Service
Code
Listed
Cash
Negotiated
Rates
Checks
Hc Liver Dis 10 Assays W/Nash
$2,517
$503
$503
39
clean
Hc Nfct Ds Dna Untrgt Ngnrj Seq
$2,126
$2,126
$2,126
39
clean
Pedcle fhchchmnaxghf
$22,462
—
$4,466
2
clean
INJ PLSM IMGE GUIDE HRVST/PR
$63,531
$445
$459
41
clean
Hc Translum Peripherl Atherectomy Brachiocephal Ea
$30,776
$11,522
$11,522
41
clean
Hc Translum Peripheral Atherectomy Iliac Artery Ea
$51,406
$18,296
$18,297
41
clean
Hc Ev Fempop Artl Revsc Tcat Plmt Iv St Grf & Clsr
$29,926
$11,522
$11,522
41
clean
Hc Fine Needle Aspiration Bx W/Us Gdn 1St Lesion
$3,178
$706
$728
41
clean
Hc Fine Needle Aspiration Bx W/Us Gdn Ea Addl
$500
—
$500
3
clean
Hc Fine Needle Aspiration Bx W/Ct Gdn 1St Lesion
$2,653
$706
$728
41
clean
Hc Fine Needle Aspiration Bx W/Ct Gdn Ea Addl
$1,379
—
$1,379
3
clean
Hc Fine Needle Asp Wo Img Guidance
$1,900
$405
$418
41
clean
Hc Image-Guided Catheter Fluid Collection Drainage
$4,105
$706
$728
41
clean
Hc Incision & Drain Skin Abscess Simple
$1,463
$200
$206
41
clean
Hc Incision & Drain Skin Abscess Complic
$2,089
$405
$418
41
clean
Hc Incision & Drain Pilonidal Cyst Simpl
$3,245
$706
$728
41
clean
Hc Remove Foreign Body Simple
$1,960
$405
$418
82
clean
Hc Remove Foreign Body Complex
$9,673
$1,648
$1,698
41
clean
Hc Incision & Drain Of Hematoma/Fluid
$6,878
$1,648
$1,698
41
clean
Hc Puncture Drainage Of Lesion
$3,003
$405
$418
41
clean
Hc Complex Drainage, Wound
$11,892
$2,899
$2,899
82
clean
Hc Debridement, Infected Skin, Ea Add 10% Bsa
$5,943
—
$2,297
3
clean
Dbrdmt skin abdominal wall
$25,000
—
$1,817
7
clean
Rmv prstc mtrlmesh abd wall
$12,500
—
$1,817
7
clean
Deb skin bone at fx site
$22,462
$2,899
$2,899
41
clean
Dbrdmt Subq Tis 1St 20Sqcm/<
$25,269
$405
$418
82
clean
Hc Debride Skin Sub-Q Tiss Muscle =<20 Sq Cm
$3,158
$737
$760
41
clean
Hc Debride Skin Sub-Q Tiss Muscle Bone =<20 Sq Cm
$5,801
$1,648
$1,698
41
clean
Hc Debride Skin Sub-Q Tiss Each Add 20 Sq Cm
$2,570
—
$2,297
3
clean
Hc Debride Skin Sub-Q Tiss Muscle Ea Add 20 Sq Cm
$2,234
—
$2,234
3
clean
Hc Trim Benign Hyperkeratotic Skin Lesion, Single
$707
$200
$206
41
clean
Hc Trim Benign Hyperkeratotic Skin Lesion,2-4
$550
$200
$206
41
clean
Hc Trim Benign Hyperkeratotic Skin Lesion,>4
$772
$200
$206
41
clean
Hc Tangential Biopsy Skin Single Lesion
$903
$405
$418
41
clean
Hc Punch Biopsy Skin Single Lesion
$1,900
$405
$418
41
clean
Hc Incisional Biopsy Skin Single Lesion
$2,674
$737
$760
41
clean
Hc Removal Of Skin Tags, Up To 15
$994
$200
$206
41
clean
Hc Shaving Skin Lesion 1 S/N/H/F/G Diam 0.5 Cm/<
$752
$200
$206
41
clean
Exc tr-ext b9+marg 0.5 cm<
$17,648
$706
$728
41
clean
Exc tr-ext b9+marg 0.6-1 cm
$16,707
$405
$418
41
clean
Exc Tr-Ext B9+Marg 1.1-2 Cm
$15,625
$706
$728
41
clean
Exc tr-ext b9+marg 2.1-3cm
$10,403
$706
$728
41
clean
Exc Tr-Ext B9+Marg 3.1-4 Cm
$12,500
$1,648
$1,698
41
clean
Exc Tr-Ext B9+Marg >4.0 Cm
$16,893
$1,648
$1,698
41
clean
Exc h-f-nk-sp b9+marg 0.5<
$17,832
$1,648
$1,698
41
clean
Exc H-F-Nk-Sp B9+Marg 0.6-1
$15,625
$706
$728
82
clean
Exc h-f-nk-sp b9+marg 1.1-2
$17,338
$1,648
$1,698
41
clean
Exc H-F-Nk-Sp B9+Marg 2.1-3
$11,833
$1,648
$1,698
41
clean
Exc h-f-nk-sp b9+marg 3.1-4
$12,500
$1,648
$1,698
41
clean
Hc Exc Skin Benig >4 Cm Scalp/Neck/Hnd/Ft/Gent
$7,322
$2,899
$2,899
41
clean
Exc face-mm b9+marg 0.6-1 cm
$12,500
$706
$728
41
clean
Exc face-mm b9+marg 1.1-2 cm
$11,111
$706
$728
41
clean
Exc Skn Hdrdnt Ax Smpl/Ntrm
$17,188
$2,899
$2,899
41
clean
Hc Trim Nail(S)
$386
$58
$59
41
clean
Hc Debridement Of Nails, 1-5
$398
$58
$61
41
clean
Hc Debridement Of Nails, 6 Or More
$438
$58
$61
41
clean
Hc Removal Of Nail Plate
$917
$200
$206
41
clean
Hc Drain Blood From Under Nail
$576
$132
$137
41
clean
Hc Removal Of Nail Bed
$2,471
$405
$418
41
clean
Hc Reconstruc Of Nail Bed
$2,905
$737
$760
41
clean
Hc Excision Of Nail Fold (Wedge), Toe
$1,998
$405
$418
41
clean
Remove Pilonidal Cyst Simple
$29,481
$2,899
$2,899
41
clean
Remove Pilonidal Cyst Exten
$21,900
$2,899
$2,899
41
clean
Inject skin lesions <w 7
$11,027
$200
$206
41
clean
Hc Repr Wnd Smp Body/Scalp/Extr <2.5 Cm
$818
$200
$206
41
clean
Hc Repr Wnd Smp Body/Scalp/Extr 2.6-7.5 Cm
$866
$200
$206
41
clean
Hc Repr Wnd Smp Body/Scalp/Extr 7.6-12.5 Cm
$890
$200
$206
41
clean
Hc Repr Wnd Smp Body/Scalp/Extr 12.6-20 Cm
$844
$405
$418
41
clean
Hc Repr Wnd Smp Body/Scalp/Extr 20.1-30 Cm
$1,865
$405
$418
41
clean
Hc Repr Wnd Smp Body/Scalp/Extr >30.1 Cm
$954
$200
$206
41
clean
Hc Repr Wnd Smp Face 2.6-5.0 Cm
$917
$200
$206
41
clean
Hc Repr Wnd Smp Face 5.1-7.5 Cm
$917
$200
$206
41
clean
Hc Repr Wnd Smp Face 12.6-20 Cm
$1,900
$405
$418
41
clean
Hc Treat Wnd Dehiscence, Simple Closure
$2,905
$737
$760
41
clean
Hc Repr Wnd Intrmd Body/Scalp/Extr <2.5 Cm
$1,865
$405
$418
41
clean
Hc Repr Wnd Intrmd Body/Scalp/Extr 2.6-7.5 Cm
$1,765
$405
$418
41
clean
Hc Repr Wnd Intrmd Body/Scalp/Extr 7.6-12.5 Cm
$1,865
$405
$418
41
clean
Hc Repr Wnd Intrmd Body/Scalp/Extr 12.5-20 Cm
$1,865
$405
$418
41
clean
Hc Repr Wnd Intrmd Body/Scalp/Extr >30.1 Cm
$8,629
$2,059
$2,121
41
clean
Hc Repr Wnd Intrmd Neck/Hnd/Ft/Gent <2.5 Cm
$1,765
$405
$418
41
clean
Hc Repr Wnd Intrmd Neck/Hnd/Ft/Gent 2.6-7.5 Cm
$1,765
$405
$418
41
clean
Hc Repr Wnd Intrmd Neck/Hnd/Ft/Gent 7.6-12.5 Cm
$3,061
$737
$760
41
clean
Hc Repr Wnd Intrmd Neck/Hnd/Ft/Gent 12.5-20 Cm
$2,905
$737
$760
41
clean
Hc Repr Wnd Intrmd Neck/Hnd/Ft/Gent 20.1-30 Cm
$2,905
$737
$760
41
clean
Hc Repr Wnd Intrmd Face <2.5 Cm
$1,998
$405
$418
41
clean
Hc Repr Wnd Intrmd Face 2.6-5.0 Cm
$1,765
$405
$418
41
clean
Hc Repr Wnd Intrmd Face 5.1-7.5 Cm
$1,865
$405
$418
41
clean
Cmplx rpr trunk 2.6-7.5 cm
$16,846
$737
$760
41
clean
Cmplx rpr trunk addl 5cm<
$5,615
—
$2,297
3
clean
Hc Repr Wnd Cplx Scalp 1.1-2.5 Cm
$2,992
$405
$418
41
clean
Hc Repr Wnd Cplx Face/Hnd/Ft/Gent 2.6-7.5 Cm
$1,931
$405
$418
41
clean
Hc Repr Wnd Cplx Face/Hnd/Ft/Gent Ea Add 5.0 Cm
$2,164
—
$2,164
3
clean
Sec clsr surg wnddehsn xtn
$20,833
$3,537
$3,537
41
clean
Tis trnfr sal 10.1-30 sqcm
$6,250
$2,059
$2,121
41
clean
Tis trnfr fccmnaghf
$8,333
$2,059
$2,121
41
clean
Tis Trnfr F/C/C/M/N/A/G/H/F
$18,750
$2,059
$2,121
41
clean
Tis Trnfr Any 30.1-60 Sq Cm
$21,875
$3,537
$3,537
41
clean
Tis trnfr addl 30 sq cm
$12,623
—
$2,297
3
clean
Wound prep trkarmleg
$9,375
$737
$760
41
clean
Wound prep addl 100 cm
$3,125
—
$2,297
3
clean
Wound prep fnhfg
$4,212
$405
$418
41
clean
Harvest cultured skin graft
$16,846
$2,059
$2,121
41
clean
Hc App Skn Sub Trnk/Arm/Leg Ttl 100Sqcm 1St 25 Sqcm
$8,746
$737
$760
41
clean
Hc App Skn Sub Trnk/Arm/Leg Ttl 100Sqcm Ea Ad 25Qsqcm
$1,228
—
$1,228
3
clean
Hc App Skn Sub Trnk/Arm/Leg >=100Sqcm 1St 100Sqcm
$17,981
$2,059
$2,121
41
clean
Hc App Skn Sub Trnk/Arm/Leg >=100Sqcm Ea Add 100Sqcm
$2,474
—
$2,297
3
clean
Hc App Skn Sub Head/Hnd/Ft/Gnt Ttl 100Sqcm 1St 25 Sqcm
$8,746
$737
$760
41
clean
Hc App Skn Sub Head/Hnd/Ft/Gnt Ttl 100Sqcm Ea Ad 25Cm
$843
—
$843
3
clean
Hc App Skn Sub Head/Hnd/Ft/Gnt >=100Sqcm 1St 100Sqcm
$5,248
$2,059
$2,121
41
clean
Hc App Skn Sub Head/Hnd/Ft/Gnt >=100Sqcm Ea Ad 100Sqcm
$1,226
—
$1,226
3
clean
Muscle-skin graft trunk
$71,250
$3,537
$3,537
41
clean
Hc Implnt Bio Implnt For Soft Tissue Reinforcement
$3,291
—
$2,297
3
clean
Hc Abrasion, Single
$550
$200
$206
41
clean
Hc Abrasion, Each Addn 4 Or Less
$253
—
$253
3
clean
Excise excess skin & tissue
$80,750
$2,899
$2,899
41
clean
Hc Removal Sutures/Staples Not Requiring Anesthesia
$4,909
—
$4,466
3
clean
Hc Treat Burn 1St Degree, Initial
$917
$200
$206
41
clean
Hc Dress/Debride Burn <5% Total Sm
$1,280
$200
$206
41
clean
Hc Dress/Debride Burn 5-10% Ttl Med
$1,284
$200
$206
41
clean
Hc Dress/Debride Burn >10% Ttl Lg
$2,008
$405
$418
41
clean
Destruct b9 lesion 1-14
$6,306
$200
$206
41
clean
Hc Chem Cautery Granulatn Tissue
$1,410
$200
$206
41
clean
Unlistd px skn muc memb subq
$5,615
$200
$206
40
clean
Hc I&D Breast Lesion
$2,301
$706
$728
41
clean
Hc I&D Breast Lesion Add On
$1,081
—
$1,081
3
clean
Hc Inject Ductogram/Galactogram
$262
—
$262
2
clean
Hc Bx Breast W Device Stereotact Guide 1St Lesion
$7,185
$1,648
$1,648
41
clean
Hc Bx Breast W Device Stereotact Guide Addl Lesion
$6,905
—
$284
2
clean
Hc Bx Breast W Device Us Guide 1St Lesion
$5,704
$1,648
$1,698
41
clean
Hc Bx Breast W Device Us Guide Addl Lesion
$4,247
—
$2,297
2
clean
Hc Bx Breast W Device Mri Guide 1St Lesion
$5,915
$1,648
$1,698
41
clean
Hc Bx Breast W Device Mri Guide Addl Lesion
$5,527
—
$2,297
2
clean
Biopsy Of Breast Open
$19,247
$3,908
$3,908
41
clean
Removal Of Breast Lesion
$20,515
$3,908
$3,908
41
clean
Excision breast lesion
$33,692
$3,908
$3,908
41
clean
Hc Perq Dev Place Breast Loc 1St Les W Mammo Guid
$1,899
$1,648
$1,648
40
clean
Hc Perq Device Placemt Breast Loc Ea Les W Guidnce
$2,046
—
$284
2
clean
Hc Perq Breast Loc Dev Place Strotact Guid 1St Les
$2,800
$706
$707
40
clean
Hc Perq Breast Loc Dev Place Us Guide 1St Lesion
$2,512
$706
$728
40
clean
Hc Perq Breast Loc Dev Place Us Guide Addl Lesion
$1,675
—
$1,675
2
clean
Partial Mastectomy
$30,684
$3,908
$3,908
41
clean
Mast Simple Complete
$42,116
$6,627
$6,628
41
clean
Mast Mod Rad
$46,327
$6,627
$6,628
41
clean
Breast reduction
$18,601
$6,627
$6,628
41
clean
Hc Unlisted Procedure Breast
$7,359
$3,908
$3,908
40
clean
Deep Muscle Biopsy
$9,466
$2,899
$2,899
41
clean
Hc Needle Biopsy,Muscle
$3,591
$1,648
$1,698
41
clean
Hc Bone Bx Tr/Ndl; Superf
$3,822
$1,648
$1,698
41
clean
Hc Bone Biopsy,Trocar/Needle Deep
$5,087
$1,648
$1,698
41
clean
Bone Biopsy Open Deep
$41,180
$2,899
$2,899
41
clean
Hc Injection Sinus Tract Therapeutic Separate Proc
$7,265
$1,548
$1,595
41
clean
Hc Inject Sinus Tract For Dx W Xray
$1,792
—
$1,792
2
clean
THER INJECTION CARP TUNNEL
$6,250
$306
$316
41
clean
Hc Drain/Inject Small Joint/Bursa
$1,121
$306
$316
41
clean
Hc Arthrocnt Aspir&/Inj Small Jt/Bursaw/Us Rec Rprt
$1,868
$306
$316
41
clean
Hc Drain/Inject Intermediate Joint/Bursa
$1,438
$306
$316
41
clean
Hc Arthrocentesis Aspir&/Inj Interm Jt/Burs W/Us
$1,511
$704
$726
41
clean
Drain/Inj Joint/Bursa W/O Us
$12,500
$306
$316
82
clean
Hc Arthrocentesis Aspir&/Inj Major Jt/Bursa W/Us
$2,188
$306
$316
41
clean
Hc Asp & Inj Bone Cyst
$1,863
$706
$728
41
clean
Removal Of Implant Deep
$33,692
$2,899
$2,899
41
clean
RMVL I-ARTIC RX DELIVERY DEV
$64,125
—
$2,297
3
clean
SP BONE AGRFT MORSEL ADD-ON
$10,589
—
$2,297
3
clean
BONE MARROW ASPIR BONE GRFG
$12,942
—
$2,297
3
clean
Hc Radiorequency Bone Tumor Ablation, Perq
$14,452
$17,500
$14,452
41
clean
Hc Ablation Bone Tumor W/ Img Gdn When Prfmd
$13,378
$7,242
$7,242
41
clean
Hc Unlisted Procedure Muscskeletal System General
$1,474
$246
$254
40
clean
Exc Face Les Sc <2 Cm
$15,625
$1,648
$1,698
41
clean
Exc Face Les Sbq 2 Cm/>
$21,875
$1,648
$1,698
41
clean
EXC FACE TUM DEEP < 2 CM
$14,583
$1,648
$1,698
41
clean
EXC FACE TUM DEEP 2 CM>
$12,500
$2,899
$2,899
41
clean
Hc Clsd Treat Temporomandibl Disloc
$1,053
$246
$254
41
clean
Hc I&D Deep Absc/Hematoma Neck/Chest
$6,070
$2,899
$2,899
41
clean
Exc Neck Les Sc 3 Cm/>
$15,625
$2,899
$2,899
41
clean
Exc Neck Tum Deep 5 Cm/>
$15,625
$2,899
$2,899
41
clean
Exc Neck Tum Deep < 5 Cm
$12,500
$2,899
$2,899
41
clean
EXC BACK LES SC < 3 CM
$12,500
$1,648
$1,698
41
clean
Exc Back Les Sc 3 Cm/>
$17,188
$1,648
$1,698
41
clean
Exc Back Tum Deep < 5 Cm
$9,466
$2,899
$2,899
41
clean
Exc Back Tum Deep 5 Cm/>
$20,313
$2,899
$2,899
41
clean
Hc Perq Cervicothoracic Inj
$10,658
$3,265
$3,266
41
clean
Hc Perq Lumbosacral Inj
$10,456
$3,265
$3,266
41
clean
Hc Perq Vertebroplasty Addl Inj
$5,950
—
$2,297
2
clean
Hc Perq Vertebral Augmentation, Thoracic
$16,309
$7,242
$7,242
41
clean
Hc Perq Vertebral Augmentation, Lumbar
$16,106
$7,242
$7,242
41
clean
Hc Perq Vertebral Augmentation Add, Thora Or Lumb
$10,910
—
$2,297
2
clean
NECK SPINE FUSE&REMOV BEL C2
$16,165
$12,814
$12,814
41
clean
*11ADDL NECK SPINE FUSION
$16,751
—
$2,297
3
clean
NECK SPINE FUSION
$16,031
$12,814
$12,814
41
clean
ARTHRODESIS, POST TECH, CERVICAL
$10,529
$17,500
$10,529
41
clean
LUMBAR SPINE FUSION
$12,635
$17,500
$12,635
41
clean
SPINE FUSION EXTRA SEGMENT
$10,529
—
$2,297
3
clean
INSERT SPINE FIXATION DEVICE - 22840 -
$12,635
—
$2,297
3
clean
INSERT SPINE FIXATION DEVICE - 22842 -
$10,529
—
$2,297
3
clean
INSERT SPINE FIXATION DEVICE - 22845 -
$14,969
—
$2,297
3
clean
INSERT SPINE FIXATION DEVICE - 22846 -
$12,942
—
$2,262
7
clean
INSJ BIOMECHANICAL DEVICE
$15,250
—
$2,297
3
clean
Hc Exc Tumor Soft Tissue Abdl Wall Subfascial <5Cm
$7,265
$2,899
$2,899
41
clean
EXC ABDL TUM DEEP 5 CM>
$11,231
$2,899
$2,899
41
clean
Exc Abd Les Sc 3 Cm/>
$14,063
$2,899
$2,899
41
clean
Showing the first 200 of 3,386 code–setting items in the file, verified codes first —
every row as JSON →
Service
Severity
Rule
Detail
CPT 80179/o
error
mrf_cash_above_gross
discounted cash price $18 exceeds gross charge $15
CPT 81443/o
error
mrf_cash_above_gross
discounted cash price $2,448 exceeds gross charge $142
CPT 20982/o
error
mrf_cash_above_gross
discounted cash price $17,500 exceeds gross charge $14,452
CPT 22600/o
error
mrf_cash_above_gross
discounted cash price $17,500 exceeds gross charge $10,529
CPT 22612/o
error
mrf_cash_above_gross
discounted cash price $17,500 exceeds gross charge $12,635
CPT 25259/o
error
mrf_cash_above_gross
discounted cash price $1,604 exceeds gross charge $1,042
CPT 28705/o
error
mrf_cash_above_gross
discounted cash price $17,500 exceeds gross charge $12,500
CPT 37182/o
error
mrf_cash_above_gross
discounted cash price $18,296 exceeds gross charge $11,701
CPT 37184/o
error
mrf_cash_above_gross
discounted cash price $18,296 exceeds gross charge $15,847
CPT 37617/o
error
mrf_cash_above_gross
discounted cash price $5,553 exceeds gross charge $4,032
CPT 49255/o
error
mrf_cash_above_gross
discounted cash price $6,461 exceeds gross charge $3,528
CPT 88319/o
error
mrf_cash_above_gross
discounted cash price $804 exceeds gross charge $668
CPT 51840/o
error
mrf_cash_above_gross
discounted cash price $4,992 exceeds gross charge $3,972
CPT 54512/o
error
mrf_cash_above_gross
discounted cash price $3,518 exceeds gross charge $3,125
CPT C9901/o
error
mrf_cash_above_gross
discounted cash price $10,609 exceeds gross charge $9,808
warn
mrf_rate_without_estimate
1,122 of 1,122 percentage/algorithm rates across 513 items carry no estimated dollar amount, which the template has required since 1 January 2025 — none of them do
CPT 73221/o
info
mrf_cash_under_tenth_of_gross
cash price $238 is 6% of the gross charge $4,131
CPT 85305/o
info
mrf_cash_under_tenth_of_gross
cash price $11 is 4% of the gross charge $311
CPT 73223/o
info
mrf_cash_under_tenth_of_gross
cash price $348 is 6% of the gross charge $6,132
CPT 85307/o
info
mrf_cash_under_tenth_of_gross
cash price $15 is 6% of the gross charge $231
CPT 73700/o
info
mrf_cash_under_tenth_of_gross
cash price $104 is 4% of the gross charge $2,620
CPT 85347/o
info
mrf_cash_under_tenth_of_gross
cash price $4 is 4% of the gross charge $100
CPT 73701/o
info
mrf_cash_under_tenth_of_gross
cash price $175 is 5% of the gross charge $3,375
CPT 85379/o
info
mrf_cash_under_tenth_of_gross
cash price $10 is 4% of the gross charge $240
CPT 73706/o
info
mrf_cash_under_tenth_of_gross
cash price $175 is 4% of the gross charge $4,192
CPT 85384/o
info
mrf_cash_under_tenth_of_gross
cash price $9 is 5% of the gross charge $185
CPT 73718/o
info
mrf_cash_under_tenth_of_gross
cash price $238 is 5% of the gross charge $4,397
CPT 85420/o
info
mrf_cash_under_tenth_of_gross
cash price $6 is 3% of the gross charge $197
CPT 73719/o
info
mrf_cash_under_tenth_of_gross
cash price $348 is 7% of the gross charge $4,754
CPT 85441/o
info
mrf_cash_under_tenth_of_gross
cash price $4 is 4% of the gross charge $99
CPT 73720/o
info
mrf_cash_under_tenth_of_gross
cash price $348 is 6% of the gross charge $5,704
CPT 85460/o
info
mrf_cash_under_tenth_of_gross
cash price $7 is 3% of the gross charge $226
CPT 73721/o
info
mrf_cash_under_tenth_of_gross
cash price $238 is 6% of the gross charge $4,024
CPT 85461/o
info
mrf_cash_under_tenth_of_gross
cash price $9 is 7% of the gross charge $134
CPT 73723/o
info
mrf_cash_under_tenth_of_gross
cash price $348 is 6% of the gross charge $6,179
CPT 85520/o
info
mrf_cash_under_tenth_of_gross
cash price $13 is 3% of the gross charge $478
CPT 74150/o
info
mrf_cash_under_tenth_of_gross
cash price $104 is 4% of the gross charge $2,450
CPT 85540/o
info
mrf_cash_under_tenth_of_gross
cash price $8 is 7% of the gross charge $117
CPT 74160/o
info
mrf_cash_under_tenth_of_gross
cash price $175 is 5% of the gross charge $3,713
CPT 85597/o
info
mrf_cash_under_tenth_of_gross
cash price $17 is 8% of the gross charge $211
CPT 74170/o
info
mrf_cash_under_tenth_of_gross
cash price $175 is 4% of the gross charge $4,038
CPT 85610/o
info
mrf_cash_under_tenth_of_gross
cash price $4 is 3% of the gross charge $135
CPT 74174/o
info
mrf_cash_under_tenth_of_gross
cash price $348 is 6% of the gross charge $5,450
CPT 85611/o
info
mrf_cash_under_tenth_of_gross
cash price $3 is 2% of the gross charge $138
CPT 74175/o
info
mrf_cash_under_tenth_of_gross
cash price $175 is 4% of the gross charge $4,771
CPT 85613/o
info
mrf_cash_under_tenth_of_gross
cash price $9 is 4% of the gross charge $208
CPT 74176/o
info
mrf_cash_under_tenth_of_gross
cash price $238 is 5% of the gross charge $5,136
CPT 85652/o
info
mrf_cash_under_tenth_of_gross
cash price $2 is 2% of the gross charge $92
CPT 74177/o
info
mrf_cash_under_tenth_of_gross
cash price $348 is 6% of the gross charge $5,683
CPT 85660/o
info
mrf_cash_under_tenth_of_gross
cash price $5 is 4% of the gross charge $136
CPT 74178/o
info
mrf_cash_under_tenth_of_gross
cash price $348 is 5% of the gross charge $6,846
CPT 85670/o
info
mrf_cash_under_tenth_of_gross
cash price $5 is 4% of the gross charge $120
CPT 74181/o
info
mrf_cash_under_tenth_of_gross
cash price $238 is 6% of the gross charge $4,172
CPT 85705/o
info
mrf_cash_under_tenth_of_gross
cash price $9 is 4% of the gross charge $235
CPT 74182/o
info
mrf_cash_under_tenth_of_gross
cash price $348 is 7% of the gross charge $4,746
CPT 85730/o
info
mrf_cash_under_tenth_of_gross
cash price $6 is 4% of the gross charge $164
CPT 74183/o
info
mrf_cash_under_tenth_of_gross
cash price $348 is 6% of the gross charge $5,405
CPT 85732/o
info
mrf_cash_under_tenth_of_gross
cash price $6 is 4% of the gross charge $150
CPT 74280/o
info
mrf_cash_under_tenth_of_gross
cash price $175 is 9% of the gross charge $1,955
CPT 85810/o
info
mrf_cash_under_tenth_of_gross
cash price $11 is 8% of the gross charge $144
CPT 75571/o
info
mrf_cash_under_tenth_of_gross
cash price $86 is 8% of the gross charge $1,028
CPT 86003/o
info
mrf_cash_under_tenth_of_gross
cash price $5 is 5% of the gross charge $93
CPT 75635/o
info
mrf_cash_under_tenth_of_gross
cash price $175 is 3% of the gross charge $5,359
CPT 86021/o
info
mrf_cash_under_tenth_of_gross
cash price $15 is 5% of the gross charge $281
CPT 76380/o
info
mrf_cash_under_tenth_of_gross
cash price $86 is 9% of the gross charge $934
CPT 86022/o
info
mrf_cash_under_tenth_of_gross
cash price $18 is 5% of the gross charge $371
CPT 76506/o
info
mrf_cash_under_tenth_of_gross
cash price $104 is 6% of the gross charge $1,723
CPT 86038/o
info
mrf_cash_under_tenth_of_gross
cash price $12 is 5% of the gross charge $223
CPT 76536/o
info
mrf_cash_under_tenth_of_gross
cash price $104 is 8% of the gross charge $1,279
CPT 86039/o
info
mrf_cash_under_tenth_of_gross
cash price $11 is 7% of the gross charge $156
CPT 76700/o
info
mrf_cash_under_tenth_of_gross
cash price $104 is 6% of the gross charge $1,739
CPT 86041/o
info
mrf_cash_under_tenth_of_gross
cash price $18 is 2% of the gross charge $1,156
CPT 76705/o
info
mrf_cash_under_tenth_of_gross
cash price $104 is 9% of the gross charge $1,150
CPT 86043/o
info
mrf_cash_under_tenth_of_gross
cash price $12 is 1% of the gross charge $1,156
CPT 76805/o
info
mrf_cash_under_tenth_of_gross
cash price $104 is 9% of the gross charge $1,117
CPT 86060/o
info
mrf_cash_under_tenth_of_gross
cash price $7 is 5% of the gross charge $152
CPT 76818/o
info
mrf_cash_under_tenth_of_gross
cash price $104 is 8% of the gross charge $1,352
CPT 86140/o
info
mrf_cash_under_tenth_of_gross
cash price $5 is 4% of the gross charge $137
CPT 76819/o
info
mrf_cash_under_tenth_of_gross
cash price $104 is 9% of the gross charge $1,199
CPT 86141/o
info
mrf_cash_under_tenth_of_gross
cash price $12 is 6% of the gross charge $200
CPT 76830/o
info
mrf_cash_under_tenth_of_gross
cash price $104 is 9% of the gross charge $1,099
CPT 86147/o
info
mrf_cash_under_tenth_of_gross
cash price $25 is 8% of the gross charge $311
CPT 76856/o
info
mrf_cash_under_tenth_of_gross
cash price $104 is 9% of the gross charge $1,198
CPT 86160/o
info
mrf_cash_under_tenth_of_gross
cash price $12 is 5% of the gross charge $227
CPT 76870/o
info
mrf_cash_under_tenth_of_gross
cash price $104 is 8% of the gross charge $1,323
CPT 86162/o
info
mrf_cash_under_tenth_of_gross
cash price $20 is 8% of the gross charge $266
CPT 76872/o
info
mrf_cash_under_tenth_of_gross
cash price $104 is 8% of the gross charge $1,371
CPT 86200/o
info
mrf_cash_under_tenth_of_gross
cash price $12 is 5% of the gross charge $238
CPT 76881/o
info
mrf_cash_under_tenth_of_gross
cash price $104 is 8% of the gross charge $1,280
CPT 86225/o
info
mrf_cash_under_tenth_of_gross
cash price $13 is 5% of the gross charge $287
CPT 76882/o
info
mrf_cash_under_tenth_of_gross
cash price $104 is 10% of the gross charge $1,070
CPT 86235/o
info
mrf_cash_under_tenth_of_gross
cash price $17 is 7% of the gross charge $255
CPT 77063/o
info
mrf_cash_under_tenth_of_gross
cash price $23 is 4% of the gross charge $514
CPT 86255/o
info
mrf_cash_under_tenth_of_gross
cash price $12 is 6% of the gross charge $190
CPT 77075/o
info
mrf_cash_under_tenth_of_gross
cash price $104 is 8% of the gross charge $1,225
CPT 86256/o
info
mrf_cash_under_tenth_of_gross
cash price $12 is 7% of the gross charge $171
CPT 78802/o
info
mrf_cash_under_tenth_of_gross
cash price $541 is 9% of the gross charge $6,147
CPT 86300/o
info
mrf_cash_under_tenth_of_gross
cash price $20 is 8% of the gross charge $255
CPT 78804/o
info
mrf_cash_under_tenth_of_gross
cash price $541 is 8% of the gross charge $6,673
CPT 86301/o
info
mrf_cash_under_tenth_of_gross
cash price $20 is 8% of the gross charge $246
CPT 80048/o
info
mrf_cash_under_tenth_of_gross
cash price $8 is 3% of the gross charge $280
CPT 86304/o
info
mrf_cash_under_tenth_of_gross
cash price $20 is 6% of the gross charge $318
CPT 80051/o
info
mrf_cash_under_tenth_of_gross
cash price $7 is 3% of the gross charge $226
CPT 86308/o
info
mrf_cash_under_tenth_of_gross
cash price $5 is 4% of the gross charge $142
CPT 80053/o
info
mrf_cash_under_tenth_of_gross
cash price $10 is 3% of the gross charge $400
CPT 86334/o
info
mrf_cash_under_tenth_of_gross
cash price $22 is 6% of the gross charge $356
CPT 80061/o
info
mrf_cash_under_tenth_of_gross
cash price $13 is 5% of the gross charge $273
CPT 86340/o
info
mrf_cash_under_tenth_of_gross
cash price $15 is 7% of the gross charge $218
CPT 80074/o
info
mrf_cash_under_tenth_of_gross
cash price $47 is 6% of the gross charge $806
CPT 86343/o
info
mrf_cash_under_tenth_of_gross
cash price $12 is 3% of the gross charge $450
CPT 80076/o
info
mrf_cash_under_tenth_of_gross
cash price $8 is 2% of the gross charge $365
CPT 86356/o
info
mrf_cash_under_tenth_of_gross
cash price $26 is 1% of the gross charge $2,756
CPT 80150/o
info
mrf_cash_under_tenth_of_gross
cash price $15 is 6% of the gross charge $238
CPT 86403/o
info
mrf_cash_under_tenth_of_gross
cash price $11 is 3% of the gross charge $380
CPT 80156/o
info
mrf_cash_under_tenth_of_gross
cash price $14 is 6% of the gross charge $245
CPT 86431/o
info
mrf_cash_under_tenth_of_gross
cash price $5 is 3% of the gross charge $151
CPT 80158/o
info
mrf_cash_under_tenth_of_gross
cash price $18 is 7% of the gross charge $246
CPT 86592/o
info
mrf_cash_under_tenth_of_gross
cash price $4 is 4% of the gross charge $93
CPT 80162/o
info
mrf_cash_under_tenth_of_gross
cash price $13 is 6% of the gross charge $212
CPT 86593/o
info
mrf_cash_under_tenth_of_gross
cash price $4 is 3% of the gross charge $119
CPT 80164/o
info
mrf_cash_under_tenth_of_gross
cash price $13 is 5% of the gross charge $252
CPT 86596/o
info
mrf_cash_under_tenth_of_gross
cash price $12 is 1% of the gross charge $2,297
CPT 80170/o
info
mrf_cash_under_tenth_of_gross
cash price $16 is 6% of the gross charge $284
CPT 86611/o
info
mrf_cash_under_tenth_of_gross
cash price $10 is 7% of the gross charge $140
CPT 80175/o
info
mrf_cash_under_tenth_of_gross
cash price $13 is 6% of the gross charge $232
CPT 86612/o
info
mrf_cash_under_tenth_of_gross
cash price $12 is 9% of the gross charge $129
CPT 80177/o
info
mrf_cash_under_tenth_of_gross
cash price $13 is 4% of the gross charge $293
CPT 86618/o
info
mrf_cash_under_tenth_of_gross
cash price $17 is 7% of the gross charge $236
CPT 80178/o
info
mrf_cash_under_tenth_of_gross
cash price $6 is 4% of the gross charge $140
CPT 86631/o
info
mrf_cash_under_tenth_of_gross
cash price $11 is 5% of the gross charge $226
CPT 86632/o
info
mrf_cash_under_tenth_of_gross
cash price $12 is 7% of the gross charge $165
CPT 80184/o
info
mrf_cash_under_tenth_of_gross
cash price $15 is 7% of the gross charge $202
CPT 86644/o
info
mrf_cash_under_tenth_of_gross
cash price $14 is 7% of the gross charge $193
CPT 80185/o
info
mrf_cash_under_tenth_of_gross
cash price $13 is 6% of the gross charge $217
CPT 86645/o
info
mrf_cash_under_tenth_of_gross
cash price $16 is 9% of the gross charge $183
CPT 80186/o
info
mrf_cash_under_tenth_of_gross
cash price $13 is 7% of the gross charge $199
CPT 86651/o
info
mrf_cash_under_tenth_of_gross
cash price $13 is 9% of the gross charge $147
CPT 80188/o
info
mrf_cash_under_tenth_of_gross
cash price $16 is 7% of the gross charge $231
CPT 86652/o
info
mrf_cash_under_tenth_of_gross
cash price $13 is 9% of the gross charge $147
CPT 0232T/o
info
mrf_cash_under_tenth_of_gross
cash price $445 is 1% of the gross charge $63,531
CPT 80192/o
info
mrf_cash_under_tenth_of_gross
cash price $16 is 8% of the gross charge $201
CPT 86653/o
info
mrf_cash_under_tenth_of_gross
cash price $13 is 9% of the gross charge $147
CPT 80194/o
info
mrf_cash_under_tenth_of_gross
cash price $14 is 9% of the gross charge $161
CPT 86654/o
info
mrf_cash_under_tenth_of_gross
cash price $13 is 9% of the gross charge $147
CPT 80197/o
info
mrf_cash_under_tenth_of_gross
cash price $13 is 3% of the gross charge $431
CPT 86663/o
info
mrf_cash_under_tenth_of_gross
cash price $13 is 8% of the gross charge $158
CPT 80198/o
info
mrf_cash_under_tenth_of_gross
cash price $14 is 6% of the gross charge $219
CPT 86664/o
info
mrf_cash_under_tenth_of_gross
cash price $15 is 8% of the gross charge $187
CPT 11400/o
info
mrf_cash_under_tenth_of_gross
cash price $706 is 4% of the gross charge $17,648
CPT 80201/o
info
mrf_cash_under_tenth_of_gross
cash price $11 is 7% of the gross charge $164
CPT 86665/o
info
mrf_cash_under_tenth_of_gross
cash price $18 is 8% of the gross charge $216
CPT 11401/o
info
mrf_cash_under_tenth_of_gross
cash price $405 is 2% of the gross charge $16,707
CPT 80202/o
info
mrf_cash_under_tenth_of_gross
cash price $13 is 4% of the gross charge $291
CPT 86666/o
info
mrf_cash_under_tenth_of_gross
cash price $10 is 7% of the gross charge $148
CPT 11402/o
info
mrf_cash_under_tenth_of_gross
cash price $706 is 5% of the gross charge $15,625
CPT 86677/o
info
mrf_cash_under_tenth_of_gross
cash price $16 is 9% of the gross charge $187
CPT 11403/o
info
mrf_cash_under_tenth_of_gross
cash price $706 is 7% of the gross charge $10,403
CPT 81001/o
info
mrf_cash_under_tenth_of_gross
cash price $3 is 2% of the gross charge $155
CPT 86689/o
info
mrf_cash_under_tenth_of_gross
cash price $19 is 5% of the gross charge $389
CPT 11406/o
info
mrf_cash_under_tenth_of_gross
cash price $1,648 is 10% of the gross charge $16,893
CPT 81002/o
info
mrf_cash_under_tenth_of_gross
cash price $3 is 3% of the gross charge $102
CPT 86694/o
info
mrf_cash_under_tenth_of_gross
cash price $14 is 9% of the gross charge $160
CPT 11420/o
info
mrf_cash_under_tenth_of_gross
cash price $1,648 is 9% of the gross charge $17,832
CPT 81003/o
info
mrf_cash_under_tenth_of_gross
cash price $2 is 4% of the gross charge $57
CPT 86695/o
info
mrf_cash_under_tenth_of_gross
cash price $13 is 8% of the gross charge $171
CPT 81005/o
info
mrf_cash_under_tenth_of_gross
cash price $2 is 3% of the gross charge $74
CPT 86701/o
info
mrf_cash_under_tenth_of_gross
cash price $8 is 3% of the gross charge $240
CPT 11422/o
info
mrf_cash_under_tenth_of_gross
cash price $1,648 is 10% of the gross charge $17,338
CPT 81015/o
info
mrf_cash_under_tenth_of_gross
cash price $3 is 1% of the gross charge $202
CPT 86704/o
info
mrf_cash_under_tenth_of_gross
cash price $12 is 6% of the gross charge $204
CPT 11441/o
info
mrf_cash_under_tenth_of_gross
cash price $706 is 6% of the gross charge $12,500
CPT 81025/o
info
mrf_cash_under_tenth_of_gross
cash price $8 is 4% of the gross charge $208
CPT 86705/o
info
mrf_cash_under_tenth_of_gross
cash price $11 is 4% of the gross charge $250
CPT 11442/o
info
mrf_cash_under_tenth_of_gross
cash price $706 is 6% of the gross charge $11,111
CPT 81206/o
info
mrf_cash_under_tenth_of_gross
cash price $163 is 10% of the gross charge $1,663
CPT 86706/o
info
mrf_cash_under_tenth_of_gross
cash price $10 is 5% of the gross charge $186
CPT 11770/o
info
mrf_cash_under_tenth_of_gross
cash price $2,899 is 10% of the gross charge $29,481
CPT 81273/o
info
mrf_cash_under_tenth_of_gross
cash price $124 is 6% of the gross charge $2,100
CPT 86707/o
info
mrf_cash_under_tenth_of_gross
cash price $11 is 7% of the gross charge $148
CPT 11900/o
info
mrf_cash_under_tenth_of_gross
cash price $200 is 2% of the gross charge $11,027
CPT 81410/o
info
mrf_cash_under_tenth_of_gross
cash price $504 is 4% of the gross charge $13,750
CPT 86708/o
info
mrf_cash_under_tenth_of_gross
cash price $12 is 6% of the gross charge $196
CPT 13101/o
info
mrf_cash_under_tenth_of_gross
cash price $737 is 4% of the gross charge $16,846
CPT 86709/o
info
mrf_cash_under_tenth_of_gross
cash price $11 is 4% of the gross charge $245
CPT 15002/o
info
mrf_cash_under_tenth_of_gross
cash price $737 is 8% of the gross charge $9,375
CPT 82010/o
info
mrf_cash_under_tenth_of_gross
cash price $8 is 4% of the gross charge $192
CPT 86735/o
info
mrf_cash_under_tenth_of_gross
cash price $13 is 9% of the gross charge $140
CPT 15004/o
info
mrf_cash_under_tenth_of_gross
cash price $405 is 10% of the gross charge $4,212
CPT 82024/o
info
mrf_cash_under_tenth_of_gross
cash price $38 is 9% of the gross charge $427
CPT 86738/o
info
mrf_cash_under_tenth_of_gross
cash price $13 is 6% of the gross charge $228
CPT 15271/o
info
mrf_cash_under_tenth_of_gross
cash price $737 is 8% of the gross charge $8,746
CPT 82040/o
info
mrf_cash_under_tenth_of_gross
cash price $4 is 4% of the gross charge $111
CPT 86747/o
info
mrf_cash_under_tenth_of_gross
cash price $15 is 8% of the gross charge $184
CPT 15275/o
info
mrf_cash_under_tenth_of_gross
cash price $737 is 8% of the gross charge $8,746
CPT 82043/o
info
mrf_cash_under_tenth_of_gross
cash price $5 is 4% of the gross charge $142
CPT 86753/o
info
mrf_cash_under_tenth_of_gross
cash price $12 is 8% of the gross charge $157
CPT 15734/o
info
mrf_cash_under_tenth_of_gross
cash price $3,537 is 5% of the gross charge $71,250
CPT 82085/o
info
mrf_cash_under_tenth_of_gross
cash price $9 is 6% of the gross charge $143
CPT 86762/o
info
mrf_cash_under_tenth_of_gross
cash price $14 is 9% of the gross charge $160
CPT 15839/o
info
mrf_cash_under_tenth_of_gross
cash price $2,899 is 4% of the gross charge $80,750