| Paring or cutting benign hyperkeratotic lesions 2-4 CPT 11056 • Dermatology | $26 | $49 | $87 |
| Tangential biopsy of skin single lesion CPT 11102 • Dermatology | $37 | $85 | $141 |
| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $56 | $107 | $185 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $68 | $100 | $166 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $23 | $66 | $175 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $38 | $89 | $211 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $29 | $76 | $175 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $33 | $82 | $163 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $55 | $119 | $186 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $71 | $130 | $226 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $82 | $161 | $250 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $75 | $137 | $207 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $71 | $184 | $286 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $94 | $201 | $331 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $100 | $234 | $356 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $77 | $205 | $300 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $49 | $102 | $182 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $27 | $74 | $99 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $7 | $10 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $125 | $166 | $242 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $34 | $96 | $121 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $45 | $122 | $194 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $47 | $105 | $173 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $72 | $118 | $176 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $17 | $33 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $6 | $10 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $16 | $52 | $88 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $4 | $46 | $81 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $53 | $145 | $503 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $15 | $38 | $130 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $26 | $69 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $68 | $320 | $820 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $601 | $2,779 | $7,402 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $21 | $94 | $248 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $239 | $1,261 | $2,196 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $190 | $325 | $605 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $105 | $601 | $855 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $91 | $475 | $993 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $172 | $284 | $555 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $285 | $367 | $433 |
| Septoplasty CPT 30520 • ENT | $478 | $707 | $973 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $140 | $211 | $318 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $80 | $118 | $188 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $193 | $263 | $384 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $293 | $423 | $632 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $310 | $433 | $511 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $171 | $219 | $257 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $254 | $348 | $418 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $362 | $527 | $596 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $141 | $208 | $279 |