| Paring or cutting benign hyperkeratotic lesions 2-4 CPT 11056 • Dermatology | $27 | $77 | $166 |
| Tangential biopsy of skin single lesion CPT 11102 • Dermatology | $37 | $113 | $237 |
| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $46 | $186 | $318 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $56 | $204 | $343 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $23 | $105 | $285 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $38 | $140 | $289 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $29 | $118 | $246 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $33 | $164 | $283 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $55 | $155 | $299 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $65 | $191 | $345 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $73 | $258 | $484 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $75 | $199 | $339 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $71 | $213 | $444 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $94 | $263 | $401 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $100 | $265 | $590 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $77 | $297 | $501 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $49 | $102 | $146 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $27 | $89 | $144 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $6 | $14 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $125 | $206 | $377 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $34 | $149 | $251 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $45 | $154 | $295 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $47 | $139 | $258 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $60 | $219 | $386 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $7 | $13 | $33 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $4 | $10 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $9 | $52 | $78 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $10 | $37 | $53 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $49 | $359 | $850 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $13 | $170 | $753 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $10 | $58 | $117 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $60 | $340 | $820 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,018 | $4,419 | $7,402 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $25 | $117 | $248 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $277 | $1,839 | $4,534 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $208 | $320 | $457 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $612 | $930 | $1,155 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $91 | $480 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $182 | $292 | $369 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $112 | $405 | $901 |
| Septoplasty CPT 30520 • ENT | $478 | $1,124 | $1,574 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $99 | $264 | $387 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $80 | $235 | $449 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $217 | $446 | $738 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $308 | $568 | $949 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $407 | $620 | $1,160 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $159 | $259 | $410 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $167 | $472 | $783 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $333 | $765 | $1,318 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $106 | $227 | $458 |