rate,206.44,102% of CMS Opps rate,908.32,76.5% of total billed charges,186.06,15.67% of total Billed charges,186.06,15.67% of total Billed charges,202.4,100% of CMS OPPS Rate,202.4,100% of CMS OPPS Rate,534.3,45% of total billed charges,831.14,70% of total billed charges,712.4,60% of total billed charges,202.4,100% of CMS OPPS Rate,182.16,90% OF UHC FEE SCHEDULE,831.14,70% of total billed charges,202.4,100% OF CMS OPPS Rate,465.52,230% OF CMS OPPS Rate,569.92,48% of total Billed charges,202.4,100% OF CMS OPPS Rate,1068.61,90% of total Billed charges,186.06,15.67% of total Billed charges,186.06,15.67% of total Billed charges,186.06,15.67% of total Billed charges,186.06,15.67% of total Billed charges,186.06,15.67% of total Billed charges,186.06,15.67% of total Billed charges,202.4,100% of CMS OPPS Rate,202.4,100% of CMS OPPS Rate,202.4,100% of CMS OPPS Rate,202.4,100% of CMS OPPS Rate,202.4,100% of CMS OPPS Rate,202.4,100% of CMS OPPS Rate,202.4,100% of CMS OPPS Rate,202.4,100% of CMS OPPS Rate,182.16,1068.61,712.4
Outpatient,Laboratory,81270,JAK2 GENE ANALYSIS VA1617PHE,300,500,324.47,354% of CMS OPPS Rate,78.35,15.67% of total Billed charges,91.66,100% of CMS OPPS Rate,91.66,100% of CMS OPPS Rate,230.74,203.89% of BCBS Fee Schedule,350,70% of total Billed Charges,375,75% of total Billed Charges,164.98,180% OF CMS OPPS RATE,400,80% of total Billed Charges,320.81,350% of CMS Opps rate,93.49,102% of CMS Opps rate,382.5,76.5% of total billed charges,78.35,15.67% of total Billed charges,78.35,15.67% of total Billed charges,91.66,100% of CMS OPPS Rate,91.66,100% of CMS OPPS Rate,225,45% of total billed charges,350,70% of total billed charges,300,60% of total billed charges,91.66,100% of CMS OPPS Rate,101.85,90% OF UHC FEE SCHEDULE,350,70% of total billed charges,91.66,100% OF CMS OPPS Rate,210.81,230% OF CMS OPPS Rate,240,48% of total Billed charges,91.66,100% OF CMS OPPS Rate,450,90% of total Billed charges,78.35,15.67% of total Billed charges,78.35,15.67% of total Billed charges,78.35,15.67% of total Billed charges,78.35,15.67% of total Billed charges,78.35,15.67% of total Billed charges,78.35,15.67% of total Billed charges,91.66,100% of CMS OPPS Rate,91.66,100% of CMS OPPS Rate,91.66,100% of CMS OPPS Rate,91.66,100% of CMS OPPS Rate,91.66,100% of CMS OPPS Rate,91.66,100% of CMS OPPS Rate,91.66,100% of CMS OPPS Rate,91.66,100% of CMS OPPS Rate,78.35,450,300
Outpatient,Laboratory,81273,GENE ANALYSIS D816 VARIANT,300,504.9,442.03,354% of CMS OPPS Rate,79.12,15.67% of total Billed charges,124.87,100% of CMS OPPS Rate,124.87,100% of CMS OPPS Rate,254.6,203.89% of BCBS Fee Schedule,353.43,70% of total Billed Charges,378.68,75% of total Billed Charges,224.76,180% OF CMS OPPS RATE,403.92,80% of total Billed Charges,437.04,350% of CMS Opps rate,127.36,102% of CMS Opps rate,386.25,76.5% of total billed charges,79.12,15.67% of total Billed charges,79.12,15.67% of total Billed charges,124.87,100% of CMS OPPS Rate,124.87,100% of CMS OPPS Rate,227.21,45% of total billed charges,353.43,70% of total billed charges,302.94,60% of total billed charges,124.87,100% of CMS OPPS Rate,112.38,90% OF UHC FEE SCHEDULE,353.43,70% of total billed charges,124.87,100% OF CMS OPPS Rate,287.2,230% OF CMS OPPS Rate,242.35,48% of total Billed charges,124.87,100% OF CMS OPPS Rate,454.41,90% of total Billed charges,79.12,15.67% of total Billed charges,79.12,15.67% of total Billed charges,79.12,15.67% of total Billed charges,79.12,15.67% of total Billed charges,79.12,15.67% of total Billed charges,79.12,15.67% of total Billed charges,124.87,100% of CMS OPPS Rate,124.87,100% of CMS OPPS Rate,124.87,100% of CMS OPPS Rate,124.87,100% of CMS OPPS Rate,124.87,100% of CMS OPPS Rate,124.87,100% of CMS OPPS Rate,124.87,100% of CMS OPPS Rate,124.87,100% of CMS OPPS Rate,79.12,454.41,302.94
Outpatient,Laboratory,81275,KRAS GENE VARIANTS EXON 2,300,634.64,684.1,354% of CMS OPPS Rate,149.58,100% of Medicaid LA Fee Schedule,193.25,100% of CMS OPPS Rate,193.25,100% of CMS OPPS Rate,394.02,203.89% of BCBS Fee Schedule,444.25,70% of total Billed Charges,475.98,75% of total Billed Charges,347.85,180% OF CMS OPPS RATE,507.71,80% of total Billed Charges,676.37,350% of CMS Opps rate,197.11,102% of CMS Opps rate,485.5,76.5% of total billed charges,149.58,100% of Medicaid LA Fee Schedule,149.58,100% of Medicaid LA Fee Schedule,193.25,100% of CMS OPPS Rate,193.25,100% of CMS OPPS Rate,285.59,45% of total billed charges,444.25,70% of total billed charges,380.78,60% of total billed charges,193.25,100% of CMS OPPS Rate,173.93,90% OF UHC FEE SCHEDULE,444.25,70% of total billed charges,193.25,100% OF CMS OPPS Rate,444.47,230% OF CMS OPPS Rate,304.63,48% of total Billed charges,193.25,100% OF CMS OPPS Rate,571.18,90% of total Billed charges,149.58,100% of Medicaid LA Fee Schedule,149.58,100% of Medicaid LA Fee Schedule,149.58,100% of Medicaid LA Fee Schedule,149.58,100% of Medicaid LA Fee Schedule,149.58,100% of Medicaid LA Fee Schedule,149.58,100% of Medicaid LA Fee Schedule,193.25,100% of CMS OPPS Rate,193.25,100% of CMS OPPS Rate,193.25,100% of CMS OPPS Rate,193.25,100% of CMS OPPS Rate,193.25,100% of CMS OPPS Rate,193.25,100% of CMS OPPS Rate,193.25,100% of CMS OPPS Rate,193.25,100% of CMS OPPS Rate,149.58,684.1,380.78
Outpatient,Laboratory,81276,KRAS GENE ANALYSIS ADDTL VAR,300,985.96,684.1,354% of CMS OPPS Rate,149.58,100% of Medicaid LA Fee Schedule,193.25,100% of CMS OPPS Rate,193.25,100% of CMS OPPS Rate,394.02,203.89% of BCBS Fee Schedule,690.17,70% of total Billed Charges,739.47,75% of total Billed Charges,347.85,180% OF CMS OPPS RATE,788.77,80% of total Billed Charges,676.37,350% of CMS Opps rate,197.11,102% of CMS Opps rate,754.26,76.5% of total billed charges,149.58,100% of Medicaid LA Fee Schedule,149.58,100% of Medicaid LA Fee Schedule,193.25,100% of CMS OPPS Rate,193.25,100% of CMS OPPS Rate,443.68,45% of total billed charges,690.17,70% of total billed charges,591.58,60% of total billed charges,193.25,100% of CMS OPPS Rate,173.93,90% OF UHC FEE SCHEDULE,690.17,70% of total billed charges,193.25,100% OF CMS OPPS Rate,444.47,230% OF CMS OPPS Rate,473.26,48% of total Billed charges,193.25,100% OF CMS OPPS Rate,887.36,90% of total Billed charges,149.58,100% of Medicaid LA Fee Schedule,149.58,100% of Medicaid LA Fee Schedule,149.58,100% of Medicaid LA Fee Schedule,149.58,100% of Medicaid LA Fee Schedule,149.58,100% of Medicaid LA Fee Schedule,149.58,100% of Medicaid LA Fee Schedule,193.25,100% of CMS OPPS Rate,193.25,100% of CMS OPPS Rate,193.25,100% of CMS OPPS Rate,193.25,100% of CMS OPPS Rate,193.25,100% of CMS OPPS Rate,193.25,100% of CMS OPPS Rate,193.25,100% of CMS OPPS Rate,193.25,100% of CMS OPPS Rate,149.58,887.36,591.58
Outpatient,Laboratory,81291,MTHFR GENE ANALYSIS,300,344,231.3,354% of CMS OPPS Rate,53.9,15.67% of total Billed charges,65.34,100% of CMS OPPS Rate,65.34,100% of CMS OPPS Rate,133.22,203.89% of BCBS Fee Schedule,N/A,Not Applicable,258,75% of total Billed Charges,117.61,180% OF CMS OPPS RATE,275.2,80% of total Billed Charges,228.69,350% of CMS Opps rate,66.64,102% of CMS Opps rate,263.16,76.5% of total billed charges,53.9,15.67% of total Billed charges,53.9,15.67% of total Billed charges,65.34,100% of CMS OPPS Rate,65.34,100% of CMS OPPS Rate,154.8,45% of total billed charges,240.8,70% of total billed charges,206.4,60% of total billed charges,65.34,100% of CMS OPPS Rate,58.81,90% OF UHC FEE SCHEDULE,240.8,70% of total billed charges,65.34,100% OF CMS OPPS Rate,150.28,230% OF CMS OPPS Rate,165.12,48% of total Billed charges,65.34,100% OF CMS OPPS Rate,309.6,90% of total Billed charges,53.9,15.67% of total Billed charges,53.9,15.67% of total Billed charges,53.9,15.67% of total Billed charges,53.9,15.67% of total Billed charges,53.9,15.67% of total Billed charges,53.9,15.67% of total Billed charges,65.34,100% of CMS OPPS Rate,65.34,100% of CMS OPPS Rate,65.34,100% of CMS OPPS Rate,65.34,100% of CMS OPPS Rate,65.34,100% of CMS OPPS Rate,65.34,100% of CMS OPPS Rate,65.34,100% of CMS OPPS Rate,65.34,100% of CMS OPPS Rate,53.9,309.6,206.4
Outpatient,Laboratory,81301,MICROSATELLITE INSTABILITY ANALYSIS,300,1970.25,1233.9,354% of CMS OPPS Rate,308.74,15.67% of total Billed charges,348.56,100% of CMS OPPS Rate,348.56,100% of CMS OPPS Rate,728.87,203.89% of BCBS Fee Schedule,1379.18,70% of total Billed Charges,1477.69,75% of total Billed Charges,627.4,180% OF CMS OPPS RATE,1576.2,80% of total Billed Charges,1219.96,350% of CMS Opps rate,355.53,102% of CMS Opps rate,1507.24,76.5% of total billed charges,308.74,15.67% of total Billed charges,308.74,15.67% of total Billed charges,348.56,100% of CMS OPPS Rate,348.56,100% of CMS OPPS Rate,886.61,45% of total billed charges,1379.18,70% of total billed charges,1182.15,60% of total billed charges,348.56,100% of CMS OPPS Rate,321.73,90% OF UHC FEE SCHEDULE,1379.18,70% of total billed charges,348.56,100% OF CMS OPPS Rate,801.68,230% OF CMS OPPS Rate,945.72,48% of total Billed charges,348.56,100% OF CMS OPPS Rate,1773.23,90% of total Billed charges,308.74,15.67% of total Billed charges,308.74,15.67% of total Billed charges,308.74,15.67% of total Billed charges,308.74,15.67% of total Billed charges,308.74,15.67% of total Billed charges,308.74,15.67% of total Billed charges,348.56,100% of CMS OPPS Rate,348.56,100% of CMS OPPS Rate,348.56,100% of CMS OPPS Rate,348.56,100% of CMS OPPS Rate,348.56,100% of CMS OPPS Rate,348.56,100% of CMS OPPS Rate,348.56,100% of CMS OPPS Rate,348.56,100% of CMS OPPS Rate,308.74,1773.23,1182.15
Outpatient,Laboratory,81313,PCA3/KLK3 (PROSTATE CANCER ANTIGEN 3),300,1275.25,902.87,354% of CMS OPPS Rate,199.83,15.67% of total Billed charges,255.05,100% of CMS OPPS Rate,255.05,100% of CMS OPPS Rate,520.02,203.89% of BCBS Fee Schedule,892.68,70% of total Billed Charges,956.44,75% of total Billed Charges,459.09,180% OF CMS OPPS RATE,1020.2,80% of total Billed Charges,892.67,350% of CMS Opps rate,260.15,102% of CMS Opps rate,975.57,76.5% of total billed charges,199.83,15.67% of total Billed charges,199.83,15.67% of total Billed charges,255.05,100% of CMS OPPS Rate,255.05,100% of CMS OPPS Rate,573.86,45% of total billed charges,892.68,70% of total billed charges,765.15,60% of total billed charges,255.05,100% of CMS OPPS Rate,229.55,90% OF UHC FEE SCHEDULE,892.68,70% of total billed charges,255.05,100% OF CMS OPPS Rate,586.61,230% OF CMS OPPS Rate,612.12,48% of total Billed charges,255.05,100% OF CMS OPPS Rate,1147.73,90% of total Billed charges,199.83,15.67% of total Billed charges,199.83,15.67% of total Billed charges,199.83,15.67% of total Billed charges,199.83,15.67% of total Billed charges,199.83,15.67% of total Billed charges,199.83,15.67% of total Billed charges,255.05,100% of CMS OPPS Rate,255.05,100% of CMS OPPS Rate,255.05,100% of CMS OPPS Rate,255.05,100% of CMS OPPS Rate,255.05,100% of CMS OPPS Rate,255.05,100% of CMS OPPS Rate,255.05,100% of CMS OPPS Rate,255.05,100% of CMS OPPS Rate,199.83,1147.73,765.15
Outpatient,Laboratory,81315,PML RARALPHA T 15 17,300,1414,733.87,354% of CMS OPPS Rate,221.57,15.67% of total Billed charges,207.31,100% of CMS OPPS Rate,207.31,100% of CMS OPPS Rate,521.84,203.89% of BCBS Fee Schedule,989.8,70% of total Billed Charges,1060.5,75% of total Billed Charges,373.15,180% OF CMS OPPS RATE,1131.2,80% of total Billed Charges,725.58,350% of CMS Opps rate,211.45,102% of CMS Opps rate,1081.71,76.5% of total billed charges,221.57,15.67% of total Billed charges,221.57,15.67% of total Billed charges,207.31,100% of CMS OPPS Rate,207.31,100% of CMS OPPS Rate,636.3,45% of total billed charges,989.8,70% of total billed charges,848.4,60% of total billed charges,207.31,100% of CMS OPPS Rate,230.35,90% OF UHC FEE SCHEDULE,989.8,70% of total billed charges,207.31,100% OF CMS OPPS Rate,476.81,230% OF CMS OPPS Rate,678.72,48% of total Billed charges,207.31,100% OF CMS OPPS Rate,1272.6,90% of total Billed charges,221.57,15.67% of total Billed charges,221.57,15.67% of total Billed charges,221.57,15.67% of total Billed charges,221.57,15.67% of total Billed charges,221.57,15.67% of total Billed charges,221.57,15.67% of total Billed charges,207.31,100% of CMS OPPS Rate,207.31,100% of CMS OPPS Rate,207.31,100% of CMS OPPS Rate,207.31,100% of CMS OPPS Rate,207.31,100% of CMS OPPS Rate,207.31,100% of CMS OPPS Rate,207.31,100% of CMS OPPS Rate,207.31,100% of CMS OPPS Rate,207.31,1272.6,848.4
Outpatient,Laboratory,81325,PMP22 GENE ANALYSIS,300,1924,2724.31,354% of CMS OPPS Rate,301.49,15.67% of total Billed charges,769.58,100% of CMS OPPS Rate,769.58,100% of CMS OPPS Rate,1569.1,203.89% of BCBS Fee Schedule,1346.8,70% of total Billed Charges,1443,75% of total Billed Charges,1385.24,180% OF CMS OPPS RATE,1539.2,80% of total Billed Charges,2693.53,350% of CMS Opps rate,784.97,102% of CMS Opps rate,1471.86,76.5% of total billed charges,301.49,15.67% of total Billed charges,301.49,15.67% of total Billed charges,769.58,100% of CMS OPPS Rate,769.58,100% of CMS OPPS Rate,865.8,45% of total billed charges,1346.8,70% of total billed charges,1154.4,60% of total billed charges,769.58,100% of CMS OPPS Rate,692.62,90% OF UHC FEE SCHEDULE,1346.8,70% of total billed charges,769.58,100% OF CMS OPPS Rate,1770.03,230% OF CMS OPPS Rate,923.52,48% of total Billed charges,769.58,100% OF CMS OPPS Rate,1731.6,90% of total Billed charges,301.49,15.67% of total Billed charges,301.49,15.67% of total Billed charges,301.49,15.67% of total Billed charges,301.49,15.67% of total Billed charges,301.49,15.67% of total Billed charges,301.49,15.67% of total Billed charges,769.58,100% of CMS OPPS Rate,769.58,100% of CMS OPPS Rate,769.58,100% of CMS OPPS Rate,769.58,100% of CMS OPPS Rate,769.58,100% of CMS OPPS Rate,769.58,100% of CMS OPPS Rate,769.58,100% of CMS OPPS Rate,769.58,100% of CMS OPPS Rate,301.49,2724.31,1154.4
Outpatient,Laboratory,81329,GENE ANALYSIS SMN1,300,1310,484.98,354% of CMS OPPS Rate,205.28,15.67% of total Billed charges,137,100% of CMS OPPS Rate,137,100% of CMS OPPS Rate,279.33,203.89% of BCBS Fee Schedule,917,70% of total Billed Charges,982.5,75% of total Billed Charges,246.6,180% OF CMS OPPS RATE,1048,80% of total Billed Charges,479.5,350% of CMS Opps rate,139.74,102% of CMS Opps rate,1002.15,76.5% of total billed charges,205.28,15.67% of total Billed charges,205.28,15.67% of total Billed charges,137,100% of CMS OPPS Rate,137,100% of CMS OPPS Rate,589.5,45% of total billed charges,917,70% of total billed charges,786,60% of total billed charges,137,100% of CMS OPPS Rate,123.3,90% OF UHC FEE SCHEDULE,917,70% of total billed charges,137,100% OF CMS OPPS Rate,315.1,230% OF CMS OPPS Rate,628.8,48% of total Billed charges,137,100% OF CMS OPPS Rate,1179,90% of total Billed charges,205.28,15.67% of total Billed charges,205.28,15.67% of total Billed charges,205.28,15.67% of total Billed charges,205.28,15.67% of total Billed charges,205.28,15.67% of total Billed charges,205.28,15.67% of total Billed charges,137,100% of CMS OPPS Rate,137,100% of CMS OPPS Rate,137,100% of CMS OPPS Rate,137,100% of CMS OPPS Rate,137,100% of CMS OPPS Rate,137,100% of CMS OPPS Rate,137,100% of CMS OPPS Rate,137,100% of CMS OPPS Rate,123.3,1179,786
Outpatient,Laboratory,81331,SNR PN/UBE3A PRADER WILLI SYNDROME,300,525,180.78,354% of CMS OPPS Rate,82.27,15.67% of total Billed charges,51.07,100% of CMS OPPS Rate,51.07,100% of CMS OPPS Rate,104.13,203.89% of BCBS Fee Schedule,367.5,70% of total Billed Charges,393.75,75% of total Billed Charges,91.92,180% OF CMS OPPS RATE,420,80% of total Billed Charges,178.74,350% of CMS Opps rate,52.09,102% of CMS Opps rate,401.63,76.5% of total billed charges,82.27,15.67% of total Billed charges,82.27,15.67% of total Billed charges,51.07,100% of CMS OPPS Rate,51.07,100% of CMS OPPS Rate,236.25,45% of total billed charges,367.5,70% of total billed charges,315,60% of total billed charges,51.07,100% of CMS OPPS Rate,45.96,90% OF UHC FEE SCHEDULE,367.5,70% of total billed charges,51.07,100% OF CMS OPPS Rate,117.46,230% OF CMS OPPS Rate,252,48% of total Billed charges,51.07,100% OF CMS OPPS Rate,472.5,90% of total Billed charges,82.27,15.67% of total Billed charges,82.27,15.67% of total Billed charges,82.27,15.67% of total Billed charges,82.27,15.67% of total Billed charges,82.27,15.67% of total Billed charges,82.27,15.67% of total Billed charges,51.07,100% of CMS OPPS Rate,51.07,100% of CMS OPPS Rate,51.07,100% of CMS OPPS Rate,51.07,100% of CMS OPPS Rate,51.07,100% of CMS OPPS Rate,51.07,100% of CMS OPPS Rate,51.07,100% of CMS OPPS Rate,51.07,100% of CMS OPPS Rate,45.96,472.5,315
Outpatient,Laboratory,81332,ALPHA 1 ANTITRYPSIN GENE ANALYSIS,300,550,154.52,354% of CMS OPPS Rate,86.19,15.67% of total Billed charges,43.65,100% of CMS OPPS Rate,43.65,100% of CMS OPPS Rate,109.88,203.89% of BCBS Fee Schedule,385,70% of total Billed Charges,412.5,75% of total Billed Charges,78.57,180% OF CMS OPPS RATE,440,80% of total Billed Charges,152.77,350% of CMS Opps rate,44.52,102% of CMS Opps rate,420.75,76.5% of total billed charges,86.19,15.67% of total Billed charges,86.19,15.67% of total Billed charges,43.65,100% of CMS OPPS Rate,43.65,100% of CMS OPPS Rate,247.5,45% of total billed charges,385,70% of total billed charges,330,60% of total billed charges,43.65,100% of CMS OPPS Rate,48.5,90% OF UHC FEE SCHEDULE,385,70% of total billed charges,43.65,100% OF CMS OPPS Rate,100.39,230% OF CMS OPPS Rate,264,48% of total Billed charges,43.65,100% OF CMS OPPS Rate,495,90% of total Billed charges,86.19,15.67% of total Billed charges,86.19,15.67% of total Billed charges,86.19,15.67% of total Billed charges,86.19,15.67% of total Billed charges,86.19,15.67% of total Billed charges,86.19,15.67% of total Billed charges,43.65,100% of CMS OPPS Rate,43.65,100% of CMS OPPS Rate,43.65,100% of CMS OPPS Rate,43.65,100% of CMS OPPS Rate,43.65,100% of CMS OPPS Rate,43.65,100% of CMS OPPS Rate,43.65,100% of CMS OPPS Rate,43.65,100% of CMS OPPS Rate,43.65,495,330
Outpatient,Laboratory,81340,T CELL ANTIGEN RECEPTOR BETA,300,1368,739.57,354% of CMS OPPS Rate,214.37,15.67% of total Billed charges,208.92,100% of CMS OPPS Rate,208.92,100% of CMS OPPS Rate,525.87,203.89% of BCBS Fee Schedule,957.6,70% of total Billed Charges,1026,75% of total Billed Charges,376.05,180% OF CMS OPPS RATE,1094.4,80% of total Billed Charges,731.22,350% of CMS Opps rate,213.09,102% of CMS Opps rate,1046.52,76.5% of total billed charges,214.37,15.67% of total Billed charges,214.37,15.67% of total Billed charges,208.92,100% of CMS OPPS Rate,208.92,100% of CMS OPPS Rate,615.6,45% of total billed charges,957.6,70% of total billed charges,820.8,60% of total billed charges,208.92,100% of CMS OPPS Rate,232.13,90% OF UHC FEE SCHEDULE,957.6,70% of total billed charges,208.92,100% OF CMS OPPS Rate,480.51,230% OF CMS OPPS Rate,656.64,48% of total Billed charges,208.92,100% OF CMS OPPS Rate,1231.2,90% of total Billed charges,214.37,15.67% of total Billed charges,214.37,15.67% of total Billed charges,214.37,15.67% of total Billed charges,214.37,15.67% of total Billed charges,214.37,15.67% of total Billed charges,214.37,15.67% of total Billed charges,208.92,100% of CMS OPPS Rate,208.92,100% of CMS OPPS Rate,208.92,100% of CMS OPPS Rate,208.92,100% of CMS OPPS Rate,208.92,100% of CMS OPPS Rate,208.92,100% of CMS OPPS Rate,208.92,100% of CMS OPPS Rate,208.92,100% of CMS OPPS Rate,208.92,1231.2,820.8
Outpatient,Laboratory,81342,T CELL ANTIGEN RECEPTOR GAMMA,300,1125,713.31,354% of CMS OPPS Rate,176.29,15.67% of total Billed charges,201.5,100% of CMS OPPS Rate,201.5,100% of CMS OPPS Rate,507.2,203.89% of BCBS Fee Schedule,787.5,70% of total Billed Charges,843.75,75% of total Billed Charges,362.7,180% OF CMS OPPS RATE,900,80% of total Billed Charges,705.25,350% of CMS Opps rate,205.53,102% of CMS Opps rate,860.63,76.5% of total billed charges,176.29,15.67% of total Billed charges,176.29,15.67% of total Billed charges,201.5,100% of CMS OPPS Rate,201.5,100% of CMS OPPS Rate,506.25,45% of total billed charges,787.5,70% of total billed charges,675,60% of total billed charges,201.5,100% of CMS OPPS Rate,223.88,90% OF UHC FEE SCHEDULE,787.5,70% of total billed charges,201.5,100% OF CMS OPPS Rate,463.45,230% OF CMS OPPS Rate,540,48% of total Billed charges,201.5,100% OF CMS OPPS Rate,1012.5,90% of total Billed charges,176.29,15.67% of total Billed charges,176.29,15.67% of total Billed charges,176.29,15.67% of total Billed charges,176.29,15.67% of total Billed charges,176.29,15.67% of total Billed charges,176.29,15.67% of total Billed charges,201.5,100% of CMS OPPS Rate,201.5,100% of CMS OPPS Rate,201.5,100% of CMS OPPS Rate,201.5,100% of CMS OPPS Rate,201.5,100% of CMS OPPS Rate,201.5,100% of CMS OPPS Rate,201.5,100% of CMS OPPS Rate,201.5,100% of CMS OPPS Rate,176.29,1012.5,675
Outpatient,Laboratory,81350,UGT1A1 GENE ANALYSIS COMMON VARIANTS,300,828.72,828.36,354% of CMS OPPS Rate,129.86,15.67% of total Billed charges,234,100% of CMS OPPS Rate,234,100% of CMS OPPS Rate,477.1,203.89% of BCBS Fee Schedule,580.1,70% of total Billed Charges,621.54,75% of total Billed Charges,421.2,180% OF CMS OPPS RATE,662.98,80% of total Billed Charges,819,350% of CMS Opps rate,238.68,102% of CMS Opps rate,633.97,76.5% of total billed charges,129.86,15.67% of total Billed charges,129.86,15.67% of total Billed charges,234,100% of CMS OPPS Rate,234,100% of CMS OPPS Rate,372.92,45% of total billed charges,580.1,70% of total billed charges,497.23,60% of total billed charges,234,100% of CMS OPPS Rate,210.6,90% OF UHC FEE SCHEDULE,580.1,70% of total billed charges,234,100% OF CMS OPPS Rate,538.2,230% OF CMS OPPS Rate,397.79,48% of total Billed charges,234,100% OF CMS OPPS Rate,745.85,90% of total Billed charges,129.86,15.67% of total Billed charges,129.86,15.67% of total Billed charges,129.86,15.67% of total Billed charges,129.86,15.67% of total Billed charges,129.86,15.67% of total Billed charges,129.86,15.67% of total Billed charges,234,100% of CMS OPPS Rate,234,100% of CMS OPPS Rate,234,100% of CMS OPPS Rate,234,100% of CMS OPPS Rate,234,100% of CMS OPPS Rate,234,100% of CMS OPPS Rate,234,100% of CMS OPPS Rate,234,100% of CMS OPPS Rate,129.86,828.36,497.23
Outpatient,Laboratory,81364,HEMOGLOBIN SUBUNIT BETA,300,1622.9,1149.01,354% of CMS OPPS Rate,254.31,15.67% of total Billed charges,324.58,100% of CMS OPPS Rate,324.58,100% of CMS OPPS Rate,661.79,203.89% of BCBS Fee Schedule,1136.03,70% of total Billed Charges,1217.18,75% of total Billed Charges,584.24,180% OF CMS OPPS RATE,1298.32,80% of total Billed Charges,1136.03,350% of CMS Opps rate,331.07,102% of CMS Opps rate,1241.52,76.5% of total billed charges,254.31,15.67% of total Billed charges,254.31,15.67% of total Billed charges,324.58,100% of CMS OPPS Rate,324.58,100% of CMS OPPS Rate,730.31,45% of total billed charges,1136.03,70% of total billed charges,973.74,60% of total billed charges,324.58,100% of CMS OPPS Rate,292.12,90% OF UHC FEE SCHEDULE,1136.03,70% of total billed charges,324.58,100% OF CMS OPPS Rate,746.53,230% OF CMS OPPS Rate,778.99,48% of total Billed charges,324.58,100% OF CMS OPPS Rate,1460.61,90% of total Billed charges,254.31,15.67% of total Billed charges,254.31,15.67% of total Billed charges,254.31,15.67% of total Billed charges,254.31,15.67% of total Billed charges,254.31,15.67% of total Billed charges,254.31,15.67% of total Billed charges,324.58,100% of CMS OPPS Rate,324.58,100% of CMS OPPS Rate,324.58,100% of CMS OPPS Rate,324.58,100% of CMS OPPS Rate,324.58,100% of CMS OPPS Rate,324.58,100% of CMS OPPS Rate,324.58,100% of CMS OPPS Rate,324.58,100% of CMS OPPS Rate,254.31,1460.61,973.74
Outpatient,Laboratory,81373,HLA CLASS 1 TYPING HLA A B OR C,300,472,451.1,354% of CMS OPPS Rate,73.96,15.67% of total Billed charges,127.43,100% of CMS OPPS Rate,127.43,100% of CMS OPPS Rate,280.31,203.89% of BCBS Fee Schedule,330.4,70% of total Billed Charges,354,75% of total Billed Charges,229.37,180% OF CMS OPPS RATE,377.6,80% of total Billed Charges,446,350% of CMS Opps rate,129.97,102% of CMS Opps rate,361.08,76.5% of total billed charges,73.96,15.67% of total Billed charges,73.96,15.67% of total Billed charges,127.43,100% of CMS OPPS Rate,127.43,100% of CMS OPPS Rate,212.4,45% of total billed charges,330.4,70% of total billed charges,283.2,60% of total billed charges,127.43,100% of CMS OPPS Rate,123.73,90% OF UHC FEE SCHEDULE,330.4,70% of total billed charges,127.43,100% OF CMS OPPS Rate,293.08,230% OF CMS OPPS Rate,226.56,48% of total Billed charges,127.43,100% OF CMS OPPS Rate,424.8,90% of total Billed charges,73.96,15.67% of total Billed charges,73.96,15.67% of total Billed charges,73.96,15.67% of total Billed charges,73.96,15.67% of total Billed charges,73.96,15.67% of total Billed charges,73.96,15.67% of total Billed charges,127.43,100% of CMS OPPS Rate,127.43,100% of CMS OPPS Rate,127.43,100% of CMS OPPS Rate,127.43,100% of CMS OPPS Rate,127.43,100% of CMS OPPS Rate,127.43,100% of CMS OPPS Rate,127.43,100% of CMS OPPS Rate,127.43,100% of CMS OPPS Rate,73.96,451.1,283.2
Outpatient,Laboratory,81374,HLA CLASS 1 TYPING EG B27 EA,300,496,263.12,354% of CMS OPPS Rate,77.72,15.67% of total Billed charges,74.33,100% of CMS OPPS Rate,74.33,100% of CMS OPPS Rate,183.11,203.89% of BCBS Fee Schedule,347.2,70% of total Billed Charges,372,75% of total Billed Charges,133.79,180% OF CMS OPPS RATE,396.8,80% of total Billed Charges,260.15,350% of CMS Opps rate,75.81,102% of CMS Opps rate,379.44,76.5% of total billed charges,77.72,15.67% of total Billed charges,77.72,15.67% of total Billed charges,74.33,100% of CMS OPPS Rate,74.33,100% of CMS OPPS Rate,223.2,45% of total billed charges,347.2,70% of total billed charges,297.6,60% of total billed charges,74.33,100% of CMS OPPS Rate,80.83,90% OF UHC FEE SCHEDULE,347.2,70% of total billed charges,74.33,100% OF CMS OPPS Rate,170.95,230% OF CMS OPPS Rate,238.08,48% of total Billed charges,74.33,100% OF CMS OPPS Rate,446.4,90% of total Billed charges,77.72,15.67% of total Billed charges,77.72,15.67% of total Billed charges,77.72,15.67% of total Billed charges,77.72,15.67% of total Billed charges,77.72,15.67% of total Billed charges,77.72,15.67% of total Billed charges,74.33,100% of CMS OPPS Rate,74.33,100% of CMS OPPS Rate,74.33,100% of CMS OPPS Rate,74.33,100% of CMS OPPS Rate,74.33,100% of CMS OPPS Rate,74.33,100% of CMS OPPS Rate,74.33,100% of CMS OPPS Rate,74.33,100% of CMS OPPS Rate,74.33,446.4,297.6
Outpatient,Laboratory,81376,"HLA CLASS II TYPING, RESOLUT",300,452,432.65,354% of CMS OPPS Rate,70.83,15.67% of total Billed charges,122.22,100% of CMS OPPS Rate,122.22,100% of CMS OPPS Rate,307.65,203.89% of BCBS Fee Schedule,316.4,70% of total Billed Charges,339,75% of total Billed Charges,219.99,180% OF CMS OPPS RATE,361.6,80% of total Billed Charges,427.77,350% of CMS Opps rate,124.66,102% of CMS Opps rate,345.78,76.5% of total billed charges,70.83,15.67% of total Billed charges,70.83,15.67% of total Billed charges,122.22,100% of CMS OPPS Rate,122.22,100% of CMS OPPS Rate,203.4,45% of total billed charges,316.4,70% of total billed charges,271.2,60% of total billed charges,122.22,100% of CMS OPPS Rate,135.8,90% OF UHC FEE SCHEDULE,316.4,70% of total billed charges,122.22,100% OF CMS OPPS Rate,281.1,230% OF CMS OPPS Rate,216.96,48% of total Billed charges,122.22,100% OF CMS OPPS Rate,406.8,90% of total Billed charges,70.83,15.67% of total Billed charges,70.83,15.67% of total Billed charges,70.83,15.67% of total Billed charges,70.83,15.67% of total Billed charges,70.83,15.67% of total Billed charges,70.83,15.67% of total Billed charges,122.22,100% of CMS OPPS Rate,122.22,100% of CMS OPPS Rate,122.22,100% of CMS OPPS Rate,122.22,100% of CMS OPPS Rate,122.22,100% of CMS OPPS Rate,122.22,100% of CMS OPPS Rate,122.22,100% of CMS OPPS Rate,122.22,100% of CMS OPPS Rate,70.83,432.65,271.2
Outpatient,Laboratory,81381,HLA CLASS I TYPING HG RESOLUTION,300,1500,601.44,354% of CMS OPPS Rate,235.05,15.67% of total Billed charges,169.9,100% of CMS OPPS Rate,169.9,100% of CMS OPPS Rate,346.41,203.89% of BCBS Fee Schedule,1050,70% of total Billed Charges,1125,75% of total Billed Charges,305.82,180% OF CMS OPPS RATE,1200,80% of total Billed Charges,594.65,350% of CMS Opps rate,173.29,102% of CMS Opps rate,1147.5,76.5% of total billed charges,235.05,15.67% of total Billed charges,235.05,15.67% of total Billed charges,169.9,100% of CMS OPPS Rate,169.9,100% of CMS OPPS Rate,675,45% of total billed charges,1050,70% of total billed charges,900,60% of total billed charges,169.9,100% of CMS OPPS Rate,152.91,90% OF UHC FEE SCHEDULE,1050,70% of total billed charges,169.9,100% OF CMS OPPS Rate,390.77,230% OF CMS OPPS Rate,720,48% of total Billed charges,169.9,100% OF CMS OPPS Rate,1350,90% of total Billed charges,235.05,15.67% of total Billed charges,235.05,15.67% of total Billed charges,235.05,15.67% of total Billed charges,235.05,15.67% of total Billed charges,235.05,15.67% of total Billed charges,235.05,15.67% of total Billed charges,169.9,100% of CMS OPPS Rate,169.9,100% of CMS OPPS Rate,169.9,100% of CMS OPPS Rate,169.9,100% of CMS OPPS Rate,169.9,100% of CMS OPPS Rate,169.9,100% of CMS OPPS Rate,169.9,100% of CMS OPPS Rate,169.9,100% of CMS OPPS Rate,152.91,1350,900
Outpatient,Laboratory,81382,"HLA CLASS II TYPING, HIGH RESOLUT",300,842.4,437.82,354% of CMS OPPS Rate,132,15.67% of total Billed charges,123.68,100% of CMS OPPS Rate,123.68,100% of CMS OPPS Rate,311.32,203.89% of BCBS Fee Schedule,589.68,70% of total Billed Charges,631.8,75% of total Billed Charges,222.62,180% OF CMS OPPS RATE,673.92,80% of total Billed Charges,432.88,350% of CMS Opps rate,126.15,102% of CMS Opps rate,644.44,76.5% of total billed charges,132,15.67% of total Billed charges,132,15.67% of total Billed charges,123.68,100% of CMS OPPS Rate,123.68,100% of CMS OPPS Rate,379.08,45% of total billed charges,589.68,70% of total billed charges,505.44,60% of total billed charges,123.68,100% of CMS OPPS Rate,137.42,90% OF UHC FEE SCHEDULE,589.68,70% of total billed charges,123.68,100% OF CMS OPPS Rate,284.46,230% OF CMS OPPS Rate,404.35,48% of total Billed charges,123.68,100% OF CMS OPPS Rate,758.16,90% of total Billed charges,132,15.67% of total Billed charges,132,15.67% of total Billed charges,132,15.67% of total Billed charges,132,15.67% of total Billed charges,132,15.67% of total Billed charges,132,15.67% of total Billed charges,123.68,100% of CMS OPPS Rate,123.68,100% of CMS OPPS Rate,123.68,100% of CMS OPPS Rate,123.68,100% of CMS OPPS Rate,123.68,100% of CMS OPPS Rate,123.68,100% of CMS OPPS Rate,123.68,100% of CMS OPPS Rate,123.68,100% of CMS OPPS Rate,123.68,758.16,505.44
Outpatient,Laboratory,81383,HLA CLASS II TYPING H RESOLUTION,300,766,386.32,354% of CMS OPPS Rate,120.03,15.67% of total Billed charges,109.13,100% of CMS OPPS Rate,109.13,100% of CMS OPPS Rate,274.7,203.89% of BCBS Fee Schedule,536.2,70% of total Billed Charges,574.5,75% of total Billed Charges,196.43,180% OF CMS OPPS RATE,612.8,80% of total Billed Charges,381.95,350% of CMS Opps rate,111.31,102% of CMS Opps rate,585.99,76.5% of total billed charges,120.03,15.67% of total Billed charges,120.03,15.67% of total Billed charges,109.13,100% of CMS OPPS Rate,109.13,100% of CMS OPPS Rate,344.7,45% of total billed charges,536.2,70% of total billed charges,459.6,60% of total billed charges,109.13,100% of CMS OPPS Rate,121.26,90% OF UHC FEE SCHEDULE,536.2,70% of total billed charges,109.13,100% OF CMS OPPS Rate,250.99,230% OF CMS OPPS Rate,367.68,48% of total Billed charges,109.13,100% OF CMS OPPS Rate,689.4,90% of total Billed charges,120.03,15.67% of total Billed charges,120.03,15.67% of total Billed charges,120.03,15.67% of total Billed charges,120.03,15.67% of total Billed charges,120.03,15.67% of total Billed charges,120.03,15.67% of total Billed charges,109.13,100% of CMS OPPS Rate,109.13,100% of CMS OPPS Rate,109.13,100% of CMS OPPS Rate,109.13,100% of CMS OPPS Rate,109.13,100% of CMS OPPS Rate,109.13,100% of CMS OPPS Rate,109.13,100% of CMS OPPS Rate,109.13,100% of CMS OPPS Rate,109.13,689.4,459.6
Outpatient,Laboratory,81400,MOLECULAR PATH PROCEDURE LEV 1,300,700,226.41,354% of CMS OPPS Rate,109.69,15.67% of total Billed charges,63.96,100% of CMS OPPS Rate,63.96,100% of CMS OPPS Rate,130.41,203.89% of BCBS Fee Schedule,490,70% of total Billed Charges,525,75% of total Billed Charges,115.12,180% OF CMS OPPS RATE,560,80% of total Billed Charges,223.86,350% of CMS Opps rate,65.23,102% of CMS Opps rate,535.5,76.5% of total billed charges,109.69,15.67% of total Billed charges,109.69,15.67% of total Billed charges,63.96,100% of CMS OPPS Rate,63.96,100% of CMS OPPS Rate,315,45% of total billed charges,490,70% of total billed charges,420,60% of total billed charges,63.96,100% of CMS OPPS Rate,57.56,90% OF UHC FEE SCHEDULE,490,70% of total billed charges,63.96,100% OF CMS OPPS Rate,147.1,230% OF CMS OPPS Rate,336,48% of total Billed charges,63.96,100% OF CMS OPPS Rate,630,90% of total Billed charges,109.69,15.67% of total Billed charges,109.69,15.67% of total Billed charges,109.69,15.67% of total Billed charges,109.69,15.67% of total Billed charges,109.69,15.67% of total Billed charges,109.69,15.67% of total Billed charges,63.96,100% of CMS OPPS Rate,63.96,100% of CMS OPPS Rate,63.96,100% of CMS OPPS Rate,63.96,100% of CMS OPPS Rate,63.96,100% of CMS OPPS Rate,63.96,100% of CMS OPPS Rate,63.96,100% of CMS OPPS Rate,63.96,100% of CMS OPPS Rate,57.56,630,420
Outpatient,Laboratory,81401,MOLECULAR PATH PROCEDURE LEV 2,300,833,484.98,354% of CMS OPPS Rate,130.53,15.67% of total Billed charges,137,100% of CMS OPPS Rate,137,100% of CMS OPPS Rate,279.33,203.89% of BCBS Fee Schedule,583.1,70% of total Billed Charges,624.75,75% of total Billed Charges,246.6,180% OF CMS OPPS RATE,666.4,80% of total Billed Charges,479.5,350% of CMS Opps rate,139.74,102% of CMS Opps rate,637.25,76.5% of total billed charges,130.53,15.67% of total Billed charges,130.53,15.67% of total Billed charges,137,100% of CMS OPPS Rate,137,100% of CMS OPPS Rate,374.85,45% of total billed charges,583.1,70% of total billed charges,499.8,60% of total billed charges,137,100% of CMS OPPS Rate,123.3,90% OF UHC FEE SCHEDULE,583.1,70% of total billed charges,137,100% OF CMS OPPS Rate,315.1,230% OF CMS OPPS Rate,399.84,48% of total Billed charges,137,100% OF CMS OPPS Rate,749.7,90% of total Billed charges,130.53,15.67% of total Billed charges,130.53,15.67% of total Billed charges,130.53,15.67% of total Billed charges,130.53,15.67% of total Billed charges,130.53,15.67% of total Billed charges,130.53,15.67% of total Billed charges,137,100% of CMS OPPS Rate,137,100% of CMS OPPS Rate,137,100% of CMS OPPS Rate,137,100% of CMS OPPS Rate,137,100% of CMS OPPS Rate,137,100% of CMS OPPS Rate,137,100% of CMS OPPS Rate,137,100% of CMS OPPS Rate,123.3,749.7,499.8
Outpatient,Laboratory,81402,MOLECULAR PATH PROCEDURE LEV 3,300,1291.68,532.16,354% of CMS OPPS Rate,202.41,15.67% of total Billed charges,150.33,100% of CMS OPPS Rate,150.33,100% of CMS OPPS Rate,306.51,203.89% of BCBS Fee Schedule,904.18,70% of total Billed Charges,968.76,75% of total Billed Charges,270.59,180% OF CMS OPPS RATE,1033.34,80% of total Billed Charges,526.15,350% of CMS Opps rate,153.33,102% of CMS Opps rate,988.14,76.5% of total billed charges,202.41,15.67% of total Billed charges,202.41,15.67% of total Billed charges,150.33,100% of CMS OPPS Rate,150.33,100% of CMS OPPS Rate,581.26,45% of total billed charges,904.18,70% of total billed charges,775.01,60% of total billed charges,150.33,100% of CMS OPPS Rate,135.3,90% OF UHC FEE SCHEDULE,904.18,70% of total billed charges,150.33,100% OF CMS OPPS Rate,345.75,230% OF CMS OPPS Rate,620.01,48% of total Billed charges,150.33,100% OF CMS OPPS Rate,1162.51,90% of total Billed charges,202.41,15.67% of total Billed charges,202.41,15.67% of total Billed charges,202.41,15.67% of total Billed charges,202.41,15.67% of total Billed charges,202.41,15.67% of total Billed charges,202.41,15.67% of total Billed charges,150.33,100% of CMS OPPS Rate,150.33,100% of CMS OPPS Rate,150.33,100% of CMS OPPS Rate,150.33,100% of CMS OPPS Rate,150.33,100% of CMS OPPS Rate,150.33,100% of CMS OPPS Rate,150.33,100% of CMS OPPS Rate,150.33,100% of CMS OPPS Rate,135.3,1162.51,775.01
Outpatient,Laboratory,81403,MOLECULAR PATHOLOGY LEV 4,300,440,655.6,354% of CMS OPPS Rate,68.95,15.67% of total Billed charges,185.2,100% of CMS OPPS Rate,185.2,100% of CMS OPPS Rate,377.6,203.89% of BCBS Fee Schedule,308,70% of total Billed Charges,330,75% of total Billed Charges,333.36,180% OF CMS OPPS RATE,352,80% of total Billed Charges,648.19,350% of CMS Opps rate,188.9,102% of CMS Opps rate,336.6,76.5% of total billed charges,68.95,15.67% of total Billed charges,68.95,15.67% of total Billed charges,185.2,100% of CMS OPPS Rate,185.2,100% of CMS OPPS Rate,198,45% of total billed charges,308,70% of total billed charges,264,60% of total billed charges,185.2,100% of CMS OPPS Rate,166.68,90% OF UHC FEE SCHEDULE,308,70% of total billed charges,185.2,100% OF CMS OPPS Rate,425.96,230% OF CMS OPPS Rate,211.2,48% of total Billed charges,185.2,100% OF CMS OPPS Rate,396,90% of total Billed charges,68.95,15.67% of total Billed charges,68.95,15.67% of total Billed charges,68.95,15.67% of total Billed charges,68.95,15.67% of total Billed charges,68.95,15.67% of total Billed charges,68.95,15.67% of total Billed charges,185.2,100% of CMS OPPS Rate,185.2,100% of CMS OPPS Rate,185.2,100% of CMS OPPS Rate,185.2,100% of CMS OPPS Rate,185.2,100% of CMS OPPS Rate,185.2,100% of CMS OPPS Rate,185.2,100% of CMS OPPS Rate,185.2,100% of CMS OPPS Rate,68.95,655.6,264
Outpatient,Laboratory,81404,MOLECULAR PATH PROCEDURE LEV 5,300,1202,972.89,354% of CMS OPPS Rate,188.35,15.67% of total Billed charges,274.83,100% of CMS OPPS Rate,274.83,100% of CMS OPPS Rate,560.35,203.89% of BCBS Fee Schedule,841.4,70% of total Billed Charges,901.5,75% of total Billed Charges,494.69,180% OF CMS OPPS RATE,961.6,80% of total Billed Charges,961.9,350% of CMS Opps rate,280.32,102% of CMS Opps rate,919.53,76.5% of total billed charges,188.35,15.67% of total Billed charges,188.35,15.67% of total Billed charges,274.83,100% of CMS OPPS Rate,274.83,100% of CMS OPPS Rate,540.9,45% of total billed charges,841.4,70% of total billed charges,721.2,60% of total billed charges,274.83,100% of CMS OPPS Rate,247.35,90% OF UHC FEE SCHEDULE,841.4,70% of total billed charges,274.83,100% OF CMS OPPS Rate,632.1,230% OF CMS OPPS Rate,576.96,48% of total Billed charges,274.83,100% OF CMS OPPS Rate,1081.8,90% of total Billed charges,188.35,15.67% of total Billed charges,188.35,15.67% of total Billed charges,188.35,15.67% of total Billed charges,188.35,15.67% of total Billed charges,188.35,15.67% of total Billed charges,188.35,15.67% of total Billed charges,274.83,100% of CMS OPPS Rate,274.83,100% of CMS OPPS Rate,274.83,100% of CMS OPPS Rate,274.83,100% of CMS OPPS Rate,274.83,100% of CMS OPPS Rate,274.83,100% of CMS OPPS Rate,274.83,100% of CMS OPPS Rate,274.83,100% of CMS OPPS Rate,188.35,1081.8,721.2
Outpatient,Laboratory,81408,MOLECULAR PATH PROCEDURE LEV 9,300,5000,7080,354% of CMS OPPS Rate,783.5,15.67% of total Billed charges,2000,100% of CMS OPPS Rate,2000,100% of CMS OPPS Rate,4077.8,203.89% of BCBS Fee Schedule,3500,70% of total Billed Charges,3750,75% of total Billed Charges,3600,180% OF CMS OPPS RATE,4000,80% of total Billed Charges,7000,350% of CMS Opps rate,2040,102% of CMS Opps rate,3825,76.5% of total billed charges,783.5,15.67% of total Billed charges,783.5,15.67% of total Billed charges,2000,100% of CMS OPPS Rate,2000,100% of CMS OPPS Rate,2250,45% of total billed charges,3500,70% of total billed charges,3000,60% of total billed charges,2000,100% of CMS OPPS Rate,1800,90% OF UHC FEE SCHEDULE,3500,70% of total billed charges,2000,100% OF CMS OPPS Rate,4600,230% OF CMS OPPS Rate,2400,48% of total Billed charges,2000,100% OF CMS OPPS Rate,4500,90% of total Billed charges,783.5,15.67% of total Billed charges,783.5,15.67% of total Billed charges,783.5,15.67% of total Billed charges,783.5,15.67% of total Billed charges,783.5,15.67% of total Billed charges,783.5,15.67% of total Billed charges,2000,100% of CMS OPPS Rate,2000,100% of CMS OPPS Rate,2000,100% of CMS OPPS Rate,2000,100% of CMS OPPS Rate,2000,100% of CMS OPPS Rate,2000,100% of CMS OPPS Rate,2000,100% of CMS OPPS Rate,2000,100% of CMS OPPS Rate,783.5,7080,3000
Outpatient,Laboratory,81445,TARGET GENOMIC S. ANAL. PANEL,300,3307,2116.6,354% of CMS OPPS Rate,518.21,15.67% of total Billed charges,597.91,100% of CMS OPPS Rate,597.91,100% of CMS OPPS Rate,1219.08,203.89% of BCBS Fee Schedule,2314.9,70% of total Billed Charges,2480.25,75% of total Billed Charges,1076.23,180% OF CMS OPPS RATE,2645.6,80% of total Billed Charges,2092.68,350% of CMS Opps rate,609.86,102% of CMS Opps rate,2529.86,76.5% of total billed charges,518.21,15.67% of total Billed charges,518.21,15.67% of total Billed charges,597.91,100% of CMS OPPS Rate,597.91,100% of CMS OPPS Rate,1488.15,45% of total billed charges,2314.9,70% of total billed charges,1984.2,60% of total billed charges,597.91,100% of CMS OPPS Rate,538.12,90% OF UHC FEE SCHEDULE,2314.9,70% of total billed charges,597.91,100% OF CMS OPPS Rate,1375.19,230% OF CMS OPPS Rate,1587.36,48% of total Billed charges,597.91,100% OF CMS OPPS Rate,2976.3,90% of total Billed charges,518.21,15.67% of total Billed charges,518.21,15.67% of total Billed charges,518.21,15.67% of total Billed charges,518.21,15.67% of total Billed charges,518.21,15.67% of total Billed charges,518.21,15.67% of total Billed charges,597.91,100% of CMS OPPS Rate,597.91,100% of CMS OPPS Rate,597.91,100% of CMS OPPS Rate,597.91,100% of CMS OPPS Rate,597.91,100% of CMS OPPS Rate,597.91,100% of CMS OPPS Rate,597.91,100% of CMS OPPS Rate,597.91,100% of CMS OPPS Rate,518.21,2976.3,1984.2
Outpatient,Laboratory,81450,TARGET GENOMIC S PANEL,300,2915,2688.73,354% of CMS OPPS Rate,456.78,15.67% of total Billed charges,759.53,100% of CMS OPPS Rate,759.53,100% of CMS OPPS Rate,1548.61,203.89% of BCBS Fee Schedule,2040.5,70% of total Billed Charges,2186.25,75% of total Billed Charges,1367.15,180% OF CMS OPPS RATE,2332,80% of total Billed Charges,2658.35,350% of CMS Opps rate,774.72,102% of CMS Opps rate,2229.98,76.5% of total billed charges,456.78,15.67% of total Billed charges,456.78,15.67% of total Billed charges,759.53,100% of CMS OPPS Rate,759.53,100% of CMS OPPS Rate,1311.75,45% of total billed charges,2040.5,70% of total billed charges,1749,60% of total billed charges,759.53,100% of CMS OPPS Rate,683.58,90% OF UHC FEE SCHEDULE,2040.5,70% of total billed charges,759.53,100% OF CMS OPPS Rate,1746.91,230% OF CMS OPPS Rate,1399.2,48% of total Billed charges,759.53,100% OF CMS OPPS Rate,2623.5,90% of total Billed charges,456.78,15.67% of total Billed charges,456.78,15.67% of total Billed charges,456.78,15.67% of total Billed charges,456.78,15.67% of total Billed charges,456.78,15.67% of total Billed charges,456.78,15.67% of total Billed charges,759.53,100% of CMS OPPS Rate,759.53,100% of CMS OPPS Rate,759.53,100% of CMS OPPS Rate,759.53,100% of CMS OPPS Rate,759.53,100% of CMS OPPS Rate,759.53,100% of CMS OPPS Rate,759.53,100% of CMS OPPS Rate,759.53,100% of CMS OPPS Rate,456.78,2688.73,1749
Outpatient,Laboratory,81455,TARGETED GENOMIC SEQUENCE ANALYSIS,300,712.52,10335.38,354% of CMS OPPS Rate,111.65,15.67% of total Billed charges,2919.6,100% of CMS OPPS Rate,2919.6,100% of CMS OPPS Rate,5952.77,203.89% of BCBS Fee Schedule,498.76,70% of total Billed Charges,534.39,75% of total Billed Charges,5255.28,180% OF CMS OPPS RATE,570.02,80% of total Billed Charges,10218.6,350% of CMS Opps rate,2977.99,102% of CMS Opps rate,545.08,76.5% of total billed charges,111.65,15.67% of total Billed charges,111.65,15.67% of total Billed charges,2919.6,100% of CMS OPPS Rate,2919.6,100% of CMS OPPS Rate,320.63,45% of total billed charges,498.76,70% of total billed charges,427.51,60% of total billed charges,2919.6,100% of CMS OPPS Rate,2627.64,90% OF UHC FEE SCHEDULE,498.76,70% of total billed charges,2919.6,100% OF CMS OPPS Rate,712.52,230% OF CMS OPPS Rate,342.01,48% of total Billed charges,2919.6,100% OF CMS OPPS Rate,641.27,90% of total Billed charges,111.65,15.67% of total Billed charges,111.65,15.67% of total Billed charges,111.65,15.67% of total Billed charges,111.65,15.67% of total Billed charges,111.65,15.67% of total Billed charges,111.65,15.67% of total Billed charges,2919.6,100% of CMS OPPS Rate,2919.6,100% of CMS OPPS Rate,2919.6,100% of CMS OPPS Rate,2919.6,100% of CMS OPPS Rate,2919.6,100% of CMS OPPS Rate,2919.6,100% of CMS OPPS Rate,2919.6,100% of CMS OPPS Rate,2919.6,100% of CMS OPPS Rate,111.65,10335.38,427.51
Outpatient,Laboratory,81479,UNLISTED MOLECULAR PROCEDURE,300,402,N/A,Not Applicable,62.99,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,130.41,203.89% of BCBS Fee Schedule,281.4,70% of total Billed Charges,301.5,75% of total Billed Charges,N/A,Not Applicable,321.6,80% of total Billed Charges,N/A,Not Applicable,N/A,Not Applicable,307.53,76.5% of total billed charges,62.99,15.67% of total Billed charges,62.99,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,180.9,45% of total billed charges,281.4,70% of total billed charges,241.2,60% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,281.4,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,192.96,48% of total Billed charges,N/A,Not Applicable,361.8,90% of total Billed charges,62.99,15.67% of total Billed charges,62.99,15.67% of total Billed charges,62.99,15.67% of total Billed charges,62.99,15.67% of total Billed charges,62.99,15.67% of total Billed charges,62.99,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,62.99,361.8,241.2
Outpatient,Laboratory,81511,FETAL CONGENITAL ABNORMALITIES,300,450,543.39,354% of CMS OPPS Rate,70.52,15.67% of total Billed charges,153.5,100% of CMS OPPS Rate,153.5,100% of CMS OPPS Rate,312.97,203.89% of BCBS Fee Schedule,315,70% of total Billed Charges,337.5,75% of total Billed Charges,276.3,180% OF CMS OPPS RATE,360,80% of total Billed Charges,537.25,350% of CMS Opps rate,156.57,102% of CMS Opps rate,344.25,76.5% of total billed charges,70.52,15.67% of total Billed charges,70.52,15.67% of total Billed charges,153.5,100% of CMS OPPS Rate,153.5,100% of CMS OPPS Rate,202.5,45% of total billed charges,315,70% of total billed charges,270,60% of total billed charges,153.5,100% of CMS OPPS Rate,138.15,90% OF UHC FEE SCHEDULE,315,70% of total billed charges,153.5,100% OF CMS OPPS Rate,353.05,230% OF CMS OPPS Rate,216,48% of total Billed charges,153.5,100% OF CMS OPPS Rate,405,90% of total Billed charges,70.52,15.67% of total Billed charges,70.52,15.67% of total Billed charges,70.52,15.67% of total Billed charges,70.52,15.67% of total Billed charges,70.52,15.67% of total Billed charges,70.52,15.67% of total Billed charges,153.5,100% of CMS OPPS Rate,153.5,100% of CMS OPPS Rate,153.5,100% of CMS OPPS Rate,153.5,100% of CMS OPPS Rate,153.5,100% of CMS OPPS Rate,153.5,100% of CMS OPPS Rate,153.5,100% of CMS OPPS Rate,153.5,100% of CMS OPPS Rate,70.52,543.39,270
Outpatient,Laboratory,81519,ONCOLOGY BREAST MRNA GENE EXPRESSION,300,8548.55,13710.42,354% of CMS OPPS Rate,1339.56,15.67% of total Billed charges,3873,100% of CMS OPPS Rate,3873,100% of CMS OPPS Rate,7896.66,203.89% of BCBS Fee Schedule,5983.99,70% of total Billed Charges,6411.41,75% of total Billed Charges,6971.4,180% OF CMS OPPS RATE,6838.84,80% of total Billed Charges,13555.5,350% of CMS Opps rate,3950.46,102% of CMS Opps rate,6539.64,76.5% of total billed charges,1339.56,15.67% of total Billed charges,1339.56,15.67% of total Billed charges,3873,100% of CMS OPPS Rate,3873,100% of CMS OPPS Rate,3846.85,45% of total billed charges,5983.99,70% of total billed charges,5129.13,60% of total billed charges,3873,100% of CMS OPPS Rate,3485.7,90% OF UHC FEE SCHEDULE,5983.99,70% of total billed charges,3873,100% OF CMS OPPS Rate,8548.55,230% OF CMS OPPS Rate,4103.3,48% of total Billed charges,3873,100% OF CMS OPPS Rate,7693.7,90% of total Billed charges,1339.56,15.67% of total Billed charges,1339.56,15.67% of total Billed charges,1339.56,15.67% of total Billed charges,1339.56,15.67% of total Billed charges,1339.56,15.67% of total Billed charges,1339.56,15.67% of total Billed charges,3873,100% of CMS OPPS Rate,3873,100% of CMS OPPS Rate,3873,100% of CMS OPPS Rate,3873,100% of CMS OPPS Rate,3873,100% of CMS OPPS Rate,3873,100% of CMS OPPS Rate,3873,100% of CMS OPPS Rate,3873,100% of CMS OPPS Rate,1339.56,13710.42,5129.13
Outpatient,Laboratory,82009,KETONE BODIES SERUM,300,28.35,16,354% of CMS OPPS Rate,4.52,100% of Medicaid LA Fee Schedule,4.51,100% of CMS OPPS Rate,4.51,100% of CMS OPPS Rate,11.38,203.89% of BCBS Fee Schedule,19.85,70% of total Billed Charges,21.26,75% of total Billed Charges,8.13,180% OF CMS OPPS RATE,22.68,80% of total Billed Charges,15.81,350% of CMS Opps rate,4.61,102% of CMS Opps rate,21.69,76.5% of total billed charges,4.52,100% of Medicaid LA Fee Schedule,4.52,100% of Medicaid LA Fee Schedule,4.51,100% of CMS OPPS Rate,4.51,100% of CMS OPPS Rate,12.76,45% of total billed charges,19.85,70% of total billed charges,17.01,60% of total billed charges,4.51,100% of CMS OPPS Rate,5.02,90% OF UHC FEE SCHEDULE,19.85,70% of total billed charges,4.51,100% OF CMS OPPS Rate,10.39,230% OF CMS OPPS Rate,13.61,48% of total Billed charges,4.51,100% OF CMS OPPS Rate,25.52,90% of total Billed charges,4.52,100% of Medicaid LA Fee Schedule,4.52,100% of Medicaid LA Fee Schedule,4.52,100% of Medicaid LA Fee Schedule,4.52,100% of Medicaid LA Fee Schedule,4.52,100% of Medicaid LA Fee Schedule,4.52,100% of Medicaid LA Fee Schedule,4.51,100% of CMS OPPS Rate,4.51,100% of CMS OPPS Rate,4.51,100% of CMS OPPS Rate,4.51,100% of CMS OPPS Rate,4.51,100% of CMS OPPS Rate,4.51,100% of CMS OPPS Rate,4.51,100% of CMS OPPS Rate,4.51,100% of CMS OPPS Rate,4.51,25.52,17.01
Outpatient,Laboratory,82010,KETONE BODY ACETONE QUANT,300,46.8,28.92,354% of CMS OPPS Rate,8.17,100% of Medicaid LA Fee Schedule,8.17,100% of CMS OPPS Rate,8.17,100% of CMS OPPS Rate,20.57,203.89% of BCBS Fee Schedule,32.76,70% of total Billed Charges,35.1,75% of total Billed Charges,14.7,180% OF CMS OPPS RATE,37.44,80% of total Billed Charges,28.59,350% of CMS Opps rate,8.33,102% of CMS Opps rate,35.8,76.5% of total billed charges,8.17,100% of Medicaid LA Fee Schedule,8.17,100% of Medicaid LA Fee Schedule,8.17,100% of CMS OPPS Rate,8.17,100% of CMS OPPS Rate,21.06,45% of total billed charges,32.76,70% of total billed charges,28.08,60% of total billed charges,8.17,100% of CMS OPPS Rate,9.08,90% OF UHC FEE SCHEDULE,32.76,70% of total billed charges,8.17,100% OF CMS OPPS Rate,18.79,230% OF CMS OPPS Rate,22.46,48% of total Billed charges,8.17,100% OF CMS OPPS Rate,42.12,90% of total Billed charges,8.17,100% of Medicaid LA Fee Schedule,8.17,100% of Medicaid LA Fee Schedule,8.17,100% of Medicaid LA Fee Schedule,8.17,100% of Medicaid LA Fee Schedule,8.17,100% of Medicaid LA Fee Schedule,8.17,100% of Medicaid LA Fee Schedule,8.17,100% of CMS OPPS Rate,8.17,100% of CMS OPPS Rate,8.17,100% of CMS OPPS Rate,8.17,100% of CMS OPPS Rate,8.17,100% of CMS OPPS Rate,8.17,100% of CMS OPPS Rate,8.17,100% of CMS OPPS Rate,8.17,100% of CMS OPPS Rate,8.17,42.12,28.08
Outpatient,Laboratory,82017,ACYLCARNITINE QUANTITIVE,300,126,59.71,354% of CMS OPPS Rate,16.87,100% of Medicaid LA Fee Schedule,16.87,100% of CMS OPPS Rate,16.87,100% of CMS OPPS Rate,42.47,203.89% of BCBS Fee Schedule,88.2,70% of total Billed Charges,94.5,75% of total Billed Charges,30.36,180% OF CMS OPPS RATE,100.8,80% of total Billed Charges,59.04,350% of CMS Opps rate,17.2,102% of CMS Opps rate,96.39,76.5% of total billed charges,16.87,100% of Medicaid LA Fee Schedule,16.87,100% of Medicaid LA Fee Schedule,16.87,100% of CMS OPPS Rate,16.87,100% of CMS OPPS Rate,56.7,45% of total billed charges,88.2,70% of total billed charges,75.6,60% of total billed charges,16.87,100% of CMS OPPS Rate,18.75,90% OF UHC FEE SCHEDULE,88.2,70% of total billed charges,16.87,100% OF CMS OPPS Rate,38.8,230% OF CMS OPPS Rate,60.48,48% of total Billed charges,16.87,100% OF CMS OPPS Rate,113.4,90% of total Billed charges,16.87,100% of Medicaid LA Fee Schedule,16.87,100% of Medicaid LA Fee Schedule,16.87,100% of Medicaid LA Fee Schedule,16.87,100% of Medicaid LA Fee Schedule,16.87,100% of Medicaid LA Fee Schedule,16.87,100% of Medicaid LA Fee Schedule,16.87,100% of CMS OPPS Rate,16.87,100% of CMS OPPS Rate,16.87,100% of CMS OPPS Rate,16.87,100% of CMS OPPS Rate,16.87,100% of CMS OPPS Rate,16.87,100% of CMS OPPS Rate,16.87,100% of CMS OPPS Rate,16.87,100% of CMS OPPS Rate,16.87,113.4,75.6
Outpatient,Laboratory,82024,ACTH(ADRENOCORTICOTR HOR),300,361.35,136.71,354% of CMS OPPS Rate,38.62,100% of Medicaid LA Fee Schedule,38.61,100% of CMS OPPS Rate,38.61,100% of CMS OPPS Rate,97.21,203.89% of BCBS Fee Schedule,252.95,70% of total Billed Charges,271.01,75% of total Billed Charges,69.51,180% OF CMS OPPS RATE,289.08,80% of total Billed Charges,135.17,350% of CMS Opps rate,39.39,102% of CMS Opps rate,276.43,76.5% of total billed charges,38.62,100% of Medicaid LA Fee Schedule,38.62,100% of Medicaid LA Fee Schedule,38.61,100% of CMS OPPS Rate,38.61,100% of CMS OPPS Rate,162.61,45% of total billed charges,252.95,70% of total billed charges,216.81,60% of total billed charges,38.61,100% of CMS OPPS Rate,42.91,90% OF UHC FEE SCHEDULE,252.95,70% of total billed charges,38.61,100% OF CMS OPPS Rate,88.82,230% OF CMS OPPS Rate,173.45,48% of total Billed charges,38.61,100% OF CMS OPPS Rate,325.22,90% of total Billed charges,38.62,100% of Medicaid LA Fee Schedule,38.62,100% of Medicaid LA Fee Schedule,38.62,100% of Medicaid LA Fee Schedule,38.62,100% of Medicaid LA Fee Schedule,38.62,100% of Medicaid LA Fee Schedule,38.62,100% of Medicaid LA Fee Schedule,38.61,100% of CMS OPPS Rate,38.61,100% of CMS OPPS Rate,38.61,100% of CMS OPPS Rate,38.61,100% of CMS OPPS Rate,38.61,100% of CMS OPPS Rate,38.61,100% of CMS OPPS Rate,38.61,100% of CMS OPPS Rate,38.61,100% of CMS OPPS Rate,38.61,325.22,216.81
Outpatient,Laboratory,82040,ALBUMIN BLOOD,300,90.9,17.52,354% of CMS OPPS Rate,4.95,100% of Medicaid LA Fee Schedule,4.95,100% of CMS OPPS Rate,4.95,100% of CMS OPPS Rate,12.46,203.89% of BCBS Fee Schedule,63.63,70% of total Billed Charges,68.18,75% of total Billed Charges,8.91,180% OF CMS OPPS RATE,72.72,80% of total Billed Charges,17.32,350% of CMS Opps rate,5.04,102% of CMS Opps rate,69.54,76.5% of total billed charges,4.95,100% of Medicaid LA Fee Schedule,4.95,100% of Medicaid LA Fee Schedule,4.95,100% of CMS OPPS Rate,4.95,100% of CMS OPPS Rate,40.91,45% of total billed charges,63.63,70% of total billed charges,54.54,60% of total billed charges,4.95,100% of CMS OPPS Rate,5.5,90% OF UHC FEE SCHEDULE,63.63,70% of total billed charges,4.95,100% OF CMS OPPS Rate,11.38,230% OF CMS OPPS Rate,43.63,48% of total Billed charges,4.95,100% OF CMS OPPS Rate,81.81,90% of total Billed charges,4.95,100% of Medicaid LA Fee Schedule,4.95,100% of Medicaid LA Fee Schedule,4.95,100% of Medicaid LA Fee Schedule,4.95,100% of Medicaid LA Fee Schedule,4.95,100% of Medicaid LA Fee Schedule,4.95,100% of Medicaid LA Fee Schedule,4.95,100% of CMS OPPS Rate,4.95,100% of CMS OPPS Rate,4.95,100% of CMS OPPS Rate,4.95,100% of CMS OPPS Rate,4.95,100% of CMS OPPS Rate,4.95,100% of CMS OPPS Rate,4.95,100% of CMS OPPS Rate,4.95,100% of CMS OPPS Rate,4.95,81.81,54.54
Outpatient,Laboratory,82042,ALBUMIN MISC SPECIMEN,300,87.75,27.54,354% of CMS OPPS Rate,6.68,100% of Medicaid LA Fee Schedule,7.78,100% of CMS OPPS Rate,7.78,100% of CMS OPPS Rate,15.86,203.89% of BCBS Fee Schedule,61.43,70% of total Billed Charges,65.81,75% of total Billed Charges,14,180% OF CMS OPPS RATE,70.2,80% of total Billed Charges,27.23,350% of CMS Opps rate,7.93,102% of CMS Opps rate,67.13,76.5% of total billed charges,6.68,100% of Medicaid LA Fee Schedule,6.68,100% of Medicaid LA Fee Schedule,7.78,100% of CMS OPPS Rate,7.78,100% of CMS OPPS Rate,39.49,45% of total billed charges,61.43,70% of total billed charges,52.65,60% of total billed charges,7.78,100% of CMS OPPS Rate,7,90% OF UHC FEE SCHEDULE,61.43,70% of total billed charges,7.78,100% OF CMS OPPS Rate,17.89,230% OF CMS OPPS Rate,42.12,48% of total Billed charges,7.78,100% OF CMS OPPS Rate,78.98,90% of total Billed charges,6.68,100% of Medicaid LA Fee Schedule,6.68,100% of Medicaid LA Fee Schedule,6.68,100% of Medicaid LA Fee Schedule,6.68,100% of Medicaid LA Fee Schedule,6.68,100% of Medicaid LA Fee Schedule,6.68,100% of Medicaid LA Fee Schedule,7.78,100% of CMS OPPS Rate,7.78,100% of CMS OPPS Rate,7.78,100% of CMS OPPS Rate,7.78,100% of CMS OPPS Rate,7.78,100% of CMS OPPS Rate,7.78,100% of CMS OPPS Rate,7.78,100% of CMS OPPS Rate,7.78,100% of CMS OPPS Rate,6.68,78.98,52.65
Outpatient,Laboratory,82043,Urine test to measure albumin,300,55.94,20.46,354% of CMS OPPS Rate,5.78,100% of Medicaid LA Fee Schedule,5.78,100% of CMS OPPS Rate,5.78,100% of CMS OPPS Rate,14.56,203.89% of BCBS Fee Schedule,39.16,70% of total Billed Charges,41.96,75% of total Billed Charges,10.4,180% OF CMS OPPS RATE,44.75,80% of total Billed Charges,20.23,350% of CMS Opps rate,5.89,102% of CMS Opps rate,42.79,76.5% of total billed charges,5.78,100% of Medicaid LA Fee Schedule,5.78,100% of Medicaid LA Fee Schedule,5.78,100% of CMS OPPS Rate,5.78,100% of CMS OPPS Rate,25.17,45% of total billed charges,39.16,70% of total billed charges,33.56,60% of total billed charges,5.78,100% of CMS OPPS Rate,6.43,90% OF UHC FEE SCHEDULE,39.16,70% of total billed charges,5.78,100% OF CMS OPPS Rate,13.29,230% OF CMS OPPS Rate,26.85,48% of total Billed charges,5.78,100% OF CMS OPPS Rate,50.35,90% of total Billed charges,5.78,100% of Medicaid LA Fee Schedule,5.78,100% of Medicaid LA Fee Schedule,5.78,100% of Medicaid LA Fee Schedule,5.78,100% of Medicaid LA Fee Schedule,5.78,100% of Medicaid LA Fee Schedule,5.78,100% of Medicaid LA Fee Schedule,5.78,100% of CMS OPPS Rate,5.78,100% of CMS OPPS Rate,5.78,100% of CMS OPPS Rate,5.78,100% of CMS OPPS Rate,5.78,100% of CMS OPPS Rate,5.78,100% of CMS OPPS Rate,5.78,100% of CMS OPPS Rate,5.78,100% of CMS OPPS Rate,5.78,50.35,33.56
Outpatient,Laboratory,82044,Urine test to measure albumin-semiquantitative,300,27.46,22.05,354% of CMS OPPS Rate,3.7,100% of Medicaid LA Fee Schedule,6.23,100% of CMS OPPS Rate,6.23,100% of CMS OPPS Rate,12.7,203.89% of BCBS Fee Schedule,19.22,70% of total Billed Charges,20.6,75% of total Billed Charges,11.21,180% OF CMS OPPS RATE,21.97,80% of total Billed Charges,21.8,350% of CMS Opps rate,6.35,102% of CMS Opps rate,21.01,76.5% of total billed charges,3.7,100% of Medicaid LA Fee Schedule,3.7,100% of Medicaid LA Fee Schedule,6.23,100% of CMS OPPS Rate,6.23,100% of CMS OPPS Rate,12.36,45% of total billed charges,19.22,70% of total billed charges,16.48,60% of total billed charges,6.23,100% of CMS OPPS Rate,5.61,90% OF UHC FEE SCHEDULE,19.22,70% of total billed charges,6.23,100% OF CMS OPPS Rate,14.32,230% OF CMS OPPS Rate,13.18,48% of total Billed charges,6.23,100% OF CMS OPPS Rate,24.71,90% of total Billed charges,3.7,100% of Medicaid LA Fee Schedule,3.7,100% of Medicaid LA Fee Schedule,3.7,100% of Medicaid LA Fee Schedule,3.7,100% of Medicaid LA Fee Schedule,3.7,100% of Medicaid LA Fee Schedule,3.7,100% of Medicaid LA Fee Schedule,6.23,100% of CMS OPPS Rate,6.23,100% of CMS OPPS Rate,6.23,100% of CMS OPPS Rate,6.23,100% of CMS OPPS Rate,6.23,100% of CMS OPPS Rate,6.23,100% of CMS OPPS Rate,6.23,100% of CMS OPPS Rate,6.23,100% of CMS OPPS Rate,3.7,24.71,16.48
Outpatient,Laboratory,82085,ALDOLASE,300,168.85,34.37,354% of CMS OPPS Rate,9.71,100% of Medicaid LA Fee Schedule,9.71,100% of CMS OPPS Rate,9.71,100% of CMS OPPS Rate,24.45,203.89% of BCBS Fee Schedule,118.2,70% of total Billed Charges,126.64,75% of total Billed Charges,17.47,180% OF CMS OPPS RATE,135.08,80% of total Billed Charges,33.98,350% of CMS Opps rate,9.9,102% of CMS Opps rate,129.17,76.5% of total billed charges,9.71,100% of Medicaid LA Fee Schedule,9.71,100% of Medicaid LA Fee Schedule,9.71,100% of CMS OPPS Rate,9.71,100% of CMS OPPS Rate,75.98,45% of total billed charges,118.2,70% of total billed charges,101.31,60% of total billed charges,9.71,100% of CMS OPPS Rate,10.79,90% OF UHC FEE SCHEDULE,118.2,70% of total billed charges,9.71,100% OF CMS OPPS Rate,22.33,230% OF CMS OPPS Rate,81.05,48% of total Billed charges,9.71,100% OF CMS OPPS Rate,151.97,90% of total Billed charges,9.71,100% of Medicaid LA Fee Schedule,9.71,100% of Medicaid LA Fee Schedule,9.71,100% of Medicaid LA Fee Schedule,9.71,100% of Medicaid LA Fee Schedule,9.71,100% of Medicaid LA Fee Schedule,9.71,100% of Medicaid LA Fee Schedule,9.71,100% of CMS OPPS Rate,9.71,100% of CMS OPPS Rate,9.71,100% of CMS OPPS Rate,9.71,100% of CMS OPPS Rate,9.71,100% of CMS OPPS Rate,9.71,100% of CMS OPPS Rate,9.71,100% of CMS OPPS Rate,9.71,100% of CMS OPPS Rate,9.71,151.97,101.31
Outpatient,Laboratory,82088,ALDOSTERONE,300,504.9,144.25,354% of CMS OPPS Rate,40.75,100% of Medicaid LA Fee Schedule,40.75,100% of CMS OPPS Rate,40.75,100% of CMS OPPS Rate,102.58,203.89% of BCBS Fee Schedule,353.43,70% of total Billed Charges,378.68,75% of total Billed Charges,73.35,180% OF CMS OPPS RATE,403.92,80% of total Billed Charges,142.62,350% of CMS Opps rate,41.56,102% of CMS Opps rate,386.25,76.5% of total billed charges,40.75,100% of Medicaid LA Fee Schedule,40.75,100% of Medicaid LA Fee Schedule,40.75,100% of CMS OPPS Rate,40.75,100% of CMS OPPS Rate,227.21,45% of total billed charges,353.43,70% of total billed charges,302.94,60% of total billed charges,40.75,100% of CMS OPPS Rate,45.28,90% OF UHC FEE SCHEDULE,353.43,70% of total billed charges,40.75,100% OF CMS OPPS Rate,93.72,230% OF CMS OPPS Rate,242.35,48% of total Billed charges,40.75,100% OF CMS OPPS Rate,454.41,90% of total Billed charges,40.75,100% of Medicaid LA Fee Schedule,40.75,100% of Medicaid LA Fee Schedule,40.75,100% of Medicaid LA Fee Schedule,40.75,100% of Medicaid LA Fee Schedule,40.75,100% of Medicaid LA Fee Schedule,40.75,100% of Medicaid LA Fee Schedule,40.75,100% of CMS OPPS Rate,40.75,100% of CMS OPPS Rate,40.75,100% of CMS OPPS Rate,40.75,100% of CMS OPPS Rate,40.75,100% of CMS OPPS Rate,40.75,100% of CMS OPPS Rate,40.75,100% of CMS OPPS Rate,40.75,100% of CMS OPPS Rate,40.75,454.41,302.94
Outpatient,Laboratory,82103,ALPHA-1 ANTITRYPSIN,300,206.8,47.57,354% of CMS OPPS Rate,13.44,100% of Medicaid LA Fee Schedule,13.44,100% of CMS OPPS Rate,13.44,100% of CMS OPPS Rate,33.83,203.89% of BCBS Fee Schedule,144.76,70% of total Billed Charges,155.1,75% of total Billed Charges,24.19,180% OF CMS OPPS RATE,165.44,80% of total Billed Charges,47.04,350% of CMS Opps rate,13.7,102% of CMS Opps rate,158.2,76.5% of total billed charges,13.44,100% of Medicaid LA Fee Schedule,13.44,100% of Medicaid LA Fee Schedule,13.44,100% of CMS OPPS Rate,13.44,100% of CMS OPPS Rate,93.06,45% of total billed charges,144.76,70% of total billed charges,124.08,60% of total billed charges,13.44,100% of CMS OPPS Rate,14.93,90% OF UHC FEE SCHEDULE,144.76,70% of total billed charges,13.44,100% OF CMS OPPS Rate,30.91,230% OF CMS OPPS Rate,99.26,48% of total Billed charges,13.44,100% OF CMS OPPS Rate,186.12,90% of total Billed charges,13.44,100% of Medicaid LA Fee Schedule,13.44,100% of Medicaid LA Fee Schedule,13.44,100% of Medicaid LA Fee Schedule,13.44,100% of Medicaid LA Fee Schedule,13.44,100% of Medicaid LA Fee Schedule,13.44,100% of Medicaid LA Fee Schedule,13.44,100% of CMS OPPS Rate,13.44,100% of CMS OPPS Rate,13.44,100% of CMS OPPS Rate,13.44,100% of CMS OPPS Rate,13.44,100% of CMS OPPS Rate,13.44,100% of CMS OPPS Rate,13.44,100% of CMS OPPS Rate,13.44,100% of CMS OPPS Rate,13.44,186.12,124.08
Outpatient,Laboratory,82104,ALPHA 1 ANTITRYPSIN PHENOTYPR,300,210,51.18,354% of CMS OPPS Rate,14.46,100% of Medicaid LA Fee Schedule,14.46,100% of CMS OPPS Rate,14.46,100% of CMS OPPS Rate,36.41,203.89% of BCBS Fee Schedule,147,70% of total Billed Charges,157.5,75% of total Billed Charges,26.02,180% OF CMS OPPS RATE,168,80% of total Billed Charges,50.61,350% of CMS Opps rate,14.74,102% of CMS Opps rate,160.65,76.5% of total billed charges,14.46,100% of Medicaid LA Fee Schedule,14.46,100% of Medicaid LA Fee Schedule,14.46,100% of CMS OPPS Rate,14.46,100% of CMS OPPS Rate,94.5,45% of total billed charges,147,70% of total billed charges,126,60% of total billed charges,14.46,100% of CMS OPPS Rate,16.07,90% OF UHC FEE SCHEDULE,147,70% of total billed charges,14.46,100% OF CMS OPPS Rate,33.25,230% OF CMS OPPS Rate,100.8,48% of total Billed charges,14.46,100% OF CMS OPPS Rate,189,90% of total Billed charges,14.46,100% of Medicaid LA Fee Schedule,14.46,100% of Medicaid LA Fee Schedule,14.46,100% of Medicaid LA Fee Schedule,14.46,100% of Medicaid LA Fee Schedule,14.46,100% of Medicaid LA Fee Schedule,14.46,100% of Medicaid LA Fee Schedule,14.46,100% of CMS OPPS Rate,14.46,100% of CMS OPPS Rate,14.46,100% of CMS OPPS Rate,14.46,100% of CMS OPPS Rate,14.46,100% of CMS OPPS Rate,14.46,100% of CMS OPPS Rate,14.46,100% of CMS OPPS Rate,14.46,100% of CMS OPPS Rate,14.46,189,126
Outpatient,Laboratory,82105,ALPHA FETOPROTEIN TUMOR M,300,105.05,59.36,354% of CMS OPPS Rate,16.69,100% of Medicaid LA Fee Schedule,16.77,100% of CMS OPPS Rate,16.77,100% of CMS OPPS Rate,42.23,203.89% of BCBS Fee Schedule,73.54,70% of total Billed Charges,78.79,75% of total Billed Charges,30.18,180% OF CMS OPPS RATE,84.04,80% of total Billed Charges,58.69,350% of CMS Opps rate,17.1,102% of CMS Opps rate,80.36,76.5% of total billed charges,16.69,100% of Medicaid LA Fee Schedule,16.69,100% of Medicaid LA Fee Schedule,16.77,100% of CMS OPPS Rate,16.77,100% of CMS OPPS Rate,47.27,45% of total billed charges,73.54,70% of total billed charges,63.03,60% of total billed charges,16.77,100% of CMS OPPS Rate,18.64,90% OF UHC FEE SCHEDULE,73.54,70% of total billed charges,16.77,100% OF CMS OPPS Rate,38.57,230% OF CMS OPPS Rate,50.42,48% of total Billed charges,16.77,100% OF CMS OPPS Rate,94.55,90% of total Billed charges,16.69,100% of Medicaid LA Fee Schedule,16.69,100% of Medicaid LA Fee Schedule,16.69,100% of Medicaid LA Fee Schedule,16.69,100% of Medicaid LA Fee Schedule,16.69,100% of Medicaid LA Fee Schedule,16.69,100% of Medicaid LA Fee Schedule,16.77,100% of CMS OPPS Rate,16.77,100% of CMS OPPS Rate,16.77,100% of CMS OPPS Rate,16.77,100% of CMS OPPS Rate,16.77,100% of CMS OPPS Rate,16.77,100% of CMS OPPS Rate,16.77,100% of CMS OPPS Rate,16.77,100% of CMS OPPS Rate,16.69,94.55,63.03
Outpatient,Laboratory,82107,AFP L3 FRACTION ISOFORM AND TOTAL,300,439.4,228.01,354% of CMS OPPS Rate,64.41,100% of Medicaid LA Fee Schedule,64.41,100% of CMS OPPS Rate,64.41,100% of CMS OPPS Rate,162.13,203.89% of BCBS Fee Schedule,307.58,70% of total Billed Charges,329.55,75% of total Billed Charges,115.93,180% OF CMS OPPS RATE,351.52,80% of total Billed Charges,225.43,350% of CMS Opps rate,65.69,102% of CMS Opps rate,336.14,76.5% of total billed charges,64.41,100% of Medicaid LA Fee Schedule,64.41,100% of Medicaid LA Fee Schedule,64.41,100% of CMS OPPS Rate,64.41,100% of CMS OPPS Rate,197.73,45% of total billed charges,307.58,70% of total billed charges,263.64,60% of total billed charges,64.41,100% of CMS OPPS Rate,71.57,90% OF UHC FEE SCHEDULE,307.58,70% of total billed charges,64.41,100% OF CMS OPPS Rate,148.14,230% OF CMS OPPS Rate,210.91,48% of total Billed charges,64.41,100% OF CMS OPPS Rate,395.46,90% of total Billed charges,64.41,100% of Medicaid LA Fee Schedule,64.41,100% of Medicaid LA Fee Schedule,64.41,100% of Medicaid LA Fee Schedule,64.41,100% of Medicaid LA Fee Schedule,64.41,100% of Medicaid LA Fee Schedule,64.41,100% of Medicaid LA Fee Schedule,64.41,100% of CMS OPPS Rate,64.41,100% of CMS OPPS Rate,64.41,100% of CMS OPPS Rate,64.41,100% of CMS OPPS Rate,64.41,100% of CMS OPPS Rate,64.41,100% of CMS OPPS Rate,64.41,100% of CMS OPPS Rate,64.41,100% of CMS OPPS Rate,64.41,395.46,263.64
Outpatient,Laboratory,82108,ALUMINUM,300,276,90.19,354% of CMS OPPS Rate,10.33,100% of Medicaid LA Fee Schedule,25.48,100% of CMS OPPS Rate,25.48,100% of CMS OPPS Rate,64.14,203.89% of BCBS Fee Schedule,193.2,70% of total Billed Charges,207,75% of total Billed Charges,45.86,180% OF CMS OPPS RATE,220.8,80% of total Billed Charges,89.18,350% of CMS Opps rate,25.98,102% of CMS Opps rate,211.14,76.5% of total billed charges,10.33,100% of Medicaid LA Fee Schedule,10.33,100% of Medicaid LA Fee Schedule,25.48,100% of CMS OPPS Rate,25.48,100% of CMS OPPS Rate,124.2,45% of total billed charges,193.2,70% of total billed charges,165.6,60% of total billed charges,25.48,100% of CMS OPPS Rate,28.31,90% OF UHC FEE SCHEDULE,193.2,70% of total billed charges,25.48,100% OF CMS OPPS Rate,58.6,230% OF CMS OPPS Rate,132.48,48% of total Billed charges,25.48,100% OF CMS OPPS Rate,248.4,90% of total Billed charges,10.33,100% of Medicaid LA Fee Schedule,10.33,100% of Medicaid LA Fee Schedule,10.33,100% of Medicaid LA Fee Schedule,10.33,100% of Medicaid LA Fee Schedule,10.33,100% of Medicaid LA Fee Schedule,10.33,100% of Medicaid LA Fee Schedule,25.48,100% of CMS OPPS Rate,25.48,100% of CMS OPPS Rate,25.48,100% of CMS OPPS Rate,25.48,100% of CMS OPPS Rate,25.48,100% of CMS OPPS Rate,25.48,100% of CMS OPPS Rate,25.48,100% of CMS OPPS Rate,25.48,100% of CMS OPPS Rate,10.33,248.4,165.6
Outpatient,Laboratory,82131,AMINO ACIDS SINGLE QUANT EA,300,300,81.34,354% of CMS OPPS Rate,21.58,100% of Medicaid LA Fee Schedule,22.98,100% of CMS OPPS Rate,22.98,100% of CMS OPPS Rate,46.85,203.89% of BCBS Fee Schedule,210,70% of total Billed Charges,225,75% of total Billed Charges,41.36,180% OF CMS OPPS RATE,240,80% of total Billed Charges,80.43,350% of CMS Opps rate,23.43,102% of CMS Opps rate,229.5,76.5% of total billed charges,21.58,100% of Medicaid LA Fee Schedule,21.58,100% of Medicaid LA Fee Schedule,22.98,100% of CMS OPPS Rate,22.98,100% of CMS OPPS Rate,135,45% of total billed charges,210,70% of total billed charges,180,60% of total billed charges,22.98,100% of CMS OPPS Rate,20.68,90% OF UHC FEE SCHEDULE,210,70% of total billed charges,22.98,100% OF CMS OPPS Rate,52.85,230% OF CMS OPPS Rate,144,48% of total Billed charges,22.98,100% OF CMS OPPS Rate,270,90% of total Billed charges,21.58,100% of Medicaid LA Fee Schedule,21.58,100% of Medicaid LA Fee Schedule,21.58,100% of Medicaid LA Fee Schedule,21.58,100% of Medicaid LA Fee Schedule,21.58,100% of Medicaid LA Fee Schedule,21.58,100% of Medicaid LA Fee Schedule,22.98,100% of CMS OPPS Rate,22.98,100% of CMS OPPS Rate,22.98,100% of CMS OPPS Rate,22.98,100% of CMS OPPS Rate,22.98,100% of CMS OPPS Rate,22.98,100% of CMS OPPS Rate,22.98,100% of CMS OPPS Rate,22.98,100% of CMS OPPS Rate,20.68,270,180
Outpatient,Laboratory,82135,ALA-AMINOLEVULINIC AC,300,154.8,58.23,354% of CMS OPPS Rate,16.45,100% of Medicaid LA Fee Schedule,16.45,100% of CMS OPPS Rate,16.45,100% of CMS OPPS Rate,41.41,203.89% of BCBS Fee Schedule,108.36,70% of total Billed Charges,116.1,75% of total Billed Charges,29.61,180% OF CMS OPPS RATE,123.84,80% of total Billed Charges,57.57,350% of CMS Opps rate,16.77,102% of CMS Opps rate,118.42,76.5% of total billed charges,16.45,100% of Medicaid LA Fee Schedule,16.45,100% of Medicaid LA Fee Schedule,16.45,100% of CMS OPPS Rate,16.45,100% of CMS OPPS Rate,69.66,45% of total billed charges,108.36,70% of total billed charges,92.88,60% of total billed charges,16.45,100% of CMS OPPS Rate,18.28,90% OF UHC FEE SCHEDULE,108.36,70% of total billed charges,16.45,100% OF CMS OPPS Rate,37.83,230% OF CMS OPPS Rate,74.3,48% of total Billed charges,16.45,100% OF CMS OPPS Rate,139.32,90% of total Billed charges,16.45,100% of Medicaid LA Fee Schedule,16.45,100% of Medicaid LA Fee Schedule,16.45,100% of Medicaid LA Fee Schedule,16.45,100% of Medicaid LA Fee Schedule,16.45,100% of Medicaid LA Fee Schedule,16.45,100% of Medicaid LA Fee Schedule,16.45,100% of CMS OPPS Rate,16.45,100% of CMS OPPS Rate,16.45,100% of CMS OPPS Rate,16.45,100% of CMS OPPS Rate,16.45,100% of CMS OPPS Rate,16.45,100% of CMS OPPS Rate,16.45,100% of CMS OPPS Rate,16.45,100% of CMS OPPS Rate,16.45,139.32,92.88
Outpatient,Laboratory,82136,AMINO ACIDS 2 TO 5 QUANTITATIVE EA,300,253,69.41,354% of CMS OPPS Rate,19.61,100% of Medicaid LA Fee Schedule,19.61,100% of CMS OPPS Rate,19.61,100% of CMS OPPS Rate,42.47,203.89% of BCBS Fee Schedule,177.1,70% of total Billed Charges,189.75,75% of total Billed Charges,35.29,180% OF CMS OPPS RATE,202.4,80% of total Billed Charges,68.63,350% of CMS Opps rate,20,102% of CMS Opps rate,193.55,76.5% of total billed charges,19.61,100% of Medicaid LA Fee Schedule,19.61,100% of Medicaid LA Fee Schedule,19.61,100% of CMS OPPS Rate,19.61,100% of CMS OPPS Rate,113.85,45% of total billed charges,177.1,70% of total billed charges,151.8,60% of total billed charges,19.61,100% of CMS OPPS Rate,18.75,90% OF UHC FEE SCHEDULE,177.1,70% of total billed charges,19.61,100% OF CMS OPPS Rate,45.1,230% OF CMS OPPS Rate,121.44,48% of total Billed charges,19.61,100% OF CMS OPPS Rate,227.7,90% of total Billed charges,19.61,100% of Medicaid LA Fee Schedule,19.61,100% of Medicaid LA Fee Schedule,19.61,100% of Medicaid LA Fee Schedule,19.61,100% of Medicaid LA Fee Schedule,19.61,100% of Medicaid LA Fee Schedule,19.61,100% of Medicaid LA Fee Schedule,19.61,100% of CMS OPPS Rate,19.61,100% of CMS OPPS Rate,19.61,100% of CMS OPPS Rate,19.61,100% of CMS OPPS Rate,19.61,100% of CMS OPPS Rate,19.61,100% of CMS OPPS Rate,19.61,100% of CMS OPPS Rate,19.61,100% of CMS OPPS Rate,18.75,227.7,151.8
Outpatient,Laboratory,82139,AMINO ACID QUANT.,300,656.5,59.71,354% of CMS OPPS Rate,16.87,100% of Medicaid LA Fee Schedule,16.87,100% of CMS OPPS Rate,16.87,100% of CMS OPPS Rate,42.47,203.89% of BCBS Fee Schedule,459.55,70% of total Billed Charges,492.38,75% of total Billed Charges,30.36,180% OF CMS OPPS RATE,525.2,80% of total Billed Charges,59.04,350% of CMS Opps rate,17.2,102% of CMS Opps rate,502.22,76.5% of total billed charges,16.87,100% of Medicaid LA Fee Schedule,16.87,100% of Medicaid LA Fee Schedule,16.87,100% of CMS OPPS Rate,16.87,100% of CMS OPPS Rate,295.43,45% of total billed charges,459.55,70% of total billed charges,393.9,60% of total billed charges,16.87,100% of CMS OPPS Rate,18.75,90% OF UHC FEE SCHEDULE,459.55,70% of total billed charges,16.87,100% OF CMS OPPS Rate,38.8,230% OF CMS OPPS Rate,315.12,48% of total Billed charges,16.87,100% OF CMS OPPS Rate,590.85,90% of total Billed charges,16.87,100% of Medicaid LA Fee Schedule,16.87,100% of Medicaid LA Fee Schedule,16.87,100% of Medicaid LA Fee Schedule,16.87,100% of Medicaid LA Fee Schedule,16.87,100% of Medicaid LA Fee Schedule,16.87,100% of Medicaid LA Fee Schedule,16.87,100% of CMS OPPS Rate,16.87,100% of CMS OPPS Rate,16.87,100% of CMS OPPS Rate,16.87,100% of CMS OPPS Rate,16.87,100% of CMS OPPS Rate,16.87,100% of CMS OPPS Rate,16.87,100% of CMS OPPS Rate,16.87,100% of CMS OPPS Rate,16.87,590.85,393.9
Outpatient,Laboratory,82140,AMMONIA PLASMA,300,105.75,51.57,354% of CMS OPPS Rate,14.57,100% of Medicaid LA Fee Schedule,14.57,100% of CMS OPPS Rate,14.57,100% of CMS OPPS Rate,36.68,203.89% of BCBS Fee Schedule,74.03,70% of total Billed Charges,79.31,75% of total Billed Charges,26.22,180% OF CMS OPPS RATE,84.6,80% of total Billed Charges,50.99,350% of CMS Opps rate,14.86,102% of CMS Opps rate,80.9,76.5% of total billed charges,14.57,100% of Medicaid LA Fee Schedule,14.57,100% of Medicaid LA Fee Schedule,14.57,100% of CMS OPPS Rate,14.57,100% of CMS OPPS Rate,47.59,45% of total billed charges,74.03,70% of total billed charges,63.45,60% of total billed charges,14.57,100% of CMS OPPS Rate,16.19,90% OF UHC FEE SCHEDULE,74.03,70% of total billed charges,14.57,100% OF CMS OPPS Rate,33.51,230% OF CMS OPPS Rate,50.76,48% of total Billed charges,14.57,100% OF CMS OPPS Rate,95.18,90% of total Billed charges,14.57,100% of Medicaid LA Fee Schedule,14.57,100% of Medicaid LA Fee Schedule,14.57,100% of Medicaid LA Fee Schedule,14.57,100% of Medicaid LA Fee Schedule,14.57,100% of Medicaid LA Fee Schedule,14.57,100% of Medicaid LA Fee Schedule,14.57,100% of CMS OPPS Rate,14.57,100% of CMS OPPS Rate,14.57,100% of CMS OPPS Rate,14.57,100% of CMS OPPS Rate,14.57,100% of CMS OPPS Rate,14.57,100% of CMS OPPS Rate,14.57,100% of CMS OPPS Rate,14.57,100% of CMS OPPS Rate,14.57,95.18,63.45
Outpatient,Laboratory,82143,AMNIOTIC FLUID SCAN,300,89,33.09,354% of CMS OPPS Rate,8.76,100% of Medicaid LA Fee Schedule,9.35,100% of CMS OPPS Rate,9.35,100% of CMS OPPS Rate,19.06,203.89% of BCBS Fee Schedule,62.3,70% of total Billed Charges,66.75,75% of total Billed Charges,16.83,180% OF CMS OPPS RATE,71.2,80% of total Billed Charges,32.72,350% of CMS Opps rate,9.53,102% of CMS Opps rate,68.09,76.5% of total billed charges,8.76,100% of Medicaid LA Fee Schedule,8.76,100% of Medicaid LA Fee Schedule,9.35,100% of CMS OPPS Rate,9.35,100% of CMS OPPS Rate,40.05,45% of total billed charges,62.3,70% of total billed charges,53.4,60% of total billed charges,9.35,100% of CMS OPPS Rate,8.42,90% OF UHC FEE SCHEDULE,62.3,70% of total billed charges,9.35,100% OF CMS OPPS Rate,21.5,230% OF CMS OPPS Rate,42.72,48% of total Billed charges,9.35,100% OF CMS OPPS Rate,80.1,90% of total Billed charges,8.76,100% of Medicaid LA Fee Schedule,8.76,100% of Medicaid LA Fee Schedule,8.76,100% of Medicaid LA Fee Schedule,8.76,100% of Medicaid LA Fee Schedule,8.76,100% of Medicaid LA Fee Schedule,8.76,100% of Medicaid LA Fee Schedule,9.35,100% of CMS OPPS Rate,9.35,100% of CMS OPPS Rate,9.35,100% of CMS OPPS Rate,9.35,100% of CMS OPPS Rate,9.35,100% of CMS OPPS Rate,9.35,100% of CMS OPPS Rate,9.35,100% of CMS OPPS Rate,9.35,100% of CMS OPPS Rate,8.42,80.1,53.4
Outpatient,Laboratory,82150,AMYLASE,300,142.65,22.93,354% of CMS OPPS Rate,6.48,100% of Medicaid LA Fee Schedule,6.48,100% of CMS OPPS Rate,6.48,100% of CMS OPPS Rate,16.31,203.89% of BCBS Fee Schedule,99.86,70% of total Billed Charges,106.99,75% of total Billed Charges,11.66,180% OF CMS OPPS RATE,114.12,80% of total Billed Charges,22.68,350% of CMS Opps rate,6.6,102% of CMS Opps rate,109.13,76.5% of total billed charges,6.48,100% of Medicaid LA Fee Schedule,6.48,100% of Medicaid LA Fee Schedule,6.48,100% of CMS OPPS Rate,6.48,100% of CMS OPPS Rate,64.19,45% of total billed charges,99.86,70% of total billed charges,85.59,60% of total billed charges,6.48,100% of CMS OPPS Rate,7.2,90% OF UHC FEE SCHEDULE,99.86,70% of total billed charges,6.48,100% OF CMS OPPS Rate,14.9,230% OF CMS OPPS Rate,68.47,48% of total Billed charges,6.48,100% OF CMS OPPS Rate,128.39,90% of total Billed charges,6.48,100% of Medicaid LA Fee Schedule,6.48,100% of Medicaid LA Fee Schedule,6.48,100% of Medicaid LA Fee Schedule,6.48,100% of Medicaid LA Fee Schedule,6.48,100% of Medicaid LA Fee Schedule,6.48,100% of Medicaid LA Fee Schedule,6.48,100% of CMS OPPS Rate,6.48,100% of CMS OPPS Rate,6.48,100% of CMS OPPS Rate,6.48,100% of CMS OPPS Rate,6.48,100% of CMS OPPS Rate,6.48,100% of CMS OPPS Rate,6.48,100% of CMS OPPS Rate,6.48,100% of CMS OPPS Rate,6.48,128.39,85.59
Outpatient,Laboratory,82154,ANDROSTANEDIOL GLUCURONIDE,300,346,102.05,354% of CMS OPPS Rate,28.83,100% of Medicaid LA Fee Schedule,28.83,100% of CMS OPPS Rate,28.83,100% of CMS OPPS Rate,72.58,203.89% of BCBS Fee Schedule,242.2,70% of total Billed Charges,259.5,75% of total Billed Charges,51.89,180% OF CMS OPPS RATE,276.8,80% of total Billed Charges,100.9,350% of CMS Opps rate,29.4,102% of CMS Opps rate,264.69,76.5% of total billed charges,28.83,100% of Medicaid LA Fee Schedule,28.83,100% of Medicaid LA Fee Schedule,28.83,100% of CMS OPPS Rate,28.83,100% of CMS OPPS Rate,155.7,45% of total billed charges,242.2,70% of total billed charges,207.6,60% of total billed charges,28.83,100% of CMS OPPS Rate,32.04,90% OF UHC FEE SCHEDULE,242.2,70% of total billed charges,28.83,100% OF CMS OPPS Rate,66.3,230% OF CMS OPPS Rate,166.08,48% of total Billed charges,28.83,100% OF CMS OPPS Rate,311.4,90% of total Billed charges,28.83,100% of Medicaid LA Fee Schedule,28.83,100% of Medicaid LA Fee Schedule,28.83,100% of Medicaid LA Fee Schedule,28.83,100% of Medicaid LA Fee Schedule,28.83,100% of Medicaid LA Fee Schedule,28.83,100% of Medicaid LA Fee Schedule,28.83,100% of CMS OPPS Rate,28.83,100% of CMS OPPS Rate,28.83,100% of CMS OPPS Rate,28.83,100% of CMS OPPS Rate,28.83,100% of CMS OPPS Rate,28.83,100% of CMS OPPS Rate,28.83,100% of CMS OPPS Rate,28.83,100% of CMS OPPS Rate,28.83,311.4,207.6
Outpatient,Laboratory,82157,"ANDROSTENEDIONE, SERUM",300,138.15,103.65,354% of CMS OPPS Rate,29.28,100% of Medicaid LA Fee Schedule,29.28,100% of CMS OPPS Rate,29.28,100% of CMS OPPS Rate,73.69,203.89% of BCBS Fee Schedule,96.71,70% of total Billed Charges,103.61,75% of total Billed Charges,52.7,180% OF CMS OPPS RATE,110.52,80% of total Billed Charges,102.48,350% of CMS Opps rate,29.86,102% of CMS Opps rate,105.68,76.5% of total billed charges,29.28,100% of Medicaid LA Fee Schedule,29.28,100% of Medicaid LA Fee Schedule,29.28,100% of CMS OPPS Rate,29.28,100% of CMS OPPS Rate,62.17,45% of total billed charges,96.71,70% of total billed charges,82.89,60% of total billed charges,29.28,100% of CMS OPPS Rate,32.53,90% OF UHC FEE SCHEDULE,96.71,70% of total billed charges,29.28,100% OF CMS OPPS Rate,67.34,230% OF CMS OPPS Rate,66.31,48% of total Billed charges,29.28,100% OF CMS OPPS Rate,124.34,90% of total Billed charges,29.28,100% of Medicaid LA Fee Schedule,29.28,100% of Medicaid LA Fee Schedule,29.28,100% of Medicaid LA Fee Schedule,29.28,100% of Medicaid LA Fee Schedule,29.28,100% of Medicaid LA Fee Schedule,29.28,100% of Medicaid LA Fee Schedule,29.28,100% of CMS OPPS Rate,29.28,100% of CMS OPPS Rate,29.28,100% of CMS OPPS Rate,29.28,100% of CMS OPPS Rate,29.28,100% of CMS OPPS Rate,29.28,100% of CMS OPPS Rate,29.28,100% of CMS OPPS Rate,29.28,100% of CMS OPPS Rate,29.28,124.34,82.89
Outpatient,Laboratory,82163,ANGIOTENSIN II,300,178,72.64,354% of CMS OPPS Rate,20.52,100% of Medicaid LA Fee Schedule,20.52,100% of CMS OPPS Rate,20.52,100% of CMS OPPS Rate,51.67,203.89% of BCBS Fee Schedule,124.6,70% of total Billed Charges,133.5,75% of total Billed Charges,36.93,180% OF CMS OPPS RATE,142.4,80% of total Billed Charges,71.82,350% of CMS Opps rate,20.93,102% of CMS Opps rate,136.17,76.5% of total billed charges,20.52,100% of Medicaid LA Fee Schedule,20.52,100% of Medicaid LA Fee Schedule,20.52,100% of CMS OPPS Rate,20.52,100% of CMS OPPS Rate,80.1,45% of total billed charges,124.6,70% of total billed charges,106.8,60% of total billed charges,20.52,100% of CMS OPPS Rate,22.81,90% OF UHC FEE SCHEDULE,124.6,70% of total billed charges,20.52,100% OF CMS OPPS Rate,47.19,230% OF CMS OPPS Rate,85.44,48% of total Billed charges,20.52,100% OF CMS OPPS Rate,160.2,90% of total Billed charges,20.52,100% of Medicaid LA Fee Schedule,20.52,100% of Medicaid LA Fee Schedule,20.52,100% of Medicaid LA Fee Schedule,20.52,100% of Medicaid LA Fee Schedule,20.52,100% of Medicaid LA Fee Schedule,20.52,100% of Medicaid LA Fee Schedule,20.52,100% of CMS OPPS Rate,20.52,100% of CMS OPPS Rate,20.52,100% of CMS OPPS Rate,20.52,100% of CMS OPPS Rate,20.52,100% of CMS OPPS Rate,20.52,100% of CMS OPPS Rate,20.52,100% of CMS OPPS Rate,20.52,100% of CMS OPPS Rate,20.52,160.2,106.8
Outpatient,Laboratory,82164,ANGIOTENSIN CONVERT ENZ,300,197.45,51.68,354% of CMS OPPS Rate,14.6,100% of Medicaid LA Fee Schedule,14.6,100% of CMS OPPS Rate,14.6,100% of CMS OPPS Rate,36.76,203.89% of BCBS Fee Schedule,138.22,70% of total Billed Charges,148.09,75% of total Billed Charges,26.28,180% OF CMS OPPS RATE,157.96,80% of total Billed Charges,51.1,350% of CMS Opps rate,14.89,102% of CMS Opps rate,151.05,76.5% of total billed charges,14.6,100% of Medicaid LA Fee Schedule,14.6,100% of Medicaid LA Fee Schedule,14.6,100% of CMS OPPS Rate,14.6,100% of CMS OPPS Rate,88.85,45% of total billed charges,138.22,70% of total billed charges,118.47,60% of total billed charges,14.6,100% of CMS OPPS Rate,16.23,90% OF UHC FEE SCHEDULE,138.22,70% of total billed charges,14.6,100% OF CMS OPPS Rate,33.58,230% OF CMS OPPS Rate,94.78,48% of total Billed charges,14.6,100% OF CMS OPPS Rate,177.71,90% of total Billed charges,14.6,100% of Medicaid LA Fee Schedule,14.6,100% of Medicaid LA Fee Schedule,14.6,100% of Medicaid LA Fee Schedule,14.6,100% of Medicaid LA Fee Schedule,14.6,100% of Medicaid LA Fee Schedule,14.6,100% of Medicaid LA Fee Schedule,14.6,100% of CMS OPPS Rate,14.6,100% of CMS OPPS Rate,14.6,100% of CMS OPPS Rate,14.6,100% of CMS OPPS Rate,14.6,100% of CMS OPPS Rate,14.6,100% of CMS OPPS Rate,14.6,100% of CMS OPPS Rate,14.6,100% of CMS OPPS Rate,14.6,177.71,118.47
Outpatient,Laboratory,82172,LIPOPROTEIN,300,68.2,74.65,354% of CMS OPPS Rate,10.69,15.67% of total Billed charges,21.09,100% of CMS OPPS Rate,21.09,100% of CMS OPPS Rate,43,203.89% of BCBS Fee Schedule,47.74,70% of total Billed Charges,51.15,75% of total Billed Charges,37.96,180% OF CMS OPPS RATE,54.56,80% of total Billed Charges,73.81,350% of CMS Opps rate,21.51,102% of CMS Opps rate,52.17,76.5% of total billed charges,10.69,15.67% of total Billed charges,10.69,15.67% of total Billed charges,21.09,100% of CMS OPPS Rate,21.09,100% of CMS OPPS Rate,30.69,45% of total billed charges,47.74,70% of total billed charges,40.92,60% of total billed charges,21.09,100% of CMS OPPS Rate,18.98,90% OF UHC FEE SCHEDULE,47.74,70% of total billed charges,21.09,100% OF CMS OPPS Rate,48.5,230% OF CMS OPPS Rate,32.74,48% of total Billed charges,21.09,100% OF CMS OPPS Rate,61.38,90% of total Billed charges,10.69,15.67% of total Billed charges,10.69,15.67% of total Billed charges,10.69,15.67% of total Billed charges,10.69,15.67% of total Billed charges,10.69,15.67% of total Billed charges,10.69,15.67% of total Billed charges,21.09,100% of CMS OPPS Rate,21.09,100% of CMS OPPS Rate,21.09,100% of CMS OPPS Rate,21.09,100% of CMS OPPS Rate,21.09,100% of CMS OPPS Rate,21.09,100% of CMS OPPS Rate,21.09,100% of CMS OPPS Rate,21.09,100% of CMS OPPS Rate,10.69,74.65,40.92
Outpatient,Laboratory,82175,ARSENIC (HEAVY METAL),300,106.15,67.15,354% of CMS OPPS Rate,18.97,100% of Medicaid LA Fee Schedule,18.97,100% of CMS OPPS Rate,18.97,100% of CMS OPPS Rate,47.75,203.89% of BCBS Fee Schedule,74.31,70% of total Billed Charges,79.61,75% of total Billed Charges,34.14,180% OF CMS OPPS RATE,84.92,80% of total Billed Charges,66.39,350% of CMS Opps rate,19.34,102% of CMS Opps rate,81.2,76.5% of total billed charges,18.97,100% of Medicaid LA Fee Schedule,18.97,100% of Medicaid LA Fee Schedule,18.97,100% of CMS OPPS Rate,18.97,100% of CMS OPPS Rate,47.77,45% of total billed charges,74.31,70% of total billed charges,63.69,60% of total billed charges,18.97,100% of CMS OPPS Rate,21.08,90% OF UHC FEE SCHEDULE,74.31,70% of total billed charges,18.97,100% OF CMS OPPS Rate,43.63,230% OF CMS OPPS Rate,50.95,48% of total Billed charges,18.97,100% OF CMS OPPS Rate,95.54,90% of total Billed charges,18.97,100% of Medicaid LA Fee Schedule,18.97,100% of Medicaid LA Fee Schedule,18.97,100% of Medicaid LA Fee Schedule,18.97,100% of Medicaid LA Fee Schedule,18.97,100% of Medicaid LA Fee Schedule,18.97,100% of Medicaid LA Fee Schedule,18.97,100% of CMS OPPS Rate,18.97,100% of CMS OPPS Rate,18.97,100% of CMS OPPS Rate,18.97,100% of CMS OPPS Rate,18.97,100% of CMS OPPS Rate,18.97,100% of CMS OPPS Rate,18.97,100% of CMS OPPS Rate,18.97,100% of CMS OPPS Rate,18.97,95.54,63.69
Outpatient,Laboratory,82180,ASCORBIC ACID BLOOD,300,248,35.01,354% of CMS OPPS Rate,9.89,100% of Medicaid LA Fee Schedule,9.89,100% of CMS OPPS Rate,9.89,100% of CMS OPPS Rate,24.87,203.89% of BCBS Fee Schedule,173.6,70% of total Billed Charges,186,75% of total Billed Charges,17.8,180% OF CMS OPPS RATE,198.4,80% of total Billed Charges,34.61,350% of CMS Opps rate,10.08,102% of CMS Opps rate,189.72,76.5% of total billed charges,9.89,100% of Medicaid LA Fee Schedule,9.89,100% of Medicaid LA Fee Schedule,9.89,100% of CMS OPPS Rate,9.89,100% of CMS OPPS Rate,111.6,45% of total billed charges,173.6,70% of total billed charges,148.8,60% of total billed charges,9.89,100% of CMS OPPS Rate,10.98,90% OF UHC FEE SCHEDULE,173.6,70% of total billed charges,9.89,100% OF CMS OPPS Rate,22.74,230% OF CMS OPPS Rate,119.04,48% of total Billed charges,9.89,100% OF CMS OPPS Rate,223.2,90% of total Billed charges,9.89,100% of Medicaid LA Fee Schedule,9.89,100% of Medicaid LA Fee Schedule,9.89,100% of Medicaid LA Fee Schedule,9.89,100% of Medicaid LA Fee Schedule,9.89,100% of Medicaid LA Fee Schedule,9.89,100% of Medicaid LA Fee Schedule,9.89,100% of CMS OPPS Rate,9.89,100% of CMS OPPS Rate,9.89,100% of CMS OPPS Rate,9.89,100% of CMS OPPS Rate,9.89,100% of CMS OPPS Rate,9.89,100% of CMS OPPS Rate,9.89,100% of CMS OPPS Rate,9.89,100% of CMS OPPS Rate,9.89,223.2,148.8
Outpatient,Laboratory,82232,B2 MICROGLOBULIN,300,130.5,57.27,354% of CMS OPPS Rate,16.18,100% of Medicaid LA Fee Schedule,16.18,100% of CMS OPPS Rate,16.18,100% of CMS OPPS Rate,40.72,203.89% of BCBS Fee Schedule,91.35,70% of total Billed Charges,97.88,75% of total Billed Charges,29.12,180% OF CMS OPPS RATE,104.4,80% of total Billed Charges,56.63,350% of CMS Opps rate,16.5,102% of CMS Opps rate,99.83,76.5% of total billed charges,16.18,100% of Medicaid LA Fee Schedule,16.18,100% of Medicaid LA Fee Schedule,16.18,100% of CMS OPPS Rate,16.18,100% of CMS OPPS Rate,58.73,45% of total billed charges,91.35,70% of total billed charges,78.3,60% of total billed charges,16.18,100% of CMS OPPS Rate,17.97,90% OF UHC FEE SCHEDULE,91.35,70% of total billed charges,16.18,100% OF CMS OPPS Rate,37.21,230% OF CMS OPPS Rate,62.64,48% of total Billed charges,16.18,100% OF CMS OPPS Rate,117.45,90% of total Billed charges,16.18,100% of Medicaid LA Fee Schedule,16.18,100% of Medicaid LA Fee Schedule,16.18,100% of Medicaid LA Fee Schedule,16.18,100% of Medicaid LA Fee Schedule,16.18,100% of Medicaid LA Fee Schedule,16.18,100% of Medicaid LA Fee Schedule,16.18,100% of CMS OPPS Rate,16.18,100% of CMS OPPS Rate,16.18,100% of CMS OPPS Rate,16.18,100% of CMS OPPS Rate,16.18,100% of CMS OPPS Rate,16.18,100% of CMS OPPS Rate,16.18,100% of CMS OPPS Rate,16.18,100% of CMS OPPS Rate,16.18,117.45,78.3
Outpatient,Laboratory,82239,BILE ACID; TOTAL,300,80,60.6,354% of CMS OPPS Rate,17.12,100% of Medicaid LA Fee Schedule,17.12,100% of CMS OPPS Rate,17.12,100% of CMS OPPS Rate,43.1,203.89% of BCBS Fee Schedule,56,70% of total Billed Charges,60,75% of total Billed Charges,30.81,180% OF CMS OPPS RATE,64,80% of total Billed Charges,59.92,350% of CMS Opps rate,17.46,102% of CMS Opps rate,61.2,76.5% of total billed charges,17.12,100% of Medicaid LA Fee Schedule,17.12,100% of Medicaid LA Fee Schedule,17.12,100% of CMS OPPS Rate,17.12,100% of CMS OPPS Rate,36,45% of total billed charges,56,70% of total billed charges,48,60% of total billed charges,17.12,100% of CMS OPPS Rate,19.03,90% OF UHC FEE SCHEDULE,56,70% of total billed charges,17.12,100% OF CMS OPPS Rate,39.37,230% OF CMS OPPS Rate,38.4,48% of total Billed charges,17.12,100% OF CMS OPPS Rate,72,90% of total Billed charges,17.12,100% of Medicaid LA Fee Schedule,17.12,100% of Medicaid LA Fee Schedule,17.12,100% of Medicaid LA Fee Schedule,17.12,100% of Medicaid LA Fee Schedule,17.12,100% of Medicaid LA Fee Schedule,17.12,100% of Medicaid LA Fee Schedule,17.12,100% of CMS OPPS Rate,17.12,100% of CMS OPPS Rate,17.12,100% of CMS OPPS Rate,17.12,100% of CMS OPPS Rate,17.12,100% of CMS OPPS Rate,17.12,100% of CMS OPPS Rate,17.12,100% of CMS OPPS Rate,17.12,100% of CMS OPPS Rate,17.12,72,48
Outpatient,Laboratory,82247,BILIRUBIN TOTAL,300,113.4,17.77,354% of CMS OPPS Rate,4.84,100% of Medicaid LA Fee Schedule,5.01,100% of CMS OPPS Rate,5.01,100% of CMS OPPS Rate,12.62,203.89% of BCBS Fee Schedule,79.38,70% of total Billed Charges,85.05,75% of total Billed Charges,9.03,180% OF CMS OPPS RATE,90.72,80% of total Billed Charges,17.56,350% of CMS Opps rate,5.12,102% of CMS Opps rate,86.75,76.5% of total billed charges,4.84,100% of Medicaid LA Fee Schedule,4.84,100% of Medicaid LA Fee Schedule,5.01,100% of CMS OPPS Rate,5.01,100% of CMS OPPS Rate,51.03,45% of total billed charges,79.38,70% of total billed charges,68.04,60% of total billed charges,5.01,100% of CMS OPPS Rate,5.57,90% OF UHC FEE SCHEDULE,79.38,70% of total billed charges,5.01,100% OF CMS OPPS Rate,11.54,230% OF CMS OPPS Rate,54.43,48% of total Billed charges,5.01,100% OF CMS OPPS Rate,102.06,90% of total Billed charges,4.84,100% of Medicaid LA Fee Schedule,4.84,100% of Medicaid LA Fee Schedule,4.84,100% of Medicaid LA Fee Schedule,4.84,100% of Medicaid LA Fee Schedule,4.84,100% of Medicaid LA Fee Schedule,4.84,100% of Medicaid LA Fee Schedule,5.01,100% of CMS OPPS Rate,5.01,100% of CMS OPPS Rate,5.01,100% of CMS OPPS Rate,5.01,100% of CMS OPPS Rate,5.01,100% of CMS OPPS Rate,5.01,100% of CMS OPPS Rate,5.01,100% of CMS OPPS Rate,5.01,100% of CMS OPPS Rate,4.84,102.06,68.04
Outpatient,Laboratory,82248,Measurement of direct bilirubin,300,66.15,17.77,354% of CMS OPPS Rate,4.84,100% of Medicaid LA Fee Schedule,5.01,100% of CMS OPPS Rate,5.01,100% of CMS OPPS Rate,12.62,203.89% of BCBS Fee Schedule,46.31,70% of total Billed Charges,49.61,75% of total Billed Charges,9.03,180% OF CMS OPPS RATE,52.92,80% of total Billed Charges,17.56,350% of CMS Opps rate,5.12,102% of CMS Opps rate,50.6,76.5% of total billed charges,4.84,100% of Medicaid LA Fee Schedule,4.84,100% of Medicaid LA Fee Schedule,5.01,100% of CMS OPPS Rate,5.01,100% of CMS OPPS Rate,29.77,45% of total billed charges,46.31,70% of total billed charges,39.69,60% of total billed charges,5.01,100% of CMS OPPS Rate,5.57,90% OF UHC FEE SCHEDULE,46.31,70% of total billed charges,5.01,100% OF CMS OPPS Rate,11.54,230% OF CMS OPPS Rate,31.75,48% of total Billed charges,5.01,100% OF CMS OPPS Rate,59.54,90% of total Billed charges,4.84,100% of Medicaid LA Fee Schedule,4.84,100% of Medicaid LA Fee Schedule,4.84,100% of Medicaid LA Fee Schedule,4.84,100% of Medicaid LA Fee Schedule,4.84,100% of Medicaid LA Fee Schedule,4.84,100% of Medicaid LA Fee Schedule,5.01,100% of CMS OPPS Rate,5.01,100% of CMS OPPS Rate,5.01,100% of CMS OPPS Rate,5.01,100% of CMS OPPS Rate,5.01,100% of CMS OPPS Rate,5.01,100% of CMS OPPS Rate,5.01,100% of CMS OPPS Rate,5.01,100% of CMS OPPS Rate,4.84,59.54,39.69
Outpatient,Laboratory,82270,"OCCULT BLOOD SCREENING, FECES",300,29.25,15.5,354% of CMS OPPS Rate,3.23,100% of Medicaid LA Fee Schedule,4.38,100% of CMS OPPS Rate,4.38,100% of CMS OPPS Rate,8.93,203.89% of BCBS Fee Schedule,20.48,70% of total Billed Charges,21.94,75% of total Billed Charges,7.88,180% OF CMS OPPS RATE,23.4,80% of total Billed Charges,15.33,350% of CMS Opps rate,4.46,102% of CMS Opps rate,22.38,76.5% of total billed charges,3.23,100% of Medicaid LA Fee Schedule,3.23,100% of Medicaid LA Fee Schedule,4.38,100% of CMS OPPS Rate,4.38,100% of CMS OPPS Rate,13.16,45% of total billed charges,20.48,70% of total billed charges,17.55,60% of total billed charges,4.38,100% of CMS OPPS Rate,3.94,90% OF UHC FEE SCHEDULE,20.48,70% of total billed charges,4.38,100% OF CMS OPPS Rate,10.07,230% OF CMS OPPS Rate,14.04,48% of total Billed charges,4.38,100% OF CMS OPPS Rate,26.33,90% of total Billed charges,3.23,100% of Medicaid LA Fee Schedule,3.23,100% of Medicaid LA Fee Schedule,3.23,100% of Medicaid LA Fee Schedule,3.23,100% of Medicaid LA Fee Schedule,3.23,100% of Medicaid LA Fee Schedule,3.23,100% of Medicaid LA Fee Schedule,4.38,100% of CMS OPPS Rate,4.38,100% of CMS OPPS Rate,4.38,100% of CMS OPPS Rate,4.38,100% of CMS OPPS Rate,4.38,100% of CMS OPPS Rate,4.38,100% of CMS OPPS Rate,4.38,100% of CMS OPPS Rate,4.38,100% of CMS OPPS Rate,3.23,26.33,17.55
Outpatient,Laboratory,82271,OCCULT BLOOD GASTRIC,300,55.8,18.83,354% of CMS OPPS Rate,4.51,100% of Medicaid LA Fee Schedule,5.32,100% of CMS OPPS Rate,5.32,100% of CMS OPPS Rate,10.85,203.89% of BCBS Fee Schedule,39.06,70% of total Billed Charges,41.85,75% of total Billed Charges,9.57,180% OF CMS OPPS RATE,44.64,80% of total Billed Charges,18.62,350% of CMS Opps rate,5.42,102% of CMS Opps rate,42.69,76.5% of total billed charges,4.51,100% of Medicaid LA Fee Schedule,4.51,100% of Medicaid LA Fee Schedule,5.32,100% of CMS OPPS Rate,5.32,100% of CMS OPPS Rate,25.11,45% of total billed charges,39.06,70% of total billed charges,33.48,60% of total billed charges,5.32,100% of CMS OPPS Rate,4.79,90% OF UHC FEE SCHEDULE,39.06,70% of total billed charges,5.32,100% OF CMS OPPS Rate,12.23,230% OF CMS OPPS Rate,26.78,48% of total Billed charges,5.32,100% OF CMS OPPS Rate,50.22,90% of total Billed charges,4.51,100% of Medicaid LA Fee Schedule,4.51,100% of Medicaid LA Fee Schedule,4.51,100% of Medicaid LA Fee Schedule,4.51,100% of Medicaid LA Fee Schedule,4.51,100% of Medicaid LA Fee Schedule,4.51,100% of Medicaid LA Fee Schedule,5.32,100% of CMS OPPS Rate,5.32,100% of CMS OPPS Rate,5.32,100% of CMS OPPS Rate,5.32,100% of CMS OPPS Rate,5.32,100% of CMS OPPS Rate,5.32,100% of CMS OPPS Rate,5.32,100% of CMS OPPS Rate,5.32,100% of CMS OPPS Rate,4.51,50.22,33.48
Outpatient,Laboratory,82272,"OCCULT BLD DIAGNOSTIC, FECES",300,29.25,14.97,354% of CMS OPPS Rate,4.23,100% of Medicaid LA Fee Schedule,4.23,100% of CMS OPPS Rate,4.23,100% of CMS OPPS Rate,8.62,203.89% of BCBS Fee Schedule,20.48,70% of total Billed Charges,21.94,75% of total Billed Charges,7.61,180% OF CMS OPPS RATE,23.4,80% of total Billed Charges,14.8,350% of CMS Opps rate,4.31,102% of CMS Opps rate,22.38,76.5% of total billed charges,4.23,100% of Medicaid LA Fee Schedule,4.23,100% of Medicaid LA Fee Schedule,4.23,100% of CMS OPPS Rate,4.23,100% of CMS OPPS Rate,13.16,45% of total billed charges,20.48,70% of total billed charges,17.55,60% of total billed charges,4.23,100% of CMS OPPS Rate,3.81,90% OF UHC FEE SCHEDULE,20.48,70% of total billed charges,4.23,100% OF CMS OPPS Rate,9.72,230% OF CMS OPPS Rate,14.04,48% of total Billed charges,4.23,100% OF CMS OPPS Rate,26.33,90% of total Billed charges,4.23,100% of Medicaid LA Fee Schedule,4.23,100% of Medicaid LA Fee Schedule,4.23,100% of Medicaid LA Fee Schedule,4.23,100% of Medicaid LA Fee Schedule,4.23,100% of Medicaid LA Fee Schedule,4.23,100% of Medicaid LA Fee Schedule,4.23,100% of CMS OPPS Rate,4.23,100% of CMS OPPS Rate,4.23,100% of CMS OPPS Rate,4.23,100% of CMS OPPS Rate,4.23,100% of CMS OPPS Rate,4.23,100% of CMS OPPS Rate,4.23,100% of CMS OPPS Rate,4.23,100% of CMS OPPS Rate,3.81,26.33,17.55
Outpatient,Laboratory,82274,OCCULT BLD FHG QUAL 1 3,300,81,56.35,354% of CMS OPPS Rate,15.92,100% of Medicaid LA Fee Schedule,15.92,100% of CMS OPPS Rate,15.92,100% of CMS OPPS Rate,40.04,203.89% of BCBS Fee Schedule,56.7,70% of total Billed Charges,60.75,75% of total Billed Charges,28.65,180% OF CMS OPPS RATE,64.8,80% of total Billed Charges,55.72,350% of CMS Opps rate,16.23,102% of CMS Opps rate,61.97,76.5% of total billed charges,15.92,100% of Medicaid LA Fee Schedule,15.92,100% of Medicaid LA Fee Schedule,15.92,100% of CMS OPPS Rate,15.92,100% of CMS OPPS Rate,36.45,45% of total billed charges,56.7,70% of total billed charges,48.6,60% of total billed charges,15.92,100% of CMS OPPS Rate,17.68,90% OF UHC FEE SCHEDULE,56.7,70% of total billed charges,15.92,100% OF CMS OPPS Rate,36.61,230% OF CMS OPPS Rate,38.88,48% of total Billed charges,15.92,100% OF CMS OPPS Rate,72.9,90% of total Billed charges,15.92,100% of Medicaid LA Fee Schedule,15.92,100% of Medicaid LA Fee Schedule,15.92,100% of Medicaid LA Fee Schedule,15.92,100% of Medicaid LA Fee Schedule,15.92,100% of Medicaid LA Fee Schedule,15.92,100% of Medicaid LA Fee Schedule,15.92,100% of CMS OPPS Rate,15.92,100% of CMS OPPS Rate,15.92,100% of CMS OPPS Rate,15.92,100% of CMS OPPS Rate,15.92,100% of CMS OPPS Rate,15.92,100% of CMS OPPS Rate,15.92,100% of CMS OPPS Rate,15.92,100% of CMS OPPS Rate,15.92,72.9,48.6
Outpatient,Laboratory,82300,CADMIUM,300,95,83.68,354% of CMS OPPS Rate,23.64,100% of Medicaid LA Fee Schedule,23.64,100% of CMS OPPS Rate,23.64,100% of CMS OPPS Rate,58.27,203.89% of BCBS Fee Schedule,66.5,70% of total Billed Charges,71.25,75% of total Billed Charges,42.55,180% OF CMS OPPS RATE,76,80% of total Billed Charges,82.74,350% of CMS Opps rate,24.11,102% of CMS Opps rate,72.68,76.5% of total billed charges,23.64,100% of Medicaid LA Fee Schedule,23.64,100% of Medicaid LA Fee Schedule,23.64,100% of CMS OPPS Rate,23.64,100% of CMS OPPS Rate,42.75,45% of total billed charges,66.5,70% of total billed charges,57,60% of total billed charges,23.64,100% of CMS OPPS Rate,25.72,90% OF UHC FEE SCHEDULE,66.5,70% of total billed charges,23.64,100% OF CMS OPPS Rate,54.37,230% OF CMS OPPS Rate,45.6,48% of total Billed charges,23.64,100% OF CMS OPPS Rate,85.5,90% of total Billed charges,23.64,100% of Medicaid LA Fee Schedule,23.64,100% of Medicaid LA Fee Schedule,23.64,100% of Medicaid LA Fee Schedule,23.64,100% of Medicaid LA Fee Schedule,23.64,100% of Medicaid LA Fee Schedule,23.64,100% of Medicaid LA Fee Schedule,23.64,100% of CMS OPPS Rate,23.64,100% of CMS OPPS Rate,23.64,100% of CMS OPPS Rate,23.64,100% of CMS OPPS Rate,23.64,100% of CMS OPPS Rate,23.64,100% of CMS OPPS Rate,23.64,100% of CMS OPPS Rate,23.64,100% of CMS OPPS Rate,23.64,85.5,57
Outpatient,Laboratory,82306,Blood test to monitor vitamin D levels,300,89,104.78,354% of CMS OPPS Rate,N/A,Not Applicable,29.6,100% of CMS OPPS Rate,29.6,100% of CMS OPPS Rate,74.52,203.89% of BCBS Fee Schedule,62.3,70% of total Billed Charges,66.75,75% of total Billed Charges,53.28,180% OF CMS OPPS RATE,71.2,80% of total Billed Charges,103.6,350% of CMS Opps rate,30.19,102% of CMS Opps rate,68.09,76.5% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,29.6,100% of CMS OPPS Rate,29.6,100% of CMS OPPS Rate,40.05,45% of total billed charges,62.3,70% of total billed charges,53.4,60% of total billed charges,29.6,100% of CMS OPPS Rate,32.9,90% OF UHC FEE SCHEDULE,62.3,70% of total billed charges,29.6,100% OF CMS OPPS Rate,68.08,230% OF CMS OPPS Rate,42.72,48% of total Billed charges,29.6,100% OF CMS OPPS Rate,80.1,90% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,29.6,100% of CMS OPPS Rate,29.6,100% of CMS OPPS Rate,29.6,100% of CMS OPPS Rate,29.6,100% of CMS OPPS Rate,29.6,100% of CMS OPPS Rate,29.6,100% of CMS OPPS Rate,29.6,100% of CMS OPPS Rate,29.6,100% of CMS OPPS Rate,29.6,104.78,53.4
Outpatient,Laboratory,82308,"CALCITONIN, SERUM",300,73.7,94.83,354% of CMS OPPS Rate,26.79,100% of Medicaid LA Fee Schedule,26.79,100% of CMS OPPS Rate,26.79,100% of CMS OPPS Rate,67.45,203.89% of BCBS Fee Schedule,51.59,70% of total Billed Charges,55.28,75% of total Billed Charges,48.22,180% OF CMS OPPS RATE,58.96,80% of total Billed Charges,93.76,350% of CMS Opps rate,27.32,102% of CMS Opps rate,56.38,76.5% of total billed charges,26.79,100% of Medicaid LA Fee Schedule,26.79,100% of Medicaid LA Fee Schedule,26.79,100% of CMS OPPS Rate,26.79,100% of CMS OPPS Rate,33.17,45% of total billed charges,51.59,70% of total billed charges,44.22,60% of total billed charges,26.79,100% of CMS OPPS Rate,29.77,90% OF UHC FEE SCHEDULE,51.59,70% of total billed charges,26.79,100% OF CMS OPPS Rate,61.61,230% OF CMS OPPS Rate,35.38,48% of total Billed charges,26.79,100% OF CMS OPPS Rate,66.33,90% of total Billed charges,26.79,100% of Medicaid LA Fee Schedule,26.79,100% of Medicaid LA Fee Schedule,26.79,100% of Medicaid LA Fee Schedule,26.79,100% of Medicaid LA Fee Schedule,26.79,100% of Medicaid LA Fee Schedule,26.79,100% of Medicaid LA Fee Schedule,26.79,100% of CMS OPPS Rate,26.79,100% of CMS OPPS Rate,26.79,100% of CMS OPPS Rate,26.79,100% of CMS OPPS Rate,26.79,100% of CMS OPPS Rate,26.79,100% of CMS OPPS Rate,26.79,100% of CMS OPPS Rate,26.79,100% of CMS OPPS Rate,26.79,94.83,44.22
Outpatient,Laboratory,82310,CALCIUM SERUM,300,88.65,18.26,354% of CMS OPPS Rate,5.16,100% of Medicaid LA Fee Schedule,5.16,100% of CMS OPPS Rate,5.16,100% of CMS OPPS Rate,12.99,203.89% of BCBS Fee Schedule,62.06,70% of total Billed Charges,66.49,75% of total Billed Charges,9.28,180% OF CMS OPPS RATE,70.92,80% of total Billed Charges,18.06,350% of CMS Opps rate,5.26,102% of CMS Opps rate,67.82,76.5% of total billed charges,5.16,100% of Medicaid LA Fee Schedule,5.16,100% of Medicaid LA Fee Schedule,5.16,100% of CMS OPPS Rate,5.16,100% of CMS OPPS Rate,39.89,45% of total billed charges,62.06,70% of total billed charges,53.19,60% of total billed charges,5.16,100% of CMS OPPS Rate,5.73,90% OF UHC FEE SCHEDULE,62.06,70% of total billed charges,5.16,100% OF CMS OPPS Rate,11.86,230% OF CMS OPPS Rate,42.55,48% of total Billed charges,5.16,100% OF CMS OPPS Rate,79.79,90% of total Billed charges,5.16,100% of Medicaid LA Fee Schedule,5.16,100% of Medicaid LA Fee Schedule,5.16,100% of Medicaid LA Fee Schedule,5.16,100% of Medicaid LA Fee Schedule,5.16,100% of Medicaid LA Fee Schedule,5.16,100% of Medicaid LA Fee Schedule,5.16,100% of CMS OPPS Rate,5.16,100% of CMS OPPS Rate,5.16,100% of CMS OPPS Rate,5.16,100% of CMS OPPS Rate,5.16,100% of CMS OPPS Rate,5.16,100% of CMS OPPS Rate,5.16,100% of CMS OPPS Rate,5.16,100% of CMS OPPS Rate,5.16,79.79,53.19
Outpatient,Laboratory,82340,CALCIUM URINE,300,98.1,21.34,354% of CMS OPPS Rate,6.03,100% of Medicaid LA Fee Schedule,6.03,100% of CMS OPPS Rate,6.03,100% of CMS OPPS Rate,15.17,203.89% of BCBS Fee Schedule,68.67,70% of total Billed Charges,73.58,75% of total Billed Charges,10.85,180% OF CMS OPPS RATE,78.48,80% of total Billed Charges,21.1,350% of CMS Opps rate,6.15,102% of CMS Opps rate,75.05,76.5% of total billed charges,6.03,100% of Medicaid LA Fee Schedule,6.03,100% of Medicaid LA Fee Schedule,6.03,100% of CMS OPPS Rate,6.03,100% of CMS OPPS Rate,44.15,45% of total billed charges,68.67,70% of total billed charges,58.86,60% of total billed charges,6.03,100% of CMS OPPS Rate,6.7,90% OF UHC FEE SCHEDULE,68.67,70% of total billed charges,6.03,100% OF CMS OPPS Rate,13.86,230% OF CMS OPPS Rate,47.09,48% of total Billed charges,6.03,100% OF CMS OPPS Rate,88.29,90% of total Billed charges,6.03,100% of Medicaid LA Fee Schedule,6.03,100% of Medicaid LA Fee Schedule,6.03,100% of Medicaid LA Fee Schedule,6.03,100% of Medicaid LA Fee Schedule,6.03,100% of Medicaid LA Fee Schedule,6.03,100% of Medicaid LA Fee Schedule,6.03,100% of CMS OPPS Rate,6.03,100% of CMS OPPS Rate,6.03,100% of CMS OPPS Rate,6.03,100% of CMS OPPS Rate,6.03,100% of CMS OPPS Rate,6.03,100% of CMS OPPS Rate,6.03,100% of CMS OPPS Rate,6.03,100% of CMS OPPS Rate,6.03,88.29,58.86
Outpatient,Laboratory,82355,STONE ANALYSIS,300,174.5,40.99,354% of CMS OPPS Rate,11.58,100% of Medicaid LA Fee Schedule,11.58,100% of CMS OPPS Rate,11.58,100% of CMS OPPS Rate,29.14,203.89% of BCBS Fee Schedule,122.15,70% of total Billed Charges,130.88,75% of total Billed Charges,20.84,180% OF CMS OPPS RATE,139.6,80% of total Billed Charges,40.53,350% of CMS Opps rate,11.81,102% of CMS Opps rate,133.49,76.5% of total billed charges,11.58,100% of Medicaid LA Fee Schedule,11.58,100% of Medicaid LA Fee Schedule,11.58,100% of CMS OPPS Rate,11.58,100% of CMS OPPS Rate,78.53,45% of total billed charges,122.15,70% of total billed charges,104.7,60% of total billed charges,11.58,100% of CMS OPPS Rate,12.86,90% OF UHC FEE SCHEDULE,122.15,70% of total billed charges,11.58,100% OF CMS OPPS Rate,26.63,230% OF CMS OPPS Rate,83.76,48% of total Billed charges,11.58,100% OF CMS OPPS Rate,157.05,90% of total Billed charges,11.58,100% of Medicaid LA Fee Schedule,11.58,100% of Medicaid LA Fee Schedule,11.58,100% of Medicaid LA Fee Schedule,11.58,100% of Medicaid LA Fee Schedule,11.58,100% of Medicaid LA Fee Schedule,11.58,100% of Medicaid LA Fee Schedule,11.58,100% of CMS OPPS Rate,11.58,100% of CMS OPPS Rate,11.58,100% of CMS OPPS Rate,11.58,100% of CMS OPPS Rate,11.58,100% of CMS OPPS Rate,11.58,100% of CMS OPPS Rate,11.58,100% of CMS OPPS Rate,11.58,100% of CMS OPPS Rate,11.58,157.05,104.7
Outpatient,Laboratory,82360,CALCULIUS ANALYSIS QUANT,300,116.18,45.55,354% of CMS OPPS Rate,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,32.4,203.89% of BCBS Fee Schedule,81.33,70% of total Billed Charges,87.14,75% of total Billed Charges,23.16,180% OF CMS OPPS RATE,92.94,80% of total Billed Charges,45.04,350% of CMS Opps rate,13.12,102% of CMS Opps rate,88.88,76.5% of total billed charges,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,52.28,45% of total billed charges,81.33,70% of total billed charges,69.71,60% of total billed charges,12.87,100% of CMS OPPS Rate,14.3,90% OF UHC FEE SCHEDULE,81.33,70% of total billed charges,12.87,100% OF CMS OPPS Rate,29.6,230% OF CMS OPPS Rate,55.77,48% of total Billed charges,12.87,100% OF CMS OPPS Rate,104.56,90% of total Billed charges,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,12.87,104.56,69.71
Outpatient,Laboratory,82365,CALCULUS SPECTROSCOPY,300,159.5,45.66,354% of CMS OPPS Rate,12.9,100% of Medicaid LA Fee Schedule,12.9,100% of CMS OPPS Rate,12.9,100% of CMS OPPS Rate,32.46,203.89% of BCBS Fee Schedule,111.65,70% of total Billed Charges,119.63,75% of total Billed Charges,23.22,180% OF CMS OPPS RATE,127.6,80% of total Billed Charges,45.15,350% of CMS Opps rate,13.15,102% of CMS Opps rate,122.02,76.5% of total billed charges,12.9,100% of Medicaid LA Fee Schedule,12.9,100% of Medicaid LA Fee Schedule,12.9,100% of CMS OPPS Rate,12.9,100% of CMS OPPS Rate,71.78,45% of total billed charges,111.65,70% of total billed charges,95.7,60% of total billed charges,12.9,100% of CMS OPPS Rate,14.33,90% OF UHC FEE SCHEDULE,111.65,70% of total billed charges,12.9,100% OF CMS OPPS Rate,29.67,230% OF CMS OPPS Rate,76.56,48% of total Billed charges,12.9,100% OF CMS OPPS Rate,143.55,90% of total Billed charges,12.9,100% of Medicaid LA Fee Schedule,12.9,100% of Medicaid LA Fee Schedule,12.9,100% of Medicaid LA Fee Schedule,12.9,100% of Medicaid LA Fee Schedule,12.9,100% of Medicaid LA Fee Schedule,12.9,100% of Medicaid LA Fee Schedule,12.9,100% of CMS OPPS Rate,12.9,100% of CMS OPPS Rate,12.9,100% of CMS OPPS Rate,12.9,100% of CMS OPPS Rate,12.9,100% of CMS OPPS Rate,12.9,100% of CMS OPPS Rate,12.9,100% of CMS OPPS Rate,12.9,100% of CMS OPPS Rate,12.9,143.55,95.7
Outpatient,Laboratory,82373,CARBOHYDRATE DEFICIENT TRANSFER,300,89,63.93,354% of CMS OPPS Rate,10.89,100% of Medicaid LA Fee Schedule,18.05,100% of CMS OPPS Rate,18.05,100% of CMS OPPS Rate,45.45,203.89% of BCBS Fee Schedule,62.3,70% of total Billed Charges,66.75,75% of total Billed Charges,32.5,180% OF CMS OPPS RATE,71.2,80% of total Billed Charges,63.21,350% of CMS Opps rate,18.42,102% of CMS Opps rate,68.09,76.5% of total billed charges,10.89,100% of Medicaid LA Fee Schedule,10.89,100% of Medicaid LA Fee Schedule,18.05,100% of CMS OPPS Rate,18.05,100% of CMS OPPS Rate,40.05,45% of total billed charges,62.3,70% of total billed charges,53.4,60% of total billed charges,18.05,100% of CMS OPPS Rate,20.06,90% OF UHC FEE SCHEDULE,62.3,70% of total billed charges,18.05,100% OF CMS OPPS Rate,41.53,230% OF CMS OPPS Rate,42.72,48% of total Billed charges,18.05,100% OF CMS OPPS Rate,80.1,90% of total Billed charges,10.89,100% of Medicaid LA Fee Schedule,10.89,100% of Medicaid LA Fee Schedule,10.89,100% of Medicaid LA Fee Schedule,10.89,100% of Medicaid LA Fee Schedule,10.89,100% of Medicaid LA Fee Schedule,10.89,100% of Medicaid LA Fee Schedule,18.05,100% of CMS OPPS Rate,18.05,100% of CMS OPPS Rate,18.05,100% of CMS OPPS Rate,18.05,100% of CMS OPPS Rate,18.05,100% of CMS OPPS Rate,18.05,100% of CMS OPPS Rate,18.05,100% of CMS OPPS Rate,18.05,100% of CMS OPPS Rate,10.89,80.1,53.4
Outpatient,Laboratory,82374,CO2 CARBON DIOXIDE,300,63.45,17.27,354% of CMS OPPS Rate,4.88,100% of Medicaid LA Fee Schedule,4.88,100% of CMS OPPS Rate,4.88,100% of CMS OPPS Rate,12.29,203.89% of BCBS Fee Schedule,44.42,70% of total Billed Charges,47.59,75% of total Billed Charges,8.78,180% OF CMS OPPS RATE,50.76,80% of total Billed Charges,17.08,350% of CMS Opps rate,4.97,102% of CMS Opps rate,48.54,76.5% of total billed charges,4.88,100% of Medicaid LA Fee Schedule,4.88,100% of Medicaid LA Fee Schedule,4.88,100% of CMS OPPS Rate,4.88,100% of CMS OPPS Rate,28.55,45% of total billed charges,44.42,70% of total billed charges,38.07,60% of total billed charges,4.88,100% of CMS OPPS Rate,5.43,90% OF UHC FEE SCHEDULE,44.42,70% of total billed charges,4.88,100% OF CMS OPPS Rate,11.22,230% OF CMS OPPS Rate,30.46,48% of total Billed charges,4.88,100% OF CMS OPPS Rate,57.11,90% of total Billed charges,4.88,100% of Medicaid LA Fee Schedule,4.88,100% of Medicaid LA Fee Schedule,4.88,100% of Medicaid LA Fee Schedule,4.88,100% of Medicaid LA Fee Schedule,4.88,100% of Medicaid LA Fee Schedule,4.88,100% of Medicaid LA Fee Schedule,4.88,100% of CMS OPPS Rate,4.88,100% of CMS OPPS Rate,4.88,100% of CMS OPPS Rate,4.88,100% of CMS OPPS Rate,4.88,100% of CMS OPPS Rate,4.88,100% of CMS OPPS Rate,4.88,100% of CMS OPPS Rate,4.88,100% of CMS OPPS Rate,4.88,57.11,38.07
Outpatient,Laboratory,82375,COHGB CARBOXYHEMOGLOBIN,300,106.15,43.61,354% of CMS OPPS Rate,12.32,100% of Medicaid LA Fee Schedule,12.32,100% of CMS OPPS Rate,12.32,100% of CMS OPPS Rate,31.01,203.89% of BCBS Fee Schedule,74.31,70% of total Billed Charges,79.61,75% of total Billed Charges,22.17,180% OF CMS OPPS RATE,84.92,80% of total Billed Charges,43.12,350% of CMS Opps rate,12.56,102% of CMS Opps rate,81.2,76.5% of total billed charges,12.32,100% of Medicaid LA Fee Schedule,12.32,100% of Medicaid LA Fee Schedule,12.32,100% of CMS OPPS Rate,12.32,100% of CMS OPPS Rate,47.77,45% of total billed charges,74.31,70% of total billed charges,63.69,60% of total billed charges,12.32,100% of CMS OPPS Rate,13.69,90% OF UHC FEE SCHEDULE,74.31,70% of total billed charges,12.32,100% OF CMS OPPS Rate,28.33,230% OF CMS OPPS Rate,50.95,48% of total Billed charges,12.32,100% OF CMS OPPS Rate,95.54,90% of total Billed charges,12.32,100% of Medicaid LA Fee Schedule,12.32,100% of Medicaid LA Fee Schedule,12.32,100% of Medicaid LA Fee Schedule,12.32,100% of Medicaid LA Fee Schedule,12.32,100% of Medicaid LA Fee Schedule,12.32,100% of Medicaid LA Fee Schedule,12.32,100% of CMS OPPS Rate,12.32,100% of CMS OPPS Rate,12.32,100% of CMS OPPS Rate,12.32,100% of CMS OPPS Rate,12.32,100% of CMS OPPS Rate,12.32,100% of CMS OPPS Rate,12.32,100% of CMS OPPS Rate,12.32,100% of CMS OPPS Rate,12.32,95.54,63.69
Outpatient,Laboratory,82378,"CEA, SERUM",300,200.75,67.11,354% of CMS OPPS Rate,18.96,100% of Medicaid LA Fee Schedule,18.96,100% of CMS OPPS Rate,18.96,100% of CMS OPPS Rate,47.73,203.89% of BCBS Fee Schedule,140.53,70% of total Billed Charges,150.56,75% of total Billed Charges,34.12,180% OF CMS OPPS RATE,160.6,80% of total Billed Charges,66.36,350% of CMS Opps rate,19.33,102% of CMS Opps rate,153.57,76.5% of total billed charges,18.96,100% of Medicaid LA Fee Schedule,18.96,100% of Medicaid LA Fee Schedule,18.96,100% of CMS OPPS Rate,18.96,100% of CMS OPPS Rate,90.34,45% of total billed charges,140.53,70% of total billed charges,120.45,60% of total billed charges,18.96,100% of CMS OPPS Rate,21.07,90% OF UHC FEE SCHEDULE,140.53,70% of total billed charges,18.96,100% OF CMS OPPS Rate,43.6,230% OF CMS OPPS Rate,96.36,48% of total Billed charges,18.96,100% OF CMS OPPS Rate,180.68,90% of total Billed charges,18.96,100% of Medicaid LA Fee Schedule,18.96,100% of Medicaid LA Fee Schedule,18.96,100% of Medicaid LA Fee Schedule,18.96,100% of Medicaid LA Fee Schedule,18.96,100% of Medicaid LA Fee Schedule,18.96,100% of Medicaid LA Fee Schedule,18.96,100% of CMS OPPS Rate,18.96,100% of CMS OPPS Rate,18.96,100% of CMS OPPS Rate,18.96,100% of CMS OPPS Rate,18.96,100% of CMS OPPS Rate,18.96,100% of CMS OPPS Rate,18.96,100% of CMS OPPS Rate,18.96,100% of CMS OPPS Rate,18.96,180.68,120.45
Outpatient,Laboratory,82379,CARNITINE TOTAL,300,289,59.71,354% of CMS OPPS Rate,16.87,100% of Medicaid LA Fee Schedule,16.87,100% of CMS OPPS Rate,16.87,100% of CMS OPPS Rate,42.47,203.89% of BCBS Fee Schedule,202.3,70% of total Billed Charges,216.75,75% of total Billed Charges,30.36,180% OF CMS OPPS RATE,231.2,80% of total Billed Charges,59.04,350% of CMS Opps rate,17.2,102% of CMS Opps rate,221.09,76.5% of total billed charges,16.87,100% of Medicaid LA Fee Schedule,16.87,100% of Medicaid LA Fee Schedule,16.87,100% of CMS OPPS Rate,16.87,100% of CMS OPPS Rate,130.05,45% of total billed charges,202.3,70% of total billed charges,173.4,60% of total billed charges,16.87,100% of CMS OPPS Rate,18.75,90% OF UHC FEE SCHEDULE,202.3,70% of total billed charges,16.87,100% OF CMS OPPS Rate,38.8,230% OF CMS OPPS Rate,138.72,48% of total Billed charges,16.87,100% OF CMS OPPS Rate,260.1,90% of total Billed charges,16.87,100% of Medicaid LA Fee Schedule,16.87,100% of Medicaid LA Fee Schedule,16.87,100% of Medicaid LA Fee Schedule,16.87,100% of Medicaid LA Fee Schedule,16.87,100% of Medicaid LA Fee Schedule,16.87,100% of Medicaid LA Fee Schedule,16.87,100% of CMS OPPS Rate,16.87,100% of CMS OPPS Rate,16.87,100% of CMS OPPS Rate,16.87,100% of CMS OPPS Rate,16.87,100% of CMS OPPS Rate,16.87,100% of CMS OPPS Rate,16.87,100% of CMS OPPS Rate,16.87,100% of CMS OPPS Rate,16.87,260.1,173.4
Outpatient,Laboratory,82380,CAROTENE,300,97,32.63,354% of CMS OPPS Rate,9.22,100% of Medicaid LA Fee Schedule,9.22,100% of CMS OPPS Rate,9.22,100% of CMS OPPS Rate,23.22,203.89% of BCBS Fee Schedule,67.9,70% of total Billed Charges,72.75,75% of total Billed Charges,16.59,180% OF CMS OPPS RATE,77.6,80% of total Billed Charges,32.27,350% of CMS Opps rate,9.4,102% of CMS Opps rate,74.21,76.5% of total billed charges,9.22,100% of Medicaid LA Fee Schedule,9.22,100% of Medicaid LA Fee Schedule,9.22,100% of CMS OPPS Rate,9.22,100% of CMS OPPS Rate,43.65,45% of total billed charges,67.9,70% of total billed charges,58.2,60% of total billed charges,9.22,100% of CMS OPPS Rate,10.25,90% OF UHC FEE SCHEDULE,67.9,70% of total billed charges,9.22,100% OF CMS OPPS Rate,21.2,230% OF CMS OPPS Rate,46.56,48% of total Billed charges,9.22,100% OF CMS OPPS Rate,87.3,90% of total Billed charges,9.22,100% of Medicaid LA Fee Schedule,9.22,100% of Medicaid LA Fee Schedule,9.22,100% of Medicaid LA Fee Schedule,9.22,100% of Medicaid LA Fee Schedule,9.22,100% of Medicaid LA Fee Schedule,9.22,100% of Medicaid LA Fee Schedule,9.22,100% of CMS OPPS Rate,9.22,100% of CMS OPPS Rate,9.22,100% of CMS OPPS Rate,9.22,100% of CMS OPPS Rate,9.22,100% of CMS OPPS Rate,9.22,100% of CMS OPPS Rate,9.22,100% of CMS OPPS Rate,9.22,100% of CMS OPPS Rate,9.22,87.3,58.2
Outpatient,Laboratory,82382,CATACHOLAMINES TOTAL URINE,300,155.16,96.64,354% of CMS OPPS Rate,22.13,100% of Medicaid LA Fee Schedule,27.3,100% of CMS OPPS Rate,27.3,100% of CMS OPPS Rate,55.66,203.89% of BCBS Fee Schedule,108.61,70% of total Billed Charges,116.37,75% of total Billed Charges,49.14,180% OF CMS OPPS RATE,124.13,80% of total Billed Charges,95.55,350% of CMS Opps rate,27.84,102% of CMS Opps rate,118.7,76.5% of total billed charges,22.13,100% of Medicaid LA Fee Schedule,22.13,100% of Medicaid LA Fee Schedule,27.3,100% of CMS OPPS Rate,27.3,100% of CMS OPPS Rate,69.82,45% of total billed charges,108.61,70% of total billed charges,93.1,60% of total billed charges,27.3,100% of CMS OPPS Rate,24.57,90% OF UHC FEE SCHEDULE,108.61,70% of total billed charges,27.3,100% OF CMS OPPS Rate,62.79,230% OF CMS OPPS Rate,74.48,48% of total Billed charges,27.3,100% OF CMS OPPS Rate,139.64,90% of total Billed charges,22.13,100% of Medicaid LA Fee Schedule,22.13,100% of Medicaid LA Fee Schedule,22.13,100% of Medicaid LA Fee Schedule,22.13,100% of Medicaid LA Fee Schedule,22.13,100% of Medicaid LA Fee Schedule,22.13,100% of Medicaid LA Fee Schedule,27.3,100% of CMS OPPS Rate,27.3,100% of CMS OPPS Rate,27.3,100% of CMS OPPS Rate,27.3,100% of CMS OPPS Rate,27.3,100% of CMS OPPS Rate,27.3,100% of CMS OPPS Rate,27.3,100% of CMS OPPS Rate,27.3,100% of CMS OPPS Rate,22.13,139.64,93.1
Outpatient,Laboratory,82383,EPINEPHRINE PLASMA,300,94.5,102.94,354% of CMS OPPS Rate,29.08,100% of Medicaid LA Fee Schedule,29.08,100% of CMS OPPS Rate,29.08,100% of CMS OPPS Rate,63.06,203.89% of BCBS Fee Schedule,66.15,70% of total Billed Charges,70.88,75% of total Billed Charges,52.34,180% OF CMS OPPS RATE,75.6,80% of total Billed Charges,101.78,350% of CMS Opps rate,29.66,102% of CMS Opps rate,72.29,76.5% of total billed charges,29.08,100% of Medicaid LA Fee Schedule,29.08,100% of Medicaid LA Fee Schedule,29.08,100% of CMS OPPS Rate,29.08,100% of CMS OPPS Rate,42.53,45% of total billed charges,66.15,70% of total billed charges,56.7,60% of total billed charges,29.08,100% of CMS OPPS Rate,27.84,90% OF UHC FEE SCHEDULE,66.15,70% of total billed charges,29.08,100% OF CMS OPPS Rate,66.88,230% OF CMS OPPS Rate,45.36,48% of total Billed charges,29.08,100% OF CMS OPPS Rate,85.05,90% of total Billed charges,29.08,100% of Medicaid LA Fee Schedule,29.08,100% of Medicaid LA Fee Schedule,29.08,100% of Medicaid LA Fee Schedule,29.08,100% of Medicaid LA Fee Schedule,29.08,100% of Medicaid LA Fee Schedule,29.08,100% of Medicaid LA Fee Schedule,29.08,100% of CMS OPPS Rate,29.08,100% of CMS OPPS Rate,29.08,100% of CMS OPPS Rate,29.08,100% of CMS OPPS Rate,29.08,100% of CMS OPPS Rate,29.08,100% of CMS OPPS Rate,29.08,100% of CMS OPPS Rate,29.08,100% of CMS OPPS Rate,27.84,102.94,56.7
Outpatient,Laboratory,82384,CATECHOLAMINES-URINE-FRACTIONATED,300,182.6,89.38,354% of CMS OPPS Rate,25.25,100% of Medicaid LA Fee Schedule,25.25,100% of CMS OPPS Rate,25.25,100% of CMS OPPS Rate,63.57,203.89% of BCBS Fee Schedule,127.82,70% of total Billed Charges,136.95,75% of total Billed Charges,45.45,180% OF CMS OPPS RATE,146.08,80% of total Billed Charges,88.37,350% of CMS Opps rate,25.75,102% of CMS Opps rate,139.69,76.5% of total billed charges,25.25,100% of Medicaid LA Fee Schedule,25.25,100% of Medicaid LA Fee Schedule,25.25,100% of CMS OPPS Rate,25.25,100% of CMS OPPS Rate,82.17,45% of total billed charges,127.82,70% of total billed charges,109.56,60% of total billed charges,25.25,100% of CMS OPPS Rate,28.06,90% OF UHC FEE SCHEDULE,127.82,70% of total billed charges,25.25,100% OF CMS OPPS Rate,58.07,230% OF CMS OPPS Rate,87.65,48% of total Billed charges,25.25,100% OF CMS OPPS Rate,164.34,90% of total Billed charges,25.25,100% of Medicaid LA Fee Schedule,25.25,100% of Medicaid LA Fee Schedule,25.25,100% of Medicaid LA Fee Schedule,25.25,100% of Medicaid LA Fee Schedule,25.25,100% of Medicaid LA Fee Schedule,25.25,100% of Medicaid LA Fee Schedule,25.25,100% of CMS OPPS Rate,25.25,100% of CMS OPPS Rate,25.25,100% of CMS OPPS Rate,25.25,100% of CMS OPPS Rate,25.25,100% of CMS OPPS Rate,25.25,100% of CMS OPPS Rate,25.25,100% of CMS OPPS Rate,25.25,100% of CMS OPPS Rate,25.25,164.34,109.56
Outpatient,Laboratory,82390,CERULOPLASMIN,300,131.45,38.01,354% of CMS OPPS Rate,10.74,100% of Medicaid LA Fee Schedule,10.74,100% of CMS OPPS Rate,10.74,100% of CMS OPPS Rate,27.04,203.89% of BCBS Fee Schedule,92.02,70% of total Billed Charges,98.59,75% of total Billed Charges,19.33,180% OF CMS OPPS RATE,105.16,80% of total Billed Charges,37.59,350% of CMS Opps rate,10.95,102% of CMS Opps rate,100.56,76.5% of total billed charges,10.74,100% of Medicaid LA Fee Schedule,10.74,100% of Medicaid LA Fee Schedule,10.74,100% of CMS OPPS Rate,10.74,100% of CMS OPPS Rate,59.15,45% of total billed charges,92.02,70% of total billed charges,78.87,60% of total billed charges,10.74,100% of CMS OPPS Rate,11.93,90% OF UHC FEE SCHEDULE,92.02,70% of total billed charges,10.74,100% OF CMS OPPS Rate,24.7,230% OF CMS OPPS Rate,63.1,48% of total Billed charges,10.74,100% OF CMS OPPS Rate,118.31,90% of total Billed charges,10.74,100% of Medicaid LA Fee Schedule,10.74,100% of Medicaid LA Fee Schedule,10.74,100% of Medicaid LA Fee Schedule,10.74,100% of Medicaid LA Fee Schedule,10.74,100% of Medicaid LA Fee Schedule,10.74,100% of Medicaid LA Fee Schedule,10.74,100% of CMS OPPS Rate,10.74,100% of CMS OPPS Rate,10.74,100% of CMS OPPS Rate,10.74,100% of CMS OPPS Rate,10.74,100% of CMS OPPS Rate,10.74,100% of CMS OPPS Rate,10.74,100% of CMS OPPS Rate,10.74,100% of CMS OPPS Rate,10.74,118.31,78.87
Outpatient,Laboratory,82397,CHEMILUMINESCENT ASSAY,300,85.95,49.98,354% of CMS OPPS Rate,5.68,100% of Medicaid LA Fee Schedule,14.12,100% of CMS OPPS Rate,14.12,100% of CMS OPPS Rate,35.54,203.89% of BCBS Fee Schedule,60.17,70% of total Billed Charges,64.46,75% of total Billed Charges,25.41,180% OF CMS OPPS RATE,68.76,80% of total Billed Charges,49.42,350% of CMS Opps rate,14.4,102% of CMS Opps rate,65.75,76.5% of total billed charges,5.68,100% of Medicaid LA Fee Schedule,5.68,100% of Medicaid LA Fee Schedule,14.12,100% of CMS OPPS Rate,14.12,100% of CMS OPPS Rate,38.68,45% of total billed charges,60.17,70% of total billed charges,51.57,60% of total billed charges,14.12,100% of CMS OPPS Rate,15.69,90% OF UHC FEE SCHEDULE,60.17,70% of total billed charges,14.12,100% OF CMS OPPS Rate,32.47,230% OF CMS OPPS Rate,41.26,48% of total Billed charges,14.12,100% OF CMS OPPS Rate,77.36,90% of total Billed charges,5.68,100% of Medicaid LA Fee Schedule,5.68,100% of Medicaid LA Fee Schedule,5.68,100% of Medicaid LA Fee Schedule,5.68,100% of Medicaid LA Fee Schedule,5.68,100% of Medicaid LA Fee Schedule,5.68,100% of Medicaid LA Fee Schedule,14.12,100% of CMS OPPS Rate,14.12,100% of CMS OPPS Rate,14.12,100% of CMS OPPS Rate,14.12,100% of CMS OPPS Rate,14.12,100% of CMS OPPS Rate,14.12,100% of CMS OPPS Rate,14.12,100% of CMS OPPS Rate,14.12,100% of CMS OPPS Rate,5.68,77.36,51.57
Outpatient,Laboratory,82435,CHLORIDE SERUM,300,63.45,16.28,354% of CMS OPPS Rate,4.6,100% of Medicaid LA Fee Schedule,4.59,100% of CMS OPPS Rate,4.59,100% of CMS OPPS Rate,11.58,203.89% of BCBS Fee Schedule,44.42,70% of total Billed Charges,47.59,75% of total Billed Charges,8.27,180% OF CMS OPPS RATE,50.76,80% of total Billed Charges,16.09,350% of CMS Opps rate,4.69,102% of CMS Opps rate,48.54,76.5% of total billed charges,4.6,100% of Medicaid LA Fee Schedule,4.6,100% of Medicaid LA Fee Schedule,4.59,100% of CMS OPPS Rate,4.59,100% of CMS OPPS Rate,28.55,45% of total billed charges,44.42,70% of total billed charges,38.07,60% of total billed charges,4.59,100% of CMS OPPS Rate,5.11,90% OF UHC FEE SCHEDULE,44.42,70% of total billed charges,4.59,100% OF CMS OPPS Rate,10.58,230% OF CMS OPPS Rate,30.46,48% of total Billed charges,4.59,100% OF CMS OPPS Rate,57.11,90% of total Billed charges,4.6,100% of Medicaid LA Fee Schedule,4.6,100% of Medicaid LA Fee Schedule,4.6,100% of Medicaid LA Fee Schedule,4.6,100% of Medicaid LA Fee Schedule,4.6,100% of Medicaid LA Fee Schedule,4.6,100% of Medicaid LA Fee Schedule,4.59,100% of CMS OPPS Rate,4.59,100% of CMS OPPS Rate,4.59,100% of CMS OPPS Rate,4.59,100% of CMS OPPS Rate,4.59,100% of CMS OPPS Rate,4.59,100% of CMS OPPS Rate,4.59,100% of CMS OPPS Rate,4.59,100% of CMS OPPS Rate,4.59,57.11,38.07
Outpatient,Laboratory,82436,CHLORIDE URINE,300,88.65,20.35,354% of CMS OPPS Rate,5.75,100% of Medicaid LA Fee Schedule,5.75,100% of CMS OPPS Rate,5.75,100% of CMS OPPS Rate,12.66,203.89% of BCBS Fee Schedule,62.06,70% of total Billed Charges,66.49,75% of total Billed Charges,10.35,180% OF CMS OPPS RATE,70.92,80% of total Billed Charges,20.12,350% of CMS Opps rate,5.86,102% of CMS Opps rate,67.82,76.5% of total billed charges,5.75,100% of Medicaid LA Fee Schedule,5.75,100% of Medicaid LA Fee Schedule,5.75,100% of CMS OPPS Rate,5.75,100% of CMS OPPS Rate,39.89,45% of total billed charges,62.06,70% of total billed charges,53.19,60% of total billed charges,5.75,100% of CMS OPPS Rate,5.59,90% OF UHC FEE SCHEDULE,62.06,70% of total billed charges,5.75,100% OF CMS OPPS Rate,13.22,230% OF CMS OPPS Rate,42.55,48% of total Billed charges,5.75,100% OF CMS OPPS Rate,79.79,90% of total Billed charges,5.75,100% of Medicaid LA Fee Schedule,5.75,100% of Medicaid LA Fee Schedule,5.75,100% of Medicaid LA Fee Schedule,5.75,100% of Medicaid LA Fee Schedule,5.75,100% of Medicaid LA Fee Schedule,5.75,100% of Medicaid LA Fee Schedule,5.75,100% of CMS OPPS Rate,5.75,100% of CMS OPPS Rate,5.75,100% of CMS OPPS Rate,5.75,100% of CMS OPPS Rate,5.75,100% of CMS OPPS Rate,5.75,100% of CMS OPPS Rate,5.75,100% of CMS OPPS Rate,5.75,100% of CMS OPPS Rate,5.59,79.79,53.19
Outpatient,Laboratory,82438,CHLORIDE MISC SPECIMEN,300,64,17.7,354% of CMS OPPS Rate,5,100% of Medicaid LA Fee Schedule,5,100% of CMS OPPS Rate,5,100% of CMS OPPS Rate,12.29,203.89% of BCBS Fee Schedule,44.8,70% of total Billed Charges,48,75% of total Billed Charges,9,180% OF CMS OPPS RATE,51.2,80% of total Billed Charges,17.5,350% of CMS Opps rate,5.1,102% of CMS Opps rate,48.96,76.5% of total billed charges,5,100% of Medicaid LA Fee Schedule,5,100% of Medicaid LA Fee Schedule,5,100% of CMS OPPS Rate,5,100% of CMS OPPS Rate,28.8,45% of total billed charges,44.8,70% of total billed charges,38.4,60% of total billed charges,5,100% of CMS OPPS Rate,5.43,90% OF UHC FEE SCHEDULE,44.8,70% of total billed charges,5,100% OF CMS OPPS Rate,11.5,230% OF CMS OPPS Rate,30.72,48% of total Billed charges,5,100% OF CMS OPPS Rate,57.6,90% of total Billed charges,5,100% of Medicaid LA Fee Schedule,5,100% of Medicaid LA Fee Schedule,5,100% of Medicaid LA Fee Schedule,5,100% of Medicaid LA Fee Schedule,5,100% of Medicaid LA Fee Schedule,5,100% of Medicaid LA Fee Schedule,5,100% of CMS OPPS Rate,5,100% of CMS OPPS Rate,5,100% of CMS OPPS Rate,5,100% of CMS OPPS Rate,5,100% of CMS OPPS Rate,5,100% of CMS OPPS Rate,5,100% of CMS OPPS Rate,5,100% of CMS OPPS Rate,5,57.6,38.4
Outpatient,Laboratory,82465,CHOLESTEROL,300,111.1,15.39,354% of CMS OPPS Rate,4.26,100% of Medicaid LA Fee Schedule,4.34,100% of CMS OPPS Rate,4.34,100% of CMS OPPS Rate,10.95,203.89% of BCBS Fee Schedule,77.77,70% of total Billed Charges,83.33,75% of total Billed Charges,7.82,180% OF CMS OPPS RATE,88.88,80% of total Billed Charges,15.22,350% of CMS Opps rate,4.43,102% of CMS Opps rate,84.99,76.5% of total billed charges,4.26,100% of Medicaid LA Fee Schedule,4.26,100% of Medicaid LA Fee Schedule,4.34,100% of CMS OPPS Rate,4.34,100% of CMS OPPS Rate,50,45% of total billed charges,77.77,70% of total billed charges,66.66,60% of total billed charges,4.34,100% of CMS OPPS Rate,4.83,90% OF UHC FEE SCHEDULE,77.77,70% of total billed charges,4.34,100% OF CMS OPPS Rate,10,230% OF CMS OPPS Rate,53.33,48% of total Billed charges,4.34,100% OF CMS OPPS Rate,99.99,90% of total Billed charges,4.26,100% of Medicaid LA Fee Schedule,4.26,100% of Medicaid LA Fee Schedule,4.26,100% of Medicaid LA Fee Schedule,4.26,100% of Medicaid LA Fee Schedule,4.26,100% of Medicaid LA Fee Schedule,4.26,100% of Medicaid LA Fee Schedule,4.34,100% of CMS OPPS Rate,4.34,100% of CMS OPPS Rate,4.34,100% of CMS OPPS Rate,4.34,100% of CMS OPPS Rate,4.34,100% of CMS OPPS Rate,4.34,100% of CMS OPPS Rate,4.34,100% of CMS OPPS Rate,4.34,100% of CMS OPPS Rate,4.26,99.99,66.66
Outpatient,Laboratory,82480,"CHOLINESTERASE, SERUM",300,138.5,27.85,354% of CMS OPPS Rate,7.87,100% of Medicaid LA Fee Schedule,7.87,100% of CMS OPPS Rate,7.87,100% of CMS OPPS Rate,19.82,203.89% of BCBS Fee Schedule,96.95,70% of total Billed Charges,103.88,75% of total Billed Charges,14.16,180% OF CMS OPPS RATE,110.8,80% of total Billed Charges,27.54,350% of CMS Opps rate,8.02,102% of CMS Opps rate,105.95,76.5% of total billed charges,7.87,100% of Medicaid LA Fee Schedule,7.87,100% of Medicaid LA Fee Schedule,7.87,100% of CMS OPPS Rate,7.87,100% of CMS OPPS Rate,62.33,45% of total billed charges,96.95,70% of total billed charges,83.1,60% of total billed charges,7.87,100% of CMS OPPS Rate,8.75,90% OF UHC FEE SCHEDULE,96.95,70% of total billed charges,7.87,100% OF CMS OPPS Rate,18.1,230% OF CMS OPPS Rate,66.48,48% of total Billed charges,7.87,100% OF CMS OPPS Rate,124.65,90% of total Billed charges,7.87,100% of Medicaid LA Fee Schedule,7.87,100% of Medicaid LA Fee Schedule,7.87,100% of Medicaid LA Fee Schedule,7.87,100% of Medicaid LA Fee Schedule,7.87,100% of Medicaid LA Fee Schedule,7.87,100% of Medicaid LA Fee Schedule,7.87,100% of CMS OPPS Rate,7.87,100% of CMS OPPS Rate,7.87,100% of CMS OPPS Rate,7.87,100% of CMS OPPS Rate,7.87,100% of CMS OPPS Rate,7.87,100% of CMS OPPS Rate,7.87,100% of CMS OPPS Rate,7.87,100% of CMS OPPS Rate,7.87,124.65,83.1
Outpatient,Laboratory,82495,"CHROMIUM, BLOOD",300,76.45,71.79,354% of CMS OPPS Rate,20.28,100% of Medicaid LA Fee Schedule,20.28,100% of CMS OPPS Rate,20.28,100% of CMS OPPS Rate,51.05,203.89% of BCBS Fee Schedule,53.52,70% of total Billed Charges,57.34,75% of total Billed Charges,36.5,180% OF CMS OPPS RATE,61.16,80% of total Billed Charges,70.98,350% of CMS Opps rate,20.68,102% of CMS Opps rate,58.48,76.5% of total billed charges,20.28,100% of Medicaid LA Fee Schedule,20.28,100% of Medicaid LA Fee Schedule,20.28,100% of CMS OPPS Rate,20.28,100% of CMS OPPS Rate,34.4,45% of total billed charges,53.52,70% of total billed charges,45.87,60% of total billed charges,20.28,100% of CMS OPPS Rate,22.54,90% OF UHC FEE SCHEDULE,53.52,70% of total billed charges,20.28,100% OF CMS OPPS Rate,46.64,230% OF CMS OPPS Rate,36.7,48% of total Billed charges,20.28,100% OF CMS OPPS Rate,68.81,90% of total Billed charges,20.28,100% of Medicaid LA Fee Schedule,20.28,100% of Medicaid LA Fee Schedule,20.28,100% of Medicaid LA Fee Schedule,20.28,100% of Medicaid LA Fee Schedule,20.28,100% of Medicaid LA Fee Schedule,20.28,100% of Medicaid LA Fee Schedule,20.28,100% of CMS OPPS Rate,20.28,100% of CMS OPPS Rate,20.28,100% of CMS OPPS Rate,20.28,100% of CMS OPPS Rate,20.28,100% of CMS OPPS Rate,20.28,100% of CMS OPPS Rate,20.28,100% of CMS OPPS Rate,20.28,100% of CMS OPPS Rate,20.28,71.79,45.87
Outpatient,Laboratory,82507,CITRATE-UR-24 HR,300,301.4,98.41,354% of CMS OPPS Rate,27.8,100% of Medicaid LA Fee Schedule,27.8,100% of CMS OPPS Rate,27.8,100% of CMS OPPS Rate,70,203.89% of BCBS Fee Schedule,210.98,70% of total Billed Charges,226.05,75% of total Billed Charges,50.04,180% OF CMS OPPS RATE,241.12,80% of total Billed Charges,97.3,350% of CMS Opps rate,28.35,102% of CMS Opps rate,230.57,76.5% of total billed charges,27.8,100% of Medicaid LA Fee Schedule,27.8,100% of Medicaid LA Fee Schedule,27.8,100% of CMS OPPS Rate,27.8,100% of CMS OPPS Rate,135.63,45% of total billed charges,210.98,70% of total billed charges,180.84,60% of total billed charges,27.8,100% of CMS OPPS Rate,30.9,90% OF UHC FEE SCHEDULE,210.98,70% of total billed charges,27.8,100% OF CMS OPPS Rate,63.94,230% OF CMS OPPS Rate,144.67,48% of total Billed charges,27.8,100% OF CMS OPPS Rate,271.26,90% of total Billed charges,27.8,100% of Medicaid LA Fee Schedule,27.8,100% of Medicaid LA Fee Schedule,27.8,100% of Medicaid LA Fee Schedule,27.8,100% of Medicaid LA Fee Schedule,27.8,100% of Medicaid LA Fee Schedule,27.8,100% of Medicaid LA Fee Schedule,27.8,100% of CMS OPPS Rate,27.8,100% of CMS OPPS Rate,27.8,100% of CMS OPPS Rate,27.8,100% of CMS OPPS Rate,27.8,100% of CMS OPPS Rate,27.8,100% of CMS OPPS Rate,27.8,100% of CMS OPPS Rate,27.8,100% of CMS OPPS Rate,27.8,271.26,180.84
Outpatient,Laboratory,82523,COLLAGEN CROSS LINKS,300,62.15,66.12,354% of CMS OPPS Rate,18.68,100% of Medicaid LA Fee Schedule,18.68,100% of CMS OPPS Rate,18.68,100% of CMS OPPS Rate,47.04,203.89% of BCBS Fee Schedule,43.51,70% of total Billed Charges,46.61,75% of total Billed Charges,33.62,180% OF CMS OPPS RATE,49.72,80% of total Billed Charges,65.38,350% of CMS Opps rate,19.05,102% of CMS Opps rate,47.54,76.5% of total billed charges,18.68,100% of Medicaid LA Fee Schedule,18.68,100% of Medicaid LA Fee Schedule,18.68,100% of CMS OPPS Rate,18.68,100% of CMS OPPS Rate,27.97,45% of total billed charges,43.51,70% of total billed charges,37.29,60% of total billed charges,18.68,100% of CMS OPPS Rate,20.76,90% OF UHC FEE SCHEDULE,43.51,70% of total billed charges,18.68,100% OF CMS OPPS Rate,42.96,230% OF CMS OPPS Rate,29.83,48% of total Billed charges,18.68,100% OF CMS OPPS Rate,55.94,90% of total Billed charges,18.68,100% of Medicaid LA Fee Schedule,18.68,100% of Medicaid LA Fee Schedule,18.68,100% of Medicaid LA Fee Schedule,18.68,100% of Medicaid LA Fee Schedule,18.68,100% of Medicaid LA Fee Schedule,18.68,100% of Medicaid LA Fee Schedule,18.68,100% of CMS OPPS Rate,18.68,100% of CMS OPPS Rate,18.68,100% of CMS OPPS Rate,18.68,100% of CMS OPPS Rate,18.68,100% of CMS OPPS Rate,18.68,100% of CMS OPPS Rate,18.68,100% of CMS OPPS Rate,18.68,100% of CMS OPPS Rate,18.68,66.12,37.29
Outpatient,Laboratory,82525,"COPPER, RBC",300,70.4,43.93,354% of CMS OPPS Rate,12.41,100% of Medicaid LA Fee Schedule,12.41,100% of CMS OPPS Rate,12.41,100% of CMS OPPS Rate,31.24,203.89% of BCBS Fee Schedule,49.28,70% of total Billed Charges,52.8,75% of total Billed Charges,22.33,180% OF CMS OPPS RATE,56.32,80% of total Billed Charges,43.43,350% of CMS Opps rate,12.65,102% of CMS Opps rate,53.86,76.5% of total billed charges,12.41,100% of Medicaid LA Fee Schedule,12.41,100% of Medicaid LA Fee Schedule,12.41,100% of CMS OPPS Rate,12.41,100% of CMS OPPS Rate,31.68,45% of total billed charges,49.28,70% of total billed charges,42.24,60% of total billed charges,12.41,100% of CMS OPPS Rate,13.79,90% OF UHC FEE SCHEDULE,49.28,70% of total billed charges,12.41,100% OF CMS OPPS Rate,28.54,230% OF CMS OPPS Rate,33.79,48% of total Billed charges,12.41,100% OF CMS OPPS Rate,63.36,90% of total Billed charges,12.41,100% of Medicaid LA Fee Schedule,12.41,100% of Medicaid LA Fee Schedule,12.41,100% of Medicaid LA Fee Schedule,12.41,100% of Medicaid LA Fee Schedule,12.41,100% of Medicaid LA Fee Schedule,12.41,100% of Medicaid LA Fee Schedule,12.41,100% of CMS OPPS Rate,12.41,100% of CMS OPPS Rate,12.41,100% of CMS OPPS Rate,12.41,100% of CMS OPPS Rate,12.41,100% of CMS OPPS Rate,12.41,100% of CMS OPPS Rate,12.41,100% of CMS OPPS Rate,12.41,100% of CMS OPPS Rate,12.41,63.36,42.24
Outpatient,Laboratory,82530,"CORTISOL (CORTISOL, FREE)",300,139.7,59.15,354% of CMS OPPS Rate,16.71,100% of Medicaid LA Fee Schedule,16.71,100% of CMS OPPS Rate,16.71,100% of CMS OPPS Rate,42.06,203.89% of BCBS Fee Schedule,97.79,70% of total Billed Charges,104.78,75% of total Billed Charges,30.07,180% OF CMS OPPS RATE,111.76,80% of total Billed Charges,58.48,350% of CMS Opps rate,17.04,102% of CMS Opps rate,106.87,76.5% of total billed charges,16.71,100% of Medicaid LA Fee Schedule,16.71,100% of Medicaid LA Fee Schedule,16.71,100% of CMS OPPS Rate,16.71,100% of CMS OPPS Rate,62.87,45% of total billed charges,97.79,70% of total billed charges,83.82,60% of total billed charges,16.71,100% of CMS OPPS Rate,18.57,90% OF UHC FEE SCHEDULE,97.79,70% of total billed charges,16.71,100% OF CMS OPPS Rate,38.43,230% OF CMS OPPS Rate,67.06,48% of total Billed charges,16.71,100% OF CMS OPPS Rate,125.73,90% of total Billed charges,16.71,100% of Medicaid LA Fee Schedule,16.71,100% of Medicaid LA Fee Schedule,16.71,100% of Medicaid LA Fee Schedule,16.71,100% of Medicaid LA Fee Schedule,16.71,100% of Medicaid LA Fee Schedule,16.71,100% of Medicaid LA Fee Schedule,16.71,100% of CMS OPPS Rate,16.71,100% of CMS OPPS Rate,16.71,100% of CMS OPPS Rate,16.71,100% of CMS OPPS Rate,16.71,100% of CMS OPPS Rate,16.71,100% of CMS OPPS Rate,16.71,100% of CMS OPPS Rate,16.71,100% of CMS OPPS Rate,16.71,125.73,83.82
Outpatient,Laboratory,82533,CORTISOL; TOTAL,300,116.1,57.7,354% of CMS OPPS Rate,16.3,100% of Medicaid LA Fee Schedule,16.3,100% of CMS OPPS Rate,16.3,100% of CMS OPPS Rate,41.02,203.89% of BCBS Fee Schedule,81.27,70% of total Billed Charges,87.08,75% of total Billed Charges,29.34,180% OF CMS OPPS RATE,92.88,80% of total Billed Charges,57.05,350% of CMS Opps rate,16.62,102% of CMS Opps rate,88.82,76.5% of total billed charges,16.3,100% of Medicaid LA Fee Schedule,16.3,100% of Medicaid LA Fee Schedule,16.3,100% of CMS OPPS Rate,16.3,100% of CMS OPPS Rate,52.25,45% of total billed charges,81.27,70% of total billed charges,69.66,60% of total billed charges,16.3,100% of CMS OPPS Rate,18.11,90% OF UHC FEE SCHEDULE,81.27,70% of total billed charges,16.3,100% OF CMS OPPS Rate,37.49,230% OF CMS OPPS Rate,55.73,48% of total Billed charges,16.3,100% OF CMS OPPS Rate,104.49,90% of total Billed charges,16.3,100% of Medicaid LA Fee Schedule,16.3,100% of Medicaid LA Fee Schedule,16.3,100% of Medicaid LA Fee Schedule,16.3,100% of Medicaid LA Fee Schedule,16.3,100% of Medicaid LA Fee Schedule,16.3,100% of Medicaid LA Fee Schedule,16.3,100% of CMS OPPS Rate,16.3,100% of CMS OPPS Rate,16.3,100% of CMS OPPS Rate,16.3,100% of CMS OPPS Rate,16.3,100% of CMS OPPS Rate,16.3,100% of CMS OPPS Rate,16.3,100% of CMS OPPS Rate,16.3,100% of CMS OPPS Rate,16.3,104.49,69.66
Outpatient,Laboratory,82540,CREATINE,300,150,16.42,354% of CMS OPPS Rate,4.64,100% of Medicaid LA Fee Schedule,4.63,100% of CMS OPPS Rate,4.63,100% of CMS OPPS Rate,11.66,203.89% of BCBS Fee Schedule,105,70% of total Billed Charges,112.5,75% of total Billed Charges,8.35,180% OF CMS OPPS RATE,120,80% of total Billed Charges,16.24,350% of CMS Opps rate,4.73,102% of CMS Opps rate,114.75,76.5% of total billed charges,4.64,100% of Medicaid LA Fee Schedule,4.64,100% of Medicaid LA Fee Schedule,4.63,100% of CMS OPPS Rate,4.63,100% of CMS OPPS Rate,67.5,45% of total billed charges,105,70% of total billed charges,90,60% of total billed charges,4.63,100% of CMS OPPS Rate,5.15,90% OF UHC FEE SCHEDULE,105,70% of total billed charges,4.63,100% OF CMS OPPS Rate,10.67,230% OF CMS OPPS Rate,72,48% of total Billed charges,4.63,100% OF CMS OPPS Rate,135,90% of total Billed charges,4.64,100% of Medicaid LA Fee Schedule,4.64,100% of Medicaid LA Fee Schedule,4.64,100% of Medicaid LA Fee Schedule,4.64,100% of Medicaid LA Fee Schedule,4.64,100% of Medicaid LA Fee Schedule,4.64,100% of Medicaid LA Fee Schedule,4.63,100% of CMS OPPS Rate,4.63,100% of CMS OPPS Rate,4.63,100% of CMS OPPS Rate,4.63,100% of CMS OPPS Rate,4.63,100% of CMS OPPS Rate,4.63,100% of CMS OPPS Rate,4.63,100% of CMS OPPS Rate,4.63,100% of CMS OPPS Rate,4.63,135,90
Outpatient,Laboratory,82542,COLUMN CHROMATOGRAPHY QUAL/QUAN,300,124.65,85.27,354% of CMS OPPS Rate,24.09,100% of Medicaid LA Fee Schedule,24.09,100% of CMS OPPS Rate,24.09,100% of CMS OPPS Rate,49.12,203.89% of BCBS Fee Schedule,87.26,70% of total Billed Charges,93.49,75% of total Billed Charges,43.36,180% OF CMS OPPS RATE,99.72,80% of total Billed Charges,84.31,350% of CMS Opps rate,24.57,102% of CMS Opps rate,95.36,76.5% of total billed charges,24.09,100% of Medicaid LA Fee Schedule,24.09,100% of Medicaid LA Fee Schedule,24.09,100% of CMS OPPS Rate,24.09,100% of CMS OPPS Rate,56.09,45% of total billed charges,87.26,70% of total billed charges,74.79,60% of total billed charges,24.09,100% of CMS OPPS Rate,21.68,90% OF UHC FEE SCHEDULE,87.26,70% of total billed charges,24.09,100% OF CMS OPPS Rate,55.4,230% OF CMS OPPS Rate,59.83,48% of total Billed charges,24.09,100% OF CMS OPPS Rate,112.19,90% of total Billed charges,24.09,100% of Medicaid LA Fee Schedule,24.09,100% of Medicaid LA Fee Schedule,24.09,100% of Medicaid LA Fee Schedule,24.09,100% of Medicaid LA Fee Schedule,24.09,100% of Medicaid LA Fee Schedule,24.09,100% of Medicaid LA Fee Schedule,24.09,100% of CMS OPPS Rate,24.09,100% of CMS OPPS Rate,24.09,100% of CMS OPPS Rate,24.09,100% of CMS OPPS Rate,24.09,100% of CMS OPPS Rate,24.09,100% of CMS OPPS Rate,24.09,100% of CMS OPPS Rate,24.09,100% of CMS OPPS Rate,21.68,112.19,74.79
Outpatient,Laboratory,82550,CK TOTAL CREATINE KINASE SERUM,300,207,23.04,354% of CMS OPPS Rate,6.51,100% of Medicaid LA Fee Schedule,6.51,100% of CMS OPPS Rate,6.51,100% of CMS OPPS Rate,16.39,203.89% of BCBS Fee Schedule,144.9,70% of total Billed Charges,155.25,75% of total Billed Charges,11.71,180% OF CMS OPPS RATE,165.6,80% of total Billed Charges,22.78,350% of CMS Opps rate,6.64,102% of CMS Opps rate,158.36,76.5% of total billed charges,6.51,100% of Medicaid LA Fee Schedule,6.51,100% of Medicaid LA Fee Schedule,6.51,100% of CMS OPPS Rate,6.51,100% of CMS OPPS Rate,93.15,45% of total billed charges,144.9,70% of total billed charges,124.2,60% of total billed charges,6.51,100% of CMS OPPS Rate,7.24,90% OF UHC FEE SCHEDULE,144.9,70% of total billed charges,6.51,100% OF CMS OPPS Rate,14.97,230% OF CMS OPPS Rate,99.36,48% of total Billed charges,6.51,100% OF CMS OPPS Rate,186.3,90% of total Billed charges,6.51,100% of Medicaid LA Fee Schedule,6.51,100% of Medicaid LA Fee Schedule,6.51,100% of Medicaid LA Fee Schedule,6.51,100% of Medicaid LA Fee Schedule,6.51,100% of Medicaid LA Fee Schedule,6.51,100% of Medicaid LA Fee Schedule,6.51,100% of CMS OPPS Rate,6.51,100% of CMS OPPS Rate,6.51,100% of CMS OPPS Rate,6.51,100% of CMS OPPS Rate,6.51,100% of CMS OPPS Rate,6.51,100% of CMS OPPS Rate,6.51,100% of CMS OPPS Rate,6.51,100% of CMS OPPS Rate,6.51,186.3,124.2
Outpatient,Laboratory,82552,"CK ISOENZ(ELECTROPH), SER",300,83.05,47.4,354% of CMS OPPS Rate,13.39,100% of Medicaid LA Fee Schedule,13.39,100% of CMS OPPS Rate,13.39,100% of CMS OPPS Rate,33.7,203.89% of BCBS Fee Schedule,58.14,70% of total Billed Charges,62.29,75% of total Billed Charges,24.1,180% OF CMS OPPS RATE,66.44,80% of total Billed Charges,46.86,350% of CMS Opps rate,13.65,102% of CMS Opps rate,63.53,76.5% of total billed charges,13.39,100% of Medicaid LA Fee Schedule,13.39,100% of Medicaid LA Fee Schedule,13.39,100% of CMS OPPS Rate,13.39,100% of CMS OPPS Rate,37.37,45% of total billed charges,58.14,70% of total billed charges,49.83,60% of total billed charges,13.39,100% of CMS OPPS Rate,14.88,90% OF UHC FEE SCHEDULE,58.14,70% of total billed charges,13.39,100% OF CMS OPPS Rate,30.79,230% OF CMS OPPS Rate,39.86,48% of total Billed charges,13.39,100% OF CMS OPPS Rate,74.75,90% of total Billed charges,13.39,100% of Medicaid LA Fee Schedule,13.39,100% of Medicaid LA Fee Schedule,13.39,100% of Medicaid LA Fee Schedule,13.39,100% of Medicaid LA Fee Schedule,13.39,100% of Medicaid LA Fee Schedule,13.39,100% of Medicaid LA Fee Schedule,13.39,100% of CMS OPPS Rate,13.39,100% of CMS OPPS Rate,13.39,100% of CMS OPPS Rate,13.39,100% of CMS OPPS Rate,13.39,100% of CMS OPPS Rate,13.39,100% of CMS OPPS Rate,13.39,100% of CMS OPPS Rate,13.39,100% of CMS OPPS Rate,13.39,74.75,49.83
Outpatient,Laboratory,82553,Blood test to detect heart enzymes,300,181.35,40.88,354% of CMS OPPS Rate,11.55,100% of Medicaid LA Fee Schedule,11.55,100% of CMS OPPS Rate,11.55,100% of CMS OPPS Rate,29.07,203.89% of BCBS Fee Schedule,126.95,70% of total Billed Charges,136.01,75% of total Billed Charges,20.79,180% OF CMS OPPS RATE,145.08,80% of total Billed Charges,40.42,350% of CMS Opps rate,11.78,102% of CMS Opps rate,138.73,76.5% of total billed charges,11.55,100% of Medicaid LA Fee Schedule,11.55,100% of Medicaid LA Fee Schedule,11.55,100% of CMS OPPS Rate,11.55,100% of CMS OPPS Rate,81.61,45% of total billed charges,126.95,70% of total billed charges,108.81,60% of total billed charges,11.55,100% of CMS OPPS Rate,12.83,90% OF UHC FEE SCHEDULE,126.95,70% of total billed charges,11.55,100% OF CMS OPPS Rate,26.56,230% OF CMS OPPS Rate,87.05,48% of total Billed charges,11.55,100% OF CMS OPPS Rate,163.22,90% of total Billed charges,11.55,100% of Medicaid LA Fee Schedule,11.55,100% of Medicaid LA Fee Schedule,11.55,100% of Medicaid LA Fee Schedule,11.55,100% of Medicaid LA Fee Schedule,11.55,100% of Medicaid LA Fee Schedule,11.55,100% of Medicaid LA Fee Schedule,11.55,100% of CMS OPPS Rate,11.55,100% of CMS OPPS Rate,11.55,100% of CMS OPPS Rate,11.55,100% of CMS OPPS Rate,11.55,100% of CMS OPPS Rate,11.55,100% of CMS OPPS Rate,11.55,100% of CMS OPPS Rate,11.55,100% of CMS OPPS Rate,11.55,163.22,108.81
Outpatient,Laboratory,82565,CREATININE SERUM,300,90.9,18.12,354% of CMS OPPS Rate,5.12,100% of Medicaid LA Fee Schedule,5.12,100% of CMS OPPS Rate,5.12,100% of CMS OPPS Rate,12.91,203.89% of BCBS Fee Schedule,63.63,70% of total Billed Charges,68.18,75% of total Billed Charges,9.21,180% OF CMS OPPS RATE,72.72,80% of total Billed Charges,17.92,350% of CMS Opps rate,5.22,102% of CMS Opps rate,69.54,76.5% of total billed charges,5.12,100% of Medicaid LA Fee Schedule,5.12,100% of Medicaid LA Fee Schedule,5.12,100% of CMS OPPS Rate,5.12,100% of CMS OPPS Rate,40.91,45% of total billed charges,63.63,70% of total billed charges,54.54,60% of total billed charges,5.12,100% of CMS OPPS Rate,5.7,90% OF UHC FEE SCHEDULE,63.63,70% of total billed charges,5.12,100% OF CMS OPPS Rate,11.77,230% OF CMS OPPS Rate,43.63,48% of total Billed charges,5.12,100% OF CMS OPPS Rate,81.81,90% of total Billed charges,5.12,100% of Medicaid LA Fee Schedule,5.12,100% of Medicaid LA Fee Schedule,5.12,100% of Medicaid LA Fee Schedule,5.12,100% of Medicaid LA Fee Schedule,5.12,100% of Medicaid LA Fee Schedule,5.12,100% of Medicaid LA Fee Schedule,5.12,100% of CMS OPPS Rate,5.12,100% of CMS OPPS Rate,5.12,100% of CMS OPPS Rate,5.12,100% of CMS OPPS Rate,5.12,100% of CMS OPPS Rate,5.12,100% of CMS OPPS Rate,5.12,100% of CMS OPPS Rate,5.12,100% of CMS OPPS Rate,5.12,81.81,54.54
Outpatient,Laboratory,82570,Test to measure creatinine in the urine,300,62.55,18.33,354% of CMS OPPS Rate,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,13.03,203.89% of BCBS Fee Schedule,43.79,70% of total Billed Charges,46.91,75% of total Billed Charges,9.32,180% OF CMS OPPS RATE,50.04,80% of total Billed Charges,18.13,350% of CMS Opps rate,5.28,102% of CMS Opps rate,47.85,76.5% of total billed charges,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,28.15,45% of total billed charges,43.79,70% of total billed charges,37.53,60% of total billed charges,5.18,100% of CMS OPPS Rate,5.75,90% OF UHC FEE SCHEDULE,43.79,70% of total billed charges,5.18,100% OF CMS OPPS Rate,11.91,230% OF CMS OPPS Rate,30.02,48% of total Billed charges,5.18,100% OF CMS OPPS Rate,56.3,90% of total Billed charges,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,5.18,56.3,37.53
Outpatient,Laboratory,82575,CREATININE CLEARANCE,300,143.55,33.48,354% of CMS OPPS Rate,9.46,100% of Medicaid LA Fee Schedule,9.46,100% of CMS OPPS Rate,9.46,100% of CMS OPPS Rate,23.79,203.89% of BCBS Fee Schedule,100.49,70% of total Billed Charges,107.66,75% of total Billed Charges,17.02,180% OF CMS OPPS RATE,114.84,80% of total Billed Charges,33.11,350% of CMS Opps rate,9.64,102% of CMS Opps rate,109.82,76.5% of total billed charges,9.46,100% of Medicaid LA Fee Schedule,9.46,100% of Medicaid LA Fee Schedule,9.46,100% of CMS OPPS Rate,9.46,100% of CMS OPPS Rate,64.6,45% of total billed charges,100.49,70% of total billed charges,86.13,60% of total billed charges,9.46,100% of CMS OPPS Rate,10.5,90% OF UHC FEE SCHEDULE,100.49,70% of total billed charges,9.46,100% OF CMS OPPS Rate,21.75,230% OF CMS OPPS Rate,68.9,48% of total Billed charges,9.46,100% OF CMS OPPS Rate,129.2,90% of total Billed charges,9.46,100% of Medicaid LA Fee Schedule,9.46,100% of Medicaid LA Fee Schedule,9.46,100% of Medicaid LA Fee Schedule,9.46,100% of Medicaid LA Fee Schedule,9.46,100% of Medicaid LA Fee Schedule,9.46,100% of Medicaid LA Fee Schedule,9.46,100% of CMS OPPS Rate,9.46,100% of CMS OPPS Rate,9.46,100% of CMS OPPS Rate,9.46,100% of CMS OPPS Rate,9.46,100% of CMS OPPS Rate,9.46,100% of CMS OPPS Rate,9.46,100% of CMS OPPS Rate,9.46,100% of CMS OPPS Rate,9.46,129.2,86.13
Outpatient,Laboratory,82585,CYROFIBRINOGEN,300,90.5,50.05,354% of CMS OPPS Rate,11.04,100% of Medicaid LA Fee Schedule,14.14,100% of CMS OPPS Rate,14.14,100% of CMS OPPS Rate,28.83,203.89% of BCBS Fee Schedule,63.35,70% of total Billed Charges,67.88,75% of total Billed Charges,25.45,180% OF CMS OPPS RATE,72.4,80% of total Billed Charges,49.49,350% of CMS Opps rate,14.42,102% of CMS Opps rate,69.23,76.5% of total billed charges,11.04,100% of Medicaid LA Fee Schedule,11.04,100% of Medicaid LA Fee Schedule,14.14,100% of CMS OPPS Rate,14.14,100% of CMS OPPS Rate,40.73,45% of total billed charges,63.35,70% of total billed charges,54.3,60% of total billed charges,14.14,100% of CMS OPPS Rate,12.73,90% OF UHC FEE SCHEDULE,63.35,70% of total billed charges,14.14,100% OF CMS OPPS Rate,32.52,230% OF CMS OPPS Rate,43.44,48% of total Billed charges,14.14,100% OF CMS OPPS Rate,81.45,90% of total Billed charges,11.04,100% of Medicaid LA Fee Schedule,11.04,100% of Medicaid LA Fee Schedule,11.04,100% of Medicaid LA Fee Schedule,11.04,100% of Medicaid LA Fee Schedule,11.04,100% of Medicaid LA Fee Schedule,11.04,100% of Medicaid LA Fee Schedule,14.14,100% of CMS OPPS Rate,14.14,100% of CMS OPPS Rate,14.14,100% of CMS OPPS Rate,14.14,100% of CMS OPPS Rate,14.14,100% of CMS OPPS Rate,14.14,100% of CMS OPPS Rate,14.14,100% of CMS OPPS Rate,14.14,100% of CMS OPPS Rate,11.04,81.45,54.3
Outpatient,Laboratory,82595,"CRYOGLOBULIN, SERUM",300,65,22.9,354% of CMS OPPS Rate,6.47,100% of Medicaid LA Fee Schedule,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,16.27,203.89% of BCBS Fee Schedule,45.5,70% of total Billed Charges,48.75,75% of total Billed Charges,11.64,180% OF CMS OPPS RATE,52,80% of total Billed Charges,22.64,350% of CMS Opps rate,6.59,102% of CMS Opps rate,49.73,76.5% of total billed charges,6.47,100% of Medicaid LA Fee Schedule,6.47,100% of Medicaid LA Fee Schedule,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,29.25,45% of total billed charges,45.5,70% of total billed charges,39,60% of total billed charges,6.47,100% of CMS OPPS Rate,7.18,90% OF UHC FEE SCHEDULE,45.5,70% of total billed charges,6.47,100% OF CMS OPPS Rate,14.88,230% OF CMS OPPS Rate,31.2,48% of total Billed charges,6.47,100% OF CMS OPPS Rate,58.5,90% of total Billed charges,6.47,100% of Medicaid LA Fee Schedule,6.47,100% of Medicaid LA Fee Schedule,6.47,100% of Medicaid LA Fee Schedule,6.47,100% of Medicaid LA Fee Schedule,6.47,100% of Medicaid LA Fee Schedule,6.47,100% of Medicaid LA Fee Schedule,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,6.47,58.5,39
Outpatient,Laboratory,82607,Blood test to measure B-12,300,188.1,53.38,354% of CMS OPPS Rate,15.08,100% of Medicaid LA Fee Schedule,15.08,100% of CMS OPPS Rate,15.08,100% of CMS OPPS Rate,37.94,203.89% of BCBS Fee Schedule,131.67,70% of total Billed Charges,141.08,75% of total Billed Charges,27.14,180% OF CMS OPPS RATE,150.48,80% of total Billed Charges,52.78,350% of CMS Opps rate,15.38,102% of CMS Opps rate,143.9,76.5% of total billed charges,15.08,100% of Medicaid LA Fee Schedule,15.08,100% of Medicaid LA Fee Schedule,15.08,100% of CMS OPPS Rate,15.08,100% of CMS OPPS Rate,84.65,45% of total billed charges,131.67,70% of total billed charges,112.86,60% of total billed charges,15.08,100% of CMS OPPS Rate,16.75,90% OF UHC FEE SCHEDULE,131.67,70% of total billed charges,15.08,100% OF CMS OPPS Rate,34.68,230% OF CMS OPPS Rate,90.29,48% of total Billed charges,15.08,100% OF CMS OPPS Rate,169.29,90% of total Billed charges,15.08,100% of Medicaid LA Fee Schedule,15.08,100% of Medicaid LA Fee Schedule,15.08,100% of Medicaid LA Fee Schedule,15.08,100% of Medicaid LA Fee Schedule,15.08,100% of Medicaid LA Fee Schedule,15.08,100% of Medicaid LA Fee Schedule,15.08,100% of CMS OPPS Rate,15.08,100% of CMS OPPS Rate,15.08,100% of CMS OPPS Rate,15.08,100% of CMS OPPS Rate,15.08,100% of CMS OPPS Rate,15.08,100% of CMS OPPS Rate,15.08,100% of CMS OPPS Rate,15.08,100% of CMS OPPS Rate,15.08,169.29,112.86
Outpatient,Laboratory,82626,DHEA,300,276.1,89.45,354% of CMS OPPS Rate,25.27,100% of Medicaid LA Fee Schedule,25.27,100% of CMS OPPS Rate,25.27,100% of CMS OPPS Rate,63.61,203.89% of BCBS Fee Schedule,193.27,70% of total Billed Charges,207.08,75% of total Billed Charges,45.48,180% OF CMS OPPS RATE,220.88,80% of total Billed Charges,88.44,350% of CMS Opps rate,25.77,102% of CMS Opps rate,211.22,76.5% of total billed charges,25.27,100% of Medicaid LA Fee Schedule,25.27,100% of Medicaid LA Fee Schedule,25.27,100% of CMS OPPS Rate,25.27,100% of CMS OPPS Rate,124.25,45% of total billed charges,193.27,70% of total billed charges,165.66,60% of total billed charges,25.27,100% of CMS OPPS Rate,28.08,90% OF UHC FEE SCHEDULE,193.27,70% of total billed charges,25.27,100% OF CMS OPPS Rate,58.12,230% OF CMS OPPS Rate,132.53,48% of total Billed charges,25.27,100% OF CMS OPPS Rate,248.49,90% of total Billed charges,25.27,100% of Medicaid LA Fee Schedule,25.27,100% of Medicaid LA Fee Schedule,25.27,100% of Medicaid LA Fee Schedule,25.27,100% of Medicaid LA Fee Schedule,25.27,100% of Medicaid LA Fee Schedule,25.27,100% of Medicaid LA Fee Schedule,25.27,100% of CMS OPPS Rate,25.27,100% of CMS OPPS Rate,25.27,100% of CMS OPPS Rate,25.27,100% of CMS OPPS Rate,25.27,100% of CMS OPPS Rate,25.27,100% of CMS OPPS Rate,25.27,100% of CMS OPPS Rate,25.27,100% of CMS OPPS Rate,25.27,248.49,165.66
Outpatient,Laboratory,82627,Blood test to measure an enzyme in the blood,300,89.1,78.69,354% of CMS OPPS Rate,22.23,100% of Medicaid LA Fee Schedule,22.23,100% of CMS OPPS Rate,22.23,100% of CMS OPPS Rate,55.97,203.89% of BCBS Fee Schedule,62.37,70% of total Billed Charges,66.83,75% of total Billed Charges,40.01,180% OF CMS OPPS RATE,71.28,80% of total Billed Charges,77.8,350% of CMS Opps rate,22.67,102% of CMS Opps rate,68.16,76.5% of total billed charges,22.23,100% of Medicaid LA Fee Schedule,22.23,100% of Medicaid LA Fee Schedule,22.23,100% of CMS OPPS Rate,22.23,100% of CMS OPPS Rate,40.1,45% of total billed charges,62.37,70% of total billed charges,53.46,60% of total billed charges,22.23,100% of CMS OPPS Rate,24.71,90% OF UHC FEE SCHEDULE,62.37,70% of total billed charges,22.23,100% OF CMS OPPS Rate,51.12,230% OF CMS OPPS Rate,42.77,48% of total Billed charges,22.23,100% OF CMS OPPS Rate,80.19,90% of total Billed charges,22.23,100% of Medicaid LA Fee Schedule,22.23,100% of Medicaid LA Fee Schedule,22.23,100% of Medicaid LA Fee Schedule,22.23,100% of Medicaid LA Fee Schedule,22.23,100% of Medicaid LA Fee Schedule,22.23,100% of Medicaid LA Fee Schedule,22.23,100% of CMS OPPS Rate,22.23,100% of CMS OPPS Rate,22.23,100% of CMS OPPS Rate,22.23,100% of CMS OPPS Rate,22.23,100% of CMS OPPS Rate,22.23,100% of CMS OPPS Rate,22.23,100% of CMS OPPS Rate,22.23,100% of CMS OPPS Rate,22.23,80.19,53.46
Outpatient,Laboratory,82652,VITAMIN D,300,299.7,136.29,354% of CMS OPPS Rate,20.52,100% of Medicaid LA Fee Schedule,38.5,100% of CMS OPPS Rate,38.5,100% of CMS OPPS Rate,96.91,203.89% of BCBS Fee Schedule,209.79,70% of total Billed Charges,224.78,75% of total Billed Charges,69.3,180% OF CMS OPPS RATE,239.76,80% of total Billed Charges,134.75,350% of CMS Opps rate,39.27,102% of CMS Opps rate,229.27,76.5% of total billed charges,20.52,100% of Medicaid LA Fee Schedule,20.52,100% of Medicaid LA Fee Schedule,38.5,100% of CMS OPPS Rate,38.5,100% of CMS OPPS Rate,134.87,45% of total billed charges,209.79,70% of total billed charges,179.82,60% of total billed charges,38.5,100% of CMS OPPS Rate,42.78,90% OF UHC FEE SCHEDULE,209.79,70% of total billed charges,38.5,100% OF CMS OPPS Rate,88.55,230% OF CMS OPPS Rate,143.86,48% of total Billed charges,38.5,100% OF CMS OPPS Rate,269.73,90% of total Billed charges,20.52,100% of Medicaid LA Fee Schedule,20.52,100% of Medicaid LA Fee Schedule,20.52,100% of Medicaid LA Fee Schedule,20.52,100% of Medicaid LA Fee Schedule,20.52,100% of Medicaid LA Fee Schedule,20.52,100% of Medicaid LA Fee Schedule,38.5,100% of CMS OPPS Rate,38.5,100% of CMS OPPS Rate,38.5,100% of CMS OPPS Rate,38.5,100% of CMS OPPS Rate,38.5,100% of CMS OPPS Rate,38.5,100% of CMS OPPS Rate,38.5,100% of CMS OPPS Rate,38.5,100% of CMS OPPS Rate,20.52,269.73,179.82
Outpatient,Laboratory,82656,"PANCREATIC ELASTASE, FECA",300,225,40.81,354% of CMS OPPS Rate,11.53,100% of Medicaid LA Fee Schedule,11.53,100% of CMS OPPS Rate,11.53,100% of CMS OPPS Rate,29.03,203.89% of BCBS Fee Schedule,157.5,70% of total Billed Charges,168.75,75% of total Billed Charges,20.75,180% OF CMS OPPS RATE,180,80% of total Billed Charges,40.35,350% of CMS Opps rate,11.76,102% of CMS Opps rate,172.13,76.5% of total billed charges,11.53,100% of Medicaid LA Fee Schedule,11.53,100% of Medicaid LA Fee Schedule,11.53,100% of CMS OPPS Rate,11.53,100% of CMS OPPS Rate,101.25,45% of total billed charges,157.5,70% of total billed charges,135,60% of total billed charges,11.53,100% of CMS OPPS Rate,12.82,90% OF UHC FEE SCHEDULE,157.5,70% of total billed charges,11.53,100% OF CMS OPPS Rate,26.51,230% OF CMS OPPS Rate,108,48% of total Billed charges,11.53,100% OF CMS OPPS Rate,202.5,90% of total Billed charges,11.53,100% of Medicaid LA Fee Schedule,11.53,100% of Medicaid LA Fee Schedule,11.53,100% of Medicaid LA Fee Schedule,11.53,100% of Medicaid LA Fee Schedule,11.53,100% of Medicaid LA Fee Schedule,11.53,100% of Medicaid LA Fee Schedule,11.53,100% of CMS OPPS Rate,11.53,100% of CMS OPPS Rate,11.53,100% of CMS OPPS Rate,11.53,100% of CMS OPPS Rate,11.53,100% of CMS OPPS Rate,11.53,100% of CMS OPPS Rate,11.53,100% of CMS OPPS Rate,11.53,100% of CMS OPPS Rate,11.53,202.5,135
Outpatient,Laboratory,82657,ENZYME ACTIVITY IN BLOOD,300,276.75,78.48,354% of CMS OPPS Rate,22.17,100% of Medicaid LA Fee Schedule,22.17,100% of CMS OPPS Rate,22.17,100% of CMS OPPS Rate,45.45,203.89% of BCBS Fee Schedule,193.73,70% of total Billed Charges,207.56,75% of total Billed Charges,39.9,180% OF CMS OPPS RATE,221.4,80% of total Billed Charges,77.59,350% of CMS Opps rate,22.61,102% of CMS Opps rate,211.71,76.5% of total billed charges,22.17,100% of Medicaid LA Fee Schedule,22.17,100% of Medicaid LA Fee Schedule,22.17,100% of CMS OPPS Rate,22.17,100% of CMS OPPS Rate,124.54,45% of total billed charges,193.73,70% of total billed charges,166.05,60% of total billed charges,22.17,100% of CMS OPPS Rate,20.06,90% OF UHC FEE SCHEDULE,193.73,70% of total billed charges,22.17,100% OF CMS OPPS Rate,50.99,230% OF CMS OPPS Rate,132.84,48% of total Billed charges,22.17,100% OF CMS OPPS Rate,249.08,90% of total Billed charges,22.17,100% of Medicaid LA Fee Schedule,22.17,100% of Medicaid LA Fee Schedule,22.17,100% of Medicaid LA Fee Schedule,22.17,100% of Medicaid LA Fee Schedule,22.17,100% of Medicaid LA Fee Schedule,22.17,100% of Medicaid LA Fee Schedule,22.17,100% of CMS OPPS Rate,22.17,100% of CMS OPPS Rate,22.17,100% of CMS OPPS Rate,22.17,100% of CMS OPPS Rate,22.17,100% of CMS OPPS Rate,22.17,100% of CMS OPPS Rate,22.17,100% of CMS OPPS Rate,22.17,100% of CMS OPPS Rate,20.06,249.08,166.05
Outpatient,Laboratory,82664,"BENCE J. PROTEIN, 24HR UR",300,129.6,217.71,354% of CMS OPPS Rate,13.56,100% of Medicaid LA Fee Schedule,61.5,100% of CMS OPPS Rate,61.5,100% of CMS OPPS Rate,125.39,203.89% of BCBS Fee Schedule,90.72,70% of total Billed Charges,97.2,75% of total Billed Charges,110.7,180% OF CMS OPPS RATE,103.68,80% of total Billed Charges,215.25,350% of CMS Opps rate,62.73,102% of CMS Opps rate,99.14,76.5% of total billed charges,13.56,100% of Medicaid LA Fee Schedule,13.56,100% of Medicaid LA Fee Schedule,61.5,100% of CMS OPPS Rate,61.5,100% of CMS OPPS Rate,58.32,45% of total billed charges,90.72,70% of total billed charges,77.76,60% of total billed charges,61.5,100% of CMS OPPS Rate,55.35,90% OF UHC FEE SCHEDULE,90.72,70% of total billed charges,61.5,100% OF CMS OPPS Rate,129.6,230% OF CMS OPPS Rate,62.21,48% of total Billed charges,61.5,100% OF CMS OPPS Rate,116.64,90% of total Billed charges,13.56,100% of Medicaid LA Fee Schedule,13.56,100% of Medicaid LA Fee Schedule,13.56,100% of Medicaid LA Fee Schedule,13.56,100% of Medicaid LA Fee Schedule,13.56,100% of Medicaid LA Fee Schedule,13.56,100% of Medicaid LA Fee Schedule,61.5,100% of CMS OPPS Rate,61.5,100% of CMS OPPS Rate,61.5,100% of CMS OPPS Rate,61.5,100% of CMS OPPS Rate,61.5,100% of CMS OPPS Rate,61.5,100% of CMS OPPS Rate,61.5,100% of CMS OPPS Rate,61.5,100% of CMS OPPS Rate,13.56,217.71,77.76
Outpatient,Laboratory,82668,ERYTHOPOIETIN,300,99.55,66.51,354% of CMS OPPS Rate,18.79,100% of Medicaid LA Fee Schedule,18.79,100% of CMS OPPS Rate,18.79,100% of CMS OPPS Rate,47.3,203.89% of BCBS Fee Schedule,69.69,70% of total Billed Charges,74.66,75% of total Billed Charges,33.82,180% OF CMS OPPS RATE,79.64,80% of total Billed Charges,65.76,350% of CMS Opps rate,19.16,102% of CMS Opps rate,76.16,76.5% of total billed charges,18.79,100% of Medicaid LA Fee Schedule,18.79,100% of Medicaid LA Fee Schedule,18.79,100% of CMS OPPS Rate,18.79,100% of CMS OPPS Rate,44.8,45% of total billed charges,69.69,70% of total billed charges,59.73,60% of total billed charges,18.79,100% of CMS OPPS Rate,20.88,90% OF UHC FEE SCHEDULE,69.69,70% of total billed charges,18.79,100% OF CMS OPPS Rate,43.21,230% OF CMS OPPS Rate,47.78,48% of total Billed charges,18.79,100% OF CMS OPPS Rate,89.6,90% of total Billed charges,18.79,100% of Medicaid LA Fee Schedule,18.79,100% of Medicaid LA Fee Schedule,18.79,100% of Medicaid LA Fee Schedule,18.79,100% of Medicaid LA Fee Schedule,18.79,100% of Medicaid LA Fee Schedule,18.79,100% of Medicaid LA Fee Schedule,18.79,100% of CMS OPPS Rate,18.79,100% of CMS OPPS Rate,18.79,100% of CMS OPPS Rate,18.79,100% of CMS OPPS Rate,18.79,100% of CMS OPPS Rate,18.79,100% of CMS OPPS Rate,18.79,100% of CMS OPPS Rate,18.79,100% of CMS OPPS Rate,18.79,89.6,59.73
Outpatient,Laboratory,82670,Blood test to measure a type of estrogen in the blood,300,166.1,98.9,354% of CMS OPPS Rate,27.94,100% of Medicaid LA Fee Schedule,27.94,100% of CMS OPPS Rate,27.94,100% of CMS OPPS Rate,70.32,203.89% of BCBS Fee Schedule,116.27,70% of total Billed Charges,124.58,75% of total Billed Charges,50.29,180% OF CMS OPPS RATE,132.88,80% of total Billed Charges,97.79,350% of CMS Opps rate,28.49,102% of CMS Opps rate,127.07,76.5% of total billed charges,27.94,100% of Medicaid LA Fee Schedule,27.94,100% of Medicaid LA Fee Schedule,27.94,100% of CMS OPPS Rate,27.94,100% of CMS OPPS Rate,74.75,45% of total billed charges,116.27,70% of total billed charges,99.66,60% of total billed charges,27.94,100% of CMS OPPS Rate,31.04,90% OF UHC FEE SCHEDULE,116.27,70% of total billed charges,27.94,100% OF CMS OPPS Rate,64.26,230% OF CMS OPPS Rate,79.73,48% of total Billed charges,27.94,100% OF CMS OPPS Rate,149.49,90% of total Billed charges,27.94,100% of Medicaid LA Fee Schedule,27.94,100% of Medicaid LA Fee Schedule,27.94,100% of Medicaid LA Fee Schedule,27.94,100% of Medicaid LA Fee Schedule,27.94,100% of Medicaid LA Fee Schedule,27.94,100% of Medicaid LA Fee Schedule,27.94,100% of CMS OPPS Rate,27.94,100% of CMS OPPS Rate,27.94,100% of CMS OPPS Rate,27.94,100% of CMS OPPS Rate,27.94,100% of CMS OPPS Rate,27.94,100% of CMS OPPS Rate,27.94,100% of CMS OPPS Rate,27.94,100% of CMS OPPS Rate,27.94,149.49,99.66
Outpatient,Laboratory,82671,ESTROGENS FRACTIONATED,300,229,114.34,354% of CMS OPPS Rate,32.3,100% of Medicaid LA Fee Schedule,32.29,100% of CMS OPPS Rate,32.29,100% of CMS OPPS Rate,81.31,203.89% of BCBS Fee Schedule,160.3,70% of total Billed Charges,171.75,75% of total Billed Charges,58.13,180% OF CMS OPPS RATE,183.2,80% of total Billed Charges,113.04,350% of CMS Opps rate,32.94,102% of CMS Opps rate,175.19,76.5% of total billed charges,32.3,100% of Medicaid LA Fee Schedule,32.3,100% of Medicaid LA Fee Schedule,32.29,100% of CMS OPPS Rate,32.29,100% of CMS OPPS Rate,103.05,45% of total billed charges,160.3,70% of total billed charges,137.4,60% of total billed charges,32.29,100% of CMS OPPS Rate,35.89,90% OF UHC FEE SCHEDULE,160.3,70% of total billed charges,32.29,100% OF CMS OPPS Rate,74.28,230% OF CMS OPPS Rate,109.92,48% of total Billed charges,32.29,100% OF CMS OPPS Rate,206.1,90% of total Billed charges,32.3,100% of Medicaid LA Fee Schedule,32.3,100% of Medicaid LA Fee Schedule,32.3,100% of Medicaid LA Fee Schedule,32.3,100% of Medicaid LA Fee Schedule,32.3,100% of Medicaid LA Fee Schedule,32.3,100% of Medicaid LA Fee Schedule,32.29,100% of CMS OPPS Rate,32.29,100% of CMS OPPS Rate,32.29,100% of CMS OPPS Rate,32.29,100% of CMS OPPS Rate,32.29,100% of CMS OPPS Rate,32.29,100% of CMS OPPS Rate,32.29,100% of CMS OPPS Rate,32.29,100% of CMS OPPS Rate,32.29,206.1,137.4
Outpatient,Laboratory,82672,"ESTROGEN, TOTAL",300,257.4,76.81,354% of CMS OPPS Rate,21.7,100% of Medicaid LA Fee Schedule,21.7,100% of CMS OPPS Rate,21.7,100% of CMS OPPS Rate,54.6,203.89% of BCBS Fee Schedule,180.18,70% of total Billed Charges,193.05,75% of total Billed Charges,39.06,180% OF CMS OPPS RATE,205.92,80% of total Billed Charges,75.95,350% of CMS Opps rate,22.13,102% of CMS Opps rate,196.91,76.5% of total billed charges,21.7,100% of Medicaid LA Fee Schedule,21.7,100% of Medicaid LA Fee Schedule,21.7,100% of CMS OPPS Rate,21.7,100% of CMS OPPS Rate,115.83,45% of total billed charges,180.18,70% of total billed charges,154.44,60% of total billed charges,21.7,100% of CMS OPPS Rate,24.1,90% OF UHC FEE SCHEDULE,180.18,70% of total billed charges,21.7,100% OF CMS OPPS Rate,49.91,230% OF CMS OPPS Rate,123.55,48% of total Billed charges,21.7,100% OF CMS OPPS Rate,231.66,90% of total Billed charges,21.7,100% of Medicaid LA Fee Schedule,21.7,100% of Medicaid LA Fee Schedule,21.7,100% of Medicaid LA Fee Schedule,21.7,100% of Medicaid LA Fee Schedule,21.7,100% of Medicaid LA Fee Schedule,21.7,100% of Medicaid LA Fee Schedule,21.7,100% of CMS OPPS Rate,21.7,100% of CMS OPPS Rate,21.7,100% of CMS OPPS Rate,21.7,100% of CMS OPPS Rate,21.7,100% of CMS OPPS Rate,21.7,100% of CMS OPPS Rate,21.7,100% of CMS OPPS Rate,21.7,100% of CMS OPPS Rate,21.7,231.66,154.44
Outpatient,Laboratory,82677,ESTRIOL(ALPHA FETOPROTEIN,300,73,85.59,354% of CMS OPPS Rate,24.18,100% of Medicaid LA Fee Schedule,24.18,100% of CMS OPPS Rate,24.18,100% of CMS OPPS Rate,60.86,203.89% of BCBS Fee Schedule,51.1,70% of total Billed Charges,54.75,75% of total Billed Charges,43.52,180% OF CMS OPPS RATE,58.4,80% of total Billed Charges,84.63,350% of CMS Opps rate,24.66,102% of CMS Opps rate,55.85,76.5% of total billed charges,24.18,100% of Medicaid LA Fee Schedule,24.18,100% of Medicaid LA Fee Schedule,24.18,100% of CMS OPPS Rate,24.18,100% of CMS OPPS Rate,32.85,45% of total billed charges,51.1,70% of total billed charges,43.8,60% of total billed charges,24.18,100% of CMS OPPS Rate,26.87,90% OF UHC FEE SCHEDULE,51.1,70% of total billed charges,24.18,100% OF CMS OPPS Rate,55.61,230% OF CMS OPPS Rate,35.04,48% of total Billed charges,24.18,100% OF CMS OPPS Rate,65.7,90% of total Billed charges,24.18,100% of Medicaid LA Fee Schedule,24.18,100% of Medicaid LA Fee Schedule,24.18,100% of Medicaid LA Fee Schedule,24.18,100% of Medicaid LA Fee Schedule,24.18,100% of Medicaid LA Fee Schedule,24.18,100% of Medicaid LA Fee Schedule,24.18,100% of CMS OPPS Rate,24.18,100% of CMS OPPS Rate,24.18,100% of CMS OPPS Rate,24.18,100% of CMS OPPS Rate,24.18,100% of CMS OPPS Rate,24.18,100% of CMS OPPS Rate,24.18,100% of CMS OPPS Rate,24.18,100% of CMS OPPS Rate,24.18,85.59,43.8
Outpatient,Laboratory,82679,ESTRONE,300,81.45,88.32,354% of CMS OPPS Rate,24.95,100% of Medicaid LA Fee Schedule,24.95,100% of CMS OPPS Rate,24.95,100% of CMS OPPS Rate,62.82,203.89% of BCBS Fee Schedule,57.02,70% of total Billed Charges,61.09,75% of total Billed Charges,44.91,180% OF CMS OPPS RATE,65.16,80% of total Billed Charges,87.32,350% of CMS Opps rate,25.44,102% of CMS Opps rate,62.31,76.5% of total billed charges,24.95,100% of Medicaid LA Fee Schedule,24.95,100% of Medicaid LA Fee Schedule,24.95,100% of CMS OPPS Rate,24.95,100% of CMS OPPS Rate,36.65,45% of total billed charges,57.02,70% of total billed charges,48.87,60% of total billed charges,24.95,100% of CMS OPPS Rate,27.73,90% OF UHC FEE SCHEDULE,57.02,70% of total billed charges,24.95,100% OF CMS OPPS Rate,57.38,230% OF CMS OPPS Rate,39.1,48% of total Billed charges,24.95,100% OF CMS OPPS Rate,73.31,90% of total Billed charges,24.95,100% of Medicaid LA Fee Schedule,24.95,100% of Medicaid LA Fee Schedule,24.95,100% of Medicaid LA Fee Schedule,24.95,100% of Medicaid LA Fee Schedule,24.95,100% of Medicaid LA Fee Schedule,24.95,100% of Medicaid LA Fee Schedule,24.95,100% of CMS OPPS Rate,24.95,100% of CMS OPPS Rate,24.95,100% of CMS OPPS Rate,24.95,100% of CMS OPPS Rate,24.95,100% of CMS OPPS Rate,24.95,100% of CMS OPPS Rate,24.95,100% of CMS OPPS Rate,24.95,100% of CMS OPPS Rate,24.95,88.32,48.87
Outpatient,Laboratory,82693,ETHYLENE GLYCOL,300,94.5,52.74,354% of CMS OPPS Rate,14.9,100% of Medicaid LA Fee Schedule,14.9,100% of CMS OPPS Rate,14.9,100% of CMS OPPS Rate,37.52,203.89% of BCBS Fee Schedule,66.15,70% of total Billed Charges,70.88,75% of total Billed Charges,26.82,180% OF CMS OPPS RATE,75.6,80% of total Billed Charges,52.15,350% of CMS Opps rate,15.19,102% of CMS Opps rate,72.29,76.5% of total billed charges,14.9,100% of Medicaid LA Fee Schedule,14.9,100% of Medicaid LA Fee Schedule,14.9,100% of CMS OPPS Rate,14.9,100% of CMS OPPS Rate,42.53,45% of total billed charges,66.15,70% of total billed charges,56.7,60% of total billed charges,14.9,100% of CMS OPPS Rate,16.56,90% OF UHC FEE SCHEDULE,66.15,70% of total billed charges,14.9,100% OF CMS OPPS Rate,34.27,230% OF CMS OPPS Rate,45.36,48% of total Billed charges,14.9,100% OF CMS OPPS Rate,85.05,90% of total Billed charges,14.9,100% of Medicaid LA Fee Schedule,14.9,100% of Medicaid LA Fee Schedule,14.9,100% of Medicaid LA Fee Schedule,14.9,100% of Medicaid LA Fee Schedule,14.9,100% of Medicaid LA Fee Schedule,14.9,100% of Medicaid LA Fee Schedule,14.9,100% of CMS OPPS Rate,14.9,100% of CMS OPPS Rate,14.9,100% of CMS OPPS Rate,14.9,100% of CMS OPPS Rate,14.9,100% of CMS OPPS Rate,14.9,100% of CMS OPPS Rate,14.9,100% of CMS OPPS Rate,14.9,100% of CMS OPPS Rate,14.9,85.05,56.7
Outpatient,Laboratory,82705,"FAT, QUALITATIVE, STOOL",300,107.55,18.05,354% of CMS OPPS Rate,5.1,100% of Medicaid LA Fee Schedule,5.09,100% of CMS OPPS Rate,5.09,100% of CMS OPPS Rate,12.82,203.89% of BCBS Fee Schedule,75.29,70% of total Billed Charges,80.66,75% of total Billed Charges,9.17,180% OF CMS OPPS RATE,86.04,80% of total Billed Charges,17.84,350% of CMS Opps rate,5.2,102% of CMS Opps rate,82.28,76.5% of total billed charges,5.1,100% of Medicaid LA Fee Schedule,5.1,100% of Medicaid LA Fee Schedule,5.09,100% of CMS OPPS Rate,5.09,100% of CMS OPPS Rate,48.4,45% of total billed charges,75.29,70% of total billed charges,64.53,60% of total billed charges,5.09,100% of CMS OPPS Rate,5.66,90% OF UHC FEE SCHEDULE,75.29,70% of total billed charges,5.09,100% OF CMS OPPS Rate,11.73,230% OF CMS OPPS Rate,51.62,48% of total Billed charges,5.09,100% OF CMS OPPS Rate,96.8,90% of total Billed charges,5.1,100% of Medicaid LA Fee Schedule,5.1,100% of Medicaid LA Fee Schedule,5.1,100% of Medicaid LA Fee Schedule,5.1,100% of Medicaid LA Fee Schedule,5.1,100% of Medicaid LA Fee Schedule,5.1,100% of Medicaid LA Fee Schedule,5.09,100% of CMS OPPS Rate,5.09,100% of CMS OPPS Rate,5.09,100% of CMS OPPS Rate,5.09,100% of CMS OPPS Rate,5.09,100% of CMS OPPS Rate,5.09,100% of CMS OPPS Rate,5.09,100% of CMS OPPS Rate,5.09,100% of CMS OPPS Rate,5.09,96.8,64.53
Outpatient,Laboratory,82710,FAT-STOOL-QUANT 72 HR,300,232,59.47,354% of CMS OPPS Rate,16.8,100% of Medicaid LA Fee Schedule,16.8,100% of CMS OPPS Rate,16.8,100% of CMS OPPS Rate,42.31,203.89% of BCBS Fee Schedule,162.4,70% of total Billed Charges,174,75% of total Billed Charges,30.24,180% OF CMS OPPS RATE,185.6,80% of total Billed Charges,58.8,350% of CMS Opps rate,17.13,102% of CMS Opps rate,177.48,76.5% of total billed charges,16.8,100% of Medicaid LA Fee Schedule,16.8,100% of Medicaid LA Fee Schedule,16.8,100% of CMS OPPS Rate,16.8,100% of CMS OPPS Rate,104.4,45% of total billed charges,162.4,70% of total billed charges,139.2,60% of total billed charges,16.8,100% of CMS OPPS Rate,18.68,90% OF UHC FEE SCHEDULE,162.4,70% of total billed charges,16.8,100% OF CMS OPPS Rate,38.64,230% OF CMS OPPS Rate,111.36,48% of total Billed charges,16.8,100% OF CMS OPPS Rate,208.8,90% of total Billed charges,16.8,100% of Medicaid LA Fee Schedule,16.8,100% of Medicaid LA Fee Schedule,16.8,100% of Medicaid LA Fee Schedule,16.8,100% of Medicaid LA Fee Schedule,16.8,100% of Medicaid LA Fee Schedule,16.8,100% of Medicaid LA Fee Schedule,16.8,100% of CMS OPPS Rate,16.8,100% of CMS OPPS Rate,16.8,100% of CMS OPPS Rate,16.8,100% of CMS OPPS Rate,16.8,100% of CMS OPPS Rate,16.8,100% of CMS OPPS Rate,16.8,100% of CMS OPPS Rate,16.8,100% of CMS OPPS Rate,16.8,208.8,139.2
Outpatient,Laboratory,82726,VERY LONG CHAIN FATTY ACID,300,550,69.91,354% of CMS OPPS Rate,19.75,100% of Medicaid LA Fee Schedule,19.75,100% of CMS OPPS Rate,19.75,100% of CMS OPPS Rate,45.45,203.89% of BCBS Fee Schedule,385,70% of total Billed Charges,412.5,75% of total Billed Charges,35.55,180% OF CMS OPPS RATE,440,80% of total Billed Charges,69.12,350% of CMS Opps rate,20.14,102% of CMS Opps rate,420.75,76.5% of total billed charges,19.75,100% of Medicaid LA Fee Schedule,19.75,100% of Medicaid LA Fee Schedule,19.75,100% of CMS OPPS Rate,19.75,100% of CMS OPPS Rate,247.5,45% of total billed charges,385,70% of total billed charges,330,60% of total billed charges,19.75,100% of CMS OPPS Rate,20.06,90% OF UHC FEE SCHEDULE,385,70% of total billed charges,19.75,100% OF CMS OPPS Rate,45.42,230% OF CMS OPPS Rate,264,48% of total Billed charges,19.75,100% OF CMS OPPS Rate,495,90% of total Billed charges,19.75,100% of Medicaid LA Fee Schedule,19.75,100% of Medicaid LA Fee Schedule,19.75,100% of Medicaid LA Fee Schedule,19.75,100% of Medicaid LA Fee Schedule,19.75,100% of Medicaid LA Fee Schedule,19.75,100% of Medicaid LA Fee Schedule,19.75,100% of CMS OPPS Rate,19.75,100% of CMS OPPS Rate,19.75,100% of CMS OPPS Rate,19.75,100% of CMS OPPS Rate,19.75,100% of CMS OPPS Rate,19.75,100% of CMS OPPS Rate,19.75,100% of CMS OPPS Rate,19.75,100% of CMS OPPS Rate,19.75,495,330
Outpatient,Laboratory,82728,Test to determine level of iron in the blood,300,111.1,48.25,354% of CMS OPPS Rate,13.63,100% of Medicaid LA Fee Schedule,13.63,100% of CMS OPPS Rate,13.63,100% of CMS OPPS Rate,34.31,203.89% of BCBS Fee Schedule,77.77,70% of total Billed Charges,83.33,75% of total Billed Charges,24.53,180% OF CMS OPPS RATE,88.88,80% of total Billed Charges,47.7,350% of CMS Opps rate,13.9,102% of CMS Opps rate,84.99,76.5% of total billed charges,13.63,100% of Medicaid LA Fee Schedule,13.63,100% of Medicaid LA Fee Schedule,13.63,100% of CMS OPPS Rate,13.63,100% of CMS OPPS Rate,50,45% of total billed charges,77.77,70% of total billed charges,66.66,60% of total billed charges,13.63,100% of CMS OPPS Rate,15.15,90% OF UHC FEE SCHEDULE,77.77,70% of total billed charges,13.63,100% OF CMS OPPS Rate,31.34,230% OF CMS OPPS Rate,53.33,48% of total Billed charges,13.63,100% OF CMS OPPS Rate,99.99,90% of total Billed charges,13.63,100% of Medicaid LA Fee Schedule,13.63,100% of Medicaid LA Fee Schedule,13.63,100% of Medicaid LA Fee Schedule,13.63,100% of Medicaid LA Fee Schedule,13.63,100% of Medicaid LA Fee Schedule,13.63,100% of Medicaid LA Fee Schedule,13.63,100% of CMS OPPS Rate,13.63,100% of CMS OPPS Rate,13.63,100% of CMS OPPS Rate,13.63,100% of CMS OPPS Rate,13.63,100% of CMS OPPS Rate,13.63,100% of CMS OPPS Rate,13.63,100% of CMS OPPS Rate,13.63,100% of CMS OPPS Rate,13.63,99.99,66.66
Outpatient,Laboratory,82731,FETAL FEBRONECTIN,300,434.7,228.01,354% of CMS OPPS Rate,22.81,100% of Medicaid LA Fee Schedule,64.41,100% of CMS OPPS Rate,64.41,100% of CMS OPPS Rate,162.13,203.89% of BCBS Fee Schedule,304.29,70% of total Billed Charges,326.03,75% of total Billed Charges,115.93,180% OF CMS OPPS RATE,347.76,80% of total Billed Charges,225.43,350% of CMS Opps rate,65.69,102% of CMS Opps rate,332.55,76.5% of total billed charges,22.81,100% of Medicaid LA Fee Schedule,22.81,100% of Medicaid LA Fee Schedule,64.41,100% of CMS OPPS Rate,64.41,100% of CMS OPPS Rate,195.62,45% of total billed charges,304.29,70% of total billed charges,260.82,60% of total billed charges,64.41,100% of CMS OPPS Rate,71.57,90% OF UHC FEE SCHEDULE,304.29,70% of total billed charges,64.41,100% OF CMS OPPS Rate,148.14,230% OF CMS OPPS Rate,208.66,48% of total Billed charges,64.41,100% OF CMS OPPS Rate,391.23,90% of total Billed charges,22.81,100% of Medicaid LA Fee Schedule,22.81,100% of Medicaid LA Fee Schedule,22.81,100% of Medicaid LA Fee Schedule,22.81,100% of Medicaid LA Fee Schedule,22.81,100% of Medicaid LA Fee Schedule,22.81,100% of Medicaid LA Fee Schedule,64.41,100% of CMS OPPS Rate,64.41,100% of CMS OPPS Rate,64.41,100% of CMS OPPS Rate,64.41,100% of CMS OPPS Rate,64.41,100% of CMS OPPS Rate,64.41,100% of CMS OPPS Rate,64.41,100% of CMS OPPS Rate,64.41,100% of CMS OPPS Rate,22.81,391.23,260.82
Outpatient,Laboratory,82746,FOLATE FOLIC ACID SERUM,300,153.9,52.03,354% of CMS OPPS Rate,14.7,100% of Medicaid LA Fee Schedule,14.7,100% of CMS OPPS Rate,14.7,100% of CMS OPPS Rate,37.01,203.89% of BCBS Fee Schedule,107.73,70% of total Billed Charges,115.43,75% of total Billed Charges,26.46,180% OF CMS OPPS RATE,123.12,80% of total Billed Charges,51.45,350% of CMS Opps rate,14.99,102% of CMS Opps rate,117.73,76.5% of total billed charges,14.7,100% of Medicaid LA Fee Schedule,14.7,100% of Medicaid LA Fee Schedule,14.7,100% of CMS OPPS Rate,14.7,100% of CMS OPPS Rate,69.26,45% of total billed charges,107.73,70% of total billed charges,92.34,60% of total billed charges,14.7,100% of CMS OPPS Rate,16.34,90% OF UHC FEE SCHEDULE,107.73,70% of total billed charges,14.7,100% OF CMS OPPS Rate,33.81,230% OF CMS OPPS Rate,73.87,48% of total Billed charges,14.7,100% OF CMS OPPS Rate,138.51,90% of total Billed charges,14.7,100% of Medicaid LA Fee Schedule,14.7,100% of Medicaid LA Fee Schedule,14.7,100% of Medicaid LA Fee Schedule,14.7,100% of Medicaid LA Fee Schedule,14.7,100% of Medicaid LA Fee Schedule,14.7,100% of Medicaid LA Fee Schedule,14.7,100% of CMS OPPS Rate,14.7,100% of CMS OPPS Rate,14.7,100% of CMS OPPS Rate,14.7,100% of CMS OPPS Rate,14.7,100% of CMS OPPS Rate,14.7,100% of CMS OPPS Rate,14.7,100% of CMS OPPS Rate,14.7,100% of CMS OPPS Rate,14.7,138.51,92.34
Outpatient,Laboratory,82747,FOLATE RBC,300,90.5,62.48,354% of CMS OPPS Rate,17.65,100% of Medicaid LA Fee Schedule,17.64,100% of CMS OPPS Rate,17.64,100% of CMS OPPS Rate,43.59,203.89% of BCBS Fee Schedule,63.35,70% of total Billed Charges,67.88,75% of total Billed Charges,31.76,180% OF CMS OPPS RATE,72.4,80% of total Billed Charges,61.77,350% of CMS Opps rate,18,102% of CMS Opps rate,69.23,76.5% of total billed charges,17.65,100% of Medicaid LA Fee Schedule,17.65,100% of Medicaid LA Fee Schedule,17.64,100% of CMS OPPS Rate,17.64,100% of CMS OPPS Rate,40.73,45% of total billed charges,63.35,70% of total billed charges,54.3,60% of total billed charges,17.64,100% of CMS OPPS Rate,19.24,90% OF UHC FEE SCHEDULE,63.35,70% of total billed charges,17.64,100% OF CMS OPPS Rate,40.59,230% OF CMS OPPS Rate,43.44,48% of total Billed charges,17.64,100% OF CMS OPPS Rate,81.45,90% of total Billed charges,17.65,100% of Medicaid LA Fee Schedule,17.65,100% of Medicaid LA Fee Schedule,17.65,100% of Medicaid LA Fee Schedule,17.65,100% of Medicaid LA Fee Schedule,17.65,100% of Medicaid LA Fee Schedule,17.65,100% of Medicaid LA Fee Schedule,17.64,100% of CMS OPPS Rate,17.64,100% of CMS OPPS Rate,17.64,100% of CMS OPPS Rate,17.64,100% of CMS OPPS Rate,17.64,100% of CMS OPPS Rate,17.64,100% of CMS OPPS Rate,17.64,100% of CMS OPPS Rate,17.64,100% of CMS OPPS Rate,17.64,81.45,54.3
Outpatient,Laboratory,82775,GALACTOSE 1 PHOSPHATE QUANT,300,393.4,74.58,354% of CMS OPPS Rate,21.07,100% of Medicaid LA Fee Schedule,21.07,100% of CMS OPPS Rate,21.07,100% of CMS OPPS Rate,53.03,203.89% of BCBS Fee Schedule,275.38,70% of total Billed Charges,295.05,75% of total Billed Charges,37.92,180% OF CMS OPPS RATE,314.72,80% of total Billed Charges,73.74,350% of CMS Opps rate,21.49,102% of CMS Opps rate,300.95,76.5% of total billed charges,21.07,100% of Medicaid LA Fee Schedule,21.07,100% of Medicaid LA Fee Schedule,21.07,100% of CMS OPPS Rate,21.07,100% of CMS OPPS Rate,177.03,45% of total billed charges,275.38,70% of total billed charges,236.04,60% of total billed charges,21.07,100% of CMS OPPS Rate,23.41,90% OF UHC FEE SCHEDULE,275.38,70% of total billed charges,21.07,100% OF CMS OPPS Rate,48.46,230% OF CMS OPPS Rate,188.83,48% of total Billed charges,21.07,100% OF CMS OPPS Rate,354.06,90% of total Billed charges,21.07,100% of Medicaid LA Fee Schedule,21.07,100% of Medicaid LA Fee Schedule,21.07,100% of Medicaid LA Fee Schedule,21.07,100% of Medicaid LA Fee Schedule,21.07,100% of Medicaid LA Fee Schedule,21.07,100% of Medicaid LA Fee Schedule,21.07,100% of CMS OPPS Rate,21.07,100% of CMS OPPS Rate,21.07,100% of CMS OPPS Rate,21.07,100% of CMS OPPS Rate,21.07,100% of CMS OPPS Rate,21.07,100% of CMS OPPS Rate,21.07,100% of CMS OPPS Rate,21.07,100% of CMS OPPS Rate,21.07,354.06,236.04
Outpatient,Laboratory,82784,Test to determine levels of immunoglobulins in the blood,300,28,32.92,354% of CMS OPPS Rate,9.3,100% of Medicaid LA Fee Schedule,9.3,100% of CMS OPPS Rate,9.3,100% of CMS OPPS Rate,23.41,203.89% of BCBS Fee Schedule,19.6,70% of total Billed Charges,21,75% of total Billed Charges,16.74,180% OF CMS OPPS RATE,22.4,80% of total Billed Charges,32.55,350% of CMS Opps rate,9.48,102% of CMS Opps rate,21.42,76.5% of total billed charges,9.3,100% of Medicaid LA Fee Schedule,9.3,100% of Medicaid LA Fee Schedule,9.3,100% of CMS OPPS Rate,9.3,100% of CMS OPPS Rate,12.6,45% of total billed charges,19.6,70% of total billed charges,16.8,60% of total billed charges,9.3,100% of CMS OPPS Rate,10.33,90% OF UHC FEE SCHEDULE,19.6,70% of total billed charges,9.3,100% OF CMS OPPS Rate,21.39,230% OF CMS OPPS Rate,13.44,48% of total Billed charges,9.3,100% OF CMS OPPS Rate,25.2,90% of total Billed charges,9.3,100% of Medicaid LA Fee Schedule,9.3,100% of Medicaid LA Fee Schedule,9.3,100% of Medicaid LA Fee Schedule,9.3,100% of Medicaid LA Fee Schedule,9.3,100% of Medicaid LA Fee Schedule,9.3,100% of Medicaid LA Fee Schedule,9.3,100% of CMS OPPS Rate,9.3,100% of CMS OPPS Rate,9.3,100% of CMS OPPS Rate,9.3,100% of CMS OPPS Rate,9.3,100% of CMS OPPS Rate,9.3,100% of CMS OPPS Rate,9.3,100% of CMS OPPS Rate,9.3,100% of CMS OPPS Rate,9.3,32.92,16.8
Outpatient,Laboratory,82785,IGE-IMMUNOGLOBULIN E,300,57.75,58.26,354% of CMS OPPS Rate,16.46,100% of Medicaid LA Fee Schedule,16.46,100% of CMS OPPS Rate,16.46,100% of CMS OPPS Rate,41.43,203.89% of BCBS Fee Schedule,40.43,70% of total Billed Charges,43.31,75% of total Billed Charges,29.62,180% OF CMS OPPS RATE,46.2,80% of total Billed Charges,57.61,350% of CMS Opps rate,16.78,102% of CMS Opps rate,44.18,76.5% of total billed charges,16.46,100% of Medicaid LA Fee Schedule,16.46,100% of Medicaid LA Fee Schedule,16.46,100% of CMS OPPS Rate,16.46,100% of CMS OPPS Rate,25.99,45% of total billed charges,40.43,70% of total billed charges,34.65,60% of total billed charges,16.46,100% of CMS OPPS Rate,18.29,90% OF UHC FEE SCHEDULE,40.43,70% of total billed charges,16.46,100% OF CMS OPPS Rate,37.85,230% OF CMS OPPS Rate,27.72,48% of total Billed charges,16.46,100% OF CMS OPPS Rate,51.98,90% of total Billed charges,16.46,100% of Medicaid LA Fee Schedule,16.46,100% of Medicaid LA Fee Schedule,16.46,100% of Medicaid LA Fee Schedule,16.46,100% of Medicaid LA Fee Schedule,16.46,100% of Medicaid LA Fee Schedule,16.46,100% of Medicaid LA Fee Schedule,16.46,100% of CMS OPPS Rate,16.46,100% of CMS OPPS Rate,16.46,100% of CMS OPPS Rate,16.46,100% of CMS OPPS Rate,16.46,100% of CMS OPPS Rate,16.46,100% of CMS OPPS Rate,16.46,100% of CMS OPPS Rate,16.46,100% of CMS OPPS Rate,16.46,58.26,34.65
Outpatient,Laboratory,82787,IGG SUBCLASS,300,93.5,28.39,354% of CMS OPPS Rate,6.75,100% of Medicaid LA Fee Schedule,8.02,100% of CMS OPPS Rate,8.02,100% of CMS OPPS Rate,20.19,203.89% of BCBS Fee Schedule,65.45,70% of total Billed Charges,70.13,75% of total Billed Charges,14.43,180% OF CMS OPPS RATE,74.8,80% of total Billed Charges,28.07,350% of CMS Opps rate,8.18,102% of CMS Opps rate,71.53,76.5% of total billed charges,6.75,100% of Medicaid LA Fee Schedule,6.75,100% of Medicaid LA Fee Schedule,8.02,100% of CMS OPPS Rate,8.02,100% of CMS OPPS Rate,42.08,45% of total billed charges,65.45,70% of total billed charges,56.1,60% of total billed charges,8.02,100% of CMS OPPS Rate,8.91,90% OF UHC FEE SCHEDULE,65.45,70% of total billed charges,8.02,100% OF CMS OPPS Rate,18.44,230% OF CMS OPPS Rate,44.88,48% of total Billed charges,8.02,100% OF CMS OPPS Rate,84.15,90% of total Billed charges,6.75,100% of Medicaid LA Fee Schedule,6.75,100% of Medicaid LA Fee Schedule,6.75,100% of Medicaid LA Fee Schedule,6.75,100% of Medicaid LA Fee Schedule,6.75,100% of Medicaid LA Fee Schedule,6.75,100% of Medicaid LA Fee Schedule,8.02,100% of CMS OPPS Rate,8.02,100% of CMS OPPS Rate,8.02,100% of CMS OPPS Rate,8.02,100% of CMS OPPS Rate,8.02,100% of CMS OPPS Rate,8.02,100% of CMS OPPS Rate,8.02,100% of CMS OPPS Rate,8.02,100% of CMS OPPS Rate,6.75,84.15,56.1
Outpatient,Laboratory,82941,GASTRIN,300,138,62.41,354% of CMS OPPS Rate,17.63,100% of Medicaid LA Fee Schedule,17.63,100% of CMS OPPS Rate,17.63,100% of CMS OPPS Rate,44.39,203.89% of BCBS Fee Schedule,96.6,70% of total Billed Charges,103.5,75% of total Billed Charges,31.73,180% OF CMS OPPS RATE,110.4,80% of total Billed Charges,61.7,350% of CMS Opps rate,17.98,102% of CMS Opps rate,105.57,76.5% of total billed charges,17.63,100% of Medicaid LA Fee Schedule,17.63,100% of Medicaid LA Fee Schedule,17.63,100% of CMS OPPS Rate,17.63,100% of CMS OPPS Rate,62.1,45% of total billed charges,96.6,70% of total billed charges,82.8,60% of total billed charges,17.63,100% of CMS OPPS Rate,19.59,90% OF UHC FEE SCHEDULE,96.6,70% of total billed charges,17.63,100% OF CMS OPPS Rate,40.54,230% OF CMS OPPS Rate,66.24,48% of total Billed charges,17.63,100% OF CMS OPPS Rate,124.2,90% of total Billed charges,17.63,100% of Medicaid LA Fee Schedule,17.63,100% of Medicaid LA Fee Schedule,17.63,100% of Medicaid LA Fee Schedule,17.63,100% of Medicaid LA Fee Schedule,17.63,100% of Medicaid LA Fee Schedule,17.63,100% of Medicaid LA Fee Schedule,17.63,100% of CMS OPPS Rate,17.63,100% of CMS OPPS Rate,17.63,100% of CMS OPPS Rate,17.63,100% of CMS OPPS Rate,17.63,100% of CMS OPPS Rate,17.63,100% of CMS OPPS Rate,17.63,100% of CMS OPPS Rate,17.63,100% of CMS OPPS Rate,17.63,124.2,82.8
Outpatient,Laboratory,82943,GLUCAGON,300,242,50.58,354% of CMS OPPS Rate,14.29,100% of Medicaid LA Fee Schedule,14.29,100% of CMS OPPS Rate,14.29,100% of CMS OPPS Rate,35.97,203.89% of BCBS Fee Schedule,169.4,70% of total Billed Charges,181.5,75% of total Billed Charges,25.72,180% OF CMS OPPS RATE,193.6,80% of total Billed Charges,50.01,350% of CMS Opps rate,14.57,102% of CMS Opps rate,185.13,76.5% of total billed charges,14.29,100% of Medicaid LA Fee Schedule,14.29,100% of Medicaid LA Fee Schedule,14.29,100% of CMS OPPS Rate,14.29,100% of CMS OPPS Rate,108.9,45% of total billed charges,169.4,70% of total billed charges,145.2,60% of total billed charges,14.29,100% of CMS OPPS Rate,15.88,90% OF UHC FEE SCHEDULE,169.4,70% of total billed charges,14.29,100% OF CMS OPPS Rate,32.86,230% OF CMS OPPS Rate,116.16,48% of total Billed charges,14.29,100% OF CMS OPPS Rate,217.8,90% of total Billed charges,14.29,100% of Medicaid LA Fee Schedule,14.29,100% of Medicaid LA Fee Schedule,14.29,100% of Medicaid LA Fee Schedule,14.29,100% of Medicaid LA Fee Schedule,14.29,100% of Medicaid LA Fee Schedule,14.29,100% of Medicaid LA Fee Schedule,14.29,100% of CMS OPPS Rate,14.29,100% of CMS OPPS Rate,14.29,100% of CMS OPPS Rate,14.29,100% of CMS OPPS Rate,14.29,100% of CMS OPPS Rate,14.29,100% of CMS OPPS Rate,14.29,100% of CMS OPPS Rate,14.29,100% of CMS OPPS Rate,14.29,217.8,145.2
Outpatient,Laboratory,82945,GLUCOSE MISC SPECIMEN,300,124.65,13.91,354% of CMS OPPS Rate,3.93,100% of Medicaid LA Fee Schedule,3.93,100% of CMS OPPS Rate,3.93,100% of CMS OPPS Rate,9.89,203.89% of BCBS Fee Schedule,87.26,70% of total Billed Charges,93.49,75% of total Billed Charges,7.07,180% OF CMS OPPS RATE,99.72,80% of total Billed Charges,13.75,350% of CMS Opps rate,4,102% of CMS Opps rate,95.36,76.5% of total billed charges,3.93,100% of Medicaid LA Fee Schedule,3.93,100% of Medicaid LA Fee Schedule,3.93,100% of CMS OPPS Rate,3.93,100% of CMS OPPS Rate,56.09,45% of total billed charges,87.26,70% of total billed charges,74.79,60% of total billed charges,3.93,100% of CMS OPPS Rate,4.37,90% OF UHC FEE SCHEDULE,87.26,70% of total billed charges,3.93,100% OF CMS OPPS Rate,9.03,230% OF CMS OPPS Rate,59.83,48% of total Billed charges,3.93,100% OF CMS OPPS Rate,112.19,90% of total Billed charges,3.93,100% of Medicaid LA Fee Schedule,3.93,100% of Medicaid LA Fee Schedule,3.93,100% of Medicaid LA Fee Schedule,3.93,100% of Medicaid LA Fee Schedule,3.93,100% of Medicaid LA Fee Schedule,3.93,100% of Medicaid LA Fee Schedule,3.93,100% of CMS OPPS Rate,3.93,100% of CMS OPPS Rate,3.93,100% of CMS OPPS Rate,3.93,100% of CMS OPPS Rate,3.93,100% of CMS OPPS Rate,3.93,100% of CMS OPPS Rate,3.93,100% of CMS OPPS Rate,3.93,100% of CMS OPPS Rate,3.93,112.19,74.79
Outpatient,Laboratory,82948,GLUCOSE BLOOD REAGENT STRIP,300,28.6,17.84,354% of CMS OPPS Rate,4.07,100% of Medicaid LA Fee Schedule,5.04,100% of CMS OPPS Rate,5.04,100% of CMS OPPS Rate,10.28,203.89% of BCBS Fee Schedule,20.02,70% of total Billed Charges,21.45,75% of total Billed Charges,9.07,180% OF CMS OPPS RATE,22.88,80% of total Billed Charges,17.64,350% of CMS Opps rate,5.14,102% of CMS Opps rate,21.88,76.5% of total billed charges,4.07,100% of Medicaid LA Fee Schedule,4.07,100% of Medicaid LA Fee Schedule,5.04,100% of CMS OPPS Rate,5.04,100% of CMS OPPS Rate,12.87,45% of total billed charges,20.02,70% of total billed charges,17.16,60% of total billed charges,5.04,100% of CMS OPPS Rate,4.54,90% OF UHC FEE SCHEDULE,20.02,70% of total billed charges,5.04,100% OF CMS OPPS Rate,11.59,230% OF CMS OPPS Rate,13.73,48% of total Billed charges,5.04,100% OF CMS OPPS Rate,25.74,90% of total Billed charges,4.07,100% of Medicaid LA Fee Schedule,4.07,100% of Medicaid LA Fee Schedule,4.07,100% of Medicaid LA Fee Schedule,4.07,100% of Medicaid LA Fee Schedule,4.07,100% of Medicaid LA Fee Schedule,4.07,100% of Medicaid LA Fee Schedule,5.04,100% of CMS OPPS Rate,5.04,100% of CMS OPPS Rate,5.04,100% of CMS OPPS Rate,5.04,100% of CMS OPPS Rate,5.04,100% of CMS OPPS Rate,5.04,100% of CMS OPPS Rate,5.04,100% of CMS OPPS Rate,5.04,100% of CMS OPPS Rate,4.07,25.74,17.16
Outpatient,Laboratory,82950,Test of glucose level in the blood,300,138.6,16.81,354% of CMS OPPS Rate,4.75,100% of Medicaid LA Fee Schedule,4.75,100% of CMS OPPS Rate,4.75,100% of CMS OPPS Rate,11.95,203.89% of BCBS Fee Schedule,97.02,70% of total Billed Charges,103.95,75% of total Billed Charges,8.55,180% OF CMS OPPS RATE,110.88,80% of total Billed Charges,16.62,350% of CMS Opps rate,4.84,102% of CMS Opps rate,106.03,76.5% of total billed charges,4.75,100% of Medicaid LA Fee Schedule,4.75,100% of Medicaid LA Fee Schedule,4.75,100% of CMS OPPS Rate,4.75,100% of CMS OPPS Rate,62.37,45% of total billed charges,97.02,70% of total billed charges,83.16,60% of total billed charges,4.75,100% of CMS OPPS Rate,5.27,90% OF UHC FEE SCHEDULE,97.02,70% of total billed charges,4.75,100% OF CMS OPPS Rate,10.92,230% OF CMS OPPS Rate,66.53,48% of total Billed charges,4.75,100% OF CMS OPPS Rate,124.74,90% of total Billed charges,4.75,100% of Medicaid LA Fee Schedule,4.75,100% of Medicaid LA Fee Schedule,4.75,100% of Medicaid LA Fee Schedule,4.75,100% of Medicaid LA Fee Schedule,4.75,100% of Medicaid LA Fee Schedule,4.75,100% of Medicaid LA Fee Schedule,4.75,100% of CMS OPPS Rate,4.75,100% of CMS OPPS Rate,4.75,100% of CMS OPPS Rate,4.75,100% of CMS OPPS Rate,4.75,100% of CMS OPPS Rate,4.75,100% of CMS OPPS Rate,4.75,100% of CMS OPPS Rate,4.75,100% of CMS OPPS Rate,4.75,124.74,83.16
Outpatient,Laboratory,82951,Test to predict likelihood of gestational diabetes,300,121.05,45.55,354% of CMS OPPS Rate,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,32.4,203.89% of BCBS Fee Schedule,84.74,70% of total Billed Charges,90.79,75% of total Billed Charges,23.16,180% OF CMS OPPS RATE,96.84,80% of total Billed Charges,45.04,350% of CMS Opps rate,13.12,102% of CMS Opps rate,92.6,76.5% of total billed charges,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,54.47,45% of total billed charges,84.74,70% of total billed charges,72.63,60% of total billed charges,12.87,100% of CMS OPPS Rate,14.3,90% OF UHC FEE SCHEDULE,84.74,70% of total billed charges,12.87,100% OF CMS OPPS Rate,29.6,230% OF CMS OPPS Rate,58.1,48% of total Billed charges,12.87,100% OF CMS OPPS Rate,108.95,90% of total Billed charges,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,12.87,108.95,72.63
Outpatient,Laboratory,82952,GTT-GLUC AFTER 3 SPECIMENS,300,47.25,13.87,354% of CMS OPPS Rate,3.92,100% of Medicaid LA Fee Schedule,3.92,100% of CMS OPPS Rate,3.92,100% of CMS OPPS Rate,9.87,203.89% of BCBS Fee Schedule,33.08,70% of total Billed Charges,35.44,75% of total Billed Charges,7.05,180% OF CMS OPPS RATE,37.8,80% of total Billed Charges,13.72,350% of CMS Opps rate,3.99,102% of CMS Opps rate,36.15,76.5% of total billed charges,3.92,100% of Medicaid LA Fee Schedule,3.92,100% of Medicaid LA Fee Schedule,3.92,100% of CMS OPPS Rate,3.92,100% of CMS OPPS Rate,21.26,45% of total billed charges,33.08,70% of total billed charges,28.35,60% of total billed charges,3.92,100% of CMS OPPS Rate,4.36,90% OF UHC FEE SCHEDULE,33.08,70% of total billed charges,3.92,100% OF CMS OPPS Rate,9.01,230% OF CMS OPPS Rate,22.68,48% of total Billed charges,3.92,100% OF CMS OPPS Rate,42.53,90% of total Billed charges,3.92,100% of Medicaid LA Fee Schedule,3.92,100% of Medicaid LA Fee Schedule,3.92,100% of Medicaid LA Fee Schedule,3.92,100% of Medicaid LA Fee Schedule,3.92,100% of Medicaid LA Fee Schedule,3.92,100% of Medicaid LA Fee Schedule,3.92,100% of CMS OPPS Rate,3.92,100% of CMS OPPS Rate,3.92,100% of CMS OPPS Rate,3.92,100% of CMS OPPS Rate,3.92,100% of CMS OPPS Rate,3.92,100% of CMS OPPS Rate,3.92,100% of CMS OPPS Rate,3.92,100% of CMS OPPS Rate,3.92,42.53,28.35
Outpatient,Laboratory,82955,G6PD (QUANTITATIVE),300,115.5,34.33,354% of CMS OPPS Rate,9.7,100% of Medicaid LA Fee Schedule,9.69,100% of CMS OPPS Rate,9.69,100% of CMS OPPS Rate,24.41,203.89% of BCBS Fee Schedule,80.85,70% of total Billed Charges,86.63,75% of total Billed Charges,17.45,180% OF CMS OPPS RATE,92.4,80% of total Billed Charges,33.94,350% of CMS Opps rate,9.89,102% of CMS Opps rate,88.36,76.5% of total billed charges,9.7,100% of Medicaid LA Fee Schedule,9.7,100% of Medicaid LA Fee Schedule,9.69,100% of CMS OPPS Rate,9.69,100% of CMS OPPS Rate,51.98,45% of total billed charges,80.85,70% of total billed charges,69.3,60% of total billed charges,9.69,100% of CMS OPPS Rate,10.77,90% OF UHC FEE SCHEDULE,80.85,70% of total billed charges,9.69,100% OF CMS OPPS Rate,22.31,230% OF CMS OPPS Rate,55.44,48% of total Billed charges,9.69,100% OF CMS OPPS Rate,103.95,90% of total Billed charges,9.7,100% of Medicaid LA Fee Schedule,9.7,100% of Medicaid LA Fee Schedule,9.7,100% of Medicaid LA Fee Schedule,9.7,100% of Medicaid LA Fee Schedule,9.7,100% of Medicaid LA Fee Schedule,9.7,100% of Medicaid LA Fee Schedule,9.69,100% of CMS OPPS Rate,9.69,100% of CMS OPPS Rate,9.69,100% of CMS OPPS Rate,9.69,100% of CMS OPPS Rate,9.69,100% of CMS OPPS Rate,9.69,100% of CMS OPPS Rate,9.69,100% of CMS OPPS Rate,9.69,100% of CMS OPPS Rate,9.69,103.95,69.3
Outpatient,Laboratory,82977,GGT GAMMA GLUTAM TRNSFRS SERUM,300,152.1,25.48,354% of CMS OPPS Rate,7.2,100% of Medicaid LA Fee Schedule,7.2,100% of CMS OPPS Rate,7.2,100% of CMS OPPS Rate,18.13,203.89% of BCBS Fee Schedule,106.47,70% of total Billed Charges,114.08,75% of total Billed Charges,12.96,180% OF CMS OPPS RATE,121.68,80% of total Billed Charges,25.2,350% of CMS Opps rate,7.34,102% of CMS Opps rate,116.36,76.5% of total billed charges,7.2,100% of Medicaid LA Fee Schedule,7.2,100% of Medicaid LA Fee Schedule,7.2,100% of CMS OPPS Rate,7.2,100% of CMS OPPS Rate,68.45,45% of total billed charges,106.47,70% of total billed charges,91.26,60% of total billed charges,7.2,100% of CMS OPPS Rate,8,90% OF UHC FEE SCHEDULE,106.47,70% of total billed charges,7.2,100% OF CMS OPPS Rate,16.56,230% OF CMS OPPS Rate,73.01,48% of total Billed charges,7.2,100% OF CMS OPPS Rate,136.89,90% of total Billed charges,7.2,100% of Medicaid LA Fee Schedule,7.2,100% of Medicaid LA Fee Schedule,7.2,100% of Medicaid LA Fee Schedule,7.2,100% of Medicaid LA Fee Schedule,7.2,100% of Medicaid LA Fee Schedule,7.2,100% of Medicaid LA Fee Schedule,7.2,100% of CMS OPPS Rate,7.2,100% of CMS OPPS Rate,7.2,100% of CMS OPPS Rate,7.2,100% of CMS OPPS Rate,7.2,100% of CMS OPPS Rate,7.2,100% of CMS OPPS Rate,7.2,100% of CMS OPPS Rate,7.2,100% of CMS OPPS Rate,7.2,136.89,91.26
Outpatient,Laboratory,82978,GLUTATHIONE,300,97.26,54.69,354% of CMS OPPS Rate,15.45,100% of Medicaid LA Fee Schedule,15.45,100% of CMS OPPS Rate,15.45,100% of CMS OPPS Rate,35.88,203.89% of BCBS Fee Schedule,68.08,70% of total Billed Charges,72.95,75% of total Billed Charges,27.81,180% OF CMS OPPS RATE,77.81,80% of total Billed Charges,54.07,350% of CMS Opps rate,15.75,102% of CMS Opps rate,74.4,76.5% of total billed charges,15.45,100% of Medicaid LA Fee Schedule,15.45,100% of Medicaid LA Fee Schedule,15.45,100% of CMS OPPS Rate,15.45,100% of CMS OPPS Rate,43.77,45% of total billed charges,68.08,70% of total billed charges,58.36,60% of total billed charges,15.45,100% of CMS OPPS Rate,15.84,90% OF UHC FEE SCHEDULE,68.08,70% of total billed charges,15.45,100% OF CMS OPPS Rate,35.53,230% OF CMS OPPS Rate,46.68,48% of total Billed charges,15.45,100% OF CMS OPPS Rate,87.53,90% of total Billed charges,15.45,100% of Medicaid LA Fee Schedule,15.45,100% of Medicaid LA Fee Schedule,15.45,100% of Medicaid LA Fee Schedule,15.45,100% of Medicaid LA Fee Schedule,15.45,100% of Medicaid LA Fee Schedule,15.45,100% of Medicaid LA Fee Schedule,15.45,100% of CMS OPPS Rate,15.45,100% of CMS OPPS Rate,15.45,100% of CMS OPPS Rate,15.45,100% of CMS OPPS Rate,15.45,100% of CMS OPPS Rate,15.45,100% of CMS OPPS Rate,15.45,100% of CMS OPPS Rate,15.45,100% of CMS OPPS Rate,15.45,87.53,58.36
Outpatient,Laboratory,82985,FRUCTOSAMINE,300,49.5,59.33,354% of CMS OPPS Rate,16.76,100% of Medicaid LA Fee Schedule,16.76,100% of CMS OPPS Rate,16.76,100% of CMS OPPS Rate,37.94,203.89% of BCBS Fee Schedule,34.65,70% of total Billed Charges,37.13,75% of total Billed Charges,30.16,180% OF CMS OPPS RATE,39.6,80% of total Billed Charges,58.66,350% of CMS Opps rate,17.09,102% of CMS Opps rate,37.87,76.5% of total billed charges,16.76,100% of Medicaid LA Fee Schedule,16.76,100% of Medicaid LA Fee Schedule,16.76,100% of CMS OPPS Rate,16.76,100% of CMS OPPS Rate,22.28,45% of total billed charges,34.65,70% of total billed charges,29.7,60% of total billed charges,16.76,100% of CMS OPPS Rate,16.75,90% OF UHC FEE SCHEDULE,34.65,70% of total billed charges,16.76,100% OF CMS OPPS Rate,38.54,230% OF CMS OPPS Rate,23.76,48% of total Billed charges,16.76,100% OF CMS OPPS Rate,44.55,90% of total Billed charges,16.76,100% of Medicaid LA Fee Schedule,16.76,100% of Medicaid LA Fee Schedule,16.76,100% of Medicaid LA Fee Schedule,16.76,100% of Medicaid LA Fee Schedule,16.76,100% of Medicaid LA Fee Schedule,16.76,100% of Medicaid LA Fee Schedule,16.76,100% of CMS OPPS Rate,16.76,100% of CMS OPPS Rate,16.76,100% of CMS OPPS Rate,16.76,100% of CMS OPPS Rate,16.76,100% of CMS OPPS Rate,16.76,100% of CMS OPPS Rate,16.76,100% of CMS OPPS Rate,16.76,100% of CMS OPPS Rate,16.75,59.33,29.7
Outpatient,Laboratory,83001,Test of hormone in the blood,300,113.3,65.77,354% of CMS OPPS Rate,18.58,100% of Medicaid LA Fee Schedule,18.57,100% of CMS OPPS Rate,18.57,100% of CMS OPPS Rate,46.77,203.89% of BCBS Fee Schedule,79.31,70% of total Billed Charges,84.98,75% of total Billed Charges,33.44,180% OF CMS OPPS RATE,90.64,80% of total Billed Charges,65.02,350% of CMS Opps rate,18.95,102% of CMS Opps rate,86.67,76.5% of total billed charges,18.58,100% of Medicaid LA Fee Schedule,18.58,100% of Medicaid LA Fee Schedule,18.57,100% of CMS OPPS Rate,18.57,100% of CMS OPPS Rate,50.99,45% of total billed charges,79.31,70% of total billed charges,67.98,60% of total billed charges,18.57,100% of CMS OPPS Rate,20.65,90% OF UHC FEE SCHEDULE,79.31,70% of total billed charges,18.57,100% OF CMS OPPS Rate,42.73,230% OF CMS OPPS Rate,54.38,48% of total Billed charges,18.57,100% OF CMS OPPS Rate,101.97,90% of total Billed charges,18.58,100% of Medicaid LA Fee Schedule,18.58,100% of Medicaid LA Fee Schedule,18.58,100% of Medicaid LA Fee Schedule,18.58,100% of Medicaid LA Fee Schedule,18.58,100% of Medicaid LA Fee Schedule,18.58,100% of Medicaid LA Fee Schedule,18.57,100% of CMS OPPS Rate,18.57,100% of CMS OPPS Rate,18.57,100% of CMS OPPS Rate,18.57,100% of CMS OPPS Rate,18.57,100% of CMS OPPS Rate,18.57,100% of CMS OPPS Rate,18.57,100% of CMS OPPS Rate,18.57,100% of CMS OPPS Rate,18.57,101.97,67.98
Outpatient,Laboratory,83002,Test of hormone in the blood,300,113.3,65.56,354% of CMS OPPS Rate,18.52,100% of Medicaid LA Fee Schedule,18.52,100% of CMS OPPS Rate,18.52,100% of CMS OPPS Rate,46.61,203.89% of BCBS Fee Schedule,79.31,70% of total Billed Charges,84.98,75% of total Billed Charges,33.33,180% OF CMS OPPS RATE,90.64,80% of total Billed Charges,64.82,350% of CMS Opps rate,18.89,102% of CMS Opps rate,86.67,76.5% of total billed charges,18.52,100% of Medicaid LA Fee Schedule,18.52,100% of Medicaid LA Fee Schedule,18.52,100% of CMS OPPS Rate,18.52,100% of CMS OPPS Rate,50.99,45% of total billed charges,79.31,70% of total billed charges,67.98,60% of total billed charges,18.52,100% of CMS OPPS Rate,20.57,90% OF UHC FEE SCHEDULE,79.31,70% of total billed charges,18.52,100% OF CMS OPPS Rate,42.59,230% OF CMS OPPS Rate,54.38,48% of total Billed charges,18.52,100% OF CMS OPPS Rate,101.97,90% of total Billed charges,18.52,100% of Medicaid LA Fee Schedule,18.52,100% of Medicaid LA Fee Schedule,18.52,100% of Medicaid LA Fee Schedule,18.52,100% of Medicaid LA Fee Schedule,18.52,100% of Medicaid LA Fee Schedule,18.52,100% of Medicaid LA Fee Schedule,18.52,100% of CMS OPPS Rate,18.52,100% of CMS OPPS Rate,18.52,100% of CMS OPPS Rate,18.52,100% of CMS OPPS Rate,18.52,100% of CMS OPPS Rate,18.52,100% of CMS OPPS Rate,18.52,100% of CMS OPPS Rate,18.52,100% of CMS OPPS Rate,18.52,101.97,67.98
Outpatient,Laboratory,83003,GROWTH HORMONE,300,131.5,59.01,354% of CMS OPPS Rate,16.67,100% of Medicaid LA Fee Schedule,16.67,100% of CMS OPPS Rate,16.67,100% of CMS OPPS Rate,41.96,203.89% of BCBS Fee Schedule,92.05,70% of total Billed Charges,98.63,75% of total Billed Charges,30,180% OF CMS OPPS RATE,105.2,80% of total Billed Charges,58.34,350% of CMS Opps rate,17,102% of CMS Opps rate,100.6,76.5% of total billed charges,16.67,100% of Medicaid LA Fee Schedule,16.67,100% of Medicaid LA Fee Schedule,16.67,100% of CMS OPPS Rate,16.67,100% of CMS OPPS Rate,59.18,45% of total billed charges,92.05,70% of total billed charges,78.9,60% of total billed charges,16.67,100% of CMS OPPS Rate,18.52,90% OF UHC FEE SCHEDULE,92.05,70% of total billed charges,16.67,100% OF CMS OPPS Rate,38.34,230% OF CMS OPPS Rate,63.12,48% of total Billed charges,16.67,100% OF CMS OPPS Rate,118.35,90% of total Billed charges,16.67,100% of Medicaid LA Fee Schedule,16.67,100% of Medicaid LA Fee Schedule,16.67,100% of Medicaid LA Fee Schedule,16.67,100% of Medicaid LA Fee Schedule,16.67,100% of Medicaid LA Fee Schedule,16.67,100% of Medicaid LA Fee Schedule,16.67,100% of CMS OPPS Rate,16.67,100% of CMS OPPS Rate,16.67,100% of CMS OPPS Rate,16.67,100% of CMS OPPS Rate,16.67,100% of CMS OPPS Rate,16.67,100% of CMS OPPS Rate,16.67,100% of CMS OPPS Rate,16.67,100% of CMS OPPS Rate,16.67,118.35,78.9
Outpatient,Laboratory,83010,"HAPTOGLOBIN,SERUM",300,103.95,44.53,354% of CMS OPPS Rate,12.58,100% of Medicaid LA Fee Schedule,12.58,100% of CMS OPPS Rate,12.58,100% of CMS OPPS Rate,31.66,203.89% of BCBS Fee Schedule,72.77,70% of total Billed Charges,77.96,75% of total Billed Charges,22.64,180% OF CMS OPPS RATE,83.16,80% of total Billed Charges,44.03,350% of CMS Opps rate,12.83,102% of CMS Opps rate,79.52,76.5% of total billed charges,12.58,100% of Medicaid LA Fee Schedule,12.58,100% of Medicaid LA Fee Schedule,12.58,100% of CMS OPPS Rate,12.58,100% of CMS OPPS Rate,46.78,45% of total billed charges,72.77,70% of total billed charges,62.37,60% of total billed charges,12.58,100% of CMS OPPS Rate,13.98,90% OF UHC FEE SCHEDULE,72.77,70% of total billed charges,12.58,100% OF CMS OPPS Rate,28.93,230% OF CMS OPPS Rate,49.9,48% of total Billed charges,12.58,100% OF CMS OPPS Rate,93.56,90% of total Billed charges,12.58,100% of Medicaid LA Fee Schedule,12.58,100% of Medicaid LA Fee Schedule,12.58,100% of Medicaid LA Fee Schedule,12.58,100% of Medicaid LA Fee Schedule,12.58,100% of Medicaid LA Fee Schedule,12.58,100% of Medicaid LA Fee Schedule,12.58,100% of CMS OPPS Rate,12.58,100% of CMS OPPS Rate,12.58,100% of CMS OPPS Rate,12.58,100% of CMS OPPS Rate,12.58,100% of CMS OPPS Rate,12.58,100% of CMS OPPS Rate,12.58,100% of CMS OPPS Rate,12.58,100% of CMS OPPS Rate,12.58,93.56,62.37
Outpatient,Laboratory,83018,HEAVY METAL: QUAN,300,165,77.73,354% of CMS OPPS Rate,10.36,100% of Medicaid LA Fee Schedule,21.96,100% of CMS OPPS Rate,21.96,100% of CMS OPPS Rate,55.29,203.89% of BCBS Fee Schedule,115.5,70% of total Billed Charges,123.75,75% of total Billed Charges,39.52,180% OF CMS OPPS RATE,132,80% of total Billed Charges,76.86,350% of CMS Opps rate,22.39,102% of CMS Opps rate,126.23,76.5% of total billed charges,10.36,100% of Medicaid LA Fee Schedule,10.36,100% of Medicaid LA Fee Schedule,21.96,100% of CMS OPPS Rate,21.96,100% of CMS OPPS Rate,74.25,45% of total billed charges,115.5,70% of total billed charges,99,60% of total billed charges,21.96,100% of CMS OPPS Rate,24.41,90% OF UHC FEE SCHEDULE,115.5,70% of total billed charges,21.96,100% OF CMS OPPS Rate,50.5,230% OF CMS OPPS Rate,79.2,48% of total Billed charges,21.96,100% OF CMS OPPS Rate,148.5,90% of total Billed charges,10.36,100% of Medicaid LA Fee Schedule,10.36,100% of Medicaid LA Fee Schedule,10.36,100% of Medicaid LA Fee Schedule,10.36,100% of Medicaid LA Fee Schedule,10.36,100% of Medicaid LA Fee Schedule,10.36,100% of Medicaid LA Fee Schedule,21.96,100% of CMS OPPS Rate,21.96,100% of CMS OPPS Rate,21.96,100% of CMS OPPS Rate,21.96,100% of CMS OPPS Rate,21.96,100% of CMS OPPS Rate,21.96,100% of CMS OPPS Rate,21.96,100% of CMS OPPS Rate,21.96,100% of CMS OPPS Rate,10.36,148.5,99
Outpatient,Laboratory,83020,"HEMOGLOBIN ELECTROPH, BLD",300,192.6,45.55,354% of CMS OPPS Rate,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,32.4,203.89% of BCBS Fee Schedule,134.82,70% of total Billed Charges,144.45,75% of total Billed Charges,23.16,180% OF CMS OPPS RATE,154.08,80% of total Billed Charges,45.04,350% of CMS Opps rate,13.12,102% of CMS Opps rate,147.34,76.5% of total billed charges,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,86.67,45% of total billed charges,134.82,70% of total billed charges,115.56,60% of total billed charges,12.87,100% of CMS OPPS Rate,14.3,90% OF UHC FEE SCHEDULE,134.82,70% of total billed charges,12.87,100% OF CMS OPPS Rate,29.6,230% OF CMS OPPS Rate,92.45,48% of total Billed charges,12.87,100% OF CMS OPPS Rate,173.34,90% of total Billed charges,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,12.87,173.34,115.56
Outpatient,Laboratory,83021,HEMOGLOBIN FRACTION QUANT,300,64.35,63.93,354% of CMS OPPS Rate,18.06,100% of Medicaid LA Fee Schedule,18.05,100% of CMS OPPS Rate,18.05,100% of CMS OPPS Rate,45.45,203.89% of BCBS Fee Schedule,45.05,70% of total Billed Charges,48.26,75% of total Billed Charges,32.5,180% OF CMS OPPS RATE,51.48,80% of total Billed Charges,63.21,350% of CMS Opps rate,18.42,102% of CMS Opps rate,49.23,76.5% of total billed charges,18.06,100% of Medicaid LA Fee Schedule,18.06,100% of Medicaid LA Fee Schedule,18.05,100% of CMS OPPS Rate,18.05,100% of CMS OPPS Rate,28.96,45% of total billed charges,45.05,70% of total billed charges,38.61,60% of total billed charges,18.05,100% of CMS OPPS Rate,20.06,90% OF UHC FEE SCHEDULE,45.05,70% of total billed charges,18.05,100% OF CMS OPPS Rate,41.53,230% OF CMS OPPS Rate,30.89,48% of total Billed charges,18.05,100% OF CMS OPPS Rate,57.92,90% of total Billed charges,18.06,100% of Medicaid LA Fee Schedule,18.06,100% of Medicaid LA Fee Schedule,18.06,100% of Medicaid LA Fee Schedule,18.06,100% of Medicaid LA Fee Schedule,18.06,100% of Medicaid LA Fee Schedule,18.06,100% of Medicaid LA Fee Schedule,18.05,100% of CMS OPPS Rate,18.05,100% of CMS OPPS Rate,18.05,100% of CMS OPPS Rate,18.05,100% of CMS OPPS Rate,18.05,100% of CMS OPPS Rate,18.05,100% of CMS OPPS Rate,18.05,100% of CMS OPPS Rate,18.05,100% of CMS OPPS Rate,18.05,63.93,38.61
Outpatient,Laboratory,83036,Blood test to measure average blood glucose levels for past 2-3 months,300,187,34.37,354% of CMS OPPS Rate,9.71,100% of Medicaid LA Fee Schedule,9.71,100% of CMS OPPS Rate,9.71,100% of CMS OPPS Rate,24.45,203.89% of BCBS Fee Schedule,130.9,70% of total Billed Charges,140.25,75% of total Billed Charges,17.47,180% OF CMS OPPS RATE,149.6,80% of total Billed Charges,33.98,350% of CMS Opps rate,9.9,102% of CMS Opps rate,143.06,76.5% of total billed charges,9.71,100% of Medicaid LA Fee Schedule,9.71,100% of Medicaid LA Fee Schedule,9.71,100% of CMS OPPS Rate,9.71,100% of CMS OPPS Rate,84.15,45% of total billed charges,130.9,70% of total billed charges,112.2,60% of total billed charges,9.71,100% of CMS OPPS Rate,10.79,90% OF UHC FEE SCHEDULE,130.9,70% of total billed charges,9.71,100% OF CMS OPPS Rate,22.33,230% OF CMS OPPS Rate,89.76,48% of total Billed charges,9.71,100% OF CMS OPPS Rate,168.3,90% of total Billed charges,9.71,100% of Medicaid LA Fee Schedule,9.71,100% of Medicaid LA Fee Schedule,9.71,100% of Medicaid LA Fee Schedule,9.71,100% of Medicaid LA Fee Schedule,9.71,100% of Medicaid LA Fee Schedule,9.71,100% of Medicaid LA Fee Schedule,9.71,100% of CMS OPPS Rate,9.71,100% of CMS OPPS Rate,9.71,100% of CMS OPPS Rate,9.71,100% of CMS OPPS Rate,9.71,100% of CMS OPPS Rate,9.71,100% of CMS OPPS Rate,9.71,100% of CMS OPPS Rate,9.71,100% of CMS OPPS Rate,9.71,168.3,112.2
Outpatient,Laboratory,83050,"METHEMOGLOBIN, BLD",300,63.45,29.02,354% of CMS OPPS Rate,8.2,100% of Medicaid LA Fee Schedule,8.19,100% of CMS OPPS Rate,8.19,100% of CMS OPPS Rate,18.45,203.89% of BCBS Fee Schedule,44.42,70% of total Billed Charges,47.59,75% of total Billed Charges,14.75,180% OF CMS OPPS RATE,50.76,80% of total Billed Charges,28.69,350% of CMS Opps rate,8.36,102% of CMS Opps rate,48.54,76.5% of total billed charges,8.2,100% of Medicaid LA Fee Schedule,8.2,100% of Medicaid LA Fee Schedule,8.19,100% of CMS OPPS Rate,8.19,100% of CMS OPPS Rate,28.55,45% of total billed charges,44.42,70% of total billed charges,38.07,60% of total billed charges,8.19,100% of CMS OPPS Rate,8.15,90% OF UHC FEE SCHEDULE,44.42,70% of total billed charges,8.19,100% OF CMS OPPS Rate,18.85,230% OF CMS OPPS Rate,30.46,48% of total Billed charges,8.19,100% OF CMS OPPS Rate,57.11,90% of total Billed charges,8.2,100% of Medicaid LA Fee Schedule,8.2,100% of Medicaid LA Fee Schedule,8.2,100% of Medicaid LA Fee Schedule,8.2,100% of Medicaid LA Fee Schedule,8.2,100% of Medicaid LA Fee Schedule,8.2,100% of Medicaid LA Fee Schedule,8.19,100% of CMS OPPS Rate,8.19,100% of CMS OPPS Rate,8.19,100% of CMS OPPS Rate,8.19,100% of CMS OPPS Rate,8.19,100% of CMS OPPS Rate,8.19,100% of CMS OPPS Rate,8.19,100% of CMS OPPS Rate,8.19,100% of CMS OPPS Rate,8.15,57.11,38.07
Outpatient,Laboratory,83051,HEMOGLOBIN-PLASMA,300,80.55,25.87,354% of CMS OPPS Rate,7.31,100% of Medicaid LA Fee Schedule,7.31,100% of CMS OPPS Rate,7.31,100% of CMS OPPS Rate,18.41,203.89% of BCBS Fee Schedule,56.39,70% of total Billed Charges,60.41,75% of total Billed Charges,13.15,180% OF CMS OPPS RATE,64.44,80% of total Billed Charges,25.58,350% of CMS Opps rate,7.45,102% of CMS Opps rate,61.62,76.5% of total billed charges,7.31,100% of Medicaid LA Fee Schedule,7.31,100% of Medicaid LA Fee Schedule,7.31,100% of CMS OPPS Rate,7.31,100% of CMS OPPS Rate,36.25,45% of total billed charges,56.39,70% of total billed charges,48.33,60% of total billed charges,7.31,100% of CMS OPPS Rate,8.13,90% OF UHC FEE SCHEDULE,56.39,70% of total billed charges,7.31,100% OF CMS OPPS Rate,16.81,230% OF CMS OPPS Rate,38.66,48% of total Billed charges,7.31,100% OF CMS OPPS Rate,72.5,90% of total Billed charges,7.31,100% of Medicaid LA Fee Schedule,7.31,100% of Medicaid LA Fee Schedule,7.31,100% of Medicaid LA Fee Schedule,7.31,100% of Medicaid LA Fee Schedule,7.31,100% of Medicaid LA Fee Schedule,7.31,100% of Medicaid LA Fee Schedule,7.31,100% of CMS OPPS Rate,7.31,100% of CMS OPPS Rate,7.31,100% of CMS OPPS Rate,7.31,100% of CMS OPPS Rate,7.31,100% of CMS OPPS Rate,7.31,100% of CMS OPPS Rate,7.31,100% of CMS OPPS Rate,7.31,100% of CMS OPPS Rate,7.31,72.5,48.33
Outpatient,Laboratory,83088,HISTAMINE,300,519.75,104.53,354% of CMS OPPS Rate,29.53,100% of Medicaid LA Fee Schedule,29.53,100% of CMS OPPS Rate,29.53,100% of CMS OPPS Rate,74.34,203.89% of BCBS Fee Schedule,363.83,70% of total Billed Charges,389.81,75% of total Billed Charges,53.15,180% OF CMS OPPS RATE,415.8,80% of total Billed Charges,103.35,350% of CMS Opps rate,30.12,102% of CMS Opps rate,397.61,76.5% of total billed charges,29.53,100% of Medicaid LA Fee Schedule,29.53,100% of Medicaid LA Fee Schedule,29.53,100% of CMS OPPS Rate,29.53,100% of CMS OPPS Rate,233.89,45% of total billed charges,363.83,70% of total billed charges,311.85,60% of total billed charges,29.53,100% of CMS OPPS Rate,32.81,90% OF UHC FEE SCHEDULE,363.83,70% of total billed charges,29.53,100% OF CMS OPPS Rate,67.91,230% OF CMS OPPS Rate,249.48,48% of total Billed charges,29.53,100% OF CMS OPPS Rate,467.78,90% of total Billed charges,29.53,100% of Medicaid LA Fee Schedule,29.53,100% of Medicaid LA Fee Schedule,29.53,100% of Medicaid LA Fee Schedule,29.53,100% of Medicaid LA Fee Schedule,29.53,100% of Medicaid LA Fee Schedule,29.53,100% of Medicaid LA Fee Schedule,29.53,100% of CMS OPPS Rate,29.53,100% of CMS OPPS Rate,29.53,100% of CMS OPPS Rate,29.53,100% of CMS OPPS Rate,29.53,100% of CMS OPPS Rate,29.53,100% of CMS OPPS Rate,29.53,100% of CMS OPPS Rate,29.53,100% of CMS OPPS Rate,29.53,467.78,311.85
Outpatient,Laboratory,83090,HOMOCYSTEINE ULTRAQUANT,300,123.75,63.43,354% of CMS OPPS Rate,17.92,100% of Medicaid LA Fee Schedule,17.92,100% of CMS OPPS Rate,17.92,100% of CMS OPPS Rate,42.47,203.89% of BCBS Fee Schedule,86.63,70% of total Billed Charges,92.81,75% of total Billed Charges,32.25,180% OF CMS OPPS RATE,99,80% of total Billed Charges,62.72,350% of CMS Opps rate,18.27,102% of CMS Opps rate,94.67,76.5% of total billed charges,17.92,100% of Medicaid LA Fee Schedule,17.92,100% of Medicaid LA Fee Schedule,17.92,100% of CMS OPPS Rate,17.92,100% of CMS OPPS Rate,55.69,45% of total billed charges,86.63,70% of total billed charges,74.25,60% of total billed charges,17.92,100% of CMS OPPS Rate,18.75,90% OF UHC FEE SCHEDULE,86.63,70% of total billed charges,17.92,100% OF CMS OPPS Rate,41.21,230% OF CMS OPPS Rate,59.4,48% of total Billed charges,17.92,100% OF CMS OPPS Rate,111.38,90% of total Billed charges,17.92,100% of Medicaid LA Fee Schedule,17.92,100% of Medicaid LA Fee Schedule,17.92,100% of Medicaid LA Fee Schedule,17.92,100% of Medicaid LA Fee Schedule,17.92,100% of Medicaid LA Fee Schedule,17.92,100% of Medicaid LA Fee Schedule,17.92,100% of CMS OPPS Rate,17.92,100% of CMS OPPS Rate,17.92,100% of CMS OPPS Rate,17.92,100% of CMS OPPS Rate,17.92,100% of CMS OPPS Rate,17.92,100% of CMS OPPS Rate,17.92,100% of CMS OPPS Rate,17.92,100% of CMS OPPS Rate,17.92,111.38,74.25
Outpatient,Laboratory,83150,HOMOVANILLIC ACID,300,66.15,79.33,354% of CMS OPPS Rate,22.41,100% of Medicaid LA Fee Schedule,22.41,100% of CMS OPPS Rate,22.41,100% of CMS OPPS Rate,48.71,203.89% of BCBS Fee Schedule,46.31,70% of total Billed Charges,49.61,75% of total Billed Charges,40.33,180% OF CMS OPPS RATE,52.92,80% of total Billed Charges,78.43,350% of CMS Opps rate,22.85,102% of CMS Opps rate,50.6,76.5% of total billed charges,22.41,100% of Medicaid LA Fee Schedule,22.41,100% of Medicaid LA Fee Schedule,22.41,100% of CMS OPPS Rate,22.41,100% of CMS OPPS Rate,29.77,45% of total billed charges,46.31,70% of total billed charges,39.69,60% of total billed charges,22.41,100% of CMS OPPS Rate,21.5,90% OF UHC FEE SCHEDULE,46.31,70% of total billed charges,22.41,100% OF CMS OPPS Rate,51.54,230% OF CMS OPPS Rate,31.75,48% of total Billed charges,22.41,100% OF CMS OPPS Rate,59.54,90% of total Billed charges,22.41,100% of Medicaid LA Fee Schedule,22.41,100% of Medicaid LA Fee Schedule,22.41,100% of Medicaid LA Fee Schedule,22.41,100% of Medicaid LA Fee Schedule,22.41,100% of Medicaid LA Fee Schedule,22.41,100% of Medicaid LA Fee Schedule,22.41,100% of CMS OPPS Rate,22.41,100% of CMS OPPS Rate,22.41,100% of CMS OPPS Rate,22.41,100% of CMS OPPS Rate,22.41,100% of CMS OPPS Rate,22.41,100% of CMS OPPS Rate,22.41,100% of CMS OPPS Rate,22.41,100% of CMS OPPS Rate,21.5,79.33,39.69
Outpatient,Laboratory,83497,5 HIAA 24HR URINE,300,146.7,45.66,354% of CMS OPPS Rate,12.9,100% of Medicaid LA Fee Schedule,12.9,100% of CMS OPPS Rate,12.9,100% of CMS OPPS Rate,32.46,203.89% of BCBS Fee Schedule,102.69,70% of total Billed Charges,110.03,75% of total Billed Charges,23.22,180% OF CMS OPPS RATE,117.36,80% of total Billed Charges,45.15,350% of CMS Opps rate,13.15,102% of CMS Opps rate,112.23,76.5% of total billed charges,12.9,100% of Medicaid LA Fee Schedule,12.9,100% of Medicaid LA Fee Schedule,12.9,100% of CMS OPPS Rate,12.9,100% of CMS OPPS Rate,66.02,45% of total billed charges,102.69,70% of total billed charges,88.02,60% of total billed charges,12.9,100% of CMS OPPS Rate,14.33,90% OF UHC FEE SCHEDULE,102.69,70% of total billed charges,12.9,100% OF CMS OPPS Rate,29.67,230% OF CMS OPPS Rate,70.42,48% of total Billed charges,12.9,100% OF CMS OPPS Rate,132.03,90% of total Billed charges,12.9,100% of Medicaid LA Fee Schedule,12.9,100% of Medicaid LA Fee Schedule,12.9,100% of Medicaid LA Fee Schedule,12.9,100% of Medicaid LA Fee Schedule,12.9,100% of Medicaid LA Fee Schedule,12.9,100% of Medicaid LA Fee Schedule,12.9,100% of CMS OPPS Rate,12.9,100% of CMS OPPS Rate,12.9,100% of CMS OPPS Rate,12.9,100% of CMS OPPS Rate,12.9,100% of CMS OPPS Rate,12.9,100% of CMS OPPS Rate,12.9,100% of CMS OPPS Rate,12.9,100% of CMS OPPS Rate,12.9,132.03,88.02
Outpatient,Laboratory,83498,HYDROXYPROGESTERONE-17,300,190.8,96.18,354% of CMS OPPS Rate,27.17,100% of Medicaid LA Fee Schedule,27.17,100% of CMS OPPS Rate,27.17,100% of CMS OPPS Rate,68.38,203.89% of BCBS Fee Schedule,133.56,70% of total Billed Charges,143.1,75% of total Billed Charges,48.9,180% OF CMS OPPS RATE,152.64,80% of total Billed Charges,95.09,350% of CMS Opps rate,27.71,102% of CMS Opps rate,145.96,76.5% of total billed charges,27.17,100% of Medicaid LA Fee Schedule,27.17,100% of Medicaid LA Fee Schedule,27.17,100% of CMS OPPS Rate,27.17,100% of CMS OPPS Rate,85.86,45% of total billed charges,133.56,70% of total billed charges,114.48,60% of total billed charges,27.17,100% of CMS OPPS Rate,30.19,90% OF UHC FEE SCHEDULE,133.56,70% of total billed charges,27.17,100% OF CMS OPPS Rate,62.49,230% OF CMS OPPS Rate,91.58,48% of total Billed charges,27.17,100% OF CMS OPPS Rate,171.72,90% of total Billed charges,27.17,100% of Medicaid LA Fee Schedule,27.17,100% of Medicaid LA Fee Schedule,27.17,100% of Medicaid LA Fee Schedule,27.17,100% of Medicaid LA Fee Schedule,27.17,100% of Medicaid LA Fee Schedule,27.17,100% of Medicaid LA Fee Schedule,27.17,100% of CMS OPPS Rate,27.17,100% of CMS OPPS Rate,27.17,100% of CMS OPPS Rate,27.17,100% of CMS OPPS Rate,27.17,100% of CMS OPPS Rate,27.17,100% of CMS OPPS Rate,27.17,100% of CMS OPPS Rate,27.17,100% of CMS OPPS Rate,27.17,171.72,114.48
Outpatient,Laboratory,83516,Chemical test of the blood to measure presence or concentration of a substance in the blood,300,116.6,40.81,354% of CMS OPPS Rate,11.53,100% of Medicaid LA Fee Schedule,11.53,100% of CMS OPPS Rate,11.53,100% of CMS OPPS Rate,N/A,Not Applicable,81.62,70% of total Billed Charges,87.45,75% of total Billed Charges,20.75,180% OF CMS OPPS RATE,93.28,80% of total Billed Charges,40.35,350% of CMS Opps rate,11.76,102% of CMS Opps rate,89.2,76.5% of total billed charges,11.53,100% of Medicaid LA Fee Schedule,11.53,100% of Medicaid LA Fee Schedule,11.53,100% of CMS OPPS Rate,11.53,100% of CMS OPPS Rate,52.47,45% of total billed charges,81.62,70% of total billed charges,69.96,60% of total billed charges,11.53,100% of CMS OPPS Rate,12.82,90% OF UHC FEE SCHEDULE,81.62,70% of total billed charges,11.53,100% OF CMS OPPS Rate,26.51,230% OF CMS OPPS Rate,55.97,48% of total Billed charges,11.53,100% OF CMS OPPS Rate,104.94,90% of total Billed charges,11.53,100% of Medicaid LA Fee Schedule,11.53,100% of Medicaid LA Fee Schedule,11.53,100% of Medicaid LA Fee Schedule,11.53,100% of Medicaid LA Fee Schedule,11.53,100% of Medicaid LA Fee Schedule,11.53,100% of Medicaid LA Fee Schedule,11.53,100% of CMS OPPS Rate,11.53,100% of CMS OPPS Rate,11.53,100% of CMS OPPS Rate,11.53,100% of CMS OPPS Rate,11.53,100% of CMS OPPS Rate,11.53,100% of CMS OPPS Rate,11.53,100% of CMS OPPS Rate,11.53,100% of CMS OPPS Rate,11.53,104.94,69.96
Outpatient,Laboratory,83519,IMMUNOASSAY RAD TECHNIQUE,300,149.05,65.13,354% of CMS OPPS Rate,5.68,100% of Medicaid LA Fee Schedule,18.39,100% of CMS OPPS Rate,18.39,100% of CMS OPPS Rate,37.52,203.89% of BCBS Fee Schedule,104.34,70% of total Billed Charges,111.79,75% of total Billed Charges,33.11,180% OF CMS OPPS RATE,119.24,80% of total Billed Charges,64.39,350% of CMS Opps rate,18.76,102% of CMS Opps rate,114.02,76.5% of total billed charges,5.68,100% of Medicaid LA Fee Schedule,5.68,100% of Medicaid LA Fee Schedule,18.39,100% of CMS OPPS Rate,18.39,100% of CMS OPPS Rate,67.07,45% of total billed charges,104.34,70% of total billed charges,89.43,60% of total billed charges,18.39,100% of CMS OPPS Rate,16.56,90% OF UHC FEE SCHEDULE,104.34,70% of total billed charges,18.39,100% OF CMS OPPS Rate,42.32,230% OF CMS OPPS Rate,71.54,48% of total Billed charges,18.39,100% OF CMS OPPS Rate,134.15,90% of total Billed charges,5.68,100% of Medicaid LA Fee Schedule,5.68,100% of Medicaid LA Fee Schedule,5.68,100% of Medicaid LA Fee Schedule,5.68,100% of Medicaid LA Fee Schedule,5.68,100% of Medicaid LA Fee Schedule,5.68,100% of Medicaid LA Fee Schedule,18.39,100% of CMS OPPS Rate,18.39,100% of CMS OPPS Rate,18.39,100% of CMS OPPS Rate,18.39,100% of CMS OPPS Rate,18.39,100% of CMS OPPS Rate,18.39,100% of CMS OPPS Rate,18.39,100% of CMS OPPS Rate,18.39,100% of CMS OPPS Rate,5.68,134.15,89.43
Outpatient,Laboratory,83520,IMMUNOASSAY ANALYTE,300,165,61.13,354% of CMS OPPS Rate,14.84,100% of Medicaid LA Fee Schedule,17.27,100% of CMS OPPS Rate,17.27,100% of CMS OPPS Rate,35.21,203.89% of BCBS Fee Schedule,115.5,70% of total Billed Charges,123.75,75% of total Billed Charges,31.08,180% OF CMS OPPS RATE,132,80% of total Billed Charges,60.44,350% of CMS Opps rate,17.61,102% of CMS Opps rate,126.23,76.5% of total billed charges,14.84,100% of Medicaid LA Fee Schedule,14.84,100% of Medicaid LA Fee Schedule,17.27,100% of CMS OPPS Rate,17.27,100% of CMS OPPS Rate,74.25,45% of total billed charges,115.5,70% of total billed charges,99,60% of total billed charges,17.27,100% of CMS OPPS Rate,15.54,90% OF UHC FEE SCHEDULE,115.5,70% of total billed charges,17.27,100% OF CMS OPPS Rate,39.72,230% OF CMS OPPS Rate,79.2,48% of total Billed charges,17.27,100% OF CMS OPPS Rate,148.5,90% of total Billed charges,14.84,100% of Medicaid LA Fee Schedule,14.84,100% of Medicaid LA Fee Schedule,14.84,100% of Medicaid LA Fee Schedule,14.84,100% of Medicaid LA Fee Schedule,14.84,100% of Medicaid LA Fee Schedule,14.84,100% of Medicaid LA Fee Schedule,17.27,100% of CMS OPPS Rate,17.27,100% of CMS OPPS Rate,17.27,100% of CMS OPPS Rate,17.27,100% of CMS OPPS Rate,17.27,100% of CMS OPPS Rate,17.27,100% of CMS OPPS Rate,17.27,100% of CMS OPPS Rate,17.27,100% of CMS OPPS Rate,14.84,148.5,99
Outpatient,Laboratory,83525,INSULIN,300,129.92,40.46,354% of CMS OPPS Rate,11.43,100% of Medicaid LA Fee Schedule,11.43,100% of CMS OPPS Rate,11.43,100% of CMS OPPS Rate,28.77,203.89% of BCBS Fee Schedule,90.94,70% of total Billed Charges,97.44,75% of total Billed Charges,20.57,180% OF CMS OPPS RATE,103.94,80% of total Billed Charges,40,350% of CMS Opps rate,11.65,102% of CMS Opps rate,99.39,76.5% of total billed charges,11.43,100% of Medicaid LA Fee Schedule,11.43,100% of Medicaid LA Fee Schedule,11.43,100% of CMS OPPS Rate,11.43,100% of CMS OPPS Rate,58.46,45% of total billed charges,90.94,70% of total billed charges,77.95,60% of total billed charges,11.43,100% of CMS OPPS Rate,12.7,90% OF UHC FEE SCHEDULE,90.94,70% of total billed charges,11.43,100% OF CMS OPPS Rate,26.28,230% OF CMS OPPS Rate,62.36,48% of total Billed charges,11.43,100% OF CMS OPPS Rate,116.93,90% of total Billed charges,11.43,100% of Medicaid LA Fee Schedule,11.43,100% of Medicaid LA Fee Schedule,11.43,100% of Medicaid LA Fee Schedule,11.43,100% of Medicaid LA Fee Schedule,11.43,100% of Medicaid LA Fee Schedule,11.43,100% of Medicaid LA Fee Schedule,11.43,100% of CMS OPPS Rate,11.43,100% of CMS OPPS Rate,11.43,100% of CMS OPPS Rate,11.43,100% of CMS OPPS Rate,11.43,100% of CMS OPPS Rate,11.43,100% of CMS OPPS Rate,11.43,100% of CMS OPPS Rate,11.43,100% of CMS OPPS Rate,11.43,116.93,77.95
Outpatient,Laboratory,83527,"INSULIN, FREE",300,190,45.84,354% of CMS OPPS Rate,12.95,100% of Medicaid LA Fee Schedule,12.95,100% of CMS OPPS Rate,12.95,100% of CMS OPPS Rate,32.58,203.89% of BCBS Fee Schedule,133,70% of total Billed Charges,142.5,75% of total Billed Charges,23.31,180% OF CMS OPPS RATE,152,80% of total Billed Charges,45.32,350% of CMS Opps rate,13.2,102% of CMS Opps rate,145.35,76.5% of total billed charges,12.95,100% of Medicaid LA Fee Schedule,12.95,100% of Medicaid LA Fee Schedule,12.95,100% of CMS OPPS Rate,12.95,100% of CMS OPPS Rate,85.5,45% of total billed charges,133,70% of total billed charges,114,60% of total billed charges,12.95,100% of CMS OPPS Rate,14.38,90% OF UHC FEE SCHEDULE,133,70% of total billed charges,12.95,100% OF CMS OPPS Rate,29.78,230% OF CMS OPPS Rate,91.2,48% of total Billed charges,12.95,100% OF CMS OPPS Rate,171,90% of total Billed charges,12.95,100% of Medicaid LA Fee Schedule,12.95,100% of Medicaid LA Fee Schedule,12.95,100% of Medicaid LA Fee Schedule,12.95,100% of Medicaid LA Fee Schedule,12.95,100% of Medicaid LA Fee Schedule,12.95,100% of Medicaid LA Fee Schedule,12.95,100% of CMS OPPS Rate,12.95,100% of CMS OPPS Rate,12.95,100% of CMS OPPS Rate,12.95,100% of CMS OPPS Rate,12.95,100% of CMS OPPS Rate,12.95,100% of CMS OPPS Rate,12.95,100% of CMS OPPS Rate,12.95,100% of CMS OPPS Rate,12.95,171,114
Outpatient,Laboratory,83540,Blood test to measure the amount of iron that is in transit in the body,300,118.35,22.9,354% of CMS OPPS Rate,6.34,100% of Medicaid LA Fee Schedule,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,16.29,203.89% of BCBS Fee Schedule,82.85,70% of total Billed Charges,88.76,75% of total Billed Charges,11.64,180% OF CMS OPPS RATE,94.68,80% of total Billed Charges,22.64,350% of CMS Opps rate,6.59,102% of CMS Opps rate,90.54,76.5% of total billed charges,6.34,100% of Medicaid LA Fee Schedule,6.34,100% of Medicaid LA Fee Schedule,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,53.26,45% of total billed charges,82.85,70% of total billed charges,71.01,60% of total billed charges,6.47,100% of CMS OPPS Rate,7.19,90% OF UHC FEE SCHEDULE,82.85,70% of total billed charges,6.47,100% OF CMS OPPS Rate,14.88,230% OF CMS OPPS Rate,56.81,48% of total Billed charges,6.47,100% OF CMS OPPS Rate,106.52,90% of total Billed charges,6.34,100% of Medicaid LA Fee Schedule,6.34,100% of Medicaid LA Fee Schedule,6.34,100% of Medicaid LA Fee Schedule,6.34,100% of Medicaid LA Fee Schedule,6.34,100% of Medicaid LA Fee Schedule,6.34,100% of Medicaid LA Fee Schedule,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,6.34,106.52,71.01
Outpatient,Laboratory,83550,Blood test that measures the amount of iron carried in the blood,300,78.88,30.93,354% of CMS OPPS Rate,8.74,100% of Medicaid LA Fee Schedule,8.74,100% of CMS OPPS Rate,8.74,100% of CMS OPPS Rate,22,203.89% of BCBS Fee Schedule,N/A,Not Applicable,59.16,75% of total Billed Charges,15.73,180% OF CMS OPPS RATE,63.1,80% of total Billed Charges,30.59,350% of CMS Opps rate,8.91,102% of CMS Opps rate,60.34,76.5% of total billed charges,8.74,100% of Medicaid LA Fee Schedule,8.74,100% of Medicaid LA Fee Schedule,8.74,100% of CMS OPPS Rate,8.74,100% of CMS OPPS Rate,35.5,45% of total billed charges,55.22,70% of total billed charges,47.33,60% of total billed charges,8.74,100% of CMS OPPS Rate,N/A,Not Applicable,55.22,70% of total billed charges,8.74,100% OF CMS OPPS Rate,20.1,230% OF CMS OPPS Rate,37.86,48% of total Billed charges,8.74,100% OF CMS OPPS Rate,70.99,90% of total Billed charges,8.74,100% of Medicaid LA Fee Schedule,8.74,100% of Medicaid LA Fee Schedule,8.74,100% of Medicaid LA Fee Schedule,8.74,100% of Medicaid LA Fee Schedule,8.74,100% of Medicaid LA Fee Schedule,8.74,100% of Medicaid LA Fee Schedule,8.74,100% of CMS OPPS Rate,8.74,100% of CMS OPPS Rate,8.74,100% of CMS OPPS Rate,8.74,100% of CMS OPPS Rate,8.74,100% of CMS OPPS Rate,8.74,100% of CMS OPPS Rate,8.74,100% of CMS OPPS Rate,8.74,100% of CMS OPPS Rate,8.74,70.99,47.33
Outpatient,Laboratory,83586,KETOSTEROIDS 17 OH,300,130,45.31,354% of CMS OPPS Rate,12.8,100% of Medicaid LA Fee Schedule,12.8,100% of CMS OPPS Rate,12.8,100% of CMS OPPS Rate,32.21,203.89% of BCBS Fee Schedule,91,70% of total Billed Charges,97.5,75% of total Billed Charges,23.04,180% OF CMS OPPS RATE,104,80% of total Billed Charges,44.8,350% of CMS Opps rate,13.05,102% of CMS Opps rate,99.45,76.5% of total billed charges,12.8,100% of Medicaid LA Fee Schedule,12.8,100% of Medicaid LA Fee Schedule,12.8,100% of CMS OPPS Rate,12.8,100% of CMS OPPS Rate,58.5,45% of total billed charges,91,70% of total billed charges,78,60% of total billed charges,12.8,100% of CMS OPPS Rate,14.22,90% OF UHC FEE SCHEDULE,91,70% of total billed charges,12.8,100% OF CMS OPPS Rate,29.44,230% OF CMS OPPS Rate,62.4,48% of total Billed charges,12.8,100% OF CMS OPPS Rate,117,90% of total Billed charges,12.8,100% of Medicaid LA Fee Schedule,12.8,100% of Medicaid LA Fee Schedule,12.8,100% of Medicaid LA Fee Schedule,12.8,100% of Medicaid LA Fee Schedule,12.8,100% of Medicaid LA Fee Schedule,12.8,100% of Medicaid LA Fee Schedule,12.8,100% of CMS OPPS Rate,12.8,100% of CMS OPPS Rate,12.8,100% of CMS OPPS Rate,12.8,100% of CMS OPPS Rate,12.8,100% of CMS OPPS Rate,12.8,100% of CMS OPPS Rate,12.8,100% of CMS OPPS Rate,12.8,100% of CMS OPPS Rate,12.8,117,78
Outpatient,Laboratory,83605,LACTIC ACID LACTATE SERUM,300,207,40.95,354% of CMS OPPS Rate,11.57,100% of Medicaid LA Fee Schedule,11.57,100% of CMS OPPS Rate,11.57,100% of CMS OPPS Rate,26.89,203.89% of BCBS Fee Schedule,144.9,70% of total Billed Charges,155.25,75% of total Billed Charges,20.82,180% OF CMS OPPS RATE,165.6,80% of total Billed Charges,40.49,350% of CMS Opps rate,11.8,102% of CMS Opps rate,158.36,76.5% of total billed charges,11.57,100% of Medicaid LA Fee Schedule,11.57,100% of Medicaid LA Fee Schedule,11.57,100% of CMS OPPS Rate,11.57,100% of CMS OPPS Rate,93.15,45% of total billed charges,144.9,70% of total billed charges,124.2,60% of total billed charges,11.57,100% of CMS OPPS Rate,11.87,90% OF UHC FEE SCHEDULE,144.9,70% of total billed charges,11.57,100% OF CMS OPPS Rate,26.61,230% OF CMS OPPS Rate,99.36,48% of total Billed charges,11.57,100% OF CMS OPPS Rate,186.3,90% of total Billed charges,11.57,100% of Medicaid LA Fee Schedule,11.57,100% of Medicaid LA Fee Schedule,11.57,100% of Medicaid LA Fee Schedule,11.57,100% of Medicaid LA Fee Schedule,11.57,100% of Medicaid LA Fee Schedule,11.57,100% of Medicaid LA Fee Schedule,11.57,100% of CMS OPPS Rate,11.57,100% of CMS OPPS Rate,11.57,100% of CMS OPPS Rate,11.57,100% of CMS OPPS Rate,11.57,100% of CMS OPPS Rate,11.57,100% of CMS OPPS Rate,11.57,100% of CMS OPPS Rate,11.57,100% of CMS OPPS Rate,11.57,186.3,124.2
Outpatient,Laboratory,83615,LDH-LACTIC DEHYDROGN,300,207,21.38,354% of CMS OPPS Rate,6.04,100% of Medicaid LA Fee Schedule,6.04,100% of CMS OPPS Rate,6.04,100% of CMS OPPS Rate,15.19,203.89% of BCBS Fee Schedule,144.9,70% of total Billed Charges,155.25,75% of total Billed Charges,10.87,180% OF CMS OPPS RATE,165.6,80% of total Billed Charges,21.14,350% of CMS Opps rate,6.16,102% of CMS Opps rate,158.36,76.5% of total billed charges,6.04,100% of Medicaid LA Fee Schedule,6.04,100% of Medicaid LA Fee Schedule,6.04,100% of CMS OPPS Rate,6.04,100% of CMS OPPS Rate,93.15,45% of total billed charges,144.9,70% of total billed charges,124.2,60% of total billed charges,6.04,100% of CMS OPPS Rate,6.71,90% OF UHC FEE SCHEDULE,144.9,70% of total billed charges,6.04,100% OF CMS OPPS Rate,13.89,230% OF CMS OPPS Rate,99.36,48% of total Billed charges,6.04,100% OF CMS OPPS Rate,186.3,90% of total Billed charges,6.04,100% of Medicaid LA Fee Schedule,6.04,100% of Medicaid LA Fee Schedule,6.04,100% of Medicaid LA Fee Schedule,6.04,100% of Medicaid LA Fee Schedule,6.04,100% of Medicaid LA Fee Schedule,6.04,100% of Medicaid LA Fee Schedule,6.04,100% of CMS OPPS Rate,6.04,100% of CMS OPPS Rate,6.04,100% of CMS OPPS Rate,6.04,100% of CMS OPPS Rate,6.04,100% of CMS OPPS Rate,6.04,100% of CMS OPPS Rate,6.04,100% of CMS OPPS Rate,6.04,100% of CMS OPPS Rate,6.04,186.3,124.2
Outpatient,Laboratory,83625,LDH ISOENZYMES,300,117,45.27,354% of CMS OPPS Rate,11.26,100% of Medicaid LA Fee Schedule,12.79,100% of CMS OPPS Rate,12.79,100% of CMS OPPS Rate,32.21,203.89% of BCBS Fee Schedule,81.9,70% of total Billed Charges,87.75,75% of total Billed Charges,23.02,180% OF CMS OPPS RATE,93.6,80% of total Billed Charges,44.76,350% of CMS Opps rate,13.04,102% of CMS Opps rate,89.51,76.5% of total billed charges,11.26,100% of Medicaid LA Fee Schedule,11.26,100% of Medicaid LA Fee Schedule,12.79,100% of CMS OPPS Rate,12.79,100% of CMS OPPS Rate,52.65,45% of total billed charges,81.9,70% of total billed charges,70.2,60% of total billed charges,12.79,100% of CMS OPPS Rate,14.22,90% OF UHC FEE SCHEDULE,81.9,70% of total billed charges,12.79,100% OF CMS OPPS Rate,29.41,230% OF CMS OPPS Rate,56.16,48% of total Billed charges,12.79,100% OF CMS OPPS Rate,105.3,90% of total Billed charges,11.26,100% of Medicaid LA Fee Schedule,11.26,100% of Medicaid LA Fee Schedule,11.26,100% of Medicaid LA Fee Schedule,11.26,100% of Medicaid LA Fee Schedule,11.26,100% of Medicaid LA Fee Schedule,11.26,100% of Medicaid LA Fee Schedule,12.79,100% of CMS OPPS Rate,12.79,100% of CMS OPPS Rate,12.79,100% of CMS OPPS Rate,12.79,100% of CMS OPPS Rate,12.79,100% of CMS OPPS Rate,12.79,100% of CMS OPPS Rate,12.79,100% of CMS OPPS Rate,12.79,100% of CMS OPPS Rate,11.26,105.3,70.2
Outpatient,Laboratory,83630,LACTOFERRIN FECAL (QUAL),300,201,69.73,354% of CMS OPPS Rate,17.65,100% of Medicaid LA Fee Schedule,19.7,100% of CMS OPPS Rate,19.7,100% of CMS OPPS Rate,49.42,203.89% of BCBS Fee Schedule,140.7,70% of total Billed Charges,150.75,75% of total Billed Charges,35.46,180% OF CMS OPPS RATE,160.8,80% of total Billed Charges,68.95,350% of CMS Opps rate,20.09,102% of CMS Opps rate,153.77,76.5% of total billed charges,17.65,100% of Medicaid LA Fee Schedule,17.65,100% of Medicaid LA Fee Schedule,19.7,100% of CMS OPPS Rate,19.7,100% of CMS OPPS Rate,90.45,45% of total billed charges,140.7,70% of total billed charges,120.6,60% of total billed charges,19.7,100% of CMS OPPS Rate,21.82,90% OF UHC FEE SCHEDULE,140.7,70% of total billed charges,19.7,100% OF CMS OPPS Rate,45.31,230% OF CMS OPPS Rate,96.48,48% of total Billed charges,19.7,100% OF CMS OPPS Rate,180.9,90% of total Billed charges,17.65,100% of Medicaid LA Fee Schedule,17.65,100% of Medicaid LA Fee Schedule,17.65,100% of Medicaid LA Fee Schedule,17.65,100% of Medicaid LA Fee Schedule,17.65,100% of Medicaid LA Fee Schedule,17.65,100% of Medicaid LA Fee Schedule,19.7,100% of CMS OPPS Rate,19.7,100% of CMS OPPS Rate,19.7,100% of CMS OPPS Rate,19.7,100% of CMS OPPS Rate,19.7,100% of CMS OPPS Rate,19.7,100% of CMS OPPS Rate,19.7,100% of CMS OPPS Rate,19.7,100% of CMS OPPS Rate,17.65,180.9,120.6
Outpatient,Laboratory,83631,LACTOFERRIN FECAL QUANTITATIVE,300,407,69.49,354% of CMS OPPS Rate,63.78,15.67% of total Billed charges,19.63,100% of CMS OPPS Rate,19.63,100% of CMS OPPS Rate,49.42,203.89% of BCBS Fee Schedule,284.9,70% of total Billed Charges,305.25,75% of total Billed Charges,35.33,180% OF CMS OPPS RATE,325.6,80% of total Billed Charges,68.7,350% of CMS Opps rate,20.02,102% of CMS Opps rate,311.36,76.5% of total billed charges,63.78,15.67% of total Billed charges,63.78,15.67% of total Billed charges,19.63,100% of CMS OPPS Rate,19.63,100% of CMS OPPS Rate,183.15,45% of total billed charges,284.9,70% of total billed charges,244.2,60% of total billed charges,19.63,100% of CMS OPPS Rate,21.82,90% OF UHC FEE SCHEDULE,284.9,70% of total billed charges,19.63,100% OF CMS OPPS Rate,45.14,230% OF CMS OPPS Rate,195.36,48% of total Billed charges,19.63,100% OF CMS OPPS Rate,366.3,90% of total Billed charges,63.78,15.67% of total Billed charges,63.78,15.67% of total Billed charges,63.78,15.67% of total Billed charges,63.78,15.67% of total Billed charges,63.78,15.67% of total Billed charges,63.78,15.67% of total Billed charges,19.63,100% of CMS OPPS Rate,19.63,100% of CMS OPPS Rate,19.63,100% of CMS OPPS Rate,19.63,100% of CMS OPPS Rate,19.63,100% of CMS OPPS Rate,19.63,100% of CMS OPPS Rate,19.63,100% of CMS OPPS Rate,19.63,100% of CMS OPPS Rate,19.63,366.3,244.2
Outpatient,Laboratory,83655,Blood test to determine the concentration of lead in the blood,300,58,42.86,354% of CMS OPPS Rate,12.11,100% of Medicaid LA Fee Schedule,12.11,100% of CMS OPPS Rate,12.11,100% of CMS OPPS Rate,30.48,203.89% of BCBS Fee Schedule,40.6,70% of total Billed Charges,43.5,75% of total Billed Charges,21.79,180% OF CMS OPPS RATE,46.4,80% of total Billed Charges,42.38,350% of CMS Opps rate,12.35,102% of CMS Opps rate,44.37,76.5% of total billed charges,12.11,100% of Medicaid LA Fee Schedule,12.11,100% of Medicaid LA Fee Schedule,12.11,100% of CMS OPPS Rate,12.11,100% of CMS OPPS Rate,26.1,45% of total billed charges,40.6,70% of total billed charges,34.8,60% of total billed charges,12.11,100% of CMS OPPS Rate,13.46,90% OF UHC FEE SCHEDULE,40.6,70% of total billed charges,12.11,100% OF CMS OPPS Rate,27.85,230% OF CMS OPPS Rate,27.84,48% of total Billed charges,12.11,100% OF CMS OPPS Rate,52.2,90% of total Billed charges,12.11,100% of Medicaid LA Fee Schedule,12.11,100% of Medicaid LA Fee Schedule,12.11,100% of Medicaid LA Fee Schedule,12.11,100% of Medicaid LA Fee Schedule,12.11,100% of Medicaid LA Fee Schedule,12.11,100% of Medicaid LA Fee Schedule,12.11,100% of CMS OPPS Rate,12.11,100% of CMS OPPS Rate,12.11,100% of CMS OPPS Rate,12.11,100% of CMS OPPS Rate,12.11,100% of CMS OPPS Rate,12.11,100% of CMS OPPS Rate,12.11,100% of CMS OPPS Rate,12.11,100% of CMS OPPS Rate,12.11,52.2,34.8
Outpatient,Laboratory,83690,LIPASE SERUM,300,142.65,24.39,354% of CMS OPPS Rate,6.89,100% of Medicaid LA Fee Schedule,6.89,100% of CMS OPPS Rate,6.89,100% of CMS OPPS Rate,17.35,203.89% of BCBS Fee Schedule,99.86,70% of total Billed Charges,106.99,75% of total Billed Charges,12.4,180% OF CMS OPPS RATE,114.12,80% of total Billed Charges,24.11,350% of CMS Opps rate,7.02,102% of CMS Opps rate,109.13,76.5% of total billed charges,6.89,100% of Medicaid LA Fee Schedule,6.89,100% of Medicaid LA Fee Schedule,6.89,100% of CMS OPPS Rate,6.89,100% of CMS OPPS Rate,64.19,45% of total billed charges,99.86,70% of total billed charges,85.59,60% of total billed charges,6.89,100% of CMS OPPS Rate,7.66,90% OF UHC FEE SCHEDULE,99.86,70% of total billed charges,6.89,100% OF CMS OPPS Rate,15.84,230% OF CMS OPPS Rate,68.47,48% of total Billed charges,6.89,100% OF CMS OPPS Rate,128.39,90% of total Billed charges,6.89,100% of Medicaid LA Fee Schedule,6.89,100% of Medicaid LA Fee Schedule,6.89,100% of Medicaid LA Fee Schedule,6.89,100% of Medicaid LA Fee Schedule,6.89,100% of Medicaid LA Fee Schedule,6.89,100% of Medicaid LA Fee Schedule,6.89,100% of CMS OPPS Rate,6.89,100% of CMS OPPS Rate,6.89,100% of CMS OPPS Rate,6.89,100% of CMS OPPS Rate,6.89,100% of CMS OPPS Rate,6.89,100% of CMS OPPS Rate,6.89,100% of CMS OPPS Rate,6.89,100% of CMS OPPS Rate,6.89,128.39,85.59
Outpatient,Laboratory,83695,LIPOPROTEIN A,300,190,50.69,354% of CMS OPPS Rate,14.32,100% of Medicaid LA Fee Schedule,14.32,100% of CMS OPPS Rate,14.32,100% of CMS OPPS Rate,32.58,203.89% of BCBS Fee Schedule,133,70% of total Billed Charges,142.5,75% of total Billed Charges,25.77,180% OF CMS OPPS RATE,152,80% of total Billed Charges,50.12,350% of CMS Opps rate,14.6,102% of CMS Opps rate,145.35,76.5% of total billed charges,14.32,100% of Medicaid LA Fee Schedule,14.32,100% of Medicaid LA Fee Schedule,14.32,100% of CMS OPPS Rate,14.32,100% of CMS OPPS Rate,85.5,45% of total billed charges,133,70% of total billed charges,114,60% of total billed charges,14.32,100% of CMS OPPS Rate,14.38,90% OF UHC FEE SCHEDULE,133,70% of total billed charges,14.32,100% OF CMS OPPS Rate,32.93,230% OF CMS OPPS Rate,91.2,48% of total Billed charges,14.32,100% OF CMS OPPS Rate,171,90% of total Billed charges,14.32,100% of Medicaid LA Fee Schedule,14.32,100% of Medicaid LA Fee Schedule,14.32,100% of Medicaid LA Fee Schedule,14.32,100% of Medicaid LA Fee Schedule,14.32,100% of Medicaid LA Fee Schedule,14.32,100% of Medicaid LA Fee Schedule,14.32,100% of CMS OPPS Rate,14.32,100% of CMS OPPS Rate,14.32,100% of CMS OPPS Rate,14.32,100% of CMS OPPS Rate,14.32,100% of CMS OPPS Rate,14.32,100% of CMS OPPS Rate,14.32,100% of CMS OPPS Rate,14.32,100% of CMS OPPS Rate,14.32,171,114
Outpatient,Laboratory,83698,ASSAY LIPOPROTEIN PLA2,300,229.35,163.93,354% of CMS OPPS Rate,45.76,100% of Medicaid LA Fee Schedule,46.31,100% of CMS OPPS Rate,46.31,100% of CMS OPPS Rate,94.42,203.89% of BCBS Fee Schedule,160.55,70% of total Billed Charges,172.01,75% of total Billed Charges,83.35,180% OF CMS OPPS RATE,183.48,80% of total Billed Charges,162.08,350% of CMS Opps rate,47.23,102% of CMS Opps rate,175.45,76.5% of total billed charges,45.76,100% of Medicaid LA Fee Schedule,45.76,100% of Medicaid LA Fee Schedule,46.31,100% of CMS OPPS Rate,46.31,100% of CMS OPPS Rate,103.21,45% of total billed charges,160.55,70% of total billed charges,137.61,60% of total billed charges,46.31,100% of CMS OPPS Rate,41.68,90% OF UHC FEE SCHEDULE,160.55,70% of total billed charges,46.31,100% OF CMS OPPS Rate,106.51,230% OF CMS OPPS Rate,110.09,48% of total Billed charges,46.31,100% OF CMS OPPS Rate,206.42,90% of total Billed charges,45.76,100% of Medicaid LA Fee Schedule,45.76,100% of Medicaid LA Fee Schedule,45.76,100% of Medicaid LA Fee Schedule,45.76,100% of Medicaid LA Fee Schedule,45.76,100% of Medicaid LA Fee Schedule,45.76,100% of Medicaid LA Fee Schedule,46.31,100% of CMS OPPS Rate,46.31,100% of CMS OPPS Rate,46.31,100% of CMS OPPS Rate,46.31,100% of CMS OPPS Rate,46.31,100% of CMS OPPS Rate,46.31,100% of CMS OPPS Rate,46.31,100% of CMS OPPS Rate,46.31,100% of CMS OPPS Rate,41.68,206.42,137.61
Outpatient,Laboratory,83700,LIPOPROTEIN ELECTROPHORES,300,135.5,39.86,354% of CMS OPPS Rate,21.23,15.67% of total Billed charges,11.26,100% of CMS OPPS Rate,11.26,100% of CMS OPPS Rate,28.34,203.89% of BCBS Fee Schedule,94.85,70% of total Billed Charges,101.63,75% of total Billed Charges,20.26,180% OF CMS OPPS RATE,108.4,80% of total Billed Charges,39.41,350% of CMS Opps rate,11.48,102% of CMS Opps rate,103.66,76.5% of total billed charges,21.23,15.67% of total Billed charges,21.23,15.67% of total Billed charges,11.26,100% of CMS OPPS Rate,11.26,100% of CMS OPPS Rate,60.98,45% of total billed charges,94.85,70% of total billed charges,81.3,60% of total billed charges,11.26,100% of CMS OPPS Rate,12.51,90% OF UHC FEE SCHEDULE,94.85,70% of total billed charges,11.26,100% OF CMS OPPS Rate,25.89,230% OF CMS OPPS Rate,65.04,48% of total Billed charges,11.26,100% OF CMS OPPS Rate,121.95,90% of total Billed charges,21.23,15.67% of total Billed charges,21.23,15.67% of total Billed charges,21.23,15.67% of total Billed charges,21.23,15.67% of total Billed charges,21.23,15.67% of total Billed charges,21.23,15.67% of total Billed charges,11.26,100% of CMS OPPS Rate,11.26,100% of CMS OPPS Rate,11.26,100% of CMS OPPS Rate,11.26,100% of CMS OPPS Rate,11.26,100% of CMS OPPS Rate,11.26,100% of CMS OPPS Rate,11.26,100% of CMS OPPS Rate,11.26,100% of CMS OPPS Rate,11.26,121.95,81.3
Outpatient,Laboratory,83701,"LIPOPROTEIN BLD,HR FRACTI",300,75.35,119.86,354% of CMS OPPS Rate,33.47,100% of Medicaid LA Fee Schedule,33.86,100% of CMS OPPS Rate,33.86,100% of CMS OPPS Rate,69.04,203.89% of BCBS Fee Schedule,52.75,70% of total Billed Charges,56.51,75% of total Billed Charges,60.94,180% OF CMS OPPS RATE,60.28,80% of total Billed Charges,118.51,350% of CMS Opps rate,34.53,102% of CMS Opps rate,57.64,76.5% of total billed charges,33.47,100% of Medicaid LA Fee Schedule,33.47,100% of Medicaid LA Fee Schedule,33.86,100% of CMS OPPS Rate,33.86,100% of CMS OPPS Rate,33.91,45% of total billed charges,52.75,70% of total billed charges,45.21,60% of total billed charges,33.86,100% of CMS OPPS Rate,30.47,90% OF UHC FEE SCHEDULE,52.75,70% of total billed charges,33.86,100% OF CMS OPPS Rate,75.35,230% OF CMS OPPS Rate,36.17,48% of total Billed charges,33.86,100% OF CMS OPPS Rate,67.82,90% of total Billed charges,33.47,100% of Medicaid LA Fee Schedule,33.47,100% of Medicaid LA Fee Schedule,33.47,100% of Medicaid LA Fee Schedule,33.47,100% of Medicaid LA Fee Schedule,33.47,100% of Medicaid LA Fee Schedule,33.47,100% of Medicaid LA Fee Schedule,33.86,100% of CMS OPPS Rate,33.86,100% of CMS OPPS Rate,33.86,100% of CMS OPPS Rate,33.86,100% of CMS OPPS Rate,33.86,100% of CMS OPPS Rate,33.86,100% of CMS OPPS Rate,33.86,100% of CMS OPPS Rate,33.86,100% of CMS OPPS Rate,30.47,119.86,45.21
Outpatient,Laboratory,83704,LIPOPROTEIN BLD QUANT NMBR,300,215.2,121.03,354% of CMS OPPS Rate,34.19,100% of Medicaid LA Fee Schedule,34.19,100% of CMS OPPS Rate,34.19,100% of CMS OPPS Rate,79.42,203.89% of BCBS Fee Schedule,150.64,70% of total Billed Charges,161.4,75% of total Billed Charges,61.54,180% OF CMS OPPS RATE,172.16,80% of total Billed Charges,119.66,350% of CMS Opps rate,34.87,102% of CMS Opps rate,164.63,76.5% of total billed charges,34.19,100% of Medicaid LA Fee Schedule,34.19,100% of Medicaid LA Fee Schedule,34.19,100% of CMS OPPS Rate,34.19,100% of CMS OPPS Rate,96.84,45% of total billed charges,150.64,70% of total billed charges,129.12,60% of total billed charges,34.19,100% of CMS OPPS Rate,35.06,90% OF UHC FEE SCHEDULE,150.64,70% of total billed charges,34.19,100% OF CMS OPPS Rate,78.63,230% OF CMS OPPS Rate,103.3,48% of total Billed charges,34.19,100% OF CMS OPPS Rate,193.68,90% of total Billed charges,34.19,100% of Medicaid LA Fee Schedule,34.19,100% of Medicaid LA Fee Schedule,34.19,100% of Medicaid LA Fee Schedule,34.19,100% of Medicaid LA Fee Schedule,34.19,100% of Medicaid LA Fee Schedule,34.19,100% of Medicaid LA Fee Schedule,34.19,100% of CMS OPPS Rate,34.19,100% of CMS OPPS Rate,34.19,100% of CMS OPPS Rate,34.19,100% of CMS OPPS Rate,34.19,100% of CMS OPPS Rate,34.19,100% of CMS OPPS Rate,34.19,100% of CMS OPPS Rate,34.19,100% of CMS OPPS Rate,34.19,193.68,129.12
Outpatient,Laboratory,83718,Blood test to measure the level of lipoproteins in the blood,300,186,28.99,354% of CMS OPPS Rate,8.19,100% of Medicaid LA Fee Schedule,8.19,100% of CMS OPPS Rate,8.19,100% of CMS OPPS Rate,20.63,203.89% of BCBS Fee Schedule,130.2,70% of total Billed Charges,139.5,75% of total Billed Charges,14.74,180% OF CMS OPPS RATE,148.8,80% of total Billed Charges,28.66,350% of CMS Opps rate,8.35,102% of CMS Opps rate,142.29,76.5% of total billed charges,8.19,100% of Medicaid LA Fee Schedule,8.19,100% of Medicaid LA Fee Schedule,8.19,100% of CMS OPPS Rate,8.19,100% of CMS OPPS Rate,83.7,45% of total billed charges,130.2,70% of total billed charges,111.6,60% of total billed charges,8.19,100% of CMS OPPS Rate,9.11,90% OF UHC FEE SCHEDULE,130.2,70% of total billed charges,8.19,100% OF CMS OPPS Rate,18.83,230% OF CMS OPPS Rate,89.28,48% of total Billed charges,8.19,100% OF CMS OPPS Rate,167.4,90% of total Billed charges,8.19,100% of Medicaid LA Fee Schedule,8.19,100% of Medicaid LA Fee Schedule,8.19,100% of Medicaid LA Fee Schedule,8.19,100% of Medicaid LA Fee Schedule,8.19,100% of Medicaid LA Fee Schedule,8.19,100% of Medicaid LA Fee Schedule,8.19,100% of CMS OPPS Rate,8.19,100% of CMS OPPS Rate,8.19,100% of CMS OPPS Rate,8.19,100% of CMS OPPS Rate,8.19,100% of CMS OPPS Rate,8.19,100% of CMS OPPS Rate,8.19,100% of CMS OPPS Rate,8.19,100% of CMS OPPS Rate,8.19,167.4,111.6
Outpatient,Laboratory,83721,LDL CHOLESTEROL DIRECT,300,102.15,37.17,354% of CMS OPPS Rate,10.42,100% of Medicaid LA Fee Schedule,10.5,100% of CMS OPPS Rate,10.5,100% of CMS OPPS Rate,24.02,203.89% of BCBS Fee Schedule,71.51,70% of total Billed Charges,76.61,75% of total Billed Charges,18.9,180% OF CMS OPPS RATE,81.72,80% of total Billed Charges,36.75,350% of CMS Opps rate,10.71,102% of CMS Opps rate,78.14,76.5% of total billed charges,10.42,100% of Medicaid LA Fee Schedule,10.42,100% of Medicaid LA Fee Schedule,10.5,100% of CMS OPPS Rate,10.5,100% of CMS OPPS Rate,45.97,45% of total billed charges,71.51,70% of total billed charges,61.29,60% of total billed charges,10.5,100% of CMS OPPS Rate,10.6,90% OF UHC FEE SCHEDULE,71.51,70% of total billed charges,10.5,100% OF CMS OPPS Rate,24.15,230% OF CMS OPPS Rate,49.03,48% of total Billed charges,10.5,100% OF CMS OPPS Rate,91.94,90% of total Billed charges,10.42,100% of Medicaid LA Fee Schedule,10.42,100% of Medicaid LA Fee Schedule,10.42,100% of Medicaid LA Fee Schedule,10.42,100% of Medicaid LA Fee Schedule,10.42,100% of Medicaid LA Fee Schedule,10.42,100% of Medicaid LA Fee Schedule,10.5,100% of CMS OPPS Rate,10.5,100% of CMS OPPS Rate,10.5,100% of CMS OPPS Rate,10.5,100% of CMS OPPS Rate,10.5,100% of CMS OPPS Rate,10.5,100% of CMS OPPS Rate,10.5,100% of CMS OPPS Rate,10.5,100% of CMS OPPS Rate,10.42,91.94,61.29
Outpatient,Laboratory,83727,LUTEINIZING RELEASE FACTOR,300,450,60.85,354% of CMS OPPS Rate,17.19,100% of Medicaid LA Fee Schedule,17.19,100% of CMS OPPS Rate,17.19,100% of CMS OPPS Rate,43.27,203.89% of BCBS Fee Schedule,315,70% of total Billed Charges,337.5,75% of total Billed Charges,30.94,180% OF CMS OPPS RATE,360,80% of total Billed Charges,60.16,350% of CMS Opps rate,17.53,102% of CMS Opps rate,344.25,76.5% of total billed charges,17.19,100% of Medicaid LA Fee Schedule,17.19,100% of Medicaid LA Fee Schedule,17.19,100% of CMS OPPS Rate,17.19,100% of CMS OPPS Rate,202.5,45% of total billed charges,315,70% of total billed charges,270,60% of total billed charges,17.19,100% of CMS OPPS Rate,19.1,90% OF UHC FEE SCHEDULE,315,70% of total billed charges,17.19,100% OF CMS OPPS Rate,39.53,230% OF CMS OPPS Rate,216,48% of total Billed charges,17.19,100% OF CMS OPPS Rate,405,90% of total Billed charges,17.19,100% of Medicaid LA Fee Schedule,17.19,100% of Medicaid LA Fee Schedule,17.19,100% of Medicaid LA Fee Schedule,17.19,100% of Medicaid LA Fee Schedule,17.19,100% of Medicaid LA Fee Schedule,17.19,100% of Medicaid LA Fee Schedule,17.19,100% of CMS OPPS Rate,17.19,100% of CMS OPPS Rate,17.19,100% of CMS OPPS Rate,17.19,100% of CMS OPPS Rate,17.19,100% of CMS OPPS Rate,17.19,100% of CMS OPPS Rate,17.19,100% of CMS OPPS Rate,17.19,100% of CMS OPPS Rate,17.19,405,270
Outpatient,Laboratory,83735,MAGNESIUM SERUM,300,111.6,23.71,354% of CMS OPPS Rate,6.7,100% of Medicaid LA Fee Schedule,6.7,100% of CMS OPPS Rate,6.7,100% of CMS OPPS Rate,16.86,203.89% of BCBS Fee Schedule,78.12,70% of total Billed Charges,83.7,75% of total Billed Charges,12.06,180% OF CMS OPPS RATE,89.28,80% of total Billed Charges,23.45,350% of CMS Opps rate,6.83,102% of CMS Opps rate,85.37,76.5% of total billed charges,6.7,100% of Medicaid LA Fee Schedule,6.7,100% of Medicaid LA Fee Schedule,6.7,100% of CMS OPPS Rate,6.7,100% of CMS OPPS Rate,50.22,45% of total billed charges,78.12,70% of total billed charges,66.96,60% of total billed charges,6.7,100% of CMS OPPS Rate,7.44,90% OF UHC FEE SCHEDULE,78.12,70% of total billed charges,6.7,100% OF CMS OPPS Rate,15.41,230% OF CMS OPPS Rate,53.57,48% of total Billed charges,6.7,100% OF CMS OPPS Rate,100.44,90% of total Billed charges,6.7,100% of Medicaid LA Fee Schedule,6.7,100% of Medicaid LA Fee Schedule,6.7,100% of Medicaid LA Fee Schedule,6.7,100% of Medicaid LA Fee Schedule,6.7,100% of Medicaid LA Fee Schedule,6.7,100% of Medicaid LA Fee Schedule,6.7,100% of CMS OPPS Rate,6.7,100% of CMS OPPS Rate,6.7,100% of CMS OPPS Rate,6.7,100% of CMS OPPS Rate,6.7,100% of CMS OPPS Rate,6.7,100% of CMS OPPS Rate,6.7,100% of CMS OPPS Rate,6.7,100% of CMS OPPS Rate,6.7,100.44,66.96
Outpatient,Laboratory,83785,MANGANESE,300,54.5,94.34,354% of CMS OPPS Rate,25.98,100% of Medicaid LA Fee Schedule,26.65,100% of CMS OPPS Rate,26.65,100% of CMS OPPS Rate,61.92,203.89% of BCBS Fee Schedule,38.15,70% of total Billed Charges,40.88,75% of total Billed Charges,47.97,180% OF CMS OPPS RATE,43.6,80% of total Billed Charges,93.27,350% of CMS Opps rate,27.18,102% of CMS Opps rate,41.69,76.5% of total billed charges,25.98,100% of Medicaid LA Fee Schedule,25.98,100% of Medicaid LA Fee Schedule,26.65,100% of CMS OPPS Rate,26.65,100% of CMS OPPS Rate,24.53,45% of total billed charges,38.15,70% of total billed charges,32.7,60% of total billed charges,26.65,100% of CMS OPPS Rate,27.33,90% OF UHC FEE SCHEDULE,38.15,70% of total billed charges,26.65,100% OF CMS OPPS Rate,54.5,230% OF CMS OPPS Rate,26.16,48% of total Billed charges,26.65,100% OF CMS OPPS Rate,49.05,90% of total Billed charges,25.98,100% of Medicaid LA Fee Schedule,25.98,100% of Medicaid LA Fee Schedule,25.98,100% of Medicaid LA Fee Schedule,25.98,100% of Medicaid LA Fee Schedule,25.98,100% of Medicaid LA Fee Schedule,25.98,100% of Medicaid LA Fee Schedule,26.65,100% of CMS OPPS Rate,26.65,100% of CMS OPPS Rate,26.65,100% of CMS OPPS Rate,26.65,100% of CMS OPPS Rate,26.65,100% of CMS OPPS Rate,26.65,100% of CMS OPPS Rate,26.65,100% of CMS OPPS Rate,26.65,100% of CMS OPPS Rate,24.53,94.34,32.7
Outpatient,Laboratory,83789,MASS SPECTROMETRY QUAL/QUANT,300,122,85.34,354% of CMS OPPS Rate,24.11,100% of Medicaid LA Fee Schedule,24.11,100% of CMS OPPS Rate,24.11,100% of CMS OPPS Rate,49.16,203.89% of BCBS Fee Schedule,85.4,70% of total Billed Charges,91.5,75% of total Billed Charges,43.39,180% OF CMS OPPS RATE,97.6,80% of total Billed Charges,84.38,350% of CMS Opps rate,24.59,102% of CMS Opps rate,93.33,76.5% of total billed charges,24.11,100% of Medicaid LA Fee Schedule,24.11,100% of Medicaid LA Fee Schedule,24.11,100% of CMS OPPS Rate,24.11,100% of CMS OPPS Rate,54.9,45% of total billed charges,85.4,70% of total billed charges,73.2,60% of total billed charges,24.11,100% of CMS OPPS Rate,21.7,90% OF UHC FEE SCHEDULE,85.4,70% of total billed charges,24.11,100% OF CMS OPPS Rate,55.45,230% OF CMS OPPS Rate,58.56,48% of total Billed charges,24.11,100% OF CMS OPPS Rate,109.8,90% of total Billed charges,24.11,100% of Medicaid LA Fee Schedule,24.11,100% of Medicaid LA Fee Schedule,24.11,100% of Medicaid LA Fee Schedule,24.11,100% of Medicaid LA Fee Schedule,24.11,100% of Medicaid LA Fee Schedule,24.11,100% of Medicaid LA Fee Schedule,24.11,100% of CMS OPPS Rate,24.11,100% of CMS OPPS Rate,24.11,100% of CMS OPPS Rate,24.11,100% of CMS OPPS Rate,24.11,100% of CMS OPPS Rate,24.11,100% of CMS OPPS Rate,24.11,100% of CMS OPPS Rate,24.11,100% of CMS OPPS Rate,21.7,109.8,73.2
Outpatient,Laboratory,83825,MERCURY QUANTITATIVE,300,106.15,57.56,354% of CMS OPPS Rate,16.26,100% of Medicaid LA Fee Schedule,16.26,100% of CMS OPPS Rate,16.26,100% of CMS OPPS Rate,40.92,203.89% of BCBS Fee Schedule,74.31,70% of total Billed Charges,79.61,75% of total Billed Charges,29.26,180% OF CMS OPPS RATE,84.92,80% of total Billed Charges,56.91,350% of CMS Opps rate,16.58,102% of CMS Opps rate,81.2,76.5% of total billed charges,16.26,100% of Medicaid LA Fee Schedule,16.26,100% of Medicaid LA Fee Schedule,16.26,100% of CMS OPPS Rate,16.26,100% of CMS OPPS Rate,47.77,45% of total billed charges,74.31,70% of total billed charges,63.69,60% of total billed charges,16.26,100% of CMS OPPS Rate,18.06,90% OF UHC FEE SCHEDULE,74.31,70% of total billed charges,16.26,100% OF CMS OPPS Rate,37.39,230% OF CMS OPPS Rate,50.95,48% of total Billed charges,16.26,100% OF CMS OPPS Rate,95.54,90% of total Billed charges,16.26,100% of Medicaid LA Fee Schedule,16.26,100% of Medicaid LA Fee Schedule,16.26,100% of Medicaid LA Fee Schedule,16.26,100% of Medicaid LA Fee Schedule,16.26,100% of Medicaid LA Fee Schedule,16.26,100% of Medicaid LA Fee Schedule,16.26,100% of CMS OPPS Rate,16.26,100% of CMS OPPS Rate,16.26,100% of CMS OPPS Rate,16.26,100% of CMS OPPS Rate,16.26,100% of CMS OPPS Rate,16.26,100% of CMS OPPS Rate,16.26,100% of CMS OPPS Rate,16.26,100% of CMS OPPS Rate,16.26,95.54,63.69
Outpatient,Laboratory,83835,METANEPHRINES,300,88,59.96,354% of CMS OPPS Rate,16.94,100% of Medicaid LA Fee Schedule,16.94,100% of CMS OPPS Rate,16.94,100% of CMS OPPS Rate,42.65,203.89% of BCBS Fee Schedule,61.6,70% of total Billed Charges,66,75% of total Billed Charges,30.49,180% OF CMS OPPS RATE,70.4,80% of total Billed Charges,59.29,350% of CMS Opps rate,17.27,102% of CMS Opps rate,67.32,76.5% of total billed charges,16.94,100% of Medicaid LA Fee Schedule,16.94,100% of Medicaid LA Fee Schedule,16.94,100% of CMS OPPS Rate,16.94,100% of CMS OPPS Rate,39.6,45% of total billed charges,61.6,70% of total billed charges,52.8,60% of total billed charges,16.94,100% of CMS OPPS Rate,18.83,90% OF UHC FEE SCHEDULE,61.6,70% of total billed charges,16.94,100% OF CMS OPPS Rate,38.96,230% OF CMS OPPS Rate,42.24,48% of total Billed charges,16.94,100% OF CMS OPPS Rate,79.2,90% of total Billed charges,16.94,100% of Medicaid LA Fee Schedule,16.94,100% of Medicaid LA Fee Schedule,16.94,100% of Medicaid LA Fee Schedule,16.94,100% of Medicaid LA Fee Schedule,16.94,100% of Medicaid LA Fee Schedule,16.94,100% of Medicaid LA Fee Schedule,16.94,100% of CMS OPPS Rate,16.94,100% of CMS OPPS Rate,16.94,100% of CMS OPPS Rate,16.94,100% of CMS OPPS Rate,16.94,100% of CMS OPPS Rate,16.94,100% of CMS OPPS Rate,16.94,100% of CMS OPPS Rate,16.94,100% of CMS OPPS Rate,16.94,79.2,52.8
Outpatient,Laboratory,83872,"MUCIN, SYNOVIAL FLUID",300,43,20.74,354% of CMS OPPS Rate,5.81,100% of Medicaid LA Fee Schedule,5.86,100% of CMS OPPS Rate,5.86,100% of CMS OPPS Rate,14.76,203.89% of BCBS Fee Schedule,30.1,70% of total Billed Charges,32.25,75% of total Billed Charges,10.54,180% OF CMS OPPS RATE,34.4,80% of total Billed Charges,20.51,350% of CMS Opps rate,5.97,102% of CMS Opps rate,32.9,76.5% of total billed charges,5.81,100% of Medicaid LA Fee Schedule,5.81,100% of Medicaid LA Fee Schedule,5.86,100% of CMS OPPS Rate,5.86,100% of CMS OPPS Rate,19.35,45% of total billed charges,30.1,70% of total billed charges,25.8,60% of total billed charges,5.86,100% of CMS OPPS Rate,6.52,90% OF UHC FEE SCHEDULE,30.1,70% of total billed charges,5.86,100% OF CMS OPPS Rate,13.47,230% OF CMS OPPS Rate,20.64,48% of total Billed charges,5.86,100% OF CMS OPPS Rate,38.7,90% of total Billed charges,5.81,100% of Medicaid LA Fee Schedule,5.81,100% of Medicaid LA Fee Schedule,5.81,100% of Medicaid LA Fee Schedule,5.81,100% of Medicaid LA Fee Schedule,5.81,100% of Medicaid LA Fee Schedule,5.81,100% of Medicaid LA Fee Schedule,5.86,100% of CMS OPPS Rate,5.86,100% of CMS OPPS Rate,5.86,100% of CMS OPPS Rate,5.86,100% of CMS OPPS Rate,5.86,100% of CMS OPPS Rate,5.86,100% of CMS OPPS Rate,5.86,100% of CMS OPPS Rate,5.86,100% of CMS OPPS Rate,5.81,38.7,25.8
Outpatient,Laboratory,83873,MYELIN BASIC PROTEIN,300,52,60.88,354% of CMS OPPS Rate,17.2,100% of Medicaid LA Fee Schedule,17.2,100% of CMS OPPS Rate,17.2,100% of CMS OPPS Rate,43.31,203.89% of BCBS Fee Schedule,36.4,70% of total Billed Charges,39,75% of total Billed Charges,30.96,180% OF CMS OPPS RATE,41.6,80% of total Billed Charges,60.2,350% of CMS Opps rate,17.54,102% of CMS Opps rate,39.78,76.5% of total billed charges,17.2,100% of Medicaid LA Fee Schedule,17.2,100% of Medicaid LA Fee Schedule,17.2,100% of CMS OPPS Rate,17.2,100% of CMS OPPS Rate,23.4,45% of total billed charges,36.4,70% of total billed charges,31.2,60% of total billed charges,17.2,100% of CMS OPPS Rate,19.12,90% OF UHC FEE SCHEDULE,36.4,70% of total billed charges,17.2,100% OF CMS OPPS Rate,39.56,230% OF CMS OPPS Rate,24.96,48% of total Billed charges,17.2,100% OF CMS OPPS Rate,46.8,90% of total Billed charges,17.2,100% of Medicaid LA Fee Schedule,17.2,100% of Medicaid LA Fee Schedule,17.2,100% of Medicaid LA Fee Schedule,17.2,100% of Medicaid LA Fee Schedule,17.2,100% of Medicaid LA Fee Schedule,17.2,100% of Medicaid LA Fee Schedule,17.2,100% of CMS OPPS Rate,17.2,100% of CMS OPPS Rate,17.2,100% of CMS OPPS Rate,17.2,100% of CMS OPPS Rate,17.2,100% of CMS OPPS Rate,17.2,100% of CMS OPPS Rate,17.2,100% of CMS OPPS Rate,17.2,100% of CMS OPPS Rate,17.2,60.88,31.2
Outpatient,Laboratory,83874,MYOGLOBIN ASSAY,300,262.9,45.73,354% of CMS OPPS Rate,12.29,100% of Medicaid LA Fee Schedule,12.92,100% of CMS OPPS Rate,12.92,100% of CMS OPPS Rate,32.52,203.89% of BCBS Fee Schedule,184.03,70% of total Billed Charges,197.18,75% of total Billed Charges,23.25,180% OF CMS OPPS RATE,210.32,80% of total Billed Charges,45.22,350% of CMS Opps rate,13.17,102% of CMS Opps rate,201.12,76.5% of total billed charges,12.29,100% of Medicaid LA Fee Schedule,12.29,100% of Medicaid LA Fee Schedule,12.92,100% of CMS OPPS Rate,12.92,100% of CMS OPPS Rate,118.31,45% of total billed charges,184.03,70% of total billed charges,157.74,60% of total billed charges,12.92,100% of CMS OPPS Rate,14.36,90% OF UHC FEE SCHEDULE,184.03,70% of total billed charges,12.92,100% OF CMS OPPS Rate,29.71,230% OF CMS OPPS Rate,126.19,48% of total Billed charges,12.92,100% OF CMS OPPS Rate,236.61,90% of total Billed charges,12.29,100% of Medicaid LA Fee Schedule,12.29,100% of Medicaid LA Fee Schedule,12.29,100% of Medicaid LA Fee Schedule,12.29,100% of Medicaid LA Fee Schedule,12.29,100% of Medicaid LA Fee Schedule,12.29,100% of Medicaid LA Fee Schedule,12.92,100% of CMS OPPS Rate,12.92,100% of CMS OPPS Rate,12.92,100% of CMS OPPS Rate,12.92,100% of CMS OPPS Rate,12.92,100% of CMS OPPS Rate,12.92,100% of CMS OPPS Rate,12.92,100% of CMS OPPS Rate,12.92,100% of CMS OPPS Rate,12.29,236.61,157.74
Outpatient,Laboratory,83876,CARDIO IQ R MYELOPEROXIDASE,300,116.4,180.04,354% of CMS OPPS Rate,18.82,100% of Medicaid LA Fee Schedule,50.86,100% of CMS OPPS Rate,50.86,100% of CMS OPPS Rate,103.7,203.89% of BCBS Fee Schedule,81.48,70% of total Billed Charges,87.3,75% of total Billed Charges,91.54,180% OF CMS OPPS RATE,93.12,80% of total Billed Charges,178.01,350% of CMS Opps rate,51.87,102% of CMS Opps rate,89.05,76.5% of total billed charges,18.82,100% of Medicaid LA Fee Schedule,18.82,100% of Medicaid LA Fee Schedule,50.86,100% of CMS OPPS Rate,50.86,100% of CMS OPPS Rate,52.38,45% of total billed charges,81.48,70% of total billed charges,69.84,60% of total billed charges,50.86,100% of CMS OPPS Rate,45.77,90% OF UHC FEE SCHEDULE,81.48,70% of total billed charges,50.86,100% OF CMS OPPS Rate,116.4,230% OF CMS OPPS Rate,55.87,48% of total Billed charges,50.86,100% OF CMS OPPS Rate,104.76,90% of total Billed charges,18.82,100% of Medicaid LA Fee Schedule,18.82,100% of Medicaid LA Fee Schedule,18.82,100% of Medicaid LA Fee Schedule,18.82,100% of Medicaid LA Fee Schedule,18.82,100% of Medicaid LA Fee Schedule,18.82,100% of Medicaid LA Fee Schedule,50.86,100% of CMS OPPS Rate,50.86,100% of CMS OPPS Rate,50.86,100% of CMS OPPS Rate,50.86,100% of CMS OPPS Rate,50.86,100% of CMS OPPS Rate,50.86,100% of CMS OPPS Rate,50.86,100% of CMS OPPS Rate,50.86,100% of CMS OPPS Rate,18.82,180.04,69.84
Outpatient,Laboratory,83880,Blood test used to diagnose heart failure,300,187.2,138.98,354% of CMS OPPS Rate,39.26,100% of Medicaid LA Fee Schedule,39.26,100% of CMS OPPS Rate,39.26,100% of CMS OPPS Rate,85.43,203.89% of BCBS Fee Schedule,131.04,70% of total Billed Charges,140.4,75% of total Billed Charges,70.66,180% OF CMS OPPS RATE,149.76,80% of total Billed Charges,137.41,350% of CMS Opps rate,40.04,102% of CMS Opps rate,143.21,76.5% of total billed charges,39.26,100% of Medicaid LA Fee Schedule,39.26,100% of Medicaid LA Fee Schedule,39.26,100% of CMS OPPS Rate,39.26,100% of CMS OPPS Rate,84.24,45% of total billed charges,131.04,70% of total billed charges,112.32,60% of total billed charges,39.26,100% of CMS OPPS Rate,37.71,90% OF UHC FEE SCHEDULE,131.04,70% of total billed charges,39.26,100% OF CMS OPPS Rate,90.29,230% OF CMS OPPS Rate,89.86,48% of total Billed charges,39.26,100% OF CMS OPPS Rate,168.48,90% of total Billed charges,39.26,100% of Medicaid LA Fee Schedule,39.26,100% of Medicaid LA Fee Schedule,39.26,100% of Medicaid LA Fee Schedule,39.26,100% of Medicaid LA Fee Schedule,39.26,100% of Medicaid LA Fee Schedule,39.26,100% of Medicaid LA Fee Schedule,39.26,100% of CMS OPPS Rate,39.26,100% of CMS OPPS Rate,39.26,100% of CMS OPPS Rate,39.26,100% of CMS OPPS Rate,39.26,100% of CMS OPPS Rate,39.26,100% of CMS OPPS Rate,39.26,100% of CMS OPPS Rate,39.26,100% of CMS OPPS Rate,37.71,168.48,112.32
Outpatient,Laboratory,83883,NEPHELOMETRY EA,300,41,48.14,354% of CMS OPPS Rate,5.68,100% of Medicaid LA Fee Schedule,13.6,100% of CMS OPPS Rate,13.6,100% of CMS OPPS Rate,34.23,203.89% of BCBS Fee Schedule,28.7,70% of total Billed Charges,30.75,75% of total Billed Charges,24.48,180% OF CMS OPPS RATE,32.8,80% of total Billed Charges,47.6,350% of CMS Opps rate,13.87,102% of CMS Opps rate,31.37,76.5% of total billed charges,5.68,100% of Medicaid LA Fee Schedule,5.68,100% of Medicaid LA Fee Schedule,13.6,100% of CMS OPPS Rate,13.6,100% of CMS OPPS Rate,18.45,45% of total billed charges,28.7,70% of total billed charges,24.6,60% of total billed charges,13.6,100% of CMS OPPS Rate,15.11,90% OF UHC FEE SCHEDULE,28.7,70% of total billed charges,13.6,100% OF CMS OPPS Rate,31.28,230% OF CMS OPPS Rate,19.68,48% of total Billed charges,13.6,100% OF CMS OPPS Rate,36.9,90% of total Billed charges,5.68,100% of Medicaid LA Fee Schedule,5.68,100% of Medicaid LA Fee Schedule,5.68,100% of Medicaid LA Fee Schedule,5.68,100% of Medicaid LA Fee Schedule,5.68,100% of Medicaid LA Fee Schedule,5.68,100% of Medicaid LA Fee Schedule,13.6,100% of CMS OPPS Rate,13.6,100% of CMS OPPS Rate,13.6,100% of CMS OPPS Rate,13.6,100% of CMS OPPS Rate,13.6,100% of CMS OPPS Rate,13.6,100% of CMS OPPS Rate,13.6,100% of CMS OPPS Rate,13.6,100% of CMS OPPS Rate,5.68,48.14,24.6
Outpatient,Laboratory,83885,"NICKEL, URINE",300,81.95,86.76,354% of CMS OPPS Rate,24.51,100% of Medicaid LA Fee Schedule,24.51,100% of CMS OPPS Rate,24.51,100% of CMS OPPS Rate,61.7,203.89% of BCBS Fee Schedule,57.37,70% of total Billed Charges,61.46,75% of total Billed Charges,44.11,180% OF CMS OPPS RATE,65.56,80% of total Billed Charges,85.78,350% of CMS Opps rate,25,102% of CMS Opps rate,62.69,76.5% of total billed charges,24.51,100% of Medicaid LA Fee Schedule,24.51,100% of Medicaid LA Fee Schedule,24.51,100% of CMS OPPS Rate,24.51,100% of CMS OPPS Rate,36.88,45% of total billed charges,57.37,70% of total billed charges,49.17,60% of total billed charges,24.51,100% of CMS OPPS Rate,27.23,90% OF UHC FEE SCHEDULE,57.37,70% of total billed charges,24.51,100% OF CMS OPPS Rate,56.37,230% OF CMS OPPS Rate,39.34,48% of total Billed charges,24.51,100% OF CMS OPPS Rate,73.76,90% of total Billed charges,24.51,100% of Medicaid LA Fee Schedule,24.51,100% of Medicaid LA Fee Schedule,24.51,100% of Medicaid LA Fee Schedule,24.51,100% of Medicaid LA Fee Schedule,24.51,100% of Medicaid LA Fee Schedule,24.51,100% of Medicaid LA Fee Schedule,24.51,100% of CMS OPPS Rate,24.51,100% of CMS OPPS Rate,24.51,100% of CMS OPPS Rate,24.51,100% of CMS OPPS Rate,24.51,100% of CMS OPPS Rate,24.51,100% of CMS OPPS Rate,24.51,100% of CMS OPPS Rate,24.51,100% of CMS OPPS Rate,24.51,86.76,49.17
Outpatient,Laboratory,83915,NUCLEOTIDASE-5-,300,128,39.47,354% of CMS OPPS Rate,11.15,100% of Medicaid LA Fee Schedule,11.15,100% of CMS OPPS Rate,11.15,100% of CMS OPPS Rate,28.08,203.89% of BCBS Fee Schedule,89.6,70% of total Billed Charges,96,75% of total Billed Charges,20.07,180% OF CMS OPPS RATE,102.4,80% of total Billed Charges,39.02,350% of CMS Opps rate,11.37,102% of CMS Opps rate,97.92,76.5% of total billed charges,11.15,100% of Medicaid LA Fee Schedule,11.15,100% of Medicaid LA Fee Schedule,11.15,100% of CMS OPPS Rate,11.15,100% of CMS OPPS Rate,57.6,45% of total billed charges,89.6,70% of total billed charges,76.8,60% of total billed charges,11.15,100% of CMS OPPS Rate,12.39,90% OF UHC FEE SCHEDULE,89.6,70% of total billed charges,11.15,100% OF CMS OPPS Rate,25.64,230% OF CMS OPPS Rate,61.44,48% of total Billed charges,11.15,100% OF CMS OPPS Rate,115.2,90% of total Billed charges,11.15,100% of Medicaid LA Fee Schedule,11.15,100% of Medicaid LA Fee Schedule,11.15,100% of Medicaid LA Fee Schedule,11.15,100% of Medicaid LA Fee Schedule,11.15,100% of Medicaid LA Fee Schedule,11.15,100% of Medicaid LA Fee Schedule,11.15,100% of CMS OPPS Rate,11.15,100% of CMS OPPS Rate,11.15,100% of CMS OPPS Rate,11.15,100% of CMS OPPS Rate,11.15,100% of CMS OPPS Rate,11.15,100% of CMS OPPS Rate,11.15,100% of CMS OPPS Rate,11.15,100% of CMS OPPS Rate,11.15,115.2,76.8
Outpatient,Laboratory,83916,OLIGOCL IMMGLOB (MS PNL),300,82,96.96,354% of CMS OPPS Rate,20.12,100% of Medicaid LA Fee Schedule,27.39,100% of CMS OPPS Rate,27.39,100% of CMS OPPS Rate,55.85,203.89% of BCBS Fee Schedule,57.4,70% of total Billed Charges,61.5,75% of total Billed Charges,49.3,180% OF CMS OPPS RATE,65.6,80% of total Billed Charges,95.86,350% of CMS Opps rate,27.93,102% of CMS Opps rate,62.73,76.5% of total billed charges,20.12,100% of Medicaid LA Fee Schedule,20.12,100% of Medicaid LA Fee Schedule,27.39,100% of CMS OPPS Rate,27.39,100% of CMS OPPS Rate,36.9,45% of total billed charges,57.4,70% of total billed charges,49.2,60% of total billed charges,27.39,100% of CMS OPPS Rate,24.65,90% OF UHC FEE SCHEDULE,57.4,70% of total billed charges,27.39,100% OF CMS OPPS Rate,62.99,230% OF CMS OPPS Rate,39.36,48% of total Billed charges,27.39,100% OF CMS OPPS Rate,73.8,90% of total Billed charges,20.12,100% of Medicaid LA Fee Schedule,20.12,100% of Medicaid LA Fee Schedule,20.12,100% of Medicaid LA Fee Schedule,20.12,100% of Medicaid LA Fee Schedule,20.12,100% of Medicaid LA Fee Schedule,20.12,100% of Medicaid LA Fee Schedule,27.39,100% of CMS OPPS Rate,27.39,100% of CMS OPPS Rate,27.39,100% of CMS OPPS Rate,27.39,100% of CMS OPPS Rate,27.39,100% of CMS OPPS Rate,27.39,100% of CMS OPPS Rate,27.39,100% of CMS OPPS Rate,27.39,100% of CMS OPPS Rate,20.12,96.96,49.2
Outpatient,Laboratory,83918,ORGANIC ACID QUANT,300,276.75,83.54,354% of CMS OPPS Rate,21.18,100% of Medicaid LA Fee Schedule,23.6,100% of CMS OPPS Rate,23.6,100% of CMS OPPS Rate,48.12,203.89% of BCBS Fee Schedule,193.73,70% of total Billed Charges,207.56,75% of total Billed Charges,42.48,180% OF CMS OPPS RATE,221.4,80% of total Billed Charges,82.6,350% of CMS Opps rate,24.07,102% of CMS Opps rate,211.71,76.5% of total billed charges,21.18,100% of Medicaid LA Fee Schedule,21.18,100% of Medicaid LA Fee Schedule,23.6,100% of CMS OPPS Rate,23.6,100% of CMS OPPS Rate,124.54,45% of total billed charges,193.73,70% of total billed charges,166.05,60% of total billed charges,23.6,100% of CMS OPPS Rate,21.24,90% OF UHC FEE SCHEDULE,193.73,70% of total billed charges,23.6,100% OF CMS OPPS Rate,54.28,230% OF CMS OPPS Rate,132.84,48% of total Billed charges,23.6,100% OF CMS OPPS Rate,249.08,90% of total Billed charges,21.18,100% of Medicaid LA Fee Schedule,21.18,100% of Medicaid LA Fee Schedule,21.18,100% of Medicaid LA Fee Schedule,21.18,100% of Medicaid LA Fee Schedule,21.18,100% of Medicaid LA Fee Schedule,21.18,100% of Medicaid LA Fee Schedule,23.6,100% of CMS OPPS Rate,23.6,100% of CMS OPPS Rate,23.6,100% of CMS OPPS Rate,23.6,100% of CMS OPPS Rate,23.6,100% of CMS OPPS Rate,23.6,100% of CMS OPPS Rate,23.6,100% of CMS OPPS Rate,23.6,100% of CMS OPPS Rate,21.18,249.08,166.05
Outpatient,Laboratory,83919,"ORGANIC ACID,SERUM",300,301.5,58.23,354% of CMS OPPS Rate,16.45,100% of Medicaid LA Fee Schedule,16.45,100% of CMS OPPS Rate,16.45,100% of CMS OPPS Rate,41.41,203.89% of BCBS Fee Schedule,211.05,70% of total Billed Charges,226.13,75% of total Billed Charges,29.61,180% OF CMS OPPS RATE,241.2,80% of total Billed Charges,57.57,350% of CMS Opps rate,16.77,102% of CMS Opps rate,230.65,76.5% of total billed charges,16.45,100% of Medicaid LA Fee Schedule,16.45,100% of Medicaid LA Fee Schedule,16.45,100% of CMS OPPS Rate,16.45,100% of CMS OPPS Rate,135.68,45% of total billed charges,211.05,70% of total billed charges,180.9,60% of total billed charges,16.45,100% of CMS OPPS Rate,18.28,90% OF UHC FEE SCHEDULE,211.05,70% of total billed charges,16.45,100% OF CMS OPPS Rate,37.83,230% OF CMS OPPS Rate,144.72,48% of total Billed charges,16.45,100% OF CMS OPPS Rate,271.35,90% of total Billed charges,16.45,100% of Medicaid LA Fee Schedule,16.45,100% of Medicaid LA Fee Schedule,16.45,100% of Medicaid LA Fee Schedule,16.45,100% of Medicaid LA Fee Schedule,16.45,100% of Medicaid LA Fee Schedule,16.45,100% of Medicaid LA Fee Schedule,16.45,100% of CMS OPPS Rate,16.45,100% of CMS OPPS Rate,16.45,100% of CMS OPPS Rate,16.45,100% of CMS OPPS Rate,16.45,100% of CMS OPPS Rate,16.45,100% of CMS OPPS Rate,16.45,100% of CMS OPPS Rate,16.45,100% of CMS OPPS Rate,16.45,271.35,180.9
Outpatient,Laboratory,83921,"ORGANIC ACID SINGLE, QUAN",300,92.4,75.08,354% of CMS OPPS Rate,21.21,100% of Medicaid LA Fee Schedule,21.21,100% of CMS OPPS Rate,21.21,100% of CMS OPPS Rate,43.25,203.89% of BCBS Fee Schedule,64.68,70% of total Billed Charges,69.3,75% of total Billed Charges,38.17,180% OF CMS OPPS RATE,73.92,80% of total Billed Charges,74.23,350% of CMS Opps rate,21.63,102% of CMS Opps rate,70.69,76.5% of total billed charges,21.21,100% of Medicaid LA Fee Schedule,21.21,100% of Medicaid LA Fee Schedule,21.21,100% of CMS OPPS Rate,21.21,100% of CMS OPPS Rate,41.58,45% of total billed charges,64.68,70% of total billed charges,55.44,60% of total billed charges,21.21,100% of CMS OPPS Rate,19.09,90% OF UHC FEE SCHEDULE,64.68,70% of total billed charges,21.21,100% OF CMS OPPS Rate,48.78,230% OF CMS OPPS Rate,44.35,48% of total Billed charges,21.21,100% OF CMS OPPS Rate,83.16,90% of total Billed charges,21.21,100% of Medicaid LA Fee Schedule,21.21,100% of Medicaid LA Fee Schedule,21.21,100% of Medicaid LA Fee Schedule,21.21,100% of Medicaid LA Fee Schedule,21.21,100% of Medicaid LA Fee Schedule,21.21,100% of Medicaid LA Fee Schedule,21.21,100% of CMS OPPS Rate,21.21,100% of CMS OPPS Rate,21.21,100% of CMS OPPS Rate,21.21,100% of CMS OPPS Rate,21.21,100% of CMS OPPS Rate,21.21,100% of CMS OPPS Rate,21.21,100% of CMS OPPS Rate,21.21,100% of CMS OPPS Rate,19.09,83.16,55.44
Outpatient,Laboratory,83930,OSMOLALITY SERUM,300,66.15,23.39,354% of CMS OPPS Rate,6.61,100% of Medicaid LA Fee Schedule,6.61,100% of CMS OPPS Rate,6.61,100% of CMS OPPS Rate,16.64,203.89% of BCBS Fee Schedule,46.31,70% of total Billed Charges,49.61,75% of total Billed Charges,11.89,180% OF CMS OPPS RATE,52.92,80% of total Billed Charges,23.13,350% of CMS Opps rate,6.74,102% of CMS Opps rate,50.6,76.5% of total billed charges,6.61,100% of Medicaid LA Fee Schedule,6.61,100% of Medicaid LA Fee Schedule,6.61,100% of CMS OPPS Rate,6.61,100% of CMS OPPS Rate,29.77,45% of total billed charges,46.31,70% of total billed charges,39.69,60% of total billed charges,6.61,100% of CMS OPPS Rate,7.34,90% OF UHC FEE SCHEDULE,46.31,70% of total billed charges,6.61,100% OF CMS OPPS Rate,15.2,230% OF CMS OPPS Rate,31.75,48% of total Billed charges,6.61,100% OF CMS OPPS Rate,59.54,90% of total Billed charges,6.61,100% of Medicaid LA Fee Schedule,6.61,100% of Medicaid LA Fee Schedule,6.61,100% of Medicaid LA Fee Schedule,6.61,100% of Medicaid LA Fee Schedule,6.61,100% of Medicaid LA Fee Schedule,6.61,100% of Medicaid LA Fee Schedule,6.61,100% of CMS OPPS Rate,6.61,100% of CMS OPPS Rate,6.61,100% of CMS OPPS Rate,6.61,100% of CMS OPPS Rate,6.61,100% of CMS OPPS Rate,6.61,100% of CMS OPPS Rate,6.61,100% of CMS OPPS Rate,6.61,100% of CMS OPPS Rate,6.61,59.54,39.69
Outpatient,Laboratory,83935,OSMOLALITY URINE,300,52.2,24.14,354% of CMS OPPS Rate,6.82,100% of Medicaid LA Fee Schedule,6.82,100% of CMS OPPS Rate,6.82,100% of CMS OPPS Rate,17.17,203.89% of BCBS Fee Schedule,36.54,70% of total Billed Charges,39.15,75% of total Billed Charges,12.27,180% OF CMS OPPS RATE,41.76,80% of total Billed Charges,23.87,350% of CMS Opps rate,6.95,102% of CMS Opps rate,39.93,76.5% of total billed charges,6.82,100% of Medicaid LA Fee Schedule,6.82,100% of Medicaid LA Fee Schedule,6.82,100% of CMS OPPS Rate,6.82,100% of CMS OPPS Rate,23.49,45% of total billed charges,36.54,70% of total billed charges,31.32,60% of total billed charges,6.82,100% of CMS OPPS Rate,7.58,90% OF UHC FEE SCHEDULE,36.54,70% of total billed charges,6.82,100% OF CMS OPPS Rate,15.68,230% OF CMS OPPS Rate,25.06,48% of total Billed charges,6.82,100% OF CMS OPPS Rate,46.98,90% of total Billed charges,6.82,100% of Medicaid LA Fee Schedule,6.82,100% of Medicaid LA Fee Schedule,6.82,100% of Medicaid LA Fee Schedule,6.82,100% of Medicaid LA Fee Schedule,6.82,100% of Medicaid LA Fee Schedule,6.82,100% of Medicaid LA Fee Schedule,6.82,100% of CMS OPPS Rate,6.82,100% of CMS OPPS Rate,6.82,100% of CMS OPPS Rate,6.82,100% of CMS OPPS Rate,6.82,100% of CMS OPPS Rate,6.82,100% of CMS OPPS Rate,6.82,100% of CMS OPPS Rate,6.82,100% of CMS OPPS Rate,6.82,46.98,31.32
Outpatient,Laboratory,83937,OSTEOCALCIN BONE PROTEIN,300,258,105.66,354% of CMS OPPS Rate,29.85,100% of Medicaid LA Fee Schedule,29.85,100% of CMS OPPS Rate,29.85,100% of CMS OPPS Rate,75.13,203.89% of BCBS Fee Schedule,180.6,70% of total Billed Charges,193.5,75% of total Billed Charges,53.73,180% OF CMS OPPS RATE,206.4,80% of total Billed Charges,104.47,350% of CMS Opps rate,30.44,102% of CMS Opps rate,197.37,76.5% of total billed charges,29.85,100% of Medicaid LA Fee Schedule,29.85,100% of Medicaid LA Fee Schedule,29.85,100% of CMS OPPS Rate,29.85,100% of CMS OPPS Rate,116.1,45% of total billed charges,180.6,70% of total billed charges,154.8,60% of total billed charges,29.85,100% of CMS OPPS Rate,33.17,90% OF UHC FEE SCHEDULE,180.6,70% of total billed charges,29.85,100% OF CMS OPPS Rate,68.65,230% OF CMS OPPS Rate,123.84,48% of total Billed charges,29.85,100% OF CMS OPPS Rate,232.2,90% of total Billed charges,29.85,100% of Medicaid LA Fee Schedule,29.85,100% of Medicaid LA Fee Schedule,29.85,100% of Medicaid LA Fee Schedule,29.85,100% of Medicaid LA Fee Schedule,29.85,100% of Medicaid LA Fee Schedule,29.85,100% of Medicaid LA Fee Schedule,29.85,100% of CMS OPPS Rate,29.85,100% of CMS OPPS Rate,29.85,100% of CMS OPPS Rate,29.85,100% of CMS OPPS Rate,29.85,100% of CMS OPPS Rate,29.85,100% of CMS OPPS Rate,29.85,100% of CMS OPPS Rate,29.85,100% of CMS OPPS Rate,29.85,232.2,154.8
Outpatient,Laboratory,83945,"OXALATE, URINE",300,194.15,51.15,354% of CMS OPPS Rate,14.45,100% of Medicaid LA Fee Schedule,14.45,100% of CMS OPPS Rate,14.45,100% of CMS OPPS Rate,32.4,203.89% of BCBS Fee Schedule,135.91,70% of total Billed Charges,145.61,75% of total Billed Charges,26.01,180% OF CMS OPPS RATE,155.32,80% of total Billed Charges,50.57,350% of CMS Opps rate,14.73,102% of CMS Opps rate,148.52,76.5% of total billed charges,14.45,100% of Medicaid LA Fee Schedule,14.45,100% of Medicaid LA Fee Schedule,14.45,100% of CMS OPPS Rate,14.45,100% of CMS OPPS Rate,87.37,45% of total billed charges,135.91,70% of total billed charges,116.49,60% of total billed charges,14.45,100% of CMS OPPS Rate,14.3,90% OF UHC FEE SCHEDULE,135.91,70% of total billed charges,14.45,100% OF CMS OPPS Rate,33.23,230% OF CMS OPPS Rate,93.19,48% of total Billed charges,14.45,100% OF CMS OPPS Rate,174.74,90% of total Billed charges,14.45,100% of Medicaid LA Fee Schedule,14.45,100% of Medicaid LA Fee Schedule,14.45,100% of Medicaid LA Fee Schedule,14.45,100% of Medicaid LA Fee Schedule,14.45,100% of Medicaid LA Fee Schedule,14.45,100% of Medicaid LA Fee Schedule,14.45,100% of CMS OPPS Rate,14.45,100% of CMS OPPS Rate,14.45,100% of CMS OPPS Rate,14.45,100% of CMS OPPS Rate,14.45,100% of CMS OPPS Rate,14.45,100% of CMS OPPS Rate,14.45,100% of CMS OPPS Rate,14.45,100% of CMS OPPS Rate,14.3,174.74,116.49
Outpatient,Laboratory,83951,ONCOPROTEIN DCP,300,550,228.01,354% of CMS OPPS Rate,64.41,100% of Medicaid LA Fee Schedule,64.41,100% of CMS OPPS Rate,64.41,100% of CMS OPPS Rate,162.13,203.89% of BCBS Fee Schedule,385,70% of total Billed Charges,412.5,75% of total Billed Charges,115.93,180% OF CMS OPPS RATE,440,80% of total Billed Charges,225.43,350% of CMS Opps rate,65.69,102% of CMS Opps rate,420.75,76.5% of total billed charges,64.41,100% of Medicaid LA Fee Schedule,64.41,100% of Medicaid LA Fee Schedule,64.41,100% of CMS OPPS Rate,64.41,100% of CMS OPPS Rate,247.5,45% of total billed charges,385,70% of total billed charges,330,60% of total billed charges,64.41,100% of CMS OPPS Rate,71.57,90% OF UHC FEE SCHEDULE,385,70% of total billed charges,64.41,100% OF CMS OPPS Rate,148.14,230% OF CMS OPPS Rate,264,48% of total Billed charges,64.41,100% OF CMS OPPS Rate,495,90% of total Billed charges,64.41,100% of Medicaid LA Fee Schedule,64.41,100% of Medicaid LA Fee Schedule,64.41,100% of Medicaid LA Fee Schedule,64.41,100% of Medicaid LA Fee Schedule,64.41,100% of Medicaid LA Fee Schedule,64.41,100% of Medicaid LA Fee Schedule,64.41,100% of CMS OPPS Rate,64.41,100% of CMS OPPS Rate,64.41,100% of CMS OPPS Rate,64.41,100% of CMS OPPS Rate,64.41,100% of CMS OPPS Rate,64.41,100% of CMS OPPS Rate,64.41,100% of CMS OPPS Rate,64.41,100% of CMS OPPS Rate,64.41,495,330
Outpatient,Laboratory,83970,PARATHORMONE,300,124,146.13,354% of CMS OPPS Rate,41.28,100% of Medicaid LA Fee Schedule,41.28,100% of CMS OPPS Rate,41.28,100% of CMS OPPS Rate,103.9,203.89% of BCBS Fee Schedule,86.8,70% of total Billed Charges,93,75% of total Billed Charges,74.3,180% OF CMS OPPS RATE,99.2,80% of total Billed Charges,144.48,350% of CMS Opps rate,42.1,102% of CMS Opps rate,94.86,76.5% of total billed charges,41.28,100% of Medicaid LA Fee Schedule,41.28,100% of Medicaid LA Fee Schedule,41.28,100% of CMS OPPS Rate,41.28,100% of CMS OPPS Rate,55.8,45% of total billed charges,86.8,70% of total billed charges,74.4,60% of total billed charges,41.28,100% of CMS OPPS Rate,45.86,90% OF UHC FEE SCHEDULE,86.8,70% of total billed charges,41.28,100% OF CMS OPPS Rate,94.94,230% OF CMS OPPS Rate,59.52,48% of total Billed charges,41.28,100% OF CMS OPPS Rate,111.6,90% of total Billed charges,41.28,100% of Medicaid LA Fee Schedule,41.28,100% of Medicaid LA Fee Schedule,41.28,100% of Medicaid LA Fee Schedule,41.28,100% of Medicaid LA Fee Schedule,41.28,100% of Medicaid LA Fee Schedule,41.28,100% of Medicaid LA Fee Schedule,41.28,100% of CMS OPPS Rate,41.28,100% of CMS OPPS Rate,41.28,100% of CMS OPPS Rate,41.28,100% of CMS OPPS Rate,41.28,100% of CMS OPPS Rate,41.28,100% of CMS OPPS Rate,41.28,100% of CMS OPPS Rate,41.28,100% of CMS OPPS Rate,41.28,146.13,74.4
Outpatient,Laboratory,83986,"PH, MISC FLUID",300,44.55,12.67,354% of CMS OPPS Rate,3.58,100% of Medicaid LA Fee Schedule,3.58,100% of CMS OPPS Rate,3.58,100% of CMS OPPS Rate,9.01,203.89% of BCBS Fee Schedule,31.19,70% of total Billed Charges,33.41,75% of total Billed Charges,6.44,180% OF CMS OPPS RATE,35.64,80% of total Billed Charges,12.53,350% of CMS Opps rate,3.65,102% of CMS Opps rate,34.08,76.5% of total billed charges,3.58,100% of Medicaid LA Fee Schedule,3.58,100% of Medicaid LA Fee Schedule,3.58,100% of CMS OPPS Rate,3.58,100% of CMS OPPS Rate,20.05,45% of total billed charges,31.19,70% of total billed charges,26.73,60% of total billed charges,3.58,100% of CMS OPPS Rate,3.98,90% OF UHC FEE SCHEDULE,31.19,70% of total billed charges,3.58,100% OF CMS OPPS Rate,8.23,230% OF CMS OPPS Rate,21.38,48% of total Billed charges,3.58,100% OF CMS OPPS Rate,40.1,90% of total Billed charges,3.58,100% of Medicaid LA Fee Schedule,3.58,100% of Medicaid LA Fee Schedule,3.58,100% of Medicaid LA Fee Schedule,3.58,100% of Medicaid LA Fee Schedule,3.58,100% of Medicaid LA Fee Schedule,3.58,100% of Medicaid LA Fee Schedule,3.58,100% of CMS OPPS Rate,3.58,100% of CMS OPPS Rate,3.58,100% of CMS OPPS Rate,3.58,100% of CMS OPPS Rate,3.58,100% of CMS OPPS Rate,3.58,100% of CMS OPPS Rate,3.58,100% of CMS OPPS Rate,3.58,100% of CMS OPPS Rate,3.58,40.1,26.73
Outpatient,Laboratory,83992,PHENCYCLIDINE PCP CONFIRM,300,126,N/A,Not Applicable,18.92,100% of Medicaid LA Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,44.86,203.89% of BCBS Fee Schedule,88.2,70% of total Billed Charges,94.5,75% of total Billed Charges,N/A,Not Applicable,100.8,80% of total Billed Charges,N/A,Not Applicable,N/A,Not Applicable,96.39,76.5% of total billed charges,18.92,100% of Medicaid LA Fee Schedule,18.92,100% of Medicaid LA Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,56.7,45% of total billed charges,88.2,70% of total billed charges,75.6,60% of total billed charges,N/A,Not Applicable,38.88,90% OF UHC FEE SCHEDULE,88.2,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,60.48,48% of total Billed charges,N/A,Not Applicable,113.4,90% of total Billed charges,18.92,100% of Medicaid LA Fee Schedule,18.92,100% of Medicaid LA Fee Schedule,18.92,100% of Medicaid LA Fee Schedule,18.92,100% of Medicaid LA Fee Schedule,18.92,100% of Medicaid LA Fee Schedule,18.92,100% of Medicaid LA Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,18.92,113.4,75.6
Outpatient,Laboratory,83993,ASSAY CALPROTECTIN FECAL,300,205,69.49,354% of CMS OPPS Rate,19.63,100% of Medicaid LA Fee Schedule,19.63,100% of CMS OPPS Rate,19.63,100% of CMS OPPS Rate,49.42,203.89% of BCBS Fee Schedule,N/A,Not Applicable,153.75,75% of total Billed Charges,35.33,180% OF CMS OPPS RATE,164,80% of total Billed Charges,68.7,350% of CMS Opps rate,20.02,102% of CMS Opps rate,156.83,76.5% of total billed charges,19.63,100% of Medicaid LA Fee Schedule,19.63,100% of Medicaid LA Fee Schedule,19.63,100% of CMS OPPS Rate,19.63,100% of CMS OPPS Rate,92.25,45% of total billed charges,143.5,70% of total billed charges,123,60% of total billed charges,19.63,100% of CMS OPPS Rate,21.82,90% OF UHC FEE SCHEDULE,143.5,70% of total billed charges,19.63,100% OF CMS OPPS Rate,45.14,230% OF CMS OPPS Rate,98.4,48% of total Billed charges,19.63,100% OF CMS OPPS Rate,184.5,90% of total Billed charges,19.63,100% of Medicaid LA Fee Schedule,19.63,100% of Medicaid LA Fee Schedule,19.63,100% of Medicaid LA Fee Schedule,19.63,100% of Medicaid LA Fee Schedule,19.63,100% of Medicaid LA Fee Schedule,19.63,100% of Medicaid LA Fee Schedule,19.63,100% of CMS OPPS Rate,19.63,100% of CMS OPPS Rate,19.63,100% of CMS OPPS Rate,19.63,100% of CMS OPPS Rate,19.63,100% of CMS OPPS Rate,19.63,100% of CMS OPPS Rate,19.63,100% of CMS OPPS Rate,19.63,100% of CMS OPPS Rate,19.63,184.5,123
Outpatient,Laboratory,84030,NEONATAL SCREENING(PKUT4),300,121.95,19.47,354% of CMS OPPS Rate,5.5,100% of Medicaid LA Fee Schedule,5.5,100% of CMS OPPS Rate,5.5,100% of CMS OPPS Rate,13.84,203.89% of BCBS Fee Schedule,85.37,70% of total Billed Charges,91.46,75% of total Billed Charges,9.9,180% OF CMS OPPS RATE,97.56,80% of total Billed Charges,19.25,350% of CMS Opps rate,5.61,102% of CMS Opps rate,93.29,76.5% of total billed charges,5.5,100% of Medicaid LA Fee Schedule,5.5,100% of Medicaid LA Fee Schedule,5.5,100% of CMS OPPS Rate,5.5,100% of CMS OPPS Rate,54.88,45% of total billed charges,85.37,70% of total billed charges,73.17,60% of total billed charges,5.5,100% of CMS OPPS Rate,6.11,90% OF UHC FEE SCHEDULE,85.37,70% of total billed charges,5.5,100% OF CMS OPPS Rate,12.65,230% OF CMS OPPS Rate,58.54,48% of total Billed charges,5.5,100% OF CMS OPPS Rate,109.76,90% of total Billed charges,5.5,100% of Medicaid LA Fee Schedule,5.5,100% of Medicaid LA Fee Schedule,5.5,100% of Medicaid LA Fee Schedule,5.5,100% of Medicaid LA Fee Schedule,5.5,100% of Medicaid LA Fee Schedule,5.5,100% of Medicaid LA Fee Schedule,5.5,100% of CMS OPPS Rate,5.5,100% of CMS OPPS Rate,5.5,100% of CMS OPPS Rate,5.5,100% of CMS OPPS Rate,5.5,100% of CMS OPPS Rate,5.5,100% of CMS OPPS Rate,5.5,100% of CMS OPPS Rate,5.5,100% of CMS OPPS Rate,5.5,109.76,73.17
Outpatient,Laboratory,84075,ALKALINE PHOSPHAT SERUM,300,90.9,18.33,354% of CMS OPPS Rate,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,13.03,203.89% of BCBS Fee Schedule,63.63,70% of total Billed Charges,68.18,75% of total Billed Charges,9.32,180% OF CMS OPPS RATE,72.72,80% of total Billed Charges,18.13,350% of CMS Opps rate,5.28,102% of CMS Opps rate,69.54,76.5% of total billed charges,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,40.91,45% of total billed charges,63.63,70% of total billed charges,54.54,60% of total billed charges,5.18,100% of CMS OPPS Rate,5.75,90% OF UHC FEE SCHEDULE,63.63,70% of total billed charges,5.18,100% OF CMS OPPS Rate,11.91,230% OF CMS OPPS Rate,43.63,48% of total Billed charges,5.18,100% OF CMS OPPS Rate,81.81,90% of total Billed charges,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,5.18,81.81,54.54
Outpatient,Laboratory,84080,ALK PHOS ISOENZYMES,300,129.25,52.32,354% of CMS OPPS Rate,14.78,100% of Medicaid LA Fee Schedule,14.78,100% of CMS OPPS Rate,14.78,100% of CMS OPPS Rate,37.21,203.89% of BCBS Fee Schedule,90.48,70% of total Billed Charges,96.94,75% of total Billed Charges,26.6,180% OF CMS OPPS RATE,103.4,80% of total Billed Charges,51.73,350% of CMS Opps rate,15.07,102% of CMS Opps rate,98.88,76.5% of total billed charges,14.78,100% of Medicaid LA Fee Schedule,14.78,100% of Medicaid LA Fee Schedule,14.78,100% of CMS OPPS Rate,14.78,100% of CMS OPPS Rate,58.16,45% of total billed charges,90.48,70% of total billed charges,77.55,60% of total billed charges,14.78,100% of CMS OPPS Rate,16.43,90% OF UHC FEE SCHEDULE,90.48,70% of total billed charges,14.78,100% OF CMS OPPS Rate,33.99,230% OF CMS OPPS Rate,62.04,48% of total Billed charges,14.78,100% OF CMS OPPS Rate,116.33,90% of total Billed charges,14.78,100% of Medicaid LA Fee Schedule,14.78,100% of Medicaid LA Fee Schedule,14.78,100% of Medicaid LA Fee Schedule,14.78,100% of Medicaid LA Fee Schedule,14.78,100% of Medicaid LA Fee Schedule,14.78,100% of Medicaid LA Fee Schedule,14.78,100% of CMS OPPS Rate,14.78,100% of CMS OPPS Rate,14.78,100% of CMS OPPS Rate,14.78,100% of CMS OPPS Rate,14.78,100% of CMS OPPS Rate,14.78,100% of CMS OPPS Rate,14.78,100% of CMS OPPS Rate,14.78,100% of CMS OPPS Rate,14.78,116.33,77.55
Outpatient,Laboratory,84100,PHOSPHORUS INORGANIC,300,73.8,16.77,354% of CMS OPPS Rate,4.74,100% of Medicaid LA Fee Schedule,4.74,100% of CMS OPPS Rate,4.74,100% of CMS OPPS Rate,11.93,203.89% of BCBS Fee Schedule,51.66,70% of total Billed Charges,55.35,75% of total Billed Charges,8.53,180% OF CMS OPPS RATE,59.04,80% of total Billed Charges,16.59,350% of CMS Opps rate,4.83,102% of CMS Opps rate,56.46,76.5% of total billed charges,4.74,100% of Medicaid LA Fee Schedule,4.74,100% of Medicaid LA Fee Schedule,4.74,100% of CMS OPPS Rate,4.74,100% of CMS OPPS Rate,33.21,45% of total billed charges,51.66,70% of total billed charges,44.28,60% of total billed charges,4.74,100% of CMS OPPS Rate,5.27,90% OF UHC FEE SCHEDULE,51.66,70% of total billed charges,4.74,100% OF CMS OPPS Rate,10.9,230% OF CMS OPPS Rate,35.42,48% of total Billed charges,4.74,100% OF CMS OPPS Rate,66.42,90% of total Billed charges,4.74,100% of Medicaid LA Fee Schedule,4.74,100% of Medicaid LA Fee Schedule,4.74,100% of Medicaid LA Fee Schedule,4.74,100% of Medicaid LA Fee Schedule,4.74,100% of Medicaid LA Fee Schedule,4.74,100% of Medicaid LA Fee Schedule,4.74,100% of CMS OPPS Rate,4.74,100% of CMS OPPS Rate,4.74,100% of CMS OPPS Rate,4.74,100% of CMS OPPS Rate,4.74,100% of CMS OPPS Rate,4.74,100% of CMS OPPS Rate,4.74,100% of CMS OPPS Rate,4.74,100% of CMS OPPS Rate,4.74,66.42,44.28
Outpatient,Laboratory,84105,PHOSPHOROUS URINE 24 HR,300,101,20.46,354% of CMS OPPS Rate,5.78,100% of Medicaid LA Fee Schedule,5.78,100% of CMS OPPS Rate,5.78,100% of CMS OPPS Rate,13.03,203.89% of BCBS Fee Schedule,70.7,70% of total Billed Charges,75.75,75% of total Billed Charges,10.4,180% OF CMS OPPS RATE,80.8,80% of total Billed Charges,20.23,350% of CMS Opps rate,5.89,102% of CMS Opps rate,77.27,76.5% of total billed charges,5.78,100% of Medicaid LA Fee Schedule,5.78,100% of Medicaid LA Fee Schedule,5.78,100% of CMS OPPS Rate,5.78,100% of CMS OPPS Rate,45.45,45% of total billed charges,70.7,70% of total billed charges,60.6,60% of total billed charges,5.78,100% of CMS OPPS Rate,5.75,90% OF UHC FEE SCHEDULE,70.7,70% of total billed charges,5.78,100% OF CMS OPPS Rate,13.29,230% OF CMS OPPS Rate,48.48,48% of total Billed charges,5.78,100% OF CMS OPPS Rate,90.9,90% of total Billed charges,5.78,100% of Medicaid LA Fee Schedule,5.78,100% of Medicaid LA Fee Schedule,5.78,100% of Medicaid LA Fee Schedule,5.78,100% of Medicaid LA Fee Schedule,5.78,100% of Medicaid LA Fee Schedule,5.78,100% of Medicaid LA Fee Schedule,5.78,100% of CMS OPPS Rate,5.78,100% of CMS OPPS Rate,5.78,100% of CMS OPPS Rate,5.78,100% of CMS OPPS Rate,5.78,100% of CMS OPPS Rate,5.78,100% of CMS OPPS Rate,5.78,100% of CMS OPPS Rate,5.78,100% of CMS OPPS Rate,5.75,90.9,60.6
Outpatient,Laboratory,84110,PORPHOBILINOGEN-URINE-24H,300,103.95,29.87,354% of CMS OPPS Rate,6,100% of Medicaid LA Fee Schedule,8.44,100% of CMS OPPS Rate,8.44,100% of CMS OPPS Rate,21.25,203.89% of BCBS Fee Schedule,72.77,70% of total Billed Charges,77.96,75% of total Billed Charges,15.19,180% OF CMS OPPS RATE,83.16,80% of total Billed Charges,29.54,350% of CMS Opps rate,8.6,102% of CMS Opps rate,79.52,76.5% of total billed charges,6,100% of Medicaid LA Fee Schedule,6,100% of Medicaid LA Fee Schedule,8.44,100% of CMS OPPS Rate,8.44,100% of CMS OPPS Rate,46.78,45% of total billed charges,72.77,70% of total billed charges,62.37,60% of total billed charges,8.44,100% of CMS OPPS Rate,9.38,90% OF UHC FEE SCHEDULE,72.77,70% of total billed charges,8.44,100% OF CMS OPPS Rate,19.41,230% OF CMS OPPS Rate,49.9,48% of total Billed charges,8.44,100% OF CMS OPPS Rate,93.56,90% of total Billed charges,6,100% of Medicaid LA Fee Schedule,6,100% of Medicaid LA Fee Schedule,6,100% of Medicaid LA Fee Schedule,6,100% of Medicaid LA Fee Schedule,6,100% of Medicaid LA Fee Schedule,6,100% of Medicaid LA Fee Schedule,8.44,100% of CMS OPPS Rate,8.44,100% of CMS OPPS Rate,8.44,100% of CMS OPPS Rate,8.44,100% of CMS OPPS Rate,8.44,100% of CMS OPPS Rate,8.44,100% of CMS OPPS Rate,8.44,100% of CMS OPPS Rate,8.44,100% of CMS OPPS Rate,6,93.56,62.37
Outpatient,Laboratory,84112,PAMG-1 RAPID ASSAY FOR RO,300,294,347.3,354% of CMS OPPS Rate,83.73,100% of Medicaid LA Fee Schedule,98.11,100% of CMS OPPS Rate,98.11,100% of CMS OPPS Rate,200.04,203.89% of BCBS Fee Schedule,205.8,70% of total Billed Charges,220.5,75% of total Billed Charges,176.59,180% OF CMS OPPS RATE,235.2,80% of total Billed Charges,343.38,350% of CMS Opps rate,100.07,102% of CMS Opps rate,224.91,76.5% of total billed charges,83.73,100% of Medicaid LA Fee Schedule,83.73,100% of Medicaid LA Fee Schedule,98.11,100% of CMS OPPS Rate,98.11,100% of CMS OPPS Rate,132.3,45% of total billed charges,205.8,70% of total billed charges,176.4,60% of total billed charges,98.11,100% of CMS OPPS Rate,88.3,90% OF UHC FEE SCHEDULE,205.8,70% of total billed charges,98.11,100% OF CMS OPPS Rate,225.65,230% OF CMS OPPS Rate,141.12,48% of total Billed charges,98.11,100% OF CMS OPPS Rate,264.6,90% of total Billed charges,83.73,100% of Medicaid LA Fee Schedule,83.73,100% of Medicaid LA Fee Schedule,83.73,100% of Medicaid LA Fee Schedule,83.73,100% of Medicaid LA Fee Schedule,83.73,100% of Medicaid LA Fee Schedule,83.73,100% of Medicaid LA Fee Schedule,98.11,100% of CMS OPPS Rate,98.11,100% of CMS OPPS Rate,98.11,100% of CMS OPPS Rate,98.11,100% of CMS OPPS Rate,98.11,100% of CMS OPPS Rate,98.11,100% of CMS OPPS Rate,98.11,100% of CMS OPPS Rate,98.11,100% of CMS OPPS Rate,83.73,347.3,176.4
Outpatient,Laboratory,84120,PORPHYRINS-QUANT-URINE24H,300,214,52.07,354% of CMS OPPS Rate,14.71,100% of Medicaid LA Fee Schedule,14.71,100% of CMS OPPS Rate,14.71,100% of CMS OPPS Rate,37.03,203.89% of BCBS Fee Schedule,149.8,70% of total Billed Charges,160.5,75% of total Billed Charges,26.47,180% OF CMS OPPS RATE,171.2,80% of total Billed Charges,51.48,350% of CMS Opps rate,15,102% of CMS Opps rate,163.71,76.5% of total billed charges,14.71,100% of Medicaid LA Fee Schedule,14.71,100% of Medicaid LA Fee Schedule,14.71,100% of CMS OPPS Rate,14.71,100% of CMS OPPS Rate,96.3,45% of total billed charges,149.8,70% of total billed charges,128.4,60% of total billed charges,14.71,100% of CMS OPPS Rate,16.34,90% OF UHC FEE SCHEDULE,149.8,70% of total billed charges,14.71,100% OF CMS OPPS Rate,33.83,230% OF CMS OPPS Rate,102.72,48% of total Billed charges,14.71,100% OF CMS OPPS Rate,192.6,90% of total Billed charges,14.71,100% of Medicaid LA Fee Schedule,14.71,100% of Medicaid LA Fee Schedule,14.71,100% of Medicaid LA Fee Schedule,14.71,100% of Medicaid LA Fee Schedule,14.71,100% of Medicaid LA Fee Schedule,14.71,100% of Medicaid LA Fee Schedule,14.71,100% of CMS OPPS Rate,14.71,100% of CMS OPPS Rate,14.71,100% of CMS OPPS Rate,14.71,100% of CMS OPPS Rate,14.71,100% of CMS OPPS Rate,14.71,100% of CMS OPPS Rate,14.71,100% of CMS OPPS Rate,14.71,100% of CMS OPPS Rate,14.71,192.6,128.4
Outpatient,Laboratory,84133,POTASSIUM URINE,300,52.2,16.74,354% of CMS OPPS Rate,4.73,100% of Medicaid LA Fee Schedule,4.73,100% of CMS OPPS Rate,4.73,100% of CMS OPPS Rate,10.85,203.89% of BCBS Fee Schedule,36.54,70% of total Billed Charges,39.15,75% of total Billed Charges,8.51,180% OF CMS OPPS RATE,41.76,80% of total Billed Charges,16.55,350% of CMS Opps rate,4.82,102% of CMS Opps rate,39.93,76.5% of total billed charges,4.73,100% of Medicaid LA Fee Schedule,4.73,100% of Medicaid LA Fee Schedule,4.73,100% of CMS OPPS Rate,4.73,100% of CMS OPPS Rate,23.49,45% of total billed charges,36.54,70% of total billed charges,31.32,60% of total billed charges,4.73,100% of CMS OPPS Rate,4.79,90% OF UHC FEE SCHEDULE,36.54,70% of total billed charges,4.73,100% OF CMS OPPS Rate,10.87,230% OF CMS OPPS Rate,25.06,48% of total Billed charges,4.73,100% OF CMS OPPS Rate,46.98,90% of total Billed charges,4.73,100% of Medicaid LA Fee Schedule,4.73,100% of Medicaid LA Fee Schedule,4.73,100% of Medicaid LA Fee Schedule,4.73,100% of Medicaid LA Fee Schedule,4.73,100% of Medicaid LA Fee Schedule,4.73,100% of Medicaid LA Fee Schedule,4.73,100% of CMS OPPS Rate,4.73,100% of CMS OPPS Rate,4.73,100% of CMS OPPS Rate,4.73,100% of CMS OPPS Rate,4.73,100% of CMS OPPS Rate,4.73,100% of CMS OPPS Rate,4.73,100% of CMS OPPS Rate,4.73,100% of CMS OPPS Rate,4.73,46.98,31.32
Outpatient,Laboratory,84134,Blood test to measure level of prealbumin,300,44,51.64,354% of CMS OPPS Rate,6.81,100% of Medicaid LA Fee Schedule,14.59,100% of CMS OPPS Rate,14.59,100% of CMS OPPS Rate,36.72,203.89% of BCBS Fee Schedule,30.8,70% of total Billed Charges,33,75% of total Billed Charges,26.26,180% OF CMS OPPS RATE,35.2,80% of total Billed Charges,51.06,350% of CMS Opps rate,14.88,102% of CMS Opps rate,33.66,76.5% of total billed charges,6.81,100% of Medicaid LA Fee Schedule,6.81,100% of Medicaid LA Fee Schedule,14.59,100% of CMS OPPS Rate,14.59,100% of CMS OPPS Rate,19.8,45% of total billed charges,30.8,70% of total billed charges,26.4,60% of total billed charges,14.59,100% of CMS OPPS Rate,16.21,90% OF UHC FEE SCHEDULE,30.8,70% of total billed charges,14.59,100% OF CMS OPPS Rate,33.55,230% OF CMS OPPS Rate,21.12,48% of total Billed charges,14.59,100% OF CMS OPPS Rate,39.6,90% of total Billed charges,6.81,100% of Medicaid LA Fee Schedule,6.81,100% of Medicaid LA Fee Schedule,6.81,100% of Medicaid LA Fee Schedule,6.81,100% of Medicaid LA Fee Schedule,6.81,100% of Medicaid LA Fee Schedule,6.81,100% of Medicaid LA Fee Schedule,14.59,100% of CMS OPPS Rate,14.59,100% of CMS OPPS Rate,14.59,100% of CMS OPPS Rate,14.59,100% of CMS OPPS Rate,14.59,100% of CMS OPPS Rate,14.59,100% of CMS OPPS Rate,14.59,100% of CMS OPPS Rate,14.59,100% of CMS OPPS Rate,6.81,51.64,26.4
Outpatient,Laboratory,84140,PREGNENOLONE,300,140.66,73.17,354% of CMS OPPS Rate,20.67,100% of Medicaid LA Fee Schedule,20.67,100% of CMS OPPS Rate,20.67,100% of CMS OPPS Rate,52.03,203.89% of BCBS Fee Schedule,98.46,70% of total Billed Charges,105.5,75% of total Billed Charges,37.2,180% OF CMS OPPS RATE,112.53,80% of total Billed Charges,72.34,350% of CMS Opps rate,21.08,102% of CMS Opps rate,107.6,76.5% of total billed charges,20.67,100% of Medicaid LA Fee Schedule,20.67,100% of Medicaid LA Fee Schedule,20.67,100% of CMS OPPS Rate,20.67,100% of CMS OPPS Rate,63.3,45% of total billed charges,98.46,70% of total billed charges,84.4,60% of total billed charges,20.67,100% of CMS OPPS Rate,22.97,90% OF UHC FEE SCHEDULE,98.46,70% of total billed charges,20.67,100% OF CMS OPPS Rate,47.54,230% OF CMS OPPS Rate,67.52,48% of total Billed charges,20.67,100% OF CMS OPPS Rate,126.59,90% of total Billed charges,20.67,100% of Medicaid LA Fee Schedule,20.67,100% of Medicaid LA Fee Schedule,20.67,100% of Medicaid LA Fee Schedule,20.67,100% of Medicaid LA Fee Schedule,20.67,100% of Medicaid LA Fee Schedule,20.67,100% of Medicaid LA Fee Schedule,20.67,100% of CMS OPPS Rate,20.67,100% of CMS OPPS Rate,20.67,100% of CMS OPPS Rate,20.67,100% of CMS OPPS Rate,20.67,100% of CMS OPPS Rate,20.67,100% of CMS OPPS Rate,20.67,100% of CMS OPPS Rate,20.67,100% of CMS OPPS Rate,20.67,126.59,84.4
Outpatient,Laboratory,84144,PROGESTERONE SERUM,300,113.3,73.84,354% of CMS OPPS Rate,20.86,100% of Medicaid LA Fee Schedule,20.86,100% of CMS OPPS Rate,20.86,100% of CMS OPPS Rate,52.52,203.89% of BCBS Fee Schedule,79.31,70% of total Billed Charges,84.98,75% of total Billed Charges,37.54,180% OF CMS OPPS RATE,90.64,80% of total Billed Charges,73.01,350% of CMS Opps rate,21.27,102% of CMS Opps rate,86.67,76.5% of total billed charges,20.86,100% of Medicaid LA Fee Schedule,20.86,100% of Medicaid LA Fee Schedule,20.86,100% of CMS OPPS Rate,20.86,100% of CMS OPPS Rate,50.99,45% of total billed charges,79.31,70% of total billed charges,67.98,60% of total billed charges,20.86,100% of CMS OPPS Rate,23.18,90% OF UHC FEE SCHEDULE,79.31,70% of total billed charges,20.86,100% OF CMS OPPS Rate,47.97,230% OF CMS OPPS Rate,54.38,48% of total Billed charges,20.86,100% OF CMS OPPS Rate,101.97,90% of total Billed charges,20.86,100% of Medicaid LA Fee Schedule,20.86,100% of Medicaid LA Fee Schedule,20.86,100% of Medicaid LA Fee Schedule,20.86,100% of Medicaid LA Fee Schedule,20.86,100% of Medicaid LA Fee Schedule,20.86,100% of Medicaid LA Fee Schedule,20.86,100% of CMS OPPS Rate,20.86,100% of CMS OPPS Rate,20.86,100% of CMS OPPS Rate,20.86,100% of CMS OPPS Rate,20.86,100% of CMS OPPS Rate,20.86,100% of CMS OPPS Rate,20.86,100% of CMS OPPS Rate,20.86,100% of CMS OPPS Rate,20.86,101.97,67.98
Outpatient,Laboratory,84145,PROCALCITONIN  PCT,300,184.1,96.35,354% of CMS OPPS Rate,25.57,100% of Medicaid LA Fee Schedule,27.22,100% of CMS OPPS Rate,27.22,100% of CMS OPPS Rate,67.45,203.89% of BCBS Fee Schedule,128.87,70% of total Billed Charges,138.08,75% of total Billed Charges,48.99,180% OF CMS OPPS RATE,147.28,80% of total Billed Charges,95.27,350% of CMS Opps rate,27.76,102% of CMS Opps rate,140.84,76.5% of total billed charges,25.57,100% of Medicaid LA Fee Schedule,25.57,100% of Medicaid LA Fee Schedule,27.22,100% of CMS OPPS Rate,27.22,100% of CMS OPPS Rate,82.85,45% of total billed charges,128.87,70% of total billed charges,110.46,60% of total billed charges,27.22,100% of CMS OPPS Rate,29.77,90% OF UHC FEE SCHEDULE,128.87,70% of total billed charges,27.22,100% OF CMS OPPS Rate,62.6,230% OF CMS OPPS Rate,88.37,48% of total Billed charges,27.22,100% OF CMS OPPS Rate,165.69,90% of total Billed charges,25.57,100% of Medicaid LA Fee Schedule,25.57,100% of Medicaid LA Fee Schedule,25.57,100% of Medicaid LA Fee Schedule,25.57,100% of Medicaid LA Fee Schedule,25.57,100% of Medicaid LA Fee Schedule,25.57,100% of Medicaid LA Fee Schedule,27.22,100% of CMS OPPS Rate,27.22,100% of CMS OPPS Rate,27.22,100% of CMS OPPS Rate,27.22,100% of CMS OPPS Rate,27.22,100% of CMS OPPS Rate,27.22,100% of CMS OPPS Rate,27.22,100% of CMS OPPS Rate,27.22,100% of CMS OPPS Rate,25.57,165.69,110.46
Outpatient,Laboratory,84146,PROLACTIN SERUM,300,113.3,68.6,354% of CMS OPPS Rate,19.38,100% of Medicaid LA Fee Schedule,19.38,100% of CMS OPPS Rate,19.38,100% of CMS OPPS Rate,48.77,203.89% of BCBS Fee Schedule,79.31,70% of total Billed Charges,84.98,75% of total Billed Charges,34.88,180% OF CMS OPPS RATE,90.64,80% of total Billed Charges,67.83,350% of CMS Opps rate,19.76,102% of CMS Opps rate,86.67,76.5% of total billed charges,19.38,100% of Medicaid LA Fee Schedule,19.38,100% of Medicaid LA Fee Schedule,19.38,100% of CMS OPPS Rate,19.38,100% of CMS OPPS Rate,50.99,45% of total billed charges,79.31,70% of total billed charges,67.98,60% of total billed charges,19.38,100% of CMS OPPS Rate,21.53,90% OF UHC FEE SCHEDULE,79.31,70% of total billed charges,19.38,100% OF CMS OPPS Rate,44.57,230% OF CMS OPPS Rate,54.38,48% of total Billed charges,19.38,100% OF CMS OPPS Rate,101.97,90% of total Billed charges,19.38,100% of Medicaid LA Fee Schedule,19.38,100% of Medicaid LA Fee Schedule,19.38,100% of Medicaid LA Fee Schedule,19.38,100% of Medicaid LA Fee Schedule,19.38,100% of Medicaid LA Fee Schedule,19.38,100% of Medicaid LA Fee Schedule,19.38,100% of CMS OPPS Rate,19.38,100% of CMS OPPS Rate,19.38,100% of CMS OPPS Rate,19.38,100% of CMS OPPS Rate,19.38,100% of CMS OPPS Rate,19.38,100% of CMS OPPS Rate,19.38,100% of CMS OPPS Rate,19.38,100% of CMS OPPS Rate,19.38,101.97,67.98
Outpatient,Laboratory,84153,PSA (prostate specific antigen),300,77.55,65.1,354% of CMS OPPS Rate,18.39,100% of Medicaid LA Fee Schedule,18.39,100% of CMS OPPS Rate,18.39,100% of CMS OPPS Rate,46.3,203.89% of BCBS Fee Schedule,54.29,70% of total Billed Charges,58.16,75% of total Billed Charges,33.1,180% OF CMS OPPS RATE,62.04,80% of total Billed Charges,64.36,350% of CMS Opps rate,18.75,102% of CMS Opps rate,59.33,76.5% of total billed charges,18.39,100% of Medicaid LA Fee Schedule,18.39,100% of Medicaid LA Fee Schedule,18.39,100% of CMS OPPS Rate,18.39,100% of CMS OPPS Rate,34.9,45% of total billed charges,54.29,70% of total billed charges,46.53,60% of total billed charges,18.39,100% of CMS OPPS Rate,20.44,90% OF UHC FEE SCHEDULE,54.29,70% of total billed charges,18.39,100% OF CMS OPPS Rate,42.29,230% OF CMS OPPS Rate,37.22,48% of total Billed charges,18.39,100% OF CMS OPPS Rate,69.8,90% of total Billed charges,18.39,100% of Medicaid LA Fee Schedule,18.39,100% of Medicaid LA Fee Schedule,18.39,100% of Medicaid LA Fee Schedule,18.39,100% of Medicaid LA Fee Schedule,18.39,100% of Medicaid LA Fee Schedule,18.39,100% of Medicaid LA Fee Schedule,18.39,100% of CMS OPPS Rate,18.39,100% of CMS OPPS Rate,18.39,100% of CMS OPPS Rate,18.39,100% of CMS OPPS Rate,18.39,100% of CMS OPPS Rate,18.39,100% of CMS OPPS Rate,18.39,100% of CMS OPPS Rate,18.39,100% of CMS OPPS Rate,18.39,69.8,46.53
Outpatient,Laboratory,84154,PSA (prostate specific antigen) measurement,300,55,65.1,354% of CMS OPPS Rate,18.39,100% of Medicaid LA Fee Schedule,18.39,100% of CMS OPPS Rate,18.39,100% of CMS OPPS Rate,46.3,203.89% of BCBS Fee Schedule,38.5,70% of total Billed Charges,41.25,75% of total Billed Charges,33.1,180% OF CMS OPPS RATE,44,80% of total Billed Charges,64.36,350% of CMS Opps rate,18.75,102% of CMS Opps rate,42.08,76.5% of total billed charges,18.39,100% of Medicaid LA Fee Schedule,18.39,100% of Medicaid LA Fee Schedule,18.39,100% of CMS OPPS Rate,18.39,100% of CMS OPPS Rate,24.75,45% of total billed charges,38.5,70% of total billed charges,33,60% of total billed charges,18.39,100% of CMS OPPS Rate,20.44,90% OF UHC FEE SCHEDULE,38.5,70% of total billed charges,18.39,100% OF CMS OPPS Rate,42.29,230% OF CMS OPPS Rate,26.4,48% of total Billed charges,18.39,100% OF CMS OPPS Rate,49.5,90% of total Billed charges,18.39,100% of Medicaid LA Fee Schedule,18.39,100% of Medicaid LA Fee Schedule,18.39,100% of Medicaid LA Fee Schedule,18.39,100% of Medicaid LA Fee Schedule,18.39,100% of Medicaid LA Fee Schedule,18.39,100% of Medicaid LA Fee Schedule,18.39,100% of CMS OPPS Rate,18.39,100% of CMS OPPS Rate,18.39,100% of CMS OPPS Rate,18.39,100% of CMS OPPS Rate,18.39,100% of CMS OPPS Rate,18.39,100% of CMS OPPS Rate,18.39,100% of CMS OPPS Rate,18.39,100% of CMS OPPS Rate,18.39,65.1,33
Outpatient,Laboratory,84155,PROTEIN SERUM,300,85.25,12.99,354% of CMS OPPS Rate,3.67,100% of Medicaid LA Fee Schedule,3.67,100% of CMS OPPS Rate,3.67,100% of CMS OPPS Rate,9.24,203.89% of BCBS Fee Schedule,59.68,70% of total Billed Charges,63.94,75% of total Billed Charges,6.6,180% OF CMS OPPS RATE,68.2,80% of total Billed Charges,12.84,350% of CMS Opps rate,3.74,102% of CMS Opps rate,65.22,76.5% of total billed charges,3.67,100% of Medicaid LA Fee Schedule,3.67,100% of Medicaid LA Fee Schedule,3.67,100% of CMS OPPS Rate,3.67,100% of CMS OPPS Rate,38.36,45% of total billed charges,59.68,70% of total billed charges,51.15,60% of total billed charges,3.67,100% of CMS OPPS Rate,4.08,90% OF UHC FEE SCHEDULE,59.68,70% of total billed charges,3.67,100% OF CMS OPPS Rate,8.44,230% OF CMS OPPS Rate,40.92,48% of total Billed charges,3.67,100% OF CMS OPPS Rate,76.73,90% of total Billed charges,3.67,100% of Medicaid LA Fee Schedule,3.67,100% of Medicaid LA Fee Schedule,3.67,100% of Medicaid LA Fee Schedule,3.67,100% of Medicaid LA Fee Schedule,3.67,100% of Medicaid LA Fee Schedule,3.67,100% of Medicaid LA Fee Schedule,3.67,100% of CMS OPPS Rate,3.67,100% of CMS OPPS Rate,3.67,100% of CMS OPPS Rate,3.67,100% of CMS OPPS Rate,3.67,100% of CMS OPPS Rate,3.67,100% of CMS OPPS Rate,3.67,100% of CMS OPPS Rate,3.67,100% of CMS OPPS Rate,3.67,76.73,51.15
Outpatient,Laboratory,84156,PROTEIN TOTAL URINE,300,50.85,12.99,354% of CMS OPPS Rate,3.67,100% of Medicaid LA Fee Schedule,3.67,100% of CMS OPPS Rate,3.67,100% of CMS OPPS Rate,9.24,203.89% of BCBS Fee Schedule,35.6,70% of total Billed Charges,38.14,75% of total Billed Charges,6.6,180% OF CMS OPPS RATE,40.68,80% of total Billed Charges,12.84,350% of CMS Opps rate,3.74,102% of CMS Opps rate,38.9,76.5% of total billed charges,3.67,100% of Medicaid LA Fee Schedule,3.67,100% of Medicaid LA Fee Schedule,3.67,100% of CMS OPPS Rate,3.67,100% of CMS OPPS Rate,22.88,45% of total billed charges,35.6,70% of total billed charges,30.51,60% of total billed charges,3.67,100% of CMS OPPS Rate,4.08,90% OF UHC FEE SCHEDULE,35.6,70% of total billed charges,3.67,100% OF CMS OPPS Rate,8.44,230% OF CMS OPPS Rate,24.41,48% of total Billed charges,3.67,100% OF CMS OPPS Rate,45.77,90% of total Billed charges,3.67,100% of Medicaid LA Fee Schedule,3.67,100% of Medicaid LA Fee Schedule,3.67,100% of Medicaid LA Fee Schedule,3.67,100% of Medicaid LA Fee Schedule,3.67,100% of Medicaid LA Fee Schedule,3.67,100% of Medicaid LA Fee Schedule,3.67,100% of CMS OPPS Rate,3.67,100% of CMS OPPS Rate,3.67,100% of CMS OPPS Rate,3.67,100% of CMS OPPS Rate,3.67,100% of CMS OPPS Rate,3.67,100% of CMS OPPS Rate,3.67,100% of CMS OPPS Rate,3.67,100% of CMS OPPS Rate,3.67,45.77,30.51
Outpatient,Laboratory,84157,PROTEIN TOTAL MISC SPEC,300,95.7,14.16,354% of CMS OPPS Rate,4,100% of Medicaid LA Fee Schedule,4,100% of CMS OPPS Rate,4,100% of CMS OPPS Rate,9.24,203.89% of BCBS Fee Schedule,66.99,70% of total Billed Charges,71.78,75% of total Billed Charges,7.2,180% OF CMS OPPS RATE,76.56,80% of total Billed Charges,14,350% of CMS Opps rate,4.08,102% of CMS Opps rate,73.21,76.5% of total billed charges,4,100% of Medicaid LA Fee Schedule,4,100% of Medicaid LA Fee Schedule,4,100% of CMS OPPS Rate,4,100% of CMS OPPS Rate,43.07,45% of total billed charges,66.99,70% of total billed charges,57.42,60% of total billed charges,4,100% of CMS OPPS Rate,4.08,90% OF UHC FEE SCHEDULE,66.99,70% of total billed charges,4,100% OF CMS OPPS Rate,9.2,230% OF CMS OPPS Rate,45.94,48% of total Billed charges,4,100% OF CMS OPPS Rate,86.13,90% of total Billed charges,4,100% of Medicaid LA Fee Schedule,4,100% of Medicaid LA Fee Schedule,4,100% of Medicaid LA Fee Schedule,4,100% of Medicaid LA Fee Schedule,4,100% of Medicaid LA Fee Schedule,4,100% of Medicaid LA Fee Schedule,4,100% of CMS OPPS Rate,4,100% of CMS OPPS Rate,4,100% of CMS OPPS Rate,4,100% of CMS OPPS Rate,4,100% of CMS OPPS Rate,4,100% of CMS OPPS Rate,4,100% of CMS OPPS Rate,4,100% of CMS OPPS Rate,4,86.13,57.42
Outpatient,Laboratory,84165,PROTEIN ELECTROPHORESIS,300,173.7,38.01,354% of CMS OPPS Rate,10.74,100% of Medicaid LA Fee Schedule,10.74,100% of CMS OPPS Rate,10.74,100% of CMS OPPS Rate,27.04,203.89% of BCBS Fee Schedule,121.59,70% of total Billed Charges,130.28,75% of total Billed Charges,19.33,180% OF CMS OPPS RATE,138.96,80% of total Billed Charges,37.59,350% of CMS Opps rate,10.95,102% of CMS Opps rate,132.88,76.5% of total billed charges,10.74,100% of Medicaid LA Fee Schedule,10.74,100% of Medicaid LA Fee Schedule,10.74,100% of CMS OPPS Rate,10.74,100% of CMS OPPS Rate,78.17,45% of total billed charges,121.59,70% of total billed charges,104.22,60% of total billed charges,10.74,100% of CMS OPPS Rate,11.93,90% OF UHC FEE SCHEDULE,121.59,70% of total billed charges,10.74,100% OF CMS OPPS Rate,24.7,230% OF CMS OPPS Rate,83.38,48% of total Billed charges,10.74,100% OF CMS OPPS Rate,156.33,90% of total Billed charges,10.74,100% of Medicaid LA Fee Schedule,10.74,100% of Medicaid LA Fee Schedule,10.74,100% of Medicaid LA Fee Schedule,10.74,100% of Medicaid LA Fee Schedule,10.74,100% of Medicaid LA Fee Schedule,10.74,100% of Medicaid LA Fee Schedule,10.74,100% of CMS OPPS Rate,10.74,100% of CMS OPPS Rate,10.74,100% of CMS OPPS Rate,10.74,100% of CMS OPPS Rate,10.74,100% of CMS OPPS Rate,10.74,100% of CMS OPPS Rate,10.74,100% of CMS OPPS Rate,10.74,100% of CMS OPPS Rate,10.74,156.33,104.22
Outpatient,Laboratory,84166,PROTEIN ELECT.URINE RAND,300,261,63.11,354% of CMS OPPS Rate,17.83,100% of Medicaid LA Fee Schedule,17.82,100% of CMS OPPS Rate,17.82,100% of CMS OPPS Rate,44.88,203.89% of BCBS Fee Schedule,182.7,70% of total Billed Charges,195.75,75% of total Billed Charges,32.09,180% OF CMS OPPS RATE,208.8,80% of total Billed Charges,62.4,350% of CMS Opps rate,18.18,102% of CMS Opps rate,199.67,76.5% of total billed charges,17.83,100% of Medicaid LA Fee Schedule,17.83,100% of Medicaid LA Fee Schedule,17.82,100% of CMS OPPS Rate,17.82,100% of CMS OPPS Rate,117.45,45% of total billed charges,182.7,70% of total billed charges,156.6,60% of total billed charges,17.82,100% of CMS OPPS Rate,19.81,90% OF UHC FEE SCHEDULE,182.7,70% of total billed charges,17.82,100% OF CMS OPPS Rate,41,230% OF CMS OPPS Rate,125.28,48% of total Billed charges,17.82,100% OF CMS OPPS Rate,234.9,90% of total Billed charges,17.83,100% of Medicaid LA Fee Schedule,17.83,100% of Medicaid LA Fee Schedule,17.83,100% of Medicaid LA Fee Schedule,17.83,100% of Medicaid LA Fee Schedule,17.83,100% of Medicaid LA Fee Schedule,17.83,100% of Medicaid LA Fee Schedule,17.82,100% of CMS OPPS Rate,17.82,100% of CMS OPPS Rate,17.82,100% of CMS OPPS Rate,17.82,100% of CMS OPPS Rate,17.82,100% of CMS OPPS Rate,17.82,100% of CMS OPPS Rate,17.82,100% of CMS OPPS Rate,17.82,100% of CMS OPPS Rate,17.82,234.9,156.6
Outpatient,Laboratory,84181,"PROTEIN, WESTERN BLOT W INTERP",300,490,60.28,354% of CMS OPPS Rate,76.78,15.67% of total Billed charges,17.03,100% of CMS OPPS Rate,17.03,100% of CMS OPPS Rate,42.86,203.89% of BCBS Fee Schedule,343,70% of total Billed Charges,367.5,75% of total Billed Charges,30.65,180% OF CMS OPPS RATE,392,80% of total Billed Charges,59.6,350% of CMS Opps rate,17.37,102% of CMS Opps rate,374.85,76.5% of total billed charges,76.78,15.67% of total Billed charges,76.78,15.67% of total Billed charges,17.03,100% of CMS OPPS Rate,17.03,100% of CMS OPPS Rate,220.5,45% of total billed charges,343,70% of total billed charges,294,60% of total billed charges,17.03,100% of CMS OPPS Rate,18.92,90% OF UHC FEE SCHEDULE,343,70% of total billed charges,17.03,100% OF CMS OPPS Rate,39.16,230% OF CMS OPPS Rate,235.2,48% of total Billed charges,17.03,100% OF CMS OPPS Rate,441,90% of total Billed charges,76.78,15.67% of total Billed charges,76.78,15.67% of total Billed charges,76.78,15.67% of total Billed charges,76.78,15.67% of total Billed charges,76.78,15.67% of total Billed charges,76.78,15.67% of total Billed charges,17.03,100% of CMS OPPS Rate,17.03,100% of CMS OPPS Rate,17.03,100% of CMS OPPS Rate,17.03,100% of CMS OPPS Rate,17.03,100% of CMS OPPS Rate,17.03,100% of CMS OPPS Rate,17.03,100% of CMS OPPS Rate,17.03,100% of CMS OPPS Rate,17.03,441,294
Outpatient,Laboratory,84182,PROTEIN WESTERN BLOT,300,88,103.4,354% of CMS OPPS Rate,20.47,100% of Medicaid LA Fee Schedule,29.21,100% of CMS OPPS Rate,29.21,100% of CMS OPPS Rate,59.56,203.89% of BCBS Fee Schedule,61.6,70% of total Billed Charges,66,75% of total Billed Charges,52.57,180% OF CMS OPPS RATE,70.4,80% of total Billed Charges,102.23,350% of CMS Opps rate,29.79,102% of CMS Opps rate,67.32,76.5% of total billed charges,20.47,100% of Medicaid LA Fee Schedule,20.47,100% of Medicaid LA Fee Schedule,29.21,100% of CMS OPPS Rate,29.21,100% of CMS OPPS Rate,39.6,45% of total billed charges,61.6,70% of total billed charges,52.8,60% of total billed charges,29.21,100% of CMS OPPS Rate,26.29,90% OF UHC FEE SCHEDULE,61.6,70% of total billed charges,29.21,100% OF CMS OPPS Rate,67.18,230% OF CMS OPPS Rate,42.24,48% of total Billed charges,29.21,100% OF CMS OPPS Rate,79.2,90% of total Billed charges,20.47,100% of Medicaid LA Fee Schedule,20.47,100% of Medicaid LA Fee Schedule,20.47,100% of Medicaid LA Fee Schedule,20.47,100% of Medicaid LA Fee Schedule,20.47,100% of Medicaid LA Fee Schedule,20.47,100% of Medicaid LA Fee Schedule,29.21,100% of CMS OPPS Rate,29.21,100% of CMS OPPS Rate,29.21,100% of CMS OPPS Rate,29.21,100% of CMS OPPS Rate,29.21,100% of CMS OPPS Rate,29.21,100% of CMS OPPS Rate,29.21,100% of CMS OPPS Rate,29.21,100% of CMS OPPS Rate,20.47,103.4,52.8
Outpatient,Laboratory,84202,ZINC (PROTOPORPHYRIN),300,35.5,50.79,354% of CMS OPPS Rate,14.35,100% of Medicaid LA Fee Schedule,14.35,100% of CMS OPPS Rate,14.35,100% of CMS OPPS Rate,36.11,203.89% of BCBS Fee Schedule,24.85,70% of total Billed Charges,26.63,75% of total Billed Charges,25.83,180% OF CMS OPPS RATE,28.4,80% of total Billed Charges,50.22,350% of CMS Opps rate,14.63,102% of CMS Opps rate,27.16,76.5% of total billed charges,14.35,100% of Medicaid LA Fee Schedule,14.35,100% of Medicaid LA Fee Schedule,14.35,100% of CMS OPPS Rate,14.35,100% of CMS OPPS Rate,15.98,45% of total billed charges,24.85,70% of total billed charges,21.3,60% of total billed charges,14.35,100% of CMS OPPS Rate,15.94,90% OF UHC FEE SCHEDULE,24.85,70% of total billed charges,14.35,100% OF CMS OPPS Rate,33,230% OF CMS OPPS Rate,17.04,48% of total Billed charges,14.35,100% OF CMS OPPS Rate,31.95,90% of total Billed charges,14.35,100% of Medicaid LA Fee Schedule,14.35,100% of Medicaid LA Fee Schedule,14.35,100% of Medicaid LA Fee Schedule,14.35,100% of Medicaid LA Fee Schedule,14.35,100% of Medicaid LA Fee Schedule,14.35,100% of Medicaid LA Fee Schedule,14.35,100% of CMS OPPS Rate,14.35,100% of CMS OPPS Rate,14.35,100% of CMS OPPS Rate,14.35,100% of CMS OPPS Rate,14.35,100% of CMS OPPS Rate,14.35,100% of CMS OPPS Rate,14.35,100% of CMS OPPS Rate,14.35,100% of CMS OPPS Rate,14.35,50.79,21.3
Outpatient,Laboratory,84206,PROINSULIN,300,46.8,94.48,354% of CMS OPPS Rate,14.15,100% of Medicaid LA Fee Schedule,26.69,100% of CMS OPPS Rate,26.69,100% of CMS OPPS Rate,54.42,203.89% of BCBS Fee Schedule,32.76,70% of total Billed Charges,35.1,75% of total Billed Charges,48.04,180% OF CMS OPPS RATE,37.44,80% of total Billed Charges,93.41,350% of CMS Opps rate,27.22,102% of CMS Opps rate,35.8,76.5% of total billed charges,14.15,100% of Medicaid LA Fee Schedule,14.15,100% of Medicaid LA Fee Schedule,26.69,100% of CMS OPPS Rate,26.69,100% of CMS OPPS Rate,21.06,45% of total billed charges,32.76,70% of total billed charges,28.08,60% of total billed charges,26.69,100% of CMS OPPS Rate,24.02,90% OF UHC FEE SCHEDULE,32.76,70% of total billed charges,26.69,100% OF CMS OPPS Rate,46.8,230% OF CMS OPPS Rate,22.46,48% of total Billed charges,26.69,100% OF CMS OPPS Rate,42.12,90% of total Billed charges,14.15,100% of Medicaid LA Fee Schedule,14.15,100% of Medicaid LA Fee Schedule,14.15,100% of Medicaid LA Fee Schedule,14.15,100% of Medicaid LA Fee Schedule,14.15,100% of Medicaid LA Fee Schedule,14.15,100% of Medicaid LA Fee Schedule,26.69,100% of CMS OPPS Rate,26.69,100% of CMS OPPS Rate,26.69,100% of CMS OPPS Rate,26.69,100% of CMS OPPS Rate,26.69,100% of CMS OPPS Rate,26.69,100% of CMS OPPS Rate,26.69,100% of CMS OPPS Rate,26.69,100% of CMS OPPS Rate,14.15,94.48,28.08
Outpatient,Laboratory,84207,PYRIDOXAL PHOS(VIT B6),300,117.7,99.47,354% of CMS OPPS Rate,17.22,100% of Medicaid LA Fee Schedule,28.1,100% of CMS OPPS Rate,28.1,100% of CMS OPPS Rate,70.73,203.89% of BCBS Fee Schedule,82.39,70% of total Billed Charges,88.28,75% of total Billed Charges,50.58,180% OF CMS OPPS RATE,94.16,80% of total Billed Charges,98.35,350% of CMS Opps rate,28.66,102% of CMS Opps rate,90.04,76.5% of total billed charges,17.22,100% of Medicaid LA Fee Schedule,17.22,100% of Medicaid LA Fee Schedule,28.1,100% of CMS OPPS Rate,28.1,100% of CMS OPPS Rate,52.97,45% of total billed charges,82.39,70% of total billed charges,70.62,60% of total billed charges,28.1,100% of CMS OPPS Rate,31.22,90% OF UHC FEE SCHEDULE,82.39,70% of total billed charges,28.1,100% OF CMS OPPS Rate,64.63,230% OF CMS OPPS Rate,56.5,48% of total Billed charges,28.1,100% OF CMS OPPS Rate,105.93,90% of total Billed charges,17.22,100% of Medicaid LA Fee Schedule,17.22,100% of Medicaid LA Fee Schedule,17.22,100% of Medicaid LA Fee Schedule,17.22,100% of Medicaid LA Fee Schedule,17.22,100% of Medicaid LA Fee Schedule,17.22,100% of Medicaid LA Fee Schedule,28.1,100% of CMS OPPS Rate,28.1,100% of CMS OPPS Rate,28.1,100% of CMS OPPS Rate,28.1,100% of CMS OPPS Rate,28.1,100% of CMS OPPS Rate,28.1,100% of CMS OPPS Rate,28.1,100% of CMS OPPS Rate,28.1,100% of CMS OPPS Rate,17.22,105.93,70.62
Outpatient,Laboratory,84210,PYRUVATE,300,266.6,51.25,354% of CMS OPPS Rate,13.97,100% of Medicaid LA Fee Schedule,14.48,100% of CMS OPPS Rate,14.48,100% of CMS OPPS Rate,29.52,203.89% of BCBS Fee Schedule,186.62,70% of total Billed Charges,199.95,75% of total Billed Charges,26.06,180% OF CMS OPPS RATE,213.28,80% of total Billed Charges,50.68,350% of CMS Opps rate,14.76,102% of CMS Opps rate,203.95,76.5% of total billed charges,13.97,100% of Medicaid LA Fee Schedule,13.97,100% of Medicaid LA Fee Schedule,14.48,100% of CMS OPPS Rate,14.48,100% of CMS OPPS Rate,119.97,45% of total billed charges,186.62,70% of total billed charges,159.96,60% of total billed charges,14.48,100% of CMS OPPS Rate,13.03,90% OF UHC FEE SCHEDULE,186.62,70% of total billed charges,14.48,100% OF CMS OPPS Rate,33.3,230% OF CMS OPPS Rate,127.97,48% of total Billed charges,14.48,100% OF CMS OPPS Rate,239.94,90% of total Billed charges,13.97,100% of Medicaid LA Fee Schedule,13.97,100% of Medicaid LA Fee Schedule,13.97,100% of Medicaid LA Fee Schedule,13.97,100% of Medicaid LA Fee Schedule,13.97,100% of Medicaid LA Fee Schedule,13.97,100% of Medicaid LA Fee Schedule,14.48,100% of CMS OPPS Rate,14.48,100% of CMS OPPS Rate,14.48,100% of CMS OPPS Rate,14.48,100% of CMS OPPS Rate,14.48,100% of CMS OPPS Rate,14.48,100% of CMS OPPS Rate,14.48,100% of CMS OPPS Rate,14.48,100% of CMS OPPS Rate,13.03,239.94,159.96
Outpatient,Laboratory,84238,RECEPTOR ASSAY NON ENDOCRINE,300,440,129.45,354% of CMS OPPS Rate,36.57,100% of Medicaid LA Fee Schedule,36.57,100% of CMS OPPS Rate,36.57,100% of CMS OPPS Rate,92.04,203.89% of BCBS Fee Schedule,308,70% of total Billed Charges,330,75% of total Billed Charges,65.82,180% OF CMS OPPS RATE,352,80% of total Billed Charges,127.99,350% of CMS Opps rate,37.3,102% of CMS Opps rate,336.6,76.5% of total billed charges,36.57,100% of Medicaid LA Fee Schedule,36.57,100% of Medicaid LA Fee Schedule,36.57,100% of CMS OPPS Rate,36.57,100% of CMS OPPS Rate,198,45% of total billed charges,308,70% of total billed charges,264,60% of total billed charges,36.57,100% of CMS OPPS Rate,40.63,90% OF UHC FEE SCHEDULE,308,70% of total billed charges,36.57,100% OF CMS OPPS Rate,84.11,230% OF CMS OPPS Rate,211.2,48% of total Billed charges,36.57,100% OF CMS OPPS Rate,396,90% of total Billed charges,36.57,100% of Medicaid LA Fee Schedule,36.57,100% of Medicaid LA Fee Schedule,36.57,100% of Medicaid LA Fee Schedule,36.57,100% of Medicaid LA Fee Schedule,36.57,100% of Medicaid LA Fee Schedule,36.57,100% of Medicaid LA Fee Schedule,36.57,100% of CMS OPPS Rate,36.57,100% of CMS OPPS Rate,36.57,100% of CMS OPPS Rate,36.57,100% of CMS OPPS Rate,36.57,100% of CMS OPPS Rate,36.57,100% of CMS OPPS Rate,36.57,100% of CMS OPPS Rate,36.57,100% of CMS OPPS Rate,36.57,396,264
Outpatient,Laboratory,84244,RENIN,300,366.3,77.84,354% of CMS OPPS Rate,21.99,100% of Medicaid LA Fee Schedule,21.99,100% of CMS OPPS Rate,21.99,100% of CMS OPPS Rate,55.36,203.89% of BCBS Fee Schedule,256.41,70% of total Billed Charges,274.73,75% of total Billed Charges,39.58,180% OF CMS OPPS RATE,293.04,80% of total Billed Charges,76.96,350% of CMS Opps rate,22.42,102% of CMS Opps rate,280.22,76.5% of total billed charges,21.99,100% of Medicaid LA Fee Schedule,21.99,100% of Medicaid LA Fee Schedule,21.99,100% of CMS OPPS Rate,21.99,100% of CMS OPPS Rate,164.84,45% of total billed charges,256.41,70% of total billed charges,219.78,60% of total billed charges,21.99,100% of CMS OPPS Rate,24.44,90% OF UHC FEE SCHEDULE,256.41,70% of total billed charges,21.99,100% OF CMS OPPS Rate,50.57,230% OF CMS OPPS Rate,175.82,48% of total Billed charges,21.99,100% OF CMS OPPS Rate,329.67,90% of total Billed charges,21.99,100% of Medicaid LA Fee Schedule,21.99,100% of Medicaid LA Fee Schedule,21.99,100% of Medicaid LA Fee Schedule,21.99,100% of Medicaid LA Fee Schedule,21.99,100% of Medicaid LA Fee Schedule,21.99,100% of Medicaid LA Fee Schedule,21.99,100% of CMS OPPS Rate,21.99,100% of CMS OPPS Rate,21.99,100% of CMS OPPS Rate,21.99,100% of CMS OPPS Rate,21.99,100% of CMS OPPS Rate,21.99,100% of CMS OPPS Rate,21.99,100% of CMS OPPS Rate,21.99,100% of CMS OPPS Rate,21.99,329.67,219.78
Outpatient,Laboratory,84252,RIBOFLAVIN (VITABMIN B2),300,276,71.64,354% of CMS OPPS Rate,13.58,100% of Medicaid LA Fee Schedule,20.23,100% of CMS OPPS Rate,20.23,100% of CMS OPPS Rate,50.93,203.89% of BCBS Fee Schedule,193.2,70% of total Billed Charges,207,75% of total Billed Charges,36.43,180% OF CMS OPPS RATE,220.8,80% of total Billed Charges,70.83,350% of CMS Opps rate,20.64,102% of CMS Opps rate,211.14,76.5% of total billed charges,13.58,100% of Medicaid LA Fee Schedule,13.58,100% of Medicaid LA Fee Schedule,20.23,100% of CMS OPPS Rate,20.23,100% of CMS OPPS Rate,124.2,45% of total billed charges,193.2,70% of total billed charges,165.6,60% of total billed charges,20.23,100% of CMS OPPS Rate,22.48,90% OF UHC FEE SCHEDULE,193.2,70% of total billed charges,20.23,100% OF CMS OPPS Rate,46.55,230% OF CMS OPPS Rate,132.48,48% of total Billed charges,20.23,100% OF CMS OPPS Rate,248.4,90% of total Billed charges,13.58,100% of Medicaid LA Fee Schedule,13.58,100% of Medicaid LA Fee Schedule,13.58,100% of Medicaid LA Fee Schedule,13.58,100% of Medicaid LA Fee Schedule,13.58,100% of Medicaid LA Fee Schedule,13.58,100% of Medicaid LA Fee Schedule,20.23,100% of CMS OPPS Rate,20.23,100% of CMS OPPS Rate,20.23,100% of CMS OPPS Rate,20.23,100% of CMS OPPS Rate,20.23,100% of CMS OPPS Rate,20.23,100% of CMS OPPS Rate,20.23,100% of CMS OPPS Rate,20.23,100% of CMS OPPS Rate,13.58,248.4,165.6
Outpatient,Laboratory,84255,SELENIUM,300,106,90.37,354% of CMS OPPS Rate,25.53,100% of Medicaid LA Fee Schedule,25.53,100% of CMS OPPS Rate,25.53,100% of CMS OPPS Rate,64.27,203.89% of BCBS Fee Schedule,74.2,70% of total Billed Charges,79.5,75% of total Billed Charges,45.95,180% OF CMS OPPS RATE,84.8,80% of total Billed Charges,89.35,350% of CMS Opps rate,26.04,102% of CMS Opps rate,81.09,76.5% of total billed charges,25.53,100% of Medicaid LA Fee Schedule,25.53,100% of Medicaid LA Fee Schedule,25.53,100% of CMS OPPS Rate,25.53,100% of CMS OPPS Rate,47.7,45% of total billed charges,74.2,70% of total billed charges,63.6,60% of total billed charges,25.53,100% of CMS OPPS Rate,28.37,90% OF UHC FEE SCHEDULE,74.2,70% of total billed charges,25.53,100% OF CMS OPPS Rate,58.71,230% OF CMS OPPS Rate,50.88,48% of total Billed charges,25.53,100% OF CMS OPPS Rate,95.4,90% of total Billed charges,25.53,100% of Medicaid LA Fee Schedule,25.53,100% of Medicaid LA Fee Schedule,25.53,100% of Medicaid LA Fee Schedule,25.53,100% of Medicaid LA Fee Schedule,25.53,100% of Medicaid LA Fee Schedule,25.53,100% of Medicaid LA Fee Schedule,25.53,100% of CMS OPPS Rate,25.53,100% of CMS OPPS Rate,25.53,100% of CMS OPPS Rate,25.53,100% of CMS OPPS Rate,25.53,100% of CMS OPPS Rate,25.53,100% of CMS OPPS Rate,25.53,100% of CMS OPPS Rate,25.53,100% of CMS OPPS Rate,25.53,95.4,63.6
Outpatient,Laboratory,84260,SEROTONIN,300,555.5,109.66,354% of CMS OPPS Rate,30.98,100% of Medicaid LA Fee Schedule,30.98,100% of CMS OPPS Rate,30.98,100% of CMS OPPS Rate,77.99,203.89% of BCBS Fee Schedule,388.85,70% of total Billed Charges,416.63,75% of total Billed Charges,55.76,180% OF CMS OPPS RATE,444.4,80% of total Billed Charges,108.43,350% of CMS Opps rate,31.59,102% of CMS Opps rate,424.96,76.5% of total billed charges,30.98,100% of Medicaid LA Fee Schedule,30.98,100% of Medicaid LA Fee Schedule,30.98,100% of CMS OPPS Rate,30.98,100% of CMS OPPS Rate,249.98,45% of total billed charges,388.85,70% of total billed charges,333.3,60% of total billed charges,30.98,100% of CMS OPPS Rate,34.43,90% OF UHC FEE SCHEDULE,388.85,70% of total billed charges,30.98,100% OF CMS OPPS Rate,71.25,230% OF CMS OPPS Rate,266.64,48% of total Billed charges,30.98,100% OF CMS OPPS Rate,499.95,90% of total Billed charges,30.98,100% of Medicaid LA Fee Schedule,30.98,100% of Medicaid LA Fee Schedule,30.98,100% of Medicaid LA Fee Schedule,30.98,100% of Medicaid LA Fee Schedule,30.98,100% of Medicaid LA Fee Schedule,30.98,100% of Medicaid LA Fee Schedule,30.98,100% of CMS OPPS Rate,30.98,100% of CMS OPPS Rate,30.98,100% of CMS OPPS Rate,30.98,100% of CMS OPPS Rate,30.98,100% of CMS OPPS Rate,30.98,100% of CMS OPPS Rate,30.98,100% of CMS OPPS Rate,30.98,100% of CMS OPPS Rate,30.98,499.95,333.3
Outpatient,Laboratory,84270,SEX HORMONE BINDING GLOB.,300,70.4,76.92,354% of CMS OPPS Rate,6.24,100% of Medicaid LA Fee Schedule,21.73,100% of CMS OPPS Rate,21.73,100% of CMS OPPS Rate,54.7,203.89% of BCBS Fee Schedule,49.28,70% of total Billed Charges,52.8,75% of total Billed Charges,39.11,180% OF CMS OPPS RATE,56.32,80% of total Billed Charges,76.05,350% of CMS Opps rate,22.16,102% of CMS Opps rate,53.86,76.5% of total billed charges,6.24,100% of Medicaid LA Fee Schedule,6.24,100% of Medicaid LA Fee Schedule,21.73,100% of CMS OPPS Rate,21.73,100% of CMS OPPS Rate,31.68,45% of total billed charges,49.28,70% of total billed charges,42.24,60% of total billed charges,21.73,100% of CMS OPPS Rate,24.15,90% OF UHC FEE SCHEDULE,49.28,70% of total billed charges,21.73,100% OF CMS OPPS Rate,49.97,230% OF CMS OPPS Rate,33.79,48% of total Billed charges,21.73,100% OF CMS OPPS Rate,63.36,90% of total Billed charges,6.24,100% of Medicaid LA Fee Schedule,6.24,100% of Medicaid LA Fee Schedule,6.24,100% of Medicaid LA Fee Schedule,6.24,100% of Medicaid LA Fee Schedule,6.24,100% of Medicaid LA Fee Schedule,6.24,100% of Medicaid LA Fee Schedule,21.73,100% of CMS OPPS Rate,21.73,100% of CMS OPPS Rate,21.73,100% of CMS OPPS Rate,21.73,100% of CMS OPPS Rate,21.73,100% of CMS OPPS Rate,21.73,100% of CMS OPPS Rate,21.73,100% of CMS OPPS Rate,21.73,100% of CMS OPPS Rate,6.24,76.92,42.24
Outpatient,Laboratory,84300,SODIUM URINE,300,52.2,17.91,354% of CMS OPPS Rate,5.06,100% of Medicaid LA Fee Schedule,5.05,100% of CMS OPPS Rate,5.05,100% of CMS OPPS Rate,12.23,203.89% of BCBS Fee Schedule,36.54,70% of total Billed Charges,39.15,75% of total Billed Charges,9.1,180% OF CMS OPPS RATE,41.76,80% of total Billed Charges,17.7,350% of CMS Opps rate,5.16,102% of CMS Opps rate,39.93,76.5% of total billed charges,5.06,100% of Medicaid LA Fee Schedule,5.06,100% of Medicaid LA Fee Schedule,5.05,100% of CMS OPPS Rate,5.05,100% of CMS OPPS Rate,23.49,45% of total billed charges,36.54,70% of total billed charges,31.32,60% of total billed charges,5.05,100% of CMS OPPS Rate,5.4,90% OF UHC FEE SCHEDULE,36.54,70% of total billed charges,5.05,100% OF CMS OPPS Rate,11.63,230% OF CMS OPPS Rate,25.06,48% of total Billed charges,5.05,100% OF CMS OPPS Rate,46.98,90% of total Billed charges,5.06,100% of Medicaid LA Fee Schedule,5.06,100% of Medicaid LA Fee Schedule,5.06,100% of Medicaid LA Fee Schedule,5.06,100% of Medicaid LA Fee Schedule,5.06,100% of Medicaid LA Fee Schedule,5.06,100% of Medicaid LA Fee Schedule,5.05,100% of CMS OPPS Rate,5.05,100% of CMS OPPS Rate,5.05,100% of CMS OPPS Rate,5.05,100% of CMS OPPS Rate,5.05,100% of CMS OPPS Rate,5.05,100% of CMS OPPS Rate,5.05,100% of CMS OPPS Rate,5.05,100% of CMS OPPS Rate,5.05,46.98,31.32
Outpatient,Laboratory,84302,SODIUM MISC SPECIMEN,300,57.6,17.2,354% of CMS OPPS Rate,4.86,100% of Medicaid LA Fee Schedule,4.86,100% of CMS OPPS Rate,4.86,100% of CMS OPPS Rate,12.23,203.89% of BCBS Fee Schedule,40.32,70% of total Billed Charges,43.2,75% of total Billed Charges,8.74,180% OF CMS OPPS RATE,46.08,80% of total Billed Charges,17.01,350% of CMS Opps rate,4.95,102% of CMS Opps rate,44.06,76.5% of total billed charges,4.86,100% of Medicaid LA Fee Schedule,4.86,100% of Medicaid LA Fee Schedule,4.86,100% of CMS OPPS Rate,4.86,100% of CMS OPPS Rate,25.92,45% of total billed charges,40.32,70% of total billed charges,34.56,60% of total billed charges,4.86,100% of CMS OPPS Rate,5.4,90% OF UHC FEE SCHEDULE,40.32,70% of total billed charges,4.86,100% OF CMS OPPS Rate,11.17,230% OF CMS OPPS Rate,27.65,48% of total Billed charges,4.86,100% OF CMS OPPS Rate,51.84,90% of total Billed charges,4.86,100% of Medicaid LA Fee Schedule,4.86,100% of Medicaid LA Fee Schedule,4.86,100% of Medicaid LA Fee Schedule,4.86,100% of Medicaid LA Fee Schedule,4.86,100% of Medicaid LA Fee Schedule,4.86,100% of Medicaid LA Fee Schedule,4.86,100% of CMS OPPS Rate,4.86,100% of CMS OPPS Rate,4.86,100% of CMS OPPS Rate,4.86,100% of CMS OPPS Rate,4.86,100% of CMS OPPS Rate,4.86,100% of CMS OPPS Rate,4.86,100% of CMS OPPS Rate,4.86,100% of CMS OPPS Rate,4.86,51.84,34.56
Outpatient,Laboratory,84305,SOMATOMEDIN(GROWTH FACT),300,271,75.26,354% of CMS OPPS Rate,21.26,100% of Medicaid LA Fee Schedule,21.26,100% of CMS OPPS Rate,21.26,100% of CMS OPPS Rate,53.52,203.89% of BCBS Fee Schedule,189.7,70% of total Billed Charges,203.25,75% of total Billed Charges,38.26,180% OF CMS OPPS RATE,216.8,80% of total Billed Charges,74.41,350% of CMS Opps rate,21.68,102% of CMS Opps rate,207.32,76.5% of total billed charges,21.26,100% of Medicaid LA Fee Schedule,21.26,100% of Medicaid LA Fee Schedule,21.26,100% of CMS OPPS Rate,21.26,100% of CMS OPPS Rate,121.95,45% of total billed charges,189.7,70% of total billed charges,162.6,60% of total billed charges,21.26,100% of CMS OPPS Rate,23.63,90% OF UHC FEE SCHEDULE,189.7,70% of total billed charges,21.26,100% OF CMS OPPS Rate,48.89,230% OF CMS OPPS Rate,130.08,48% of total Billed charges,21.26,100% OF CMS OPPS Rate,243.9,90% of total Billed charges,21.26,100% of Medicaid LA Fee Schedule,21.26,100% of Medicaid LA Fee Schedule,21.26,100% of Medicaid LA Fee Schedule,21.26,100% of Medicaid LA Fee Schedule,21.26,100% of Medicaid LA Fee Schedule,21.26,100% of Medicaid LA Fee Schedule,21.26,100% of CMS OPPS Rate,21.26,100% of CMS OPPS Rate,21.26,100% of CMS OPPS Rate,21.26,100% of CMS OPPS Rate,21.26,100% of CMS OPPS Rate,21.26,100% of CMS OPPS Rate,21.26,100% of CMS OPPS Rate,21.26,100% of CMS OPPS Rate,21.26,243.9,162.6
Outpatient,Laboratory,84307,SOMATOSTATIN,300,194,64.71,354% of CMS OPPS Rate,18.28,100% of Medicaid LA Fee Schedule,18.28,100% of CMS OPPS Rate,18.28,100% of CMS OPPS Rate,46,203.89% of BCBS Fee Schedule,135.8,70% of total Billed Charges,145.5,75% of total Billed Charges,32.9,180% OF CMS OPPS RATE,155.2,80% of total Billed Charges,63.98,350% of CMS Opps rate,18.64,102% of CMS Opps rate,148.41,76.5% of total billed charges,18.28,100% of Medicaid LA Fee Schedule,18.28,100% of Medicaid LA Fee Schedule,18.28,100% of CMS OPPS Rate,18.28,100% of CMS OPPS Rate,87.3,45% of total billed charges,135.8,70% of total billed charges,116.4,60% of total billed charges,18.28,100% of CMS OPPS Rate,20.3,90% OF UHC FEE SCHEDULE,135.8,70% of total billed charges,18.28,100% OF CMS OPPS Rate,42.04,230% OF CMS OPPS Rate,93.12,48% of total Billed charges,18.28,100% OF CMS OPPS Rate,174.6,90% of total Billed charges,18.28,100% of Medicaid LA Fee Schedule,18.28,100% of Medicaid LA Fee Schedule,18.28,100% of Medicaid LA Fee Schedule,18.28,100% of Medicaid LA Fee Schedule,18.28,100% of Medicaid LA Fee Schedule,18.28,100% of Medicaid LA Fee Schedule,18.28,100% of CMS OPPS Rate,18.28,100% of CMS OPPS Rate,18.28,100% of CMS OPPS Rate,18.28,100% of CMS OPPS Rate,18.28,100% of CMS OPPS Rate,18.28,100% of CMS OPPS Rate,18.28,100% of CMS OPPS Rate,18.28,100% of CMS OPPS Rate,18.28,174.6,116.4
Outpatient,Laboratory,84311,"SPECTROPHOTOMETRY ANALYTE, OTHER",300,113.4,28.67,354% of CMS OPPS Rate,8.1,100% of Medicaid LA Fee Schedule,8.1,100% of CMS OPPS Rate,8.1,100% of CMS OPPS Rate,17.6,203.89% of BCBS Fee Schedule,79.38,70% of total Billed Charges,85.05,75% of total Billed Charges,14.58,180% OF CMS OPPS RATE,90.72,80% of total Billed Charges,28.35,350% of CMS Opps rate,8.26,102% of CMS Opps rate,86.75,76.5% of total billed charges,8.1,100% of Medicaid LA Fee Schedule,8.1,100% of Medicaid LA Fee Schedule,8.1,100% of CMS OPPS Rate,8.1,100% of CMS OPPS Rate,51.03,45% of total billed charges,79.38,70% of total billed charges,68.04,60% of total billed charges,8.1,100% of CMS OPPS Rate,7.77,90% OF UHC FEE SCHEDULE,79.38,70% of total billed charges,8.1,100% OF CMS OPPS Rate,18.63,230% OF CMS OPPS Rate,54.43,48% of total Billed charges,8.1,100% OF CMS OPPS Rate,102.06,90% of total Billed charges,8.1,100% of Medicaid LA Fee Schedule,8.1,100% of Medicaid LA Fee Schedule,8.1,100% of Medicaid LA Fee Schedule,8.1,100% of Medicaid LA Fee Schedule,8.1,100% of Medicaid LA Fee Schedule,8.1,100% of Medicaid LA Fee Schedule,8.1,100% of CMS OPPS Rate,8.1,100% of CMS OPPS Rate,8.1,100% of CMS OPPS Rate,8.1,100% of CMS OPPS Rate,8.1,100% of CMS OPPS Rate,8.1,100% of CMS OPPS Rate,8.1,100% of CMS OPPS Rate,8.1,100% of CMS OPPS Rate,7.77,102.06,68.04
Outpatient,Laboratory,84376,REDUCING SUBSTANCES(STOOL,300,104.85,19.47,354% of CMS OPPS Rate,5.5,100% of Medicaid LA Fee Schedule,5.5,100% of CMS OPPS Rate,5.5,100% of CMS OPPS Rate,13.84,203.89% of BCBS Fee Schedule,73.4,70% of total Billed Charges,78.64,75% of total Billed Charges,9.9,180% OF CMS OPPS RATE,83.88,80% of total Billed Charges,19.25,350% of CMS Opps rate,5.61,102% of CMS Opps rate,80.21,76.5% of total billed charges,5.5,100% of Medicaid LA Fee Schedule,5.5,100% of Medicaid LA Fee Schedule,5.5,100% of CMS OPPS Rate,5.5,100% of CMS OPPS Rate,47.18,45% of total billed charges,73.4,70% of total billed charges,62.91,60% of total billed charges,5.5,100% of CMS OPPS Rate,6.11,90% OF UHC FEE SCHEDULE,73.4,70% of total billed charges,5.5,100% OF CMS OPPS Rate,12.65,230% OF CMS OPPS Rate,50.33,48% of total Billed charges,5.5,100% OF CMS OPPS Rate,94.37,90% of total Billed charges,5.5,100% of Medicaid LA Fee Schedule,5.5,100% of Medicaid LA Fee Schedule,5.5,100% of Medicaid LA Fee Schedule,5.5,100% of Medicaid LA Fee Schedule,5.5,100% of Medicaid LA Fee Schedule,5.5,100% of Medicaid LA Fee Schedule,5.5,100% of CMS OPPS Rate,5.5,100% of CMS OPPS Rate,5.5,100% of CMS OPPS Rate,5.5,100% of CMS OPPS Rate,5.5,100% of CMS OPPS Rate,5.5,100% of CMS OPPS Rate,5.5,100% of CMS OPPS Rate,5.5,100% of CMS OPPS Rate,5.5,94.37,62.91
Outpatient,Laboratory,84377,SUGARS MULTIPLE QL EA SPECIMEN,300,256.3,19.47,354% of CMS OPPS Rate,5.5,100% of Medicaid LA Fee Schedule,5.5,100% of CMS OPPS Rate,5.5,100% of CMS OPPS Rate,13.84,203.89% of BCBS Fee Schedule,179.41,70% of total Billed Charges,192.23,75% of total Billed Charges,9.9,180% OF CMS OPPS RATE,205.04,80% of total Billed Charges,19.25,350% of CMS Opps rate,5.61,102% of CMS Opps rate,196.07,76.5% of total billed charges,5.5,100% of Medicaid LA Fee Schedule,5.5,100% of Medicaid LA Fee Schedule,5.5,100% of CMS OPPS Rate,5.5,100% of CMS OPPS Rate,115.34,45% of total billed charges,179.41,70% of total billed charges,153.78,60% of total billed charges,5.5,100% of CMS OPPS Rate,6.11,90% OF UHC FEE SCHEDULE,179.41,70% of total billed charges,5.5,100% OF CMS OPPS Rate,12.65,230% OF CMS OPPS Rate,123.02,48% of total Billed charges,5.5,100% OF CMS OPPS Rate,230.67,90% of total Billed charges,5.5,100% of Medicaid LA Fee Schedule,5.5,100% of Medicaid LA Fee Schedule,5.5,100% of Medicaid LA Fee Schedule,5.5,100% of Medicaid LA Fee Schedule,5.5,100% of Medicaid LA Fee Schedule,5.5,100% of Medicaid LA Fee Schedule,5.5,100% of CMS OPPS Rate,5.5,100% of CMS OPPS Rate,5.5,100% of CMS OPPS Rate,5.5,100% of CMS OPPS Rate,5.5,100% of CMS OPPS Rate,5.5,100% of CMS OPPS Rate,5.5,100% of CMS OPPS Rate,5.5,100% of CMS OPPS Rate,5.5,230.67,153.78
Outpatient,Laboratory,84392,SULFATE URINE,300,16,19.43,354% of CMS OPPS Rate,5.49,100% of Medicaid LA Fee Schedule,5.49,100% of CMS OPPS Rate,5.49,100% of CMS OPPS Rate,11.95,203.89% of BCBS Fee Schedule,11.2,70% of total Billed Charges,12,75% of total Billed Charges,9.88,180% OF CMS OPPS RATE,12.8,80% of total Billed Charges,19.21,350% of CMS Opps rate,5.59,102% of CMS Opps rate,12.24,76.5% of total billed charges,5.49,100% of Medicaid LA Fee Schedule,5.49,100% of Medicaid LA Fee Schedule,5.49,100% of CMS OPPS Rate,5.49,100% of CMS OPPS Rate,7.2,45% of total billed charges,11.2,70% of total billed charges,9.6,60% of total billed charges,5.49,100% of CMS OPPS Rate,5.27,90% OF UHC FEE SCHEDULE,11.2,70% of total billed charges,5.49,100% OF CMS OPPS Rate,12.62,230% OF CMS OPPS Rate,7.68,48% of total Billed charges,5.49,100% OF CMS OPPS Rate,14.4,90% of total Billed charges,5.49,100% of Medicaid LA Fee Schedule,5.49,100% of Medicaid LA Fee Schedule,5.49,100% of Medicaid LA Fee Schedule,5.49,100% of Medicaid LA Fee Schedule,5.49,100% of Medicaid LA Fee Schedule,5.49,100% of Medicaid LA Fee Schedule,5.49,100% of CMS OPPS Rate,5.49,100% of CMS OPPS Rate,5.49,100% of CMS OPPS Rate,5.49,100% of CMS OPPS Rate,5.49,100% of CMS OPPS Rate,5.49,100% of CMS OPPS Rate,5.49,100% of CMS OPPS Rate,5.49,100% of CMS OPPS Rate,5.27,19.43,9.6
Outpatient,Laboratory,84402,"TESTOSTERONE, FREE",300,184.8,90.16,354% of CMS OPPS Rate,25.47,100% of Medicaid LA Fee Schedule,25.47,100% of CMS OPPS Rate,25.47,100% of CMS OPPS Rate,64.12,203.89% of BCBS Fee Schedule,129.36,70% of total Billed Charges,138.6,75% of total Billed Charges,45.84,180% OF CMS OPPS RATE,147.84,80% of total Billed Charges,89.14,350% of CMS Opps rate,25.97,102% of CMS Opps rate,141.37,76.5% of total billed charges,25.47,100% of Medicaid LA Fee Schedule,25.47,100% of Medicaid LA Fee Schedule,25.47,100% of CMS OPPS Rate,25.47,100% of CMS OPPS Rate,83.16,45% of total billed charges,129.36,70% of total billed charges,110.88,60% of total billed charges,25.47,100% of CMS OPPS Rate,28.31,90% OF UHC FEE SCHEDULE,129.36,70% of total billed charges,25.47,100% OF CMS OPPS Rate,58.58,230% OF CMS OPPS Rate,88.7,48% of total Billed charges,25.47,100% OF CMS OPPS Rate,166.32,90% of total Billed charges,25.47,100% of Medicaid LA Fee Schedule,25.47,100% of Medicaid LA Fee Schedule,25.47,100% of Medicaid LA Fee Schedule,25.47,100% of Medicaid LA Fee Schedule,25.47,100% of Medicaid LA Fee Schedule,25.47,100% of Medicaid LA Fee Schedule,25.47,100% of CMS OPPS Rate,25.47,100% of CMS OPPS Rate,25.47,100% of CMS OPPS Rate,25.47,100% of CMS OPPS Rate,25.47,100% of CMS OPPS Rate,25.47,100% of CMS OPPS Rate,25.47,100% of CMS OPPS Rate,25.47,100% of CMS OPPS Rate,25.47,166.32,110.88
Outpatient,Laboratory,84403,TESTOSTERONE SERUM,300,113.3,91.36,354% of CMS OPPS Rate,25.81,100% of Medicaid LA Fee Schedule,25.81,100% of CMS OPPS Rate,25.81,100% of CMS OPPS Rate,64.98,203.89% of BCBS Fee Schedule,79.31,70% of total Billed Charges,84.98,75% of total Billed Charges,46.45,180% OF CMS OPPS RATE,90.64,80% of total Billed Charges,90.33,350% of CMS Opps rate,26.32,102% of CMS Opps rate,86.67,76.5% of total billed charges,25.81,100% of Medicaid LA Fee Schedule,25.81,100% of Medicaid LA Fee Schedule,25.81,100% of CMS OPPS Rate,25.81,100% of CMS OPPS Rate,50.99,45% of total billed charges,79.31,70% of total billed charges,67.98,60% of total billed charges,25.81,100% of CMS OPPS Rate,28.68,90% OF UHC FEE SCHEDULE,79.31,70% of total billed charges,25.81,100% OF CMS OPPS Rate,59.36,230% OF CMS OPPS Rate,54.38,48% of total Billed charges,25.81,100% OF CMS OPPS Rate,101.97,90% of total Billed charges,25.81,100% of Medicaid LA Fee Schedule,25.81,100% of Medicaid LA Fee Schedule,25.81,100% of Medicaid LA Fee Schedule,25.81,100% of Medicaid LA Fee Schedule,25.81,100% of Medicaid LA Fee Schedule,25.81,100% of Medicaid LA Fee Schedule,25.81,100% of CMS OPPS Rate,25.81,100% of CMS OPPS Rate,25.81,100% of CMS OPPS Rate,25.81,100% of CMS OPPS Rate,25.81,100% of CMS OPPS Rate,25.81,100% of CMS OPPS Rate,25.81,100% of CMS OPPS Rate,25.81,100% of CMS OPPS Rate,25.81,101.97,67.98
Outpatient,Laboratory,84425,"VITAMIN B 1, SERUM",300,138.6,75.15,354% of CMS OPPS Rate,21.23,100% of Medicaid LA Fee Schedule,21.23,100% of CMS OPPS Rate,21.23,100% of CMS OPPS Rate,53.44,203.89% of BCBS Fee Schedule,97.02,70% of total Billed Charges,103.95,75% of total Billed Charges,38.21,180% OF CMS OPPS RATE,110.88,80% of total Billed Charges,74.3,350% of CMS Opps rate,21.65,102% of CMS Opps rate,106.03,76.5% of total billed charges,21.23,100% of Medicaid LA Fee Schedule,21.23,100% of Medicaid LA Fee Schedule,21.23,100% of CMS OPPS Rate,21.23,100% of CMS OPPS Rate,62.37,45% of total billed charges,97.02,70% of total billed charges,83.16,60% of total billed charges,21.23,100% of CMS OPPS Rate,23.59,90% OF UHC FEE SCHEDULE,97.02,70% of total billed charges,21.23,100% OF CMS OPPS Rate,48.82,230% OF CMS OPPS Rate,66.53,48% of total Billed charges,21.23,100% OF CMS OPPS Rate,124.74,90% of total Billed charges,21.23,100% of Medicaid LA Fee Schedule,21.23,100% of Medicaid LA Fee Schedule,21.23,100% of Medicaid LA Fee Schedule,21.23,100% of Medicaid LA Fee Schedule,21.23,100% of Medicaid LA Fee Schedule,21.23,100% of Medicaid LA Fee Schedule,21.23,100% of CMS OPPS Rate,21.23,100% of CMS OPPS Rate,21.23,100% of CMS OPPS Rate,21.23,100% of CMS OPPS Rate,21.23,100% of CMS OPPS Rate,21.23,100% of CMS OPPS Rate,21.23,100% of CMS OPPS Rate,21.23,100% of CMS OPPS Rate,21.23,124.74,83.16
Outpatient,Laboratory,84432,THYROGLOBULIN,300,125.95,56.85,354% of CMS OPPS Rate,16.06,100% of Medicaid LA Fee Schedule,16.05,100% of CMS OPPS Rate,16.05,100% of CMS OPPS Rate,40.43,203.89% of BCBS Fee Schedule,88.17,70% of total Billed Charges,94.46,75% of total Billed Charges,28.9,180% OF CMS OPPS RATE,100.76,80% of total Billed Charges,56.21,350% of CMS Opps rate,16.38,102% of CMS Opps rate,96.35,76.5% of total billed charges,16.06,100% of Medicaid LA Fee Schedule,16.06,100% of Medicaid LA Fee Schedule,16.05,100% of CMS OPPS Rate,16.05,100% of CMS OPPS Rate,56.68,45% of total billed charges,88.17,70% of total billed charges,75.57,60% of total billed charges,16.05,100% of CMS OPPS Rate,17.85,90% OF UHC FEE SCHEDULE,88.17,70% of total billed charges,16.05,100% OF CMS OPPS Rate,36.93,230% OF CMS OPPS Rate,60.46,48% of total Billed charges,16.05,100% OF CMS OPPS Rate,113.36,90% of total Billed charges,16.06,100% of Medicaid LA Fee Schedule,16.06,100% of Medicaid LA Fee Schedule,16.06,100% of Medicaid LA Fee Schedule,16.06,100% of Medicaid LA Fee Schedule,16.06,100% of Medicaid LA Fee Schedule,16.06,100% of Medicaid LA Fee Schedule,16.05,100% of CMS OPPS Rate,16.05,100% of CMS OPPS Rate,16.05,100% of CMS OPPS Rate,16.05,100% of CMS OPPS Rate,16.05,100% of CMS OPPS Rate,16.05,100% of CMS OPPS Rate,16.05,100% of CMS OPPS Rate,16.05,100% of CMS OPPS Rate,16.05,113.36,75.57
Outpatient,Laboratory,84436,Blood test to measure a type of thyroid hormone,300,157.95,24.31,354% of CMS OPPS Rate,5.86,100% of Medicaid LA Fee Schedule,6.87,100% of CMS OPPS Rate,6.87,100% of CMS OPPS Rate,17.29,203.89% of BCBS Fee Schedule,110.57,70% of total Billed Charges,118.46,75% of total Billed Charges,12.36,180% OF CMS OPPS RATE,126.36,80% of total Billed Charges,24.04,350% of CMS Opps rate,7,102% of CMS Opps rate,120.83,76.5% of total billed charges,5.86,100% of Medicaid LA Fee Schedule,5.86,100% of Medicaid LA Fee Schedule,6.87,100% of CMS OPPS Rate,6.87,100% of CMS OPPS Rate,71.08,45% of total billed charges,110.57,70% of total billed charges,94.77,60% of total billed charges,6.87,100% of CMS OPPS Rate,7.63,90% OF UHC FEE SCHEDULE,110.57,70% of total billed charges,6.87,100% OF CMS OPPS Rate,15.8,230% OF CMS OPPS Rate,75.82,48% of total Billed charges,6.87,100% OF CMS OPPS Rate,142.16,90% of total Billed charges,5.86,100% of Medicaid LA Fee Schedule,5.86,100% of Medicaid LA Fee Schedule,5.86,100% of Medicaid LA Fee Schedule,5.86,100% of Medicaid LA Fee Schedule,5.86,100% of Medicaid LA Fee Schedule,5.86,100% of Medicaid LA Fee Schedule,6.87,100% of CMS OPPS Rate,6.87,100% of CMS OPPS Rate,6.87,100% of CMS OPPS Rate,6.87,100% of CMS OPPS Rate,6.87,100% of CMS OPPS Rate,6.87,100% of CMS OPPS Rate,6.87,100% of CMS OPPS Rate,6.87,100% of CMS OPPS Rate,5.86,142.16,94.77
Outpatient,Laboratory,84439,Blood test to evaluate thyroid function,300,149.05,31.93,354% of CMS OPPS Rate,9.02,100% of Medicaid LA Fee Schedule,9.02,100% of CMS OPPS Rate,9.02,100% of CMS OPPS Rate,22.69,203.89% of BCBS Fee Schedule,104.34,70% of total Billed Charges,111.79,75% of total Billed Charges,16.23,180% OF CMS OPPS RATE,119.24,80% of total Billed Charges,31.57,350% of CMS Opps rate,9.2,102% of CMS Opps rate,114.02,76.5% of total billed charges,9.02,100% of Medicaid LA Fee Schedule,9.02,100% of Medicaid LA Fee Schedule,9.02,100% of CMS OPPS Rate,9.02,100% of CMS OPPS Rate,67.07,45% of total billed charges,104.34,70% of total billed charges,89.43,60% of total billed charges,9.02,100% of CMS OPPS Rate,10.02,90% OF UHC FEE SCHEDULE,104.34,70% of total billed charges,9.02,100% OF CMS OPPS Rate,20.74,230% OF CMS OPPS Rate,71.54,48% of total Billed charges,9.02,100% OF CMS OPPS Rate,134.15,90% of total Billed charges,9.02,100% of Medicaid LA Fee Schedule,9.02,100% of Medicaid LA Fee Schedule,9.02,100% of Medicaid LA Fee Schedule,9.02,100% of Medicaid LA Fee Schedule,9.02,100% of Medicaid LA Fee Schedule,9.02,100% of Medicaid LA Fee Schedule,9.02,100% of CMS OPPS Rate,9.02,100% of CMS OPPS Rate,9.02,100% of CMS OPPS Rate,9.02,100% of CMS OPPS Rate,9.02,100% of CMS OPPS Rate,9.02,100% of CMS OPPS Rate,9.02,100% of CMS OPPS Rate,9.02,100% of CMS OPPS Rate,9.02,134.15,89.43
Outpatient,Laboratory,84442,"THYROID BIND GLOBN, SER",300,76.5,52.32,354% of CMS OPPS Rate,14.78,100% of Medicaid LA Fee Schedule,14.78,100% of CMS OPPS Rate,14.78,100% of CMS OPPS Rate,37.21,203.89% of BCBS Fee Schedule,53.55,70% of total Billed Charges,57.38,75% of total Billed Charges,26.6,180% OF CMS OPPS RATE,61.2,80% of total Billed Charges,51.73,350% of CMS Opps rate,15.07,102% of CMS Opps rate,58.52,76.5% of total billed charges,14.78,100% of Medicaid LA Fee Schedule,14.78,100% of Medicaid LA Fee Schedule,14.78,100% of CMS OPPS Rate,14.78,100% of CMS OPPS Rate,34.43,45% of total billed charges,53.55,70% of total billed charges,45.9,60% of total billed charges,14.78,100% of CMS OPPS Rate,16.43,90% OF UHC FEE SCHEDULE,53.55,70% of total billed charges,14.78,100% OF CMS OPPS Rate,33.99,230% OF CMS OPPS Rate,36.72,48% of total Billed charges,14.78,100% OF CMS OPPS Rate,68.85,90% of total Billed charges,14.78,100% of Medicaid LA Fee Schedule,14.78,100% of Medicaid LA Fee Schedule,14.78,100% of Medicaid LA Fee Schedule,14.78,100% of Medicaid LA Fee Schedule,14.78,100% of Medicaid LA Fee Schedule,14.78,100% of Medicaid LA Fee Schedule,14.78,100% of CMS OPPS Rate,14.78,100% of CMS OPPS Rate,14.78,100% of CMS OPPS Rate,14.78,100% of CMS OPPS Rate,14.78,100% of CMS OPPS Rate,14.78,100% of CMS OPPS Rate,14.78,100% of CMS OPPS Rate,14.78,100% of CMS OPPS Rate,14.78,68.85,45.9
Outpatient,Laboratory,84443,"Blood test, thyroid stimulating hormone (TSH)",300,329.45,59.47,354% of CMS OPPS Rate,16.8,100% of Medicaid LA Fee Schedule,16.8,100% of CMS OPPS Rate,16.8,100% of CMS OPPS Rate,42.31,203.89% of BCBS Fee Schedule,230.62,70% of total Billed Charges,247.09,75% of total Billed Charges,30.24,180% OF CMS OPPS RATE,263.56,80% of total Billed Charges,58.8,350% of CMS Opps rate,17.13,102% of CMS Opps rate,252.03,76.5% of total billed charges,16.8,100% of Medicaid LA Fee Schedule,16.8,100% of Medicaid LA Fee Schedule,16.8,100% of CMS OPPS Rate,16.8,100% of CMS OPPS Rate,148.25,45% of total billed charges,230.62,70% of total billed charges,197.67,60% of total billed charges,16.8,100% of CMS OPPS Rate,18.68,90% OF UHC FEE SCHEDULE,230.62,70% of total billed charges,16.8,100% OF CMS OPPS Rate,38.64,230% OF CMS OPPS Rate,158.14,48% of total Billed charges,16.8,100% OF CMS OPPS Rate,296.51,90% of total Billed charges,16.8,100% of Medicaid LA Fee Schedule,16.8,100% of Medicaid LA Fee Schedule,16.8,100% of Medicaid LA Fee Schedule,16.8,100% of Medicaid LA Fee Schedule,16.8,100% of Medicaid LA Fee Schedule,16.8,100% of Medicaid LA Fee Schedule,16.8,100% of CMS OPPS Rate,16.8,100% of CMS OPPS Rate,16.8,100% of CMS OPPS Rate,16.8,100% of CMS OPPS Rate,16.8,100% of CMS OPPS Rate,16.8,100% of CMS OPPS Rate,16.8,100% of CMS OPPS Rate,16.8,100% of CMS OPPS Rate,16.8,296.51,197.67
Outpatient,Laboratory,84445,THYROID STIM.IMMUNOGLOB,300,615.45,180.04,354% of CMS OPPS Rate,22.43,100% of Medicaid LA Fee Schedule,50.86,100% of CMS OPPS Rate,50.86,100% of CMS OPPS Rate,128,203.89% of BCBS Fee Schedule,430.82,70% of total Billed Charges,461.59,75% of total Billed Charges,91.54,180% OF CMS OPPS RATE,492.36,80% of total Billed Charges,178.01,350% of CMS Opps rate,51.87,102% of CMS Opps rate,470.82,76.5% of total billed charges,22.43,100% of Medicaid LA Fee Schedule,22.43,100% of Medicaid LA Fee Schedule,50.86,100% of CMS OPPS Rate,50.86,100% of CMS OPPS Rate,276.95,45% of total billed charges,430.82,70% of total billed charges,369.27,60% of total billed charges,50.86,100% of CMS OPPS Rate,56.5,90% OF UHC FEE SCHEDULE,430.82,70% of total billed charges,50.86,100% OF CMS OPPS Rate,116.97,230% OF CMS OPPS Rate,295.42,48% of total Billed charges,50.86,100% OF CMS OPPS Rate,553.91,90% of total Billed charges,22.43,100% of Medicaid LA Fee Schedule,22.43,100% of Medicaid LA Fee Schedule,22.43,100% of Medicaid LA Fee Schedule,22.43,100% of Medicaid LA Fee Schedule,22.43,100% of Medicaid LA Fee Schedule,22.43,100% of Medicaid LA Fee Schedule,50.86,100% of CMS OPPS Rate,50.86,100% of CMS OPPS Rate,50.86,100% of CMS OPPS Rate,50.86,100% of CMS OPPS Rate,50.86,100% of CMS OPPS Rate,50.86,100% of CMS OPPS Rate,50.86,100% of CMS OPPS Rate,50.86,100% of CMS OPPS Rate,22.43,553.91,369.27
Outpatient,Laboratory,84446,VITAMIN E,300,89.1,50.19,354% of CMS OPPS Rate,14.18,100% of Medicaid LA Fee Schedule,14.18,100% of CMS OPPS Rate,14.18,100% of CMS OPPS Rate,35.7,203.89% of BCBS Fee Schedule,62.37,70% of total Billed Charges,66.83,75% of total Billed Charges,25.52,180% OF CMS OPPS RATE,71.28,80% of total Billed Charges,49.63,350% of CMS Opps rate,14.46,102% of CMS Opps rate,68.16,76.5% of total billed charges,14.18,100% of Medicaid LA Fee Schedule,14.18,100% of Medicaid LA Fee Schedule,14.18,100% of CMS OPPS Rate,14.18,100% of CMS OPPS Rate,40.1,45% of total billed charges,62.37,70% of total billed charges,53.46,60% of total billed charges,14.18,100% of CMS OPPS Rate,15.76,90% OF UHC FEE SCHEDULE,62.37,70% of total billed charges,14.18,100% OF CMS OPPS Rate,32.61,230% OF CMS OPPS Rate,42.77,48% of total Billed charges,14.18,100% OF CMS OPPS Rate,80.19,90% of total Billed charges,14.18,100% of Medicaid LA Fee Schedule,14.18,100% of Medicaid LA Fee Schedule,14.18,100% of Medicaid LA Fee Schedule,14.18,100% of Medicaid LA Fee Schedule,14.18,100% of Medicaid LA Fee Schedule,14.18,100% of Medicaid LA Fee Schedule,14.18,100% of CMS OPPS Rate,14.18,100% of CMS OPPS Rate,14.18,100% of CMS OPPS Rate,14.18,100% of CMS OPPS Rate,14.18,100% of CMS OPPS Rate,14.18,100% of CMS OPPS Rate,14.18,100% of CMS OPPS Rate,14.18,100% of CMS OPPS Rate,14.18,80.19,53.46
Outpatient,Laboratory,84450,AST OR SGOT,300,198.55,18.33,354% of CMS OPPS Rate,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,13.03,203.89% of BCBS Fee Schedule,138.99,70% of total Billed Charges,148.91,75% of total Billed Charges,9.32,180% OF CMS OPPS RATE,158.84,80% of total Billed Charges,18.13,350% of CMS Opps rate,5.28,102% of CMS Opps rate,151.89,76.5% of total billed charges,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,89.35,45% of total billed charges,138.99,70% of total billed charges,119.13,60% of total billed charges,5.18,100% of CMS OPPS Rate,5.75,90% OF UHC FEE SCHEDULE,138.99,70% of total billed charges,5.18,100% OF CMS OPPS Rate,11.91,230% OF CMS OPPS Rate,95.3,48% of total Billed charges,5.18,100% OF CMS OPPS Rate,178.7,90% of total Billed charges,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,5.18,178.7,119.13
Outpatient,Laboratory,84460,Blood test to evaluate liver function,300,253,18.76,354% of CMS OPPS Rate,5.3,100% of Medicaid LA Fee Schedule,5.3,100% of CMS OPPS Rate,5.3,100% of CMS OPPS Rate,13.33,203.89% of BCBS Fee Schedule,177.1,70% of total Billed Charges,189.75,75% of total Billed Charges,9.54,180% OF CMS OPPS RATE,202.4,80% of total Billed Charges,18.55,350% of CMS Opps rate,5.4,102% of CMS Opps rate,193.55,76.5% of total billed charges,5.3,100% of Medicaid LA Fee Schedule,5.3,100% of Medicaid LA Fee Schedule,5.3,100% of CMS OPPS Rate,5.3,100% of CMS OPPS Rate,113.85,45% of total billed charges,177.1,70% of total billed charges,151.8,60% of total billed charges,5.3,100% of CMS OPPS Rate,5.89,90% OF UHC FEE SCHEDULE,177.1,70% of total billed charges,5.3,100% OF CMS OPPS Rate,12.19,230% OF CMS OPPS Rate,121.44,48% of total Billed charges,5.3,100% OF CMS OPPS Rate,227.7,90% of total Billed charges,5.3,100% of Medicaid LA Fee Schedule,5.3,100% of Medicaid LA Fee Schedule,5.3,100% of Medicaid LA Fee Schedule,5.3,100% of Medicaid LA Fee Schedule,5.3,100% of Medicaid LA Fee Schedule,5.3,100% of Medicaid LA Fee Schedule,5.3,100% of CMS OPPS Rate,5.3,100% of CMS OPPS Rate,5.3,100% of CMS OPPS Rate,5.3,100% of CMS OPPS Rate,5.3,100% of CMS OPPS Rate,5.3,100% of CMS OPPS Rate,5.3,100% of CMS OPPS Rate,5.3,100% of CMS OPPS Rate,5.3,227.7,151.8
Outpatient,Laboratory,84466,TRANSFERRIN,300,210.1,45.17,354% of CMS OPPS Rate,12.76,100% of Medicaid LA Fee Schedule,12.76,100% of CMS OPPS Rate,12.76,100% of CMS OPPS Rate,32.13,203.89% of BCBS Fee Schedule,147.07,70% of total Billed Charges,157.58,75% of total Billed Charges,22.96,180% OF CMS OPPS RATE,168.08,80% of total Billed Charges,44.66,350% of CMS Opps rate,13.01,102% of CMS Opps rate,160.73,76.5% of total billed charges,12.76,100% of Medicaid LA Fee Schedule,12.76,100% of Medicaid LA Fee Schedule,12.76,100% of CMS OPPS Rate,12.76,100% of CMS OPPS Rate,94.55,45% of total billed charges,147.07,70% of total billed charges,126.06,60% of total billed charges,12.76,100% of CMS OPPS Rate,14.18,90% OF UHC FEE SCHEDULE,147.07,70% of total billed charges,12.76,100% OF CMS OPPS Rate,29.34,230% OF CMS OPPS Rate,100.85,48% of total Billed charges,12.76,100% OF CMS OPPS Rate,189.09,90% of total Billed charges,12.76,100% of Medicaid LA Fee Schedule,12.76,100% of Medicaid LA Fee Schedule,12.76,100% of Medicaid LA Fee Schedule,12.76,100% of Medicaid LA Fee Schedule,12.76,100% of Medicaid LA Fee Schedule,12.76,100% of Medicaid LA Fee Schedule,12.76,100% of CMS OPPS Rate,12.76,100% of CMS OPPS Rate,12.76,100% of CMS OPPS Rate,12.76,100% of CMS OPPS Rate,12.76,100% of CMS OPPS Rate,12.76,100% of CMS OPPS Rate,12.76,100% of CMS OPPS Rate,12.76,100% of CMS OPPS Rate,12.76,189.09,126.06
Outpatient,Laboratory,84478,TRIGLYCERIDES,300,121.95,20.31,354% of CMS OPPS Rate,5.74,100% of Medicaid LA Fee Schedule,5.74,100% of CMS OPPS Rate,5.74,100% of CMS OPPS Rate,14.46,203.89% of BCBS Fee Schedule,85.37,70% of total Billed Charges,91.46,75% of total Billed Charges,10.33,180% OF CMS OPPS RATE,97.56,80% of total Billed Charges,20.09,350% of CMS Opps rate,5.85,102% of CMS Opps rate,93.29,76.5% of total billed charges,5.74,100% of Medicaid LA Fee Schedule,5.74,100% of Medicaid LA Fee Schedule,5.74,100% of CMS OPPS Rate,5.74,100% of CMS OPPS Rate,54.88,45% of total billed charges,85.37,70% of total billed charges,73.17,60% of total billed charges,5.74,100% of CMS OPPS Rate,6.38,90% OF UHC FEE SCHEDULE,85.37,70% of total billed charges,5.74,100% OF CMS OPPS Rate,13.2,230% OF CMS OPPS Rate,58.54,48% of total Billed charges,5.74,100% OF CMS OPPS Rate,109.76,90% of total Billed charges,5.74,100% of Medicaid LA Fee Schedule,5.74,100% of Medicaid LA Fee Schedule,5.74,100% of Medicaid LA Fee Schedule,5.74,100% of Medicaid LA Fee Schedule,5.74,100% of Medicaid LA Fee Schedule,5.74,100% of Medicaid LA Fee Schedule,5.74,100% of CMS OPPS Rate,5.74,100% of CMS OPPS Rate,5.74,100% of CMS OPPS Rate,5.74,100% of CMS OPPS Rate,5.74,100% of CMS OPPS Rate,5.74,100% of CMS OPPS Rate,5.74,100% of CMS OPPS Rate,5.74,100% of CMS OPPS Rate,5.74,109.76,73.17
Outpatient,Laboratory,84479,T3 RESIN UPTAKE SERUM,300,143.55,22.9,354% of CMS OPPS Rate,5.69,100% of Medicaid LA Fee Schedule,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,107.66,75% of total Billed Charges,11.64,180% OF CMS OPPS RATE,114.84,80% of total Billed Charges,22.64,350% of CMS Opps rate,6.59,102% of CMS Opps rate,109.82,76.5% of total billed charges,5.69,100% of Medicaid LA Fee Schedule,5.69,100% of Medicaid LA Fee Schedule,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,64.6,45% of total billed charges,100.49,70% of total billed charges,86.13,60% of total billed charges,6.47,100% of CMS OPPS Rate,7.18,90% OF UHC FEE SCHEDULE,100.49,70% of total billed charges,6.47,100% OF CMS OPPS Rate,14.88,230% OF CMS OPPS Rate,68.9,48% of total Billed charges,6.47,100% OF CMS OPPS Rate,129.2,90% of total Billed charges,5.69,100% of Medicaid LA Fee Schedule,5.69,100% of Medicaid LA Fee Schedule,5.69,100% of Medicaid LA Fee Schedule,5.69,100% of Medicaid LA Fee Schedule,5.69,100% of Medicaid LA Fee Schedule,5.69,100% of Medicaid LA Fee Schedule,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,5.69,129.2,86.13
Outpatient,Laboratory,84480,Blood test to evaluate thyroid function,300,136.4,50.19,354% of CMS OPPS Rate,7.83,100% of Medicaid LA Fee Schedule,14.18,100% of CMS OPPS Rate,14.18,100% of CMS OPPS Rate,35.7,203.89% of BCBS Fee Schedule,95.48,70% of total Billed Charges,102.3,75% of total Billed Charges,25.52,180% OF CMS OPPS RATE,109.12,80% of total Billed Charges,49.63,350% of CMS Opps rate,14.46,102% of CMS Opps rate,104.35,76.5% of total billed charges,7.83,100% of Medicaid LA Fee Schedule,7.83,100% of Medicaid LA Fee Schedule,14.18,100% of CMS OPPS Rate,14.18,100% of CMS OPPS Rate,61.38,45% of total billed charges,95.48,70% of total billed charges,81.84,60% of total billed charges,14.18,100% of CMS OPPS Rate,15.76,90% OF UHC FEE SCHEDULE,95.48,70% of total billed charges,14.18,100% OF CMS OPPS Rate,32.61,230% OF CMS OPPS Rate,65.47,48% of total Billed charges,14.18,100% OF CMS OPPS Rate,122.76,90% of total Billed charges,7.83,100% of Medicaid LA Fee Schedule,7.83,100% of Medicaid LA Fee Schedule,7.83,100% of Medicaid LA Fee Schedule,7.83,100% of Medicaid LA Fee Schedule,7.83,100% of Medicaid LA Fee Schedule,7.83,100% of Medicaid LA Fee Schedule,14.18,100% of CMS OPPS Rate,14.18,100% of CMS OPPS Rate,14.18,100% of CMS OPPS Rate,14.18,100% of CMS OPPS Rate,14.18,100% of CMS OPPS Rate,14.18,100% of CMS OPPS Rate,14.18,100% of CMS OPPS Rate,14.18,100% of CMS OPPS Rate,7.83,122.76,81.84
Outpatient,Laboratory,84481,TRIIODOTHYRONINE T3 FREE,300,173.25,59.96,354% of CMS OPPS Rate,12.02,100% of Medicaid LA Fee Schedule,16.94,100% of CMS OPPS Rate,16.94,100% of CMS OPPS Rate,42.65,203.89% of BCBS Fee Schedule,121.28,70% of total Billed Charges,129.94,75% of total Billed Charges,30.49,180% OF CMS OPPS RATE,138.6,80% of total Billed Charges,59.29,350% of CMS Opps rate,17.27,102% of CMS Opps rate,132.54,76.5% of total billed charges,12.02,100% of Medicaid LA Fee Schedule,12.02,100% of Medicaid LA Fee Schedule,16.94,100% of CMS OPPS Rate,16.94,100% of CMS OPPS Rate,77.96,45% of total billed charges,121.28,70% of total billed charges,103.95,60% of total billed charges,16.94,100% of CMS OPPS Rate,18.83,90% OF UHC FEE SCHEDULE,121.28,70% of total billed charges,16.94,100% OF CMS OPPS Rate,38.96,230% OF CMS OPPS Rate,83.16,48% of total Billed charges,16.94,100% OF CMS OPPS Rate,155.93,90% of total Billed charges,12.02,100% of Medicaid LA Fee Schedule,12.02,100% of Medicaid LA Fee Schedule,12.02,100% of Medicaid LA Fee Schedule,12.02,100% of Medicaid LA Fee Schedule,12.02,100% of Medicaid LA Fee Schedule,12.02,100% of Medicaid LA Fee Schedule,16.94,100% of CMS OPPS Rate,16.94,100% of CMS OPPS Rate,16.94,100% of CMS OPPS Rate,16.94,100% of CMS OPPS Rate,16.94,100% of CMS OPPS Rate,16.94,100% of CMS OPPS Rate,16.94,100% of CMS OPPS Rate,16.94,100% of CMS OPPS Rate,12.02,155.93,103.95
Outpatient,Laboratory,84482,"T3, REVERSE",300,92.4,55.79,354% of CMS OPPS Rate,5.69,100% of Medicaid LA Fee Schedule,15.76,100% of CMS OPPS Rate,15.76,100% of CMS OPPS Rate,39.68,203.89% of BCBS Fee Schedule,64.68,70% of total Billed Charges,69.3,75% of total Billed Charges,28.36,180% OF CMS OPPS RATE,73.92,80% of total Billed Charges,55.16,350% of CMS Opps rate,16.07,102% of CMS Opps rate,70.69,76.5% of total billed charges,5.69,100% of Medicaid LA Fee Schedule,5.69,100% of Medicaid LA Fee Schedule,15.76,100% of CMS OPPS Rate,15.76,100% of CMS OPPS Rate,41.58,45% of total billed charges,64.68,70% of total billed charges,55.44,60% of total billed charges,15.76,100% of CMS OPPS Rate,17.51,90% OF UHC FEE SCHEDULE,64.68,70% of total billed charges,15.76,100% OF CMS OPPS Rate,36.24,230% OF CMS OPPS Rate,44.35,48% of total Billed charges,15.76,100% OF CMS OPPS Rate,83.16,90% of total Billed charges,5.69,100% of Medicaid LA Fee Schedule,5.69,100% of Medicaid LA Fee Schedule,5.69,100% of Medicaid LA Fee Schedule,5.69,100% of Medicaid LA Fee Schedule,5.69,100% of Medicaid LA Fee Schedule,5.69,100% of Medicaid LA Fee Schedule,15.76,100% of CMS OPPS Rate,15.76,100% of CMS OPPS Rate,15.76,100% of CMS OPPS Rate,15.76,100% of CMS OPPS Rate,15.76,100% of CMS OPPS Rate,15.76,100% of CMS OPPS Rate,15.76,100% of CMS OPPS Rate,15.76,100% of CMS OPPS Rate,5.69,83.16,55.44
Outpatient,Laboratory,84484,Blood test to measure a certain protein in the blood to determine heart muscle damage,300,360.9,44.14,354% of CMS OPPS Rate,12.47,100% of Medicaid LA Fee Schedule,12.47,100% of CMS OPPS Rate,12.47,100% of CMS OPPS Rate,25.43,203.89% of BCBS Fee Schedule,252.63,70% of total Billed Charges,270.68,75% of total Billed Charges,22.44,180% OF CMS OPPS RATE,288.72,80% of total Billed Charges,43.64,350% of CMS Opps rate,12.71,102% of CMS Opps rate,276.09,76.5% of total billed charges,12.47,100% of Medicaid LA Fee Schedule,12.47,100% of Medicaid LA Fee Schedule,12.47,100% of CMS OPPS Rate,12.47,100% of CMS OPPS Rate,162.41,45% of total billed charges,252.63,70% of total billed charges,216.54,60% of total billed charges,12.47,100% of CMS OPPS Rate,11.22,90% OF UHC FEE SCHEDULE,252.63,70% of total billed charges,12.47,100% OF CMS OPPS Rate,28.68,230% OF CMS OPPS Rate,173.23,48% of total Billed charges,12.47,100% OF CMS OPPS Rate,324.81,90% of total Billed charges,12.47,100% of Medicaid LA Fee Schedule,12.47,100% of Medicaid LA Fee Schedule,12.47,100% of Medicaid LA Fee Schedule,12.47,100% of Medicaid LA Fee Schedule,12.47,100% of Medicaid LA Fee Schedule,12.47,100% of Medicaid LA Fee Schedule,12.47,100% of CMS OPPS Rate,12.47,100% of CMS OPPS Rate,12.47,100% of CMS OPPS Rate,12.47,100% of CMS OPPS Rate,12.47,100% of CMS OPPS Rate,12.47,100% of CMS OPPS Rate,12.47,100% of CMS OPPS Rate,12.47,100% of CMS OPPS Rate,11.22,324.81,216.54
Outpatient,Laboratory,84520,BUN SERUM,300,81.95,13.98,354% of CMS OPPS Rate,3.95,100% of Medicaid LA Fee Schedule,3.95,100% of CMS OPPS Rate,3.95,100% of CMS OPPS Rate,9.95,203.89% of BCBS Fee Schedule,57.37,70% of total Billed Charges,61.46,75% of total Billed Charges,7.11,180% OF CMS OPPS RATE,65.56,80% of total Billed Charges,13.82,350% of CMS Opps rate,4.02,102% of CMS Opps rate,62.69,76.5% of total billed charges,3.95,100% of Medicaid LA Fee Schedule,3.95,100% of Medicaid LA Fee Schedule,3.95,100% of CMS OPPS Rate,3.95,100% of CMS OPPS Rate,36.88,45% of total billed charges,57.37,70% of total billed charges,49.17,60% of total billed charges,3.95,100% of CMS OPPS Rate,4.39,90% OF UHC FEE SCHEDULE,57.37,70% of total billed charges,3.95,100% OF CMS OPPS Rate,9.08,230% OF CMS OPPS Rate,39.34,48% of total Billed charges,3.95,100% OF CMS OPPS Rate,73.76,90% of total Billed charges,3.95,100% of Medicaid LA Fee Schedule,3.95,100% of Medicaid LA Fee Schedule,3.95,100% of Medicaid LA Fee Schedule,3.95,100% of Medicaid LA Fee Schedule,3.95,100% of Medicaid LA Fee Schedule,3.95,100% of Medicaid LA Fee Schedule,3.95,100% of CMS OPPS Rate,3.95,100% of CMS OPPS Rate,3.95,100% of CMS OPPS Rate,3.95,100% of CMS OPPS Rate,3.95,100% of CMS OPPS Rate,3.95,100% of CMS OPPS Rate,3.95,100% of CMS OPPS Rate,3.95,100% of CMS OPPS Rate,3.95,73.76,49.17
Outpatient,Laboratory,84540,UREA NITROGEN URINE,300,69.75,19.68,354% of CMS OPPS Rate,5.51,100% of Medicaid LA Fee Schedule,5.56,100% of CMS OPPS Rate,5.56,100% of CMS OPPS Rate,11.95,203.89% of BCBS Fee Schedule,48.83,70% of total Billed Charges,52.31,75% of total Billed Charges,10,180% OF CMS OPPS RATE,55.8,80% of total Billed Charges,19.45,350% of CMS Opps rate,5.67,102% of CMS Opps rate,53.36,76.5% of total billed charges,5.51,100% of Medicaid LA Fee Schedule,5.51,100% of Medicaid LA Fee Schedule,5.56,100% of CMS OPPS Rate,5.56,100% of CMS OPPS Rate,31.39,45% of total billed charges,48.83,70% of total billed charges,41.85,60% of total billed charges,5.56,100% of CMS OPPS Rate,5.27,90% OF UHC FEE SCHEDULE,48.83,70% of total billed charges,5.56,100% OF CMS OPPS Rate,12.78,230% OF CMS OPPS Rate,33.48,48% of total Billed charges,5.56,100% OF CMS OPPS Rate,62.78,90% of total Billed charges,5.51,100% of Medicaid LA Fee Schedule,5.51,100% of Medicaid LA Fee Schedule,5.51,100% of Medicaid LA Fee Schedule,5.51,100% of Medicaid LA Fee Schedule,5.51,100% of Medicaid LA Fee Schedule,5.51,100% of Medicaid LA Fee Schedule,5.56,100% of CMS OPPS Rate,5.56,100% of CMS OPPS Rate,5.56,100% of CMS OPPS Rate,5.56,100% of CMS OPPS Rate,5.56,100% of CMS OPPS Rate,5.56,100% of CMS OPPS Rate,5.56,100% of CMS OPPS Rate,5.56,100% of CMS OPPS Rate,5.27,62.78,41.85
Outpatient,Laboratory,84550,URIC ACID SERUM,300,124.65,16,354% of CMS OPPS Rate,4.52,100% of Medicaid LA Fee Schedule,4.51,100% of CMS OPPS Rate,4.51,100% of CMS OPPS Rate,11.38,203.89% of BCBS Fee Schedule,87.26,70% of total Billed Charges,93.49,75% of total Billed Charges,8.13,180% OF CMS OPPS RATE,99.72,80% of total Billed Charges,15.81,350% of CMS Opps rate,4.61,102% of CMS Opps rate,95.36,76.5% of total billed charges,4.52,100% of Medicaid LA Fee Schedule,4.52,100% of Medicaid LA Fee Schedule,4.51,100% of CMS OPPS Rate,4.51,100% of CMS OPPS Rate,56.09,45% of total billed charges,87.26,70% of total billed charges,74.79,60% of total billed charges,4.51,100% of CMS OPPS Rate,5.02,90% OF UHC FEE SCHEDULE,87.26,70% of total billed charges,4.51,100% OF CMS OPPS Rate,10.39,230% OF CMS OPPS Rate,59.83,48% of total Billed charges,4.51,100% OF CMS OPPS Rate,112.19,90% of total Billed charges,4.52,100% of Medicaid LA Fee Schedule,4.52,100% of Medicaid LA Fee Schedule,4.52,100% of Medicaid LA Fee Schedule,4.52,100% of Medicaid LA Fee Schedule,4.52,100% of Medicaid LA Fee Schedule,4.52,100% of Medicaid LA Fee Schedule,4.51,100% of CMS OPPS Rate,4.51,100% of CMS OPPS Rate,4.51,100% of CMS OPPS Rate,4.51,100% of CMS OPPS Rate,4.51,100% of CMS OPPS Rate,4.51,100% of CMS OPPS Rate,4.51,100% of CMS OPPS Rate,4.51,100% of CMS OPPS Rate,4.51,112.19,74.79
Outpatient,Laboratory,84560,URIC ACID URINE,300,124.65,17.98,354% of CMS OPPS Rate,5.08,100% of Medicaid LA Fee Schedule,5.08,100% of CMS OPPS Rate,5.08,100% of CMS OPPS Rate,11.95,203.89% of BCBS Fee Schedule,87.26,70% of total Billed Charges,93.49,75% of total Billed Charges,9.14,180% OF CMS OPPS RATE,99.72,80% of total Billed Charges,17.78,350% of CMS Opps rate,5.18,102% of CMS Opps rate,95.36,76.5% of total billed charges,5.08,100% of Medicaid LA Fee Schedule,5.08,100% of Medicaid LA Fee Schedule,5.08,100% of CMS OPPS Rate,5.08,100% of CMS OPPS Rate,56.09,45% of total billed charges,87.26,70% of total billed charges,74.79,60% of total billed charges,5.08,100% of CMS OPPS Rate,5.27,90% OF UHC FEE SCHEDULE,87.26,70% of total billed charges,5.08,100% OF CMS OPPS Rate,11.68,230% OF CMS OPPS Rate,59.83,48% of total Billed charges,5.08,100% OF CMS OPPS Rate,112.19,90% of total Billed charges,5.08,100% of Medicaid LA Fee Schedule,5.08,100% of Medicaid LA Fee Schedule,5.08,100% of Medicaid LA Fee Schedule,5.08,100% of Medicaid LA Fee Schedule,5.08,100% of Medicaid LA Fee Schedule,5.08,100% of Medicaid LA Fee Schedule,5.08,100% of CMS OPPS Rate,5.08,100% of CMS OPPS Rate,5.08,100% of CMS OPPS Rate,5.08,100% of CMS OPPS Rate,5.08,100% of CMS OPPS Rate,5.08,100% of CMS OPPS Rate,5.08,100% of CMS OPPS Rate,5.08,100% of CMS OPPS Rate,5.08,112.19,74.79
Outpatient,Laboratory,84577,UROBILINOGEN-STOOL,300,91.5,59.47,354% of CMS OPPS Rate,12.93,100% of Medicaid LA Fee Schedule,16.8,100% of CMS OPPS Rate,16.8,100% of CMS OPPS Rate,42.31,203.89% of BCBS Fee Schedule,64.05,70% of total Billed Charges,68.63,75% of total Billed Charges,30.24,180% OF CMS OPPS RATE,73.2,80% of total Billed Charges,58.8,350% of CMS Opps rate,17.13,102% of CMS Opps rate,70,76.5% of total billed charges,12.93,100% of Medicaid LA Fee Schedule,12.93,100% of Medicaid LA Fee Schedule,16.8,100% of CMS OPPS Rate,16.8,100% of CMS OPPS Rate,41.18,45% of total billed charges,64.05,70% of total billed charges,54.9,60% of total billed charges,16.8,100% of CMS OPPS Rate,18.68,90% OF UHC FEE SCHEDULE,64.05,70% of total billed charges,16.8,100% OF CMS OPPS Rate,38.64,230% OF CMS OPPS Rate,43.92,48% of total Billed charges,16.8,100% OF CMS OPPS Rate,82.35,90% of total Billed charges,12.93,100% of Medicaid LA Fee Schedule,12.93,100% of Medicaid LA Fee Schedule,12.93,100% of Medicaid LA Fee Schedule,12.93,100% of Medicaid LA Fee Schedule,12.93,100% of Medicaid LA Fee Schedule,12.93,100% of Medicaid LA Fee Schedule,16.8,100% of CMS OPPS Rate,16.8,100% of CMS OPPS Rate,16.8,100% of CMS OPPS Rate,16.8,100% of CMS OPPS Rate,16.8,100% of CMS OPPS Rate,16.8,100% of CMS OPPS Rate,16.8,100% of CMS OPPS Rate,16.8,100% of CMS OPPS Rate,12.93,82.35,54.9
Outpatient,Laboratory,84585,VMA-URINE-24 HOUR,300,135,54.87,354% of CMS OPPS Rate,15.5,100% of Medicaid LA Fee Schedule,15.5,100% of CMS OPPS Rate,15.5,100% of CMS OPPS Rate,39,203.89% of BCBS Fee Schedule,94.5,70% of total Billed Charges,101.25,75% of total Billed Charges,27.9,180% OF CMS OPPS RATE,108,80% of total Billed Charges,54.25,350% of CMS Opps rate,15.81,102% of CMS Opps rate,103.28,76.5% of total billed charges,15.5,100% of Medicaid LA Fee Schedule,15.5,100% of Medicaid LA Fee Schedule,15.5,100% of CMS OPPS Rate,15.5,100% of CMS OPPS Rate,60.75,45% of total billed charges,94.5,70% of total billed charges,81,60% of total billed charges,15.5,100% of CMS OPPS Rate,17.22,90% OF UHC FEE SCHEDULE,94.5,70% of total billed charges,15.5,100% OF CMS OPPS Rate,35.65,230% OF CMS OPPS Rate,64.8,48% of total Billed charges,15.5,100% OF CMS OPPS Rate,121.5,90% of total Billed charges,15.5,100% of Medicaid LA Fee Schedule,15.5,100% of Medicaid LA Fee Schedule,15.5,100% of Medicaid LA Fee Schedule,15.5,100% of Medicaid LA Fee Schedule,15.5,100% of Medicaid LA Fee Schedule,15.5,100% of Medicaid LA Fee Schedule,15.5,100% of CMS OPPS Rate,15.5,100% of CMS OPPS Rate,15.5,100% of CMS OPPS Rate,15.5,100% of CMS OPPS Rate,15.5,100% of CMS OPPS Rate,15.5,100% of CMS OPPS Rate,15.5,100% of CMS OPPS Rate,15.5,100% of CMS OPPS Rate,15.5,121.5,81
Outpatient,Laboratory,84586,VIP-VASOACT POLYPEPTIDE,300,365.85,125.06,354% of CMS OPPS Rate,35.33,100% of Medicaid LA Fee Schedule,35.33,100% of CMS OPPS Rate,35.33,100% of CMS OPPS Rate,88.94,203.89% of BCBS Fee Schedule,256.1,70% of total Billed Charges,274.39,75% of total Billed Charges,63.59,180% OF CMS OPPS RATE,292.68,80% of total Billed Charges,123.65,350% of CMS Opps rate,36.03,102% of CMS Opps rate,279.88,76.5% of total billed charges,35.33,100% of Medicaid LA Fee Schedule,35.33,100% of Medicaid LA Fee Schedule,35.33,100% of CMS OPPS Rate,35.33,100% of CMS OPPS Rate,164.63,45% of total billed charges,256.1,70% of total billed charges,219.51,60% of total billed charges,35.33,100% of CMS OPPS Rate,39.26,90% OF UHC FEE SCHEDULE,256.1,70% of total billed charges,35.33,100% OF CMS OPPS Rate,81.25,230% OF CMS OPPS Rate,175.61,48% of total Billed charges,35.33,100% OF CMS OPPS Rate,329.27,90% of total Billed charges,35.33,100% of Medicaid LA Fee Schedule,35.33,100% of Medicaid LA Fee Schedule,35.33,100% of Medicaid LA Fee Schedule,35.33,100% of Medicaid LA Fee Schedule,35.33,100% of Medicaid LA Fee Schedule,35.33,100% of Medicaid LA Fee Schedule,35.33,100% of CMS OPPS Rate,35.33,100% of CMS OPPS Rate,35.33,100% of CMS OPPS Rate,35.33,100% of CMS OPPS Rate,35.33,100% of CMS OPPS Rate,35.33,100% of CMS OPPS Rate,35.33,100% of CMS OPPS Rate,35.33,100% of CMS OPPS Rate,35.33,329.27,219.51
Outpatient,Laboratory,84588,ADH-ANTI DIURETIC HOR,300,99.55,120.14,354% of CMS OPPS Rate,27.3,100% of Medicaid LA Fee Schedule,33.94,100% of CMS OPPS Rate,33.94,100% of CMS OPPS Rate,85.43,203.89% of BCBS Fee Schedule,69.69,70% of total Billed Charges,74.66,75% of total Billed Charges,61.09,180% OF CMS OPPS RATE,79.64,80% of total Billed Charges,118.79,350% of CMS Opps rate,34.61,102% of CMS Opps rate,76.16,76.5% of total billed charges,27.3,100% of Medicaid LA Fee Schedule,27.3,100% of Medicaid LA Fee Schedule,33.94,100% of CMS OPPS Rate,33.94,100% of CMS OPPS Rate,44.8,45% of total billed charges,69.69,70% of total billed charges,59.73,60% of total billed charges,33.94,100% of CMS OPPS Rate,37.71,90% OF UHC FEE SCHEDULE,69.69,70% of total billed charges,33.94,100% OF CMS OPPS Rate,78.06,230% OF CMS OPPS Rate,47.78,48% of total Billed charges,33.94,100% OF CMS OPPS Rate,89.6,90% of total Billed charges,27.3,100% of Medicaid LA Fee Schedule,27.3,100% of Medicaid LA Fee Schedule,27.3,100% of Medicaid LA Fee Schedule,27.3,100% of Medicaid LA Fee Schedule,27.3,100% of Medicaid LA Fee Schedule,27.3,100% of Medicaid LA Fee Schedule,33.94,100% of CMS OPPS Rate,33.94,100% of CMS OPPS Rate,33.94,100% of CMS OPPS Rate,33.94,100% of CMS OPPS Rate,33.94,100% of CMS OPPS Rate,33.94,100% of CMS OPPS Rate,33.94,100% of CMS OPPS Rate,33.94,100% of CMS OPPS Rate,27.3,120.14,59.73
Outpatient,Laboratory,84590,VITAMIN A(RETINOL),300,222.75,41.09,354% of CMS OPPS Rate,11.61,100% of Medicaid LA Fee Schedule,11.61,100% of CMS OPPS Rate,11.61,100% of CMS OPPS Rate,29.22,203.89% of BCBS Fee Schedule,155.93,70% of total Billed Charges,167.06,75% of total Billed Charges,20.89,180% OF CMS OPPS RATE,178.2,80% of total Billed Charges,40.63,350% of CMS Opps rate,11.84,102% of CMS Opps rate,170.4,76.5% of total billed charges,11.61,100% of Medicaid LA Fee Schedule,11.61,100% of Medicaid LA Fee Schedule,11.61,100% of CMS OPPS Rate,11.61,100% of CMS OPPS Rate,100.24,45% of total billed charges,155.93,70% of total billed charges,133.65,60% of total billed charges,11.61,100% of CMS OPPS Rate,12.9,90% OF UHC FEE SCHEDULE,155.93,70% of total billed charges,11.61,100% OF CMS OPPS Rate,26.7,230% OF CMS OPPS Rate,106.92,48% of total Billed charges,11.61,100% OF CMS OPPS Rate,200.48,90% of total Billed charges,11.61,100% of Medicaid LA Fee Schedule,11.61,100% of Medicaid LA Fee Schedule,11.61,100% of Medicaid LA Fee Schedule,11.61,100% of Medicaid LA Fee Schedule,11.61,100% of Medicaid LA Fee Schedule,11.61,100% of Medicaid LA Fee Schedule,11.61,100% of CMS OPPS Rate,11.61,100% of CMS OPPS Rate,11.61,100% of CMS OPPS Rate,11.61,100% of CMS OPPS Rate,11.61,100% of CMS OPPS Rate,11.61,100% of CMS OPPS Rate,11.61,100% of CMS OPPS Rate,11.61,100% of CMS OPPS Rate,11.61,200.48,133.65
Outpatient,Laboratory,84591,"VITAMIN, NOS",300,84.15,60.39,354% of CMS OPPS Rate,16.13,100% of Medicaid LA Fee Schedule,17.05,100% of CMS OPPS Rate,17.05,100% of CMS OPPS Rate,34.78,203.89% of BCBS Fee Schedule,58.91,70% of total Billed Charges,63.11,75% of total Billed Charges,30.7,180% OF CMS OPPS RATE,67.32,80% of total Billed Charges,59.71,350% of CMS Opps rate,17.4,102% of CMS Opps rate,64.37,76.5% of total billed charges,16.13,100% of Medicaid LA Fee Schedule,16.13,100% of Medicaid LA Fee Schedule,17.05,100% of CMS OPPS Rate,17.05,100% of CMS OPPS Rate,37.87,45% of total billed charges,58.91,70% of total billed charges,50.49,60% of total billed charges,17.05,100% of CMS OPPS Rate,15.35,90% OF UHC FEE SCHEDULE,58.91,70% of total billed charges,17.05,100% OF CMS OPPS Rate,39.23,230% OF CMS OPPS Rate,40.39,48% of total Billed charges,17.05,100% OF CMS OPPS Rate,75.74,90% of total Billed charges,16.13,100% of Medicaid LA Fee Schedule,16.13,100% of Medicaid LA Fee Schedule,16.13,100% of Medicaid LA Fee Schedule,16.13,100% of Medicaid LA Fee Schedule,16.13,100% of Medicaid LA Fee Schedule,16.13,100% of Medicaid LA Fee Schedule,17.05,100% of CMS OPPS Rate,17.05,100% of CMS OPPS Rate,17.05,100% of CMS OPPS Rate,17.05,100% of CMS OPPS Rate,17.05,100% of CMS OPPS Rate,17.05,100% of CMS OPPS Rate,17.05,100% of CMS OPPS Rate,17.05,100% of CMS OPPS Rate,15.35,75.74,50.49
Outpatient,Laboratory,84597,VITAMIN K,300,169.4,48.56,354% of CMS OPPS Rate,10.25,100% of Medicaid LA Fee Schedule,13.72,100% of CMS OPPS Rate,13.72,100% of CMS OPPS Rate,34.54,203.89% of BCBS Fee Schedule,118.58,70% of total Billed Charges,127.05,75% of total Billed Charges,24.69,180% OF CMS OPPS RATE,135.52,80% of total Billed Charges,48.02,350% of CMS Opps rate,13.99,102% of CMS Opps rate,129.59,76.5% of total billed charges,10.25,100% of Medicaid LA Fee Schedule,10.25,100% of Medicaid LA Fee Schedule,13.72,100% of CMS OPPS Rate,13.72,100% of CMS OPPS Rate,76.23,45% of total billed charges,118.58,70% of total billed charges,101.64,60% of total billed charges,13.72,100% of CMS OPPS Rate,15.25,90% OF UHC FEE SCHEDULE,118.58,70% of total billed charges,13.72,100% OF CMS OPPS Rate,31.55,230% OF CMS OPPS Rate,81.31,48% of total Billed charges,13.72,100% OF CMS OPPS Rate,152.46,90% of total Billed charges,10.25,100% of Medicaid LA Fee Schedule,10.25,100% of Medicaid LA Fee Schedule,10.25,100% of Medicaid LA Fee Schedule,10.25,100% of Medicaid LA Fee Schedule,10.25,100% of Medicaid LA Fee Schedule,10.25,100% of Medicaid LA Fee Schedule,13.72,100% of CMS OPPS Rate,13.72,100% of CMS OPPS Rate,13.72,100% of CMS OPPS Rate,13.72,100% of CMS OPPS Rate,13.72,100% of CMS OPPS Rate,13.72,100% of CMS OPPS Rate,13.72,100% of CMS OPPS Rate,13.72,100% of CMS OPPS Rate,10.25,152.46,101.64
Outpatient,Laboratory,84600,ISOPROPANOL,300,46,60.56,354% of CMS OPPS Rate,17.11,100% of Medicaid LA Fee Schedule,17.11,100% of CMS OPPS Rate,17.11,100% of CMS OPPS Rate,40.47,203.89% of BCBS Fee Schedule,32.2,70% of total Billed Charges,34.5,75% of total Billed Charges,30.79,180% OF CMS OPPS RATE,36.8,80% of total Billed Charges,59.88,350% of CMS Opps rate,17.45,102% of CMS Opps rate,35.19,76.5% of total billed charges,17.11,100% of Medicaid LA Fee Schedule,17.11,100% of Medicaid LA Fee Schedule,17.11,100% of CMS OPPS Rate,17.11,100% of CMS OPPS Rate,20.7,45% of total billed charges,32.2,70% of total billed charges,27.6,60% of total billed charges,17.11,100% of CMS OPPS Rate,17.87,90% OF UHC FEE SCHEDULE,32.2,70% of total billed charges,17.11,100% OF CMS OPPS Rate,39.35,230% OF CMS OPPS Rate,22.08,48% of total Billed charges,17.11,100% OF CMS OPPS Rate,41.4,90% of total Billed charges,17.11,100% of Medicaid LA Fee Schedule,17.11,100% of Medicaid LA Fee Schedule,17.11,100% of Medicaid LA Fee Schedule,17.11,100% of Medicaid LA Fee Schedule,17.11,100% of Medicaid LA Fee Schedule,17.11,100% of Medicaid LA Fee Schedule,17.11,100% of CMS OPPS Rate,17.11,100% of CMS OPPS Rate,17.11,100% of CMS OPPS Rate,17.11,100% of CMS OPPS Rate,17.11,100% of CMS OPPS Rate,17.11,100% of CMS OPPS Rate,17.11,100% of CMS OPPS Rate,17.11,100% of CMS OPPS Rate,17.11,60.56,27.6
Outpatient,Laboratory,84630,ZINC,300,202.4,40.32,354% of CMS OPPS Rate,11.39,100% of Medicaid LA Fee Schedule,11.39,100% of CMS OPPS Rate,11.39,100% of CMS OPPS Rate,28.67,203.89% of BCBS Fee Schedule,141.68,70% of total Billed Charges,151.8,75% of total Billed Charges,20.5,180% OF CMS OPPS RATE,161.92,80% of total Billed Charges,39.86,350% of CMS Opps rate,11.61,102% of CMS Opps rate,154.84,76.5% of total billed charges,11.39,100% of Medicaid LA Fee Schedule,11.39,100% of Medicaid LA Fee Schedule,11.39,100% of CMS OPPS Rate,11.39,100% of CMS OPPS Rate,91.08,45% of total billed charges,141.68,70% of total billed charges,121.44,60% of total billed charges,11.39,100% of CMS OPPS Rate,12.65,90% OF UHC FEE SCHEDULE,141.68,70% of total billed charges,11.39,100% OF CMS OPPS Rate,26.19,230% OF CMS OPPS Rate,97.15,48% of total Billed charges,11.39,100% OF CMS OPPS Rate,182.16,90% of total Billed charges,11.39,100% of Medicaid LA Fee Schedule,11.39,100% of Medicaid LA Fee Schedule,11.39,100% of Medicaid LA Fee Schedule,11.39,100% of Medicaid LA Fee Schedule,11.39,100% of Medicaid LA Fee Schedule,11.39,100% of Medicaid LA Fee Schedule,11.39,100% of CMS OPPS Rate,11.39,100% of CMS OPPS Rate,11.39,100% of CMS OPPS Rate,11.39,100% of CMS OPPS Rate,11.39,100% of CMS OPPS Rate,11.39,100% of CMS OPPS Rate,11.39,100% of CMS OPPS Rate,11.39,100% of CMS OPPS Rate,11.39,182.16,121.44
Outpatient,Laboratory,84681,"C-PEPTIDE, SERUM",300,89.1,73.66,354% of CMS OPPS Rate,13.96,15.67% of total Billed charges,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,52.4,203.89% of BCBS Fee Schedule,62.37,70% of total Billed Charges,66.83,75% of total Billed Charges,37.45,180% OF CMS OPPS RATE,71.28,80% of total Billed Charges,72.83,350% of CMS Opps rate,21.22,102% of CMS Opps rate,68.16,76.5% of total billed charges,13.96,15.67% of total Billed charges,13.96,15.67% of total Billed charges,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,40.1,45% of total billed charges,62.37,70% of total billed charges,53.46,60% of total billed charges,20.81,100% of CMS OPPS Rate,23.13,90% OF UHC FEE SCHEDULE,62.37,70% of total billed charges,20.81,100% OF CMS OPPS Rate,47.86,230% OF CMS OPPS Rate,42.77,48% of total Billed charges,20.81,100% OF CMS OPPS Rate,80.19,90% of total Billed charges,13.96,15.67% of total Billed charges,13.96,15.67% of total Billed charges,13.96,15.67% of total Billed charges,13.96,15.67% of total Billed charges,13.96,15.67% of total Billed charges,13.96,15.67% of total Billed charges,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,13.96,80.19,53.46
Outpatient,Laboratory,84702,HCG QUANTITATIVE SERUM,300,457.6,53.27,354% of CMS OPPS Rate,15.05,100% of Medicaid LA Fee Schedule,15.05,100% of CMS OPPS Rate,15.05,100% of CMS OPPS Rate,37.9,203.89% of BCBS Fee Schedule,320.32,70% of total Billed Charges,343.2,75% of total Billed Charges,27.09,180% OF CMS OPPS RATE,366.08,80% of total Billed Charges,52.67,350% of CMS Opps rate,15.35,102% of CMS Opps rate,350.06,76.5% of total billed charges,15.05,100% of Medicaid LA Fee Schedule,15.05,100% of Medicaid LA Fee Schedule,15.05,100% of CMS OPPS Rate,15.05,100% of CMS OPPS Rate,205.92,45% of total billed charges,320.32,70% of total billed charges,274.56,60% of total billed charges,15.05,100% of CMS OPPS Rate,16.73,90% OF UHC FEE SCHEDULE,320.32,70% of total billed charges,15.05,100% OF CMS OPPS Rate,34.61,230% OF CMS OPPS Rate,219.65,48% of total Billed charges,15.05,100% OF CMS OPPS Rate,411.84,90% of total Billed charges,15.05,100% of Medicaid LA Fee Schedule,15.05,100% of Medicaid LA Fee Schedule,15.05,100% of Medicaid LA Fee Schedule,15.05,100% of Medicaid LA Fee Schedule,15.05,100% of Medicaid LA Fee Schedule,15.05,100% of Medicaid LA Fee Schedule,15.05,100% of CMS OPPS Rate,15.05,100% of CMS OPPS Rate,15.05,100% of CMS OPPS Rate,15.05,100% of CMS OPPS Rate,15.05,100% of CMS OPPS Rate,15.05,100% of CMS OPPS Rate,15.05,100% of CMS OPPS Rate,15.05,100% of CMS OPPS Rate,15.05,411.84,274.56
Outpatient,Laboratory,84703,Blood test to assess for pregnancy,300,221.65,26.62,354% of CMS OPPS Rate,7.52,100% of Medicaid LA Fee Schedule,7.52,100% of CMS OPPS Rate,7.52,100% of CMS OPPS Rate,18.94,203.89% of BCBS Fee Schedule,155.16,70% of total Billed Charges,166.24,75% of total Billed Charges,13.53,180% OF CMS OPPS RATE,177.32,80% of total Billed Charges,26.32,350% of CMS Opps rate,7.67,102% of CMS Opps rate,169.56,76.5% of total billed charges,7.52,100% of Medicaid LA Fee Schedule,7.52,100% of Medicaid LA Fee Schedule,7.52,100% of CMS OPPS Rate,7.52,100% of CMS OPPS Rate,99.74,45% of total billed charges,155.16,70% of total billed charges,132.99,60% of total billed charges,7.52,100% of CMS OPPS Rate,8.36,90% OF UHC FEE SCHEDULE,155.16,70% of total billed charges,7.52,100% OF CMS OPPS Rate,17.29,230% OF CMS OPPS Rate,106.39,48% of total Billed charges,7.52,100% OF CMS OPPS Rate,199.49,90% of total Billed charges,7.52,100% of Medicaid LA Fee Schedule,7.52,100% of Medicaid LA Fee Schedule,7.52,100% of Medicaid LA Fee Schedule,7.52,100% of Medicaid LA Fee Schedule,7.52,100% of Medicaid LA Fee Schedule,7.52,100% of Medicaid LA Fee Schedule,7.52,100% of CMS OPPS Rate,7.52,100% of CMS OPPS Rate,7.52,100% of CMS OPPS Rate,7.52,100% of CMS OPPS Rate,7.52,100% of CMS OPPS Rate,7.52,100% of CMS OPPS Rate,7.52,100% of CMS OPPS Rate,7.52,100% of CMS OPPS Rate,7.52,199.49,132.99
Outpatient,Laboratory,85007,Blood test to assess for infection,300,69.75,13.45,354% of CMS OPPS Rate,3.05,100% of Medicaid LA Fee Schedule,3.8,100% of CMS OPPS Rate,3.8,100% of CMS OPPS Rate,8.64,203.89% of BCBS Fee Schedule,48.83,70% of total Billed Charges,52.31,75% of total Billed Charges,6.84,180% OF CMS OPPS RATE,55.8,80% of total Billed Charges,13.3,350% of CMS Opps rate,3.87,102% of CMS Opps rate,53.36,76.5% of total billed charges,3.05,100% of Medicaid LA Fee Schedule,3.05,100% of Medicaid LA Fee Schedule,3.8,100% of CMS OPPS Rate,3.8,100% of CMS OPPS Rate,31.39,45% of total billed charges,48.83,70% of total billed charges,41.85,60% of total billed charges,3.8,100% of CMS OPPS Rate,3.82,90% OF UHC FEE SCHEDULE,48.83,70% of total billed charges,3.8,100% OF CMS OPPS Rate,8.74,230% OF CMS OPPS Rate,33.48,48% of total Billed charges,3.8,100% OF CMS OPPS Rate,62.78,90% of total Billed charges,3.05,100% of Medicaid LA Fee Schedule,3.05,100% of Medicaid LA Fee Schedule,3.05,100% of Medicaid LA Fee Schedule,3.05,100% of Medicaid LA Fee Schedule,3.05,100% of Medicaid LA Fee Schedule,3.05,100% of Medicaid LA Fee Schedule,3.8,100% of CMS OPPS Rate,3.8,100% of CMS OPPS Rate,3.8,100% of CMS OPPS Rate,3.8,100% of CMS OPPS Rate,3.8,100% of CMS OPPS Rate,3.8,100% of CMS OPPS Rate,3.8,100% of CMS OPPS Rate,3.8,100% of CMS OPPS Rate,3.05,62.78,41.85
Outpatient,Laboratory,85025,"Complete blood cell count, with differential white blood cells, automated",300,180.45,27.5,354% of CMS OPPS Rate,7.77,100% of Medicaid LA Fee Schedule,7.77,100% of CMS OPPS Rate,7.77,100% of CMS OPPS Rate,19.55,203.89% of BCBS Fee Schedule,126.32,70% of total Billed Charges,135.34,75% of total Billed Charges,13.98,180% OF CMS OPPS RATE,144.36,80% of total Billed Charges,27.19,350% of CMS Opps rate,7.92,102% of CMS Opps rate,138.04,76.5% of total billed charges,7.77,100% of Medicaid LA Fee Schedule,7.77,100% of Medicaid LA Fee Schedule,7.77,100% of CMS OPPS Rate,7.77,100% of CMS OPPS Rate,81.2,45% of total billed charges,126.32,70% of total billed charges,108.27,60% of total billed charges,7.77,100% of CMS OPPS Rate,8.63,90% OF UHC FEE SCHEDULE,126.32,70% of total billed charges,7.77,100% OF CMS OPPS Rate,17.87,230% OF CMS OPPS Rate,86.62,48% of total Billed charges,7.77,100% OF CMS OPPS Rate,162.41,90% of total Billed charges,7.77,100% of Medicaid LA Fee Schedule,7.77,100% of Medicaid LA Fee Schedule,7.77,100% of Medicaid LA Fee Schedule,7.77,100% of Medicaid LA Fee Schedule,7.77,100% of Medicaid LA Fee Schedule,7.77,100% of Medicaid LA Fee Schedule,7.77,100% of CMS OPPS Rate,7.77,100% of CMS OPPS Rate,7.77,100% of CMS OPPS Rate,7.77,100% of CMS OPPS Rate,7.77,100% of CMS OPPS Rate,7.77,100% of CMS OPPS Rate,7.77,100% of CMS OPPS Rate,7.77,100% of CMS OPPS Rate,7.77,162.41,108.27
Outpatient,Laboratory,85027,"Complete blood count, automated",300,121.95,22.9,354% of CMS OPPS Rate,6.47,100% of Medicaid LA Fee Schedule,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,16.27,203.89% of BCBS Fee Schedule,85.37,70% of total Billed Charges,91.46,75% of total Billed Charges,11.64,180% OF CMS OPPS RATE,97.56,80% of total Billed Charges,22.64,350% of CMS Opps rate,6.59,102% of CMS Opps rate,93.29,76.5% of total billed charges,6.47,100% of Medicaid LA Fee Schedule,6.47,100% of Medicaid LA Fee Schedule,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,54.88,45% of total billed charges,85.37,70% of total billed charges,73.17,60% of total billed charges,6.47,100% of CMS OPPS Rate,7.18,90% OF UHC FEE SCHEDULE,85.37,70% of total billed charges,6.47,100% OF CMS OPPS Rate,14.88,230% OF CMS OPPS Rate,58.54,48% of total Billed charges,6.47,100% OF CMS OPPS Rate,109.76,90% of total Billed charges,6.47,100% of Medicaid LA Fee Schedule,6.47,100% of Medicaid LA Fee Schedule,6.47,100% of Medicaid LA Fee Schedule,6.47,100% of Medicaid LA Fee Schedule,6.47,100% of Medicaid LA Fee Schedule,6.47,100% of Medicaid LA Fee Schedule,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,6.47,109.76,73.17
Outpatient,Laboratory,85045,RETICULOCYTE  AUTOMATED,300,38.7,14.12,354% of CMS OPPS Rate,3.99,100% of Medicaid LA Fee Schedule,3.99,100% of CMS OPPS Rate,3.99,100% of CMS OPPS Rate,10.05,203.89% of BCBS Fee Schedule,27.09,70% of total Billed Charges,29.03,75% of total Billed Charges,7.18,180% OF CMS OPPS RATE,30.96,80% of total Billed Charges,13.96,350% of CMS Opps rate,4.06,102% of CMS Opps rate,29.61,76.5% of total billed charges,3.99,100% of Medicaid LA Fee Schedule,3.99,100% of Medicaid LA Fee Schedule,3.99,100% of CMS OPPS Rate,3.99,100% of CMS OPPS Rate,17.42,45% of total billed charges,27.09,70% of total billed charges,23.22,60% of total billed charges,3.99,100% of CMS OPPS Rate,4.44,90% OF UHC FEE SCHEDULE,27.09,70% of total billed charges,3.99,100% OF CMS OPPS Rate,9.17,230% OF CMS OPPS Rate,18.58,48% of total Billed charges,3.99,100% OF CMS OPPS Rate,34.83,90% of total Billed charges,3.99,100% of Medicaid LA Fee Schedule,3.99,100% of Medicaid LA Fee Schedule,3.99,100% of Medicaid LA Fee Schedule,3.99,100% of Medicaid LA Fee Schedule,3.99,100% of Medicaid LA Fee Schedule,3.99,100% of Medicaid LA Fee Schedule,3.99,100% of CMS OPPS Rate,3.99,100% of CMS OPPS Rate,3.99,100% of CMS OPPS Rate,3.99,100% of CMS OPPS Rate,3.99,100% of CMS OPPS Rate,3.99,100% of CMS OPPS Rate,3.99,100% of CMS OPPS Rate,3.99,100% of CMS OPPS Rate,3.99,34.83,23.22
Outpatient,Laboratory,85048,WBC WHITE BLD CELL COUNT BLD,300,116.6,8.99,354% of CMS OPPS Rate,2.54,100% of Medicaid LA Fee Schedule,2.54,100% of CMS OPPS Rate,2.54,100% of CMS OPPS Rate,6.38,203.89% of BCBS Fee Schedule,81.62,70% of total Billed Charges,87.45,75% of total Billed Charges,4.57,180% OF CMS OPPS RATE,93.28,80% of total Billed Charges,8.89,350% of CMS Opps rate,2.59,102% of CMS Opps rate,89.2,76.5% of total billed charges,2.54,100% of Medicaid LA Fee Schedule,2.54,100% of Medicaid LA Fee Schedule,2.54,100% of CMS OPPS Rate,2.54,100% of CMS OPPS Rate,52.47,45% of total billed charges,81.62,70% of total billed charges,69.96,60% of total billed charges,2.54,100% of CMS OPPS Rate,2.82,90% OF UHC FEE SCHEDULE,81.62,70% of total billed charges,2.54,100% OF CMS OPPS Rate,5.84,230% OF CMS OPPS Rate,55.97,48% of total Billed charges,2.54,100% OF CMS OPPS Rate,104.94,90% of total Billed charges,2.54,100% of Medicaid LA Fee Schedule,2.54,100% of Medicaid LA Fee Schedule,2.54,100% of Medicaid LA Fee Schedule,2.54,100% of Medicaid LA Fee Schedule,2.54,100% of Medicaid LA Fee Schedule,2.54,100% of Medicaid LA Fee Schedule,2.54,100% of CMS OPPS Rate,2.54,100% of CMS OPPS Rate,2.54,100% of CMS OPPS Rate,2.54,100% of CMS OPPS Rate,2.54,100% of CMS OPPS Rate,2.54,100% of CMS OPPS Rate,2.54,100% of CMS OPPS Rate,2.54,100% of CMS OPPS Rate,2.54,104.94,69.96
Outpatient,Laboratory,85049,PLATELET COUNT AUTOMATED,300,54.9,15.85,354% of CMS OPPS Rate,4.48,100% of Medicaid LA Fee Schedule,4.48,100% of CMS OPPS Rate,4.48,100% of CMS OPPS Rate,11.28,203.89% of BCBS Fee Schedule,38.43,70% of total Billed Charges,41.18,75% of total Billed Charges,8.06,180% OF CMS OPPS RATE,43.92,80% of total Billed Charges,15.68,350% of CMS Opps rate,4.56,102% of CMS Opps rate,42,76.5% of total billed charges,4.48,100% of Medicaid LA Fee Schedule,4.48,100% of Medicaid LA Fee Schedule,4.48,100% of CMS OPPS Rate,4.48,100% of CMS OPPS Rate,24.71,45% of total billed charges,38.43,70% of total billed charges,32.94,60% of total billed charges,4.48,100% of CMS OPPS Rate,4.98,90% OF UHC FEE SCHEDULE,38.43,70% of total billed charges,4.48,100% OF CMS OPPS Rate,10.3,230% OF CMS OPPS Rate,26.35,48% of total Billed charges,4.48,100% OF CMS OPPS Rate,49.41,90% of total Billed charges,4.48,100% of Medicaid LA Fee Schedule,4.48,100% of Medicaid LA Fee Schedule,4.48,100% of Medicaid LA Fee Schedule,4.48,100% of Medicaid LA Fee Schedule,4.48,100% of Medicaid LA Fee Schedule,4.48,100% of Medicaid LA Fee Schedule,4.48,100% of CMS OPPS Rate,4.48,100% of CMS OPPS Rate,4.48,100% of CMS OPPS Rate,4.48,100% of CMS OPPS Rate,4.48,100% of CMS OPPS Rate,4.48,100% of CMS OPPS Rate,4.48,100% of CMS OPPS Rate,4.48,100% of CMS OPPS Rate,4.48,49.41,32.94
Outpatient,Laboratory,85055,RETICULATED PLATELET ASSAY,300,60,126.51,354% of CMS OPPS Rate,28.04,100% of Medicaid LA Fee Schedule,35.74,100% of CMS OPPS Rate,35.74,100% of CMS OPPS Rate,72.87,203.89% of BCBS Fee Schedule,42,70% of total Billed Charges,45,75% of total Billed Charges,64.33,180% OF CMS OPPS RATE,48,80% of total Billed Charges,125.09,350% of CMS Opps rate,36.45,102% of CMS Opps rate,45.9,76.5% of total billed charges,28.04,100% of Medicaid LA Fee Schedule,28.04,100% of Medicaid LA Fee Schedule,35.74,100% of CMS OPPS Rate,35.74,100% of CMS OPPS Rate,27,45% of total billed charges,42,70% of total billed charges,36,60% of total billed charges,35.74,100% of CMS OPPS Rate,32.17,90% OF UHC FEE SCHEDULE,42,70% of total billed charges,35.74,100% OF CMS OPPS Rate,60,230% OF CMS OPPS Rate,28.8,48% of total Billed charges,35.74,100% OF CMS OPPS Rate,54,90% of total Billed charges,28.04,100% of Medicaid LA Fee Schedule,28.04,100% of Medicaid LA Fee Schedule,28.04,100% of Medicaid LA Fee Schedule,28.04,100% of Medicaid LA Fee Schedule,28.04,100% of Medicaid LA Fee Schedule,28.04,100% of Medicaid LA Fee Schedule,35.74,100% of CMS OPPS Rate,35.74,100% of CMS OPPS Rate,35.74,100% of CMS OPPS Rate,35.74,100% of CMS OPPS Rate,35.74,100% of CMS OPPS Rate,35.74,100% of CMS OPPS Rate,35.74,100% of CMS OPPS Rate,35.74,100% of CMS OPPS Rate,27,126.51,36
Outpatient,Laboratory,85060,BLOOD SMEAR PERIPHERAL INTERP,300,N/A,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,50.26,203.89% of BCBS Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,23,90% OF UHC FEE SCHEDULE,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,23,50.26,N/A
Outpatient,Laboratory,85210,FACTOR II ACTIVITY,300,100,45.94,354% of CMS OPPS Rate,7.04,100% of Medicaid LA Fee Schedule,12.98,100% of CMS OPPS Rate,12.98,100% of CMS OPPS Rate,32.68,203.89% of BCBS Fee Schedule,70,70% of total Billed Charges,75,75% of total Billed Charges,23.36,180% OF CMS OPPS RATE,80,80% of total Billed Charges,45.43,350% of CMS Opps rate,13.23,102% of CMS Opps rate,76.5,76.5% of total billed charges,7.04,100% of Medicaid LA Fee Schedule,7.04,100% of Medicaid LA Fee Schedule,12.98,100% of CMS OPPS Rate,12.98,100% of CMS OPPS Rate,45,45% of total billed charges,70,70% of total billed charges,60,60% of total billed charges,12.98,100% of CMS OPPS Rate,14.43,90% OF UHC FEE SCHEDULE,70,70% of total billed charges,12.98,100% OF CMS OPPS Rate,29.85,230% OF CMS OPPS Rate,48,48% of total Billed charges,12.98,100% OF CMS OPPS Rate,90,90% of total Billed charges,7.04,100% of Medicaid LA Fee Schedule,7.04,100% of Medicaid LA Fee Schedule,7.04,100% of Medicaid LA Fee Schedule,7.04,100% of Medicaid LA Fee Schedule,7.04,100% of Medicaid LA Fee Schedule,7.04,100% of Medicaid LA Fee Schedule,12.98,100% of CMS OPPS Rate,12.98,100% of CMS OPPS Rate,12.98,100% of CMS OPPS Rate,12.98,100% of CMS OPPS Rate,12.98,100% of CMS OPPS Rate,12.98,100% of CMS OPPS Rate,12.98,100% of CMS OPPS Rate,12.98,100% of CMS OPPS Rate,7.04,90,60
Outpatient,Laboratory,85220,FACTOR V ACTIVITY,300,110,62.48,354% of CMS OPPS Rate,17.22,100% of Medicaid LA Fee Schedule,17.64,100% of CMS OPPS Rate,17.64,100% of CMS OPPS Rate,44.43,203.89% of BCBS Fee Schedule,77,70% of total Billed Charges,82.5,75% of total Billed Charges,31.76,180% OF CMS OPPS RATE,88,80% of total Billed Charges,61.77,350% of CMS Opps rate,18,102% of CMS Opps rate,84.15,76.5% of total billed charges,17.22,100% of Medicaid LA Fee Schedule,17.22,100% of Medicaid LA Fee Schedule,17.64,100% of CMS OPPS Rate,17.64,100% of CMS OPPS Rate,49.5,45% of total billed charges,77,70% of total billed charges,66,60% of total billed charges,17.64,100% of CMS OPPS Rate,19.61,90% OF UHC FEE SCHEDULE,77,70% of total billed charges,17.64,100% OF CMS OPPS Rate,40.59,230% OF CMS OPPS Rate,52.8,48% of total Billed charges,17.64,100% OF CMS OPPS Rate,99,90% of total Billed charges,17.22,100% of Medicaid LA Fee Schedule,17.22,100% of Medicaid LA Fee Schedule,17.22,100% of Medicaid LA Fee Schedule,17.22,100% of Medicaid LA Fee Schedule,17.22,100% of Medicaid LA Fee Schedule,17.22,100% of Medicaid LA Fee Schedule,17.64,100% of CMS OPPS Rate,17.64,100% of CMS OPPS Rate,17.64,100% of CMS OPPS Rate,17.64,100% of CMS OPPS Rate,17.64,100% of CMS OPPS Rate,17.64,100% of CMS OPPS Rate,17.64,100% of CMS OPPS Rate,17.64,100% of CMS OPPS Rate,17.22,99,66
Outpatient,Laboratory,85230,FACTOR VII ACTIVITY,300,101.75,63.36,354% of CMS OPPS Rate,17.22,100% of Medicaid LA Fee Schedule,17.89,100% of CMS OPPS Rate,17.89,100% of CMS OPPS Rate,45.06,203.89% of BCBS Fee Schedule,71.23,70% of total Billed Charges,76.31,75% of total Billed Charges,32.21,180% OF CMS OPPS RATE,81.4,80% of total Billed Charges,62.64,350% of CMS Opps rate,18.25,102% of CMS Opps rate,77.84,76.5% of total billed charges,17.22,100% of Medicaid LA Fee Schedule,17.22,100% of Medicaid LA Fee Schedule,17.89,100% of CMS OPPS Rate,17.89,100% of CMS OPPS Rate,45.79,45% of total billed charges,71.23,70% of total billed charges,61.05,60% of total billed charges,17.89,100% of CMS OPPS Rate,19.89,90% OF UHC FEE SCHEDULE,71.23,70% of total billed charges,17.89,100% OF CMS OPPS Rate,41.17,230% OF CMS OPPS Rate,48.84,48% of total Billed charges,17.89,100% OF CMS OPPS Rate,91.58,90% of total Billed charges,17.22,100% of Medicaid LA Fee Schedule,17.22,100% of Medicaid LA Fee Schedule,17.22,100% of Medicaid LA Fee Schedule,17.22,100% of Medicaid LA Fee Schedule,17.22,100% of Medicaid LA Fee Schedule,17.22,100% of Medicaid LA Fee Schedule,17.89,100% of CMS OPPS Rate,17.89,100% of CMS OPPS Rate,17.89,100% of CMS OPPS Rate,17.89,100% of CMS OPPS Rate,17.89,100% of CMS OPPS Rate,17.89,100% of CMS OPPS Rate,17.89,100% of CMS OPPS Rate,17.89,100% of CMS OPPS Rate,17.22,91.58,61.05
Outpatient,Laboratory,85240,"FACTOR VIII ASSAY, PLASMA",300,304.2,63.36,354% of CMS OPPS Rate,17.9,100% of Medicaid LA Fee Schedule,17.89,100% of CMS OPPS Rate,17.89,100% of CMS OPPS Rate,45.06,203.89% of BCBS Fee Schedule,212.94,70% of total Billed Charges,228.15,75% of total Billed Charges,32.21,180% OF CMS OPPS RATE,243.36,80% of total Billed Charges,62.64,350% of CMS Opps rate,18.25,102% of CMS Opps rate,232.71,76.5% of total billed charges,17.9,100% of Medicaid LA Fee Schedule,17.9,100% of Medicaid LA Fee Schedule,17.89,100% of CMS OPPS Rate,17.89,100% of CMS OPPS Rate,136.89,45% of total billed charges,212.94,70% of total billed charges,182.52,60% of total billed charges,17.89,100% of CMS OPPS Rate,19.89,90% OF UHC FEE SCHEDULE,212.94,70% of total billed charges,17.89,100% OF CMS OPPS Rate,41.17,230% OF CMS OPPS Rate,146.02,48% of total Billed charges,17.89,100% OF CMS OPPS Rate,273.78,90% of total Billed charges,17.9,100% of Medicaid LA Fee Schedule,17.9,100% of Medicaid LA Fee Schedule,17.9,100% of Medicaid LA Fee Schedule,17.9,100% of Medicaid LA Fee Schedule,17.9,100% of Medicaid LA Fee Schedule,17.9,100% of Medicaid LA Fee Schedule,17.89,100% of CMS OPPS Rate,17.89,100% of CMS OPPS Rate,17.89,100% of CMS OPPS Rate,17.89,100% of CMS OPPS Rate,17.89,100% of CMS OPPS Rate,17.89,100% of CMS OPPS Rate,17.89,100% of CMS OPPS Rate,17.89,100% of CMS OPPS Rate,17.89,273.78,182.52
Outpatient,Laboratory,85244,CLOTTING FACTOR VIII ANTIGEN,300,360,72.28,354% of CMS OPPS Rate,20.42,100% of Medicaid LA Fee Schedule,20.42,100% of CMS OPPS Rate,20.42,100% of CMS OPPS Rate,51.4,203.89% of BCBS Fee Schedule,252,70% of total Billed Charges,270,75% of total Billed Charges,36.75,180% OF CMS OPPS RATE,288,80% of total Billed Charges,71.47,350% of CMS Opps rate,20.82,102% of CMS Opps rate,275.4,76.5% of total billed charges,20.42,100% of Medicaid LA Fee Schedule,20.42,100% of Medicaid LA Fee Schedule,20.42,100% of CMS OPPS Rate,20.42,100% of CMS OPPS Rate,162,45% of total billed charges,252,70% of total billed charges,216,60% of total billed charges,20.42,100% of CMS OPPS Rate,22.69,90% OF UHC FEE SCHEDULE,252,70% of total billed charges,20.42,100% OF CMS OPPS Rate,46.96,230% OF CMS OPPS Rate,172.8,48% of total Billed charges,20.42,100% OF CMS OPPS Rate,324,90% of total Billed charges,20.42,100% of Medicaid LA Fee Schedule,20.42,100% of Medicaid LA Fee Schedule,20.42,100% of Medicaid LA Fee Schedule,20.42,100% of Medicaid LA Fee Schedule,20.42,100% of Medicaid LA Fee Schedule,20.42,100% of Medicaid LA Fee Schedule,20.42,100% of CMS OPPS Rate,20.42,100% of CMS OPPS Rate,20.42,100% of CMS OPPS Rate,20.42,100% of CMS OPPS Rate,20.42,100% of CMS OPPS Rate,20.42,100% of CMS OPPS Rate,20.42,100% of CMS OPPS Rate,20.42,100% of CMS OPPS Rate,20.42,324,216
Outpatient,Laboratory,85245,RISTOCETIN COFACTOR,300,91.3,81.2,354% of CMS OPPS Rate,22.94,100% of Medicaid LA Fee Schedule,22.94,100% of CMS OPPS Rate,22.94,100% of CMS OPPS Rate,57.74,203.89% of BCBS Fee Schedule,63.91,70% of total Billed Charges,68.48,75% of total Billed Charges,41.29,180% OF CMS OPPS RATE,73.04,80% of total Billed Charges,80.29,350% of CMS Opps rate,23.39,102% of CMS Opps rate,69.84,76.5% of total billed charges,22.94,100% of Medicaid LA Fee Schedule,22.94,100% of Medicaid LA Fee Schedule,22.94,100% of CMS OPPS Rate,22.94,100% of CMS OPPS Rate,41.09,45% of total billed charges,63.91,70% of total billed charges,54.78,60% of total billed charges,22.94,100% of CMS OPPS Rate,25.49,90% OF UHC FEE SCHEDULE,63.91,70% of total billed charges,22.94,100% OF CMS OPPS Rate,52.76,230% OF CMS OPPS Rate,43.82,48% of total Billed charges,22.94,100% OF CMS OPPS Rate,82.17,90% of total Billed charges,22.94,100% of Medicaid LA Fee Schedule,22.94,100% of Medicaid LA Fee Schedule,22.94,100% of Medicaid LA Fee Schedule,22.94,100% of Medicaid LA Fee Schedule,22.94,100% of Medicaid LA Fee Schedule,22.94,100% of Medicaid LA Fee Schedule,22.94,100% of CMS OPPS Rate,22.94,100% of CMS OPPS Rate,22.94,100% of CMS OPPS Rate,22.94,100% of CMS OPPS Rate,22.94,100% of CMS OPPS Rate,22.94,100% of CMS OPPS Rate,22.94,100% of CMS OPPS Rate,22.94,100% of CMS OPPS Rate,22.94,82.17,54.78
Outpatient,Laboratory,85246,VON WILLEBRAND FACT AG,300,193.05,81.2,354% of CMS OPPS Rate,22.94,100% of Medicaid LA Fee Schedule,22.94,100% of CMS OPPS Rate,22.94,100% of CMS OPPS Rate,57.74,203.89% of BCBS Fee Schedule,135.14,70% of total Billed Charges,144.79,75% of total Billed Charges,41.29,180% OF CMS OPPS RATE,154.44,80% of total Billed Charges,80.29,350% of CMS Opps rate,23.39,102% of CMS Opps rate,147.68,76.5% of total billed charges,22.94,100% of Medicaid LA Fee Schedule,22.94,100% of Medicaid LA Fee Schedule,22.94,100% of CMS OPPS Rate,22.94,100% of CMS OPPS Rate,86.87,45% of total billed charges,135.14,70% of total billed charges,115.83,60% of total billed charges,22.94,100% of CMS OPPS Rate,25.49,90% OF UHC FEE SCHEDULE,135.14,70% of total billed charges,22.94,100% OF CMS OPPS Rate,52.76,230% OF CMS OPPS Rate,92.66,48% of total Billed charges,22.94,100% OF CMS OPPS Rate,173.75,90% of total Billed charges,22.94,100% of Medicaid LA Fee Schedule,22.94,100% of Medicaid LA Fee Schedule,22.94,100% of Medicaid LA Fee Schedule,22.94,100% of Medicaid LA Fee Schedule,22.94,100% of Medicaid LA Fee Schedule,22.94,100% of Medicaid LA Fee Schedule,22.94,100% of CMS OPPS Rate,22.94,100% of CMS OPPS Rate,22.94,100% of CMS OPPS Rate,22.94,100% of CMS OPPS Rate,22.94,100% of CMS OPPS Rate,22.94,100% of CMS OPPS Rate,22.94,100% of CMS OPPS Rate,22.94,100% of CMS OPPS Rate,22.94,173.75,115.83
Outpatient,Laboratory,85247,VON WILLEBRAND MULTIMERS,300,91.3,81.2,354% of CMS OPPS Rate,22.94,100% of Medicaid LA Fee Schedule,22.94,100% of CMS OPPS Rate,22.94,100% of CMS OPPS Rate,57.74,203.89% of BCBS Fee Schedule,63.91,70% of total Billed Charges,68.48,75% of total Billed Charges,41.29,180% OF CMS OPPS RATE,73.04,80% of total Billed Charges,80.29,350% of CMS Opps rate,23.39,102% of CMS Opps rate,69.84,76.5% of total billed charges,22.94,100% of Medicaid LA Fee Schedule,22.94,100% of Medicaid LA Fee Schedule,22.94,100% of CMS OPPS Rate,22.94,100% of CMS OPPS Rate,41.09,45% of total billed charges,63.91,70% of total billed charges,54.78,60% of total billed charges,22.94,100% of CMS OPPS Rate,25.49,90% OF UHC FEE SCHEDULE,63.91,70% of total billed charges,22.94,100% OF CMS OPPS Rate,52.76,230% OF CMS OPPS Rate,43.82,48% of total Billed charges,22.94,100% OF CMS OPPS Rate,82.17,90% of total Billed charges,22.94,100% of Medicaid LA Fee Schedule,22.94,100% of Medicaid LA Fee Schedule,22.94,100% of Medicaid LA Fee Schedule,22.94,100% of Medicaid LA Fee Schedule,22.94,100% of Medicaid LA Fee Schedule,22.94,100% of Medicaid LA Fee Schedule,22.94,100% of CMS OPPS Rate,22.94,100% of CMS OPPS Rate,22.94,100% of CMS OPPS Rate,22.94,100% of CMS OPPS Rate,22.94,100% of CMS OPPS Rate,22.94,100% of CMS OPPS Rate,22.94,100% of CMS OPPS Rate,22.94,100% of CMS OPPS Rate,22.94,82.17,54.78
Outpatient,Laboratory,85250,"FACTOR IX ASSAY, PLASMA",300,292.95,67.4,354% of CMS OPPS Rate,19.04,100% of Medicaid LA Fee Schedule,19.04,100% of CMS OPPS Rate,19.04,100% of CMS OPPS Rate,47.93,203.89% of BCBS Fee Schedule,205.07,70% of total Billed Charges,219.71,75% of total Billed Charges,34.27,180% OF CMS OPPS RATE,234.36,80% of total Billed Charges,66.64,350% of CMS Opps rate,19.42,102% of CMS Opps rate,224.11,76.5% of total billed charges,19.04,100% of Medicaid LA Fee Schedule,19.04,100% of Medicaid LA Fee Schedule,19.04,100% of CMS OPPS Rate,19.04,100% of CMS OPPS Rate,131.83,45% of total billed charges,205.07,70% of total billed charges,175.77,60% of total billed charges,19.04,100% of CMS OPPS Rate,21.16,90% OF UHC FEE SCHEDULE,205.07,70% of total billed charges,19.04,100% OF CMS OPPS Rate,43.79,230% OF CMS OPPS Rate,140.62,48% of total Billed charges,19.04,100% OF CMS OPPS Rate,263.66,90% of total Billed charges,19.04,100% of Medicaid LA Fee Schedule,19.04,100% of Medicaid LA Fee Schedule,19.04,100% of Medicaid LA Fee Schedule,19.04,100% of Medicaid LA Fee Schedule,19.04,100% of Medicaid LA Fee Schedule,19.04,100% of Medicaid LA Fee Schedule,19.04,100% of CMS OPPS Rate,19.04,100% of CMS OPPS Rate,19.04,100% of CMS OPPS Rate,19.04,100% of CMS OPPS Rate,19.04,100% of CMS OPPS Rate,19.04,100% of CMS OPPS Rate,19.04,100% of CMS OPPS Rate,19.04,100% of CMS OPPS Rate,19.04,263.66,175.77
Outpatient,Laboratory,85260,FACTOR X ACTIVITY,300,92.5,63.36,354% of CMS OPPS Rate,17.22,100% of Medicaid LA Fee Schedule,17.89,100% of CMS OPPS Rate,17.89,100% of CMS OPPS Rate,45.06,203.89% of BCBS Fee Schedule,64.75,70% of total Billed Charges,69.38,75% of total Billed Charges,32.21,180% OF CMS OPPS RATE,74,80% of total Billed Charges,62.64,350% of CMS Opps rate,18.25,102% of CMS Opps rate,70.76,76.5% of total billed charges,17.22,100% of Medicaid LA Fee Schedule,17.22,100% of Medicaid LA Fee Schedule,17.89,100% of CMS OPPS Rate,17.89,100% of CMS OPPS Rate,41.63,45% of total billed charges,64.75,70% of total billed charges,55.5,60% of total billed charges,17.89,100% of CMS OPPS Rate,19.89,90% OF UHC FEE SCHEDULE,64.75,70% of total billed charges,17.89,100% OF CMS OPPS Rate,41.17,230% OF CMS OPPS Rate,44.4,48% of total Billed charges,17.89,100% OF CMS OPPS Rate,83.25,90% of total Billed charges,17.22,100% of Medicaid LA Fee Schedule,17.22,100% of Medicaid LA Fee Schedule,17.22,100% of Medicaid LA Fee Schedule,17.22,100% of Medicaid LA Fee Schedule,17.22,100% of Medicaid LA Fee Schedule,17.22,100% of Medicaid LA Fee Schedule,17.89,100% of CMS OPPS Rate,17.89,100% of CMS OPPS Rate,17.89,100% of CMS OPPS Rate,17.89,100% of CMS OPPS Rate,17.89,100% of CMS OPPS Rate,17.89,100% of CMS OPPS Rate,17.89,100% of CMS OPPS Rate,17.89,100% of CMS OPPS Rate,17.22,83.25,55.5
Outpatient,Laboratory,85270,FACTOR XI,300,95.4,63.36,354% of CMS OPPS Rate,17.22,100% of Medicaid LA Fee Schedule,17.89,100% of CMS OPPS Rate,17.89,100% of CMS OPPS Rate,45.06,203.89% of BCBS Fee Schedule,66.78,70% of total Billed Charges,71.55,75% of total Billed Charges,32.21,180% OF CMS OPPS RATE,76.32,80% of total Billed Charges,62.64,350% of CMS Opps rate,18.25,102% of CMS Opps rate,72.98,76.5% of total billed charges,17.22,100% of Medicaid LA Fee Schedule,17.22,100% of Medicaid LA Fee Schedule,17.89,100% of CMS OPPS Rate,17.89,100% of CMS OPPS Rate,42.93,45% of total billed charges,66.78,70% of total billed charges,57.24,60% of total billed charges,17.89,100% of CMS OPPS Rate,19.89,90% OF UHC FEE SCHEDULE,66.78,70% of total billed charges,17.89,100% OF CMS OPPS Rate,41.17,230% OF CMS OPPS Rate,45.79,48% of total Billed charges,17.89,100% OF CMS OPPS Rate,85.86,90% of total Billed charges,17.22,100% of Medicaid LA Fee Schedule,17.22,100% of Medicaid LA Fee Schedule,17.22,100% of Medicaid LA Fee Schedule,17.22,100% of Medicaid LA Fee Schedule,17.22,100% of Medicaid LA Fee Schedule,17.22,100% of Medicaid LA Fee Schedule,17.89,100% of CMS OPPS Rate,17.89,100% of CMS OPPS Rate,17.89,100% of CMS OPPS Rate,17.89,100% of CMS OPPS Rate,17.89,100% of CMS OPPS Rate,17.89,100% of CMS OPPS Rate,17.89,100% of CMS OPPS Rate,17.89,100% of CMS OPPS Rate,17.22,85.86,57.24
Outpatient,Laboratory,85280,FACTOR XII,300,95.4,68.49,354% of CMS OPPS Rate,17.22,100% of Medicaid LA Fee Schedule,19.35,100% of CMS OPPS Rate,19.35,100% of CMS OPPS Rate,48.71,203.89% of BCBS Fee Schedule,66.78,70% of total Billed Charges,71.55,75% of total Billed Charges,34.83,180% OF CMS OPPS RATE,76.32,80% of total Billed Charges,67.72,350% of CMS Opps rate,19.73,102% of CMS Opps rate,72.98,76.5% of total billed charges,17.22,100% of Medicaid LA Fee Schedule,17.22,100% of Medicaid LA Fee Schedule,19.35,100% of CMS OPPS Rate,19.35,100% of CMS OPPS Rate,42.93,45% of total billed charges,66.78,70% of total billed charges,57.24,60% of total billed charges,19.35,100% of CMS OPPS Rate,21.5,90% OF UHC FEE SCHEDULE,66.78,70% of total billed charges,19.35,100% OF CMS OPPS Rate,44.5,230% OF CMS OPPS Rate,45.79,48% of total Billed charges,19.35,100% OF CMS OPPS Rate,85.86,90% of total Billed charges,17.22,100% of Medicaid LA Fee Schedule,17.22,100% of Medicaid LA Fee Schedule,17.22,100% of Medicaid LA Fee Schedule,17.22,100% of Medicaid LA Fee Schedule,17.22,100% of Medicaid LA Fee Schedule,17.22,100% of Medicaid LA Fee Schedule,19.35,100% of CMS OPPS Rate,19.35,100% of CMS OPPS Rate,19.35,100% of CMS OPPS Rate,19.35,100% of CMS OPPS Rate,19.35,100% of CMS OPPS Rate,19.35,100% of CMS OPPS Rate,19.35,100% of CMS OPPS Rate,19.35,100% of CMS OPPS Rate,17.22,85.86,57.24
Outpatient,Laboratory,85290,CLOTTING FACTOR XIII,300,426,57.84,354% of CMS OPPS Rate,16.34,100% of Medicaid LA Fee Schedule,16.34,100% of CMS OPPS Rate,16.34,100% of CMS OPPS Rate,41.12,203.89% of BCBS Fee Schedule,298.2,70% of total Billed Charges,319.5,75% of total Billed Charges,29.41,180% OF CMS OPPS RATE,340.8,80% of total Billed Charges,57.19,350% of CMS Opps rate,16.66,102% of CMS Opps rate,325.89,76.5% of total billed charges,16.34,100% of Medicaid LA Fee Schedule,16.34,100% of Medicaid LA Fee Schedule,16.34,100% of CMS OPPS Rate,16.34,100% of CMS OPPS Rate,191.7,45% of total billed charges,298.2,70% of total billed charges,255.6,60% of total billed charges,16.34,100% of CMS OPPS Rate,18.15,90% OF UHC FEE SCHEDULE,298.2,70% of total billed charges,16.34,100% OF CMS OPPS Rate,37.58,230% OF CMS OPPS Rate,204.48,48% of total Billed charges,16.34,100% OF CMS OPPS Rate,383.4,90% of total Billed charges,16.34,100% of Medicaid LA Fee Schedule,16.34,100% of Medicaid LA Fee Schedule,16.34,100% of Medicaid LA Fee Schedule,16.34,100% of Medicaid LA Fee Schedule,16.34,100% of Medicaid LA Fee Schedule,16.34,100% of Medicaid LA Fee Schedule,16.34,100% of CMS OPPS Rate,16.34,100% of CMS OPPS Rate,16.34,100% of CMS OPPS Rate,16.34,100% of CMS OPPS Rate,16.34,100% of CMS OPPS Rate,16.34,100% of CMS OPPS Rate,16.34,100% of CMS OPPS Rate,16.34,100% of CMS OPPS Rate,16.34,383.4,255.6
Outpatient,Laboratory,85291,CLOTTING FACTOR XIII SCRN SOLUBILITY,300,129.2,32.24,354% of CMS OPPS Rate,9.11,100% of Medicaid LA Fee Schedule,9.11,100% of CMS OPPS Rate,9.11,100% of CMS OPPS Rate,22.39,203.89% of BCBS Fee Schedule,90.44,70% of total Billed Charges,96.9,75% of total Billed Charges,16.39,180% OF CMS OPPS RATE,103.36,80% of total Billed Charges,31.88,350% of CMS Opps rate,9.29,102% of CMS Opps rate,98.84,76.5% of total billed charges,9.11,100% of Medicaid LA Fee Schedule,9.11,100% of Medicaid LA Fee Schedule,9.11,100% of CMS OPPS Rate,9.11,100% of CMS OPPS Rate,58.14,45% of total billed charges,90.44,70% of total billed charges,77.52,60% of total billed charges,9.11,100% of CMS OPPS Rate,9.88,90% OF UHC FEE SCHEDULE,90.44,70% of total billed charges,9.11,100% OF CMS OPPS Rate,20.95,230% OF CMS OPPS Rate,62.02,48% of total Billed charges,9.11,100% OF CMS OPPS Rate,116.28,90% of total Billed charges,9.11,100% of Medicaid LA Fee Schedule,9.11,100% of Medicaid LA Fee Schedule,9.11,100% of Medicaid LA Fee Schedule,9.11,100% of Medicaid LA Fee Schedule,9.11,100% of Medicaid LA Fee Schedule,9.11,100% of Medicaid LA Fee Schedule,9.11,100% of CMS OPPS Rate,9.11,100% of CMS OPPS Rate,9.11,100% of CMS OPPS Rate,9.11,100% of CMS OPPS Rate,9.11,100% of CMS OPPS Rate,9.11,100% of CMS OPPS Rate,9.11,100% of CMS OPPS Rate,9.11,100% of CMS OPPS Rate,9.11,116.28,77.52
Outpatient,Laboratory,85300,CLOTTING INHIBITORS,300,36,41.94,354% of CMS OPPS Rate,11.85,100% of Medicaid LA Fee Schedule,11.85,100% of CMS OPPS Rate,11.85,100% of CMS OPPS Rate,29.83,203.89% of BCBS Fee Schedule,25.2,70% of total Billed Charges,27,75% of total Billed Charges,21.33,180% OF CMS OPPS RATE,28.8,80% of total Billed Charges,41.47,350% of CMS Opps rate,12.08,102% of CMS Opps rate,27.54,76.5% of total billed charges,11.85,100% of Medicaid LA Fee Schedule,11.85,100% of Medicaid LA Fee Schedule,11.85,100% of CMS OPPS Rate,11.85,100% of CMS OPPS Rate,16.2,45% of total billed charges,25.2,70% of total billed charges,21.6,60% of total billed charges,11.85,100% of CMS OPPS Rate,13.17,90% OF UHC FEE SCHEDULE,25.2,70% of total billed charges,11.85,100% OF CMS OPPS Rate,27.25,230% OF CMS OPPS Rate,17.28,48% of total Billed charges,11.85,100% OF CMS OPPS Rate,32.4,90% of total Billed charges,11.85,100% of Medicaid LA Fee Schedule,11.85,100% of Medicaid LA Fee Schedule,11.85,100% of Medicaid LA Fee Schedule,11.85,100% of Medicaid LA Fee Schedule,11.85,100% of Medicaid LA Fee Schedule,11.85,100% of Medicaid LA Fee Schedule,11.85,100% of CMS OPPS Rate,11.85,100% of CMS OPPS Rate,11.85,100% of CMS OPPS Rate,11.85,100% of CMS OPPS Rate,11.85,100% of CMS OPPS Rate,11.85,100% of CMS OPPS Rate,11.85,100% of CMS OPPS Rate,11.85,100% of CMS OPPS Rate,11.85,41.94,21.6
Outpatient,Laboratory,85301,ANTITHROMBIN III,300,152.1,38.26,354% of CMS OPPS Rate,10.81,100% of Medicaid LA Fee Schedule,10.81,100% of CMS OPPS Rate,10.81,100% of CMS OPPS Rate,27.22,203.89% of BCBS Fee Schedule,106.47,70% of total Billed Charges,114.08,75% of total Billed Charges,19.45,180% OF CMS OPPS RATE,121.68,80% of total Billed Charges,37.83,350% of CMS Opps rate,11.02,102% of CMS Opps rate,116.36,76.5% of total billed charges,10.81,100% of Medicaid LA Fee Schedule,10.81,100% of Medicaid LA Fee Schedule,10.81,100% of CMS OPPS Rate,10.81,100% of CMS OPPS Rate,68.45,45% of total billed charges,106.47,70% of total billed charges,91.26,60% of total billed charges,10.81,100% of CMS OPPS Rate,12.02,90% OF UHC FEE SCHEDULE,106.47,70% of total billed charges,10.81,100% OF CMS OPPS Rate,24.86,230% OF CMS OPPS Rate,73.01,48% of total Billed charges,10.81,100% OF CMS OPPS Rate,136.89,90% of total Billed charges,10.81,100% of Medicaid LA Fee Schedule,10.81,100% of Medicaid LA Fee Schedule,10.81,100% of Medicaid LA Fee Schedule,10.81,100% of Medicaid LA Fee Schedule,10.81,100% of Medicaid LA Fee Schedule,10.81,100% of Medicaid LA Fee Schedule,10.81,100% of CMS OPPS Rate,10.81,100% of CMS OPPS Rate,10.81,100% of CMS OPPS Rate,10.81,100% of CMS OPPS Rate,10.81,100% of CMS OPPS Rate,10.81,100% of CMS OPPS Rate,10.81,100% of CMS OPPS Rate,10.81,100% of CMS OPPS Rate,10.81,136.89,91.26
Outpatient,Laboratory,85302,CLOTTING INHIBI PROTEIN C AG,300,108.48,42.51,354% of CMS OPPS Rate,12.01,100% of Medicaid LA Fee Schedule,12.01,100% of CMS OPPS Rate,12.01,100% of CMS OPPS Rate,30.24,203.89% of BCBS Fee Schedule,75.94,70% of total Billed Charges,81.36,75% of total Billed Charges,21.61,180% OF CMS OPPS RATE,86.78,80% of total Billed Charges,42.03,350% of CMS Opps rate,12.25,102% of CMS Opps rate,82.99,76.5% of total billed charges,12.01,100% of Medicaid LA Fee Schedule,12.01,100% of Medicaid LA Fee Schedule,12.01,100% of CMS OPPS Rate,12.01,100% of CMS OPPS Rate,48.82,45% of total billed charges,75.94,70% of total billed charges,65.09,60% of total billed charges,12.01,100% of CMS OPPS Rate,13.35,90% OF UHC FEE SCHEDULE,75.94,70% of total billed charges,12.01,100% OF CMS OPPS Rate,27.62,230% OF CMS OPPS Rate,52.07,48% of total Billed charges,12.01,100% OF CMS OPPS Rate,97.63,90% of total Billed charges,12.01,100% of Medicaid LA Fee Schedule,12.01,100% of Medicaid LA Fee Schedule,12.01,100% of Medicaid LA Fee Schedule,12.01,100% of Medicaid LA Fee Schedule,12.01,100% of Medicaid LA Fee Schedule,12.01,100% of Medicaid LA Fee Schedule,12.01,100% of CMS OPPS Rate,12.01,100% of CMS OPPS Rate,12.01,100% of CMS OPPS Rate,12.01,100% of CMS OPPS Rate,12.01,100% of CMS OPPS Rate,12.01,100% of CMS OPPS Rate,12.01,100% of CMS OPPS Rate,12.01,100% of CMS OPPS Rate,12.01,97.63,65.09
Outpatient,Laboratory,85303,"PROTEIN C, PLASMA",300,193.95,48.99,354% of CMS OPPS Rate,13.84,100% of Medicaid LA Fee Schedule,13.84,100% of CMS OPPS Rate,13.84,100% of CMS OPPS Rate,34.82,203.89% of BCBS Fee Schedule,135.77,70% of total Billed Charges,145.46,75% of total Billed Charges,24.91,180% OF CMS OPPS RATE,155.16,80% of total Billed Charges,48.44,350% of CMS Opps rate,14.11,102% of CMS Opps rate,148.37,76.5% of total billed charges,13.84,100% of Medicaid LA Fee Schedule,13.84,100% of Medicaid LA Fee Schedule,13.84,100% of CMS OPPS Rate,13.84,100% of CMS OPPS Rate,87.28,45% of total billed charges,135.77,70% of total billed charges,116.37,60% of total billed charges,13.84,100% of CMS OPPS Rate,15.37,90% OF UHC FEE SCHEDULE,135.77,70% of total billed charges,13.84,100% OF CMS OPPS Rate,31.83,230% OF CMS OPPS Rate,93.1,48% of total Billed charges,13.84,100% OF CMS OPPS Rate,174.56,90% of total Billed charges,13.84,100% of Medicaid LA Fee Schedule,13.84,100% of Medicaid LA Fee Schedule,13.84,100% of Medicaid LA Fee Schedule,13.84,100% of Medicaid LA Fee Schedule,13.84,100% of Medicaid LA Fee Schedule,13.84,100% of Medicaid LA Fee Schedule,13.84,100% of CMS OPPS Rate,13.84,100% of CMS OPPS Rate,13.84,100% of CMS OPPS Rate,13.84,100% of CMS OPPS Rate,13.84,100% of CMS OPPS Rate,13.84,100% of CMS OPPS Rate,13.84,100% of CMS OPPS Rate,13.84,100% of CMS OPPS Rate,13.84,174.56,116.37
Outpatient,Laboratory,85305,"PROTEIN S AG, TOTAL",300,65.25,41.09,354% of CMS OPPS Rate,11.61,100% of Medicaid LA Fee Schedule,11.61,100% of CMS OPPS Rate,11.61,100% of CMS OPPS Rate,29.22,203.89% of BCBS Fee Schedule,45.68,70% of total Billed Charges,48.94,75% of total Billed Charges,20.89,180% OF CMS OPPS RATE,52.2,80% of total Billed Charges,40.63,350% of CMS Opps rate,11.84,102% of CMS Opps rate,49.92,76.5% of total billed charges,11.61,100% of Medicaid LA Fee Schedule,11.61,100% of Medicaid LA Fee Schedule,11.61,100% of CMS OPPS Rate,11.61,100% of CMS OPPS Rate,29.36,45% of total billed charges,45.68,70% of total billed charges,39.15,60% of total billed charges,11.61,100% of CMS OPPS Rate,12.9,90% OF UHC FEE SCHEDULE,45.68,70% of total billed charges,11.61,100% OF CMS OPPS Rate,26.7,230% OF CMS OPPS Rate,31.32,48% of total Billed charges,11.61,100% OF CMS OPPS Rate,58.73,90% of total Billed charges,11.61,100% of Medicaid LA Fee Schedule,11.61,100% of Medicaid LA Fee Schedule,11.61,100% of Medicaid LA Fee Schedule,11.61,100% of Medicaid LA Fee Schedule,11.61,100% of Medicaid LA Fee Schedule,11.61,100% of Medicaid LA Fee Schedule,11.61,100% of CMS OPPS Rate,11.61,100% of CMS OPPS Rate,11.61,100% of CMS OPPS Rate,11.61,100% of CMS OPPS Rate,11.61,100% of CMS OPPS Rate,11.61,100% of CMS OPPS Rate,11.61,100% of CMS OPPS Rate,11.61,100% of CMS OPPS Rate,11.61,58.73,39.15
Outpatient,Laboratory,85306,PROTEIN S PLASMA,300,200.25,54.23,354% of CMS OPPS Rate,15.32,100% of Medicaid LA Fee Schedule,15.32,100% of CMS OPPS Rate,15.32,100% of CMS OPPS Rate,38.58,203.89% of BCBS Fee Schedule,140.18,70% of total Billed Charges,150.19,75% of total Billed Charges,27.57,180% OF CMS OPPS RATE,160.2,80% of total Billed Charges,53.62,350% of CMS Opps rate,15.62,102% of CMS Opps rate,153.19,76.5% of total billed charges,15.32,100% of Medicaid LA Fee Schedule,15.32,100% of Medicaid LA Fee Schedule,15.32,100% of CMS OPPS Rate,15.32,100% of CMS OPPS Rate,90.11,45% of total billed charges,140.18,70% of total billed charges,120.15,60% of total billed charges,15.32,100% of CMS OPPS Rate,17.03,90% OF UHC FEE SCHEDULE,140.18,70% of total billed charges,15.32,100% OF CMS OPPS Rate,35.23,230% OF CMS OPPS Rate,96.12,48% of total Billed charges,15.32,100% OF CMS OPPS Rate,180.23,90% of total Billed charges,15.32,100% of Medicaid LA Fee Schedule,15.32,100% of Medicaid LA Fee Schedule,15.32,100% of Medicaid LA Fee Schedule,15.32,100% of Medicaid LA Fee Schedule,15.32,100% of Medicaid LA Fee Schedule,15.32,100% of Medicaid LA Fee Schedule,15.32,100% of CMS OPPS Rate,15.32,100% of CMS OPPS Rate,15.32,100% of CMS OPPS Rate,15.32,100% of CMS OPPS Rate,15.32,100% of CMS OPPS Rate,15.32,100% of CMS OPPS Rate,15.32,100% of CMS OPPS Rate,15.32,100% of CMS OPPS Rate,15.32,180.23,120.15
Outpatient,Laboratory,85307,ACTIVATED PROTEIN C RESISTANCE,300,194,54.23,354% of CMS OPPS Rate,15.32,100% of Medicaid LA Fee Schedule,15.32,100% of CMS OPPS Rate,15.32,100% of CMS OPPS Rate,38.58,203.89% of BCBS Fee Schedule,135.8,70% of total Billed Charges,145.5,75% of total Billed Charges,27.57,180% OF CMS OPPS RATE,155.2,80% of total Billed Charges,53.62,350% of CMS Opps rate,15.62,102% of CMS Opps rate,148.41,76.5% of total billed charges,15.32,100% of Medicaid LA Fee Schedule,15.32,100% of Medicaid LA Fee Schedule,15.32,100% of CMS OPPS Rate,15.32,100% of CMS OPPS Rate,87.3,45% of total billed charges,135.8,70% of total billed charges,116.4,60% of total billed charges,15.32,100% of CMS OPPS Rate,17.03,90% OF UHC FEE SCHEDULE,135.8,70% of total billed charges,15.32,100% OF CMS OPPS Rate,35.23,230% OF CMS OPPS Rate,93.12,48% of total Billed charges,15.32,100% OF CMS OPPS Rate,174.6,90% of total Billed charges,15.32,100% of Medicaid LA Fee Schedule,15.32,100% of Medicaid LA Fee Schedule,15.32,100% of Medicaid LA Fee Schedule,15.32,100% of Medicaid LA Fee Schedule,15.32,100% of Medicaid LA Fee Schedule,15.32,100% of Medicaid LA Fee Schedule,15.32,100% of CMS OPPS Rate,15.32,100% of CMS OPPS Rate,15.32,100% of CMS OPPS Rate,15.32,100% of CMS OPPS Rate,15.32,100% of CMS OPPS Rate,15.32,100% of CMS OPPS Rate,15.32,100% of CMS OPPS Rate,15.32,100% of CMS OPPS Rate,15.32,174.6,116.4
Outpatient,Laboratory,85335,FACTOR INHIBITOR TEST,300,50,45.55,354% of CMS OPPS Rate,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,32.4,203.89% of BCBS Fee Schedule,35,70% of total Billed Charges,37.5,75% of total Billed Charges,23.16,180% OF CMS OPPS RATE,40,80% of total Billed Charges,45.04,350% of CMS Opps rate,13.12,102% of CMS Opps rate,38.25,76.5% of total billed charges,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,22.5,45% of total billed charges,35,70% of total billed charges,30,60% of total billed charges,12.87,100% of CMS OPPS Rate,14.3,90% OF UHC FEE SCHEDULE,35,70% of total billed charges,12.87,100% OF CMS OPPS Rate,29.6,230% OF CMS OPPS Rate,24,48% of total Billed charges,12.87,100% OF CMS OPPS Rate,45,90% of total Billed charges,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,12.87,45.55,30
Outpatient,Laboratory,85347,COAGULATION TIME ACTIVATED,300,68.72,15.15,354% of CMS OPPS Rate,3.5,100% of Medicaid LA Fee Schedule,4.28,100% of CMS OPPS Rate,4.28,100% of CMS OPPS Rate,10.72,203.89% of BCBS Fee Schedule,48.1,70% of total Billed Charges,51.54,75% of total Billed Charges,7.7,180% OF CMS OPPS RATE,54.98,80% of total Billed Charges,14.98,350% of CMS Opps rate,4.36,102% of CMS Opps rate,52.57,76.5% of total billed charges,3.5,100% of Medicaid LA Fee Schedule,3.5,100% of Medicaid LA Fee Schedule,4.28,100% of CMS OPPS Rate,4.28,100% of CMS OPPS Rate,30.92,45% of total billed charges,48.1,70% of total billed charges,41.23,60% of total billed charges,4.28,100% of CMS OPPS Rate,4.73,90% OF UHC FEE SCHEDULE,48.1,70% of total billed charges,4.28,100% OF CMS OPPS Rate,9.84,230% OF CMS OPPS Rate,32.99,48% of total Billed charges,4.28,100% OF CMS OPPS Rate,61.85,90% of total Billed charges,3.5,100% of Medicaid LA Fee Schedule,3.5,100% of Medicaid LA Fee Schedule,3.5,100% of Medicaid LA Fee Schedule,3.5,100% of Medicaid LA Fee Schedule,3.5,100% of Medicaid LA Fee Schedule,3.5,100% of Medicaid LA Fee Schedule,4.28,100% of CMS OPPS Rate,4.28,100% of CMS OPPS Rate,4.28,100% of CMS OPPS Rate,4.28,100% of CMS OPPS Rate,4.28,100% of CMS OPPS Rate,4.28,100% of CMS OPPS Rate,4.28,100% of CMS OPPS Rate,4.28,100% of CMS OPPS Rate,3.5,61.85,41.23
Outpatient,Laboratory,85362,FDP FIBRIN DEGRAD PROD SERUM,300,176.85,24.39,354% of CMS OPPS Rate,6.69,100% of Medicaid LA Fee Schedule,6.89,100% of CMS OPPS Rate,6.89,100% of CMS OPPS Rate,17.35,203.89% of BCBS Fee Schedule,123.8,70% of total Billed Charges,132.64,75% of total Billed Charges,12.4,180% OF CMS OPPS RATE,141.48,80% of total Billed Charges,24.11,350% of CMS Opps rate,7.02,102% of CMS Opps rate,135.29,76.5% of total billed charges,6.69,100% of Medicaid LA Fee Schedule,6.69,100% of Medicaid LA Fee Schedule,6.89,100% of CMS OPPS Rate,6.89,100% of CMS OPPS Rate,79.58,45% of total billed charges,123.8,70% of total billed charges,106.11,60% of total billed charges,6.89,100% of CMS OPPS Rate,7.66,90% OF UHC FEE SCHEDULE,123.8,70% of total billed charges,6.89,100% OF CMS OPPS Rate,15.84,230% OF CMS OPPS Rate,84.89,48% of total Billed charges,6.89,100% OF CMS OPPS Rate,159.17,90% of total Billed charges,6.69,100% of Medicaid LA Fee Schedule,6.69,100% of Medicaid LA Fee Schedule,6.69,100% of Medicaid LA Fee Schedule,6.69,100% of Medicaid LA Fee Schedule,6.69,100% of Medicaid LA Fee Schedule,6.69,100% of Medicaid LA Fee Schedule,6.89,100% of CMS OPPS Rate,6.89,100% of CMS OPPS Rate,6.89,100% of CMS OPPS Rate,6.89,100% of CMS OPPS Rate,6.89,100% of CMS OPPS Rate,6.89,100% of CMS OPPS Rate,6.89,100% of CMS OPPS Rate,6.89,100% of CMS OPPS Rate,6.69,159.17,106.11
Outpatient,Laboratory,85379,D-DIMER QUAN,300,205.2,36.03,354% of CMS OPPS Rate,10.18,100% of Medicaid LA Fee Schedule,10.18,100% of CMS OPPS Rate,10.18,100% of CMS OPPS Rate,25.61,203.89% of BCBS Fee Schedule,143.64,70% of total Billed Charges,153.9,75% of total Billed Charges,18.32,180% OF CMS OPPS RATE,164.16,80% of total Billed Charges,35.63,350% of CMS Opps rate,10.38,102% of CMS Opps rate,156.98,76.5% of total billed charges,10.18,100% of Medicaid LA Fee Schedule,10.18,100% of Medicaid LA Fee Schedule,10.18,100% of CMS OPPS Rate,10.18,100% of CMS OPPS Rate,92.34,45% of total billed charges,143.64,70% of total billed charges,123.12,60% of total billed charges,10.18,100% of CMS OPPS Rate,11.3,90% OF UHC FEE SCHEDULE,143.64,70% of total billed charges,10.18,100% OF CMS OPPS Rate,23.41,230% OF CMS OPPS Rate,98.5,48% of total Billed charges,10.18,100% OF CMS OPPS Rate,184.68,90% of total Billed charges,10.18,100% of Medicaid LA Fee Schedule,10.18,100% of Medicaid LA Fee Schedule,10.18,100% of Medicaid LA Fee Schedule,10.18,100% of Medicaid LA Fee Schedule,10.18,100% of Medicaid LA Fee Schedule,10.18,100% of Medicaid LA Fee Schedule,10.18,100% of CMS OPPS Rate,10.18,100% of CMS OPPS Rate,10.18,100% of CMS OPPS Rate,10.18,100% of CMS OPPS Rate,10.18,100% of CMS OPPS Rate,10.18,100% of CMS OPPS Rate,10.18,100% of CMS OPPS Rate,10.18,100% of CMS OPPS Rate,10.18,184.68,123.12
Outpatient,Laboratory,85384,FIBRINOGEN PLASMA,300,73.8,34.4,354% of CMS OPPS Rate,9.72,100% of Medicaid LA Fee Schedule,9.72,100% of CMS OPPS Rate,9.72,100% of CMS OPPS Rate,21.39,203.89% of BCBS Fee Schedule,51.66,70% of total Billed Charges,55.35,75% of total Billed Charges,17.49,180% OF CMS OPPS RATE,59.04,80% of total Billed Charges,34.02,350% of CMS Opps rate,9.91,102% of CMS Opps rate,56.46,76.5% of total billed charges,9.72,100% of Medicaid LA Fee Schedule,9.72,100% of Medicaid LA Fee Schedule,9.72,100% of CMS OPPS Rate,9.72,100% of CMS OPPS Rate,33.21,45% of total billed charges,51.66,70% of total billed charges,44.28,60% of total billed charges,9.72,100% of CMS OPPS Rate,9.44,90% OF UHC FEE SCHEDULE,51.66,70% of total billed charges,9.72,100% OF CMS OPPS Rate,22.35,230% OF CMS OPPS Rate,35.42,48% of total Billed charges,9.72,100% OF CMS OPPS Rate,66.42,90% of total Billed charges,9.72,100% of Medicaid LA Fee Schedule,9.72,100% of Medicaid LA Fee Schedule,9.72,100% of Medicaid LA Fee Schedule,9.72,100% of Medicaid LA Fee Schedule,9.72,100% of Medicaid LA Fee Schedule,9.72,100% of Medicaid LA Fee Schedule,9.72,100% of CMS OPPS Rate,9.72,100% of CMS OPPS Rate,9.72,100% of CMS OPPS Rate,9.72,100% of CMS OPPS Rate,9.72,100% of CMS OPPS Rate,9.72,100% of CMS OPPS Rate,9.72,100% of CMS OPPS Rate,9.72,100% of CMS OPPS Rate,9.44,66.42,44.28
Outpatient,Laboratory,85390,COAGULOPATHY SCREEN INTERP REPORT,300,77.44,54.79,354% of CMS OPPS Rate,6.67,100% of Medicaid LA Fee Schedule,15.48,100% of CMS OPPS Rate,15.48,100% of CMS OPPS Rate,31.56,203.89% of BCBS Fee Schedule,54.21,70% of total Billed Charges,58.08,75% of total Billed Charges,27.86,180% OF CMS OPPS RATE,61.95,80% of total Billed Charges,54.18,350% of CMS Opps rate,15.78,102% of CMS Opps rate,59.24,76.5% of total billed charges,6.67,100% of Medicaid LA Fee Schedule,6.67,100% of Medicaid LA Fee Schedule,15.48,100% of CMS OPPS Rate,15.48,100% of CMS OPPS Rate,34.85,45% of total billed charges,54.21,70% of total billed charges,46.46,60% of total billed charges,15.48,100% of CMS OPPS Rate,13.93,90% OF UHC FEE SCHEDULE,54.21,70% of total billed charges,15.48,100% OF CMS OPPS Rate,35.6,230% OF CMS OPPS Rate,37.17,48% of total Billed charges,15.48,100% OF CMS OPPS Rate,69.7,90% of total Billed charges,6.67,100% of Medicaid LA Fee Schedule,6.67,100% of Medicaid LA Fee Schedule,6.67,100% of Medicaid LA Fee Schedule,6.67,100% of Medicaid LA Fee Schedule,6.67,100% of Medicaid LA Fee Schedule,6.67,100% of Medicaid LA Fee Schedule,15.48,100% of CMS OPPS Rate,15.48,100% of CMS OPPS Rate,15.48,100% of CMS OPPS Rate,15.48,100% of CMS OPPS Rate,15.48,100% of CMS OPPS Rate,15.48,100% of CMS OPPS Rate,15.48,100% of CMS OPPS Rate,15.48,100% of CMS OPPS Rate,6.67,69.7,46.46
Outpatient,Laboratory,85397,COAGULATION AND FIBRINOLYSIS ACTIVITY,300,440,109.24,354% of CMS OPPS Rate,30.86,100% of Medicaid LA Fee Schedule,30.86,100% of CMS OPPS Rate,30.86,100% of CMS OPPS Rate,62.92,203.89% of BCBS Fee Schedule,308,70% of total Billed Charges,330,75% of total Billed Charges,55.54,180% OF CMS OPPS RATE,352,80% of total Billed Charges,108.01,350% of CMS Opps rate,31.47,102% of CMS Opps rate,336.6,76.5% of total billed charges,30.86,100% of Medicaid LA Fee Schedule,30.86,100% of Medicaid LA Fee Schedule,30.86,100% of CMS OPPS Rate,30.86,100% of CMS OPPS Rate,198,45% of total billed charges,308,70% of total billed charges,264,60% of total billed charges,30.86,100% of CMS OPPS Rate,27.77,90% OF UHC FEE SCHEDULE,308,70% of total billed charges,30.86,100% OF CMS OPPS Rate,70.97,230% OF CMS OPPS Rate,211.2,48% of total Billed charges,30.86,100% OF CMS OPPS Rate,396,90% of total Billed charges,30.86,100% of Medicaid LA Fee Schedule,30.86,100% of Medicaid LA Fee Schedule,30.86,100% of Medicaid LA Fee Schedule,30.86,100% of Medicaid LA Fee Schedule,30.86,100% of Medicaid LA Fee Schedule,30.86,100% of Medicaid LA Fee Schedule,30.86,100% of CMS OPPS Rate,30.86,100% of CMS OPPS Rate,30.86,100% of CMS OPPS Rate,30.86,100% of CMS OPPS Rate,30.86,100% of CMS OPPS Rate,30.86,100% of CMS OPPS Rate,30.86,100% of CMS OPPS Rate,30.86,100% of CMS OPPS Rate,27.77,396,264
Outpatient,Laboratory,85410,FIBRINOLYTIC FACTOR INHIBITORS,300,69.62,27.29,354% of CMS OPPS Rate,7.71,100% of Medicaid LA Fee Schedule,7.71,100% of CMS OPPS Rate,7.71,100% of CMS OPPS Rate,19.39,203.89% of BCBS Fee Schedule,48.73,70% of total Billed Charges,52.22,75% of total Billed Charges,13.87,180% OF CMS OPPS RATE,55.7,80% of total Billed Charges,26.98,350% of CMS Opps rate,7.86,102% of CMS Opps rate,53.26,76.5% of total billed charges,7.71,100% of Medicaid LA Fee Schedule,7.71,100% of Medicaid LA Fee Schedule,7.71,100% of CMS OPPS Rate,7.71,100% of CMS OPPS Rate,31.33,45% of total billed charges,48.73,70% of total billed charges,41.77,60% of total billed charges,7.71,100% of CMS OPPS Rate,8.56,90% OF UHC FEE SCHEDULE,48.73,70% of total billed charges,7.71,100% OF CMS OPPS Rate,17.73,230% OF CMS OPPS Rate,33.42,48% of total Billed charges,7.71,100% OF CMS OPPS Rate,62.66,90% of total Billed charges,7.71,100% of Medicaid LA Fee Schedule,7.71,100% of Medicaid LA Fee Schedule,7.71,100% of Medicaid LA Fee Schedule,7.71,100% of Medicaid LA Fee Schedule,7.71,100% of Medicaid LA Fee Schedule,7.71,100% of Medicaid LA Fee Schedule,7.71,100% of CMS OPPS Rate,7.71,100% of CMS OPPS Rate,7.71,100% of CMS OPPS Rate,7.71,100% of CMS OPPS Rate,7.71,100% of CMS OPPS Rate,7.71,100% of CMS OPPS Rate,7.71,100% of CMS OPPS Rate,7.71,100% of CMS OPPS Rate,7.71,62.66,41.77
Outpatient,Laboratory,85420,FIBRINOLYTIC FACTORS AND INHIB,300,280,23.11,354% of CMS OPPS Rate,6.53,100% of Medicaid LA Fee Schedule,6.53,100% of CMS OPPS Rate,6.53,100% of CMS OPPS Rate,16.43,203.89% of BCBS Fee Schedule,196,70% of total Billed Charges,210,75% of total Billed Charges,11.75,180% OF CMS OPPS RATE,224,80% of total Billed Charges,22.85,350% of CMS Opps rate,6.66,102% of CMS Opps rate,214.2,76.5% of total billed charges,6.53,100% of Medicaid LA Fee Schedule,6.53,100% of Medicaid LA Fee Schedule,6.53,100% of CMS OPPS Rate,6.53,100% of CMS OPPS Rate,126,45% of total billed charges,196,70% of total billed charges,168,60% of total billed charges,6.53,100% of CMS OPPS Rate,7.25,90% OF UHC FEE SCHEDULE,196,70% of total billed charges,6.53,100% OF CMS OPPS Rate,15.01,230% OF CMS OPPS Rate,134.4,48% of total Billed charges,6.53,100% OF CMS OPPS Rate,252,90% of total Billed charges,6.53,100% of Medicaid LA Fee Schedule,6.53,100% of Medicaid LA Fee Schedule,6.53,100% of Medicaid LA Fee Schedule,6.53,100% of Medicaid LA Fee Schedule,6.53,100% of Medicaid LA Fee Schedule,6.53,100% of Medicaid LA Fee Schedule,6.53,100% of CMS OPPS Rate,6.53,100% of CMS OPPS Rate,6.53,100% of CMS OPPS Rate,6.53,100% of CMS OPPS Rate,6.53,100% of CMS OPPS Rate,6.53,100% of CMS OPPS Rate,6.53,100% of CMS OPPS Rate,6.53,100% of CMS OPPS Rate,6.53,252,168
Outpatient,Laboratory,85520,HEPARIN ASSAY,300,176,46.33,354% of CMS OPPS Rate,10.33,100% of Medicaid LA Fee Schedule,13.09,100% of CMS OPPS Rate,13.09,100% of CMS OPPS Rate,32.95,203.89% of BCBS Fee Schedule,123.2,70% of total Billed Charges,132,75% of total Billed Charges,23.56,180% OF CMS OPPS RATE,140.8,80% of total Billed Charges,45.81,350% of CMS Opps rate,13.35,102% of CMS Opps rate,134.64,76.5% of total billed charges,10.33,100% of Medicaid LA Fee Schedule,10.33,100% of Medicaid LA Fee Schedule,13.09,100% of CMS OPPS Rate,13.09,100% of CMS OPPS Rate,79.2,45% of total billed charges,123.2,70% of total billed charges,105.6,60% of total billed charges,13.09,100% of CMS OPPS Rate,14.54,90% OF UHC FEE SCHEDULE,123.2,70% of total billed charges,13.09,100% OF CMS OPPS Rate,30.1,230% OF CMS OPPS Rate,84.48,48% of total Billed charges,13.09,100% OF CMS OPPS Rate,158.4,90% of total Billed charges,10.33,100% of Medicaid LA Fee Schedule,10.33,100% of Medicaid LA Fee Schedule,10.33,100% of Medicaid LA Fee Schedule,10.33,100% of Medicaid LA Fee Schedule,10.33,100% of Medicaid LA Fee Schedule,10.33,100% of Medicaid LA Fee Schedule,13.09,100% of CMS OPPS Rate,13.09,100% of CMS OPPS Rate,13.09,100% of CMS OPPS Rate,13.09,100% of CMS OPPS Rate,13.09,100% of CMS OPPS Rate,13.09,100% of CMS OPPS Rate,13.09,100% of CMS OPPS Rate,13.09,100% of CMS OPPS Rate,10.33,158.4,105.6
Outpatient,Laboratory,85549,"LYSOZYME, SERUM",300,200.5,66.37,354% of CMS OPPS Rate,18.75,100% of Medicaid LA Fee Schedule,18.75,100% of CMS OPPS Rate,18.75,100% of CMS OPPS Rate,47.2,203.89% of BCBS Fee Schedule,140.35,70% of total Billed Charges,150.38,75% of total Billed Charges,33.75,180% OF CMS OPPS RATE,160.4,80% of total Billed Charges,65.62,350% of CMS Opps rate,19.12,102% of CMS Opps rate,153.38,76.5% of total billed charges,18.75,100% of Medicaid LA Fee Schedule,18.75,100% of Medicaid LA Fee Schedule,18.75,100% of CMS OPPS Rate,18.75,100% of CMS OPPS Rate,90.23,45% of total billed charges,140.35,70% of total billed charges,120.3,60% of total billed charges,18.75,100% of CMS OPPS Rate,20.84,90% OF UHC FEE SCHEDULE,140.35,70% of total billed charges,18.75,100% OF CMS OPPS Rate,43.12,230% OF CMS OPPS Rate,96.24,48% of total Billed charges,18.75,100% OF CMS OPPS Rate,180.45,90% of total Billed charges,18.75,100% of Medicaid LA Fee Schedule,18.75,100% of Medicaid LA Fee Schedule,18.75,100% of Medicaid LA Fee Schedule,18.75,100% of Medicaid LA Fee Schedule,18.75,100% of Medicaid LA Fee Schedule,18.75,100% of Medicaid LA Fee Schedule,18.75,100% of CMS OPPS Rate,18.75,100% of CMS OPPS Rate,18.75,100% of CMS OPPS Rate,18.75,100% of CMS OPPS Rate,18.75,100% of CMS OPPS Rate,18.75,100% of CMS OPPS Rate,18.75,100% of CMS OPPS Rate,18.75,100% of CMS OPPS Rate,18.75,180.45,120.3
Outpatient,Laboratory,85557,OSMOTIC FRAG.RBC INCUBATE,300,56.5,47.29,354% of CMS OPPS Rate,13.36,100% of Medicaid LA Fee Schedule,13.36,100% of CMS OPPS Rate,13.36,100% of CMS OPPS Rate,33.62,203.89% of BCBS Fee Schedule,39.55,70% of total Billed Charges,42.38,75% of total Billed Charges,24.04,180% OF CMS OPPS RATE,45.2,80% of total Billed Charges,46.76,350% of CMS Opps rate,13.62,102% of CMS Opps rate,43.22,76.5% of total billed charges,13.36,100% of Medicaid LA Fee Schedule,13.36,100% of Medicaid LA Fee Schedule,13.36,100% of CMS OPPS Rate,13.36,100% of CMS OPPS Rate,25.43,45% of total billed charges,39.55,70% of total billed charges,33.9,60% of total billed charges,13.36,100% of CMS OPPS Rate,14.84,90% OF UHC FEE SCHEDULE,39.55,70% of total billed charges,13.36,100% OF CMS OPPS Rate,30.72,230% OF CMS OPPS Rate,27.12,48% of total Billed charges,13.36,100% OF CMS OPPS Rate,50.85,90% of total Billed charges,13.36,100% of Medicaid LA Fee Schedule,13.36,100% of Medicaid LA Fee Schedule,13.36,100% of Medicaid LA Fee Schedule,13.36,100% of Medicaid LA Fee Schedule,13.36,100% of Medicaid LA Fee Schedule,13.36,100% of Medicaid LA Fee Schedule,13.36,100% of CMS OPPS Rate,13.36,100% of CMS OPPS Rate,13.36,100% of CMS OPPS Rate,13.36,100% of CMS OPPS Rate,13.36,100% of CMS OPPS Rate,13.36,100% of CMS OPPS Rate,13.36,100% of CMS OPPS Rate,13.36,100% of CMS OPPS Rate,13.36,50.85,33.9
Outpatient,Laboratory,85576,PLT AGGRN -ARISTOCETIN EA (PLAVIX),300,102.15,88.18,354% of CMS OPPS Rate,16.35,100% of Medicaid LA Fee Schedule,24.91,100% of CMS OPPS Rate,24.91,100% of CMS OPPS Rate,54.07,203.89% of BCBS Fee Schedule,71.51,70% of total Billed Charges,76.61,75% of total Billed Charges,44.83,180% OF CMS OPPS RATE,81.72,80% of total Billed Charges,87.18,350% of CMS Opps rate,25.4,102% of CMS Opps rate,78.14,76.5% of total billed charges,16.35,100% of Medicaid LA Fee Schedule,16.35,100% of Medicaid LA Fee Schedule,24.91,100% of CMS OPPS Rate,24.91,100% of CMS OPPS Rate,45.97,45% of total billed charges,71.51,70% of total billed charges,61.29,60% of total billed charges,24.91,100% of CMS OPPS Rate,23.87,90% OF UHC FEE SCHEDULE,71.51,70% of total billed charges,24.91,100% OF CMS OPPS Rate,57.29,230% OF CMS OPPS Rate,49.03,48% of total Billed charges,24.91,100% OF CMS OPPS Rate,91.94,90% of total Billed charges,16.35,100% of Medicaid LA Fee Schedule,16.35,100% of Medicaid LA Fee Schedule,16.35,100% of Medicaid LA Fee Schedule,16.35,100% of Medicaid LA Fee Schedule,16.35,100% of Medicaid LA Fee Schedule,16.35,100% of Medicaid LA Fee Schedule,24.91,100% of CMS OPPS Rate,24.91,100% of CMS OPPS Rate,24.91,100% of CMS OPPS Rate,24.91,100% of CMS OPPS Rate,24.91,100% of CMS OPPS Rate,24.91,100% of CMS OPPS Rate,24.91,100% of CMS OPPS Rate,24.91,100% of CMS OPPS Rate,16.35,91.94,61.29
Outpatient,Laboratory,85597,"PHOSPHOLIPID NEUTRALIZATION, PLT",300,91.16,63.64,354% of CMS OPPS Rate,16.35,100% of Medicaid LA Fee Schedule,17.98,100% of CMS OPPS Rate,17.98,100% of CMS OPPS Rate,45.24,203.89% of BCBS Fee Schedule,63.81,70% of total Billed Charges,68.37,75% of total Billed Charges,32.36,180% OF CMS OPPS RATE,72.93,80% of total Billed Charges,62.93,350% of CMS Opps rate,18.33,102% of CMS Opps rate,69.74,76.5% of total billed charges,16.35,100% of Medicaid LA Fee Schedule,16.35,100% of Medicaid LA Fee Schedule,17.98,100% of CMS OPPS Rate,17.98,100% of CMS OPPS Rate,41.02,45% of total billed charges,63.81,70% of total billed charges,54.7,60% of total billed charges,17.98,100% of CMS OPPS Rate,19.97,90% OF UHC FEE SCHEDULE,63.81,70% of total billed charges,17.98,100% OF CMS OPPS Rate,41.35,230% OF CMS OPPS Rate,43.76,48% of total Billed charges,17.98,100% OF CMS OPPS Rate,82.04,90% of total Billed charges,16.35,100% of Medicaid LA Fee Schedule,16.35,100% of Medicaid LA Fee Schedule,16.35,100% of Medicaid LA Fee Schedule,16.35,100% of Medicaid LA Fee Schedule,16.35,100% of Medicaid LA Fee Schedule,16.35,100% of Medicaid LA Fee Schedule,17.98,100% of CMS OPPS Rate,17.98,100% of CMS OPPS Rate,17.98,100% of CMS OPPS Rate,17.98,100% of CMS OPPS Rate,17.98,100% of CMS OPPS Rate,17.98,100% of CMS OPPS Rate,17.98,100% of CMS OPPS Rate,17.98,100% of CMS OPPS Rate,16.35,82.04,54.7
Outpatient,Laboratory,85598,"PHOSPHOLIPID NEURTRALIZATION, HEXAGONAL",300,204,63.64,354% of CMS OPPS Rate,17.43,100% of Medicaid LA Fee Schedule,17.98,100% of CMS OPPS Rate,17.98,100% of CMS OPPS Rate,45.24,203.89% of BCBS Fee Schedule,142.8,70% of total Billed Charges,153,75% of total Billed Charges,32.36,180% OF CMS OPPS RATE,163.2,80% of total Billed Charges,62.93,350% of CMS Opps rate,18.33,102% of CMS Opps rate,156.06,76.5% of total billed charges,17.43,100% of Medicaid LA Fee Schedule,17.43,100% of Medicaid LA Fee Schedule,17.98,100% of CMS OPPS Rate,17.98,100% of CMS OPPS Rate,91.8,45% of total billed charges,142.8,70% of total billed charges,122.4,60% of total billed charges,17.98,100% of CMS OPPS Rate,19.97,90% OF UHC FEE SCHEDULE,142.8,70% of total billed charges,17.98,100% OF CMS OPPS Rate,41.35,230% OF CMS OPPS Rate,97.92,48% of total Billed charges,17.98,100% OF CMS OPPS Rate,183.6,90% of total Billed charges,17.43,100% of Medicaid LA Fee Schedule,17.43,100% of Medicaid LA Fee Schedule,17.43,100% of Medicaid LA Fee Schedule,17.43,100% of Medicaid LA Fee Schedule,17.43,100% of Medicaid LA Fee Schedule,17.43,100% of Medicaid LA Fee Schedule,17.98,100% of CMS OPPS Rate,17.98,100% of CMS OPPS Rate,17.98,100% of CMS OPPS Rate,17.98,100% of CMS OPPS Rate,17.98,100% of CMS OPPS Rate,17.98,100% of CMS OPPS Rate,17.98,100% of CMS OPPS Rate,17.98,100% of CMS OPPS Rate,17.43,183.6,122.4
Outpatient,Laboratory,85610,"Blood test, clotting time",300,67.95,15.18,354% of CMS OPPS Rate,4.29,100% of Medicaid LA Fee Schedule,4.29,100% of CMS OPPS Rate,4.29,100% of CMS OPPS Rate,9.89,203.89% of BCBS Fee Schedule,47.57,70% of total Billed Charges,50.96,75% of total Billed Charges,7.72,180% OF CMS OPPS RATE,54.36,80% of total Billed Charges,15.01,350% of CMS Opps rate,4.37,102% of CMS Opps rate,51.98,76.5% of total billed charges,4.29,100% of Medicaid LA Fee Schedule,4.29,100% of Medicaid LA Fee Schedule,4.29,100% of CMS OPPS Rate,4.29,100% of CMS OPPS Rate,30.58,45% of total billed charges,47.57,70% of total billed charges,40.77,60% of total billed charges,4.29,100% of CMS OPPS Rate,4.37,90% OF UHC FEE SCHEDULE,47.57,70% of total billed charges,4.29,100% OF CMS OPPS Rate,9.86,230% OF CMS OPPS Rate,32.62,48% of total Billed charges,4.29,100% OF CMS OPPS Rate,61.16,90% of total Billed charges,4.29,100% of Medicaid LA Fee Schedule,4.29,100% of Medicaid LA Fee Schedule,4.29,100% of Medicaid LA Fee Schedule,4.29,100% of Medicaid LA Fee Schedule,4.29,100% of Medicaid LA Fee Schedule,4.29,100% of Medicaid LA Fee Schedule,4.29,100% of CMS OPPS Rate,4.29,100% of CMS OPPS Rate,4.29,100% of CMS OPPS Rate,4.29,100% of CMS OPPS Rate,4.29,100% of CMS OPPS Rate,4.29,100% of CMS OPPS Rate,4.29,100% of CMS OPPS Rate,4.29,100% of CMS OPPS Rate,4.29,61.16,40.77
Outpatient,Laboratory,85611,PROTHROMBIN TM MIXING STD,300,26.55,13.94,354% of CMS OPPS Rate,3.94,100% of Medicaid LA Fee Schedule,3.94,100% of CMS OPPS Rate,3.94,100% of CMS OPPS Rate,9.93,203.89% of BCBS Fee Schedule,18.59,70% of total Billed Charges,19.91,75% of total Billed Charges,7.09,180% OF CMS OPPS RATE,21.24,80% of total Billed Charges,13.79,350% of CMS Opps rate,4.01,102% of CMS Opps rate,20.31,76.5% of total billed charges,3.94,100% of Medicaid LA Fee Schedule,3.94,100% of Medicaid LA Fee Schedule,3.94,100% of CMS OPPS Rate,3.94,100% of CMS OPPS Rate,11.95,45% of total billed charges,18.59,70% of total billed charges,15.93,60% of total billed charges,3.94,100% of CMS OPPS Rate,4.38,90% OF UHC FEE SCHEDULE,18.59,70% of total billed charges,3.94,100% OF CMS OPPS Rate,9.06,230% OF CMS OPPS Rate,12.74,48% of total Billed charges,3.94,100% OF CMS OPPS Rate,23.9,90% of total Billed charges,3.94,100% of Medicaid LA Fee Schedule,3.94,100% of Medicaid LA Fee Schedule,3.94,100% of Medicaid LA Fee Schedule,3.94,100% of Medicaid LA Fee Schedule,3.94,100% of Medicaid LA Fee Schedule,3.94,100% of Medicaid LA Fee Schedule,3.94,100% of CMS OPPS Rate,3.94,100% of CMS OPPS Rate,3.94,100% of CMS OPPS Rate,3.94,100% of CMS OPPS Rate,3.94,100% of CMS OPPS Rate,3.94,100% of CMS OPPS Rate,3.94,100% of CMS OPPS Rate,3.94,100% of CMS OPPS Rate,3.94,23.9,15.93
Outpatient,Laboratory,85613,LUPUS ANTICOAGULANT,300,68.2,33.91,354% of CMS OPPS Rate,9.58,100% of Medicaid LA Fee Schedule,9.58,100% of CMS OPPS Rate,9.58,100% of CMS OPPS Rate,24.12,203.89% of BCBS Fee Schedule,47.74,70% of total Billed Charges,51.15,75% of total Billed Charges,17.24,180% OF CMS OPPS RATE,54.56,80% of total Billed Charges,33.53,350% of CMS Opps rate,9.77,102% of CMS Opps rate,52.17,76.5% of total billed charges,9.58,100% of Medicaid LA Fee Schedule,9.58,100% of Medicaid LA Fee Schedule,9.58,100% of CMS OPPS Rate,9.58,100% of CMS OPPS Rate,30.69,45% of total billed charges,47.74,70% of total billed charges,40.92,60% of total billed charges,9.58,100% of CMS OPPS Rate,10.65,90% OF UHC FEE SCHEDULE,47.74,70% of total billed charges,9.58,100% OF CMS OPPS Rate,22.03,230% OF CMS OPPS Rate,32.74,48% of total Billed charges,9.58,100% OF CMS OPPS Rate,61.38,90% of total Billed charges,9.58,100% of Medicaid LA Fee Schedule,9.58,100% of Medicaid LA Fee Schedule,9.58,100% of Medicaid LA Fee Schedule,9.58,100% of Medicaid LA Fee Schedule,9.58,100% of Medicaid LA Fee Schedule,9.58,100% of Medicaid LA Fee Schedule,9.58,100% of CMS OPPS Rate,9.58,100% of CMS OPPS Rate,9.58,100% of CMS OPPS Rate,9.58,100% of CMS OPPS Rate,9.58,100% of CMS OPPS Rate,9.58,100% of CMS OPPS Rate,9.58,100% of CMS OPPS Rate,9.58,100% of CMS OPPS Rate,9.58,61.38,40.92
Outpatient,Laboratory,85651,SED RATE ESR BLD,300,80.85,15.11,354% of CMS OPPS Rate,4.27,100% of Medicaid LA Fee Schedule,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,8.93,203.89% of BCBS Fee Schedule,56.6,70% of total Billed Charges,60.64,75% of total Billed Charges,7.68,180% OF CMS OPPS RATE,64.68,80% of total Billed Charges,14.94,350% of CMS Opps rate,4.35,102% of CMS Opps rate,61.85,76.5% of total billed charges,4.27,100% of Medicaid LA Fee Schedule,4.27,100% of Medicaid LA Fee Schedule,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,36.38,45% of total billed charges,56.6,70% of total billed charges,48.51,60% of total billed charges,4.26,100% of CMS OPPS Rate,3.94,90% OF UHC FEE SCHEDULE,56.6,70% of total billed charges,4.26,100% OF CMS OPPS Rate,9.82,230% OF CMS OPPS Rate,38.81,48% of total Billed charges,4.26,100% OF CMS OPPS Rate,72.77,90% of total Billed charges,4.27,100% of Medicaid LA Fee Schedule,4.27,100% of Medicaid LA Fee Schedule,4.27,100% of Medicaid LA Fee Schedule,4.27,100% of Medicaid LA Fee Schedule,4.27,100% of Medicaid LA Fee Schedule,4.27,100% of Medicaid LA Fee Schedule,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,3.94,72.77,48.51
Outpatient,Laboratory,85652,SEDIMENTATION RATE AUTOMATED,300,18.5,9.55,354% of CMS OPPS Rate,2.7,100% of Medicaid LA Fee Schedule,2.7,100% of CMS OPPS Rate,2.7,100% of CMS OPPS Rate,6.79,203.89% of BCBS Fee Schedule,12.95,70% of total Billed Charges,13.88,75% of total Billed Charges,4.86,180% OF CMS OPPS RATE,14.8,80% of total Billed Charges,9.45,350% of CMS Opps rate,2.75,102% of CMS Opps rate,14.15,76.5% of total billed charges,2.7,100% of Medicaid LA Fee Schedule,2.7,100% of Medicaid LA Fee Schedule,2.7,100% of CMS OPPS Rate,2.7,100% of CMS OPPS Rate,8.33,45% of total billed charges,12.95,70% of total billed charges,11.1,60% of total billed charges,2.7,100% of CMS OPPS Rate,3,90% OF UHC FEE SCHEDULE,12.95,70% of total billed charges,2.7,100% OF CMS OPPS Rate,6.21,230% OF CMS OPPS Rate,8.88,48% of total Billed charges,2.7,100% OF CMS OPPS Rate,16.65,90% of total Billed charges,2.7,100% of Medicaid LA Fee Schedule,2.7,100% of Medicaid LA Fee Schedule,2.7,100% of Medicaid LA Fee Schedule,2.7,100% of Medicaid LA Fee Schedule,2.7,100% of Medicaid LA Fee Schedule,2.7,100% of Medicaid LA Fee Schedule,2.7,100% of CMS OPPS Rate,2.7,100% of CMS OPPS Rate,2.7,100% of CMS OPPS Rate,2.7,100% of CMS OPPS Rate,2.7,100% of CMS OPPS Rate,2.7,100% of CMS OPPS Rate,2.7,100% of CMS OPPS Rate,2.7,100% of CMS OPPS Rate,2.7,16.65,11.1
Outpatient,Laboratory,85660,SICKLE CELL SCREEN BLD,300,61.65,19.5,354% of CMS OPPS Rate,5.51,100% of Medicaid LA Fee Schedule,5.51,100% of CMS OPPS Rate,5.51,100% of CMS OPPS Rate,13.86,203.89% of BCBS Fee Schedule,43.16,70% of total Billed Charges,46.24,75% of total Billed Charges,9.91,180% OF CMS OPPS RATE,49.32,80% of total Billed Charges,19.28,350% of CMS Opps rate,5.62,102% of CMS Opps rate,47.16,76.5% of total billed charges,5.51,100% of Medicaid LA Fee Schedule,5.51,100% of Medicaid LA Fee Schedule,5.51,100% of CMS OPPS Rate,5.51,100% of CMS OPPS Rate,27.74,45% of total billed charges,43.16,70% of total billed charges,36.99,60% of total billed charges,5.51,100% of CMS OPPS Rate,6.12,90% OF UHC FEE SCHEDULE,43.16,70% of total billed charges,5.51,100% OF CMS OPPS Rate,12.67,230% OF CMS OPPS Rate,29.59,48% of total Billed charges,5.51,100% OF CMS OPPS Rate,55.49,90% of total Billed charges,5.51,100% of Medicaid LA Fee Schedule,5.51,100% of Medicaid LA Fee Schedule,5.51,100% of Medicaid LA Fee Schedule,5.51,100% of Medicaid LA Fee Schedule,5.51,100% of Medicaid LA Fee Schedule,5.51,100% of Medicaid LA Fee Schedule,5.51,100% of CMS OPPS Rate,5.51,100% of CMS OPPS Rate,5.51,100% of CMS OPPS Rate,5.51,100% of CMS OPPS Rate,5.51,100% of CMS OPPS Rate,5.51,100% of CMS OPPS Rate,5.51,100% of CMS OPPS Rate,5.51,100% of CMS OPPS Rate,5.51,55.49,36.99
Outpatient,Laboratory,85670,"THROMBIN TIME, PLASMA",300,107.91,20.42,354% of CMS OPPS Rate,5.77,100% of Medicaid LA Fee Schedule,5.77,100% of CMS OPPS Rate,5.77,100% of CMS OPPS Rate,14.52,203.89% of BCBS Fee Schedule,75.54,70% of total Billed Charges,80.93,75% of total Billed Charges,10.38,180% OF CMS OPPS RATE,86.33,80% of total Billed Charges,20.19,350% of CMS Opps rate,5.88,102% of CMS Opps rate,82.55,76.5% of total billed charges,5.77,100% of Medicaid LA Fee Schedule,5.77,100% of Medicaid LA Fee Schedule,5.77,100% of CMS OPPS Rate,5.77,100% of CMS OPPS Rate,48.56,45% of total billed charges,75.54,70% of total billed charges,64.75,60% of total billed charges,5.77,100% of CMS OPPS Rate,6.41,90% OF UHC FEE SCHEDULE,75.54,70% of total billed charges,5.77,100% OF CMS OPPS Rate,13.27,230% OF CMS OPPS Rate,51.8,48% of total Billed charges,5.77,100% OF CMS OPPS Rate,97.12,90% of total Billed charges,5.77,100% of Medicaid LA Fee Schedule,5.77,100% of Medicaid LA Fee Schedule,5.77,100% of Medicaid LA Fee Schedule,5.77,100% of Medicaid LA Fee Schedule,5.77,100% of Medicaid LA Fee Schedule,5.77,100% of Medicaid LA Fee Schedule,5.77,100% of CMS OPPS Rate,5.77,100% of CMS OPPS Rate,5.77,100% of CMS OPPS Rate,5.77,100% of CMS OPPS Rate,5.77,100% of CMS OPPS Rate,5.77,100% of CMS OPPS Rate,5.77,100% of CMS OPPS Rate,5.77,100% of CMS OPPS Rate,5.77,97.12,64.75
Outpatient,Laboratory,85730,Coagulation assessment blood test,300,152.1,21.27,354% of CMS OPPS Rate,6.01,100% of Medicaid LA Fee Schedule,6.01,100% of CMS OPPS Rate,6.01,100% of CMS OPPS Rate,15.13,203.89% of BCBS Fee Schedule,106.47,70% of total Billed Charges,114.08,75% of total Billed Charges,10.81,180% OF CMS OPPS RATE,121.68,80% of total Billed Charges,21.03,350% of CMS Opps rate,6.13,102% of CMS Opps rate,116.36,76.5% of total billed charges,6.01,100% of Medicaid LA Fee Schedule,6.01,100% of Medicaid LA Fee Schedule,6.01,100% of CMS OPPS Rate,6.01,100% of CMS OPPS Rate,68.45,45% of total billed charges,106.47,70% of total billed charges,91.26,60% of total billed charges,6.01,100% of CMS OPPS Rate,6.68,90% OF UHC FEE SCHEDULE,106.47,70% of total billed charges,6.01,100% OF CMS OPPS Rate,13.82,230% OF CMS OPPS Rate,73.01,48% of total Billed charges,6.01,100% OF CMS OPPS Rate,136.89,90% of total Billed charges,6.01,100% of Medicaid LA Fee Schedule,6.01,100% of Medicaid LA Fee Schedule,6.01,100% of Medicaid LA Fee Schedule,6.01,100% of Medicaid LA Fee Schedule,6.01,100% of Medicaid LA Fee Schedule,6.01,100% of Medicaid LA Fee Schedule,6.01,100% of CMS OPPS Rate,6.01,100% of CMS OPPS Rate,6.01,100% of CMS OPPS Rate,6.01,100% of CMS OPPS Rate,6.01,100% of CMS OPPS Rate,6.01,100% of CMS OPPS Rate,6.01,100% of CMS OPPS Rate,6.01,100% of CMS OPPS Rate,6.01,136.89,91.26
Outpatient,Laboratory,85732,"PTT SUBSTITUTION,PLASMA",300,27.45,22.9,354% of CMS OPPS Rate,6.47,100% of Medicaid LA Fee Schedule,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,16.27,203.89% of BCBS Fee Schedule,19.22,70% of total Billed Charges,20.59,75% of total Billed Charges,11.64,180% OF CMS OPPS RATE,21.96,80% of total Billed Charges,22.64,350% of CMS Opps rate,6.59,102% of CMS Opps rate,21,76.5% of total billed charges,6.47,100% of Medicaid LA Fee Schedule,6.47,100% of Medicaid LA Fee Schedule,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,12.35,45% of total billed charges,19.22,70% of total billed charges,16.47,60% of total billed charges,6.47,100% of CMS OPPS Rate,7.18,90% OF UHC FEE SCHEDULE,19.22,70% of total billed charges,6.47,100% OF CMS OPPS Rate,14.88,230% OF CMS OPPS Rate,13.18,48% of total Billed charges,6.47,100% OF CMS OPPS Rate,24.71,90% of total Billed charges,6.47,100% of Medicaid LA Fee Schedule,6.47,100% of Medicaid LA Fee Schedule,6.47,100% of Medicaid LA Fee Schedule,6.47,100% of Medicaid LA Fee Schedule,6.47,100% of Medicaid LA Fee Schedule,6.47,100% of Medicaid LA Fee Schedule,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,6.47,100% of CMS OPPS Rate,6.47,24.71,16.47
Outpatient,Laboratory,85810,VISCOSITY PLASMA,300,41.8,41.31,354% of CMS OPPS Rate,11.67,100% of Medicaid LA Fee Schedule,11.67,100% of CMS OPPS Rate,11.67,100% of CMS OPPS Rate,29.38,203.89% of BCBS Fee Schedule,29.26,70% of total Billed Charges,31.35,75% of total Billed Charges,21,180% OF CMS OPPS RATE,33.44,80% of total Billed Charges,40.84,350% of CMS Opps rate,11.9,102% of CMS Opps rate,31.98,76.5% of total billed charges,11.67,100% of Medicaid LA Fee Schedule,11.67,100% of Medicaid LA Fee Schedule,11.67,100% of CMS OPPS Rate,11.67,100% of CMS OPPS Rate,18.81,45% of total billed charges,29.26,70% of total billed charges,25.08,60% of total billed charges,11.67,100% of CMS OPPS Rate,12.97,90% OF UHC FEE SCHEDULE,29.26,70% of total billed charges,11.67,100% OF CMS OPPS Rate,26.84,230% OF CMS OPPS Rate,20.06,48% of total Billed charges,11.67,100% OF CMS OPPS Rate,37.62,90% of total Billed charges,11.67,100% of Medicaid LA Fee Schedule,11.67,100% of Medicaid LA Fee Schedule,11.67,100% of Medicaid LA Fee Schedule,11.67,100% of Medicaid LA Fee Schedule,11.67,100% of Medicaid LA Fee Schedule,11.67,100% of Medicaid LA Fee Schedule,11.67,100% of CMS OPPS Rate,11.67,100% of CMS OPPS Rate,11.67,100% of CMS OPPS Rate,11.67,100% of CMS OPPS Rate,11.67,100% of CMS OPPS Rate,11.67,100% of CMS OPPS Rate,11.67,100% of CMS OPPS Rate,11.67,100% of CMS OPPS Rate,11.67,41.31,25.08
Outpatient,Laboratory,86000,"AGGLUTININS,FEBRILE",300,24,24.7,354% of CMS OPPS Rate,6.98,100% of Medicaid LA Fee Schedule,6.98,100% of CMS OPPS Rate,6.98,100% of CMS OPPS Rate,17.58,203.89% of BCBS Fee Schedule,16.8,70% of total Billed Charges,18,75% of total Billed Charges,12.56,180% OF CMS OPPS RATE,19.2,80% of total Billed Charges,24.43,350% of CMS Opps rate,7.11,102% of CMS Opps rate,18.36,76.5% of total billed charges,6.98,100% of Medicaid LA Fee Schedule,6.98,100% of Medicaid LA Fee Schedule,6.98,100% of CMS OPPS Rate,6.98,100% of CMS OPPS Rate,10.8,45% of total billed charges,16.8,70% of total billed charges,14.4,60% of total billed charges,6.98,100% of CMS OPPS Rate,7.76,90% OF UHC FEE SCHEDULE,16.8,70% of total billed charges,6.98,100% OF CMS OPPS Rate,16.05,230% OF CMS OPPS Rate,11.52,48% of total Billed charges,6.98,100% OF CMS OPPS Rate,21.6,90% of total Billed charges,6.98,100% of Medicaid LA Fee Schedule,6.98,100% of Medicaid LA Fee Schedule,6.98,100% of Medicaid LA Fee Schedule,6.98,100% of Medicaid LA Fee Schedule,6.98,100% of Medicaid LA Fee Schedule,6.98,100% of Medicaid LA Fee Schedule,6.98,100% of CMS OPPS Rate,6.98,100% of CMS OPPS Rate,6.98,100% of CMS OPPS Rate,6.98,100% of CMS OPPS Rate,6.98,100% of CMS OPPS Rate,6.98,100% of CMS OPPS Rate,6.98,100% of CMS OPPS Rate,6.98,100% of CMS OPPS Rate,6.98,24.7,14.4
Outpatient,Laboratory,86001,IGG SPECIFIC ALLERGINS,300,33.55,27.68,354% of CMS OPPS Rate,7.27,100% of Medicaid LA Fee Schedule,7.82,100% of CMS OPPS Rate,7.82,100% of CMS OPPS Rate,15.94,203.89% of BCBS Fee Schedule,23.49,70% of total Billed Charges,25.16,75% of total Billed Charges,14.07,180% OF CMS OPPS RATE,26.84,80% of total Billed Charges,27.37,350% of CMS Opps rate,7.97,102% of CMS Opps rate,25.67,76.5% of total billed charges,7.27,100% of Medicaid LA Fee Schedule,7.27,100% of Medicaid LA Fee Schedule,7.82,100% of CMS OPPS Rate,7.82,100% of CMS OPPS Rate,15.1,45% of total billed charges,23.49,70% of total billed charges,20.13,60% of total billed charges,7.82,100% of CMS OPPS Rate,7.04,90% OF UHC FEE SCHEDULE,23.49,70% of total billed charges,7.82,100% OF CMS OPPS Rate,17.98,230% OF CMS OPPS Rate,16.1,48% of total Billed charges,7.82,100% OF CMS OPPS Rate,30.2,90% of total Billed charges,7.27,100% of Medicaid LA Fee Schedule,7.27,100% of Medicaid LA Fee Schedule,7.27,100% of Medicaid LA Fee Schedule,7.27,100% of Medicaid LA Fee Schedule,7.27,100% of Medicaid LA Fee Schedule,7.27,100% of Medicaid LA Fee Schedule,7.82,100% of CMS OPPS Rate,7.82,100% of CMS OPPS Rate,7.82,100% of CMS OPPS Rate,7.82,100% of CMS OPPS Rate,7.82,100% of CMS OPPS Rate,7.82,100% of CMS OPPS Rate,7.82,100% of CMS OPPS Rate,7.82,100% of CMS OPPS Rate,7.04,30.2,20.13
Outpatient,Laboratory,86003,IGE SPECIFIC ALLERGINS,300,40.7,18.47,354% of CMS OPPS Rate,5.22,100% of Medicaid LA Fee Schedule,5.22,100% of CMS OPPS Rate,5.22,100% of CMS OPPS Rate,13.13,203.89% of BCBS Fee Schedule,28.49,70% of total Billed Charges,30.53,75% of total Billed Charges,9.39,180% OF CMS OPPS RATE,32.56,80% of total Billed Charges,18.27,350% of CMS Opps rate,5.32,102% of CMS Opps rate,31.14,76.5% of total billed charges,5.22,100% of Medicaid LA Fee Schedule,5.22,100% of Medicaid LA Fee Schedule,5.22,100% of CMS OPPS Rate,5.22,100% of CMS OPPS Rate,18.32,45% of total billed charges,28.49,70% of total billed charges,24.42,60% of total billed charges,5.22,100% of CMS OPPS Rate,5.8,90% OF UHC FEE SCHEDULE,28.49,70% of total billed charges,5.22,100% OF CMS OPPS Rate,12,230% OF CMS OPPS Rate,19.54,48% of total Billed charges,5.22,100% OF CMS OPPS Rate,36.63,90% of total Billed charges,5.22,100% of Medicaid LA Fee Schedule,5.22,100% of Medicaid LA Fee Schedule,5.22,100% of Medicaid LA Fee Schedule,5.22,100% of Medicaid LA Fee Schedule,5.22,100% of Medicaid LA Fee Schedule,5.22,100% of Medicaid LA Fee Schedule,5.22,100% of CMS OPPS Rate,5.22,100% of CMS OPPS Rate,5.22,100% of CMS OPPS Rate,5.22,100% of CMS OPPS Rate,5.22,100% of CMS OPPS Rate,5.22,100% of CMS OPPS Rate,5.22,100% of CMS OPPS Rate,5.22,100% of CMS OPPS Rate,5.22,36.63,24.42
Outpatient,Laboratory,86008,ALLERGEN SPECIFIC IGE PURIFIED EA,300,110.7,63.47,354% of CMS OPPS Rate,17.93,100% of Medicaid LA Fee Schedule,17.93,100% of CMS OPPS Rate,17.93,100% of CMS OPPS Rate,45.14,203.89% of BCBS Fee Schedule,77.49,70% of total Billed Charges,83.03,75% of total Billed Charges,32.27,180% OF CMS OPPS RATE,88.56,80% of total Billed Charges,62.75,350% of CMS Opps rate,18.28,102% of CMS Opps rate,84.69,76.5% of total billed charges,17.93,100% of Medicaid LA Fee Schedule,17.93,100% of Medicaid LA Fee Schedule,17.93,100% of CMS OPPS Rate,17.93,100% of CMS OPPS Rate,49.82,45% of total billed charges,77.49,70% of total billed charges,66.42,60% of total billed charges,17.93,100% of CMS OPPS Rate,19.93,90% OF UHC FEE SCHEDULE,77.49,70% of total billed charges,17.93,100% OF CMS OPPS Rate,41.23,230% OF CMS OPPS Rate,53.14,48% of total Billed charges,17.93,100% OF CMS OPPS Rate,99.63,90% of total Billed charges,17.93,100% of Medicaid LA Fee Schedule,17.93,100% of Medicaid LA Fee Schedule,17.93,100% of Medicaid LA Fee Schedule,17.93,100% of Medicaid LA Fee Schedule,17.93,100% of Medicaid LA Fee Schedule,17.93,100% of Medicaid LA Fee Schedule,17.93,100% of CMS OPPS Rate,17.93,100% of CMS OPPS Rate,17.93,100% of CMS OPPS Rate,17.93,100% of CMS OPPS Rate,17.93,100% of CMS OPPS Rate,17.93,100% of CMS OPPS Rate,17.93,100% of CMS OPPS Rate,17.93,100% of CMS OPPS Rate,17.93,99.63,66.42
Outpatient,Laboratory,86021,ANTIBODY ID LEUKOCYTE ABS,300,54.45,53.27,354% of CMS OPPS Rate,15.05,100% of Medicaid LA Fee Schedule,15.05,100% of CMS OPPS Rate,15.05,100% of CMS OPPS Rate,37.9,203.89% of BCBS Fee Schedule,38.12,70% of total Billed Charges,40.84,75% of total Billed Charges,27.09,180% OF CMS OPPS RATE,43.56,80% of total Billed Charges,52.67,350% of CMS Opps rate,15.35,102% of CMS Opps rate,41.65,76.5% of total billed charges,15.05,100% of Medicaid LA Fee Schedule,15.05,100% of Medicaid LA Fee Schedule,15.05,100% of CMS OPPS Rate,15.05,100% of CMS OPPS Rate,24.5,45% of total billed charges,38.12,70% of total billed charges,32.67,60% of total billed charges,15.05,100% of CMS OPPS Rate,16.73,90% OF UHC FEE SCHEDULE,38.12,70% of total billed charges,15.05,100% OF CMS OPPS Rate,34.61,230% OF CMS OPPS Rate,26.14,48% of total Billed charges,15.05,100% OF CMS OPPS Rate,49.01,90% of total Billed charges,15.05,100% of Medicaid LA Fee Schedule,15.05,100% of Medicaid LA Fee Schedule,15.05,100% of Medicaid LA Fee Schedule,15.05,100% of Medicaid LA Fee Schedule,15.05,100% of Medicaid LA Fee Schedule,15.05,100% of Medicaid LA Fee Schedule,15.05,100% of CMS OPPS Rate,15.05,100% of CMS OPPS Rate,15.05,100% of CMS OPPS Rate,15.05,100% of CMS OPPS Rate,15.05,100% of CMS OPPS Rate,15.05,100% of CMS OPPS Rate,15.05,100% of CMS OPPS Rate,15.05,100% of CMS OPPS Rate,15.05,53.27,32.67
Outpatient,Laboratory,86022,ANTI-PLATELET ANTIBODY,300,94.5,65.02,354% of CMS OPPS Rate,18.37,100% of Medicaid LA Fee Schedule,18.37,100% of CMS OPPS Rate,18.37,100% of CMS OPPS Rate,46.24,203.89% of BCBS Fee Schedule,66.15,70% of total Billed Charges,70.88,75% of total Billed Charges,33.06,180% OF CMS OPPS RATE,75.6,80% of total Billed Charges,64.29,350% of CMS Opps rate,18.73,102% of CMS Opps rate,72.29,76.5% of total billed charges,18.37,100% of Medicaid LA Fee Schedule,18.37,100% of Medicaid LA Fee Schedule,18.37,100% of CMS OPPS Rate,18.37,100% of CMS OPPS Rate,42.53,45% of total billed charges,66.15,70% of total billed charges,56.7,60% of total billed charges,18.37,100% of CMS OPPS Rate,20.41,90% OF UHC FEE SCHEDULE,66.15,70% of total billed charges,18.37,100% OF CMS OPPS Rate,42.25,230% OF CMS OPPS Rate,45.36,48% of total Billed charges,18.37,100% OF CMS OPPS Rate,85.05,90% of total Billed charges,18.37,100% of Medicaid LA Fee Schedule,18.37,100% of Medicaid LA Fee Schedule,18.37,100% of Medicaid LA Fee Schedule,18.37,100% of Medicaid LA Fee Schedule,18.37,100% of Medicaid LA Fee Schedule,18.37,100% of Medicaid LA Fee Schedule,18.37,100% of CMS OPPS Rate,18.37,100% of CMS OPPS Rate,18.37,100% of CMS OPPS Rate,18.37,100% of CMS OPPS Rate,18.37,100% of CMS OPPS Rate,18.37,100% of CMS OPPS Rate,18.37,100% of CMS OPPS Rate,18.37,100% of CMS OPPS Rate,18.37,85.05,56.7
Outpatient,Laboratory,86023,PLATELET ASSOCIATED ABS,300,74.12,44.1,354% of CMS OPPS Rate,12.46,100% of Medicaid LA Fee Schedule,12.46,100% of CMS OPPS Rate,12.46,100% of CMS OPPS Rate,31.36,203.89% of BCBS Fee Schedule,51.88,70% of total Billed Charges,55.59,75% of total Billed Charges,22.42,180% OF CMS OPPS RATE,59.3,80% of total Billed Charges,43.61,350% of CMS Opps rate,12.7,102% of CMS Opps rate,56.7,76.5% of total billed charges,12.46,100% of Medicaid LA Fee Schedule,12.46,100% of Medicaid LA Fee Schedule,12.46,100% of CMS OPPS Rate,12.46,100% of CMS OPPS Rate,33.35,45% of total billed charges,51.88,70% of total billed charges,44.47,60% of total billed charges,12.46,100% of CMS OPPS Rate,13.84,90% OF UHC FEE SCHEDULE,51.88,70% of total billed charges,12.46,100% OF CMS OPPS Rate,28.65,230% OF CMS OPPS Rate,35.58,48% of total Billed charges,12.46,100% OF CMS OPPS Rate,66.71,90% of total Billed charges,12.46,100% of Medicaid LA Fee Schedule,12.46,100% of Medicaid LA Fee Schedule,12.46,100% of Medicaid LA Fee Schedule,12.46,100% of Medicaid LA Fee Schedule,12.46,100% of Medicaid LA Fee Schedule,12.46,100% of Medicaid LA Fee Schedule,12.46,100% of CMS OPPS Rate,12.46,100% of CMS OPPS Rate,12.46,100% of CMS OPPS Rate,12.46,100% of CMS OPPS Rate,12.46,100% of CMS OPPS Rate,12.46,100% of CMS OPPS Rate,12.46,100% of CMS OPPS Rate,12.46,100% of CMS OPPS Rate,12.46,66.71,44.47
Outpatient,Laboratory,86038,ANA(REFLEX TITER),300,228.8,42.79,354% of CMS OPPS Rate,12.09,100% of Medicaid LA Fee Schedule,12.09,100% of CMS OPPS Rate,12.09,100% of CMS OPPS Rate,30.42,203.89% of BCBS Fee Schedule,160.16,70% of total Billed Charges,171.6,75% of total Billed Charges,21.76,180% OF CMS OPPS RATE,183.04,80% of total Billed Charges,42.31,350% of CMS Opps rate,12.33,102% of CMS Opps rate,175.03,76.5% of total billed charges,12.09,100% of Medicaid LA Fee Schedule,12.09,100% of Medicaid LA Fee Schedule,12.09,100% of CMS OPPS Rate,12.09,100% of CMS OPPS Rate,102.96,45% of total billed charges,160.16,70% of total billed charges,137.28,60% of total billed charges,12.09,100% of CMS OPPS Rate,13.43,90% OF UHC FEE SCHEDULE,160.16,70% of total billed charges,12.09,100% OF CMS OPPS Rate,27.8,230% OF CMS OPPS Rate,109.82,48% of total Billed charges,12.09,100% OF CMS OPPS Rate,205.92,90% of total Billed charges,12.09,100% of Medicaid LA Fee Schedule,12.09,100% of Medicaid LA Fee Schedule,12.09,100% of Medicaid LA Fee Schedule,12.09,100% of Medicaid LA Fee Schedule,12.09,100% of Medicaid LA Fee Schedule,12.09,100% of Medicaid LA Fee Schedule,12.09,100% of CMS OPPS Rate,12.09,100% of CMS OPPS Rate,12.09,100% of CMS OPPS Rate,12.09,100% of CMS OPPS Rate,12.09,100% of CMS OPPS Rate,12.09,100% of CMS OPPS Rate,12.09,100% of CMS OPPS Rate,12.09,100% of CMS OPPS Rate,12.09,205.92,137.28
Outpatient,Laboratory,86039,Blood test to determine autoimmune disorders,300,233.2,39.5,354% of CMS OPPS Rate,11.16,100% of Medicaid LA Fee Schedule,11.16,100% of CMS OPPS Rate,11.16,100% of CMS OPPS Rate,28.1,203.89% of BCBS Fee Schedule,163.24,70% of total Billed Charges,174.9,75% of total Billed Charges,20.08,180% OF CMS OPPS RATE,186.56,80% of total Billed Charges,39.06,350% of CMS Opps rate,11.38,102% of CMS Opps rate,178.4,76.5% of total billed charges,11.16,100% of Medicaid LA Fee Schedule,11.16,100% of Medicaid LA Fee Schedule,11.16,100% of CMS OPPS Rate,11.16,100% of CMS OPPS Rate,104.94,45% of total billed charges,163.24,70% of total billed charges,139.92,60% of total billed charges,11.16,100% of CMS OPPS Rate,12.4,90% OF UHC FEE SCHEDULE,163.24,70% of total billed charges,11.16,100% OF CMS OPPS Rate,25.66,230% OF CMS OPPS Rate,111.94,48% of total Billed charges,11.16,100% OF CMS OPPS Rate,209.88,90% of total Billed charges,11.16,100% of Medicaid LA Fee Schedule,11.16,100% of Medicaid LA Fee Schedule,11.16,100% of Medicaid LA Fee Schedule,11.16,100% of Medicaid LA Fee Schedule,11.16,100% of Medicaid LA Fee Schedule,11.16,100% of Medicaid LA Fee Schedule,11.16,100% of CMS OPPS Rate,11.16,100% of CMS OPPS Rate,11.16,100% of CMS OPPS Rate,11.16,100% of CMS OPPS Rate,11.16,100% of CMS OPPS Rate,11.16,100% of CMS OPPS Rate,11.16,100% of CMS OPPS Rate,11.16,100% of CMS OPPS Rate,11.16,209.88,139.92
Outpatient,Laboratory,86060,STREPTOZYME TITER,300,66.15,25.84,354% of CMS OPPS Rate,7.3,100% of Medicaid LA Fee Schedule,7.3,100% of CMS OPPS Rate,7.3,100% of CMS OPPS Rate,18.37,203.89% of BCBS Fee Schedule,46.31,70% of total Billed Charges,49.61,75% of total Billed Charges,13.14,180% OF CMS OPPS RATE,52.92,80% of total Billed Charges,25.55,350% of CMS Opps rate,7.44,102% of CMS Opps rate,50.6,76.5% of total billed charges,7.3,100% of Medicaid LA Fee Schedule,7.3,100% of Medicaid LA Fee Schedule,7.3,100% of CMS OPPS Rate,7.3,100% of CMS OPPS Rate,29.77,45% of total billed charges,46.31,70% of total billed charges,39.69,60% of total billed charges,7.3,100% of CMS OPPS Rate,8.11,90% OF UHC FEE SCHEDULE,46.31,70% of total billed charges,7.3,100% OF CMS OPPS Rate,16.79,230% OF CMS OPPS Rate,31.75,48% of total Billed charges,7.3,100% OF CMS OPPS Rate,59.54,90% of total Billed charges,7.3,100% of Medicaid LA Fee Schedule,7.3,100% of Medicaid LA Fee Schedule,7.3,100% of Medicaid LA Fee Schedule,7.3,100% of Medicaid LA Fee Schedule,7.3,100% of Medicaid LA Fee Schedule,7.3,100% of Medicaid LA Fee Schedule,7.3,100% of CMS OPPS Rate,7.3,100% of CMS OPPS Rate,7.3,100% of CMS OPPS Rate,7.3,100% of CMS OPPS Rate,7.3,100% of CMS OPPS Rate,7.3,100% of CMS OPPS Rate,7.3,100% of CMS OPPS Rate,7.3,100% of CMS OPPS Rate,7.3,59.54,39.69
Outpatient,Laboratory,86063,STREPTOZYME SCREEN,300,63.8,20.42,354% of CMS OPPS Rate,5.77,100% of Medicaid LA Fee Schedule,5.77,100% of CMS OPPS Rate,5.77,100% of CMS OPPS Rate,14.52,203.89% of BCBS Fee Schedule,44.66,70% of total Billed Charges,47.85,75% of total Billed Charges,10.38,180% OF CMS OPPS RATE,51.04,80% of total Billed Charges,20.19,350% of CMS Opps rate,5.88,102% of CMS Opps rate,48.81,76.5% of total billed charges,5.77,100% of Medicaid LA Fee Schedule,5.77,100% of Medicaid LA Fee Schedule,5.77,100% of CMS OPPS Rate,5.77,100% of CMS OPPS Rate,28.71,45% of total billed charges,44.66,70% of total billed charges,38.28,60% of total billed charges,5.77,100% of CMS OPPS Rate,6.41,90% OF UHC FEE SCHEDULE,44.66,70% of total billed charges,5.77,100% OF CMS OPPS Rate,13.27,230% OF CMS OPPS Rate,30.62,48% of total Billed charges,5.77,100% OF CMS OPPS Rate,57.42,90% of total Billed charges,5.77,100% of Medicaid LA Fee Schedule,5.77,100% of Medicaid LA Fee Schedule,5.77,100% of Medicaid LA Fee Schedule,5.77,100% of Medicaid LA Fee Schedule,5.77,100% of Medicaid LA Fee Schedule,5.77,100% of Medicaid LA Fee Schedule,5.77,100% of CMS OPPS Rate,5.77,100% of CMS OPPS Rate,5.77,100% of CMS OPPS Rate,5.77,100% of CMS OPPS Rate,5.77,100% of CMS OPPS Rate,5.77,100% of CMS OPPS Rate,5.77,100% of CMS OPPS Rate,5.77,100% of CMS OPPS Rate,5.77,57.42,38.28
Outpatient,Laboratory,86140,CRP (C-REACT PROT),300,78.65,18.33,354% of CMS OPPS Rate,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,13.03,203.89% of BCBS Fee Schedule,55.06,70% of total Billed Charges,58.99,75% of total Billed Charges,9.32,180% OF CMS OPPS RATE,62.92,80% of total Billed Charges,18.13,350% of CMS Opps rate,5.28,102% of CMS Opps rate,60.17,76.5% of total billed charges,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,35.39,45% of total billed charges,55.06,70% of total billed charges,47.19,60% of total billed charges,5.18,100% of CMS OPPS Rate,5.75,90% OF UHC FEE SCHEDULE,55.06,70% of total billed charges,5.18,100% OF CMS OPPS Rate,11.91,230% OF CMS OPPS Rate,37.75,48% of total Billed charges,5.18,100% OF CMS OPPS Rate,70.79,90% of total Billed charges,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,5.18,70.79,47.19
Outpatient,Laboratory,86141,CRP - HIGH SENSITIVITY,300,167.75,45.84,354% of CMS OPPS Rate,12.95,100% of Medicaid LA Fee Schedule,12.95,100% of CMS OPPS Rate,12.95,100% of CMS OPPS Rate,32.58,203.89% of BCBS Fee Schedule,117.43,70% of total Billed Charges,125.81,75% of total Billed Charges,23.31,180% OF CMS OPPS RATE,134.2,80% of total Billed Charges,45.32,350% of CMS Opps rate,13.2,102% of CMS Opps rate,128.33,76.5% of total billed charges,12.95,100% of Medicaid LA Fee Schedule,12.95,100% of Medicaid LA Fee Schedule,12.95,100% of CMS OPPS Rate,12.95,100% of CMS OPPS Rate,75.49,45% of total billed charges,117.43,70% of total billed charges,100.65,60% of total billed charges,12.95,100% of CMS OPPS Rate,14.38,90% OF UHC FEE SCHEDULE,117.43,70% of total billed charges,12.95,100% OF CMS OPPS Rate,29.78,230% OF CMS OPPS Rate,80.52,48% of total Billed charges,12.95,100% OF CMS OPPS Rate,150.98,90% of total Billed charges,12.95,100% of Medicaid LA Fee Schedule,12.95,100% of Medicaid LA Fee Schedule,12.95,100% of Medicaid LA Fee Schedule,12.95,100% of Medicaid LA Fee Schedule,12.95,100% of Medicaid LA Fee Schedule,12.95,100% of Medicaid LA Fee Schedule,12.95,100% of CMS OPPS Rate,12.95,100% of CMS OPPS Rate,12.95,100% of CMS OPPS Rate,12.95,100% of CMS OPPS Rate,12.95,100% of CMS OPPS Rate,12.95,100% of CMS OPPS Rate,12.95,100% of CMS OPPS Rate,12.95,100% of CMS OPPS Rate,12.95,150.98,100.65
Outpatient,Laboratory,86146,BETA 2 GLYCOPROTEIN 1 AB,300,76,90.09,354% of CMS OPPS Rate,16.15,100% of Medicaid LA Fee Schedule,25.45,100% of CMS OPPS Rate,25.45,100% of CMS OPPS Rate,64.06,203.89% of BCBS Fee Schedule,53.2,70% of total Billed Charges,57,75% of total Billed Charges,45.81,180% OF CMS OPPS RATE,60.8,80% of total Billed Charges,89.07,350% of CMS Opps rate,25.95,102% of CMS Opps rate,58.14,76.5% of total billed charges,16.15,100% of Medicaid LA Fee Schedule,16.15,100% of Medicaid LA Fee Schedule,25.45,100% of CMS OPPS Rate,25.45,100% of CMS OPPS Rate,34.2,45% of total billed charges,53.2,70% of total billed charges,45.6,60% of total billed charges,25.45,100% of CMS OPPS Rate,28.28,90% OF UHC FEE SCHEDULE,53.2,70% of total billed charges,25.45,100% OF CMS OPPS Rate,58.53,230% OF CMS OPPS Rate,36.48,48% of total Billed charges,25.45,100% OF CMS OPPS Rate,68.4,90% of total Billed charges,16.15,100% of Medicaid LA Fee Schedule,16.15,100% of Medicaid LA Fee Schedule,16.15,100% of Medicaid LA Fee Schedule,16.15,100% of Medicaid LA Fee Schedule,16.15,100% of Medicaid LA Fee Schedule,16.15,100% of Medicaid LA Fee Schedule,25.45,100% of CMS OPPS Rate,25.45,100% of CMS OPPS Rate,25.45,100% of CMS OPPS Rate,25.45,100% of CMS OPPS Rate,25.45,100% of CMS OPPS Rate,25.45,100% of CMS OPPS Rate,25.45,100% of CMS OPPS Rate,25.45,100% of CMS OPPS Rate,16.15,90.09,45.6
Outpatient,Laboratory,86147,Blood test to determine cause of inappropriate blood clot formation,300,139.7,90.09,354% of CMS OPPS Rate,14.15,100% of Medicaid LA Fee Schedule,25.45,100% of CMS OPPS Rate,25.45,100% of CMS OPPS Rate,64.06,203.89% of BCBS Fee Schedule,97.79,70% of total Billed Charges,104.78,75% of total Billed Charges,45.81,180% OF CMS OPPS RATE,111.76,80% of total Billed Charges,89.07,350% of CMS Opps rate,25.95,102% of CMS Opps rate,106.87,76.5% of total billed charges,14.15,100% of Medicaid LA Fee Schedule,14.15,100% of Medicaid LA Fee Schedule,25.45,100% of CMS OPPS Rate,25.45,100% of CMS OPPS Rate,62.87,45% of total billed charges,97.79,70% of total billed charges,83.82,60% of total billed charges,25.45,100% of CMS OPPS Rate,28.28,90% OF UHC FEE SCHEDULE,97.79,70% of total billed charges,25.45,100% OF CMS OPPS Rate,58.53,230% OF CMS OPPS Rate,67.06,48% of total Billed charges,25.45,100% OF CMS OPPS Rate,125.73,90% of total Billed charges,14.15,100% of Medicaid LA Fee Schedule,14.15,100% of Medicaid LA Fee Schedule,14.15,100% of Medicaid LA Fee Schedule,14.15,100% of Medicaid LA Fee Schedule,14.15,100% of Medicaid LA Fee Schedule,14.15,100% of Medicaid LA Fee Schedule,25.45,100% of CMS OPPS Rate,25.45,100% of CMS OPPS Rate,25.45,100% of CMS OPPS Rate,25.45,100% of CMS OPPS Rate,25.45,100% of CMS OPPS Rate,25.45,100% of CMS OPPS Rate,25.45,100% of CMS OPPS Rate,25.45,100% of CMS OPPS Rate,14.15,125.73,83.82
Outpatient,Laboratory,86148,PHOSPHATIDYL AB,300,48,56.88,354% of CMS OPPS Rate,15.65,100% of Medicaid LA Fee Schedule,16.07,100% of CMS OPPS Rate,16.07,100% of CMS OPPS Rate,40.45,203.89% of BCBS Fee Schedule,33.6,70% of total Billed Charges,36,75% of total Billed Charges,28.92,180% OF CMS OPPS RATE,38.4,80% of total Billed Charges,56.24,350% of CMS Opps rate,16.39,102% of CMS Opps rate,36.72,76.5% of total billed charges,15.65,100% of Medicaid LA Fee Schedule,15.65,100% of Medicaid LA Fee Schedule,16.07,100% of CMS OPPS Rate,16.07,100% of CMS OPPS Rate,21.6,45% of total billed charges,33.6,70% of total billed charges,28.8,60% of total billed charges,16.07,100% of CMS OPPS Rate,17.86,90% OF UHC FEE SCHEDULE,33.6,70% of total billed charges,16.07,100% OF CMS OPPS Rate,36.96,230% OF CMS OPPS Rate,23.04,48% of total Billed charges,16.07,100% OF CMS OPPS Rate,43.2,90% of total Billed charges,15.65,100% of Medicaid LA Fee Schedule,15.65,100% of Medicaid LA Fee Schedule,15.65,100% of Medicaid LA Fee Schedule,15.65,100% of Medicaid LA Fee Schedule,15.65,100% of Medicaid LA Fee Schedule,15.65,100% of Medicaid LA Fee Schedule,16.07,100% of CMS OPPS Rate,16.07,100% of CMS OPPS Rate,16.07,100% of CMS OPPS Rate,16.07,100% of CMS OPPS Rate,16.07,100% of CMS OPPS Rate,16.07,100% of CMS OPPS Rate,16.07,100% of CMS OPPS Rate,16.07,100% of CMS OPPS Rate,15.65,56.88,28.8
Outpatient,Laboratory,86160,COMPLEMENT AG,300,44,42.48,354% of CMS OPPS Rate,12,100% of Medicaid LA Fee Schedule,12,100% of CMS OPPS Rate,12,100% of CMS OPPS Rate,30.2,203.89% of BCBS Fee Schedule,30.8,70% of total Billed Charges,33,75% of total Billed Charges,21.6,180% OF CMS OPPS RATE,35.2,80% of total Billed Charges,42,350% of CMS Opps rate,12.24,102% of CMS Opps rate,33.66,76.5% of total billed charges,12,100% of Medicaid LA Fee Schedule,12,100% of Medicaid LA Fee Schedule,12,100% of CMS OPPS Rate,12,100% of CMS OPPS Rate,19.8,45% of total billed charges,30.8,70% of total billed charges,26.4,60% of total billed charges,12,100% of CMS OPPS Rate,13.33,90% OF UHC FEE SCHEDULE,30.8,70% of total billed charges,12,100% OF CMS OPPS Rate,27.6,230% OF CMS OPPS Rate,21.12,48% of total Billed charges,12,100% OF CMS OPPS Rate,39.6,90% of total Billed charges,12,100% of Medicaid LA Fee Schedule,12,100% of Medicaid LA Fee Schedule,12,100% of Medicaid LA Fee Schedule,12,100% of Medicaid LA Fee Schedule,12,100% of Medicaid LA Fee Schedule,12,100% of Medicaid LA Fee Schedule,12,100% of CMS OPPS Rate,12,100% of CMS OPPS Rate,12,100% of CMS OPPS Rate,12,100% of CMS OPPS Rate,12,100% of CMS OPPS Rate,12,100% of CMS OPPS Rate,12,100% of CMS OPPS Rate,12,100% of CMS OPPS Rate,12,42.48,26.4
Outpatient,Laboratory,86161,"COMPLEMENT AG,FUCTIONAL",300,80,42.48,354% of CMS OPPS Rate,12,100% of Medicaid LA Fee Schedule,12,100% of CMS OPPS Rate,12,100% of CMS OPPS Rate,30.2,203.89% of BCBS Fee Schedule,56,70% of total Billed Charges,60,75% of total Billed Charges,21.6,180% OF CMS OPPS RATE,64,80% of total Billed Charges,42,350% of CMS Opps rate,12.24,102% of CMS Opps rate,61.2,76.5% of total billed charges,12,100% of Medicaid LA Fee Schedule,12,100% of Medicaid LA Fee Schedule,12,100% of CMS OPPS Rate,12,100% of CMS OPPS Rate,36,45% of total billed charges,56,70% of total billed charges,48,60% of total billed charges,12,100% of CMS OPPS Rate,13.33,90% OF UHC FEE SCHEDULE,56,70% of total billed charges,12,100% OF CMS OPPS Rate,27.6,230% OF CMS OPPS Rate,38.4,48% of total Billed charges,12,100% OF CMS OPPS Rate,72,90% of total Billed charges,12,100% of Medicaid LA Fee Schedule,12,100% of Medicaid LA Fee Schedule,12,100% of Medicaid LA Fee Schedule,12,100% of Medicaid LA Fee Schedule,12,100% of Medicaid LA Fee Schedule,12,100% of Medicaid LA Fee Schedule,12,100% of CMS OPPS Rate,12,100% of CMS OPPS Rate,12,100% of CMS OPPS Rate,12,100% of CMS OPPS Rate,12,100% of CMS OPPS Rate,12,100% of CMS OPPS Rate,12,100% of CMS OPPS Rate,12,100% of CMS OPPS Rate,12,72,48
Outpatient,Laboratory,86162,CH50 (TOTAL COMPLEMENT),300,261.25,71.93,354% of CMS OPPS Rate,20.32,100% of Medicaid LA Fee Schedule,20.32,100% of CMS OPPS Rate,20.32,100% of CMS OPPS Rate,51.16,203.89% of BCBS Fee Schedule,182.88,70% of total Billed Charges,195.94,75% of total Billed Charges,36.57,180% OF CMS OPPS RATE,209,80% of total Billed Charges,71.12,350% of CMS Opps rate,20.72,102% of CMS Opps rate,199.86,76.5% of total billed charges,20.32,100% of Medicaid LA Fee Schedule,20.32,100% of Medicaid LA Fee Schedule,20.32,100% of CMS OPPS Rate,20.32,100% of CMS OPPS Rate,117.56,45% of total billed charges,182.88,70% of total billed charges,156.75,60% of total billed charges,20.32,100% of CMS OPPS Rate,22.58,90% OF UHC FEE SCHEDULE,182.88,70% of total billed charges,20.32,100% OF CMS OPPS Rate,46.73,230% OF CMS OPPS Rate,125.4,48% of total Billed charges,20.32,100% OF CMS OPPS Rate,235.13,90% of total Billed charges,20.32,100% of Medicaid LA Fee Schedule,20.32,100% of Medicaid LA Fee Schedule,20.32,100% of Medicaid LA Fee Schedule,20.32,100% of Medicaid LA Fee Schedule,20.32,100% of Medicaid LA Fee Schedule,20.32,100% of Medicaid LA Fee Schedule,20.32,100% of CMS OPPS Rate,20.32,100% of CMS OPPS Rate,20.32,100% of CMS OPPS Rate,20.32,100% of CMS OPPS Rate,20.32,100% of CMS OPPS Rate,20.32,100% of CMS OPPS Rate,20.32,100% of CMS OPPS Rate,20.32,100% of CMS OPPS Rate,20.32,235.13,156.75
Outpatient,Laboratory,86200,Blood test to diagnose rheumatoid arthritis,300,115.5,45.84,354% of CMS OPPS Rate,12.95,100% of Medicaid LA Fee Schedule,12.95,100% of CMS OPPS Rate,12.95,100% of CMS OPPS Rate,32.58,203.89% of BCBS Fee Schedule,80.85,70% of total Billed Charges,86.63,75% of total Billed Charges,23.31,180% OF CMS OPPS RATE,92.4,80% of total Billed Charges,45.32,350% of CMS Opps rate,13.2,102% of CMS Opps rate,88.36,76.5% of total billed charges,12.95,100% of Medicaid LA Fee Schedule,12.95,100% of Medicaid LA Fee Schedule,12.95,100% of CMS OPPS Rate,12.95,100% of CMS OPPS Rate,51.98,45% of total billed charges,80.85,70% of total billed charges,69.3,60% of total billed charges,12.95,100% of CMS OPPS Rate,14.38,90% OF UHC FEE SCHEDULE,80.85,70% of total billed charges,12.95,100% OF CMS OPPS Rate,29.78,230% OF CMS OPPS Rate,55.44,48% of total Billed charges,12.95,100% OF CMS OPPS Rate,103.95,90% of total Billed charges,12.95,100% of Medicaid LA Fee Schedule,12.95,100% of Medicaid LA Fee Schedule,12.95,100% of Medicaid LA Fee Schedule,12.95,100% of Medicaid LA Fee Schedule,12.95,100% of Medicaid LA Fee Schedule,12.95,100% of Medicaid LA Fee Schedule,12.95,100% of CMS OPPS Rate,12.95,100% of CMS OPPS Rate,12.95,100% of CMS OPPS Rate,12.95,100% of CMS OPPS Rate,12.95,100% of CMS OPPS Rate,12.95,100% of CMS OPPS Rate,12.95,100% of CMS OPPS Rate,12.95,100% of CMS OPPS Rate,12.95,103.95,69.3
Outpatient,Laboratory,86215,DNA ANTIBODY,300,130,46.9,354% of CMS OPPS Rate,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,33.34,203.89% of BCBS Fee Schedule,91,70% of total Billed Charges,97.5,75% of total Billed Charges,23.85,180% OF CMS OPPS RATE,104,80% of total Billed Charges,46.37,350% of CMS Opps rate,13.51,102% of CMS Opps rate,99.45,76.5% of total billed charges,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,58.5,45% of total billed charges,91,70% of total billed charges,78,60% of total billed charges,13.25,100% of CMS OPPS Rate,14.72,90% OF UHC FEE SCHEDULE,91,70% of total billed charges,13.25,100% OF CMS OPPS Rate,30.47,230% OF CMS OPPS Rate,62.4,48% of total Billed charges,13.25,100% OF CMS OPPS Rate,117,90% of total Billed charges,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,117,78
Outpatient,Laboratory,86225,ANTI-DS DNA,300,47.3,48.63,354% of CMS OPPS Rate,13.74,100% of Medicaid LA Fee Schedule,13.74,100% of CMS OPPS Rate,13.74,100% of CMS OPPS Rate,34.6,203.89% of BCBS Fee Schedule,33.11,70% of total Billed Charges,35.48,75% of total Billed Charges,24.73,180% OF CMS OPPS RATE,37.84,80% of total Billed Charges,48.09,350% of CMS Opps rate,14.01,102% of CMS Opps rate,36.18,76.5% of total billed charges,13.74,100% of Medicaid LA Fee Schedule,13.74,100% of Medicaid LA Fee Schedule,13.74,100% of CMS OPPS Rate,13.74,100% of CMS OPPS Rate,21.29,45% of total billed charges,33.11,70% of total billed charges,28.38,60% of total billed charges,13.74,100% of CMS OPPS Rate,15.27,90% OF UHC FEE SCHEDULE,33.11,70% of total billed charges,13.74,100% OF CMS OPPS Rate,31.6,230% OF CMS OPPS Rate,22.7,48% of total Billed charges,13.74,100% OF CMS OPPS Rate,42.57,90% of total Billed charges,13.74,100% of Medicaid LA Fee Schedule,13.74,100% of Medicaid LA Fee Schedule,13.74,100% of Medicaid LA Fee Schedule,13.74,100% of Medicaid LA Fee Schedule,13.74,100% of Medicaid LA Fee Schedule,13.74,100% of Medicaid LA Fee Schedule,13.74,100% of CMS OPPS Rate,13.74,100% of CMS OPPS Rate,13.74,100% of CMS OPPS Rate,13.74,100% of CMS OPPS Rate,13.74,100% of CMS OPPS Rate,13.74,100% of CMS OPPS Rate,13.74,100% of CMS OPPS Rate,13.74,100% of CMS OPPS Rate,13.74,48.63,28.38
Outpatient,Laboratory,86226,DNA ANTIBODY SGL STRANDED,300,249,42.86,354% of CMS OPPS Rate,12.11,100% of Medicaid LA Fee Schedule,12.11,100% of CMS OPPS Rate,12.11,100% of CMS OPPS Rate,30.48,203.89% of BCBS Fee Schedule,174.3,70% of total Billed Charges,186.75,75% of total Billed Charges,21.79,180% OF CMS OPPS RATE,199.2,80% of total Billed Charges,42.38,350% of CMS Opps rate,12.35,102% of CMS Opps rate,190.49,76.5% of total billed charges,12.11,100% of Medicaid LA Fee Schedule,12.11,100% of Medicaid LA Fee Schedule,12.11,100% of CMS OPPS Rate,12.11,100% of CMS OPPS Rate,112.05,45% of total billed charges,174.3,70% of total billed charges,149.4,60% of total billed charges,12.11,100% of CMS OPPS Rate,13.46,90% OF UHC FEE SCHEDULE,174.3,70% of total billed charges,12.11,100% OF CMS OPPS Rate,27.85,230% OF CMS OPPS Rate,119.52,48% of total Billed charges,12.11,100% OF CMS OPPS Rate,224.1,90% of total Billed charges,12.11,100% of Medicaid LA Fee Schedule,12.11,100% of Medicaid LA Fee Schedule,12.11,100% of Medicaid LA Fee Schedule,12.11,100% of Medicaid LA Fee Schedule,12.11,100% of Medicaid LA Fee Schedule,12.11,100% of Medicaid LA Fee Schedule,12.11,100% of CMS OPPS Rate,12.11,100% of CMS OPPS Rate,12.11,100% of CMS OPPS Rate,12.11,100% of CMS OPPS Rate,12.11,100% of CMS OPPS Rate,12.11,100% of CMS OPPS Rate,12.11,100% of CMS OPPS Rate,12.11,100% of CMS OPPS Rate,12.11,224.1,149.4
Outpatient,Laboratory,86235,EXTRACTABLE N AG IGG ABS,300,33.5,63.47,354% of CMS OPPS Rate,14.15,100% of Medicaid LA Fee Schedule,17.93,100% of CMS OPPS Rate,17.93,100% of CMS OPPS Rate,45.14,203.89% of BCBS Fee Schedule,23.45,70% of total Billed Charges,25.13,75% of total Billed Charges,32.27,180% OF CMS OPPS RATE,26.8,80% of total Billed Charges,62.75,350% of CMS Opps rate,18.28,102% of CMS Opps rate,25.63,76.5% of total billed charges,14.15,100% of Medicaid LA Fee Schedule,14.15,100% of Medicaid LA Fee Schedule,17.93,100% of CMS OPPS Rate,17.93,100% of CMS OPPS Rate,15.08,45% of total billed charges,23.45,70% of total billed charges,20.1,60% of total billed charges,17.93,100% of CMS OPPS Rate,19.93,90% OF UHC FEE SCHEDULE,23.45,70% of total billed charges,17.93,100% OF CMS OPPS Rate,33.5,230% OF CMS OPPS Rate,16.08,48% of total Billed charges,17.93,100% OF CMS OPPS Rate,30.15,90% of total Billed charges,14.15,100% of Medicaid LA Fee Schedule,14.15,100% of Medicaid LA Fee Schedule,14.15,100% of Medicaid LA Fee Schedule,14.15,100% of Medicaid LA Fee Schedule,14.15,100% of Medicaid LA Fee Schedule,14.15,100% of Medicaid LA Fee Schedule,17.93,100% of CMS OPPS Rate,17.93,100% of CMS OPPS Rate,17.93,100% of CMS OPPS Rate,17.93,100% of CMS OPPS Rate,17.93,100% of CMS OPPS Rate,17.93,100% of CMS OPPS Rate,17.93,100% of CMS OPPS Rate,17.93,100% of CMS OPPS Rate,14.15,63.47,20.1
Outpatient,Laboratory,86255,FLORESCENT CHEM ABS,300,193.05,42.65,354% of CMS OPPS Rate,12.05,100% of Medicaid LA Fee Schedule,12.05,100% of CMS OPPS Rate,12.05,100% of CMS OPPS Rate,30.34,203.89% of BCBS Fee Schedule,135.14,70% of total Billed Charges,144.79,75% of total Billed Charges,21.69,180% OF CMS OPPS RATE,154.44,80% of total Billed Charges,42.17,350% of CMS Opps rate,12.29,102% of CMS Opps rate,147.68,76.5% of total billed charges,12.05,100% of Medicaid LA Fee Schedule,12.05,100% of Medicaid LA Fee Schedule,12.05,100% of CMS OPPS Rate,12.05,100% of CMS OPPS Rate,86.87,45% of total billed charges,135.14,70% of total billed charges,115.83,60% of total billed charges,12.05,100% of CMS OPPS Rate,13.39,90% OF UHC FEE SCHEDULE,135.14,70% of total billed charges,12.05,100% OF CMS OPPS Rate,27.71,230% OF CMS OPPS Rate,92.66,48% of total Billed charges,12.05,100% OF CMS OPPS Rate,173.75,90% of total Billed charges,12.05,100% of Medicaid LA Fee Schedule,12.05,100% of Medicaid LA Fee Schedule,12.05,100% of Medicaid LA Fee Schedule,12.05,100% of Medicaid LA Fee Schedule,12.05,100% of Medicaid LA Fee Schedule,12.05,100% of Medicaid LA Fee Schedule,12.05,100% of CMS OPPS Rate,12.05,100% of CMS OPPS Rate,12.05,100% of CMS OPPS Rate,12.05,100% of CMS OPPS Rate,12.05,100% of CMS OPPS Rate,12.05,100% of CMS OPPS Rate,12.05,100% of CMS OPPS Rate,12.05,100% of CMS OPPS Rate,12.05,173.75,115.83
Outpatient,Laboratory,86256,ANTI-SMOOTH MUSCLE ANTIB,300,39.05,42.65,354% of CMS OPPS Rate,12.05,100% of Medicaid LA Fee Schedule,12.05,100% of CMS OPPS Rate,12.05,100% of CMS OPPS Rate,30.34,203.89% of BCBS Fee Schedule,27.34,70% of total Billed Charges,29.29,75% of total Billed Charges,21.69,180% OF CMS OPPS RATE,31.24,80% of total Billed Charges,42.17,350% of CMS Opps rate,12.29,102% of CMS Opps rate,29.87,76.5% of total billed charges,12.05,100% of Medicaid LA Fee Schedule,12.05,100% of Medicaid LA Fee Schedule,12.05,100% of CMS OPPS Rate,12.05,100% of CMS OPPS Rate,17.57,45% of total billed charges,27.34,70% of total billed charges,23.43,60% of total billed charges,12.05,100% of CMS OPPS Rate,13.39,90% OF UHC FEE SCHEDULE,27.34,70% of total billed charges,12.05,100% OF CMS OPPS Rate,27.71,230% OF CMS OPPS Rate,18.74,48% of total Billed charges,12.05,100% OF CMS OPPS Rate,35.15,90% of total Billed charges,12.05,100% of Medicaid LA Fee Schedule,12.05,100% of Medicaid LA Fee Schedule,12.05,100% of Medicaid LA Fee Schedule,12.05,100% of Medicaid LA Fee Schedule,12.05,100% of Medicaid LA Fee Schedule,12.05,100% of Medicaid LA Fee Schedule,12.05,100% of CMS OPPS Rate,12.05,100% of CMS OPPS Rate,12.05,100% of CMS OPPS Rate,12.05,100% of CMS OPPS Rate,12.05,100% of CMS OPPS Rate,12.05,100% of CMS OPPS Rate,12.05,100% of CMS OPPS Rate,12.05,100% of CMS OPPS Rate,12.05,42.65,23.43
Outpatient,Laboratory,86300,Blood test to monitor breast cancer,300,79.75,73.66,354% of CMS OPPS Rate,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,52.4,203.89% of BCBS Fee Schedule,55.83,70% of total Billed Charges,59.81,75% of total Billed Charges,37.45,180% OF CMS OPPS RATE,63.8,80% of total Billed Charges,72.83,350% of CMS Opps rate,21.22,102% of CMS Opps rate,61.01,76.5% of total billed charges,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,35.89,45% of total billed charges,55.83,70% of total billed charges,47.85,60% of total billed charges,20.81,100% of CMS OPPS Rate,23.13,90% OF UHC FEE SCHEDULE,55.83,70% of total billed charges,20.81,100% OF CMS OPPS Rate,47.86,230% OF CMS OPPS Rate,38.28,48% of total Billed charges,20.81,100% OF CMS OPPS Rate,71.78,90% of total Billed charges,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,20.81,73.66,47.85
Outpatient,Laboratory,86301,"IA, QUANT; CA 19-9",300,198.45,73.66,354% of CMS OPPS Rate,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,52.4,203.89% of BCBS Fee Schedule,138.92,70% of total Billed Charges,148.84,75% of total Billed Charges,37.45,180% OF CMS OPPS RATE,158.76,80% of total Billed Charges,72.83,350% of CMS Opps rate,21.22,102% of CMS Opps rate,151.81,76.5% of total billed charges,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,89.3,45% of total billed charges,138.92,70% of total billed charges,119.07,60% of total billed charges,20.81,100% of CMS OPPS Rate,23.13,90% OF UHC FEE SCHEDULE,138.92,70% of total billed charges,20.81,100% OF CMS OPPS Rate,47.86,230% OF CMS OPPS Rate,95.26,48% of total Billed charges,20.81,100% OF CMS OPPS Rate,178.61,90% of total Billed charges,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,20.81,178.61,119.07
Outpatient,Laboratory,86304,Blood test to monitor for cancer,300,207.9,73.66,354% of CMS OPPS Rate,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,52.4,203.89% of BCBS Fee Schedule,145.53,70% of total Billed Charges,155.93,75% of total Billed Charges,37.45,180% OF CMS OPPS RATE,166.32,80% of total Billed Charges,72.83,350% of CMS Opps rate,21.22,102% of CMS Opps rate,159.04,76.5% of total billed charges,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,93.56,45% of total billed charges,145.53,70% of total billed charges,124.74,60% of total billed charges,20.81,100% of CMS OPPS Rate,23.13,90% OF UHC FEE SCHEDULE,145.53,70% of total billed charges,20.81,100% OF CMS OPPS Rate,47.86,230% OF CMS OPPS Rate,99.79,48% of total Billed charges,20.81,100% OF CMS OPPS Rate,187.11,90% of total Billed charges,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,20.81,187.11,124.74
Outpatient,Laboratory,86305,HUMAN EPIDIDYMIS PROTEIN 4,300,512,73.66,354% of CMS OPPS Rate,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,52.4,203.89% of BCBS Fee Schedule,358.4,70% of total Billed Charges,384,75% of total Billed Charges,37.45,180% OF CMS OPPS RATE,409.6,80% of total Billed Charges,72.83,350% of CMS Opps rate,21.22,102% of CMS Opps rate,391.68,76.5% of total billed charges,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,230.4,45% of total billed charges,358.4,70% of total billed charges,307.2,60% of total billed charges,20.81,100% of CMS OPPS Rate,23.13,90% OF UHC FEE SCHEDULE,358.4,70% of total billed charges,20.81,100% OF CMS OPPS Rate,47.86,230% OF CMS OPPS Rate,245.76,48% of total Billed charges,20.81,100% OF CMS OPPS Rate,460.8,90% of total Billed charges,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,20.81,460.8,307.2
Outpatient,Laboratory,86308,MONONUCLEOSIS SCRN BLD,300,115.5,18.33,354% of CMS OPPS Rate,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,13.03,203.89% of BCBS Fee Schedule,80.85,70% of total Billed Charges,86.63,75% of total Billed Charges,9.32,180% OF CMS OPPS RATE,92.4,80% of total Billed Charges,18.13,350% of CMS Opps rate,5.28,102% of CMS Opps rate,88.36,76.5% of total billed charges,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,51.98,45% of total billed charges,80.85,70% of total billed charges,69.3,60% of total billed charges,5.18,100% of CMS OPPS Rate,5.75,90% OF UHC FEE SCHEDULE,80.85,70% of total billed charges,5.18,100% OF CMS OPPS Rate,11.91,230% OF CMS OPPS Rate,55.44,48% of total Billed charges,5.18,100% OF CMS OPPS Rate,103.95,90% of total Billed charges,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of Medicaid LA Fee Schedule,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,5.18,103.95,69.3
Outpatient,Laboratory,86316,IMMUNOASSAY/TUMOR AG,300,62,73.66,354% of CMS OPPS Rate,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,52.4,203.89% of BCBS Fee Schedule,43.4,70% of total Billed Charges,46.5,75% of total Billed Charges,37.45,180% OF CMS OPPS RATE,49.6,80% of total Billed Charges,72.83,350% of CMS Opps rate,21.22,102% of CMS Opps rate,47.43,76.5% of total billed charges,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,27.9,45% of total billed charges,43.4,70% of total billed charges,37.2,60% of total billed charges,20.81,100% of CMS OPPS Rate,23.13,90% OF UHC FEE SCHEDULE,43.4,70% of total billed charges,20.81,100% OF CMS OPPS Rate,47.86,230% OF CMS OPPS Rate,29.76,48% of total Billed charges,20.81,100% OF CMS OPPS Rate,55.8,90% of total Billed charges,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of Medicaid LA Fee Schedule,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,20.81,100% of CMS OPPS Rate,20.81,73.66,37.2
Outpatient,Laboratory,86317,"IMMUNOASSAY, INFECTIOUS A",300,93.6,53.06,354% of CMS OPPS Rate,14.99,100% of Medicaid LA Fee Schedule,14.99,100% of CMS OPPS Rate,14.99,100% of CMS OPPS Rate,37.72,203.89% of BCBS Fee Schedule,65.52,70% of total Billed Charges,70.2,75% of total Billed Charges,26.98,180% OF CMS OPPS RATE,74.88,80% of total Billed Charges,52.46,350% of CMS Opps rate,15.28,102% of CMS Opps rate,71.6,76.5% of total billed charges,14.99,100% of Medicaid LA Fee Schedule,14.99,100% of Medicaid LA Fee Schedule,14.99,100% of CMS OPPS Rate,14.99,100% of CMS OPPS Rate,42.12,45% of total billed charges,65.52,70% of total billed charges,56.16,60% of total billed charges,14.99,100% of CMS OPPS Rate,16.65,90% OF UHC FEE SCHEDULE,65.52,70% of total billed charges,14.99,100% OF CMS OPPS Rate,34.47,230% OF CMS OPPS Rate,44.93,48% of total Billed charges,14.99,100% OF CMS OPPS Rate,84.24,90% of total Billed charges,14.99,100% of Medicaid LA Fee Schedule,14.99,100% of Medicaid LA Fee Schedule,14.99,100% of Medicaid LA Fee Schedule,14.99,100% of Medicaid LA Fee Schedule,14.99,100% of Medicaid LA Fee Schedule,14.99,100% of Medicaid LA Fee Schedule,14.99,100% of CMS OPPS Rate,14.99,100% of CMS OPPS Rate,14.99,100% of CMS OPPS Rate,14.99,100% of CMS OPPS Rate,14.99,100% of CMS OPPS Rate,14.99,100% of CMS OPPS Rate,14.99,100% of CMS OPPS Rate,14.99,100% of CMS OPPS Rate,14.99,84.24,56.16
Outpatient,Laboratory,86320,IMMUNOELECTROPHORESIS SERUM,300,202.24,105.91,354% of CMS OPPS Rate,20.47,100% of Medicaid LA Fee Schedule,29.92,100% of CMS OPPS Rate,29.92,100% of CMS OPPS Rate,61,203.89% of BCBS Fee Schedule,141.57,70% of total Billed Charges,151.68,75% of total Billed Charges,53.85,180% OF CMS OPPS RATE,161.79,80% of total Billed Charges,104.72,350% of CMS Opps rate,30.51,102% of CMS Opps rate,154.71,76.5% of total billed charges,20.47,100% of Medicaid LA Fee Schedule,20.47,100% of Medicaid LA Fee Schedule,29.92,100% of CMS OPPS Rate,29.92,100% of CMS OPPS Rate,91.01,45% of total billed charges,141.57,70% of total billed charges,121.34,60% of total billed charges,29.92,100% of CMS OPPS Rate,26.93,90% OF UHC FEE SCHEDULE,141.57,70% of total billed charges,29.92,100% OF CMS OPPS Rate,68.81,230% OF CMS OPPS Rate,97.08,48% of total Billed charges,29.92,100% OF CMS OPPS Rate,182.02,90% of total Billed charges,20.47,100% of Medicaid LA Fee Schedule,20.47,100% of Medicaid LA Fee Schedule,20.47,100% of Medicaid LA Fee Schedule,20.47,100% of Medicaid LA Fee Schedule,20.47,100% of Medicaid LA Fee Schedule,20.47,100% of Medicaid LA Fee Schedule,29.92,100% of CMS OPPS Rate,29.92,100% of CMS OPPS Rate,29.92,100% of CMS OPPS Rate,29.92,100% of CMS OPPS Rate,29.92,100% of CMS OPPS Rate,29.92,100% of CMS OPPS Rate,29.92,100% of CMS OPPS Rate,29.92,100% of CMS OPPS Rate,20.47,182.02,121.34
Outpatient,Laboratory,86334,IMMUNOFIXATION ELECT.SER,300,85.05,79.08,354% of CMS OPPS Rate,20.47,100% of Medicaid LA Fee Schedule,22.34,100% of CMS OPPS Rate,22.34,100% of CMS OPPS Rate,56.25,203.89% of BCBS Fee Schedule,59.54,70% of total Billed Charges,63.79,75% of total Billed Charges,40.21,180% OF CMS OPPS RATE,68.04,80% of total Billed Charges,78.19,350% of CMS Opps rate,22.78,102% of CMS Opps rate,65.06,76.5% of total billed charges,20.47,100% of Medicaid LA Fee Schedule,20.47,100% of Medicaid LA Fee Schedule,22.34,100% of CMS OPPS Rate,22.34,100% of CMS OPPS Rate,38.27,45% of total billed charges,59.54,70% of total billed charges,51.03,60% of total billed charges,22.34,100% of CMS OPPS Rate,24.83,90% OF UHC FEE SCHEDULE,59.54,70% of total billed charges,22.34,100% OF CMS OPPS Rate,51.38,230% OF CMS OPPS Rate,40.82,48% of total Billed charges,22.34,100% OF CMS OPPS Rate,76.55,90% of total Billed charges,20.47,100% of Medicaid LA Fee Schedule,20.47,100% of Medicaid LA Fee Schedule,20.47,100% of Medicaid LA Fee Schedule,20.47,100% of Medicaid LA Fee Schedule,20.47,100% of Medicaid LA Fee Schedule,20.47,100% of Medicaid LA Fee Schedule,22.34,100% of CMS OPPS Rate,22.34,100% of CMS OPPS Rate,22.34,100% of CMS OPPS Rate,22.34,100% of CMS OPPS Rate,22.34,100% of CMS OPPS Rate,22.34,100% of CMS OPPS Rate,22.34,100% of CMS OPPS Rate,22.34,100% of CMS OPPS Rate,20.47,79.08,51.03
Outpatient,Laboratory,86335,IMMUNFIX E-PHORSIS/URINE,300,94.5,103.89,354% of CMS OPPS Rate,14.81,15.67% of total Billed charges,29.35,100% of CMS OPPS Rate,29.35,100% of CMS OPPS Rate,73.87,203.89% of BCBS Fee Schedule,66.15,70% of total Billed Charges,70.88,75% of total Billed Charges,52.83,180% OF CMS OPPS RATE,75.6,80% of total Billed Charges,102.72,350% of CMS Opps rate,29.93,102% of CMS Opps rate,72.29,76.5% of total billed charges,14.81,15.67% of total Billed charges,14.81,15.67% of total Billed charges,29.35,100% of CMS OPPS Rate,29.35,100% of CMS OPPS Rate,42.53,45% of total billed charges,66.15,70% of total billed charges,56.7,60% of total billed charges,29.35,100% of CMS OPPS Rate,32.61,90% OF UHC FEE SCHEDULE,66.15,70% of total billed charges,29.35,100% OF CMS OPPS Rate,67.5,230% OF CMS OPPS Rate,45.36,48% of total Billed charges,29.35,100% OF CMS OPPS Rate,85.05,90% of total Billed charges,14.81,15.67% of total Billed charges,14.81,15.67% of total Billed charges,14.81,15.67% of total Billed charges,14.81,15.67% of total Billed charges,14.81,15.67% of total Billed charges,14.81,15.67% of total Billed charges,29.35,100% of CMS OPPS Rate,29.35,100% of CMS OPPS Rate,29.35,100% of CMS OPPS Rate,29.35,100% of CMS OPPS Rate,29.35,100% of CMS OPPS Rate,29.35,100% of CMS OPPS Rate,29.35,100% of CMS OPPS Rate,29.35,100% of CMS OPPS Rate,14.81,103.89,56.7
Outpatient,Laboratory,86336,Blood test to monitor for cancer in the ovaries or testis,300,76.5,55.18,354% of CMS OPPS Rate,15.59,100% of Medicaid LA Fee Schedule,15.59,100% of CMS OPPS Rate,15.59,100% of CMS OPPS Rate,39.23,203.89% of BCBS Fee Schedule,53.55,70% of total Billed Charges,57.38,75% of total Billed Charges,28.06,180% OF CMS OPPS RATE,61.2,80% of total Billed Charges,54.56,350% of CMS Opps rate,15.9,102% of CMS Opps rate,58.52,76.5% of total billed charges,15.59,100% of Medicaid LA Fee Schedule,15.59,100% of Medicaid LA Fee Schedule,15.59,100% of CMS OPPS Rate,15.59,100% of CMS OPPS Rate,34.43,45% of total billed charges,53.55,70% of total billed charges,45.9,60% of total billed charges,15.59,100% of CMS OPPS Rate,17.32,90% OF UHC FEE SCHEDULE,53.55,70% of total billed charges,15.59,100% OF CMS OPPS Rate,35.85,230% OF CMS OPPS Rate,36.72,48% of total Billed charges,15.59,100% OF CMS OPPS Rate,68.85,90% of total Billed charges,15.59,100% of Medicaid LA Fee Schedule,15.59,100% of Medicaid LA Fee Schedule,15.59,100% of Medicaid LA Fee Schedule,15.59,100% of Medicaid LA Fee Schedule,15.59,100% of Medicaid LA Fee Schedule,15.59,100% of Medicaid LA Fee Schedule,15.59,100% of CMS OPPS Rate,15.59,100% of CMS OPPS Rate,15.59,100% of CMS OPPS Rate,15.59,100% of CMS OPPS Rate,15.59,100% of CMS OPPS Rate,15.59,100% of CMS OPPS Rate,15.59,100% of CMS OPPS Rate,15.59,100% of CMS OPPS Rate,15.59,68.85,45.9
Outpatient,Laboratory,86337,INSULIN ANTIBODIES,300,67,75.79,354% of CMS OPPS Rate,9.87,100% of Medicaid LA Fee Schedule,21.41,100% of CMS OPPS Rate,21.41,100% of CMS OPPS Rate,53.89,203.89% of BCBS Fee Schedule,46.9,70% of total Billed Charges,50.25,75% of total Billed Charges,38.53,180% OF CMS OPPS RATE,53.6,80% of total Billed Charges,74.93,350% of CMS Opps rate,21.83,102% of CMS Opps rate,51.26,76.5% of total billed charges,9.87,100% of Medicaid LA Fee Schedule,9.87,100% of Medicaid LA Fee Schedule,21.41,100% of CMS OPPS Rate,21.41,100% of CMS OPPS Rate,30.15,45% of total billed charges,46.9,70% of total billed charges,40.2,60% of total billed charges,21.41,100% of CMS OPPS Rate,23.79,90% OF UHC FEE SCHEDULE,46.9,70% of total billed charges,21.41,100% OF CMS OPPS Rate,49.24,230% OF CMS OPPS Rate,32.16,48% of total Billed charges,21.41,100% OF CMS OPPS Rate,60.3,90% of total Billed charges,9.87,100% of Medicaid LA Fee Schedule,9.87,100% of Medicaid LA Fee Schedule,9.87,100% of Medicaid LA Fee Schedule,9.87,100% of Medicaid LA Fee Schedule,9.87,100% of Medicaid LA Fee Schedule,9.87,100% of Medicaid LA Fee Schedule,21.41,100% of CMS OPPS Rate,21.41,100% of CMS OPPS Rate,21.41,100% of CMS OPPS Rate,21.41,100% of CMS OPPS Rate,21.41,100% of CMS OPPS Rate,21.41,100% of CMS OPPS Rate,21.41,100% of CMS OPPS Rate,21.41,100% of CMS OPPS Rate,9.87,75.79,40.2
Outpatient,Laboratory,86340,ANTI-INTRINSIC FACT ANTIB,300,158.85,53.38,354% of CMS OPPS Rate,7.83,100% of Medicaid LA Fee Schedule,15.08,100% of CMS OPPS Rate,15.08,100% of CMS OPPS Rate,37.94,203.89% of BCBS Fee Schedule,111.2,70% of total Billed Charges,119.14,75% of total Billed Charges,27.14,180% OF CMS OPPS RATE,127.08,80% of total Billed Charges,52.78,350% of CMS Opps rate,15.38,102% of CMS Opps rate,121.52,76.5% of total billed charges,7.83,100% of Medicaid LA Fee Schedule,7.83,100% of Medicaid LA Fee Schedule,15.08,100% of CMS OPPS Rate,15.08,100% of CMS OPPS Rate,71.48,45% of total billed charges,111.2,70% of total billed charges,95.31,60% of total billed charges,15.08,100% of CMS OPPS Rate,16.75,90% OF UHC FEE SCHEDULE,111.2,70% of total billed charges,15.08,100% OF CMS OPPS Rate,34.68,230% OF CMS OPPS Rate,76.25,48% of total Billed charges,15.08,100% OF CMS OPPS Rate,142.97,90% of total Billed charges,7.83,100% of Medicaid LA Fee Schedule,7.83,100% of Medicaid LA Fee Schedule,7.83,100% of Medicaid LA Fee Schedule,7.83,100% of Medicaid LA Fee Schedule,7.83,100% of Medicaid LA Fee Schedule,7.83,100% of Medicaid LA Fee Schedule,15.08,100% of CMS OPPS Rate,15.08,100% of CMS OPPS Rate,15.08,100% of CMS OPPS Rate,15.08,100% of CMS OPPS Rate,15.08,100% of CMS OPPS Rate,15.08,100% of CMS OPPS Rate,15.08,100% of CMS OPPS Rate,15.08,100% of CMS OPPS Rate,7.83,142.97,95.31
Outpatient,Laboratory,86341,ISLET CELL ABS,300,71,83.43,354% of CMS OPPS Rate,23.57,100% of Medicaid LA Fee Schedule,23.57,100% of CMS OPPS Rate,23.57,100% of CMS OPPS Rate,49.81,203.89% of BCBS Fee Schedule,49.7,70% of total Billed Charges,53.25,75% of total Billed Charges,42.42,180% OF CMS OPPS RATE,56.8,80% of total Billed Charges,82.49,350% of CMS Opps rate,24.04,102% of CMS Opps rate,54.32,76.5% of total billed charges,23.57,100% of Medicaid LA Fee Schedule,23.57,100% of Medicaid LA Fee Schedule,23.57,100% of CMS OPPS Rate,23.57,100% of CMS OPPS Rate,31.95,45% of total billed charges,49.7,70% of total billed charges,42.6,60% of total billed charges,23.57,100% of CMS OPPS Rate,21.99,90% OF UHC FEE SCHEDULE,49.7,70% of total billed charges,23.57,100% OF CMS OPPS Rate,54.21,230% OF CMS OPPS Rate,34.08,48% of total Billed charges,23.57,100% OF CMS OPPS Rate,63.9,90% of total Billed charges,23.57,100% of Medicaid LA Fee Schedule,23.57,100% of Medicaid LA Fee Schedule,23.57,100% of Medicaid LA Fee Schedule,23.57,100% of Medicaid LA Fee Schedule,23.57,100% of Medicaid LA Fee Schedule,23.57,100% of Medicaid LA Fee Schedule,23.57,100% of CMS OPPS Rate,23.57,100% of CMS OPPS Rate,23.57,100% of CMS OPPS Rate,23.57,100% of CMS OPPS Rate,23.57,100% of CMS OPPS Rate,23.57,100% of CMS OPPS Rate,23.57,100% of CMS OPPS Rate,23.57,100% of CMS OPPS Rate,21.99,83.43,42.6
Outpatient,Laboratory,86343,LHR TEST,300,139.5,44.1,354% of CMS OPPS Rate,21.86,15.67% of total Billed charges,12.46,100% of CMS OPPS Rate,12.46,100% of CMS OPPS Rate,31.36,203.89% of BCBS Fee Schedule,97.65,70% of total Billed Charges,104.63,75% of total Billed Charges,22.42,180% OF CMS OPPS RATE,111.6,80% of total Billed Charges,43.61,350% of CMS Opps rate,12.7,102% of CMS Opps rate,106.72,76.5% of total billed charges,21.86,15.67% of total Billed charges,21.86,15.67% of total Billed charges,12.46,100% of CMS OPPS Rate,12.46,100% of CMS OPPS Rate,62.78,45% of total billed charges,97.65,70% of total billed charges,83.7,60% of total billed charges,12.46,100% of CMS OPPS Rate,13.84,90% OF UHC FEE SCHEDULE,97.65,70% of total billed charges,12.46,100% OF CMS OPPS Rate,28.65,230% OF CMS OPPS Rate,66.96,48% of total Billed charges,12.46,100% OF CMS OPPS Rate,125.55,90% of total Billed charges,21.86,15.67% of total Billed charges,21.86,15.67% of total Billed charges,21.86,15.67% of total Billed charges,21.86,15.67% of total Billed charges,21.86,15.67% of total Billed charges,21.86,15.67% of total Billed charges,12.46,100% of CMS OPPS Rate,12.46,100% of CMS OPPS Rate,12.46,100% of CMS OPPS Rate,12.46,100% of CMS OPPS Rate,12.46,100% of CMS OPPS Rate,12.46,100% of CMS OPPS Rate,12.46,100% of CMS OPPS Rate,12.46,100% of CMS OPPS Rate,12.46,125.55,83.7
Outpatient,Laboratory,86352,CELL FUNCTION ASSAY W/STIM,300,270,480.94,354% of CMS OPPS Rate,89.62,100% of Medicaid LA Fee Schedule,135.86,100% of CMS OPPS Rate,135.86,100% of CMS OPPS Rate,341.98,203.89% of BCBS Fee Schedule,189,70% of total Billed Charges,202.5,75% of total Billed Charges,244.54,180% OF CMS OPPS RATE,216,80% of total Billed Charges,475.51,350% of CMS Opps rate,138.57,102% of CMS Opps rate,206.55,76.5% of total billed charges,89.62,100% of Medicaid LA Fee Schedule,89.62,100% of Medicaid LA Fee Schedule,135.86,100% of CMS OPPS Rate,135.86,100% of CMS OPPS Rate,121.5,45% of total billed charges,189,70% of total billed charges,162,60% of total billed charges,135.86,100% of CMS OPPS Rate,150.96,90% OF UHC FEE SCHEDULE,189,70% of total billed charges,135.86,100% OF CMS OPPS Rate,270,230% OF CMS OPPS Rate,129.6,48% of total Billed charges,135.86,100% OF CMS OPPS Rate,243,90% of total Billed charges,89.62,100% of Medicaid LA Fee Schedule,89.62,100% of Medicaid LA Fee Schedule,89.62,100% of Medicaid LA Fee Schedule,89.62,100% of Medicaid LA Fee Schedule,89.62,100% of Medicaid LA Fee Schedule,89.62,100% of Medicaid LA Fee Schedule,135.86,100% of CMS OPPS Rate,135.86,100% of CMS OPPS Rate,135.86,100% of CMS OPPS Rate,135.86,100% of CMS OPPS Rate,135.86,100% of CMS OPPS Rate,135.86,100% of CMS OPPS Rate,135.86,100% of CMS OPPS Rate,135.86,100% of CMS OPPS Rate,89.62,480.94,162
Outpatient,Laboratory,86353,LYMPH TRANSFORMATION,300,338,173.56,354% of CMS OPPS Rate,49.03,100% of Medicaid LA Fee Schedule,49.03,100% of CMS OPPS Rate,49.03,100% of CMS OPPS Rate,123.41,203.89% of BCBS Fee Schedule,236.6,70% of total Billed Charges,253.5,75% of total Billed Charges,88.25,180% OF CMS OPPS RATE,270.4,80% of total Billed Charges,171.6,350% of CMS Opps rate,50.01,102% of CMS Opps rate,258.57,76.5% of total billed charges,49.03,100% of Medicaid LA Fee Schedule,49.03,100% of Medicaid LA Fee Schedule,49.03,100% of CMS OPPS Rate,49.03,100% of CMS OPPS Rate,152.1,45% of total billed charges,236.6,70% of total billed charges,202.8,60% of total billed charges,49.03,100% of CMS OPPS Rate,54.48,90% OF UHC FEE SCHEDULE,236.6,70% of total billed charges,49.03,100% OF CMS OPPS Rate,112.76,230% OF CMS OPPS Rate,162.24,48% of total Billed charges,49.03,100% OF CMS OPPS Rate,304.2,90% of total Billed charges,49.03,100% of Medicaid LA Fee Schedule,49.03,100% of Medicaid LA Fee Schedule,49.03,100% of Medicaid LA Fee Schedule,49.03,100% of Medicaid LA Fee Schedule,49.03,100% of Medicaid LA Fee Schedule,49.03,100% of Medicaid LA Fee Schedule,49.03,100% of CMS OPPS Rate,49.03,100% of CMS OPPS Rate,49.03,100% of CMS OPPS Rate,49.03,100% of CMS OPPS Rate,49.03,100% of CMS OPPS Rate,49.03,100% of CMS OPPS Rate,49.03,100% of CMS OPPS Rate,49.03,100% of CMS OPPS Rate,49.03,304.2,202.8
Outpatient,Laboratory,86355,B CELL TOTAL COUNT,300,113,133.56,354% of CMS OPPS Rate,37.73,100% of Medicaid LA Fee Schedule,37.72,100% of CMS OPPS Rate,37.72,100% of CMS OPPS Rate,94.97,203.89% of BCBS Fee Schedule,79.1,70% of total Billed Charges,84.75,75% of total Billed Charges,67.91,180% OF CMS OPPS RATE,90.4,80% of total Billed Charges,132.05,350% of CMS Opps rate,38.48,102% of CMS Opps rate,86.45,76.5% of total billed charges,37.73,100% of Medicaid LA Fee Schedule,37.73,100% of Medicaid LA Fee Schedule,37.72,100% of CMS OPPS Rate,37.72,100% of CMS OPPS Rate,50.85,45% of total billed charges,79.1,70% of total billed charges,67.8,60% of total billed charges,37.72,100% of CMS OPPS Rate,41.92,90% OF UHC FEE SCHEDULE,79.1,70% of total billed charges,37.72,100% OF CMS OPPS Rate,86.77,230% OF CMS OPPS Rate,54.24,48% of total Billed charges,37.72,100% OF CMS OPPS Rate,101.7,90% of total Billed charges,37.73,100% of Medicaid LA Fee Schedule,37.73,100% of Medicaid LA Fee Schedule,37.73,100% of Medicaid LA Fee Schedule,37.73,100% of Medicaid LA Fee Schedule,37.73,100% of Medicaid LA Fee Schedule,37.73,100% of Medicaid LA Fee Schedule,37.72,100% of CMS OPPS Rate,37.72,100% of CMS OPPS Rate,37.72,100% of CMS OPPS Rate,37.72,100% of CMS OPPS Rate,37.72,100% of CMS OPPS Rate,37.72,100% of CMS OPPS Rate,37.72,100% of CMS OPPS Rate,37.72,100% of CMS OPPS Rate,37.72,133.56,67.8
Outpatient,Laboratory,86357,NATURAL KILLER CELLS TOTAL CNT,300,134,133.56,354% of CMS OPPS Rate,37.73,100% of Medicaid LA Fee Schedule,37.72,100% of CMS OPPS Rate,37.72,100% of CMS OPPS Rate,94.97,203.89% of BCBS Fee Schedule,93.8,70% of total Billed Charges,100.5,75% of total Billed Charges,67.91,180% OF CMS OPPS RATE,107.2,80% of total Billed Charges,132.05,350% of CMS Opps rate,38.48,102% of CMS Opps rate,102.51,76.5% of total billed charges,37.73,100% of Medicaid LA Fee Schedule,37.73,100% of Medicaid LA Fee Schedule,37.72,100% of CMS OPPS Rate,37.72,100% of CMS OPPS Rate,60.3,45% of total billed charges,93.8,70% of total billed charges,80.4,60% of total billed charges,37.72,100% of CMS OPPS Rate,41.92,90% OF UHC FEE SCHEDULE,93.8,70% of total billed charges,37.72,100% OF CMS OPPS Rate,86.77,230% OF CMS OPPS Rate,64.32,48% of total Billed charges,37.72,100% OF CMS OPPS Rate,120.6,90% of total Billed charges,37.73,100% of Medicaid LA Fee Schedule,37.73,100% of Medicaid LA Fee Schedule,37.73,100% of Medicaid LA Fee Schedule,37.73,100% of Medicaid LA Fee Schedule,37.73,100% of Medicaid LA Fee Schedule,37.73,100% of Medicaid LA Fee Schedule,37.72,100% of CMS OPPS Rate,37.72,100% of CMS OPPS Rate,37.72,100% of CMS OPPS Rate,37.72,100% of CMS OPPS Rate,37.72,100% of CMS OPPS Rate,37.72,100% of CMS OPPS Rate,37.72,100% of CMS OPPS Rate,37.72,100% of CMS OPPS Rate,37.72,133.56,80.4
Outpatient,Laboratory,86359,LYPHOCYTES/GATED CELLS,300,127,133.56,354% of CMS OPPS Rate,37.73,100% of Medicaid LA Fee Schedule,37.72,100% of CMS OPPS Rate,37.72,100% of CMS OPPS Rate,94.97,203.89% of BCBS Fee Schedule,88.9,70% of total Billed Charges,95.25,75% of total Billed Charges,67.91,180% OF CMS OPPS RATE,101.6,80% of total Billed Charges,132.05,350% of CMS Opps rate,38.48,102% of CMS Opps rate,97.16,76.5% of total billed charges,37.73,100% of Medicaid LA Fee Schedule,37.73,100% of Medicaid LA Fee Schedule,37.72,100% of CMS OPPS Rate,37.72,100% of CMS OPPS Rate,57.15,45% of total billed charges,88.9,70% of total billed charges,76.2,60% of total billed charges,37.72,100% of CMS OPPS Rate,41.92,90% OF UHC FEE SCHEDULE,88.9,70% of total billed charges,37.72,100% OF CMS OPPS Rate,86.77,230% OF CMS OPPS Rate,60.96,48% of total Billed charges,37.72,100% OF CMS OPPS Rate,114.3,90% of total Billed charges,37.73,100% of Medicaid LA Fee Schedule,37.73,100% of Medicaid LA Fee Schedule,37.73,100% of Medicaid LA Fee Schedule,37.73,100% of Medicaid LA Fee Schedule,37.73,100% of Medicaid LA Fee Schedule,37.73,100% of Medicaid LA Fee Schedule,37.72,100% of CMS OPPS Rate,37.72,100% of CMS OPPS Rate,37.72,100% of CMS OPPS Rate,37.72,100% of CMS OPPS Rate,37.72,100% of CMS OPPS Rate,37.72,100% of CMS OPPS Rate,37.72,100% of CMS OPPS Rate,37.72,100% of CMS OPPS Rate,37.72,133.56,76.2
Outpatient,Laboratory,86360,CD4(HELPER/INDUCER),300,141,166.3,354% of CMS OPPS Rate,46.98,100% of Medicaid LA Fee Schedule,46.98,100% of CMS OPPS Rate,46.98,100% of CMS OPPS Rate,118.28,203.89% of BCBS Fee Schedule,98.7,70% of total Billed Charges,105.75,75% of total Billed Charges,84.56,180% OF CMS OPPS RATE,112.8,80% of total Billed Charges,164.43,350% of CMS Opps rate,47.91,102% of CMS Opps rate,107.87,76.5% of total billed charges,46.98,100% of Medicaid LA Fee Schedule,46.98,100% of Medicaid LA Fee Schedule,46.98,100% of CMS OPPS Rate,46.98,100% of CMS OPPS Rate,63.45,45% of total billed charges,98.7,70% of total billed charges,84.6,60% of total billed charges,46.98,100% of CMS OPPS Rate,52.21,90% OF UHC FEE SCHEDULE,98.7,70% of total billed charges,46.98,100% OF CMS OPPS Rate,108.05,230% OF CMS OPPS Rate,67.68,48% of total Billed charges,46.98,100% OF CMS OPPS Rate,126.9,90% of total Billed charges,46.98,100% of Medicaid LA Fee Schedule,46.98,100% of Medicaid LA Fee Schedule,46.98,100% of Medicaid LA Fee Schedule,46.98,100% of Medicaid LA Fee Schedule,46.98,100% of Medicaid LA Fee Schedule,46.98,100% of Medicaid LA Fee Schedule,46.98,100% of CMS OPPS Rate,46.98,100% of CMS OPPS Rate,46.98,100% of CMS OPPS Rate,46.98,100% of CMS OPPS Rate,46.98,100% of CMS OPPS Rate,46.98,100% of CMS OPPS Rate,46.98,100% of CMS OPPS Rate,46.98,100% of CMS OPPS Rate,46.98,166.3,84.6
Outpatient,Laboratory,86361,CD4  ABSOLUTE COUNT,300,142.2,94.8,354% of CMS OPPS Rate,26.78,100% of Medicaid LA Fee Schedule,26.78,100% of CMS OPPS Rate,26.78,100% of CMS OPPS Rate,67.41,203.89% of BCBS Fee Schedule,99.54,70% of total Billed Charges,106.65,75% of total Billed Charges,48.2,180% OF CMS OPPS RATE,113.76,80% of total Billed Charges,93.73,350% of CMS Opps rate,27.31,102% of CMS Opps rate,108.78,76.5% of total billed charges,26.78,100% of Medicaid LA Fee Schedule,26.78,100% of Medicaid LA Fee Schedule,26.78,100% of CMS OPPS Rate,26.78,100% of CMS OPPS Rate,63.99,45% of total billed charges,99.54,70% of total billed charges,85.32,60% of total billed charges,26.78,100% of CMS OPPS Rate,29.75,90% OF UHC FEE SCHEDULE,99.54,70% of total billed charges,26.78,100% OF CMS OPPS Rate,61.59,230% OF CMS OPPS Rate,68.26,48% of total Billed charges,26.78,100% OF CMS OPPS Rate,127.98,90% of total Billed charges,26.78,100% of Medicaid LA Fee Schedule,26.78,100% of Medicaid LA Fee Schedule,26.78,100% of Medicaid LA Fee Schedule,26.78,100% of Medicaid LA Fee Schedule,26.78,100% of Medicaid LA Fee Schedule,26.78,100% of Medicaid LA Fee Schedule,26.78,100% of CMS OPPS Rate,26.78,100% of CMS OPPS Rate,26.78,100% of CMS OPPS Rate,26.78,100% of CMS OPPS Rate,26.78,100% of CMS OPPS Rate,26.78,100% of CMS OPPS Rate,26.78,100% of CMS OPPS Rate,26.78,100% of CMS OPPS Rate,26.78,127.98,85.32
Outpatient,Laboratory,86376,MICROSOMAL AB,300,95.7,51.5,354% of CMS OPPS Rate,14.55,100% of Medicaid LA Fee Schedule,14.55,100% of CMS OPPS Rate,14.55,100% of CMS OPPS Rate,36.62,203.89% of BCBS Fee Schedule,66.99,70% of total Billed Charges,71.78,75% of total Billed Charges,26.19,180% OF CMS OPPS RATE,76.56,80% of total Billed Charges,50.92,350% of CMS Opps rate,14.84,102% of CMS Opps rate,73.21,76.5% of total billed charges,14.55,100% of Medicaid LA Fee Schedule,14.55,100% of Medicaid LA Fee Schedule,14.55,100% of CMS OPPS Rate,14.55,100% of CMS OPPS Rate,43.07,45% of total billed charges,66.99,70% of total billed charges,57.42,60% of total billed charges,14.55,100% of CMS OPPS Rate,16.16,90% OF UHC FEE SCHEDULE,66.99,70% of total billed charges,14.55,100% OF CMS OPPS Rate,33.46,230% OF CMS OPPS Rate,45.94,48% of total Billed charges,14.55,100% OF CMS OPPS Rate,86.13,90% of total Billed charges,14.55,100% of Medicaid LA Fee Schedule,14.55,100% of Medicaid LA Fee Schedule,14.55,100% of Medicaid LA Fee Schedule,14.55,100% of Medicaid LA Fee Schedule,14.55,100% of Medicaid LA Fee Schedule,14.55,100% of Medicaid LA Fee Schedule,14.55,100% of CMS OPPS Rate,14.55,100% of CMS OPPS Rate,14.55,100% of CMS OPPS Rate,14.55,100% of CMS OPPS Rate,14.55,100% of CMS OPPS Rate,14.55,100% of CMS OPPS Rate,14.55,100% of CMS OPPS Rate,14.55,100% of CMS OPPS Rate,14.55,86.13,57.42
Outpatient,Laboratory,86403,PA SCREEN EA AB,300,74.7,40.85,354% of CMS OPPS Rate,11.54,100% of Medicaid LA Fee Schedule,11.54,100% of CMS OPPS Rate,11.54,100% of CMS OPPS Rate,25.65,203.89% of BCBS Fee Schedule,52.29,70% of total Billed Charges,56.03,75% of total Billed Charges,20.77,180% OF CMS OPPS RATE,59.76,80% of total Billed Charges,40.38,350% of CMS Opps rate,11.77,102% of CMS Opps rate,57.15,76.5% of total billed charges,11.54,100% of Medicaid LA Fee Schedule,11.54,100% of Medicaid LA Fee Schedule,11.54,100% of CMS OPPS Rate,11.54,100% of CMS OPPS Rate,33.62,45% of total billed charges,52.29,70% of total billed charges,44.82,60% of total billed charges,11.54,100% of CMS OPPS Rate,11.32,90% OF UHC FEE SCHEDULE,52.29,70% of total billed charges,11.54,100% OF CMS OPPS Rate,26.54,230% OF CMS OPPS Rate,35.86,48% of total Billed charges,11.54,100% OF CMS OPPS Rate,67.23,90% of total Billed charges,11.54,100% of Medicaid LA Fee Schedule,11.54,100% of Medicaid LA Fee Schedule,11.54,100% of Medicaid LA Fee Schedule,11.54,100% of Medicaid LA Fee Schedule,11.54,100% of Medicaid LA Fee Schedule,11.54,100% of Medicaid LA Fee Schedule,11.54,100% of CMS OPPS Rate,11.54,100% of CMS OPPS Rate,11.54,100% of CMS OPPS Rate,11.54,100% of CMS OPPS Rate,11.54,100% of CMS OPPS Rate,11.54,100% of CMS OPPS Rate,11.54,100% of CMS OPPS Rate,11.54,100% of CMS OPPS Rate,11.32,67.23,44.82
Outpatient,Laboratory,86406,PA TITER EA AB,300,74.7,37.66,354% of CMS OPPS Rate,10.64,100% of Medicaid LA Fee Schedule,10.64,100% of CMS OPPS Rate,10.64,100% of CMS OPPS Rate,26.77,203.89% of BCBS Fee Schedule,52.29,70% of total Billed Charges,56.03,75% of total Billed Charges,19.15,180% OF CMS OPPS RATE,59.76,80% of total Billed Charges,37.24,350% of CMS Opps rate,10.85,102% of CMS Opps rate,57.15,76.5% of total billed charges,10.64,100% of Medicaid LA Fee Schedule,10.64,100% of Medicaid LA Fee Schedule,10.64,100% of CMS OPPS Rate,10.64,100% of CMS OPPS Rate,33.62,45% of total billed charges,52.29,70% of total billed charges,44.82,60% of total billed charges,10.64,100% of CMS OPPS Rate,11.82,90% OF UHC FEE SCHEDULE,52.29,70% of total billed charges,10.64,100% OF CMS OPPS Rate,24.47,230% OF CMS OPPS Rate,35.86,48% of total Billed charges,10.64,100% OF CMS OPPS Rate,67.23,90% of total Billed charges,10.64,100% of Medicaid LA Fee Schedule,10.64,100% of Medicaid LA Fee Schedule,10.64,100% of Medicaid LA Fee Schedule,10.64,100% of Medicaid LA Fee Schedule,10.64,100% of Medicaid LA Fee Schedule,10.64,100% of Medicaid LA Fee Schedule,10.64,100% of CMS OPPS Rate,10.64,100% of CMS OPPS Rate,10.64,100% of CMS OPPS Rate,10.64,100% of CMS OPPS Rate,10.64,100% of CMS OPPS Rate,10.64,100% of CMS OPPS Rate,10.64,100% of CMS OPPS Rate,10.64,100% of CMS OPPS Rate,10.64,67.23,44.82
Outpatient,Laboratory,86430,RA(REFLEX TITER),300,94.5,21.73,354% of CMS OPPS Rate,6.14,100% of Medicaid LA Fee Schedule,6.14,100% of CMS OPPS Rate,6.14,100% of CMS OPPS Rate,14.27,203.89% of BCBS Fee Schedule,66.15,70% of total Billed Charges,70.88,75% of total Billed Charges,11.05,180% OF CMS OPPS RATE,75.6,80% of total Billed Charges,21.49,350% of CMS Opps rate,6.26,102% of CMS Opps rate,72.29,76.5% of total billed charges,6.14,100% of Medicaid LA Fee Schedule,6.14,100% of Medicaid LA Fee Schedule,6.14,100% of CMS OPPS Rate,6.14,100% of CMS OPPS Rate,42.53,45% of total billed charges,66.15,70% of total billed charges,56.7,60% of total billed charges,6.14,100% of CMS OPPS Rate,6.3,90% OF UHC FEE SCHEDULE,66.15,70% of total billed charges,6.14,100% OF CMS OPPS Rate,14.12,230% OF CMS OPPS Rate,45.36,48% of total Billed charges,6.14,100% OF CMS OPPS Rate,85.05,90% of total Billed charges,6.14,100% of Medicaid LA Fee Schedule,6.14,100% of Medicaid LA Fee Schedule,6.14,100% of Medicaid LA Fee Schedule,6.14,100% of Medicaid LA Fee Schedule,6.14,100% of Medicaid LA Fee Schedule,6.14,100% of Medicaid LA Fee Schedule,6.14,100% of CMS OPPS Rate,6.14,100% of CMS OPPS Rate,6.14,100% of CMS OPPS Rate,6.14,100% of CMS OPPS Rate,6.14,100% of CMS OPPS Rate,6.14,100% of CMS OPPS Rate,6.14,100% of CMS OPPS Rate,6.14,100% of CMS OPPS Rate,6.14,85.05,56.7
Outpatient,Laboratory,86431,RA QUANTITATIVE,300,88,20.07,354% of CMS OPPS Rate,5.67,100% of Medicaid LA Fee Schedule,5.67,100% of CMS OPPS Rate,5.67,100% of CMS OPPS Rate,14.27,203.89% of BCBS Fee Schedule,61.6,70% of total Billed Charges,66,75% of total Billed Charges,10.2,180% OF CMS OPPS RATE,70.4,80% of total Billed Charges,19.84,350% of CMS Opps rate,5.78,102% of CMS Opps rate,67.32,76.5% of total billed charges,5.67,100% of Medicaid LA Fee Schedule,5.67,100% of Medicaid LA Fee Schedule,5.67,100% of CMS OPPS Rate,5.67,100% of CMS OPPS Rate,39.6,45% of total billed charges,61.6,70% of total billed charges,52.8,60% of total billed charges,5.67,100% of CMS OPPS Rate,6.3,90% OF UHC FEE SCHEDULE,61.6,70% of total billed charges,5.67,100% OF CMS OPPS Rate,13.04,230% OF CMS OPPS Rate,42.24,48% of total Billed charges,5.67,100% OF CMS OPPS Rate,79.2,90% of total Billed charges,5.67,100% of Medicaid LA Fee Schedule,5.67,100% of Medicaid LA Fee Schedule,5.67,100% of Medicaid LA Fee Schedule,5.67,100% of Medicaid LA Fee Schedule,5.67,100% of Medicaid LA Fee Schedule,5.67,100% of Medicaid LA Fee Schedule,5.67,100% of CMS OPPS Rate,5.67,100% of CMS OPPS Rate,5.67,100% of CMS OPPS Rate,5.67,100% of CMS OPPS Rate,5.67,100% of CMS OPPS Rate,5.67,100% of CMS OPPS Rate,5.67,100% of CMS OPPS Rate,5.67,100% of CMS OPPS Rate,5.67,79.2,52.8
Outpatient,Laboratory,86480,"TB TEST,CELL IMMUN MEASUR",300,186,219.4,354% of CMS OPPS Rate,61.98,100% of Medicaid LA Fee Schedule,61.98,100% of CMS OPPS Rate,61.98,100% of CMS OPPS Rate,156.02,203.89% of BCBS Fee Schedule,130.2,70% of total Billed Charges,139.5,75% of total Billed Charges,111.56,180% OF CMS OPPS RATE,148.8,80% of total Billed Charges,216.93,350% of CMS Opps rate,63.21,102% of CMS Opps rate,142.29,76.5% of total billed charges,61.98,100% of Medicaid LA Fee Schedule,61.98,100% of Medicaid LA Fee Schedule,61.98,100% of CMS OPPS Rate,61.98,100% of CMS OPPS Rate,83.7,45% of total billed charges,130.2,70% of total billed charges,111.6,60% of total billed charges,61.98,100% of CMS OPPS Rate,68.87,90% OF UHC FEE SCHEDULE,130.2,70% of total billed charges,61.98,100% OF CMS OPPS Rate,142.55,230% OF CMS OPPS Rate,89.28,48% of total Billed charges,61.98,100% OF CMS OPPS Rate,167.4,90% of total Billed charges,61.98,100% of Medicaid LA Fee Schedule,61.98,100% of Medicaid LA Fee Schedule,61.98,100% of Medicaid LA Fee Schedule,61.98,100% of Medicaid LA Fee Schedule,61.98,100% of Medicaid LA Fee Schedule,61.98,100% of Medicaid LA Fee Schedule,61.98,100% of CMS OPPS Rate,61.98,100% of CMS OPPS Rate,61.98,100% of CMS OPPS Rate,61.98,100% of CMS OPPS Rate,61.98,100% of CMS OPPS Rate,61.98,100% of CMS OPPS Rate,61.98,100% of CMS OPPS Rate,61.98,100% of CMS OPPS Rate,61.98,219.4,111.6
Outpatient,Laboratory,86481,TB AG RESPONSE T-CELL SUSP,300,300,354,354% of CMS OPPS Rate,80.56,100% of Medicaid LA Fee Schedule,100,100% of CMS OPPS Rate,100,100% of CMS OPPS Rate,203.89,203.89% of BCBS Fee Schedule,210,70% of total Billed Charges,225,75% of total Billed Charges,180,180% OF CMS OPPS RATE,240,80% of total Billed Charges,350,350% of CMS Opps rate,102,102% of CMS Opps rate,229.5,76.5% of total billed charges,80.56,100% of Medicaid LA Fee Schedule,80.56,100% of Medicaid LA Fee Schedule,100,100% of CMS OPPS Rate,100,100% of CMS OPPS Rate,135,45% of total billed charges,210,70% of total billed charges,180,60% of total billed charges,100,100% of CMS OPPS Rate,90,90% OF UHC FEE SCHEDULE,210,70% of total billed charges,100,100% OF CMS OPPS Rate,230,230% OF CMS OPPS Rate,144,48% of total Billed charges,100,100% OF CMS OPPS Rate,270,90% of total Billed charges,80.56,100% of Medicaid LA Fee Schedule,80.56,100% of Medicaid LA Fee Schedule,80.56,100% of Medicaid LA Fee Schedule,80.56,100% of Medicaid LA Fee Schedule,80.56,100% of Medicaid LA Fee Schedule,80.56,100% of Medicaid LA Fee Schedule,100,100% of CMS OPPS Rate,100,100% of CMS OPPS Rate,100,100% of CMS OPPS Rate,100,100% of CMS OPPS Rate,100,100% of CMS OPPS Rate,100,100% of CMS OPPS Rate,100,100% of CMS OPPS Rate,100,100% of CMS OPPS Rate,80.56,354,180
Outpatient,Laboratory,86592,Blood test to screen for syphilis,300,80.55,15.11,354% of CMS OPPS Rate,4.27,100% of Medicaid LA Fee Schedule,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,10.75,203.89% of BCBS Fee Schedule,56.39,70% of total Billed Charges,60.41,75% of total Billed Charges,7.68,180% OF CMS OPPS RATE,64.44,80% of total Billed Charges,14.94,350% of CMS Opps rate,4.35,102% of CMS Opps rate,61.62,76.5% of total billed charges,4.27,100% of Medicaid LA Fee Schedule,4.27,100% of Medicaid LA Fee Schedule,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,36.25,45% of total billed charges,56.39,70% of total billed charges,48.33,60% of total billed charges,4.26,100% of CMS OPPS Rate,4.74,90% OF UHC FEE SCHEDULE,56.39,70% of total billed charges,4.26,100% OF CMS OPPS Rate,9.82,230% OF CMS OPPS Rate,38.66,48% of total Billed charges,4.26,100% OF CMS OPPS Rate,72.5,90% of total Billed charges,4.27,100% of Medicaid LA Fee Schedule,4.27,100% of Medicaid LA Fee Schedule,4.27,100% of Medicaid LA Fee Schedule,4.27,100% of Medicaid LA Fee Schedule,4.27,100% of Medicaid LA Fee Schedule,4.27,100% of Medicaid LA Fee Schedule,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,72.5,48.33
Outpatient,Laboratory,86593,RPR TITER,300,80.55,15.57,354% of CMS OPPS Rate,4.4,100% of Medicaid LA Fee Schedule,4.4,100% of CMS OPPS Rate,4.4,100% of CMS OPPS Rate,11.09,203.89% of BCBS Fee Schedule,56.39,70% of total Billed Charges,60.41,75% of total Billed Charges,7.92,180% OF CMS OPPS RATE,64.44,80% of total Billed Charges,15.4,350% of CMS Opps rate,4.48,102% of CMS Opps rate,61.62,76.5% of total billed charges,4.4,100% of Medicaid LA Fee Schedule,4.4,100% of Medicaid LA Fee Schedule,4.4,100% of CMS OPPS Rate,4.4,100% of CMS OPPS Rate,36.25,45% of total billed charges,56.39,70% of total billed charges,48.33,60% of total billed charges,4.4,100% of CMS OPPS Rate,4.9,90% OF UHC FEE SCHEDULE,56.39,70% of total billed charges,4.4,100% OF CMS OPPS Rate,10.12,230% OF CMS OPPS Rate,38.66,48% of total Billed charges,4.4,100% OF CMS OPPS Rate,72.5,90% of total Billed charges,4.4,100% of Medicaid LA Fee Schedule,4.4,100% of Medicaid LA Fee Schedule,4.4,100% of Medicaid LA Fee Schedule,4.4,100% of Medicaid LA Fee Schedule,4.4,100% of Medicaid LA Fee Schedule,4.4,100% of Medicaid LA Fee Schedule,4.4,100% of CMS OPPS Rate,4.4,100% of CMS OPPS Rate,4.4,100% of CMS OPPS Rate,4.4,100% of CMS OPPS Rate,4.4,100% of CMS OPPS Rate,4.4,100% of CMS OPPS Rate,4.4,100% of CMS OPPS Rate,4.4,100% of CMS OPPS Rate,4.4,72.5,48.33
Outpatient,Laboratory,86606,ASPERGILLUS ABS,300,50.6,53.27,354% of CMS OPPS Rate,15.05,100% of Medicaid LA Fee Schedule,15.05,100% of CMS OPPS Rate,15.05,100% of CMS OPPS Rate,37.9,203.89% of BCBS Fee Schedule,35.42,70% of total Billed Charges,37.95,75% of total Billed Charges,27.09,180% OF CMS OPPS RATE,40.48,80% of total Billed Charges,52.67,350% of CMS Opps rate,15.35,102% of CMS Opps rate,38.71,76.5% of total billed charges,15.05,100% of Medicaid LA Fee Schedule,15.05,100% of Medicaid LA Fee Schedule,15.05,100% of CMS OPPS Rate,15.05,100% of CMS OPPS Rate,22.77,45% of total billed charges,35.42,70% of total billed charges,30.36,60% of total billed charges,15.05,100% of CMS OPPS Rate,16.73,90% OF UHC FEE SCHEDULE,35.42,70% of total billed charges,15.05,100% OF CMS OPPS Rate,34.61,230% OF CMS OPPS Rate,24.29,48% of total Billed charges,15.05,100% OF CMS OPPS Rate,45.54,90% of total Billed charges,15.05,100% of Medicaid LA Fee Schedule,15.05,100% of Medicaid LA Fee Schedule,15.05,100% of Medicaid LA Fee Schedule,15.05,100% of Medicaid LA Fee Schedule,15.05,100% of Medicaid LA Fee Schedule,15.05,100% of Medicaid LA Fee Schedule,15.05,100% of CMS OPPS Rate,15.05,100% of CMS OPPS Rate,15.05,100% of CMS OPPS Rate,15.05,100% of CMS OPPS Rate,15.05,100% of CMS OPPS Rate,15.05,100% of CMS OPPS Rate,15.05,100% of CMS OPPS Rate,15.05,100% of CMS OPPS Rate,15.05,53.27,30.36
Outpatient,Laboratory,86609,"BACTERIUM ABS,IMMUNOASSAY",300,39,45.59,354% of CMS OPPS Rate,12.88,100% of Medicaid LA Fee Schedule,12.88,100% of CMS OPPS Rate,12.88,100% of CMS OPPS Rate,32.42,203.89% of BCBS Fee Schedule,27.3,70% of total Billed Charges,29.25,75% of total Billed Charges,23.18,180% OF CMS OPPS RATE,31.2,80% of total Billed Charges,45.08,350% of CMS Opps rate,13.13,102% of CMS Opps rate,29.84,76.5% of total billed charges,12.88,100% of Medicaid LA Fee Schedule,12.88,100% of Medicaid LA Fee Schedule,12.88,100% of CMS OPPS Rate,12.88,100% of CMS OPPS Rate,17.55,45% of total billed charges,27.3,70% of total billed charges,23.4,60% of total billed charges,12.88,100% of CMS OPPS Rate,14.31,90% OF UHC FEE SCHEDULE,27.3,70% of total billed charges,12.88,100% OF CMS OPPS Rate,29.62,230% OF CMS OPPS Rate,18.72,48% of total Billed charges,12.88,100% OF CMS OPPS Rate,35.1,90% of total Billed charges,12.88,100% of Medicaid LA Fee Schedule,12.88,100% of Medicaid LA Fee Schedule,12.88,100% of Medicaid LA Fee Schedule,12.88,100% of Medicaid LA Fee Schedule,12.88,100% of Medicaid LA Fee Schedule,12.88,100% of Medicaid LA Fee Schedule,12.88,100% of CMS OPPS Rate,12.88,100% of CMS OPPS Rate,12.88,100% of CMS OPPS Rate,12.88,100% of CMS OPPS Rate,12.88,100% of CMS OPPS Rate,12.88,100% of CMS OPPS Rate,12.88,100% of CMS OPPS Rate,12.88,100% of CMS OPPS Rate,12.88,45.59,23.4
Outpatient,Laboratory,86611,BARTONELLA ABS,300,96.3,36.03,354% of CMS OPPS Rate,10.18,100% of Medicaid LA Fee Schedule,10.18,100% of CMS OPPS Rate,10.18,100% of CMS OPPS Rate,25.61,203.89% of BCBS Fee Schedule,67.41,70% of total Billed Charges,72.23,75% of total Billed Charges,18.32,180% OF CMS OPPS RATE,77.04,80% of total Billed Charges,35.63,350% of CMS Opps rate,10.38,102% of CMS Opps rate,73.67,76.5% of total billed charges,10.18,100% of Medicaid LA Fee Schedule,10.18,100% of Medicaid LA Fee Schedule,10.18,100% of CMS OPPS Rate,10.18,100% of CMS OPPS Rate,43.34,45% of total billed charges,67.41,70% of total billed charges,57.78,60% of total billed charges,10.18,100% of CMS OPPS Rate,11.3,90% OF UHC FEE SCHEDULE,67.41,70% of total billed charges,10.18,100% OF CMS OPPS Rate,23.41,230% OF CMS OPPS Rate,46.22,48% of total Billed charges,10.18,100% OF CMS OPPS Rate,86.67,90% of total Billed charges,10.18,100% of Medicaid LA Fee Schedule,10.18,100% of Medicaid LA Fee Schedule,10.18,100% of Medicaid LA Fee Schedule,10.18,100% of Medicaid LA Fee Schedule,10.18,100% of Medicaid LA Fee Schedule,10.18,100% of Medicaid LA Fee Schedule,10.18,100% of CMS OPPS Rate,10.18,100% of CMS OPPS Rate,10.18,100% of CMS OPPS Rate,10.18,100% of CMS OPPS Rate,10.18,100% of CMS OPPS Rate,10.18,100% of CMS OPPS Rate,10.18,100% of CMS OPPS Rate,10.18,100% of CMS OPPS Rate,10.18,86.67,57.78
Outpatient,Laboratory,86612,ANTI-BLASTOMYCES AB,300,131.4,45.66,354% of CMS OPPS Rate,12.9,100% of Medicaid LA Fee Schedule,12.9,100% of CMS OPPS Rate,12.9,100% of CMS OPPS Rate,32.48,203.89% of BCBS Fee Schedule,91.98,70% of total Billed Charges,98.55,75% of total Billed Charges,23.22,180% OF CMS OPPS RATE,105.12,80% of total Billed Charges,45.15,350% of CMS Opps rate,13.15,102% of CMS Opps rate,100.52,76.5% of total billed charges,12.9,100% of Medicaid LA Fee Schedule,12.9,100% of Medicaid LA Fee Schedule,12.9,100% of CMS OPPS Rate,12.9,100% of CMS OPPS Rate,59.13,45% of total billed charges,91.98,70% of total billed charges,78.84,60% of total billed charges,12.9,100% of CMS OPPS Rate,14.34,90% OF UHC FEE SCHEDULE,91.98,70% of total billed charges,12.9,100% OF CMS OPPS Rate,29.67,230% OF CMS OPPS Rate,63.07,48% of total Billed charges,12.9,100% OF CMS OPPS Rate,118.26,90% of total Billed charges,12.9,100% of Medicaid LA Fee Schedule,12.9,100% of Medicaid LA Fee Schedule,12.9,100% of Medicaid LA Fee Schedule,12.9,100% of Medicaid LA Fee Schedule,12.9,100% of Medicaid LA Fee Schedule,12.9,100% of Medicaid LA Fee Schedule,12.9,100% of CMS OPPS Rate,12.9,100% of CMS OPPS Rate,12.9,100% of CMS OPPS Rate,12.9,100% of CMS OPPS Rate,12.9,100% of CMS OPPS Rate,12.9,100% of CMS OPPS Rate,12.9,100% of CMS OPPS Rate,12.9,100% of CMS OPPS Rate,12.9,118.26,78.84
Outpatient,Laboratory,86615,BORDETELLA P. ABS,300,40.7,46.69,354% of CMS OPPS Rate,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,33.19,203.89% of BCBS Fee Schedule,28.49,70% of total Billed Charges,30.53,75% of total Billed Charges,23.74,180% OF CMS OPPS RATE,32.56,80% of total Billed Charges,46.16,350% of CMS Opps rate,13.45,102% of CMS Opps rate,31.14,76.5% of total billed charges,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,18.32,45% of total billed charges,28.49,70% of total billed charges,24.42,60% of total billed charges,13.19,100% of CMS OPPS Rate,14.65,90% OF UHC FEE SCHEDULE,28.49,70% of total billed charges,13.19,100% OF CMS OPPS Rate,30.33,230% OF CMS OPPS Rate,19.54,48% of total Billed charges,13.19,100% OF CMS OPPS Rate,36.63,90% of total Billed charges,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,46.69,24.42
Outpatient,Laboratory,86617,BORRELIA B. ABS CONFIRM,300,54.45,54.83,354% of CMS OPPS Rate,15.49,100% of Medicaid LA Fee Schedule,15.49,100% of CMS OPPS Rate,15.49,100% of CMS OPPS Rate,39,203.89% of BCBS Fee Schedule,38.12,70% of total Billed Charges,40.84,75% of total Billed Charges,27.88,180% OF CMS OPPS RATE,43.56,80% of total Billed Charges,54.21,350% of CMS Opps rate,15.79,102% of CMS Opps rate,41.65,76.5% of total billed charges,15.49,100% of Medicaid LA Fee Schedule,15.49,100% of Medicaid LA Fee Schedule,15.49,100% of CMS OPPS Rate,15.49,100% of CMS OPPS Rate,24.5,45% of total billed charges,38.12,70% of total billed charges,32.67,60% of total billed charges,15.49,100% of CMS OPPS Rate,17.22,90% OF UHC FEE SCHEDULE,38.12,70% of total billed charges,15.49,100% OF CMS OPPS Rate,35.62,230% OF CMS OPPS Rate,26.14,48% of total Billed charges,15.49,100% OF CMS OPPS Rate,49.01,90% of total Billed charges,15.49,100% of Medicaid LA Fee Schedule,15.49,100% of Medicaid LA Fee Schedule,15.49,100% of Medicaid LA Fee Schedule,15.49,100% of Medicaid LA Fee Schedule,15.49,100% of Medicaid LA Fee Schedule,15.49,100% of Medicaid LA Fee Schedule,15.49,100% of CMS OPPS Rate,15.49,100% of CMS OPPS Rate,15.49,100% of CMS OPPS Rate,15.49,100% of CMS OPPS Rate,15.49,100% of CMS OPPS Rate,15.49,100% of CMS OPPS Rate,15.49,100% of CMS OPPS Rate,15.49,100% of CMS OPPS Rate,15.49,54.83,32.67
Outpatient,Laboratory,86618,BORRELIA B. ABS,300,152.35,60.28,354% of CMS OPPS Rate,17.03,100% of Medicaid LA Fee Schedule,17.03,100% of CMS OPPS Rate,17.03,100% of CMS OPPS Rate,42.86,203.89% of BCBS Fee Schedule,106.65,70% of total Billed Charges,114.26,75% of total Billed Charges,30.65,180% OF CMS OPPS RATE,121.88,80% of total Billed Charges,59.6,350% of CMS Opps rate,17.37,102% of CMS Opps rate,116.55,76.5% of total billed charges,17.03,100% of Medicaid LA Fee Schedule,17.03,100% of Medicaid LA Fee Schedule,17.03,100% of CMS OPPS Rate,17.03,100% of CMS OPPS Rate,68.56,45% of total billed charges,106.65,70% of total billed charges,91.41,60% of total billed charges,17.03,100% of CMS OPPS Rate,18.92,90% OF UHC FEE SCHEDULE,106.65,70% of total billed charges,17.03,100% OF CMS OPPS Rate,39.16,230% OF CMS OPPS Rate,73.13,48% of total Billed charges,17.03,100% OF CMS OPPS Rate,137.12,90% of total Billed charges,17.03,100% of Medicaid LA Fee Schedule,17.03,100% of Medicaid LA Fee Schedule,17.03,100% of Medicaid LA Fee Schedule,17.03,100% of Medicaid LA Fee Schedule,17.03,100% of Medicaid LA Fee Schedule,17.03,100% of Medicaid LA Fee Schedule,17.03,100% of CMS OPPS Rate,17.03,100% of CMS OPPS Rate,17.03,100% of CMS OPPS Rate,17.03,100% of CMS OPPS Rate,17.03,100% of CMS OPPS Rate,17.03,100% of CMS OPPS Rate,17.03,100% of CMS OPPS Rate,17.03,100% of CMS OPPS Rate,17.03,137.12,91.41
Outpatient,Laboratory,86622,BRUCELLA ABORTUS ABS,300,36,31.61,354% of CMS OPPS Rate,8.93,100% of Medicaid LA Fee Schedule,8.93,100% of CMS OPPS Rate,8.93,100% of CMS OPPS Rate,22.49,203.89% of BCBS Fee Schedule,25.2,70% of total Billed Charges,27,75% of total Billed Charges,16.07,180% OF CMS OPPS RATE,28.8,80% of total Billed Charges,31.25,350% of CMS Opps rate,9.1,102% of CMS Opps rate,27.54,76.5% of total billed charges,8.93,100% of Medicaid LA Fee Schedule,8.93,100% of Medicaid LA Fee Schedule,8.93,100% of CMS OPPS Rate,8.93,100% of CMS OPPS Rate,16.2,45% of total billed charges,25.2,70% of total billed charges,21.6,60% of total billed charges,8.93,100% of CMS OPPS Rate,9.93,90% OF UHC FEE SCHEDULE,25.2,70% of total billed charges,8.93,100% OF CMS OPPS Rate,20.53,230% OF CMS OPPS Rate,17.28,48% of total Billed charges,8.93,100% OF CMS OPPS Rate,32.4,90% of total Billed charges,8.93,100% of Medicaid LA Fee Schedule,8.93,100% of Medicaid LA Fee Schedule,8.93,100% of Medicaid LA Fee Schedule,8.93,100% of Medicaid LA Fee Schedule,8.93,100% of Medicaid LA Fee Schedule,8.93,100% of Medicaid LA Fee Schedule,8.93,100% of CMS OPPS Rate,8.93,100% of CMS OPPS Rate,8.93,100% of CMS OPPS Rate,8.93,100% of CMS OPPS Rate,8.93,100% of CMS OPPS Rate,8.93,100% of CMS OPPS Rate,8.93,100% of CMS OPPS Rate,8.93,100% of CMS OPPS Rate,8.93,32.4,21.6
Outpatient,Laboratory,86625,CAMPYLOBACTER ABS,300,63.45,46.44,354% of CMS OPPS Rate,13.12,100% of Medicaid LA Fee Schedule,13.12,100% of CMS OPPS Rate,13.12,100% of CMS OPPS Rate,33.03,203.89% of BCBS Fee Schedule,44.42,70% of total Billed Charges,47.59,75% of total Billed Charges,23.61,180% OF CMS OPPS RATE,50.76,80% of total Billed Charges,45.92,350% of CMS Opps rate,13.38,102% of CMS Opps rate,48.54,76.5% of total billed charges,13.12,100% of Medicaid LA Fee Schedule,13.12,100% of Medicaid LA Fee Schedule,13.12,100% of CMS OPPS Rate,13.12,100% of CMS OPPS Rate,28.55,45% of total billed charges,44.42,70% of total billed charges,38.07,60% of total billed charges,13.12,100% of CMS OPPS Rate,14.58,90% OF UHC FEE SCHEDULE,44.42,70% of total billed charges,13.12,100% OF CMS OPPS Rate,30.17,230% OF CMS OPPS Rate,30.46,48% of total Billed charges,13.12,100% OF CMS OPPS Rate,57.11,90% of total Billed charges,13.12,100% of Medicaid LA Fee Schedule,13.12,100% of Medicaid LA Fee Schedule,13.12,100% of Medicaid LA Fee Schedule,13.12,100% of Medicaid LA Fee Schedule,13.12,100% of Medicaid LA Fee Schedule,13.12,100% of Medicaid LA Fee Schedule,13.12,100% of CMS OPPS Rate,13.12,100% of CMS OPPS Rate,13.12,100% of CMS OPPS Rate,13.12,100% of CMS OPPS Rate,13.12,100% of CMS OPPS Rate,13.12,100% of CMS OPPS Rate,13.12,100% of CMS OPPS Rate,13.12,100% of CMS OPPS Rate,13.12,57.11,38.07
Outpatient,Laboratory,86631,CHLAMYDIA PNEUM. ABS,300,71.1,41.84,354% of CMS OPPS Rate,11.82,100% of Medicaid LA Fee Schedule,11.82,100% of CMS OPPS Rate,11.82,100% of CMS OPPS Rate,29.77,203.89% of BCBS Fee Schedule,49.77,70% of total Billed Charges,53.33,75% of total Billed Charges,21.27,180% OF CMS OPPS RATE,56.88,80% of total Billed Charges,41.37,350% of CMS Opps rate,12.05,102% of CMS Opps rate,54.39,76.5% of total billed charges,11.82,100% of Medicaid LA Fee Schedule,11.82,100% of Medicaid LA Fee Schedule,11.82,100% of CMS OPPS Rate,11.82,100% of CMS OPPS Rate,32,45% of total billed charges,49.77,70% of total billed charges,42.66,60% of total billed charges,11.82,100% of CMS OPPS Rate,13.14,90% OF UHC FEE SCHEDULE,49.77,70% of total billed charges,11.82,100% OF CMS OPPS Rate,27.18,230% OF CMS OPPS Rate,34.13,48% of total Billed charges,11.82,100% OF CMS OPPS Rate,63.99,90% of total Billed charges,11.82,100% of Medicaid LA Fee Schedule,11.82,100% of Medicaid LA Fee Schedule,11.82,100% of Medicaid LA Fee Schedule,11.82,100% of Medicaid LA Fee Schedule,11.82,100% of Medicaid LA Fee Schedule,11.82,100% of Medicaid LA Fee Schedule,11.82,100% of CMS OPPS Rate,11.82,100% of CMS OPPS Rate,11.82,100% of CMS OPPS Rate,11.82,100% of CMS OPPS Rate,11.82,100% of CMS OPPS Rate,11.82,100% of CMS OPPS Rate,11.82,100% of CMS OPPS Rate,11.82,100% of CMS OPPS Rate,11.82,63.99,42.66
Outpatient,Laboratory,86632,CHLAMYDIA PNEUM. IGM ABS,300,67.05,44.88,354% of CMS OPPS Rate,12.68,100% of Medicaid LA Fee Schedule,12.68,100% of CMS OPPS Rate,12.68,100% of CMS OPPS Rate,31.93,203.89% of BCBS Fee Schedule,46.94,70% of total Billed Charges,50.29,75% of total Billed Charges,22.82,180% OF CMS OPPS RATE,53.64,80% of total Billed Charges,44.38,350% of CMS Opps rate,12.93,102% of CMS Opps rate,51.29,76.5% of total billed charges,12.68,100% of Medicaid LA Fee Schedule,12.68,100% of Medicaid LA Fee Schedule,12.68,100% of CMS OPPS Rate,12.68,100% of CMS OPPS Rate,30.17,45% of total billed charges,46.94,70% of total billed charges,40.23,60% of total billed charges,12.68,100% of CMS OPPS Rate,14.09,90% OF UHC FEE SCHEDULE,46.94,70% of total billed charges,12.68,100% OF CMS OPPS Rate,29.16,230% OF CMS OPPS Rate,32.18,48% of total Billed charges,12.68,100% OF CMS OPPS Rate,60.35,90% of total Billed charges,12.68,100% of Medicaid LA Fee Schedule,12.68,100% of Medicaid LA Fee Schedule,12.68,100% of Medicaid LA Fee Schedule,12.68,100% of Medicaid LA Fee Schedule,12.68,100% of Medicaid LA Fee Schedule,12.68,100% of Medicaid LA Fee Schedule,12.68,100% of CMS OPPS Rate,12.68,100% of CMS OPPS Rate,12.68,100% of CMS OPPS Rate,12.68,100% of CMS OPPS Rate,12.68,100% of CMS OPPS Rate,12.68,100% of CMS OPPS Rate,12.68,100% of CMS OPPS Rate,12.68,100% of CMS OPPS Rate,12.68,60.35,40.23
Outpatient,Laboratory,86635,ANTIBODY COCCIDIOIDES,300,41,40.6,354% of CMS OPPS Rate,11.47,100% of Medicaid LA Fee Schedule,11.47,100% of CMS OPPS Rate,11.47,100% of CMS OPPS Rate,28.89,203.89% of BCBS Fee Schedule,28.7,70% of total Billed Charges,30.75,75% of total Billed Charges,20.64,180% OF CMS OPPS RATE,32.8,80% of total Billed Charges,40.14,350% of CMS Opps rate,11.69,102% of CMS Opps rate,31.37,76.5% of total billed charges,11.47,100% of Medicaid LA Fee Schedule,11.47,100% of Medicaid LA Fee Schedule,11.47,100% of CMS OPPS Rate,11.47,100% of CMS OPPS Rate,18.45,45% of total billed charges,28.7,70% of total billed charges,24.6,60% of total billed charges,11.47,100% of CMS OPPS Rate,12.75,90% OF UHC FEE SCHEDULE,28.7,70% of total billed charges,11.47,100% OF CMS OPPS Rate,26.38,230% OF CMS OPPS Rate,19.68,48% of total Billed charges,11.47,100% OF CMS OPPS Rate,36.9,90% of total Billed charges,11.47,100% of Medicaid LA Fee Schedule,11.47,100% of Medicaid LA Fee Schedule,11.47,100% of Medicaid LA Fee Schedule,11.47,100% of Medicaid LA Fee Schedule,11.47,100% of Medicaid LA Fee Schedule,11.47,100% of Medicaid LA Fee Schedule,11.47,100% of CMS OPPS Rate,11.47,100% of CMS OPPS Rate,11.47,100% of CMS OPPS Rate,11.47,100% of CMS OPPS Rate,11.47,100% of CMS OPPS Rate,11.47,100% of CMS OPPS Rate,11.47,100% of CMS OPPS Rate,11.47,100% of CMS OPPS Rate,11.47,40.6,24.6
Outpatient,Laboratory,86638,ANTIBODY COXIELLA BURNETI,300,80,42.9,354% of CMS OPPS Rate,12.12,100% of Medicaid LA Fee Schedule,12.12,100% of CMS OPPS Rate,12.12,100% of CMS OPPS Rate,30.52,203.89% of BCBS Fee Schedule,56,70% of total Billed Charges,60,75% of total Billed Charges,21.81,180% OF CMS OPPS RATE,64,80% of total Billed Charges,42.42,350% of CMS Opps rate,12.36,102% of CMS Opps rate,61.2,76.5% of total billed charges,12.12,100% of Medicaid LA Fee Schedule,12.12,100% of Medicaid LA Fee Schedule,12.12,100% of CMS OPPS Rate,12.12,100% of CMS OPPS Rate,36,45% of total billed charges,56,70% of total billed charges,48,60% of total billed charges,12.12,100% of CMS OPPS Rate,13.47,90% OF UHC FEE SCHEDULE,56,70% of total billed charges,12.12,100% OF CMS OPPS Rate,27.87,230% OF CMS OPPS Rate,38.4,48% of total Billed charges,12.12,100% OF CMS OPPS Rate,72,90% of total Billed charges,12.12,100% of Medicaid LA Fee Schedule,12.12,100% of Medicaid LA Fee Schedule,12.12,100% of Medicaid LA Fee Schedule,12.12,100% of Medicaid LA Fee Schedule,12.12,100% of Medicaid LA Fee Schedule,12.12,100% of Medicaid LA Fee Schedule,12.12,100% of CMS OPPS Rate,12.12,100% of CMS OPPS Rate,12.12,100% of CMS OPPS Rate,12.12,100% of CMS OPPS Rate,12.12,100% of CMS OPPS Rate,12.12,100% of CMS OPPS Rate,12.12,100% of CMS OPPS Rate,12.12,100% of CMS OPPS Rate,12.12,72,48
Outpatient,Laboratory,86641,CRYTOCOCCUS AG AGGLU,300,72.5,51.01,354% of CMS OPPS Rate,14.41,100% of Medicaid LA Fee Schedule,14.41,100% of CMS OPPS Rate,14.41,100% of CMS OPPS Rate,36.27,203.89% of BCBS Fee Schedule,50.75,70% of total Billed Charges,54.38,75% of total Billed Charges,25.93,180% OF CMS OPPS RATE,58,80% of total Billed Charges,50.43,350% of CMS Opps rate,14.69,102% of CMS Opps rate,55.46,76.5% of total billed charges,14.41,100% of Medicaid LA Fee Schedule,14.41,100% of Medicaid LA Fee Schedule,14.41,100% of CMS OPPS Rate,14.41,100% of CMS OPPS Rate,32.63,45% of total billed charges,50.75,70% of total billed charges,43.5,60% of total billed charges,14.41,100% of CMS OPPS Rate,16.01,90% OF UHC FEE SCHEDULE,50.75,70% of total billed charges,14.41,100% OF CMS OPPS Rate,33.14,230% OF CMS OPPS Rate,34.8,48% of total Billed charges,14.41,100% OF CMS OPPS Rate,65.25,90% of total Billed charges,14.41,100% of Medicaid LA Fee Schedule,14.41,100% of Medicaid LA Fee Schedule,14.41,100% of Medicaid LA Fee Schedule,14.41,100% of Medicaid LA Fee Schedule,14.41,100% of Medicaid LA Fee Schedule,14.41,100% of Medicaid LA Fee Schedule,14.41,100% of CMS OPPS Rate,14.41,100% of CMS OPPS Rate,14.41,100% of CMS OPPS Rate,14.41,100% of CMS OPPS Rate,14.41,100% of CMS OPPS Rate,14.41,100% of CMS OPPS Rate,14.41,100% of CMS OPPS Rate,14.41,100% of CMS OPPS Rate,14.41,65.25,43.5
Outpatient,Laboratory,86644,Blood test to monitor for cytomegalovirus,300,106.15,50.94,354% of CMS OPPS Rate,14.39,100% of Medicaid LA Fee Schedule,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,36.23,203.89% of BCBS Fee Schedule,74.31,70% of total Billed Charges,79.61,75% of total Billed Charges,25.9,180% OF CMS OPPS RATE,84.92,80% of total Billed Charges,50.36,350% of CMS Opps rate,14.67,102% of CMS Opps rate,81.2,76.5% of total billed charges,14.39,100% of Medicaid LA Fee Schedule,14.39,100% of Medicaid LA Fee Schedule,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,47.77,45% of total billed charges,74.31,70% of total billed charges,63.69,60% of total billed charges,14.39,100% of CMS OPPS Rate,15.99,90% OF UHC FEE SCHEDULE,74.31,70% of total billed charges,14.39,100% OF CMS OPPS Rate,33.09,230% OF CMS OPPS Rate,50.95,48% of total Billed charges,14.39,100% OF CMS OPPS Rate,95.54,90% of total Billed charges,14.39,100% of Medicaid LA Fee Schedule,14.39,100% of Medicaid LA Fee Schedule,14.39,100% of Medicaid LA Fee Schedule,14.39,100% of Medicaid LA Fee Schedule,14.39,100% of Medicaid LA Fee Schedule,14.39,100% of Medicaid LA Fee Schedule,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,14.39,95.54,63.69
Outpatient,Laboratory,86645,"ANTI-CMV AB,IGM",300,106.15,59.64,354% of CMS OPPS Rate,16.85,100% of Medicaid LA Fee Schedule,16.85,100% of CMS OPPS Rate,16.85,100% of CMS OPPS Rate,42.41,203.89% of BCBS Fee Schedule,74.31,70% of total Billed Charges,79.61,75% of total Billed Charges,30.33,180% OF CMS OPPS RATE,84.92,80% of total Billed Charges,58.97,350% of CMS Opps rate,17.18,102% of CMS Opps rate,81.2,76.5% of total billed charges,16.85,100% of Medicaid LA Fee Schedule,16.85,100% of Medicaid LA Fee Schedule,16.85,100% of CMS OPPS Rate,16.85,100% of CMS OPPS Rate,47.77,45% of total billed charges,74.31,70% of total billed charges,63.69,60% of total billed charges,16.85,100% of CMS OPPS Rate,18.72,90% OF UHC FEE SCHEDULE,74.31,70% of total billed charges,16.85,100% OF CMS OPPS Rate,38.75,230% OF CMS OPPS Rate,50.95,48% of total Billed charges,16.85,100% OF CMS OPPS Rate,95.54,90% of total Billed charges,16.85,100% of Medicaid LA Fee Schedule,16.85,100% of Medicaid LA Fee Schedule,16.85,100% of Medicaid LA Fee Schedule,16.85,100% of Medicaid LA Fee Schedule,16.85,100% of Medicaid LA Fee Schedule,16.85,100% of Medicaid LA Fee Schedule,16.85,100% of CMS OPPS Rate,16.85,100% of CMS OPPS Rate,16.85,100% of CMS OPPS Rate,16.85,100% of CMS OPPS Rate,16.85,100% of CMS OPPS Rate,16.85,100% of CMS OPPS Rate,16.85,100% of CMS OPPS Rate,16.85,100% of CMS OPPS Rate,16.85,95.54,63.69
Outpatient,Laboratory,86648,DIPTHERIA TOXOID IGG ABS,300,54.9,53.84,354% of CMS OPPS Rate,15.21,100% of Medicaid LA Fee Schedule,15.21,100% of CMS OPPS Rate,15.21,100% of CMS OPPS Rate,38.27,203.89% of BCBS Fee Schedule,38.43,70% of total Billed Charges,41.18,75% of total Billed Charges,27.37,180% OF CMS OPPS RATE,43.92,80% of total Billed Charges,53.23,350% of CMS Opps rate,15.51,102% of CMS Opps rate,42,76.5% of total billed charges,15.21,100% of Medicaid LA Fee Schedule,15.21,100% of Medicaid LA Fee Schedule,15.21,100% of CMS OPPS Rate,15.21,100% of CMS OPPS Rate,24.71,45% of total billed charges,38.43,70% of total billed charges,32.94,60% of total billed charges,15.21,100% of CMS OPPS Rate,16.89,90% OF UHC FEE SCHEDULE,38.43,70% of total billed charges,15.21,100% OF CMS OPPS Rate,34.98,230% OF CMS OPPS Rate,26.35,48% of total Billed charges,15.21,100% OF CMS OPPS Rate,49.41,90% of total Billed charges,15.21,100% of Medicaid LA Fee Schedule,15.21,100% of Medicaid LA Fee Schedule,15.21,100% of Medicaid LA Fee Schedule,15.21,100% of Medicaid LA Fee Schedule,15.21,100% of Medicaid LA Fee Schedule,15.21,100% of Medicaid LA Fee Schedule,15.21,100% of CMS OPPS Rate,15.21,100% of CMS OPPS Rate,15.21,100% of CMS OPPS Rate,15.21,100% of CMS OPPS Rate,15.21,100% of CMS OPPS Rate,15.21,100% of CMS OPPS Rate,15.21,100% of CMS OPPS Rate,15.21,100% of CMS OPPS Rate,15.21,53.84,32.94
Outpatient,Laboratory,86651,CALIF LA CROSSE VIRUS ENC,300,31.95,46.69,354% of CMS OPPS Rate,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,33.19,203.89% of BCBS Fee Schedule,22.37,70% of total Billed Charges,23.96,75% of total Billed Charges,23.74,180% OF CMS OPPS RATE,25.56,80% of total Billed Charges,46.16,350% of CMS Opps rate,13.45,102% of CMS Opps rate,24.44,76.5% of total billed charges,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,14.38,45% of total billed charges,22.37,70% of total billed charges,19.17,60% of total billed charges,13.19,100% of CMS OPPS Rate,14.65,90% OF UHC FEE SCHEDULE,22.37,70% of total billed charges,13.19,100% OF CMS OPPS Rate,30.33,230% OF CMS OPPS Rate,15.34,48% of total Billed charges,13.19,100% OF CMS OPPS Rate,28.76,90% of total Billed charges,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,46.69,19.17
Outpatient,Laboratory,86652,EASTERN EQUINE ENCEPH ABS,300,31.95,46.69,354% of CMS OPPS Rate,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,33.19,203.89% of BCBS Fee Schedule,22.37,70% of total Billed Charges,23.96,75% of total Billed Charges,23.74,180% OF CMS OPPS RATE,25.56,80% of total Billed Charges,46.16,350% of CMS Opps rate,13.45,102% of CMS Opps rate,24.44,76.5% of total billed charges,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,14.38,45% of total billed charges,22.37,70% of total billed charges,19.17,60% of total billed charges,13.19,100% of CMS OPPS Rate,14.65,90% OF UHC FEE SCHEDULE,22.37,70% of total billed charges,13.19,100% OF CMS OPPS Rate,30.33,230% OF CMS OPPS Rate,15.34,48% of total Billed charges,13.19,100% OF CMS OPPS Rate,28.76,90% of total Billed charges,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,46.69,19.17
Outpatient,Laboratory,86653,ST LOUIS ENCEPH. ABS,300,31.95,46.69,354% of CMS OPPS Rate,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,33.19,203.89% of BCBS Fee Schedule,22.37,70% of total Billed Charges,23.96,75% of total Billed Charges,23.74,180% OF CMS OPPS RATE,25.56,80% of total Billed Charges,46.16,350% of CMS Opps rate,13.45,102% of CMS Opps rate,24.44,76.5% of total billed charges,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,14.38,45% of total billed charges,22.37,70% of total billed charges,19.17,60% of total billed charges,13.19,100% of CMS OPPS Rate,14.65,90% OF UHC FEE SCHEDULE,22.37,70% of total billed charges,13.19,100% OF CMS OPPS Rate,30.33,230% OF CMS OPPS Rate,15.34,48% of total Billed charges,13.19,100% OF CMS OPPS Rate,28.76,90% of total Billed charges,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,46.69,19.17
Outpatient,Laboratory,86654,WESTERN EQUINE ENCEPH ABS,300,31.95,46.69,354% of CMS OPPS Rate,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,33.19,203.89% of BCBS Fee Schedule,22.37,70% of total Billed Charges,23.96,75% of total Billed Charges,23.74,180% OF CMS OPPS RATE,25.56,80% of total Billed Charges,46.16,350% of CMS Opps rate,13.45,102% of CMS Opps rate,24.44,76.5% of total billed charges,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,14.38,45% of total billed charges,22.37,70% of total billed charges,19.17,60% of total billed charges,13.19,100% of CMS OPPS Rate,14.65,90% OF UHC FEE SCHEDULE,22.37,70% of total billed charges,13.19,100% OF CMS OPPS Rate,30.33,230% OF CMS OPPS Rate,15.34,48% of total Billed charges,13.19,100% OF CMS OPPS Rate,28.76,90% of total Billed charges,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,46.69,19.17
Outpatient,Laboratory,86658,COXSACKIE ENTEROVIRUS EA,300,74.5,46.12,354% of CMS OPPS Rate,13.03,100% of Medicaid LA Fee Schedule,13.03,100% of CMS OPPS Rate,13.03,100% of CMS OPPS Rate,32.79,203.89% of BCBS Fee Schedule,52.15,70% of total Billed Charges,55.88,75% of total Billed Charges,23.45,180% OF CMS OPPS RATE,59.6,80% of total Billed Charges,45.6,350% of CMS Opps rate,13.29,102% of CMS Opps rate,56.99,76.5% of total billed charges,13.03,100% of Medicaid LA Fee Schedule,13.03,100% of Medicaid LA Fee Schedule,13.03,100% of CMS OPPS Rate,13.03,100% of CMS OPPS Rate,33.53,45% of total billed charges,52.15,70% of total billed charges,44.7,60% of total billed charges,13.03,100% of CMS OPPS Rate,14.47,90% OF UHC FEE SCHEDULE,52.15,70% of total billed charges,13.03,100% OF CMS OPPS Rate,29.96,230% OF CMS OPPS Rate,35.76,48% of total Billed charges,13.03,100% OF CMS OPPS Rate,67.05,90% of total Billed charges,13.03,100% of Medicaid LA Fee Schedule,13.03,100% of Medicaid LA Fee Schedule,13.03,100% of Medicaid LA Fee Schedule,13.03,100% of Medicaid LA Fee Schedule,13.03,100% of Medicaid LA Fee Schedule,13.03,100% of Medicaid LA Fee Schedule,13.03,100% of CMS OPPS Rate,13.03,100% of CMS OPPS Rate,13.03,100% of CMS OPPS Rate,13.03,100% of CMS OPPS Rate,13.03,100% of CMS OPPS Rate,13.03,100% of CMS OPPS Rate,13.03,100% of CMS OPPS Rate,13.03,100% of CMS OPPS Rate,13.03,67.05,44.7
Outpatient,Laboratory,86663,EBV PNL (AB EARLY AG),300,158.4,46.44,354% of CMS OPPS Rate,13.12,100% of Medicaid LA Fee Schedule,13.12,100% of CMS OPPS Rate,13.12,100% of CMS OPPS Rate,33.03,203.89% of BCBS Fee Schedule,110.88,70% of total Billed Charges,118.8,75% of total Billed Charges,23.61,180% OF CMS OPPS RATE,126.72,80% of total Billed Charges,45.92,350% of CMS Opps rate,13.38,102% of CMS Opps rate,121.18,76.5% of total billed charges,13.12,100% of Medicaid LA Fee Schedule,13.12,100% of Medicaid LA Fee Schedule,13.12,100% of CMS OPPS Rate,13.12,100% of CMS OPPS Rate,71.28,45% of total billed charges,110.88,70% of total billed charges,95.04,60% of total billed charges,13.12,100% of CMS OPPS Rate,14.58,90% OF UHC FEE SCHEDULE,110.88,70% of total billed charges,13.12,100% OF CMS OPPS Rate,30.17,230% OF CMS OPPS Rate,76.03,48% of total Billed charges,13.12,100% OF CMS OPPS Rate,142.56,90% of total Billed charges,13.12,100% of Medicaid LA Fee Schedule,13.12,100% of Medicaid LA Fee Schedule,13.12,100% of Medicaid LA Fee Schedule,13.12,100% of Medicaid LA Fee Schedule,13.12,100% of Medicaid LA Fee Schedule,13.12,100% of Medicaid LA Fee Schedule,13.12,100% of CMS OPPS Rate,13.12,100% of CMS OPPS Rate,13.12,100% of CMS OPPS Rate,13.12,100% of CMS OPPS Rate,13.12,100% of CMS OPPS Rate,13.12,100% of CMS OPPS Rate,13.12,100% of CMS OPPS Rate,13.12,100% of CMS OPPS Rate,13.12,142.56,95.04
Outpatient,Laboratory,86664,EBV ANTIGEN,300,158.4,54.12,354% of CMS OPPS Rate,15.29,100% of Medicaid LA Fee Schedule,15.29,100% of CMS OPPS Rate,15.29,100% of CMS OPPS Rate,38.49,203.89% of BCBS Fee Schedule,110.88,70% of total Billed Charges,118.8,75% of total Billed Charges,27.52,180% OF CMS OPPS RATE,126.72,80% of total Billed Charges,53.51,350% of CMS Opps rate,15.59,102% of CMS Opps rate,121.18,76.5% of total billed charges,15.29,100% of Medicaid LA Fee Schedule,15.29,100% of Medicaid LA Fee Schedule,15.29,100% of CMS OPPS Rate,15.29,100% of CMS OPPS Rate,71.28,45% of total billed charges,110.88,70% of total billed charges,95.04,60% of total billed charges,15.29,100% of CMS OPPS Rate,16.99,90% OF UHC FEE SCHEDULE,110.88,70% of total billed charges,15.29,100% OF CMS OPPS Rate,35.16,230% OF CMS OPPS Rate,76.03,48% of total Billed charges,15.29,100% OF CMS OPPS Rate,142.56,90% of total Billed charges,15.29,100% of Medicaid LA Fee Schedule,15.29,100% of Medicaid LA Fee Schedule,15.29,100% of Medicaid LA Fee Schedule,15.29,100% of Medicaid LA Fee Schedule,15.29,100% of Medicaid LA Fee Schedule,15.29,100% of Medicaid LA Fee Schedule,15.29,100% of CMS OPPS Rate,15.29,100% of CMS OPPS Rate,15.29,100% of CMS OPPS Rate,15.29,100% of CMS OPPS Rate,15.29,100% of CMS OPPS Rate,15.29,100% of CMS OPPS Rate,15.29,100% of CMS OPPS Rate,15.29,100% of CMS OPPS Rate,15.29,142.56,95.04
Outpatient,Laboratory,86665,Blood test to diagnose mononucleosis,300,158.4,64.21,354% of CMS OPPS Rate,18.14,100% of Medicaid LA Fee Schedule,18.14,100% of CMS OPPS Rate,18.14,100% of CMS OPPS Rate,45.67,203.89% of BCBS Fee Schedule,110.88,70% of total Billed Charges,118.8,75% of total Billed Charges,32.65,180% OF CMS OPPS RATE,126.72,80% of total Billed Charges,63.49,350% of CMS Opps rate,18.5,102% of CMS Opps rate,121.18,76.5% of total billed charges,18.14,100% of Medicaid LA Fee Schedule,18.14,100% of Medicaid LA Fee Schedule,18.14,100% of CMS OPPS Rate,18.14,100% of CMS OPPS Rate,71.28,45% of total billed charges,110.88,70% of total billed charges,95.04,60% of total billed charges,18.14,100% of CMS OPPS Rate,20.16,90% OF UHC FEE SCHEDULE,110.88,70% of total billed charges,18.14,100% OF CMS OPPS Rate,41.72,230% OF CMS OPPS Rate,76.03,48% of total Billed charges,18.14,100% OF CMS OPPS Rate,142.56,90% of total Billed charges,18.14,100% of Medicaid LA Fee Schedule,18.14,100% of Medicaid LA Fee Schedule,18.14,100% of Medicaid LA Fee Schedule,18.14,100% of Medicaid LA Fee Schedule,18.14,100% of Medicaid LA Fee Schedule,18.14,100% of Medicaid LA Fee Schedule,18.14,100% of CMS OPPS Rate,18.14,100% of CMS OPPS Rate,18.14,100% of CMS OPPS Rate,18.14,100% of CMS OPPS Rate,18.14,100% of CMS OPPS Rate,18.14,100% of CMS OPPS Rate,18.14,100% of CMS OPPS Rate,18.14,100% of CMS OPPS Rate,18.14,142.56,95.04
Outpatient,Laboratory,86666,EHRLICHIA ABS,300,31.95,36.03,354% of CMS OPPS Rate,10.18,100% of Medicaid LA Fee Schedule,10.18,100% of CMS OPPS Rate,10.18,100% of CMS OPPS Rate,25.61,203.89% of BCBS Fee Schedule,22.37,70% of total Billed Charges,23.96,75% of total Billed Charges,18.32,180% OF CMS OPPS RATE,25.56,80% of total Billed Charges,35.63,350% of CMS Opps rate,10.38,102% of CMS Opps rate,24.44,76.5% of total billed charges,10.18,100% of Medicaid LA Fee Schedule,10.18,100% of Medicaid LA Fee Schedule,10.18,100% of CMS OPPS Rate,10.18,100% of CMS OPPS Rate,14.38,45% of total billed charges,22.37,70% of total billed charges,19.17,60% of total billed charges,10.18,100% of CMS OPPS Rate,11.3,90% OF UHC FEE SCHEDULE,22.37,70% of total billed charges,10.18,100% OF CMS OPPS Rate,23.41,230% OF CMS OPPS Rate,15.34,48% of total Billed charges,10.18,100% OF CMS OPPS Rate,28.76,90% of total Billed charges,10.18,100% of Medicaid LA Fee Schedule,10.18,100% of Medicaid LA Fee Schedule,10.18,100% of Medicaid LA Fee Schedule,10.18,100% of Medicaid LA Fee Schedule,10.18,100% of Medicaid LA Fee Schedule,10.18,100% of Medicaid LA Fee Schedule,10.18,100% of CMS OPPS Rate,10.18,100% of CMS OPPS Rate,10.18,100% of CMS OPPS Rate,10.18,100% of CMS OPPS Rate,10.18,100% of CMS OPPS Rate,10.18,100% of CMS OPPS Rate,10.18,100% of CMS OPPS Rate,10.18,100% of CMS OPPS Rate,10.18,36.03,19.17
Outpatient,Laboratory,86668,FEBRILE AGGL (FRANC TULR),300,87,50.12,354% of CMS OPPS Rate,13.42,100% of Medicaid LA Fee Schedule,14.16,100% of CMS OPPS Rate,14.16,100% of CMS OPPS Rate,28.87,203.89% of BCBS Fee Schedule,60.9,70% of total Billed Charges,65.25,75% of total Billed Charges,25.48,180% OF CMS OPPS RATE,69.6,80% of total Billed Charges,49.56,350% of CMS Opps rate,14.44,102% of CMS Opps rate,66.56,76.5% of total billed charges,13.42,100% of Medicaid LA Fee Schedule,13.42,100% of Medicaid LA Fee Schedule,14.16,100% of CMS OPPS Rate,14.16,100% of CMS OPPS Rate,39.15,45% of total billed charges,60.9,70% of total billed charges,52.2,60% of total billed charges,14.16,100% of CMS OPPS Rate,12.74,90% OF UHC FEE SCHEDULE,60.9,70% of total billed charges,14.16,100% OF CMS OPPS Rate,32.56,230% OF CMS OPPS Rate,41.76,48% of total Billed charges,14.16,100% OF CMS OPPS Rate,78.3,90% of total Billed charges,13.42,100% of Medicaid LA Fee Schedule,13.42,100% of Medicaid LA Fee Schedule,13.42,100% of Medicaid LA Fee Schedule,13.42,100% of Medicaid LA Fee Schedule,13.42,100% of Medicaid LA Fee Schedule,13.42,100% of Medicaid LA Fee Schedule,14.16,100% of CMS OPPS Rate,14.16,100% of CMS OPPS Rate,14.16,100% of CMS OPPS Rate,14.16,100% of CMS OPPS Rate,14.16,100% of CMS OPPS Rate,14.16,100% of CMS OPPS Rate,14.16,100% of CMS OPPS Rate,14.16,100% of CMS OPPS Rate,12.74,78.3,52.2
Outpatient,Laboratory,86671,SACCHAROMYCES CEREVIS.ABS,300,128.15,43.36,354% of CMS OPPS Rate,12.25,100% of Medicaid LA Fee Schedule,12.25,100% of CMS OPPS Rate,12.25,100% of CMS OPPS Rate,30.85,203.89% of BCBS Fee Schedule,89.71,70% of total Billed Charges,96.11,75% of total Billed Charges,22.05,180% OF CMS OPPS RATE,102.52,80% of total Billed Charges,42.87,350% of CMS Opps rate,12.49,102% of CMS Opps rate,98.03,76.5% of total billed charges,12.25,100% of Medicaid LA Fee Schedule,12.25,100% of Medicaid LA Fee Schedule,12.25,100% of CMS OPPS Rate,12.25,100% of CMS OPPS Rate,57.67,45% of total billed charges,89.71,70% of total billed charges,76.89,60% of total billed charges,12.25,100% of CMS OPPS Rate,13.62,90% OF UHC FEE SCHEDULE,89.71,70% of total billed charges,12.25,100% OF CMS OPPS Rate,28.17,230% OF CMS OPPS Rate,61.51,48% of total Billed charges,12.25,100% OF CMS OPPS Rate,115.34,90% of total Billed charges,12.25,100% of Medicaid LA Fee Schedule,12.25,100% of Medicaid LA Fee Schedule,12.25,100% of Medicaid LA Fee Schedule,12.25,100% of Medicaid LA Fee Schedule,12.25,100% of Medicaid LA Fee Schedule,12.25,100% of Medicaid LA Fee Schedule,12.25,100% of CMS OPPS Rate,12.25,100% of CMS OPPS Rate,12.25,100% of CMS OPPS Rate,12.25,100% of CMS OPPS Rate,12.25,100% of CMS OPPS Rate,12.25,100% of CMS OPPS Rate,12.25,100% of CMS OPPS Rate,12.25,100% of CMS OPPS Rate,12.25,115.34,76.89
Outpatient,Laboratory,86677,Blood test to if peptic ulcers are caused by a certain bacterium,300,55.55,59.64,354% of CMS OPPS Rate,14.15,100% of Medicaid LA Fee Schedule,16.85,100% of CMS OPPS Rate,16.85,100% of CMS OPPS Rate,36.52,203.89% of BCBS Fee Schedule,N/A,Not Applicable,41.66,75% of total Billed Charges,30.33,180% OF CMS OPPS RATE,44.44,80% of total Billed Charges,58.97,350% of CMS Opps rate,17.18,102% of CMS Opps rate,42.5,76.5% of total billed charges,14.15,100% of Medicaid LA Fee Schedule,14.15,100% of Medicaid LA Fee Schedule,16.85,100% of CMS OPPS Rate,16.85,100% of CMS OPPS Rate,25,45% of total billed charges,38.89,70% of total billed charges,33.33,60% of total billed charges,16.85,100% of CMS OPPS Rate,16.12,90% OF UHC FEE SCHEDULE,38.89,70% of total billed charges,16.85,100% OF CMS OPPS Rate,38.75,230% OF CMS OPPS Rate,26.66,48% of total Billed charges,16.85,100% OF CMS OPPS Rate,50,90% of total Billed charges,14.15,100% of Medicaid LA Fee Schedule,14.15,100% of Medicaid LA Fee Schedule,14.15,100% of Medicaid LA Fee Schedule,14.15,100% of Medicaid LA Fee Schedule,14.15,100% of Medicaid LA Fee Schedule,14.15,100% of Medicaid LA Fee Schedule,16.85,100% of CMS OPPS Rate,16.85,100% of CMS OPPS Rate,16.85,100% of CMS OPPS Rate,16.85,100% of CMS OPPS Rate,16.85,100% of CMS OPPS Rate,16.85,100% of CMS OPPS Rate,16.85,100% of CMS OPPS Rate,16.85,100% of CMS OPPS Rate,14.15,59.64,33.33
Outpatient,Laboratory,86682,"STRONGYLOIDES, IGG ABS",300,108.9,46.05,354% of CMS OPPS Rate,13.01,100% of Medicaid LA Fee Schedule,13.01,100% of CMS OPPS Rate,13.01,100% of CMS OPPS Rate,32.74,203.89% of BCBS Fee Schedule,76.23,70% of total Billed Charges,81.68,75% of total Billed Charges,23.41,180% OF CMS OPPS RATE,87.12,80% of total Billed Charges,45.53,350% of CMS Opps rate,13.27,102% of CMS Opps rate,83.31,76.5% of total billed charges,13.01,100% of Medicaid LA Fee Schedule,13.01,100% of Medicaid LA Fee Schedule,13.01,100% of CMS OPPS Rate,13.01,100% of CMS OPPS Rate,49.01,45% of total billed charges,76.23,70% of total billed charges,65.34,60% of total billed charges,13.01,100% of CMS OPPS Rate,14.45,90% OF UHC FEE SCHEDULE,76.23,70% of total billed charges,13.01,100% OF CMS OPPS Rate,29.92,230% OF CMS OPPS Rate,52.27,48% of total Billed charges,13.01,100% OF CMS OPPS Rate,98.01,90% of total Billed charges,13.01,100% of Medicaid LA Fee Schedule,13.01,100% of Medicaid LA Fee Schedule,13.01,100% of Medicaid LA Fee Schedule,13.01,100% of Medicaid LA Fee Schedule,13.01,100% of Medicaid LA Fee Schedule,13.01,100% of Medicaid LA Fee Schedule,13.01,100% of CMS OPPS Rate,13.01,100% of CMS OPPS Rate,13.01,100% of CMS OPPS Rate,13.01,100% of CMS OPPS Rate,13.01,100% of CMS OPPS Rate,13.01,100% of CMS OPPS Rate,13.01,100% of CMS OPPS Rate,13.01,100% of CMS OPPS Rate,13.01,98.01,65.34
Outpatient,Laboratory,86684,HAEMOPHILUS INF. B ABS,300,189.9,56.07,354% of CMS OPPS Rate,15.84,100% of Medicaid LA Fee Schedule,15.84,100% of CMS OPPS Rate,15.84,100% of CMS OPPS Rate,39.88,203.89% of BCBS Fee Schedule,132.93,70% of total Billed Charges,142.43,75% of total Billed Charges,28.51,180% OF CMS OPPS RATE,151.92,80% of total Billed Charges,55.44,350% of CMS Opps rate,16.15,102% of CMS Opps rate,145.27,76.5% of total billed charges,15.84,100% of Medicaid LA Fee Schedule,15.84,100% of Medicaid LA Fee Schedule,15.84,100% of CMS OPPS Rate,15.84,100% of CMS OPPS Rate,85.46,45% of total billed charges,132.93,70% of total billed charges,113.94,60% of total billed charges,15.84,100% of CMS OPPS Rate,17.6,90% OF UHC FEE SCHEDULE,132.93,70% of total billed charges,15.84,100% OF CMS OPPS Rate,36.43,230% OF CMS OPPS Rate,91.15,48% of total Billed charges,15.84,100% OF CMS OPPS Rate,170.91,90% of total Billed charges,15.84,100% of Medicaid LA Fee Schedule,15.84,100% of Medicaid LA Fee Schedule,15.84,100% of Medicaid LA Fee Schedule,15.84,100% of Medicaid LA Fee Schedule,15.84,100% of Medicaid LA Fee Schedule,15.84,100% of Medicaid LA Fee Schedule,15.84,100% of CMS OPPS Rate,15.84,100% of CMS OPPS Rate,15.84,100% of CMS OPPS Rate,15.84,100% of CMS OPPS Rate,15.84,100% of CMS OPPS Rate,15.84,100% of CMS OPPS Rate,15.84,100% of CMS OPPS Rate,15.84,100% of CMS OPPS Rate,15.84,170.91,113.94
Outpatient,Laboratory,86687,HTLV I ANTIBODY,300,75.82,32.17,354% of CMS OPPS Rate,9.09,100% of Medicaid LA Fee Schedule,9.09,100% of CMS OPPS Rate,9.09,100% of CMS OPPS Rate,21.12,203.89% of BCBS Fee Schedule,53.07,70% of total Billed Charges,56.87,75% of total Billed Charges,16.36,180% OF CMS OPPS RATE,60.66,80% of total Billed Charges,31.81,350% of CMS Opps rate,9.27,102% of CMS Opps rate,58,76.5% of total billed charges,9.09,100% of Medicaid LA Fee Schedule,9.09,100% of Medicaid LA Fee Schedule,9.09,100% of CMS OPPS Rate,9.09,100% of CMS OPPS Rate,34.12,45% of total billed charges,53.07,70% of total billed charges,45.49,60% of total billed charges,9.09,100% of CMS OPPS Rate,9.32,90% OF UHC FEE SCHEDULE,53.07,70% of total billed charges,9.09,100% OF CMS OPPS Rate,20.9,230% OF CMS OPPS Rate,36.39,48% of total Billed charges,9.09,100% OF CMS OPPS Rate,68.24,90% of total Billed charges,9.09,100% of Medicaid LA Fee Schedule,9.09,100% of Medicaid LA Fee Schedule,9.09,100% of Medicaid LA Fee Schedule,9.09,100% of Medicaid LA Fee Schedule,9.09,100% of Medicaid LA Fee Schedule,9.09,100% of Medicaid LA Fee Schedule,9.09,100% of CMS OPPS Rate,9.09,100% of CMS OPPS Rate,9.09,100% of CMS OPPS Rate,9.09,100% of CMS OPPS Rate,9.09,100% of CMS OPPS Rate,9.09,100% of CMS OPPS Rate,9.09,100% of CMS OPPS Rate,9.09,100% of CMS OPPS Rate,9.09,68.24,45.49
Outpatient,Laboratory,86688,HTLV II ANTIBODY,300,95.26,49.56,354% of CMS OPPS Rate,12.87,100% of Medicaid LA Fee Schedule,14,100% of CMS OPPS Rate,14,100% of CMS OPPS Rate,35.25,203.89% of BCBS Fee Schedule,66.68,70% of total Billed Charges,71.45,75% of total Billed Charges,25.2,180% OF CMS OPPS RATE,76.21,80% of total Billed Charges,49,350% of CMS Opps rate,14.28,102% of CMS Opps rate,72.87,76.5% of total billed charges,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,14,100% of CMS OPPS Rate,14,100% of CMS OPPS Rate,42.87,45% of total billed charges,66.68,70% of total billed charges,57.16,60% of total billed charges,14,100% of CMS OPPS Rate,15.56,90% OF UHC FEE SCHEDULE,66.68,70% of total billed charges,14,100% OF CMS OPPS Rate,32.2,230% OF CMS OPPS Rate,45.72,48% of total Billed charges,14,100% OF CMS OPPS Rate,85.73,90% of total Billed charges,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,14,100% of CMS OPPS Rate,14,100% of CMS OPPS Rate,14,100% of CMS OPPS Rate,14,100% of CMS OPPS Rate,14,100% of CMS OPPS Rate,14,100% of CMS OPPS Rate,14,100% of CMS OPPS Rate,14,100% of CMS OPPS Rate,12.87,85.73,57.16
Outpatient,Laboratory,86689,HIV-1 CONFIRM  BANDS,300,57.75,68.49,354% of CMS OPPS Rate,19.35,100% of Medicaid LA Fee Schedule,19.35,100% of CMS OPPS Rate,19.35,100% of CMS OPPS Rate,48.73,203.89% of BCBS Fee Schedule,40.43,70% of total Billed Charges,43.31,75% of total Billed Charges,34.83,180% OF CMS OPPS RATE,46.2,80% of total Billed Charges,67.72,350% of CMS Opps rate,19.73,102% of CMS Opps rate,44.18,76.5% of total billed charges,19.35,100% of Medicaid LA Fee Schedule,19.35,100% of Medicaid LA Fee Schedule,19.35,100% of CMS OPPS Rate,19.35,100% of CMS OPPS Rate,25.99,45% of total billed charges,40.43,70% of total billed charges,34.65,60% of total billed charges,19.35,100% of CMS OPPS Rate,21.51,90% OF UHC FEE SCHEDULE,40.43,70% of total billed charges,19.35,100% OF CMS OPPS Rate,44.5,230% OF CMS OPPS Rate,27.72,48% of total Billed charges,19.35,100% OF CMS OPPS Rate,51.98,90% of total Billed charges,19.35,100% of Medicaid LA Fee Schedule,19.35,100% of Medicaid LA Fee Schedule,19.35,100% of Medicaid LA Fee Schedule,19.35,100% of Medicaid LA Fee Schedule,19.35,100% of Medicaid LA Fee Schedule,19.35,100% of Medicaid LA Fee Schedule,19.35,100% of CMS OPPS Rate,19.35,100% of CMS OPPS Rate,19.35,100% of CMS OPPS Rate,19.35,100% of CMS OPPS Rate,19.35,100% of CMS OPPS Rate,19.35,100% of CMS OPPS Rate,19.35,100% of CMS OPPS Rate,19.35,100% of CMS OPPS Rate,19.35,68.49,34.65
Outpatient,Laboratory,86692,"HEP DELTA VIRUS, TOTAL",300,124.85,60.74,354% of CMS OPPS Rate,15.55,100% of Medicaid LA Fee Schedule,17.16,100% of CMS OPPS Rate,17.16,100% of CMS OPPS Rate,43.2,203.89% of BCBS Fee Schedule,87.4,70% of total Billed Charges,93.64,75% of total Billed Charges,30.88,180% OF CMS OPPS RATE,99.88,80% of total Billed Charges,60.06,350% of CMS Opps rate,17.5,102% of CMS Opps rate,95.51,76.5% of total billed charges,15.55,100% of Medicaid LA Fee Schedule,15.55,100% of Medicaid LA Fee Schedule,17.16,100% of CMS OPPS Rate,17.16,100% of CMS OPPS Rate,56.18,45% of total billed charges,87.4,70% of total billed charges,74.91,60% of total billed charges,17.16,100% of CMS OPPS Rate,19.07,90% OF UHC FEE SCHEDULE,87.4,70% of total billed charges,17.16,100% OF CMS OPPS Rate,39.46,230% OF CMS OPPS Rate,59.93,48% of total Billed charges,17.16,100% OF CMS OPPS Rate,112.37,90% of total Billed charges,15.55,100% of Medicaid LA Fee Schedule,15.55,100% of Medicaid LA Fee Schedule,15.55,100% of Medicaid LA Fee Schedule,15.55,100% of Medicaid LA Fee Schedule,15.55,100% of Medicaid LA Fee Schedule,15.55,100% of Medicaid LA Fee Schedule,17.16,100% of CMS OPPS Rate,17.16,100% of CMS OPPS Rate,17.16,100% of CMS OPPS Rate,17.16,100% of CMS OPPS Rate,17.16,100% of CMS OPPS Rate,17.16,100% of CMS OPPS Rate,17.16,100% of CMS OPPS Rate,17.16,100% of CMS OPPS Rate,15.55,112.37,74.91
Outpatient,Laboratory,86694,ANTI HERPES II IGG AB,300,218.5,50.94,354% of CMS OPPS Rate,14.39,100% of Medicaid LA Fee Schedule,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,36.23,203.89% of BCBS Fee Schedule,152.95,70% of total Billed Charges,163.88,75% of total Billed Charges,25.9,180% OF CMS OPPS RATE,174.8,80% of total Billed Charges,50.36,350% of CMS Opps rate,14.67,102% of CMS Opps rate,167.15,76.5% of total billed charges,14.39,100% of Medicaid LA Fee Schedule,14.39,100% of Medicaid LA Fee Schedule,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,98.33,45% of total billed charges,152.95,70% of total billed charges,131.1,60% of total billed charges,14.39,100% of CMS OPPS Rate,15.99,90% OF UHC FEE SCHEDULE,152.95,70% of total billed charges,14.39,100% OF CMS OPPS Rate,33.09,230% OF CMS OPPS Rate,104.88,48% of total Billed charges,14.39,100% OF CMS OPPS Rate,196.65,90% of total Billed charges,14.39,100% of Medicaid LA Fee Schedule,14.39,100% of Medicaid LA Fee Schedule,14.39,100% of Medicaid LA Fee Schedule,14.39,100% of Medicaid LA Fee Schedule,14.39,100% of Medicaid LA Fee Schedule,14.39,100% of Medicaid LA Fee Schedule,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,14.39,196.65,131.1
Outpatient,Laboratory,86695,HERPES SIM.VIRUS 1 ABS,300,45.1,46.69,354% of CMS OPPS Rate,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,33.19,203.89% of BCBS Fee Schedule,31.57,70% of total Billed Charges,33.83,75% of total Billed Charges,23.74,180% OF CMS OPPS RATE,36.08,80% of total Billed Charges,46.16,350% of CMS Opps rate,13.45,102% of CMS Opps rate,34.5,76.5% of total billed charges,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,20.3,45% of total billed charges,31.57,70% of total billed charges,27.06,60% of total billed charges,13.19,100% of CMS OPPS Rate,14.65,90% OF UHC FEE SCHEDULE,31.57,70% of total billed charges,13.19,100% OF CMS OPPS Rate,30.33,230% OF CMS OPPS Rate,21.65,48% of total Billed charges,13.19,100% OF CMS OPPS Rate,40.59,90% of total Billed charges,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,46.69,27.06
Outpatient,Laboratory,86696,HERPES SIMPLEX 2 ABS,300,240.35,68.49,354% of CMS OPPS Rate,19.35,100% of Medicaid LA Fee Schedule,19.35,100% of CMS OPPS Rate,19.35,100% of CMS OPPS Rate,48.73,203.89% of BCBS Fee Schedule,168.25,70% of total Billed Charges,180.26,75% of total Billed Charges,34.83,180% OF CMS OPPS RATE,192.28,80% of total Billed Charges,67.72,350% of CMS Opps rate,19.73,102% of CMS Opps rate,183.87,76.5% of total billed charges,19.35,100% of Medicaid LA Fee Schedule,19.35,100% of Medicaid LA Fee Schedule,19.35,100% of CMS OPPS Rate,19.35,100% of CMS OPPS Rate,108.16,45% of total billed charges,168.25,70% of total billed charges,144.21,60% of total billed charges,19.35,100% of CMS OPPS Rate,21.51,90% OF UHC FEE SCHEDULE,168.25,70% of total billed charges,19.35,100% OF CMS OPPS Rate,44.5,230% OF CMS OPPS Rate,115.37,48% of total Billed charges,19.35,100% OF CMS OPPS Rate,216.32,90% of total Billed charges,19.35,100% of Medicaid LA Fee Schedule,19.35,100% of Medicaid LA Fee Schedule,19.35,100% of Medicaid LA Fee Schedule,19.35,100% of Medicaid LA Fee Schedule,19.35,100% of Medicaid LA Fee Schedule,19.35,100% of Medicaid LA Fee Schedule,19.35,100% of CMS OPPS Rate,19.35,100% of CMS OPPS Rate,19.35,100% of CMS OPPS Rate,19.35,100% of CMS OPPS Rate,19.35,100% of CMS OPPS Rate,19.35,100% of CMS OPPS Rate,19.35,100% of CMS OPPS Rate,19.35,100% of CMS OPPS Rate,19.35,216.32,144.21
Outpatient,Laboratory,86698,ANTI-HISTOPLASMA ANTIBODY,300,97.2,48.81,354% of CMS OPPS Rate,13.79,100% of Medicaid LA Fee Schedule,13.79,100% of CMS OPPS Rate,13.79,100% of CMS OPPS Rate,31.46,203.89% of BCBS Fee Schedule,68.04,70% of total Billed Charges,72.9,75% of total Billed Charges,24.82,180% OF CMS OPPS RATE,77.76,80% of total Billed Charges,48.26,350% of CMS Opps rate,14.06,102% of CMS Opps rate,74.36,76.5% of total billed charges,13.79,100% of Medicaid LA Fee Schedule,13.79,100% of Medicaid LA Fee Schedule,13.79,100% of CMS OPPS Rate,13.79,100% of CMS OPPS Rate,43.74,45% of total billed charges,68.04,70% of total billed charges,58.32,60% of total billed charges,13.79,100% of CMS OPPS Rate,13.89,90% OF UHC FEE SCHEDULE,68.04,70% of total billed charges,13.79,100% OF CMS OPPS Rate,31.71,230% OF CMS OPPS Rate,46.66,48% of total Billed charges,13.79,100% OF CMS OPPS Rate,87.48,90% of total Billed charges,13.79,100% of Medicaid LA Fee Schedule,13.79,100% of Medicaid LA Fee Schedule,13.79,100% of Medicaid LA Fee Schedule,13.79,100% of Medicaid LA Fee Schedule,13.79,100% of Medicaid LA Fee Schedule,13.79,100% of Medicaid LA Fee Schedule,13.79,100% of CMS OPPS Rate,13.79,100% of CMS OPPS Rate,13.79,100% of CMS OPPS Rate,13.79,100% of CMS OPPS Rate,13.79,100% of CMS OPPS Rate,13.79,100% of CMS OPPS Rate,13.79,100% of CMS OPPS Rate,13.79,100% of CMS OPPS Rate,13.79,87.48,58.32
Outpatient,Laboratory,86701,HIV-1 STAT SCREEN,300,123.75,31.47,354% of CMS OPPS Rate,8.89,100% of Medicaid LA Fee Schedule,8.89,100% of CMS OPPS Rate,8.89,100% of CMS OPPS Rate,22.37,203.89% of BCBS Fee Schedule,86.63,70% of total Billed Charges,92.81,75% of total Billed Charges,16,180% OF CMS OPPS RATE,99,80% of total Billed Charges,31.11,350% of CMS Opps rate,9.06,102% of CMS Opps rate,94.67,76.5% of total billed charges,8.89,100% of Medicaid LA Fee Schedule,8.89,100% of Medicaid LA Fee Schedule,8.89,100% of CMS OPPS Rate,8.89,100% of CMS OPPS Rate,55.69,45% of total billed charges,86.63,70% of total billed charges,74.25,60% of total billed charges,8.89,100% of CMS OPPS Rate,9.87,90% OF UHC FEE SCHEDULE,86.63,70% of total billed charges,8.89,100% OF CMS OPPS Rate,20.44,230% OF CMS OPPS Rate,59.4,48% of total Billed charges,8.89,100% OF CMS OPPS Rate,111.38,90% of total Billed charges,8.89,100% of Medicaid LA Fee Schedule,8.89,100% of Medicaid LA Fee Schedule,8.89,100% of Medicaid LA Fee Schedule,8.89,100% of Medicaid LA Fee Schedule,8.89,100% of Medicaid LA Fee Schedule,8.89,100% of Medicaid LA Fee Schedule,8.89,100% of CMS OPPS Rate,8.89,100% of CMS OPPS Rate,8.89,100% of CMS OPPS Rate,8.89,100% of CMS OPPS Rate,8.89,100% of CMS OPPS Rate,8.89,100% of CMS OPPS Rate,8.89,100% of CMS OPPS Rate,8.89,100% of CMS OPPS Rate,8.89,111.38,74.25
Outpatient,Laboratory,86702,HIV 2 IGG ABS (REFLEX),300,52.5,47.86,354% of CMS OPPS Rate,12.87,100% of Medicaid LA Fee Schedule,13.52,100% of CMS OPPS Rate,13.52,100% of CMS OPPS Rate,34.03,203.89% of BCBS Fee Schedule,36.75,70% of total Billed Charges,39.38,75% of total Billed Charges,24.33,180% OF CMS OPPS RATE,42,80% of total Billed Charges,47.32,350% of CMS Opps rate,13.79,102% of CMS Opps rate,40.16,76.5% of total billed charges,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,13.52,100% of CMS OPPS Rate,13.52,100% of CMS OPPS Rate,23.63,45% of total billed charges,36.75,70% of total billed charges,31.5,60% of total billed charges,13.52,100% of CMS OPPS Rate,15.02,90% OF UHC FEE SCHEDULE,36.75,70% of total billed charges,13.52,100% OF CMS OPPS Rate,31.09,230% OF CMS OPPS Rate,25.2,48% of total Billed charges,13.52,100% OF CMS OPPS Rate,47.25,90% of total Billed charges,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,13.52,100% of CMS OPPS Rate,13.52,100% of CMS OPPS Rate,13.52,100% of CMS OPPS Rate,13.52,100% of CMS OPPS Rate,13.52,100% of CMS OPPS Rate,13.52,100% of CMS OPPS Rate,13.52,100% of CMS OPPS Rate,13.52,100% of CMS OPPS Rate,12.87,47.86,31.5
Outpatient,Laboratory,86703,Blood test to diagnose HIV,300,169.2,48.53,354% of CMS OPPS Rate,12.87,100% of Medicaid LA Fee Schedule,13.71,100% of CMS OPPS Rate,13.71,100% of CMS OPPS Rate,34.5,203.89% of BCBS Fee Schedule,118.44,70% of total Billed Charges,126.9,75% of total Billed Charges,24.67,180% OF CMS OPPS RATE,135.36,80% of total Billed Charges,47.98,350% of CMS Opps rate,13.98,102% of CMS Opps rate,129.44,76.5% of total billed charges,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,13.71,100% of CMS OPPS Rate,13.71,100% of CMS OPPS Rate,76.14,45% of total billed charges,118.44,70% of total billed charges,101.52,60% of total billed charges,13.71,100% of CMS OPPS Rate,15.23,90% OF UHC FEE SCHEDULE,118.44,70% of total billed charges,13.71,100% OF CMS OPPS Rate,31.53,230% OF CMS OPPS Rate,81.22,48% of total Billed charges,13.71,100% OF CMS OPPS Rate,152.28,90% of total Billed charges,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,13.71,100% of CMS OPPS Rate,13.71,100% of CMS OPPS Rate,13.71,100% of CMS OPPS Rate,13.71,100% of CMS OPPS Rate,13.71,100% of CMS OPPS Rate,13.71,100% of CMS OPPS Rate,13.71,100% of CMS OPPS Rate,13.71,100% of CMS OPPS Rate,12.87,152.28,101.52
Outpatient,Laboratory,86704,Blood test indicating infection with Hepatitis B,300,188.1,42.65,354% of CMS OPPS Rate,12.05,100% of Medicaid LA Fee Schedule,12.05,100% of CMS OPPS Rate,12.05,100% of CMS OPPS Rate,30.34,203.89% of BCBS Fee Schedule,131.67,70% of total Billed Charges,141.08,75% of total Billed Charges,21.69,180% OF CMS OPPS RATE,150.48,80% of total Billed Charges,42.17,350% of CMS Opps rate,12.29,102% of CMS Opps rate,143.9,76.5% of total billed charges,12.05,100% of Medicaid LA Fee Schedule,12.05,100% of Medicaid LA Fee Schedule,12.05,100% of CMS OPPS Rate,12.05,100% of CMS OPPS Rate,84.65,45% of total billed charges,131.67,70% of total billed charges,112.86,60% of total billed charges,12.05,100% of CMS OPPS Rate,13.39,90% OF UHC FEE SCHEDULE,131.67,70% of total billed charges,12.05,100% OF CMS OPPS Rate,27.71,230% OF CMS OPPS Rate,90.29,48% of total Billed charges,12.05,100% OF CMS OPPS Rate,169.29,90% of total Billed charges,12.05,100% of Medicaid LA Fee Schedule,12.05,100% of Medicaid LA Fee Schedule,12.05,100% of Medicaid LA Fee Schedule,12.05,100% of Medicaid LA Fee Schedule,12.05,100% of Medicaid LA Fee Schedule,12.05,100% of Medicaid LA Fee Schedule,12.05,100% of CMS OPPS Rate,12.05,100% of CMS OPPS Rate,12.05,100% of CMS OPPS Rate,12.05,100% of CMS OPPS Rate,12.05,100% of CMS OPPS Rate,12.05,100% of CMS OPPS Rate,12.05,100% of CMS OPPS Rate,12.05,100% of CMS OPPS Rate,12.05,169.29,112.86
Outpatient,Laboratory,86705,HEPATITIS B CORE IGM AB,300,67.82,41.66,354% of CMS OPPS Rate,11.77,100% of Medicaid LA Fee Schedule,11.77,100% of CMS OPPS Rate,11.77,100% of CMS OPPS Rate,29.65,203.89% of BCBS Fee Schedule,47.47,70% of total Billed Charges,50.87,75% of total Billed Charges,21.18,180% OF CMS OPPS RATE,54.26,80% of total Billed Charges,41.19,350% of CMS Opps rate,12,102% of CMS Opps rate,51.88,76.5% of total billed charges,11.77,100% of Medicaid LA Fee Schedule,11.77,100% of Medicaid LA Fee Schedule,11.77,100% of CMS OPPS Rate,11.77,100% of CMS OPPS Rate,30.52,45% of total billed charges,47.47,70% of total billed charges,40.69,60% of total billed charges,11.77,100% of CMS OPPS Rate,13.09,90% OF UHC FEE SCHEDULE,47.47,70% of total billed charges,11.77,100% OF CMS OPPS Rate,27.07,230% OF CMS OPPS Rate,32.55,48% of total Billed charges,11.77,100% OF CMS OPPS Rate,61.04,90% of total Billed charges,11.77,100% of Medicaid LA Fee Schedule,11.77,100% of Medicaid LA Fee Schedule,11.77,100% of Medicaid LA Fee Schedule,11.77,100% of Medicaid LA Fee Schedule,11.77,100% of Medicaid LA Fee Schedule,11.77,100% of Medicaid LA Fee Schedule,11.77,100% of CMS OPPS Rate,11.77,100% of CMS OPPS Rate,11.77,100% of CMS OPPS Rate,11.77,100% of CMS OPPS Rate,11.77,100% of CMS OPPS Rate,11.77,100% of CMS OPPS Rate,11.77,100% of CMS OPPS Rate,11.77,100% of CMS OPPS Rate,11.77,61.04,40.69
Outpatient,Laboratory,86706,HEP B SURFACE AB,300,190.85,38.01,354% of CMS OPPS Rate,10.74,100% of Medicaid LA Fee Schedule,10.74,100% of CMS OPPS Rate,10.74,100% of CMS OPPS Rate,27.04,203.89% of BCBS Fee Schedule,133.6,70% of total Billed Charges,143.14,75% of total Billed Charges,19.33,180% OF CMS OPPS RATE,152.68,80% of total Billed Charges,37.59,350% of CMS Opps rate,10.95,102% of CMS Opps rate,146,76.5% of total billed charges,10.74,100% of Medicaid LA Fee Schedule,10.74,100% of Medicaid LA Fee Schedule,10.74,100% of CMS OPPS Rate,10.74,100% of CMS OPPS Rate,85.88,45% of total billed charges,133.6,70% of total billed charges,114.51,60% of total billed charges,10.74,100% of CMS OPPS Rate,11.93,90% OF UHC FEE SCHEDULE,133.6,70% of total billed charges,10.74,100% OF CMS OPPS Rate,24.7,230% OF CMS OPPS Rate,91.61,48% of total Billed charges,10.74,100% OF CMS OPPS Rate,171.77,90% of total Billed charges,10.74,100% of Medicaid LA Fee Schedule,10.74,100% of Medicaid LA Fee Schedule,10.74,100% of Medicaid LA Fee Schedule,10.74,100% of Medicaid LA Fee Schedule,10.74,100% of Medicaid LA Fee Schedule,10.74,100% of Medicaid LA Fee Schedule,10.74,100% of CMS OPPS Rate,10.74,100% of CMS OPPS Rate,10.74,100% of CMS OPPS Rate,10.74,100% of CMS OPPS Rate,10.74,100% of CMS OPPS Rate,10.74,100% of CMS OPPS Rate,10.74,100% of CMS OPPS Rate,10.74,100% of CMS OPPS Rate,10.74,171.77,114.51
Outpatient,Laboratory,86707,HEPATITIS BE ANTIBODY,300,162.8,40.95,354% of CMS OPPS Rate,11.57,100% of Medicaid LA Fee Schedule,11.57,100% of CMS OPPS Rate,11.57,100% of CMS OPPS Rate,29.12,203.89% of BCBS Fee Schedule,113.96,70% of total Billed Charges,122.1,75% of total Billed Charges,20.82,180% OF CMS OPPS RATE,130.24,80% of total Billed Charges,40.49,350% of CMS Opps rate,11.8,102% of CMS Opps rate,124.54,76.5% of total billed charges,11.57,100% of Medicaid LA Fee Schedule,11.57,100% of Medicaid LA Fee Schedule,11.57,100% of CMS OPPS Rate,11.57,100% of CMS OPPS Rate,73.26,45% of total billed charges,113.96,70% of total billed charges,97.68,60% of total billed charges,11.57,100% of CMS OPPS Rate,12.85,90% OF UHC FEE SCHEDULE,113.96,70% of total billed charges,11.57,100% OF CMS OPPS Rate,26.61,230% OF CMS OPPS Rate,78.14,48% of total Billed charges,11.57,100% OF CMS OPPS Rate,146.52,90% of total Billed charges,11.57,100% of Medicaid LA Fee Schedule,11.57,100% of Medicaid LA Fee Schedule,11.57,100% of Medicaid LA Fee Schedule,11.57,100% of Medicaid LA Fee Schedule,11.57,100% of Medicaid LA Fee Schedule,11.57,100% of Medicaid LA Fee Schedule,11.57,100% of CMS OPPS Rate,11.57,100% of CMS OPPS Rate,11.57,100% of CMS OPPS Rate,11.57,100% of CMS OPPS Rate,11.57,100% of CMS OPPS Rate,11.57,100% of CMS OPPS Rate,11.57,100% of CMS OPPS Rate,11.57,100% of CMS OPPS Rate,11.57,146.52,97.68
Outpatient,Laboratory,86708,Blood test indicating infection with Hepatitis A,300,156.15,43.86,354% of CMS OPPS Rate,12.39,100% of Medicaid LA Fee Schedule,12.39,100% of CMS OPPS Rate,12.39,100% of CMS OPPS Rate,31.17,203.89% of BCBS Fee Schedule,109.31,70% of total Billed Charges,117.11,75% of total Billed Charges,22.3,180% OF CMS OPPS RATE,124.92,80% of total Billed Charges,43.36,350% of CMS Opps rate,12.63,102% of CMS Opps rate,119.45,76.5% of total billed charges,12.39,100% of Medicaid LA Fee Schedule,12.39,100% of Medicaid LA Fee Schedule,12.39,100% of CMS OPPS Rate,12.39,100% of CMS OPPS Rate,70.27,45% of total billed charges,109.31,70% of total billed charges,93.69,60% of total billed charges,12.39,100% of CMS OPPS Rate,13.76,90% OF UHC FEE SCHEDULE,109.31,70% of total billed charges,12.39,100% OF CMS OPPS Rate,28.49,230% OF CMS OPPS Rate,74.95,48% of total Billed charges,12.39,100% OF CMS OPPS Rate,140.54,90% of total Billed charges,12.39,100% of Medicaid LA Fee Schedule,12.39,100% of Medicaid LA Fee Schedule,12.39,100% of Medicaid LA Fee Schedule,12.39,100% of Medicaid LA Fee Schedule,12.39,100% of Medicaid LA Fee Schedule,12.39,100% of Medicaid LA Fee Schedule,12.39,100% of CMS OPPS Rate,12.39,100% of CMS OPPS Rate,12.39,100% of CMS OPPS Rate,12.39,100% of CMS OPPS Rate,12.39,100% of CMS OPPS Rate,12.39,100% of CMS OPPS Rate,12.39,100% of CMS OPPS Rate,12.39,100% of CMS OPPS Rate,12.39,140.54,93.69
Outpatient,Laboratory,86709,ANTI -HEPATITIS A AB IGM,300,57.42,39.86,354% of CMS OPPS Rate,11.26,100% of Medicaid LA Fee Schedule,11.26,100% of CMS OPPS Rate,11.26,100% of CMS OPPS Rate,28.34,203.89% of BCBS Fee Schedule,40.19,70% of total Billed Charges,43.07,75% of total Billed Charges,20.26,180% OF CMS OPPS RATE,45.94,80% of total Billed Charges,39.41,350% of CMS Opps rate,11.48,102% of CMS Opps rate,43.93,76.5% of total billed charges,11.26,100% of Medicaid LA Fee Schedule,11.26,100% of Medicaid LA Fee Schedule,11.26,100% of CMS OPPS Rate,11.26,100% of CMS OPPS Rate,25.84,45% of total billed charges,40.19,70% of total billed charges,34.45,60% of total billed charges,11.26,100% of CMS OPPS Rate,12.51,90% OF UHC FEE SCHEDULE,40.19,70% of total billed charges,11.26,100% OF CMS OPPS Rate,25.89,230% OF CMS OPPS Rate,27.56,48% of total Billed charges,11.26,100% OF CMS OPPS Rate,51.68,90% of total Billed charges,11.26,100% of Medicaid LA Fee Schedule,11.26,100% of Medicaid LA Fee Schedule,11.26,100% of Medicaid LA Fee Schedule,11.26,100% of Medicaid LA Fee Schedule,11.26,100% of Medicaid LA Fee Schedule,11.26,100% of Medicaid LA Fee Schedule,11.26,100% of CMS OPPS Rate,11.26,100% of CMS OPPS Rate,11.26,100% of CMS OPPS Rate,11.26,100% of CMS OPPS Rate,11.26,100% of CMS OPPS Rate,11.26,100% of CMS OPPS Rate,11.26,100% of CMS OPPS Rate,11.26,100% of CMS OPPS Rate,11.26,51.68,34.45
Outpatient,Laboratory,86710,ANTI-INFLUENZA VIRUS AB,300,72.9,47.96,354% of CMS OPPS Rate,13.55,100% of Medicaid LA Fee Schedule,13.55,100% of CMS OPPS Rate,13.55,100% of CMS OPPS Rate,34.11,203.89% of BCBS Fee Schedule,51.03,70% of total Billed Charges,54.68,75% of total Billed Charges,24.39,180% OF CMS OPPS RATE,58.32,80% of total Billed Charges,47.42,350% of CMS Opps rate,13.82,102% of CMS Opps rate,55.77,76.5% of total billed charges,13.55,100% of Medicaid LA Fee Schedule,13.55,100% of Medicaid LA Fee Schedule,13.55,100% of CMS OPPS Rate,13.55,100% of CMS OPPS Rate,32.81,45% of total billed charges,51.03,70% of total billed charges,43.74,60% of total billed charges,13.55,100% of CMS OPPS Rate,15.06,90% OF UHC FEE SCHEDULE,51.03,70% of total billed charges,13.55,100% OF CMS OPPS Rate,31.16,230% OF CMS OPPS Rate,34.99,48% of total Billed charges,13.55,100% OF CMS OPPS Rate,65.61,90% of total Billed charges,13.55,100% of Medicaid LA Fee Schedule,13.55,100% of Medicaid LA Fee Schedule,13.55,100% of Medicaid LA Fee Schedule,13.55,100% of Medicaid LA Fee Schedule,13.55,100% of Medicaid LA Fee Schedule,13.55,100% of Medicaid LA Fee Schedule,13.55,100% of CMS OPPS Rate,13.55,100% of CMS OPPS Rate,13.55,100% of CMS OPPS Rate,13.55,100% of CMS OPPS Rate,13.55,100% of CMS OPPS Rate,13.55,100% of CMS OPPS Rate,13.55,100% of CMS OPPS Rate,13.55,100% of CMS OPPS Rate,13.55,65.61,43.74
Outpatient,Laboratory,86711,ANTIBODY JC VIRUS,300,1363,59.79,354% of CMS OPPS Rate,16.89,100% of Medicaid LA Fee Schedule,16.89,100% of CMS OPPS Rate,16.89,100% of CMS OPPS Rate,36.23,203.89% of BCBS Fee Schedule,954.1,70% of total Billed Charges,1022.25,75% of total Billed Charges,30.4,180% OF CMS OPPS RATE,1090.4,80% of total Billed Charges,59.11,350% of CMS Opps rate,17.22,102% of CMS Opps rate,1042.7,76.5% of total billed charges,16.89,100% of Medicaid LA Fee Schedule,16.89,100% of Medicaid LA Fee Schedule,16.89,100% of CMS OPPS Rate,16.89,100% of CMS OPPS Rate,613.35,45% of total billed charges,954.1,70% of total billed charges,817.8,60% of total billed charges,16.89,100% of CMS OPPS Rate,15.99,90% OF UHC FEE SCHEDULE,954.1,70% of total billed charges,16.89,100% OF CMS OPPS Rate,38.84,230% OF CMS OPPS Rate,654.24,48% of total Billed charges,16.89,100% OF CMS OPPS Rate,1226.7,90% of total Billed charges,16.89,100% of Medicaid LA Fee Schedule,16.89,100% of Medicaid LA Fee Schedule,16.89,100% of Medicaid LA Fee Schedule,16.89,100% of Medicaid LA Fee Schedule,16.89,100% of Medicaid LA Fee Schedule,16.89,100% of Medicaid LA Fee Schedule,16.89,100% of CMS OPPS Rate,16.89,100% of CMS OPPS Rate,16.89,100% of CMS OPPS Rate,16.89,100% of CMS OPPS Rate,16.89,100% of CMS OPPS Rate,16.89,100% of CMS OPPS Rate,16.89,100% of CMS OPPS Rate,16.89,100% of CMS OPPS Rate,15.99,1226.7,817.8
Outpatient,Laboratory,86713,ANTI-LEGION PNEUMOPH AB,300,36.85,54.16,354% of CMS OPPS Rate,15.3,100% of Medicaid LA Fee Schedule,15.3,100% of CMS OPPS Rate,15.3,100% of CMS OPPS Rate,38.51,203.89% of BCBS Fee Schedule,25.8,70% of total Billed Charges,27.64,75% of total Billed Charges,27.54,180% OF CMS OPPS RATE,29.48,80% of total Billed Charges,53.55,350% of CMS Opps rate,15.6,102% of CMS Opps rate,28.19,76.5% of total billed charges,15.3,100% of Medicaid LA Fee Schedule,15.3,100% of Medicaid LA Fee Schedule,15.3,100% of CMS OPPS Rate,15.3,100% of CMS OPPS Rate,16.58,45% of total billed charges,25.8,70% of total billed charges,22.11,60% of total billed charges,15.3,100% of CMS OPPS Rate,17,90% OF UHC FEE SCHEDULE,25.8,70% of total billed charges,15.3,100% OF CMS OPPS Rate,35.19,230% OF CMS OPPS Rate,17.69,48% of total Billed charges,15.3,100% OF CMS OPPS Rate,33.17,90% of total Billed charges,15.3,100% of Medicaid LA Fee Schedule,15.3,100% of Medicaid LA Fee Schedule,15.3,100% of Medicaid LA Fee Schedule,15.3,100% of Medicaid LA Fee Schedule,15.3,100% of Medicaid LA Fee Schedule,15.3,100% of Medicaid LA Fee Schedule,15.3,100% of CMS OPPS Rate,15.3,100% of CMS OPPS Rate,15.3,100% of CMS OPPS Rate,15.3,100% of CMS OPPS Rate,15.3,100% of CMS OPPS Rate,15.3,100% of CMS OPPS Rate,15.3,100% of CMS OPPS Rate,15.3,100% of CMS OPPS Rate,15.3,54.16,22.11
Outpatient,Laboratory,86720,ANTI-LEPTOSPIRA AB,300,148,57.34,354% of CMS OPPS Rate,16.2,100% of Medicaid LA Fee Schedule,16.2,100% of CMS OPPS Rate,16.2,100% of CMS OPPS Rate,33.19,203.89% of BCBS Fee Schedule,103.6,70% of total Billed Charges,111,75% of total Billed Charges,29.16,180% OF CMS OPPS RATE,118.4,80% of total Billed Charges,56.7,350% of CMS Opps rate,16.52,102% of CMS Opps rate,113.22,76.5% of total billed charges,16.2,100% of Medicaid LA Fee Schedule,16.2,100% of Medicaid LA Fee Schedule,16.2,100% of CMS OPPS Rate,16.2,100% of CMS OPPS Rate,66.6,45% of total billed charges,103.6,70% of total billed charges,88.8,60% of total billed charges,16.2,100% of CMS OPPS Rate,14.65,90% OF UHC FEE SCHEDULE,103.6,70% of total billed charges,16.2,100% OF CMS OPPS Rate,37.26,230% OF CMS OPPS Rate,71.04,48% of total Billed charges,16.2,100% OF CMS OPPS Rate,133.2,90% of total Billed charges,16.2,100% of Medicaid LA Fee Schedule,16.2,100% of Medicaid LA Fee Schedule,16.2,100% of Medicaid LA Fee Schedule,16.2,100% of Medicaid LA Fee Schedule,16.2,100% of Medicaid LA Fee Schedule,16.2,100% of Medicaid LA Fee Schedule,16.2,100% of CMS OPPS Rate,16.2,100% of CMS OPPS Rate,16.2,100% of CMS OPPS Rate,16.2,100% of CMS OPPS Rate,16.2,100% of CMS OPPS Rate,16.2,100% of CMS OPPS Rate,16.2,100% of CMS OPPS Rate,16.2,100% of CMS OPPS Rate,14.65,133.2,88.8
Outpatient,Laboratory,86723,LISTERIA AB MONOCYTOGENES,300,144,46.69,354% of CMS OPPS Rate,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,33.19,203.89% of BCBS Fee Schedule,100.8,70% of total Billed Charges,108,75% of total Billed Charges,23.74,180% OF CMS OPPS RATE,115.2,80% of total Billed Charges,46.16,350% of CMS Opps rate,13.45,102% of CMS Opps rate,110.16,76.5% of total billed charges,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,64.8,45% of total billed charges,100.8,70% of total billed charges,86.4,60% of total billed charges,13.19,100% of CMS OPPS Rate,14.65,90% OF UHC FEE SCHEDULE,100.8,70% of total billed charges,13.19,100% OF CMS OPPS Rate,30.33,230% OF CMS OPPS Rate,69.12,48% of total Billed charges,13.19,100% OF CMS OPPS Rate,129.6,90% of total Billed charges,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,129.6,86.4
Outpatient,Laboratory,86727,ANTIBODY LYMPH CHORIOMENINGTIS,300,46,45.55,354% of CMS OPPS Rate,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,32.4,203.89% of BCBS Fee Schedule,32.2,70% of total Billed Charges,34.5,75% of total Billed Charges,23.16,180% OF CMS OPPS RATE,36.8,80% of total Billed Charges,45.04,350% of CMS Opps rate,13.12,102% of CMS Opps rate,35.19,76.5% of total billed charges,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,20.7,45% of total billed charges,32.2,70% of total billed charges,27.6,60% of total billed charges,12.87,100% of CMS OPPS Rate,14.3,90% OF UHC FEE SCHEDULE,32.2,70% of total billed charges,12.87,100% OF CMS OPPS Rate,29.6,230% OF CMS OPPS Rate,22.08,48% of total Billed charges,12.87,100% OF CMS OPPS Rate,41.4,90% of total Billed charges,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of Medicaid LA Fee Schedule,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,12.87,100% of CMS OPPS Rate,12.87,45.55,27.6
Outpatient,Laboratory,86735,ANTI-MUMPS AB,300,50.6,46.19,354% of CMS OPPS Rate,13.05,100% of Medicaid LA Fee Schedule,13.05,100% of CMS OPPS Rate,13.05,100% of CMS OPPS Rate,32.85,203.89% of BCBS Fee Schedule,35.42,70% of total Billed Charges,37.95,75% of total Billed Charges,23.49,180% OF CMS OPPS RATE,40.48,80% of total Billed Charges,45.67,350% of CMS Opps rate,13.31,102% of CMS Opps rate,38.71,76.5% of total billed charges,13.05,100% of Medicaid LA Fee Schedule,13.05,100% of Medicaid LA Fee Schedule,13.05,100% of CMS OPPS Rate,13.05,100% of CMS OPPS Rate,22.77,45% of total billed charges,35.42,70% of total billed charges,30.36,60% of total billed charges,13.05,100% of CMS OPPS Rate,14.5,90% OF UHC FEE SCHEDULE,35.42,70% of total billed charges,13.05,100% OF CMS OPPS Rate,30.01,230% OF CMS OPPS Rate,24.29,48% of total Billed charges,13.05,100% OF CMS OPPS Rate,45.54,90% of total Billed charges,13.05,100% of Medicaid LA Fee Schedule,13.05,100% of Medicaid LA Fee Schedule,13.05,100% of Medicaid LA Fee Schedule,13.05,100% of Medicaid LA Fee Schedule,13.05,100% of Medicaid LA Fee Schedule,13.05,100% of Medicaid LA Fee Schedule,13.05,100% of CMS OPPS Rate,13.05,100% of CMS OPPS Rate,13.05,100% of CMS OPPS Rate,13.05,100% of CMS OPPS Rate,13.05,100% of CMS OPPS Rate,13.05,100% of CMS OPPS Rate,13.05,100% of CMS OPPS Rate,13.05,100% of CMS OPPS Rate,13.05,46.19,30.36
Outpatient,Laboratory,86738,ANTI MYCOPLASMA PNEUM  AB,300,181.35,46.86,354% of CMS OPPS Rate,13.24,100% of Medicaid LA Fee Schedule,13.24,100% of CMS OPPS Rate,13.24,100% of CMS OPPS Rate,33.32,203.89% of BCBS Fee Schedule,126.95,70% of total Billed Charges,136.01,75% of total Billed Charges,23.83,180% OF CMS OPPS RATE,145.08,80% of total Billed Charges,46.34,350% of CMS Opps rate,13.5,102% of CMS Opps rate,138.73,76.5% of total billed charges,13.24,100% of Medicaid LA Fee Schedule,13.24,100% of Medicaid LA Fee Schedule,13.24,100% of CMS OPPS Rate,13.24,100% of CMS OPPS Rate,81.61,45% of total billed charges,126.95,70% of total billed charges,108.81,60% of total billed charges,13.24,100% of CMS OPPS Rate,14.71,90% OF UHC FEE SCHEDULE,126.95,70% of total billed charges,13.24,100% OF CMS OPPS Rate,30.45,230% OF CMS OPPS Rate,87.05,48% of total Billed charges,13.24,100% OF CMS OPPS Rate,163.22,90% of total Billed charges,13.24,100% of Medicaid LA Fee Schedule,13.24,100% of Medicaid LA Fee Schedule,13.24,100% of Medicaid LA Fee Schedule,13.24,100% of Medicaid LA Fee Schedule,13.24,100% of Medicaid LA Fee Schedule,13.24,100% of Medicaid LA Fee Schedule,13.24,100% of CMS OPPS Rate,13.24,100% of CMS OPPS Rate,13.24,100% of CMS OPPS Rate,13.24,100% of CMS OPPS Rate,13.24,100% of CMS OPPS Rate,13.24,100% of CMS OPPS Rate,13.24,100% of CMS OPPS Rate,13.24,100% of CMS OPPS Rate,13.24,163.22,108.81
Outpatient,Laboratory,86747,PARVOVIRUS AB  EA,300,56.65,53.2,354% of CMS OPPS Rate,15.03,100% of Medicaid LA Fee Schedule,15.03,100% of CMS OPPS Rate,15.03,100% of CMS OPPS Rate,37.84,203.89% of BCBS Fee Schedule,39.66,70% of total Billed Charges,42.49,75% of total Billed Charges,27.05,180% OF CMS OPPS RATE,45.32,80% of total Billed Charges,52.6,350% of CMS Opps rate,15.33,102% of CMS Opps rate,43.34,76.5% of total billed charges,15.03,100% of Medicaid LA Fee Schedule,15.03,100% of Medicaid LA Fee Schedule,15.03,100% of CMS OPPS Rate,15.03,100% of CMS OPPS Rate,25.49,45% of total billed charges,39.66,70% of total billed charges,33.99,60% of total billed charges,15.03,100% of CMS OPPS Rate,16.7,90% OF UHC FEE SCHEDULE,39.66,70% of total billed charges,15.03,100% OF CMS OPPS Rate,34.56,230% OF CMS OPPS Rate,27.19,48% of total Billed charges,15.03,100% OF CMS OPPS Rate,50.99,90% of total Billed charges,15.03,100% of Medicaid LA Fee Schedule,15.03,100% of Medicaid LA Fee Schedule,15.03,100% of Medicaid LA Fee Schedule,15.03,100% of Medicaid LA Fee Schedule,15.03,100% of Medicaid LA Fee Schedule,15.03,100% of Medicaid LA Fee Schedule,15.03,100% of CMS OPPS Rate,15.03,100% of CMS OPPS Rate,15.03,100% of CMS OPPS Rate,15.03,100% of CMS OPPS Rate,15.03,100% of CMS OPPS Rate,15.03,100% of CMS OPPS Rate,15.03,100% of CMS OPPS Rate,15.03,100% of CMS OPPS Rate,15.03,53.2,33.99
Outpatient,Laboratory,86753,ENTAMOEBA HISTOLYTICA ABS,300,138.5,43.86,354% of CMS OPPS Rate,12.39,100% of Medicaid LA Fee Schedule,12.39,100% of CMS OPPS Rate,12.39,100% of CMS OPPS Rate,31.17,203.89% of BCBS Fee Schedule,96.95,70% of total Billed Charges,103.88,75% of total Billed Charges,22.3,180% OF CMS OPPS RATE,110.8,80% of total Billed Charges,43.36,350% of CMS Opps rate,12.63,102% of CMS Opps rate,105.95,76.5% of total billed charges,12.39,100% of Medicaid LA Fee Schedule,12.39,100% of Medicaid LA Fee Schedule,12.39,100% of CMS OPPS Rate,12.39,100% of CMS OPPS Rate,62.33,45% of total billed charges,96.95,70% of total billed charges,83.1,60% of total billed charges,12.39,100% of CMS OPPS Rate,13.76,90% OF UHC FEE SCHEDULE,96.95,70% of total billed charges,12.39,100% OF CMS OPPS Rate,28.49,230% OF CMS OPPS Rate,66.48,48% of total Billed charges,12.39,100% OF CMS OPPS Rate,124.65,90% of total Billed charges,12.39,100% of Medicaid LA Fee Schedule,12.39,100% of Medicaid LA Fee Schedule,12.39,100% of Medicaid LA Fee Schedule,12.39,100% of Medicaid LA Fee Schedule,12.39,100% of Medicaid LA Fee Schedule,12.39,100% of Medicaid LA Fee Schedule,12.39,100% of CMS OPPS Rate,12.39,100% of CMS OPPS Rate,12.39,100% of CMS OPPS Rate,12.39,100% of CMS OPPS Rate,12.39,100% of CMS OPPS Rate,12.39,100% of CMS OPPS Rate,12.39,100% of CMS OPPS Rate,12.39,100% of CMS OPPS Rate,12.39,124.65,83.1
Outpatient,Laboratory,86757,"ANTIBODY INFLU,RICKETTSIA",300,58,68.49,354% of CMS OPPS Rate,19.35,100% of Medicaid LA Fee Schedule,19.35,100% of CMS OPPS Rate,19.35,100% of CMS OPPS Rate,48.73,203.89% of BCBS Fee Schedule,40.6,70% of total Billed Charges,43.5,75% of total Billed Charges,34.83,180% OF CMS OPPS RATE,46.4,80% of total Billed Charges,67.72,350% of CMS Opps rate,19.73,102% of CMS Opps rate,44.37,76.5% of total billed charges,19.35,100% of Medicaid LA Fee Schedule,19.35,100% of Medicaid LA Fee Schedule,19.35,100% of CMS OPPS Rate,19.35,100% of CMS OPPS Rate,26.1,45% of total billed charges,40.6,70% of total billed charges,34.8,60% of total billed charges,19.35,100% of CMS OPPS Rate,21.51,90% OF UHC FEE SCHEDULE,40.6,70% of total billed charges,19.35,100% OF CMS OPPS Rate,44.5,230% OF CMS OPPS Rate,27.84,48% of total Billed charges,19.35,100% OF CMS OPPS Rate,52.2,90% of total Billed charges,19.35,100% of Medicaid LA Fee Schedule,19.35,100% of Medicaid LA Fee Schedule,19.35,100% of Medicaid LA Fee Schedule,19.35,100% of Medicaid LA Fee Schedule,19.35,100% of Medicaid LA Fee Schedule,19.35,100% of Medicaid LA Fee Schedule,19.35,100% of CMS OPPS Rate,19.35,100% of CMS OPPS Rate,19.35,100% of CMS OPPS Rate,19.35,100% of CMS OPPS Rate,19.35,100% of CMS OPPS Rate,19.35,100% of CMS OPPS Rate,19.35,100% of CMS OPPS Rate,19.35,100% of CMS OPPS Rate,19.35,68.49,34.8
Outpatient,Laboratory,86762,Blood test to determine if antibodies exist for rubella,300,43,50.94,354% of CMS OPPS Rate,14.39,100% of Medicaid LA Fee Schedule,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,36.23,203.89% of BCBS Fee Schedule,30.1,70% of total Billed Charges,32.25,75% of total Billed Charges,25.9,180% OF CMS OPPS RATE,34.4,80% of total Billed Charges,50.36,350% of CMS Opps rate,14.67,102% of CMS Opps rate,32.9,76.5% of total billed charges,14.39,100% of Medicaid LA Fee Schedule,14.39,100% of Medicaid LA Fee Schedule,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,19.35,45% of total billed charges,30.1,70% of total billed charges,25.8,60% of total billed charges,14.39,100% of CMS OPPS Rate,15.99,90% OF UHC FEE SCHEDULE,30.1,70% of total billed charges,14.39,100% OF CMS OPPS Rate,33.09,230% OF CMS OPPS Rate,20.64,48% of total Billed charges,14.39,100% OF CMS OPPS Rate,38.7,90% of total Billed charges,14.39,100% of Medicaid LA Fee Schedule,14.39,100% of Medicaid LA Fee Schedule,14.39,100% of Medicaid LA Fee Schedule,14.39,100% of Medicaid LA Fee Schedule,14.39,100% of Medicaid LA Fee Schedule,14.39,100% of Medicaid LA Fee Schedule,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,14.39,50.94,25.8
Outpatient,Laboratory,86765,Blood test to determine if antibodies exist for measles,300,62,45.59,354% of CMS OPPS Rate,12.88,100% of Medicaid LA Fee Schedule,12.88,100% of CMS OPPS Rate,12.88,100% of CMS OPPS Rate,32.42,203.89% of BCBS Fee Schedule,43.4,70% of total Billed Charges,46.5,75% of total Billed Charges,23.18,180% OF CMS OPPS RATE,49.6,80% of total Billed Charges,45.08,350% of CMS Opps rate,13.13,102% of CMS Opps rate,47.43,76.5% of total billed charges,12.88,100% of Medicaid LA Fee Schedule,12.88,100% of Medicaid LA Fee Schedule,12.88,100% of CMS OPPS Rate,12.88,100% of CMS OPPS Rate,27.9,45% of total billed charges,43.4,70% of total billed charges,37.2,60% of total billed charges,12.88,100% of CMS OPPS Rate,14.31,90% OF UHC FEE SCHEDULE,43.4,70% of total billed charges,12.88,100% OF CMS OPPS Rate,29.62,230% OF CMS OPPS Rate,29.76,48% of total Billed charges,12.88,100% OF CMS OPPS Rate,55.8,90% of total Billed charges,12.88,100% of Medicaid LA Fee Schedule,12.88,100% of Medicaid LA Fee Schedule,12.88,100% of Medicaid LA Fee Schedule,12.88,100% of Medicaid LA Fee Schedule,12.88,100% of Medicaid LA Fee Schedule,12.88,100% of Medicaid LA Fee Schedule,12.88,100% of CMS OPPS Rate,12.88,100% of CMS OPPS Rate,12.88,100% of CMS OPPS Rate,12.88,100% of CMS OPPS Rate,12.88,100% of CMS OPPS Rate,12.88,100% of CMS OPPS Rate,12.88,100% of CMS OPPS Rate,12.88,100% of CMS OPPS Rate,12.88,55.8,37.2
Outpatient,Laboratory,86768,SALMONELLA ANTIBODY,300,37,46.69,354% of CMS OPPS Rate,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,33.19,203.89% of BCBS Fee Schedule,25.9,70% of total Billed Charges,27.75,75% of total Billed Charges,23.74,180% OF CMS OPPS RATE,29.6,80% of total Billed Charges,46.16,350% of CMS Opps rate,13.45,102% of CMS Opps rate,28.31,76.5% of total billed charges,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,16.65,45% of total billed charges,25.9,70% of total billed charges,22.2,60% of total billed charges,13.19,100% of CMS OPPS Rate,14.65,90% OF UHC FEE SCHEDULE,25.9,70% of total billed charges,13.19,100% OF CMS OPPS Rate,30.33,230% OF CMS OPPS Rate,17.76,48% of total Billed charges,13.19,100% OF CMS OPPS Rate,33.3,90% of total Billed charges,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of Medicaid LA Fee Schedule,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,100% of CMS OPPS Rate,13.19,46.69,22.2
Outpatient,Laboratory,86769,SAR COVID-19 ANTIBODY,300,144,149.14,354% of CMS OPPS Rate,31.6,100% of Medicaid LA Fee Schedule,42.13,100% of CMS OPPS Rate,42.13,100% of CMS OPPS Rate,72,50% of total billed charges,100.8,70% of total Billed Charges,108,75% of total Billed Charges,75.83,180% OF CMS OPPS RATE,115.2,80% of total Billed Charges,147.45,350% of CMS Opps rate,42.97,102% of CMS Opps rate,110.16,76.5% of total billed charges,31.6,100% of Medicaid LA Fee Schedule,31.6,100% of Medicaid LA Fee Schedule,42.13,100% of CMS OPPS Rate,42.13,100% of CMS OPPS Rate,64.8,45% of total billed charges,100.8,70% of total billed charges,86.4,60% of total billed charges,42.13,100% of CMS OPPS Rate,72,50% OF TOTAL BILLED CHARGES,100.8,70% of total billed charges,42.13,100% OF CMS OPPS Rate,96.89,230% OF CMS OPPS Rate,69.12,48% of total Billed charges,42.13,100% OF CMS OPPS Rate,129.6,90% of total Billed charges,31.6,100% of Medicaid LA Fee Schedule,31.6,100% of Medicaid LA Fee Schedule,31.6,100% of Medicaid LA Fee Schedule,31.6,100% of Medicaid LA Fee Schedule,31.6,100% of Medicaid LA Fee Schedule,31.6,100% of Medicaid LA Fee Schedule,42.13,100% of CMS OPPS Rate,42.13,100% of CMS OPPS Rate,42.13,100% of CMS OPPS Rate,42.13,100% of CMS OPPS Rate,42.13,100% of CMS OPPS Rate,42.13,100% of CMS OPPS Rate,42.13,100% of CMS OPPS Rate,42.13,100% of CMS OPPS Rate,31.6,149.14,86.4
Outpatient,Laboratory,86774,TETANUS TOXOID IGG ABS,300,54.9,52.39,354% of CMS OPPS Rate,11.93,100% of Medicaid LA Fee Schedule,14.8,100% of CMS OPPS Rate,14.8,100% of CMS OPPS Rate,37.25,203.89% of BCBS Fee Schedule,38.43,70% of total Billed Charges,41.18,75% of total Billed Charges,26.64,180% OF CMS OPPS RATE,43.92,80% of total Billed Charges,51.8,350% of CMS Opps rate,15.09,102% of CMS Opps rate,42,76.5% of total billed charges,11.93,100% of Medicaid LA Fee Schedule,11.93,100% of Medicaid LA Fee Schedule,14.8,100% of CMS OPPS Rate,14.8,100% of CMS OPPS Rate,24.71,45% of total billed charges,38.43,70% of total billed charges,32.94,60% of total billed charges,14.8,100% of CMS OPPS Rate,16.44,90% OF UHC FEE SCHEDULE,38.43,70% of total billed charges,14.8,100% OF CMS OPPS Rate,34.04,230% OF CMS OPPS Rate,26.35,48% of total Billed charges,14.8,100% OF CMS OPPS Rate,49.41,90% of total Billed charges,11.93,100% of Medicaid LA Fee Schedule,11.93,100% of Medicaid LA Fee Schedule,11.93,100% of Medicaid LA Fee Schedule,11.93,100% of Medicaid LA Fee Schedule,11.93,100% of Medicaid LA Fee Schedule,11.93,100% of Medicaid LA Fee Schedule,14.8,100% of CMS OPPS Rate,14.8,100% of CMS OPPS Rate,14.8,100% of CMS OPPS Rate,14.8,100% of CMS OPPS Rate,14.8,100% of CMS OPPS Rate,14.8,100% of CMS OPPS Rate,14.8,100% of CMS OPPS Rate,14.8,100% of CMS OPPS Rate,11.93,52.39,32.94
Outpatient,Laboratory,86777,TOXOPLASMA (TOXO AB),300,66.15,50.94,354% of CMS OPPS Rate,13.81,100% of Medicaid LA Fee Schedule,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,36.23,203.89% of BCBS Fee Schedule,46.31,70% of total Billed Charges,49.61,75% of total Billed Charges,25.9,180% OF CMS OPPS RATE,52.92,80% of total Billed Charges,50.36,350% of CMS Opps rate,14.67,102% of CMS Opps rate,50.6,76.5% of total billed charges,13.81,100% of Medicaid LA Fee Schedule,13.81,100% of Medicaid LA Fee Schedule,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,29.77,45% of total billed charges,46.31,70% of total billed charges,39.69,60% of total billed charges,14.39,100% of CMS OPPS Rate,15.99,90% OF UHC FEE SCHEDULE,46.31,70% of total billed charges,14.39,100% OF CMS OPPS Rate,33.09,230% OF CMS OPPS Rate,31.75,48% of total Billed charges,14.39,100% OF CMS OPPS Rate,59.54,90% of total Billed charges,13.81,100% of Medicaid LA Fee Schedule,13.81,100% of Medicaid LA Fee Schedule,13.81,100% of Medicaid LA Fee Schedule,13.81,100% of Medicaid LA Fee Schedule,13.81,100% of Medicaid LA Fee Schedule,13.81,100% of Medicaid LA Fee Schedule,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,13.81,59.54,39.69
Outpatient,Laboratory,86778,"TOXOPLASMA, IGM ABS",300,66.15,51.01,354% of CMS OPPS Rate,14.41,100% of Medicaid LA Fee Schedule,14.41,100% of CMS OPPS Rate,14.41,100% of CMS OPPS Rate,36.25,203.89% of BCBS Fee Schedule,46.31,70% of total Billed Charges,49.61,75% of total Billed Charges,25.93,180% OF CMS OPPS RATE,52.92,80% of total Billed Charges,50.43,350% of CMS Opps rate,14.69,102% of CMS Opps rate,50.6,76.5% of total billed charges,14.41,100% of Medicaid LA Fee Schedule,14.41,100% of Medicaid LA Fee Schedule,14.41,100% of CMS OPPS Rate,14.41,100% of CMS OPPS Rate,29.77,45% of total billed charges,46.31,70% of total billed charges,39.69,60% of total billed charges,14.41,100% of CMS OPPS Rate,16,90% OF UHC FEE SCHEDULE,46.31,70% of total billed charges,14.41,100% OF CMS OPPS Rate,33.14,230% OF CMS OPPS Rate,31.75,48% of total Billed charges,14.41,100% OF CMS OPPS Rate,59.54,90% of total Billed charges,14.41,100% of Medicaid LA Fee Schedule,14.41,100% of Medicaid LA Fee Schedule,14.41,100% of Medicaid LA Fee Schedule,14.41,100% of Medicaid LA Fee Schedule,14.41,100% of Medicaid LA Fee Schedule,14.41,100% of Medicaid LA Fee Schedule,14.41,100% of CMS OPPS Rate,14.41,100% of CMS OPPS Rate,14.41,100% of CMS OPPS Rate,14.41,100% of CMS OPPS Rate,14.41,100% of CMS OPPS Rate,14.41,100% of CMS OPPS Rate,14.41,100% of CMS OPPS Rate,14.41,100% of CMS OPPS Rate,14.41,59.54,39.69
Outpatient,Laboratory,86780,Blood test to determine existence of certain bacterium that causes syphilis,300,82.35,46.86,354% of CMS OPPS Rate,13.24,100% of Medicaid LA Fee Schedule,13.24,100% of CMS OPPS Rate,13.24,100% of CMS OPPS Rate,33.32,203.89% of BCBS Fee Schedule,57.65,70% of total Billed Charges,61.76,75% of total Billed Charges,23.83,180% OF CMS OPPS RATE,65.88,80% of total Billed Charges,46.34,350% of CMS Opps rate,13.5,102% of CMS Opps rate,63,76.5% of total billed charges,13.24,100% of Medicaid LA Fee Schedule,13.24,100% of Medicaid LA Fee Schedule,13.24,100% of CMS OPPS Rate,13.24,100% of CMS OPPS Rate,37.06,45% of total billed charges,57.65,70% of total billed charges,49.41,60% of total billed charges,13.24,100% of CMS OPPS Rate,14.71,90% OF UHC FEE SCHEDULE,57.65,70% of total billed charges,13.24,100% OF CMS OPPS Rate,30.45,230% OF CMS OPPS Rate,39.53,48% of total Billed charges,13.24,100% OF CMS OPPS Rate,74.12,90% of total Billed charges,13.24,100% of Medicaid LA Fee Schedule,13.24,100% of Medicaid LA Fee Schedule,13.24,100% of Medicaid LA Fee Schedule,13.24,100% of Medicaid LA Fee Schedule,13.24,100% of Medicaid LA Fee Schedule,13.24,100% of Medicaid LA Fee Schedule,13.24,100% of CMS OPPS Rate,13.24,100% of CMS OPPS Rate,13.24,100% of CMS OPPS Rate,13.24,100% of CMS OPPS Rate,13.24,100% of CMS OPPS Rate,13.24,100% of CMS OPPS Rate,13.24,100% of CMS OPPS Rate,13.24,100% of CMS OPPS Rate,13.24,74.12,49.41
Outpatient,Laboratory,86787,ANTI-VARICELLA  EIA,300,105.05,45.59,354% of CMS OPPS Rate,12.88,100% of Medicaid LA Fee Schedule,12.88,100% of CMS OPPS Rate,12.88,100% of CMS OPPS Rate,32.42,203.89% of BCBS Fee Schedule,73.54,70% of total Billed Charges,78.79,75% of total Billed Charges,23.18,180% OF CMS OPPS RATE,84.04,80% of total Billed Charges,45.08,350% of CMS Opps rate,13.13,102% of CMS Opps rate,80.36,76.5% of total billed charges,12.88,100% of Medicaid LA Fee Schedule,12.88,100% of Medicaid LA Fee Schedule,12.88,100% of CMS OPPS Rate,12.88,100% of CMS OPPS Rate,47.27,45% of total billed charges,73.54,70% of total billed charges,63.03,60% of total billed charges,12.88,100% of CMS OPPS Rate,14.31,90% OF UHC FEE SCHEDULE,73.54,70% of total billed charges,12.88,100% OF CMS OPPS Rate,29.62,230% OF CMS OPPS Rate,50.42,48% of total Billed charges,12.88,100% OF CMS OPPS Rate,94.55,90% of total Billed charges,12.88,100% of Medicaid LA Fee Schedule,12.88,100% of Medicaid LA Fee Schedule,12.88,100% of Medicaid LA Fee Schedule,12.88,100% of Medicaid LA Fee Schedule,12.88,100% of Medicaid LA Fee Schedule,12.88,100% of Medicaid LA Fee Schedule,12.88,100% of CMS OPPS Rate,12.88,100% of CMS OPPS Rate,12.88,100% of CMS OPPS Rate,12.88,100% of CMS OPPS Rate,12.88,100% of CMS OPPS Rate,12.88,100% of CMS OPPS Rate,12.88,100% of CMS OPPS Rate,12.88,100% of CMS OPPS Rate,12.88,94.55,63.03
Outpatient,Laboratory,86788,"WEST NILE VIRUS AB, IGM",300,60,59.64,354% of CMS OPPS Rate,16.85,100% of Medicaid LA Fee Schedule,16.85,100% of CMS OPPS Rate,16.85,100% of CMS OPPS Rate,42.41,203.89% of BCBS Fee Schedule,42,70% of total Billed Charges,45,75% of total Billed Charges,30.33,180% OF CMS OPPS RATE,48,80% of total Billed Charges,58.97,350% of CMS Opps rate,17.18,102% of CMS Opps rate,45.9,76.5% of total billed charges,16.85,100% of Medicaid LA Fee Schedule,16.85,100% of Medicaid LA Fee Schedule,16.85,100% of CMS OPPS Rate,16.85,100% of CMS OPPS Rate,27,45% of total billed charges,42,70% of total billed charges,36,60% of total billed charges,16.85,100% of CMS OPPS Rate,18.72,90% OF UHC FEE SCHEDULE,42,70% of total billed charges,16.85,100% OF CMS OPPS Rate,38.75,230% OF CMS OPPS Rate,28.8,48% of total Billed charges,16.85,100% OF CMS OPPS Rate,54,90% of total Billed charges,16.85,100% of Medicaid LA Fee Schedule,16.85,100% of Medicaid LA Fee Schedule,16.85,100% of Medicaid LA Fee Schedule,16.85,100% of Medicaid LA Fee Schedule,16.85,100% of Medicaid LA Fee Schedule,16.85,100% of Medicaid LA Fee Schedule,16.85,100% of CMS OPPS Rate,16.85,100% of CMS OPPS Rate,16.85,100% of CMS OPPS Rate,16.85,100% of CMS OPPS Rate,16.85,100% of CMS OPPS Rate,16.85,100% of CMS OPPS Rate,16.85,100% of CMS OPPS Rate,16.85,100% of CMS OPPS Rate,16.85,59.64,36
Outpatient,Laboratory,86789,WEST NILE VIRUS ANTIBODY,300,43,50.94,354% of CMS OPPS Rate,14.39,100% of Medicaid LA Fee Schedule,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,36.23,203.89% of BCBS Fee Schedule,30.1,70% of total Billed Charges,32.25,75% of total Billed Charges,25.9,180% OF CMS OPPS RATE,34.4,80% of total Billed Charges,50.36,350% of CMS Opps rate,14.67,102% of CMS Opps rate,32.9,76.5% of total billed charges,14.39,100% of Medicaid LA Fee Schedule,14.39,100% of Medicaid LA Fee Schedule,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,19.35,45% of total billed charges,30.1,70% of total billed charges,25.8,60% of total billed charges,14.39,100% of CMS OPPS Rate,15.99,90% OF UHC FEE SCHEDULE,30.1,70% of total billed charges,14.39,100% OF CMS OPPS Rate,33.09,230% OF CMS OPPS Rate,20.64,48% of total Billed charges,14.39,100% OF CMS OPPS Rate,38.7,90% of total Billed charges,14.39,100% of Medicaid LA Fee Schedule,14.39,100% of Medicaid LA Fee Schedule,14.39,100% of Medicaid LA Fee Schedule,14.39,100% of Medicaid LA Fee Schedule,14.39,100% of Medicaid LA Fee Schedule,14.39,100% of Medicaid LA Fee Schedule,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,14.39,100% of CMS OPPS Rate,14.39,50.94,25.8
Outpatient,Laboratory,86790,WEST NILE VIRUS ABS,300,204.3,45.59,354% of CMS OPPS Rate,12.88,100% of Medicaid LA Fee Schedule,12.88,100% of CMS OPPS Rate,12.88,100% of CMS OPPS Rate,32.42,203.89% of BCBS Fee Schedule,143.01,70% of total Billed Charges,153.23,75% of total Billed Charges,23.18,180% OF CMS OPPS RATE,163.44,80% of total Billed Charges,45.08,350% of CMS Opps rate,13.13,102% of CMS Opps rate,156.29,76.5% of total billed charges,12.88,100% of Medicaid LA Fee Schedule,12.88,100% of Medicaid LA Fee Schedule,12.88,100% of CMS OPPS Rate,12.88,100% of CMS OPPS Rate,91.94,45% of total billed charges,143.01,70% of total billed charges,122.58,60% of total billed charges,12.88,100% of CMS OPPS Rate,14.31,90% OF UHC FEE SCHEDULE,143.01,70% of total billed charges,12.88,100% OF CMS OPPS Rate,29.62,230% OF CMS OPPS Rate,98.06,48% of total Billed charges,12.88,100% OF CMS OPPS Rate,183.87,90% of total Billed charges,12.88,100% of Medicaid LA Fee Schedule,12.88,100% of Medicaid LA Fee Schedule,12.88,100% of Medicaid LA Fee Schedule,12.88,100% of Medicaid LA Fee Schedule,12.88,100% of Medicaid LA Fee Schedule,12.88,100% of Medicaid LA Fee Schedule,12.88,100% of CMS OPPS Rate,12.88,100% of CMS OPPS Rate,12.88,100% of CMS OPPS Rate,12.88,100% of CMS OPPS Rate,12.88,100% of CMS OPPS Rate,12.88,100% of CMS OPPS Rate,12.88,100% of CMS OPPS Rate,12.88,100% of CMS OPPS Rate,12.88,183.87,122.58
Outpatient,Laboratory,86800,"ANTI-THYROGLOBULIN AB,SER",300,95.7,56.32,354% of CMS OPPS Rate,15.91,100% of Medicaid LA Fee Schedule,15.91,100% of CMS OPPS Rate,15.91,100% of CMS OPPS Rate,40.04,203.89% of BCBS Fee Schedule,66.99,70% of total Billed Charges,71.78,75% of total Billed Charges,28.63,180% OF CMS OPPS RATE,76.56,80% of total Billed Charges,55.68,350% of CMS Opps rate,16.22,102% of CMS Opps rate,73.21,76.5% of total billed charges,15.91,100% of Medicaid LA Fee Schedule,15.91,100% of Medicaid LA Fee Schedule,15.91,100% of CMS OPPS Rate,15.91,100% of CMS OPPS Rate,43.07,45% of total billed charges,66.99,70% of total billed charges,57.42,60% of total billed charges,15.91,100% of CMS OPPS Rate,17.68,90% OF UHC FEE SCHEDULE,66.99,70% of total billed charges,15.91,100% OF CMS OPPS Rate,36.59,230% OF CMS OPPS Rate,45.94,48% of total Billed charges,15.91,100% OF CMS OPPS Rate,86.13,90% of total Billed charges,15.91,100% of Medicaid LA Fee Schedule,15.91,100% of Medicaid LA Fee Schedule,15.91,100% of Medicaid LA Fee Schedule,15.91,100% of Medicaid LA Fee Schedule,15.91,100% of Medicaid LA Fee Schedule,15.91,100% of Medicaid LA Fee Schedule,15.91,100% of CMS OPPS Rate,15.91,100% of CMS OPPS Rate,15.91,100% of CMS OPPS Rate,15.91,100% of CMS OPPS Rate,15.91,100% of CMS OPPS Rate,15.91,100% of CMS OPPS Rate,15.91,100% of CMS OPPS Rate,15.91,100% of CMS OPPS Rate,15.91,86.13,57.42
Outpatient,Laboratory,86803,Blood test to determine infection with Hepatitis C,300,188.1,50.51,354% of CMS OPPS Rate,14.27,100% of Medicaid LA Fee Schedule,14.27,100% of CMS OPPS Rate,14.27,100% of CMS OPPS Rate,35.91,203.89% of BCBS Fee Schedule,131.67,70% of total Billed Charges,141.08,75% of total Billed Charges,25.68,180% OF CMS OPPS RATE,150.48,80% of total Billed Charges,49.94,350% of CMS Opps rate,14.55,102% of CMS Opps rate,143.9,76.5% of total billed charges,14.27,100% of Medicaid LA Fee Schedule,14.27,100% of Medicaid LA Fee Schedule,14.27,100% of CMS OPPS Rate,14.27,100% of CMS OPPS Rate,84.65,45% of total billed charges,131.67,70% of total billed charges,112.86,60% of total billed charges,14.27,100% of CMS OPPS Rate,15.85,90% OF UHC FEE SCHEDULE,131.67,70% of total billed charges,14.27,100% OF CMS OPPS Rate,32.82,230% OF CMS OPPS Rate,90.29,48% of total Billed charges,14.27,100% OF CMS OPPS Rate,169.29,90% of total Billed charges,14.27,100% of Medicaid LA Fee Schedule,14.27,100% of Medicaid LA Fee Schedule,14.27,100% of Medicaid LA Fee Schedule,14.27,100% of Medicaid LA Fee Schedule,14.27,100% of Medicaid LA Fee Schedule,14.27,100% of Medicaid LA Fee Schedule,14.27,100% of CMS OPPS Rate,14.27,100% of CMS OPPS Rate,14.27,100% of CMS OPPS Rate,14.27,100% of CMS OPPS Rate,14.27,100% of CMS OPPS Rate,14.27,100% of CMS OPPS Rate,14.27,100% of CMS OPPS Rate,14.27,100% of CMS OPPS Rate,14.27,169.29,112.86
Outpatient,Laboratory,86804,HEPATITIS C CONFIRM,300,182.25,54.83,354% of CMS OPPS Rate,15.49,100% of Medicaid LA Fee Schedule,15.49,100% of CMS OPPS Rate,15.49,100% of CMS OPPS Rate,39,203.89% of BCBS Fee Schedule,127.58,70% of total Billed Charges,136.69,75% of total Billed Charges,27.88,180% OF CMS OPPS RATE,145.8,80% of total Billed Charges,54.21,350% of CMS Opps rate,15.79,102% of CMS Opps rate,139.42,76.5% of total billed charges,15.49,100% of Medicaid LA Fee Schedule,15.49,100% of Medicaid LA Fee Schedule,15.49,100% of CMS OPPS Rate,15.49,100% of CMS OPPS Rate,82.01,45% of total billed charges,127.58,70% of total billed charges,109.35,60% of total billed charges,15.49,100% of CMS OPPS Rate,17.22,90% OF UHC FEE SCHEDULE,127.58,70% of total billed charges,15.49,100% OF CMS OPPS Rate,35.62,230% OF CMS OPPS Rate,87.48,48% of total Billed charges,15.49,100% OF CMS OPPS Rate,164.03,90% of total Billed charges,15.49,100% of Medicaid LA Fee Schedule,15.49,100% of Medicaid LA Fee Schedule,15.49,100% of Medicaid LA Fee Schedule,15.49,100% of Medicaid LA Fee Schedule,15.49,100% of Medicaid LA Fee Schedule,15.49,100% of Medicaid LA Fee Schedule,15.49,100% of CMS OPPS Rate,15.49,100% of CMS OPPS Rate,15.49,100% of CMS OPPS Rate,15.49,100% of CMS OPPS Rate,15.49,100% of CMS OPPS Rate,15.49,100% of CMS OPPS Rate,15.49,100% of CMS OPPS Rate,15.49,100% of CMS OPPS Rate,15.49,164.03,109.35
Outpatient,Laboratory,86812,HLA-B27,300,206.8,91.36,354% of CMS OPPS Rate,25.81,100% of Medicaid LA Fee Schedule,25.81,100% of CMS OPPS Rate,25.81,100% of CMS OPPS Rate,64.96,203.89% of BCBS Fee Schedule,144.76,70% of total Billed Charges,155.1,75% of total Billed Charges,46.45,180% OF CMS OPPS RATE,165.44,80% of total Billed Charges,90.33,350% of CMS Opps rate,26.32,102% of CMS Opps rate,158.2,76.5% of total billed charges,25.81,100% of Medicaid LA Fee Schedule,25.81,100% of Medicaid LA Fee Schedule,25.81,100% of CMS OPPS Rate,25.81,100% of CMS OPPS Rate,93.06,45% of total billed charges,144.76,70% of total billed charges,124.08,60% of total billed charges,25.81,100% of CMS OPPS Rate,28.67,90% OF UHC FEE SCHEDULE,144.76,70% of total billed charges,25.81,100% OF CMS OPPS Rate,59.36,230% OF CMS OPPS Rate,99.26,48% of total Billed charges,25.81,100% OF CMS OPPS Rate,186.12,90% of total Billed charges,25.81,100% of Medicaid LA Fee Schedule,25.81,100% of Medicaid LA Fee Schedule,25.81,100% of Medicaid LA Fee Schedule,25.81,100% of Medicaid LA Fee Schedule,25.81,100% of Medicaid LA Fee Schedule,25.81,100% of Medicaid LA Fee Schedule,25.81,100% of CMS OPPS Rate,25.81,100% of CMS OPPS Rate,25.81,100% of CMS OPPS Rate,25.81,100% of CMS OPPS Rate,25.81,100% of CMS OPPS Rate,25.81,100% of CMS OPPS Rate,25.81,100% of CMS OPPS Rate,25.81,100% of CMS OPPS Rate,25.81,186.12,124.08
Outpatient,Laboratory,87015,"CONCENTRATION,MICRO",300,48.15,23.64,354% of CMS OPPS Rate,6.68,100% of Medicaid LA Fee Schedule,6.68,100% of CMS OPPS Rate,6.68,100% of CMS OPPS Rate,16.8,203.89% of BCBS Fee Schedule,33.71,70% of total Billed Charges,36.11,75% of total Billed Charges,12.02,180% OF CMS OPPS RATE,38.52,80% of total Billed Charges,23.38,350% of CMS Opps rate,6.81,102% of CMS Opps rate,36.83,76.5% of total billed charges,6.68,100% of Medicaid LA Fee Schedule,6.68,100% of Medicaid LA Fee Schedule,6.68,100% of CMS OPPS Rate,6.68,100% of CMS OPPS Rate,21.67,45% of total billed charges,33.71,70% of total billed charges,28.89,60% of total billed charges,6.68,100% of CMS OPPS Rate,7.42,90% OF UHC FEE SCHEDULE,33.71,70% of total billed charges,6.68,100% OF CMS OPPS Rate,15.36,230% OF CMS OPPS Rate,23.11,48% of total Billed charges,6.68,100% OF CMS OPPS Rate,43.34,90% of total Billed charges,6.68,100% of Medicaid LA Fee Schedule,6.68,100% of Medicaid LA Fee Schedule,6.68,100% of Medicaid LA Fee Schedule,6.68,100% of Medicaid LA Fee Schedule,6.68,100% of Medicaid LA Fee Schedule,6.68,100% of Medicaid LA Fee Schedule,6.68,100% of CMS OPPS Rate,6.68,100% of CMS OPPS Rate,6.68,100% of CMS OPPS Rate,6.68,100% of CMS OPPS Rate,6.68,100% of CMS OPPS Rate,6.68,100% of CMS OPPS Rate,6.68,100% of CMS OPPS Rate,6.68,100% of CMS OPPS Rate,6.68,43.34,28.89
Outpatient,Laboratory,87040,Blood test to screen for bacteria in the blood,300,279.9,36.53,354% of CMS OPPS Rate,10.32,100% of Medicaid LA Fee Schedule,10.32,100% of CMS OPPS Rate,10.32,100% of CMS OPPS Rate,25.98,203.89% of BCBS Fee Schedule,195.93,70% of total Billed Charges,209.93,75% of total Billed Charges,18.57,180% OF CMS OPPS RATE,223.92,80% of total Billed Charges,36.12,350% of CMS Opps rate,10.52,102% of CMS Opps rate,214.12,76.5% of total billed charges,10.32,100% of Medicaid LA Fee Schedule,10.32,100% of Medicaid LA Fee Schedule,10.32,100% of CMS OPPS Rate,10.32,100% of CMS OPPS Rate,125.96,45% of total billed charges,195.93,70% of total billed charges,167.94,60% of total billed charges,10.32,100% of CMS OPPS Rate,11.47,90% OF UHC FEE SCHEDULE,195.93,70% of total billed charges,10.32,100% OF CMS OPPS Rate,23.73,230% OF CMS OPPS Rate,134.35,48% of total Billed charges,10.32,100% OF CMS OPPS Rate,251.91,90% of total Billed charges,10.32,100% of Medicaid LA Fee Schedule,10.32,100% of Medicaid LA Fee Schedule,10.32,100% of Medicaid LA Fee Schedule,10.32,100% of Medicaid LA Fee Schedule,10.32,100% of Medicaid LA Fee Schedule,10.32,100% of Medicaid LA Fee Schedule,10.32,100% of CMS OPPS Rate,10.32,100% of CMS OPPS Rate,10.32,100% of CMS OPPS Rate,10.32,100% of CMS OPPS Rate,10.32,100% of CMS OPPS Rate,10.32,100% of CMS OPPS Rate,10.32,100% of CMS OPPS Rate,10.32,100% of CMS OPPS Rate,10.32,251.91,167.94
Outpatient,Laboratory,87045,"CULTURE/SEN, STOOL",300,173.7,33.41,354% of CMS OPPS Rate,9.44,100% of Medicaid LA Fee Schedule,9.44,100% of CMS OPPS Rate,9.44,100% of CMS OPPS Rate,23.77,203.89% of BCBS Fee Schedule,121.59,70% of total Billed Charges,130.28,75% of total Billed Charges,16.99,180% OF CMS OPPS RATE,138.96,80% of total Billed Charges,33.04,350% of CMS Opps rate,9.62,102% of CMS Opps rate,132.88,76.5% of total billed charges,9.44,100% of Medicaid LA Fee Schedule,9.44,100% of Medicaid LA Fee Schedule,9.44,100% of CMS OPPS Rate,9.44,100% of CMS OPPS Rate,78.17,45% of total billed charges,121.59,70% of total billed charges,104.22,60% of total billed charges,9.44,100% of CMS OPPS Rate,10.49,90% OF UHC FEE SCHEDULE,121.59,70% of total billed charges,9.44,100% OF CMS OPPS Rate,21.71,230% OF CMS OPPS Rate,83.38,48% of total Billed charges,9.44,100% OF CMS OPPS Rate,156.33,90% of total Billed charges,9.44,100% of Medicaid LA Fee Schedule,9.44,100% of Medicaid LA Fee Schedule,9.44,100% of Medicaid LA Fee Schedule,9.44,100% of Medicaid LA Fee Schedule,9.44,100% of Medicaid LA Fee Schedule,9.44,100% of Medicaid LA Fee Schedule,9.44,100% of CMS OPPS Rate,9.44,100% of CMS OPPS Rate,9.44,100% of CMS OPPS Rate,9.44,100% of CMS OPPS Rate,9.44,100% of CMS OPPS Rate,9.44,100% of CMS OPPS Rate,9.44,100% of CMS OPPS Rate,9.44,100% of CMS OPPS Rate,9.44,156.33,104.22
Outpatient,Laboratory,87046,Blood test to identify bacteria that may be contributing to symptoms in the gastrointestinal tract,300,28,33.41,354% of CMS OPPS Rate,3.56,100% of Medicaid LA Fee Schedule,9.44,100% of CMS OPPS Rate,9.44,100% of CMS OPPS Rate,23.77,203.89% of BCBS Fee Schedule,19.6,70% of total Billed Charges,21,75% of total Billed Charges,16.99,180% OF CMS OPPS RATE,22.4,80% of total Billed Charges,33.04,350% of CMS Opps rate,9.62,102% of CMS Opps rate,21.42,76.5% of total billed charges,3.56,100% of Medicaid LA Fee Schedule,3.56,100% of Medicaid LA Fee Schedule,9.44,100% of CMS OPPS Rate,9.44,100% of CMS OPPS Rate,12.6,45% of total billed charges,19.6,70% of total billed charges,16.8,60% of total billed charges,9.44,100% of CMS OPPS Rate,10.49,90% OF UHC FEE SCHEDULE,19.6,70% of total billed charges,9.44,100% OF CMS OPPS Rate,21.71,230% OF CMS OPPS Rate,13.44,48% of total Billed charges,9.44,100% OF CMS OPPS Rate,25.2,90% of total Billed charges,3.56,100% of Medicaid LA Fee Schedule,3.56,100% of Medicaid LA Fee Schedule,3.56,100% of Medicaid LA Fee Schedule,3.56,100% of Medicaid LA Fee Schedule,3.56,100% of Medicaid LA Fee Schedule,3.56,100% of Medicaid LA Fee Schedule,9.44,100% of CMS OPPS Rate,9.44,100% of CMS OPPS Rate,9.44,100% of CMS OPPS Rate,9.44,100% of CMS OPPS Rate,9.44,100% of CMS OPPS Rate,9.44,100% of CMS OPPS Rate,9.44,100% of CMS OPPS Rate,9.44,100% of CMS OPPS Rate,3.56,33.41,16.8
Outpatient,Laboratory,87070,Test of body fluid other than blood to assess for bacteria,300,222.3,30.51,354% of CMS OPPS Rate,8.62,100% of Medicaid LA Fee Schedule,8.61,100% of CMS OPPS Rate,8.61,100% of CMS OPPS Rate,21.69,203.89% of BCBS Fee Schedule,155.61,70% of total Billed Charges,166.73,75% of total Billed Charges,15.51,180% OF CMS OPPS RATE,177.84,80% of total Billed Charges,30.16,350% of CMS Opps rate,8.79,102% of CMS Opps rate,170.06,76.5% of total billed charges,8.62,100% of Medicaid LA Fee Schedule,8.62,100% of Medicaid LA Fee Schedule,8.61,100% of CMS OPPS Rate,8.61,100% of CMS OPPS Rate,100.04,45% of total billed charges,155.61,70% of total billed charges,133.38,60% of total billed charges,8.61,100% of CMS OPPS Rate,9.58,90% OF UHC FEE SCHEDULE,155.61,70% of total billed charges,8.61,100% OF CMS OPPS Rate,19.82,230% OF CMS OPPS Rate,106.7,48% of total Billed charges,8.61,100% OF CMS OPPS Rate,200.07,90% of total Billed charges,8.62,100% of Medicaid LA Fee Schedule,8.62,100% of Medicaid LA Fee Schedule,8.62,100% of Medicaid LA Fee Schedule,8.62,100% of Medicaid LA Fee Schedule,8.62,100% of Medicaid LA Fee Schedule,8.62,100% of Medicaid LA Fee Schedule,8.61,100% of CMS OPPS Rate,8.61,100% of CMS OPPS Rate,8.61,100% of CMS OPPS Rate,8.61,100% of CMS OPPS Rate,8.61,100% of CMS OPPS Rate,8.61,100% of CMS OPPS Rate,8.61,100% of CMS OPPS Rate,8.61,100% of CMS OPPS Rate,8.61,200.07,133.38
Outpatient,Laboratory,87071,CULTURE BACTERIAL QUANT,300,173.7,35.01,354% of CMS OPPS Rate,7.14,100% of Medicaid LA Fee Schedule,9.89,100% of CMS OPPS Rate,9.89,100% of CMS OPPS Rate,23.77,203.89% of BCBS Fee Schedule,121.59,70% of total Billed Charges,130.28,75% of total Billed Charges,17.8,180% OF CMS OPPS RATE,138.96,80% of total Billed Charges,34.61,350% of CMS Opps rate,10.08,102% of CMS Opps rate,132.88,76.5% of total billed charges,7.14,100% of Medicaid LA Fee Schedule,7.14,100% of Medicaid LA Fee Schedule,9.89,100% of CMS OPPS Rate,9.89,100% of CMS OPPS Rate,78.17,45% of total billed charges,121.59,70% of total billed charges,104.22,60% of total billed charges,9.89,100% of CMS OPPS Rate,10.49,90% OF UHC FEE SCHEDULE,121.59,70% of total billed charges,9.89,100% OF CMS OPPS Rate,22.74,230% OF CMS OPPS Rate,83.38,48% of total Billed charges,9.89,100% OF CMS OPPS Rate,156.33,90% of total Billed charges,7.14,100% of Medicaid LA Fee Schedule,7.14,100% of Medicaid LA Fee Schedule,7.14,100% of Medicaid LA Fee Schedule,7.14,100% of Medicaid LA Fee Schedule,7.14,100% of Medicaid LA Fee Schedule,7.14,100% of Medicaid LA Fee Schedule,9.89,100% of CMS OPPS Rate,9.89,100% of CMS OPPS Rate,9.89,100% of CMS OPPS Rate,9.89,100% of CMS OPPS Rate,9.89,100% of CMS OPPS Rate,9.89,100% of CMS OPPS Rate,9.89,100% of CMS OPPS Rate,9.89,100% of CMS OPPS Rate,7.14,156.33,104.22
Outpatient,Laboratory,87075,ANAEROB BACT CULTURE W ID,300,54.9,33.52,354% of CMS OPPS Rate,9.47,100% of Medicaid LA Fee Schedule,9.47,100% of CMS OPPS Rate,9.47,100% of CMS OPPS Rate,23.83,203.89% of BCBS Fee Schedule,38.43,70% of total Billed Charges,41.18,75% of total Billed Charges,17.04,180% OF CMS OPPS RATE,43.92,80% of total Billed Charges,33.14,350% of CMS Opps rate,9.65,102% of CMS Opps rate,42,76.5% of total billed charges,9.47,100% of Medicaid LA Fee Schedule,9.47,100% of Medicaid LA Fee Schedule,9.47,100% of CMS OPPS Rate,9.47,100% of CMS OPPS Rate,24.71,45% of total billed charges,38.43,70% of total billed charges,32.94,60% of total billed charges,9.47,100% of CMS OPPS Rate,10.52,90% OF UHC FEE SCHEDULE,38.43,70% of total billed charges,9.47,100% OF CMS OPPS Rate,21.78,230% OF CMS OPPS Rate,26.35,48% of total Billed charges,9.47,100% OF CMS OPPS Rate,49.41,90% of total Billed charges,9.47,100% of Medicaid LA Fee Schedule,9.47,100% of Medicaid LA Fee Schedule,9.47,100% of Medicaid LA Fee Schedule,9.47,100% of Medicaid LA Fee Schedule,9.47,100% of Medicaid LA Fee Schedule,9.47,100% of Medicaid LA Fee Schedule,9.47,100% of CMS OPPS Rate,9.47,100% of CMS OPPS Rate,9.47,100% of CMS OPPS Rate,9.47,100% of CMS OPPS Rate,9.47,100% of CMS OPPS Rate,9.47,100% of CMS OPPS Rate,9.47,100% of CMS OPPS Rate,9.47,100% of CMS OPPS Rate,9.47,49.41,32.94
Outpatient,Laboratory,87076,"ANAEROBIC ISOLATE,ADD ID",300,86.85,28.6,354% of CMS OPPS Rate,8.08,100% of Medicaid LA Fee Schedule,8.08,100% of CMS OPPS Rate,8.08,100% of CMS OPPS Rate,20.33,203.89% of BCBS Fee Schedule,60.8,70% of total Billed Charges,65.14,75% of total Billed Charges,14.54,180% OF CMS OPPS RATE,69.48,80% of total Billed Charges,28.28,350% of CMS Opps rate,8.24,102% of CMS Opps rate,66.44,76.5% of total billed charges,8.08,100% of Medicaid LA Fee Schedule,8.08,100% of Medicaid LA Fee Schedule,8.08,100% of CMS OPPS Rate,8.08,100% of CMS OPPS Rate,39.08,45% of total billed charges,60.8,70% of total billed charges,52.11,60% of total billed charges,8.08,100% of CMS OPPS Rate,8.97,90% OF UHC FEE SCHEDULE,60.8,70% of total billed charges,8.08,100% OF CMS OPPS Rate,18.58,230% OF CMS OPPS Rate,41.69,48% of total Billed charges,8.08,100% OF CMS OPPS Rate,78.17,90% of total Billed charges,8.08,100% of Medicaid LA Fee Schedule,8.08,100% of Medicaid LA Fee Schedule,8.08,100% of Medicaid LA Fee Schedule,8.08,100% of Medicaid LA Fee Schedule,8.08,100% of Medicaid LA Fee Schedule,8.08,100% of Medicaid LA Fee Schedule,8.08,100% of CMS OPPS Rate,8.08,100% of CMS OPPS Rate,8.08,100% of CMS OPPS Rate,8.08,100% of CMS OPPS Rate,8.08,100% of CMS OPPS Rate,8.08,100% of CMS OPPS Rate,8.08,100% of CMS OPPS Rate,8.08,100% of CMS OPPS Rate,8.08,78.17,52.11
Outpatient,Laboratory,87077,Test of a wound for type of bacterial infection,300,37.8,28.6,354% of CMS OPPS Rate,8.08,100% of Medicaid LA Fee Schedule,8.08,100% of CMS OPPS Rate,8.08,100% of CMS OPPS Rate,20.33,203.89% of BCBS Fee Schedule,26.46,70% of total Billed Charges,28.35,75% of total Billed Charges,14.54,180% OF CMS OPPS RATE,30.24,80% of total Billed Charges,28.28,350% of CMS Opps rate,8.24,102% of CMS Opps rate,28.92,76.5% of total billed charges,8.08,100% of Medicaid LA Fee Schedule,8.08,100% of Medicaid LA Fee Schedule,8.08,100% of CMS OPPS Rate,8.08,100% of CMS OPPS Rate,17.01,45% of total billed charges,26.46,70% of total billed charges,22.68,60% of total billed charges,8.08,100% of CMS OPPS Rate,8.97,90% OF UHC FEE SCHEDULE,26.46,70% of total billed charges,8.08,100% OF CMS OPPS Rate,18.58,230% OF CMS OPPS Rate,18.14,48% of total Billed charges,8.08,100% OF CMS OPPS Rate,34.02,90% of total Billed charges,8.08,100% of Medicaid LA Fee Schedule,8.08,100% of Medicaid LA Fee Schedule,8.08,100% of Medicaid LA Fee Schedule,8.08,100% of Medicaid LA Fee Schedule,8.08,100% of Medicaid LA Fee Schedule,8.08,100% of Medicaid LA Fee Schedule,8.08,100% of CMS OPPS Rate,8.08,100% of CMS OPPS Rate,8.08,100% of CMS OPPS Rate,8.08,100% of CMS OPPS Rate,8.08,100% of CMS OPPS Rate,8.08,100% of CMS OPPS Rate,8.08,100% of CMS OPPS Rate,8.08,100% of CMS OPPS Rate,8.08,34.02,22.68
Outpatient,Laboratory,87081,Medical test to find an infection,300,219.15,23.47,354% of CMS OPPS Rate,6.63,100% of Medicaid LA Fee Schedule,6.63,100% of CMS OPPS Rate,6.63,100% of CMS OPPS Rate,16.68,203.89% of BCBS Fee Schedule,153.41,70% of total Billed Charges,164.36,75% of total Billed Charges,11.93,180% OF CMS OPPS RATE,175.32,80% of total Billed Charges,23.2,350% of CMS Opps rate,6.76,102% of CMS Opps rate,167.65,76.5% of total billed charges,6.63,100% of Medicaid LA Fee Schedule,6.63,100% of Medicaid LA Fee Schedule,6.63,100% of CMS OPPS Rate,6.63,100% of CMS OPPS Rate,98.62,45% of total billed charges,153.41,70% of total billed charges,131.49,60% of total billed charges,6.63,100% of CMS OPPS Rate,7.36,90% OF UHC FEE SCHEDULE,153.41,70% of total billed charges,6.63,100% OF CMS OPPS Rate,15.24,230% OF CMS OPPS Rate,105.19,48% of total Billed charges,6.63,100% OF CMS OPPS Rate,197.24,90% of total Billed charges,6.63,100% of Medicaid LA Fee Schedule,6.63,100% of Medicaid LA Fee Schedule,6.63,100% of Medicaid LA Fee Schedule,6.63,100% of Medicaid LA Fee Schedule,6.63,100% of Medicaid LA Fee Schedule,6.63,100% of Medicaid LA Fee Schedule,6.63,100% of CMS OPPS Rate,6.63,100% of CMS OPPS Rate,6.63,100% of CMS OPPS Rate,6.63,100% of CMS OPPS Rate,6.63,100% of CMS OPPS Rate,6.63,100% of CMS OPPS Rate,6.63,100% of CMS OPPS Rate,6.63,100% of CMS OPPS Rate,6.63,197.24,131.49
Outpatient,Laboratory,87086,Culture of the urine to determine number of bacteria,300,135,28.56,354% of CMS OPPS Rate,8.07,100% of Medicaid LA Fee Schedule,8.07,100% of CMS OPPS Rate,8.07,100% of CMS OPPS Rate,20.31,203.89% of BCBS Fee Schedule,94.5,70% of total Billed Charges,101.25,75% of total Billed Charges,14.52,180% OF CMS OPPS RATE,108,80% of total Billed Charges,28.24,350% of CMS Opps rate,8.23,102% of CMS Opps rate,103.28,76.5% of total billed charges,8.07,100% of Medicaid LA Fee Schedule,8.07,100% of Medicaid LA Fee Schedule,8.07,100% of CMS OPPS Rate,8.07,100% of CMS OPPS Rate,60.75,45% of total billed charges,94.5,70% of total billed charges,81,60% of total billed charges,8.07,100% of CMS OPPS Rate,8.96,90% OF UHC FEE SCHEDULE,94.5,70% of total billed charges,8.07,100% OF CMS OPPS Rate,18.56,230% OF CMS OPPS Rate,64.8,48% of total Billed charges,8.07,100% OF CMS OPPS Rate,121.5,90% of total Billed charges,8.07,100% of Medicaid LA Fee Schedule,8.07,100% of Medicaid LA Fee Schedule,8.07,100% of Medicaid LA Fee Schedule,8.07,100% of Medicaid LA Fee Schedule,8.07,100% of Medicaid LA Fee Schedule,8.07,100% of Medicaid LA Fee Schedule,8.07,100% of CMS OPPS Rate,8.07,100% of CMS OPPS Rate,8.07,100% of CMS OPPS Rate,8.07,100% of CMS OPPS Rate,8.07,100% of CMS OPPS Rate,8.07,100% of CMS OPPS Rate,8.07,100% of CMS OPPS Rate,8.07,100% of CMS OPPS Rate,8.07,121.5,81
Outpatient,Laboratory,87088,Culture of the urine to determine bacterial infection,300,48.15,28.63,354% of CMS OPPS Rate,8.09,100% of Medicaid LA Fee Schedule,8.09,100% of CMS OPPS Rate,8.09,100% of CMS OPPS Rate,20.37,203.89% of BCBS Fee Schedule,33.71,70% of total Billed Charges,36.11,75% of total Billed Charges,14.56,180% OF CMS OPPS RATE,38.52,80% of total Billed Charges,28.31,350% of CMS Opps rate,8.25,102% of CMS Opps rate,36.83,76.5% of total billed charges,8.09,100% of Medicaid LA Fee Schedule,8.09,100% of Medicaid LA Fee Schedule,8.09,100% of CMS OPPS Rate,8.09,100% of CMS OPPS Rate,21.67,45% of total billed charges,33.71,70% of total billed charges,28.89,60% of total billed charges,8.09,100% of CMS OPPS Rate,8.99,90% OF UHC FEE SCHEDULE,33.71,70% of total billed charges,8.09,100% OF CMS OPPS Rate,18.6,230% OF CMS OPPS Rate,23.11,48% of total Billed charges,8.09,100% OF CMS OPPS Rate,43.34,90% of total Billed charges,8.09,100% of Medicaid LA Fee Schedule,8.09,100% of Medicaid LA Fee Schedule,8.09,100% of Medicaid LA Fee Schedule,8.09,100% of Medicaid LA Fee Schedule,8.09,100% of Medicaid LA Fee Schedule,8.09,100% of Medicaid LA Fee Schedule,8.09,100% of CMS OPPS Rate,8.09,100% of CMS OPPS Rate,8.09,100% of CMS OPPS Rate,8.09,100% of CMS OPPS Rate,8.09,100% of CMS OPPS Rate,8.09,100% of CMS OPPS Rate,8.09,100% of CMS OPPS Rate,8.09,100% of CMS OPPS Rate,8.09,43.34,28.89
Outpatient,Laboratory,87102,CULTURE-FUNGUS-MISC-SPEC,300,100.35,29.77,354% of CMS OPPS Rate,8.41,100% of Medicaid LA Fee Schedule,8.41,100% of CMS OPPS Rate,8.41,100% of CMS OPPS Rate,21.16,203.89% of BCBS Fee Schedule,70.25,70% of total Billed Charges,75.26,75% of total Billed Charges,15.13,180% OF CMS OPPS RATE,80.28,80% of total Billed Charges,29.43,350% of CMS Opps rate,8.57,102% of CMS Opps rate,76.77,76.5% of total billed charges,8.41,100% of Medicaid LA Fee Schedule,8.41,100% of Medicaid LA Fee Schedule,8.41,100% of CMS OPPS Rate,8.41,100% of CMS OPPS Rate,45.16,45% of total billed charges,70.25,70% of total billed charges,60.21,60% of total billed charges,8.41,100% of CMS OPPS Rate,9.34,90% OF UHC FEE SCHEDULE,70.25,70% of total billed charges,8.41,100% OF CMS OPPS Rate,19.34,230% OF CMS OPPS Rate,48.17,48% of total Billed charges,8.41,100% OF CMS OPPS Rate,90.32,90% of total Billed charges,8.41,100% of Medicaid LA Fee Schedule,8.41,100% of Medicaid LA Fee Schedule,8.41,100% of Medicaid LA Fee Schedule,8.41,100% of Medicaid LA Fee Schedule,8.41,100% of Medicaid LA Fee Schedule,8.41,100% of Medicaid LA Fee Schedule,8.41,100% of CMS OPPS Rate,8.41,100% of CMS OPPS Rate,8.41,100% of CMS OPPS Rate,8.41,100% of CMS OPPS Rate,8.41,100% of CMS OPPS Rate,8.41,100% of CMS OPPS Rate,8.41,100% of CMS OPPS Rate,8.41,100% of CMS OPPS Rate,8.41,90.32,60.21
Outpatient,Laboratory,87103,"CULTURE,FUNGAL/BLOOD",300,279.9,72.42,354% of CMS OPPS Rate,10.33,100% of Medicaid LA Fee Schedule,20.46,100% of CMS OPPS Rate,20.46,100% of CMS OPPS Rate,41.72,203.89% of BCBS Fee Schedule,195.93,70% of total Billed Charges,209.93,75% of total Billed Charges,36.82,180% OF CMS OPPS RATE,223.92,80% of total Billed Charges,71.61,350% of CMS Opps rate,20.86,102% of CMS Opps rate,214.12,76.5% of total billed charges,10.33,100% of Medicaid LA Fee Schedule,10.33,100% of Medicaid LA Fee Schedule,20.46,100% of CMS OPPS Rate,20.46,100% of CMS OPPS Rate,125.96,45% of total billed charges,195.93,70% of total billed charges,167.94,60% of total billed charges,20.46,100% of CMS OPPS Rate,18.41,90% OF UHC FEE SCHEDULE,195.93,70% of total billed charges,20.46,100% OF CMS OPPS Rate,47.05,230% OF CMS OPPS Rate,134.35,48% of total Billed charges,20.46,100% OF CMS OPPS Rate,251.91,90% of total Billed charges,10.33,100% of Medicaid LA Fee Schedule,10.33,100% of Medicaid LA Fee Schedule,10.33,100% of Medicaid LA Fee Schedule,10.33,100% of Medicaid LA Fee Schedule,10.33,100% of Medicaid LA Fee Schedule,10.33,100% of Medicaid LA Fee Schedule,20.46,100% of CMS OPPS Rate,20.46,100% of CMS OPPS Rate,20.46,100% of CMS OPPS Rate,20.46,100% of CMS OPPS Rate,20.46,100% of CMS OPPS Rate,20.46,100% of CMS OPPS Rate,20.46,100% of CMS OPPS Rate,20.46,100% of CMS OPPS Rate,10.33,251.91,167.94
Outpatient,Laboratory,87106,"FUNGAL ID, YEAST",300,47.25,36.53,354% of CMS OPPS Rate,10.32,100% of Medicaid LA Fee Schedule,10.32,100% of CMS OPPS Rate,10.32,100% of CMS OPPS Rate,25.98,203.89% of BCBS Fee Schedule,33.08,70% of total Billed Charges,35.44,75% of total Billed Charges,18.57,180% OF CMS OPPS RATE,37.8,80% of total Billed Charges,36.12,350% of CMS Opps rate,10.52,102% of CMS Opps rate,36.15,76.5% of total billed charges,10.32,100% of Medicaid LA Fee Schedule,10.32,100% of Medicaid LA Fee Schedule,10.32,100% of CMS OPPS Rate,10.32,100% of CMS OPPS Rate,21.26,45% of total billed charges,33.08,70% of total billed charges,28.35,60% of total billed charges,10.32,100% of CMS OPPS Rate,11.47,90% OF UHC FEE SCHEDULE,33.08,70% of total billed charges,10.32,100% OF CMS OPPS Rate,23.73,230% OF CMS OPPS Rate,22.68,48% of total Billed charges,10.32,100% OF CMS OPPS Rate,42.53,90% of total Billed charges,10.32,100% of Medicaid LA Fee Schedule,10.32,100% of Medicaid LA Fee Schedule,10.32,100% of Medicaid LA Fee Schedule,10.32,100% of Medicaid LA Fee Schedule,10.32,100% of Medicaid LA Fee Schedule,10.32,100% of Medicaid LA Fee Schedule,10.32,100% of CMS OPPS Rate,10.32,100% of CMS OPPS Rate,10.32,100% of CMS OPPS Rate,10.32,100% of CMS OPPS Rate,10.32,100% of CMS OPPS Rate,10.32,100% of CMS OPPS Rate,10.32,100% of CMS OPPS Rate,10.32,100% of CMS OPPS Rate,10.32,42.53,28.35
Outpatient,Laboratory,87107,"FUNGAL ID, MOLD",300,47.25,36.53,354% of CMS OPPS Rate,10.32,100% of Medicaid LA Fee Schedule,10.32,100% of CMS OPPS Rate,10.32,100% of CMS OPPS Rate,25.98,203.89% of BCBS Fee Schedule,33.08,70% of total Billed Charges,35.44,75% of total Billed Charges,18.57,180% OF CMS OPPS RATE,37.8,80% of total Billed Charges,36.12,350% of CMS Opps rate,10.52,102% of CMS Opps rate,36.15,76.5% of total billed charges,10.32,100% of Medicaid LA Fee Schedule,10.32,100% of Medicaid LA Fee Schedule,10.32,100% of CMS OPPS Rate,10.32,100% of CMS OPPS Rate,21.26,45% of total billed charges,33.08,70% of total billed charges,28.35,60% of total billed charges,10.32,100% of CMS OPPS Rate,11.47,90% OF UHC FEE SCHEDULE,33.08,70% of total billed charges,10.32,100% OF CMS OPPS Rate,23.73,230% OF CMS OPPS Rate,22.68,48% of total Billed charges,10.32,100% OF CMS OPPS Rate,42.53,90% of total Billed charges,10.32,100% of Medicaid LA Fee Schedule,10.32,100% of Medicaid LA Fee Schedule,10.32,100% of Medicaid LA Fee Schedule,10.32,100% of Medicaid LA Fee Schedule,10.32,100% of Medicaid LA Fee Schedule,10.32,100% of Medicaid LA Fee Schedule,10.32,100% of CMS OPPS Rate,10.32,100% of CMS OPPS Rate,10.32,100% of CMS OPPS Rate,10.32,100% of CMS OPPS Rate,10.32,100% of CMS OPPS Rate,10.32,100% of CMS OPPS Rate,10.32,100% of CMS OPPS Rate,10.32,100% of CMS OPPS Rate,10.32,42.53,28.35
Outpatient,Laboratory,87109,CULTURE MYCOPLASMA,300,276,54.48,354% of CMS OPPS Rate,15.39,100% of Medicaid LA Fee Schedule,15.39,100% of CMS OPPS Rate,15.39,100% of CMS OPPS Rate,38.74,203.89% of BCBS Fee Schedule,193.2,70% of total Billed Charges,207,75% of total Billed Charges,27.7,180% OF CMS OPPS RATE,220.8,80% of total Billed Charges,53.86,350% of CMS Opps rate,15.69,102% of CMS Opps rate,211.14,76.5% of total billed charges,15.39,100% of Medicaid LA Fee Schedule,15.39,100% of Medicaid LA Fee Schedule,15.39,100% of CMS OPPS Rate,15.39,100% of CMS OPPS Rate,124.2,45% of total billed charges,193.2,70% of total billed charges,165.6,60% of total billed charges,15.39,100% of CMS OPPS Rate,17.1,90% OF UHC FEE SCHEDULE,193.2,70% of total billed charges,15.39,100% OF CMS OPPS Rate,35.39,230% OF CMS OPPS Rate,132.48,48% of total Billed charges,15.39,100% OF CMS OPPS Rate,248.4,90% of total Billed charges,15.39,100% of Medicaid LA Fee Schedule,15.39,100% of Medicaid LA Fee Schedule,15.39,100% of Medicaid LA Fee Schedule,15.39,100% of Medicaid LA Fee Schedule,15.39,100% of Medicaid LA Fee Schedule,15.39,100% of Medicaid LA Fee Schedule,15.39,100% of CMS OPPS Rate,15.39,100% of CMS OPPS Rate,15.39,100% of CMS OPPS Rate,15.39,100% of CMS OPPS Rate,15.39,100% of CMS OPPS Rate,15.39,100% of CMS OPPS Rate,15.39,100% of CMS OPPS Rate,15.39,100% of CMS OPPS Rate,15.39,248.4,165.6
Outpatient,Laboratory,87110,CULTURE-CHLAMYDIA-MISC SP,300,50,69.38,354% of CMS OPPS Rate,19.6,100% of Medicaid LA Fee Schedule,19.6,100% of CMS OPPS Rate,19.6,100% of CMS OPPS Rate,49.32,203.89% of BCBS Fee Schedule,35,70% of total Billed Charges,37.5,75% of total Billed Charges,35.28,180% OF CMS OPPS RATE,40,80% of total Billed Charges,68.6,350% of CMS Opps rate,19.99,102% of CMS Opps rate,38.25,76.5% of total billed charges,19.6,100% of Medicaid LA Fee Schedule,19.6,100% of Medicaid LA Fee Schedule,19.6,100% of CMS OPPS Rate,19.6,100% of CMS OPPS Rate,22.5,45% of total billed charges,35,70% of total billed charges,30,60% of total billed charges,19.6,100% of CMS OPPS Rate,21.77,90% OF UHC FEE SCHEDULE,35,70% of total billed charges,19.6,100% OF CMS OPPS Rate,45.08,230% OF CMS OPPS Rate,24,48% of total Billed charges,19.6,100% OF CMS OPPS Rate,45,90% of total Billed charges,19.6,100% of Medicaid LA Fee Schedule,19.6,100% of Medicaid LA Fee Schedule,19.6,100% of Medicaid LA Fee Schedule,19.6,100% of Medicaid LA Fee Schedule,19.6,100% of Medicaid LA Fee Schedule,19.6,100% of Medicaid LA Fee Schedule,19.6,100% of CMS OPPS Rate,19.6,100% of CMS OPPS Rate,19.6,100% of CMS OPPS Rate,19.6,100% of CMS OPPS Rate,19.6,100% of CMS OPPS Rate,19.6,100% of CMS OPPS Rate,19.6,100% of CMS OPPS Rate,19.6,100% of CMS OPPS Rate,19.6,69.38,30
Outpatient,Laboratory,87116,"CULTURE, AFB",300,57.6,38.23,354% of CMS OPPS Rate,10.8,100% of Medicaid LA Fee Schedule,10.8,100% of CMS OPPS Rate,10.8,100% of CMS OPPS Rate,27.2,203.89% of BCBS Fee Schedule,40.32,70% of total Billed Charges,43.2,75% of total Billed Charges,19.44,180% OF CMS OPPS RATE,46.08,80% of total Billed Charges,37.8,350% of CMS Opps rate,11.01,102% of CMS Opps rate,44.06,76.5% of total billed charges,10.8,100% of Medicaid LA Fee Schedule,10.8,100% of Medicaid LA Fee Schedule,10.8,100% of CMS OPPS Rate,10.8,100% of CMS OPPS Rate,25.92,45% of total billed charges,40.32,70% of total billed charges,34.56,60% of total billed charges,10.8,100% of CMS OPPS Rate,12.01,90% OF UHC FEE SCHEDULE,40.32,70% of total billed charges,10.8,100% OF CMS OPPS Rate,24.84,230% OF CMS OPPS Rate,27.65,48% of total Billed charges,10.8,100% OF CMS OPPS Rate,51.84,90% of total Billed charges,10.8,100% of Medicaid LA Fee Schedule,10.8,100% of Medicaid LA Fee Schedule,10.8,100% of Medicaid LA Fee Schedule,10.8,100% of Medicaid LA Fee Schedule,10.8,100% of Medicaid LA Fee Schedule,10.8,100% of Medicaid LA Fee Schedule,10.8,100% of CMS OPPS Rate,10.8,100% of CMS OPPS Rate,10.8,100% of CMS OPPS Rate,10.8,100% of CMS OPPS Rate,10.8,100% of CMS OPPS Rate,10.8,100% of CMS OPPS Rate,10.8,100% of CMS OPPS Rate,10.8,100% of CMS OPPS Rate,10.8,51.84,34.56
Outpatient,Laboratory,87118,MYCOBACTERIAL ID,300,N/A,51.71,354% of CMS OPPS Rate,4.97,100% of Medicaid LA Fee Schedule,14.61,100% of CMS OPPS Rate,14.61,100% of CMS OPPS Rate,29.79,203.89% of BCBS Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,26.29,180% OF CMS OPPS RATE,N/A,Not Applicable,51.13,350% of CMS Opps rate,14.9,102% of CMS Opps rate,N/A,Not Applicable,4.97,100% of Medicaid LA Fee Schedule,4.97,100% of Medicaid LA Fee Schedule,14.61,100% of CMS OPPS Rate,14.61,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,14.61,100% of CMS OPPS Rate,13.15,90% OF UHC FEE SCHEDULE,N/A,Not Applicable,14.61,100% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,14.61,100% OF CMS OPPS Rate,N/A,Not Applicable,4.97,100% of Medicaid LA Fee Schedule,4.97,100% of Medicaid LA Fee Schedule,4.97,100% of Medicaid LA Fee Schedule,4.97,100% of Medicaid LA Fee Schedule,4.97,100% of Medicaid LA Fee Schedule,4.97,100% of Medicaid LA Fee Schedule,14.61,100% of CMS OPPS Rate,14.61,100% of CMS OPPS Rate,14.61,100% of CMS OPPS Rate,14.61,100% of CMS OPPS Rate,14.61,100% of CMS OPPS Rate,14.61,100% of CMS OPPS Rate,14.61,100% of CMS OPPS Rate,14.61,100% of CMS OPPS Rate,4.97,51.71,N/A
Outpatient,Laboratory,87140,CULTURE TYPING IMMUNOFLOUR,300,124,19.71,354% of CMS OPPS Rate,5.57,100% of Medicaid LA Fee Schedule,5.57,100% of CMS OPPS Rate,5.57,100% of CMS OPPS Rate,14.03,203.89% of BCBS Fee Schedule,86.8,70% of total Billed Charges,93,75% of total Billed Charges,10.02,180% OF CMS OPPS RATE,99.2,80% of total Billed Charges,19.49,350% of CMS Opps rate,5.68,102% of CMS Opps rate,94.86,76.5% of total billed charges,5.57,100% of Medicaid LA Fee Schedule,5.57,100% of Medicaid LA Fee Schedule,5.57,100% of CMS OPPS Rate,5.57,100% of CMS OPPS Rate,55.8,45% of total billed charges,86.8,70% of total billed charges,74.4,60% of total billed charges,5.57,100% of CMS OPPS Rate,6.19,90% OF UHC FEE SCHEDULE,86.8,70% of total billed charges,5.57,100% OF CMS OPPS Rate,12.81,230% OF CMS OPPS Rate,59.52,48% of total Billed charges,5.57,100% OF CMS OPPS Rate,111.6,90% of total Billed charges,5.57,100% of Medicaid LA Fee Schedule,5.57,100% of Medicaid LA Fee Schedule,5.57,100% of Medicaid LA Fee Schedule,5.57,100% of Medicaid LA Fee Schedule,5.57,100% of Medicaid LA Fee Schedule,5.57,100% of Medicaid LA Fee Schedule,5.57,100% of CMS OPPS Rate,5.57,100% of CMS OPPS Rate,5.57,100% of CMS OPPS Rate,5.57,100% of CMS OPPS Rate,5.57,100% of CMS OPPS Rate,5.57,100% of CMS OPPS Rate,5.57,100% of CMS OPPS Rate,5.57,100% of CMS OPPS Rate,5.57,111.6,74.4
Outpatient,Laboratory,87143,CULTURE TYPING GAS HIGH PRESSURE GLC,300,80.52,44.32,354% of CMS OPPS Rate,12.52,100% of Medicaid LA Fee Schedule,12.52,100% of CMS OPPS Rate,12.52,100% of CMS OPPS Rate,31.52,203.89% of BCBS Fee Schedule,56.36,70% of total Billed Charges,60.39,75% of total Billed Charges,22.53,180% OF CMS OPPS RATE,64.42,80% of total Billed Charges,43.82,350% of CMS Opps rate,12.77,102% of CMS Opps rate,61.6,76.5% of total billed charges,12.52,100% of Medicaid LA Fee Schedule,12.52,100% of Medicaid LA Fee Schedule,12.52,100% of CMS OPPS Rate,12.52,100% of CMS OPPS Rate,36.23,45% of total billed charges,56.36,70% of total billed charges,48.31,60% of total billed charges,12.52,100% of CMS OPPS Rate,13.91,90% OF UHC FEE SCHEDULE,56.36,70% of total billed charges,12.52,100% OF CMS OPPS Rate,28.79,230% OF CMS OPPS Rate,38.65,48% of total Billed charges,12.52,100% OF CMS OPPS Rate,72.47,90% of total Billed charges,12.52,100% of Medicaid LA Fee Schedule,12.52,100% of Medicaid LA Fee Schedule,12.52,100% of Medicaid LA Fee Schedule,12.52,100% of Medicaid LA Fee Schedule,12.52,100% of Medicaid LA Fee Schedule,12.52,100% of Medicaid LA Fee Schedule,12.52,100% of CMS OPPS Rate,12.52,100% of CMS OPPS Rate,12.52,100% of CMS OPPS Rate,12.52,100% of CMS OPPS Rate,12.52,100% of CMS OPPS Rate,12.52,100% of CMS OPPS Rate,12.52,100% of CMS OPPS Rate,12.52,100% of CMS OPPS Rate,12.52,72.47,48.31
Outpatient,Laboratory,87147,"CULTURE,TYPING AGGL ID",300,69.75,18.33,354% of CMS OPPS Rate,5.04,100% of Medicaid LA Fee Schedule,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,13.03,203.89% of BCBS Fee Schedule,48.83,70% of total Billed Charges,52.31,75% of total Billed Charges,9.32,180% OF CMS OPPS RATE,55.8,80% of total Billed Charges,18.13,350% of CMS Opps rate,5.28,102% of CMS Opps rate,53.36,76.5% of total billed charges,5.04,100% of Medicaid LA Fee Schedule,5.04,100% of Medicaid LA Fee Schedule,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,31.39,45% of total billed charges,48.83,70% of total billed charges,41.85,60% of total billed charges,5.18,100% of CMS OPPS Rate,5.75,90% OF UHC FEE SCHEDULE,48.83,70% of total billed charges,5.18,100% OF CMS OPPS Rate,11.91,230% OF CMS OPPS Rate,33.48,48% of total Billed charges,5.18,100% OF CMS OPPS Rate,62.78,90% of total Billed charges,5.04,100% of Medicaid LA Fee Schedule,5.04,100% of Medicaid LA Fee Schedule,5.04,100% of Medicaid LA Fee Schedule,5.04,100% of Medicaid LA Fee Schedule,5.04,100% of Medicaid LA Fee Schedule,5.04,100% of Medicaid LA Fee Schedule,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,5.18,100% of CMS OPPS Rate,5.04,62.78,41.85
Outpatient,Laboratory,87149,CULTURE TYPING ID BY DNA OR RNA,300,184,70.97,354% of CMS OPPS Rate,20.05,100% of Medicaid LA Fee Schedule,20.05,100% of CMS OPPS Rate,20.05,100% of CMS OPPS Rate,50.48,203.89% of BCBS Fee Schedule,128.8,70% of total Billed Charges,138,75% of total Billed Charges,36.09,180% OF CMS OPPS RATE,147.2,80% of total Billed Charges,70.17,350% of CMS Opps rate,20.45,102% of CMS Opps rate,140.76,76.5% of total billed charges,20.05,100% of Medicaid LA Fee Schedule,20.05,100% of Medicaid LA Fee Schedule,20.05,100% of CMS OPPS Rate,20.05,100% of CMS OPPS Rate,82.8,45% of total billed charges,128.8,70% of total billed charges,110.4,60% of total billed charges,20.05,100% of CMS OPPS Rate,22.28,90% OF UHC FEE SCHEDULE,128.8,70% of total billed charges,20.05,100% OF CMS OPPS Rate,46.11,230% OF CMS OPPS Rate,88.32,48% of total Billed charges,20.05,100% OF CMS OPPS Rate,165.6,90% of total Billed charges,20.05,100% of Medicaid LA Fee Schedule,20.05,100% of Medicaid LA Fee Schedule,20.05,100% of Medicaid LA Fee Schedule,20.05,100% of Medicaid LA Fee Schedule,20.05,100% of Medicaid LA Fee Schedule,20.05,100% of Medicaid LA Fee Schedule,20.05,100% of CMS OPPS Rate,20.05,100% of CMS OPPS Rate,20.05,100% of CMS OPPS Rate,20.05,100% of CMS OPPS Rate,20.05,100% of CMS OPPS Rate,20.05,100% of CMS OPPS Rate,20.05,100% of CMS OPPS Rate,20.05,100% of CMS OPPS Rate,20.05,165.6,110.4
Outpatient,Laboratory,87150,CULTURE TYPING ID BY DNA PROBE,300,105,124.21,354% of CMS OPPS Rate,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,88.35,203.89% of BCBS Fee Schedule,73.5,70% of total Billed Charges,78.75,75% of total Billed Charges,63.16,180% OF CMS OPPS RATE,84,80% of total Billed Charges,122.81,350% of CMS Opps rate,35.79,102% of CMS Opps rate,80.33,76.5% of total billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,47.25,45% of total billed charges,73.5,70% of total billed charges,63,60% of total billed charges,35.09,100% of CMS OPPS Rate,39,90% OF UHC FEE SCHEDULE,73.5,70% of total billed charges,35.09,100% OF CMS OPPS Rate,80.7,230% OF CMS OPPS Rate,50.4,48% of total Billed charges,35.09,100% OF CMS OPPS Rate,94.5,90% of total Billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,124.21,63
Outpatient,Laboratory,87153,CULTURE TYPING ID BY NUCLEIC A. SEQUENCE,300,712.1,408.37,354% of CMS OPPS Rate,115.36,100% of Medicaid LA Fee Schedule,115.36,100% of CMS OPPS Rate,115.36,100% of CMS OPPS Rate,290.38,203.89% of BCBS Fee Schedule,498.47,70% of total Billed Charges,534.08,75% of total Billed Charges,207.64,180% OF CMS OPPS RATE,569.68,80% of total Billed Charges,403.76,350% of CMS Opps rate,117.66,102% of CMS Opps rate,544.76,76.5% of total billed charges,115.36,100% of Medicaid LA Fee Schedule,115.36,100% of Medicaid LA Fee Schedule,115.36,100% of CMS OPPS Rate,115.36,100% of CMS OPPS Rate,320.45,45% of total billed charges,498.47,70% of total billed charges,427.26,60% of total billed charges,115.36,100% of CMS OPPS Rate,128.18,90% OF UHC FEE SCHEDULE,498.47,70% of total billed charges,115.36,100% OF CMS OPPS Rate,265.32,230% OF CMS OPPS Rate,341.81,48% of total Billed charges,115.36,100% OF CMS OPPS Rate,640.89,90% of total Billed charges,115.36,100% of Medicaid LA Fee Schedule,115.36,100% of Medicaid LA Fee Schedule,115.36,100% of Medicaid LA Fee Schedule,115.36,100% of Medicaid LA Fee Schedule,115.36,100% of Medicaid LA Fee Schedule,115.36,100% of Medicaid LA Fee Schedule,115.36,100% of CMS OPPS Rate,115.36,100% of CMS OPPS Rate,115.36,100% of CMS OPPS Rate,115.36,100% of CMS OPPS Rate,115.36,100% of CMS OPPS Rate,115.36,100% of CMS OPPS Rate,115.36,100% of CMS OPPS Rate,115.36,100% of CMS OPPS Rate,115.36,640.89,427.26
Outpatient,Laboratory,87168,MACROSCOPIC EXAM ARTHROPOD,300,306,15.11,354% of CMS OPPS Rate,4.27,100% of Medicaid LA Fee Schedule,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,10.75,203.89% of BCBS Fee Schedule,214.2,70% of total Billed Charges,229.5,75% of total Billed Charges,7.68,180% OF CMS OPPS RATE,244.8,80% of total Billed Charges,14.94,350% of CMS Opps rate,4.35,102% of CMS Opps rate,234.09,76.5% of total billed charges,4.27,100% of Medicaid LA Fee Schedule,4.27,100% of Medicaid LA Fee Schedule,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,137.7,45% of total billed charges,214.2,70% of total billed charges,183.6,60% of total billed charges,4.26,100% of CMS OPPS Rate,4.74,90% OF UHC FEE SCHEDULE,214.2,70% of total billed charges,4.26,100% OF CMS OPPS Rate,9.82,230% OF CMS OPPS Rate,146.88,48% of total Billed charges,4.26,100% OF CMS OPPS Rate,275.4,90% of total Billed charges,4.27,100% of Medicaid LA Fee Schedule,4.27,100% of Medicaid LA Fee Schedule,4.27,100% of Medicaid LA Fee Schedule,4.27,100% of Medicaid LA Fee Schedule,4.27,100% of Medicaid LA Fee Schedule,4.27,100% of Medicaid LA Fee Schedule,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,275.4,183.6
Outpatient,Laboratory,87172,PINWORM SLIDE,300,69.75,15.11,354% of CMS OPPS Rate,4.27,100% of Medicaid LA Fee Schedule,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,10.75,203.89% of BCBS Fee Schedule,48.83,70% of total Billed Charges,52.31,75% of total Billed Charges,7.68,180% OF CMS OPPS RATE,55.8,80% of total Billed Charges,14.94,350% of CMS Opps rate,4.35,102% of CMS Opps rate,53.36,76.5% of total billed charges,4.27,100% of Medicaid LA Fee Schedule,4.27,100% of Medicaid LA Fee Schedule,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,31.39,45% of total billed charges,48.83,70% of total billed charges,41.85,60% of total billed charges,4.26,100% of CMS OPPS Rate,4.74,90% OF UHC FEE SCHEDULE,48.83,70% of total billed charges,4.26,100% OF CMS OPPS Rate,9.82,230% OF CMS OPPS Rate,33.48,48% of total Billed charges,4.26,100% OF CMS OPPS Rate,62.78,90% of total Billed charges,4.27,100% of Medicaid LA Fee Schedule,4.27,100% of Medicaid LA Fee Schedule,4.27,100% of Medicaid LA Fee Schedule,4.27,100% of Medicaid LA Fee Schedule,4.27,100% of Medicaid LA Fee Schedule,4.27,100% of Medicaid LA Fee Schedule,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,62.78,41.85
Outpatient,Laboratory,87177,OVA & PARASITE EXAM,300,63.8,31.5,354% of CMS OPPS Rate,8.9,100% of Medicaid LA Fee Schedule,8.9,100% of CMS OPPS Rate,8.9,100% of CMS OPPS Rate,22.41,203.89% of BCBS Fee Schedule,44.66,70% of total Billed Charges,47.85,75% of total Billed Charges,16.02,180% OF CMS OPPS RATE,51.04,80% of total Billed Charges,31.15,350% of CMS Opps rate,9.07,102% of CMS Opps rate,48.81,76.5% of total billed charges,8.9,100% of Medicaid LA Fee Schedule,8.9,100% of Medicaid LA Fee Schedule,8.9,100% of CMS OPPS Rate,8.9,100% of CMS OPPS Rate,28.71,45% of total billed charges,44.66,70% of total billed charges,38.28,60% of total billed charges,8.9,100% of CMS OPPS Rate,9.89,90% OF UHC FEE SCHEDULE,44.66,70% of total billed charges,8.9,100% OF CMS OPPS Rate,20.47,230% OF CMS OPPS Rate,30.62,48% of total Billed charges,8.9,100% OF CMS OPPS Rate,57.42,90% of total Billed charges,8.9,100% of Medicaid LA Fee Schedule,8.9,100% of Medicaid LA Fee Schedule,8.9,100% of Medicaid LA Fee Schedule,8.9,100% of Medicaid LA Fee Schedule,8.9,100% of Medicaid LA Fee Schedule,8.9,100% of Medicaid LA Fee Schedule,8.9,100% of CMS OPPS Rate,8.9,100% of CMS OPPS Rate,8.9,100% of CMS OPPS Rate,8.9,100% of CMS OPPS Rate,8.9,100% of CMS OPPS Rate,8.9,100% of CMS OPPS Rate,8.9,100% of CMS OPPS Rate,8.9,100% of CMS OPPS Rate,8.9,57.42,38.28
Outpatient,Laboratory,87181,"SUSCEPTIBILITY,AGAR DIL",300,137.5,16.81,354% of CMS OPPS Rate,4.75,100% of Medicaid LA Fee Schedule,4.75,100% of CMS OPPS Rate,4.75,100% of CMS OPPS Rate,11.95,203.89% of BCBS Fee Schedule,96.25,70% of total Billed Charges,103.13,75% of total Billed Charges,8.55,180% OF CMS OPPS RATE,110,80% of total Billed Charges,16.62,350% of CMS Opps rate,4.84,102% of CMS Opps rate,105.19,76.5% of total billed charges,4.75,100% of Medicaid LA Fee Schedule,4.75,100% of Medicaid LA Fee Schedule,4.75,100% of CMS OPPS Rate,4.75,100% of CMS OPPS Rate,61.88,45% of total billed charges,96.25,70% of total billed charges,82.5,60% of total billed charges,4.75,100% of CMS OPPS Rate,5.27,90% OF UHC FEE SCHEDULE,96.25,70% of total billed charges,4.75,100% OF CMS OPPS Rate,10.92,230% OF CMS OPPS Rate,66,48% of total Billed charges,4.75,100% OF CMS OPPS Rate,123.75,90% of total Billed charges,4.75,100% of Medicaid LA Fee Schedule,4.75,100% of Medicaid LA Fee Schedule,4.75,100% of Medicaid LA Fee Schedule,4.75,100% of Medicaid LA Fee Schedule,4.75,100% of Medicaid LA Fee Schedule,4.75,100% of Medicaid LA Fee Schedule,4.75,100% of CMS OPPS Rate,4.75,100% of CMS OPPS Rate,4.75,100% of CMS OPPS Rate,4.75,100% of CMS OPPS Rate,4.75,100% of CMS OPPS Rate,4.75,100% of CMS OPPS Rate,4.75,100% of CMS OPPS Rate,4.75,100% of CMS OPPS Rate,4.75,123.75,82.5
Outpatient,Laboratory,87184,SENSITIVITY DISK PER PLAT,300,123.75,26.47,354% of CMS OPPS Rate,7.48,100% of Medicaid LA Fee Schedule,7.48,100% of CMS OPPS Rate,7.48,100% of CMS OPPS Rate,17.35,203.89% of BCBS Fee Schedule,86.63,70% of total Billed Charges,92.81,75% of total Billed Charges,13.46,180% OF CMS OPPS RATE,99,80% of total Billed Charges,26.18,350% of CMS Opps rate,7.62,102% of CMS Opps rate,94.67,76.5% of total billed charges,7.48,100% of Medicaid LA Fee Schedule,7.48,100% of Medicaid LA Fee Schedule,7.48,100% of CMS OPPS Rate,7.48,100% of CMS OPPS Rate,55.69,45% of total billed charges,86.63,70% of total billed charges,74.25,60% of total billed charges,7.48,100% of CMS OPPS Rate,7.66,90% OF UHC FEE SCHEDULE,86.63,70% of total billed charges,7.48,100% OF CMS OPPS Rate,17.2,230% OF CMS OPPS Rate,59.4,48% of total Billed charges,7.48,100% OF CMS OPPS Rate,111.38,90% of total Billed charges,7.48,100% of Medicaid LA Fee Schedule,7.48,100% of Medicaid LA Fee Schedule,7.48,100% of Medicaid LA Fee Schedule,7.48,100% of Medicaid LA Fee Schedule,7.48,100% of Medicaid LA Fee Schedule,7.48,100% of Medicaid LA Fee Schedule,7.48,100% of CMS OPPS Rate,7.48,100% of CMS OPPS Rate,7.48,100% of CMS OPPS Rate,7.48,100% of CMS OPPS Rate,7.48,100% of CMS OPPS Rate,7.48,100% of CMS OPPS Rate,7.48,100% of CMS OPPS Rate,7.48,100% of CMS OPPS Rate,7.48,111.38,74.25
Outpatient,Laboratory,87185,"SUSCEPTIBILITY,ENZYME",300,37.8,16.81,354% of CMS OPPS Rate,4.75,100% of Medicaid LA Fee Schedule,4.75,100% of CMS OPPS Rate,4.75,100% of CMS OPPS Rate,11.95,203.89% of BCBS Fee Schedule,26.46,70% of total Billed Charges,28.35,75% of total Billed Charges,8.55,180% OF CMS OPPS RATE,30.24,80% of total Billed Charges,16.62,350% of CMS Opps rate,4.84,102% of CMS Opps rate,28.92,76.5% of total billed charges,4.75,100% of Medicaid LA Fee Schedule,4.75,100% of Medicaid LA Fee Schedule,4.75,100% of CMS OPPS Rate,4.75,100% of CMS OPPS Rate,17.01,45% of total billed charges,26.46,70% of total billed charges,22.68,60% of total billed charges,4.75,100% of CMS OPPS Rate,5.27,90% OF UHC FEE SCHEDULE,26.46,70% of total billed charges,4.75,100% OF CMS OPPS Rate,10.92,230% OF CMS OPPS Rate,18.14,48% of total Billed charges,4.75,100% OF CMS OPPS Rate,34.02,90% of total Billed charges,4.75,100% of Medicaid LA Fee Schedule,4.75,100% of Medicaid LA Fee Schedule,4.75,100% of Medicaid LA Fee Schedule,4.75,100% of Medicaid LA Fee Schedule,4.75,100% of Medicaid LA Fee Schedule,4.75,100% of Medicaid LA Fee Schedule,4.75,100% of CMS OPPS Rate,4.75,100% of CMS OPPS Rate,4.75,100% of CMS OPPS Rate,4.75,100% of CMS OPPS Rate,4.75,100% of CMS OPPS Rate,4.75,100% of CMS OPPS Rate,4.75,100% of CMS OPPS Rate,4.75,100% of CMS OPPS Rate,4.75,34.02,22.68
Outpatient,Laboratory,87186,A test used to determine which medications work on bacteria for fungi,300,157.95,30.62,354% of CMS OPPS Rate,8.65,100% of Medicaid LA Fee Schedule,8.65,100% of CMS OPPS Rate,8.65,100% of CMS OPPS Rate,21.76,203.89% of BCBS Fee Schedule,110.57,70% of total Billed Charges,118.46,75% of total Billed Charges,15.57,180% OF CMS OPPS RATE,126.36,80% of total Billed Charges,30.27,350% of CMS Opps rate,8.82,102% of CMS Opps rate,120.83,76.5% of total billed charges,8.65,100% of Medicaid LA Fee Schedule,8.65,100% of Medicaid LA Fee Schedule,8.65,100% of CMS OPPS Rate,8.65,100% of CMS OPPS Rate,71.08,45% of total billed charges,110.57,70% of total billed charges,94.77,60% of total billed charges,8.65,100% of CMS OPPS Rate,9.6,90% OF UHC FEE SCHEDULE,110.57,70% of total billed charges,8.65,100% OF CMS OPPS Rate,19.89,230% OF CMS OPPS Rate,75.82,48% of total Billed charges,8.65,100% OF CMS OPPS Rate,142.16,90% of total Billed charges,8.65,100% of Medicaid LA Fee Schedule,8.65,100% of Medicaid LA Fee Schedule,8.65,100% of Medicaid LA Fee Schedule,8.65,100% of Medicaid LA Fee Schedule,8.65,100% of Medicaid LA Fee Schedule,8.65,100% of Medicaid LA Fee Schedule,8.65,100% of CMS OPPS Rate,8.65,100% of CMS OPPS Rate,8.65,100% of CMS OPPS Rate,8.65,100% of CMS OPPS Rate,8.65,100% of CMS OPPS Rate,8.65,100% of CMS OPPS Rate,8.65,100% of CMS OPPS Rate,8.65,100% of CMS OPPS Rate,8.65,142.16,94.77
Outpatient,Laboratory,87190,"TUBERCLE BACILLUS, MIC",300,16,25.87,354% of CMS OPPS Rate,7.27,100% of Medicaid LA Fee Schedule,7.31,100% of CMS OPPS Rate,7.31,100% of CMS OPPS Rate,14.9,203.89% of BCBS Fee Schedule,11.2,70% of total Billed Charges,12,75% of total Billed Charges,13.15,180% OF CMS OPPS RATE,12.8,80% of total Billed Charges,25.58,350% of CMS Opps rate,7.45,102% of CMS Opps rate,12.24,76.5% of total billed charges,7.27,100% of Medicaid LA Fee Schedule,7.27,100% of Medicaid LA Fee Schedule,7.31,100% of CMS OPPS Rate,7.31,100% of CMS OPPS Rate,7.2,45% of total billed charges,11.2,70% of total billed charges,9.6,60% of total billed charges,7.31,100% of CMS OPPS Rate,6.58,90% OF UHC FEE SCHEDULE,11.2,70% of total billed charges,7.31,100% OF CMS OPPS Rate,16,230% OF CMS OPPS Rate,7.68,48% of total Billed charges,7.31,100% OF CMS OPPS Rate,14.4,90% of total Billed charges,7.27,100% of Medicaid LA Fee Schedule,7.27,100% of Medicaid LA Fee Schedule,7.27,100% of Medicaid LA Fee Schedule,7.27,100% of Medicaid LA Fee Schedule,7.27,100% of Medicaid LA Fee Schedule,7.27,100% of Medicaid LA Fee Schedule,7.31,100% of CMS OPPS Rate,7.31,100% of CMS OPPS Rate,7.31,100% of CMS OPPS Rate,7.31,100% of CMS OPPS Rate,7.31,100% of CMS OPPS Rate,7.31,100% of CMS OPPS Rate,7.31,100% of CMS OPPS Rate,7.31,100% of CMS OPPS Rate,6.58,25.87,9.6
Outpatient,Laboratory,87205,A lab test used to detect bacteria or fungi in a sample taken from the site of a suspected infection,300,86.85,15.11,354% of CMS OPPS Rate,4.27,100% of Medicaid LA Fee Schedule,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,10.75,203.89% of BCBS Fee Schedule,60.8,70% of total Billed Charges,65.14,75% of total Billed Charges,7.68,180% OF CMS OPPS RATE,69.48,80% of total Billed Charges,14.94,350% of CMS Opps rate,4.35,102% of CMS Opps rate,66.44,76.5% of total billed charges,4.27,100% of Medicaid LA Fee Schedule,4.27,100% of Medicaid LA Fee Schedule,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,39.08,45% of total billed charges,60.8,70% of total billed charges,52.11,60% of total billed charges,4.26,100% of CMS OPPS Rate,4.74,90% OF UHC FEE SCHEDULE,60.8,70% of total billed charges,4.26,100% OF CMS OPPS Rate,9.82,230% OF CMS OPPS Rate,41.69,48% of total Billed charges,4.26,100% OF CMS OPPS Rate,78.17,90% of total Billed charges,4.27,100% of Medicaid LA Fee Schedule,4.27,100% of Medicaid LA Fee Schedule,4.27,100% of Medicaid LA Fee Schedule,4.27,100% of Medicaid LA Fee Schedule,4.27,100% of Medicaid LA Fee Schedule,4.27,100% of Medicaid LA Fee Schedule,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,78.17,52.11
Outpatient,Laboratory,87206,AFB SMEAR-MISC SPEC,300,54.9,19.08,354% of CMS OPPS Rate,5.39,100% of Medicaid LA Fee Schedule,5.39,100% of CMS OPPS Rate,5.39,100% of CMS OPPS Rate,13.56,203.89% of BCBS Fee Schedule,38.43,70% of total Billed Charges,41.18,75% of total Billed Charges,9.7,180% OF CMS OPPS RATE,43.92,80% of total Billed Charges,18.86,350% of CMS Opps rate,5.49,102% of CMS Opps rate,42,76.5% of total billed charges,5.39,100% of Medicaid LA Fee Schedule,5.39,100% of Medicaid LA Fee Schedule,5.39,100% of CMS OPPS Rate,5.39,100% of CMS OPPS Rate,24.71,45% of total billed charges,38.43,70% of total billed charges,32.94,60% of total billed charges,5.39,100% of CMS OPPS Rate,5.99,90% OF UHC FEE SCHEDULE,38.43,70% of total billed charges,5.39,100% OF CMS OPPS Rate,12.39,230% OF CMS OPPS Rate,26.35,48% of total Billed charges,5.39,100% OF CMS OPPS Rate,49.41,90% of total Billed charges,5.39,100% of Medicaid LA Fee Schedule,5.39,100% of Medicaid LA Fee Schedule,5.39,100% of Medicaid LA Fee Schedule,5.39,100% of Medicaid LA Fee Schedule,5.39,100% of Medicaid LA Fee Schedule,5.39,100% of Medicaid LA Fee Schedule,5.39,100% of CMS OPPS Rate,5.39,100% of CMS OPPS Rate,5.39,100% of CMS OPPS Rate,5.39,100% of CMS OPPS Rate,5.39,100% of CMS OPPS Rate,5.39,100% of CMS OPPS Rate,5.39,100% of CMS OPPS Rate,5.39,100% of CMS OPPS Rate,5.39,49.41,32.94
Outpatient,Laboratory,87207,"MALARIA SMEAR, BLD",300,63,21.2,354% of CMS OPPS Rate,5.99,100% of Medicaid LA Fee Schedule,5.99,100% of CMS OPPS Rate,5.99,100% of CMS OPPS Rate,15.09,203.89% of BCBS Fee Schedule,44.1,70% of total Billed Charges,47.25,75% of total Billed Charges,10.78,180% OF CMS OPPS RATE,50.4,80% of total Billed Charges,20.96,350% of CMS Opps rate,6.1,102% of CMS Opps rate,48.2,76.5% of total billed charges,5.99,100% of Medicaid LA Fee Schedule,5.99,100% of Medicaid LA Fee Schedule,5.99,100% of CMS OPPS Rate,5.99,100% of CMS OPPS Rate,28.35,45% of total billed charges,44.1,70% of total billed charges,37.8,60% of total billed charges,5.99,100% of CMS OPPS Rate,6.66,90% OF UHC FEE SCHEDULE,44.1,70% of total billed charges,5.99,100% OF CMS OPPS Rate,13.77,230% OF CMS OPPS Rate,30.24,48% of total Billed charges,5.99,100% OF CMS OPPS Rate,56.7,90% of total Billed charges,5.99,100% of Medicaid LA Fee Schedule,5.99,100% of Medicaid LA Fee Schedule,5.99,100% of Medicaid LA Fee Schedule,5.99,100% of Medicaid LA Fee Schedule,5.99,100% of Medicaid LA Fee Schedule,5.99,100% of Medicaid LA Fee Schedule,5.99,100% of CMS OPPS Rate,5.99,100% of CMS OPPS Rate,5.99,100% of CMS OPPS Rate,5.99,100% of CMS OPPS Rate,5.99,100% of CMS OPPS Rate,5.99,100% of CMS OPPS Rate,5.99,100% of CMS OPPS Rate,5.99,100% of CMS OPPS Rate,5.99,56.7,37.8
Outpatient,Laboratory,87209,"SMEAR, COMPLEX STAIN",300,54,63.64,354% of CMS OPPS Rate,17.98,100% of Medicaid LA Fee Schedule,17.98,100% of CMS OPPS Rate,17.98,100% of CMS OPPS Rate,45.24,203.89% of BCBS Fee Schedule,37.8,70% of total Billed Charges,40.5,75% of total Billed Charges,32.36,180% OF CMS OPPS RATE,43.2,80% of total Billed Charges,62.93,350% of CMS Opps rate,18.33,102% of CMS Opps rate,41.31,76.5% of total billed charges,17.98,100% of Medicaid LA Fee Schedule,17.98,100% of Medicaid LA Fee Schedule,17.98,100% of CMS OPPS Rate,17.98,100% of CMS OPPS Rate,24.3,45% of total billed charges,37.8,70% of total billed charges,32.4,60% of total billed charges,17.98,100% of CMS OPPS Rate,19.97,90% OF UHC FEE SCHEDULE,37.8,70% of total billed charges,17.98,100% OF CMS OPPS Rate,41.35,230% OF CMS OPPS Rate,25.92,48% of total Billed charges,17.98,100% OF CMS OPPS Rate,48.6,90% of total Billed charges,17.98,100% of Medicaid LA Fee Schedule,17.98,100% of Medicaid LA Fee Schedule,17.98,100% of Medicaid LA Fee Schedule,17.98,100% of Medicaid LA Fee Schedule,17.98,100% of Medicaid LA Fee Schedule,17.98,100% of Medicaid LA Fee Schedule,17.98,100% of CMS OPPS Rate,17.98,100% of CMS OPPS Rate,17.98,100% of CMS OPPS Rate,17.98,100% of CMS OPPS Rate,17.98,100% of CMS OPPS Rate,17.98,100% of CMS OPPS Rate,17.98,100% of CMS OPPS Rate,17.98,100% of CMS OPPS Rate,17.98,63.64,32.4
Outpatient,Laboratory,87220,FUNGUS DIR PREP-MISC SPEC,300,61.65,15.11,354% of CMS OPPS Rate,4.27,100% of Medicaid LA Fee Schedule,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,10.75,203.89% of BCBS Fee Schedule,43.16,70% of total Billed Charges,46.24,75% of total Billed Charges,7.68,180% OF CMS OPPS RATE,49.32,80% of total Billed Charges,14.94,350% of CMS Opps rate,4.35,102% of CMS Opps rate,47.16,76.5% of total billed charges,4.27,100% of Medicaid LA Fee Schedule,4.27,100% of Medicaid LA Fee Schedule,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,27.74,45% of total billed charges,43.16,70% of total billed charges,36.99,60% of total billed charges,4.26,100% of CMS OPPS Rate,4.74,90% OF UHC FEE SCHEDULE,43.16,70% of total billed charges,4.26,100% OF CMS OPPS Rate,9.82,230% OF CMS OPPS Rate,29.59,48% of total Billed charges,4.26,100% OF CMS OPPS Rate,55.49,90% of total Billed charges,4.27,100% of Medicaid LA Fee Schedule,4.27,100% of Medicaid LA Fee Schedule,4.27,100% of Medicaid LA Fee Schedule,4.27,100% of Medicaid LA Fee Schedule,4.27,100% of Medicaid LA Fee Schedule,4.27,100% of Medicaid LA Fee Schedule,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,55.49,36.99
Outpatient,Laboratory,87230,"TOXIN, TISSUE CULTURE",300,63,69.87,354% of CMS OPPS Rate,19.74,100% of Medicaid LA Fee Schedule,19.73,100% of CMS OPPS Rate,19.73,100% of CMS OPPS Rate,49.69,203.89% of BCBS Fee Schedule,44.1,70% of total Billed Charges,47.25,75% of total Billed Charges,35.53,180% OF CMS OPPS RATE,50.4,80% of total Billed Charges,69.08,350% of CMS Opps rate,20.13,102% of CMS Opps rate,48.2,76.5% of total billed charges,19.74,100% of Medicaid LA Fee Schedule,19.74,100% of Medicaid LA Fee Schedule,19.73,100% of CMS OPPS Rate,19.73,100% of CMS OPPS Rate,28.35,45% of total billed charges,44.1,70% of total billed charges,37.8,60% of total billed charges,19.73,100% of CMS OPPS Rate,21.93,90% OF UHC FEE SCHEDULE,44.1,70% of total billed charges,19.73,100% OF CMS OPPS Rate,45.4,230% OF CMS OPPS Rate,30.24,48% of total Billed charges,19.73,100% OF CMS OPPS Rate,56.7,90% of total Billed charges,19.74,100% of Medicaid LA Fee Schedule,19.74,100% of Medicaid LA Fee Schedule,19.74,100% of Medicaid LA Fee Schedule,19.74,100% of Medicaid LA Fee Schedule,19.74,100% of Medicaid LA Fee Schedule,19.74,100% of Medicaid LA Fee Schedule,19.73,100% of CMS OPPS Rate,19.73,100% of CMS OPPS Rate,19.73,100% of CMS OPPS Rate,19.73,100% of CMS OPPS Rate,19.73,100% of CMS OPPS Rate,19.73,100% of CMS OPPS Rate,19.73,100% of CMS OPPS Rate,19.73,100% of CMS OPPS Rate,19.73,69.87,37.8
Outpatient,Laboratory,87252,CULTURE-VIRUS-MISC SPEC,300,229.5,92.28,354% of CMS OPPS Rate,26.07,100% of Medicaid LA Fee Schedule,26.07,100% of CMS OPPS Rate,26.07,100% of CMS OPPS Rate,65.61,203.89% of BCBS Fee Schedule,160.65,70% of total Billed Charges,172.13,75% of total Billed Charges,46.92,180% OF CMS OPPS RATE,183.6,80% of total Billed Charges,91.24,350% of CMS Opps rate,26.59,102% of CMS Opps rate,175.57,76.5% of total billed charges,26.07,100% of Medicaid LA Fee Schedule,26.07,100% of Medicaid LA Fee Schedule,26.07,100% of CMS OPPS Rate,26.07,100% of CMS OPPS Rate,103.28,45% of total billed charges,160.65,70% of total billed charges,137.7,60% of total billed charges,26.07,100% of CMS OPPS Rate,28.96,90% OF UHC FEE SCHEDULE,160.65,70% of total billed charges,26.07,100% OF CMS OPPS Rate,59.96,230% OF CMS OPPS Rate,110.16,48% of total Billed charges,26.07,100% OF CMS OPPS Rate,206.55,90% of total Billed charges,26.07,100% of Medicaid LA Fee Schedule,26.07,100% of Medicaid LA Fee Schedule,26.07,100% of Medicaid LA Fee Schedule,26.07,100% of Medicaid LA Fee Schedule,26.07,100% of Medicaid LA Fee Schedule,26.07,100% of Medicaid LA Fee Schedule,26.07,100% of CMS OPPS Rate,26.07,100% of CMS OPPS Rate,26.07,100% of CMS OPPS Rate,26.07,100% of CMS OPPS Rate,26.07,100% of CMS OPPS Rate,26.07,100% of CMS OPPS Rate,26.07,100% of CMS OPPS Rate,26.07,100% of CMS OPPS Rate,26.07,206.55,137.7
Outpatient,Laboratory,87253,VIRUS ISOLATE;ADDTL OR ID,300,135.5,71.5,354% of CMS OPPS Rate,20.2,100% of Medicaid LA Fee Schedule,20.2,100% of CMS OPPS Rate,20.2,100% of CMS OPPS Rate,50.85,203.89% of BCBS Fee Schedule,94.85,70% of total Billed Charges,101.63,75% of total Billed Charges,36.36,180% OF CMS OPPS RATE,108.4,80% of total Billed Charges,70.7,350% of CMS Opps rate,20.6,102% of CMS Opps rate,103.66,76.5% of total billed charges,20.2,100% of Medicaid LA Fee Schedule,20.2,100% of Medicaid LA Fee Schedule,20.2,100% of CMS OPPS Rate,20.2,100% of CMS OPPS Rate,60.98,45% of total billed charges,94.85,70% of total billed charges,81.3,60% of total billed charges,20.2,100% of CMS OPPS Rate,22.45,90% OF UHC FEE SCHEDULE,94.85,70% of total billed charges,20.2,100% OF CMS OPPS Rate,46.46,230% OF CMS OPPS Rate,65.04,48% of total Billed charges,20.2,100% OF CMS OPPS Rate,121.95,90% of total Billed charges,20.2,100% of Medicaid LA Fee Schedule,20.2,100% of Medicaid LA Fee Schedule,20.2,100% of Medicaid LA Fee Schedule,20.2,100% of Medicaid LA Fee Schedule,20.2,100% of Medicaid LA Fee Schedule,20.2,100% of Medicaid LA Fee Schedule,20.2,100% of CMS OPPS Rate,20.2,100% of CMS OPPS Rate,20.2,100% of CMS OPPS Rate,20.2,100% of CMS OPPS Rate,20.2,100% of CMS OPPS Rate,20.2,100% of CMS OPPS Rate,20.2,100% of CMS OPPS Rate,20.2,100% of CMS OPPS Rate,20.2,121.95,81.3
Outpatient,Laboratory,87254,VIRUS ISOLATION SHELL TECHNIQUE,300,247.1,69.24,354% of CMS OPPS Rate,7.4,100% of Medicaid LA Fee Schedule,19.55,100% of CMS OPPS Rate,19.55,100% of CMS OPPS Rate,49.24,203.89% of BCBS Fee Schedule,172.97,70% of total Billed Charges,185.33,75% of total Billed Charges,35.2,180% OF CMS OPPS RATE,197.68,80% of total Billed Charges,68.46,350% of CMS Opps rate,19.95,102% of CMS Opps rate,189.03,76.5% of total billed charges,7.4,100% of Medicaid LA Fee Schedule,7.4,100% of Medicaid LA Fee Schedule,19.55,100% of CMS OPPS Rate,19.55,100% of CMS OPPS Rate,111.2,45% of total billed charges,172.97,70% of total billed charges,148.26,60% of total billed charges,19.55,100% of CMS OPPS Rate,21.74,90% OF UHC FEE SCHEDULE,172.97,70% of total billed charges,19.55,100% OF CMS OPPS Rate,44.98,230% OF CMS OPPS Rate,118.61,48% of total Billed charges,19.55,100% OF CMS OPPS Rate,222.39,90% of total Billed charges,7.4,100% of Medicaid LA Fee Schedule,7.4,100% of Medicaid LA Fee Schedule,7.4,100% of Medicaid LA Fee Schedule,7.4,100% of Medicaid LA Fee Schedule,7.4,100% of Medicaid LA Fee Schedule,7.4,100% of Medicaid LA Fee Schedule,19.55,100% of CMS OPPS Rate,19.55,100% of CMS OPPS Rate,19.55,100% of CMS OPPS Rate,19.55,100% of CMS OPPS Rate,19.55,100% of CMS OPPS Rate,19.55,100% of CMS OPPS Rate,19.55,100% of CMS OPPS Rate,19.55,100% of CMS OPPS Rate,7.4,222.39,148.26
Outpatient,Laboratory,87255,"VIRUS ISOLATION, WITH ID",300,102,119.86,354% of CMS OPPS Rate,33.86,100% of Medicaid LA Fee Schedule,33.86,100% of CMS OPPS Rate,33.86,100% of CMS OPPS Rate,85.25,203.89% of BCBS Fee Schedule,71.4,70% of total Billed Charges,76.5,75% of total Billed Charges,60.94,180% OF CMS OPPS RATE,81.6,80% of total Billed Charges,118.51,350% of CMS Opps rate,34.53,102% of CMS Opps rate,78.03,76.5% of total billed charges,33.86,100% of Medicaid LA Fee Schedule,33.86,100% of Medicaid LA Fee Schedule,33.86,100% of CMS OPPS Rate,33.86,100% of CMS OPPS Rate,45.9,45% of total billed charges,71.4,70% of total billed charges,61.2,60% of total billed charges,33.86,100% of CMS OPPS Rate,37.63,90% OF UHC FEE SCHEDULE,71.4,70% of total billed charges,33.86,100% OF CMS OPPS Rate,77.87,230% OF CMS OPPS Rate,48.96,48% of total Billed charges,33.86,100% OF CMS OPPS Rate,91.8,90% of total Billed charges,33.86,100% of Medicaid LA Fee Schedule,33.86,100% of Medicaid LA Fee Schedule,33.86,100% of Medicaid LA Fee Schedule,33.86,100% of Medicaid LA Fee Schedule,33.86,100% of Medicaid LA Fee Schedule,33.86,100% of Medicaid LA Fee Schedule,33.86,100% of CMS OPPS Rate,33.86,100% of CMS OPPS Rate,33.86,100% of CMS OPPS Rate,33.86,100% of CMS OPPS Rate,33.86,100% of CMS OPPS Rate,33.86,100% of CMS OPPS Rate,33.86,100% of CMS OPPS Rate,33.86,100% of CMS OPPS Rate,33.86,119.86,61.2
Outpatient,Laboratory,87265,BORDETELLA PERTUSSIS DFA,300,61,42.4,354% of CMS OPPS Rate,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,30.18,203.89% of BCBS Fee Schedule,42.7,70% of total Billed Charges,45.75,75% of total Billed Charges,21.56,180% OF CMS OPPS RATE,48.8,80% of total Billed Charges,41.93,350% of CMS Opps rate,12.21,102% of CMS Opps rate,46.67,76.5% of total billed charges,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,27.45,45% of total billed charges,42.7,70% of total billed charges,36.6,60% of total billed charges,11.98,100% of CMS OPPS Rate,13.32,90% OF UHC FEE SCHEDULE,42.7,70% of total billed charges,11.98,100% OF CMS OPPS Rate,27.55,230% OF CMS OPPS Rate,29.28,48% of total Billed charges,11.98,100% OF CMS OPPS Rate,54.9,90% of total Billed charges,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,54.9,36.6
Outpatient,Laboratory,87269,"INFECTIOUS AGENT AG, GIARDIA",300,278,48.17,354% of CMS OPPS Rate,13.61,100% of Medicaid LA Fee Schedule,13.61,100% of CMS OPPS Rate,13.61,100% of CMS OPPS Rate,30.18,203.89% of BCBS Fee Schedule,194.6,70% of total Billed Charges,208.5,75% of total Billed Charges,24.49,180% OF CMS OPPS RATE,222.4,80% of total Billed Charges,47.63,350% of CMS Opps rate,13.88,102% of CMS Opps rate,212.67,76.5% of total billed charges,13.61,100% of Medicaid LA Fee Schedule,13.61,100% of Medicaid LA Fee Schedule,13.61,100% of CMS OPPS Rate,13.61,100% of CMS OPPS Rate,125.1,45% of total billed charges,194.6,70% of total billed charges,166.8,60% of total billed charges,13.61,100% of CMS OPPS Rate,13.32,90% OF UHC FEE SCHEDULE,194.6,70% of total billed charges,13.61,100% OF CMS OPPS Rate,31.3,230% OF CMS OPPS Rate,133.44,48% of total Billed charges,13.61,100% OF CMS OPPS Rate,250.2,90% of total Billed charges,13.61,100% of Medicaid LA Fee Schedule,13.61,100% of Medicaid LA Fee Schedule,13.61,100% of Medicaid LA Fee Schedule,13.61,100% of Medicaid LA Fee Schedule,13.61,100% of Medicaid LA Fee Schedule,13.61,100% of Medicaid LA Fee Schedule,13.61,100% of CMS OPPS Rate,13.61,100% of CMS OPPS Rate,13.61,100% of CMS OPPS Rate,13.61,100% of CMS OPPS Rate,13.61,100% of CMS OPPS Rate,13.61,100% of CMS OPPS Rate,13.61,100% of CMS OPPS Rate,13.61,100% of CMS OPPS Rate,13.32,250.2,166.8
Outpatient,Laboratory,87270,CHLAMYDIA TRACHOMATIS,300,53.5,42.4,354% of CMS OPPS Rate,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,30.18,203.89% of BCBS Fee Schedule,37.45,70% of total Billed Charges,40.13,75% of total Billed Charges,21.56,180% OF CMS OPPS RATE,42.8,80% of total Billed Charges,41.93,350% of CMS Opps rate,12.21,102% of CMS Opps rate,40.93,76.5% of total billed charges,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,24.08,45% of total billed charges,37.45,70% of total billed charges,32.1,60% of total billed charges,11.98,100% of CMS OPPS Rate,13.32,90% OF UHC FEE SCHEDULE,37.45,70% of total billed charges,11.98,100% OF CMS OPPS Rate,27.55,230% OF CMS OPPS Rate,25.68,48% of total Billed charges,11.98,100% OF CMS OPPS Rate,48.15,90% of total Billed charges,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,48.15,32.1
Outpatient,Laboratory,87271,CMV BY DFA,300,49.95,47.5,354% of CMS OPPS Rate,13.42,100% of Medicaid LA Fee Schedule,13.42,100% of CMS OPPS Rate,13.42,100% of CMS OPPS Rate,30.18,203.89% of BCBS Fee Schedule,34.97,70% of total Billed Charges,37.46,75% of total Billed Charges,24.15,180% OF CMS OPPS RATE,39.96,80% of total Billed Charges,46.97,350% of CMS Opps rate,13.68,102% of CMS Opps rate,38.21,76.5% of total billed charges,13.42,100% of Medicaid LA Fee Schedule,13.42,100% of Medicaid LA Fee Schedule,13.42,100% of CMS OPPS Rate,13.42,100% of CMS OPPS Rate,22.48,45% of total billed charges,34.97,70% of total billed charges,29.97,60% of total billed charges,13.42,100% of CMS OPPS Rate,13.32,90% OF UHC FEE SCHEDULE,34.97,70% of total billed charges,13.42,100% OF CMS OPPS Rate,30.86,230% OF CMS OPPS Rate,23.98,48% of total Billed charges,13.42,100% OF CMS OPPS Rate,44.96,90% of total Billed charges,13.42,100% of Medicaid LA Fee Schedule,13.42,100% of Medicaid LA Fee Schedule,13.42,100% of Medicaid LA Fee Schedule,13.42,100% of Medicaid LA Fee Schedule,13.42,100% of Medicaid LA Fee Schedule,13.42,100% of Medicaid LA Fee Schedule,13.42,100% of CMS OPPS Rate,13.42,100% of CMS OPPS Rate,13.42,100% of CMS OPPS Rate,13.42,100% of CMS OPPS Rate,13.42,100% of CMS OPPS Rate,13.42,100% of CMS OPPS Rate,13.42,100% of CMS OPPS Rate,13.42,100% of CMS OPPS Rate,13.32,47.5,29.97
Outpatient,Laboratory,87272,"INFECTIOUS AGENT AG, CRYPTOSPOR",300,250.2,42.4,354% of CMS OPPS Rate,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,30.18,203.89% of BCBS Fee Schedule,175.14,70% of total Billed Charges,187.65,75% of total Billed Charges,21.56,180% OF CMS OPPS RATE,200.16,80% of total Billed Charges,41.93,350% of CMS Opps rate,12.21,102% of CMS Opps rate,191.4,76.5% of total billed charges,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,112.59,45% of total billed charges,175.14,70% of total billed charges,150.12,60% of total billed charges,11.98,100% of CMS OPPS Rate,13.32,90% OF UHC FEE SCHEDULE,175.14,70% of total billed charges,11.98,100% OF CMS OPPS Rate,27.55,230% OF CMS OPPS Rate,120.1,48% of total Billed charges,11.98,100% OF CMS OPPS Rate,225.18,90% of total Billed charges,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,225.18,150.12
Outpatient,Laboratory,87273,INFECTIOUS AGENT AG HERPES2,300,80,42.4,354% of CMS OPPS Rate,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,30.18,203.89% of BCBS Fee Schedule,56,70% of total Billed Charges,60,75% of total Billed Charges,21.56,180% OF CMS OPPS RATE,64,80% of total Billed Charges,41.93,350% of CMS Opps rate,12.21,102% of CMS Opps rate,61.2,76.5% of total billed charges,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,36,45% of total billed charges,56,70% of total billed charges,48,60% of total billed charges,11.98,100% of CMS OPPS Rate,13.32,90% OF UHC FEE SCHEDULE,56,70% of total billed charges,11.98,100% OF CMS OPPS Rate,27.55,230% OF CMS OPPS Rate,38.4,48% of total Billed charges,11.98,100% OF CMS OPPS Rate,72,90% of total Billed charges,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,72,48
Outpatient,Laboratory,87274,HERPES SIMPLES L AG,300,33,42.4,354% of CMS OPPS Rate,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,30.18,203.89% of BCBS Fee Schedule,23.1,70% of total Billed Charges,24.75,75% of total Billed Charges,21.56,180% OF CMS OPPS RATE,26.4,80% of total Billed Charges,41.93,350% of CMS Opps rate,12.21,102% of CMS Opps rate,25.25,76.5% of total billed charges,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,14.85,45% of total billed charges,23.1,70% of total billed charges,19.8,60% of total billed charges,11.98,100% of CMS OPPS Rate,13.32,90% OF UHC FEE SCHEDULE,23.1,70% of total billed charges,11.98,100% OF CMS OPPS Rate,27.55,230% OF CMS OPPS Rate,15.84,48% of total Billed charges,11.98,100% OF CMS OPPS Rate,29.7,90% of total Billed charges,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,42.4,19.8
Outpatient,Laboratory,87275,"INFLUENZA B,AG BY IF",300,32.5,43.36,354% of CMS OPPS Rate,12.25,100% of Medicaid LA Fee Schedule,12.25,100% of CMS OPPS Rate,12.25,100% of CMS OPPS Rate,30.18,203.89% of BCBS Fee Schedule,22.75,70% of total Billed Charges,24.38,75% of total Billed Charges,22.05,180% OF CMS OPPS RATE,26,80% of total Billed Charges,42.87,350% of CMS Opps rate,12.49,102% of CMS Opps rate,24.86,76.5% of total billed charges,12.25,100% of Medicaid LA Fee Schedule,12.25,100% of Medicaid LA Fee Schedule,12.25,100% of CMS OPPS Rate,12.25,100% of CMS OPPS Rate,14.63,45% of total billed charges,22.75,70% of total billed charges,19.5,60% of total billed charges,12.25,100% of CMS OPPS Rate,13.32,90% OF UHC FEE SCHEDULE,22.75,70% of total billed charges,12.25,100% OF CMS OPPS Rate,28.17,230% OF CMS OPPS Rate,15.6,48% of total Billed charges,12.25,100% OF CMS OPPS Rate,29.25,90% of total Billed charges,12.25,100% of Medicaid LA Fee Schedule,12.25,100% of Medicaid LA Fee Schedule,12.25,100% of Medicaid LA Fee Schedule,12.25,100% of Medicaid LA Fee Schedule,12.25,100% of Medicaid LA Fee Schedule,12.25,100% of Medicaid LA Fee Schedule,12.25,100% of CMS OPPS Rate,12.25,100% of CMS OPPS Rate,12.25,100% of CMS OPPS Rate,12.25,100% of CMS OPPS Rate,12.25,100% of CMS OPPS Rate,12.25,100% of CMS OPPS Rate,12.25,100% of CMS OPPS Rate,12.25,100% of CMS OPPS Rate,12.25,43.36,19.5
Outpatient,Laboratory,87276,INFLUENZA A ANTIGEN,300,33,56.88,354% of CMS OPPS Rate,16.07,100% of Medicaid LA Fee Schedule,16.07,100% of CMS OPPS Rate,16.07,100% of CMS OPPS Rate,32.77,203.89% of BCBS Fee Schedule,23.1,70% of total Billed Charges,24.75,75% of total Billed Charges,28.92,180% OF CMS OPPS RATE,26.4,80% of total Billed Charges,56.24,350% of CMS Opps rate,16.39,102% of CMS Opps rate,25.25,76.5% of total billed charges,16.07,100% of Medicaid LA Fee Schedule,16.07,100% of Medicaid LA Fee Schedule,16.07,100% of CMS OPPS Rate,16.07,100% of CMS OPPS Rate,14.85,45% of total billed charges,23.1,70% of total billed charges,19.8,60% of total billed charges,16.07,100% of CMS OPPS Rate,14.46,90% OF UHC FEE SCHEDULE,23.1,70% of total billed charges,16.07,100% OF CMS OPPS Rate,33,230% OF CMS OPPS Rate,15.84,48% of total Billed charges,16.07,100% OF CMS OPPS Rate,29.7,90% of total Billed charges,16.07,100% of Medicaid LA Fee Schedule,16.07,100% of Medicaid LA Fee Schedule,16.07,100% of Medicaid LA Fee Schedule,16.07,100% of Medicaid LA Fee Schedule,16.07,100% of Medicaid LA Fee Schedule,16.07,100% of Medicaid LA Fee Schedule,16.07,100% of CMS OPPS Rate,16.07,100% of CMS OPPS Rate,16.07,100% of CMS OPPS Rate,16.07,100% of CMS OPPS Rate,16.07,100% of CMS OPPS Rate,16.07,100% of CMS OPPS Rate,16.07,100% of CMS OPPS Rate,16.07,100% of CMS OPPS Rate,14.46,56.88,19.8
Outpatient,Laboratory,87278,INFECTIOUS A AG BY IMMUNOFLUORSCNT,300,224,55.22,354% of CMS OPPS Rate,15.6,100% of Medicaid LA Fee Schedule,15.6,100% of CMS OPPS Rate,15.6,100% of CMS OPPS Rate,31.81,203.89% of BCBS Fee Schedule,156.8,70% of total Billed Charges,168,75% of total Billed Charges,28.08,180% OF CMS OPPS RATE,179.2,80% of total Billed Charges,54.6,350% of CMS Opps rate,15.91,102% of CMS Opps rate,171.36,76.5% of total billed charges,15.6,100% of Medicaid LA Fee Schedule,15.6,100% of Medicaid LA Fee Schedule,15.6,100% of CMS OPPS Rate,15.6,100% of CMS OPPS Rate,100.8,45% of total billed charges,156.8,70% of total billed charges,134.4,60% of total billed charges,15.6,100% of CMS OPPS Rate,14.04,90% OF UHC FEE SCHEDULE,156.8,70% of total billed charges,15.6,100% OF CMS OPPS Rate,35.88,230% OF CMS OPPS Rate,107.52,48% of total Billed charges,15.6,100% OF CMS OPPS Rate,201.6,90% of total Billed charges,15.6,100% of Medicaid LA Fee Schedule,15.6,100% of Medicaid LA Fee Schedule,15.6,100% of Medicaid LA Fee Schedule,15.6,100% of Medicaid LA Fee Schedule,15.6,100% of Medicaid LA Fee Schedule,15.6,100% of Medicaid LA Fee Schedule,15.6,100% of CMS OPPS Rate,15.6,100% of CMS OPPS Rate,15.6,100% of CMS OPPS Rate,15.6,100% of CMS OPPS Rate,15.6,100% of CMS OPPS Rate,15.6,100% of CMS OPPS Rate,15.6,100% of CMS OPPS Rate,15.6,100% of CMS OPPS Rate,14.04,201.6,134.4
Outpatient,Laboratory,87279,"PARAINFLUENZA,AG BY IF",300,32.5,58.16,354% of CMS OPPS Rate,16.18,100% of Medicaid LA Fee Schedule,16.43,100% of CMS OPPS Rate,16.43,100% of CMS OPPS Rate,33.5,203.89% of BCBS Fee Schedule,22.75,70% of total Billed Charges,24.38,75% of total Billed Charges,29.57,180% OF CMS OPPS RATE,26,80% of total Billed Charges,57.5,350% of CMS Opps rate,16.75,102% of CMS Opps rate,24.86,76.5% of total billed charges,16.18,100% of Medicaid LA Fee Schedule,16.18,100% of Medicaid LA Fee Schedule,16.43,100% of CMS OPPS Rate,16.43,100% of CMS OPPS Rate,14.63,45% of total billed charges,22.75,70% of total billed charges,19.5,60% of total billed charges,16.43,100% of CMS OPPS Rate,14.79,90% OF UHC FEE SCHEDULE,22.75,70% of total billed charges,16.43,100% OF CMS OPPS Rate,32.5,230% OF CMS OPPS Rate,15.6,48% of total Billed charges,16.43,100% OF CMS OPPS Rate,29.25,90% of total Billed charges,16.18,100% of Medicaid LA Fee Schedule,16.18,100% of Medicaid LA Fee Schedule,16.18,100% of Medicaid LA Fee Schedule,16.18,100% of Medicaid LA Fee Schedule,16.18,100% of Medicaid LA Fee Schedule,16.18,100% of Medicaid LA Fee Schedule,16.43,100% of CMS OPPS Rate,16.43,100% of CMS OPPS Rate,16.43,100% of CMS OPPS Rate,16.43,100% of CMS OPPS Rate,16.43,100% of CMS OPPS Rate,16.43,100% of CMS OPPS Rate,16.43,100% of CMS OPPS Rate,16.43,100% of CMS OPPS Rate,14.63,58.16,19.5
Outpatient,Laboratory,87280,"RSV AG, BY IF",300,32.5,47.5,354% of CMS OPPS Rate,13.42,100% of Medicaid LA Fee Schedule,13.42,100% of CMS OPPS Rate,13.42,100% of CMS OPPS Rate,30.18,203.89% of BCBS Fee Schedule,22.75,70% of total Billed Charges,24.38,75% of total Billed Charges,24.15,180% OF CMS OPPS RATE,26,80% of total Billed Charges,46.97,350% of CMS Opps rate,13.68,102% of CMS Opps rate,24.86,76.5% of total billed charges,13.42,100% of Medicaid LA Fee Schedule,13.42,100% of Medicaid LA Fee Schedule,13.42,100% of CMS OPPS Rate,13.42,100% of CMS OPPS Rate,14.63,45% of total billed charges,22.75,70% of total billed charges,19.5,60% of total billed charges,13.42,100% of CMS OPPS Rate,13.32,90% OF UHC FEE SCHEDULE,22.75,70% of total billed charges,13.42,100% OF CMS OPPS Rate,30.86,230% OF CMS OPPS Rate,15.6,48% of total Billed charges,13.42,100% OF CMS OPPS Rate,29.25,90% of total Billed charges,13.42,100% of Medicaid LA Fee Schedule,13.42,100% of Medicaid LA Fee Schedule,13.42,100% of Medicaid LA Fee Schedule,13.42,100% of Medicaid LA Fee Schedule,13.42,100% of Medicaid LA Fee Schedule,13.42,100% of Medicaid LA Fee Schedule,13.42,100% of CMS OPPS Rate,13.42,100% of CMS OPPS Rate,13.42,100% of CMS OPPS Rate,13.42,100% of CMS OPPS Rate,13.42,100% of CMS OPPS Rate,13.42,100% of CMS OPPS Rate,13.42,100% of CMS OPPS Rate,13.42,100% of CMS OPPS Rate,13.32,47.5,19.5
Outpatient,Laboratory,87281,INFECTIOUS AGENT AG PNEUMOCYSTIS C.,300,109.2,42.4,354% of CMS OPPS Rate,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,30.18,203.89% of BCBS Fee Schedule,76.44,70% of total Billed Charges,81.9,75% of total Billed Charges,21.56,180% OF CMS OPPS RATE,87.36,80% of total Billed Charges,41.93,350% of CMS Opps rate,12.21,102% of CMS Opps rate,83.54,76.5% of total billed charges,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,49.14,45% of total billed charges,76.44,70% of total billed charges,65.52,60% of total billed charges,11.98,100% of CMS OPPS Rate,13.32,90% OF UHC FEE SCHEDULE,76.44,70% of total billed charges,11.98,100% OF CMS OPPS Rate,27.55,230% OF CMS OPPS Rate,52.42,48% of total Billed charges,11.98,100% OF CMS OPPS Rate,98.28,90% of total Billed charges,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,98.28,65.52
Outpatient,Laboratory,87290,INFECTIOUS AGENT AG VARICELLA,300,190,47.5,354% of CMS OPPS Rate,13.42,100% of Medicaid LA Fee Schedule,13.42,100% of CMS OPPS Rate,13.42,100% of CMS OPPS Rate,30.18,203.89% of BCBS Fee Schedule,133,70% of total Billed Charges,142.5,75% of total Billed Charges,24.15,180% OF CMS OPPS RATE,152,80% of total Billed Charges,46.97,350% of CMS Opps rate,13.68,102% of CMS Opps rate,145.35,76.5% of total billed charges,13.42,100% of Medicaid LA Fee Schedule,13.42,100% of Medicaid LA Fee Schedule,13.42,100% of CMS OPPS Rate,13.42,100% of CMS OPPS Rate,85.5,45% of total billed charges,133,70% of total billed charges,114,60% of total billed charges,13.42,100% of CMS OPPS Rate,13.32,90% OF UHC FEE SCHEDULE,133,70% of total billed charges,13.42,100% OF CMS OPPS Rate,30.86,230% OF CMS OPPS Rate,91.2,48% of total Billed charges,13.42,100% OF CMS OPPS Rate,171,90% of total Billed charges,13.42,100% of Medicaid LA Fee Schedule,13.42,100% of Medicaid LA Fee Schedule,13.42,100% of Medicaid LA Fee Schedule,13.42,100% of Medicaid LA Fee Schedule,13.42,100% of Medicaid LA Fee Schedule,13.42,100% of Medicaid LA Fee Schedule,13.42,100% of CMS OPPS Rate,13.42,100% of CMS OPPS Rate,13.42,100% of CMS OPPS Rate,13.42,100% of CMS OPPS Rate,13.42,100% of CMS OPPS Rate,13.42,100% of CMS OPPS Rate,13.42,100% of CMS OPPS Rate,13.42,100% of CMS OPPS Rate,13.32,171,114
Outpatient,Laboratory,87305,ASPERGUILLUS AG EIA,300,232.2,42.4,354% of CMS OPPS Rate,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,30.18,203.89% of BCBS Fee Schedule,162.54,70% of total Billed Charges,174.15,75% of total Billed Charges,21.56,180% OF CMS OPPS RATE,185.76,80% of total Billed Charges,41.93,350% of CMS Opps rate,12.21,102% of CMS Opps rate,177.63,76.5% of total billed charges,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,104.49,45% of total billed charges,162.54,70% of total billed charges,139.32,60% of total billed charges,11.98,100% of CMS OPPS Rate,13.32,90% OF UHC FEE SCHEDULE,162.54,70% of total billed charges,11.98,100% OF CMS OPPS Rate,27.55,230% OF CMS OPPS Rate,111.46,48% of total Billed charges,11.98,100% OF CMS OPPS Rate,208.98,90% of total Billed charges,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,208.98,139.32
Outpatient,Laboratory,87324,A test of the stool to diagnose Clostridium difficile (C. diff) infection,300,91.8,42.4,354% of CMS OPPS Rate,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,30.18,203.89% of BCBS Fee Schedule,64.26,70% of total Billed Charges,68.85,75% of total Billed Charges,21.56,180% OF CMS OPPS RATE,73.44,80% of total Billed Charges,41.93,350% of CMS Opps rate,12.21,102% of CMS Opps rate,70.23,76.5% of total billed charges,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,41.31,45% of total billed charges,64.26,70% of total billed charges,55.08,60% of total billed charges,11.98,100% of CMS OPPS Rate,13.32,90% OF UHC FEE SCHEDULE,64.26,70% of total billed charges,11.98,100% OF CMS OPPS Rate,27.55,230% OF CMS OPPS Rate,44.06,48% of total Billed charges,11.98,100% OF CMS OPPS Rate,82.62,90% of total Billed charges,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,82.62,55.08
Outpatient,Laboratory,87327,CRYPTOCOCCUS NEOFORM AG IA,300,N/A,47.5,354% of CMS OPPS Rate,13.42,100% of Medicaid LA Fee Schedule,13.42,100% of CMS OPPS Rate,13.42,100% of CMS OPPS Rate,30.18,203.89% of BCBS Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,24.15,180% OF CMS OPPS RATE,N/A,Not Applicable,46.97,350% of CMS Opps rate,13.68,102% of CMS Opps rate,N/A,Not Applicable,13.42,100% of Medicaid LA Fee Schedule,13.42,100% of Medicaid LA Fee Schedule,13.42,100% of CMS OPPS Rate,13.42,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,13.42,100% of CMS OPPS Rate,13.32,90% OF UHC FEE SCHEDULE,N/A,Not Applicable,13.42,100% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,13.42,100% OF CMS OPPS Rate,N/A,Not Applicable,13.42,100% of Medicaid LA Fee Schedule,13.42,100% of Medicaid LA Fee Schedule,13.42,100% of Medicaid LA Fee Schedule,13.42,100% of Medicaid LA Fee Schedule,13.42,100% of Medicaid LA Fee Schedule,13.42,100% of Medicaid LA Fee Schedule,13.42,100% of CMS OPPS Rate,13.42,100% of CMS OPPS Rate,13.42,100% of CMS OPPS Rate,13.42,100% of CMS OPPS Rate,13.42,100% of CMS OPPS Rate,13.42,100% of CMS OPPS Rate,13.42,100% of CMS OPPS Rate,13.42,100% of CMS OPPS Rate,13.32,47.5,N/A
Outpatient,Laboratory,87328,CRYPTOSPOR AG BY EIA,300,54,48.92,354% of CMS OPPS Rate,13.82,100% of Medicaid LA Fee Schedule,13.82,100% of CMS OPPS Rate,13.82,100% of CMS OPPS Rate,30.18,203.89% of BCBS Fee Schedule,37.8,70% of total Billed Charges,40.5,75% of total Billed Charges,24.87,180% OF CMS OPPS RATE,43.2,80% of total Billed Charges,48.37,350% of CMS Opps rate,14.09,102% of CMS Opps rate,41.31,76.5% of total billed charges,13.82,100% of Medicaid LA Fee Schedule,13.82,100% of Medicaid LA Fee Schedule,13.82,100% of CMS OPPS Rate,13.82,100% of CMS OPPS Rate,24.3,45% of total billed charges,37.8,70% of total billed charges,32.4,60% of total billed charges,13.82,100% of CMS OPPS Rate,13.32,90% OF UHC FEE SCHEDULE,37.8,70% of total billed charges,13.82,100% OF CMS OPPS Rate,31.78,230% OF CMS OPPS Rate,25.92,48% of total Billed charges,13.82,100% OF CMS OPPS Rate,48.6,90% of total Billed charges,13.82,100% of Medicaid LA Fee Schedule,13.82,100% of Medicaid LA Fee Schedule,13.82,100% of Medicaid LA Fee Schedule,13.82,100% of Medicaid LA Fee Schedule,13.82,100% of Medicaid LA Fee Schedule,13.82,100% of Medicaid LA Fee Schedule,13.82,100% of CMS OPPS Rate,13.82,100% of CMS OPPS Rate,13.82,100% of CMS OPPS Rate,13.82,100% of CMS OPPS Rate,13.82,100% of CMS OPPS Rate,13.82,100% of CMS OPPS Rate,13.82,100% of CMS OPPS Rate,13.82,100% of CMS OPPS Rate,13.32,48.92,32.4
Outpatient,Laboratory,87329,GIARDIA AG DETECTION EIA,300,78.65,42.4,354% of CMS OPPS Rate,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,30.18,203.89% of BCBS Fee Schedule,55.06,70% of total Billed Charges,58.99,75% of total Billed Charges,21.56,180% OF CMS OPPS RATE,62.92,80% of total Billed Charges,41.93,350% of CMS Opps rate,12.21,102% of CMS Opps rate,60.17,76.5% of total billed charges,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,35.39,45% of total billed charges,55.06,70% of total billed charges,47.19,60% of total billed charges,11.98,100% of CMS OPPS Rate,13.32,90% OF UHC FEE SCHEDULE,55.06,70% of total billed charges,11.98,100% OF CMS OPPS Rate,27.55,230% OF CMS OPPS Rate,37.75,48% of total Billed charges,11.98,100% OF CMS OPPS Rate,70.79,90% of total Billed charges,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,70.79,47.19
Outpatient,Laboratory,87337,ENTAMOEBA HISTOLYTICA AG,300,64.9,42.4,354% of CMS OPPS Rate,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,30.18,203.89% of BCBS Fee Schedule,45.43,70% of total Billed Charges,48.68,75% of total Billed Charges,21.56,180% OF CMS OPPS RATE,51.92,80% of total Billed Charges,41.93,350% of CMS Opps rate,12.21,102% of CMS Opps rate,49.65,76.5% of total billed charges,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,29.21,45% of total billed charges,45.43,70% of total billed charges,38.94,60% of total billed charges,11.98,100% of CMS OPPS Rate,13.32,90% OF UHC FEE SCHEDULE,45.43,70% of total billed charges,11.98,100% OF CMS OPPS Rate,27.55,230% OF CMS OPPS Rate,31.15,48% of total Billed charges,11.98,100% OF CMS OPPS Rate,58.41,90% of total Billed charges,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,58.41,38.94
Outpatient,Laboratory,87338,HPYLORI STOOL IA,300,127.05,50.9,354% of CMS OPPS Rate,6.46,100% of Medicaid LA Fee Schedule,14.38,100% of CMS OPPS Rate,14.38,100% of CMS OPPS Rate,36.21,203.89% of BCBS Fee Schedule,88.94,70% of total Billed Charges,95.29,75% of total Billed Charges,25.88,180% OF CMS OPPS RATE,101.64,80% of total Billed Charges,50.33,350% of CMS Opps rate,14.66,102% of CMS Opps rate,97.19,76.5% of total billed charges,6.46,100% of Medicaid LA Fee Schedule,6.46,100% of Medicaid LA Fee Schedule,14.38,100% of CMS OPPS Rate,14.38,100% of CMS OPPS Rate,57.17,45% of total billed charges,88.94,70% of total billed charges,76.23,60% of total billed charges,14.38,100% of CMS OPPS Rate,15.98,90% OF UHC FEE SCHEDULE,88.94,70% of total billed charges,14.38,100% OF CMS OPPS Rate,33.07,230% OF CMS OPPS Rate,60.98,48% of total Billed charges,14.38,100% OF CMS OPPS Rate,114.35,90% of total Billed charges,6.46,100% of Medicaid LA Fee Schedule,6.46,100% of Medicaid LA Fee Schedule,6.46,100% of Medicaid LA Fee Schedule,6.46,100% of Medicaid LA Fee Schedule,6.46,100% of Medicaid LA Fee Schedule,6.46,100% of Medicaid LA Fee Schedule,14.38,100% of CMS OPPS Rate,14.38,100% of CMS OPPS Rate,14.38,100% of CMS OPPS Rate,14.38,100% of CMS OPPS Rate,14.38,100% of CMS OPPS Rate,14.38,100% of CMS OPPS Rate,14.38,100% of CMS OPPS Rate,14.38,100% of CMS OPPS Rate,6.46,114.35,76.23
Outpatient,Laboratory,87339,H PYLORI AG IA,300,N/A,56.64,354% of CMS OPPS Rate,16,100% of Medicaid LA Fee Schedule,16,100% of CMS OPPS Rate,16,100% of CMS OPPS Rate,32.62,203.89% of BCBS Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,28.8,180% OF CMS OPPS RATE,N/A,Not Applicable,56,350% of CMS Opps rate,16.32,102% of CMS Opps rate,N/A,Not Applicable,16,100% of Medicaid LA Fee Schedule,16,100% of Medicaid LA Fee Schedule,16,100% of CMS OPPS Rate,16,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,16,100% of CMS OPPS Rate,14.4,90% OF UHC FEE SCHEDULE,N/A,Not Applicable,16,100% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,16,100% OF CMS OPPS Rate,N/A,Not Applicable,16,100% of Medicaid LA Fee Schedule,16,100% of Medicaid LA Fee Schedule,16,100% of Medicaid LA Fee Schedule,16,100% of Medicaid LA Fee Schedule,16,100% of Medicaid LA Fee Schedule,16,100% of Medicaid LA Fee Schedule,16,100% of CMS OPPS Rate,16,100% of CMS OPPS Rate,16,100% of CMS OPPS Rate,16,100% of CMS OPPS Rate,16,100% of CMS OPPS Rate,16,100% of CMS OPPS Rate,16,100% of CMS OPPS Rate,16,100% of CMS OPPS Rate,14.4,56.64,N/A
Outpatient,Laboratory,87340,HEP B SURFACE AG,300,169.2,36.56,354% of CMS OPPS Rate,10.33,100% of Medicaid LA Fee Schedule,10.33,100% of CMS OPPS Rate,10.33,100% of CMS OPPS Rate,26,203.89% of BCBS Fee Schedule,118.44,70% of total Billed Charges,126.9,75% of total Billed Charges,18.59,180% OF CMS OPPS RATE,135.36,80% of total Billed Charges,36.15,350% of CMS Opps rate,10.53,102% of CMS Opps rate,129.44,76.5% of total billed charges,10.33,100% of Medicaid LA Fee Schedule,10.33,100% of Medicaid LA Fee Schedule,10.33,100% of CMS OPPS Rate,10.33,100% of CMS OPPS Rate,76.14,45% of total billed charges,118.44,70% of total billed charges,101.52,60% of total billed charges,10.33,100% of CMS OPPS Rate,11.48,90% OF UHC FEE SCHEDULE,118.44,70% of total billed charges,10.33,100% OF CMS OPPS Rate,23.75,230% OF CMS OPPS Rate,81.22,48% of total Billed charges,10.33,100% OF CMS OPPS Rate,152.28,90% of total Billed charges,10.33,100% of Medicaid LA Fee Schedule,10.33,100% of Medicaid LA Fee Schedule,10.33,100% of Medicaid LA Fee Schedule,10.33,100% of Medicaid LA Fee Schedule,10.33,100% of Medicaid LA Fee Schedule,10.33,100% of Medicaid LA Fee Schedule,10.33,100% of CMS OPPS Rate,10.33,100% of CMS OPPS Rate,10.33,100% of CMS OPPS Rate,10.33,100% of CMS OPPS Rate,10.33,100% of CMS OPPS Rate,10.33,100% of CMS OPPS Rate,10.33,100% of CMS OPPS Rate,10.33,100% of CMS OPPS Rate,10.33,152.28,101.52
Outpatient,Laboratory,87341,HEPATITIS B SURFACE AG IA,300,50,36.56,354% of CMS OPPS Rate,10.33,100% of Medicaid LA Fee Schedule,10.33,100% of CMS OPPS Rate,10.33,100% of CMS OPPS Rate,26,203.89% of BCBS Fee Schedule,35,70% of total Billed Charges,37.5,75% of total Billed Charges,18.59,180% OF CMS OPPS RATE,40,80% of total Billed Charges,36.15,350% of CMS Opps rate,10.53,102% of CMS Opps rate,38.25,76.5% of total billed charges,10.33,100% of Medicaid LA Fee Schedule,10.33,100% of Medicaid LA Fee Schedule,10.33,100% of CMS OPPS Rate,10.33,100% of CMS OPPS Rate,22.5,45% of total billed charges,35,70% of total billed charges,30,60% of total billed charges,10.33,100% of CMS OPPS Rate,11.48,90% OF UHC FEE SCHEDULE,35,70% of total billed charges,10.33,100% OF CMS OPPS Rate,23.75,230% OF CMS OPPS Rate,24,48% of total Billed charges,10.33,100% OF CMS OPPS Rate,45,90% of total Billed charges,10.33,100% of Medicaid LA Fee Schedule,10.33,100% of Medicaid LA Fee Schedule,10.33,100% of Medicaid LA Fee Schedule,10.33,100% of Medicaid LA Fee Schedule,10.33,100% of Medicaid LA Fee Schedule,10.33,100% of Medicaid LA Fee Schedule,10.33,100% of CMS OPPS Rate,10.33,100% of CMS OPPS Rate,10.33,100% of CMS OPPS Rate,10.33,100% of CMS OPPS Rate,10.33,100% of CMS OPPS Rate,10.33,100% of CMS OPPS Rate,10.33,100% of CMS OPPS Rate,10.33,100% of CMS OPPS Rate,10.33,45,30
Outpatient,Laboratory,87350,HEPATITIS BE ANTIGEN,300,222.75,40.81,354% of CMS OPPS Rate,11.53,100% of Medicaid LA Fee Schedule,11.53,100% of CMS OPPS Rate,11.53,100% of CMS OPPS Rate,29.01,203.89% of BCBS Fee Schedule,155.93,70% of total Billed Charges,167.06,75% of total Billed Charges,20.75,180% OF CMS OPPS RATE,178.2,80% of total Billed Charges,40.35,350% of CMS Opps rate,11.76,102% of CMS Opps rate,170.4,76.5% of total billed charges,11.53,100% of Medicaid LA Fee Schedule,11.53,100% of Medicaid LA Fee Schedule,11.53,100% of CMS OPPS Rate,11.53,100% of CMS OPPS Rate,100.24,45% of total billed charges,155.93,70% of total billed charges,133.65,60% of total billed charges,11.53,100% of CMS OPPS Rate,12.81,90% OF UHC FEE SCHEDULE,155.93,70% of total billed charges,11.53,100% OF CMS OPPS Rate,26.51,230% OF CMS OPPS Rate,106.92,48% of total Billed charges,11.53,100% OF CMS OPPS Rate,200.48,90% of total Billed charges,11.53,100% of Medicaid LA Fee Schedule,11.53,100% of Medicaid LA Fee Schedule,11.53,100% of Medicaid LA Fee Schedule,11.53,100% of Medicaid LA Fee Schedule,11.53,100% of Medicaid LA Fee Schedule,11.53,100% of Medicaid LA Fee Schedule,11.53,100% of CMS OPPS Rate,11.53,100% of CMS OPPS Rate,11.53,100% of CMS OPPS Rate,11.53,100% of CMS OPPS Rate,11.53,100% of CMS OPPS Rate,11.53,100% of CMS OPPS Rate,11.53,100% of CMS OPPS Rate,11.53,100% of CMS OPPS Rate,11.53,200.48,133.65
Outpatient,Laboratory,87380,HEPATITIS DELTA AG IEA,300,166.1,64.99,354% of CMS OPPS Rate,17.21,100% of Medicaid LA Fee Schedule,18.36,100% of CMS OPPS Rate,18.36,100% of CMS OPPS Rate,41.31,203.89% of BCBS Fee Schedule,116.27,70% of total Billed Charges,124.58,75% of total Billed Charges,33.04,180% OF CMS OPPS RATE,132.88,80% of total Billed Charges,64.26,350% of CMS Opps rate,18.72,102% of CMS Opps rate,127.07,76.5% of total billed charges,17.21,100% of Medicaid LA Fee Schedule,17.21,100% of Medicaid LA Fee Schedule,18.36,100% of CMS OPPS Rate,18.36,100% of CMS OPPS Rate,74.75,45% of total billed charges,116.27,70% of total billed charges,99.66,60% of total billed charges,18.36,100% of CMS OPPS Rate,18.23,90% OF UHC FEE SCHEDULE,116.27,70% of total billed charges,18.36,100% OF CMS OPPS Rate,42.22,230% OF CMS OPPS Rate,79.73,48% of total Billed charges,18.36,100% OF CMS OPPS Rate,149.49,90% of total Billed charges,17.21,100% of Medicaid LA Fee Schedule,17.21,100% of Medicaid LA Fee Schedule,17.21,100% of Medicaid LA Fee Schedule,17.21,100% of Medicaid LA Fee Schedule,17.21,100% of Medicaid LA Fee Schedule,17.21,100% of Medicaid LA Fee Schedule,18.36,100% of CMS OPPS Rate,18.36,100% of CMS OPPS Rate,18.36,100% of CMS OPPS Rate,18.36,100% of CMS OPPS Rate,18.36,100% of CMS OPPS Rate,18.36,100% of CMS OPPS Rate,18.36,100% of CMS OPPS Rate,18.36,100% of CMS OPPS Rate,17.21,149.49,99.66
Outpatient,Laboratory,87385,HISTOPLASMA CAPSUL  AG IA,300,186.3,46.9,354% of CMS OPPS Rate,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,30.18,203.89% of BCBS Fee Schedule,130.41,70% of total Billed Charges,139.73,75% of total Billed Charges,23.85,180% OF CMS OPPS RATE,149.04,80% of total Billed Charges,46.37,350% of CMS Opps rate,13.51,102% of CMS Opps rate,142.52,76.5% of total billed charges,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,83.84,45% of total billed charges,130.41,70% of total billed charges,111.78,60% of total billed charges,13.25,100% of CMS OPPS Rate,13.32,90% OF UHC FEE SCHEDULE,130.41,70% of total billed charges,13.25,100% OF CMS OPPS Rate,30.47,230% OF CMS OPPS Rate,89.42,48% of total Billed charges,13.25,100% OF CMS OPPS Rate,167.67,90% of total Billed charges,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of Medicaid LA Fee Schedule,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,100% of CMS OPPS Rate,13.25,167.67,111.78
Outpatient,Laboratory,87389,Test for HIV,300,200,85.24,354% of CMS OPPS Rate,24.08,100% of Medicaid LA Fee Schedule,24.08,100% of CMS OPPS Rate,24.08,100% of CMS OPPS Rate,60.62,203.89% of BCBS Fee Schedule,140,70% of total Billed Charges,150,75% of total Billed Charges,43.34,180% OF CMS OPPS RATE,160,80% of total Billed Charges,84.28,350% of CMS Opps rate,24.56,102% of CMS Opps rate,153,76.5% of total billed charges,24.08,100% of Medicaid LA Fee Schedule,24.08,100% of Medicaid LA Fee Schedule,24.08,100% of CMS OPPS Rate,24.08,100% of CMS OPPS Rate,90,45% of total billed charges,140,70% of total billed charges,120,60% of total billed charges,24.08,100% of CMS OPPS Rate,26.76,90% OF UHC FEE SCHEDULE,140,70% of total billed charges,24.08,100% OF CMS OPPS Rate,55.38,230% OF CMS OPPS Rate,96,48% of total Billed charges,24.08,100% OF CMS OPPS Rate,180,90% of total Billed charges,24.08,100% of Medicaid LA Fee Schedule,24.08,100% of Medicaid LA Fee Schedule,24.08,100% of Medicaid LA Fee Schedule,24.08,100% of Medicaid LA Fee Schedule,24.08,100% of Medicaid LA Fee Schedule,24.08,100% of Medicaid LA Fee Schedule,24.08,100% of CMS OPPS Rate,24.08,100% of CMS OPPS Rate,24.08,100% of CMS OPPS Rate,24.08,100% of CMS OPPS Rate,24.08,100% of CMS OPPS Rate,24.08,100% of CMS OPPS Rate,24.08,100% of CMS OPPS Rate,24.08,100% of CMS OPPS Rate,24.08,180,120
Outpatient,Laboratory,87390,HIV-1 ANTIGEN,300,182,85.17,354% of CMS OPPS Rate,23.8,100% of Medicaid LA Fee Schedule,24.06,100% of CMS OPPS Rate,24.06,100% of CMS OPPS Rate,49.06,203.89% of BCBS Fee Schedule,127.4,70% of total Billed Charges,136.5,75% of total Billed Charges,43.3,180% OF CMS OPPS RATE,145.6,80% of total Billed Charges,84.21,350% of CMS Opps rate,24.54,102% of CMS Opps rate,139.23,76.5% of total billed charges,23.8,100% of Medicaid LA Fee Schedule,23.8,100% of Medicaid LA Fee Schedule,24.06,100% of CMS OPPS Rate,24.06,100% of CMS OPPS Rate,81.9,45% of total billed charges,127.4,70% of total billed charges,109.2,60% of total billed charges,24.06,100% of CMS OPPS Rate,21.65,90% OF UHC FEE SCHEDULE,127.4,70% of total billed charges,24.06,100% OF CMS OPPS Rate,55.33,230% OF CMS OPPS Rate,87.36,48% of total Billed charges,24.06,100% OF CMS OPPS Rate,163.8,90% of total Billed charges,23.8,100% of Medicaid LA Fee Schedule,23.8,100% of Medicaid LA Fee Schedule,23.8,100% of Medicaid LA Fee Schedule,23.8,100% of Medicaid LA Fee Schedule,23.8,100% of Medicaid LA Fee Schedule,23.8,100% of Medicaid LA Fee Schedule,24.06,100% of CMS OPPS Rate,24.06,100% of CMS OPPS Rate,24.06,100% of CMS OPPS Rate,24.06,100% of CMS OPPS Rate,24.06,100% of CMS OPPS Rate,24.06,100% of CMS OPPS Rate,24.06,100% of CMS OPPS Rate,24.06,100% of CMS OPPS Rate,21.65,163.8,109.2
Outpatient,Laboratory,87400,INFLUENZA AOR B EACH,300,N/A,50.02,354% of CMS OPPS Rate,9.08,100% of Medicaid LA Fee Schedule,14.13,100% of CMS OPPS Rate,14.13,100% of CMS OPPS Rate,30.18,203.89% of BCBS Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,25.43,180% OF CMS OPPS RATE,N/A,Not Applicable,49.45,350% of CMS Opps rate,14.41,102% of CMS Opps rate,N/A,Not Applicable,9.08,100% of Medicaid LA Fee Schedule,9.08,100% of Medicaid LA Fee Schedule,14.13,100% of CMS OPPS Rate,14.13,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,14.13,100% of CMS OPPS Rate,13.32,90% OF UHC FEE SCHEDULE,N/A,Not Applicable,14.13,100% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,14.13,100% OF CMS OPPS Rate,N/A,Not Applicable,9.08,100% of Medicaid LA Fee Schedule,9.08,100% of Medicaid LA Fee Schedule,9.08,100% of Medicaid LA Fee Schedule,9.08,100% of Medicaid LA Fee Schedule,9.08,100% of Medicaid LA Fee Schedule,9.08,100% of Medicaid LA Fee Schedule,14.13,100% of CMS OPPS Rate,14.13,100% of CMS OPPS Rate,14.13,100% of CMS OPPS Rate,14.13,100% of CMS OPPS Rate,14.13,100% of CMS OPPS Rate,14.13,100% of CMS OPPS Rate,14.13,100% of CMS OPPS Rate,14.13,100% of CMS OPPS Rate,9.08,50.02,N/A
Outpatient,Laboratory,87420,RESP SYNCYTIAL AG IA,300,342.9,49.24,354% of CMS OPPS Rate,13.91,100% of Medicaid LA Fee Schedule,13.91,100% of CMS OPPS Rate,13.91,100% of CMS OPPS Rate,30.18,203.89% of BCBS Fee Schedule,240.03,70% of total Billed Charges,257.18,75% of total Billed Charges,25.03,180% OF CMS OPPS RATE,274.32,80% of total Billed Charges,48.68,350% of CMS Opps rate,14.18,102% of CMS Opps rate,262.32,76.5% of total billed charges,13.91,100% of Medicaid LA Fee Schedule,13.91,100% of Medicaid LA Fee Schedule,13.91,100% of CMS OPPS Rate,13.91,100% of CMS OPPS Rate,154.31,45% of total billed charges,240.03,70% of total billed charges,205.74,60% of total billed charges,13.91,100% of CMS OPPS Rate,13.32,90% OF UHC FEE SCHEDULE,240.03,70% of total billed charges,13.91,100% OF CMS OPPS Rate,31.99,230% OF CMS OPPS Rate,164.59,48% of total Billed charges,13.91,100% OF CMS OPPS Rate,308.61,90% of total Billed charges,13.91,100% of Medicaid LA Fee Schedule,13.91,100% of Medicaid LA Fee Schedule,13.91,100% of Medicaid LA Fee Schedule,13.91,100% of Medicaid LA Fee Schedule,13.91,100% of Medicaid LA Fee Schedule,13.91,100% of Medicaid LA Fee Schedule,13.91,100% of CMS OPPS Rate,13.91,100% of CMS OPPS Rate,13.91,100% of CMS OPPS Rate,13.91,100% of CMS OPPS Rate,13.91,100% of CMS OPPS Rate,13.91,100% of CMS OPPS Rate,13.91,100% of CMS OPPS Rate,13.91,100% of CMS OPPS Rate,13.32,308.61,205.74
Outpatient,Laboratory,87425,ROTAVIRUS AG-STOOL,300,111.6,42.4,354% of CMS OPPS Rate,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,30.18,203.89% of BCBS Fee Schedule,78.12,70% of total Billed Charges,83.7,75% of total Billed Charges,21.56,180% OF CMS OPPS RATE,89.28,80% of total Billed Charges,41.93,350% of CMS Opps rate,12.21,102% of CMS Opps rate,85.37,76.5% of total billed charges,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,50.22,45% of total billed charges,78.12,70% of total billed charges,66.96,60% of total billed charges,11.98,100% of CMS OPPS Rate,13.32,90% OF UHC FEE SCHEDULE,78.12,70% of total billed charges,11.98,100% OF CMS OPPS Rate,27.55,230% OF CMS OPPS Rate,53.57,48% of total Billed charges,11.98,100% OF CMS OPPS Rate,100.44,90% of total Billed charges,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100.44,66.96
Outpatient,Laboratory,87427,SHIGA-LIKE TOXIN AG IA,300,108.24,42.4,354% of CMS OPPS Rate,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,30.18,203.89% of BCBS Fee Schedule,75.77,70% of total Billed Charges,81.18,75% of total Billed Charges,21.56,180% OF CMS OPPS RATE,86.59,80% of total Billed Charges,41.93,350% of CMS Opps rate,12.21,102% of CMS Opps rate,82.8,76.5% of total billed charges,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,48.71,45% of total billed charges,75.77,70% of total billed charges,64.94,60% of total billed charges,11.98,100% of CMS OPPS Rate,13.32,90% OF UHC FEE SCHEDULE,75.77,70% of total billed charges,11.98,100% OF CMS OPPS Rate,27.55,230% OF CMS OPPS Rate,51.96,48% of total Billed charges,11.98,100% OF CMS OPPS Rate,97.42,90% of total Billed charges,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,97.42,64.94
Outpatient,Laboratory,87449,AG DETECT NOS IA MULT,300,60.3,42.4,354% of CMS OPPS Rate,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,30.18,203.89% of BCBS Fee Schedule,42.21,70% of total Billed Charges,45.23,75% of total Billed Charges,21.56,180% OF CMS OPPS RATE,48.24,80% of total Billed Charges,41.93,350% of CMS Opps rate,12.21,102% of CMS Opps rate,46.13,76.5% of total billed charges,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,27.14,45% of total billed charges,42.21,70% of total billed charges,36.18,60% of total billed charges,11.98,100% of CMS OPPS Rate,13.32,90% OF UHC FEE SCHEDULE,42.21,70% of total billed charges,11.98,100% OF CMS OPPS Rate,27.55,230% OF CMS OPPS Rate,28.94,48% of total Billed charges,11.98,100% OF CMS OPPS Rate,54.27,90% of total Billed charges,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of Medicaid LA Fee Schedule,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,100% of CMS OPPS Rate,11.98,54.27,36.18
Outpatient,Laboratory,87450,AG DETECT NOS IA SINGLE,300,N/A,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,24.14,203.89% of BCBS Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,10.66,90% OF UHC FEE SCHEDULE,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,10.66,24.14,N/A
Outpatient,Laboratory,87471,INFECTIOUS AGENT BARTONELLA DNA PRBE,300,238.8,124.21,354% of CMS OPPS Rate,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,88.35,203.89% of BCBS Fee Schedule,167.16,70% of total Billed Charges,179.1,75% of total Billed Charges,63.16,180% OF CMS OPPS RATE,191.04,80% of total Billed Charges,122.81,350% of CMS Opps rate,35.79,102% of CMS Opps rate,182.68,76.5% of total billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,107.46,45% of total billed charges,167.16,70% of total billed charges,143.28,60% of total billed charges,35.09,100% of CMS OPPS Rate,39,90% OF UHC FEE SCHEDULE,167.16,70% of total billed charges,35.09,100% OF CMS OPPS Rate,80.7,230% OF CMS OPPS Rate,114.62,48% of total Billed charges,35.09,100% OF CMS OPPS Rate,214.92,90% of total Billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,214.92,143.28
Outpatient,Laboratory,87480,CANDIDA  SPECIES DNA DIR PROBE,300,136.6,70.97,354% of CMS OPPS Rate,20.05,100% of Medicaid LA Fee Schedule,20.05,100% of CMS OPPS Rate,20.05,100% of CMS OPPS Rate,50.48,203.89% of BCBS Fee Schedule,95.62,70% of total Billed Charges,102.45,75% of total Billed Charges,36.09,180% OF CMS OPPS RATE,109.28,80% of total Billed Charges,70.17,350% of CMS Opps rate,20.45,102% of CMS Opps rate,104.5,76.5% of total billed charges,20.05,100% of Medicaid LA Fee Schedule,20.05,100% of Medicaid LA Fee Schedule,20.05,100% of CMS OPPS Rate,20.05,100% of CMS OPPS Rate,61.47,45% of total billed charges,95.62,70% of total billed charges,81.96,60% of total billed charges,20.05,100% of CMS OPPS Rate,22.28,90% OF UHC FEE SCHEDULE,95.62,70% of total billed charges,20.05,100% OF CMS OPPS Rate,46.11,230% OF CMS OPPS Rate,65.57,48% of total Billed charges,20.05,100% OF CMS OPPS Rate,122.94,90% of total Billed charges,20.05,100% of Medicaid LA Fee Schedule,20.05,100% of Medicaid LA Fee Schedule,20.05,100% of Medicaid LA Fee Schedule,20.05,100% of Medicaid LA Fee Schedule,20.05,100% of Medicaid LA Fee Schedule,20.05,100% of Medicaid LA Fee Schedule,20.05,100% of CMS OPPS Rate,20.05,100% of CMS OPPS Rate,20.05,100% of CMS OPPS Rate,20.05,100% of CMS OPPS Rate,20.05,100% of CMS OPPS Rate,20.05,100% of CMS OPPS Rate,20.05,100% of CMS OPPS Rate,20.05,100% of CMS OPPS Rate,20.05,122.94,81.96
Outpatient,Laboratory,87481,CANDIDA  SPECIES AMPLFD PROBE TECH,300,240.7,124.21,354% of CMS OPPS Rate,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,88.35,203.89% of BCBS Fee Schedule,168.49,70% of total Billed Charges,180.53,75% of total Billed Charges,63.16,180% OF CMS OPPS RATE,192.56,80% of total Billed Charges,122.81,350% of CMS Opps rate,35.79,102% of CMS Opps rate,184.14,76.5% of total billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,108.32,45% of total billed charges,168.49,70% of total billed charges,144.42,60% of total billed charges,35.09,100% of CMS OPPS Rate,39,90% OF UHC FEE SCHEDULE,168.49,70% of total billed charges,35.09,100% OF CMS OPPS Rate,80.7,230% OF CMS OPPS Rate,115.54,48% of total Billed charges,35.09,100% OF CMS OPPS Rate,216.63,90% of total Billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,216.63,144.42
Outpatient,Laboratory,87483,INFECTIOUS AGENT BY DNA CNS PATHOGENS,300,1931.5,1475.4,354% of CMS OPPS Rate,43.58,100% of Medicaid LA Fee Schedule,416.78,100% of CMS OPPS Rate,416.78,100% of CMS OPPS Rate,N/A,Not Applicable,1352.05,70% of total Billed Charges,1448.63,75% of total Billed Charges,750.2,180% OF CMS OPPS RATE,1545.2,80% of total Billed Charges,1458.73,350% of CMS Opps rate,425.11,102% of CMS Opps rate,1477.6,76.5% of total billed charges,43.58,100% of Medicaid LA Fee Schedule,43.58,100% of Medicaid LA Fee Schedule,416.78,100% of CMS OPPS Rate,416.78,100% of CMS OPPS Rate,869.18,45% of total billed charges,1352.05,70% of total billed charges,1158.9,60% of total billed charges,416.78,100% of CMS OPPS Rate,463.1,90% OF UHC FEE SCHEDULE,1352.05,70% of total billed charges,416.78,100% OF CMS OPPS Rate,958.59,230% OF CMS OPPS Rate,927.12,48% of total Billed charges,416.78,100% OF CMS OPPS Rate,1738.35,90% of total Billed charges,43.58,100% of Medicaid LA Fee Schedule,43.58,100% of Medicaid LA Fee Schedule,43.58,100% of Medicaid LA Fee Schedule,43.58,100% of Medicaid LA Fee Schedule,43.58,100% of Medicaid LA Fee Schedule,43.58,100% of Medicaid LA Fee Schedule,416.78,100% of CMS OPPS Rate,416.78,100% of CMS OPPS Rate,416.78,100% of CMS OPPS Rate,416.78,100% of CMS OPPS Rate,416.78,100% of CMS OPPS Rate,416.78,100% of CMS OPPS Rate,416.78,100% of CMS OPPS Rate,416.78,100% of CMS OPPS Rate,43.58,1738.35,1158.9
Outpatient,Laboratory,87486,CHLAMYDIA PNEUM PROBE,300,239,124.21,354% of CMS OPPS Rate,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,N/A,Not Applicable,167.3,70% of total Billed Charges,179.25,75% of total Billed Charges,63.16,180% OF CMS OPPS RATE,191.2,80% of total Billed Charges,122.81,350% of CMS Opps rate,35.79,102% of CMS Opps rate,182.84,76.5% of total billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,107.55,45% of total billed charges,167.3,70% of total billed charges,143.4,60% of total billed charges,35.09,100% of CMS OPPS Rate,39,90% OF UHC FEE SCHEDULE,167.3,70% of total billed charges,35.09,100% OF CMS OPPS Rate,80.7,230% OF CMS OPPS Rate,114.72,48% of total Billed charges,35.09,100% OF CMS OPPS Rate,215.1,90% of total Billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,215.1,143.4
Outpatient,Laboratory,87491,Test that detects Chlamydia,300,105,124.21,354% of CMS OPPS Rate,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,88.35,203.89% of BCBS Fee Schedule,73.5,70% of total Billed Charges,78.75,75% of total Billed Charges,63.16,180% OF CMS OPPS RATE,84,80% of total Billed Charges,122.81,350% of CMS Opps rate,35.79,102% of CMS Opps rate,80.33,76.5% of total billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,47.25,45% of total billed charges,73.5,70% of total billed charges,63,60% of total billed charges,35.09,100% of CMS OPPS Rate,39,90% OF UHC FEE SCHEDULE,73.5,70% of total billed charges,35.09,100% OF CMS OPPS Rate,80.7,230% OF CMS OPPS Rate,50.4,48% of total Billed charges,35.09,100% OF CMS OPPS Rate,94.5,90% of total Billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,124.21,63
Outpatient,Laboratory,87493,INFECTIOUS AGENT DNA CLOSTRIDIUM D,300,252,131.93,354% of CMS OPPS Rate,37.27,100% of Medicaid LA Fee Schedule,37.27,100% of CMS OPPS Rate,37.27,100% of CMS OPPS Rate,88.35,203.89% of BCBS Fee Schedule,176.4,70% of total Billed Charges,189,75% of total Billed Charges,67.08,180% OF CMS OPPS RATE,201.6,80% of total Billed Charges,130.44,350% of CMS Opps rate,38.01,102% of CMS Opps rate,192.78,76.5% of total billed charges,37.27,100% of Medicaid LA Fee Schedule,37.27,100% of Medicaid LA Fee Schedule,37.27,100% of CMS OPPS Rate,37.27,100% of CMS OPPS Rate,113.4,45% of total billed charges,176.4,70% of total billed charges,151.2,60% of total billed charges,37.27,100% of CMS OPPS Rate,39,90% OF UHC FEE SCHEDULE,176.4,70% of total billed charges,37.27,100% OF CMS OPPS Rate,85.72,230% OF CMS OPPS Rate,120.96,48% of total Billed charges,37.27,100% OF CMS OPPS Rate,226.8,90% of total Billed charges,37.27,100% of Medicaid LA Fee Schedule,37.27,100% of Medicaid LA Fee Schedule,37.27,100% of Medicaid LA Fee Schedule,37.27,100% of Medicaid LA Fee Schedule,37.27,100% of Medicaid LA Fee Schedule,37.27,100% of Medicaid LA Fee Schedule,37.27,100% of CMS OPPS Rate,37.27,100% of CMS OPPS Rate,37.27,100% of CMS OPPS Rate,37.27,100% of CMS OPPS Rate,37.27,100% of CMS OPPS Rate,37.27,100% of CMS OPPS Rate,37.27,100% of CMS OPPS Rate,37.27,100% of CMS OPPS Rate,37.27,226.8,151.2
Outpatient,Laboratory,87496,CMV DNA DETECTOR,300,227.7,124.21,354% of CMS OPPS Rate,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,88.35,203.89% of BCBS Fee Schedule,159.39,70% of total Billed Charges,170.78,75% of total Billed Charges,63.16,180% OF CMS OPPS RATE,182.16,80% of total Billed Charges,122.81,350% of CMS Opps rate,35.79,102% of CMS Opps rate,174.19,76.5% of total billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,102.47,45% of total billed charges,159.39,70% of total billed charges,136.62,60% of total billed charges,35.09,100% of CMS OPPS Rate,39,90% OF UHC FEE SCHEDULE,159.39,70% of total billed charges,35.09,100% OF CMS OPPS Rate,80.7,230% OF CMS OPPS Rate,109.3,48% of total Billed charges,35.09,100% OF CMS OPPS Rate,204.93,90% of total Billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,204.93,136.62
Outpatient,Laboratory,87497,CYTOMEGALOVIRUS NA QUAN,300,138.6,151.65,354% of CMS OPPS Rate,42.84,100% of Medicaid LA Fee Schedule,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,107.82,203.89% of BCBS Fee Schedule,97.02,70% of total Billed Charges,103.95,75% of total Billed Charges,77.11,180% OF CMS OPPS RATE,110.88,80% of total Billed Charges,149.94,350% of CMS Opps rate,43.69,102% of CMS Opps rate,106.03,76.5% of total billed charges,42.84,100% of Medicaid LA Fee Schedule,42.84,100% of Medicaid LA Fee Schedule,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,62.37,45% of total billed charges,97.02,70% of total billed charges,83.16,60% of total billed charges,42.84,100% of CMS OPPS Rate,47.59,90% OF UHC FEE SCHEDULE,97.02,70% of total billed charges,42.84,100% OF CMS OPPS Rate,98.53,230% OF CMS OPPS Rate,66.53,48% of total Billed charges,42.84,100% OF CMS OPPS Rate,124.74,90% of total Billed charges,42.84,100% of Medicaid LA Fee Schedule,42.84,100% of Medicaid LA Fee Schedule,42.84,100% of Medicaid LA Fee Schedule,42.84,100% of Medicaid LA Fee Schedule,42.84,100% of Medicaid LA Fee Schedule,42.84,100% of Medicaid LA Fee Schedule,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,42.84,151.65,83.16
Outpatient,Laboratory,87498,ENTEROVIRUS DNA AMP PROBE,300,323.1,124.21,354% of CMS OPPS Rate,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,88.35,203.89% of BCBS Fee Schedule,226.17,70% of total Billed Charges,242.33,75% of total Billed Charges,63.16,180% OF CMS OPPS RATE,258.48,80% of total Billed Charges,122.81,350% of CMS Opps rate,35.79,102% of CMS Opps rate,247.17,76.5% of total billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,145.4,45% of total billed charges,226.17,70% of total billed charges,193.86,60% of total billed charges,35.09,100% of CMS OPPS Rate,39,90% OF UHC FEE SCHEDULE,226.17,70% of total billed charges,35.09,100% OF CMS OPPS Rate,80.7,230% OF CMS OPPS Rate,155.09,48% of total Billed charges,35.09,100% OF CMS OPPS Rate,290.79,90% of total Billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,290.79,193.86
Outpatient,Laboratory,87501,MYCOPLASMA PNEUM PROB,300,154,181.63,354% of CMS OPPS Rate,51.31,100% of Medicaid LA Fee Schedule,51.31,100% of CMS OPPS Rate,51.31,100% of CMS OPPS Rate,129.16,203.89% of BCBS Fee Schedule,107.8,70% of total Billed Charges,115.5,75% of total Billed Charges,92.35,180% OF CMS OPPS RATE,123.2,80% of total Billed Charges,179.58,350% of CMS Opps rate,52.33,102% of CMS Opps rate,117.81,76.5% of total billed charges,51.31,100% of Medicaid LA Fee Schedule,51.31,100% of Medicaid LA Fee Schedule,51.31,100% of CMS OPPS Rate,51.31,100% of CMS OPPS Rate,69.3,45% of total billed charges,107.8,70% of total billed charges,92.4,60% of total billed charges,51.31,100% of CMS OPPS Rate,57.02,90% OF UHC FEE SCHEDULE,107.8,70% of total billed charges,51.31,100% OF CMS OPPS Rate,118.01,230% OF CMS OPPS Rate,73.92,48% of total Billed charges,51.31,100% OF CMS OPPS Rate,138.6,90% of total Billed charges,51.31,100% of Medicaid LA Fee Schedule,51.31,100% of Medicaid LA Fee Schedule,51.31,100% of Medicaid LA Fee Schedule,51.31,100% of Medicaid LA Fee Schedule,51.31,100% of Medicaid LA Fee Schedule,51.31,100% of Medicaid LA Fee Schedule,51.31,100% of CMS OPPS Rate,51.31,100% of CMS OPPS Rate,51.31,100% of CMS OPPS Rate,51.31,100% of CMS OPPS Rate,51.31,100% of CMS OPPS Rate,51.31,100% of CMS OPPS Rate,51.31,100% of CMS OPPS Rate,51.31,100% of CMS OPPS Rate,51.31,181.63,92.4
Outpatient,Laboratory,87502,INFECTIOUS AGENT BY DNA INFLUENZA,300,596,339.13,354% of CMS OPPS Rate,95.8,100% of Medicaid LA Fee Schedule,95.8,100% of CMS OPPS Rate,95.8,100% of CMS OPPS Rate,214.21,203.89% of BCBS Fee Schedule,417.2,70% of total Billed Charges,447,75% of total Billed Charges,172.44,180% OF CMS OPPS RATE,476.8,80% of total Billed Charges,335.3,350% of CMS Opps rate,97.71,102% of CMS Opps rate,455.94,76.5% of total billed charges,95.8,100% of Medicaid LA Fee Schedule,95.8,100% of Medicaid LA Fee Schedule,95.8,100% of CMS OPPS Rate,95.8,100% of CMS OPPS Rate,268.2,45% of total billed charges,417.2,70% of total billed charges,357.6,60% of total billed charges,95.8,100% of CMS OPPS Rate,94.55,90% OF UHC FEE SCHEDULE,417.2,70% of total billed charges,95.8,100% OF CMS OPPS Rate,220.34,230% OF CMS OPPS Rate,286.08,48% of total Billed charges,95.8,100% OF CMS OPPS Rate,536.4,90% of total Billed charges,95.8,100% of Medicaid LA Fee Schedule,95.8,100% of Medicaid LA Fee Schedule,95.8,100% of Medicaid LA Fee Schedule,95.8,100% of Medicaid LA Fee Schedule,95.8,100% of Medicaid LA Fee Schedule,95.8,100% of Medicaid LA Fee Schedule,95.8,100% of CMS OPPS Rate,95.8,100% of CMS OPPS Rate,95.8,100% of CMS OPPS Rate,95.8,100% of CMS OPPS Rate,95.8,100% of CMS OPPS Rate,95.8,100% of CMS OPPS Rate,95.8,100% of CMS OPPS Rate,95.8,100% of CMS OPPS Rate,94.55,536.4,357.6
Outpatient,Laboratory,87507,INFECTIOUS AGENT BY DNA GI PATHGN,300,1250,1475.4,354% of CMS OPPS Rate,416.78,100% of Medicaid LA Fee Schedule,416.78,100% of CMS OPPS Rate,416.78,100% of CMS OPPS Rate,N/A,Not Applicable,875,70% of total Billed Charges,937.5,75% of total Billed Charges,750.2,180% OF CMS OPPS RATE,1000,80% of total Billed Charges,1458.73,350% of CMS Opps rate,425.11,102% of CMS Opps rate,956.25,76.5% of total billed charges,416.78,100% of Medicaid LA Fee Schedule,416.78,100% of Medicaid LA Fee Schedule,416.78,100% of CMS OPPS Rate,416.78,100% of CMS OPPS Rate,562.5,45% of total billed charges,875,70% of total billed charges,750,60% of total billed charges,416.78,100% of CMS OPPS Rate,463.1,90% OF UHC FEE SCHEDULE,875,70% of total billed charges,416.78,100% OF CMS OPPS Rate,958.59,230% OF CMS OPPS Rate,600,48% of total Billed charges,416.78,100% OF CMS OPPS Rate,1125,90% of total Billed charges,416.78,100% of Medicaid LA Fee Schedule,416.78,100% of Medicaid LA Fee Schedule,416.78,100% of Medicaid LA Fee Schedule,416.78,100% of Medicaid LA Fee Schedule,416.78,100% of Medicaid LA Fee Schedule,416.78,100% of Medicaid LA Fee Schedule,416.78,100% of CMS OPPS Rate,416.78,100% of CMS OPPS Rate,416.78,100% of CMS OPPS Rate,416.78,100% of CMS OPPS Rate,416.78,100% of CMS OPPS Rate,416.78,100% of CMS OPPS Rate,416.78,100% of CMS OPPS Rate,416.78,100% of CMS OPPS Rate,416.78,1475.4,750
Outpatient,Laboratory,87510,Blood test for vaginitis,300,136.6,70.97,354% of CMS OPPS Rate,20.05,100% of Medicaid LA Fee Schedule,20.05,100% of CMS OPPS Rate,20.05,100% of CMS OPPS Rate,50.48,203.89% of BCBS Fee Schedule,95.62,70% of total Billed Charges,102.45,75% of total Billed Charges,36.09,180% OF CMS OPPS RATE,109.28,80% of total Billed Charges,70.17,350% of CMS Opps rate,20.45,102% of CMS Opps rate,104.5,76.5% of total billed charges,20.05,100% of Medicaid LA Fee Schedule,20.05,100% of Medicaid LA Fee Schedule,20.05,100% of CMS OPPS Rate,20.05,100% of CMS OPPS Rate,61.47,45% of total billed charges,95.62,70% of total billed charges,81.96,60% of total billed charges,20.05,100% of CMS OPPS Rate,22.28,90% OF UHC FEE SCHEDULE,95.62,70% of total billed charges,20.05,100% OF CMS OPPS Rate,46.11,230% OF CMS OPPS Rate,65.57,48% of total Billed charges,20.05,100% OF CMS OPPS Rate,122.94,90% of total Billed charges,20.05,100% of Medicaid LA Fee Schedule,20.05,100% of Medicaid LA Fee Schedule,20.05,100% of Medicaid LA Fee Schedule,20.05,100% of Medicaid LA Fee Schedule,20.05,100% of Medicaid LA Fee Schedule,20.05,100% of Medicaid LA Fee Schedule,20.05,100% of CMS OPPS Rate,20.05,100% of CMS OPPS Rate,20.05,100% of CMS OPPS Rate,20.05,100% of CMS OPPS Rate,20.05,100% of CMS OPPS Rate,20.05,100% of CMS OPPS Rate,20.05,100% of CMS OPPS Rate,20.05,100% of CMS OPPS Rate,20.05,122.94,81.96
Outpatient,Laboratory,87511,GARDNERELLA V AMPLFD PROBE TECH,300,240.7,124.21,354% of CMS OPPS Rate,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,88.35,203.89% of BCBS Fee Schedule,168.49,70% of total Billed Charges,180.53,75% of total Billed Charges,63.16,180% OF CMS OPPS RATE,192.56,80% of total Billed Charges,122.81,350% of CMS Opps rate,35.79,102% of CMS Opps rate,184.14,76.5% of total billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,108.32,45% of total billed charges,168.49,70% of total billed charges,144.42,60% of total billed charges,35.09,100% of CMS OPPS Rate,39,90% OF UHC FEE SCHEDULE,168.49,70% of total billed charges,35.09,100% OF CMS OPPS Rate,80.7,230% OF CMS OPPS Rate,115.54,48% of total Billed charges,35.09,100% OF CMS OPPS Rate,216.63,90% of total Billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,216.63,144.42
Outpatient,Laboratory,87516,HEPATITIS B AMPL PROBE,300,265.65,124.21,354% of CMS OPPS Rate,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,88.35,203.89% of BCBS Fee Schedule,185.96,70% of total Billed Charges,199.24,75% of total Billed Charges,63.16,180% OF CMS OPPS RATE,212.52,80% of total Billed Charges,122.81,350% of CMS Opps rate,35.79,102% of CMS Opps rate,203.22,76.5% of total billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,119.54,45% of total billed charges,185.96,70% of total billed charges,159.39,60% of total billed charges,35.09,100% of CMS OPPS Rate,39,90% OF UHC FEE SCHEDULE,185.96,70% of total billed charges,35.09,100% OF CMS OPPS Rate,80.7,230% OF CMS OPPS Rate,127.51,48% of total Billed charges,35.09,100% OF CMS OPPS Rate,239.09,90% of total Billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,239.09,159.39
Outpatient,Laboratory,87517,"HEP. B,VIRUS QUANT",300,275,151.65,354% of CMS OPPS Rate,42.84,100% of Medicaid LA Fee Schedule,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,107.82,203.89% of BCBS Fee Schedule,192.5,70% of total Billed Charges,206.25,75% of total Billed Charges,77.11,180% OF CMS OPPS RATE,220,80% of total Billed Charges,149.94,350% of CMS Opps rate,43.69,102% of CMS Opps rate,210.38,76.5% of total billed charges,42.84,100% of Medicaid LA Fee Schedule,42.84,100% of Medicaid LA Fee Schedule,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,123.75,45% of total billed charges,192.5,70% of total billed charges,165,60% of total billed charges,42.84,100% of CMS OPPS Rate,47.59,90% OF UHC FEE SCHEDULE,192.5,70% of total billed charges,42.84,100% OF CMS OPPS Rate,98.53,230% OF CMS OPPS Rate,132,48% of total Billed charges,42.84,100% OF CMS OPPS Rate,247.5,90% of total Billed charges,42.84,100% of Medicaid LA Fee Schedule,42.84,100% of Medicaid LA Fee Schedule,42.84,100% of Medicaid LA Fee Schedule,42.84,100% of Medicaid LA Fee Schedule,42.84,100% of Medicaid LA Fee Schedule,42.84,100% of Medicaid LA Fee Schedule,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,42.84,247.5,165
Outpatient,Laboratory,87521,HEPATITIS C RNA PROBE,300,143.55,124.21,354% of CMS OPPS Rate,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,88.35,203.89% of BCBS Fee Schedule,100.49,70% of total Billed Charges,107.66,75% of total Billed Charges,63.16,180% OF CMS OPPS RATE,114.84,80% of total Billed Charges,122.81,350% of CMS Opps rate,35.79,102% of CMS Opps rate,109.82,76.5% of total billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,64.6,45% of total billed charges,100.49,70% of total billed charges,86.13,60% of total billed charges,35.09,100% of CMS OPPS Rate,39,90% OF UHC FEE SCHEDULE,100.49,70% of total billed charges,35.09,100% OF CMS OPPS Rate,80.7,230% OF CMS OPPS Rate,68.9,48% of total Billed charges,35.09,100% OF CMS OPPS Rate,129.2,90% of total Billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,129.2,86.13
Outpatient,Laboratory,87522,HEPATITIS C QUANTIFICATION,300,268.95,151.65,354% of CMS OPPS Rate,42.84,100% of Medicaid LA Fee Schedule,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,107.82,203.89% of BCBS Fee Schedule,188.27,70% of total Billed Charges,201.71,75% of total Billed Charges,77.11,180% OF CMS OPPS RATE,215.16,80% of total Billed Charges,149.94,350% of CMS Opps rate,43.69,102% of CMS Opps rate,205.75,76.5% of total billed charges,42.84,100% of Medicaid LA Fee Schedule,42.84,100% of Medicaid LA Fee Schedule,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,121.03,45% of total billed charges,188.27,70% of total billed charges,161.37,60% of total billed charges,42.84,100% of CMS OPPS Rate,47.59,90% OF UHC FEE SCHEDULE,188.27,70% of total billed charges,42.84,100% OF CMS OPPS Rate,98.53,230% OF CMS OPPS Rate,129.1,48% of total Billed charges,42.84,100% OF CMS OPPS Rate,242.06,90% of total Billed charges,42.84,100% of Medicaid LA Fee Schedule,42.84,100% of Medicaid LA Fee Schedule,42.84,100% of Medicaid LA Fee Schedule,42.84,100% of Medicaid LA Fee Schedule,42.84,100% of Medicaid LA Fee Schedule,42.84,100% of Medicaid LA Fee Schedule,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,42.84,242.06,161.37
Outpatient,Laboratory,87529,HERPES SIMPLEX DNA PROBE,300,242.55,124.21,354% of CMS OPPS Rate,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,88.35,203.89% of BCBS Fee Schedule,169.79,70% of total Billed Charges,181.91,75% of total Billed Charges,63.16,180% OF CMS OPPS RATE,194.04,80% of total Billed Charges,122.81,350% of CMS Opps rate,35.79,102% of CMS Opps rate,185.55,76.5% of total billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,109.15,45% of total billed charges,169.79,70% of total billed charges,145.53,60% of total billed charges,35.09,100% of CMS OPPS Rate,39,90% OF UHC FEE SCHEDULE,169.79,70% of total billed charges,35.09,100% OF CMS OPPS Rate,80.7,230% OF CMS OPPS Rate,116.42,48% of total Billed charges,35.09,100% OF CMS OPPS Rate,218.3,90% of total Billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,218.3,145.53
Outpatient,Laboratory,87530,HERPES S.VIRUS QUANT,300,129,151.65,354% of CMS OPPS Rate,42.84,100% of Medicaid LA Fee Schedule,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,107.82,203.89% of BCBS Fee Schedule,90.3,70% of total Billed Charges,96.75,75% of total Billed Charges,77.11,180% OF CMS OPPS RATE,103.2,80% of total Billed Charges,149.94,350% of CMS Opps rate,43.69,102% of CMS Opps rate,98.69,76.5% of total billed charges,42.84,100% of Medicaid LA Fee Schedule,42.84,100% of Medicaid LA Fee Schedule,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,58.05,45% of total billed charges,90.3,70% of total billed charges,77.4,60% of total billed charges,42.84,100% of CMS OPPS Rate,47.59,90% OF UHC FEE SCHEDULE,90.3,70% of total billed charges,42.84,100% OF CMS OPPS Rate,98.53,230% OF CMS OPPS Rate,61.92,48% of total Billed charges,42.84,100% OF CMS OPPS Rate,116.1,90% of total Billed charges,42.84,100% of Medicaid LA Fee Schedule,42.84,100% of Medicaid LA Fee Schedule,42.84,100% of Medicaid LA Fee Schedule,42.84,100% of Medicaid LA Fee Schedule,42.84,100% of Medicaid LA Fee Schedule,42.84,100% of Medicaid LA Fee Schedule,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,42.84,151.65,77.4
Outpatient,Laboratory,87532,INFECTIOUS AGENT BY DNA HPV6,300,238.8,124.21,354% of CMS OPPS Rate,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,88.35,203.89% of BCBS Fee Schedule,167.16,70% of total Billed Charges,179.1,75% of total Billed Charges,63.16,180% OF CMS OPPS RATE,191.04,80% of total Billed Charges,122.81,350% of CMS Opps rate,35.79,102% of CMS Opps rate,182.68,76.5% of total billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,107.46,45% of total billed charges,167.16,70% of total billed charges,143.28,60% of total billed charges,35.09,100% of CMS OPPS Rate,39,90% OF UHC FEE SCHEDULE,167.16,70% of total billed charges,35.09,100% OF CMS OPPS Rate,80.7,230% OF CMS OPPS Rate,114.62,48% of total Billed charges,35.09,100% OF CMS OPPS Rate,214.92,90% of total Billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,214.92,143.28
Outpatient,Laboratory,87533,HPV 6 DNA QUANTITATIVE,300,698,147.83,354% of CMS OPPS Rate,24.93,100% of Medicaid LA Fee Schedule,41.76,100% of CMS OPPS Rate,41.76,100% of CMS OPPS Rate,105.11,203.89% of BCBS Fee Schedule,488.6,70% of total Billed Charges,523.5,75% of total Billed Charges,75.16,180% OF CMS OPPS RATE,558.4,80% of total Billed Charges,146.16,350% of CMS Opps rate,42.59,102% of CMS Opps rate,533.97,76.5% of total billed charges,24.93,100% of Medicaid LA Fee Schedule,24.93,100% of Medicaid LA Fee Schedule,41.76,100% of CMS OPPS Rate,41.76,100% of CMS OPPS Rate,314.1,45% of total billed charges,488.6,70% of total billed charges,418.8,60% of total billed charges,41.76,100% of CMS OPPS Rate,46.4,90% OF UHC FEE SCHEDULE,488.6,70% of total billed charges,41.76,100% OF CMS OPPS Rate,96.04,230% OF CMS OPPS Rate,335.04,48% of total Billed charges,41.76,100% OF CMS OPPS Rate,628.2,90% of total Billed charges,24.93,100% of Medicaid LA Fee Schedule,24.93,100% of Medicaid LA Fee Schedule,24.93,100% of Medicaid LA Fee Schedule,24.93,100% of Medicaid LA Fee Schedule,24.93,100% of Medicaid LA Fee Schedule,24.93,100% of Medicaid LA Fee Schedule,41.76,100% of CMS OPPS Rate,41.76,100% of CMS OPPS Rate,41.76,100% of CMS OPPS Rate,41.76,100% of CMS OPPS Rate,41.76,100% of CMS OPPS Rate,41.76,100% of CMS OPPS Rate,41.76,100% of CMS OPPS Rate,41.76,100% of CMS OPPS Rate,24.93,628.2,418.8
Outpatient,Laboratory,87535,"HIV-1, DNA DETECTOR,BLD",300,243.9,124.21,354% of CMS OPPS Rate,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,88.35,203.89% of BCBS Fee Schedule,170.73,70% of total Billed Charges,182.93,75% of total Billed Charges,63.16,180% OF CMS OPPS RATE,195.12,80% of total Billed Charges,122.81,350% of CMS Opps rate,35.79,102% of CMS Opps rate,186.58,76.5% of total billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,109.76,45% of total billed charges,170.73,70% of total billed charges,146.34,60% of total billed charges,35.09,100% of CMS OPPS Rate,39,90% OF UHC FEE SCHEDULE,170.73,70% of total billed charges,35.09,100% OF CMS OPPS Rate,80.7,230% OF CMS OPPS Rate,117.07,48% of total Billed charges,35.09,100% OF CMS OPPS Rate,219.51,90% of total Billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,219.51,146.34
Outpatient,Laboratory,87536,"HIV-1 ACCUQUANT, RNA, SER",300,255,301.25,354% of CMS OPPS Rate,84.91,100% of Medicaid LA Fee Schedule,85.1,100% of CMS OPPS Rate,85.1,100% of CMS OPPS Rate,214.21,203.89% of BCBS Fee Schedule,178.5,70% of total Billed Charges,191.25,75% of total Billed Charges,153.17,180% OF CMS OPPS RATE,204,80% of total Billed Charges,297.84,350% of CMS Opps rate,86.8,102% of CMS Opps rate,195.08,76.5% of total billed charges,84.91,100% of Medicaid LA Fee Schedule,84.91,100% of Medicaid LA Fee Schedule,85.1,100% of CMS OPPS Rate,85.1,100% of CMS OPPS Rate,114.75,45% of total billed charges,178.5,70% of total billed charges,153,60% of total billed charges,85.1,100% of CMS OPPS Rate,94.55,90% OF UHC FEE SCHEDULE,178.5,70% of total billed charges,85.1,100% OF CMS OPPS Rate,195.73,230% OF CMS OPPS Rate,122.4,48% of total Billed charges,85.1,100% OF CMS OPPS Rate,229.5,90% of total Billed charges,84.91,100% of Medicaid LA Fee Schedule,84.91,100% of Medicaid LA Fee Schedule,84.91,100% of Medicaid LA Fee Schedule,84.91,100% of Medicaid LA Fee Schedule,84.91,100% of Medicaid LA Fee Schedule,84.91,100% of Medicaid LA Fee Schedule,85.1,100% of CMS OPPS Rate,85.1,100% of CMS OPPS Rate,85.1,100% of CMS OPPS Rate,85.1,100% of CMS OPPS Rate,85.1,100% of CMS OPPS Rate,85.1,100% of CMS OPPS Rate,85.1,100% of CMS OPPS Rate,85.1,100% of CMS OPPS Rate,84.91,301.25,153
Outpatient,Laboratory,87538,HIV 2 AMPLIF NA PROBE,300,328,124.21,354% of CMS OPPS Rate,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,88.35,203.89% of BCBS Fee Schedule,229.6,70% of total Billed Charges,246,75% of total Billed Charges,63.16,180% OF CMS OPPS RATE,262.4,80% of total Billed Charges,122.81,350% of CMS Opps rate,35.79,102% of CMS Opps rate,250.92,76.5% of total billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,147.6,45% of total billed charges,229.6,70% of total billed charges,196.8,60% of total billed charges,35.09,100% of CMS OPPS Rate,39,90% OF UHC FEE SCHEDULE,229.6,70% of total billed charges,35.09,100% OF CMS OPPS Rate,80.7,230% OF CMS OPPS Rate,157.44,48% of total Billed charges,35.09,100% OF CMS OPPS Rate,295.2,90% of total Billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,295.2,196.8
Outpatient,Laboratory,87541,INFECTIOUS AGENT BY DNA PNEUMOPHILA,300,230.72,124.21,354% of CMS OPPS Rate,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,88.35,203.89% of BCBS Fee Schedule,161.5,70% of total Billed Charges,173.04,75% of total Billed Charges,63.16,180% OF CMS OPPS RATE,184.58,80% of total Billed Charges,122.81,350% of CMS Opps rate,35.79,102% of CMS Opps rate,176.5,76.5% of total billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,103.82,45% of total billed charges,161.5,70% of total billed charges,138.43,60% of total billed charges,35.09,100% of CMS OPPS Rate,39,90% OF UHC FEE SCHEDULE,161.5,70% of total billed charges,35.09,100% OF CMS OPPS Rate,80.7,230% OF CMS OPPS Rate,110.75,48% of total Billed charges,35.09,100% OF CMS OPPS Rate,207.65,90% of total Billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,207.65,138.43
Outpatient,Laboratory,87551,MYCOBACTERIA DNA RNA PROBE,300,700,170.76,354% of CMS OPPS Rate,47.32,100% of Medicaid LA Fee Schedule,48.24,100% of CMS OPPS Rate,48.24,100% of CMS OPPS Rate,98.36,203.89% of BCBS Fee Schedule,490,70% of total Billed Charges,525,75% of total Billed Charges,86.83,180% OF CMS OPPS RATE,560,80% of total Billed Charges,168.84,350% of CMS Opps rate,49.2,102% of CMS Opps rate,535.5,76.5% of total billed charges,47.32,100% of Medicaid LA Fee Schedule,47.32,100% of Medicaid LA Fee Schedule,48.24,100% of CMS OPPS Rate,48.24,100% of CMS OPPS Rate,315,45% of total billed charges,490,70% of total billed charges,420,60% of total billed charges,48.24,100% of CMS OPPS Rate,43.42,90% OF UHC FEE SCHEDULE,490,70% of total billed charges,48.24,100% OF CMS OPPS Rate,110.95,230% OF CMS OPPS Rate,336,48% of total Billed charges,48.24,100% OF CMS OPPS Rate,630,90% of total Billed charges,47.32,100% of Medicaid LA Fee Schedule,47.32,100% of Medicaid LA Fee Schedule,47.32,100% of Medicaid LA Fee Schedule,47.32,100% of Medicaid LA Fee Schedule,47.32,100% of Medicaid LA Fee Schedule,47.32,100% of Medicaid LA Fee Schedule,48.24,100% of CMS OPPS Rate,48.24,100% of CMS OPPS Rate,48.24,100% of CMS OPPS Rate,48.24,100% of CMS OPPS Rate,48.24,100% of CMS OPPS Rate,48.24,100% of CMS OPPS Rate,48.24,100% of CMS OPPS Rate,48.24,100% of CMS OPPS Rate,43.42,630,420
Outpatient,Laboratory,87556,MYCOBACTERIUM TUB. PROBE,300,480.15,147.54,354% of CMS OPPS Rate,41.68,100% of Medicaid LA Fee Schedule,41.68,100% of CMS OPPS Rate,41.68,100% of CMS OPPS Rate,88.35,203.89% of BCBS Fee Schedule,336.11,70% of total Billed Charges,360.11,75% of total Billed Charges,75.02,180% OF CMS OPPS RATE,384.12,80% of total Billed Charges,145.88,350% of CMS Opps rate,42.51,102% of CMS Opps rate,367.31,76.5% of total billed charges,41.68,100% of Medicaid LA Fee Schedule,41.68,100% of Medicaid LA Fee Schedule,41.68,100% of CMS OPPS Rate,41.68,100% of CMS OPPS Rate,216.07,45% of total billed charges,336.11,70% of total billed charges,288.09,60% of total billed charges,41.68,100% of CMS OPPS Rate,39,90% OF UHC FEE SCHEDULE,336.11,70% of total billed charges,41.68,100% OF CMS OPPS Rate,95.86,230% OF CMS OPPS Rate,230.47,48% of total Billed charges,41.68,100% OF CMS OPPS Rate,432.14,90% of total Billed charges,41.68,100% of Medicaid LA Fee Schedule,41.68,100% of Medicaid LA Fee Schedule,41.68,100% of Medicaid LA Fee Schedule,41.68,100% of Medicaid LA Fee Schedule,41.68,100% of Medicaid LA Fee Schedule,41.68,100% of Medicaid LA Fee Schedule,41.68,100% of CMS OPPS Rate,41.68,100% of CMS OPPS Rate,41.68,100% of CMS OPPS Rate,41.68,100% of CMS OPPS Rate,41.68,100% of CMS OPPS Rate,41.68,100% of CMS OPPS Rate,41.68,100% of CMS OPPS Rate,41.68,100% of CMS OPPS Rate,39,432.14,288.09
Outpatient,Laboratory,87561,MYCOBACTERIA AVIUM BY AMP PROBE,300,270,124.21,354% of CMS OPPS Rate,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,88.35,203.89% of BCBS Fee Schedule,189,70% of total Billed Charges,202.5,75% of total Billed Charges,63.16,180% OF CMS OPPS RATE,216,80% of total Billed Charges,122.81,350% of CMS Opps rate,35.79,102% of CMS Opps rate,206.55,76.5% of total billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,121.5,45% of total billed charges,189,70% of total billed charges,162,60% of total billed charges,35.09,100% of CMS OPPS Rate,39,90% OF UHC FEE SCHEDULE,189,70% of total billed charges,35.09,100% OF CMS OPPS Rate,80.7,230% OF CMS OPPS Rate,129.6,48% of total Billed charges,35.09,100% OF CMS OPPS Rate,243,90% of total Billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,243,162
Outpatient,Laboratory,87590,NEISSERIA GON. DIRECT PROBE,300,64,95.15,354% of CMS OPPS Rate,26.88,100% of Medicaid LA Fee Schedule,26.88,100% of CMS OPPS Rate,26.88,100% of CMS OPPS Rate,54.81,203.89% of BCBS Fee Schedule,44.8,70% of total Billed Charges,48,75% of total Billed Charges,48.38,180% OF CMS OPPS RATE,51.2,80% of total Billed Charges,94.08,350% of CMS Opps rate,27.41,102% of CMS Opps rate,48.96,76.5% of total billed charges,26.88,100% of Medicaid LA Fee Schedule,26.88,100% of Medicaid LA Fee Schedule,26.88,100% of CMS OPPS Rate,26.88,100% of CMS OPPS Rate,28.8,45% of total billed charges,44.8,70% of total billed charges,38.4,60% of total billed charges,26.88,100% of CMS OPPS Rate,24.19,90% OF UHC FEE SCHEDULE,44.8,70% of total billed charges,26.88,100% OF CMS OPPS Rate,61.82,230% OF CMS OPPS Rate,30.72,48% of total Billed charges,26.88,100% OF CMS OPPS Rate,57.6,90% of total Billed charges,26.88,100% of Medicaid LA Fee Schedule,26.88,100% of Medicaid LA Fee Schedule,26.88,100% of Medicaid LA Fee Schedule,26.88,100% of Medicaid LA Fee Schedule,26.88,100% of Medicaid LA Fee Schedule,26.88,100% of Medicaid LA Fee Schedule,26.88,100% of CMS OPPS Rate,26.88,100% of CMS OPPS Rate,26.88,100% of CMS OPPS Rate,26.88,100% of CMS OPPS Rate,26.88,100% of CMS OPPS Rate,26.88,100% of CMS OPPS Rate,26.88,100% of CMS OPPS Rate,26.88,100% of CMS OPPS Rate,24.19,95.15,38.4
Outpatient,Laboratory,87591,Blood test for an STD,300,185.4,124.21,354% of CMS OPPS Rate,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,88.35,203.89% of BCBS Fee Schedule,129.78,70% of total Billed Charges,139.05,75% of total Billed Charges,63.16,180% OF CMS OPPS RATE,148.32,80% of total Billed Charges,122.81,350% of CMS Opps rate,35.79,102% of CMS Opps rate,141.83,76.5% of total billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,83.43,45% of total billed charges,129.78,70% of total billed charges,111.24,60% of total billed charges,35.09,100% of CMS OPPS Rate,39,90% OF UHC FEE SCHEDULE,129.78,70% of total billed charges,35.09,100% OF CMS OPPS Rate,80.7,230% OF CMS OPPS Rate,88.99,48% of total Billed charges,35.09,100% OF CMS OPPS Rate,166.86,90% of total Billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,166.86,111.24
Outpatient,Laboratory,87623,INFECTIOUS AGENT HPV LOW RISK TYPE,300,316.7,124.21,354% of CMS OPPS Rate,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,88.35,203.89% of BCBS Fee Schedule,221.69,70% of total Billed Charges,237.53,75% of total Billed Charges,63.16,180% OF CMS OPPS RATE,253.36,80% of total Billed Charges,122.81,350% of CMS Opps rate,35.79,102% of CMS Opps rate,242.28,76.5% of total billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,142.52,45% of total billed charges,221.69,70% of total billed charges,190.02,60% of total billed charges,35.09,100% of CMS OPPS Rate,39,90% OF UHC FEE SCHEDULE,221.69,70% of total billed charges,35.09,100% OF CMS OPPS Rate,80.7,230% OF CMS OPPS Rate,152.02,48% of total Billed charges,35.09,100% OF CMS OPPS Rate,285.03,90% of total Billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,285.03,190.02
Outpatient,Laboratory,87624,Detection test for human papillomavirus (hpv),300,238.8,124.21,354% of CMS OPPS Rate,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,88.35,203.89% of BCBS Fee Schedule,167.16,70% of total Billed Charges,179.1,75% of total Billed Charges,63.16,180% OF CMS OPPS RATE,191.04,80% of total Billed Charges,122.81,350% of CMS Opps rate,35.79,102% of CMS Opps rate,182.68,76.5% of total billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,107.46,45% of total billed charges,167.16,70% of total billed charges,143.28,60% of total billed charges,35.09,100% of CMS OPPS Rate,39,90% OF UHC FEE SCHEDULE,167.16,70% of total billed charges,35.09,100% OF CMS OPPS Rate,80.7,230% OF CMS OPPS Rate,114.62,48% of total Billed charges,35.09,100% OF CMS OPPS Rate,214.92,90% of total Billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,214.92,143.28
Outpatient,Laboratory,87625,"INFECTIOUS AGENT DNA HPV TYPE 16, 18",300,239,143.54,354% of CMS OPPS Rate,40.55,100% of Medicaid LA Fee Schedule,40.54,100% of CMS OPPS Rate,40.54,100% of CMS OPPS Rate,88.35,203.89% of BCBS Fee Schedule,167.3,70% of total Billed Charges,179.25,75% of total Billed Charges,72.98,180% OF CMS OPPS RATE,191.2,80% of total Billed Charges,141.92,350% of CMS Opps rate,41.36,102% of CMS Opps rate,182.84,76.5% of total billed charges,40.55,100% of Medicaid LA Fee Schedule,40.55,100% of Medicaid LA Fee Schedule,40.54,100% of CMS OPPS Rate,40.54,100% of CMS OPPS Rate,107.55,45% of total billed charges,167.3,70% of total billed charges,143.4,60% of total billed charges,40.54,100% of CMS OPPS Rate,39,90% OF UHC FEE SCHEDULE,167.3,70% of total billed charges,40.54,100% OF CMS OPPS Rate,93.26,230% OF CMS OPPS Rate,114.72,48% of total Billed charges,40.54,100% OF CMS OPPS Rate,215.1,90% of total Billed charges,40.55,100% of Medicaid LA Fee Schedule,40.55,100% of Medicaid LA Fee Schedule,40.55,100% of Medicaid LA Fee Schedule,40.55,100% of Medicaid LA Fee Schedule,40.55,100% of Medicaid LA Fee Schedule,40.55,100% of Medicaid LA Fee Schedule,40.54,100% of CMS OPPS Rate,40.54,100% of CMS OPPS Rate,40.54,100% of CMS OPPS Rate,40.54,100% of CMS OPPS Rate,40.54,100% of CMS OPPS Rate,40.54,100% of CMS OPPS Rate,40.54,100% of CMS OPPS Rate,40.54,100% of CMS OPPS Rate,39,215.1,143.4
Outpatient,Laboratory,87633,INFECTIOUS AGENT BY DNA RESP VIRUS,300,1250,1475.4,354% of CMS OPPS Rate,195.88,15.67% of total Billed charges,416.78,100% of CMS OPPS Rate,416.78,100% of CMS OPPS Rate,1049.12,203.89% of BCBS Fee Schedule,875,70% of total Billed Charges,937.5,75% of total Billed Charges,750.2,180% OF CMS OPPS RATE,1000,80% of total Billed Charges,1458.73,350% of CMS Opps rate,425.11,102% of CMS Opps rate,956.25,76.5% of total billed charges,195.88,15.67% of total Billed charges,195.88,15.67% of total Billed charges,416.78,100% of CMS OPPS Rate,416.78,100% of CMS OPPS Rate,562.5,45% of total billed charges,875,70% of total billed charges,750,60% of total billed charges,416.78,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,416.78,100% OF CMS OPPS Rate,958.59,230% OF CMS OPPS Rate,600,48% of total Billed charges,416.78,100% OF CMS OPPS Rate,1125,90% of total Billed charges,195.88,15.67% of total Billed charges,195.88,15.67% of total Billed charges,195.88,15.67% of total Billed charges,195.88,15.67% of total Billed charges,195.88,15.67% of total Billed charges,195.88,15.67% of total Billed charges,416.78,100% of CMS OPPS Rate,416.78,100% of CMS OPPS Rate,416.78,100% of CMS OPPS Rate,416.78,100% of CMS OPPS Rate,416.78,100% of CMS OPPS Rate,416.78,100% of CMS OPPS Rate,416.78,100% of CMS OPPS Rate,416.78,100% of CMS OPPS Rate,195.88,1475.4,750
Outpatient,Laboratory,87653,Blood test for strep infection,300,239,124.21,354% of CMS OPPS Rate,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,88.35,203.89% of BCBS Fee Schedule,167.3,70% of total Billed Charges,179.25,75% of total Billed Charges,63.16,180% OF CMS OPPS RATE,191.2,80% of total Billed Charges,122.81,350% of CMS Opps rate,35.79,102% of CMS Opps rate,182.84,76.5% of total billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,107.55,45% of total billed charges,167.3,70% of total billed charges,143.4,60% of total billed charges,35.09,100% of CMS OPPS Rate,39,90% OF UHC FEE SCHEDULE,167.3,70% of total billed charges,35.09,100% OF CMS OPPS Rate,80.7,230% OF CMS OPPS Rate,114.72,48% of total Billed charges,35.09,100% OF CMS OPPS Rate,215.1,90% of total Billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,215.1,143.4
Outpatient,Laboratory,87660,TRICHOMONUS VAGINALIS DIR PROB,300,136.6,70.97,354% of CMS OPPS Rate,20.05,100% of Medicaid LA Fee Schedule,20.05,100% of CMS OPPS Rate,20.05,100% of CMS OPPS Rate,50.48,203.89% of BCBS Fee Schedule,95.62,70% of total Billed Charges,102.45,75% of total Billed Charges,36.09,180% OF CMS OPPS RATE,109.28,80% of total Billed Charges,70.17,350% of CMS Opps rate,20.45,102% of CMS Opps rate,104.5,76.5% of total billed charges,20.05,100% of Medicaid LA Fee Schedule,20.05,100% of Medicaid LA Fee Schedule,20.05,100% of CMS OPPS Rate,20.05,100% of CMS OPPS Rate,61.47,45% of total billed charges,95.62,70% of total billed charges,81.96,60% of total billed charges,20.05,100% of CMS OPPS Rate,22.28,90% OF UHC FEE SCHEDULE,95.62,70% of total billed charges,20.05,100% OF CMS OPPS Rate,46.11,230% OF CMS OPPS Rate,65.57,48% of total Billed charges,20.05,100% OF CMS OPPS Rate,122.94,90% of total Billed charges,20.05,100% of Medicaid LA Fee Schedule,20.05,100% of Medicaid LA Fee Schedule,20.05,100% of Medicaid LA Fee Schedule,20.05,100% of Medicaid LA Fee Schedule,20.05,100% of Medicaid LA Fee Schedule,20.05,100% of Medicaid LA Fee Schedule,20.05,100% of CMS OPPS Rate,20.05,100% of CMS OPPS Rate,20.05,100% of CMS OPPS Rate,20.05,100% of CMS OPPS Rate,20.05,100% of CMS OPPS Rate,20.05,100% of CMS OPPS Rate,20.05,100% of CMS OPPS Rate,20.05,100% of CMS OPPS Rate,20.05,122.94,81.96
Outpatient,Laboratory,87661,Blood test for an STD,300,280,124.21,354% of CMS OPPS Rate,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,88.35,203.89% of BCBS Fee Schedule,196,70% of total Billed Charges,210,75% of total Billed Charges,63.16,180% OF CMS OPPS RATE,224,80% of total Billed Charges,122.81,350% of CMS Opps rate,35.79,102% of CMS Opps rate,214.2,76.5% of total billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,126,45% of total billed charges,196,70% of total billed charges,168,60% of total billed charges,35.09,100% of CMS OPPS Rate,39,90% OF UHC FEE SCHEDULE,196,70% of total billed charges,35.09,100% OF CMS OPPS Rate,80.7,230% OF CMS OPPS Rate,134.4,48% of total Billed charges,35.09,100% OF CMS OPPS Rate,252,90% of total Billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,252,168
Outpatient,Laboratory,87798,BACTERIAL DETECTION PROBE,300,105,124.21,354% of CMS OPPS Rate,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,N/A,Not Applicable,73.5,70% of total Billed Charges,78.75,75% of total Billed Charges,63.16,180% OF CMS OPPS RATE,84,80% of total Billed Charges,122.81,350% of CMS Opps rate,35.79,102% of CMS Opps rate,80.33,76.5% of total billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,47.25,45% of total billed charges,73.5,70% of total billed charges,63,60% of total billed charges,35.09,100% of CMS OPPS Rate,39,90% OF UHC FEE SCHEDULE,73.5,70% of total billed charges,35.09,100% OF CMS OPPS Rate,80.7,230% OF CMS OPPS Rate,50.4,48% of total Billed charges,35.09,100% OF CMS OPPS Rate,94.5,90% of total Billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,100% of CMS OPPS Rate,35.09,124.21,63
Outpatient,Laboratory,87799,"INFECTIOUS A. DNA, QUANT",300,245.85,151.65,354% of CMS OPPS Rate,16.7,100% of Medicaid LA Fee Schedule,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,107.82,203.89% of BCBS Fee Schedule,172.1,70% of total Billed Charges,184.39,75% of total Billed Charges,77.11,180% OF CMS OPPS RATE,196.68,80% of total Billed Charges,149.94,350% of CMS Opps rate,43.69,102% of CMS Opps rate,188.08,76.5% of total billed charges,16.7,100% of Medicaid LA Fee Schedule,16.7,100% of Medicaid LA Fee Schedule,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,110.63,45% of total billed charges,172.1,70% of total billed charges,147.51,60% of total billed charges,42.84,100% of CMS OPPS Rate,47.59,90% OF UHC FEE SCHEDULE,172.1,70% of total billed charges,42.84,100% OF CMS OPPS Rate,98.53,230% OF CMS OPPS Rate,118.01,48% of total Billed charges,42.84,100% OF CMS OPPS Rate,221.27,90% of total Billed charges,16.7,100% of Medicaid LA Fee Schedule,16.7,100% of Medicaid LA Fee Schedule,16.7,100% of Medicaid LA Fee Schedule,16.7,100% of Medicaid LA Fee Schedule,16.7,100% of Medicaid LA Fee Schedule,16.7,100% of Medicaid LA Fee Schedule,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,42.84,100% of CMS OPPS Rate,16.7,221.27,147.51
Outpatient,Laboratory,87801,Blood test to determine genetic material of certain infectious agents,300,478.8,248.5,354% of CMS OPPS Rate,53.11,100% of Medicaid LA Fee Schedule,70.2,100% of CMS OPPS Rate,70.2,100% of CMS OPPS Rate,176.69,203.89% of BCBS Fee Schedule,335.16,70% of total Billed Charges,359.1,75% of total Billed Charges,126.36,180% OF CMS OPPS RATE,383.04,80% of total Billed Charges,245.7,350% of CMS Opps rate,71.6,102% of CMS Opps rate,366.28,76.5% of total billed charges,53.11,100% of Medicaid LA Fee Schedule,53.11,100% of Medicaid LA Fee Schedule,70.2,100% of CMS OPPS Rate,70.2,100% of CMS OPPS Rate,215.46,45% of total billed charges,335.16,70% of total billed charges,287.28,60% of total billed charges,70.2,100% of CMS OPPS Rate,77.99,90% OF UHC FEE SCHEDULE,335.16,70% of total billed charges,70.2,100% OF CMS OPPS Rate,161.46,230% OF CMS OPPS Rate,229.82,48% of total Billed charges,70.2,100% OF CMS OPPS Rate,430.92,90% of total Billed charges,53.11,100% of Medicaid LA Fee Schedule,53.11,100% of Medicaid LA Fee Schedule,53.11,100% of Medicaid LA Fee Schedule,53.11,100% of Medicaid LA Fee Schedule,53.11,100% of Medicaid LA Fee Schedule,53.11,100% of Medicaid LA Fee Schedule,70.2,100% of CMS OPPS Rate,70.2,100% of CMS OPPS Rate,70.2,100% of CMS OPPS Rate,70.2,100% of CMS OPPS Rate,70.2,100% of CMS OPPS Rate,70.2,100% of CMS OPPS Rate,70.2,100% of CMS OPPS Rate,70.2,100% of CMS OPPS Rate,53.11,430.92,287.28
Outpatient,Laboratory,87804,Flu test,300,171,58.58,354% of CMS OPPS Rate,16.18,100% of Medicaid LA Fee Schedule,16.55,100% of CMS OPPS Rate,16.55,100% of CMS OPPS Rate,33.74,203.89% of BCBS Fee Schedule,119.7,70% of total Billed Charges,128.25,75% of total Billed Charges,29.79,180% OF CMS OPPS RATE,136.8,80% of total Billed Charges,57.92,350% of CMS Opps rate,16.88,102% of CMS Opps rate,130.82,76.5% of total billed charges,16.18,100% of Medicaid LA Fee Schedule,16.18,100% of Medicaid LA Fee Schedule,16.55,100% of CMS OPPS Rate,16.55,100% of CMS OPPS Rate,76.95,45% of total billed charges,119.7,70% of total billed charges,102.6,60% of total billed charges,16.55,100% of CMS OPPS Rate,14.9,90% OF UHC FEE SCHEDULE,119.7,70% of total billed charges,16.55,100% OF CMS OPPS Rate,38.06,230% OF CMS OPPS Rate,82.08,48% of total Billed charges,16.55,100% OF CMS OPPS Rate,153.9,90% of total Billed charges,16.18,100% of Medicaid LA Fee Schedule,16.18,100% of Medicaid LA Fee Schedule,16.18,100% of Medicaid LA Fee Schedule,16.18,100% of Medicaid LA Fee Schedule,16.18,100% of Medicaid LA Fee Schedule,16.18,100% of Medicaid LA Fee Schedule,16.55,100% of CMS OPPS Rate,16.55,100% of CMS OPPS Rate,16.55,100% of CMS OPPS Rate,16.55,100% of CMS OPPS Rate,16.55,100% of CMS OPPS Rate,16.55,100% of CMS OPPS Rate,16.55,100% of CMS OPPS Rate,16.55,100% of CMS OPPS Rate,14.9,153.9,102.6
Outpatient,Laboratory,87806,INFECTIOUS AGENT HIV 1 AG HIV 1/2 AB,300,153,116,354% of CMS OPPS Rate,29.64,100% of Medicaid LA Fee Schedule,32.77,100% of CMS OPPS Rate,32.77,100% of CMS OPPS Rate,66.81,203.89% of BCBS Fee Schedule,107.1,70% of total Billed Charges,114.75,75% of total Billed Charges,58.98,180% OF CMS OPPS RATE,122.4,80% of total Billed Charges,114.69,350% of CMS Opps rate,33.42,102% of CMS Opps rate,117.05,76.5% of total billed charges,29.64,100% of Medicaid LA Fee Schedule,29.64,100% of Medicaid LA Fee Schedule,32.77,100% of CMS OPPS Rate,32.77,100% of CMS OPPS Rate,68.85,45% of total billed charges,107.1,70% of total billed charges,91.8,60% of total billed charges,32.77,100% of CMS OPPS Rate,29.49,90% OF UHC FEE SCHEDULE,107.1,70% of total billed charges,32.77,100% OF CMS OPPS Rate,75.37,230% OF CMS OPPS Rate,73.44,48% of total Billed charges,32.77,100% OF CMS OPPS Rate,137.7,90% of total Billed charges,29.64,100% of Medicaid LA Fee Schedule,29.64,100% of Medicaid LA Fee Schedule,29.64,100% of Medicaid LA Fee Schedule,29.64,100% of Medicaid LA Fee Schedule,29.64,100% of Medicaid LA Fee Schedule,29.64,100% of Medicaid LA Fee Schedule,32.77,100% of CMS OPPS Rate,32.77,100% of CMS OPPS Rate,32.77,100% of CMS OPPS Rate,32.77,100% of CMS OPPS Rate,32.77,100% of CMS OPPS Rate,32.77,100% of CMS OPPS Rate,32.77,100% of CMS OPPS Rate,32.77,100% of CMS OPPS Rate,29.49,137.7,91.8
Outpatient,Laboratory,87880,Test for strep A,300,108.24,58.51,354% of CMS OPPS Rate,16.18,100% of Medicaid LA Fee Schedule,16.53,100% of CMS OPPS Rate,16.53,100% of CMS OPPS Rate,33.7,203.89% of BCBS Fee Schedule,75.77,70% of total Billed Charges,81.18,75% of total Billed Charges,29.75,180% OF CMS OPPS RATE,86.59,80% of total Billed Charges,57.85,350% of CMS Opps rate,16.86,102% of CMS Opps rate,82.8,76.5% of total billed charges,16.18,100% of Medicaid LA Fee Schedule,16.18,100% of Medicaid LA Fee Schedule,16.53,100% of CMS OPPS Rate,16.53,100% of CMS OPPS Rate,48.71,45% of total billed charges,75.77,70% of total billed charges,64.94,60% of total billed charges,16.53,100% of CMS OPPS Rate,14.88,90% OF UHC FEE SCHEDULE,75.77,70% of total billed charges,16.53,100% OF CMS OPPS Rate,38.01,230% OF CMS OPPS Rate,51.96,48% of total Billed charges,16.53,100% OF CMS OPPS Rate,97.42,90% of total Billed charges,16.18,100% of Medicaid LA Fee Schedule,16.18,100% of Medicaid LA Fee Schedule,16.18,100% of Medicaid LA Fee Schedule,16.18,100% of Medicaid LA Fee Schedule,16.18,100% of Medicaid LA Fee Schedule,16.18,100% of Medicaid LA Fee Schedule,16.53,100% of CMS OPPS Rate,16.53,100% of CMS OPPS Rate,16.53,100% of CMS OPPS Rate,16.53,100% of CMS OPPS Rate,16.53,100% of CMS OPPS Rate,16.53,100% of CMS OPPS Rate,16.53,100% of CMS OPPS Rate,16.53,100% of CMS OPPS Rate,14.88,97.42,64.94
Outpatient,Laboratory,87899,INFECTIOUS AGENT AG OTHER,300,108.24,56.88,354% of CMS OPPS Rate,16.07,100% of Medicaid LA Fee Schedule,16.07,100% of CMS OPPS Rate,16.07,100% of CMS OPPS Rate,32.77,203.89% of BCBS Fee Schedule,75.77,70% of total Billed Charges,81.18,75% of total Billed Charges,28.92,180% OF CMS OPPS RATE,86.59,80% of total Billed Charges,56.24,350% of CMS Opps rate,16.39,102% of CMS Opps rate,82.8,76.5% of total billed charges,16.07,100% of Medicaid LA Fee Schedule,16.07,100% of Medicaid LA Fee Schedule,16.07,100% of CMS OPPS Rate,16.07,100% of CMS OPPS Rate,48.71,45% of total billed charges,75.77,70% of total billed charges,64.94,60% of total billed charges,16.07,100% of CMS OPPS Rate,14.46,90% OF UHC FEE SCHEDULE,75.77,70% of total billed charges,16.07,100% OF CMS OPPS Rate,36.96,230% OF CMS OPPS Rate,51.96,48% of total Billed charges,16.07,100% OF CMS OPPS Rate,97.42,90% of total Billed charges,16.07,100% of Medicaid LA Fee Schedule,16.07,100% of Medicaid LA Fee Schedule,16.07,100% of Medicaid LA Fee Schedule,16.07,100% of Medicaid LA Fee Schedule,16.07,100% of Medicaid LA Fee Schedule,16.07,100% of Medicaid LA Fee Schedule,16.07,100% of CMS OPPS Rate,16.07,100% of CMS OPPS Rate,16.07,100% of CMS OPPS Rate,16.07,100% of CMS OPPS Rate,16.07,100% of CMS OPPS Rate,16.07,100% of CMS OPPS Rate,16.07,100% of CMS OPPS Rate,16.07,100% of CMS OPPS Rate,14.46,97.42,64.94
Outpatient,Laboratory,87900,INFECTIOUS AGENT SUSC. PHENOTYPE,300,1176.14,461.43,354% of CMS OPPS Rate,130.35,100% of Medicaid LA Fee Schedule,130.35,100% of CMS OPPS Rate,130.35,100% of CMS OPPS Rate,328.1,203.89% of BCBS Fee Schedule,823.3,70% of total Billed Charges,882.11,75% of total Billed Charges,234.63,180% OF CMS OPPS RATE,940.91,80% of total Billed Charges,456.22,350% of CMS Opps rate,132.95,102% of CMS Opps rate,899.75,76.5% of total billed charges,130.35,100% of Medicaid LA Fee Schedule,130.35,100% of Medicaid LA Fee Schedule,130.35,100% of CMS OPPS Rate,130.35,100% of CMS OPPS Rate,529.26,45% of total billed charges,823.3,70% of total billed charges,705.68,60% of total billed charges,130.35,100% of CMS OPPS Rate,144.83,90% OF UHC FEE SCHEDULE,823.3,70% of total billed charges,130.35,100% OF CMS OPPS Rate,299.8,230% OF CMS OPPS Rate,564.55,48% of total Billed charges,130.35,100% OF CMS OPPS Rate,1058.53,90% of total Billed charges,130.35,100% of Medicaid LA Fee Schedule,130.35,100% of Medicaid LA Fee Schedule,130.35,100% of Medicaid LA Fee Schedule,130.35,100% of Medicaid LA Fee Schedule,130.35,100% of Medicaid LA Fee Schedule,130.35,100% of Medicaid LA Fee Schedule,130.35,100% of CMS OPPS Rate,130.35,100% of CMS OPPS Rate,130.35,100% of CMS OPPS Rate,130.35,100% of CMS OPPS Rate,130.35,100% of CMS OPPS Rate,130.35,100% of CMS OPPS Rate,130.35,100% of CMS OPPS Rate,130.35,100% of CMS OPPS Rate,130.35,1058.53,705.68
Outpatient,Laboratory,87901,INFECTIOUS AGENT GENOTYPE,300,772,911.37,354% of CMS OPPS Rate,257.45,100% of Medicaid LA Fee Schedule,257.45,100% of CMS OPPS Rate,257.45,100% of CMS OPPS Rate,648.04,203.89% of BCBS Fee Schedule,540.4,70% of total Billed Charges,579,75% of total Billed Charges,463.41,180% OF CMS OPPS RATE,617.6,80% of total Billed Charges,901.07,350% of CMS Opps rate,262.59,102% of CMS Opps rate,590.58,76.5% of total billed charges,257.45,100% of Medicaid LA Fee Schedule,257.45,100% of Medicaid LA Fee Schedule,257.45,100% of CMS OPPS Rate,257.45,100% of CMS OPPS Rate,347.4,45% of total billed charges,540.4,70% of total billed charges,463.2,60% of total billed charges,257.45,100% of CMS OPPS Rate,286.06,90% OF UHC FEE SCHEDULE,540.4,70% of total billed charges,257.45,100% OF CMS OPPS Rate,592.13,230% OF CMS OPPS Rate,370.56,48% of total Billed charges,257.45,100% OF CMS OPPS Rate,694.8,90% of total Billed charges,257.45,100% of Medicaid LA Fee Schedule,257.45,100% of Medicaid LA Fee Schedule,257.45,100% of Medicaid LA Fee Schedule,257.45,100% of Medicaid LA Fee Schedule,257.45,100% of Medicaid LA Fee Schedule,257.45,100% of Medicaid LA Fee Schedule,257.45,100% of CMS OPPS Rate,257.45,100% of CMS OPPS Rate,257.45,100% of CMS OPPS Rate,257.45,100% of CMS OPPS Rate,257.45,100% of CMS OPPS Rate,257.45,100% of CMS OPPS Rate,257.45,100% of CMS OPPS Rate,257.45,100% of CMS OPPS Rate,257.45,911.37,463.2
Outpatient,Laboratory,87902,"HEPATITIS C, GENOTYPE",300,772,911.37,354% of CMS OPPS Rate,257.45,100% of Medicaid LA Fee Schedule,257.45,100% of CMS OPPS Rate,257.45,100% of CMS OPPS Rate,648.04,203.89% of BCBS Fee Schedule,540.4,70% of total Billed Charges,579,75% of total Billed Charges,463.41,180% OF CMS OPPS RATE,617.6,80% of total Billed Charges,901.07,350% of CMS Opps rate,262.59,102% of CMS Opps rate,590.58,76.5% of total billed charges,257.45,100% of Medicaid LA Fee Schedule,257.45,100% of Medicaid LA Fee Schedule,257.45,100% of CMS OPPS Rate,257.45,100% of CMS OPPS Rate,347.4,45% of total billed charges,540.4,70% of total billed charges,463.2,60% of total billed charges,257.45,100% of CMS OPPS Rate,286.06,90% OF UHC FEE SCHEDULE,540.4,70% of total billed charges,257.45,100% OF CMS OPPS Rate,592.13,230% OF CMS OPPS Rate,370.56,48% of total Billed charges,257.45,100% OF CMS OPPS Rate,694.8,90% of total Billed charges,257.45,100% of Medicaid LA Fee Schedule,257.45,100% of Medicaid LA Fee Schedule,257.45,100% of Medicaid LA Fee Schedule,257.45,100% of Medicaid LA Fee Schedule,257.45,100% of Medicaid LA Fee Schedule,257.45,100% of Medicaid LA Fee Schedule,257.45,100% of CMS OPPS Rate,257.45,100% of CMS OPPS Rate,257.45,100% of CMS OPPS Rate,257.45,100% of CMS OPPS Rate,257.45,100% of CMS OPPS Rate,257.45,100% of CMS OPPS Rate,257.45,100% of CMS OPPS Rate,257.45,100% of CMS OPPS Rate,257.45,911.37,463.2
Outpatient,Laboratory,87903,"PHENOTYPE, DNA HIV W/CULT",300,916,1729.85,354% of CMS OPPS Rate,488.66,100% of Medicaid LA Fee Schedule,488.66,100% of CMS OPPS Rate,488.66,100% of CMS OPPS Rate,1230.03,203.89% of BCBS Fee Schedule,641.2,70% of total Billed Charges,687,75% of total Billed Charges,879.58,180% OF CMS OPPS RATE,732.8,80% of total Billed Charges,1710.31,350% of CMS Opps rate,498.43,102% of CMS Opps rate,700.74,76.5% of total billed charges,488.66,100% of Medicaid LA Fee Schedule,488.66,100% of Medicaid LA Fee Schedule,488.66,100% of CMS OPPS Rate,488.66,100% of CMS OPPS Rate,412.2,45% of total billed charges,641.2,70% of total billed charges,549.6,60% of total billed charges,488.66,100% of CMS OPPS Rate,542.95,90% OF UHC FEE SCHEDULE,641.2,70% of total billed charges,488.66,100% OF CMS OPPS Rate,916,230% OF CMS OPPS Rate,439.68,48% of total Billed charges,488.66,100% OF CMS OPPS Rate,824.4,90% of total Billed charges,488.66,100% of Medicaid LA Fee Schedule,488.66,100% of Medicaid LA Fee Schedule,488.66,100% of Medicaid LA Fee Schedule,488.66,100% of Medicaid LA Fee Schedule,488.66,100% of Medicaid LA Fee Schedule,488.66,100% of Medicaid LA Fee Schedule,488.66,100% of CMS OPPS Rate,488.66,100% of CMS OPPS Rate,488.66,100% of CMS OPPS Rate,488.66,100% of CMS OPPS Rate,488.66,100% of CMS OPPS Rate,488.66,100% of CMS OPPS Rate,488.66,100% of CMS OPPS Rate,488.66,100% of CMS OPPS Rate,412.2,1729.85,549.6
Outpatient,Laboratory,87904,"PHENOTYPE, DNA HIV W/CLT",300,66,92.28,354% of CMS OPPS Rate,26.07,100% of Medicaid LA Fee Schedule,26.07,100% of CMS OPPS Rate,26.07,100% of CMS OPPS Rate,65.61,203.89% of BCBS Fee Schedule,46.2,70% of total Billed Charges,49.5,75% of total Billed Charges,46.92,180% OF CMS OPPS RATE,52.8,80% of total Billed Charges,91.24,350% of CMS Opps rate,26.59,102% of CMS Opps rate,50.49,76.5% of total billed charges,26.07,100% of Medicaid LA Fee Schedule,26.07,100% of Medicaid LA Fee Schedule,26.07,100% of CMS OPPS Rate,26.07,100% of CMS OPPS Rate,29.7,45% of total billed charges,46.2,70% of total billed charges,39.6,60% of total billed charges,26.07,100% of CMS OPPS Rate,28.96,90% OF UHC FEE SCHEDULE,46.2,70% of total billed charges,26.07,100% OF CMS OPPS Rate,59.96,230% OF CMS OPPS Rate,31.68,48% of total Billed charges,26.07,100% OF CMS OPPS Rate,59.4,90% of total Billed charges,26.07,100% of Medicaid LA Fee Schedule,26.07,100% of Medicaid LA Fee Schedule,26.07,100% of Medicaid LA Fee Schedule,26.07,100% of Medicaid LA Fee Schedule,26.07,100% of Medicaid LA Fee Schedule,26.07,100% of Medicaid LA Fee Schedule,26.07,100% of CMS OPPS Rate,26.07,100% of CMS OPPS Rate,26.07,100% of CMS OPPS Rate,26.07,100% of CMS OPPS Rate,26.07,100% of CMS OPPS Rate,26.07,100% of CMS OPPS Rate,26.07,100% of CMS OPPS Rate,26.07,100% of CMS OPPS Rate,26.07,92.28,39.6
Outpatient,Laboratory,87906,GENOTYPE ANALYSIS BY DNA HIV1,300,878,455.7,354% of CMS OPPS Rate,128.73,100% of Medicaid LA Fee Schedule,128.72,100% of CMS OPPS Rate,128.72,100% of CMS OPPS Rate,324.02,203.89% of BCBS Fee Schedule,614.6,70% of total Billed Charges,658.5,75% of total Billed Charges,231.71,180% OF CMS OPPS RATE,702.4,80% of total Billed Charges,450.55,350% of CMS Opps rate,131.3,102% of CMS Opps rate,671.67,76.5% of total billed charges,128.73,100% of Medicaid LA Fee Schedule,128.73,100% of Medicaid LA Fee Schedule,128.72,100% of CMS OPPS Rate,128.72,100% of CMS OPPS Rate,395.1,45% of total billed charges,614.6,70% of total billed charges,526.8,60% of total billed charges,128.72,100% of CMS OPPS Rate,143.03,90% OF UHC FEE SCHEDULE,614.6,70% of total billed charges,128.72,100% OF CMS OPPS Rate,296.07,230% OF CMS OPPS Rate,421.44,48% of total Billed charges,128.72,100% OF CMS OPPS Rate,790.2,90% of total Billed charges,128.73,100% of Medicaid LA Fee Schedule,128.73,100% of Medicaid LA Fee Schedule,128.73,100% of Medicaid LA Fee Schedule,128.73,100% of Medicaid LA Fee Schedule,128.73,100% of Medicaid LA Fee Schedule,128.73,100% of Medicaid LA Fee Schedule,128.72,100% of CMS OPPS Rate,128.72,100% of CMS OPPS Rate,128.72,100% of CMS OPPS Rate,128.72,100% of CMS OPPS Rate,128.72,100% of CMS OPPS Rate,128.72,100% of CMS OPPS Rate,128.72,100% of CMS OPPS Rate,128.72,100% of CMS OPPS Rate,128.72,790.2,526.8
Outpatient,Laboratory,87910,INFECTIOUS AGENT GENOTYPE CMV,300,1765.75,911.37,354% of CMS OPPS Rate,257.45,100% of Medicaid LA Fee Schedule,257.45,100% of CMS OPPS Rate,257.45,100% of CMS OPPS Rate,648.04,203.89% of BCBS Fee Schedule,1236.03,70% of total Billed Charges,1324.31,75% of total Billed Charges,463.41,180% OF CMS OPPS RATE,1412.6,80% of total Billed Charges,901.07,350% of CMS Opps rate,262.59,102% of CMS Opps rate,1350.8,76.5% of total billed charges,257.45,100% of Medicaid LA Fee Schedule,257.45,100% of Medicaid LA Fee Schedule,257.45,100% of CMS OPPS Rate,257.45,100% of CMS OPPS Rate,794.59,45% of total billed charges,1236.03,70% of total billed charges,1059.45,60% of total billed charges,257.45,100% of CMS OPPS Rate,286.06,90% OF UHC FEE SCHEDULE,1236.03,70% of total billed charges,257.45,100% OF CMS OPPS Rate,592.13,230% OF CMS OPPS Rate,847.56,48% of total Billed charges,257.45,100% OF CMS OPPS Rate,1589.18,90% of total Billed charges,257.45,100% of Medicaid LA Fee Schedule,257.45,100% of Medicaid LA Fee Schedule,257.45,100% of Medicaid LA Fee Schedule,257.45,100% of Medicaid LA Fee Schedule,257.45,100% of Medicaid LA Fee Schedule,257.45,100% of Medicaid LA Fee Schedule,257.45,100% of CMS OPPS Rate,257.45,100% of CMS OPPS Rate,257.45,100% of CMS OPPS Rate,257.45,100% of CMS OPPS Rate,257.45,100% of CMS OPPS Rate,257.45,100% of CMS OPPS Rate,257.45,100% of CMS OPPS Rate,257.45,100% of CMS OPPS Rate,257.45,1589.18,1059.45
Outpatient,Laboratory,87999,HIV TROPISM ASSAY,300,1662.15,299.19,18% of total billed charges for Outpatient Setting,260.46,15.67% of total Billed charges,299.19,18% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,1163.51,70% of total Billed Charges,1246.61,75% of total Billed Charges,831.08,50% of total Billed Charges,1329.72,80% of total Billed Charges,997.29,60% of total Billed Charges,N/A,Not Applicable,1271.54,76.5% of total billed charges,260.46,15.67% of total Billed charges,260.46,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,747.97,45% of total billed charges,1163.51,70% of total billed charges,997.29,60% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,1163.51,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,797.83,48% of total Billed charges,1662.15,100% of total Billed charges,1495.94,90% of total Billed charges,260.46,15.67% of total Billed charges,260.46,15.67% of total Billed charges,260.46,15.67% of total Billed charges,260.46,15.67% of total Billed charges,260.46,15.67% of total Billed charges,260.46,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,260.46,1662.15,997.29
Outpatient,Laboratory,88104,CYTOPATHOLOGY WASH BRUSH,300,96.5,109.29,354% of CMS APC rate,21.23,100% of Medicaid LA Fee Schedule,30.87,100% of CMS OPPS Rate,30.87,100% of CMS OPPS Rate,64.84,203.89% of BCBS Fee Schedule,67.55,70% of total Billed Charges,72.38,75% of total Billed Charges,55.57,180% OF CMS OPPS RATE,77.2,80% of total Billed Charges,108.05,350% of CMS Opps rate,31.49,102% of CMS Opps rate,73.82,76.5% of total billed charges,21.23,100% of Medicaid LA Fee Schedule,21.23,100% of Medicaid LA Fee Schedule,30.87,100% of CMS OPPS Rate,30.87,100% of CMS OPPS Rate,43.43,45% of total billed charges,67.55,70% of total billed charges,57.9,60% of total billed charges,30.87,100% of CMS OPPS Rate,28.62,90% OF UHC FEE SCHEDULE,67.55,70% of total billed charges,30.87,100% OF CMS OPPS Rate,71,230% OF CMS OPPS Rate,46.32,48% of total Billed charges,30.87,100% OF CMS OPPS Rate,86.85,90% of total Billed charges,21.23,100% of Medicaid LA Fee Schedule,21.23,100% of Medicaid LA Fee Schedule,21.23,100% of Medicaid LA Fee Schedule,21.23,100% of Medicaid LA Fee Schedule,21.23,100% of Medicaid LA Fee Schedule,21.23,100% of Medicaid LA Fee Schedule,30.87,100% of CMS OPPS Rate,30.87,100% of CMS OPPS Rate,30.87,100% of CMS OPPS Rate,30.87,100% of CMS OPPS Rate,30.87,100% of CMS OPPS Rate,30.87,100% of CMS OPPS Rate,30.87,100% of CMS OPPS Rate,30.87,100% of CMS OPPS Rate,21.23,109.29,57.9
Outpatient,Laboratory,88108,"CYTOPAHTOLOGY FLUID,CONC",300,156.2,109.29,354% of CMS APC rate,25.07,100% of Medicaid LA Fee Schedule,30.87,100% of CMS OPPS Rate,30.87,100% of CMS OPPS Rate,64.84,203.89% of BCBS Fee Schedule,109.34,70% of total Billed Charges,117.15,75% of total Billed Charges,55.57,180% OF CMS OPPS RATE,124.96,80% of total Billed Charges,108.05,350% of CMS Opps rate,31.49,102% of CMS Opps rate,119.49,76.5% of total billed charges,25.07,100% of Medicaid LA Fee Schedule,25.07,100% of Medicaid LA Fee Schedule,30.87,100% of CMS OPPS Rate,30.87,100% of CMS OPPS Rate,70.29,45% of total billed charges,109.34,70% of total billed charges,93.72,60% of total billed charges,30.87,100% of CMS OPPS Rate,28.62,90% OF UHC FEE SCHEDULE,109.34,70% of total billed charges,30.87,100% OF CMS OPPS Rate,71,230% OF CMS OPPS Rate,74.98,48% of total Billed charges,30.87,100% OF CMS OPPS Rate,140.58,90% of total Billed charges,25.07,100% of Medicaid LA Fee Schedule,25.07,100% of Medicaid LA Fee Schedule,25.07,100% of Medicaid LA Fee Schedule,25.07,100% of Medicaid LA Fee Schedule,25.07,100% of Medicaid LA Fee Schedule,25.07,100% of Medicaid LA Fee Schedule,30.87,100% of CMS OPPS Rate,30.87,100% of CMS OPPS Rate,30.87,100% of CMS OPPS Rate,30.87,100% of CMS OPPS Rate,30.87,100% of CMS OPPS Rate,30.87,100% of CMS OPPS Rate,30.87,100% of CMS OPPS Rate,30.87,100% of CMS OPPS Rate,25.07,140.58,93.72
Outpatient,Laboratory,88112,Urine test,300,134,161.36,354% of CMS APC rate,57.32,100% of Medicaid LA Fee Schedule,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,91.14,203.89% of BCBS Fee Schedule,93.8,70% of total Billed Charges,100.5,75% of total Billed Charges,82.04,180% OF CMS OPPS RATE,107.2,80% of total Billed Charges,159.53,350% of CMS Opps rate,46.49,102% of CMS Opps rate,102.51,76.5% of total billed charges,57.32,100% of Medicaid LA Fee Schedule,57.32,100% of Medicaid LA Fee Schedule,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,60.3,45% of total billed charges,93.8,70% of total billed charges,80.4,60% of total billed charges,45.58,100% of CMS OPPS Rate,40.23,90% OF UHC FEE SCHEDULE,93.8,70% of total billed charges,45.58,100% OF CMS OPPS Rate,104.83,230% OF CMS OPPS Rate,64.32,48% of total Billed charges,45.58,100% OF CMS OPPS Rate,120.6,90% of total Billed charges,57.32,100% of Medicaid LA Fee Schedule,57.32,100% of Medicaid LA Fee Schedule,57.32,100% of Medicaid LA Fee Schedule,57.32,100% of Medicaid LA Fee Schedule,57.32,100% of Medicaid LA Fee Schedule,57.32,100% of Medicaid LA Fee Schedule,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,40.23,161.36,80.4
Outpatient,Laboratory,88120,CYTOPATHOLOGY FISH 3-5 SPECIMENS,300,1287.43,506.06,354% of CMS APC rate,297.98,100% of Medicaid LA Fee Schedule,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,263.39,203.89% of BCBS Fee Schedule,901.2,70% of total Billed Charges,965.57,75% of total Billed Charges,257.32,180% OF CMS OPPS RATE,1029.94,80% of total Billed Charges,500.34,350% of CMS Opps rate,145.81,102% of CMS Opps rate,984.88,76.5% of total billed charges,297.98,100% of Medicaid LA Fee Schedule,297.98,100% of Medicaid LA Fee Schedule,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,579.34,45% of total billed charges,901.2,70% of total billed charges,772.46,60% of total billed charges,142.95,100% of CMS OPPS Rate,116.26,90% OF UHC FEE SCHEDULE,901.2,70% of total billed charges,142.95,100% OF CMS OPPS Rate,328.79,230% OF CMS OPPS Rate,617.97,48% of total Billed charges,142.95,100% OF CMS OPPS Rate,1158.69,90% of total Billed charges,297.98,100% of Medicaid LA Fee Schedule,297.98,100% of Medicaid LA Fee Schedule,297.98,100% of Medicaid LA Fee Schedule,297.98,100% of Medicaid LA Fee Schedule,297.98,100% of Medicaid LA Fee Schedule,297.98,100% of Medicaid LA Fee Schedule,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,116.26,1158.69,772.46
Outpatient,Laboratory,88141,Cervical cancer screening test with interpretation,300,152.56,27.46,18% of total billed charges for Outpatient Setting,18.99,100% of Medicaid LA Fee Schedule,27.46,18% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,106.79,70% of total Billed Charges,114.42,75% of total Billed Charges,76.28,50% of total Billed Charges,122.05,80% of total Billed Charges,91.54,60% of total Billed Charges,N/A,Not Applicable,116.71,76.5% of total billed charges,18.99,100% of Medicaid LA Fee Schedule,18.99,100% of Medicaid LA Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,68.65,45% of total billed charges,106.79,70% of total billed charges,91.54,60% of total billed charges,N/A,Not Applicable,29.81,90% OF UHC FEE SCHEDULE,106.79,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,73.23,48% of total Billed charges,152.56,100% of total Billed charges,137.3,90% of total Billed charges,18.99,100% of Medicaid LA Fee Schedule,18.99,100% of Medicaid LA Fee Schedule,18.99,100% of Medicaid LA Fee Schedule,18.99,100% of Medicaid LA Fee Schedule,18.99,100% of Medicaid LA Fee Schedule,18.99,100% of Medicaid LA Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,18.99,152.56,91.54
Outpatient,Laboratory,88142,PAP smear,300,136.26,71.72,354% of CMS OPPS Rate,15.87,100% of Medicaid LA Fee Schedule,20.26,100% of CMS OPPS Rate,20.26,100% of CMS OPPS Rate,50.99,203.89% of BCBS Fee Schedule,95.38,70% of total Billed Charges,102.2,75% of total Billed Charges,36.46,180% OF CMS OPPS RATE,109.01,80% of total Billed Charges,70.91,350% of CMS Opps rate,20.66,102% of CMS Opps rate,104.24,76.5% of total billed charges,15.87,100% of Medicaid LA Fee Schedule,15.87,100% of Medicaid LA Fee Schedule,20.26,100% of CMS OPPS Rate,20.26,100% of CMS OPPS Rate,61.32,45% of total billed charges,95.38,70% of total billed charges,81.76,60% of total billed charges,20.26,100% of CMS OPPS Rate,22.51,90% OF UHC FEE SCHEDULE,95.38,70% of total billed charges,20.26,100% OF CMS OPPS Rate,46.59,230% OF CMS OPPS Rate,65.4,48% of total Billed charges,20.26,100% OF CMS OPPS Rate,122.63,90% of total Billed charges,15.87,100% of Medicaid LA Fee Schedule,15.87,100% of Medicaid LA Fee Schedule,15.87,100% of Medicaid LA Fee Schedule,15.87,100% of Medicaid LA Fee Schedule,15.87,100% of Medicaid LA Fee Schedule,15.87,100% of Medicaid LA Fee Schedule,20.26,100% of CMS OPPS Rate,20.26,100% of CMS OPPS Rate,20.26,100% of CMS OPPS Rate,20.26,100% of CMS OPPS Rate,20.26,100% of CMS OPPS Rate,20.26,100% of CMS OPPS Rate,20.26,100% of CMS OPPS Rate,20.26,100% of CMS OPPS Rate,15.87,122.63,81.76
Outpatient,Laboratory,88160,"CYTOLOGY SMEAR,OTHER",300,78,80.32,354% of CMS APC rate,17.06,100% of Medicaid LA Fee Schedule,22.69,100% of CMS OPPS Rate,22.69,100% of CMS OPPS Rate,35.62,203.89% of BCBS Fee Schedule,54.6,70% of total Billed Charges,58.5,75% of total Billed Charges,40.84,180% OF CMS OPPS RATE,62.4,80% of total Billed Charges,79.41,350% of CMS Opps rate,23.14,102% of CMS Opps rate,59.67,76.5% of total billed charges,17.06,100% of Medicaid LA Fee Schedule,17.06,100% of Medicaid LA Fee Schedule,22.69,100% of CMS OPPS Rate,22.69,100% of CMS OPPS Rate,35.1,45% of total billed charges,54.6,70% of total billed charges,46.8,60% of total billed charges,22.69,100% of CMS OPPS Rate,15.72,90% OF UHC FEE SCHEDULE,54.6,70% of total billed charges,22.69,100% OF CMS OPPS Rate,52.18,230% OF CMS OPPS Rate,37.44,48% of total Billed charges,22.69,100% OF CMS OPPS Rate,70.2,90% of total Billed charges,17.06,100% of Medicaid LA Fee Schedule,17.06,100% of Medicaid LA Fee Schedule,17.06,100% of Medicaid LA Fee Schedule,17.06,100% of Medicaid LA Fee Schedule,17.06,100% of Medicaid LA Fee Schedule,17.06,100% of Medicaid LA Fee Schedule,22.69,100% of CMS OPPS Rate,22.69,100% of CMS OPPS Rate,22.69,100% of CMS OPPS Rate,22.69,100% of CMS OPPS Rate,22.69,100% of CMS OPPS Rate,22.69,100% of CMS OPPS Rate,22.69,100% of CMS OPPS Rate,22.69,100% of CMS OPPS Rate,15.72,80.32,46.8
Outpatient,Laboratory,88172,ASPIRATE-FINE NEEDLE EVAL,300,388,506.06,354% of CMS APC rate,18.51,100% of Medicaid LA Fee Schedule,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,263.39,203.89% of BCBS Fee Schedule,271.6,70% of total Billed Charges,291,75% of total Billed Charges,257.32,180% OF CMS OPPS RATE,310.4,80% of total Billed Charges,500.34,350% of CMS Opps rate,145.81,102% of CMS Opps rate,296.82,76.5% of total billed charges,18.51,100% of Medicaid LA Fee Schedule,18.51,100% of Medicaid LA Fee Schedule,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,174.6,45% of total billed charges,271.6,70% of total billed charges,232.8,60% of total billed charges,142.95,100% of CMS OPPS Rate,116.26,90% OF UHC FEE SCHEDULE,271.6,70% of total billed charges,142.95,100% OF CMS OPPS Rate,328.79,230% OF CMS OPPS Rate,186.24,48% of total Billed charges,142.95,100% OF CMS OPPS Rate,349.2,90% of total Billed charges,18.51,100% of Medicaid LA Fee Schedule,18.51,100% of Medicaid LA Fee Schedule,18.51,100% of Medicaid LA Fee Schedule,18.51,100% of Medicaid LA Fee Schedule,18.51,100% of Medicaid LA Fee Schedule,18.51,100% of Medicaid LA Fee Schedule,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,18.51,506.06,232.8
Outpatient,Laboratory,88173,ASPIRATE-F.N. INTERP/RPT,300,148.5,161.36,354% of CMS APC rate,37.04,100% of Medicaid LA Fee Schedule,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,91.14,203.89% of BCBS Fee Schedule,103.95,70% of total Billed Charges,111.38,75% of total Billed Charges,82.04,180% OF CMS OPPS RATE,118.8,80% of total Billed Charges,159.53,350% of CMS Opps rate,46.49,102% of CMS Opps rate,113.6,76.5% of total billed charges,37.04,100% of Medicaid LA Fee Schedule,37.04,100% of Medicaid LA Fee Schedule,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,66.83,45% of total billed charges,103.95,70% of total billed charges,89.1,60% of total billed charges,45.58,100% of CMS OPPS Rate,40.23,90% OF UHC FEE SCHEDULE,103.95,70% of total billed charges,45.58,100% OF CMS OPPS Rate,104.83,230% OF CMS OPPS Rate,71.28,48% of total Billed charges,45.58,100% OF CMS OPPS Rate,133.65,90% of total Billed charges,37.04,100% of Medicaid LA Fee Schedule,37.04,100% of Medicaid LA Fee Schedule,37.04,100% of Medicaid LA Fee Schedule,37.04,100% of Medicaid LA Fee Schedule,37.04,100% of Medicaid LA Fee Schedule,37.04,100% of Medicaid LA Fee Schedule,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,37.04,161.36,89.1
Outpatient,Laboratory,88175,PAP smear,300,166,94.19,354% of CMS OPPS Rate,25.59,100% of Medicaid LA Fee Schedule,26.61,100% of CMS OPPS Rate,26.61,100% of CMS OPPS Rate,66.69,203.89% of BCBS Fee Schedule,116.2,70% of total Billed Charges,124.5,75% of total Billed Charges,47.89,180% OF CMS OPPS RATE,132.8,80% of total Billed Charges,93.13,350% of CMS Opps rate,27.14,102% of CMS Opps rate,126.99,76.5% of total billed charges,25.59,100% of Medicaid LA Fee Schedule,25.59,100% of Medicaid LA Fee Schedule,26.61,100% of CMS OPPS Rate,26.61,100% of CMS OPPS Rate,74.7,45% of total billed charges,116.2,70% of total billed charges,99.6,60% of total billed charges,26.61,100% of CMS OPPS Rate,29.44,90% OF UHC FEE SCHEDULE,116.2,70% of total billed charges,26.61,100% OF CMS OPPS Rate,61.2,230% OF CMS OPPS Rate,79.68,48% of total Billed charges,26.61,100% OF CMS OPPS Rate,149.4,90% of total Billed charges,25.59,100% of Medicaid LA Fee Schedule,25.59,100% of Medicaid LA Fee Schedule,25.59,100% of Medicaid LA Fee Schedule,25.59,100% of Medicaid LA Fee Schedule,25.59,100% of Medicaid LA Fee Schedule,25.59,100% of Medicaid LA Fee Schedule,26.61,100% of CMS OPPS Rate,26.61,100% of CMS OPPS Rate,26.61,100% of CMS OPPS Rate,26.61,100% of CMS OPPS Rate,26.61,100% of CMS OPPS Rate,26.61,100% of CMS OPPS Rate,26.61,100% of CMS OPPS Rate,26.61,100% of CMS OPPS Rate,25.59,149.4,99.6
Outpatient,Laboratory,88177,"CYTOPATH, EVAL FNA IMMEDIATE",300,44.56,8.02,18% of total billed charges for Outpatient Setting,18.36,100% of Medicaid LA Fee Schedule,8.02,18% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,31.19,70% of total Billed Charges,33.42,75% of total Billed Charges,22.28,50% of total Billed Charges,35.65,80% of total Billed Charges,26.74,60% of total Billed Charges,N/A,Not Applicable,34.09,76.5% of total billed charges,18.36,100% of Medicaid LA Fee Schedule,18.36,100% of Medicaid LA Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,20.05,45% of total billed charges,31.19,70% of total billed charges,26.74,60% of total billed charges,N/A,Not Applicable,7.13,90% OF UHC FEE SCHEDULE,31.19,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,21.39,48% of total Billed charges,44.56,100% of total Billed charges,40.1,90% of total Billed charges,18.36,100% of Medicaid LA Fee Schedule,18.36,100% of Medicaid LA Fee Schedule,18.36,100% of Medicaid LA Fee Schedule,18.36,100% of Medicaid LA Fee Schedule,18.36,100% of Medicaid LA Fee Schedule,18.36,100% of Medicaid LA Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,7.13,44.56,26.74
Outpatient,Laboratory,88184,FLOW CYTOMETRY 1ST MARKER,300,767,1043.05,354% of CMS APC rate,38.33,100% of Medicaid LA Fee Schedule,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,439.24,203.89% of BCBS Fee Schedule,536.9,70% of total Billed Charges,575.25,75% of total Billed Charges,530.36,180% OF CMS OPPS RATE,613.6,80% of total Billed Charges,1031.26,350% of CMS Opps rate,300.54,102% of CMS Opps rate,586.76,76.5% of total billed charges,38.33,100% of Medicaid LA Fee Schedule,38.33,100% of Medicaid LA Fee Schedule,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,345.15,45% of total billed charges,536.9,70% of total billed charges,460.2,60% of total billed charges,294.64,100% of CMS OPPS Rate,193.89,90% OF UHC FEE SCHEDULE,536.9,70% of total billed charges,294.64,100% OF CMS OPPS Rate,677.69,230% OF CMS OPPS Rate,368.16,48% of total Billed charges,294.64,100% OF CMS OPPS Rate,690.3,90% of total Billed charges,38.33,100% of Medicaid LA Fee Schedule,38.33,100% of Medicaid LA Fee Schedule,38.33,100% of Medicaid LA Fee Schedule,38.33,100% of Medicaid LA Fee Schedule,38.33,100% of Medicaid LA Fee Schedule,38.33,100% of Medicaid LA Fee Schedule,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,38.33,1043.05,460.2
Outpatient,Laboratory,88185,FLOW CYTOMETRY ADD MARKER,300,96,17.28,18% of total billed charges for Outpatient Setting,18.93,100% of Medicaid LA Fee Schedule,17.28,18% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,67.2,70% of total Billed Charges,72,75% of total Billed Charges,48,50% of total Billed Charges,76.8,80% of total Billed Charges,57.6,60% of total Billed Charges,N/A,Not Applicable,73.44,76.5% of total billed charges,18.93,100% of Medicaid LA Fee Schedule,18.93,100% of Medicaid LA Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,43.2,45% of total billed charges,67.2,70% of total billed charges,57.6,60% of total billed charges,N/A,Not Applicable,27.54,90% OF UHC FEE SCHEDULE,67.2,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,46.08,48% of total Billed charges,96,100% of total Billed charges,86.4,90% of total Billed charges,18.93,100% of Medicaid LA Fee Schedule,18.93,100% of Medicaid LA Fee Schedule,18.93,100% of Medicaid LA Fee Schedule,18.93,100% of Medicaid LA Fee Schedule,18.93,100% of Medicaid LA Fee Schedule,18.93,100% of Medicaid LA Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,17.28,96,57.6
Outpatient,Laboratory,88187,"FLOW CYTOMETRY INTERP,2-8",300,162,29.16,18% of total billed charges for Outpatient Setting,25.39,15.67% of total Billed charges,29.16,18% of total billed charges,N/A,Not Applicable,136.97,203.89% of BCBS Fee Schedule,113.4,70% of total Billed Charges,121.5,75% of total Billed Charges,81,50% of total Billed Charges,129.6,80% of total Billed Charges,97.2,60% of total Billed Charges,N/A,Not Applicable,123.93,76.5% of total billed charges,25.39,15.67% of total Billed charges,25.39,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,72.9,45% of total billed charges,113.4,70% of total billed charges,97.2,60% of total billed charges,N/A,Not Applicable,43.42,90% OF UHC FEE SCHEDULE,113.4,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,77.76,48% of total Billed charges,162,100% of total Billed charges,145.8,90% of total Billed charges,25.39,15.67% of total Billed charges,25.39,15.67% of total Billed charges,25.39,15.67% of total Billed charges,25.39,15.67% of total Billed charges,25.39,15.67% of total Billed charges,25.39,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,25.39,162,97.2
Outpatient,Laboratory,88188,FLOW CYTOMETRY INTERP 9 TO 15 CELLS,300,435.5,78.39,18% of total billed charges for Outpatient Setting,68.24,15.67% of total Billed charges,78.39,18% of total billed charges,N/A,Not Applicable,177.12,203.89% of BCBS Fee Schedule,304.85,70% of total Billed Charges,326.63,75% of total Billed Charges,217.75,50% of total Billed Charges,348.4,80% of total Billed Charges,261.3,60% of total Billed Charges,N/A,Not Applicable,333.16,76.5% of total billed charges,68.24,15.67% of total Billed charges,68.24,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,195.98,45% of total billed charges,304.85,70% of total billed charges,261.3,60% of total billed charges,N/A,Not Applicable,59.94,90% OF UHC FEE SCHEDULE,304.85,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,209.04,48% of total Billed charges,435.5,100% of total Billed charges,391.95,90% of total Billed charges,68.24,15.67% of total Billed charges,68.24,15.67% of total Billed charges,68.24,15.67% of total Billed charges,68.24,15.67% of total Billed charges,68.24,15.67% of total Billed charges,68.24,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,59.94,435.5,261.3
Outpatient,Laboratory,88189,FLOW CYTOMETRY INTERP 16 OR MORE,300,162,29.16,18% of total billed charges for Outpatient Setting,25.39,15.67% of total Billed charges,29.16,18% of total billed charges,N/A,Not Applicable,220.04,203.89% of BCBS Fee Schedule,113.4,70% of total Billed Charges,121.5,75% of total Billed Charges,81,50% of total Billed Charges,129.6,80% of total Billed Charges,97.2,60% of total Billed Charges,N/A,Not Applicable,123.93,76.5% of total billed charges,25.39,15.67% of total Billed charges,25.39,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,72.9,45% of total billed charges,113.4,70% of total billed charges,97.2,60% of total billed charges,N/A,Not Applicable,80.03,90% OF UHC FEE SCHEDULE,113.4,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,77.76,48% of total Billed charges,162,100% of total Billed charges,145.8,90% of total Billed charges,25.39,15.67% of total Billed charges,25.39,15.67% of total Billed charges,25.39,15.67% of total Billed charges,25.39,15.67% of total Billed charges,25.39,15.67% of total Billed charges,25.39,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,25.39,220.04,97.2
Outpatient,Laboratory,88230,"TISSUE CULT (CHROM), BLD",300,275,412.37,354% of CMS OPPS Rate,77.9,100% of Medicaid LA Fee Schedule,116.49,100% of CMS OPPS Rate,116.49,100% of CMS OPPS Rate,293.23,203.89% of BCBS Fee Schedule,192.5,70% of total Billed Charges,206.25,75% of total Billed Charges,209.68,180% OF CMS OPPS RATE,220,80% of total Billed Charges,407.71,350% of CMS Opps rate,118.81,102% of CMS Opps rate,210.38,76.5% of total billed charges,77.9,100% of Medicaid LA Fee Schedule,77.9,100% of Medicaid LA Fee Schedule,116.49,100% of CMS OPPS Rate,116.49,100% of CMS OPPS Rate,123.75,45% of total billed charges,192.5,70% of total billed charges,165,60% of total billed charges,116.49,100% of CMS OPPS Rate,129.44,90% OF UHC FEE SCHEDULE,192.5,70% of total billed charges,116.49,100% OF CMS OPPS Rate,267.92,230% OF CMS OPPS Rate,132,48% of total Billed charges,116.49,100% OF CMS OPPS Rate,247.5,90% of total Billed charges,77.9,100% of Medicaid LA Fee Schedule,77.9,100% of Medicaid LA Fee Schedule,77.9,100% of Medicaid LA Fee Schedule,77.9,100% of Medicaid LA Fee Schedule,77.9,100% of Medicaid LA Fee Schedule,77.9,100% of Medicaid LA Fee Schedule,116.49,100% of CMS OPPS Rate,116.49,100% of CMS OPPS Rate,116.49,100% of CMS OPPS Rate,116.49,100% of CMS OPPS Rate,116.49,100% of CMS OPPS Rate,116.49,100% of CMS OPPS Rate,116.49,100% of CMS OPPS Rate,116.49,100% of CMS OPPS Rate,77.9,412.37,165
Outpatient,Laboratory,88233,"TISSUE CULT (CHRM),TISSUE",300,479.25,498.18,354% of CMS OPPS Rate,77.9,100% of Medicaid LA Fee Schedule,140.72,100% of CMS OPPS Rate,140.72,100% of CMS OPPS Rate,354.24,203.89% of BCBS Fee Schedule,335.48,70% of total Billed Charges,359.44,75% of total Billed Charges,253.31,180% OF CMS OPPS RATE,383.4,80% of total Billed Charges,492.55,350% of CMS Opps rate,143.54,102% of CMS Opps rate,366.63,76.5% of total billed charges,77.9,100% of Medicaid LA Fee Schedule,77.9,100% of Medicaid LA Fee Schedule,140.72,100% of CMS OPPS Rate,140.72,100% of CMS OPPS Rate,215.66,45% of total billed charges,335.48,70% of total billed charges,287.55,60% of total billed charges,140.72,100% of CMS OPPS Rate,156.37,90% OF UHC FEE SCHEDULE,335.48,70% of total billed charges,140.72,100% OF CMS OPPS Rate,323.67,230% OF CMS OPPS Rate,230.04,48% of total Billed charges,140.72,100% OF CMS OPPS Rate,431.33,90% of total Billed charges,77.9,100% of Medicaid LA Fee Schedule,77.9,100% of Medicaid LA Fee Schedule,77.9,100% of Medicaid LA Fee Schedule,77.9,100% of Medicaid LA Fee Schedule,77.9,100% of Medicaid LA Fee Schedule,77.9,100% of Medicaid LA Fee Schedule,140.72,100% of CMS OPPS Rate,140.72,100% of CMS OPPS Rate,140.72,100% of CMS OPPS Rate,140.72,100% of CMS OPPS Rate,140.72,100% of CMS OPPS Rate,140.72,100% of CMS OPPS Rate,140.72,100% of CMS OPPS Rate,140.72,100% of CMS OPPS Rate,77.9,498.18,287.55
Outpatient,Laboratory,88237,"TISSUE CULT (CHRM), BM",300,431,508.87,354% of CMS OPPS Rate,77.9,100% of Medicaid LA Fee Schedule,143.75,100% of CMS OPPS Rate,143.75,100% of CMS OPPS Rate,317.93,203.89% of BCBS Fee Schedule,301.7,70% of total Billed Charges,323.25,75% of total Billed Charges,258.75,180% OF CMS OPPS RATE,344.8,80% of total Billed Charges,503.12,350% of CMS Opps rate,146.62,102% of CMS Opps rate,329.72,76.5% of total billed charges,77.9,100% of Medicaid LA Fee Schedule,77.9,100% of Medicaid LA Fee Schedule,143.75,100% of CMS OPPS Rate,143.75,100% of CMS OPPS Rate,193.95,45% of total billed charges,301.7,70% of total billed charges,258.6,60% of total billed charges,143.75,100% of CMS OPPS Rate,140.34,90% OF UHC FEE SCHEDULE,301.7,70% of total billed charges,143.75,100% OF CMS OPPS Rate,330.62,230% OF CMS OPPS Rate,206.88,48% of total Billed charges,143.75,100% OF CMS OPPS Rate,387.9,90% of total Billed charges,77.9,100% of Medicaid LA Fee Schedule,77.9,100% of Medicaid LA Fee Schedule,77.9,100% of Medicaid LA Fee Schedule,77.9,100% of Medicaid LA Fee Schedule,77.9,100% of Medicaid LA Fee Schedule,77.9,100% of Medicaid LA Fee Schedule,143.75,100% of CMS OPPS Rate,143.75,100% of CMS OPPS Rate,143.75,100% of CMS OPPS Rate,143.75,100% of CMS OPPS Rate,143.75,100% of CMS OPPS Rate,143.75,100% of CMS OPPS Rate,143.75,100% of CMS OPPS Rate,143.75,100% of CMS OPPS Rate,77.9,508.87,258.6
Outpatient,Laboratory,88239,TISSUE CULT NEOPLASTIC TUMOR,300,336,522.22,354% of CMS OPPS Rate,77.9,100% of Medicaid LA Fee Schedule,147.52,100% of CMS OPPS Rate,147.52,100% of CMS OPPS Rate,371.32,203.89% of BCBS Fee Schedule,235.2,70% of total Billed Charges,252,75% of total Billed Charges,265.53,180% OF CMS OPPS RATE,268.8,80% of total Billed Charges,516.32,350% of CMS Opps rate,150.47,102% of CMS Opps rate,257.04,76.5% of total billed charges,77.9,100% of Medicaid LA Fee Schedule,77.9,100% of Medicaid LA Fee Schedule,147.52,100% of CMS OPPS Rate,147.52,100% of CMS OPPS Rate,151.2,45% of total billed charges,235.2,70% of total billed charges,201.6,60% of total billed charges,147.52,100% of CMS OPPS Rate,163.91,90% OF UHC FEE SCHEDULE,235.2,70% of total billed charges,147.52,100% OF CMS OPPS Rate,336,230% OF CMS OPPS Rate,161.28,48% of total Billed charges,147.52,100% OF CMS OPPS Rate,302.4,90% of total Billed charges,77.9,100% of Medicaid LA Fee Schedule,77.9,100% of Medicaid LA Fee Schedule,77.9,100% of Medicaid LA Fee Schedule,77.9,100% of Medicaid LA Fee Schedule,77.9,100% of Medicaid LA Fee Schedule,77.9,100% of Medicaid LA Fee Schedule,147.52,100% of CMS OPPS Rate,147.52,100% of CMS OPPS Rate,147.52,100% of CMS OPPS Rate,147.52,100% of CMS OPPS Rate,147.52,100% of CMS OPPS Rate,147.52,100% of CMS OPPS Rate,147.52,100% of CMS OPPS Rate,147.52,100% of CMS OPPS Rate,77.9,522.22,201.6
Outpatient,Laboratory,88261,CHROM ALALYSIS CNT 5 CELLS,300,1252,935.76,354% of CMS OPPS Rate,176.64,100% of Medicaid LA Fee Schedule,264.33,100% of CMS OPPS Rate,264.33,100% of CMS OPPS Rate,538.96,203.89% of BCBS Fee Schedule,876.4,70% of total Billed Charges,939,75% of total Billed Charges,475.81,180% OF CMS OPPS RATE,1001.6,80% of total Billed Charges,925.18,350% of CMS Opps rate,269.62,102% of CMS Opps rate,957.78,76.5% of total billed charges,176.64,100% of Medicaid LA Fee Schedule,176.64,100% of Medicaid LA Fee Schedule,264.33,100% of CMS OPPS Rate,264.33,100% of CMS OPPS Rate,563.4,45% of total billed charges,876.4,70% of total billed charges,751.2,60% of total billed charges,264.33,100% of CMS OPPS Rate,237.91,90% OF UHC FEE SCHEDULE,876.4,70% of total billed charges,264.33,100% OF CMS OPPS Rate,607.98,230% OF CMS OPPS Rate,600.96,48% of total Billed charges,264.33,100% OF CMS OPPS Rate,1126.8,90% of total Billed charges,176.64,100% of Medicaid LA Fee Schedule,176.64,100% of Medicaid LA Fee Schedule,176.64,100% of Medicaid LA Fee Schedule,176.64,100% of Medicaid LA Fee Schedule,176.64,100% of Medicaid LA Fee Schedule,176.64,100% of Medicaid LA Fee Schedule,264.33,100% of CMS OPPS Rate,264.33,100% of CMS OPPS Rate,264.33,100% of CMS OPPS Rate,264.33,100% of CMS OPPS Rate,264.33,100% of CMS OPPS Rate,264.33,100% of CMS OPPS Rate,264.33,100% of CMS OPPS Rate,264.33,100% of CMS OPPS Rate,176.64,1126.8,751.2
Outpatient,Laboratory,88262,CHROM ANALY 15 - 20 CELLS,300,423.45,444.23,354% of CMS OPPS Rate,125.49,100% of Medicaid LA Fee Schedule,125.49,100% of CMS OPPS Rate,125.49,100% of CMS OPPS Rate,313.75,203.89% of BCBS Fee Schedule,296.42,70% of total Billed Charges,317.59,75% of total Billed Charges,225.88,180% OF CMS OPPS RATE,338.76,80% of total Billed Charges,439.21,350% of CMS Opps rate,127.99,102% of CMS Opps rate,323.94,76.5% of total billed charges,125.49,100% of Medicaid LA Fee Schedule,125.49,100% of Medicaid LA Fee Schedule,125.49,100% of CMS OPPS Rate,125.49,100% of CMS OPPS Rate,190.55,45% of total billed charges,296.42,70% of total billed charges,254.07,60% of total billed charges,125.49,100% of CMS OPPS Rate,138.49,90% OF UHC FEE SCHEDULE,296.42,70% of total billed charges,125.49,100% OF CMS OPPS Rate,288.62,230% OF CMS OPPS Rate,203.26,48% of total Billed charges,125.49,100% OF CMS OPPS Rate,381.11,90% of total Billed charges,125.49,100% of Medicaid LA Fee Schedule,125.49,100% of Medicaid LA Fee Schedule,125.49,100% of Medicaid LA Fee Schedule,125.49,100% of Medicaid LA Fee Schedule,125.49,100% of Medicaid LA Fee Schedule,125.49,100% of Medicaid LA Fee Schedule,125.49,100% of CMS OPPS Rate,125.49,100% of CMS OPPS Rate,125.49,100% of CMS OPPS Rate,125.49,100% of CMS OPPS Rate,125.49,100% of CMS OPPS Rate,125.49,100% of CMS OPPS Rate,125.49,100% of CMS OPPS Rate,125.49,100% of CMS OPPS Rate,125.49,444.23,254.07
Outpatient,Laboratory,88264,CHROM. ANALYSIS 20-50CELL,300,434,511.91,354% of CMS OPPS Rate,144.61,100% of Medicaid LA Fee Schedule,144.61,100% of CMS OPPS Rate,144.61,100% of CMS OPPS Rate,313.75,203.89% of BCBS Fee Schedule,303.8,70% of total Billed Charges,325.5,75% of total Billed Charges,260.29,180% OF CMS OPPS RATE,347.2,80% of total Billed Charges,506.13,350% of CMS Opps rate,147.5,102% of CMS Opps rate,332.01,76.5% of total billed charges,144.61,100% of Medicaid LA Fee Schedule,144.61,100% of Medicaid LA Fee Schedule,144.61,100% of CMS OPPS Rate,144.61,100% of CMS OPPS Rate,195.3,45% of total billed charges,303.8,70% of total billed charges,260.4,60% of total billed charges,144.61,100% of CMS OPPS Rate,138.49,90% OF UHC FEE SCHEDULE,303.8,70% of total billed charges,144.61,100% OF CMS OPPS Rate,332.6,230% OF CMS OPPS Rate,208.32,48% of total Billed charges,144.61,100% OF CMS OPPS Rate,390.6,90% of total Billed charges,144.61,100% of Medicaid LA Fee Schedule,144.61,100% of Medicaid LA Fee Schedule,144.61,100% of Medicaid LA Fee Schedule,144.61,100% of Medicaid LA Fee Schedule,144.61,100% of Medicaid LA Fee Schedule,144.61,100% of Medicaid LA Fee Schedule,144.61,100% of CMS OPPS Rate,144.61,100% of CMS OPPS Rate,144.61,100% of CMS OPPS Rate,144.61,100% of CMS OPPS Rate,144.61,100% of CMS OPPS Rate,144.61,100% of CMS OPPS Rate,144.61,100% of CMS OPPS Rate,144.61,100% of CMS OPPS Rate,138.49,511.91,260.4
Outpatient,Laboratory,88271,MOLECULAR CYTOGENETICS,300,74.7,75.82,354% of CMS OPPS Rate,21.42,100% of Medicaid LA Fee Schedule,21.42,100% of CMS OPPS Rate,21.42,100% of CMS OPPS Rate,53.91,203.89% of BCBS Fee Schedule,52.29,70% of total Billed Charges,56.03,75% of total Billed Charges,38.55,180% OF CMS OPPS RATE,59.76,80% of total Billed Charges,74.97,350% of CMS Opps rate,21.84,102% of CMS Opps rate,57.15,76.5% of total billed charges,21.42,100% of Medicaid LA Fee Schedule,21.42,100% of Medicaid LA Fee Schedule,21.42,100% of CMS OPPS Rate,21.42,100% of CMS OPPS Rate,33.62,45% of total billed charges,52.29,70% of total billed charges,44.82,60% of total billed charges,21.42,100% of CMS OPPS Rate,23.8,90% OF UHC FEE SCHEDULE,52.29,70% of total billed charges,21.42,100% OF CMS OPPS Rate,49.26,230% OF CMS OPPS Rate,35.86,48% of total Billed charges,21.42,100% OF CMS OPPS Rate,67.23,90% of total Billed charges,21.42,100% of Medicaid LA Fee Schedule,21.42,100% of Medicaid LA Fee Schedule,21.42,100% of Medicaid LA Fee Schedule,21.42,100% of Medicaid LA Fee Schedule,21.42,100% of Medicaid LA Fee Schedule,21.42,100% of Medicaid LA Fee Schedule,21.42,100% of CMS OPPS Rate,21.42,100% of CMS OPPS Rate,21.42,100% of CMS OPPS Rate,21.42,100% of CMS OPPS Rate,21.42,100% of CMS OPPS Rate,21.42,100% of CMS OPPS Rate,21.42,100% of CMS OPPS Rate,21.42,100% of CMS OPPS Rate,21.42,75.82,44.82
Outpatient,Laboratory,88273,CHROM. HYBRIDIZATION,300,83,123.22,354% of CMS OPPS Rate,34.81,100% of Medicaid LA Fee Schedule,34.81,100% of CMS OPPS Rate,34.81,100% of CMS OPPS Rate,80.86,203.89% of BCBS Fee Schedule,58.1,70% of total Billed Charges,62.25,75% of total Billed Charges,62.65,180% OF CMS OPPS RATE,66.4,80% of total Billed Charges,121.83,350% of CMS Opps rate,35.5,102% of CMS Opps rate,63.5,76.5% of total billed charges,34.81,100% of Medicaid LA Fee Schedule,34.81,100% of Medicaid LA Fee Schedule,34.81,100% of CMS OPPS Rate,34.81,100% of CMS OPPS Rate,37.35,45% of total billed charges,58.1,70% of total billed charges,49.8,60% of total billed charges,34.81,100% of CMS OPPS Rate,35.69,90% OF UHC FEE SCHEDULE,58.1,70% of total billed charges,34.81,100% OF CMS OPPS Rate,80.06,230% OF CMS OPPS Rate,39.84,48% of total Billed charges,34.81,100% OF CMS OPPS Rate,74.7,90% of total Billed charges,34.81,100% of Medicaid LA Fee Schedule,34.81,100% of Medicaid LA Fee Schedule,34.81,100% of Medicaid LA Fee Schedule,34.81,100% of Medicaid LA Fee Schedule,34.81,100% of Medicaid LA Fee Schedule,34.81,100% of Medicaid LA Fee Schedule,34.81,100% of CMS OPPS Rate,34.81,100% of CMS OPPS Rate,34.81,100% of CMS OPPS Rate,34.81,100% of CMS OPPS Rate,34.81,100% of CMS OPPS Rate,34.81,100% of CMS OPPS Rate,34.81,100% of CMS OPPS Rate,34.81,100% of CMS OPPS Rate,34.81,123.22,49.8
Outpatient,Laboratory,88274,MOLECULAR CYTOGENETICS INTERF,300,302.4,150.02,354% of CMS OPPS Rate,42.38,100% of Medicaid LA Fee Schedule,42.38,100% of CMS OPPS Rate,42.38,100% of CMS OPPS Rate,87.63,203.89% of BCBS Fee Schedule,211.68,70% of total Billed Charges,226.8,75% of total Billed Charges,76.28,180% OF CMS OPPS RATE,241.92,80% of total Billed Charges,148.33,350% of CMS Opps rate,43.22,102% of CMS Opps rate,231.34,76.5% of total billed charges,42.38,100% of Medicaid LA Fee Schedule,42.38,100% of Medicaid LA Fee Schedule,42.38,100% of CMS OPPS Rate,42.38,100% of CMS OPPS Rate,136.08,45% of total billed charges,211.68,70% of total billed charges,181.44,60% of total billed charges,42.38,100% of CMS OPPS Rate,38.68,90% OF UHC FEE SCHEDULE,211.68,70% of total billed charges,42.38,100% OF CMS OPPS Rate,97.47,230% OF CMS OPPS Rate,145.15,48% of total Billed charges,42.38,100% OF CMS OPPS Rate,272.16,90% of total Billed charges,42.38,100% of Medicaid LA Fee Schedule,42.38,100% of Medicaid LA Fee Schedule,42.38,100% of Medicaid LA Fee Schedule,42.38,100% of Medicaid LA Fee Schedule,42.38,100% of Medicaid LA Fee Schedule,42.38,100% of Medicaid LA Fee Schedule,42.38,100% of CMS OPPS Rate,42.38,100% of CMS OPPS Rate,42.38,100% of CMS OPPS Rate,42.38,100% of CMS OPPS Rate,42.38,100% of CMS OPPS Rate,42.38,100% of CMS OPPS Rate,42.38,100% of CMS OPPS Rate,42.38,100% of CMS OPPS Rate,38.68,272.16,181.44
Outpatient,Laboratory,88275,MOLECULAR CYTOGEN 100 300 CELLS,300,326.14,181.21,354% of CMS OPPS Rate,51.19,100% of Medicaid LA Fee Schedule,51.19,100% of CMS OPPS Rate,51.19,100% of CMS OPPS Rate,104.37,203.89% of BCBS Fee Schedule,228.3,70% of total Billed Charges,244.61,75% of total Billed Charges,92.14,180% OF CMS OPPS RATE,260.91,80% of total Billed Charges,179.16,350% of CMS Opps rate,52.21,102% of CMS Opps rate,249.5,76.5% of total billed charges,51.19,100% of Medicaid LA Fee Schedule,51.19,100% of Medicaid LA Fee Schedule,51.19,100% of CMS OPPS Rate,51.19,100% of CMS OPPS Rate,146.76,45% of total billed charges,228.3,70% of total billed charges,195.68,60% of total billed charges,51.19,100% of CMS OPPS Rate,46.07,90% OF UHC FEE SCHEDULE,228.3,70% of total billed charges,51.19,100% OF CMS OPPS Rate,117.73,230% OF CMS OPPS Rate,156.55,48% of total Billed charges,51.19,100% OF CMS OPPS Rate,293.53,90% of total Billed charges,51.19,100% of Medicaid LA Fee Schedule,51.19,100% of Medicaid LA Fee Schedule,51.19,100% of Medicaid LA Fee Schedule,51.19,100% of Medicaid LA Fee Schedule,51.19,100% of Medicaid LA Fee Schedule,51.19,100% of Medicaid LA Fee Schedule,51.19,100% of CMS OPPS Rate,51.19,100% of CMS OPPS Rate,51.19,100% of CMS OPPS Rate,51.19,100% of CMS OPPS Rate,51.19,100% of CMS OPPS Rate,51.19,100% of CMS OPPS Rate,51.19,100% of CMS OPPS Rate,51.19,100% of CMS OPPS Rate,46.07,293.53,195.68
Outpatient,Laboratory,88280,CHROM. ANALY ADD KARYOTES,300,121.5,118.48,354% of CMS OPPS Rate,32.29,100% of Medicaid LA Fee Schedule,33.47,100% of CMS OPPS Rate,33.47,100% of CMS OPPS Rate,68.24,203.89% of BCBS Fee Schedule,85.05,70% of total Billed Charges,91.13,75% of total Billed Charges,60.24,180% OF CMS OPPS RATE,97.2,80% of total Billed Charges,117.14,350% of CMS Opps rate,34.13,102% of CMS Opps rate,92.95,76.5% of total billed charges,32.29,100% of Medicaid LA Fee Schedule,32.29,100% of Medicaid LA Fee Schedule,33.47,100% of CMS OPPS Rate,33.47,100% of CMS OPPS Rate,54.68,45% of total billed charges,85.05,70% of total billed charges,72.9,60% of total billed charges,33.47,100% of CMS OPPS Rate,30.12,90% OF UHC FEE SCHEDULE,85.05,70% of total billed charges,33.47,100% OF CMS OPPS Rate,76.98,230% OF CMS OPPS Rate,58.32,48% of total Billed charges,33.47,100% OF CMS OPPS Rate,109.35,90% of total Billed charges,32.29,100% of Medicaid LA Fee Schedule,32.29,100% of Medicaid LA Fee Schedule,32.29,100% of Medicaid LA Fee Schedule,32.29,100% of Medicaid LA Fee Schedule,32.29,100% of Medicaid LA Fee Schedule,32.29,100% of Medicaid LA Fee Schedule,33.47,100% of CMS OPPS Rate,33.47,100% of CMS OPPS Rate,33.47,100% of CMS OPPS Rate,33.47,100% of CMS OPPS Rate,33.47,100% of CMS OPPS Rate,33.47,100% of CMS OPPS Rate,33.47,100% of CMS OPPS Rate,33.47,100% of CMS OPPS Rate,30.12,118.48,72.9
Outpatient,Laboratory,88285,CHROM ANALYSIS ADD CELLS,300,135,95.26,354% of CMS OPPS Rate,6.68,100% of Medicaid LA Fee Schedule,26.91,100% of CMS OPPS Rate,26.91,100% of CMS OPPS Rate,54.87,203.89% of BCBS Fee Schedule,94.5,70% of total Billed Charges,101.25,75% of total Billed Charges,48.43,180% OF CMS OPPS RATE,108,80% of total Billed Charges,94.18,350% of CMS Opps rate,27.44,102% of CMS Opps rate,103.28,76.5% of total billed charges,6.68,100% of Medicaid LA Fee Schedule,6.68,100% of Medicaid LA Fee Schedule,26.91,100% of CMS OPPS Rate,26.91,100% of CMS OPPS Rate,60.75,45% of total billed charges,94.5,70% of total billed charges,81,60% of total billed charges,26.91,100% of CMS OPPS Rate,24.22,90% OF UHC FEE SCHEDULE,94.5,70% of total billed charges,26.91,100% OF CMS OPPS Rate,61.89,230% OF CMS OPPS Rate,64.8,48% of total Billed charges,26.91,100% OF CMS OPPS Rate,121.5,90% of total Billed charges,6.68,100% of Medicaid LA Fee Schedule,6.68,100% of Medicaid LA Fee Schedule,6.68,100% of Medicaid LA Fee Schedule,6.68,100% of Medicaid LA Fee Schedule,6.68,100% of Medicaid LA Fee Schedule,6.68,100% of Medicaid LA Fee Schedule,26.91,100% of CMS OPPS Rate,26.91,100% of CMS OPPS Rate,26.91,100% of CMS OPPS Rate,26.91,100% of CMS OPPS Rate,26.91,100% of CMS OPPS Rate,26.91,100% of CMS OPPS Rate,26.91,100% of CMS OPPS Rate,26.91,100% of CMS OPPS Rate,6.68,121.5,81
Outpatient,Laboratory,88291,CYTOGENETICS INTERP.,300,95.4,17.17,18% of total billed charges for Outpatient Setting,6.07,100% of Medicaid LA Fee Schedule,17.17,18% of total billed charges,N/A,Not Applicable,77.36,203.89% of BCBS Fee Schedule,66.78,70% of total Billed Charges,71.55,75% of total Billed Charges,47.7,50% of total Billed Charges,76.32,80% of total Billed Charges,57.24,60% of total Billed Charges,N/A,Not Applicable,72.98,76.5% of total billed charges,6.07,100% of Medicaid LA Fee Schedule,6.07,100% of Medicaid LA Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,42.93,45% of total billed charges,66.78,70% of total billed charges,57.24,60% of total billed charges,N/A,Not Applicable,36.25,38% of total billed charges,66.78,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,45.79,48% of total Billed charges,95.4,100% of total Billed charges,85.86,90% of total Billed charges,6.07,100% of Medicaid LA Fee Schedule,6.07,100% of Medicaid LA Fee Schedule,6.07,100% of Medicaid LA Fee Schedule,6.07,100% of Medicaid LA Fee Schedule,6.07,100% of Medicaid LA Fee Schedule,6.07,100% of Medicaid LA Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6.07,95.4,57.24
Outpatient,Laboratory,88300,"SURG/PATH, GROSS ONLY",300,115.5,80.32,354% of CMS APC rate,10.53,100% of Medicaid LA Fee Schedule,22.69,100% of CMS OPPS Rate,22.69,100% of CMS OPPS Rate,35.62,203.89% of BCBS Fee Schedule,80.85,70% of total Billed Charges,86.63,75% of total Billed Charges,40.84,180% OF CMS OPPS RATE,92.4,80% of total Billed Charges,79.41,350% of CMS Opps rate,23.14,102% of CMS Opps rate,88.36,76.5% of total billed charges,10.53,100% of Medicaid LA Fee Schedule,10.53,100% of Medicaid LA Fee Schedule,22.69,100% of CMS OPPS Rate,22.69,100% of CMS OPPS Rate,51.98,45% of total billed charges,80.85,70% of total billed charges,69.3,60% of total billed charges,22.69,100% of CMS OPPS Rate,15.72,90% OF UHC FEE SCHEDULE,80.85,70% of total billed charges,22.69,100% OF CMS OPPS Rate,52.18,230% OF CMS OPPS Rate,55.44,48% of total Billed charges,22.69,100% OF CMS OPPS Rate,103.95,90% of total Billed charges,10.53,100% of Medicaid LA Fee Schedule,10.53,100% of Medicaid LA Fee Schedule,10.53,100% of Medicaid LA Fee Schedule,10.53,100% of Medicaid LA Fee Schedule,10.53,100% of Medicaid LA Fee Schedule,10.53,100% of Medicaid LA Fee Schedule,22.69,100% of CMS OPPS Rate,22.69,100% of CMS OPPS Rate,22.69,100% of CMS OPPS Rate,22.69,100% of CMS OPPS Rate,22.69,100% of CMS OPPS Rate,22.69,100% of CMS OPPS Rate,22.69,100% of CMS OPPS Rate,22.69,100% of CMS OPPS Rate,10.53,103.95,69.3
Outpatient,Laboratory,88302,SURG/PATH GR & MICRO II,300,142.65,80.32,354% of CMS APC rate,24.46,100% of Medicaid LA Fee Schedule,22.69,100% of CMS OPPS Rate,22.69,100% of CMS OPPS Rate,64.84,203.89% of BCBS Fee Schedule,99.86,70% of total Billed Charges,106.99,75% of total Billed Charges,40.84,180% OF CMS OPPS RATE,114.12,80% of total Billed Charges,79.41,350% of CMS Opps rate,23.14,102% of CMS Opps rate,109.13,76.5% of total billed charges,24.46,100% of Medicaid LA Fee Schedule,24.46,100% of Medicaid LA Fee Schedule,22.69,100% of CMS OPPS Rate,22.69,100% of CMS OPPS Rate,64.19,45% of total billed charges,99.86,70% of total billed charges,85.59,60% of total billed charges,22.69,100% of CMS OPPS Rate,28.62,90% OF UHC FEE SCHEDULE,99.86,70% of total billed charges,22.69,100% OF CMS OPPS Rate,52.18,230% OF CMS OPPS Rate,68.47,48% of total Billed charges,22.69,100% OF CMS OPPS Rate,128.39,90% of total Billed charges,24.46,100% of Medicaid LA Fee Schedule,24.46,100% of Medicaid LA Fee Schedule,24.46,100% of Medicaid LA Fee Schedule,24.46,100% of Medicaid LA Fee Schedule,24.46,100% of Medicaid LA Fee Schedule,24.46,100% of Medicaid LA Fee Schedule,22.69,100% of CMS OPPS Rate,22.69,100% of CMS OPPS Rate,22.69,100% of CMS OPPS Rate,22.69,100% of CMS OPPS Rate,22.69,100% of CMS OPPS Rate,22.69,100% of CMS OPPS Rate,22.69,100% of CMS OPPS Rate,22.69,100% of CMS OPPS Rate,22.69,128.39,85.59
Outpatient,Laboratory,88304,SURG/PATH GR & MICRO III,300,213.95,161.36,354% of CMS APC rate,35.09,100% of Medicaid LA Fee Schedule,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,91.14,203.89% of BCBS Fee Schedule,149.77,70% of total Billed Charges,160.46,75% of total Billed Charges,82.04,180% OF CMS OPPS RATE,171.16,80% of total Billed Charges,159.53,350% of CMS Opps rate,46.49,102% of CMS Opps rate,163.67,76.5% of total billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,96.28,45% of total billed charges,149.77,70% of total billed charges,128.37,60% of total billed charges,45.58,100% of CMS OPPS Rate,40.23,90% OF UHC FEE SCHEDULE,149.77,70% of total billed charges,45.58,100% OF CMS OPPS Rate,104.83,230% OF CMS OPPS Rate,102.7,48% of total Billed charges,45.58,100% OF CMS OPPS Rate,192.56,90% of total Billed charges,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,35.09,100% of Medicaid LA Fee Schedule,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,35.09,192.56,128.37
Outpatient,Laboratory,88305,Test of tissues for diagnosis of abnormalities,300,232.1,161.36,354% of CMS APC rate,49.42,100% of Medicaid LA Fee Schedule,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,91.14,203.89% of BCBS Fee Schedule,162.47,70% of total Billed Charges,174.08,75% of total Billed Charges,82.04,180% OF CMS OPPS RATE,185.68,80% of total Billed Charges,159.53,350% of CMS Opps rate,46.49,102% of CMS Opps rate,177.56,76.5% of total billed charges,49.42,100% of Medicaid LA Fee Schedule,49.42,100% of Medicaid LA Fee Schedule,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,104.45,45% of total billed charges,162.47,70% of total billed charges,139.26,60% of total billed charges,45.58,100% of CMS OPPS Rate,40.23,90% OF UHC FEE SCHEDULE,162.47,70% of total billed charges,45.58,100% OF CMS OPPS Rate,104.83,230% OF CMS OPPS Rate,111.41,48% of total Billed charges,45.58,100% OF CMS OPPS Rate,208.89,90% of total Billed charges,49.42,100% of Medicaid LA Fee Schedule,49.42,100% of Medicaid LA Fee Schedule,49.42,100% of Medicaid LA Fee Schedule,49.42,100% of Medicaid LA Fee Schedule,49.42,100% of Medicaid LA Fee Schedule,49.42,100% of Medicaid LA Fee Schedule,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,40.23,208.89,139.26
Outpatient,Laboratory,88307,SURG/PATH GR & MICRO V,300,767,1043.05,354% of CMS APC rate,70.7,100% of Medicaid LA Fee Schedule,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,439.24,203.89% of BCBS Fee Schedule,536.9,70% of total Billed Charges,575.25,75% of total Billed Charges,530.36,180% OF CMS OPPS RATE,613.6,80% of total Billed Charges,1031.26,350% of CMS Opps rate,300.54,102% of CMS Opps rate,586.76,76.5% of total billed charges,70.7,100% of Medicaid LA Fee Schedule,70.7,100% of Medicaid LA Fee Schedule,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,345.15,45% of total billed charges,536.9,70% of total billed charges,460.2,60% of total billed charges,294.64,100% of CMS OPPS Rate,193.89,90% OF UHC FEE SCHEDULE,536.9,70% of total billed charges,294.64,100% OF CMS OPPS Rate,677.69,230% OF CMS OPPS Rate,368.16,48% of total Billed charges,294.64,100% OF CMS OPPS Rate,690.3,90% of total Billed charges,70.7,100% of Medicaid LA Fee Schedule,70.7,100% of Medicaid LA Fee Schedule,70.7,100% of Medicaid LA Fee Schedule,70.7,100% of Medicaid LA Fee Schedule,70.7,100% of Medicaid LA Fee Schedule,70.7,100% of Medicaid LA Fee Schedule,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,70.7,1043.05,460.2
Outpatient,Laboratory,88309,SURG/PATH GR & MICRO VI,300,1700,2498.97,354% of CMS APC rate,70.7,100% of Medicaid LA Fee Schedule,705.92,100% of CMS OPPS Rate,705.92,100% of CMS OPPS Rate,1102.96,203.89% of BCBS Fee Schedule,1190,70% of total Billed Charges,1275,75% of total Billed Charges,1270.66,180% OF CMS OPPS RATE,1360,80% of total Billed Charges,2470.73,350% of CMS Opps rate,720.04,102% of CMS Opps rate,1300.5,76.5% of total billed charges,70.7,100% of Medicaid LA Fee Schedule,70.7,100% of Medicaid LA Fee Schedule,705.92,100% of CMS OPPS Rate,705.92,100% of CMS OPPS Rate,765,45% of total billed charges,1190,70% of total billed charges,1020,60% of total billed charges,705.92,100% of CMS OPPS Rate,486.86,90% OF UHC FEE SCHEDULE,1190,70% of total billed charges,705.92,100% OF CMS OPPS Rate,1623.62,230% OF CMS OPPS Rate,816,48% of total Billed charges,705.92,100% OF CMS OPPS Rate,1530,90% of total Billed charges,70.7,100% of Medicaid LA Fee Schedule,70.7,100% of Medicaid LA Fee Schedule,70.7,100% of Medicaid LA Fee Schedule,70.7,100% of Medicaid LA Fee Schedule,70.7,100% of Medicaid LA Fee Schedule,70.7,100% of Medicaid LA Fee Schedule,705.92,100% of CMS OPPS Rate,705.92,100% of CMS OPPS Rate,705.92,100% of CMS OPPS Rate,705.92,100% of CMS OPPS Rate,705.92,100% of CMS OPPS Rate,705.92,100% of CMS OPPS Rate,705.92,100% of CMS OPPS Rate,705.92,100% of CMS OPPS Rate,70.7,2498.97,1020
Outpatient,Laboratory,88311,DECALCIFICATION OF BONE,300,194.85,35.07,18% of total billed charges for Outpatient Setting,5.7,100% of Medicaid LA Fee Schedule,35.07,18% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,136.4,70% of total Billed Charges,146.14,75% of total Billed Charges,97.43,50% of total Billed Charges,155.88,80% of total Billed Charges,116.91,60% of total Billed Charges,N/A,Not Applicable,149.06,76.5% of total billed charges,5.7,100% of Medicaid LA Fee Schedule,5.7,100% of Medicaid LA Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,87.68,45% of total billed charges,136.4,70% of total billed charges,116.91,60% of total billed charges,N/A,Not Applicable,8.42,90% OF UHC FEE SCHEDULE,136.4,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,93.53,48% of total Billed charges,194.85,100% of total Billed charges,175.37,90% of total Billed charges,5.7,100% of Medicaid LA Fee Schedule,5.7,100% of Medicaid LA Fee Schedule,5.7,100% of Medicaid LA Fee Schedule,5.7,100% of Medicaid LA Fee Schedule,5.7,100% of Medicaid LA Fee Schedule,5.7,100% of Medicaid LA Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,5.7,194.85,116.91
Outpatient,Laboratory,88312,Blood test to assist with diagnosis,300,222.75,161.36,354% of CMS APC rate,12.02,100% of Medicaid LA Fee Schedule,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,91.14,203.89% of BCBS Fee Schedule,155.93,70% of total Billed Charges,167.06,75% of total Billed Charges,82.04,180% OF CMS OPPS RATE,178.2,80% of total Billed Charges,159.53,350% of CMS Opps rate,46.49,102% of CMS Opps rate,170.4,76.5% of total billed charges,12.02,100% of Medicaid LA Fee Schedule,12.02,100% of Medicaid LA Fee Schedule,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,100.24,45% of total billed charges,155.93,70% of total billed charges,133.65,60% of total billed charges,45.58,100% of CMS OPPS Rate,40.23,90% OF UHC FEE SCHEDULE,155.93,70% of total billed charges,45.58,100% OF CMS OPPS Rate,104.83,230% OF CMS OPPS Rate,106.92,48% of total Billed charges,45.58,100% OF CMS OPPS Rate,200.48,90% of total Billed charges,12.02,100% of Medicaid LA Fee Schedule,12.02,100% of Medicaid LA Fee Schedule,12.02,100% of Medicaid LA Fee Schedule,12.02,100% of Medicaid LA Fee Schedule,12.02,100% of Medicaid LA Fee Schedule,12.02,100% of Medicaid LA Fee Schedule,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,12.02,200.48,133.65
Outpatient,Laboratory,88313,Blood test to assist with diagnosis,300,203.5,109.29,354% of CMS APC rate,5.7,100% of Medicaid LA Fee Schedule,30.87,100% of CMS OPPS Rate,30.87,100% of CMS OPPS Rate,64.84,203.89% of BCBS Fee Schedule,142.45,70% of total Billed Charges,152.63,75% of total Billed Charges,55.57,180% OF CMS OPPS RATE,162.8,80% of total Billed Charges,108.05,350% of CMS Opps rate,31.49,102% of CMS Opps rate,155.68,76.5% of total billed charges,5.7,100% of Medicaid LA Fee Schedule,5.7,100% of Medicaid LA Fee Schedule,30.87,100% of CMS OPPS Rate,30.87,100% of CMS OPPS Rate,91.58,45% of total billed charges,142.45,70% of total billed charges,122.1,60% of total billed charges,30.87,100% of CMS OPPS Rate,28.62,90% OF UHC FEE SCHEDULE,142.45,70% of total billed charges,30.87,100% OF CMS OPPS Rate,71,230% OF CMS OPPS Rate,97.68,48% of total Billed charges,30.87,100% OF CMS OPPS Rate,183.15,90% of total Billed charges,5.7,100% of Medicaid LA Fee Schedule,5.7,100% of Medicaid LA Fee Schedule,5.7,100% of Medicaid LA Fee Schedule,5.7,100% of Medicaid LA Fee Schedule,5.7,100% of Medicaid LA Fee Schedule,5.7,100% of Medicaid LA Fee Schedule,30.87,100% of CMS OPPS Rate,30.87,100% of CMS OPPS Rate,30.87,100% of CMS OPPS Rate,30.87,100% of CMS OPPS Rate,30.87,100% of CMS OPPS Rate,30.87,100% of CMS OPPS Rate,30.87,100% of CMS OPPS Rate,30.87,100% of CMS OPPS Rate,5.7,183.15,122.1
Outpatient,Laboratory,88314,HISTOCHEM.STAIN(TULANE MC,300,162,29.16,18% of total billed charges for Outpatient Setting,38.17,100% of Medicaid LA Fee Schedule,29.16,18% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,113.4,70% of total Billed Charges,121.5,75% of total Billed Charges,81,50% of total Billed Charges,129.6,80% of total Billed Charges,97.2,60% of total Billed Charges,N/A,Not Applicable,123.93,76.5% of total billed charges,38.17,100% of Medicaid LA Fee Schedule,38.17,100% of Medicaid LA Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,72.9,45% of total billed charges,113.4,70% of total billed charges,97.2,60% of total billed charges,N/A,Not Applicable,57.02,90% OF UHC FEE SCHEDULE,113.4,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,77.76,48% of total Billed charges,162,100% of total Billed charges,145.8,90% of total Billed charges,38.17,100% of Medicaid LA Fee Schedule,38.17,100% of Medicaid LA Fee Schedule,38.17,100% of Medicaid LA Fee Schedule,38.17,100% of Medicaid LA Fee Schedule,38.17,100% of Medicaid LA Fee Schedule,38.17,100% of Medicaid LA Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,29.16,162,97.2
Outpatient,Laboratory,88319,SPECIAL STAIN W INTERP GRP III,300,257.5,2498.97,354% of CMS APC rate,40.35,15.67% of total Billed charges,705.92,100% of CMS OPPS Rate,257.5,100% of CMS OPPS Rate,1102.96,203.89% of BCBS Fee Schedule,180.25,70% of total Billed Charges,193.13,75% of total Billed Charges,1270.66,180% OF CMS OPPS RATE,206,80% of total Billed Charges,2470.73,350% of CMS Opps rate,257.5,102% of CMS Opps rate,196.99,76.5% of total billed charges,40.35,15.67% of total Billed charges,40.35,15.67% of total Billed charges,705.92,100% of CMS OPPS Rate,705.92,100% of CMS OPPS Rate,115.88,45% of total billed charges,180.25,70% of total billed charges,154.5,60% of total billed charges,705.92,100% of CMS OPPS Rate,486.86,90% OF UHC FEE SCHEDULE,180.25,70% of total billed charges,705.92,100% OF CMS OPPS Rate,1623.62,230% OF CMS OPPS Rate,123.6,48% of total Billed charges,257.5,100% OF CMS OPPS Rate,231.75,90% of total Billed charges,40.35,15.67% of total Billed charges,40.35,15.67% of total Billed charges,40.35,15.67% of total Billed charges,40.35,15.67% of total Billed charges,40.35,15.67% of total Billed charges,40.35,15.67% of total Billed charges,705.92,100% of CMS OPPS Rate,705.92,100% of CMS OPPS Rate,705.92,100% of CMS OPPS Rate,705.92,100% of CMS OPPS Rate,705.92,100% of CMS OPPS Rate,705.92,100% of CMS OPPS Rate,705.92,100% of CMS OPPS Rate,705.92,100% of CMS OPPS Rate,40.35,2498.97,154.5
Outpatient,Laboratory,88321,PATHOLOGY CONSULT,300,232,109.29,354% of CMS APC rate,56.53,100% of Medicaid LA Fee Schedule,30.87,100% of CMS OPPS Rate,30.87,100% of CMS OPPS Rate,64.84,203.89% of BCBS Fee Schedule,162.4,70% of total Billed Charges,174,75% of total Billed Charges,55.57,180% OF CMS OPPS RATE,185.6,80% of total Billed Charges,108.05,350% of CMS Opps rate,31.49,102% of CMS Opps rate,177.48,76.5% of total billed charges,56.53,100% of Medicaid LA Fee Schedule,56.53,100% of Medicaid LA Fee Schedule,30.87,100% of CMS OPPS Rate,30.87,100% of CMS OPPS Rate,104.4,45% of total billed charges,162.4,70% of total billed charges,139.2,60% of total billed charges,30.87,100% of CMS OPPS Rate,28.62,90% OF UHC FEE SCHEDULE,162.4,70% of total billed charges,30.87,100% OF CMS OPPS Rate,71,230% OF CMS OPPS Rate,111.36,48% of total Billed charges,30.87,100% OF CMS OPPS Rate,208.8,90% of total Billed charges,56.53,100% of Medicaid LA Fee Schedule,56.53,100% of Medicaid LA Fee Schedule,56.53,100% of Medicaid LA Fee Schedule,56.53,100% of Medicaid LA Fee Schedule,56.53,100% of Medicaid LA Fee Schedule,56.53,100% of Medicaid LA Fee Schedule,30.87,100% of CMS OPPS Rate,30.87,100% of CMS OPPS Rate,30.87,100% of CMS OPPS Rate,30.87,100% of CMS OPPS Rate,30.87,100% of CMS OPPS Rate,30.87,100% of CMS OPPS Rate,30.87,100% of CMS OPPS Rate,30.87,100% of CMS OPPS Rate,28.62,208.8,139.2
Outpatient,Laboratory,88323,"CONSULT & REPORT, REFERED",300,134,161.36,354% of CMS APC rate,70.7,100% of Medicaid LA Fee Schedule,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,91.14,203.89% of BCBS Fee Schedule,93.8,70% of total Billed Charges,100.5,75% of total Billed Charges,82.04,180% OF CMS OPPS RATE,107.2,80% of total Billed Charges,159.53,350% of CMS Opps rate,46.49,102% of CMS Opps rate,102.51,76.5% of total billed charges,70.7,100% of Medicaid LA Fee Schedule,70.7,100% of Medicaid LA Fee Schedule,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,60.3,45% of total billed charges,93.8,70% of total billed charges,80.4,60% of total billed charges,45.58,100% of CMS OPPS Rate,40.23,90% OF UHC FEE SCHEDULE,93.8,70% of total billed charges,45.58,100% OF CMS OPPS Rate,104.83,230% OF CMS OPPS Rate,64.32,48% of total Billed charges,45.58,100% OF CMS OPPS Rate,120.6,90% of total Billed charges,70.7,100% of Medicaid LA Fee Schedule,70.7,100% of Medicaid LA Fee Schedule,70.7,100% of Medicaid LA Fee Schedule,70.7,100% of Medicaid LA Fee Schedule,70.7,100% of Medicaid LA Fee Schedule,70.7,100% of Medicaid LA Fee Schedule,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,45.58,100% of CMS OPPS Rate,40.23,161.36,80.4
Outpatient,Laboratory,88325,CONSULT WITH COMPREHENSIVE REVIEW,300,884.25,506.06,354% of CMS APC rate,56.53,100% of Medicaid LA Fee Schedule,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,91.14,203.89% of BCBS Fee Schedule,618.98,70% of total Billed Charges,663.19,75% of total Billed Charges,257.32,180% OF CMS OPPS RATE,707.4,80% of total Billed Charges,500.34,350% of CMS Opps rate,145.81,102% of CMS Opps rate,676.45,76.5% of total billed charges,56.53,100% of Medicaid LA Fee Schedule,56.53,100% of Medicaid LA Fee Schedule,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,397.91,45% of total billed charges,618.98,70% of total billed charges,530.55,60% of total billed charges,142.95,100% of CMS OPPS Rate,40.23,90% OF UHC FEE SCHEDULE,618.98,70% of total billed charges,142.95,100% OF CMS OPPS Rate,328.79,230% OF CMS OPPS Rate,424.44,48% of total Billed charges,142.95,100% OF CMS OPPS Rate,795.83,90% of total Billed charges,56.53,100% of Medicaid LA Fee Schedule,56.53,100% of Medicaid LA Fee Schedule,56.53,100% of Medicaid LA Fee Schedule,56.53,100% of Medicaid LA Fee Schedule,56.53,100% of Medicaid LA Fee Schedule,56.53,100% of Medicaid LA Fee Schedule,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,40.23,795.83,530.55
Outpatient,Laboratory,88331,"FROZEN SECTION, INITIAL",300,388,506.06,354% of CMS APC rate,42.47,100% of Medicaid LA Fee Schedule,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,263.39,203.89% of BCBS Fee Schedule,271.6,70% of total Billed Charges,291,75% of total Billed Charges,257.32,180% OF CMS OPPS RATE,310.4,80% of total Billed Charges,500.34,350% of CMS Opps rate,145.81,102% of CMS Opps rate,296.82,76.5% of total billed charges,42.47,100% of Medicaid LA Fee Schedule,42.47,100% of Medicaid LA Fee Schedule,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,174.6,45% of total billed charges,271.6,70% of total billed charges,232.8,60% of total billed charges,142.95,100% of CMS OPPS Rate,116.26,90% OF UHC FEE SCHEDULE,271.6,70% of total billed charges,142.95,100% OF CMS OPPS Rate,328.79,230% OF CMS OPPS Rate,186.24,48% of total Billed charges,142.95,100% OF CMS OPPS Rate,349.2,90% of total Billed charges,42.47,100% of Medicaid LA Fee Schedule,42.47,100% of Medicaid LA Fee Schedule,42.47,100% of Medicaid LA Fee Schedule,42.47,100% of Medicaid LA Fee Schedule,42.47,100% of Medicaid LA Fee Schedule,42.47,100% of Medicaid LA Fee Schedule,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,42.47,506.06,232.8
Outpatient,Laboratory,88332,"FROZEN SECTION, EA ADD'L",300,87.12,15.68,18% of total billed charges for Outpatient Setting,14.15,100% of Medicaid LA Fee Schedule,15.68,18% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,60.98,70% of total Billed Charges,65.34,75% of total Billed Charges,43.56,50% of total Billed Charges,69.7,80% of total Billed Charges,52.27,60% of total Billed Charges,N/A,Not Applicable,66.65,76.5% of total billed charges,14.15,100% of Medicaid LA Fee Schedule,14.15,100% of Medicaid LA Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,39.2,45% of total billed charges,60.98,70% of total billed charges,52.27,60% of total billed charges,N/A,Not Applicable,19.44,90% OF UHC FEE SCHEDULE,60.98,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,41.82,48% of total Billed charges,87.12,100% of total Billed charges,78.41,90% of total Billed charges,14.15,100% of Medicaid LA Fee Schedule,14.15,100% of Medicaid LA Fee Schedule,14.15,100% of Medicaid LA Fee Schedule,14.15,100% of Medicaid LA Fee Schedule,14.15,100% of Medicaid LA Fee Schedule,14.15,100% of Medicaid LA Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,14.15,87.12,52.27
Outpatient,Laboratory,88333,"CYTOLOGY EXAM, TOUCH PREP INITIAL",300,1700,2498.97,354% of CMS APC rate,266.39,15.67% of total Billed charges,705.92,100% of CMS OPPS Rate,705.92,100% of CMS OPPS Rate,1102.96,203.89% of BCBS Fee Schedule,1190,70% of total Billed Charges,1275,75% of total Billed Charges,1270.66,180% OF CMS OPPS RATE,1360,80% of total Billed Charges,2470.73,350% of CMS Opps rate,720.04,102% of CMS Opps rate,1300.5,76.5% of total billed charges,266.39,15.67% of total Billed charges,266.39,15.67% of total Billed charges,705.92,100% of CMS OPPS Rate,705.92,100% of CMS OPPS Rate,765,45% of total billed charges,1190,70% of total billed charges,1020,60% of total billed charges,705.92,100% of CMS OPPS Rate,486.86,90% OF UHC FEE SCHEDULE,1190,70% of total billed charges,705.92,100% OF CMS OPPS Rate,1623.62,230% OF CMS OPPS Rate,816,48% of total Billed charges,705.92,100% OF CMS OPPS Rate,1530,90% of total Billed charges,266.39,15.67% of total Billed charges,266.39,15.67% of total Billed charges,266.39,15.67% of total Billed charges,266.39,15.67% of total Billed charges,266.39,15.67% of total Billed charges,266.39,15.67% of total Billed charges,705.92,100% of CMS OPPS Rate,705.92,100% of CMS OPPS Rate,705.92,100% of CMS OPPS Rate,705.92,100% of CMS OPPS Rate,705.92,100% of CMS OPPS Rate,705.92,100% of CMS OPPS Rate,705.92,100% of CMS OPPS Rate,705.92,100% of CMS OPPS Rate,266.39,2498.97,1020
Outpatient,Laboratory,88334,"CYTOLOGY EXAM, TOUCH PREP ADD",300,75.1,13.52,18% of total billed charges for Outpatient Setting,11.77,15.67% of total Billed charges,13.52,18% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,52.57,70% of total Billed Charges,56.33,75% of total Billed Charges,37.55,50% of total Billed Charges,60.08,80% of total Billed Charges,45.06,60% of total Billed Charges,N/A,Not Applicable,57.45,76.5% of total billed charges,11.77,15.67% of total Billed charges,11.77,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,33.8,45% of total billed charges,52.57,70% of total billed charges,45.06,60% of total billed charges,N/A,Not Applicable,14.58,90% OF UHC FEE SCHEDULE,52.57,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,36.05,48% of total Billed charges,75.1,100% of total Billed charges,67.59,90% of total Billed charges,11.77,15.67% of total Billed charges,11.77,15.67% of total Billed charges,11.77,15.67% of total Billed charges,11.77,15.67% of total Billed charges,11.77,15.67% of total Billed charges,11.77,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,11.77,75.1,45.06
Outpatient,Laboratory,88341,IMMHIST STAIN EA  ADDTL AB,300,223.5,40.23,18% of total billed charges for Outpatient Setting,59.94,100% of Medicaid LA Fee Schedule,40.23,18% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,156.45,70% of total Billed Charges,167.63,75% of total Billed Charges,111.75,50% of total Billed Charges,178.8,80% of total Billed Charges,134.1,60% of total Billed Charges,N/A,Not Applicable,170.98,76.5% of total billed charges,59.94,100% of Medicaid LA Fee Schedule,59.94,100% of Medicaid LA Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,100.58,45% of total billed charges,156.45,70% of total billed charges,134.1,60% of total billed charges,N/A,Not Applicable,58.32,90% OF UHC FEE SCHEDULE,156.45,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,107.28,48% of total Billed charges,223.5,100% of total Billed charges,201.15,90% of total Billed charges,59.94,100% of Medicaid LA Fee Schedule,59.94,100% of Medicaid LA Fee Schedule,59.94,100% of Medicaid LA Fee Schedule,59.94,100% of Medicaid LA Fee Schedule,59.94,100% of Medicaid LA Fee Schedule,59.94,100% of Medicaid LA Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,40.23,223.5,134.1
Outpatient,Laboratory,88342,Pathology test,300,388,506.06,354% of CMS APC rate,49.84,100% of Medicaid LA Fee Schedule,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,439.24,203.89% of BCBS Fee Schedule,271.6,70% of total Billed Charges,291,75% of total Billed Charges,257.32,180% OF CMS OPPS RATE,310.4,80% of total Billed Charges,500.34,350% of CMS Opps rate,145.81,102% of CMS Opps rate,296.82,76.5% of total billed charges,49.84,100% of Medicaid LA Fee Schedule,49.84,100% of Medicaid LA Fee Schedule,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,174.6,45% of total billed charges,271.6,70% of total billed charges,232.8,60% of total billed charges,142.95,100% of CMS OPPS Rate,193.89,90% OF UHC FEE SCHEDULE,271.6,70% of total billed charges,142.95,100% OF CMS OPPS Rate,328.79,230% OF CMS OPPS Rate,186.24,48% of total Billed charges,142.95,100% OF CMS OPPS Rate,349.2,90% of total Billed charges,49.84,100% of Medicaid LA Fee Schedule,49.84,100% of Medicaid LA Fee Schedule,49.84,100% of Medicaid LA Fee Schedule,49.84,100% of Medicaid LA Fee Schedule,49.84,100% of Medicaid LA Fee Schedule,49.84,100% of Medicaid LA Fee Schedule,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,49.84,506.06,232.8
Outpatient,Laboratory,88344,IMMHIST STAIN MULTIPLE AB PER SLIDE,300,767,1043.05,354% of CMS APC rate,103.69,100% of Medicaid LA Fee Schedule,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,439.24,203.89% of BCBS Fee Schedule,536.9,70% of total Billed Charges,575.25,75% of total Billed Charges,530.36,180% OF CMS OPPS RATE,613.6,80% of total Billed Charges,1031.26,350% of CMS Opps rate,300.54,102% of CMS Opps rate,586.76,76.5% of total billed charges,103.69,100% of Medicaid LA Fee Schedule,103.69,100% of Medicaid LA Fee Schedule,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,345.15,45% of total billed charges,536.9,70% of total billed charges,460.2,60% of total billed charges,294.64,100% of CMS OPPS Rate,193.89,90% OF UHC FEE SCHEDULE,536.9,70% of total billed charges,294.64,100% OF CMS OPPS Rate,677.69,230% OF CMS OPPS Rate,368.16,48% of total Billed charges,294.64,100% OF CMS OPPS Rate,690.3,90% of total Billed charges,103.69,100% of Medicaid LA Fee Schedule,103.69,100% of Medicaid LA Fee Schedule,103.69,100% of Medicaid LA Fee Schedule,103.69,100% of Medicaid LA Fee Schedule,103.69,100% of Medicaid LA Fee Schedule,103.69,100% of Medicaid LA Fee Schedule,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,103.69,1043.05,460.2
Outpatient,Laboratory,88346,IMMUNOFLUOR ANTB 1ST STAIN,300,767,1043.05,354% of CMS APC rate,98.09,100% of Medicaid LA Fee Schedule,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,439.24,203.89% of BCBS Fee Schedule,536.9,70% of total Billed Charges,575.25,75% of total Billed Charges,530.36,180% OF CMS OPPS RATE,613.6,80% of total Billed Charges,1031.26,350% of CMS Opps rate,300.54,102% of CMS Opps rate,586.76,76.5% of total billed charges,98.09,100% of Medicaid LA Fee Schedule,98.09,100% of Medicaid LA Fee Schedule,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,345.15,45% of total billed charges,536.9,70% of total billed charges,460.2,60% of total billed charges,294.64,100% of CMS OPPS Rate,193.89,90% OF UHC FEE SCHEDULE,536.9,70% of total billed charges,294.64,100% OF CMS OPPS Rate,677.69,230% OF CMS OPPS Rate,368.16,48% of total Billed charges,294.64,100% OF CMS OPPS Rate,690.3,90% of total Billed charges,98.09,100% of Medicaid LA Fee Schedule,98.09,100% of Medicaid LA Fee Schedule,98.09,100% of Medicaid LA Fee Schedule,98.09,100% of Medicaid LA Fee Schedule,98.09,100% of Medicaid LA Fee Schedule,98.09,100% of Medicaid LA Fee Schedule,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,98.09,1043.05,460.2
Outpatient,Laboratory,88348,ELECTRON MICROSCOPY,300,1205,2498.97,354% of CMS APC rate,111.73,100% of Medicaid LA Fee Schedule,705.92,100% of CMS OPPS Rate,705.92,100% of CMS OPPS Rate,1102.96,203.89% of BCBS Fee Schedule,843.5,70% of total Billed Charges,903.75,75% of total Billed Charges,1270.66,180% OF CMS OPPS RATE,964,80% of total Billed Charges,2470.73,350% of CMS Opps rate,720.04,102% of CMS Opps rate,921.83,76.5% of total billed charges,111.73,100% of Medicaid LA Fee Schedule,111.73,100% of Medicaid LA Fee Schedule,705.92,100% of CMS OPPS Rate,705.92,100% of CMS OPPS Rate,542.25,45% of total billed charges,843.5,70% of total billed charges,723,60% of total billed charges,705.92,100% of CMS OPPS Rate,486.86,90% OF UHC FEE SCHEDULE,843.5,70% of total billed charges,705.92,100% OF CMS OPPS Rate,1623.62,230% OF CMS OPPS Rate,578.4,48% of total Billed charges,705.92,100% OF CMS OPPS Rate,1084.5,90% of total Billed charges,111.73,100% of Medicaid LA Fee Schedule,111.73,100% of Medicaid LA Fee Schedule,111.73,100% of Medicaid LA Fee Schedule,111.73,100% of Medicaid LA Fee Schedule,111.73,100% of Medicaid LA Fee Schedule,111.73,100% of Medicaid LA Fee Schedule,705.92,100% of CMS OPPS Rate,705.92,100% of CMS OPPS Rate,705.92,100% of CMS OPPS Rate,705.92,100% of CMS OPPS Rate,705.92,100% of CMS OPPS Rate,705.92,100% of CMS OPPS Rate,705.92,100% of CMS OPPS Rate,705.92,100% of CMS OPPS Rate,111.73,2498.97,723
Outpatient,Laboratory,88350,IMMUNOFLUORESCENT  EA ADDL  SNGL AB,300,193.76,34.88,18% of total billed charges for Outpatient Setting,74.54,100% of Medicaid LA Fee Schedule,34.88,18% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,135.63,70% of total Billed Charges,145.32,75% of total Billed Charges,96.88,50% of total Billed Charges,155.01,80% of total Billed Charges,116.26,60% of total Billed Charges,N/A,Not Applicable,148.23,76.5% of total billed charges,74.54,100% of Medicaid LA Fee Schedule,74.54,100% of Medicaid LA Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,87.19,45% of total billed charges,135.63,70% of total billed charges,116.26,60% of total billed charges,N/A,Not Applicable,39.2,90% OF UHC FEE SCHEDULE,135.63,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,93,48% of total Billed charges,193.76,100% of total Billed charges,174.38,90% of total Billed charges,74.54,100% of Medicaid LA Fee Schedule,74.54,100% of Medicaid LA Fee Schedule,74.54,100% of Medicaid LA Fee Schedule,74.54,100% of Medicaid LA Fee Schedule,74.54,100% of Medicaid LA Fee Schedule,74.54,100% of Medicaid LA Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,34.88,193.76,116.26
Outpatient,Laboratory,88360,MORPHOMETRIC ANAL HER 2 NEU,300,388,506.06,354% of CMS APC rate,60.8,15.67% of total Billed charges,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,439.24,203.89% of BCBS Fee Schedule,271.6,70% of total Billed Charges,291,75% of total Billed Charges,257.32,180% OF CMS OPPS RATE,310.4,80% of total Billed Charges,500.34,350% of CMS Opps rate,145.81,102% of CMS Opps rate,296.82,76.5% of total billed charges,60.8,15.67% of total Billed charges,60.8,15.67% of total Billed charges,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,174.6,45% of total billed charges,271.6,70% of total billed charges,232.8,60% of total billed charges,142.95,100% of CMS OPPS Rate,193.89,90% OF UHC FEE SCHEDULE,271.6,70% of total billed charges,142.95,100% OF CMS OPPS Rate,328.79,230% OF CMS OPPS Rate,186.24,48% of total Billed charges,142.95,100% OF CMS OPPS Rate,349.2,90% of total Billed charges,60.8,15.67% of total Billed charges,60.8,15.67% of total Billed charges,60.8,15.67% of total Billed charges,60.8,15.67% of total Billed charges,60.8,15.67% of total Billed charges,60.8,15.67% of total Billed charges,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,60.8,506.06,232.8
Outpatient,Laboratory,88361,MORPHOMETRIC ANALYSIS TUMOR,300,378,1043.05,354% of CMS APC rate,105.39,100% of Medicaid LA Fee Schedule,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,439.24,203.89% of BCBS Fee Schedule,264.6,70% of total Billed Charges,283.5,75% of total Billed Charges,530.36,180% OF CMS OPPS RATE,302.4,80% of total Billed Charges,1031.26,350% of CMS Opps rate,300.54,102% of CMS Opps rate,289.17,76.5% of total billed charges,105.39,100% of Medicaid LA Fee Schedule,105.39,100% of Medicaid LA Fee Schedule,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,170.1,45% of total billed charges,264.6,70% of total billed charges,226.8,60% of total billed charges,294.64,100% of CMS OPPS Rate,193.89,90% OF UHC FEE SCHEDULE,264.6,70% of total billed charges,294.64,100% OF CMS OPPS Rate,677.69,230% OF CMS OPPS Rate,181.44,48% of total Billed charges,294.64,100% OF CMS OPPS Rate,340.2,90% of total Billed charges,105.39,100% of Medicaid LA Fee Schedule,105.39,100% of Medicaid LA Fee Schedule,105.39,100% of Medicaid LA Fee Schedule,105.39,100% of Medicaid LA Fee Schedule,105.39,100% of Medicaid LA Fee Schedule,105.39,100% of Medicaid LA Fee Schedule,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,105.39,1043.05,226.8
Outpatient,Laboratory,88362,NERVE TEASING PREPARATION,300,950,2498.97,354% of CMS APC rate,148.87,15.67% of total Billed charges,705.92,100% of CMS OPPS Rate,705.92,100% of CMS OPPS Rate,1102.96,203.89% of BCBS Fee Schedule,665,70% of total Billed Charges,712.5,75% of total Billed Charges,1270.66,180% OF CMS OPPS RATE,760,80% of total Billed Charges,2470.73,350% of CMS Opps rate,720.04,102% of CMS Opps rate,726.75,76.5% of total billed charges,148.87,15.67% of total Billed charges,148.87,15.67% of total Billed charges,705.92,100% of CMS OPPS Rate,705.92,100% of CMS OPPS Rate,427.5,45% of total billed charges,665,70% of total billed charges,570,60% of total billed charges,705.92,100% of CMS OPPS Rate,486.86,90% OF UHC FEE SCHEDULE,665,70% of total billed charges,705.92,100% OF CMS OPPS Rate,1623.62,230% OF CMS OPPS Rate,456,48% of total Billed charges,705.92,100% OF CMS OPPS Rate,855,90% of total Billed charges,148.87,15.67% of total Billed charges,148.87,15.67% of total Billed charges,148.87,15.67% of total Billed charges,148.87,15.67% of total Billed charges,148.87,15.67% of total Billed charges,148.87,15.67% of total Billed charges,705.92,100% of CMS OPPS Rate,705.92,100% of CMS OPPS Rate,705.92,100% of CMS OPPS Rate,705.92,100% of CMS OPPS Rate,705.92,100% of CMS OPPS Rate,705.92,100% of CMS OPPS Rate,705.92,100% of CMS OPPS Rate,705.92,100% of CMS OPPS Rate,148.87,2498.97,570
Outpatient,Laboratory,88364,IN SITU HYBRIDIZATION PER SPEC (EG FISH),300,445.2,80.14,18% of total billed charges for Outpatient Setting,85.85,100% of Medicaid LA Fee Schedule,80.14,18% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,311.64,70% of total Billed Charges,333.9,75% of total Billed Charges,222.6,50% of total Billed Charges,356.16,80% of total Billed Charges,267.12,60% of total Billed Charges,N/A,Not Applicable,340.58,76.5% of total billed charges,85.85,100% of Medicaid LA Fee Schedule,85.85,100% of Medicaid LA Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,200.34,45% of total billed charges,311.64,70% of total billed charges,267.12,60% of total billed charges,N/A,Not Applicable,88.45,90% OF UHC FEE SCHEDULE,311.64,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,213.7,48% of total Billed charges,445.2,100% of total Billed charges,400.68,90% of total Billed charges,85.85,100% of Medicaid LA Fee Schedule,85.85,100% of Medicaid LA Fee Schedule,85.85,100% of Medicaid LA Fee Schedule,85.85,100% of Medicaid LA Fee Schedule,85.85,100% of Medicaid LA Fee Schedule,85.85,100% of Medicaid LA Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,80.14,445.2,267.12
Outpatient,Laboratory,88365,IN SITU HYBRIDIZATION PROBE,300,388,506.06,354% of CMS APC rate,61.04,100% of Medicaid LA Fee Schedule,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,263.39,203.89% of BCBS Fee Schedule,271.6,70% of total Billed Charges,291,75% of total Billed Charges,257.32,180% OF CMS OPPS RATE,310.4,80% of total Billed Charges,500.34,350% of CMS Opps rate,145.81,102% of CMS Opps rate,296.82,76.5% of total billed charges,61.04,100% of Medicaid LA Fee Schedule,61.04,100% of Medicaid LA Fee Schedule,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,174.6,45% of total billed charges,271.6,70% of total billed charges,232.8,60% of total billed charges,142.95,100% of CMS OPPS Rate,116.26,90% OF UHC FEE SCHEDULE,271.6,70% of total billed charges,142.95,100% OF CMS OPPS Rate,328.79,230% OF CMS OPPS Rate,186.24,48% of total Billed charges,142.95,100% OF CMS OPPS Rate,349.2,90% of total Billed charges,61.04,100% of Medicaid LA Fee Schedule,61.04,100% of Medicaid LA Fee Schedule,61.04,100% of Medicaid LA Fee Schedule,61.04,100% of Medicaid LA Fee Schedule,61.04,100% of Medicaid LA Fee Schedule,61.04,100% of Medicaid LA Fee Schedule,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,61.04,506.06,232.8
Outpatient,Laboratory,88367,MORPHOMETRIC ANALYSIS IN SITU,300,804.6,1043.05,354% of CMS APC rate,98.24,100% of Medicaid LA Fee Schedule,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,439.24,203.89% of BCBS Fee Schedule,563.22,70% of total Billed Charges,603.45,75% of total Billed Charges,530.36,180% OF CMS OPPS RATE,643.68,80% of total Billed Charges,1031.26,350% of CMS Opps rate,300.54,102% of CMS Opps rate,615.52,76.5% of total billed charges,98.24,100% of Medicaid LA Fee Schedule,98.24,100% of Medicaid LA Fee Schedule,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,362.07,45% of total billed charges,563.22,70% of total billed charges,482.76,60% of total billed charges,294.64,100% of CMS OPPS Rate,193.89,90% OF UHC FEE SCHEDULE,563.22,70% of total billed charges,294.64,100% OF CMS OPPS Rate,677.69,230% OF CMS OPPS Rate,386.21,48% of total Billed charges,294.64,100% OF CMS OPPS Rate,724.14,90% of total Billed charges,98.24,100% of Medicaid LA Fee Schedule,98.24,100% of Medicaid LA Fee Schedule,98.24,100% of Medicaid LA Fee Schedule,98.24,100% of Medicaid LA Fee Schedule,98.24,100% of Medicaid LA Fee Schedule,98.24,100% of Medicaid LA Fee Schedule,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,98.24,1043.05,482.76
Outpatient,Laboratory,88368,MORPHOMETRIC ANALYSIS EA,300,630,1043.05,354% of CMS APC rate,116.06,100% of Medicaid LA Fee Schedule,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,439.24,203.89% of BCBS Fee Schedule,441,70% of total Billed Charges,472.5,75% of total Billed Charges,530.36,180% OF CMS OPPS RATE,504,80% of total Billed Charges,1031.26,350% of CMS Opps rate,300.54,102% of CMS Opps rate,481.95,76.5% of total billed charges,116.06,100% of Medicaid LA Fee Schedule,116.06,100% of Medicaid LA Fee Schedule,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,283.5,45% of total billed charges,441,70% of total billed charges,378,60% of total billed charges,294.64,100% of CMS OPPS Rate,193.89,90% OF UHC FEE SCHEDULE,441,70% of total billed charges,294.64,100% OF CMS OPPS Rate,677.69,230% OF CMS OPPS Rate,302.4,48% of total Billed charges,294.64,100% OF CMS OPPS Rate,567,90% of total Billed charges,116.06,100% of Medicaid LA Fee Schedule,116.06,100% of Medicaid LA Fee Schedule,116.06,100% of Medicaid LA Fee Schedule,116.06,100% of Medicaid LA Fee Schedule,116.06,100% of Medicaid LA Fee Schedule,116.06,100% of Medicaid LA Fee Schedule,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,294.64,100% of CMS OPPS Rate,116.06,1043.05,378
Outpatient,Laboratory,88372,PROTEIN ANALYSIS TISSUE W BLOT,300,157,28.26,18% of total billed charges for Outpatient Setting,20.47,100% of Medicaid LA Fee Schedule,28.26,18% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,109.9,70% of total Billed Charges,117.75,75% of total Billed Charges,78.5,50% of total Billed Charges,125.6,80% of total Billed Charges,94.2,60% of total Billed Charges,N/A,Not Applicable,120.11,76.5% of total billed charges,20.47,100% of Medicaid LA Fee Schedule,20.47,100% of Medicaid LA Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,70.65,45% of total billed charges,109.9,70% of total billed charges,94.2,60% of total billed charges,N/A,Not Applicable,25.27,90% OF UHC FEE SCHEDULE,109.9,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,75.36,48% of total Billed charges,157,100% of total Billed charges,141.3,90% of total Billed charges,20.47,100% of Medicaid LA Fee Schedule,20.47,100% of Medicaid LA Fee Schedule,20.47,100% of Medicaid LA Fee Schedule,20.47,100% of Medicaid LA Fee Schedule,20.47,100% of Medicaid LA Fee Schedule,20.47,100% of Medicaid LA Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,20.47,157,94.2
Outpatient,Laboratory,88373,MORPHOMETRIC ANALYSIS AUTOMATED,300,330,59.4,18% of total billed charges for Outpatient Setting,53.82,100% of Medicaid LA Fee Schedule,59.4,18% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,231,70% of total Billed Charges,247.5,75% of total Billed Charges,165,50% of total Billed Charges,264,80% of total Billed Charges,198,60% of total Billed Charges,N/A,Not Applicable,252.45,76.5% of total billed charges,53.82,100% of Medicaid LA Fee Schedule,53.82,100% of Medicaid LA Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,148.5,45% of total billed charges,231,70% of total billed charges,198,60% of total billed charges,N/A,Not Applicable,46.33,90% OF UHC FEE SCHEDULE,231,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,158.4,48% of total Billed charges,330,100% of total Billed charges,297,90% of total Billed charges,53.82,100% of Medicaid LA Fee Schedule,53.82,100% of Medicaid LA Fee Schedule,53.82,100% of Medicaid LA Fee Schedule,53.82,100% of Medicaid LA Fee Schedule,53.82,100% of Medicaid LA Fee Schedule,53.82,100% of Medicaid LA Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,46.33,330,198
Outpatient,Laboratory,88374,MORPHOMETRIC ANALYSIS IN SITU QUANT EA,300,664.82,506.06,354% of CMS APC rate,179.59,100% of Medicaid LA Fee Schedule,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,263.39,203.89% of BCBS Fee Schedule,465.37,70% of total Billed Charges,498.62,75% of total Billed Charges,257.32,180% OF CMS OPPS RATE,531.86,80% of total Billed Charges,500.34,350% of CMS Opps rate,145.81,102% of CMS Opps rate,508.59,76.5% of total billed charges,179.59,100% of Medicaid LA Fee Schedule,179.59,100% of Medicaid LA Fee Schedule,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,299.17,45% of total billed charges,465.37,70% of total billed charges,398.89,60% of total billed charges,142.95,100% of CMS OPPS Rate,116.26,90% OF UHC FEE SCHEDULE,465.37,70% of total billed charges,142.95,100% OF CMS OPPS Rate,328.79,230% OF CMS OPPS Rate,319.11,48% of total Billed charges,142.95,100% OF CMS OPPS Rate,598.34,90% of total Billed charges,179.59,100% of Medicaid LA Fee Schedule,179.59,100% of Medicaid LA Fee Schedule,179.59,100% of Medicaid LA Fee Schedule,179.59,100% of Medicaid LA Fee Schedule,179.59,100% of Medicaid LA Fee Schedule,179.59,100% of Medicaid LA Fee Schedule,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,116.26,598.34,398.89
Outpatient,Laboratory,88377,MORPHOMETRIC ANALYSIS EA MULTIPLX PROBE,300,388,506.06,354% of CMS APC rate,189.43,100% of Medicaid LA Fee Schedule,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,263.39,203.89% of BCBS Fee Schedule,271.6,70% of total Billed Charges,291,75% of total Billed Charges,257.32,180% OF CMS OPPS RATE,310.4,80% of total Billed Charges,500.34,350% of CMS Opps rate,145.81,102% of CMS Opps rate,296.82,76.5% of total billed charges,189.43,100% of Medicaid LA Fee Schedule,189.43,100% of Medicaid LA Fee Schedule,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,174.6,45% of total billed charges,271.6,70% of total billed charges,232.8,60% of total billed charges,142.95,100% of CMS OPPS Rate,116.26,90% OF UHC FEE SCHEDULE,271.6,70% of total billed charges,142.95,100% OF CMS OPPS Rate,328.79,230% OF CMS OPPS Rate,186.24,48% of total Billed charges,142.95,100% OF CMS OPPS Rate,349.2,90% of total Billed charges,189.43,100% of Medicaid LA Fee Schedule,189.43,100% of Medicaid LA Fee Schedule,189.43,100% of Medicaid LA Fee Schedule,189.43,100% of Medicaid LA Fee Schedule,189.43,100% of Medicaid LA Fee Schedule,189.43,100% of Medicaid LA Fee Schedule,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,142.95,100% of CMS OPPS Rate,116.26,506.06,232.8
Outpatient,Laboratory,88381,MICRODISSECTION MANUAL,300,466.2,83.92,18% of total billed charges for Outpatient Setting,73.05,15.67% of total Billed charges,83.92,18% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,326.34,70% of total Billed Charges,349.65,75% of total Billed Charges,233.1,50% of total Billed Charges,372.96,80% of total Billed Charges,279.72,60% of total Billed Charges,N/A,Not Applicable,356.64,76.5% of total billed charges,73.05,15.67% of total Billed charges,73.05,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,209.79,45% of total billed charges,326.34,70% of total billed charges,279.72,60% of total billed charges,N/A,Not Applicable,88.78,90% OF UHC FEE SCHEDULE,326.34,70% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,223.78,48% of total Billed charges,466.2,100% of total Billed charges,419.58,90% of total Billed charges,73.05,15.67% of total Billed charges,73.05,15.67% of total Billed charges,73.05,15.67% of total Billed charges,73.05,15.67% of total Billed charges,73.05,15.67% of total Billed charges,73.05,15.67% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,73.05,466.2,279.72
Outpatient,Laboratory,89050,CELL COUNT MISC FLUID,300,89.1,16.7,354% of CMS OPPS Rate,4.72,100% of Medicaid LA Fee Schedule,4.72,100% of CMS OPPS Rate,4.72,100% of CMS OPPS Rate,11.89,203.89% of BCBS Fee Schedule,62.37,70% of total Billed Charges,66.83,75% of total Billed Charges,8.49,180% OF CMS OPPS RATE,71.28,80% of total Billed Charges,16.52,350% of CMS Opps rate,4.81,102% of CMS Opps rate,68.16,76.5% of total billed charges,4.72,100% of Medicaid LA Fee Schedule,4.72,100% of Medicaid LA Fee Schedule,4.72,100% of CMS OPPS Rate,4.72,100% of CMS OPPS Rate,40.1,45% of total billed charges,62.37,70% of total billed charges,53.46,60% of total billed charges,4.72,100% of CMS OPPS Rate,5.25,90% OF UHC FEE SCHEDULE,62.37,70% of total billed charges,4.72,100% OF CMS OPPS Rate,10.85,230% OF CMS OPPS Rate,42.77,48% of total Billed charges,4.72,100% OF CMS OPPS Rate,80.19,90% of total Billed charges,4.72,100% of Medicaid LA Fee Schedule,4.72,100% of Medicaid LA Fee Schedule,4.72,100% of Medicaid LA Fee Schedule,4.72,100% of Medicaid LA Fee Schedule,4.72,100% of Medicaid LA Fee Schedule,4.72,100% of Medicaid LA Fee Schedule,4.72,100% of CMS OPPS Rate,4.72,100% of CMS OPPS Rate,4.72,100% of CMS OPPS Rate,4.72,100% of CMS OPPS Rate,4.72,100% of CMS OPPS Rate,4.72,100% of CMS OPPS Rate,4.72,100% of CMS OPPS Rate,4.72,100% of CMS OPPS Rate,4.72,80.19,53.46
Outpatient,Laboratory,89051,CELL COUNT W DIFF MISC FLUIDS,300,115.5,19.82,354% of CMS OPPS Rate,5.6,100% of Medicaid LA Fee Schedule,5.6,100% of CMS OPPS Rate,5.6,100% of CMS OPPS Rate,13.86,203.89% of BCBS Fee Schedule,80.85,70% of total Billed Charges,86.63,75% of total Billed Charges,10.07,180% OF CMS OPPS RATE,92.4,80% of total Billed Charges,19.59,350% of CMS Opps rate,5.71,102% of CMS Opps rate,88.36,76.5% of total billed charges,5.6,100% of Medicaid LA Fee Schedule,5.6,100% of Medicaid LA Fee Schedule,5.6,100% of CMS OPPS Rate,5.6,100% of CMS OPPS Rate,51.98,45% of total billed charges,80.85,70% of total billed charges,69.3,60% of total billed charges,5.6,100% of CMS OPPS Rate,6.12,90% OF UHC FEE SCHEDULE,80.85,70% of total billed charges,5.6,100% OF CMS OPPS Rate,12.88,230% OF CMS OPPS Rate,55.44,48% of total Billed charges,5.6,100% OF CMS OPPS Rate,103.95,90% of total Billed charges,5.6,100% of Medicaid LA Fee Schedule,5.6,100% of Medicaid LA Fee Schedule,5.6,100% of Medicaid LA Fee Schedule,5.6,100% of Medicaid LA Fee Schedule,5.6,100% of Medicaid LA Fee Schedule,5.6,100% of Medicaid LA Fee Schedule,5.6,100% of CMS OPPS Rate,5.6,100% of CMS OPPS Rate,5.6,100% of CMS OPPS Rate,5.6,100% of CMS OPPS Rate,5.6,100% of CMS OPPS Rate,5.6,100% of CMS OPPS Rate,5.6,100% of CMS OPPS Rate,5.6,100% of CMS OPPS Rate,5.6,103.95,69.3
Outpatient,Laboratory,89055,"LEUKOCYTES, STOOL",300,75.6,15.11,354% of CMS OPPS Rate,4.27,100% of Medicaid LA Fee Schedule,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,10.75,203.89% of BCBS Fee Schedule,52.92,70% of total Billed Charges,56.7,75% of total Billed Charges,7.68,180% OF CMS OPPS RATE,60.48,80% of total Billed Charges,14.94,350% of CMS Opps rate,4.35,102% of CMS Opps rate,57.83,76.5% of total billed charges,4.27,100% of Medicaid LA Fee Schedule,4.27,100% of Medicaid LA Fee Schedule,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,34.02,45% of total billed charges,52.92,70% of total billed charges,45.36,60% of total billed charges,4.26,100% of CMS OPPS Rate,4.74,90% OF UHC FEE SCHEDULE,52.92,70% of total billed charges,4.26,100% OF CMS OPPS Rate,9.82,230% OF CMS OPPS Rate,36.29,48% of total Billed charges,4.26,100% OF CMS OPPS Rate,68.04,90% of total Billed charges,4.27,100% of Medicaid LA Fee Schedule,4.27,100% of Medicaid LA Fee Schedule,4.27,100% of Medicaid LA Fee Schedule,4.27,100% of Medicaid LA Fee Schedule,4.27,100% of Medicaid LA Fee Schedule,4.27,100% of Medicaid LA Fee Schedule,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,100% of CMS OPPS Rate,4.26,68.04,45.36
Outpatient,Laboratory,89060,CRYSTAL ID BY LIGHT MICROSCOPY,300,85.05,25.94,354% of CMS OPPS Rate,7.33,100% of Medicaid LA Fee Schedule,7.33,100% of CMS OPPS Rate,7.33,100% of CMS OPPS Rate,18,203.89% of BCBS Fee Schedule,59.54,70% of total Billed Charges,63.79,75% of total Billed Charges,13.19,180% OF CMS OPPS RATE,68.04,80% of total Billed Charges,25.65,350% of CMS Opps rate,7.47,102% of CMS Opps rate,65.06,76.5% of total billed charges,7.33,100% of Medicaid LA Fee Schedule,7.33,100% of Medicaid LA Fee Schedule,7.33,100% of CMS OPPS Rate,7.33,100% of CMS OPPS Rate,38.27,45% of total billed charges,59.54,70% of total billed charges,51.03,60% of total billed charges,7.33,100% of CMS OPPS Rate,7.95,90% OF UHC FEE SCHEDULE,59.54,70% of total billed charges,7.33,100% OF CMS OPPS Rate,16.85,230% OF CMS OPPS Rate,40.82,48% of total Billed charges,7.33,100% OF CMS OPPS Rate,76.55,90% of total Billed charges,7.33,100% of Medicaid LA Fee Schedule,7.33,100% of Medicaid LA Fee Schedule,7.33,100% of Medicaid LA Fee Schedule,7.33,100% of Medicaid LA Fee Schedule,7.33,100% of Medicaid LA Fee Schedule,7.33,100% of Medicaid LA Fee Schedule,7.33,100% of CMS OPPS Rate,7.33,100% of CMS OPPS Rate,7.33,100% of CMS OPPS Rate,7.33,100% of CMS OPPS Rate,7.33,100% of CMS OPPS Rate,7.33,100% of CMS OPPS Rate,7.33,100% of CMS OPPS Rate,7.33,100% of CMS OPPS Rate,7.33,76.55,51.03
Outpatient,Laboratory,89190,EOSINOPHILS NASAL SMEAR,300,58,20.49,354% of CMS OPPS Rate,5.79,100% of Medicaid LA Fee Schedule,5.79,100% of CMS OPPS Rate,5.79,100% of CMS OPPS Rate,11.95,203.89% of BCBS Fee Schedule,40.6,70% of total Billed Charges,43.5,75% of total Billed Charges,10.42,180% OF CMS OPPS RATE,46.4,80% of total Billed Charges,20.26,350% of CMS Opps rate,5.9,102% of CMS Opps rate,44.37,76.5% of total billed charges,5.79,100% of Medicaid LA Fee Schedule,5.79,100% of Medicaid LA Fee Schedule,5.79,100% of CMS OPPS Rate,5.79,100% of CMS OPPS Rate,26.1,45% of total billed charges,40.6,70% of total billed charges,34.8,60% of total billed charges,5.79,100% of CMS OPPS Rate,5.27,90% OF UHC FEE SCHEDULE,40.6,70% of total billed charges,5.79,100% OF CMS OPPS Rate,13.31,230% OF CMS OPPS Rate,27.84,48% of total Billed charges,5.79,100% OF CMS OPPS Rate,52.2,90% of total Billed charges,5.79,100% of Medicaid LA Fee Schedule,5.79,100% of Medicaid LA Fee Schedule,5.79,100% of Medicaid LA Fee Schedule,5.79,100% of Medicaid LA Fee Schedule,5.79,100% of Medicaid LA Fee Schedule,5.79,100% of Medicaid LA Fee Schedule,5.79,100% of CMS OPPS Rate,5.79,100% of CMS OPPS Rate,5.79,100% of CMS OPPS Rate,5.79,100% of CMS OPPS Rate,5.79,100% of CMS OPPS Rate,5.79,100% of CMS OPPS Rate,5.79,100% of CMS OPPS Rate,5.79,100% of CMS OPPS Rate,5.27,52.2,34.8
Outpatient,Laboratory,89325,SPERM ANTIBODIES,300,77.32,37.77,354% of CMS OPPS Rate,12.12,15.67% of total Billed charges,10.67,100% of CMS OPPS Rate,10.67,100% of CMS OPPS Rate,26.87,203.89% of BCBS Fee Schedule,54.12,70% of total Billed Charges,57.99,75% of total Billed Charges,19.2,180% OF CMS OPPS RATE,61.86,80% of total Billed Charges,37.34,350% of CMS Opps rate,10.88,102% of CMS Opps rate,59.15,76.5% of total billed charges,12.12,15.67% of total Billed charges,12.12,15.67% of total Billed charges,10.67,100% of CMS OPPS Rate,10.67,100% of CMS OPPS Rate,34.79,45% of total billed charges,54.12,70% of total billed charges,46.39,60% of total billed charges,10.67,100% of CMS OPPS Rate,11.86,90% OF UHC FEE SCHEDULE,54.12,70% of total billed charges,10.67,100% OF CMS OPPS Rate,24.54,230% OF CMS OPPS Rate,37.11,48% of total Billed charges,10.67,100% OF CMS OPPS Rate,69.59,90% of total Billed charges,12.12,15.67% of total Billed charges,12.12,15.67% of total Billed charges,12.12,15.67% of total Billed charges,12.12,15.67% of total Billed charges,12.12,15.67% of total Billed charges,12.12,15.67% of total Billed charges,10.67,100% of CMS OPPS Rate,10.67,100% of CMS OPPS Rate,10.67,100% of CMS OPPS Rate,10.67,100% of CMS OPPS Rate,10.67,100% of CMS OPPS Rate,10.67,100% of CMS OPPS Rate,10.67,100% of CMS OPPS Rate,10.67,100% of CMS OPPS Rate,10.67,69.59,46.39
Outpatient,Outpatient Surgical And Diagnostice Procedures,19120,REMOVAL OF BREAST LESION,360,5467,11063.57,354% of CMS APC rate,N/A,Not Applicable,3125.3,100% of CMS OPPS Rate,3125.3,100% of CMS OPPS Rate,5450.55,203.89% of ASC Tier Grouping Fee Schedule,3826.9,70% of total Billed Charges,4100.25,75% of total Billed Charges,5625.54,180% OF CMS OPPS RATE,4373.6,80% of total Billed Charges,10938.56,350% of CMS Opps rate,3187.8,102% of CMS Opps rate,4182.26,76.5% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,3125.3,100% of CMS OPPS Rate,3125.3,100% of CMS OPPS Rate,2460.15,45% of total billed charges,3826.9,70% of total billed charges,3280.2,60% of total billed charges,3125.3,100% of CMS OPPS Rate,1665,100% OF UHC ASC Tier Grouping,3826.9,70% of total billed charges,3125.3,100% OF CMS OPPS Rate,7188.19,230% OF CMS OPPS Rate,2624.16,48% of total Billed charges,3125.3,100% OF CMS OPPS Rate,4920.3,90% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,3125.3,100% of CMS OPPS Rate,3125.3,100% of CMS OPPS Rate,3125.3,100% of CMS OPPS Rate,3125.3,100% of CMS OPPS Rate,3125.3,100% of CMS OPPS Rate,3125.3,100% of CMS OPPS Rate,3125.3,100% of CMS OPPS Rate,3125.3,100% of CMS OPPS Rate,1665,11063.57,3280.2
Outpatient,Outpatient Surgical And Diagnostice Procedures,20610,Draining or injecting medication into a major joint/bursa without ultrasound,360,195,875,354% of CMS APC rate,N/A,Not Applicable,247.17,100% of CMS OPPS Rate,195,100% of CMS OPPS Rate,498.92,203.89% of ASC Tier Grouping Fee Schedule,136.5,70% of total Billed Charges,146.25,75% of total Billed Charges,444.91,180% OF CMS OPPS RATE,156,80% of total Billed Charges,865.1,350% of CMS Opps rate,195,102% of CMS Opps rate,149.18,76.5% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,247.17,100% of CMS OPPS Rate,247.17,100% of CMS OPPS Rate,87.75,45% of total billed charges,136.5,70% of total billed charges,117,60% of total billed charges,247.17,100% of CMS OPPS Rate,657,100% OF UHC ASC Tier Grouping,136.5,70% of total billed charges,247.17,100% OF CMS OPPS Rate,568.49,230% OF CMS OPPS Rate,93.6,48% of total Billed charges,195,100% OF CMS OPPS Rate,175.5,90% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,247.17,100% of CMS OPPS Rate,247.17,100% of CMS OPPS Rate,247.17,100% of CMS OPPS Rate,247.17,100% of CMS OPPS Rate,247.17,100% of CMS OPPS Rate,247.17,100% of CMS OPPS Rate,247.17,100% of CMS OPPS Rate,247.17,100% of CMS OPPS Rate,87.75,875,117
Outpatient,Outpatient Surgical And Diagnostice Procedures,24340,TENODESIS BICEPS TENDON ELBOW SEPARATE PROCEDURE,360,N/A,21287.29,354% of CMS APC rate,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,N/A,Not Applicable,9716.3,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,10824.04,180% OF CMS OPPS RATE,N/A,Not Applicable,21046.75,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,2385,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,6013.36,100% OF CMS OPPS Rate,13830.72,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,2385,21287.29,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,24341,REPAIR TENDON/MUSCLE UPPER ARM/ELBOW EA,360,N/A,21287.29,354% of CMS APC rate,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,N/A,Not Applicable,10745.06,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,10824.04,180% OF CMS OPPS RATE,N/A,Not Applicable,21046.75,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,2385,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,6013.36,100% OF CMS OPPS Rate,13830.72,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,2385,21287.29,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,24342,RINSJ RPTD BICEPS/TRICEPS TDN DSTL W/WO TDN GRF,360,N/A,21287.29,354% of CMS APC rate,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,N/A,Not Applicable,11202.31,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,10824.04,180% OF CMS OPPS RATE,N/A,Not Applicable,21046.75,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,2385,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,6013.36,100% OF CMS OPPS Rate,13830.72,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,2385,21287.29,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,24586,OPTX PERIARTICULAR FRACTURE &/DISLOCATION ELBO,360,N/A,41991.51,354% of CMS APC rate,N/A,Not Applicable,11862.01,100% of CMS OPPS Rate,N/A,Not Applicable,20639.62,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,21351.61,180% OF CMS OPPS RATE,N/A,Not Applicable,41517.03,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,11862.01,100% of CMS OPPS Rate,11862.01,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,11862.01,100% of CMS OPPS Rate,2895,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,11862.01,100% OF CMS OPPS Rate,27282.61,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,11862.01,100% of CMS OPPS Rate,11862.01,100% of CMS OPPS Rate,11862.01,100% of CMS OPPS Rate,11862.01,100% of CMS OPPS Rate,11862.01,100% of CMS OPPS Rate,11862.01,100% of CMS OPPS Rate,11862.01,100% of CMS OPPS Rate,11862.01,100% of CMS OPPS Rate,2895,41991.51,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,24665,OPEN TX RADIAL HEAD/NECK FRACTURE,360,N/A,21287.29,354% of CMS APC rate,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,N/A,Not Applicable,10745.06,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,10824.04,180% OF CMS OPPS RATE,N/A,Not Applicable,21046.75,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,2895,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,6013.36,100% OF CMS OPPS Rate,13830.72,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,2895,21287.29,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,24685,PEN TREATMENT ULNAR FRACTURE PROXIMAL END,360,N/A,21287.29,354% of CMS APC rate,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,N/A,Not Applicable,10745.06,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,10824.04,180% OF CMS OPPS RATE,N/A,Not Applicable,21046.75,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,2895,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,6013.36,100% OF CMS OPPS Rate,13830.72,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,2895,21287.29,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,25116,RAD EXC BURSA SYNVA WRST/F/ARM TDN SHTHS XTNSRS,360,N/A,9579.52,354% of CMS APC rate,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,N/A,Not Applicable,5069.77,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,4870.93,180% OF CMS OPPS RATE,N/A,Not Applicable,9471.28,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,1665,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,2706.08,100% OF CMS OPPS Rate,6223.98,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,1665,9579.52,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,25545,OPEN TREATMENT OF ULNAR SHAFT FRACTURE,360,N/A,21287.29,354% of CMS APC rate,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,N/A,Not Applicable,11202.31,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,10824.04,180% OF CMS OPPS RATE,N/A,Not Applicable,21046.75,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,2895,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,6013.36,100% OF CMS OPPS Rate,13830.72,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,2895,21287.29,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,25607,OPTX DSTL RADL X-ARTIC FX/EPIPHYSL SEP,360,N/A,21287.29,354% of CMS APC rate,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,N/A,Not Applicable,11202.31,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,10824.04,180% OF CMS OPPS RATE,N/A,Not Applicable,21046.75,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,2895,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,6013.36,100% OF CMS OPPS Rate,13830.72,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,2895,21287.29,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,25608,OPTX DSTL RADL I-ARTIC FX/EPIPHYSL SEP 2 FRAG,360,N/A,21287.29,354% of CMS APC rate,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,N/A,Not Applicable,10745.06,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,10824.04,180% OF CMS OPPS RATE,N/A,Not Applicable,21046.75,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,2895,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,6013.36,100% OF CMS OPPS Rate,13830.72,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,2895,21287.29,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,25609,OPTX DSTL RADL I-ARTIC FX/EPIPHYSL SEP 3 FRAG,360,N/A,21287.29,354% of CMS APC rate,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,N/A,Not Applicable,9716.3,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,10824.04,180% OF CMS OPPS RATE,N/A,Not Applicable,21046.75,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,2895,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,6013.36,100% OF CMS OPPS Rate,13830.72,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,2895,21287.29,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,25652,OPEN TREATMENT ULNAR STYLOID FRACTURE,360,N/A,21287.29,354% of CMS APC rate,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,N/A,Not Applicable,11430.93,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,10824.04,180% OF CMS OPPS RATE,N/A,Not Applicable,21046.75,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,2895,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,6013.36,100% OF CMS OPPS Rate,13830.72,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,2895,21287.29,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,27130,ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT,360,N/A,41991.51,354% of CMS APC rate,N/A,Not Applicable,11862.01,100% of CMS OPPS Rate,N/A,Not Applicable,20639.62,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,21351.61,180% OF CMS OPPS RATE,N/A,Not Applicable,41517.03,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,11862.01,100% of CMS OPPS Rate,11862.01,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,11862.01,100% of CMS OPPS Rate,3565,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,11862.01,100% OF CMS OPPS Rate,27282.61,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,11862.01,100% of CMS OPPS Rate,11862.01,100% of CMS OPPS Rate,11862.01,100% of CMS OPPS Rate,11862.01,100% of CMS OPPS Rate,11862.01,100% of CMS OPPS Rate,11862.01,100% of CMS OPPS Rate,11862.01,100% of CMS OPPS Rate,11862.01,100% of CMS OPPS Rate,3565,41991.51,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,27606,TENOTOMY PRQ ACHILLES TENDON SPX GENERAL ANES,360,N/A,9579.52,354% of CMS APC rate,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,N/A,Not Applicable,3613.54,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,4870.93,180% OF CMS OPPS RATE,N/A,Not Applicable,9471.28,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,1665,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,2706.08,100% OF CMS OPPS Rate,6223.98,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,1665,9579.52,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,27626,ARTHROTOMY W/SYNOVECTOMY ANKLE TENOSYNOVECTOMY,360,N/A,9579.52,354% of CMS APC rate,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,N/A,Not Applicable,3613.54,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,4870.93,180% OF CMS OPPS RATE,N/A,Not Applicable,9471.28,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2028,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,2706.08,100% OF CMS OPPS Rate,6223.98,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2028,9579.52,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,27658,REPAIR FLEXOR TENDON LEG PRIMARY W/O GRAFT EACH,360,N/A,9579.52,354% of CMS APC rate,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,N/A,Not Applicable,3613.54,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,4870.93,180% OF CMS OPPS RATE,N/A,Not Applicable,9471.28,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,1665,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,2706.08,100% OF CMS OPPS Rate,6223.98,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,1665,9579.52,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,27769,OPEN TREATMENT POSTERIOR MALLEOLUS FRACTURE,360,N/A,21287.29,354% of CMS APC rate,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,N/A,Not Applicable,9716.3,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,10824.04,180% OF CMS OPPS RATE,N/A,Not Applicable,21046.75,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,2895,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,6013.36,100% OF CMS OPPS Rate,13830.72,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,2895,21287.29,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,27792,OPEN TX DISTAL FIBULAR FRACTURE LAT MALLEOLUS,360,N/A,21287.29,354% of CMS APC rate,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,N/A,Not Applicable,9716.3,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,10824.04,180% OF CMS OPPS RATE,N/A,Not Applicable,21046.75,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,2895,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,6013.36,100% OF CMS OPPS Rate,13830.72,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,2895,21287.29,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,27814,OPEN TREATMENT BIMALLEOLAR ANKLE FRACTURE,360,N/A,21287.29,354% of CMS APC rate,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,N/A,Not Applicable,9716.3,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,10824.04,180% OF CMS OPPS RATE,N/A,Not Applicable,21046.75,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,2895,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,6013.36,100% OF CMS OPPS Rate,13830.72,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,2895,21287.29,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,27822,OPEN TX TRIMALLEOLAR ANKLE FX W/O FIXJ PST LIP,360,N/A,21287.29,354% of CMS APC rate,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,N/A,Not Applicable,9716.3,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,10824.04,180% OF CMS OPPS RATE,N/A,Not Applicable,21046.75,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,2895,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,6013.36,100% OF CMS OPPS Rate,13830.72,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,2895,21287.29,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,27823,OPEN TX TRIMALLEOLAR ANKLE FX W/FIXJ PST LIP,360,N/A,21287.29,354% of CMS APC rate,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,N/A,Not Applicable,10745.06,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,10824.04,180% OF CMS OPPS RATE,N/A,Not Applicable,21046.75,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,2895,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,6013.36,100% OF CMS OPPS Rate,13830.72,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,2895,21287.29,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,27827,OPEN TREATMENT FRACTURE DISTAL TIBIA ONLY,360,N/A,41991.51,354% of CMS APC rate,N/A,Not Applicable,11862.01,100% of CMS OPPS Rate,N/A,Not Applicable,19401.23,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,21351.61,180% OF CMS OPPS RATE,N/A,Not Applicable,41517.03,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,11862.01,100% of CMS OPPS Rate,11862.01,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,11862.01,100% of CMS OPPS Rate,2895,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,11862.01,100% OF CMS OPPS Rate,27282.61,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,11862.01,100% of CMS OPPS Rate,11862.01,100% of CMS OPPS Rate,11862.01,100% of CMS OPPS Rate,11862.01,100% of CMS OPPS Rate,11862.01,100% of CMS OPPS Rate,11862.01,100% of CMS OPPS Rate,11862.01,100% of CMS OPPS Rate,11862.01,100% of CMS OPPS Rate,2895,41991.51,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,27828,OPEN TREATMENT FRACTURE DISTAL TIBIA & FIBULA,360,N/A,41991.51,354% of CMS APC rate,N/A,Not Applicable,11862.01,100% of CMS OPPS Rate,N/A,Not Applicable,19401.23,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,21351.61,180% OF CMS OPPS RATE,N/A,Not Applicable,41517.03,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,11862.01,100% of CMS OPPS Rate,11862.01,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,11862.01,100% of CMS OPPS Rate,2895,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,11862.01,100% OF CMS OPPS Rate,27282.61,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,11862.01,100% of CMS OPPS Rate,11862.01,100% of CMS OPPS Rate,11862.01,100% of CMS OPPS Rate,11862.01,100% of CMS OPPS Rate,11862.01,100% of CMS OPPS Rate,11862.01,100% of CMS OPPS Rate,11862.01,100% of CMS OPPS Rate,11862.01,100% of CMS OPPS Rate,2895,41991.51,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,28200,RPR TDN FLXR FOOT 1/2 W/O FREE GRAFG EACH TENDON,360,N/A,9579.52,354% of CMS APC rate,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,N/A,Not Applicable,4584.36,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,4870.93,180% OF CMS OPPS RATE,N/A,Not Applicable,9471.28,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,1665,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,2706.08,100% OF CMS OPPS Rate,6223.98,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,1665,9579.52,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,28208,REPAIR TENDON EXTENSOR FOOT 1/2 EACH TENDON,360,N/A,9579.52,354% of CMS APC rate,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,N/A,Not Applicable,4584.36,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,4870.93,180% OF CMS OPPS RATE,N/A,Not Applicable,9471.28,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,1665,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,2706.08,100% OF CMS OPPS Rate,6223.98,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,1665,9579.52,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,29822,ARTHROSCOPY SHOULDER SURG DEBRIDEMENT LIMITED,360,N/A,9579.52,354% of CMS APC rate,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,N/A,Not Applicable,4584.36,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,4870.93,180% OF CMS OPPS RATE,N/A,Not Applicable,9471.28,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2028,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,2706.08,100% OF CMS OPPS Rate,6223.98,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2028,9579.52,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,29823,ARTHROSCOPY SHOULDER SURG DEBRIDEMENT EXTENSIVE,360,N/A,9579.52,354% of CMS APC rate,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,N/A,Not Applicable,3613.54,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,4870.93,180% OF CMS OPPS RATE,N/A,Not Applicable,9471.28,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2895,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,2706.08,100% OF CMS OPPS Rate,6223.98,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,9579.52,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,29824,ARTHROSCOPY SHOULDER DISTAL CLAVICULECTOMY,360,N/A,9579.52,354% of CMS APC rate,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,N/A,Not Applicable,3613.54,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,4870.93,180% OF CMS OPPS RATE,N/A,Not Applicable,9471.28,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2895,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,2706.08,100% OF CMS OPPS Rate,6223.98,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,9579.52,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,29827,ARTHROSCOPY SHOULDER ROTATOR CUFF REPAIR,360,N/A,21287.29,354% of CMS APC rate,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,N/A,Not Applicable,8687.51,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,10824.04,180% OF CMS OPPS RATE,N/A,Not Applicable,21046.75,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,2895,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,6013.36,100% OF CMS OPPS Rate,13830.72,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,2895,21287.29,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,29875,ARTHROSCOPY KNEE SYNOVECTOMY LIMITED SPX,360,N/A,9579.52,354% of CMS APC rate,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,N/A,Not Applicable,5069.77,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,4870.93,180% OF CMS OPPS RATE,N/A,Not Applicable,9471.28,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2028,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,2706.08,100% OF CMS OPPS Rate,6223.98,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2028,9579.52,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,29877,ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG,360,N/A,9579.52,354% of CMS APC rate,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,N/A,Not Applicable,5069.77,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,4870.93,180% OF CMS OPPS RATE,N/A,Not Applicable,9471.28,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2028,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,2706.08,100% OF CMS OPPS Rate,6223.98,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2028,9579.52,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,29880,Surgery to remove of all or part of a torn meniscus in both medial and lateral compartments,360,N/A,9579.52,354% of CMS APC rate,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,N/A,Not Applicable,5069.77,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,4870.93,180% OF CMS OPPS RATE,N/A,Not Applicable,9471.28,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2028,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,2706.08,100% OF CMS OPPS Rate,6223.98,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2028,9579.52,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,29881,Surgery to remove of all or part of a torn meniscus in one compartment,360,N/A,9579.52,354% of CMS APC rate,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,N/A,Not Applicable,5069.77,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,4870.93,180% OF CMS OPPS RATE,N/A,Not Applicable,9471.28,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2028,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,2706.08,100% OF CMS OPPS Rate,6223.98,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2028,9579.52,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,29882,ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL/LATERAL,360,N/A,9579.52,354% of CMS APC rate,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,N/A,Not Applicable,4584.36,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,4870.93,180% OF CMS OPPS RATE,N/A,Not Applicable,9471.28,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2028,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,2706.08,100% OF CMS OPPS Rate,6223.98,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2028,9579.52,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,29883,ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL&LATERAL,360,N/A,9579.52,354% of CMS APC rate,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,N/A,Not Applicable,3613.54,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,4870.93,180% OF CMS OPPS RATE,N/A,Not Applicable,9471.28,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2028,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,2706.08,100% OF CMS OPPS Rate,6223.98,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2028,9579.52,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,29884,ARTHROSCOPY KNEE W/LYSIS ADHESIONS W/WO MANJ SPX,360,N/A,9579.52,354% of CMS APC rate,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,N/A,Not Applicable,5069.77,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,4870.93,180% OF CMS OPPS RATE,N/A,Not Applicable,9471.28,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2028,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,2706.08,100% OF CMS OPPS Rate,6223.98,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2028,9579.52,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,29895,ARTHROSCOPY ANKLE SURGICAL SYNOVECTOMY PARTIAL,360,N/A,9579.52,354% of CMS APC rate,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,N/A,Not Applicable,4098.94,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,4870.93,180% OF CMS OPPS RATE,N/A,Not Applicable,9471.28,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2028,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,2706.08,100% OF CMS OPPS Rate,6223.98,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2706.08,100% of CMS OPPS Rate,2028,9579.52,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,30400,RHINP PRIM LAT&ALAR CRTLGS&/ELVTN NASAL TI,360,5010,17184.2,354% of CMS APC rate,N/A,Not Applicable,4854.29,100% of CMS OPPS Rate,4854.29,100% of CMS OPPS Rate,6723.23,203.89% of ASC Tier Grouping Fee Schedule,3507,70% of total Billed Charges,3757.5,75% of total Billed Charges,8737.71,180% OF CMS OPPS RATE,4008,80% of total Billed Charges,16990.02,350% of CMS Opps rate,4951.37,102% of CMS Opps rate,3832.65,76.5% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,4854.29,100% of CMS OPPS Rate,4854.29,100% of CMS OPPS Rate,2254.5,45% of total billed charges,3507,70% of total billed charges,3006,60% of total billed charges,4854.29,100% of CMS OPPS Rate,1665,100% OF UHC ASC Tier Grouping,3507,70% of total billed charges,4854.29,100% OF CMS OPPS Rate,11164.87,230% OF CMS OPPS Rate,2404.8,48% of total Billed charges,4854.29,100% OF CMS OPPS Rate,4509,90% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,4854.29,100% of CMS OPPS Rate,4854.29,100% of CMS OPPS Rate,4854.29,100% of CMS OPPS Rate,4854.29,100% of CMS OPPS Rate,4854.29,100% of CMS OPPS Rate,4854.29,100% of CMS OPPS Rate,4854.29,100% of CMS OPPS Rate,4854.29,100% of CMS OPPS Rate,1665,17184.2,3006
Outpatient,Outpatient Surgical And Diagnostice Procedures,30420,RHINOPLASTY PRIMARY W/MAJOR SEPTAL REPAIR,360,N/A,17184.2,354% of CMS APC rate,N/A,Not Applicable,4854.29,100% of CMS OPPS Rate,N/A,Not Applicable,5927.06,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,8737.71,180% OF CMS OPPS RATE,N/A,Not Applicable,16990.02,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,4854.29,100% of CMS OPPS Rate,4854.29,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,4854.29,100% of CMS OPPS Rate,2385,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,4854.29,100% OF CMS OPPS Rate,11164.87,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,4854.29,100% of CMS OPPS Rate,4854.29,100% of CMS OPPS Rate,4854.29,100% of CMS OPPS Rate,4854.29,100% of CMS OPPS Rate,4854.29,100% of CMS OPPS Rate,4854.29,100% of CMS OPPS Rate,4854.29,100% of CMS OPPS Rate,4854.29,100% of CMS OPPS Rate,2385,17184.2,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,30520,Repair procedures of the nose,360,N/A,9155.9,354% of CMS APC rate,N/A,Not Applicable,2586.41,100% of CMS OPPS Rate,N/A,Not Applicable,2017.65,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,4655.54,180% OF CMS OPPS RATE,N/A,Not Applicable,9052.45,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2586.41,100% of CMS OPPS Rate,2586.41,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2586.41,100% of CMS OPPS Rate,1665,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,2586.41,100% OF CMS OPPS Rate,5948.75,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2586.41,100% of CMS OPPS Rate,2586.41,100% of CMS OPPS Rate,2586.41,100% of CMS OPPS Rate,2586.41,100% of CMS OPPS Rate,2586.41,100% of CMS OPPS Rate,2586.41,100% of CMS OPPS Rate,2586.41,100% of CMS OPPS Rate,2586.41,100% of CMS OPPS Rate,1665,9155.9,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,31237,"Surgical nasal/ sinus endoscopy with biopsy, polypectomy or debridement",360,N/A,5144.5,354% of CMS APC rate,N/A,Not Applicable,1453.25,100% of CMS OPPS Rate,N/A,Not Applicable,2051.15,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,2615.84,180% OF CMS OPPS RATE,N/A,Not Applicable,5086.37,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,1453.25,100% of CMS OPPS Rate,1453.25,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,1453.25,100% of CMS OPPS Rate,1280,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,1453.25,100% OF CMS OPPS Rate,3342.47,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,1453.25,100% of CMS OPPS Rate,1453.25,100% of CMS OPPS Rate,1453.25,100% of CMS OPPS Rate,1453.25,100% of CMS OPPS Rate,1453.25,100% of CMS OPPS Rate,1453.25,100% of CMS OPPS Rate,1453.25,100% of CMS OPPS Rate,1453.25,100% of CMS OPPS Rate,1280,5144.5,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,37221,REVSC OPN/PRQ ILIAC ART W/STNT PLMT & ANGIOPLSTY,360,26820,34162.33,354% of CMS APC rate,N/A,Not Applicable,9650.37,100% of CMS OPPS Rate,9650.37,100% of CMS OPPS Rate,18215.31,203.89% of ASC Tier Grouping Fee Schedule,18774,70% of total Billed Charges,20115,75% of total Billed Charges,17370.66,180% OF CMS OPPS RATE,21456,80% of total Billed Charges,33776.32,350% of CMS Opps rate,9843.37,102% of CMS Opps rate,20517.3,76.5% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,9650.37,100% of CMS OPPS Rate,9650.37,100% of CMS OPPS Rate,12069,45% of total billed charges,18774,70% of total billed charges,16092,60% of total billed charges,9650.37,100% of CMS OPPS Rate,3565,100% OF UHC ASC Tier Grouping,18774,70% of total billed charges,9650.37,100% OF CMS OPPS Rate,22195.86,230% OF CMS OPPS Rate,12873.6,48% of total Billed charges,9650.37,100% OF CMS OPPS Rate,24138,90% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,9650.37,100% of CMS OPPS Rate,9650.37,100% of CMS OPPS Rate,9650.37,100% of CMS OPPS Rate,9650.37,100% of CMS OPPS Rate,9650.37,100% of CMS OPPS Rate,9650.37,100% of CMS OPPS Rate,9650.37,100% of CMS OPPS Rate,9650.37,100% of CMS OPPS Rate,3565,34162.33,16092
Outpatient,Outpatient Surgical And Diagnostice Procedures,37226,REVSC OPN/PRQ FEM/POP W/STNT/ANGIOP SM VSL,360,26820,34162.33,354% of CMS APC rate,N/A,Not Applicable,9650.37,100% of CMS OPPS Rate,9650.37,100% of CMS OPPS Rate,18215.31,203.89% of ASC Tier Grouping Fee Schedule,18774,70% of total Billed Charges,20115,75% of total Billed Charges,17370.66,180% OF CMS OPPS RATE,21456,80% of total Billed Charges,33776.32,350% of CMS Opps rate,9843.37,102% of CMS Opps rate,20517.3,76.5% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,9650.37,100% of CMS OPPS Rate,9650.37,100% of CMS OPPS Rate,12069,45% of total billed charges,18774,70% of total billed charges,16092,60% of total billed charges,9650.37,100% of CMS OPPS Rate,3565,100% OF UHC ASC Tier Grouping,18774,70% of total billed charges,9650.37,100% OF CMS OPPS Rate,22195.86,230% OF CMS OPPS Rate,12873.6,48% of total Billed charges,9650.37,100% OF CMS OPPS Rate,24138,90% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,9650.37,100% of CMS OPPS Rate,9650.37,100% of CMS OPPS Rate,9650.37,100% of CMS OPPS Rate,9650.37,100% of CMS OPPS Rate,9650.37,100% of CMS OPPS Rate,9650.37,100% of CMS OPPS Rate,9650.37,100% of CMS OPPS Rate,9650.37,100% of CMS OPPS Rate,3565,34162.33,16092
Outpatient,Outpatient Surgical And Diagnostice Procedures,41800,DRG ABSC CST HMTMA FROM DENTOALVEOLAR STRUXS,360,160.8,373.66,354% of CMS APC rate,N/A,Not Applicable,105.55,100% of CMS OPPS Rate,105.55,100% of CMS OPPS Rate,214.17,203.89% of ASC Tier Grouping Fee Schedule,112.56,70% of total Billed Charges,120.6,75% of total Billed Charges,190,180% OF CMS OPPS RATE,128.64,80% of total Billed Charges,369.44,350% of CMS Opps rate,107.66,102% of CMS Opps rate,123.01,76.5% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,105.55,100% of CMS OPPS Rate,105.55,100% of CMS OPPS Rate,72.36,45% of total billed charges,112.56,70% of total billed charges,96.48,60% of total billed charges,105.55,100% of CMS OPPS Rate,657,100% OF UHC ASC Tier Grouping,112.56,70% of total billed charges,105.55,100% OF CMS OPPS Rate,242.77,230% OF CMS OPPS Rate,77.18,48% of total Billed charges,105.55,100% OF CMS OPPS Rate,144.72,90% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,105.55,100% of CMS OPPS Rate,105.55,100% of CMS OPPS Rate,105.55,100% of CMS OPPS Rate,105.55,100% of CMS OPPS Rate,105.55,100% of CMS OPPS Rate,105.55,100% of CMS OPPS Rate,105.55,100% of CMS OPPS Rate,105.55,100% of CMS OPPS Rate,72.36,657,96.48
Outpatient,Outpatient Surgical And Diagnostice Procedures,42700,I&D ABSCESS PERITONSILLAR,360,N/A,668.83,354% of CMS APC rate,N/A,Not Applicable,188.93,100% of CMS OPPS Rate,N/A,Not Applicable,363.94,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,340.08,180% OF CMS OPPS RATE,N/A,Not Applicable,661.27,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,188.93,100% of CMS OPPS Rate,188.93,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,188.93,100% of CMS OPPS Rate,657,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,188.93,100% OF CMS OPPS Rate,434.54,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,188.93,100% of CMS OPPS Rate,188.93,100% of CMS OPPS Rate,188.93,100% of CMS OPPS Rate,188.93,100% of CMS OPPS Rate,188.93,100% of CMS OPPS Rate,188.93,100% of CMS OPPS Rate,188.93,100% of CMS OPPS Rate,188.93,100% of CMS OPPS Rate,188.93,668.83,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,43246,EGD PERCUTANEOUS PLACEMENT GASTROSTOMY TUBE,360,1197.2,5604.8,354% of CMS APC rate,N/A,Not Applicable,1583.28,100% of CMS OPPS Rate,1197.2,100% of CMS OPPS Rate,2735.69,203.89% of ASC Tier Grouping Fee Schedule,838.04,70% of total Billed Charges,897.9,75% of total Billed Charges,2849.9,180% OF CMS OPPS RATE,957.76,80% of total Billed Charges,5541.47,350% of CMS Opps rate,1197.2,102% of CMS Opps rate,915.86,76.5% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,1583.28,100% of CMS OPPS Rate,1583.28,100% of CMS OPPS Rate,538.74,45% of total billed charges,838.04,70% of total billed charges,718.32,60% of total billed charges,1583.28,100% of CMS OPPS Rate,1280,100% OF UHC ASC Tier Grouping,838.04,70% of total billed charges,1583.28,100% OF CMS OPPS Rate,3641.53,230% OF CMS OPPS Rate,574.66,48% of total Billed charges,1197.2,100% OF CMS OPPS Rate,1077.48,90% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,1583.28,100% of CMS OPPS Rate,1583.28,100% of CMS OPPS Rate,1583.28,100% of CMS OPPS Rate,1583.28,100% of CMS OPPS Rate,1583.28,100% of CMS OPPS Rate,1583.28,100% of CMS OPPS Rate,1583.28,100% of CMS OPPS Rate,1583.28,100% of CMS OPPS Rate,538.74,5604.8,718.32
Outpatient,Outpatient Surgical And Diagnostice Procedures,43774,LAPS GASTRIC RESTRICTIVE PX REMOVE DEVICE & PORT,360,N/A,10493.59,354% of CMS APC rate,N/A,Not Applicable,2964.29,100% of CMS OPPS Rate,N/A,Not Applicable,4754.55,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,5335.72,180% OF CMS OPPS RATE,N/A,Not Applicable,10375.02,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2964.29,100% of CMS OPPS Rate,2964.29,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2964.29,100% of CMS OPPS Rate,3565,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,2964.29,100% OF CMS OPPS Rate,6817.86,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2964.29,100% of CMS OPPS Rate,2964.29,100% of CMS OPPS Rate,2964.29,100% of CMS OPPS Rate,2964.29,100% of CMS OPPS Rate,2964.29,100% of CMS OPPS Rate,2964.29,100% of CMS OPPS Rate,2964.29,100% of CMS OPPS Rate,2964.29,100% of CMS OPPS Rate,2964.29,10493.59,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,46220,EXCISION SINGLE EXTERNAL PAPILLA OR TAG ANUS,360,N/A,3485.03,354% of CMS APC rate,N/A,Not Applicable,984.47,100% of CMS OPPS Rate,N/A,Not Applicable,1909.21,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,1772.04,180% OF CMS OPPS RATE,N/A,Not Applicable,3445.65,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,984.47,100% of CMS OPPS Rate,984.47,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,984.47,100% of CMS OPPS Rate,1280,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,984.47,100% OF CMS OPPS Rate,2264.28,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,984.47,100% of CMS OPPS Rate,984.47,100% of CMS OPPS Rate,984.47,100% of CMS OPPS Rate,984.47,100% of CMS OPPS Rate,984.47,100% of CMS OPPS Rate,984.47,100% of CMS OPPS Rate,984.47,100% of CMS OPPS Rate,984.47,100% of CMS OPPS Rate,984.47,3485.03,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,46255,HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP,360,N/A,8269.1,354% of CMS APC rate,N/A,Not Applicable,2335.89,100% of CMS OPPS Rate,N/A,Not Applicable,4438.05,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,4204.62,180% OF CMS OPPS RATE,N/A,Not Applicable,8175.66,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2335.89,100% of CMS OPPS Rate,2335.89,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2335.89,100% of CMS OPPS Rate,1665,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,2335.89,100% OF CMS OPPS Rate,5372.58,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2335.89,100% of CMS OPPS Rate,2335.89,100% of CMS OPPS Rate,2335.89,100% of CMS OPPS Rate,2335.89,100% of CMS OPPS Rate,2335.89,100% of CMS OPPS Rate,2335.89,100% of CMS OPPS Rate,2335.89,100% of CMS OPPS Rate,2335.89,100% of CMS OPPS Rate,1665,8269.1,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,46260,HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO,360,N/A,8269.1,354% of CMS APC rate,N/A,Not Applicable,2335.89,100% of CMS OPPS Rate,N/A,Not Applicable,4626.92,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,4204.62,180% OF CMS OPPS RATE,N/A,Not Applicable,8175.66,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2335.89,100% of CMS OPPS Rate,2335.89,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2335.89,100% of CMS OPPS Rate,1665,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,2335.89,100% OF CMS OPPS Rate,5372.58,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2335.89,100% of CMS OPPS Rate,2335.89,100% of CMS OPPS Rate,2335.89,100% of CMS OPPS Rate,2335.89,100% of CMS OPPS Rate,2335.89,100% of CMS OPPS Rate,2335.89,100% of CMS OPPS Rate,2335.89,100% of CMS OPPS Rate,2335.89,100% of CMS OPPS Rate,1665,8269.1,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,47562,Removal of gallbladder using an endoscope,360,N/A,16773.81,354% of CMS APC rate,N/A,Not Applicable,4738.35,100% of CMS OPPS Rate,N/A,Not Applicable,8968.94,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,8529.04,180% OF CMS OPPS RATE,N/A,Not Applicable,16584.27,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,4738.35,100% of CMS OPPS Rate,4738.35,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,4738.35,100% of CMS OPPS Rate,2895,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,4738.35,100% OF CMS OPPS Rate,10898.23,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,4738.35,100% of CMS OPPS Rate,4738.35,100% of CMS OPPS Rate,4738.35,100% of CMS OPPS Rate,4738.35,100% of CMS OPPS Rate,4738.35,100% of CMS OPPS Rate,4738.35,100% of CMS OPPS Rate,4738.35,100% of CMS OPPS Rate,4738.35,100% of CMS OPPS Rate,2895,16773.81,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,49440,INSERT GASTROSTOMY TUBE PERCUTANEOUS,360,1680,5604.8,354% of CMS APC rate,N/A,Not Applicable,1583.28,100% of CMS OPPS Rate,1583.28,100% of CMS OPPS Rate,2852.09,203.89% of ASC Tier Grouping Fee Schedule,1176,70% of total Billed Charges,1260,75% of total Billed Charges,2849.9,180% OF CMS OPPS RATE,1344,80% of total Billed Charges,5541.47,350% of CMS Opps rate,1614.94,102% of CMS Opps rate,1285.2,76.5% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,1583.28,100% of CMS OPPS Rate,1583.28,100% of CMS OPPS Rate,756,45% of total billed charges,1176,70% of total billed charges,1008,60% of total billed charges,1583.28,100% of CMS OPPS Rate,1280,100% OF UHC ASC Tier Grouping,1176,70% of total billed charges,1583.28,100% OF CMS OPPS Rate,3641.53,230% OF CMS OPPS Rate,806.4,48% of total Billed charges,1583.28,100% OF CMS OPPS Rate,1512,90% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,1583.28,100% of CMS OPPS Rate,1583.28,100% of CMS OPPS Rate,1583.28,100% of CMS OPPS Rate,1583.28,100% of CMS OPPS Rate,1583.28,100% of CMS OPPS Rate,1583.28,100% of CMS OPPS Rate,1583.28,100% of CMS OPPS Rate,1583.28,100% of CMS OPPS Rate,756,5604.8,1008
Outpatient,Outpatient Surgical And Diagnostice Procedures,49560,REPAIR FIRST ABDOMINAL WALL HERNIA,360,N/A,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,5579.43,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,5579.43,5579.43,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,49561,RPR 1ST INCAL/VNT HERNIA INCARCERATED,360,N/A,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,5816.86,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,5816.86,5816.86,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,49585,Repair of umbilical hernia in patients over 5 years old,360,N/A,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,5816.86,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,5816.86,5816.86,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,49587,RPR UMBILICAL HERNIA AGE 5 YRS/> INCARCERATED,360,N/A,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,5816.86,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,5816.86,5816.86,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,50590,Surgical procedures on the kidney to break up and remove kidney stones,360,16657.47,10314.75,354% of CMS APC rate,N/A,Not Applicable,2913.77,100% of CMS OPPS Rate,2913.77,100% of CMS OPPS Rate,7102.85,203.89% of ASC Tier Grouping Fee Schedule,11660.23,70% of total Billed Charges,12493.1,75% of total Billed Charges,5244.78,180% OF CMS OPPS RATE,13325.98,80% of total Billed Charges,10198.2,350% of CMS Opps rate,2972.04,102% of CMS Opps rate,12742.96,76.5% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,2913.77,100% of CMS OPPS Rate,2913.77,100% of CMS OPPS Rate,7495.86,45% of total billed charges,11660.23,70% of total billed charges,9994.48,60% of total billed charges,2913.77,100% of CMS OPPS Rate,2895,100% OF UHC ASC Tier Grouping,11660.23,70% of total billed charges,2913.77,100% OF CMS OPPS Rate,6701.67,230% OF CMS OPPS Rate,7995.59,48% of total Billed charges,2913.77,100% OF CMS OPPS Rate,14991.72,90% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2913.77,100% of CMS OPPS Rate,2913.77,100% of CMS OPPS Rate,2913.77,100% of CMS OPPS Rate,2913.77,100% of CMS OPPS Rate,2913.77,100% of CMS OPPS Rate,2913.77,100% of CMS OPPS Rate,2913.77,100% of CMS OPPS Rate,2913.77,100% of CMS OPPS Rate,2895,14991.72,9994.48
Outpatient,Outpatient Surgical And Diagnostice Procedures,52204,CYSTOURETHROSCOPY WITH BIOPSY,360,N/A,5969.39,354% of CMS APC rate,N/A,Not Applicable,1686.27,100% of CMS OPPS Rate,N/A,Not Applicable,2938.73,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,3035.28,180% OF CMS OPPS RATE,N/A,Not Applicable,5901.95,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,1686.27,100% of CMS OPPS Rate,1686.27,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,1686.27,100% of CMS OPPS Rate,1665,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,1686.27,100% OF CMS OPPS Rate,3878.42,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,1686.27,100% of CMS OPPS Rate,1686.27,100% of CMS OPPS Rate,1686.27,100% of CMS OPPS Rate,1686.27,100% of CMS OPPS Rate,1686.27,100% of CMS OPPS Rate,1686.27,100% of CMS OPPS Rate,1686.27,100% of CMS OPPS Rate,1686.27,100% of CMS OPPS Rate,1665,5969.39,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,52310,Removing an indwelling ureteral stent by cystoscopy,360,N/A,5969.39,354% of CMS APC rate,N/A,Not Applicable,1686.27,100% of CMS OPPS Rate,N/A,Not Applicable,3388.18,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,3035.28,180% OF CMS OPPS RATE,N/A,Not Applicable,5901.95,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,1686.27,100% of CMS OPPS Rate,1686.27,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,1686.27,100% of CMS OPPS Rate,1280,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,1686.27,100% OF CMS OPPS Rate,3878.42,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,1686.27,100% of CMS OPPS Rate,1686.27,100% of CMS OPPS Rate,1686.27,100% of CMS OPPS Rate,1686.27,100% of CMS OPPS Rate,1686.27,100% of CMS OPPS Rate,1686.27,100% of CMS OPPS Rate,1686.27,100% of CMS OPPS Rate,1686.27,100% of CMS OPPS Rate,1280,5969.39,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,52352,CYSTO W/URETEROSCOPY W/RMVL/MANJ STONES,360,N/A,10314.75,354% of CMS APC rate,N/A,Not Applicable,2913.77,100% of CMS OPPS Rate,N/A,Not Applicable,6422.8,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,5244.78,180% OF CMS OPPS RATE,N/A,Not Applicable,10198.2,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2913.77,100% of CMS OPPS Rate,2913.77,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2913.77,100% of CMS OPPS Rate,1665,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,2913.77,100% OF CMS OPPS Rate,6701.67,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2913.77,100% of CMS OPPS Rate,2913.77,100% of CMS OPPS Rate,2913.77,100% of CMS OPPS Rate,2913.77,100% of CMS OPPS Rate,2913.77,100% of CMS OPPS Rate,2913.77,100% of CMS OPPS Rate,2913.77,100% of CMS OPPS Rate,2913.77,100% of CMS OPPS Rate,1665,10314.75,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,58120,DILATION & CURETTAGE DX&/THER NONOBSTETRIC,360,N/A,9099.29,354% of CMS APC rate,N/A,Not Applicable,2570.42,100% of CMS OPPS Rate,N/A,Not Applicable,3938.85,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,4626.76,180% OF CMS OPPS RATE,N/A,Not Applicable,8996.49,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2570.42,100% of CMS OPPS Rate,2570.42,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2570.42,100% of CMS OPPS Rate,1665,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,2570.42,100% OF CMS OPPS Rate,5911.97,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,2570.42,100% of CMS OPPS Rate,2570.42,100% of CMS OPPS Rate,2570.42,100% of CMS OPPS Rate,2570.42,100% of CMS OPPS Rate,2570.42,100% of CMS OPPS Rate,2570.42,100% of CMS OPPS Rate,2570.42,100% of CMS OPPS Rate,2570.42,100% of CMS OPPS Rate,1665,9099.29,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,63030,Surgical procedure to decompress a herniated vertebra,360,N/A,21287.29,354% of CMS APC rate,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,N/A,Not Applicable,11202.31,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,10824.04,180% OF CMS OPPS RATE,N/A,Not Applicable,21046.75,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,2895,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,6013.36,100% OF CMS OPPS Rate,13830.72,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,6013.36,100% of CMS OPPS Rate,2895,21287.29,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,64417,INJECTION ANESTHETIC AGENT AXILLARY NERVE,360,N/A,2742.49,354% of CMS APC rate,N/A,Not Applicable,774.71,100% of CMS OPPS Rate,N/A,Not Applicable,1370.51,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,1394.48,180% OF CMS OPPS RATE,N/A,Not Applicable,2711.51,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,774.71,100% of CMS OPPS Rate,774.71,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,774.71,100% of CMS OPPS Rate,915,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,774.71,100% OF CMS OPPS Rate,1781.84,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,774.71,100% of CMS OPPS Rate,774.71,100% of CMS OPPS Rate,774.71,100% of CMS OPPS Rate,774.71,100% of CMS OPPS Rate,774.71,100% of CMS OPPS Rate,774.71,100% of CMS OPPS Rate,774.71,100% of CMS OPPS Rate,774.71,100% of CMS OPPS Rate,774.71,2742.49,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,64418,INJECTION ANESTHETIC AGENT SUPRASCAPULAR NERVE,360,N/A,2073.62,354% of CMS APC rate,N/A,Not Applicable,585.77,100% of CMS OPPS Rate,N/A,Not Applicable,1107.9,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,1054.38,180% OF CMS OPPS RATE,N/A,Not Applicable,2050.19,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,585.77,100% of CMS OPPS Rate,585.77,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,585.77,100% of CMS OPPS Rate,915,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,585.77,100% OF CMS OPPS Rate,1347.26,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,585.77,100% of CMS OPPS Rate,585.77,100% of CMS OPPS Rate,585.77,100% of CMS OPPS Rate,585.77,100% of CMS OPPS Rate,585.77,100% of CMS OPPS Rate,585.77,100% of CMS OPPS Rate,585.77,100% of CMS OPPS Rate,585.77,100% of CMS OPPS Rate,585.77,2073.62,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,64450,INJECTION ANES OTHER PERIPHERAL NERVE/BRANCH,360,N/A,2073.62,354% of CMS APC rate,N/A,Not Applicable,585.77,100% of CMS OPPS Rate,N/A,Not Applicable,1107.9,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,1054.38,180% OF CMS OPPS RATE,N/A,Not Applicable,2050.19,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,585.77,100% of CMS OPPS Rate,585.77,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,585.77,100% of CMS OPPS Rate,915,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,585.77,100% OF CMS OPPS Rate,1347.26,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,585.77,100% of CMS OPPS Rate,585.77,100% of CMS OPPS Rate,585.77,100% of CMS OPPS Rate,585.77,100% of CMS OPPS Rate,585.77,100% of CMS OPPS Rate,585.77,100% of CMS OPPS Rate,585.77,100% of CMS OPPS Rate,585.77,100% of CMS OPPS Rate,585.77,2073.62,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,64704,NEUROPLASTY NERVE HAND/FOOT,360,N/A,5784.8,354% of CMS APC rate,N/A,Not Applicable,1634.12,100% of CMS OPPS Rate,N/A,Not Applicable,3283.65,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,2941.42,180% OF CMS OPPS RATE,N/A,Not Applicable,5719.43,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,1634.12,100% of CMS OPPS Rate,1634.12,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,1634.12,100% of CMS OPPS Rate,1665,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,1634.12,100% OF CMS OPPS Rate,3758.48,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,1634.12,100% of CMS OPPS Rate,1634.12,100% of CMS OPPS Rate,1634.12,100% of CMS OPPS Rate,1634.12,100% of CMS OPPS Rate,1634.12,100% of CMS OPPS Rate,1634.12,100% of CMS OPPS Rate,1634.12,100% of CMS OPPS Rate,1634.12,100% of CMS OPPS Rate,1634.12,5784.8,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,64708,NEURP MAJOR PRPH NRV ARM/LEG OPN OTH/THN SPEC,360,N/A,5784.8,354% of CMS APC rate,N/A,Not Applicable,1634.12,100% of CMS OPPS Rate,N/A,Not Applicable,2791.11,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,2941.42,180% OF CMS OPPS RATE,N/A,Not Applicable,5719.43,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,1634.12,100% of CMS OPPS Rate,1634.12,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,1634.12,100% of CMS OPPS Rate,1665,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,1634.12,100% OF CMS OPPS Rate,3758.48,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,1634.12,100% of CMS OPPS Rate,1634.12,100% of CMS OPPS Rate,1634.12,100% of CMS OPPS Rate,1634.12,100% of CMS OPPS Rate,1634.12,100% of CMS OPPS Rate,1634.12,100% of CMS OPPS Rate,1634.12,100% of CMS OPPS Rate,1634.12,100% of CMS OPPS Rate,1634.12,5784.8,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,29826,Shaving of shoulder bone using an endoscope,360,N/A,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,657,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,657,657,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,42820,Removal of tonsils and adenoid glands patient younger than age 12,360,N/A,17184.2,354% of CMS APC rate,N/A,Not Applicable,4854.29,100% of CMS OPPS Rate,N/A,Not Applicable,8669.42,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,8737.71,180% OF CMS OPPS RATE,N/A,Not Applicable,16990.02,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,4854.29,100% of CMS OPPS Rate,4854.29,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,4854.29,100% of CMS OPPS Rate,1665,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,4854.29,100% OF CMS OPPS Rate,11164.87,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,4854.29,100% of CMS OPPS Rate,4854.29,100% of CMS OPPS Rate,4854.29,100% of CMS OPPS Rate,4854.29,100% of CMS OPPS Rate,4854.29,100% of CMS OPPS Rate,4854.29,100% of CMS OPPS Rate,4854.29,100% of CMS OPPS Rate,4854.29,100% of CMS OPPS Rate,1665,17184.2,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,43235,"Diagnostic examination of esophagus, stomach, and/or upper small bowel using an endoscope",360,N/A,2656.66,354% of CMS APC rate,N/A,Not Applicable,750.47,100% of CMS OPPS Rate,N/A,Not Applicable,1515.9,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,1350.84,180% OF CMS OPPS RATE,N/A,Not Applicable,2626.64,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,750.47,100% of CMS OPPS Rate,750.47,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,750.47,100% of CMS OPPS Rate,1280,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,750.47,100% OF CMS OPPS Rate,1726.08,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,750.47,100% of CMS OPPS Rate,750.47,100% of CMS OPPS Rate,750.47,100% of CMS OPPS Rate,750.47,100% of CMS OPPS Rate,750.47,100% of CMS OPPS Rate,750.47,100% of CMS OPPS Rate,750.47,100% of CMS OPPS Rate,750.47,100% of CMS OPPS Rate,750.47,2656.66,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,43239,"Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope",360,N/A,2656.66,354% of CMS APC rate,N/A,Not Applicable,750.47,100% of CMS OPPS Rate,N/A,Not Applicable,1515.9,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,1350.84,180% OF CMS OPPS RATE,N/A,Not Applicable,2626.64,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,750.47,100% of CMS OPPS Rate,750.47,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,750.47,100% of CMS OPPS Rate,1280,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,750.47,100% OF CMS OPPS Rate,1726.08,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,750.47,100% of CMS OPPS Rate,750.47,100% of CMS OPPS Rate,750.47,100% of CMS OPPS Rate,750.47,100% of CMS OPPS Rate,750.47,100% of CMS OPPS Rate,750.47,100% of CMS OPPS Rate,750.47,100% of CMS OPPS Rate,750.47,100% of CMS OPPS Rate,750.47,2656.66,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,45378,Diagnostic examination of large bowel using an endoscope,360,N/A,2674.46,354% of CMS APC rate,N/A,Not Applicable,755.49,100% of CMS OPPS Rate,N/A,Not Applicable,1447.58,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,1359.89,180% OF CMS OPPS RATE,N/A,Not Applicable,2644.24,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,755.49,100% of CMS OPPS Rate,755.49,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,755.49,100% of CMS OPPS Rate,1280,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,755.49,100% OF CMS OPPS Rate,1737.64,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,755.49,100% of CMS OPPS Rate,755.49,100% of CMS OPPS Rate,755.49,100% of CMS OPPS Rate,755.49,100% of CMS OPPS Rate,755.49,100% of CMS OPPS Rate,755.49,100% of CMS OPPS Rate,755.49,100% of CMS OPPS Rate,755.49,100% of CMS OPPS Rate,755.49,2674.46,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,45380,Biopsy of large bowel using an endoscope,360,N/A,3485.03,354% of CMS APC rate,N/A,Not Applicable,984.47,100% of CMS OPPS Rate,N/A,Not Applicable,1909.21,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,1772.04,180% OF CMS OPPS RATE,N/A,Not Applicable,3445.65,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,984.47,100% of CMS OPPS Rate,984.47,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,984.47,100% of CMS OPPS Rate,1280,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,984.47,100% OF CMS OPPS Rate,2264.28,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,984.47,100% of CMS OPPS Rate,984.47,100% of CMS OPPS Rate,984.47,100% of CMS OPPS Rate,984.47,100% of CMS OPPS Rate,984.47,100% of CMS OPPS Rate,984.47,100% of CMS OPPS Rate,984.47,100% of CMS OPPS Rate,984.47,100% of CMS OPPS Rate,984.47,3485.03,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,45385,Removal of polyps or growths of large bowel using an endoscope,360,N/A,3485.03,354% of CMS APC rate,N/A,Not Applicable,984.47,100% of CMS OPPS Rate,N/A,Not Applicable,1909.21,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,1772.04,180% OF CMS OPPS RATE,N/A,Not Applicable,3445.65,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,984.47,100% of CMS OPPS Rate,984.47,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,984.47,100% of CMS OPPS Rate,1280,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,984.47,100% OF CMS OPPS Rate,2264.28,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,984.47,100% of CMS OPPS Rate,984.47,100% of CMS OPPS Rate,984.47,100% of CMS OPPS Rate,984.47,100% of CMS OPPS Rate,984.47,100% of CMS OPPS Rate,984.47,100% of CMS OPPS Rate,984.47,100% of CMS OPPS Rate,984.47,100% of CMS OPPS Rate,984.47,3485.03,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,49505,Repair of groin hernia patient age 5 years or older,360,N/A,11398.68,354% of CMS APC rate,N/A,Not Applicable,3219.96,100% of CMS OPPS Rate,N/A,Not Applicable,5579.43,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,5795.94,180% OF CMS OPPS RATE,N/A,Not Applicable,11269.88,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,3219.96,100% of CMS OPPS Rate,3219.96,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,3219.96,100% of CMS OPPS Rate,2028,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,3219.96,100% OF CMS OPPS Rate,7405.92,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,3219.96,100% of CMS OPPS Rate,3219.96,100% of CMS OPPS Rate,3219.96,100% of CMS OPPS Rate,3219.96,100% of CMS OPPS Rate,3219.96,100% of CMS OPPS Rate,3219.96,100% of CMS OPPS Rate,3219.96,100% of CMS OPPS Rate,3219.96,100% of CMS OPPS Rate,2028,11398.68,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,55866,Surgical removal of prostate and surrounding lymph nodes using an endoscope,360,N/A,29244.87,354% of CMS APC rate,N/A,Not Applicable,8261.25,100% of CMS OPPS Rate,N/A,Not Applicable,15486.3,203.89% of ASC Tier Grouping Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,14870.26,180% OF CMS OPPS RATE,N/A,Not Applicable,28914.41,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,8261.25,100% of CMS OPPS Rate,8261.25,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,8261.25,100% of CMS OPPS Rate,3565,100% OF UHC ASC Tier Grouping,N/A,Not Applicable,8261.25,100% OF CMS OPPS Rate,19000.9,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,8261.25,100% of CMS OPPS Rate,8261.25,100% of CMS OPPS Rate,8261.25,100% of CMS OPPS Rate,8261.25,100% of CMS OPPS Rate,8261.25,100% of CMS OPPS Rate,8261.25,100% of CMS OPPS Rate,8261.25,100% of CMS OPPS Rate,8261.25,100% of CMS OPPS Rate,3565,29244.87,N/A
Outpatient,Outpatient Surgical And Diagnostice Procedures,62323,Injection of substance into spinal canal of lower back or sacrum using imaging guidance,360,1008,2073.62,354% of CMS APC rate,N/A,Not Applicable,585.77,100% of CMS OPPS Rate,585.77,100% of CMS OPPS Rate,1107.9,203.89% of ASC Tier Grouping Fee Schedule,705.6,70% of total Billed Charges,756,75% of total Billed Charges,1054.38,180% OF CMS OPPS RATE,806.4,80% of total Billed Charges,2050.19,350% of CMS Opps rate,597.47,102% of CMS Opps rate,771.12,76.5% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,585.77,100% of CMS OPPS Rate,585.77,100% of CMS OPPS Rate,453.6,45% of total billed charges,705.6,70% of total billed charges,604.8,60% of total billed charges,585.77,100% of CMS OPPS Rate,915,100% OF UHC ASC Tier Grouping,705.6,70% of total billed charges,585.77,100% OF CMS OPPS Rate,1347.26,230% OF CMS OPPS Rate,483.84,48% of total Billed charges,585.77,100% OF CMS OPPS Rate,907.2,90% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,585.77,100% of CMS OPPS Rate,585.77,100% of CMS OPPS Rate,585.77,100% of CMS OPPS Rate,585.77,100% of CMS OPPS Rate,585.77,100% of CMS OPPS Rate,585.77,100% of CMS OPPS Rate,585.77,100% of CMS OPPS Rate,585.77,100% of CMS OPPS Rate,453.6,2073.62,604.8
Outpatient,Outpatient Surgical And Diagnostice Procedures,64483,Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance,360,1200,2742.49,354% of CMS APC rate,N/A,Not Applicable,774.71,100% of CMS OPPS Rate,774.71,100% of CMS OPPS Rate,1370.51,203.89% of ASC Tier Grouping Fee Schedule,840,70% of total Billed Charges,900,75% of total Billed Charges,1394.48,180% OF CMS OPPS RATE,960,80% of total Billed Charges,2711.51,350% of CMS Opps rate,790.2,102% of CMS Opps rate,918,76.5% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,774.71,100% of CMS OPPS Rate,774.71,100% of CMS OPPS Rate,540,45% of total billed charges,840,70% of total billed charges,720,60% of total billed charges,774.71,100% of CMS OPPS Rate,915,100% OF UHC ASC Tier Grouping,840,70% of total billed charges,774.71,100% OF CMS OPPS Rate,1781.84,230% OF CMS OPPS Rate,576,48% of total Billed charges,774.71,100% OF CMS OPPS Rate,1080,90% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,774.71,100% of CMS OPPS Rate,774.71,100% of CMS OPPS Rate,774.71,100% of CMS OPPS Rate,774.71,100% of CMS OPPS Rate,774.71,100% of CMS OPPS Rate,774.71,100% of CMS OPPS Rate,774.71,100% of CMS OPPS Rate,774.71,100% of CMS OPPS Rate,540,2742.49,720
Outpatient,Outpatient Surgical And Diagnostice Procedures,66984,Removal of cataract with insertion of lens,360,2008.4,6949.53,354% of CMS APC rate,N/A,Not Applicable,1963.14,100% of CMS OPPS Rate,1963.14,100% of CMS OPPS Rate,3838.58,203.89% of ASC Tier Grouping Fee Schedule,1405.88,70% of total Billed Charges,1506.3,75% of total Billed Charges,3533.66,180% OF CMS OPPS RATE,1606.72,80% of total Billed Charges,6871.01,350% of CMS Opps rate,2002.4,102% of CMS Opps rate,1536.43,76.5% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,1963.14,100% of CMS OPPS Rate,1963.14,100% of CMS OPPS Rate,903.78,45% of total billed charges,1405.88,70% of total billed charges,1205.04,60% of total billed charges,1963.14,100% of CMS OPPS Rate,1665,100% OF UHC ASC Tier Grouping,1405.88,70% of total billed charges,1963.14,100% OF CMS OPPS Rate,4515.22,230% OF CMS OPPS Rate,964.03,48% of total Billed charges,1963.14,100% OF CMS OPPS Rate,1807.56,90% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,1963.14,100% of CMS OPPS Rate,1963.14,100% of CMS OPPS Rate,1963.14,100% of CMS OPPS Rate,1963.14,100% of CMS OPPS Rate,1963.14,100% of CMS OPPS Rate,1963.14,100% of CMS OPPS Rate,1963.14,100% of CMS OPPS Rate,1963.14,100% of CMS OPPS Rate,903.78,6949.53,1205.04
Outpatient,Radiology,70450,CT scan head or brain without dye,350,2102.98,343.95,354% of CMS APC rate,329.54,100% of Medicaid LA Fee Schedule,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,233.37,203.89% of BCBS Fee Schedule,1472.09,70% of total Billed Charges,1577.24,75% of total Billed Charges,174.89,180% OF CMS OPPS RATE,1682.38,80% of total Billed Charges,340.07,350% of CMS Opps rate,99.1,102% of CMS Opps rate,1608.78,76.5% of total billed charges,329.54,100% of Medicaid LA Fee Schedule,329.54,100% of Medicaid LA Fee Schedule,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,946.34,45% of total billed charges,1472.09,70% of total billed charges,1261.79,60% of total billed charges,97.16,100% of CMS OPPS Rate,1709,Case rate,1472.09,70% of total billed charges,97.16,100% OF CMS OPPS Rate,223.47,230% OF CMS OPPS Rate,1009.43,48% of total Billed charges,97.16,100% OF CMS OPPS Rate,1892.68,90% of total Billed charges,329.54,100% of Medicaid LA Fee Schedule,329.54,100% of Medicaid LA Fee Schedule,329.54,100% of Medicaid LA Fee Schedule,329.54,100% of Medicaid LA Fee Schedule,329.54,100% of Medicaid LA Fee Schedule,329.54,100% of Medicaid LA Fee Schedule,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,97.16,1892.68,1261.79
Outpatient,Radiology,70553,MRI scan of brain before and after contrast,610,2027.5,1185.68,354% of CMS APC rate,317.71,100% of Medicaid LA Fee Schedule,334.94,100% of CMS OPPS Rate,334.94,100% of CMS OPPS Rate,930.49,203.89% of BCBS Fee Schedule,1419.25,70% of total Billed Charges,1520.63,75% of total Billed Charges,602.88,180% OF CMS OPPS RATE,1622,80% of total Billed Charges,1172.28,350% of CMS Opps rate,341.63,102% of CMS Opps rate,1551.04,76.5% of total billed charges,317.71,100% of Medicaid LA Fee Schedule,317.71,100% of Medicaid LA Fee Schedule,334.94,100% of CMS OPPS Rate,334.94,100% of CMS OPPS Rate,912.38,45% of total billed charges,1419.25,70% of total billed charges,1216.5,60% of total billed charges,334.94,100% of CMS OPPS Rate,1437,Case rate,1419.25,70% of total billed charges,334.94,100% OF CMS OPPS Rate,770.35,230% OF CMS OPPS Rate,973.2,48% of total Billed charges,334.94,100% OF CMS OPPS Rate,1824.75,90% of total Billed charges,317.71,100% of Medicaid LA Fee Schedule,317.71,100% of Medicaid LA Fee Schedule,317.71,100% of Medicaid LA Fee Schedule,317.71,100% of Medicaid LA Fee Schedule,317.71,100% of Medicaid LA Fee Schedule,317.71,100% of Medicaid LA Fee Schedule,334.94,100% of CMS OPPS Rate,334.94,100% of CMS OPPS Rate,334.94,100% of CMS OPPS Rate,334.94,100% of CMS OPPS Rate,334.94,100% of CMS OPPS Rate,334.94,100% of CMS OPPS Rate,334.94,100% of CMS OPPS Rate,334.94,100% of CMS OPPS Rate,317.71,1824.75,1216.5
Outpatient,Radiology,72110,"X-ray of lower and sacral spine, minimum of 4 views",324,506.44,343.96,354% of CMS APC rate,79.36,100% of Medicaid LA Fee Schedule,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,233.37,203.89% of BCBS Fee Schedule,354.51,70% of total Billed Charges,379.83,75% of total Billed Charges,174.89,180% OF CMS OPPS RATE,405.15,80% of total Billed Charges,340.07,350% of CMS Opps rate,99.1,102% of CMS Opps rate,387.43,76.5% of total billed charges,79.36,100% of Medicaid LA Fee Schedule,79.36,100% of Medicaid LA Fee Schedule,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,227.9,45% of total billed charges,354.51,70% of total billed charges,303.86,60% of total billed charges,97.16,100% of CMS OPPS Rate,364,Case rate,354.51,70% of total billed charges,97.16,100% OF CMS OPPS Rate,223.47,230% OF CMS OPPS Rate,243.09,48% of total Billed charges,97.16,100% OF CMS OPPS Rate,455.8,90% of total Billed charges,79.36,100% of Medicaid LA Fee Schedule,79.36,100% of Medicaid LA Fee Schedule,79.36,100% of Medicaid LA Fee Schedule,79.36,100% of Medicaid LA Fee Schedule,79.36,100% of Medicaid LA Fee Schedule,79.36,100% of Medicaid LA Fee Schedule,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,79.36,455.8,303.86
Outpatient,Radiology,72148,MRI scan of lower spinal canal,610,1746,751.51,354% of CMS APC rate,273.6,100% of Medicaid LA Fee Schedule,212.29,100% of CMS OPPS Rate,212.29,100% of CMS OPPS Rate,473.66,203.89% of BCBS Fee Schedule,1222.2,70% of total Billed Charges,1309.5,75% of total Billed Charges,382.12,180% OF CMS OPPS RATE,1396.8,80% of total Billed Charges,743.02,350% of CMS Opps rate,216.53,102% of CMS Opps rate,1335.69,76.5% of total billed charges,273.6,100% of Medicaid LA Fee Schedule,273.6,100% of Medicaid LA Fee Schedule,212.29,100% of CMS OPPS Rate,212.29,100% of CMS OPPS Rate,785.7,45% of total billed charges,1222.2,70% of total billed charges,1047.6,60% of total billed charges,212.29,100% of CMS OPPS Rate,1437,Case rate,1222.2,70% of total billed charges,212.29,100% OF CMS OPPS Rate,488.26,230% OF CMS OPPS Rate,838.08,48% of total Billed charges,212.29,100% OF CMS OPPS Rate,1571.4,90% of total Billed charges,273.6,100% of Medicaid LA Fee Schedule,273.6,100% of Medicaid LA Fee Schedule,273.6,100% of Medicaid LA Fee Schedule,273.6,100% of Medicaid LA Fee Schedule,273.6,100% of Medicaid LA Fee Schedule,273.6,100% of Medicaid LA Fee Schedule,212.29,100% of CMS OPPS Rate,212.29,100% of CMS OPPS Rate,212.29,100% of CMS OPPS Rate,212.29,100% of CMS OPPS Rate,212.29,100% of CMS OPPS Rate,212.29,100% of CMS OPPS Rate,212.29,100% of CMS OPPS Rate,212.29,100% of CMS OPPS Rate,212.29,1571.4,1047.6
Outpatient,Radiology,72193,"CT scan, pelvis, with contrast",350,2036.32,580.36,354% of CMS APC rate,319.09,100% of Medicaid LA Fee Schedule,163.94,100% of CMS OPPS Rate,163.94,100% of CMS OPPS Rate,515.31,203.89% of BCBS Fee Schedule,1425.42,70% of total Billed Charges,1527.24,75% of total Billed Charges,295.1,180% OF CMS OPPS RATE,1629.06,80% of total Billed Charges,573.8,350% of CMS Opps rate,167.22,102% of CMS Opps rate,1557.78,76.5% of total billed charges,319.09,100% of Medicaid LA Fee Schedule,319.09,100% of Medicaid LA Fee Schedule,163.94,100% of CMS OPPS Rate,163.94,100% of CMS OPPS Rate,916.34,45% of total billed charges,1425.42,70% of total billed charges,1221.79,60% of total billed charges,163.94,100% of CMS OPPS Rate,1709,Case rate,1425.42,70% of total billed charges,163.94,100% OF CMS OPPS Rate,377.07,230% OF CMS OPPS Rate,977.43,48% of total Billed charges,163.94,100% OF CMS OPPS Rate,1832.69,90% of total Billed charges,319.09,100% of Medicaid LA Fee Schedule,319.09,100% of Medicaid LA Fee Schedule,319.09,100% of Medicaid LA Fee Schedule,319.09,100% of Medicaid LA Fee Schedule,319.09,100% of Medicaid LA Fee Schedule,319.09,100% of Medicaid LA Fee Schedule,163.94,100% of CMS OPPS Rate,163.94,100% of CMS OPPS Rate,163.94,100% of CMS OPPS Rate,163.94,100% of CMS OPPS Rate,163.94,100% of CMS OPPS Rate,163.94,100% of CMS OPPS Rate,163.94,100% of CMS OPPS Rate,163.94,100% of CMS OPPS Rate,163.94,1832.69,1221.79
Outpatient,Radiology,73721,MRI of lower extremity joint (knee/ankle) without dye,610,N/A,751.51,354% of CMS APC rate,N/A,Not Applicable,212.29,100% of CMS OPPS Rate,N/A,Not Applicable,473.66,203.89% of BCBS Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,382.12,180% OF CMS OPPS RATE,N/A,Not Applicable,743.02,350% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,212.29,100% of CMS OPPS Rate,212.29,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,212.29,100% of CMS OPPS Rate,1437,Case rate,N/A,Not Applicable,212.29,100% OF CMS OPPS Rate,488.26,230% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,212.29,100% of CMS OPPS Rate,212.29,100% of CMS OPPS Rate,212.29,100% of CMS OPPS Rate,212.29,100% of CMS OPPS Rate,212.29,100% of CMS OPPS Rate,212.29,100% of CMS OPPS Rate,212.29,100% of CMS OPPS Rate,212.29,100% of CMS OPPS Rate,212.29,1437,N/A
Outpatient,Radiology,74177,CT scan of abdomen and pelvis with contrast,350,4840,1185.68,354% of CMS APC rate,758.43,100% of Medicaid LA Fee Schedule,334.94,100% of CMS OPPS Rate,334.94,100% of CMS OPPS Rate,515.31,203.89% of BCBS Fee Schedule,3388,70% of total Billed Charges,3630,75% of total Billed Charges,602.88,180% OF CMS OPPS RATE,3872,80% of total Billed Charges,1172.28,350% of CMS Opps rate,341.63,102% of CMS Opps rate,3702.6,76.5% of total billed charges,758.43,100% of Medicaid LA Fee Schedule,758.43,100% of Medicaid LA Fee Schedule,334.94,100% of CMS OPPS Rate,334.94,100% of CMS OPPS Rate,2178,45% of total billed charges,3388,70% of total billed charges,2904,60% of total billed charges,334.94,100% of CMS OPPS Rate,1709,Case rate,3388,70% of total billed charges,334.94,100% OF CMS OPPS Rate,770.35,230% OF CMS OPPS Rate,2323.2,48% of total Billed charges,334.94,100% OF CMS OPPS Rate,4356,90% of total Billed charges,758.43,100% of Medicaid LA Fee Schedule,758.43,100% of Medicaid LA Fee Schedule,758.43,100% of Medicaid LA Fee Schedule,758.43,100% of Medicaid LA Fee Schedule,758.43,100% of Medicaid LA Fee Schedule,758.43,100% of Medicaid LA Fee Schedule,334.94,100% of CMS OPPS Rate,334.94,100% of CMS OPPS Rate,334.94,100% of CMS OPPS Rate,334.94,100% of CMS OPPS Rate,334.94,100% of CMS OPPS Rate,334.94,100% of CMS OPPS Rate,334.94,100% of CMS OPPS Rate,334.94,100% of CMS OPPS Rate,334.94,4356,2904
Outpatient,Radiology,76700,Ultrasound of abdomen with all areas scanned,402,903.27,343.95,354% of CMS APC rate,141.54,100% of Medicaid LA Fee Schedule,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,233.37,203.89% of BCBS Fee Schedule,632.29,70% of total Billed Charges,677.45,75% of total Billed Charges,174.89,180% OF CMS OPPS RATE,722.62,80% of total Billed Charges,340.07,350% of CMS Opps rate,99.1,102% of CMS Opps rate,691,76.5% of total billed charges,141.54,100% of Medicaid LA Fee Schedule,141.54,100% of Medicaid LA Fee Schedule,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,406.47,45% of total billed charges,632.29,70% of total billed charges,541.96,60% of total billed charges,97.16,100% of CMS OPPS Rate,446,Case rate,632.29,70% of total billed charges,97.16,100% OF CMS OPPS Rate,223.47,230% OF CMS OPPS Rate,433.57,48% of total Billed charges,97.16,100% OF CMS OPPS Rate,812.94,90% of total Billed charges,141.54,100% of Medicaid LA Fee Schedule,141.54,100% of Medicaid LA Fee Schedule,141.54,100% of Medicaid LA Fee Schedule,141.54,100% of Medicaid LA Fee Schedule,141.54,100% of Medicaid LA Fee Schedule,141.54,100% of Medicaid LA Fee Schedule,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,97.16,812.94,541.96
Outpatient,Radiology,76805,Abdominal ultrasound of pregnant uterus (greater or equal to 14 weeks 0 days) single or first fetus,402,559.35,343.95,354% of CMS APC rate,87.65,100% of Medicaid LA Fee Schedule,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,233.37,203.89% of BCBS Fee Schedule,391.55,70% of total Billed Charges,419.51,75% of total Billed Charges,174.89,180% OF CMS OPPS RATE,447.48,80% of total Billed Charges,340.07,350% of CMS Opps rate,99.1,102% of CMS Opps rate,427.9,76.5% of total billed charges,87.65,100% of Medicaid LA Fee Schedule,87.65,100% of Medicaid LA Fee Schedule,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,251.71,45% of total billed charges,391.55,70% of total billed charges,335.61,60% of total billed charges,97.16,100% of CMS OPPS Rate,446,Case rate,391.55,70% of total billed charges,97.16,100% OF CMS OPPS Rate,223.47,230% OF CMS OPPS Rate,268.49,48% of total Billed charges,97.16,100% OF CMS OPPS Rate,503.42,90% of total Billed charges,87.65,100% of Medicaid LA Fee Schedule,87.65,100% of Medicaid LA Fee Schedule,87.65,100% of Medicaid LA Fee Schedule,87.65,100% of Medicaid LA Fee Schedule,87.65,100% of Medicaid LA Fee Schedule,87.65,100% of Medicaid LA Fee Schedule,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,87.65,503.42,335.61
Outpatient,Radiology,76830,Ultrasound of the pelvis through vagina,402,397.21,343.95,354% of CMS APC rate,62.24,100% of Medicaid LA Fee Schedule,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,233.37,203.89% of BCBS Fee Schedule,278.05,70% of total Billed Charges,297.91,75% of total Billed Charges,174.89,180% OF CMS OPPS RATE,317.77,80% of total Billed Charges,340.07,350% of CMS Opps rate,99.1,102% of CMS Opps rate,303.87,76.5% of total billed charges,62.24,100% of Medicaid LA Fee Schedule,62.24,100% of Medicaid LA Fee Schedule,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,178.74,45% of total billed charges,278.05,70% of total billed charges,238.33,60% of total billed charges,97.16,100% of CMS OPPS Rate,446,Case rate,278.05,70% of total billed charges,97.16,100% OF CMS OPPS Rate,223.47,230% OF CMS OPPS Rate,190.66,48% of total Billed charges,97.16,100% OF CMS OPPS Rate,357.49,90% of total Billed charges,62.24,100% of Medicaid LA Fee Schedule,62.24,100% of Medicaid LA Fee Schedule,62.24,100% of Medicaid LA Fee Schedule,62.24,100% of Medicaid LA Fee Schedule,62.24,100% of Medicaid LA Fee Schedule,62.24,100% of Medicaid LA Fee Schedule,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,97.16,100% of CMS OPPS Rate,62.24,446,238.33
Outpatient,Radiology,77065,"Diagnostic mammography, including computer-aided detection (cad) when performed; unilateral",401,N/A,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,174.06,203.89% of BCBS Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,323,Case rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,174.06,323,N/A
Outpatient,Radiology,77066,"Diagnostic mammography, including computer-aided detection (cad) when performed; bilateral",401,320,351.27,354% of CMS OPPS Rate,50.14,100% of Medicaid LA Fee Schedule,99.23,100% of CMS OPPS Rate,99.23,100% of CMS OPPS Rate,222.24,203.89% of BCBS Fee Schedule,224,70% of total Billed Charges,240,75% of total Billed Charges,178.61,180% OF CMS OPPS RATE,256,80% of total Billed Charges,347.31,350% of CMS Opps rate,101.21,102% of CMS Opps rate,244.8,76.5% of total billed charges,50.14,100% of Medicaid LA Fee Schedule,50.14,100% of Medicaid LA Fee Schedule,99.23,100% of CMS OPPS Rate,99.23,100% of CMS OPPS Rate,144,45% of total billed charges,224,70% of total billed charges,192,60% of total billed charges,99.23,100% of CMS OPPS Rate,323,Case rate,224,70% of total billed charges,99.23,100% OF CMS OPPS Rate,228.23,230% OF CMS OPPS Rate,153.6,48% of total Billed charges,99.23,100% OF CMS OPPS Rate,288,90% of total Billed charges,50.14,100% of Medicaid LA Fee Schedule,50.14,100% of Medicaid LA Fee Schedule,50.14,100% of Medicaid LA Fee Schedule,50.14,100% of Medicaid LA Fee Schedule,50.14,100% of Medicaid LA Fee Schedule,50.14,100% of Medicaid LA Fee Schedule,99.23,100% of CMS OPPS Rate,99.23,100% of CMS OPPS Rate,99.23,100% of CMS OPPS Rate,99.23,100% of CMS OPPS Rate,99.23,100% of CMS OPPS Rate,99.23,100% of CMS OPPS Rate,99.23,100% of CMS OPPS Rate,99.23,100% of CMS OPPS Rate,50.14,351.27,192
Outpatient,Radiology,77067,Mammography of both breasts-2 or more views,403,307.34,291.38,354% of CMS OPPS Rate,48.16,100% of Medicaid LA Fee Schedule,82.31,100% of CMS OPPS Rate,82.31,100% of CMS OPPS Rate,183.83,203.89% of BCBS Fee Schedule,215.14,70% of total Billed Charges,230.51,75% of total Billed Charges,148.16,180% OF CMS OPPS RATE,245.87,80% of total Billed Charges,288.09,350% of CMS Opps rate,83.96,102% of CMS Opps rate,235.12,76.5% of total billed charges,48.16,100% of Medicaid LA Fee Schedule,48.16,100% of Medicaid LA Fee Schedule,82.31,100% of CMS OPPS Rate,82.31,100% of CMS OPPS Rate,138.3,45% of total billed charges,215.14,70% of total billed charges,184.4,60% of total billed charges,82.31,100% of CMS OPPS Rate,323,Case rate,215.14,70% of total billed charges,82.31,100% OF CMS OPPS Rate,189.31,230% OF CMS OPPS Rate,147.52,48% of total Billed charges,82.31,100% OF CMS OPPS Rate,276.61,90% of total Billed charges,48.16,100% of Medicaid LA Fee Schedule,48.16,100% of Medicaid LA Fee Schedule,48.16,100% of Medicaid LA Fee Schedule,48.16,100% of Medicaid LA Fee Schedule,48.16,100% of Medicaid LA Fee Schedule,48.16,100% of Medicaid LA Fee Schedule,82.31,100% of CMS OPPS Rate,82.31,100% of CMS OPPS Rate,82.31,100% of CMS OPPS Rate,82.31,100% of CMS OPPS Rate,82.31,100% of CMS OPPS Rate,82.31,100% of CMS OPPS Rate,82.31,100% of CMS OPPS Rate,82.31,100% of CMS OPPS Rate,48.16,323,184.4
Outpatient,Therapy,90832,"Psychotherapy, 30 min",900,356,268.22,354% of CMS APC rate,N/A,Not Applicable,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,252.72,203.89% of BCBS Fee Schedule,267,75% of total billed charges,267,75% of total Billed Charges,238.41,180% OF CMS OPPS RATE,284.8,80% of total Billed Charges,268.22,350% of CMS Opps rate,135.1,102% of CMS Opps rate,272.34,76.5% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,160.2,45% of total billed charges,249.2,70% of total billed charges,213.6,60% of total billed charges,132.44,100% of CMS OPPS Rate,249.2,70% OF TOTAL BILLED CHARGES,249.2,70% of total billed charges,132.44,100% OF CMS OPPS Rate,268.22,230% OF CMS OPPS Rate,170.88,48% of total Billed charges,132.44,100% OF CMS OPPS Rate,320.4,90% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,132.44,320.4,213.6
Outpatient,Therapy,90834,"Psychotherapy, 45 min",900,356,268.22,354% of CMS APC rate,N/A,Not Applicable,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,252.72,203.89% of BCBS Fee Schedule,267,75% of total billed charges,267,75% of total Billed Charges,238.41,180% OF CMS OPPS RATE,284.8,80% of total Billed Charges,268.22,350% of CMS Opps rate,135.1,102% of CMS Opps rate,272.34,76.5% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,160.2,45% of total billed charges,249.2,70% of total billed charges,213.6,60% of total billed charges,132.44,100% of CMS OPPS Rate,249.2,70% OF TOTAL BILLED CHARGES,249.2,70% of total billed charges,132.44,100% OF CMS OPPS Rate,268.22,230% OF CMS OPPS Rate,170.88,48% of total Billed charges,132.44,100% OF CMS OPPS Rate,320.4,90% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,132.44,320.4,213.6
Outpatient,Therapy,90837,"Psychotherapy, 60 min",900,175.05,268.22,354% of CMS APC rate,N/A,Not Applicable,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,252.72,203.89% of BCBS Fee Schedule,131.29,75% of total billed charges,131.29,75% of total Billed Charges,238.41,180% OF CMS OPPS RATE,140.04,80% of total Billed Charges,268.22,350% of CMS Opps rate,135.1,102% of CMS Opps rate,133.91,76.5% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,78.77,45% of total billed charges,122.54,70% of total billed charges,105.03,60% of total billed charges,132.44,100% of CMS OPPS Rate,122.54,70% OF TOTAL BILLED CHARGES,122.54,70% of total billed charges,132.44,100% OF CMS OPPS Rate,268.22,230% OF CMS OPPS Rate,84.02,48% of total Billed charges,132.44,100% OF CMS OPPS Rate,157.55,90% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,78.77,268.22,105.03
Outpatient,Therapy,90846,"Family psychotherapy, not including patient, 50 min",900,280,268.22,354% of CMS APC rate,N/A,Not Applicable,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,252.72,203.89% of BCBS Fee Schedule,210,75% of total billed charges,210,75% of total Billed Charges,238.41,180% OF CMS OPPS RATE,224,80% of total Billed Charges,268.22,350% of CMS Opps rate,135.1,102% of CMS Opps rate,214.2,76.5% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,126,45% of total billed charges,196,70% of total billed charges,168,60% of total billed charges,132.44,100% of CMS OPPS Rate,196,70% OF TOTAL BILLED CHARGES,196,70% of total billed charges,132.44,100% OF CMS OPPS Rate,268.22,230% OF CMS OPPS Rate,134.4,48% of total Billed charges,132.44,100% OF CMS OPPS Rate,252,90% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,126,268.22,168
Outpatient,Therapy,90847,"Family psychotherapy, including patient, 50 min",900,280,268.22,354% of CMS APC rate,N/A,Not Applicable,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,252.72,203.89% of BCBS Fee Schedule,210,75% of total billed charges,210,75% of total Billed Charges,238.41,180% OF CMS OPPS RATE,224,80% of total Billed Charges,268.22,350% of CMS Opps rate,135.1,102% of CMS Opps rate,214.2,76.5% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,126,45% of total billed charges,196,70% of total billed charges,168,60% of total billed charges,132.44,100% of CMS OPPS Rate,196,70% OF TOTAL BILLED CHARGES,196,70% of total billed charges,132.44,100% OF CMS OPPS Rate,268.22,230% OF CMS OPPS Rate,134.4,48% of total Billed charges,132.44,100% OF CMS OPPS Rate,252,90% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,132.44,100% of CMS OPPS Rate,126,268.22,168
Outpatient,Therapy,90853,Group psychotherapy,900,274,244.09,354% of CMS APC rate,N/A,Not Applicable,68.94,100% of CMS OPPS Rate,68.94,100% of CMS OPPS Rate,146.68,203.89% of BCBS Fee Schedule,205.5,75% of total billed charges,205.5,75% of total Billed Charges,124.11,180% OF CMS OPPS RATE,219.2,80% of total Billed Charges,241.33,350% of CMS Opps rate,70.31,102% of CMS Opps rate,209.61,76.5% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,68.94,100% of CMS OPPS Rate,68.94,100% of CMS OPPS Rate,123.3,45% of total billed charges,191.8,70% of total billed charges,164.4,60% of total billed charges,68.94,100% of CMS OPPS Rate,191.8,70% OF TOTAL BILLED CHARGES,191.8,70% of total billed charges,68.94,100% OF CMS OPPS Rate,158.59,230% OF CMS OPPS Rate,131.52,48% of total Billed charges,68.94,100% OF CMS OPPS Rate,246.6,90% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,68.94,100% of CMS OPPS Rate,68.94,100% of CMS OPPS Rate,68.94,100% of CMS OPPS Rate,68.94,100% of CMS OPPS Rate,68.94,100% of CMS OPPS Rate,68.94,100% of CMS OPPS Rate,68.94,100% of CMS OPPS Rate,68.94,100% of CMS OPPS Rate,68.94,246.6,164.4
Outpatient,Therapy,97110,"Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes",900,N/A,99.47,354% of CMS OPPS Rate,N/A,Not Applicable,28.1,100% of CMS OPPS Rate,28.1,100% of CMS OPPS Rate,63.27,203.89% of BCBS Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,50.58,180% OF CMS OPPS RATE,N/A,Not Applicable,98.35,350% of CMS Opps rate,28.66,102% of CMS Opps rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,28.1,100% of CMS OPPS Rate,28.1,100% of CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,28.1,100% of CMS OPPS Rate,278,Case rate,N/A,Not Applicable,28.1,100% OF CMS OPPS Rate,64.63,230% OF CMS OPPS Rate,N/A,Not Applicable,28.1,100% OF CMS OPPS Rate,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,28.1,100% of CMS OPPS Rate,28.1,100% of CMS OPPS Rate,28.1,100% of CMS OPPS Rate,28.1,100% of CMS OPPS Rate,28.1,100% of CMS OPPS Rate,28.1,100% of CMS OPPS Rate,28.1,100% of CMS OPPS Rate,28.1,100% of CMS OPPS Rate,28.1,278,N/A
Physician,Physician,99203,"New patient office or other outpatient visit, typically 30 min",960,344,N/A,Not Applicable,31.5,100% of Medicaid LA Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,78.06,100% of BCBS Fee Schedule,101.6,100% of CIGNA Fee Schedule,101.6,100% of CIGNA Fee Schedule,75.33,180% OF CMS OPPS RATE,97.71,140% OF CMS OPPS RATE,106.53,140% of CMS OPPS RATE,76.09,102% of CMS Opps rate,122,100% OF FEE SCHEDULE,31.5,100% of Medicaid LA Fee Schedule,31.5,100% of Medicaid LA Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,101.43,100% of OPPS Fee Schedule Rate,75.33,100% of OPPS Fee Schedule Rate,75.33,100% of OPPS Fee Schedule,N/A,Not Applicable,81.81,100% OF UHC FEE SCHEDULE,81.81,100% OF UHC FEE SCHEDULE,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,122,100% OF CMS OPPS Rate,31.5,90% of total Billed charges,31.5,100% of Medicaid LA Fee Schedule,31.5,100% of Medicaid LA Fee Schedule,31.5,100% of Medicaid LA Fee Schedule,31.5,100% of Medicaid LA Fee Schedule,31.5,100% of Medicaid LA Fee Schedule,31.5,100% of Medicaid LA Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,31.5,122,206.4
Physician,Physician,99204,"New patient office of other outpatient visit, typically 45 min",960,527,N/A,Not Applicable,56.7,100% of Medicaid LA Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,131.75,100% of BCBS Fee Schedule,143.92,100% of CIGNA Fee Schedule,143.92,100% of CIGNA Fee Schedule,127.33,180% OF CMS OPPS RATE,144.75,140% OF CMS OPPS RATE,180.07,140% of CMS OPPS RATE,128.62,102% of CMS Opps rate,182,100% OF FEE SCHEDULE,56.7,100% of Medicaid LA Fee Schedule,56.7,100% of Medicaid LA Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,157.52,100% of OPPS Fee Schedule Rate,127.33,100% of OPPS Fee Schedule Rate,127.33,100% of OPPS Fee Schedule,N/A,Not Applicable,121.07,100% OF UHC FEE SCHEDULE,121.07,100% OF UHC FEE SCHEDULE,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,182,100% OF CMS OPPS Rate,56.7,90% of total Billed charges,56.7,100% of Medicaid LA Fee Schedule,56.7,100% of Medicaid LA Fee Schedule,56.7,100% of Medicaid LA Fee Schedule,56.7,100% of Medicaid LA Fee Schedule,56.7,100% of Medicaid LA Fee Schedule,56.7,100% of Medicaid LA Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,56.7,182,316.2
Physician,Physician,99205,"New patient office of other outpatient visit, typically 60 min",960,665,N/A,Not Applicable,66.15,100% of Medicaid LA Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,171.67,100% of BCBS Fee Schedule,183.38,100% of CIGNA Fee Schedule,183.38,100% of CIGNA Fee Schedule,166.11,180% OF CMS OPPS RATE,192.77,140% OF CMS OPPS RATE,234.91,140% of CMS OPPS RATE,167.79,102% of CMS Opps rate,229,100% OF FEE SCHEDULE,66.15,100% of Medicaid LA Fee Schedule,66.15,100% of Medicaid LA Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,199.3,100% of OPPS Fee Schedule Rate,166.11,100% of OPPS Fee Schedule Rate,166.11,100% of OPPS Fee Schedule,N/A,Not Applicable,161.14,100% OF UHC FEE SCHEDULE,161.14,100% OF UHC FEE SCHEDULE,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,229,100% OF CMS OPPS Rate,66.15,90% of total Billed charges,66.15,100% of Medicaid LA Fee Schedule,66.15,100% of Medicaid LA Fee Schedule,66.15,100% of Medicaid LA Fee Schedule,66.15,100% of Medicaid LA Fee Schedule,66.15,100% of Medicaid LA Fee Schedule,66.15,100% of Medicaid LA Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,66.15,234.91,399
Physician,Physician,99243,"Patient office consultation, typically 40 min",960,450,N/A,Not Applicable,66.15,100% of Medicaid LA Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,96.72,100% of BCBS Fee Schedule,127.85,100% of CIGNA Fee Schedule,127.85,100% of CIGNA Fee Schedule,94.25,180% OF CMS OPPS RATE,126.85,140% OF CMS OPPS RATE,133.28,140% of CMS OPPS RATE,95.2,102% of CMS Opps rate,180,100% OF FEE SCHEDULE,66.15,100% of Medicaid LA Fee Schedule,66.15,100% of Medicaid LA Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,137.94,100% of OPPS Fee Schedule Rate,94.25,100% of OPPS Fee Schedule Rate,94.25,100% of OPPS Fee Schedule,N/A,Not Applicable,106.36,100% OF UHC FEE SCHEDULE,106.36,100% OF UHC FEE SCHEDULE,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,180,100% OF CMS OPPS Rate,66.15,90% of total Billed charges,66.15,100% of Medicaid LA Fee Schedule,66.15,100% of Medicaid LA Fee Schedule,66.15,100% of Medicaid LA Fee Schedule,66.15,100% of Medicaid LA Fee Schedule,66.15,100% of Medicaid LA Fee Schedule,66.15,100% of Medicaid LA Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,66.15,180,270
Physician,Physician,99244,"Patient office consultation, typically 60 min",960,547,N/A,Not Applicable,66.15,100% of Medicaid LA Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,155.49,100% of BCBS Fee Schedule,181.6,100% of CIGNA Fee Schedule,181.6,100% of CIGNA Fee Schedule,151.53,180% OF CMS OPPS RATE,187.21,140% OF CMS OPPS RATE,214.28,140% of CMS OPPS RATE,153.06,102% of CMS Opps rate,252,100% OF FEE SCHEDULE,66.15,100% of Medicaid LA Fee Schedule,66.15,100% of Medicaid LA Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,204.96,100% of OPPS Fee Schedule Rate,151.53,100% of OPPS Fee Schedule Rate,151.53,100% of OPPS Fee Schedule,N/A,Not Applicable,156.62,100% OF UHC FEE SCHEDULE,156.62,100% OF UHC FEE SCHEDULE,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,252,100% OF CMS OPPS Rate,66.15,90% of total Billed charges,66.15,100% of Medicaid LA Fee Schedule,66.15,100% of Medicaid LA Fee Schedule,66.15,100% of Medicaid LA Fee Schedule,66.15,100% of Medicaid LA Fee Schedule,66.15,100% of Medicaid LA Fee Schedule,66.15,100% of Medicaid LA Fee Schedule,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,66.15,252,328.2
Physician,Physician,99385,Initial new patient preventive medicine evaluation (18?39 years),960,665,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,92.35,100% of BCBS Fee Schedule,123.05,100% of CIGNA Fee Schedule,123.05,100% of CIGNA Fee Schedule,96.31,180% OF CMS OPPS RATE,111.05,140% OF CMS OPPS RATE,136.19,140% of CMS OPPS RATE,97.28,102% of CMS Opps rate,198,100% OF FEE SCHEDULE,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,399,60% of total Billed charges,96.31,100% of OPPS Fee Schedule Rate,96.31,100% of OPPS Fee Schedule,N/A,Not Applicable,137.7,100% OF UHC FEE SCHEDULE,137.7,100% OF UHC FEE SCHEDULE,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,198,100% OF CMS OPPS Rate,92.35,90% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,92.35,399,399
Physician,Physician,99386,Initial new patient preventive medicine evaluation (40?64 years),960,665,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,112.39,100% of BCBS Fee Schedule,145.04,100% of CIGNA Fee Schedule,145.04,100% of CIGNA Fee Schedule,117.29,180% OF CMS OPPS RATE,136.02,140% OF CMS OPPS RATE,165.86,140% of CMS OPPS RATE,118.47,102% of CMS Opps rate,240,100% OF FEE SCHEDULE,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,399,60% of total Billed charges,117.29,100% of OPPS Fee Schedule Rate,117.29,100% of OPPS Fee Schedule,N/A,Not Applicable,168.06,100% OF UHC FEE SCHEDULE,168.06,100% OF UHC FEE SCHEDULE,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,240,100% OF CMS OPPS Rate,112.39,90% of total Billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,112.39,399,399
Outpatient Medical Services,Laboratory,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,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,Laboratory,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,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
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,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,55700,Biopsy of prostate gland,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,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
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,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
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,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
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,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,62322,Injection of substance into spinal canal of lower back or sacrum using imaging guidanc,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,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
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,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
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,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
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,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,SLEEP STUDY,95810,Sleep study,920,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A