State prevailing rates

Please note that the CHAMPUS Maximum Allowable Charges (CMAC) take precedence over the state prevailing rates listed below.

Latest update: 03-13-2019
CPT code State Provider class Modifier Current pricing Effective date
0359T AL 01 00 $500.00 2/3/2016
0359T AL 04 00 $500.00 2/3/2016
0360T AL 01 00 $62.50 2/3/2016
0360T AL 04 00 $62.50 2/3/2016
0361T AL 01 00 $62.50 2/3/2016
0361T AL 04 00 $62.50 2/3/2016
0364T AL 01 00 $62.50 1/1/2018
0364T AL 04 00 $62.50 1/1/2018
0364T AL 01 00 $62.50 7/12/2018
0364T AL 04 00 $62.50 7/12/2018
0365T AL 01 00 $62.50 2/3/2016
0365T AL 04 00 $62.50 2/3/2016
0368T AL 01 00 $62.50 2/3/2016
0368T AL 04 00 $62.50 2/3/2016
0369T AL 01 00 $62.50 2/3/2016
0369T AL 04 00 $62.50 2/3/2016
0370T AL 01 00 $125.00 2/3/2016
0370T AL 04 00 $125.00 2/3/2016
15876 AL 01 00 $2,538.80 1/1/2018
15876 AL 04 00 $2,538.80 1/1/2018
15876 AL 01 00 $2,538.80 7/12/2018
15876 AL 04 00 $2,538.80 7/12/2018
15878 AL 01 00 $1,367.00 1/1/2018
15878 AL 04 00 $1,367.00 1/1/2018
15878 AL 01 00 $1,367.00 7/12/2018
15878 AL 04 00 $1,367.00 7/12/2018
15879 AL 01 00 $1,562.30 1/1/2018
15879 AL 04 00 $1,404.80 1/1/2018
15879 AL 01 00 $1,562.30 7/12/2018
15879 AL 04 00 $1,404.80 7/12/2018
17380 AL 01 00 $148.00 2/3/2016
17380 AL 04 00 $148.00 2/3/2016
24940 AL 01 00 $1,608.00 1/1/2018
24940 AL 04 00 $1,545.30 1/1/2018
24940 AL 01 00 $1,608.00 7/12/2018
24940 AL 04 00 $1,545.30 7/12/2018
32850 AL 01 00 $3,691.00 1/1/2018
32850 AL 04 00 $3,691.00 1/1/2018
32850 AL 01 00 $3,691.00 7/12/2018
32850 AL 04 00 $3,691.00 7/12/2018
33940 AL 01 00 $2,987.90 1/1/2018
33940 AL 04 00 $2,987.90 1/1/2018
33940 AL 01 00 $2,987.90 7/12/2018
33940 AL 04 00 $2,987.90 7/12/2018
37765 AL 01 00 $612.31 2/3/2016
37765 AL 04 00 $612.31 2/3/2016
50300 AL 01 00 $1,072.00 1/1/2018
50300 AL 04 00 $1,072.00 1/1/2018
50300 AL 01 00 $1,072.00 7/12/2018
50300 AL 04 00 $1,072.00 7/12/2018
65767 AL 01 00 $2,974.30 1/1/2018
65767 AL 04 00 $2,974.30 1/1/2018
65767 AL 01 00 $2,974.30 7/12/2018
65767 AL 04 00 $2,974.30 7/12/2018
74300 AL 01 00 $750.00 5/5/2017
74300 AL 01 00 $750.00 1/1/2018
74300 AL 04 00 $750.00 1/1/2018
74300 AL 01 00 $750.00 7/12/2018
74300 AL 04 00 $750.00 7/12/2018
74300 AL 01 00 $896.00 1/1/2019
74300 AL 04 00 $896.00 1/1/2019
74300 AL 01 TC $864.75 1/1/2018
74300 AL 04 TC $864.75 1/1/2018
74300 AL 01 TC $864.75 7/12/2018
74300 AL 04 TC $864.75 7/12/2018
74328 AL 01 00 $562.00 1/1/2019
74328 AL 04 00 $562.00 1/1/2019
74330 AL 01 00 $1,286.64 1/1/2018
74330 AL 04 00 $1,280.09 1/1/2018
74330 AL 01 00 $1,286.64 7/12/2018
74330 AL 04 00 $1,280.09 7/12/2018
74330 AL 01 00 $808.00 1/1/2019
74330 AL 04 00 $808.00 1/1/2019
74330 AL 01 TC $1,243.00 1/1/2018
74330 AL 04 TC $1,243.00 1/1/2018
74330 AL 01 TC $1,243.00 7/12/2018
74330 AL 04 TC $1,243.00 7/12/2018
74360 AL 01 00 $445.00 1/1/2019
74360 AL 04 00 $445.00 1/1/2019
75894 AL 01 00 $359.00 1/1/2019
75894 AL 04 00 $359.00 1/1/2019
75970 AL 01 00 $2,406.50 1/1/2019
75970 AL 04 00 $2,406.50 1/1/2019
76001 AL 01 00 $816.75 1/1/2018
76001 AL 04 00 $811.83 1/1/2018
76001 AL 01 00 $816.75 7/12/2018
76001 AL 04 00 $811.83 7/12/2018
76001 AL 01 TC $784.00 1/1/2018
76001 AL 04 TC $784.00 1/1/2018
76001 AL 01 TC $784.00 7/12/2018
76001 AL 04 TC $784.00 7/12/2018
77385 AL 01 00 $1,740.00 2/3/2016
77385 AL 04 00 $1,740.00 2/3/2016
77386 AL 01 00 $2,091.00 2/3/2016
77386 AL 04 00 $2,091.00 2/3/2016
80300 AL 01 00 $78.00 2/3/2016
80300 AL 04 00 $78.00 2/3/2016
80301 AL 01 00 $330.00 2/3/2016
80301 AL 04 00 $330.00 2/3/2016
80320 AL 01 00 $109.50 2/3/2016
80320 AL 04 00 $109.50 2/3/2016
80324 AL 01 00 $140.00 2/3/2016
80324 AL 04 00 $140.00 2/3/2016
80332 AL 01 00 $48.96 2/3/2016
80332 AL 04 00 $48.96 2/3/2016
80336 AL 01 00 $187.53 2/3/2016
80336 AL 04 00 $187.53 2/3/2016
80345 AL 01 00 $79.90 2/3/2016
80345 AL 04 00 $79.90 2/3/2016
80346 AL 01 00 $300.00 2/3/2016
80346 AL 04 00 $300.00 2/3/2016
80348 AL 01 00 $50.59 2/3/2016
80348 AL 04 00 $50.59 2/3/2016
80349 AL 01 00 $35.20 2/3/2016
80349 AL 04 00 $35.20 2/3/2016
80353 AL 01 00 $105.00 2/3/2016
80353 AL 04 00 $105.00 2/3/2016
80354 AL 01 00 $48.96 2/3/2016
80354 AL 04 00 $48.96 2/3/2016
80355 AL 01 00 $31.65 2/3/2016
80355 AL 04 00 $31.65 2/3/2016
80356 AL 01 00 $50.59 2/3/2016
80356 AL 04 00 $50.59 2/3/2016
80358 AL 01 00 $50.23 2/3/2016
80358 AL 04 00 $50.23 2/3/2016
80359 AL 01 00 $90.00 2/3/2016
80359 AL 04 00 $90.00 2/3/2016
80360 AL 01 00 $97.92 2/3/2016
80360 AL 04 00 $97.92 2/3/2016
80361 AL 01 00 $270.36 2/3/2016
80361 AL 04 00 $270.36 2/3/2016
80363 AL 01 00 $99.55 2/3/2016
80363 AL 04 00 $99.55 2/3/2016
80363 AL 01 90 $45.00 2/3/2016
80363 AL 04 90 $45.00 2/3/2016
80364 AL 01 00 $100.00 2/3/2016
80364 AL 04 00 $100.00 2/3/2016
80365 AL 01 00 $101.18 2/3/2016
80365 AL 04 00 $101.18 2/3/2016
80365 AL 01 90 $37.00 2/3/2016
80365 AL 04 90 $37.00 2/3/2016
80366 AL 01 00 $48.96 2/3/2016
80366 AL 04 00 $48.96 2/3/2016
80366 AL 01 90 $35.20 2/3/2016
80366 AL 04 90 $35.20 2/3/2016
80367 AL 01 00 $48.96 2/3/2016
80367 AL 04 00 $48.96 2/3/2016
80367 AL 01 90 $35.20 2/3/2016
80367 AL 04 90 $35.20 2/3/2016
80368 AL 01 00 $97.92 2/3/2016
80368 AL 04 00 $97.92 2/3/2016
80368 AL 01 90 $35.20 2/3/2016
80368 AL 04 90 $35.20 2/3/2016
80369 AL 01 00 $52.79 2/3/2016
80369 AL 04 00 $52.79 2/3/2016
80370 AL 01 00 $100.00 2/3/2016
80370 AL 04 00 $100.00 2/3/2016
80372 AL 01 00 $48.96 2/3/2016
80372 AL 04 00 $48.96 2/3/2016
80373 AL 01 00 $48.96 2/3/2016
80373 AL 04 00 $48.96 2/3/2016
81228 AL 01 00 $2,000.10 2/3/2016
81228 AL 04 00 $2,000.10 2/3/2016
81244 AL 01 00 $120.00 1/1/2018
81244 AL 04 00 $120.00 1/1/2018
81244 AL 01 00 $120.00 7/12/2018
81244 AL 04 00 $120.00 7/12/2018
81377 AL 04 00 $380.50 2/3/2016
81377 AL 01 59 $380.50 2/3/2016
86860 AL 01 00 $37.50 1/1/2018
86860 AL 04 00 $37.50 1/1/2018
86860 AL 01 00 $37.50 7/12/2018
86860 AL 04 00 $37.50 7/12/2018
86921 AL 01 00 $178.00 1/1/2018
86921 AL 04 00 $178.00 1/1/2018
86921 AL 01 00 $178.00 7/12/2018
86921 AL 04 00 $178.00 7/12/2018
86921 AL 01 00 $289.00 1/1/2019
86921 AL 04 00 $289.00 1/1/2019
86930 AL 01 00 $43.75 1/1/2018
86930 AL 04 00 $43.75 1/1/2018
86930 AL 01 00 $43.75 7/12/2018
86930 AL 04 00 $43.75 7/12/2018
86931 AL 01 00 $51.70 1/1/2018
86931 AL 04 00 $51.70 1/1/2018
86931 AL 01 00 $51.70 7/12/2018
86931 AL 04 00 $51.70 7/12/2018
86932 AL 01 00 $92.80 1/1/2018
86932 AL 04 00 $92.80 1/1/2018
86932 AL 01 00 $92.80 7/12/2018
86932 AL 04 00 $92.80 7/12/2018
86950 AL 01 00 $69.50 1/1/2018
86950 AL 04 00 $69.50 1/1/2018
86950 AL 01 00 $69.50 7/12/2018
86950 AL 04 00 $69.50 7/12/2018
86970 AL 01 00 $34.90 1/1/2018
86970 AL 04 00 $34.90 1/1/2018
86970 AL 01 00 $34.90 7/12/2018
86970 AL 04 00 $34.90 7/12/2018
86971 AL 01 00 $41.30 1/1/2018
86971 AL 04 00 $41.30 1/1/2018
86971 AL 01 00 $41.30 7/12/2018
86971 AL 04 00 $41.30 7/12/2018
86975 AL 01 00 $31.00 1/1/2018
86975 AL 04 00 $31.00 1/1/2018
86975 AL 01 00 $31.00 7/12/2018
86975 AL 04 00 $31.00 7/12/2018
86976 AL 01 00 $212.00 1/1/2018
86976 AL 04 00 $212.00 1/1/2018
86976 AL 01 00 $212.00 7/12/2018
86976 AL 04 00 $212.00 7/12/2018
86978 AL 01 00 $20.70 1/1/2018
86978 AL 04 00 $20.70 1/1/2018
86978 AL 01 00 $20.70 7/12/2018
86978 AL 04 00 $20.70 7/12/2018
90650 AL 01 00 $191.00 1/1/2018
90650 AL 04 00 $191.00 1/1/2018
90650 AL 01 00 $191.00 7/12/2018
90650 AL 04 00 $191.00 7/12/2018
90661 AL 01 00 $30.00 1/1/2019
90661 AL 04 00 $30.00 1/1/2019
90681 AL 01 00 $182.00 1/1/2018
90681 AL 04 00 $182.00 1/1/2018
90681 AL 01 00 $182.00 7/12/2018
90681 AL 04 00 $182.00 7/12/2018
90681 AL 01 00 $160.00 1/1/2019
90681 AL 04 00 $160.00 1/1/2019
90696 AL 01 00 $70.00 1/1/2018
90696 AL 04 00 $70.00 1/1/2018
90696 AL 01 00 $70.00 7/12/2018
90696 AL 04 00 $70.00 7/12/2018
90696 AL 01 00 $125.00 1/1/2019
90696 AL 04 00 $125.00 1/1/2019
90736 AL 01 00 $235.51 7/19/2017
90736 AL 04 00 $235.51 7/19/2017
90736 AL 01 00 $254.35 7/20/2017
90736 AL 04 00 $254.35 7/20/2017
90736 AL 01 00 $254.35 1/1/2018
90736 AL 04 00 $254.35 1/1/2018
90736 AL 01 NU $235.51 10/19/2016
90736 AL 04 NU $235.51 10/19/2016
90993 AL 01 00 $4,831.00 1/1/2018
90993 AL 04 00 $60.00 1/1/2018
90993 AL 01 00 $4,831.00 7/12/2018
90993 AL 04 00 $60.00 7/12/2018
92978 AL 01 00 $1,038.00 1/1/2019
92978 AL 04 00 $1,038.00 1/1/2019
93299 AL 01 00 $100.00 5/5/2017
93299 AL 01 00 $100.00 1/1/2018
93299 AL 04 00 $100.00 1/1/2018
93299 AL 01 00 $100.00 7/12/2018
93299 AL 04 00 $100.00 7/12/2018
93299 AL 01 00 $100.00 1/1/2019
93299 AL 04 00 $100.00 1/1/2019
93609 AL 01 00 $4,754.92 1/1/2018
93609 AL 04 00 $4,715.63 1/1/2018
93609 AL 01 00 $4,754.92 7/12/2018
93609 AL 04 00 $4,715.63 7/12/2018
93609 AL 01 TC $4,493.00 1/1/2018
93609 AL 04 TC $4,493.00 1/1/2018
93609 AL 01 TC $4,493.00 7/12/2018
93609 AL 04 TC $4,493.00 7/12/2018
93620 AL 01 00 $8,823.34 1/1/2018
93620 AL 04 00 $8,731.79 1/1/2018
93620 AL 01 00 $8,823.34 7/12/2018
93620 AL 04 00 $8,731.79 7/12/2018
93620 AL 01 00 $46,682.78 1/1/2019
93620 AL 04 00 $46,682.78 1/1/2019
93620 AL 01 TC $8,213.00 1/1/2018
93620 AL 04 TC $8,213.00 1/1/2018
93620 AL 01 TC $8,213.00 7/12/2018
93620 AL 04 TC $8,213.00 7/12/2018
93621 AL 01 00 $6,407.42 1/1/2018
93621 AL 04 00 $6,390.86 1/1/2018
93621 AL 01 00 $6,407.42 7/12/2018
93621 AL 04 00 $6,390.86 7/12/2018
93621 AL 01 00 $9,673.00 1/1/2019
93621 AL 04 00 $9,673.00 1/1/2019
93621 AL 01 TC $6,297.00 1/1/2018
93621 AL 04 TC $6,297.00 1/1/2018
93621 AL 01 TC $6,297.00 7/12/2018
93621 AL 04 TC $6,297.00 7/12/2018
93623 AL 01 00 $3,927.55 1/1/2018
93623 AL 04 00 $3,905.29 1/1/2018
93623 AL 01 00 $3,927.55 7/12/2018
93623 AL 04 00 $3,905.29 7/12/2018
93623 AL 01 00 $9,280.00 1/1/2019
93623 AL 04 00 $9,280.00 1/1/2019
93623 AL 01 TC $3,778.00 1/1/2018
93623 AL 04 TC $3,778.00 1/1/2018
93623 AL 01 TC $3,778.00 7/12/2018
93623 AL 04 TC $3,778.00 7/12/2018
93641 AL 01 00 $1,607.00 1/1/2019
93641 AL 04 00 $1,607.00 1/1/2019
93662 AL 01 00 $5,532.00 1/1/2019
93662 AL 04 00 $5,532.00 1/1/2019
99000 AL 01 00 $20.00 5/5/2017
99000 AL 04 00 $20.00 5/5/2017
99000 AL 01 00 $20.00 1/1/2018
99000 AL 04 00 $20.00 1/1/2018
99000 AL 01 00 $20.00 7/12/2018
99000 AL 04 00 $20.00 7/12/2018
99001 AL 01 00 $45.00 1/1/2018
99001 AL 04 00 $7.00 1/1/2018
99001 AL 01 00 $45.00 7/12/2018
99001 AL 04 00 $7.00 7/12/2018
99002 AL 01 00 $90.00 1/1/2018
99002 AL 04 00 $90.00 1/1/2018
99002 AL 01 00 $90.00 7/12/2018
99002 AL 04 00 $90.00 7/12/2018
99071 AL 01 00 $6.00 2/3/2016
99071 AL 04 00 $6.00 2/3/2016
A0130 AL 01 00 $25.00 1/1/2018
A0130 AL 04 00 $25.00 1/1/2018
A0130 AL 01 00 $25.00 7/12/2018
A0130 AL 04 00 $25.00 7/12/2018
A0380 AL 01 00 $2.00 1/1/2018
A0380 AL 04 00 $2.00 1/1/2018
A0380 AL 01 00 $2.00 7/12/2018
A0380 AL 04 00 $2.00 7/12/2018
A0382 AL 01 00 $35.00 1/1/2018
A0382 AL 04 00 $35.00 1/1/2018
A0382 AL 01 00 $35.00 7/12/2018
A0382 AL 04 00 $35.00 7/12/2018
A0384 AL 01 00 $100.00 1/1/2018
A0384 AL 04 00 $100.00 1/1/2018
A0384 AL 01 00 $100.00 7/12/2018
A0384 AL 04 00 $100.00 7/12/2018
A0390 AL 01 00 $2.00 1/1/2018
A0390 AL 04 00 $2.00 1/1/2018
A0390 AL 01 00 $2.00 7/12/2018
A0390 AL 04 00 $2.00 7/12/2018
A0392 AL 01 00 $55.00 1/1/2018
A0392 AL 04 00 $55.00 1/1/2018
A0392 AL 01 00 $55.00 7/12/2018
A0392 AL 04 00 $55.00 7/12/2018
A0394 AL 01 00 $80.00 1/1/2018
A0394 AL 04 00 $80.00 1/1/2018
A0394 AL 01 00 $80.00 7/12/2018
A0394 AL 04 00 $80.00 7/12/2018
A0398 AL 01 00 $35.00 1/1/2018
A0398 AL 04 00 $35.00 1/1/2018
A0398 AL 01 00 $35.00 7/12/2018
A0398 AL 04 00 $35.00 7/12/2018
A0422 AL 01 00 $25.00 1/1/2018
A0422 AL 04 00 $25.00 1/1/2018
A0422 AL 01 00 $25.00 7/12/2018
A0422 AL 04 00 $25.00 7/12/2018
A0430 AL 01 00 $6,290.85 12/11/2015
A0430 AL 04 00 $6,290.85 12/11/2015
A0430 AL 01 00 $4,545.14 1/1/2018
A0430 AL 04 00 $4,545.14 1/1/2018
A0430 AL 01 00 $4,545.14 4/9/2018
A0430 AL 04 00 $4,545.14 4/9/2018
A0430 AL 01 00 $3,863.37 1/1/2019
A0430 AL 04 00 $3,863.37 1/1/2019
A0431 AL 01 00 $3,586.73 12/11/2015
A0431 AL 04 00 $3,586.73 12/11/2015
A0431 AL 01 00 $2,591.41 1/1/2018
A0431 AL 04 00 $2,591.41 1/1/2018
A0431 AL 01 00 $2,591.41 4/9/2018
A0431 AL 04 00 $2,591.41 4/9/2018
A0431 AL 01 00 $2,202.70 1/1/2019
A0431 AL 04 00 $2,202.70 1/1/2019
A0435 AL 01 00 $17.39 12/11/2015
A0435 AL 04 00 $17.39 12/11/2015
A0435 AL 01 00 $12.56 1/1/2018
A0435 AL 04 00 $12.56 1/1/2018
A0435 AL 01 00 $12.56 4/9/2018
A0435 AL 04 00 $12.56 4/9/2018
A0435 AL 01 00 $10.68 1/1/2019
A0435 AL 04 00 $10.68 1/1/2019
A0436 AL 01 00 $36.13 12/11/2015
A0436 AL 04 00 $36.13 12/11/2015
A0436 AL 01 00 $26.10 1/1/2018
A0436 AL 04 00 $26.10 1/1/2018
A0436 AL 01 00 $26.10 4/9/2018
A0436 AL 04 00 $26.10 4/9/2018
A0436 AL 01 00 $22.19 1/1/2019
A0436 AL 04 00 $22.19 1/1/2019
A4206 AL 01 00 $0.50 1/1/2018
A4206 AL 04 00 $0.50 1/1/2018
A4206 AL 01 00 $0.50 7/12/2018
A4206 AL 04 00 $0.50 7/12/2018
A4207 AL 01 00 $0.40 1/1/2018
A4207 AL 04 00 $0.40 1/1/2018
A4207 AL 01 00 $0.40 7/12/2018
A4207 AL 04 00 $0.40 7/12/2018
A4208 AL 01 00 $8.50 1/1/2018
A4208 AL 04 00 $8.50 1/1/2018
A4208 AL 01 00 $8.50 7/12/2018
A4208 AL 04 00 $8.50 7/12/2018
A4209 AL 01 00 $24.00 5/5/2017
A4209 AL 04 00 $24.00 5/5/2017
A4209 AL 01 00 $24.00 1/1/2018
A4209 AL 04 00 $24.00 1/1/2018
A4209 AL 01 00 $24.00 7/12/2018
A4209 AL 04 00 $24.00 7/12/2018
A4210 AL 01 00 $12.95 1/1/2018
A4210 AL 04 00 $12.95 1/1/2018
A4210 AL 01 00 $12.95 7/12/2018
A4210 AL 04 00 $12.95 7/12/2018
A4212 AL 01 00 $11.50 1/1/2018
A4212 AL 04 00 $11.50 1/1/2018
A4212 AL 01 00 $11.50 7/12/2018
A4212 AL 04 00 $11.50 7/12/2018
A4213 AL 01 00 $2.00 1/1/2018
A4213 AL 04 00 $2.00 1/1/2018
A4213 AL 01 00 $2.00 7/12/2018
A4213 AL 04 00 $2.00 7/12/2018
A4215 AL 01 00 $7.00 5/5/2017
A4215 AL 04 00 $7.00 5/5/2017
A4215 AL 01 00 $7.00 1/1/2018
A4215 AL 04 00 $7.00 1/1/2018
A4215 AL 01 00 $7.00 7/12/2018
A4215 AL 04 00 $7.00 7/12/2018
A4215 AL 01 00 $125.00 1/1/2019
A4215 AL 04 00 $125.00 1/1/2019
A4220 AL 01 00 $60.00 1/1/2018
A4220 AL 04 00 $60.00 1/1/2018
A4220 AL 01 00 $60.00 7/12/2018
A4220 AL 04 00 $60.00 7/12/2018
A4223 AL 01 00 $320.00 5/5/2017
A4223 AL 04 00 $320.00 5/5/2017
A4223 AL 01 00 $320.00 1/1/2018
A4223 AL 04 00 $320.00 1/1/2018
A4223 AL 01 00 $320.00 7/12/2018
A4223 AL 04 00 $320.00 7/12/2018
A4223 AL 01 00 $350.00 1/1/2019
A4223 AL 04 00 $350.00 1/1/2019
A4223 AL 01 NU $320.00 1/1/2018
A4223 AL 04 NU $320.00 1/1/2018
A4223 AL 01 NU $320.00 7/12/2018
A4223 AL 04 NU $320.00 7/12/2018
A4230 AL 01 00 $29.41 1/1/2018
A4230 AL 04 00 $29.41 1/1/2018
A4230 AL 01 00 $29.41 7/12/2018
A4230 AL 04 00 $29.41 7/12/2018
A4232 AL 01 00 $10.00 5/5/2017
A4232 AL 04 00 $10.00 5/5/2017
A4232 AL 01 00 $10.00 1/1/2018
A4232 AL 04 00 $10.00 1/1/2018
A4232 AL 01 00 $10.00 7/12/2018
A4232 AL 04 00 $10.00 7/12/2018
A4232 AL 01 00 $5.00 1/1/2019
A4232 AL 04 00 $5.00 1/1/2019
A4244 AL 01 00 $1.80 1/1/2018
A4244 AL 04 00 $1.80 1/1/2018
A4244 AL 01 00 $1.80 7/12/2018
A4244 AL 04 00 $1.80 7/12/2018
A4245 AL 01 00 $2.50 1/1/2018
A4245 AL 04 00 $2.50 1/1/2018
A4245 AL 01 00 $2.50 7/12/2018
A4245 AL 04 00 $2.50 7/12/2018
A4246 AL 01 00 $8.00 1/1/2018
A4246 AL 04 00 $8.00 1/1/2018
A4246 AL 01 00 $8.00 7/12/2018
A4246 AL 04 00 $8.00 7/12/2018
A4247 AL 01 00 $5.00 1/1/2018
A4247 AL 04 00 $5.00 1/1/2018
A4247 AL 01 00 $5.00 7/12/2018
A4247 AL 04 00 $5.00 7/12/2018
A4250 AL 01 00 $55.00 1/1/2018
A4250 AL 04 00 $55.00 1/1/2018
A4250 AL 01 00 $55.00 7/12/2018
A4250 AL 04 00 $55.00 7/12/2018
A4263 AL 01 00 $38.00 5/5/2017
A4263 AL 04 00 $38.00 5/5/2017
A4263 AL 01 00 $75.00 1/1/2018
A4263 AL 04 00 $75.00 1/1/2018
A4263 AL 01 00 $75.00 7/12/2018
A4263 AL 04 00 $75.00 7/12/2018
A4263 AL 01 00 $50.00 1/1/2019
A4263 AL 04 00 $50.00 1/1/2019
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V5264 AL 01 00 $70.00 5/5/2017
V5264 AL 04 00 $65.00 5/5/2017
V5264 AL 01 00 $80.00 1/1/2018
V5264 AL 04 00 $80.00 1/1/2018
V5264 AL 01 00 $80.00 7/12/2018
V5264 AL 04 00 $80.00 7/12/2018
V5264 AL 01 00 $80.00 1/1/2019
V5264 AL 04 00 $80.00 1/1/2019
V5266 AL 01 00 $48.00 1/1/2018
V5266 AL 04 00 $48.00 1/1/2018
V5266 AL 01 00 $48.00 7/12/2018
V5266 AL 04 00 $48.00 7/12/2018
V5266 AL 01 00 $1.00 1/1/2019
V5266 AL 04 00 $1.00 1/1/2019
V5267 AL 01 00 $201.59 1/1/2018
V5267 AL 04 00 $201.59 1/1/2018
V5267 AL 01 00 $201.59 7/12/2018
V5267 AL 04 00 $201.59 7/12/2018
V5267 AL 01 00 $300.00 1/1/2019
V5267 AL 04 00 $300.00 1/1/2019
V5275 AL 01 00 $25.00 5/5/2017
V5275 AL 04 00 $25.00 5/5/2017
V5275 AL 01 00 $25.00 1/1/2018
V5275 AL 04 00 $25.00 1/1/2018
V5275 AL 01 00 $25.00 7/12/2018
V5275 AL 04 00 $25.00 7/12/2018