State prevailing rates

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

Latest update: 08-01-2018
CPT code State Provider class Modifier Current pricing Effective date Past pricing Past effective date
0359T CT 01 00 $500.00 02/04/16
0359T CT 04 00 $500.00 02/04/16
0360T CT 01 00 $62.50 02/04/16
0360T CT 04 00 $62.50 02/04/16
0361T CT 01 00 $62.50 02/04/16
0361T CT 04 00 $62.50 02/04/16
0364T CT 01 00 $62.50 05/25/17
0364T CT 04 00 $62.50 05/25/17
0365T CT 01 00 $62.50 02/04/16
0365T CT 04 00 $62.50 02/04/16
0368T CT 01 00 $62.50 02/04/16
0368T CT 04 00 $62.50 02/04/16
0369T CT 01 00 $62.50 02/04/16
0369T CT 04 00 $62.50 02/04/16
0370T CT 01 00 $125.00 02/04/16
0370T CT 04 00 $125.00 02/04/16
15824 CT 01 00 $343.40 05/25/17
15824 CT 04 00 $343.40 05/25/17
15825 CT 01 00 $343.40 05/25/17
15825 CT 04 00 $343.40 05/25/17
15826 CT 01 00 $343.40 05/25/17
15826 CT 04 00 $343.40 05/25/17
15828 CT 01 00 $343.40 05/25/17
15828 CT 04 00 $343.40 05/25/17
15829 CT 01 00 $343.40 05/25/17
15829 CT 04 00 $343.40 05/25/17
15876 CT 01 00 $343.40 05/25/17
15876 CT 04 00 $343.40 05/25/17
15878 CT 01 00 $343.40 05/25/17
15878 CT 04 00 $343.40 05/25/17
15879 CT 01 00 $343.40 05/25/17
15879 CT 04 00 $343.40 05/25/17
17380 CT 01 00 $343.40 02/04/16
17380 CT 04 00 $343.40 02/04/16
21088 CT 01 00 $343.40 02/04/16
21088 CT 04 00 $343.40 02/04/16
22841 CT 01 00 $343.40 05/25/17
22841 CT 04 00 $343.40 05/25/17
24940 CT 01 00 $343.40 05/25/17
24940 CT 04 00 $343.40 05/25/17
32850 CT 01 00 $343.40 05/25/17
32850 CT 04 00 $343.40 05/25/17
33930 CT 01 00 $343.40 05/25/17
33930 CT 04 00 $343.40 05/25/17
33940 CT 01 00 $343.40 05/25/17
33940 CT 04 00 $343.40 05/25/17
36468 CT 01 00 $505.00 02/04/16
36468 CT 04 00 $505.00 02/04/16
41821 CT 01 00 $343.40 05/25/17
41821 CT 04 00 $343.40 05/25/17
41870 CT 01 00 $343.40 05/25/17
41870 CT 04 00 $343.40 05/25/17
43496 CT 01 00 $343.40 05/25/17
43496 CT 04 00 $343.40 05/25/17
47133 CT 01 00 $343.40 05/25/17
47133 CT 04 00 $343.40 05/25/17
48160 CT 01 00 $343.40 05/25/17
48160 CT 04 00 $343.40 05/25/17
48550 CT 01 00 $343.40 05/25/17
48550 CT 04 00 $343.40 05/25/17
49906 CT 01 00 $343.40 05/25/17
49906 CT 04 00 $343.40 05/25/17
50300 CT 01 00 $343.40 05/25/17
50300 CT 04 00 $343.40 05/25/17
55970 CT 01 00 $343.40 05/25/17
55970 CT 04 00 $343.40 05/25/17
55980 CT 01 00 $343.40 05/25/17
55980 CT 04 00 $343.40 05/25/17
58974 CT 01 00 $343.40 02/04/16
58974 CT 04 00 $343.40 02/04/16
65767 CT 01 00 $343.40 05/25/17
65767 CT 04 00 $343.40 05/25/17
65771 CT 01 00 $343.40 02/04/16
65771 CT 04 00 $343.40 02/04/16
69090 CT 01 00 $343.40 02/04/16
69090 CT 04 00 $343.40 02/04/16
69710 CT 01 00 $343.40 02/04/16
69710 CT 04 00 $343.40 02/04/16
76001 CT 01 00 $1,143.00 05/25/17
76001 CT 01 TC $485.95 05/25/17
76001 CT 04 00 $521.00 05/25/17
76001 CT 04 TC $485.95 05/25/17
78609 CT 01 00 $343.40 05/25/17
78609 CT 04 00 $343.40 05/25/17
79300 CT 01 00 $343.40 05/25/17
79300 CT 04 00 $343.40 05/25/17
80301 CT 01 00 $291.58 02/04/16
80301 CT 04 00 $291.58 02/04/16
80320 CT 01 00 $103.96 02/04/16
80320 CT 04 00 $103.96 02/04/16
80346 CT 01 00 $75.00 02/04/16
80346 CT 04 00 $75.00 02/04/16
81508 CT 01 00 $201.88 02/04/16
81508 CT 04 00 $201.88 02/04/16
86860 CT 01 00 $127.85 05/25/17
86860 CT 04 00 $127.85 05/25/17
86890 CT 01 00 $303.71 05/25/17
86890 CT 04 00 $303.71 05/25/17
86891 CT 01 00 $100.00 05/25/17
86891 CT 04 00 $100.00 05/25/17
86930 CT 01 00 $10.00 05/25/17
86930 CT 04 00 $10.00 05/25/17
86931 CT 01 00 $10.00 05/25/17
86931 CT 04 00 $10.00 05/25/17
86932 CT 01 00 $10.00 05/25/17
86932 CT 04 00 $10.00 05/25/17
86950 CT 01 00 $50.00 05/25/17
86950 CT 04 00 $50.00 05/25/17
86970 CT 01 00 $160.00 05/25/17
86970 CT 04 00 $160.00 05/25/17
86971 CT 01 00 $160.00 05/25/17
86971 CT 04 00 $160.00 05/25/17
86972 CT 01 00 $160.00 05/25/17
86972 CT 04 00 $160.00 05/25/17
86975 CT 01 00 $160.00 05/25/17
86975 CT 04 00 $160.00 05/25/17
86976 CT 01 00 $160.00 05/25/17
86976 CT 04 00 $160.00 05/25/17
86977 CT 01 00 $160.00 05/25/17
86977 CT 04 00 $160.00 05/25/17
86978 CT 01 00 $160.00 05/25/17
86978 CT 04 00 $160.00 05/25/17
90736 CT 01 00 $254.35 07/20/17
90736 CT 04 00 $254.35 07/20/17
90993 CT 01 00 $343.40 05/25/17
90993 CT 04 00 $343.40 05/25/17
92993 CT 01 00 $343.40 05/25/17
92993 CT 04 00 $343.40 05/25/17
93299 CT 01 00 $700.00 04/21/17
93299 CT 04 00 $550.00 05/25/17
99000 CT 01 00 $25.00 04/21/17
99000 CT 04 00 $25.00 04/20/17
99001 CT 01 00 $65.78 05/25/17
99001 CT 04 00 $43.00 05/25/17
99071 CT 01 00 $2.10 02/04/16
99071 CT 04 00 $2.10 02/04/16
99075 CT 01 00 $2.10 02/04/16
99075 CT 04 00 $2.10 02/04/16
99455 CT 01 00 $343.40 02/04/16
99455 CT 04 00 $343.40 02/04/16
A0225 CT 01 00 $249.80 05/25/17
A0225 CT 04 00 $249.80 05/25/17
A4206 CT 01 00 $.34 05/25/17
A4206 CT 04 00 $.34 05/25/17
A4209 CT 01 00 $5.50 05/25/17
A4209 CT 04 00 $5.50 05/25/17
A4211 CT 01 00 $232.96 05/25/17
A4211 CT 04 00 $232.96 05/25/17
A4212 CT 01 00 $25.00 05/25/17
A4212 CT 04 00 $25.00 05/25/17
A4213 CT 01 00 $25.00 05/25/17
A4213 CT 04 00 $25.00 05/25/17
A4215 CT 01 00 $18.54 05/25/17 $6.80 08/28/15
A4215 CT 04 00 $18.54 05/25/17 $6.80 08/28/15
A4218 CT 01 00 $4.75 05/25/17
A4218 CT 04 00 $4.75 05/25/17
A4220 CT 01 00 $200.00 05/25/17
A4220 CT 04 00 $200.00 05/25/17
A4223 CT 01 00 $394.47 04/20/17
A4223 CT 01 NU $394.47 05/25/17
A4223 CT 04 00 $394.47 04/20/17
A4223 CT 04 NU $394.47 05/25/17
A4245 CT 01 00 $4.00 05/25/17
A4245 CT 04 00 $4.00 05/25/17
A4250 CT 01 00 $.76 05/25/17
A4250 CT 04 00 $.76 05/25/17
A4263 CT 01 00 $50.00 05/25/17
A4263 CT 04 00 $50.00 05/25/17
A4270 CT 01 00 $2.00 05/25/17
A4270 CT 04 00 $2.00 05/25/17
A4284 CT 01 00 $17.54 04/20/17
A4284 CT 04 00 $17.54 04/20/17
A4285 CT 01 00 $6.37 05/25/17
A4285 CT 04 00 $6.37 05/25/17
A4305 CT 01 00 $80.00 04/20/17 $42.32 08/29/15
A4305 CT 04 00 $80.00 04/20/17 $42.32 08/29/15
A4483 CT 01 00 $11.50 05/25/17
A4483 CT 04 00 $11.50 05/25/17
A4500 CT 01 00 $60.00 05/25/17
A4500 CT 04 00 $60.00 05/25/17
A4550 CT 01 00 $100.00 04/20/17
A4550 CT 04 00 $100.00 04/20/17
A4570 CT 01 00 $84.00 05/25/17
A4570 CT 04 00 $84.00 05/25/17
A4580 CT 01 00 $100.00 05/25/17
A4580 CT 04 00 $100.00 05/25/17
A4590 CT 01 00 $80.00 05/25/17
A4590 CT 04 00 $80.00 05/25/17
A4606 CT 01 00 $78.50 05/25/17
A4606 CT 04 00 $78.50 05/25/17
A4627 CT 01 00 $70.00 05/25/17
A4627 CT 04 00 $70.00 05/25/17
A4648 CT 01 00 $292.00 05/25/17
A4648 CT 04 00 $292.00 05/25/17
A4657 CT 01 00 $84.30 04/20/17 $67.50 08/31/15
A4657 CT 04 00 $84.30 04/20/17 $67.50 08/31/15
A4770 CT 01 00 $160.00 05/25/17
A4770 CT 04 00 $160.00 05/25/17
A4927 CT 01 00 $9.79 05/25/17
A4927 CT 04 00 $9.79 05/25/17
A6208 CT 01 00 $67.11 05/25/17
A6208 CT 04 00 $67.11 05/25/17
A6213 CT 01 00 $9.80 05/25/17
A6213 CT 04 00 $9.80 05/25/17
A6411 CT 01 00 $10.00 05/25/17
A6411 CT 04 00 $10.00 05/25/17
A6450 CT 01 00 $8.00 05/25/17
A6450 CT 04 00 $8.00 05/25/17
A6451 CT 01 00 $1.99 05/25/17
A6451 CT 04 00 $1.99 05/25/17
A6530 CT 01 00 $44.00 05/25/17
A6530 CT 04 00 $44.00 05/25/17
A6533 CT 01 00 $76.00 05/25/17
A6533 CT 04 00 $76.00 05/25/17
A6534 CT 01 00 $89.95 05/25/17
A6534 CT 04 00 $89.95 05/25/17
A6539 CT 01 00 $180.00 05/25/17
A6539 CT 04 00 $180.00 05/25/17
A9276 CT 01 00 $27.00 04/20/17
A9276 CT 04 00 $27.00 04/20/17
A9282 CT 01 00 $2,000.00 05/25/17
A9282 CT 04 00 $2,000.00 05/25/17
A9283 CT 01 00 $75.00 05/25/17
A9283 CT 04 00 $75.00 05/25/17
A9500 CT 01 00 $464.00 04/20/17 $356.00 09/01/15
A9500 CT 04 00 $464.00 05/25/17
A9502 CT 01 00 $330.00 04/20/17
A9502 CT 04 00 $125.00 05/25/17
A9503 CT 01 00 $109.13 04/20/17 $103.82 09/02/15
A9503 CT 04 00 $84.00 05/25/17
A9505 CT 01 00 $125.00 05/25/17
A9505 CT 04 00 $31.74 05/25/17
A9507 CT 01 00 $3,244.35 05/25/17
A9507 CT 04 00 $3,244.35 05/25/17
A9510 CT 01 00 $361.00 05/25/17
A9510 CT 04 00 $361.00 05/25/17
A9512 CT 01 00 $178.00 05/25/17
A9512 CT 04 00 $178.00 05/25/17
A9516 CT 01 00 $223.00 04/20/17
A9516 CT 04 00 $68.45 05/25/17
A9517 CT 01 00 $33.31 05/25/17
A9517 CT 04 00 $33.31 05/25/17
A9521 CT 01 00 $567.61 05/25/17
A9521 CT 04 00 $567.61 05/25/17
A9528 CT 01 00 $130.00 05/25/17
A9528 CT 04 00 $130.00 05/25/17
A9530 CT 01 00 $28.91 05/25/17
A9530 CT 04 00 $28.91 05/25/17
A9537 CT 01 00 $355.00 04/20/17 $219.00 09/03/15
A9537 CT 04 00 $59.54 05/25/17
A9538 CT 01 00 $24.70 05/25/17
A9538 CT 04 00 $24.70 05/25/17
A9539 CT 01 00 $16.25 05/25/17
A9539 CT 04 00 $16.25 05/25/17
A9540 CT 01 00 $91.25 05/25/17
A9540 CT 04 00 $91.25 05/25/17
A9541 CT 01 00 $665.00 04/20/17
A9541 CT 04 00 $75.35 05/25/17
A9542 CT 01 00 $2,769.63 05/25/17
A9542 CT 04 00 $2,769.63 05/25/17
A9551 CT 01 00 $126.63 05/25/17
A9551 CT 04 00 $126.63 05/25/17
A9552 CT 01 00 $2,289.81 04/20/17
A9552 CT 04 00 $1,826.10 05/25/17
A9555 CT 01 00 $1,995.00 05/25/17
A9555 CT 04 00 $1,995.00 05/25/17
A9556 CT 01 00 $32.04 05/25/17
A9556 CT 04 00 $32.04 05/25/17
A9558 CT 01 00 $38.96 05/25/17
A9558 CT 04 00 $38.96 05/25/17
A9560 CT 01 00 $515.55 05/25/17
A9560 CT 04 00 $114.00 05/25/17
A9561 CT 01 00 $34.56 05/25/17
A9561 CT 04 00 $34.56 05/25/17
A9562 CT 01 00 $1,336.83 05/25/17
A9562 CT 04 00 $445.51 05/25/17
A9600 CT 01 00 $1,014.13 05/25/17
A9600 CT 04 00 $1,014.13 05/25/17
A9901 CT 01 00 $175.00 05/25/17
A9901 CT 04 00 $175.00 05/25/17
B4158 CT 01 00 $3.31 05/25/17
B4158 CT 04 00 $3.31 05/25/17
B4160 CT 01 00 $5.22 05/25/17
B4160 CT 04 00 $5.22 05/25/17
B4161 CT 01 00 $14.58 05/25/17
B4161 CT 04 00 $14.58 05/25/17
B4172 CT 01 00 $195.00 05/25/17
B4172 CT 04 00 $195.00 05/25/17
B5200 CT 01 00 $4.94 05/25/17
B5200 CT 04 00 $4.94 05/25/17
C1717 CT 01 00 $369.30 05/25/17
C1717 CT 04 00 $369.30 05/25/17
C1729 CT 01 00 $657.86 05/25/17
C1729 CT 04 00 $657.86 05/25/17
C1730 CT 01 00 $551.83 05/25/17
C1730 CT 04 00 $551.83 05/25/17
C1732 CT 01 00 $3,480.45 05/25/17
C1732 CT 04 00 $3,480.45 05/25/17
C1751 CT 01 00 $2,309.46 05/25/17
C1751 CT 04 00 $2,309.46 05/25/17
C1758 CT 01 00 $33.60 05/25/17
C1758 CT 04 00 $33.60 05/25/17
C1760 CT 01 00 $919.00 05/25/17
C1760 CT 04 00 $919.00 05/25/17
C1762 CT 01 00 $5,369.00 05/25/17
C1762 CT 04 00 $5,369.00 05/25/17
C1763 CT 01 00 $4,769.00 05/25/17
C1763 CT 04 00 $4,769.00 05/25/17
C1769 CT 01 00 $304.50 05/25/17 $278.00 09/17/15
C1769 CT 04 00 $304.50 05/25/17 $278.00 09/17/15
C1771 CT 01 00 $2,291.00 05/25/17
C1771 CT 04 00 $2,291.00 05/25/17
C1776 CT 01 00 $10,140.00 05/25/17
C1776 CT 04 00 $10,140.00 05/25/17
C1778 CT 01 00 $7,900.00 05/25/17
C1778 CT 04 00 $7,900.00 05/25/17
C1780 CT 01 00 $3,515.00 05/25/17
C1780 CT 04 00 $3,515.00 05/25/17
C1781 CT 01 00 $1,819.00 05/25/17
C1781 CT 04 00 $1,819.00 05/25/17
C1788 CT 01 00 $4,149.14 05/25/17 $3,351.60 09/21/15
C1788 CT 04 00 $4,149.14 05/25/17 $3,351.60 09/21/15
C1789 CT 01 00 $2,955.00 05/25/17
C1789 CT 04 00 $2,955.00 05/25/17
C1820 CT 01 00 $33,715.00 05/25/17
C1820 CT 04 00 $33,715.00 05/25/17
C1874 CT 01 00 $5,650.00 05/25/17
C1874 CT 04 00 $5,650.00 05/25/17
C1876 CT 01 00 $6,063.35 05/25/17
C1876 CT 04 00 $6,063.35 05/25/17
C1887 CT 01 00 $504.00 05/25/17 $484.00 09/21/15
C1887 CT 04 00 $504.00 05/25/17 $484.00 09/21/15
C1893 CT 01 00 $379.04 05/25/17
C1893 CT 04 00 $379.04 05/25/17
C1894 CT 01 00 $180.18 05/25/17
C1894 CT 04 00 $180.18 05/25/17
C2617 CT 01 00 $736.00 05/25/17
C2617 CT 04 00 $736.00 05/25/17
C5011 CT 01 00 $500.00 05/25/17
C5011 CT 04 00 $500.00 05/25/17
C7220 CT 01 00 $436.00 05/25/17
C7220 CT 04 00 $436.00 05/25/17
C8900 CT 01 00 $1,702.00 05/25/17
C8900 CT 04 00 $1,702.00 05/25/17
C8902 CT 01 00 $2,536.31 05/25/17
C8902 CT 04 00 $2,536.31 05/25/17
C8908 CT 01 00 $3,900.00 05/25/17
C8908 CT 04 00 $3,900.00 05/25/17
C8911 CT 01 00 $2,819.60 05/25/17
C8911 CT 04 00 $2,819.60 05/25/17
C8920 CT 01 00 $2,403.15 04/20/17
C8920 CT 04 00 $2,403.15 04/20/17
C8929 CT 01 00 $2,391.00 05/25/17
C8929 CT 04 00 $2,391.00 05/25/17
C9113 CT 01 00 $34.80 05/25/17
C9113 CT 04 00 $30.00 05/25/17
D0120 CT 01 00 $58.00 05/25/17
D0120 CT 04 00 $58.00 05/25/17
D0140 CT 01 00 $95.00 05/25/17
D0140 CT 04 00 $95.00 05/25/17
D0145 CT 01 00 $75.00 04/20/17
D0145 CT 04 00 $75.00 04/20/17
D0150 CT 01 00 $150.00 05/25/17
D0150 CT 04 00 $150.00 05/25/17
D0220 CT 01 00 $30.00 05/25/17
D0220 CT 04 00 $30.00 05/25/17
D0274 CT 01 00 $90.00 05/25/17
D0274 CT 04 00 $90.00 05/25/17
D0330 CT 01 00 $185.00 05/25/17
D0330 CT 04 00 $185.00 05/25/17
D1110 CT 01 00 $95.00 05/25/17
D1110 CT 04 00 $95.00 05/25/17
D1120 CT 01 00 $85.00 05/25/17
D1120 CT 04 00 $85.00 05/25/17
D1206 CT 01 00 $45.00 05/25/17
D1206 CT 04 00 $45.00 05/25/17
D1208 CT 01 00 $50.00 05/25/17
D1208 CT 04 00 $50.00 05/25/17
D7140 CT 01 00 $247.00 04/20/17
D7140 CT 04 00 $220.00 05/25/17
D7210 CT 01 00 $350.00 05/25/17
D7210 CT 04 00 $350.00 05/25/17
D7220 CT 01 00 $436.00 05/25/17
D7220 CT 04 00 $436.00 05/25/17
D7230 CT 01 00 $525.00 05/25/17 $495.00 09/23/15
D7230 CT 04 00 $355.00 05/25/17
D7240 CT 01 00 $625.00 04/20/17 $580.00 09/23/15
D7240 CT 04 00 $430.00 05/25/17
D9220 CT 01 00 $475.00 05/25/17
D9220 CT 04 00 $400.00 05/25/17
D9221 CT 01 00 $205.00 05/25/17
D9221 CT 04 00 $205.00 05/25/17
D9223 CT 01 00 $225.00 04/20/17
D9223 CT 04 00 $225.00 04/20/17
D9230 CT 01 00 $150.00 05/25/17
D9230 CT 04 00 $150.00 05/25/17
D9241 CT 01 00 $525.00 05/25/17
D9241 CT 04 00 $400.00 05/25/17
D9310 CT 01 00 $200.00 05/25/17
D9310 CT 04 00 $200.00 05/25/17
D9610 CT 01 00 $100.00 05/25/17
D9610 CT 04 00 $100.00 05/25/17
E0118 CT 01 00 $620.00 05/25/17
E0118 CT 01 NU $620.00 05/25/17
E0118 CT 04 00 $620.00 05/25/17
E0118 CT 04 NU $620.00 05/25/17
E0245 CT 01 00 $80.00 05/25/17
E0245 CT 01 NU $80.00 05/25/17
E0245 CT 04 00 $80.00 05/25/17
E0245 CT 04 NU $80.00 05/25/17
E0246 CT 01 00 $46.00 02/04/16
E0246 CT 01 RR $3.83 02/04/16
E0246 CT 04 00 $46.00 02/04/16
E0246 CT 04 RR $3.83 02/04/16
E0352 CT 01 00 $45.53 05/25/17
E0352 CT 04 00 $45.53 05/25/17
E0430 CT 01 00 $287.00 05/25/17
E0430 CT 04 00 $287.00 05/25/17
E0435 CT 01 00 $1,365.00 05/25/17
E0435 CT 01 NU $1,365.00 05/25/17
E0435 CT 04 00 $1,365.00 05/25/17
E0435 CT 04 NU $1,365.00 05/25/17
E0440 CT 01 00 $2,610.00 05/25/17
E0440 CT 01 NU $2,610.00 05/25/17
E0440 CT 04 00 $2,610.00 05/25/17
E0440 CT 04 NU $2,610.00 05/25/17
E0445 CT 01 RR $1,282.31 04/20/17
E0445 CT 04 RR $1,282.31 04/20/17
E0455 CT 01 00 $2,750.00 05/25/17
E0455 CT 01 RR $229.17 05/25/17
E0455 CT 04 00 $2,750.00 05/25/17
E0455 CT 04 RR $229.17 05/25/17
E0486 CT 01 00 $2,852.75 05/25/17
E0486 CT 01 NU $2,852.75 05/25/17
E0486 CT 04 00 $2,852.75 05/25/17
E0486 CT 04 NU $2,852.75 05/25/17
E0619 CT 01 RR $853.78 05/25/17
E0619 CT 04 RR $853.78 05/25/17
E0700 CT 01 00 $32.00 05/25/17
E0700 CT 01 RR $2.67 05/25/17
E0700 CT 04 00 $32.00 05/25/17
E0700 CT 04 RR $2.67 05/25/17
E0710 CT 01 00 $12.00 05/25/17
E0710 CT 01 RR $1.00 05/25/17
E0710 CT 04 00 $12.00 05/25/17
E0710 CT 04 RR $1.00 05/25/17
E0970 CT 01 00 $68.00 05/25/17
E0970 CT 01 RR $5.67 05/25/17
E0970 CT 04 00 $68.00 05/25/17
E0970 CT 04 RR $5.67 05/25/17
E1085 CT 01 00 $845.00 05/25/17
E1085 CT 01 NU $845.00 05/25/17
E1085 CT 01 RR $70.83 05/25/17
E1085 CT 04 00 $845.00 05/25/17
E1085 CT 04 NU $845.00 05/25/17
E1085 CT 04 RR $70.83 05/25/17
E1086 CT 01 00 $830.00 05/25/17
E1086 CT 01 NU $830.00 05/25/17
E1086 CT 01 RR $69.17 05/25/17
E1086 CT 04 00 $830.00 05/25/17
E1086 CT 04 NU $830.00 05/25/17
E1086 CT 04 RR $69.17 05/25/17
E1089 CT 01 00 $1,200.00 05/25/17
E1089 CT 01 RR $100.00 05/25/17
E1089 CT 04 00 $1,200.00 05/25/17
E1089 CT 04 RR $100.00 05/25/17
E1090 CT 01 00 $880.00 05/25/17
E1090 CT 01 NU $880.00 05/25/17
E1090 CT 01 RR $73.33 05/25/17
E1090 CT 04 00 $880.00 05/25/17
E1090 CT 04 NU $880.00 05/25/17
E1090 CT 04 RR $73.33 05/25/17
E1130 CT 01 00 $475.00 05/25/17
E1130 CT 01 NU $475.00 05/25/17
E1130 CT 01 RR $124.32 05/25/17
E1130 CT 04 00 $475.00 05/25/17
E1130 CT 04 NU $475.00 05/25/17
E1130 CT 04 RR $124.32 05/25/17
E1140 CT 01 00 $695.00 05/25/17
E1140 CT 01 NU $695.00 05/25/17
E1140 CT 01 RR $57.92 05/25/17
E1140 CT 04 00 $695.00 05/25/17
E1140 CT 04 NU $695.00 05/25/17
E1140 CT 04 RR $57.92 05/25/17
E1250 CT 01 00 $888.00 05/25/17
E1250 CT 01 NU $888.00 05/25/17
E1250 CT 01 RR $74.00 05/25/17
E1250 CT 04 00 $888.00 05/25/17
E1250 CT 04 NU $888.00 05/25/17
E1250 CT 04 RR $74.00 05/25/17
E1260 CT 01 00 $965.00 05/25/17
E1260 CT 01 NU $965.00 05/25/17
E1260 CT 01 RR $80.42 05/25/17
E1260 CT 04 00 $965.00 05/25/17
E1260 CT 04 NU $965.00 05/25/17
E1260 CT 04 RR $80.42 05/25/17
E1285 CT 01 00 $1,201.00 05/25/17
E1285 CT 01 NU $1,201.00 05/25/17
E1285 CT 01 RR $100.83 05/25/17
E1285 CT 04 00 $1,201.00 05/25/17
E1285 CT 04 NU $1,201.00 05/25/17
E1285 CT 04 RR $100.83 05/25/17
E1290 CT 01 00 $1,383.00 05/25/17
E1290 CT 01 NU $1,383.00 05/25/17
E1290 CT 04 00 $1,383.00 05/25/17
E1290 CT 04 NU $1,383.00 05/25/17
E1353 CT 01 RR $8.33 05/25/17
E1353 CT 04 RR $8.33 05/25/17
E1355 CT 01 RR $10.00 05/25/17
E1355 CT 04 RR $10.00 05/25/17
E2617 CT 01 00 $2,133.00 05/25/17
E2617 CT 04 00 $2,133.00 05/25/17
G0129 CT 01 00 $282.00 04/20/17
G0129 CT 04 00 $282.00 04/20/17
G0155 CT 01 00 $140.00 02/04/16
G0155 CT 04 00 $140.00 02/04/16
G0177 CT 01 00 $188.50 04/20/17
G0177 CT 04 00 $188.50 04/20/17
G0378 CT 01 00 $428.00 04/20/17
G0378 CT 04 00 $256.00 04/20/17 $180.30 09/29/15
G0379 CT 01 00 $450.00 05/25/17
G0379 CT 04 00 $450.00 05/25/17
G0380 CT 01 00 $418.00 04/20/17
G0380 CT 04 00 $114.01 05/25/17
G0381 CT 01 00 $470.50 04/20/17 $186.47 09/29/15
G0381 CT 04 00 $65.00 05/25/17
G0382 CT 01 00 $666.50 04/20/17 $295.93 09/29/15
G0382 CT 04 00 $191.00 05/25/17
G0383 CT 01 00 $471.74 05/25/17
G0383 CT 04 00 $471.74 05/25/17
G0390 CT 01 00 $6,549.10 05/25/17
G0390 CT 04 00 $6,549.10 05/25/17
G0410 CT 01 00 $177.65 04/20/17
G0410 CT 04 00 $177.65 04/20/17
G0463 CT 01 00 $325.00 04/20/17 $198.00 09/30/15
G0463 CT 04 00 $325.00 04/20/17 $198.00 09/30/15
G0472 CT 01 00 $126.00 05/25/17
G0472 CT 04 00 $126.00 05/25/17
G8539 CT 01 00 $31.25 05/25/17
G8539 CT 04 00 $31.25 05/25/17
G8542 CT 01 00 $31.25 05/25/17
G8542 CT 04 00 $31.25 05/25/17
H0015 CT 01 00 $276.00 09/18/17 $262.00 02/24/16
H0015 CT 01 00 $262.00 02/24/16
H0015 CT 04 00 $276.00 09/18/17 $262.00 02/24/16
H0015 CT 04 00 $262.00 02/24/16
H0020 CT 01 00 $117.51 05/25/17
H0020 CT 04 00 $117.51 05/25/17
H0035 CT 01 00 $262.00 09/22/15 $248.00 01/03/14
H0035 CT 01 00 $276.00 09/18/17 $262.00 09/22/15
H0035 CT 04 00 $262.00 09/22/15 $248.00 01/03/14
H0035 CT 04 00 $276.00 09/18/17 $262.00 09/22/15
H0037 CT 01 00 $349.00 09/22/15 $331.00 01/03/14
H0037 CT 01 00 $368.00 09/18/17 $349.00 09/22/15
H0037 CT 04 00 $349.00 09/22/15 $331.00 01/03/14
H0037 CT 04 00 $368.00 09/18/17 $349.00 09/22/15
H0049 CT 01 00 $50.00 04/20/17
H0049 CT 04 00 $50.00 05/25/17
H2013 CT 01 00 $343.00 04/20/17 $270.00 09/30/15
H2013 CT 04 00 $270.00 05/25/17
H2015 CT 01 00 $28.82 02/04/16
H2015 CT 04 00 $28.82 02/04/16
H2019 CT 01 00 $18.75 05/25/17
H2019 CT 04 00 $12.50 05/25/17
K0739 CT 01 00 $24.83 12/01/15 $24.30 12/19/13
K0739 CT 01 00 $25.48 01/24/18 $25.08 12/29/16
K0739 CT 04 00 $24.83 12/01/15 $24.30 12/19/13
K0739 CT 04 00 $25.48 01/24/18 $25.08 12/29/16
L3216 CT 01 00 $128.00 02/04/16
L3216 CT 04 00 $128.00 02/04/16
L3260 CT 01 00 $36.00 05/25/17
L3260 CT 04 00 $36.00 05/25/17
L4205 CT 01 00 $22.65 12/01/15 $22.16 12/19/13
L4205 CT 01 00 $23.25 01/24/18 $22.88 12/29/16
L4205 CT 04 00 $22.65 12/01/15 $22.16 12/19/13
L4205 CT 04 00 $23.25 01/24/18 $22.88 12/29/16
L7520 CT 01 00 $30.08 12/01/15 $29.43 12/19/13
L7520 CT 01 00 $30.87 01/24/18 $30.38 12/29/16
L7520 CT 04 00 $30.08 12/01/15 $29.43 12/19/13
L7520 CT 04 00 $30.87 01/24/18 $30.38 12/29/16
L8010 CT 01 00 $126.67 05/25/17
L8010 CT 04 00 $126.67 05/25/17
L8680 CT 01 00 $4,000.00 04/20/17
L8680 CT 04 00 $4,000.00 04/20/17
P9016 CT 01 00 $729.00 04/20/17
P9016 CT 04 00 $292.30 05/25/17
P9033 CT 01 00 $448.92 05/25/17
P9033 CT 04 00 $448.92 05/25/17
P9037 CT 01 00 $2,218.27 05/25/17
P9037 CT 04 00 $2,218.27 05/25/17
P9040 CT 01 00 $837.62 04/20/17
P9040 CT 04 00 $752.00 05/25/17
P9044 CT 01 00 $771.25 05/25/17
P9044 CT 04 00 $771.25 05/25/17
P9603 CT 01 00 $9.35 05/25/17
P9603 CT 04 00 $9.35 05/25/17
P9604 CT 01 00 $9.55 05/25/17
P9604 CT 04 00 $9.50 05/25/17
R0070 CT 01 00 $260.20 05/25/17
R0070 CT 04 00 $260.20 05/25/17
S0199 CT 01 00 $1,400.00 05/25/17
S0199 CT 04 00 $1,400.00 05/25/17
S0580 CT 01 00 $37.00 02/04/16
S0580 CT 04 00 $37.00 02/04/16
S1040 CT 01 00 $3,800.00 05/25/17
S1040 CT 04 00 $3,800.00 05/25/17
S5108 CT 01 00 $31.25 05/25/17
S5108 CT 04 00 $31.25 05/25/17
S5110 CT 01 00 $31.25 05/25/17
S5110 CT 04 00 $31.25 05/25/17
S5115 CT 01 00 $31.25 05/25/17
S5115 CT 04 00 $31.25 05/25/17
S9083 CT 01 00 $136.00 02/04/16
S9083 CT 04 00 $136.00 02/04/16
S9088 CT 01 00 $65.00 02/04/16
S9088 CT 04 00 $65.00 02/04/16
S9430 CT 01 00 $201.25 04/20/17
S9430 CT 04 00 $201.25 05/25/17
S9480 CT 01 00 $276.00 09/18/17 $262.00 02/24/16
S9480 CT 01 00 $262.00 02/24/16
S9480 CT 04 00 $276.00 09/18/17 $262.00 02/24/16
S9480 CT 04 00 $262.00 02/24/16
T1015 CT 01 00 $143.00 05/25/17
T1015 CT 04 00 $143.00 05/25/17
T1016 CT 01 00 $42.00 04/20/17 $37.50 10/03/15
T1016 CT 04 00 $30.00 02/04/16
T1017 CT 01 00 $49.00 04/20/17
T1017 CT 04 00 $33.00 02/04/16 $32.50 08/06/14
T1024 CT 01 00 $115.98 05/25/17
T1024 CT 04 00 $77.32 05/25/17
V2025 CT 01 00 $179.00 02/04/16 $189.00 08/06/14
V2025 CT 04 00 $179.00 02/04/16 $189.00 08/06/14
V2781 CT 01 00 $147.50 05/25/17
V2781 CT 04 00 $147.50 05/25/17
V5110 CT 01 00 $1,000.00 05/25/17
V5110 CT 04 00 $1,000.00 05/25/17
V5140 CT 01 00 $610.00 05/25/17
V5140 CT 04 00 $610.00 05/25/17
V5160 CT 01 00 $3,500.00 05/25/17
V5160 CT 04 00 $3,500.00 05/25/17
V5257 CT 01 00 $3,000.00 05/25/17
V5257 CT 04 00 $3,000.00 05/25/17
V5261 CT 01 00 $2,300.00 05/25/17
V5261 CT 04 00 $2,300.00 05/25/17
V5264 CT 01 00 $185.00 05/25/17
V5264 CT 04 00 $185.00 05/25/17
V5265 CT 01 00 $182.00 05/25/17
V5265 CT 04 00 $182.00 05/25/17
V5266 CT 01 00 $80.00 05/25/17
V5266 CT 04 00 $80.00 05/25/17
V5267 CT 01 00 $430.10 05/25/17
V5267 CT 04 00 $430.10 05/25/17