Code of Massachusetts Regulations
101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES
Title 101 CMR 318.00 - Rates for Radiology Services
Section 318.04 - Maximum Allowable Fees - Radiology Services

Universal Citation: 101 MA Code of Regs 101.318

Current through Register 1518, March 29, 2024

(1) Unless otherwise specified, guidelines, notes, and definitions provided in the 2020 CPT Coding Handbook are applicable to the use of the procedure codes and modifiers listed below, as well as their corresponding descriptions. For code descriptions, see the radiology services code spreadsheet at: www.mass.gov/regulations/101-CMR-31800-radiology .

(2) Modifiers.

(a) 26: Professional Component. The component of a service or procedure representing the physician's or other qualified health care professional's work interpreting or performing the service or procedure. (When the physician or other qualified health care professional component is reported separately, the addition of modifier 26 to the procedure code will allow payment of the professional component allowable fee (PC F ee) contained in 101 CMR 318.04(3), adjusted by 101 CMR 318.03 as applicable.)

(b) 51: Multiple Procedures. Most radiology services do not require modifier 51. Modifier 51 applies only to nuclear medicine procedure codes 78306, 78320, 78802, 78803, 78806 and 78807 and should be used only when a whole body bone, tumor, or infection study is performed on the same day prior to a SPECT bone, tumor, or infection study, respectively. Under these circumstances, the modifier must be used to report multiple procedures performed at the same session. The service code for the major procedure or service must be reported without a modifier. The secondary, additional, or lesser procedure(s) must be identified by adding modifier 51 to the end of the service code for the secondary procedure(s). (The addition of modifier 51 to the second and subsequent procedure codes allows payment of 50% of the allowable fee contained in 101 CMR 318.04(3), adjusted by 101 CMR 318.03 as applicable, to the eligible provider. Note: This modifier should not be used with designated "add-on" codes or with codes in which the narrative begins with "each additional".)

(c) 52: Reduced Services. Under certain circumstances, a service or procedure is partially reduced or eliminated at the physician's or other qualified health care professional's election. Under these circumstances, the service provided can be identified by its usual procedure number and addition of modifier 52, signifying that the service is reduced. This provides a means of reporting reduced services without disturbing the identification of the basic service.

(d) 59: Distinct Procedural Service. To identify a procedure distinct or independent from other services performed on the same day, add modifier 59 to the end of the appropriate service code. Modifier 59 is used to identify sevices/procedures that are not normally reported together, but are appropriate under certain circumstances, for example, different site or organ system. However, when another already established modifier is appropriate, it should be used rather than modifier 59.

(e) PA: Surgical or Other Invasive Procedure Performed on the Wrong Body Part. This modifier is applied to report Provider Preventable Conditions in accordance with 42 CFR 447.26 and results in nonpayment for services.

(f) PB: Surgical or Other Invasive Procedure Performed on the Wrong Patient. This modifier is applied to report Provider Preventable Conditions in accordance with 42 CFR 447.26 and results in nonpayment for services.

(g) PC: Wrong Surgical or Other Invasive Procedure Performed on a Patient. This modifier is applied to report Provider Preventable Conditions in accordance with 42 CFR 447.26 and results in nonpayment for services.

(h) SA: Nurse Practitioner Rendering Service in Collaboration with a Physician. This modifier is to be applied to service codes billed by a physician that were performed by a certified nurse practitioner employed by the physician (the physician employer must be practicing as an individual and not practicing as a professional corporation or as a member of a group practice). A certified nurse practitioner billing under his/her own individual provider number, or a group practice, should not use this modifier.

(i) TC: Technical Component. The component of a service or procedure representing the cost of rent, equipment, utilities, supplies, administrative and technical salaries and benefits, and other overhead expenses of the service or procedures, excluding the physician's or other qualified health care professional's professional component. (When the technical component is reported separately, the addition of modifier TC to the procedure code will allow payment of the technical component allowable fee (TC Fee) contained in 101 CMR 318.04(3), adjusted by 101 CMR 318.03 as applicable.)

(j) XE: Separate Encounter. A service that is distinct because it occurred during a separate encounter.

(k) XS: Separate Structure. A service that is distinct because it was performed on a separate organ/structure.

(l) XP: Separate Practitioner. A service that is distinct because it was performed by a different practitioner.

(m) XU: Unusual Non-overlapping Service. The use of a service that is distinct because it does not overlap usual components of the main service.

(3) Fee Schedule.

(a) NFAC - "Non-facility ". These amounts apply when the service is performed in a nonfacility setting.

(b) FAC - "Facility ". These amounts, also known as the Facility Setting Fee, apply when the service is performed in a facility setting.

(c) Global Fee. These amounts apply when no site of service differential rate is specified.

Code

NFAC

FAC

Global

PC

TC

Description (see radiology services code spreadsheet at www.mass.gov/regulations/101-CMR-31800-radiology)

70010

-

-

$46.52

-

-

70015

-

-

$130.09

$45.79

$84.30

70030

-

-

$24.71

$6.49

$18.21

70100

-

-

$29.32

$7.05

$22.27

70110

-

-

$33.79

$9.78

$24.01

70120

-

-

$29.32

$7.05

$22.27

70130

-

-

$47.72

$13.28

$34.45

70134

-

-

$45.16

$13.61

$31.55

70140

-

-

$24.95

$7.89

$17.06

70150

-

-

$36.66

$10.33

$26.33

70160

-

-

$29.06

$6.78

$22.27

70170

-

-

-

$11.39

$187.19

70190

-

-

$30.70

$8.71

$21.98

70200

-

-

$37.19

$10.86

$26.33

70210

-

-

$24.71

$6.78

$17.92

70220

-

-

$29.22

$8.69

$20.53

70240

-

-

$26.69

$7.60

$19.08

70250

-

-

$28.45

$7.92

$20.53

70260

-

-

$35.16

$11.15

$24.01

70300

-

-

$10.97

$4.35

$6.62

70310

-

-

$31.40

$5.94

$25.46

70320

-

-

$44.58

$8.98

$35.60

70328

-

-

$26.71

$7.05

$19.66

70330

-

-

$41.35

$9.51

$31.84

70332

-

-

$64.87

$20.86

$44.01

70336

-

-

$298.41

$56.87

$241.54

70350

-

-

$13.69

$7.07

$6.62

70355

-

-

$15.07

$8.16

$6.91

70360

-

-

$24.39

$7.05

$17.35

70370

-

-

$71.29

$11.34

$59.95

70371

-

-

$85.44

$32.74

$52.70

70380

-

-

$28.77

$6.49

$22.27

70390

-

-

$90.52

$14.63

$75.89

70450

-

-

$91.84

$32.76

$59.08

70460

-

-

$129.99

$43.37

$86.62

70470

-

-

$152.50

$48.78

$103.72

70480

-

-

$139.14

$49.05

$90.09

70481

-

-

$179.26

$43.37

$135.89

70482

-

-

$194.77

$48.49

$146.28

70486

-

-

$111.26

$33.05

$78.21

70487

-

-

$133.18

$43.37

$89.80

70488

-

-

$162.64

$48.78

$113.86

70490

-

-

$130.74

$49.34

$81.40

70491

-

-

$161.50

$53.15

$108.35

70492

-

-

$195.27

$62.57

$132.70

70496

-

-

$213.45

$67.18

$146.28

70498

-

-

$213.45

$67.18

$146.28

70540

-

-

$277.15

$51.48

$225.67

70542

-

-

$431.34

$62.57

$368.77

70543

-

-

$471.81

$82.14

$389.67

70544

-

-

$295.37

$46.06

$249.31

70545

-

-

$317.29

$46.06

$271.23

70546

-

-

$488.62

$57.16

$431.46

70547

-

-

$296.18

$46.35

$249.83

70548

-

-

$350.24

$57.69

$292.55

70549

-

-

$501.87

$69.37

$432.50

70551

-

-

$265.46

$57.16

$208.30

70552

-

-

$331.04

$68.55

$262.49

70553

-

-

$465.47

$88.08

$377.39

70554

-

-

$370.32

$81.07

$289.25

70555

-

-

-

$96.74

-

70557

-

-

-

$123.41

$386.60

70558

-

-

-

$132.71

$146.32

70559

-

-

-

$126.37

$146.32

71045

-

-

$20.34

$7.05

$13.29

71046

-

-

$26.03

$8.40

$17.63

71047

-

-

$32.87

$10.60

$22.27

71048

-

-

$35.67

$12.53

$23.14

71100

-

-

$28.35

$8.69

$19.66

71101

-

-

$32.58

$10.31

$22.27

71110

-

-

$34.27

$11.42

$22.85

71111

-

-

$40.86

$12.50

$28.36

71120

-

-

$26.08

$7.87

$18.21

71130

-

-

$31.83

$8.69

$23.14

71250

-

-

$125.86

$44.46

$81.40

71260

-

-

$156.63

$47.99

$108.64

71270

-

-

$185.56

$52.86

$132.70

71271

-

-

$209.27

$41.23

$168.04

71275

-

-

$216.18

$69.90

$146.28

71550

-

-

$333.21

$56.34

$276.87

71551

-

-

$621.66

$66.36

$555.30

71552

-

-

$538.57

$86.21

$452.36

71555

-

-

$370.10

$68.77

$301.33

72020

-

-

$19.23

$6.23

$13.00

72040

-

-

$30.38

$8.69

$21.69

72050

-

-

$40.40

$10.60

$29.81

72052

-

-

$47.58

$11.68

$35.89

72070

-

-

$25.21

$7.87

$17.35

72072

-

-

$30.65

$8.95

$21.69

72074

-

-

$34.37

$9.49

$24.88

72080

-

-

$27.22

$8.42

$18.79

72081

-

-

$33.18

$10.33

$22.85

72082

-

-

$54.17

$12.48

$41.69

72083

-

-

$63.06

$14.12

$48.94

72084

-

-

$74.80

$16.00

$58.79

72100

-

-

$30.38

$8.69

$21.69

72110

-

-

$38.69

$10.04

$28.65

72114

-

-

$47.58

$11.68

$35.89

72120

-

-

$31.54

$8.69

$22.85

72125

-

-

$124.22

$38.48

$85.75

72126

-

-

$156.10

$46.88

$109.22

72127

-

-

$184.38

$48.78

$135.60

72128

-

-

$124.22

$38.48

$85.75

72129

-

-

$157.26

$46.88

$110.38

72130

-

-

$184.67

$48.78

$135.89

72131

-

-

$123.64

$38.48

$85.17

72132

-

-

$156.39

$46.88

$109.51

72133

-

-

$183.51

$48.49

$135.02

72141

-

-

$263.11

$57.16

$205.95

72142

-

-

$436.30

$68.84

$367.46

72146

-

-

$263.24

$57.16

$206.08

72147

-

-

$435.23

$68.55

$366.68

72148

-

-

$263.11

$57.16

$205.95

72149

-

-

$434.44

$68.55

$365.89

72156

-

-

$466.25

$88.08

$378.17

72157

-

-

$466.51

$88.08

$378.43

72158

-

-

$465.86

$88.08

$377.78

72159

-

-

$379.29

$69.37

$309.92

72170

-

-

$22.68

$6.78

$15.90

72190

-

-

$32.34

$9.78

$22.56

72191

-

-

$215.05

$68.77

$146.28

72192

-

-

$115.60

$41.73

$73.86

72193

-

-

$190.78

$44.46

$146.32

72194

-

-

$193.15

$46.88

$146.28

72195

-

-

$296.77

$56.34

$240.43

72196

-

-

$442.99

$66.65

$376.34

72197

-

-

$480.76

$84.04

$396.72

72198

-

-

$371.26

$68.21

$303.05

72200

-

-

$25.58

$6.78

$18.79

72202

-

-

$30.36

$8.95

$21.40

72220

-

-

$25.00

$6.78

$18.21

72240

-

-

$88.50

$35.22

$53.28

72255

-

-

$89.82

$36.53

$53.28

72265

-

-

$81.74

$31.36

$50.39

72270

-

-

$112.35

$51.82

$60.53

72275

-

-

$104.81

$30.37

$74.44

72285

-

-

$96.83

$45.57

$51.26

72295

-

-

$85.22

$32.81

$52.42

73000

-

-

$25.02

$6.52

$18.50

73010

-

-

$22.10

$7.07

$15.03

73020

-

-

$16.93

$5.96

$10.97

73030

-

-

$26.42

$7.34

$19.08

73040

-

-

$96.75

$21.15

$75.60

73050

-

-

$24.97

$7.34

$17.63

73060

-

-

$25.02

$6.52

$18.50

73070

-

-

$22.70

$6.52

$16.19

73080

-

-

$24.71

$6.78

$17.92

73085

-

-

$90.57

$22.51

$68.07

73090

-

-

$22.99

$6.52

$16.48

73092

-

-

$24.15

$6.23

$17.92

73100

-

-

$26.18

$6.52

$19.66

73110

-

-

$31.08

$6.78

$24.30

73115

-

-

$101.68

$21.73

$79.95

73120

-

-

$24.15

$6.52

$17.63

73130

-

-

$27.90

$6.78

$21.11

73140

-

-

$28.57

$5.43

$23.14

73200

-

-

$128.57

$38.48

$90.09

73201

-

-

$178.32

$44.46

$133.86

73202

-

-

$193.15

$46.88

$146.28

73206

-

-

$215.05

$68.77

$146.28

73218

-

-

$312.99

$52.06

$260.93

73219

-

-

$461.80

$62.86

$398.94

73220

-

-

$507.37

$82.43

$424.94

73221

-

-

$265.83

$52.84

$212.99

73222

-

-

$591.26

$62.86

$528.40

73223

-

-

$496.52

$82.43

$414.09

73225

-

-

$380.30

$66.94

$313.36

73501

-

-

$25.26

$7.34

$17.92

73502

-

-

$36.18

$8.69

$27.49

73503

-

-

$44.75

$10.60

$34.16

73521

-

-

$31.83

$8.69

$23.14

73522

-

-

$41.51

$11.42

$30.10

73523

-

-

$47.26

$12.24

$35.02

73525

-

-

$98.98

$22.79

$76.18

73551

-

-

$23.28

$6.52

$16.77

73552

-

-

$27.58

$7.05

$20.53

73560

-

-

$26.76

$6.52

$20.24

73562

-

-

$31.35

$7.34

$24.01

73564

-

-

$35.02

$8.69

$26.33

73565

-

-

$31.11

$6.81

$24.30

73580

-

-

$109.70

$22.22

$87.49

73590

-

-

$24.44

$6.23

$18.21

73592

-

-

$24.15

$6.23

$17.92

73600

-

-

$25.31

$6.52

$18.79

73610

-

-

$27.90

$6.78

$21.11

73615

-

-

$103.03

$22.51

$80.53

73620

-

-

$22.12

$5.94

$16.19

73630

-

-

$26.16

$6.49

$19.66

73650

-

-

$22.41

$6.23

$16.19

73660

-

-

$22.49

$5.14

$17.35

73700

-

-

$123.64

$38.48

$85.17

73701

-

-

$154.84

$44.46

$110.38

73702

-

-

$186.82

$46.59

$140.24

73706

-

-

$218.30

$72.03

$146.28

73718

-

-

$290.63

$51.77

$238.86

73719

-

-

$330.25

$62.57

$267.68

73720

-

-

$479.65

$82.14

$397.51

73721

-

-

$265.05

$52.06

$212.99

73722

-

-

$592.17

$62.86

$529.31

73723

-

-

$496.39

$82.43

$413.96

73725

-

-

$371.39

$69.03

$302.36

74018

-

-

$23.23

$7.05

$16.19

74019

-

-

$28.62

$8.95

$19.66

74021

-

-

$33.16

$10.31

$22.85

74022

-

-

$38.54

$12.21

$26.33

74150

-

-

$118.49

$45.79

$72.70

74160

-

-

$195.39

$49.07

$146.32

74170

-

-

$200.16

$53.88

$146.28

74174

-

-

$324.38

$83.95

$240.43

74175

-

-

$215.89

$69.61

$146.28

74176

-

-

$158.45

$66.91

$91.54

74177

-

-

$261.97

$70.19

$191.78

74178

-

-

$294.55

$76.97

$217.58

74181

-

-

$284.10

$56.34

$227.76

74182

-

-

$371.04

$66.65

$304.39

74183

-

-

$409.75

$84.04

$325.71

74185

-

-

$373.61

$68.50

$305.11

74190

-

-

-

$17.82

$386.60

74210

-

-

$75.47

$22.76

$52.70

74220

-

-

$76.89

$23.03

$53.86

74221

-

-

$86.79

$26.84

$59.95

74230

-

-

$104.06

$20.35

$83.72

74235

-

-

-

$45.79

-

74240

-

-

$96.02

$31.14

$64.88

74246

-

-

$110.56

$34.66

$75.89

74248

-

-

$65.39

$26.84

$38.55

74250

-

-

$96.57

$31.41

$65.17

74251

-

-

$191.29

$44.97

$146.32

74261

-

-

$182.25

$92.16

$90.09

74262

-

-

$242.29

$95.97

$146.32

74263

-

-

$606.91

$88.19

$518.72

74270

-

-

$122.96

$39.83

$83.14

74280

-

-

$177.45

$48.23

$129.22

74283

-

-

$197.47

$79.85

$117.63

74290

-

-

$66.08

$12.21

$53.86

74300

-

-

-

$13.81

-

74301

-

-

-

$8.13

-

74328

-

-

-

$27.42

-

74329

-

-

-

$27.42

-

74330

-

-

-

$35.24

-

74340

-

-

-

$20.86

-

74355

-

-

-

$29.50

-

74360

-

-

-

$21.64

-

74363

-

-

-

$33.55

-

74400

-

-

$103.00

$18.71

$84.30

74410

-

-

$104.74

$18.42

$86.33

74415

-

-

$122.71

$18.71

$104.01

74420

-

-

$58.87

$19.50

$39.37

74425

-

-

$104.69

$19.24

$85.46

74430

-

-

$31.88

$12.21

$19.66

74440

-

-

$74.04

$14.09

$59.95

74445

-

-

-

$42.28

$90.09

74450

-

-

-

$12.48

$187.19

74455

-

-

$78.51

$12.48

$66.04

74470

-

-

-

$20.28

$386.60

74485

-

-

$90.24

$30.87

$59.37

74710

-

-

$31.49

$13.28

$18.21

74712

-

-

$340.28

$114.94

$225.34

74713

-

-

$212.15

$71.28

$140.87

74740

-

-

$72.55

$14.63

$57.92

74742

-

-

-

$23.58

-

74775

-

-

-

$23.85

$187.19

75557

-

-

$296.43

$88.89

$207.54

75559

-

-

$457.20

$109.16

$348.04

75561

-

-

$409.25

$97.84

$311.41

75563

-

-

$553.55

$113.00

$440.55

75565

-

-

$50.73

$9.49

$41.24

75571

-

-

$83.90

$22.21

$61.69

75572

-

-

$198.43

$66.64

$131.78

75573

-

-

$243.53

$97.29

$146.23

75574

-

-

$237.07

$90.80

$146.28

75600

-

-

$162.15

$19.01

$143.13

75605

-

-

$103.12

$42.01

$61.11

75625

-

-

$109.22

$53.33

$55.89

75630

-

-

$133.60

$74.52

$59.08

75635

-

-

$236.98

$90.71

$146.28

75705

-

-

$198.52

$89.05

$109.47

75710

-

-

$128.86

$65.72

$63.14

75716

-

-

$137.40

$72.85

$64.54

75726

-

-

$145.10

$75.00

$70.10

75731

-

-

$130.21

$43.93

$86.28

75733

-

-

$140.47

$49.02

$91.45

75736

-

-

$119.89

$41.43

$78.46

75741

-

-

$113.14

$48.26

$64.88

75743

-

-

$127.26

$61.51

$65.75

75746

-

-

$114.80

$42.43

$72.37

75756

-

-

$130.47

$42.74

$87.73

75774

-

-

$85.18

$37.11

$48.07

75801

-

-

-

$33.17

$506.30

75803

-

-

-

$45.01

$1,309.72

75805

-

-

-

$31.41

$1,309.72

75807

-

-

-

$42.65

$2,225.31

75809

-

-

$73.15

$18.13

$55.02

75810

-

-

-

$37.71

$1,309.72

75820

-

-

$86.08

$26.41

$59.66

75822

-

-

$100.13

$39.60

$60.53

75825

-

-

$99.51

$42.16

$57.34

75827

-

-

$103.52

$42.41

$61.11

75831

-

-

$103.99

$41.43

$62.56

75833

-

-

$124.42

$55.24

$69.18

75840

-

-

$112.00

$43.93

$68.07

75842

-

-

$136.17

$57.72

$78.46

75860

-

-

$109.50

$42.88

$66.62

75870

-

-

$146.01

$48.67

$97.34

75872

-

-

$112.00

$43.93

$68.07

75880

-

-

$94.91

$26.84

$68.07

75885

-

-

$118.03

$52.00

$66.04

75887

-

-

$118.90

$52.58

$66.33

75889

-

-

$107.31

$41.28

$66.04

75891

-

-

$109.05

$42.15

$66.91

75893

-

-

$92.60

$20.77

$71.83

75894

-

-

-

$54.92

-

75898

-

-

-

$68.93

$1,309.72

75901

-

-

$176.82

$18.08

$158.74

75902

-

-

$68.42

$14.56

$53.86

75956

-

-

-

$261.22

-

75957

-

-

-

$223.53

-

75958

-

-

-

$148.26

-

75959

-

-

-

$130.34

-

75970

-

-

-

$30.49

-

75984

-

-

$78.83

$26.70

$52.13

75989

-

-

$96.09

$44.83

$51.26

76000

-

-

$33.28

$11.88

$21.40

76010

-

-

$22.94

$7.05

$15.90

76080

-

-

$46.90

$19.99

$26.91

76098

-

-

$34.17

$12.19

$21.98

76100

-

-

$78.01

$23.86

$54.15

76101

-

-

$78.27

$20.69

$57.59

76102

-

-

$114.28

$24.24

$90.05

76120

-

-

$87.58

$14.58

$72.99

76125

-

-

-

$10.31

-

76140

-

-

I.C.

-

-

76145

-

-

$703.38

-

-

76376

-

-

$18.26

$7.58

$10.68

76377

-

-

$56.63

$30.59

$26.04

76380

-

-

$113.94

$37.08

$76.86

76390

-

-

$422.96

$54.26

$368.70

76391

-

-

$256.61

$42.87

$213.74

76496

-

-

-

-

$64.01

76497

-

-

-

-

$64.01

76498

-

-

-

-

$76.86

76499

-

-

I.C.

-

-

76506

-

-

$92.38

$24.60

$67.78

76510

-

-

$72.39

$37.07

$35.31

76511

-

-

$49.06

$27.95

$21.11

76512

-

-

$41.72

$24.38

$17.35

76513

-

-

$79.73

$27.90

$51.84

76514

-

-

$9.42

$6.28

$3.14

76516

-

-

$38.35

$17.81

$20.53

76519

-

-

$53.07

$24.13

$28.94

76529

-

-

$66.62

$25.51

$41.11

76536

-

-

$93.22

$21.68

$71.54

76604

-

-

$63.00

$22.18

$40.82

76641

-

-

$85.56

$27.93

$57.63

76642

-

-

$69.74

$26.02

$43.72

76700

-

-

$98.31

$31.41

$66.91

76705

-

-

$72.86

$22.47

$50.39

76706

-

-

$91.51

$21.12

$70.38

76770

-

-

$90.46

$28.19

$62.27

76775

-

-

$46.51

$22.21

$24.30

76776

-

-

$125.64

$29.50

$96.14

76800

-

-

$113.69

$44.75

$68.94

76801

-

-

$97.29

$38.21

$59.08

76802

-

-

$49.42

$31.74

$17.68

76805

-

-

$111.78

$38.21

$73.57

76810

-

-

$72.39

$37.95

$34.45

76811

-

-

$140.18

$72.74

$67.44

76812

-

-

$157.87

$68.11

$89.76

76813

-

-

$95.96

$45.28

$50.68

76814

-

-

$61.73

$38.01

$23.72

76815

-

-

$66.91

$24.93

$41.98

76816

-

-

$90.19

$32.56

$57.63

76817

-

-

$76.23

$28.75

$47.49

76818

-

-

$93.71

$40.18

$53.53

76819

-

-

$68.94

$29.57

$39.37

76820

-

-

$36.90

$19.26

$17.63

76821

-

-

$72.05

$26.60

$45.46

76825

-

-

$219.05

$63.21

$155.84

76826

-

-

$130.48

$31.45

$99.03

76827

-

-

$58.44

$21.96

$36.47

76828

-

-

$41.10

$21.43

$19.66

76830

-

-

$98.70

$26.57

$72.12

76831

-

-

$95.44

$27.66

$67.78

76856

-

-

$87.68

$26.28

$61.40

76857

-

-

$38.34

$18.97

$19.37

76870

-

-

$84.04

$24.38

$59.66

76872

-

-

$115.84

$25.75

$90.09

76873

-

-

$139.68

$60.31

$79.37

76881

-

-

$61.79

$24.16

$37.63

76882

-

-

$45.33

$18.71

$26.62

76885

-

-

$92.49

$28.48

$64.01

76886

-

-

$84.38

$23.85

$60.53

76932

-

-

-

$26.53

-

76936

-

-

$214.93

$74.45

$140.48

76937

-

-

$29.03

$11.06

$17.97

76940

-

-

-

$78.97

-

76941

-

-

-

$51.55

-

76942

-

-

$45.13

$24.31

$20.82

76945

-

-

-

$25.51

-

76946

-

-

$25.35

$14.38

$10.97

76948

-

-

$60.53

$25.51

$35.02

76965

-

-

$72.96

$52.42

$20.53

76975

-

-

-

$32.12

$187.19

76977

-

-

$5.58

$2.15

$3.43

76978

-

-

$262.51

$61.99

$200.52

76979

-

-

$179.03

$33.00

$146.03

76981

-

-

$86.48

$22.76

$63.72

76982

-

-

$76.92

$22.76

$54.15

76983

-

-

$47.08

$19.26

$27.82

76998

-

-

-

$48.28

-

76999

-

-

I.C.

-

-

77001

-

-

$77.43

$14.29

$63.14

77002

-

-

$86.89

$21.44

$65.46

77003

-

-

$80.95

$23.03

$57.92

77011

-

-

$187.00

$49.08

$137.92

77012

-

-

$119.34

$56.78

$62.56

77013

-

-

-

$146.35

-

77014

-

-

$97.73

$34.88

$62.85

77021

-

-

$375.64

$56.04

$319.60

77022

-

-

-

$166.16

-

77046

-

-

$267.96

$55.79

$212.17

77047

-

-

$273.28

$61.50

$211.78

77048

-

-

$361.54

$80.52

$281.02

77049

-

-

$367.98

$88.34

$279.64

77053

-

-

$45.35

$13.81

$31.55

77054

-

-

$58.76

$17.35

$41.40

77061

-

-

I.C.

-

-

77062

-

-

I.C.

-

-

77063

-

-

$43.32

$23.03

$20.29

77065

-

-

$107.30

$31.41

$75.89

77066

-

-

$135.24

$38.48

$96.76

77067

-

-

$148.95

$42.79

$106.16

77071

-

-

$42.11

-

-

77072

-

-

$20.02

$7.31

$12.71

77073

-

-

$35.17

$10.58

$24.59

77074

-

-

$50.38

$17.09

$33.29

77075

-

-

$76.15

$21.41

$54.73

77076

-

-

$82.15

$26.84

$55.31

77077

-

-

$36.44

$13.30

$23.14

77078

-

-

$73.49

$9.49

$64.01

77080

-

-

$31.59

$7.58

$24.01

77081

-

-

$25.79

$7.87

$17.92

77084

-

-

$362.09

$61.79

$300.30

77085

-

-

$42.65

$11.39

$31.26

77086

-

-

$27.61

$6.49

$21.11

77261

-

-

$55.53

-

-

77262

-

-

$84.06

-

-

77263

-

-

$131.24

-

-

77280

-

-

$225.62

$29.16

$196.46

77285

-

-

$378.24

$45.02

$333.22

77290

-

-

$403.90

$64.30

$339.60

77293

-

-

$364.67

$82.50

$282.16

77295

-

-

$388.49

$175.45

$213.05

77299

-

-

I.C.

-

-

77300

-

-

$52.83

$25.34

$27.49

77301

-

-

$1,543.26

$326.63

$1,216.63

77306

-

-

$118.85

$57.49

$61.35

77307

-

-

$229.82

$118.75

$111.07

77316

-

-

$174.94

$57.49

$117.45

77317

-

-

$229.40

$75.43

$153.97

77318

-

-

$327.36

$118.46

$208.90

77321

-

-

$75.07

$39.47

$35.60

77331

-

-

$51.01

$35.70

$15.32

77332

-

-

$37.60

$18.51

$19.08

77333

-

-

$96.81

$30.77

$66.04

77334

-

-

$101.54

$47.38

$54.15

77336

-

-

$64.94

-

-

77338

-

-

$387.82

$175.45

$212.38

77370

-

-

$101.24

-

-

77371

-

-

I.C.

-

-

77372

-

-

$858.11

-

-

77373

-

-

$987.48

-

-

77385

-

-

I.C.

-

-

77386

-

-

I.C.

-

-

77387

-

-

I.C.

-

-

77399

-

-

I.C.

-

-

77401

-

-

$19.95

-

-

77402

-

-

I.C.

-

-

77407

-

-

I.C.

-

-

77412

-

-

I.C.

-

-

77417

-

-

$9.23

-

-

77423

-

-

I.C.

-

-

77424

-

-

I.C.

-

-

77425

-

-

I.C.

-

-

77427

-

-

$148.27

-

-

77431

-

-

$82.50

-

-

77432

-

-

$330.47

-

-

77435

-

-

$499.16

-

-

77469

-

-

$247.74

-

-

77470

-

-

$104.41

$83.59

$20.82

77499

-

-

I.C.

-

-

77520

-

-

I.C.

-

-

77522

-

-

I.C.

-

-

77523

-

-

I.C.

-

-

77525

-

-

I.C.

-

-

77600

-

-

$378.00

$55.35

$322.65

77605

-

-

$689.46

$79.30

$610.17

77610

-

-

$555.43

$53.66

$501.77

77615

-

-

$869.35

$75.70

$793.65

77620

-

-

$496.21

$65.45

$430.76

77750

-

-

$302.61

$204.29

$98.32

77761

-

-

$321.26

$157.49

$163.78

77762

-

-

$423.90

$236.15

$187.74

77763

-

-

$597.05

$354.66

$242.39

77767

-

-

$193.48

$43.28

$150.20

77768

-

-

$290.54

$57.49

$233.05

77770

-

-

$270.26

$80.06

$190.20

77771

-

-

$481.53

$155.29

$326.24

77772

-

-

$726.12

$219.49

$506.63

77778

-

-

$688.25

$358.14

$330.12

77789

-

-

$102.10

$47.41

$54.69

77790

-

-

$12.42

-

-

77799

-

-

I.C.

-

-

78012

-

-

$66.88

$7.31

$59.57

78013

-

-

$158.03

$13.83

$144.20

78014

-

-

$197.28

$18.68

$178.60

78015

-

-

$184.36

$25.46

$158.89

78016

-

-

$231.90

$26.06

$205.85

78018

-

-

$257.22

$31.66

$225.56

78020

-

-

$67.04

$21.33

$45.70

78070

-

-

$243.46

$29.78

$213.67

78071

-

-

$289.92

$44.94

$244.98

78072

-

-

$365.41

$58.99

$306.42

78075

-

-

$369.35

$28.48

$340.87

78099

-

-

I.C.

-

-

78102

-

-

$139.57

$20.30

$119.28

78103

-

-

$177.54

$26.76

$150.78

78104

-

-

$204.62

$29.78

$174.84

78110

-

-

$57.03

$6.15

$50.88

78111

-

-

$60.43

$7.24

$53.19

78120

-

-

$58.38

$7.51

$50.88

78121

-

-

$63.67

$10.47

$53.19

78122

-

-

$78.42

$16.24

$62.18

78130

-

-

$102.28

$19.62

$82.67

78140

-

-

$90.69

$19.62

$71.07

78185

-

-

$140.19

$12.89

$127.30

78191

-

-

$102.28

$19.62

$82.67

78195

-

-

$290.79

$44.65

$246.13

78199

-

-

I.C.

-

-

78201

-

-

$156.85

$16.22

$140.63

78202

-

-

$168.86

$18.37

$150.49

78215

-

-

$160.50

$18.42

$142.08

78216

-

-

$105.23

$20.83

$84.41

78226

-

-

$269.69

$27.90

$241.79

78227

-

-

$364.52

$34.37

$330.14

78230

-

-

$143.30

$17.35

$125.94

78231

-

-

$85.98

$16.65

$69.33

78232

-

-

$84.37

$15.03

$69.33

78258

-

-

$177.28

$26.79

$150.49

78261

-

-

$167.30

$22.03

$145.27

78262

-

-

$196.80

$25.73

$171.07

78264

-

-

$273.62

$29.81

$243.82

78265

-

-

$323.45

$37.08

$286.38

78266

-

-

$353.73

$37.79

$315.94

78267

-

-

I.C.

-

-

78268

-

-

I.C.

-

-

78278

-

-

$286.08

$37.63

$248.45

78282

-

-

-

$12.35

$295.59

78290

-

-

$271.57

$25.44

$246.13

78291

-

-

$208.97

$32.97

$175.99

78299

-

-

I.C.

-

-

78300

-

-

$188.34

$23.85

$164.49

78305

-

-

$228.02

$31.65

$196.37

78306

-

-

$247.28

$32.73

$214.54

78315

-

-

$284.27

$38.72

$245.55

78350

-

-

$25.74

$8.40

$17.35

78351

-

-

$11.93

-

-

78399

-

-

I.C.

-

-

78414

-

-

-

$16.82

-

78428

-

-

$151.43

$28.96

$122.47

78429

-

-

-

$64.10

$11.55

78430

-

-

-

$60.84

$11.55

78431

-

-

-

$70.91

$1,807.37

78432

-

-

-

$75.42

$2,208.79

78433

-

-

-

$82.45

$2,208.79

78434

-

-

-

$23.87

-

78445

-

-

$160.74

$19.44

$141.30

78451

-

-

$275.27

$51.46

$223.82

78452

-

-

$384.64

$60.68

$323.97

78453

-

-

$248.09

$38.19

$209.91

78454

-

-

$356.14

$51.22

$304.93

78456

-

-

$252.82

$37.12

$215.70

78457

-

-

$143.34

$28.70

$114.64

78458

-

-

$167.85

$34.95

$132.90

78459

-

-

-

$58.14

$1,021.63

78466

-

-

$163.82

$27.15

$136.67

78468

-

-

$157.37

$29.78

$127.59

78469

-

-

$182.59

$34.71

$147.88

78472

-

-

$185.92

$37.08

$148.84

78473

-

-

$235.34

$54.42

$180.92

78481

-

-

$143.02

$37.08

$105.94

78483

-

-

$195.73

$55.00

$140.72

78491

-

-

-

$56.52

$1,158.72

78492

-

-

-

$66.61

$1,158.72

78494

-

-

$184.15

$44.68

$139.48

78496

-

-

$34.29

$18.68

$15.61

78499

-

-

I.C.

-

-

78579

-

-

$153.92

$18.42

$135.51

78580

-

-

$194.13

$27.90

$166.23

78582

-

-

$273.43

$40.33

$233.09

78597

-

-

$164.30

$27.05

$137.25

78598

-

-

$249.71

$31.40

$218.31

78599

-

-

I.C.

-

-

78600

-

-

$151.06

$16.80

$134.26

78601

-

-

$178.13

$19.24

$158.89

78605

-

-

$163.88

$20.35

$143.53

78606

-

-

$271.96

$24.09

$247.87

78608

-

-

-

$54.93

$1,158.72

78609

-

-

$58.56

$58.56

-

78610

-

-

$143.13

$11.39

$131.74

78630

-

-

$277.95

$25.73

$252.22

78635

-

-

$278.12

$23.58

$254.54

78645

-

-

$267.25

$21.12

$246.13

78650

-

-

$226.91

$19.62

$207.30

78660

-

-

$151.22

$20.35

$130.87

78699

-

-

I.C.

-

-

78700

-

-

$140.40

$16.77

$123.62

78701

-

-

$179.63

$18.42

$161.21

78707

-

-

$190.22

$35.97

$154.26

78708

-

-

$143.24

$45.21

$98.03

78709

-

-

$300.41

$52.25

$248.16

78725

-

-

$88.74

$13.80

$74.93

78730

-

-

$62.48

$6.01

$56.47

78740

-

-

$178.27

$20.83

$157.44

78761

-

-

$173.54

$27.40

$146.14

78799

-

-

I.C.

-

-

78800

-

-

$212.55

$24.58

$187.97

78801

-

-

$233.39

$27.84

$205.56

78802

-

-

$256.50

$29.49

$227.01

78803

-

-

$319.17

$40.28

$278.89

78804

-

-

$543.81

$37.87

$505.94

78808

-

-

$32.51

-

-

78811

-

-

-

$57.88

$1,021.63

78812

-

-

-

$71.13

$1,158.72

78813

-

-

-

$71.34

$1,158.72

78814

-

-

-

$81.43

$1,158.72

78815

-

-

-

$91.28

$1,158.72

78816

-

-

-

$92.00

$1,158.72

78830

-

-

$403.64

$55.20

$348.45

78831

-

-

$584.58

$67.34

$517.24

78832

-

-

$761.47

$78.44

$683.03

78835

-

-

$84.21

$17.31

$66.91

78999

-

-

I.C.

-

-

79005

-

-

$108.75

$67.68

$41.07

79101

-

-

$117.34

$75.69

$41.65

79200

-

-

$106.81

$63.43

$43.39

79300

-

-

-

$50.81

-

79403

-

-

$150.20

$83.67

$66.53

79440

-

-

$95.80

$63.43

$32.37

79445

-

-

-

$87.52

-

79999

-

-

I.C.

-

-

0394T

-

-

I.C.

-

-

0395T

-

-

I.C.

-

-

A4641

-

-

I.C.

-

-

A9500

-

-

I.C.

-

-

A9502

-

-

I.C.

-

-

A9503

-

-

I.C.

-

-

A9505

-

-

I.C.

-

-

A9512

-

-

I.C.

-

-

A9537

-

-

I.C.

-

-

A9552

-

-

I.C.

-

-

A9586

-

-

I.C.

-

-

A9587

-

-

I.C.

-

-

A9588

-

-

I.C.

-

-

A9591

-

-

I.C.

-

-

G0279

-

-

$43.32

$23.03

$20.29

G0297

-

-

$191.42

$39.30

$152.12

G6001

-

-

$94.38

$24.86

$69.52

G6002

-

-

$60.40

$15.81

$44.59

G6003

-

-

$152.41

-

-

G6004

-

-

$115.31

-

-

G6005

-

-

$115.31

-

-

G6006

-

-

$115.31

-

-

G6007

-

-

$216.46

-

-

G6008

-

-

$159.07

-

-

G6009

-

-

$157.92

-

-

G6010

-

-

$157.92

-

-

G6011

-

-

$213.85

-

-

G6012

-

-

$210.96

-

-

G6013

-

-

$211.24

-

-

G6014

-

-

$211.24

-

-

G6015

-

-

$296.86

-

-

G6016

-

-

$295.88

-

-

G6017

-

-

$60.40

$15.81

$44.59

R0075

-

-

I.C.

-

-

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