Service
Code
Listed
Cash
Negotiated
Rates
Checks
Hc Nfct Ds Rna 4 Targets Upper Respiratory Specimen
$713
$142
$143
28
clean
Fna Bx W/Us Gdn 1St Les
$1,719
$906
$906
86
clean
Hc Fine Needle Aspiration Bx W/Fluor Gdn 1St Lesion
$3,518
$906
$906
43
clean
Hc Fine Needle Asp Wo Img Guidance
$2,059
$520
$520
43
clean
Hc Image-Guided Catheter Fluid Collection Drainage
$6,782
$906
$906
43
clean
Hc Incision & Drain Skin Abscess Simple
$1,337
$256
$257
43
clean
Hc Incision & Drain Skin Abscess Complic
$2,231
$520
$520
43
clean
Hc Incision & Drain Pilonidal Cyst Simpl
$3,936
$906
$906
43
clean
Hc Incision & Drain Pilonidal Cyst Complicated
$3,825
$906
$906
43
clean
Hc Remove Foreign Body Simple
$2,059
$520
$520
43
clean
Hc Incision & Drain Of Hematoma/Fluid
$9,070
$2,113
$2,114
43
clean
Hc Puncture Drainage Of Lesion
$2,231
$520
$520
43
clean
Hc Debride Skin Sub-Q Tiss Muscle =<20 Sq Cm
$3,061
$945
$946
43
clean
Hc Trim Benign Hyperkeratotic Skin Lesion, Single
$903
$256
$257
43
clean
Hc Punch Biopsy Skin Ea Sep/Additional Lesion
$577
—
$55
7
clean
Hc Removal Of Skin Tags, Up To 15
$1,070
$256
$257
43
clean
Exc Tr-Ext B9+Marg 1.1-2 Cm
$7,500
$906
$906
43
clean
Exc tr-ext b9+marg >4.0 cm
$8,750
$2,113
$2,114
86
clean
Hc Exc Skin Benig <0.5 Cm Scalp/Neck/Hnd/Ft/Gent
$5,442
$2,113
$2,114
43
clean
Exc Face-Mm B9+Marg 0.6-1 Cm
$8,517
$906
$906
43
clean
Exc snhfg mal+mrg >4 cm
$10,500
$3,717
$3,718
86
clean
Hc Removal Of Nail Plate
$1,337
$256
$257
43
clean
Hc Removal Of Nail Plate, Simple, Ea Ad
$1,316
—
$21
7
clean
Hc Drain Blood From Under Nail
$672
$170
$170
43
clean
Hc Removal Of Nail Bed
$2,231
$520
$520
86
clean
Hc Reconstruc Of Nail Bed
$3,513
$945
$946
43
clean
Hc Excision Of Nail Fold (Wedge), Toe
$2,059
$520
$520
43
clean
Remove Pilonidal Cyst Compl
$12,500
$3,717
$3,718
43
clean
Hc Tattooing Incl Micropigmentation 6.1-20.0 Cm
$2,108
$945
$946
37
clean
Hc Repr Wnd Smp Body/Scalp/Extr <2.5 Cm
$1,471
$256
$257
43
clean
Hc Repr Wnd Smp Body/Scalp/Extr 2.6-7.5 Cm
$1,337
$256
$257
43
clean
Hc Repr Wnd Smp Body/Scalp/Extr 7.6-12.5 Cm
$1,337
$256
$257
43
clean
Hc Repr Wnd Smp Body/Scalp/Extr 12.6-20 Cm
$2,231
$520
$520
43
clean
Hc Repr Wnd Smp Body/Scalp/Extr 20.1-30 Cm
$2,059
$520
$520
43
clean
Hc Repr Wnd Smp Body/Scalp/Extr >30.1 Cm
$1,718
$256
$257
43
clean
Hc Repr Wnd Smp Face 2.6-5.0 Cm
$1,337
$256
$257
43
clean
Hc Repr Wnd Smp Face 5.1-7.5 Cm
$1,070
$256
$257
43
clean
Hc Repr Wnd Smp Face 7.6-12.5 Cm
$1,161
$256
$257
43
clean
Hc Repr Wnd Smp Face 12.6-20 Cm
$1,338
$520
$520
43
clean
Hc Repr Wnd Smp Face 20.1-30 Cm
$1,998
$520
$520
43
clean
Hc Treat Wnd Dehiscence, Simple Closure
$3,513
$945
$946
43
clean
Hc Repr Wnd Intrmd Body/Scalp/Extr <2.5 Cm
$2,059
$520
$520
43
clean
Hc Repr Wnd Intrmd Body/Scalp/Extr 2.6-7.5 Cm
$2,059
$520
$520
43
clean
Hc Repr Wnd Intrmd Body/Scalp/Extr 7.6-12.5 Cm
$2,059
$520
$520
43
clean
Hc Repr Wnd Intrmd Body/Scalp/Extr 12.5-20 Cm
$2,059
$520
$520
43
clean
Hc Repr Wnd Intrmd Body/Scalp/Extr 20.1-30 Cm
$2,108
$945
$946
43
clean
Hc Repr Wnd Intrmd Neck/Hnd/Ft/Gent <2.5 Cm
$2,059
$520
$520
43
clean
Hc Repr Wnd Intrmd Neck/Hnd/Ft/Gent 2.6-7.5 Cm
$2,059
$520
$520
43
clean
Hc Repr Wnd Intrmd Neck/Hnd/Ft/Gent 7.6-12.5 Cm
$3,120
$945
$946
43
clean
Hc Repr Wnd Intrmd Face <2.5 Cm
$2,059
$520
$520
43
clean
Hc Repr Wnd Intrmd Face 2.6-5.0 Cm
$2,059
$520
$520
43
clean
Hc Repr Wnd Intrmd Face 5.1-7.5 Cm
$1,338
$520
$520
43
clean
Hc Repr Wnd Intrmd Face 7.6-12.5 Cm
$1,463
$520
$520
43
clean
Hc Repr Wnd Cplx Scalp 2.6-7.5 Cm
$3,120
$520
$520
43
clean
Hc Repr Wnd Cplx Scalp Add 5.0 Cm
$884
—
$84
7
clean
Hc Repr Wnd Cplx Face/Hnd/Ft/Gent 2.6-7.5 Cm
$3,120
$520
$520
43
clean
Sec Clsr Surg Wnd/Dehsn Xtn
$13,000
$4,535
$4,535
43
clean
Hc Adjacent Tissue Trns/Reargmt F/C/C/M/N/A/G/H/F 10Sqcm/&Lt
$6,121
$2,640
$2,641
43
clean
Hc Treat Burn 1St Degree, Initial
$1,120
$256
$257
43
clean
Hc Dress/Debride Burn <5% Total Sm
$1,337
$256
$257
43
clean
Hc Chem Cautery Granulatn Tissue
$882
$256
$257
43
clean
Mastotomy Expl Drg Absc Dp
$13,015
$2,113
$2,114
43
clean
Hc Bx Breast W Device Us Guide 1St Lesion
$7,498
$2,113
$2,114
43
clean
Removal Of Breast Lesion
$13,000
$5,011
$5,011
43
clean
Excision Breast Lesion
$18,750
$5,011
$5,011
43
clean
Hc Perq Dev Place Breast Loc 1St Les W Mammo Guid
$6,000
$2,113
$2,114
43
clean
Hc Perq Device Placemt Breast Loc Ea Les W Guidnce
$2,621
—
$152
7
clean
Hc Perq Breast Loc Dev Place Strotact Guid 1St Les
$2,361
$906
$906
86
clean
Hc Perq Breast Loc Dev Place Us Guide 1St Lesion
$3,245
$906
$906
43
clean
Hc Deep Muscle Biopsy
$12,916
$3,717
$3,718
43
clean
Hc Needle Biopsy,Muscle
$7,498
$2,113
$2,114
43
clean
Hc Bone Biopsy,Trocar/Needle Deep
$5,442
$2,113
$2,114
43
clean
Hc Bone Biopsy,Excisional Deep
$14,127
$3,717
$3,718
43
clean
Removal Of Foreign Body
$9,000
$3,717
$3,718
43
clean
Hc Inject Trigger Point1-2 Muscle
$1,946
$392
$393
43
clean
Hc Inject Trigger Points, > 3
$1,657
$392
$393
43
clean
Hc Drain/Inject Small Joint/Bursa
$994
$392
$393
43
clean
Drain/Inj Joint/Bursa W/O Us - 20605 - OR36020605
$17,807
$392
$393
86
clean
Hc Arthrocentesis Aspir&/Inj Interm Jt/Burs W/Us
$3,173
$903
$903
43
clean
Drain/Inj Joint/Bursa W/O Us - 20610 - OR36020610
$11,750
$392
$393
86
clean
Hc Arthrocentesis Aspir&/Inj Major Jt/Bursa W/Us
$1,558
$392
$393
43
clean
Hc Aspirat/Injection Ganglion Cyst(S)
$1,476
$392
$393
43
clean
Removal Of Implant Deep
$22,500
$3,717
$3,718
43
clean
Hc Clsd Treat Temporomandibl Disloc
$1,228
$315
$316
43
clean
Exc Back Les Sc 3 Cm/>
$13,000
$2,113
$2,114
43
clean
Exc Shoulder Les Sc 3 Cm/>
$16,250
$2,113
$2,114
43
clean
PARTIAL REMOVAL COLLAR BONE
$18,681
$4,187
$4,188
86
clean
PARTIAL REMOVAL OF SCAPULA
$9,375
$4,187
$4,188
86
clean
MUSCLE TRANSFER SHOULDERARM
$37,500
$9,286
$9,287
86
clean
REPAIR ROTATOR CUFF ACUTE
$20,625
$9,286
$9,287
86
clean
TENODESIS OF LONG TENDON OF BICEPS
$16,841
$9,286
$9,287
86
clean
REPAIR SHOULDER CAPSULE - 23455 -
$6,875
$9,286
$6,875
86
clean
Repair Shoulder Capsule - 23462 - OR36023462
$32,500
$9,286
$9,287
43
clean
RECONSTRUCT SHOULDER JOINT
$31,500
$22,440
$22,441
74
clean
REVISION OF COLLARBONE
$13,000
$16,431
$13,000
86
clean
Optx Clavicular Fx W/Int Fix
$27,675
$9,286
$9,287
43
clean
OPTX ACROMCLV DISLC AQTCHRN
$6,875
$9,286
$6,875
86
clean
Optx Acrclv Dslc Aq/Chrn Grf
$22,750
$9,286
$9,287
43
clean
Hc Clsd Treat Scapula Fx Wo Manip
$1,123
$315
$316
43
clean
Hc Clsd Treat Scapula Fx W Manip
$7,657
$2,058
$2,058
43
clean
Hc Clsd Treat Prox Humerus Fx W Manip
$5,394
$2,058
$2,058
43
clean
Hc Clsd Treat Shldr Disloc W Manip Wo Anes
$1,531
$315
$316
43
clean
Cltx Sho Dslc W/Mnpj W/Anes
$13,000
$2,058
$2,058
43
clean
OPTX ACUTE SHOULDER DISLC
$6,875
$9,286
$6,875
86
clean
Hc Clsd Treat Shldr Disloc,Gr Tub Fx, W Manip
$5,394
$2,058
$2,058
43
clean
Hc Clsd Treat Shldr Disloc,Prox Hum Fx W Manip
$5,394
$2,058
$2,058
43
clean
UNLISTED PROCEDURE SHOULDER
$6,250
$315
$316
72
clean
EXC ARMELBOW LES SC 3 CM>
$8,750
$3,717
$3,718
86
clean
Excision Olecranon Bursa
$13,000
$4,187
$4,188
43
clean
TENODESIS BICEPS TDN AT ELBW
$19,500
$9,286
$9,287
86
clean
Rpr Tdn/Musc Upr A/E Each
$19,500
$9,286
$9,287
43
clean
Repair Of Ruptured Tendon
$42,250
$9,286
$9,287
43
clean
Hc Clsd Treat Mid Humerus Fx W Manip
$8,002
$2,058
$2,058
43
clean
Hc Clsd Treat Humeral Supracondylar Fx Wo Manip
$792
$315
$316
43
clean
Hc Clsd Treat Elbow Disloc Wo Anes
$1,319
$315
$316
43
clean
Hc Clsd Treat Monteggia Fx/Disloc Elbow W Manip
$5,394
$2,058
$2,058
43
clean
Hc Clsd Treat Radial Head Disloc Child W Amnip
$1,319
$315
$316
43
clean
Hc Clsd Treat Ulnar Fx Prox End W Manip
$8,002
$2,058
$2,058
43
clean
TREAT ULNAR FRACTURE
$19,900
$9,286
$9,287
86
clean
INCISION OF TENDON SHEATH
$6,500
$2,058
$2,058
86
clean
EXC FOREARM TUM DEEP < 3 CM
$6,500
$2,113
$2,114
86
clean
REMOVE WRIST JOINT CARTILAGE
$6,500
$4,187
$4,188
86
clean
Remove Wrist Tendon Lesion
$10,500
$2,058
$2,058
43
clean
PARTIAL REMOVAL OF ULNA
$6,500
$4,187
$4,188
86
clean
Hc Inj For Wrist X-Ray
$870
—
$261
7
clean
Hc Clsd Treat Radial Shaft Fx W Manip
$8,299
$2,058
$2,058
43
clean
Hc Clsd Treat Ulna Shaft Fx W Manip
$1,076
$315
$316
43
clean
Hc Clsd Treat Rad/Ulna Shaft Fx W Manip
$8,299
$2,058
$2,058
43
clean
Hc Clsd Treat Distl Rad/Ulna Fx W Manip
$8,991
$2,058
$2,058
43
clean
Treat fx rad intra-articul
$18,400
$9,286
$9,287
86
clean
Hc Clsd Treat Radioulna Disloc W Manip
$1,035
$315
$316
43
clean
Hc Clsd Treat Lunate Disloc W Manip
$7,657
$2,058
$2,058
43
clean
Hc Drain Finger Abscess Simple
$1,569
$256
$257
43
clean
Hc Drain Finger Abscess,Complicated
$8,383
$2,113
$2,114
43
clean
Incise finger tendon sheath
$5,722
$2,058
$2,058
43
clean
Exc hand tum deep < 1.5 cm
$6,500
$2,113
$2,114
86
clean
Tendon excision palmfinger
$4,583
$2,058
$2,058
43
clean
Repair finger tendon
$8,125
$2,058
$2,058
86
clean
Release handfinger tendon
$6,500
$4,187
$4,188
86
clean
Repair Nonunion Hand
$19,500
$9,286
$9,287
43
clean
Hc Clsd Treat Metacarpal Fx W Manip Ea
$1,319
$315
$316
43
clean
Treat Metacarpal Fracture
$15,167
$4,187
$4,188
43
clean
Treat Thumb Fracture
$16,250
$4,187
$4,188
43
clean
Hc Clsd Treat Carpometacar Disloc,Non-Thumb W Anes
$792
$315
$316
43
clean
Hc Clsd Treat Mc-P Disloc W Manip Wo Anes
$1,228
$315
$316
43
clean
Hc Clsd Treat Prox/Mid Fing Shft Fx W Manip Ea
$1,319
$315
$316
43
clean
Hc Clsd Treat Fingr Articular Fx W Manip Ea
$8,991
$2,058
$2,058
43
clean
Hc Clsd Treat Dist Fingr Fx W Manip Ea
$1,228
$315
$316
43
clean
Hc Clsd Treat Ip Jnt Disloc W Manip Wo Anes
$1,319
$315
$316
43
clean
Hc Amp Mtcrpl W/Finger/Thumb W/Wo Inteross Transfer
$10,864
$4,187
$4,188
43
clean
Hc Amputation Of Finger/Thumb
$18,107
$4,187
$4,188
43
clean
Hc Clsd Treat Traumatic Hip Disloc Wo Anes
$1,389
$315
$316
43
clean
Hc Clsd Treat Post Hip Arthrplas Disloc W Anes
$1,243
$315
$316
43
clean
Exploration of knee joint
$6,125
$4,187
$4,188
86
clean
Repair of kneecap tendon
$15,258
$9,286
$9,287
86
clean
Repair of thigh muscle
$7,575
$9,286
$7,575
86
clean
Total Knee Arthroplasty
$33,450
$16,431
$16,432
43
clean
Hc Clsd Treat Tibial Plateau Fx Wo Manip
$1,283
$315
$316
43
clean
Hc Clsd Treat Tib Plat Fx W/Wo Manip
$16,873
$4,187
$4,188
43
clean
Hc Clsd Treat Knee Disloc Wo Anes
$1,670
$315
$316
43
clean
Hc Clsd Treat Patellr Disloc Wo Anes
$1,319
$315
$316
43
clean
Fixation Of Knee Joint
$13,000
$2,058
$2,058
43
clean
Repair of ankle ligament - 27695 -
$13,000
$9,286
$9,287
86
clean
Repair of ankle ligament - 27698 -
$27,500
$9,286
$9,287
86
clean
Hc Removal Of Ankle Implant
$15,420
$4,187
$4,188
43
clean
Repair fibula nonunion
$37,813
$9,286
$9,287
86
clean
Hc Clsd Treat Tibia Shaft Fx W Manip
$8,991
$2,058
$2,058
43
clean
Treatment Of Tibia Fracture
$26,000
$16,431
$16,432
43
clean
Hc Clsd Treat Med Malleolus Fx W Manip
$5,394
$2,058
$2,058
43
clean
Hc Clsd Treat Pst Malleolus Fx W Manip
$5,394
$2,058
$2,058
43
clean
Hc Clsd Treat Dist Fibula Fx W Manip
$1,418
$315
$316
43
clean
Treatment of ankle fracture - 27792 -
$18,000
$9,286
$9,287
86
clean
Hc Clsd Treat Bimalleolar Ankle Fx W/O Manip
$792
$315
$316
43
clean
Hc Clsd Treat Bimalleolar Ankle Fx W Manip
$8,299
$2,058
$2,058
43
clean
Treatment of ankle fracture - 27814 -
$30,000
$9,286
$9,287
86
clean
Hc Clsd Treat Trimalleolar Fx Wo Manip
$792
$315
$316
43
clean
Hc Clsd Treat Trimalleolar Fx W Manip
$8,299
$2,058
$2,058
43
clean
Hc Clsd Treat Weight Bear Dist Tib W Manip
$8,299
$2,058
$2,058
43
clean
Treat lower leg joint
$12,250
$9,286
$9,287
86
clean
Hc Clsd Treat Ankle Disloc Wo Anes
$1,228
$315
$316
43
clean
Exc Foot/Toe Tum Sc 1.5 Cm/>
$9,000
$3,717
$3,718
43
clean
Exc Foot/Toe Tum Sc < 1.5 Cm
$14,214
$2,113
$2,114
43
clean
Removal Of Toe Lesions
$13,000
$2,058
$2,058
43
clean
Removal Of Heel Spur
$13,000
$4,187
$4,188
43
clean
Partial removal of foot bone
$15,558
$4,187
$4,188
86
clean
Repair of foot tendon
$7,779
$4,187
$4,188
43
clean
Repair Of Hammertoe
$19,500
$4,187
$4,188
43
clean
Corrj Halux Rigdus W/O Implt
$13,000
$4,187
$4,188
43
clean
Cor Hlx Vlgs Rsc Prx Phlx Bs
$21,525
$4,187
$4,188
43
clean
Hc Clsd Treat Metatarsal Fx W Manip
$1,228
$315
$316
43
clean
Treat Metatarsal Fracture
$19,500
$9,286
$9,287
43
clean
Hc Clsd Treat Toe Fx W Manip Ea
$1,319
$315
$316
43
clean
Hc Clsd Treat Tarsal Disloc Wo Anes
$1,228
$315
$316
43
clean
Hc Clsd Treat Mt-Phal Toe Disloc Wo Anes
$792
$315
$316
43
clean
Hc Clsd Treat I-P Jt,Toe Disloc Wo Anes
$1,228
$315
$316
43
clean
Hc Open Treatment Interphalangeal Joint Dislocation
$12,192
$4,187
$4,188
43
clean
Partial Amputation Of Toe
$26,000
$4,187
$4,188
43
clean
Hc Apply Long Arm Splint
$1,052
$207
$208
43
clean
Hc Apply Forearm Splint Static
$924
$170
$170
43
clean
Hc Apply Finger Splint Static
$840
$170
$170
43
clean
Showing the first 200 of 2,299 code–setting items in the file, verified codes first —
every row as JSON →
Service
Severity
Rule
Detail
CPT 23455/o
error
mrf_cash_above_gross
discounted cash price $9,286 exceeds gross charge $6,875
CPT 23485/o
error
mrf_cash_above_gross
discounted cash price $16,431 exceeds gross charge $13,000
CPT 23550/o
error
mrf_cash_above_gross
discounted cash price $9,286 exceeds gross charge $6,875
CPT 23660/o
error
mrf_cash_above_gross
discounted cash price $9,286 exceeds gross charge $6,875
CPT 27385/o
error
mrf_cash_above_gross
discounted cash price $9,286 exceeds gross charge $7,575
CPT 29828/o
error
mrf_cash_above_gross
discounted cash price $9,286 exceeds gross charge $9,010
CPT 47539/o
error
mrf_cash_above_gross
discounted cash price $7,737 exceeds gross charge $6,500
CPT 57220/o
error
mrf_cash_above_gross
discounted cash price $6,402 exceeds gross charge $5,000
warn
mrf_rate_without_estimate
84 of 84 percentage/algorithm rates across 69 items carry no estimated dollar amount, which the template has required since 1 January 2025 — none of them do
CPT 83789/o
info
mrf_cash_under_tenth_of_gross
cash price $24 is 10% of the gross charge $250
CPT 83835/o
info
mrf_cash_under_tenth_of_gross
cash price $16 is 6% of the gross charge $262
CPT 83874/o
info
mrf_cash_under_tenth_of_gross
cash price $12 is 3% of the gross charge $384
CPT 83880/o
info
mrf_cash_under_tenth_of_gross
cash price $39 is 7% of the gross charge $591
CPT 83930/o
info
mrf_cash_under_tenth_of_gross
cash price $6 is 2% of the gross charge $258
CPT 83935/o
info
mrf_cash_under_tenth_of_gross
cash price $6 is 2% of the gross charge $252
CPT 83970/o
info
mrf_cash_under_tenth_of_gross
cash price $41 is 10% of the gross charge $422
CPT 83986/o
info
mrf_cash_under_tenth_of_gross
cash price $3 is 2% of the gross charge $135
CPT 83993/o
info
mrf_cash_under_tenth_of_gross
cash price $19 is 5% of the gross charge $366
CPT 84030/o
info
mrf_cash_under_tenth_of_gross
cash price $5 is 3% of the gross charge $186
CPT 84075/o
info
mrf_cash_under_tenth_of_gross
cash price $5 is 4% of the gross charge $142
CPT 84100/o
info
mrf_cash_under_tenth_of_gross
cash price $4 is 2% of the gross charge $193
CPT 84105/o
info
mrf_cash_under_tenth_of_gross
cash price $5 is 5% of the gross charge $110
CPT 84132/o
info
mrf_cash_under_tenth_of_gross
cash price $4 is 2% of the gross charge $166
CPT 23929/o
info
mrf_cash_under_tenth_of_gross
cash price $315 is 5% of the gross charge $6,250
CPT 84133/o
info
mrf_cash_under_tenth_of_gross
cash price $4 is 2% of the gross charge $186
CPT 84134/o
info
mrf_cash_under_tenth_of_gross
cash price $14 is 6% of the gross charge $232
CPT 84144/o
info
mrf_cash_under_tenth_of_gross
cash price $20 is 6% of the gross charge $363
CPT 84145/o
info
mrf_cash_under_tenth_of_gross
cash price $27 is 5% of the gross charge $496
CPT 84146/o
info
mrf_cash_under_tenth_of_gross
cash price $19 is 5% of the gross charge $399
CPT 84153/o
info
mrf_cash_under_tenth_of_gross
cash price $18 is 7% of the gross charge $252
CPT 84154/o
info
mrf_cash_under_tenth_of_gross
cash price $18 is 9% of the gross charge $190
CPT 84155/o
info
mrf_cash_under_tenth_of_gross
cash price $3 is 2% of the gross charge $165
CPT 84156/o
info
mrf_cash_under_tenth_of_gross
cash price $3 is 2% of the gross charge $178
CPT 84157/o
info
mrf_cash_under_tenth_of_gross
cash price $4 is 2% of the gross charge $205
CPT 29999/o
info
mrf_cash_under_tenth_of_gross
cash price $315 is 2% of the gross charge $18,450
CPT 84165/o
info
mrf_cash_under_tenth_of_gross
cash price $10 is 4% of the gross charge $244
CPT 84295/o
info
mrf_cash_under_tenth_of_gross
cash price $4 is 3% of the gross charge $144
CPT 84300/o
info
mrf_cash_under_tenth_of_gross
cash price $5 is 2% of the gross charge $206
CPT 84302/o
info
mrf_cash_under_tenth_of_gross
cash price $4 is 4% of the gross charge $104
CPT 84315/o
info
mrf_cash_under_tenth_of_gross
cash price $3 is 1% of the gross charge $393
CPT 84403/o
info
mrf_cash_under_tenth_of_gross
cash price $25 is 10% of the gross charge $254
CPT 42999/o
info
mrf_cash_under_tenth_of_gross
cash price $303 is 4% of the gross charge $6,925
CPT 84436/o
info
mrf_cash_under_tenth_of_gross
cash price $6 is 2% of the gross charge $260
CPT 84439/o
info
mrf_cash_under_tenth_of_gross
cash price $9 is 3% of the gross charge $341
CPT 43761/o
info
mrf_cash_under_tenth_of_gross
cash price $319 is 6% of the gross charge $5,436
CPT 84443/o
info
mrf_cash_under_tenth_of_gross
cash price $16 is 4% of the gross charge $434
CPT 84450/o
info
mrf_cash_under_tenth_of_gross
cash price $5 is 3% of the gross charge $149
CPT 84460/o
info
mrf_cash_under_tenth_of_gross
cash price $5 is 2% of the gross charge $201
CPT 45915/o
info
mrf_cash_under_tenth_of_gross
cash price $1,531 is 6% of the gross charge $26,000
CPT 84466/o
info
mrf_cash_under_tenth_of_gross
cash price $12 is 8% of the gross charge $153
CPT 45999/o
info
mrf_cash_under_tenth_of_gross
cash price $1,190 is 9% of the gross charge $13,954
CPT 84478/o
info
mrf_cash_under_tenth_of_gross
cash price $5 is 3% of the gross charge $181
CPT 84479/o
info
mrf_cash_under_tenth_of_gross
cash price $6 is 3% of the gross charge $223
CPT 84480/o
info
mrf_cash_under_tenth_of_gross
cash price $14 is 4% of the gross charge $371
CPT 84484/o
info
mrf_cash_under_tenth_of_gross
cash price $12 is 3% of the gross charge $474
CPT 52276/o
info
mrf_cash_under_tenth_of_gross
cash price $2,675 is 8% of the gross charge $33,883
CPT 84520/o
info
mrf_cash_under_tenth_of_gross
cash price $3 is 2% of the gross charge $166
CPT 53600/o
info
mrf_cash_under_tenth_of_gross
cash price $319 is 1% of the gross charge $31,098
CPT 84540/o
info
mrf_cash_under_tenth_of_gross
cash price $5 is 3% of the gross charge $175
CPT 84550/o
info
mrf_cash_under_tenth_of_gross
cash price $4 is 2% of the gross charge $191
CPT 84560/o
info
mrf_cash_under_tenth_of_gross
cash price $5 is 3% of the gross charge $170
CPT 84590/o
info
mrf_cash_under_tenth_of_gross
cash price $11 is 10% of the gross charge $115
CPT 84597/o
info
mrf_cash_under_tenth_of_gross
cash price $13 is 9% of the gross charge $149
CPT 84630/o
info
mrf_cash_under_tenth_of_gross
cash price $11 is 5% of the gross charge $205
CPT 64418/o
info
mrf_cash_under_tenth_of_gross
cash price $903 is 6% of the gross charge $14,625
CPT 84702/o
info
mrf_cash_under_tenth_of_gross
cash price $15 is 3% of the gross charge $487
CPT 70336/o
info
mrf_cash_under_tenth_of_gross
cash price $305 is 6% of the gross charge $4,738
CPT 84703/o
info
mrf_cash_under_tenth_of_gross
cash price $7 is 2% of the gross charge $335
CPT 70450/o
info
mrf_cash_under_tenth_of_gross
cash price $133 is 2% of the gross charge $6,964
CPT 85007/o
info
mrf_cash_under_tenth_of_gross
cash price $3 is 2% of the gross charge $152
CPT 70460/o
info
mrf_cash_under_tenth_of_gross
cash price $224 is 6% of the gross charge $3,856
CPT 85014/o
info
mrf_cash_under_tenth_of_gross
cash price $2 is 2% of the gross charge $117
CPT 70470/o
info
mrf_cash_under_tenth_of_gross
cash price $224 is 4% of the gross charge $5,599
CPT 85018/o
info
mrf_cash_under_tenth_of_gross
cash price $2 is 2% of the gross charge $112
CPT 70480/o
info
mrf_cash_under_tenth_of_gross
cash price $133 is 2% of the gross charge $5,350
CPT 85025/o
info
mrf_cash_under_tenth_of_gross
cash price $7 is 2% of the gross charge $301
CPT 70481/o
info
mrf_cash_under_tenth_of_gross
cash price $224 is 5% of the gross charge $4,717
CPT 85027/o
info
mrf_cash_under_tenth_of_gross
cash price $6 is 4% of the gross charge $158
CPT 70482/o
info
mrf_cash_under_tenth_of_gross
cash price $224 is 4% of the gross charge $5,685
CPT 85032/o
info
mrf_cash_under_tenth_of_gross
cash price $4 is 3% of the gross charge $138
CPT 70486/o
info
mrf_cash_under_tenth_of_gross
cash price $133 is 2% of the gross charge $6,183
CPT 85044/o
info
mrf_cash_under_tenth_of_gross
cash price $4 is 2% of the gross charge $165
CPT 70487/o
info
mrf_cash_under_tenth_of_gross
cash price $224 is 5% of the gross charge $4,518
CPT 85045/o
info
mrf_cash_under_tenth_of_gross
cash price $3 is 2% of the gross charge $163
CPT 70488/o
info
mrf_cash_under_tenth_of_gross
cash price $224 is 4% of the gross charge $5,749
CPT 85048/o
info
mrf_cash_under_tenth_of_gross
cash price $2 is 2% of the gross charge $93
CPT 70490/o
info
mrf_cash_under_tenth_of_gross
cash price $133 is 2% of the gross charge $5,350
CPT 85049/o
info
mrf_cash_under_tenth_of_gross
cash price $4 is 3% of the gross charge $147
CPT 70491/o
info
mrf_cash_under_tenth_of_gross
cash price $224 is 5% of the gross charge $4,640
CPT 85220/o
info
mrf_cash_under_tenth_of_gross
cash price $17 is 6% of the gross charge $293
CPT 70492/o
info
mrf_cash_under_tenth_of_gross
cash price $224 is 4% of the gross charge $6,061
CPT 85300/o
info
mrf_cash_under_tenth_of_gross
cash price $11 is 6% of the gross charge $190
CPT 70496/o
info
mrf_cash_under_tenth_of_gross
cash price $224 is 3% of the gross charge $7,088
CPT 85301/o
info
mrf_cash_under_tenth_of_gross
cash price $10 is 10% of the gross charge $104
CPT 70498/o
info
mrf_cash_under_tenth_of_gross
cash price $224 is 3% of the gross charge $6,986
CPT 85302/o
info
mrf_cash_under_tenth_of_gross
cash price $12 is 7% of the gross charge $173
CPT 70540/o
info
mrf_cash_under_tenth_of_gross
cash price $305 is 7% of the gross charge $4,611
CPT 85303/o
info
mrf_cash_under_tenth_of_gross
cash price $13 is 4% of the gross charge $293
CPT 70543/o
info
mrf_cash_under_tenth_of_gross
cash price $446 is 8% of the gross charge $5,677
CPT 85305/o
info
mrf_cash_under_tenth_of_gross
cash price $11 is 3% of the gross charge $354
CPT 70544/o
info
mrf_cash_under_tenth_of_gross
cash price $305 is 6% of the gross charge $5,095
CPT 85306/o
info
mrf_cash_under_tenth_of_gross
cash price $15 is 6% of the gross charge $272
CPT 70547/o
info
mrf_cash_under_tenth_of_gross
cash price $305 is 6% of the gross charge $5,095
CPT 85362/o
info
mrf_cash_under_tenth_of_gross
cash price $6 is 3% of the gross charge $212
CPT 70551/o
info
mrf_cash_under_tenth_of_gross
cash price $305 is 5% of the gross charge $5,922
CPT 85378/o
info
mrf_cash_under_tenth_of_gross
cash price $9 is 2% of the gross charge $476
CPT 70553/o
info
mrf_cash_under_tenth_of_gross
cash price $446 is 5% of the gross charge $8,454
CPT 85379/o
info
mrf_cash_under_tenth_of_gross
cash price $10 is 3% of the gross charge $397
CPT 71111/o
info
mrf_cash_under_tenth_of_gross
cash price $133 is 8% of the gross charge $1,575
CPT 85384/o
info
mrf_cash_under_tenth_of_gross
cash price $9 is 3% of the gross charge $278
CPT 71250/o
info
mrf_cash_under_tenth_of_gross
cash price $133 is 2% of the gross charge $6,179
CPT 85610/o
info
mrf_cash_under_tenth_of_gross
cash price $4 is 2% of the gross charge $182
CPT 71260/o
info
mrf_cash_under_tenth_of_gross
cash price $224 is 4% of the gross charge $5,911
CPT 85611/o
info
mrf_cash_under_tenth_of_gross
cash price $3 is 9% of the gross charge $34
CPT 71270/o
info
mrf_cash_under_tenth_of_gross
cash price $224 is 4% of the gross charge $5,614
CPT 85613/o
info
mrf_cash_under_tenth_of_gross
cash price $9 is 8% of the gross charge $118
CPT 71275/o
info
mrf_cash_under_tenth_of_gross
cash price $224 is 4% of the gross charge $6,227
CPT 85651/o
info
mrf_cash_under_tenth_of_gross
cash price $4 is 2% of the gross charge $191
CPT 71550/o
info
mrf_cash_under_tenth_of_gross
cash price $305 is 6% of the gross charge $5,103
CPT 85652/o
info
mrf_cash_under_tenth_of_gross
cash price $2 is 1% of the gross charge $134
CPT 72050/o
info
mrf_cash_under_tenth_of_gross
cash price $133 is 10% of the gross charge $1,351
CPT 85660/o
info
mrf_cash_under_tenth_of_gross
cash price $5 is 3% of the gross charge $166
CPT 72110/o
info
mrf_cash_under_tenth_of_gross
cash price $133 is 10% of the gross charge $1,399
CPT 85670/o
info
mrf_cash_under_tenth_of_gross
cash price $5 is 5% of the gross charge $110
CPT 72114/o
info
mrf_cash_under_tenth_of_gross
cash price $133 is 10% of the gross charge $1,362
CPT 85705/o
info
mrf_cash_under_tenth_of_gross
cash price $9 is 5% of the gross charge $200
CPT 72125/o
info
mrf_cash_under_tenth_of_gross
cash price $133 is 2% of the gross charge $5,885
CPT 85730/o
info
mrf_cash_under_tenth_of_gross
cash price $6 is 2% of the gross charge $249
CPT 72126/o
info
mrf_cash_under_tenth_of_gross
cash price $446 is 8% of the gross charge $5,639
CPT 85732/o
info
mrf_cash_under_tenth_of_gross
cash price $6 is 5% of the gross charge $125
CPT 72127/o
info
mrf_cash_under_tenth_of_gross
cash price $224 is 7% of the gross charge $3,274
CPT 86003/o
info
mrf_cash_under_tenth_of_gross
cash price $5 is 7% of the gross charge $75
CPT 72128/o
info
mrf_cash_under_tenth_of_gross
cash price $133 is 3% of the gross charge $5,260
CPT 86022/o
info
mrf_cash_under_tenth_of_gross
cash price $18 is 4% of the gross charge $416
CPT 72129/o
info
mrf_cash_under_tenth_of_gross
cash price $224 is 4% of the gross charge $5,176
CPT 86038/o
info
mrf_cash_under_tenth_of_gross
cash price $12 is 7% of the gross charge $178
CPT 72130/o
info
mrf_cash_under_tenth_of_gross
cash price $224 is 4% of the gross charge $5,330
CPT 86039/o
info
mrf_cash_under_tenth_of_gross
cash price $11 is 5% of the gross charge $239
CPT 72131/o
info
mrf_cash_under_tenth_of_gross
cash price $133 is 3% of the gross charge $5,260
CPT 86060/o
info
mrf_cash_under_tenth_of_gross
cash price $7 is 4% of the gross charge $170
CPT 72132/o
info
mrf_cash_under_tenth_of_gross
cash price $446 is 8% of the gross charge $5,802
CPT 86140/o
info
mrf_cash_under_tenth_of_gross
cash price $5 is 2% of the gross charge $216
CPT 72133/o
info
mrf_cash_under_tenth_of_gross
cash price $224 is 4% of the gross charge $5,027
CPT 86141/o
info
mrf_cash_under_tenth_of_gross
cash price $12 is 7% of the gross charge $173
CPT 72141/o
info
mrf_cash_under_tenth_of_gross
cash price $305 is 5% of the gross charge $6,198
CPT 86160/o
info
mrf_cash_under_tenth_of_gross
cash price $12 is 8% of the gross charge $156
CPT 72142/o
info
mrf_cash_under_tenth_of_gross
cash price $446 is 7% of the gross charge $6,092
CPT 86171/o
info
mrf_cash_under_tenth_of_gross
cash price $10 is 4% of the gross charge $224
CPT 72146/o
info
mrf_cash_under_tenth_of_gross
cash price $305 is 5% of the gross charge $6,198
CPT 86225/o
info
mrf_cash_under_tenth_of_gross
cash price $13 is 9% of the gross charge $145
CPT 72148/o
info
mrf_cash_under_tenth_of_gross
cash price $305 is 5% of the gross charge $6,379
CPT 86226/o
info
mrf_cash_under_tenth_of_gross
cash price $12 is 8% of the gross charge $155
CPT 72156/o
info
mrf_cash_under_tenth_of_gross
cash price $446 is 7% of the gross charge $6,821
CPT 86235/o
info
mrf_cash_under_tenth_of_gross
cash price $17 is 9% of the gross charge $182
CPT 72157/o
info
mrf_cash_under_tenth_of_gross
cash price $446 is 7% of the gross charge $6,606
CPT 86255/o
info
mrf_cash_under_tenth_of_gross
cash price $12 is 9% of the gross charge $127
CPT 72158/o
info
mrf_cash_under_tenth_of_gross
cash price $446 is 5% of the gross charge $8,360
CPT 86256/o
info
mrf_cash_under_tenth_of_gross
cash price $12 is 6% of the gross charge $211
CPT 72191/o
info
mrf_cash_under_tenth_of_gross
cash price $224 is 4% of the gross charge $5,614
CPT 86300/o
info
mrf_cash_under_tenth_of_gross
cash price $20 is 6% of the gross charge $350
CPT 72192/o
info
mrf_cash_under_tenth_of_gross
cash price $133 is 2% of the gross charge $5,618
CPT 86301/o
info
mrf_cash_under_tenth_of_gross
cash price $20 is 8% of the gross charge $250
CPT 72193/o
info
mrf_cash_under_tenth_of_gross
cash price $224 is 5% of the gross charge $4,824
CPT 86304/o
info
mrf_cash_under_tenth_of_gross
cash price $20 is 4% of the gross charge $489
CPT 72194/o
info
mrf_cash_under_tenth_of_gross
cash price $224 is 4% of the gross charge $5,764
CPT 86308/o
info
mrf_cash_under_tenth_of_gross
cash price $5 is 2% of the gross charge $232
CPT 72195/o
info
mrf_cash_under_tenth_of_gross
cash price $305 is 7% of the gross charge $4,612
CPT 86316/o
info
mrf_cash_under_tenth_of_gross
cash price $20 is 9% of the gross charge $230
CPT 72196/o
info
mrf_cash_under_tenth_of_gross
cash price $446 is 8% of the gross charge $5,889
CPT 86376/o
info
mrf_cash_under_tenth_of_gross
cash price $14 is 7% of the gross charge $211
CPT 72197/o
info
mrf_cash_under_tenth_of_gross
cash price $446 is 5% of the gross charge $8,270
CPT 86403/o
info
mrf_cash_under_tenth_of_gross
cash price $11 is 6% of the gross charge $171
CPT 73110/o
info
mrf_cash_under_tenth_of_gross
cash price $111 is 10% of the gross charge $1,124
CPT 86430/o
info
mrf_cash_under_tenth_of_gross
cash price $6 is 3% of the gross charge $217
CPT 73200/o
info
mrf_cash_under_tenth_of_gross
cash price $133 is 3% of the gross charge $5,310
CPT 86431/o
info
mrf_cash_under_tenth_of_gross
cash price $5 is 3% of the gross charge $150
CPT 73202/o
info
mrf_cash_under_tenth_of_gross
cash price $224 is 5% of the gross charge $4,400
CPT 86592/o
info
mrf_cash_under_tenth_of_gross
cash price $4 is 3% of the gross charge $139
CPT 73206/o
info
mrf_cash_under_tenth_of_gross
cash price $224 is 5% of the gross charge $4,470
CPT 86618/o
info
mrf_cash_under_tenth_of_gross
cash price $17 is 9% of the gross charge $196
CPT 73221/o
info
mrf_cash_under_tenth_of_gross
cash price $305 is 5% of the gross charge $6,379
CPT 86635/o
info
mrf_cash_under_tenth_of_gross
cash price $11 is 10% of the gross charge $114
CPT 73562/o
info
mrf_cash_under_tenth_of_gross
cash price $111 is 10% of the gross charge $1,114
CPT 86641/o
info
mrf_cash_under_tenth_of_gross
cash price $14 is 5% of the gross charge $299
CPT 73630/o
info
mrf_cash_under_tenth_of_gross
cash price $111 is 6% of the gross charge $1,914
CPT 86658/o
info
mrf_cash_under_tenth_of_gross
cash price $13 is 9% of the gross charge $142
CPT 73700/o
info
mrf_cash_under_tenth_of_gross
cash price $133 is 2% of the gross charge $5,841
CPT 86677/o
info
mrf_cash_under_tenth_of_gross
cash price $16 is 4% of the gross charge $389
CPT 73701/o
info
mrf_cash_under_tenth_of_gross
cash price $224 is 4% of the gross charge $5,500
CPT 86694/o
info
mrf_cash_under_tenth_of_gross
cash price $14 is 8% of the gross charge $171
CPT 73702/o
info
mrf_cash_under_tenth_of_gross
cash price $224 is 4% of the gross charge $5,500
CPT 86696/o
info
mrf_cash_under_tenth_of_gross
cash price $19 is 8% of the gross charge $228
CPT 73706/o
info
mrf_cash_under_tenth_of_gross
cash price $224 is 4% of the gross charge $5,602
CPT 86701/o
info
mrf_cash_under_tenth_of_gross
cash price $8 is 4% of the gross charge $228
CPT 73718/o
info
mrf_cash_under_tenth_of_gross
cash price $305 is 9% of the gross charge $3,295
CPT 86702/o
info
mrf_cash_under_tenth_of_gross
cash price $13 is 7% of the gross charge $196
CPT 73719/o
info
mrf_cash_under_tenth_of_gross
cash price $446 is 7% of the gross charge $5,984
CPT 86703/o
info
mrf_cash_under_tenth_of_gross
cash price $13 is 4% of the gross charge $348
CPT 73720/o
info
mrf_cash_under_tenth_of_gross
cash price $446 is 7% of the gross charge $6,326
CPT 86704/o
info
mrf_cash_under_tenth_of_gross
cash price $12 is 4% of the gross charge $271