O_CATALOG_DISP O_ACTIVITY_SUBTYPE_DISP CPT HCPCS CDM CPT_MOD REVENUE TC_FEE TC_SCHEDULE PC_CDM PC_REVENUE PC_CPT_MOD_1 PC_CPT_MOD_ADDTL MOD_PRIORITY PC_FEE PC_SCHEDULE FACILITY_DISP CD CRT D Generator Change Cardiac Device 33264 481 0 972 0 0 CD CRT D Generator Insertion Cardiac Device 33231 481 0 972 0 0 CD CRT D Implant Dual w/ LV Lead Cardiac Device 33249 481 0 972 0 0 CD CRT D LV Lead Insertion Cardiac Device 33224 481 0 972 0 0 CD CRT D LV Lead Reposition Cardiac Device 33226 481 0 972 0 0 CD CRT D RT AV and LV Lead Insertion Cardiac Device 33217 481 0 972 0 0 CD CRT D Right Lead Reposition Cardiac Device 33215 481 0 972 0 0 CD CRT P Generator Change Cardiac Device 33229 481 0 972 0 0 CD CRT P Generator Insertion Cardiac Device 33221 481 0 972 0 0 CD CRT P Implant Atrial w/ LV Lead Cardiac Device 33206 481 0 972 0 0 CD CRT P Implant Dual w/ LV Lead Cardiac Device 33208 481 0 972 0 0 CD CRT P Implant Ventrical w/ LV Lead Cardiac Device 33207 481 0 972 0 0 CD CRT P LV Lead Insertion Cardiac Device 33224 481 0 972 0 0 CD CRT P LV Lead Reposition Cardiac Device 33226 481 0 972 0 0 CD CRT P RT AV and LV Lead Insertion Cardiac Device 33217 481 0 972 0 0 CD CRT P Right Lead Reposition Cardiac Device 33215 481 0 972 0 0 CD Debridement of Pocket Cardiac Device 11042 761 0 972 0 0 CD Hematoma Evacuation Cardiac Device 10140 481 0 972 0 0 CD ICD Gen Change Dual Lead Cardiac Device 33263 481 0 972 0 0 CD ICD Gen Change Single Lead Cardiac Device 33262 481 0 972 0 0 CD ICD Gen Explant/Change Sgl to Dual Cardiac Device 33241 481 0 972 0 0 CD ICD Gen Insert to Dual Lead Sys Cardiac Device 33230 481 0 972 0 0 CD ICD Gen Insert to Single Lead Sys Cardiac Device 33240 481 0 972 0 0 CD ICD Generator Explant Cardiac Device 33241 481 0 972 0 0 CD ICD Implant Cardiac Device 33249 481 0 Pioneer Medical Center Base Price Schedule 972 0 0 CD ICD Lead Explant Dual Cardiac Device 33244 481 0 972 0 0 CD ICD Lead Explant Single Cardiac Device 33244 481 0 972 0 0 CD ICD Lead Insertion Dual Cardiac Device 33217 481 0 972 0 0 CD ICD Lead Insertion Single Cardiac Device 33216 481 0 972 0 0 CD ICD Lead Repair Dual Cardiac Device 33220 481 0 972 0 0 CD ICD Lead Repair Single Cardiac Device 33218 481 0 972 0 0 CD ICD Lead Repositioning Cardiac Device 33215 481 0 972 0 0 CD ICD Pocket Relocation Cardiac Device 33223 481 0 972 0 0 CD ICD Subcutaneous Implant/Replace Cardiac Device 33270 481 0 972 0 0 CD Incision and Removal FB Cardiac Device 10120 481 0 972 0 0 CD Infective Pocket I/D Cardiac Device 10180 481 0 972 0 0 CD Pacemaker Dual Lead Explant Cardiac Device 33235 481 0 972 0 0 CD Pacemaker Dual Lead Repair Cardiac Device 33220 481 0 972 0 0 CD Pacemaker Duel Lead Insert Cardiac Device 33217 481 0 972 0 0 CD Pacemaker Explant Cardiac Device 33233 481 0 Pioneer Medical Center Base Price Schedule 972 0 0 CD Pacemaker Implant Atrial Cardiac Device 33206 481 0 972 0 0 CD Pacemaker Implant Dual Chamber Cardiac Device 33208 481 0 972 0 0 CD Pacemaker Implant Ventricular Cardiac Device 33207 481 0 972 0 0 CD Pacemaker Lead Reposition Cardiac Device 33215 481 0 972 0 0 CD Pacemaker Leadless Insert Cardiac Device 33274 481 0 972 0 0 CD Pacemaker Pocket Relocation Cardiac Device 33222 481 0 972 0 0 CD Pacemaker Single Lead Explant Cardiac Device 33234 481 0 972 0 0 CD Pacemaker Single Lead Insert Cardiac Device 33216 481 0 972 0 0 CD Pacemaker Single Lead Repair Cardiac Device 33218 481 0 972 0 0 CD Pacer Gen Change Dual Lead Sys Cardiac Device 33228 481 0 972 0 0 CD Pacer Gen Change Single Lead Sys Cardiac Device 33227 481 0 972 0 0 CD Pacer Gen Change Single to Dual Cardiac Device 33214 481 0 972 0 0 CD Pacer Gen Insert to Dual Lead Sys Cardiac Device 33213 481 0 972 0 0 CD Pacer Gen Insert to Single Lead Sys Cardiac Device 33212 481 0 972 0 0 CD Temporary Transvenous Pacemaker Cardiac Device 33210 481 0 972 0 0 CM Cardiac Continuous Mntr 3/21 Dy Home Cardiovascular Monitoring 0 985 0 0 CM Cardiac Continuous Monitor 3 to 21 Dy Cardiovascular Monitoring 730 0 985 0 0 CM Cardiac Event Monitor 30 Day Cardiovascular Monitoring 93272 6009708 731 315 Pioneer Medical Center Base Price Schedule 985 0 0 Pioneer Medical Center CM Cardiac Event Monitor 30 Day Home Cardiovascular Monitoring 93272 0 985 0 0 Pioneer Medical Center CM Holter Monitor 24 Hr Cardiovascular Monitoring 93227 6009559 731 286 Pioneer Medical Center Base Price Schedule 985 0 0 Pioneer Medical Center CM Holter Monitor 24 Hr Home Cardiovascular Monitoring 93227 0 985 0 0 Pioneer Medical Center CM Holter Monitor 3 to 7 Day Cardiovascular Monitoring 93244 6009419 731 57 Pioneer Medical Center Base Price Schedule 985 0 0 Pioneer Medical Center CM Holter Monitor 3 to 7 Day Home Cardiovascular Monitoring 93244 0 985 0 0 Pioneer Medical Center CM Holter Monitor 48 Hr Cardiovascular Monitoring 93227 6009559 731 286 Pioneer Medical Center Base Price Schedule 985 0 0 Pioneer Medical Center CM Holter Monitor 48 Hr Home Cardiovascular Monitoring 93227 0 985 0 0 Pioneer Medical Center CM Holter Monitor 8 to 15 Day Cardiovascular Monitoring 93248 6009401 731 57 Pioneer Medical Center Base Price Schedule 985 0 0 Pioneer Medical Center CM Holter Monitor 8 to 15 Day Home Cardiovascular Monitoring 93248 0 985 0 0 Pioneer Medical Center CM Mobile CV Telemetry 30 Day Cardiovascular Monitoring 93228 0 985 0 0 Pioneer Medical Center CM Mobile CV Telemetry 30 Day Home Cardiovascular Monitoring 93228 0 985 0 0 Pioneer Medical Center CT Abd/Pelvis/LE Venogram Computed Tomography 75635 5600267 350 3215 Pioneer Medical Center Base Price Schedule 2000420 972 26 0 414.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Abdomen Angiography Computed Tomography 74175 5600259 350 3275.5 Pioneer Medical Center Base Price Schedule 2000412 972 26 0 327.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Abdomen Triphasic Computed Tomography 74170 5600242 350 2757.5 Pioneer Medical Center Base Price Schedule 2000396 972 26 0 242 Prof PMC Base Price Schedule Pioneer Medical Center CT Abdomen Upper w/ Contrast Computed Tomography 74160 5600234 350 2756.5 Pioneer Medical Center Base Price Schedule 2000388 972 26 0 219.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Abdomen Upper w/wo Contrast Computed Tomography 74170 5600242 350 2757.5 Pioneer Medical Center Base Price Schedule 2000396 972 26 0 242 Prof PMC Base Price Schedule Pioneer Medical Center CT Abdomen Upper wo Contrast Computed Tomography 74150 5600226 350 1899 Pioneer Medical Center Base Price Schedule 2000370 972 26 0 206 Prof PMC Base Price Schedule Pioneer Medical Center CT Abdomen/Pelvis Angiography Computed Tomography 74174 5600465 350 5422.5 Pioneer Medical Center Base Price Schedule 2000495 972 26 0 315 Prof PMC Base Price Schedule Pioneer Medical Center CT Abdomen/Pelvis w/ Contrast Computed Tomography 74177 5600481 350 3956 Pioneer Medical Center Base Price Schedule 2000511 972 26 0 260.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Abdomen/Pelvis w/wo Contrast Computed Tomography 74178 5600499 350 5405.5 Pioneer Medical Center Base Price Schedule 2000529 972 26 0 214 Prof PMC Base Price Schedule Pioneer Medical Center CT Abdomen/Pelvis wo Contrast Computed Tomography 74176 5600473 350 2712 Pioneer Medical Center Base Price Schedule 2000503 972 26 0 250 Prof PMC Base Price Schedule Pioneer Medical Center CT Abdominal Aortagram w/ Runoff Computed Tomography 75635 5600267 350 3215 Pioneer Medical Center Base Price Schedule 2000420 972 26 0 414.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Abdominal Paracentesis Computed Tomography 49083 350 0 972 0 0 Pioneer Medical Center CT Abdominal/Retroperitoneal BX Computed Tomography 77012 350 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center CT Adrenal w/wo Contrast Computed Tomography 74170 350 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 CT Ankle Arthrogram L Computed Tomography 73701 LT 350 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center CT Ankle Arthrogram R Computed Tomography 73701 RT 350 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center CT Ankle Inj L Computed Tomography 77012 LT 350 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 CT Ankle Inj R Computed Tomography 77012 RT 350 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 CT Ankle w/ Contrast L Computed Tomography 73701 5600341 LT 350 1746.5 Pioneer Medical Center Base Price Schedule 2000347 972 26 LT 2 201.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Ankle w/ Contrast R Computed Tomography 73701 5600341 RT 350 1746.5 Pioneer Medical Center Base Price Schedule 2000347 972 26 RT 2 201.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Ankle w/wo Contrast L Computed Tomography 73702 5600333 LT 350 2583.5 Pioneer Medical Center Base Price Schedule 2000354 972 26 LT 2 209 Prof PMC Base Price Schedule Pioneer Medical Center CT Ankle w/wo Contrast R Computed Tomography 73702 5600333 RT 350 2583.5 Pioneer Medical Center Base Price Schedule 2000354 972 26 RT 2 209 Prof PMC Base Price Schedule Pioneer Medical Center CT Ankle wo Contrast L Computed Tomography 73700 5600218 LT 350 1696.5 Pioneer Medical Center Base Price Schedule 2000339 972 26 LT 2 174 Prof PMC Base Price Schedule Pioneer Medical Center CT Ankle wo Contrast R Computed Tomography 73700 5600218 RT 350 1696.5 Pioneer Medical Center Base Price Schedule 2000339 972 26 RT 2 174 Prof PMC Base Price Schedule Pioneer Medical Center CT Aorta Gated Angiography Computed Tomography 71275 352 0 972 26 0 0 Pioneer Medical Center CT Arthrex Protocol w/Interp L Computed Tomography 73200 LT 350 0 972 26 LT 2 0 CT Arthrex Protocol w/Interp R Computed Tomography 73200 RT 350 0 972 26 RT 2 0 CT Biomet Protocol L Computed Tomography 77011 350 0 Pioneer Medical Center Base Price Schedule 0 0 CT Biomet Protocol R Computed Tomography 77011 350 0 Pioneer Medical Center Base Price Schedule 0 0 CT Bone Deep BX Computed Tomography 77012 350 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center CT Bone Density Scan Computed Tomography 77078 350 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 CT Bone Marrow BX Computed Tomography 77012 350 0 972 26 0 0 Pioneer Medical Center CT Bone Superficial BX Computed Tomography 77012 350 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center CT C Spine w/ Contrast Computed Tomography 72126 5600127 350 2088.5 Pioneer Medical Center Base Price Schedule 2000172 972 26 0 199 Prof PMC Base Price Schedule Pioneer Medical Center CT C Spine w/wo Contrast Computed Tomography 72127 5600515 350 1029.5 Pioneer Medical Center Base Price Schedule 2000545 972 26 0 302.5 Prof PMC Base Price Schedule Pioneer Medical Center CT C Spine wo Contrast Computed Tomography 72125 5600119 350 1959.5 Pioneer Medical Center Base Price Schedule 2000164 972 26 0 185.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Cardiac Ablation Computed Tomography 75572 350 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center CT Cardiac Angiography Computed Tomography 75574 0 0 0 CT Cardiac Calcium Score Computed Tomography 75571 350 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center CT Cardiac Congenital Disease Computed Tomography 75573 350 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center CT Cardiac Morphology Computed Tomography 75572 350 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center CT Cardiac and Coronary Art Computed Tomography 75574 350 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 CT Cardiac and Coronary Art w/ Ca Score Computed Tomography 75574 350 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center CT Cardiac and Coronary Arteries Computed Tomography 0 0 0 CT Celiac Plexus Block Anesthetic Computed Tomography 64530 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center CT Celiac Plexus Destruction Computed Tomography 64680 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center CT Cerebral Perfusion Computed Tomography 0042T 351 0 972 0 0 CT Chest Angio PE Protocol Computed Tomography 71275 5600101 352 2760.5 Pioneer Medical Center Base Price Schedule 2000156 972 26 0 328.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Chest Angiography Computed Tomography 71275 5600101 352 2760.5 Pioneer Medical Center Base Price Schedule 2000156 972 26 0 328.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Chest Endobronchial Valve Protocol Computed Tomography 71250 350 0 0 0 Pioneer Medical Center CT Chest High Resolution wo Contrast Computed Tomography 71250 5600085 350 1854.5 Pioneer Medical Center Base Price Schedule 2000131 972 26 0 177.5 Prof PMC Base Price Schedule CT Chest Overread Computed Tomography 71260 350 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center CT Chest Tube Placement Computed Tomography 32557 350 0 972 0 0 Pioneer Medical Center CT Chest w/ Contrast Computed Tomography 71260 5600093 350 2161 Pioneer Medical Center Base Price Schedule 2000149 972 26 0 213 Prof PMC Base Price Schedule Pioneer Medical Center CT Chest w/wo Contrast Computed Tomography 71270 5600432 350 3135.5 Pioneer Medical Center Base Price Schedule 2000214 972 26 0 235.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Chest wo Contrast Computed Tomography 71250 5600085 350 1854.5 Pioneer Medical Center Base Price Schedule 2000131 972 26 0 177.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Chest/Abd Angiography Computed Tomography 71275 5600101 352 2760.5 Pioneer Medical Center Base Price Schedule 2000156 972 26 0 328.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Chest/Abd w/ Contrast Computed Tomography 71260 5600093 350 2161 Pioneer Medical Center Base Price Schedule 2000149 972 26 0 213 Prof PMC Base Price Schedule Pioneer Medical Center CT Chest/Abd w/wo Contrast Computed Tomography 71270 350 0 972 26 0 0 Pioneer Medical Center CT Chest/Abd wo Contrast Computed Tomography 71250 5600085 350 1854.5 Pioneer Medical Center Base Price Schedule 2000131 972 26 0 177.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Chest/Abd/Pelvis Angiography Computed Tomography 71275 5600101 350 2760.5 Pioneer Medical Center Base Price Schedule 2000156 972 26 0 328.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Chest/Abd/Pelvis w/ Contrast Computed Tomography 71260 5600093 350 2161 Pioneer Medical Center Base Price Schedule 2000149 972 26 0 213 Prof PMC Base Price Schedule Pioneer Medical Center CT Chest/Abd/Pelvis w/wo Contrast Computed Tomography 71270 5600432 350 3135.5 Pioneer Medical Center Base Price Schedule 2000214 972 26 0 235.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Chest/Abd/Pelvis wo Contrast Computed Tomography 71250 5600085 350 1854.5 Pioneer Medical Center Base Price Schedule 2000131 972 26 0 177.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Cholecystostomy Percutaneous Computed Tomography 47490 361 0 972 0 0 Pioneer Medical Center CT Clavicle w/ Contrast L Computed Tomography 73201 5600424 LT 350 1588.5 Pioneer Medical Center Base Price Schedule 2000297 972 26 LT 2 201.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Clavicle w/ Contrast R Computed Tomography 73201 5600424 RT 350 1588.5 Pioneer Medical Center Base Price Schedule 2000297 972 26 RT 2 201.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Clavicle w/wo Contrast L Computed Tomography 73202 5600416 LT 350 2213.5 Pioneer Medical Center Base Price Schedule 2000313 972 26 LT 2 209 Prof PMC Base Price Schedule Pioneer Medical Center CT Clavicle w/wo Contrast R Computed Tomography 73202 5600416 RT 350 2213.5 Pioneer Medical Center Base Price Schedule 2000313 972 26 RT 2 209 Prof PMC Base Price Schedule Pioneer Medical Center CT Clavicle wo Contrast L Computed Tomography 73200 5600200 LT 350 1843 Pioneer Medical Center Base Price Schedule 2000289 972 26 LT 2 177.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Clavicle wo Contrast R Computed Tomography 73200 5600200 RT 350 1843 Pioneer Medical Center Base Price Schedule 2000289 972 26 RT 2 177.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Colonography Diagnostic wo Contrast Computed Tomography 74261 350 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 CT Colonography Screening Computed Tomography 74263 350 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 CT Coronary Arteries only Computed Tomography 0 0 0 CT Coronary Arteries w/ Ca Eval Computed Tomography 0 0 0 CT Cryo Bone Tumor Computed Tomography 20983 350 0 972 0 0 Pioneer Medical Center CT Cryo Breast Tumor Guide Computed Tomography 77013 350 0 972 26 0 0 Pioneer Medical Center CT Cryo Fibroadenoma Guide Computed Tomography 77013 350 0 972 26 0 0 Pioneer Medical Center CT Cryo LE Distal/Periph Nerve Guide Computed Tomography 77013 350 0 972 26 0 0 Pioneer Medical Center CT Cryo Liver Tumor Guide Computed Tomography 77013 350 0 972 26 0 0 Pioneer Medical Center CT Cryo Prostate Tumor Guide Computed Tomography 77013 350 0 972 26 0 0 Pioneer Medical Center CT Cryo Pulmonary Tumor Guide Computed Tomography 77013 350 0 972 26 0 0 Pioneer Medical Center CT Cryo Renal Tumor Guide Computed Tomography 77013 350 0 972 26 0 0 Pioneer Medical Center CT Cryo Truncal Nerve Guide Computed Tomography 77013 350 0 972 26 0 0 Pioneer Medical Center CT Cryo UE Distal/Periph Nerve Guide Computed Tomography 77013 350 0 972 26 0 0 Pioneer Medical Center CT Cystogram Computed Tomography 72192 5600499 350 5405.5 Pioneer Medical Center Base Price Schedule 2000529 972 26 0 214 Prof PMC Base Price Schedule Pioneer Medical Center CT Dental Planning wo Contrast Computed Tomography 70486 52 350 0 972 26 52 2 0 CT Elbow Arthrogram L Computed Tomography 73201 LT 350 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center CT Elbow Arthrogram R Computed Tomography 73201 RT 350 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center CT Elbow Inj L Computed Tomography 77012 LT 350 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 CT Elbow Inj R Computed Tomography 77012 RT 350 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 CT Elbow w/ Contrast L Computed Tomography 73201 5600424 LT 350 1588.5 Pioneer Medical Center Base Price Schedule 2000297 972 26 LT 2 201.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Elbow w/ Contrast R Computed Tomography 73201 5600424 RT 350 1588.5 Pioneer Medical Center Base Price Schedule 2000297 972 26 RT 2 201.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Elbow w/wo Contrast L Computed Tomography 73202 5600416 LT 350 2213.5 Pioneer Medical Center Base Price Schedule 2000313 972 26 LT 2 209 Prof PMC Base Price Schedule Pioneer Medical Center CT Elbow w/wo Contrast R Computed Tomography 73202 5600416 RT 350 2213.5 Pioneer Medical Center Base Price Schedule 2000313 972 26 RT 2 209 Prof PMC Base Price Schedule Pioneer Medical Center CT Elbow wo Contrast L Computed Tomography 73200 5600200 LT 350 1843 Pioneer Medical Center Base Price Schedule 2000289 972 26 LT 2 177.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Elbow wo Contrast R Computed Tomography 73200 5600200 RT 350 1843 Pioneer Medical Center Base Price Schedule 2000289 972 26 RT 2 177.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Enterography Computed Tomography 74177 5600481 350 3956 Pioneer Medical Center Base Price Schedule 2000511 972 26 0 260.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Epidural Inj Cervical Spine Computed Tomography 62321 761 0 972 0 0 CT Epidural Inj Lumbar Spine Computed Tomography 62323 761 0 972 0 0 CT Epidural Inj Lumbar Spine ANES Computed Tomography 62323 761 0 0 0 CT Epidural Inj T Spine ANES Computed Tomography 62321 761 0 0 0 CT Epidural Inj Thoracic Spine Computed Tomography 62321 761 0 972 0 0 CT Esophogram Computed Tomography 71250 5600085 350 1854.5 Pioneer Medical Center Base Price Schedule 2000131 972 26 0 177.5 Prof PMC Base Price Schedule CT Extremity Lower Angiography L Computed Tomography 73706 5600291 LT 350 3320 Pioneer Medical Center Base Price Schedule 2000362 972 26 LT 2 327.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Extremity Lower Angiography R Computed Tomography 73706 5600291 RT 352 3320 Pioneer Medical Center Base Price Schedule 2000362 972 26 RT 2 327.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Extremity Lower Gout Protocol L Computed Tomography 73700 LT 350 0 972 26 LT 2 0 CT Extremity Lower Gout Protocol R Computed Tomography 73700 RT 350 0 972 26 RT 2 0 CT Extremity Lower w/ Contrast L Computed Tomography 73701 5600341 LT 350 1746.5 Pioneer Medical Center Base Price Schedule 2000347 972 26 LT 2 201.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Extremity Lower w/ Contrast R Computed Tomography 73701 5600341 RT 350 1746.5 Pioneer Medical Center Base Price Schedule 2000347 972 26 RT 2 201.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Extremity Lower w/wo Cont L Computed Tomography 73702 5600333 LT 350 2583.5 Pioneer Medical Center Base Price Schedule 2000354 972 26 LT 2 209 Prof PMC Base Price Schedule Pioneer Medical Center CT Extremity Lower w/wo Cont R Computed Tomography 73702 5600333 RT 350 2583.5 Pioneer Medical Center Base Price Schedule 2000354 972 26 RT 2 209 Prof PMC Base Price Schedule Pioneer Medical Center CT Extremity Lower wo Contrast L Computed Tomography 73700 5600218 LT 350 1696.5 Pioneer Medical Center Base Price Schedule 2000339 972 26 LT 2 174 Prof PMC Base Price Schedule Pioneer Medical Center CT Extremity Lower wo Contrast R Computed Tomography 73700 5600218 RT 350 1696.5 Pioneer Medical Center Base Price Schedule 2000339 972 26 RT 2 174 Prof PMC Base Price Schedule Pioneer Medical Center CT Extremity Upper Angiography L Computed Tomography 73206 5600309 LT 352 3135.5 Pioneer Medical Center Base Price Schedule 2000321 972 26 LT 2 310.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Extremity Upper Angiography R Computed Tomography 73206 5600309 RT 352 3135.5 Pioneer Medical Center Base Price Schedule 2000321 972 26 RT 2 310.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Extremity Upper Gout Protocol L Computed Tomography 73200 LT 350 0 972 26 LT 2 0 CT Extremity Upper Gout Protocol R Computed Tomography 73200 RT 350 0 972 26 RT 2 0 CT Extremity Upper w/ Contrast L Computed Tomography 73201 5600424 LT 350 1588.5 Pioneer Medical Center Base Price Schedule 2000297 972 26 LT 2 201.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Extremity Upper w/ Contrast R Computed Tomography 73201 5600424 RT 350 1588.5 Pioneer Medical Center Base Price Schedule 2000297 972 26 RT 2 201.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Extremity Upper w/wo Cont L Computed Tomography 73202 5600416 LT 350 2213.5 Pioneer Medical Center Base Price Schedule 2000313 972 26 LT 2 209 Prof PMC Base Price Schedule Pioneer Medical Center CT Extremity Upper w/wo Cont R Computed Tomography 73202 5600416 RT 350 2213.5 Pioneer Medical Center Base Price Schedule 2000313 972 26 RT 2 209 Prof PMC Base Price Schedule Pioneer Medical Center CT Extremity Upper wo Contrast L Computed Tomography 73200 5600200 LT 350 1843 Pioneer Medical Center Base Price Schedule 2000289 972 26 LT 2 177.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Extremity Upper wo Contrast R Computed Tomography 73200 5600200 RT 350 1843 Pioneer Medical Center Base Price Schedule 2000289 972 26 RT 2 177.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Facet Injection C or T Spine by Rad Computed Tomography 0 0 0 CT Facet Joint Destruction C/T Bilat Computed Tomography 64633 50 761 0 972 50 0 0 Pioneer Medical Center CT Facet Joint Destruction Cerv/Thor Computed Tomography 64633 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center CT Facet Joint Destruction L/S Bilat Computed Tomography 64635 50 761 0 972 50 0 0 Pioneer Medical Center CT Facet Joint Destruction Lumb/Sacr Computed Tomography 64635 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center CT Facet Joint Inj Cerv/Thor Bilat Rad Computed Tomography 64490 50 761 0 Pioneer Medical Center Base Price Schedule 972 50 0 0 Pioneer Medical Center CT Facet Joint Inj Cerv/Thor Uni Rad Computed Tomography 64490 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center CT Facet Joint Inj L/S Bilat ANES Computed Tomography 64493 761 0 0 0 CT Facet Joint Inj L/S Uni ANES Computed Tomography 64493 761 0 0 0 CT Facet Joint Inj Lumb/Sacr Bilat Rad Computed Tomography 64493 50 761 0 Pioneer Medical Center Base Price Schedule 972 50 0 0 Pioneer Medical Center CT Facet Joint Inj Lumb/Sacr Uni Rad Computed Tomography 64493 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center CT Facial Bones NO Reading Computed Tomography 76380 0 0 0 CT Facial Bones w/ Contrast Computed Tomography 70487 350 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 CT Facial Bones w/wo Contrast Computed Tomography 70488 350 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 CT Facial Bones wo Contrast Computed Tomography 70486 350 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 CT Femur w/ Contrast L Computed Tomography 73701 5600341 LT 350 1746.5 Pioneer Medical Center Base Price Schedule 2000347 972 26 LT 2 201.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Femur w/ Contrast R Computed Tomography 73701 5600341 RT 350 1746.5 Pioneer Medical Center Base Price Schedule 2000347 972 26 RT 2 201.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Femur w/wo Contrast L Computed Tomography 73702 5600333 LT 350 2583.5 Pioneer Medical Center Base Price Schedule 2000354 972 26 LT 2 209 Prof PMC Base Price Schedule Pioneer Medical Center CT Femur w/wo Contrast R Computed Tomography 73702 5600333 RT 350 2583.5 Pioneer Medical Center Base Price Schedule 2000354 972 26 RT 2 209 Prof PMC Base Price Schedule Pioneer Medical Center CT Femur wo Contrast L Computed Tomography 73700 5600218 LT 350 1696.5 Pioneer Medical Center Base Price Schedule 2000339 972 26 LT 2 174 Prof PMC Base Price Schedule Pioneer Medical Center CT Femur wo Contrast R Computed Tomography 73700 5600218 RT 350 1696.5 Pioneer Medical Center Base Price Schedule 2000339 972 26 RT 2 174 Prof PMC Base Price Schedule Pioneer Medical Center CT Finger/s w/ Contrast L Computed Tomography 73201 350 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 CT Finger/s w/ Contrast R Computed Tomography 73201 350 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 CT Finger/s wo Contrast L Computed Tomography 73200 LT 350 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 CT Finger/s wo Contrast R Computed Tomography 73200 RT 350 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 CT Foot Inj L Computed Tomography 77012 LT 350 0 972 26 LT 2 0 CT Foot Inj R Computed Tomography 77012 RT 350 0 972 26 RT 2 0 CT Foot w/ Contrast L Computed Tomography 73701 5600341 LT 350 1746.5 Pioneer Medical Center Base Price Schedule 2000347 972 26 LT 2 201.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Foot w/ Contrast R Computed Tomography 73701 5600341 RT 350 1746.5 Pioneer Medical Center Base Price Schedule 2000347 972 26 RT 2 201.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Foot w/wo Contrast L Computed Tomography 73702 5600333 LT 350 2583.5 Pioneer Medical Center Base Price Schedule 2000354 972 26 LT 2 209 Prof PMC Base Price Schedule Pioneer Medical Center CT Foot w/wo Contrast R Computed Tomography 73702 5600333 RT 350 2583.5 Pioneer Medical Center Base Price Schedule 2000354 972 26 RT 2 209 Prof PMC Base Price Schedule Pioneer Medical Center CT Foot wo Contrast L Computed Tomography 73700 5600218 LT 350 1696.5 Pioneer Medical Center Base Price Schedule 2000339 972 26 LT 2 174 Prof PMC Base Price Schedule Pioneer Medical Center CT Foot wo Contrast R Computed Tomography 73700 5600218 RT 350 1696.5 Pioneer Medical Center Base Price Schedule 2000339 972 26 RT 2 174 Prof PMC Base Price Schedule Pioneer Medical Center CT Forearm w/ Contrast L Computed Tomography 73201 5600424 LT 350 1588.5 Pioneer Medical Center Base Price Schedule 2000297 972 26 LT 2 201.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Forearm w/ Contrast R Computed Tomography 73201 5600424 RT 350 1588.5 Pioneer Medical Center Base Price Schedule 2000297 972 26 RT 2 201.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Forearm w/wo Contrast L Computed Tomography 73202 5600416 LT 350 2213.5 Pioneer Medical Center Base Price Schedule 2000313 972 26 LT 2 209 Prof PMC Base Price Schedule Pioneer Medical Center CT Forearm w/wo Contrast R Computed Tomography 73202 5600416 RT 350 2213.5 Pioneer Medical Center Base Price Schedule 2000313 972 26 RT 2 209 Prof PMC Base Price Schedule Pioneer Medical Center CT Forearm wo Contrast L Computed Tomography 73200 5600200 LT 350 1843 Pioneer Medical Center Base Price Schedule 2000289 972 26 LT 2 177.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Forearm wo Contrast R Computed Tomography 73200 5600200 RT 350 1843 Pioneer Medical Center Base Price Schedule 2000289 972 26 RT 2 177.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Hand w/ Contrast L Computed Tomography 73201 5600424 LT 350 1588.5 Pioneer Medical Center Base Price Schedule 2000297 972 26 LT 2 201.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Hand w/ Contrast R Computed Tomography 73201 5600424 RT 350 1588.5 Pioneer Medical Center Base Price Schedule 2000297 972 26 RT 2 201.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Hand w/wo Contrast L Computed Tomography 73202 5600416 LT 350 2213.5 Pioneer Medical Center Base Price Schedule 2000313 972 26 LT 2 209 Prof PMC Base Price Schedule Pioneer Medical Center CT Hand w/wo Contrast R Computed Tomography 73202 5600416 RT 350 2213.5 Pioneer Medical Center Base Price Schedule 2000313 972 26 RT 2 209 Prof PMC Base Price Schedule Pioneer Medical Center CT Hand wo Contrast L Computed Tomography 73200 5600200 LT 350 1843 Pioneer Medical Center Base Price Schedule 2000289 972 26 LT 2 177.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Hand wo Contrast R Computed Tomography 73200 5600200 RT 350 1843 Pioneer Medical Center Base Price Schedule 2000289 972 26 RT 2 177.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Head Angiography Computed Tomography 70496 5600051 351 2560 Pioneer Medical Center Base Price Schedule 2000115 972 26 0 302.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Head Angiography wo COW Computed Tomography 351 0 0 0 CT Head Venogram Computed Tomography 70496 5600051 351 2560 Pioneer Medical Center Base Price Schedule 2000115 972 26 0 302.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Head w/ Contrast Computed Tomography 70460 5600325 350 2213.5 Pioneer Medical Center Base Price Schedule 2000024 972 26 0 192 Prof PMC Base Price Schedule Pioneer Medical Center CT Head w/wo Contrast Computed Tomography 70470 5600010 350 2540.5 Pioneer Medical Center Base Price Schedule 2000032 972 26 0 219.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Head wo Contrast Computed Tomography 70450 5600002 350 1713.5 Pioneer Medical Center Base Price Schedule 2000016 972 26 0 145.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Head/C Spine wo Contrast Computed Tomography 70450 5600002 350 1713.5 Pioneer Medical Center Base Price Schedule 2000016 972 26 0 145.5 Prof PMC Base Price Schedule CT Head/Neck Angiography Computed Tomography 70496 5600051 351 2560 Pioneer Medical Center Base Price Schedule 2000115 972 26 0 302.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Hemothorax Abscess Drain Computed Tomography 75989 350 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center CT Hip Arthrogram L Computed Tomography 73701 LT 350 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center CT Hip Arthrogram R Computed Tomography 73701 RT 350 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center CT Hip Inj L Computed Tomography 77012 LT 350 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 CT Hip Inj R Computed Tomography 77012 RT 350 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 CT Hip w/ Contrast L Computed Tomography 73701 5600341 LT 350 1746.5 Pioneer Medical Center Base Price Schedule 2000347 972 26 LT 2 201.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Hip w/ Contrast R Computed Tomography 73701 5600341 RT 350 1746.5 Pioneer Medical Center Base Price Schedule 2000347 972 26 RT 2 201.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Hip w/wo Contrast L Computed Tomography 73702 5600333 LT 350 2583.5 Pioneer Medical Center Base Price Schedule 2000354 972 26 LT 2 209 Prof PMC Base Price Schedule Pioneer Medical Center CT Hip w/wo Contrast R Computed Tomography 73702 5600333 RT 350 2583.5 Pioneer Medical Center Base Price Schedule 2000354 972 26 RT 2 209 Prof PMC Base Price Schedule Pioneer Medical Center CT Hip wo Contrast L Computed Tomography 73700 5600218 LT 350 1696.5 Pioneer Medical Center Base Price Schedule 2000339 972 26 LT 2 174 Prof PMC Base Price Schedule Pioneer Medical Center CT Hip wo Contrast R Computed Tomography 73700 5600218 RT 350 1696.5 Pioneer Medical Center Base Price Schedule 2000339 972 26 RT 2 174 Prof PMC Base Price Schedule Pioneer Medical Center CT Humerus w/ Contrast L Computed Tomography 73201 5600424 LT 350 1588.5 Pioneer Medical Center Base Price Schedule 2000297 972 26 LT 2 201.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Humerus w/ Contrast R Computed Tomography 73201 5600424 RT 350 1588.5 Pioneer Medical Center Base Price Schedule 2000297 972 26 RT 2 201.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Humerus w/wo Contrast L Computed Tomography 73202 5600416 LT 350 2213.5 Pioneer Medical Center Base Price Schedule 2000313 972 26 LT 2 209 Prof PMC Base Price Schedule Pioneer Medical Center CT Humerus w/wo Contrast R Computed Tomography 73202 5600416 RT 350 2213.5 Pioneer Medical Center Base Price Schedule 2000313 972 26 RT 2 209 Prof PMC Base Price Schedule Pioneer Medical Center CT Humerus wo Contrast L Computed Tomography 73200 5600200 LT 350 1843 Pioneer Medical Center Base Price Schedule 2000289 972 26 LT 2 177.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Humerus wo Contrast R Computed Tomography 73200 5600200 RT 350 1843 Pioneer Medical Center Base Price Schedule 2000289 972 26 RT 2 177.5 Prof PMC Base Price Schedule Pioneer Medical Center CT IVP Stockdale Protocol Computed Tomography 74170 350 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 CT IVP w/wo Contrast Computed Tomography 74178 5600499 350 5405.5 Pioneer Medical Center Base Price Schedule 2000529 972 26 0 214 Prof PMC Base Price Schedule Pioneer Medical Center CT Knee Arthrogram L Computed Tomography 73701 LT 350 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center CT Knee Arthrogram R Computed Tomography 73701 RT 350 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center CT Knee Inj L Computed Tomography 77012 LT 350 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 CT Knee Inj R Computed Tomography 77012 RT 350 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 CT Knee w/ Contrast L Computed Tomography 73701 5600341 LT 350 1746.5 Pioneer Medical Center Base Price Schedule 2000347 972 26 LT 2 201.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Knee w/ Contrast R Computed Tomography 73701 5600341 RT 350 1746.5 Pioneer Medical Center Base Price Schedule 2000347 972 26 RT 2 201.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Knee w/wo Contrast L Computed Tomography 73702 5600333 LT 350 2583.5 Pioneer Medical Center Base Price Schedule 2000354 972 26 LT 2 209 Prof PMC Base Price Schedule Pioneer Medical Center CT Knee w/wo Contrast R Computed Tomography 73702 5600333 RT 350 2583.5 Pioneer Medical Center Base Price Schedule 2000354 972 26 RT 2 209 Prof PMC Base Price Schedule Pioneer Medical Center CT Knee wo Contrast L Computed Tomography 73700 5600218 LT 350 1696.5 Pioneer Medical Center Base Price Schedule 2000339 972 26 LT 2 174 Prof PMC Base Price Schedule Pioneer Medical Center CT Knee wo Contrast R Computed Tomography 73700 5600218 RT 350 1696.5 Pioneer Medical Center Base Price Schedule 2000339 972 26 RT 2 174 Prof PMC Base Price Schedule Pioneer Medical Center CT L Spine w/ Contrast Computed Tomography 72132 5600150 350 2487 Pioneer Medical Center Base Price Schedule 2000230 972 26 0 184.5 Prof PMC Base Price Schedule Pioneer Medical Center CT L Spine w/wo Contrast Computed Tomography 72133 5600531 350 2614.5 Pioneer Medical Center Base Price Schedule 2000560 972 26 0 208 Prof PMC Base Price Schedule Pioneer Medical Center CT L Spine wo Contrast Computed Tomography 72131 5600143 350 1957.5 Pioneer Medical Center Base Price Schedule 2000222 972 26 0 172 Prof PMC Base Price Schedule Pioneer Medical Center CT Limited 1 to 10 Cuts Computed Tomography 76380 5600382 350 1292 Pioneer Medical Center Base Price Schedule 2000446 972 26 0 168.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Liver Abscess Drain Computed Tomography 49405 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center CT Liver BX Computed Tomography 77012 350 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center CT Localization Device Plcmt Initial Computed Tomography 10035 350 0 972 0 0 Pioneer Medical Center CT Lumbar Puncture Diagnostic Computed Tomography 62328 350 0 972 26 0 0 CT Lung BX Computed Tomography 32408 350 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center CT Lung Low Dose Computed Tomography 71271 45071271TC 350 2726.5 Pioneer Medical Center Base Price Schedule 45071271PC 972 26 0 182 Prof PMC Base Price Schedule Pioneer Medical Center CT Lung Perc Localization Computed Tomography 77011 350 0 0 0 Pioneer Medical Center CT Lymph Node Fine Needle Aspiration Computed Tomography 10009 350 0 972 0 0 Pioneer Medical Center CT Lymph Node Superficial BX Computed Tomography 77012 350 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center CT Materialise Protocol Bilat Computed Tomography 77011 350 0 0 0 CT Maxillofacial w/ Contrast Computed Tomography 70487 5600358 350 1903 Pioneer Medical Center Base Price Schedule 2000081 972 26 0 226 Prof PMC Base Price Schedule Pioneer Medical Center CT Maxillofacial w/wo Contrast Computed Tomography 70488 5600440 350 2213.5 Pioneer Medical Center Base Price Schedule 2000479 972 26 0 206 Prof PMC Base Price Schedule Pioneer Medical Center CT Maxillofacial wo Contrast Computed Tomography 70486 5600036 350 1452 Pioneer Medical Center Base Price Schedule 2000073 972 26 0 195.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Microwave Ablation Guidance Computed Tomography 77013 350 0 972 26 0 0 Pioneer Medical Center CT Misc Guide define in Spec Inst Computed Tomography 77012 350 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center CT Miscellaneous Abscess Drain Computed Tomography 75989 350 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center CT Monarch Protocol Computed Tomography 77011 350 0 0 0 Pioneer Medical Center CT Monarch Protocol w/ Interp Computed Tomography 71250 350 0 972 26 0 0 Pioneer Medical Center CT Muscle BX Computed Tomography 77012 350 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center CT MyKnee Protocol L Computed Tomography 77011 350 0 0 0 CT MyKnee Protocol R Computed Tomography 77011 350 0 0 0 CT Navigational Bronch Planning Computed Tomography 77011 350 0 0 0 Pioneer Medical Center CT Neck Angiography Computed Tomography 70498 5600077 351 2572 Pioneer Medical Center Base Price Schedule 2000123 972 26 0 302.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Needle Localization Guidance Computed Tomography 77012 350 0 972 26 0 0 Pioneer Medical Center CT Nephrostomy Tube Placement Computed Tomography 50432 329 0 972 0 0 Pioneer Medical Center CT Nerve Root Block L Spine by NonRad Computed Tomography 64483 761 0 0 0 Pioneer Medical Center CT Nerve Root Block L Spine by Rad Computed Tomography 64483 761 0 972 0 0 Pioneer Medical Center CT Nerve Root Block L/S by Rad Bilat Computed Tomography 64483 50 761 0 972 50 0 0 Pioneer Medical Center CT Nerve Root Inj C Spine by Non Rad Computed Tomography 64479 761 0 0 0 CT Nerve Root Inj C Spine by Rad Computed Tomography 64479 761 0 972 0 0 Pioneer Medical Center CT Nerve Root Inj C/T by Rad Bilat Computed Tomography 64479 50 761 0 972 50 0 0 Pioneer Medical Center CT Nerve Root Inj T Spine by Rad Computed Tomography 64479 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center CT Newclip Protocol L Computed Tomography 77011 350 0 0 0 Pioneer Medical Center CT Newclip Protocol R Computed Tomography 77011 350 0 0 0 Pioneer Medical Center CT Orbits w/ Contrast Computed Tomography 70481 5600374 350 2397 Pioneer Medical Center Base Price Schedule 2000057 972 26 0 236.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Orbits w/wo Contrast Computed Tomography 70482 5600366 350 2768 Pioneer Medical Center Base Price Schedule 2000065 972 26 0 249 Prof PMC Base Price Schedule Pioneer Medical Center CT Orbits wo Contrast Computed Tomography 70480 5600028 350 1788.5 Pioneer Medical Center Base Price Schedule 2000040 972 26 0 220.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Pancreas BX Computed Tomography 77012 350 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center CT Pancreas Pseuodocyst Drain Computed Tomography 49405 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center CT Pancreas w/wo Contrast Computed Tomography 74170 350 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 CT Parathyroid 4D w/wo Contrast Computed Tomography 70492 350 0 972 26 0 0 Pioneer Medical Center CT Pelvis Angiography Computed Tomography 72191 5600168 352 3313 Pioneer Medical Center Base Price Schedule 2000248 972 26 0 315 Prof PMC Base Price Schedule Pioneer Medical Center CT Pelvis w/ Contrast Computed Tomography 72193 5600184 350 2136 Pioneer Medical Center Base Price Schedule 2000263 972 26 0 201.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Pelvis w/wo Contrast Computed Tomography 72194 5600192 350 2730 Pioneer Medical Center Base Price Schedule 2000271 972 26 0 209 Prof PMC Base Price Schedule Pioneer Medical Center CT Pelvis wo Contrast Computed Tomography 72192 5600176 350 1788.5 Pioneer Medical Center Base Price Schedule 2000255 972 26 0 187.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Peritoneal Abscess Drain Computed Tomography 49406 350 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center CT Petrous Study 2 Way Computed Tomography 70480 5600028 350 1788.5 Pioneer Medical Center Base Price Schedule 2000040 972 26 0 220.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Pleura BX Computed Tomography 77012 350 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center CT Pre IGSS Sinus Planning Only Computed Tomography 77011 350 0 0 0 Pioneer Medical Center CT Pre IGSS Sinus w/ Interpretation Computed Tomography 70486 350 0 972 26 0 0 Pioneer Medical Center CT Prophecy Inbone Protocol L Computed Tomography 77011 350 0 0 0 Pioneer Medical Center CT Prophecy Inbone Protocol R Computed Tomography 77011 350 0 0 0 Pioneer Medical Center CT Prostate BX Computed Tomography 77012 350 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center CT RITA Ablation Guide Computed Tomography 77013 350 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center CT RITA Bone Lesion Computed Tomography 20982 361 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center CT Renal Angiogram Computed Tomography 74175 5600259 350 3275.5 Pioneer Medical Center Base Price Schedule 2000412 972 26 0 327.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Renal BX Computed Tomography 77012 350 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center CT Renal Cyst Aspiration Computed Tomography 77012 350 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center CT Renal Stone Computed Tomography 74176 5600473 350 2712 Pioneer Medical Center Base Price Schedule 2000503 972 26 0 250 Prof PMC Base Price Schedule Pioneer Medical Center CT Renal or Perirenal Abscess Drain Computed Tomography 49405 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center CT Retroperitoneal Abscess Drain Computed Tomography 49406 350 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center CT SC Joint wo Contrast Computed Tomography 73200 350 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 CT SI Arthrogram L Computed Tomography 27096 G0260 LT 761 0 Pioneer Medical Center Base Price Schedule 972 LT 0 0 CT SI Arthrogram R Computed Tomography 27096 RT 761 0 Pioneer Medical Center Base Price Schedule 972 RT 0 0 CT SI Inject Therapeutic Bilateral Computed Tomography 27096 G0260 50 761 0 972 50 0 0 Pioneer Medical Center CT SI Inject Therapeutic L Computed Tomography 27096 G0260 LT 761 0 Pioneer Medical Center Base Price Schedule 972 LT 0 0 Pioneer Medical Center CT SI Inject Therapeutic L ANES Computed Tomography 27096 761 0 0 0 CT SI Inject Therapeutic R Computed Tomography 27096 G0260 RT 761 0 Pioneer Medical Center Base Price Schedule 972 RT 0 0 Pioneer Medical Center CT SI Inject Therapeutic R ANES Computed Tomography 27096 761 0 0 0 CT SI Inject Theraputic Bilat ANES Computed Tomography 27096 761 0 0 0 CT SI Inject for Imaging L Computed Tomography 27096 G0259 LT 361 0 Pioneer Medical Center Base Price Schedule 972 LT 0 0 CT SI Inject for Imaging R Computed Tomography 27096 G0259 RT 761 0 Pioneer Medical Center Base Price Schedule 972 RT 0 0 CT Scanogram Computed Tomography 77073 5600507 350 740 Pioneer Medical Center Base Price Schedule 2000537 972 26 0 50 Prof PMC Base Price Schedule Pioneer Medical Center CT Scapula w/ Contrast L Computed Tomography 73201 5600424 LT 350 1588.5 Pioneer Medical Center Base Price Schedule 2000297 972 26 LT 2 201.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Scapula w/ Contrast R Computed Tomography 73201 5600424 RT 350 1588.5 Pioneer Medical Center Base Price Schedule 2000297 972 26 RT 2 201.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Scapula w/wo Contrast L Computed Tomography 73202 5600416 LT 350 2213.5 Pioneer Medical Center Base Price Schedule 2000313 972 26 LT 2 209 Prof PMC Base Price Schedule Pioneer Medical Center CT Scapula w/wo Contrast R Computed Tomography 73202 5600416 RT 350 2213.5 Pioneer Medical Center Base Price Schedule 2000313 972 26 RT 2 209 Prof PMC Base Price Schedule Pioneer Medical Center CT Scapula wo Contrast L Computed Tomography 73200 5600200 LT 350 1843 Pioneer Medical Center Base Price Schedule 2000289 972 26 LT 2 177.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Scapula wo Contrast R Computed Tomography 73200 5600200 RT 350 1843 Pioneer Medical Center Base Price Schedule 2000289 972 26 RT 2 177.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Sclerotherapy Fluid Collection Perc Computed Tomography 49185 761 0 972 0 0 Pioneer Medical Center CT Sella w/ Contrast Computed Tomography 70481 5600374 350 2397 Pioneer Medical Center Base Price Schedule 2000057 972 26 0 236.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Sella w/ Coronals wo Contrast Computed Tomography 70480 5600028 350 1788.5 Pioneer Medical Center Base Price Schedule 2000040 972 26 0 220.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Shoulder Arthrogram L Computed Tomography 73201 LT 350 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center CT Shoulder Arthrogram R Computed Tomography 73201 RT 350 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center CT Shoulder Inj L Computed Tomography 77012 LT 350 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 CT Shoulder Inj R Computed Tomography 77012 RT 350 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 CT Shoulder w/ Contrast L Computed Tomography 73201 5600424 LT 350 1588.5 Pioneer Medical Center Base Price Schedule 2000297 972 26 LT 2 201.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Shoulder w/ Contrast R Computed Tomography 73201 5600424 RT 350 1588.5 Pioneer Medical Center Base Price Schedule 2000297 972 26 RT 2 201.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Shoulder w/wo Contrast L Computed Tomography 73202 5600416 LT 350 2213.5 Pioneer Medical Center Base Price Schedule 2000313 972 26 LT 2 209 Prof PMC Base Price Schedule Pioneer Medical Center CT Shoulder w/wo Contrast R Computed Tomography 73202 5600416 RT 350 2213.5 Pioneer Medical Center Base Price Schedule 2000313 972 26 RT 2 209 Prof PMC Base Price Schedule Pioneer Medical Center CT Shoulder wo Contrast L Computed Tomography 73200 5600200 LT 350 1843 Pioneer Medical Center Base Price Schedule 2000289 972 26 LT 2 177.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Shoulder wo Contrast R Computed Tomography 73200 5600200 RT 350 1843 Pioneer Medical Center Base Price Schedule 2000289 972 26 RT 2 177.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Sinus Limited Computed Tomography 76380 5600382 350 1292 Pioneer Medical Center Base Price Schedule 2000446 972 26 0 168.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Sinus w/ Contrast Computed Tomography 70487 5600358 350 1903 Pioneer Medical Center Base Price Schedule 2000081 972 26 0 226 Prof PMC Base Price Schedule Pioneer Medical Center CT Sinus w/wo Contrast Computed Tomography 70488 5600440 350 2213.5 Pioneer Medical Center Base Price Schedule 2000479 972 26 0 206 Prof PMC Base Price Schedule Pioneer Medical Center CT Sinus wo Contrast Computed Tomography 70486 5600036 350 1452 Pioneer Medical Center Base Price Schedule 2000073 972 26 0 195.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Soft Tissue Fluid Drainage Computed Tomography 10030 761 0 972 0 0 Pioneer Medical Center CT Soft Tissue Neck w/ Contrast Computed Tomography 70491 5600044 350 2277 Pioneer Medical Center Base Price Schedule 2000107 972 26 0 236.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Soft Tissue Neck w/wo Contrast Computed Tomography 70492 5600457 350 1971 Pioneer Medical Center Base Price Schedule 2000487 972 26 0 206 Prof PMC Base Price Schedule Pioneer Medical Center CT Soft Tissue Neck wo Contrast Computed Tomography 70490 5600390 350 2030.5 Pioneer Medical Center Base Price Schedule 2000099 972 26 0 220.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Spine Inj Intrathecal Contrast Computed Tomography 77012 350 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 CT Stealth C Spine wo Contrast Computed Tomography 77011 350 0 Pioneer Medical Center Base Price Schedule 0 0 CT Stealth Head w/ Contrast Computed Tomography 77011 350 0 Pioneer Medical Center Base Price Schedule 0 0 CT Stealth Head wo Contrast Computed Tomography 77011 350 0 Pioneer Medical Center Base Price Schedule 0 0 CT Stealth L Spine wo Contrast Computed Tomography 77011 350 0 Pioneer Medical Center Base Price Schedule 0 0 CT Stealth Sinus w/ Contrast Computed Tomography 77011 350 0 0 0 CT Stealth Sinus wo Contrast Computed Tomography 77011 350 0 Pioneer Medical Center Base Price Schedule 0 0 CT Stealth T Spine wo Contrast Computed Tomography 77011 350 0 Pioneer Medical Center Base Price Schedule 0 0 CT Stereotactic Localization Computed Tomography 77011 350 0 Pioneer Medical Center Base Price Schedule 0 0 Pioneer Medical Center CT Sternum w/ Contrast Computed Tomography 71260 5600093 350 2161 Pioneer Medical Center Base Price Schedule 2000149 972 26 0 213 Prof PMC Base Price Schedule Pioneer Medical Center CT Sternum w/wo Contrast Computed Tomography 71270 5600432 350 3135.5 Pioneer Medical Center Base Price Schedule 2000214 972 26 0 235.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Sternum wo Contrast Computed Tomography 71250 5600085 350 1854.5 Pioneer Medical Center Base Price Schedule 2000131 972 26 0 177.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Subdiaphramatic Abscess Drain Computed Tomography 49405 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center CT T Spine w/ Contrast Computed Tomography 72129 5600523 350 2576 Pioneer Medical Center Base Price Schedule 2000552 972 26 0 287.5 Prof PMC Base Price Schedule Pioneer Medical Center CT T Spine w/wo Contrast Computed Tomography 72130 350 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center CT T Spine wo Contrast Computed Tomography 72128 5600408 350 2062 Pioneer Medical Center Base Price Schedule 2000198 972 26 0 172 Prof PMC Base Price Schedule Pioneer Medical Center CT Temporal Bones w/ Contrast Computed Tomography 70481 5600374 350 2397 Pioneer Medical Center Base Price Schedule 2000057 972 26 0 236.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Temporal Bones w/wo Contrast Computed Tomography 70482 5600366 350 2768 Pioneer Medical Center Base Price Schedule 2000065 972 26 0 249 Prof PMC Base Price Schedule Pioneer Medical Center CT Temporal Bones wo Contrast Computed Tomography 70480 5600028 350 1788.5 Pioneer Medical Center Base Price Schedule 2000040 972 26 0 220.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Therapy Planning Computed Tomography 77014 350 0 Pioneer Medical Center Base Price Schedule 0 0 Pioneer Medical Center CT Thoracentesis Computed Tomography 32555 761 0 972 0 0 Pioneer Medical Center CT Tib-Fib w/ Contrast L Computed Tomography 73701 5600341 LT 350 1746.5 Pioneer Medical Center Base Price Schedule 2000347 972 26 LT 2 201.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Tib-Fib w/ Contrast R Computed Tomography 73701 5600341 RT 350 1746.5 Pioneer Medical Center Base Price Schedule 2000347 972 26 RT 2 201.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Tib-Fib w/wo Contrast L Computed Tomography 73702 5600333 LT 350 2583.5 Pioneer Medical Center Base Price Schedule 2000354 972 26 LT 2 209 Prof PMC Base Price Schedule Pioneer Medical Center CT Tib-Fib w/wo Contrast R Computed Tomography 73702 5600333 RT 350 2583.5 Pioneer Medical Center Base Price Schedule 2000354 972 26 RT 2 209 Prof PMC Base Price Schedule Pioneer Medical Center CT Tib-Fib wo Contrast L Computed Tomography 73700 5600218 LT 350 1696.5 Pioneer Medical Center Base Price Schedule 2000339 972 26 LT 2 174 Prof PMC Base Price Schedule Pioneer Medical Center CT Tib-Fib wo Contrast R Computed Tomography 73700 5600218 RT 350 1696.5 Pioneer Medical Center Base Price Schedule 2000339 972 26 RT 2 174 Prof PMC Base Price Schedule Pioneer Medical Center CT Transforaminal ESI Lumbar Computed Tomography 64483 761 0 972 0 0 CT Transforaminal ESI Lumbar Bilateral Computed Tomography 64483 50 761 0 972 50 0 0 CT Trigger Point Muscle Inj Computed Tomography 77012 350 0 972 26 0 0 Pioneer Medical Center CT Unlisted Procedure Computed Tomography 76497 350 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 CT Veterinary Computed Tomography 76497 350 0 0 0 CT Visceral Abscess Drain Computed Tomography 49405 761 0 972 0 0 Pioneer Medical Center CT Wrist Arthrogram L Computed Tomography 73201 LT 350 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center CT Wrist Arthrogram R Computed Tomography 73201 RT 350 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center CT Wrist Inj L Computed Tomography 77012 LT 350 0 972 26 LT 2 0 CT Wrist Inj R Computed Tomography 77012 RT 350 0 972 26 RT 2 0 CT Wrist w/ Contrast L Computed Tomography 73201 5600424 LT 350 1588.5 Pioneer Medical Center Base Price Schedule 2000297 972 26 LT 2 201.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Wrist w/ Contrast R Computed Tomography 73201 5600424 RT 350 1588.5 Pioneer Medical Center Base Price Schedule 2000297 972 26 RT 2 201.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Wrist w/wo Contrast L Computed Tomography 73202 5600416 LT 350 2213.5 Pioneer Medical Center Base Price Schedule 2000313 972 26 LT 2 209 Prof PMC Base Price Schedule Pioneer Medical Center CT Wrist w/wo Contrast R Computed Tomography 73202 5600416 RT 350 2213.5 Pioneer Medical Center Base Price Schedule 2000313 972 26 RT 2 209 Prof PMC Base Price Schedule Pioneer Medical Center CT Wrist wo Contrast L Computed Tomography 73200 5600200 LT 350 1843 Pioneer Medical Center Base Price Schedule 2000289 972 26 LT 2 177.5 Prof PMC Base Price Schedule Pioneer Medical Center CT Wrist wo Contrast R Computed Tomography 73200 5600200 RT 350 1843 Pioneer Medical Center Base Price Schedule 2000289 972 26 RT 2 177.5 Prof PMC Base Price Schedule Pioneer Medical Center DV AICD Interrogation/In Dept Cardiac Device Check 93289 480 0 972 26 0 0 DV AICD Interrogation/Remote Cardiac Device Check 93298 480 0 972 0 0 DV AICD PeriPX Eval/Program/In Dept Cardiac Device Check 93287 480 0 972 26 0 0 DV AICD Program Dual Lead/In Dept Cardiac Device Check 93283 480 0 972 26 0 0 DV AICD Program Multi Lead/In Dept Cardiac Device Check 93284 480 0 972 26 0 0 DV AICD Program Single Lead/In Dept Cardiac Device Check 93282 480 0 972 26 0 0 DV ILR Interrogation Eval/In Dept Cardiac Device Check 93291 480 0 972 26 0 0 DV ILR Interrogation/Remote Cardiac Device Check 93298 480 0 972 0 0 DV ILR Program/In Dept Cardiac Device Check 93285 480 0 972 26 0 0 DV ILR Program/Remote Cardiac Device Check 0650T 480 0 972 0 0 DV Pacemaker Interrogation/In Dept Cardiac Device Check 93288 480 0 972 26 0 0 DV Pacemaker Interrogation/Remote Cardiac Device Check 93294 480 0 972 0 0 DV Pacemaker PeriPX Eval/Program/In Dept Cardiac Device Check 93286 480 0 972 26 0 0 DV Pacemaker Program Dual Lead/In Dept Cardiac Device Check 93280 480 0 972 26 0 0 DV Pacemaker Program Multi Lead/In Dept Cardiac Device Check 93281 480 0 972 26 0 0 DV Pacemaker Program Single Lead/In Dept Cardiac Device Check 93279 480 0 972 26 0 0 DV Pacemaker TTM Check Cardiac Device Check 93293 480 0 972 26 0 0 Pioneer Medical Center DV SICD Interrogation/In Dept Cardiac Device Check 93261 480 0 972 26 0 0 DV SICD Program/In Dept Cardiac Device Check 93260 480 0 26 0 0 EC 3D Echocardiogram Complete Echocardiography 93306 6007314 483 2581.5 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center EC Echo Congenital Complete Echocardiography 93303 483 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center EC Echo Congenital Limited Echocardiography 93304 483 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center EC Echo w/o Doppler/Color Flow Echocardiography 93307 6007108 483 2088.5 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center EC Echocardiogram Bubble Echocardiography 93306 6007314 483 2581.5 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center EC Echocardiogram Complete Echocardiography 93306 6007314 483 2581.5 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center EC Echocardiogram Contrast Echocardiography 93306 6007314 483 2581.5 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center EC Echocardiogram Limited Echocardiography 93308 6007405 483 1009 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center EC Echocardiogram Stress Echocardiography 93351 483 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center EC Echocardiogram Stress by APP Echocardiography 93350 482 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center EC Echocardiogram Stress by APP Contrast Echocardiography 93350 483 0 972 26 0 0 Pioneer Medical Center EC Echocardiogram Stress w/ Contrast Echocardiography 93351 483 0 972 26 0 0 Pioneer Medical Center EC Fetal Echo Limited/Follow Up Echocardiography 76826 483 0 972 26 0 0 Pioneer Medical Center EC Fetal Echocardiogram Echocardiography 76825 483 0 972 26 0 0 Pioneer Medical Center EC Pericardiocentesis Echocardiography 33016 761 0 972 0 0 Pioneer Medical Center EC Read Outside Films Echocardiography 76140 0 972 0 0 EC TEE for Interventional Guidance Echocardiography 93355 483 0 972 0 0 Pioneer Medical Center EC TEE for Monitoring Echocardiography 93318 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center EC Transesophageal Congenital Echocardiography 93315 483 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center EC Transesophageal Echo Echocardiography 93312 483 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center EK Electrocardiogram Complete ECG 93010 6009203 730 238.5 Pioneer Medical Center Base Price Schedule 985 0 0 Pioneer Medical Center EK Electrocardiogram Stress ECG 93018 482 0 Pioneer Medical Center Base Price Schedule 985 0 0 Pioneer Medical Center EK Electrocardiogram Stress NC ECG 0 Pioneer Medical Center Base Price Schedule 985 0 0 Pioneer Medical Center EK Electrocardiogram Stress RX ECG 93018 482 0 Pioneer Medical Center Base Price Schedule 985 0 0 Pioneer Medical Center EK Signal Averaged EKG ECG 93278 730 0 Pioneer Medical Center Base Price Schedule 985 26 0 0 Pioneer Medical Center EK Welcome to Medicare EKG ECG G0403 730 0 Pioneer Medical Center Base Price Schedule 985 0 0 Pioneer Medical Center EP Ablation for AV Node Electrophysiology 93650 481 0 Pioneer Medical Center Base Price Schedule 972 0 0 EP Ablation for Atrial Fibrillation Electrophysiology 93656 481 0 Pioneer Medical Center Base Price Schedule 972 0 0 EP Ablation for Atrial Flutter Electrophysiology 93653 481 0 Pioneer Medical Center Base Price Schedule 972 0 0 EP Ablation for PVC Electrophysiology 93654 481 0 972 0 0 EP Ablation for SVT Electrophysiology 93653 481 0 Pioneer Medical Center Base Price Schedule 972 0 0 EP Ablation for VT Electrophysiology 93654 481 0 Pioneer Medical Center Base Price Schedule 972 0 0 EP Ablation for WPW Electrophysiology 93653 481 0 Pioneer Medical Center Base Price Schedule 972 0 0 EP Eval of ICD Leads w/ DFTs Electrophysiology 93641 481 0 0 0 EP Eval w/ Induct Arrhythmia Electrophysiology 93620 481 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 EP Eval wo Induct Arrhythmia Electrophysiology 93619 481 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 EP Follow Up Electrophysiology 93624 481 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 EP ICD Eval Electrophysiology 93642 481 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 EP Loop Recorder Explant Electrophysiology 33286 481 0 Pioneer Medical Center Base Price Schedule 972 0 0 EP Loop Recorder Implant Electrophysiology 33285 481 0 Pioneer Medical Center Base Price Schedule 972 0 0 EP Tilt Table Study Electrophysiology 93660 481 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 HC ASD Repair Heart Cath 93580 481 0 Pioneer Medical Center Base Price Schedule 972 0 0 HC Ather/BMS Stent LAD Initial Heart Cath 92933 LD 481 0 972 LD 0 0 HC Ather/BMS Stent LT Circ Initial Heart Cath 92933 LC 481 0 972 LC 0 0 HC Ather/BMS Stent LT Main Initial Heart Cath 92933 LM 481 0 972 LM 0 0 HC Ather/BMS Stent RCA Initial Heart Cath 92933 RC 481 0 972 RC 0 0 HC Ather/BMS Stent Ramus Initial Heart Cath 92933 RI 481 0 972 RI 0 0 HC Ather/DES Stent LAD Initial Heart Cath 92933 LD 481 0 972 LD 0 0 HC Ather/DES Stent LT Circ Initial Heart Cath 92933 LC 481 0 972 LC 0 0 HC Ather/DES Stent LT Main Initial Heart Cath 92933 LM 481 0 972 LM 0 0 HC Ather/DES Stent RCA Initial Heart Cath 92933 RC 481 0 972 RC 0 0 HC Ather/DES Stent Ramus Initial Heart Cath 92933 RI 481 0 972 RI 0 0 HC Atherectomy LAD Initial Heart Cath 92924 LD 481 0 972 LD 0 0 HC Atherectomy LT Circumflex Initial Heart Cath 92924 LC 481 0 972 LC 0 0 HC Atherectomy LT Main Initial Heart Cath 92924 LM 481 0 972 LM 0 0 HC Atherectomy RCA Initial Heart Cath 92924 RC 481 0 972 RC 0 0 HC Atherectomy Ramus Initial Heart Cath 92924 RI 481 0 972 RI 0 0 HC BMS Stent LAD Initial Heart Cath 92928 LD 481 0 Pioneer Medical Center Base Price Schedule 972 LD 0 0 HC BMS Stent LT Circumflex Initial Heart Cath 92928 LC 481 0 Pioneer Medical Center Base Price Schedule 972 LC 0 0 HC BMS Stent LT Main Initial Heart Cath 92928 LM 481 0 972 LM 0 0 HC BMS Stent RT Coronary Initial Heart Cath 92928 RC 481 0 Pioneer Medical Center Base Price Schedule 972 RC 0 0 HC BMS Stent Ramus Initial Heart Cath 92928 RI 481 0 972 RI 0 0 HC BMS Stent/PCI CTO LAD Initial Heart Cath 92943 LD 481 0 972 LD 0 0 HC BMS Stent/PCI CTO LT Circ Initial Heart Cath 92943 LC 481 0 972 LC 0 0 HC BMS Stent/PCI CTO LT Main Initial Heart Cath 92943 LM 481 0 972 LM 0 0 HC BMS Stent/PCI CTO RCA Initial Heart Cath 92943 RC 481 0 972 RC 0 0 HC BMS Stent/PCI CTO Ramus Initial Heart Cath 92943 RI 481 0 972 RI 0 0 HC BMS Stent/PCI Graft LAD Initial Heart Cath 92937 LD 481 0 972 LD 0 0 HC BMS Stent/PCI Graft LT Circ Initial Heart Cath 92937 LC 481 0 972 LC 0 0 HC BMS Stent/PCI Graft LT Main Initial Heart Cath 92937 LM 481 0 972 LM 0 0 HC BMS Stent/PCI Graft RCA Initial Heart Cath 92937 RC 481 0 972 RC 0 0 HC BMS Stent/PCI Graft Ramus Initial Heart Cath 92937 RI 481 0 972 RI 0 0 HC BMS Stent/PCI Ttl/Subttl Occl LAD Heart Cath 92941 LD 481 0 972 LD 0 0 HC BMS Stent/PCI Ttl/Subttl Occl LCA Heart Cath 92941 LC 481 0 972 LC 0 0 HC BMS Stent/PCI Ttl/Subttl Occl LM Heart Cath 92941 LM 481 0 972 LM 0 0 HC BMS Stent/PCI Ttl/Subttl Occl RCA Heart Cath 92941 RC 481 0 972 RC 0 0 HC BMS Stent/PCI Ttl/Subttl Occl Ramus Heart Cath 92941 RI 481 0 972 RI 0 0 HC Cardiac Fluoroscopy Heart Cath 76000 481 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 HC Cardioversion Heart Cath 92960 481 0 Pioneer Medical Center Base Price Schedule 972 0 0 HC Coronary Angiography Heart Cath 93454 481 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 HC Cors and Grafts Heart Cath 93455 481 0 972 26 0 0 HC Cors with RT Heart Cath Heart Cath 93456 481 0 972 26 0 0 HC Cors/Grafts w/ RT Heart Cath Heart Cath 93457 481 0 972 26 0 0 HC DES Stent LAD Initial Heart Cath 92928 LD 481 0 Pioneer Medical Center Base Price Schedule 972 LD 0 0 HC DES Stent LT Circumflex Initial Heart Cath 92928 LC 481 0 Pioneer Medical Center Base Price Schedule 972 LC 0 0 HC DES Stent LT Main Initial Heart Cath 92928 LM 481 0 972 LM 0 0 HC DES Stent RT Coronary Initial Heart Cath 92928 RC 481 0 Pioneer Medical Center Base Price Schedule 972 RC 0 0 HC DES Stent Ramus Initial Heart Cath 92928 RI 481 0 972 RI 0 0 HC DES Stent/PCI CTO LAD Initial Heart Cath 92943 LD 481 0 972 LD 0 0 HC DES Stent/PCI CTO LT Circ Initial Heart Cath 92943 LC 481 0 972 LC 0 0 HC DES Stent/PCI CTO LT Main Initial Heart Cath 92943 LM 481 0 972 LM 0 0 HC DES Stent/PCI CTO RCA Initial Heart Cath 92943 RC 481 0 972 RC 0 0 HC DES Stent/PCI CTO Ramus Initial Heart Cath 92943 RI 481 0 972 RI 0 0 HC DES Stent/PCI Graft LAD Initial Heart Cath 92937 LD 481 0 972 LD 0 0 HC DES Stent/PCI Graft LT Circ Initial Heart Cath 92937 LC 481 0 972 LC 0 0 HC DES Stent/PCI Graft LT Main Initial Heart Cath 92937 LM 481 0 972 LM 0 0 HC DES Stent/PCI Graft RCA Initial Heart Cath 92937 RC 481 0 972 RC 0 0 HC DES Stent/PCI Graft Ramus Initial Heart Cath 92937 RI 481 0 972 RI 0 0 HC DES Stent/PCI Ttl/Subttl Occl LAD Heart Cath 92941 LD 481 0 972 LD 0 0 HC DES Stent/PCI Ttl/Subttl Occl LCA Heart Cath 92941 LC 481 0 972 LC 0 0 HC DES Stent/PCI Ttl/Subttl Occl LM Heart Cath 92941 LM 481 0 972 LM 0 0 HC DES Stent/PCI Ttl/Subttl Occl RCA Heart Cath 92941 RC 481 0 972 RC 0 0 HC DES Stent/PCI Ttl/Subttl Occl Ramus Heart Cath 92941 RI 481 0 972 RI 0 0 HC Endomyocardial Biopsy Heart Cath 93505 481 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 HC Heart Cath Procedure Request Heart Cath 0 Pioneer Medical Center Base Price Schedule 0 0 HC Insert Vent Assist Device LT Heart Heart Cath 33990 481 0 972 0 0 HC Insert Vent Assist Device RT Heart Heart Cath 33995 481 0 972 0 0 HC Intra-Aortic Balloon Placement Heart Cath 33967 481 0 Pioneer Medical Center Base Price Schedule 972 0 0 HC LAA Closure Heart Cath 33340 481 0 972 0 0 HC LT Heart Cath LV/Cor/Grafts Heart Cath 93459 481 0 972 26 0 0 HC LT Heart Cath LV/Cors Heart Cath 93458 481 0 972 26 0 0 HC LT/RT Retrograde for CCA Heart Cath 481 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 HC Left Heart Cath Heart Cath 93452 481 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 HC PCI Acute MI Revascularization Heart Cath 92941 481 0 972 0 0 HC PCI Angioplasty Heart Cath 92920 481 0 972 0 0 HC PCI CTO Revascularization Heart Cath 92943 481 0 972 0 0 HC PCI Definite Request Heart Cath 0 Pioneer Medical Center Base Price Schedule 0 0 HC PCI Graft Revascularization Heart Cath 92937 481 0 972 0 0 HC PCI Stent Placement Heart Cath 92928 481 0 972 0 0 HC PCI Stent/Atherectomy Heart Cath 92933 481 0 972 0 0 HC PFO Repair Heart Cath 93580 481 0 972 0 0 HC PTCA CTO LAD Initial Heart Cath 92943 LD 481 0 972 LD 0 0 HC PTCA CTO LT Circ Initial Heart Cath 92943 LC 481 0 972 LC 0 0 HC PTCA CTO LT Main Initial Heart Cath 92943 LM 481 0 972 LM 0 0 HC PTCA CTO RCA Initial Heart Cath 92943 RC 481 0 972 RC 0 0 HC PTCA CTO Ramus Initial Heart Cath 92943 RI 481 0 972 RI 0 0 HC PTCA Graft LAD Initial Heart Cath 92937 LD 481 0 972 LD 0 0 HC PTCA Graft LT Circumflex Initial Heart Cath 92937 LC 481 0 972 LC 0 0 HC PTCA Graft LT Main Initial Heart Cath 92937 LM 481 0 972 LM 0 0 HC PTCA Graft RCA Initial Heart Cath 92937 RC 481 0 972 RC 0 0 HC PTCA Graft Ramus Initial Heart Cath 92937 RI 481 0 972 RI 0 0 HC PTCA LAD Initial Heart Cath 92920 LD 481 0 Pioneer Medical Center Base Price Schedule 972 LD 0 0 HC PTCA LT Circumflex Initial Heart Cath 92920 LC 481 0 Pioneer Medical Center Base Price Schedule 972 LC 0 0 HC PTCA LT Main Initial Heart Cath 92920 LM 481 0 972 LM 0 0 HC PTCA RT Coronary Initial Heart Cath 92920 RC 481 0 Pioneer Medical Center Base Price Schedule 972 RC 0 0 HC PTCA Ramus Initial Heart Cath 92920 RI 481 0 972 RI 0 0 HC PTCA Ttl/Subttl Occlusion LAD Heart Cath 92941 LD 481 0 972 LD 0 0 HC PTCA Ttl/Subttl Occlusion LCA Heart Cath 92941 LC 481 0 972 LC 0 0 HC PTCA Ttl/Subttl Occlusion LM Heart Cath 92941 LM 481 0 972 LM 0 0 HC PTCA Ttl/Subttl Occlusion RCA Heart Cath 92941 RC 481 0 972 RC 0 0 HC PTCA Ttl/Subttl Occlusion Ramus Heart Cath 92941 RI 481 0 972 RI 0 0 HC PVL Aortic Valve Heart Cath 93591 481 0 972 0 0 HC PVL Mitral Valve Heart Cath 93590 481 0 972 0 0 HC Pericardial Drain Placement Heart Cath 33017 481 0 972 26 0 0 HC Pericardiocentesis Heart Cath 33016 481 0 Pioneer Medical Center Base Price Schedule 972 0 0 HC Peripheral Angio Request Heart Cath 0 Pioneer Medical Center Base Price Schedule 0 0 HC Pressure Sensor Implant PA w/ RHC Heart Cath 33289 481 0 972 0 0 HC RT Congenital Anomalies Heart Cath 481 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 HC RT and LT Heart Cath LV Gram Heart Cath 93453 481 0 972 26 0 0 HC RT and LT Heart Cath LV/Cor/Grafts Heart Cath 93461 481 0 972 26 0 0 HC RT and LT Heart Cath LV/Cors Heart Cath 93460 481 0 972 26 0 0 HC Read Outside Films Heart Cath 76140 0 972 0 0 HC Removal Intra-Aortic Balloon Perc Heart Cath 33968 481 0 972 0 0 HC Removal Ventricular Assist Device Heart Cath 33992 481 0 972 0 0 HC Reposition Ventricular Assist Device Heart Cath 33993 481 0 972 0 0 HC Right Heart Cath Heart Cath 93451 481 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 HC Septal Reduction Therapy w/ LHC Heart Cath 93583 481 0 972 26 0 0 HC Swan-Ganz Catheter Placement Heart Cath 93503 481 0 Pioneer Medical Center Base Price Schedule 972 0 0 HC TAVR Open Axillary Artery Heart Cath 33363 360 0 972 62 0 0 HC TAVR Open Femoral Artery Heart Cath 33362 360 0 972 62 0 0 HC TAVR Open Iliac Artery Heart Cath 33364 360 0 972 62 0 0 HC TAVR Percutaneous Femoral Art Heart Cath 33361 360 0 972 62 0 0 HC TAVR Subclavian Heart Cath 33999 360 0 972 62 0 0 HC TAVR Transaortic Heart Cath 33365 360 0 972 62 0 0 HC TAVR Transapical Heart Cath 33366 360 0 972 62 0 0 HC TAVR Transcarotid Heart Cath 33999 360 0 972 62 0 0 HC TMV Implant Heart Cath 0483T 360 0 972 0 0 HC TMV Repair Initial Prosthesis Heart Cath 33418 360 0 972 0 0 HC TTV Repair Initial Prosthesis Heart Cath 0569T 360 0 972 0 0 HC Temporary Transvenous Pacemaker Heart Cath 33210 481 0 Pioneer Medical Center Base Price Schedule 972 0 0 HC Valvuloplasty Aortic Balloon Perc Heart Cath 92986 481 0 972 0 0 HC Valvuloplasty Mitral Balloon Perc Heart Cath 92987 481 0 972 0 0 HC Vascular Surgery Unlisted Heart Cath 37799 481 0 972 0 0 IR AV Dialysis Shunt Interventional Radiology 0 0 0 IR AV Dialysis Shunt New Access Interventional Radiology 36901 320 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR AV Dialysis Shunt Post Dialysis Interventional Radiology 36901 52 320 0 Pioneer Medical Center Base Price Schedule 972 52 0 0 IR Abdominal Aortagram Interventional Radiology 75625 323 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Abdominal Aortagram w/ Runoff Interventional Radiology 75630 323 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Abdominal/Retroperitoneal BX Interventional Radiology 77002 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Abscess Drain Empyema/Hemothorax Interventional Radiology 75989 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Abscess Drain Miscellaneous Interventional Radiology 75989 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Abscess Drain Perirenal or Renal Interventional Radiology 49405 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR Abscess Drain Peritoneal Interventional Radiology 49406 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR Abscess Drain Retroperitoneal Interventional Radiology 49406 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR Abscess Drain Subdiaphramatic Interventional Radiology 49405 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR Abscess Drainage Catheter Change Interventional Radiology 75984 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Abscess or Cyst Drain Hepatomy Interventional Radiology 49405 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR Adrenal Angiography Bilateral Interventional Radiology 75733 323 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Adrenal Angiography Unilateral L Interventional Radiology 75731 LT 323 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 IR Adrenal Angiography Unilateral R Interventional Radiology 75731 RT 323 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 IR Adrenal Venography Bilateral Interventional Radiology 75842 323 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Adrenal Venography Unilateral L Interventional Radiology 75840 LT 320 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 IR Adrenal Venography Unilateral R Interventional Radiology 75840 RT 320 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 IR Angio through Existing Catheter Interventional Radiology 75898 323 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Angiogram/Interventional Procedure Interventional Radiology 0 Pioneer Medical Center Base Price Schedule 0 0 IR Antegrade Pyelogram Interventional Radiology 50430 320 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR Atherectomy Peripheral Artery Interventional Radiology 0 0 0 IR Atherectomy Peripheral Artery addtl Interventional Radiology 0 0 0 IR Atherectomy Renal Artery Interventional Radiology 0 0 0 IR Atherectomy Visceral Artery Interventional Radiology 0 0 0 IR Atherectomy Visceral Artery addtl Interventional Radiology 0 0 0 IR BX Bone Deep Interventional Radiology 77002 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR BX Bone Superficial Interventional Radiology 77002 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR BX Liver Interventional Radiology 77002 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR BX Liver w/ Other Major Procedure Interventional Radiology 77002 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR BX Lung Interventional Radiology 77002 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR BX Muscle Interventional Radiology 77002 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR BX Pancreas Interventional Radiology 77002 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR BX Pleura Interventional Radiology 77002 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR BX Prostate Interventional Radiology 77002 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR BX Renal Interventional Radiology 77002 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Balloon Occlusion Temp Head/Neck Interventional Radiology 61623 761 0 972 0 0 IR Biliary Convert Ext to Int/Ext Drain Interventional Radiology 47535 320 0 972 0 0 IR Biliary Convert Int/Ext to Ext Drain Interventional Radiology 47536 320 0 972 0 0 IR Biliary Drain Int/Ext Cath Placement Interventional Radiology 47534 320 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR Biliary Drainage Catheter Change Interventional Radiology 75984 323 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Biliary Drainage Percutaneous Interventional Radiology 47533 320 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR Biliary Drainage Removal w/ Fluoro Interventional Radiology 47537 320 0 972 0 0 IR Biliary Duct Dilitation w/ Stent Interventional Radiology 74363 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Biliary Duct Dilitation w/o Stent Interventional Radiology 74363 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Biliary Exchange Ext Drain Cath Interventional Radiology 47536 320 0 972 0 0 IR Biliary Stent Existing Access Interventional Radiology 47538 320 0 972 0 0 IR Biliary Stent New Access Interventional Radiology 47539 320 0 972 0 0 IR Biliary Stent New Access w/ Drain Interventional Radiology 47540 320 0 972 0 0 IR Biliary Stonebasket via T Tube Interventional Radiology 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Biliary Tree Access Small Bowel Perc Interventional Radiology 47541 320 0 972 0 0 IR Biopsy Transcatheter Interventional Radiology 75970 323 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Brachial Retrograde L Interventional Radiology 75710 LT 323 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 IR Brachial Retrograde R Interventional Radiology 75710 RT 323 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 IR Carotid Cerebral Bilateral Interventional Radiology 323 0 Pioneer Medical Center Base Price Schedule 0 0 IR Carotid Cerebral Unilateral L Interventional Radiology 323 0 Pioneer Medical Center Base Price Schedule 0 0 IR Carotid Cerebral Unilateral R Interventional Radiology 323 0 Pioneer Medical Center Base Price Schedule 0 0 IR Carotid Cervical Bilateral Interventional Radiology 323 0 Pioneer Medical Center Base Price Schedule 0 0 IR Carotid Cervical Unilateral L Interventional Radiology 323 0 Pioneer Medical Center Base Price Schedule 0 0 IR Carotid Cervical Unilateral R Interventional Radiology 323 0 Pioneer Medical Center Base Price Schedule 0 0 IR Carotid External Bilateral Interventional Radiology 323 0 Pioneer Medical Center Base Price Schedule 0 0 IR Carotid External Unilateral L Interventional Radiology 323 0 Pioneer Medical Center Base Price Schedule 0 0 IR Carotid External Unilateral R Interventional Radiology 320 0 Pioneer Medical Center Base Price Schedule 0 0 IR Carotid Extracrani/Cmn Carotid Inj Bi Interventional Radiology 36222 50 761 0 Pioneer Medical Center Base Price Schedule 972 50 0 0 IR Carotid Extracrani/Cmn Carotid Inj L Interventional Radiology 36222 LT 761 0 Pioneer Medical Center Base Price Schedule 972 LT 0 0 IR Carotid Extracrani/Cmn Carotid Inj R Interventional Radiology 36222 RT 761 0 Pioneer Medical Center Base Price Schedule 972 RT 0 0 IR Carotid Intracrani/Cmn Carotid Inj Bi Interventional Radiology 36223 50 761 0 Pioneer Medical Center Base Price Schedule 972 50 0 0 IR Carotid Intracrani/Cmn Carotid Inj L Interventional Radiology 36223 LT 761 0 Pioneer Medical Center Base Price Schedule 972 LT 0 0 IR Carotid Intracrani/Cmn Carotid Inj R Interventional Radiology 36223 RT 761 0 Pioneer Medical Center Base Price Schedule 972 RT 0 0 IR Carotid Intracrani/Int Carotid Inj Bi Interventional Radiology 36224 50 761 0 Pioneer Medical Center Base Price Schedule 972 50 0 0 IR Carotid Intracrani/Int Carotid Inj L Interventional Radiology 36224 LT 761 0 Pioneer Medical Center Base Price Schedule 972 LT 0 0 IR Carotid Intracrani/Int Carotid Inj R Interventional Radiology 36224 RT 761 0 Pioneer Medical Center Base Price Schedule 972 RT 0 0 IR Carotid Stent Interventional Radiology 37215 361 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR Carotid/Vertebral Non-selective Interventional Radiology 36221 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR Cath Patency Check Central Venous Interventional Radiology 36598 361 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR Cecostomy Tube Place w/ Fluoro Interventional Radiology 49442 320 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR Cervicocerebral Arch Interventional Radiology 36221 323 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR Chemo Embolization Interventional Radiology 75894 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Cholecystostomy Percutaneous Interventional Radiology 47490 320 0 972 0 0 IR Consult for Vertebroplasty Interventional Radiology 0 Pioneer Medical Center Base Price Schedule 0 0 IR Diskography Cervical or Thoracic Interventional Radiology 72285 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Diskography Lumbar Interventional Radiology 72295 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Duod/Jej Tube Place w/ Fluoro Interventional Radiology 49441 320 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR Duod/Jej Tube Replace w/ Fluoro Interventional Radiology 49451 320 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR Embolization Arterial Non Hemorrhage Interventional Radiology 37242 361 0 972 0 0 Pioneer Medical Center IR Embolization Hemorrhage/Lymph Extrav Interventional Radiology 37244 361 0 972 0 0 Pioneer Medical Center IR Embolization Transcatheter Interventional Radiology 75894 323 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Embolization Tumor/Organ Ischemia Interventional Radiology 37243 361 0 972 0 0 Pioneer Medical Center IR Embolization Venous Non Hemorrhage Interventional Radiology 37241 361 0 972 0 0 Pioneer Medical Center IR Endovascular Extension Prosthesis Interventional Radiology 323 0 Pioneer Medical Center Base Price Schedule 972 26 62 2 0 IR Endovascular Iliac Artery Interventional Radiology 34707 323 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR Endovascular Repair Infrarenal AAA Interventional Radiology 323 0 Pioneer Medical Center Base Price Schedule 972 26 62 2 0 IR Endovascular Repair Thoracic Aorta Interventional Radiology 75956 320 0 972 26 0 0 IR Endovascular Thoracic Aorta wo Subcla Interventional Radiology 75957 323 0 972 26 0 0 IR Epidural Venography Interventional Radiology 75872 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Extremity Angiography Bilateral Interventional Radiology 75716 323 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Extremity Angiography Unilateral L Interventional Radiology 75710 LT 323 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Extremity Angiography Unilateral R Interventional Radiology 75710 RT 323 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 IR Extremity Venography Bilateral Interventional Radiology 75822 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Extremity Venography Unilateral L Interventional Radiology 75820 LT 320 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 IR Extremity Venography Unilateral R Interventional Radiology 75820 RT 320 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 IR Fem/Pop Artery Atherectomy L Interventional Radiology 37225 LT 361 0 Pioneer Medical Center Base Price Schedule 972 LT 0 0 IR Fem/Pop Artery Atherectomy R Interventional Radiology 37225 RT 361 0 Pioneer Medical Center Base Price Schedule 972 RT 0 0 IR Fem/Pop Artery Atherectomy Bilat Interventional Radiology 37225 50 761 0 972 50 0 0 IR Fem/Pop Artery PTA L Interventional Radiology 37224 LT 361 0 Pioneer Medical Center Base Price Schedule 972 LT 0 0 IR Fem/Pop Artery PTA R Interventional Radiology 37224 RT 361 0 Pioneer Medical Center Base Price Schedule 972 RT 0 0 IR Fem/Pop Artery Stent L Interventional Radiology 37226 LT 361 0 Pioneer Medical Center Base Price Schedule 972 LT 0 0 IR Fem/Pop Artery Stent R Interventional Radiology 37226 RT 361 0 Pioneer Medical Center Base Price Schedule 972 RT 0 0 IR Fem/Pop Artery Stent/Atherectomy L Interventional Radiology 37227 LT 361 0 Pioneer Medical Center Base Price Schedule 972 LT 0 0 IR Fem/Pop Artery Stent/Atherectomy R Interventional Radiology 37227 RT 361 0 Pioneer Medical Center Base Price Schedule 972 RT 0 0 IR Fluid Collection Drain Non Imaging Interventional Radiology 10140 761 0 972 0 0 IR Foreign Body Removal Transcather Interventional Radiology 37197 320 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR G-tube Change to GJ w/ Fluoro Interventional Radiology 49446 320 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR GJ Tube Replace w/ Fluoro Interventional Radiology 49452 320 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR GU Dilation/EndoUro Existing Access Interventional Radiology 50436 320 0 972 26 0 0 IR GU Dilation/EndoUro New Access Interventional Radiology 50437 320 0 972 26 0 0 IR Gastro or Jejunostomy Tube Change Interventional Radiology 75984 0 0 0 IR Gastro/Cecostomy Tube Replace w/ Fl Interventional Radiology 49450 320 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR Gastro/Colon Tube Fluoro Check Interventional Radiology 49465 320 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR Gastro/Colon Tube Obst Mat Removal Interventional Radiology 49460 361 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR Gastrostomy Tube Placement Interventional Radiology 49440 320 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR Hepatic Portography w/ Hemodynamic Interventional Radiology 75885 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Hepatic Portography w/o Hemodynamic Interventional Radiology 75887 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Hepatic Venography w/ Hemodynamic Interventional Radiology 75889 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Hepatic Venography w/o Hemodynamic Interventional Radiology 75891 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR IVC Filter Placement Interventional Radiology 37191 361 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR IVC Filter Reposition Interventional Radiology 37192 361 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR IVC Filter Retrieval Interventional Radiology 37193 361 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR IVC Venography Interventional Radiology 75825 323 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR IVUS Non Coronary Initial Vessel Interventional Radiology 37252 320 0 972 0 0 IR Iliac Artery Atherectomy L Interventional Radiology 0238T LT 361 0 Pioneer Medical Center Base Price Schedule 972 LT 0 0 IR Iliac Artery Atherectomy R Interventional Radiology 0238T RT 323 0 Pioneer Medical Center Base Price Schedule 972 RT 0 0 IR Iliac Artery PTA Initial Vessel Bilat Interventional Radiology 37220 50 361 0 972 50 0 0 IR Iliac Artery PTA Initial Vessel L Interventional Radiology 37220 LT 361 0 Pioneer Medical Center Base Price Schedule 972 LT 0 0 IR Iliac Artery PTA Initial Vessel R Interventional Radiology 37220 RT 361 0 Pioneer Medical Center Base Price Schedule 972 RT 0 0 IR Iliac Artery Stent Bilateral Interventional Radiology 37221 50 361 0 972 50 0 0 IR Iliac Artery Stent Initial L Interventional Radiology 37221 LT 361 0 Pioneer Medical Center Base Price Schedule 972 LT 0 0 IR Iliac Artery Stent Initial R Interventional Radiology 37221 RT 361 0 Pioneer Medical Center Base Price Schedule 972 RT 0 0 IR Infusion Intracranial Non Thromb Interventional Radiology 61650 320 0 972 0 0 IR Infusion Port or Cath Insertion Interventional Radiology 77001 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Infusion Port/Catheter Removal Interventional Radiology 77001 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Inj Intercostal Nerve Single Blk Bil Interventional Radiology 64420 50 761 0 972 50 0 0 IR Inj Intercostal Nerve Single Block L Interventional Radiology 64420 LT 761 0 972 26 LT 2 0 IR Inj Intercostal Nerve Single Block R Interventional Radiology 64420 RT 761 0 972 26 RT 2 0 IR Intercostal Nerve Injection Interventional Radiology 77002 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Internal Mammary Angiography Interventional Radiology 75756 323 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Intraperitoneal Cath Tunnelled Place Interventional Radiology 49418 361 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR Intraperitoneal Cath Tunnelled Remova Interventional Radiology 76000 320 0 972 26 0 0 IR Jejunostomy Tube Placement Interventional Radiology 49441 0 0 0 IR Needle Guidance Miscellaneous Interventional Radiology 77002 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Nephro Convert to NephroUreteral Cath Interventional Radiology 50434 320 0 972 0 0 IR NephroUreteral Cath Placement Perc Interventional Radiology 50433 320 0 972 0 0 IR Nephrostogram Interventional Radiology 50430 320 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR Nephrostomy Dilatation Interventional Radiology 74485 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Nephrostomy Tube Change Interventional Radiology 50435 323 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center IR Nephrostomy Tube Placement Interventional Radiology 50432 320 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR Nephrostomy Tube Placement Bilat Interventional Radiology 50432 50 320 0 972 50 0 0 IR Nephrostomy Tube Removal w/ Fluoro Interventional Radiology 50389 361 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR Orbital Venography Interventional Radiology 75880 323 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR PICC Placement Interventional Radiology 36573 320 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR PICC Placement < 5 yo Interventional Radiology 36572 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR PICC Placement by RN Interventional Radiology 0 0 0 IR PICC Removal wo Imaging Guidance Interventional Radiology 761 0 0 0 IR PICC Replacement Interventional Radiology 36584 320 0 972 0 0 IR PT Cholangiogram Interventional Radiology 47532 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR PTA Addtl Visceral Artery L Interventional Radiology 37247 LT 323 0 Pioneer Medical Center Base Price Schedule 972 LT 0 0 IR PTA Addtl Visceral Artery R Interventional Radiology 37247 RT 323 0 Pioneer Medical Center Base Price Schedule 972 RT 0 0 IR PTA Aorta Interventional Radiology 37246 323 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR PTA Brachiocephalic Arteries L Interventional Radiology 37246 LT 323 0 Pioneer Medical Center Base Price Schedule 972 LT 0 0 IR PTA Brachiocephalic Arteries R Interventional Radiology 37246 RT 323 0 Pioneer Medical Center Base Price Schedule 972 RT 0 0 IR PTA Peripheral Dial Segment L Interventional Radiology 36902 LT 323 0 972 LT 0 0 IR PTA Peripheral Dial Segment R Interventional Radiology 36902 RT 323 0 972 RT 0 0 IR PTA Pulmonary Artery Interventional Radiology 92997 323 0 972 0 0 IR PTA Renal or Visceral Artery L Interventional Radiology 37246 LT 323 0 Pioneer Medical Center Base Price Schedule 972 LT 0 0 IR PTA Renal or Visceral Artery R Interventional Radiology 37246 RT 323 0 Pioneer Medical Center Base Price Schedule 972 RT 0 0 IR PTA Subclavian/Axillary Artery L Interventional Radiology 37246 LT 323 0 972 LT 0 0 IR PTA Subclavian/Axillary Artery R Interventional Radiology 37246 RT 323 0 972 RT 0 0 IR PTA Venous L Interventional Radiology 37248 LT 323 0 Pioneer Medical Center Base Price Schedule 972 LT 0 0 IR PTA Venous R Interventional Radiology 37248 RT 323 0 Pioneer Medical Center Base Price Schedule 972 RT 0 0 IR Pelvis Angiography each vessel Interventional Radiology 75736 323 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Pleural Drain w/ Cath No Imaging Interventional Radiology 32556 761 0 972 0 0 IR Pleural Drainage w/ Cath Insertion Interventional Radiology 32557 361 0 972 0 0 IR Pulmonary Angiography Bilateral Interventional Radiology 75743 323 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Pulmonary Angiography Unilateral L Interventional Radiology 75741 LT 323 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 IR Pulmonary Angiography Unilateral R Interventional Radiology 75741 RT 323 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 IR Pulmonary Non Selective Interventional Radiology 75746 323 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR RFA Bone Tumor Interventional Radiology 20982 320 0 972 0 0 IR Removal of Intraluminal Material Interventional Radiology 75902 323 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Removal of Pericatheter Material Interventional Radiology 75901 323 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Renal Angiogram Selective Bilat Interventional Radiology 36252 323 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR Renal Angiogram Selective L Interventional Radiology 36251 LT 361 0 Pioneer Medical Center Base Price Schedule 972 LT 0 0 IR Renal Angiogram Selective R Interventional Radiology 36251 RT 361 0 Pioneer Medical Center Base Price Schedule 972 RT 0 0 IR Renal Angiogram Superselect Bilat Interventional Radiology 36254 323 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR Renal Angiogram Superselect L Interventional Radiology 36253 LT 361 0 Pioneer Medical Center Base Price Schedule 972 LT 0 0 IR Renal Angiogram Superselect R Interventional Radiology 36253 RT 361 0 Pioneer Medical Center Base Price Schedule 972 RT 0 0 IR Renal Angiography Bilateral Interventional Radiology 0 0 0 IR Renal Angiography Unilateral L Interventional Radiology LT 0 LT 2 0 IR Renal Angiography Unilateral R Interventional Radiology RT 0 RT 2 0 IR Renal Cyst Study Translumbar Interventional Radiology 74470 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Renal Venography Bilateral Interventional Radiology 75833 323 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Renal Venography Unilateral L Interventional Radiology 75831 LT 323 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 IR Renal Venography Unilateral R Interventional Radiology 75831 RT 323 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 IR SVC Venography Interventional Radiology 75827 323 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Sacroplasty Bilateral Interventional Radiology 0201T 329 0 972 0 0 Pioneer Medical Center IR Sacroplasty Unilateral L Interventional Radiology 0200T 329 0 972 0 0 Pioneer Medical Center IR Sacroplasty Unilateral R Interventional Radiology 0200T 329 0 972 0 0 Pioneer Medical Center IR Sinus or Jugular Venography Interventional Radiology 75860 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Spinal Cord or Syrinx Cyst Aspiration Interventional Radiology 77002 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Spinal Selective Angiography each ves Interventional Radiology 75705 323 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Stent Intro Arterial General Interventional Radiology 37236 361 0 972 0 0 Pioneer Medical Center IR Stent Intro Venous General Interventional Radiology 37238 361 0 972 0 0 Pioneer Medical Center IR Stent Introduction Intravascular Interventional Radiology 0 Pioneer Medical Center Base Price Schedule 0 0 IR Stent Peripheral Dial Segment L Interventional Radiology 36903 LT 323 0 972 LT 0 0 IR Stent Peripheral Dial Segment R Interventional Radiology 36903 RT 323 0 972 RT 0 0 IR Superior Sagittal Sinus Venography Interventional Radiology 75870 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR TIPS Insertion Interventional Radiology 37182 361 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR TIPS Revision Interventional Radiology 37183 361 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR Thoracic Aortagram Interventional Radiology 75605 323 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Thromb/PTA Peripheral Dial Seg L Interventional Radiology 36905 LT 323 0 972 LT 0 0 IR Thromb/PTA Peripheral Dial Seg R Interventional Radiology 36905 RT 323 0 972 RT 0 0 IR Thromb/Stent Peripheral Dial Seg L Interventional Radiology 36906 LT 323 0 972 LT 0 0 IR Thromb/Stent Peripheral Dial Seg R Interventional Radiology 36906 RT 323 0 972 RT 0 0 IR Thrombect/lysis Arterial Intracrani Interventional Radiology 61645 320 0 972 0 0 IR Thrombectomy Dialysis Circuit L Interventional Radiology 36904 LT 323 0 972 LT 0 0 IR Thrombectomy Dialysis Circuit R Interventional Radiology 36904 RT 323 0 972 RT 0 0 "IR Thrombectomy, Arterial Addtl" Interventional Radiology 37185 361 0 Pioneer Medical Center Base Price Schedule 972 0 0 "IR Thrombectomy, Arterial Initial" Interventional Radiology 37184 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 "IR Thrombectomy, Arterial Initial Bilat" Interventional Radiology 37184 50 361 0 972 50 0 0 "IR Thrombectomy, Arterial Secondary" Interventional Radiology 37186 361 0 Pioneer Medical Center Base Price Schedule 972 0 0 "IR Thrombectomy, Venous Initial" Interventional Radiology 37187 361 0 Pioneer Medical Center Base Price Schedule 972 0 0 "IR Thrombectomy, Venous Subsequent Days" Interventional Radiology 37188 361 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR Thrombolysis Arterial Interventional Radiology 37211 323 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR Thrombolysis Arterial Bilateral Interventional Radiology 37211 50 323 0 972 50 0 0 IR Thrombolysis Cessation Interventional Radiology 37214 323 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR Thrombolysis Subsequent Day Interventional Radiology 37213 323 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR Thrombolysis Vasc Device Interventional Radiology 36593 361 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR Thrombolysis Venous Interventional Radiology 37212 323 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR Tib/Peroneal Artery PTA Initial L Interventional Radiology 37228 LT 361 0 Pioneer Medical Center Base Price Schedule 972 LT 0 0 IR Tib/Peroneal Artery PTA Initial R Interventional Radiology 37228 RT 361 0 Pioneer Medical Center Base Price Schedule 972 RT 0 0 IR Tib/Peroneal Artery Stent Initial L Interventional Radiology 37230 LT 361 0 Pioneer Medical Center Base Price Schedule 972 LT 0 0 IR Tib/Peroneal Artery Stent Initial R Interventional Radiology 37230 RT 361 0 Pioneer Medical Center Base Price Schedule 972 RT 0 0 IR Tib/Peroneal Atherectomy Initial L Interventional Radiology 37229 LT 361 0 Pioneer Medical Center Base Price Schedule 972 LT 0 0 IR Tib/Peroneal Atherectomy Initial R Interventional Radiology 37229 RT 361 0 Pioneer Medical Center Base Price Schedule 972 RT 0 0 IR Tib/Peroneal Stent/Atherect Initial L Interventional Radiology 37231 LT 361 0 Pioneer Medical Center Base Price Schedule 972 LT 0 0 IR Tib/Peroneal Stent/Atherect Initial R Interventional Radiology 37231 RT 361 0 Pioneer Medical Center Base Price Schedule 972 RT 0 0 IR Ureteral BX Interventional Radiology 50606 361 0 972 0 0 "IR Ureteral Stent Ext Rem/Rep, Perc Bil" Interventional Radiology 50387 50 361 0 972 50 0 0 "IR Ureteral Stent Ext Remove/Rep, Perc" Interventional Radiology 50387 361 0 Pioneer Medical Center Base Price Schedule 972 0 0 "IR Ureteral Stent Int Removal, Perc" Interventional Radiology 50384 361 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR Ureteral Stent Int Remove/Rep Perc Interventional Radiology 50382 361 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR Ureteral Stent Place Existing Tract Interventional Radiology 50693 320 0 972 0 0 IR Ureteral Stent Place w/ Nephro Cath Interventional Radiology 50695 320 0 972 0 0 IR Ureteral Stent Place wo Nephro Cath Interventional Radiology 50694 320 0 972 0 0 IR Ureteral Stent Removal TransUrethral Interventional Radiology 50386 761 0 972 0 0 "IR Ureteral Stent w/Nephro Cath, Bilat" Interventional Radiology 50695 50 320 0 972 50 0 0 IR Ureterostomy Tube Change Interventional Radiology 75984 361 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Uterine Fibroid Embolization Interventional Radiology 37243 320 0 Pioneer Medical Center Base Price Schedule 972 0 0 IR Venogram Interventional Radiology 0 Pioneer Medical Center Base Price Schedule 0 0 IR Venous Access Device Interventional Radiology 0 Pioneer Medical Center Base Price Schedule 0 0 IR Venous Sampling/Renins Interventional Radiology 75893 323 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 IR Vertebral Artery Stent Initial Bilat Interventional Radiology 0075T 50 761 0 972 50 0 0 IR Vertebral Artery Stent Initial LT Interventional Radiology 0075T LT 761 0 972 26 LT 2 0 IR Vertebral Artery Stent Initial RT Interventional Radiology 0075T RT 761 0 972 26 RT 2 0 IR Vertebral Intracrani or Cervical L Interventional Radiology LT 323 0 Pioneer Medical Center Base Price Schedule LT 2 0 IR Vertebral Intracrani or Cervical R Interventional Radiology RT 323 0 Pioneer Medical Center Base Price Schedule RT 2 0 IR Vertebral/Subclavian Inj Bil Interventional Radiology 36225 50 320 0 Pioneer Medical Center Base Price Schedule 972 50 0 0 IR Vertebral/Subclavian Inj L Interventional Radiology 36225 LT 320 0 Pioneer Medical Center Base Price Schedule 972 LT 0 0 IR Vertebral/Subclavian Inj R Interventional Radiology 36225 RT 320 0 Pioneer Medical Center Base Price Schedule 972 RT 0 0 IR Vertebral/Vert Inj Bil Interventional Radiology 36226 50 320 0 Pioneer Medical Center Base Price Schedule 972 50 0 0 IR Vertebral/Vert Inj L Interventional Radiology 36226 LT 320 0 Pioneer Medical Center Base Price Schedule 972 LT 0 0 IR Vertebral/Vert Inj R Interventional Radiology 36226 RT 320 0 Pioneer Medical Center Base Price Schedule 972 RT 0 0 IR Vertebroplasty w/ Fluoro Interventional Radiology 0 0 0 IR Visceral Angiography each vessel Interventional Radiology 75726 323 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 MA Breast Clip Placement L Mammography 19281 401 0 972 LT 0 0 MA Breast Clip Placement R Mammography 19281 401 0 972 RT 0 0 MA Breast Localization L Mammography 19281 LT 401 0 Pioneer Medical Center Base Price Schedule 972 LT 0 0 MA Breast Localization L MG Mammography 19281 LT 401 0 Pioneer Medical Center Base Price Schedule 972 LT 0 0 MA Breast Localization R Mammography 19281 RT 401 0 Pioneer Medical Center Base Price Schedule 972 RT 0 0 MA Breast Localization R MG Mammography 19281 RT 401 0 Pioneer Medical Center Base Price Schedule 972 RT 0 0 MA Breast Surgical Specimen Mammography 76098 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 MA Breast Surgical Specimen MG Mammography 76098 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 MA Galactogram Multiple Ducts Bilat MG Mammography 77054 401 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 MA Galactogram Multiple Ducts Bilateral Mammography 77054 401 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center MA Galactogram Multiple Ducts L Mammography 77054 LT 401 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center MA Galactogram Multiple Ducts L MG Mammography 77054 401 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 MA Galactogram Multiple Ducts R Mammography 77054 RT 401 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center MA Galactogram Multiple Ducts R MG Mammography 77054 401 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 MA Galactogram Single Duct L Mammography 77053 LT 401 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center MA Galactogram Single Duct L MG Mammography 77053 401 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 MA Galactogram Single Duct R Mammography 77053 RT 401 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center MA Galactogram Single Duct R MG Mammography 77053 401 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 MA Mammogram Addtl Views L Mammography 77065 401 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 MA Mammogram Addtl Views L MG Mammography 77065 401 0 972 26 0 0 MA Mammogram Addtl Views R Mammography 77065 401 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 MA Mammogram Addtl Views R MG Mammography 77065 401 0 972 26 0 0 MA Mammogram Diag Bilat w/ Implant Mammography 77066 401 0 972 26 0 0 MA Mammogram Diag Bilat w/Tomo+Implant Mammography 77066 401 0 972 26 0 0 MA Mammogram Diag Uni w/ Implant L Mammography 77065 LT 401 0 972 26 0 0 MA Mammogram Diag Uni w/ Implant R Mammography 77065 401 0 972 26 0 0 MA Mammogram Diag Uni w/Tomo+Implant L Mammography 77065 LT 401 0 972 26 0 0 MA Mammogram Diag Uni w/Tomo+Implant R Mammography 77065 401 0 972 26 0 0 MA Mammogram Diagnostic Bilat w/ Tomo Mammography 77066 401 0 972 26 0 0 MA Mammogram Diagnostic Bilateral Mammography 77066 401 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center MA Mammogram Diagnostic Uni w/ Tomo L Mammography 77065 401 0 972 26 0 0 MA Mammogram Diagnostic Uni w/ Tomo R Mammography 77065 401 0 972 26 0 0 MA Mammogram Diagnostic Unilateral L Mammography 77065 401 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center MA Mammogram Diagnostic Unilateral R Mammography 77065 401 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center MA Mammogram Digital Diag Bilat MG Mammography 77066 401 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 MA Mammogram Digital Diag L MG Mammography 77065 401 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 MA Mammogram Digital Diag R MG Mammography 77065 401 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 MA Mammogram Digital Screen L MG Mammography 77067 52 403 0 Pioneer Medical Center Base Price Schedule 972 26 52 2 0 MA Mammogram Digital Screen R MG Mammography 77067 52 403 0 Pioneer Medical Center Base Price Schedule 972 26 52 2 0 MA Mammogram Digital Screening MG Mammography 77067 403 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 MA Mammogram Post Loc Device Bilat Mammography 77066 401 0 972 26 0 0 MA Mammogram Post Loc Device Uni L Mammography 77065 401 0 972 26 0 0 MA Mammogram Post Loc Device Uni R Mammography 77065 401 0 972 26 0 0 MA Mammogram Screen Bilat w/ Implant Mammography 77067 403 0 972 26 0 0 MA Mammogram Screen Bilat w/Tomo+Implant Mammography 77067 403 0 972 26 0 0 MA Mammogram Screen Uni LT Mammography 77067 52 403 0 Pioneer Medical Center Base Price Schedule 972 26 52 2 0 Pioneer Medical Center MA Mammogram Screen Uni RT Mammography 77067 52 403 0 Pioneer Medical Center Base Price Schedule 972 26 52 2 0 Pioneer Medical Center MA Mammogram Screen Uni w/ Implant L Mammography 77067 52 403 0 972 26 52 2 0 MA Mammogram Screen Uni w/ Implant R Mammography 77067 52 403 0 972 26 52 2 0 MA Mammogram Screen Uni w/Tomo+Implant L Mammography 77067 52 403 0 972 26 52 2 0 MA Mammogram Screen Uni w/Tomo+Implant R Mammography 77067 52 403 0 972 26 52 2 0 MA Mammogram Screening Mammography 77067 403 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center MA Mammogram Screening Implants/Extended Mammography 77067 403 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center MA Mammogram Screening Uni w/ Tomo L Mammography 77067 52 403 0 972 26 52 2 0 MA Mammogram Screening Uni w/ Tomo R Mammography 77067 52 403 0 972 26 52 2 0 MA Mammogram Screening w/ Tomo Mammography 77067 403 0 972 26 0 0 MA Read Outside Films Mammography 76140 0 972 0 0 MA Stereotactic Breast Biopsy L Mammography 19081 LT 320 0 Pioneer Medical Center Base Price Schedule 972 LT 0 0 Pioneer Medical Center MA Stereotactic Breast Biopsy R Mammography 19081 RT 320 0 Pioneer Medical Center Base Price Schedule 972 RT 0 0 Pioneer Medical Center MA Stereotactic Breast Localization L Mammography 19283 LT 761 0 972 LT 0 0 Pioneer Medical Center MA Stereotactic Breast Localization R Mammography 19283 RT 761 0 972 RT 0 0 Pioneer Medical Center MA Tomosynthesis Breast Biopsy L Mammography 19499 LT 401 0 972 LT 0 0 MA Tomosynthesis Breast Biopsy R Mammography 19499 RT 401 0 972 RT 0 0 MR Abbreviated Breast MRI 77049 610 0 972 26 0 0 Pioneer Medical Center MR Abdomen Angio w/ Contrast MRI 74185 3000536 610 1737 Pioneer Medical Center Base Price Schedule 3100534 972 26 0 519.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Abdomen Angio w/wo Contrast MRI 74185 3000536 610 1737 Pioneer Medical Center Base Price Schedule 3100534 972 26 0 519.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Abdomen Angio wo Contrast MRI 74185 3000536 610 1737 Pioneer Medical Center Base Price Schedule 3100534 972 26 0 519.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Abdomen Angiography MRI 74185 3000536 610 1737 Pioneer Medical Center Base Price Schedule 3100534 972 26 0 519.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Abdomen w/ Contrast MRI 74182 614 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center MR Abdomen w/wo Contrast MRI 74183 3000452 610 3431 Pioneer Medical Center Base Price Schedule 3100450 972 26 0 440 Prof PMC Base Price Schedule Pioneer Medical Center MR Abdomen wo Contrast MRI 74181 3000445 610 1295 Pioneer Medical Center Base Price Schedule 3100443 972 26 0 440 Prof PMC Base Price Schedule Pioneer Medical Center MR Achilles w/wo Contrast L MRI 73720 3000338 610 3510.5 Pioneer Medical Center Base Price Schedule 3100336 972 26 LT 2 350 Prof PMC Base Price Schedule MR Achilles w/wo Contrast R MRI 73720 3000338 610 3510.5 Pioneer Medical Center Base Price Schedule 3100336 972 26 RT 2 350 Prof PMC Base Price Schedule MR Achilles wo Contrast L MRI 73718 3000320 610 1621.5 Pioneer Medical Center Base Price Schedule 3100328 972 26 LT 2 291.5 Prof PMC Base Price Schedule MR Achilles wo Contrast R MRI 73718 3000320 610 1621.5 Pioneer Medical Center Base Price Schedule 3100328 972 26 RT 2 291.5 Prof PMC Base Price Schedule MR Angio Aorta w Runoff MRI 74185 3000536 610 1737 Pioneer Medical Center Base Price Schedule 3100534 972 26 0 519.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Angio Aorta w Runoff wo Contrast MRI 74185 3000536 610 1737 Pioneer Medical Center Base Price Schedule 3100534 972 26 0 519.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Ankle Arthrogram L MRI 73722 LT 610 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center MR Ankle Arthrogram R MRI 73722 RT 610 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center MR Ankle w/ Contrast L MRI 73722 LT 610 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center MR Ankle w/ Contrast R MRI 73722 RT 610 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center MR Ankle w/wo Contrast L MRI 73723 3000395 LT 610 2486 Pioneer Medical Center Base Price Schedule 3100393 972 26 LT 2 366 Prof PMC Base Price Schedule Pioneer Medical Center MR Ankle w/wo Contrast R MRI 73723 3000395 RT 610 2486 Pioneer Medical Center Base Price Schedule 3100393 972 26 RT 2 366 Prof PMC Base Price Schedule Pioneer Medical Center MR Ankle wo Contrast L MRI 73721 3000387 LT 610 1482.5 Pioneer Medical Center Base Price Schedule 3100385 972 26 LT 2 291.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Ankle wo Contrast R MRI 73721 3000387 RT 610 1482.5 Pioneer Medical Center Base Price Schedule 3100385 972 26 RT 2 291.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Biomet Signature Protocol L MRI LT 610 0 Pioneer Medical Center Base Price Schedule 0 0 Pioneer Medical Center MR Biomet Signature Protocol R MRI RT 610 0 Pioneer Medical Center Base Price Schedule 0 0 Pioneer Medical Center MR Bone Marrow Blood Supply wo Contrast MRI 77084 610 0 972 26 0 0 MR Brachial Plexus w/ Contrast MRI 71551 610 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center MR Brachial Plexus w/wo Contrast MRI 71552 3000072 610 3059.5 Pioneer Medical Center Base Price Schedule 3100070 972 26 0 492 Prof PMC Base Price Schedule Pioneer Medical Center MR Brachial Plexus wo Contrast MRI 71550 3000064 610 1603.5 Pioneer Medical Center Base Price Schedule 3100062 972 26 0 475 Prof PMC Base Price Schedule Pioneer Medical Center MR Brain DTI w/ Contrast MRI 76498 610 0 972 26 0 0 Pioneer Medical Center MR Brain DTI w/wo Contrast MRI 76498 610 0 972 26 0 0 Pioneer Medical Center MR Brain DTI wo Contrast MRI 76498 610 0 972 26 0 0 Pioneer Medical Center MR Brain MRA w/ Contrast MRI 70545 615 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center MR Brain MRA w/wo Contrast MRI 70546 3000478 615 2927 Pioneer Medical Center Base Price Schedule 3100476 972 26 0 522.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Brain MRA wo Contrast MRI 70544 3000460 615 1638.5 Pioneer Medical Center Base Price Schedule 3100468 972 26 0 351 Prof PMC Base Price Schedule Pioneer Medical Center MR Brain MRV w/ Contrast MRI 70545 615 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center MR Brain MRV wo Contrast MRI 70544 3000460 610 1638.5 Pioneer Medical Center Base Price Schedule 3100468 972 26 0 351 Prof PMC Base Price Schedule Pioneer Medical Center MR Brain Neuroquant wo Contrast MRI 70551 3000007 610 1482.5 Pioneer Medical Center Base Price Schedule 3100005 972 26 0 511 Prof PMC Base Price Schedule Pioneer Medical Center MR Brain Perfusion Only w/ Contrast MRI 76498 610 0 972 26 0 0 Pioneer Medical Center MR Brain Rapid wo Contrast MRI 70551 52 610 0 972 26 52 2 0 MR Brain w/ Contrast MRI 70552 800070552 610 2188 Pioneer Medical Center Base Price Schedule 802670552 972 26 0 261 Prof PMC Base Price Schedule Pioneer Medical Center MR Brain w/ Contrast Limited MRI 70552 52 611 0 972 52 26 2 0 Pioneer Medical Center MR Brain w/wo Contrast MRI 70553 3000015 610 2848.5 Pioneer Medical Center Base Price Schedule 3100013 972 26 0 576.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Brain w/wo Contrast w/ Perfusion MRI 70553 3000015 610 2848.5 Pioneer Medical Center Base Price Schedule 3100013 972 26 0 576.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Brain wo Contrast MRI 70551 3000007 610 1482.5 Pioneer Medical Center Base Price Schedule 3100005 972 26 0 511 Prof PMC Base Price Schedule Pioneer Medical Center MR Brain wo Contrast Limited MRI 70551 3000007 52 610 1482.5 Pioneer Medical Center Base Price Schedule 3100005 972 26 52 2 511 Prof PMC Base Price Schedule Pioneer Medical Center MR Brain wo Contrast for Shunt MRI 70551 3000007 610 1482.5 Pioneer Medical Center Base Price Schedule 3100005 972 26 0 511 Prof PMC Base Price Schedule MR Breast Bilateral w/ Contrast MRI 76498 610 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center MR Breast Bilateral w/ Contrast MG MRI 76498 610 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 MR Breast Bilateral w/wo Contrast MRI 77049 610 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center MR Breast Bilateral w/wo Contrast MG MRI 610 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 MR Breast Bilateral wo Contrast MRI 77047 610 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center MR Breast Bilateral wo Contrast MG MRI 610 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 MR Breast Biopsy L MRI 19085 LT 610 0 Pioneer Medical Center Base Price Schedule 972 LT 0 0 Pioneer Medical Center MR Breast Biopsy L MG MRI 19085 610 0 Pioneer Medical Center Base Price Schedule 972 LT 0 0 MR Breast Biopsy R MRI 19085 RT 610 0 Pioneer Medical Center Base Price Schedule 972 RT 0 0 Pioneer Medical Center MR Breast Biopsy R MG MRI 19085 610 0 Pioneer Medical Center Base Price Schedule 972 RT 0 0 MR Breast Implant Bilateral w/ Contrast MRI 76498 610 0 Pioneer Medical Center Base Price Schedule 972 0 0 MR Breast Implant Bilateral w/wo Contras MRI 77049 610 0 Pioneer Medical Center Base Price Schedule 972 0 0 MR Breast Implant Bilateral wo Contrast MRI 77047 610 0 Pioneer Medical Center Base Price Schedule 972 0 0 MR Breast Implant Unilateral L w/ Contra MRI 76498 LT 610 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 MR Breast Implant Unilateral L w/wo Cont MRI 77048 LT 610 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 MR Breast Implant Unilateral L wo Contra MRI 77046 LT 610 0 Pioneer Medical Center Base Price Schedule 972 0 0 MR Breast Implant Unilateral R w/ Contra MRI 76498 RT 610 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 MR Breast Implant Unilateral R w/wo Cont MRI 77048 RT 610 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 MR Breast Implant Unilateral R wo Contra MRI 77046 RT 610 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 MR Breast Localization L MRI 19287 LT 610 0 Pioneer Medical Center Base Price Schedule 972 LT 0 0 Pioneer Medical Center MR Breast Localization L MG MRI 19287 610 0 Pioneer Medical Center Base Price Schedule 972 0 0 MR Breast Localization R MRI 19287 RT 610 0 Pioneer Medical Center Base Price Schedule 972 RT 0 0 Pioneer Medical Center MR Breast Localization R MG MRI 19287 610 0 Pioneer Medical Center Base Price Schedule 972 0 0 MR Breast Unilateral w/ Contrast L MRI 76498 LT 610 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center MR Breast Unilateral w/ Contrast L MG MRI 610 0 Pioneer Medical Center Base Price Schedule 972 0 0 MR Breast Unilateral w/ Contrast R MRI 76498 RT 610 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center MR Breast Unilateral w/ Contrast R MG MRI 610 0 Pioneer Medical Center Base Price Schedule 972 0 0 MR Breast Unilateral w/wo Contrast L MRI 77048 LT 610 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center MR Breast Unilateral w/wo Contrast L MG MRI 610 0 Pioneer Medical Center Base Price Schedule 972 0 0 MR Breast Unilateral w/wo Contrast R MRI 77048 RT 610 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center MR Breast Unilateral w/wo Contrast R MG MRI 610 0 Pioneer Medical Center Base Price Schedule 972 0 0 MR Breast Unilateral wo Contrast L MRI 77046 LT 610 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center MR Breast Unilateral wo Contrast L MG MRI 610 0 Pioneer Medical Center Base Price Schedule 972 0 0 MR Breast Unilateral wo Contrast R MRI 77046 RT 610 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center MR Breast Unilateral wo Contrast R MG MRI 610 0 Pioneer Medical Center Base Price Schedule 972 0 0 MR C Spine w/ Contrast MRI 72142 610 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center MR C Spine w/ Contrast Limited MRI 72142 52 610 0 972 26 52 2 0 Pioneer Medical Center MR C Spine w/wo Contrast MRI 72156 3000098 610 3524.5 Pioneer Medical Center Base Price Schedule 3100096 972 26 0 488.5 Prof PMC Base Price Schedule Pioneer Medical Center MR C Spine w/wo Contrast Limited MRI 72156 3000098 52 612 3524.5 Pioneer Medical Center Base Price Schedule 3100096 972 26 52 2 488.5 Prof PMC Base Price Schedule Pioneer Medical Center MR C Spine wo Contrast MRI 72141 3000080 610 1203 Pioneer Medical Center Base Price Schedule 3100088 972 26 0 459 Prof PMC Base Price Schedule Pioneer Medical Center MR C Spine wo Contrast Limited MRI 72141 3000080 52 612 1203 Pioneer Medical Center Base Price Schedule 3100088 972 26 52 2 459 Prof PMC Base Price Schedule Pioneer Medical Center MR Cardiac Stress w/wo Contrast MRI 75563 610 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center MR Cardiac Stress wo Contrast MRI 75559 610 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center MR Cardiac w/wo Contrast MRI 75561 610 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center MR Cardiac wo Contrast MRI 75557 610 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center MR Carotid MRA w/ Contrast MRI 70548 615 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center MR Carotid MRA w/wo Contrast MRI 70549 3000494 615 3149.5 Pioneer Medical Center Base Price Schedule 3100492 972 26 0 522.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Carotid MRA wo Contrast MRI 70547 3000486 615 1835 Pioneer Medical Center Base Price Schedule 3100484 972 26 0 351 Prof PMC Base Price Schedule Pioneer Medical Center MR Chest Angio for PE w/wo Contrast MRI 71555 610 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 MR Chest Angio w/ Contrast MRI 71555 615 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center MR Chest Angio w/wo Contrast MRI 71555 615 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center MR Chest Angio wo Contrast MRI 71555 615 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center MR Chest w/ Contrast MRI 71551 610 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center MR Chest w/wo Contrast MRI 71552 3000072 610 3059.5 Pioneer Medical Center Base Price Schedule 3100070 972 26 0 492 Prof PMC Base Price Schedule Pioneer Medical Center MR Chest wo Contrast MRI 71550 3000064 610 1603.5 Pioneer Medical Center Base Price Schedule 3100062 972 26 0 475 Prof PMC Base Price Schedule Pioneer Medical Center MR Cholangiogram w/wo Contrast MRI 74183 3000452 610 3431 Pioneer Medical Center Base Price Schedule 3100450 972 26 0 440 Prof PMC Base Price Schedule Pioneer Medical Center MR Cholangiogram wo Contrast MRI 74181 3000445 610 1295 Pioneer Medical Center Base Price Schedule 3100443 972 26 0 440 Prof PMC Base Price Schedule Pioneer Medical Center MR Clavicle w/ Contrast L MRI 73219 LT 619 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center MR Clavicle w/ Contrast R MRI 73219 RT 619 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center MR Clavicle w/wo Contrast L MRI 73220 3000171 LT 610 4048 Pioneer Medical Center Base Price Schedule 3100179 972 26 LT 2 378.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Clavicle w/wo Contrast R MRI 73220 3000171 RT 610 4048 Pioneer Medical Center Base Price Schedule 3100179 972 26 RT 2 378.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Clavicle wo Contrast L MRI 73218 3000163 610 1570.5 Pioneer Medical Center Base Price Schedule 3100161 972 26 LT 2 291.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Clavicle wo Contrast R MRI 73218 3000163 610 1570.5 Pioneer Medical Center Base Price Schedule 3100161 972 26 RT 2 291.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Cranial Nerve/Brain w/ Contrast MRI 70552 610 0 972 26 0 0 MR Cranial Nerve/Brain w/wo Contrast MRI 70553 3000015 610 2848.5 Pioneer Medical Center Base Price Schedule 3100013 972 26 0 576.5 Prof PMC Base Price Schedule MR Cranial Nerve/Brain wo Contrast MRI 70551 3000007 610 1482.5 Pioneer Medical Center Base Price Schedule 3100005 972 26 0 511 Prof PMC Base Price Schedule MR Defecography MRI 72195 610 0 972 26 0 0 Pioneer Medical Center MR Elbow Arthrogram L MRI 73222 LT 610 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center MR Elbow Arthrogram R MRI 73222 RT 610 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center MR Elbow w/ Contrast L MRI 73222 LT 610 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center MR Elbow w/ Contrast R MRI 73222 RT 610 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center MR Elbow w/wo Contrast L MRI 73223 3000270 LT 610 3415.5 Pioneer Medical Center Base Price Schedule 3100278 972 26 LT 2 390 Prof PMC Base Price Schedule Pioneer Medical Center MR Elbow w/wo Contrast R MRI 73223 3000270 RT 610 3415.5 Pioneer Medical Center Base Price Schedule 3100278 972 26 RT 2 390 Prof PMC Base Price Schedule Pioneer Medical Center MR Elbow wo Contrast L MRI 73221 3000262 LT 610 1880 Pioneer Medical Center Base Price Schedule 3100260 972 26 LT 2 306.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Elbow wo Contrast R MRI 73221 3000262 RT 610 1880 Pioneer Medical Center Base Price Schedule 3100260 972 26 RT 2 306.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Enterography MRI 74183 3000452 610 3431 Pioneer Medical Center Base Price Schedule 3100450 972 26 0 440 Prof PMC Base Price Schedule Pioneer Medical Center MR Extremity Lower Angio w/ Contrast L MRI 73725 3000528 LT 615 0 Pioneer Medical Center Base Price Schedule 3100526 972 26 LT 2 522.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Extremity Lower Angio w/ Contrast R MRI 73725 3000528 RT 615 0 Pioneer Medical Center Base Price Schedule 3100526 972 26 RT 2 522.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Extremity Lower Angio w/wo Contrast L MRI 73725 3000528 LT 615 0 Pioneer Medical Center Base Price Schedule 3100526 972 26 LT 2 522.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Extremity Lower Angio w/wo Contrast R MRI 73725 3000528 RT 615 0 Pioneer Medical Center Base Price Schedule 3100526 972 26 RT 2 522.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Extremity Lower Angio wo Contrast L MRI 73725 3000528 LT 615 0 Pioneer Medical Center Base Price Schedule 3100526 972 26 LT 2 522.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Extremity Lower Angio wo Contrast R MRI 73725 3000528 RT 615 0 Pioneer Medical Center Base Price Schedule 3100526 972 26 RT 2 522.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Extremity Lower w/ Contrast Limited L MRI 73719 52 610 0 972 0 0 Pioneer Medical Center MR Extremity Lower w/ Contrast Limited R MRI 73719 52 610 0 0 0 Pioneer Medical Center MR Extremity Upper Angio w/ Contrast L MRI 73225 3000510 LT 615 1927 Pioneer Medical Center Base Price Schedule 3100518 972 26 LT 2 500 Prof PMC Base Price Schedule Pioneer Medical Center MR Extremity Upper Angio w/ Contrast R MRI 73225 3000510 RT 615 1927 Pioneer Medical Center Base Price Schedule 3100518 972 26 RT 2 500 Prof PMC Base Price Schedule Pioneer Medical Center MR Extremity Upper Angio w/wo Contrast L MRI 73225 3000510 LT 615 1927 Pioneer Medical Center Base Price Schedule 3100518 972 26 LT 2 500 Prof PMC Base Price Schedule Pioneer Medical Center MR Extremity Upper Angio w/wo Contrast R MRI 73225 3000510 RT 615 1927 Pioneer Medical Center Base Price Schedule 3100518 972 26 RT 2 500 Prof PMC Base Price Schedule Pioneer Medical Center MR Extremity Upper Angio wo Contrast L MRI 73225 3000510 LT 615 1927 Pioneer Medical Center Base Price Schedule 3100518 972 26 LT 2 500 Prof PMC Base Price Schedule Pioneer Medical Center MR Extremity Upper Angio wo Contrast R MRI 73225 3000510 RT 615 1927 Pioneer Medical Center Base Price Schedule 3100518 972 26 RT 2 500 Prof PMC Base Price Schedule Pioneer Medical Center MR Extremity Upper w/ Contrast Limited L MRI 73219 52 610 0 972 26 52 2 0 Pioneer Medical Center MR Extremity Upper w/ Contrast Limited L MRI 73219 52 610 0 972 26 LT 3 0 Pioneer Medical Center MR Extremity Upper w/ Contrast Limited R MRI 73219 52 610 0 972 26 52 2 0 Pioneer Medical Center MR Extremity Upper w/ Contrast Limited R MRI 73219 52 610 0 972 26 RT 3 0 Pioneer Medical Center MR Femur w/ Contrast L MRI 73719 LT 610 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center MR Femur w/ Contrast R MRI 73719 RT 610 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center MR Femur w/wo Contrast L MRI 73720 3000338 LT 610 3510.5 Pioneer Medical Center Base Price Schedule 3100336 972 26 LT 2 350 Prof PMC Base Price Schedule Pioneer Medical Center MR Femur w/wo Contrast R MRI 73720 3000338 RT 610 3510.5 Pioneer Medical Center Base Price Schedule 3100336 972 26 RT 2 350 Prof PMC Base Price Schedule Pioneer Medical Center MR Femur wo Contrast L MRI 73718 3000320 LT 610 1621.5 Pioneer Medical Center Base Price Schedule 3100328 972 26 LT 2 291.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Femur wo Contrast R MRI 73718 3000320 RT 610 1621.5 Pioneer Medical Center Base Price Schedule 3100328 972 26 RT 2 291.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Fetus wo Contrast MRI 74712 610 0 972 26 0 0 Pioneer Medical Center MR Finger/s w/wo Contrast L MRI 73220 3000171 LT 610 4048 Pioneer Medical Center Base Price Schedule 3100179 972 26 LT 2 378.5 Prof PMC Base Price Schedule MR Finger/s w/wo Contrast R MRI 73220 3000171 RT 610 4048 Pioneer Medical Center Base Price Schedule 3100179 972 26 RT 2 378.5 Prof PMC Base Price Schedule MR Finger/s wo Contrast L MRI 73218 3000163 LT 610 1570.5 Pioneer Medical Center Base Price Schedule 3100161 972 26 LT 2 291.5 Prof PMC Base Price Schedule MR Finger/s wo Contrast R MRI 73218 3000163 RT 610 1570.5 Pioneer Medical Center Base Price Schedule 3100161 972 26 RT 2 291.5 Prof PMC Base Price Schedule MR Foot w/ Contrast L MRI 73719 LT 610 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center MR Foot w/ Contrast R MRI 73719 RT 610 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center MR Foot w/wo Contrast L MRI 73720 3000338 LT 610 3510.5 Pioneer Medical Center Base Price Schedule 3100336 972 26 LT 2 350 Prof PMC Base Price Schedule Pioneer Medical Center MR Foot w/wo Contrast R MRI 73720 3000338 RT 610 3510.5 Pioneer Medical Center Base Price Schedule 3100336 972 26 RT 2 350 Prof PMC Base Price Schedule Pioneer Medical Center MR Foot wo Contrast L MRI 73718 3000320 LT 610 1621.5 Pioneer Medical Center Base Price Schedule 3100328 972 26 LT 2 291.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Foot wo Contrast R MRI 73718 3000320 RT 610 1621.5 Pioneer Medical Center Base Price Schedule 3100328 972 26 RT 2 291.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Forearm w/ Contrast L MRI 73219 LT 610 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center MR Forearm w/ Contrast R MRI 73219 RT 610 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center MR Forearm w/wo Contrast L MRI 73220 3000171 LT 610 4048 Pioneer Medical Center Base Price Schedule 3100179 972 26 LT 2 378.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Forearm w/wo Contrast R MRI 73220 3000171 RT 610 4048 Pioneer Medical Center Base Price Schedule 3100179 972 26 RT 2 378.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Forearm wo Contrast L MRI 73218 3000163 LT 610 1570.5 Pioneer Medical Center Base Price Schedule 3100161 972 26 LT 2 291.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Forearm wo Contrast R MRI 73218 3000163 RT 610 1570.5 Pioneer Medical Center Base Price Schedule 3100161 972 26 RT 2 291.5 Prof PMC Base Price Schedule Pioneer Medical Center MR GK AVM MRI 76498 611 0 0 0 Pioneer Medical Center MR GK Acoustic Neuroma MRI 76498 611 0 0 0 Pioneer Medical Center MR GK Brain Mets MRI 76498 611 0 0 0 Pioneer Medical Center MR GK Cavernous Malformation MRI 76498 611 0 0 0 Pioneer Medical Center MR GK Epilepsy MRI 76498 611 0 0 0 Pioneer Medical Center MR GK Meningioma MRI 76498 611 0 0 0 Pioneer Medical Center MR GK Pituitary MRI 76498 611 0 0 0 Pioneer Medical Center MR GK Tremor MRI 76498 611 0 0 0 Pioneer Medical Center MR GK Trigeminal Neuralgia MRI 76498 611 0 0 0 Pioneer Medical Center MR Hand w/ Contrast L MRI 73219 LT 610 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center MR Hand w/ Contrast R MRI 73219 RT 610 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center MR Hand w/wo Contrast L MRI 73220 3000171 LT 610 4048 Pioneer Medical Center Base Price Schedule 3100179 972 26 LT 2 378.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Hand w/wo Contrast R MRI 73220 3000171 RT 610 4048 Pioneer Medical Center Base Price Schedule 3100179 972 26 RT 2 378.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Hand wo Contrast L MRI 73218 3000163 LT 610 1570.5 Pioneer Medical Center Base Price Schedule 3100161 972 26 LT 2 291.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Hand wo Contrast R MRI 73218 3000163 RT 610 1570.5 Pioneer Medical Center Base Price Schedule 3100161 972 26 RT 2 291.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Hip Arthrogram L MRI 73722 LT 610 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center MR Hip Arthrogram R MRI 73722 RT 610 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center MR Hip w/ Contrast L MRI 73722 LT 610 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center MR Hip w/ Contrast R MRI 73722 RT 610 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center MR Hip w/wo Contrast L MRI 73723 3000395 LT 610 2486 Pioneer Medical Center Base Price Schedule 3100393 972 26 LT 2 366 Prof PMC Base Price Schedule Pioneer Medical Center MR Hip w/wo Contrast R MRI 73723 3000395 RT 610 2486 Pioneer Medical Center Base Price Schedule 3100393 972 26 RT 2 366 Prof PMC Base Price Schedule Pioneer Medical Center MR Hip wo Contrast L MRI 73721 3000387 LT 610 1482.5 Pioneer Medical Center Base Price Schedule 3100385 972 26 LT 2 291.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Hip wo Contrast R MRI 73721 3000387 RT 610 1482.5 Pioneer Medical Center Base Price Schedule 3100385 972 26 RT 2 291.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Humerus w/ Contrast L MRI 73219 LT 610 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center MR Humerus w/ Contrast R MRI 73219 RT 610 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center MR Humerus w/wo Contrast L MRI 73220 3000171 LT 610 4048 Pioneer Medical Center Base Price Schedule 3100179 972 26 LT 2 378.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Humerus w/wo Contrast R MRI 73220 3000171 RT 610 4048 Pioneer Medical Center Base Price Schedule 3100179 972 26 RT 2 378.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Humerus wo Contrast L MRI 73218 3000163 LT 610 1570.5 Pioneer Medical Center Base Price Schedule 3100161 972 26 LT 2 291.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Humerus wo Contrast R MRI 73218 3000163 RT 610 1570.5 Pioneer Medical Center Base Price Schedule 3100161 972 26 RT 2 291.5 Prof PMC Base Price Schedule Pioneer Medical Center MR IAC w/ Contrast MRI 70552 610 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center MR IAC w/wo Contrast MRI 70553 3000015 610 2848.5 Pioneer Medical Center Base Price Schedule 3100013 972 26 0 576.5 Prof PMC Base Price Schedule Pioneer Medical Center MR IAC wo Contrast MRI 70551 3000007 610 1482.5 Pioneer Medical Center Base Price Schedule 3100005 972 26 0 511 Prof PMC Base Price Schedule Pioneer Medical Center MR Joint Lower w/ Contrast L MRI 73722 LT 610 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center MR Joint Lower w/ Contrast R MRI 73722 RT 610 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center MR Joint Lower w/ and w/o Contrast L MRI 73723 3000395 LT 610 2486 Pioneer Medical Center Base Price Schedule 3100393 972 26 LT 2 366 Prof PMC Base Price Schedule Pioneer Medical Center MR Joint Lower w/ and w/o Contrast R MRI 73723 3000395 RT 610 2486 Pioneer Medical Center Base Price Schedule 3100393 972 26 RT 2 366 Prof PMC Base Price Schedule Pioneer Medical Center MR Joint Lower w/o Contrast L MRI 73721 3000387 LT 610 1482.5 Pioneer Medical Center Base Price Schedule 3100385 972 26 LT 2 291.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Joint Lower w/o Contrast R MRI 73721 3000387 RT 610 1482.5 Pioneer Medical Center Base Price Schedule 3100385 972 26 RT 2 291.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Joint Upper w/ Contrast L MRI 73222 LT 619 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center MR Joint Upper w/ Contrast R MRI 73222 RT 619 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center MR Joint Upper w/ and w/o Contrast L MRI 73223 3000270 LT 610 3415.5 Pioneer Medical Center Base Price Schedule 3100278 972 26 LT 2 390 Prof PMC Base Price Schedule Pioneer Medical Center MR Joint Upper w/ and w/o Contrast R MRI 73223 3000270 RT 610 3415.5 Pioneer Medical Center Base Price Schedule 3100278 972 26 RT 2 390 Prof PMC Base Price Schedule Pioneer Medical Center MR Joint Upper w/o Contrast L MRI 73221 3000262 LT 610 1880 Pioneer Medical Center Base Price Schedule 3100260 972 26 LT 2 306.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Joint Upper w/o Contrast R MRI 73221 3000262 RT 610 1880 Pioneer Medical Center Base Price Schedule 3100260 972 26 RT 2 306.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Knee Arthrogram L MRI 73722 LT 610 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center MR Knee Arthrogram R MRI 73722 RT 610 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center MR Knee w/ Contrast L MRI 73722 LT 610 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center MR Knee w/ Contrast R MRI 73722 RT 610 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center MR Knee w/wo Contrast L MRI 73723 3000395 LT 610 2486 Pioneer Medical Center Base Price Schedule 3100393 972 26 LT 2 366 Prof PMC Base Price Schedule Pioneer Medical Center MR Knee w/wo Contrast R MRI 73723 3000395 RT 610 2486 Pioneer Medical Center Base Price Schedule 3100393 972 26 RT 2 366 Prof PMC Base Price Schedule Pioneer Medical Center MR Knee wo Contrast L MRI 73721 3000387 LT 610 1482.5 Pioneer Medical Center Base Price Schedule 3100385 972 26 LT 2 291.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Knee wo Contrast R MRI 73721 3000387 RT 610 1482.5 Pioneer Medical Center Base Price Schedule 3100385 972 26 RT 2 291.5 Prof PMC Base Price Schedule Pioneer Medical Center MR L Spine w/ Contrast MRI 72149 610 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center MR L Spine w/ Contrast Limited MRI 72149 52 612 0 972 26 52 2 0 Pioneer Medical Center MR L Spine w/wo Contrast MRI 72158 3000130 610 3096 Pioneer Medical Center Base Price Schedule 3100138 972 26 0 470.5 Prof PMC Base Price Schedule Pioneer Medical Center MR L Spine w/wo Contrast Limited MRI 72158 3000130 52 612 3096 Pioneer Medical Center Base Price Schedule 3100138 972 26 52 2 470.5 Prof PMC Base Price Schedule Pioneer Medical Center MR L Spine wo Contrast MRI 72148 3000122 610 1482.5 Pioneer Medical Center Base Price Schedule 3100120 972 26 0 377.5 Prof PMC Base Price Schedule Pioneer Medical Center MR L Spine wo Contrast Limited MRI 72148 3000122 52 612 1482.5 Pioneer Medical Center Base Price Schedule 3100120 972 26 52 2 377.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Liver Elastography MRI 76391 610 0 972 26 0 0 MR Liver w/wo Contrast MRI 74183 3000452 610 3431 Pioneer Medical Center Base Price Schedule 3100450 972 26 0 440 Prof PMC Base Price Schedule MR MBJ Procedure MRI 0 Pioneer Medical Center Base Price Schedule 0 0 MR Orbit w/ Contrast MRI 70542 610 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center MR Orbit w/wo Contrast MRI 70543 3000031 610 2832.5 Pioneer Medical Center Base Price Schedule 3100039 972 26 0 533 Prof PMC Base Price Schedule Pioneer Medical Center MR Orbit wo Contrast MRI 70540 3000023 610 2487 Pioneer Medical Center Base Price Schedule 3100021 972 26 0 533 Prof PMC Base Price Schedule Pioneer Medical Center MR Pelvis Angio w/ Contrast MRI 72198 3000502 610 1743 Pioneer Medical Center Base Price Schedule 3100500 972 26 0 519.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Pelvis Angio w/wo Contrast MRI 72198 3000502 610 1743 Pioneer Medical Center Base Price Schedule 3100500 972 26 0 519.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Pelvis Angio wo Contrast MRI 72198 3000502 610 1743 Pioneer Medical Center Base Price Schedule 3100500 972 26 0 519.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Pelvis w/ Contrast MRI 72196 610 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center MR Pelvis w/wo Contrast MRI 72197 3000155 610 3559.5 Pioneer Medical Center Base Price Schedule 3100153 972 26 0 457 Prof PMC Base Price Schedule Pioneer Medical Center MR Pelvis w/wo Contrast Female MRI 72197 3000155 610 3559.5 Pioneer Medical Center Base Price Schedule 3100153 972 26 0 457 Prof PMC Base Price Schedule MR Pelvis wo Contrast MRI 72195 3000148 610 1727 Pioneer Medical Center Base Price Schedule 3100146 972 26 0 413.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Pelvis wo Contrast Female MRI 72195 3000148 610 1727 Pioneer Medical Center Base Price Schedule 3100146 972 26 0 413.5 Prof PMC Base Price Schedule MR Pelvis wo Contrast Limited MRI 72195 3000148 52 610 1727 Pioneer Medical Center Base Price Schedule 3100146 972 26 52 2 413.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Pelvis wo Contrast Male w/ Glucagon MRI 72195 3000148 610 1727 Pioneer Medical Center Base Price Schedule 3100146 972 26 0 413.5 Prof PMC Base Price Schedule MR Pituitary w/wo Contrast MRI 70553 3000015 610 2848.5 Pioneer Medical Center Base Price Schedule 3100013 972 26 0 576.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Prostate w/ Contrast MRI 72196 610 0 972 26 0 0 Pioneer Medical Center MR Prostate w/wo Contrast MRI 72197 3000155 610 3559.5 Pioneer Medical Center Base Price Schedule 3100153 972 26 0 457 Prof PMC Base Price Schedule Pioneer Medical Center MR Prostate wo Contrast MRI 72195 3000148 610 1727 Pioneer Medical Center Base Price Schedule 3100146 972 26 0 413.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Rectal w/ contrast MRI 72196 610 0 972 26 0 0 Pioneer Medical Center MR Rectal w/wo Contrast MRI 72197 3000155 610 3559.5 Pioneer Medical Center Base Price Schedule 3100153 972 26 0 457 Prof PMC Base Price Schedule Pioneer Medical Center MR Rectal wo Contrast MRI 72195 3000148 610 1727 Pioneer Medical Center Base Price Schedule 3100146 972 26 0 413.5 Prof PMC Base Price Schedule Pioneer Medical Center MR SC Joint wo Contrast MRI 71550 3000064 610 1603.5 Pioneer Medical Center Base Price Schedule 3100062 972 26 0 475 Prof PMC Base Price Schedule MR Sacrum w/ Contrast MRI 72196 610 0 972 26 0 0 Pioneer Medical Center MR Sacrum w/wo Contrast MRI 72197 3000155 610 3559.5 Pioneer Medical Center Base Price Schedule 3100153 972 26 0 457 Prof PMC Base Price Schedule Pioneer Medical Center MR Sacrum wo Contrast MRI 72195 3000148 610 1727 Pioneer Medical Center Base Price Schedule 3100146 972 26 0 413.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Scapula w/ Contrast L MRI 73219 LT 619 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center MR Scapula w/ Contrast R MRI 73219 RT 619 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center MR Scapula w/wo Contrast L MRI 73220 3000171 LT 610 4048 Pioneer Medical Center Base Price Schedule 3100179 972 26 LT 2 378.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Scapula w/wo Contrast R MRI 73220 3000171 RT 610 4048 Pioneer Medical Center Base Price Schedule 3100179 972 26 RT 2 378.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Scapula wo Contrast L MRI 73218 3000163 610 1570.5 Pioneer Medical Center Base Price Schedule 3100161 972 26 0 291.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Scapula wo Contrast R MRI 73218 3000163 610 1570.5 Pioneer Medical Center Base Price Schedule 3100161 972 26 0 291.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Shoulder Arthrogram L MRI 73222 LT 610 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center MR Shoulder Arthrogram R MRI 73222 RT 610 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center MR Shoulder w/ Contrast L MRI 73222 LT 610 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center MR Shoulder w/ Contrast R MRI 73222 RT 610 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center MR Shoulder w/wo Contrast L MRI 73223 3000270 LT 610 3415.5 Pioneer Medical Center Base Price Schedule 3100278 972 26 LT 2 390 Prof PMC Base Price Schedule Pioneer Medical Center MR Shoulder w/wo Contrast R MRI 73223 3000270 RT 610 3415.5 Pioneer Medical Center Base Price Schedule 3100278 972 26 RT 2 390 Prof PMC Base Price Schedule Pioneer Medical Center MR Shoulder wo Contrast L MRI 73221 3000262 LT 610 1880 Pioneer Medical Center Base Price Schedule 3100260 972 26 LT 2 306.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Shoulder wo Contrast R MRI 73221 3000262 RT 610 1880 Pioneer Medical Center Base Price Schedule 3100260 972 26 RT 2 306.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Skull Base/Brain w/ Contrast MRI 70552 610 0 972 26 0 0 MR Skull Base/Brain w/wo Contrast MRI 70553 3000015 610 2848.5 Pioneer Medical Center Base Price Schedule 3100013 972 26 0 576.5 Prof PMC Base Price Schedule MR Skull Base/Brain wo Contrast MRI 70551 3000007 610 1482.5 Pioneer Medical Center Base Price Schedule 3100005 972 26 0 511 Prof PMC Base Price Schedule MR Soft Tissue Neck w/ Contrast MRI 70542 610 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center MR Soft Tissue Neck w/wo Contrast MRI 70543 3000031 610 2832.5 Pioneer Medical Center Base Price Schedule 3100039 972 26 0 533 Prof PMC Base Price Schedule Pioneer Medical Center MR Soft Tissue Neck wo Contrast MRI 70540 3000023 610 2487 Pioneer Medical Center Base Price Schedule 3100021 972 26 0 533 Prof PMC Base Price Schedule Pioneer Medical Center MR Spine Angio w/ Contrast MRI 72159 610 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center MR Spine Angio w/wo Contrast MRI 72159 610 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center MR Spine Angio wo Contrast MRI 72159 610 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center MR Spine MRA MRI 72159 610 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center MR Spine Myelopathy w/ Contrast MRI 76498 610 0 972 26 0 0 Pioneer Medical Center MR Spine Myelopathy w/wo Contrast MRI 76498 610 0 972 26 0 0 Pioneer Medical Center MR Spine Myelopathy wo Contrast MRI 76498 610 0 972 26 0 0 Pioneer Medical Center MR Stereotactic Localization MRI 77021 610 0 Pioneer Medical Center Base Price Schedule 0 0 Pioneer Medical Center MR Stereotactic Planning MRI 76498 611 0 Pioneer Medical Center Base Price Schedule 0 0 Pioneer Medical Center MR Sternum w/wo Contrast MRI 71552 3000072 610 3059.5 Pioneer Medical Center Base Price Schedule 3100070 972 26 0 492 Prof PMC Base Price Schedule MR Sternum wo Contrast MRI 71550 3000064 610 1603.5 Pioneer Medical Center Base Price Schedule 3100062 972 26 0 475 Prof PMC Base Price Schedule MR T Spine w/ Contrast MRI 72147 610 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center MR T Spine w/ Contrast Limited MRI 72147 52 612 0 972 26 52 2 0 Pioneer Medical Center MR T Spine w/wo Contrast MRI 72157 3000114 610 3688 Pioneer Medical Center Base Price Schedule 3100112 972 26 0 538.5 Prof PMC Base Price Schedule Pioneer Medical Center MR T Spine w/wo Contrast Limited MRI 72157 3000114 52 612 3688 Pioneer Medical Center Base Price Schedule 3100112 972 26 52 2 538.5 Prof PMC Base Price Schedule Pioneer Medical Center MR T Spine wo Contrast MRI 72146 3000106 610 1666 Pioneer Medical Center Base Price Schedule 3100104 972 26 0 412.5 Prof PMC Base Price Schedule Pioneer Medical Center MR T Spine wo Contrast Limited MRI 72146 3000106 52 612 1666 Pioneer Medical Center Base Price Schedule 3100104 972 26 52 2 412.5 Prof PMC Base Price Schedule Pioneer Medical Center MR TMJ Joints MRI 70336 610 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center MR TMJ Joints w/ Contrast MRI 70336 610 0 972 26 0 0 Pioneer Medical Center MR TMJ Joints w/wo Contrast MRI 70336 610 0 972 26 0 0 Pioneer Medical Center MR TMJ Joints wo Contrast MRI 70336 610 0 972 26 0 0 Pioneer Medical Center MR TP Brain w/ Contrast MRI 76498 611 0 Pioneer Medical Center Base Price Schedule 0 0 Pioneer Medical Center MR TP C Spine wo Contrast MRI 76498 612 0 0 0 Pioneer Medical Center MR TP L Spine wo Contrast MRI 76498 612 0 0 0 Pioneer Medical Center MR TP Lower Extremity w/ Contrast MRI 76498 610 0 0 0 Pioneer Medical Center MR TP Pelvis wo contrast MRI 76498 610 0 Pioneer Medical Center Base Price Schedule 0 0 Pioneer Medical Center MR TP Prostate wo Contrast MRI 72195 3000148 610 1727 Pioneer Medical Center Base Price Schedule 0 0 Pioneer Medical Center MR TP T Spine wo Contrast MRI 76498 612 0 0 0 Pioneer Medical Center MR TP Upper Extremity w/ Contrast MRI 76498 610 0 0 0 Pioneer Medical Center MR Tib-Fib w/ Contrast L MRI 73719 LT 610 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center MR Tib-Fib w/ Contrast R MRI 73719 RT 610 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center MR Tib-Fib w/wo Contrast L MRI 73720 3000338 LT 610 3510.5 Pioneer Medical Center Base Price Schedule 3100336 972 26 LT 2 350 Prof PMC Base Price Schedule Pioneer Medical Center MR Tib-Fib w/wo Contrast R MRI 73720 3000338 RT 610 3510.5 Pioneer Medical Center Base Price Schedule 3100336 972 26 RT 2 350 Prof PMC Base Price Schedule Pioneer Medical Center MR Tib-Fib wo Contrast L MRI 73718 3000320 LT 610 1621.5 Pioneer Medical Center Base Price Schedule 3100328 972 26 LT 2 291.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Tib-Fib wo Contrast R MRI 73718 3000320 RT 610 1621.5 Pioneer Medical Center Base Price Schedule 3100328 972 26 RT 2 291.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Urography w/wo Contrast MRI 74183 3000452 610 3431 Pioneer Medical Center Base Price Schedule 3100450 972 26 0 440 Prof PMC Base Price Schedule Pioneer Medical Center MR Veterinary MRI 76498 610 0 0 0 MR Whole Body w/ Contrast MRI 71551 52 610 0 972 26 52 2 0 Pioneer Medical Center MR Whole Body w/wo Contrast MRI 71552 3000072 52 610 3059.5 Pioneer Medical Center Base Price Schedule 3100070 972 26 52 2 492 Prof PMC Base Price Schedule Pioneer Medical Center MR Whole Body wo Contrast MRI 71550 3000064 52 610 1603.5 Pioneer Medical Center Base Price Schedule 3100062 972 26 52 2 475 Prof PMC Base Price Schedule Pioneer Medical Center MR Whole Body wo Contrast CRMO MRI 612 0 0 0 MR Wrist Arthrogram L MRI 73222 LT 610 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center MR Wrist Arthrogram R MRI 73222 RT 610 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center MR Wrist w/ Contrast L MRI 73222 LT 610 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center MR Wrist w/ Contrast R MRI 73222 RT 610 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center MR Wrist w/wo Contrast L MRI 73223 3000270 LT 610 3415.5 Pioneer Medical Center Base Price Schedule 3100278 972 26 LT 2 390 Prof PMC Base Price Schedule Pioneer Medical Center MR Wrist w/wo Contrast R MRI 73223 3000270 RT 610 3415.5 Pioneer Medical Center Base Price Schedule 3100278 972 26 RT 2 390 Prof PMC Base Price Schedule Pioneer Medical Center MR Wrist wo Contrast L MRI 73221 3000262 LT 610 1880 Pioneer Medical Center Base Price Schedule 3100260 972 26 LT 2 306.5 Prof PMC Base Price Schedule Pioneer Medical Center MR Wrist wo Contrast R MRI 73221 3000262 RT 610 1880 Pioneer Medical Center Base Price Schedule 3100260 972 26 RT 2 306.5 Prof PMC Base Price Schedule Pioneer Medical Center NM Acute Thrombosis Venogram Nuc Med 78456 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Bexxar Diagnostic Scan Nuc Med 78804 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Bexxar Therapeutic Dose Nuc Med 79403 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Bone Scan 3 Phase Nuc Med 78315 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Bone Scan Limited Planar Nuc Med 78300 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Bone Scan Multiple Nuc Med 78305 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 NM Bone Scan SPECT Nuc Med 78803 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Bone Scan Total Body Planar Nuc Med 78306 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Brain Scan Diamox SPECT Nuc Med 78803 341 0 974 0 0 Pioneer Medical Center NM Brain Scan Planar w/ Flow Nuc Med 78606 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Brain Scan SPECT Nuc Med 78803 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Brain Scan Static 4 View Nuc Med 78605 341 0 974 26 0 0 Pioneer Medical Center NM Breast Tumor Localization L Nuc Med 78800 LT 341 0 Pioneer Medical Center Base Price Schedule 974 26 LT 2 0 Pioneer Medical Center NM Breast Tumor Localization R Nuc Med 78800 RT 341 0 Pioneer Medical Center Base Price Schedule 974 26 RT 2 0 Pioneer Medical Center NM CSF Leakage Localization Nuc Med 78650 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Cardiac Amyloid Tumor SPECT Nuc Med 78803 341 0 974 0 0 Pioneer Medical Center NM Cardiac Shunt Study Nuc Med 78428 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Cisternogram Nuc Med 78630 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Diagnostic Isotope Administration Nuc Med 0 Pioneer Medical Center Base Price Schedule 974 0 0 Pioneer Medical Center NM GI Bleed Scan Nuc Med 78278 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Gallium Scan Nuc Med 78802 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Gastric Emptying Study Nuc Med 78264 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM HIDA Scan Nuc Med 78226 341 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center NM HIDA Scan w/ CCK Nuc Med 78227 341 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center NM I 123 Whole Body Scan Nuc Med 78018 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM I 131 Thyrogen Whole Body Nuc Med 78018 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM I 131 Whole Body Scan Nuc Med 78018 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Inflam Process Localization SPECT Nuc Med 0 Pioneer Medical Center Base Price Schedule 0 0 Pioneer Medical Center NM Inject IV Non Imaging Localization Nuc Med 78808 341 0 Pioneer Medical Center Base Price Schedule 974 0 0 Pioneer Medical Center NM Intracavity Colloid Therapy Nuc Med 79200 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Kidney SPECT Nuc Med 78803 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Liver SPECT w/ Vascular Flow Nuc Med 78803 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Liver/Spleen Imaging w/ Flow Nuc Med 78216 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Liver/Spleen SPECT Nuc Med 78803 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Liver/Spleen Static Planar Nuc Med 78215 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Lung Perfusion Imaging Nuc Med 78580 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Lung Quantitative Diff Perf/Vent Nuc Med 78598 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Lung Quantitative Diff Perfusion Nuc Med 78597 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Lung Scan Ventilation/Perfusion Nuc Med 78582 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Lung Ventilation Imaging Nuc Med 78579 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Lutathera Therapy Nuc Med 79101 342 0 974 26 0 0 Pioneer Medical Center NM Lymphatic Imaging Nuc Med 78195 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM MIBG Whole Body Planar Multi Day Nuc Med 78804 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM MIBG Whole Body Planar Single Day Nuc Med 78802 341 0 974 26 0 0 Pioneer Medical Center NM MIRP Parathyroid Localization Nuc Med 78099 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM MUGA Scan Rest or Stress Nuc Med 78472 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Marrow Bone Scan Limited Nuc Med 78102 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Marrow Bone Scan Whole Body Nuc Med 78104 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Meckels Localization Scan Nuc Med 78290 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Metastron Therapy Nuc Med 79101 342 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Myocard Perf Dual Isotope Treadmill Nuc Med 78452 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Myocardial Perf Cardiolite Pharm Nuc Med 78452 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 NM Myocardial Perf Cardiolite Treadmill Nuc Med 78452 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 NM Myocardial Perf Dual Isotope Pharm Nuc Med 78452 340 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Myocardial Perf Myoview Pharm Nuc Med 78452 340 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Myocardial Perf Myoview Treadmill Nuc Med 78452 340 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Myocardial Perf Rest Only Nuc Med 78451 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Myocardial Perf Stress Only Nuc Med 78451 341 0 972 26 0 0 NM Myocardial Perf Thallium Pharm Nuc Med 78452 340 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Myocardial Perf Thallium Treadmill Nuc Med 78452 340 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Myocardial Perfusion Multi Pharm Nuc Med 78452 340 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 NM Myocardial Perfusion Multi Treadmill Nuc Med 78452 340 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 NM Myocardial Viability Study Nuc Med 78451 340 0 974 26 0 0 Pioneer Medical Center NM Octreo Scan Nuc Med 78802 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Oncoscint Planar Nuc Med 78802 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Oncoscint SPECT Nuc Med 78803 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Parathyroid Scan Nuc Med 78070 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Parathyroid Scan Planar Nuc Med 78070 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Parathyroid Scan Planar/SPECT Nuc Med 78071 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Peritoneal Venous Shunt Study Nuc Med 78291 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Plasma Volume Nuc Med 78111 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Pluvicto PSMA Therapy Nuc Med 79101 342 0 974 0 0 Pioneer Medical Center NM Polycythemia Vera Nuc Med 79101 342 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Prostascint SPECT Nuc Med 78803 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Quadramet Therapy Nuc Med 79101 342 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Radio Seed Mgmt Explant Nuc Med 78999 341 0 0 0 NM Radio Seed Mgmt Implant Nuc Med 78999 341 0 0 0 NM Red Cell Sequestration Nuc Med 78140 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Red Cell Volume Nuc Med 78121 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Reflux Study Nuc Med 78262 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Renal Scan Static Nuc Med 78700 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Renal Scan w/ Flow and Function Nuc Med 78707 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Renal Scan w/ Lasix Nuc Med 78708 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Renal Scan w/ Vascular Flow Nuc Med 78701 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Renal Scan w/ Vasotec Multi Study Nuc Med 78709 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Renal Scan w/ Vasotec Single Study Nuc Med 78708 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM SPECT/CT Multi Area Nuc Med 78832 341 0 972 26 0 0 Pioneer Medical Center NM SPECT/CT Single Area Nuc Med 78830 341 0 972 26 0 0 Pioneer Medical Center NM Salivary Scan Nuc Med 78231 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Sentinel Node Non Imaging Nuc Med 38792 361 0 Pioneer Medical Center Base Price Schedule 974 0 0 Pioneer Medical Center NM Testicular Imaging w/ Flow Nuc Med 78761 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Therasphere Therapeutic Dose Nuc Med 79445 341 0 974 26 0 0 Pioneer Medical Center NM Thyroid CA Gland Ablation Nuc Med 79005 342 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center NM Thyroid CA Mets Therapy Carcinoma Nuc Med 79005 342 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center NM Thyroid Scan Only Nuc Med 78013 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Thyroid Therapy Hyperthyroid Followup Nuc Med 79005 342 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center NM Thyroid Therapy Hyperthyroid Initial Nuc Med 79005 342 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center NM Thyroid Uptake Only Nuc Med 78012 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Thyroid Uptake and Scan Multiple Nuc Med 78014 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Thyroid Uptake and Scan Single Nuc Med 78014 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Tumor Localization Multiple Areas Nuc Med 78801 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Tumor Localization Multiple SPECT Nuc Med 78831 341 0 974 26 0 0 Pioneer Medical Center NM Tumor Localization SPECT Nuc Med 78803 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Urea Breath Test Nuc Med 78267 341 0 Pioneer Medical Center Base Price Schedule 974 0 0 Pioneer Medical Center NM VCUG Nuc Med 78740 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM VP Shunt Evaluation Nuc Med 78645 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM White Cell Localization Complete Nuc Med 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM White Cell Localization Limited Nuc Med 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Xofigo Therapeutic Dose Nuc Med 79101 342 0 974 26 0 0 Pioneer Medical Center NM Zevalin In 111 Diagnostic Scan Nuc Med 78804 341 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center NM Zevalin Y 90 Theraputic Dose Nuc Med 79403 342 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center OR Abdomen Single View Surgery 74018 4508065 320 355 Pioneer Medical Center Base Price Schedule 1531300 972 26 0 71 Prof PMC Base Price Schedule OR Ankle Arthroscopy L Surgery 0 Pioneer Medical Center Base Price Schedule 0 0 OR Ankle Arthroscopy R Surgery 0 Pioneer Medical Center Base Price Schedule 0 0 OR Ankle L Surgery 73600 LT 320 0 Pioneer Medical Center Base Price Schedule 1530229 972 26 LT 2 53.5 Prof PMC Base Price Schedule OR Ankle R Surgery 73600 4500500 RT 320 314 Pioneer Medical Center Base Price Schedule 1530229 972 26 RT 2 53.5 Prof PMC Base Price Schedule OR C Spine Single View Surgery 72020 4500856 320 343.5 Pioneer Medical Center Base Price Schedule 1530260 972 26 0 53.5 Prof PMC Base Price Schedule OR Calcaneous L Surgery 73650 4505814 LT 320 327.5 Pioneer Medical Center Base Price Schedule 1530344 972 26 LT 2 53.5 Prof PMC Base Price Schedule OR Calcaneous R Surgery 73650 4505814 RT 320 327.5 Pioneer Medical Center Base Price Schedule 1530344 972 26 RT 2 53.5 Prof PMC Base Price Schedule OR Central Line w/ Fluoro Surgery 77001 320 0 Pioneer Medical Center Base Price Schedule 0 0 OR Chest Single View Surgery 71045 4508008 320 173 Pioneer Medical Center Base Price Schedule 1531326 972 26 0 67 Prof PMC Base Price Schedule OR Chest Two View Surgery 71046 4508016 320 238.5 Pioneer Medical Center Base Price Schedule 1531334 972 26 0 78.5 Prof PMC Base Price Schedule OR Cholangiogram Addtl Surgery 74301 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 OR Cholangiogram Initial Surgery 74300 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 OR Clavicle L Surgery 73000 LT 320 0 972 26 LT 2 0 OR Clavicle R Surgery 73000 RT 320 0 972 26 RT 2 0 OR Elbow Arthroscopy L Surgery 0 Pioneer Medical Center Base Price Schedule 0 0 OR Elbow Arthroscopy R Surgery 0 Pioneer Medical Center Base Price Schedule 0 0 OR Elbow L Surgery 73070 4501201 LT 320 319.5 Pioneer Medical Center Base Price Schedule 1530385 972 26 LT 2 53.5 Prof PMC Base Price Schedule OR Elbow R Surgery 73070 4501201 RT 320 319.5 Pioneer Medical Center Base Price Schedule 1530385 972 26 RT 2 53.5 Prof PMC Base Price Schedule OR Femur L Surgery 73552 4507232 LT 320 184.5 Pioneer Medical Center Base Price Schedule 1531219 972 26 LT 2 71 Prof PMC Base Price Schedule OR Femur R Surgery 73552 4507232 RT 320 184.5 Pioneer Medical Center Base Price Schedule 1531219 972 26 RT 2 71 Prof PMC Base Price Schedule OR Femur Single View L Surgery 73551 4507224 LT 320 156 Pioneer Medical Center Base Price Schedule 1531201 972 26 LT 2 64 Prof PMC Base Price Schedule OR Femur Single View R Surgery 73551 4507224 RT 320 156 Pioneer Medical Center Base Price Schedule 1531201 972 26 RT 2 64 Prof PMC Base Price Schedule OR Finger L Surgery 73140 4501706 LT 320 299 Pioneer Medical Center Base Price Schedule 1530187 972 26 LT 2 43.5 Prof PMC Base Price Schedule OR Finger R Surgery 73140 4501706 RT 320 299 Pioneer Medical Center Base Price Schedule 1530187 972 26 RT 2 43.5 Prof PMC Base Price Schedule OR Fluoro less than 1 Hour Surgery 76000 320 0 Pioneer Medical Center Base Price Schedule 0 0 OR Foot L Surgery 73620 4502001 LT 320 271.5 Pioneer Medical Center Base Price Schedule 1530179 972 26 LT 2 53.5 Prof PMC Base Price Schedule OR Foot R Surgery 73620 4502001 RT 320 271.5 Pioneer Medical Center Base Price Schedule 1530179 972 26 RT 2 53.5 Prof PMC Base Price Schedule OR Forearm L Surgery 73090 4502100 LT 320 329.5 Pioneer Medical Center Base Price Schedule 1530153 972 26 LT 2 60.5 Prof PMC Base Price Schedule OR Forearm R Surgery 73090 4502100 RT 320 329.5 Pioneer Medical Center Base Price Schedule 1530153 972 26 RT 2 60.5 Prof PMC Base Price Schedule OR Hand L Surgery 73120 4502407 LT 320 282 Pioneer Medical Center Base Price Schedule 1530401 972 26 LT 2 53.5 Prof PMC Base Price Schedule OR Hand R Surgery 73120 4502407 RT 320 282 Pioneer Medical Center Base Price Schedule 1530401 972 26 RT 2 53.5 Prof PMC Base Price Schedule OR Hip Arthroscopy L Surgery 0 Pioneer Medical Center Base Price Schedule 0 0 OR Hip Arthroscopy R Surgery 0 Pioneer Medical Center Base Price Schedule 0 0 OR Hip L Surgery 73501 4507166 LT 320 162.5 Pioneer Medical Center Base Price Schedule 1531144 972 26 LT 2 71 Prof PMC Base Price Schedule OR Hip R Surgery 73501 4507166 RT 320 162.5 Pioneer Medical Center Base Price Schedule 1531144 972 26 RT 2 71 Prof PMC Base Price Schedule OR Humerus L Surgery 73060 4502704 LT 320 316 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 OR Humerus R Surgery 73060 4502704 RT 320 316 Pioneer Medical Center Base Price Schedule 1530252 972 26 RT 2 64 Prof PMC Base Price Schedule OR Knee Arthroscopy L Surgery 0 Pioneer Medical Center Base Price Schedule 0 0 OR Knee Arthroscopy R Surgery 0 Pioneer Medical Center Base Price Schedule 0 0 OR Knee L Surgery 73560 4502902 LT 320 311.5 Pioneer Medical Center Base Price Schedule 1530435 972 26 LT 2 62.5 Prof PMC Base Price Schedule OR Knee R Surgery 73560 4502902 RT 320 311.5 Pioneer Medical Center Base Price Schedule 1530435 972 26 RT 2 62.5 Prof PMC Base Price Schedule OR L Spine Single View Surgery 72020 4500856 320 343.5 Pioneer Medical Center Base Price Schedule 1530260 972 26 0 53.5 Prof PMC Base Price Schedule OR Pacer Insertion with Fluoro Surgery 0 Pioneer Medical Center Base Price Schedule 0 0 OR Pelvis Single View Surgery 72170 4500609 320 167.5 Pioneer Medical Center Base Price Schedule 1530062 972 26 0 76.5 Prof PMC Base Price Schedule OR Scope GI Colonoscopy Surgery 0 0 0 OR Scope GI EGD Surgery 0 0 0 OR Scope GYN Diagnostic Lap Surgery 0 0 0 OR Scope GYN Hysteroscopy Surgery 0 0 0 OR Scope GYN LAVH Surgery 0 0 0 OR Scope GYN Lap Cystectomy Surgery 0 0 0 OR Scope GYN Lap Oophorectomy Surgery 0 0 0 OR Scope GYN Lap Salpingectomy Surgery 0 0 0 OR Scope GYN TLH Surgery 0 0 0 OR Shoulder Arthroscopy L Surgery 0 Pioneer Medical Center Base Price Schedule 0 0 OR Shoulder Arthroscopy R Surgery 0 Pioneer Medical Center Base Price Schedule 0 0 OR Shoulder L Surgery 73020 4504601 LT 320 294.5 Pioneer Medical Center Base Price Schedule 1530658 972 26 LT 2 49 Prof PMC Base Price Schedule OR Shoulder R Surgery 73020 4504601 RT 320 294.5 Pioneer Medical Center Base Price Schedule 1530658 972 26 RT 2 49 Prof PMC Base Price Schedule OR Skull Limited Surgery 70250 4505202 320 363.5 Pioneer Medical Center Base Price Schedule 1530492 972 26 0 72 Prof PMC Base Price Schedule OR T Spine Single View Surgery 72020 4500856 320 343.5 Pioneer Medical Center Base Price Schedule 1530260 972 26 0 53.5 Prof PMC Base Price Schedule OR Tibia Fibula L Surgery 73590 4505707 LT 320 297 Pioneer Medical Center Base Price Schedule 1530112 972 26 LT 2 62.5 Prof PMC Base Price Schedule OR Tibia Fibula R Surgery 73590 4505707 RT 320 297 Pioneer Medical Center Base Price Schedule 1530112 972 26 RT 2 62.5 Prof PMC Base Price Schedule OR Toes L Surgery 73660 4505806 LT 320 308.5 Pioneer Medical Center Base Price Schedule 1530005 972 26 LT 2 45.5 Prof PMC Base Price Schedule OR Toes R Surgery 73660 4505806 RT 320 308.5 Pioneer Medical Center Base Price Schedule 1530005 972 26 RT 2 45.5 Prof PMC Base Price Schedule OR UDE VCUG Surgery 74455 320 0 972 26 0 0 OR Urography Retrograde Surgery 74420 320 0 Pioneer Medical Center Base Price Schedule 0 0 OR Wrist Arthroscopy L Surgery 0 Pioneer Medical Center Base Price Schedule 0 0 OR Wrist Arthroscopy R Surgery 0 Pioneer Medical Center Base Price Schedule 0 0 OR Wrist L Surgery 73100 4506002 LT 320 257 Pioneer Medical Center Base Price Schedule 1530146 972 26 LT 2 53.5 Prof PMC Base Price Schedule OR Wrist R Surgery 73100 4506002 RT 320 257 Pioneer Medical Center Base Price Schedule 1530146 972 26 RT 2 53.5 Prof PMC Base Price Schedule PI Brain Imaging Metabolic Eval PET Imaging 78608 404 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center PI Heart Muscle Imaging Initial Study PET Imaging 78459 404 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center PI Lymphoma Restaging PET Imaging 78812 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 PI Myocardial Viability PET Imaging 78459 404 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center PI PET/CT Cu-64 Dotatate PET Imaging 78815 404 0 974 26 0 0 Pioneer Medical Center PI PET/CT Limited Area PET Imaging 78814 404 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center PI PET/CT PSMA Vertex to Mid Thigh PET Imaging 78815 404 0 974 26 0 0 Pioneer Medical Center PI PET/CT Skull base to Mid Thigh PET Imaging 78815 404 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center PI PET/CT Whole Body PET Imaging 78816 404 0 Pioneer Medical Center Base Price Schedule 974 26 0 0 Pioneer Medical Center US AAA Screening Ultrasound 76706 4506424 402 594.5 Pioneer Medical Center Base Price Schedule 1530922 972 26 0 203.5 Prof PMC Base Price Schedule Pioneer Medical Center US AV Hemodialysis Access / Fistula / Gr Ultrasound 93990 921 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US AV Hemodialysis Access / Fistula / Gr Ultrasound 93990 LT 921 0 972 26 LT 2 0 Pioneer Medical Center US AV Hemodialysis Access / Fistula / Gr Ultrasound 93990 RT 921 0 972 26 RT 2 0 Pioneer Medical Center US AV Mapping Initial MDCR Ultrasound 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US AV Vessel Mapping Bilat Ultrasound 93985 402 0 972 26 0 0 Pioneer Medical Center US AV Vessel Mapping L Ultrasound 93986 LT 402 0 972 26 LT 2 0 Pioneer Medical Center US AV Vessel Mapping R Ultrasound 93986 RT 402 0 972 26 RT 2 0 Pioneer Medical Center US Abdomen Ultrasound 76700 4506051 402 876.5 Pioneer Medical Center Base Price Schedule 1530328 972 26 0 285.5 Prof PMC Base Price Schedule Pioneer Medical Center US Abdomen Limited Ultrasound 76705 4506101 402 663.5 Pioneer Medical Center Base Price Schedule 1530690 972 26 0 204.5 Prof PMC Base Price Schedule Pioneer Medical Center US Abdomen Retroperitoneal Ultrasound 76770 4506655 402 772.5 Pioneer Medical Center Base Price Schedule 1530526 972 26 0 257 Prof PMC Base Price Schedule Pioneer Medical Center US Abdomen Retroperitoneal Limited Ultrasound 76775 4506408 402 541 Pioneer Medical Center Base Price Schedule 1530518 972 26 0 203.5 Prof PMC Base Price Schedule Pioneer Medical Center US Abdominal Doppler Complete Ultrasound 93975 4507018 921 1882 Pioneer Medical Center Base Price Schedule 1530393 972 26 0 367 Prof PMC Base Price Schedule Pioneer Medical Center US Abdominal Doppler Limited Ultrasound 93976 4507026 921 1070.5 Pioneer Medical Center Base Price Schedule 1530583 972 26 0 255.5 Prof PMC Base Price Schedule Pioneer Medical Center US Abdominal/Retroperitoneal BX Ultrasound 76942 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US Ablation Guidance Ultrasound 76940 402 0 972 26 0 0 Pioneer Medical Center US Amniocentesis Diagnostic Ultrasound 76946 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US Amniocentesis Therapeutic Ultrasound 59001 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center US Amniofusion Ultrasound 59070 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center US Ankle Brachial Index Ultrasound 93922 921 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US Ankle Inj for Arthrogram L Ultrasound 76942 LT 402 0 972 26 LT 2 0 Pioneer Medical Center US Ankle Inj for Arthrogram R Ultrasound 76942 RT 402 0 972 26 RT 2 0 Pioneer Medical Center US Aorta Ultrasound 76775 4506408 402 541 Pioneer Medical Center Base Price Schedule 1530518 972 26 0 203.5 Prof PMC Base Price Schedule Pioneer Medical Center US Aorta IVC or Iliac Doppler Comp/Bilat Ultrasound 93978 921 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US Aorta or IVC Doppler Limited Ultrasound 93979 921 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US Arterial Lower Extremity Complete Ultrasound 93925 921 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US Arterial Lower Extremity Limited L Ultrasound 93926 LT 921 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center US Arterial Lower Extremity Limited R Ultrasound 93926 RT 921 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center US Arterial Mapping UE w/ Allens Bilat Ultrasound 93930 921 0 972 26 0 0 Pioneer Medical Center US Arterial Upper Extremity Complete Ultrasound 93930 921 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US Arterial Upper Extremity Limited L Ultrasound 93931 LT 921 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center US Arterial Upper Extremity Limited R Ultrasound 93931 RT 921 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center US Bicep Injection L Ultrasound 76942 LT 402 0 972 26 LT 2 0 Pioneer Medical Center US Bicep Injection R Ultrasound 76942 RT 402 0 972 26 RT 2 0 Pioneer Medical Center US Biliary Drainage Percutaneous Ultrasound 47533 402 0 972 0 0 Pioneer Medical Center US Breast Axilla Localization L Ultrasound 10035 LT 402 0 972 26 LT 2 0 Pioneer Medical Center US Breast Axilla Localization R Ultrasound 10035 RT 402 0 972 26 RT 2 0 Pioneer Medical Center US Breast Axilla Lymph Node BX L Ultrasound 76942 LT 402 0 972 26 RT 2 0 Pioneer Medical Center US Breast Axilla Lymph Node BX R Ultrasound 76942 RT 402 0 972 26 RT 2 0 Pioneer Medical Center US Breast Biopsy L Ultrasound 19083 LT 761 0 Pioneer Medical Center Base Price Schedule 972 LT 0 0 Pioneer Medical Center US Breast Biopsy L MG Ultrasound 19083 LT 761 0 Pioneer Medical Center Base Price Schedule 972 LT 0 0 US Breast Biopsy R Ultrasound 19083 RT 761 0 Pioneer Medical Center Base Price Schedule 972 RT 0 0 Pioneer Medical Center US Breast Biopsy R MG Ultrasound 19083 RT 402 0 Pioneer Medical Center Base Price Schedule 972 RT 0 0 US Breast Clip Placement L Ultrasound 19285 LT 402 0 972 LT 0 0 Pioneer Medical Center US Breast Clip Placement R Ultrasound 19285 RT 402 0 972 RT 0 0 Pioneer Medical Center US Breast Complete L Ultrasound 76641 LT 402 0 972 26 LT 2 0 Pioneer Medical Center US Breast Complete L MG Ultrasound 76641 LT 402 0 972 26 LT 2 0 US Breast Complete L and R Ultrasound 76641 LT 402 0 972 26 LT 2 0 US Breast Complete R Ultrasound 76641 RT 402 0 972 26 RT 2 0 Pioneer Medical Center US Breast Complete R MG Ultrasound 76641 RT 402 0 972 26 RT 2 0 US Breast Cyst Aspiration Additional L Ultrasound 76942 LT 402 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center US Breast Cyst Aspiration Additional R Ultrasound 76942 RT 402 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center US Breast Cyst Aspiration Addl L MG Ultrasound 76942 LT 402 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 US Breast Cyst Aspiration Addl R MG Ultrasound 76942 402 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 US Breast Cyst Aspiration L Ultrasound 76942 LT 402 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center US Breast Cyst Aspiration L MG Ultrasound 76942 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 US Breast Cyst Aspiration R Ultrasound 76942 RT 402 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center US Breast Cyst Aspiration R MG Ultrasound 76942 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 US Breast L Ultrasound 76642 4506416 LT 402 437.5 Pioneer Medical Center Base Price Schedule 1530906 972 26 LT 2 118.5 Prof PMC Base Price Schedule Pioneer Medical Center US Breast L MG Ultrasound 76642 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 US Breast L and R Ultrasound 76642 4506416 LT 402 437.5 Pioneer Medical Center Base Price Schedule 1530906 972 26 LT 2 118.5 Prof PMC Base Price Schedule Pioneer Medical Center US Breast L and R MG Ultrasound 76642 LT 402 0 972 26 LT 2 0 US Breast Localization L Ultrasound 19285 LT 402 0 Pioneer Medical Center Base Price Schedule 972 LT 0 0 Pioneer Medical Center US Breast Localization L MG Ultrasound 19285 402 0 Pioneer Medical Center Base Price Schedule 972 LT 0 0 US Breast Localization R Ultrasound 19285 RT 402 0 Pioneer Medical Center Base Price Schedule 972 RT 0 0 Pioneer Medical Center US Breast Localization R MG Ultrasound 19285 402 0 Pioneer Medical Center Base Price Schedule 972 0 0 US Breast R Ultrasound 76642 4506416 RT 402 437.5 Pioneer Medical Center Base Price Schedule 1530906 972 26 RT 2 118.5 Prof PMC Base Price Schedule Pioneer Medical Center US Breast R MG Ultrasound 76642 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 US Breast Skin Punch Biopsy Ultrasound 11104 761 0 972 0 0 Pioneer Medical Center US Carotid Doppler Bilateral Ultrasound 93880 4506952 921 1783.5 Pioneer Medical Center Base Price Schedule 1530310 972 26 0 149 Prof PMC Base Price Schedule Pioneer Medical Center US Carotid Doppler Limited L Ultrasound 93882 LT 921 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center US Carotid Doppler Limited R Ultrasound 93882 RT 921 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center US Carotid Intima Atheroma Eval Bilat Ultrasound 93895 921 0 972 26 0 0 US Chest Ultrasound 76604 4506044 402 555.5 Pioneer Medical Center Base Price Schedule 1531037 972 26 0 145.5 Prof PMC Base Price Schedule Pioneer Medical Center US Chest w/ Cardiac Ultrasound 76604 402 0 972 26 0 0 US Digital Brachial Index Ultrasound 93922 921 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US Echoencephalogram Ultrasound 76506 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US Elastography Liver Ultrasound 76981 402 0 972 0 0 US Elbow Inj for Arthrogram L Ultrasound 76942 LT 402 0 972 26 LT 2 0 Pioneer Medical Center US Elbow Inj for Arthrogram R Ultrasound 76942 RT 402 0 972 26 RT 2 0 Pioneer Medical Center US Endorectal Ultrasound 0 0 0 US Extremity Lower Non Vascular L Ultrasound 76882 4506259 LT 402 428.5 Pioneer Medical Center Base Price Schedule 1530773 972 26 LT 2 93.5 Prof PMC Base Price Schedule Pioneer Medical Center US Extremity Lower Non Vascular R Ultrasound 76882 4506259 RT 402 428.5 Pioneer Medical Center Base Price Schedule 1530773 972 26 RT 2 93.5 Prof PMC Base Price Schedule Pioneer Medical Center US Extremity Upper Non Vascular L Ultrasound 76882 4506259 LT 402 428.5 Pioneer Medical Center Base Price Schedule 1530773 972 26 LT 2 93.5 Prof PMC Base Price Schedule Pioneer Medical Center US Extremity Upper Non Vascular R Ultrasound 76882 4506259 RT 402 428.5 Pioneer Medical Center Base Price Schedule 1530773 972 26 RT 2 93.5 Prof PMC Base Price Schedule Pioneer Medical Center US FAST Ultrasound 76705 402 0 972 26 0 0 US FOCUS CV Non Tunnelled Cath Place Ultrasound 76937 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 US FOCUS CV Tunnelled Cath Place Ultrasound 76937 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 US FOCUS Paracentesis Ultrasound 49083 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 US FOCUS Thoracentesis Ultrasound 32555 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 US FOCUS Thoracentesis w/ Tube Insertion Ultrasound 32557 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 US FOCUS Tube Thoracostomy w/ or wo seal Ultrasound 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 US Femoral Nerve Injection L Ultrasound 64447 LT 402 0 972 26 LT 2 0 Pioneer Medical Center US Femoral Nerve Injection R Ultrasound 64447 RT 402 0 972 26 RT 2 0 Pioneer Medical Center US Fine Needle Aspiration Ultrasound 10005 402 0 972 0 0 Pioneer Medical Center US Fluid Collection Aspiration Perc Ultrasound 10030 761 0 972 0 0 Pioneer Medical Center US Fluid Drainage w/ Drain Placement Ultrasound 75989 402 0 972 26 0 0 Pioneer Medical Center US GYN Pelvis Complete Ultrasound 76830 4507711 402 611.5 Pioneer Medical Center Base Price Schedule 1530609 972 26 0 244.5 Prof PMC Base Price Schedule Pioneer Medical Center US GYN Pelvis Transvaginal Ultrasound 76830 4507711 402 611.5 Pioneer Medical Center Base Price Schedule 1530609 972 26 0 244.5 Prof PMC Base Price Schedule Pioneer Medical Center US Guidance by ANES Ultrasound 76942 402 0 0 0 US Guidance by Anesthesiologist Ultrasound 0 Pioneer Medical Center Base Price Schedule 972 0 0 US Hemothorax Abscess Drain Ultrasound 75989 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US Hip Infant Static Ultrasound 76886 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US Hip Infant/Dynamic w/ Physician Ultrasound 76885 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US Hip Inj for Arthrogram L Ultrasound 76942 LT 402 0 972 26 LT 2 0 Pioneer Medical Center US Hip Inj for Arthrogram R Ultrasound 76942 RT 402 0 972 26 RT 2 0 Pioneer Medical Center US Hysterosonogram Ultrasound 76831 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US IVF Follicular Study Ultrasound 76857 4506010 402 567 Pioneer Medical Center Base Price Schedule 1530807 972 26 0 119.5 Prof PMC Base Price Schedule Pioneer Medical Center US Iliac Doppler L Ultrasound 93979 LT 920 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center US Iliac Doppler R Ultrasound 93979 RT 921 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center US Iliopsoas Bursa Injection L Ultrasound 20606 921 0 972 0 0 Pioneer Medical Center US Iliopsoas Bursa Injection R Ultrasound 20206 921 0 972 0 0 Pioneer Medical Center US Intraoperative Ultrasound 76998 402 0 Pioneer Medical Center Base Price Schedule 0 0 US Joint Intermediate Inject/Asp L Ultrasound 20606 LT 761 0 972 LT 0 0 Pioneer Medical Center US Joint Intermediate Inject/Asp R Ultrasound 20606 RT 761 0 972 RT 0 0 Pioneer Medical Center US Joint Lower Non Vasc Complete L Ultrasound 76881 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US Joint Lower Non Vasc Complete R Ultrasound 76881 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US Joint Major Inject/Asp L Ultrasound 20611 LT 761 0 972 LT 0 0 Pioneer Medical Center US Joint Major Inject/Asp R Ultrasound 20611 RT 761 0 972 RT 0 0 Pioneer Medical Center US Joint Small Inject/Asp L Ultrasound 20604 LT 761 0 972 LT 0 0 Pioneer Medical Center US Joint Small Inject/Asp R Ultrasound 20604 RT 761 0 972 RT 0 0 Pioneer Medical Center US Joint Upper Non Vasc Complete L Ultrasound 76881 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US Joint Upper Non Vasc Complete R Ultrasound 76881 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US Knee Inj for Arthrogram L Ultrasound 76942 LT 402 0 972 26 LT 2 0 Pioneer Medical Center US Knee Inj for Arthrogram R Ultrasound 76942 RT 402 0 972 26 RT 2 0 Pioneer Medical Center US Liver Abscess Drain Ultrasound 49405 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center US Liver BX Ultrasound 76942 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US Localization Device Plcmt Initial Ultrasound 10035 402 0 972 0 0 Pioneer Medical Center US Lung BX Ultrasound 76942 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US Lymph Node Fine Needle Aspiration Ultrasound 10005 402 0 972 0 0 Pioneer Medical Center US Lymph Node Superficial BX Ultrasound 76942 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US MFM Image Ultrasound 0 0 0 US MSK Achilles Tendon L Ultrasound 76882 LT 402 0 972 26 LT 2 0 US MSK Achilles Tendon R Ultrasound 76882 RT 402 0 972 26 RT 2 0 US MSK Bicep Tendon L Ultrasound 76882 LT 402 0 972 26 LT 2 0 US MSK Bicep Tendon R Ultrasound 76882 RT 402 0 972 26 RT 2 0 US MSK Lower Ext L Ultrasound 76882 LT 402 0 972 26 LT 2 0 US MSK Lower Ext R Ultrasound 76882 RT 402 0 972 26 RT 2 0 US MSK Upper Ext L Ultrasound 76882 LT 402 0 972 26 LT 2 0 US MSK Upper Ext R Ultrasound 76882 RT 402 0 972 26 RT 2 0 US Mesenteric Artery Ultrasound 93975 4507018 921 1882 Pioneer Medical Center Base Price Schedule 1530393 972 26 0 367 Prof PMC Base Price Schedule Pioneer Medical Center US Midline Vascular Access Guide Ultrasound 76937 402 0 0 0 Pioneer Medical Center US Miscellaneous Abcess Drain Ultrasound 75989 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US Miscellaneous Needle Guidance Ultrasound 76942 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US Muscle BX Ultrasound 76942 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US Nephrostomy Tube Placement Ultrasound 50432 329 0 972 0 0 Pioneer Medical Center US Noninvasive Lower Extrem Art w/ Ex Ultrasound 93924 921 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US Noninvasive Lower Extrem Art wo Ex Ultrasound 93923 921 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US Noninvasive Upper Extrem Art w/ Ex Ultrasound 93924 921 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US Noninvasive Upper Extrem Art wo Ex Ultrasound 93923 921 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US OB Amniofusion Transabd Ultrasound 59070 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center US OB Chorionic Villus Sampling Ultrasound 76945 402 0 972 26 0 0 Pioneer Medical Center US OB Detailed Study Ultrasound 76811 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US OB Detailed Study Each Addtl Fetus Ultrasound 76812 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US OB Doppler Echo Complete Ultrasound 76827 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US OB Doppler Echo Ltd/Follow Up Ultrasound 76828 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US OB Echo Follow Up/Repeat Ultrasound 76826 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US OB Fetal Biophys w/o non Stress Ultrasound 76819 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US OB Fetal Biophysical Profile w/ NST Ultrasound 76818 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US OB Fetal Fluid Drain Ultrasound 59074 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center US OB Fetal Nuchal Transl. 1st Gest Ultrasound 76813 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US OB Fetal Nuchal Transl. ea. Addtl. Ultrasound 76814 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US OB Fetal Umbilical Doppler Ultrasound 76827 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US OB First Trimester Ultrasound 76801 4506325 402 657 Pioneer Medical Center Base Price Schedule 1530823 972 26 0 178.5 Prof PMC Base Price Schedule Pioneer Medical Center US OB First Trimester Each Addtl Fetus Ultrasound 76802 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US OB Follow up/Repeat Ultrasound 76816 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US OB Limited Ultrasound 76815 4506036 402 447.5 Pioneer Medical Center Base Price Schedule 1530914 972 26 0 128.5 Prof PMC Base Price Schedule Pioneer Medical Center US OB Over 14 weeks Ultrasound 76805 4506317 402 700 Pioneer Medical Center Base Price Schedule 1530500 972 26 0 272.5 Prof PMC Base Price Schedule Pioneer Medical Center US OB Over 14 weeks Each Addtl Fetus Ultrasound 76810 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US OB Transvaginal Ultrasound 76817 4507802 402 403.5 Pioneer Medical Center Base Price Schedule 1531235 972 26 0 168.5 Prof PMC Base Price Schedule Pioneer Medical Center US OB Viewpoint Merge Ultrasound 0 Pioneer Medical Center Base Price Schedule 0 0 Pioneer Medical Center US OR Needle Guidance Ultrasound 76942 402 0 0 0 Pioneer Medical Center US OR Needle Guide w/ Application Ultrasound 76942 402 0 0 0 US OR Prostate Volume w/ Application Ultrasound 76873 402 0 0 0 US Ophthalmic FB Loc L Ultrasound 76529 LT 402 0 972 26 LT 2 0 US Ophthalmic FB Loc R Ultrasound 76529 RT 402 0 972 26 RT 2 0 US Ophthalmic L Ultrasound 76512 LT 402 0 972 26 LT 2 0 US Ophthalmic R Ultrasound 76512 RT 402 0 972 26 RT 2 0 US PICC Placement Ultrasound 36573 402 0 0 0 Pioneer Medical Center US PICC Placement by Rad Ultrasound 36573 402 0 972 0 0 Pioneer Medical Center US PICC Replacement Ultrasound 36584 402 0 0 0 Pioneer Medical Center US POC Office Guidance Ultrasound 0 0 0 US Pancreas BX Ultrasound 76942 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US Paracentesis Ultrasound 49083 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center US Parathyroid Ultrasound 76536 4506804 402 653.5 Pioneer Medical Center Base Price Schedule 1530591 972 26 0 187.5 Prof PMC Base Price Schedule Pioneer Medical Center US Parotid BX Ultrasound 76942 402 0 972 26 0 0 Pioneer Medical Center US Pelvis Limited Ultrasound 76857 4506010 402 567 Pioneer Medical Center Base Price Schedule 1530807 972 26 0 119.5 Prof PMC Base Price Schedule Pioneer Medical Center US Pelvis TransAbd Only Ultrasound 76856 4506507 402 731.5 Pioneer Medical Center Base Price Schedule 1530468 972 26 0 213 Prof PMC Base Price Schedule Pioneer Medical Center US Penis Non Vascular Ultrasound 76857 4506010 402 567 Pioneer Medical Center Base Price Schedule 1530807 972 26 0 119.5 Prof PMC Base Price Schedule Pioneer Medical Center US Pericardiocentesis Ultrasound 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center US Peritoneal Abscess Drain Ultrasound 49406 402 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center US Platelet Rich Plasma Inject L Ultrasound 0232T LT 761 0 972 LT 0 0 Pioneer Medical Center US Platelet Rich Plasma Inject R Ultrasound 0232T RT 761 0 972 RT 0 0 Pioneer Medical Center US Pleura BX Ultrasound 76942 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US Pleural Drainage w/ Cath Insertion Ultrasound 32557 761 0 972 0 0 Pioneer Medical Center US Prostate BX Ultrasound 76942 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 US Prostate Fiducial Marker Placement Ultrasound 76942 402 0 972 26 0 0 US Pseudoaneurysm Repair Ultrasound 76936 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US REI Follicular Study Ultrasound 76857 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 US RITA Visceral Ablation Guide Ultrasound 76940 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US Renal Ultrasound 76775 4506408 402 541 Pioneer Medical Center Base Price Schedule 1530518 972 26 0 203.5 Prof PMC Base Price Schedule Pioneer Medical Center US Renal BX Ultrasound 76942 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US Renal Cyst Aspiraton Ultrasound 76942 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US Renal Transplant Ultrasound 76776 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US Renal or Perirenal Abscess Drain Ultrasound 49405 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center US Renal w/ Bladder Ultrasound 76770 4506655 402 772.5 Pioneer Medical Center Base Price Schedule 1530526 972 26 0 257 Prof PMC Base Price Schedule Pioneer Medical Center US Renal w/ Doppler Ultrasound 76775 4506408 402 541 Pioneer Medical Center Base Price Schedule 1530518 972 26 0 203.5 Prof PMC Base Price Schedule Pioneer Medical Center US Retroperitoneal Abscess Drain Ultrasound 49406 402 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center US Sclerotherapy Fluid Collection Perc Ultrasound 49185 761 0 972 0 0 Pioneer Medical Center US Shock Ultrasound 76705 402 0 972 26 0 0 US Shoulder Inj for Arthrogram L Ultrasound 76942 LT 402 0 972 26 LT 2 0 Pioneer Medical Center US Shoulder Inj for Arthrogram R Ultrasound 76942 RT 402 0 972 26 RT 2 0 Pioneer Medical Center US Soft Tissue Fluid Drainage Ultrasound 10030 761 0 972 0 0 Pioneer Medical Center US Soft Tissue Neck Ultrasound 76536 4506804 402 653.5 Pioneer Medical Center Base Price Schedule 1530591 972 26 0 187.5 Prof PMC Base Price Schedule Pioneer Medical Center US Spinal Canal Ultrasound 76800 4522264 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US Stab Phlebectomy 1-9 Incisions Ultrasound 37799 761 0 972 0 0 Pioneer Medical Center US Stab Phlebectomy 10-20 Incisions Ultrasound 37765 761 0 972 0 0 Pioneer Medical Center US Stab Phlebectomy 20+ Incisions Ultrasound 37766 761 0 972 0 0 Pioneer Medical Center US Subdiaphramatic Abscess Drain Ultrasound 49405 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center US Submandibular BX Ultrasound 76942 402 0 972 26 0 0 Pioneer Medical Center US Temporal Artery Doppler Ultrasound 93880 4506952 921 1783.5 Pioneer Medical Center Base Price Schedule 1530310 972 26 0 149 Prof PMC Base Price Schedule Pioneer Medical Center US Testicular Ultrasound 76870 4506754 402 741 Pioneer Medical Center Base Price Schedule 1530765 972 26 0 214 Prof PMC Base Price Schedule Pioneer Medical Center US Testicular w/ Doppler Ultrasound 76870 4506754 402 741 Pioneer Medical Center Base Price Schedule 1530674 972 26 0 90 Prof PMC Base Price Schedule Pioneer Medical Center US Therapy Planning Ultrasound 0 Pioneer Medical Center Base Price Schedule 0 0 US Thoracentesis Ultrasound 32555 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center US Thoracentesis Bilateral Ultrasound 32555 50 761 0 972 50 0 0 Pioneer Medical Center US Thyroid Ultrasound 76536 4506804 402 653.5 Pioneer Medical Center Base Price Schedule 1530591 972 26 0 187.5 Prof PMC Base Price Schedule Pioneer Medical Center US Thyroid Fine Needle Aspiration Ultrasound 10005 402 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center US Transcranial Doppler Ultrasound 93886 921 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US Transcranial Doppler Limited Ultrasound 93888 921 0 972 0 0 Pioneer Medical Center US Transrectal Ultrasound 76872 402 0 972 26 0 0 US Trigger Point Injection Ultrasound 76942 402 0 972 26 0 0 Pioneer Medical Center US Tube Thoracostomy Ultrasound 32551 761 0 972 0 0 Pioneer Medical Center US Unlisted Procedure Ultrasound 76999 402 0 972 26 0 0 US Vascular Access Guidance Ultrasound 76937 402 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US Venous Abl Sclero wo Imaging LE Bilat Ultrasound 36471 50 761 0 972 50 0 0 Pioneer Medical Center US Venous Abl Sclero wo Imaging LE LT Ultrasound 36471 LT 761 0 972 LT 0 0 Pioneer Medical Center US Venous Abl Sclero wo Imaging LE RT Ultrasound 36471 RT 761 0 972 0 0 Pioneer Medical Center US Venous Ablation Adhesive Bilat Ultrasound 36482 50 761 0 972 26 50 2 0 Pioneer Medical Center US Venous Ablation Adhesive L Ultrasound 36482 LT 761 0 972 26 LT 2 0 Pioneer Medical Center US Venous Ablation Adhesive R Ultrasound 36482 RT 761 0 972 26 RT 2 0 Pioneer Medical Center US Venous Ablation Guidance Ultrasound 0 Pioneer Medical Center Base Price Schedule 0 0 Pioneer Medical Center US Venous Ablation Laser LE Initial LT Ultrasound 36478 LT 761 0 972 LT 0 0 Pioneer Medical Center US Venous Ablation Laser LE Initial RT Ultrasound 36478 RT 761 0 972 RT 0 0 Pioneer Medical Center US Venous Ablation MOCA LE Initial LT Ultrasound 36473 LT 761 0 972 LT 0 0 Pioneer Medical Center US Venous Ablation MOCA LE Initial RT Ultrasound 36473 RT 761 0 972 RT 0 0 Pioneer Medical Center US Venous Ablation RFA LE Initial Bilat Ultrasound 36475 50 761 0 972 50 0 0 Pioneer Medical Center US Venous Ablation RFA LE Initial LT Ultrasound 36475 LT 761 0 972 LT 0 0 Pioneer Medical Center US Venous Ablation RFA LE Initial RT Ultrasound 36475 RT 761 0 972 RT 0 0 Pioneer Medical Center US Venous Ablation Sclerotherapy LE LT Ultrasound 76942 LT 402 0 972 26 LT 2 0 Pioneer Medical Center US Venous Ablation Sclerotherapy LE RT Ultrasound 76942 RT 402 0 972 26 RT 2 0 Pioneer Medical Center US Venous Doppler Bilateral Ultrasound 93970 4507000 921 1513.5 Pioneer Medical Center Base Price Schedule 1530757 972 26 0 220.5 Prof PMC Base Price Schedule Pioneer Medical Center US Venous Doppler Lower Extremity Bilat Ultrasound 93970 4507000 921 1513.5 Pioneer Medical Center Base Price Schedule 1530757 972 26 0 220.5 Prof PMC Base Price Schedule Pioneer Medical Center US Venous Doppler Lower Extremity L Ultrasound 93971 4507117 LT 921 1042 Pioneer Medical Center Base Price Schedule 1530302 972 26 LT 2 141 Prof PMC Base Price Schedule Pioneer Medical Center US Venous Doppler Lower Extremity R Ultrasound 93971 4507117 RT 921 1042 Pioneer Medical Center Base Price Schedule 1530302 972 26 RT 2 141 Prof PMC Base Price Schedule Pioneer Medical Center US Venous Doppler Unilateral L Ultrasound 93971 4507117 LT 921 1042 Pioneer Medical Center Base Price Schedule 1530302 972 26 LT 2 141 Prof PMC Base Price Schedule Pioneer Medical Center US Venous Doppler Unilateral R Ultrasound 93971 4507117 RT 921 1042 Pioneer Medical Center Base Price Schedule 1530302 972 26 RT 2 141 Prof PMC Base Price Schedule Pioneer Medical Center US Venous Doppler Upper Extremity Bilat Ultrasound 93970 4507000 921 1513.5 Pioneer Medical Center Base Price Schedule 1530757 972 26 0 220.5 Prof PMC Base Price Schedule Pioneer Medical Center US Venous Doppler Upper Extremity L Ultrasound 93971 4507117 LT 921 1042 Pioneer Medical Center Base Price Schedule 1530302 972 26 LT 2 141 Prof PMC Base Price Schedule Pioneer Medical Center US Venous Doppler Upper Extremity R Ultrasound 93971 4507117 RT 921 1042 Pioneer Medical Center Base Price Schedule 1530302 972 26 RT 2 141 Prof PMC Base Price Schedule Pioneer Medical Center US Venous Mapping Bilateral Ultrasound 93970 4507000 921 1513.5 Pioneer Medical Center Base Price Schedule 1530757 972 26 0 220.5 Prof PMC Base Price Schedule Pioneer Medical Center US Venous Mapping Unilateral L Ultrasound 93971 4507117 LT 921 1042 Pioneer Medical Center Base Price Schedule 1530302 972 26 LT 2 141 Prof PMC Base Price Schedule Pioneer Medical Center US Venous Mapping Unilateral R Ultrasound 93971 4507117 RT 921 1042 Pioneer Medical Center Base Price Schedule 1530302 972 26 RT 2 141 Prof PMC Base Price Schedule Pioneer Medical Center US Venous Refill Physiological Study Bil Ultrasound 921 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center US Venous Saphenous Mapping Bilat Ultrasound 93970 4507000 921 1513.5 Pioneer Medical Center Base Price Schedule 1530757 972 26 0 220.5 Prof PMC Base Price Schedule Pioneer Medical Center US Venous Saphenous Mapping Unilat L Ultrasound 93971 4507117 LT 921 1042 Pioneer Medical Center Base Price Schedule 1530302 972 26 LT 2 141 Prof PMC Base Price Schedule Pioneer Medical Center US Venous Saphenous Mapping Unilat R Ultrasound 93971 4507117 RT 921 1042 Pioneer Medical Center Base Price Schedule 1530302 972 26 RT 2 141 Prof PMC Base Price Schedule Pioneer Medical Center US Venous Valve Competency Bilateral Ultrasound 93970 4507000 921 1513.5 Pioneer Medical Center Base Price Schedule 1530757 972 26 0 220.5 Prof PMC Base Price Schedule Pioneer Medical Center US Venous Valve Competency L Ultrasound 93971 4507117 LT 921 1042 Pioneer Medical Center Base Price Schedule 1530302 972 26 LT 2 141 Prof PMC Base Price Schedule Pioneer Medical Center US Venous Valve Competency R Ultrasound 93971 4507117 RT 921 1042 Pioneer Medical Center Base Price Schedule 1530302 972 26 RT 2 141 Prof PMC Base Price Schedule Pioneer Medical Center US Veterinary Ultrasound 76999 402 0 0 0 US Wrist Inj for Arthrogram L Ultrasound 76942 LT 402 0 972 26 LT 2 0 Pioneer Medical Center US Wrist Inj for Arthrogram R Ultrasound 76942 RT 402 0 972 26 RT 2 0 Pioneer Medical Center US eFAST Ultrasound 76705 402 0 972 26 0 0 XR AC Joints w/ and w/o weights Bilat General X-ray exams 73050 4500203 320 385 Pioneer Medical Center Base Price Schedule 1530369 972 26 0 68 Prof PMC Base Price Schedule Pioneer Medical Center XR AC Joints w/o weights Bilateral General X-ray exams 73050 4500203 320 385 Pioneer Medical Center Base Price Schedule 1530369 972 26 0 68 Prof PMC Base Price Schedule Pioneer Medical Center XR AP Pelvis/Lateral Hip L General X-ray exams 73502 4507174 LT 320 271.5 Pioneer Medical Center Base Price Schedule 1531151 972 26 LT 2 85 Prof PMC Base Price Schedule Pioneer Medical Center XR AP Pelvis/Lateral Hip R General X-ray exams 73502 4507174 RT 320 271.5 Pioneer Medical Center Base Price Schedule 1531151 972 26 RT 2 85 Prof PMC Base Price Schedule Pioneer Medical Center XR Abdomen 3 Views General X-ray exams 74021 4508081 320 435.5 Pioneer Medical Center Base Price Schedule 1531318 972 26 0 110.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Abdomen Decubitus Only General X-ray exams 74018 4508065 320 355 Pioneer Medical Center Base Price Schedule 1531300 972 26 0 71 Prof PMC Base Price Schedule Pioneer Medical Center XR Abdomen Flat and Decubitus General X-ray exams 74019 4508073 320 394.5 Pioneer Medical Center Base Price Schedule 1513131 972 26 0 102.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Abdomen Flat and Semi Upright General X-ray exams 74019 4508073 320 394.5 Pioneer Medical Center Base Price Schedule 1513131 972 26 0 102.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Abdomen Flat and Upright General X-ray exams 74019 4508073 320 394.5 Pioneer Medical Center Base Price Schedule 1513131 972 26 0 102.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Abdomen Flatplate General X-ray exams 74018 4508065 320 355 Pioneer Medical Center Base Price Schedule 1531300 972 26 0 71 Prof PMC Base Price Schedule Pioneer Medical Center XR Abdomen Upright General X-ray exams 74018 4508065 320 355 Pioneer Medical Center Base Price Schedule 1531300 972 26 0 71 Prof PMC Base Price Schedule Pioneer Medical Center XR Acute Abdominal Series General X-ray exams 74022 4500302 320 539.5 Pioneer Medical Center Base Price Schedule 1530054 972 26 0 110.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Ankle Arthrogram L General X-ray exams 73615 LT 320 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center XR Ankle Arthrogram R General X-ray exams 73615 RT 320 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center XR Ankle Complete L General X-ray exams 73610 4500401 LT 320 342.5 Pioneer Medical Center Base Price Schedule 1530096 972 26 LT 2 62.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Ankle Complete R General X-ray exams 73610 4500401 RT 320 342.5 Pioneer Medical Center Base Price Schedule 1530096 972 26 RT 2 62.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Ankle Limited L General X-ray exams 73600 4500500 LT 320 314 Pioneer Medical Center Base Price Schedule 1530229 972 26 LT 2 53.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Ankle Limited R General X-ray exams 73600 4500500 RT 320 314 Pioneer Medical Center Base Price Schedule 1530229 972 26 RT 2 53.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Axillary Nerve Inj ANES General X-ray exams 64417 761 0 0 0 XR B Read Chest PA Only General X-ray exams 71045 320 0 0 0 XR Bariatric Ba/Food Follow Through General X-ray exams 74250 320 0 972 26 0 0 Pioneer Medical Center XR Barium Enema General X-ray exams 74270 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR Barium Enema w/ Air Contrast General X-ray exams 74280 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR Barium Swallow for Foreign Body General X-ray exams 74220 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR Bone Age Study General X-ray exams 77072 4503017 320 159 Pioneer Medical Center Base Price Schedule 1530930 972 26 0 49 Prof PMC Base Price Schedule Pioneer Medical Center XR Bone Length Study General X-ray exams 77073 4504023 320 718.5 Pioneer Medical Center Base Price Schedule 1531029 972 26 0 83 Prof PMC Base Price Schedule Pioneer Medical Center XR Bone Survey Infant General X-ray exams 77076 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR Bone Survey for Metastasis Limited General X-ray exams 77074 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR Bronch w/ Fluoro General X-ray exams 76000 0 Pioneer Medical Center Base Price Schedule 0 0 XR C Spine AP Lateral and Odontoid General X-ray exams 72040 4500807 320 339 Pioneer Medical Center Base Price Schedule 1530088 972 26 0 72 Prof PMC Base Price Schedule Pioneer Medical Center XR C Spine AP and Lateral Only General X-ray exams 72040 4500807 320 339 Pioneer Medical Center Base Price Schedule 1530088 972 26 0 72 Prof PMC Base Price Schedule Pioneer Medical Center XR C Spine AP/Lat/Flex/Extend Only General X-ray exams 72050 4500708 320 519.5 Pioneer Medical Center Base Price Schedule 1530377 972 26 0 106 Prof PMC Base Price Schedule Pioneer Medical Center XR C Spine Complete w/ Obliques General X-ray exams 72050 4500708 320 519.5 Pioneer Medical Center Base Price Schedule 1530377 972 26 0 106 Prof PMC Base Price Schedule Pioneer Medical Center XR C Spine Flex/Extend Only General X-ray exams 72040 4500807 320 339 Pioneer Medical Center Base Price Schedule 1530088 972 26 0 72 Prof PMC Base Price Schedule Pioneer Medical Center XR C Spine Lat/Flex/Ext Only General X-ray exams 72040 4500807 320 339 Pioneer Medical Center Base Price Schedule 1530088 972 26 0 72 Prof PMC Base Price Schedule Pioneer Medical Center XR C Spine Single View General X-ray exams 72020 4500856 320 343.5 Pioneer Medical Center Base Price Schedule 1530260 972 26 0 53.5 Prof PMC Base Price Schedule Pioneer Medical Center XR C Spine w/ Obliques and Flex/Extend General X-ray exams 72052 4501805 320 640 Pioneer Medical Center Base Price Schedule 1530278 972 26 0 118.5 Prof PMC Base Price Schedule Pioneer Medical Center XR C spine 2 or 3 Views General X-ray exams 72040 320 0 972 26 0 0 XR C spine 4 or 5 Views General X-ray exams 72050 320 0 972 26 0 0 XR C spine 6 or More Views General X-ray exams 72052 320 0 972 26 0 0 XR Calcaneous L General X-ray exams 73650 4505814 LT 320 327.5 Pioneer Medical Center Base Price Schedule 1530344 972 26 LT 2 53.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Calcaneous R General X-ray exams 73650 4505814 RT 320 327.5 Pioneer Medical Center Base Price Schedule 1530344 972 26 RT 2 53.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Carpal Tunnel TX INJ by ANES General X-ray exams 20526 0 0 0 XR Celiac Plexus Block Anesthetic General X-ray exams 64530 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center XR Celiac Plexus Block by ANES General X-ray exams 64530 761 0 0 0 Pioneer Medical Center XR Celiac Plexus Neurolytic Dest by ANES General X-ray exams 64680 761 0 Pioneer Medical Center Base Price Schedule 0 0 Pioneer Medical Center XR Chest Decubitus L General X-ray exams 71045 4508008 LT 324 173 Pioneer Medical Center Base Price Schedule 1531326 972 26 LT 2 67 Prof PMC Base Price Schedule Pioneer Medical Center XR Chest Decubitus R General X-ray exams 71045 4508008 RT 324 173 Pioneer Medical Center Base Price Schedule 1531326 972 26 RT 2 67 Prof PMC Base Price Schedule Pioneer Medical Center XR Chest Inspiration and Expiration General X-ray exams 71046 4508016 324 238.5 Pioneer Medical Center Base Price Schedule 1531334 972 26 0 78.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Chest Lateral Only General X-ray exams 71045 4508008 324 173 Pioneer Medical Center Base Price Schedule 1531326 972 26 0 67 Prof PMC Base Price Schedule Pioneer Medical Center XR Chest PA and Lat w/ Obliques General X-ray exams 71048 4508032 324 314 Pioneer Medical Center Base Price Schedule 1531359 972 26 0 118.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Chest PA and Lateral General X-ray exams 71046 4508016 324 238.5 Pioneer Medical Center Base Price Schedule 1531334 972 26 0 78.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Chest PA/AP Only General X-ray exams 71045 4508008 324 173 Pioneer Medical Center Base Price Schedule 1531326 972 26 0 67 Prof PMC Base Price Schedule Pioneer Medical Center XR Chest Rpt w/ Nipple Markers General X-ray exams 71045 4508008 320 173 Pioneer Medical Center Base Price Schedule 1531326 972 26 0 67 Prof PMC Base Price Schedule Pioneer Medical Center XR Chest w/ Apical Lordotic General X-ray exams 71047 4508024 324 258 Pioneer Medical Center Base Price Schedule 1531342 972 26 0 91 Prof PMC Base Price Schedule Pioneer Medical Center XR Chest/Abdomen AP Infant General X-ray exams 71045 4508008 324 173 Pioneer Medical Center Base Price Schedule 1531326 972 26 0 67 Prof PMC Base Price Schedule Pioneer Medical Center XR Clavicle L General X-ray exams 73000 4501102 LT 320 261.5 Pioneer Medical Center Base Price Schedule 1530336 972 26 LT 2 61.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Clavicle R General X-ray exams 73000 4501102 RT 320 261.5 Pioneer Medical Center Base Price Schedule 1530336 972 26 RT 2 61.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Colon Enema Therapeutic General X-ray exams 74283 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 XR Colon Water Soluble Contrast General X-ray exams 74270 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR Cystography General X-ray exams 74430 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 XR DXA Appendicular Skeleton General X-ray exams 77081 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR DXA Appendicular Skeleton NR General X-ray exams 77081 320 0 Pioneer Medical Center Base Price Schedule 972 0 0 XR DXA Axial Skeleton General X-ray exams 77080 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR DXA Axial Skeleton NR General X-ray exams 77080 320 0 Pioneer Medical Center Base Price Schedule 972 0 0 XR DXA Axial w/ Vertebral FX Assessment General X-ray exams 77085 320 0 972 26 0 0 Pioneer Medical Center XR DXA Axial w/ Vertebral FX Assesst NR General X-ray exams 77085 320 0 0 0 XR DXA Body Composition General X-ray exams 76499 320 0 0 0 XR DXA Vertebral FX Assessment General X-ray exams 77086 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR DXA Vertebral FX Assessment NR General X-ray exams 77086 320 0 Pioneer Medical Center Base Price Schedule 972 0 0 XR Dacryocystogram General X-ray exams 70170 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR Digitize Outside Films General X-ray exams 0 Pioneer Medical Center Base Price Schedule 0 0 XR EGD w/fluoro Non-Rad General X-ray exams 76000 0 0 0 XR ERC Biliary Duct System General X-ray exams 74328 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 XR ERCP General X-ray exams 74330 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 XR ERP Pancreatic Duct System General X-ray exams 74329 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 XR Elbow AP and Lateral L General X-ray exams 73070 4501201 LT 320 319.5 Pioneer Medical Center Base Price Schedule 1530385 972 26 LT 2 53.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Elbow AP and Lateral R General X-ray exams 73070 4501201 RT 320 319.5 Pioneer Medical Center Base Price Schedule 1530385 972 26 RT 2 53.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Elbow Arthrogram L General X-ray exams 73085 LT 320 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center XR Elbow Arthrogram R General X-ray exams 73085 RT 320 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center XR Elbow Complete L General X-ray exams 73080 4501300 LT 320 369 Pioneer Medical Center Base Price Schedule 1530633 972 26 LT 2 62.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Elbow Complete R General X-ray exams 73080 4501300 RT 320 369 Pioneer Medical Center Base Price Schedule 1530633 972 26 RT 2 62.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Elbow Injection for CT/MRI L General X-ray exams 77002 LT 320 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center XR Elbow Injection for CT/MRI R General X-ray exams 77002 RT 320 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center XR Enteroclysis General X-ray exams 74251 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR Entire Spine AP and Lateral General X-ray exams 72082 4507133 320 335 Pioneer Medical Center Base Price Schedule 1531110 972 26 0 122 Prof PMC Base Price Schedule Pioneer Medical Center XR Epidural Blood Patch by ANES General X-ray exams 62273 761 0 0 0 Pioneer Medical Center XR Epidural Inj Cer/Thor by ANES General X-ray exams 62321 761 0 0 0 Pioneer Medical Center XR Epidural Inj L Spine by Rad General X-ray exams 62323 320 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center XR Epidural Inj Lumb/Sacr by ANES General X-ray exams 62323 761 0 Pioneer Medical Center Base Price Schedule 0 0 Pioneer Medical Center XR Epidural inj Cervical Spine by Rad General X-ray exams 62321 320 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center XR Esophageal Dilitation General X-ray exams 74360 320 0 Pioneer Medical Center Base Price Schedule 0 0 XR Esophagram General X-ray exams 74220 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR Eye Detect for Foreign Body General X-ray exams 70030 4504031 320 260.5 Pioneer Medical Center Base Price Schedule 1531409 972 26 0 59.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Facet Inj L Spine ANES General X-ray exams 64493 0 0 0 XR Facet Inj Lumb/Sac Spine ANES General X-ray exams 64494 0 0 0 XR Facet Joint Dest C/T ANES General X-ray exams 64634 0 0 0 XR Facet Joint Dest Lum/Sac ANES General X-ray exams 64636 0 0 0 XR Facet Joint Destruction Cerv/Thor General X-ray exams 64633 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center XR Facet Joint Destruction Lumb/Sacr General X-ray exams 64635 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 XR Facet Joint Inj C/T Bilat ANES General X-ray exams 64490 50 761 0 Pioneer Medical Center Base Price Schedule 0 0 Pioneer Medical Center XR Facet Joint Inj Cerv/Thor ANES General X-ray exams 64490 761 0 Pioneer Medical Center Base Price Schedule 0 0 Pioneer Medical Center XR Facet Joint Inj Cerv/Thor Bilat Rad General X-ray exams 64490 50 361 0 Pioneer Medical Center Base Price Schedule 972 50 0 0 Pioneer Medical Center XR Facet Joint Inj Cerv/Thor Uni Rad General X-ray exams 64490 361 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center XR Facet Joint Inj L/S Bilat ANES General X-ray exams 64493 50 761 0 Pioneer Medical Center Base Price Schedule 0 0 Pioneer Medical Center XR Facet Joint Inj Lumb/Sacr ANES General X-ray exams 64493 761 0 Pioneer Medical Center Base Price Schedule 0 0 Pioneer Medical Center XR Facet Joint Inj Lumb/Sacr Bilat Rad General X-ray exams 64493 50 361 0 Pioneer Medical Center Base Price Schedule 972 50 0 0 Pioneer Medical Center XR Facet Joint Inj Lumb/Sacr Uni Rad General X-ray exams 64493 361 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center XR Facet Neurolytic Dest C/T Bilat ANES General X-ray exams 64633 50 761 0 0 0 Pioneer Medical Center XR Facet Neurolytic Dest Cerv/Thor ANES General X-ray exams 64633 761 0 0 0 Pioneer Medical Center XR Facet Neurolytic Dest L/S Bilat ANES General X-ray exams 64635 50 761 0 0 0 Pioneer Medical Center XR Facet Neurolytic Dest Lumb/Sacr ANES General X-ray exams 64635 761 0 0 0 Pioneer Medical Center XR Facet inj C/T Spine ANES General X-ray exams 64490 0 0 0 XR Facial Bones Complete General X-ray exams 70150 4501409 320 543.5 Pioneer Medical Center Base Price Schedule 1530559 972 26 0 85 Prof PMC Base Price Schedule Pioneer Medical Center XR Facial Bones Limited General X-ray exams 70140 4501508 320 203.5 Pioneer Medical Center Base Price Schedule 1530815 972 26 0 65 Prof PMC Base Price Schedule Pioneer Medical Center XR Femur L General X-ray exams 73552 4507232 LT 320 184.5 Pioneer Medical Center Base Price Schedule 1531219 972 26 LT 2 71 Prof PMC Base Price Schedule Pioneer Medical Center XR Femur R General X-ray exams 73552 4507232 RT 320 184.5 Pioneer Medical Center Base Price Schedule 1531219 972 26 RT 2 71 Prof PMC Base Price Schedule Pioneer Medical Center XR Femur Single View L General X-ray exams 73551 4507224 LT 320 156 Pioneer Medical Center Base Price Schedule 1531201 972 26 LT 2 64 Prof PMC Base Price Schedule Pioneer Medical Center XR Femur Single View R General X-ray exams 73551 4507224 RT 320 156 Pioneer Medical Center Base Price Schedule 1531201 972 26 RT 2 64 Prof PMC Base Price Schedule Pioneer Medical Center XR Finger L General X-ray exams 73140 4501706 LT 320 299 Pioneer Medical Center Base Price Schedule 1530187 972 26 LT 2 43.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Finger R General X-ray exams 73140 4501706 RT 320 299 Pioneer Medical Center Base Price Schedule 1530187 972 26 RT 2 43.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Fistula or Sinus Tract Study General X-ray exams 76080 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR Fluoro Diaphragm General X-ray exams 76000 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 XR Fluoro Non-Rad General X-ray exams 76000 320 0 0 0 XR Fluoro less than 1 Hour General X-ray exams 76000 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 XR Foot Arthritis PA Only Bilateral General X-ray exams 73620 4502001 320 271.5 Pioneer Medical Center Base Price Schedule 1530179 972 26 0 53.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Foot Complete L General X-ray exams 73630 4501904 LT 320 339 Pioneer Medical Center Base Price Schedule 1530104 972 26 LT 2 62.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Foot Complete R General X-ray exams 73630 4501904 RT 320 339 Pioneer Medical Center Base Price Schedule 1530104 972 26 RT 2 62.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Foot Limited L General X-ray exams 73620 4502001 LT 320 271.5 Pioneer Medical Center Base Price Schedule 1530179 972 26 LT 2 53.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Foot Limited R General X-ray exams 73620 4502001 RT 320 271.5 Pioneer Medical Center Base Price Schedule 1530179 972 26 RT 2 53.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Forearm L General X-ray exams 73090 4502100 LT 320 329.5 Pioneer Medical Center Base Price Schedule 1530153 972 26 LT 2 60.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Forearm R General X-ray exams 73090 4502100 RT 320 329.5 Pioneer Medical Center Base Price Schedule 1530153 972 26 RT 2 60.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Gastrografin Swallow General X-ray exams 74220 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR Genicular Nerve Branch Inj ANES General X-ray exams 64454 761 0 0 0 XR Genicular Neurolytic Dest by ANES General X-ray exams 64624 761 0 0 0 Pioneer Medical Center XR Greater Occipital Nerv Inj ANES General X-ray exams 64405 0 0 0 XR Groshong Cath Single Lumen General X-ray exams 77001 0 0 0 XR Hand Arthritis PA Only Bilateral General X-ray exams 73120 4502407 320 282 Pioneer Medical Center Base Price Schedule 1530401 972 26 0 53.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Hand Arthritis PA and Lateral L General X-ray exams 73130 4502308 LT 320 349 Pioneer Medical Center Base Price Schedule 1530021 972 26 LT 2 64 Prof PMC Base Price Schedule Pioneer Medical Center XR Hand Arthritis PA and Lateral R General X-ray exams 73130 4502308 RT 320 349 Pioneer Medical Center Base Price Schedule 1530021 972 26 RT 2 64 Prof PMC Base Price Schedule Pioneer Medical Center XR Hand Complete L General X-ray exams 73130 4502308 LT 320 349 Pioneer Medical Center Base Price Schedule 1530021 972 26 LT 2 64 Prof PMC Base Price Schedule Pioneer Medical Center XR Hand Complete R General X-ray exams 73130 4502308 RT 320 349 Pioneer Medical Center Base Price Schedule 1530021 972 26 RT 2 64 Prof PMC Base Price Schedule Pioneer Medical Center XR Hand Limited L General X-ray exams 73120 4502407 LT 320 282 Pioneer Medical Center Base Price Schedule 1530401 972 26 LT 2 53.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Hand Limited R General X-ray exams 73120 4502407 RT 320 282 Pioneer Medical Center Base Price Schedule 1530401 972 26 RT 2 53.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Hip 4 or More Views L General X-ray exams 73503 4507182 LT 320 299 Pioneer Medical Center Base Price Schedule 1531169 972 26 LT 2 108 Prof PMC Base Price Schedule Pioneer Medical Center XR Hip 4 or More Views R General X-ray exams 73503 4507182 RT 320 299 Pioneer Medical Center Base Price Schedule 1531169 972 26 RT 2 108 Prof PMC Base Price Schedule Pioneer Medical Center XR Hip AP L General X-ray exams 73501 4507166 LT 320 162.5 Pioneer Medical Center Base Price Schedule 1531144 972 26 LT 2 71 Prof PMC Base Price Schedule Pioneer Medical Center XR Hip AP R General X-ray exams 73501 4507166 RT 320 162.5 Pioneer Medical Center Base Price Schedule 1531144 972 26 RT 2 71 Prof PMC Base Price Schedule Pioneer Medical Center XR Hip Arthrocentesis Asp or Inj L General X-ray exams 77002 LT 320 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center XR Hip Arthrocentesis Asp or Inj R General X-ray exams 77002 RT 320 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center XR Hip Arthrogram L General X-ray exams 73525 LT 320 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center XR Hip Arthrogram R General X-ray exams 73525 RT 320 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center XR Hip Complete L General X-ray exams 73502 4507174 LT 320 271.5 Pioneer Medical Center Base Price Schedule 1531151 972 26 LT 2 85 Prof PMC Base Price Schedule Pioneer Medical Center XR Hip Complete R General X-ray exams 73502 4507174 RT 320 271.5 Pioneer Medical Center Base Price Schedule 1531151 972 26 RT 2 85 Prof PMC Base Price Schedule Pioneer Medical Center XR Hip Injection for CT/MRI L General X-ray exams 77002 LT 320 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center XR Hip Injection for CT/MRI R General X-ray exams 77002 RT 320 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center XR Hips 2 Views Bilat General X-ray exams 73521 4507190 320 227 Pioneer Medical Center Base Price Schedule 1531177 972 26 0 89 Prof PMC Base Price Schedule Pioneer Medical Center XR Hips 5 or More Views Bilat General X-ray exams 73523 4507216 320 325.5 Pioneer Medical Center Base Price Schedule 1531193 972 26 0 122 Prof PMC Base Price Schedule Pioneer Medical Center XR Humerus L General X-ray exams 73060 4502704 LT 320 316 Pioneer Medical Center Base Price Schedule 1530252 972 26 LT 2 64 Prof PMC Base Price Schedule Pioneer Medical Center XR Humerus R General X-ray exams 73060 4502704 RT 320 316 Pioneer Medical Center Base Price Schedule 1530252 972 26 RT 2 64 Prof PMC Base Price Schedule Pioneer Medical Center XR Hysterosalpingogram General X-ray exams 74740 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR IVP Limited General X-ray exams 74400 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 XR IVP w/ Tomography General X-ray exams 74415 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 XR Iliopsoas Bursa Injection L General X-ray exams 77002 LT 320 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center XR Iliopsoas Bursa Injection R General X-ray exams 77002 RT 320 0 972 26 RT 2 0 Pioneer Medical Center XR Incorrect Report General X-ray exams 0 Pioneer Medical Center Base Price Schedule 972 0 0 XR Intercostal Inject Multi by ANES General X-ray exams 64421 761 0 0 0 Pioneer Medical Center XR Intercostal Inject Single by ANES General X-ray exams 64420 761 0 0 0 Pioneer Medical Center XR Intercostal Neurolytic Dest by ANES General X-ray exams 64620 761 0 0 0 Pioneer Medical Center XR Internal Auditory Meatuses General X-ray exams 70134 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR Intrathecal Med Inj Non-Rad General X-ray exams 62323 320 0 0 0 Pioneer Medical Center XR Intrathecal Med Inj by Rad General X-ray exams 62323 320 0 972 0 0 Pioneer Medical Center XR Joint Asp for Infection L General X-ray exams 77002 LT 320 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center XR Joint Asp for Infection R General X-ray exams 77002 RT 320 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center XR Joint Injection Intermediate L General X-ray exams 77002 LT 320 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center XR Joint Injection Intermediate R General X-ray exams 77002 RT 320 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center XR Joint Intermediate Inj ANES General X-ray exams 77002 320 0 0 0 XR Joint Major Inj ANES General X-ray exams 77002 320 0 0 0 XR Joint Small Inj ANES General X-ray exams 77002 320 0 0 0 XR Joint Survey 1 View General X-ray exams 77077 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR Knee 3 View L General X-ray exams 73562 4502811 LT 320 350 Pioneer Medical Center Base Price Schedule 1530138 972 26 LT 2 64 Prof PMC Base Price Schedule Pioneer Medical Center XR Knee 3 View R General X-ray exams 73562 4502811 RT 320 350 Pioneer Medical Center Base Price Schedule 1530138 972 26 RT 2 64 Prof PMC Base Price Schedule Pioneer Medical Center XR Knee 4 or More Views L General X-ray exams 73564 4502803 LT 320 367 Pioneer Medical Center Base Price Schedule 1530419 972 26 LT 2 78.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Knee 4 or More Views R General X-ray exams 73564 4502803 RT 320 367 Pioneer Medical Center Base Price Schedule 1530419 972 26 RT 2 78.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Knee AP and Lateral L General X-ray exams 73560 4502902 LT 320 311.5 Pioneer Medical Center Base Price Schedule 1530435 972 26 LT 2 62.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Knee AP and Lateral R General X-ray exams 73560 4502902 RT 320 311.5 Pioneer Medical Center Base Price Schedule 1530435 972 26 RT 2 62.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Knee Arthrocentesis Asp or Inj L General X-ray exams 77002 LT 320 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center XR Knee Arthrocentesis Asp or Inj R General X-ray exams 77002 RT 320 0 972 26 RT 2 0 Pioneer Medical Center XR Knee Arthrogram L General X-ray exams 73580 LT 320 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center XR Knee Arthrogram R General X-ray exams 73580 RT 320 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center XR Knee Bilateral Standing AP General X-ray exams 73565 4502829 320 613.5 Pioneer Medical Center Base Price Schedule 1530203 972 26 0 62.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Knee Injection for CT/MR L General X-ray exams 77002 LT 320 0 972 26 LT 2 0 Pioneer Medical Center XR Knee Injection for CT/MR R General X-ray exams 77002 RT 320 0 972 26 LT 2 0 Pioneer Medical Center XR Kyphoplasty Lumbar Interventional Radiology 22514 329 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center XR Kyphoplasty Thoracic Interventional Radiology 22513 329 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center XR L Spine AP and Lateral General X-ray exams 72100 4503306 320 372 Pioneer Medical Center Base Price Schedule 1530039 972 26 0 71 Prof PMC Base Price Schedule Pioneer Medical Center XR L Spine AP/Lat/Flex/Ext Flat/Upright General X-ray exams 72114 4501029 320 769.5 Pioneer Medical Center Base Price Schedule 1530781 972 26 0 124 Prof PMC Base Price Schedule Pioneer Medical Center XR L Spine AP/Lat/Flex/Extend Only General X-ray exams 72110 4503207 320 568 Pioneer Medical Center Base Price Schedule 1530120 972 26 0 108 Prof PMC Base Price Schedule Pioneer Medical Center XR L Spine Bending Views Only General X-ray exams 72120 4500419 320 474 Pioneer Medical Center Base Price Schedule 1530997 972 26 0 71 Prof PMC Base Price Schedule Pioneer Medical Center XR L Spine Complete w/ Bending Views General X-ray exams 72114 4501029 320 769.5 Pioneer Medical Center Base Price Schedule 1530781 972 26 0 124 Prof PMC Base Price Schedule Pioneer Medical Center XR L Spine Flex/Extend Only General X-ray exams 72100 4503306 320 372 Pioneer Medical Center Base Price Schedule 1530039 972 26 0 71 Prof PMC Base Price Schedule Pioneer Medical Center XR L Spine Lat/Flex/Ext Only General X-ray exams 72100 4503306 320 372 Pioneer Medical Center Base Price Schedule 1530039 972 26 0 71 Prof PMC Base Price Schedule Pioneer Medical Center XR L Spine Single View General X-ray exams 72020 4500856 320 343.5 Pioneer Medical Center Base Price Schedule 1530260 972 26 0 53.5 Prof PMC Base Price Schedule Pioneer Medical Center XR L/S Spine Complete General X-ray exams 72110 4503207 320 568 Pioneer Medical Center Base Price Schedule 1530120 972 26 0 108 Prof PMC Base Price Schedule Pioneer Medical Center XR L/S Spots Only General X-ray exams 72100 4503306 320 372 Pioneer Medical Center Base Price Schedule 1530039 972 26 0 71 Prof PMC Base Price Schedule Pioneer Medical Center XR Loopogram General X-ray exams 74425 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR Lower Extremity Infant L General X-ray exams 73592 4506465 LT 320 102.5 Pioneer Medical Center Base Price Schedule 1530971 972 26 LT 2 48 Prof PMC Base Price Schedule Pioneer Medical Center XR Lower Extremity Infant R General X-ray exams 73592 4506465 RT 320 102.5 Pioneer Medical Center Base Price Schedule 1530971 972 26 RT 2 48 Prof PMC Base Price Schedule Pioneer Medical Center XR Lumbar Puncture General X-ray exams 62328 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR Lumbar Puncture Diagnostic General X-ray exams 62328 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center XR Lumbar Puncture Diagnostic ANES General X-ray exams 62270 0 0 0 XR Lumbar Puncture Non Rad General X-ray exams 0 0 0 Pioneer Medical Center XR Lumbar Puncture Therapeutic General X-ray exams 62329 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center XR Lumbar Puncture for Chemo Non-Imaging General X-ray exams 96450 335 0 0 0 Pioneer Medical Center XR Lumbar Puncture for Chemotherapy General X-ray exams 77003 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR Lymphangiogram Abd/Pelvis Bilat General X-ray exams 75807 320 0 972 26 0 0 Pioneer Medical Center XR Lymphangiogram Abd/Pelvis Uni General X-ray exams 75805 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR Mandible Complete General X-ray exams 70110 4503405 320 547 Pioneer Medical Center Base Price Schedule 1530831 972 26 0 61.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Mandible Limited L General X-ray exams 70100 4503504 LT 320 145.5 Pioneer Medical Center Base Price Schedule 1530450 972 26 LT 2 60.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Mandible Limited R General X-ray exams 70100 4503504 RT 320 145.5 Pioneer Medical Center Base Price Schedule 1530450 972 26 RT 2 60.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Mastoid Limited L General X-ray exams 70120 4503702 LT 320 168.5 Pioneer Medical Center Base Price Schedule 1530849 972 26 LT 2 40 Prof PMC Base Price Schedule Pioneer Medical Center XR Mastoid Limited R General X-ray exams 70120 4503702 RT 320 168.5 Pioneer Medical Center Base Price Schedule 1530849 972 26 RT 2 40 Prof PMC Base Price Schedule Pioneer Medical Center XR Mastoids Complete Bilateral General X-ray exams 70130 4503603 320 248 Pioneer Medical Center Base Price Schedule 1530856 972 26 0 67 Prof PMC Base Price Schedule Pioneer Medical Center XR Myelogram Cervical General X-ray exams 62302 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center XR Myelogram Complete General X-ray exams 62305 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 XR Myelogram Lumbar General X-ray exams 62304 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 XR Myelogram Post Fossa General X-ray exams 70010 320 0 Pioneer Medical Center Base Price Schedule 972 0 0 XR Myelogram Thoracic General X-ray exams 62303 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 XR NG Tube Place/RD Consult Hold TF General X-ray exams 74340 320 0 972 26 0 0 XR NG Tube Place/RD Consult Start TF General X-ray exams 74340 320 0 972 26 0 0 XR NIOSH Chest PA Only General X-ray exams 71045 4508008 320 173 Pioneer Medical Center Base Price Schedule 1531326 972 26 0 67 Prof PMC Base Price Schedule XR Nasal Bones General X-ray exams 70160 4503801 320 265 Pioneer Medical Center Base Price Schedule 1530575 972 26 0 49 Prof PMC Base Price Schedule Pioneer Medical Center XR Naso or Orogastric tube by Rad General X-ray exams 43752 361 0 Pioneer Medical Center Base Price Schedule 972 0 0 XR Nasojejunal Feeding Tube Placement General X-ray exams 74340 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR Nasojejunal Feeding Tube Reposition General X-ray exams 76000 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR Nerve Root Block C/T Bilat by ANES General X-ray exams 64479 50 761 0 0 0 Pioneer Medical Center XR Nerve Root Block Cerv/Thor by ANES General X-ray exams 64479 761 0 0 0 Pioneer Medical Center XR Nerve Root Block L Spine by Rad General X-ray exams 64483 361 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center XR Nerve Root Block L/S Bilat by ANES General X-ray exams 64483 50 761 0 0 0 Pioneer Medical Center XR Nerve Root Block Lumb/Sacr by ANES General X-ray exams 64483 761 0 Pioneer Medical Center Base Price Schedule 0 0 Pioneer Medical Center XR Nerve Root Block T Spine by Rad General X-ray exams 64479 361 0 972 0 0 Pioneer Medical Center XR Nose to Rectum/Foreign Body Child General X-ray exams 76010 4502209 320 220.5 Pioneer Medical Center Base Price Schedule 1530989 972 26 0 66 Prof PMC Base Price Schedule Pioneer Medical Center XR O Ankle Arthritis Series L General X-ray exams 73610 4500401 LT 320 342.5 Pioneer Medical Center Base Price Schedule 1530096 972 26 LT 2 62.5 Prof PMC Base Price Schedule Pioneer Medical Center XR O Ankle Arthritis Series R General X-ray exams 73610 4500401 RT 320 342.5 Pioneer Medical Center Base Price Schedule 1530096 972 26 RT 2 62.5 Prof PMC Base Price Schedule Pioneer Medical Center XR O Foot Subtalar View Only L General X-ray exams 73620 4502001 LT 320 271.5 Pioneer Medical Center Base Price Schedule 1530179 972 26 LT 2 53.5 Prof PMC Base Price Schedule Pioneer Medical Center XR O Foot Subtalar View Only R General X-ray exams 73620 4502001 RT 320 271.5 Pioneer Medical Center Base Price Schedule 1530179 972 26 RT 2 53.5 Prof PMC Base Price Schedule Pioneer Medical Center XR O Foot w/ Subtalar View L General X-ray exams 73630 4501904 LT 320 339 Pioneer Medical Center Base Price Schedule 1530104 972 26 LT 2 62.5 Prof PMC Base Price Schedule Pioneer Medical Center XR O Foot w/ Subtalar View R General X-ray exams 73630 4501904 RT 320 339 Pioneer Medical Center Base Price Schedule 1530104 972 26 RT 2 62.5 Prof PMC Base Price Schedule Pioneer Medical Center XR O Hand w/ Brewerton L General X-ray exams 73130 4502308 LT 320 349 Pioneer Medical Center Base Price Schedule 1530021 972 26 LT 2 64 Prof PMC Base Price Schedule Pioneer Medical Center XR O Hand w/ Brewerton R General X-ray exams 73130 4502308 RT 320 349 Pioneer Medical Center Base Price Schedule 1530021 972 26 RT 2 64 Prof PMC Base Price Schedule Pioneer Medical Center XR O Knee Arthritis Series Bilat General X-ray exams 73564 4502803 LT 320 367 Pioneer Medical Center Base Price Schedule 1530419 972 26 LT 2 78.5 Prof PMC Base Price Schedule Pioneer Medical Center XR O Knee Arthritis Series L General X-ray exams 73564 4502803 LT 320 367 Pioneer Medical Center Base Price Schedule 1530419 972 26 LT 2 78.5 Prof PMC Base Price Schedule Pioneer Medical Center XR O Knee Arthritis Series R General X-ray exams 73564 4502803 RT 320 367 Pioneer Medical Center Base Price Schedule 1530419 972 26 RT 2 78.5 Prof PMC Base Price Schedule Pioneer Medical Center XR O Knee Merchant View Only L General X-ray exams 73560 4502902 LT 320 311.5 Pioneer Medical Center Base Price Schedule 1530435 972 26 LT 2 62.5 Prof PMC Base Price Schedule Pioneer Medical Center XR O Knee Merchant View Only R General X-ray exams 73560 4502902 RT 320 311.5 Pioneer Medical Center Base Price Schedule 1530435 972 26 RT 2 62.5 Prof PMC Base Price Schedule Pioneer Medical Center XR O Knee w/ Merchant View Bilat General X-ray exams 73562 4502811 LT 320 350 Pioneer Medical Center Base Price Schedule 1530138 972 26 LT 2 64 Prof PMC Base Price Schedule Pioneer Medical Center XR O Knee w/ Merchant View L General X-ray exams 73562 4502811 LT 320 350 Pioneer Medical Center Base Price Schedule 1530138 972 26 LT 2 64 Prof PMC Base Price Schedule Pioneer Medical Center XR O Knee w/ Merchant View R General X-ray exams 73562 4502811 RT 320 350 Pioneer Medical Center Base Price Schedule 1530138 972 26 RT 2 64 Prof PMC Base Price Schedule Pioneer Medical Center XR O Pelvis AP Supine General X-ray exams 72170 320 0 26 0 0 XR O Shoulder Anterior Instability L General X-ray exams 73030 4504700 LT 320 346.5 Pioneer Medical Center Base Price Schedule 1500008 972 26 LT 2 78.5 Prof PMC Base Price Schedule Pioneer Medical Center XR O Shoulder Anterior Instability R General X-ray exams 73030 4504700 RT 320 346.5 Pioneer Medical Center Base Price Schedule 1500008 972 26 RT 2 78.5 Prof PMC Base Price Schedule Pioneer Medical Center XR O Shoulder Impingement L General X-ray exams 73030 4504700 LT 320 346.5 Pioneer Medical Center Base Price Schedule 1500008 972 26 LT 2 78.5 Prof PMC Base Price Schedule Pioneer Medical Center XR O Shoulder Impingement R General X-ray exams 73030 4504700 RT 320 346.5 Pioneer Medical Center Base Price Schedule 1500008 972 26 RT 2 78.5 Prof PMC Base Price Schedule Pioneer Medical Center XR O Shoulder Outlet L General X-ray exams 73020 4504601 LT 320 294.5 Pioneer Medical Center Base Price Schedule 1530658 972 26 LT 2 49 Prof PMC Base Price Schedule Pioneer Medical Center XR O Shoulder Outlet R General X-ray exams 73020 4504601 RT 320 294.5 Pioneer Medical Center Base Price Schedule 1530658 972 26 RT 2 49 Prof PMC Base Price Schedule Pioneer Medical Center XR O Shoulder Trauma L General X-ray exams 73030 4504700 LT 320 346.5 Pioneer Medical Center Base Price Schedule 1500008 972 26 LT 2 78.5 Prof PMC Base Price Schedule Pioneer Medical Center XR O Shoulder Trauma R General X-ray exams 73030 4504700 RT 320 346.5 Pioneer Medical Center Base Price Schedule 1500008 972 26 RT 2 78.5 Prof PMC Base Price Schedule Pioneer Medical Center XR O Shoulder True AP L General X-ray exams 73020 4504601 LT 320 294.5 Pioneer Medical Center Base Price Schedule 1530658 972 26 LT 2 49 Prof PMC Base Price Schedule Pioneer Medical Center XR O Shoulder True AP R General X-ray exams 73020 4504601 RT 320 294.5 Pioneer Medical Center Base Price Schedule 1530658 972 26 RT 2 49 Prof PMC Base Price Schedule Pioneer Medical Center XR O Shoulder True AP/Axillary L General X-ray exams 73030 4504700 LT 320 346.5 Pioneer Medical Center Base Price Schedule 1500008 972 26 LT 2 78.5 Prof PMC Base Price Schedule Pioneer Medical Center XR O Shoulder True AP/Axillary R General X-ray exams 73030 4504700 RT 320 346.5 Pioneer Medical Center Base Price Schedule 1500008 972 26 RT 2 78.5 Prof PMC Base Price Schedule Pioneer Medical Center XR O Shoulder True AP/Y View L General X-ray exams 73030 4504700 LT 320 346.5 Pioneer Medical Center Base Price Schedule 1500008 972 LT 26 2 78.5 Prof PMC Base Price Schedule Pioneer Medical Center XR O Shoulder True AP/Y View R General X-ray exams 73030 4504700 RT 320 346.5 Pioneer Medical Center Base Price Schedule 1500008 972 RT 26 2 78.5 Prof PMC Base Price Schedule Pioneer Medical Center XR O Shoulder Wespoint L General X-ray exams 73020 4504601 LT 320 294.5 Pioneer Medical Center Base Price Schedule 1530658 972 26 LT 2 49 Prof PMC Base Price Schedule Pioneer Medical Center XR O Shoulder Wespoint R General X-ray exams 73020 4504601 RT 320 294.5 Pioneer Medical Center Base Price Schedule 1530658 972 26 RT 2 49 Prof PMC Base Price Schedule Pioneer Medical Center XR O Total Knee post TH L General X-ray exams 73562 LT 320 0 972 26 LT 2 0 Pioneer Medical Center XR O Total Knee post TH R General X-ray exams 73562 RT 320 0 972 26 RT 2 0 Pioneer Medical Center XR O Wrist Clenched Fist L General X-ray exams 73110 4505905 LT 320 342.5 Pioneer Medical Center Base Price Schedule 1530211 972 26 LT 2 64 Prof PMC Base Price Schedule Pioneer Medical Center XR O Wrist Clenched Fist R General X-ray exams 73110 4505905 RT 320 342.5 Pioneer Medical Center Base Price Schedule 1530211 972 26 RT 2 64 Prof PMC Base Price Schedule Pioneer Medical Center XR O Wrist Motion Series L General X-ray exams 73110 4505905 LT 320 342.5 Pioneer Medical Center Base Price Schedule 1530211 972 26 LT 2 64 Prof PMC Base Price Schedule Pioneer Medical Center XR O Wrist Motion Series R General X-ray exams 73110 4505905 RT 320 342.5 Pioneer Medical Center Base Price Schedule 1530211 972 26 RT 2 64 Prof PMC Base Price Schedule Pioneer Medical Center XR O Wrist Roberts View Only L General X-ray exams 73100 4506002 LT 320 257 Pioneer Medical Center Base Price Schedule 1530146 972 26 LT 2 53.5 Prof PMC Base Price Schedule Pioneer Medical Center XR O Wrist Roberts View Only R General X-ray exams 73100 4506002 RT 320 257 Pioneer Medical Center Base Price Schedule 1530146 972 26 RT 2 53.5 Prof PMC Base Price Schedule Pioneer Medical Center XR O Wrist Scaphoid Views Only L General X-ray exams 73100 4506002 LT 320 257 Pioneer Medical Center Base Price Schedule 1530146 972 26 LT 2 53.5 Prof PMC Base Price Schedule Pioneer Medical Center XR O Wrist Scaphoid Views Only R General X-ray exams 73100 4506002 RT 320 257 Pioneer Medical Center Base Price Schedule 1530146 972 26 RT 2 53.5 Prof PMC Base Price Schedule Pioneer Medical Center XR O Wrist w/ Carpal Tunnel L General X-ray exams 73110 4505905 LT 320 342.5 Pioneer Medical Center Base Price Schedule 1530211 972 26 LT 2 64 Prof PMC Base Price Schedule Pioneer Medical Center XR O Wrist w/ Carpal Tunnel R General X-ray exams 73110 4505905 RT 320 342.5 Pioneer Medical Center Base Price Schedule 1530211 972 26 RT 2 64 Prof PMC Base Price Schedule Pioneer Medical Center XR O Wrist w/ Hamate L General X-ray exams 73110 4505905 LT 320 342.5 Pioneer Medical Center Base Price Schedule 1530211 972 26 LT 2 64 Prof PMC Base Price Schedule Pioneer Medical Center XR O Wrist w/ Hamate R General X-ray exams 73110 4505905 RT 320 342.5 Pioneer Medical Center Base Price Schedule 1530211 972 26 RT 2 64 Prof PMC Base Price Schedule Pioneer Medical Center XR O Wrist w/ Pisotriguetrial L General X-ray exams 73110 4505905 LT 320 342.5 Pioneer Medical Center Base Price Schedule 1530211 972 26 LT 2 64 Prof PMC Base Price Schedule Pioneer Medical Center XR O Wrist w/ Pisotriguetrial R General X-ray exams 73110 4505905 RT 320 342.5 Pioneer Medical Center Base Price Schedule 1530211 972 26 RT 2 64 Prof PMC Base Price Schedule Pioneer Medical Center XR O Wrist w/ Roberts L General X-ray exams 73110 4505905 LT 320 342.5 Pioneer Medical Center Base Price Schedule 1530211 972 26 LT 2 64 Prof PMC Base Price Schedule Pioneer Medical Center XR O Wrist w/ Roberts R General X-ray exams 73110 4505905 RT 320 342.5 Pioneer Medical Center Base Price Schedule 1530211 972 26 RT 2 64 Prof PMC Base Price Schedule Pioneer Medical Center XR O Wrist w/ Scaphoid L General X-ray exams 73110 4505905 LT 320 342.5 Pioneer Medical Center Base Price Schedule 1530211 972 26 LT 2 64 Prof PMC Base Price Schedule Pioneer Medical Center XR O Wrist w/ Scaphoid R General X-ray exams 73110 4505905 RT 320 342.5 Pioneer Medical Center Base Price Schedule 1530211 972 26 RT 2 64 Prof PMC Base Price Schedule Pioneer Medical Center XR Optic Foramina General X-ray exams 70190 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR Orbits Complete for Fracture General X-ray exams 70200 4503900 320 247 Pioneer Medical Center Base Price Schedule 1530641 972 26 0 88 Prof PMC Base Price Schedule Pioneer Medical Center XR Orbits for MRI General X-ray exams 70030 4504031 320 260.5 Pioneer Medical Center Base Price Schedule 1531409 972 26 0 59.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Osseous Survey Complete General X-ray exams 77075 4505079 320 663.5 Pioneer Medical Center Base Price Schedule 1531011 972 26 0 145.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Osseous Survey Infant General X-ray exams 77076 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR Osseous Survey Limited General X-ray exams 77074 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR PAIN Needle Guide Non Spinal General X-ray exams 77002 320 0 Pioneer Medical Center Base Price Schedule 0 0 XR PAIN Spine Guidance NC General X-ray exams 0 Pioneer Medical Center Base Price Schedule 0 0 XR PAIN Spine Proc Fluoro Guide General X-ray exams 77003 320 0 Pioneer Medical Center Base Price Schedule 0 0 XR Pacs Merge General X-ray exams 0 Pioneer Medical Center Base Price Schedule 0 0 XR Paranasal Sinuses Complete General X-ray exams 70220 4504908 320 488.5 Pioneer Medical Center Base Price Schedule 1530484 972 26 0 93.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Paranasal Sinuses Limited General X-ray exams 70210 4505053 320 172 Pioneer Medical Center Base Price Schedule 1530864 972 26 0 40 Prof PMC Base Price Schedule Pioneer Medical Center XR Paravertebral L Spine inj ANES General X-ray exams 64484 0 0 0 XR Pelvis AP General X-ray exams 72170 4500609 320 167.5 Pioneer Medical Center Base Price Schedule 1530062 972 26 0 76.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Pelvis Complete General X-ray exams 72190 4504015 320 298 Pioneer Medical Center Base Price Schedule 1530799 972 26 0 88 Prof PMC Base Price Schedule Pioneer Medical Center XR Pelvis Complete w/ Judet Views General X-ray exams 72190 4504015 320 298 Pioneer Medical Center Base Price Schedule 1530799 972 26 0 88 Prof PMC Base Price Schedule Pioneer Medical Center XR Pelvis Infant or Child General X-ray exams 72170 4500609 320 167.5 Pioneer Medical Center Base Price Schedule 1530062 972 26 0 76.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Pelvis and Bilateral Hips General X-ray exams 73522 4507208 320 269.5 Pioneer Medical Center Base Price Schedule 1531185 972 26 0 111.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Pelvis w/ Judet Views General X-ray exams 72190 4504015 320 298 Pioneer Medical Center Base Price Schedule 1530799 972 26 0 88 Prof PMC Base Price Schedule Pioneer Medical Center XR Peripheral Neurolytic Dest by ANES General X-ray exams 64640 761 0 0 0 Pioneer Medical Center XR Peripherl Nerve/Branch Inj ANES General X-ray exams 64450 761 0 0 0 XR Peritoneogram General X-ray exams 74190 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR Plantar Digital Nerve Inj ANES General X-ray exams 64455 0 0 0 XR Pouchogram General X-ray exams 50431 320 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center XR Pudendal Nerve Inj ANES General X-ray exams 64430 0 0 0 XR Rad Professional Consult General X-ray exams 76140 0 Pioneer Medical Center Base Price Schedule 972 0 0 XR Read Outside Films General X-ray exams 76140 320 0 Pioneer Medical Center Base Price Schedule 972 0 0 XR Removal of Esophageal Foreign Body General X-ray exams 74235 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 XR Ribs Comp Bilat w/o Chest PA General X-ray exams 71110 4504205 320 456 Pioneer Medical Center Base Price Schedule 1530708 972 26 0 106 Prof PMC Base Price Schedule Pioneer Medical Center XR Ribs Complete w/ PA Chest Bilateral General X-ray exams 71111 4505020 320 584 Pioneer Medical Center Base Price Schedule 1530161 972 26 0 118.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Ribs Complete w/ PA Chest L General X-ray exams 71101 4504304 LT 320 475 Pioneer Medical Center Base Price Schedule 1530195 972 26 LT 2 102.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Ribs Complete w/ PA Chest R General X-ray exams 71101 4504304 RT 320 475 Pioneer Medical Center Base Price Schedule 1530195 972 26 RT 2 102.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Ribs L w/o Chest PA General X-ray exams 71100 4504403 LT 320 375 Pioneer Medical Center Base Price Schedule 1530682 972 26 LT 2 84 Prof PMC Base Price Schedule Pioneer Medical Center XR Ribs R w/o Chest PA General X-ray exams 71100 4504403 RT 320 375 Pioneer Medical Center Base Price Schedule 1530682 972 26 RT 2 84 Prof PMC Base Price Schedule Pioneer Medical Center XR SBFT w/ Barium General X-ray exams 74250 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR SBFT w/ Barium and Gastrografin General X-ray exams 74250 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR SBFT w/ Gastrografin General X-ray exams 74250 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR SC Joints General X-ray exams 71130 4505038 320 247 Pioneer Medical Center Base Price Schedule 1530880 972 26 0 49 Prof PMC Base Price Schedule Pioneer Medical Center XR SGL Tendon or Ligament Inj ANES General X-ray exams 20550 0 0 0 XR SI Joint Arthrography General X-ray exams 27096 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center XR SI Joint Inj ANES General X-ray exams 64451 761 0 0 0 XR SI Joint Injection Bilateral General X-ray exams 27096 G0260 50 761 0 972 50 0 0 Pioneer Medical Center XR SI Joint Injection Unilateral General X-ray exams 27096 G0260 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center XR SI Joint Injection by ANES General X-ray exams 27096 761 0 Pioneer Medical Center Base Price Schedule 0 0 Pioneer Medical Center XR SI Joints Complete General X-ray exams 72202 4504817 320 343.5 Pioneer Medical Center Base Price Schedule 1531045 972 26 0 48 Prof PMC Base Price Schedule Pioneer Medical Center XR SI Joints Limited General X-ray exams 72200 4504809 320 343.5 Pioneer Medical Center Base Price Schedule 1530237 972 26 0 71 Prof PMC Base Price Schedule Pioneer Medical Center XR SI RFA ANES General X-ray exams 64625 0 0 0 XR SUP Hypogastric Plexus Inj ANES General X-ray exams 64517 0 0 0 XR Sacrum and Coccyx General X-ray exams 72220 4504429 320 389 Pioneer Medical Center Base Price Schedule 1530245 972 26 0 72 Prof PMC Base Price Schedule Pioneer Medical Center XR Scapula L General X-ray exams 73010 4504502 LT 320 293.5 Pioneer Medical Center Base Price Schedule 1530351 972 26 LT 2 68 Prof PMC Base Price Schedule Pioneer Medical Center XR Scapula R General X-ray exams 73010 4504502 RT 320 293.5 Pioneer Medical Center Base Price Schedule 1530351 972 26 RT 2 68 Prof PMC Base Price Schedule Pioneer Medical Center XR Sciatic Nerve Inj ANES General X-ray exams 77002 761 0 0 0 XR Scoliosis Study 2 or 3 Views General X-ray exams 72082 4507133 320 335 Pioneer Medical Center Base Price Schedule 1531110 972 26 0 122 Prof PMC Base Price Schedule Pioneer Medical Center XR Scoliosis Study Single View General X-ray exams 72081 4507125 320 203.5 Pioneer Medical Center Base Price Schedule 1531102 972 26 0 100 Prof PMC Base Price Schedule Pioneer Medical Center XR Sella Turcica General X-ray exams 70240 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR Send Films to OR General X-ray exams 0 Pioneer Medical Center Base Price Schedule 972 0 0 XR Shoulder 2 View L General X-ray exams 73030 4504700 LT 320 346.5 Pioneer Medical Center Base Price Schedule 1500008 972 26 LT 2 78.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Shoulder 2 View R General X-ray exams 73030 4504700 RT 320 346.5 Pioneer Medical Center Base Price Schedule 1500008 972 26 RT 2 78.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Shoulder 4 or 5 Views L General X-ray exams 73030 4504700 320 346.5 Pioneer Medical Center Base Price Schedule 1500008 972 26 LT 2 78.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Shoulder 4 or 5 Views R General X-ray exams 73030 4504700 320 346.5 Pioneer Medical Center Base Price Schedule 1500008 972 26 RT 2 78.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Shoulder AP L General X-ray exams 73020 4504601 LT 320 294.5 Pioneer Medical Center Base Price Schedule 1530658 972 26 LT 2 49 Prof PMC Base Price Schedule Pioneer Medical Center XR Shoulder AP R General X-ray exams 73020 4504601 RT 320 294.5 Pioneer Medical Center Base Price Schedule 1530658 972 26 RT 2 49 Prof PMC Base Price Schedule Pioneer Medical Center XR Shoulder Arthrocentesis Asp or Inj L General X-ray exams 77002 LT 320 0 972 26 LT 2 0 Pioneer Medical Center XR Shoulder Arthrocentesis Asp or Inj R General X-ray exams 77002 RT 320 0 972 26 RT 2 0 Pioneer Medical Center XR Shoulder Arthrogram L General X-ray exams 73040 LT 320 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center XR Shoulder Arthrogram R General X-ray exams 73040 RT 320 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center XR Shoulder Axillary L General X-ray exams 73020 4504601 LT 320 294.5 Pioneer Medical Center Base Price Schedule 1530658 972 26 LT 2 49 Prof PMC Base Price Schedule Pioneer Medical Center XR Shoulder Axillary R General X-ray exams 73020 4504601 RT 320 294.5 Pioneer Medical Center Base Price Schedule 1530658 972 26 RT 2 49 Prof PMC Base Price Schedule Pioneer Medical Center XR Shoulder Complete L General X-ray exams 73030 4504700 LT 320 346.5 Pioneer Medical Center Base Price Schedule 1500008 972 26 LT 2 78.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Shoulder Complete R General X-ray exams 73030 4504700 RT 320 346.5 Pioneer Medical Center Base Price Schedule 1500008 972 26 RT 2 78.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Shoulder Injection for CT/MRI L General X-ray exams 77002 LT 320 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center XR Shoulder Injection for CT/MRI R General X-ray exams 77002 RT 320 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center XR Shunt Injection Fluoro Guidance General X-ray exams 77002 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR Shunt Study AP and Lat General X-ray exams 70250 4505202 320 363.5 Pioneer Medical Center Base Price Schedule 1530492 972 26 0 72 Prof PMC Base Price Schedule Pioneer Medical Center XR Shuntogram General X-ray exams 75809 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR Sialogram General X-ray exams 70390 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR Skull Complete General X-ray exams 70260 4505103 320 268.5 Pioneer Medical Center Base Price Schedule 1530666 972 26 0 109.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Skull Limited General X-ray exams 70250 4505202 320 363.5 Pioneer Medical Center Base Price Schedule 1530492 972 26 0 72 Prof PMC Base Price Schedule Pioneer Medical Center XR Soft Tissue Neck General X-ray exams 70360 4503108 320 324 Pioneer Medical Center Base Price Schedule 1530542 972 26 0 66 Prof PMC Base Price Schedule Pioneer Medical Center XR Sphenopalatin Ganglion Inj ANES General X-ray exams 64505 0 0 0 XR Stellate Ganglion Block General X-ray exams 77002 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR Stellate Ganglion Block by ANES General X-ray exams 77002 320 0 Pioneer Medical Center Base Price Schedule 0 0 Pioneer Medical Center XR Stellate Ganglion Inj ANES General X-ray exams 64510 0 0 0 XR Sternum General X-ray exams 71120 4505400 320 369 Pioneer Medical Center Base Price Schedule 1530617 972 26 0 72 Prof PMC Base Price Schedule Pioneer Medical Center XR Super Hypogastric Neuro Dest by ANES General X-ray exams 64681 761 0 0 0 Pioneer Medical Center XR Suprascapular Nerve Inj ANES General X-ray exams 64418 761 0 0 0 XR Sympathetic Nerve Inj T/L ANES General X-ray exams 64520 761 0 0 0 XR T Spine 4 or More Views General X-ray exams 72074 4505061 320 431.5 Pioneer Medical Center Base Price Schedule 1530740 972 26 0 72 Prof PMC Base Price Schedule Pioneer Medical Center XR T Spine AP and Lateral General X-ray exams 72070 4505657 320 350 Pioneer Medical Center Base Price Schedule 1530625 972 26 0 71 Prof PMC Base Price Schedule Pioneer Medical Center XR T Spine AP and Lateral w/ Swimmers General X-ray exams 72072 4505608 320 428.5 Pioneer Medical Center Base Price Schedule 1530476 972 26 0 76.5 Prof PMC Base Price Schedule Pioneer Medical Center XR T Spine Single View General X-ray exams 72020 4500856 320 343.5 Pioneer Medical Center Base Price Schedule 1530260 972 26 0 53.5 Prof PMC Base Price Schedule Pioneer Medical Center XR T Tube Cholangiogram General X-ray exams 47531 320 0 Pioneer Medical Center Base Price Schedule 972 0 0 XR T and L Spine 4 or 5 Views General X-ray exams 72083 4507141 320 366 Pioneer Medical Center Base Price Schedule 1531128 972 26 0 129.5 Prof PMC Base Price Schedule Pioneer Medical Center XR T and L Spine 6 or More Views General X-ray exams 72084 4507158 320 477 Pioneer Medical Center Base Price Schedule 1531136 972 26 0 152.5 Prof PMC Base Price Schedule Pioneer Medical Center XR T/L Junction Only AP and Lateral General X-ray exams 72080 4505509 320 372 Pioneer Medical Center Base Price Schedule 1530724 972 26 0 76.5 Prof PMC Base Price Schedule Pioneer Medical Center XR TAP Block Inj Bilat ANES General X-ray exams 64486 50 761 0 0 0 XR TAP Block Inj Uni ANES General X-ray exams 64486 761 0 0 0 XR TMJ Arthrogram L General X-ray exams 70332 LT 320 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center XR TMJ Arthrogram R General X-ray exams 70332 RT 320 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center XR TMJ Bilateral General X-ray exams 70330 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR TMJ L General X-ray exams 70328 LT 320 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center XR TMJ R General X-ray exams 70328 RT 320 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center XR Tendon origin/insert Inj ANES General X-ray exams 20551 0 0 0 XR Tibia Fibula L General X-ray exams 73590 4505707 LT 320 297 Pioneer Medical Center Base Price Schedule 1530112 972 26 LT 2 62.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Tibia Fibula R General X-ray exams 73590 4505707 RT 320 297 Pioneer Medical Center Base Price Schedule 1530112 972 26 RT 2 62.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Toes L General X-ray exams 73660 4505806 LT 320 308.5 Pioneer Medical Center Base Price Schedule 1530005 972 26 LT 2 45.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Toes R General X-ray exams 73660 4505806 RT 320 308.5 Pioneer Medical Center Base Price Schedule 1530005 972 26 RT 2 45.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Tomography Indicate Site in Comments General X-ray exams 76100 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR Transforaminal ESI C/T Bilat by ANES General X-ray exams 64479 50 761 0 0 0 Pioneer Medical Center XR Transforaminal ESI Cerv/Thor by ANES General X-ray exams 64479 761 0 0 0 Pioneer Medical Center XR Transforaminal ESI L/S Bilat by ANES General X-ray exams 64483 50 761 0 0 0 Pioneer Medical Center XR Transforaminal ESI Lumb/Sacr by ANES General X-ray exams 64483 761 0 0 0 Pioneer Medical Center XR Trigger Point 1/2 Musc Inj ANES General X-ray exams 77002 320 0 0 0 XR Trigger Points 3/> Inj ANES General X-ray exams 77002 0 0 0 XR UDE Cystography General X-ray exams 74430 320 0 972 26 0 0 XR UDE VCUG General X-ray exams 74455 320 0 972 26 0 0 XR Unlisted Diagnostic Procedure General X-ray exams 76499 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 XR Unlisted Fluoroscopy Procedure General X-ray exams 76496 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 XR Upper Extremity Infant L General X-ray exams 73092 4506440 LT 320 109.5 Pioneer Medical Center Base Price Schedule 1530955 972 26 LT 2 45.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Upper Extremity Infant R General X-ray exams 73092 4506440 RT 320 109.5 Pioneer Medical Center Base Price Schedule 1530955 972 26 RT 2 45.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Upper GI and SBFT w/ Air Contrast General X-ray exams 74246 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR Upper GI and SBFT w/ Ba and Gastro General X-ray exams 74240 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR Upper GI and SBFT w/ Barium General X-ray exams 74240 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR Upper GI and SBFT w/ Gastrografin General X-ray exams 74240 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR Upper GI w/ Air Contrast General X-ray exams 74246 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR Upper GI w/ Air w/o KUB General X-ray exams 74246 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR Upper GI w/ Barium General X-ray exams 74240 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR Upper GI w/ Barium w/o KUB General X-ray exams 74240 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR Upper GI w/ Gastrografin General X-ray exams 74240 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR Ureterography via Ureterostomy or Ca General X-ray exams 50431 320 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center XR Urethrocystography Retrograde General X-ray exams 74450 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR Vertebroplasty Lumbar General X-ray exams 22511 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center XR Vertebroplasty Thoracic General X-ray exams 22510 761 0 Pioneer Medical Center Base Price Schedule 972 0 0 Pioneer Medical Center XR Veterinary General X-ray exams 76499 320 0 0 0 XR Video Swallow General X-ray exams 74230 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 Pioneer Medical Center XR Video Swallow w/ Esophagram General X-ray exams 74230 320 0 972 26 0 0 XR Voiding Cysto Urethrography General X-ray exams 74455 320 0 Pioneer Medical Center Base Price Schedule 972 26 0 0 XR Wrist AP and Lateral L General X-ray exams 73100 4506002 LT 320 257 Pioneer Medical Center Base Price Schedule 1530146 972 26 LT 2 53.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Wrist AP and Lateral R General X-ray exams 73100 4506002 RT 320 257 Pioneer Medical Center Base Price Schedule 1530146 972 26 RT 2 53.5 Prof PMC Base Price Schedule Pioneer Medical Center XR Wrist Arthrogram L General X-ray exams 73115 LT 320 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center XR Wrist Arthrogram R General X-ray exams 73115 RT 320 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center XR Wrist Complete L General X-ray exams 73110 4505905 LT 320 342.5 Pioneer Medical Center Base Price Schedule 1530211 972 26 LT 2 64 Prof PMC Base Price Schedule Pioneer Medical Center XR Wrist Complete R General X-ray exams 73110 4505905 RT 320 342.5 Pioneer Medical Center Base Price Schedule 1530211 972 26 RT 2 64 Prof PMC Base Price Schedule Pioneer Medical Center XR Wrist Injection for CT/MRI L General X-ray exams 77002 LT 320 0 Pioneer Medical Center Base Price Schedule 972 26 LT 2 0 Pioneer Medical Center XR Wrist Injection for CT/MRI R General X-ray exams 77002 RT 320 0 Pioneer Medical Center Base Price Schedule 972 26 RT 2 0 Pioneer Medical Center