CPT Codes and Fees


TABLE OF CONTENTS

CPT Codes and Fees,
Effective January 1, 2015

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

Evaluation & Management, Medicine, Physical Therapy

Effective January 1, 2015

ABBREVIATIONS: 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

OFF

FAC

TC (27)

PC (26)

Units Required

90281

BR

 

 

 

 

 

90283

BR

 

 

 

 

 

90284

BR

 

 

 

 

 

90287

BR

 

 

 

 

 

90288

BR

 

 

 

 

 

90291

BR

 

 

 

 

 

90296

BR

 

 

 

 

 

90371

BR

 

 

 

 

 

90375

BR

 

 

 

 

 

90376

BR

 

 

 

 

 

90378

BR

 

 

 

 

 

90384

BR

 

 

 

 

 

90385

BR

 

 

 

 

 

90386

BR

 

 

 

 

 

90389

BR

 

 

 

 

 

90393

BR

 

 

 

 

 

90396

BR

 

 

 

 

 

90399

BR

 

 

 

 

 

90460

 

$45.96

 

 

 

 

90461

 

$23.05

 

 

 

 

90471

BR

 

 

 

 

 

90472

BR

 

 

 

 

 

90473

BR

 

 

 

 

 

90474

BR

 

 

 

 

 

90476

BR

 

 

 

 

 

90477

BR

 

 

 

 

 

90581

BR

 

 

 

 

 

90585

BR

 

 

 

 

 

90586

BR

 

 

 

 

 

90630

BR

 

 

 

 

 

90632

BR

 

 

 

 

 

90633

BR

 

 

 

 

 

90634

BR

 

 

 

 

 

90636

BR

 

 

 

 

 

90644

BR

 

 

 

 

 

90645

BR

 

 

 

 

 

90646

BR

 

 

 

 

 

90647

BR

 

 

 

 

 

90648

BR

 

 

 

 

 

90649

BR

 

 

 

 

 

90650

BR

 

 

 

 

 

90651

BR

 

 

 

 

 

90653

BR

 

 

 

 

 

90654 BR          

90655

BR

 

 

 

 

 

90656

BR

 

 

 

 

 

90657

BR

 

 

 

 

 

90658

BR

 

 

 

 

 

90659

BR

 

 

 

 

 

90660

BR

 

 

 

 

 

90661

BR

 

 

 

 

 

90662

BR

 

 

 

 

 

90664

BR

 

 

 

 

 

90666

BR

 

 

 

 

 

90667

BR

 

 

 

 

 

90668

BR

 

 

 

 

 

90669

BR

 

 

 

 

 

90670

BR

 

 

 

 

 

90672

BR

 

 

 

 

 

90673

BR

 

 

 

 

 

90675

BR

 

 

 

 

 

90676

BR

 

 

 

 

 

90680

BR

 

 

 

 

 

90681

BR

 

 

 

 

 

90685

BR

 

 

 

 

 

90686

BR

 

 

 

 

 

90687

BR

 

 

 

 

 

90688

BR

 

 

 

 

 

90690

BR

 

 

 

 

 

90691

BR

 

 

 

 

 

90692

BR

 

 

 

 

 

90693

BR

 

 

 

 

 

90696

BR

 

 

 

 

 

90698

BR

 

 

 

 

 

90700

$25.15

 

 

 

 

 

90702

$13.67

 

 

 

 

 

90703

$12.58

 

 

 

 

 

90704

$22.97

 

 

 

 

 

90705

$20.78

 

 

 

 

 

90706

$21.88

 

 

 

 

 

90707

$28.44

 

 

 

 

 

90708

$25.15

 

 

 

 

 

90710

$34.46

 

 

 

 

 

90712

$13.67

 

 

 

 

 

90713

$26.26

 

 

 

 

 

90714

$24.19

 

 

 

 

 

90715

BR

 

 

 

 

 

90716

$34.46

 

 

 

 

 

90717

$33.37

 

 

 

 

 

90719

$20.78

 

 

 

 

 

90720

$37.75

 

 

 

 

 

90721

BR

 

 

 

 

 

90723

BR

 

 

 

 

 

90725

$14.77

 

 

 

 

 

90727

$20.78

 

 

 

 

 

90732

$18.04

 

 

 

 

 

90733

$39.93

 

 

 

 

 

90734

BR

 

 

 

 

 

90735

$16.40

 

 

 

 

 

90736

BR

 

 

 

 

 

90738

BR

 

 

 

 

 

90739

BR

 

 

 

 

 

90740

BR

 

 

 

 

 

90743

BR

 

 

 

 

 

90744

BR

 

 

 

 

 

90746

BR

 

 

 

 

 

90747

BR

 

 

 

 

 

90748

BR

 

 

 

 

 

90749

BR

 

 

 

 

 

90780

$54.70

 

 

 

 

 

90781

$27.35

 

 

 

 

 

90782

$5.47

 

 

 

 

 

90783

$20.24

 

 

 

 

 

90784

$23.51

 

 

 

 

 

90785

 

$7.28 $7.28

 

 

 

90788

$5.47

 

 

 

 

 

90791

 

$230.38 $181.04

 

 

 

90792

 

$192.13 $187.15

 

 

 

90799

BR

 

 

 

 

 

90832

  $95.97 $76.05      
90833   $64.15 $63.64      
90834   $124.65 $114.19      
90836 $104.20 $104.20
90837   $182.65 $172.19      
90838   $168.25 $167.26
90839 BR          
90840 BR          

90845

$115.96

 

 

 

 

 

90846

$129.07

 

 

 

 

 

90847

$146.58

 

 

 

 

 

90849

$44.86

 

 

 

 

 

90853

$36.64

 

 

 

 

 

90863

BR

 

 

 

 

 

90865

$175.16

 

 

 

 

 

90867

BR

 

 

 

 

 

90868

BR

 

 

 

 

 

90869   $899.83 $234.24      

90870

$129.07

 

 

 

 

 

90871

$188.70

 

 

 

 

 

90875

$71.19

 

 

 

 

YES

90876

$110.74

 

 

 

 

YES

90880

$149.86

 

 

 

 

 

90882

$98.45

 

 

 

 

 

90885

BR

 

 

 

 

 

90887

$95.72

 

 

 

 

 

90889

$80.41

 

 

 

 

 

90899

BR

 

 

 

 

 

90901

$78.00

 

 

 

 

 

90911

$124.00

 

 

 

 

 

90935

$141.11

 

 

 

 

 

90937

$247.76

 

 

 

 

 

90939

BR

 

 

 

 

 

90940

BR

 

 

 

 

 

90945

$132.91

 

 

 

 

 

90947

$221.50

 

 

 

 

 

90951

$1,922.58

 

 

 

 

 

90952

BR

 

 

 

 

 

90953

BR

 

 

 

 

 

90954

$1,578.58

 

 

 

 

 

90955

$893.77

 

 

 

 

 

90956

$605.43

 

 

 

 

 

90957

$1,267.02

 

 

 

 

 

90958

$854.82

 

 

 

 

 

90959

$560.96

 

 

 

 

 

90960

$561.93

 

 

 

 

 

90961

$453.67

 

 

 

 

 

90962

$328.10

 

 

 

 

 

90963

$1,086.05

 

 

 

 

 

90964

$906.30

 

 

 

 

 

90965

$862.05

 

 

 

 

 

90966

$448.87

 

 

 

 

 

90967 $38.85          

90968

$30.32

 

 

 

 

 

90969

$29.58

 

 

 

 

 

90970

$15.68

 

 

 

 

 

90989

$526.69

 

 

 

 

 

90993

$88.05

 

 

 

 

 

90997

$218.23

 

 

 

 

 

90999

PA

 

 

 

 

 

91010

$204.55

 

 

$40.91

$163.64

 

91013

$45.77

 

 

$26.00

$19.78

 

91020

$228.61

 

 

$45.72

$182.89

 

91022

$334.14

 

 

$217.14

$117.00

 

91030

$92.43

 

 

$9.24

$83.19

 

91034

$352.90

 

 

$273.70

$79.20

 

91035

$697.98

 

 

$569.46

$128.51

 

91037

$224.96

 

 

$145.75

$79.20

 

91038

$193.42

 

 

$103.66

$89.75

 

91040

$679.14

 

 

$599.92

$79.20

 

91065

$66.19

 

 

$13.24

$52.95

 

91110

$1,378.53

 

 

 

 

 

91111 $1,085.40     $1,004.97 $80.42  
91112 $1,745.63     $1,574.56 $171.07  

91117

 

$280.51

$298.66

 

 

 

91120

$670.44

 

 

$590.85

$79.60

 

91122

$210.66

 

 

$42.13

$168.53

 

91132

BR

 

 

 

 

 

91133

BR

 

 

 

 

 

91200

$67.07

 

 

$38.98

$28.09

 

91299

BR

 

 

 

 

 

92002

$82.21

 

 

 

 

 

92004

$120.14

 

 

 

 

 

92012

$65.63

 

 

 

 

 

92014

$83.68

 

 

 

 

 

92015

$36.64

 

 

 

 

 

92018

$103.92

 

 

 

 

 

92019

$93.52

 

 

 

 

 

92020

$34.46

 

 

 

 

 

92025

$43.61

 

 

$18.04

$25.56

 

92060

$56.98

 

 

$9.88

$47.10

 

92065

$38.60

 

 

$8.55

$30.05

 

92071   $74.14 $66.33      
92072   $236.45 $190.94      

92081

$35.94

 

 

$8.01

$27.93

 

92082

$49.40

 

 

$10.41

$38.99

 

92083

$71.20

 

 

$15.22

$55.98

 

92100

$61.26

 

 

 

 

 

92132

$72.06

 

 

$30.03

$42.02

 

92133

$88.60

 

 

$30.03

$58.57

 

92134

$88.60

 

 

$30.03

$58.57

 

92136

$113.27

 

 

$71.26

$42.01

 

92140

$41.57

 

 

 

 

 

92145

$29.28

 

 

$12.27

$17.01

 

92225

$53.59

 

 

 

 

 

92226

$47.04

 

 

 

 

 

92227

 

$22.64

 

 

 

 

92228

$59.55

 

 

$24.66

$34.90

 

92230

$67.28

 

 

 

 

 

92235

$128.60

 

 

$54.48

$74.12

 

92240

$132.02

 

 

$49.99

$82.03

 

92250

$45.67

 

 

$9.35

$36.32

 

92260

$54.15

 

 

 

 

 

92265

$57.84

 

 

$12.29

$45.55

 

92270

$78.92

 

 

$16.56

$62.36

 

92275

$101.53

 

 

$21.36

$80.17

 

92283

$24.52

 

 

$6.40

$18.12

 

92284

$36.95

 

 

$9.35

$27.60

 

92285

$26.09

 

 

$5.88

$20.21

 

92286

$101.09

 

 

$21.36

$79.73

 

92287

$120.33

 

 

 

 

 

92310

$127.98

 

 

 

 

 

92311

$102.83

 

 

 

 

 

92312

$125.25

 

 

 

 

 

92313

$93.52

 

 

 

 

 

92314

$75.48

 

 

 

 

 

92315

$57.43

 

 

 

 

 

92316

$84.23

 

 

 

 

 

92317

$43.75

 

 

 

 

 

92325

$19.15

 

 

 

 

 

92326

$78.76

 

 

 

 

 

92341

$51.41

 

 

 

 

 

92342

$57.97

 

 

 

 

 

92352

$35.00

 

 

 

 

 

92353

$46.48

 

 

 

 

 

92354

$422.24

 

 

 

 

 

92355

$205.65

 

 

 

 

 

92358

$47.04

 

 

 

 

 

92370

$35.00

 

 

 

 

 

92371

$30.08

 

 

 

 

 

92499

BR

 

 

 

 

 

92502

$138.38

 

 

 

 

 

92504

$22.97

 

 

 

 

 

92507

$44.86

 

 

 

 

 

92508

$22.97

 

 

 

 

 

92511

$100.96

 

 

 

 

 

92512

$53.59

 

 

 

 

 

92516

$43.21

 

 

 

 

 

92520

$67.81

 

 

 

 

 

92521

 

$174.32

$174.32

 

 

 

92522

 

$141.88

$141.88

 

 

 

92523

 

$294.16

$294.16

 

 

 

92524

 

$147.10

$147.10

 

 

 

92526

$52.43

 

 

 

 

 

92531

$25.15

 

 

 

 

 

92532

$36.64

 

 

 

 

 

92533

$57.43

 

 

 

 

 

92534

$28.44

 

 

 

 

 

92540

$185.21

 

 

$31.42

$153.80

 

92541

$56.33

 

 

$11.27

$45.06

 

92542

$49.22

 

 

$9.84

$39.38

 

92543

$62.90

 

 

$12.58

$50.32

 

92544

$38.28

 

 

$7.66

$30.62

 

92545

$32.82

 

 

$6.56

$26.26

 

92546

$42.66

 

 

$8.53

$34.13

 

92547

$27.89

 

 

$5.58

$22.31

 

92548

$119.05

 

 

$71.98

$47.07

 

92551

$16.40

 

 

 

 

 

92552

$21.88

 

 

 

 

 

92553

$32.82

 

 

 

 

 

92555

$18.60

 

 

 

 

 

92556

$28.44

 

 

 

 

 

92557

$59.08

 

 

 

 

 

92558 BR          

92559

$48.13

 

 

 

 

 

92560

$28.44

 

 

 

 

 

92561

$35.55

 

 

 

 

 

92562

$20.24

 

 

 

 

 

92563

$18.60

 

 

 

 

 

92564

$23.51

 

 

 

 

 

92565

$19.69

 

 

 

 

 

92567

$26.26

 

 

 

 

 

92568

$18.60

 

 

 

 

 

92570

$61.31

$57.87

 

 

 

 

92571

$19.15

 

 

 

 

 

92572

$4.38

 

 

 

 

 

92575

$15.31

 

 

 

 

 

92576

$21.88

 

 

 

 

 

92577

$35.55

 

 

 

 

 

92579

$36.33

 

 

 

 

 

92582

$36.10

 

 

 

 

 

92583

$44.30

 

 

 

 

 

92584

$123.07

 

 

 

 

 

92585

$195.26

 

 

$97.63

$97.63

 

92586

$107.06

 

 

 

 

 

92587

$82.29

 

 

$69.44

$12.85

 

92588

$113.67

 

 

$78.53

$35.14

 

92589

$26.80

 

 

 

 

 

92590

$74.39

 

 

 

 

 

92591

$97.36

 

 

 

 

 

92592

$27.35

 

 

 

 

 

92593

$51.41

 

 

 

 

 

92594

$27.35

 

 

 

 

 

92595

$51.41

 

 

 

 

 

92596

$28.99

 

 

 

 

 

92597

$112.33

 

 

 

 

 

92601

$191.46

 

 

 

 

 

92602

$134.11

 

 

 

 

 

92603

$128.69

 

 

 

 

 

92604

$87.56

 

 

 

 

 

92605

BR

 

 

 

 

 

92606

BR

 

 

 

 

 

92607

$159.93

 

 

 

 

 

92608

$31.14

 

 

 

 

 

92609

$86.54

 

 

 

 

 

92610

$60.86

 

 

 

 

 

92611

$66.27

 

 

 

 

 

92612

 

$255.83

$101.07

 

 

YES

92613

BR

 

 

 

 

 

92614

 

$197.93

$101.07

 

 

YES

92615

BR

 

 

 

 

 

92616

 

$271.82

$147.90

 

 

YES

92617

BR

 

 

 

 

 

92618 BR          

92620

$65.44

 

 

 

 

 

92621

$16.14

 

 

 

 

 

92625

$64.33

 

 

 

 

 

92626

$123.49

 

 

 

 

 

92627

$31.06

 

 

 

 

 

92630

BR

 

 

 

 

 

92633

BR

 

 

 

 

 

92640 $77.67          

92700

BR

 

 

 

 

 

92920

 

$809.13 $809.13

 

 

 

92921

BR

 

 

 

 

 

92924

 

$961.81 $961.81

 

 

 

92925

BR

 

 

 

 

 

92928

 

$898.45 $898.45

 

 

 

92929

BR

 

 

 

 

 

92933

 

$1,004.71 $1,004.71

 

 

 

92934

BR

 

 

 

 

 

92937

 

$897.42 $897.42

 

 

 

92938

BR

 

 

 

 

 

92941

 

$1,006.65 $1,006.65

 

 

 

92943

 

$1,006.65 $1,006.65

 

 

 

92944

BR

 

 

 

 

 

92950

$318.32

 

 

 

 

 

92953

$70.55

 

 

 

 

 

92960

$216.59

 

 

 

 

 

92961

$349.35

 

 

 

 

 

92970

$368.63

 

 

 

 

 

92971

$150.95

 

 

 

 

 

92973

$260.70

 

 

 

 

 

92974

$273.69

 

 

 

 

 

92975

$678.20

 

 

 

 

 

92977

$394.34

 

 

 

 

 

92978

$359.67

 

 

$220.06

$139.61

 

92979

$221.96

 

 

$110.27

$111.69

 

92986

$1,698.23

 

 

 

 

 

92987

$1,733.64

 

 

 

 

 

92990

$1,353.67

 

 

 

 

 

92992

$3,429.18

 

 

 

 

 

92993

$2,402.67

 

 

 

 

 

92997

$1,357.01

 

 

 

 

 

92998

$524.43

 

 

 

 

 

93000

$39.37

 

 

$23.62

$15.75

 

93005

$21.88

 

 

 

 

 

93010

$16.95

 

 

$0.00

$16.95

 

93015

$161.89

 

 

$80.94

$80.95

 

93016

$43.75

 

 

 

 

 

93017

$82.03

 

 

 

 

 

93018

$35.55

 

 

 

 

 

93024

$194.70

 

 

$77.88

$116.82

 

93025

$387.21

 

 

 

 

 

93040

$21.88

 

 

$7.66

$14.22

 

93041

$7.11

 

 

 

 

 

93042

$14.77

 

 

 

 

 

93224

$230.81

 

 

$138.49

$92.32

 

93225

$60.70

 

 

$60.70

$0.00

 

93226

$107.20

 

 

 

 

 

93227

$63.44

 

 

 

 

 

93228

$51.25

 

 

 

 

 

93229

BR

 

 

 

 

 

93260

$126.89

 

 

$40.94

$85.95

 

93261

$226.43

 

 

$135.86

$90.57

 

93268

$226.43

 

 

$135.86

$90.57

 

93270

$60.70

 

 

 

 

 

93271

$117.05

 

 

 

 

 

93272

$48.68

 

 

$0.00

$48.68

 

93278

$104.47

 

 

$62.68

$41.79

 

93279

$108.85

 

 

$36.94

$71.91

 

93280

$128.98

 

 

$42.64

$86.33

 

93281

$150.79

 

 

$50.00

$100.80

 

93282

$139.30

 

 

$45.18

$94.12

 

93283

$169.76

 

 

$51.38

$118.39

 

93284

$199.04

 

 

$58.24

$140.80

 

93285

$93.69

 

 

$34.88

$58.81

 

93286

$53.02

 

 

$22.93

$30.10

 

93287

$70.14

 

 

$25.94

$44.21

 

93288

$83.78

 

 

$35.56

$48.22

 

93289

$129.72

 

 

$42.64

$87.08

 

93290

$62.27

 

 

$19.76

$42.52

 

93291

$80.36

 

 

$31.66

$48.70

 

93292

$72.78

 

 

$24.56

$48.22

 

93293

$113.07

 

 

$79.41

$33.66

 

93294

$73.07

 

 

 

 

 

93295

$132.11

 

 

 

 

 

93296

$69.20

 

 

 

 

 

93297

$51.25

 

 

 

 

 

93298

$58.81

 

 

 

 

 

93299

BR

 

 

 

 

 

93303

$300.01

 

 

$186.93

$113.08

 

93304

$164.33

 

 

$94.07

$70.26

 

93306

$509.19

 

 

$366.04

$143.15

 

93307

$336.93

 

 

$237.62

$99.31

 

93308

$162.22

 

 

$102.54

$59.68

 

93312

$339.65

 

 

$186.81

$152.84

 

93313

$85.32

 

 

$0.00

$85.32

 

93314

$271.82

 

 

$163.09

$108.73

 

93315

$385.83

 

 

$184.40

$201.43

 

93316

$79.52

 

 

 

 

 

93317

$305.82

 

 

$184.40

$121.42

 

93318

BR

 

 

 

 

 

93320

$131.80

 

 

$79.08

$52.72

 

93321

$73.83

 

 

$44.30

$29.53

 

93325

$148.77

 

 

$89.26

$59.51

 

93350

$227.52

 

 

$136.51

$91.01

 

93351

$530.43

 

 

 

 

 

93352

$73.73

 

 

 

 

 

93355

 

$223.62

$223.62

 

 

 

93451

$1,504.56

 

 

$1,215.54

$289.02

 

93452

$1,667.14

 

 

$1,161.12

$506.02

 

93453

$2,182.08

 

 

$1,518.38

$663.69

 

93454

$1,719.69

 

 

$1,209.51

$510.18

 

93455

$2,006.71

 

 

$1,417.59

$589.12

 

93456

$2,152.41

 

 

$1,498.90

$653.51

 

93457

$2,439.20

 

 

$1,706.50

$732.70

 

93458

$2,075.12

 

 

$1,452.53

$622.59

 

93459

$2,292.02

 

 

$1,590.94

$701.08

 

93460

$2,452.74

 

 

$1,671.57

$781.17

 

93461

$2,810.38

 

 

$1,948.86

$861.51

 

93462

 

$397.02

$397.02

 

 

 

93463

 

$211.19

$211.19

 

 

 

93464

$496.13

 

 

$310.22

$185.92

 

93503

$254.87

 

 

$114.69

$140.18

 

93505

$497.16

 

 

$223.72

$273.44

 

93530

$1,312.71

 

 

$892.48

$420.23

 

93531

$3,282.77

 

 

$2,550.31

$732.46

 

93532

$3,393.03

 

 

$2,482.21

$910.82

 

93533

$2,990.39

 

 

$2,482.21

$508.18

 

93561

$126.89

 

 

$76.13

$50.76

 

93562

$59.61

 

 

$35.77

$23.84

 

93565

 

$86.09

$86.09

 

 

 

93566

 

$335.37

$86.09

 

 

 

93567

 

$277.21

$97.15

 

 

 

93568

 

$303.17

$88.15

 

 

 

93571

$377.76

 

 

$245.83

$131.93

 

93572

$348.74

 

 

$242.83

$105.91

 

93580

$1,451.39

 

 

 

 

 

93581

$1,949.18

 

 

 

 

 

93582

 

$1,045.03

$1,045.03

 

 

 

93583

 

$1,163.15

$1,163.15

 

 

 

93600

$348.39

 

 

$156.78

$191.61

 

93602

$258.16

 

 

$116.17

$141.99

 

93603

$307.37

 

 

$138.32

$169.05

 

93609

$864.70

 

 

$389.11

$475.59

 

93610

$345.66

 

 

$155.55

$190.11

 

93612

$359.88

 

 

$161.95

$197.93

 

93613

$554.61

 

 

$0.00

$554.61

 

93615

$85.87

 

 

$38.64

$47.23

 

93616

$164.08

 

 

$73.84

$90.24

 

93618

$701.71

 

 

$315.77

$385.94

 

93619

$1,261.77

 

 

$567.80

$693.97

 

93620

$1,748.00

 

 

$786.60

$961.40

 

93621

$2,432.76

 

 

$1,094.74

$1,338.02

 

93622

$2,432.76

 

 

$1,094.74

$1,338.02

 

93623

$551.86

 

 

$248.34

$303.52

 

93624

$505.92

 

 

$227.66

$278.26

 

93631

$1,011.83

 

 

$455.32

$556.51

 

93640

$841.18

 

 

$378.53

$462.65

 

93641

$1,028.23

 

 

$462.70

$565.53

 

93642

$947.29

 

 

$426.28

$521.01

 

93644

$560.87

 

 

$194.65

$366.23

 

93650

$1,292.41

 

 

$581.58

$710.83

 

93651

$1,779.17

 

 

$800.63

$978.54

 

93652

$1,855.19

 

 

$834.84

$1,020.35

 

93653

 

$1,223.01

$1,223.01

 

 

 

93654

 

$1,632.19 $1,632.19    

 

93655

 

$1,611.57 $1,611.57    

 

93656

 

$1,632.77 $1,632.77    

 

93657

 

$1,611.95 $1,611.95    

 

93660

BR

 

 

BR

BR

 

93662

$456.76

 

 

$220.60

$236.16

 

93668

BR

 

 

 

 

 

93701

$51.63

 

 

$38.14

$13.49

 

93702

 

$106.35

$106.35

 

 

 

93724

$602.17

 

 

$481.74

$120.43

 

93740

$31.73

 

 

$25.38

$6.35

 

93745

BR

 

 

 

 

 

93750

$101.35

$88.99

 

 

 

 

93770

$19.15

 

 

$11.49

$7.66

 

93784

$306.28

 

 

$183.77

$122.51

 

93786

$45.95

 

 

 

 

 

93788

$137.82

 

 

 

 

 

93790

$122.51

 

 

$0.00

$122.51

 

93797

$25.15

 

 

 

 

 

93798

$39.37

 

 

$0.00

$39.37

 

93799

BR

 

 

 

 

 

93880

$237.92

 

 

$142.75

$95.17

 

93882

$158.06

 

 

$94.84

$63.22

 

93886

$282.22

 

 

$169.33

$112.89

 

93888

$187.59

 

 

$112.55

$75.04

 

93890

$348.51

 

 

$264.19

$84.32

 

93892

$371.90

 

 

$275.26

$96.63

 

93893

$364.69

 

 

$268.06

$96.63

 

93895

BR

 

 

 

 

 

93922

$86.41

 

 

$51.85

$34.56

 

93923

$162.44

 

 

$97.46

$64.98

 

93924

$177.21

 

 

$106.33

$70.88

 

93925

$237.36

 

 

$142.42

$94.94

 

93926

$158.62

 

 

$95.17

$63.45

 

93930

$242.85

 

 

$145.71

$97.14

 

93931

$161.89

 

 

$97.13

$64.76

 

93965

$96.81

 

 

$58.09

$38.72

 

93970

$263.07

 

 

$157.84

$105.23

 

93971

$175.02

 

 

$105.01

$70.01

 

93975

$351.68

 

 

$211.01

$140.67

 

93976

$235.18

 

 

$141.11

$94.07

 

93978

$247.21

 

 

$148.33

$98.88

 

93979

$164.62

 

 

$98.77

$65.85

 

93980

$312.84

 

 

$187.70

$125.14

 

93981

$215.50

 

 

$129.30

$86.20

 

93982

 

$78.84

 

 

 

 

93990

$147.67

 

 

$88.60

$59.07

 

93998 BR          
94002 $129.35          
94003 $94.14          
94004 $68.65          
94005 BR          

94010

$43.75

 

 

$26.25

$17.50

 

94011

 

 

$189.97

 

 

 

94012

 

 

$292.17

 

 

 

94013

 

 

$61.47

 

 

 

94014

$60.72

 

 

$22.35

$38.37

 

94015

BR

 

 

 

 

 

94016

$38.92

 

 

 

 

 

94060

$81.50

 

 

$48.90

$32.60

 

94070

$123.07

 

 

$73.84

$49.23

 

94150

$16.40

 

 

$9.84

$6.56

 

94200

$25.15

 

 

$17.60

$7.55

 

94250

$19.69

 

 

$13.78

$5.91

 

94375

$50.86

 

 

$35.60

$15.26

 

94400

$63.99

 

 

$44.79

$19.20

 

94450

$52.50

 

 

$36.75

$15.75

 

94452

$76.58

 

 

$52.28

$24.31

 

94453

$109.11

 

 

$77.75

$31.36

 

94610 $91.40          

94620

$152.04

 

 

$106.43

$45.61

 

94621

$138.34

 

 

$76.72

$61.62

 

94640

$20.24

 

 

 

 

 

94642

$112.12

 

 

 

 

 

94644 $51.54          
94645 $19.53          

94660

$77.12

 

 

 

 

 

94662

$55.79

 

 

 

 

 

94664

$25.71

 

 

 

 

 

94667

$28.44

 

 

 

 

 

94668

$17.51

 

 

 

 

 

94669

 

$51.95

$51.95

 

 

 

94680

$56.88

 

 

$34.13

$22.75

 

94681

$96.25

 

 

$57.75

$38.50

 

94690

$32.26

 

 

$19.36

$12.90

 

94726  $103.56     $78.98 $24.58  
94727 $81.62     $57.04 $24.58  
94728 $81.62     $57.04 $24.58  
94729 $102.61     $86.29 $16.32  

94750

$54.70

 

 

$32.82

$21.88

 

94760

$13.13

 

 

 

 

 

94761

$33.37

 

 

 

 

 

94762

$55.79

 

 

 

 

 

94770

$32.82

 

 

$19.69

$13.13

 

94772

BR

 

 

 

 

 

94774 BR          
94775 BR          
94776 BR          
94777 BR          
94780     $46.82      
94781     $16.32      

94799

BR

 

 

 

 

 

95004

$4.93

 

 

 

 

YES

95012 $26.88          
95017   $31.11 $5.62      
95018   $32.31 $10.89

95024

$7.11

 

 

 

 

YES

95027

$7.11

 

 

 

 

YES

95028

$10.93

 

 

 

 

YES

95044

$9.84

 

 

 

 

YES

95052

$12.04

 

 

 

 

YES

95056

$8.75

 

 

 

 

 

95060

$16.95

 

 

 

 

 

95065

$9.84

 

 

 

 

 

95070

$108.29

 

 

 

 

 

95071

$138.91

 

 

 

 

 

95076

 

$176.69

$110.41

 

 

 

95079

 

$125.39 $101.47

 

 

 

95115

$18.60

 

 

 

 

 

95117

$24.06

 

 

 

 

 

95120

$12.58

 

 

 

 

 

95125

$15.31

 

 

 

 

 

95130

$21.88

 

 

 

 

 

95131

$27.35

 

 

 

 

 

95132

$33.37

 

 

 

 

 

95133

$39.93

 

 

 

 

 

95134

$48.13

 

 

 

 

 

95144

$9.84

 

 

 

 

 

95145

$20.78

 

 

 

 

 

95146

$34.46

 

 

 

 

 

95147

$49.22

 

 

 

 

 

95148

$49.22

 

 

 

 

 

95149

$60.70

 

 

 

 

 

95165

$8.20

 

 

 

 

 

95170

$21.33

 

 

 

 

 

95180

$113.76

 

 

 

 

 

95199

BR

 

 

 

 

 

95250

$77.03

 

 

 

 

 

95251

$42.38

 

 

 

 

 

95782

$1,537.43

 

 

$1,341.61 $195.83

 

95783

$1,640.99

 

 

$1,427.07 $213.92

 

95800

$408.42

 

 

$291.41

$117.01

 

95801

$193.27

 

 

$89.84

$103.43

 

95803

BR

 

 

 

 

 

95805

$383.94

 

 

$230.36

$153.58

 

95806

SC

 

 

SC

SC

 

95807

$538.18

 

 

$322.91

$215.27

 

95808

$591.24

 

 

$354.74

$236.50

 

95810

$637.72

 

 

$382.63

$255.09

 

95811

$705.66

 

 

$366.92

$338.74

 

95812

$152.60

 

 

$91.56

$61.04

 

95813

$187.06

 

 

$112.24

$74.82

 

95816

$136.73

 

 

$82.04

$54.69

 

95819

$149.86

 

 

$89.92

$59.94

 

95822

$175.02

 

 

$105.01

$70.01

 

95824

$89.70

 

 

$53.82

$35.88

 

95827

$214.94

 

 

$128.96

$85.98

 

95829

$353.37

 

 

$8.01

$345.36

 

95830

$130.71

 

 

$0.00

$130.71

 

95831

$31.58

 

 

 

 

 

95832

$29.86

 

 

 

 

 

95833

$47.10

 

 

 

 

 

95834

$66.61

 

 

 

 

 

95851

$28.72

 

 

 

 

 

95852

$18.94

 

 

 

 

 

95857

$54.15

 

 

 

 

 

95860

$107.20

 

 

$64.32

$42.88

 

95861

$183.22

 

 

$109.93

$73.29

 

95863

$217.68

 

 

$130.61

$87.07

 

95864

$283.31

 

 

$169.99

$113.32

 

95865

$178.10

 

 

$38.62

$139.50

 

95866

$120.55

 

 

$12.17

$108.37

 

95867

$91.34

 

 

$54.80

$36.54

 

95868

$178.30

 

 

$106.98

$71.32

 

95869

$47.04

 

 

$28.22

$18.82

 

95870

$48.75

 

 

$11.22

$37.53

 

95872

$144.40

 

 

$86.64

$57.76

 

95873

$43.51

 

 

$11.79

$31.74

 

95874

$44.07

 

 

$11.79

$32.28

 

95875

$103.36

 

 

$62.02

$41.34

 

95885 $108.07     $72.64 $35.43  
95886 $171.10     $76.53 $94.57  
95887 $152.09     $77.83 $74.26  

95905

$152.06

 

 

$146.33

$5.73

 

95907

$141.71

 

 

$79.30

$62.41

 

95908

$174.95

 

 

$99.59

$75.37

 

95909

$209.57

 

 

$119.01

$90.57

 

95910

$275.95

 

 

$116.86

$159.09

 

95911

$334.34

 

 

$198.80

$135.55

 

95912

$391.75

 

 

$238.39

$153.35

 

95913

$454.36

 

 

$282.82

$171.54

 

95921

$55.98

 

 

$18.38

$37.60

 

95922

$58.62

 

 

$18.38

$40.24

 

95923

$55.98

 

 

$18.38

$37.60

 

95924

$221.94

 

 

$89.08

$132.86

 

95925

$160.80

 

 

$96.48

$64.32

 

95926

$107.41

 

 

$45.37

$62.04

 

95927

$107.41

 

 

$45.37

$62.04

 

95928

$260.54

 

 

$132.41

$128.12

 

95929

$271.06

 

 

$142.94

$128.12

 

95930

$61.48

 

 

$12.80

$48.68

 

95933

$95.72

 

 

$57.43

$38.29

 

95937

$71.65

 

 

$42.99

$28.66

YES

95938 $568.11     $481.15 $86.95  
95939 $893.07     $664.29 $228.78  
95940   $48.82 $48.82      
95941 BR          
95943 BR          

95950

$454.50

 

 

$272.70

$181.80

YES

95951

$655.23

 

 

$393.14

$262.09

YES

95953

$537.64

 

 

$322.58

$215.06

YES

95954

$257.87

 

 

$25.64

$232.23

 

95955

$215.05

 

 

$104.96

$110.09

 

95956

$552.40

 

 

$331.44

$220.96

YES

95957

$227.18

 

 

$90.00

$137.18

 

95958

$494.46

 

 

$92.40

$402.06

 

95961

$301.25

 

 

$68.37

$232.88

 

95962

$313.63

 

 

$68.37

$245.26

YES

95965

$620.50

 

 

$0.00

$620.50

 

95966

$313.24

 

 

$0.00

$313.24

 

95967

$274.51

 

 

$0.00

$274.51

 

95970

$32.48

 

 

 

 

 

95971

$54.62

 

 

 

 

 

95972

$102.57

 

 

 

 

 

95973

$64.10

 

 

 

 

 

95974

$210.82

 

 

 

 

 

95975

$124.38

 

 

 

 

 

95978

 

$323.36

$288.47

 

 

 

95979

 

$149.45

$139.48

 

 

 

95980

 

 

$76.49

 

 

 

95981

 

$53.25

$30.08

 

 

 

95982

 

$81.25

$60.23

 

 

 

95990

$82.35

 

 

 

 

 

95991

 

$126.15

$58.05

 

 

 

95992

BR

 

 

 

 

 

95999

BR

 

 

 

 

 

96000

$138.88

 

 

 

 

 

96001

$165.76

 

 

 

 

 

96002

$31.95

 

 

 

 

 

96003

$29.53

 

 

 

 

 

96004

$140.92

 

 

 

 

 

96020 $250.95          
96040 BR          

96101

 

$149.09

$148.00

 

 

 

96102

 

$66.68

$39.69

 

 

 

96103

 

$42.87

$40.67

 

 

 

96105

$89.15

 

 

 

 

YES

96110

BR

 

 

 

 

 

96111

$89.15

 

 

 

 

YES

96116

 

$163.99

$153.53

 

 

 

96118

 

$194.85

$152.98

 

 

 

96119

 

$96.02

$50.29

 

 

 

96120

 

$72.06

$40.67

 

 

 

96125

 

$180.66

$152.42

 

 

 

96127

 

$7.79

$7.79

 

 

 

96150

 

$39.59

$39.07

 

 

YES

96151

 

$38.49

$37.43

 

 

YES

96152

 

$36.85

$35.79

 

 

YES

96153

$8.01

 

 

 

 

YES

96154

 

$35.76

$35.23

 

 

YES

96155

$34.68

 

 

 

 

YES

96360

$107.33

 

 

 

 

 

96361

$31.25

 

 

 

 

 

96365

$130.91

 

 

 

 

 

96366

$42.07

 

 

 

 

 

96367

$66.17

 

 

 

 

 

96368

$39.26

 

 

 

 

 

96369

$285.08

 

 

 

 

 

96370

$30.39

 

 

 

 

 

96371

$137.92

 

 

 

 

 

96372

$40.58

 

 

 

 

 

96374

$103.91

 

 

 

 

 

96375

$45.05

 

 

 

 

 

96376

BR

 

 

 

 

 

96379

BR

 

 

 

 

 

96401

$77.40

 

 

 

 

 

96402

$67.40

 

 

 

 

 

96405

$53.59

 

 

 

 

 

96406

$81.02

 

 

 

 

 

96409

$178.08

 

 

 

 

 

96411

$102.97

 

 

 

 

 

96413

$251.20

 

 

 

 

 

96415

$56.47

 

 

 

 

 

96416

$165.45

 

 

 

 

 

96417

$122.67

 

 

 

 

 

96420

$61.26

 

 

 

 

 

96422

$60.17

 

 

 

 

 

96423

$23.51

 

 

 

 

YES

96425

$69.46

 

 

 

 

 

96440

$167.35

 

 

 

 

 

96446

 

$349.66

$41.92

 

 

 

96450

$144.93

 

 

 

 

 

96521

$222.56

 

 

 

 

 

96522

$160.86

 

 

 

 

 

96523

$40.80

 

 

 

 

 

96542

$132.36

 

 

 

 

 

96549

BR

 

 

 

 

 

96567

$87.82

 

 

 

 

YES

96570

$107.72

 

 

 

 

 

96571

$55.49

 

 

 

 

YES

96900

$19.69

 

 

 

 

 

96902

BR

 

 

 

 

 

96904 $101.96          

96910

$28.44

 

 

 

 

 

96912

$32.26

 

 

 

 

 

96913

$66.19

 

 

 

 

 

96920

 

$223.79

$92.30

 

 

YES

96921

 

$229.24

$93.96

 

 

YES

96922

 

$316.55

$168.30

 

 

YES

96999

BR

 

 

 

 

 

97001

$73.52

 

 

 

 

 

97002

$31.88

 

 

 

 

 

97003

$75.71

 

 

 

 

 

97004

$32.21

 

 

 

 

 

97005

BR

 

 

 

 

 

97006

BR

 

 

 

 

 

97010

$14.65

 

 

 

 

 

97012

$19.85

 

 

 

 

 

97014

$17.01

 

 

 

 

 

97016

$19.37

 

 

 

 

 

97018

$16.07

 

 

 

 

 

97022

$19.85

 

 

 

 

 

97024

$14.65

 

 

 

 

 

97026

$13.70

 

 

 

 

 

97028

$17.48

 

 

 

 

 

97032

$17.48

 

 

 

 

YES

97033

$18.43

 

 

 

 

YES

97034

$14.16

 

 

 

 

YES

97035

$14.65

 

 

 

 

YES

97036

$26.93

 

 

 

 

YES

97039

$24.10

 

 

 

 

 

97110

$26.45

 

 

 

 

YES

97112

$26.45

 

 

 

 

YES

97113

$29.30

 

 

 

 

YES

97116

$23.15

 

 

 

 

YES

97124

$20.79

 

 

 

 

YES

97139

$17.01

 

 

 

 

YES

97140

$28.13

 

 

 

 

YES

97150

$21.26

 

 

 

 

 

97530

$27.88

 

 

 

 

YES

97532

 

$33.71

$26.44

 

 

YES

97533

 

$36.61

$26.44

 

 

YES

97535

$22.93

 

 

 

 

YES

97537

$22.93

 

 

 

 

YES

97542

$19.27

 

 

 

 

YES

97545

Per Agm

 

 

 

 

 

97546

Per Agm

 

 

 

 

 

97597

$63.23

 

 

 

 

 

97598

$80.83

 

 

 

 

 

97602

BR

 

 

 

 

 

97605

BR

 

 

 

 

 

97606

 

$78.07

$46.55

 

 

 

97607

BR

 

 

 

 

 

97608

BR

 

 

 

 

 

97610

BR

 

 

 

 

 

97750

$31.66

 

 

 

 

YES

97755

$45.99

 

 

 

 

 

97760

 

$49.17

$41.07

 

 

 

97761

 

$45.29

$40.08

 

 

 

97762

 

$40.81

$27.51

 

 

 

97799

BR

 

 

 

 

 

97802

BR

 

 

 

 

 

97803

BR

 

 

 

 

 

97804

BR

 

 

 

 

 

97810

BR

 

 

 

 

 

97811

BR

 

 

 

 

 

97813

BR

 

 

 

 

 

97814

BR

 

 

 

 

 

98925

$30.15

 

 

 

 

 

98926

$45.45

 

 

 

 

 

98927

$54.00

 

 

 

 

 

98928

$63.00

 

 

 

 

 

98929

$68.41

 

 

 

 

 

98940

$35.83

 

 

 

 

 

98941

$45.36

 

 

 

 

 

98942

$55.80

 

 

 

 

 

98943

$32.95

 

 

 

 

 

98960

BR

 

 

 

 

 

98961

BR

 

 

 

 

 

98962

BR

 

 

 

 

 

98966

BR

 

 

 

 

 

98967

BR

 

 

 

 

 

98968

BR

 

 

 

 

 

98969

BR

 

 

 

 

 

99000

$8.75

 

 

 

 

 

99001

$9.84

 

 

 

 

 

99002

$14.22

 

 

 

 

 

99024

NA

 

 

 

 

 

99026

BR

 

 

 

 

 

99027

BR

 

 

 

 

 

99050

$26.26

 

 

 

 

 

99051

BR

 

 

 

 

 

99053

BR

 

 

 

 

 

99056

$34.46

 

 

 

 

 

99058

$35.55

 

 

 

 

 

99060

BR

 

 

 

 

 

99070

SC

 

 

 

 

 

99071

NA

 

 

 

 

 

99075

SC

 

 

 

 

 

99078

$15.00

 

 

 

 

 

99080

$165.00

 

 

 

 

 

99082

BR

 

 

 

 

 

99090

NA

 

 

 

 

 

99091

BR

 

 

 

 

 

99100

NA

 

 

 

 

 

99116

$100.00

 

 

 

 

 

99135

NA

 

 

 

 

 

99140

NA

 

 

 

 

 

99143

BR

 

 

 

 

 

99144

$38.11

 

 

 

 

 

99145

BR

 

 

 

 

 

99148

BR

 

 

 

 

 

99149

BR

 

 

 

 

 

99150

BR

 

 

 

 

 

99170

$198.65

 

 

 

 

 

99172

BR

 

 

 

 

 

99173

BR

 

 

 

 

 

99174

BR

 

 

 

 

 

99175

$68.37

 

 

 

 

 

99183

$209.48

 

 

$0.00

$209.48

 

99184

 

$361.93

$361.93

 

 

 

99188

BR

 

 

 

 

 

99190

$699.53

 

 

$419.72

$279.81

 

99191

$524.51

 

 

$314.71

$209.80

 

99192

$349.50

 

 

$209.70

$139.80

 

99195

$21.33

 

 

 

 

 

99199

BR

 

 

 

 

 

99201

$53.82

 

 

 

 

 

99202

$86.68

 

 

 

 

 

99203

$119.56

 

 

 

 

 

99204

$179.36

 

 

 

 

 

99205

$225.67

 

 

 

 

 

99211

$26.14

 

 

 

 

 

99212

$47.07

 

 

 

 

 

99213

$66.51

 

 

 

 

 

99214

$103.13

 

 

 

 

 

99215

$162.90

 

 

 

 

 

99217

$84.77

 

 

 

 

 

99218

$92.43

 

 

 

 

 

99219

$147.13

 

 

 

 

 

99220

$186.50

 

 

 

 

 

99221

$90.79

 

 

 

 

 

99222

$151.51

 

 

 

 

 

99223

$194.17

 

 

 

 

 

99224

 

 

 $55.79

 

 

 

99225

 

 

 $99.00

 

 

 

99226

 

 

 $148.00

 

 

 

99231

$46.48

 

 

 

 

 

99232

$70.01

 

 

 

 

 

99233

$97.36

 

 

 

 

 

99234

$170.06

 

 

 

 

 

99235

$233.43

 

 

 

 

 

99236

$283.67

 

 

 

 

 

99238

$82.59

 

 

 

 

 

99239

$119.55

 

 

 

 

 

99241

$62.35

 

 

 

 

 

99242

$98.99

 

 

 

 

 

99243

$128.53

 

 

 

 

 

99244

$182.13

 

 

 

 

 

99245

$244.47

 

 

 

 

 

99251

$63.99

 

 

 

 

 

99252

$99.54

 

 

 

 

 

99253

$132.36

 

 

 

 

 

99254

$182.68

 

 

 

 

 

99255

$247.76

 

 

 

 

 

99281

$30.46

 

 

 

 

 

99282

$46.56

 

 

 

 

 

99283

$86.22

 

 

 

 

 

99284

$131.63

 

 

 

 

 

99285

$207.52

 

 

 

 

 

99288

BR

 

 

 

 

 

99291

$266.91

 

 

 

 

 

99292

$129.62

 

 

 

 

 

99304

$100.76

 

 

 

 

 

99305

$133.79

 

 

 

 

 

99306

$165.13

 

 

 

 

 

99307

$51.95

 

 

 

 

 

99308

$86.20

 

 

 

 

 

99309

$121.49

 

 

 

 

 

99310

$152.01

 

 

 

 

 

99315

$86.63

 

 

 

 

 

99316

$105.73

 

 

 

 

 

99318

$100.76

 

 

 

 

 

99324

$89.38

 

 

 

 

 

99325

$131.16

 

 

 

 

 

99326

$190.44

 

 

 

 

 

99327

$250.87

 

 

 

 

 

99328

$310.69

 

 

 

 

 

99334

$69.08

 

 

 

 

 

99335

$109.70

 

 

 

 

 

99336

$169.58

 

 

 

 

 

99337

$249.77

 

 

 

 

 

99339

BR

 

 

 

 

 

99340

BR

 

 

 

 

 

99341

$91.40

 

 

 

 

 

99342

$120.71

 

 

 

 

 

99343

$158.08

 

 

 

 

 

99344

$204.20

 

 

 

 

 

99345

$243.43

 

 

 

 

 

99347

$64.34

 

 

 

 

 

99348

$94.41

 

 

 

 

 

99349

$138.17

 

 

 

 

 

99350

$198.86

 

 

 

 

 

99354

$125.31

 

 

 

 

 

99355

$125.31

 

 

 

 

 

99356

$120.33

 

 

 

 

 

99357

$120.33

 

 

 

 

 

99358

$153.13

 

 

 

 

 

99359

$76.57

 

 

 

 

 

99360

$90.79

 

 

 

 

 

99366

BR

 

 

 

 

 

99367

BR

 

 

 

 

 

99368

BR

 

 

 

 

 

99374

BR

 

 

 

 

 

99375

$86.81

 

 

 

 

 

99377

BR

 

 

 

 

 

99378

$117.60

 

 

 

 

 

99379

BR

 

 

 

 

 

99380

BR

 

 

 

 

 

99381

$132.78

 

 

 

 

 

99382

$151.76

 

 

 

 

 

99383

$151.76

 

 

 

 

 

99384

$170.72

 

 

 

 

 

99385

$160.39

 

 

 

 

 

99386

$197.17

 

 

 

 

 

99387

$215.56

 

 

 

 

 

99391

$113.82

 

 

 

 

 

99392

$132.78

 

 

 

 

 

99393

$132.78

 

 

 

 

 

99394

$151.76

 

 

 

 

 

99395

$143.13

 

 

 

 

 

99396

$160.39

 

 

 

 

 

99397

$179.35

 

 

 

 

 

99401

$51.16

 

 

 

 

 

99402

$102.32

 

 

 

 

 

99403

$153.48

 

 

 

 

 

99404

$204.64

 

 

 

 

 

99406

 

$24.21

$22.76

 

 

 

99407

 

$48.06

$45.88

 

 

 

99408

BR

 

 

 

 

 

99409

BR

 

 

 

 

 

99411

$56.91

 

 

 

 

 

99412

$73.01

 

 

 

 

 

99420

BR

 

 

 

 

 

99429

BR

 

 

 

 

 

99441

$45.00

 

 

 

 

 

99442

$60.00

 

 

 

 

 

99443

$75.00

 

 

 

 

 

99444

BR

 

 

 

 

 

99446

BR

 

 

 

 

 

99447

BR

 

 

 

 

 

99448

BR

 

 

 

 

 

99449

BR

 

 

 

 

 

99450

BR

 

 

 

 

 

99455

$125.31

 

 

 

 

 

99456

$182.13

 

 

 

 

 

99460

$112.64

 

 

 

 

 

99461

$166.32

 

 

 

 

 

99462

$60.07

 

 

 

 

 

99463

 

 

$150.69

 

 

 

99464

$141.77

 

 

 

 

 

99465

$290.01

 

 

 

 

 

99466

$463.40

 

 

 

 

 

99467

$231.38

 

 

 

 

 

99468

$1,736.81

 

 

 

 

 

99469

$760.59

 

 

 

 

 

99471

$1,547.22

 

 

 

 

 

99472

$766.71

 

 

 

 

 

99475

$1,067.55

 

 

 

 

 

99476

$636.23

 

 

 

 

 

99477

$642.56

 

 

 

 

 

99479

$242.07

 

 

 

 

 

99480

$232.80

 

 

 

 

 

99485

BR

 

 

 

 

 

99486

BR

 

 

 

 

 

99487

BR

 

 

 

 

 

99489

BR

 

 

 

 

 

99495

 

$246.73 $203.87

 

 

 

99496

 

$348.33 $299.00

 

 

 

99499

BR

 

 

 

 

 

99500

BR

 

 

 

 

 

99501

BR

 

 

 

 

 

99502

BR

 

 

 

 

 

99503

BR

 

 

 

 

 

99504

BR

 

 

 

 

 

99505

BR

 

 

 

 

 

99506

BR

 

 

 

 

 

99507

BR

 

 

 

 

 

99509

BR

 

 

 

 

 

99510

BR

 

 

 

 

 

99511

BR

 

 

 

 

 

99512

BR

 

 

 

 

 

99551

BR

 

 

 

 

 

99552

BR

 

 

 

 

 

99553

BR

 

 

 

 

 

99554

BR

 

 

 

 

 

99555

BR

 

 

 

 

 

99556

BR

 

 

 

 

 

99557

BR

 

 

 

 

 

99558

BR

 

 

 

 

 

99559

BR

 

 

 

 

 

99560

BR

 

 

 

 

 

99561

BR

 

 

 

 

 

99562

BR

 

 

 

 

 

99563

BR

 

 

 

 

 

99564

BR

 

 

 

 

 

99565

BR

 

 

 

 

 

99566

BR

 

 

 

 

 

99567

BR

 

 

 

 

 

99568

BR

 

 

 

 

 

99569

BR

 

 

 

 

 

99600

BR

 

 

 

 

 

99601

In Full

 

 

 

 

 

99602

In Full

 

 

 

 

 

99605

BR

 

 

 

 

 

99606

BR

 

 

 

 

 

99607

BR

 

 

 

 

 

 

©Current Procedural Terminology (CPT) Codes and Descriptors
Are Copyrighted by the American Medical Association.


N.C. Industrial Commission ·  Medical Fees Section
4337 Mail Service Center ·  Raleigh, NC 27699-4337
Telephone: (919) 807-2503 ·  Fax: (919) 715-0280
NCIC Home Page: http://www.ic.nc.gov//