Addendum A.-Final OPPS APCs for CY 2012					
APC	Group Title	SI	Relative Weight 	Payment Rate 	National Unadjusted Copayment 	Minimum Unadjusted Copayment 
0001	Level I Photochemotherapy	S	0.5043	$35.31	.	$7.07
0002	Fine Needle Biopsy/Aspiration	T	1.6118	$112.85	.	$22.57
0003	Bone Marrow Biopsy/Aspiration	T	3.5548	$248.89	.	$49.78
0004	Level I Needle Biopsy/ Aspiration Except Bone Marrow	T	4.5721	$320.12	.	$64.03
0005	Level II Needle Biopsy/Aspiration Except Bone Marrow	T	8.1596	$571.30	.	$114.26
0006	Level I Incision & Drainage	T	1.4209	$99.49	.	$19.90
0007	Level II Incision & Drainage	T	12.8082	$896.78	.	$179.36
0008	Level III Incision and Drainage	T	20.5510	"$1,438.90"	.	$287.78
0012	Level I Debridement & Destruction	T	0.3878	$27.15	.	$5.43
0013	Level II Debridement & Destruction	T	0.8768	$61.39	.	$12.28
0015	Level III Debridement & Destruction	T	1.4966	$104.79	.	$20.96
0016	Level IV Debridement & Destruction	T	2.7597	$193.22	.	$38.65
0017	Level V Debridement & Destruction	T	21.6700	"$1,517.25"	.	$303.45
0019	Level I Excision/ Biopsy	T	4.3953	$307.74	.	$61.55
0020	Level II Excision/ Biopsy	T	8.2918	$580.56	.	$116.12
0021	Level III Excision/ Biopsy	T	16.9957	"$1,189.97"	.	$238.00
0022	Level IV Excision/ Biopsy	T	23.2636	"$1,628.82"	$350.74	$325.77
0028	Level I Breast Surgery	T	25.5066	"$1,785.87"	.	$357.18
0029	Level II Breast Surgery	T	33.3398	"$2,334.32"	$580.94	$466.87
0030	Level III Breast Surgery	T	45.0217	"$3,152.24"	$747.07	$630.45
0031	Smoking Cessation Services	X	0.2988	$20.92	.	$4.19
0034	Mental Health Services Composite	S	2.7298	$191.13	.	$38.23
0035	Vascular Puncture and Minor Diagnostic Procedures	X	0.2673	$18.72	.	$3.75
0037	Level IV Needle Biopsy/Aspiration Except Bone Marrow	T	15.3535	"$1,074.99"	$227.40	$215.00
0039	Level I Implantation of Neurostimulator Generator	S	216.9330	"$15,188.78"	.	"$3,037.76"
0040	Level I Implantation/Revision/Replacement of Neurostimulator Electrodes 	S	63.3729	"$4,437.12"	.	$887.43
0041	Level I Arthroscopy	T	29.7721	"$2,084.52"	.	$416.91
0042	Level II Arthroscopy	T	57.0707	"$3,995.86"	$804.74	$799.18
0045	Bone/Joint Manipulation Under Anesthesia	T	15.4596	"$1,082.42"	$268.44	$216.49
0047	Arthroplasty without Prosthesis	T	41.2873	"$2,890.77"	.	$578.16
0048	Level I Arthroplasty or Implantation with Prosthesis	T	60.9147	"$4,265.00"	.	$853.00
0049	Level I Musculoskeletal Procedures Except Hand and Foot	T	22.0797	"$1,545.93"	.	$309.19
0050	Level II Musculoskeletal Procedures Except Hand and Foot	T	32.4461	"$2,271.75"	.	$454.35
0051	Level III Musculoskeletal Procedures Except Hand and Foot	T	47.5032	"$3,325.98"	.	$665.20
0052	Level IV Musculoskeletal Procedures Except Hand and Foot	T	88.8483	"$6,220.80"	.	"$1,244.16"
0053	Level I Hand Musculoskeletal Procedures	T	17.1902	"$1,203.59"	$253.49	$240.72
0054	Level II Hand Musculoskeletal Procedures	T	28.8625	"$2,020.84"	.	$404.17
0055	Level I Foot Musculoskeletal Procedures	T	22.0963	"$1,547.09"	$353.25	$309.42
0056	Level II Foot Musculoskeletal Procedures	T	58.4586	"$4,093.04"	.	$818.61
0057	Bunion Procedures	T	32.7262	"$2,291.36"	$475.91	$458.28
0058	Level I Strapping and Cast Application	S	1.1255	$78.80	.	$15.76
0060	Manipulation Therapy	S	0.3428	$24.00	.	$4.80
0061	Level II Implantation/Revision/Replacement of Neurostimulator Electrodes 	S	88.6050	"$6,203.77"	.	"$1,240.76"
0062	Level I Treatment Fracture/Dislocation	T	26.1202	"$1,828.83"	$372.85	$365.77
0063	Level II Treatment Fracture/Dislocation	T	49.8979	"$3,493.65"	.	$698.73
0064	Level III Treatment Fracture/Dislocation	T	68.1203	"$4,769.51"	.	$953.91
0065	"Level I Stereotactic Radiosurgery, MRgFUS, and MEG"	S	12.8903	$902.53	.	$180.51
0066	"Level II Stereotactic Radiosurgery, MRgFUS, and MEG"	S	35.9961	"$2,520.30"	.	$504.06
0067	"Level III Stereotactic Radiosurgery, MRgFUS, and MEG"	S	48.1833	"$3,373.60"	.	$674.72
0069	Thoracoscopy	T	34.5272	"$2,417.46"	$591.64	$483.50
0070	Thoracentesis/Lavage Procedures	T	5.5061	$385.52	.	$77.11
0071	Level I Endoscopy Upper Airway	T	1.0729	$75.12	.	$15.03
0072	Level II Endoscopy Upper Airway	T	1.8643	$130.53	.	$26.11
0073	Level III Endoscopy Upper Airway	T	4.4119	$308.90	$67.83	$61.78
0074	Level IV Endoscopy Upper Airway	T	21.2774	"$1,489.76"	.	$297.96
0075	Level V Endoscopy Upper Airway	T	30.3487	"$2,124.89"	$444.55	$424.98
0076	Level I Endoscopy Lower Airway	T	10.4689	$732.99	$189.82	$146.60
0077	Level I Pulmonary Treatment	S	0.4237	$29.67	$7.74	$5.94
0078	Level III Pulmonary Treatment	S	1.4089	$98.65	.	$19.73
0079	Ventilation Initiation and Management	S	3.1979	$223.90	.	$44.78
0080	Diagnostic Cardiac Catheterization	T	38.8523	"$2,720.28"	$836.90	$544.06
0082	Coronary or Non-Coronary Atherectomy	T	105.0651	"$7,356.24"	.	"$1,471.25"
0083	"Coronary Angioplasty, Valvuloplasty, and Level I Endovascular Revascularization of the Lower Extremity "	T	65.8519	"$4,610.69"	.	$922.14
0084	Level I Electrophysiologic Procedures	S	9.9330	$695.47	.	$139.10
0085	Level II Electrophysiologic Procedures	T	53.2719	"$3,729.89"	.	$745.98
0086	Level III Electrophysiologic Procedures	T	121.8174	"$8,529.17"	.	"$1,705.84"
0088	Thrombectomy	T	41.0387	"$2,873.37"	$655.18	$574.68
0089	Insertion/Replacement of Permanent Pacemaker and Electrodes	T	112.1218	"$7,850.32"	"$1,643.98"	"$1,570.07"
0090	Level I Insertion/Replacement of Permanent Pacemaker 	T	94.2220	"$6,597.05"	"$1,593.50"	"$1,319.41"
0091	Level II Vascular Ligation	T	44.2272	"$3,096.61"	.	$619.33
0092	Level I Vascular Ligation	T	26.8120	"$1,877.27"	.	$375.46
0093	Vascular Reconstruction/Fistula Repair without Device	T	31.1505	"$2,181.03"	.	$436.21
0094	Level I Resuscitation and Cardioversion	S	2.2326	$156.32	$43.83	$31.27
0095	Cardiac Rehabilitation	S	0.9930	$69.53	.	$13.91
0096	Level II Noninvasive Physiologic Studies	S	1.5248	$106.76	$36.86	$21.36
0097	Level I Noninvasive Physiologic Studies	S	0.9350	$65.46	.	$13.10
0099	Electrocardiograms/Cardiography	S	0.3817	$26.73	.	$5.35
0100	Cardiac Stress Tests	X	2.5439	$178.11	$41.37	$35.63
0101	Tilt Table Evaluation	S	4.2669	$298.75	$100.24	$59.75
0102	Level II Pulmonary Treatment	S	0.5346	$37.43	.	$7.49
0103	Miscellaneous Vascular Procedures	T	16.3852	"$1,147.23"	.	$229.45
0104	Transcatheter Placement of Intracoronary Stents	T	81.1503	"$5,681.82"	.	"$1,136.37"
0105	"Repair/Revision/Removal of Pacemakers, AICDs, or Vascular Devices"	T	21.7420	"$1,522.29"	.	$304.46
0106	Insertion/Replacement of Pacemaker Leads and/or Electrodes	T	47.1769	"$3,303.14"	.	$660.63
0107	Insertion of Cardioverter-Defibrillator Pulse Generator	T	341.5859	"$23,916.48"	.	"$4,783.30"
0108	"Insertion/Replacement/Repair of AICD Leads, Generator, and Pacing Electrodes"	T	426.1201	"$29,835.22"	.	"$5,967.05"
0110	Transfusion	S	3.4217	$239.57	.	$47.92
0111	Blood Product Exchange	S	11.6629	$816.59	$189.89	$163.32
0112	Apheresis and Stem Cell Procedures	S	35.6252	"$2,494.33"	.	$498.87
0113	Excision Lymphatic System	T	25.2738	"$1,769.57"	.	$353.92
0114	Thyroid/Lymphadenectomy Procedures	T	51.2792	"$3,590.36"	.	$718.08
0115	Cannula/Access Device Procedures	T	37.4593	"$2,622.75"	.	$524.55
0121	Level I Tube or Catheter Changes or Repositioning	T	6.2123	$434.96	.	$87.00
0126	Level I Urinary and Anal Procedures	T	1.1095	$77.68	$16.21	$15.54
0127	"Level IV Stereotactic Radiosurgery, MRgFUS, and MEG"	S	106.5454	"$7,459.88"	.	"$1,491.98"
0128	Echocardiogram with Contrast	S	7.9593	$557.28	$166.16	$111.46
0129	Level I Closed Treatment Fracture	T	1.5020	$105.16	.	$21.04
0130	Level I Laparoscopy	T	38.9223	"$2,725.18"	$659.53	$545.04
0131	Level II Laparoscopy	T	47.9394	"$3,356.53"	"$1,001.89"	$671.31
0132	Level III Laparoscopy	T	71.5658	"$5,010.75"	"$1,236.99"	"$1,002.15"
0133	Level I Skin Repair	T	1.1922	$83.47	$23.34	$16.70
0134	Level II Skin Repair	T	3.2354	$226.53	.	$45.31
0135	Level III Skin Repair	T	4.9271	$344.98	.	$69.00
0136	Level IV Skin Repair	T	16.7703	"$1,174.19"	.	$234.84
0137	Level V Skin Repair	T	21.4409	"$1,501.21"	.	$300.25
0138	Level II Closed Treatment Fracture 	T	5.0454	$353.26	.	$70.66
0139	Level III Closed Treatment Fracture 	T	18.9489	"$1,326.73"	.	$265.35
0140	Esophageal Dilation without Endoscopy	T	6.5866	$461.17	.	$92.24
0141	Level I Upper GI Procedures	T	8.4511	$591.71	$138.69	$118.35
0142	Level I Small Intestine Endoscopy	T	10.4394	$730.93	$152.78	$146.19
0143	Lower GI Endoscopy	T	9.3693	$656.00	$186.06	$131.20
0146	Level I Sigmoidoscopy and Anoscopy	T	6.2205	$435.53	.	$87.11
0147	Level II Sigmoidoscopy and Anoscopy	T	11.0417	$773.10	.	$154.62
0148	Level I Anal/Rectal Procedures	T	5.5158	$386.19	.	$77.24
0149	Level III Anal/Rectal Procedures	T	24.4382	"$1,711.07"	.	$342.22
0150	Level IV Anal/Rectal Procedures	T	32.9805	"$2,309.16"	.	$461.84
0151	Endoscopic Retrograde Cholangio-Pancreatography (ERCP)	T	24.6966	"$1,729.16"	.	$345.84
0152	Level I Percutaneous Abdominal and Biliary Procedures	T	29.1415	"$2,040.37"	.	$408.08
0153	Peritoneal and Abdominal Procedures	T	27.2798	"$1,910.02"	.	$382.01
0154	Hernia/Hydrocele Procedures	T	32.9294	"$2,305.58"	$464.85	$461.12
0155	Level II Anal/Rectal Procedures	T	15.4175	"$1,079.47"	.	$215.90
0156	Level III Urinary and Anal Procedures	T	3.1886	$223.25	.	$44.65
0157	Colorectal Cancer Screening: Barium Enema	S	2.7510	$192.61	.	$38.53
0158	Colorectal Cancer Screening: Colonoscopy	T	8.3164	$582.28	$0.00	$0.00
0159	Colorectal Cancer Screening: Flexible Sigmoidoscopy	S	5.3772	$376.49	$0.00	$0.00
0160	Level I Cystourethroscopy and other Genitourinary Procedures	T	6.7736	$474.26	.	$94.86
0161	Level II Cystourethroscopy and other Genitourinary Procedures	T	17.4715	"$1,223.28"	.	$244.66
0162	Level III Cystourethroscopy and other Genitourinary Procedures	T	26.2973	"$1,841.23"	.	$368.25
0163	Level IV Cystourethroscopy and other Genitourinary Procedures	T	37.0730	"$2,595.70"	.	$519.14
0164	Level II Urinary and Anal Procedures	T	1.9499	$136.52	.	$27.31
0165	Level IV Urinary and Anal Procedures	T	20.4158	"$1,429.43"	.	$285.89
0166	Level I Urethral Procedures	T	21.0031	"$1,470.55"	.	$294.11
0168	Level II Urethral Procedures	T	32.3061	"$2,261.94"	.	$452.39
0169	Lithotripsy	T	52.0882	"$3,647.01"	$997.74	$729.41
0170	Dialysis	S	6.2419	$437.03	.	$87.41
0172	Level I Partial Hospitalization (3 services) for CMHCs	P	1.3944	$97.63	.	$19.53
0173	Level II Partial Hospitalization (4 or more services) for CMHCs	P	1.6255	$113.81	.	$22.77
0174	Level IV Laparoscopy	T	111.6495	"$7,817.25"	"$2,055.58"	"$1,563.45"
0175	Level I Partial Hospitalization (3 services) for Hospital-based PHPs	P	2.2954	$160.71	.	$32.15
0176	Level II Partial Hospitalization (4 or more services) for Hospital-based PHPs	P	2.7298	$191.13	.	$38.23
0181	Level II Male Genital Procedures	T	34.6069	"$2,423.04"	$607.60	$484.61
0183	Level I Male Genital Procedures	T	23.5454	"$1,648.55"	.	$329.71
0184	Prostate Biopsy	T	13.7727	$964.31	.	$192.87
0188	Level II Female Reproductive Proc	T	1.5841	$110.91	.	$22.19
0189	Level III Female Reproductive Proc	T	3.4818	$243.78	.	$48.76
0190	Level I Hysteroscopy	T	23.0098	"$1,611.05"	$424.28	$322.21
0191	Level I Female Reproductive Proc	T	0.1337	$9.36	$1.95	$1.88
0192	Level IV Female Reproductive Proc	T	6.6979	$468.96	.	$93.80
0193	Level V Female Reproductive Proc	T	20.6493	"$1,445.78"	.	$289.16
0195	Level VI Female Reproductive Procedures	T	35.9087	"$2,514.18"	.	$502.84
0202	Level VII Female Reproductive Procedures	T	45.9895	"$3,220.00"	$981.50	$644.00
0203	Level IV Nerve Injections	T	12.7996	$896.18	.	$179.24
0204	Level I Nerve Injections	T	2.6055	$182.43	.	$36.49
0206	Level II Nerve Injections	T	3.8754	$271.34	.	$54.27
0207	Level III Nerve Injections	T	7.4537	$521.88	.	$104.38
0208	Laminotomies and Laminectomies	T	50.7343	"$3,552.21"	.	$710.45
0209	"Level II Extended EEG, Sleep, and Cardiovascular Studies"	S	11.3569	$795.16	$268.73	$159.04
0213	"Level I Extended EEG, Sleep, and Cardiovascular Studies"	S	2.4298	$170.12	$53.58	$34.03
0215	Level I Nerve and Muscle Tests	S	0.6335	$44.36	.	$8.88
0216	Level III Nerve and Muscle Tests	S	2.6488	$185.46	.	$37.10
0218	Level II Nerve and Muscle Tests	S	1.2025	$84.19	.	$16.84
0220	Level I Nerve Procedures	T	18.8921	"$1,322.75"	.	$264.55
0221	Level II Nerve Procedures	T	36.1290	"$2,529.61"	.	$505.93
0224	Implantation of Catheter/Reservoir/Shunt	T	41.5547	"$2,909.49"	.	$581.90
0227	Implantation of Drug Infusion Device	T	192.7379	"$13,494.74"	.	"$2,698.95"
0229	Level II Endovascular Revascularization of the Lower Extremity 	T	115.5014	"$8,086.95"	.	"$1,617.39"
0230	Level I Eye Tests & Treatments	S	0.6424	$44.98	.	$9.00
0231	Level III Eye Tests & Treatments	S	2.0294	$142.09	.	$28.42
0232	Level I Anterior Segment Eye Procedures	T	2.8247	$197.77	$42.27	$39.56
0233	Level III Anterior Segment Eye Procedures	T	16.6214	"$1,163.76"	.	$232.76
0234	Level IV Anterior Segment Eye Procedures	T	23.2851	"$1,630.33"	$347.90	$326.07
0235	Level I Posterior Segment Eye Procedures	T	4.8135	$337.02	.	$67.41
0237	Level II Posterior Segment Eye Procedures	T	21.5368	"$1,507.92"	.	$301.59
0238	Level I Repair and Plastic Eye Procedures	T	3.1036	$217.30	.	$43.46
0239	Level II Repair and Plastic Eye Procedures	T	7.6566	$536.08	.	$107.22
0240	Level III Repair and Plastic Eye Procedures	T	19.7786	"$1,384.82"	$296.20	$276.97
0241	Level IV Repair and Plastic Eye Procedures	T	27.3416	"$1,914.35"	$383.45	$382.87
0242	Level V Repair and Plastic Eye Procedures	T	40.4039	"$2,828.92"	$597.36	$565.79
0243	Strabismus/Muscle Procedures	T	24.8671	"$1,741.09"	$411.91	$348.22
0244	Corneal and Amniotic Membrane Transplant	T	37.8979	"$2,653.46"	$794.94	$530.70
0246	Cataract Procedures with IOL Insert	T	23.8810	"$1,672.05"	$490.37	$334.41
0247	Laser Eye Procedures	T	5.4120	$378.93	$102.28	$75.79
0249	Cataract Procedures without IOL Insert	T	30.9855	"$2,169.48"	$516.99	$433.90
0250	Level I ENT Procedures	T	1.0709	$74.98	$24.12	$15.00
0251	Level II ENT Procedures	T	3.1150	$218.10	.	$43.62
0252	Level III ENT Procedures	T	7.4614	$522.42	$104.55	$104.49
0253	Level IV ENT Procedures	T	16.8699	"$1,181.16"	$279.20	$236.24
0254	Level V ENT Procedures	T	24.8895	"$1,742.66"	.	$348.54
0255	Level II Anterior Segment Eye Procedures	T	7.2190	$505.45	$101.81	$101.09
0256	Level VI ENT Procedures	T	45.0377	"$3,153.36"	.	$630.68
0259	Level VII ENT Procedures	T	412.7299	"$28,897.70"	"$7,948.75"	"$5,779.54"
0260	Level I Plain Film Except Teeth	X	0.6409	$44.87	.	$8.98
0261	Level II Plain Film Except Teeth Including Bone Density Measurement	X	1.0790	$75.55	.	$15.11
0262	Plain Film of Teeth	X	0.4640	$32.49	.	$6.50
0263	Level I Miscellaneous Radiology Procedures	X	3.3643	$235.55	.	$47.11
0265	Level I Diagnostic and Screening Ultrasound	S	0.8990	$62.94	$22.26	$12.59
0266	Level II Diagnostic and Screening Ultrasound	S	1.3781	$96.49	$37.23	$19.30
0267	Level III Diagnostic and Screening Ultrasound	S	2.1681	$151.80	$59.37	$30.36
0269	Level II Echocardiogram Without Contrast 	S	5.6156	$393.18	.	$78.64
0270	Level III Echocardiogram Without Contrast 	S	8.2952	$580.80	$133.61	$116.16
0272	Fluoroscopy	X	1.2171	$85.22	$30.47	$17.05
0274	Myelography	S	7.0678	$494.86	.	$98.98
0275	Arthrography	S	4.0104	$280.79	$68.90	$56.16
0276	Level I Digestive Radiology	S	1.2186	$85.32	$33.87	$17.07
0277	Level II Digestive Radiology	S	2.0340	$142.41	$53.90	$28.49
0278	Diagnostic Urography	S	2.6196	$183.41	$58.44	$36.69
0279	Level II Angiography and Venography	S	29.7209	"$2,080.94"	.	$416.19
0280	Level III Angiography and Venography	S	49.6878	"$3,478.94"	.	$695.79
0282	Miscellaneous Computed Axial Tomography	S	1.5251	$106.78	$35.57	$21.36
0283	Computed Tomography with Contrast	S	4.2929	$300.57	$96.62	$60.12
0284	Magnetic Resonance Imaging and Magnetic Resonance Angiography with Contrast	S	6.2343	$436.50	$146.69	$87.30
0288	Bone Density:Axial Skeleton	S	1.0218	$71.54	$0.00	$0.00
0293	Level VI Anterior Segment Eye Procedures	T	117.1298	"$8,200.96"	.	"$1,640.20"
0299	Hyperthermia and Radiation Treatment Procedures	S	5.6386	$394.79	.	$78.96
0300	Level I Radiation Therapy	S	1.4252	$99.79	.	$19.96
0301	Level II Radiation Therapy	S	2.4149	$169.08	.	$33.82
0303	Treatment Device Construction	X	2.8573	$200.06	$66.95	$40.02
0304	Level I Therapeutic Radiation Treatment Preparation	X	1.5329	$107.33	$34.63	$21.47
0305	Level II Therapeutic Radiation Treatment Preparation	X	3.7681	$263.83	$88.76	$52.77
0308	Positron Emission Tomography (PET) imaging	S	14.8260	"$1,038.06"	.	$207.62
0310	Level III Therapeutic Radiation Treatment Preparation	X	13.6332	$954.54	$325.27	$190.91
0312	Radioelement Applications	S	5.4044	$378.39	.	$75.68
0313	Brachytherapy	S	9.9687	$697.97	$263.92	$139.60
0315	Level II Implantation of Neurostimulator Generator 	S	285.5893	"$19,995.82"	.	"$3,999.17"
0317	Level II Miscellaneous Radiology Procedures	X	5.7208	$400.55	.	$80.11
0318	Implantation of Neurostimulator Pulse Generator and Electrode 	S	346.4693	"$24,258.39"	"$9,121.76"	"$4,851.68"
0319	Level III Endovascular Revascularization of the Lower Extremity	T	203.0553	"$14,217.12"	"$5,559.48"	"$2,843.43"
0320	Electroconvulsive Therapy	S	5.9715	$418.10	.	$83.62
0322	Brief Individual Psychotherapy	S	1.1395	$79.78	.	$15.96
0323	Extended Individual Psychotherapy	S	1.5910	$111.40	.	$22.28
0324	Family Psychotherapy	S	1.8190	$127.36	.	$25.48
0325	Group Psychotherapy	S	0.8088	$56.63	$11.70	$11.33
0330	Dental Procedures	S	8.2687	$578.94	.	$115.79
0331	Combined Abdomen and Pelvis CT without Contrast 	S	5.7930	$405.60	$156.82	$81.12
0332	Computed Tomography without Contrast	S	2.7436	$192.10	$74.27	$38.42
0333	Computed Tomography without Contrast followed by Contrast	S	4.7767	$334.45	$116.13	$66.89
0334	Combined Abdomen and Pelvis CT with Contrast 	S	8.2987	$581.04	$187.25	$116.21
0336	Magnetic Resonance Imaging and Magnetic Resonance Angiography without Contrast	S	4.8381	$338.74	$133.48	$67.75
0337	Magnetic Resonance Imaging and Magnetic Resonance Angiography without Contrast followed by Contrast	S	7.6347	$534.55	$197.64	$106.91
0340	Minor Ancillary Procedures	X	0.6499	$45.50	.	$9.10
0341	Skin Tests	X	0.0806	$5.64	$2.09	$1.13
0342	Level I Pathology	X	0.1601	$11.21	.	$2.25
0343	Level III Pathology	X	0.5259	$36.82	$10.84	$7.37
0344	Level IV Pathology	X	0.8180	$57.27	$15.56	$11.46
0345	Level I Transfusion Laboratory Procedures	X	0.2135	$14.95	.	$2.99
0346	Level II Transfusion Laboratory Procedures	X	0.3538	$24.77	.	$4.96
0347	Level III Transfusion Laboratory Procedures	X	0.6730	$47.12	.	$9.43
0350	Administration of flu and PPV vaccine	S	0.3545	$24.82	$0.00	$0.00
0360	Level I Alimentary Tests	X	1.7152	$120.09	$33.87	$24.02
0361	Level II Alimentary Tests	X	4.0827	$285.85	$83.23	$57.17
0363	Level I Otorhinolaryngologic Function Tests	X	0.9638	$67.48	$17.10	$13.50
0364	Level I Audiometry	X	0.4911	$34.38	$7.06	$6.88
0365	Level II Audiometry	X	1.2175	$85.24	$18.05	$17.05
0366	Level III Audiometry	X	1.6864	$118.07	$23.65	$23.62
0367	Level I Pulmonary Test	X	0.7420	$51.95	$13.76	$10.39
0368	Level II Pulmonary Tests	X	0.8906	$62.36	$20.93	$12.48
0369	Level III Pulmonary Tests	X	2.6868	$188.12	$38.23	$37.63
0370	Multiple Allergy Tests	X	1.1369	$79.60	.	$15.92
0373	Level I Neuropsychological Testing	X	1.3842	$96.92	.	$19.39
0375	Ancillary Outpatient Services When Patient Expires	S	86.2468	"$6,038.66"	.	"$1,207.74"
0377	Level II Cardiac Imaging	S	9.6018	$672.28	.	$134.46
0378	Level II Pulmonary Imaging	S	4.5192	$316.42	$126.56	$63.29
0381	Single Allergy Tests	X	0.4426	$30.99	.	$6.20
0382	Level II Neuropsychological Testing	X	2.5717	$180.06	.	$36.02
0383	Cardiac Computed Tomographic Imaging	S	3.7417	$261.98	.	$52.40
0384	GI Procedures with Stents	T	29.2172	"$2,045.67"	.	$409.14
0385	Level I Prosthetic Urological Procedures	S	104.8530	"$7,341.39"	.	"$1,468.28"
0386	Level II Prosthetic Urological Procedures	S	169.3017	"$11,853.83"	.	"$2,370.77"
0387	Level II Hysteroscopy	T	38.3457	"$2,684.81"	$655.55	$536.97
0388	Discography	S	22.7689	"$1,594.19"	.	$318.84
0389	Level I Non-imaging Nuclear Medicine	S	1.5569	$109.01	$26.88	$21.81
0390	Level I Endocrine Imaging	S	1.8944	$132.64	$47.64	$26.53
0391	Level II Endocrine Imaging	S	3.1610	$221.32	$65.46	$44.27
0392	Level II Non-imaging Nuclear Medicine	S	2.2892	$160.28	$39.07	$32.06
0393	Hematologic Processing & Studies	S	6.9196	$484.48	.	$96.90
0394	Hepatobiliary Imaging	S	4.1909	$293.43	$90.78	$58.69
0395	GI Tract Imaging	S	3.4841	$243.94	$87.01	$48.79
0396	Bone Imaging	S	3.5304	$247.18	$94.20	$49.44
0397	Vascular Imaging	S	2.0980	$146.89	$33.94	$29.38
0398	Level I Cardiac Imaging	S	4.2548	$297.90	$93.33	$59.58
0400	Hematopoietic Imaging	S	3.6580	$256.12	$90.92	$51.23
0401	Level I Pulmonary Imaging	S	2.8915	$202.45	$71.16	$40.49
0402	Level II Nervous System Imaging	S	8.6793	$607.69	.	$121.54
0403	Level I Nervous System Imaging	S	3.4408	$240.91	$72.42	$48.19
0404	Renal and Genitourinary Studies	S	4.5536	$318.82	$81.52	$63.77
0406	Level I Tumor/Infection Imaging	S	4.0053	$280.44	$85.08	$56.09
0407	Level I Radionuclide Therapy	S	3.2941	$230.64	$78.13	$46.13
0408	Level III Tumor/Infection Imaging	S	13.6750	$957.47	.	$191.50
0409	Red Blood Cell Tests	X	0.1101	$7.71	$2.17	$1.55
0412	IMRT Treatment Delivery	S	6.5452	$458.27	.	$91.66
0413	Level II Radionuclide Therapy	S	4.0373	$282.68	.	$56.54
0414	Level II Tumor/Infection Imaging	S	7.0664	$494.76	.	$98.96
0415	Level II Endoscopy Lower Airway	T	28.9051	"$2,023.82"	$459.92	$404.77
0419	Level II Upper GI Procedures 	T	12.6671	$886.90	$207.88	$177.38
0422	Level III Upper GI Procedures	T	25.9792	"$1,818.96"	.	$363.80
0423	Level II Percutaneous Abdominal and Biliary Procedures	T	58.4890	"$4,095.17"	.	$819.04
0424	Level II Small Intestine Endoscopy 	T	15.7819	"$1,104.99"	$240.64	$221.00
0425	Level II Arthroplasty or Implantation with Prosthesis	T	132.5319	"$9,279.35"	.	"$1,855.87"
0426	Level II Strapping and Cast Application	S	2.5699	$179.93	.	$35.99
0427	Level II Tube or Catheter Changes or Repositioning	T	16.2412	"$1,137.14"	.	$227.43
0428	Level III Sigmoidoscopy and Anoscopy	T	23.9777	"$1,678.82"	.	$335.77
0429	Level V Cystourethroscopy and other Genitourinary Procedures	T	45.7676	"$3,204.46"	.	$640.90
0432	Health and Behavior Services	S	0.5154	$36.09	.	$7.22
0433	Level II Pathology	X	0.2434	$17.04	$5.06	$3.41
0434	Cardiac Defect Repair	T	171.3141	"$11,994.73"	.	"$2,398.95"
0436	Level I Drug Administration	S	0.3545	$24.82	.	$4.97
0437	Level II Drug Administration	S	0.4972	$34.81	.	$6.97
0438	Level III Drug Administration	S	1.0388	$72.73	.	$14.55
0439	Level IV Drug Administration	S	1.8098	$126.71	.	$25.35
0440	Level V Drug Administration	S	2.9679	$207.80	.	$41.56
0442	Dosimetric Drug Administration	S	21.9850	"$1,539.30"	.	$307.86
0604	Level 1 Hospital Clinic Visits	V	0.7689	$53.84	.	$10.77
0605	Level 2 Hospital Clinic Visits	V	1.0311	$72.19	.	$14.44
0606	Level 3 Hospital Clinic Visits	V	1.3588	$95.14	.	$19.03
0607	Level 4 Hospital Clinic Visits	V	1.8647	$130.56	.	$26.12
0608	Level 5 Hospital Clinic Visits	V	2.5237	$176.70	.	$35.34
0609	Level 1 Type A Emergency Visits	V	0.7181	$50.28	$12.04	$10.06
0613	Level 2 Type A Emergency Visits	V	1.2356	$86.51	$20.79	$17.31
0614	Level 3 Type A Emergency Visits	V	1.9447	$136.16	$33.59	$27.24
0615	Level 4 Type A Emergency Visits	V	3.1277	$218.99	$47.70	$43.80
0616	Level 5 Type A Emergency Visits	V	4.6152	$323.14	$71.44	$64.63
0617	Critical Care	S	6.6453	$465.28	$104.95	$93.06
0618	Trauma Response with Critical Care	S	11.2658	$788.79	.	$157.76
0621	Level I Vascular Access Procedures	T	11.0639	$774.65	.	$154.93
0622	Level II Vascular Access Procedures	T	25.2672	"$1,769.11"	.	$353.83
0623	Level III Vascular Access Procedures	T	30.3507	"$2,125.03"	.	$425.01
0624	Phlebotomy and Minor Vascular Access Device Procedures	X	0.6068	$42.49	$12.33	$8.50
0626	Level 1 Type B Emergency Visits	V	0.5627	$39.40	.	$7.88
0627	Level 2 Type B Emergency Visits	V	0.7972	$55.82	.	$11.17
0628	Level 3 Type B Emergency Visits	V	1.3178	$92.27	.	$18.46
0629	Level 4 Type B Emergency Visits	V	1.9503	$136.55	.	$27.31
0630	Level 5 Type B Emergency Visits	V	3.7639	$263.53	.	$52.71
0648	Level IV Breast Surgery	T	62.4125	"$4,369.87"	.	$873.98
0651	Complex Interstitial Radiation Source Application	S	11.9274	$835.11	.	$167.03
0652	Insertion of Intraperitoneal and Pleural Catheters	T	30.8430	"$2,159.50"	.	$431.90
0653	Vascular Reconstruction/Fistula Repair with Device	T	43.8023	"$3,066.86"	.	$613.38
0654	Level II Insertion/Replacement of Permanent Pacemaker 	T	103.3418	"$7,235.58"	.	"$1,447.12"
0655	Insertion/Replacement/Conversion of a Permanent Dual Chamber Pacemaker or Pacing Electrode	T	137.6558	"$9,638.11"	.	"$1,927.63"
0656	Transcatheter Placement of Intracoronary Drug-Eluting Stents	T	105.6644	"$7,398.20"	.	"$1,479.64"
0659	Hyperbaric Oxygen	S	1.4941	$104.61	.	$20.93
0660	Level II Otorhinolaryngologic Function Tests	X	1.8189	$127.35	$27.10	$25.47
0661	Level V Pathology	X	2.3496	$164.51	.	$32.91
0662	CT Angiography	S	4.8375	$338.70	$114.37	$67.74
0664	Level I Proton Beam Radiation Therapy	S	16.9101	"$1,183.98"	.	$236.80
0665	Bone Density:AppendicularSkeleton	S	0.4865	$34.06	$0.00	$0.00
0667	Level II Proton Beam Radiation Therapy	S	22.1209	"$1,548.82"	.	$309.77
0668	Level I Angiography and Venography	T	9.4045	$658.47	.	$131.70
0672	Level III Posterior Segment Eye Procedures	T	41.0159	"$2,871.77"	.	$574.36
0673	Level V Anterior Segment Eye Procedures	T	41.5778	"$2,911.11"	$634.95	$582.23
0674	Prostate Cryoablation	T	113.8112	"$7,968.60"	.	"$1,593.72"
0676	Thrombolysis and Other Device Revisions 	T	2.3021	$161.18	.	$32.24
0678	External Counterpulsation	T	1.3360	$93.54	.	$18.71
0679	Level II Resuscitation and Cardioversion	S	5.3254	$372.86	$95.30	$74.58
0680	Insertion of Patient Activated Event Recorders	S	80.3579	"$5,626.34"	.	"$1,125.27"
0683	Level II Photochemotherapy	S	3.0368	$212.62	.	$42.53
0685	Level III Needle Biopsy/Aspiration Except Bone Marrow	T	9.6713	$677.15	.	$135.43
0687	Revision/Removal of Neurostimulator Electrodes	T	20.7198	"$1,450.72"	$385.30	$290.15
0688	Revision/Removal of Neurostimulator Pulse Generator Receiver	T	31.1002	"$2,177.51"	$768.94	$435.51
0690	Level I Electronic Analysis of Devices	S	0.4928	$34.50	.	$6.90
0691	Level III Electronic Analysis of Devices	S	2.3930	$167.55	.	$33.51
0692	Level II Electronic Analysis of Devices	S	1.5944	$111.63	.	$22.33
0694	Mohs Surgery	T	5.0714	$355.08	$88.08	$71.02
0697	Level I Echocardiogram Without Contrast 	S	3.1615	$221.36	.	$44.28
0698	Level II Eye Tests & Treatments	S	1.0589	$74.14	.	$14.83
0699	Level IV Eye Tests & Treatments	T	15.4248	"$1,079.98"	.	$216.00
0701	Sr89 strontium	K		$954.77	.	$190.96
0726	Dexrazoxane HCl injection	K		$207.92	.	$41.59
0728	Filgrastim 300 mcg injection	K		$246.80	.	$49.36
0731	Sargramostim injection	K		$24.22	.	$4.85
0735	Ampho b cholesteryl sulfate	K		$14.56	.	$2.92
0736	Amphotericin b liposome inj	K		$14.25	.	$2.85
0738	Rasburicase	K		$188.98	.	$37.80
0747	Chlorothiazide sodium inj	K		$269.86	.	$53.98
0751	Mechlorethamine hcl inj	K		$154.88	.	$30.98
0752	Dactinomycin injection	K		$567.28	.	$113.46
0759	"Naltrexone, depot form"	K		$2.78	.	$0.56
0800	Leuprolide acetate	K		$590.71	.	$118.15
0802	Etoposide oral	K		$37.54	.	$7.51
0807	Aldesleukin injection	K		$969.60	.	$193.92
0809	Bcg live intravesical vac	K		$117.34	.	$23.47
0810	Goserelin acetate implant	K		$186.43	.	$37.29
0812	Carmustine injection	K		$172.53	.	$34.51
0814	Asparaginase injection	K		$62.08	.	$12.42
0820	Daunorubicin injection	K		$15.60	.	$3.12
0821	Daunorubicin citrate inj	K		$56.58	.	$11.32
0823	Docetaxel injection	K		$15.75	.	$3.15
0825	Nelarabine injection	K		$113.99	.	$22.80
0827	Floxuridine injection	K		$60.82	.	$12.17
0828	Gemcitabine hcl injection	K		$89.64	.	$17.93
0830	Irinotecan injection	K		$6.42	.	$1.29
0831	Ifosfamide injection	K		$32.03	.	$6.41
0832	Idarubicin hcl injection	K		$58.32	.	$11.67
0835	Cosyntropin injection NOS	K		$99.76	.	$19.96
0836	Interferon alfa-2b inj	K		$16.82	.	$3.37
0838	Interferon gamma 1-b inj	K		$582.59	.	$116.52
0840	Inj melphalan hydrochl	K		"$1,512.71"	.	$302.55
0842	Fludarabine phosphate inj	K		$101.84	.	$20.37
0843	Pegaspargase injection	K		"$2,675.40"	.	$535.08
0844	Pentostatin injection	K		"$1,084.10"	.	$216.82
0849	Rituximab injection	K		$615.22	.	$123.05
0850	Streptozocin injection	K		$265.69	.	$53.14
0851	Thiotepa injection	K		$131.18	.	$26.24
0856	Porfimer sodium injection	K		"$19,348.11"	.	"$3,869.63"
0858	Inj cladribine	K		$23.94	.	$4.79
0861	Leuprolide acetate injeciton	K		$4.42	.	$0.89
0864	Mitoxantrone hydrochl	K		$37.36	.	$7.48
0865	Interferon alfa-n3 inj	K		$31.20	.	$6.24
0868	Oral aprepitant	K		$6.06	.	$1.22
0873	Hyalgan/supartz inj per dose	K		$88.00	.	$17.60
0874	Synvisc or synvisc-one	K		$11.93	.	$2.39
0875	Euflexxa inj per dose	K		$146.10	.	$29.22
0877	Orthovisc inj per dose	K		$166.14	.	$33.23
0884	Rho d immune globulin inj	K		$82.14	.	$16.43
0887	Azathioprine parenteral	K		$122.53	.	$24.51
0890	Lymphocyte immune globulin	K		$556.51	.	$111.31
0900	Alglucerase injection	K		$41.24	.	$8.25
0901	Alpha 1 proteinase inhibitor	K		$3.83	.	$0.77
0902	"Injection,onabotulinumtoxinA"	K		$5.38	.	$1.08
0903	Cytomegalovirus imm IV /vial	K		$947.86	.	$189.58
0910	Interferon beta-1b / .25 MG	K		$211.59	.	$42.32
0913	Ganciclovir long act implant	K		"$16,640.00"	.	"$3,328.00"
0917	Adenosine injection	K		$94.42	.	$18.89
0925	Factor viii	K		$0.85	.	$0.17
0927	Factor viii recombinant	K		$1.09	.	$0.22
0928	Factor ix complex	K		$0.91	.	$0.19
0929	Anti-inhibitor	K		$1.60	.	$0.32
0931	Factor IX non-recombinant	K		$0.89	.	$0.18
0932	Factor IX recombinant	K		$1.14	.	$0.23
0933	Gamma globulin > 10 CC inj	K		$206.16	.	$41.24
0934	"Capecitabine, oral"	K		$24.63	.	$4.93
0943	Octagam injection	K		$55.80	.	$11.16
0944	Gammagard liquid injection	K		$37.08	.	$7.42
0945	Rhophylac injection	K		$5.09	.	$1.02
0946	Hepagam b im injection	K		$52.11	.	$10.43
0947	Flebogamma injection	G		$35.15	.	$6.90
0948	Gamunex/gamunex c	K		$36.78	.	$7.36
0949	"Frozen plasma, pooled, sd"	R	0.9547	$66.84	.	$13.37
0950	Whole blood for transfusion	R	2.7245	$190.76	.	$38.16
0951	Reclast injection	K		$218.44	.	$43.69
0952	Cryoprecipitate each unit	R	1.1823	$82.78	.	$16.56
0954	RBC leukocytes reduced	R	2.8408	$198.90	.	$39.78
0955	"Plasma, frz between 8-24hour"	R	1.0400	$72.82	.	$14.57
0956	"Plasma protein fract,5%,50ml"	R	0.2574	$18.02	.	$3.61
0957	"Platelets, each unit"	R	1.2822	$89.77	.	$17.96
0958	Plaelet rich plasma unit	R	2.0257	$141.83	.	$28.37
0959	Red blood cells unit	R	2.1303	$149.16	.	$29.84
0960	Washed red blood cells unit	R	4.1045	$287.38	.	$57.48
0961	"Albumin (human),5%, 50ml"	K		$21.32	.	$4.27
0963	"Albumin (human), 5%, 250 ml"	K		$61.94	.	$12.39
0964	"Albumin (human), 25%, 20 ml"	K		$26.84	.	$5.37
0965	"Albumin (human), 25%, 50ml"	K		$68.03	.	$13.61
0966	"Plasmaprotein fract,5%,250ml"	R	1.0362	$72.55	.	$14.51
0967	Blood split unit	R	1.6761	$117.35	.	$23.47
0968	Platelets leukoreduced irrad	R	1.9996	$140.00	.	$28.00
0969	RBC leukoreduced irradiated	R	3.7309	$261.22	.	$52.25
1009	Cryoprecipitatereducedplasma	R	1.0622	$74.37	.	$14.88
1010	"Blood, l/r, cmv-neg"	R	2.6930	$188.55	.	$37.71
1011	"Platelets, hla-m, l/r, unit"	R	11.4695	$803.05	.	$160.61
1013	Platelets leukocytes reduced	R	1.8720	$131.07	.	$26.22
1015	Injection glatiramer acetate	K		$109.30	.	$21.86
1016	"Blood, l/r, froz/degly/wash"	R	1.4989	$104.95	.	$20.99
1017	"Plt, aph/pher, l/r, cmv-neg"	R	5.4802	$383.70	.	$76.74
1018	"Blood, l/r, irradiated"	R	2.0966	$146.80	.	$29.36
1019	Plate pheres leukoredu irrad	R	9.8804	$691.79	.	$138.36
1020	"Plt, pher, l/r cmv-neg, irr"	R	8.7936	$615.69	.	$123.14
1021	"RBC, frz/deg/wsh, l/r, irrad"	R	6.4103	$448.82	.	$89.77
1022	"RBC, l/r, cmv-neg, irrad"	R	4.3700	$305.97	.	$61.20
1023	Pralidoxime chloride inj	K		$88.51	.	$17.71
1052	"Injection, voriconazole"	K		$6.07	.	$1.22
1064	"I131 iodide cap, rx"	K		$17.26	.	$3.46
1083	Adalimumab injection	K		$410.95	.	$82.19
1084	Denileukin diftitox inj	K		"$1,603.01"	.	$320.61
1086	Temozolomide	K		$9.48	.	$1.90
1138	"Hepagam b intravenous, inj"	K		$52.11	.	$10.43
1139	Protein c concentrate	K		$12.90	.	$2.58
1142	Supprelin LA implant	K		"$15,418.48"	.	"$3,083.70"
1150	"I131 iodide sol, rx"	K		$10.49	.	$2.10
1166	Cytarabine liposome inj	K		$503.48	.	$100.70
1167	"Inj, epirubicin hcl"	K		$1.87	.	$0.38
1168	"Inj, temsirolimus"	K		$50.57	.	$10.12
1178	Busulfan injection	K		$18.72	.	$3.75
1203	Verteporfin injection	K		$9.76	.	$1.96
1207	"Octreotide injection, depot"	K		$117.11	.	$23.43
1213	Antihemophilic viii/vwf comp	K		$0.90	.	$0.18
1214	Inj IVIG privigen 500 mg	K		$34.42	.	$6.89
1221	Dimethyl sulfoxide 50%	K		$94.38	.	$18.88
1222	Pentastarch 10% solution	K		$13.23	.	$2.65
1226	Inj streptokinase /250000 IU	K		$19.78	.	$3.96
1232	Mitomycin 5 MG inj	K		$19.55	.	$3.91
1235	Valrubicin injection	K		$959.07	.	$191.82
1236	Levoleucovorin injection	K		$1.58	.	$0.32
1237	Inj iron dextran	K		$11.53	.	$2.31
1238	Topotecan oral	K		$77.92	.	$15.59
1239	Rotavirus vacc 2 dose oral	K		$106.60	.	$21.32
1240	Apligraf skin sub	K		$35.88	.	$7.18
1241	Oasis wound matrix skin sub	K		$5.74	.	$1.15
1242	Oasis burn matrix skin sub	K		$5.74	.	$1.15
1243	Integra BMWD skin sub	K		$16.26	.	$3.26
1244	Integra DRT skin sub	K		$9.62	.	$1.93
1245	Dermagraft skin sub	K		$40.51	.	$8.11
1246	Graftjacket skin sub	K		$94.95	.	$18.99
1247	Integra matrix skin sub	K		$21.73	.	$4.35
1248	Primatrix skin sub	K		$31.42	.	$6.29
1249	Cymetra allograft	K		$332.25	.	$66.45
1250	Graftjacket express allograf	K		$332.25	.	$66.45
1251	Integra flowable wound matri	K		"$1,019.89"	.	$203.98
1252	Gammagraft skin sub	K		$6.78	.	$1.36
1253	Triamcinolone A inj PRS-free	K		$3.41	.	$0.69
1263	Antithrombin iii injection	K		$2.71	.	$0.55
1268	Xyntha inj	K		$1.07	.	$0.22
1270	Alloderm skin sub	K		$31.72	.	$6.35
1272	Acetylcysteine injection	K		$2.74	.	$0.55
1274	Edetate calcium disodium inj	K		$189.47	.	$37.90
1275	"Vivaglobin, inj"	K		$12.48	.	$2.50
1279	Factor VIII (porcine)	K		$9.12	.	$1.83
1280	Corticotropin injection	K		"$2,516.22"	.	$503.25
1281	Bevacizumab injection	K		$1.50	.	$0.30
1287	Alloskin skin sub	K		$8.26	.	$1.66
1289	AbobotulinumtoxinA	K		$7.29	.	$1.46
1290	Human fibrinogen conc inj	K		$71.57	.	$14.32
1291	Rilonacept injection	K		$23.64	.	$4.73
1295	Sm 153 lexidronam	K		"$7,592.00"	.	"$1,518.40"
1296	Degarelix injection	K		$2.71	.	$0.55
1297	"Ferumoxytol, non-esrd"	K		$0.65	.	$0.13
1304	Perphenazine injeciton	K		$19.54	.	$3.91
1306	Urea injection	K		$72.00	.	$14.40
1307	Oral busulfan	K		$3.77	.	$0.76
1308	Mecasermin injection	K		$25.65	.	$5.13
1311	Canakinumab injection	G		$88.97	.	$17.46
1312	Hizentra injection	K		$7.15	.	$1.43
1327	Imiglucerase injection	K		$41.20	.	$8.24
1331	Olanzapine long-acting inj	K		$2.70	.	$0.54
1332	Antithrombin recombinant	K		$101.40	.	$20.28
1338	"Methyl aminolevulinate, top"	K		$74.52	.	$14.91
1339	Oral fludarabine phosphate	G		$77.93	.	$15.30
1340	"Collagenase, clost hist inj"	G		$37.51	.	$7.36
1341	Amobarbital 125 MG inj	K		$113.08	.	$22.62
1342	Matristem micromatrix	K		$2.94	.	$0.59
1343	Ganciclovir sodium injection	K		$66.58	.	$13.32
1344	Gonadorelin hydroch/ 100 mcg	K		$167.25	.	$33.45
1345	Theraskin	K		$32.84	.	$6.57
1347	Oxacillin sodium injeciton	K		$2.51	.	$0.51
1349	Anidulafungin injection	K		$1.20	.	$0.24
1350	Topotecan injection	K		$9.85	.	$1.97
1351	Matristem wound matrix	K		$4.52	.	$0.91
1352	Wilate injection	G		$0.87	.	$0.17
1353	Belimumab injection	G		$38.61	.	$7.58
1354	Hydroxyprogesterone caproate	K		$2.52	.	$0.51
1355	Itraconazole injection	K		$372.55	.	$74.51
1357	Inj protirelin per 250 mcg	K		$27.03	.	$5.41
1358	Phentolaine mesylate inj	K		$53.76	.	$10.76
1359	Foscarnet sodium injection	K		$14.37	.	$2.88
1360	Apomorphine hydrochloride	K		$5.12	.	$1.03
1361	Enfuvirtide injection	K		$0.51	.	$0.11
1362	Inj heparin sodium per 10 u	K		$0.18	.	$0.04
1373	Inj heparin sodium per 1000u	K		$0.27	.	$0.06
1374	Sumatriptan succinate / 6 MG	K		$76.71	.	$15.35
1408	Cyclophosphamide 100 MG inj	K		$13.43	.	$2.69
1412	Vinorelbine tartrate inj	K		$17.45	.	$3.49
1413	Lumizyme injection	G		$148.30	.	$29.10
1415	Glassia injection	K		$3.81	.	$0.77
1416	Factor XIII anti-hem factor	G		$8.44	.	$1.66
1417	Gel-one	K		"$1,014.00"	.	$202.80
1418	Oral everolimus	K		$5.68	.	$1.14
1419	Dermacell	K		$31.52	.	$6.31
1426	Eribulin mesylate injection	G		$90.06	.	$17.68
1491	New Technology  - Level IA ($0-$10)	S		$5.00	.	$1.00
1492	New Technology  - Level IB ($10-$20)	S		$15.00	.	$3.00
1493	New Technology  - Level IC ($20-$30)	S		$25.00	.	$5.00
1494	New Technology  - Level ID ($30-$40)	S		$35.00	.	$7.00
1495	New Technology  - Level IE ($40-$50)	S		$45.00	.	$9.00
1496	New Technology  - Level IA ($0-$10)	T		$5.00	.	$1.00
1497	New Technology  - Level IB($10-$20)	T		$15.00	.	$3.00
1498	New Technology  - Level IC ($20-$30)	T		$25.00	.	$5.00
1499	New Technology  - Level ID($30-$40)	T		$35.00	.	$7.00
1500	New Technology  - Level IE ($40-$50)	T		$45.00	.	$9.00
1502	New Technology - Level II   ($50 - $100)	S		$75.00	.	$15.00
1503	New Technology - Level III   ($100 - $200)	S		$150.00	.	$30.00
1504	New Technology - Level IV  ($200 - $300)	S		$250.00	.	$50.00
1505	New Technology - Level V   ($300 - $400)	S		$350.00	.	$70.00
1506	New Technology - Level VI  ($400 - $500)	S		$450.00	.	$90.00
1507	New Technology - Level VII  ($500 - $600)	S		$550.00	.	$110.00
1508	New Technology - Level VIII ($600 - $700)	S		$650.00	.	$130.00
1509	New Technology - Level IX   ($700 - $800)	S		$750.00	.	$150.00
1510	New Technology - Level X    ($800 - $900)	S		$850.00	.	$170.00
1511	New Technology - Level XI   ($900 - $1000)	S		$950.00	.	$190.00
1512	New Technology - Level XII  ($1000 - $1100)	S		"$1,050.00"	.	$210.00
1513	New Technology - Level XIII  ($1100 - $1200)	S		"$1,150.00"	.	$230.00
1514	New Technology - Level XIV ($1200- $1300)	S		"$1,250.00"	.	$250.00
1515	New Technology - Level XV ($1300 - $1400)	S		"$1,350.00"	.	$270.00
1516	New Technology - Level XVI  ($1400 - $1500)	S		"$1,450.00"	.	$290.00
1517	New Technology - Level XVII ($1500-$1600)	S		"$1,550.00"	.	$310.00
1518	New Technology - Level XVIII ($1600-$1700)	S		"$1,650.00"	.	$330.00
1519	New Technology - Level IXX ($1700-$1800)	S		"$1,750.00"	.	$350.00
1520	New Technology - Level XX ($1800-$1900)	S		"$1,850.00"	.	$370.00
1521	New Technology - Level XXI ($1900-$2000)	S		"$1,950.00"	.	$390.00
1522	New Technology - Level XXII ($2000-$2500)	S		"$2,250.00"	.	$450.00
1523	New Technology - Level XXIII ($2500-$3000)	S		"$2,750.00"	.	$550.00
1524	New Technology - Level XXIV ($3000-$3500)	S		"$3,250.00"	.	$650.00
1525	New Technology - Level XXV ($3500-$4000)	S		"$3,750.00"	.	$750.00
1526	New Technology - Level XXVI ($4000-$4500)	S		"$4,250.00"	.	$850.00
1527	New Technology - Level XXVII ($4500-$5000)	S		"$4,750.00"	.	$950.00
1528	New Technology - Level XXVIII ($5000-$5500)	S		"$5,250.00"	.	"$1,050.00"
1529	New Technology - Level XXIX ($5500-$6000)	S		"$5,750.00"	.	"$1,150.00"
1530	New Technology - Level XXX ($6000-$6500)	S		"$6,250.00"	.	"$1,250.00"
1531	New Technology - Level XXXI ($6500-$7000)	S		"$6,750.00"	.	"$1,350.00"
1532	New Technology - Level XXXII ($7000-$7500)	S		"$7,250.00"	.	"$1,450.00"
1533	New Technology - Level XXXIII ($7500-$8000)	S		"$7,750.00"	.	"$1,550.00"
1534	New Technology - Level XXXIV ($8000-$8500)	S		"$8,250.00"	.	"$1,650.00"
1535	New Technology - Level XXXV ($8500-$9000)	S		"$8,750.00"	.	"$1,750.00"
1536	New Technology - Level XXXVI ($9000-$9500)	S		"$9,250.00"	.	"$1,850.00"
1537	New Technology - Level XXXVII ($9500-$10000)	S		"$9,750.00"	.	"$1,950.00"
1539	New Technology - Level II   ($50 - $100)	T		$75.00	.	$15.00
1540	New Technology - Level III   ($100 - $200)	T		$150.00	.	$30.00
1541	New Technology - Level IV  ($200 - $300)	T		$250.00	.	$50.00
1542	New Technology - Level V   ($300 - $400)	T		$350.00	.	$70.00
1543	New Technology - Level VI  ($400 - $500)	T		$450.00	.	$90.00
1544	New Technology - Level VII  ($500 - $600)	T		$550.00	.	$110.00
1545	New Technology - Level VIII ($600 - $700)	T		$650.00	.	$130.00
1546	New Technology - Level IX   ($700 - $800)	T		$750.00	.	$150.00
1547	New Technology - Level X    ($800 - $900)	T		$850.00	.	$170.00
1548	New Technology - Level XI   ($900 - $1000)	T		$950.00	.	$190.00
1549	New Technology - Level XII  ($1000 - $1100)	T		"$1,050.00"	.	$210.00
1550	New Technology - Level XIII  ($1100 - $1200)	T		"$1,150.00"	.	$230.00
1551	New Technology - Level XIV ($1200- $1300)	T		"$1,250.00"	.	$250.00
1552	New Technology - Level XV ($1300 - $1400)	T		"$1,350.00"	.	$270.00
1553	New Technology - Level XVI  ($1400 - $1500)	T		"$1,450.00"	.	$290.00
1554	New Technology - Level XVII ($1500-$1600)	T		"$1,550.00"	.	$310.00
1555	New Technology - Level XVIII ($1600-$1700)	T		"$1,650.00"	.	$330.00
1556	New Technology - Level XIX ($1700-$1800)	T		"$1,750.00"	.	$350.00
1557	New Technology - Level XX ($1800-$1900)	T		"$1,850.00"	.	$370.00
1558	New Technology - Level XXI ($1900-$2000)	T		"$1,950.00"	.	$390.00
1559	New Technology - Level XXII ($2000-$2500)	T		"$2,250.00"	.	$450.00
1560	New Technology - Level XXIII ($2500-$3000)	T		"$2,750.00"	.	$550.00
1561	New Technology - Level XXIV ($3000-$3500)	T		"$3,250.00"	.	$650.00
1562	New Technology - Level XXV ($3500-$4000)	T		"$3,750.00"	.	$750.00
1563	New Technology - Level XXVI ($4000-$4500)	T		"$4,250.00"	.	$850.00
1564	New Technology - Level XXVII ($4500-$5000)	T		"$4,750.00"	.	$950.00
1565	New Technology - Level XXVIII ($5000-$5500)	T		"$5,250.00"	.	"$1,050.00"
1566	New Technology - Level XXIX ($5500-$6000)	T		"$5,750.00"	.	"$1,150.00"
1567	New Technology - Level XXX ($6000-$6500)	T		"$6,250.00"	.	"$1,250.00"
1568	New Technology - Level XXXI ($6500-$7000)	T		"$6,750.00"	.	"$1,350.00"
1569	New Technology - Level XXXII ($7000-$7500)	T		"$7,250.00"	.	"$1,450.00"
1570	New Technology - Level XXXIII ($7500-$8000)	T		"$7,750.00"	.	"$1,550.00"
1571	New Technology - Level XXXIV ($8000-$8500)	T		"$8,250.00"	.	"$1,650.00"
1572	New Technology - Level XXXV ($8500-$9000)	T		"$8,750.00"	.	"$1,750.00"
1573	New Technology - Level XXXVI ($9000-$9500)	T		"$9,250.00"	.	"$1,850.00"
1574	New Technology - Level XXXVII ($9500-$10000)	T		"$9,750.00"	.	"$1,950.00"
1605	Abciximab injection	K		$548.95	.	$109.79
1607	Eptifibatide injection	K		$22.02	.	$4.41
1608	Etanercept injection	K		$204.31	.	$40.87
1609	"Rho(D) immune globulin h, sd"	K		$17.21	.	$3.45
1612	"Daclizumab, parenteral"	K		$516.41	.	$103.29
1613	Trastuzumab injection	K		$71.08	.	$14.22
1630	"Hep b ig, im"	K		$113.50	.	$22.70
1631	Baclofen intrathecal trial	K		$76.39	.	$15.28
1633	Alefacept	K		$38.72	.	$7.75
1643	"Y90 ibritumomab, rx"	K		"$36,100.41"	.	"$7,220.09"
1645	"I131 tositumomab, rx"	K		"$29,618.96"	.	"$5,923.80"
1670	Tetanus immune globulin inj	K		$245.02	.	$49.01
1675	P32 Na phosphate	K		$126.14	.	$25.23
1676	P32 chromic phosphate	K		$579.98	.	$116.00
1683	Basiliximab	K		"$2,190.58"	.	$438.12
1684	Corticorelin ovine triflutal	K		$5.58	.	$1.12
1685	"Darbepoetin alfa, non-esrd"	K		$3.14	.	$0.63
1686	"Epoetin alfa, non-esrd"	K		$9.70	.	$1.94
1687	Digoxin immune fab (ovine)	K		$626.71	.	$125.35
1688	Ethanolamine oleate	K		$294.28	.	$58.86
1689	Fomepizole	K		$6.91	.	$1.39
1690	Hemin	K		$10.41	.	$2.09
1693	Lepirudin	K		$346.19	.	$69.24
1694	Ziconotide injection	K		$6.48	.	$1.30
1695	Nesiritide injection	K		$46.36	.	$9.28
1696	Palifermin injection	K		$11.45	.	$2.29
1697	Pegaptanib sodium injection	K		"$1,001.34"	.	$200.27
1700	Inj secretin synthetic human	K		$26.98	.	$5.40
1701	Treprostinil injection	K		$60.08	.	$12.02
1704	"Humate-P, inj"	K		$0.88	.	$0.18
1705	Factor viia	K		$1.52	.	$0.31
1709	Azacitidine injection	K		$5.15	.	$1.03
1710	Clofarabine injection	K		$119.68	.	$23.94
1711	Vantas implant	K		"$3,816.98"	.	$763.40
1712	Paclitaxel protein bound	K		$9.33	.	$1.87
1716	"Brachytx, non-str, Gold-198"	U	0.5004	$35.04	.	$7.01
1717	"Brachytx, non-str, HDR Ir-192"	U	3.3224	$232.62	.	$46.53
1719	"Brachytx, NS, Non-HDRIr-192"	U	0.4544	$31.82	.	$6.37
1738	Oxaliplatin	K		$9.96	.	$2.00
1739	"Pegademase bovine, 25 iu"	K		$248.56	.	$49.72
1741	"Urofollitropin, 75 iu"	K		$65.66	.	$13.14
1749	"Endo, colon, retro imaging"	H				
1830	Power bone marrow bx needle	H				
1840	Telescopic intraocular lens	H				
1886	"Catheter, ablation"	H				
2210	Methyldopate hcl injection	K		$39.16	.	$7.84
2616	"Brachytx, non-str,Yttrium-90"	U	224.7054	"$15,732.97"	.	"$3,146.60"
2632	Iodine I-125 sodium iodide	U	0.2404	$16.83	.	$3.37
2634	"Brachytx, non-str, HA, I-125"	U	0.8944	$62.62	.	$12.53
2635	"Brachytx, non-str, HA, P-103"	U	0.3855	$26.99	.	$5.40
2636	"Brachy linear, non-str,P-103"	U	0.5294	$37.07	.	$7.42
2638	"Brachytx, stranded, I-125"	U	0.6498	$45.50	.	$9.10
2639	"Brachytx, non-stranded,I-125"	U	0.5078	$35.55	.	$7.11
2640	"Brachytx, stranded, P-103"	U	1.1433	$80.05	.	$16.01
2641	"Brachytx, non-stranded,P-103"	U	0.9180	$64.27	.	$12.86
2642	"Brachytx, stranded, C-131"	U	1.7379	$121.68	.	$24.34
2643	"Brachytx, non-stranded,C-131"	U	1.1044	$77.33	.	$15.47
2698	"Brachytx, stranded, NOS"	U	0.6498	$45.50	.	$9.10
2699	"Brachytx, non-stranded, NOS"	U	0.3855	$26.99	.	$5.40
2731	"Immune globulin, powder"	K		$30.46	.	$6.10
2770	Quinupristin/dalfopristin	K		$171.48	.	$34.30
3041	Bivalirudin	K		$2.71	.	$0.55
3043	Gamma globulin 1 CC inj	K		$20.62	.	$4.13
3050	Sermorelin acetate injection	K		$1.77	.	$0.36
7000	Amifostine	K		$315.94	.	$63.19
7011	Oprelvekin injection	K		$239.90	.	$47.98
7034	Somatropin injection	K		$61.81	.	$12.37
7035	Teniposide	K		$316.31	.	$63.27
7036	"Urokinase 250,000 IU inj"	K		$449.09	.	$89.82
7038	Monoclonal antibodies	K		"$1,111.59"	.	$222.32
7041	Tirofiban HCl	K		$8.92	.	$1.79
7042	"Capecitabine, oral"	K		$7.32	.	$1.47
7043	Infliximab injection	K		$62.01	.	$12.41
7046	Doxorubicin hcl liposome inj	K		$525.35	.	$105.07
7048	Alteplase recombinant	K		$42.24	.	$8.45
7049	Filgrastim 480 mcg injection	K		$390.07	.	$78.02
7051	Leuprolide acetate implant	K		"$4,728.88"	.	$945.78
7308	Aminolevulinic acid hcl top	K		$147.80	.	$29.56
8000	Cardiac Electrophysiologic Evaluation and Ablation Composite	T	161.5528	"$11,311.28"	.	"$2,262.26"
8001	LDR Prostate Brachytherapy Composite	T	47.7031	"$3,339.98"	.	$668.00
8002	Level I Extended Assessment & Management Composite	V	5.6151	$393.15	.	$78.63
8003	Level II Extended Assessment & Management Composite	V	10.2925	$720.64	.	$144.13
8004	Ultrasound Composite	S	2.7374	$191.66	.	$38.34
8005	CT and CTA without Contrast Composite	S	6.1687	$431.91	.	$86.39
8006	CT and CTA with Contrast Composite	S	10.3084	$721.75	.	$144.35
8007	MRI and MRA without Contrast Composite	S	9.9975	$699.98	.	$140.00
8008	MRI and MRA with Contrast Composite	S	14.2917	"$1,000.65"	.	$200.13
9001	Linezolid injection	K		$34.48	.	$6.90
9002	Tenecteplase injection	K		$57.15	.	$11.43
9003	Palivizumab	K		"$1,158.85"	.	$231.77
9004	Gemtuzumab ozogamicin inj	K		"$2,690.84"	.	$538.17
9005	Reteplase injection	K		"$1,623.59"	.	$324.72
9006	Tacrolimus injection	K		$136.86	.	$27.38
9012	Arsenic trioxide injection	K		$40.10	.	$8.02
9018	"Inj, rimabotulinumtoxinB"	K		$10.78	.	$2.16
9019	Caspofungin acetate	K		$13.32	.	$2.67
9022	IM inj interferon beta 1-a	K		$238.30	.	$47.66
9023	Rho d immune globulin	K		$21.52	.	$4.31
9024	Amphotericin b lipid complex	K		$8.42	.	$1.69
9032	Baclofen 10 MG injection	K		$187.46	.	$37.50
9033	Cidofovir injection	K		$742.66	.	$148.54
9038	Inj estrogen conjugate	K		$103.54	.	$20.71
9042	Glucagon hydrochloride	K		$101.30	.	$20.26
9044	Ibutilide fumarate injection	K		$133.80	.	$26.76
9046	Iron sucrose injection	K		$0.32	.	$0.07
9104	Antithymocyte globuln rabbit	K		$432.20	.	$86.44
9108	Thyrotropin injection	K		"$1,032.25"	.	$206.45
9110	Alemtuzumab injection	K		$575.18	.	$115.04
9115	Zoledronic acid	K		$220.30	.	$44.06
9119	"Injection, pegfilgrastim 6mg"	K		"$2,676.49"	.	$535.30
9120	"Injection, Fulvestrant"	K		$83.63	.	$16.73
9121	"Injection, argatroban"	K		$20.16	.	$4.04
9122	Triptorelin pamoate	K		$176.18	.	$35.24
9124	Daptomycin injection	K		$0.48	.	$0.10
9125	"Risperidone, long acting"	K		$5.07	.	$1.02
9126	Natalizumab injection	K		$10.32	.	$2.07
9133	"Rabies ig, im/sc"	K		$185.74	.	$37.15
9134	"Rabies ig, heat treated"	K		$177.81	.	$35.57
9135	"Varicella-zoster ig, im"	K		$94.28	.	$18.86
9137	"Bcg vaccine, percut"	K		$112.23	.	$22.45
9139	"Rabies vaccine, im"	K		$205.48	.	$41.10
9140	"Rabies vaccine, id"	K		$139.69	.	$27.94
9143	"Meningococcal vaccine, sc"	K		$110.75	.	$22.15
9144	"Encephalitis vaccine, sc"	K		$100.15	.	$20.03
9145	"Meningococcal vaccine, im"	K		$92.92	.	$18.59
9207	Bortezomib injection	K		$40.67	.	$8.14
9208	Agalsidase beta injection	K		$138.53	.	$27.71
9209	Laronidase injection	K		$26.33	.	$5.27
9210	Palonosetron hcl	K		$18.83	.	$3.77
9213	Pemetrexed injection	K		$52.76	.	$10.56
9214	Bevacizumab injection	K		$59.98	.	$12.00
9215	Cetuximab injection	K		$49.53	.	$9.91
9217	Leuprolide acetate suspnsion	K		$216.90	.	$43.38
9224	Galsulfase injection	K		$341.40	.	$68.28
9225	Fluocinolone acetonide implt	K		"$18,980.00"	.	"$3,796.00"
9227	Micafungin sodium injection	K		$0.98	.	$0.20
9228	Tigecycline injection	K		$1.30	.	$0.26
9229	Ibandronate sodium injection	K		$148.02	.	$29.61
9230	Abatacept injection	K		$20.72	.	$4.15
9231	Decitabine injection	K		$31.94	.	$6.39
9232	Idursulfase injection	K		$446.44	.	$89.29
9233	Ranibizumab injection	K		$395.53	.	$79.11
9234	Alglucosidase alfa injection	K		$155.84	.	$31.17
9235	Panitumumab injection	K		$85.59	.	$17.12
9236	Eculizumab injection	K		$186.37	.	$37.28
9237	"Inj, lanreotide acetate"	K		$30.98	.	$6.20
9240	"Injection, ixabepilone"	K		$63.47	.	$12.70
9242	"Injection, fosaprepitant"	K		$1.69	.	$0.34
9243	Bendamustine injection	K		$18.47	.	$3.70
9244	Regadenoson injection	K		$51.22	.	$10.25
9245	Romiplostim injection	K		$45.87	.	$9.18
9248	"Inj, clevidipine butyrate"	K		$2.66	.	$0.54
9249	Certolizumab pegol inj	K		$4.12	.	$0.83
9250	Artiss fibrin sealant	K		$129.72	.	$25.95
9251	C1 esterase inhibitor inj	K		$43.37	.	$8.68
9252	Plerixafor injection	K		$275.80	.	$55.16
9253	Temozolomide injection	K		$4.75	.	$0.95
9254	"Injection, lacosamide"	K		$0.15	.	$0.03
9255	Paliperidone palmitate inj	K		$6.56	.	$1.32
9256	Dexamethasone intra implant	K		$192.26	.	$38.46
9258	Telavancin injection	G		$2.10	.	$0.42
9259	Pralatrexate injection	G		$165.63	.	$32.50
9260	Ofatumumab injection	G		$45.41	.	$8.91
9261	Ustekinumab injection	G		$117.56	.	$23.07
9263	Ecallantide injection	G		$289.07	.	$56.73
9264	Tocilizumab injection	G		$3.47	.	$0.68
9265	Romidepsin injection	G		$224.79	.	$44.11
9268	Capsaicin 8% patch	G		$25.55	.	$5.02
9269	"C-1 esterase, berinert"	G		$30.23	.	$5.94
9270	Gammaplex IVIG	G		$37.29	.	$7.32
9271	Velaglucerase alfa	G		$349.51	.	$68.59
9272	"Inj, denosumab"	G		$14.47	.	$2.84
9273	Sipuleucel-T auto CD54+	G		"$32,860.00"	.	"$6,448.00"
9274	Crotalidae Poly Immune Fab	G		"$2,111.36"	.	$414.31
9275	Hexaminolevulinate HCl	G		$623.28	$0.00	$0.00
9276	Cabazitaxel injection	G		$135.57	.	$26.61
9278	Incobotulinumtoxin A	G		$5.53	.	$1.08
9279	"Injection, ibuprofen"	G		$1.62	.	$0.32
9281	"Injection, pegloticase"	G		$301.75	.	$59.22
9282	"Inj, ceftaroline fosamil"	G		$0.74	.	$0.14
9283	"Injection, acetaminophen"	G		$0.11	.	$0.03
9284	Ipilimumab injection	G		$127.20	.	$24.96
9285	"Patch, lidocaine/tetracaine"	G		$13.57	.	$2.67
9286	"Injection, belatacept"	G		$3.91	.	$0.77
9287	"Inj, brentuximab vedotin"	G		$95.40	.	$18.72
9300	Omalizumab injection	K		$21.34	.	$4.27
9358	"SurgiMend, fetal"	K		$10.91	.	$2.19
9360	"SurgiMend, neonatal"	K		$11.23	.	$2.25
9363	Integra Meshed Bil Wound Mat	K		$20.60	.	$4.12
9365	Oasis tri-layer wound matrix	G		$10.39	.	$2.04
9366	EpiFix wound cover	G		$177.77	.	$34.89
9367	Endoform Dermal Template	G		$4.35	.	$0.86
9406	Iodine I-123 ioflupane	G		"$1,908.00"	$0.00	$0.00
9500	"Platelets, irradiated"	R	1.8342	$128.42	.	$25.69
9501	Platelet pheres leukoreduced	R	7.6960	$538.84	.	$107.77
9502	Platelet pheresis irradiated	R	7.9257	$554.93	.	$110.99
9503	Fr frz plasma donor retested	R	1.1562	$80.95	.	$16.19
9504	RBC deglycerolized	R	3.4084	$238.64	.	$47.73
9505	RBC irradiated	R	2.8419	$198.98	.	$39.80
9506	"Granulocytes, pheresis unit"	R	19.1478	"$1,340.65"	.	$268.13
9507	"Platelets, pheresis"	R	6.3148	$442.14	.	$88.43
9508	Plasma 1 donor frz w/in 8 hr	R	1.1408	$79.87	.	$15.98