|
CPT Codes and Fees, |
| Surgery, Part 1 (10000-29999) |
| Surgery, Part 2 (30000-49999) |
| Surgery, Part 3 (50000-69999) |
| Assistant Surgery Guide |
| Radiology |
| Pathology and Laboratory |
| Evaluation & Management, Medicine, Physical Therapy |
|
Commission Assigned Codes |
| N.C. Industrial Commission Assigned Codes |
Effective January 1, 2015ABBREVIATIONS: BR = by report (i.e., report is
needed to establish fee), CPT = Current Procedural Terminology, FAC
= services were performed in a facility setting, FUD = follow-up
days (i.e., number of days in global period), NA = no allowance, OFF
= services were performed in physician office setting, PC (26) =
professional component, PER AGM = per agreement, SC =
special consideration (see Guides or contact Industrial Commission), TBA
= to be assigned, TC (27) = technical component, Total =
total fee, and Units = requires time or number of units.
|
| CPT Code | Total | TC (27) | PC (26) |
| 70010 | $374.52 | $243.44 | $131.08 |
| 70015 | $194.73 | $126.57 | $68.16 |
| 70030 | $42.06 | $25.24 | $16.82 |
| 70100 | $49.53 | $29.72 | $19.81 |
| 70110 | $61.74 | $37.04 | $24.70 |
| 70120 | $54.96 | $32.98 | $21.98 |
| 70130 | $80.73 | $48.44 | $32.29 |
| 70134 | $77.34 | $46.40 | $30.94 |
| 70140 | $55.64 | $33.38 | $22.26 |
| 70150 | $72.60 | $43.56 | $29.04 |
| 70160 | $48.18 | $28.91 | $19.27 |
| 70170 | $86.16 | $56.00 | $30.16 |
| 70190 | $57.66 | $34.60 | $23.06 |
| 70200 | $74.64 | $44.78 | $29.86 |
| 70210 | $53.61 | $32.17 | $21.44 |
| 70220 | $71.91 | $43.15 | $28.76 |
| 70240 | $44.10 | $26.46 | $17.64 |
| 70250 | $60.39 | $36.23 | $24.16 |
| 70260 | $86.85 | $52.11 | $34.74 |
| 70300 | $25.77 | $15.46 | $10.31 |
| 70310 | $40.71 | $24.43 | $16.28 |
| 70320 | $69.21 | $41.53 | $27.68 |
| 70328 | $47.49 | $28.49 | $19.00 |
| 70330 | $73.95 | $44.37 | $29.58 |
| 70332 | $179.12 | $116.43 | $62.69 |
| 70336 | $768.71 | $614.97 | $153.74 |
| 70350 | $39.36 | $23.62 | $15.74 |
| 70355 | $53.61 | $32.17 | $21.44 |
| 70360 | $42.06 | $25.24 | $16.82 |
| 70370 | $109.92 | $65.95 | $43.97 |
| 70371 | $207.60 | $124.56 | $83.04 |
| 70373 | $149.94 | $97.46 | $52.48 |
| 70380 | $57.00 | $34.20 | $22.80 |
| 70390 | $144.51 | $93.93 | $50.58 |
| 70450 | $367.05 | $256.93 | $110.12 |
| 70460 | $449.82 | $328.37 | $121.45 |
| 70470 | $548.88 | $411.66 | $137.22 |
| 70480 | $407.76 | $285.43 | $122.33 |
| 70481 | $473.58 | $345.71 | $127.87 |
| 70482 | $565.85 | $424.39 | $141.46 |
| 70486 | $394.20 | $275.94 | $118.26 |
| 70487 | $465.44 | $339.77 | $125.67 |
| 70488 | $563.13 | $422.35 | $140.78 |
| 70490 | $407.76 | $285.43 | $122.33 |
| 70491 | $473.58 | $345.71 | $127.87 |
| 70492 | $565.85 | $424.39 | $141.46 |
| 70496 | $685.33 | $506.93 | $178.40 |
| 70498 | $685.33 | $506.93 | $178.40 |
| 70540 | $818.93 | $655.14 | $163.79 |
| 70542 | $1,059.18 | $943.25 | $115.93 |
| 70543 | $1,901.96 | $1,746.30 | $155.66 |
| 70544 | $913.77 | $793.74 | $120.03 |
| 70545 | $913.77 | $793.74 | $120.03 |
| 70546 | $1,744.99 | $1,566.71 | $178.28 |
| 70547 | $913.77 | $793.74 | $120.03 |
| 70548 | $913.77 | $793.74 | $120.03 |
| 70549 | $1,744.99 | $1,566.71 | $178.28 |
| 70551 | $818.93 | $655.14 | $163.79 |
| 70552 | $983.12 | $786.50 | $196.62 |
| 70553 | $1,731.46 | $1,385.17 | $346.29 |
| 70554 | $1,108.05 | $921.14 | $186.91 |
| 70555 | $223.81 | ||
| 70557 | $282.61 | ||
| 70558 | $312.29 | ||
| 70559 | $313.19 | ||
| 71010 | $45.45 | $27.27 | $18.18 |
| 71015 | $52.23 | $31.34 | $20.89 |
| 71020 | $58.35 | $35.01 | $23.34 |
| 71021 | $70.56 | $42.34 | $28.22 |
| 71022 | $73.95 | $44.37 | $29.58 |
| 71023 | $84.12 | $50.47 | $33.65 |
| 71030 | $77.34 | $46.40 | $30.94 |
| 71034 | $130.95 | $78.57 | $52.38 |
| 71035 | $48.84 | $29.30 | $19.54 |
| 71100 | $55.64 | $33.38 | $22.26 |
| 71101 | $67.17 | $40.30 | $26.87 |
| 71110 | $73.95 | $44.37 | $29.58 |
| 71111 | $84.81 | $50.89 | $33.92 |
| 71120 | $58.35 | $35.01 | $23.34 |
| 71130 | $63.09 | $37.85 | $25.24 |
| 71250 | $467.46 | $327.22 | $140.24 |
| 71260 | $545.49 | $398.21 | $147.28 |
| 71270 | $665.58 | $499.18 | $166.40 |
| 71275 | $746.11 | $623.41 | $122.70 |
| 71550 | $830.45 | $664.36 | $166.09 |
| 71551 | $1,073.47 | $944.89 | $128.58 |
| 71552 | $1,908.79 | $1,740.56 | $168.23 |
| 71555 | $844.70 | $675.76 | $168.94 |
| 72010 | $105.15 | $63.09 | $42.06 |
| 72020 | $40.02 | $24.01 | $16.01 |
| 72040 | $57.00 | $34.20 | $22.80 |
| 72050 | $83.46 | $50.08 | $33.38 |
| 72052 | $103.14 | $61.88 | $41.26 |
| 72069 | $50.88 | $30.53 | $20.35 |
| 72070 | $60.39 | $36.23 | $24.16 |
| 72072 | $65.82 | $39.49 | $26.33 |
| 72074 | $75.99 | $45.59 | $30.40 |
| 72080 | $61.74 | $37.04 | $24.70 |
| 72090 | $67.86 | $40.72 | $27.14 |
| 72100 | $61.74 | $37.04 | $24.70 |
| 72110 | $84.81 | $50.89 | $33.92 |
| 72114 | $106.53 | $63.92 | $42.61 |
| 72120 | $75.30 | $45.18 | $30.12 |
| 72125 | $467.46 | $327.22 | $140.24 |
| 72126 | $543.45 | $396.72 | $146.73 |
| 72127 | $655.40 | $491.55 | $163.85 |
| 72128 | $467.46 | $327.22 | $140.24 |
| 72129 | $543.45 | $396.72 | $146.73 |
| 72130 | $655.40 | $491.55 | $163.85 |
| 72131 | $467.46 | $327.22 | $140.24 |
| 72132 | $543.45 | $396.72 | $146.73 |
| 72133 | $655.40 | $491.55 | $163.85 |
| 72141 | $830.45 | $664.36 | $166.09 |
| 72142 | $995.99 | $796.79 | $199.20 |
| 72146 | $905.09 | $724.07 | $181.02 |
| 72147 | $995.99 | $796.79 | $199.20 |
| 72148 | $893.54 | $714.83 | $178.71 |
| 72149 | $983.12 | $786.50 | $196.62 |
| 72156 | $1,750.46 | $1,400.37 | $350.09 |
| 72157 | $1,750.46 | $1,400.37 | $350.09 |
| 72158 | $1,731.46 | $1,385.17 | $346.29 |
| 72159 | $914.58 | $731.66 | $182.92 |
| 72170 | $47.49 | $28.49 | $19.00 |
| 72190 | $61.05 | $36.63 | $24.42 |
| 72191 | $721.79 | $599.09 | $122.70 |
| 72192 | $460.68 | $322.48 | $138.20 |
| 72193 | $523.79 | $382.37 | $141.42 |
| 72194 | $628.26 | $471.19 | $157.07 |
| 72195 | $897.58 | $788.82 | $108.76 |
| 72196 | $830.45 | $664.36 | $166.09 |
| 72197 | $1,917.80 | $1,748.75 | $169.05 |
| 72198 | $844.02 | $675.22 | $168.80 |
| 72200 | $48.18 | $28.91 | $19.27 |
| 72202 | $55.64 | $33.38 | $22.26 |
| 72220 | $50.88 | $30.53 | $20.35 |
| 72240 | $373.83 | $242.99 | $130.84 |
| 72255 | $348.74 | $226.68 | $122.06 |
| 72265 | $326.34 | $212.12 | $114.22 |
| 72270 | $495.29 | $321.94 | $173.35 |
| 72275 | $195.35 | $146.70 | $48.65 |
| 72285 | $586.88 | $381.47 | $205.41 |
| 72295 | $554.99 | $360.74 | $194.25 |
| 73000 | $46.82 | $28.09 | $18.73 |
| 73010 | $48.18 | $28.91 | $19.27 |
| 73020 | $42.75 | $25.65 | $17.10 |
| 73030 | $51.57 | $30.94 | $20.63 |
| 73040 | $179.12 | $116.43 | $62.69 |
| 73050 | $59.70 | $35.82 | $23.88 |
| 73060 | $50.88 | $30.53 | $20.35 |
| 73070 | $46.14 | $27.68 | $18.46 |
| 73080 | $50.88 | $30.53 | $20.35 |
| 73085 | $179.12 | $116.43 | $62.69 |
| 73090 | $46.82 | $28.09 | $18.73 |
| 73092 | $44.79 | $26.87 | $17.92 |
| 73100 | $44.79 | $26.87 | $17.92 |
| 73110 | $48.84 | $29.30 | $19.54 |
| 73115 | $147.24 | $95.71 | $51.53 |
| 73120 | $44.79 | $26.87 | $17.92 |
| 73130 | $48.84 | $29.30 | $19.54 |
| 73140 | $37.98 | $22.79 | $15.19 |
| 73200 | $403.70 | $282.59 | $121.11 |
| 73201 | $467.46 | $341.25 | $126.21 |
| 73202 | $564.50 | $423.37 | $141.13 |
| 73206 | $648.09 | $525.39 | $122.70 |
| 73218 | $884.02 | $786.76 | $97.26 |
| 73219 | $1,059.18 | $943.25 | $115.93 |
| 73220 | $818.93 | $655.14 | $163.79 |
| 73221 | $768.71 | $614.97 | $153.74 |
| 73222 | $1,059.18 | $943.25 | $115.93 |
| 73223 | $1,901.96 | $1,697.64 | $155.66 |
| 73225 | $835.20 | $668.16 | $167.04 |
| 73500 | $44.79 | $26.87 | $17.92 |
| 73510 | $54.96 | $32.98 | $21.98 |
| 73520 | $65.82 | $39.49 | $26.33 |
| 73525 | $179.12 | $116.43 | $62.69 |
| 73530 | $59.04 | $35.42 | $23.62 |
| 73540 | $54.27 | $32.56 | $21.71 |
| 73550 | $50.88 | $30.53 | $20.35 |
| 73560 | $47.49 | $28.49 | $19.00 |
| 73562 | $52.23 | $31.34 | $20.89 |
| 73564 | $59.04 | $35.42 | $23.62 |
| 73565 | $45.45 | $27.27 | $18.18 |
| 73580 | $211.01 | $137.16 | $73.85 |
| 73590 | $47.49 | $28.49 | $19.00 |
| 73592 | $44.79 | $26.87 | $17.92 |
| 73600 | $44.79 | $26.87 | $17.92 |
| 73610 | $48.84 | $29.30 | $19.54 |
| 73615 | $179.12 | $116.43 | $62.69 |
| 73620 | $44.79 | $26.87 | $17.92 |
| 73630 | $48.84 | $29.30 | $19.54 |
| 73650 | $43.41 | $26.05 | $17.36 |
| 73660 | $37.98 | $22.79 | $15.19 |
| 73700 | $403.70 | $282.59 | $121.11 |
| 73701 | $467.46 | $341.25 | $126.21 |
| 73702 | $564.50 | $423.37 | $141.13 |
| 73706 | $648.09 | $525.39 | $122.70 |
| 73718 | $884.02 | $786.76 | $97.26 |
| 73719 | $1,059.18 | $943.25 | $115.93 |
| 73720 | $818.93 | $655.14 | $163.79 |
| 73721 | $768.71 | $614.97 | $153.74 |
| 73722 | $1,059.18 | $943.25 | $115.93 |
| 73723 | $1,901.96 | $1,746.30 | $155.66 |
| 73725 | $841.31 | $673.05 | $168.26 |
| 74000 | $48.84 | $29.30 | $19.54 |
| 74010 | $57.00 | $34.20 | $22.80 |
| 74020 | $63.78 | $38.27 | $25.51 |
| 74022 | $75.30 | $45.18 | $30.12 |
| 74150 | $455.25 | $318.67 | $136.58 |
| 74160 | $534.63 | $390.28 | $144.35 |
| 74170 | $646.58 | $484.93 | $161.65 |
| 74174 | $1,030.04 | $829.79 | $200.25 |
| 74175 | $721.79 | $599.09 | $122.70 |
| 74176 | $409.70 | $247.84 | $161.86 |
| 74177 | $642.63 | $472.89 | $169.74 |
| 74178 | $812.79 | $625.04 | $187.75 |
| 74181 | $830.45 | $664.36 | $166.09 |
| 74182 | $1,073.47 | $918.72 | $128.58 |
| 74183 | $1,917.80 | $1,748.75 | $169.05 |
| 74185 | $844.02 | $675.22 | $168.80 |
| 74190 | $118.74 | $77.18 | $41.56 |
| 74210 | $105.84 | $63.50 | $42.34 |
| 74220 | $116.01 | $69.61 | $46.40 |
| 74230 | $130.26 | $78.16 | $52.10 |
| 74235 | $271.38 | $176.40 | $94.98 |
| 74240 | $154.68 | $92.81 | $61.87 |
| 74241 | $156.72 | $94.03 | $62.69 |
| 74245 | $231.36 | $138.82 | $92.54 |
| 74246 | $166.23 | $99.74 | $66.49 |
| 74247 | $168.27 | $100.96 | $67.31 |
| 74249 | $242.22 | $145.33 | $96.89 |
| 74250 | $123.48 | $74.09 | $49.39 |
| 74251 | $137.73 | $82.64 | $55.09 |
| 74260 | $138.42 | $83.05 | $55.37 |
| 74261 | $747.19 | $540.82 | $206.37 |
| 74262 | $839.31 | $612.79 | $226.52 |
| 74263 | BR | BR | BR |
| 74270 | $169.62 | $101.77 | $67.85 |
| 74280 | $230.01 | $138.01 | $92.00 |
| 74283 | $347.37 | $208.42 | $138.95 |
| 74290 | $75.30 | $45.18 | $30.12 |
| 74300 | $99.06 | $64.39 | $34.67 |
| 74301 | $56.31 | $36.60 | $19.71 |
| 74305 | $88.20 | $57.33 | $30.87 |
| 74320 | $242.22 | $157.44 | $84.78 |
| 74327 | $173.70 | $112.90 | $60.80 |
| 74328 | $257.82 | $167.58 | $90.24 |
| 74329 | $257.82 | $167.58 | $90.24 |
| 74330 | $257.82 | $167.58 | $90.24 |
| 74340 | $211.01 | $137.16 | $73.85 |
| 74355 | $232.04 | $150.83 | $81.21 |
| 74360 | $242.22 | $157.44 | $84.78 |
| 74363 | $453.21 | $294.59 | $158.62 |
| 74400 | $148.59 | $89.15 | $59.44 |
| 74410 | $164.88 | $98.93 | $65.95 |
| 74415 | $175.05 | $105.03 | $70.02 |
| 74420 | $193.37 | $116.02 | $77.35 |
| 74425 | $112.62 | $73.20 | $39.42 |
| 74430 | $94.32 | $61.31 | $33.01 |
| 74440 | $105.15 | $68.35 | $36.80 |
| 74445 | $176.40 | $114.66 | $61.74 |
| 74450 | $120.09 | $78.06 | $42.03 |
| 74455 | $126.87 | $82.47 | $44.40 |
| 74470 | $127.56 | $82.91 | $44.65 |
| 74475 | $298.53 | $194.04 | $104.49 |
| 74480 | $298.53 | $194.04 | $104.49 |
| 74485 | $242.22 | $157.44 | $84.78 |
| 74710 | $96.33 | $57.80 | $38.53 |
| 74740 | $115.35 | $74.98 | $40.37 |
| 74742 | $246.96 | $160.52 | $86.44 |
| 74775 | $147.90 | $88.74 | $59.16 |
| 75557 | $976.82 | $752.82 | $224.01 |
| 75559 | $1,429.11 | $1,142.80 | $286.32 |
| 75561 | $1,322.49 | $1,074.69 | $247.80 |
| 75563 | $1,641.25 | $1,343.89 | $297.35 |
| 75565 | $166.58 | $143.06 | $23.52 |
| 75571 | $164.21 | $111.66 | $52.55 |
| 75572 | $482.16 | $322.32 | $159.84 |
| 75573 | $685.26 | $456.44 | $228.81 |
| 75574 | $1059.16 | $841.11 | $218.05 |
| 75600 | $808.74 | $727.87 | $80.87 |
| 75605 | $870.48 | $739.91 | $130.57 |
| 75625 | $870.48 | $739.91 | $130.57 |
| 75630 | $918.65 | $780.85 | $137.80 |
| 75635 | $791.43 | $599.08 | $192.35 |
| 75658 | $886.76 | $753.75 | $133.01 |
| 75705 | $970.22 | $776.18 | $194.04 |
| 75710 | $870.48 | $739.91 | $130.57 |
| 75716 | $886.76 | $753.75 | $133.01 |
| 75726 | $870.48 | $739.91 | $130.57 |
| 75731 | $870.48 | $739.91 | $130.57 |
| 75733 | $886.76 | $753.75 | $133.01 |
| 75736 | $870.48 | $739.91 | $130.57 |
| 75741 | $886.76 | $753.75 | $133.01 |
| 75743 | $920.00 | $782.00 | $138.00 |
| 75746 | $870.48 | $739.91 | $130.57 |
| 75756 | $870.48 | $739.91 | $130.57 |
| 75774 | $796.52 | $716.87 | $79.65 |
| 75791 | $558.82 | $403.45 | $155.37 |
| 75801 | $405.05 | $324.04 | $81.01 |
| 75803 | $438.30 | $350.64 | $87.66 |
| 75805 | $446.43 | $357.14 | $89.29 |
| 75807 | $479.69 | $383.75 | $95.94 |
| 75809 | $90.92 | $59.10 | $31.82 |
| 75810 | $870.48 | $739.91 | $130.57 |
| 75820 | $124.17 | $80.71 | $43.46 |
| 75822 | $189.96 | $123.47 | $66.49 |
| 75825 | $870.48 | $739.91 | $130.57 |
| 75827 | $870.48 | $739.91 | $130.57 |
| 75831 | $870.48 | $739.91 | $130.57 |
| 75833 | $903.74 | $768.18 | $135.56 |
| 75840 | $870.48 | $739.91 | $130.57 |
| 75842 | $903.74 | $768.18 | $135.56 |
| 75860 | $870.48 | $739.91 | $130.57 |
| 75870 | $870.48 | $739.91 | $130.57 |
| 75872 | $870.48 | $739.91 | $130.57 |
| 75880 | $124.17 | $105.54 | $18.63 |
| 75885 | $898.97 | $764.12 | $134.85 |
| 75887 | $898.97 | $764.12 | $134.85 |
| 75889 | $870.48 | $739.91 | $130.57 |
| 75891 | $870.48 | $739.91 | $130.57 |
| 75893 | $814.16 | $732.74 | $81.42 |
| 75894 | $1,584.23 | $1,425.81 | $158.42 |
| 75896 | $1,393.58 | $1,254.22 | $139.36 |
| 75898 | $221.19 | $176.95 | $44.24 |
| 75901 | $163.39 | $116.86 | $46.53 |
| 75902 | $153.72 | $116.86 | $36.87 |
| 75945 | $304.39 | $272.99 | $31.40 |
| 75946 | $168.19 | $136.79 | $31.40 |
| 75952 | $430.00 | ||
| 75953 | $164.31 | ||
| 75954 | $156.51 | ||
| 75956 | $737.94 | ||
| 75957 | $632.26 | ||
| 75958 | $421.58 | ||
| 75959 | $369.09 | ||
| 75962 | $1,004.15 | $903.73 | $100.42 |
| 75964 | $542.10 | $487.89 | $54.21 |
| 75966 | $1,076.75 | $969.07 | $107.68 |
| 75968 | $542.10 | $487.89 | $54.21 |
| 75970 | $778.22 | $700.40 | $77.82 |
| 75978 | $1,018.40 | $916.56 | $101.84 |
| 75980 | $464.76 | $325.33 | $139.43 |
| 75982 | $506.15 | $354.30 | $151.85 |
| 75984 | $187.26 | $121.72 | $65.54 |
| 75989 | $303.27 | $197.13 | $106.14 |
| 76000 | $94.32 | $61.31 | $33.01 |
| 76001 | $223.89 | $145.53 | $78.36 |
| 76010 | $48.84 | $31.75 | $17.09 |
| 76080 | $116.01 | $75.41 | $40.60 |
| 76085 | $25.46 | $19.58 | $5.88 |
| 76098 | $40.71 | $24.43 | $16.28 |
| 76100 | $131.63 | $78.98 | $52.65 |
| 76101 | $141.81 | $85.09 | $56.72 |
| 76102 | $160.80 | $96.48 | $64.32 |
| 76120 | $99.74 | $59.84 | $39.90 |
| 76125 | $73.28 | $43.97 | $29.31 |
| 76140 | BR | BR | BR |
| 76376 | $258.76 | $238.20 | $20.60 |
| 76377 | $330.06 | $249.14 | $80.93 |
| 76380 | $305.31 | $213.72 | $91.59 |
| 76390 | $866.44 | $729.75 | $136.69 |
| 76490 | $293.53 | $105.23 | $188.30 |
| 76496 | BR | BR | BR |
| 76497 | BR | BR | BR |
| 76498 | BR | BR | BR |
| 76499 | BR | BR | BR |
| 76506 | $146.55 | $80.60 | $65.95 |
| 76510 | $316.38 | $153.11 | $163.28 |
| 76511 | $154.02 | $84.71 | $69.31 |
| 76512 | $155.37 | $85.45 | $69.92 |
| 76513 | $155.37 | $85.45 | $69.92 |
| 76514 | $22.89 | $4.55 | $18.35 |
| 76516 | $127.56 | $70.16 | $57.40 |
| 76519 | $127.56 | $70.16 | $57.40 |
| 76529 | $137.73 | $75.75 | $61.98 |
| 76536 | $139.77 | $76.87 | $62.90 |
| 76604 | $132.30 | $72.76 | $59.54 |
| 76641 | $202.33 | $130.89 | $71.44 |
| 76642 | $166.89 | $100.25 | $66.64 |
| 76700 | $196.76 | $108.22 | $88.54 |
| 76705 | $142.47 | $78.36 | $64.11 |
| 76770 | $190.65 | $104.86 | $85.79 |
| 76775 | $141.81 | $78.00 | $63.81 |
| 76776 | $224.85 | $157.19 | $67.66 |
| 76800 | $193.37 | $106.35 | $87.02 |
| 76801 | $169.23 | $74.11 | $95.12 |
| 76802 | $131.85 | $51.94 | $79.91 |
| 76805 | $221.85 | $122.02 | $99.83 |
| 76810 | $441.69 | $242.93 | $198.76 |
| 76811 | $436.02 | $251.06 | $184.97 |
| 76812 | $257.66 | $84.40 | $173.26 |
| 76813 | $228.71 | $125.03 | $103.68 |
| 76814 | $151.02 | $64.07 | $86.95 |
| 76815 | $147.90 | $81.34 | $66.56 |
| 76816 | $122.13 | $67.17 | $54.96 |
| 76817 | $175.62 | $103.51 | $72.11 |
| 76818 | $171.66 | $94.41 | $77.25 |
| 76819 | $178.22 | $114.48 | $63.74 |
| 76820 | $167.95 | $116.32 | $51.62 |
| 76821 | $188.29 | $116.32 | $71.97 |
| 76825 | $206.94 | $113.82 | $93.12 |
| 76826 | $140.45 | $77.25 | $63.20 |
| 76827 | $187.26 | $102.99 | $84.27 |
| 76828 | $122.79 | $67.53 | $55.26 |
| 76830 | $158.76 | $87.32 | $71.44 |
| 76831 | $168.34 | $99.37 | $68.97 |
| 76856 | $158.76 | $87.32 | $71.44 |
| 76857 | $99.74 | $54.86 | $44.88 |
| 76870 | $153.33 | $84.33 | $69.00 |
| 76872 | $158.76 | $87.32 | $71.44 |
| 76873 | $271.62 | $144.55 | $127.07 |
| 76881 | $217.31 | $162.19 | $55.12 |
| 76882 | $57.19 | $18.97 | $38.22 |
| 76885 | $169.62 | $99.37 | $70.25 |
| 76886 | $151.33 | $92.41 | $58.92 |
| 76930 | $156.72 | $86.20 | $70.52 |
| 76932 | $156.72 | $86.20 | $70.52 |
| 76936 | $519.03 | $285.47 | $233.56 |
| 76937 | $60.76 | $29.73 | $31.03 |
| 76940 | $313.21 | $116.68 | $196.53 |
| 76941 | $221.19 | $121.65 | $99.54 |
| 76942 | $156.72 | $86.20 | $70.52 |
| 76945 | $177.09 | $97.40 | $79.69 |
| 76946 | $128.91 | $70.90 | $58.01 |
| 76948 | $128.91 | $70.90 | $58.01 |
| 76965 | $563.49 | $340.59 | $222.90 |
| 76970 | $101.76 | $55.97 | $45.79 |
| 76975 | $168.27 | $92.55 | $75.72 |
| 76977 | $75.68 | $55.45 | $20.23 |
| 76998 | $113.01 | ||
| 76999 | BR | BR | BR |
| 77001 | $148.88 | $114.25 | $34.63 |
| 77002 | $136.49 | $88.20 | $48.29 |
| 77003 | $135.10 | $80.67 | $54.43 |
| 77011 | $882.31 | $772.30 | $110.01 |
| 77012 | $580.00 | $475.08 | $104.94 |
| 77013 | $362.07 | ||
| 77014 | $307.56 | $230.06 | $77.50 |
| 77021 | $889.04 | $750.99 | $138.04 |
| 77022 | $386.00 | $386.00 | $0.00 |
| 77051 | $30.67 | $25.13 | $5.55 |
| 77052 | $30.67 | $25.13 | $5.55 |
| 77053 | $182.61 | $149.69 | $32.93 |
| 77054 | $262.11 | $221.19 | $40.92 |
| 77055 | $142.79 | $79.52 | $63.27 |
| 77056 | $178.14 | $99.84 | $78.30 |
| 77057 | $149.41 | $86.14 | $63.27 |
| 77058 | $1,440.31 | $1,292.91 | $147.39 |
| 77059 | $1,777.15 | $1,629.76 | $147.39 |
| 77061 | BR | ||
| 77063 | $104.80 | $46.80 | $58.00 |
| 77071 | $52.90 | ||
| 77072 | $40.75 | $24.23 | $16.52 |
| 77073 | $76.11 | $51.65 | $24.46 |
| 77074 | $115.64 | $74.72 | $40.92 |
| 77075 | $161.60 | $111.96 | $49.67 |
| 77076 | $132.73 | $69.46 | $63.27 |
| 77077 | $97.83 | $69.25 | $28.58 |
| 77078 | $257.84 | $235.55 | $22.29 |
| 77080 | $199.18 | $179.16 | $20.01 |
| 77081 | $72.46 | $51.66 | $20.80 |
| 77084 | $976.10 | $830.94 | $145.16 |
| 77085 | $104.21 | $74.83 | $29.38 |
| 77086 | $65.78 | $48.76 | $17.01 |
| 77261 | $132.30 | ||
| 77262 | $200.82 | ||
| 77263 | $298.53 | ||
| 77280 | $277.50 | $194.25 | $83.25 |
| 77285 | $436.94 | $305.86 | $131.08 |
| 77290 | $542.78 | $379.95 | $162.83 |
| 77293 | $845.31 | $647.56 | $197.74 |
| 77295 | $2,124.97 | $1,487.48 | $637.49 |
| 77299 | BR | BR | BR |
| 77300 | $140.45 | $70.22 | $70.23 |
| 77301 | $2,573.25 | $1,804.36 | $768.89 |
| 77306 | $271.34 | $133.50 | $137.85 |
| 77307 | $531.73 | $244.71 | $287.02 |
| 77316 | $346.06 | $208.21 | $137.85 |
| 77317 | $452.64 | $271.32 | $181.32 |
| 77318 | $655.35 | $368.32 | $287.02 |
| 77321 | $335.16 | $217.85 | $117.31 |
| 77331 | $113.31 | $22.66 | $90.65 |
| 77332 | $132.99 | $66.49 | $66.50 |
| 77333 | $195.39 | $97.69 | $97.70 |
| 77334 | $313.46 | $172.40 | $141.06 |
| 77336 | $180.48 | ||
| 77338 | $877.59 | $457.09 | $420.50 |
| 77370 | $211.68 | ||
| 77371 | $2,077.76 | ||
| 77372 | $1,576.45 | ||
| 77373 | $2,942.06 | ||
| 77385 | BR | ||
| 77386 | BR | ||
| 77387 | BR | ||
| 77399 | BR | BR | BR |
| 77401 | $107.19 | ||
| 77402 | $107.19 | ||
| 77407 | $126.20 | ||
| 77412 | $141.12 | ||
| 77417 | $35.97 | ||
| 77422 | $123.03 | ||
| 77423 | $160.62 | ||
| 77424 | BR | BR | BR |
| 77425 | BR | BR | BR |
| 77427 | $305.94 | ||
| 77431 | $172.32 | ||
| 77432 | $837.92 | ||
| 77435 | $1,216.77 | ||
| 77469 | BR | BR | BR |
| 77470 | $872.51 | $610.76 | $261.75 |
| 77499 | BR | BR | BR |
| 77520 | BR | BR | BR |
| 77522 | BR | BR | BR |
| 77523 | BR | BR | BR |
| 77525 | BR | BR | BR |
| 77600 | $333.12 | $166.56 | $166.56 |
| 77605 | $444.39 | $222.19 | $222.20 |
| 77610 | $333.12 | $166.56 | $166.56 |
| 77615 | $444.39 | $222.19 | $222.20 |
| 77620 | $333.12 | $166.56 | $166.56 |
| 77750 | $517.68 | $77.65 | $440.03 |
| 77761 | $490.53 | $122.63 | $367.90 |
| 77762 | $728.00 | $182.00 | $546.00 |
| 77763 | $1,033.31 | $206.66 | $826.65 |
| 77776 | $576.02 | $115.20 | $460.82 |
| 77777 | $922.04 | $230.51 | $691.53 |
| 77778 | $1,306.73 | $261.35 | $1,045.38 |
| 77785 | $340.82 | $205.27 | $135.55 |
| 77786 | $1019.34 | $713.97 | $305.37 |
| 77787 | $1515.02 | $1046.33 | $468.69 |
| 77789 | $126.87 | $25.37 | $101.50 |
| 77790 | $129.60 | $25.92 | $103.68 |
| 77799 | BR | BR | BR |
| 78012 | $151.45 | $133.99 | $17.46 |
| 78013 | $382.59 | $348.80 | $33.79 |
| 78014 | $442.25 | $397.02 | $45.24 |
| 78015 | $220.50 | $154.35 | $66.15 |
| 78016 | $289.71 | $202.80 | $86.91 |
| 78018 | $419.30 | $293.51 | $125.79 |
| 78020 | $53.02 | $53.02 | $0.00 |
| 78070 | $158.76 | $111.13 | $47.63 |
| 78071 | $661.56 | $554.03 | $107.53 |
| 78072 | $149.20 | ||
| 78075 | $399.62 | $279.73 | $119.89 |
| 78099 | BR | BR | BR |
| 78102 | $176.40 | $132.30 | $44.10 |
| 78103 | $263.25 | $197.44 | $65.81 |
| 78104 | $323.64 | $242.73 | $80.91 |
| 78110 | $75.30 | $56.47 | $18.83 |