Service
Code
Listed
Cash
Negotiated
Rates
Checks
Hc Liver Dis 10 Assays W/Nash
$2,517
$503
$503
45
clean
Hc Nfct Ds Bct/Vir Respir Dna/Rna 22 Trgt Sarscov2
$2,178
$416
$417
45
clean
INJ PLSM IMGE GUIDE HRVST/PR
$14,583
$446
$447
45
clean
Hc Translum Peripherl Atherectomy Brachiocephal Ea
$29,007
$11,539
$11,540
45
clean
Hc Translum Peripheral Atherectomy Iliac Artery Ea
$46,064
$18,324
$18,325
45
clean
Hc Nfct Ds Rna 4 Targets Upper Respiratory Specimen
$713
$142
$143
45
clean
Hc Myocardial Perfusion Echo Ischm/Viability Assmt (0439T)
$1,511
—
$314
4
clean
Njx b1 sub mtrl sbchdrl dfct
$12,053
$3,270
$3,271
45
clean
Hc Fine Needle Aspiration Bx W/Us Gdn 1St Lesion
$3,250
$707
$708
45
clean
Hc Fine Needle Aspiration Bx W/Fluor Gdn 1St Lesion
$2,897
$707
$708
45
clean
Hc Fine Needle Aspiration Bx W/Ct Gdn 1St Lesion
$3,250
$707
$708
45
clean
Hc Fine Needle Aspiration Bx W/Mr Gdn 1St Lesion
$2,897
$707
$708
45
clean
Hc Fine Needle Asp Wo Img Guidance
$1,758
$406
$406
45
clean
Hc Image-Guided Catheter Fluid Collection Drainage
$2,897
$707
$708
45
clean
Hc Incision & Drain Skin Abscess Simple
$1,291
$200
$201
90
clean
Hc Incision & Drain Skin Abscess Complic
$1,729
$406
$406
45
clean
Hc Incision & Drain Pilonidal Cyst Simpl
$3,250
$707
$708
45
clean
Hc Incision & Drain Pilonidal Cyst Complicated
$4,055
$707
$708
45
clean
Hc Remove Foreign Body Simple
$1,758
$406
$406
90
clean
Inc&Rmvl Fb Subq Tiss Comp
$12,577
$1,650
$1,651
45
clean
Hc Incision & Drain Of Hematoma/Fluid
$7,035
$1,650
$1,651
90
clean
Hc Puncture Drainage Of Lesion
$1,758
$406
$406
45
clean
Hc Complex Drainage, Wound
$11,892
$2,903
$2,904
45
clean
Hc Debridement, Infected Skin, Up To 10% Bsa
$2,414
$406
$406
45
clean
Hc Debride W Fb Remove, Fx/Disloc
$2,897
$707
$708
45
clean
Deb skin bone at fx site
$7,537
$2,903
$2,904
45
clean
Dbrdmt Subq Tis 1St 20Sqcm/<
$12,931
$406
$406
90
clean
Hc Debride Skin Sub-Q Tiss Muscle =<20 Sq Cm
$2,769
$738
$739
45
clean
Dbrdmt Bone 1St 20 Sq Cm/<
$15,721
$1,650
$1,651
90
clean
Hc Trim Benign Hyperkeratotic Skin Lesion, Single
$898
$200
$201
45
clean
Hc Trim Benign Hyperkeratotic Skin Lesion,2-4
$882
$200
$201
45
clean
Hc Trim Benign Hyperkeratotic Skin Lesion,>4
$882
$200
$201
45
clean
Hc Tangential Biopsy Skin Single Lesion
$882
$406
$406
45
clean
Hc Punch Biopsy Skin Single Lesion
$882
$406
$406
45
clean
Hc Incisional Biopsy Skin Single Lesion
$1,570
$738
$739
45
clean
Hc Removal Of Skin Tags, Up To 15
$898
$200
$201
45
clean
Exc Tr-Ext B9+Marg 0.6-1 Cm
$15,721
$406
$406
45
clean
Exc Tr-Ext B9+Marg 1.1-2 Cm
$10,345
$707
$708
45
clean
Exc Tr-Ext B9+Marg 2.1-3Cm
$10,345
$707
$708
45
clean
Exc Tr-Ext B9+Marg 3.1-4 Cm
$14,224
$1,650
$1,651
45
clean
Exc Tr-Ext B9+Marg >4.0 Cm
$11,951
$1,650
$1,651
45
clean
Exc H-F-Nk-Sp B9+Marg 0.5/<
$10,345
$1,650
$1,651
45
clean
Exc h-f-nk-sp b9+marg 0.6-1
$9,215
$707
$708
45
clean
Exc H-F-Nk-Sp B9+Marg 1.1-2
$11,951
$1,650
$1,651
45
clean
Hc Exc Skin Benig >4 Cm Scalp/Neck/Hnd/Ft/Gent
$11,892
$2,903
$2,904
45
clean
Exc Face-Mm B9+Marg 0.6-1 Cm
$12,931
$707
$708
45
clean
Exc tr-ext mal+marg 0.6-1 cm
$5,172
$707
$708
45
clean
Exc tr-ext mal+marg >4 cm
$8,620
$1,650
$1,651
45
clean
Hc Exc Skin Malig <0.5 Cm Face,Facial
$3,245
$707
$708
45
clean
Hc Debridement Of Nails, 1-5
$399
$58
$59
45
clean
Hc Debridement Of Nails, 6 Or More
$399
$58
$59
45
clean
Hc Removal Of Nail Plate
$938
$200
$201
45
clean
Hc Drain Blood From Under Nail
$563
$133
$133
45
clean
Hc Removal Of Nail Bed
$2,199
$406
$406
45
clean
Hc Biopsy, Nail Unit (Sep Proc)
$2,897
$707
$708
45
clean
Hc Reconstruc Of Nail Bed
$2,621
$738
$739
45
clean
Hc Excision Of Nail Fold (Wedge), Toe
$1,758
$406
$406
45
clean
Remove pilonidal cyst simple
$35,488
$2,903
$2,904
45
clean
Remove Pilonidal Cyst Exten
$22,010
$2,903
$2,904
45
clean
Insertion drug dlvr implant
$4,716
$133
$133
45
clean
Remove drug implant device
$13,143
$446
$447
45
clean
Hc Repr Wnd Smp Body/Scalp/Extr <2.5 Cm
$938
$200
$201
45
clean
Hc Repr Wnd Smp Body/Scalp/Extr 2.6-7.5 Cm
$938
$200
$201
45
clean
Hc Repr Wnd Smp Body/Scalp/Extr 7.6-12.5 Cm
$938
$200
$201
45
clean
Hc Repr Wnd Smp Body/Scalp/Extr 12.6-20 Cm
$1,758
$406
$406
45
clean
Hc Repr Wnd Smp Body/Scalp/Extr 20.1-30 Cm
$1,765
$406
$406
45
clean
Hc Repr Wnd Smp Body/Scalp/Extr >30.1 Cm
$882
$200
$201
45
clean
Hc Repr Wnd Smp Face 2.6-5.0 Cm
$938
$200
$201
45
clean
Hc Repr Wnd Smp Face 5.1-7.5 Cm
$938
$200
$201
45
clean
Hc Repr Wnd Smp Face 12.6-20 Cm
$1,729
$406
$406
45
clean
Hc Repr Wnd Smp Face 20.1-30 Cm
$1,570
$406
$406
45
clean
Hc Treat Wnd Dehiscence, Simple Closure
$2,414
$738
$739
90
clean
Hc Repr Wnd Intrmd Body/Scalp/Extr <2.5 Cm
$1,758
$406
$406
45
clean
Hc Repr Wnd Intrmd Body/Scalp/Extr 2.6-7.5 Cm
$1,758
$406
$406
45
clean
Intmd rpr strext 7.6-12.5
$4,310
$406
$406
45
clean
Hc Repr Wnd Intrmd Body/Scalp/Extr 12.5-20 Cm
$1,729
$406
$406
45
clean
Hc Repr Wnd Intrmd Body/Scalp/Extr 20.1-30 Cm
$2,414
$738
$739
45
clean
Intmd rpr n-hfgenit 2.5cm<
$3,668
$406
$406
45
clean
Hc Repr Wnd Intrmd Neck/Hnd/Ft/Gent 7.6-12.5 Cm
$2,621
$738
$739
45
clean
Hc Repr Wnd Intrmd Face <2.5 Cm
$1,729
$406
$406
45
clean
Hc Repr Wnd Intrmd Face 2.6-5.0 Cm
$1,758
$406
$406
45
clean
Hc Repr Wnd Intrmd Face 5.1-7.5 Cm
$1,729
$406
$406
45
clean
Hc Repr Wnd Intrmd Face 7.6-12.5 Cm
$1,758
$406
$406
45
clean
Hc Repr Wnd Intrmd Face 12.6-20 Cm
$1,570
$406
$406
45
clean
Hc Repr Wnd Cplx Scalp 1.1-2.5 Cm
$2,414
$406
$406
45
clean
Hc Repr Wnd Cplx Scalp 2.6-7.5 Cm
$2,414
$406
$406
45
clean
Hc Repr Wnd Cplx Eye/Ear/Nose/Lip 1.1-2.5 Cm
$2,414
$738
$739
45
clean
Sec Clsr Surg Wnd/Dehsn Xtn
$25,154
$3,542
$3,542
45
clean
Tis trnfr trunk 10 sq cm<
$10,810
$2,062
$2,063
45
clean
Hc Prep Wnd Trk/Ar/Lg 100 Sqcm Or 1% Peds
$8,577
$738
$739
45
clean
Hc Prep Wnd Head/Hnd/Ft/Gent 100 Sqcm Or 1% Peds
$2,414
$406
$406
45
clean
Hc Skin Pinch Graft Procedure <2 Cm
$2,414
$738
$739
45
clean
Hc App Skn Sub Trnk/Arm/Leg Ttl 100Sqcm 1St 25 Sqcm
$8,577
$738
$739
45
clean
Hc App Skn Sub Trnk/Arm/Leg >=100Sqcm 1St 100Sqcm
$13,831
$2,062
$2,063
45
clean
Skin sub graft facenkhfg
$8,385
$738
$739
45
clean
Hc Removal Sutures Under Anesthesia Other Surgeon
$8,629
$2,062
$2,063
45
clean
Hc Treat Burn 1St Degree, Initial
$938
$200
$201
45
clean
Hc Dress/Debride Burn <5% Total Sm
$938
$200
$201
45
clean
Hc Dress/Debride Burn 5-10% Ttl Med
$882
$200
$201
45
clean
Hc Dress/Debride Burn >10% Ttl Lg
$1,729
$406
$406
45
clean
Hc Destruc Benign/Premal,First Lesion
$882
$200
$201
45
clean
Hc Destruction Benign Lesions Up To 14
$130
$200
$130
45
clean
Hc Chem Cautery Granulatn Tissue
$938
$200
$201
45
clean
Hc I&D Breast Lesion
$3,250
$707
$708
45
clean
Hc Mastotomy W Explor/Drain Absc, Deep
$6,878
$1,650
$1,651
45
clean
Hc Bx Breast W Device Stereotact Guide 1St Lesion
$7,148
$1,650
$1,651
45
clean
Hc Bx Breast W Device Us Guide 1St Lesion
$7,148
$1,650
$1,651
45
clean
Hc Bx Breast W Device Mri Guide 1St Lesion
$6,878
$1,650
$1,651
45
clean
Bx Breast Percut W/O Image
$12,577
$1,650
$1,651
45
clean
Removal Of Breast Lesion
$10,345
$3,914
$3,914
45
clean
Hc Perq Dev Place Breast Loc 1St Les W Mammo Guid
$7,148
$1,650
$1,651
45
clean
Hc Perq Breast Loc Dev Place Mri Guide 1St Lesion
$2,897
$707
$708
45
clean
Partial Mastectomy
$22,990
$3,914
$3,914
45
clean
Mast simple complete
$12,577
$6,637
$6,638
45
clean
Mast mod rad
$14,149
$6,637
$6,638
45
clean
Hc Explore Wound,Neck
$2,436
$539
$539
45
clean
Hc Explore Wound Abdomen/Flank/Back
$7,745
$2,062
$2,063
45
clean
Hc Explore Wound Extremity
$2,897
$1,650
$1,651
45
clean
Deep Muscle Biopsy
$15,721
$2,903
$2,904
45
clean
Hc Needle Biopsy,Muscle
$7,148
$1,650
$1,651
45
clean
Hc Bone Bx Tr/Ndl; Superf
$7,148
$1,650
$1,651
45
clean
Hc Bone Biopsy,Trocar/Needle Deep
$7,148
$1,650
$1,651
45
clean
Bone Biopsy Open Superficial
$25,154
$2,903
$2,904
90
clean
REMOVAL OF FOREIGN BODY
$25,223
$1,650
$1,651
45
clean
REMOVE MUSCLE FOREIGN BODY
$10,810
$2,903
$2,904
45
clean
INJ TENDON SHEATHLIGAMENT
$6,896
$306
$307
45
clean
Hc Inject Trigger Point1-2 Muscle
$1,365
$306
$307
45
clean
Hc Drain/Inject Small Joint/Bursa
$1,237
$306
$307
45
clean
Hc Drain/Inject Intermediate Joint/Bursa
$1,306
$306
$307
45
clean
Drain/Inj Joint/Bursa W/O Us
$10,345
$306
$307
90
clean
Hc Arthrocentesis Aspir&/Inj Major Jt/Bursa W/Us
$1,365
$306
$307
45
clean
Hc Aspirat/Injection Ganglion Cyst(S)
$1,237
$306
$307
45
clean
TREATMENT OF BONE CYST
$4,716
$707
$708
45
clean
Hc Removal Of Implant, Superficial
$6,878
$1,650
$1,651
45
clean
Removal Of Implant Deep
$20,662
$2,903
$2,904
45
clean
Rmvl Ext Fixj Sys Under Anes
$12,577
$1,607
$1,607
45
clean
Hc Radiorequency Bone Tumor Ablation, Perq
$28,498
$17,527
$17,527
45
clean
UNLISTED PX MUSCSKEL GENERAL
$10,481
$246
$247
45
clean
Exc Face Les Sbq 2 Cm/>
$12,931
$1,650
$1,651
45
clean
Hc Clsd Treat Nose Xf Wo Stabil
$1,724
$1,551
$1,551
45
clean
Hc I&D Deep Absc/Hematoma Neck/Chest
$11,892
$2,903
$2,904
90
clean
Hc Biopsy Soft Tissue Neck/Chest
$7,148
$1,650
$1,651
45
clean
EXC NECK LES SC 3 CM>
$23,150
$2,903
$2,904
45
clean
EXC NECK TUM DEEP 5 CM>
$10,810
$2,903
$2,904
45
clean
EXC NECK LES SC < 3 CM
$8,108
$1,650
$1,651
45
clean
EXC NECK TUM DEEP < 5 CM
$9,274
$2,903
$2,904
45
clean
EXC BACK LES SC 3 CM>
$10,861
$1,650
$1,651
45
clean
Exc Back Tum Deep 5 Cm/>
$29,206
$2,903
$2,904
45
clean
Hc Perq Cervicothoracic Inj
$13,117
$3,270
$3,271
45
clean
Hc Perq Lumbosacral Inj
$13,117
$3,270
$3,271
45
clean
Hc Perq Vertebral Augmentation, Thoracic
$31,325
$7,253
$7,254
45
clean
Hc Perq Vertebral Augmentation, Lumbar
$28,498
$7,253
$7,254
45
clean
LUMBAR SPINE FUSION
$5,520
$17,527
$5,520
45
clean
Exc Abdl Tum Deep < 5 Cm
$12,577
$2,903
$2,904
45
clean
Exc Abd Les Sc 3 Cm/>
$12,931
$2,903
$2,904
45
clean
Drain Shoulder Lesion
$31,443
$2,903
$2,904
45
clean
Exc Shoulder Les Sc 3 Cm/>
$14,224
$1,650
$1,651
45
clean
Exc Shoulder Tum Deep 5 Cm/>
$20,689
$2,903
$2,904
45
clean
Exc Shoulder Les Sc < 3 Cm
$15,517
$1,650
$1,651
45
clean
Exc Shoulder Tum Deep < 5 Cm
$10,345
$2,903
$2,904
45
clean
INCISION OF TENDON & MUSCLE
$15,517
$7,253
$7,254
45
clean
Repair Rotator Cuff Acute
$25,154
$7,253
$7,254
45
clean
Repair Rotator Cuff Chronic
$33,539
$7,253
$7,254
45
clean
TENODESIS OF LONG TENDON OF BICEPS
$8,385
$7,253
$7,254
45
clean
Hc Arthroplasty Glenohumrl Jt Hemiarthroplasty
$62,966
$12,833
$12,834
90
clean
Hc Arthroplasty Glenohumeral Joint Total Shoulder
$62,966
$17,527
$17,527
90
clean
Hc Revis Reconst Shoulder Joint
$62,966
$12,833
$12,834
45
clean
Optx Clavicular Fx W/Int Fix
$26,726
$7,253
$7,254
45
clean
Hc Clsd Treat Prox Humerus Fx Wo Manip
$1,214
$246
$247
45
clean
Hc Clsd Treat Prox Humerus Fx W Manip
$904
$1,607
$904
45
clean
OPTX PROX HUMRL FX WINT FIX
$39,429
$12,833
$12,834
45
clean
Cltx Sho Dslc W/Mnpj Wo Anes
$12,577
$246
$247
90
clean
Cltx Sho Dslc W/Mnpj W/Anes
$12,577
$1,607
$1,607
45
clean
Hc Clsd Treat Shldr Disloc,Gr Tub Fx, W Manip
$7,086
$1,607
$1,607
45
clean
Exc Arm/Elbow Les Sc 3 Cm/>
$12,999
$2,903
$2,904
45
clean
Ex Arm/Elbow Tum Deep 5 Cm/>
$53,452
$2,903
$2,904
45
clean
EXC ARMELBOW LES SC < 3 CM
$4,928
$1,650
$1,651
45
clean
Ex Arm/Elbow Tum Deep < 5 Cm
$12,931
$2,903
$2,904
45
clean
Rpr Tdn/Musc Upr A/E Each
$34,587
$7,253
$7,254
45
clean
Treat Humerus Fracture - 24538 - OR36024538
$17,975
$7,253
$7,254
45
clean
Treat Humerus Fracture - 24546 - OR36024546
$53,452
$12,833
$12,834
45
clean
Hc Clsd Treat Elbow Disloc Wo Anes
$1,040
$246
$247
45
clean
Hc Clsd Treat Elbow Disloc W Anes
$773
$1,607
$773
45
clean
TREAT RADIUS FRACTURE
$13,143
$7,253
$7,254
45
clean
Treat Ulnar Fracture
$47,164
$7,253
$7,254
45
clean
Incision Of Tendon Sheath
$10,345
$1,607
$1,607
45
clean
EXC FOREARM LES SC 3 CM>
$5,172
$1,650
$1,651
45
clean
Exc Forearm Les Sc < 3 Cm
$10,345
$1,650
$1,651
45
clean
RESECT FOREARMWRIST TUM<3CM
$5,619
$2,903
$2,904
45
clean
Remove Wrist Tendon Lesion
$10,345
$1,607
$1,607
45
clean
REMOVE WRISTFOREARM LESION - 25115 -
$3,206
$1,607
$1,607
45
clean
REMOVE WRISTFOREARM LESION - 25116 -
$3,448
$3,270
$3,271
45
clean
Excise Wrist Tendon Sheath
$12,577
$1,607
$1,607
45
clean
Repair Forearm Tendon/Muscle
$12,931
$3,270
$3,271
45
clean
Hc Clsd Treat Radial Shaft Fx Wo Amnip
$290
$246
$247
45
clean
Hc Clsd Treat Radial Shaft Fx W Manip
$7,086
$1,607
$1,607
45
clean
Optx Ulnar Shft Fx Int Fixj
$18,866
$7,253
$7,254
45
clean
Optx Rdl&Uln Shft Fx Rds&Uln
$39,303
$7,253
$7,254
45
clean
Hc Clsd Treat Distl Rad/Ulna Fx Wo Manip
$498
$246
$247
45
clean
Cltx Dst Rdl Fx/Ephys Sep W/
$12,577
$1,607
$1,607
45
clean
Showing the first 200 of 3,114 code–setting items in the file, verified codes first —
every row as JSON →
Service
Severity
Rule
Detail
CPT 24605/o
error
mrf_cash_above_gross
discounted cash price $1,607 exceeds gross charge $773
CPT 27266/o
error
mrf_cash_above_gross
discounted cash price $1,607 exceeds gross charge $436
CPT 27438/o
error
mrf_cash_above_gross
discounted cash price $12,833 exceeds gross charge $12,360
CPT 92553/o
error
mrf_cash_above_gross
discounted cash price $128 exceeds gross charge $66
CPT 27786/o
error
mrf_cash_above_gross
discounted cash price $246 exceeds gross charge $199
CPT 93798/o
error
mrf_cash_above_gross
discounted cash price $128 exceeds gross charge $102
CPT 28820/o
error
mrf_cash_above_gross
discounted cash price $3,270 exceeds gross charge $3,144
CPT 94642/o
error
mrf_cash_above_gross
discounted cash price $218 exceeds gross charge $108
CPT 96420/o
error
mrf_cash_above_gross
discounted cash price $330 exceeds gross charge $257
CPT 29405/o
error
mrf_cash_above_gross
discounted cash price $279 exceeds gross charge $126
CPT 29425/o
error
mrf_cash_above_gross
discounted cash price $279 exceeds gross charge $191
CPT 29540/o
error
mrf_cash_above_gross
discounted cash price $162 exceeds gross charge $88
CPT 29799/o
error
mrf_cash_above_gross
discounted cash price $162 exceeds gross charge $88
CPT 29855/o
error
mrf_cash_above_gross
discounted cash price $7,253 exceeds gross charge $5,502
CPT 37182/o
error
mrf_cash_above_gross
discounted cash price $18,324 exceeds gross charge $4,039
CPT 63047/o
error
mrf_cash_above_gross
discounted cash price $7,253 exceeds gross charge $5,520
CPT 81443/o
error
mrf_cash_above_gross
discounted cash price $2,448 exceeds gross charge $142
CPT 86902/o
error
mrf_cash_above_gross
discounted cash price $358 exceeds gross charge $82
CPT 86905/o
error
mrf_cash_above_gross
discounted cash price $358 exceeds gross charge $76
CPT 17110/o
error
mrf_cash_above_gross
discounted cash price $200 exceeds gross charge $130
CPT 22612/o
error
mrf_cash_above_gross
discounted cash price $17,527 exceeds gross charge $5,520
CPT 23605/o
error
mrf_cash_above_gross
discounted cash price $1,607 exceeds gross charge $904
warn
mrf_rate_without_estimate
754 of 754 percentage/algorithm rates across 346 items carry no estimated dollar amount, which the template has required since 1 January 2025 — none of them do
CPT 83505/o
info
mrf_cash_under_tenth_of_gross
cash price $24 is 4% of the gross charge $667
CPT 89050/o
info
mrf_cash_under_tenth_of_gross
cash price $4 is 2% of the gross charge $215
CPT 25660/o
info
mrf_cash_under_tenth_of_gross
cash price $246 is 9% of the gross charge $2,761
CPT 83519/o
info
mrf_cash_under_tenth_of_gross
cash price $18 is 4% of the gross charge $450
CPT 89051/o
info
mrf_cash_under_tenth_of_gross
cash price $5 is 3% of the gross charge $186
CPT 26145/o
info
mrf_cash_under_tenth_of_gross
cash price $1,607 is 9% of the gross charge $18,358
CPT 83520/o
info
mrf_cash_under_tenth_of_gross
cash price $17 is 2% of the gross charge $1,030
CPT 89055/o
info
mrf_cash_under_tenth_of_gross
cash price $4 is 2% of the gross charge $198
CPT 26605/o
info
mrf_cash_under_tenth_of_gross
cash price $246 is 8% of the gross charge $3,078
CPT 83525/o
info
mrf_cash_under_tenth_of_gross
cash price $11 is 5% of the gross charge $227
CPT 89060/o
info
mrf_cash_under_tenth_of_gross
cash price $7 is 7% of the gross charge $96
CPT 83527/o
info
mrf_cash_under_tenth_of_gross
cash price $12 is 8% of the gross charge $143
CPT 89190/o
info
mrf_cash_under_tenth_of_gross
cash price $5 is 9% of the gross charge $58
CPT 83529/o
info
mrf_cash_under_tenth_of_gross
cash price $17 is 6% of the gross charge $282
CPT 83540/o
info
mrf_cash_under_tenth_of_gross
cash price $6 is 4% of the gross charge $165
CPT 83550/o
info
mrf_cash_under_tenth_of_gross
cash price $8 is 5% of the gross charge $172
CPT 92608/o
info
mrf_cash_under_tenth_of_gross
cash price $46 is 10% of the gross charge $465
CPT 27618/o
info
mrf_cash_under_tenth_of_gross
cash price $1,650 is 7% of the gross charge $23,436
CPT 83593/o
info
mrf_cash_under_tenth_of_gross
cash price $28 is 3% of the gross charge $851
CPT 92610/o
info
mrf_cash_under_tenth_of_gross
cash price $57 is 7% of the gross charge $853
CPT 27658/o
info
mrf_cash_under_tenth_of_gross
cash price $3,270 is 7% of the gross charge $47,164
CPT 83605/o
info
mrf_cash_under_tenth_of_gross
cash price $11 is 2% of the gross charge $619
CPT 27685/o
info
mrf_cash_under_tenth_of_gross
cash price $3,270 is 9% of the gross charge $34,587
CPT 83615/o
info
mrf_cash_under_tenth_of_gross
cash price $6 is 6% of the gross charge $106
CPT 83625/o
info
mrf_cash_under_tenth_of_gross
cash price $12 is 7% of the gross charge $162
CPT 93226/o
info
mrf_cash_under_tenth_of_gross
cash price $58 is 5% of the gross charge $1,207
CPT 83631/o
info
mrf_cash_under_tenth_of_gross
cash price $19 is 9% of the gross charge $219
CPT 28080/o
info
mrf_cash_under_tenth_of_gross
cash price $1,607 is 8% of the gross charge $19,410
CPT 83690/o
info
mrf_cash_under_tenth_of_gross
cash price $6 is 3% of the gross charge $222
CPT 28200/o
info
mrf_cash_under_tenth_of_gross
cash price $3,270 is 9% of the gross charge $34,587
CPT 83700/o
info
mrf_cash_under_tenth_of_gross
cash price $11 is 6% of the gross charge $175
CPT 93976/o
info
mrf_cash_under_tenth_of_gross
cash price $104 is 8% of the gross charge $1,266
CPT 83718/o
info
mrf_cash_under_tenth_of_gross
cash price $8 is 4% of the gross charge $202
CPT 28899/o
info
mrf_cash_under_tenth_of_gross
cash price $246 is 1% of the gross charge $18,866
CPT 83721/o
info
mrf_cash_under_tenth_of_gross
cash price $10 is 9% of the gross charge $106
CPT 83727/o
info
mrf_cash_under_tenth_of_gross
cash price $17 is 3% of the gross charge $589
CPT 97012/o
info
mrf_cash_under_tenth_of_gross
cash price $14 is 8% of the gross charge $185
CPT 83789/o
info
mrf_cash_under_tenth_of_gross
cash price $24 is 4% of the gross charge $663
CPT 97018/o
info
mrf_cash_under_tenth_of_gross
cash price $5 is 3% of the gross charge $153
CPT 83825/o
info
mrf_cash_under_tenth_of_gross
cash price $16 is 9% of the gross charge $178
CPT 97022/o
info
mrf_cash_under_tenth_of_gross
cash price $15 is 10% of the gross charge $155
CPT 83835/o
info
mrf_cash_under_tenth_of_gross
cash price $16 is 7% of the gross charge $219
CPT 97032/o
info
mrf_cash_under_tenth_of_gross
cash price $14 is 7% of the gross charge $199
CPT 83864/o
info
mrf_cash_under_tenth_of_gross
cash price $28 is 8% of the gross charge $332
CPT 97035/o
info
mrf_cash_under_tenth_of_gross
cash price $13 is 7% of the gross charge $200
CPT 29898/o
info
mrf_cash_under_tenth_of_gross
cash price $3,270 is 8% of the gross charge $41,923
CPT 83872/o
info
mrf_cash_under_tenth_of_gross
cash price $5 is 5% of the gross charge $100
CPT 97750/o
info
mrf_cash_under_tenth_of_gross
cash price $32 is 7% of the gross charge $453
CPT 29999/o
info
mrf_cash_under_tenth_of_gross
cash price $246 is 2% of the gross charge $13,209
CPT 83874/o
info
mrf_cash_under_tenth_of_gross
cash price $12 is 9% of the gross charge $141
CPT 97804/o
info
mrf_cash_under_tenth_of_gross
cash price $12 is 4% of the gross charge $285
CPT 83918/o
info
mrf_cash_under_tenth_of_gross
cash price $23 is 4% of the gross charge $575
CPT C8901/o
info
mrf_cash_under_tenth_of_gross
cash price $238 is 9% of the gross charge $2,646
CPT 83930/o
info
mrf_cash_under_tenth_of_gross
cash price $6 is 8% of the gross charge $74
CPT C8903/o
info
mrf_cash_under_tenth_of_gross
cash price $175 is 6% of the gross charge $2,829
CPT 83935/o
info
mrf_cash_under_tenth_of_gross
cash price $6 is 8% of the gross charge $74
CPT C8906/o
info
mrf_cash_under_tenth_of_gross
cash price $348 is 10% of the gross charge $3,494
CPT 83986/o
info
mrf_cash_under_tenth_of_gross
cash price $3 is 7% of the gross charge $42
CPT C8908/o
info
mrf_cash_under_tenth_of_gross
cash price $348 is 7% of the gross charge $5,250
CPT 83993/o
info
mrf_cash_under_tenth_of_gross
cash price $19 is 6% of the gross charge $314
CPT 84030/o
info
mrf_cash_under_tenth_of_gross
cash price $5 is 5% of the gross charge $91
CPT 84060/o
info
mrf_cash_under_tenth_of_gross
cash price $7 is 3% of the gross charge $274
CPT 84075/o
info
mrf_cash_under_tenth_of_gross
cash price $5 is 3% of the gross charge $167
CPT G0283/o
info
mrf_cash_under_tenth_of_gross
cash price $12 is 6% of the gross charge $196
CPT 36819/o
info
mrf_cash_under_tenth_of_gross
cash price $5,562 is 10% of the gross charge $56,563
CPT 84100/o
info
mrf_cash_under_tenth_of_gross
cash price $4 is 10% of the gross charge $42
CPT 84105/o
info
mrf_cash_under_tenth_of_gross
cash price $5 is 10% of the gross charge $52
CPT 84110/o
info
mrf_cash_under_tenth_of_gross
cash price $8 is 9% of the gross charge $86
CPT 84132/o
info
mrf_cash_under_tenth_of_gross
cash price $4 is 8% of the gross charge $51
CPT 84133/o
info
mrf_cash_under_tenth_of_gross
cash price $4 is 7% of the gross charge $57
CPT P9019/o
info
mrf_cash_under_tenth_of_gross
cash price $52 is 10% of the gross charge $540
CPT 84138/o
info
mrf_cash_under_tenth_of_gross
cash price $21 is 10% of the gross charge $213
CPT 84155/o
info
mrf_cash_under_tenth_of_gross
cash price $3 is 3% of the gross charge $91
CPT 49507/o
info
mrf_cash_under_tenth_of_gross
cash price $3,579 is 7% of the gross charge $52,572
CPT 84156/o
info
mrf_cash_under_tenth_of_gross
cash price $3 is 1% of the gross charge $210
CPT 84157/o
info
mrf_cash_under_tenth_of_gross
cash price $4 is 5% of the gross charge $84
CPT 52000/o
info
mrf_cash_under_tenth_of_gross
cash price $697 is 4% of the gross charge $18,866
CPT 84165/o
info
mrf_cash_under_tenth_of_gross
cash price $10 is 5% of the gross charge $191
CPT 52318/o
info
mrf_cash_under_tenth_of_gross
cash price $3,523 is 8% of the gross charge $44,020
CPT 84181/o
info
mrf_cash_under_tenth_of_gross
cash price $17 is 4% of the gross charge $450
CPT 84182/o
info
mrf_cash_under_tenth_of_gross
cash price $29 is 6% of the gross charge $450
CPT 84210/o
info
mrf_cash_under_tenth_of_gross
cash price $14 is 9% of the gross charge $153
CPT 56605/o
info
mrf_cash_under_tenth_of_gross
cash price $920 is 8% of the gross charge $11,638
CPT 84220/o
info
mrf_cash_under_tenth_of_gross
cash price $9 is 1% of the gross charge $1,045
CPT 57500/o
info
mrf_cash_under_tenth_of_gross
cash price $920 is 8% of the gross charge $10,991
CPT 84234/o
info
mrf_cash_under_tenth_of_gross
cash price $64 is 8% of the gross charge $776
CPT 84295/o
info
mrf_cash_under_tenth_of_gross
cash price $4 is 5% of the gross charge $83
CPT 84300/o
info
mrf_cash_under_tenth_of_gross
cash price $5 is 7% of the gross charge $68
CPT 58999/o
info
mrf_cash_under_tenth_of_gross
cash price $202 is 2% of the gross charge $11,882
CPT 84302/o
info
mrf_cash_under_tenth_of_gross
cash price $4 is 9% of the gross charge $44
CPT 84311/o
info
mrf_cash_under_tenth_of_gross
cash price $8 is 3% of the gross charge $314
CPT 84376/o
info
mrf_cash_under_tenth_of_gross
cash price $5 is 3% of the gross charge $188
CPT 64447/o
info
mrf_cash_under_tenth_of_gross
cash price $705 is 8% of the gross charge $8,947
CPT 84378/o
info
mrf_cash_under_tenth_of_gross
cash price $11 is 10% of the gross charge $112
CPT 64708/o
info
mrf_cash_under_tenth_of_gross
cash price $1,952 is 7% of the gross charge $26,726
CPT 84392/o
info
mrf_cash_under_tenth_of_gross
cash price $5 is 4% of the gross charge $125
CPT 64712/o
info
mrf_cash_under_tenth_of_gross
cash price $1,952 is 9% of the gross charge $22,010
CPT 84402/o
info
mrf_cash_under_tenth_of_gross
cash price $25 is 9% of the gross charge $266
CPT 70336/o
info
mrf_cash_under_tenth_of_gross
cash price $238 is 9% of the gross charge $2,732
CPT 84436/o
info
mrf_cash_under_tenth_of_gross
cash price $6 is 3% of the gross charge $185
CPT 70450/o
info
mrf_cash_under_tenth_of_gross
cash price $104 is 4% of the gross charge $2,924
CPT 84437/o
info
mrf_cash_under_tenth_of_gross
cash price $6 is 3% of the gross charge $178
CPT 70460/o
info
mrf_cash_under_tenth_of_gross
cash price $175 is 9% of the gross charge $2,026
CPT 84439/o
info
mrf_cash_under_tenth_of_gross
cash price $9 is 4% of the gross charge $225
CPT 70470/o
info
mrf_cash_under_tenth_of_gross
cash price $175 is 5% of the gross charge $3,546
CPT 84450/o
info
mrf_cash_under_tenth_of_gross
cash price $5 is 3% of the gross charge $177
CPT 70480/o
info
mrf_cash_under_tenth_of_gross
cash price $104 is 4% of the gross charge $2,854
CPT 84460/o
info
mrf_cash_under_tenth_of_gross
cash price $5 is 3% of the gross charge $177
CPT 70481/o
info
mrf_cash_under_tenth_of_gross
cash price $175 is 8% of the gross charge $2,231
CPT 84478/o
info
mrf_cash_under_tenth_of_gross
cash price $5 is 4% of the gross charge $138
CPT 70482/o
info
mrf_cash_under_tenth_of_gross
cash price $175 is 4% of the gross charge $3,983
CPT 84479/o
info
mrf_cash_under_tenth_of_gross
cash price $6 is 3% of the gross charge $199
CPT 70486/o
info
mrf_cash_under_tenth_of_gross
cash price $104 is 4% of the gross charge $2,898
CPT 84481/o
info
mrf_cash_under_tenth_of_gross
cash price $16 is 5% of the gross charge $329
CPT 70488/o
info
mrf_cash_under_tenth_of_gross
cash price $175 is 6% of the gross charge $3,036
CPT 84484/o
info
mrf_cash_under_tenth_of_gross
cash price $12 is 7% of the gross charge $170
CPT 70490/o
info
mrf_cash_under_tenth_of_gross
cash price $104 is 3% of the gross charge $3,715
CPT 84485/o
info
mrf_cash_under_tenth_of_gross
cash price $7 is 9% of the gross charge $82
CPT 70491/o
info
mrf_cash_under_tenth_of_gross
cash price $175 is 5% of the gross charge $3,354
CPT 84488/o
info
mrf_cash_under_tenth_of_gross
cash price $7 is 9% of the gross charge $82
CPT 70492/o
info
mrf_cash_under_tenth_of_gross
cash price $175 is 4% of the gross charge $4,294
CPT 84510/o
info
mrf_cash_under_tenth_of_gross
cash price $10 is 5% of the gross charge $201
CPT 70496/o
info
mrf_cash_under_tenth_of_gross
cash price $175 is 6% of the gross charge $2,876
CPT 84520/o
info
mrf_cash_under_tenth_of_gross
cash price $3 is 2% of the gross charge $157
CPT 70498/o
info
mrf_cash_under_tenth_of_gross
cash price $175 is 7% of the gross charge $2,657
CPT 84540/o
info
mrf_cash_under_tenth_of_gross
cash price $5 is 3% of the gross charge $157
CPT 70540/o
info
mrf_cash_under_tenth_of_gross
cash price $238 is 5% of the gross charge $4,956
CPT 84550/o
info
mrf_cash_under_tenth_of_gross
cash price $4 is 5% of the gross charge $84
CPT 70543/o
info
mrf_cash_under_tenth_of_gross
cash price $348 is 7% of the gross charge $4,956
CPT 84560/o
info
mrf_cash_under_tenth_of_gross
cash price $5 is 4% of the gross charge $134
CPT 70544/o
info
mrf_cash_under_tenth_of_gross
cash price $238 is 10% of the gross charge $2,384
CPT 84585/o
info
mrf_cash_under_tenth_of_gross
cash price $15 is 4% of the gross charge $351
CPT 70551/o
info
mrf_cash_under_tenth_of_gross
cash price $238 is 5% of the gross charge $4,956
CPT 84597/o
info
mrf_cash_under_tenth_of_gross
cash price $13 is 7% of the gross charge $179
CPT 70553/o
info
mrf_cash_under_tenth_of_gross
cash price $348 is 7% of the gross charge $4,956
CPT 84681/o
info
mrf_cash_under_tenth_of_gross
cash price $20 is 9% of the gross charge $212
CPT 71250/o
info
mrf_cash_under_tenth_of_gross
cash price $104 is 3% of the gross charge $3,722
CPT 84702/o
info
mrf_cash_under_tenth_of_gross
cash price $15 is 4% of the gross charge $366
CPT 71260/o
info
mrf_cash_under_tenth_of_gross
cash price $175 is 5% of the gross charge $3,522
CPT 84703/o
info
mrf_cash_under_tenth_of_gross
cash price $7 is 5% of the gross charge $137
CPT 71270/o
info
mrf_cash_under_tenth_of_gross
cash price $175 is 4% of the gross charge $4,300
CPT 85002/o
info
mrf_cash_under_tenth_of_gross
cash price $4 is 4% of the gross charge $90
CPT 71275/o
info
mrf_cash_under_tenth_of_gross
cash price $175 is 6% of the gross charge $3,166
CPT 85007/o
info
mrf_cash_under_tenth_of_gross
cash price $3 is 5% of the gross charge $60
CPT 71550/o
info
mrf_cash_under_tenth_of_gross
cash price $238 is 6% of the gross charge $3,802
CPT 85008/o
info
mrf_cash_under_tenth_of_gross
cash price $3 is 5% of the gross charge $57
CPT 71552/o
info
mrf_cash_under_tenth_of_gross
cash price $348 is 9% of the gross charge $3,802
CPT 85009/o
info
mrf_cash_under_tenth_of_gross
cash price $5 is 6% of the gross charge $79
CPT 72052/o
info
mrf_cash_under_tenth_of_gross
cash price $104 is 10% of the gross charge $1,091
CPT 85014/o
info
mrf_cash_under_tenth_of_gross
cash price $2 is 5% of the gross charge $42
CPT 72125/o
info
mrf_cash_under_tenth_of_gross
cash price $104 is 3% of the gross charge $3,535
CPT 85018/o
info
mrf_cash_under_tenth_of_gross
cash price $2 is 3% of the gross charge $61
CPT 72127/o
info
mrf_cash_under_tenth_of_gross
cash price $175 is 6% of the gross charge $3,058
CPT 85025/o
info
mrf_cash_under_tenth_of_gross
cash price $7 is 4% of the gross charge $157
CPT 72128/o
info
mrf_cash_under_tenth_of_gross
cash price $104 is 3% of the gross charge $3,188
CPT 85027/o
info
mrf_cash_under_tenth_of_gross
cash price $6 is 5% of the gross charge $118
CPT 72129/o
info
mrf_cash_under_tenth_of_gross
cash price $175 is 4% of the gross charge $4,964
CPT 85041/o
info
mrf_cash_under_tenth_of_gross
cash price $3 is 8% of the gross charge $40
CPT 72130/o
info
mrf_cash_under_tenth_of_gross
cash price $175 is 5% of the gross charge $3,636
CPT 85045/o
info
mrf_cash_under_tenth_of_gross
cash price $3 is 4% of the gross charge $77
CPT 72131/o
info
mrf_cash_under_tenth_of_gross
cash price $104 is 3% of the gross charge $3,968
CPT 85048/o
info
mrf_cash_under_tenth_of_gross
cash price $2 is 4% of the gross charge $49
CPT 72132/o
info
mrf_cash_under_tenth_of_gross
cash price $348 is 9% of the gross charge $3,965
CPT 85049/o
info
mrf_cash_under_tenth_of_gross
cash price $4 is 5% of the gross charge $78
CPT 72133/o
info
mrf_cash_under_tenth_of_gross
cash price $175 is 5% of the gross charge $3,878
CPT 85230/o
info
mrf_cash_under_tenth_of_gross
cash price $17 is 8% of the gross charge $213
CPT 72141/o
info
mrf_cash_under_tenth_of_gross
cash price $238 is 6% of the gross charge $4,225
CPT 85240/o
info
mrf_cash_under_tenth_of_gross
cash price $17 is 6% of the gross charge $278
CPT 72142/o
info
mrf_cash_under_tenth_of_gross
cash price $348 is 9% of the gross charge $3,810
CPT 85245/o
info
mrf_cash_under_tenth_of_gross
cash price $22 is 8% of the gross charge $278
CPT 72146/o
info
mrf_cash_under_tenth_of_gross
cash price $238 is 8% of the gross charge $2,882
CPT 85246/o
info
mrf_cash_under_tenth_of_gross
cash price $22 is 8% of the gross charge $278
CPT 72148/o
info
mrf_cash_under_tenth_of_gross
cash price $238 is 5% of the gross charge $4,340
CPT 85250/o
info
mrf_cash_under_tenth_of_gross
cash price $19 is 8% of the gross charge $231
CPT 72149/o
info
mrf_cash_under_tenth_of_gross
cash price $348 is 9% of the gross charge $3,914
CPT 85260/o
info
mrf_cash_under_tenth_of_gross
cash price $17 is 5% of the gross charge $352
CPT 72156/o
info
mrf_cash_under_tenth_of_gross
cash price $348 is 8% of the gross charge $4,225